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*

No abstract available.
Child* ; Humans ; Lung*

OBJECTIVES: To develop reliable tools for measuring communication skills in schizophrenia, the present study proposed the concept of communication intelligence, consisting of conversational competence, emotional competence, and empathic competence, and explored its neurobiological underpinnings using regional gray matter volume with healthy people. METHODS: Communicative intelligence scores were obtained from 126 healthy young participants. Correlation analyses between regional volume distributions and communication intelligence subcomponents were conducted using voxel-based morphometry of structural MRI. RESULTS: The significant positive correlations between the regional gray matter volumes with conversational competence were found mainly at the ventromedial frontal gyrus while the negative correlations between the bilateral middle frontal gyrus. With emotional competence, the volume of right superior temporal gyrus was positively and that of bilateral insula was negatively correlated. With empathic competence, the volume of the left middle frontal gyrus was positively and that of the insula was negatively correlated. CONCLUSION: Each of the subcomponents of communicative intelligence scores showed distinctive neurobiological underpinnings. The regions for the subcomponents, which constitute a common network for social cognition and emotion, are highly associated with the regions of the schizophrenia pathology. In conclusion, communicative intelligence scales have neurobiological basis to evaluate social skills of patients with schizophrenia.
Cognition ; Humans ; Intelligence* ; Magnetic Resonance Imaging ; Mental Competency ; Pathology ; Schizophrenia ; Weights and Measures

No abstract available.