• The Korean Journal of Gastroenterology
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• v.72 no.5
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• pp.271-273
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• 2018

내시경 시술 전 일시적으로 항응고제를 중단하는 것은 위장관 출혈의 위험과 혈전색전증의 위험 사이에 적절한 균형을 잡기 어렵기 때문에 논란의 여지가 많다. 와파린은 새로운 경구용 항응고제(direct oral anticoagulant agent, DOAC)보다 임상의에게 더 친숙하고, 효과를 쉽고 빠르게 전환시킬 수 있다는 장점이 있지만 복잡한 약역동학 특징과 좁은 치료적 범위 때문에 관리가 어렵다. 반면, DOAC는 약물의 모니터링 및 용량 조절 없이 정해진 용량으로 처방이 가능하며, 빠르게 작용하고, 반감기가 짧아 관리가 쉽지만 해독제가 없다는 단점이 있다. 이전 연구들에서 DOAC를 복용한 환자들은 와파린을 복용한 환자들보다 시술과 관련되지 않은 위장관 출혈의 위험이 높았다고 보고한 바 있다. 하지만 시술과 관련된 위장관 출혈 위험에 대하여는 알려진 바가 없는 실정이다. 미국이나 유럽 내시경 가이드라인들에서는 저위험 내시경 시술을 받는 환자들에서는 와파린과 DOAC를 유지하도록 권고하고 있으며, 고위험 시술의 경우에는 와파린를 사용하는 환자들에서 헤파린 교량 요법(heparin bridging)을 시행하도록 권고하고 있다. 임상적으로 DOAC를 사용하는 환자들 또한 혈전색전증을 예방하기 위하여 헤파린 교량 요법을 시행해볼 수 있는데, 와파린 및 DOAC의 헤파린 교량 요법과 관련된 출혈 및 혈전색전증 위험의 차이 또한 명확하지 않다. 따라서 저자들은 1) 와파린과 DOAC 치료를 받는 환자들에서의 출혈, 혈전색전증 및 사망의 위험을 비교하고자 하였으며, 2) 13종류의 고위험 내시경 시술 중에서 시술별 위험을 비교하고, 3) 헤파린 교량 요법이 합병증의 발생을 증가시키지 않는지 확인하고자 본 연구를 진행하였다. 일본 대규모 국가 입원 환자 데이터베이스를 이용하여 2014년 4월부터 2015년 5월까지 시술 전 와파린 또는 DOAC(rivaroxaban, apixaban, dabigatran, edoxaban)를 복용하고, 13종류의 고위험 내시경 시술을 시행받은 20세 이상의 성인 환자 총 16,977명을 확인하였다. 고위험 시술은 용종 절제술, 내시경 점막절제술, 내시경 점막하박리술, 협착 부위의 풍선확장술, 내시경 지혈술, 내시경 정맥결찰술, 내시경 주사 경화요법, 내시경 괄약근절개술, 내시경 초음파 유도하 미세침 흡인 검사, 경피적 위루술을 포함하였다. 일대일 성향 점수 매칭 분석(propensity score matching, 나이, 성별, 체질량 지수, 기저 질환, 병원의 규모, 시술의 종류, 약물의 종류를 매칭)을 시행하여 와파린군과 DOAC군에서 시술 위장관 출혈 및 혈전색전증, 사망의 발생을 비교하였다. 또한 경구항혈전제와 헤파린 교량 치료 시행 유무에 따라, DOAC 단독군, 와파린 단독군, DOAC와 헤파린 교량 요법군, 와파린과 헤파린 교량요법군으로 나누어, 하위군(subgroup) 분석을 시행하였다. 5,046쌍이 성향 점수 매칭 분석에 포함되었으며, 와파린군에서 DOAC군보다 통계적으로 의미 있게 위장관 출혈의 비율이 높았다(12.0% vs. 9.9% p=0.02). 혈전색전증 발생률(5.4% vs. 4.7%)과 입원중 사망률(5.4% vs. 4.7%)은 양 군에서 의미 있는 차이는 없었다. DOAC 종류별로 나누어 하위군 분석을 시행하였을 때, 와파린군은 rivaroxaban군에 비하여 위장관 출혈의 비율이 높았으며, rivaroxaban군, dabigatran군에 비하여 혈전색전증의 비율이 높았고, 입원 중 사망률에서는 의미 있는 차이는 없었다. 내시경 시술의 종류로 보정하였을 때 위장관 출혈 및 혈전색전증, 사망률은 DOAC 단독으로 치료한 환자에서보다 와파린과 헤파린 교량 요법(bridging) 또는 DOAC과 헤파린 교량 요법을 시행한 환자에서 높았다. 시술 종류 중에서는 위루관 삽입술에 비하여 내시경 점막하박리술, 내시경 점막절제술 및 내시경 정맥류결찰술, 내시경 주사경화요법을 시행한 환자에서 위장관 출혈의 위험이 가장 높았으며, 하부 내시경 점막절제술, 하부 용종 절제술, 내시경적 유두괄약근절제술 또는 내시경 초음파 유도하 미세침 흡인 검사는 중등도 위험을 보였다.

• Journal of Korean Philosophical Society
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• v.117
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• pp.327-354
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• 2011

This study has a key assumption that 'characteristics of discouse can be found in not its inside, but its outside'. The prism through which we can see those characteristics was provided by Foucault and Bakhtin who were introduced in the study. As an effort co probe the outside of discourse, the study is briefed 'the three attributes of discourse' that were suggested by Foucault First, discourse has the principle of selection and exclusion, which is based on power relations. Second, discourse is not transparent at all since it is always offensive towards other discourses and defensive against selected ones Third, discourse which is naturally accepted because of its dailiness had a deep structure secretly hidden in it. Based on the above attributes, Foucault and Bakhtin paid their attention to the outside of discourse. Specifically, they considered discourse fundamentally and went beyond it, and reflected the procedures of discourse. This study focused on 'Socrates', something common in the two scholars' works with discourse. In dealing with discourse, Bakhtin started with 'Socratic dialogue' that is based on the dialogic nature of human thoughts which purse the truth. For Foucault, it was Socrates who had the 'courage to cell the truth' and practiced 'self-consideration'. According to Foucault, the ethics of self-practice originated from the philosopher. The ethics is neither the precise representation of individual life that is withdrawn towards the inner self, nor the skills of happiness. It is just relational and cross-sectional. For a better understanding, this study pointed out that Kafka created a variety of 'dialogic voices' focusing on the outside of discourse. Dialogues found in his writings are 'interminable dialogues' that truly 'communicate with different times and different spaces'. For example, his novel, 'Der Prozess' opens the possibility of discussing in various ways the court which is look beyond conventions and extraordinary. Kafka's novels have a structure that their starting point found at the introduction reappears at the termination, presenting multi-vocal dialogues.

• Journal of Korean Philosophical Society
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• v.137
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• pp.57-79
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• 2016

The purpose of this paper is to explain MacIntyre's critique of moral pluralism of modern society and reveal the limits of his critique of liberalism. It is a distinctive feature of the social and cultural order that we inhabit that disagreements over central moral issues are peculiarly unsettleable. Debates concerned with the value of human life such as those over abortion and euthanasia, or about distributive justice and property rights, or about war and peace degenerate into confrontations of assertion and counter-assertion because the protagonists of rival positions invoke incommensurable forms of moral assertion against each other. We usually call this situation 'modern moral pluralism' and concede as the natural outcome of the activities of human reason under free institution. But in After Virtue, MacIntyre vigorously criticizes modern moral pluralism. The main cause he took which brought about this state of affairs was the failure of 'the Enlightenment project'. According to MacIntyre, the Enlightenment project which has dominated philosophy for the past three hundred years promised a conception of rationality independent of historical and social context, and independent of any specific understanding of man's nature or purpose. But not only has that promise in fact been unfulfilled, the project is itself fundamentally flawed and the promise could never be fulfilled. In consequence, modern moral and political thought are in a state of disarray from which they can be rescued only if we revert to an Aristotelian paradigm, with its essential commitment, and construct an account of practical reason premised on that commitment. But one of the deepest difficulties with the argument of After Virtue is that the very extent of its critique of the modern world seems to cast doubt on the possibility of any realistic revival under the conditions of modernity of the Aristotelianism which MacIntyre advocates. Especially when we consider we are not only the characters found in our narratives but also we ourselves are the author of our own narratives. Moral pluralism is not seen as disaster but rather as the natural outcome of the activities of human reason under enduring free institutions.

• Korean Journal of Heritage: History & Science
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• v.47 no.2
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• pp.114-131
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• 2014

The Portrait of Yang Zhuxi(楊竹西小像) at the Palace Museum in Beijing holds important significance as one of the rare portraits from Yuan Period and as a painting with a definite year of creation in 1363. It is also noteworthy in that it is the only remaining work of Wang Yi(王繹), who was one of the critical portrait painters during the second half of Yuan Period and the author of Xiexiang Mijue(寫像秘訣), the first book on the portrait theories, that it was created in conjunction with Ni Zan(倪瓚), one of the utmost landscape painters of the times, and that it was an early case of landscape and figure painting-format portraits. The figure in Portrait of Yang Zhuxi was originally known as Yang Wu(楊瑀), a high official during Yuan Period, but it was a misunderstanding on the part of Li Rihua(李日華), a literary figure from Ming Dynasty. The actual model was Yang Qian(楊謙), a reclusive literary figure in the Songjiang(松江) region. Yang Qian is estimated as one of the central figures with a high reputation in the literary community of Jiangnan those days. Portrait of Yang Zhuxi was depicted by borrowing the icon of such hermits as Su Shih(蘇軾), which seems like a proper choice to express Yang Zhuxi, a reclusive literary figure. Furthermore, the rocks and pine trees described by Ni Zan reinforced the significance of the portrait through their traditional symbolism of man of virtue and man of letters, respectively. Portrait of Yang Zhuxi used the Baimiao Manner(白描法), thus being differentiated from other portraits from the same period. Even though there is no coloring in the painting, it boasts more excellent realism than colored portraits. It expressed the body with the graceful and controlled Li Gonglin(李公麟) and Zhao Mengfu(趙孟?) style Baimiao Manner, raising its dignity further. In terms of functions, Portrait of Yang Zhuxi is strongly characterized by the appreciative function unlike other portraits focused on the ceremonial function. Being created to be viewed and appreciated by the model himself and his friends, the portrait was very significant to promote their friendship. However, there was a great intention to reflect the emotions of the model himself and his friends in the painting beyond the simple appreciation level.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.37 no.2
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• pp.40-53
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• 2019

This study was conducted to investigate the changes in Scenic Spots by utilizing the "Sinjeungdonggukyeojiseungram(新增東國輿地勝覽)" and "Joseonhwanyeoseungnam(朝鮮?與勝覽)" to interpret "Joseonmyeongseungsiseon(朝鮮名勝詩選, 1915)". By examining the historical context when "Joseonmyeongseungsiseon" was published, it documented the Japanese's memories of 'Sino-Japanese War(淸日戰爭)' in 1894, which implies the 'policy of assimilation' by the Japanese Government-General of Korea after the Japanese annexation of Korea(1910). Detailed information about the author 'Narushima Sagimura(成島鷺村)' can be found in preface. In the "Joseonmyeongseungsiseon", it dedicates most of the part in describing the Scenic Spot especially in 'Anseong Do (15 lines)', where has the memories of war such as the 'First Sino-Japanese War'. The number of Scenic Spots, commonly mentioned in both "Sinjeungdonggukyeoji seungram" and "Joseonhwanyeoseungnam" in Cheonan province are 13 in total. Most of the content contains a similar structure. But 'Honggyeongwon(弘慶院)' and 'Seonghwanyeok(成歡驛)' has both the common Joseon Dynasty landscape point of view, and the additional historical context which are about the 'Jeongyujaeran(丁酉再亂)' or 'First Sino-Japanese War' consequently enlightens the 'placeness' of the Scenic Spots. Among the newly described Scenic Spots, 'Anseongdo(安城渡)' is the part that focuses on the memory of the 'Anseongcheon Battle' that gave Japan its first defeat in the Sino-Japanese War. Especially, by introducing the poetry of 'Sinobu Shunpei' it maximizes the appreciation through emphasizing the direct correlation between placeness and the poem itself. While the Joseon Dynasty poems are 10 pieces in total and their title and the subject matters are all related to historical spots, and the appreciation also maximizes when fully interpreted with understanding the historical context. However, it's contextual meanings are neglected by dividing the actual structures into separate pages. When looking at the location of famous historic sites, they come in many different types, considering the location, meaning, size, and conditions surrounding them. It appears as a service space for travelers, a place for sightseeing, relaxation or return, a temple space for paying respects or memorial services, a fortress facility for defense and protection, or a fishing area for wages, and an old battlefield. Especially, it is noted that the area is diverse as the cultural landscape of Cheonan, given that the battle space between the hermitage and the Donghangnongmin(東學農民) is shared with each other. It is necessary to establish policies for the preservation and restoration of local cultural assets based on these points in the future.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.19 no.1
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• pp.20-25
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• 2019

Very-long-chain acyl-CoA dehydrogenase (VLCAD) deficiency (OMIM#201475) is an autosomal recessively inherited metabolic disorder of mitochondrial long-chain fatty acid oxidation. The clinical features of VLCAD deficiency is classified by three clinical forms according to the severity. Here, we report a case of later-onset episodic myopathic form of VLCAD deficiency whose diagnosis was confirmed by plasma acylcarnitine analysis and" multigene panel multigene panel sequencing. A 34-year old female patient visited genetics clinic for genetic evaluation for history of recurrent myopathy with intermittent rhabdomyolysis. She suffered first episode of rhabdomyolysis with acute renal failure requiring hemodialysis at twelve years old. After then, she suffered several times of recurrent rhabdomyolysis provoked by prolonged exercise or fasting. Physical and neurologic exam was normal. Serum AST/ALT and creatinine kinase (CK) levels were mildly elevated. However, according to her previous medical records, her AST/ALT, CK were highly elevated when she had rhabdomyolysis. In suspicion of fatty acid oxidation disorder, multigene panel sequencing and plasma acylcarnitine analysis were performed in non-fasting, asymptomatic condition for the differential diagnosis. Plasma acylcarnitine analysis revealed elevated levels of C14:1 ($1.453{\mu}mol/L$; reference, 0.044-0.285), and C14:2 ($0.323{\mu}mol/L$; 0.032-0.301) and upper normal level of C14 ($0.841{\mu}mol/L$; 0.065 -0.920). Two heterozygous mutation in ACADVL were detected by multigene panel sequencing and confirmed by Sanger sequencing: c.[1202G>A(;) 1349G>A] (p.[(Ser 401Asn)(;)(Arg450His)]). Diagnosis of VLCAD deficiency was confirmed and frequent meal with low-fat diet was educated for preventing acute metabolic derangement. Fatty acid oxidation disorders have diagnostic challenges due to their intermittent clinical and laboratorial presentations, especially in milder late-onset forms. We suggest that multigene panel sequencing could be a useful diagnostic tool for the genetically and clinically heterogeneous fatty acid oxidation disorders.

• (The) Korean Journal of Educational Psychology
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• v.31 no.4
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• pp.767-794
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• 2017

Creativity is a social byproduct formed in a specific sociocultural context. Although creativity differs according to the level of culture ranging from supranational, national, professional to organizational levels, research studies documented in literature have mainly dealt with creativity in the (super)national level. For example, differences in personal creativity in the East and the West led by collectivism and individualism, respectively have been dominating in the studies about cultural differences in creativity. Consequently, the domain specificity of creativity and the effects of a more micro level of culture, such as domains, occupations, and organizations, on creative outcomes have been dismissed. Understanding the characteristics of domains, and sociocultural and environmental factors leading to creative products is worth investigating considering that the conception of creativity today highly relies on the nature of domains valued in a certain sociocultural environment. This study reviewed a wide range of literature regarding creativity and sociocultural and environmental factors in order to explore how culture and/or cultural factors inspired creative thinking and generating ideas for creative performance and products. Cultural factors were identified either as a value or a practice (custom) and examined on the supernational, national, professional, and organizational levels. For supernational and national cultures, issues on individualism, collectivism, artistic social atmosphere, and multi-cultural experiences were discussed, while the professional and organizational cultures delved topics on the domain of architecture in which both originality and functionality are greatly valued for creativity. The authors concluded that the impact of culture on creative thinking and idea generation varied according to the levels of culture although issues on multifactorial aspects of culture, differences between personal and collective creativity, and the identification of culture either as a value or a practice (custom) should be discussed further for future studies.

• Journal of the Korean Applied Science and Technology
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• v.35 no.4
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• pp.1038-1047
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• 2018

This study confirmed possibility of cosmetic material for Espresso coffee grounds extracted at high temperature, high pressure, short time and Dutch coffee grounds extracted at low temperature, atmospheric pressure, long time. For this purpose, we evaluated the biological activities of antioxidant, anti-wrinkles and antimicrobial effects using ethanol extracts of Esproso and Dutch coffee grounds. The results of total polyphenolic compound contents was $90.39{\pm}0.04mg/g$ for Dutch coffee grounds extract, which was higher than $64.96{\pm}0.38mg/g$ for Espresso coffee grounds extract, based on $113.63{\pm}0.22mg/g$ for coffee beans extract as the reference one. DPPH radical scavenging activity and SOD-like activity of Dutch coffee grounds extract were found to be better than those of Espresso coffee grounds extracts, referenced on coffee bean extract. As a result of inhibition effect of Elastase activity, Dutch coffee grounds extract showed higher inhibition effect than Espresso coffee grounds extract, based on coffee bean extract. In addition, Dutch coffee grounds extract showed good anti-microbial effects at Escherichia coli, Bacillus, Propionibacterium acnes and there was little difference in the clear zone size between Dutch coffee grounds extract and coffee bean extract as a reference one. From the results of the experiments, it was confirmed that Dutch coffee grounds extract had excellent antioxidant, anti-wrinkle and antimicrobial effects and could be used as safe natural cosmetic material in the future.

• The Korean Journal of Archival Studies
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• no.46
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• pp.95-152
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• 2015

"Archives of Everyday Life" refers to an organization or facility which collects, appraises, selects and preserves the document from the memory of individuals, groups, or a society through categorizing and classifying lives and cultures of ordinary people. The document includes materials such as diaries, autobiography, letters, and notes. It also covers any digital files or hypertext like posts from blogs and online communities, or photos uploaded on Social Network Services. Many research fields including the Records Management Studies has continuously claimed the necessity of collection and preservation of ordinary people's records on daily life produced every moment. Especially diary is a written record reflecting the facts experienced by an individual and his self-examination. Its originality, individuality and uniqueness are considered truly valuable as a document regardless of the era. Lately many diaries have been discovered and presented to the historical research communities, and diverse researchers in human and social studies have embarked more in-depth research on diaries, their authors, and social background of the time. Furthermore, researchers from linguistics, educational studies, and psychology analyze linguistic behaviors, status of cultural assimilation, and emotional or psychological changes of an author. In this study, we are conducting a metastudy from various research on diaries in order to reaffirm the value of "The 12th May Diaries Collection" as everyday life archives. "The 12th May Diaries Collection" consists of diaries produced and donated directly by citizens on the 12th May every year. It was only 2013 when Digital Archiving Institute in Univ. of Myungji organized the first "Annual call for the 12th May". Now more than 2,000 items were collected including hand writing diaries, digital documents, photos, audio and video files, etc. The age of participants also varies from children to senior citizens. In this study, quantitative analysis will be made on the diaries collected as well as more profound discoveries on the detailed contents of each item. It is not difficult to see stories about family and friends, school life, concerns over career path, daily life and feelings of citizens ranging all different generations, regions, and professions. Based on keyword and descriptors of each item, more comprehensive examination will be further made. Additionally this study will also provide suggestions to examine future research opportunities of these diaries for different fields such as linguistics, educational studies, historical studies or humanities considering diverse formats and contents of diaries. Finally this study will also discuss necessary tasks and challenges for "the 12th May Diaries Collection" to be continuously collected and preserved as Everyday Life Archives.

• Korean journal of health promotion
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• v.18 no.4
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• pp.177-183
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• 2018

Background: Many studies have reported that adolescents living with single parent have a high risk of obesity. However, those studies did not explore the implication of the gender of single parent living with adolescents. This study investigated the differences in obesity rates according to status of co-residence with their parents in Korean adolescents. The family living with single parent was classified into the family living with single father and the family living with single mother. Methods: This cross-sectional study involved 59,602 adolescents who participated in the 2017 Korea Youth Risk Behavior Web-based Survey. The data on height, weight, status of co-residence with parents, and the other variables were obtained through online questionnaires. Results: In male adolescents, the family living with single mother was related to a high proportion of obesity (odds ratio [OR] 1.24, 95% confidence interval [CI] 1.09-1.40) and overweight (OR 1.17, 95% CI 1.03-1.34). However, in female adolescents, the family living with single father was related to a high proportion of obesity (OR 1.49, 95% CI 1.23-1.82). In addition, female adolescents living with neither parent were more likely to be obese (OR 1.47, 95% CI 1.13-1.91) and overweight (OR 1.31, 95% CI 1.00-1.70). Conclusions: This study showed a risk of obesity in adolescents living with single parent differs according to the gender of single parent living with adolescents. Not adolescents living with a same-gender parent, but those living with an opposite-gender parent have a high risk of obesity.