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The Changing Patterns and Predisposing Factors of Delirium at End of Life in Palliative Care Unit (완화 병동에서 임종기 섬망의 변화 양상과 선행 요인)

  • Rim, Mi-Roo;Kang, Sang-Gu;Choi, Seo-Hyeon;Cho, Jinhyun;Lee, Moon-Hee;Kim, Hye-Young;Bae, Jae-Nam;Lee, Jeong-Seop;Kim, Won-Hyoung
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.94-101
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    • 2018
  • Objectives : The purpose of this study is to investigate the change pattern and the leading factors of delirium in the palliative ward from 2 weeks before to the end of life. Methods : From October 2015 to August 2017, a retrospective chart review was conducted on the final 180 patients of 207 patients with terminal cancer patients at the Inha University Hospital. Clinical records were collected during palliative care hospitalization. Patients were diagnosed with three subtypes of delirium through the Richmond Agitation Sedation Scale and the Nursing Delirium Screening Scale, which were evaluated daily. Results : The prevalence of delirium 13 days before death was 46%, of which 18.3% were hyperactive subtypes, 13.8% were hypoactive subtypes, and mixed subtypes were 13.8%. And hyperactive delirium gradually decreased with the approach to the end of the day, and the mixed subtype gradually increased until 4 days before the end of life. Of the patients, the day before death, 86.9% were diagnosed with delirium. In multivariate analysis, hematologic malignancy was associated with a lower rate of delirium at the end of life than gastrointestinal cancer. Overweight was associated with hyperactive, mixed, and hypoactive delirium. Conclusions : Most palliative care patients experienced delirium at the end of life. Overweight was considered as a protective factor that reduced the all subtypes of delirium at the end of life. Further prospective studies are needed to reveal the prevalence of terminal delirium, and their risk factors.

Clinical Practice Guideline for Cardiac Rehabilitation in Korea

  • Kim, Chul;Sung, Jidong;Lee, Jong Hwa;Kim, Won-Seok;Lee, Goo Joo;Jee, Sungju;Jung, Il-Young;Rah, Ueon Woo;Kim, Byung Ok;Choi, Kyoung Hyo;Kwon, Bum Sun;Yoo, Seung Don;Bang, Heui Je;Shin, Hyung-Ik;Kim, Yong Wook;Jung, Heeyoune;Kim, Eung Ju;Lee, Jung Hwan;Jung, In Hyun;Jung, Jae-Seung;Lee, Jong-Young;Han, Jae-Young;Han, Eun Young;Won, Yu Hui;Han, Woosik;Baek, Sora;Joa, Kyung-Lim;Lee, Sook Joung;Kim, Ae Ryoung;Lee, So Young;Kim, Jihee;Choi, Hee Eun;Lee, Byeong-Ju;Kim, Soon
    • Journal of Chest Surgery
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    • v.52 no.4
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    • pp.248-329
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    • 2019
  • Background: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. Methods: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors-primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. Results: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Conclusion: Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

Assessment of Fire-Damaged Mortar using Color image Analysis (색도 이미지 분석을 이용한 화재 피해 모르타르의 손상 평가)

  • Park, Kwang-Min;Lee, Byung-Do;Yoo, Sung-Hun;Ham, Nam-Hyuk;Roh, Young-Sook
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.23 no.3
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    • pp.83-91
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    • 2019
  • The purpose of this study is to assess a fire-damaged concrete structure using a digital camera and image processing software. To simulate it, mortar and paste samples of W/C=0.5(general strength) and 0.3(high strength) were put into an electric furnace and simulated from $100^{\circ}C$ to $1000^{\circ}C$. Here, the paste was processed into a powder to measure CIELAB chromaticity, and the samples were taken with a digital camera. The RGB chromaticity was measured by color intensity analyzer software. As a result, the residual compressive strength of W/C=0.5 and 0.3 was 87.2 % and 86.7 % at the heating temperature of $400^{\circ}C$. However there was a sudden decrease in strength at the temperature above $500^{\circ}C$, while the residual compressive strength of W/C=0.5 and 0.3 was 55.2 % and 51.9 % of residual strength. At the temperature $700^{\circ}C$ or higher, W/C=0.5 and W/C=0.3 show 26.3% and 27.8% of residual strength, so that the durability of the structure could not be secured. The results of $L^*a^*b$ color analysis show that $b^*$ increases rapidly after $700^{\circ}C$. It is analyzed that the intensity of yellow becomes strong after $700^{\circ}C$. Further, the RGB analysis found that the histogram kurtosis and frequency of Red and Green increases after $700^{\circ}C$. It is analyzed that number of Red and Green pixels are increased. Therefore, it is deemed possible to estimate the degree of damage by checking the change in yellow($b^*$ or R+G) when analyzing the chromaticity of the fire-damaged concrete structures.

A Study on the Slit Jade Earring Excavated in the Korean Peninsula (한반도 출토 결상이식(玦狀耳飾) 소고)

  • Lim, Seng Kyeong
    • Korean Journal of Heritage: History & Science
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    • v.45 no.4
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    • pp.4-21
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    • 2012
  • Jade ornaments, which include slit earrings, scoop-shaped objects and tubular beads have been extensively identified in Northeast Asia, such as Korea, China, Japan and the Maritime Province of Siberia. Among them slit earrings are distributed in the whole area of Northeast Asia. Although this object shows the typological differences in accordance with the excavated region in detail, all of them are characterised by the slit on the centre of jade ring. The buried context and the shape of this object suggest that this artefact was the earring; thus it is named to 'slit earring'. Most of slit earrings of the Neolithic Age concentrate in Northeast China and the areas south of the Yangtze River, and the Japanese Archipelago. However, unfortunately, Slit earrings, which were produced in the tradition of the incipient and early phases of the Neolithic Age in Northeast Asia, have not been excavated in the Korean Peninsula. The number of slit earrings reported so far is eight, and especially until the 20th century, almost none was reported with its exact excavation location and only three of them are known as excavated through surface surveys and preliminary excavations. However, from the beginning of the 21st century onwards, the number of discovered slit earrings is increasing. Particularly, five pieces of this object uncovered in the 21st century are discovered in the official excavation; thus the exact archaeological context such as buried locations and chronologies could be estimated. By considering the buried context, slit earrings are associated with stone axes, which were produced in the incipient and early phase of the Neolithic Age in the Korean Peninsula. In addition, considering the number of unearthed objects is a few, it could be postulate that slit earring was the artefact that only a few persons, who had a special role in the society, could possess. However, slit jade earrings that have been excavated in the Korean Peninsula are extremely low in their number compared to the cases of its neighbouring countries such as China and Japan, and the researches on this subject have not been much conducted in Korea. Therefore, it is my supposition that slit earrings, which have been discovered in the Korean Peninsula, might be the imported item from the nearby areas. Particularly, the Southern Coast was closely connected with Japanese Islands and the Eastern Coast was interchanged with Northeast China or the Maritime Province of Siberia. Considering that excavations and researches on the Neolithic remains in the Korean Peninsula have not been sufficiently and actively conducted, it could be expected that the further investigations and researches will reveal the sufficient quantities of slit earrings in near future.

A Study on the Sanctuary of the Residence in East China Sea Skirts Area (동중국해권 민가의 성역(聖域)에 관한 연구)

  • Youn, Lily;Onomichi, Kenji
    • Korean Journal of Heritage: History & Science
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    • v.43 no.2
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    • pp.60-81
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    • 2010
  • Jeju Island, in Korea, shows many characteristics that are differentiated from the rest of Korea. Its culture is rooted in mythology which advocates a egalitarian, rather than hierarchical, social structure, the place of women in the home is relatively high, and the formation of buildings, the separation of cooking and heating facilities, and the living format of residential homes is dissimilar. These disparities in culture indicate that Jeju Island's heritage was not formed only from influences from the North, but also from other places as well. To fill in the blanks, residential homes in Jeju Island were compared with those scattered throughout the East China Sea, which connect the southern coastline of the Korean peninsula and Jeju Island. The regions encompassed by the East China Sea, sharing the Kuroshio current and a seasonal wind, can be considered as one cultural region integrating cultural aspects from the continental North and the oceanbound South. The unique characteristics of southern culture as seen in southern residences was examined through an investigation of the sacred places in which gods were considered to dwell. First, the myths of these areas usually concerned with the ocean, and a sterile environment made sustenance impossible without a dual livelihood, usually taking on the forms of half-farming and half-fishing, or half-farming, half-gardening. Although family compositions were strongly matricentric or collateral thanks to southern influence, a patriarchical system like those found in the North were present in the upper classes and in the cities. Therefore, residential spaces were not divided based on age or gender, as in hierarchical societies, but according to family and function. Second, these areas had local belief systems based on animism and ancestor worship, and household deities were closely related to women, agriculture and fire. The deities of the kitchen, the granary and the toilet were mostly female, and the role of priest was often filled by a woman. After Buddhism and Confucianism were introduced from mainland Korea, China and Japan, the sacred areas of the household took on a dual form, integrating the female-focused local rites with male-centered Buddhist and Confucian rites. Third, in accordance with worship of a kitchen deity, a granary deity, and a toilet deity led to these areas of the home being separated into disparate buildings. Eventually, these areas became absorbed into the home as architectural technology was further developed and lifestyles were changed. There was also integration of northern and southern cultures, with rites concerning granary and toilet deities coming from China, and the personality of the kitchen deity being related to the southern sea. In addition, the use of stone in separate kitchens, granaries, and toilets is a distinguishing characteristic of the East China Sea. This research is a part of the results gained from a project funded by the Korea Research Foundation in 2006.

Development of Topic Trend Analysis Model for Industrial Intelligence using Public Data (텍스트마이닝을 활용한 공개데이터 기반 기업 및 산업 토픽추이분석 모델 제안)

  • Park, Sunyoung;Lee, Gene Moo;Kim, You-Eil;Seo, Jinny
    • Journal of Technology Innovation
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    • v.26 no.4
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    • pp.199-232
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    • 2018
  • There are increasing needs for understanding and fathoming of business management environment through big data analysis at industrial and corporative level. The research using the company disclosure information, which is comprehensively covering the business performance and the future plan of the company, is getting attention. However, there is limited research on developing applicable analytical models leveraging such corporate disclosure data due to its unstructured nature. This study proposes a text-mining-based analytical model for industrial and firm level analyses using publicly available company disclousre data. Specifically, we apply LDA topic model and word2vec word embedding model on the U.S. SEC data from the publicly listed firms and analyze the trends of business topics at the industrial and corporate levels. Using LDA topic modeling based on SEC EDGAR 10-K document, whole industrial management topics are figured out. For comparison of different pattern of industries' topic trend, software and hardware industries are compared in recent 20 years. Also, the changes of management subject at firm level are observed with comparison of two companies in software industry. The changes of topic trends provides lens for identifying decreasing and growing management subjects at industrial and firm level. Mapping companies and products(or services) based on dimension reduction after using word2vec word embedding model and principal component analysis of 10-K document at firm level in software industry, companies and products(services) that have similar management subjects are identified and also their changes in decades. For suggesting methodology to develop analysis model based on public management data at industrial and corporate level, there may be contributions in terms of making ground of practical methodology to identifying changes of managements subjects. However, there are required further researches to provide microscopic analytical model with regard to relation of technology management strategy between management performance in case of related to various pattern of management topics as of frequent changes of management subject or their momentum. Also more studies are needed for developing competitive context analysis model with product(service)-portfolios between firms.

Decomposition of Eco-friendly Liquid Propellants over Ruthenium/Al2O3/metal foam Catalysts (Ru/Al2O3/메탈폼 촉매를 이용한 친환경 액체추진제 분해)

  • Yoo, Dalsan;Jeon, Jong-Ki
    • Clean Technology
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    • v.25 no.3
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    • pp.256-262
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    • 2019
  • Hydroxylammonium nitrate (HAN)-based liquid propellants are attracting attention as environmentally friendly propellants because they are not carcinogens and the combustion gases have little toxicity. The catalyst used to decompose the HAN-based liquid propellant in a thruster must have both low temperature activity and high heat resistance. The objective of this study is to prepare an Ru/alumina/metal foam catalyst by supporting alumina slurry on the surface of NiCrAl metal foam using a washing coating method and then to support a ruthenium precursor thereon. The decomposition activity of a HAN aqueous solution of the Ru/alumina/metal foam catalyst was evaluated. The effect of the number of repetitive coatings of alumina slurry on the physical properties of the alumina/metal foam was analyzed. As the number of alumina wash coatings increased, mesopores with a diameter of about 7 nm were well-developed, thereby increasing the surface area and pore volume. It was optimal to repeat the wash coating alumina on the metal foam 12 times to maximize the surface area and pore volume of the alumina/metal foam. Mesopores were also well developed on the surface of the Ru/alumina/metal foam catalyst. It was found that the metal form itself without the active metal and alumina can promote the decomposition reaction of the HAN aqueous solution. In the case of the Ru/alumina/metal foam-550 catalyst, the decomposition onset temperature was significantly lowered compared with that of the thermal decomposition reaction, and ${\Delta}P$ could be greatly increased in the decomposition of the HAN aqueous solution. However, when the catalyst was calcined at $1,200^{\circ}C$, the catalytic activity was lowered inevitably because the surface area and pore volume of the catalyst were drastically reduced and Ru was sintered. Further research is needed to improve the heat resistance of Ru/alumina/metal foam catalysts.

A Study on Seeking a Multilateral Cooperation Framework for the Inter-Korean Exchange of Intangible Cultural Heritage - Through a Multinational Nomination of a Representative List of Intangible Cultural Heritage of Humanity - (남북 무형유산 교류 협력의 다자간 협력 틀 모색 - 유네스코 인류무형문화유산 남북 공동 등재 사례 -)

  • Kim, Deoksoon
    • Korean Journal of Heritage: History & Science
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    • v.52 no.3
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    • pp.252-269
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    • 2019
  • Since the inauguration of the Kim Jong-un regime in 2012, the safeguarding and management system of cultural heritage in the Democratic People's Republic of Korea (DPRK) has been changing to a form similar to that of a democratic country's legal system. In addition, the National Authority for the Protection of Cultural Heritage (NAPCH) has continuously recorded and cataloged intangible cultural heritage elements in the DPRK, listing Arirang, kimchi-making, and ssireum on the UNESCO Intangible Cultural Heritage Representative List. In particular, the multinational nomination of ssireum in October 2018 is symbolic in terms of inter-Korean exchanges and cooperation for peace and reconciliation, raising expectations for the further multinational nomination of the two Koreas' intangible cultural heritage. Currently, South Korea lists 20 items on its Representative List of the Intangible Cultural Heritage of Humanity, three of which are shared by various countries with multinational nominations such as falconry, tug-of-war, and ssireum. However, when comparing the process of applying for multinational nomination in the three elements that follow, it is necessary to discuss whether these cases reflect the nature of multinational nomination. In particular, in the case of ssireum, without a working-level consultation between the two Koreas to prepare an application for a multinational nomination, each applied for a single registration; these applications were approved exceptionally as a multinational nomination by the Intergovernmental Committee under the leadership of the Secretary-General of UNESCO, and no bilateral exchanges have taken place until now. This is symbolic, formal, and substantially similar to the individual listings in terms of the spirit of co-listing on the premise of mutual exchange and cooperation. Therefore, the only way to strengthen the effectiveness of the multinational nomination between the two Koreas and to guarantee the spirit of multinational nomination is to request multilateral co-registration, including the two Koreas. For this, the Korean government needs a strategic approach, such as finding elements for multilateral co-listing; accumulating expertise, capabilities, and experience as a leading country in multilateral co-listing; and building cooperative governance with stakeholders. Besides, to reduce the volatility of inter-Korean cultural exchanges and cooperation depending on political situations and the special nature of inter-Korean relations, measures should be taken toward achieving inter-Korean cultural heritage exchanges and cooperation under a multilateral cooperation system using UNESCO, an international organization.

Protective effect of Gabjubaekmok (Diospyros kaki) extract against amyloid beta (Aβ)-induced cognitive impairment in a mouse model (아밀로이드 베타(amyloid beta)로 유도된 인지장애 마우스 모델에서 갑주백목(Diospyros kaki) 추출물의 인지기능 및 뇌 신경세포 보호 효과)

  • Yoo, Seul Ki;Kim, Jong Min;Park, Seon Kyeong;Kang, Jin Yong;Han, Hye Ju;Park, Hyo Won;Kim, Chul-Woo;Lee, Uk;Heo, Ho Jin
    • Korean Journal of Food Science and Technology
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    • v.51 no.4
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    • pp.379-392
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    • 2019
  • The current study investigated the effect of Gabjubaekmok (Diospyros kaki) ethanolic extract (GEE) on $H_2O_2$-induced human neuroblastoma MC-IXC cells and amyloid beta $(A{\beta})_{1-42}$-induced ICR (Institute of Cancer Research) mice. GEE showed significant antioxidant activity that was evaluated based on ABTS, DPPH scavenging activity, and inhibition of malondialdehyde (MDA) and acetylcholinesterase activity. Further, GEE inhibited ROS production and increased cell viability in $H_2O_2$-induced MC-IXC cells. Administration of GEE ameliorated the cognitive dysfunction on $A{\beta}$-induced ICR mice as evaluated using Y-maze, passive avoidance, and Morris water maze tests. Results of ex vivo test using brain tissues showed that, GEE protected the cholinergic system and mitochondrial functions by increasing the levels of antioxidants such as ROS, mitochondrial membrane potential (MMP), and adenosine triphosphate (ATP) against $A{\beta}$-induced cognitive dysfunction. Moreover, GEE decreasd the expression levels of apoptosis-related proteins such as $TNF-{\alpha}$, p-JNK, p-tau, BAX and caspase 3. While, expression levels of p-Akt and $p-GSK3{\beta}$ increased than $A{\beta}$ group. Finally, gallic acid was identified as the main compound of GEE using high performance liquid chromatography.

Forest Vegetation Structure in Maruguem (the Ridge Line) Area of Gitdaebaegibong to Jukryeong, Baekdudaegan (백두대간(깃대배기봉-죽령 구간) 마루금 주변의 산림식생구조)

  • Song, Ju Hyeon;Yun, Chung Weon
    • Journal of Korean Society of Forest Science
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    • v.108 no.2
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    • pp.147-167
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    • 2019
  • This study was conducted to analyze forest vegetation structure in the Marugeum (Ridge) area of Gitdaebaegibong to Jukryeong, Baekdudaegan. Data were collected in 298 quadrates through a Braun-Blanquet vegetation survey from April, 2018 to October, 2018. Forest vegetation was classified into 13 vegetation units. A Quercus mongolica community was divided into Morus bombycis, Filipendula glaberrima, Fraxinus sieboldiana, Prunus maackii unit and Q. mongolica typical unit. The M. bombycis unit was further classified into a Deutzia glabrata group and M. bombycis typical group. The F. glaberrima unit was subdivided into a Veratrum oxysepalum group, Arundinella hirta group, and F. glaberrima typical group. The F. sieboldiana unit was divided into a Pinus densiflora group, Larix kaempferi group, and F. sieboliana typical group. The relationship between vegetation units and environmental factors was studied through coincidence analysis and CCA. The F. glaberrima unit (VU 6~8) was distributed by elevation above 1,200 m and other vegetation units were distributed below 1,200 m. Results of the CCA analysis showed that the F. glaberrima unit distribution is positively correlated with elevation. As a result of species diversity, the F. glaberrima unit was higher than other vegetation units. A similarity index analysis revealed that the F. sieboldiana unit (VU 9~11) was relatively homogeneous, and the M. bombycis unit (VU 1~5) and A. girta group (VU 7) were relatively heterogeneous. A detrended correspondence analysis determined that the distance between the statistical axes of the M. bombycis and F. glaberrima units was the greatest, which is consistent with the analysis of the similarity index. As a result of interspecific correlation of major woody plants, hydrophilic species were positively correlated, and a negative correlation was found between Q. mongolica and intolerant species such as P. densiflora and L. kaempferi.