• Journal of Hospice and Palliative Care
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• v.12 no.4
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• pp.194-198
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• 2009

Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea Purpose: Malignant bowel obstruction causes gastrointestinal symptoms and leads to diminished quality of life in patients with advanced cancer. Several studies have shown the efficacy of octreotide for the relief of malignant bowel obstruction-related symptoms. The aim of this study is to assess the efficacy and safety of octreotide in patients with malignant bowel obstruction. Methods: We retrospectively reviewed medical records of twenty nine patients who had suffered from malignant bowel obstruction without clinical improvement of conservative care and subsequently, received octreotide treatment. Initial dosage of octreotide was 0.1 mg/day, and dose was escalated depending on the clinical effect. For each patient, we assessed visual analogue scale (VAS) of pain, number of vomiting episode, and amount of nasogastric tube drainage. Results: Median dosage of octreotide was 0.2 mg/day (range 0.1~0.6), and median duration from initial medication to death was 20 days (range 2~103). VAS before and after octreotide treatment were 5.6$\pm$1.24, and 2.7$\pm$0.96, respectively. The numbers of vomiting episode before and after octreotide treatment were 3.6/day$\pm$2.5, and 0.4/day$\pm$0.8, respectively. The mean amounts of nasogastric tube drainage before and after octreotide treatment were 975$\pm$1,083 cc/day and 115$\pm$196 cc/day, respectively. Statistically significant reduction in VAS, the number of vomiting episode and the amount of nasogastric tube drainage were observed after octreotide treatment (P<0.05). Conclusion: Administration of octreotide in patients with malignant bowel obstruction, which is uncontrolled by other medication, was effective and safe. In such clinical situations, physicians should consider to add of octreotide for symptomatic control.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.4
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• pp.2691-2703
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• 2015

This research aims to provide basic materials for assisting DNR patient cares by understanding ICU nurses' awareness and ethical attitude regarding DNR. A total of 154 results were analyzed which were collected from Aug. 1st to Sep. 5th in 2014 by surveying nurses working in ICU (from 1 advanced general hospital in G metropolitan city and other general hospitals of more than 700 beds in Cheolla provinces). (1) For the decision attitudes of DNR, there were both consent and objection. Consent for the patient's opinion of rejecting further treatment and life extension despite of bad prognosis. And objection for no conducting DNR in the case of the patient's wish, treatment requested by the guardian, and CPR for the patient who has no chance. (2) Objection for artificial respirator and other treatment requested by the patient's family and the entrance of guardians into ICU. Consent for the passive use of artificial respirator by the doctor and the decrease of basic care to stabilize patients physically and mentally. No specific opinion for treatment not following aseptic techniques. Objection for frequent reports to primary care physician requested by the family. (3) Acknowledging less interest by the doctor, while supporting the health care team in the case of the guardian's complaint, objection for the DNR decision mede by the primary care physician. Objection for the DNR decision by the guideline. Objection or neutrality for straightforward explanation to the patient of bad prognosis. Objection for straightforward explanation of the patient's status (even near to death) to the patient him/herself or the guardian. In conclusion, the subject of DNR is the patient and the patient's opinion should be fully reflected. The conflict arising from the scope of medical practice and decision processes should be minimized. The standard and guideline for DNR decision is required for the ethical decision making for the patient along with agreements based on full explanations.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.5
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• pp.2178-2188
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• 2012

This study is based upon 200 final responses from a survey conducted for 153 nurses and 147 nursing students in Busan and Gyeongnam province from september to october 2011. It is carried out to compare and understand the spiritual needs of nurses and nursing students that are inclined to be more exposed unhealthy people rather than healthy people. In this study, the level of spiritual care needs was divided into five fields such as 'love and fellowship', 'hope and peace', 'meaning and purpose of life', 'acceptance of death' and 'relationship with God' and was investigated. As a result, the love and fellowship was the highest level in group of nurses (r = 3.82) and the relationship with God was the lowest one (r = 2.73). In contrast, a group of nursing students showed that love and fellowship was the highest level (r = 3.92) and relationship with God was the lowest (r = 2.99) among five fields. There were statistical significances between nurses and nursing students in 'acceptance of death' and 'relationship with God' (p < 0.05). When looking at correlation between fields of spiritual needs of nurses, the correlation between 'meaning and purpose of life' and 'hope and peace' was the highest (r = .699) and the correlation between 'relationship with God' and 'hope and peace' was the lowest (r = .247). As the result of analysis on correlation between fields of spiritual needs of nursing students, the correlation between 'meaning and purpose of life' and 'hope and peace' was the highest (r = .660) and the correlation between 'acceptance of death' and 'relationship with God' was the lowest (r = .277). Therefore, it would be imperative to develop a more efficient and systemized education program for the spiritual care of nursing patients, on the basis of understanding the spiritual needs of nurses and nursing students.

• Journal of Biomedical Engineering Research
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• v.19 no.3
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• pp.279-284
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• 1998

Deep hypothermic circulatory arrest(DHCA), in which systemic temperatures of 2$0^{\circ}C$ or less are used to allow temporary cessation of the circulation, is an useful adjunct in cardiac surgery. Because man in natural circumstances is never exposed to the extreme hypothermic condition, however, one of the controversial aspects is appropriate blood gas management($\alpha$STAT versus PH-STAT) during DHCA. This study aims to compare $\alpha$STAT with PH-STAT management for control of blood gases in experimental cardiopulmonary bypass(CPB) circuits with a membrane oxygenator. Fourteen young pigs were assigned to one of two strategies of gas manipulation. After a median sternotomy, CPB was established. Core cooling was initiated and continued until nasopharyngeal temperature fell below 2$0^{\circ}C$. The flow rate was set at 2,500 ml/min. Once their temperatures were below 2$0^{\circ}C$, the animals were subjected to circulatory arrest for 40mins. During cooling, blood gas was maintained according to either $\alpha$$\alpha$STAT or pH-STAT strategies. After DHCA, the body was rewarmed to normal body temperature. Arterial blood gases were measured before the onset of CPB, before cooling, before DHCA, at the point of 27$^{\circ}C$ during re-warming, on completion of re-warming. Cooling time was significantly shorter in $\alpha$-STAT than PH-STAT strategy, while there was no significant differences in rewarming time between two groups. Carbon dioxide was added between 5.5 and 3.0% in PH-STAT, while no carbon dioxide was added in $\alpha$STAT management. Amounts of oxygen administration were gradually lowered as temperature decreased. In this way, criteria of PH, PaCO, and PaO adjustments were satisfied in both $\alpha$STAT and PH-STAT management groups.

• Journal of Ginseng Research
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• v.30 no.3
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• pp.165-171
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• 2006

For several thousand years, Korean ginseng has been used as a medicinal herb in the oriental countries. Korea is the ginseng suzerain and, for that reason, the ginseng as a special crop in Korea has been exported to the world market since the era of the three Kingdoms. Hong Kong is the pivot of ginseng import from all of the world. In 1970s, Korea ginseng had a high market share (about 30%) in Hong Kong. However, recently, the market share of Korean ginseng in Hong Kong has been significantly reduced due to the mass production from China and Canada. Besides, America with aggressive marketing strategy takes the leadership in the international ginseng market in Hong Kong. Therefore, it is necessary for Korea to know and understand world ginseng market condition and situation in Hong Kong. The objective of this study is to identify the actual import situation at international ginseng market in Hong Kong. This study analyzed the ginseng import demand model which effected by several price variables from major importing countries at the international ginseng market in Hong Kong. The findings of this study show that the import price of Korean ginseng has an effect on the quantity of ginseng imported from other countries in Hong Kong. In addition, the quantity of ginseng imported from Korea in Hong Kong is influenced by the import price of ginseng from other countries. In conclusion, Korean ginseng plays an important role at the international ginseng market in Hong Kong.

• Journal of Life Science
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• v.18 no.3
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• pp.291-297
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• 2008

We investigated whether 1) the combined capsaicin (75 mg), sesamin (30 mg), and L-carnitine (900 mg) (CCSC) ingestion enhances autonomic nervous system (ANS) activities including thermogenic sympathetic activity as energy metabolic modulator, 2) ${\beta}_3-AR$ polymorphism of each subject influences with ANS activity. Seven healthy males $(22.0{\pm}0.5\;yr)$ volunteered for this study. The cardiac autonomic nervous activities evaluated by means of heart rate variability of power spectral analysis were continuously measured during 5 min every 30 min for total 120 min resting condition with CCSC or placebo oral administration chosen at random. The results indicated that, there are not $Arp/Arg^{64}$ variants of the ${\beta}_3-AR$ genotypes in our subjects. There were not also significant differences in heart rate during rest between both trials. The difference of ANS activity did not reach the statistical significance between both trials. However, the significant improvement showed TOTAL power, HF component, and the indices of SNS and PNS activities before and at 30 min after CCSC ingestion (p<0.05, respectively). In conclusions, although each component of combined CCSC is associated with lipolysis and/or fat oxidation, the combined CCSC consumption is not influenced in stimulation of thermogenic sympathetic activity as modulator of energy metabolism. In rather, our results suggested that CCSC ingestion improves the balance of both SNS and PNS activities. Therefore, it will be considered many combined nutrient components for ergogenic and/or lipolysis effects as well as genetic variants affecting ANS activity in further studies.

• Journal of Life Science
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• v.23 no.5
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• pp.698-702
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• 2013

It is known that black sticky rice with giant embryo (BSRGB, Milyang 263) and giant embryo rice (GER) contains higher levels of GABA than rice. Therefore, feeding BSRGB, GER, or rice freely to C57BL/6 mice with two-hour alcohol intake for 16 days was investigated. For two-hour alcohol intake, a repeated measure ANOVA (three treatment groups repeated across 16 days; 8 two-day blocks) yielded a significant group by block interaction (df=16, F=3.109, p=0.004). The independent t-test showed that significant suppression of two-hour alcohol intake was observed when subjects were administered with BSRGB, compared with the rice alone across all the two-day blocks (p<0.05). The paired t-test revealed that a significant suppression of two-hour alcohol intake was observed starting 4 to 16 days after freely feeding with BSRGB compared to before feeding. However, there is no significant difference in the two-hour alcohol intake observed between the before and after administration of rice. A repeated measure ANOVA revealed no significant group by block interaction for 22-hour water intake and body weight. However, a repeated measure ANOVA revealed a significant grouping by block interaction for food intake. These results indicate a change of two-hour alcohol intake is presumably caused by GABA, which is found in higher levels in BSRGB than in rice.

• KDI Journal of Economic Policy
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• v.30 no.2
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• pp.99-128
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• 2008

Nearly all Koreans are insured through National Health Insurance(NHI). While NHI coverage is nearly universal, it is not complete. Coverage is largely limited to minimal level of hospital and physician expenses, and copayments are required in each case. As a result, Korea's public insurance system covers roughly 50% of overall individual health expenditures, and the remaining 50% consists of copayments for basic services, spending on services that are either not covered or poorly covered by the public system. In response to these gaps in the public system, 64% of the Korean population has supplemental private health insurance. Expansion of private health insurance raises negative externality issue. Like public financing schemes in other countries, the Korean system imposes cost-sharing on patients as a strategy for controlling utilization. Because most insurance policies reimburse patients for their out-of-pocket payments, supplemental insurance is likely to negate the impact of the policy, raising both total and public sector health spending. So far, most empirical analysis of supplemental health insurance to date has focused on the US Medigap programme. It is found that those with supplements apparently consume more health care. Two reasons for higher health care consumption by those with supplements suggest themselves. One is the moral hazard effect: by eliminating copayments and deductibles, supplements reduce the marginal price of care and induce additional consumption. The other explanation is that supplements are purchased by those who anticipate high health expenditures - adverse effect. The main issue addressed has been the separation of the moral hazard effect from the adverse selection one. The general conclusion is that the evidence on adverse selection based on observable variables is mixed. This article investigates the extent to which private supplementary insurance affect use of health care services by public health insurance enrollees, using Korean administrative data and private supplements related data collected through all relevant private insurance companies. I applied a multivariate two-part model to analyze the effects of various types of supplements on the likelihood and level of public health insurance spending and estimated marginal effects of supplements. Separate models were estimated for inpatients and outpatients in public insurance spending. The first part of the model estimated the likelihood of positive spending using probit regression, and the second part estimated the log of spending for those with positive spending. Use of a detailed information of individuals' public health insurance from administration data and of private insurance status from insurance companies made it possible to control for health status, the types of supplemental insurance owned by theses individuals, and other factors that explain spending variations across supplemental insurance categories in isolating the effects of supplemental insurance. Data from 2004 to 2006 were used, and this study found that private insurance increased the probability of a physician visit by less than 1 percent and a hospital admission by about 1 percent. However, supplemental insurance was not found to be associated with a bigger health care service utilization. Two-part models of health care utilization and expenditures showed that those without supplemental insurance had higher inpatient and outpatient expenditures than those with supplements, even after controlling for observable differences.

• Proceedings of the Ginseng society Conference
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• 2007.12a
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• pp.57-58
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• 2007

Purpose: Ginseng is a well-known medical plant used in traditional Oriental medicine. Korean red ginseng (KRG) has been known to have potent biological activities such as radical scavenging, vasodilating, anti-tumor and anti-diabetic activities. However, the mechanism of the beneficial effects of KRG on diabetes is yet to be elucidated. The present study was designed to investigate the anti-diabetic effect and mechanism of KRG extract in C57BL/KsJ db/db mice. Methods: The db/db mice were randomly divided into six groups: diabetic control group (DC), red ginseng extract low dose group (RGL, 100 mg/kg), red ginseng extract high dose group (RGH, 200 mg/kg), metformin group (MET, 300 mg/kg), glipizide group (GPZ, 15 mg/kg) and pioglitazone group (PIO, 30 mg/kg), and treated with drugs once per day for 10 weeks. During the experiment, body weight and blood glucose levels were measured once every week. At the end of treatment, we measured Hemoglobin A1c (HbA1c), blood glucose, insulin, triglyceride (TG), adiponectin, leptin, non-esterified fatty acid (NEFA). Morphological analyses of liver, pancreas and white adipose tissue were done by histological observation through hematoxylin-eosin staining. Pancreatic islet insulin and glucagon levels were detected by double-immunofluorescence staining. To elucidate an action of mechanism of KRG, DNA microarray analyses were performed, and western blot and RT-PCR were conducted for validation. Results: Compared to the DC group mice, body weight gain of PIO treated group mice showed 15.2% increase, but the other group mice did not showed significant differences. Compared to the DC group, fasting blood glucose levels were decreased by 19.8% in RGL, 18.3% in RGH, 67.7% in MET, 52.3% in GPZ, 56.9% in PIO-treated group. With decreased plasma glucose levels, the insulin resistance index of the RGL-treated group was reduced by 27.7% compared to the DC group. Insulin resistance values for positive drugs were all markedly decreased by 80.8%, 41.1% and 68.9%, compared to that of DC group. HbA1c levels in RGL, RGH, MET, GPZ and PIO-treated groups were also decreased by 11.0%, 6.4%, 18.9%, 16.1% and 27.9% compared to that of DC group, and these figure revealed a similar trend shown in plasma glucose levels. Plasma TG and NEFA levels were decreased by 18.8% and 16.8%, respectively, and plasma adiponectin and leptin levels were increased by 20.6% and 12.1%, respectively, in the RGL-treated group compared to those in DC group. Histological analysis of the liver of mice treated with KRG revealed a significantly decreased number of lipid droplets compared to the DC group. The control mice exhibited definitive loss and degeneration of islet, whereas mice treated with KRG preserved islet architecture. Compared to the DC group mice, KRG resulted in significant reduction of adipocytes. From the pancreatic islet double-immunofluorescence staining, we observed KRG has increased insulin production, but decreased glucagon production. KRG treatment resulted in stimulation of AMP-activated protein kinase (AMPK) phosphorylation in the db/db mice liver. To elucidate mechanism of action of KRG extract, microarray analysis was conducted in the liver tissue of mice treated with KRG extract, and results suggest that red ginseng affects on hepatic expression of genes responsible for glycolysis, gluconeogenesis and fatty acid oxidation. In summary, multiple administration of KRG showed the hypoglycemic activity and improved glucose tolerance. In addition, KRG increased glucose utilization and improved insulin sensitivity through inhibition of lipogenesis and activation of fatty acid $\beta$-oxidation in the liver tissue. In view of our present data, we may suggest that KRG could provide a solid basis for the development of new anti-diabetic drug.

• Journal of dental hygiene science
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• v.4 no.3
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• pp.133-140
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• 2004

It examines closely the occupation characteristic primary factor which the dentistry hygienic company field which is working to presence at a sickbed is undergoing the degree and from the research which it sees and it grasps the adaptation method against it gropes bitterly with development of the dentistry hygienic company individual to join in, it contributed in dentistry medical treatment service quality improvement and the research which tries to sleep it attempted. Currently the dentistry hygiene which works from Seoul and the condition area subject matter dentist unit, the dentistry hospital and the general hospital dentistry back it did in the object which it will burn. 116 issues which become frequency in question 120 it used SPSS 10.0 and it analyzed. Result of this study is as following. (1) Was expose that stress degree by factor feels about commonness on the whole, and angle prospects and support connection stress at company were the biggest item by item, and appeared as on the other hand relation connection stress with patient is the smallest. (2) Stress that stress degree by each receives in case of there are a lot of other businesses to characteristic businesses except appeared highest. On the other hand, was expose that feel the lowest stress degree an item that other a type of occupation and discord are. (3) 'Do action of that throw goods or closes the door bump' appeared article highest by short term adaptation method about stress, and 'Think and gives up by fate' appeared highest by special skill adaptation method. Short term adaptation method appeared high than special skill adaptation method on the whole but the difference appeared as is very small. (4) Stress degree comparison by general special quality was shown difference that stress by only dental hygiene administration of justice selection motive keeps in mind. (5) All of the result that compare short term, long term adaptation method about stress that feel new dental higienist apple career dental higienist same difference be, but displayed high result in same munhang. (6) Was expose that difference that keep in mind from all arguments in comparison of short term adaptation method by general special quality does not exist, on the other hand, comparison of long-term adaptation method displayed result that religion among only variable keeps in mind statistically.