• Journal of Hospice and Palliative Care
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• v.21 no.2
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• pp.51-57
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• 2018

Purpose: End-of-life (EoL) decisions are challenging and multifaceted for patients and physicians. This study was aimed to explore how EoL care is practiced for patients with a do-not-resuscitate (DNR) order. Methods: We retrospectively analyzed medical records of patients who died after agreeing to a DNR order in 2016 at a university hospital. Characteristics including cause of death, intensity of EoL care, and other factors were reviewed and statistically analyzed. Results: Of total 375 patients, 170 patients (45.3%) died with malignancies, and 205 patients (54.6%) with other causes involving the central nervous system (19.2%), pulmonary (14.7%), cardiologic (6.7%) and infectious (6.4%) conditions. Both the cancer and non-cancer patient groups showed a short duration from DNR to death (median 3 days vs 2 days, P=0.629). An intensive care group comprising patients who received one or more intensive treatments such as ventilator (n=205) showed a higher number of non-cancer patients and a shorter duration from DNR to death than a group that withheld treatment before DNR (P<0.05). Conclusion: EoL decisions were made very late by both cancer and non-cancer patients. About half of the patients did not have cancer, and two-thirds of them decided DNR during intensive treatment. To make a good EoL decision, a shared decision making with patients should be done at an earlier stage.

• Korean Journal of Head & Neck Oncology
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• v.15 no.2
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• pp.149-155
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• 1999

Objectives: To study the clinical features of the primary nasal/nasopharyngeal non-Hodgkin's lymphomas and to evaluate the implication of immunophenotyping as a prognostic factor. Patients and Methods: From January 1990 to December 1997,41 patients(median age, 41 years) of primary nasal/nasopharyngeal non-Hodgkin's lymphoma were studied. The clinical records and paraffin-embedded tissue blocks were reviewed retrospectively. The histologic features, immunophenotypic findings(pan-T, pan-B, CD3, CD56) and Epstein-Barr virus in situ hybridizatios were examined. The prognostic factors for clinical outcome were evaluated in these patients. According to Ann-Arbor system, there were 30 patiets(73%) with stage IE, 4(10%) with stage IIE, 3(7%) with stage IIIE, 4(10%) with stage IVE lymphoma. Among the patients with stage IE/IIE, 4 patients received local radiation alone, 4 received chemotherapy alone, 25 received combination chemotherapy and radiotherapy and 1 refused treatment. The patients with stage IIIE/IVE were given combination chemotherapy and radiotherapy. Results: Immunophenotyping were performed in 40 patients and staining results were as follows: 3(7%) patients with B cell, 17(42%) with T cell, 18(44%) with NK/T cell(CD56 positive), and two patients with unclassifiable result. Epstein-Barr(EB) virus in situ hybridization were performed in 28 patients and 23(82%) patients had positive EBV-encoded RNAs(EBERs). 21(55%) patients achieved a complete remission. There was no difference in complete remission between radiation alone and combination therapy. With median follow-up of 30 months, 5-years disease free survival of complete responders was 60% and 5-years overall survival rate was 36%. Multivariate analysis showed that better overall survival was related with absence of B symptoms, ECOG performance${\leq}1$ and non-NK cells. Conclusion: Most of all cases were positive for EBER. Since NK/T phenotype carried the worst prognosis, analysis for CD56 expression should be done. Further prospective studies were warranted to evaluate the role of chemotherapy in stage IE/IIE.

• Journal of Hospice and Palliative Care
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• v.7 no.2
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• pp.200-213
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• 2004

Purpose: The purpose of this study was to create an electronic nursing record form to build a hospice nursing process database to be used in the u-hospital EMR system. Specific aims of the study were: 1. To generate a complete, accurate, and simple electronic nursing record form. 2. To verify its appropriateness following documentation with the standardized hospice protocol. 3. To verify its validity and finalize the hospice nursing process database through discussion among hospice professionals. Methods: Nursing records from three independent hospice organizations were collected and analyzed by five expert hospice nurses with more than 10 years of experience, and a nursing record database was developed. This database was applied to 81 hospice patients at three hospice organizations to verify its completeness. Results: 1. An electronic nursing record form with completeness, accuracy, and simplicity was developed. 2. The completeness of the standardized home hospice service protocol was 95.86 percent. 3. The hospice nursing process database contains 18 items on health problems, 79 items on related causes and major symptoms, and 229 items on nursing interventions. Conclusion: The new nursing record form and database will reduce documentation time and articulate and streamline the working process among team members. They can also improve the quality of hospice services, and ultimately enable us to estimate hospice service costs.

• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.314-322
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• 2010

Purpose : Through a clinical and retrospective analysis of pediatric patients who visited the Regional Emergency Medical Center of Masan Samsung Hospital from January 2007 to December 2008, we characterized pediatric and adolescent emergency patients to improve emergency care in future. Methods : We reviewed the medical records of 14,065 pediatric patients below 19 years of age. Results : The male to female ratio was 1.5:1, and the most common age group was less than 3 years (49.6%). The peak month was May (10.0%), the peak day of the week was Sunday (24.7%), and the peak time of day was 20:00-0:59 (8.5%). There was no difference in the number of visits per day based on weather (sunny, rain [below 10 mm per day], snow, and fog) or daily temperature difference; however, visits increased on sandy, dusty days and decreased on rainy days with more than 10 mm of rain per day. Based on the international classification of disease (ICD)-10 system, the most common disease code was code R (symptoms, sign, and abnormal clinical laboratory finding) (31.5%), and the most common symptom was fever (13.1%). Final outcomes were discharged (73.8%), admitted (25.7%), transferred (0.4%), and expired (0.1%). In adolescent patients aged 15-9 years, the most common disease code was Injury & Poisoning (code S&T, 36.9%); the most common symptom was abdominal pain (9.6%). Conclusion : Pediatric patients visiting the emergency center were most likely to be male and under 3 years of age and to visit between 20:00 and 21:00 on Sundays and in May, and the most common symptom was fever. Differences between adolescents and pediatric patients showed that adolescents had a higher visiting rate with abdominal pain and a larger temperature difference.

• Cartoon and Animation Studies
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• s.28
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• pp.27-53
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• 2012

American superhero comics are being produced in numerous different forms for multiple, and cross-platform media. In cinema, films based on superhero comics top the list of all time box office records. The same phenomenon of the 'Invasion of Superhero' is duplicated in Korean box office 2012, however, the korean fans are not familiar with the superheroes from the publication which provides the original source of characters and stories for other superhero related media products. Based on observing the multiple and vastness of world building characteristics of superhero comic, this paper attempts to associate the continuous creative nature and the infinite repetition of superheroes and comic texts with the identity of superhero on ontological level. First, chapter 2 examines how one superhero exists in multiple and different worlds individually by utilizing the concept of 'multi-universe' or 'multiverse' in comic texts. Initially, duplicating a superhero on multiple settings and series destroyed continuity and allowed contradiction and paradox confused narrative as a whole, but it also gave chances for comics to be more vibrant and experimental with their stories and characters. Chapter 3 analyzes the superhero comic texts in the light of repetition, concept developed by french philosopher Gilles Deleuze, and make the argument that the superheroes and texts are not repeated to generate surplus of source for economic utilitarian purposes, but it is, first and foremost, a repetition of creativeness and capability. Many concepts introduced by Deleuze in his early masterpiece, $\acute{e}$rence et R$\acute{e}$p$\acute{e}$tition> are taken to support this argument. Mainly, his critical views on generality of the identity and his effort to replace the Plato's system of representation with vibrant creative, and renewal energy of r$\acute{e}$p$\acute{e}$tition. According to Deleuze, repetition is similar concept, if not identical, to what Nietzsche called the 'eternal return' which allows the return of the Overhuman or the Superhuman, and he extends his idea that the returning Overhuman is the singular simulacre which opposes the generalization of identity, in the likes of Plato's Idea. Thus, the superhero's identity is ever changing, ever returning, and ever renewing Overhuman. The superhero must be repeated to fully actualize his/her existence. Also, based on Deleuze's reading of Bergson's texts on the Virtual, the superhero, for example Superman, is actualization of his/her multiplisit$\acute{e}$, the internally multiple, and differentiated variations from itself. These every Supermans' multiplisit$\acute{e}$ shares common memory, past, and duration, thus the Virtual of Superman. Superman becomes himself only by actualizing the movement and differentiation from these multiplisit$\acute{e}$ in his virtual on the surface of reality. On chapter 4, a popular Korean comic book character Oh, Hae-Sung's r$\acute{e}$p$\acute{e}$tition and multiplist$\acute{e}$ are analyzed, and makes comparison to that of Superman to distinguish the repetition from r$\acute{e}$p$\acute{e}$tition, and multiplicit$\acute{e}$ from diversity.

• Journal of Acupuncture Research
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• v.30 no.4
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• pp.55-68
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• 2013

Objectives : The purpose of this study is to analyze the distribution, relationship, prognosis and improvement score of idiopathic facial palsy inpatients according to constitutional differentiation ; Sasang constition, Hyungsang classification, Sasang constition combined with Hyungsang classification. Methods : A study was done on 102 patients who were diagnosed and treated as idiopathic facial palsy from April 2012 to Nomember 2012 at the Department of Acupuncture and Moxibution Medicine, Dong-eui Oriental University Hospital. Medical records of inpatinets who underwent facial ENoG, NET test were analyzed. Changes of HBGS grade and Yanagihara's score were also evaluated. We classified inpaients acording to Sasang constitution by consulting to Department of Sasang constitutinal medicine, and to Hyungsang classification(Dam-body, Bangkwang-body) by measuring under medical system of 3D facial shapes(RS-400FL). The constitutional differentiation and general characteristics were initially analyzed, and valuse on ENoG, NET were correlated with constitutinal differentiation. Results of HBGS and Yanagihara's score were also correlated with constitutinal differentiation. Results : 1. Each 39.2 percent of idiopathic facial palsy inpatients were the Taeeumin and Soyangin, 21.6 percent were the Soeumin. 2. 75.5 percent of idiopathic facial palsy inpatients were the Bangkwang-body, 24.5 percent were the Dam-body. 3. 34.3 percent of idiopathic facial palsy inpatinets were the Taeeum-Bangkwang, 21.6 percent were the Soyang-Bangkwang, 19.6 percent were the Soeum-Bangkwang, 17.6 percent were the Soyang-Dam, 4.9 percent were the Taeem-Dam, 2 percent were the Soeum-Dam. 4. By sex, the each ratio of Taeeumin, Soeumin, Bangkwang-body, Taeeum-Bangkwang, Soeum-Bangkwang, Soyang-Bangkwang was higher in female, that of Dam-body, Taeeum-Dam, Soyang-Dam was higher in male. 5. By relations between Sasang constitution and Hyungsang classification, the each ratio of Taeeumin and Soeumin was higher in Bangkwang-body. 6. By values on ENoG and NET, evaluations of HBGS's grade and Yanagihara's score, there were no significant difference. Conclusions : In idiopathic facial palsy inpatients, the proportion of Taeeum and Soyang among the Sasang constitution was higher, that of Dam among the Hyungsang classification was higher, that of Taeeum-Bangkwang among the Sasang combined with Hyungsang was the highest. It would seem that Bangkwang-body, female were closely related to Taeeumin, Soeumin. Also, Dam-body were closely related to male. But when comparing groups, there was no statistically significant difference in prognosis and improvement.

• Tuberculosis and Respiratory Diseases
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• v.43 no.3
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• pp.331-338
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• 1996

Background : Lung cancer continues to be the leading cause of cancer death in the United States and it's incidence has been rapidly increasing in Korea, too. The overall cure rate for non-small cell lung cancer(NSCLC) is approximately 10%, and the cure is generally achieved by surgery. Unfortunately, however, less than 15% of all patients and less than 25% of those who present with localized disease are candidates for curative surgical resection. So preoperative staging evaluation followed by curative resection has a major role in determining the long tenn prognosis of NSCLC patients. Therefore, we have conducted this study to compare pre-operative and post-operative staging and the long-tenn relapse-free survival rates in NSCLC patients according to its stage. Methods : We analyzed the medical records of 217 NSCLC patients who were operated on for curative resection in Seoul National University Hospital, retrospectively. Among them, 170 patients who were completely resected were selected to determine the long term relapse-free survival rates. Results : Among 217 NSCLC patients, men were 157 and women were 30. The median age was 58 and the difference between men and women was not found. The discrepancy rate between preoperative and postoperative staging was 40.1%. Its major cause was due to the difference of nodal staging. The 3-year relapse-free survival rates were 73%, 53% and 48% in stage I, II and IIIa, respectively. There was no difference of relapse-free duration in recurred patients according to the stage or histologic types. Conclusion : The postoperative pathologic staging determines the long tenn prognosis of patients with NSCLC after surgery, but current preoperative clinical staging can not predict the postoperative pathologic staging correctly. So the improved modality of staging system is required to predict the pathologic staging more correctly.

• Tuberculosis and Respiratory Diseases
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• v.45 no.4
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• pp.805-812
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• 1998

Background: Among the variety of opportunistic infections, pneumonia comprises the major morbidity in immunocompromised patients. Pneumocystis carnii pneumonia (PCP) and cytomegalovirus (CMV) pneumonia are common infectious illness of immunocompromised hosts. Although there are many reports regarding to the co-infection of PCP and CMV diagnosed by bronchoalveolar lavage (BAL) fluid examination, the effects of CMV co-infection on the outcome of PCP is still controversial. The purpose of this investigation is to evaluate the effects of CMV detected by BAL fluid examination on the clinical course of PCP in the immunocompromised patients other than human immunodeficiency virus infection. Method: Ten patients with PCP were enrolled and retrospective analysis of their medical records were done. HIV infected persons were excluded. The PCP was diagnosed by BAL fluid examination with Calcofluor-White staining. CMV was detected in BAL fluid by Shell-vial culture system. Chest radiographic findings were reviewed. We used Fisher's exact test and Mann-Whitney U test for statistical analysis of data. Results: The underlying disorders of patients were idiopathic pulmonary fibrosis (n=1), renal transplantation (n=4), necrotizing vasculitis (n=l), systemic lupus erythematosus (n=1), brain tumor (n=1), chronic myelogenous leukemia (n=1), unidentified (n=1). There were no difference in clinical course, APACHE III score, arterial blood gas analysis, white blood cell count, lymphocyte count, serum albumin concentration, chest radiographic findings and mortality between patients with PCP alone (n=4) and those with CMV co-infection (n=6). Univariate analysis regarding to the factors that associated with mortality of PCP were revealed that the application of mechanical ventilation (p=0.028), the level of APACHE III score (p=0.018) and serum albumin concentration (p=0.048) were related to the mortality of patients with PCP. Conclusion: The clinical course of PCP patients co-infected by CMV were not different from PCP only patients. Instead, accompanied respiratory failure, high APACHE III score and poor nutritional status were associated with poor outcome of PCP.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.1
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• pp.97-101
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• 2010

The practice pattern of pediatric dentistry in the university dental hospital has been changing for the last several decades, due to socioeconomic changes, developments in dental materials and increasing number of private pediatric dental clinics. The purpose of this study is to survey the changing patterns of pediatric dental treatment in the university dental hospital and to present the future direction for pediatric dentistry. Patient distribution and practice trends were reviewed based on the OCS (order communication system) records of the department of pediatric dentistry, Seoul National University Dental Hospital from 2001 to 2008. Results were as follows; 1. The number of patients increased up to 2005 and decreased in 2006, and has remained constant up to 2008. 2. The proportion of preventive and orthodontic treatment increased and the proportion of restorative and pulpal treatment decreased. 3. In restorative treatment, amalgam restoration decreased and resin restoration increased. 4. Frequency of sedation decreased in 2006, 2007 and increased in 2008. 5. Frequency of general anesthesia increased up to 2008.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.35 no.1
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• pp.10-24
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• 2017

The research takes note of the formation process and settling period of Gwandong-Palkyung(關東八景, Eight Sites of Eastern Korea), the representative palgyeong(prominent eight sites) and jipgyeong(集景, landscape collection of scenic beauty), and investigates the time of formation regarding the palkyung and jipgeyong of Gwandong's scenic beauty through the analysis and interpretation of bibliographic data, and reference data. The result of the study is as follows. As the first document that records the terminology of "Gwandong-Palkyung" is "Daphongeunggil(答洪應吉)" of Yi, Hwang(李滉), Gwandong-Palkyung is inferred to be settled within the recognition of the people even before the 16th century. The geographic analysis result including "Sinjeung Donggukyeojiseungram(新增東國輿地勝覽)", Gwandong-Palkyung expanded as Gwandong-Sipkyung in early to middle of the 16th century. The first confirmed landscape collection regarding Gwandong-Palkyung in this study is confirmed in Shin Zup(申楫)'s "Yeonggwandong-Palkyung(詠關東八景)", thus, the terminology of Gwandong-Palkyung existed before 16th century at the latest. The settlement time of current "Palkyung" collection is estimated to be early 17th century at the latest. Poetries regarding Gwandong-Palkyung, and the frequency on the appearance of Gwandong scenic beauties are analyzed as making clear of the concentrated phenomenon on the sceneries of Gwandong-Palkyung. On the other hand, the collection of Gwandong-Palkyung in the domain of arts is confirmed initially in the ${\ll}$Gwandongpalkyungdobyeong(關東八景圖屛)${\gg}$ of Heo, Pil(許泌). Gwandong-Palkyung, expressed as the actual scene landscape painting shows similar tendencies of the conditions in the jipgyeong from the poetry, but the appearance rate of the painting subject was more prominent in visual solidarity and cohesion due to the reflection of the importance on icon(圖像) of the art works produced with particular meaning in the case of fixed ideal system. From late Joseon to modern times, ${\ll}$palpokbyeongpung(八幅屛風)${\gg}$ of various forms of folk painting is a corroborative evidence notifying that the cultural phenomenon of Gwandong-Palkyung has entered the universal period of embrace. Also, the 13 scenic beauties of Gangwon-Do appearing in the games of Namseungdo and Myeongseungyuramdo include Gwandong-Palkyung, which confirms the settlement of Gwandog-Palkyung even within the culture of games in late Joseon. Such results demonstrate the existence of awareness regarding Gwandong-Palkyung from the first half of the 15th century, which is presumed to have completely settled in the 17th century through the continuous development of formative process in the 16th century. Ultimately, Gwandong-Palkyung is the concrete formation of regional scenic beauties that individually gained its reputations as scenery from the Koryo Dynasty to late 17th century. Gwandong-Palkyung of the scenic beauty of Gwandong is a unique cultural scenery of the region that have germinated and formed through the process of cutting and polishing of long time to collect the best eight of scenic beauty from the many participation of sightseeing culture.