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A Clinical Study on Transpulmonary Leukostasis and Prophylactic Effects of Steroid in Cardiac Surgery (심장수술시 백혈구의 폐내정체와 스테로이드의 예방적 효과에 관한 연구)

  • 최석철
    • Biomedical Science Letters
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    • v.2 no.2
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    • pp.133-151
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    • 1996
  • After cardiac surgery, it has been recognized that various complications were associated with injured humoral and cellular immunity by cardiopulmonary bypass(CPB). Especially, in postoperative pulmonary dysfunction, transpulmonary leukostasis followed complement activation and inflammatory responses are major pathogen. Some studies have showed that pretreated-corticosteroids before CPB protected postoperative pulmonary dysfunction. Corticosteroids may inhibit complement and leukocyte activation. On based previous studies, present investigator determined changes of leukocyte counts and transpulmonary leukostasis during cardiac surgery and postoperative periods. For the evaluation of postoperative pulmonary function and edema, $PaO_2$ and chest X-ray were compared between pre-CPB and post-CPB. Fever and other parameters were also observed postoperatively. The aim of this study was to define for the prophylactic effects of corticosteroid(Solu-Medrol: 30mg/kg) on all the researched parameters. This study was prospectively designed with randomized-blind fashion for 50 patients undergoing cardiac surgery. According to the purpose of study, all patients were divided into placebo and steroid group. : Placebo group was 25 patients received normal saline(not corticosteroid), and steroid group was 25patients received corticosteroid(Solu-Medrol: 30mg/kg) before initiation of CPB. The results of study were summarized as follows. 1. Total peripheral leukocyte counts decreased significantly at 5 minutes of CPB in all patients(P<0.01), and began to increase progressively at later periods of CPB with neutrophilia. The significant rise remained at postoperative 7th day(P<0.05). 2. During partial CPB, transpulmonary leukostasis occurred in placebo group(P<0.001), whereas it was prevented in steroid group. 3. In both groups, peripheral lymphocyte counts were stable during CPB, but began to reduce at time of intensive care unit(ICU) and the lymphocytopenia remained until postoperative 3rd day. The lymphocyte counts recovered on postoperative 7th day. 4. In both groups, peripheral counts of monocyte were relatively stable in the early peroid of CPB, and increased gradually in the later periods of CPB. This significant monocytosis remained throughout postoperlative periods(P<0.05). 5. The mean value of postoperative $paO)_2$ was lower than that of pre-CPB in placebo group(P=0.01) but didn't significant in steroid group(P=0.90). In the incidence of pulmonary edema signs and fever, placebo group was higher than steroid group(P=0.001, p=0.01, respectively). However mechanical respiratory supporting and care periods at intensive care unit were not significant difference between two groups(P>.0.05).With the above results, the investigator concluded that leukocyte activation and pulmonary sequestration were caused by cardiac surgery with CPB and demonstrated that high dose corticosteroid will provide prophylactic effect for pulmonary leukostasis and higher neutrophilia. These effects may ameliorate postoperative pulmonary dysfunction and contribute to postoperative less morbidity. However, further study should be performed because postoperative lymphocytopenia continued for 3 days in both groups, which may suspected damage or suppression of cell-mediated immunity with used corticosteroid.

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System Development for Measuring Group Engagement in the Art Center (공연장에서 다중 몰입도 측정을 위한 시스템 개발)

  • Ryu, Joon Mo;Choi, Il Young;Choi, Lee Kwon;Kim, Jae Kyeong
    • Journal of Intelligence and Information Systems
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    • v.20 no.3
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    • pp.45-58
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    • 2014
  • The Korean Culture Contents spread out to Worldwide, because the Korean wave is sweeping in the world. The contents stand in the middle of the Korean wave that we are used it. Each country is ongoing to keep their Culture industry improve the national brand and High added value. Performing contents is important factor of arousal in the enterprise industry. To improve high arousal confidence of product and positive attitude by populace is one of important factor by advertiser. Culture contents is the same situation. If culture contents have trusted by everyone, they will give information their around to spread word-of-mouth. So, many researcher study to measure for person's arousal analysis by statistical survey, physiological response, body movement and facial expression. First, Statistical survey has a problem that it is not possible to measure each person's arousal real time and we cannot get good survey result after they watched contents. Second, physiological response should be checked with surround because experimenter sets sensors up their chair or space by each of them. Additionally it is difficult to handle provided amount of information with real time from their sensor. Third, body movement is easy to get their movement from camera but it difficult to set up experimental condition, to measure their body language and to get the meaning. Lastly, many researcher study facial expression. They measures facial expression, eye tracking and face posed. Most of previous studies about arousal and interest are mostly limited to reaction of just one person and they have problems with application multi audiences. They have a particular method, for example they need room light surround, but set limits only one person and special environment condition in the laboratory. Also, we need to measure arousal in the contents, but is difficult to define also it is not easy to collect reaction by audiences immediately. Many audience in the theater watch performance. We suggest the system to measure multi-audience's reaction with real-time during performance. We use difference image analysis method for multi-audience but it weaks a dark field. To overcome dark environment during recoding IR camera can get the photo from dark area. In addition we present Multi-Audience Engagement Index (MAEI) to calculate algorithm which sources from sound, audience' movement and eye tracking value. Algorithm calculates audience arousal from the mobile survey, sound value, audience' reaction and audience eye's tracking. It improves accuracy of Multi-Audience Engagement Index, we compare Multi-Audience Engagement Index with mobile survey. And then it send the result to reporting system and proposal an interested persons. Mobile surveys are easy, fast, and visitors' discomfort can be minimized. Also additional information can be provided mobile advantage. Mobile application to communicate with the database, real-time information on visitors' attitudes focused on the content stored. Database can provide different survey every time based on provided information. The example shown in the survey are as follows: Impressive scene, Satisfied, Touched, Interested, Didn't pay attention and so on. The suggested system is combine as 3 parts. The system consist of three parts, External Device, Server and Internal Device. External Device can record multi-Audience in the dark field with IR camera and sound signal. Also we use survey with mobile application and send the data to ERD Server DB. The Server part's contain contents' data, such as each scene's weights value, group audience weights index, camera control program, algorithm and calculate Multi-Audience Engagement Index. Internal Device presents Multi-Audience Engagement Index with Web UI, print and display field monitor. Our system is test-operated by the Mogencelab in the DMC display exhibition hall which is located in the Sangam Dong, Mapo Gu, Seoul. We have still gotten from visitor daily. If we find this system audience arousal factor with this will be very useful to create contents.

Self-optimizing feature selection algorithm for enhancing campaign effectiveness (캠페인 효과 제고를 위한 자기 최적화 변수 선택 알고리즘)

  • Seo, Jeoung-soo;Ahn, Hyunchul
    • Journal of Intelligence and Information Systems
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    • v.26 no.4
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    • pp.173-198
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    • 2020
  • For a long time, many studies have been conducted on predicting the success of campaigns for customers in academia, and prediction models applying various techniques are still being studied. Recently, as campaign channels have been expanded in various ways due to the rapid revitalization of online, various types of campaigns are being carried out by companies at a level that cannot be compared to the past. However, customers tend to perceive it as spam as the fatigue of campaigns due to duplicate exposure increases. Also, from a corporate standpoint, there is a problem that the effectiveness of the campaign itself is decreasing, such as increasing the cost of investing in the campaign, which leads to the low actual campaign success rate. Accordingly, various studies are ongoing to improve the effectiveness of the campaign in practice. This campaign system has the ultimate purpose to increase the success rate of various campaigns by collecting and analyzing various data related to customers and using them for campaigns. In particular, recent attempts to make various predictions related to the response of campaigns using machine learning have been made. It is very important to select appropriate features due to the various features of campaign data. If all of the input data are used in the process of classifying a large amount of data, it takes a lot of learning time as the classification class expands, so the minimum input data set must be extracted and used from the entire data. In addition, when a trained model is generated by using too many features, prediction accuracy may be degraded due to overfitting or correlation between features. Therefore, in order to improve accuracy, a feature selection technique that removes features close to noise should be applied, and feature selection is a necessary process in order to analyze a high-dimensional data set. Among the greedy algorithms, SFS (Sequential Forward Selection), SBS (Sequential Backward Selection), SFFS (Sequential Floating Forward Selection), etc. are widely used as traditional feature selection techniques. It is also true that if there are many risks and many features, there is a limitation in that the performance for classification prediction is poor and it takes a lot of learning time. Therefore, in this study, we propose an improved feature selection algorithm to enhance the effectiveness of the existing campaign. The purpose of this study is to improve the existing SFFS sequential method in the process of searching for feature subsets that are the basis for improving machine learning model performance using statistical characteristics of the data to be processed in the campaign system. Through this, features that have a lot of influence on performance are first derived, features that have a negative effect are removed, and then the sequential method is applied to increase the efficiency for search performance and to apply an improved algorithm to enable generalized prediction. Through this, it was confirmed that the proposed model showed better search and prediction performance than the traditional greed algorithm. Compared with the original data set, greed algorithm, genetic algorithm (GA), and recursive feature elimination (RFE), the campaign success prediction was higher. In addition, when performing campaign success prediction, the improved feature selection algorithm was found to be helpful in analyzing and interpreting the prediction results by providing the importance of the derived features. This is important features such as age, customer rating, and sales, which were previously known statistically. Unlike the previous campaign planners, features such as the combined product name, average 3-month data consumption rate, and the last 3-month wireless data usage were unexpectedly selected as important features for the campaign response, which they rarely used to select campaign targets. It was confirmed that base attributes can also be very important features depending on the type of campaign. Through this, it is possible to analyze and understand the important characteristics of each campaign type.

A study on Broad Quantification Calibration to various isotopes for Quantitative Analysis and its SUVs assessment in SPECT/CT (SPECT/CT 장비에서 정량분석을 위한 핵종 별 Broad Quantification Calibration 시행 및 SUV 평가를 위한 팬텀 실험에 관한 연구)

  • Hyun Soo, Ko;Jae Min, Choi;Soon Ki, Park
    • The Korean Journal of Nuclear Medicine Technology
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    • v.26 no.2
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    • pp.20-31
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    • 2022
  • Purpose Broad Quantification Calibration(B.Q.C) is the procedure for Quantitative Analysis to measure Standard Uptake Value(SUV) in SPECT/CT scanner. B.Q.C was performed with Tc-99m, I-123, I-131, Lu-177 respectively and then we acquired the phantom images whether the SUVs were measured accurately. Because there is no standard for SUV test in SPECT, we used ACR Esser PET phantom alternatively. The purpose of this study was to lay the groundwork for Quantitative Analysis with various isotopes in SPECT/CT scanner. Materials and Methods Siemens SPECT/CT Symbia Intevo 16 and Intevo Bold were used for this study. The procedure of B.Q.C has two steps; first is point source Sensitivity Cal. and second is Volume Sensitivity Cal. to calculate Volume Sensitivity Factor(VSF) using cylinder phantom. To verify SUV, we acquired the images with ACR Esser PET phantom and then we measured SUVmean on background and SUVmax on hot vials(25, 16, 12, 8 mm). SPSS was used to analyze the difference in the SUV between Intevo 16 and Intevo Bold by Mann-Whitney test. Results The results of Sensitivity(CPS/MBq) and VSF were in Detector 1, 2 of four isotopes (Intevo 16 D1 sensitivity/D2 sensitivity/VSF and Intevo Bold) 87.7/88.6/1.08, 91.9/91.2/1.07 on Tc-99m, 79.9/81.9/0.98, 89.4/89.4/0.98 on I-123, 124.8/128.9/0.69, 130.9, 126.8/0.71, on I-131, 8.7/8.9/1.02, 9.1/8.9/1.00 on Lu-177 respectively. The results of SUV test with ACR Esser PET phantom were (Intevo 16 BKG SUVmean/25mm SUVmax/16mm/12mm/8mm and Intevo Bold) 1.03/2.95/2.41/1.96/1.84, 1.03/2.91/2.38/1.87/1.82 on Tc-99m, 0.97/2.91/2.33/1.68/1.45, 1.00/2.80/2.23/1.57/1.32 on I-123, 0.96/1.61/1.13/1.02/0.69, 0.94/1.54/1.08/0.98/ 0.66 on I-131, 1.00/6.34/4.67/2.96/2.28, 1.01/6.21/4.49/2.86/2.21 on Lu-177. And there was no statistically significant difference of SUV between Intevo 16 and Intevo Bold(p>0.05). Conclusion Only Qualitative Analysis was possible with gamma camera in the past. On the other hand, it's possible to acquire not only anatomic localization, 3D tomography but also Quantitative Analysis with SUV measurements in SPECT/CT scanner. We could lay the groundwork for Quantitative Analysis with various isotopes; Tc-99m, I-123, I-131, Lu-177 by carrying out B.Q.C and could verify the SUV measurement with ACR phantom. It needs periodic calibration to maintain for precision of Quantitative evaluation. As a result, we can provide Quantitative Analysis on follow up scan with the SPECT/CT exams and evaluate the therapeutic response in theranosis.

Experimental Studies on the Antitumor Effects of Jinryungtang Gagambang Extract (진령탕가감방의 항종양효과(抗腫瘍效果)에 관(關)한 실험적(實驗的) 연구(硏究))

  • Jeong, Jun-Tak;Moon, Goo;Moon, Suk-Jae
    • THE JOURNAL OF KOREAN ORIENTAL ONCOLOGY
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    • v.4 no.1
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    • pp.37-53
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    • 1998
  • The sprig of Jinryungtang Gagambang has been used for curing as a traditional medicine without any experimental evidence to support the rational basis for their clinical use. This experiment was carried out to evaluate the possible therapeutic or antitumoral effects of Jinryungtang Gagambang extract against cancer, and to study some mechanisms responsible for its effect. The cytotoxic and antitumor effects were evaluated on human cell liens (A549, hep3B, Caki-1, Sarcoma 180) after exposure to Jinryungtang Gagambang extract using in ILS, colony forming efficency and SRB assay which were regarded as a valuable method for cytotoxic and antitumor effects of unknown compound on tumor cell lines. The results obtained in this studies were as follows. 1. As a result of exposure to Jinryungtang Gagambang extract, the proliferation of A549, hep3B, Caki-1, good correlations were shown from the results of SRB assay and those of clogenetic assay. 2. The oral administration of Jinryungtang Gagambang extract showed significant effects of increase of MST(mean survival time) and ILS(increased life span) depending on the increasing concentration. 3. Against squamous cell carcinoma induced by MCA, Jinryungtang Gagambang decreased not only the frequency of tumor production but also the number and weight of tumors per tumor bearing mice(TBM). Jinryungtang Gagambang also significantly suppressed the development of 3LL cell-implanted tumors by frequency and their size, and some developed tumors were regressed by the continuous treatment of Jinryungtang Gagambang extract into TBM. 4. Jinryungtang Gagambang extract also increased NK cell activities. According to the above results, it could be suggested that Jinryungtang Gagambang extract has prominent antiutmor effect.

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The Effects of Formative Assessment Using Mobile Applications on Interest and Self-Directedness in Science Instruction (모바일을 활용한 형성평가가 과학수업의 흥미성과 자기주도성에 미치는 영향)

  • Kwak, Hyoungsuk;Shin, Youngjoon
    • Journal of The Korean Association For Science Education
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    • v.34 no.3
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    • pp.285-294
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    • 2014
  • This study investigates the effects of formative assessment utilizing mobile applications on interest and self-directedness in science instruction. The study subjects are two 6th grade classes from H elementary school located in Incheon, and the experimental group and the comparative group are composed of 21 students, respectively. The students from the experimental group have been taught with mobile devices while the comparative group has been taught in methods consistent with the current teaching standards. For the sake of research, the results of the method applied to the mobile device focus group have been edited using Google Drive Forms, entered as QR codes and stored in order for them to later be utilized for teaching and learning process. In the process, the teacher has provided the students with feedback based on their answers. The students of comparative group are to solve the same formative assessment in paper. As a result, the teacher of the mobile device focus group has been able to go through twenty-nine questions on formative assessment in the teaching and learning process, confirm the correct answers five times and provide feedback twenty-five times for additional explanation. In the inquiry about interest, the mobile device group scored 4.64 points and the standard one scored just 1.99 points (p<0.01). Fifteen students answered in the interview that and the major reason why they scored high has been because it was fun to study with mobile devices. When it comes to self-directedness over the process of teaching and learning, the mobile device focus group has answered positively but the standard group has scored relatively low (p<0.01).

EHen of Flavonoid(+)-Catechin as Stabilizer in Rat Fed Fresh and Peroxidized Fish Oil (어유 및 과산화 어유를 섭칠한 횐쥐에 있어서 플라보노이드 (+)-카데킨의 산화안정 효과)

  • 권미나;최재수;변대석
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.22 no.4
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    • pp.381-391
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    • 1993
  • To evaluate the antioxidizing effect of flavonoid on fish oil and peroxidized fish oil, rats were fed with diets containing 5% corn oil (CO), 5% corn oil and 15% fresh fish oil (FO) or peroxidixed fish oil (PFO) for 4weeks. An half of FO and PFO group rats were injected with 10mg flavonoid (+)-catechin (a day per kg body weight) (FO-C and PFO-C). FO and FO-C group rats showed higher increase in body weight as compared to PFO, PFO-C group rats. Whereas, the opposite result was obtained in case of liver weight increase. In addition, catechin apparently reduced liver weight by 12~17%. Phospholipid, cholesterol, triglyceride and lipid peroxide content in serum and cholesterol, lipid peroxide content in liver and adipose tissue of PFO, PFO-C group rats were significantly higher than those of FO, FO-C one. These results suggested that catechin reduced the synthesis of lipid and protected effectively against lipid peroxidation. In fatty acids profile of neutral lipid and phospholipid, the ratio of polyunsaturated fatty acids (PUFA) versus saturated fatty acids (SFA) in PFO, PFO-C were lower than that of FO or FO-C because of ruduced PUFA. Contrary to our expectation, the enzyme activities of superoxide dismutase(SOD), catalase and glutathione peroxidase (GSH-Px) in rat liver of FO and FO-C group were lower than those of PFO and PFO-C group. These results were quite interesting and might be explained in terms of homeostasis. In case of total lipid in liver, $C_{20:5}$, $C_{22:6}$ fatty acids were decreased in rat fed peroxidized fish oil. In conclusion, catechin was considered to be an antioxidative and hepatoprotective drug and hypolipidemic agent.

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Quality Characteristics of Baked Yakgwa Containing Different Amounts of Perilla frutescens Powder (자소엽 첨가량에 따른 구운 약과의 품질 특성)

  • Kim, Su In;Lee, Jin Seon;Son, Da Kyung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.46 no.9
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    • pp.1106-1113
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    • 2017
  • The objective of this study was to determine the quality characteristics of fried yakgwa and baked yakgwa prepared with different amounts of P. frutescens powder. Moisture contents of fried yakgwa were 7.05%, and moisture content of baked yakgwa with different amounts of P. frutescens powder were 12.42~10.44% and decreased with higher amount of P. frutescens powder. This result can be attributed to loss of water in yakgwa in the course of the fried process. Although the degree of expansion of baked yakgwa was lower than that of fried yakgwa, size and shape of yakgwa were maintained. Yakgwa is appropriate as a cookie type product. Crude lipid contents of fried yakgwa were higher than those of baked yakgwa due to the exchange reaction of water and fat during the fried process. Energy of fried yakgwa was 501 kcal and was higher than that of baked yakgwa with different amounts of P. frutescens powder. This greatly affected the fat content of each sample. Energy of baked yakgwa increased with higher amount of P. frutescens powder due to the characteristics of the ingredients or jasoyeop. For chromaticity determination, L values of fried yakgwa were lower, but a, and b values were higher than those of baked yakgwa, and L, a, and b values decreased when P. frutescens powder increased. Texture measurement showed that hardness, cohesiveness, chewiness, gumminess increased with higher amounts of P. frutescens powder, whereas springiness decreased. The antioxidant activities of fried yakgwa measured based on DPPH scavenging activity were higher than those of baked yakgwa with 0%~0.2% P. frutescens powder and lower than those of baked yakgwa with 0.3%~0.4% P. frutescens powder. In the sensory evaluation, baked yakgwa with 0.1% addition of P. frutescens powder showed the highest preference in terms of overall acceptance, and 0% addition of P. frutescens powder showed the highest preference in terms of color and flavor. These results suggest that P. frutescens powder may be a useful ingredient in baked yakgwa to improve quality and sensory properties.

Photoprotection and Anti-inflammatory Effects of Chinese Medical Plants (약용식물추출물의 광보호 효과와 항염증 효과 연구)

  • Jin-Hwa, Kim;Sung-Min, Park;Gwan-Sub, Sim;Bum-Chun , Lee;Hyeong-Bae, Pyo
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.30 no.2
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    • pp.227-233
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    • 2004
  • Chronic exposure to solar radiation, particularly ultraviolet (UV) light, causes a variety of adverse reactions on human skin, such as sunburn, photoaging and photocarcinogenesis. Free radicals and reactive oxygen species (ROS) caused by UV exposure or other environmental facts play critical roles in cellular damage. And, repeated-UV irradiation activated the expression of the matrix metalloproteinase (MMP) and induced skin irritation. Therefore, the development of effective and safe photoprotectants that can reduce and improve the skin damage has been required. The purpose of this study was to investigate the photo-protective effect of several chinese medical plants (Juniperus chinensis) on the UV -induced skin cell damages. We tested free radical and superoxide scavenging effect in vitro. Fluorometric assays of the proteolytic activities of MMP-1 (collagenase) were performed using fluorescent collagen substrates. UVA induced MMP-1 synthesis and activity were analyzed by enzyme-linked immunosorbent assay (ELISA) and gelatin-based zymography in skin fibroblasts. We also examined anti-inflammatory effects by the determination test of proinflammatory cytokine, interleukin 6 in HaCaT keratinocytes. Expression of prostaglandin E$_2$ (PGE$_2$) after UVB irradiation was measured by competitive enzyme immunoassay(EIA) using PGE$_2$ monoclonal antibody. In the human skin we tested anti-irritation effect on the SLS-induced damage skin after appling the extract containing emulsion. We found that Juniperus chinensis extract had potent radical scavenging effect by 98% at 100$\mu\textrm{g}$/mL. The extract of Juniperus chinensis showed strong inhibitory effect on MMP-1 activities by 97% at 100 $\mu\textrm{g}$/mL and suppressed the UVA induced expression of MMP-1 by 79% at 25$\mu\textrm{g}$/mL. This extract also showed strong inhibition on MMP-2 activity in UVA irradiated fibroblast by zymography. In the test of proinflammatory cytokines of human keratinocytes Juniperus chinensis extract decreased expression of interleukin 6 about 30%. The amount of PGE$_2$ by HaCaT keratinocytes was significantly increased at the doses of above 10 mJ/$\textrm{cm}^2$ of UVB (p < 0.05). At the concentrations of 3.2-25$\mu\textrm{g}$/mL of this extract, the production of PGE$_2$ by HaCaT keratinocytes (24 h after 10mJ/$\textrm{cm}^2$ UVB irradiation) was significantly inhibited in culture supernatants (p < 0.05). In SLS-induced skin irritation model in vivo, we found to reduce skin erythema and improve barrier recovery after appling Juniperus chinensis extract containing emulsion when compared to irritated non-treated and placebo-treated skin. Our results suggest that Juniperus chinensis extract can be effectively used for the prevention of UV and SLS-induced adverse skin reactions and applied as anti-aging and anti-irritation cosmetics.

Modeling Study of Development of Dying Well Education Program for the Medical Personnel in Korea (의료진 대상 웰 다잉 교육프로그램 개발을 위한 모델링에 관한 연구)

  • Kim, Kwang-Hwan;Kim, Yong-Ha;Ahn, Sang-Yoon;Lee, Chong Hyung;Hwang, Hye-Jeong;Lee, Moo-Sik;Kim, Moon-Joon;Park, Arma;Shim, Moon-Sook;Song, Hyeon-Dong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.10
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    • pp.6234-6241
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    • 2014
  • The purpose of this study was to examine the status of medical staff stress and accommodating manners on the death of patients in a hospital setting for serving the basic information to develop a death education program of medical personnel from April 1 to April 30, 2014. A survey was performed on 353 medical personnel at K university hospital, located in Daejeon metropolitan city. Frequency analysis, chi-square test, and independent t-test were used to analyze the data. The results showed that 'to understand the value of the time and preparedness of a meaningful future' were the most important perspectives on the contents of death education (p<0.05), 'in order to change perceptions and attitudes toward death positively' was the most important reason why they required death education'(p<0.05), 'case-based teaching and problem-based learning' was the most effective way of death education (p<0.05), 'negative or hostile response of a patient's guardian to medical personnel' was the largest stress that medical personnel confront upon witnessing a death'(p<0.05). An understanding of the death of patients by medical personnel and an awareness of the need for death education will help improve the understanding of the patient, their guardian, and medical personnel themselves. The main findings will contribute to the development of a specific death education program on the medical personnel in a hospital setting.