No abstract available.
Education, Medical* ; Evidence-Based Medicine*

Why should physicians be ethical? First of all, it is one of the categorical imperatives (golden rules) to be an ethical person. So as a human being, all physicians should endeavor to be an ethical member of the society. However, there is another important reason for physicians to be ethical, more ethical than any other members of the society. Medicine, the so-called learned profession, is defined by the knowledge held by their members and by the application of that knowledge to the needs of fellow citizens. The relationship between physicians and patients can only be secured when physicians succeed in obtaining trust from the public. Society will accept the professional autonomy and monopoly market power held by the medical organization only if the organization shows continuing effort of self-regulation according to their strict code of ethics. At now, physicians are facing a powerful challenge from the modern society that denies professional authority and stresses independence and self-sufficiency of individual social members. There is a clear tendency that modern society no longer sees medicine as a benevolent help by the paternalistic physicians to the patients in need but as a mere trade between providers and consumers. Any unethical behavior of physicians may justify the intrusion by the third party into the traditional doctor-patient relationship in the name of fair trade. In this sense, ethics of physicians may be the best policy to defend the long tradition of Hippocratic medicine.
Codes of Ethics ; Ethics* ; Humans ; Paternalism ; Professional Autonomy ; Self-Control

No abstract available.
Violence*

No abstract available.
Child* ; Humans ; Peak Expiratory Flow Rate*

The implementation of the PBL curriculum is now a mandate not a choice. However, for the established schools with large numbers of students and insufficient resources, the whole-scale conversion from traditional curriculum to PBL is almost impossible. Various alternative curricula have been introduced to many institutions, but they all have more or less shortcomings that impede the advantages of PBL approach. To solve this dilemma, I proposed a new alternative PBL curriculum, the 'Triple-phase PBL Curriculum', which is consisted with pre-PBL, PBL, and Post-PBL phase. I also explained its rationale and advantages over other alternatives.
Curriculum ; Humans ; Problem-Based Learning* ; Schools, Medical*

BACKGROUND: After the development of the Q-switched lasers, it was possible to remove tattoos without causing scarring. Currently, Q-switched ruby lasers, Q-switched Nd: YAG lasers and Q-switched alexandrite lasers are used selectively to treat tattoos. The objective of this study was to determine the difference of effectiveness aceording to color, site and duration in removing tattoo pigments by the alexandrite laser. MATERIALS AND METHODS: 30 tattoos were treated with a Q-switched alexandrite laser(model IL-l, Candela Laser Corporation. Wayland. U.S.A.). Pretreatment evaluation included a clinical desrviption of the site, color, duration and photographs were taken. The effects were examined by fether photo graphs and telephone follow-up. The response was expressed as the percentage area cleared of the tattoo. The clearance was graded as follows: clear, >95%; excellent, 76-95%; good, 51-75%; fair, 26-50%; poor < 25%. The occurence of adverse events were also examined. RESULTS: 1""he results are summarized as follows: 1. Treatment with fluences that ranged from 6.0-8.0J/cm2 was given on average 1.7 times and better results were achived than expected in 80% of all patients with tattoo. 2. The effectiveness of laser therapy correlated with the number of treatments. 3. After 1 laser session, tattoos of black and darkblue showed better results than light blue in terms of color. 4. After 1 laser session, the sites of tattoos on upper extremitise showed better results than those of the eyebmw, eyeline and face. 5. Differences in duration after 1 laser session were not seen. 6. Hyperpigmentation in 2 cases and bulla formation in 1 case occurred and all complications had ceased after a few months. CONCLUSION: The alexandrite laser is an effective treatment for cosmetic, general and traumatic tattoos with a low incidence of significant adverse effects and provides excellent cosmetic results.
Cicatrix ; Follow-Up Studies ; Humans ; Hyperpigmentation ; Incidence ; Laser Therapy ; Lasers, Solid-State* ; Telephone

No abstract available.
Education, Medical* ; Internationality*

Breast cancer is one of the leading causes of death attributable to cancer in women. In view of the limitations of conventional predictable factors of the breast cancer, additional second-generation parameters would be valuable in selecting the patients who would be most likely to be beneficial from adjuvant therapy and breast reconstruction. The author investigated the HER2/neu gene amplification and the number of chromosome 17 in 39 cases of paraffin embedded breast cancer tissues, 20 cases without lymph node metastasis and 19 cases with lymph node metastasis, using fluorescent in situ hybridization(FISH) and compared the results with HER2/neu and p 53 protein expression detected by immunohistochemical method. Eleven cases fibroadenoma were used as benign tumor control. Numerical aberrations of chromosome 17 were found in 17 out 39 breast cancer cases (44%)(monosomy in 10 cases, 26%; trisomy in 3 cases, 8%; tetrasomy in 3 cases, 8%; polysomy in 1 case ,3%), and the frequency of each type aberration was not significantly different between the negative and positive groups in lymph node metastasis. Monosomy of chromosome 17 was found in 2 out of 11(12%) fibroadenoma cases. HER2/neu gene amplification was found in 8 out of 39 cases (19%) and other 2 cases revealed HER2/neu gene amplification in lymph node metastatic tumor only, not in original tumor. Fourteen out of 19 cases of breast cancer with lymph metastasis showed HER2/neu protein expression both in original and metastatic tumors. All of the six cases showing HER2/neu gene amplification in original and/or metastatic tumor revealed HER2/neu protein expression. The frequency of HER2/neu gene amplification in the 39 breast cancer cases was not different between metastatic and non-metastatic groups(p= 0.284). However, HER2/neu protein expression was increased significantly in the metastatic group(p=0.028). None of the 11 fibroadenoma cases revealed HER2/neu gene amplification or HER2/ neu protein expression. Nine out of 19 cases of breast cancer with lymph node metastasis showed p 53 protein accumulation in original tumor(47%), but 3 of them revealed p 53 protein accumulation only in original tumor. The frequency of p 53 protein accumulation was not significantly different between metastatic and non-metastatic groups. None of the 11 fibroadenoma cases revealed p 53 protein accumulation. In conclusion, there are no differences between the lymph node metastatic group and non-metastatic groups in numerical aberrations of the chromosome 17 , amplification of the HER2/neu gene expression and accumulation of the p 53 protein in breast cancer. However, the HER2/neu protein expression was increased significantly in lymph node metastatic group, so it could be one of the predictors of the metastasis in breast cancer.
Breast Neoplasms* ; Breast* ; Cause of Death ; Chromosomes, Human, Pair 17* ; Female ; Fibroadenoma ; Gene Amplification* ; Gene Expression ; Humans ; Lymph Nodes ; Mammaplasty ; Monosomy ; Neoplasm Metastasis ; Paraffin ; Tetrasomy ; Trisomy

For the evaluation of the 51Cr labelled in-vivo crossmatching test as a transfusion safety test, We examined the viability of the thransfused autologous and heterologous 51Cr labelled red cell at 1 hour and 24 hour in 6 normal volunteers and 4 patients whose RBC had been stored in CPDA-1 media from 1 day to 30 day. In both autologous transfusion control group(n=3) and allogeneic transfusion control group(n=3), the in-vivo RBC survival rate were more than 70% at 1 hour and 24 hour compared to that of basal 3 minute result(percent counted as 100%), and the eluted free radioisotope activity was less than 5% compared to that of whole blood. The crossmatch incompatible patient group also satisfied the safe transfusion criteria. The mean labelling efficiency which was tested in three patients was more than 95% and also satisfactory to reliable test. We concluded that in-vivo crossmatching test using 51Cr radioisotope would give us valuable informations about transfusion safety, especially in serologically incompatible patients.
Healthy Volunteers ; Humans ; Survival Rate

No abstract available.
Frontal Sinus*