• Journal of Hospice and Palliative Care
• /
• v.11 no.3
• /
• pp.136-139
• /
• 2008

Purpose: Epidural morphine infusion has been used to control pain in cancer patients whose cancer pain can not be controlled high dose intravenous morphine injection. To study the effectiveness and side effects of epidural morphine for the treatment of cancer pain in terminal patients at Hospice Ward, we evaluated the change in morphine equivalent daily dose for effectiveness and complications of epidural morphine infusion. Methods: We retrospectively analyzed 24 terminal cancer patients who were treated with continuous epidural morphine between 2001 and 2004 at Hospice Ward of St. Vincent's Hospital. Results: The median of baseline morphine equivalent daily dose was 615 mg, whereas the median dose of initial epidural morphine was 16 mg. The median of morphine daily equivalent daily dose dropped from 615 mg to 274 mg in one week after epidural morphine infusion therapy (P-value=0.000). The median survival from the time of the first catheter insertion was 35 days. In 6 patients, the catheter was removed due to complications, however the catheter was reinserted in 3 patients. Conclusion: Cancer pain management by epidural morphine infusion is very effective method with low rate of severe complication.

• Korean Security Journal
• /
• no.24
• /
• pp.147-170
• /
• 2010

This study is to present a improvement directions for the protection of industrial key technology. For the purpose of the study, the survey was carried out on the administrative security activity of 68 enterprises including Large companies, small-midium companies and public corporations. survey result on the 10 items of security policy, 10 items of personal management and 7 items of the assets management are as follows; First, stable foundation for the efficient implement of security policy is needed. Carrying a security policy into practice and continuous upgrade should be fulfilled with drawing-up of the policy. Also for the vitalization of security activity, arrangement of security organization and security manager are needed with mutual assistance in the company. Periodic security inspection should be practiced for the improvement of security level and security understanding. Second, the increase of investment for security job is needed for security invigoration. Securing cooperation channel with professional security facility such as National Intelligence Service, Korea internet & security agency, Information security consulting company, security research institute is needed, also security outsourcing could be considered as the method of above investment. Especially small-midium company is very vulnerable compared with Large company and public corporation in security management, so increase of government's budget for security support system is necessary. Third, human resource management is important, because the main cause of leak of confidential information is person. Regular education rate for new employee and staff members is relatively high, but the vitalization of security oath for staff members and the third party who access to key technology is necessary. Also access right to key information should be changed whenever access right changes. Reinforcement of management of resigned person such as security oath, the elimination of access right to key information and the deletion of account. is needed. Forth, the control and management of important asset including patent and design should be tightened. Classification of importance of asset and periodic inspection are necessary with the effects evaluation of leak of asset.

• Journal of Science of Art and Design
• /
• v.10
• /
• pp.183-218
• /
• 2006

Colors change in time corresponding with the value system and aesthetic consciousness of the time. The roles that colors play in painting can be divided into the formative role based on the contrast and harmony of color planes and the aesthetic role expressed by colors to represent the objects. The aesthetic consciousness of the orient starts with the Civility(禮) and Pleasure(樂), which is closely related with restrained or tempered human feelings. In the art world of the orient including poem, painting, and music, what are seen and felt from the objects are not represented in all. Added by the sentiment laid background, the beauty of the orient emphasizes the beauty of restraint and temperance, which has long been the essential aesthetic emotion of the orient. From the very inception of oriental painting, colors had become a symbolic system in which the five colors associated with the philosophy of Yin and Yang and Five Forces were symbolically connected with the four sacred animals of Red Peacock, Black Turtle, Blue Dragon, and White Tiger. In this color system the use of colors was not free from ideological matters, and was further constrained by the limited color production and distribution. Therefore, development in color expression seemed to have been very much limited because of the unavailability and unreadiness of various colors. Studies into the flow in oriental painting show that color expression in oriental painting have changed from symbolic color expression to poetic expression, and then to emotional color expression as the mode of painting changes in time. As oriental painting transformed from the art of religious or ceremonial purpose to one of appreciation, the mast visible change in color expression is the one of realism(simulation). Rooted on the naturalistic color expression of the orient where the fundamental properties of objects were considered mast critical, this realistic color expression depicts the genuine color properties that the objects posses, with many examples in the Flower & Bird Painting prior to the North Sung dynasty. This realistic expression of colors changed as poetic sentiments were fused with painting in later years of the North Sung dynasty, in which a conversion to light ink and light coloring in the use of ink and colors was witnessed, and subjective emotion was intervened and represented. This mode of color expression had established as free and creative coloring with vivid expression of individuality. The fusion of coloring and lyricism was borrowed from the trend in painting after the North Sung dynasty which was mentioned earlier, and from the trend in which painting was fused with poetic sentiments to express the emotion of artists, accompanied with such features as light coloring and compositional change. Here, the lyricism refers to the artist's subjective perspective of the world and expression of it in refined words with certain rhythm, the essence of which is the integration of the artist's ego and the world. The poetic ego projects the emotion and sentiment toward the external objects or assimilates them in order to express the emotion and sentiment of one's own ego in depth and most efficiently. This is closely related with the rationale behind the long-standing tradition of continuous representation of same objects in oriental painting from ancient times to contemporary days. According to the thoughts of the orient, nature was not just an object of expression, but recognized as a personified body, to which the artist projects his or her emotions. The result is the rebirth of meaning in painting, completely different from what the same objects previously represented. This process helps achieve the integration and unity between the objects and the ego. Therefore, this paper discussed the lyrical expression of colors in the works of the author, drawing upon the poetic expression method reflected in the traditional Flower and Bird Painting, one of the painting modes mainly depending on color expression. Based on the related discussion and analysis, it was possible to identify the deep thoughts and the distinctive expression methods of the orient and to address the significance to prioritize the issue of transmission and development of these precious traditions, which will constitute the main identity of the author's future work.

• Journal of Chest Surgery
• /
• v.42 no.3
• /
• pp.311-316
• /
• 2009

Background: Clopidogrel is widely used just before coronary artery bypass surgery, yet its pharmacological effect can cause postoperative bleeding-related complications. The purpose of this study was to find the effect of preoperative clopidogrel exposure on the blood transfusion requirement and on the rate of reexploration for bleeding control and the rate of readmission caused by bleeding in patients who undergo off-pump coronary artery bypass surgery (OPCAB). Material and Method: This study included 103 patients who had been on clopidogrel preoperatively and they underwent OPCAB by one surgeon from January, 2005 to November, 2007. We divided the patient into two group. Group 1 consisted of 45 patients who stopped cloidogrel 5 days before surgery and group 2 consisted of 58 patients who were taking clopidogrel within 5 days before surgery. Two groups were compared in terms of the bleeding related reoperation rate and the readmission rate, the amount of postoperative bleeding and the required amount of transfusion. Result: There were no significant differences between the two groups concerning the demographic, echocardiographic and hematologic features. There were no significant differences in the postoperative bleeding amount, but the amount of required transfusion was greater in group 2 (p=0.018). While group 1 showed a 0% reoperation rate for hemostasis and 0% readmission rate as related to postoperative bleeding, group 2 showed a 6.9% reoperation and a 5.2% readmission rate, but three were no statistically significant differences between the two groups. Conclusion: Continuous use of clopidogrel did not cause postoperative major bleeding, but can increase the amount of bleeding and the amount of required transfusion postoperatively. We that discontinuation of clopidogrel for a while before elective OPCAB can help the patient's postoperative recovery.

• Journal of Chest Surgery
• /
• v.42 no.3
• /
• pp.344-349
• /
• 2009

Background: The clinical history and physical findings of the patients with spontaneous pneumothorax depend largely on the extent of the collapse of the lung and the presence of pre-existing pulmonary disease. Large primary spontaneous pneumothorax is a possible serious condition and. so more active treatment will be necessary for these patients. The therapeutic guideline for large pneumothorax remains controversial. Therefore, by assessing the clinical results of surgical treatment for large primary pneumothorax, we aim to determine the indicators of treatment. Material and Method: Among 348 patients with primary spontaneous pneumothorax and who underwent surgical treatment from August 2004 through December 2007, 58 patients who responded to treatment for a large primary pneumothorax were included in the current study. We then retrospectively evaluated the operative findings and the surgical results. The patients with a pneumothorax of 80% or more, including those patients with tension pneumothorax, were considered to have a "large pneumothorax". Most of these patients Should be treated with a 12F chest tube. Thoracoscopic wedge resection was considered for treating recurrent pneumothorax, continuous air leakage, controlateral pneumothorax and first episode pneumothorax with visible blebs (> 1cm) seen on the computed tomography. Result: There were 50 men and 8 women with a mean age of 28.2 years (range: $14\sim54$ years). The mean length of hospitalization was 5.3 days (range: $2\sim10$ days). Nine patients underwent chest tube drainage only. Forty-nine patients underwent thoracoscopic wedge resection. The mean follow up time was 27.8 months (range: $10\sim58$ months). The actual site of air leakage could be located in 35 patients (71.4%) and this was correlated with pleural adhesion (p=0.005). The initial air leakage tended to be more correlated with intra-operative air leakage, although this was not statistically significant (p=0.066). The recurrence rate was 11.1 % for the patients with chest tube drainage and 2.0% for the patients with thoracoscopic wedge resection. Conclusion: Large primary pneumothorax requires an early diagnosis and early treatment. Thoracoscopic wedge resection may help to prevent recurrence of large primary pneumothorax.

• The Journal of Korean Academy of Prosthodontics
• /
• v.49 no.3
• /
• pp.197-205
• /
• 2011

Purpose: This study was to evaluate the accuracy of the implant torque controller used in dental clinics and to investigate whether it was applied appropriately. Materials and methods: Fifty dentists who work in dental clinics were enrolled in this study. Dental (implant) practice career, experience frequency of implant screw loosening and fracture, education of implant torque controller application and infection control methods were included in the survey. 25 Ncm and 30 Ncm of the tightening torque applied to the implant screw were measured by 50 clinicians. After measuring the torque value by using the torque controller, the torque mean according to where education about the implant torque controller was received was analyzed with independent t-test at the significance level of 0.05. Results: The torque controller used in private dental clinics showed 4.78% error ratio. When 50 dentists applied 25 Ncm to the implant screw was $29.0{\pm}8.4$ Ncm, and that in 30 Ncm was $34.3{\pm}9.1$ Ncm. Statistical significance was found between the group that was educated about implant torque application and the group that was not educated. Conclusion: During the prosthodontic treatment with implant, there was difference between actual applied torsion force and the amount torque controller indicated. Clinicians have to not only be well-informed about the accurate usage method of the torque controller, but also keep and manage the torque controller so as to maintain continuous and accurate torque values. Through this, it is considered to achieve clinical results to minimize problems of screw loosening or fracture.

• Journal of Chest Surgery
• /
• v.35 no.4
• /
• pp.267-273
• /
• 2002

Background: We performed a phase IV clinical trial to examine the usefulness of a continuous infusion of nicardipine hydrochloride to control hypertension in patients with acute aortic dissection. material and Method: Systolic/diastolic blood pressure, and heart rate were monitored before and after the intravenous administration of nicardipine in 31 patients with aortic diseases. The period of nicardipine administration in each patient was from 3 to 14 days. Efficacy was evaluated by determining the average amount of blood pressure reduction on the 3rd day of drug administration. The dosage of another antihypertensive agent was slowly tapered down, and ultimately replaced by the test drug. Result: 28 patients were diagnosed as acute aortic dissection, 2 patients as rupture of the aortic arch aneurysm, and 1 patient as traumatic aortic rupture. Mean age was 53.9 $\pm$ 14.9(29~89) years, and 21 patients(67.7%) were male. 14 patients(32.3%) had complications associated with underlying aortic disease: aortic insufficiency in 7, hemopericardium in 6, acute renal failure in 1, paraplegia in 1, lower extremity ischemia in 1, and hemothorax in 1. The time needed to reach the target blood pressure was within 15 minutes in 16, from 15 to 30 minutes in 10, from 30 to 45 minutes in 3 and from 45 to 60 minutes in 2, and their baseline average systolic, diastolic, and mean arterial blood pressures(mmHg) were 147$\pm$23, 82.3$\pm$ 18.6, and 104 $\pm$ 18, respectively. Average systolic, diastolic, and mean arterial blood pressures(mmHg) on the third day of nicardipine infusion were 119$\pm$ 12, 69$\pm$9, and 86$\pm$8, and they all showed statistically significant decrease(p<0.05). The average systolic, diastolic, and mean arterial blood pressure(mmHg) after the discontinuation of the nicardipine infusion were 119 $\pm$ 15, 71 $\pm$ 14, and 86$\pm$ 13, respectively. No significant difference was observed between the average pressures measured on the third day and those measured after the discontinuation of the nicardipine infusion, and no definite side effects were observed during the study period. Conclusion: Nicardipine hydrochloride was both effective and safe at controlling blood pressure in patients with acute aortic dissection.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.13 no.3
• /
• pp.110-122
• /
• 2009

Purpose: Nowadays, A medical institution assesment could get more interest about a quality of medical services from many hospitals that developed the active activities for improving medical services. Also, there is an other additional issue which is the patients risk management. Uijeongbu ST. Mary's hospital Nuclear Medicine department has been changed many work process after PET-CT introduction and renovation of its place since 2008. Therefore, modified structure and the way of existing work process have contained risk factors. The purpose of this study would be the appropriate risk management process while imaging examination process, the removal risk factors and improved activities through the analysis risk factors. Materials and Methods: Nuclear Medicine department new process should analysis through many-sided, Firstly, make and trained risk management manual after then apply an actual work. Result analysis showed the number of risk accident occurrence that comparing the last year and after the improved activities. Secondly, producing risk management public relations film has been showed an applicable patient after then the customer service measurement checked for a hundred patient by questionnaire. Lastly, Risk factors were eliminated through the facilities participation improving activities which could change for the better risk factors. Results: The number of safety accident occurrence(medication error, fall and collision) were checked as zero after the improving activities both PET-CT and gamma camera examination. The results of questionnaire showed as follows; 74% marked as understanding of the test process and 81% checked "satisfaction" after the public relations film showing. The question "Did you consider about the risk factors?", both PET-CT and gamma camera checked as 94% and 89% respectively. Customer risk management could be accomplished effectively through the improving activities at the nuclear medicine department. Conclusions: The study would be an opportunity that spread risk factors were systematically showed and analyzied. Also, It showed the possibility of the minimized safety accident and its feedback, if application of the response manuel that could be a standard of radiology technician's work method to react safety accident. It was the more effective that visual material could be easy to approach as a methodology of risk factors. As far as I have concerned that It could help the safety and convenience through continuous and detailed activities that offer to patients.

• Research in Community and Public Health Nursing
• /
• v.7 no.2
• /
• pp.294-312
• /
• 1996

Relatively young widows, who are left with young children by a sudden death of their husbands, will be faced with not only psychological troubles such as individual anxiety and frustration but also the dual burden of playing both father and mother roles in a family, Also, family members have difficulty in adapting themselves to new circumstances of the family system, the training and raising of family members, and management of the family economy. In this study, the realistic resources on the experience of middle-aged women who are bereaved of their husbands by accidents were explored. The purpose of this study is to help widows adapt to life in society and live a more positive life by setting a new goals and recovering from a lost and twisted life. 11 women, who have experienced the loss their husbands and live in the Seoul metropolitan area were studied. The research took 116 days from December 15, 1995 to April 8, 1996. The method of research was direct interviews. While having interviews with them, the contents were recorded with their consent. The ground theory was that used by Strauss & Corbin(1990) in the analysis of the data. 81 concepts were analyzed and they were subdirided into 22 subordinate categories through the course of the analysis. These were then classified into 9 general categories. In the course of being categorized, 'absurdity' was showed as a core category. The subordinate categories 'surprise', 'gloom', 'grudge', 'helplessness', 'emptiness', and 'loss' were united in the core category 'absurdity'. Ominous presentiment, belated notice, death, surprise, gloom, grudge, helplessness, emptiness, loss, the situation of the children, lack of support from neighbors, support from neighbors, mulling over ways to live, choosing a job, strengthening, reinforcement, burden, sadness, smoldering, yearning, overcoming these 22 subordinate categories were re-composed into 9 general ones the husband's death, absurdity, presence of children, existence of support, self-support ability, preparation of countermeasures, self-reinforcement, toilsomeness, and overcoming. 'Absurdity' widows experience was shown in the results of 'toilsomeness' and 'overcoming' through reaction, confrontation, and adaptation. According to the analysis the central phenomenon was absurdity, the causal condition of the death of a husband, the presence of children and the existence of support, and the meditated situation of self-support. To solve absurdity, the preparation of countermeasures and self-reinforcements were shown resulting in toilsomeness and overcoming. Through the contrast in the data, the following statements were deduced: (1) If the death of the husband is expected, the more a widow will feel absurdity. (2) The more children she has and the younger she is, the more a widow will feel absurdity. (3) The lower support she is given, the more a widow will feel absurdity. (4) The larger self-ability she has, the more actively she will prepare countermeasures. (5) The smaller self-ability she has, the more passively she will prepare countermeasures. (6) The larger self-ability she has, the weaker self-reinforcement she will preform. (7) The smaller self-ability she has, the stronger self-reinforcement she will perform. (8) The more actively she prepares countermeasures for absurdity, the better she will overcome. (9) The more passively she prepares counter measure for absurdity, the worse she will overcome. (10) The stronger self-reinforcement for absurdity she performs, the better she will overcome. (11) The weaker self-reinforcement for absurdity she performs, the worse she will overcome. Through the results in this study, the following suggested: 1) A study whose object is all family members, and a comparative study on the case of a husband who has lost his wife should be done. These studies can be expected to develop a more refined theory. 2) Because of the collapse of the extended family system and the changes of family culture in Korea, a widow's status and position are apt to be ambiguous between her husband's home and her parent's. Therefore a new study on family culture should be made. 3) A continuous study on growing social Self Help Groups should be requested for the widows of this study to re-establish and recover from their twisted and scattered lives.

• Journal of radiological science and technology
• /
• v.29 no.3
• /
• pp.185-195
• /
• 2006

Purpose: This study investigated the status of radiation exposure doses since the establishment of the "Regulations on Safety Management of Diagnostic Radiation Generation Device" in January 6, 1995. Method: The level of radiation exposure in people engaged or having been engaged in radiation-related industries of inspection organizations, educational organizations, military units, hospitals, public health centers, businesses, research organizations or clinics over a 5 year period from Jan. 1, 2000 to Dec. 31, 2004 was measured. The 149,205 measurement data of 57,136 workers registered in a measurement organization were analysed in this study. Frequency analysis, a Chi-square test, Chi-square trend test, and ANOVA was used for data analysis. Results: Among 57,136, men were 40,870(71.5%). 50.3% of them were radiologic technologists, otherwise medical doctors(22.7%), nurse(2.9%) and others(24.1%). The average of depth radiation and surface radiation during the 5-year period were found to decrease each year. Both the depth radiation and surface radiation exposure were significantly higher in males, in older age groups, in radiological technologists of occupation. The departments of nuclear medicine had the highest exposure of both depth and surface radiation of the divisions of labor. There were 1.98 and 2.57 per 1,000 person-year were exposed more than 20 mSv(limit recommended by International Commission on Radiological Protection) in depth and surface radiation consequently. Conclusion: The total exposure per worker was siginifcantly decreased by year. But Careful awareness is needed for the workers who exposed over 20 mSv per year. In order to minimize exposure to radiation, each person engaged in a radiation-related industry must adhere to the individual safety management guidelines more thoroughly. In addition, systematic education and continuous guidance aimed at increasing the awareness of safety must be provided.