• Title/Summary/Keyword: 의식(意識)

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A Legal Analysis on the Absence of Provisions Regarding Non-relative Patients in the Act of Decisions-Making in Life-Sustaining Medicine (연명의료결정법에서 무연고자 규정미비 등에 관한 법적 고찰)

  • Moon, Sang Hyuk
    • The Korean Society of Law and Medicine
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    • v.24 no.4
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    • pp.103-128
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    • 2023
  • According to the current act of Decision-Marking in Life-Sustaining Medicine, the decision to withhold or discontinue life-sustaining treatment is primarily based on the wishes of a patient in the dying process. Decision-making regarding life-sustaining treatment for these patients is made by the patient, if he or she is conscious, directly expressing his/her intention for life-sustaining treatment in writing or verbally or by writing an advance medical directive and physician orders for life-sustaining treatment. It can be exercised. On the other hand, if the patient has not written an advance medical directive or physician orders for life-sustaining treatment, the patient's intention can be confirmed with a statement from the patient's family, or a decision to discontinue life-sustaining treatment can be made with the consent of all members of the patient's family. However, in the case of an unrelated patient who has no family or whose family is unknown, if an advance medical directive or physician orders for life-sustaining treatment are not written before hospitalization and a medical condition prevents the patient from expressing his or her opinion, the patient's will cannot be known and the patient cannot be informed. A situation arises where a decision must be made as to whether to continue or discontinue life-sustaining treatment. This study reviewed discussions and measures for unbefriended patients under the current law in order to suggest policy measures for deciding on life-sustaining treatment in the case of unbefriended patients. First, we looked at the application of the adult guardian system, but although an adult guardian can replace consent for medical treatment that infringes on the body, permission from the family court is required in cases where death may occur as a direct result of medical treatment. It cannot be said to be an appropriate solution for patients in the process of dying. Second, in accordance with Article 14 of the Life-Sustaining Treatment Decision Act, we looked at the deliberation of medical institution ethics committees on decisions to discontinue life-sustaining treatment for patients without family ties.Under the current law, the medical institution ethics committee cannot make decisions on discontinuation of life-sustaining treatment for unbefriended patients, so through revision, matters regarding decisions on discontinuation of life-sustaining treatment for unbefriended patients are reflected in Article 14 of the same Act or separate provisions for unbefriended patients are made. It is necessary to establish and amend new provisions. In addition, the medical institution ethics committee must make a decision on unbefriended patients, but if the medical institution cannot make such a decision, there is a need to revise the law so that the public ethics committee can make decisions, such as discontinuing life-sustaining treatment for unbefriended patients.

Privacy Intrusion Intention on SNS: From Perspective of Intruders (SNS상에서 프라이버시 침해의도: 가해자 관점으로)

  • Eden Lee;Sanghui Kim;DongBack Seo
    • Information Systems Review
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    • v.20 no.1
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    • pp.17-39
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    • 2018
  • SNS enables people to easily connect and communicate with each other. People share information, including personal information, through SNS. Users are concerned about their privacies, but they unconsciously or consciously disclose their personal information on SNS to interact with others. The privacy of a self-disclosed person can be intruded by others. A person can write, fabricate, or distribute a story using the disclosed information of another even without obtaining consent from the information owner. Many studies focused on privacy intrusion, especially from the perspective of a victim. However, only a few studies examined privacy intrusion from the perspective of an intruder on SNS. This study focuses on the intention of privacy intrusion from the perspective of an intruder on SNS and the factors that affect intention. Privacy intrusion intentions are categorized into two types. The first type is intrusion of privacy by writing one's personal information without obtaining consent from the information owner;, whereas the other type pertains to intrusion of privacy by distributing one's personal information without obtaining consent from the information owner. A research model is developed based on motivation theory to identify how these factors affect these two types of privacy intrusion intentions on SNS. From the perspective of motivation theory, we draw one extrinsic motivational factor (response cost) and four intrinsic motivational factors, namely, perceived enjoyment, experience of being intruded on privacy, experience of invading someone's privacy, and punishment behavior. After analyzing 202survey data, we conclude that different factors affect these two types of privacy intrusion intention. However, no relationship was found between the two types of privacy intrusion intentions. One of the most interesting findings is that the experience of privacy intrusion is the most significant factor related to the two types of privacy intrusion intentions. The findings contribute to the literature on privacy by suggesting two types of privacy intrusion intentions on SNS and identifying their antecedents from the perspective of an intruder. Practitioners can also use the findings to develop SNS applications that can improve protection of user privacies and legitimize proper regulations relevant to online privacy.

A Study on the Crime Prevention Design and Consumer Perception (CPTED) of Multi-Family Housing in China (중국 공동주택의 범죄 예방을 위한 디자인과 소비자의 인식에 관한 연구)

  • Kong, De Xin;Lee, Dong Hun;Park, Hae Rim
    • Journal of Service Research and Studies
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    • v.14 no.1
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    • pp.63-76
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    • 2024
  • Multi-family housing plays a crucial role as a living and experiencing space, and its environment has a direct impact on the well-being and stability of its residents. Therefore, Crime Prevention Design (CPTED) for multi-family housing is of utmost importance. However, crime-related data in China is not disclosed to the public because of its specificity, making it difficult for researchers to conduct further in-depth studies based on accurate crime data. As a result, the establishment and application of CPTED theory in terms of crime prevention is limited and delayed. This study aims to explore three aspects of CPTED in multi-family housing as perceived by home-buying consumers. It investigated consumer perception of the CPTED, the importance of each element and ways to increase awareness of CPTED in multifamily housing in order to effectively improve multifamily crime prevention design principles and further enhance public safety. This study examined the current state and future trends of CPTED in China by analyzing relevant research reports and literature, aiming to gain insights into the crime prevention awareness of Chinese homeowners. In addition, a survey was conducted on Chinese consumers to unravel the importance of CPTED and increase awareness of its various elements in multifamily-family. This study used a Likert scale and SPSS reliability analysis to determine the cognitive status of multi-family CPTED, the importance of each element, and proposed an improvement plan based on the analysis results. As this study was limited by the difficulty of implementation and the lack of validation of its practical effectiveness, it is recommended that future research needs to validate the effectiveness of crime prevention designs and produce more practical results. Furthermore, it is crucial to utilize this study to inform the implementation of security solutions that are tailored to the unique characteristics of each district. Additionally, it is important to offer guidance on how to enhance community safety by increasing residents' awareness of security through education and information dissemination. The author hopes that the representative multi-family CPTED awareness, the importance of each element, and plans for improvement shall be summarized from this study, and provide foundational data for the future development of CPTED based on the Chinese region.

Archival Science and Constitutional Point of View (헌법적 관점의 기록학)

  • Lee, Youngnam
    • The Korean Journal of Archival Studies
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    • no.79
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    • pp.121-168
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    • 2024
  • Record & archives management is at the heart of archival science. We must be faithful to record & archives management. However, isn't there a paradox that arises the more faithful we are to record & archives management? The paradox is that 'being a responsible manager and efficiently managing records' is rather reduces the interest in the social existence of humans who create and use such records. Why do humans produce and use records? It may be because human beings have been living with the concept of records. The concept is 'the same as the design of thoughts'. There is no need to doubt this direction because as record & archives management develops, more valuable records are preserved more systematically, and they are been served with wider scope and appropriateness. However, if we observe this situation from a human point of view rather than record & archives management, we find that humans appearing in record & archives management are limited to the object of using records. If humans are perceived differently based on the hypothesis of reviewing from the ground up, we can encounter a unique context about the relationship between humans and records or between records and humans. If it reaches the norm that human beings have dignity that cannot be transferred to anyone, have the right to pursue happiness, and must live by enjoying freedom, equality, and social basic rights, in short, if human beings are recognized from a constitutional point of view, we can newly recognize the social role and direction of records. The constitution and international human rights norms document basic human rights as the final norm and clarify that it is the duty of the state to guarantee and practice them. The social role of records from a constitutional point of view is the practice of records that proliferate basic human rights. The practice of archiving, which multiplies basic human rights, may also be a civic consciousness required of experts, but on the other hand, it can be a professional way for archival studies. If record management is a two-lane round trip, it can be said that the interaction between record management and record practice, which multiplies basic human rights, is a pioneering four-lane round trip. This article examines the practice of archiving, which has been developed in and out of record & archives management, by clearly grasping the constitutional perspective from the perspective of archival studies, and examines the social role of archival studies in this context. The social role of archival studies is to provide new linguistic rules for archiving.

A Psychological Interpretation of Fairly Tale Mokdoryung, Son of Tree (한국민담 '목(木)도령'의 분석심리학적 해석)

  • Jin-Sook Kim
    • Sim-seong Yeon-gu
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    • v.25 no.2
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    • pp.224-264
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    • 2010
  • A brief story of the tale follows : Mokdoryung was a son of an arbor tree and a fairly. When the boy was 7-8 years old, mother-fairy returned to the sky. By using father-tree, Mokdoryung survived from the flood where he saved ants, mosquitos, and a boy with the same age. They arrived on top of the highest mountain, met an old woman with two daughters, worked as servants. With help of insects, Mokdoryung passed the trials, married to a wise daughter and 2 couples became the ancestor of the mankind. Interpretation of the tale starts with amplification of tree which symbolizes Self and Libido. As the son of the tree-spirit and a fairly from the sky, Mokdoryung is a kind of 'divine child' which represents a psychic possibility to understand archetypal nature of unconscious. Adversities of early childhood due to mother's absence regarded as necessary condition for 'divine child' to attain highest good. Flood can be compensation of absence of feminine as well as to bring a new life. The notion of father·tree becomes a kind of life-boat has to do with union of opposite(vertical phallic tree and horizontal feminine boat). Ants and mosquitoes represent upper and lower level of unconsciousness, they mediate divine power. Therefore respecting insects means respecting unconscious, and reward of insects means salvation come from unconscious. The boy saved from the flood presents emergence of psychic energy in its latent unconscious condition to create mental dynamism. The old woman is Great Mother or anima, the controller or guider of unconscious. Working as servants can be an active service for the divine marriage. Trials of separating millet from sand, and finding right direction relate to separatio, means one needs to be separated from unconscious before conunctio, union of opposite. Two sets of couple becoming ancestor of man-kind has to do with number 4 (quaternity) as well as regeneration. Although the tale includes both positive couple (Mokdoryung, wise daugther in east room). and negative couple(shadow side of Mokdoryung, step daughter in west room)as ancestors of mankind, "Good" seems to be more valued than "evil".

A Jungian Perspective on 'Spiritual Exercises' of St. Ignatius (이냐시오 '영신수련'에 대한 분석심리학적 고찰)

  • Jung Taek Kim
    • Sim-seong Yeon-gu
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    • v.25 no.1
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    • pp.27-64
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    • 2010
  • The main focus of this article investigates Jung's analytic implications of the Spiritual Exercises by St. Ignatius of Loyola. The Exercises is referred to not only as the tool for transformation that transformed Ignatius from a soldier of the world into a soldier of God and led him to a completely changed life but also as a tool which galvanizes self-realization, i.e., individuation process, in which a faithful experiences the presence of God in his life and is in search for himself in a new way. The interest in the Exercises regarded as a Western version of Yoga of the East which is a tool for transformation led Jung to give a series of 20 lectures on the Exercises in a seminar held in Zurich from 1939 to 1940. Curiosity about Jung's understanding on the Exercises provokes my desire to step into this research. The Exercises is a book for spiritual exercises that prepare and dispose one's soul to rid itself of all disordered attachments and to order one's life. The Exercises is made up of four Weeks. The First begins with 'Principle and Foundation' which illustrates what human beings are created for. It leads retreatants to rid themselves of disordered attachments and to have a new perspective on life by the consideration and contemplation of sins as the subversion of the Principle and Foundation. The Second is the period in which retreatants accept Christ as the Master of their lives through the meditation and contemplation of the life of Christ. In the Third, retreatants take part in the salvation history of Christ not only by actively participating in the Passion of Christ but also by incorporating the Passion into their lives. The Fourth aids retreatants to undergo their transformation and experience it deeply in order to participate in the new life of Christ who by His resurrection overcame death. In conclusion, Jung viewed the Exercises as a Western tool which plays the similar role of Yoga of the East which engenders inner transformation. The four-week-long retreat helps retreatants to meditate on God who unifies everything and is Himself/Herself the perfect union or the unity so that imperfect retreatants are given opportunities to undergo complete metamorphosis into the immortal, indivisible, and impeccable God. Jung understood that this metamorphosis leads human beings to the totality, that is, the genuine self as the image of God. The author interprets that it is the transformation that the Exercises tries to attain, which resonates with individuation, the key element of analytic psychology.

Characteristic on the Layout and Semantic Interpretation of Chungryu-Gugok, Dongaksan Mountain, Gokseong (곡성 동악산 청류구곡(淸流九曲)의 형태 및 의미론적 특성)

  • Rho, Jae-Hyun;Shin, Sang-Sup;Huh, Joon;Lee, Jung-Han;Han, Sang-Yub
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.32 no.4
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    • pp.24-36
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    • 2014
  • The result of the research conducted for the purpose of investigating the semantic value and the layout of the Cheongryu Gugok of Dorimsa Valley, which exhibits a high level of completeness and scenic preservation value among the three gugoks distributed in the area around Mt. Dongak of Gogseong is as follows.4) The area around Cheongryu Gugok shows a case where the gugok culture, which has been enjoyed as a model of the Neo-Confucianism culture and bedrock scenery, such as waterfall, riverside, pond, and flatland, following the beautiful valley, has been actually substituted, and is an outstanding scenery site as stated in a local map of Gokseong-hyeon in 1872 as "Samnam Jeil Amban Gyeryu Cheongryu-dong(三南第一巖盤溪流 淸流洞: Cheongryu-dong, the best rock mooring in the Samnam area)." Cheongryu Gugok, which is differentiated through the seasonal scenery and epigrams established on both land route and waterway, was probably established by the lead of Sun-tae Jeong(丁舜泰, ?~1916) and Byeong-sun Cho(曺秉順, 1876~1921) before 1916 during the Japanese colonization period. However, based on the fact that a number of Janggugiso of ancient sages, such as political activists, Buddhist leaders, and Neo-Confucian scholars, have been established, it is presumed to have been utilized as a hermit site and scenery site visited by masters from long ago. Cheongryu Gugok, which is formed on the rock floor of the bed rock of Dorimsa Valley, is formed in a total length of 1.2km and average gok(曲) length of 149m on a mountain type stream, which appears to be shorter compared to other gugoks in Korea. The rock writings of the three gugoks in Mt. Dongak, such as Cheongryu Gugok, which was the only one verified in the Jeonnam area, total 165 in number, which is determined to be the assembly place for the highest number of rock writings in the nation. In particular, a result of analyzing the rock writings in Cheongryu Gugok totaling 112 places showed 49pieces(43.8%) with the meaning of 'moral training' in epigram, 21pieces (18.8%) of human life, 16pieces(14.2%) of seasonal scenery, and 12pieces(10.6%) of Janggugiso such as Jangguchur, and the ratio occupied by poem verses appeared to be six cases(3.6%). Sweyeonmun(鎖烟門), which was the first gok of land route, and Jesiinganbyeolyucheon(除是人間別有天) which was the ninth gok of the waterway, corresponds to the Hongdanyeonse(虹斷烟鎖) of the first gok and Jesiinganbyeolyucheon of the ninth gok established in Jaecheon, Chungbuk by Se-hwa Park(朴世和, 1834~1910), which is inferred to be the name of Gugok having the same origin. In addition, the Daeeunbyeong(大隱屛) of the sixth gok. of land route corresponds to the Chu Hsi's Wuyi-Gugok of the seventh gok, which is acknowledged as the basis for Gugok Wollim, and the rock writings and stonework of 'Amseojae(巖棲齋)' and 'Pogyeongjae(抱經齋)' between the seventh gok and eighth gok is a trace comparable with Wuyi Jeongsa(武夷精舍) placed below Wuyi Gugok Eunbyeon-bong, which is understood to be the activity base of Cheongryu-dong of the Giho Sarim(畿湖士林). The rock writings in the Mt. Dongak area, including famous sayings by masters such as Sunsaeuhje(鮮史御帝, Emperor Gojong), Bogahyowoo(保家孝友, Emperor Gojong), Manchunmungywol(萬川明月, King Joengjo), Biryeobudong(非禮不動, Chongzhen Emperor of the Ming Dynasty)', Samusa(思無邪, Euijong of the Ming Dynasty), Baksechungpwoong(百世淸風, Chu Hsi), and Chungryususuk-Dongakpungkyung(淸流水石 動樂風景, Heungseon Daewongun) can be said to be a repository of semantic symbolic cultural scenery, instead of only expressing Confucian aesthetics. In addition, Cheongryu Gugok is noticeable with its feature as a cluster of cultural scenery of the three religions of Confucian-Buddhism-Taoism, where the Confucianism value system, Buddhist concept, and Taoist concept co-exists for mind training and cultivation. Cheongryu Gugok has a semantic feature and spatial character as a basis for history and cultural struggle for the Anti-Japan spirit that has been conceived during the process of establishing and utilizing the spirit of the learning, loyalty for the Emperor and expulsion of barbarians, and inspiration of Anti-Japan force, by inheriting the sense of Dotong(道統) of Neo-Confucianism by the Confucian scholar class at the end of the Joseon era that is represented by Ik-hyun Choi(崔益鉉, 1833~1906), Woo Jeon(田愚, 1841~1922), Woo-man Gi(奇宇萬, 1846~1916), Byung-sun Song(宋秉璿, 1836~1905), and Hyeon Hwang(黃玹, 1855~1910).

The influence with buddhist music appearing in PanYeombul out of Ogu exorcism of East coast - focused on the song by Kim Janggil - (동해안 오구굿 중 판염불에 나타난 불교음악의 영향 - 김장길의 소리를 중심으로 -)

  • Seo, Jeong-mae
    • (The) Research of the performance art and culture
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    • no.34
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    • pp.277-313
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    • 2017
  • This study is to find out the correlation with buddhist music after analyzing the rhythm of six pieces of PanYeombul sung by Kim Janggil out of Ogu exorcism of East coast the findings summarized are as follows. First, PanYeombul by Kim Janggil, performed on Oct, 16, 2016, was composed of , , , , , , , , , , and . Still, even if PanYeombul is performed by the same male shaman, the composition can be added or left out depending on some circumstances, which means the procedures are flexible. Seeing that there is common component of in additoin to compared with Kimyongtaek, it can be said that the component of is an important part in PanYeombul of Ogu exorcism of East coast Second, is usually referred to 'SinmyojangguDaedalani' in buddhist ritual, While Kim yongtaek accepts this practice in title, Kim Janggil uses 'YeomhwajangguDaedalani' as the title which makes his song different from others. Yeomhwa means "picking up flowers with fingers" which has been used in buddhism, not in common Considering this fact, the conclusion can be reached that by using the term 'Daedalani' from a buddhist chant, but making differentiation from buddhism, Kim Janggil is making the effort to be different from buddhist rituals. give some unique meaning to shaman rituals. Third, PanYeombul of Ogu exorcism of East coast may be divided into two main parts - the former part is PanYeombul and the latter part is Jiokga. In performing PanYeombul, male shaman sits singing alone and playing Jing himself, on the other hand, in case of Jiokga, he stands singing a solo with gwaeggwari in his hand accompanied by other musicians with the rhythm of Samgongjaebi. As the song and the accompaniment are in the form of giving and taking like duet. it is in peak in terms of music. Accordingly, PanYeombul can be divided into PanYeombul and Jiokga, But since it is performed by one male shaman and sung a solo, it is usually seen as one procedure. Jing, which is a kind of accompaniment in PanYeombul by Kim Janggil, has the role to distinguish a phrase and settle the musical paragraph. When the buddhist chant with one word-one note is performed. it requires the performer to catch his or her breath or clear throat. Just then, Jing comes out for filling out the intervals. Also, its role to distinguish a phrase and settle the musical paragraph helps make it clear to deliver words. The rhythm of Jing is mostly made up of small triple time except equal small binary time, comes out with overwhelmingly more frequency of Sutsoe(♪♩) than Amsoe(♩♪), and often shows syncopation. By often using Off Beat or short-long rhythm even in accompaniment of equal small binary time, he tris to give some variation to monotonous and equal rhythm for the musical vitality. These are similar to Sutsoe rhythm which can evoke tension and Kim Janggil makes these things his characierisiic of rhythm. Fifth, all the pieces consist of mi, sol, la, do, re and the descending melody like do'${\searrow}$la${\searrow}$sol${\searrow}$mi appears most frequently. The descending melody usually arouses the feeling of sorrow, so the sadness for the deceased is presented properly, which suggests his musical talent. Generally, pieces take on Menari-tori as a whole where the length of sol appears for a short time in descending la${\searrow}$sol${\searrow}$mi of perfect four degrees. Sixth, Even he accepts the lines of buddhist chant, he changes them in some degree. For example, he inserted some words between lines like 'Wonwangsaeng' and 'NamuAmitabul' and added Korean words like hapsosa to the lines of buddhist service written in Chinese character. Also, he inserted some words like 'iiiiiii~' to express the feeling of sadness. These are to maximize the desire of the deceased to go to the heaven and at the same time to diminish the sign of buddhism and strengthen the features of shamanism. Seventh, the effort to decrease the sign of buddhism is made in pasting lines of two songs. For example, Between the last words 'Wonsuaenapsu of Dage and the first words 'Jisimgwimyeongrye' of Chiljeongrye, there is usually a short pause to distinguish paragraphs, But he continues two songs without any pause to get rid of the feelings of buddhist chant. In terms of melody, he makes a distance from buddhist chant in an effort that he gives some traits to shaman rituals which are different from buddhist even if he uses the lines of buddhist rituals. Eighth, the analyzed pieces can be in four categories - no regular melody , , equal small binary time , eotmori melody of ten eighth time with 3+2+3+2 mixed small time . and Samgongjaebi melody 3+2+3 mixed small time . Each piece has its unique melody. Although of buddhist ritual is often performed, by using eotmori melody, he evokes the feeling of shaman and is another example of giving unique characteristic to the shaman of East coast by using Samgongjaebi melody.

Evaluation of Error Factors in Quantitative Analysis of Lymphoscintigraphy (Lymphoscintigraphy의 정량분석 시 오류 요인에 관한 평가)

  • Yeon, Joon-Ho;Kim, Soo-Yung;Choi, Sung-Ook;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.76-82
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    • 2011
  • Purpose: Lymphoscintigraphy is absolutely being used standard examination in lymphatic diagnosis, evaluation after treatment, and it is useful for lymphedema to plan therapy. In case of lymphoscintigraphy of lower-extremity lymphedema, it had an effect on results if patients had not pose same position on the examination of 1 min, 1 hour and 2 hours after injection. So we'll study the methods to improve confidence with minimized quantitative analysis errors by influence factors. Materials and Methods: Being used the Infinia of GE Co. we injected $^{99m}Tc$-phytate 37 MBq (1.0 mCi) 4 sylinges into 40 people's feet hypodermically from June to August 2010 in Samsung Medical Center. After we acquired images of fixed and unfixed condition, we confirmed the count values change by attenuation of soft tissue and bone according to different feet position. And we estimated 5 times increasing 2 cm of distance between $^{99m}Tc$ point source and detector each time to check counts difference according to distance change by different feet position. Finally, we compared 1 and 6 min lymphoscintigraphy images with same position to check the effect of quantitative analysis results owing to difference of amounts of movement of the $^{99m}Tc$-phytate in the lymphatic duct. Results: Percentage difference regarding error values showed minimum 2.7% and maximum 25.8% when comparing fixed and unfixed feet position of lymphoscintigraphy examination at 1 min after injection. And count values according to distance were 173,661 (2 cm), 172,095 (4 cm), 170,996 (6 cm), 167,677 (8 cm), 169,208 counts (10 cm) which distance was increased interval of 2 cm and basal value was mean 176,587 counts, and percentage difference values were not over 2.5% such as 1.27, 1.79, 2.04, 2.42, 2.35%. Also, Assessment results about amounts of movement in lymphatic duct within 6 min until scanning after injection showed minimum 0.15%, and maximum 2.3% which were amounts of movement. We can recognize that error values represent over 20% due to only attenuation of soft tissue and bone except for distance difference (2.42%) and amounts of movement in lymphatic duct (2.3%). Conclusion: It was show that if same patients posed different feet position on the examination of 1 min, 1 hour and 2 hours after injection in the lymphoscintigraphy which is evaluating lymphatic flow of patients with lymphedema and analyzing amount of intake by lymphatic system, maximum error value represented 25.8% due to attenuation of soft tissue and bone, and PASW (Predictive Analytics Software) showed that fixed and unfixed feet position was different each other. And difference of distance between detector and feet and change of count values by difference of examination beginning time after injection influence on quantitative analysis results partially. Therefore, we'll make an effort to fix feet position and make the most of fixing board in lymphoscintigraphy with quantitative analysis.

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Psychotherapy for Somatoform Disorder (신체형 장애의 정신치료)

  • Lee, Moo-Suk
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.2
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    • pp.269-276
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    • 1996
  • A theroretical study was made on the psychodynamism of somatoform disorder. Somatoform disorder is caused by a defense mechanism of somatization. Somatization is the tendency to react to stimuli(drives, defenses, and conflict between them) physically rather than psychically(Moore, 1990). Ford(1983) said it is a way of life, and Dunbar(1954) said it is the shift of psychic energy toward expression in somatic symptoms. As used by Max Shur(1955), somatization links symptom formation to the regression that may occur in response to acute and chronic conflict. In the neurotic individual psychic conflict often provokes regressive phenomena that may include somatic manifestations characteristic of an earlier developmental phase. Schur calls this resomatization. Pain is the most common example of a somatization reaction to conflict. The pain has an unconscious significance derived from childhood experiences. It is used to win love, to punish misdeeds, as well as a means to amend. Among all pains, chest pain has a special meaning. Generally speaking, 'I have pain in my chest' is about the same as 'I have pain in my mind'. The chest represent the mind, and the mind reminds us about the heart. So we have a high tendency to recognize mental pain as cardiac pain. Kellner(1990) said rage and hostility, especially repressed hostility, are important factors in somatization. In 'Psychoanalytic Observation on Cardiac Pain', psychoanalyst Bacon(1953) presented clinical cases of patients who complained of cardiac pain in a psychoanalytic session that spread from the left side of their chests down their left arms. The pain was from rage and fear which came after their desire to be loved was frustrated by the analyet. She said desires related to cardiac pain were dependency needs and aggressions. Empatic relationship and therapeutic alliances are indispensable to psychotherapy in somatoform disorder. The beginning of therapy is to discover a precipitating event from the time their symptoms have started and to help the patient understand a relation between the symptom and precipitating event. Its remedial process is to find and interpret a intrapsychic conflict shown through the symptoms of the patient. Three cases of somatoform disorder patients treated based on this therapeutic method were introduced. The firt patient, Mr. H, had been suffering from hysterical aphasia with repressed rage as ie psychodynamic cause. An interpretation related to the precipitating event was given by written communication, and he recovered from his aphasia after 3 days of the session. The second patient was a dentist in a cardiac neurosis with agitation and hypochondriasis, whose psychodynamism was caused by a fear that he might lose his father's love. His symptom was also interpreted in relation to the precipitating event. It showed the patient a child-within afraid of losing his father's love. His condition improved after getting a didactic interpretation which told him, to be master of himself, The third patient was a lady transferred from the deparment of internal medicine. She had a frequent and violent fit of chest pains, whose psychodynamic cause was separation anxiety and a rage due to the frustration of dependency needs. Her symptom vanished dramatically when she wore a holler EKG monitor and did not occur during monitoring. By this experience she found her symptom was a psychogenic one, and a therapeutic alliance was formed. later in reguar psychotherapy sessions, she was told the relaton between symptoms and precipitating events. Through this she understood that her separation anxiety was connected to the symptom and she became less terrifide when it occurred. Now she can travel abroad and take well part in social activities.

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