• Title/Summary/Keyword: access to medicine

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A Study on the Precedents Changing Related to Using Medical Devices of Korean Medicine Doctors (한의사 의료기기 사용과 관련된 판례 및 기존 연구 분석과 경향 변화)

  • Park, Jeongsu;Oh, Kichang;Kwon, Sanghyuk;Chu, Hongmin;Kim, Jungsang
    • The Journal of Internal Korean Medicine
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    • v.42 no.6
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    • pp.1303-1318
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    • 2021
  • Objectives: The aim of this study was to examine the debate on the use of medical devices between Western Medicine and Korean Medicine, as this is one of the greatest conflicts in Korea's medical profession. Judicial precedents and interpretations of authority serve as regulations because medical affairs law states that Korean Medicine practices are ambiguous. Method: We conducted a search in the Korean RISS, OASIS, and DBPIA databases using several keywords associated with medical devices, Korean Medicine, and Korean Medicine Doctors. The search period was until November 5 2021. The retrieved papers were classified according to the selection and exclusion criteria by checking the title, abstract, and text. For precedents, searches were done regarding comprehensive legal information, etc., and in the case of non-disclosure precedents, we requested access to the precedents by web-court requests. Results: A total of 80 documents were found as a result of the search, and 13 publications were included in the study. The selected publications were classified and analyzed by this research team into Korean medicine, Western medicine, and legal or state agency research. In the existing literature and judgments, the arguments that played a major role changed depending on the time the judgment was made. "Social conventions", "curriculum", "academic principles", and "health and hygiene dangers" were the key arguments. Conclusions: Further studies will be needed that can comprehensively arrange the existing literature and clinical results, and continuous study will be needed to verify that the use of medical devices by Korean medicine doctors is helpful for prognosis and accurate treatment of their patients.

Paclitaxel Coating Inhibits Inflammation Surrounding Subcutaneously Implanted Expanded Polytetrafluoroethylene (ePTFE) Hemodialysis Grafts in Rabbit Model

  • Baek, In-Su;Lee, Yu-Ji;Park, Soo-Jin;Bai, Cheng Zhe;Park, Jong-Sang;Kim, Dae-Joong
    • Bulletin of the Korean Chemical Society
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    • v.31 no.2
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    • pp.281-285
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    • 2010
  • Hemodialysis vascular access dysfunction (HVAD) due to the aggressive development of venous neointimal hyperplasia remains a major complication for patients with synthetic arteriovenous grafts. Paclitaxel-coated expanded polytetrafluoroethylene (ePTFE) grafts effectively prevent neointimal hyperplasia and stenosis. However, perigraft inflammation or edema can be another complication of ePTFE grafts, preventing early cannulation. Three different types of ePTFE grafts, including grafts without paclitaxel coating (control group, n = 12), grafts with paclitaxel coating at a dose density of $0.61ug/mm^2$ (low concentration group, n = 12), and grafts with paclitaxel coating at a dose density of $1.15ug/mm^2$ (high concentration group, n = 12) were placed in the backs of 12 rabbits, simultaneously. Six rabbits were euthanized after one week and the remaining six were euthanized two weeks after implantation. Perigraft inflammation, graft wall inflammation, stromal cell proliferation, blood vessel formation, tissue necrosis and edema were analyzed for the grafts in each animal. Inflammation surrounding the paclitaxel-coated grafts was significantly reduced compared to the control group. Stromal cell layers were detected at the interface between the graft and the surrounding tissue in the control group, infiltrated into the graft interstices, and differentiated into myofibroblasts for graft healing. Paclitaxel-coated grafts inhibited stromal cell proliferation and infiltration into the graft wall. Tissue necrosis and edema were not detected in either of the paclitaxel-coated graft groups.

Study On the Six Channels Demonstration Answering the Question in Treatise on Exogenous Febrile Disease (${\ll}$상한론(傷寒論)${\gg}$의 육경변증(六經辨證) 설문에 관한 연구)

  • Park, Min-Kwan;Kim, Min-Yong;Park, Young-Jae
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.9 no.2
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    • pp.83-93
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    • 2005
  • It is well known that Treatise on Exogenous Febrile Disease is one of the oldest and most authoritative books in Oriental Medicine, suggesting the concept of Exogenous Febrile and Six channels as a theoretical basis of clinical experience and prescription. But, since Thang Thongjing had written the book, the numberous medical practitioners and theorists asserted their various and different views on the concept of Exogenous Febrile and its Six channels. 3UM-3YANG of Treatise on Exogenous Febrile Disease is basically the thing of specialization UM-YANG, eventually UM-YANG are two functional characteristics in human body. It is specialized to 3UM-3YANG by spatial and time criteria Therefore, it is important to apprehend the concept correctly that was written on Treatise on Exogenous Febrile Disease. I'd like to look into a bodily state by answering the question that is easy to access and based on Six Channels.

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Statistical Methods for Multivariate Missing Data in Health Survey Research (보건조사연구에서 다변량결측치가 내포된 자료를 효율적으로 분석하기 위한 통계학적 방법)

  • Kim, Dong-Kee;Park, Eun-Cheol;Sohn, Myong-Sei;Kim, Han-Joong;Park, Hyung-Uk;Ahn, Chae-Hyung;Lim, Jong-Gun;Song, Ki-Jun
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.4 s.63
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    • pp.875-884
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    • 1998
  • Missing observations are common in medical research and health survey research. Several statistical methods to handle the missing data problem have been proposed. The EM algorithm (Expectation-Maximization algorithm) is one of the ways of efficiently handling the missing data problem based on sufficient statistics. In this paper, we developed statistical models and methods for survey data with multivariate missing observations. Especially, we adopted the EM algorithm to handle the multivariate missing observations. We assume that the multivariate observations follow a multivariate normal distribution, where the mean vector and the covariance matrix are primarily of interest. We applied the proposed statistical method to analyze data from a health survey. The data set we used came from a physician survey on Resource-Based Relative Value Scale(RBRVS). In addition to the EM algorithm, we applied the complete case analysis, which uses only completely observed cases, and the available case analysis, which utilizes all available information. The residual and normal probability plots were evaluated to access the assumption of normality. We found that the residual sum of squares from the EM algorithm was smaller than those of the complete-case and the available-case analyses.

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Deep Vein Thrombosis Due to Hematoma as a Rare Complication after Femoral Arterial Catheterization

  • Kim, Minsoo;Lee, Jong-Young;Lee, Cheol Whan;Lee, Seung-Whan;Kang, Soo-Jin;Yoon, Yong Hoon;Om, Sang Yong;Kim, Young-Hak
    • Journal of Yeungnam Medical Science
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    • v.30 no.1
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    • pp.31-35
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    • 2013
  • Hematoma is quite a common complication of femoral arterial catheterization. However, to the best of our knowledge, there have been no previous studies regarding deep vein thrombosis (DVT) caused by compression of a vein due to a hematoma. We report a case of a hematoma developing after femoral arterial catheterization and causing extensive symptomatic DVT. A 59-year-old male was seen in our Emergency Department with right lower leg swelling 15 days after coronary stent implantation performed using right femoral artery access. Computed tomographic (CT) scanning revealed a large hematoma (45 mm in its longest diameter) compressing the common femoral vein and with DVT from the right external iliac vein to the popliteal vein. Due to the extensive DVT involvement, we decided to release the compressed common femoral vein by surgical evacuation of the large hematoma. However, even following evacuation of the hematoma, as the DVT did not resolve soon, further mechanical thrombectomy and catheter-directed thrombolysis were performed. Angiography then showed nearly resolved DVT, and the leg swelling was improved. The patient was discharged with the anticoagulation medication, warfarin.

Strategy Considerations in Genome Cohort Construction in Korea (한국 유전체 코호트 구축의 전략적 고려사항)

  • Sung, Joo-Hon;Cho, Sung-Il
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.2
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    • pp.95-101
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    • 2007
  • Focusing on complex diseases of public health significance, strategic issues regarding the on-going Korean Genome Cohort were reviewed: target size and diseases, measurements, study design issues, and follow-up strategy of the cohort. Considering the epidemiologic characteristics of Korean population as well as strengths and drawbacks of current research environment, we tried to tailor the experience of other existing cohorts into proposals for this Korean study. Currently 100,000 individuals have been participating the new Genome Cohort in Korea. Target size of de novo collection is recommended to be set as between 300,000 to 500,000. This target size would allow acceptable power to detect genetic and environmental factors of moderate effect size and possible interactions between them. Family units and/or special subgroups are recommended to parallel main body of adult individuals to increase the overall efficiency of the study. Given that response rate to the conventional re-contact method may not be satisfactory, successful follow-up is the main key to the achievement of the Korean Genome Cohort. Access to the central database such as National Health Insurance data can provide enormous potential for near-complete case detection. Efforts to build consensus amongst scientists from broad fields and stakeholders are crucial to unleash the centralized database as well as to refine the commitment of this national project.

Intrathecal Catheter and Subcutaneous Access Port Implantation in Pain Management for Terminal Cancer Patient - A case report - (말기암 환자의 통증치료를 위한 지주막하강내 카테터 거치와 피하 이식형 약제 주입기 삽입 - 증례보고 -)

  • Seo, Kwi Chu;Chung, Jin Yong;Kim, Ho Young;Rho, Woon Seok;Kim, Bong Il;Song, Seok Young
    • The Korean Journal of Pain
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    • v.20 no.2
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    • pp.240-245
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    • 2007
  • It is important to treat cancer-related pain in cancer patients to ensure the life quality of the patient, as well as to improve their life span. It has been estimated that at least 5% of cancer patients have pain refractory to medical treatment. Therefore, the need for epidural or intrathecal analgesia with opioids and local anesthetics is indicated if systemic treatment has failed. Intrathecal catheter placement and implantation of the injection port for administration of opioids and local anesthetics may improve pain relief in patients who are unresponsive to epidural routes. Although intrathecal implantation has several complications, similar infection rates have been reported between intrathecal and epidural administration. In addition, intrathecal administration showed better outcomes, including improved pain control, lowered daily doses, and an improvement in the level of drowsiness experienced when compared to epidural administration. We report here a case in which a terminal cancer patient was treated using an intrathecal catheter and subcutaneous port. The patient had cancer-related pain that could not be controlled by epidural opioid administration. Based on the results presented here, we suggest that intrathecal implantation is a feasible long term pain management method for intractable cancer pain patients.

Biological Signal Measurements in SiMACS (SiMACS에서의 생체신호 수집)

  • Lim, J.J.;Choi, Y.S.;Kim, D.H.;Kim, E.J.;Lee, H.J.;Woo, E.J.;Park, S.H.
    • Proceedings of the KOSOMBE Conference
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    • v.1994 no.05
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    • pp.53-56
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    • 1994
  • We have developed biological signal measurement modules and data acquisition and control card for a biological signal measurement, archiving, and communication system (SiMACS). Biological signals included in this system are ECG, EEG, EMG, invasive blood pressure, respiration, and temperature. Parameters of each module can be controlled by PC-base IDPU (intelligent data processing unit) through a data acquisition and control card. The data acquisition and control card can collect up to 16 channels of biological signals with sampling rate of $50\;{\sim}\;2,000Hz$ and 12-bit resolution. All measurement moduls and data acquisition functions are controlled by microcontroller which receives commands from PC. All data transfers among PC, microcontroller, and ADC are done through a shared RAM access by polling method for real rime operation.

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Complete atrioventricular block during tunneled cuffed hemodialysis catheter insertion in a patient with pre-existing left bundle branch block

  • Choi, Eun Woo;Jung, Ji Yoon;Su, Jun Huck;Park, Sae Huyn;Cho, Kyu Hyang;Yoon, Kyung Woo;Park, Jong Won;Do, Jun Young;Kang, Seok Hui
    • Journal of Yeungnam Medical Science
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    • v.32 no.2
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    • pp.152-154
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    • 2015
  • Arrhythmias are complications of tunneled cuffed hemodialysis catheter insertion. Most complications associated with arrhythmias occur during guide-wire access, where the guide wire can cause traumatic damage to the conduction system of the heart. Conducting system injury in tunneled cuffed hemodialysis catheter insertion often involves the right bundle, causing right bundle branch block (RBBB). Transient RBBB with sinus rhythm is not usually accompanied by abnormal vital signs. However if patients already have left bundle branch block (LBBB), new onset RBBB can cause complete atrioventricular block (AVB), which can lead to fatal complications requiring invasive treatment. We report on a patient with LBBB who developed complete AVB during hemodialysis catheter insertion.

Differences in Utilization of Health Care Services by the Type of Disability (장애 유형별 의료서비스 이용의 차이)

  • Yoon, Tae-Ho;Jeong, Baek-Geun;Kang, Yune-Sik;Lee, Sang-Yi;Kim, Chul-Woung
    • Health Policy and Management
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    • v.17 no.2
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    • pp.33-51
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    • 2007
  • The disabled population is a vulnerable group, having very complex medical conditions, but little is known about differences in the level of access by type of disability. This study was performed to investigate the differences of health care utilization by the type of disability. The database was constructed from registry of the disabled and health insurance and medical aid claims data submitted to the Korea Health Insurance Cooperation during in the year 2003. The disability classified three groups according to the Disabled Welfare Act; physically disability with external dysfunction, physically disability with organic disease, and mentally disability. There were huge differences in health care utilization by the type of disability. For the inpatient care, those with a mental disability were more likely to utilize health care services in terms of average visit number of medical facilities and visit days per case, but the treatment amount per case was the highest in physically disabled with organic disease. For the outpatient care, those who the physically disabled with organic disease were more likely to utilize health care services in terms of average visit number of medical facilities, treatment amount per case, and the treatment days per case. Also, those who physically disabled with organic disease were more likely to utilize general hospital for both inpatient and outpatient care, and spent more out-of-pocket expenditure. As the number of persons with disabilities rises, the need to consider new approaches to protecting their health grows increasingly. Especially, Korean health care system should be refined to be more responsive to the needs of the type of disability.