• 대한상한금궤의학회지
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• v.6 no.1
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• pp.1-25
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• 2014

Objective : The purpose of this study is exploring value of Shanghanlun six diagnostic system as Narrative Medicine by analyzing cases. Methods : In the article, we examined the theory of narrative medicine and current studies. And then key elements of narrative medicine was defined. On the basis of these, two medical cases were analyzed by reordering in accordance with time sequences and causality for confirming narrative factors. Results : The narrative approach to analyzing cases shows us that different diseases could be the result of same pathological patterns based on Shanghanlun. This tells us following four aspects. [1] Shanghanlun is the causes-oriented records and the text includes narrative factors. [2] Shanghanlun six diagnostic system is a process of constructing plot of medical case history through the clinical interpretation of contextual meaning of patient's life. [3] In the process of diagnosis, Schemata and script are engaged in assuming and confirming six patterns diseases. [4] The subjective factors of an individual can be applied universally through the provision of Shanghanlun. Conclusions : Narrative factors of Shanghanlun six diagnostic system suggest the possibility and value of Shanghan Medicine as Narrative Medicine in terms of Medical Humanities, essence of medical diagnosis and therapeutic action.

• Journal of Korean Academy of Nursing
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• v.35 no.7
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• pp.1333-1342
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• 2005

Purpose: This paper was aimed to inquire into Ricoeur's self -hermeneutics and narrative ethics, and apply it to personal identity constituting caring and care ethics in the practice of nursing. Its purpose is to provide a philosophical foundation for caring in nursing. Method: According to Ricoeur's narrative identity, ontological caring was interpreted as personal identity constituting caring. His ethics were described as care ethics, which contributed to preserving and promoting the personal dignity of the client, as self in search for the good life in the nursing practice. Results: Narrative understanding of the client pointed to the ontological role of care in the constitution of personal identity. From an ethical aspect of the narrative, respect for personal identity and personal dignity of the client was crucial to an ethical caring attitude, promoting self-esteem in the nursing practice. Conclusion: This paper suggested that Ricoeur's ethics could provide a philosophical basis for understanding ontological and ethical caring in nursing. This contributed to protection of the client from the threat of personal identity, as well as respecting their personal dignity.

• Journal of Yeungnam Medical Science
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• v.40 no.4
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• pp.335-342
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• 2023

Diabetic foot ulcers (DFUs) are among the most serious complications of diabetes and are a source of reduced quality of life and financial burden for the people involved. For effective DFU management, an evidence-based treatment strategy that considers the patient's clinical context and wound condition is required. This treatment strategy should include conventional practices (surgical debridement, antibiotics, vascular assessment, offloading, and amputation) coordinated by interdisciplinary DFU experts. In addition, several adjuvant therapies can be considered for nonhealing wounds. In this narrative review, we aim to highlight the current trends in DFU management and review the up-to-date guidelines.

• Journal of Korea Multimedia Society
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• v.25 no.4
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• pp.640-648
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• 2022

Menopausal women have to care for their health. Menopause is a symptom that needs to be managed in the long term, which requires safe and economical treatment even after long term use. This study proposes digital-based exercise therapy. This study also suggests resistance exercise and walking exercise methods according to the proof of previous studies. It provides motivational contents for those who cannot perform regularly. As motivational methods, self-efficacy and narrative-based history methods are accepted. Self-efficacy is improved through voice agents feedback during exercise. Feedback is a type of messages such as encouragement and motivation. The narrative-based history consists of characters of visualization that improves through values, which leveraged by the exercise.

• Journal of Yeungnam Medical Science
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• v.40 no.4
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• pp.321-327
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• 2023

Recently, the International Working Group on the Diabetic Foot and the Infectious Diseases Society of America divided diabetic foot disease into diabetic foot infection (DFI) and diabetic foot osteomyelitis (DFO). DFI is usually diagnosed clinically, while numerous methods exist to diagnose DFO. In this narrative review, the authors aim to summarize the updated data on the diagnosis of DFO. An extensive literature search using "diabetic foot [MeSH]" and "osteomyelitis [MeSH]" or "diagnosis" was performed using PubMed and Google Scholar in July 2023. The possibility of DFO is based on inflammatory clinical signs, including the probe-to-bone (PTB) test. Elevated inflammatory biochemical markers, especially erythrocyte sedimentation rate, are beneficial. Distinguishing abnormal findings of plain radiographs is also a first-line approach. Moreover, sophisticated modalities, including magnetic resonance imaging and nuclear medicine imaging, are helpful if doubt remains after a first-line diagnosis. Transcutaneous bone biopsy, which does not pass through the wound, is necessary to avoid contaminating the sample. This review focuses on the current diagnostic techniques for DFOs with an emphasis on the updates. To obtain the correct therapeutic results, selecting a proper option is necessary. Based on these numerous diagnosis modalities and indications, the proper choice of diagnostic tool can have favorable treatment outcomes.

• Journal of Popular Narrative
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• v.26 no.3
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• pp.291-323
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• 2020

In this paper, I review Pellegrino's Reader, The Philosophy of Medicine Reborn. Pellegrino has emphasized the humanities' reflection on the ethics of medicine. He insists that medical ethics should be re-established as modern society changes. This paper, based on Pellegrino's view, noted the problematic situation in literature and popular narrative texts. Indeed, I wanted to see what answer medical ethics could provide for us. Medical personnel had a philosophical dilemma or a conflict between reality and ethics. Pellegrino argues that medical personnel, above all, need to sympathize with the patient's pain and respond to their needs through interaction with them. This may seem like a very legitimate declaration. But a physician in literary texts and popular narrative texts is often exposed to this ethical dilemma. Through Lee Cheongjun's novel, we can reflect on how a medical personnel could lead a patient to a state of "goodness". And through medical dramas, we can grasp what ethical behaviors the public demands from a medical personnel. Now that the world is suffering from COVID-19, medical workers are in a great trouble, but at the same time, they are respected by the public and are also enhancing their value as ethical beings. Now that medical care has become an everyday narrative, medical ethics is becoming a prerequisite for living. This paper attempted to recognize the importance of medical ethics and to review the ethical issues embodied in medical narratives.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.4
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• pp.179-192
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• 2023

Obstructive sleep apnea (OSA) is a common sleep-breathing disorder associated with significant comorbidities and perioperative complications. This narrative review is aimed at comprehensively overviewing preoperative risk evaluation and perioperative management strategies for patients with OSA. OSA is characterized by recurrent episodes of upper airway obstruction during sleep leading to hypoxemia and arousal. Anatomical features, such as upper airway narrowing and obesity, contribute to the development of OSA. OSA can be diagnosed based on polysomnography findings, and positive airway pressure therapy is the mainstay of treatment. However, alternative therapies, such as oral appliances or upper airway surgery, can be considered for patients with intolerance. Patients with OSA face perioperative challenges due to difficult airway management, comorbidities, and effects of sedatives and analgesics. Anatomical changes, reduced upper airway muscle tone, and obesity increase the risks of airway obstruction, and difficulties in intubation and mask ventilation. OSA-related comorbidities, such as cardiovascular and respiratory disorders, further increase perioperative risks. Sedatives and opioids can exacerbate respiratory depression and compromise airway patency. Therefore, careful consideration of alternative pain management options is necessary. Although the association between OSA and postoperative mortality remains controversial, concerns exist regarding adverse outcomes in patients with OSA. Understanding the pathophysiology of OSA, implementing appropriate preoperative evaluations, and tailoring perioperative management strategies are vital to ensure patient safety and optimize surgical outcomes.

• Dementia and Neurocognitive Disorders
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• v.22 no.1
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• pp.16-27
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• 2023

Alzheimer's disease (AD), one of the most representative neurodegenerative diseases, has diverse neurobiological and pathophysiological mechanisms. Treatment strategies targeting a single mechanism have repeated faced failures because the mechanism of neuronal cell death is very complex that is not fully understood yet. Since complex mechanisms exist to explain AD, a variety of diagnostic biomarkers for diagnosing AD are required. Moreover, standardized evaluations for comprehensive diagnosis using neuropsychological, imaging, and laboratory tools are needed. In this review, we summarize the latest clinical, neuropsychological, imaging, and laboratory evaluations to diagnose patients with AD based on our own experience in conducting a prospective study.

• Journal of Yeungnam Medical Science
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• v.39 no.2
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• pp.89-97
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• 2022

More than 2 years after the explosion of the coronavirus disease 2019 (COVID-19) pandemic, extensive efforts have been made to develop safe and efficacious vaccines against infections with severe acute respiratory syndrome coronavirus 2. The pandemic has opened a new era of vaccine development based on next-generation platforms, including messenger RNA (mRNA)-based technologies, and paved the way for the future of mRNA-based therapeutics to provide protection against a wide range of infectious diseases. Multiple vaccines have been developed at an unprecedented pace to protect against COVID-19 worldwide. However, important knowledge gaps remain to be addressed, especially in terms of how vaccines induce immunogenicity and efficacy in those who are elderly. Here, we discuss the various vaccine platforms that have been utilized to combat COVID-19 and emphasize how these platforms can be a powerful tool to react quickly to future pandemics.

• The Journal of Korean Medicine
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• v.40 no.2
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• pp.89-93
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• 2019

Objectives: There are substantial variations on the methods of identifying Sa-sang typology in clinical practice. This review aimed to describe the clinical experiences on the classification of Sa-sang typology based on index signs for practice of Tae-Geuk acupuncture. Methods: Core physical signs and interpretation of treatment response for the classification of Sa-sang typology are suggested based on 42-year clinical experiences of the expert (the first author). Results: Epigastric tenderness and hepatic dullness sound are the most important physical sign in the classification of Sa-sang typology. Clinical experiences indicate that there may be a positive association between the presence of epigastric tenderness and hepatic dullness sound. Four sets of acupuncture points are matched for four types of Sa-sang institution, respectively. Appropriate match will resolve epigastric tenderness and hepatic dullness sound, while this will not happen if inappropriate match is employed. Conclusion: I suggest that two physical signs (i.e., epigastric tenderness and hepatic dullness sound) are essential for the classification of Sa-sang typology in Tae-Geuk acupuncture.