• Title/Summary/Keyword: life-and-death problem

Search Result 97, Processing Time 0.035 seconds

The Supreme Decision on the Withdrawal of Life Sustaining Treatment: 'Madam kim' Case Reviewed by the Life Sustaining Treatment Determination Act ('김할머니' 사례로 살펴본 가정적 연명의료결정에 관한 연구 -호스피스·완화의료 및 임종과정에 있는 환자의 연명의료결정에 관한 법률과 관련하여-)

  • Kim, Jang Ha
    • The Korean Society of Law and Medicine
    • /
    • v.17 no.2
    • /
    • pp.257-279
    • /
    • 2016
  • Recently, the Well-dying Act was legislated in Korea, and it will come into effect in August 4, 2017. This Act allows to withdraw the life sustaining treatment from impending death patients and also provide the hospice and palliative treatment to terminal patients. In the Supreme Court's case so called "Madam Kim", medical condition of Madam Kim was a persistent vegetative status owing to brain damage and her family members wanted to remove the artificial ventilation. In 2009, the Supreme Court allowed to withdraw the artificial ventilation under the specific conditions. We applied this new Well-dying Act to the Madam Kim's case hypothetically in order to know this Act can reasonably solve the problem of life sustaining treatment for dying or terminal patients. For the impending patients, the Well-dying Act has the problem not to withdraw the futile treatment due to the advance directives of patients. Vice versa, the terminal patients have no chance to withdraw the life sustaining treatment due to the this Act impose the duty to provide the hospice and palliative treatment despite of advance directives. We need to ruke out the persistent vegetative patients from the terminal patients caused by the cancer, acquired immune deficiency syndrome, chronic obstructive lung disease and chronic liver cirrhosis, In addition, we have to discuss the effect of the advance directives of terminal patients in view of self determination right.

  • PDF

촉매제에 의한 연탄깨스 제거에 관한 연구

  • Heo, Jin
    • Journal of the Korean Professional Engineers Association
    • /
    • v.5 no.19
    • /
    • pp.3-16
    • /
    • 1972
  • 1. Purposes and importances of the study. In gaining heating resources by combustion of briquette, which is the necessaries of every day's life, victims occur from poisonous affection of combustion gas (carbon mono-oxide) in every year and this gas attributable to increase death rate proportion to the high demand of briquette usage. It arise great problem ill point of national sanitation. Therefore, the study has a big aim to accomplish depressing CO gas or stimulating comlete combustion by both the methods of physical improvement of present combustion devices and chemical improvement by using V$_2$O$\sub$5/ catalyst to depress CO gas or fasten complete combustion Progress. Sucessful result of this study will not only to decrease the death rate but also to contribute fearless handling of briquette combustion so as to perform improving public Welfare. 2. Contents and scope of study. A. comparison of present and improved fuel hole device. B. Examination of effectness of improved elements. C. Effectness of miffed usage of catalyst. D. Comparison of Catalyst effectness. E. Examination of effectness of black slate containing V$_2$O$\sub$5/. 3. Results and recommendations of the study A. Absolute necessity of supplying secondary air by improved combustion device. B. Oxide Vanadium (V$_2$O$\sub$5/) has the greatest effectness to eliminate CO gas. C. Most effective catalyst of V$_2$O$\sub$5/ containing slate comes from "Samgoe" coal mine. D. By plastering catalyst on the cover plate of fire hole, it stimulate chemical reaction of re-combustion and preserving heat. E. Recommend to continute further precise study to practice with low-cost and handy devices to be applied the study results.

  • PDF

Effects of Methanol Extract of Jukryukjichul-hwan on Global Cerebral Ischemia of Rats (죽력지출환(竹瀝枳朮丸)의 메탄올추출 엑기스가 흰쥐의 전뇌허혈에 미치는 영향)

  • Ryu Ji-Cheal;Kim Young-Kyun;Kwon Jung-Nam
    • The Journal of Korean Medicine
    • /
    • v.27 no.2 s.66
    • /
    • pp.1-13
    • /
    • 2006
  • Objectives : Ischemic brain injury is a worldwide problem that often causes irreversible brain damage. Moreover, prevention of ischemic brain injury is more important than anything else, since after-effects of stroke significantly threat the quality of life. Jukryukjichul-hwan (JRH) is an oriental medicinal formula for stroke patients in Korea. This study evaluated neuroprotective effects of methanol extract of JRH on global cerebral ischemia in rats. Changes of the pyramidal neurons, Bax and TUNEL immuno-positive neurons in CA1 hippocampus were observed using immunohistochemistry. Methods : Sprague-Dawley Rats were induced with temporal global cerebral ischemia (TGI) by occluding the bilateral common carotid artery with hypotension, The rats were divided into 3 groups. We treated one group with methanol extract of JRH after operation, another group before and after the operation. We observed Bax expressions inducing apoptosis of neurons and TUNEL-positive Pyramidal Neurons as an index of survival and apoptosis of pyramidal neurons in CA1 Hippocampus. Results : JRH treatment before and after TGI inhibited Bax expression in CA1 hippocampus. JRH treatment before and after TGI reduced the cell death of pyramidal neurons in CA1 hippocampus. JRH treatment after TGI reduced the cell death of pyramidal neurons in CA1 hippocampus. JRH treatment before and after TGI reduced TUNEL-positive cells in CA1 hippocampus. Conclusion : These results suggest that JRH has a neuroprotective effect (by anti-apoptosis) against cerebral ischemia.

  • PDF

Two Cases of Methylmalonic Acidemia where Refusal to Blood Transfusion Led to Death (종교상의 이유로 수혈을 거부하여 사망한 메틸 말로닌산 혈증 환아 2례)

  • Jang, Ha Won;Lee, Yong Wook;Chang, Meayoung;Kil, Hong Ryang;Kim, Sook Za
    • Journal of The Korean Society of Inherited Metabolic disease
    • /
    • v.18 no.2
    • /
    • pp.50-54
    • /
    • 2018
  • Jehovah's Witnesses do not accept blood transfusions, because of their particular interpretation of the Old and New Testaments. When people with such religious convictions are in need of medical care, their faith and belief may become an obstacle for proper treatment, and pose legal, ethical, and medical challenges for the health care providers. We report two inherited metabolic disorder cases in South Korea where the infants died whilst under medical care because of parental refusal of blood transfusions for religious reasons. Case 1 had methylmalonic acidemia, Down syndrome and associated congenital cardiac anomalies requiring surgery. Case 2 had anemia and methylmalonic acidemia requiring dialysis to treat hyperammonemia and metabolic acidosis. For effective medical management, they needed life-saving blood transfusions. As a part of alternative treatment, Erythropoietin was administered in both cases. As a result, two babies died from their extremely low hemoglobin and hematocrit. The hemoglobin concentrations below 2.7 g/dL without cardiac problem and 5.4 g/dL with cardiac anomaly complicated by pulmonary hypertension are considered life-threatening hemoglobin threshold. The medical professional must respect and accommodate religious beliefs of the patients who can make informed decisions. However, when parents or legal guardians oppose medical treatment of their babies and incompetent care receivers on cultural and religious grounds, the duty to assist and save persons exposed to serious danger, particularly life-threatening events must come first.

  • PDF

Analysis of Postpneumonectomy Complications (전폐절제술후 발생한 합병증에 대한 분석)

  • 허강배
    • Journal of Chest Surgery
    • /
    • v.26 no.8
    • /
    • pp.613-619
    • /
    • 1993
  • As developing surgical techniques and postoperative cares, a pneumonectomy is a relatively popular surgical method in disease which is not treated completely with other type of pulmonary resection, but a postpneumonectomy complication is a life-threatening serious problem if it occurred. We performed one hundred twenty-five cases of pneumonectomy for treatment of various causes of pulmonary diseases in Kosin Medical College during about ten years, and we experienced 41 cases of postoperative complications in 29 patients, so we analyzed them. The most common complication is an empyema thoracis in 13 cases[10.4%], of which one case combined with bronchopleural fistula died on early postoperative day. Of them except one case, the early postoperative empyema thoracis[within 30 days] were 6 cases, and the late postoperative empyema thoracis[above 30 days] were 6 cases. The main etiologic pathogens were a staphylococcus in early postoperative empyema and a streptococcus in late postoperative empyema, but the most cases were mixed infections with pseudomonas, klebsiella, acinectobacter, and candida. The treatment of postoperative empyema thoracis were that 4 cases were treated with open drainage using chest tube, 7 cases with Clagett`s operation, and 1 case with thoracoplasty. The next common complication was a postoperative serious respiratory insufficiency in 7 cases. And the other complications were massive postoperative bleeding in 5 cases, of which 2 cases advanced to occurrence of postoperative empyema thoracis, and wound disruption in 4 cases, cardiac arrhythmia in 3 cases, contralateral pneumothorax and pneumonia in each of 2 cases, esophagopleural fistula in 1 case. The postoperative deaths were 9 cases[7.2%] of 125 cases, the causes of death were respiratory insufficiency in 6 cases, sepsis in 2 cases, and cardiac arrhythmia in 1 case.

  • PDF

Gait Feature Vectors for Post-stroke Prediction using Wearable Sensor

  • Hong, Seunghee;Kim, Damee;Park, Hongkyu;Seo, Young;Hussain, Iqram;Park, Se Jin
    • Science of Emotion and Sensibility
    • /
    • v.22 no.3
    • /
    • pp.55-64
    • /
    • 2019
  • Stroke is a health problem experienced by many elderly people around the world. Stroke has a devastating effect on quality of life, causing death or disability. Hemiplegia is clearly an early sign of a stroke and can be detected through patterns of body balance and gait. The goal of this study was to determine various feature vectors of foot pressure and gait parameters of patients with stroke through the use of a wearable sensor and to compare the gait parameters with those of healthy elderly people. To monitor the participants at all times, we used a simple measuring device rather than a medical device. We measured gait data of 220 healthy people older than 65 years of age and of 63 elderly patients who had experienced stroke less than 6 months earlier. The center of pressure and the acceleration during standing and gait-related tasks were recorded by a wearable insole sensor worn by the participants. Both the average acceleration and the maximum acceleration were significantly higher in the healthy participants (p < .01) than in the patients with stroke. Thus gait parameters are helpful for determining whether they are patients with stroke or normal elderly people.

Surgical Management of Gastroesophageal Reflux Disease (소아 위식도 역류 질환의 외과적 치료)

  • Kim, Seong-Chul;Kim, Dae-Yeon;Kim, Kyung-Mo;Kim, In-Koo
    • Advances in pediatric surgery
    • /
    • v.6 no.2
    • /
    • pp.100-105
    • /
    • 2000
  • Eleven children with gastroesophageal reflux disease underwent fundoplication. Eight had neurological impairment, two had hiatal hernias and one had a history of esophageal repair for esophageal atresia. The most common and significant symptom was vomiting(81.8 %), followed by recurrent respiratory infections(72.7 %) and failure to thrive(72.7 %). The most common diagnostic tool was 24 hour esophageal pH study, which showed pH less than 4 for more than 10 % of the total recorded time in 6 of 9 patients. Nissen fundoplication was performed in 10 patients. Thal fundoplication was carried out in one patient with esophageal atresia. Stamm gastrostomy was added for nutritional and/or swallowing problem in all 8 patients with neurological impairment. The median follow up period was 13 months. There was one late death of unrelated cause and one recurrence. The quality of life after antireflux surgery was greatly improved. Antireflux surgery should be done if indicated, and a simultaneous gastrostomy considered in a patient with neurological impairment.

  • PDF

Optimal Amount and Mixture Ratio of Seeding of the Exotic and Native Plants for Slope Revegetation(I) (사면 녹화용 외래초종과 재래 목·초본식물의 적정 파종량 및 혼파비에 관한 연구(I))

  • Jeon, Gi-Seong;Woo, Bo-Myeong
    • Journal of the Korean Society of Environmental Restoration Technology
    • /
    • v.2 no.2
    • /
    • pp.33-42
    • /
    • 1999
  • The objective of this study was to determine the optimal amount and the mixture ratio of seeds for revegetation species by investigating their growth characteristics. For the purpose of the experiments, 15 plants were chosen. In May of 1995 to September of 1998, the nursery seedbeds of the College of Agriculture and Life Sciences, Seoul National University were seeded with the mixtures of those species. Then, the nursery seedbeds were treated to investigate the effects of the amount of seeding, the amount of fertilizer, and the depth of soil on the growth characteristics. As the results of the experiments, it was found that the effects of all the treatments on growth of shoots and roots were significant in the early phase. For the expected number of seedlings more than 3,000 per square meter, many seedlings got withered to death while the survivors were suppressed to grow slow in the early stage due to the density problem.

  • PDF

In situ Delivery of Therapeutic Proteins by Recombinant Lactococcus lactis

  • Steidler, Lothar;Neirynck, Sabine
    • Journal of Microbiology
    • /
    • v.41 no.2
    • /
    • pp.63-72
    • /
    • 2003
  • Chronic inflammatory bowel disease (IBD) such as Crohn's disease or ulcerative colitis, affects around 2 in every 1000 individuals in western countries and its incidence, particularly amongst children, is increasing. IBD shows extreme morbidity with impact on all aspects of quality of life. If left untreated, IBD can lead to death. Conventional treatment of IBD involves powerful immunosuppressive chemotherapies and surgical intervention. Long-term anti-inflammatory medication is required and so patients are often subject to a spectrum of unpleasant side effects. Interleukin-10 (IL-10) is a cytokine that acts to suppress inflammation. When however administered by injection, the high levels of IL-10 that are distributed throughout the body also lead to side effects. Lactococcus lactis can be genetically engineered to secrete biologically active cytokines. When applied to the mucosa, these L. lactis can actively deliver such cytokines. By use of this principle we developed a new therapeutic approach for IBD. Administration of L. lactis that secretes murine IL-10 cures and prevents IBD in mice. The use of the engineered L. lactis gets around the problem of delivering IL-10, allowing dramatic reduction of the effective dose. A sincere concern exists about the possible dangers of uncontrolled, deliberate release of genetically modified microorganisms, such as could occur following application in healthcare. We engaged in the establishment of adequate means for biological growth control of engineered L. lactis by targeted gene exchange between thyA and hIL-10.

A Study on Effect of Individual Education about Chemical Therapy for Preventing Cancer on Quality of Life of Patient Who Suffers From Cancer (항암화학요법에 관한 개별교육이 암 환자의 삶의 질에 미치는 효과)

  • Choo, Yeun-Hwa;Kim, Kyung-Hee
    • Asian Oncology Nursing
    • /
    • v.4 no.2
    • /
    • pp.103-109
    • /
    • 2004
  • The disease occurrence rate of the cancer is rapidly increased and It is becoming the main factor for the death The chemical therapy for preventing the cancer is recently used for many patients and thus extended the life of the patients. However, the side effect caused by the medical substances when performing the chemical therapy for preventing the cancer and the consequent mental and social problem are incurred to deteriorate the quality of the life. Therefore, it is needed to help the patient In order to reduce the above problems, and so this study was executed in order to examine the effect of the individual education on the quality of the life of the patients who are treated by the chemical therapy for preventing the cancer. The study was performed from Jan. 19. 2004 to Apr. 18. 2004 for the patients who were firstly treated by the chemical therapy for preventing the cancer in a university hospital located in the downtown in Seoul. The individual education on the chemical therapy for preventing the cancer was provided to 40 patients of the experimental group. The study plan is the experimental plan before and after the sole group, and it is the beginning experimental plan. The title of the booklet on the chemical therapy for preventing the cancer is "Cancer, The more you know, the more you can be cured", and the book was composed up of the side effect of the chemical therapy for preventing the cancer, treatment way for the side effect, and guide of the daily life. The survey with the questionnaire sheet was distributed to the experi- mental group before the education, the survey sheet was made out when they were hospitalized for 3-4 weeks after the education, and the data were examined by using SPSS statistical program with making our the survey questionnaires and the change of the quality of the life before and after the education of the patients who are treated by the chemical therapy for preventing the cancer was analyzed by using the parred t-test. The research result was verified that it has the meaningful that the quality of the life for the physical field, mental field, social field, and spiritual field after the individual education. The suggestion concluded by the above research result is as follows. First, there is the limitation to interpret the result since it was the beginning experimental plan for the sole group. Thus, it is suggested that the similar experimental plan should be executed with the expansion of the research subject and also with the contrast group. Second, it is suggested that the study on the change of the quality of the lifeaccording to the support of the individual education and family of the patients who are treated by the anti-cancer therapy.

  • PDF