BACKGROUND: Recently ethical problems such as sex discrimination, euthanasia, trade in organ transplantation, medical certificate, and doctors' prescription are in issue. Doctors believe that their ethical level is high, but their social reputation is not. The objective of this study was to find out how family physicians responded to ethical problems in a primary care field. METHODS: Information was obtained by questionnaire survey from 613 family physicians in Seoul & Kyunggi Province from Aug. to Sep. 1997. Overall respondents were 149 (24.3%). RESULTS: The rate of the family physicians who never performed defensive medical practice was 9.4%, seldom was 56.4%, sometimes was 26.8%, and frequently was 7.4%. The rate of the family physicians who never performed excessive medical practice was 38.3%, seldom was 31.5%, sometimes was 22.1%, and frequently was 8.1% respectively. The rate of those who received premium in purchasing medicine was 90.6%. They regarded registered nurses, aid nurses and other technicians as companions who had the same rights to doctors. 58.3% of the respondents answered that ethical level of themselves was above average compared to other people. 51.6% of the respondents answered that their ethical level was above average to other medical specialists. They agreed to artificial abortion in 57.7%, euthanasia in 65.1%, brain death in 87.9%, and in vitro fertilization in 74.5%. They disagreed to homosexuality in 79.2%, sex exchange surgery in 72.5%. CONCLUSION: Most family physicians answered that their ethical level was high, but they had difficulties in problems concerning excessive practice and the premium purchasing medicine.
Brain Death ; Surveys and Questionnaires ; Ethics, Medical ; Euthanasia ; Fertilization in Vitro ; Friends ; Gyeonggi-do ; Homosexuality ; Human Rights ; Humans ; Organ Transplantation ; Physicians, Family* ; Prescriptions ; Primary Health Care ; Seoul ; Sexism ; Specialization ; Transplants

Functional loss of the tumor suppressor gene p53 is one of the most frequently detected and diffusely distributed findings among human cancers. Their mutant protein products or point mutations can be detected through immunohistochemistry(IHC) or polymerase chain reaction and single stranded conformational polymorphism(PCR-SSCP). Evaluation of the DNA content of the tumor cell by flow cytometry(FCM) can provide indirect evidence of the functional loss of p53, because the spindle checkpoint in the mitotic phase depends on p53. To evaluate the correlation between p53 mutation and the status of lymph node metastasis or the histological grade of the tumor cell, IHC, SSCP, and FCM in the same tissue was performed from 43 patients of human breast cancer. The results obtained are as follows; 1. Functional loss of p53 was detected in 81.4% of the breast cancer cases by using triple tests and 58.1% at the cases by double test(IHC and SSCP). Positive rates by single test were 41.8% by IHC, 44.2% by SSCP, and 58.1% by FCM. 2. For breast carcinomas no correlation between lymph-node metastasis and the functional loss of p53 detected by IHC or SSCP. 3. The correlation between the functional loss of p53 detected by IHC or SSCP and the aneuploidy of the tumor cells was statistically significant. 4. The triple tests revealed a functional loss of p53 in all cases of grade III breast cancer.
Aneuploidy ; Breast Neoplasms* ; Breast* ; DNA* ; Genes, Tumor Suppressor ; Humans ; Lymph Nodes* ; Mutant Proteins ; Neoplasm Metastasis ; Ploidies* ; Point Mutation ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational

BACKGROUND/AIMS: The standard treatment for chronic hepatitis C patients infected with HCV genotype-2 is a combination of pegylated interferon alfa and ribavirin over a 24 week period. It is unclear if a shorter treatment duration is possible for patients showing a rapid virological response (RVR) without compromising the sustained virologic response (SVR) in Korea. METHODS: 42 patients chronically infected with the HCV genotype-2 were treated with peginterferon alfa-2a 180 mcg/wk plus ribavirin 800 mg/d for 24 weeks and followed up for 24 weeks. The HCV RNA was qualitatively assessed after 4 weeks of treatment, and RVR was defined as undetectable HCV RNA at the 4th week. Retrospectively, 26 patients were treated with the standard treatment strategy (> or =80% of the intended duration and dosage), 14 patients with a short-term treatment strategy (<80% intended duration and dosage) and 2 patients were excluded. RESULTS: Among the 42 patients, 35 patients (83%) had RVR and 38 patients (90%) had a sustained virologic response (SVR). All 7 patients without RVR were treated with the standard treatment strategy, in whom 6 patients (86%) had SVR. Among the 35 patients with RVR, 14 patients were treated with short-term treatment and 19 patients were treated with the standard treatment. SVR was obtained in 12 out of the 14 patients (86%) in the short-term treatment group and 18 out of the 19 (95%) in the standard treatment group (P=0.373). CONCLUSION: HCV genotype-2 patients who have RVR with peginterferon and ribavirin treatment can be treated with a short-term treatment without compromising the chances for SVR. However, an additional trial will be needed to optimize the treatment duration.
Adolescent ; Adult ; Aged ; Antiviral Agents/*administration & dosage/therapeutic use ; Data Interpretation, Statistical ; Drug Therapy, Combination ; Female ; Genotype ; Hepacivirus/genetics ; Hepatitis C, Chronic/*drug therapy ; Humans ; Interferon Alfa-2a/*administration & dosage/therapeutic use ; Male ; Middle Aged ; Polyethylene Glycols/*administration & dosage/therapeutic use ; Retrospective Studies ; Ribavirin/*administration & dosage/therapeutic use ; Time Factors ; Treatment Outcome