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Study for Diagnostic Efficacy of Minibronchoalveolar Lavage in the Detection of Etiologic Agents of Ventilator-associated Pneumonia in Patients Receiving Antibiotics (항생제를 사용하고 있었던 인공호흡기 연관 폐렴환자에서의 원인균 발견을 위한 소량 기관지폐포세척술의 진단적 효용성에 관한 연구)

  • Moon, Doo-Seop;Lim, Chae-Man;Pai, Chik-Hyun;Kim, Mi-Na;Chin, Jae-Yong;Shim, Tae-Sun;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.3
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    • pp.321-330
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    • 1999
  • Background : Early diagnosis and proper antibiotic treatment are very important in the management of ventilator-associated pneumonia (VAP) because of its high mortality. Bronchoscopy with a protected specimen brush (PSB) has been considered the standard method to isolate the causative organisms of VAP. However, this method burdens consumer economically to purchase a PSB. Another useful method for the diagnosis of VAP is quantitative cultures of aspirated specimens through bronchoscopic bronchoalveolar lavage (BAL), for which the infusion of more than 120 m1 of saline has been recommended for adequate sampling of a pulmonary segment. However, occasionally it leads to deterioration of the patient's condition. We studied the diagnostic efficacy of minibronchoalveolar lavage (miniBAL), which retrieves only 25 ml of BAL fluid, in the isolation of causative organisms of VAP. Methods: We included 38 consecutive patients (41 cases) suspected of having VAP on the basis of clinical evidence, who had received antibiotics before the bronchoscopy. The two diagnostic techniques of PSB and miniBAL, which were performed one after another at the same pulmonary segment, 'were compared prospectively. The cut-off values for quantitative cultures to define causative bacteria of VAP were more than $10^3$ colony-forming units (cfu)/ml for PSB and more than $10^4$ cfu/ml for BAL. Results: The amount of instilled normal saline required to retrieve 25 ml of BAL fluid was $93{\pm}32 ml$ (mean${\pm}$SD). The detection rate of causative agents was 46.3% (19/41) with PSB and 43.9% (18/41) with miniBAL. The concordance rate of PSB and miniBAL in the bacterial culture was 85.4% (35/41). Although arterial blood oxygen saturation dropped significantly (p<0.05) during ($92{\pm}10%$) and 10 min after ($95{\pm}3%$) miniBAL compared with the baseline ($97{\pm}3%$), all except 3 cases were within normal ranges. The significantly elevated heart rate during ($l25{\pm}24$/min, p<0.05) miniBAL compared with the baseline ($1l1{\pm}22$/min) recovered again in 10 min after ($111{\pm}26$/min) miniBAL. Transient hypotension was developed during the procedure in two cases. The procedure was stopped in one case due to atrial flutter. Conclusion: MiniBAL is a safe and effective technique to detect the causative organisms of VAP.

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Changes in Fatty Acid Composition of Grain after Milling (곡류 도정에 따른 지방산 조성 변화 연구)

  • Cho, Young-Sook;Kim, Yu-Na;Kim, Su-Yeonk;Kim, Jung-Bong;Kim, Heon-Woong;Kim, Se-Na;Kim, So-Young;Park, Hong-Ju;Kim, Jae-Hyun
    • Korean Journal of Environmental Agriculture
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    • v.30 no.4
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    • pp.409-413
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    • 2011
  • BACKGROUND: Cereals, especially rice is the staple food of oriental nations and because it is very important for Korean food, to determine the extent of nutrient losses due to milling, we analyzed the fatty acid using by GC-FID(Gas Chromatography-Flame Ionization Detector). Experimented rice cereals were rice, glutinous rice, Heuinchalssalbori, Seodunchalbori, Saessalbori, Keunalbori No.1, barnyard millet produced in Korea. METHODS AND RESULTS: After milling, the contents of fatty acids in the rice, glutinous rice, Heuinchalssalbori, and Seodunchalbori, Keunalbori No.1 rather decreased, but in the Saessalbori, and barnyard mille increased. Particularly, fatty acid content of the rice decreased from 24.8 mg/g to 6.4 mg/g, glutinous rice decreased from 29.4 mg/g to 11.7 mg/g after milling. There were also significant changes in the compositions of fatty acid among samples. Stearic acid ($C_{18:0}$) increased from 5% to 15%, but oleic acid ($C_{18:1}$) and linoleic acid ($C_{18:2}$) decreased in the rice after milling. CONCLUSION(s):In the brown rice, 11 different types of fatty acids were detected, and its highest content was found in grains. However, milled grain was observed only seven fatty acids in the case of rice. This result insisted that a portion of the lipid layer was significantly lost during the milling operation in rice.

Liability of the Compensation for Damage Caused by the International Passenger's Carrier by Air in Montreal Convention (몬트리올조약에 있어 국제항공여객운송인의 손해배상책임)

  • Kim, Doo-Hwan
    • The Korean Journal of Air & Space Law and Policy
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    • v.18
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    • pp.9-39
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    • 2003
  • The rule of the Warsaw Convention of 1929 are well known and still being all over the world. The Warsaw Convention is undoubtedly the most widely accepted private international air law treaty with some 140 countries. In the international legal system for air transportation, the Warsaw Convention has played a major role for more than half century, and has been revised many times in consideration of the rapid developments of air high technology, changes of social and economic circumstances, need for the protection of passengers. Some amendments became effective, but others are still not effective. As a result, the whole international legal system for air transportation is at past so complicated and tangled. However, the 'Warsaw system' consists of the Warsaw Convention of 1929 the Guadalajara Convention of 1961, a supplementary convention, and the following six protocols: (1) the Hague Protocol of 1955, (2) the Guatemala Protocol of 1971, (3) the Montreal Additional Protocols, No.1, (4) the Montreal Additional Protocol No.2, (5) the Montreal Additional Protocol No.3, and (6) the Montreal Additional Protocol No.4. of 1975. As a fundamental principle of the air carrier's liability in the international convention and protocols, for instance in the Warsaw Convention and the Hague Protocol, the principle of limited liability and a presumed fault system has been adopted. Subsequently, the Montreal Inter-carrier Agreement of 1966, the Guatemala City Protocol, the Montreal Additional Protocol No.3, and the Montreal Additional Protocol No. 4 of 1975 maintained the limited liability, but substituted the presumed liability system by an absolute liability, that is, strict liability system. The Warsaw System, which sets relatively low compensation limits for victims of aircraft accidents and regulates the limited liability for death and injury of air passengers, had become increasingly outdated. Japanese Airlines and Inter-carrier Agreement of International Air Transport Association in 1995 has been adopted the unlimited liability of air carrier in international flight. The IATA Inter-Carrier Agreement, in which airlines in international air transportation agree to waive the limit of damages, was long and hard in coming, but it was remarkable achievement given the political and economic realities of the world. IATA deserves enormous credit for bringing it about. The Warsaw System is controversial and questionable. In order to find rational solution to disputes between nations which adopted differing liability systems in international air transportation, we need to reform the liability of air carriers the 'Warsaw system' and fundamentally, to unify the liability system among the nations. The International Civil Aviation Organization(ICAO) will therefore reinforce its efforts to further promote a legal environment that adequately reflects the public interest and the needs of the parties involved. The ICAO Study Group met in April, 1998, together with the Drafting Committee. The time between the "Special Group on the Modernization and Consolidation of the 'Warsaw system'(SGMW)" and the Diplomatic Conference must be actively utilized to arrange for profound studies of the outstanding issues and for wide international consultations with a view to narrowing the scope of differences and preparing for a global international consensus. From 11 to 28 May 1999 the ICAO Headquarters at Montreal hosted a Diplomatic Conference convened to consider, with a view to adoption, a draft Convention intended to modernize and to integrate replace the instruments of the Warsaw system. The Council of ICAO convened this Conference under the Procedure for the Adoption of International Conventions. Some 525 participants from 121 Contracting States of ICAO attended, one non-contracting State, 11 observer delegations from international organizations, a total of 544 registered participants took part in the historic three-week conference which began on 10 May. The Conference was a success since it adopted a new Convention for the Unification of Certain Rules for International Carriage by Air. The 1999 Montreal Convention, created and signed by representatives of 52 countries at an international conference convened by ICAO at Montreal on May 28, 1999, came into effect on November 4, 2003. Representatives of 30 countries have now formally ratified the Convention under their respective national procedures and ratification of the United States, which was the 30th country to ratify, took place on September 5, 2003. Under Article 53.6 of the Montreal Convention, it enters into force on the 60th day following the deposit of the 30th instrument of ratification or acceptation. The United States' ratification was deposited with ICAO on September 5, 2003. The ICAO have succeeded in modernizing and consolidating a 70-year old system of international instruments of private international law into one legal instrument that will provide, for years to come, an adequate level of compensation for those involved in international aircraft accidents. An international diplomatic conference on air law by ICAO of 1999 succeeded in adopting a new regime for air carrier liability, replacing the Warsaw Convention and five other related legal instruments with a single convention that provided for unlimited liability in relation to passengers. Victims of international air accidents and their families will be better protected and compensated under the new Montreal Convention, which modernizes and consolidates a seventy-five year old system of international instruments of private international law into one legal instrument. A major feature of the new legal instrument is the concept of unlimited liability. Whereas the Warsaw Convention set a limit of 125,000 Gold Francs (approximately US$ 8,300) in case of death or injury to passengers, the Montreal Convention introduces a two-tier system. The first tier includes strict liability up to l00,000 Special Drawing Rights (SDR: approximately US$ 135,000), irrespective of a carrier's fault. The second tier is based on presumption of fault of a carrier and has no limit of liability. The 1999 Montreal Convention also includes the following main elements; 1. In cases of aircraft accidents, air carriers are called upon to provide advance payments, without delay, to assist entitled persons in meeting immediate economic needs; the amount of this initial payment will be subject to national law and will be deductable from the final settlement; 2. Air carriers must submit proof of insurance, thereby ensuring the availability of financial resources in cases of automatic payments or litigation; 3. The legal action for damages resulting from the death or injury of a passenger may be filed in the country where, at the time of the accident, the passenger had his or her principal and permanent residence, subject to certain conditions. The new Montreal Convention of 1999 included the 5th jurisdiction - the place of residence of the claimant. The acceptance of the 5th jurisdiction is a diplomatic victory for the US and it can be realistically expected that claimants' lawyers will use every opportunity to file the claim in the US jurisdiction - it brings advantages in the liberal system of discovery, much wider scope of compensable non-economic damages than anywhere else in the world and the jury system prone to very generous awards. 4. The facilitation in the recovery of damages without the need for lengthy litigation, and simplification and modernization of documentation related to passengers. In developing this new Montreal Convention, we were able to reach a delicate balance between the needs and interests of all partners in international civil aviation, States, the travelling public, air carriers and the transport industry. Unlike the Warsaw Convention, the threshold of l00,000 SDR specified by the Montreal Convention, as well as remaining liability limits in relation to air passengers and delay, are subject to periodic review and may be revised once every five years. The primary aim of unification of private law as well as the new Montreal Convention is not only to remove or to minimize the conflict of laws but also to avoid conflict of jurisdictions. In order to find a rational solution to disputes between nations which have adopted differing liability systems in international air transport, we need fundamentally to reform their countries's domestic air law based on the new Montreal Convention. It is a desirable and necessary for us to ratify rapidly the new Montreal Convention by the contracting states of lCAO including the Republic of Korea. According to the Korean and Japanese ideas, airlines should not only pay compensation to passengers immediately after the accident, but also the so-called 'condolence' money to the next of kin. Condolence money is a gift to help a dead person's spirit in the hereafter : it is given on account of the grief and sorrow suffered by the next of kin, and it has risen considerably over the years. The total amount of the Korean and Japanese claims in the case of death is calculated on the basis of the loss of earned income, funeral expenses and material demage (baggage etc.), plus condolence money. The economic and social change will be occurred continuously after conclusion of the new Montreal Convention. In addition, the real value of life and human right will be enhanced substantially. The amount of compensation for damage caused by aircraft accident has increased in dollar amount as well as in volume. All air carrier's liability should extend to loss of expectation of leisure activities, as well as to damage to property, and mental and physical injuries. When victims are not satisfied with the amount of the compensation for damage caused by aircraft accident for which an airline corporation is liable under the current liability system. I also would like to propose my opinion that it is reasonable and necessary for us to interpret broadly the meaning of the bodily injury on Article 17 of the new Montreal Convention so as to be included the mental injury and condolence. Furthermore, Korea and Japan has not existed the Air Transport Act regulated the civil liability of air carrier such as Air Transport Act (Luftverkehrsgestz) in Germany. It is necessary for us to enact "the Korean Air Transport Contract Act (provisional title)" in order to regulate the civil liability of air carrier including the protection of the victims and injured persons caused by aircraft accident.

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Attitudes on Medical Market Opening and Factors for Selecting a Foreign Hospital of Korean University Hospital Outpatients (환자들의 의료시장개방에 대한 인식도와 외국병원 선택요인 - S대학교병원 외래환자들을 대상으로 -)

  • Yoon, Yur-Yong;Yu, Seung-Hum;Kim, You-Young;Oh, Hyohn-Joo
    • Korea Journal of Hospital Management
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    • v.8 no.3
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    • pp.32-48
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    • 2003
  • Korea is to open its medical markets to foreign hospitals starting in the year 2006 regardless of our will(DDA, Doha Development Agenda). To accurately understand the characteristics of Korean medical users, their detailed and various needs, their attitudes toward the opening of Korean medical markets, and factors affecting these users in choosing foreign medical service providers would be first step needs to be taken by the Korean medical facilities that need to survive and develope through the fiercely competitive era coming with the opening of Korean medical markets to foreign medical service providers and would be very important in hospital management. The subjects of this study were 500 patients randomly selected from the outpatients who visited one of university hospitals in Seoul on the 14th-16th days of April 2003, and conducted a self-completion questionnaire. The answers of 463 respondents among the selected patients(93% of a responding rate)were analyzed through the Excel and statistics programs. The attitudes on the opening of the medical markets were shown in agreement 56.5%(247 persons), disagreement 6.9%(30 persons), and no idea 36.6%(160 persons). In consideration of only the answers as agreement and disagreement exclusive of the answer as no idea, 89.2% of the respondents agreed to the opening of the medical markets while 10.8% objected to the opening. The approval rate was higher with the higher education and income levels. Moreover, The approval rate for the opening of the medical markets was relatively high regardless of the satisfaction in the medical service, and the most important reason of the agreement was the guarantee of the patients(national)option. The main reason of the disagreement was high medical fee(50.5%), and the other reasons showing low rates were outflow of the domestic fund to the foreign countries(13.6%), damage of medical influences on the public(11.4%), lack of competition of the domestic medical industry(9.1%)and so on. As for the factors of selecting the foreign hospitals in the opening of the medical markets, the patients considered the authority(competency)of doctors firstly, and the other principal factors were worldwide fame and reliance, specific explanation of doctors, modernized medical instruments, convenient consultation procedure, etc. The patients agreed to the opening of the medical markets at a high rate regardless of the satisfaction in the medical service, and the most principal reason of the agreement was the guarantee of the patients(national)option for the medical care. Connected with the factors to select the hospitals, the approval reasons for the opening of the medical markets were the authority(competency)of the doctors as the first one, and then fame and tradition, reliance, overall diagnosis and modernized medical instruments, doctors specific explanation, and so on. However, these factors are actually associated with the Quality of the medical care, and consequently the approval reasons for the opening of the medical markets are connected with the security of the medical care. Accordingly, the guarantee of the patients(national)option answered as the main reason of the agreement can be also understood as the awareness of the right to have a variety of options for the security of the medical quality.

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Attitude Confidence and User Resistance for Purchasing Wearable Devices on Virtual Reality: Based on Virtual Reality Headgears (가상현실 웨어러블 기기의 구매 촉진을 위한 태도 자신감과 사용자 저항 태도: 가상현실 헤드기어를 중심으로)

  • Sohn, Bong-Jin;Park, Da-Sul;Choi, Jaewon
    • Journal of Intelligence and Information Systems
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    • v.22 no.3
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    • pp.165-183
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    • 2016
  • Over the past decade, there has been a rapid diffusion of technological devices and a rising number of various devices, resulting in an escalation of virtual reality technology. Technological market has rapidly been changed from smartphone to wearable devices based on virtual reality. Virtual reality can make users feel real situation through sensing interaction, voice, motion capture and so on. Facebook.com, Google, Samsung, LG, Sony and so on have investigated developing platform of virtual reality. the pricing of virtual reality devices also had decreased into 30% from their launched period. Thus market infrastructure in virtual reality have rapidly been developed to crease marketplace. However, most consumers recognize that virtual reality is not ease to purchase or use. That could not lead consumers to positive attitude for devices and purchase the related devices in the early market. Through previous studies related to virtual reality, there are few studies focusing on why the devices for virtual reality stayed in early stage in adoption & diffusion context in the market. Almost previous studies considered the reasons of hard adoption for innovative products in the viewpoints of Typology of Innovation Resistance, MIR(Management of Innovation Resistant), UTAUT & UTAUT2. However, product-based antecedents also important to increase user intention to purchase and use products in the technological market. In this study, we focus on user acceptance and resistance for increasing purchase and usage promotions of wearable devices related to virtual reality based on headgear products like Galaxy Gear. Especially, we added a variables like attitude confidence as a dimension for user resistance. The research questions of this study are follows. First, how attitude confidence and innovativeness resistance affect user intention to use? Second, What factors related to content and brand contexts can affect user intention to use? This research collected data from the participants who have experiences using virtual rality headgears aged between 20s to 50s located in South Korea. In order to collect data, this study used a pilot test and through making face-to-face interviews on three specialists, face validity and content validity were evaluated for the questionnaire validity. Cleansing the data, we dropped some outliers and data of irrelevant papers. Totally, 156 responses were used for testing the suggested hypotheses. Through collecting data, demographics and the relationships among variables were analyzed through conducting structural equation modeling by PLS. The data showed that the sex of respondents who have experience using social commerce sites (male=86(55.1%), female=70(44.9%). The ages of respondents are mostly from 20s (74.4%) to 30s (16.7%). 126 respondents (80.8%) have used virtual reality devices. The results of our model estimation are as follows. With the exception of Hypothesis 1 and 7, which deals with the two relationships between brand awareness to attitude confidence, and quality of content to perceived enjoyment, all of our hypotheses were supported. In compliance with our hypotheses, perceived ease of use (H2) and use innovativeness (H3) were supported with its positively influence for the attitude confidence. This finding indicates that the more ease of use and innovativeness for devices increased, the more users' attitude confidence increased. Perceived price (H4), enjoyment (H5), Quantity of contents (H6) significantly increase user resistance. However, perceived price positively affect user innovativeness resistance meanwhile perceived enjoyment and quantity of contents negatively affect user innovativeness resistance. In addition, aesthetic exterior (H6) was also positively associated with perceived price (p<0.01). Also projection quality (H8) can increase perceived enjoyment (p<0.05). Finally, attitude confidence (H10) increased user intention to use virtual reality devices. however user resistance (H11) negatively affect user intention to use virtual reality devices. The findings of this study show that attitude confidence and user innovativeness resistance differently influence customer intention for using virtual reality devices. There are two distinct characteristic of attitude confidence: perceived ease of use and user innovativeness. This study identified the antecedents of different roles of perceived price (aesthetic exterior) and perceived enjoyment (quality of contents & projection quality). The findings indicated that brand awareness and quality of contents for virtual reality is not formed within virtual reality market yet. Therefore, firms should developed brand awareness for their product in the virtual market to increase market share.

A study on the medical thought of 'You-Yi(尤怡)' (우이(尤怡)의 의학사상(醫學思想)에 관(關)한 연구(硏究))

  • Jung, Sung-Che;Kim, Ki-Wook;Park, Hyun-Guk
    • The Journal of Dong Guk Oriental Medicine
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    • v.6 no.1
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    • pp.1-34
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    • 1997
  • The present writer studied the medical thought of 'You-Yi(尤怡)', the medical expert of the early 'Qing(淸)' Dynasty, which can be summarized as following. 1. 'You-Yi' writed many essays and treaties about 'Shang-Han-Lun(傷寒論)' and 'Jin-Gui-Yao-Lue(金?要略)', both of which are the writings of 'Zhang-Zhong-Jing(張仲景)', the medical saint of 'Han(漢)' Dynasty, and those writings include 'Shang-Han-Guan-Zhu-Ji(傷寒貫珠集)', 'Jin-Gui-Yao-Lue-Xin-Dian(金?要略心典)', 'Yi-Xue-Dou-Shu-Ji(醫學讀書記)', 'Jin-Gui-Yi(金?翼)', and 'Jing-Xiang-Lou-Yi-An(靜香樓醫案)'. 2. A theory of 'Tai-Yang(太陽)' syndrome, including 'San-Gang-Ding-Li(三綱鼎立)', was proposed by 'Fang-You-Zhi'(方有執)' and 'Yu-Chang(喩昌)' and it came to be one of the leading theory of the 'Shang-Han-Lun', 'You-Yi' rejected their opinions in which they insisted that the 'Feng(風)' hurts the 'Wei'(衛)' and the 'Han(寒)' hurts the 'Ying(營)', and he advocated his particular idea that the 'Xie-Qi'(邪氣)' can directly hit skin, flesh, 'Ying-Wei(營衛)', the Five Organs and the Six Viscera(五臟六腑), regardless of 'Zhong-Feng(中風)' or 'Shang-Han(傷寒)', and he insisted that there is need to be anxious about Whether the 'Ying-Wei' is strong or weak. 3. In 'Shang-Han-Guan-Zhu-Ji', 'You-Yi' invented the eight classifications in treating the 'Shang-Han' and he did not follow the old theories hitherto. He divided the book into six parts via the clinical experiences, and the Classification and Logics in Treatment(辨證論治), and he put several titles on 'Jin-Gui-Yao-Lue. And he newly edited the original text of 'Shang-Han-Lun' and arranged 'Zhong-Jing(仲景)'s Six Meridian(六經) categories. Each syndrome in 'Tai-Yang' 'Yang-Ming(陽明)', 'Shao-Yang(少陽)', 'Tai-Yin'(太陰)', 'Shao-Yin(少陰)' and 'Jue-Yin(厥陰)' has its own categories in treatment. 4. In explaining the Six Meridian(六經) and the Organs and Viscera(臟腑), 'You-Yi' legislated the syndrome in 'Three Yang(三陽)' into Meridian(經) and Viscera(腑) ; the syndrome in 'Three Yin(三陰)'into Meridian(經) and Organs(腑). He also concluded that 'Shang-Han-Lun' not only discussed 'Wai-Gan(外感)' but also included the Internal Hurt(內傷) and Miscellaneous Diseases(雜病). 5. In his academic research, 'You-Yi' followed 'Zhong-Jing' in classifications and prescriptions and succeeded the theory of 'Ma-Chu(마숙)' and 'Li-Zhong-Zi(李中梓)', but was not tied to any stereotyped former practices. He put emphasis on the Spleen(脾) and the Kidney(腎) as he harmonized the Middle Energizer(中焦焦) with the taste of 'Gan(甘)' and 'Wen(溫)' and enjoyed strengthening 'Yang' by benefitting the 'Qi(氣)'. 6. He discussed in detail the causes, mechanism and symptoms on 'Tan-Yin(痰飮)' and proposed the seven categorizes in treatment. 7. He sorted the causes of 'Zhong-Feng' into two kinds of the 'Feng' via 'Wai-Gan' and Internal Hurt, and recognized these two 'Feng's correlate as mutual sources of diseases. He insisted that the origin of the 'Feng' exists in the 'Liver(肝). He also established the eight categories in treating the 'Feng'. 8. 'You-Yi' belong to the classifications and Logical Treatment School. And he, considering he respected and followed 'Zhong-Jing' and 'Li-Zhong-Zi', belongs to the successor to the 'Wen-Bu(溫補)' School. 9. His writings, especially the 'Shang-Han-Guan-Zhu-Ji' and the 'Jin-Gui-Yao-Lue-Xin-Dian', are excellent commentary works on the originals, so they served as significant guide books for many junior scholars. For penetrating the 'Shang-Han-Lun' with his unique way of classification of treatment, he has been highly appreciated by later generations including scholars like 'Tang-Li-San(唐立三)' in the 'Qing' Dynasty, and so many more ones thenceforth. In conclusion, on the base of this study, it is hopefully proposed that the still more profound research on the medical thought of 'You-Yi', as one of the most distinguished scholars, an expert clinician and an earnest writer as well.

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Analysis of Causes for Primary Treatment Failure of Pulmonary Tuberculosis (폐결핵환자에서 초치료실패에 대한 요인 분석)

  • Park, Seung-Kyu;Choi, In-Hwan;Kim, Cheon-Tae;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1234-1244
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    • 1997
  • Background : Nowadays drug resistant tuberculosis is making problems in the treatment of pulmonary tuberculosis and its number is increasing. Several reasons for this are considered including irregular medication, poor drug compliance and wrong regimens. But there are treatment failure cases in spite of regular medication with short-term standard regimens. We reviewed clinical data of 50 patients to find out possible causes of this. Method : Subject of this study was 50 patients who failed in the primary treatment of pulmonary tuberculosis in spite of regular medication with short-term standard regimens. All of them were under treatment with secondary regimens in National Masan Tuberculosis Hospital on Oct 1996. The patient's records were analyzed retrospectively and direct interviews with patients were done. Results : There were relatively more patients in the age of 20th. Male overwhelmed in number. There were smoking in 22 patients and drinking in 24 patients during medication. 17(34%) patients had family history of tuberculosis. Public health center was the most common site for the initial diagnosis among medical institutes. 42 patients had subjective symptoms for pulmonary tuberculosis. 38 patients got sufficient explanation from medical institute about tuberculosis and medication courses. 24 patients had bilateral lesions on chest X-ray film and 43 patients had cavitary lesions. 29 patients had past history for pulmonary tuberculosis with regular medication. The results of drug sensitivity test showed resistance in 41 patients of whom we could get the results. Conclusion : Main cause of treatment failure of pulmonary tuberculosis in spite of regular medication with short-term standard regimens was drug resistance. Several factors were considered to be related to high prevalence of drug resistance, including age of 20th, male, family history for tuberculosis, bilateral lesions or remaining cavitary lesion on chest X-ray film.

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Function of the Korean String Indexing System for the Subject Catalog (주제목록을 위한 한국용어열색인 시스템의 기능)

  • Yoon Kooho
    • Journal of the Korean Society for Library and Information Science
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    • v.15
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    • pp.225-266
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    • 1988
  • Various theories and techniques for the subject catalog have been developed since Charles Ammi Cutter first tried to formulate rules for the construction of subject headings in 1876. However, they do not seem to be appropriate to Korean language because the syntax and semantics of Korean language are different from those of English and other European languages. This study therefore attempts to develop a new Korean subject indexing system, namely Korean String Indexing System(KOSIS), in order to increase the use of subject catalogs. For this purpose, advantages and disadvantages between the classed subject catalog nd the alphabetical subject catalog, which are typical subject ca-alogs in libraries, are investigated, and most of remarkable subject indexing systems, in particular the PRECIS developed by the British National Bibliography, are reviewed and analysed. KOSIS is a string indexing based on purely the syntax and semantics of Korean language, even though considerable principles of PRECIS are applied to it. The outlines of KOSIS are as follows: 1) KOSIS is based on the fundamentals of natural language and an ingenious conjunction of human indexing skills and computer capabilities. 2) KOSIS is. 3 string indexing based on the 'principle of context-dependency.' A string of terms organized accoding to his principle shows remarkable affinity with certain patterns of words in ordinary discourse. From that point onward, natural language rather than classificatory terms become the basic model for indexing schemes. 3) KOSIS uses 24 role operators. One or more operators should be allocated to the index string, which is organized manually by the indexer's intellectual work, in order to establish the most explicit syntactic relationship of index terms. 4) Traditionally, a single -line entry format is used in which a subject heading or index entry is presented as a single sequence of words, consisting of the entry terms, plus, in some cases, an extra qualifying term or phrase. But KOSIS employs a two-line entry format which contains three basic positions for the production of index entries. The 'lead' serves as the user's access point, the 'display' contains those terms which are themselves context dependent on the lead, 'qualifier' sets the lead term into its wider context. 5) Each of the KOSIS entries is co-extensive with the initial subject statement prepared by the indexer, since it displays all the subject specificities. Compound terms are always presented in their natural language order. Inverted headings are not produced in KOSIS. Consequently, the precision ratio of information retrieval can be increased. 6) KOSIS uses 5 relational codes for the system of references among semantically related terms. Semantically related terms are handled by a different set of routines, leading to the production of 'See' and 'See also' references. 7) KOSIS was riginally developed for a classified catalog system which requires a subject index, that is an index -which 'trans-lates' subject index, that is, an index which 'translates' subjects expressed in natural language into the appropriate classification numbers. However, KOSIS can also be us d for a dictionary catalog system. Accordingly, KOSIS strings can be manipulated to produce either appropriate subject indexes for a classified catalog system, or acceptable subject headings for a dictionary catalog system. 8) KOSIS is able to maintain a constistency of index entries and cross references by means of a routine identification of the established index strings and reference system. For this purpose, an individual Subject Indicator Number and Reference Indicator Number is allocated to each new index strings and new index terms, respectively. can produce all the index entries, cross references, and authority cards by means of either manual or mechanical methods. Thus, detailed algorithms for the machine-production of various outputs are provided for the institutions which can use computer facilities.

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The influence of the four noted physicians of Geum-Won era on the completion of the medicine in the Chosun dynasty (금원사대가의학(金元四大家醫學)이 조선조의학(朝鮮朝醫學) 형성(形成)에 미친 영향(影響))

  • Cheong, Myeon;Hong, Won Sik
    • Journal of Korean Medical classics
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    • v.9
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    • pp.432-552
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    • 1996
  • The influence of the four noted physicians of Geum-Won era(金元代) on the completion of the medicine in the Chosun dynasty(朝鮮朝) can be summarized as follows. 1. The four noted physicians of Geum-Won era were Yoo-Wan-So(劉完素), Jang-Jong-Jung(張從正), Lee-Go(李杲), Ju-Jin-Heung(朱震亨). 2. Yoo-Wan-So(劉完索) made his theory on the basic of Nae-Kyung("內經") and Sane-Han-Lon("傷寒論"), his idea of medicine was characterized in his books, for exemple, application of O-Oon-Yuk-Ki(五運六氣), Ju-Wha theory(主火論) and hang-hae-seng-je theory(亢害承制論). from his theory and method of study, many deviations of oriental medicine occurred. He made an effort for study of Nae-Kyung, which had been depressed for many years, on the contrary of the way old study that Nae-Kyung had been only explained or revised, he applied the theory of Nae-Kyung to clinical care. The theory of Yuk-Gi-Byung-Gi(六氣病機) and On-Yeul-Byung(溫熱病) had much influenced on his students and posterities, not to mention Jang-Ja-Wha and Ju-Jin-Heung, who were among the four noted physicians therefore he became the father of Yuk-Gi(六氣) and On-Yeul(溫熱) schools. 3. Jang-Jong-Jung(張從正) emulated Yoo-Wan-So as a model, and followed his Yuk-Gi-Chi-Byung(六氣致病) theory, but he insisted on the use of the chiaphoretic, the emetic and the paregoric to get rid of the causes, specially he insisted on the use of the paregoric, so they called him Gong-Ha-Pa(攻下派). He insisted on the theory that if we would strenthen ourselves we should use food, id get rid of cause, should use the paregoric, emetic and diaphoretic. Jang-Jong-Jung'S Gang-Sim-Wha(降心火) theory, which he improved Yoo-Wan-So's Han-Ryang(寒凉) theory influenced to originate Ju-Jin-Heung'S Ja-Eum-Gang-Wha(滋陰降火) theory. 4. Lee-Go(李杲) insisted on the theory that Bi-Wi(脾胃) played a loading role in the physiological function and pathological change, and that the internal disease was originated by the need of Gi(氣) came from the disorder of digestive organs, and that the causes of internal disease were the irregular meal, the overwork, and mental shock. Lee-Go made an effort for study about the struggle of Jung-Sa(正邪) and in the theory of the prescription he asserted the method of Seung-Yang-Bo-Gi(升陽補氣), but he also used the method of Go-Han-Gang-Wha(苦寒降火). 5. The authors of Eui-Hak-Jung-Jun("醫學正傳"), Eui-Hak-Ib-Moon("醫學入門"), and Man-Byung-Whoi-Choon("萬病回春") analyzed the medical theory of the four noted physicians and added their own experiences. They helped organizing existing complicated theories of the four noted physicians imported in our country, and affected the formation of medical science in the Choson dynasty largely. Eui-Hak-Jung-Jun("醫學正傳") was written by Woo-Dan(虞槫), in this book, he quoted the theories of Yoo-Wan-So, Jang-Jong-Jung, Lee-Go, Ju-Jin-Heung, especially, Ju-Jin-Heung was respected by him, it affected the writing of Eui-Lim-Choal-Yo("醫林撮要"). Eui-Hak-ib-Moon("醫學入門"), written by Lee-Chun(李杲), followed the medical science of Lee-Go and ju-jin-heung from the four noted physicians of Geum-Won era. Its characteristics of Taoism, idea of caring of health, and organization affected Dong-Eui-Bo-Kham("東醫寶鑑"). Gong-Jung-Hyun(龔延賢) wrote Man-Byung-Whoi-Choon("萬病回春") using the best part of the theories of Yoo-Wan-So, Jang-Jong-Jung, Lee-Go, Ju-Jin-Heung, this book affected Dong-Eui-Soo-Se-Bo-Won("東醫壽世保元") partly. 6. our medical science was developed from the experience of the treatment of disease obtained from human life, these medical knowledge was arranged and organized in Hyang-Yak-Jib-Sung-Bang("鄕藥集成方"), medical books imported from China was organized in Eui-Bang-Yoo-Chwi("醫方類聚"), which formed the base of medical development in the Chosun dynasty. 7. Eui-Lim-Choal-Yo("醫林撮要") was written by Jung-Kyung-Sun(鄭敬先) and revised by Yang-Yui-Soo(楊禮壽). It was written on the base of Woo-Dan's Eui-Jung-Jun, which compiled the medical science of the four noted physicians of Geum-Won era. It contained confusing theories of the four noted physicians of Geum-Won era and organized medical books of Myung era, therefore it completed the basic form of Byun-Geung-Non-Chi (辨證論治) influenced the writing of Dong-Eui-Bo-Kham("東醫寶鑑"). 8. Dong-Eui-Bo-Kham("東醫寶鑑") was written on the base of basic theory of Eum-Yang-O-Haeng(陰陽五行) and the theory of respondence of heaven and man(天人相應說) in Nae-Kyung. It contained several theories and knowledge, such as the theory of Essence(精), vitalforce(氣), and spirit(神) of Taoism, medical science of geum-won era, our original medical knowledge and experience. It had established the basic organization of our medical science and completed the Byun-Geung-Non-Chi (辨證論治). Dong-Eui-Bo-Kham developed medical science from simple medical treatment to protective medical science by caring of health. And it also discussed human cultivation and Huh-Joon's(許浚) own view of human life through the book. Dong-Eui-Bo-Kham adopted most part of Lee-Go(李杲) and Ju-Jin-Heung's(朱震亨) theory and new theory of "The kidney is the basis of apriority. The spleen is the basis of posterior", so it emphasized the role of spleen and kidney(脾腎) for Jang-Boo-Byung-Gi(臟腑病機). It contained Ju-Jin-Heung's theory of the cause and treatment of disease by colour or fatness of man(black or white, fat or thin). It also contained Ju-Jin-Heung's theory of "phlegm break out fever, fever break out palsy"(痰生熱 熱生風) and the theory of Sang-Wha(相火論). Dong-Eui-Bo-Kham contained Lee-Go's theory of Wha-Yu-Won-Bool-Yang-Lib (火與元氣不兩立論) quoted the theory of Bi-Wi(脾胃論) and the theory of Nae-Oi-Sang-Byun(內外傷辨). For the use of medicine, it followed the theory by Lee-Go. lt used Yoo-Wan-So'S theory of Oh-Gi-Kwa-Keug-Gae-Wi-Yul-Byung(五志過極皆爲熱病) for the treatment of hurt-spirit(傷神) because fever was considered as the cause of disease. It also used Jang-Jons-Jung's theory of Saeng-Keug-Je-Seung(生克制勝) for the treatment of mental disease. 9. Lee-je-ma's Dong-Eui-Soo-Se-Bo-Won("東醫壽世保元") adopted medical theories of Song-Won-Myung era and analyzed these theories using the physical constitutional theory of Sa-Sang-In(四象人). It added Dong-Mu's main idea to complete the theory and clinics of Sa-Sang-Eui-Hak(四象醫學). Lee-Je-Ma didn't quote the four noted physicians of Geum-Won era to discuss that the physical constitutional theory of disease and medicine from Tae-Eum-In(太陰人), So-Yang-In(少陽人), So-Eum-In(少陰人), and Tae-Yang-In(太陽人) was invented from their theories.

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An International Collaborative Program To Discover New Drugs from Tropical Biodiversity of Vietnam and Laos

  • Soejarto, Djaja D.;Pezzuto, John M.;Fong, Harry H.S.;Tan, Ghee Teng;Zhang, Hong Jie;Tamez, Pamela;Aydogmus, Zeynep;Chien, Nguyen Quyet;Franzblau, Scott G.;Gyllenhaal, Charlotte;Regalado, Jacinto C.;Hung, Nguyen Van;Hoang, Vu Dinh;Hiep, Nguyen Tien;Xuan, Le Thi;Hai, Nong Van;Cuong, Nguyen Manh;Bich, Truong Quang;Loc, Phan Ke;Vu, Bui Minh;Southavong, Boun Hoong
    • Natural Product Sciences
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    • v.8 no.1
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    • pp.1-15
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    • 2002
  • An International Cooperative Biodiversity Group (ICBG) program based at the University of Illinois at Chicago initiated its activities in 1998, with the following specific objectives: (a) inventory and conservation of of plants of Cuc Phuong National Park in Vietnam and of medicinal plants of Laos; (b) drug discovery (and development) based on plants of Vietnam and Laos; and (c) economic development of communities participating in the ICBG project both in Vietnam and Laos. Member-institutions and an industrial partner of this ICBG are bound by a Memorandum of Agreement that recognizes property and intellectual property rights, prior informed consent for access to genetic resources and to indigenous knowledge, the sharing of benefits that may arise from the drug discovery effort, and the provision of short-term and long-term benefits to host country institutions and communities. The drug discovery effort is targeted to the search for agents for therapies against malaria (antimalarial assay of plant extracts, using Plasmodium falciparum clones), AIDS (anti-HIV-l activity using HOG.R5 reporter cell line (through transactivation of the green fluorescent protein/GFP gene), cancer (screening of plant extracts in 6 human tumor cell lines - KB, Col-2, LU-l, LNCaP, HUVEC, hTert-RPEl), tuberculosis (screening of extracts in the microplate Alamar Blue assay against Mycobacterium tuberculosis $H_{37}Ra\;and\;H_{37}Rv),$ all performed at UIC, and CNS-related diseases (with special focus on Alzheimer's disease, pain and rheumatoid arthritis, and asthma), peformed at Glaxo Smith Kline (UK). Source plants were selected based on two approaches: biodiversity-based (plants of Cuc Phuong National Park) and ethnobotany-based (medicinal plants of Cuc Phuong National Park in Vietnam and medicinal plants of Laos). At mc, as of July, 2001, active leads had been identified in the anti-HIV, anticancer, antimalarial, and anti- TB assay, after the screening of more than 800 extracts. At least 25 biologically active compounds have been isolated, 13 of which are new with anti-HIV activity, and 3 also new with antimalarial activity. At GSK of 21 plant samples with a history of use to treat CNS-related diseases tested to date, a number showed activity against one or more of the CNS assay targets used, but no new compounds have been isolated. The results of the drug discovery effort to date indicate that tropical plant diversity of Vietnam and Laos unquestionably harbors biologically active chemical entities, which, through further research, may eventually yield candidates for drug development. Although the substantial monetary benefit of the drug discovery process (royalties) is a long way off, the UIC ICBG program provides direct and real-term benefits to host country institutions and communities.