• Sleep Medicine and Psychophysiology
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• v.22 no.2
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• pp.64-69
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• 2015

Objectives: We investigated whether sleep behaviors, severity of insomnia and circadian typology are associated with quality of life among Gyeongsang National University (GNU) medical students. Methods: Questionnaires were distributed to 46 fourth-year students of GNU Medical School. The hospital anxiety-depression scale, insomnia severity index (ISI), morningness-eveningness questionnaire (MEQ) and WHO Quality of Life-BREF (WHOQOL-BREF) were used. Results: Quality of life in terms of physical health was associated with age, weekday total sleep time (TST), weekend TST, catch up sleep, depression, ISI score, and MEQ score. Quality of life in terms of psychological health was correlated to weekday and weekend TST, anxiety, ISI score and MEQ score. Sex, weekday TST, depression, and ISI score were revealed to influence the social aspect of quality of life, and weekday and weekend TST, and ISI score were associated with quality of life in terms of environment. Multiple regression analysis showed that better sleep quality predicted to a higher quality of life in terms of physical, psychological and environmental health, and eveningness was associated with a better quality of life in terms of physical and psychological health. Conclusion: It is concluded that physical, psychological, and environmental aspects of quality of life were associated with quality of sleep and that physical and psychological aspects of quality of life were related to eveningness in GNU medical students. Therefore, it is equally important to treat emotional problem as well as improve sleep quality.

• Journal of Hospice and Palliative Care
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• v.17 no.2
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• pp.66-74
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• 2014

Purpose: This study is aimed to investigate perceptions of caregivers and medical staff toward do not resuscitate (DNR) and advance directives (AD). Methods: Participants were 141 caregivers and 272 medical staff members from five general hospitals. A questionnaire used for the study consisted of 20 items: 14 about DNR perceptions, three about AD, one each for age, gender and employment. Results: Both medical staff and caregivers strongly recognized the need for DNR and AD, and the level of recognition was higher with medical staff than caregivers (DNR ${\chi}^2=44.56$, P=0.001; AD ${\chi}^2=16.23$, P=0.001). The main reason for the recognition was to alleviate sufferings of patients in the terminal phase. In most cases, DNR and AD were filled out when patients with terminal conditions were admitted, and patients made the decisions by consulting with their guardians. Medical staff better recognized the need and for growing demand for guidelines for the DNR and AD decision making process than caregivers (${\chi}^2=7.41$, P=0.0025). Conclusion: This study showed that patients highly rely on their caregivers when making decisions for DNR and AD. Thus, it is important that patients and caregivers are provided with objective information about the decisions. Since participants' strong support for DNR and AD was mainly aimed at alleviating patients' suffering, further study is needed in the association with hospice care. Medical staff also needs to understand the different views held by caregivers and fully consider the disparity when informing patients/caregivers to make the DNR and AD decisions.

• The Korean Society of Law and Medicine
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• v.18 no.1
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• pp.143-169
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• 2017

The Act on Special Cases Concerning the Punishment, etc. of Child Abuse Crimes intends to encourage reporting and punishment of child abuse by using the concept of 'crime' in child abuse cases. Article 10 of the Act imposes duty to report child abuse on a number of different professions, including medical professionals. Currently, more than 80% of child abuse cases occur among family members and the detection rate of child abuse is as low as 0.5% in Korea. On the other hand, medical professionals can identify child abuse relatively clearly with specific medical opinions. Therefore, it is necessary that medical professions are informed of this duty and does not bear disincentive from reporting. This paper makes policy suggestions in this regard. First, it is necessary that medical students and medical professionals receive regular education about the obligation to report child abuse. Education should include details of the reporting duty, as well as the fact that there is legal obligation to report even if the child abuse is "suspicious", not certain. Second, it is imperative to establish and implement protective programs for medical professionals who report child abuse. The current law provides a rough framework for protection of people who report child abuse, but it is necessary to produce detailed guidelines that are applicable in the context of medical setting. Education for medical students and medical professionals should include the contents of these guidelines, so that they do not hesitate reporting because they fear the aftermath of reporting. Third, it is highly recommended that physicians use the national Baby/Infant Health Checkup Program as an opportunity to detect child abuse. In Korea, the Baby/Infant Health Checkup Program provides physicians to periodically monitor health condition of all babies and children until the age of 71 months. In order to utilize this program for early detection of child abuse, it is imperative that the bBaby/Infant Health Checkup Program is modified to involve child abuse experts and medical professionals who participate in the program are educated about child abuse.

• Journal of Preventive Medicine and Public Health
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• v.10 no.1
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• pp.166-175
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• 1977

The author have performed an epidemiological study on the accidental deaths at industry from 1970 to 1975, in order to seek for the preventive measures of industrial accident with the under-standing of its cause and characteristics of the accidental deaths. The obtained results were as follows; 1. Total number of deaths for 6 years were 361 (350 males, 11 females). and the mean death rate was 33.8 per 100,000 industrial workers during 6 years. By the highest as 52.9 was in 1974 and the lowest as 13.7 in 1970. By the industry group, the death rate of Electricity, Gas and Water was 149.3, Construction 83.9 and the lowest was Manufacturing as 18.3. 2. Standardized mortality rate of the cases by the age group showed that 20-29 years old group was 43.0, 40-49 years old group 38.1, 30-39 years old group 32.0, and the lowest as 17.9 was under 19 years old group. 3. The cumulative percentage of the cases by years of service showed that under 6 months was 60.4%, under 1 year 72.9%, under 2 years 83.1%. 4. By the month of occurrence, the highest was 15.8% which occurred in August and the lowest was 5.8% in February. The highest as 19.1% was on Friday and the lowest as 11.9% on Monday by the day of a week. 5. By the causes of accident, car accidents was 28.3%, fall accidents 19.1%, accidents by a crash 9.1% in that order. By the location of injury, head was 44.6%, multiple injuries 33.0%, chest 10.5%, and back was the lowest as 1.9%. The distribution of the cases by nature of injury shelved that cerebral contusion and hemorrhage was 39.4%, fracture and dislocation 33.2%, asphyxia 8.0% in that order. 6. The cumulative percentage of the cases by the duration from injury to death showed that the injuried day was 74.2%, within 3 days after injury 88.5%, within 7 days 96.1%. Therefore most of the cases were occurred within 7 days after injury. 7. Byythe daily mean wages, most of the cases as 91.7% were under 2,000 won, and more 4,000 won was 1.6% merely.

• Journal of Chest Surgery
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• v.35 no.5
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• pp.365-368
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• 2002

Background: Coronary artery bypass grafting(CABG) imposes large amount of medical costs, which are greatly affected by the surgical approach, quality of perioperative care and associated co-morbidities. Recently, off-pump CABG(OPCAB) has been introduced and performed with increasing frequency. To evaluate the efficacy of OPCAB in view of financial impact, we analyzed the costs and medical resources of OPCAB and compared with conventional CABG. Material and Method: From January 1998 to July 1999, 184 patients underwent CABG operation; 111 patients with OPCAB(group I) and 73 patients with conventional CABG(group II). We prospectively collected clinical data including risk factors and retrospectively reviewed the hospital resources. Result: Preoperative parameters including risk factors, postoperative mortality, morbidity and length of hospital stay were not different between the two groups, Duration of stay in the intensive care unit(ICU) (51.3 vs 128.3 hours, p<0.01) and ventilator, support time(14.9 vs 56.2 hours, p<0.01) were significantly shorter in the OPCAB group. Total hospital coats were 17,220,000 add 21,250,000(Korean Won) in group I and II, respectively(p<0.01). There were significant differences in operation fee, costs for operative materials, transfusion and diagnostic radiology between two groups. In group I, all the resources except diagnostic radiology were significantly decreased compared with group II. Conclusion: OPCAB has a beneficial effect on hospital charge and resource utilization. Shorter duration of the ICU stay and ventilatory support time may reduce the total hospital costs.

• The Korean Society of Law and Medicine
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• v.20 no.2
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• pp.3-39
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• 2019

Even after the Constitutional Court decided on August 23, 2012 that the provisions of abortion were constitutional, discussions on the abolition of abortion continued. The controversy about abortion is not only happening recently, but it has already existed since the time when the Penal Code was enacted, and it shares the history of modern legislation with the Republic of Korea. Legislators whom submitted amendment while insisting upon the eradication of abortion in the process of enacting criminal law at that time, presented social and economic adaptation reasons as the core reason. From then on, the abolition of abortion has been discussed during the development dictatorship, but this was not intended to guarantee women's human rights, but it was closely connected to the national policy projects of "Contraception" and "Family Planning" of the Park's dictatorship. Since then, the enactment of the Mother and Child Health Law, which restrictively allow artificial abortion, was held on February 8, 1973, in an emergency cabinet meeting that replaced the legislative power after the National Assembly was disbanded. It became effected May 10th. The reason behind the Mother and Child Health Law that included legalization of abortion in part was that the Revitalizing Reform at that time did not allow any opinion, so it seem to be it was difficult for the religious to express opposition. The "Maternal and Child Health Law" enacted in this way has been maintained through several amendments. It can be seen that the question of maintenance of abortion has been running on parallel lines without any significant difference from the time when the Penal Code was enacted. On August 23, 2012, the Constitutional Court decided that the Constitutional Opinion and the unonstitutional Opinion were 4: 4. However, it was decided by the Constitution without satisfying the quorum for unconstitutional decision of the Constitutional Court. This argument about abolition of abortion is settled for the the time being with the decision of the constitutional inconsistency of the Constitutional Court, and now, the National Assembly bears the issue of new legislation. In other words, the improved legislation must be executed until December 31, 2020, and if the previous improved legislation is not implemented, the crime of abortion (Article 269, Paragraph 1, Article 270 of the Criminal Code) Article 1 (1) will cease to be effective from 1 January 2021. Therefore, in the following, we will look into the reason of the Constitutional Court's constitutional discordance adjudication on criminal abortion(II), and how it structurally differs from the previous Constitutional Court and the Supreme Court. After considering key issues arised from the constitutional discordance adjudication(III), the legislative direction and within the scope of legislative discretion in accordance with the criteria presented by the Constitutional Court We reviewed the proposed revisions to the Penal Code and the Mather and Child Health Act of Korea(IV).

• Journal of agricultural medicine and community health
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• v.36 no.2
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• pp.87-100
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• 2011

Objectives: This study aimed to identify factors associated with smoking relapse. Methods: The study sample was recruited among subjects who were enrolled in the smoking cessation clinic of a public health center and had succeeded in quitting smoking for at least six months. A total of 159 male subjects were followed via mail survey one year later. The independent variables in the analyses were socio-demographic characteristics, smoking history and behavior, receipt of smoking cessation aids, health behaviors and components of the health belief model (HBM). The dependent variable was smoking relapse assessed one year after quitting. Ordered logit regressions were used to identify factors associated with smoking relapse. Results: The relapse rate of the ex-smokers in our sample was 25.8%, and the occasional smoking rate was 17.0%. Univariate analyses revealed that only factors related to the HBM, such as perceived susceptibility to diseases (p<0.01), perceived severity of diseases (p<0.01), perceived health benefits of not smoking (p<0.01), perceived barriers to quitting smoking due to increasing stress and difficulty in social life (p<0.01), and self-efficacy (p<0.01) were associated with the likelihood of relapse for ex-smokers. Ordered logit analyses yielded two significant factors affecting the likelihood of relapse, the perceived barriers to quitting smoking and self-efficacy. Conclusions: Our results indicate that higher levels of barriers to quitting smoking and lower levels of self-efficacy were significantly related to risk of smoking relapse. These findings may be useful for identifying those at highest risk for relapse and choosing the optimal strategies for prevention of relapse for ex-smokers.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.6 no.1
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• pp.78-95
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• 1999

The grafting of a kidney has been found to be the best medical treatment for patients who have renal insufficiency failure, but the patients still have experienced much trouble and apprehension. This study was done to further nursing theory developing for patients who have has a kidney graft from another person. The research method followed grounded theory methodology of Strauss and Corbin. The subjects were three female and four male patients. This study done befween Oct. 1997 and Mar. 1998. All of the subjects were interviewed by the author. Interview were done by the long interview technique and observation. In the process of data analysis, 'heart-boiling' was found to be the core phenomenon. The results were composed to 101 concepts. These concepts were grouped into nineteen categories, and then to twelve categories. There were 12 super-class categories as follows ; 'pain', 'heart-boiling', 'experience of dialysis', 'term of admission to a hospital', 'support of other person', 'dependence on God', 'direction', 'negative reaction', 'positive reaction', 'comfortable', 'lacking', 'acceptance'. In this process, 14 hypotheses were derived from the categories as follows ; (1) The more experience with dialysis that the patients have, the stronger the heart-boiling will tend to be. (2) The less experience with dialysis the patients have, the weaker the heart-boiling will tend to be. (3) The longer admission to hospital the patients have, the stronger the heart-boiling will be. (4) The shorter the admission to hospital the patients have, the weaker the heart-boiling will be. (5) The weaker the intense-grief is, the more positive the reaction to heart-boiling the patients wll have. (6) The stronger the intense-grief is, the more negative the reaction to heart-boiling the patients will have. (7) The stronger the support of other persons that the patients have, the more positive the reaction to heart-boiling the patients will have. (8) The weaker the support of other person that the patients have, the more negative the reaction to heart-boiling the patients will have. (9) The stronger the dependence on God that the patients have, the mure positive reaction to heart-boiling the patients will have. (10) The weaker the dependence on God that the patients have, the more negative reaction to heart-boiling the patients will have. (11) The more positive thoughts that the patients have, the more positive reaction to heart-boiling the patinets will have. (12) The more negative thoughts that the patients have, the more negative reaction to heart-boiling the patients will have. (13) The more positive reaction the patients have, the more free from heart-boiling the patients tend to be. (14) The more negative reaction the patients have, the less free from heart-boiling the patients tend to be. From the analysis of observed data and comparing each class, I concluded that there are four formula relation types between reaction of patients and heart-boiling. (1) If patients have the experience of dialysis, have a long term admission to hospital, are strong in heart-boiling, depend on God, have positive thoughts and another's strong support, they experience release by positive reaction to the intense-grief. (2) If patients have the experience of dialysis, have a short term admission to hospital, are weak in heart-boiling, do not depend on God, have negative thoughts, and have few supports from others, they experience attachment to heart-boiling though a negative reaction. (3) If patients have the experience of dialysis, have a long term admission to hospital, are strong in heart-boiling, do not depend on God, and have negative thoughts, they experience attachment to heart-boiling through negative reaction in spite of support from another. (4) If patients have the experience of dialysis, have a long term admission into hospital, are strong in heart-boiling and satisfaction is low, but they have positive thoughts, then they experience acceptance and harmony through the positive reaction to heart-boiling. The results of this study are expected to help the way nurses care for patients who have had a kidney graft from another.

• The Korean Society of Law and Medicine
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• v.16 no.2
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• pp.263-291
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• 2015

In May, 2015, a 68 years old man, who has been Middle East Saudi Arabia and the United Arab Emirates, had high fever, muscle aches, cough and shortness of breath. he went two local hospital near his house and the S Medical Center emergency center. He was diagnosed MERS(Middle East respiratory syndrome) and the diseases had put South Korea the fear of epidemics for three months. Especially, this disease has firstly reported in Middle East Asia in September 2012 and spreaded to twenty-six countries. In 21, July, 2015, European Center for disease prevention and control reported 533 people were died and in South Korea, 186 people were infected, 36 people were died and 16,693 people were isolated from MERS. South Korea government were faced into epidemic control and blamed from public. Especially, hospital acquired infection, disease control chain, opening of information, ventilation, lack of isolation bed, the problem of function of local health center, the issue of reparation for hospital and insurance cover rate, the classification of disease, the role of Korea Centers for disease control and prevention, the culture of visiting hospital to see sick people, the issue of hospital multiple room and other related social support policy. it is time to study and discuss to solve these problems. South Korea citizens felt fear and fright from MERS. What is wore, they thought the dieses were out of their government control. It was unusual case for word except Middle East Asia. numerous tourists canceled visiting korea. South korea economic were severly damaged especially, tourism industry. South korea government should admit that they had failed initial action against MERS and take full reasonability from any damages. The government have to open information to public in terms of epidemic diseases and try to prevent any other epidemic diseases and try to work with local governments.

• Korean Journal of Plant Resources
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• v.28 no.2
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• pp.145-152
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• 2015

The present study aimed to investigate comparative anti-inflammatory effects of Litsea japonica fruit and leaf extract considering the balance of safety and efficacy. Dose response studies were performed to determine the inhibitory effects of 70% EtOH extract of leaf (L70%) on the pro-inflammatory enzymes expression, COX-2/PGE2 and NO/iNOS, and pro-inflammatory cytokines production, IL-$1{\beta}$, IL-6, and TNF-$\alpha$ in lipopolysaccharide (LPS)-stimulated RAW 264.7 cells. We also examined comparative effects of 30 and 70% EtOH extract of fruits (F30% and F70%) at low concentration ($10{\mu}g/ml$ ) in the same conditions. L70% at 50 and $100{\mu}g/ml$ showed inhibitory effects on almost all the inflammatory mediators we examined except for COX-2 regulation, but there were no effects at $10{\mu}g/ml$. Since $100{\mu}g/ml$ of L70% have 18.2% cytotoxicity, we compared the effects of fruit extract, F30% and F70% at $10{\mu}g/ml$ on the regulation of NO/iNOS, PGE2, IL-$1{\beta}$, IL-6, and TNF-$\alpha$ and obtained that fruit extacts are more efficacious and safe than leaf. This study suggests that the 30% EtOH fraction of L. japonica fruit could be a good candidate for development as a functional food supplement in the prevention of inflammatory disorders.