• Journal of Digestive Cancer Research
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• v.4 no.2
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• pp.122-126
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• 2016

Leptomeningeal carcinomatosis occurs in approximately 5% of patients with cancer. The most common cancers involving the leptomeninges are breast, lung cancer and melanoma. However, gastric adenocarcinoma has been rarely reported with leptomeningeal carcinomatosis. The presenting manifestations are usually headache, visual disturbances and seizures. We report a case of leptomeningeal metastasis that presented as a gastric cancer. A 75-year old man was transferred to our hospital for further evaluation and treatment after being diagnosed with adenocarcinoma through endoscopic biopsy during a regular health examination. An abdominal computed tomography (CT) showed AGC, stage IA (cT1N0M0), while an endoscopic examination showed AGC, Borrmann type 2. The patient is currently under observation after undergoing radical subtotal gastrectomy with gastroduodenostomy and subsequent administration of oral chemotherapeutic agents. As an abdominal CT response assessment performed after surgery revealed new metastasis to the liver, the patient received palliative chemotherapy as recurrence was suspected. After receiving chemotherapy in the order of DP (Cisplatin + Docetaxel), FOLFIRI (5-FU + Leucovorin + Irinotecan), an abdominal CT response assessment showed complete response. Since decreased mentality maintained throughout the follow up period based on outpatient clinic, brain MRI was performed and revealed multiple leptomeningeal metastasis. The Patient died 2 days after the diagnosis.

• Safety and Health at Work
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• v.15 no.3
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• pp.300-309
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• 2024

Background: Risk perception plays a crucial role in workers' unsafe behaviors. However, little research has explored why workers generate biased risk perceptions, namely underestimating or overestimating the risks of unsafe actions. Cognitive biases in risk perception arise from uncertainties about the dangers of unsafe behaviors. As a typical heuristic strategy, the anchoring effect is critical in decision-making under uncertain conditions. Consequently, this study empirically analyzed the influence of anchoring effects on workers' risk perception. Methods: In 2022, a survey was conducted with 1,418 coal mine workers from Shanxi Province, China. The survey instruments assessed workers' risk perception of unsafe behavior, anchoring effects, need for cognition, and safety knowledge. Multivariable linear regression models were employed to analyze the associations among these variables. Results: The findings verified the proposed anchoring effects. Specifically, experimenter-provided high-risk anchors led workers to overestimate unsafe behavior risks, thus reducing their tendency to engage in such behavior. In contrast, experimenter-provided low-risk anchors and accident-injury experiences (self-generated anchors) decreased workers' risk perception, increasing their propensity to engage in unsafe behavior. Additionally, workers' safety knowledge and need for cognition significantly affected anchoring effects. Conclusion: This research enhances workplace safety studies by applying the anchoring effect from psychology to risk perception research. Suggestions for improving risk perception encompass implementing hazard warnings, fostering safety education, and providing training. Furthermore, managers should give special attention to workers with accident-injury experience and promptly correct their accident fluke mentality, thereby improving overall risk awareness.

• Korean Journal of Hospice Care
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• v.2 no.1
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• pp.58-74
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• 2002

This paper constitutes a descriptive investigation and used a structured questionnaire to investigate nurses' and doctors' recognition of cancer patients. The subjects were extracted from the medical personnel working at the internal medicine, the surgery ward, the obstetrics and gynecology department, the pediatrics department, the cancer ward, and the emergency room of five general hospitals located in Seoul and Gyeonggi Province. The research lasted from August, 2001 to September 2001. Total 137 nurses and 65 doctors were included and made out the questionnaires directly distributed by the investigator. The study tool was also developed by the investigator and consisted of such items as the demographic and social characteristics, the medical personnel's recognition degree of cancer and cancer patients, their recognition of the management of cancer patients, and their participation in a hospice. The results were analyzed using the SPSS Window program in terms of technological statistics, ranks, t-test, and ANOVA. The reliability was represented in Cronbach' α=.75. The nurses' and doctors' recognition degree of cancer and cancer patients had an overall average of 3.86 at the 5 point-scale. The items that received an average of 4.0 or more included 'Medical personnel should explain about the cancer cure plans to the cancer patient and his or her family', 'A patient whose case has been diagnosed as a terminal cancer should be notified of it, 'If I were a cancer patient, I would want to get informed of it,' and 'Cancer shall be conquered whenever it is'. In the meantime, the items that received an average of 3.0 or less was 'My relationship with the cancer patient's family has gotten worse since I announced his or her impending death.' And according to the general characteristics and the difference test, the recognition degree of cancer and cancer patient was high among the subgroups of nurses, females, married persons, who were in their 30s, who had a family member that was a cancer patient, and who received a hospice education. The biggest number of the nurses and doctors saw 'a gradual approach over several days'(68.8%) as a method to tell a cancer patient about his or her cancer diagnosis or impending death. Those who usually tell tragic news were the physician in charge(62.8%), the family members or relatives(32.1%) and the clergymen(3.8%) in the order. The greatest number of them recommended a cancer patient's home as the place where he or she should face death because they thought 'it would stabilize his or her mentality'(91.9%) while a number of them recommended the hospital because they 'should give the psychological satisfaction to the patient'(40%) or 'should try their best until the last moment of the patient's death'(30%). A majority of the medical personnel regarded 'smoking or drinking' and 'diet' as the causes of cancer. The biggest symptom of a cancer patient was 'pain' and the pain management of a cancer patient was mostly impeded by the 'excessive fear of drug addiction, tolerance to drugs and side effects of drugs' by medical personnel, the patient, and his or her family. The most frequently adopted treatment plan of a terminal cancer patient was 'to do whatever the patient or his or her family wants' to resort to a hospice' and 'to continue active treatment efforts' in the order. The biggest reasons why a terminal cancer patient went to see a doctor were 'pain alleviation' 'control of symptoms other than pain(intravenous supply)' and 'incapability of the patient's family' in the order. Terminal cancer patients placed their major concern in 'spiritual(religious) matter' 'emotional matters' their family' 'existence' and 'physical matters' in the order. 113(58.5%) of the whole medical personnel answered they 'would recommend' an alternative treatment to a terminal cancer patient mostly because they assumed it would 'stabilize the patient's mentality.' Meanwhile, 80(41.5%) of them chose 'not to recommend it mostly due to the unverified effects and high cost of it(78.7%). A majority of them, I. e. 190(94.1%) subjects said they 'would recommend' a hospice to a terminal cancer patient mostly because they thought it would help the patient to 'mentally prepare'(66.6%) Only 17.3% of them, however, had received a hospice education, most of which was done through the hospital duty education(41.4%) and volunteer training(34.5%). The follows are results of this study: 1. The nurses and the doctors turned out to be still passive and experience confusion in dealing with a cancer patient despite their great sense of responsibility for him or her. 2.Nurses and Doctors realize the need of a hospice, but an extremely small number of them participate in a hospice education or performance. Thus, a whole recognition of a hospice should be changed, for which purpose a hospice education for nurses and doctors should be provided. 3.Terminal cancer patients preferred their home to a hospital as the place to face their impending death because they felt it would bring 'mental stability.' And most of nurses and doctors think it would be unnecessary for them to be hospitalized just for control of their symptoms. Accordingly a terminal cancer patient can be cared at home, and a home hospice care needs to be activated.

• Journal of Acupuncture Research
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• v.17 no.4
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• pp.149-159
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• 2000

Bee-venom Acupucture has good effect on pain control but We may be anxious about the problem of side-effect. Bee-venom components are composed of phospholipase $A_2$, hyaluronidase, melitin, apamin, MCD peptide, citrate and so on. Especially Apamin, MCD peptide and histamine cause severe reacting that is named Anaphylaxis. Anaphylaxis is a clinical syndrome characterized by the acute system reaction of multiple organ systems to an IgE-mediated immunologic mediator release in previously sensitized individuals. Respiratory and dermatologic manifestations are the most commonly expressed clinical features of anaphylaxis, and a majority of anaphylactic reactions initially appear to be localized to these two systems. Anaphylatic reaction of bee-venom are expressed clinically ulticaria, itching sensation, erythema, dizziness, nausea, hypotension and so on. Especially ulticaria and erythema are end points of increased vascular permeability and vasodilatation at the other extreme of the clinical spectrum, Gastrointestinal mucosal edema and smooth muscle contraction can result in cramping abdominal pain, nausea, and vomiting. Therefore, we have observed anaphylatic reaction of bee-venom in 11 patients, who visited WonKwang University Kunpo Oriental Medical Center, treated bee venom. The results were summarized as follows : 1. The patient distribution ratio, in regard to sex, was shown to be 1 : 2.67 for male to females. In regard to age, it was shown that people in their 30's was the most predominant case, followed by people in their 20's, 30's, 50's and 60's, respectively. 2. When Anaphylaxis was occured, it was observed to abnormality of CBC, LFT, IgE, IgG. 3. In regard to patient condition, it was observed that fatigue was most frequent. 4. In regard to the number of times and quantity of bee venom inj., it was observed that anaphylaxis is most frequent at 7-10 times(1.6-2.0cc) 5. In regard to duration of reaction, it was observed that people in their l0min' was most frequent. In disappearing duration of anaphylaxic reaction, The results showed under 60min lcases(9%), 60-120min 7cases(64%) and 180-240min 3cases(27%). 6. In symptoms of anaphylaxis, The results showed hypotension 8cases(19%), itching sensation 7cases(16%), nausea 4cases(9%), erythema 4cases(9%) and dizziness 4cases(9%). In mentality, The results showed drowsy 8case(73%) and alert 3cases(27%). 7. Generally, patients were treated with Avil, Dexa IM and PDS, peniramine, cimetidine, Q-zyme per os after H/S, N/S inj. $O_2$ was supplied according to patient's symptom. In 1 severe case, Dopamine was iv injected.

• Korean Journal of Psychosomatic Medicine
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• v.19 no.2
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• pp.109-114
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• 2011

The abnormalities in Hypothalamic-pituitary-adrenal(HPA) axis are associated with many psychiatric symptoms including depression. We present a report of a 71 year old man who was admitted to the psychiatric department presenting symptoms of headache, avolition, loss of energy, psychomotor retardation, poor appetite, insomnia, anxiety resulting from adrenal insufficiency and hypopituitarism. Hypothyroidism and electrolyte disturbance were managed and headache, insomnia, anxiety, GI symptoms were improved. But he remained in anergic state. After discharge, he was readmitted to infection department with high fever and drowsy mentality. Adrenal insufficiency was recognized and he was treated with corticosteroid replacement therapy. Finally his diagnosis was made as panhypopituitarism and overall symptoms were resolved. In this case, we showed how the atypical symptoms resulting from hypopituitarism develop and progress. Hypothyroidism, adrenal insufficiency, and growth hormone deficiency resulting secondarily from panhypopituitarism were associated with various nonspecific symptoms such as loss of energy, fatigue, insomnia, weight loss, decreased appetite etc. In clinical situation, differential diagnosis with depression is needed when clinicians were met a patient with these nonspecific symptoms. It is important that laboratory tests and differential diagnosis with endocrine diseases should be conducted, especially in geriatric patients with nonspecific symptoms like anergia, fatigue, poor appetite and so on.

• Journal of The Korean Society of Clinical Toxicology
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• v.14 no.2
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• pp.136-143
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• 2016

Purpose: In patients with altered mentality caused by drugs or unknown causes, ammonia is checked to facilitate differential diagnosis or diagnose hepatic coma. This helps early prevention and treatment of brain damage due to hyperammonemia. This study was conducted to evaluate clinical characteristics of intoxicated adult patients with hyperammonemia. Methods: We evaluated 95 patients with hyperammonemia among intoxicated patients above the age of 15 who visited our ED from January 2013 to December 2015. We analyzed the demographic characteristics and type of poisoning substance, reason for ingestion, toxicological characteristics such as elapsed time from ingestion to hospital visit, lab, clinical progression and complications. Data were evaluated using the student's t test or Mann-Whitney U test for continuous variables, and Chi-square test and Fisher's exact test for frequency analysis of categorical variables. Results: When compared to healthy individuals, patients with hyperammonemia showed statistical significance on their SOFA score (p=0.016) and poison severity score (p<0.001). Additionally, patients with hyperammonemia showed significantly different initial serum AST level (p=0.012) and maximum serum AST level during the hospital stay (p=0.026) when compared to healthy individuals. Moreover, individuals with sustained hyperammonemia compared to transient hyperammonemia showed clinically significant SOFA scores (p<0.001), poison severity scores (p=0.007), mortality rates in the ICU (p=0.021), as well as different duration of hospital stay (p=0.037), serum creatinine level (p=0.002), erythrocyte sedimentation rate (p=0.025), and serum myoglobin (p=0.015). Conclusion: Most poisoning-induced hyperammonemia cases were transient and recovered without special treatment. Therefore, hyperammonemia is almost non-specific among poisoning patients.

• Journal of Digital Convergence
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• v.13 no.12
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• pp.359-366
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• 2015

In Pingyu, China, 2003, murders caused by the game occurred. The perpetrator murdered 17 people under 20 years old by imitating the character of warrior of the game in the real world. This event was to draw the public's attention to a change of mentality and morality of the youth from the game. People have pointed to the problem of emotional design in the process of designing online games. Game designers have not considered making the game in the most ethical component. The moral element of the game design is a very important factor in forming the psychological changes and outlook on life and values of gamers. Therefore, to understand the rational moral standards is an important part of the online game design. This paper aims the design of a "moral system" role, contents and tasks settings and community game design elements of the game by using a systematic process of the moral element in online gaming. Hence the result is the formation of moral attitudes and values to the user of the online game allows the gamers to introduce a moral system in online games.

• The Journal of Korean Medical History
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• v.23 no.1
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• pp.55-65
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• 2010

The narration of "Donguibogam" is focused on humans whilst medical books before it focused on diseases. This is shown from the first subtitle of External Body(身形門) chapter, [The Origin of Hyung-Ki(形氣之始)]. The contents of [The Origin of Hyung-Ki] explains that the human body is composed of 'Hyung(形)' and 'Ki(氣)' This perspective is shown throughout "Donguibogam". First, in the aspect of construction, the viewpoint is shown from the JipRye(集例). It divides the body into inside and outside, which is a result of Hyung-Ki perspective. This continues in the table of contents. Naegyeongpyeon(內景) and Oehyeongpyeon(外形) describes the inside and outside of the body, in other words 'Hyung-Ki'. Japbyeongpyeon(雜病) describes complex illnesses with mixed insides and outsides. Tangaekpyeon(湯液) and Chimgupyeon(鍼灸) can be understood as division of treatment methods into inside and outside. When we look at the contents, the human body is created on the basis of the essence and vital energy of the world. Cheon-Ki becomes the 'Ki' that forms the functions of the body, while Ji-Ki becomes the 'Hyung' that constructs the bodily structure. It is considered that 'Hyung' is composed of SaDae(the body essence, vital energy, mentality and blood), and 'Ki' is composed of OSang(the five Jang organs and six Bu organs). 'Hyung' and 'Ki' show various appearances according to physiology and pathology. 'Hyung' is especially shown by obesity or thinness, 'Ki' by color. The obese may have Ki deficiency, coldness, dampness or phlegm. The thin could have blood deficiency, heat, fire or dryness. The color could show the pathology of the five Jang organs by the five colors, but it can simply be divided into black and white, where black means Eum deficiency, and white means Yang deficiency. It is said that the distinctive feature of traditional Korean medicine is that it is a constitutional medicine. In this perspective, further study on 'Hyung-Ki' is of value. If "Donguibogam" was the foundation of the Sasang Constitutional Medicine(四象醫學), study on 'Hyung-Ki' means searching for the origin of the Sasang Constitutional Medicine. Also, the study on Sasang Constitutional Medicine and Hyungsang medicine(形象醫學) will show the modern image of "Donguibogam". Hence, interchange study between "Donguibogam", Sasang Constitutional Medicine and Hyungsang medicine through the term 'Hyung-Ki' could hopefully lead to academic progression.

• Journal of The Korean Society of Clinical Toxicology
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• v.5 no.1
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• pp.36-42
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• 2007

Purpose: To assess the epidemiology and the clinical features of Glufosinate herbicide in Korea. Methods: Data was prospectively collected during 1 year since August 2005 from 38 hospital in Korea. We analyzed the epidemiologic characters and clinical manifestations of Glufosinate poisoning. In addition, the characteristics of patients with severe central nervous system toxicity were separately analyzed to find poor prognosis relating factors. Results: During study periods, there were 715 persons of poisoning of herbicides and insecticides. 6.3% (45 persons) of the agricultural chemicals poisoning had Glufosinate poisoning. There were 36 cases of suicide attempts and 7 cases of accidental exposure, The major of poisoning route was oral ingestion (44 cases). 28.9 % of the study patients had not toxic symptoms. The most common symptoms were gastrointestinal symptoms relating surfactant irritation. 67.7% of central nervous symptoms occurred lately. 10 persons showed severe central nervous system toxicity. 4 persons of them showed poor outcomes (1 death, 3 hopeless discharged). Complications of respiratory failure and renal failure related with poor outcome. Conclusion: Majority of patients ingested Glufosinate for suicide attempt. 22.2% of patients with Glufosinate poisoning showed delayed serious central nervous system toxicity. Early supportive care of altered mentality may prevent late respiratory complications and improve the outcomes.

• Journal of Korean Physical Therapy Science
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• v.3 no.3
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• pp.57-64
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• 1996

The purpose of this study is to investigate risk factor found in the patients with stroke in physical therapy. A questionnaire survey was carried out for 130 the patients, who had comparatively alert mentality, hospitalized in kyung hee oriental medical hospital with stroke from January, 1st to May 31st, 1996. Major findings of this stuty were as follows. 1. The stroke patients 67(51.5%)were males and 63(48.5%) femals. The age groups of 50 to 69 years accounted for 67.6% of the total stroke patients are the highest. The job groups of commerce and business of patients 58.5%. The living groups of major citys of the revealed the highest incidence(40.8%). 2. There were 40 patients (30.8 %) who had hemorrhage related condions as the direct cause of their stroke, and 90 patients (69.2 %) who had cerebral infarction with no hemorrhaging as the cause. of the disease that the patients suffered from before their stroke, blood pressure related problems were most numberous 76 patients(58.5%) had such problems. 3. A month before their attack of stroke, were asked what thay thought could become the causes of their strokes. The most frequently mentioned answers were fatigue, drinking too much, and smoking, as chosen by 45 patients(34.6 %). 4. In regarding the relation between stress and stroke, (37.7%), of the surveyed belonged to the most numerous group had of people who said they were not under stress. Yet this group had a large number of parents. And 22.3 % of the surveyed named conflicts among parents, siblings, and relatives. 5. Questions were asked to find out the relationship between complications of stroke and smoking or drinking. It was surprising to see a high rate of attack among the 55.4 % majority who answered that they did not smoke nor drink. 6. To sum up the affect of food on attack of stroke, 42.5% of the people who had a sprcey and salty diet had a higher rate of attack then the group of people with leisurely nature. 7. Looking at the family history, 40.4% of the patients said their parents also suffered the disease. This percentage is the highest. And 40.0% answered that there is no one who suffered in their family history. Judging from the percentages and family.