• Title/Summary/Keyword: Medicine Act

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Evaluation of Average CT to Reduce the Artifact in PET/CT (PET/CT 검사에서 호흡에 따른 인공산물을 줄이기 위한 Average CT의 유용성)

  • Kim, Jung-Sun;Nam, Ki-Pyo;Park, Seung-Yong;Ryu, Jae-Kwang;Cha, Min-Kyeong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.3-7
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    • 2010
  • Purpose: The usefulness of Positron Emission Tomography (PET) images in diagnosis, staging, recurrent and treatment response evaluation has already been known. However, tumors which are small size, located in lower lobe of lung or upper lobe of liver are shown misalignment, distortion and different Standard Uptake Value (SUV) by respiration in PET images. Therefore, if radiotherapy based on normal respiration, it may cause low treatment response or more side effects because targets which had to treat, out of treat range or over dose to normal tissue. The purpose of this study is to evaluate attenuation-correction with Average CT (ACT) for more accuracy SUV measurement and minimize artifact by respiration. Materials and Methods: 13 patients, who had tumors which are around the diaphragm, underwent ACT scan after Helical CT (HCT) scan with PET/CT (Discovery DSTE 8; GE Healthcare). We quantified the differences between attenuation corrected image with HCT and attenuation corrected image with ACT in artifact size and maximum SUV ($SUV_{max}$). Artifacts were evaluated by measurement of the curved photogenic area in the lower thorax of the PET images for all patients. $SUV_{max}$ was measured separately at the primary tumors. Analysis program was Advantage Workstation v4.3 (GE Healthcare). Patients were injected with 7.4 MBq (0.2 $mC_i$) per kg of $^{18}F$-FDG and scanned 1 hour after injection. The PET acquisition was 3 minute per bed. Results: Significantly lower artifact were observed in PET/ACT images than in PET/HCT images (below-thoracic artifacts caused by under corrected $1.5{\pm}3.5$ cm vs. $13.4{\pm}4.2$ cm). Significantly higher $SUV_{max}$ were noted in PET/ACT images than in PET/HCT images in the primary tumor. Compared with PET/HCT images, $SUV_{max}$ in PET/ACT images were higher by $5.3{\pm}3.9%$ (mean value) tumor. The highest difference was observed in Lower lobe of lung (7.7 to 8.7; 13%). Conclusion: Due to its significantly reduced artifacts in lower thoracic, attenuation corrected image with ACT images provided more reliable $SUV_{max}$ and may be helpful in monitoring treatment response. Moreover, ACT can separate upper lobe of liver and lower lobe of lung, it may be helpful in interpretation. ACT will be clinically useful, considering increased dose caused by ACT scan and adapt.

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A study on the Legislations and Amendments of the Medical and Pharmaceutical Laws and Regulations - Focusing on the Duties of Korean (Oriental) Medicine Doctors and Korean (Oriental) Pharmacists as well as the Public Health System - (한의사·한약사 임무 및 공공제도 중심의 의약법규 제·개정 고찰)

  • Eom, Seok-Ki;Shin, Min-Seop;Kwon, Soon-Jo
    • The Journal of Korean Medical History
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    • v.26 no.2
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    • pp.175-185
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    • 2013
  • Purpose : The current Medical Law and the Pharmaceutical Affairs Act, which are incapable of utilizing the research results and the advanced academic, clinical, and pharmaceutical system of the present-day Korean (Oriental) medicine, have limitations and create a paradox by provoking social conflict among the professionals in the field. The aim of this study was to find out the legal and systematic problems that contributed to a complicated conflict amongst Korean (Oriental) medicine doctors, doctors, pharmacists, and Korean (Oriental) pharmacists regarding the classification of their functions. Methods : We reviewed the history and characteristics of the legislation regarding the duties of Korean (Oriental) medicine doctors and Korean (Oriental) pharmacists as well as the relevant and important public health policies since the enactment of the National Medical Services Law in 1951. We focused on the laws and regulations that are made in the process of the separating functions of physicians and pharmacists and the dispute between the Korean (Oriental) medicine doctors and the Korean (Oriental) pharmacists in the 1990s and 2000s. Results : The legislations and amendments of the medical and pharmaceutical laws and regulations that reflect the modern academic, clinical, and pharmaceutical system of the Korean (Oriental) medicine and the research results could be summarized as follows: 1) A partial amendment of the Medical Law in 1987, which added the provision of "Oriental health guidance" as one of the duties of Korean (Oriental) medicine doctors, assured a place for Korean (Oriental) medicine doctors in the field of public health. 2) A partial revision of Pharmaceutical Affairs Act in 1994 established a new system for Korean (Oriental) pharmacists, bringing about the creation of dualistic pharmaceutical system that complements the dualistic medical system. 3) The Promotion of the Research and Development of Wonder Drugs by Using Natural Substances Act was legislated in 2000 in order to stimulate research and development of Korean (Oriental) medicine and its industrialization. 4) Oriental Medicine Promotion Act in 2003 was enacted to lay foundation to specify and promote technology and industry that are related to Korean (Oriental) medicine. Discussions and conclusions : Although the dualistic medical and pharmaceutical system is set up by the Medical Law and Pharmaceutical Affairs Act, it is shown that the relevant regulations have been developed from a perspective of the western medicine.

The Legal Perspectives of the Medical Practice in Korean Medicine (한방의료행위의 법적 개념에 관한 연구)

  • Lee, Hai-Woong
    • Journal of Society of Preventive Korean Medicine
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    • v.21 no.2
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    • pp.45-53
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    • 2017
  • Background and Aim : Lately the age of competition has come among the medical service area. At the same time disputes over the medical practice related to the medical person's territory tend to increase. In part it is due to the increased medical persons but in part it is because the medical practice is not defined clearly in the Medical Service Act for the practice of each medical person. So the legal definition of medical practice will be discussed here. Materials and Method : The cases from the court have been confirmed the difference between the two medical persons regarding the actual events. Legal aspects of medical practice in Korean medicine and the related cases will be reviewed and analysed. Results : The form of medical practice consists of administrating Korean medicine treatment and providing guidance for health based on Korean medicine. For medical doctors the practice includes medical treatment and guidance for health. Circular definition in the Medical Service Act over the medical practice, medical person and medical instruments makes it difficult to understand the whole idea. Therefore, the court has a tendency to decide the medical practice of medical doctor of Korean medicine from the some reliable points which is: 1) it is based on the principle of traditional Korean Medicine, 2) it is practiced by the medical doctor of Korean Medicine, 3) it can do harm to the patient without proper involvement of the medical doctor of Korean Medicine. Now the Act on the promotion of Korean Medicine and Pharmaceuticals makes it include the concept of "scientifically applied and developed" medical practice of Korean Medicine. Conclusions : With the essential change in the Act on the promotion of Korean Medicine and Pharmaceuticals, it is expected that even slight change can be seen in the court cases. However, still the concept of medical practice in the Medical Service Act remains the same. Modernisation of Korean Medicine, enhancement of textbooks and clinical practice training and the effort to amend the law to clearly define the medical practice of Korean Medicine will contribute to the clinical and academic environment. Evidence based Korean Medicine and even the unification of east-west medicine could be considered for the situation.

Recent Trends in the Withdrawal of Life-Sustaining Treatment in Patients with Acute Cerebrovascular Disease : 2017-2021

  • Seung Hwan Kim;Ji Hwan Jang;Young Zoon Kim;Kyu Hong Kim;Taek Min Nam
    • Journal of Korean Neurosurgical Society
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    • v.67 no.1
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    • pp.73-83
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    • 2024
  • Objective : The Act on Life-Sustaining Treatment (LST) decisions for end-of-life patients has been effective since February 2018. An increasing number of patients and their families want to withhold or withdraw from LST when medical futility is expected. This study aimed to investigate the status of the Act on LST decisions for patients with acute cerebrovascular disease at a single hospital. Methods : Between January 2017 and December 2021, 227 patients with acute cerebrovascular diseases, including hemorrhagic stroke (n=184) and ischemic stroke (n=43), died at the hospital. The study period was divided into the periods before and after the Act. Results : The duration of hospitalization decreased after the Act was implemented compared to before (15.9±16.1 vs. 11.2±18.6 days, p=0.127). The rate of obtaining consent for the LST plan tended to increase after the Act (139/183 [76.0%] vs. 27/44 [61.4%], p=0.077). Notably, none of the patients made an LST decision independently. Ventilator withdrawal was more frequently performed after the Act than before (52/183 [28.4%] vs. 0/44 [0%], p<0.001). Conversely, the rate of organ donation decreased after the Act was implemented (5/183 [2.7%] vs. 6/44 [13.6%], p=0.008). Refusal to undergo surgery was more common after the Act was implemented than before (87/149 [58.4%] vs. 15/41 [36.6%], p=0.021) among the 190 patients who required surgery. Conclusion : After the Act on LST decisions was implemented, the rate of LST withdrawal increased in patients with acute cerebrovascular disease. However, the decision to withdraw LST was made by the patient's family rather than the patient themselves. After the execution of the Act, we also observed an increased rate of refusal to undergo surgery and a decreased rate of organ donation. The Act on LST decisions may reduce unnecessary treatments that prolong end-of-life processes without a curative effect. However, the widespread application of this law may also reduce beneficial treatments and contribute to a decline in organ donation.

The Protecton of Privacy on Secondary Use of Personal Health Imformation (의료기관 개인건강정보의 이차적 이용)

  • Kim, Jang-Han
    • The Korean Society of Law and Medicine
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    • v.11 no.1
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    • pp.117-143
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    • 2010
  • Along with the development of digital technologies, the information obtained during the medical procedures was working as a source of valuable assets. Especially, the secondary use of personal health information gives the ordeal to privacy protection problems. In korea, the usage of personal medical information is basically regulated by the several laws in view of general and administrative Act like Medicine Act, Public institutions' personal information protection Act, Information-Network Act etc. There is no specific health information protection Act. Health information exchange program for the blood donor referral related with teratogenic drugs and contagious disease and medical treatment reporting system for income tax convenience are the two examples of recently occurred secondary use of health information in Korea. Basically the secondary use of protected health information is depend on the risk-benefit analysis. But to accomplish the minimal invasion to privacy, we need to consider collection limitation principle first. If the expected results were attained with alternative method which is less privacy invasive, we could consider the present method is unconstitutional due to the violation of proportionality rule.

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A study on revised direction of the school health act for first aid instructor qualification (응급처치 교육 강사 자격요건에 대한 학교보건법 개정 방향에 관한 연구)

  • Kim, Ji-Won;Kang, Min Seong
    • The Korean Journal of Emergency Medical Services
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    • v.24 no.2
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    • pp.155-162
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    • 2020
  • Purpose: The aim of this study was to suggest the qualification criteria for the instructors of first aid education for teachers in the School Health Act. Methods: We compared and analyzed the approval provisions for qualifying as first aid educators under the School Health Act, the Emergency Medical Services Act, and prior studies of first aid education. Results: The comparison of the studies demonstrated some key points. First, the first aid education of teachers could be improved through the knowledge of professional instructors. Second, the doctors, emergency nurse practitioners, and emergency medical technicians (EMT) were suitable as specialized first aid instructors. Third, for qualifying as first aid instructor, only the EMTs required more than five years of career. Conclusion: We suggest that all emergency medical service providers qualify to become first aid educators. Additionally, the requirement of EMTs to have more than 5 years of career to qualify as an instructor should be eliminated.

Identification and Antioxidant Activity of Marine Actinomycetes Streptomyces sp. ACT-1 (해양방선균 Streptomyces sp. ACT-1의 동정 및 항산화 활성)

  • Kim, Man-Chul;Kim, Ju-Sang;Kim, Yun-Beom;Harikrishnan, Ramasamy;Han, Yong-Jae;Heo, Moon-Soo
    • Korean Journal of Microbiology
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    • v.45 no.4
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    • pp.397-403
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    • 2009
  • For the research of the natural antioxidant from marine sources, an antioxidant-producing marine actinomycetes was isolated from sea water in Jeju coastal area. The strain was identified based on 16S rDNA sequencing, the morphology by a method of scanning electron microscopy, physiological and biochemical characteristics and cellular fatty acid analysis. The isolated strain ACT-1 cell size was $0.5\sim1.0{\mu}m$ and gram positive, aerobic, nonmotile, substrate mycelium are red and gray aerial mycelium. 16S rRNA sequence analysis showed that were Gram-positive bacteria grouped on Streptomyces genus. Results of cellular fatty acid analysis showed that major cellular fatty acids were $C_{15:0}$ anteiso (39.33%), $C_{16:1}$ cis 9 (11.96%), $C_{16:0}$ (13.08%) and $C_{17:0}$ anteiso (10.99%). Finally, strain was identified Streptomyces sp. ACT-1. The antioxidant activity of methanol extract from Streptomyces sp. ACT-1 was evaluated by measuring DPPH, hydroxyl, and alkyl radical scavenging activity using an electron spin resonance (ESR) spectrometer. DPPH radical scavenging activity of SBME-1 (Streptomyces broth methanol extract) was 67% at $1,000{\mu}g$/ml. Hydroxyl radical scavenging activity of SBME-1 was 84% at $500{\mu}g$/ml. Alkyl radical scavenging activity of SBME-1 was 71% at $1,000{\mu}g$/ml.

A Study on Enacting the Radiologic Technologist Act for the Civil Right to Health in Korea (건강권과 방사선사법 제정에 관한 고찰)

  • Lim, Chang-Seon
    • Journal of radiological science and technology
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    • v.30 no.4
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    • pp.313-320
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    • 2007
  • There are the Medical Radiation Health and Safety Act(the Patient Radiation Health and Safety Act, the Radiologic Technologist Act), the Medical Laboratory Technologist Act, the Physical Therapy Practice Act, and the Dental Hygienist Act, etc in America. However, Korea has only one Act for a medical radiologic technologist(including radiation therapy technologist, nuclear medicine technologist), medical laboratory technologist, physical therapist, occupational therapy examiner, dental hygienist, and so on. It is the Medical Technologist Act. Therefore, the Medical Radiation Health and Safety Act for a radiologic technologist(including radiation therapy technologist, nuclear medicine technologist) has to be enacted independently in Korea. It is the purpose of this Act to provide for the appropriate certification of persons using radioactive materials, equipment emitting ionizing radiation on humans or performing medical imaging for diagnostic and therapeutic purposes. In Korea, the radiologic technologist is a "fusion technologist" who is a person other than a licensed practitioner as a radiographer, radiation therapist, nuclear medicine technologist, computed tomography technologist, magnetic resonance technologist, mammographer, sonographer, medical dosimetrist, quality management technologist, etc. This Act will have some provisions related to the definitions, reserved title, scope of practice, specialized technologist, application for licensure, radiologic technology council, renewal, continuing education, the radiation control advisory commission, etc. This Act will ensure that quality radiation therapy treatments are delivered and that quality diagnostic information is presented for interpretation, which will lead to accurate diagnosis, treatment and cure. Accurate diagnosis can be provided only when a personnel is properly educated in technique, equipment operation and radiation safety. In the end, this Act will protect the civil right to health. By regulating the personnel responsible for performing those procedures, this Act will mean improved care for patients-higher quality images, improved accuracy, and less exposure to radiation.

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Analysis and characterization of the functional TGFβ receptors required for BMP6-induced osteogenic differentiation of mesenchymal progenitor cells

  • Zhang, Yan;Zhang, De-Ying;Zhao, Yan-Fang;Wang, Jin;He, Juan-Wen;Luo, Jinyong
    • BMB Reports
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    • v.46 no.2
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    • pp.107-112
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    • 2013
  • Although BMP6 is highly capable of inducing osteogenic differentiation of mesenchymal progenitor cells (MPCs), the molecular mechanism involved remains to be fully elucidated. Using dominant negative (dn) mutant form of type I and type II $TGF{\beta}$ receptors, we demonstrated that three dn-type I receptors (dnALK2, dnALK3, dnALK6), and three dn-type II receptors (dnBMPRII, dnActRII, dnActRIIB), effectively diminished BMP6-induced osteogenic differentiation of MPCs. These findings suggested that ALK2, ALK3, ALK6, BMPRII, ActRII and ActRIIB are essential for BMP6-induced osteogenic differentiation of MPCs. However, MPCs in this study do not express ActRIIB. Moreover, RNA interference of ALK2, ALK3, ALK6, BMPRII and ActRII inhibited BMP6-induced osteogenic differentiation in MPCs. Our results strongly suggested that BMP6-induced osteogenic differentiation of MPCs is mediated by its functional $TGF{\beta}$ receptors including ALK2, ALK3, ALK6, BMPRII, and ActRII.

Implication of Korean Medicine Principles in Herbal Medicinal Preparations on Pharmaceutical Affairs Act (약사법상 한약제제의 정의 중 한방원리의 의미에 대한 고찰)

  • Lim, Hyun-Jin;Kim, Ji-Hoon;Cho, Sun-Young;Park, Sun-Dong;Kim, Yun-Kyung
    • Herbal Formula Science
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    • v.23 no.1
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    • pp.1-14
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    • 2015
  • Objectives : In Pharmaceutical Affairs Act, herbal medicinal preparations are defined as medicines made by Korean medicine principles. But in Act, Korean medicine principles are vague. Thus, there is a request to explain what the Korean medicine principles are. The aim of this study is to suggest implications of Korean medicine principles in definition of herbal medicinal preparations. Methods : With regard for definition of Korean medicine principles, we referred to the domestic and foreign regulations and literature about the history of herbal medicinal preparations. As a result, the meaning of Korean medicine principles was historically examined from various angles. Results : Through this study, we studied the Korean medicine principles from the past medical history. Due to the broad definition of Korean medicinal principles, we tried to extract general ideas of medicine principles first. We also found that we had scientific formulations based on korean medicine principles which could be used in modern society. In the end, we found that numerous medicine principles which include ‘Four qi and five flavors theory’, ‘Processing of medicinals’, ‘Yin and yang theory’, ‘Five phases theory’, ‘Meridian entry of viscera and bowels theory’, ‘Herb Couplet Interaction theory’, ‘Sovereign, minister, assistant and courier theory’, etc. Conclusions : Innumerable principles used from the past existed. These principles were broad and could be used as modern scientific principles. Based on these facts, we illustrated details of Korean medicine principles, hope this principles be widely shared and Korean herbal medicinal preparations be further developed.