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The Effects of Nurses' Knowledge of Withdrawal of Life-Sustaining Treatment, Death Anxiety, Perceptions of Hospice on Their Attitudes toward Withdrawal of Life-Sustaining Treatment

  • Lee, Young Eun;Jung, Yu Jin;Jang, Yoo Na;Jeong, Hyo Eun
    • Journal of Hospice and Palliative Care
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    • v.23 no.3
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    • pp.114-125
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    • 2020
  • Purpose: This descriptive study investigated the effects of nurses' knowledge of withdrawal of life-sustaining treatment, death anxiety, and perceptions of hospice care on their attitudes toward withdrawal of life-sustaining treatment. Methods: Data were collected from 262 nurses at tertiary hospitals, general hospitals, or primary hospitals in Busan, Korea, and statistically analyzed using the t-test, analysis of variance, the Scheffé test, Pearson correlation coefficients, and hierarchical regression analysis. Results: The participants' scores were 3.68±0.45 (out of 5) for attitudes toward withdrawal of life-sustaining treatment, 0.65±0.15 (out of 1) for knowledge of withdrawal of life-sustaining treatment, 2.61±0.26 (out of 4) for death anxiety, and 4.06±0.43 (out of 5) for perceptions of hospice care. Furthermore, knowledge of withdrawal of life-sustaining treatment and perceptions of hospice care showed positive correlations with attitudes toward withdrawal of life-sustaining treatment, while death anxiety showed a negative correlation. The most significant factors influencing attitudes toward withdrawal of life-sustaining treatment were perceptions of hospice care, followed by having experienced caring for patients who withdrew life-sustaining treatment, death anxiety, having a spouse, and ethical values, and the overall explanatory power was 43.0%. Conclusion: This study showed that perceptions of hospice were an important factor influencing nurses' attitudes toward withdrawal of life-sustaining treatment. Therefore, it is necessary to develop and validate educational intervention programs that can improve perceptions of hospice care.

A Study on the Combined Treatment of Municipal Solid Waste Landfill Leachate (도시폐기물매립지침출수의 병합처리에 관한 연구)

  • 김동민;이병인
    • Journal of environmental and Sanitary engineering
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    • v.11 no.1
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    • pp.45-55
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    • 1996
  • An experimental research was conducted in order to study the combined treatment o of municipal landfill leachate and municipal sewage. The landfill leachate was that of Nanjido landfill site, and the municipal sewage was that of Chungnang municipal sewage treatment plant in Seoul. Several sets of bench~scale sequencing batch reactor(SBR) were used as e experimental apparatus. Specially investigated items in this experiment were the removal efficiency of substrate and the influence of treatment time. The experiment lasted for about 2 years. The result are as follows ; 1. The characteristics of leachate were pH 7.5~8.2, BOD 80~336mg/L, COD 908~1,460mg/L, NH3-N 1,409~2,330mg/L, T~P 2.7~7.lmg/L, Cl~3,540~4,085mg/L, a and heavy metals are a very small amount. And the characteristics of sewage were pH 6.9~7.3, BOD 78.4~129.3mg/L, COD 121.2~305.0mg/L, T~N 14.9~36.4mg/L, T-P 2.3~8.9mg/L. 2. The treatability of leachate alone was not treat well. So for the good treatment of leachate, it was necessary to deal with the pretreatment before bi이ogical treatment and a combined treatment of municipal sewage. 3. The various contents of the leachate were 5%, 10%, 30%, and 50%, and the removal efficiency of COD was 86.0%, 82.8%, 60.6%, and 31.7%. The maximum content of the leachate which could be sucessfully treated by SBR in the combined treatment was 10% of that of sewage. And the removal efficiency of COD increased n notably, as its treatment time increased. 4. The various contents of the electrolytic treated leachate were 5%, 10%, 30%, and 50%, and the removal efficiency of COD was 89.9%, 86.1%, 79.2%, and 69.8%. The maximum content of the leachate which could be sucessfully treated by SBR in the combined treatment was 30 % of that of sewage. And the removal efficiency of C COD increased notably, as its treatment time increased.

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A Study on the Mandibular Movements in the Patients with TMJ Lock Closed -Range and pattern of mandibulr movement- (악관절 폐구성 과두걸림 환자의 하악운동에 관한 연구 -치료전후의 하악운동 범위 및 양상 -)

  • Sung-Chang Chung;Hyung-Suk Kim
    • Journal of Oral Medicine and Pain
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    • v.16 no.1
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    • pp.113-120
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    • 1991
  • The authors examined the patterns and various ranges of mandibular movements in TMJ lock closed patients in the frontal, sagittal and horizontal plane pre-end post-treatment. And the author obtained the following results. 1. In the frontal plane, the patterns and ranges of mandibular movement of the patients were very irregular and small before treatment. But after the treatment, the patterns were similar to the typical shield shape of the normal subjects. And the velocity of opening and closing was improved after the treatment. 2. In the sagittal plane, the mean amount of maximum mouth opening was 27.0±4.0mm before treatment and 44.0±5.4mm after treatment. And there was statistically significant improvement(p<0.005). The patterns of the movement were very irregular and small before treatment, but were similar to the shape of "Posselt's envelope of motion" after the treatment. The velocity of opening and closing was improved after the treatment 3. In the horizontal plane, the mean amount of maximum laterotrusion was 8l2±2.5mm in the affected side and 6.7±2.2mm in the non-affected side before treatment. There was a significant difference between the sides(p<0.05). After the treatment, the mean was 10.4±2.6mm in the affected side and 8.9±2.3mm in the non-affected side and there was no significant difference between the sides(p>0.05). There was no significant difference in the mean amount of maximum protrusion between the before and aftertreatment(p>0.05), but the patterns of the movements were improved.

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Clinical Analysis of the Conservative Treatment for Diabetic Foot Osteomyelitis (당뇨병성 족부 골수염 치료에서 보존적 치료에 대한 임상적 고찰)

  • Kim, Yong-Beom;Lee, Eun Jung;Cho, Jaeho;Kwon, Min-Soo;Kang, Seung-Gu;Chun, Dong-Il
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.3
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    • pp.107-113
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    • 2015
  • Purpose: The question of surgical versus non-surgical treatment for diabetic foot osteomyelitis remains subject to debate. The aims of this study were to analyse the outcome of conservative treatment (antibiotic treatment and conservative surgery) for diabetic foot osteomyelitis and identify the predictive factors of remission in conservative treatment of diabetic foot osteomyelitis. Materials and Methods: Seventy-seven patients with diabetic foot osteomyelitis who initially received conservative treatment from January 2004 to July 2013 were identified, and their medical records were reviewed. Diabetic foot osteomyelitis was defined by imaging studies or histological evidence. Remission was defined as the absence of any sign of infection at the initial or contiguous site assessed at least 12 months after the end of treatment. The demographic, clinical, and therapeutic factors were analysed. Results: The mean age of the patients was $62.7{\pm}12.2$ years, and 47 patients (61.0%) were male. The median diabetes duration was $15.7{\pm}11.2$ years and mean HbA1c was $8.7%{\pm}2.4%$. Forty-eight patients (62.3%) healed with conservative treatment (antibiotic treatment and conservative surgery). Twenty-five patients (32.5%) underwent amputation. In the multivariate analysis, concomitant peripheral artery disease and inadequate antibiotic therapy were associated with failure of conservative treatment. Conclusion: Antibiotics alone, or with conservative surgery, were successful in treatment of diabetic foot osteomyelitis in 62.3% of the patients. Concomitant peripheral artery disease and inadequate antimicrobial therapy were risk factors for remission in conservatively treated diabetic foot osteomyelitis.

A Study for Natural Dyeing Textiles with Bean-Juice Treatment Method (콩즙 처리 방법에 따른 천연염색포의 염색성 연구)

  • Park, Kyeon-Soon;Choi, In-Ryu;Bae, Kye-In
    • Journal of the Korea Fashion and Costume Design Association
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    • v.9 no.2
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    • pp.85-92
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    • 2007
  • This study focused on bean-juice treatment method which have dyeing property to indigo, yellow soil, sappan wood, cochineal and also on the possibility of applying to mordanting. This is different from the active mordanting using chemicals. Natural mordants with development of dyeing are not harmful, also are the medicines for disease. Limestone and ash neutralize the acidic soil. bean-juice protein adhere to cellulose surface and change the physical properties of protein so that coloring of dye is better than before and film non-soluble in water is made. Therefore the color made from bean-juice process lasts after washing. This study try to show one of the ways to improve the current method using the heavy metal which can have bad effects for environment and human being. Bean-juice(raw bean, heated bean) treatment method can be the way to fix the natural dyeing problem of bad dyeing. Bean-juice had been treated under various condition with pre-treatment, post-treatment and raw bean, heated bean. Following results are obtained in this study. In the case of Indigo dyeing, pre-treatment of heated bean shows the biggest difference of color. In the case of yellow soil dyeing, pre-treatment of raw bean-juice shows the biggest gap of color. Pre-treatment of heated bean in sappan wood dyeing case and post-treatment of raw bean show bigger color difference than pre-treatment of raw bean. In cochineal dyeing, raw bean pre-treatment shows the biggest color difference.

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Long-term effects of gonadotropin-releasing hormone analogs in girls with central precocious puberty

  • Kim, Eun Young
    • Clinical and Experimental Pediatrics
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    • v.58 no.1
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    • pp.1-7
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    • 2015
  • Gonadotropin-releasing hormone analogs (GnRHa) are widely used to treat central precocious puberty (CPP). The efficacy and safety of GnRHa treatment are known, but concerns regarding long-term complications are increasing. Follow-up observation results after GnRHa treatment cessation in female CPP patients up to adulthood showed that treatment (especially <6 years) was beneficial for final adult height relative to that of pretreated or untreated patients. Puberty was recovered within 1 year after GnRHa treatment discontinuation, and there were no abnormalities in reproductive function. CPP patients had a relatively high body mass index (BMI) at the time of CPP diagnosis, but BMI standard deviation score maintenance during GnRHa treatment seemed to prevent the aggravation of obesity in many cases. Bone mineral density decreases during GnRHa treatment but recovers to normal afterwards, and peak bone mass formation through bone mineral accretion during puberty is not affected. Recent studies reported a high prevalence of polycystic ovarian syndrome in CPP patients after GnRHa treatment, but it remains unclear whether the cause is the reproductive mechanism of CPP or GnRHa treatment itself. Studies of the psychosocial effects on CPP patients after GnRHa treatment are very limited. Some studies have reported decreases in psychosocial problems after GnRHa treatment. Overall, GnRHa seems effective and safe for CPP patients, based on long-term follow-up studies. There have been only a few long-term studies on GnRHa treatment in CPP patients in Korea; therefore, additional long-term follow-up investigations are needed to establish the efficacy and safety of GnRHa in the Korean population.

Material Stability Assessment of Low Oxygen and Heating Treatment (저산소 및 열처리법에 대한 문화재 재질 안정성 평가)

  • Jang, Han Gyeol;Baek, Na Yeon;Kang, Dai Ill
    • Journal of Conservation Science
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    • v.30 no.2
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    • pp.149-156
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    • 2014
  • Low oxygen treatment and heating treatment are used to prevent insects in the field of food science. These eco-friendly control methods can be applied to biological control technique in conservation treatment of organic cultural properties. To evaluate material stability, low-oxygen treatment and low oxygen treatment are applied to wood, pigment, paper and textile that are related to historical wooden buildings. As a result, wood moisture content declined after low oxygen treatment. But decline rate is a little, so it can be expected to turn back original state as time passes. And test result on pigment, paper, textile of chrominance and strength of test materials are stable. But after heating treatment, pigments are separated.

Postnatal weight gain in the first two weeks as a predicting factor of severe retinopathy of prematurity requiring treatment

  • Kim, Jongmoon;Jin, Jang Yong;Kim, Sung Shin
    • Clinical and Experimental Pediatrics
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    • v.58 no.2
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    • pp.52-59
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    • 2015
  • Purpose: This study aimed to investigate the relative weight gain at 2-week intervals up to 6 weeks after birth to predict retinopathy of prematurity (ROP) requiring treatment among very low birth weight infants. Methods: A total of 211 preterm infants with birth weights <1,500 g and gestational age <32 weeks were retrospectively reviewed. The main outcome was the development of ROP requiring treatment. Body weight measurements were recorded daily. Relative weight gains (g/kg/day) were calculated at the second, fourth, and sixth week after birth. Results: Of the 211 infants, 89 developed ROP, of which 41 spontaneously regressed and 48 with early treatment of ROP type I required laser treatment. The relative weight gain at 2, 4, and 6 weeks postnatal age was significantly lower in infants with ROP requiring treatment than in infants without ROP or those with spontaneous regression (P<0.001, P=0.005, and P=0.004, respectively). On logistic regression, poor relative weight gain in the first 2 weeks was found to be related to ROP requiring treatment (adjusted odds ratio, 0.809; 95% confidence interval, 0.695-0.941; P=0.006). Relative weight gain at 2 weeks postnatal age was significantly lower in infants with ROP requiring treatment compared to that in ROP requiring no treatment (P=0.012). Conclusion: Poor postnatal weight gain in the first 2 weeks of life is an important and independent risk factor for ROP requiring treatment. Postnatal weight gain can predict the development of severe ROP requiring treatment.

The Comparison of Effect of Sports Massage, Kaltenborn-Evjenth Orthopedic Manipulative Therapy and Electrical Therapy, General Exercise Therapy in ROM Increase and Pain Reduction in Patients with Frozen Shoulder (동결견 환자의 관절가동범위 회복과 통증 감소에 있어서 스포츠 마사지 및 Kaltenborn-Evjenth정형도수치료와 전기치료 및 일반 운동치료의 효과 비교)

  • Nam, Hyoung-Chun;Woo, Kwang-Seog
    • Journal of Korean Physical Therapy Science
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    • v.10 no.2
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    • pp.73-85
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    • 2003
  • The purpose of the present study was to the investigate the effect of sports massage, kaltenborn-evjenth orthopedic manipulative therapy and electrical therapy, general exercise on the limitation of range of motion(ROM) and on the pain(VAS) in patients with frozen shoulder. Fiftheen frozen shoulder patients between 50 and 60 years of age(females) were selected and were divided equally by random distribution into A group(sports massage, kaltenborn-evjenth orthopedic manipulative therapy, N=7)and B(electrical therapy, general exercise therapy, N=7) group. The results obtained were as follows : 1) The range of motion between two groups are significantly different in the treatment times, the ROM of A group increase in after-treatment(2 week 4 week) in comparison with ROM in before-treatment, it is significant increase. And it is significant difference in B group. 2) The pain level between two groups are not significantly different in the treatment times, the pain level of A group decrease in after-treatment(2 week, 4 week) in comparison with before-treatment, it is significant decrease. And it is significant difference in B group. Although the pain level of the A group decrease in after 2 week treatment in comparison with before-treatment but it is not significant decrease. Although the pain level of the B group decrease in after 4 week treatment in comparison with after 2 week treatment, but it is not significant decrease. 3) The A group is more effective in increasing the ROM and decreasing the pain level than B group during treatment times. The results showed that both A group method and B group method are effective ROM increase and pain reduce, but A group method is superior to B group method in ROM increase and pain reduce.

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Outcomes of the Multimodal Treatment of Malignant Pleural Mesiothelioma: The Role of Surgery

  • Na, Bub-Se;Kim, Ji Seong;Hyun, Kwanyong;Park, In Kyu;Kang, Chang Hyun;Kim, Young Tae
    • Journal of Chest Surgery
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    • v.51 no.1
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    • pp.35-40
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    • 2018
  • Background: The treatment of malignant pleural mesothelioma (MPM) is challenging, and multimodal treatment including surgery is recommended; however, the role of surgery is debated. The treatment outcomes of MPM in Korea have not been reported. We analyzed the outcomes of MPM in the context of multimodal treatment, including surgery. Methods: The records of 29 patients with pathologically proven MPM from April 1998 to July 2015 were retrospectively reviewed. The treatment outcomes of the surgery and non-surgery groups were compared. Results: The overall median survival time was 10.6 months, and the overall 3-year survival rate was 25%. No postoperative 30-day or in-hospital mortality occurred in the surgery group. Postoperative complications included tachyarrhythmia (n=4), pulmonary thromboembolism (n=1), pneumonia (n=1), chylothorax (n=1), and wound complications (n=3). The treatment outcomes between the surgery and non-surgery groups were not significantly different (3-year survival rate: 31.3% vs. 16.7%, respectively; p=0.47). In a subgroup analysis, there was no significant difference in the treatment outcomes between the extrapleural pneumonectomy group and the non-surgery group (3-year survival rate: 45.5% vs. 16.7%, respectively; p=0.23). Conclusion: Multimodal treatment incorporating surgery did not show better outcomes than non-surgical treatment. A nationwide multicenter data registry and prospective randomized controlled studies are necessary to optimize the treatment of MPM.