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A Study on the 'Zhe Zhong Pai'(折衷派) of the Traditional Medicine of Japan (일본(日本) 의학醫學의 '절충파(折衷派)'에 관(關)한 연구(硏究))

  • Park, Hyun-Kuk;Kim, Ki-Wook
    • Journal of Korean Medical classics
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    • v.20 no.3
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    • pp.121-141
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    • 2007
  • The outline and characteristics of the important doctors of the 'Zhe Zhong Pai'(折衷派) are as follows. Part 1. In the late Edo(江戶) period The 'Zhe Zhong Pai', which tried to take the theory and clinical treatment of the 'Hou Shi Pai (後世派)' and the 'Gu Fang Pai (古方派)' and get their strong points to make treatments perfect, appeared. Their point was 'The main part is the art of the ancients, The latter prescriptions are to be used'(以古法爲主, 後世方爲用) and the "Shang Han Lun(傷寒論)" was revered for its treatments but in actual use it was not kept at that. As mentioned above The 'Zhe Zhong Pai ' viewed treatments as the base, which was the view of most doctors in the Edo period, However, the reason the 'Zhe Zhong Pai' is not valued as much as the 'Gu Fang Pai' by medical history books in Japan is because the 'Zhe Zhong Pai' does not have the substantiation or uniqueness of the 'Gu Fang Pai', and also because the view of 'gather as well as store up' was the same as the 'Kao Zheng Pai', Moreover, the 'compromise'(折衷) point of view was from taking in both Chinese and western medical knowledge systems(漢蘭折衷), Generally the pioneer of the 'Zhe Zhong Pai' is seen as Mochizuki Rokumon(望月鹿門) and after that was Fukui Futei(福井楓亭), Wadato Kaku(和田東郭), Yamada Seichin(山田正珍) and Taki Motohiro(多紀元簡), Part 2. The lives of Wada Tokaku(和田東郭), Nakagame Kinkei(中神琴溪), Nei Teng Xi Zhe(內藤希哲), the important doctors of the 'Zhe Zhong Pai', are as follows First. Wada Tokaku(和田東郭, 1743-1803) was born when the 'Hou Shi Pai' was already declining and the 'Gu Fang Pai' was flourishing and learned medicine from a 'Hou Shi Pai' doctor, Hu Tian Xu Shan(戶田旭山) and a 'Gu Fang Pai' doctor, Yoshimasu Todo(吉益東洞). He was not hindered by 'the old ways(古方), and did not lean towards 'the new ways(後世方)' and formed a way of compromise that 'looked at hardness and softness as the same'(剛柔相摩) by setting 'the cure of the disease' as the base, and said that to cure diseases 'the old way' must be used, but 'the new way' was necessary to supplement its shortcomings. His works include "Dao Shui Suo Yan", "Jiao Chiang Fang Yi Je" and "Yi Xue Sho(醫學說)" Second. Nakagame Kinkei(中神琴溪, 1744-1833) was famous for leaving Yoshirnasu Todo(吉益東洞) and changing to the 'Zhe Zhong Pai', and in his early years used qing fen(輕粉) to cure geisha(妓女) of syphilis. His argument was "the "Shang Han Lun" must be revered but needs to be adapted", "Zhong jing can be made into a follower but I cannot become his follower", "the later medical texts such as "Ru Men Shi Qin(儒門事親)" should only be used for its prescriptions and not its theories". His works include "Shang Han Lun Yue Yan(傷寒論約言) Third. Nei Teng Xi Zhe(內藤希哲, 1701-1735) learned medicine from Qing Shui Xian Sheng(淸水先生) and went out to Edo. In his book "Yi Jing Jie Huo Lun(醫經解惑論)" he tells of how he went from 'learning'(學) to 'skepticism'(惑) and how skepticism made him learn in 'the six skepticisms'(六惑). In the latter years Xi Zhe(希哲) combines the "Shen Nong Ben Cao jing(神農本草經)", the main text for herbal medicine, "Ming Tang jing(明堂經)" of accupuncture, basic theory texts "Huang Dui Nei jing(黃帝內徑)" and "Nan jing(難經)" with the "Shang Han Za Bing Lun", a book that the 'Gu Fang Pai' saw as opposing to the rest, and became 'an expert of five scriptures'(五經一貫). Part 3. Asada Showhaku(淺田宗伯, 1815-1894) started medicine at Zhong Cun Zhong(中村中倧) and learned 'the old way'(古方) from Yoshirnasu Todo and got experience through Chuan Yue(川越) and Fu jing(福井) and received teachings in texts, history and Wang Yangmin's principles(陽明學) from famous teachers. Showhaku(宗伯) meets a medical official of the makufu(幕府), Ben Kang Zong Yuan(本康宗圓), and recieves help from the 3 great doctors of the Edo period, Taki Motokato(多紀元堅), Xiao Dao Xue GU(小島學古) and Xi Duo Cun Kao Chuang and further develops his arts. At 47 he diagnoses the general Jia Mao(家茂) with 'heart failure from beriberi'(脚氣衝心) and becomes a Zheng Shi(徵I), at 51 he cures a minister from France and received a present from Napoleon, at 65 he becomes the court physician and saves Ming Gong(明宮) jia Ren Qn Wang(嘉仁親王, later the 大正犬皇) from bodily convulsions and becomes 'the vassal of merit who saved the national polity(國體)' At the 7th year of the Meiji(明治) he becomes the 2nd owner of Wen Zhi She(溫知社) and takes part in the 'kampo continuation movement'. In his latter years he saw 14000 patients a year, so we can estimate the quality and quantity of his clinical skills Showhaku(宗伯) wrote over 80 books including the "Ju Chuang Shu Ying(橘窓書影)", "WU Wu Yao Shi Fang Han(勿誤藥室方函)", "Shang Han Biang Shu(傷寒辨術)", "jing Qi Shen Lun(精氣神論)", "Hunag Guo Ming Yi Chuan(皇國名醫傳)" and the "Xian Jhe Yi Hua(先哲醫話)". Especially in the "Ju Chuang Shu Ying(橘窓書影)" he says "the old theories are the main, and the new prescriptions are to be used"(以古法爲主, 後世方爲用), stating the 'Zhe Zhong Pai' way of thinking. In the first volume of "Shung Han Biang Shu(傷寒辨術) and "Za Bing Lun Shi(雜病論識)", 'Zong Ping'(總評), He discerns the parts that are not Zhang Zhong Jing's writings and emphasizes his theories and practical uses.

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Psychotherapy for Somatoform Disorder (신체형 장애의 정신치료)

  • Lee, Moo-Suk
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.2
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    • pp.269-276
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    • 1996
  • A theroretical study was made on the psychodynamism of somatoform disorder. Somatoform disorder is caused by a defense mechanism of somatization. Somatization is the tendency to react to stimuli(drives, defenses, and conflict between them) physically rather than psychically(Moore, 1990). Ford(1983) said it is a way of life, and Dunbar(1954) said it is the shift of psychic energy toward expression in somatic symptoms. As used by Max Shur(1955), somatization links symptom formation to the regression that may occur in response to acute and chronic conflict. In the neurotic individual psychic conflict often provokes regressive phenomena that may include somatic manifestations characteristic of an earlier developmental phase. Schur calls this resomatization. Pain is the most common example of a somatization reaction to conflict. The pain has an unconscious significance derived from childhood experiences. It is used to win love, to punish misdeeds, as well as a means to amend. Among all pains, chest pain has a special meaning. Generally speaking, 'I have pain in my chest' is about the same as 'I have pain in my mind'. The chest represent the mind, and the mind reminds us about the heart. So we have a high tendency to recognize mental pain as cardiac pain. Kellner(1990) said rage and hostility, especially repressed hostility, are important factors in somatization. In 'Psychoanalytic Observation on Cardiac Pain', psychoanalyst Bacon(1953) presented clinical cases of patients who complained of cardiac pain in a psychoanalytic session that spread from the left side of their chests down their left arms. The pain was from rage and fear which came after their desire to be loved was frustrated by the analyet. She said desires related to cardiac pain were dependency needs and aggressions. Empatic relationship and therapeutic alliances are indispensable to psychotherapy in somatoform disorder. The beginning of therapy is to discover a precipitating event from the time their symptoms have started and to help the patient understand a relation between the symptom and precipitating event. Its remedial process is to find and interpret a intrapsychic conflict shown through the symptoms of the patient. Three cases of somatoform disorder patients treated based on this therapeutic method were introduced. The firt patient, Mr. H, had been suffering from hysterical aphasia with repressed rage as ie psychodynamic cause. An interpretation related to the precipitating event was given by written communication, and he recovered from his aphasia after 3 days of the session. The second patient was a dentist in a cardiac neurosis with agitation and hypochondriasis, whose psychodynamism was caused by a fear that he might lose his father's love. His symptom was also interpreted in relation to the precipitating event. It showed the patient a child-within afraid of losing his father's love. His condition improved after getting a didactic interpretation which told him, to be master of himself, The third patient was a lady transferred from the deparment of internal medicine. She had a frequent and violent fit of chest pains, whose psychodynamic cause was separation anxiety and a rage due to the frustration of dependency needs. Her symptom vanished dramatically when she wore a holler EKG monitor and did not occur during monitoring. By this experience she found her symptom was a psychogenic one, and a therapeutic alliance was formed. later in reguar psychotherapy sessions, she was told the relaton between symptoms and precipitating events. Through this she understood that her separation anxiety was connected to the symptom and she became less terrifide when it occurred. Now she can travel abroad and take well part in social activities.

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Study on the Dietary Habit, Nutrient Intake, and Health Status According to Their Majors Among College Women in Sahmyook University (삼육대학교 여대생의 전공에 따른 식습관, 영양소섭취상태 및 건강습관에 관한 비교)

  • Chung, Keun-Hee;Shin, Kyung-Ok;Jung, Tae-Hwan;Choi, Kyung-Soon;Jeon, Woo-Min;Chung, Dong-Keun;Lee, Dong-Sup
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.39 no.6
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    • pp.826-836
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    • 2010
  • This study was conducted to compare the dietary habits, nutrient intake and health status of female college students at Sahmyook University according to their majors. Specifically, women majoring in literature and science (77), food and nutrition (103) and sport (73) were evaluated. College women in the sports department were more likely to have a part-time job and had greater expenses than women in the other departments. The average height of college women in the sports department (164.3${\pm}$4.6 cm) was 2.04 cm taller than that of women with other majors (162.3${\pm}$4.7 cm). College women in the department of literature and science were more likely to have an unbalanced diet, even though they commonly ate small amounts of fruit as snacks. They were more prone to take nutrient tablets and vitamins when compared to women in the other departments. College women in the department of sport were more likely to have unbalanced meals (31.5%) and to overeat. Students in the department of food and nutrition ate more fruit, vitamin C and E but less cholesterol containing foods (p<0.05), less fast food and fried food than students in the other departments. The subjects in the department of sport ate less bread, sweet potatoes, fast foods and fried foods but more calories, fat, vitamin A, vitamin B, niacin, Ca, P and cholesterol than students in the other departments (p<0.05). They were also more likely to exercise for more than two hours a day. The most common problems among college women were going without meals, eating an unbalanced diet, overeating, intake of ill-balanced nutrients and lack of exercise. It was found that college women in the department of sport had a better intake of nutrients and maintained healthier life styles.

Correlation analysis of radiation therapy position and dose factors for left breast cancer (좌측 유방암의 방사선치료 자세와 선량인자의 상관관계 분석)

  • Jeon, Jaewan;Park, Cheolwoo;Hong, Jongsu;Jin, Seongjin;Kang, Junghun
    • The Journal of Korean Society for Radiation Therapy
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    • v.29 no.1
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    • pp.37-48
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    • 2017
  • Purpose: The most basic conditions of radiation therapy is to prevent unnecessary exposure of normal tissue. The risk factors that are important o evaluate the dose emitted to the lung and heart from radiation therapy for breast cancer. Therefore, comparing the dose factors of a normal tissue according to the radion treatment position and Seeking an effective radiation treatment for breast cancer through the analysis of the correlation relationship. Materials and Methods: Computed tomography was conducted among 30 patients with left breast cancer in supine and prone position. Eclipse Treatment Planning System (Ver.11) was established by computerized treatment planning. Using the DVH compared the incident dose to normal tissue by position. Based on the result, Using the SPSS (ver.18) analyzed the dose in each normal tissue factors and Through the correlation analysis between variables, independent sample test examined the association. Finally The HI, CI value were compared Using the MIRADA RTx (ver. ad 1.6) in the supine, prone position Results: The results of computerized treatment planning of breast cancer in the supine position were V20, $16.5{\pm}2.6%$ and V30, $13.8{\pm}2.2%$ and Mean dose, $779.1{\pm}135.9cGy$ (absolute value). In the prone position it showed in the order $3.1{\pm}2.2%$, $1.8{\pm}1.7%$, $241.4{\pm}138.3cGy$. The prone position showed overall a lower dose. The average radiation dose 537.7 cGy less was exposured. In the case of heart, it showed that V30, $8.1{\pm}2.6%$ and $5.1{\pm}2.5%$, Mean dose, $594.9{\pm}225.3$ and $408{\pm}183.6cGy$ in the order supine, prone position. Results of statistical analysis, Cronbach's Alpha value of reliability analysis index is 0.563. The results of the correlation analysis between variables, position and dose factors of lung is about 0.89 or more, Which means a high correlation. For the heart, on the other hand it is less correlated to V30 (0.488), mean dose (0.418). Finally The results of independent samples t-test, position and dose factors of lung and heart were significantly higher in both the confidence level of 99 %. Conclusion: Radiation therapy is currently being developed state-of-the-art linear accelerator and a variety of treatment plan technology. The basic premise of the development think normal tissue protection around PTV. Of course, if you treat a breast cancer patient is in the prone position it take a lot of time and reproducibility of set-up problems. Nevertheless, As shown in the experiment results it is possible to reduce the dose to enter the lungs and the heart from the prone position. In conclusion, if a sufficient treatment time in the prone position and place correct confirmation will be more effective when the radiation treatment to patient.

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APPLICATION OF FUZZY SET THEORY IN SAFEGUARDS

  • Fattah, A.;Nishiwaki, Y.
    • Proceedings of the Korean Institute of Intelligent Systems Conference
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    • 1993.06a
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    • pp.1051-1054
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    • 1993
  • The International Atomic Energy Agency's Statute in Article III.A.5 allows it“to establish and administer safeguards designed to ensure that special fissionable and other materials, services, equipment, facilities and information made available by the Agency or at its request or under its supervision or control are not used in such a way as to further any military purpose; and to apply safeguards, at the request of the parties, to any bilateral or multilateral arrangement, or at the request of a State, to any of that State's activities in the field of atomic energy”. Safeguards are essentially a technical means of verifying the fulfilment of political obligations undertaken by States and given a legal force in international agreements relating to the peaceful uses of nuclear energy. The main political objectives are: to assure the international community that States are complying with their non-proliferation and other peaceful undertakings; and to deter (a) the diversion of afeguarded nuclear materials to the production of nuclear explosives or for military purposes and (b) the misuse of safeguarded facilities with the aim of producing unsafeguarded nuclear material. It is clear that no international safeguards system can physically prevent diversion. The IAEA safeguards system is basically a verification measure designed to provide assurance in those cases in which diversion has not occurred. Verification is accomplished by two basic means: material accountancy and containment and surveillance measures. Nuclear material accountancy is the fundamental IAEA safeguards mechanism, while containment and surveillance serve as important complementary measures. Material accountancy refers to a collection of measurements and other determinations which enable the State and the Agency to maintain a current picture of the location and movement of nuclear material into and out of material balance areas, i. e. areas where all material entering or leaving is measurab e. A containment measure is one that is designed by taking advantage of structural characteristics, such as containers, tanks or pipes, etc. To establish the physical integrity of an area or item by preventing the undetected movement of nuclear material or equipment. Such measures involve the application of tamper-indicating or surveillance devices. Surveillance refers to both human and instrumental observation aimed at indicating the movement of nuclear material. The verification process consists of three over-lapping elements: (a) Provision by the State of information such as - design information describing nuclear installations; - accounting reports listing nuclear material inventories, receipts and shipments; - documents amplifying and clarifying reports, as applicable; - notification of international transfers of nuclear material. (b) Collection by the IAEA of information through inspection activities such as - verification of design information - examination of records and repo ts - measurement of nuclear material - examination of containment and surveillance measures - follow-up activities in case of unusual findings. (c) Evaluation of the information provided by the State and of that collected by inspectors to determine the completeness, accuracy and validity of the information provided by the State and to resolve any anomalies and discrepancies. To design an effective verification system, one must identify possible ways and means by which nuclear material could be diverted from peaceful uses, including means to conceal such diversions. These theoretical ways and means, which have become known as diversion strategies, are used as one of the basic inputs for the development of safeguards procedures, equipment and instrumentation. For analysis of implementation strategy purposes, it is assumed that non-compliance cannot be excluded a priori and that consequently there is a low but non-zero probability that a diversion could be attempted in all safeguards ituations. An important element of diversion strategies is the identification of various possible diversion paths; the amount, type and location of nuclear material involved, the physical route and conversion of the material that may take place, rate of removal and concealment methods, as appropriate. With regard to the physical route and conversion of nuclear material the following main categories may be considered: - unreported removal of nuclear material from an installation or during transit - unreported introduction of nuclear material into an installation - unreported transfer of nuclear material from one material balance area to another - unreported production of nuclear material, e. g. enrichment of uranium or production of plutonium - undeclared uses of the material within the installation. With respect to the amount of nuclear material that might be diverted in a given time (the diversion rate), the continuum between the following two limiting cases is cons dered: - one significant quantity or more in a short time, often known as abrupt diversion; and - one significant quantity or more per year, for example, by accumulation of smaller amounts each time to add up to a significant quantity over a period of one year, often called protracted diversion. Concealment methods may include: - restriction of access of inspectors - falsification of records, reports and other material balance areas - replacement of nuclear material, e. g. use of dummy objects - falsification of measurements or of their evaluation - interference with IAEA installed equipment.As a result of diversion and its concealment or other actions, anomalies will occur. All reasonable diversion routes, scenarios/strategies and concealment methods have to be taken into account in designing safeguards implementation strategies so as to provide sufficient opportunities for the IAEA to observe such anomalies. The safeguards approach for each facility will make a different use of these procedures, equipment and instrumentation according to the various diversion strategies which could be applicable to that facility and according to the detection and inspection goals which are applied. Postulated pathways sets of scenarios comprise those elements of diversion strategies which might be carried out at a facility or across a State's fuel cycle with declared or undeclared activities. All such factors, however, contain a degree of fuzziness that need a human judgment to make the ultimate conclusion that all material is being used for peaceful purposes. Safeguards has been traditionally based on verification of declared material and facilities using material accountancy as a fundamental measure. The strength of material accountancy is based on the fact that it allows to detect any diversion independent of the diversion route taken. Material accountancy detects a diversion after it actually happened and thus is powerless to physically prevent it and can only deter by the risk of early detection any contemplation by State authorities to carry out a diversion. Recently the IAEA has been faced with new challenges. To deal with these, various measures are being reconsidered to strengthen the safeguards system such as enhanced assessment of the completeness of the State's initial declaration of nuclear material and installations under its jurisdiction enhanced monitoring and analysis of open information and analysis of open information that may indicate inconsistencies with the State's safeguards obligations. Precise information vital for such enhanced assessments and analyses is normally not available or, if available, difficult and expensive collection of information would be necessary. Above all, realistic appraisal of truth needs sound human judgment.

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Validity and Pertinence of Administrative Capital City Proposal (행정수도 건설안의 타당성과 시의성)

  • 김형국
    • Journal of the Korean Geographical Society
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    • v.38 no.2
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    • pp.312-323
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    • 2003
  • This writer absolutely agrees with the government that regional disequilibrium is severe enough to consider moving the administrative capital. Pursuing this course solely to establish a balanced development, however, is not a convincing enough reason. The capital city is directly related to not only the social and economic situation but, much more importantly, to the domestic political situation as well. In the mid-1970s, the proposal by the Third Republic to move the capital city temporarily was based completely on security reasons. At e time, the then opposition leader Kim, Dae-jung said that establishing a safe distance from the demilitarized zone(DMZ) reflected a typically military decision. His view was that retaining the capital city close to the DMZ would show more consideration for the will of the people to defend their own country. In fact, independent Pakistan moved its capital city from Karachi to Islamabad, situated dose to Kashmir the subject of hot territorial dispute with India. It is regrettable that no consideration has been given to the urgent political situation in the Korean peninsula, which is presently enveloped in a dense nuclear fog. As a person requires health to pursue his/her dream, a country must have security to implement a balanced territorial development. According to current urban theories, the fate of a country depends on its major cities. A negligently guarded capital city runs the risk of becoming hostage and bringing ruin to the whole country. In this vein, North Koreas undoubted main target of attack in the armed communist reunification of Korea is Seoul. For the preservation of our state, therefore, it is only right that Seoul must be shielded to prevent becoming hostage to North Korea. The location of the US Armed Forces to the north of the capital city is based on the judgment that defense of Seoul is of absolute importance. At the same time, regardless of their different standpoints, South and North Korea agree that division of the Korean people into two separate countries is abnormal. Reunification, which so far has defied all predictions, may be realized earlier than anyone expects. The day of reunification seems to be the best day for the relocation of the capital city. Building a proper capital city would take at least twenty years, and a capital city cannot be dragged from one place to another. On the day of a free and democratic reunification, a national agreement will be reached naturally to find a nationally symbolic city as in Brazil or Australia. Even if security does not pose a problem, the governments way of thinking would not greatly contribute to the balanced development of the country. The Chungcheon region, which is earmarked as the new location of the capital city, has been the greatest beneficiary of its proximity to the capital region. Not being a disadvantaged region, locating the capital city there would not help alleviate regional disparity. If it is absolutely necessary to find a candidate region at present, considering security, balanced regional development and post-reunification scenario of the future, Cheolwon area located in the middle of the Korean peninsula may be a plausible choice. Even if the transfer of capital is delayed in consideration of the present political conflict between the South and the North Koreas, there is a definite shortcut to realizing a balanced regional development. It can be found not in the geographical dispersal of the central government, but in the decentralization of power to the provinces. If the government has surplus money to build a new symbolic capital city, it is only right that it should improve, for instance, the quality of drinking water which now everyone eschews, and to help the regional subway authority whose chronic deficit state resoled in a recent disastrous accident. And it is proper to time the transfer of capital city to coincide with that of the reunification of Korea whenever Providence intends.

A Study on the Archives and Records Management in Korea - Overview and Future Direction - (한국의 기록관리 현황 및 발전방향에 관한 연구)

  • Han, Sang-Wan;Kim, Sung-Soo
    • Journal of Korean Society of Archives and Records Management
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    • v.2 no.2
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    • pp.1-38
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    • 2002
  • This study examines the status quo of Korean archives and records management from the Governmental as well as professional activities for the development of the field in relation to the new legislation on records management. Among many concerns, this study primarily explores the following four perspectives: 1) the Government Archives and Records Services; 2) the Korean Association of Archives; 3) the Korean Society of Archives and Records Management; 4) the Journal of Korean Society of Archives and Records Management. One of the primary tasks of the is to build the special depository within which the Presidential Library should be located. As a result, the position of the GARS can be elevated and directed by an official at the level of vice-minister right under a president as a governmental representative of managing the public records. In this manner, GARS can sustain its independency and take custody of public records across government agencies. made efforts in regard to the preservation of paper records, the preservation of digital resources in new media formats, facilities and equipments, education of archivists and continuing, training of practitioners, and policy-making of records preservation. For further development, academia and corporate should cooperate continuously to face with the current problems. has held three international conferences to date. The topics of conferences include respectively: 1) records management and archival education of Korea, Japan, and China; 2) knowledge management and metadata for the fulfillment of archives and information science; and 3) electronic records management and preservation with the understanding of ongoing archival research in the States, Europe, and Asia. The Society continues to play a leading role in both of theory and practice for the development of archival science in Korea. It should also suggest an educational model of archival curricula that fits into the Korean context. The Journals of Records Management & Archives Society of Korea have been published on the six major topics to date. Findings suggest that "Special Archives" on regional or topical collections are desirable because it can house subject holdings on specialty or particular figures in that region. In addition, archival education at the undergraduate level is more desirable for Korean situations where practitioners are strongly needed and professionals with master degrees go to manager positions. Departments of Library and Information Science in universities, therefore, are needed to open archival science major or track at the undergraduate level in order to meet current market demands. The qualification of professional archivists should be moderate as well.

One-stop Evaluation Protocol of Ischemic Heart Disease: Myocardial Fusion PET Study (허혈성 심장 질환의 One-stop Evaluation Protocol: Myocardial Fusion PET Study)

  • Kim, Kyong-Mok;Lee, Byung-Wook;Lee, Dong-Wook;Kim, Jeong-Su;Jang, Yeong-Do;Bang, Chan-Seok;Baek, Jong-Hun;Lee, In-Su
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.33-37
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    • 2010
  • Purpose: In the early stage of using PET/CT, it was used to damper revision but recently shows that CT with MDCT is commonly used and works well for an anatomical diagnosis. This hospital makes the accuracy and convenience more higher in the diagnosis and evaluate of coronary heart disease through concurrently running myocardial perfusion SPECT examination, myocardial PET examination with FDG, and CT coronary artery CT angiography(coronary CTA) used PET/CT with 64-slice. This report shows protocol and image based on results from about 400 coronary heart disease examinations since having 64 channels PET/CT in July 2007. Materials and Methods: An Equipment for this examination is 64-slice CT and Discovery VCT (DVCT) that is consisted of PET with BGO ($Bi_4Ge_3O_{12}$) scintillation crystal by GE health care. First myocardial perfusion SPECT with pharmacologic stress test to reduce waiting time of a patient and get a quick diagnosis and evaluation, and right after it, myocardial FDG PET examination and coronary CTA run without a break. One-stop evaluation protocol of ischemic heart disease is as follows. 1)Myocardial perfusion SPECT with pharmacologic stress: A patient is injected with $^{99m}Tc$-MIBI 10 mCi and does not have any fatty food for myocardial PET examination and drink natural water with ursodeoxcholic acid 100 mg and we get SPECT image in an hour. 2)Myocardial FDG PET: To reduce blood fatty content and to increase uptake of FDG, we used creative oral glucose load using insulin and Acipimox to according to blood acid content. A patient is injected with $^{18}F$-FDG 5 mCi for reduction of his radiation exposure and we get a gated image an hour later and get delay image when we need. 3) Coronary CTA: The most important point is to control heart rate and to get cooperation of patient's breath. In order to reduce a heart rate of him or her below 65 beats, let him or her take beta blocker 50 mg ~ 200 mg after a consultation with a doctor about it and have breath-practices then have the examination. Right before the examination, we spray isosorbide dinitrate 3 to 5 times to lower tension of bessel wall and to extension a blood wall of a patient. It makes to get better the shape of an anatomy. At filming, a patient is injected CT contrast with high pressure and have enough practices before the examination in order to have no problem. For reduction of his radiation exposure, we have to do ECG-triggered X-ray tube modulation exposure. Results: We evaluate coronary artery stenosis through coronary CTA and study correlation (culprit vessel check) of a decline between stenosis and perfusion from the myocardial perfusion SPECT with pharmacologic stress, coronary CTA, and can check viability of infarction or hibernating myocardium by FDG PET. Conclusion: The examination makes us to set up a direction of remedy (drug treatment, PCI, CABG) because we can estimate of effect from remedy, lesion site and severity. In addition, we have an advantage that it takes just 3 hours and one-stop in that all of process of examinations run in succession and at the same time. Therefore it shows that the method is useful in one stop evaluation of ischemic heart disease.

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Clinical Analysis of Arteriovenous Fistula in Chronic Renal Failure Patients (만성 신부전 환자에서의 동정맥루 조성술의 임상고찰)

  • Song Chang-Min;Ahn Jae-Bum;Kim In-Sub;Kim Woo-Sik;Shin Yong-Chul;Yoo Hwan-Kuk;Kim Byung-Yul
    • Journal of Chest Surgery
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    • v.39 no.9 s.266
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    • pp.692-698
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    • 2006
  • Background: Owing to the fact that the average life span has increased and the progress in medical science has been made, the number of patients with chronic renal failure (CRF) who have to take hemodialysis (HD) has been going up gradually. Accordingly, it is considered to be as a significant issue to obtain blood vessels which can be used repetitively and supply enough blood flows. Therefore, there have been various kinds of study on an inosculation rate andfactors influencing it following an arteriovenous fistula (AV fistula) and lots of studies are ongoing for the purpose of escalating the inosculation rate. The authors analyzed the effects of short-term result, age, sex, diabetes and hypertension on arteriovenous inosculations in 134 anatomical snuffbox operated subjects among the patients who have taken an AV fistula at this center. Material and Method: Based on 134 patients who underwent an AV fistula at the department of thoracic surgery of this center from July, 2000 to May, 2004, the difference in arteriovenous inosculation rate was compared and analyzed depending or age (discriminated by 65-year-old), sex and the condition of the presence or absence of diabetes and hypertension. Correlation analyses were conducted for each parameter and statistical tests were performed by using SPSS for windows Release 11.0.1, which were determined to be statistically significant if p value was below 0.05. Result: The total number of operations was 169 including 35 of re-operations. The male/female rate was 70 : 64 (52% : 48%). The average age was $56.3{\pm}12.26$ years and there were 33 (24%) old aged patients above 65-year-old; there were 103 (71%) patients with hypertension and 90 (67%) patients with diabetes. Overall arteriovenous inosculation rate was $93{\pm}2.4%,\;91{\pm}2.7%,\;89{\pm}3.0%$ at 6, 12, 24 months, respectively. The arteriovenous inosculation rate of above 65-year-old patient group was $85{\pm}4.8%,\;80{\pm}5.8%,\;80{\pm}5.8%$ and below 64-year-old patient group's was $85{\pm}4.8%,\;80{\pm}5.8%,\;80{\pm}5.8%$ at given time points, respectively, which showed higher inosculation rate in below 64-year-old patient group with a statistical significance (p=0.0034). However, no statistical significance was found between the patients with hypertension and diabetes and the patients with no complication. In addition, there was no statistical significance in inosculation rate between male and female. Conclusion: The arteriovenous inosculation ratewas higher in the treated patient below 64-year-old than in the treated patient above 65-year-old. Thus it is advantageous for increase in long-term inosculation rate to obtain hemodialysis routes at an early age. The conditions of sex and the presence or absence of diabetes and hyper- tension do not make statistically significant effect on the arteriovenous inosculation rate.

Differential Effects of Recovery Efforts on Products Attitudes (제품태도에 대한 회복노력의 차별적 효과)

  • Kim, Cheon-GIl;Choi, Jung-Mi
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.1
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    • pp.33-58
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    • 2008
  • Previous research has presupposed that the evaluation of consumer who received any recovery after experiencing product failure should be better than the evaluation of consumer who did not receive any recovery. The major purposes of this article are to examine impacts of product defect failures rather than service failures, and to explore effects of recovery on postrecovery product attitudes. First, this article deals with the occurrence of severe and unsevere failure and corresponding service recovery toward tangible products rather than intangible services. Contrary to intangible services, purchase and usage are separable for tangible products. This difference makes it clear that executing an recovery strategy toward tangible products is not plausible right after consumers find out product failures. The consumers may think about backgrounds and causes for the unpleasant events during the time gap between product failure and recovery. The deliberation may dilutes positive effects of recovery efforts. The recovery strategies which are provided to consumers experiencing product failures can be classified into three types. A recovery strategy can be implemented to provide consumers with a new product replacing the old defective product, a complimentary product for free, a discount at the time of the failure incident, or a coupon that can be used on the next visit. This strategy is defined as "a rewarding effort." Meanwhile a product failure may arise in exchange for its benefit. Then the product provider can suggest a detail explanation that the defect is hard to escape since it relates highly to the specific advantage to the product. The strategy may be called as "a strengthening effort." Another possible strategy is to recover negative attitude toward own brand by giving prominence to the disadvantages of a competing brand rather than the advantages of its own brand. The strategy is reflected as "a weakening effort." This paper emphasizes that, in order to confirm its effectiveness, a recovery strategy should be compared to being nothing done in response to the product failure. So the three types of recovery efforts is discussed in comparison to the situation involving no recovery effort. The strengthening strategy is to claim high relatedness of the product failure with another advantage, and expects the two-sidedness to ease consumers' complaints. The weakening strategy is to emphasize non-aversiveness of product failure, even if consumers choose another competitive brand. The two strategies can be effective in restoring to the original state, by providing plausible motives to accept the condition of product failure or by informing consumers of non-responsibility in the failure case. However the two may be less effective strategies than the rewarding strategy, since it tries to take care of the rehabilitation needs of consumers. Especially, the relative effect between the strengthening effort and the weakening effort may differ in terms of the severity of the product failure. A consumer who realizes a highly severe failure is likely to attach importance to the property which caused the failure. This implies that the strengthening effort would be less effective under the condition of high product severity. Meanwhile, the failing property is not diagnostic information in the condition of low failure severity. Consumers would not pay attention to non-diagnostic information, and with which they are not likely to change their attitudes. This implies that the strengthening effort would be more effective under the condition of low product severity. A 2 (product failure severity: high or low) X 4 (recovery strategies: rewarding, strengthening, weakening, or doing nothing) between-subjects design was employed. The particular levels of product failure severity and the types of recovery strategies were determined after a series of expert interviews. The dependent variable was product attitude after the recovery effort was provided. Subjects were 284 consumers who had an experience of cosmetics. Subjects were first given a product failure scenario and were asked to rate the comprehensibility of the failure scenario, the probability of raising complaints against the failure, and the subjective severity of the failure. After a recovery scenario was presented, its comprehensibility and overall evaluation were measured. The subjects assigned to the condition of no recovery effort were exposed to a short news article on the cosmetic industry. Next, subjects answered filler questions: 42 items of the need for cognitive closure and 16 items of need-to-evaluate. In the succeeding page a subject's product attitude was measured on an five-item, six-point scale, and a subject's repurchase intention on an three-item, six-point scale. After demographic variables of age and sex were asked, ten items of the subject's objective knowledge was checked. The results showed that the subjects formed more favorable evaluations after receiving rewarding efforts than after receiving either strengthening or weakening efforts. This is consistent with Hoffman, Kelley, and Rotalsky (1995) in that a tangible service recovery could be more effective that intangible efforts. Strengthening and weakening efforts also were effective compared to no recovery effort. So we found that generally any recovery increased products attitudes. The results hint us that a recovery strategy such as strengthening or weakening efforts, although it does not contain a specific reward, may have an effect on consumers experiencing severe unsatisfaction and strong complaint. Meanwhile, strengthening and weakening efforts were not expected to increase product attitudes under the condition of low severity of product failure. We can conclude that only a physical recovery effort may be recognized favorably as a firm's willingness to recover its fault by consumers experiencing low involvements. Results of the present experiment are explained in terms of the attribution theory. This article has a limitation that it utilized fictitious scenarios. Future research deserves to test a realistic effect of recovery for actual consumers. Recovery involves a direct, firsthand experience of ex-users. Recovery does not apply to non-users. The experience of receiving recovery efforts can be relatively more salient and accessible for the ex-users than for non-users. A recovery effort might be more likely to improve product attitude for the ex-users than for non-users. Also the present experiment did not include consumers who did not have an experience of the products and who did not perceive the occurrence of product failure. For the non-users and the ignorant consumers, the recovery efforts might lead to decreased product attitude and purchase intention. This is because the recovery trials may give an opportunity for them to notice the product failure.

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