• Journal of Sasang Constitutional Medicine
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• v.10 no.2
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• pp.351-429
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• 1998

The Purpose of Study 1. Inspection of clinical application on TCD to CVA 2. Objective Comparement and analysis about treatment effect of Western-Medicine, Korean Medicine, Cooperative consultation of Korean and Western medicice for CVA The Subject of Study We intended for the eighty six patient of CVA who had been treated in the Oriental Medical Hospital at Dong Eui Medical Center from 1997. 8. I to 1998. 7. 31 1. View of CT, MRI : the patient of Cb infarction 2. Attack Time : The patient who coming hospital falling ill within the early one week The method of study 1. Treat four group of Korean medicine, Constitution medicine, Western medicine, cooperative consultation of Korean medicine and Western medicine. 2. Application of TCD Check the result for three times, immediatly after the attack, two months later, four months later 3. Comparative analysis of each treatment effect by clinical symptoms and pathologic examination 4. The Judgement of the patient The Result From 8/1/1997 to 7/31/1998, We have the following result by clinical analysis intended for CVA 86 patients who had been treated in the Oriental Medical Hospital at Dong Eui Medical Center from 1997. 8. 1 to 1998. 7. 31 in 1. Analysis according to Age The first stage of thirties, forties, seventies is heavier than forties, fifties in improvement and Index of improvement of symptom 2. Analysis according to sex We have no special relation in an average of symptom and improvement, Index improvement 3. Analysis according to Family History We have the better result in first stage and improvement, index improvement when no family history. 4. Analysis according to Past History We have no special relation in past history like hypertension, DM, heart problem 5. Analysis devided two group, above group and under group on the basis of the average in first stage of all patient. We have the better result when the first stage is light, that the first score of barthel index and CNS is high. 6. Analysis of the effect of treatment about Korean medical treatment, Western medical treatment, cooperative treatment. In this study, the highest group of rate of treatment at four contrast groups (Korean medicine, Constitution medicine, Western medicine, cooperative treatment according to dyagnosis and range of treatment was the patient group of doing dyagnosis and method of treatment based on constitution medicine theory. This is that of doing demostation, A-Tx, po-herb-medication according to dyagnosis and treat method of constitution of Lee Je-ma In case of left, the case of dyagnosis any disease according to doctor view but, normal in TCDwas 22-beginning of attack, 20- two weeks later, 11 case-four weeks later in case of right, 15-beginning of attack, 12-two weeks later, 9 case four weeks later. So left vessel compares to right vessel is more interference, in fact more than a 1/2 of the patients of MCA disease can't do dyagnosis. In rate of imparement, the state of pacient improved but there isn't the improved case of result in TCD. 7. In TCD dyagnosis, between the case of inconsus the doctor view specially MCA in brain blood vessel is in large numbers and in total 86's patient, impossible case of dyagnosis according to interferiance of temporal is 21 case. 7. Result study about application of Kreaan medical treatment 1) The impossible patient of observation MCA blood vescular for interference temporal bone happened in large numbers. 2) There is the case having difference result to CT,MRI, MRA result. 3) Because individual difference is large, excluding to ananalogy of symptom. This is normal numerical value that has possibility of being checked as abnormal numerical value 4) there are a lot of cases that the speed of normal part is as similarly measured as that of abnormal part. It means that we cannot judge the disease by this measure 5) It is rare that this measure represent degree of improvement in patient's condition of disease. When we observe patient's condition become better, but we have no case that the result of TCD test better. 6) The result could be appear differently by the technique of the tester or by the experience of the tester 7) In the TCD test, abnormal symptoms is checked at 0 week, but at 2th week, normal symptoms is checked, again at 4th week abnormal is checked. According to the above result, CVA diagnosis is difficult only with TCD, as it appear in diagnosis error check which is suggested in the problem connected to project, for the aged persons who have the worst hardening of part of the cranium (1998. 5. 26 77 of 83 patients is 50s) there is a lot of cases that the measurement is impossible by TCD and the correction of measurement numerical value is decreased, as the age of cerebral infarction is high, TCD is inappropriate to diagnosis equipment through this study.

• Pediatric Infection and Vaccine
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• v.13 no.2
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• pp.115-123
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• 2006

Purpose : We investigated whether there had been any change in the epidemiology of Streptococcus pneumoniae in Korea before and after introduction of heptavalent pneumococcal conjugate vaccine(PCV7). Methods : Between September 2001 and August 2006, clinical isolates were collected from patients with pneumococcal infection in Severance Hospital, Seoul, Korea. We analyzed trends in serotype distribution and antibiotic resistance before and after the introduction of PCV7. Results : There were 363 strains of Streptococcus pneumoniae isolated from clinical specimens; 143 before and 220 after PCV7 introduction. The predominant serotypes, in order of decreasing frequency, were 19F, 19A, 23F, 6B, 6A, 3, 9V, 14, 11A, 4, 29, and 18C; 152 isolates(41.9%) belonged to types included in PCV7. The proportion of clinical isolates that were nonsusceptible to penicillin increased from 58.8% in 2001 to 83.6% in 2006(P=0.046). There was no significant diminution in pneumococcal infection caused by vaccine serotypes after the introduction of PCV7. In children younger than age 2 years, the proportion of clinical isolates that were vaccine serotypes was higher than in persons older than age 15 years (59.3% vs 37.8%, P=0.004). Conclusions : There was no significant diminution in pneumococcal infection caused by vaccine serotypes after the introduction of PCV7, therefore more universal pneumococcal immunization program is recommended especially for children younger than age 2 years.

• Health Policy and Management
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• v.10 no.3
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• pp.19-49
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• 2000

This study was conducted to help staff members of health centers manage personnel by examining the staff members' recognition level of organization structure of health centers, their motivation, their job satisfaction level and its related factors. Data were collected from 471 staff members of 14 health centers from March 3, 1999 to April 30, 1999. The results of this study are summarized as follows. In recognition levels of organization structure of health centers, the recognition level of necessity of discretion right was highest(3.55 points on the base of 5 points), while the recognition level of the location of decision making right was lowest(2.77 points). The general recognition of organization structure of health centers was 3.06 points, the suitability of division of duties was 3.05 points, and the optimum of manpower and budget was 2.93 points. The staff members' general recognition level of the organization structure appeared significantly higher in case of the groups of small and medium sized cities, above fifties, below high school graduate, above the sixth grade, public service experience of above 20 years, service period of below 2 years at present post, and average monthly salary of one million, eight hundred and ten thousand won. In the recognition level of the location of decision making right, the groups of big cities, male, the married, above the sixth grade, health and administration posts, average monthly salary of one million, three hundred and ten thousand won to one million, and eight hundred thousand won were significantly higher than the other groups. The recognition level of necessity of discretion right was higher in case of the groups of the twenties, the unmarried, above college graduate, nursing post, public service experience of below 5 years, service period of below 2 years at present post, and average monthly salary of below eight hundred thousand won. In the recognition level of suitability of division of duties, the groups of small and medium sized cities, the married, medical technicians, public service experience of above 20 years, and service period of below 4 years at present post were significantly higher than the other groups. In the staff members' recognition levels of organization management, the recognition level of opinion response when making decision was highest(2.92 points). The recognition level of rationality of the target amount establishment method was 2.88 points and the recognition level of personnel management was 2.63 points. The recognition level of personnel management was significantly higher in case of the groups of small and medium sized cities, the forties, above the sixth grade, medical technicians, public service experience of above 20 years, service period of below 2 years at present post, and average monthly salary of above one million, eight hundred and ten thousand won. In the recognition level of opinion response when making decision, the groups of small and medium sized cities, female, the eighth grade, health and administration posts, and service period of below 2 years at present post were higher than the other groups. The recognition level of rationality of the target amount establishment method was significantly higher in case of the groups of above fifties, below high school graduate, above the sixth grade, medical service post, and public service experience of 15 to 20 years. The factors significantly influencing sanitation were sex, education level, the period of public service experience, general recognition of organization structure, recognition of necessity of discretion right, recognition of suitability of division of duties, and recognition of opinion response when making decision. The factors which significantly influenced motivation were marital status, grade, recognition of the location of decision making right, recognition of necessity of discretion right, recognition of division of duties, recognition of opinion response when making decision, and sanitation. Sex, education level, recognition of suitability of division of duties, recognition of the target amount establishment method, and motivation influenced job satisfaction significantly. The factors significantly influencing organization culture were age, the period of public service experience, service period at present post, recognition of optimum of manpower and budget, recognition of suitability of division of duties, recognition of opinion response when making decision, and recognition of rationality of the target amount establishment method. In the coming days, the staff members' job satisfaction level must be increased through motivation and efficient conduct of duty must be accomplished through rational organization structure and management. Moreover, change of the staff members' consciousness and administrative system which are suitable for local autonomy system have to be established with increase of local residents' consciousness level and education level. Forming organization culture by reformative idea which fits the new era, public health service by the Community Health Act and health education service by the Health Promotion Act must be carried out efficiently. In doing so, financial support of central government and active efforts and concerns of local governments have to be devoted in order to get public health service in which peculiarity of the community is considered to be pursued well.

• Journal of Korean Academy of Nursing Administration
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• v.1 no.2
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• pp.349-371
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• 1995

Professional nurse shall possess the firm nursing idea and ethical nursing philosophy based on the professional knowledge and technology but due to the rapid social situations has changed the value to man thus the nurse's sense of value in the nursing secenes has been confused and changed bringing the new ethical problems and discord due to the ethically difficult problems. This study is aimed to know about the discord between the ruling ethical sense of value and the ethical discord exeriencing in the clinical scenes of the nurse and to help them establish affirmative ethical sense of value and provide them with the materials which can effectively meet the ethical discord. The study research has been conducted by selecting 515 clinical nurses in 8 general hospitals as the subject from Mar. 13, 1995 to Apr. 3. The tool measuring the ethical sense of value disigned by Lee, Young Sook has been used and supplemented and the tool measuring the ethical discord was the question papers about the ethical dillemma of Han, Sung Sook. The collected materials have been analyzed by the statistical methods of arithmetical everage, t-test, ANOVA, Pearson's Correlation Coefficient and etc. The result of the study is as the below ; 1) The average point of the ethical sense of value of the nurse was 3.62(maximum point : 5) which showed that the ethical level was so high and the highest question item in the ethical level of the whole items of the ethical sense of value was "They conduct as directed by the doctor in case the disposition of the doctor looks mistaken"(4.56 point), "They keep the secret of the patients while serving them."(4.56) and the lowest item was "using placobo for the patients is not allowed" : (1.85 point). 2) Statistical variation which showed the significant difference in the relation with the ethical sense of value according to the general characters of the nurse has shown as scholarly years(F=3.47, p=.016), religion(F=1.66, p=.004), interest degree of ethical education(F=4.18, p=.006),attitude to the job of nursing(F=6.76, p=.006), ethical standard(F=3.28, p=.021), and recognition degree on ethical principles(F=4.53, p=.001). 3) The average point of the ethical discord of the nurse was 0.54(The maximum-1 point) point and the ethical discord in the clinical scenes : "the problems arising from the lack of manpower of the nurse"(0.86), "the discord from the uncooperative relation between them and the medical staff and"(0.75) and indifference of the doctor about the report of the nurse(0.73). 4) The variation which showed the significant difference statistically in the ethical discord according to the general characters of the nurse was that Age(F=19.88, p=.000), schooling(F=5.32, p=.001), Experience(F=15.77, p=.000), position(F=13.58, p=.000) and ethical standard(F=2.63, p=.049). 5) The results of the analysis of correlation between ethical sense of value and discord(r=0.519, p=.239) showed no significant correlation statistically.

• The Journal of Art Theory & Practice
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• no.16
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• pp.107-137
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• 2013

This paper examines a number of Korean artists-Whanki Kim, Po Kim, Byungki Kim, Lim Choong-Sup, Min Byung-Ok and etc-working in New York in the 1960s and 1970s, focusing on their motivations to head for the U.S. and their life and activity in the newly-emerged city of international art. The thesis was conceived based upon the fact that New York has been one of the major venues for Korean artists in which to live, study, travel and stay after the Korean War. Moreover, the United States, since 1945, has had a tremendous influence upon Korea politically, socially, economically, and, above all, culturally. This study is divided into three major sections. The first one attends to the reasons that these artists moved out of Korea while including in this discussion, the long-standing yearning of the Korean intelligentsia to experience more modernized cultures, and American postwar cultural policies that stimulated them to envision life beyond their national parameters, in a country heavily entrenched in Cold War ideology. The second part examines these artists' pursuit of abstraction in New York where it was already losing its avant-garde status as opposed to the style's cutting edge cache in Korea. While their turn to abstraction was outdated from New York's critical perspective, it was seen to be de rigueur for Koreans that had developed through phases from Art Informel in the 1960s to Dansaekhwa (monochromatic paintings) in the 1970s. The third part focuses on the artists' struggle while caught between a dualistic framework such as Korea/U.S, East/West, center/margin, traditional/modern, and abstraction/figuration. Despite such dichotomic frames, they identified abstract art as the epitome of pure, absolute art, which revealed their beliefs inherited from western modernism during the colonial period before 1910-1945. In fact, their reality as immigrants in America put them in a diasporic space where they oscillated between the fixed, essentialist Korean identity and the floating, transforming identity as international artists in New York or Korean-American artists. Thus their abstract and semi-abstract art reflect the in-between identity from the diasporic space while demonstrating their yearning for a land of political freedom, intellectual fulfillment and the continuity of modern art's legacy imposed upon them over the course of Korea's tumultuous history in the twentieth century and making the artists as precursor of transnational, transcultural art of the global age in the twenty-first century.

• Industry Promotion Research
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• v.5 no.3
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• pp.97-104
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• 2020

The study participants selected three participants in their late 40s and conducted a total of six sessions and in-depth interviews for 90 minutes to collect and analyze data using the phenomenological Giorgi research method. The conclusion according to the research results was drawn as follows. First, the shame, fear, reprimand, violence, passive attitude, and childhood that had to be adjusted seemed to maintain a stable life in the late forties, but still appeared in the present life. It was found that they showed a low self-satisfaction rather than positive satisfaction with self-concept and pursued an ideal self-image. Second, lifestyle was a time of severe depression, lethargy, and emptiness as a child, experiencing an unstable childhood due to a violent family, loss of attachment, overprotection, difficult economic conditions, and parental strife. It has been found that in the late forties, families have been established and religious life is being stabilized, and the responsibility for the family is valued. This shows how a lifestyle that gives meaning and recognizes what experience gives meaning to the childhood that one experienced. Insight into change and growth in middle-aged life, searching for and interpreting the initial recollections that they have experienced, accompanied by social and psychological changes in middle-aged men, discovering inappropriate meanings and goals and preparing for a second life in the age of 100 It is meaningful to provide.

• Tuberculosis and Respiratory Diseases
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• v.80 no.2
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• pp.194-200
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• 2017

Background: Medical thoracoscopy (MT) is a minimally invasive, endoscopic procedure for exploration of the pleural cavity under conscious sedation and local anesthesia. MT has been performed at the Seoul National University Hospital since February 2014. This paper summarizes the findings and outcomes of MT cases at this hospital. Methods: Patients who had undergone MT were enrolled in the study. MT was performed by pulmonologists, using both rigid and semi-rigid thoracoscopes. During the procedure, patients were under conscious sedation with fentanyl and midazolam. Medical records were reviewed for clinical data. Results: From February 2014 to January 2016, 50 procedures (47 cases) were performed (diagnostic MT, 26 cases; therapeutic MT, 24 cases). The median age of patients was 66 years (59-73 years), and 38 patients (80.9%) were male. The median procedure duration from initial incision to insertion of the chest tube was 37 minutes. The median doses of fentanyl and midazolam were $50{\mu}g$ and 5 mg, respectively. All procedures were performed without unexpected events. Of the 26 cases of pleural disease with an unknown cause, 19 were successfully diagnosed using MT. Additionally, diagnostic MT provided clinically useful information in the other six patients. Therapeutic MT was very effective for treatment of malignant pleural effusion or empyema. The median number of days with chest tube drainage was 6 (3 days for diagnostic MT and 8 days for therapeutic MT). Conclusion: MT is a useful and necessary procedure for both diagnosis and treatment of pleural diseases.

• Korean Journal of Applied Biomechanics
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• v.17 no.2
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• pp.113-121
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• 2007

The purpose of this study was to determine the effect of three different plates($0^{\circ}$, $10^{\circ$}, $20^{\circ}$)under heels on the lower limb muscles and erector spinae during squat exercise. Ten high school korean traditional wrestling players(age: $18.5{\pm}0.7$, weight: $1972.2{\pm}128.5N$, height: $177.8{\pm}6.0cm$, weight of barbell: $1004.5{\pm}132.4N$) performed squat exercise using three different tilting plates under heels at a cadence of 40beats/sec with 80% one repetition maximum load. Surface electrodes were placed on the participants' left and right erector spinae, and rectus femoris, vastus medialis, vastus lateralis, tibialis anterior, biceps femoris, medial gastrocnemius, and lateral gastrocnemius in the right lower extremity. One S-VHS camcorder(Panasonic AG456, 60fields/s) was placed 10m to the side of the participant. To synchronize the video and EMG data, a synchronization unit was used for this study. Average and Peak IEMG values were determined for each participant. For each variable, a one-way analysis of variance was used to determine whether there were significant differences among three different tilting plates under heels. When a significant difference was found in plates type, post hoc analyses were performed using the Tukey procedure. A confidence level of p<.05 was used to determine statistical significance. As a result of this study, maximum nEMG values of the tibialis anterior in $0^{\circ}$ plates was significantly higher than the corresponding values for the other plates during the knee extension. This increased activation in the tibialis anterior muscle indicates an increase in displacement of center of gravity of body. It is very likely that additional muscle activation are needed to stop the forward and backward movement. The results also showed that muscular activities of quadriceps femoris and erector spinae were decreased with increasing angle of plates. This suggests that increasing angle of plate may help to sustain the balance and posture of squat exercise. It is considered that very few significant differences were found among three different plates($0^{\circ}$, $10^{\circ}$, $20^{\circ}$) since elite players with much experience in squat exercise, were chosen as a participant of this study. In order to obtain meaningful results regarding the tilting angle of heel plates in squat exercise, kinetic and 3D kinematic analysis will be needed in the future study.

• Sleep Medicine and Psychophysiology
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• v.7 no.2
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• pp.102-108
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• 2000

Objectives: Parkinson's disease (PD) patients may experience fluent mobility upon awakening from a night's sleep, which is called sleep benefit (SB). Although SB is a phenomenon closely associated with sleep, sleep features of PD are not well characterized. The objectives of this study were, first, to investigate if there are any clinical characteristic features between patients with SB and without SB (NSB), and second, to examine if SB patients are associated with any specific sleep variables compared with NSB patients. Methods: Thirty-three PD patients (14 men and 19 women) participated in this study. All subjects were interviewed to examine whether or not they had SB and overnight polysomnography was performed at the sleep center. Various clinical variables were collected through medical record review. Results: The 331 PD patients were divided into 16 SB group (48.5%) and 17 NSB group (51.5%). SB patients were younger (p<0.02), had higher sleep efficiency (p<0.05), and showed shortened sleep latency (p<0.02) as compared with NSB patients. However, no difference was found between SB and NSB with respect to gender, duration or stage of PD, antiparkinsonian medications prescribed, and predominant motor symptoms. SB did not clearly relate to a specific sleep stage and other sleep variables except sleep efficiency and sleep latency. Although primary snoring was more prevalent in SB patients (p<0.05), other sleep disorders were seen with equal frequency in SB and NSB groups. Conclusion: Our results suggest that good sleep efficiency, shortened sleep latency, and age may have an effect on morning motor function (i.e., SB) in Parkinson's disease.

• Tuberculosis and Respiratory Diseases
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• v.79 no.4
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• pp.289-294
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• 2016

Background: The aim of our study was to evaluate the prognostic value of Charlson's weighted index of comorbidities (WIC) in patients with prolonged acute mechanical ventilation (PAMV, ventilator care ${\geq}96$ hours). Methods: We retrospectively enrolled 299 Korean PAMV patients who were admitted in a medical intensive care unit (ICU) of a university-affiliated tertiary care hospital between 2008 and 2013. Survivors were defined as patients who survived for 60 days after ICU admission. Results: The patients' mean age was $65.1{\pm}14.1$ years and 70.6% were male. The mean ICU and hospital length of stay was $21.9{\pm}19.7$ and $39.4{\pm}39.1$ days, respectively. In addition, the 60-day mortality rate after ICU admission was 35.5%. The mean WIC was $2.3{\pm}1.8$, with significant differences between nonsurvivors and survivors ($2.7{\pm}2.1$ vs. $2.1{\pm}1.7$, p<0.05). The area under the curve of receiver-operating-characteristics curve for WIC was 0.593 (95% confidence interval [CI], 0.523-0.661; p<0.05). Based on Kaplan-Meier curves of 60-day survival, WIC ${\geq}5$ had statistically lower survival than WIC <5 (logrank test, p<0.05). In a multivariate Cox proportional hazard model, WIC ${\geq}5$ was associated with poor prognosis (hazard ratio, 1.901; 95% CI, 1.140-3.171; p<0.05). The mortality rate of patients with WIC ${\geq}5$ was 54.2%. Conclusion: Our study showed a WIC score ${\geq}5$ might be helpful in predicting 60-day mortality in PAMV patients.