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Survey of Current Status of the Patients with Home Ventilator in Seoul and Kyunggi Province (가정용 인공호흡기를 사용하는 서울 및 경기 지역 환자의 실태)

  • Ahn, Jong-Joon;Lee, Ki-Man;Shim, Tae-Sun;Lim, Chae-Man;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.5
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    • pp.624-632
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    • 2000
  • Background : Home ventilation can decrease hospital-acquired infection, increase physical activity, improve nutritional status, enhance quality of life, and reduce medical costs. The number of patient using home ventilators has been increasing, particularly in Europe and United States. Although the number of patients with home ventilation has been increasing in Korea, the current status of these patients is not well known. This study was undertaken to obtain basic information upon these patients in addition to evaluating any problems related to patients' home care in our country. Methods : A register of 92 patients with home ventilators in Seoul and Kyunggi Province were obtained from commercial ventilator supply companies. The patients were contacted by phone and 29 of them accepted our visit. Information concerning education about home care before discharge, equipment cost, and problems related to home care were documented. The mode and preset variables of the home ventilator were checked; tidal volume (TV), peak airway pressure, and oxygen saturation were measured. Results : There were 26 males (90%) and their mean age was 48.0 (${\pm}20.1$) years. The underlying diseases were : 21 neuromuscular disorders, 2 spinal cord injuries, 6 chronic lung diseases. Among the caregivers, spouses (n=14) predominated. Education for home care before discharge was performed primarily by intensive care unit nurses and the education for ventilator management by commercial companies. Twenty-five of the 29 patients had tracheostomies. Volume targeted type (VTT ; n=20, 69%) was more frequently used than the pressure targeted type (PTT). Twenty-three of the 29 patients purchased a ventilator privately, which cost 7,450,000 (${\pm}$3,290,000) won for a PTT, and 14,280.000 (${\pm}$3,130,000) won for a VTT. Total cost for the equipment was 11,430,000 (${\pm}$634,000) won. The average cost required for home care per month was 1,120,000 (${\pm}$1,360, 000) won. Conclusion : The commonest underlying disease of the patients was neuromuscular disease. The VTT ventilator was primarily used with tracheostomy. Patients and their families considered the financial difficulties associated with purchasing and maintaining equipment for home care an urgent problem. Some patients were aided by a visiting nurse, however most patients were neglected and left without professional medical supervision.

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Clinical Study of Corrosive Esophagitis (부식성 식도염에 관한 임상적 고찰)

  • 이원상;정승규;최홍식;김상기;김광문;홍원표
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.6-7
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    • 1981
  • With the improvement of living standard and educational level of the people, there is an increasing awareness about the dangers of toxic substances and lethal drugs. In addition to the above, the governmental control of these substances has led to a progressive decrease in the accidents with corrosive substances. However there are still sporadic incidences of suicidal attempts with the substances due to the unbalance between the cultural development in society and individual emotion. The problem is explained by the fact that there is a variety of corrosive agents easily available to the people due to the considerable industrial development and industrialization. Salzen(1920), Bokey(1924) were pioneers on the subject of the corrosive esophagitis and esophageal stenosis by dilatation method. Since then there had been a continuing improvement on the subject with researches on various acid(Pitkin, 1935, Carmody, 1936) and alkali (Tree, 1942, Tucker, 1951) corrosive agents, and the use of steroid (Spain, 1950) and antibiotics. Recently, early esophagoscopic examination is emphasized on the purpose of determining the way of the treatment in corrosive esophagitis patients. In order to find the effective treatment of such patients in future, the authors selected 96 corrosive esophagitis patients who were admitted and treated at the ENT department of Severance hospital from 1971 to March, 1981 to attempt a clinical study. 1. Sex incidence……male: female=1 : 1.7, Age incidence……21-30 years age group; 38 cases (39.6%). 2. Suicidal attempt……80 cases(83.3%), Accidental ingestion……16 cases (16.7%). Among those who ingested the substance accidentally, children below ten years were most numerous with nine patients. 3. Incidence acetic acid……41 cases(41.8%), lye…20 cases (20.4%), HCI……17 cases (17.3%). There was a trend of rapid rise in the incidence of acidic corrosive agents especially acetic acid. 4. Lavage……57 cases (81.1%). 5. Nasogastric tube insertion……80 cases (83.3%), No insertion……16 cases(16.7%), late admittance……10 cases, failure…4 cases, other……2 cases. 6. Tracheostomy……17 cases(17.7%), respiratory problems(75.0%), mental problems (25.0%). 7. Early endoscopy……11 cases(11.5%), within 48 hours……6 cases (54.4%). Endoscopic results; moderate mucosal ulceration…8 cases (72.7%), mild mucosal erythema……2 cases (18.2%), severe mucosal ulceration……1 cases (9.1%) and among those who took early endoscopic examination; 6 patients were confirmed mild lesion and so they were discharged after endoscopy. Average period of admittance in the cases of nasogastric tube insertion was 4 weeks. 8. Nasogastric tube indwelling period……average 11.6 days, recently our treatment trend in the corrosive esophagitis patients with nasogastric tube indwelling is determined according to the finding of early endoscopy. 9. The No. of patients who didn't given and delayed administration of steroid……7 cases(48.9%): causes; kind of drug(acid, unknown)……12 cases, late admittance……11 cases, mild case…9 cases, contraindication……7 cases, other …8 cases. 10. Management of stricture; bougienage……7 cases, feeding gastrostomy……6 cases, other surgical management……4 cases. 11. Complication……27 cases(28.1%); cardio-pulmonary……10 cases, visceral rupture……8 cases, massive bleeding……6 cases, renal failure……4 cases, other…2 cases, expire and moribund discharge…8 cases. 12. No. of follow-up case……23 cases; esophageal stricture……13 cases and site of stricture; hypopharynx……1 case, mid third of esophagus…5 cases, upper third of esophagus…3 cases, lower third of esophagus……3 cases pylorus……1 case, diffuse esophageal stenosis……1 case.

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Patient Satisfaction with Cancer Pain Management (암성통증관리 만족도)

  • Lee, So-Woo;Kim, Si-Young;Hong, Young-Seon;Kim, Eun-Kyung;Kim, Hyun-Sook
    • Journal of Hospice and Palliative Care
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    • v.6 no.1
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    • pp.22-33
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    • 2003
  • Purpose : The purpose of this study was to evaluate the present status of patients' satisfaction and the reasons for any satisfaction or dissatisfaction in cancer pain management Methods : A cross-sectional survey was used to obtain the feedback about pain management. The results of the survey were collected from 59 in- or out-patient who had cancer treatment at two of the teaching hospitals in Seoul from July, 2002 to November, 2002. The data was obtained by a structured questionnaire based on the American Cancer Society Patient Outcome Questionnaire(APS-POQ) and other previous research. The clinical information for all patients were compiled by reviewing their medical records. Resuts : 1) The subjects' mean score of the worst pain was 6.77, the average pain score was 3.80, and the pain score after management was 2.93 for the past 24 hours. The mean score of total pain interference was $25.03{\pm}12.82$. Many of the subjects had false beliefs about pain such as 'the experience of pain is a sign that the illness has gotten worse', 'pain medicine should be 'saved' in case the pain gets worse' and 'people get addicted to pain medicine easily'. 2) 66.1% of the subjects were properly medicated with analgesics. 33.9% of the subjects reported use of various methods in controlling pain other than the prescribed medication. Only 33.9% of the subjects had a chance to be educated about pain management by doctors or nurses. 3) The mean score of patients' satisfaction with pain management was $4.19{\pm}1.14$. 72.9% of the subjects answered 'satisfied' with pain management. The reasons for dissatisfaction were 'the pain was not relieved even after the pain management', 'I was not quickly and promptly treated when I complained of pain', 'doctors and nurses didn't pay much attention to my complaints of pain.', and 'there was no appropriate information given on the methods of administration, effect duration and side effects of pain medicine.' The reasons for satisfaction were: 'the pain was relieved after the pain management.', 'doctors and nurses quickly and promptly controlled my pain.', 'doctors and nurses paid enough attention to my complaints of pain.' and 'trust in my physician'. 4) In pain severity or pain interference, no significant difference was found between the satisfied group and dissatisfied group. On the belief 'good patients avoid talking about pain', a significant difference was found between the satisfied group and dissatisfied group. Conclusions : The patients' satisfaction with cancer pain management has increased over the years but still about 30% of patients reported to be 'not satisfied' for various reasons. The results of this study suggest that patients' education should be done to improve satisfaction in the pain management program.

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A Study of Intangible Cultural Heritage Communities through a Social Network Analysis - Focused on the Item of Jeongseon Arirang - (소셜 네트워크 분석을 통한 무형문화유산 공동체 지식연결망 연구 - 정선아리랑을 중심으로 -)

  • Oh, Jung-shim
    • Korean Journal of Heritage: History & Science
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    • v.52 no.3
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    • pp.172-187
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    • 2019
  • Knowledge of intangible cultural heritage is usually disseminated through word-of-mouth and actions rather than written records. Thus, people assemble to teach others about it and form communities. Accordingly, to understand and spread information about intangible cultural heritage properly, it is necessary to understand not only their attributes but also a community's relational characteristics. Community members include specialized transmitters who work under the auspices of institutions, and general transmitters who enjoy intangible cultural heritage in their daily lives. They converse about intangible cultural heritage in close relationships. However, to date, research has focused only on professionals. Thus, this study focused on the roles of general transmitters of intangible cultural heritage information by investigating intangible cultural heritage communities centering around Jeongseon Arirang; a social network analysis was performed. Regarding the research objectives presented in the introduction, the main findings of the study are summarized as follows. First, there were 197 links between 74 members of the Jeongseon Arirang Transmission Community. One individual had connections with 2.7 persons on average, and all were connected through two steps in the community. However, the density and the clustering coefficient were low, 0.036 and 0.32, respectively; therefore, the cohesiveness of this community was low, and the relationships between the members were not strong. Second, 'Young-ran Yu', 'Nam-gi Kim' and 'Gil-ja Kim' were found to be the prominent figures of the Jeongseon Arirang Transmission Community, and the central structure of the network was concentrated around these three individuals. Being located in the central structure of the network indicates that a person is popular and ranked high. Also, it means that a person has an advantage in terms of the speed and quantity of the acquisition of information and resources, and is in a relatively superior position in terms of bargaining power. Third, to understand the replaceability of the roles of Young-ran Yu, Nam-gi Kim, and Gil-ja Kim, who were found to be the major figures through an analysis of the central structure, structural equivalence was profiled. The results of the analysis showed that the positions and roles of Young-ran Yu, Nam-gi Kim, and Gil-ja Kim were unrivaled and irreplaceable in the Jeongseon Arirang Transmission Community. However, considering that these three members were in their 60s and 70s, it seemed that it would be necessary to prepare measures for the smooth maintenance and operation of the community. Fourth, to examine the subgroup hidden in the network of the Jeongseon Arirang Transmission Community, an analysis of communities was conducted. A community refers to a subgroup clearly differentiated based on modularity. The results of the analysis identified the existence of four communities. Furthermore, the results of an analysis of the central structure showed that the communities were formed and centered around Young-ran Yu, Hyung-jo Kim, Nam-gi Kim, and Gil-ja Kim. Most of the transmission TAs recommended by those members, students who completed a course, transmission scholarship holders, and the general members taught in the transmission classes of the Jeongseon Arirang Preservation Society were included as members of the communities. Through these findings, it was discovered that it is possible to maintain the transmission genealogy, making an exchange with the general members by employing the present method for the transmission of Jeongseon Arirang, the joint transmission method. It is worth paying attention to the joint transmission method as it overcomes the demerits of the existing closed one-on-one apprentice method and provides members with an opportunity to learn their masters' various singing styles. This study is significant for the following reasons: First, by collecting and examining data using a social network analysis method, this study analyzed phenomena that had been difficult to investigate using existing statistical analyses. Second, by adopting a different approach to the previous method in which the genealogy was understood, looking at oral data, this study analyzed the structures of the transmitters' relationships with objective and quantitative data. Third, this study visualized and presented the abstract structures of the relationships among the transmitters of intangible cultural heritage information on a 2D spring map. The results of this study can be utilized as a baseline for the development of community-centered policies for the protection of intangible cultural heritage specified in the UNESCO Convention for the Safeguarding of Intangible Cultural Heritage. To achieve this, it would be necessary to supplement this study through case studies and follow-up studies on more aspects in the future.

The cinematic interpretation of pansori and its transformation process (판소리의 영화적 해석과 변모의 과정)

  • Song, So-ra
    • (The) Research of the performance art and culture
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    • no.43
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    • pp.47-78
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    • 2021
  • This study was written to examine the acceptance of pansori in movies based on pansori, and to explore changes in modern society's perception and expectations of pansori. A pansori is getting the love of the upper and lower castes in the late Joseon period, but loses the status at the time of the Japanese colonial rule and Korean War. In response, the country designated pansori as an important intangible cultural asset in 1964 to protect the disappearance of pansori. Until the 1980s, however, pansori did not gain popularity by itself. After the 2000s, Pansori tried to breathe in with the contemporary public due to the socio-cultural demand to globalize our culture. And now Pansori is one of the most popular cultures in the world today, as the pop band Feel the Rhythm of KOREA shows. The changing public perception of pansori and its status in modern society can also be seen in the mass media called movies. This study explored the process of this change with six films based on pansori, from "Seopyeonje" directed by Lim Kwon-taek in 1993 to the film "The Singer" in 2020. First, the films "Seopyeonje" and "Hwimori" were produced in the 1990s. Both of these films show the reality of pansori, which has fallen out of public interest due to the crisis of transmission in the early and mid-20th century. And in the midst of that, he captured the scene of a singer struggling fiercely for the artistic completion of Pansori itself. Next, look at the film "Lineage of the Voice" in 2008 and "DURESORI: The Voice of East" in 2012. These two films depict the growth of children who perform art, featuring contemporary children who play pansori and Korean traditional music. Pansori in these films is no longer an old piece of music, nor is it a sublime art that is completed in harsh training. It is only naturally treated as one of the contemporary arts. Finally, "The Sound of a Flower" in 2015 and "The Singer" in 2020. The two films constructed a story from Pansori's history based on the time background of the film during the late Joseon Dynasty, when Pansori was loved the most by the people. This reflects the atmosphere of the times when traditions are used as the subject of cultural content, and shows the changed public perception of pansori and the status of pansori.

Biliary Atresia in Korea - A Survey by the Korean Association of Pediatric Surgeons - (담도폐색증 - 대한소아외과학회회원 대상 전국조사 -)

  • Choi, Kum-Ja;Kim, S.C.;Kim, S.K.;Kim, W.K.;Kim, I.K.;Kim, J.E.;Kim, J.C.;Kim, H.Y.;Kim, H.H.;Park, K.W.;Park, W.H.;Song, Y.T.;Oh, S.M.;Lee, D.S.;Lee, M.D.;Lee, S.K.;Lee, S.C.;Jhung, S.Y.;Jhung, S.E.;P.M., Jung;S.O., Choi;Choi, S.H.;Han, S.J.;Huh, Y.S.;Hong, C.;Hwbang, E.H.
    • Advances in pediatric surgery
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    • v.8 no.2
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    • pp.143-155
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    • 2002
  • A survey on biliary atresia was made among 26 members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and a case registration form for each patient during the twentyone-year period of 1980-2000. Three hundred and eighty patients were registered from 18 institutions. The average number of patients per surgeon was one to two every year. The male to female ratio was 1:1.3. The age of patients on diagnosis with biliary atresia was on average $65.4{\pm} 36.2$ days old. The national distribution was 32.8% in Seoul, 25.3% in Gyoungki-Do, 21.6% in Gyoungsang-Do, 9.27% in Choongchung-Do, etc. in order. The most common clinical presentation was jaundice (98.4%) and change of stool color (86.2%) was second. Two hundred eighty (74.7%) of 375 patients were operated by 80 days of age. Three hundred thirty six (9 1.9%) of 366 patients were operated on by the original Kasai procedure, and 305 (84.3%) of 362 patients were observed by bile-drainage postoperatively. The overall postoperative complication rate was 18.5% and the overall postoperative mortality rate was 6.8%. The associated anomalies were observed in 72 cases (22.5%). One hundred ninty five (64.7%) of 302 patients have been alive in follow-up and 49 (25.1%) have survived over 5 years without problem after operation. Ascending cholangitis, varices and ascites affected survival significantly, and the important long-term prognostic factor was the occurrence of complications.

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Interpretation of Praying Letter and Estimation of Production Period on Samsaebulhoedo at Yongjusa Temple (용주사(龍珠寺) <삼세불회도(三世佛會圖)>의 축원문(祝願文) 해석(解釋)과 제작시기(製作時期) 추정(推定))

  • Kang, Kwan-shik
    • MISULJARYO - National Museum of Korea Art Journal
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    • v.96
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    • pp.155-180
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    • 2019
  • Samsaebulhoedo(三世佛會圖) at Yongjusa Temple(龍珠寺), regarded as a monumental masterpiece consisting of different elements such as Confucian and Buddhist ideas, palace academy garden and Buddhist artist styles, unique traditional and western painting styles, is one of the representative works that symbolically illustrate the development and innovation of painting in the late Joseon dynasty. However, the absence of painting inscriptions raised persistent controversy over the past half century among researchers as to the matters of estimating its production period, identifying the original author and analyzing style characteristics. In the end, the work failed to gain recognitions commensurate with its historical significance and value. It is the particularly vital issue in that estimating the production period of the existing masterpiece is the beginning of all other discussions. However, this issue has caused the ensuing debates since all details are difficult to be interpreted to a concise form due to a number of different records on painters and mixture of traditional buddhist painting styles used by buddhist painters and innovative western styles used by ordinary painters. Contrary to other ordinary Buddhist paintings, this painting, Samsaebulhoedo, has a praying letter for the royal establishment at the center of the main altar. It should be noted that regarding this painting, its original version-His Royal Highness King, Her Majesty, His Royal Crown Prince主上殿下, 王妃殿下, 世子邸下-was erased and instead added Her Love Majesty慈宮邸下 in front of Her Majesty. This praying letter can be assumed as one of the significant and objective evidence for estimating its production period. The new argument of the late 19th century production focused on this praying letter, and proposed that King Sunjo was then the first-born son when Yongjusa Temple was built in 1790 and it was not until January 1, 1800 that he was ascended to the Crown Prince. In this light, the existing praying letter with the eulogistic title-Crown Prince世子-should be considered revised after his ascension to the throne. Styles and icons bore some resemblance to Samsaebulhoedo at Cheongryongsa Temple or Bongeunsa Temple portrayed by Buddhist painters in the late 19th century. Therefore, the remaining Samsaebulhoedo should be depicted by them in the same period as western styles were introduced in Buddhist painting in later days. Following extensive investigations, praying letters in Buddhist paintings in the late 19th century show that it was usual to record specification such as class, birth date and family name of people during the dynasty at the point of producing Buddhist paintings. It is easy to find that those who passed away decades ago cannot be revised to use eulogistic titles as seen by the praying letters in Samsaebulhoedo at Yongju Temple. As "His Royal Highness King, Her Majesty, His Royal Crown Prince" was generally used around 1790 regardless of the presence of first-born son or Crown Prince, it was rather natural to write the eulogistic title "His Royal Crown Prince" in the praying letter of Samsaebulhoedo. Contrary to ordinary royal hierarchy, Her Love Majesty was placed in front of Her Majesty. Based on this, the praying letter was assumed to be revised since King Jeongjo placed royal status of Hyegyeonggung before the Queen, which was an exceptional case during King Jeongjo's reign, due to unusual relationships among King Jeongjo, Hyegyeonggung and the Queen arising from the death of Crown Prince(思悼世子). At that time, there was a special case of originally writing a formal tripod praying letter, as can be seen from ordinary praying letter in Buddhist paintings, erasing it and adding a special eulogistic title: Her Love Majesty. This indicates that King Jeongjo identified that Hyegyeonggung was erased, and commanded to add it; nevertheless, ceremony leaders of Yongju Temple, built as a palace for holding ceremonies of Hyeonryungwon(顯隆園) are Jeongjo, the son of his father and his wife Hyegyeonggung (Her Love Majesty)(惠慶宮(慈宮)). This revision is believed to be ordered by King Jeongjo on January 17, 1791 when the King paid his first visit to the Hyeonryungwon since the establishment of Hyeonryungwon and Yongju Temple, stopped by Yongju Temple on his way to palace and saw Samsaebulhoedo for the first and last time. As shown above, this letter consisting of special contents and forms can be seen an obvious, objective testament to the original of Samsebulhoedo painted in 1790 when Yongju Temple was built.