• Title/Summary/Keyword: Past disease

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A Review on the Change of Health Policy Based on Ethical Issues (윤리적 쟁점을 중심으로 한 보건의료정책 변화의 고찰)

  • Lee, Dong Hyun;Kim, So Yoon;Sohn, Myongsei
    • Health Policy and Management
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    • v.28 no.3
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    • pp.222-225
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    • 2018
  • Health policy is a historical product in the process of development, including the political and economic factors of the state as well as the social and cultural elements of the country. Bioethics began to debate the ethical questions that arise in the overall process of life's birth and death, and gradually evolved by presenting ethical directions for various social phenomena. Especially, according to the moral awakening of 'scientific medicine' which caused in some human problems in the rapidized scientific society from the late 19th century to the early 20th century, as a result of distress including the concept of various social relations, it is possible to say that it has reached the bioethics. Although health policy and bioethics are different in terms of starting and concept, they can be found in common with social, cultural, and political diversity in the times. In 2004, 'Bioethics Law' was enacted through the issue of research ethics in the life sciences. Therefore, in order to examine ethical aspects of current health policy direction and major issues, it can be divided into before and after enactment of 'Bioethics Law' in 2004. The authors would like to examine how the evolution of the ethical viewpoint on the health policy has changed in line with the enactment of the 'Bioethics Law' and how it is trying to solve it from an ethical point of view. Through the various events that took place in the 1990s and the 2000s, various discussions on bioethics were conducted in Korea. Prior to the enactment of the 'Bioethics Law,' ethical judgments of professions, distribution of healthcare resources, if the discussion focused on the ethical judgment of abortion, and the various events that appeared in the early 2000s became the beginning to inform that the ethical debate about the life, death, and dignity of human beings began in earnest in Korea with the enactment of the 'Bioethics Law.' Since then, 'Hospice and Palliative care Law' which was enacted in 2017, is based on the fact that the health policy of our country focuses on the treatment of the past diseases, health promotion, and delivery of health care services. It was an opportunity to let them know that even the quality problems were included. Therefore, considering the various circumstances, the ethical issue facing Korea's health care system in the future is the change of the demographic structure due to aging and what is to be considered as the beginning and the process of life in the overall process of life. It is the worry about how to die and when it sees as death. This has far exceeded the paradigm of traditional health care policies such as disease prevention and management and health promotion, and calls for innovative policy response at the national level that reflects the new paradigm, which in many cases creates a predictable ethical environment. And health policy should be shifted in the direction of future ethical review considering sustainability in the development process of future health care rather than coercive management.

A Case of Tracheal Bronchus Associated with Bilateral Superior Vena Cava Anomaly (양측성 상대정맥 기형을 동반한 기관성 기관지 1예)

  • Jeong, Jae-Hee;Park, Moo-Suk;Kim, Hee-Man;Park, Jung-Tak;Chung, Jae-Ho;Choi, Byoung-Wook;Kim, Young-Sam;Chang, Joon;Kim, Sung-Kyu;Kim, Se-Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.3
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    • pp.337-343
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    • 2002
  • A tracheal bronchus, an aberrant bronchus arising directly from the trachea, is an infrequent congenital anomaly. The incidence of this anomaly ranges from 0.5 to 5%. It usually originates from the right lateral wall of the trachea at the level <2 cm above the tracheal bifurcation. These patients usually are asymptomatic, but some patients may experience recurrent pneumonia, chronic bronchitis, bronchiectasis, or asthmatic episodes. A tracheal bronchus may be associated with other anomalies such as a tracheal stenosis, pulmonary agenesis, pulmonary sequestration, congenital heart disease, a pulmonary venous anomaly and Down's syndrome. This anomaly is usually diagnosed incidentally during bronchoscopy in patients with respiratory problems. Here we report a case of a 20-year-old man with a past history of bronchial asthma, which was incidentally diagnosed as a tracheal bronchus during a medical examination prior to military service, and was associated with a bilateral superior vena cava anomaly.

Research on Ginseng Production During the Past 20 years (인삼재배 분야의 과거 20년 연구)

  • Park, Hoon
    • Journal of Ginseng Research
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    • v.20 no.4
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    • pp.472-500
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    • 1996
  • Researches on mineral nutrition, physiology and phyrsiological diseases, . cultivaction methods. brceding. pest control quality management and extension during 1976-1995 in Korea were reviewed Review in brceding and pest control was restricted to the researches directely related to cultivaction. Mineral nulrient up take. partion and varicos factors such as top dreasing. Light intersity etc. and interrelationship between minerals were investigated. Top dressing was not effective due to low minera1 requorement Physiological characteristics on tempelature light and water were well elucidated and applied to assess traditional cultivation method and its inovation. Photosyrnthetic pigments. light harvest proteins and activity of related enzymes were studied. In nitrogen metabolism arginine, praline, ammonium, threonine appeared to have important role in re growth of shoot Saponin metabolism was studied in relation to growth and new ginsenosides were found but physiological role of saponin was not clearly elucidated yet Endogenous growth regulators were reported and various erogenous growth regulators were studied for growth stimulation. short stem and seed pruning etc. Various physiological diseases were investigated for cause and control measures were established. Water culture was little studied Forest culture was studied but not retched the recommendable stage Drip irrigation straw mulching. seasonal shading and soil preparation method including soil fertility adjustment were established for practical application. Shading materials completely changed to polyethylene net and materials of polymers The research on ginseng cultivation in paddy field opened the way to establish the permanent ginseng cultivation plantation Ginseng harvester and seeder were developed in the late 1950s. Transplanted and many other machines were developed in the early 1990s. In ginseng breeding only pure line selection was of practical significance several verities were at the stage of seed propagation at ginseng plantations. Mutation breeding (${\gamma}$-ray. X-ray chemicals) was not successful. The research on plantlet formation through tissue culture was a little progressed but still far behind to vegetative propagation. Disease control research was concentrated in the isolation and identification of pathogans. their ecological charactelistics and biological control and soil humigation. Potato root rot nematodes was found and control method was established. Insect and small animal control research was greatly progresses in identification, ecological investigation, and ecological and physical control. Weed control was less important due to the development of mulching method of ridge and ditch. Quality factors of raw ginseng in relation to red ginseng process were extensively studied. Traditional quality measures were elucidated in accordance with modern analytical chemistry resulting in the importance of peptides in the centrat part rather than ginsenosides For large root production growth promoting rootzone micrcorganisms (PGPRM) were isolated and active compounds were identified. Field test on PGPRM was on going. Varictus methods formality improvement through cultivation were developed. Management research of ginseng production was rare Extension was active throuch official and private organizations and through workshop for the extension specialists, and direct lectures to grower's. Extension services made the researcher to understand the existing problems at grower's fields. Research environment for ginseng production was in prime time only for three years when Korea Ginseng Research Institute was established then gradually aggravated.

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Cellular and Molecular Roles of $\beta$ Cell Autoantigens, Macrophages and T Cells in the Pathogenesis of Automimmune Diabetes

  • Yoon, Ji-Won;Jun, Hee-Sook
    • Archives of Pharmacal Research
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    • v.22 no.5
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    • pp.437-447
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    • 1999
  • Type I diabetes, also known as insulin-dependent diabetes mellitus (IDDM) results from the destruction of insulin-producing pancreatic $\beta$ cells by a progressive $\beta$ cell-specific autoimmune process. The pathogenesis of autoimmune IDDM has been extensively studied for the past two decades using animal models such as the non-obese diabetic (NOD) mouse and the Bio-Breeding (BB) rat. However, the initial events that trigger the immune responses leading to the selective destruction of the $\beta$ cells are poorly understood. It is thought that $\beta$ cell auto-antigens are involved in the triggering of $\beta$ cell-specific autoimmunity. Among a dozen putative $\beta$ cell autoantigens, glutamic acid decarboxylase (GAD) has bee proposed as perhaps the strongest candidate in both humans and the NOD mouse. In the NOD mouse, GAD, as compared with other $\beta$ cell autoantigens, provokes the earliest T cell proliferative response. The suppression of GAD expression in the $\beta$ cells results in the prevention of autoimmune diabetes in NOD mice. In addition, the major populations of cells infiltrating the iselts during the early stage of insulitis in BB rats and NOD mice are macrophages and dendritic cells. The inactivation of macrophages in NOD mice results in the prevention of T cell mediated autoimmune diabetes. Macrophages are primary contributors to the creation of the immune environment conducive to the development and activation of $\beta$cell-specific Th1-type CD4+ T cells and CD8+ cytotoxic T cells that cause autoimmune diabetes in NOD mice. CD4+ and CD8+ T cells are both believed to be important for the destruction of $\beta$ cells. These cells, as final effectors, can kill the insulin-producing $\beta$ cells by the induction of apoptosis. In addition, CD8+ cytotoxic T cells release granzyme and cytolysin (perforin), which are also toxic to $\beta$ cells. In this way, macrophages, CD4+ T cells and CD8+ T cells act synergistically to kill the $\beta$ cells in conjunction with $\beta$ cell autoantigens and MHC class I and II antigens, resulting in the onset of autoimmune type I diabetes.

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Stellate Ganglion Block and Electrical Acupuncture for Treatment of Allergic Rhinitis (성상신경절 차단과 전기침 자극에 의한 알레르기성 비염의 치료)

  • Kim, Jin-Seung;Jin, Sun-Mi;Cho, Sung-Kyung;Kim, Bong-Il;Lee, Sang-Hwa
    • The Korean Journal of Pain
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    • v.6 no.2
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    • pp.208-212
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    • 1993
  • Allergy is one of the most common intractable disease, and also allergic rhinitis is the common symptom of the allergic diseases encountered in the otolaryngologic department. There are number of treatment such as: allergen avoidance by environmental control, pharmacotherapy, allergen immunotherapy and more. But choosing the exact reguired treatment is very difficult and troublesome. During the past 3 years, we have provided treatments to 49 allergic rhinitis patients with the combined therapy of stellate ganglion block(SGB) and eletrical acupuncture(E-AP) with very good results. From our experiences we highly recommend the combined therapy with SGB and E-AP for allergic rhinitis.

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A SURVEY OF DENTAL TREATMENT UNDER GENERAL ANESTHESIA (전신마취하에 치료한 환자에 대한 실태조사)

  • Kim, Ha-Na;Baik, Byeong-Ju;Kim, Jae-Gon;Kwon, Byoung-Woo;Yang, Yeon-Mi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.33 no.2
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    • pp.317-322
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    • 2006
  • Dental caries in children has declined over the past few decades. However, Certain populations of children experience high levels of dental disease. To perform the highest quality dental care for the pediatric patient, the practitioner may need to use pharmacological means to obtain a quiescent, cooperative patient. Furthermore, complex treatment can impose high demands on the very young, making use of general anesthesia the preferred approach for some patients. General anesthesia is widely used to provide comprehensive dental treatment for children in USA and Europe and Scandinavia etc. Parental and patient satisfaction following completion of dental care under general anesthesia is reportedly high. Dental general anesthesia has disadvantage that it is expansive and carries a small but significant risk of mortality. However, It has the advantage of permitting treatment at a single visit, allowing immediate relief of pain and requiring little or no cooperation from the child. Rampant caries was the major indication for use of general anesthesia in the youngest age group or medically compromised patients. This study describe the characteristics of patient receiving comprehensive dental treatment under general anesthesia at the pediatric dentistry of Chonbuk National University Hospital in Jeonju, Korea in the 4year period between December 2001 and April 2005.

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Herpes Simplex Virus Infection after Corrective Rhinoplasty through External Approach: Two Case Reports (외접근 비교정술 후 발생한 단순 포진 바이러스 감염 치험례)

  • Kim, Hong Il;Hwang, So Min;Ahn, Sung-Min;Lim, Kwang Ryeol;Jung, Yong Hui;Song, Jennifer K.;Jeong, Jae Yong
    • Archives of Craniofacial Surgery
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    • v.13 no.1
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    • pp.68-71
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    • 2012
  • Purpose: Eczema herpeticum, caused by herpes simplex virus, is an infectious disease involving skin and internal organs. Varieties of physiologic, psychosocial, or environmental stress reactivate reservoir virus which exists in the trigeminal nerve ganglia. Authors report rare cases of nasal eczema herpeticum following corrective rhinoplasty. Methods: First case, 22-year-old female underwent corrective rhioplasty through an external approach in a local clinic. She developed progressive and painful erythema, nodules and vesicles on nose on the 9th day postoperatively. This unfamiliar lesion lead to a misdiagnosis as a bacterial infection, and had accelerated its progress to the trigeminal innervation of the nasal unit. Second case, a 23-year-old female underwent corrective rhinoplasty by external lateral osteotomy. Ten days after the surgery, disruption occurred on the external osteotomy site, and the ulceration gradually worsened. The surgeon misdiagnosed it as secondary bacterial infection and only an antibacterial agent was applied. Results: Both cases were healed effectively without any complication with proper wound dressing and antiviral therapy, and show no sequelae during an 8-month follow-up period. Conclusion: Eczema herpeticum is rare in the field of plastic surgery, but it should be kept in mind that secondary bacterial infections may lead to serious complications such as full-thickness skin loss. Thus, acknowledgement of the patient's past history regarding perioral or intraoral lesion may provide the surgeon with the possible expectancy of eczema herpeticum. Thus, if anyone develops eczema herpeticum, following facial plastic surgery, early diagnosis and immediate proper antiviral therapy will allow fast recovery without serious complications.

Clinical Finding of MDR Tuberculosis and Frequency of MOTT (다제내성결핵의 임상적 특성과 비결핵항산균증의 빈도)

  • Bae, Mi-Hee;Kim, Hwa-Jung;Kwon, Eun-Soo;Kim, Cheol-Min;Kim, Cheon-Tae;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1123-1142
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    • 1998
  • Background : The frequency of MOTT has risen as the prevalence of tuberculosis has been declining. Our country has been also. The most of MOTT was resistant to the major anti-tuberculous drugs. Method : To compare clinical characteristics and frequencies of MDR tuberculosis with MOTT, the author studied 65 patients showing AFB culture positive with sputum. The data were collected from 176 patients who had been admitted at the National Masan Tuberculosis Hospital from May to June, 1997 to April, 1998. Result : The frequency of MDR tuberculosis was 43.1% and that of MOTT was 9.2%. Among 65 isolated mycobacteria, 3 cases were M. intracellulare. 2 cases were M. fortuitum, and 1 case was unidentified MOTT. The most frequent age group in 65 culture positive patients was 4th decade and the mean age was 44. The mean age was 61 in MOTT and 42 in M. tuberculosis and had significant difference(p<0.01). The numbers with past history of treatment were 2.3 in MDR tuberculosis and 1.7 in non-MDR tuberculosis and had significant difference(p<0.05). At the time of admission, the most frequent regimen for the treatment of MDR tuberculosis was 24 months regimen(85.7%) with the 2nd line anti-tuberculosis drugs. For non-MDR tuberculosis, 9 or 12 months regimen (72.9%) with the 1st line anti-tuberculosis drugs and had significant difference (p<0.01). At the time of admission, the symptom of weight loss was shown in 84.7% of M. tuberculosis and 50.0% in MOTT and there was significant difference(p<0.05) between them. All of the MOTT were identified to be resistant against INH and PAS. Drug resistance rates to INH, OFX(p<0.01) and PAS(p<0.05) in MOTT were higher than in MDR. All of three M. intracellulare strains were resistant to INH, RFP, PAS and OFX. All of two M. fortuitum strains were resistant to most anti-tuberculosis drugs. And the other MOTT was resistant to INH, EMB and PAS. Conclusion : MOTT was more common in elderly patients than M. tuberculosis. MOTT cases should be considered to be the probability of multiple drug resistance and treatment failure during the 1st treatment because they showed more resistance to anti-tuberculosis drugs than M. tuberculosis cases. Therefore, there should be more careful investigations for clinical characteristics, natural history of disease, and efficient management for MOTT.

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A Case of Fulminant Bronchiolitis Obliterans Organizing Pneumonia (특발성 폐섬유화증과 감별진단을 요하는 전격성 폐쇄성 세기관지염 기질화 폐렴 (Fulminant Bronchiolitis Obliterans Organizing Pneumonia) 1예 보고)

  • Kim, Mi-Seon;Chang, Jung-Hyun;Kim, Tai-Hee;Cha, Ju-Hyun;Kim, Hae-Young;Sung, Sun-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.204-212
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    • 1998
  • Bronchiolitis obliterans organizing pneumonia(BOOP) is a type of diffuse interstitial lung disease that has emerged in the past decade as an important cause of acute respiratory illness in adult. Clinically, the entity usually starts with a subacute influenza-like illness, followed by cough, progressive dyspnea, and weight loss. Organized inflammatory polypoid materials predominantly affecting distal bronchioles, alveolar ducts, and peribronchial alveolar spaces are a key pathologic findings. BOOP is characterized by a good response to glucocorticoid and an excellent prognosis. However, there is a subset of BOOP who presents with a fulminant course leading to death or chronic severe fibrosis with marked impairment of lung function. Recently, we have experienced a case of rapidly progressive BOOP, diagnosed by open lung biopsy and showed a reluctant response to corticosteroid.

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A Study on the Effect which the Method of Deep Breathing with the Use of Incentive Spirometer has on the function of pulmonary Ventilation - In Upper Abdominal Operation Patients - (Incentive Spirometer를 사용한 심호흡 방법이 폐환기 기능에 미치는 효과에 관한 연구 -상복부 수술 환자를 대상으로-)

  • 김종혜;변영순
    • Journal of Korean Academy of Nursing
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    • v.21 no.3
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    • pp.268-280
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    • 1991
  • The nursing intervention for the prevention of the pulmonary complication and of the function lowering of pulmonary ventilation which emerge with high generation frequency during the nursing of operation patient is necessary for performing the qualitative nursing for operation patient. So, this researcher tried this study so as to obtain the data which can be utilized for the trial of nursing intervention, by grasping the effect that the deep breathing with Incentive Spirometer has on the function of pulmonary ventilation, analysing the factor to have influence on the function of pulmonary ventilation, and applying the effective method of deep breathing to the clinic. By making 42 patients who underwent the operation of upper abdomen after admitting G Hospital in Seoul from Mar. 7, 1991 to Apr.30, 1991 as the object, they were classified into the experiment group that the deep breathing was made with the use of Incentive Spiromenter and the comparison group that the deep breathing exercise was made without the use of Incentive Spirometer. And then, by measuring Tidal Volume and Forced Vital Capacity with Respirometer and $O_2$ Saturation with Pulse Oximeter at preoperation postoperation 24 hours, 72 hours, and 120 hours data were collected. The collected data were analyzed with of, average, standard deviation, x$^2$-test, t-test and ANOVA by SPSS. The result of this study is as follows : 1. As for the hypothesis that the function of pulmonary ventilation at postoperation 24 hours, 72 hours and 120 hours will be better in the experiment group that the deep breathing was made with the use of Incentive Spirometer, in comparison with the comparison group that deep breathing was made without the use of Incentive Spirometer, experiment group and comparison group didn't show the significant difference in Tidal Volume, Foreced Vital Capacity and $O_2$ Saturation at postoperation 24 hours and 72 hours. But experiment group and comparison group showed the significant difference in Tidal Volume at postoperation 120 hours (p<0.01). So, this hypothesis was supported partially. 2. The variables that there were the significant differences about the function of pulmonary ventilation in experiment group at postoperation 24 hours stastically were smoking existence (p<0.05), and the variables that there were not significant differences about the function of pulmonary ventilation were distinction of sex, age, anesthetic duration, smoking extent, body weight, surface area of body, existence of narcotic use, regular exercise existence, and past experience existence of respiratory disease. As above result, it appeared that the method of deep breathing with the use of the Incentive Spirometer is more effective for the function recovery of pulmonary ventilation, in comparison with the deep breathing without use of Incentive Spirometer and that smoking existence was the factor to have influence on the function of pulmonary ventilation. In the aspect of clinic, the trial of nursing intervention of deep breathing with use of Incentive Spirometer is expected. And, in the aspect of study, the study through various operative site patients about the effect of Incentive Spirometer use at the clinic will have to be confirmed.

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