• 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.

• Korean Journal of Heritage: History & Science
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• v.53 no.4
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• pp.2-31
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• 2020

CheomSeongDae (瞻星臺) is a stone structure built in Gyeongju, the former Silla Dynasty capital, during the reign of Queen Seondeok (632~647AD). There exist dozens of hypotheses regarding its original purpose. Depending on to whom you ask, the answer could be a celestial observatory, a religious altar, a Buddhist stupa, a monumental tower symbolizing scientific knowledge, and so on. The most common perception of the structure among lay people is a stargazing tower. Historians, however, have suggested that it was intended as "a gateway to the heavens", specifically the Trāyastriṃśa or the second of the six heavens of Kāmadhātu located on the top of Mountain Sumeru. The name "Cheom-seong-dae" could be interpreted in many different ways. 'Cheom (瞻)' could refer to looking up, staring, or admiring, etc.; 'Seong (星)' could mean a star, heaven, night, etc.; and 'heaven' in that context can be a physical or religious reference. 'Dae (臺)' usually refers to a high platform on which people stand or things are placed. Researchers from the science fields often read 'cheom-seong' as 'looking at stars'; while historians read it as 'admiring the Trāyastriṃśa' or 'adoring Śakra'. Śakra is said to be the ruler of Trāyastriṃśa' who governs the Four Heavenly Kings in the Cāturmahārājika heaven, the first of the six heavens of Kāmadhātu. Śakra is the highest authority of the heavenly kings in direct contact with humankind. This paper examined the usages of 'cheom-seong' in Chinese literature dated prior to the publication of 『Samguk Yusa』, a late 13th century Korean Buddhist historical book that contains the oldest record of the structure among all extant historical texts. I found the oldest usage of cheom-seong (瞻星臺) in 『Ekottara Āgama』, a Buddhist script translated into Chinese in the late 4th century, and was surprised to learn that its meaning was 'looking up at the brightness left by Śakra'. I also found that 'cheom-seong' had been incorporated in various religious contexts, such as Hinduism, Confucianism, Buddhist, Christianism, and Taoism. In Buddhism, there was good, bad, and neutral cheom-seong. Good cheom-seong meant to look up to heaven in the practice of asceticism, reading the heavenly god's intentions, and achieving the mindfulness of Buddhism. Bad cheom-seong included all astrological fortunetelling activities performed outside the boundaries of Buddhism. Neutral cheom-seong is secular. It may help people to understand the nature of the physical world, but was considered to have little meaning unless relating to the spiritual world of Buddhism. Cheom-seong had been performed repetitively in the processes of constructing Buddhist temples in China. According to Buddhist scripts, Queen Māyā of Sakya, the birth mother of Gautama Buddha, died seven days after the birth of Buddha, and was reborn in the Trāyastriṃśa heaven. Buddha, before reaching nirvana, ascended from Jetavana to Trāyastriṃśa and spent three months together with his mother. Gautama Buddha then returned to the human world, stepping upon the stairs built by Viśvakarman, the deity of the creative power in Trāyastriṃśa. In later years, King Asoka built a stupa at the site where Buddha descended. Since then, people have believed that the stairway to the heavens appears at a Buddhist stupa. Carefully examining the paragraphic structure of 『Samguk Yusa』's records on Cheomseongdae, plus other historical records, the fact that the alignment between the tomb of Queen Seondeok and Cheomseongdae perfectly matches the sunrise direction at the winter solstice supports this paper's position that Chemseongdae, built in the early years of Queen SeonDeok's reign (632~647AD), was a gateway to the Trāyastriṃśa heaven, just like the stupa at the Daci Temple (慈恩寺) in China built in 654. The meaning of 'Cheom-seong-dae' thus turns out to be 'adoring Trāyastriṃśa stupa', not 'stargazing platform'.

• Tuberculosis and Respiratory Diseases
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• v.45 no.1
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• pp.5-19
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• 1998

Introduction: Direct histologic and bacteriologic examination of a representative specimen of lung tissue is the only certain method of providing an accurate diagnosis in various pulmonary diseases including diffuse pulmonary diseases. The purpose of national survey was to define the indication, incidence, effectiveness, safety and complication of open and thoracoscopic lung biopsy in korea. Methods: A multicenter registry of 37 university or general hospitals equipped more than 400 patient's bed were retrospectively collected and analyzed for 3 years from the January 1994 to December 1996 using the same registry protocol. Results: 1) There were 511 cases from the 37 hospitals during 3 years. The mean age was 50.2 years(${\pm}15.1$ years) and men was more prevalent than women(54.9% vs 45.9%). 2) The open lung biopsy was performed in 313 cases(62%) and thoracoscopic lung biopsy was performed in 192 cases(38%). The incidence of lung biopsy was more higher in diffuse lung disease(305 cases, 59.7%) than in localized lung disease(206 cases, 40.3%) 3) The duration after abnormalities was found in chest X-ray until lung biopsy was 82.4 days(open lung biopsy: 72.8 days, thoracoscopic lung biopsy: 99.4 days). The bronchoscopy was performed in 272 cases(53.2%), bronchoalveolar lavage was performed in 123 cases(24.1%) and percutaneous lung biopsy was performed in 72 cases(14.1%) before open or thoracoscopic lung biopsy. 4) There were 230 cases(45.0%) of interstitial lung disease, 133 cases(26.0%) of thoracic malignancies, 118 cases(23.1%) of infectious lung disease including tuberculosis and 30 cases (5.9 %) of other lung diseases including congenital anomalies. No significant differences were noted in diagnostic rate and disease characteristics between open lung biopsy and thoracoscopic lung biopsy. 5) The final diagnosis through an open or thoracoscopic lung biopsy was as same as the presumptive diagnosis before the biopsy in 302 cases(59.2%). The identical diagnostic rate was 66.5% in interstitial lung diseases, 58.7% in thoracic malignancies, 32.7% in lung infections, 55.1 % in pulmonary tuberculosis, 62.5% in other lung diseases including congenital anomalies. 6) One days after lung biopsy, $PaCO_2$ was increased from the prebiopsy level of $38.9{\pm}5.8mmHg$ to the $40.2{\pm}7.1mmHg$(P<0.05) and $PaO_2/FiO_2$ was decreased from the prebiopsy level of $380.3{\pm}109.3mmHg$ to the $339.2{\pm}138.2mmHg$(P=0.01). 7) There was a 10.1 % of complication after lung biopsy. The complication rate in open lung biopsy was much higher than in thoracoscopic lung biopsy(12.4% vs 5.8%, P<0.05). The incidence of complication was pneumothorax(23 cases, 4.6%), hemothorax(7 cases, 1.4%), death(6 cases, 1.2%) and others(15 cases, 2.9%). 8) The 5 cases of death due to lung biopsy were associated with open lung biopsy and one fatal case did not describe the method of lung biopsy. The underlying disease was 3 cases of thoracic malignancies(2 cases of bronchoalveolar cell cancer and one malignant mesothelioma), 2 cases of metastatic lung cancer, and one interstitial lung disease. The duration between open lung biopsy and death was $15.5{\pm}9.9$ days. 9) Despite the lung biopsy, 19 cases (3.7%) could not diagnosed. These findings were caused by biopsy was taken other than target lesion(5 cases), too small size to interpretate(3 cases), pathologic inability(11 cases). 10) The contribution of open or thoracoscopic lung biopsy to the final diagnosis was defininitely helpful(334 cases, 66.5%), moderately helpful(140 cases, 27.9%), not helpful or impossible to judge(28 cases, 5.6%). Overall, open or thoracoscopic lung biopsy were helpful to diagnose the lung lesion in 94.4 % of total cases. Conclusions: The open or thoracoscopic lung biopsy were relatively safe and reliable diagnostic method of lung lesion which could not diagnosed by other diagnostic approaches such as bronchoscopy. We recommend the thoracoscopic lung biopsy when the patients were in critical condition because the thoracoscopic biopsy was more safe and have equal diagnostic results compared with the open lung biopsy.