• Journal of Yeungnam Medical Science
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• v.8 no.2
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• pp.52-62
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• 1991

The toxic effect of azalea extract, expecially on cardiovascular system, is relatively unclear. The purpose of this study is to study the possible underlying mechanism and effect of toxic ingredient of azalea on cardiovascular system. The 71 healthy rabbits were divided into 10 groups : In group as preliminary study ; 4cc of normal saline was administered intravenously(N) ; 0.7gm/kg and 1.0gm/kg of azalea extract was administered respectively in the same route, volume(A1, A2) ; atropine was administered intravenously(A) ; after pretreatment with atropine(0.04mg/kg) to block parasympathetic system, azalea extract was injected like the above groups(AA1, AA2) ; normal saline, 0.7gm/kg and 1.0gm/kg of azalea extract were administered respectively with 0.2cc(1 : 1000) epinephrine(E0,E1,E2). We measured the following indices at I minute interval during first 10 minutes and then 10 minute interval during next 30 minutes : RR interval, QTc interval, maximal systolic and diastolic pressure drop with occuring time and presence of significant arrhythmia. The results were as follows : 1. The changes of RR interval, QTc interval were significantly increased in groups by Azalea extract. The blood pressure change was significantly decreased in groups by Azalea extract. There were no significant differences according to dosage of Azalea extract. 2. The changes of RR interval, blood pressure were significant differences between administration of atropine and Azalea extract after pretreatment with atropine, but not in the change of QTc interval. 3. There were no significant differences in the change of RR interval, ATc interval, blood pressure drop according to pretreatment with atropine. 4. The interaction between epineprine and Azalea extract was not noted by the effect of epineprine itself. 5. The ST change by 0.7gm/kg, 1.0gm/kg of Azalea extract was revealed in 1 case(14.0%), 7 case(100%), respectively. 6. Most of all cases with arrhthymia, ventricular tachycardia, ventricular fibrillation, were noted in the group by epineprine, except one case by Azalea extract(1.0gm/kg). It was idioventricular rhythm. In conclusion, azalea extract has negative inotropic and chronotropic effect with arrhythmogenic potential possibly through direct myocardial ischemia or injury but we cann't be absolutely exclusive of actions of autonmic nervous system, especially parasympathetic nervous system.

• Journal of Korean Physical Therapy Science
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• v.5 no.3
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• pp.659-674
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• 1998

This Study was to investigate elaborated research themes and direction through specifying the problems of clinical practice education and looking for the direction of improvement. It was in the basis of the viewpoint of the educators that professors and therapists who were the subjects of this study. Perform this study, the 15 colleges' professors and the 55 hospitals' therapists was made up questionnaire, and the data was analysing by Chi-square test and percentage. The results were as follow : ${\cdot}$ In a personal history among the general qualities, professors have little clinical practice history(l-5 years, 53.3%), and therapists have little lecture career(1-5 years, 43.6%, have no 49.0%), ${\cdot}$ The 78.6% subjects were unsatisfied of clinical practice systems. ${\cdot}$ The correlation between clinical history, school career and lecture career and the satisfaction level of clinical practice systems has no(P<.005), ${\cdot}$ The subjects were agreed to that clinical practice curriculum should be changed(67.1%), reinforced(82.9%), and specified(90.0%). ${\cdot}$ The clinical practice credits are 11 points averagely. ${\cdot}$ In the clinical practice curriculum, it made no difference in the practicum of diseases, modality, and the therapeutic techniques between professors and therapists. ${\cdot}$ The 100% professors said that the practicum of the patients' assessment is necessary, and the 63.6% therapists were training for that. ${\cdot}$ The 66.7% professors said that the practicum of the clinical psychology is necessary, and only the 20.0% therapists were training for that. ${\cdot}$ The 93.3% professors said that the practicum of the patients' management is necessary, and the 50.9% therapists were training for that. ${\cdot}$ The 66.7% professors said that the practicum of the medical ethics is necessary, and the 34.5% therapists were training for that. ${\cdot}$ The 46.7% professors said that the practicum of the hospital administration is necessary, but the 54.5% therapists have not training. ${\cdot}$ The 33.3% professors said that the practicum of the pharmacology is necessary, but the 81.8% therapists have not training. ${\cdot}$ The 86.7% professors said that the practicum of the patient's education is necessary, and the 43.6% therapists have training. ${\cdot}$ The 66.7% professors said that the practicum of the prosthesis and brace is necessary, but the 14.5% therapists have not training. ${\cdot}$ The 60.0% professors said that the practicum of the exercise prescription is necessary, but the 25.5% therapists have not training. ${\cdot}$ The 53.5% professors said that the practicum of the emergency treatment is necessary, but the 52.7% therapists have not training. ${\cdot}$ Drawing up the plan about the curriculum of clinical practice, the professors (46.7%) were agreed to national master plan framing by an expert advisor, but the therapists (58.2%) said that the plan that make the most of hospitals' characteristics should be specified. ${\cdot}$ It was found that a clinical special therapists(54.5%) was good as a person in charge of clinical practice education, in that each therapist's own good time (34.5%) was. ${\cdot}$ It made use of the form framing by college(40.0%) as the clinical practice textbook, the form framing by hospital (42.9%) and each therapist(22.9%) as the plan, and the form framing by college (74.3%) as the measurement. ${\cdot}$ The most difficult point in clinical practice education was the lacks of the theory-praciticum linkage(78.2%). ${\cdot}$ It was found that the period of clinical practice was in the second semester-third grade (40.0%) and the desirable period was in the first semester-third grade(50.0%). ${\cdot}$ Professors (53.3%) were agreed that the desirable clinical practice duration was from four months to six months(60.0%), and the therapists (60.0%) were agreed that from one month to three months. ${\cdot}$ This study presented the lacks of rearing the experts, the lacks of cultural education, and the lacks of the theory-clinical practice linkage. There were need to develop the systematic programs, clinical practice textbooks, the measurements and the special hospital for clinical practice. And it was need to reduce the gab between of the hospitals for clinical practice, to cut down the costs. and to improve the labour conditions of leaders. In view of this findings, it takes notice of that both professor and therapist were dissatisfied at the present clinical practice systems. These results point out the problems of clinical practice systems, and do not make expect to us the successive and positive clinical practice. The general, specific and intensive plan about the problems and the direction of improvement that establishing the level of hospital for clinical practice and physiotherapy can be elaborated.

• Radiation Oncology Journal
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• v.11 no.1
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• pp.29-34
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• 1993

Experiments have been carried out with C3H mouse fibrosarcoma (FSa II) to determine the effect of different sequence and time intervals between irradiation and administration of cis-diammihedichloroplatinum (cis-DDP) with gross tumors (6 mm in diameter), microscopic tumors (3 days after transplantation of $10^3$ cells) and cells in culture. The drug was administered either 24, 12, 8, 4, 2, 1, 0.5 hour before irradiation, immediately before irradiation, or 0.5, 1, 2, 4, 8, 12, 24 hours after irradiation. In case of in vivo studies, tumor growth delay was used as an end point. Clonogenic cell surviving fraction was used for in vitro studies. Tumor growth delay for gross tumor after 10 Gy radiation plus 10 mg/kg cis-DDP ranged from 6.3 to 10.66 days and the enhancement ratio ranged from 1.37 to 2.23. The most effective combination was when cis-DDP was given 4 hours before irradiation. Tumor growth delay for microscopic tumor after 5 Gy of radiation and 5 mg/kg of cis-DDP ranged from 3.55 to 11.98 days with enhancement ratio from 2.05 to 6.92. Microscopic tumors showed response significantly greater than additive in every time interval and the most effective treatments were when cis-DDP was given 2 and 1 hour before irradiation. In in vitro experiment, the surviving fraction after 6 Gy of radiation and 1 hour exposure to 4 ${\mu}M$ cis-DDP fluctuated as a function of time between treatments, but the difference between maximum and minimum surviving fractions was very small. According to the above results the sequence and time interval between irradiation and chemotherapy is very critical especially for the management of microscopic tumors as in the case of postoperative adjuvant treatment.

• The Korean Society of Law and Medicine
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• v.21 no.1
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• pp.187-220
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• 2020

Today, administrative legislation is becoming more and more important in that it not only sets the legal life relationship of the people in great detail and detail, but is closely related to the occurrence, extinction, and alteration of rights and obligations held by prisoners. In the United States, the types of administrative legislation are divided into substantive and interpretative regulations, so-called substantive regulations, which give prior notice and opportunity to comment on interested parties through formal or informal administrative procedures in accordance with Article 553 of the Federal Administrative Procedures Act. On the other hand, the interpretation regulation, which is "the regulation established by the Administration for the simple interpretation of statutes," does not require prior notice or comment because it does not affect the people's rights obligations. The Azar v. Allina Health Service, 587 U.S. 1804, 2019 ruling by the U.S. Constitutional Court, subject to this research paper, is about a dispute over a new decision to require Medicare to determine the amount of compensation for care providers that provide medical services for the poor, and should the regulations be regarded as substantive under the Administrative Procedures Act and should not be given a hearing or a simple internal process for processing. Given that the current administrative procedure law of our country stipulates the procedures for administrative pre-announcement through Articles 42.1 and 44.1, but that our courts have not judged violations of legislative pre-announcement procedures under the Administrative Procedures Act so far as to judge the illegality of administrative legislation, the dispute of the U.S. Constitutional Court will provide new implications for controlling legal orders beyond simple legal interpretation and has great significance in terms of readjustment of relevant regulations under future administrative procedures.

• Journal of Hospice and Palliative Care
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• v.19 no.2
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• pp.119-126
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• 2016

Purpose: This study analyzed the difference in survival time of patients with delirium according to sedative medication. Methods: From January 2012 through December 2013, a retrospective cohort study was performed using the electronic medical records (EMR) of Pusan National University Hospital. Among 900 patients who died from cancer, we selected 240 who suffered delirium based on the EMR. The Nu-DESC delirium screening test was used to diagnose delirium. Results: The median length of delirium period was five days. Delirium characteristics were dominated by inappropriate behaviors (35.0%). Sedatives were administered in 72.1% of the cases. The most frequently used sedative was haloperidol which was used in 59.6% of cases. The delirium period significantly differed by patients' age (F=3.96, P=0.021), cancer type (F=3.31, P=0.010), chemotherapy (t=-3.44 P=0.001). The average survival time was 16.85 days for the sedative medication group and 9.37 days for the non-medication group, which, however, was not significant (t=1.766, P=0.079). Conclusion: In this study, the use of sedatives did not affect patients' survival time. Thus, appropriate sedative medication can be positively recommended to comfort terminal cancer patients and their families.

• Journal of Pharmaceutical Investigation
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• v.31 no.4
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• pp.289-295
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• 2001

Carvedilol is an antihypertensive and antianginal compound that combines nonselective beta-adrenoceptor blocking and vasodilation properties and is devoid of intrinsic sympathomimetic activity. The purpose of the present study was to evaluate the bioequivalence of two carvedilol tablets, $Dilatrend^{TM}$ (Chong Kun Dang Pharmaceutical Co., Ltd.) and $Carvelol^{TM}$ (Dae Won Pharmaceutical Co., Ltd.), according to the prior and revised guidelines of Korea Food and Drug Administration (KFDA). The carvedilol release from the two carvedilol tablets in vitro was tested using KP VII Apparatus II method with various different kinds of dissolution media (pH 1.2, 4.0, 6.8 buffer solution, water and blend of PSB80 into water). Eighteen normal male volunteers, $24.22{\pm}1.86$ years in age and $64.81{\pm}4.56\;kg$ in body weight, were divided into two groups and a randomized $2{\times}2$ cross-over study was employed. After one tablet containing 25 mg of carvedilol was orally administered, blood was taken at predetermined time intervals and the concentrations of carvedilol in serum were determined using HPLC method with fluorescence detector. The dissolution profiles of two carvedilol tablets were very similar at all dissolution media. Besides, the pharmacokinetic parameters such as $AUC_t$, $C_{max}$ and $T_{max}$ were calculated and ANOVA test was utilized for the statistical analysis of the parameters using non-transformed and logarithmically transformed $AUC_t$ and $C_{max}$. The results showed that the differences in $AUC_t$, $C_{max}$ and $T_{max}$ between two tablets based on the $Dilatrend^{TM}$ were 2.23%, -2.00% and 0.00%, respectively. Minimum detectable differences $({\Delta})$ at ${\alpha}=0.05$ and $1-{\beta}=0.8$ were less than 20% (e.g., 13.55% and 17.61% for $AUC_t$ and $C_{max}$, respectively). The powers $(l-{\beta})$ at ${\alpha}=0.05$, ${\Delta}=0.2$ for $AUC_t$ and $C_{max}$ were 98.08% and 88.81%, respectively. The 90% confidence intervals were within ${\pm}20%$ (e.g., $-5.69{\sim}10.16$ and $-12.30{\sim}8.30$ for $AUC_t$ and $C_{max}$, respectively). There were no sequence effect between two tablets in logarithmically transformed $AUC_t$ and $C_{max}$. The 90% confidence intervals using logarithmically transformed were within the acceptance range of log(0.8) to log(1.25) (e.g., $0.95{\sim}1.11$ and $0.89{\sim}1.09$ for $AUC_t$ and $C_{max}$, respectively). Two parameters met the criteria of prior and revised KFDA guideline for bioequivalence, indicating that $Carvelol^{TM}$ tablet is bioequivalent to $Dilatrend^{TM}$ tablet.

• Journal of Hospice and Palliative Care
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• v.12 no.4
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• pp.194-198
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• 2009

Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea Purpose: Malignant bowel obstruction causes gastrointestinal symptoms and leads to diminished quality of life in patients with advanced cancer. Several studies have shown the efficacy of octreotide for the relief of malignant bowel obstruction-related symptoms. The aim of this study is to assess the efficacy and safety of octreotide in patients with malignant bowel obstruction. Methods: We retrospectively reviewed medical records of twenty nine patients who had suffered from malignant bowel obstruction without clinical improvement of conservative care and subsequently, received octreotide treatment. Initial dosage of octreotide was 0.1 mg/day, and dose was escalated depending on the clinical effect. For each patient, we assessed visual analogue scale (VAS) of pain, number of vomiting episode, and amount of nasogastric tube drainage. Results: Median dosage of octreotide was 0.2 mg/day (range 0.1~0.6), and median duration from initial medication to death was 20 days (range 2~103). VAS before and after octreotide treatment were 5.6$\pm$1.24, and 2.7$\pm$0.96, respectively. The numbers of vomiting episode before and after octreotide treatment were 3.6/day$\pm$2.5, and 0.4/day$\pm$0.8, respectively. The mean amounts of nasogastric tube drainage before and after octreotide treatment were 975$\pm$1,083 cc/day and 115$\pm$196 cc/day, respectively. Statistically significant reduction in VAS, the number of vomiting episode and the amount of nasogastric tube drainage were observed after octreotide treatment (P<0.05). Conclusion: Administration of octreotide in patients with malignant bowel obstruction, which is uncontrolled by other medication, was effective and safe. In such clinical situations, physicians should consider to add of octreotide for symptomatic control.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.4
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• pp.2691-2703
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• 2015

This research aims to provide basic materials for assisting DNR patient cares by understanding ICU nurses' awareness and ethical attitude regarding DNR. A total of 154 results were analyzed which were collected from Aug. 1st to Sep. 5th in 2014 by surveying nurses working in ICU (from 1 advanced general hospital in G metropolitan city and other general hospitals of more than 700 beds in Cheolla provinces). (1) For the decision attitudes of DNR, there were both consent and objection. Consent for the patient's opinion of rejecting further treatment and life extension despite of bad prognosis. And objection for no conducting DNR in the case of the patient's wish, treatment requested by the guardian, and CPR for the patient who has no chance. (2) Objection for artificial respirator and other treatment requested by the patient's family and the entrance of guardians into ICU. Consent for the passive use of artificial respirator by the doctor and the decrease of basic care to stabilize patients physically and mentally. No specific opinion for treatment not following aseptic techniques. Objection for frequent reports to primary care physician requested by the family. (3) Acknowledging less interest by the doctor, while supporting the health care team in the case of the guardian's complaint, objection for the DNR decision mede by the primary care physician. Objection for the DNR decision by the guideline. Objection or neutrality for straightforward explanation to the patient of bad prognosis. Objection for straightforward explanation of the patient's status (even near to death) to the patient him/herself or the guardian. In conclusion, the subject of DNR is the patient and the patient's opinion should be fully reflected. The conflict arising from the scope of medical practice and decision processes should be minimized. The standard and guideline for DNR decision is required for the ethical decision making for the patient along with agreements based on full explanations.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.5
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• pp.2178-2188
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• 2012

This study is based upon 200 final responses from a survey conducted for 153 nurses and 147 nursing students in Busan and Gyeongnam province from september to october 2011. It is carried out to compare and understand the spiritual needs of nurses and nursing students that are inclined to be more exposed unhealthy people rather than healthy people. In this study, the level of spiritual care needs was divided into five fields such as 'love and fellowship', 'hope and peace', 'meaning and purpose of life', 'acceptance of death' and 'relationship with God' and was investigated. As a result, the love and fellowship was the highest level in group of nurses (r = 3.82) and the relationship with God was the lowest one (r = 2.73). In contrast, a group of nursing students showed that love and fellowship was the highest level (r = 3.92) and relationship with God was the lowest (r = 2.99) among five fields. There were statistical significances between nurses and nursing students in 'acceptance of death' and 'relationship with God' (p < 0.05). When looking at correlation between fields of spiritual needs of nurses, the correlation between 'meaning and purpose of life' and 'hope and peace' was the highest (r = .699) and the correlation between 'relationship with God' and 'hope and peace' was the lowest (r = .247). As the result of analysis on correlation between fields of spiritual needs of nursing students, the correlation between 'meaning and purpose of life' and 'hope and peace' was the highest (r = .660) and the correlation between 'acceptance of death' and 'relationship with God' was the lowest (r = .277). Therefore, it would be imperative to develop a more efficient and systemized education program for the spiritual care of nursing patients, on the basis of understanding the spiritual needs of nurses and nursing students.

• Journal of Biomedical Engineering Research
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• v.19 no.3
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• pp.279-284
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• 1998

Deep hypothermic circulatory arrest(DHCA), in which systemic temperatures of 2$0^{\circ}C$ or less are used to allow temporary cessation of the circulation, is an useful adjunct in cardiac surgery. Because man in natural circumstances is never exposed to the extreme hypothermic condition, however, one of the controversial aspects is appropriate blood gas management($\alpha$STAT versus PH-STAT) during DHCA. This study aims to compare $\alpha$STAT with PH-STAT management for control of blood gases in experimental cardiopulmonary bypass(CPB) circuits with a membrane oxygenator. Fourteen young pigs were assigned to one of two strategies of gas manipulation. After a median sternotomy, CPB was established. Core cooling was initiated and continued until nasopharyngeal temperature fell below 2$0^{\circ}C$. The flow rate was set at 2,500 ml/min. Once their temperatures were below 2$0^{\circ}C$, the animals were subjected to circulatory arrest for 40mins. During cooling, blood gas was maintained according to either $\alpha$$\alpha$STAT or pH-STAT strategies. After DHCA, the body was rewarmed to normal body temperature. Arterial blood gases were measured before the onset of CPB, before cooling, before DHCA, at the point of 27$^{\circ}C$ during re-warming, on completion of re-warming. Cooling time was significantly shorter in $\alpha$-STAT than PH-STAT strategy, while there was no significant differences in rewarming time between two groups. Carbon dioxide was added between 5.5 and 3.0% in PH-STAT, while no carbon dioxide was added in $\alpha$STAT management. Amounts of oxygen administration were gradually lowered as temperature decreased. In this way, criteria of PH, PaCO, and PaO adjustments were satisfied in both $\alpha$STAT and PH-STAT management groups.