• Journal of Chest Surgery
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• v.6 no.1
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• pp.7-14
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• 1973

Ventilatory functions and arterial respiratory gases were studied in 24 patients who underwent resectional surgery for pulmonary tuberculosis. Postoperative measurements were made 24 hours, 72 hours and 7 days after surgery and the results were compared to preoperative values. Twenty-four hours postoperatively, there occurred striking increase in respiratory rate, minute ventilation, dead space ventilation and dead space tidal volume ratio, and the increase in minute ventilation was caused primarily by the increase in respiratory rate. However, alveolar ventilation, oxygen consumption, carbon dioxide elimination and respiratory quotient showed no significant postoperative changes although two of the last values showed slight decreases 24 hours after surgery. The lowest arterial oxygen saturation level was obtained 24 hours postoperatively followed by gradual rises but not to the preoperative levels until 7 days after surgery. A decreased arterial carbon dioxide tension with elevated pit was noted 24 hours after surgery, which returned to the preoperative level on the following measurement.

• Journal of Hospice and Palliative Care
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• v.10 no.4
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• pp.190-194
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• 2007

Purpose: Individual cancer patients often experience many symptoms that impair their quality of life at the end of life. Identifying symptoms at the terminal stage of cancer patients and possible imminent death prediction by using that assessment can assist physicians and patients in preparing the 'peaceful death'. This study examines symptom experience during the last 48 hours of life of terminal cancer patients, and determines whether symptom experience change with proximal to death. Methods: The medical records of 89 patients who died with terminal cancer at a hospital between July 1, 2003 and March 31, 2006 were reviewed. Symptom prevalence at the last 48 hours was analyzed along with the change of symptom experience at the admission, $48{\sim}24$ hours, and $24{\sim}0$ hours before death. Results: Median age of all patients was 62 years old (range $16{\sim}97$). During the last 48 hours, symptom prevalence was described as follows; unclear consciousness (57%), pain (30%), fever (22%), and dyspnea (19%). According to the primary site, unclear consciousness was notified the most frequent symptom, but fever was relatively high prevalence in patients of biliary origin cancer rather than other site cancer (P=0.012). As death was Impending, the prevalence of poor appetite and general weakness were decreased, while that of unclear consciousness was increased, which were all statistically significant (P < 0.05). Conclusion: The presence of unclear consciousness could be regarded as the symptom indicator as imminent death of terminal canter patients.

• Journal of Hospice and Palliative Care
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• v.5 no.1
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• pp.17-23
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• 2002

Purpose : The prevalence of symptoms in patients with terminal cancer varies considerably and these symptoms are very difficult to control. However, patients can spend their last days or hours of life without suffering pain with appropriate care. One of the major concerns during last days of life is to predict the time of death. We would like to investigate symptom prevalence during terminal cancer patients' last 48 hours in Korea, and therefore contribute to predict the time of death and to help to determine appropriate treatments. Methods : The data for this study was recorded from 92 of 132 patients who died with terminal cancer at the hospital between February 1 and October 31, 2000. We investigated the symptom prevalence during the last 48 hours through medical obligation record and analyzed the changes of symptom prevalence at the admission, $48{\sim}24$ hours and $24{\sim}0$ hours before death. Results : The predominant symptom prevalence was pain (57.6%), followed by confusion (55.4%), dyspnea (48.9%), voiding difficulty (42.4%) in the last 48 hours before death. From the statistical analysis for the changes of symptom prevalence in time, pain, nausea and vomiting were decreased but noisy and moist breathing, sweating, groan, restlessness and agitation, and loss of consciousness were increased (P<0.05). Conclusion : The results from this study show the tendency to increase of prevalence of noisy and moist breathing, sweating, groan, restlessness and agitation as well as loss of consciousness in 48 hours before death. Therefore the symptoms above can be used for the important indicators to predict the imminent death.

• Environmental Analysis Health and Toxicology
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• v.23 no.1
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• pp.63-65
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• 2008

The tissue distribution of $TiO_2$, nanopaprticles was investigated in mice after oral administration, and skin treatment. Male mice were treated with the dose of 5 g/kg of $TiO_2$ for three consecutive days and sacrificed at 24 hours after the last administration. As results, the orally administered $TiO_2$ nanoparticels were shown to be distributed in the testis, lung, and brain at 24 hours after the last treatment. Kidney does not seem to be the main target of $TiO_2$ nanoparticle distribution. It means that $TiO_2$ nanoparticles (17 nm) are easily absorbed through entero-gastric system and may cause toxicity in brain, lung, and reproductive organs. The distribution of skin treatment showed the same pattern like oral administration.

• Environmental Analysis Health and Toxicology
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• v.23 no.2
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• pp.139-141
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• 2008

Tissue distribution of $SiO_2$ nanopaprticles was investigated in mice after oral administration or skin treatment. ICR Male mice were treated with $SiO_2$ nanoparticles 2.5 g/kg/day for five consecutive days and sacrificed at 24 hours after the last administration. As results, the orally administered $SiO_2$ nanoparticels were distributed in the testis and kidney but not in lung at 24 hours after the last treatment. In case of skin treatment, $SiO_2$ nanoparticles were distributed to lung as well as testis, brain, kidney and liver. The results suggested that $SiO_2$ nanoparticles (12 nm) are easily absorbed through entero-gastric system or skin.

• Journal of Hospice and Palliative Care
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• v.2 no.2
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• pp.125-137
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• 1999

Purpose : Surveying the rates, severity, and variables influencing depression and their correlation between pain and depression in Korean cancer patients, we attempted to provide a basic database for the effective depression management program. Methods : The results of survey were colleted from 10 patients who were hospitalized at Seoul National University Hospital for cancer treatment from February to June of 1999. Factors of depression and the level of pain were examined by self-reported survey employing Korean version of Beck Depression Inventory(BDI) and an abridged version of Brief pain Inventory respectively. The purpose of this study and guidelines for the questionnaires were clearly explained to participating patients by Resgitered Nurses before answering the survey. Demographic and clinical characteristics of patients were compiled by reviewing their medical records in corporation with a family physician. The difference in the level of depression among patient groups was analyzed with the t-test and ANOVA, and the correlation between variables with Pearson correlation coefficient. Results : 1) 142 subjects comprised 79 male and 63 female, and their mean age was 51.86. 2) The mean scores of the worst pain for last 24-hours was 6.08(SD 2.23), the average pain for last 24-hours 4.44(SD 1.85), and the mean scores of pain at the time of survey 3.48(SD 2.25), while the mean scores of the least pain for last 24-hours 2.25(SD 1.83). 3) The mean BDI scores were 23.73(SD 0.99), and 55.6% of patients were evaluated to be in depression(cutting point 21). Scores of depression for cancer patients were higher than normal population. 4) The correlation between worst pain for last 24-hours and depression(r=0.252, P=0.002), average pain for last 24-hours and depression(r=0.225, P=0.007), present pain and depression(r=0.291, P=0.000) were significant. 5) Significant differences were found among groups of cancer patients with pain with respect to gender(t=3.59, p=0.000), level of education(F=4.063, P=0.009), ECOG(F=3.352, P=0.021). There was significant positive correlation between depression and pain(r=0.171, P=0.042). Conclusions : More than 50% of cancer patients with pain are suffering from depression. We have shown that the variables like the degree of pain, gender, level of education, ECOG, and age are significantly related to the depression in cancer patients. The findings of this study may be used for assessing high-risk patients in need of intervention and for planning effective therapeutic strategies for them after the routine assessment. Further study is necessary to investigate the cultural differences and the variables influencing on depression in Korean cancer patients.

• Journal of Hospice and Palliative Care
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• v.1 no.1
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• pp.47-55
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• 1998

Background : It is almost important therapy modality to control pain for the terminal cancer patients for the last 24 hours because those terminally illed patient deserved to have pain free and peaceful time before death. Physician who is deal with terminal cancer patients for their last 24 hours does not need to worry about drug addiction or other untoward side reactions of pain medications. The purpose of this study was to evaluate if terminally illed cancer patient was given pain medication properly and sufficiently and if there was any different behavior to control pain of terminal cancer patients between medical physicians and surgeons in terms of type, amount and administration route and frequency. Methods : A retrospective chart audit of analgesic type, amount and administration route was performed on the medical recorders of 160 hospitalized terminal cancer patients who had died in the Korea University Medical Center Anam Hospital during the period of July 1, 1994 to June 30, 1995. Patients were classified into 103 patients were cared for by medical physicians and 57 patients were cared for by surgeons. After then, we analysed the difference of pain control pattern between them. Different types and amount of analgesics were converted to a common standard, an oral morphine equivalents(OME) relative to 1mg of oral morphine. Results : 1) The total number of patients was 160, male 102 cases(63.8%), and the female was 58 cases(36.2%) respectively. 2) The mean age was 56.4(${\pm}14.62$) years old and mean admission period was 27.8 days(${\pm}34.85$). 3) The frequent cancer site was stomach 42 cases(26.315), lung and liver 29 cases(18.1%) each, pancreas 10 cases(6.2%) in order 4) 125 out of 160 subjects (78.13%) complained pain, and 66 out of 103(64.08%) and 31 out of 57(54.39%) were treated with analgesics to relieve pain. 50 out of 97(51.55%) were able to continue on oral medication. 5) 86 cases(53.75%) were well oriented 24 hours prior to death. 6) The frequent analgesics for regular basis were long acting form of oral morphine 34 cases(Medical phsicians 24, Surgeons 10), intravenous morphine 26 cases(Medical physicians 20, Surgeons 6) in order, and the most common p.r.n.(pro re nata) analgesics used was intravenous morphine. 7) The mean amount of analgesics on regular basis was 115.41 OME by medical physicians and 52.7 OME by surseons(P<0.05). The mean amount of p.r.n. analgesics was significantly larger in patients are for by surgeons(66.64 OME) than medical physicians 23.49 OME(P<0.01). 8) The mean frequency of administrated number of p.r.n. analgesics was 0.62 times/day on medical part and 1.88 times/day on surgical part (P<0.001). Conclusion : Of the 97 patients with advanced cancer, 51.55% were able to take oral medications in the last day of life. The parenteral analgesics were more frequently used in the patients cared for by surgeons than medical physicians. Over the half of terminal cancer patients were well oriented in the last day of life. Doctor's knowledge and attitude towards pain is very important to mange the pain, effectively.

• Journal of Periodontal and Implant Science
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• v.26 no.4
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• pp.841-858
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• 1996

Epidermal growth factor(EGF) is one of polypeptide growth factors. EGF has been reported as a biological mediator which regulates activities of wound healing process including the cell proliferation, migration and metabolism. The purposes of this study is to evaluate the effects of EGF on the human periodontal ligament cells and human gingival fibroblast cells that promote regeneration of periodntal tissue. The mitogenic effects of epidermal growth factor on human periodontal ligament cells and human gingival fibroblasts were evaluated by determining the incorporation of 5-Bromo-2'-deoxy-uridine into DNA of the cells in a dose dependent manner. The prepared cells were the primary cultured gingival fibroblast and periodontal ligament cells from humans, the fourth or sixth subpassages were used in the experiments. Cells were seeded in DMEM containing 10% FBS. 1, 10, 50, 100, $200{\eta}g/ml$ and epidermal growth factor were added to the quiescent cells for 24 hours, 48 hours and 72 hours. They were labeled with $10\{mu}l/200{\mu}l$ 5-Bromo-2'-deoxy-uridine for the last 6 hours of each culture. The results of the five determinants were presented as mean and S.D.. The results were as follows : The DNA synthetic activity of human gingival fibroblasts were increased dose dependently by epidermal growth factor at 24 hours, 48 hours and 72 hours. The mitogenic effects were similar at the 24 and 48 hours of epidermal growth factor, but the DNA synthetic activity of human gingival fibroblasts generally decreased at 72 hours. The DNA synthetic activity of human periodontal ligament cells were increased dose dependently by epidermal growth factor at 24 hours but the DNA synthetic activity decreased at $200{\eta}g/ml$ of each hour. Generally the maximum mitogenic effects were observed at the 48 hours application of epidermal growth factor. The DNA synthetic activity of human periodontal ligament cells generally decreased lower at 24, 72 hours than at 48 hours the application of epidermal growth factor. In the comparison of DNA synthetic activity between human gingival fibroblasts and human periodontal ligament cells, human periodontal ligament cells had slightly higher proliferation activity than human gingival fibroblasts for a longer time at the high dosage of the epidermal growth factor. In conclusion, epidermal growth factor have important roles in the stimulation of DNA synthesis in human periodontal ligament cells and human gingival fibroblasts, and thus may be useful for clinical applications in periodontal regenerative procedures.

• Journal of Periodontal and Implant Science
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• v.26 no.2
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• pp.414-428
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• 1996

The use of basic fibroblast growth factor which function as potent biologic mediators regulating numerous activities of wound healing has been suggested for the promotion of periodontal regeneration. The mitogenic effects of basic fibroblast growth factor on human periodontal ligament cells and human gingival fibroblasts were evaluated by determining the incorporation of 5-Bromo-2'deoxy-uridine into DNA of the cells in a dose -dependent manner. The cells which were prepared were the primary cultured gingival fibroblasts and periodontal ligament cells from human the fourth or sixth subpassages were used in the experiments. The cells which were seeded DMEM contain 10% FBS. The added concentrations of basic fibroblast growth factor were 0.1, 1, 10, 50, $l00{\eta}g/ml$ and basic fibroblast growth factor were added to the quiescent cells for 24 hours, 48 hours and 72 hours. They were labeled with $10{\mu}l/200{\mu}l$ 5Bromo-2'-deoxy-uridine for the last 6 hours of each culture. The results of the five determinants were presented as mean and S.D.. The results were as follows. : The DNA synthetic activity of human gingival fibroblasts was increased dose dependently by basic fibroblast growth factor at 24 hours, 48 hours and 72 hours. The similar mitogenic effects were at the 24 and 48 hours of basic fibroblast growth factor, but the DNA synthetic activity of human gingival fibroblasts generally decreased at 72 hours. The DNA synthetic activity of human periodontal ligament cells was increased dose dependently to $50{\eta}g/ml$ by basic fibroblast growth factor at 24, 48 and 72 hours, but the DNA synthetic activity decreased at $l00{\eta}g/ml$ of each hour. Generally the maximum mitogenic effects were at the 48 hours application of basic fibroblast growth factor. The DNA synthetic activity of human periodontal ligament cells generally decreased lower at 72 hours than at 24, 48 hours the application of basic fibroblast growth factor. In the comparison of DNA synthetic activity between human gingival fibroblasts and human periodontal ligament cells, human periodontal ligament cells had slightly higher proliferation activity than human gingival fibroblasts for a longer time at the high dosage of the basic fibroblast growth factor.In conclusion, basic fibroblast growth factor have important roles in the stimulation of DNA synthesis in human periodontal ligament cells and human gingival fibroblasts, and thus may be useful for clinical applications in periodontal regenerative procedures.

• Journal of Hospice and Palliative Care
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• v.6 no.1
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• pp.34-44
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• 2003

Purpose : The purpose of this study was to elucidate the effects of hospice care on pain management of the terminal cancer patients. Method : The subjects of the study were 37 terminal cancer patients hospitalized in the general hospital in JeonJu with the hospice care nit. The data were collected using the questionaire with interviews from July to Nov. in 2000. The severity and interference of pain were examined with the self reported survey based on the Korean version of Brief Pain Inventory (BPI-K). The data were analyzed with the mean, SDs, paired t-test. The hospice care to provide for three weeks. Results : 1) The mean scores of the worst pain for the last 24-hours measured with the pain severity of BPI-K were pre-intervention (6.35) and post (4.76). The pain interference of BPI-K in pre-intervention was enjoy (8.22), work (7.46), walk (7.08) and activity (7.08), while post was of enjoy (6.62), work (6.43), walk (6.11) and activity (5.78), respectively. 2) In pain severity, significant difference was found between the pre-intervention and post in all of followings. - worst pain for last 24 hours (t=4.085, P=.000) - least pain for last 24 hours (t=4.020, P=.000) - average pain for last 24 hours (t=4.254, P=.000) - pain right now (t=4.017, P=.000) 3) In pain interference, significant difference was found between the pre- intervention and the post in all of followings. - activity (t=3.137, P=.003) - mood (t=6.713, P=.000) - walk (t=2.027, P=.050) - work (t=2.132, P=.040) - relate (t=4.143, P=.000) - sleep (t=4.071, P=.000) - enjoy (t=3.881, P=.000) Conclusion : The terminal cancer patients who were offered hospice care had significantly lower hospice care pain and pain interference than those without hospice care. According to these results, hospice care can be regarded as an effective modality in relief of pain in the terminal ill-patients.