• Childhood Kidney Diseases
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• v.2 no.2
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• pp.187-191
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• 1998

Yersinia pseudotuberculosis, a gram-negative coccobacillus, is a member of the enterobacteriaceae family, and the illness has fever, abdominal pain, diarrhea, mesenteric lymphadenitis, terminal ileitis, arthropathy, erythema nodosum. Specially in children, it is known as an important cause of acute renal failure due to acute tubulointerstitial nephritis. It has been recognized in a worldwide distribution. For the first time, the cases of acute renal failure caused by this organism were reported in Japan in 1980's. In Korea, the first case accompanying with ARF was reported in 1988. Since that, many cases have been reported in Seoul area, but no case in other places. So we report 2 cases of Y.P. infection accompanying with ARF in Pusan area, for the first time in other place than Seoul area.

• Health Policy and Management
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• v.10 no.1
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• pp.1-30
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• 2000

One form of complementary and alternative medicine (CAM), oriental medicine has developed differently from the western medicine under its own environment and history. Western medicine was introduced to Korea about 120 years ago. But unfortunately, there still is an indisputable lack of cooperative movement between oriental medicine ＆ western medicine. However, the market share of CAM has grown markedly in most industrialized countries (the United States, Europe, Australia, and Asia). In these countries, alternative medicine such as acupuncture and herbal remedies was adopted as a "complementary" therapies of mainstream medicine, to calm the symptoms of terminal illness. Recently in Korea, there was a movement to cooperate oriental medicine ＆ western medicine. However, until this time in Korea, there was a conflict between oriental medicine ＆ western medicine. They blame each other. Such as "Other side is guilty of improper evaluation of patients, possibly suppressing effective therapies of their own side and profit-motivated". Though most western medicine practitioners criticize oriental medicine, the level of adopting alternative forms of health care by the public and by some western medicine practitioners will continue to increase. Therefore oriental medicine ＆ western medicine share a mutual responsibility to apply evidence-based practices, to seek scientific empirical proof through planned interventions, and to increase the quality of health care.lity of health care.

• The Korean Society of Law and Medicine
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• v.15 no.1
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• pp.211-237
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• 2014

Because of unpredictability and high possibility of abnormal results by clinical trials compared to general medical behaviors, a procedure for ensuring with sufficient explanations by investigators must be secured. Therefore, in a sequence of clinical trials, what kinds of scope, stage, and method of explanations provided by investigators, including doctors or researchers, to trial subjects are closely related to the compensation for damages by violation of liability for explanation. In case of application of clinical trials to patients who have critical illness such as cancer, issues of "Quality of Life" regarding trial subjects, cancer patients, should be discussed. Especially, in case of clinical trials for terminal cancer patients, the right of subjects' self-determination, which is a fundamental principle in medical behaviors, should be discussed. The right of self-determination includes participation in clinical trials for the possibility of life-sustaining even a little bit, or no participation in clinical trials in order to have a time for completing the rest of his life. Like this, if the extent and scope of explanations related to the issues of "Quality of Life" are raised as main issues, the evaluation of "Quality of Life", should be a prerequisite. In many occasions, realistically, despite bad results such as deaths or serious adverse drug reactions after clinical trials, it may not be easy for compensating to trial subjects or their survivors, who requested civil compensation for damage. Futhermore, in abnormal results after concealment of clinical trials or performance of clinical trials without permission, and in the case of trial subjects' failures of proving proximate cause between the clinical trials and abnormal results, problematic results such as no protection to the trial subjects could be occurred. In performing clinical trials, investigators should provide sufficient explanations for trial subjects and secure voluntary informed consents from the trial subjects. Therefore, clinical trials without trial subjects' permissions and the informed consent process violate trial subjects' rights of self-determination, and the investigators shall be liable for compensation for damages. Then, issues might be addressed are what are essential contents of patients' "rights of self-determination" infringed by clinical trials without subjects' permissions. Two perspectives about patients' rights of self-determination might be considered. One perspective regards physical distress of patients (subjects) from therapies without sufficient explanations as the crux of the matter. The other perspective regards infringement of human dignity caused by being subjects without permission as the crux of the matter irrespective of risks' big and small influences. This research follows perspective of the latter. Forming constant fiduciary relation between investigators (doctors) and subjects (patients) pursuant medical contracts, and in accordance with this fiduciary relation, subjects, who are patients, have expectations of explanations and treatments by the best ways. If doctors and patients set this forth as a premise, doctors should assume civil liability when doctors infringe patients' expectations.

• Tuberculosis and Respiratory Diseases
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• v.46 no.5
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• pp.709-717
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• 1999

Background & Method : Bronchiolitis obliterans organizing pneumonia(BOOP) is a specific clinicopathologic condition characterized by chronic inflammatory interstitial infiltrates. Cryptogenic form of BOOP presents subacute clinical course of flu-like illness, such as cough, fever, dyspnea with exertion and other constitutional symptoms. Pathologically it shows the presence of granulation tissue filling the lumen of terminal and respiratory bronchioles, extending into distal airspaces. Recently, we reviewed 24 cases of idiopathic type of BOOP, 5 cases of our hospital and another 19 cases on Korean literatures, and compared with reviewed data from foreign literatures. Results : Mean age was 54 years old and there was female preponderance in domestic reports. Their common presenting symptoms were dyspnea and cough, and mean duration of illness was 41 days. On chest examination, inspiratory crackle was a common finding. The laboratory findings were nonspecific except hypoxemia. Lung function studies revealed restrictive defect or combined obstructive and restrictive pattern in most patients. Bilateral patchy and nonsegmental alveolar opacities constituted characterized radiographic finding, highlighted on high resolution computed tomogram. It showed a favorable prognosis with an excellent responsiveness to corticosteroid therapy. The clinical features and laboratory findings were similar between domestic and foreign cases except female preponderance in Korean cases. Conclusion : If the clinical course is atypical or pregressive under proper treatment, clinicians should reevaluate clinical features and radiographic findings under the consideration of BOOP. Tissue confirmation would be recommended for the definitive diagnosis of BOOP.

• The Korean Society of Law and Medicine
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• v.9 no.1
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• pp.413-459
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• 2008

The Law has intervened to define rare circumstances in which a person should choose continuing life in United States. On the one hand, the law has traditionally acted to preservelife and to respect the sanctity of life. On the other hand, one's control over one's own body, and the right to determine what kind of medical care one will receive, is equally well respected and historically grounded. The competent patients have the right to forgo life-sustaining treatment, courts in United States have left many unanswered questions about the nature of that right. The right to choose to forgo life-sustaining treatment is a manifestation of a patient's autonomy interest. In United States, The Karen Quilan case gave rise to legislative activity in the host of state capitals, and several states had adopted statutes that formally recognized some forms of written directives describing some circumstances in which certain kinds of medical care could be terminated. These statues were sometimes dominated 'living will' acts, sometimes 'right to die' acts and ocasionally 'natural death' acts. Today virtually every state has produced a living will statue. In Korea, courts do not permit a terminally ill person to withhold or withdraw life-sustaining treatment. Living wills apply in case of terminal illness owing to a defect in legislation. Now In Korea, these lively dispute of legal policy on the preconditions and concrete procedure of living will act and natural death act. Through the legislation of living will act and natural death act, we should prepare some circumstances to respect patient's autonomy on the right to die. We should frame the cultural standard to make a decision of forgoing life-sustainin1g treatment under the discreet procedure.

• The Korean Journal of Physiology and Pharmacology
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• v.17 no.2
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• pp.133-137
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• 2013

Vascular cell adhesion molecule 1 (VCAM-1), intercellular adhesion molecule 1 (ICAM-1), P- and E-selectin play a pivotal role for initiation of atherosclerosis. Ginsenoside, a class of steroid glycosides, is abundant in Panax ginseng root, which has been used for prevention of illness in Korea. In this study, we investigated the mechanism(s) by which ginsenoside Rg2 may inhibit VCAM-1 and ICAM-1 expressions stimulated with lipopolysaccharide (LPS) in human umbilical vein endothelial cell (HUVEC). LPS increased VCAM-1 and ICAM-1 expression. Ginsenoside Rg2 prevented LPS-mediated increase of VCAM-1 and ICAM-1 expression. On the other hand, JSH, a nuclear factor kappa B (NF-${\kappa}B$) inhibitor, reduced both VCAM-1 and ICAM-1 expression stimulated with LPS. SB202190, inhibitor of p38 mitogen-activated protein kinase (p38 MAPK), and wortmannin, phosphatidylinositol 3-kinase (PI3-kinase) inhibitor, reduced LPS-mediated VCAM-1 but not ICAM-1 expression. PD98059, inhibitor of mitogen-activated protein kinase kinase/extracellular signal-regulated kinase (MEK/ERK) did not affect VCAM-1 and ICAM-1 expression stimulated with LPS. SP600125, inhibitor of c-Jun N-terminal kinase (JNK), reduced LPS-mediated ICAM-1 but not VCAM-1 expression. LPS reduced IkappaB${\alpha}$ ($I{\kappa}B{\alpha}$) expression, in a time-dependent manner within 1 hr. Ginsenoside Rg2 prevented the decrease of $I{\kappa}B{\alpha}$ expression stimulated with LPS. Moreover, ginsenoside Rg2 reduced LPS-mediated THP-1 monocyte adhesion to HUVEC, in a concentration-dependent manner. These data provide a novel mechanism where the ginsenoside Rg2 may provide direct vascular benefits with inhibition of leukocyte adhesion into vascular wall thereby providing protection against vascular inflammatory disease.

• The Journal of the Korea Contents Association
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• v.15 no.3
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• pp.229-240
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• 2015

Purpose: The purpose of this study was to investigate the attitudes towards death and euthanasia among nurses and general population. Methods: The participants were 192 nurses and 255 people. Data were collected using structured questionnaires from March 5 to May 30. 2010 and analyzed with descriptive statistics, t-test, one-way ANOVA and Pearson correlation coefficients by using SAS Program 12.0. Results: The attitudes towards death showed significantly higher scores in nurses than general population. The attitudes towards euthanasia showed significantly higher scores in nurses. There were significant positive correlations between attitudes towards death and euthanasia in nurses and. people. Conclusion: The above results indicated that the higher level of cognition towards death, the more positive attitudes towards euthanasia. Besides, nurses treating with terminal illness were higher level of cognition on death and positive attitudes towards euthanasia. Therefore, we should established the strategy and education program to understand on death and euthanasia for people including the health care providers.

• Journal of Digital Convergence
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• v.11 no.3
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• pp.305-310
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• 2013

To provide medical services to patients who have a terminal illness, recent hospital patients to monitor the state of the device attached to the body, the body insertion device is. U-Healthcare Environment and hospital officials indiscriminately exploited by the patient's vital information, however, could threaten the patient's life problems are appearing. In this paper, depending on the level of authority, hospital officials, Union of ID-based authentication model is proposed to use a patient's vital information. Union proposed model identify different authentication system is used in hospitals that exist in various forms in a number of ID information, health / medical information sharing between hospitals without exposure to unnecessary personal information, you can be assured of the anonymity. In particular, with easy access to patient information, hospital officials about the malicious act to protect patient information to access level for the rights granted by third parties to prevent easy access.

• Journal of Ginseng Research
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• v.41 no.1
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• pp.96-102
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• 2017

Background: Korean ginseng, Panax ginseng Meyer, has been used as a traditional oriental medicine to treat illness and promote health for several thousand years. Ginsenosides are the main constituents for the pharmacological effects of P. ginseng. Since several ginsenosides, including ginsenoside (G)-Rg3 and G-Rp1, have reported antiplatelet activity, here we investigate the ability of G-Rp4 to modulate adenosine diphosphate (ADP)-induced platelet aggregation. The ginsenoside Rp4, a similar chemical structure of G-Rp1, was prepared from G-Rg1 by chemical modification. Methods: To examine the effects of G-Rp4 on platelet activation, we performed several experiments, including antiplatelet ability, the modulation of intracellular calcium concentration, and P-selectin expression. In addition, we examined the activation of integrin ${\alpha}IIb{\beta}_3$ and the phosphorylation of signaling molecules using fibrinogen binding assay and immunoblotting in rat washed platelets. Results: G-Rp4 inhibited ADP-induced platelet aggregation in a dose-dependent manner. We found that G-Rp4 decreased calcium mobilization and P-selectin expression in ADP-activated platelets. Moreover, fibrinogen binding to integrin ${\alpha}IIb{\beta}_3$ by ADP was attenuated in G-Rp4-treated platelets. G-Rp4 significantly attenuated phosphorylation of extracellular signal-regulated protein kinases 1 and 2, p38, and c-Jun N-terminal kinase, as well as protein kinase B, phosphatidylinositol 3-kinase, and phospholipase C-${\gamma}$ phosphorylations. Conclusion: G-Rp4 significantly inhibited ADP-induced platelet aggregation and this is mediated via modulating the intracellular signaling molecules. These results indicate that G-Rp4 could be a potential candidate as a therapeutic agent against platelet-related cardiovascular diseases.

• Journal of Hospice and Palliative Care
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• v.16 no.3
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• pp.175-182
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• 2013

Purpose: Spirituality is an important domain and is related with physical and psychological symptoms in terminal cancer patient. The aim of this study is to examine how patients' spirituality is associated with their physical and psychological symptoms as it has been explored by few studies. Methods: In this cross sectional study, 50 patients in the palliative ward of a tertiary hospital were interviewed. Spiritual well-being, depression, anxiety and pain is measured by Functional Assessment of Chronic-Illness Therapy-Spirituality (FACIT-Sp), hospital anxiety and depression scale (HADS) and the Korean version of the Brief Pain Inventory (BPI-K). The correlations between patients' spiritual well-being and anxiety, depression and pain were analysed. The association between spiritual well-being and age, gender, palliative performance scale (PPS), religion, mean pain intensity, anxiety, depression were assessed by univariate and multivariate regression analyses. Results: Spiritual well-being was negatively correlated with the mean pain intensity (r=-0.283, P<0.05), anxiety (r=-0.613, P<0.05) and depression (r=-0.526, P<0.05). In multivariate regression analysis, spiritual well-being showed negative association with anxiety (OR=-1.03, 95% CI=-1.657~-0.403, P=0.002) and positive association with the existence of religion (OR=9.193, 95% CI=4.158~14.229, P<0.001). Conclusion: In this study, patients' anxiety and existence of religion were significantly associated with spiritual well-being after adjusting age, gender, PPS, mean pain intensity, depression. Prospective studies are warranted.