1.Expectations and concerns regarding medical advertisements via large commercial medical platform advertising companies: a legal perspective
Raeun KIM ; Hakyoung PARK ; Jiwon SHINN ; Hun-Sung KIM
Cardiovascular Prevention and Pharmacotherapy 2024;6(2):48-56
Advertising in the medical and legal fields, which are among Korea's leading professions, has increasingly utilized major advertising platforms such as LawTalk and UNNI—two of the most prominent and contentious platforms in their respective fields. While it is generally unproblematic for professionals like lawyers and doctors to promote public interest through advertising on these commercial platforms, the creation of a profit-driven structure has the potential to undermine their professional ecosystems. This article explores the issues associated with advertising in the medical field through large commercial platforms, drawing on notable examples from the legal and medical fields in Korea. Specifically, we analyze two of the most popular yet controversial platforms in these sectors, LawTalk and UNNI. In Korea, the format and method of advertising are legal as long as they do not involve referring or soliciting clients, thereby making platform advertising lawful when used solely for that purpose. Nevertheless, it is crucial to prevent medical advertising platforms from establishing market monopolies by skirting various profit regulations and laws. In response to these concerns, the Korean Bar Association has prohibited all advertisements by platform companies. The medical community should closely examine the rationale and process behind this decision. Given the significant social influence of large corporate platforms and the unique social responsibilities of the medical and legal professions, future platform advertising should be subject to distinct legal and institutional regulations that differ from those applied to general services.
2.Diverse perspectives on remote collaborative care for chronic disease management
Seo Yeon BAIK ; Hakyoung PARK ; Jiwon SHINN ; Hun-Sung KIM
Cardiovascular Prevention and Pharmacotherapy 2024;6(1):26-32
Remote collaborative care is a program that improves medical services by linking local and remote physicians with residents in areas where access to medical facilities is limited, utilizing information and communication technology. As a result, patients can obtain medical advice and counseling at local hospitals without needing to travel to distant facilities. This care model involves communication between doctors, facilitating the accurate transfer of medical information and reducing the risk of misunderstandings. For instance, managing conditions such as blood pressure or blood glucose is more straightforward because a local hospital can assess the patient's status while a remote hospital simultaneously provides high-quality, specialized medical services. With the rise in poorly controlled hypertension or diabetes, the need for remote collaborative care has also increased. This care model enables local hospitals to maintain continuous patient care with the support of remote facilities. This is particularly true following acute cardiovascular treatment, where local hospitals, assisted by remote institutions, can safely offer high-quality services such as rehabilitation and follow-up care. Although remote hospitals have many advantages with the increasing number of patients, many difficulties remain in commercializing unsystematized remote collaborative care. Specifically, low reimbursements for medical services must be addressed, proper equipment is needed, more time and effort must be invested, and the liability issue must also be dealt with. Nevertheless, remote collaborative care using information and communication technology will be necessary in the future. Medical staff need to objectively examine the advantages and disadvantages of remote collaborative care from various perspectives and find ways to revitalize it.
3.Evaluation of improved transvenous heartworm extraction brush in dogs with caval syndrome
Jihyun KIM ; Junemoe JEONG ; Kanghyo PARK ; Kyoungin SHIN ; In Sung JANG ; Hakyoung YOON
Journal of Veterinary Science 2023;24(4):e46-
Background:
Heartworm infection in dogs is caused by Dirofilaria immitis and common in shelter animals and outdoors dogs. Caval syndrome can develop with severe infection and physical heartworm removal is essential with heartworm burdens. In this study, we used an improved transvenous heartworm extraction brush, which was expected to cause less cardiovascular damage and allow easier manipulation.
Objectives:
This study aims to evaluate efficacy of this improved transvenous heartworm extraction brush.
Methods:
The brush was designed to improve upon the limitations of the previous brushtype devices. The brush was made of a polyvinyl chloride tube and threads of polyamides or polyglyconates. Metal material was inserted at the front tip for easy visualization under fluoroscopy. The eight dogs diagnosed with caval syndrome with large numbers of heartworms and pulmonary hypertension were used in this study. The removal procedure began with the dissection of the subcutaneous tissue around the right jugular vein. The device was inserted through the jugular vein. After insertion, the tube was rotated to catch the heartworms and extracted with the heartworms hanging on the threads. The procedure was repeated several times. Lastly, jugular vein and skin sutures were made. Adulticidal therapy was administered after heartworm removal.
Results:
The mean number of removed heartworms was 10.5 ± 4.24 and mean number of remaining heartworms was 0.63 ± 1.06. Total procedure time was 72.63 ± 51.36. Except for three cases, heartworms were not detected on ultrasonography after the procedure. No procedure-related side effects were observed within the 1- to 2-mon.
Conclusions
An improved transvenous heartworm extraction brush is efficient for heartworm removal in dogs with caval syndrome.
4.Ectopic insulinoma in a dog with insulin-induced hypoglycemia: a case report
Jiwon KIM ; Insun HWANG ; Danbee KWON ; Kanghyo PARK ; Hakyoung YOON
Journal of Veterinary Science 2023;24(3):e39-
A 7-year-old spayed female Shih Tzu dog was presented for evaluation of recurrent hypoglycemia. Serum insulin levels during hypoglycemia were 35.3 μIU/mL. Ultrasonography and computed tomography showed a mesenteric nodule between the kidney and the portal vein, but no pancreatic mass was observed. During surgery, the nodule had neither anatomical adhesions nor vascular connections to the pancreas. Pancreatic inspection and palpation revealed no abnormalities. Hypoglycemia improved after resection of the nodule.Histopathological examination confirmed the nodule to be an islet cell carcinoma. Although extremely rare, ectopic insulinoma should be considered as a possible cause of insulininduced hypoglycemia in dogs.
5.Chemoradiotherapy is not superior to radiotherapy alone after radical surgery for cervical cancer patients with intermediate-risk factor
Hakyoung KIM ; Won PARK ; Young Seok KIM ; Yeon Joo KIM
Journal of Gynecologic Oncology 2020;31(3):e35-
Objectives:
There is no consensus on whether giving adjuvant concurrent chemoradiotherapy (CCRT) is more effective than adjuvant radiotherapy (RT) alone in patients with early stage cervical cancer and intermediate-risk factor(s). The purpose of this study was to evaluate survival difference according to adjuvant treatment in the intermediate-risk group.
Methods:
From 2000 to 2014, the medical records of patients with stage IB–IIA cervical cancer and a history of radical hysterectomy with pelvic lymph node dissection, followed by pelvic RT at a dose ≥40 Gy were retrospectively reviewed. Among these, 316 patients with one or more intermediate-risk factor(s) and no high-risk factors were included. The criteria defined the intermediate-risk group as those patients with any of the following intermediate-risk factors: lymphovascular space involvement, over one-half stromal invasion, or tumor size ≥4 cm.
Results:
The median follow-up duration was 70 months (range: 3–203 months). According to adjuvant treatment (adjuvant RT alone vs. adjuvant CCRT), the 5-year recurrence-free survival rates (90.8% vs. 88.9%, p=0.631) and 5-year overall survival rates (95.9% vs. 91.0%, p=0.287) did not show a significant difference in patients with any of the intermediate-risk factors. In multivariate analysis, a distinct survival difference according to adjuvant treatment was not found regardless of the number of risk factors.
Conclusion
The present study showed that giving RT together with chemotherapy is not more effective than RT alone for stage IB–IIA cervical cancer patients with intermediate-risk factor(s).
6.Current status of remote collaborative care for hypertension in medically underserved areas
Seo Yeon BAIK ; Kyoung Min KIM ; Hakyoung PARK ; Jiwon SHINN ; Hun-Sung KIM
Cardiovascular Prevention and Pharmacotherapy 2024;6(1):33-39
Background:
Remote collaborative care (ReCC) is a legally recognized form of telehealth that facilitates communication between physicians. This study aimed to analyze the effectiveness of ReCC services and establish a foundation for the usefulness and effectiveness of ReCC.
Methods:
This retrospective cohort study utilized data from the Digital Healthcare Information System (DHIS) managed by the Korea Social Security Information Service. We extracted data on patients who were registered from January 2017 through September 2023 to investigate the effects of various factors.
Results:
A total of 10,407 individuals participated in the remote collaborative consultation service provided by the DHIS. Of these participants, those aged ≥80 years represented 39.2% (4,085 patients), while those aged 70 to 79 years comprised 36.9% (3,838 patients). The conditions treated included hypertension, affecting 69.2% (7,203 patients), and diabetes, affecting 21.1% (2,201 patients). Although various measurement items were recorded, most data beyond blood pressure readings were missing, posing a challenge for analysis. Notably, there was a significant reduction in blood pressure that was sustained at follow-up intervals of 1, 3, 6, and 12 months post-baseline (all P<0.05).
Conclusions
Owing to the lack of data, follow-up assessments for conditions other than hypertension proved to be challenging. Medical staff should increase their focus on and engagement with the system. Remote consultations have demonstrated efficacy in managing hypertension in medically underserved areas, where access to healthcare services is often limited. This suggests the potential for expanded use of remote chronic care in the future.
7.Can we omit prophylactic inguinal nodal irradiation in anal cancer patients?.
Hakyoung KIM ; Hee Chul PARK ; Jeong Il YU ; Doo Ho CHOI ; Yong Chan AHN ; Seung Tae KIM ; Joon Oh PARK ; Young Suk PARK ; Hee Cheol KIM
Radiation Oncology Journal 2015;33(2):83-88
PURPOSE: To evaluate the appropriateness of prophylactic inguinal nodal irradiation (PINI), we analyzed patterns of failure in anal cancer patients who were inguinal node-negative at presentation and did not receive PINI. MATERIALS AND METHODS: We retrospectively reviewed the records of 33 anal cancer patients treated by definitive concurrent chemoradiation therapy (CCRT) between 1994 and 2013. Radiotherapy consisted of a total dose of 44-45 Gy (22-25 fractions in 5 weeks) on the whole pelvis, anus, and perineum. Except inguinal lymphadenopathy was present at initial diagnosis, the entire inguinal chain was not included in the radiation field. In other words, there was no PINI. RESULTS: The median follow-up duration was 50 months (range, 4 to 218 months). Median survival and progression-free survival (PFS) were 57 months (range, 10 to 218 months) and 50 months (range, 4 to 218 months), respectively. Among the survival, the median follow-up duration was 51 months (range, 12 to 218 months). The 5-year overall survival and PFS rates were 93.4% and 88.8%, respectively. Although none of the patients received inguinal node irradiation for prophylactic purposes, there was no inguinal recurrence. CONCLUSION: Treatment of anal cancer by omitting PINI might be considered in selected patients with clinically uninvolved inguinal nodes.
Anal Canal
;
Anus Neoplasms*
;
Diagnosis
;
Disease-Free Survival
;
Follow-Up Studies
;
Humans
;
Lymph Nodes
;
Lymphatic Diseases
;
Pelvis
;
Perineum
;
Radiotherapy
;
Recurrence
;
Retrospective Studies
8.Can we omit prophylactic inguinal nodal irradiation in anal cancer patients?.
Hakyoung KIM ; Hee Chul PARK ; Jeong Il YU ; Doo Ho CHOI ; Yong Chan AHN ; Seung Tae KIM ; Joon Oh PARK ; Young Suk PARK ; Hee Cheol KIM
Radiation Oncology Journal 2015;33(2):83-88
PURPOSE: To evaluate the appropriateness of prophylactic inguinal nodal irradiation (PINI), we analyzed patterns of failure in anal cancer patients who were inguinal node-negative at presentation and did not receive PINI. MATERIALS AND METHODS: We retrospectively reviewed the records of 33 anal cancer patients treated by definitive concurrent chemoradiation therapy (CCRT) between 1994 and 2013. Radiotherapy consisted of a total dose of 44-45 Gy (22-25 fractions in 5 weeks) on the whole pelvis, anus, and perineum. Except inguinal lymphadenopathy was present at initial diagnosis, the entire inguinal chain was not included in the radiation field. In other words, there was no PINI. RESULTS: The median follow-up duration was 50 months (range, 4 to 218 months). Median survival and progression-free survival (PFS) were 57 months (range, 10 to 218 months) and 50 months (range, 4 to 218 months), respectively. Among the survival, the median follow-up duration was 51 months (range, 12 to 218 months). The 5-year overall survival and PFS rates were 93.4% and 88.8%, respectively. Although none of the patients received inguinal node irradiation for prophylactic purposes, there was no inguinal recurrence. CONCLUSION: Treatment of anal cancer by omitting PINI might be considered in selected patients with clinically uninvolved inguinal nodes.
Anal Canal
;
Anus Neoplasms*
;
Diagnosis
;
Disease-Free Survival
;
Follow-Up Studies
;
Humans
;
Lymph Nodes
;
Lymphatic Diseases
;
Pelvis
;
Perineum
;
Radiotherapy
;
Recurrence
;
Retrospective Studies
9.Awareness Analysis of the National Support Policy for Newborns and Infants With Hearing Loss Who Performed National Infant Health Checkup
Seok Hyun PARK ; Jeongho LEE ; Ky Young CHO ; Hakyoung KIM ; Jiwon CHANG ; Kyu Young CHOI ; Su-Kyoung PARK
Korean Journal of Otolaryngology - Head and Neck Surgery 2023;66(1):31-39
Background and Objectives:
It is well recognized that early detection and intervention are most important for the prevention of neonatal hearing loss. The national support policy in Korea for newborn hearing screening has been changed since October 2018; however, parent awareness of the change still needs to be increased. This study investigated how well parents, who have underwent national infant checkups of their children, were aware of the Korean national policy for neonatal and infant hearing loss in parents.Subjects and Method A survey of neonatal hearing tests and national support policies conducted for 353 parents was analyzed. The survey included questions about parent awareness of the neonatal hearing screening test period, confirmatory test period, national support for these expenses, and hearing aid support. Also evaluated were the necessity of national guidance and management system for neonatal hearing.
Results:
The test time of neonatal hearing screening was correctly recognized by 82.2% of the parents. The percentage increased after the national insurance coverage started in October 2018 in Korea, and the rate was higher for parents who visited an otolaryngology clinic rather than a pediatric clinic. The test time of the confirmatory test was correctly recognized only by 20.4%. National support policy for neonatal hearing screening tests, confirmatory hearing tests, and hearing aids were acknowledged by 50.7%, 43.1%, and 56.1% of the parents, respectively.
Conclusion
These results indicate the necessity of efforts to increase the awareness of neonatal hearing tests and relevant support policies in Korea to ultimately achieve early hearing detection and intervention of neonates and infants in Korea.
10.Effect of bathing on atopic dermatitis during the summer season
Hakyoung KIM ; Jeongsuk BAN ; Mi Ran PARK ; Do Soo KIM ; Hye Young KIM ; Youngshin HAN ; Kangmo AHN ; Jihyun KIM
Asia Pacific Allergy 2012;2(4):269-274
BACKGROUND: There are little objective data regarding the optimal practice methods of bathing, although bathing and the use of moisturizers are the most important facets to atopic dermatitis (AD) management. OBJECTIVE: We performed this study to evaluate the effect of bathing on AD. METHODS: Ninety-six children with AD were enrolled during the summer season. Parents were educated to bathe them once daily with mildly acidic cleansers, and to apply emollients for 14 days. Parents recorded the frequency of bathing and skin symptoms in a diary. Scoring AD (SCORAD) scores were measured at the initial and follow-up visits. Patients were divided into two groups, based on the compliance of bathing; poor compliance was defined as ≥ 2 bathless days. RESULTS: There was an improvement of SCORAD score, itching, and insomnia in the good compliance group (all p < 0.001). The mean change in SCORAD score from the baseline at the follow-up visit was greater in the good compliance group than the poor compliance group (p = 0.038). CONCLUSION: Daily bathing using weakly acidic syndets can reduce skin symptoms of pediatric AD during the summer season.
Baths
;
Child
;
Compliance
;
Dermatitis, Atopic
;
Detergents
;
Education
;
Emollients
;
Follow-Up Studies
;
Humans
;
Parents
;
Pruritus
;
Seasons
;
Skin
;
Skin Care
;
Sleep Initiation and Maintenance Disorders