• Title/Summary/Keyword: 객관분석

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A Study on the Purpose-in-Life Level in Patients with Traumatic Brain Injury (외상성 뇌 손상 환자의 삶의 목적 수준에 관한 연구)

  • Rho, Seung-Ho;Kim, Sung-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.184-195
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    • 1999
  • Objectives : As traumatic brain injury(TBI) leaves chronic sequelae in mind and body, the injured patients should rectify the meaning and object that they have pursued in their lives and set up a new purpose in life that they may make the rest of their lives meaningful. This study was designed to investigate the purpose and quality of life levels and the influence of demographic and clinical variables on the levels in the patients with TBI, and to be of some help to their rehabilitation. Methods : In order to assess the purpose in life(PIL) and the quality of life(QOL) levels, Purpose-in-Life Test, Sickness Impact Profile, Quality of Life Index, Head Injury Symptom Ckecklist, and Neurobehavioral Rating Scale were administered to the subjects. The subjects were thirty-two patients with TBI and the same numbered normal controls. The TBI group was composed of 16 to 65 year-aged patients who had received mild or severe TBI at least 12 months before, and the controls were siblings or friends of the patients whose age, sex, and educational level were similar to them. Results : 1) The PIL and QOL levels of the patients with TBI remained significantly lower than that of control group after their symptoms of injury were stabilized(p<.01, p<.01). 2) The mean PIL score of TBI group was $58.8{\pm}23.2$, which was to be regarded as the level of existential vacuum. 3) The PIL level of TBI group was significantly correlated with the QOL level(p <.01). 4) The subgroup with lower PIL level in patients with TBI has significantly higher rate of female than that with higher PIL(p<.05), the PIL level of female patients was significantly lower than that of male patients(p <.05). 5) The significant differences in PIL levels were not found, in which comparison was performed between each pair of subgroups of patients with TBI divided by severity of injury(mild vs severe), marital status(married vs unmarried), and occupational status prior to injury(employed vs unemployed). Conclusion : The PIL of patients with TBI still remained the level of existential vacuum after symptoms of sequelae had been stabilized, The QOL level was also extremely low, and as the PIL level was low the QOL was also low. The demographic and clinical variables except sex did not have influence on the PIL level in brain-injured patients. It is suggested that every patient should admit their mental and physical limitations caused by brain injury and revise their purpose in life for successful rehabilitation.

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Correlation of the Ultrasonography with the Physical Examinations and Simple Radiography in Measurement of Amount of Effusion of the Knee Joint (슬관절 활액 양 측정에서의 신체검사와 단순 방사선 검사, 초음파의 상관성)

  • Kim, Jung-Man;Ra, Ki-Hang;Nam, Ho-Jin;Lee, Jung-Woo
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.1
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    • pp.15-20
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    • 2010
  • Purpose: The goal of this study is to find out how useful ultrasonography is in measuring amount of effusion within the knee joint in comparison with physical examination and simple radiography. Materials and Methods: We evaluated total 60 cases which were suspicious for joint effusion. Average age was 61.3 years. The group was consisted of 22 males and 38 females, and 24 obese people and 36 non-obese people. Stroke test and patella floating test were done as physical examination. Amount of joint effusion was classified into 3 groups in simple lateral radiographic view and ultrasonography was used for recheck-up. Results: 39 cases were found positive in stroke test, and patella floating was shown in 20 cases. In simple lateral radiographic view, 47 cases of grade I, 7 cases of grade II and 3 cases of grade III were checked. Average $7.67{\pm}2.90mm$ amount of effusion was checked by ultrasonography. Amount of fluid in stroke test, patella floating test and simple lateral radiographic view showed close correlation with ultrasonography. Gender did not seem to affect physical examination, but strong correlation was found in female in simple radiography. Obese group showed closer relationship with all 3 exams compared with non-obese group. Physical examination was relatively effective with nonobese group, but not with obese group. And it was not easy to measure the amount of fluid with simple radiographic view, but we could obtain objective data from ultrasonography by measuring the amount of effusion dynamically. Conclusion: We concluded that more objective data was obtained with ultrasonography in comparison with physical examinations and simple radiography in the aspect of measuring amount of joint fluid.

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Entre l' espace sculptural et, l' espace architectural (조각공간과 건축공간의 관계)

  • Lee Bong-Soon
    • Journal of Science of Art and Design
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    • v.5
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    • pp.175-216
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    • 2003
  • 시각이 아닌 오감체계에 관계하는 때문에 현대미술은 외관만으로 이루어지지 않는다. 곧 예술 작품들은 하나의 장소를 관객에게 제공하여, 심리적, 물리적, 또는 예술이 존재여부에 관한 갖가지 질문들을 제기한다. 모든 예술 작품은 메시지를 담고 있다. 이러한 관점에서 개념 또는 아이디어에 우선하는 현대미술은 그들의 메시지를 전달하기 위해 우리의 사회적 배경과 보편성을 간과할 수 없다. 우리의 물체 인식은 결국 우리의 경험체계를 통해서 이루어진다고 간주하면, 현대미술의 새로운 형태는 보편적 특질들이 그 특질들 이상의 상태로 보여지도록 유도한다. 이러한 창조 행위의 시작은 현대인간의 문화 읽기이며 문화는 인간과 자연의 긴밀한 관계 속에서 이루어진다. 역사는 지나간 시간을 기록한 것이며, 이 또한 우리의 지식과 정보 체계에 속한다. 회화가 평면에 입체감을 표현하는 것과는 달리 조각은 자연 속, 즉 실재공간 속에 있는 모든 것을 표현하기 때문에 시각(visible) 이외에도 촉각(tangible)이 관여하게 된다. 조각의 특수성은 촉각(tangible)이 우선하는 것이다. 그러나 시각과 촉각은 매우 적극적으로 미학적 경험에 참여하는 감각으로 이들을 서로 분리하여 생각하기가 무척 힘들다. 왜냐하면 어떤 경험에 있어서 기억연합 또는 감각 연합에 의해 하나의 감각이 다른 여러 감각을 촉발하여 연쇄반응 혹은 '형태 Gestalt'를 이루기 때문이다. 대부분의 근대 조각 작품들은 조각대 위에 고정되어 있는 구상 형태를 지녔기 때문에 조각작품 자체가 지닌 외적 형태와 그 자체내의 공간이 더욱 중요한 역할을 하게 된다. 말하자면 미로의 비너스 조각은 대리석과 비너스 형태의 결합이다. 때문에 관객은 그 주변을 돌면서 우리 신체의 내적 공간과 시각에 의존하면서 그 작품의 중량감, 양감, 형태 등의 특질과 만나게 된다. 그러나 현대 추상조각과 개념조각은 이보다 좀 더 확장된 공간을 제시한다. 이것은 현대조각이 건축개념을 수용한 때문이며, 그것이 때로는 안 쪽에서 때로는 바깥 쪽에서 그 형태를 결정하며, 보고 듣고 느끼고 만져지고 왕래하는 등의 인식 영역인 관객의 오감체계에 직접적으로 관계하기 때문이다. 우리는 건축 공간에서, 시각 외에도 청각이나 촉각을 통해 지각한다. 대강 요약하자면 공간은 객관적 상태이기보다는 인식영역의 주관성을 통해 받아들여진 우리가 지나쳐온 것들이나 체험된 공간이다. 여기서 '받아들여지는' 일은 과거 경험들의 주체들, 언어와 문화에 의해서 이루어져야 한다. 건물, 즉 둘러싸고 있는 공간은 중앙이 아니다. 중앙은 바로 나, 둘러싸여진 나이다 나는 나의 동작에 따라 그 공간의 시스템을 변화시킬 수 있는 유동적인 중심이다 (이때의 나는 위치의 축을 변화시키는 것이 아니라, 그들을 탐색하는 것이다). 작품이 대형화되면서 이러한 건축공간개념이 현대 조각가들의 작품개념에 이용되었다고 본다. 현대미술에서 In situ작업과 특정한 장소를 위한 기획되어진 최근의 프로젝트 작업들은 대형화되어있으며, 건축에서처럼 특정한 장소를 만들어낸다. 로잘린드 크라우스(Rosalind Krauss)는 또한 '조각영역의 확장 (La sculpture dans le champ elargi)'에서 현대조각이 건축과 환경의 영역을 침범하고 있음을 지적한다. 그녀에 의하면, 1960년대 이후의 현대조각은 이러한 탈 귀속성과 조각의 자율성을 획득함으로써 조각은 건축물이 아니면서 건축물 주변에 위치하거나 풍경이 아니면서 풍경 안에 자리잡게 되었다. 이와 같이 현대의 대형조각 작품들 - 예를 들어 대형화된 미니별 조각이나 개념미술, 또는 대지예술 등 -은 풍경의 실재가 아니기 때문에 환경으로부터 구분된다고 언급하고 있다. 이들 조각은 더 이상 만져지는 실체이거나 점유하는 공간의 상징언어를 지닌 조각의 범주에 한정되지 않게 된다. 조각과 건축의 공간인식을 인체의 크기와 관련하여 보면, 메를로 퐁티(Merleau-Ponty)의 '지각의 현상학' 은 우리가 논하는 작품의 공간체계를 분석하는데 지침표가 되어준다. 메를로 퐁티가 말하는 지각은 정신에 의해서만 이루어지는 것이 아니며, 몸과 함께 이루어지는 현상이다. 지각은 우리가 부단히 눈을 움직이고 만지고 냄새를 맡고 주변을 돌아 다니면서 세계와의 직접적인 접촉을 통해 이루어 진다. 몸의 움직임을 통하여 나타나는 신체적 표현은 몸 자체가 원천적으로 지향적 활동의 주체로서 파악되는 한 이미 항상(恒常, constant) 의미 현상을 지니다. 우리의 지각이 움직이는 몸의 지향 활동을 통해 이루어진다는 것은 우리의 몸의 지향활동이 의식에 선행함을 의미한다. 몸의 움직임은 의식의 의도를 표현할 때에만 의미를 나타내는 기호가 되는 것이 아니라, 이미 그 자체가 살아있는 표현이다. 우리의 몸짓, 표정은 우리 의식이 의도하기 전에 이미 의미가 담겨있다. 몸은 그 자체가 기호(Signe)적이다. 결국. 메를로 퐁티에게서 세상(le monde entier)은 그 자신이 주체가 되어 인식한다, 그리고 이 인식 구조에는 우리의 몸이 구심점(le point centripete)이 된다. 만약 우리가 이러한 메를로 퐁티의 개념을 염두에 둔다면, 예술작품의 특성에 매우 중요한 역할을 하고 있는 재료와 크기를 이해할 수 있을 것이다.

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Posterior Cruciate Ligament Augmentation Using an Autogenous Hamstring Tendon Graft and the Posterior-Posterior Triangulation Technique (만성 단독 후방십자인대 파열에서 자가 슬괵건과 후-후 삼각술기를 이용한 만성 후방십자인대 보강술)

  • Kim, Yeung Jin;Chae, Soo Uk;Choi, Byong San;Kim, Jong Yun;Lee, Hwang Yong;Han, Chang Wan;Han, Su Hyoun
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.24-30
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    • 2013
  • Purpose: To evaluate the outcome of arthroscopic posterior cruciate ligament (PCL) augmentation using an autogenous hamstring tendon graft and the posterior-posterior triangulation technique with preservation of ligament remnant or elongated ligament. Materials and Methods: From January 2002 to December 2009, we performed PCL augmentation using an autogenous hamstring tendon graft and the posterior-posterior triangulation technique in 32 patients. The mean age was 35.2 years. Twenty two cases were male and 10 cases were female. Average follow-up period was 5 years and 5 months (range: 2-7.9). Subjective and objective parameters were utilized in analyses, such as the mean range of motion, post. drawer test, Lysholm knee score, Tegner activity score, International Knee Documentation Cominittee (IKDC) grade, and second look arthroscopic examination. Results: At last follow up posterior displacement by the Telos stress test decreased from $10.8{\pm}5.1\;mm$ to $2.8{\pm}3.7\;mm$ (p<0.05). The final Lysholm knee score improved from $60.4{\pm}5.8$ to $84.6{\pm}4.8$. Tegner activity score improved from 3.2 to 4.8. The final IKDC grade was A in 18, B in 11, C in 3. Postoperative Lysholm knee score, IKDC grades, Tegner activity scale, and posterior displacement demonstrated statistically significant improvement compared to the preoperative state (p<0.05). Conclusion: Arthroscopic PCL reconstruction using an autogenous hamstring tendon with preservation of ligament remnant showed a good clinical results and posterior stability.

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MUSIC THERAPY FOR ADOLESCENTS WITH CONDUCT DISORDER (품행장애 청소년의 음악치료 사례연구)

  • Jhin, Hea-Kyung;Kwon, Hea-Kyung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.1
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    • pp.110-123
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    • 2000
  • The short-term music therapy was performed for adolescents with conduct disorder admitted to Seoul National Mental Hospital for 3 months from Jun to September, 1998. This case study focused mainly on two female patients who participated regularly in the group music therapy. The music therapy process was divided into three phases;beginning, opening up, and closing. This music therapy session consisted of three parts;hello song as beginning, various musical activities, and sound & movement activity as closing. Free musical improvisation, song discussion, musical monodrama, and sound & movement were the mainly applied techniques. Free improvisation was used to enhance, motivate, identify and contain the adolescents' feelings and ideas. Song discussion was used to convey their thoughts and to support each other. Musical monodrama was used to make them have insights into interpersonal relationships. Sound & movement was used to enhance spontaneity. It made them explore their body and voice as an expressive medium. Throughout three months period of music therapy, patient A's communication skill, socialization, and behavior areas were assessed with improvement. She could use music as a symbolic form and was able to share her feelings about herself and her family. Patient B's self-expression and cognitive areas were assessed with improvement. She became more spontaneous and could verbalize her emotions during the group session. Music as a non-verbal and therefore often a non-threatening medium wherein so much can be expressed provided two female patients an atmosphere where a sense of trust may be regained.

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The Role of Inhaled Corticosteroid in the Management of Chronic Cough (만성 기침에서 스테로이드 흡입제의 역할)

  • Lee, Kyung-Hun;Jang, Seung Hun;Lee, Jung-Hwa;Eom, Kwang-Seok;Bahn, Joon-Woo;Kim, Dong-Gyu;Shin, Tae Rim;Park, Sang Myon;Lee, Myung-Gu;Kim, Chul-Hong;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.2
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    • pp.221-227
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    • 2006
  • Background : Cough may be a consequence of bronchial hyperresponsiveness or inflammation. Empirical treatment is important in this context because it difficult to verify the obvious cause of cough using laboratory tests, Corticosteroid has a nonspecific anti-inflammatory effect, and can be used for cough management. However, its response rate has not yet been fully elucidated. This study investigated the short- term effects of inhaled corticosteroid on chronic cough Methods : Patients with chronic cough with a normal chest radiograph and a pulmonary function test were enrolled. Cases with a prior respiratory infection within 8 weeks, a history of bronchial asthma, objective wheezing on examination, subjective symptoms of gastroesophageal reflux or taking an ACE inhibitor were excluded. On the first visit, a methacholine bronchial provocation test, spontaneous sputum eosinophil count performed twice and a paranasal sinus radiograph were checked, and the patients were treated with budesonide turbuhaler $800{\mu}g/day$ for ten days. The primary outcome measure was a decrease in the cough score after treatment. Results : Sixty nine chronic coughers were finally analyzed. The final diagnoses by the routine tests were as follows: bronchial asthma 13.0%, eosinophilic bronchitis 18.8%, paranasal sinusitis 23.2% and non-diagnostic cases 53.6%. The following responses to the inhaled corticosteroid were observed: definite responders, 76.8%, possible responders, 2.9% and non-responders, 20.3%. The response rate was not affected by the final diagnosis even in the non-diagnostic cases. There were minimal adverse drug related effects during the empirical treatment. Conclusion : Routine objective tests such as methacholine provocation, sputum eosinophil count and simple radiographs were notare not suitable for diagnosing chronic cough Therefore, empirical treatment is important. Short term inhaled corticosteroid is effective and can guide a further treatment plan for chronic cough.

A Search of Regional Concept in the Post-Modern Era: In Case of Identity (포스트모던 시대에 적합한 지역 개념의 모색: 동일성(identity) 개념을 중심으로)

  • Leem, Byoung-Jo;Ryu, Je-Hun
    • Journal of the Korean Geographical Society
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    • v.42 no.4
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    • pp.582-600
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    • 2007
  • In a long history of geography, a variety of regional concepts have been suggested to represent the particular situations in each period. Today, post-modem situations, characterized by the development of capitalism and globalization, demand a new variety of regional concepts. The regional characteristics, such as social relations, institutional systems, ideologies and symbolism, are now perceived basically on the level of subjectivity. Currently, it is the most urgent task to integrate many conflicting opinions among a variety of subjects into the one that would seek a voluntary consent from the majority of regional residents. In this paper, it is suggested that the concept of identity is the most efficient in examining and explaining the post-modem trend of a region: variability, subjectivity, mobility, changeability, Finally, it is suggested that a special attention should be paid to the role of institutions, that is institutionalization, in the construction of regional identity, to understand and interpret the cultural-historical aspect of a regional change.

Critical Pathway for Operable Gastric Cancer (위암수술 환자에서의 Critical Pathway의 개발과 적용)

  • Song, Kyo-Young;Kim, Seung-Nam;Park, Cho-Hyun
    • Journal of Gastric Cancer
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    • v.5 no.2
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    • pp.95-100
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    • 2005
  • Purpose: Critical pathways (CP), also known as clinical pathways, are management plans that display goals for patients and have led to improved outcomes for many disease entities. This study was aimed at developing a critical pathway for the surgical treatment of gastric cancer patients and evaluating its usefulness. Materials and Methods: A CP was developed and implemented by a team of surgeons, nurses, nutritionists, and administrative officials. Among the 117 patients who received curative gastrectomies for gastric cancer at Kangnam St. Mary's Hospital, The Catholic University of Korea, between October 2003 and August 2004, 26 patients were treated according to the CP. We evaluated its usefulness by comparing the clinical characterisctics, postoperative progress, hospital stays, and costs between the CP and the non-CP groups. Patient satisfaction was also surveyed with questionnaires. Results: Of the initial 26 patients in the CP group, two were excluded from the final evaluation; one patient had a duodenal stump leakage, and the other had a gastric stasis postoperatively. In 8 patients, protocol violation occurred; six patients refused to be discharged on the $7^{th}$ postoperative day, one patient who had an gastric staisis postoperatively stayed for 2 additional days, and one patient who needed ICU care stayed for 4 additional days. The drop-out rate was $7.7\%$ (2/26), and the variance rate was $30.8\%$ (8/26). The mean hospital stay was 11.3 days ($10\~15$ days) for the CP group compared with 17.5 days ($9\∼68$ days) for the non-CP group, resulting in a difference of about 6 days (P<0.05). The mean hospital stays after surgery were 10.3 days ($7\∼68$ days) and 8.3 days ($7\∼12$ days) for the non-CP and the CP groups, respectively, but the difference was statistically not significant (P>0.05). The mean charge during the hospital stay was higher in the non-CP group ( $\\$ 6,292,200) than in the CP group ( $\\$ 4,863,685). The charge per hospital day was higher in the CP group ( $\\$ 430,414) than in the non-CP group ( $\\$ 359,554). Patient satisfaction was higher in the CP group than in the non-CP group. Conclusion: By developing and applying a critical pathway in the surgical treatment of stomach cancer patients, we could reduce the length of hospital stay as well as the cost. A multi-centered prospective study to establish a standard treatment pathway and to demonstrate its effectiveness is needed in the future.

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The effect of education and training with balloons on pulmonary function test in children (교육과 풍선을 이용한 연습이 소아 폐기능 검사에 미치는 영향)

  • Hong, Yong Hee;Ha, Sun Mi;Jeon, You Hoon;Yang, Hyeon Jong;Pyun, Bok Yang
    • Clinical and Experimental Pediatrics
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    • v.51 no.5
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    • pp.506-511
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    • 2008
  • Purpose : The results of pulmonary function test (PFT) in children are variable according to the patient's cooperation and comprehensiveness. This study has intended to figure out the effectiveness of pre-education and training with balloons on PFT in children. Methods : One hundred six children mean aged $9.35{\pm}2.92\;years$ were tested. All participants performed PFT twice in 30 minutes intervals. First PFT were performed after usual instruction and second PFT were performed according to randomly classified grouping; Group 1 : repeat PFT after training with balloons, Group 2 : repeat PFT after training and education, both, Group 3 : repeat PFT after education about objects and necessities of pulmonary function test, Group 4 : repeat PFT without any education and training. Results : There were no difference statistically on the results of percent of predicted $FEV_1$, $FEV_1/FVC$, $FEF_{25-75%}$ and PEFR in Group 1, 2 and 4 patients. In some cases, the average is decreased with repeated PFT. At the case of repeated PFT after education, the average of percent of predicted $FEV_1$, $FEV_1/FVC$, $FEF_{25-75%}$ and PEFR is increased. There was statistically significant difference on the value of $FEV_1$, $FEF_{25-75%}$ and PEFR between first and second PFT in Group 3. Conclusion : Training with balloons before PFT causes fatigueness and lowers concentration. Understanding of PFT makes results better than training. Therefore, enough explanation and education about PFT before examination is most effective for appropriate PFT in children.

The Correlation between Concepts on Chemical Reaction Rates and Concepts on Chemical Equilibrium in High School Students (고등학생들의 화학반응속도 개념과 화학평형 개념간의 상관관계)

  • Park, Guk-Tae;Kim, Gyeong-Su;Park, Gwang-Seo;Kim, Eun-Suk;Kim, Dong-Jin
    • Journal of the Korean Chemical Society
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    • v.50 no.3
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    • pp.247-255
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    • 2006
  • The purpose of this study was to investigate the correlation between concepts on chemical reaction rates and concepts on chemical equilibrium in high school students. The subjects of the investigation consisted of 120 third grade students attending high school in K city of Kyunggi province. For this study, questionnaire relevant to the subject of chemical reaction rates and chemical equilibrium was developed and the answers were analyzed. As a result of the study, a large percentage of high school students answered questions on reaction rates correctly, but only a small percentage of the students could give explanations. Many high school students answered questions on the rates of forward reactions correctly, but not the questions on the rates of reverse reactions. For the concepts on chemical equilibrium, many high school students gave correct answers when faced with equilibrium questions that only required the understanding of one side of the reaction. But the students could not answer the questions requiring understanding of both forward and reverse reactions as well. Overall, there was a little high correlation between concepts on chemical reaction rates and concepts on chemical equilibrium in high school students. Especially, high school students with little understanding of reverse reaction rates did not understand that chemical equilibrium is a dynamic equilibrium. Also, high school students with little understanding of the collision mechanism regarding chemical reaction rates did not understand the effect of concentration and catalyst factors on chemical equilibrium. And the correlation between concepts on chemical reaction rates and concepts on chemical equilibrium related to concentration and catalyst factors was low. In conclusion, the formation of scientific concepts on chemical reactions rates can decrease misconceptions on chemical equilibrium. Also the teaching-learning method limited to one side of a reaction can cause difficulty in forming the concepts on chemical dynamic equilibrium. Therefore, the development of a teaching-learning method which covers both the forward and reverse reactions can be effective in helping students form the concepts on chemical equilibrium.