It is a general recognition that more serious criminal acts in a certain area of society should be given more serious condemation than the same general crimnal act. In particular, considering the purpose of the medical treatment and the trust relationship between the doctor and the patient, the sexual violence by doctor in medical field can not be placed on the same line as that of the general public. But the special legislation to solve this through criminal legal sanctions is not desirable. The basic principle of criminal law ist ultima ratio, so the principle of supplementality. It means to try to solve by all possible means and finally to enter with punishment. A flat and hasty Reaction without the considering of the speciality of medical treatment will cause serious cracking in that area. In addition, it will not be able to expect desirable results in legal practice by breaking down the legal system. Rather, administrative regulation is more efficient than punishment sanctions. But the best way is autonomous control by members of the medical area. Penalties in criminal law must make an enterance at the last, and administrative regulation should be timely intervene in specific situations through diversification. In conclusion, state interventions should be farthest in order to proceed to autonomous control of medical area.
In this study, to provide the implications of dental health care training direction in the future after researching the effect on the use of dental hygiene devices, data were collected from 320 patients who visited dental clinics located in Seoul and Gyeonggi-do for about 6 months between December 2013 and May 2014. Among them, the following results were obtained by analyzing 299 copies accounting for 93.4% of the collected data after excluding 21 copies lacking in answer. It was shown that education about dental hygiene devices had statistically significant effects on the dependent variables, perception of dental hygiene devices (p<0.001). Based upon the results above, it is considered that for the sake of prevention of oral diseases, more opportunities to learn correct knowledge and usage of suitable dental hygiene devices for individual oral conditions should be provided for patients, and active patient education as well as the development, implementation and publicity of systematic and popular oral health education programs will contribute to improved oral health.
Yu, Chang-Min;Koh, Won-Jung;Kim, Kyung Chan;Lee, Byoung-Hoon;Hwang, Jung Hye;Kang, Eun Hae;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Kwon, O Jung;Ki, Chang-Seok;Kim, Jong-Won
Tuberculosis and Respiratory Diseases
/
v.54
no.6
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pp.628-634
/
2003
Bronchiectasis is defined as an abnormal, irreversible dilatation of the bronchi, which may result from a number of possible causes, and the recognition of these causes may lead to a specific management strategy. Immunodeficiency is known as one of the conditions associated with bronchiectasis. X-linked agammaglobulinemia is a rare inheritable immunodeficiency disorder, caused by a differentiation block, leading almost to the complete absence of B lymphocytes and plasma cells. The affected protein is a cytoplasmic protein tyrosine kinase, Bruton's tyrosine kinase. The early detection and treatment with immunoglobulin replacement are most important for the management of recurrent infections and for reducing severe complications. We report a 20-year-old male patient, with X-linked agammaglobulinemia associated with bilateral bronchiectasis, carrying a missense mutation(R520P) in the BTK gene.
Our health is intimately connected to the health of our environment. The contemporary world view which sees a radical distinction between humans as subjects and world as object can obscure our recognition of how much we rely on nature for health and survival. Indigenous traditions and contemporary scholars remind us that we live in a universe in which all things are connected, and in which nature continues to offer its gifts in co-creative partnership for the health and wellbeing of all. Living in awareness of our relationship with nature enables us to open more to the experience of nature's nurturing. Many complementary therapies derive from ancient practices that involve nature in healing partnership. Essential oils have been used for thousands of years. Hippocrates claimed that the way to health was through aromatic baths and massages. Much anecdotal evidence exists regarding aromatherapeutic positive effects on recipients. Aromatherapy is a branch of complementary or alternative therapy which is increasing in popularity, yet has scant scientific credibility. Aromatherapy should be defined as treatment using odors and practised as such. However, essential oils are usually used in conjunction with therapeutic massage and often combined with counselling of some kind. Aromatherapy complements and enhances the therapeutic powers of massage. Massage is one of the most wonderful ways to relax and is throughly beneficial to health. Massage can help unknot tense and aching muscles and other minor symptoms of stress, leaving patients fresh and energized. As the use of aromatherapy within a health care setting has grown so rapidly in recent years, and will continue to do so, the need for suitable training has become apparent. No health service can afford the risk of having staff who are inadequately trained in the practice of aromatherapy using essential oils incorrectly on those in a state of ill-health, especially if the essential oils used are not to a standard suitable for therapeutic use. Training to an acceptable level in aromatic therapy is essential for safety and effectiveness. Knowledge of the nature and make-up of essential oils, their effect on the body and the emotions, and how, when, and where to apply them is imperative in order for them to be beneficial to a patient's health. In order to achieve best practice, further research is necessary to explore the use of aromatherapy in the management of multiple disorder.
Background: This study was designed to determine etiologic factors for iatrogenic pneumothorax in an era of in-creased use of invasive procedures and to evaluate its impact on morbidity. Material and Method: Subjects were 112 patients (65 men and 47 women ranging in age from 20 to 90 years) who were diagnosed with an iatrogenic pneumothorax between January 2005 and December 2008. We reviewed medical records retrospectively. Result: The leading causes of iatrogenic pneumothorax were percutaneous needle aspiration (50), central venous catheterization (29), acupuncture (14), thoracentesis (8) and positive pressure ventilation (7). The majority of the patients (60 of 114) were treated with chest tubes. The mean duration of hospital treatment was 5.8 $({\pm}4.0)$ days. Hospitalization was prolonged in 24 patients (21.1%). No patient died from iatrogenic pneumothorax. Conclusion: In our study, the most common cause of Iatrogenic pneumothorax was percutaneous needle aspiration. The mortality and morbidity from iatrogenic pneumothorax is not significant. The recognition of pneumothorax, depends on careful examination after completion of an invasive procedure, and should be followed by prompt and definitive therapy.
This study is to provide evidence-based recommendations for the most-effective treatments of benign prostatic hyperplasia based on patient preference or clinical need, and to meta-analyze the Korean literatures for the development of BPH treatment guidelines. For these analyses, extensive literature searches (208 articles), with priority given to the Korean Journal of Urology, were conducted from 1960 to August, 1996. Meta-analysis, like all statistical analysis, has two main functions: data summarization (qualitative meta-analysis) and smoothing o. pattern recognition (quantitative meta-analysis). As well, critical reviews and syntheses with the mean and 90-percent confidence intervals for the likelihood were used to evaluate empirical evidence and significant outcomes of the BPH treatment literatures (106 articles). For this task, the Methodologic Panel for BPH Guidelines was composed of multidisciplinary experts in the field. The results of the study were summarized as follows: For all that watchful waiting is an appropriate treatment strategy for the majority of patients with prostatism, we couldn't find the Korean literatures which carried this article. The literatures on alpha-1-adrenergic receptor blockers provide no evidence to suggest that any one alpha blocker is more effective than another. The finasteride reduces the size of the prostate, on average, and leads to a small yet perceptible reduction in sysptoms. Of all treatment options, prostate surgery with transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), and so on, offers the best chance for symptom improvement. However, surgery also has the highest rates of significant complications. Therefore, surgery need not always be a treatment of last resort. Balloon dilation of the prostatic urethra is clearly less effective than surgery in relieving symptoms, but it is associated with fewer complications. Emerging technologies for treating BPH include lasers, coils, stents, thermal therapy and hyperthermia. Established technologies will also be reanalyzed as results of new trials are reported. Although this study has some limitations due to lacking for good quality literatures, ' it provides a cornerstone for our medical research. It represents the most current scientific knowledge regarding the clinical epidemiology including treatment of BPH. It will be revised and updated as needed.
Purpose: To find objective validity of minimal acupuncture using a modified guide tube as a method to verify the effect of acupuncture. Methods: Subjects of this study were participants of a randomized clinical trial which was practiced to verify the effect of acupuncture on postmenopausal hot flash. There were 2 arms of treatment, one's for active acupuncture group(AG) with manipulation and De qi, the other's for minimal acupuncture group(MG) using a modified guide tube which was designed to give minimal stimulation to the patient. After 8 weeks' treatment followed by 4 weeks' observation, participants were asked to fill in self-report forms on their education, previous experiences of acupuncture, original idea on the efficacy of acupuncture and recognition of blinding. Results: 19 participants of 26 in AG and 19 of 26 in MG completed the self-report form. There was no difference between AG and MG in their education(p=0.5976, Fisher exact test) and previous experiences of acupuncture(p=0.9999, Fisher exact test). In their original ideas on the efficacy of acupuncture, most of AG and MG respondents have been thought that acupuncture is very effective or quite effective, and there was no difference between 2 groups(p=0.5065). 16 of 19 in AG and 14 of 19 in MG believed that they underwent more effective way, there was no statistical difference between 2 groups(p=0.6928, Fisher exact test). Participants believed in undergoing more effective way not because they recognized treatment method, but they were satisfied with the effectiveness of treatment retrospectively. Conclusion: As the result of this study, these authors suggest that minimal acupuncture using a modified guide tube is acceptable as a method to verify the effect of acupuncture in acupuncture-familiar Korean culture. Also further studies on the stimulation-specific effect of minimal acupuncture are demanded.
Kim, Dong Uk;Park, Hyung Ki;Lee, Gyeoung Hae;Chang, Jae Chil;Park, Hye Ran;Park, Sukh Que;Cho, Sung Jin
Journal of Korean Neurosurgical Society
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v.64
no.6
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pp.995-1003
/
2021
Objective : People are living longer and the elderly population continues to increase. The incidence of degenerative spinal diseases (DSDs) in the elderly population is quite high. Therefore, we are facing more cases of DSD and offering more surgical solutions in geriatric patients. Understanding the significance and association of frailty and central sarcopenia as risk factors for spinal surgery in elderly patients will be helpful in improving surgical outcomes. We conducted a retrospective cohort analysis of prospectively collected data to assess the impact of preoperative central sarcopenia, frailty, and comorbidity on surgical outcome in elderly patients with DSD. Methods : We conducted a retrospective analysis of patients who underwent elective spinal surgery performed from January 1, 2019 to September 30, 2020 at our hospital. We included patients aged 65 and over who underwent surgery on the thoracic or lumbar spine and were diagnosed as DSD. Central sarcopenia was measured by the 50th percentile of psoas : L4 vertebral index (PLVI) using the cross-sectional area of the psoas muscle. We used the Korean version of the fatigue, resistance, ambulation, illnesses, and loss of weight (K-FRAIL) scale to measure frailty. Comorbidity was confirmed and scored using the Charlson Comorbidity Index (CCI). As a tool for measuring surgical outcome, we used the Clavien-Dindo (CD) classification for postoperative complications and the length of stay (LOS). Results : This study included 85 patients (35 males and 50 females). The mean age was 74.05±6.47 years. Using the K-FRAIL scale, four patients were scored as robust, 44 patients were pre-frail and 37 patients were frail. The mean PLVI was 0.61±0.19. According to the CD classification, 50 patients were classified as grade 1, 19 as grade 2, and four as grade 4. The mean LOS was 12.35±8.17 days. Multivariate stepwise regression analysis showed that postoperative complication was significantly associated with surgical invasiveness and K-FRAIL scale. LOS was significantly associated with surgical invasiveness and CCI. K-FRAIL scale showed a significant correlation with CCI and PLVI. Conclusion : The present study demonstrates that frailty, comorbidity, and surgical invasiveness are important risk factors for postoperative complications and LOS in elderly patients with DSD. Preoperative recognition of these factors may be useful for perioperative optimization, risk stratification, and patient counseling.
An accurate prediction of emotion is a very important issue for the sake of patient-centered medical device development and emotion-related psychology fields. Although there have been many studies on emotion prediction, no studies have applied the heart rate variability and neuro-fuzzy approach to emotion prediction. We propose ANFEP(Adaptive Neuro Fuzzy System for Emotion Prediction) HRV. The ANFEP bases its core functions on an ANFIS(Adaptive Neuro-Fuzzy Inference System) which integrates neural networks with fuzzy systems as a vehicle for training predictive models. To prove the proposed model, 50 participants were invited to join the experiment and Heart rate variability was obtained and used to input the ANFEP model. The ANFEP model with STDRR and RMSSD as inputs and two membership functions per input variable showed the best results. The result out of applying the ANFEP to the HRV metrics proved to be significantly robust when compared with benchmarking methods like linear regression, support vector regression, neural network, and random forest. The results show that reliable prediction of emotion is possible with less input and it is necessary to develop a more accurate and reliable emotion recognition system.
Tumor suppressor genes (TSGs) play a crucial role in maintaining cellular homeostasis. When the function of these genes is lost, it can lead to cellular plasticity that drives the development of various cancers, including small-cell lung cancer (SCLC), which is known for its aggressive nature. SCLC is primarily driven by numerous loss-of-function mutations in TSGs, often involving genes that encode epigenetic regulators. These mutations pose a significant therapeutic challenge as they are not directly targetable. However, understanding the molecular changes resulting from these mutations might provide insights for developing tumor intervention strategies. We propose that despite the heterogeneous genomic landscape of SCLC, the effects of mutations in patient tumors converge on a few critical pathways that drive malignancy. Specifically, alterations in epigenetic regulators lead to transcriptional dysregulation, pushing mutant cells toward a highly plastic state that makes them immune evasive and highly metastatic. This review will highlight studies showing how an imbalance of epigenetic regulators with opposing functions leads to the loss of immune recognition markers, effectively hiding tumor cells from the immune system. Additionally, we will discuss the role of epigenetic regulators in maintaining neuroendocrine features and how aberrant transcriptional control promotes epithelial-to-mesenchymal transition during tumor development. Although these pathways seem distinct, we emphasize that they often share common molecular drivers and mediators. Understanding the connection among frequently altered epigenetic regulators will provide valuable insights into the molecular mechanisms underlying SCLC development, potentially revealing preventive and therapeutic vulnerabilities for SCLC and other cancers with similar mutations.
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