• The Korean Society of Law and Medicine
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• v.10 no.2
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• pp.309-341
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• 2009

According to a case of Supreme Court's Sentence No. 2009DA17417 (May 21, 2009), the Supreme Court judges that 'the right to life is the ultimate one of basic human rights stipulated in the Constitution, so it is required to very limitedly and conservatively determine whether to discontinue any medical practice on which patient's life depends directly.' In addition, the Supreme Court admits that 'only if a patient who comes to a fatal phase before death due to attack of any irreversible disease may execute his or her right of self-determination based on human respect and values and human right to pursue happiness, it is permissible to discontinue life-sustaining treatment for him or her, unless there is any special circumstance.' Furthermore, the Supreme Court finds that 'if a patient who is attacked by any irreversible disease informs medical personnel of his or her intention to agree on the refusal or discontinuance of life-sustaining treatment in advance of his or her potential irreversible loss of consciousness, it is justifiable that he or she already executes the right of self-determination according to prior medical instructions, unless there is any special circumstance where it is reasonably concluded that his or her physician is changed after prior medical instructions for him or her.' The Supreme Court also finds that 'if a patient remains at irreversible loss of consciousness without any prior medical instruction, he or she cannot express his or her intentions at all, so it is rational and complying with social norms to admit possibility of estimating his or her own intentions on withdrawal of life-sustaining treatment, provided that such a withdrawal of life-sustaining treatment meets his or her interests in view of his or her usual sense of values or beliefs and it is reasonably concluded that he or she could likely choose to discontinue life-sustaining treatment, even if he or she were given any chance to execute his or her right of self-determination.' This judgment is very significant in a sense that it suggests the reasonable orientation of solutions for issues posed concerning withdrawal of meaningless life-sustaining medical efforts. The issues concerning removal of medical instruments for meaningless life-sustaining treatment and discontinuance of such treatment in regard to medical treatment for terminal cases don't seem to be so much big deal when a patient has clear consciousness enough to express his or her intentions, but it counts that there is any issue regarding a patient who comes to irreversible loss of consciousness and cannot express his or her intentions. Therefore, it is required to develop an institutional instrument that allows relevant authority to estimate the scope of physician's medical duties for terminal patients as well as a patient's intentions to withdraw any meaningless treatment during his or her terminal phase involving loss of consciousness. However, Korean judicial authority has yet to clarify detailed cases where it is permissible to discontinue any life-sustaining treatment for a patient in accordance with his or her right of self-determination. In this context, it is inevitable and challenging to make better legislation to improve relevant systems concerning withdrawal of life-sustaining treatment. The State must assure the human basic rights for its citizens and needs to prepare a system to assure such basic rights through legislative efforts. In this sense, simply entrusting physician, patient or his or her family with any critical issue like the withdrawal of meaningless life-sustaining treatment, even without any reasonable standard established for such entrustment, means the neglect of official duties by the State. Nevertheless, this issue is not a matter that can be resolved simply by legislative efforts. In order for our society to accept judicial system for withdrawal of life-sustaining treatment, it is important to form a social consensus about this issue and also make proactive discussions on it from a variety of standpoints.

• Journal of Korean Academy of Nursing
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• v.28 no.2
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• pp.441-456
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• 1998

The purpose of this study was to develop a reliable and valid instrument to measure hope for cancer patients in Korea. This Hope Scale(Kim & Lee Hope Scale ; KLHS ) was developed based on not only critical universal attributes explaining both basic hope (generalized hope) and specific hope but also particular characteristics varing from culture and situation, which were revealed in a comprehensive review of the literature. Initially 60 items were generated from three sources : 36 items from the Q-sample used in the Kim's study, 1992, 21 representative items(statements) from the rest Q-population of the above study, 3 items related to the newly discovered category in the new qualitative study using 10 open ended question(death and dying) from the new qualitative study on the 20 cancer patients. At first 3 items were eliminated by the critique of the content validity experts, who were high experienced nurse, nursing professors. And then 4 items were eliminated in consideration of corrected item total correlation coefficiency, theoretical framework of this study. After that, 14 items were eliminated in comparing two or three items identified with the same meaning in each factor by this research team with factor loading and communality. This Hope Scale was finally constructed with 39 items. Psychometric evaluation was done on 492 adults(104 cancer patients, 388 adults who imagined who were cancer patients ranging from 18 to 76 years old. The results revealed high internal consistency Alpha coefficiency of .9351. Princial Component Factor Analysis with Varimax Rotation resulted in 8 factors with more than 1.0 of Eigenvalue. Referring to Eigenvalues, percent of variances(>60%), reproduced correlation matrix, and our theoretical framework, we decided the eight factors were the best1 solution to represent hope dimensions sufficiently. The eight factors were "confidence in possibility of cure", "sense of internal satisfaction", "being in communion", "meaning of life", "Korean hope perspectives", "belief in god", "self confidence", "self-worth". Among these factors, "confidence in possibility of cure", "sense of internal satisfaction", "Korean hope perspectives" were identified as different hope dimensions from those of Nowotny Hope Scale and Herth Hope Scale. There was significant negative correlation of r=-.4736 between this hope scale and Beck Hopelessness Scale (BHS), and significant positive correlation of r=.3685 between this hope scale and Life Orientation Test (LOT) which indicate convergent and discriminant validity. The range of hope scores was from 71 to 244, with a mean of 171.97(SD=28.16).

• Journal of Life Science
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• v.18 no.3
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• pp.304-310
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• 2008

Heat shock protein 70 (HSP70) is known as molecular chaperone, the fundamental protein participating in various processes, from nascent protein synthesis to protection of proteins during abiotic stresses and developmental programs. However, their biological functions in plants are not yet well known. Here, NtHSP70-1 (AY372069), HSP70 of Nicotiana tabacum induced by heat stress was investigated. To analyze the protective role of NtHSP70-1, transgenic tobacco plants, which constitutively overexpressed NtHSP70-1 as well as contained either the vector alone or having NtHSP70-1 in the antisense orientation, were constructed. The altered NtHSP70-1 levels in plants were confirmed by western blotting and transgenic sense lines exhibited tolerance to heat stress. Seedlings with the constitutively expressed NtHSP70-1 grew as green or healthy plants after heat stress. In contrast, transgenic vector or antisense lines exhibited yellowing of leaves or some delay in growth, which finally led to death. Evaluation of chlorophyll contents of heat-shocked transgenic tobacco seedlings indicated that NtHSP70-1 contributes to thermotolerance by preventing chlorophyll synthesis in plants.

• Cross-Cultural Studies
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• v.42
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• pp.419-449
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• 2016

The Russian icon and Korean tangwha (幀畵, altar portrait of Buddha) are based on the similarity of the divine Being. Each has the characteristic index that forms an existential connection with the object and at the same time, implies the symbolic meaning of the scriptures and doctrines of the Russian Orthodox and Buddhists. Russian icon and Korean tangwha with these attributes have origins in the Byzantine, India and China. Unlike most religious art, Russian icon and Korean tangwha clearly reveal profane orientation and mystical elements. This artistic phenomenon has evolved from the mystical religious culture in Russia and tantric rituals of the early Joseon period. Iconostasis, created from historical figures of the Old Testament, Jesus, the New Testament represent the principles of the macrocosm. Each icon of iconostasis has integrity, while each floor has another narrative and a meta-discourse on the entire composition. Three-Platforms of amrtakundalin can also have a huge epic that is directed from the Low-Platform to the High-Platform for the purpose of salvation. While the narrative of iconostasis has a time structure, from the beginning of the universe up to date in chronological time, amrtakundalin have pictorial transitions of time and space that rises from this life to a heavenly world. Despite the different world views of the Russian Orthodox and Buddhists, iconographical format and symbolism of heaven and hell in the Iconostasis, Last Judgment and amrtakundalin are similar. There is a constant antagonism between heaven and hell, light and darkness, water and flame. Iconographical contents include the water of life and nectar, the book of life and 'eoppu', and the scales and mirror of Karma that discriminate between the good and evil before judgment. The dualistic coordinate concept such as light and darkness, life and death, or heaven and hell that appears in the narrative structure of iconostasis, the Last Judgment and amrtakundalin leads the people to spiritual awakening.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.790-798
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• 1999

Background: As the early outcome after coronary artery bypass grafting(CABG) has been stabilized, neurologic complication has now become one of the most important morbidity. The aim of this study was to find out the risk factors associated with the neurologic complications after CABG. Material and Method: In 351 patients who underwent CABG, the incidence and features of neurologic complications, with associated perioperative risk factors, were retrospectively reviewed. Neurologic complication was defined as a new cerebral infarction confirmed by postoperative neurologic examination and radiologic studies, or delayed recovery of consciousness and orientation for more than 24 hours after the operation. Result: Neurologic complications occurred in 18 patients(5.1%), of these nine(2.6%) were diagnosed as having new cerebral infarctions(stroke). Stroke was manifested as motor paralysis in four patients, mental retardation or orientation abnormality in four, and brain death in one. Statistical analysis revealed the following variables as significant risk factors for neurologic complications by both univariate and multivariate analyses: cardiopulmonary bypass longer than 180 minutes, atheroma of the ascending aorta, carotid artery stenosis detected by Duplex sonography, and past history of cerebrovascular accident or transient ischemic attack. Age over 65 years, aortic calcification detected by simple X-ray, and intraoperative myocardial infarction were significant risk factors by univariate analysis only. Neither the severity of carotid artery stenosis nor technical modifications such as cannulation of the aortic arch or single clamp technique, which were expected to affect the inciden e of neurologic complications, had significant relationship with the incidence. Conclusion: This study confirmed the strong association between neurologic complications after CABG and atherosclerosis of the arterial system. Therefore, to minimize the incidence of neurologic complications, systematic evaluation focused on atherosclerotic lesions of the arterial system followed by adequate alteration of operative strategy is needed.