• Nuclear Medicine and Molecular Imaging
• /
• v.40 no.2
• /
• pp.53-57
• /
• 2006

Radionuclide therapy has been used for more than 50 years and proved to be a safe and effective modality. However, the patients' right to have the excellent medical service is seriously disturbed by excessive regulations of government institutions such as Korea Institute of Nuclear Safety (KINS), Health Insurance Review Agency (HIRA) and Korea Food and Drug Administration (KFDA). For example, the patients should wait for more than 6 months to have I-131 treatment in many hospitals it is strongly recommended to mitigate the regulations to resonable levels to solve the problems. If HIRA allow the hospitals to charge reasonable rate for radionuclide therapy room, then more hospitals would invest to build the radionuclide therapy rooms and the patients' waiting time would decrease. The waiting time would also decrease, if KINS allow 2 patients to share a radionuclide therapy room. Finally, it is strongly recommended to lower the threshold for approval of new therapeutic radiopharmaceuticals by KFDA, which would allow new effective therapeutic raoiopharmaceuticals to be introduced to clinical practices more easily.

• Journal of Hospice and Palliative Care
• /
• v.25 no.4
• /
• pp.139-197
• /
• 2022

Patients with terminal cancer experience very severe symptoms during the end of life, and palliative sedation (PS) may be considered if those symptoms are refractory to any other treatment. This brief report presents ethical considerations, practices, and recent concerns on PS. PS is quite different from euthanasia. There is a lack of consensus and standards on protocols, but its notable effects have been reported in hospice care settings. Most studies to date have reported no difference in survival between patients receiving PS and those not, and PS must be conducted proportionally with the lightest level of sedation. The most common indication for PS is delirium, and midazolam is the main sedative used. It is recommended that information regarding PS should be provided to patients and their caregivers repeatedly as early as possible. Existential suffering alone is not an indication for PS, and there is a lack of evidence on bispectral analysis. Additional research on PS is needed in Korea.

• Journal of Digestive Cancer Research
• /
• v.11 no.3
• /
• pp.130-140
• /
• 2023

Gastric cancer (GC) is one of the most common malignant tumors worldwide, with a 5-year survival rate of < 40%. The diagnosis and treatment decisions of GC rely on human experts' judgments on medical images; therefore, the accuracy can be hindered by image condition, objective criterion, limited experience, and interobserver discrepancy. In recent years, several applications of artificial intelligence (AI) have emerged in the GC field based on improvement of computational power and deep learning algorithms. AI can support various clinical practices in endoscopic examination, pathologic confirmation, radiologic staging, and prognosis prediction. This review has systematically summarized the current status of AI applications after a comprehensive literature search. Although the current approaches are challenged by data scarcity and poor interpretability, future directions of this field are likely to overcome the risk and enhance their accuracy and applicability in clinical practice.

• Journal of Korean Academy of Nursing
• /
• v.29 no.6
• /
• pp.1403-1418
• /
• 1999

Nursing is a discipline that helps to understand human being, to mitigate pains in life by promoting and recovering health, and to study the basic principles in sustaining and preserving life. To understand man and thus to nurse, it is essential to take the way of life of the specific person, his/her ideas, and natural environment into consideration. This means, the temperament, geography, environment and society peculiar to Korea have formed its own culture distinguished from those of other people. Thoughts and philosophy develop as a products of the specific culture and society. Therefore, accurate understanding of the concepts of nursing in the traditional thoughts and philosophy is indispensible to define Korean nursing. Modern Korean nursing at first rooted in the westernized nursing and western nursing intervention has been applied ever since its introduction in the late 19th century under the paradigm of western natural science. However, Koreans in the past made use of alternative therapy which put its emphasis on the organic and holistic view of life as well as a means for traditional medicine and nursing. This alternative therapy has been largely ignored since the introduction of western medical science, and was considered something used only by the aged or the uneducated. Moreover, Health concerned practices and customary traditional therapy have been discarded in the clinical medicine as "unscientific" or "unsystematic". As described above, it is true that Korean nursing has developed in the quantitative aspect only adhering to western nursing intervention. Now it is the time to stop to hold ourself and to look back our past. To find and develop the originality of Korean nursing to cope with the globalization, it is necessary to rediscover nursing (alternative) therapy in Korean culture ignored so far. For this purpose, this study examines the oriental philosophy to explore alternative nursing theory now under development. Also it aims to present ways to apply alternative therapy to nursing education, research and clinical practices and ultimately to show the desirable direction of the nursing to go in the future. Yangsaeng theory of Taoism and Yin-yang, Oh-hang(five elements) and khi theory in Dongeuibogam which gave enormous influences on Korean medical culture and treatment together with Sahsang(four temperaments) emphasized in Dongeuisusebowon will be examined as conceptual framework. Concepts of nursing are categorized into views on each the universe, the human being and nursing. Views on human being is classified into subcategories of body, life, health, and disease. Also it emphasizes the necessity of including alternative therapy in nursing intervention. Views on the universe is classified into yin-yang, khi, and temperament. Nursing will be available anywhere and easily accessible with this new nursing intervention. Trying to give a new thoughts to all those traditional concepts and alternative therapy, this article suggests the necessity of developing original Korean nursing theory and nursing intervention.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.21 no.5
• /
• pp.565-576
• /
• 2020

This study compares and analyzes satisfaction with Korean and Canadian primary medical care based on a survey of Koreans living in Canada. Based on data collected from Koreans who live in Canada, a paired sample t-test, analysis of variance (ANOVA), and GLM were used. The main conclusions of this study are as follows. First, overall satisfaction with Korean primary care was high. Second, the results of the analysis were stable, regardless of gender, age, education, and residential area. Third, overall satisfaction with Korean medical care was higher than for medical care in Canada. Fourth, satisfaction was high in terms of treatment skill and technology, and promptness in appointments, but was low in terms of medical expense. Fifth, there was a high level of confidence in physician skills and practices, but there was no significant difference in terms of sufficient counseling and explanations. Finally, the survey found that the tendency to increase medical treatment volume in order to increase a physician's own income was large. As a result of detailed analysis, it was concluded that Korea's primary care is more competitive than in Canada, but the primary medical doctors' patient interview and explanation obligations, and incentives to control income and medical expenses, need to be improved.

• Archives of Craniofacial Surgery
• /
• v.17 no.4
• /
• pp.190-197
• /
• 2016

Background: The cheek rotation flap has sufficient blood flow and large flap size and it is also flexible and easy to manipulate. It has been used for reconstruction of defects on cheek, lower eyelid, or medial and lateral canthus. For the large defects on central nose, paramedian forehead flap has been used, but patients were reluctant despite the remaining same skin tone on damaged area because of remaining scars on forehead. However, the cheek flap is cosmetically superior as it uses the adjacent large flap. Thus, the study aims to demonstrate its versatility with clinical practices. Methods: This is retrospective case study on 38 patients who removed facial masses and reconstructed by the cheek rotation flap from 2008 to 2015. It consists of defects on cheek (16), lower eyelid (12), nose (3), medial canthus (3), lateral canthus (2), and preauricle (2). Buccal mucosa was used for the reconstruction of eyelid conjunctiva, and skin graft was processed for nasal mucosa reconstruction. Results: The average defect size was $6.4cm^2$, and the average flap size was $47.3cm^2$. Every flap recovered without complications such as abnormal slant, entropion or ectropion in lower eyelid, but revision surgery required in three cases of nasal side wall reconstruction due to the occurrence of dog ear on nasolabial sulcus. Conclusion: The cheek rotation flap can be applicable instead of paramedian forehead flap for the large nasal sidewall defect reconstruction as well as former medial and lateral canthal defect reconstruction.

• Journal of Korean Medical classics
• /
• v.29 no.3
• /
• pp.57-74
• /
• 2016

Subject : Treatment of acupuncture & moxibustion in Huangdineijing Objectives : Discover the principles and substances of acupuncture & moxibustion treatment of Huangdineijing Methods : The author reviewed the Huangdineijing: Suwen, Lingshu to gain a realistic sense of the facts and the medical book's contents that deal with the practices of acupuncture & moxibustion treatment for clinical praxis. Conclusions : 1. The acupuncture & moxibustion of Huangdineijing can be defined as follows. A treatment for correcting of meridian's drift by proper selection of surgical site, using suitable implementation and appropriate manipulation skill from a correct judgement of meridian's flowing through sensing the pulse for diagnosis when the meridian's flowing which come and go constantly driven by the tidal order of defensive Qi tactually appeared hard or soft caused by diseases, thus bring out the soft & gradual 50 laps circulation of nutrient Qi moderately driven by defensive Qi. 2. Today's acupuncture & moxibustion treatments greatly differ from those of Huangdineijing in that we do not know the substance of that treatment which is correcting of meridian's drift and do not obligatorily carry out feeling of the pulse for diagnosis which is a measure & judgement of meridian's flowing against a preliminary treatment in parallel with treatment so reduce use and power of that treatment. 3. I could form a list of general principle from the substances of acupuncture & moxibustion of Huangdineijing like as the flowing or fate of meridian Qi(tidally going in order of defensive Qi and nutrient Qi), deficiency or excess of Meridian flowing, comparing diagnosis before and after treatment, bring out the soft & gradual Qi. That was imposing "the concept of time" on recognition and treatment to human body.

• Journal of Genetic Medicine
• /
• v.15 no.2
• /
• pp.72-78
• /
• 2018

Purpose: Physicians' attitudes may have a strong influence on women's decision regarding prenatal screening options. The aim of this study is to assess the physicians' attitudes toward prenatal screening for fetal aneuploidy including non-invasive prenatal testing (NIPT) in South Korea. Materials and Methods: Questionnaires were distributed and collected at several obstetrics-gynecological conferences and meetings. The questionnaire included 31 multiple choice and 5 fill-in-the-blank questions. Seven questions requested physicians' demographic information, 17 questions requested information about the NIPT with cell-free fetal DNA, and 12 questions requested information about general prenatal screening practices. Results: Of the 203 obstetricians that completed the survey. In contrast with professional guidelines recommending the universal offering of aneuploidy screening, only 53.7% answered that prenatal aneuploidy testing (screening and/or invasive diagnostic testing) should be offered to all pregnant women. Physicians tended to have positive attitudes toward the clinical application of NIPT as both primary and secondary screening methods for patients at high-risk for fetal trisomy. However, for patients at average-risk for fetal trisomy, physicians tended to have positive attitudes only as a secondary screening method. Physicians with more knowledge about NIPT were found to tend to inform their patients that the detection rate of NIPT is higher. Conclusion: This is the first study to investigate expert opinion on prenatal screening in South Korea. Education of physicians is essential to ensure responsible patient counseling, informed consent, and appropriate management after NIPT.

• Journal of Pharmacopuncture
• /
• v.22 no.4
• /
• pp.260-268
• /
• 2019

Objectives: The Clinical Decision Support System (CDSS), which analyzes and uses electronic health records (EHR) for medical care, pursues patient-centered medical care. It is necessary to establish the CDSS in Korean medical services for objectification and standardization. For this purpose, analyses were performed on the points to be followed for CDSS implementation with a focus on herbal medicine prescription. Methods: To establish the CDSS in the prescription of Traditional Korean Medicine, the current prescription practices of Traditional Korean Medicine doctors were analyzed. We also analyzed whether the prescription support function of the electronic chart was implemented. A questionnaire survey was conducted querying Traditional Korean Medicine doctors working at Traditional Korean Medicine clinics and hospitals, to investigate their desired CDSS functions, and their perceived effects on herbal medicine prescription. The implementation of the CDSS among the audit software developers used by the Korean medical doctors was examined. Results: On average, 41.2% of Traditional Korean Medicine doctors working in Traditional Korean Medicine clinics manipulated 1 to 4 herbs, and 31.2% adjusted 4 to 7 herbs. On average, 52.5% of Traditional Korean Medicine doctors working in Traditional Korean Medicine hospitals adjusted 1 to 4 herbs, and 35.5% adjusted 4 to 7 herbs. Questioning the desired prescription support function in the electronic medical record system, the Traditional Korean Medicine doctors working at Korean medicine clinics desired information on 'medicine name, meridian entry, flavor of medicinals, nature of medicinals, efficacy,' 'herb combination information' and 'search engine by efficacy of prescription.' The doctors also desired compounding contraindications (eighteen antagonisms, nineteen incompatibilities) and other contraindicatory prescriptions, 'medicine information' and 'prescription analysis information through basic constitution analyses.' The implementation of prescription support function varied by clinics and hospitals. Conclusion: In order to implement and utilize the CDSS in a medical service, clinical information must be generated and managed in a standardized form. For this purpose, standardization of terminology, coding of prescriptions using a combination of herbal medicines, and unification such as the preparation method and the weights and measures should be integrated.

• The Journal of Korean Medical History
• /
• v.31 no.1
• /
• pp.123-134
• /
• 2018

Today, knowledge itself has become a resource which must be protected by the pertinent community of its contributors and users, from being manipulated or distorted by third-party players. The preservation of knowledge in relationship to the cultural context of its origins, has been recognized by international organizations intent on maintaining authentic voice and perspective. Globally, the WIPO (World Intellectual Property Organization) organizes the annual IGC (Intergovernmental Committee) meeting to address various issues associated with each country's utilization of intellectual and bio source property. Korean Medicine is the official name for the traditional medicine that has been inherited from the cultures of the Korean Peninsula. It is one of the four practices of East Asian Medicine including Traditional Chinese Medicine (TCM) from China, Kampo Medicine of Japan, and Sino-Vietnamese Medicine in Vietnam. As a cultural treasure representing centuries of evolving knowledge, Korean Medicine is protected under intellectual property rights afforded by WIPO, and must be understood in relationship to, and distinct from, TCM. It is understood that China has a strong political purpose to claim all the traditional medicines of the East Asian region under the name of TCM, including Korean Medicine. In fact TCM was authorized as the representative name for all East Asian medicine by decisions made by the ISO (International Standard Organization) in 2015. This paper proposes a pilot study on how to protect the intellectual property of Korean Medicine from efforts by China to claim it under the umbrella of TCM. Using the Uibang Yuchui (醫方類聚, Classified Collection of Medical Formulas) this paper suggests establishing a Database of UBYC, which was published in 1477 by the Joseon Korea government. UBYC was the reorganized version of contemporary East Asian medical sources, and has already hundreds of year's rich indigenous and culturally specific medical history of Korea, from which Korean Medicine has been built.