• Women's Health Nursing
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• v.7 no.2
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• pp.169-187
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• 2001

This study was performed to probe the effect of exercise program on muscle strength, endurance, flexibility, pain, disability level and life satisfaction in female teachers of elementary school who complain of low back pain. For this study, 44 female teachers aged 30-50 years with mechanical low back pain of 6 months' duration, who had the structural normalities in the lumbar spine, were recruited from April 1 to July 10 1999. Twenty three out of them were assigned to the experimental group and twenty one to the control group. The exercise program consisted of education on right postures, the etiology and diagnosis of low back pain, and exercise intervention such as muscle relaxation, elongation and strengthening. With 8 weeks program, the subjects received two sessions of education and six sessions of group exercise in the 1st week, while three sessions of group exercise and four sessions of individual exercise weekly and two sessions of education during the later 7 weeks. The muscle strength and endurance were measured by Cybex 770, the flexibility by flexibility measurement machine, the intensity of pain by Visual Analogue Scale (VAS), the level of disability by Oswestry low back pain disability scale, depression by Beck depression inventory (BDI), and life satisfaction by Life satisfaction index-Z. Study measurements were taken before and after 8 weeks exercise program. Data were analyzed using paired t-test, t-test, and ANCOVA. The results were as follows ; 1. The flexors and extensors peak torque and flexors peak torque per body weight of experimental group were significantly increased at test velocities $30^{\circ}$/sec, $60^{\circ}$/sec compared with those of control group. There was no significant difference in extensors peak torque per flexors peak torque at $30^{\circ}/sec$, $60^{\circ}/sec$ between experimental and control group. 2. The flexors and extensors total work and flexors total work per body weight of experimental group were significantly increased at $120^{\circ}/sec$, compared with those of control group. 3.The flexibility of lumbar spine in experimental group was significantly increased compared with that of control group. The pains in anterior, posterior, left lateral and right lateral bending and in rotation of experimental group were significantly increased compared with those of control group. 4. The Oswestry disability scores of experimental and control group were significantly decreased, and there was no difference in the Oswestry disability score change between experimental and control group. 5. The scores of BDI of experimental group were significantly decreased compared with those of control group. Life satisfaction index-Z scores of experimental group were not changed, but those of control group were significantly decreased. There was no difference in the score change of Life satisfaction index-Z between experimental and control group. 6. ANCOVA analysis for the data variables of inhomogeneous baseline represented that there was no significant difference in extensors peak torque and extensors total work at $120^{\circ}/sec$ and extensor total work per body weight at $120^{\circ}/sec$ change between experimental group and control group. These findings indicate that the exercise program could be effective in increasing the muscle strength, endurance, flexibility and decreasing pain, improving depression in female teachers of elementary school with chronic low back pain. It is suggested that the exercise program could be an essential factor for the effective nursing intervention to the patients suffered from chronic low back pain.

• Journal of Korean Society of Forest Science
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• v.74 no.1
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• pp.47-55
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• 1986

During the past 4 years, I have made a careful analysis of the present rotating system of hunting areas, on the one hand, by asking a group of hunters to fill out a questionnaire, and on the other hand, by referring to the written documents on the subject. And, as a result, it is concluded that this system, by varying the hunting grounds each year, contains in itself several problems as follows. 1. The hunters find it quite inconvenient to use a different hunting ground year after year and they also complain that the present hunting ground charge is more than it is worth. Therefore, it is expected that the number of hunters will explosively increase in the future with the betterment of hunting conditions. 2. The hunters have almost no information about game and they are, as a whole, lacking in the ethics of hunting. 3. The allotment of time in hunting training courses is not so sufficient that it is next to impossible to improve the quality of hunters. 4. As a rule, the population density of wildlife is so sparse that it falls short of the proper standard of it. 5. The present hunting system does not seem to contribute to the advancement of tourism. 6. It is absolutely necessary to make a general survey of the situation of wildlife for the legal protection of it. Besides, the interests of hunters are so closely tied up with those of farmers and foresters that dreastic measures should be taken to settle their conflicting differences. For the purpose of solving the above-mentioned problems and at the same time, of developing sound hunting practices in the long run, I hereby make two suggestions. 1. The Establishment of the Hunting License Test System It is desirable to issue a license to a prospective hunter after he has met a special qualification and then passed a test so that he may have bits of information needed for his hunting activities. 2. The Introduction of The Revier System The fundamental concept of this system is based on the assumption that the private landowner should reserve a right to the pursuit of game and take responsibility for wildlife management.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.1
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• pp.72-80
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• 2020

Objectives : The aim of this study was to compare the effect of Selective Serotonin Reuptake Inhibitor (SSRI) and Serotonin Norepinephrine Reuptake Inhibitor (SNRI) for mood symptoms, pain, and somatic symptoms in elderly depression patients with pain and somatic symptoms. Methods : This study is a prospective open-label study conducted by a single institution. A total of 43 subjects diagnosed with major depressive disorder under the DSM-5 diagnostic criteria participated in this study (average age: 72.53, 58.1% women). The subjects were classified as SSRI and SNRI groups. Depressive symptoms, pain, and somatic symptoms were evaluated by Korean version of the Hamilton Depression Rating Scale (K-HDRS), visual analogue scale (VAS) and Patient Health Questionnare-15 (PHQ-15) respectively at baseline and six weeks later. Two-way repeated-measure ANOVA was performed to analyze changes in the KHDRS, VAS, and PHQ-15 scores. Results : In the SSRI and SNRI groups, K-HDRS, VAS, and PHQ-15 all showed significant improvement after 6 weeks compared to each baseline values. There were no differences in therapeutic effect between the two groups. Conclusions : We found that SSRI and SNRI both improved somatic symptoms and pain in elderly depression patients. The results of this study are thought to help select antidepressants when administering medication to elderly depression patients who complain pain and somatic symptoms. Further research is needed on the longterm effects of the SSRI and SNRI.

• Sleep Medicine and Psychophysiology
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• v.15 no.2
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• pp.94-99
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• 2008

The most common cause of obstructive sleep apnea syndrome (OSAS) in childhood is adenotonsillar hypertrophy. Adenotonsillectomy improves the symptoms quite well in most cases. However, some patients could experience the OSAS again after adenotonsillectomy, who might have several risk factors such as incomplete operation, misdiagnosis, combined anatomical malformation, sinusitis or chronic allergic rhinitis, obesity, initial severe OSAS, and early onset OSAS. We report a case of 11-year-old obese boy who presented with snoring for several years. He was obese with body mass index (BMI) of $26.3kg/m^2$ and also found to have fatty liver by ultrasonogram. Initial polysomnography (PSG) showed that he met the criteria of severe OSAS with the apnea-hypopnea index (AHI) of 70.5. He underwent adenotonsillectomy and symptoms improved immediately. Four months later symptoms were relieved with AHI of 0, but 1 year after the adenotonsillectomy he started to complain snoring again and the subsequent PSG results showed that OSAS has relapsed with AHI of 43. Paranasal sinus X-ray and physical examination showed sinusitis and re-growth of adenoid. Obesity was proved not to be a contributing factor because his BMI decreased to normal range ($23.1kg/m^2$) after diet control and regular exercise. Also, liver transaminase was normalized and fatty liver was disappeared on follow-up abdominal ultrasonogram. After treatment of sinusitis, symptoms were relieved with decreased AHI (8.5). This case suggests that simple adenotonsillectomy might not be the end of OSAS treatment in childhood. Patients who had adenotonsillectomy should be followed by subsequent PSG if symptoms recur. It is also important to be aware of risk factors in the recurrent OSAS for the proper intervention according to the cause.

• Korean Journal of Occupational Health Nursing
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• v.6 no.2
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• pp.110-127
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• 1997

The aim of this study is to present the basic datum for the promotion of effectiveness and improvement of nursery tasks, by grasping the situation of operating room nurses tasks and the degree of their fatigue. For these researches, 70 nurses out of the operating rooms of 3 university-affiliated hospitals-two in Seoul and one in Pusan, were chosen at random by a non-probability sampling method. These researches were done from April 14 to April 26 in 1997 by questionairing method. The questionaire was composed of 30 items, which asks the examinees of their physical, mental, and neurosensory symptoms, with 10 items respectively. The reliability of the research instrument was turned out very high with Cronbach's ${\alpha}=.9376$. The datum were electronically processed using Statistics Program for Social Sciences(SPSS). The analysis of datum in this study has a general character, in which the demosociological character and the special ex-officio character was calculated by frequency and percentage. The situation of tasks in operating rooms was calculated by frequency and percentage. The fatigue of operating room nurses was calculated by average and standard deviation. To compare the fatigue with regard to the character of operating room nurse's tasks, t-test and F-test(ANOVA) were used after the character of variations, and the variations at the level of P<.05 which might have some meaning was verified after the fact with Duncan's Multiple Range(DMR). The results of this research are as follows : 1) The nurses working in operating rooms show their fatigue in three fields-in Group I physical symptoms 3.28, in Group III neurosensory symptoms 2.85, and in Group II mental symptoms 2.73, which shows I Dominant type (general type). 2) They complain, in Group I they are "feeling the heavy legs," 3.28 and in Group II they "occasionally forget soon what to do," 3.09. and in Group III, they "feel lumbago," 3.47, which is the highest rate of the three. The highest rate results from the character of their tasks, in which they have to move rapidly the heavy appliances and do their jobs standing many hours, especially wearing heavy radiation protector. 3) As to transportation, subway using group feel the greatest fatigue, 3.18(F=4.315, P=.008). 4) As to department, nurses in the orthopedic's surgery part feel the greatest fatigue, 3.26(F=2.040, P=.050). 5) As to the change of physical symptoms, the group answering that they found physical abnormality after working in operating rooms show the greatest fatigue, 3.12(t=-3.13, P=.003). 6) At to the general circumstances, the group answering that they receive insufficient consideration on their physical abnormality in their department, show the greatest fatigue, 3.10(F=3.200, P=0.47). 7) As to the relation with superior officers, the group answering that their superior officer has an impetuous temperament, show great fatigue, 3.11(F=4.855, P=.011). 8) As to the time of feeling fatigue, the fatigue reaches the highest point 1~2 hours after operations, 3.04(F=2.703, P=.046). 9) When they feel fatigue after scrub nurse duties, they feel the greatest fatigue 2 hours after the duties, 3.09( F=2.841, P=.038). 10) As to the operation instruments, when they use complex instruments borrowing from the outside in addition to the basic instruments, their fatigue becomes the greatest, 3.09(F=7.831, P=.000). 11) As to the kind of operation, when they participate in orthopedic's surgery operations, they feel the greatest fatigue, 3.18(F=4.362, P=.000). With the above results, it is proved that the degree of operating room nurses' fatigue is considerably high. So it may be concluded that the measure for lessening the fatigue should be find immediately, not on the level of personal matters but on the level of hospital nursing administration.

• Tuberculosis and Respiratory Diseases
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• v.58 no.3
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• pp.295-298
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• 2005

We report a case of a 48-year-old man with a paradoxic upper airway obstruction and central sleep apnea that developed after an anterior cervical spinal fusion. Nine months before being admitted to this hospital, he was diagnosed with a herniated intervertebral disc between the 5th and 6th cervical spine, and the first operation was carried out. Two months later, a pseudoarthrosis has developed and a second operation, an anterior interbody fusion of the C5 and C6 using autogenous strut bone graft, was performed. After the second operation, he began to complain of snoring, excessive daytime sleepiness, insomnia, and a bizarre sound heard near the upper airway during breathing. Nasopharyngoscope and magnetic resonance imaging disclosed a paradoxical narrowing of the nasopharynx during expiration. On the overnight polysomnography, the apnea index was 8.7/h (central apnea, 7.0/h; obstructive apnea, 1.7/h). Nasal continuous positive airway pressure was applied, but he complained of pressure-intolerance, and laser-assisted uvulopalatoplasty was then performed. Two months after surgery, clinical symptoms as well as the apneas had improved markedly. We suggest that this paradoxic upper airway obstruction might be associated with the anterior cervical spinal surgery even though the mechanism is unclear. This case also emphasizes that an upper airway obstruction can contribute to the development of central sleep apnea.

• Clinical and Experimental Pediatrics
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• v.49 no.5
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• pp.533-538
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• 2006

Purpose : The headache, one of the symptoms of meningitis, is related to abrupt elevation of intracranial pressure(ICP) or stimulation of intracranial nociceptive structure. However, in cases of mild elevation of ICP or normal findings of cerebrospinal fluid(CSF) analysis, patients sometimes complain of headaches. Therefore, other pathways may contribute to the occurrence of headaches in aseptic meningitis or meningismus. We intend to investigate the role of substance P(SP) and calcitonin gene-related peptide(CGRP) in aseptic meningitis or meningismus. Methods : We measured leukocyte count, the concentration of protein and glucose in CSF and ICP of patients with meningeal irritation sign. We also measured SP and CGRP levels by using immunoassay. We analyzed the relationship between the presence of headache and the value of SP and CGRP. Results : The concentrations of CGRP($18.8{\pm}10.5ng/mL$) in CSF and ICP($14.8{\pm}4.5cmH_2O$) in aseptic meningitis group were significantly higher than in those($14.1{\pm}7.4ng/mL$ and $12.0{\pm}5.1cmH_2O$, respectively) of the meningismus group(P<0.05). There was no significant difference in the SP levels between the two groups. In the aseptic meningitis group, the concentrations of SP and CGRP were significantly higher in the normal ICP group than in the elevated ICP group(P<0.05). Conclusion : Headaches in children with aseptic meningitis or meningismus is considered to be related to the elevation of the CSF levels of SP and CGRP.

• THE INTERNATIONAL COMMERCE & LAW REVIEW
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• v.49
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• pp.283-324
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• 2011

The purpose of this paper is to research the air waybill and the carrier's liability in respect of the carriage of cargo by air under the Montreal Convention of 1999. The Warsaw Convention for the unification of certain rules for international carriage by air was adopted in 1929 and modified successively in 1955, 1961, 1971, 1975 and 1999. The Montreal Convention of 1999 modernized and consolidated the Warsaw Convention and related instruments. Under the Montreal Convention, in respect of the carriage of cargo, the air waybill shall be made out by the consignor. If, at the request of the consignor, the carrier makes it out, the carrier shall be deemed to have done so on behalf of the consignor. The air waybill shall be made out in three orignal parts. Under the Montreal Convention, the consignor shall indemnify the carrier against all damages suffered by the carrier or any other person to whom the carrier is liable, by reason of the irregularity, incorrectness or incompleteness of the particulars and statement furnished by the consignor or on its behalf. The air waybill is not a document of title or negotiable instrument. Under the Montreal Convention, the air waybill is prima facie evidence of the conclusion of the contract, of the acceptance of the cargo and of the conditions of carriage. If the carrier carries out the instructions of the consignor for the disposition of the cargo without requiring the production of the part of the air waybill, the carrier will be liable, for any damage which may be accused thereby to any person who is lawfully in possession of the part of the air waybill. Under the Montreal Convention, the carrier is liable by application of principle of strict liability for the damage sustained during the carriage of cargo by air. The carrier is liable for the destruction or loss of, or damage to cargo and delay during the carriage by air. The period of the carriage by air does not extend to any carriage by land, by sea or by inland waterway performed outside an airport. Under the Montreal Convention, the carrier's liability is limited to a sum of 17 Special Drawing Rights per kilogramme. Any provision tending to relieve the carrier of liability or to fix a lower limit than that which is laid down in this Convention shall be and void. Under the Montreal Convention, if the carrier proves that the damage was caused by the negligence or other wrongful act or omission of the person claiming compensation, or the person from whom he derives his rights, the carrier shall be wholly or partly exonerated from ist liability to the claimant to the extent that such negligence or wrongful act or omission caused the damage. Under the Montreal Convention, any action for damages, however founded, whether under this Convention or in contract or in tort or otherwise, can only be brought subject to the conditions and such limits of liability as are set out in this Convention. Under the Montreal Convention, in the case of damage the person entitled to delivery must complain to the carrier forthwith after the discovery of the damage, and at the latest, within fourteen days from the date of receipt of cargo. In the case of delay, the complaint must be made at the latest within twenty-one days from the date on which the cargo has been placed at his disposal. if no complaint is made within the times aforesaid, no action shall lie against the carrier, save in the case of fraud on its part. Under the Montreal Convention, the right to damage shall be extinguished if an action is not brought within a period of two years, reckoned from the date of arrival at the destination, or from the date on which the aircraft ought to have arrived, or from the date on which the carriage stopped. In conclusion, the Montreal Convention has main outstanding issues with respect to the carrier's liability in respect of the carriage of cargo by air as follows : The amounts of limits of the carrier's liability, the duration of the carrier's liability, and the aviation liability insurance. Therefore, the conditions and limits of the carrier's liability under the Montreal Convention should be readjusted and regulated in detail.

• Korean Journal of Psychosomatic Medicine
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• v.9 no.1
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• pp.28-36
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• 2001

Objectives : This study was undertaken to identify the clinical and psychological characteristics in patients of mental disability assessment following traumatic brain injury who had the finding with or without abnormal brain imaging study. Methods : A consecutive series of 59 patients were assessed in hospital from January 1994 to December 1998. Patients were divided into 2 groups based on normal or abnormal brain imaging and the two groups were compared in demographic characteristics, psychiatric symptoms, type of head injury, clinical psychological findings. There were 27 patients with abnormal findings and 32 with normal findings in brain imaging study. Results : Abnormal finding group in brain imaging study had significantly higher incidence of psychosis, decreased memory, decreased appetite, increased nihilistic idea, and intracranial hemorrhage. Also, abnormal finding group showed significantly lower level of performance on the block design subtest of K-WAIS and had significantly lower scores on F, hypochodriasis, depression, hysteria, psychopathic deviate, psychasthenia and schizophrenia subscale of the MMPI. Conclusion : The findings suggest that the patients undergone brain surgery due to intracranial hemorrage at that time of brain injury may have higher frequency of abnormal findings in brain imaging study, complain more cognitive and affective symptoms, and have lower the abstract concept formation and perceptual organization abilities.

• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.115-120
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• 1999

Purpose : After the total or partial meniscectomy of the lateral discoid meniscus, many patients complain the residual pain or the recurrent symptoms of the meniscus, and some of them need reoperation. We analyzed the causes of the reoperation after initial meniscectomy. Material & Method : Two hundred seventy three patients with the symptomatic lateral discoid meniscus were treated by arthroscopic meniscectomy between October, 1989 and September, 1998. Of the 273 patients, 69 patients were treated by total meniscectomy and 204 patients were treated by partial meniscectomy. The male to female sex ratio was 1:1.04, and the average of the age was 23.1 years old(from 4 to 59 years old). The reoperation was done in 8 patients, of which 1 was the case of total meniscectomy at the initial operation, and the rest 7 were the case of partial meniscectomy. Results : Of the 8 reoperations, 3 patients recurred the meniscal symptoms within the 3rd week after the initial operation, and 5 patients recurred beyond the 3rd week after the initial operation. Among the 3 patients of carly recurrence, 2 patients showed inadequate sizes of the remnant meniscus, and 1 patient showed posterolateral instability of the remained meniscus. Among the 5 patients of late recurrence, 3 patients showed rerupture of the meniscus, and 2 patients showed associated pathology of degenerative arthritis following osteochondritis dissecans. Conclusions : The reoperation rate after initial meniscectomy of the lateral discoid meniscus was higher in partial meniscectomy than total meniscectomy. During the operation of the lateral discoid meniscus, we must determine the adequate resectional margin, confirm the remnant meniscus by probing, and look for the associated pathologies.