Rapid progress in modern medical technology has made it possible to sustain life and/or delay death using 'heroic' treatments. The availability of life-sustaining treatment brings several issues in end-of-life care such as 'dying with dignity' and an radical increase in health care costs. The use of Advance Directives(AD) have been widely heralded by health care providers, gerontologists, and advocacy groups as means of protecting patients' right to accept or refuse life-sustaining treatment in end-of-life care. The use of AD can not only improve patients' autonomy and quality of life but also bring efficiency in distributing health care resources. The proportion of older persons in Korean population has been increasing. Those 65 years of age or over were about 7 percent of the population. Death and dying is not limited to older persons, but it is more prevalent among them. In conjunction with an aging population and the increasing prevalence of death, the issues of death and dying will become crucial in near future in terms of 'dying with dignity', 'autonomy', and 'self-control'. This paper attempts to explode and establish the concept of advance directives (AD) based on literature review. Data sources are computer searches with the MEDLINE database. Due to the lack of prior study on AD for a Korean cases, studies abroad are reviewed. This paper suggests the need for future study on the possibility of the use of AD in Korea.
Advance Directives* ; Aging ; Surveys and Questionnaires ; Delivery of Health Care ; Health Care Costs ; Health Personnel ; Humans ; Korea ; Patient Rights ; Prevalence ; Quality of Life

No abstract available.
Carboxyhemoglobin* ; Humans ; Hyperbilirubinemia* ; Infant, Newborn*

Esophageal cancers are highly malignant neoplasms. Prognosis of esophageal cancer treated by external irradiation alone is rather poor because of local recurrence and distant metastasis. Recently intracavitary irradiation has been used as a boost therapy after external irradiation to obtain better local control. One case of esophageal cancer has been treated by high dose rate remote-controlled after loading unit as boost therapy after external irradiation. The result was excellent in short term follow up esophagogram but esophageal bleeding and esophagotracheal fistula were noted in further follow up examination after inappropriate posttreatment management including insufficient chemotherapy due to poor general condition. We reviewed possible causes of esophageal bleeding and esophagotracheal fistula after external irradiation and high dose rate ICR.
Drug Therapy ; Esophageal Neoplasms* ; Follow-Up Studies ; Hemorrhage ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Tracheoesophageal Fistula

Heterotopic pregnancy is the coexistency of intrauterine and extrauterine pregnancy. The incidence of heterotopic pregnancy is about 1 to 30,000 pregnancy in a natural cycle. However, the frequency of heterotopic pregnancy has steadily increased because of rising incidence of pelvic inflammatory disease, pelvic surgery and the development of ovulation induction and assisted reproduction. Because heterotopic pregnancy is difficult to diagnose and it has high morbidity and mortality rate, one should always take this into consideration and should conduct careful and thorough gynecologic evaluation. We have experienced a case of heterotopic pregnancy in a 29-year old woman who presented with acute abdominal pain in a natural cycle and report this case with a brief review of literature.
Abdominal Pain ; Adult ; Female ; Humans ; Incidence ; Mortality ; Ovulation Induction ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Heterotopic* ; Reproduction

PURPOSE: This study was done to explore the process of accepting CATs among nurses who experienced CATs in Korea. METHODS: Grounded theory methodology was utilized. Data were collected from 10 nurses during individual in-depth interviews. Theoretical sampling was used until the data reached saturation. Data were analyzed using the constant comparative analysis method. RESULTS: The core category emerged as "resolving the doubt and integrating" explaining the process of accepting CATs. The nurses engaged in three stages: need awareness, look for solution and integration. Causal conditions were interest as a nursing intervention and orthodox medical limitations. Context was lack of basis for application and increase in social interest. Strategies were new knowledge acquisition, having a strong will, combined with existing knowledge, and individualized intervention. Intervening conditions were others' eye, exhaustion for nurses and physical environment. Consequences were expanding of the nursing role and improved nurse satisfaction. CONCLUSION: The results of the study should facilitate application of CATs in nursing practice. To help nurses who are interested in CATs, there is a need for education programs, and further research on CATs.
Adult ; *Attitude of Health Personnel ; Awareness ; *Complementary Therapies ; Female ; Humans ; Interviews as Topic ; Middle Aged ; *Models, Theoretical ; Nurse's Role ; Nurses/*psychology ; Social Support

No abstract available.
Aneurysm, Dissecting* ; Paraplegia*

No abstract available.
Knee Joint* ; Knee* ; Torque*

PURPOSE: The purpose of this study was to provide basic data on preventive child abuse program development. METHOD: Data were collected on 105 high-risk families of child abuse intervention was obtained from their main child rearer who raised the child under 18 years, olds during 10 months period from May, 2000 to March 2001. RESULT: The results were as follows : 1. Child abuse occurred in the subject's home, in the case of mild child abuse, 'throwing an object at the child' had the highest percentage 39.1%, in severe child abuse, 'rod, stick, belt, broom beating or using a variety of objects such as' had the highest percentage 49.5%, and in very severe child abuse, 'hospitalized by belting' had the highest percentage 3.8%. 2. The degree of child abuse potential showed high risk child abuse score with a mean of 213.3. The degree of beliefs in corporal punishment showed that subjects perceived corporal punishment of children positively with a mean of 32.2. 3. With respect to the child abuse potential, there were significant correlations with the subjects' age (r=.294, p=.002), education level (r=-.442, p=.000), and family income (r=-.355, p=.000). CONCLUSION: From this study not only child abuse occurrence but also child abuse potential were severely increased in poor livelihood families. Therefore to the high risk group, individual preventive approach must be applied.
Child ; Child Abuse ; Cytisus ; Education ; Humans ; Only Child ; Program Development ; Punishment

PURPOSE: The purpose of this study was to evaluate the quality of meta-analysis regarding exercise using Assessment of Multiple Systematic Reviews (AMSTAR) as well as to compare effect size according to outcomes. METHODS: Electronic databases including the Korean Studies Information Service System (KISS), the National Assembly Library and the DBpia, HAKJISAand RISS4U for the dates 1990 to January 2014 were searched for 'meta-analysis' and 'exercise' in the fields of medical, nursing, physical therapy and physical exercise in Korea. AMSTAR was scored for quality assessment of the 33 articles included in the study. Data were analyzed using descriptive statistics, t-test, ANOVA and chi2-test. RESULTS: The mean score for AMSTAR evaluations was 4.18 (SD=1.78) and about 67% were classified at the low-quality level and 30% at the moderate-quality level. The scores of quality were statistically different by field of research, number of participants, number of databases, financial support and approval by IRB. The effect size that presented in individual studies were different by type of exercise in the applied intervention. CONCLUSION: This critical appraisal of meta-analysis published in various field that focused on exercise indicates that a guideline such as the PRISMA checklist should be strongly recommended for optimum reporting of meta-analysis across research fields.
Databases, Factual ; *Exercise ; Humans ; Publishing/*standards ; Republic of Korea ; Research

No abstract available.