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Attitudes of Medical Students' towards End-of-life Care Decision-making (일개 의과대학생의 말기 환자 치료 결정에 대한 태도)

  • Oh, Seung-Min;Cho, Wan-Je;Kim, Jong-Koo;Lee, Hye-Ree;Lee, Duk-Chul;Shim, Jae-Yong
    • Journal of Hospice and Palliative Care
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    • v.11 no.3
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    • pp.140-146
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    • 2008
  • Purpose: Sooner of later, end-of-life care decision-making will unfold and be settled during the professional lives of medical students. However, there is prevalent ambiguity and uncertainty between the palliative treatment and euthanasia. We conducted this survey to investigate attitudes of medical students towards end-of-life making decisions, and to find out which factors primarily influenced the attitudes. Methods: A study was conducted among medical students at one university, the Republic of Korea. A written questionnaire was sent to all the 1st, 2nd, and 3rd-year medical students. It presented 5 statements on end-of-life decision-making. Students were asked whether they agreed or disagreed with each statement. Results: The response rate was 74.4%, and 267 questionnaires were analyzed. Percentages of agreement with each statements on Voluntary active euthanasia (VAE), Physician assisted suicide (PAS), Withholding life-sustaining management, Withdrawing life-sustaining management, and Terminal sedation (TS) was 37.1%, 21.7%, 58.4%, 60.3%, and 41.6%, respectively. The grade of students, religious activity, and educational experience were determinant factors. Agreement on each statements was higher in the low religious activity group than in the high religious activity group. Agreement on TS was higher among 3rd year students during their clerkship than among 1st and 2nd year students. Age of students and the experience of dying-people care had no significant influence. Conclusion: In end-of-life decision-making, religious and educational factors influenced medical students' attitudes. Especially, the experience of education during clerkship had significant influence on the attitude. Proper teaching on end-of-life decisions should further be considered during medical students' clerkship.

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Herbicidal Effect on Perennial Paddy Weed Sagittaria and Eleocharis (답(畓) 다년생잡초(多年生雜草) 올미 및 올방개에 대한 제초체(除草劑) 작용성(作用性)에 관한 연구(硏究))

  • Chang, Y.H.;Kusanagi, Tokuichi
    • Korean Journal of Weed Science
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    • v.2 no.1
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    • pp.41-46
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    • 1982
  • Herbicidal effectivity on perennial paddy weeds such as Sagittaria pygmaea Miq. and Eleocharis kuroguwai Ohwi was evaluated. Herbicides used were butachlor [2-chloro-2, 6-dietyl-N(butoxymethyl)-acetanilide], benthiocarb [S-(4-chlorobenzy)-N, N-diethyl-thiocarbamate], molinate (S-ethyhexahyaro-l-Hazpine-carbothiate], SW-751, Chlormethoxynil (2.4-dichlorophenyl-3-methoxy-4-nitrophenyl-ether), CNP (2.4.6-trichlorophenyl-4-nitrophenylether),oxadiazon [2-tertbutyl-4-(2.4-dichloro-S-isopropoxyphenyl)-5-OXO-1.3.4-Oxadiazoline], dinuron [1-dimethyl-benthyl)-3-pheratrylurea], bentazon [3-isopropyl-IH-2.1.3-benzothiadiazine-(4)3H-one-2.2-dioxide], ACN (3-chloro-2-amino-l.4-naphthoquinone), MCPB [4-(2-methyl-4chlorophenoxy), butyric acid], 2.4-D (sodium 2.4-dichlorophenoxy acetic acid), MCP) sodium 2-methyl-4-chlorophenoxy acetic acid), SST-5, TH 63. Graszin D (Bentazon/2.4-D) and Graszin M (Bentazon/MCP) Herbicidal effectivity was divided into three types. Type I was the complete control both leaf and tuber, and SW-751 was belonged to this type. Type II was the partial control that exhibit complete control within certain period after herbicide application. After a certain period, however, the lateral bud have the germinability and grow normally, there after. Chloromethoxynil, CNP, ACN, and Oxadiazon were belonged to this group. Type III was no control at all. For E. kuroguwai, application of CNP, Chloromethoxnil, Oxadiazon and SW-751 gave good control in the early stage shile 2.4-D, MCP, bentazon and glaszin-D controlled well the intermediate stage application. Based on this results, E. kuroguwai can be controlled by herbicide application either in the early stage or in the intermediate stage.

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A Study on Developing Web based Logistic Information System(KT-Logis) (웹 기반 통합물류정보시스템(KT-Logis) 개발에 관한 연구)

  • 오상호;김태준
    • Proceedings of the Korean DIstribution Association Conference
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    • 2001.11b
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    • pp.125-141
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    • 2001
  • In this paper, the current problems of logistics industry in Korea and their possible solutions were discussed. With Korea Telecoms KT-Logis, the supplier and demander of logistics service would not have to invest large sum of money into their computer system. All they need is just a computer with internet connected. What KT-Logis influence on the logistics industry are the following; 1. Many logistics service supplier and demander can do the business on the web with one computer system. 2. This web based computer system does not only work on the office but also apply on the field worker such as delivery personnel or even the forwarder with mobile phone. 3. KT-Logis is an integrated system which cover the broad arrange of logistics management from truck management to customer relations management. 4. Finally, KT-Logis is web based systems which suits for current e-business and mobile environment. In future, more studies should be done to develop more progressive integrated logistics information systems with enterprise resource planning(ERP) and supply chain management(SCM).

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Estimation of Moisture Content in Cucumber and Watermelon Seedlings Using Hyperspectral Imagery (초분광영상 이용 오이 및 수박 묘의 수분함량 추정)

  • Kim, Seong-Heon;Kang, Jeong-Gyun;Ryu, Chan-Seok;Kang, Ye-Seong;Sarkar, Tapash Kumar;Kang, Dong Hyeon;Ku, Yang-Gyu;Kim, Dong-Eok
    • Journal of Bio-Environment Control
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    • v.27 no.1
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    • pp.34-39
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    • 2018
  • This research was conducted to estimate moisture content in cucurbitaceae seedlings, such as cucumber and watermelon, using hyperspectral imagery. Using a hyperspectral image acquisition system, the reflectance of leaf area of cucumber and watermelon seedlings was calculated after providing water stress. Then, moisture content in each seedling was measured by using a dry oven. Finally, using reflectance and moisture content, the moisture content estimation models were developed by PLSR analysis. After developing the estimation models, performance of the cucumber showed 0.73 of $R^2$, 1.45% of RMSE, and 1.58% of RE. Performance of the watermelon showed 0.66 of $R^2$, 1.06% of RMSE, and 1.14% of RE. The model performed slightly better after removing one sample from cucumber seedlings as outlier and unnecessary. Hence, the performance of new model for cucumber seedlings showed 0.79 of $R^2$, 1.10% of RMSE, and 1.20% of RE. The model performance combined with all samples showed 0.67 of $R^2$, 1.26% of RMSE, and 1.36% of RE. The model of cucumber showed better performance than the model of watermelon. This is because variables of cucumber are consisted of widely distributed variation, and it affected the performance. Further, accuracy and precision of the cucumber model were increased when an insignificant sample was eliminated from the dataset. Finally, it is considered that both models can be significantly used to estimate moisture content, as gradients of trend line are almost same and intersected. It is considered that the accuracy and precision of the estimating models possibly can be improved, if the models are constructed by using variables with widely distributed variation. The improved models will be utilized as the basis for developing low-priced sensors.

The Short Term and Intermediate Term Results of using a T-tube in Patients with Tracheal Stenosis (기관 협착 환자에서의 T-튜브의 중단기 결과)

  • Sa, Young Jo;Moon, Seok-Whan;Kim, Young-Du;Jin, Ung;Park, Jae-Kil;Kim, Jae Jun;Kim, Chi-Kyung;Jo, Keon Hyon;Park, Chan Beom;Yim, Hyeon Woo
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.63-71
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    • 2009
  • Background: The treatment of tracheal stenosis includes less invasive bronchoscopic intervention and more invasive segmental resection & anastomosis. Depending on the patient's clinical features, sometimes all these methods are inappropriate. Silicone T-tube stenting has recently been used as an alternative, safe management of tracheal stenosis. We studied the short term and Intermediate term results of using T-tubes in patients with tracheal stenosis, and this tracheal stenosis was caused by various underlying diseases. Material and Method: We retrospectively reviewed 57 patients with tracheal stenosis and who were treated with T-tubes between Jan 1997 and Apr 2007. Based on the patient's medical records and the imaging studies, we evaluated the clinical findings and status of T-tube removal. Result: There was no T-tube related morbidity or mortality in this series. On follow-up, one patient underwent sleeve resection and end-to-end anastomosis. The T-tube could be successfully removed from 13 patients (13/57, 22.8%) without additional interventions. For another four patients, a T-tube was again inserted after removal of the first T-tube due to tracheomalacia or recurrent stenosis. Four patients died of underlying disease and cancer. The patients' gender and previous tracheostomy significantly affected T-tube removal. By contrast, multiple logistic regression analysis identified gender as a predictor of successfully removing a T-tube. Gender (p=0.033) and previous tracheostomy (p=0.036) were the two factors for success or failure of T-tube removal. Conclusion: A T-tube provided reliable patency of a stenotic airway that was caused by any etiology. We have proven that using a T-tube is safe and effective therapy for patients with tracheal stenosis for the short term or the intermediate term.

3-Dimensional Reconstruction of Parallel fiber-Purkinje Cell Synapses Using High-Voltage Electron Microscopy (고압전자현미경을 이용한 소뇌 평행섬유-조롱박세포간 신경연접의 3차원 재구성)

  • Lee, Kea-Joo;Kweon, Hee-Seok;Kang, Ji-Seoun;Rhyu, Im-Joo
    • Applied Microscopy
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    • v.35 no.1
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    • pp.31-39
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    • 2005
  • Synapses are contact points where one neuron communicates with another. The morphological change of synapses under various physiological or pathological conditions has long been hypothesized to modify their functional properties. 3-dimensional (3-D) reconstruction of synapses with serial ultrathin sections has contributed to the understanding of ultrastructural dimensions and compositions of synapses. The 3-D reconstruction procedures, however, require a great amount of expertise as well as include prohibitively timeconsuming processes. Here, we introduce efficient 3-D reconstruction technique using high-voltage electron microscopy (HVEM). Primarily, we established an optimal section thickness and staining condition to observe synaptic structures in detail under HVEM. The result showed that synaptic profiles were preserved at the section thickness of 250 nm without the overlapping of synaptic ultrastructures. An increase in the reaction time of en bloc staining was most efficient to enhance contrast than the extension of postembedding staining or the addition of uranyl acetate during dehydration. Then, 3-D reconstruction of parallel fiber-Purkinje cell synapses in the rat cerebellum was carried out with serial HVEM images and reconstruction software. The images were aligned and the contours of synapses were outlined on each section. 3-D synapses were finally extracted from the section files by grouping all the synaptic contours. The reconstructed synapse model clearly demonstrated the configuration of pre and postsynaptic components. These results suggest that 3-D reconstruction of synapses using HVEM is much efficient and suitable for massive quantitative studies on synaptic connectivity than conventional TEM approach using numerous ultrathin sections.

Influence of Blockade of Sympathetic Nervous System, Renin-Angiotensin System, and Vasopressin System on Basal Blood Pressure Levels and on Pressor Response to Norepinephrine, Angiotensin II, and Vasopressin (교감신경계, Renin-Angiotensin계, Vasopressin계의 차단이 혈압 및 Norepinephrine, Angiotensin II 및 Vasopressin의 승압효과에 미치는 영향)

  • Chung, Haeng-Nam
    • The Korean Journal of Pharmacology
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    • v.28 no.1
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    • pp.61-74
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    • 1992
  • Influence of the blockade of the three major pressor systems-sympathetic nervous system (SNS), renin-angiotensin system (RAS) and vasopressin system-on the pressor responsiveness to norepinephrine (NE), angiotensin II (AII), and vasopressin (VP) as well as on basal blood pressure (BP) levels was investigated in urethane-anesthetized rabbits. To block the SNS and RAS, chlorisondamine (CS) and pirenzepine (PZ), sympathetic ganglionic blockers, and enalapril (ENAL), an inhibitor of angiotensin converting enzyme, respectively were used. And for suppressing the VP system bremazocine (BREM), a kappa opiate receptor agonist shown to suppress plasma levels of VP, was employed. Each of CS (0.4 mg/kg), ENAL (2 mg/kg), and BREM (0.25 mg/kg) produced almost same levels of steady hypotensive state. The hypotensive effect of BREM was significantly attenuated by desmopressin, a synthetic VP-like analogue, suggesting the hypotension being at least in part due to suppression of plasma levels of VP. CS, ENAL and BREM elicited further fall of the BP which had been lowered by ENAL or BREM, CS or BREM, and CS or ENAL, respectively. The hypotension produced by both CS and PZ together with either of ENAL or BREM was more marked than that produced by the three drugs other than CS. CS potentiated the pressor response not only to NE but to AII and VP. The pressor effect of AII was increased by ENAL and BREM, too. The pressor response to VP was also enhanced by BREM. Blockade of ${\alpha}-adrenergic$ receptors with phentolamine or phenoxybenzamine potentiated the pressor response to AII and that to VP. The results on basal BP levels indicate that the three major pressor systems are all participating in control of BP, but SNS has the greatest potential for supporting BP. The finding that blockade of one of the pressor systems induced enhanced pressor responsiveness to the pressor hormone of that particular system as well as to the pressor hormone(s) of the other systems(s) provides evidence for important interactions among the three major pressor systems.

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Effects of Split Nitrogen Application on Growth Characters, Yield Potential and Feed Value in Jeju Italian Millet (제주조의 질소분시 횟수에 따른 생육반응, 수량성 및 사료가치 변화)

  • Cho, Nam-Ki;Kang, Young-Kil;Song, Chang-Kil;Ko, Dong-Hwan;Cho, Young-Il
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.23 no.1
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    • pp.37-42
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    • 2003
  • This study was conducted at a volcanic ash soil in the Experimental Farm of Cheju national university from May 1, 2000 to August 25, 2000 to determine the optimum frequency of split N application for. forage production of Jeju Italian millet(Setaria italica Beauvis). N .rate was applied with 200kg N/ha, and frequencies of the split application were 1. 2, 3, 4 and f times. Days to heading was 87 days in the N applied plot all at once, was delayed to 93 days at the five times split-applied plot. Plant height was the greatest (143cm) at the four times split-applied plot, but above o. below that was short. Leaf length, number of leaves and nodes were a similar tendency to plant height. SPAD(Soil Plant Analysis Development) reading values rose 34.3∼36.2 as N was split-applied from one to five times. Fresh forage, dry matter, crude Protein and TDN yield at the H split-applied to four times increased 33.08∼5l.50MT/ha, 9.94∼13.36MT/ha, 0.93∼1.70MT/ha and 5.06∼7.28MT/ha, respectively, but at the five tines split-applied plot decreased to 49.33MT/ha, 12.69MT/ha, 1.65MT/ha and 6.98 MT/ha, respectively. As the increasing of N split-applied. crude protein, crude fat NFE and TDN content increased 9.4∼13.0%, 1.5∼l.9%, 44.5∼45.5% and 50.9∼55.0%, respectively, whereas crude fiber and crude ash content decreased 35.3∼31.6% and 9.3∼8.3, respectively.

Volume Rendering System of e-Science Electron Microscopy using Grid (Gird를 이용한 e-사이언스 전자현미경 볼륨 랜더링 시스템)

  • Jeong, Won-Gu;Jeong, Jong-Man;Lee, Ho;Choe, Sang-Su;Ahn, Young-heon;Hur, Man-Hoi;Kim, Jay;Kim, Eunsung;Jung, Im Y.;Yeom, Heon Y.;Cho, Kum Won;Kweon, Hee-Seok
    • Proceedings of the Korea Contents Association Conference
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    • 2007.11a
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    • pp.560-564
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    • 2007
  • Korea Basic Science Institute(KBSI) has three general electron microscopes including High Voltage Electron Microscope(HVEM) which is the only one in Korea. Observed images through an electron microscope are what they are tilted by each step and saved, offering the more better circumstances for observers, a reconstruction to 3D could be a essential process. In this process, a warping method decreases distortions maximumly of avoided parts of a camera's focus. All these image treatment processes and 3D reconstruction processes are based on an accompaniment of a highly efficient computer, a number of Grid Node Personal computers share this process in a short time and dispose of it. Grid Node Personal computers' purpose is to make an owner can share different each other and various computing resources efficiently and also Grid Node Personal computers is applying to solve problems like a role scheduling needed for a constructing system, a resource management, a security, a capacity measurement, a condition monitoring and so on. Grid Node Personal computers accomplish roles of a highly efficient computer that general individuals felt hard to use, moreover, a image treatment using the warping method becomes a foundation for reconstructing to more closer shape with an real object of observation. Construction of the electron microscope volume 랜더링 system based on Grid Node Personal computer through the warping process can offer more convenient and speedy experiment circumstances to observers, and makes them meet with experiment outcome that is similar to real shapes and is easy to understand.

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Comparison of Carotenoid Pigments on Manchurian Trout, Brachymystax lenok and Masu Salmon, Oncorhynchus macrostomus in the Family Salmonidae (연어과에 속하는 열목어와 산천어의 Carotenoid 색소성분의 비교)

  • BAEK Sung-Han;HA Bong-Seuk
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.31 no.2
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    • pp.278-287
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    • 1998
  • Carotenoids in integument of wild manchurian trout, Brachymystax lenok, and wild and cultured masu salmon Oncohynchus macrostomus, which are all the Korean native cold fresh water fish, were investigated by thin layer chromatography, column chromatography and HPLC. The total carotenoid contents of the wild manchurian trout were $3.72\;mg\%$ which is relatively higher compare to other species of salmonidae. The carotenoids were composed of $36.9\%$ zeaxanthin and $14.7\%$ $\beta-carotene$ as the major compounds, $7.8\%$ triol $7.3\%$ isocryptoxanthin, $5.7\%$ 4-hydroxy echinenone, $4.7\%$ lutein, $4.5\%$ salmoxanthin and $2.2\%$ astaxanthin as minor compounds, and other carotenoids such as canthaxanthin, tunaxanthin A, tunaxanthin B, tunaxanthin C, $\beta-cryptoxanthin$ and $\alpha-cryptoxanthin$ as minute carotenoids. Wild masu salmon contained more total carotenoids than cultured one and the contents were $0.82\;mg\%$ and $0.66\;mg\%$, respectively. The composition of the carotenoids from wild masu salmon were $20.7\%$ xeaxanthin, $17.0\%$ isocryptoxanthin and $15.8\%\;\beta-carotene$ as major compounds, and $6.2\%$ triol, $6.1\%$ 4-hydroxy echinenone, $6.1\%$ salmoxanthin, $5.9\%$ canthaxanthin, $5.8\%$ lutein, $4.9\%$ $\alpha-cryptoxanthin$ and $1.0\%$ astaxanthin as minor compounds. The composition of the carotenoids from cultured masu salmon were $19.7\%$ isocryptoxanthin, $18.0\%$ $\beta-carotene$ and $10.3\%$ zeaxanthin as the major compounds, and $8.9\%\;\beta-cryptoxanthin$, $8.5\%\;\alpha-cryptoxanthin$, $8.0\%$ lutein, $7.6\%$ canthaxanthin, $5.1\%$ triol and $2.0\%$ astaxanthin as minor carotenoids. Based on these data, wild masu salmon contained more zeaxanthin, salmoxanthin and 4-hydroxy echinenone while cultured masu salmon contained more $\alpha-cryptoxanthin$, indicating that carotenoid pigment of masu salmon depends on their living conditions. Unlike wild masu salmon, 4-hydroxy echinenone and salmoxanthin which are the characteristic carotenoids of salmons, were not found in the integument of cultured masu salmon. Unlike manchurian trout, both wild and cultured masu salmon did not contain tunaxanthin A, tunaxanthin B and tunaxanthin C.

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