• The Korean Society of Law and Medicine
• /
• v.10 no.2
• /
• pp.183-201
• /
• 2009

Im Allgemeinen auch psychische Patienten k$\ddot{o}$nnen sich daruber selbst entscheiden, $\ddot{a}$rztliche Behandlung zu nehmen und ins Krankenhaus aufgenommen zu werden. Im S$\ddot{u}$dkorea bei der zwangsweisen Unterbringung wird kein KBGB des privatlichen Rechts, sondern Gesetz $\ddot{u}$ber psychisch Gesundheitspflege des $\ddot{o}$ffentlichen Rechts vorz$\ddot{u}$glich verwandt. Aber das noch kann ein selbst Bestimmungsrecht von der psychischen Patient verletzen. Im Deutschland regelt BGB $\S$ 1906 Zwangsunterbringung der psychische Patienten, die Gef$\ddot{a}$hr des Selbstmord oder der Eigengef$\ddot{a}$hrdung haben. Au$\ss$erdemhat jedes Land eigen Gesetz $\ddot{u}$ber psychischen Kranken, das $\ddot{o}$ffentliche Vorschrift f$\ddot{u}$r Zwangsunterbringung regelt. Im Fall der Zwangsunterbringung im Deutschland BGB $\S$ 1906 wird prim$\ddot{a}$rer als $\ddot{o}$ffentlich Rechts verwandt, um die Selbstbestimmungsrecht der Patienten zu unterstutzen. Auch im Korea KBGB (koreanisches B$\ddot{u}$rgerliches Gesetzbuch) Ver$\ddot{a}$nderungen f$\ddot{u}$r die Einf$\ddot{u}$hrung des Betreuungsrechts, die sich mit der Zwangsunterbringung befassen, sollten diskutiert werden, damit die Selbstbestimmung sch$\ddot{a}$tzen.

• Tuberculosis and Respiratory Diseases
• /
• v.61 no.2
• /
• pp.178-183
• /
• 2006

A-61-year-old COPD patient was hospitalized due to dyspnea and was diagnosed with acute exacerbation of COPD. During the hospital stay, the patient's dyspnea was aggravated by massive spontaneous subcutaneous emphysema. Multiple 16 gauge intravenous catheters were inserted at the midclavicular line for drainage. Although subcutaneous catheter drainage was carried out, respiratory failure developed with an increased in massive subcutaneous emphysema. Continuous suction drainage with wall suction was applied resulting in the rapid resolution of the subcutaneous emphysema. We report a case of the that effective management of massive subcutaneous emphysema using multiple 16 gauge intravenous catheters with continuous suction.

• Korean Journal of Social Welfare Studies
• /
• v.47 no.3
• /
• pp.85-111
• /
• 2016

This study aims to analyse major changes of Mental Health Promotion and Welfare Service Support Act(MHPWSSA) and critically discuss these changes based on the major discourses on Mental Health Act revision. For this purposes this study reviewed literatures and government reports to understand human rights discourses, welfare discourses, and prevention discourses. Secondly, the major changes of MHPWSSA were analysed and discussed based on those discourses. This study found that MHPWSSA defined the concept of people with mental disorders narrowly, tightened the involuntary admission procedures, introduced welfare service support provisions and mental health promotion provisions. But this study shows that the new legislation may well be criticised due to neglect of the concept of disability and people with psychiatric disability, involuntary admission without mental capacity assessment, neglect of the basic values and principles of self determination and independent living common in welfare of the persons with disability. And the new legislation may be criticised due to overuse of the concept of mental health promotion as encompassing promotion, prevention, treatment and rehabilitation.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.11 no.1
• /
• pp.110-123
• /
• 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.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.18 no.5
• /
• pp.211-218
• /
• 2017

This study examined the effects of a computer-assisted cognitive rehabilitation program on the depression, cognitive functions, and daily functions of stroke patients. Forty-four stroke patients were divided into the treatment group and control group, consisting of 22 patients each. The patients in the treatment group were treated with a computer-assisted cognitive rehabilitation program for 6 weeks, 5 times a week, for a total of 30 times. Depression, cognitive functions, and daily functions was gauged by the BDI, NSCE, and k-MBI, respectively. The treatment group showed decreases in depression, and increases in both cognitive functions and daily functions by the end of the rehabilitation program. Compared to the treatment group, the control group did not show significant improvements in depression, cognitive functions, and daily functions. Therefore, these findings indicate that a computer-assisted cognitive rehabilitation program has a positive effect on depression, cognitive functions, and daily functions in stroke patients.

• Tuberculosis and Respiratory Diseases
• /
• v.46 no.3
• /
• pp.350-362
• /
• 1999

Background: Acute Respiratory failure which is developed after extubation in the weaning process from mechanical ventilation is an important cause of weaning failure. Once it was developed, endotracheal reintubation has been done for respiratory support. Noninvasive Positive Pressure Ventilation (NIPPV) has been used in the management of acute or chronic respiratory failure, as an alternative to endotracheal intubation, using via nasal or facial mask. In this study, we evaluated the usefulness of NIPPV as an alternative method of reintubation in patients who developed acute respiratory failure after extubation. Method: We retrospectively analyzed thirty one patients(eighteen males and thirteen females, mean ages $63\pm13.2$ years) who were developed acute respiratory failure within forty eight hours after extubation, or were extubated unintentionally at medical intensive care unit(MICU) of Asan Medical Center. NIPPV was applied to the patients. Ventilatory mode of NIPPV, level of ventilatory support and inspiratory oxygen concentration were adjusted according to the patient condition and results of blood gas analysis by the attending doctors at MICU. NIPPV was completely weaned when the patients maintained stable clinical condition under 8 $cmH_2O$ of pressure support level. Weaning success was defined as maintenance of stable spontaneous breathing more than forty eight hours after discontinuation of NIPPV. Respiratory rate, heart rate, arterial blood gas analysis, level of pressure support, and level of PEEP were monitored just before extubation, at thirty minutes, six hours, twenty four hours after initiation of NIPPV. They were also measured at just before weaning from NIPPV in success group, and just before reintubation in failure group. Results: NIPPV was successfully applied to thirty-one patients of thirty-two trials and one patient could not tolerated NIPPV longer than thirty minutes. Endotracheal reintubation was successfully obviated in fourteen patients (45%) among them. There was no difference in age, sex, APACHE III score on admission at MICU, duration of intubation, interval from extubation to initiation of NIPPV, baseline heart rate, respiratory rate, arterial blood gas, and $PaO_2/FiO_2$ between the success and the failure group. Heart rate and respiration rate were significantly decreased with increase $SaO_2$ after thirty minutes of NIPPV in both groups(p<0.05). However, in the patients of failure group, heart rate and respiratory rate were increased again with decrease in $SaO_2$ leading to endotracheal reintubation. The success rate of NIPPV treatment was significantly higher in the patients with COPD compared to other diseases(62% vs 39%) (p=0.007). The causes of failure were deterioration of arterial blood gas without aggravation of underlying disease(n=9), aggravation of undelying disease(n=5), mask intolerance(n=2), and retained airway secretion(n=l). Conclusion: NIPPV would be a useful therapeutic alternative which can avoid reintubation in patient who developed acute respiratory failure after extubation.

• Clinical and Experimental Pediatrics
• /
• v.49 no.9
• /
• pp.959-965
• /
• 2006

Purpose : The purpose of this study was to investigate the effect of prophylactic indomethacin on reduction of patent ductus arteriosus(PDA) and intraventricular hemorrhage(IVH) in extremely low birth weight infants(ELBWI). Methods : Retrospective review of 84 ELBWI who were admitted to our neonatal intensive care unit from June 2004 to April 2006 was performed. Patients were divided into prophylactic group(n=28) and control group(n=56), where prophylactic indomethacin were given within 6 hours after birth. Clinical outcomes were compared between these groups. Results : There were no significant differences in gestational age, birth weight, incidence of hemodynamically significant PDA and severe IVH, and mortality between prophylactic group and control group. However, there were more frequent indications for therapeutic indomethacin, higher incidence of intestinal perforation, and longer time to achieve full enteral feeding in prophylactic group than control group. The incidence of other adverse events attributed to indomethacin prophylaxis did not differ between two groups. Conclusions : Prophylactic indomethacin may not prevent hemodynamically significant PDA and severe IVH in ELBWI. On the contrary, it may be associated with increased risk of adverse events. Further efforts should be investigated to decrease PDA and severe IVH in ELBWI.

• Tuberculosis and Respiratory Diseases
• /
• v.42 no.6
• /
• pp.878-887
• /
• 1995

Background: It is reported that frequency of pulmonary involvement in the patients with rheumatoid arthritis reaches 10 to 50% and pulmonary involvement is a principal cause of death. As immunology and radiology has developed, interest for the early diagnosis of pulmonary involvement is increasing. Method: Among the patients at Hanyang University Hospital from March, 1990 to July, 1995, we compared the 29 patients having pulmonary involvement with the 18 patients controls in clinical and chest high resolution computed tomography(HRCT) findings by immunological markers and findings of pulmonary function test. We sought useful markers for early diagnosis of pulmonary involvement with noninvasive investigations. Results: The ratio of males to females was 14 : 15 in the group of pulmonary involvement, and all of the 18 patients were females in the control group. Smoking history was 31%(9/29) in the former group and none in the latter group. Rheumatoid factor(RF) was positive in 95.5%(28/29) of the pulmonary involvement group and in 100%(18/18) of the control group(p=0.12). Antiperinuclear factor(APF) showed a significant difference: 86.9%(20/23, average value: 2.0) was positive in the pulmonary involvement group and 50%(8/16, average value: 1.1) in the control group(p=0.04). Antinuclear antibody(ANA) was positive in 60.7%(17/28) of the pulmonary involvement group and in 72.2%(13/18) of the control group(p=0.33). Cryoglobulin also showed a significant difference: 72%(18/25) in the pulmonary involvement group was positive and 56.2%(9/16) in the control group was positive(p=0.02). Bony erosion was positive in 61.5%(16/26) of the pulmonary involvement group and in 77.7%(14/18) of the control group(p=0.8). On the pulmonary function test, the average value of alveolar volume corrected diffusion capacity and residual volume in the pulmonary involvement group and in the control group were 1.07mmol/rnin/KPa(predicted value: 64.2%), 1.32L(predicted value: 70%) and 1.44mmol/min/KPa, 3.75L(predicted value: 86.6%), respectively(p=0.003, p=0.004), showing a significant difference. Conclusion: APF or cryoglobulin on the serological test, the measurement of residual volume and alveolar volume corrected diffusion capacity may be used as effective markers in the diagnosis of pulmonary involvement of the patients with rheumatoid arthritis.