• Title/Summary/Keyword: Medical treatment law

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A study on zhenjiusunanyaozhi(鍼灸素難要旨) (침구소난요지(鍼灸素難要旨)에 대한 연구(硏究))

  • Sim, Cheol-Ung;Kim, Jae-Jung;Kim, Jang-Saeng;Lee, Si-Hyeong
    • Journal of the Korean Institute of Oriental Medical Informatics
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    • v.17 no.2
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    • pp.130-287
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    • 2011
  • "zhenjiusunanyaozhi(鍼灸素難要旨)" is composed of three volumes and published in 1529 by Gao Wu(高武). Gao Wu(高武) is skillful in astronomy, the art of war and the law as well as a medical practitioner in Ming Dynasty. The books he wrote "zhenjiujuying(鍼灸聚英)", "zhizhi(直指)", "douzhenzhengzong(痘疹正宗)", "shexuezhinan(射學指南)", "zhenjiujieyao(鍼灸節要)". "zhenjiusunanyaozhi鍼灸素難要旨" is written by classifying the origin of acupuncture and moxibustion. In other words, it is edited by classifying the contents related to acupuncture and moxibustion out of the ancient Chinese medical book "yellow emperor's canon of medicine and yellow emperor eighty-one difficult" in which are composed of 3 volumes as follows, Volume 1 says the main diseases on "the nine acupuncture needles figure" (九針圖), "the reinforcing and reducing the meridian" (補瀉), "the needle depth" (針刺深淺), "the five shu points - metal, wood, water, fire, earth" (正,滎,輸,經,合) based on 18 chapters in terms of acupuncture in "yellow emperor eighty-one Difficult "難經"", in which it quotes the annotation of "the difficulty by the original meaning "難經本義"" written by Hua Shou(滑壽) in Yuan Dynasty. Volume 2 is composed of 2 parts. Part 1 says the method of treatment on 36 Chapters, the method of acupuncture use in the Linshu "靈樞" and the Suwen "素問" such as "the rule of acupuncture use" (用針方宜), "the nine-pin method" (九針式) and "the nine-pin to only use the time appropriate to consider nature of Heaven, Earth and person" (九針應天地人時以起用) etc., Part 2 says "the five difficult acupuncture(五亂刺)", "the rise and fall of energy and blood(氣血盛衰)". "the pain tolerance(耐痛)" and ect., in which are in terms of method of treatment collected the original texts of 59 chapters on acupuncture to each disease and of 8 chapters on moxibustion in the Linshu "靈樞" and the Suwen "素問". Volume 3 includes 10 chapters in which consist of "the stabbing to disease in 12 meridians (十二經病刺)", "the eight extra meridian disease (寄經八脈病)", "the twelve meridians(十二經脈)", "the fifteen collaterals (十五絡脈), the twelve meridian muscles (十二經筋)", "the acupoint (孔穴)" and etc. This is the book edited comprehensively by classifying the contents on the theory of acupuncture and moxibustion and the circulations of meridians in "yellow emperor's canon of medicine and yellow emperor eighty-one difficult" and there is no case story in particular except his comments in person. This study is for the purpose of helping researching and developing acupuncture and moxibustion and applying their clinical training.

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A Study on the Major Issues and Legislative Considerations of CCTV Installation in an Operating Room (수술실 CCTV 설치의 쟁점과 입법방향에 관한 소고(小考))

  • Kim, Sungeun;Choe, A Reum;Bae, Kyounghee
    • The Korean Society of Law and Medicine
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    • v.22 no.2
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    • pp.111-138
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    • 2021
  • 'Unlicensed medical practice by a non-medical practitioner' often represented by surrogate surgery or so-called 'ghost surgery,' causes irreparable damage to life or body, and therefore calls for very strict and effective controls. The 'bill on installment of CCTVs in an operating room' to prevent unlicensed surrogate surgery has been discussed for a long time, but due to numerous issues and heated confrontations, it has been pending in the National Assembly. Nevertheless, it is expected that the bill will be discussed again in earnest in the National Assembly because surrogate surgery and factory-type cosmetic surgery, which has been performed mainly in the field of cosmetic surgery, has also been occurring in the field of therapeutic surgery. In general, an operating room is considered as being locked or closed, as well as disallowing implicit complicity among insiders. Hence, if the insiders conspire to commit or cover up an illegal act, or if a surgeon performs rapid cosmetic surgery and then leaves the recipient (or medical institution) so as to perform more operations for profit - even if it is legitimate practice - it may result in serious consequences in terms of the recovery of a patient. In this case, installation of CCTVs can be of great help in identifying an illegal act and assessing any occurrence of negligence. On the other hand, while the fundamental purpose of therapeutic surgery is to restore a patient's life or body - that is, lifesaving - installation of CCTVs may base the relationship between a surgeon and a patient on distrust and surveillance, so it may increase the number of requests for CCTV footage or lead to more disputes, as well as placing a burden on the surgeon when best results are not achieved for a patient. As a result, the surgeon may choose non-invasive treatment contrary to conscience instead of risky but necessary surgery, or he/she may have significant difficulty in determining the timing of surgery, which may limit the provision of effective surgical medical care. Then, in terms of the relationship between a surgeon and patient, and in the long run, there could be significant disadvantages for the public and patients if CCTV footage is allowed. In this paper, we review domestic and overseas cases and issues regarding installation of CCTVs in an operating room, and present various viewpoints and suggestions to promote legislation with minimized legal problems and side effects, thereby contributing to protection of the lives and health of the public, patients, and recipients of surgery.

Cardiac Intracoronary Stenting vs CABG: Prevention of Medical Accident (심장 스텐트 시술과 의료사고 예방)

  • Kim, Kyoung Reay;Park, Kook Yang
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.163-194
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    • 2017
  • Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

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Overview of personalized medicine in the disease genomic era

  • Hong, Kyung-Won;Oh, Berm-Seok
    • BMB Reports
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    • v.43 no.10
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    • pp.643-648
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    • 2010
  • Sir William Osler (1849-1919) recognized that "variability is the law of life, and as no two faces are the same, so no two bodies are alike, and no two individuals react alike and behave alike under the abnormal conditions we know as disease". Accordingly, the traditional methods of medicine are not always best for all patients. Over the last decade, the study of genomes and their derivatives (RNA, protein and metabolite) has rapidly advanced to the point that genomic research now serves as the basis for many medical decisions and public health initiatives. Genomic tools such as sequence variation, transcription and, more recently, personal genome sequencing enable the precise prediction and treatment of disease. At present, DNA-based risk assessment for common complex diseases, application of molecular signatures for cancer diagnosis and prognosis, genome-guided therapy, and dose selection of therapeutic drugs are the important issues in personalized medicine. In order to make personalized medicine effective, these genomic techniques must be standardized and integrated into health systems and clinical workflow. In addition, full application of personalized or genomic medicine requires dramatic changes in regulatory and reimbursement policies as well as legislative protection related to privacy. This review aims to provide a general overview of these topics in the field of personalized medicine.

The Status and Future Challenges of Tobacco Control Policy in Korea

  • Cho, Hong-Jun
    • Journal of Preventive Medicine and Public Health
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    • v.47 no.3
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    • pp.129-135
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    • 2014
  • Tobacco use is the most important preventable risk factor for premature death. The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC), the first international public health treaty, came into force in 2005. This paper reviews the present status of tobacco control policies in Korea according to the WHO FCTC recommendations. In Korea, cigarette use is high among adult males (48.2% in 2010), and cigarette prices are the lowest among the Organization for Economic Cooperation and Development countries with no tax increases since 2004. Smoke-free policies have shown incremental progress since 1995, but smoking is still permitted in many indoor public places. More than 30% of non-smoking adults and adolescents are exposed to second-hand smoke. Public education on the harmful effects of tobacco is currently insufficient and the current policies have not been adequately evaluated. There is no comprehensive ban on tobacco advertising, promotion, or sponsorship in Korea. Cigarette packages have text health warnings on only 30% of the main packaging area, and misleading terms such as "mild" and "light" are permitted. There are nationwide smoking cessation clinics and a Quitline service, but cessation services are not covered by public insurance schemes and there are no national treatment guidelines. The sale of tobacco to minors is prohibited by law, but is poorly enforced. The socioeconomic inequality of smoking prevalence has widened, although the government considers inequality reduction to be a national goal. The tobacco control policies in Korea have faltered recently and priority should be given to the development of comprehensive tobacco control policies.

Prenatal Genetic Test (산전 유전자 검사)

  • Han, You-Jung;Ryu, Hyun-Mee
    • Journal of Genetic Medicine
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    • v.8 no.2
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    • pp.100-104
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    • 2011
  • Genetic testing has been generalized for the diagnosis of diseases and is an important method of research with advances in the life sciences. In particular, we should give better attention to the genetic test for a fetus. Because the fetus has no autonomy, ethical and social issues can arise. Therefore, appropriate genetic counseling is needed for parents to be informed with the characteristics, natural progress, and possible treatment of a genetic disease, prior to the prenatal genetic test. Physicians should also inform parents how a particular genetic risk factor relates with the likelihood of a disease, in order to assist the parents in making the best decision. Furthermore, the current law for prenatal genetic testing should be approached rationally.

The Analysis on the Perception of Medical Accident and Dispute of Dental Hygienist (치과위생사의 의료사고 및 의료분쟁에 대한 인식정도 분석)

  • Lee, Sun-Mi;Lim, Mi-Hee;Han, Myeong-Suk
    • Journal of dental hygiene science
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    • v.8 no.4
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    • pp.241-246
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    • 2008
  • he purpose of this study was to examine the awareness of dental hygienists about medical malpractice and dispute. The subjects in this study were 206 dental hygienists at dental clinics, on whom a survey was conducted. After SPSSWIN 14.0 program was utilized to analyze the collected data, the following findings were given: 1. As for experiences of being complained from patients by age, the dental hygienists who were at the age of 21 to 23 made up the largest age group (39.2%) who had ever meet patients who had grievances. By career, those who had worked for less than a year constituted the greatest group (30.4%) who had the same experiences. It indicated that the dental hygienists who were younger and had a less career had been more complained from patients. 2. In terms of problems posed by patients, scaling came into question the most (14.5%), followed by diagnosis (14.4%), impression (12.9%) and radiography (11.0%). 3. Regarding perception of scaling treatment, 90.8 percent, the greatest percentage, kept records of patients about scaling. As to how to do that, 34.5 percent, the largest percentage, wrote it down and then signed their name. Concerning the way of explaining how to take care of oral health, 82.5 percent gave an explanation without any prints. 4. As to knowledge on the medical law, they got a mean of 12.34 out of possible 16 points. 5. Concerning the necessity of education about the prevention of medical accidents and countermeasures, 70.4 percent felt the strong and urgent need for that.

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Dose Distribution&Calibration in HDR Intracavitary Irradiation for Uterine Cervical Cancer (자궁경부암의 강내치료를 위한 선량측정)

  • 김진기;김정수;김형진;권형철
    • Progress in Medical Physics
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    • v.6 no.1
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    • pp.13-18
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    • 1995
  • Dose distribution of HDR-RALS source represents an inverse square law as the distance. Difference of measurement value and calculation value according of brachytherapy. Therefore, in HDR-RALS dose calibration and calculation have an important effect in treatment of uterine cervical cancer and absorbed dose of interesting points. In intracavitary therapy, particula attention is paid for precise determination of the doses to be applied. In this report, we have discussed that the calibration of a HDR-RALS, differences between calculation dose use of isodose chart and measurement in rectum. Dose rate calibration of radiation sources are obtained from air kerma and Г factor with calibraed ion chamber for cobalt source. and used semiconductor detector for compared with measurement in phantom. Eighteen patients were treated with a HDR-RALS for intrcavitarty irradiation (ICR) using a cobalt-cesium source. Repoductivity of dose measurements were 0.3 -1.1% in phantom. The means of dose distribution was -6- +21% between calculation of isodose chart and measurement of recyum, and was same mean value upper 6.3% in measurement value than calculation does.

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The study on advertisement of dental devices & instrument during Japanese colonized period (광고를 통해 본 일제강점기 치과 장비 및 기구 광고에 관한 연구)

  • Shin, Jai-Eui
    • The Journal of the Korean dental association
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    • v.48 no.12
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    • pp.893-918
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    • 2010
  • This article is purposed of reviewing the development history of Japanese dental devices and instrument, and their related advertisement activities during the Japanese colonized period in Korea in early 20th century. Japanese dental devices and instrument were redesigned to accommodate their ergonomic shape above the simple imitation, and it implies the excessive desires brought them frustrations. The tragic earthquake on Sep. l, 1923, medical insurance law enforcement on Jan. 1, 1927, celebration of "Cavity prevention Day" started on Jun. 4, 1928, and the attack of Manchuria and China by Japan after 1931, all of these historical incidents become the preliminary requirement for the development of dental devices. On Nov. 1, 1937, Japanese government started to control dental materials, driving the campaigns for excluding foreign products and encourging the use of local products. In 1939, Nakajima dental manufacturers used this political and social atmosphere on their advertisement as saying "Our Nakajima's products have no compromise with the short raw materials, but only commitment to our quality". Since after 1940, the price and supply have been strongly under control, and the control group was appeared to manage all of supply and distribution of raw materials, regular price system, and specifications. At last, the Japanese national power were devastated in its production and distribution capacities, and get to the frustrated period. The main advertised dental devices and instruments in Korea during the Japanese colonized period were 1) dental chair, unit and cabinet, 2) dental x-ray, 3) compressors, 4) dental needles, 5) small instrument and carryon medical(emergency) kit, 6) oral hygiene and pyorrhea alveolaris, infrared rays, sunlight lamp, ultrashort wave treatment devices, 7)crown former, electric furnace, casting machine, articulator, electric lathe, and laboratory equipments, etc.

A Study on Approach toward Integrative Dental-Hygienist Curriculum Model (치과위생사 통합교육과정 모형 접근에 관한 연구)

  • Hwang, Mi-Yeong;Lee, Chun-Sun
    • Journal of Korean society of Dental Hygiene
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    • v.7 no.4
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    • pp.595-609
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    • 2007
  • The purpose of this study was to classify the courses of the dental-hygiene curricula into several categories by field, to incorporate the subjects in the same category into an integrated course, and to suggest how to ensure the successful phase-in application of integrative education according to Ronald M. Harden's 11-stage integrative ladder model. The findings of the study were as follows: 1. When the existing curricula were analyzed, it's found that many credits were provided to the courses in the area of basic dentistry that offered both theory and practice. In particular, the subjects tested by the national examination were offered by every college. In the field of public oral health, the largest number of credits was allocated to theory of oral prophylaxis and practice courses. In clinical area, clinical practice, in the area of dental office management, dental insurance course was given the largest credit. There were 31 to 61 major subjects in the colleges, which indicated that the major subjects were segmented in detail. 2. It seemed necessary to incorporate the subjects in the field of basic dentistry into oral biology, and theory of oral prophylaxis/practice, preventive dentistry/practice, preclinical stage, emergency treatment and introduction to dental hygiene should be integrated in to clinical dental hygiene. The courses in clinical area should be combined into clinical dentistry, and in the field of medical management, dental insurance, hospital management and medical relation law should be incorporated into management of dental clinic. 3. In the 11-stage integrative ladder, the subjects in the same field could perfectly be incorporated as the stages advanced. Each of the subjects was less emphasized, and communication and joint plans among teachers who were respectively in charge of the courses were increasingly considered important. Specifically, there should be a consensus among the teachers in regard to the outline of teaching programs, order of education. objects and objectives of programs and what and how to evaluate.

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