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Art Therapy and Hospice & Palliative Care in Korea (한국의 예술치료와 호스피스 완화의료)

  • Kim, Chang Gon
    • Journal of Hospice and Palliative Care
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    • v.18 no.2
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    • pp.85-96
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    • 2015
  • In Korea, modern art therapy was developed in the 1960s and 1970s in the form of supplementary activities for patients in psychiatry. Along with the foundation of the Korean Association for Clinical Art in 1982 by psychiatric doctors, the therapy involved more various arts forms such as music, art, dance, poetry therapy, and psychodrama. More organizations with specific expertise opened such as the Korean Art Therapy Association, Korean Art Therapy Association, etc. in the 1990s and the Korea Arts Therapy Institute in 2001. As of April 2015, the members of the Korean Art Therapy Association total 15,000, including 6,200 regular members. The arts in integrative arts therapy (IAT) is an individual's creative activity which is related to his inner world, and the forms of IAT include music, drawing, dance and poetry therapy. From the aspect of phenomenology, IAT is psychophysical therapy involving the arts that helps patients recognize and perceive their experiences with an aim of at a recovery of the body and creativity from the phenomenological aspect. It is also a therapeutic activity that targets growth and development of the body and mind. Meta-analysis of the effects of art therapy with a focus on that involving music, drawing, dance movement and IAT in recent years in Korea, significant effects were observed in all factors but physical function. The biggest effect was mentality adaptation followed by activity adaptation and physiology. In the run up to the implementation of the daily flat-rate system for the health insurance reimbursement for palliative care in July 2015, the Ministry of Health and Welfare is reviewing the coverage of music therapy, drawing therapy and flower therapy, which are currently practiced by 56 hospice institutes in Korea. This is a meaningful step because the coverage of hospice and palliative care came after that of art therapy for psychiatric patients was approved in 1977. Still, there is a need clarify the therapeutic mechanism by exploring causality among the treatment media, mediation type and treatment effects. To address the issue of indiscriminately issued licenses, more efforts are needed to ensure expertise and identity of the licensed therapists through education, training and supervision.

The Effects of Magnesium Rich Sea Mineral Water on Atopic Dermatitis-like Skin Lesions in Hairless Mice (마그네슘 풍부 해양미네랄 용액이 hairless 마우스의 아토피성 피부염에 미치는 영향)

  • Kim, Dong-Heui;Lee, Kyu-Jae;Qi, Xu-Feng;Lee, Young-Mi;Yoon, Yang-Suk;Kim, Jeong-Lye;Chang, Byung-Soo;Ryang, Yong-Suk
    • Applied Microscopy
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    • v.38 no.3
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    • pp.167-174
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    • 2008
  • Atopic dermatitis (AD) is a chronically relapsing inflammatory skin disease that often has asthma and allergic rhinitis. Magnesium salts, the important component of minerals in Dead Sea water, are known to exhibit beneficial effects in inflammatory disease. Favorable effects of magnesium ions and sea water treated to the skin of patients with contact dermatitis have been reported. But histological and immunological investigations are insufficient. This study was performed to examine the inhibitory effect of magnesium-rich sea mineral water on the development of AD-like skin lesions in hairless mice. AD-like skin lesions are induced by the repeated application of 2,4-dinitrochlorobenzene (DNCB). Local application of magnesium-rich sea mineral water on hairless mice skin applied with DNCB inhibited the development of AD-like skin lesions as exemplified by a significant increase in skin hydration (p<0.01), and a decrease in epidermal water loss (p<0.01). Serum IgE level was also significantly decreased (p<0.01). These results suggest that magnesium-rich sea mineral water inhibits the development of DNCB-induced AD-like skin lesions in hairless mice. These observations indicate that magnesium-rich sea mineral water may be alternative and assistant substances for the management of AD.

VCUG Studies on the Clinical Usefulness of Aids (VCUG 보조기구의 임상적 유용성에 관한 고찰)

  • Choe, Dea yeon;Kim, Dong hyun
    • Journal of the Korean Society of Radiology
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    • v.9 no.7
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    • pp.529-533
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    • 2015
  • VCUG(Voiding Cystourethrography) study is being performed to check urinary reflex symptom from bladder to ureter or kidney in the method of filling the bladder with radiation opaque contrast agent. However, VCUG study have been performed impersonally, patients have to be naked and open their legs and then void. This method is so impersonal that it is immediately needed to improve the way of testing and crete new aid. Therefore, this study through producing underwear for VCUG, analysis and compares the test time of VCUG, patient radiation dose and patient satisfaction. The target of this study was 79 Male and Female patients who visited genitourinary clinic of PNUYH for their VCUG tests AXIUM Iconos R200(Siemens Medical System : Germany) and self-produced plastic underwears made by vinyl and plasic molding machine were used. The 79 patient were divided into two groups : experiment of patient and comparison group of we patient (using aid) in order to compare, testing time, DAP (dose area product) and patient satisfaction. There was time reduction, from 35.3min of comparison group to 27.8min experimentation group by 7.5min decrease. And comparison group of $4566.6{\mu}Gym^2$(DAP) decreased experimental group (using aid) of $3411.9{\mu}Gym^2$ by $1154.7{\mu}Gym^2$. In the case of patients satisfaction study, anxiety had a drop by 3.45 of comparison group to 2.51 experimentation group by 0.94 decrease. in experimental group. And shame had a drop by 4.02 of comparison group to 3.08 experimentation group by 0.94 increase. in experimental group. Difference of the smooth voiding had a drop by 1.90 of comparison group to 2.84 experimentation group by 0.94 increase. in experimental group. In addition satisfaction had a rise by 1.19 in experimental group. There were also other opinions of uncomfortableness on it and troublesome to wear. VCUG is one of the sensitive care required test. Therefore staff and the aid can give patients such comfortable and the aid can consentive on voiding. As a result test time and DAP can be reduced. It is needed to make testing at more comfortable for patients.

Diagnostic Classification of Chest X-ray Pneumonia using Inception V3 Modeling (Inception V3를 이용한 흉부촬영 X선 영상의 폐렴 진단 분류)

  • Kim, Ji-Yul;Ye, Soo-Young
    • Journal of the Korean Society of Radiology
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    • v.14 no.6
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    • pp.773-780
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    • 2020
  • With the development of the 4th industrial, research is being conducted to prevent diseases and reduce damage in various fields of science and technology such as medicine, health, and bio. As a result, artificial intelligence technology has been introduced and researched for image analysis of radiological examinations. In this paper, we will directly apply a deep learning model for classification and detection of pneumonia using chest X-ray images, and evaluate whether the deep learning model of the Inception series is a useful model for detecting pneumonia. As the experimental material, a chest X-ray image data set provided and shared free of charge by Kaggle was used, and out of the total 3,470 chest X-ray image data, it was classified into 1,870 training data sets, 1,100 validation data sets, and 500 test data sets. I did. As a result of the experiment, the result of metric evaluation of the Inception V3 deep learning model was 94.80% for accuracy, 97.24% for precision, 94.00% for recall, and 95.59 for F1 score. In addition, the accuracy of the final epoch for Inception V3 deep learning modeling was 94.91% for learning modeling and 89.68% for verification modeling for pneumonia detection and classification of chest X-ray images. For the evaluation of the loss function value, the learning modeling was 1.127% and the validation modeling was 4.603%. As a result, it was evaluated that the Inception V3 deep learning model is a very excellent deep learning model in extracting and classifying features of chest image data, and its learning state is also very good. As a result of matrix accuracy evaluation for test modeling, the accuracy of 96% for normal chest X-ray image data and 97% for pneumonia chest X-ray image data was proven. The deep learning model of the Inception series is considered to be a useful deep learning model for classification of chest diseases, and it is expected that it can also play an auxiliary role of human resources, so it is considered that it will be a solution to the problem of insufficient medical personnel. In the future, this study is expected to be presented as basic data for similar studies in the case of similar studies on the diagnosis of pneumonia using deep learning.

Serologic follow-up Study in neurocysticercosis patients by ELISA after praziquantel treatment (프라지콴텔 치료후 효소면역측정법에 의한 뇌 유구낭미충증 환자의 혈청학적 추적검사)

  • Cho, Seung-Yull;Kim, Suk-Il;Kang, Shin-Yong
    • Parasites, Hosts and Diseases
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    • v.24 no.2
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    • pp.159-170
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    • 1986
  • A total of 69 patients of confirmed neurocysticercosis was followed serologically by ELISA up to 22 months after praziquantel treatment. The intervals and numbers of follow-up were variable by patient. Serially collected samples of serum and CSF were examined simultaneously for their specific IgG antibody levels by ELISA, using cystic fluid, saline extracts of bladder wall and scolex as antigen. Within 4 months after praziquantel treatment, the antibody levels were elevated temporarily in both serum and CSF in most patients. In some cases antibody levels exhibited steady declining tendency after the treatment. Concomitant administration of dexamethasone appeared to suppress the elevation of antibody levels. The rate of mean absorbance of antibody changed more in serum than in CSF. The rate of elevation was greater in antibodies to parenchymal antigens than that to cystic fluid, but absolute difference of antibody levels was greater in antibody to cystic fluid. Previously negative samples for IgG antibody may become positive after the praziquantel treatment, which could be used as a complementary tool (provocation test) in serodiagnosis. One month was considered to be sufficient interval for the follow-up test for that purpose. In the follow-up of up to 22 months, only few cases of chronic neurocysticercosis showed declining tendency of IgG antibody levels below negative range. During acute encephalitic attacks in chronic patients, IgG antibody to parenchymal antigen were elevated in CSF temporarily. These results indicated that serologic follow-up of every year was recommendable to differentiate the cured patients from chronic patients with slowly calcifying lesions.

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A Study on the Reality and Improvement of Autonomous Police System in Jeju Special Self-Government Province (제주자치경찰 시스템의 실태와 발전모델에 관한 연구)

  • Cho, Chul-Ok
    • Korean Security Journal
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    • no.14
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    • pp.485-516
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    • 2007
  • Jeju Special Self-Government Province adopted an autonomous police system for the first time since 60 years in Korean police. The purpose of autonomous police system is to offer a police service to be suitable in regional conditions. But Jeju autonomous police system for nearly one year after adoption is criticized to be established on the ground of political reason but not local decentralization. Actually Jeju autonomous police has not a clear cut jurisdiction and operation scope because of the jurisdiction duplication between national and autonomous police. The original task is confined on environment and sightseeing so on given to administration police for local self-government. So criminal investigation authority on general crimes is not to Jeuju autonomous police on account of special judicial police. First, it is the structural rationalization of Jeju autonomous police system. It speaks that Jeju provincial police bureau and police station have to be as national police institution, on the other hand, patrol district station and police box have to be as autonomous police institution. Of course, functional division has to be followed. National police performs managing all the assembly and demonstration by the management law on assembly and demonstration including the suppression against any large scale demonstration and disturbance, also the investigation on serious crimes just as international crimes and broaden area crimes including all the felony. Together national police performs the duty concerned to all the foreign affairs and national securities in along with the investigation on traffic accidents. On the other hand, autonomous police performs the function for citizen's life safety as crime prevention and the enforcement on the violation against police operation law, together the traffic management and the regulation on traffic violations. and the investigation on minor crime as simple violence or petty larceny including the management on local big events. Second, the budgetary of autonomous police is rationalized by the share of budgeting between Korean government and Jeju special self-government province. Third, urgent arrest authority on general crime and the rights of claims for the summary trial on minor crimes are given to autonomous police. Of course, this problem is resolved naturally in case of giving the investigation rights to autonomous police on minor crimes.

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When Robots Meet the Elderly: The Contexts of Interaction and the Role of Mediators (노인과 로봇은 어떻게 만나는가: 상호작용의 조건과 매개자의 역할)

  • Shin, Heesun;Jeon, Chihyung
    • Journal of Science and Technology Studies
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    • v.18 no.2
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    • pp.135-179
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    • 2018
  • How do robots interact with the elderly? In this paper, we analyze the contexts of interaction between robots and the elderly and the role of mediators in initiating, facilitating, and maintaining the interaction. We do not attempt to evaluate the robot's performance or measure the impact of robots on the elderly. Instead, we focus on the circumstances and contexts within which a robot is situated as it interacts with the elderly. Our premise is that the success of human-robot interaction does not depend solely on the robot's technical capability, but also on the pre-arranged settings and local contingencies at the site of interaction. We select three television shows that feature robots for the elderly and one "dementia-prevention" robot in a regional healthcare center as our sites for observing robot-elderly interaction: "Grandma's Robot"(tvN), "Co-existence Experiment''(JTBC), "Future Diary"(MBC), and the Silbot class in Suwon. By analyzing verbal and non-verbal interactions between the elderly and the robots in these programs, we point out that in most cases the robots and the elderly do not meet one-to-one; the interaction is usually mediated by an actor who is not an old person. These mediators are not temporary or secondary components in the robot-elderly interaction; they play a key role in the relationship by arranging the first meeting, triggering initial interactions, and carefully observing unfolding interactions. At critical moments, the mediators prevent the interaction from falling apart by intervening verbally or physically. Based on our observation of the robot-elderly interaction, we argue that we can better understand and evaluate the human-robot interaction in general by paying attention to the existence and role of the mediators. We suggest that researchers in human-robot interaction should expand their analytical focus from one-to-one interactions between humans and robots to human-robot-human interactions in diverse real-world situations.

Analysis of DNA Ploidy with Bronchoscopic Brushing Specimen as A Diagnostic Aid for Lung Cancer (폐암 진단에 있어서 기관지솔질표본의 DNA 배수성 검사의 의의)

  • Kim, Young-Chul;Lee, Shin-Seok;Chung, Ik-Joo;Kang, Yu-Ho;Choi, In-Seon;Park, Kyung-Ok;Juhng, Sang-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.4
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    • pp.354-362
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    • 1994
  • Objectives and Methods : The presence of aneuploidy or high proliferative activity in cytologic specimens is considered as complementary for the diagnosis of malignancy. To evaluate the diagnostic usefulness of DNA ploidy and cell cycle analysis in lung cancer, we compared the diagnostic yielding rates of DNA ploidy test by brushing specimens using flow cytometry with bronchoscopic forceps biopsy and brushing cytology. Results : Of the seventy-six cases, 55 cases proved to have malignant diseases(squamous cell cancer: 27, adenocarcinoma: 7, large cell cancer: 1, undifferentiated: 4 and small cell cancer: 16). The incidence of aneuploidy in lung cancer patients was 32.7%(18/55), as opposed to no cases in benign disease. And the proportion of high proliferative activity(S+G2M>22%) in lung cancer patients was 42.9%(15/35), but none in benign diseases. In fifty-six of 75 cases(74.7%), cytology of brushing specimens and DNA analysis(either aneuploidy or high proliferative activity vs. diploidy and low proliferative activity) were in concordance. The sensitivity with only brushing cytology was 41.8%(23/55), but with the addition of DNA analysis, it was increased to 56.4%(31/55), without decreasing the specificity(100%). And there was a case whose clue for malignancy was absent except aneuploidy, and he was confirmed to have squamous cell cancer following open thoracotomy. There were no differences in the frequency of aneuploidy or high proliferative activity between histologic subtypes of bronchogenic malignancy. Conclusions : The diagnostic detection rate of lung cancer was improved with the addition of DNA ploidy and cell cycle analysis, and the presence of aneuploidy or high proliferative activity was a relatively specific indicator of malignant disease. It would be useful to test DNA ploidy and cell cycle analysis with brushing specimen for the diagnosis of bronchogenic malignancy particularly in patients whose biopsy specimen could not be obtainable.

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Vinorelbine Monotherapy on Advanced Non-small Cell Lung Cancer (진행성 비소세포폐암 환자에서 Vinorelbine의 단독요법)

  • Kim, Myung-Hoon;Park, Hee-Sun;An, Jin-Yong;Kwon, Sun-Jung;Lee, Yun-Sun;Jeong, Sung-Su;Kim, Ju-Ock;Kim, Sung-Young
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.5
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    • pp.475-484
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    • 2002
  • Background : Unresectable non-small cell lung cancer has a poor response to chemotherapy and has an unfortunate prognosis. More effective and less toxic cytotoxic agents are needed to improve the outcome of these patients. The efficacy and safety of vinorelbine monotherapy in these advanced lung cancer patients was evaluanted. Materials and Methods : Sixteen patients with non-small cell lung cancer in stage III or IV, who received vinorelbine alone as an initial anticancer chemotherapy from June 1996 to December 2000 were enrolled in this study. Vinorelbine was given intravenously at a dose 30mg/$m^2$ every week. Results : A mong the sixteen patients, six had a partial response(38%) and the median survival was 16 weeks. The median response duration was 27 weeks (95% CI 6-47), and the time to progression was 16 weeks(95% CI 6-26). Among a total of 112 cycles, neutropenia(WHO grade 3 or 4) and anemia(grade 3) occurred in 9% and 3%, respectively. Only 1 patient required hospitalization for neutropenic fever. Non-hematologic toxicity was minor and was easily controlled. Conclusion : Vinorelbine monotherapy was well tolerated, and moderately effective in patients with advanced non-small cell lung cancer.

The Effect of Midazolam As Sedative Agent in Bronchoscopy (기관지내시경 검사시 전처치로서 Midazolam의 효과)

  • Lee, Sang-Haak;Hyun, Dae-Sing;Lee, Sook-Young;Kim, Seok-Chan;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.6
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    • pp.612-618
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    • 2002
  • Background : Bronchoscopy is an important diagnostic and a therapeutic tool in chest medicine. However, most patients feel that a bronchoscopy is an unpleasant procedure, and it is important to sedate the patients appropriately, particularly where repetitive examinations are required. Midazolam is a sedative drug with amnestic qualities and a rapid 2 hour half-life. This study have attempted to determine the safety, appropriate dosage, and the effect of midazolam premedication in patients who underwent a bronchoscopy. Methods : One hundred and eighty consecutive patients undergoing bronchoscopy were enrolled in this study. The patients received a midzolam doses of 0.03 mg/kg, 0.06 mg/kg, or a placebo. An additional dose of lidocaine, the total number of coughs, and the duration of the procedures were recorded with monitoring the the blood pressure, heart rate, and oxygen saturation. The level of satisfaction was assessed by the patient, bronchoscopist, and the nurse. Results : The blood pressure, pulse rates, oxygen saturation, number of coughs, lidocaine dose, and procedure time in the 3 groups were similar. There was a trend for the midazolam 0.03 mg/kg group to satisfy bronchoscopists more than the other two groups. The nurses' acceptability was lower in the midazolam 0.06 mg/kg group than the other groups. The patients' acceptablity was greater in both the midazolam 0.03 mg/kg and 0.06 mg/kg groups than in the control group. Conclusion : Sedation with low doses of intravenous midazolam is a safe technique for fiberoptic bronchoscopy with a low morbidity and high acceptable to patients and bronchoscopists.