• Journal of Digestive Cancer Research
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• v.1 no.1
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• pp.36-42
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• 2013

Background/Aims: Gemcitabine is regarded as a reference regimen for advanced pancreatic cancer and shows relatively safe toxicity profiles compared with other cytotoxic agents. However, many oncologists are appeared to be still reluctant to treat elderly pancreatic cancer patients with cytotoxic chemotherapy because of predicted low response rate and potential adverse events. Methods: All patients who were received gemcitabine based chemotherapy between 2007 and 2010 were identified and clinical, laboratory, radiographic data were retrospectively reviewed. Patients were divided into two groups based on their ages: less than 65, and equal or more than 65 years old. Gemcitabine, at a dose of 1,000 mg per square meter of body surface area, was administered by intravenously over 30 minutes weekly for 3 weeks followed by 1 week rest, alone or along with other chemotherapeutic agents including cisplatin, capecitabine and erlotinib. Results: A total of 61 patients were identified and all patients were not eligible to receive operation because of advanced stage at diagnosis. Twenty three patients (37.7%) were equal or more than 65 year of age. Mean age was 56 years old and 71 years old in each group. Laboratory data including CA 19-9 were not significantly different. More gemcitabine monotherapy was delivered (56.5% vs. 26.3%, p=0.029) and less second or third line therapy was adminis- tered (17.4% vs. 50.0%, p=0.014) in elderly group. Cholangitis occurred and stent placement were performed similarly in both groups. Conclusion: Gemcitabine based chemotherapy can be administered safely to elderly pancreatic cancer patients and comparable response rate and progression free survival can be expected as young patients.

• Journal of Practical Agriculture & Fisheries Research
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• v.25 no.4
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• pp.118-126
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• 2024

Recently, the alternative meat (food) market is growing rapidly due to the increase in meat consumption due to global population growth and income improvement, as well as issues such as equal welfare, carbon neutrality, and sustainability. The government is also developing a green bio convergence new industry development plan to foster alternative foods, but there are difficulties in commercialization due to the lack of technology and insufficient production facilities among domestic small and medium-sized enterprises, so it is necessary to build joint utilization facilities and equipment to resolve the difficulties faced by companies. am. In addition, small and medium-sized enterprises are having difficulty developing and commercializing plant-based meat substitutes due to a lack of technical skills, and related equipment is expensive, making it difficult to build equipment on their own. Accordingly, Jeollabuk-do is pursuing a strategy to secure the source technology for development, processing, and industrialization of plant-based substitute meat at the level of developed countries by establishing a plant-based alternative meat industrialization center. In this study, an economic feasibility analysis study was conducted when a plant-based alternative meat industrialization center is built in Jeollabuk-do. As a result of the analysis, B/C=1.32, NPV=374 million won, and IRR=4.8%, showing that there is economic feasibility in establishing an alternative meat industrialization center. In addition, as a result of analyzing the regional economic ripple effect resulting from the establishment of an industrialization center, if 38 billion won is invested in Jeollabuk-do, the nationwide production inducement effect is 74 billion won, the added value inducement effect is 29.8 billion won, and the employment inducement effect is 672 people

• Journal of Korean Society of Forest Science
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• v.113 no.1
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• pp.107-117
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• 2024

This study investigated temporal changes in forest physical variables and their effects on thermal comfort and physiological and psychological responses. Environmental factors (air temperature, mean radiant temperature, wind speed, and relative humidity), the predicted mean vote (PMV), and the predicted percentage of dissatisfied (PPD) visitors were continuously measured between 9:00 AM and 6:00 PM. We assessed the physiological and psychological responses (heart rate variability, heart rate, oral temperature, blood pressure, pulse rate, thermal sensation vote, comfort sensation vote, and subjective feelings) of 30 male university students (average age: 21.7±1.9 years), who closed their eyes and relaxed for 5 minutes every hour. Examination of correlations between environmental factors and physiological responses showed that ① the mean radiant temperature, wind speed, and relative humidity significantly changed with time; ② PMV and PPD also showed significant changes over time, and the thermal sensation vote corresponded with PMV; however, the comfort sensation vote did not correspond with PPD; ③ Among the physiological responses, parasympathetic nerve activity, sympathetic nerve activity, heart rate, and diastolic blood pressure significantly varied with time, with parasympathetic nerve activity having the lowest value and sympathetic nerve activity the highest at the highest air temperature (2:00-4:00 PM); and ④ Air temperature, mean radiant temperature, and wind speed showed a negative correlation with parasympathetic nerve activity and a positive correlation with sympathetic nerve activity. These findings indicate that the relaxation effects of the forest environment depend on what time of day people are exposed to it, and the changes occurring in forest environmental factors over time modulate these effects.

• Journal of Chest Surgery
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• v.37 no.3
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• pp.210-219
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• 2004

Extracellular $K^{+}$ concentration ([ $K^{+}$]$_{0}$ ) can be increased within several mM by the efflux of intracellular $K^{+}$. To investigate the effect of an increase in [ $K^{+}$]$_{0}$ on vascular contractility, we attempted to examine whether extracellular $K^{+}$ might modulate vascular contractility, endothelium-dependent relaxation (EDR) and intracellular $Ca^2$$^{+}$ concentration ([C $a^2$$^{+}$]$_{i}$ ) in endothelial cells (EC). We observed isometric contractions in rabbit carotid, superior mesenteric, basilar arteries and movse aorta. [C $a^2$$^{+}$]$_{i}$ was recorded by microfluorimeter using Fura-2/AM in EC. No change in contractility was recorded by the increase in [ $K^{+}$]$_{0}$ from 6 to 12 mM in conduit artery such as rabbit carotid artery. whereas resistant vessels, such as basilar and branches of superior mesenteric arteries (SMA), were relaxed by the increase. In basilar artery, the relaxation by the increase in [ $K^{+}$]$_{0}$ to from 1 to 3 mM was bigger than that by the increase from 6 to 12 mM. In contrast, in branches of SMA, the relaxation by the increase in [ $K^{+}$]$_{0}$ to from 6 to 12 mM is bigger than that by the increase from 1 to 3 mM. $Ba^2$$^{+}$ (30 $\mu$M) did not inhibit the relaxation by the increase in [ $K^{+}$]$_{0}$ from 1 to 3 mM but did inhibit the relaxation by the increase from 6 to 12 mM. In the mouse aorta without the endothelium or treated with $N^{G}$_nitro-L-arginine (30 $\mu$M), nitric oxide synthesis blocker, the increase in [ $K^{+}$]$_{0}$ from 6 to 12 mM did not change the magnitude of contraction induced either norepinephrine or prostaglandin $F_2$$_{\alpha}$. The increase in [ $K^{+}$]$_{0}$ up to 12 mM did not induce contraction of mouse aorta but the increase more than 12 mM induced contraction. In the mouse aorta, EDR was completely inhibited on increasing [ $K^{+}$]$_{0}$ from 6 to 12 mM. In cultured mouse aorta EC, [C $a^2$$^{+}$]$_{i}$ , was increased by acetylcholine or ATP application and the increased [C $a^2$$^{+}$]$_{i}$ , was reduced by the increase in [ $K^{+}$]$_{0}$ reversibly and concentration-dependently. In human umbilical vein EC, similar effect of extracellular $K^{+}$ was observed. Ouabain, a N $a^{+}$ - $K^{+}$ pump blocker, and N $i^2$$^{+}$, a N $a^{+}$ - $Ca^2$$^{+}$ exchanger blocker, reversed the inhibitory effect of extracellular $K^{+}$. In resistant arteries, the increase in [ $K^{+}$]$_{0}$ relaxes vascular smooth muscle and the underlying mechanisms differ according to the kinds of the arteries; $Ba^2$$^{+}$-insensitive mechanism in basilar artery and $Ba^2$$^{+}$ -sensitive one in branches of SMA. It also inhibits [C $a^2$$^{+}$]$_{i}$ , increase in EC and thereby EDR. The initial mechanism of the inhibition may be due to the activation of N $a^{+}$ - $K^{+}$pump. activation of N $a^{+}$ - $K^{+}$pump.p.p.p.

• The Korean Journal of Air & Space Law and Policy
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• v.35 no.2
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• pp.313-374
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• 2020

The idea of creating a new International Space Agency (ISA) is only my academic and practical opinion. It is necessary for us to establish ISA as an international organization for the efficient and rapid exploitation of natural resources in the moon, Mars and other celestial bodies. The establishment of ISA as a new international regime is based on the Article 11, 5 and Article 18 of the 1979 Moon Agreement. In order to establish as a preliminary procedure, it needs to make a "Draft for the Convention on the Establishment of an International Space Agency" among the space-faring countries. In this paper, I was examined the domestic space legislation in the United States, Luxembourg, European Space Agency, China, Japan, the Republic of Korea as well as space exploration and planning of the moons, Mars, Asteroids, Venus, Jupiter, Saturn, Titan and Other Celestial Bodies. The creation of an ISA would lead to a strengthening of the cooperation needed essentially by the developed countries towards joint and cooperative undertakings in space and would act as a catalyst for the space exploration and exploitation of the moon, Mars and other celestial bodies. It will be managed effectively and centrally the exploitation and exploitation of space the natural resources, technology, manpower and finances as an independent organization in order to get the benefit of the space developed countries by ISA. It is desirable and necessary for us to establish ISA in order to promote cooperation in space policy, law, science technology and industry among the space developed countries in the near future. The establishment of the ISA will be promoted the international cooperation among the space-faring countries in exploration and exploitations of the natural resources in the moon and other celestial bodies. I would propose the "Draft for the Convention for the Establishment of an International Space Agency." in refering the "Convention for the Establishment of a European Space Agency." This "Draft for the Convention Convention for the Establishment of an ISA" must pass the abovementioned "Draft for the Convention" by two-third majority of Diplomatic Conference in the UNCOPUOS. Finally, a very important point is need that a political drive at the highest level and a solemn statement by heads of state of the space devloped countries including the United Nations for the space exploitation of the medium and long term. It should be noted that this political drive will be necessary not only to set up the organization, but also during a subsequent period. It is desirable and necessary for us to establish the ISA in order to develop the space industry, to strengthen friendly relations and to promote research cooperation among the space-faring countries based on the new ideology and creative ideas. If the heads of the superpowers including the United Nations will be agreed to establish ISA at a summit conference, 1 am sure that it is possible to establish an ISA in the near future.

• Journal of Preventive Medicine and Public Health
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• v.5 no.1
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• pp.57-95
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• 1972

This study was conducted to assess the effectiveness of service by maternity aids concerning maternal and child health in improving simultaneously infant mortality, contraception and vital registration among expectant mothers in rural Korea, where there is less apportunity for maternal and child health care. It is unrealistic to expect to solve this problem in rural Korea through professional persons considering the situation of medical facilities and the socioeconomic condition of residents. So, we intended to adopt a system of services by maternity aids who were educated formally among indigenous women. After the women were trained in maternal and child health, contraception, and registration for a short period, they were assigned as a maternity aids to each village to help with various activities concerning maternal and child health, for example, registration of pregnant women, home visiting to check for complications, supplying of delivery kits, attendance at delivery, persuasion of contraception, and invitation for registration and so on. Mean-while, four researchers called on the maternity aids to collect materials concerning vital events, maternal child health, contraception and registration, and to give further instruction and supervision as the program proceeded. A. Changes of women's attitude by services of maternity aid. Now, we examined to what extent' such a service system to expectant mothers affected a change in attitude of women residing in the study area as compared to women of the control area. 1) In the birth and death places, there were no changes between last and present infants, in study or control area. 2) In regard to attendants at delivery, there were no changes except for a small percentage of attendance (8%) by maternity aid in study area. But, I expect that more maternity sids could be used as attendants at delivery if they would be trained further and if there was more explanation to the residents about such a service. 3) Considering the rate of utilization of sterilized delivery kit, I am sure that more than 90 percent would be used if the delivery kit were supplied in the proper time. There were significant differences in rates between the study and the control areas. 4) Taking into consideration the utilization rate of the clinic for prenatal care and well baby care, if suck facilities were installed, it would probably be well utilized. 5) In the contraception, the rate of approval was as high as 89 percent in study area as compared to 82 percent in the control area. 6) Considering the rate of pre-and post-partum acceptance on contraception were as much as 70 percent or more, if motivation to use contraception was given to them adequately, the government could reach the goals for family planning as planned. 7) In the vital registration, the rate of birth registration in the study area was some what improved compared to that of the control area, while the rate of death registration was not changed at all. Taking into account the fact that the rate of confirmation of vital events by maternity aids was remarkably high, if the registration system changed to a 'notification' system instead of formal registration ststem, it would be improved significantly compared to present system. B. Effect of the project Thus, with changes in the residents' attitude, was there a reduction in the infant death rate? 1) It is very difficult problem to compare the mortality of infants between last and present infants, because many women don't want to answer accurately about their dead children especially the infants that died within a few days after birth. In this study the data of present death comes from the maternity aides who followed up every pregnancy they had recorded to see what had happened. They seem to have very reliable information on what happened in first few weeks with follow up visitits to check out later changes. From these calculaton, when we compared the rate of infant death between last and present infant, there was remarkable reduction of death rate for present infant compare to that of last children, namely, the former was 30, while the latter 42. The figure is the lowest rate that I have ever heard. As the quality of data we could assess by comparing the causes of death. In the current death rate by communicable disease was much lower compare to the last child especially, tetanus cases and pneumonia. 2) Next, how many respondents used contraception after birth because of frequent contact with the maternity aid. In the registered cases, the respondents showed a tendency to practice contraception at an earlier age and with a small number of children. In a comparison of the rate of contraception between the study and the control area, the rate in the former was significantly higher than that of the latter. What is more, the proportion favoring smaller numbers of children and younger women rose in the study area as compared to the control area. 3) Regarding vital registration, though the rate of registration was gradually improved by efforts of maternity aid, it would be better to change the registration system. 4) In the crude birth rate, the rate in the study area was 22.2 while in the control area was 26.5. Natural increase rate showed 15.4 in the study area, while control area was 19.1. 5) In assessment of the efficiency of the maternity aids judging by the cost-effect viewpoint, the workers in the Medium area seemed to be more efficiency than those of other areas.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.35 no.3
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• pp.41-66
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• 2017

The purpose of this research is to empirically trace the junctures of Yigye-gugok managed by Gwan-am Hong Gyeong-mo, a grandson of Yigye Hong Yang-ho who originally designed Yigye-gugok, while reviewing the features of the forms and patterns of gugok. The results of the research are as follows. 1. Ui-dong was part of the domain of the capital during the Chosun dynasty, which also is located in the city of Seoul as a matter of administrative zone. Likewisely, Yigye-gugok is taken as a special meaning for it was one and only gugok. Starting with Mangyeong Waterfall as the $1^{st}$ gok, Yigye follows through the $2^{nd}$ gok of Jeokchwibyeong Rock, the $3^{rd}$ gok of Chanunbong Peak, the $4^{th}$ gok of Jinuigang Rock, the $5^{th}$ gok of Okkyeongdae Rock, the $6^{th}$ gok of Wolyeongdam Pond, the $7^{th}$ gok of Tagyeongam Rock, the $8^{th}$ gok of Myeongoktan Stream, and the $9^{th}$ gok of Jaeganjeong Pavilion. Of these, Mangyeong Waterfall, Chanunbong Peak, and Okkyeongdae Rock are distinct for their locations in as much as their features, while estimated locations for Jinuigang Rock, Wolyeongdam Pond, Myeongoktan Stream, and Jaeganjeong Pavilion were discovered. However, Jeokchwibyeong Rock and Tagyeongam Rock demonstrated multiple locations in close resemblance to documentary literatures within secretive proximity, whereas geography, scenery, and sighted objects were considered to evaluate the 1st estimated location. Through these endeavored, it was possible to identify the shipping routes and structures for the total distance of 2.1km running from the $1^{st}$ gok to the $9^{th}$ gok, which nears Gwanam's description of 5ri(里), or approximately 1.96km for gugok. 2. Set towards the end of the $18^{th}$ century, Yigye-gugok originated from a series of work shaping the space of Hong Yang-ho's tomb into a space for the family. Comparing Yigye-gugok to other gugoks, numerous differences are apparent from beyond the rather more general format such as adjoining the $8^{th}$ gok while paving through the lower directions from the upper directions of the water. This gives rises to the interpretation such that Yigye-gugok was positioned to separate the doman of the family from those of the other families in power, thereby taking over Ui-dong. Yet, the aspect of the possession of the space lends itself to the determination that the location positioned at the $8^{th}$ gok above Mangyeongpok Waterfall representing Wooyi-dong was a consequence of the centrifugal space creation efforts. 3. While writings and poetic works were manufactured in such large quantities in Yigye-gugok whose products of setters and managers seemed intended towards gugok-do and letters carved on the rocks among others, there is yet a tremendous lack of visual media in the same respect. 'Yigye-gugok Daejacheop' Specimens of Handwriting offers the traces of Gwanam's attempts to engrave gakja at the food of Yigye-gugok. This research was able to ascertain that 'Yigye-gugok Daejacheop' Specimens of Handwriting was a product of Hong Yang-ho's collections maintained under the auspices of the National Central Museum, which are renowned for Song Shi-yeol's penmanship.

• Journal of environmental and Sanitary engineering
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• v.24 no.4
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• pp.1-26
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• 2009

We conclude the following with air pollution data measured from city measurement net administered and managed in Gwangju for the last 7 years from January in 2001 to December in 2007. In addition, some major statistics governed by Gwangju city and data administered by Gwangju as national official statistics obtained by estimating the amount of national air pollutant emission from National Institute of Environmental Research were used. The results are as follows ; 1. The distribution by main managements of air emission factory is the following ; Gwangju City Hall(67.8%) > Gwangsan District Office(13.6%) > Buk District Office(9.8%) > Seo District Office(5.5%) > Nam District Office(3.0%) > Dong District Office(0.3%) and the distribution by districts of air emission factory ; Buk District(32.8%) > Gwangsan District(22.4%) > Seo District(21.8%) > Nam District(14.9%) > Dong District(8.1%). That by types(Year 2004~2007 average) is also following ; Type 5(45.2%) > Type 4(40.7%) > Type 3(8.6%) > Type 2(3.2%) > Type 1(2.2%) and the most of them are small size of factory, Type 4 and 5. 2. The distribution by districts of the number of car registrations is the following ; Buk District(32.8%) > Gwangsan District(22.4%) > Seo District(21.8%) > Nam District(14.9%) > Dong District(8.1%) and the distribution by use of car fuel in 2001 ; Gasoline(56.3%) > Diesel(30.3%) > LPG(13.4%) > etc.(0.2%). In 2007, there was no ranking change ; Gasoline(47.8%) > Diesel(35.6%) > LPG(16.2%) >etc.(0.4%). The number of gasoline cars increased slightly, but that of diesel and LPG cars increased remarkably. 3. The distribution by items of the amount of air pollutant emission in Gwangju is the following; CO(36.7%) > NOx(32.7%) > VOC(26.7%) > SOx(2.3%) > PM-10(1.5%). The amount of CO and NOx, which are generally generated from cars, is very large percentage among them. 4. The distribution by mean of air pollutant emission(SOx, NOx, CO, VOC, PM-10) of each county for 5 years(2001~2005) is the following ; Buk District(31.0%) > Gwangsan District(28.2%) > Seo District(20.4%) > Nam District(12.5%) > Dong District(7.9%). The amount of air pollutant emission in Buk District, which has the most population, car registrations, and air pollutant emission businesses, was the highest. On the other hand, that of air pollutant emission in Dong District, which has the least population, car registrations, and air pollutant emission businesses, was the least. 5. The average rates of SOx for 5 years(2001~2005) in Gwangju is the following ; Non industrial combustion(59.5%) > Combustion in manufacturing industry(20.4%) > Road transportation(11.4%) > Non-road transportation(3.8%) > Waste disposal(3.7%) > Production process(1.1%). And the distribution of average amount of SOx emission of each county is shown as Gwangsan District(33.3%) > Buk District(28.0%) > Seo District(19.3%) > Nam District(10.2%) > Dong District(9.1%). 6. The distribution of the amount of NOx emission in Gwangju is shown as Road transportation(59.1%) > Non-road transportation(18.9%) > Non industrial combustion(13.3%) > Combustion in manufacturing industry(6.9%) > Waste disposal(1.6%) > Production process(0.1%). And the distribution of the amount of NOx emission from each county is the following ; Buk District(30.7%) > Gwangsan District(28.8%) > Seo District(20.5%) > Nam District(12.2%) > Dong District(7.8%). 7. The distribution of the amount of carbon monoxide emission in Gwangju is shown as Road transportation(82.0%) > Non industrial combustion(10.6%) > Non-road transportation(5.4%) > Combustion in manufacturing industry(1.7%) > Waste disposal(0.3%). And the distribution of the amount of carbon monoxide emission from each county is the following ; Buk District(33.0%) > Seo District(22.3%) > Gwangsan District(21.3%) > Nam District(14.3%) > Dong District(9.1%). 8. The distribution of the amount of Volatile Organic Compound emission in Gwangju is shown as Solvent utilization(69.5%) > Road transportation(19.8%) > Energy storage & transport(4.4%) > Non-road transportation(2.8%) > Waste disposal(2.4%) > Non industrial combustion(0.5%) > Production process(0.4%) > Combustion in manufacturing industry(0.3%). And the distribution of the amount of Volatile Organic Compound emission from each county is the following ; Gwangsan District(36.8%) > Buk District(28.7%) > Seo District(17.8%) > Nam District(10.4%) > Dong District(6.3%). 9. The distribution of the amount of minute dust emission in Gwangju is shown as Road transportation(76.7%) > Non-road transportation(16.3%) > Non industrial combustion(6.1%) > Combustion in manufacturing industry(0.7%) > Waste disposal(0.2%) > Production process(0.1%). And the distribution of the amount of minute dust emission from each county is the following ; Buk District(32.8%) > Gwangsan District(26.0%) > Seo District(19.5%) > Nam District(13.2%) > Dong District(8.5%). 10. According to the major source of emission of each items, that of oxides of sulfur is Non industrial combustion, heating of residence, business and agriculture and stockbreeding. And that of NOx, carbon monoxide, minute dust is Road transportation, emission of cars and two-wheeled vehicles. Also, that of VOC is Solvent utilization emission facilities due to Solvent utilization. 11. The concentration of sulfurous acid gas has been 0.004ppm since 2001 and there has not been no concentration change year by year. It is considered that the use of sulfurous acid gas is now reaching to the stabilization stage. This is found by the facts that the use of fuel is steadily changing from solid or liquid fuel to low sulfur liquid fuel containing very little amount of sulfur element or gas, so that nearly no change in concentration has been shown regularly. 12. Concerning changes of the concentration of throughout time, the concentration of NO has been shown relatively higher than that of $NO_2$ between 6AM~1PM and the concentration of $NO_2$ higher during the other time. The concentration of NOx(NO, $NO_2$) has been relatively high during weekday evenings. This result shows that there is correlation between the concentration of NOx and car traffics as we can see the Road transportation which accounts for 59.1% among the amount of NOx emission. 13. 49.1~61.2% of PM-10 shows PM-2.5 concerning the relationship between PM-10 and PM-2.5 and PM-2.5 among dust accounts for 45.4%~44.5% of PM-10 during March and April which is the lowest rates. This proves that particles of yellow sand that are bigger than the size $2.5\;{\mu}m$ are sent more than those that are smaller from China. This result shows that particles smaller than $2.5\;{\mu}m$ among dust exist much during July~August and December~January and 76.7% of minute dust is proved to be road transportation in Gwangju.

• Journal of the Korean Society of Food Science and Nutrition
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• v.43 no.10
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• pp.1594-1606
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• 2014

The purpose of this study was to examine safety accidents related to school foodservice, working and operating environments of school foodservice, status and awareness of safety education, educational needs, and information on qualitative improvement of school foodservice. The subjects in this study were 234 cooks in charge of cooking at elementary and secondary schools in Chungbuk. A survey was conducted from July 30 to August 8, 2012, and among 202 questionnaires gathered, 194 completed questionnaires were analyzed. Statistical analyses were performed on data utilizing the SPSS version 19.0. The main results of this study were as follows: 44.3% of workers experienced safety accidents. The most frequent safety accident was 'once' (60.5%), and most safety accidents took place between June and August (31.4%). The time at which most safety accidents happened was between 8 and 11 am. Most safety accidents happened during cooking (52.3%) and while using a soup pot or frying pot (52.4%). The most common accidents were 'burns', 'wrist and arm pain', and 'slips and falls'. Respondents who experienced safety accidents replied that 57.6% of employees dealt with injuries at their own expense, and only 35.3% utilized industrial accident insurance. In terms of the operating environment, the score for 'offering information and application' was highest (3.76 points), whereas that for 'security of budget' was lowest (1.77 points). As for accident education, employees received safety education approximately 3.45 times and 5.10 hours per year. Improving the working environment of school foodservice cooks requires administrative and financial support. Furthermore, educational materials and guidelines based on the working environment and safety accident status of school foodservice cooks are required in order to minimize potential risk factors and control safety accidents in school foodservice.

• Journal of Hospice and Palliative Care
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• v.5 no.2
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• pp.111-124
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• 2002

Purpose : Although the average life expectancy has increased due to advances in medicine, mortality due to cancer is on an increasing trend. Consequently, the number of terminally ill cancer patients is also on the rise. Predicting the survival period is an important issue in the treatment of terminally ill cancer patients since the choice of treatment would vary significantly by the patents, their families, and physicians according to the expected survival. Therefore, we investigated the prognostic factors for increased mortality risk in terminally ill cancer patients to help treat these patients by predicting the survival period. Methods : We investigated 31 clinical parameters in 157 terminally ill cancer patients admitted to in the Department of Family Medicine, National Health Insurance Corporation Ilsan Hospital between July 1, 2000 and August 31, 2001. We confirmed the patients' survival as of October 31, 2001 based on medical records and personal data. The survival rates and median survival times were estimated by the Kaplan-Meier method and Log-rank test was used to compare the differences between the survival rates according to each clinical parameter. Cox's proportional hazard model was used to determine the most predictive subset from the prognostic factors among many clinical parameters which affect the risk of death. We predicted the mean, median, the first quartile value and third quartile value of the expected lifetimes by Weibull proportional hazard regression model. Results : Out of 157 patients, 79 were male (50.3%). The mean age was $65.1{\pm}13.0$ years in males and was $64.3{\pm}13.7$ years in females. The most prevalent cancer was gastric cancer (36 patients, 22.9%), followed by lung cancer (27, 17.2%), and cervical cancer (20, 12.7%). The survival time decreased with to the following factors; mental change, anorexia, hypotension, poor performance status, leukocytosis, neutrophilia, elevated serum creatinine level, hypoalbuminemia, hyperbilirubinemia, elevated SGPT, prolonged prothrombin time (PT), prolonged activated partial thromboplastin time (aPTT), hyponatremia, and hyperkalemia. Among these factors, poor performance status, neutrophilia, prolonged PT and aPTT were significant prognostic factors of death risk in these patients according to the results of Cox's proportional hazard model. We predicted that the median life expectancy was 3.0 days when all of the above 4 factors were present, $5.7{\sim}8.2$ days when 3 of these 4 factors were present, $11.4{\sim}20.0$ days when 2 of the 4 were present, and $27.9{\sim}40.0$ when 1 of the 4 was present, and 77 days when none of these 4 factors were present. Conclusions : In terminally ill cancer patients, we found that the prognostic factors related to reduced survival time were poor performance status, neutrophilia, prolonged PT and prolonged am. The four prognostic factors enabled the prediction of life expectancy in terminally ill cancer patients.