• 호스피스학술지
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• 제5권2호
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• pp.75-85
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• 2005

The objective of this research is to provide the basic material for effective hospice care by analyzing the recognition of families who have terminally ill patients over death. To do so, this research is designed to investigate the general tendency toward death and changes after hospice care. To analyse the initial status of the recognition about the death, questionnaires were provided to the families of the terminally ill patients who were taken hospice care from June 1st, 2005 to September 10th, 2005 at Saemmul Hospice. The same questionnaires were distributed to research some changes of the recognition of the death after 3 weeks. As the Data Analysis Methodology, SPSS v.10.0 statistics program were utilized. The summary of this research is as follows. First, by gender, it is analyzed that women have more fear than men in terms of incompetence sense after death. By religion, Christians have less fear than other religious people in terms of fear toward after death and general sense of death. Second, those who experienced deaths of close family members, relatives, friends for the past 3 years have more fear toward the moment of death than those who did not experience it. Third, statistically valid difference was found in terms of fear toward the moment of death, fear toward incompetence, fear toward after death, and fear toward death before and after the hospice care was taken. Based on the result of this research, terminally ill patients' families facing death have shown significant differences on fear and incompetence before and after hospice care was offered. It is necessary that the hospice care should be settled more professionally by expanding the opportunities of hospice care and institutionalizing the system. In addition, hospice activities which are focused on providing hope after death and facing death with dignity and peace should be expanded increasingly as the family members who experienced deaths showed higher degree of fear and powerlessness and Christians have less fear toward death with the help of biblical influence. It is also required that hospice care specialized in recognizing the importance of terminal cancer patients and their families at the same time.

• 한국인구학
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• 제16권2호
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• pp.65-83
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• 1993

The purpose of this study is estimate limits of Korean life expectancy at birth by 'Gompertz growth curse Model', 'Cause-Elimination Model' and Multidimensional models of Senescencee and Mortality'. Data used in Gompertz curve were obtained from all life tables published from 1905 to 1990 in Korea, and life expectancies at birth of eighteen groups were selected at five-year interval in consideration of time-series changes. Data used in Cause-Elimination Model are 'Cause of Death statistics in 1991' published in 1992 by National Bureau of Statistics of Korea and 'life table of 1989' published in 1990 by National Bureau of Statistics, Economic Planning Board of Korea. The materials are all classifiable death data, 119, 253 cases of male and 82, 420 cases of female, which is from 1991 Causes of Death statistics. The cases of death analyzed belong to one of 8 categories; i.e., Infectious and Parasitic Diseases(001-139; with notation of Infectious Diseases), Malignant Neoplasms(140-208), Hypertensive Diseases(401-405), Ischemic Heart Dieases and Diseases of Pulmonary Circulation and Other Forms of Heart Diseases(410-429;with notation of Heart Disease), Cerebrovascular Diseases(430-438), Chronic Liver Diseases and Cirrhosis(571; with notation of Liver Diseases), Injury and Poisoning(800-999) and all other disease. Data used in 'Multidimensional models of senescence and mortality' were life table of 1989 published by National Bureau of statistics, Economic Planning Board of Korea and life table of 1970, 1978-79, 1983, 1985 and 1987. The major findings may be summarised as follows: 1. Estimate equations of Gompertz growth curve using life expectancy at birth during the 1905-1990 period are as the following. Male : y = 88.047697 $\times$ $0.199690^{0.903381x}$ Female : y = 95.632828 $\times$ $0.199690^{0.903381x}$ Limits of life expectancy at birth, which were estimated by Gompertz growth curve, are 88.05 for male and 95.63 for female. 2. The effect on life expectancy at birth eliminationg all causes death is 14.04 years(for male) and 10.86 years(for female). Astonishingly, eliminating the malignant neoplasms increase life expectancy at birth by 2.85 years for male 2.03 years for female in 1991. In table 8 we show the effect on life expectancy at birth of separately eliminating each of the 8 categorical causes of death. The theoretical limit to life expectancy by Cause-Elimination Model is 80.96 for male and 85.82 for female. 3. If the same rate of delay [0.376 year(male), 0.435 year(femable) per calendar year] continued, then life expectancy at birth would reach 74.82(male) years and 84, 10(female) years in 2010. With 14.04-years(male) and 10.86-years(female) effect attributable in 2010 would be 88.86 years(male) and 94.96(femable) years. 4. 'Multidimensional models of senescence and death' permits calculations of the value of the attribution coefficient (B), percent of loss per year of physiologic function. The results of Ro and B during the 1970-1989 period are listed in table 9. Estimate of limit to Korean life expectancy at birth by 'Multidimensional models of senescence and death' is 99.47 years for male and 104.74 years for female in 1989.

• 대한의생명과학회지
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• 제12권4호
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• pp.439-442
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• 2006

To evaluate the postmortem changes in activities of oxygen free radical metabolizing enzymes, the rats were sacrificed with cervical dislocation and were kept in an incubator at $25^{\circ}C$, 70% of humidity for 12 hours. The activities of aniline hydroxylase, catalase, glutathione-S-transferase and superoxlde dismutase were decreased with the time. On the other hand, the activity and type conversion ratio (type D ${\to}$type O) of hepatic xanthine oxidase (XO) were gradually increased. From these changes of XO, the estimation of death time (mathematical equation) could be determined with the least square method. To clarify the cause of increasing XO activity, enzyme kinetics were examined. The Km values of XO were decreased with the time. In conclusion, the determination of liver XO activity might be used for the estimation of death time in the early postmortem period.

• 한국국방경영분석학회지
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• 제6권2호
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• pp.129-149
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• 1980

In medical follow-up, equipment lifetesting, various military situations, and other fields, one often desires to calculate survival probability as a function of time, p(t). If the observer is able to record the time of occurrence of the event of interest (called a 'death'), then an empirical, non-parametric estimate may simply by obtained from the fraction of survivors after various elapsed times. The estimation is more complicated when the data are truncated, i.e., when the observer loses track of some individuals before death occurs. The product-limit method of Kaplan and Meier is one way of estimating p(t) when the mechanism causing truncation is independent of the mechanism causing death. This paper proposes jackknife estimators of logistic trans-formation and compares it to the product-limit method. A computer simulation is used to generate the times of death and truncation from a variety of assumed distributions.

• 대한불안의학회지
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• 제16권1호
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• pp.1-8
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• 2020

Objective : This study aims to examine the association between exposure to suicide events and suicide ideation by analyzing the levels of suicide ideation among the groups with exposure to suicide death, non-suicide death, and no death in their social relationships. Methods : Data were derived from Wave I of the Longitudinal Study of Suicide Survivors' Mental Health. 1,998 adults nationwide selected using a stratified sampling method based on the Korean Census Data, were categorized into 3 groups with exposure to suicidal death, non-suicidal death, and no death. The levels of depression (Brief CES-D), subjective health status, and suicidal ideation (SSI) were measured. To examine the association between exposure to suicide and the level of suicide ideation, multiple regression analysis was used after controlling the socio-demographic and clinical factors including subjective health status and depression. Results : 32% reported their exposure to suicide. Compared to the other groups, the suicide-exposed group's level of depression and suicide ideation were significantly higher but the subjective health status was lower. Multiple regression model revealed that suicide exposure had a statistically significant association with suicidal ideation at p=0.000 even after controlling the clinical characteristics. Conclusion : HThe findings suggest that exposure to suicide is a risk factor for suicidal ideation. In the clinical field, it is necessary to consider patients' experience in exposure to suicide while treating and intervening in suicide-related cases. At the policy level, a mental health system for suicide prevention should consider this risk factor for those exposed to suicide in their family and social relationships.

• Anatomy and Cell Biology
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• 제57권2호
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• pp.155-162
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• 2024

Cerebral ischemia is the important cause of worldwide disability and mortality, that is one of the obstruction of blood vessels supplying to the brain. In early stage, glutamate excitotoxicity and high level of intracellular calcium (Ca²⁺) are the major processes which can promote many downstream signaling involving in neuronal death and brain tissue damaging. Moreover, autophagy, the reusing of damaged cell organelles, is affected in early ischemia. Under ischemic conditions, autophagy plays an important role to maintain energy of the brain and its function. In the other hand, over intracellular Ca²⁺ accumulation triggers excessive autophagic process and lysosomal degradation leading to autophagic process impairment which finally induce neuronal death. This article reviews the association between intracellular Ca²⁺ and autophagic process in acute stage of ischemic stroke.

• 호스피스학술지
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• 제7권2호
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• pp.15-25
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• 2007

The purpose of this study was to survey the hospital staff's perception of hospice and death and thereby, suggest the ways to help them have a mature attitude towards and a better understanding of death through an effective education on hospice. For this purpose, this study was designed to provide some data useful for the hospital staff not experienced in facing the dying patients to handle the desperate situation skillfully and engage themselves more effectively in their hospice services. For this study, the researcher conducted a questionnaire survey for the staff of 'C' hospital in Seoul about their hospice philosophy, attitudes towards hospice and perception of death for the period from February, 2006 to March, 2006. A total of 751 subjects responded effectively to the survey. The data collected were analyzed using the SF55 11.0 for ANOVA and T-test in order to test the relationships among subjects' perception of death, their demographic variables, their health condition, their hospice philosophy formed from their experiences of patients' death and hospice services and their attitudes towards hospice. Besides, the correlations among their hospice philosophy, perception of death and attitudes towards hospice were tested. The results of this study can be summarized as follows; First, as a result of testing the relationships among subjects' experiences of health consulting. their experiences of patients' death and hospice and their hospice philosophy, it was confirmed that their experiences of health and death consulting and their experiences of having been educated were relevant. Second, it was found that such variables as health condition, death, experience of hospice and attitude towards hospice were not significantly correlated with each other. Third, as a consequence of testing the relationships among health condition, death, experience of hospice and perception of death, it was disclosed that only the physical health condition was significant. Fourth, it was confirmed that subjects' hospice philosophy, perception of death and attitudes towards hospice were at the usual level on average. Fifth, hospice philosophy, perception of death and attitudes towards hospice were found correlated significantly with each other. Sixth, as a result of the stepwise variable adjustment for such variables as hospice philosophy, perception of death, attitudes towards hospice, it was found that the adjusted r-square value was 0.347 when departments, experience of having been requested by dying patient for consulting, experience of having been educated on hospice, religion and marital status were set as independent variables. And the estimated value of each variable was found significant. Seventh, as a consequence of conducting the multiple regression analysis by setting 'religion' as significant independent variable, it was found that the estimated value of physical health condition was not significant statistically. This, as a result of the simple regression analysis for 'religion' only, its explanatory power was found .197, while its adjusted r-square value was 0.20. Eight, it was found that subjects' attitude towards hospice was significantly correlated with such variables of experience of patient's or relative's death, experience of having been requested for consulting about death, gender, marital status and departments. As a result of the multiple regression analysis and the subsequent stepwise adjustment for this variable, it was found that only 'experience of having been requested for consulting' had some explanatory power: its adjusted r-square value was 0.089. As discussed above, this study tested the correlations among various variables including hospital staff's attitude towards hospice and perception of death and thereby, provided for the data useful for their education on hospice. This study may be significant in that it proved that it would be essential to educate hospital staff on hospice for more effective care of hospice patients and their family members at hospital.

• 한국동물위생학회지
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• 제22권4호
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• pp.325-347
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• 1999

This study was conducted to investigate the epidemiological, clinicopathological, microbiological, pathological observations and other tests from sudden death in feedlot cattle at the region of Sarari in Korea during the period from 1994 to 1999. Massive or sporadic occurrence of sudden death has been observed in 101 heads of 47 farmhouse. There were 20.8% in spring, 29.7% in summer, 16.8% in autumn, 32.7% in winter, and 62.3% in reproductive, 27.7% in growing, 5.0% in beef cattle, 5.0% in calf in prevalence of sudden death in cattle. Enterotoxemia(88.0%), pneumonia(3.5%), intestinal diarrhea(3.5%), liver abscess(1.5%) and indigestion(1.5%) were detected from 67 heads of sudden death cattle. In clinical observations, cattle were generally died of sudden recumbency with convulsions followed anorexia, depression, ataxia, muscular tremor, tachycardia and dyspnea without any premonitory symptoms. Epidemiological surveys showed no evidence that other factors such as pesticide, insecticide, fertilizer, chemical drug3 and those of others caused sudden death. Macroscopically, there were coagulation disorders of blood, congestion, edema and haemorrhage of lung, congestion and haemorrhages, watery and blood-tinged contents of small intestine. Histopathologically, we observed pulmonary congestion and haemorrhage, necrotic intestinal mucosa accompanied with haemorrhage and congestion, and also increased globule leukocytes between bronchial epithelia with mild pneumonia. Clinicopathologically, only elevation of blood glucose and aspartate aminotransferase(AST) was detected. Magnesium and calcium deficiency were not detected, but parasites were detected highly in normal and dead cattles. Microbiologically, Clostridium(Cl) pefringens were detected from small intestinal contents of 94% (63/67) of sudden death cattle and 51%(51/101) of slaughter cattle, and the population were $10^{6-8}$/cfu/$m\ell$ after 16~32 hours. Consequently, it was proved that the cause of death in cattle was enterotoxemia. Pathogenic test of mouse and goat inoculated with Cl perfringens type A toxin has been demonstrated as similar observation to natural cases. In antimicrobial susceptibility test, ampicillin, bacitracin, polymycin, cephalothin, penicillin, choramphenicol, erythromycin, tetracycline were highly susceptible, and amikacin, gentamicin, kanamycin, neomycin, streptomycin, sulfamethoxine, sulfamethazine were resistant. Cl perfringens were resisted for 4 hours in 3% formalin, 20 minutes in 4% phenol, 20 minutes in 0.5% mercuric chloride and 40 minutes in 0.1% sodium hydroxide, respectively. The useful method to prevent from occurrance of enterotoxemia in feedlot cattle was a dietary administration of antibiotics and miyari acid.

• Neonatal Medicine
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• 제28권3호
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• pp.99-107
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• 2021

Purpose: Studies have been conducted on the prevalence and infant mortality rate of congenital anomalies; however, studies on child mortality are rare. Therefore, we evaluated the characteristics of deaths associated with congenital anomalies among children born in Korea who died within 5 years of age. Methods: Birth-to-death cohort linked data of children under the age of 5 years from 2010 to 2013, and statistical data on the cause of death by age from 1999 to 2019, both provided by the Korea National Statistical Office's Microdata Integrated Service, were retrospectively investigated. We investigated the trends and characteristics of mortality associated with congenital anomalies. Results: Among 1,858,945 children, 6,510 children who died were under 5 years of age, and among them, 1,229 deaths were associated with congenital anomalies, while 5,281 deaths were due to other causes. Deaths associated with congenital anomalies accounted for 18.9% of all deaths. When comparing congenital anomalies by systems, anomalies of the cardiovascular system (52.6%) were the most common. The mortality rate associated with congenital anomalies and those of other causes showed similar declining trends in 21 years. Conclusion: The mortality rate of congenital anomalies during the first 5 years of life did not increase differently from the prevalence of congenital anomalies but rather decreased. Deaths associated with congenital anomalies accounted for 20.5% of all infant deaths and 12.1% of child deaths, since the major causes of death in infants and children are slightly different, continuous and careful monitoring is required.

• 호스피스학술지
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• 제7권2호
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• pp.26-41
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• 2007

There are three things that are not known to the human being. That is when, where and how one will die. Most people live ignoring death. However, elements of death linger everywhere. The purpose of this treatise is investigates about justification Deciding for Other directions. First, I will investigate about Deciding for Other directions, when patient can not decide own, I will do investigate agent's decision's problem. Second, These four principles provide the common ground for biomedical ethics. Principlism argue that a method using four principles can resolve controversies in bioethics. The method holds that there are four principles-respect for autonomy, nonamleficence, beneficence, justice- that articulate the necessary conditions of common morality for health care and bioethics. Beauchamp and Childress respond by arguing that the two problems are nc the meaning or interpretation but the process of specification. Third, So, Supplement four principles' problem to Levinas concept of the Other theory. Levinas concept of the Other is very resemblant with 'Love your neighbour as yourself." Christians believe that Love is above all and they act accordingly. They base this faith mainly upon the motto of "love your neighbour as yourself." Fourth. difficult part of Levinas concept of the Other is that there is no human to equal infinite sense of responsibility. Can be supplemented about this through cooperation of community. Four principles can be brought to bear on moral choices. And they asserts that each principles has weigh but they do not assign a priority weighting of ranking. All the principles are equal in moral decision making.