• The Korean Society of Law and Medicine
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• v.11 no.2
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• pp.239-274
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• 2010

Advance directive refers to a description of the treatment method a patient wants to be provided with in case where the person is unconscious or lacks an ability to decision making in a future period or a declaration of intention that delegates and appoints another person who makes a decision regarding a treatment method on behalf of the person. Advance directive is usually a document form, but oral statement is acceptable as well. Advance directive may have a variety of forms though, it basically consists of two basic forms. That is, one is a living will, and the other is a surrogate decision making. Though the importance of advance directive has been emphasized, and the necessity of adopting the system has been strongly argued for so far, the debates on criteria, method, and procedure alike have not yet reached an agreement. It is because even the concept of advance directive is more or less ambiguous, and each specific method has its own theoretical limitations and practical constraints. Thus the inquiries on advance directive raised in the study are summarized as the meaning, practicability, and philosophical foundation of the advance directive. Firstly, the theoretical limitations of Advance directive may be categorized into conceptual and moral limitations. In case of conceptual limitations, authors of advance directives may not be well aware, in advance, of the particular situation in which he or her will experience in the future, and patients may experience the change in his or her values and lack the understanding and information about the future situation due to the changes in treatment methods. In case of moral limitations, a patient has a limited moral autonomy right and self identity that have an impact on his or her preference. Secondly, in case of practical constraints for advance directive, there exist cultural features, low ratio of documentation, as patients themselves admit, and low predictability and stability of patient's own preference regarding life-sustaining care. And the problem of validity and accuracy in proxy's decision making is also raised. Those who administer a living will, especially, may have a difficulty in understanding the directive by a patient, so that the accuracy of execution cannot be secured. In the sense, it is needed to implement a legal device in order to solve such problems. In summary, it is urgently required to understand the limitations and explore desired alternatives to overcome the relevant problems in advance, which must contribute to successfully adopting and effectively operating the advance directive system in Korea.

• Journal of Physiology & Pathology in Korean Medicine
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• v.16 no.2
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• pp.373-379
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• 2002

This paper was the design of aerosol generator for inhalation toxicology study of lead and evaluation with real time monitoring, and applied several engineering methodology to classical aerosol generator to cope with it's disadvantages. According to the testing conditions, source temperature 50℃ and inlet-duct band heater temperature 150℃, aerosol generation results for sodium chloride and lead acetate were as followings: CPM(Count Per Minute) for Sodium chloride that used for the testing material in aerosol generation and inhalation system was decreased in the 2nd and the 3rd hour's serial trials, but CVs(coefficient of variation) were maintained within 10%. CPMs for 5 and 2.5 gram of lead acetate that used for aerosol generation and inhalation exposure of lead showed similar results because of the sedimentation of lead acetate on piezoelectric crystal with time. For that reason, heating and mixing of nebulizing solution will be needed to generate lead aerosol with stable profile and maximum generation efficiency. Fluctuations of 10 and 5 gram lead acetate were low but 2.5gram was high. However, CVs for 10, 5, and 2.5gram lead acetate were within 10%. Considering the theoretical efficiencies for sodium chloride and lead acetate, 5gram sodium chloride and 2.5gram lead acetate were appropriate choice. Aerosol generation characteristics for two materials with 1 hour interval were different with respect to the fluctuation of CPM and the decrease to 10gram in it's material. For that reason, sodium chloride can not be used to estimate the aerosol generation and it's related parts for lead acetate. According to the testing conditions, source temperature 20, 50, 70℃, and inlet-duct band heater temperature 20, 50, 100, 150, 200℃, aerosol generation results for sodium chloride and lead acetate were as followings: Excluding inlet-duct band temperature 200℃, maximum CPM for sodium chloride was manifested in source temperature 70℃ with each inlet-duct band temperature conditions. We suggest that this condition was the optimum in the design of aerosol generator, inhalation system, and the testing. Maximum CPMs for 10, 5, and 2.5gram sodium chloride were from source temperature 70℃ and inlet-duct band temperature 20℃. Excluding inlet-duct band temperature 50, 200℃, maximum CPMs for lead acetate were indicated in source temperature 50℃ with each inlet-duct band temperature conditions. We suggest that this condition was the optimum in the design of aerosol generator, inhalation system, and the testing for lead inhalation study. Source and inlet-duct band temperatures for 10, 5, 2.5gram lead acetate were 50 and 100℃, 50 and 100℃, 50 and 150℃, respectively. In conclusion, considering above 2 paragraphs of results for aerosol generation, 5gram efficiencies for sodium chloride, lead acetate were higher than 2.5gram's. If inlet-duct band temperature was same, aerosol generation was increased with increase of source temperature. To get maximum aerosol generation will be the conditions that set the appropriate inlet-duel band temperature for each materials and increase the source temperature.

• Progress in Medical Physics
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• v.23 no.3
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• pp.145-153
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• 2012

In this study, we quantify the residual motion artifact in 4D-CT scan using the dynamic lung phantom which could simulate respiratory target motion and suggest a simple one-dimension theoretical model to explain and characterize the source of motion artifacts in 4DCT scanning. We set-up regular 1D sine motion and adjusted three level of amplitude (10, 20, 30 mm) with fixed period (4s). The 4DCT scans are acquired in helical mode and phase information provided by the belt type respiratory monitoring system. The images were sorted into ten phase bins ranging from 0% to 90%. The reconstructed images were subsequently imported into the Treatment Planning System (CorePLAN, SC&J) for target delineation using a fixed contour window and dimensions of the three targets are measured along the direction of motion. Target dimension of each phase image have same changing trend. The error is minimum at 50% phase in all case (10, 20, 30 mm) and we found that ${\Delta}S$ (target dimension change) of 10, 20 and 30 mm amplitude were 0 (0%), 0.1 (5%), 0.1 (5%) cm respectively compare to the static image of target diameter (2 cm). while the error is maximum at 30% and 80% phase ${\Delta}S$ of 10, 20 and 30 mm amplitude were 0.2 (10%), 0.7 (35%), 0.9 (45%) cm respectively. Based on these result, we try to analysis the residual motion artifact in 4D-CT scan using a simple one-dimension theoretical model and also we developed a simulation program. Our results explain the effect of residual motion on each phase target displacement and also shown that residual motion artifact was affected that the target velocity at each phase. In this study, we focus on provides a more intuitive understanding about the residual motion artifact and try to explain the relationship motion parameters of the scanner, treatment couch and tumor. In conclusion, our results could help to decide the appropriate reconstruction phase and CT parameters which reduce the residual motion artifact in 4DCT.

• Journal of Korean Neurosurgical Society
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• v.46 no.4
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• pp.317-321
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• 2009

Objective : In the thoracic spine, insertion of a pedicle screw is annoying due to small pedicle size and wide morphological variation between different levels of the spine and between individuals. The aim of our study was to analyze radiologic parameters of the pedicle morphometry from T1 to T8 using computed tomographic myelography (CTM) in Korean population. Methods : For evaluation of the thoracic pedicle morphometry, the authors prospectively analyzed a consecutive series of 26 patients with stable thoracic spines. With the consent of patients, thoracic CTM were performed, from T1 to T8. We calculated the transverse outer diameters and the transverse angles of the pedicle, distance from the cord to the inner cortical wall of the pedicle, and distance from the cord to the dura. Results : Transverse outer pedicle diameter was widest at T1 ($7.66{\pm}2.14\;mm$) and narrowest at T4 ($4.38{\pm}1.55\;mm$). Transverse pedicle angle was widest at T1 ($30.2{\pm}12.0^{\circ}$ and it became less than $9.0^{\circ}$ below T6 level. Theoretical safety zone of the medial perforation of the pedicle screw, namely, distance from the cord to inner cortical wall of the pedicle was more than 4.5 mm. Conclusion : Based on this study, we suggest that the current pedicle screw system is not always suitable for Korean patients. Computed tomography is required before performing a transpedicular screw fixation at the thoracic levels.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.1
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• pp.43-51
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• 2023

Purpose : This study suggests that the unique chakra arrangement of Tibetan singing bowls resembles the mantra of chakra lotus in the tantric tradition and the structure of chakra ascent, The two aim at the liberation of consciousness and confirm that they have a body, mind, and conscious healing mechanism. Methods : First, the structural characteristics of Tibetan singing bowls arrangement and chakra lotus mantra arrangement were investigated through the consideration of previous studies. Next, the healing mechanism of Tibetan singing bowls, which has been learned in Nepal, was examined through previous studies and literature to clarify that the rise of chakra in the two systems has a balance of body, mind, and consciousness and aims at liberation of consciousness. Results : The arrangement of Tibetan chakras is similar to the mantra of chakra lotus. Both have a structure in which the auxiliary sound of the previous chakra is interlocked with the structure of being the main sound of the next chakra to raise the chakra. At this time, the rise of the chakra is the liberation of consciousness by the ultimate purpose. Conclusion : Tibetan chakra are structurally similar to chakra lotus mantras and chakra ascents, as they have a theoretical background to tantric traditions. Chakra is the quality of inner consciousness that is conveyed to the outside and expressed in its own actions. Therefore, chakras should be well coordinated to lead our lives healthily. In this point, the chakra arrangement of Tibetan singing bowls is a system that exposes the inner balance to the outside and heals us more directly. Therefore, Tibetan singing bowls therapy has an integrated medical value in restoring our mind and body balance. Because chakras are dimensions of consciousness, the study of chakras is abstract or lacking, so more systematic and scientific study of chakras is needed.

• Korean Journal of Acupuncture
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• v.30 no.3
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• pp.171-177
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• 2013

Objectives : The purpose of this study is to investigate the mechanism of Cosmetic Acupuncture through reinterpretation of anatomy and physiology. Methods : The causes of wrinkle increases and rapid aging of facial skin were studied and the theoretical system of Cosmetic Acupuncture treatment was analyzed through anatomy and physiology reinterpretation. Results and Conclusions : An increase in wrinkles and rapid aging of facial skin is caused by xerosis. Skin condition represents the condition of subcutaneous muscle. The reason why skin becomes easily dry is the heat produced by craniofacial part. Craniofacial part always generates lot of physiological fever because of the muscles. This physiological fever is produced from the muscles that are responsible for maintaining skull suture, controlling the movement of temporomandibular joint, maintaining head and neck posture. Controlling this fever is the crux of Cosmetic Acupuncture mechanism. These muscles correspond to Foot Taeyang meridian-muscle, Foot Soyang meridian-muscle and Foot Yangmyung meridian-muscle. Cosmetic Acupuncture is effective for preventing facial skin from aging and wrinkle increase by mechanical stimulus on facial muscles, and for controlling craniofacial part meridian-muscle system producing the heat.

• Korean Journal of Adult Nursing
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• v.25 no.5
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• pp.574-584
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• 2013

Purpose: The purpose of this study was to evaluate the effects of a simulation based clinical reasoning practice program on clinical competence in nursing students. The program was based on the theoretical frameworks of simulation models and experiential learning theory. Methods: The program consisted of eight scenarios which includes three main symptoms (abdominal pain, changes in mental status, dyspnea), for improvement of clinical competencies in nursing students. A nonequivalent control group pretest-posttest design was used for evaluation of the effects of the program. Fifty-two junior nursing students in Y University participated in the experimental group (n=25) or control group (n=27). Critical thinking was measured using a self-administered questionnaire. Clinical judgment and clinical performance were measured by a rater using the Rubric. Descriptive analysis, t-test, Mann-Whitney U, Wilcoxon signed rank test was used for data analyses. Results: Clinical judgment and clinical performance increased in the experimental group, but there were no significant differences in critical thinking. Conclusion: Results indicate that the program developed in this study is a useful strategy to enhance clinical judgment and clinical performance in nursing students. However, the program did not significantly enhance critical thinking disposition, and further study is needed to measure integrated clinical competence including critical thinking skills.

• Health Policy and Management
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• v.16 no.4
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• pp.68-85
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• 2006

With the competitive environment accelerating in healthcare industry, the hospital network system is considered as one of the strategies for clinical and managerial efficiency. This study was intended to offer a theoretical view on the hospital network system and to analyze the current network status of hospitals in Korea. Specifically, network types were classified based on the criteria modified from previous studies, and were used to describe and compare the scope and intensity of associated activities. The questionnaire survey was conducted with 237 hospitals during the period of December 27 2005 to January 25 2006. Above 90% of tertiary and secondary care hospitals were under the network system, while only 20% of primary care clinics were affiliated. In general, the scope and intensity of network activities was limited. Vertical and/or clinical integration was more common than horizontal and/or managerial integration. Three most frequent types of hospital network systems were clinical-vertical integration (Type A), clinical/managerial-vertical integration(Type B), and clinical/managerial-horizontal /vertical integration (Type C). Such network types differentiated significantly different features of affiliated hospitals and network systems. The affiliation duration to the network system was the only significant factor influencing on the network type. The strategic approach to the network system was emphasized for hospitals to increase the potential advantage of hospital network systems.

• Journal of Ginseng Research
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• v.41 no.3
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• pp.339-346
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• 2017

Background: In this study, we investigated how to convert the Panax ginseng DNA sequence code and chemical fingerprints into a two-dimensional code. In order to improve the compression efficiency, GATC2Bytes and digital merger compression algorithms are proposed. Methods: HPLC chemical fingerprint data of 10 groups of P. ginseng from Northeast China and the internal transcribed spacer 2 (ITS2) sequence code as the DNA sequence code were ready for conversion. In order to convert such data into a two-dimensional code, the following six steps were performed: First, the chemical fingerprint characteristic data sets were obtained through the inflection filtering algorithm. Second, precompression processing of such data sets is undertaken. Third, precompression processing was undertaken with the P. ginseng DNA (ITS2) sequence codes. Fourth, the precompressed chemical fingerprint data and the DNA (ITS2) sequence code were combined in accordance with the set data format. Such combined data can be compressed by Zlib, an open source data compression algorithm. Finally, the compressed data generated a two-dimensional code called a quick response code (QR code). Results: Through the abovementioned converting process, it can be found that the number of bytes needed for storing P. ginseng chemical fingerprints and its DNA (ITS2) sequence code can be greatly reduced. After GTCA2Bytes algorithm processing, the ITS2 compression rate reaches 75% and the chemical fingerprint compression rate exceeds 99.65% via filtration and digital merger compression algorithm processing. Therefore, the overall compression ratio even exceeds 99.36%. The capacity of the formed QR code is around 0.5k, which can easily and successfully be read and identified by any smartphone. Conclusion: P. ginseng chemical fingerprints and its DNA (ITS2) sequence code can form a QR code after data processing, and therefore the QR code can be a perfect carrier of the authenticity and quality of P. ginseng information. This study provides a theoretical basis for the development of a quality traceability system of traditional Chinese medicine based on a two-dimensional code.

• Korean Medical Education Review
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• v.11 no.2
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• pp.3-14
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• 2009

The current medical practices in Korea have raised many new ethical issues. The current education system in medical colleges, however, is finding it difficult to cope with these rapidly arising medical issues. Many educators, therefore, became much more concerned about the importance of ethics and character education in medical colleges, but teaching methods or educational programs centered around the same have not yet been developed. Dilemma discussion is regarded as an available teaching method but is not frequently used in medical education. In this respect, this study aims to apply dilemma discussion programs to ethics and character education for medical students. It was discovered that dilemma discussion is an effective instructional method for enhancing the moral reasoning ability of medical students. According to $Rest^{\circ}{\phi}s$ theoretical framework, however, a dilemma discussion program focuses on two components of morality: moral judgment and moral sensitivity. Moral judgment and moral sensitivity are major components in predicting moral behaviors. Therefore, the target of dilemma discussion programs is to focus on these two components. It is reasonable to integrate moral judgment with moral sensitivity for ethics and character education in medical schools.