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The Analysis of the Current Status of Medical Accidents and Disputes Researched in the Korean Web Sites (인터넷 사이트를 통해 살펴본 의료사고 및 의료분쟁의 현황에 관한 분석)

  • Cha, Yu-Rim;Kwon, Jeong-Seung;Choi, Jong-Hoon;Kim, Chong-Youl
    • Journal of Oral Medicine and Pain
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    • v.31 no.4
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    • pp.297-316
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    • 2006
  • The increasing tendency of medical disputes is one of the remarkable social phenomena. Especially we must not overlook the phenomenon that production and circulation of information related to medical accidents is increasing rapidly through the internet. In this research, we evaluated the web sites which provide the information related to medical accidents using the keyword "medical accidents" in March 2006, and classified the 28 web sites according to the kinds of establishers. We also analyzed the contents of the sites, and checked and compared the current status of the web sites and problems that have to be improved. Finally, we suggested the possible solutions to prevent medical accidents. The detailed results were listed below. 1. Medical practitioners, general public, and lawyers were all familiar with and prefer the term "medical accidents" mainly. 2. In the number of sites searched by the keyword "medical accidents", lawyer had the most sites and medical practitioners had the least ones. 3. Many sites by general public and lawyers had their own medical record analysts but there was little professional analysts for dentistry. 4. General public were more interested in the prevention of medical accidents but the lawyers were more interested in the process after medical accidents. The sites by medical practitioners dealt with the least remedies of medical accidents, compared with other sites. 5. General public wanted the third party such as government intervention into the disputes including the medical dispute arbitration law or/and the establishment of independent medical dispute judgment institution. 6. In the comparison among the establishers of web sites, medical practitioners dealt with the least examples of medical accidents. 7. The suggestion of cases in counseling articles related to dental accidents were considered less importantly than the reality. 8. Whereas there were many articles about domestic cases related to the bloody dental treatment, in the open counseling articles the number of dental treatment regarding to non insurance treatment was large. 9. In comparing offered information of medical accidents based on the establishers, general public offered vocabularies, lawyers offered related laws and medical practitioners offered medical knowledge relatively. 10. They all cited the news pressed by the media to offer the current status of domestic medical accidents. Especially among the web sites by general public, NGOs provided the plentiful statistical data related to medical accidents. 11. The web sites that collect the medical accidents were only two. As a result of our research, we found out that, in the flood of information, medical disputes can be occurred by the wrong information from third party, and the medical practitioners have the most passive attitudes on the medical accidents. Thus, it is crucial to have the mutual interchange and exchange of information between lawyer, patients and medical practitioners, so that based on clear mutual comprehension we can solve the accidents and disputes more positively and actively.

M-mode Ultrasound Assessment of Diaphragmatic Excursions in Chronic Obstructive Pulmonary Disease : Relation to Pulmonary Function Test and Mouth Pressure (만성폐쇄성 폐질환 환자에서 M-mode 초음파로 측정한 횡격막 운동)

  • Lim, Sung-Chul;Jang, Il-Gweon;Park, Hyeong-Kwan;Hwang, Jun-Hwa;Kang, Yu-Ho;Kim, Young-Chul;Park, Kyung-Ok
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.736-745
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    • 1998
  • Background: Respiratory muscle interaction is further profoundly affected by a number of pathologic conditions. Hyperinflation may be particularly severe in chronic obstructive pulmonary disease(COPD) patients, in whom the functional residual capacity(FRC) often exceeds predicted total lung capacity(TLC). Hyperinflation reduces the diaphragmatic effectiveness as a pressure generator and reduces diaphragmatic contribution to chest wall motion. Ultrasonography has recently been shown to be a sensitive and reproducible method of assessing diaphragmatic excursion. This study was performed to evaluate how differences of diaphragmatic excursion measured by ultrasonography associate with normal subjects and COPD patients. Methods: We measured diaphragmatic excursions with ultrasonography on 28 healthy subjects(l6 medical students, 12 age-matched control) and 17 COPD patients. Ultrasonographic measurements were performed during tidal breathing and maximal respiratory efforts approximating vital capacity breathing using Aloka KEC-620 with 3.5 MHz transducer. Measurements were taken in the supine posture. The ultrasonographic probe was positioned transversely in the midclavicular line below the right subcostal margin. After detecting the right hemidiaphragm in the B-mode the ultrasound beam was then positioned so that it was approximately parallel to the movement of middle or posterior third of right diaphragm. Recordings in the M-mode at this position were made throughout the test. Measurements of diaphragmatic excursion on M-mode tracing were calculated by the average gap in 3 times-respiration cycle. Pulmonary function test(SensorMedics 2800), maximal inspiratory(PImax) and expiratory mouth pressure(PEmax, Vitalopower KH-101, Chest) were measured in the seated posture. Results: During the tidal breathing, diaphragmatic excursions were recorded $1.5{\pm}0.5cm$, $1.7{\pm}0.5cm$ and $1.5{\pm}0.6cm$ in medical students, age-matched control group and COPD patients, respectively. Diaphragm excursions during maximal respiratory efforts were significantly decreased in COPD patients ($3.7{\pm}1.3cm$) when compared with medical students, age-matched control group($6.7{\pm}1.3cm$, $5.8{\pm}1.2cm$, p< 0.05}. During maximal respiratory efforts in control subjects, diaphragm excursions were correlated with $FEV_1$, FEVl/FVC, PEF, PIF, and height. In COPD patients, diaphragm excursions during maximal respiratory efforts were correlated with PEmax(maximal expiratory pressure), age, and %FVC. In multiple regression analysis, the combination of PEmax and age was an independent marker of diaphragm excursions during maximal respiratory efforts with COPD patients. Conclusion: COPD subjects had smaller diaphragmatic excursions during maximal respiratory efforts than control subjects. During maximal respiratory efforts in COPD patients, diaphragm excursions were well correlated with PEmax. These results suggest that diaphragm excursions during maximal respiratory efforts with COPD patients may be valuable at predicting the pulmonary function.

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A Study on the Yousang-Dae Goksuro(Curve-Waterway) in Gangneung, Yungok-Myun, Yoodung Ri (강릉 연곡면 유등리 '유상대(流觴臺)' 곡수로(曲水路)의 조명(照明))

  • Rho, Jae-Hyun;Shin, Sang-Sup;Lee, Jung-Han;Huh, Jun;Park, Joo-Sung
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.30 no.1
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    • pp.14-21
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    • 2012
  • The object of the study, Yousang-Dae(流觴臺) and engraved Go broad text on the flat rock in Gangneung-si Yungok-myun Yoodung-ri Baemgol, reveals that the place was for appreciating arts like Yusang Goksu and Taoist hermit's games. three times of detail reconnaissance survey brought about the results as follows. There is a the text, Manwolsan(滿月山) Baegundongcheon(白雲洞天), engraved on the rock in Baegunsa(白雲寺) that had been built by Doun at the first year of King Hungang(in 875) of the United Shilla, became in ruins in the middle of Joseon, and then was rebuilt in 1954. The text is an invaluable evidence indicating that the tradition of Taoist hermit and Sunbee(classical scholars) culture has been generated in Baemgol Valley. According to the 2nd vol. of Donghoseungram(東湖勝覽), the chronicle of Gangneung published by Choi Baeksoon in 1934, there is a record saying that 'Baegunsa in Namjeonhyeon is the classroom where famous teachers like Yulgok Lee Yi or Seongje Choi Ok were teaching' that verifies the historic property of the place. In addition, the management of Nujeong(樓亭) and Dongcheon can be traced through Baegunjeong(白雲亭) constructed by Kim Yoonkyung(金潤卿) in Muo year, the 9th year of Cheoljong(1858) according to Donghoseungram and the completed version of Jeungboyimyoungji(增補臨瀛誌). Also, Baegundongdongcheon(白雲亭洞天), the text engraved on the standing stone across the stream from Yousang-Dae stone, was created 3 years after the Baegunjeong construction in the 12th year of Cheoljong(1861), which refers a symbolic sign closely related with Yousang-Dae. Based on this premise and circumstance, with careful studying the remains of 'Yusang-dae' Goksuro, we discovered that the Sebun-seok(細分石) controling the amount and the speed of moving water and the remains of furrows of Keumbae-soek(擒盃石) and Yubae-gong(留盃孔) containing water stream with cups through the mountain stream and rocks around Yusang-Dae. In addition, as 21 people's names engraved under the statement of 'Oh-Seong(午星)' were discovered on the bottom of the rock, this clearly confirms that the place was one of the main cultural footholds of tasting the arts which have characteristics of Yu-Sang-Gok-Su-Yeon(流觴曲水宴) until the middle of the 20th century. It implies that the arts tasting culture of Sunbees had been inherited centering on Yusang-dae in this particular place until the middle of the 20th century. It is necessary to be studied in depth because the place is a historic and unique cultural place where 'Confucianism, Buddhism, and Zen'were combined together. Based on the result of the study, the identification of 23 people as well as the writer of Yusang-Dae text should be carefully studied in depth in terms of the characteristics of the place through gathering data about appreciation of arts like Yusanggoksu. Likewise, we should make efforts to discover the chess board engraved on the rock described on the documents, thus we should consider to establish plans to recover the original shape of the place, for example, breaking the cement pavement of the road, additional excavation, changing the existing route, and so fourth.

Gender Differences in Pain in Cancer Patients (성별에 따른 암환자의 통증 차이)

  • Kim, Hyun-Sook;Lee, So-Woo;Yun, Young-Ho;Yu, Su-Jeong;Heo, Dae-Seog
    • Journal of Hospice and Palliative Care
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    • v.4 no.1
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    • pp.14-25
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    • 2001
  • Purpose : To determine whether there exist gender differences in pain in Korean cancer patients and whether the depression and performance that are often expressed differently between men and women with cancer interact with pain. Method : The results of survey were collected from 140 in- and out-patients (78 male and 62 female) who had cancer treatment at one of the university hospital in Seoul for four months from February of 1999. The severity and interference of pain were examined with the self-reported survey based on Korean version of Brief Pain Inventory (BPI-K). Demographic and clinical information for all patient were compiled by reviewing their medical records, and the level of depression was examined with the Korean version of Beck Depression Inventory (BDI-K). Usual statistical methods, e.g., frequences, means and SDs were used to characterize the sample. The chi-square tests for categorical data and t-test for numerical data were used for group comparison. And the correlation between variables were performed using Pearson correlation coefficient. Resuts : 1) The mean scores of the worst pain for last 24-hours measured with the pain severity of BPI-K were 5.77 in male and 6.45 in female. The pain interference of BPI-K in men was in the order of mood (5.49), enjoy (5.36), and work (5.00), and in women were work (7.48), enjoy (7.16), and mood (6.53). 2) In pain severity, significant difference was found between men and women in the average pain for last 24-hours (t=-2.130, P=.035). In pain interference, significant difference was found between men and women in activity (t=-2.450, P=.015), mood (t=-2,321, P=.022), walk (t=-2.762, P=.007), work (t=-4.946, P=.000), relate (t=-2.595, P=.010), sleep (t=-2.071, P=.040), enjoy (t=-3.198, P=.001). 3) It was found that the items of pain and depression are significantly correlated in men but not in women. Men also exhibited higher correlation in the items of pain and performance status than women. Conclusions : Women report significantly greater average pain for last 24-hours and for all items of pain interference than men. Pain and depression are significantly correlated in men. The results of this study suggest that gender differences in pain should be considered for planning effective pain management program.

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A Study on the Traditional House Landscape Styles Recorded in 'Jipkyungjaeyoungsi(集景題詠詩, Series of Poems on Gardens Poetry)' ('집경제영시(集景題詠詩)'를 통해 본 전통주택의 조경문화 향유양상)

  • Shin, Sang Sup
    • Korean Journal of Heritage: History & Science
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    • v.49 no.3
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    • pp.32-51
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    • 2016
  • This study examines, based on the database of the Institute for the Translation of Korean Classics(ITKC), the garden plants and their symbolism, and the landscape culture recorded in 'Jipkyungjaeyoungsi(the Series of Poems on Gardens Poetry)' in relevance to traditional houses. First, Jipkyungjaeyoungsi had been continuously written since mid-Goryeo dynasty, when it was first brought in, until the late Joseon dynasty. It was mainly enjoyed by the upper class who chose the path of civil servants. 33 pieces of Jaeyoungsi(題詠詩) in 25 books out of a total of 165 books are related to residential gardens. The first person who wrote a poem in relation to this is believed to be Lee GyuBo(1168~1241) in the late Goryeo dynasty. He is believed to be the first person to contribute to the expansion of natural materials and the variation of entertainment in landscape culture with such books as 'Toesikjaepalyoung(退食齋八詠)', 'Gabeunjeungyukyoung(家盆中六詠)'and 'Gapoyukyoung(家圃六詠)'. Second, most of the poems used the names of the guesthouses. Out of the 33 sections, 19(57.5%) used 8 yeong(詠), then it was in the sequence of 4 yeong(詠), 6 yeong, 10 yeong, 14 yeong, 15 yeong, 16 yeong, 36 yeong(詠) and so on. In the poem writing, it appears to break the patterns of Sosangpalkyung(瀟湘八景) type of writings and is differentiated by (1) focusing on the independent title of the scenery, (2) combining the names of the place and landscape, (3) focusing on the name of the landscape. Third, the subtitles were derived from (1) mostly natural landscape focused on nature and garden plants(22 sections, 66.7%), (2) cultural landscape focused on landscape facilities such as guesthouses, ponds and pavilions(3 sections), (3) complex cultural scenery focused on the activities of people in nature(8 sections). Residents enjoy not only their aesthetic preferences and actual view, but the ideation of the scenery. Especially, they display attachment to and preference for vegetables and herbs, which had been neglected. Fourth, the percentage of deciduous tree population(17 species) rated higher(80.9%) compared to the evergreens(4 species). These aspects are similar results with the listed rate in 'Imwonkyungjaeji(林園經濟志)' by Seo YuGu [evergreen 18 species(21.2%) and deciduous trees 67 species(78.8%)] and precedent researches [Byun WooHyuk(1976), Jung DongOh(1977), Lee Sun(2006)]. Fifth, the frequency of the occurrence of garden plants were plum blossoms(14 times), bamboos(14 times), pine trees(11 times), lotus(11 times), chrysanthemum(10 times), willows(5 times), pomegranates(4 times), maple trees(14 times), royal foxglove trees, common crapemyrtle, chestnut trees, peony, plantains, reeds and a cockscombs(2 times). Thus, the frequency were higher with symbolic plants in relations to (1) Confucian norms(pine trees, oriental arbor vitae, plum blossoms, chrysanthemums, bamboos and lotus), (2) living philosophy of sustain-ability(chrysanthemum, willow), (3) the ideology of seclusion and seeking peace of mind(royal foxglove ree, bamboo). Sixth, it was possible to trace plants in the courtyard and outer garden, vegetable and herb garden. Many symbolic plants were introduced in the courtyard, and it became cultural landscape beyond aesthetic taste. In the vegetable and herb garden, vegetables, fruits and medicinal plants are apparently introduced for epigenetic use. The plants that were displayed to be observed and enjoyed were the sweet flag, pomegranate, daphne odora, chrysanthemum, bamboo, lotus and plum blossom. Seventh, it was possible to understand garden culture related to landscaping materials through poetic words such as pavilions, ponds, stream, flower pot, oddly shaped stones, backyard, orchard, herb garden, flower bed, chrysanthemum fence, boating, fishing, passing the glass around, feet bathing, flower blossom, forest of apricot trees, peach blossoms, stroking the pine tree, plum flower blossoming through the snow and frosted chrysanthemum.

Analysis of Korean Dietary Patterns using Food Intake Data - Focusing on Kimchi and Alcoholic Beverages (식품섭취량을 활용한 우리나라 식이 패턴 분석 - 김치류 및 주류 중심으로)

  • Kim, Soo-Hwaun;Choi, Jang-Duck;Kim, Sheen-Hee;Lee, Joon-Goo;Kwon, Yu-Jihn;Shin, Choonshik;Shin, Min-Su;Chun, So-Young;Kang, Gil-Jin
    • Journal of Food Hygiene and Safety
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    • v.34 no.3
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    • pp.251-262
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    • 2019
  • In this study, we analyzed Korean dietary habits with food intake data from the Korea National Health and Nutrition Examination Survey (KNHANES) and the Korea Centers for Disease Control and Prevention and we proposed a set of management guidelines for future Korean dietary habits. A total of 839 food items (1,419 foods) were analyzed according to the food catagories in "Food Code", which is the representative food classification system in Korea. The average total daily food intake was 1,585.77 g/day, with raw and processed foods accounting for 858.96 g/day and 726.81 g/day, respectively. Cereal grains contributed to the highest proportion of the food intake. Over 90% of subjects consumed cereal grains (99.09%) and root and tuber vegetables (95.80%) among the top 15 consumed food groups. According to the analysis by item, rice, Korean cabbage kimchi, apple, radish, egg, chili pepper, onion, wheat, soybean curds, potato, cucumber and pork were major (at least 1% of the average daily intake, 158.6 g/day) and frequently (eaten by more than 25% of subjects, 5,168 persons) consumed food items, and Korean spices were at the top of this list. In the case of kimchi, the proportion of intake of Korean cabbage kimchi (64.89 g/day) was the highest. In the case of alcoholic beverages, intake was highest by order of beer (63.53 g/day), soju (39.11 g/day) and makgeolli (19.70 g/day), and intake frequency was high in order of soju (11.3%), beer (7.2%), and sake (6.6%). Analysis results by seasonal intake trends showed that cereal grains have steadily decreased and beverages have slightly risen. In the case of alcoholic beverage consumption frequency, some kinds of makgeolli, wine, sake, and black raspberry wine have decreased gradually year by year. The consumption trend for kimchi has been gradually decreasing as well.

The Modern Understanding and Misunderstanding about the Thirteen-story Stone Pagoda of Wongaksa Temple (원각사(圓覺寺)13층탑(層塔)에 대한 근대적 인식과 오해)

  • Nam, Dongsin
    • MISULJARYO - National Museum of Korea Art Journal
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    • v.100
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    • pp.50-80
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    • 2021
  • This paper critically examines the history of the theories connected to the Wongaksa Temple Pagoda that have developed over the last 100 years focusing on the original number of stories the pagoda would have reached. Part II of this paper retraces the dynamic process of the rediscovery of the Wongaksa Temple Pagoda by Westerners who traveled to Korea during the port-opening period. Koreans at the time viewed the Wongaksa Temple Pagoda as an object of no particular appeal or even as an eyesore. However, Westerners appreciated it as a wonder or magnificent sight. Since these Westerners had almost no prior knowledge of Buddhist pagodas, they were able to write objective travelogues. At the time, these visitors generally accepted the theory common among Joseon intellectuals that Wongaksa Temple Pagoda once had thirteen stories. Part III focuses on Japanese government-affiliated scholars' academic research on the Wongaksa Temple Pagoda after the proclamation of the Korean Empire and the Japanese Government-General of Korea's subsequent management of the pagoda as a cultural property during the colonial era. It also discusses issues with Japanese academic research and management. In particular, this portion sheds light on the shift in theories about the original number of stories of the Wongaksa Temple Pagoda from the ten-story theory supported by Sekino Tadashi (關野 貞), whose ideas have held a great influence on this issue over the last 100 years, to the thirteen-story theory and then to the idea that it had more than thirteen. Finally, Part IV addresses the change from the multi-story theory to the ten-story theory in the years after Korea's liberation from Japan until 1962. Moreover, it highlights how Korean intellectuals of the Japanese colonial era predominantly accepted the thirteen-story theory. Since 1962, a considerable quantity of significant research on the Wongaksa Temple Pagoda has been published. However, since most of these studies have applied the ten-story theory suggested in 1962, they are not individually discussed in this paper. This retracing of the history of theories about the Wongaksa Temple Pagoda has verified that although there are reasonable grounds for supporting the thirteen-story theory, it has not been proved in the last 100 years. Moreover, the number of pagoda stories has not been fully discussed in academia. The common theory that both Wongaksa Temple Pagoda and Gyeongcheonsa Temple Pagoda were ten-story pagodas was first formulated by Sekino Tadashi 100 years ago. Since the abrasion of the Wongaksa Temple Stele was so severe the inscriptions on the stele were almost illegible, Sekino argued that the Wongaksa Temple Pagoda was a ten-story pagoda based on an architectural analysis of the then-current condition of the pagoda. Immediately after Sekino presented his argument, a woodblock-printed version of the inscriptions on the Wongaksa Temple Stele was found. This version included a phrase that a thirteen-story pagoda had been erected. In a similar vein, the Dongguk yeoji seungnam (Geographic Encyclopedia of Korea) published by the orders of King Seongjong in the late fifteenth century documented that Gyeongcheonsa Temple Pagoda, the model for the Wongaksa Temple Pagoda, was also a thirteen-story pagoda. The Wongaksa Temple Stele erected on the orders of King Sejo after the establishment of the Wongaksa Temple Pagoda evidently shows that Sekino's ten-story premise is flawed. Sekino himself wrote that "as [the pagoda] consists of a three-story stereobate and a ten-story body, people call it a thirteen-story pagoda," although he viewed the number of stories of the pagoda body as that of the entire pagoda. The inscriptions on the Wongaksa Temple Stele also clearly indicate that the king ordered the construction of the Wongaksa Temple Pagoda as a thirteen-story pagoda. Although unprecedented, this thirteen-story pagoda comprised a ten-story pagoda body over a three-story stereobate. Why would King Sejo have built a thirteen-story pagoda in an unusual form consisting of a ten-story body on top of a three-story stereobate? In order to fully understand King Sejo's intention in building a thirteen-story pagoda, analyzing the Wongaksa Temple Pagoda is necessary. This begins with the restoration of its original name. I disprove Sekino's ten-story theory built upon flawed premises and an eclectic over-thirteen-story theory and urge applying the thirteen-story theory, as the inscriptions on the Wongaksa Temple Stele stated that the pagoda was originally built as a thirteen-story pagoda.

A Study on the Dietary Behaviors, Physical Development and Nutrient Intakes in Preschool Children (학령 전 아동의 식습관, 신체 발달 및 영양 섭취상태에 관한 연구)

  • Yu, Kyeong-Hee
    • Journal of Nutrition and Health
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    • v.42 no.1
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    • pp.23-37
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    • 2009
  • The purpose of this study was to investigate the health status of preschool children using the questionnaires about dietary behaviors and anthropometric indices. And also nutritional status was investigated using questionnaires for 24-hr recall method. The study was conducted in 145 children aged 3 to 6 years and questionnaires for dietary behaviors and dietary intakes were performed by mothers of children in Ulsan. Just nine percent of children were graded as good in terms of having healthy eating habits, this means that the nutrition education for the dietary behaviors should be more focused on preschool children. With regard to the frequency of food intake, children consumed green & yellow vegetables less frequently, meanwhile consumed high protein source food (meat, egg and bean) and milk and its product more frequently. Children almost never consumed fried foods as often as 1-2 times a weak. In assessment of the health status, children have the highest prevalence of colds and allergy, but lower prevalence of clinical symptoms due to the nutritional deficiency. The mean height was $103.6\;{\pm}\;6.4\;cm$ and significantly different among age (p < 0.05), but was not significantly different between sex. The mean weight was $17.8\;{\pm}\;3.0\;kg$ and significantly different in 5, 6years old among age. By the WLI criteria, 11.1% of children were underweight and 17.4% of children were overweight or obese. By the Rohrer index criteria, any children were not underweight and 86.8% of children were overweight or obese. By the Kaup index criteria, 2.8% of children were underweight and 29.2% of children were overweight or obese. And Obesity Index criteria, 2.1% of children were underweight and 20.8% of children were overweight or obese. The results of obesity rate by all criteria except Rohrer index indicated similar level, were significantly high in age 3 with all criteria, and decreased with age increased. The energy intake of children was lower than EER (Estimated Energy Requirements) of Dietary Reference Intakes for Koreans (KDRIs) by as much as 85.7%. Acceptable Macronutrient Distribution Ranges (AMDR) was 62.6:21.5:15.7 as carbohydrate:protein:lipid, so children consumed protein more, but consumed lipid less compared with those of KDRIs. Vitamin A intake was 133% of recommended intakes (RI) and calcium intake which was identified as the nutrient most likely to be lacking in diets was 98.9% of RI. The intakes of all minerals and vitamins except folate were higher than KDRIs. 33.3% of children were distributed in insufficiency of energy intake, 42.7% of children were distributed in insufficiency of lipid intake. These results indicate that the need of developing of nutrition education program and further concern of a public health center, university and children care center about dietary life for preschool children.