• Journal of Hospice and Palliative Care
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• v.18 no.2
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• pp.105-111
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• 2015

Purpose: Fatigue, energy loss, feeling of helplessness, poor appetite, pain besides general weakness are major symptoms presented to terminally ill cancer patients. These symptoms are similar to those that appeared with adrenal insufficiency. Also, for terminally ill cancer patients who are hospitalized for palliative care, opioid agents are prescribed to control moderate to severe pain. We studied the relationship of opioid agents and adrenal insufficiency. Methods: From November 2013 through June 2014, we monitored the serum level of cortisol and dehydroepiandrosterone sulfate (DHEAS, serum) in 55 cancer patients who were over 18 years old and were treated at a hospice center. We also checked the treatment period and dosage of opioid agents. Results: The DHEAS level, treatment period and dosage of opioid agents did not have significant correlation. Correlation between the serum cortisol level and the opioid agent treatment period was not significant either, but the serum cortisol level was positively correlated with the dosage of opioid agents (P value 0.0322). Conclusion: This study did not identify a novel link between treatment period, dosage of opioid agents and adrenal insufficiency. But, the DHEAS level was mostly below the normal level in patients who were treated with opioid agents.

• Journal of Hospice and Palliative Care
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• v.13 no.4
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• pp.216-224
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• 2010

Purpose: The purpose of this study was to evaluate a community-based cancer patient management program (CBPCMP) which was collaborated between a hospice center and public health centers. Methods: The CBPCMP proceeded on four steps; 1) Signing agreements with three public health centers, 2) Enrolling the domiciliary terminal cancer patients, 3) Providing home hospice service, and 4) Inquiring patient's level of satisfaction. From February 1 to December 31 in 2009, 43 terminal cancer patients were referred and provided with home hospice service. The hospice team made a total of 605 visits. Medical records for each visit and data from satisfaction surveys were analyzed. Results: 76.7% of patients were older than 60 years, and 90.7% of the patients were alert. The level of functional status for 76.7% of patients rated as lower than ECOG grade 1. 62.8% of the patients or their caregivers signed hospice service agreements. On the initial evaluation, the most frequent reasons for referral were general weakness (86.0%), followed by anorexia (72.1%). Nurses visited the patients' most frequently (371 visits), followed by volunteers (216 visits). Nurses provided emotional support and health promotion counseling on 95.1% and 22.9% of visits, respectively. The mean satisfaction score rated by patients and their family was 4.45 out of 5. Conclusion: This study tested CBPCMP in collaboration with hospice centers and public health centers. CBPCMP showed a possibility to improve the quality of end of life care. To insure the quality care, however, the guidelines for home hospice service should be developed.

• Journal of Hospice and Palliative Care
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• v.13 no.4
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• pp.232-242
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• 2010

Purpose: This study was done to investigate effects of foot massage and supportive communication provided by hospice volunteers on depression, anxiety, and mood of cancer patients who are going under intravenous chemotherapy at out patient department (OPD). Methods: A non-equivalent control group non-synchronized design was used. Sixty-four participants were recruited from out-patients setting in a university hospital by a convenient sampling. Two trained- hospice volunteers first provided regular hospice volunteer service to 34 patients in the control group. Subsequently, foot massage and supportive communication were provided to 30 participants in the experimental group. After the intervention, all participants answered the structured questionnaire with visual analog scales on depression, anxiety, and mood including general characteristics. Data were analyzed using descriptive statistics, two sample t-test, and paired t-test by PASW 17. Results: After the intervention, changes in negative moods, i.e. strain and powerlessness in the experimental group were significantly different from those in control group; strain and powerlessness in the experimental group were significantly decreased by foot massage and supportive communication provided by hospice volunteers. Conclusion: The current findings provide an empirical evidence of a brief and efficacious intervention for cancer patients. Further studies are warranted with larger sample size to validate the effectiveness of foot massage and supportive communication as a solid intervention for cancer patients who are undergoing intravenous chemotherapy at OPD.

• Journal of Hospice and Palliative Care
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• v.17 no.2
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• pp.66-74
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• 2014

Purpose: This study is aimed to investigate perceptions of caregivers and medical staff toward do not resuscitate (DNR) and advance directives (AD). Methods: Participants were 141 caregivers and 272 medical staff members from five general hospitals. A questionnaire used for the study consisted of 20 items: 14 about DNR perceptions, three about AD, one each for age, gender and employment. Results: Both medical staff and caregivers strongly recognized the need for DNR and AD, and the level of recognition was higher with medical staff than caregivers (DNR ${\chi}^2=44.56$, P=0.001; AD ${\chi}^2=16.23$, P=0.001). The main reason for the recognition was to alleviate sufferings of patients in the terminal phase. In most cases, DNR and AD were filled out when patients with terminal conditions were admitted, and patients made the decisions by consulting with their guardians. Medical staff better recognized the need and for growing demand for guidelines for the DNR and AD decision making process than caregivers (${\chi}^2=7.41$, P=0.0025). Conclusion: This study showed that patients highly rely on their caregivers when making decisions for DNR and AD. Thus, it is important that patients and caregivers are provided with objective information about the decisions. Since participants' strong support for DNR and AD was mainly aimed at alleviating patients' suffering, further study is needed in the association with hospice care. Medical staff also needs to understand the different views held by caregivers and fully consider the disparity when informing patients/caregivers to make the DNR and AD decisions.

• Journal of the Korean Society of Environmental Restoration Technology
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• v.3 no.3
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• pp.45-76
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• 2000

The purposes of this study were to investigate and understand the present status of various types of "deserts", such as sand desert, gravel desert, rock desert, earth desert, salt desert, desert, rocky desert, gobi desert, sandy desert, clay desert, etc., and the general countermeasures for the combating "desertification" "desertization", and to develop the technologies on the revegetation and restoration for the combating desertification in China. The methods of this study were mainly composed of field surveys on the several experimental sites and research institutes related to combating desertification in China, and examinations on the various technologies for the combating desertification at the Daxing Experimental Station of Beijing Forestry University. The conclusion from this study may be summarized as follows; 1. Status and tendency of desertification in China : China is one of the countries seriously threatened by desertification. Desertification affected areas in China are mainly distributed in arid, semi-arid and dry sub-humid areas in China, covering the most regions of the Northeast China (eastern region of Inner-Mongolia), the northern part of the North China (middle and western region of Inner-Mongolia, Shaanxi, Ningsha, Gansu) and the western part of the Northwest China (Xinzang, Qinghai, Xizang). The total area affected by desertification in China is approximately 2.622 million $km^2$. It covers 27.3% of the total territory of China. Until recently, it is estimated that the annual spreading ratio of desertification in China is 2,460 $km^2$. Therefore, desertification is mostly serious problems facing to the Chinese people. 2. The causes and environmental effect of desertification : The desertification in China is mainly caused by compound factors, including natural condition and human activities. In China, the desertification is started by the decrease of precipitation, continuous dry and drought, strong wind, wind and water erosion, land degradation and loss of natural vegetation caused by climate variation, and accelerated by the human activities, such as over-cultivating, over-grazing, over-cutting of woods, irrational use of water resources. Because desertification has affected the geographical features, soil nutrients contents, salinity, vegetation coverage and the functions of ecosystem, the environmental deteriorations in the desertification affected areas are very seriously. 3. The fundamental strategies of combating desertification in China are the increase of education and awareness of people through various mass media, the revision of laws to guarantee operation of Desertification Combating Law and to improve many relating laws and regulations, the application of advanced technologies and training of experts, the establishment of discriminative policies, and increasing arrangement of budget-investment, and so on. China, as a signed country in UNCCD, has made efforts for the combating desertification. Korea is also signed country in UNCCD, so we should play an important role in the desertification combating projects of China for the northest asia and global environmental conservation as well as environmental conservation of Korea.

• Childhood Kidney Diseases
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• v.6 no.2
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• pp.188-197
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• 2002

Purpose : Nowadays, drinks, foods and snacks have frequently been intensified with calcium and the insights into the importance of calcium-intake in general has developed in Korea. In this decade, we found the numbers of children who was visited to our hospital for evaluation of hematuria defined with hypercalciuria were increased. So we tried to compare the mean levels of serum calcium, alkaline phosphate, sodium, potassium, chloride, BUN, creatinine, bicarbonate and urinary pH who visited our hospital in 1991, 1992 with in 2000, 2001. Materials and methods : Between January 1991 to December 1992, and between January 2000 to December 2001, each 366 children and 488 children, aged 1 month to 15 years, who presented in our hospital for tonsilectomy and adenoidectomy or for inguinal herniorrhaphy were enrolled in the study, The children in the study were checked the level of serum calcium, alkaline phosphate, sodium, potassium, chloride, BUN, creatinine, bicarbonate and urinary pH with the machine which was corrected the similar levels of practical chemical levels in serum. We compared each mean levels in 1991s' group with in 2001s' group totally and separately through the age and sex. We used t-test to analysis data. Results : The levels of serum calcium, alkaline phosphate, creatinine, sodium, potassium, and urinary pH of 2001s' group were significantly higher than the levels of 1991s' group(P<0.05). The each level was $9.91{\pm}0.50\;mg/dL,\;248.58{\pm}94.98\;U/L,\;0.61{\pm}0.14\;mg/dL,\;138.64{\pm}2.22\;mM/L,\;4.35{\pm}0.40\;mM/L,\;6.18{\pm}0.86$ in 2001s' and $9.13{\pm}0.68;mg/dL,\;198.26{\pm}79.34\;U/L,\;0.433{\pm}0.18\;mg/dL,\;137.86{\pm}2.67\;mM/L,\;4.22{\pm}0.36\;mM/L,\;5.83{\pm}0.95$ in 1991s'. And the levels of serum bicarbonate, $23.64{\pm}2.57\;mM/L$ in 2001s' was significantly lower than the 1991s', $24.60{\pm}2.23\;mM/L$(P<0.05). The similar results were detected each age and sex group. Conclusion : The levels of serum calcium increase in this decade. The results will be used as a basic data for the national health plan in the years to come.

• Childhood Kidney Diseases
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• v.6 no.2
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• pp.227-236
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• 2002

Purpose : A study was done to assess the incidence and classification of congenital urinary tract anomalies detected by antenatal ultrasonogram. Methods : We reviewed 558 cases of urinary tract anomaly which were detected by antenatal ultrasonogram and postnatally confirmed between June 1989 and May 2002. We investigated the incidence and classified congenital urinary tract anomalies by review of medical records, antenatal and postnatal radiologic studies retrospectively. Results : In 558 cases of congenital urinary tract anomalies, 292 cases of hydronephrosis were found and the most common. Another anomalies were composed of 65 cases of multicystic dysplastic kidney, 32 cases of hydroureteronephrosis, 31 cases of duplication of kidney, 25 cases of renal agenesis, 21 cases of simple renal cyst, 20 cases of polycystic disease, 13 cases of ureterocele, 11 cases of renal hypoplasia, 10 cases of horseshoe kidney, 9 cases of vesicoureteral reflux, 8 cases of posterior urethral valve, 7 cases of bladder diverticulum, 6 casts of megaureter, 5 cases of ectopia, 2 cases of megacystis, and 1 case of medullary cystic disease. In 82 of the 558 cases, there were two or more combined urinary tract anomalies. Associated diseases other than urinary tract were observed in 13 cases, of which the congenital heart disease was the most common. Conclusion : The congenital urinary tract anomaly is frequently found and diverse during the antenatal ultrasonography. The multicenter study is needed to investigate precise incidence and distribution of each anomalies in general population.

• Childhood Kidney Diseases
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• v.3 no.1
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• pp.1-10
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• 1999

Purpose: Up to date there is no nationwide survey on epidemiological or clinical data of nephrotic syndrome, so we investigated about age of onset, sex, result of renal biopsy, treatment method, its results of treatment, its responsiveness, time of response to treatment and pattern of relapse in Korea. Methods: Between 1987 and 1997, 2193 patients with primary nephrotic syndrome diagnosed at 38 university hospital and general hospital in Korea were included. Of these 1655 were male and 538 were female. Incidence peaked at 1-5 years of age. Results: Results were as follows; 1) Among 2193 cases, male was 1655($75.5\%$), female was 538 cases($24.5\%$) and male to female ratio was about 3:1. Among 1752 patients with MCNS, male was 1338, female was 414 and male to female ratio was about 3.23:1. The most prevalent age group was 1-5 years of age. 2) Renal biopsy was done in 942 cases($43\%$), pathologic findings were as follows; MCNS 646 cases($68.6\%$), FSCS 149 cases($15.8\%$). 3) Regimen of treatment were as follows; prednisolone 1191 cases, Calcort 192 cases, cyclophosphamide 251 cases, cyclosporin A 223 cases, MPD pulse therapy 120 cases.4) Complete response to treatment were noted in 1597 cases($82.2\%$, n=1944). 5) Responsiveness according to result of renal biopsy were significantly different between MCNS and FSGS. Complete response were noted in $86.5\%$ among patients with MCNS, $35.8\%$ in patients with FSGS. 6) Time of response to treatment were noted between 1 and 4 weeks after treatment in 879 cases($67.4\%$, n=1305). 7) 994 cases($73.1\%$) relapsed during follow up, most frequently between 2 months and 6 months after response. Conclusion : Nationwide survey of epidemiological and clinical data were performed in childhood primary nephrotic syndrome. Most of the clinical and epidemiological data were similar to other reports from U.S.A. and from Europe, however male to female ratio is higher in Korean nephrotic syndrome(3:1 in contrast to 2:1).

• Proceedings of the Korean Society for Rock Mechanics Conference
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• 2000.09a
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• pp.183-193
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• 2000

A series of studies such as geological logging data analysis, detailed geological survey, rock mass evaluation, in-situ and laboratory tests, rock strength and mechanical properties of the rock were concerned. The stability of the slope were carried out inorder to design the pit slope and individual benches using the stereographic projection analysis and numerical methods in Roto Pit of Pasir coal fetid. The bedding plane was one of the major discontinuities in the Roto Pit and the dip of which is about $60^{\circ}$in the northern part and $83^{\circ}$in the southern part. The dip of bedding becomes steeper from north to south. The plane and toppling failures are presented in many slopes. In laboratory test the average uniaxial compressive strength of mudstone was 9 MPa and that of weak sandstone was 10 MPa. In-situ test showed that the rocks of Roto north mining area are mostly weak enough to be classified in grade from R2(weak) to R3(medium strong weak) and the coal is classified in grades from R1(Very weak) to R2(Weak). The detailed stability analysis were carried out on 4 areas of Roto north(east, west, south and north), and 2 areas of Roto south(east and west). In this paper, the minimum factor of safety was set to 1.2 which is a general criterion for open pit mines. Using the stereographic projection analysis and the limit equilibrium method, slope angles were calculated as 30~$36^{\circ}$for a factor of safety greater than 1.2. Then these results were re-evaluated by numerical analysis using FLAC. The final slope angles were determined by rational described abode. A final slope of 34 degrees can guarantee the stability for the eastern part of the Roto north area, 33 degrees for the western part, 35 degrees for the northern part and 35 degrees for the southern part. For the Roto south area, 36 degrees was suggested for both sides of the pit. Once the pit slope is designed based on the stability analysis and the safety measures. the stability of 니ope should be checked periodically during the mining operations. Because the slope face will be exposed long time to the rain fall, a study such aspreventive measures against weathering and erosion is highly recommended to be implemented.

• Tunnel and Underground Space
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• v.10 no.3
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• pp.430-440
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• 2000

A series of studies such as geological logging data analysis, detailed geological survey, rock mass evaluation, in-situ and laboratory tests, rock strength and mechanical properties of the rock were concerned. The stability of the slope were carried out inorder to design the pit slope and individual benches using the stereographic projection analysis and numerical methods in Roto Pit of Pasir coal field. The bedding plane was one of the major discontinuities in the Roto Pit and the dip of which is about 60$^{\circ}$ in the northern part and 83$^{\circ}$ in the southern part. The dip of bedding becomes steeper from north to south. The plane and toppling failures are presented in many slopes. In laboratory test the average uniaxial compressive strength of mudstone was 9MPa and that of weak sandstone was 10MPa. In-situ test showed that the rocks of Roto north mining area are mostly weak enough to be classified in grade from R2(weak) to R3(medium strong weak) and the coal is classified in grades from R1(Very weak) to R2(Weak). The detailed stability analysis were carried out on 4 areas of Roto north (east, west, south and north), and 2 areas of Roto south(east and west). In this paper, the minimum factor of safety was set to 1.2 which is a general criterion for open pit mines. Using the stereographic projection analysis and the limit equilibrium method, slope angles were calculated as 30∼36$^{\circ}$ for a factor of safety greater than 1.2. Then these results were re-evaluated by numerical analysis using FLAC. The final slope angles were determined by rational described above. A final slope of 34 degrees can guarantee the stability for the eastern part of the Roto north area, 33 degrees for the western part, 35 degrees for the northern part and 35 degrees for the southern part. For the Roto south area, 36 degrees was suggested for both sides of the pit. Once the pit slope is designed based on the stability analysis and the safety measures, the stability of slope should be checked periodically during the mining operations. Because the slope face will be exposed long time to the rain fall, a study such aspreventive measures against weathering and erosion is highly recommended to be implemented.