• Journal of Chest Surgery
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• 제22권6호
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• pp.970-979
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• 1989

From April 1982 to December, 1988, multiple valve replacement was performed in 49 patients. Mitral and aortic valve replacement were done in 42 patients, 4 underwent mitral and tricuspid valve replacement and 3 patients underwent triple valve replacement. Of the valve implanted, 50 were Duromedics, 21 St. Jude, 13 Bjork-Shiley, 9 Carpentier-Edwards, 6 Ionescu-Shiley, and 2 Medtronic. The hospital mortality rate was 28.5 % [14 patients] and the late mortality rate was 6.1 % [3 patients], the mortality rate was high in early operative period but decreased with time. [20% at 1986, 18.2 % at 1987, 9.5% at 1988] The causes of death were low cardiac output in 8, congestive heart failure in 2, multiple organ failure in 1, LV rupture in 1, intracerebral hemorrhage in 1 and sudden death in l. The actuarial survival rate excluding operative death was 77% at 7 years.

• Journal of Chest Surgery
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• 제28권12호
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• pp.1113-1121
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• 1995

From August, 1986 to December, 1993, mitral valve replacement was performed in 178 patients. Of the valve implanted, 114 were St.Jude Medical, 47 Duromedics, 16 Carpenter-Edward and 1 Ionesc-Shiley. The hospital mortality rate was 2.8%[5 patients and the late mortality rate was 7.5%[13 patients . The causes of hospital death were LV rupture in 1, renal failure in 1, cardiac tamponade in 1, valve malfunction in 1 and hypoxic brain damage in 1. The causes of late death were sudden death in 6, congestive heart failure in 4, brain ischemic injury in 3. Follow-up was done on 155 surviving patients : mean follow-up period was 50.94$\pm$8.04 months. The actual survival rate was 88.2% at 8 years. We concluded, therefore, that good clinical results could be achieved with mitral valve replacement in mid-term follow-up, and long-term follow-up is also necessary.

• Journal of Chest Surgery
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• 제33권2호
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• pp.160-166
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• 2000

Background: The purpose of this study is to evaluate and analyze the surgical results in patients undergoing operations for multiple for multiple valvular heart diseases. Material and method: From April 1982 to June 1997 multiple valve replacement was performed in 150 patients mitral and aortic valve replacement were done in 135 patients mitral and tricuspid valve replacements in 10 patients triple replacements in 4 patients and aortic and tricuspid valve replacement in 1 patient. Of the valves implanted 157 were St. Jude 104 Duromedics 20 Carpenter-Edwards 6 Bjork-Shiley 6 Ionescu-Shiley and 2 Medtronics. Result: The hospital mortality rate was 10.7% (16/150) and the late mortality rate was 7.2% (8/134) The mortality rate was high in early operative period but decreased with time. The causes of death were low cardiac output in 9 sudden death in 3 congestive heart failure in 3 bleeding in 2 cerebral thrombosis in 1 leukemia in 1 multiorgan failure in 1 and so on . The actuarial survival rate excluding operative death was 83.1% at 15 years. Conclusion: With a follow-up now extending to 15 years the multiple valve replacement continues to be reliable procedure with relatively low mortality and morbidity.

• The Korean Journal of Legal Medicine
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• 제42권4호
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• pp.159-163
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• 2018

Progressive muscular dystrophy (PMD) is a primary muscle disease characterized by progressive muscle weakness and wasting, which is inherited by an X-linked recessive pattern and occurs mainly in males. There are several types of muscular dystrophies classified according to the distribution of predominant muscle weakness including Duchenne and Becker, Emery-Dreifuss, facioscapulohumeral, oculopharyngeal, and limb-girdle type. Clinical manifestations of PMD are clumsy, unsteady gait, pneumonia, heart failure, pulmonary edema, hydropericardium, hydrothorax, aspiration, syncopal attacks, and sudden cardiac death. The deceased was a 34-year-old man, and the onset of the first clinical symptom, gait disturbance, was in his late teens. His elder brother had the same disease and experienced brain death after a head trauma and died after mechanical ventilation was discontinued. After an autopsy, we found contracture of the joints, pseudohypertrophy of the calf, wasting and fat replacement of the thigh muscle, pericardial effusion (80 mL), fibrosis and fat replacement of the cardiac ventricular wall, pulmonary edema, and froth in the bronchus. The cause of death was heart failure and dyspnea due to muscular dystrophy. There was no sign or suspicion of foul play in his death.

• 대한한의학방제학회지
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• 제11권1호
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• pp.57-90
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• 2003

The result of Bibliographic studies on the pathological mechanism of the sudden coma, we got the conclusion like this. 1. The sudden coma is an acute syndrome that refers to be a sudden fainting, an unconsciousness, an aphasia or a cold clammy limb, and immediately awakes or dies, and awakes in a short time, and if we awake, it doesn't leave over and above a sequela. 2. The clinical presentation of the sudden coma can be summarized as follows : The 1st is a disease raising the sudden death due to unconsciousness accompanied by wry mouth & sudden syncope with coma. The 2nd is simply the state of cold limbs. The 3rd is the meaning of the physique and symptomes of the six meridians. The last is the ancient method of expression in contrast of the beriberi. 3. The pathological mechanism of the sudden coma consists of the toxoid from outside, Qi and Xie, fatigue, damp phegm, the damage from seven emotions and the damage from five mental elements, especially the mental disorder due to the angry energy, causes the problems when the fleming-up of liver fire and the depressed of liver qi raise the physiological disorder. 4. Therapeutic methods of sudden coma are soothing the liver and remove stasis, soothing depression and circulating of the qi, calming the liver and suppressing yang. When that is early stage, at first, we must checking upward adverse flow of the qi after promoting the circulation of qi and awakening, and then, we must regulate excessive deficiency of yin yang by therapy that is based on differentiated in symptoms according to heat & cold, deficiency & excess, and use invigorating herb medicine for supporting vigour.

• 대한의용생체공학회:의공학회지
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• 제36권2호
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• pp.48-53
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• 2015

Sudden infant death syndrome(SIDS) continues to be general cause of infant death. Also, apnea is supposed to be one of the main risk factor of SIDS. Therefore, Infant's respiratory monitoring and real-time apnea detection is very important to prevent SIDS. In this study, we proposed a non-contact home monitoring system for infant's respiration using Doppler radar in order to prevent SIDS. The respiration data were acquired from a commercialized baby simulator(Simbaby$^{TM}$) using a Doppler radar. To evaluate a performance of the proposed system, the simulator was placed in a supine and prone position and the chest belt was used simultaneously as a reference signal. As a result, correlation coefficients between respiration rates of Doppler radar and the chest belt in each position were 0.95(p < 0.001) and 0.98(p < 0.001), respectively. The averages of difference were $-0.29{\pm}5.21(mean{\pm}1.96{\cdot}$ standard deviation) in supine and $-0.12{\pm}3.05$ in prone from Bland-Altman analysis. The results indicated an excellent performance in detecting apnea with a sensitivity of 100% and a positive predictive value of 100% in each posture respectively. These results demonstrated that a proposed Doppler radar system is suitable for non-contact respiratory monitoring in order to prevent SIDS of infant.

• 기본간호학회지
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• 제5권2호
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• pp.237-256
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• 1998

Death and dying of human being is a comprehensive system, and death orientation, the subjective meaning related to every component of the death system is developed throughout life. This study was designed and carried out to identify, describe and classify the orientations of Korean adult towards the death system. In an attempt to measure the subjective meaning of death and dying, unstructured Q-methodology was used. The 65 Q-statements developed by Kim(1994), used by Kim(1994) and Park(1996) were adopted as Q-population and 39 Q-statements were selected by the three researchers for Q-items for this study. Thirty-three P-samples were sampled from P-population of literate Korean men and women, 35 and 55 years of age, lived in urban Korea for the last 10 years. Sortings of the 39 Q-items according to the level of personal agreement, and a forced normal distribution into the 9 levels were carried out by the P-samples. The Z-scores of the Q-sort data were computed, and the principal components factor analysis by PC-QUANL Program were carried out. The demographic, socio-cultural and health-related attributes of the P-samples were descriptively analysed. Eight types of death orientation were identified ; Type I ; 'naturalist'. Six P-samples. Death is a natural phenomena, to be accepted as it is and to follow its natural course. Prefer to be informed of all facts and possibilities concernig the course of dying and death to occur to self. Type II ; 'life-after-life negator'. Three P-samples. Time and process of death is the destiny of each person. Death means 'darkness' and 'end to every thing, the absolute end'. Yet, wish physical integrity at the dying and after death. Type III ; 'life-after-life believer'. Six P-samples. Men are travellers passing by this life bound to the life-after-life. Priority concerns are on the activities to prepare self for the eternal life ahead. Disregard premature and sudden death. Type IV ; 'here-now believer' Five P-samples. Positive regard to the cremation of the body and donation of the organs on death. Regard religious and customary post-motem rituals meaningless. Negate life-after life. Type V; 'believer of rituals'. Five P-samples. Death being accepted as a part of, a natural end to, and destiny of human life. Concerned to ensure a dignified end to personal life and dignified post-mortem rituals. Type VI ; 'Realist'(derived from Type I). Two P-samples. Life and death as universal reality. The abrupt death at golden age at the peak of happiness is favored to avoid inevitable physical and mental distress of self and the family. Agreed to the cremation of the body. Disregard rituals. Type VII : 'Fatalist' (derived from Type II). Five P-samples. Not favored, yet, all man are destined to death, the inevitable end of all living beings. To ensure dignified end by personal consummation, information on one's dying and imminent death are to be shared. Type VIII ; 'reality avoider'(derived from Type III). One P-sample. Negative to longevity, artificial prolongation of, meaningless and distressful life. Highly positive to postmortem organ donation.

• 한국콘텐츠학회논문지
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• 제22권5호
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• pp.503-517
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• 2022

본 연구는 노인 장기요양 서비스를 제공하는 기관에서 종사하는 사회복지사들이 임종 케어 과정에서 겪는 심리·사회적 경험 및 역할에 대해 알아보았다. 심층 면접을 통한 자료 분석 결과 사회복지사들은 임종 케어 과정에서 빈번한 죽음 경험으로 인해 기가 빠지고 소진됨을 경험하였으며 돌아가신 노인분들에게 더 잘해드리지 못한 것에 대해 아쉬움과 정든 분에 대한 그리움을 나타냈다. 그리고 갑작스러운 죽음이 발생하면 가족들의 비난과 불평을 겪기도 하였다. 임종 케어시 사회복지사들의 주된 역할로 죽음 징후가 나타나면 가족들에게 수시로 연락하여 소통하였고 임종 후 주 부양자 가족들을 위로하고 지지하였다. 응급상황 대처를 위한 사전준비와 응급조치에 대한 법적 안전망, 사회복지사들의 소진을 막기 위한 재충전 프로그램 및 지지 모임, 임종 케어를 위한 표준화된 매뉴얼과 교육의 필요성이 제시되었다. 또한 노인분의 존엄한 죽음을 위하여 죽음 준비교육, 호스피스 케어, 사전 의료의향서 등의 필요성도 강조되었다.

• 대한수사과학회지
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• 제2권2호
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• pp.30-49
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• 2007

부검은 검안만으로 사인 또는 사망의 종류를 확인할 수 없는 경우 시체를 해부하여 이를 확인하는 검시(檢屍)방법이다. 본 연구자는 대학병원 직원들의 부검에 대한 인식도를 알아보기 위해 설문지를 이용하여 2007년 4월 2일부터 5월 4일까지 1개월간 대구광역시 영남대학교의료원의 직원들을 대상으로 설문조사를 실시하였다. 전체 286 명 중 남자가 121 명(42.3%), 여자가 165 명(57.7%)이었으며, 의사 57 명(19.9%), 간호사 71 명(24.8%), 의료기술직 83 명(29.0%), 행정사무직 58 명(20.3%), 기타 직종 17 명(5.9%)이었다.대상자들의 설문조사를 살펴보면 부검에 대한 교육정도에서 의사는 2회 이상이 61.4%인데, 간호사는 1.4%, 의료기술직은 15.7%, 행정사무직은 1.7%, 기타 직종은 5.9%로 의사들에 비해 교육정도가 많이 부족하였다. 본인이나 가족이 갑자기 쓰러져 사망했을 때 부검을 의뢰하겠는가라는 질문에 의사는 의뢰한다가 59.6%로 높았으나, 간호사는 22.5%, 의료기술직은 39.8%, 행정사무직은 41.4%, 기타 직종은 35.3%로 낮게 나타났다. 직장 동료가 근무 중 갑자기 쓰러져 사망한 경우 부검을 해야 한다고 생각하는가라는 질문에서도 의사는 그렇다가 66.7%로 높았으나, 간호사는 33.8%, 의료기술직은 39.8%, 행정사무직은 43.1%, 기타 직종은 17.6%로 낮게 나타났다. 병원내 환자가 병사했을 때 부검을 해야 한다고 생각하는가라는 질문에서도 의사는 그렇다가 50.9%, 간호사는 8.5%, 의료기술직은 19.3%, 행정사무직은 24.1%, 기타 직종은 17.6%로 낮게 나타났다. 부검은 어떤 곳에서 해야 하는가라는 질문에 의사는 의과대학 법의학교실이 73.7%로 가장 높았고, 다른 직종에서는 국립과학수사연구소가 가장 높게 나타났는데, 간호사는 62.0% 의료기술직은 59.0%, 행정사무직은 46.6%, 기타 직종은 58.8%이었다. 부검의 주체는 모든 직종에서 대부분의 대상자들이 전문 법의병리의사가 되어야 한다고 생각하는 것으로 나타났는데, 의사는 98.2%, 간호사는 94.4%, 의료 기술직은 96.4%, 행정사무직은 89.7%, 기타 직종은 88.2%이었다. 평소 부검의 필요성은 의사는 73.7%, 간호사는 23.9%, 의료기술직은 47.0%, 행정사무직은 34.5%, 기타 직종은 23.5%로 의사들이 평소 부검의 필요성을 많이 느끼는 것으로 나타났다. 사후 본인의 사체를 의과대학이나 연구기관 등에 기증할 용의가 있는가라는 질문에 의사는 22.8%, 간호사는 11.3%, 의료기술직은 24.1%, 행정사무직은 22.4%, 기타 직종은 23.5%만이 있다라고 답했다. 대상자들의 설문조사를 분석한 결과, 의사들에 비해 다른 직종의 대상자들이 부검에 대한 교육정도나 거부감이 더 큰 것으로 나타났다. 부검에 대한 부정적 의식의 개선을 위해 전문 인력의 양성과 관련 법률을 정비하여 우리나라 실정에 맞는 올바른 검시제도의 정착과 국민들에 대한 체계적인 법의학교육에 힘써야 할 것이다.

• 한국동물위생학회지
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• 제23권4호
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• pp.309-312
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• 2000

Pathological findings of natural cases of rabbit hemorrhagic disease was investigated. Clinically inappentence, increase in body temperature, depression, bloody foam from nostrils, and sudden death were recognized. Characteristic anatomical findings were hemorrhages in the lungs, liver, kidneys, and heart. Intestinal catarrh and retention of turbid urine in urinary bladder were also often observed. Severe .necrosis of hepatic cells, massive hemorrhages in many organs and membranous glomerulonephritis with hyaline droplet formation were characteristic changes under the microscopy. Perivascular cuffing of brain and catarrhal enteritis were also seen in many cases.