Unlike medical students, doctors-in-training (residents) are physicians who can legally provide medical treatment with a medical doctor's license obtained from Korea the Ministry of Health and Welfare, and thus they are liable for the care they provide. Therefore, residents need to be aware of the legal and risks they facing in medical practice and ensure that they have the ability to deal with such risks. Legal responsibilities of residents can be examined from three perspectives: the relationships between patients and doctors, the relationships between doctors and medical officials, and the Korean health and welfare system. With regard to the relationships between patients and doctors, the legal responsibilities of doctors-in-training span a diverse range of liability for explanation (informed consent), malpractice, medical records, prohibition on revealing medical secrets, emergency medical treatment, treatment for the opposite sex, and other basic responsibilities. They will be liable for any damage caused under Article 268 of the Criminal Code, which addresses the crime of professional negligence resulting in injury or in death, and Article 750 of the Civil Code, which addresses torts liability, and above and beyond them of legal liability in general. With regard to the relationships between doctors and medical officials, the legal responsibilities can be classified into two types of relationships. One is between a doctor and a senior doctor, and the other is between a doctor and a doctor from a different medical specialization. it there is miscommunication between two or more doctors, it could lead to poor outcomes for patients. Regarding the health and welfare system, the issuance of medical licenses and the duty of notification are the most important legal responsibilities. The system's treatment of residents require special caution as issuance of falsified medical licenses has caused serious social problems. Laws that state the various notification duties allow no exceptions even for the residents. Residints should therefore understand the basic notification duties involved in cases of accidental death, child abuse, and etc. and prepare for contingencies.
Child ; Child Abuse ; Crime ; Criminals ; Dietary Sucrose ; Dissent and Disputes ; Emergencies ; Humans ; Jurisprudence ; Korea ; Liability, Legal ; Licensure ; Malpractice ; Medical Records ; Social Problems ; Students, Medical

PURPOSE: The purpose of this study was to test the effects of a forgiveness therapy program to improve self-esteem, anger and forgiveness in people who abuse alcohol. METHODS: A non-equivalent control group pre-posttest design was employed. Participants were 38 people who abuse alcohol and who agreed to participate in this study. They were assigned to the experimental group in Alcoholics Anonymous meetings of J hospital(n=19) and the control group in Alcoholics Anonymous meetings of B hospital(n=19). The eight session program was provided once a week for 8 weeks. The data were analyzed using percentage, chi2-test, Kolmogorov - Smirnov test, and t-test with SPSS 21.0 program. RESULTS: The results showed significant decrease in state anger and increase in self-esteem and forgiveness in the experimental group compared to the control group. CONCLUSION: The findings show that forgiveness therapy program has a positive effect on self-esteem, anger, and forgiveness of people who abuse alcohol but further studies will be needed in order to determine the long term effects of an extended integrated program on rehabilitation of these people.
Alcoholics ; Alcoholics Anonymous ; Anger* ; Forgiveness* ; Humans ; Rehabilitation

For orthodontic tooth movement, optimal orthodontic force should be maintained without periodontal breakdown and alveolar bone should be remodeled physiologically. Therefore, To obtain proper occlusion through tooth movement within alveolar bone, we should know the biomechanics of teeth and supporting tissues. The present study was performed to observe histologic changes of periodontal tissue immediately after application of orthodontic force and during the retention period in growing young adult dogs. In this study, experimental group contained between mandibular left canie and 1st molar and control group contained contralateral teeth of same animal. The .018"x.22" stainless steel closed coil spring(Dentaurum Co.) was ligated on the experimental teeth at initial 200gm-force from mandibular canine to 1st molar. The animals(4 to 6 months aged young adult dogs) were sacrificed on 0, 14, 28 days after the finish of appliance activation, and then tissue samples were divided into hematoxylin-eosin(HE) staining section, ground section, alkaline phosphatase(ALP) staining section, and tartrate-resistant acid phosphatase(TRAP) staining section. Thereafter, the preparations were examined under light microsopy. The following results were obtained: 1. Immediately after the finish of appliance activation, the periodontal space was increased in tension side, but decreased in pressure side compared to that of control. The hyalinized zone was also observed in the periodontium. 2. After the 14-day retention, periodontal space was decreased in tension side and slightly increased in pressure side compared to that of immediately after the finish of appliance activation. The hyalinized zone was repaired and a few osteoblasts showing slightly new bone formation were seen. Osteoblasts were scarcely observed along the alveolar bone. 3. After the 28-day retention, the periodontal fibers are normally repaired. A lot of TRAP(+) osteoclasts and increased alveolar bone resorption were observed in pressure side, and AP(+) osteoblast and increased new bone formation were observed in tension side.
Animals ; Bone Resorption ; Dogs* ; Humans ; Hyalin ; Molar ; Osteoblasts ; Osteoclasts ; Osteogenesis ; Periodontium ; Stainless Steel ; Tooth Movement* ; Tooth* ; Young Adult*

PURPOSE: The purpose of this study was to investigate the effects of constraint-induced (CI) movement using self-efficacy on U/E function of chronic hemiplegic patients. CI movement discourages the use of the unaffected U/E, combined with intensive training of the affected U/E. METHOD: A non-equivalent pretest-posttest design was used. Study subjects were 40 hemiplegic patients conveniently selected from 2 different community health centers. The experimental subjects participated in the CI movement program for 6 hours daily over a period of two weeks. The exercises for affected U/E consisted of warming up, main exercise and ADL practice. To encourage the participants' behaviors self-efficacy enhancing strategies were used, which included performance accomplishment, vicarious experience, verbal persuasion and emotional arousal. RESULT: After 2 weeks of treatment, the grip power, pinch power, wrist flexion/extension, elbow flexion, and shoulder flexion/extension were significantly higher in the experimental subjects than in the control subjects. However, there was no significant difference in hand functions of the two groups. CONCLUSION: The above results show that the constraint-induced movement using self-efficacy could be an effective nursing intervention for improving U/E function of chronic hemiplegic patients. Long term studies are needed to determine the lasting effects of constraint-induced movement.
Adult ; Aged ; Exercise Therapy/*methods ; Female ; Hemiplegia/*rehabilitation ; Humans ; Male ; Middle Aged ; Motor Skills ; Self Efficacy ; Treatment Outcome ; *Upper Extremity

Cervical disc replacement (CDR) has emerged as an alternative surgical option to cervical arthrodesis. With increasing numbers of patients and longer follow-ups, complications related to the device and/or aging spine are growing, leaving us with a new challenge in the management and surgical revision of CDR. The purpose of this study is to review the current literature regarding reoperations following CDR and to discuss about the approaches and solutions for the current and future potential complications associated with CDR. The published rates of reoperation (mean, 1.0%; range, 0%-3.1%), revision (mean, 0.2%; range, 0%-0.5%), and removal (mean, 1.2%; range, 0%-1.9%) following CDR are low and comparable to the published rates of reoperation (mean, 1.7%; range; 0%-3.4%), revision (mean, 1.5%; range, 0%-4.7%), and removal (mean, 2.0%; range, 0%-3.4%) following cervical arthrodesis. The surgical interventions following CDR range from the repositioning to explantation followed by fusion or the reimplantation to posterior foraminotomy or fusion. Strict patient selection, careful preoperative radiographic review and surgical planning, as well as surgical technique may reduce adverse events and the need for future intervention. Minimal literature and no guidelines exist for the approaches and techniques in revision and for the removal of implants following CDR. Adherence to strict indications and precise surgical technique may reduce the number of reoperations, revisions, and removals following CDR. Long-term follow-up studies are needed, assessing the implant survivorship and its effect on the revision and removal rates.
Aging ; Arthrodesis ; Arthroplasty ; Foraminotomy ; Humans ; Intervertebral Disc ; Patient Selection ; Reoperation ; Replantation ; Spine ; Survival Rate

Collagen induced arthritis (CIA)is an animal model that in many ways resembles rheumatoid arthritis (RA). CIA can be induced in susceptible animals by immunization with type II collagen (CII). Like RA,CIA is characterized by intense joint inflammation and destruction.On histological examination,there is synovitis accompanied by erosion of cartilage and subchondral bone. Autoanti-bodies to CII initiate joint inflammation by binding to articular cartilage,forming antigen-antibody complexes locally and activating hemolytic complement. Susceptibility to CIA in mice is linked to the expression of specific class II MHC Molecules,which dictate the T cell determinants on CII,and therefore,the subsets of T cells that can be activated by CII.In addition to activation of B cells reactive to CII,the T cells stimulate monocytes/macrophages.These cells amplify the inflammatory cascade by secretion of proinflammatory monokines, including TNF-alpha and IL-1,leading to the production of other proinflammatory proteins,including matrix metalloproteinases (MMPs).The importance of CIA lies in its possible relationship to arthritis in humans.Progress in understanding CIA has contributed to the development of new therapies for RA.In addition,it has been found that mice with human HLA-DR1,DR4 and HLA-DQ8 transgenes,which have been demonstrated to be the susceptibility markers for RA, confer susceptibility to CIA.These observations coupled with the finding of T cells and B cells reactive with CII in the inflamed joints of RA patients establish the potential role of CII autoimmunity in the pathogenesis of RA.
Animals ; Antigen-Antibody Complex ; Arthritis ; Arthritis, Experimental* ; Arthritis, Rheumatoid* ; Autoimmunity* ; B-Lymphocytes ; Cartilage ; Collagen ; Collagen Type II* ; Complement System Proteins ; Humans ; Immunization ; Inflammation ; Joints ; Matrix Metalloproteinases ; Mice ; Models, Animal ; Monokines ; Synovitis ; T-Lymphocytes ; Tumor Necrosis Factor-alpha

PURPOSE: To report a case of bleb dysesthesia successfully treated after Baerveldt tube implantation. CASE SUMMARY: A 37-year-old woman presented with a history of persistent foreign body sensation and pain in the left eye. The patient was referred to our hospital and was diagnosed as having had plateau iris syndrome. Having shown no improvement with conservative management, she eventually received trabeculectomy in the left eye six months prior to her current presentation. Under the impression of bleb dysesthesia, she received artificial tears and a bandage contact lens. These, however, failed to alleviate her symptoms. She then had a compression suture of the bleb and bleb revision. These were performed sequentially but neither was effective. Finally, a Baerveldt tube implantation was performed successfully, and, three months later, bleb revision was performed using a donor sclera, which resulted in no further complaint of ocular discomfort. CONCLUSIONS: Bleb dysesthesia, although not a common postoperative complication, can occur after trabeculectomy and can be successfully treated with Baerveldt tube implantation. Patients should receive appropriate counseling and advice on bleb dysesthesia prior to undergoing trabeculectomy.
Adult ; Bandages ; Blister ; Counseling ; Eye ; Female ; Foreign Bodies ; Humans ; Iris ; Ophthalmic Solutions ; Paresthesia ; Postoperative Complications ; Sclera ; Sensation ; Sutures ; Tissue Donors ; Trabeculectomy

Non-operative management has been preferred in blunt spleen injury. Moreover children are more susceptible to post-splenectomy infection, spleen should be preserved if possible. However, splenectomy is inevitable to patients with severe splenic injury. Therefore splenic autotransplantation could be the last chance for preserving splenic function in these patients although efficacy has not proven. Here we reported four cases of children who were underwent splenic autotransplantation successfully after blunt trauma.

OBJECTIVE: The cognitive, Affective, and Somatic Empathy Scale (CASES) suggests novel three components structure of empathy. Although CASES developed to assess the trait empathy of both children and adult, the validation in adult sample is not yet conducted. This study developed Korean version of CASES (CASES-K) and examined the psychometric properties in young adult for first time. METHODS: Confirmatory factor analysis was conducted to test whether the factor structure suggested in initial development study is valid in Korean young adult population. 350 young adults participated, and 44 of them also answered to other empathy scales for validation. The construct validity was ascertained through a series of correlational analysis with widely used trait empathy scales. RESULTS: The result of confirmatory factor analysis supports the three-factor model of empathy consists of affective, cognitive and somatic facets. The construct validity was ascertained through a series of correlational analysis with widely used trait empathy scales. The result of correlational analysis supports the validity of CASES-K, and especially the separation of somatic empathy from affective empathy. CONCLUSION: The current study provides the first evidence of the validity and utility of the CASES-K in young adult population. The result also supports the commonality of three factor structure of empathy in both East Asian and Caucasian, from the children to adults.
Adult ; Asian Continental Ancestry Group ; Child ; Empathy ; Humans ; Psychometrics ; Weights and Measures ; Young Adult

PURPOSE: A new unmatched type-O packed red blood cell (UORBC) storage system was established in Ajou University Hospital Trauma Center. This system was expected to deliver faster and more efficient transfusion. METHODS: On March 2016, a new blood storage bank was installed in the trauma bay. Sixty patients who received UORBC from March 2016 to August 2016 were compared with 50 traumatic shock patients who received transfusions at the trauma bay in 2015. Time of transfusion, mortality, adverse transfusion reaction and change of systolic blood pressure were reviewed. RESULTS: Transfusion time from arrival at the hospital was significantly shorter in 2016 (14.07±11.14 min vs. 34.72±15.17 min, p < 0.001), but 24-hour mortality was not significantly different (13.3% vs. 20.8%, p=0.292). Systolic blood pressure significantly increased after UORBC transfusion (92.49 mmHg to 107.15 mmHg, p=0.002). Of the 60 patients who received UORBC in trauma bay, 47 (78.3%) patients had an incompatible ABO type, but no adverse transfusion reaction was notated. CONCLUSION: UORBC allows early blood transfusion and improved systolic blood pressure without significant adverse reactions.
ABO Blood-Group System ; Bays ; Blood Pressure ; Blood Transfusion ; Erythrocyte Transfusion* ; Erythrocytes* ; Humans ; Mortality ; Shock* ; Shock, Traumatic ; Transfusion Reaction ; Trauma Centers