• Journal of Chest Surgery
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• v.19 no.1
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• pp.35-42
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• 1986

Prevention of thrombombolism after rosthetic cardiac valve replacement is essential for the patients. About 90% of patients are free of major and minor thromboembolic complications 5 year after replacement of cardiac valves with prosthetic devices when they are under control of anticoagulant therapy. Ticlopidine is a drug that alter platelet function to have an antithrombotic effect. It is an antiaggregating agent which inhibits primary platelet function to have an antithrombotic effect. It is an antiaggregating agent which inhibits primary platelet aggregation induced by ADP and increases the production of prostaglandin $D_{2}$. Aspirin in small doses inhibits platelet synthesis of prostaglandins by irreversibly blocking the enzyme cyclo-oxygenase. Platelet secretion and aggregation are impaired with Ticlopidine and Aspirin. the thromboembolic event sof 54 patient s who were treated with Ticlopidine and Aspirin after cardiac valve replacement were evaluated and compared with that of 79 patients who were treated with Wafarin and Aspirin after the same type of operation. The follow-up period ranged from 4 to 110 months (mean of 48 months). there were 11 major thromboembolic episodes including three deaths in the warfarin goup during mean follow-up period of 56 months. two cases of CVA and one hemoarthrosis were noted due to overdose of Warfarin. Inticlopidine group, there was only one fatal thromboembolic epdisode three month after mitral valve replacement during mean follow-up period of 18 months. Two episodes of hypermenorrhea resulting anemia ere noted in the ticlopidine group. We measured the parameters of platelet function in aggreagation curve of platelet with platelet aggregometer (chrono-log Aggregometer, Model No. 430) Aggregation test was performed with three final concentrations of epinephrine in 10 uM/L, ADP in 5uM/L. 28 patients with prosthetic cardiac valves and 35 healthy volunteers were subgrouped as follows to analyze the effect of antithrombotic drugs used. Group I ; 11 patients treated with 250-500 mg of ticlopidine and 0.5gm of Aspirin as a daily single dose after cardiac valve replacement (14 St. Jude Medical and 1 Carpentier-Edwards, 9 patients with atrial fibrillation among them) Group II ; 10 patients treated with 3-5 mg of Warfarin and 0.75 gm of Aspirin daily to prolong prothrombin time around 20 seconds for more than 6 months and single Aspirin dose was maintained afterward as a life-long regimes(3 St. Jude Medical, 1 Hall-Kaster and 7 Carpentier-Edwards valve, 9 patients in atrial fibrilation). Group III ; 7 patients who quit anticoagulant treatment (Warfarin + Aspirin) 6-12 months after the regime as group II (3 St. Jude Medical. 1 bjork-Shiley, 1 Hall-Kaster, 3 Carpentier-Edwards valve, 2 of them are with atrial fibrillation). Group IV ; 35 healthy vounteers (28 males and 7 females). The following results were obtained. 1. The mean maximal platelet aggregability in Group I induced by 10uM/L epinephrine was 15.6%, and 17.5 and 18.7% in BM in proportion to the induction by 5 and 10 uM/L ADP. 2. The mean maximal platelet aggregability in Group II induced by 10uM/L epinephrine was 16.5%, and 27.4 and 44.7% in BM in proportion to the induction by 5 and 10uM/L ADP. 3. The mean maximal platelet aggregability in group III induced by 10uM/L epinephrine was 65%, and 56.5 and 51.8% in BM in proportion to the induction by 5 and 10 uM/L ADP. 4. The mean maximal platelet aggregability in the normal subjects induced by 10 uM/L epinephrine was 64%, and 65 and 69% in Bm inproportion to the induction by 5 and 10 uM/L ADP. 5. Reversible change of platelet aggregation curve induced by 5 and 10uM/L was noted all of the patients in Group I. conclusion : Ticlopidine is an antiaggregating agent which inhibits primary platelet aggregation induced by ADP, and increases the production of prostaglandin $D_{2}$. Ticlopidine and Aspirin produced a significant inhibition of platelet in the presence of ADP and epinephrine in our study. Acccording to our brief experience, 250 mg of ticlopidine and low dose of Aspirin resulted synergistic superior effect to each drug alone in prevention of thromboembolism after prosthetic cardiac valve replacement.

• Journal of Chest Surgery
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• v.42 no.6
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• pp.732-737
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• 2009

Background: Many video-assisted thoracic surgery (VATS) lobectomies are performed as a potential alternative to thoracotomy despite the controversy about the safety and the associated morbidity/mortality rates. Material and Method: Between November 2006 and August 2008, we performed 87 lobectomies (VATS 36, Thoracotomy 51) and we retrospectively reviewed the surgical treatment results. A VATS lobectomy was performed by a 4~5 cm thoracotomy without rib spreading and this included anatomic hilar dissection, individual vessel and bronchus stapling and lymph node dissection. Result: We studied 52 male and 35 female patients whose age ranged from 6 to 79 (average age: $59.8{\pm}15.0$ years). The cases were diagnosed with lung cancer (66) (SQC 24, ADC 38, others 4), pulmonary metastasis (2), carcinoid (2) and benign diseases (17). There was no intraoperative death. Postoperative complications were seen in 5 (15.6%) VATS and 33 (64.7%) thoracotomies, and perioperative death caused by adult respiratory distress syndrome occurred in 1 (2.8%) VATS and 3 (5.9%) thoracotomies. Three patients Underwent conversion to thoracotomy (8.3%). The mean time to chest tube removal was 6 days for VATS and 9.4 days for thoracotomy (p<0.001), and the mean length of the hospital stay was 8 days for VATS and 12.8 days for thoracotomy (p<0.001). Conclusion: VATS lobectomy can be performed safely with low morbidity/mortality rates. Furthermore, all the patients benefited from earlier postoperative rehabilitation and less pain and they were candidates for an earlier return to normal activities.

• Radiation Oncology Journal
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• v.20 no.3
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• pp.215-220
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• 2002

Purpose : Preoperative radiotherapy has been used to induce tumor regression and allow complete resection of rectal cancer with a sphincter preservation surgery. This study was performed to determine the effectiveness of preoperative radiotherapy for $T_2,\;T_3$ distal rectal carcinoma. Materials and Methods : From November 1995 to June 1997, fifteen patients with invasive distal rectal cancer were treated with preoperative radiotherapy followed by sphincter preservation surgery. Classification by preoperative T stage consisted of 7 $T_2$ and 8 $T_3$ tumors. Radiation therapy was delivered with 6 MV and 15 MV linear accelerator, at 1.8 Gy fractions for 5 days per week. Total radiation doses were 45 Gy to 50.4 Gy (median : 50.4 Gy). Sphincter preservation surgery was peformed $4\~6$ weeks after the completion of radiotherapy. Median follow-up was 22 months (range : $16\~37\;months$). Results : One patient $(6.7\%)$ had a complete pathologic response. Comparing the stage at the diagnostic workup with the pathologic stage, tumor downstaging of T stages occurred in 11 of 15 patients $(73.3\%)$ and $N_1$ stages occurred in 2 of 5 patients $(40\%)$. No patient developed progressive disease undergoing treatment. Two patients suffered local recurrence at 7 and 20 months, and one a distant metastasis at 30 months. No grade 3 or 4 toxicity was observed. Conclusion : Our experience suggests that preoperative radiotherapy followed by sphincter preservation surgery is well tolerated, and can significantly reduce the tumor burden for $T_2\;T_3$ distal rectal cancer.

• Childhood Kidney Diseases
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• v.9 no.1
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• pp.38-45
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• 2005

Purpose : The purpose of this study was to analyze the therapeutic effect of plasmapheresis in various pediatric diseases. Methods : Therapeutic plasmapheresis was performed by COBE Spectra centrifugation. Nine cases were included in this study. The number an[;. method of plasmapheresis, together with the progress and prognosis of each case were retrospectively reviewed. Results : The patients' ages ranged from 26 mont]Is to 16 years of age, and the mean age was 9.9 years. There were S males and 4 females. The underlying diseases requiring plasmapheresis included 2 cases of hemolytic uremic svndrome(HUS), 1 case of lupus nephritis, 2 cases of rapidly Progressive glomerulonephritis(RPGN), 1 case of focal segmental glomorulosclerosis(FSGS), 1 case of systemic vasculitis after pulmonary hemorrhage, 1 case of acute renal failure associated with pulmonary hemoIThage, and 1 case of acute rejection after renal transplantation. The average number of plasmapheresis performed was 6.2 times with a range of 3 to 13 times. The patients with HUS, lupus nephritis, ANCA positive systemic vasculitis induced by pulmonary hemorrhage and ARF-associated pulmonary hemorrhage showed a good response to therapeutic plasmapheresis, but the patients with RPGN, refractory FSGS, and acute rejection after renal transplantation were not responsive to treatment. The most common side effect was hypocalcemia which was rarely symptomatic. Vital signs were not compromised. Conclusion : Although it is presumptuous to generalize the therapeutic effects of plasma pheresis in different diseases due to the small number of study subjects, this study shows that plasmapheresis may be an effective therapeutic modality in various pediatrics diseases and should be considered as a therapeutic option.

• 한국노년학
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• v.36 no.3
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• pp.525-540
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• 2016

The purpose of this study was to investigate what kind of experiences the deaf elderly would have in the course of life. It also aimed to promote the understanding of their living difficulties and culture among people with normal hearing and provide basic data to help them live with others as members of the community. Phenomenological qualitative research was conducted as part of the methodology. The subjects include seven deaf old people. Based on the results of in-depth interview and analysis, the life experiences of the deaf elderly were categorized into "unforgettable wounds," "life in the community," "life with the family," "marriage of the deaf elderly", and "living by adjusting to reality." First, the subcategories of "unforgettable wounds" include "receiving no treatment for fever," "damage by the Korean War," "alienation from the family," and "people's cold eyes." It turned out that the deaf elderly had led a life, suffering from the heart wounds that they could not forget. Second, the subcategories of "life in the community" include "inconvenience in life," "disadvantages in life," and "severed life." The deaf elderly were not only subjected to inconvenience and disadvantages in life, but also suffered loneliness, being cut off from the community. Third, the subcategories of "life with the family" include "not communicating with children," "being abandoned again," "being used by the family," "being lonely even with the family," and "wishing to live independently from the family." The deaf elderly were not supported by their families and were abandoned or used by them, leading a solitary life. Fourth, the subcategories of "marriage of the deaf elderly" include"send as a surrogate mother," "frequent remarriage and divorce," "lean on as a married couple." Deaf elderly form their own culture of the marriage and lean on each other. Finally, the subcategories of "living by adjusting to reality" include "getting help from neighbors," "behaving oneself right in life," "learning Hangul," "living by working," "living freely," "living by missing," and "controlling the impulse to end life," "resorting to religion." The deaf elderly made the most alienated and vulnerable group with no access to benefits due to their limitations as a linguistic and social minority, but they made efforts to form their own culture and adjust to reality for themselves. Based on those findings, the study made the following proposals: first, there is a need for practical approaches to heal the ineffaceable wounds in the hearts of deaf elderly. Second, there is a need for policies to help them experience no inconvenience and disadvantages as members of community and communicate with people with normal hearing. Third, there should be practical approaches to enable them to get recognition and support from their families and share love with them. Finally, there should be practical policy approaches to help people with normal hearing understand the culture of deaf elderly and assist the deaf elderly to receive supports from the community and live with others within the community.

• The Journal of Korean Philosophical History
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• no.58
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• pp.201-243
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• 2018

Understanding the theory of how a religion accepts the perspective on death is a prerequisite to grasp the identity and characteristics of such religion. Furthermore, contemplating the perspective on death, itself has a significant meaning as the contemplation provides an insight on how religion has, currently is and how it would influence the practical life of the human race. This current study compares and analyzes the perspective on death accepted by New Religions of Jeungsan, Confucianism and Taoism. By comparing the perspectives on death, this study seeks to conclude the similarity and discrepancy of New Religions of Jeungsan, Confucianism and Taoism. The objective of this study is to summarize the religious characteristic and identity of New Religions of Jeungsan, and the social role of New Religions of Jeungsan. How does New Religions of Jeungsan preach afterlife? This question implies varieties of questions including: In what shape or form does human exist in afterlife?; Does human maintain their original identity in afterlife?; What happens to relations with family members in afterlife?; What is one's role in afterlife, and what would one experience in afterlife? or Does soul transmigrate or are reborn? This current study compares the answers to these questions one by one with Confucianism and Taoism.In general, this current study was conducted with a non-religious methodology. Death can be explained in three different domains: the psychological domain explaining the individual psychological awareness upon encountering death; the philosophical-religious domain explaining the death through the philosophical understanding of the human concept; and the socio-cultural domain explaining death through the social ceremonies upon death.This current study focuses on the philosophical domain of the perspective on death accepted by New Religions of Jeungsan, with a comparison of the socio-cultural significance. To understand the perspective on death preached by New Religions of Jeungsan, It is indispensable to explain the five key elements of Hon(魂), Baek (魄), Shin(神), Young(靈) and Seon(仙) that construe death. The perspective on death preached by New Religions of Jeungsan imposes a multi layer of acceptance and overcoming. This current study complements the problems and limits of previous studies by comparison with Confucianism and Taoism. Throughout this process, this current study intends to highlight the key elements of the perspective on death preached by Deasunjinrihoe, and identify the aspects of each key element. With the sophisticated discussion of the perspective on death provided by New Religions of Jeungsan with clarity, this current study will provide grounds for future studies to extract, in detail, the aspects of the perspective on death preached by New Religions of Jeungsan, in further subjects including: discussions on death such as rituals for death, treatment of bodies, funerals, educating death, euthanasia, or suicide; discussions on the existence of hell; discussions on psychological aspects of ones who encounter death; or discussions on rebirth of those who died during the creation era. This current study will provide an overview on what kind of perspective on death does those who are faithful to New Religions of Jeungsan have and currently are living their life with.

• Korean Journal of Culture and Social Issue
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• v.22 no.4
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• pp.523-541
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• 2016

Both the child's and defendant's testimonies play crucial roles in the court's ruling of a child abuse case. Thus, empirical studies examining a child's truthful report, that is, disclosure, of his or her experience and recantation of the disclosure have manifold practical implications. The objective of the present study was to examine how easily a child recants his or her testimony after witnessing and disclosing an adult engaging in a small mistake. Furthermore, this study examined whether the child's age and emotional support from his or her caregiver predict the recantation of the child's testimony. Children of age 5-8 years played with dolls with the experimenter and witnessed the experimenter breaking the doll mask. The experimenter asked the children to keep it a secret. Then the children had the first memory interview, during which the interviewer induced the child to disclose the incident. Based on the treatment conditions, some children were provided supportive feedback while other received unsupportive feedback from their primary caregivers (mother) regarding the disclosure, then were interviewed for the second time. First, the author of this study examined whether the children would recant their disclosure (whether they would deny the incident after telling the truth of about what happened to the doll), and also examined the features of the child's voluntary reports, that is, the degree of their honesty. The findings of the experiment indicated that there were age-specific differences in the frequency of recantation, meaning that older children (8-9-year-olds) showed a stronger tendency to maintain their recantation in the second interview than relatively younger children (6-7-year-olds). Furthermore, children who received supportive responses from their mothers regarding the disclosure demonstrated more honest reports compared to those who received unsupportive responses from their mothers. The findings of this study assist the understanding of the effects of social-motivational factors on the process of children disclosing the truth when voluntarily recalling a negative incident that they had experienced and provide practical implications in legal aspects.

• Korea Science and Art Forum
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• v.19
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• pp.281-292
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• 2015

For this study, I conducted a survey investigating current situation, user preference, and field experiment. Hospitals utilizing digital sign systems at least five years were selected, which are connected with visual elements (layout, typo, color) used in waiting areas and elements of the systems (time, video time line). The results obtained from the field survey showed that digital sign systems used the color of typo and background contrasted to one another to increase explicitness and to ensure easy understanding of contents. In addition, the Gothic typo with relatively high legibility was adopted. Time and video timeline, which characterize digital sign systems, showed the advertising screens of the hospitals and the guidance of medical treatment at regular intervals. Moreover, survey results on user satisfaction showed that a majority of respondents indicated they had difficulty in understanding digital information conveyed from digital sign systems due to time setting for rotational speed or the small size of typo although most of the users had previous experience with digital sign systems. The highest proportion of respondents (n=86, 86%) answered that information related to medical departments was what they sought most frequently and that this kind of information should be importantly considered in digital sign systems. For the experiment, new samples with restructured contents of current digital sign systems were created and tested while keeping its design unchanged as well as applying these new samples. Study participants were in their 20s through 50s. When the size of typo was larger under the same conditions for all age groups, study participants found the desired information approximately 3.5 seconds faster. In addition, those in their 20-30s and 40-50s showed the time difference of 4.7 seconds for small typo and 6 seconds for large typo, which suggested that there was a difference by age in the amount of time taken in the experiment to find the desired information from the rotating digital sign system regardless of age and the size of typo.

• The Korean Society of Law and Medicine
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• v.24 no.3
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• pp.59-104
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• 2023

This essay attempts to analyze the public health welfare conception within the text of the Beveridge Report and its realization via the NHS in Great Britain. Once referring to the influence of the Report to create the foundations of the 20th-century welfare system, the quest to scrutinize the original intentions of the Report and its succession to the NHS is certainly intriguing. Furthermore, when regarding the significance of public health policy for a modern state, the effort to engage in Beveridge's conception and its realization is more than timely. In light of such a premise, this paper indulges in its study by the following methods. First, the historical background of the Report - namely, the role of the spirit of the age and the experience of the Emergency Medical Service are to be analyzed to identify the origins of the welfare policies proposed by Beveridge. Furthermore, the public health welfare conception of the Report conceived from its time is reflected upon by engaging on the goal towards social welfare and public health scheme. Lastly, the aims of the NHS and its management, treatment classification, and rehabilitation program are reviewed for comparative analysis with the Report to survey the realization of Beveridge's design. In this process, this paper not only takes into account the original text of the Report - but also other essential works of law and public policy, including the NHS Constitution for England and the National Health Service Act of 1946. The intentions of this study are not bound by merely coinciding with the Report, but resonate significance via reflecting upon the Beveridgian legacy on the modern welfare state from the current perspective. The structured analysis to research the aims and policies of the Report and to compare them to the reality of the NHS may provide an opportunity to confirm the realization of Beveridge's scheme in British society. In addition, this essay is part of an academic endeavor to critically assess the past and the present of the welfare institution in the public health sector. As such, it is hopeful that the essay sheds light on further studies concerning the constructive remedies of the Korean welfare system as well.

• Health Policy and Management
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• v.34 no.3
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• pp.271-281
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• 2024

Background: The unmet healthcare needs (UHNs) of people with disabilities (PWD) are not only detrimental to their quality of life but also can lead to serious health outcomes including death. A variety of factors including socioeconomic, personal, and environmental factors affect UHNs for PWD. Previous studies focused on individual socioeconomic and disability characteristics as influencing factors. Our studies included environmental factors that have a significant impact on the use of healthcare service by PWD. Methods: We analyzed the UHNs status and influencing factors among 4,326 adults with disabilities using the Korea Disability Life Data. Chisquare analysis identified differences in UHNs by general, disability, and environmental characteristics. Logistic regression determined factors affecting UHNs. Results: Those with low educational level (adjusted odds ratio [aOR], 1.229; 95% confidence interval [CI], 1.024-1.475), those with low income level (aOR, 1.416; 95% CI, 1.015-1.976), those who enrolled in private insurance (aOR, 1.234; 95% CI, 1.018-1.496), those who need help with daily living (aOR, 1.298; 95% CI, 1.059-1.592), those who did not go out (OR, 1.566; 95% CI, 1.274-1.924), those who use taxis (aOR, 1.407; 95% CI, 1.047-1.891) or call taxi for people with disabilities when going to the hospital (aOR, 1.370; 95% CI, 1.001-1.875), the communication disabled (aOR, 1.304; 95% CI, 1.029-1.651), those with poor subjective health status (aOR, 1.248; 95% CI, 1.043-1.494), those who felt the explanation of treatment results was insufficient (aOR, 4.035; 95% CI, 1.365-11.927), hose dissatisfied with healthcare services (aOR, 3.515; 95% CI, 2.741-4.508) were more likely to experience UHNs. Conclusion: Effective healthcare service provision for PWD requires not only financial assistance but also social support, along with education for healthcare staff, policies that consider the characteristics of disabilities.