• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.163-194
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• 2017

Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.5.2-5
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• 1982

With the improvement of living standard and socioenvironmental change, esophageal stricture due to acetic acid, Hcl, insecticides and lye has led to decrease remarkably. Esophageal stricture has decreased because of immediate treatment and adequate management. However there are still sporadic incidents of esophageal stricture due to inadequate treatment and uncooperation of patients. The authors recently have experienced seven severe cases of esophageal stricture. All six patients were treated with 18-51 French Sippy esophageal dilating bougie. One patient was transfered to thoracic surgery department due to complete esophageal obstruction. Case 1. A 23 year old housewife who ingested Hcl for suicide. After Witzel's operation, she visited to dilate esophageal first constriction stircture due to swallowing difficulty postoperation 2 months later. We were treated successfully. Case 2. A case of esophageal stricuture in the second and third physiologic constriction part. The patient was 51 years old man who ingested lye accidently, and was dilated by bougination. Case 3. The patient was 43 year-old man who ingested acetic acid as a mistake and was treated inadequately at hopsital. Inspite of treatment, esophageal stricture developed at the third physiologic part. We are trying to dilate the esophagues now. Case 4. The patient was 55 year-old woman who had ingested Hcl for the purpose of suicidal attempt. 2 months later gastroduodenal anastomoisis due to pyloric region stenosis, the first physiologic constriction stricture was dilated successfully. Case 5. The patient was 41 year-old woman who ingested Hcl for suicide 4 months ago. There was indwelled orogastric tube for 1 month but esophageal stricture developed at the first and 3rd constriction part. She was treated by using a bougination. Case 6. An athlete 21 year old man, ingested acetic acid 2 spoonful per 3 days by purpose in order to soften the bone for last 14 months. There was complete esophageal obsturction in esophagogram and transferred to the thoracic surgery department. Case 7. A 3 year-old girl was ingested lye at a accident. She had a bougination for 16 months under the general anesthesia for dilation due to whole irregular esophageal stricture. She developed lower esophageal perforation, but healed eventually.

• Korean Journal of Environment and Ecology
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• v.27 no.6
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• pp.765-776
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• 2013

This study was conducted to find out availability of a urban forest (Eudeungsan) as a substitute place of Mudeungsan Provincial Park (MPP) in overuse problem and to identify related factors to place substitutability. During June-August of 2012, 232 samples who have ever visited both of the two places (i.e., MPP and Euduengsan) in Gwang-ju city were selected by using convenient sampling and snowball sampling methods. Self-administered questionnaire survey was conducted, and the valid responses from 225 samples (97.0%) were used for data analysis. 24.2% of respondents had "considerably" or "very much" intention to use the substitute place, and 65.5% of respondents showed "a little" or "somewhat" 10.3% of respondents didn't have any intention to visit Eudeungsan as a substitute place of MPP. Generally, socio-demographic and visiting characteristics were not related with intention to visit Eudeungsan as a substitute place of MPP. It was only found that respondents who largely visit 'alone' to Eudeungsan tended to have higher intention to visit the substitute place than those who visit 'in group.' Three factors of reasons to visit Eudeungsan (i.e.,Challenge/self-development: ${\beta}=0.35$; Accessibility/familiarity: ${\beta}=0.27$; Adventure: ${\beta}=-0.19$) influenced intention to visit the substitute place. Relationship between reasons to visit and intention to visit the substitute place was found. No direct relationship was found between perceived similarity of the places and intention to visit substitute place, and similarity of recreation experiences showed perfect mediating effects between the two variables.

• Radiation Oncology Journal
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• v.8 no.1
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• pp.85-93
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• 1990

A series of 25 patients with residual, recurrent, and unresectable gastric cancer received various combination of surgery, radiotherapy (RT), chemotherapy (CT), and hyperthermia (HT). They were placed into 7 categories; 1) CT and HT-14 patients; 2) RT and HT-15 patients; 3) surgery, RT and HT-2 patients; 4) surgery, RT, HT and CT-1 patient; 5) RT, HT and CT -1 patient; 6) RT and CT-1 patient; 7) RT alone-1 patient. Three patients had curative resection. 21 patients received irradiation with tightly contoured portals to spare as much small bowel, kidney and marrow as possible. Hyperthermia was applied regionally once or twice a week for 23 patients using 8 MHz radiofrequency capacitive heating device (Thermotron RF-8). HT was given approximately 30 min after RT 7 patients were treated with CT: 4 patients received HT and concomitant Mitomycin-C; 3 patients received HT and sequential 5-FU+Adriamycin+Mitomycin-C. There was not any treatment related deaths. There was also no evidence of treatment related problems with liver, kidney, stomach, or spinal cord except only one case of transient diabetic ketoacidosis. The tumor response was evaluable in 22 patients. None achieved complete remission.11 ($50\%$) achieved partial remission. The response rate was correlated with total radiation dose and achieved maximum temperature. 9 of 14 ($64\%$) received more than 4000 cGy showed partial remission; especially, all 3 patients received more than 5500 cGy achieved partial response.8 of the 12 patients ($67\%$) who achieved maximal temperature more than $41^{\circ}C$ showed partial response in comparing with $25\%$ (2 of 8 patients, below $41^{\circ}C$). The numbers of HT, however, was not correlated with the response. 3 of the 25 patients ($12\%$) remain alive. The one who was surgically unresectable and underwent irradiation alone is in progression of the disease with distant metastases. The remaining two patients with curative resection are alive with free of disease, 24 and 35 months, respectively. The median survival by response are 11.5 months in responders and 4.6 months in non-responders.

• Journal of the Korean Society of Food Science and Nutrition
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• v.38 no.5
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• pp.618-625
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• 2009

The purposes of this study were to evaluate food safety knowledge and to assess home food safety performance of home-delivered meal service recipients. Two facilities providing home-delivered meal services for older adults were located in Seoul. A total of 120 service recipients were surveyed using an individual interview technique and 97 responses were used for data analysis. A statistical data analysis was completed using SPSS program (ver.14) for descriptive analysis, t-test, ANOVA, and correlation analysis. The majority of the participants were 70 years old or older and females. They perceived their health status as poor or very poor and took more than one kind of medicines. An average score of the food safety knowledge test was 11.48 based on 18 points (63.8%). The results revealed that the older adults knew the importance of hand washing but were not aware of when and how to wash hands. There was room to improve knowledge on cleaning and sanitizing fresh fruits and using wiping cloth. The knowledge score for each category was not significantly different by gender and age. The home food safety practices of the older adults was rated as 2.8 out of 4 points; the highest score was associated for proper food handling category and the lowest score was for cleaning and sanitizing. The worst performance was related to managing hand cuts and wounds (1.96). The total knowledge score and an average performance score were significantly correlated (p<0.01). Food safety education programs targeting the older adults who receive home-delivered meal services would improve the recipients' food safety knowledge and practices related to consumption of the meals at home. The programs should focus on not only improving food safety knowledge but also changing food safety practices.

• Journal of Nutrition and Health
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• v.50 no.5
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• pp.519-529
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• 2017

Purpose: The purpose of this study was to explore whether or not there is a relationship between doctor's awareness of clinical nutrition service and needs for a clinical dietitian. Methods: A cross-sectional survey design was used. The research was carried out by using questionnaires that had been specifically designed for the study. The research was conducted from September to October, 2013 for 311 doctors at 43 hospitals (with over 400 beds). Frequency analysis, factor analysis, reliability analysis, confirmatory factor analysis, and bootstrapping analysis were conducted using SPSS 21.0. Results: 'Implementation of clinical nutritional service' (p < 0.001) and 'usefulness on clinical nutrition service' (p < 0.001) were found to be correlated with 'importance of clinical nutrition service' as an independent variable. The correlation between 'importance of clinical nutrition service' as a mediating variable and 'needs for clinical dietitian' as a dependent variable was also confirmed (p < 0.001). The results of the bootstrapping test showed that the mediating effect of 'importance of clinical nutrition service' was significant. The indirect effect value between 'implementation of clinical nutrition service' and 'needs for clinical dietitian' was 0.040, indirect effect value between 'usefulness on clinical nutrition service' and 'needs for clinical dietitian' was 0.095. Conclusion: The frequency of providing clinical nutritional services, the quality of clinical nutritional services, and the degree of implementation of clinical nutritional services were found to be important for positive perception of clinical nutrition services by doctors. Therefore, proper provision of clinical nutrition services and effective therapeutic effects will be continuously highlighted, which will increase the awareness of the physician and ultimately increase the demand for clinical nutrition service.

• Journal of Chest Surgery
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• v.31 no.5
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• pp.488-493
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• 1998

In the preoperative evaluation before coronary artery bypass surgery, review of the coronary arteriogram is the most important step. Expected "normal" lumen diameter at a given coronary anatomic location is a basis for quantative estimation of coronary disease severity that could be more useful than the traditional "percent stenosis". The distribution and number of major coronary artery branches are determinants of number of bypass grafts needed. We reviewed the coronary artery anatomy in 174 adult patients who revealed no coronary pathology in angiographic studies done from September 1994 to June 1996. Quantative analysis was done in all cases by a single person using a Computerized System (Arripro 35ⓡ). The results were follows; 1) The mean diametre of left main coronary artery was 4.45 mm(range 2.74~6.72). The pattern of branching was bifurcation in 67.24%, trifurcation in 28.74% and quadrifurcation in 4.02% of the patients. 2) The mean diametre of left anterior descending artery was 3.17 mm(range 2.10~5.85), 2.79 (range 1.55~5.59) and 2.17 mm(range 1.37~3.81) in the proximal, mid, and the distal portions, respectively. The number of diagonal branches of left anterior artery was from one to four(mode=2). 3) The mean diametre of proximal and distal left circumflex artery were 3.17mm(range 1.74~4.89) and 2.19 mm(range 1.21~4.46). The number of obtuse marginal branches of left circumflex artery is from one to six(mode 2). 4) The mean diametre of proximal and distal right coronary artery, the posterior descending artery and the largest posterolateral branch were mean 3.51 mm(range 2.07~5.67), 2.09 mm (range 1.42~3.60), 2.09 mm(range 1.02~3.60) and 2.30 mm(range 1.39~4.39). 5) The right coronary artery dominant was 163 cases(93.68%) of the total 174 cases. 6) The large significant acute marginal artery was visualized in more than half of the people. half of the people.

• Journal of Nutrition and Health
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• v.50 no.3
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• pp.284-293
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• 2017

Purpose: This study was conducted to examine the behavioral intentions of breastfeeding in single women using the theory of planned behavior. Methods: The questionnaires were distributed to 350 single women in her 20~30s, and 316 respondents were analyzed by descriptive statistics, Spearman's correlation, and multiple regression analysis. Results: The subjects showed strong intentions and favorable attitudes toward breastfeeding. The subjects were more favorably influenced by their mothers, siblings, friends, and coworkers who previously experienced breastfeeding than ones with no breastfeeding experiences. There were significant correlations between breastfeeding intention and attitudes (r = 0.321, p < 0.0001), subjective norms (r = 0.434, p < 0.0001), and perceived control (r = 0.307, p < 0.0001). However, regression analysis with two different age groups revealed that subjective norms (p < 0.0001) and perceived control (p < 0.001) contributed to the model of explaining breastfeeding intentions in subjects who were 25 years old or younger, whereas attitudes did not. In addition, subjects who were more than 25 years old showed that attitudes (p < 0.003) and subjective norms (p = 0.002) contributed to the model of explaining breastfeeding intentions while perceived control (p < 0.070) showed less contribution. Conclusion: These results suggest that the theory of planned behavior can be a useful tool to increase the rate of breastfeeding intentions in single women when designing educational materials, which requires consideration of age differences.

• Journal of the Korean Applied Science and Technology
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• v.35 no.4
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• pp.1120-1133
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• 2018

The purpose of this study is to validate the failure attribution factors affecting emotional changes after a failed service by local restaurant users, and the relapse effects of the perceived failure of a customer's brand relationship. In this study, the implications of this study can be divided into the null theory and the homogenous theory, in which the study of the relationship between individual belief that influences the null theory and the post-gender emotional response is minimal. The independence of the crash response (angerous VS compassion) has been equally validated as building a belief-gathering-emotion three-step model. First, emotional BRQ (intimate and love) has a reduction effect on controllable geeks, and behavioral BRQ (relative existence) has an extended effect on controllable geeks. From a management perspective, restaurant managers should be less aware of the repeatability of a customer's service failure and call for customer sympathy. Integratedly, restaurant managers must control the customer's perception of service failure and restore the impact of the customer's BRQ on emotional reactions. A variety of service recovery measures should be established and the cerumen should be controlled. In addition, since BRQs have different effects on anger and sympathy (extended VS), different service failure recovery plans should be presented depending on the characteristics of the customer BRQ. For example, measures such as monetary compensation or fair dealing, emotional distribution to close and loving customers, and persuasion of reciprocal benefits to interdependent customers should be developed according to circumstances. This study explored the effectiveness of the geeks after a service failure and has limitations that do not take into account the various regulatory factors in the BRQ-return-Empression process. Thus, in further studies, the effects of adjusting service failure strength should be considered and a more complete model should be built.

• The Korean Journal of Archival Studies
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• no.34
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• pp.3-28
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• 2012

The year of 2013 is the first year that the new president takes the power and administrates the national affairs. In Korea, when the new president comes, the new administration brings big changes in the politics, economy, and society. The government management style has been changed according to the orientation and styles of the new president. Public records management is a critical and effective business tool to establish and carry out the government policies as well as an essential tool for democracy. Modern democracy is based on good governance. Creation and free use of full and accurate public records makes the good communication between the government and the public possible, and people's participation in the policy-making and surveillance of government activities for public good can work. During the present administration, communication between the president and the people was cutoff and people's participation in the national affairs have been further limited. Furthermore, in the present administration, the public records management was not regarded important, Whatever new administration comes, the year of 2013 is the time for the new administration to realize again the importance of the public records management and put it back to the normal track. Here are the major issues in the public records management to be concerned and resolved; (1) to ensure technological and institutional management of the electronic records in the government and safe transfer of the massive electronic records, (2) to establish an independent national records management and archives authority to be based on good governance, (3) to innovate the public records management in the public agencies including their agency records offices (RMO) and records management systems (RMS) (4) to establish local government archives and document local government policies and activities (5) supporting and promotion for documentation of the total society as a public service (6) expanding employment of professional records managers and archivists in the central and local governments, and standardization of professional competency and certification. In this paper, I will introduce the major issues in the public records management and suggest the policies and solutions that the Korean records professionals considered and discussed. This analysis and suggestions are the outcome of our professional considerations and discussions.