This primary study was done to develop an ethical guideline for organ transplantation, a life-saving treatment which helps improve the quality of life. This study tried to identify the current situation in Korea, in terms of ethical considerations in organ transplantations. This study collected basic data in organ transplantations, in the hope that procedure of organ transplantations could be developed that would be fair to both organ donors and recipients. The immediate goals of this study were : 1)to identify staff in charge of organ transplantations and their jobs in the hospital, 2)to survey whether there exists a Hospital Ethics Committee(HEC), 3)to research what consideration are formally taken in selecting recipients, and 4)to accumulate data on how consent from donors are currently obtained. The study used a survey questionnaire and received responses from 31 hospitals out of 45 hospitals where organ transplantation are being done. Organ transplantation coordinators were found in 16 hospitals, but the job description varied among hospitals. The survey showed that all 16 hospitals with an HEC that health care personnel unnecessarily dominate the committee. The study notes that HECs should be vitalized by recruiting, as members, ethicists, theologians, patients, guardians, as well as the general public outside of the hospital. The study revealed that in selecting recipients the hospital take into account ABO blood type, histocompatibility, age, waiting time. and level of patient compliance. Finally, it was shown that in the cases of living donors the transplanting hospitals seek a formal consent, whereas there are no common consenting practice established for cadaveric donors. The study concludes with three proposals. First, a nationwide institution responsible exclusively for procurement and distribution of cadaveric organs for transplantation should be established. Second. we should rebuild the national health insurance system so that have costly organ transplantation expenses are substantially covered. Last, but certainly not least. there is a need to emphasize the HEC's committment to prepare a proper ethical guideline for organ transplantation in general.
In recent years, we recognize a new paradigm in the development process:From object oriented development, to the development process which has focused on the use of standard components. In recent years a lot of research related to the component-based development has been done, especially in business domain. but still there are many open and unresolved problems in this area. such as established development process for a distributed environment, formal process, infrastructure for COTS, development and management tool considering maintenance to guarantee a proper treatment of components. It also required a service and an application integration for component. In this paper, we propose cooperative information systems (CIS) that supports component based development. It must address for component based systems to achieve their full potential. We identify a set of CIS organized 3-tier which is a presentation layer, business logic layer and data control layer. We also discuss the specific roles and activities for the layers. we also define the behavior and managed information for business logic layer as core level. As an illustration of the CIS, we present a successful considerations which is widely helpful to user when they make decision in component development and assemble. Also, we expect to component reusability and efficiency in business domain.
Kim, Taek-Soo;Park, Jeong Hoon;Lee, Jun Young;Yang, Seung Dae;Chang, Dong-Jo
Journal of Radiation Industry
/
v.10
no.4
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pp.181-187
/
2016
Selective ${\beta}_1$-agonist and antagonists are used for the treatment of cardiac diseases including congestive heart failure, angina pectoris and arrhythmia. Selective ${\beta}_1$-antagonists including nebivolol have high binding affinity on ${\beta}_1$-adrenergic receptor, not ${\beta}_2$-receptor mainly expressed in smooth muscle. Nebivolol is one of most selective ${\beta}_1$-blockers in clinically used ${\beta}_1$-blockers including atenolol and bisoprolol. We tried to develop clinically useful cardiac PET tracers using a selective ${\beta}_1$-blocker. Nebivolol is $C_2$-symmetric and has two chromane moiety with a secondary amino alcohol and aromatic fluorine. We adopted the general synthetic strategy using epoxide ring opening reaction. Unlike formal synthesis of nebivolol, we prepared two chromane building blocks with fluorine and iodine which was transformed to diaryliodonium salt for labelling of $^{18}F$. Two epoxide building blocks were readily prepared from commercially available chromene carboxylic acids (1, 8). Then, the amino alcohol building block (15) was prepared by ammonolysis of epoxide (14) followed by coupling reaction with the other building block, epoxide (7). Diaryliodonium salt, a precursor for $^{18}F$-aromatic substitution, was synthesized in moderate yield which was readily subjected to $^{18}F$-aromatic substitution to give $^{18}F$-labelled nebivolol.
Pratomo, Hadi;Amelia, Tiara;Nurlin, Fatmawati;Adisasmita, Asri C.
Clinical and Experimental Pediatrics
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v.63
no.11
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pp.433-437
/
2020
Background: Indonesia is one of the countries with the highest preterm birth rate. Preterm infants are more likely than term and normal weight infants to experience neonatal mortality and morbidity due to acute respiratory, gastrointestinal, immunologic, central nervous system, hearing, and vision problems. Kangaroo mother care (KMC) is a proven cost-effective intervention to help reduce mortality rates among preterm infants; however, it has not been fully implemented in hospitals. Purpose: Assess KMC knowledge and perceptions among health providers. Methods: This qualitative study was conducted from December 2015 to April 2016 and consisted of 21 in-depth interviews and 3 focus group discussions (FGDs). The 3 categories of health personnel in the study were clinical providers, hospital management representatives, and Indonesian Midwife Association members. Results: Most health providers know about the benefits of KMC including stabilizing temperatures, weight gain, and maternal-infant bonding and reducing human resources and labor costs. They were also aware of which newborns were eligible for KMC treatment. Their knowledge was mostly gained from observation or obtained from pediatricians and personal experience. They believed that a low birth weight infant in an incubator could not be treated with KMC and that it could only be practiced if a special gown was used when holding the baby. This perception could be caused by a lack of formal KMC training, leading to misunderstanding of its aspects. Conclusion: In conclusion, KMC knowledge of clinical providers in the 2 hospitals was sufficient, primarily due to their health-related educational background. Some perceptions could be potential barriers to or facilitate the implementation of KMC practice. These perceptions should be considered in future KMC training designs.
Backgrounds/Aims: While patients with borderline resectable pancreatic cancer (BRPC) are a target population for neoadjuvant chemotherapy (NAC), formal guidelines for neoadjuvant therapy are lacking. We assessed the perioperative and oncological outcomes in patients with BRPC undergoing NAC with FOLFIRINOX for patients undergoing upfront surgery (US). Methods: The AHPBA criteria for borderline resectability and/or a CA19-9 level > 100 µ/mL defined borderline resectable tumors retrieved from a prospectively populated institutional registry from 2007 to 2020. The primary outcome was overall survival (OS) at 1 and 3 years. A Cox Proportional Hazard model based on intention to treat was used. A receiver-operator characteristics (ROC) curve was constructed to assess the discriminatory capability of the use of CA19-9 > 100 µ/mL to predict resectability and mortality. Results: Forty BRPC patients underwent NAC, while 46 underwent US. The median OS with NAC was 19.8 months (interquartile range [IQR], 10.3-44.24) vs. 10.6 months (IQR, 6.37-17.6) with US. At 1 year, 70% of the NAC group and 41.3% of the US group survived (p = 0.008). At 3 years, 42.5 % of the NAC group and 10.9% of the US group survived (p = 0.001). NAC significantly reduced the hazard of death (adjusted hazard ratio, 0.20; 95% confidence interval, 0.07-0.54; p = 0.001). CA19-9 > 100 µ/mL showed poor discrimination in predicting mortality, but was a moderate predictor of resectability. Conclusions: We found a survival benefit of NAC with FOLFIRINOX for BRPC. Greater pre-treatment of CA19-9 and multivessel involvement on initial imaging were associated with progression of the disease following NAC.
Kim, Kyung-tai;Ko, Young-jin;Kim, Yong-suk;Kim, Chang-hwan
Journal of Acupuncture Research
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v.22
no.3
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pp.123-135
/
2005
Objective : The aim of this study was to rivew systemically literature and clinical trials in the treatment of urinary incontinence or lower urinary tract syndrome(LUTS). Methods : Computerized literature searches were carried out on two electronic database, and computerized searching on some korea oriental medicine journals in library of Kyung-Hee Medical center. Results : 1. Three reports of review study, six reports of experimental study and fourteen reports of clinical trials were collected and reviewed. Three reports of review study were all printed in the korea oriental medicine journal. From 2000, researches and studies have been increased in quantity and improved in quality. 2. Urinary disturbance include variable symptoms of lower urinary tract symptoms, urinary incontinence, in theaspect of Oriental medicine these symptoms are anurin, dysuria, urinary incontinence, nochumal enuresis, uracratia and so on. 3. Roughly physiological procedure of Acupuncture in Treatment of Urianry Disturbance may be that effect of acupuncture stimulation for parasympathetic nerve, sleep-arousal system in cerebrum, pontine/spinal urination center and pudendal/pelvic nerve affect bladder in expansion of bladder capacity, inhibition of urinary contraction and affection in periurethral muscle by continuous excitement of spinal annular circuit and synapse of neuron. 4. Clinical result for acupuncture treatment in urinary disturbance is summarized that acupuncture treatment in urianation disturbance of Neurogenic Bladder, Incontinence, Cycitis, Nocturnal Enuresis, Prostatitis/Pelvic Pain Syndrom and so on is significant clinical trials and technique. Conclusion : Hereafter, in the old age society these variable urinary disturbance patients are increased and desire of treatment may be also increased. So study of various and formal treatment and tecnnique is needed.
Kim, Jeong Hoon;Ra, Young Shin;Kim, Joon Soo;Ahn, Jae Sung;Kim, Chang Jin;Kwun, Byung Duk
Journal of Korean Neurosurgical Society
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v.30
no.5
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pp.575-580
/
2001
Purpose : In general, pineal region tumors are managed by using microsurgical approach or stereoctactic biopsy. However, in selected cases endoscopic approach to pineal lesions might prove to be as effective as microsurgery and less invasive. We report an alternative surgical strategy for managing certain patients with pineal neoplasms that allows treatment of the symptomatic hydrocephalus as well as tumor biopsy under direct vision in the same sitting. Materials and Methods : Twenty-two patients with pineal region tumors with associated hydrocephalus were treated in one session by endoscopic third ventriculostomy and endoscopic tumor biopsy at our institution from October 1996 to January 2000. All patients were retrospectively evaluated. Results : There was no operative mortality. There was one cause of significant bleeding during biopsy, but was controlled endoscopically, and the patient recovered completely without neurologic deficit resulting from intra-operative bleeding. The symptoms related to increased intracranial pressure(ICP) have resolved in all patients, and the need for a shunt is completely eliminated. Histological diagnosis was achieved in 21 of the 22 patients by this procedure. A biopsy was not obtained in one patient. Although this pineal region tumor was seen endoscopically, this could not be biopsied because of technical difficulties in working around an enlarged massa intermedia. The lesions included fourteen germinomas, three mixed germ cell tumors, and one each of the followings: pineocytoma, pineoblastoma, pineocytoma/pineoblastoma(intermediate type), meningioma, and low grade glioma. Five of the 22 patients subsequently underwent formal microsurgical tumor removal. Additional chemotherapy or radiotherapy could then be initiated according to the histological diagnosis. Conclusion : We consider that endoscopy affords a minimally invasive way of reaching three objectives by one-step surgery in the management of pineal region tumors with associated hydrocephalus : 1) cerebrospinal fluid(CSF) sample for analysis of tumour markers and cytology, 2) treatment of hydrocephalus by third ventriculostomy, and 3) several biopsy specimens can be obtained identifying tumors which will require further open surgery or adjuvant radiation and/or chemotherapy. However, complications and morbidities should be emphasized so as to be avoided with further technical experience.
Abu-Helalah, Munir Ahmad;Alshraideh, Hussam Ahmad;Al-Hanaqta, Motasem Mohammad;Arqoub, Kamal Hasan
Asian Pacific Journal of Cancer Prevention
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v.15
no.18
/
pp.7653-7664
/
2014
Background: Colorectal ranked first among cancers reported in males and ranked second amongst females in Jordan, accounting for 12.7% and 10.5% of cancers in males and females, respectively. Colorectal cancer patients can suffer several consequences after treatment that include pain and fatigue, constipation, stoma complications, sexual problems, appearance and body-image concerns as well as psychological dysfunction. There is no published quantitative data on the health-related quality of life and psychological wellbeing of Jordanian colorectal cancer survivors. Method: This project was a cross-sectional study of colorectal cancer survivors diagnosed in 2009 and 2010. Assessment was performed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the colorectal cancer specific module (EORTC QLQ-CR 29) and the Hospital Anxiety and Depression Scale (HADS). Data on potential predictors of scores were also collected. Results: A total of 241 subjects completed the study with mean age of $56.7{\pm}13.6$. Males represented 52.3% of study participants. A majority of participants reported good to high overall health; the mean Global health score was $79.74{\pm}23.31$ with only 6.64% of study participants scoring less than 33.3%. The striking result in this study was that none of the study participants participated in a psychosocial support group; only 4 of them (1.7%) were even offered such support. The mean scores for HADS, depression score, and anxiety score were $8.25{\pm}9$, $4.35{\pm}4.9$ and $3.9{\pm}4.6$, respectively. However, 77.1% of study participants were within the normal category for the depression score and 81.7% were within this category for anxiety score; 5.4% of participants had severe anxiety and 5.4% of them had severe depression. Discussion: Patients with colorectal cancer in Jordan have a good quality of life and psychological wellbeing scores when compared with patients from western countries. None of the colorectal cancer patients managed at the Ministry of Health received any formal counselling, or participated in psychological or social support programmes. This highlights the urgent need for a psychosocial support programme, psychological screening and consultations for patients diagnosed with colorectal cancer at the Ministry of Health Hospitals.
This study was conducted to obtain a basic information related to a more systematic safety education and measures against children's accidents by a descriptive survey with regard to accidents actually experienced by elementary schoolers, their perceived safety education activities and school facilities to their safety lives. The data was collected among 1,654 pupils, belonging to the 5th and 6th grades in Pusan from Nov. 20 to Dec. 1, 2000. The data was analyzed using SPSSWIN(7.5). The results were as follows ; 1. According to the perception by elementary schoolers, they received safety life instruction at school in most cases from teachers in charge of their own class (41.0%). Such safety education was provided often during formal classes(24.4%). Traffic guidance was given by parents, highest in frequency(67.3%). 2. Matters as most often treated during safety life instruction were safety knowledge or dangerous things(37.5%). A majority of notices of school safety instruction were presented sometimes(48.4%). Source of knowledge about safety lives included teacher (35.3%), parents(32.9%), TV and newspaper (29.9%). As a source of knowledge of emergency treatment, school nurses were accounted for 41.3% that was highest. 3.Among the 1,654 students, 91.8% experienced at least more than one case of safety accident. The most frequent type and cause of safety accident were wound(33.7%). and self-carelessness(38.4%) respectively. In most cases, the subject experienced such accident during a break time(32.2%) and at a playgrounds. Part of body as most often damaged by accidents were arms and legs, 25.4% higher than any other sides problem solving measures against the accident were taken by school nurse in most cases, 44.8% in percentage point. 4. Those students' perceived safety management of school facilities showed that they considered classroom facilities as most safe (61.6%), while playground facilities as least safe(42.8%). They also responded that the treatment of glass fragments or stones at playground is the most important item of safety management.
Kim Chan Yong;Je Yeong Wan;Lee Je Hui;Park Heung Deuk
대한방사선치료학회:학술대회논문집
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2005.06a
/
pp.19-22
/
2005
Introduction: Daily Q.A is the important step which must be preceded in a radiation treatment. Specially, radiation output measurement and laser alignment, SSD indicator related to a patient set-up recurrence must be confirmed for a reasonable radiation treatment. Daily Q.A proceeds correctness and a prompt way, and needs an objective measurement basis. Manufacture of the device which can facilitate confirmation of output measurement and appliances check at one time was requested. Methods and Materials: Produced the phantom formal daily check device which can confirm a lot of appliances check (output measurement and laser alignment, field size, SSD indicator) with one time of set up at a time, and measurement observed a linear accelerator (4 machine) for four months and evaluated efficiency. Result: We were able to confirm an laser alignment, field size, SSD indicator check at the same time, and out put measurement was possible with the same set up, so daily Q.A time was reduced, and were able to confirm an objective basis about each item measurement. As a result of having measured for four months, output measurement within ${\pm}\;2\%$, and measured laser alignment, field size, SSD indicator in range within ${\pm}\;1mm$. Conclusion: We can enforce output measurement and appliances check conveniently and time was reduced and was able to raise efficiency of business. We were able to bring n cost reduction by substitution expensive commercialized equipment. Further It is necessary to makes a product as strong and slight materials, and improve convenience of use.
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