• Sleep Medicine and Psychophysiology
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• v.29 no.1
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• pp.15-20
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• 2022

Objectives: Suicide is the major public mental health concerns all over the world. The comparison of suicide attempters and suicide completers could be the fundamental evidence for the suicide prevention. The aim of this study is to explore the differences between suicide attempters and suicide completers in terms of the stressors, suicide methods, and psychiatric diagnosis. Methods: Two types of secondary data were collected for the analyses. Data of the suicide attempters (n = 680) were gathered by intensive reviewing the medical records of Samsung Medical Center, Seoul, Republic of Korea. Data of suicide completers (n = 11,722) were collected by the psychological autopsy data which were gathered by Korean Foundation for Suicide Prevention. Suicidal methods, psychiatric disorders and stressors before suicidal attempt were compared between suicide attempter and completers. Results: Suicide completers were older and male predominant compared to suicidal attempt. Hanging or gas intoxication were more commonly used in the suicide completion, while wrist cutting or drug intoxication were more common in suicide attempters. All types of stressors were found to be high in suicide completers than suicide attempters. However, the proportion of economic and physical stress were greater in suicide completers, while the proportion of family stress were greater in suicide attempters. According to the recorded diagnoses, the rates of depressive disorders, sleep-wake disorders, substance-related disorders were higher in suicide completers, while the rates of anxiety disorders and trauma- and stressor-related disorders, bipolar and related disorders and somatic symptom disorders were higher in suicide attempters. However, after controlling the gender and age, there were no significant differences in diagnosis between suicide attempters and suicide completers. Conclusion: These findings implicate that suicide attempters and completers differed in suicide methods and type of stress. The results suggests that economic stressors, physical illness might raise the risk of suicide completion.

• The Korean Journal of Zoology
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• v.13 no.3
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• pp.68-74
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• 1970

In the previous studies, the present author found that high proportion of the follicular oocytes from mouse and rabbit ovaries are able to resume their maturation division in the anterior chamber of the eye in which they have been incubated by auto- or homoplastic transplantation. Especially in the case of the homoplastic transplantation, it was known that no trouble has been detected in the process of resumption of the oval maturation in particular connection with the antigen-antibody reaction between donor and recipient. These findings provide a possibility that the follicular oocytes from various animals would be matured in the eye even after the xenoplastic transplantation. Under such an assumption, the present studies were performed to examine the behavior of the follicular oocytes in the eye chamber of the animals of different species. For the donor of the follicular oocytes, domestic rabbits, albino rats of Sprague-Dowley strain, and albino mice of A-strain bred in our laboratory were used. The oocytes obtained from the ovarian follicules were introduced to the anterior chamber of the eye of different species of animals, with an exception of rabbit in which only the female animals were used as a recipient. The procedures of collection of ova, introduction to the eye, harvest from the eye ball, fixation, and staining were the same as mentioned in the previous reports (Cho, 1967b; Cho and Kim, 1968). The conclusions obtained are summarized as below. 1. The rabbit follicular oocytes are able to mature in the eye chambers of both male mouse and rat, although the proportion of the maturation is lower than when they are incubated autoplastically in the eye. When the ova were incubated in the male mouse eye for 24 hours, 21 per cent of them showed chromosomes at metaphase I and II, whereas the rate was 32 per cent when they were incubated in the eye of the male rat. These are apparently low comparing to the rate of 52 per cent of autoplastic transplantation. 2. When rat follicular oocytes were transferred into the mouse eye chamber and recovered after 24 hours, 43 per cent of them produced the mataphase I and II chromosomes. This proportion was higher than the result of the homoplastic transplantation which yielded 23 per cent of the ova on maturation. 3. The most striking result was found in the experiment with mouse follicular oocytes. Seventy-six per cent of the oocytes resumed their maturation division within 24 hours after they were transferred into the male rat eye chamber, and this figure was significantly high compared to the result o 55 per cent obtained by the homoplastic transplantation. In the rat eye, the induction of the degenerative ova also was low (19%). On the other hand, the proportion of the oval maturation decreased to 45 per cent, while that of degeneration increased 33 per cent when they were incubated in the eye of the female rabbit. 4. It was apparent from the present experiments that the follicular oocytes can reveal their activation to maturation in the eye chamber which contains aqueous humor which is known to be composed of low protein content and of very little gamma-globulin which acts as an antibody(Oser, 1965), and that it shows higher osmolarity than blood serum(Levene, 1958). Taking these properities into consideration the humor may provide unfavourable environment to the cells and tissues incubated in. However, it could be noteworthy finding that only the follicular oocytes in the eye of the different species can grow in healthy condition although the maturation rates are varied with the animal species. The fact that the rabbit follicular oocytes show the lower proportion in maturation may be due to the greater amount of the yolk granules in the egg cytoplasm than those in the mouse and rat oocytes. That the mouse oocytes incubated in the eye of the rat mouse and rat oocytes. That the mouse oocytes incubated in the eye of the rat resumed their maturation process in greater proportion would e explained by the fact that the rat eye chamber particularly provides the better environment to the mouse oocytes than the eye chamber of mouse does.

• Korean Journal of Cognitive Science
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• v.34 no.3
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• pp.181-196
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• 2023

Size, velocity, and time equivalence are mechanisms that allow us to perceive objects in three-dimensional space consistently, despite errors on the two-dimensional retinal image. These mechanisms work on common cues, suggesting that the perception of motion distance, motion speed, and motion time may share common processing. This can lead to the hypothesis that, despite the spatial nature of visual stimuli distorting temporal perception, the perception of motion speed and the perception of motion duration will tend to oppose each other, as observed for objects moving in the environment. To test this hypothesis, the present study measured perceived speed using Müller-Lyer illusion stimulus to determine the relationship between the time-perception consequences of motion stimuli observed in previous studies and the speed perception measured in the present study. Experiment 1 manipulated the perceived motion trajectory while controlling for the retinal motion trajectory, and Experiment 2 manipulated the retinal motion trajectory while controlling for the perceived motion trajectory. The result is that the speed of the inward stimulus, which is perceived to be shorter, is estimated to be higher than that of the outward stimulus, which is perceived to be longer than the actual distance traveled. Taken together with previous time perception findings, namely that time perception is expanded for outward stimuli and contracted for inward stimuli, this suggests that when the perceived trajectory of a stimulus manipulated by the Müller-Lyer illusion is controlled for, perceived speed decreases with increasing duration and increases with decreasing duration when the perceived distance of the stimulus is constant. This relationship suggests that the relationship between time and speed perceived by spatial cues corresponds to the properties of objects moving in the environment, i.e, an increase in time decreases speed and a decrease in time increases speed when distance remains the same.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.5
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• pp.383-393
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• 2008

Purpose: Cancer specific killing can be achieved by therapeutic gene activated by cancer specific promotor. Expression of sodium iodide symporter (NIS) gene causes transportation and concentration of iodide into the cell, therefore radioiodine treatment after NIS gene transfer to cancer cell could be a form of radionuclide gene therapy. luciferase (Luc) gene transfected cancer cell can be monitored by in vivo optical imaging after D-luciferin injection. Aims of the study are to make vector with both therapeutic NIS gene driven by AFP promoter and reporter Luc gene driven by CMV promoter, to perform hepatocellular carcinoma specific radiodiodine gene therapy by the vector, and assessment of the therapy effect by optical imaging using luciferase expression. Materials and Methods: A Vector with AFP promoter driven NIS gene and CMV promoter driven Luc gene (AFP-NIS-CMV-Luc) was constructed. Liver cancer cell (HepG2, Huh-7) and non liver cancer cell (HCT-15) were transfected with the vector using liposome. Expression of the NIS gene at mRNA level was elucidated by RT-PCR. Radioiodide uptake, perchlorate blockade, and washout tests were performed and bioluminescence also measured by luminometer in these cells. In vitro clonogenic assay with 1-131 was performed. In vivo nuclear imaging was obtained with gamma camera after 1-131 intraperitoneal injection. Results: A Vector with AFP-NIS-CMV-Luc was constructed and successfully transfected into HepG2, Huh-7 and HCT-15 cells. HepG2 and Huh-7 cells with AFP-NIS-CMV-Luc gene showed higher iodide uptake than non transfected cells and the higher iodide uptake was totally blocked by addition of perchlorate. HCT-15 cell did not showed any change of iodide uptake by the gene transfection. Transfected cells had higher light output than control cells. In vitro clonogenic assay, transfected HepG2 and Huh-7 cells showed lower colony count than non transfected HepG2 and Huh-7 cells, but transfected HCT-15 cell did not showed any difference than non transfected HCT-15 cell. Number of Huh-7 cells with AFP-NIS-CMV-Luc gene transfection was positively correlated with radioidine accumulation and luciferase activity. In vivo nuclear imaging with 1-131 was successful in AFP-NIS-CMV-Luc gene transfected Huh-7 cell xenograft on nude mouse. Conclusion: A Vector with AFP promoter driven NIS and CMV promoter driven Luc gene was constructed. Transfection of the vector showed liver cancer cell specific enhancement of 1-131 cytotoxicity by AFP promoter, and the effect of the radioiodine therapy can be successfully assessed by non-invasive luminescence measurement.

• Tuberculosis and Respiratory Diseases
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• v.48 no.4
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• pp.448-463
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• 2000

Background : Pulmonary infiltrate is a frequent cause of morbidity and mortality in patients with leukemia. It is often hard to obtain a reliable diagnosis by clinical and radiologic findings alone. The aim of this study was to evaluate diagnostic and therapeutic benefits of invasive procedures for new lung infiltrates in leukemia. Methods : Patients with leukemia who developed new lung infiltrates from December 1994 to March 1999 were included in this study. These patients were classified into the empirical group who received empirical therapy only and into the invasive group who underwent bronchoscopy or surgical lung biopsy for the diagnostic purpose of new lung infiltrates. A retrospective chart review was done to find the etiologies of new lung infiltrates, the yield of invasive procedures, outcome as well as predicting factors for survival. Results : 1) One hundred-two episodes of new lung infiltrates developed in 90 patients with leukemia. Invasive procedures were performed in 44 episodes while 58 episodes were treated with empirical therapy only. 2) Invasive procedures yielded a specific diagnosis in 72.7%(32/44), of which 78.1% had infectious etiology. Therapeutic plan was changed in 52.3%(23/44) of patients after invasive procedures. None of them showed procedure-related mortality. 3) The overall survival rate was 62.7%(64/102). Survival rate in the invasive group (79.5%) was significantly better than that in the empirical group (50.0%) (p=0.002). 4) Upon multivariate analysis, the performance of invasive procedures, no need for mechanical ventilation and achievement of complete remission of leukemia after induction chemotherapy were the independent predicting factors for survival in patients with leukemia and new lung infiltrates. Conclusion : Bronchoscopy and surgical lung biopsy are useful in the diagnosis of new lung infiltrates in patients with leukemia. However, survival benefits of invasive procedures should be considered together with disease status of leukemia and severity of respiratory compromise.

• Restorative Dentistry and Endodontics
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• v.25 no.3
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• pp.390-398
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• 2000

The purpose of this study was to evaluate the apical fitness of non-standardized gutta-percha cones in root canals prepared with rotary Ni-Ti root canal instruments of various tapers and apical tip sizes. Simulated sixty curved root canals of plastic blocks were prepared with crown-down technique using rotary root canal instruments of Maillefer ProFile$^{(R)}$ .04 and .06 taper (Maillefer Instrument SA, Switzerland). Specimens were divided into six groups and prepared as follows: Group 1, prepared up to size 25 of .04 taper ; Group 2, prepared up to size 30 of .04 taper ; Group 3, prepared up to size 35 of .04 taper ; Group 4, prepared up to size 25 of .06 taper ; Group 5, prepared up to size 30 of .06 taper ; Group 6 ; prepared up to size 35 of .06 taper. After cutting off the coronal portion of plastic, blocks perpendicular to the long axis of the canal with the use of a diamond saw, apical 5mm of canal space was analyzed. Prepared apical canal spaces were duplicated using rubber base impression material to evaluate two dimensional total area of apical canal space. Various sized gutta-percha cones were applied in the 5mm-apical canal space, which were size 25, size 30 and size 35 standardized gutta-percha cone, Diadent Dia-Pro ISO-.04$^{TM}$ and .06$^{TM}$(Diadent, Korea), and medium-fine (MF), fine (F), fine-medium (FM) and medium (M) sized non-standardized gutta-percha cones (Diadent, Korea). Coronal excess gutta-percha were cut off with a sharp blade. Photographs of impressed apical canal spaces and gutta-percha cones were taken with a CCD camera under a stereomicroscope and stored in a computer. Areas of the total canal space and gutta-percha cones were calculated using a digitalized image analysing program, CompuScope (Sungjin Multimedia Co., Korea). Ratio of apical fitness was obtained by calculating the area of gutta-percha cone to the total area of the canal space. The data were analysed statistically using One-way Analysis of Variance and Duncan's Multiple Range Test. The results were as follows: 1. In canals prepared up to size 25 ProFile$^{(R)}$ of .04 taper, non-standardized MF and F cones occupied significantly more canal space than Dia-Pro ISO-.04$^{TM}$ or size 25 standardized ones (p<0.05). 2. In canals prepared up to size 30 ProFile$^{(R)}$ of .04 taper, non-standardized F cones occupied significantly more canal space than Dia-Pro ISO-.04$^{TM}$ or size 30 standardized ones (p<0.05), and non-standardized MF cones occupied more canal space than size 30 standardized ones (p<0.05). 3. In canals prepared up to size 35 ProFile$^{(R)}$ of .04 taper, there was no significant difference in canal space occupation among non-standardized MF and F, size 35 standardized, and Dia-Pro ISO-.04$^{TM}$ cones (p>0.05). 4. In canals prepared up to size 25 ProFile$^{(R)}$ of .06 taper, non-standardized MF and F cones occupied significantly more canal space than Dia-Pro ISO-.06$^{TM}$, or size 25 standardized ones (p<0.05), and Dia-Pro ISO-.06$^{TM}$, cones occupied significantly more space than size 25 standardized ones (p<0.05). 5. In canals prepared up to size 30 ProFile$^{(R)}$ of .06 taper, non-standardized FM cones occupied significantly more canal space than Dia-Pro ISO-.06$^{TM}$ or size 30 standardized ones (p<0.05), and non-standardized F cones occupied significantly more canal space than size 30 standardized ones (p<0.05). 6. In canals prepared up to size 35 ProFile$^{(R)}$ of .06 taper, non-standardized M and FM, Dia-Pro ISO-.06$^{TM}$ occupied significantly more canal space than size 35 standardized ones (p<0.05). In summary, in both canals prepared with .04 or .06 taper ProFile$^{(R)}$, non-standardized cones showed better fitness than Dia-Pro ISO$^{TM}$ or standardized ones, which was more characteristic in smaller canals.

• Tuberculosis and Respiratory Diseases
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• v.47 no.6
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• pp.824-835
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• 1999

Background: Sleep-related breathing disorders are commonly found in patients with chronic renal failure and particularly, sleep apnea may have an influence on the long-term mortality rates in these patients. Maintenance hemodialysis is the mainstay of medical measures for correcting the metabolic derangements of chronic renal failure but it is uncertain whether it may alleviate sleep disorders including sleep apnea. Methods: Forty seven patients on maintenance hemodialysis were surveyed with the sleep questionnaire about their clinical symptoms related to sleep disorders. Among them, 15 patients underwent the polysomnography and their blood levels of urea nitrogen, creatinine, electrolytes and the arterial blood gases in the nights before and following hemodialysis were measured. Results: Forty(85.1%) of the 47 patients complained of the symptoms associated with sleep-wake cycle disturbances, 55.3% experienced snoring and 27.7% reported witnessed apneas. The duration of REM sleep increased significantly in the nights after hemodialysis compared to the nights without hemodialysis(p<0.05) and the percentage of total sleep time comprising NREM sleep decreased significantly in the nights following hemodialysis compared to the nights before hemodialysis(p<0.05). The percentage of total sleep time consisting of the stage 1 and 2 NREM sleep showed the trend for a decrease in the nights after hemodialysis(p=0.051), while the percentage of total sleep time comprising the stage 3 and 4 NREM sleep did not change between nights. The obstructive sleep apnea was more predominant type than the central one in both nights and there were no differences in the apnea index and the apnea-hypopnea index between the nights. The decrease in the blood level of urea nitrogen, creatinine, potassium and phosphorus was observed after hemodialysis(p<0.05), but the differences of parameters measured during polysomnography between the nights did not correlate with the changes of biochemical factors obtained on the two nights. Arterial blood gas analysis showed that pH was significantly greater in the nights after hemodialysis than in the nights before hemodialysis(p<0.05), but there were no correlations between the parameters examined during polysomnography and the parameters of arterial blood gas analysis(p<0.05). Conclusion: These results suggest that chronic renal failure is an important systemic disorder which is strongly associated with sleep disorders. Maintenance hemodialysis, although it is a widely accepted measure to treat chronic renal failure, did not significantly modulate the sleep architecture and the severity of sleep apnea. Thus, taking the patients with chronic renal failure into account, it is advisable to try not only to find a substantial way for correcting metabolic derangements but also to consider the institution of more effective treatments for sleep disorders.

• Magazine of the Korean Society of Agricultural Engineers
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• v.7 no.1
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• pp.861-876
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• 1965

During my stay in the Netherlands, I have studied the following, primarily in relation to the Mokpo Yong-san project which had been studied by the NEDECO for a feasibility report. 1. Unit hydrograph at Naju There are many ways to make unit hydrograph, but I want explain here to make unit hydrograph from the- actual run of curve at Naju. A discharge curve made from one rain storm depends on rainfall intensity per houre After finriing hydrograph every two hours, we will get two-hour unit hydrograph to devide each ordinate of the two-hour hydrograph by the rainfall intensity. I have used one storm from June 24 to June 26, 1963, recording a rainfall intensity of average 9. 4 mm per hour for 12 hours. If several rain gage stations had already been established in the catchment area. above Naju prior to this storm, I could have gathered accurate data on rainfall intensity throughout the catchment area. As it was, I used I the automatic rain gage record of the Mokpo I moteorological station to determine the rainfall lntensity. In order. to develop the unit ~Ydrograph at Naju, I subtracted the basic flow from the total runoff flow. I also tried to keed the difference between the calculated discharge amount and the measured discharge less than 1O~ The discharge period. of an unit graph depends on the length of the catchment area. 2. Determination of sluice dimension Acoording to principles of design presently used in our country, a one-day storm with a frequency of 20 years must be discharged in 8 hours. These design criteria are not adequate, and several dams have washed out in the past years. The design of the spillway and sluice dimensions must be based on the maximun peak discharge flowing into the reservoir to avoid crop and structure damages. The total flow into the reservoir is the summation of flow described by the Mokpo hydrograph, the basic flow from all the catchment areas and the rainfall on the reservoir area. To calculate the amount of water discharged through the sluiceCper half hour), the average head during that interval must be known. This can be calculated from the known water level outside the sluiceCdetermined by the tide) and from an estimated water level inside the reservoir at the end of each time interval. The total amount of water discharged through the sluice can be calculated from this average head, the time interval and the cross-sectional area of' the sluice. From the inflow into the .reservoir and the outflow through the sluice gates I calculated the change in the volume of water stored in the reservoir at half-hour intervals. From the stored volume of water and the known storage capacity of the reservoir, I was able to calculate the water level in the reservoir. The Calculated water level in the reservoir must be the same as the estimated water level. Mean stand tide will be adequate to use for determining the sluice dimension because spring tide is worse case and neap tide is best condition for the I result of the calculatio 3. Tidal computation for determination of the closure curve. During the construction of a dam, whether by building up of a succession of horizontael layers or by building in from both sides, the velocity of the water flowinii through the closing gapwill increase, because of the gradual decrease in the cross sectional area of the gap. 1 calculated the . velocities in the closing gap during flood and ebb for the first mentioned method of construction until the cross-sectional area has been reduced to about 25% of the original area, the change in tidal movement within the reservoir being negligible. Up to that point, the increase of the velocity is more or less hyperbolic. During the closing of the last 25 % of the gap, less water can flow out of the reservoir. This causes a rise of the mean water level of the reservoir. The difference in hydraulic head is then no longer negligible and must be taken into account. When, during the course of construction. the submerged weir become a free weir the critical flow occurs. The critical flow is that point, during either ebb or flood, at which the velocity reaches a maximum. When the dam is raised further. the velocity decreases because of the decrease\ulcorner in the height of the water above the weir. The calculation of the currents and velocities for a stage in the closure of the final gap is done in the following manner; Using an average tide with a neglible daily quantity, I estimated the water level on the pustream side of. the dam (inner water level). I determined the current through the gap for each hour by multiplying the storage area by the increment of the rise in water level. The velocity at a given moment can be determined from the calcalated current in m3/sec, and the cross-sectional area at that moment. At the same time from the difference between inner water level and tidal level (outer water level) the velocity can be calculated with the formula $h= \frac{V^2}{2g}$ and must be equal to the velocity detertnined from the current. If there is a difference in velocity, a new estimate of the inner water level must be made and entire procedure should be repeated. When the higher water level is equal to or more than 2/3 times the difference between the lower water level and the crest of the dam, we speak of a "free weir." The flow over the weir is then dependent upon the higher water level and not on the difference between high and low water levels. When the weir is "submerged", that is, the higher water level is less than 2/3 times the difference between the lower water and the crest of the dam, the difference between the high and low levels being decisive. The free weir normally occurs first during ebb, and is due to. the fact that mean level in the estuary is higher than the mean level of . the tide in building dams with barges the maximum velocity in the closing gap may not be more than 3m/sec. As the maximum velocities are higher than this limit we must use other construction methods in closing the gap. This can be done by dump-cars from each side or by using a cable way.e or by using a cable way.

• Journal of Korean Philosophical Society
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• v.105
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• pp.49-74
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• 2008

Le but de notre recherche est $d^{\prime}{\acute{e}}clairer$ la nature du $d{\acute{e}}passement$ de soi aux actes humaines dnas le Thomisme. Dans le Thomisme la nature humaine qui a la raison et la $volont{\acute{e}}$ a une $intentionnalit{\acute{e}}$ ver la fin ultime. De sorte que les actes humaines qui $corr{\grave{e}}spondent$ cette nature humaine a un $caract{\grave{e}}re$ du $d{\acute{e}}passement$ de soi visant toujours plus que le $pr{\acute{e}}sent$. Le fondement de cet acte du $d{\acute{e}}passement$ de soi est $l^{\prime}{\hat{a}}me$ rationelle qui est la forme substantielle de l'homme et de soi subsistante. Chez st. Thomas ce $caract{\grave{e}}re$ du $d{\acute{e}}passement$ a trois ${\acute{e}}taps$ distinctes : (1)le $d{\acute{e}}passement$ dans l'ordre du $progr{\grave{e}}s$ naturel (2)le $d{\acute{e}}passement$ de soi dans l'ordre morale (3)le $d{\acute{e}}passement$ de soi dans l'ordre de la religion. Le $d{\acute{e}}passement$ dans l'ordre du $progr{\grave{e}}s$ naturel apparaît d'abord au $caract{\grave{e}}re$ de $l^{\prime}{\hat{a}}me$ rationelle. St. Thomas $d{\acute{e}}finit$ les vertus rationelles comme $^{\prime}pl{\acute{e}}nitude$ dans le $f{\acute{e}}blesse$, parce qu'il $consid{\grave{e}}re$ la vertu rationelle comme $finalit{\acute{e}}$ des $facult{\acute{e}}s$ du sens $ext{\acute{e}}rieur$. L'homme par le sens $ext{\acute{e}}rieur$ reçoit des $esp{\grave{e}}ces$ sensibles(especies sensibilis), et $poss{\grave{e}}de$ les images. Puis cette images sensible devenant la $r{\acute{e}}alit{\acute{e}}$ spirituelle sous forme du $m{\acute{e}}moire$ et du souvenir, devient aussi la partie de son existence. Donc chez st. Thomas la vertue rationnelle n'est pas simplement un $facult{\acute{e}}$ $sp{\acute{e}}culative$, mais elle est dans l'ordre du devenir et du $pl{\acute{e}}nitude$. A cette raison st. Thomas compare la raison(ratio) comme $g{\acute{e}}n{\acute{e}}ration$(generatio) et l'intelleigence(intellectus) comme ${\hat{e}}tre$(esse). C'est-${\grave{a}}$-dire la raison $d{\acute{e}}passe$ le sensible et l'intelligence $d{\acute{e}}passe$ la raison. Le $d{\acute{e}}passement$ de soi dans l'ordre morale $li{\acute{e}}$ au $progr{\grave{e}}s$ de la conscience. Chez st. Thomas la perception de l'objet $ext{\acute{e}}rieur$ ayant pour but d'avoir conscience de soi, se perfectionne ${\grave{a}}$ ceci. D'avoir conscience de soi signifie d'avoir $l^{\prime}identit{\acute{e}}$ de soi, et de-$l{\grave{a}}$ apparaît l'acte moral en tnat qu'acte $sp{\acute{e}}cifique$ humain. La raison pour laquelle la vie morale elle-$m{\hat{e}}me$ a un $caract{\grave{e}}$ du $d{\acute{e}}passement$, c'est que l'acte humaine qui corresfonde ${\grave{a}}$ $l^{\prime}identit{\acute{e}}$ du soi est une vie qui vise toujours plus que le $pr{\acute{e}}sent$ ou $l^{\prime}id{\acute{e}}al$. Quant au problem du $d{\acute{e}}passement$ dans l'ordre de la religion, chez st. Thomas en raison de $l^{\prime}affinit{\acute{e}}$ entre Dieu et l'homme, $o{\grave{u}}$ il y a des vertues infuses(virtutes infusas), il y a une sorte du $d{\acute{e}}passement$ religieux. Car ces vertues infuses signifie la communication entre Dieu(${\hat{E}}tre$ absolu) et l'homme(${\hat{e}}tre$ fine) et cela signifie le $d{\acute{e}}passement$ de l'humain vers le divin. Cette $id{\acute{e}}e$ thomiste permet de penser que $o{\grave{u}}$ il y a un $d{\acute{e}}passement$ de soi dans la vie religuse d'une personne, il y a une intervention $r{\acute{e}}elle$ de la providence divine. Cette $pens{\acute{e}}e$ thomiste sera alors un $caract{\grave{e}}$ $r{\acute{e}}aliste$ face ${\grave{a}}$ la $pens{\acute{e}}e$ $id{\acute{e}}aliste$ qui n'admette que le $d{\acute{e}}passement$ absolu comme $d{\acute{e}}passement$ religieux.

• Journal of agricultural medicine and community health
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• v.1 no.1
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• pp.5-9
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• 1976

The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.