• 제목/요약/키워드: Sustaining Phase

검색결과 34건 처리시간 0.022초

무의미한 연명치료 중단 등의 기준에 관한 재고 - 대법원 2009.5.21 선고 2009다17417사건 판결을 중심으로 - (Review on the Justifiable Grounds for Withdrawal of Meaningless Life-sustaining Treatment -Based on a case of Supreme Court's Sentence No. 2009DA17417 (May 21, 2009)-)

  • 문성제
    • 의료법학
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    • 제10권2호
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    • pp.309-341
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    • 2009
  • According to a case of Supreme Court's Sentence No. 2009DA17417 (May 21, 2009), the Supreme Court judges that 'the right to life is the ultimate one of basic human rights stipulated in the Constitution, so it is required to very limitedly and conservatively determine whether to discontinue any medical practice on which patient's life depends directly.' In addition, the Supreme Court admits that 'only if a patient who comes to a fatal phase before death due to attack of any irreversible disease may execute his or her right of self-determination based on human respect and values and human right to pursue happiness, it is permissible to discontinue life-sustaining treatment for him or her, unless there is any special circumstance.' Furthermore, the Supreme Court finds that 'if a patient who is attacked by any irreversible disease informs medical personnel of his or her intention to agree on the refusal or discontinuance of life-sustaining treatment in advance of his or her potential irreversible loss of consciousness, it is justifiable that he or she already executes the right of self-determination according to prior medical instructions, unless there is any special circumstance where it is reasonably concluded that his or her physician is changed after prior medical instructions for him or her.' The Supreme Court also finds that 'if a patient remains at irreversible loss of consciousness without any prior medical instruction, he or she cannot express his or her intentions at all, so it is rational and complying with social norms to admit possibility of estimating his or her own intentions on withdrawal of life-sustaining treatment, provided that such a withdrawal of life-sustaining treatment meets his or her interests in view of his or her usual sense of values or beliefs and it is reasonably concluded that he or she could likely choose to discontinue life-sustaining treatment, even if he or she were given any chance to execute his or her right of self-determination.' This judgment is very significant in a sense that it suggests the reasonable orientation of solutions for issues posed concerning withdrawal of meaningless life-sustaining medical efforts. The issues concerning removal of medical instruments for meaningless life-sustaining treatment and discontinuance of such treatment in regard to medical treatment for terminal cases don't seem to be so much big deal when a patient has clear consciousness enough to express his or her intentions, but it counts that there is any issue regarding a patient who comes to irreversible loss of consciousness and cannot express his or her intentions. Therefore, it is required to develop an institutional instrument that allows relevant authority to estimate the scope of physician's medical duties for terminal patients as well as a patient's intentions to withdraw any meaningless treatment during his or her terminal phase involving loss of consciousness. However, Korean judicial authority has yet to clarify detailed cases where it is permissible to discontinue any life-sustaining treatment for a patient in accordance with his or her right of self-determination. In this context, it is inevitable and challenging to make better legislation to improve relevant systems concerning withdrawal of life-sustaining treatment. The State must assure the human basic rights for its citizens and needs to prepare a system to assure such basic rights through legislative efforts. In this sense, simply entrusting physician, patient or his or her family with any critical issue like the withdrawal of meaningless life-sustaining treatment, even without any reasonable standard established for such entrustment, means the neglect of official duties by the State. Nevertheless, this issue is not a matter that can be resolved simply by legislative efforts. In order for our society to accept judicial system for withdrawal of life-sustaining treatment, it is important to form a social consensus about this issue and also make proactive discussions on it from a variety of standpoints.

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(Glycine+Urea) 혼합연료를 이요한 자발착화 연소반응법에 의한 우수한 소결성의 초미분체 LaAlO$_3$ 분말 합성 (Synthesis of Ultrafine LaAlO$_3$ Powders with Good Sinterability by Self-Sustaining Combustion Method Using (Glycine+Urea) Fuel)

  • 남희동;최우성;이병하;박성
    • 한국세라믹학회지
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    • 제36권2호
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    • pp.203-209
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    • 1999
  • Si 기판위에 Ba2YCu3O7-$\delta$ 고온초전도체를 응용하기 위해 요구되는 buffer층으로 유망한 재료인 LaAlO3 단일상 분말을 고상반응법과 자발착한 연소반응법으로 제조하였다. 제조된 LaAlO3 분말의 입자형태와 결정상태는 scanning electron microscope (SEM)과 X-ray diffractometer (XRD)를 이용하여 분석하였다. 분말의 비표면적과 소결특성은 각각 Brunauer-Emmett-Teller(BET) 방법과 dilatometer를 측정하였다. 고상반응법으로 LaAlO3 분말을 제조할 때에는 하소온도를 150$0^{\circ}C$까지 높게 하여도 단일상을 얻는 것이 어려웠으나 자발착한 연소반응법에 의한 분말제조는 $650^{\circ}C$의 저온에서 하소하여도 쉽게 얻을 수 있었다. Dilatometer 측정을 통하여 분석해 보면, 고상반응법에 의한 분말보다 자발착한 연소반응법에 의한 분말로 제조된 소결체가 고상반응법에 의한 소결체에 비해 1.4배나 큰 소멸밀도(98.87%)를 가졌다. 이렇게 소결밀도에서 큰 차이가 나는 것은 자발착한 연소방법에 의한 분말의 평균 입자크기가 nano crystal size이고 비표면적 값(56.54 $m^2$/g)이 매우 크기 때문이다. 두가지 방법으로 제조된 분말을 이용, LaAlO3 layer를 스크린 프린팅과 소결법으로 Si 기판상에 제조하였으며 자발착한 연소합성법으로 제조된 분말은 110$0^{\circ}C$에서 우수한 소결특성을 나타내었다.

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이중추력형 로켓 모터의 개발 (Development of the Dual-Thrust Rocket Motor)

  • 이도형;윤명원;황갑성
    • 한국항공우주학회지
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    • 제32권9호
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    • pp.130-135
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    • 2004
  • 본 논문은 국내 최초로 그레인의 형상을 조절하여 설계한 이중추력형 로켓 모터의 개발에 관하여 기술하였다. 저연소속도 저연 추친제의 조성 및 finocyl형 그레인을 이용한 로켓 모터의 설계와 연소시험 데이터의 분석/평가 결과를 상술하였다. 개발된 이중추력형 로켓 모터는 비행시험에 성공적으로 적용되어 유도탄의 성능향상에 크게 기여하였고, 개발 결과는 향후 유사한 로켓 모터의 개발에 유용하게 사용될 것이다.

A New High Efficiency Phase Shifted Full Bridge Converter for a Power Sustaining Module of Plasma Display Panel

  • Lee Woo-Jin;Kim Chong-Eun;Han Sang-Kyoo;Moon Gun-Woo
    • Journal of Power Electronics
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    • 제6권1호
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    • pp.45-51
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    • 2006
  • A new high efficiency phase shifted full bridge (PSFB) converter for the power sustaining module of a plasma display panel (PDP) is proposed in this paper. The proposed converter employs a voltage doubler rectifier without an output inductor. Since it has no output inductor, the voltage stresses of the secondary rectifier diodes can be clamped at the output voltage level. No dissipative resistor-capacitor (RC) snubber for rectifier diodes is needed. Therefore, high efficiency, as well as, a low noise output voltage can be realized. Due to the elimination of the large output inductor, it features a simple structure, lower cost, smaller mass and lighter weight. Furthermore, the proposed converter has wide zero voltage switching (ZVS) ranges with low current stresses of the primary switches. Also the resonance between the leakage inductor of the transformer and the capacitor of the voltage doubler cell reduces the current stresses of the rectifier diodes. In this paper, operational principles, an analysis of the proposed converter and experimental results are presented.

명중률 향상을 위한 이중추력형 비행모터 개발에 대한 연구 (A Study on Development of the Dual-thrust Flight Motor for Enhancing the Hit Probability)

  • 김한준;김은미;김남식;이원복;양영준
    • 한국추진공학회지
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    • 제18권4호
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    • pp.74-80
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    • 2014
  • 본 논문은 무유도 로켓탄의 명중률을 향상시키기 위해 개발한 이중추력형 비행모터에 관하여 기술하였다. 고연소속도 특성을 지닌 더블베이스 추진제의 형상 조절을 통해 이중추력형 비행모터를 설계하였으며, 실제 지상연소시험을 통해 이중추력 성능을 확인하였다. 연소시험 결과 서스테이닝 단계와 부스팅 단계의 추력비는 약 1:7.6으로 정상적인 이중추력 특성을 보였으며, 압력강하에 의한 추진제 소화현상은 나타나지 않았다.

Self-Sustaining Combustion Process를 이용한 NiO/YSZ 초미세 복합분말 제조 (Preparation of NiO/YSZ Ultra-Fine Powder Composites Using Self-Sustaining Combustion Process)

  • 김선재;정충환;김경호;김영석;국일현
    • 한국세라믹학회지
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    • 제33권4호
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    • pp.411-417
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    • 1996
  • Ultrafine NiO/YSZ (Yttria Stabilized Zirconia) powders were made by using a glycine nitrate process which is used as anode material for solid oxide fuel cells. The specific surface areas of synthesized NiO/YSZ powders were examined with controlling pH of a precursor solution and the content of glycine. The binding of glycine with metal nitrates occurring in the precursor solution was analyzed by using FTIR. The characteristics of synthesized powders were examined with X-ray diffraction(XRD) Brunauer Emmett Teller with N2 absorption. scanning electron microscopy (SEM). and transmission electron microscopy (TEM). Ultrafine NiO/YSZ powders of 15-18 m2/g were obtained through GNP when the content of glycine was controlled to 1 or 2 times the stoichiometric ratio in the precursor solutions. Strongly acid precursor solution increased the specific surface area of the synthesized powders. This is suggested to be the increased binding of metal nitrates and glycine under a strong acid solution of pH=0.5 that lets glycine consist of mainly the amine group of {{{{ { NH}`_{3 } ^{+ } }}. After sintering and reducing treatment of NiO/YSZ powders synthesized by GNP the Ni/YSZ pellet showed ideal microstructure where very fine Ni particles of 3-5 ${\mu}{\textrm}{m}$ were distributed uniformly and fine pore around Ni metal particles was formed. leading to anincrease of the triple phase boundary among gas Ni and YSZ.

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PDP 유지전원단을 위한 높은 효율을 갖는 새로운 페이지쉬프트 풀브릿지 컨버터 (A New High Efficiency Phase Shifted Full Bridge Converter for Sustaining Power Module of Plasma Display Panel)

  • 이우진;김정은;한상규;문건우
    • 전력전자학회:학술대회논문집
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    • 전력전자학회 2005년도 전력전자학술대회 논문집
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    • pp.445-448
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    • 2005
  • PDP 유지전원단을 위한 고효율을 갖는 새로운 페이지 쉬프트 풀브릿지 컨버터를 제안한다. 제안된 컨버터는 Rectifier로 Voltage Doubler를 사용함으로서, 큰 사이즈의 Output Inductor가 없게 되어 간단한 구조를 가지게 되며 Rectifier Diodes의 전압 스트레스가 출력전압으로 클램핑되어서 스너버회로가 필요없다는 장점을 가지게 된다. 또한 넓은 영전압 스위칭 구간을 가지며, 트랜스포머의 기생성분인 Leakage 인덕터와 Voltage doubler의 캐패시터간의 공진을 이용함으로서 전류가 작은 RMS값을 가지게 되어서 낮은 도통손실과 Rectifier Diode의 전류 스트레스 또한 낮다는 장점을 가지게 된다. 본 논문을 통해 제안된 컨버터의 동작원리와 해석, 실험을 수행하였다.

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Phase-Separated Pixel Isolation Method for Roll-to-Roll Processing in Flexible Liquid Crystal Displays

  • Kim, Hak-Rin;Jang, Se-Jin;Jung, Jong-Wook;Jin, Min-Young;Kim, Jae-Hoon
    • Journal of Information Display
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    • 제6권1호
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    • pp.1-7
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    • 2005
  • We propose new fabrication methods of a pixel-isolated liquid crystal (LC) structure for flexible display applications. In the LC structure fabricated through the proposed method, the patterned interpixel walls for sustaining the cell thickness are supported by the solidified polymer layer through anisotropic phase separation of LC/polymer composite, causing the alignment of the LC molecules to have very good mechanical stability against external pressure. In addition, we show that such pixel-isolating walls can be made by the stamping method which can be applied to fabricate large size plastic LCDs by roll-to-roll processing.

Multi-Level을 사용한 PDP 구동회로에서 Timing 변화에 따른 특성 변화에 관한 연구 (A study on performance characteristic of Multi-level PDP driver circuit in accordance of signal time)

  • 김중수;강순은;송석호;노정욱;홍성수;사공석진
    • 전력전자학회:학술대회논문집
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    • 전력전자학회 2005년도 전력전자학술대회 논문집
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    • pp.96-98
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    • 2005
  • Proposed Multi-level PDP sustain Driver make use of element which has a low voltage rating instead of suggested method by the existing Webber and it passes through a second phase both rising and falling at sustaining voltage waveform In accordance with the change of timing phase(Tr1, Ti1, Tr2) performance comparison of a electric discharge characteristics in a PDP module has been carried out. At the conclusion of experimentation, the feature is extended by alteration of Ti1 and it has little to do with alteration of Tr1.

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한국 호스피스 완화의료의 역사 (The History of Hospice and Palliative Care in Korea)

  • 김창곤
    • Journal of Hospice and Palliative Care
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    • 제22권1호
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    • pp.1-7
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    • 2019
  • 한국에서 호스피스의 기원은 11세기 초, 고려시대의 동서대비원(東西大悲院)에서 그 유래를 찾을 수 있다. 한국에 호스피스가 도입된 이후, 50여년이 흘렀고, 초기에는 종교적 배경과 민간차원의 활동이 더디게 발전해왔으나, 1990년대에 각 종교단체가 구성되고 학회가 출범한 이후, 2000년대 초기부터 정부의 개입으로 제도화가 진행되면서 본격적인 성장기를 맞게 되었다. 비록 말기암환자와 그 가족들의 고통이 경감되고 삶의 질과 서비스의 질은 향상되었으나, 안정적인 재정기반을 보장할 수 있는 현실적인 보상체계는 마련되지 못했었다. 그러나, 2015년에 호스피스 완화의료 서비스에 대한 국민건강보험 급여수가가 인정되었고, 2016년에 "호스피스 완화의료 및 임종과정에 있는 환자의 연명의료결정에 관한 법률"이 제정되어 말기환자의 무의미한 연명치료를 거부할 수 있게 되었으며, 호스피스 완화의료 서비스의 대상 질환이 확대되면서 서비스제공자들에게는 더 많은 도전과 과제들이 남아있다.