According to the advance of antiretroviral regimen and the early treatment strategy, people living with human immunodeficiency virus (PLWH) are achieving the goal of virologic suppression and immune restoration. Most of them no more die of acquired immunodeficiency syndrome (AIDS) defining illnesses, and become older with chronic comorbidities such as cardiovascular, metabolic, hepatic, renal and neurological diseases. However some PLWH still visit hospitals as late presenters with very low CD4+ T cell counts, so that they suffer AIDS defining illnesses to die or experience severe neurological complications resulting in disabilities. Early palliative interventions are needed on the various symptoms of PLWH. Thus far chronic pains such as distal symmetric sensory polyneuropathies have been underevaluated. Active pain-relieving interventions are important to them. Recently we define end of life condition of human immunodeficiency virus (HIV) or eligibility to hospice care after adjusting current status of HIV treatment. Hospice teams should pay attention to the specific medical conditions, psychological needs, and social circumstances of PLWH. With just standard precautions as common infection control measures, general hospice cares can be provided to them like to other hospices subjects. For giving PLWH opportunities to have the end of life with value and dignity, hospice multidisciplinary team should intervene them early and aggressively. Now we need more clinical experiences and institutional improvements.
Acquired Immunodeficiency Syndrome ; Cell Count ; Chronic Pain ; Comorbidity ; HIV* ; Hospice Care ; Hospices* ; Infection Control ; Palliative Care* ; Polyneuropathies

No abstract available.
Adenoids* ; Carcinoma, Adenoid Cystic* ; Trachea*

No abstract available.
Takayasu Arteritis*

Since the introduction of effective antiretroviral therapy (ART) in the late 1990s, the prognosis for people living with human immunodeficiency virus (HIV) (PLWH) has dramatically improved. High-income countries like South Korea have had rapid declines in HIV-related deaths. Scientific advancements including pre-exposure prophylaxis (PrEP) and “undetectable equals untransmittable (U = U)” knowledge have contributed progress towards the goal of ending the acquired immune deficiency syndrome epidemic by 2030. However, the application of these advancements has been limited in South Korea. Evidence shows that HIV-related stigma and discrimination in healthcare settings remain strong in this region.We review key principles for stigma reduction and people-centered approaches in the era of U = U and identify three priorities: 1) immediate intervention in HIV stigma drivers in healthcare settings; 2) social stigma reduction on multiple levels; and 3) collaboration with key populations.

Individuals living with human immunodeficiency virus (HIV) encounter challenges throughout the care continuum, right from the time of diagnosis to the culmination of the treatment process.Current Concepts: The Republic of Korea, like many other countries, has been addressing the needs of people living with HIV (PLWH) by providing financial support for medical expenditures. Currently, HIV counseling specialist nurses offer psychological support at 28 institutions, assisting patients in maintaining viral suppression state and adhering to antiretroviral therapy. Care and welfare services are also provided by non-governmental organizations funded by the Korean Disease Control and Prevention Agency (KDCA). The accessibility of medical institutions for PLWH has seen gradual improvement, with KDCA issuing guidelines for healthcare facilities catering to this population. In addition, the legal and medical insurance coverage issues related to long-term care institutionalization have been addressed. However, PLWH continues to face challenges in treatment and hospitalization, especially with a recent increase in immigrant PLWH, highlighting a lack of support for undocumented immigrants seeking treatment.Discussion and Conclusion: Healthcare policies are shifting from merely managing, isolating, and treating PLWH to prioritizing their human rights. Going forward, it is imperative to empower PLWH and support their self-care efforts.

BACKGROUND: On previous reports, the incidence of hepatitis C in Korean leprous patients is too high (55.6~69%). We investigated the percentage of the leprous patients with hepatitis C, genotypes, and risk factors in National Sorokdo Hospital. METHODS: Out of total 714 leprous patients in National Sorokdo Hospital, 147 selected risky patients (with abnormal AST/ALT, platelet Blood Transfusion ; Female ; Genotype* ; Hepacivirus ; Hepatitis C* ; Hepatitis* ; Humans ; Incidence ; Leprosy ; Leprosy, Lepromatous ; Leprosy, Tuberculoid ; Male ; Risk Factors* ; Tattooing

A rare case of intradural cerebellar vermian schwannoma has been reported. A 43 years old woman admitted to our hospital because of headache and weakness of upper extremities. CT brain scan showed an irregular lower density with intermixed high density at the middle posterior fossa, and large lower density with peripheral irregular thickness of rim enhancement after contrast media. CT cervical spine showed a lower density with displaced cord to the right side on the dorsal surface at C1 portion. Total enucleation of irregular brownish-gray large cystic mass resulted in uneventful recovery. There was no attachment to any nerve root.
Adult ; Brain ; Contrast Media ; Female ; Headache ; Humans ; Neurilemmoma* ; Spine ; Upper Extremity

Physicians who have defected from North Korea and settled in South Korea (North Korean defector physicians, NKDPs) have experienced hardship in the occupational integration process due to their low socio-economic status, lack of information, and differences in medicosocial cultures, English-based medical terminology, and the clinical knowledge gap between North and South Korea. Here, we review the relevant literature on the credentialing process for former Soviet physicians in Israel. We present empirical findings regarding the ongoing educational experience of NKDPs preparing for the Korean national medical licensing examination. The approval process from the National Health Personnel Licensing Examination Board for NKDPs to sit for the national medical licensing examination under the current licensing system needs more objective credentialing criteria. Systematic and sustained supportive plans are needed for educating NKPDs to prepare for the licensing examination. Securing additional internships and residencies is needed for further sustained training of NKDPs after certification. A continuing medical education program can address the needs of those who have not completed a residency program for primary care and improve quality of care. We hope more extensive discussion will take place on the credentialing and integration of NKPDs following a policy of engagement from the perspective of human resource building and partnership for unification of the medical system between South and North Korea.
Certification ; Credentialing ; Democratic People's Republic of Korea ; Education, Medical, Continuing ; Health Personnel ; Humans ; Hypogonadism ; Internship and Residency ; Israel ; Licensure ; Mitochondrial Diseases ; Ophthalmoplegia ; Primary Health Care ; Refugees ; Republic of Korea

PURPOSE: This study was performed to evaluate the relation between nodal micrometastasis and tumor angiogenesis, and to assess potential molecular markers pertaining to the development of nodal micrometastasis. MATERIALS AND METHODS: Immunohistochemical studies were performed to evaluate the expression patterns of Phosphatase, and its Tensin homolog, deleted from chromosome TEN (PTEN), and the vascular endothelial growth factor (VEGF) and microvessel density (MVD) in 41 stage I non-small cell lung cancer (NSCLC), using anti-PTEN monoclonal, anti-VEGF polyclonal and anti-CD34 monoclonal antibodies, respectively. The occult micrometastasis in 503 dissected regional lymph nodes were also evaluated using anti-cytokeratin (CK) monoclonal antibody. RESULTS: CK positive cells were identified in 13 (31.7%) of the 41 cases and in 23 (4.6%) of the 503 lymph nodes. There were 19 and 22 cases with positive and negative VEGF expressions, respectively, and 10 (52.7%) and 3 (13.6%) of these, respectively, showed nodal micrometastasis (p<0.05). There were 9 cases with loss of PTEN expression, and 4 of these showed nodal micrometastasis, whereas 9 (21.8%) of 32 positive PTEN expression cases showed nodal micrometastasis (p<0.05). The MVD in the tumors with nodal micrometastasis was 60.4+/-22.6, whereas that in the tumors without nodal micrometastasis was 52.0+/-18.2. The loss of PTEN expression, an increased VEGF expression and a high MVD, within primary tumors, were significantly associated with nodal micrometastasis. CONCLUSION: The results indicate a possible value in using these biological markers, associated with tumor angiogenesis, for predicting the risk of nodal micrometastasis in NSCLC.
Antibodies, Monoclonal ; Biomarkers ; Carcinoma, Non-Small-Cell Lung* ; Humans ; Lymph Nodes* ; Microvessels ; Neoplasm Micrometastasis* ; Vascular Endothelial Growth Factor A

BACKGROUND: This study was performed to examine the significance of the circumferential resection margin (CRM) involvement by a tumor on the postoperative survival after esophageal cancer surgery. METHODS: Fifty nine resected cases of esophageal cancers were retrospectively reviewed. The presence of a tumor either at, or within 1 mm of, the CRM was recorded. By an immunohistochemical study for Ki-67, the Ki-67 differential grades (Ki-67 DG) were defined according to the differences between the Ki-67 labeling indices of the central and of peripheral areas of the tumor nearest to the CRM: Ki-67 DG 0 (< or =10%) and Ki-67 DG 1 (>10%). The CRM involvement was correlated with the clinicopathological factors, Ki-67 DG and survival data. RESULTS: CRM involvement was found in 26 (44.1%) of the 59 cases. There were significant differences in the cases, both with and without CRM involvement of tumor cells, in relation to lymph node metastasis, lymphovascular, perineural invasions and tumor stage (p<0.05). Ten (38.3%) of the 26 with, and 3 (9.1%) of 33 cases without, CRM involvement, showed Ki-67 DG 1 (p=0.007). The 3-year survivals of patients with and without CRM involvement were 26.8 and 61.8%, respectively (p=0.003). CONCLUSIONS: These results show that the CRM involvement status may be used as a predictor of survival after esophageal cancer surgery, and CRM involvement is more an indicator of an advanced disease than of an incomplete resection.
Esophageal Neoplasms* ; Esophagectomy* ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies