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A Study on the Availability of the On-Board Imager(OBI) and Cone-Beam CT(CBCT) in the Verification of Patient Set-up (온보드 영상장치(On-Board Imager) 및 콘빔CT(CBCT)를 이용한 환자 자세 검증의 유용성에 대한 연구)

  • Bak, Jino;Park, Sung-Ho;Park, Suk-Won
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.118-125
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    • 2008
  • Purpose: On-line image guided radiation therapy(on-line IGRT) and(kV X-ray images or cone beam CT images) were obtained by an on-board imager(OBI) and cone beam CT(CBCT), respectively. The images were then compared with simulated images to evaluate the patient's setup and correct for deviations. The setup deviations between the simulated images(kV or CBCT images), were computed from 2D/2D match or 3D/3D match programs, respectively. We then investigated the correctness of the calculated deviations. Materials and Methods: After the simulation and treatment planning for the RANDO phantom, the phantom was positioned on the treatment table. The phantom setup process was performed with side wall lasers which standardized treatment setup of the phantom with the simulated images, after the establishment of tolerance limits for laser line thickness. After a known translation or rotation angle was applied to the phantom, the kV X-ray images and CBCT images were obtained. Next, 2D/2D match and 3D/3D match with simulation CT images were taken. Lastly, the results were analyzed for accuracy of positional correction. Results: In the case of the 2D/2D match using kV X-ray and simulation images, a setup correction within $0.06^{\circ}$ for rotation only, 1.8 mm for translation only, and 2.1 mm and $0.3^{\circ}$ for both rotation and translation, respectively, was possible. As for the 3D/3D match using CBCT images, a correction within $0.03^{\circ}$ for rotation only, 0.16 mm for translation only, and 1.5 mm for translation and $0.0^{\circ}$ for rotation, respectively, was possible. Conclusion: The use of OBI or CBCT for the on-line IGRT provides the ability to exactly reproduce the simulated images in the setup of a patient in the treatment room. The fast detection and correction of a patient's positional error is possible in two dimensions via kV X-ray images from OBI and in three dimensions via CBCT with a higher accuracy. Consequently, the on-line IGRT represents a promising and reliable treatment procedure.

Oxidative Inactivation of Peroxiredoxin Isoforms by H2O2 in Pulmonary Epithelial, Macrophage, and other Cell Lines with their Subsequent Regeneration (폐포상피세포, 대식세포를 비롯한 각종 세포주에서 H2O2에 의한 Peroxiredoxin 동위효소들의 산화에 따른 불활성화와 재생)

  • Oh, Yoon Jung;Kim, Young Sun;Choi, Young In;Shin, Seung Soo;Park, Joo Hun;Choi, Young Hwa;Park, Kwang Joo;Park, Rae Woong;Hwang, Sung Chul
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.1
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    • pp.31-42
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    • 2005
  • Background : Peroxiredoxins (Prxs) are a relatively newly recognized, novel family of peroxidases that reduce $H_2O_2$ and alkylhydroperoxide into water and alcohol, respectively. There are 6 known isoforms of Prxs present in human cells. Normally, Prxs exist in a head-to-tail homodimeric state in a reduced form. However, in the presence of excess $H_2O_2$, it can be oxidized on its catalytically active cysteine site into inactive oxidized forms. This study surveyed the types of the Prx isoforms present in the pulmonary epithelial, macrophage, endothelial, and other cell lines and observed their response to oxidative stress. Methods : This study examined the effect of exogenous, excess $H_2O_2$ on the Prxs of established cell lines originating from the pulmonary epithelium, macrophages, and other cell lines, which are known to be exposed to high oxygen partial pressures or are believed to be subject to frequent oxidative stress, using non-reducing SDS polyacrylamide electrophoresis (PAGE) and 2 dimensional electrophoresis. Result : The addition of excess $H_2O_2$ to the culture media of the various cell-lines caused the immediate inactivation of Prxs, as evidenced by their inability to form dimers by a disulfide cross linkage. This was detected as a subsequent shift to its monomeric forms on the non-reducing SDS PAGE. These findings were further confirmed by 2 dimensional electrophoresis and immunoblot analysis by a shift toward a more acidic isoelectric point (pI). However, the subsequent reappearance of the dimeric Prxs with a comparable, corresponding decrease in the monomeric bands was noted on the non-reducing SDS PAGE as early as 30 minutes after the $H_2O_2$ treatment suggesting regeneration after oxidation. The regenerated dimers can again be converted to the inactivated form by a repeated $H_2O_2$ treatment, indicating that the protein is still catalytically active. The recovery of Prxs to the original dimeric state was not inhibited by a pre-treatment with cycloheximide, nor by a pretreatment with inhibitors of protein synthesis, which suggests that the reappearance of dimers occurs via a regeneration process rather than via the de novo synthesis of the active protein. Conclusion : The cells, in general, appeared to be equipped with an established system for regenerating inactivated Prxs, and this system may function as a molecular "on-off switch" in various oxidative signal transduction processes. The same mechanisms might applicable other proteins associated with signal transduction where the active catalytic site cysteines exist.

A study of the Medical System in the Early Chosun-Dynasty (조선시대(朝鮮時代) 전기(前期)의 의료제도(醫療制度)에 대한 연구(硏究))

  • Han, Dae-Hee;Kang, Hyo-Shin
    • Journal of Korean Medical classics
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    • v.9
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    • pp.555-652
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    • 1996
  • Up to the present the scholastic achievements in the history of the medical system have been rather scare despite its importance in the Korean History. Hence, this dissertation attempts to examine the significance of the institute in the Korean History, covering the period from the ancient times through the early Chosun-Dynasty. In the ancient times, the medical practice relied primarily upon human instincts and experiences at the same time, shaman's incantations were widely believed to cure diseases, the workings of evil spirits supposedly. For the period from the Old Chosun through Samhan(巫堂), Chinese refugees brought a long medical knowledge and skills of the continent. New Chinese medicine, traditional practices and incantations were generally used at this time. Medicine and the medical system were arranged by the period of the Three Countries(三國時代). No definite record concerning Koguryo remains now. As for Paekje, however, history shows that they set up the system under the Chinese influence, assigning medical posts such as Euibaksa(medical doctor), Chaeyaksa(pharmacist), and Jukeumsa(medicine man) within Yakbu(department of medicine). Scientifically advanced, they sent experts to Japan, giving a tremendous influence on the development of the science on ancient Japan. After the unification of the three countries, Shilla had their own system after the model of Dang(唐). This system of the Unified Shilla was continued down to Koryo and became the backbone of the future ones. In the ancient time religion and medicine were closely related. The curative function of the shaman was absolute. Buddhism played a notable part in medical practice, too, producing numerous medical monks. The medical system of Koryo followed the model of Dang with some borrowings from Song(宋). Sangyakkuk(尙藥局) was to deal exclusively with the diseases of the monarch whereas Taeeuigam(太醫監) was the central office to handle the national medical administration and the qualification test and education for doctors. In addition, Dongsodaebiwon(東西大悲院), Jewibo(濟危寶), and Hyeminkuk(惠民局) were public hospitals for the people, and a few aristocrats practiced medicine privately. In 987, the 6th year of Songjong(成宗), local medical operations were installed for curing the sick and educating medical students. Later Hyonjong(顯宗), established Yakjom(clinics, 藥店) throughout the country and officials were sent there to see patients. Foreign experts, mainly from Song, were invited frequently to deliver their advanced technology, and contributed to the great progress of the science in Korea. Medical officials were equipped with better land and salary than others, enjoying appropriate social respect. Koryo exchanged doctors, medicine and books mainly with Song, but also had substantial interrelations with Yuan(元), Ming(明), Kitan(契丹), Yojin(女眞), and Japan. Among them, however, Song was most influential to the development of medicine in Koryo. During Koryo Dynasty Buddhism, the national religion at the time, exercised bigger effect on medicine than in any other period. By conducting national ceremonies and public rituals to cure diseases, Taoism also affected the way people regarded illness. Curative shamanism was still in practice as well. These religious practices, however, were now engaged only when medication was already in use or when medicine could not held not help any more. The advanced medical system of Koryo were handed down to Chosun and served the basis for further progress. Hence, then played well the role to connect the ancient medicine and the modern one. The early Chosun followed and systemized the scientific and technical achievement in medicine during the Koryo Dynasty, and furthermore, founded the basis of the future developments. Especially the 70 years approximately from the reign of Sejong(世宗) to that of Songjong(成宗) withnessed a termendous progress in the field with the reestablishment of the medical system. The functions of the three medical institute Naeeuiwon(內醫院), Joneuigam(典醫監), Hyeminkuk(惠民局) were expanded. The second, particualy, not only systemized all the medical practices of the whole nation, but also grew and distributed domestic medicaments which had been continually developed since the late Koryo period. In addition, Hyeminso(惠民局, Hwarinwon(活人院)) and Jesaenwon(濟生院)(later merged to the first) played certain parts in the curing illness. Despite the active medical education in the capital and the country, the results were not substantial, for the aristocracy avoided the profession due to the social prejudice against technicians including medical docotors. During the early Chosun-Dynasty, the science was divided into Chimgueui (acupuncturist), Naryogeui(specialist in scrofula) and Chijongeui (specialist in boil). For the textbooks, those for the qualification exam were used, including several written by the natives. With the introduction on Neoconfucianism(性理學) which reinforced sexual segregation, female doctors appeared for the female patients who refused to be seen by male doctors. This system first appeared in 1406, the sixth year of Taejong(太宗), but finally set up during the reign of Sejong. As slaves to the offices, the lowest class, female doctors drew no respect. However, this is still significant in the aspect of women's participation in society. They were precedents of midwives. Medical officials were selected through the civil exam and a special test. Those who passed exams were given temporary jobs and took permanent posts later. At that time the test score, the work experience and the performance record of the prospective doctor were all taken into consideration, for it was a specialized office. Most doctors were given posts that changed every six months, and therefore had fewer chances for a goverment office than the aristocracy. At the beginning the social status of those in medicine was not that low, but with the prejudice gradully rising among the aristocracy, it became generally agreed to belong to the upper-middle technician class. Dealing with life, however, they received social respect and courtesy from the public. Sometimes they collected wealth with their skills. They kept improving techniques and finally came to take an important share in modernization process during the late Chosun-Dynasty.

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The Current Status of the Discussions on International Norms Related to Space Activities in the UN COPUOS Legal Subcommittee (우주활동 국제규범에 관한 유엔 우주평화적이용위원회 법률소위원회의 최근 논의 현황)

  • Jung, Yung-Jin
    • The Korean Journal of Air & Space Law and Policy
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    • v.29 no.1
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    • pp.127-160
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    • 2014
  • The UN COPUOS was established in 1959 as a permanent committee of the UN General Assembly with the aims to promote international cooperation in peaceful uses of outer space, to formulate space-related programmes within the UN, to encourage research and dissemination of information on space, and to study legal problems arising from the outer space activities. Its members have been enlarged from 24 members in 1959 to 76 in 2014. The Legal Subcommittee, which has been established under COPUOS in 1962 to deal with legal problems associated with space activities, through its first three decades of work has set up a framework of international space law: the five treaties and agreements - namely the Outer Space Treaty, Rescue Agreement, Liability Convention, Registration Convention, Moon Agreement - and the five declarations and legal principles. However, some sceptical views on this legal framework has been expressed, concerning the applicability of existing international space law to practical issues and new kinds of emerging space activities. UNISPACE III, which took place in 1999, served as a momentum to revitalize the discussions of the legal issues faced by the international community in outer space activities. The agenda of the Legal Subcommittee is currently structured into three categories: regular items, single issue/items, and items considered under a multi-year workplan. The regular items, which deal with basic legal issues, include definition and delimitation of outer space, status and application of the five UN treaties on outer space, and national legislation relevant to the peaceful exploration and use of outer space. The single issues/items, which are decided upon the preceding year, are discussed only for one year in the plenary unless renewed. They include items related to the use of nuclear power sources in outer space and to the space debris mitigation. The agenda items considered under a multi-year work plan are discussed in working group. Items under this category deal with non-legally binding UN instruments on outer space and international mechanism for cooperation. In recent years, the Subcommittee has made some progress on agenda items related to nuclear power sources, space debris, and international cooperation by means of establishing non-legally binding instruments, or soft law. The Republic of Korea became the member state of COPUOS in 2001, after rotating seats every two years with Cuba and Peru since 1994. Korea's joining of COPUOS seems to be late, in considering that some countries with hardly any space activity, such Chad, Sierra Leone, Kenya, Lebanon, Cameroon, joined COPUOS as early as 1960s and 1970s and contributed to the drafting of the aforementioned treaties, declarations, and legal principles. Given the difficulties to conclude a treaty and un urgency to regulate newly emerging space activities, Legal Subcommittee now focuses its effort on developing soft law such as resolutions and guideline to be adopted by UN General Assembly. In order to have its own practices reflected in the international practices, one of the constituent elements of international customary law, Korea should analyse its technical capability, policy, and law related to outer space activities and participate actively in the formation process of the soft law.

The Correlation between Acholic Stool and the Result of $Tc^{99m}$ DISIDA Hepatobiliary Scintigraphy and Biochemical Test in Neonatal Cholestasis (신생아 담즙 정체증에서 무담즙변의 유무와 $Tc^{99m}$ DISIDA 간담도 주사 결과간의 상관성과 생화학적 검사의 차이에 관한 연구)

  • Joo, Eun-Young;Ahn, Yeon-Mo;Kim, Yong-Joo;Moon, Soo-Ji;Choi, Yun-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.1
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    • pp.51-61
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    • 2002
  • Purpose: The most common causes of neonatal cholestasis are neonatal hepatitis (NH) and extrahepatic biliary atresia (EHBA). Since neonatal cholestasis presents with variable expression of same pathologic process and has similar clinical, biochemical, and histologic features between EHBA and idiopathic neonatal hepatitis (NH), differential diagnosis is often difficult. We reviewed the differences of clinical characteristics and laboratory data to find out any correlation between the results of $Tc^{99m}$ DISIDA scan and presence of acholic stool. Methods: Between June 1993 and January 2001, total 29 infants younger than 4 month-old underwent $Tc^{99m}$ DISIDA scan. Their biochemical tests and clinical course were reviewed retrospectively. Results: Patients who had negative intestinal activity on $Tc^{99m}$ DISIDA scan showed acholic stool and revealed higher serum direct bilirubin and urine bilirubin level. 18.2% of patients with acholic stool showed intestinal activity on $Tc^{99m}$ DISIDA scan and 81.8% of them did not. All the patients without acholic stool showed positive intestinal activity on $Tc^{99m}$ DISIDA scan. The result of $Tc^{99m}$ DISIDA scan and the presence of acholic stool showed high negative correlation (r :-0.858). Patients with acholic stool and negative intestinal activity on $Tc^{99m}$ DISIDA scan showed higher serum total bilirubin level. Patients without acholic stool and positive intestinal activity on $Tc^{99m}$ DISIDA scan showed higher serum level of ALT. Conclusion: Patients with acholic stool and negative intestinal activity showed high correlation, but 18.2% of patients with acholic stool showed positive intestinal activity. So operative cholangiogram or transcutaneous liver biopsy should be performed for confirmation.

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Evaluation of a colloid gel(Slime) as a body compensator for radiotherapy (Colloid gel(Slime)의 방사선 치료 시 표면 보상체로서의 유용성 평가)

  • Lee, Hun Hee;Kim, Chan Kyu;Song, Kwan Soo;Bang, Mun Kyun;Kang, Dong Yun;Sin, Dong Ho;Lee, Du Heon
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.191-199
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    • 2018
  • Purpose : In this study, we evaluated the usefulness of colloid gel(slime) as a compensator for irregular patient surfaces in radiation therapy. Materials and Methods : For this study, colloid gel suitable for treatment was made and four experiments were conducted to evaluate the applicability of radiation therapy. Trilogy(Varian) and CT(SOMATOM, Siemens) were used as treatment equipment and CT equipment. First, the homogeneity according to the composition of colloid gel was measured using EBT3 Film(RIT). Second, the Hounsfield Unit(HU) value of colloid gel was measured and confirmed by CRIS phantom, Eclipse RTP(Eclipse 13.1, Varian) and CT. Third, to measure the deformation and degeneration of colloid gel during the treatment period, it was measured 3 times daily for 2 weeks using an ion chamber(PTW-30013, PTW). The fourth experiment was compared the treatment plan and measured dose distributions using bolus, rice, colloid gel and additional, dose profiles in an environment similar to actual treatment using our own acrylic phantom. Result : First experiment, density of the colloid gel cases 1, 2 and 3 was $1.02g/cm^3$, $0.99g/cm^3$ and $0.96g/cm^3$. When the homogeneity was measured at 6 MV and 9 MeV, case 1 was more homogeneous than the other cases, as 1.55 and 1.98. In the second experiment, the HU values of case 1, 2, 3 were 15 and when the treatment plan was compared with the measured doses, the difference was within 1 % at all 9, 12 MeV and a difference of -1.53 % and -1.56 % within the whole 2 % at 6 MV. In the third experiment, the dose change of colloid gel was measured to be about 1 % for 2 weeks. In the fourth experiment, the dose difference between the treatment plan and EBT3 film was similar for both colloid gel and bolus, rice at 6 MV. But colloid gel showed less dose difference than bolus and rice at 9 MeV. Also, dose profile of colloid gel showed a more uniform dose distribution than the bolus and rice. Conclusion : In this study, the density of colloid gel prepared for radiation therapy was $1.02g/cm^3$ similar to the density of water, and alteration or deformation was not observed during the radiotherapy process. Although we pay attention to the density when manufacturing colloid gel, it is sufficient in that it can deliver the dose uniformly through the compensation of the patient's body surface more than the bolus and rice, and can be manufactured at low cost. Further studies and studies for clinical applications are expected to be applicable to radiation therapy.

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Antioxidant and Antibacterial Activities of Glycyrrhiza uralensis Fisher (Jecheon, Korea) Extracts Obtained by various Extract Conditions (한국 제천 감초(Glycyrrhiza uralensis Fisher)의 추출 조건별 추출물의 항산화 및 항균 활성 평가)

  • Ha, Ji Hoon;Jeong, Yoon Ju;Seong, Joon Seob;Kim, Kyoung Mi;Kim, A Young;Fu, Min Min;Suh, Ji Young;Lee, Nan Hee;Park, Jino;Park, Soo Nam
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.41 no.4
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    • pp.361-373
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    • 2015
  • This study was carried out to evaluate the antioxidant and antibacterial activities of Glycyrriza uralensis Fisher (Jecheon, Korea) extracts obtained by various extraction conditions (85% ethanol, heating temperatures and times), and to establish the optimal extraction condition of G. uralensis for the application as cosmetic ingredients. The extracts obtained under different conditions were concentrated and made in the powdered (sample-1) and were the crude extract solutions without concentration (sample-2). The antioxidant effects were determined by free radical scavenging activity ($FSC_{50}$), ROS scavenging activity ($OSC_{50}$), and cellular protective effects. Antibacterial activity was determined by minimum inhibitory concentration (MIC) on human skin flora. DPPH free radical scavenging activity of sample-1 ($100{\mu}g/mL$) was 10% higher in group extracted for 6 h than 12 h, but sample-2 didn't show any significant differences. The extraction yield extracted with same temperature for 12 h was 2.6 times higher than 6 h, but total flavonoid content was 1.1 times higher. These results indicated that total flavonoid content hardly increased with increasing extraction time. Free radical scavenging activity, ROS scavenging activity and cellular protective effects were not dependent on the yield of extraction, but total flavonoid content of extraction. Antibacterial activity on three skin flora (S. aureus, B. subtilis, P. acnes)of sample-1 in different extraction conditions were evaluated on same concentration, and the group extracted at 25 and $40^{\circ}C$ showed 16 times higher than methyl paraben ($2,500{\mu}g/mL$). In conclusion, 85% ethanol extracts of G. uralensis extracted at $40^{\circ}C$ for 6 h showed the highest antioxidant and antibacterial activity. These results indicate that the extraction condition is important to be optimized by comprehensive evaluation of extraction yield with various conditions, yield of active component, and activity test with concentrations, and activity of 100% extract, for manufacturing process of products.

Thinking in Terms of East-West Contacts through Spreading Process of Sarmathia-Pattened Scabbard on Tillya-Tepe Site in Afghanistan (아프가니스탄 틸랴 테페의 사르마티아(Sarmathia)식 검집 패용 방식의 전개 과정으로 본 동서교섭)

  • Lee, Song Ran
    • Korean Journal of Heritage: History & Science
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    • v.45 no.4
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    • pp.54-73
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    • 2012
  • In this article, we examined the patterns of activities of the Sarmathians though in a humble measure, with a focus on the regions where the Sarmathian sheaths spreaded. One of the main weapons the mounted nomads like the Scythias, the Sarmathians, and the Alans used at war was a spear. Though complementary, a sword was the most convenient and appropriate weapon when fighting at a near distance, fallen from the horse to the ground. The Sarmathian swords continued the tradition of the Akinakes which the Scythias or the Persians used, but those of the Sarmathians showed some advances in terms of the easiness with which a sword was drawn out from a sheath, and the way the sheaths were worn to parts of a human body. It turns out that the Sarmathian sheaths, which were designed for the people to draw swords easily, having the sheaths attached to thighs through 4 bumps, spread extensively from Pazyryk, Altai, to South Siberia, Bactria, Parthia and Rome. The most noteworthy out of all the Sarmathian sheaths were the ones that were excavated from the 4th tomb in Tillatepe, Afghanistan which belonged to the region of Bactria. The owner of the fourth tomb of Tilla-tepe whose region was under the control of Kushan Dynasty at that time, was buried wearing Sarmathian swords, and regarded as a big shot in the region of Bactria which was also under the governance of Kushan Dynasty. The fact that the owner of the tomb wore two swords suggests that there had been active exchange between Bactria and Sarmathia. It seemed that the reason why the Sarmathians could play an important role in the exchange between the East and the West might have something to do with their role of supplying Chinese goods to Silk Road. That's why we are interested in how the copper mirrors of Han Dynasty, decoration beads like melon-type beads, crystal beads and goldring articulated beads, and the artifacts of South China which produced silks were excavated in the northern steppe route where the Sarmathians actively worked. Our study have established that the eye beads discovered in Sarmathian tomb estimated to have been built around the 1st century B.C. were reprocessed in China, and then imported to Sarmathia again. We should note the Huns as a medium between the Sarmathians and the South China which were far apart from each other. Thus gold-ring articulated beads which were spread out mainly across the South China has been discovered in the Huns' remains. On the other hand, between 2nd century B.C. and 2nd century A.D. which were main periods of the Sarmathians, it was considered that the traffic route connecting the steppe route and the South China might be West-South silk road which started from Yunnan, passed through Myanmar, Pakistan, and Afghanistan, and then went into the east of India. The West-south Silk road is presumed to have been used by nomadic tribes who wanted to get the goods from South China before the Oasis route was activated by the Han Dynasty's policy of managing the countries bordering on Western China.

Dreams of Admiral Yi Sun-sin (1545-1598) in Nanjung Ilgi (Diary in War Time) and Some Aspects of His Personality: From Jungian Viewpoint (≪난중일기≫에서 본 이순신의 꿈과 인격의 몇 가지 측면: 분석심리학적 입장에서)

  • Bou-Yong Rhi
    • Sim-seong Yeon-gu
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    • v.37 no.2
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    • pp.99-148
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    • 2022
  • This study aims at the psychological elucidation of some conscious aspects of the personality of Yi Sun-sin (1545-1598), the Korean national hero, and the unconscious teleologic meanings of his dreams mentioned in Nanjung Ilgi (Diary in War Time) from the viewpoint of analytical psychology of C.G. Jung. Yi Sun-sin was a man of discipline, incorporated with the spirit of Confucian filial piety, hyo (hsiao) and royalty, chung. He was a stern man but with a warm heart. In his diary, Yi Sun-sin poured forth his feelings of suffering, despair, and extreme solicitude caused by slanders of his political opponents, his grief for the loss of mother and son, and his worries about the fate of his country, which the Japanese invaders now plundered. The moon night offered him the opportunity to touch with his inner soul, by reciting poems, playing Korean string, 'Keomungo', and flute. Further, he widened his scope by asking for the answers from the 'Heaven' through divination and dream. Yi Sun-sin's attitude toward his mother who raised the future hero and maternal principles were considered in concern with the Jungian term 'mother complex'. Won Gyun, Yi Sun-sin's rival admiral, who persistently accused Yi Sun-sin of 'slanders,' certainly represents the unconscious shadow image of Yi Sun-sin. The reciprocal 'shadow' projection has intervened in the conflicting relationship between Yi and Won. In concern to the argument for the suicidal death of Yi Sun-sin, the author found no evidence supporting such an argument, No trace of latent suicidal wish was found in his dreams. For Yi Sun-sin, the determination of the life and death depends on Heaven. 32 dreams from the diary and 3 from other historical references were reviewed and analyzed in the Jungian way. Symbols of anima, Self, and individuation process were found. His dream repeatedly suggests that Yi Sun-sin is an extraordinary man chosen by the divine man (神人). In the dream, Yi Sun-sin was a disciple of the divine man receiving instructions on various strategies, and he alone could see the great thing or events. The dream of a beautiful blue and red dragon, whom he was friendly touching, indicates Yi Sun-sin's eligibility for the kingship. Yi Sun-sin seemingly did not aware of this message of the unconscious. Perhaps he sensed something special but did not identify with 'the disciple of gods' and 'royal dragon' in his dream. His modest attitude toward the dream has prevented him from falling into ego inflation. There were warning signals in two dreams that suggested disorders in the dreamer's instinctive feminine drive. Spirits of the dead father and brothers appear in the dream, giving advice or mourning for the death of Sun-sin's mother. Though Yi Sun-sin was a genuine Confucian gentleman, a dream revealed his unconscious drive to destroy the Confucian authoritative 'Persona' by trampling down the cylindrical traditional Korean hat. To the dreams of synchronicity phenomena Yi Sun-sin immediately solves the problem in concrete reality. He understood dreams as valuable messages from the superior entity, for example, the Confucian Heaven (天) or Heaven's Decree (天命). Furthermore, the 'Heaven' presumably arranged for him the way to the national hero and imposed necessary trials upon him. Both his persecutors and advocates of him guided him in the way of a hero. Yi Sun-sin followed his destiny and completed the living myth of the hero. His mother, King Seon-jo, and prime minister Liu Seong Yong, all have contributed to embodying the myth of the hero. Yi Sun-sin died and became god, the divine healer of the nation.

A Study on the long-term Hemodialysis patient중s hypotension and preventation from Blood loss in coil during the Hemodialysis (장기혈액투석환자의 투석중 혈압하강과 Coil내 혈액손실 방지를 위한 기초조사)

  • 박순옥
    • Journal of Korean Academy of Nursing
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    • v.11 no.2
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    • pp.83-104
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    • 1981
  • Hemodialysis is essential treatment for the chronic renal failure patient's long-term cure and for the patient management before and after kidney transplantation. It sustains the endstage renal failure patient's life which didn't get well despite strict regimen and furthermore it becomes an essential treatment to maintain civil life. Bursing implementation in hemodialysis may affect the significant effect on patient's life. The purpose of this study was to obtain the basic data to solve the hypotension problem encountable to patient and the blood loss problem affecting hemodialysis patient'a anemic states by incomplete rinsing of blood in coil through all process of hemodialysis. The subjects for this study were 44 patients treated hemodialysis 691 times in the hemodialysis unit, The .data was collected at Gang Nam 51. Mary's Hospital from January 1, 1981 to April 30, 1981 by using the direct observation method and the clinical laboratory test for laboratory data and body weight and was analysed by the use of analysis of Chi-square, t-test and anlysis of varience. The results obtained an follows; A. On clinical laboratory data and other data by dialysis Procedure. The average initial body weight was 2.37 ± 0.97kg, and average body weight after every dialysis was 2.33 ± 0.9kg. The subject's average hemoglobin was 7.05±1.93gm/dl and average hematocrit was 20.84± 3.82%. Average initial blood pressure was 174.03±23,75mmHg and after dialysis was 158.45±25.08mmHg. The subject's average blood ion due to blood sample for laboratory data was 32.78±13.49cc/ month. The subject's average blood replacement for blood complementation was 1.31 ±0.88 pint/ month for every patient. B. On the hypotensive state and the coping approaches occurrence rate of hypotension was 28.08%. It was 194 cases among 691 times. 1. In degrees of initial blood pressure, the most 36.6% was in the group of 150-179mmHg, and in degrees of hypotension during dialysis, the most 28.9% in the group of 40-50mmHg, especially if the initial blood pressure was under 180mmHg, 59.8% clinical symptoms appeared in the group of“above 20mmHg of hypotension”. If initial blood pressure was above 180mmHg, 34.2% of clinical symptoms were appeared in the group of“above 40mmHg of hypotension”. These tendencies showed the higher initial blood pressure and the stronger degree of hypotension, these results showed statistically singificant differences. (P=0.0000) 2. Of the occuring times of hypotension,“after 3 hrs”were 29.4%, the longer the dialyzing procedure, the stronger degree of hypotension ann these showed statistically significant differences. (P=0.0142). 3. Of the dispersion of symptoms observed, sweat and flush were 43.3%, and Yawning, and dizziness 37.6%. These were the important symptoms implying hypotension during hemodialysis accordingly. Strages of procedures in coping with hypotension were as follows ; 45.9% were recovered by reducing the blood flow rate from 200cc/min to 1 00cc/min, and by reducing venous pressure to 0-30mmHg. 33.51% were recovered by controling (adjusting) blood flow rate and by infusion of 300cc of 0,9% Normal saline. 4.1% were recovered by infusion of over 300cc of 0.9% normal saline. 3.6% by substituting Nor-epinephiine, 5.7% by substituting blood transfusion, and 7,2% by substituting Albumin were recovered. And the stronger the degree of symptoms observed in hypotention, the more the treatments required for recovery and these showed statistically significant differences (P=0.0000). C. On the effects of the changes of blood pressure and osmolality by albumin and hemofiltration. 1. Changes of blood pressure in the group which didn't required treatment in hypotension and the group required treatment, were averaged 21.5mmHg and 44.82mmHg. So the difference in the latter was bigger than the former and these showed statistically significant difference (P=0.002). On the changes of osmolality, average mean were 12.65mOsm, and 17.57mOsm. So the difference was bigger in the latter than in the former but these not showed statistically significance (P=0.323). 2. Changes of blood pressure in the group infused albumin and in the group didn't required treatment in hypotension, were averaged 30mmHg and 21.5mmHg. So there was no significant differences and it showed no statistical significance (P=0.503). Changes of osmolality were averaged 5.63mOsm and 12.65mOsm. So the difference was smaller in the former but these was no stitistical significance (P=0.287). Changes of blood pressure in the group infused Albumin and in the group required treatment in hypotension were averaged 30mmHg and 44.82mmHg. So the difference was smaller in the former but there is no significant difference (P=0.061). Changes of osmolality were averaged 8.63mOsm, and 17.59mOsm. So the difference were smaller in the former but these not showed statistically significance (P=0.093). 3. Changes of blood pressure in the group iutplemented hemofiltration and in the Uoup didn't required treatment in hypotension were averaged 22mmHg and 21.5mmHg. So there was no significant differences and also these showed no statistical significance (P=0.320). Changes of osmolality were averaged 0.4mOsm and 12.65mOsm. So the difference was smaller in the former but these not showed statistical significance(P=0.199). Changes of blood pressure in the group implemented hemofiltration and in the group required treatment in hypotension were averaged 22mmHg and 44.82mmHg. So the difference was smatter in the former and these showed statistically significant differences (P=0.035). Changes of osmolality were averaged 0.4mOsm and 17.59mOsm. So the difference was smaller in the former but these not showed statistical significance (P=0.086). D. On the changes of body weight, and blood pressure, between the group of hemofiltration and hemodialysis. 1, Changes of body weight in the group implemented hemofiltration and hemodialysis were averaged 3.340 and 3.320. So there was no significant differences and these showed no statistically significant difference, (P=0.185) but standard deviation of body weight averaged in comparison with standard difference of body weight was statistically significant difference (P=0.0000). Change of blood Pressure in the group implemented hemofiltration and hemodialysis were averaged 17.81mmHg and 19.47mmHg. So there was no significant differences and these showed no statistically significant difference (P=0.119), But in comparison with standard deviation about difference of blood pressure was statistically significant difference. (P=0.0000). E. On the blood infusion method in coil after hemodialysis and residual blood losing method in coil. 1, On comparing and analysing Hct of residual blood in coil by factors influencing blood infusion method. Infusion method of saline 200cc reduced residual blood in coil after the quantitative comparison of Saline Occ, 50cc, 100cc, 200cc and the differences showed statistical significance (p < 0.001). Shaking Coil method reduced residual blood in Coil in comparison of Shaking Coil method and Non-Shaking Coil method this showed statistically significant difference (P < 0.05). Adjusting pressure in Coil at OmmHg method reduced residual blood in Coil in comparison of adjusting pressure in Coil at OmmHg and 200mmHg, and this showed statistically significant difference (P < 0.001). 2. Comparing blood infusion method divided into 10 methods in Coil with every factor respectively, there was seldom difference in group of choosing Saline 100cc infusion between Coil at OmmHg. The measured quantity of blood loss was averaged 13.49cc. Shaking Coil method in case of choosing saline 50cc infusion while adjusting pressure in coil at OmmHg was the most effective to reduce residual blood. The measured quantity of blood loss was averaged 15.18cc.

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