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The Limitations of Advance Directive (사전의료지시의 한계)

  • Oh, Se-Hyuk;Jeong, Hwa-Seong
    • The Korean Society of Law and Medicine
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    • v.11 no.2
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    • pp.239-274
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    • 2010
  • Advance directive refers to a description of the treatment method a patient wants to be provided with in case where the person is unconscious or lacks an ability to decision making in a future period or a declaration of intention that delegates and appoints another person who makes a decision regarding a treatment method on behalf of the person. Advance directive is usually a document form, but oral statement is acceptable as well. Advance directive may have a variety of forms though, it basically consists of two basic forms. That is, one is a living will, and the other is a surrogate decision making. Though the importance of advance directive has been emphasized, and the necessity of adopting the system has been strongly argued for so far, the debates on criteria, method, and procedure alike have not yet reached an agreement. It is because even the concept of advance directive is more or less ambiguous, and each specific method has its own theoretical limitations and practical constraints. Thus the inquiries on advance directive raised in the study are summarized as the meaning, practicability, and philosophical foundation of the advance directive. Firstly, the theoretical limitations of Advance directive may be categorized into conceptual and moral limitations. In case of conceptual limitations, authors of advance directives may not be well aware, in advance, of the particular situation in which he or her will experience in the future, and patients may experience the change in his or her values and lack the understanding and information about the future situation due to the changes in treatment methods. In case of moral limitations, a patient has a limited moral autonomy right and self identity that have an impact on his or her preference. Secondly, in case of practical constraints for advance directive, there exist cultural features, low ratio of documentation, as patients themselves admit, and low predictability and stability of patient's own preference regarding life-sustaining care. And the problem of validity and accuracy in proxy's decision making is also raised. Those who administer a living will, especially, may have a difficulty in understanding the directive by a patient, so that the accuracy of execution cannot be secured. In the sense, it is needed to implement a legal device in order to solve such problems. In summary, it is urgently required to understand the limitations and explore desired alternatives to overcome the relevant problems in advance, which must contribute to successfully adopting and effectively operating the advance directive system in Korea.

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A Sentence Reduction Method using Part-of-Speech Information and Templates (품사 정보와 템플릿을 이용한 문장 축소 방법)

  • Lee, Seung-Soo;Yeom, Ki-Won;Park, Ji-Hyung;Cho, Sung-Bae
    • Journal of KIISE:Software and Applications
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    • v.35 no.5
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    • pp.313-324
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    • 2008
  • A sentence reduction is the information compression process which removes extraneous words and phrases and retains basic meaning of the original sentence. Most researches in the sentence reduction have required a large number of lexical and syntactic resources and focused on extracting or removing extraneous constituents such as words, phrases and clauses of the sentence via the complicated parsing process. However, these researches have some problems. First, the lexical resource which can be obtained in loaming data is very limited. Second, it is difficult to reduce the sentence to languages that have no method for reliable syntactic parsing because of an ambiguity and exceptional expression of the sentence. In order to solve these problems, we propose the sentence reduction method which uses templates and POS(part of speech) information without a parsing process. In our proposed method, we create a new sentence using both Sentence Reduction Templates that decide the reduction sentence form and Grammatical POS-based Reduction Rules that compose the grammatical sentence structure. In addition, We use Viterbi algorithms at HMM(Hidden Markov Models) to avoid the exponential calculation problem which occurs under applying to Sentence Reduction Templates. Finally, our experiments show that the proposed method achieves acceptable results in comparison to the previous sentence reduction methods.

Research on the Creation of Small Parks in Daegu Elementary Schools (대구광역시 초등학교 소공원 조성에 관한 연구)

  • Kim Hu-Kyung;Lee Hyun-Taek
    • Journal of the Korean Institute of Landscape Architecture
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    • v.33 no.3 s.110
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    • pp.78-83
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    • 2005
  • The purpose of this project is to create small parks in elementary schools in order to improve the educational environment and also to increase the amount of greenspace in the city. Above all, the main goal is to create space for local residents in which they can enjoy their leisure time. During a basic investigation and document investigation of elementary schools in Daegu, I placed the priority on choosing the schools that showed the most promise. Also, by doing a survey about the present conditions at schools, I verified, compared, and analyzed the validity of creating small parks in elementary schools. The summary of the results are as follows. The average area available for building small parte in Daegu elementary schools is $7,447m^2$. Even though this area is not as large as a neighborhood parti the difference is not that great. Therefore, I assumed that building small parks in schools would be as effective as building neighborhood parks. The standard size for a children's parks is $1,500m^2$, and if small parks were to be constructed in all school areas with available space larger than a children's park (i.e., larger than $1,500m^2$), the amount of added park greenspace would equal $1,217,953m^2$. The number of schools with areas under $1,500m^2$ is only 3% of all schools in which small parte can be created(5 schools). Schools that have between $1,500m^2$ and $8,000m^2$of greenspace make up 59.7% of all schools in which small parte can be created (98 schools). Schools that have greenspace of more than $8,000m^2$ make up 37% of all school in which small parks can be created (61 schools). The standard area for neighborhood parte is $10,000m^2$ (building-to-land ratio 20%). Schools that have areas that are larger than the standard area for neighborhood parte make up 31% of all elementary schools in Daegu (61 schools). Therefore city greenspace would increase to a total of $694,805m^2$ by making use of these schools, which would represent 7% of the park greenspace in Daegu.

Fistula Formation Between the Disc and Dura after Percutaneous Endoscopic Lumbar Discectomy - A Case Report - (경피적 내시경 요추 추간판 절제술 후 발생한 추간판과 경막 사이의 누공 형성 - 증례 보고 -)

  • Kim, Hak Sun;Kim, Hyoung Bok;Chung, Hoon-Jae;Yang, Jea Ho
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.180-184
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    • 2018
  • Study Design: Case report Objectives: To document fistula formation between the disc and dura by an unrecognized dural tear after percutaneous endoscopic lumbar discectomy (PELD). Summary of Literature Review: The risk of durotomy is relatively low with PELD, but cases of unrecognized durotomies have been reported. An effective diagnostic tool for such situations has not yet been identified. Materials and Methods: A patient twice underwent transforaminal PELD under the diagnosis of a herniated lumbar disc at L4-5. She still complained of intractable pain and motor weakness around the left lower extremity at 6 months postoperatively. Magnetic resonance imaging showed no specific findings suggestive of violation of the nerve root. However, L5 and S1 nerve root injury was noted on electromyography. An exploratory operation was planned to characterize damage to the neural structures. Results: In the exploration, a dural tear was found at the previous operative site, along with a fistula between the disc and dura was also found at the dural tear site. The durotomy site was located on the ventrolateral side of the dura and measured approximately 5 mm. The durotomy site was repaired with Nylon 5-0 and adhesive sealants. The patient's preoperative symptoms diminished considerably. Conclusions: Fistula formation between the disc and dura can be caused by an unrecognized dural tear after PELD. Discography is a reliable diagnostic tool for fistulas formed by an unrecognized durotomy.

Methodology for Identifying Issues of User Reviews from the Perspective of Evaluation Criteria: Focus on a Hotel Information Site (사용자 리뷰의 평가기준 별 이슈 식별 방법론: 호텔 리뷰 사이트를 중심으로)

  • Byun, Sungho;Lee, Donghoon;Kim, Namgyu
    • Journal of Intelligence and Information Systems
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    • v.22 no.3
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    • pp.23-43
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    • 2016
  • As a result of the growth of Internet data and the rapid development of Internet technology, "big data" analysis has gained prominence as a major approach for evaluating and mining enormous data for various purposes. Especially, in recent years, people tend to share their experiences related to their leisure activities while also reviewing others' inputs concerning their activities. Therefore, by referring to others' leisure activity-related experiences, they are able to gather information that might guarantee them better leisure activities in the future. This phenomenon has appeared throughout many aspects of leisure activities such as movies, traveling, accommodation, and dining. Apart from blogs and social networking sites, many other websites provide a wealth of information related to leisure activities. Most of these websites provide information of each product in various formats depending on different purposes and perspectives. Generally, most of the websites provide the average ratings and detailed reviews of users who actually used products/services, and these ratings and reviews can actually support the decision of potential customers in purchasing the same products/services. However, the existing websites offering information on leisure activities only provide the rating and review based on one stage of a set of evaluation criteria. Therefore, to identify the main issue for each evaluation criterion as well as the characteristics of specific elements comprising each criterion, users have to read a large number of reviews. In particular, as most of the users search for the characteristics of the detailed elements for one or more specific evaluation criteria based on their priorities, they must spend a great deal of time and effort to obtain the desired information by reading more reviews and understanding the contents of such reviews. Although some websites break down the evaluation criteria and direct the user to input their reviews according to different levels of criteria, there exist excessive amounts of input sections that make the whole process inconvenient for the users. Further, problems may arise if a user does not follow the instructions for the input sections or fill in the wrong input sections. Finally, treating the evaluation criteria breakdown as a realistic alternative is difficult, because identifying all the detailed criteria for each evaluation criterion is a challenging task. For example, if a review about a certain hotel has been written, people tend to only write one-stage reviews for various components such as accessibility, rooms, services, or food. These might be the reviews for most frequently asked questions, such as distance between the nearest subway station or condition of the bathroom, but they still lack detailed information for these questions. In addition, in case a breakdown of the evaluation criteria was provided along with various input sections, the user might only fill in the evaluation criterion for accessibility or fill in the wrong information such as information regarding rooms in the evaluation criteria for accessibility. Thus, the reliability of the segmented review will be greatly reduced. In this study, we propose an approach to overcome the limitations of the existing leisure activity information websites, namely, (1) the reliability of reviews for each evaluation criteria and (2) the difficulty of identifying the detailed contents that make up the evaluation criteria. In our proposed methodology, we first identify the review content and construct the lexicon for each evaluation criterion by using the terms that are frequently used for each criterion. Next, the sentences in the review documents containing the terms in the constructed lexicon are decomposed into review units, which are then reconstructed by using the evaluation criteria. Finally, the issues of the constructed review units by evaluation criteria are derived and the summary results are provided. Apart from the derived issues, the review units are also provided. Therefore, this approach aims to help users save on time and effort, because they will only be reading the relevant information they need for each evaluation criterion rather than go through the entire text of review. Our proposed methodology is based on the topic modeling, which is being actively used in text analysis. The review is decomposed into sentence units rather than considering the whole review as a document unit. After being decomposed into individual review units, the review units are reorganized according to each evaluation criterion and then used in the subsequent analysis. This work largely differs from the existing topic modeling-based studies. In this paper, we collected 423 reviews from hotel information websites and decomposed these reviews into 4,860 review units. We then reorganized the review units according to six different evaluation criteria. By applying these review units in our methodology, the analysis results can be introduced, and the utility of proposed methodology can be demonstrated.