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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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Conservation Status, Construction Type and Stability Considerations for Fortress Wall in Hongjuupseong (Town Wall) of Hongseong, Korea (홍성 홍주읍성 성벽의 보존상태 및 축성유형과 안정성 고찰)

  • Park, Junhyoung;Lee, Chanhee
    • Korean Journal of Heritage: History & Science
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    • v.51 no.3
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    • pp.4-31
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    • 2018
  • It is difficult to ascertain exactly when the Hongjuupseong (Town Wall) was first constructed, due to it had undergone several times of repair and maintenance works since it was piled up newly in 1415, when the first year of the reign of King Munjong (the 5th King of the Joseon Dynasty). Parts of its walls were demolished during the Japanese occupation, leaving the wall as it is today. Hongseong region is also susceptible to historical earthquakes for geological reasons. There have been records of earthquakes, such as the ones in 1978 and 1979 having magnitudes of 5.0 and 4.0, respectively, which left part of the walls collapsed. Again, in 2010, heavy rainfall destroyed another part of the wall. The fortress walls of the Hongjuupseong comprise various rocks, types of facing, building methods, and filling materials, according to sections. Moreover, the remaining wall parts were reused in repair works, and characteristics of each period are reflected vertically in the wall. Therefore, based on the vertical distribution of the walls, the Hongjuupseong was divided into type I, type II, and type III, according to building types. The walls consist mainly of coarse-grained granites, but, clearly different types of rocks were used for varying types of walls. The bottom of the wall shows a mixed variety of rocks and natural and split stones, whereas the center is made up mostly of coarse-grained granites. For repairs, pink feldspar granites was used, but it was different from the rock variety utilized for Suguji and Joyangmun Gate. Deterioration types to the wall can be categorized into bulging, protrusion of stones, missing stones at the basement, separation of framework, fissure and fragmentation, basement instability, and structural deformation. Manually and light-wave measurements were used to check the amount and direction of behavior of the fortress walls. A manual measurement revealed the sections that were undergoing structural deformation. Compared with the result of the light-wave measurement, the two monitoring methods proved correlational. As a result, the two measuring methods can be used complementarily for the long-term conservation and management of the wall. Additionally, the measurement system must be maintained, managed, and improved for the stability of the Hongjuupseong. The measurement of Nammunji indicated continuing changes in behavior due to collapse and rainfall. It can be greatly presumed that accumulated changes over the long period reached the threshold due to concentrated rainfall and subsequent behavioral irregularities, leading to the walls' collapse. Based on the findings, suggestions of the six grades of management from 0 to 5 have been made, to manage the Hongjuupseong more effectively. The applied suggested grade system of 501.9 m (61.10%) was assessed to grade 1, 29.5 m (3.77%) to grade 2, 10.4 m (1.33%) to grade 3, 241.2 m (30.80%) and grade 4. The sections with grade 4 concentrated around the west of Honghwamun Gate and the east of the battlement, which must be monitored regularly in preparation for a potential emergency. The six-staged management grade system is cyclical, where after performing repair and maintenance works through a comprehensive stability review, the section returned to grade 0. It is necessary to monitor thoroughly and evaluate grades on a regular basis.

The 1998, 1999 Patterns of Care Study for Breast Irradiation After Breast-Conserving Surgery in Korea (1998, 1999년도 우리나라에서 시행된 유방보존수술 후 방사선치료 현황 조사)

  • Suh Chang-Ok;Shin Hyun Soo;Cho Jae Ho;Park Won;Ahn Seung Do;Shin Kyung Hwan;Chung Eun Ji;Keum Ki Chang;Ha Sung Whan;Ahn Sung Ja;Kim Woo Cheol;Lee Myung Za;Ahn Ki Jung
    • Radiation Oncology Journal
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    • v.22 no.3
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    • pp.192-199
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    • 2004
  • Purpose: To determine the patterns on evaluation and treatment in the patient with early breast cancer treated with conservative surgery and radiotherapy and to improve the radiotherapy techiniques, nationwide survey was peformed. Materials and Methods: A web-based database system for korean Patterns of Care Study (PCS) for 6 common cancers was developed. Two hundreds sixty-one randomly selected records of eligible patients treated between 1998$\~$1999 from 15 hospitals were reviewed. Results: The patients ages ranged from 24 to 85 years(median 45 years). Infiltrating ductal carcinoma was most common histologic type (88.9$\%$) followed by medullary carcinoma (4.2$\%$) and infiltrating lobular carcinoma (1.5$\%$). Pathologic T stage by AJCC was T1 in 59.7$\%$ of the casses, T2 in 29.5$\%$ of the cases, Tis in 8.8$\%$ of the cases. Axillary lymph node dissection was peformed I\in 91.2$\%$ of the cases and 69.7$\%$ were node negative. AJCC stage was 0 in 8.8$\%$ of the cases, stage I in 44.9$\%$ of the cases, stage IIa in 33.3$\%$ of the cases, and stage IIb in 8.4$\%$ of the cases. Estrogen and progesteron receptors were evaluated in 71.6$\%$, and 70.9$\%$ of the patients, respectively. Surgical methods of breast-conserving surgery was excision/lumpectomy in 37.2$\%$, wide excision in 11.5$\%$, quadrantectomy in 23$\%$ and partial mastectomy in 27.5$\%$ of the cases. A pathologically confirmed negative margin was obtained in 90.8$\%$ of the cases. Pathological margin was involved with tumor in 10 patients and margin was close (less than 2 mm) in 10 patients. All the patients except one recieved more than 90$\%$ of the planned radiotherapy dose. Radiotherapy volume was breast only In 88$\%$ of the cases, breast+supraclavicular fossa (SCL) in 5$\%$ of the cases, and breast+ SCL+ posterior axillary boost in 4.2%$\%$of the cases. Only one patient received isolated internal mammary lymph node irradiation. Used radiation beam was Co-60 in 8 cases, 4 MV X-ray in 115 cases, 6 MV X-ray in 125 cases, and 10 MV X-ray in 11 cases. The radiation dose to the whole breast was 45$\~$59.4 Gy (median 50.4) and boost dose was 8$\~$20 Gy (median 10 Gy). The total radiation dose delivered was 50.4$\~$70.4 Gy (median 60.4 Gy). Conclusion: There was no major deviation from current standard in the patterns of evaluation and treatment for the patients with early breast cancer treated with breast conservation method. Some varieties were identified in boost irradiation dose. Separate analysis for the datails of radiotherapy planning will be followed and the outcome of treatment is needed to evaluate the process.

Interpretation of Praying Letter and Estimation of Production Period on Samsaebulhoedo at Yongjusa Temple (용주사(龍珠寺) <삼세불회도(三世佛會圖)>의 축원문(祝願文) 해석(解釋)과 제작시기(製作時期) 추정(推定))

  • Kang, Kwan-shik
    • MISULJARYO - National Museum of Korea Art Journal
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    • v.96
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    • pp.155-180
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    • 2019
  • Samsaebulhoedo(三世佛會圖) at Yongjusa Temple(龍珠寺), regarded as a monumental masterpiece consisting of different elements such as Confucian and Buddhist ideas, palace academy garden and Buddhist artist styles, unique traditional and western painting styles, is one of the representative works that symbolically illustrate the development and innovation of painting in the late Joseon dynasty. However, the absence of painting inscriptions raised persistent controversy over the past half century among researchers as to the matters of estimating its production period, identifying the original author and analyzing style characteristics. In the end, the work failed to gain recognitions commensurate with its historical significance and value. It is the particularly vital issue in that estimating the production period of the existing masterpiece is the beginning of all other discussions. However, this issue has caused the ensuing debates since all details are difficult to be interpreted to a concise form due to a number of different records on painters and mixture of traditional buddhist painting styles used by buddhist painters and innovative western styles used by ordinary painters. Contrary to other ordinary Buddhist paintings, this painting, Samsaebulhoedo, has a praying letter for the royal establishment at the center of the main altar. It should be noted that regarding this painting, its original version-His Royal Highness King, Her Majesty, His Royal Crown Prince主上殿下, 王妃殿下, 世子邸下-was erased and instead added Her Love Majesty慈宮邸下 in front of Her Majesty. This praying letter can be assumed as one of the significant and objective evidence for estimating its production period. The new argument of the late 19th century production focused on this praying letter, and proposed that King Sunjo was then the first-born son when Yongjusa Temple was built in 1790 and it was not until January 1, 1800 that he was ascended to the Crown Prince. In this light, the existing praying letter with the eulogistic title-Crown Prince世子-should be considered revised after his ascension to the throne. Styles and icons bore some resemblance to Samsaebulhoedo at Cheongryongsa Temple or Bongeunsa Temple portrayed by Buddhist painters in the late 19th century. Therefore, the remaining Samsaebulhoedo should be depicted by them in the same period as western styles were introduced in Buddhist painting in later days. Following extensive investigations, praying letters in Buddhist paintings in the late 19th century show that it was usual to record specification such as class, birth date and family name of people during the dynasty at the point of producing Buddhist paintings. It is easy to find that those who passed away decades ago cannot be revised to use eulogistic titles as seen by the praying letters in Samsaebulhoedo at Yongju Temple. As "His Royal Highness King, Her Majesty, His Royal Crown Prince" was generally used around 1790 regardless of the presence of first-born son or Crown Prince, it was rather natural to write the eulogistic title "His Royal Crown Prince" in the praying letter of Samsaebulhoedo. Contrary to ordinary royal hierarchy, Her Love Majesty was placed in front of Her Majesty. Based on this, the praying letter was assumed to be revised since King Jeongjo placed royal status of Hyegyeonggung before the Queen, which was an exceptional case during King Jeongjo's reign, due to unusual relationships among King Jeongjo, Hyegyeonggung and the Queen arising from the death of Crown Prince(思悼世子). At that time, there was a special case of originally writing a formal tripod praying letter, as can be seen from ordinary praying letter in Buddhist paintings, erasing it and adding a special eulogistic title: Her Love Majesty. This indicates that King Jeongjo identified that Hyegyeonggung was erased, and commanded to add it; nevertheless, ceremony leaders of Yongju Temple, built as a palace for holding ceremonies of Hyeonryungwon(顯隆園) are Jeongjo, the son of his father and his wife Hyegyeonggung (Her Love Majesty)(惠慶宮(慈宮)). This revision is believed to be ordered by King Jeongjo on January 17, 1791 when the King paid his first visit to the Hyeonryungwon since the establishment of Hyeonryungwon and Yongju Temple, stopped by Yongju Temple on his way to palace and saw Samsaebulhoedo for the first and last time. As shown above, this letter consisting of special contents and forms can be seen an obvious, objective testament to the original of Samsebulhoedo painted in 1790 when Yongju Temple was built.

The actual aspects of North Korea's 1950s Changgeuk through the Chunhyangjeon in the film Moranbong(1958) and the album Corée Moranbong(1960) (영화 <모란봉>(1958)과 음반 (1960) 수록 <춘향전>을 통해 본 1950년대 북한 창극의 실제적 양상)

  • Song, Mi-Kyoung
    • (The) Research of the performance art and culture
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    • no.43
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    • pp.5-46
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    • 2021
  • The film Moranbong is the product of a trip to North Korea in 1958, when Armangati, Chris Marker, Claude Lantzmann, Francis Lemarck and Jean-Claude Bonardo left at the invitation of Joseon Film. However, for political reasons, the film was not immediately released, and it was not until 2010 that it was rediscovered and received attention. The movie consists of the narratives of Young-ran and Dong-il, set in the Korean War, that are folded into the narratives of Chunhyang and Mongryong in the classic Chunhyangjeon of Joseon. At this time, Joseon's classics are reproduced in the form of the drama Chunhyangjeon, which shares the time zone with the two main characters, and the two narratives are covered in a total of six scenes. There are two layers of middle-story frames in the movie, and if the same narrative is set in North Korea in the 1950s, there is an epic produced by the producers and actors of the Changgeuk Chunhyangjeon and the Changgeuk Chunhyangjeon as a complete work. In the outermost frame of the movie, Dong-il is the main character, but in the inner double frame, Young-ran, who is an actor growing up with the Changgeuk Chunhyangjeon and a character in the Changgeuk Chunhyangjeon, is the center. The following three OST albums are Corée Moranbong released in France in 1960, Musique de corée released in 1970, and 朝鮮の伝統音樂-唱劇 「春香伝」と伝統樂器- released in 1968 in Japan. While Corée Moranbong consists only of the music from the film Moranbong, the two subsequent albums included additional songs collected and recorded by Pyongyang National Broadcasting System. However, there is no information about the movie Moranbong on the album released in Japan. Under the circumstances, it is highly likely that the author of the record label or music commentary has not confirmed the existence of the movie Moranbong, and may have intentionally excluded related contents due to the background of the film's ban on its release. The results of analyzing the detailed scenes of the Changgeuk Chunhyangjeon, Farewell Song, Sipjang-ga, Chundangsigwa, Bakseokti and Prison Song in the movie Moranbong or OST album in the 1950s are as follows. First, the process of establishing the North Korean Changgeuk Chunhyangjeon in the 1950s was confirmed. The play, compiled in 1955 through the Joseon Changgeuk Collection, was settled in the form of a Changgeuk that can be performed in the late 1950s by the Changgeuk Chunhyangjeon between 1956 and 1958. Since the 1960s, Chunhyangjeon has no longer been performed as a traditional pansori-style Changgeuk, so the film Moranbong and the album Corée moranbong are almost the last records to capture the Changgeuk Chunhyangjeon and its music. Second, we confirmed the responses of the actors to the controversy over Takseong in the North Korean creative world in the 1950s. Until 1959, there was a voice of criticism surrounding Takseong and a voice of advocacy that it was also a national characteristic. Shin Woo-sun, who almost eliminated Takseong with clear and high-pitched phrases, air man who changed according to the situation, who chose Takseong but did not actively remove Takseong, Lim So-hyang, who tried to maintain his own tone while accepting some of modern vocalization. Although Cho Sang-sun and Lim So-hyang were also guaranteed roles to continue their voices, the selection/exclusion patterns in the movie Moranbong were linked to the Takseong removal guidelines required by North Korean musicians in the name of Dang and People in the 1950s. Second, Changgeuk actors' response to the controversy over the turbidity of the North Korean Changgeuk community in the 1950s was confirmed. Until 1959, there were voices of criticism and support surrounding Taksung in North Korea. Shin Woo-sun, who showed consistent performance in removing turbidity with clear, high-pitched vocal sounds, Gong Gi-nam, who did not actively remove turbidity depending on the situation, Cho Sang-sun, who accepted some of the vocalization required by the party, while maintaining his original tone. On the other hand, Cho Sang-seon and Lim So-hyang were guaranteed roles to continue their sounds, but the selection/exclusion patterns of Moranbong was independently linked to the guidelines for removing turbidity that the Gugak musicians who crossed to North Korea had been asked for.