• The Korean Society of Law and Medicine
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• v.23 no.1
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• pp.149-176
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• 2022

South Korean law strictly prohibits engagement in medical activities by non-medical practitioners. In the country, tattooing is classified as a medical practice, and non-medical practitioners who engage in it are penalized because they are unauthorized to carry out this procedure. In reality, however, people rarely seek tattooing services from medical personnel. Arguing that their freedom of job selection is violated, non-medical personnel who make a living as tattoo artists reject the characterization of the procedure as a form of medical treatment and demand the decriminalization of tattooing by non-medical practitioners. Nevertheless, tattooing can cause health- and hygiene-related dangers when it is not performed by medical professionals because it involves penetration into the skin using needles. Hence, stringent management is necessary for infection prevention. The gap between reality and the law gives rise to the need for proactive thinking about the institutionalization of tattoo practice by non-medical personnel. Policymakers should reflect on the fact that only minimal tattooing services are currently performed by medical staff while also accounting for health and safety. On this basis, this study examined tattoo-related legislation in South Korea to determine whether the procedure corresponds to medical practice and identify ways to solve problems that occur from the perspective of health care. As a response that promotes safety and reflects reality, this research proposed a three-phase approach.

• Journal of Convergence Society for SMB
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• v.6 no.1
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• pp.33-38
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• 2016

Disease of patient who visited the hospital can cause different symptoms of the disease, depending on the environment and lifestyle. Recent medical services offered in patients has changed in the environment that can be selected for treatment by analyzing the patient according to the disease symptoms. In this paper, we propose an efficient method to manage disease control because the treatment method may change at any patients suffering from the disease according to the patient conditions by grouping the different treatments to patients for disease information. The proposed scheme has a feature that can be ingested by the patient big disease information, as well as to improve the treatment efficiency of the medical treatment the increase patient satisfaction. The proposed sheme can handle big data by clustering of disease information for patients suffering from diseases such as patient consent small groups. In addition, the proposed scheme has the advantage that can be conveniently accessed via a particular keyword, the treatment method according to patient disease information. The experimental results, the proposed method has been improved by 23% in terms of efficiency compared to conventional techniques, disease management time is gained 11.3% improved results. Medical service user satisfaction seen from the survey is to obtain a high 31.5% results.

• Clinical Endoscopy
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• v.56 no.5
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• pp.650-657
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• 2023

Background/Aims: Endoscopic ultrasound gallbladder drainage (EUS-GBD) is gaining attention as a treatment method for cholecystitis. However, only a few studies have assessed the outcomes of permanent stenting with EUS-GBD. Therefore, we evaluated the clinical outcomes of permanent stenting using EUS-GBD. Methods: This was a retrospective, single-center cohort study. The criteria for EUS-GBD at our institution are a high risk for surgery, inability to perform surgery owing to poor performance status, and inability to obtain consent for emergency surgery. EUS-GBD was performed using a 7-Fr double-pigtail plastic stent with a dilating device. The primary outcomes were the recurrence-free rate of cholecystitis and the late-stage complication-avoidance rate. Secondary outcomes were technical success, clinical success, and procedural adverse events. Results: A total of 41 patients were included in the analysis. The median follow-up period was 168 (range, 10-1,238) days. The recurrence-free and late-stage complication-avoidance rates during the follow-up period were 95% (38 cases) and 90% (36 cases), respectively. There were only two cases of cholecystitis recurrence during the study period. Conclusions: EUS-GBD using double-pigtail plastic stent was safe and effective with few complications, even in the long term, in patients with acute cholecystitis.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.105-138
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• 2017

This is case comments of several representative legal cases regarding self- determination right of patient. In a case in which an intoxicated patient attempted suicide refusing treatment, the Supreme Court ruled that the medical team's respect for the patient's decision was an act of malpractice, and that in particular medical situations (medical emergencies) the physician's duty to preserve life supersedes the patient's rights to autonomy. Afterwards, at the request of the patient's family, and considering the patient's condition (irrecoverable death stage, etc.) consistent with a persistent vegetative state, the Supreme Court deduced the patient's intention and decide to withdraw life-sustaining treatment. More recently, regarding patients who refuse blood transfusions or other necessary treatment due to religious beliefs, the Supreme Court established a standard of judgment that can be seen as conferring equal value to the physician's duty to respect patient autonomy and to preserve life. An empirical study of legal precedent with regard to cases in which the physician's duty to preserve life conflicts with the patient's autonomy, grounded in respect for human dignity, can reveal how the Court's perspective has reflected the role of the patient as a decision-making subject and ways of respecting autonomy in Korean society, and how the Court's stance has changed alongside changing societal beliefs. The Court has shifted from judging the right to life as the foremost value and prioritizing this over the patient's autonomy, to beginning to at least consider the patient's formally stated or deducible wishes when withholding or withdrawing treatment, and to considering exercises of self determination right based on religious belief or certain other justifications with informed refusal. This will have a substantial impact on medical community going forward, and provide implicit and explicit guidance for physicians who are practicing medicine within this environment.

• The Journal of Korean Obstetrics and Gynecology
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• v.32 no.1
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• pp.73-84
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• 2019

Objectives: The purpose of this study is to collect and analyze the KCD codes applied to the treatment of 27 postpartum women who had been treated with Korean traditional medicine in a Korean medicine hospital, so that this study may be used as a basic data for setting the direction of postpartum Korean medical treatment research. Methods: It was approved by the Institutional Review Board (IRB) of ${\bigcirc}{\bigcirc}$ University medical center (IRB approval number : WSOH IRB H1708-02-01). Twenty-seven postpartum women who had been treated at ${\bigcirc}{\bigcirc}$ University medical center were received outpatient treatment for two weeks (from September 27, 2017 to January 5, 2018), and the KCD codes applied to the mothers were collected after obtaining the consent. On the day of registration of the study, the fertility, obstetric history and high-risk pregnancies were identified through an interview. Results: 1. The mean age of the 27 subjects was $33.33{\pm}3.99\;years$ old. Among the subjects, 17 mothers (63.0%) were high-risk pregnancy and 10 mothers (37.0%) were normal. 2. Among the 22 major disease categories, 8 categories were used. M code (musculoskeletal system) was used 243 times (70.85%), followed by R code (unclassified symptom) of 51 times (14.87%) and U code (special purpose code) of 23 times (6.71%). 3. The most commonly used code among the ten frequently used codes was M25.57 (joint pain, ankle and foot), a total of 47 times. Of the remaining nine codes, except for R60.1 (systemic edema) and U68.4 (The deficiency of yang in Bi), all codes were M codes (musculoskeletal system). 4. The M code (musculoskeletal system) was the most used major disease category in high-risk group, a total of 159 times. But in specific categories, the most commonly used code was R60.1 (systemic edema), a total of 28 times. 5. In normal group, the M code (musculoskeletal system) was the most used major disease category, a total of 84 times. Also, in specific categories, the most commonly used code was M25.57 (joint pain, ankle and foot), total 29 times. 6. The U code, corresponding to 'the diagnosis of childbirth and other obstetrical medical use', was used 23 times (6.71%), O code three times (0.87%) and Z code two times (0.58%), which was less than 10% of the total number of codes used. Conclusion: When analyzing KCD codes related to Korean medicine treatment for postpartum diseases, it is important to select the KCD codes that reflect the actual clinical state.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.6935-6939
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• 2015

Background: Currently, a comprehensive program for screening and early detection of cervical cancer does not exist in Iran. This study aimed to determine the prevalence of abnormal Papanicolaou (Pap) smears and some related factors among women living in Zanjan, Iran. Materials and Methods: This cross-sectional study was conducted in 2012 in Zanjan on 4274 married women aged 20-65 years. The study participants were selected through two-stage cluster sampling. After obtaining written consent, demographic and fertility questionnaires were completed. Samples from cervix were obtained through a standard method using the Rover Cervex- Brush. Evaluation and interpretation of the samples were reported using the Bethesda 2001 method. Data were statistically analyzed using chi-square and logistic regression models. Results: Most inflammatory changes in the samples were mild (37.4%). Abnormal atypical changes in the epithelial cells were found in 4.04%. The highest percentage of abnormal changes in the epithelial cells was atypical squamous cells of undetermined significance (ASCUS) (1.9%). Abnormal results of Pap smear was significantly and independently associated with age, papillomavirus infection, and lack of awareness about Pap smear tests. Conclusions: Given the high prevalence of inflammatory and precancerous changes in this study, compared to other studies in Iran and other Muslim countries, and the effect of demographic variables and individual factors on abnormal results, increasing the awareness of women and their families regarding the risk factors for cervical cancer, preventive measures such as screening, and timely treatment seem necessary.

• The Journal of Korean Medicine
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• v.28 no.2 s.70
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• pp.66-79
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• 2007

Objectives : To explore the type and frequency of short term reactions, de Qi associated with acupuncture treatment and to determine the incidence of adverse events following acupuncture in Korea. Subjects and methods : This study is a retrospective and cross-sectional survey of patient reports. 1095 subjects, 585 of out-patients of the Oriental Medicine of Stroke & Neurological Disorders Center, East-West NEO Medical Center of Kyunghee University and 510 of out-patients of the Department of Cardiovascular & Neurologic Diseases (Stoke Center), Hospital of Oriental Medicine, Kyunghee Medical Center, from June through November of 2006, who had acupuncture, gave informed consent and completed one survey form. On this form, patients were asked to report short term acupuncture reactions, de Qi, patient satisfaction measurement (using VAS), and adverse events relating to acupuncture treatment. The acupuncturists of this study are Korean Medicine Doctors (KMD) who had worked as practitioners for 3-30 years or more. Results : The average age of the 1095 subjects was 58 years old. Positive short term acupuncture reactions after treatment were reported by 878 (80.2%), negative short term acupuncture reactions by 75 (6.8%) and no reactions were reported by 142 (13.0%). The most common positive short term acupuncture reactions were feeling 'relaxed', 472 (43.1%), followed by feeling 'less pain' 90 (8.2%), 'energized' 16 ( 1.5%), 'tingling' 16 (1.5%), 'heat feeling or Cold feeling' 10 (0.9%), and others 274 (25.0%), respectively. Negative short term acupuncture reactions were feeling 'pain' 37 (3.4%), tiredness 24 (2.2%), dizziness 9 (0.8%), and others 5 (0.2%), respectively. Traditionally described needling sensations of de Qi refer to a patient's response to distention, pulling, soreness, heaviness, numbness. 39.7% of subjects reported de Qi during needling, experiencing 'distention' 333 (30.4%), 'soreness' 52 (4.7%), 'pulling' 22 (2.0%), 'heaviness' 18 (1.6%), and 'numbness' 10 (0.9%) respectively. Positive short term acupuncture reactions and de Qi rate were the highest in the less than 40 years group (83/96 86.5%, 50/96 52.1%). No acupuncture reactions were highly seen in the over 70 years old group (31/187, 16.6%). Patient satisfaction level using VAS was a comparatively high $72.9{\pm}19.9$. Adverse events were only bleeding in 92 (8.4%) of the total subjects. High sensitive acupoints were 95 points as GV26 (54 times), LI4 (54 times), ST36 (53 times), GB20 (37 times), HT8(34 times), LV3 (29 times), SI3 (29 times), and LI11 (27 times) in order. Main impressions were stroke patients 430 (16.9%), headache 185 (16.9%), hypertension 97 (8.9%), and dizziness 85 (7.8%). Conclusions : Although 8 different Korean Medicine Doctors participated in this research, we obtained similar results from each. There were no significantly different results between the two hospitals. Short term acupuncture reactions and de Qi were most related to age. Except for bleeding there were no adverse events relating to acupuncture treatment in this study. We consider acupuncture treatment as very safe depending on practitioners. Positive short term acupuncture reactions after treatment were 12 times higher than negative short term acupuncture reactions. Subjects were comparatively satisfied with acupuncture treatment.

• Journal of Oriental Neuropsychiatry
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• v.30 no.2
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• pp.59-69
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• 2019

Objectives: Case report is a description of medical experience that contains a patient's information and treatments. It has been used to determine the effectiveness and side effect of the treatments. Case report can be used for medical, scientific, or educational purposes. The objective of this study was to evaluate the quality of case reports published in Journal of Oriental Neuropsychiatry from 2013 to 2017 using CARE and CARES guideline. Methods: Case reports were selected from Journal of Oriental Neuropsychiatry and their quality assessed using CARE guideline and CARES guideline. The items of CARE and CARES guideline were assessed as 'Sufficient', 'Not sufficient', 'Not reported', 'Not applicable'. The outcome was analyzed using case reports and items. Results: 26 case reports were selected. For CARE guideline, 'Sufficient' percentage was min at 22.2%, max at 46.4% with a median of 39.3%. Sum of 'Sufficient', 'Not sufficient' percentage was min at 59.3%, max at 85.7% with a median of 75.0%. Items 'Timeline', 'Diagnostic assessment', 'Follow up and outcomes', 'Informed consent' were not reported in more than 50% of all case reports. Items 'Keywords', 'Abstract', 'Introduction', 'patient information', 'Diagnostic assessment', 'Therapeutic interventions', 'Follow up and outcomes' were not sufficiently reported in more than 50% of all case reports. For CARES guideline, 'Sufficient' percentage was min at 0%, max at 50% with a median of 0%. Sum of 'Sufficient', 'Not sufficient' percentage was min at 33.3%, max at 100% with a median of 92.9%. Items of herbal prescription 'herb', 'decoction', 'use', items of acupuncture treatment 'materials', 'techniques', items of moxibustion treatment 'materials', 'techniques' were not sufficiently reported in more than 50% of all case reports. Conclusions: The reporting rate of items was good. But the quality of reporting was low. Also, particular items were not reported frequently. Therefore, there is a need to improve the quality of case reports in Journal of Oriental Neuropsychiatry.

• The Korean Society of Law and Medicine
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• v.17 no.2
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• pp.125-144
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• 2016

All forms of Clinical trial should be fully equipped with protection systems for experimental subjects considering their uncertainty and various risks. Existing laws have some regulations in pharmaceutical affairs act and medical device act. Nonetheless, there is a limit to protect the subjects considering law objective to perform administration of medicine. Furthermore, the clinical trial on minor has no direct regulations in pharmaceutical affairs act, but prescribes certain portion in clinical trial assessment guideline on infants or medicine clinical trial management standard, however there is a limit because that is just recommendation not having legal effectiveness. The legislative solution would be possible for legal problems of clinical trial on minor by examining treatment system on minor in organ transplant act and clinical trial on minor in other foreign laws stronger than usual medical practice in terms of degree of human body invasion. I suppose that the control system of clinical trial being done focusing on the pharmaceutical affairs act, medical device act and other guidelines in existing laws system should be resolved by legislating 'trial subject protection law', in addition, this would be well balanced in organ transplant act on protection system of minor organ donors. Furthermore, the judgement on the consent ability and spontaneity in clinical trial on minor should be judged considering maturity and mentality of minor by clinical trial institutional review board based on legislative solution mentioned above.

• Journal of dental hygiene science
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• v.10 no.5
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• pp.315-321
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• 2010

The aim of this study was to assess change of the oral health related quality of life after fixed prosthetic treatment using implant therapy. One hundreds and twenty patients from 3 dental clinics in Seoul, Incheon and Daegu were recruited after verbal consent. The oral health related quality of life by OHIP-14, the treatment satisfaction by North Texas Periodontal Associates and the oral health interest w+ere measured before fixed prosthetic treatment using implant and one months after prosthetics. Total OHIP-14 changed significantly between pre- and post- treatment (p<0.001). Although gender(p=0.01), economic status (p=0.04) and education status (p=0.01) affect to OHIP-14 significantly before treatment, these factors didn't have effects on OHIP-14 after treatment. The subjective satisfaction in masticatory function, social function and psychological function increased significantly after treatment (p<0.001). Besides, the patients' oral health interests increased significantly after treatment (p<0.001). The fixed prosthetic treatment using implant therapy can improve the oral health related quality of life, subjective satisfaction of mastication, social function and psychological function, and oral health interest of dental patients.