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Gastrointestinal Foreign Bodies: Review of 96 Cases (소아의 위장관 이물에 대한 고찰)

  • Lee, Min-Rye;Kang, Ki-Su;Jung, Hae-Sung;Seo, Ji-Hyoun;Lim, Jae-Young;Park, Chan-Hoo;Choi, Myoung-Bum;Woo, Hyang-Ok;Youn, Hee-Shang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.2
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    • pp.136-142
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    • 2002
  • Purpose: Foreign body swallowing is common in children. Most of foreign bodies passed upper esophagus are removed spontaneously. But recently, therapeutic endoscopy in children is widely used. In this study, we reviewed gastric foreign bodies regarding types, location, interval from swallowing, complications, and treatment or method of removal. Methods: We reviewed medical records of 96 cases with foreign bodies in gastrointestinal tract at Department of Pediatrics in Gyeongsang National University Hospital (GNUH) from Feb 1987 to Feb 2002. Results: The peak age of patients (male=60, female=36) with foreign bodies in gastrointestinal tract was 2 to 5 years of age. Sixty two patients (64.5%) were asymptomatic. The location of foreign bodies in gastrointestinal tract were detected by simple X-ray in eighty one patients (86.0%), barium study (1 case), and gastroduodenoscopy in 37 cases. The most common location was stomach (63.5%). The most common foreign body was coin (41.7%). In thirty seven cases (38.5%), foreign bodies were removed with flexible gastroduodenoscopy. Fifty four patients (56.3%) visited GNUH in 24 hours after swallowing foreign bodies. The long interval (over 24 hours) of swallowing of foreign bodies is related with high frequency of endoscopic removal. Conclusion: The flexible gastroduodenoscopy was effective in diagnosis and removal of foreign bodies. Further studies for indication and validity of endoscopic removal of foreign bodies in upper gastrointestinal tract are needed.

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The Legitimate and Eldest Son Complex in Changseongameirok (<창선감의록>의 적장자 콤플렉스)

  • Jo, Kwangkuk
    • Journal of Korean Classical Literature and Education
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    • no.38
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    • pp.65-101
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    • 2018
  • In the late Joseon Dynasty, patriarchal ideology became central to the family and the clan, and once again became acutely felt with "the familism of clan rules that centered around a legitimate and eldest son." The establishment of the family-clan system, though somewhat complex, was largely aimed at the family line of "a paternalist-a legitimate and eldest son." The trend was not limited to a particular family, but rather, was a historical and social trend. Changseonggameirok showed how to solve the family crisis by setting up a problem for the next generation's patriarch. This paper tries to explain the issue of Hwachun's complex as the legitimate and eldest son complex. First, it suggests that Hwachun's complex is as universal as the Cain complex, also known as the eldest son complex, and that Hwachun's complex is a special instance of the legitimate and eldest son complex in Changseonggameirok. Next this paper studies the aspects of Hwachun's legitimate and eldest son complex combined with Mrs. Sim's complex, as well as her daughter-in-law's complex, and eventually tracks the development of the family-clan complex. As a result, we've come to a new conclusion that the legitimate and eldest son complex was found in Changseonggameirok for the first time in Korean literary history. This paper also examines the fact that when the legitimate and eldest son complex was transferred to Hwajin, it became a family complex that Hwajin had to contend with; this paper tracks the process wherein Hwajin's filial piety solved the legitimate and eldest son complex. As a result, we realized that Hwajin's filial duty and brotherly love went beyond his feelings for Mrs. Sim and Hwachun, and supported the substantiation for "the familism of a clan that is based on rules of the legitimate and eldest son" in the course of public opinion. However the familism of these rules was not embodied in the absolute; in the royal family, for example, it was rather flexibly implemented when the characters admitted to breaking the law. In addition, this paper provides the room for a critical reading of Changseonggameirok, reflecting back on the underlying guilt and psychological pain of the characters who are affected by the particular rules, and concluding that guilt and suffering are fundamentally insoluble. This is because the two ideas, "the legitimate and eldest son complex" and "the familism of a clan rules centered on a legitimate and eldest son" are two sides of the same coin.

A Study on the Protection of Personal Information in the Medical Service Act (의료법의 개인정보보호에 관한 연구)

  • Sung, Soo-Yeon
    • The Korean Society of Law and Medicine
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    • v.21 no.2
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    • pp.75-103
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    • 2020
  • There is a growing voice that medical information should be shared because it can prepare for genetic diseases or cancer by analyzing and utilizing medical information in big data or artificial intelligence to develop medical technology and improve patient care. The utilization and protection of patients' personal information are the same as two sides of the same coin. Medical institutions or medical personnel should take extra caution in handling personal information with high environmental distinct characteristics and sensitivity, which is different from general information processors. In general, the patient's personal information is processed by medical personnel or medical institutions through the processes of collection, creation, and destruction. Still, the use of terms related to personal information in the Medical Service Act is jumbled, or the scope of application is unclear, so it relies on the interpretation of precedents. For the medical personnel or the founder of the medical institution, in the case of infringement of Article 24(4), it cannot be regarded that it means only medical treatment information among personal information, whether or not it should be treated the same as the personal information under Article 23, because the sensitive information of patients is recorded, saved, and stored in electronic medical records. Although the prohibition of information leakage under Article 19 of the Medical Service Act has a revision; 'secret' that was learned in business was revised to 'information', but only the name was changed, and the benefit and protection of the law is the same as the 'secret' of the criminal law, such that the patient's right to self-determination of personal information is not protected. The Privacy Law and the Local Health Act consider the benefit and protection of the law in 'information learned in business' as the right to self-determination of personal information and stipulate the same penalties for personal information infringement such as leakage, forgery, alteration, and damage. The privacy regulations of the Medical Service Act require that the terms be adjusted uniformly because the jumbled use of terms can confuse information subjects, information processors, and shows certain limitations on the protection of personal information because the contents or scope of the regulations of the Medical Service Law for special corporations and the Privacy Law may cause confusion in interpretation. The patient's personal information is sensitive and must be safely protected in its use and processing. Personal information must be processed in accordance with the protection principle of Privacy Law, and the rights such as privacy, freedom, personal rights, and the right to self-determination of personal information of patients or guardians, the information subject, must be guaranteed.

A Study on "Reason and Madness" in Hegel's 『Phenomenology of Spirit』 - An Interpretation searching for the possibility of the dialogue between Hegel and Lacan - (헤겔 『정신현상학』에서의 '이성과 광기'의 문제 - 헤겔의 라캉과의 대화 가능성에서 본 하나의 해석 -)

  • Lee, Jong-chul
    • Journal of Korean Philosophical Society
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    • v.115
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    • pp.249-279
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    • 2010
  • The Law of the Heart, which appears in the chapter "B. The Actualization of Rational Self-consciousness Through its own Activity" in Hegel's Phenomenology of Spirit represents that the self-certainty of the reason may be the another face of the Madness. The Reason's indubitable certainty is the testimony of the truth for Descartes, and it also plays a role as the moral maxim of the conscience for Kant. But this subjective certainty unavoidably leads to the Madness of self-conceit, which unifies the consciousness and the reality ignoring the difference between them. The typical attitude appearing in the reformer like Don Quixote and also romantic idealists reveals the fact that modern reason and the psychosis can be both faces of one and the same coin. The Mirror Stage, the Imaginary, and the Formula of the Desire in Lacan's Theory shows that the Image of completeness is the result of Mis-understanding. Even if the Mirror stage is necessary for the Formation of the subject, at the same time it should also lead to the next stage, i.e., the Symbolic Order. It is considered as the realm of the Otherness, which refers to the realm of language or that of law. If the Ego can't go through the symbolic castration acted on by the Name of the Father, he will be remained in the prison of the Imaginary. The Madness also shows the similar process. For Hegel the Discipline of the Labor or the Death as absolute Otherness that inevitably delays the Desire plays the same role as the name of Father. It may be the experience of Separation or that of Sublation of the individual towards the universal, which is equivalent to the experience of Symbolic castration in Lacan. Furthermore there may be the difference between Hegel and Lacan as the following; while in Hegel the experience of Separation is founded on the spontaneity of the Spirit, for Lacan it is to be compelled and structured by the absolute Other.

Diagnostic Approach to the Solitary Pulmonary Nodule : Reappraisal of the Traditional Clinical Parameters for Differentiating Malignant Nodule from Benign Nodule (고립성 폐결절에 대한 진단적 접근 : 악성결절과 양성결절의 감별 지표에 대한 재검토)

  • Kho, Won Jung;Kim, Cheol Hyeon;Jang, Seung Hun;Lee, Jae Ho;Yoo, Chul Gyu;Chung, Hee Soon;Kim, Young Whan;Han, Sung Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.500-518
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    • 1996
  • Background : The solitary pulmonary nodule(SPN) presents a diagnostic dilemma to the physician and the patient. Many clinical characteristics(i.e. age, smoking history, prior history of malignancy) and radiological characteristics( i.e. size, calcification, growth rate, several findings of computed tomography) have been proposed to help to determine whether the SPN was benign or malignant. However, most of these diagnostic guidelines are based on the data collected before computed tomography(CT) has been introduced and lung cancer was not as common as these days. Moreover, it is not well established whether these guidelines from western populations could be applicable to Korean patients. Methods : We had a retrospective analysis of the case records and radiographic findings in 114 patients presenting with SPN from Jan. 1994 to Feb. 1995 in Seoul National University Hospital, a tertiary referral hospital. Results : We observed the following results ; (1) Out of 113 SPNs, the etiology was documented in 94 SP IS. There were 34 benign SP s and 60 malignant SPNs. Among which, 49 SPNs were primary lung cancers and the most common hi stologic type was adenocarcinoma. (2) The average age of patients with benign and malignant SPNs was $49.7{\pm}12.0$ and $58.1{\pm}10.0$ years, respectively( p=0.0004), and the malignant SPNs had a striking linear propensity to increase with age. (3) No significant difference in the hi story of smoking was noted between the patients with benign SPNs($13.0{\pm}17.6$ pack- year) and those with malignant SPNs($18.6{\pm}25.1$ pack-year) (p=0.2108). (4) 9 out of 10 patients with prior history of malignancy had malignant SPNs. 5 were new primary lung cancers with no relation to prior malignancy. (5) The average size of benign SPNs($3.01{\pm}1.20cm$) and malignant SPNs($2.98{\pm}0.97cm$) was not significantly different(p=0.8937). (6) The volume doubling time could be calculated in 22 SPNs. 9 SPNs had the volume doubling time longer than 400 days. Out of these, 6 were malignant SPNs. (7) The CT findings suggesting malignancy included the lobulated or spiculated border, air- bronchogram, pleural tail, and lymphadenopathy. In contrast, calcification, central low attenuation, cavity with even thickness, well-marginated border, and peri nodular micronodules were more suggestive for benign nodule. (8) The diagnostic yield of percutaneous needle aspiration and biopsy was 57.6%(19/33) of benign SPNs and 81.0%(47/58) of malignant SPNs. The diagnostic value of sputum analysis and bronchoscopic evaluations were relatively very low. (9) 42.3%(11/26) of SPNs of undetermined etiology preoperatively turned out to be malignant after surgical resection. Overall, 75.4%(46/61) of surgically resected SPNs were malignant. Conclusions : We conclude that the likelihood of malignant SPN correlates the age of patient, prior history of malignancy, some CT findings including lobulated or spiculated border, air-bronchogram, pleural tail and lymphadenopathy. However, the history of smoking, the size of the nodule, and the volume doubling time are not helpful to determent whether the SPN is benign or malignant, which have been regarded as valuable clinical parameters previously. We suggest that aggressive diagnostic approach including surgical resection is necessary in patient with SPNs.

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