Gradation of Disability in Human Body Injuries （hereinafter referred to as Gradation） has been released and used since January 2017, and has become the most widely used standard in forensic science practice. This paper calculates and rates the visual system evaluation provisions of the current domestic disability evaluation criteria represented by the Gradation which used the methods of Guides to the Evaluation of Permanent Impairment （hereinafter referred to as GEPI） issued by American Medical Association （AMA）. Through comparing, a good correlation between the provisions in Gradation and whole person impairment rating index in GEPI was shown. On the basis of this, suggestions are put forward to amend some provisions of Gradation, in order to provide reference for the revision and further improvement of domestic standards and provisions.
American Medical Association ; China ; Disability Evaluation ; Disabled Persons ; Forensic Medicine/standards* ; Forensic Sciences ; Guidelines as Topic ; Humans ; United States

In recent years, acupuncture has been used widely as an adjuvant treatment for the in vitro fertilization (IVF). " " published in on May 15, 2018, the research findings do not support the use of acupuncture to improve the rate of live births among the women undergoing IVF. In order to avoid the misunderstanding of the scholars at home and abroad for the clinical effects of acupuncture on IVF assistance, the authors put forward the doubts after the analysis from the following 3 aspects, including the acupuncture scheme, outcomes and result explanation. Additionally, the thinking and suggestions are proposed for the future development of the clinical trials of acupuncture IVF assistance in terms of selecting the proper participants, being abided by the standards of the evidence-based medicine, designing multi-acupuncture schemes and setting up the rational control, as well as conducting the overall analysis of the trial data.
Acupuncture ; American Medical Association ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Live Birth ; Pregnancy ; Pregnancy Rate ; United States

In June 27, 2017, there were two acupuncture clinical trials published in (). The conclusions were that electroacupuncture could relieve the leakage of urine of female stress urinary incontinence and that acupuncture with clomiphene or not could not improve the live birth rate of female with polycystic ovarian syndrome, compared with shallow insertion at non-acupoint combined with clomiphene placebo. The Youth Committee of the China Association of Acupuncture-Moxibustion held an academic salon about the above two trials on September 7, 2017. It is considered that rigorous design is key to clinical acupuncture-moxibustion trial, that acupuncture-moxibustion therapy is with psychosomatic medicine theory. The clinical acupuncture-moxibustion research method was discussed, including study group selection, acupuncture control, the primary outcome, the interpretation of result, etc.
Acupuncture Therapy ; American Medical Association ; China ; Female ; Humans ; Moxibustion ; Randomized Controlled Trials as Topic ; United States

Recently, the Korean Medical Association (KMA) launched the KMA Policy system based upon the American Medical Association (AMA) Policy system. The KMA's official positions on health issues and medical ethics, as well as its constitution, bylaws, and directives, will be included in the KMA Policy system. The AMA's organizational structure and decision making process provided essential information for developing the KMA Policy system. Through the KMA Policy system, hereafter, the KMA should introduce a procedure not only to decide upon positions on various health issues but also a means to open them to the public. In addition, the KMA can expect the continuity and transparency of work, enhanced benefits to members, public credibility, and growth of its social reputation by means of KMA Policy. Furthermore, the system would be beneficial for both KMA members and the public, as they can easily access KMA Policy, and, in turn, access the healthcare systems of Korea and its medical knowledge. To achieve a successful KMA Policy system, the definite authority and responsibility should be granted to the organizational bodies of the KMA, for example, the House of Delegates and Board of Trustees, and the regional societies and other sections. These various groups must then efficiently divide up their work and cooperate systematically. Moreover, it is crucial that each individual member of the KMA pay much more attention to health issues and participate in the decision making process on KMA Policy.
American Medical Association ; Constitution and Bylaws ; Decision Making ; Delivery of Health Care ; Ethics, Medical ; Financing, Organized ; Humans ; Korea ; Power (Psychology)* ; Trustees

OBJECTIVE: To compare the swallowing characteristics of dysphagic patients with traumatic brain injury (TBI) with those of dysphagic stroke patients. METHODS: Forty-one patients with TBI were selected from medical records (between December 2004 to March 2013) and matched to patients with stroke (n=41) based on age, sex, and disease duration. Patients' swallowing characteristics were analyzed retrospectively using a videofluoroscopic swallowing study (VFSS) and compared between both groups. Following thorough review of medical records, patients who had a history of diseases that could affect swallowing function at the time of the study were excluded. Dysphagia characteristics and severity were evaluated using the American Speech-Language-Hearing Association National Outcome Measurement System swallowing scale, clinical dysphagia scale, and the videofluoroscopic dysphagia scale. RESULTS: There was a significant difference in radiological lesion location (p=0.024) between the two groups. The most common VFSS finding was aspiration or penetration, followed by decreased laryngeal elevation and reduced epiglottis inversion. Swallowing function, VFSS findings, or quantified dysphagia severity showed no significant differences between the groups. In a subgroup analysis of TBI patients, the incidence of tube feeding was higher in patients with surgical intervention than in those without (p=0.011). CONCLUSION: The swallowing characteristics of dysphagic patients after TBI were comparable to those of dysphagic stroke patients. Common VFSS findings comprised aspiration or penetration, decreased laryngeal elevation, and reduced epiglottis inversion. Patients who underwent surgical intervention after TBI were at high risk of tube feeding requirement.
American Speech-Language-Hearing Association ; Brain Injuries* ; Deglutition ; Deglutition Disorders* ; Enteral Nutrition ; Epiglottis ; Fluoroscopy ; Humans ; Incidence ; Medical Records ; Retrospective Studies ; Stroke*

OBJECTIVE: To evaluate the functional characteristics of swallowing and to analyze the parameters of dysphagia in head and neck cancer patients after concurrent chemoradiotherapy (CCRT). METHODS: The medical records of 32 patients with head and neck cancer who were referred for a videofluoroscopic swallowing study from January 2012 to May 2015 were retrospectively reviewed. The patients were allocated by duration after starting CCRT into early phase (<1 month after radiation therapy) and late phase (>1 month after radiation therapy) groups. We measured the modified penetration aspiration scale (MPAS) and American Speech-Language-Hearing Association National Outcome Measurement System swallowing scale (ASHA-NOMS). The oral transit time (OTT), pharyngeal delay time (PDT), and pharyngeal transit time (PTT) were recorded to assess the swallowing physiology. RESULTS: Among 32 cases, 18 cases (56%) were of the early phase. In both groups, the most common tumor site was the hypopharynx (43.75%) with a histologic type of squamous cell carcinoma (75%). PTT was significantly longer in the late phase (p=0.03). With all types of boluses, except for soup, both phases showed a statistically significant difference in MPAS results. The mean ASHA-NOMS level for the early phase was 5.83±0.78 and that for the late phase was 3.79±1.80, with statistical significance (p=0.01). The PTT and ASHA-NOMS level showed a statistically significant correlation (correlation coefficient=–0.52, p=0.02). However, it showed no relationship with the MPAS results. CONCLUSION: The results of our study suggest that in the late phase that after CCRT, the OTT, PDT, and PTT were longer than in the early phase and the PTT prolongation was statistically significant. Therefore, swallowing therapy targeting the pharyngeal phase is recommended after CCRT.
American Speech-Language-Hearing Association ; Carcinoma, Squamous Cell ; Chemoradiotherapy* ; Deglutition Disorders ; Deglutition* ; Head and Neck Neoplasms* ; Head* ; Humans ; Hypopharynx ; Medical Records ; Physiology ; Retrospective Studies

PURPOSE: The internet has become one of the most important media outlets used to obtain health information. Therefore, the quality of health information available on the internet is very important. We evaluated the quality of internet-derived health information on allergic rhinitis, rhinitis and sinusitis and compared these results to those of previous studies performed five years ago. METHODS: The terms "allergic rhinitis (AR)", "rhinitis" and "sinusitis" were searched among the four most commonly used search engines in South Korea. These websites were evaluated according to the author, the Journal of the American Medical Association (JAMA) benchmarks, the DISCERN questionnaire and the Allergic rhinitis and its Impact on Asthma (ARIA) 2008 Update. RESULTS: A total of 120 websites were obtained and analyzed. For all diseases, "Oriental physician" had the largest portion (almost half of all websites), followed by "Western physician". Based on analyses using the JAMA benchmark, "Attribution" and "Disclosure" were ignored in almost all surveyed websites. According to the scores of the DISCERN question, the majority of websites did not supply appropriate references for their health information, and information on the negative aspects of treatment such as risks and uncertainty was not provided in several websites. In an analysis based on the ARIA 2008 Update concepts, 65% of websites pertaining to health information on AR contained unreliable information. CONCLUSIONS: The quality of health information on the internet was not acceptable. Thus, governmental regulation or control to improve the quality of health information is required.
American Medical Association ; Asthma ; Internet* ; Korea ; Rhinitis* ; Search Engine ; Sinusitis* ; Uncertainty ; Surveys and Questionnaires

PURPOSE: In 2004, the American Heart Association (AHA) had published an algorithm for the diagnosis of incomplete Kawasaki disease (KD). The aim of the present study was to investigate characteristics of supplemental laboratory criteria in this algorithm. METHODS: We retrospectively examined the medical records of 355 patients with KD who were treated with intravenous immunoglobulin (IVIG) during the acute phase of the disease. Laboratory data were obtained before the initial IVIG administration and up to 10 days after fever onset. In 106 patients, laboratory testing was performed more than twice. RESULTS: The AHA supplemental laboratory criteria were fulfilled in 90 patients (25.4%), and the frequency of laboratory examination (odds ratio [OR], 1.981; 95% confidence interval [CI], 1.391-2.821; P<0.001) was a significant predictor of it. The fulfillment of AHA supplemental laboratory criteria was significantly associated with refractoriness to the initial IVIG administration (OR, 2.388; 95% CI, 1.182-4.826; P=0.013) and dilatation of coronary arteries (OR, 2.776; 95% CI, 1.519-5.074; P=0.001). CONCLUSION: Repeated laboratory testing increased the rate of fulfillment of the AHA supplemental laboratory criteria in children with KD.
American Heart Association ; Child* ; Coronary Vessels ; Diagnosis ; Dilatation ; Fever ; Humans ; Immunoglobulins ; Immunoglobulins, Intravenous ; Medical Records ; Mucocutaneous Lymph Node Syndrome* ; Retrospective Studies

BACKGROUND AND OBJECTIVES: In disability rating of hearing injury, there are some medicolegal considerations, such as discrepancy in estimating values between McBride system and the American Medical Association system, and difficulties in judging the hearing level in boundary cases. We have therefore felt the need of complementary hearing disability evaluation methods that reflect reality. As a first step, we have pointed out current situation and problems in legal advisory cases of hearing injury. SUBJECTS AND METHOD: For the past 14 years, we have provided legal advisory on hearing injury for 121 cases for courts (group A) or insurance companies (group B). Eleven cases of 'aggravation of disability' were excluded. Data were summarized and tested statistically. We have used unpaired t-test for continuous variables such as age, hearing, hearing disability, disability rating, Fisher's exact test for dichotomous variable such as gender, group (A/B), and Pearson's correlation test for correlation coefficients between continuous variables. RESULTS: Subjects were more frequently males (3:1) and in the fifth decade of life. The averages of audiometry were around 40 dB. There were significant differences in hearing and disability rating between younger and older group. Group B is significantly older than group A. The type of disability or accident did not influence hearing and disability rating. CONCLUSION: This paper could help figure out the current situation with respect to medicolegal considerations of hearing injury discrepancies in disability rating and could also serve well to recognize the necessity for a complementary hearing disability evaluation method, especially for borderline hearing level.
American Medical Association ; Audiometry ; Disability Evaluation ; Hearing Loss ; Hearing* ; Humans ; Insurance ; Jurisprudence ; Male

PURPOSE: In the evaluation of visual field defect, Goldmann kinetic perimetry is the preferred method. However, in many cases, Humphrey static perimetry is performed for visual disability evaluation in Korea. In the present study we investigated the correlation between Goldmann kinetic perimetry and Humphrey static perimetry for disability evaluation using visual field score (VFS). METHODS: This study included 126 eyes, classified into the following groups: 60 eyes, normal group; 11 eyes, contraction of central visual field group; 42 eyes, irregular visual field group; 13 eyes, hemianopsia group. All subjects were examined with Goldmann kinetic perimetry and Humphrey static perimetry. We studied the correlation of the VFS between Goldmann kinetic perimetry and Humphrey static perimetry according to the Korean Academy of Medical Science Guides for Impairment Evaluation (KAMS Guides) and American Medical Association Guides for the Evaluation of Permanent Impairment (AMA Guides). RESULTS: Regarding contraction of central visual field group, Goldmann VFS, Humphrey VFS and extended Humphery VFS showed no statistical significance (AMA: p = 0.50, p = 0.30, KMAS: p = 0.36, p = 0.18. respectively). In the irregular visual field and hemianopsia groups, Goldmann VFS and Humphrey VFS showed statistical significance (AMA: p = 0.00, p = 0.00, KMAS: p = 0.00, p = 0.00. respectively). Goldmann VFS and extended Humphrey VFS showed no statistical significance (AMA: p = 0.13, p = 0.12, KMAS: p = 0.08, p = 0.99. respectively). CONCLUSIONS: The contraction of central visual field based on Humphrey static perimetry can be applied to visual disability evaluation. However, in the majority of cases, there is a difference between the two tests and Goldmann kinetic perimetry should be used first in the evaluation of visual field disability evaluation.
American Medical Association ; Disability Evaluation* ; Hemianopsia ; Korea ; Methods ; Visual Field Tests* ; Visual Fields