Background: Many countries need help with the problem of an unbalanced distribution of physicians and hospitals. Moreover, various policies and strategies have been proposed to solve this problem. This study aimed to examine the determinants of the unbalanced distribution of physicians. Methods: From the 2020 Korean Physician Survey data, 4,181 physicians practicing in Korea were limited to the subjects of the study. We analyzed the factors influencing physicians’ choice of practice location and their willingness to change their practice location from an urban to a rural area. Results: The region of physicians’ hometown, medical school, and residency training hospitals determined their choice of practice location. The type of affiliated healthcare organization and the location of physicians’ hometown, medical school, and residency training hospitals affected their willingness to change their practice location from an urban to a rural area. Furthermore, the concordance rate of the regions of physicians’ hometown, medical school, and residency training hospitals with the region of their practice location was 24.9%. Conclusion In South Korea, policies for doctors have been designed without considering why they are reluctant to work in rural hospitals. To have a balanced distribution of physicians and hospitals, it is necessary to accurately analyze the status of medical resources based on regions and identify the current and future medical demand. The social situation, such as future demographic change and regional extinction, must also be fully considered. Furthermore, policies should be implemented that encourage physicians to work in rural hospitals.

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Background: A bill for the mandatory installation of closed-circuit television (CCTV) in operating rooms, still likely in breach of the constitution, was approved. When a bill infringing on individuals’ fundamental rights is drafted, alternative means of minimizing the infringement of the offender’s rights should be considered ahead of the draft. To this end, alternatives on the bill identified through the consciousness of the offender would be most realistic and much more effective. Thus, this study examined doctors’ consciousness on the mandatory installation of CCTV in operating rooms, the appropriateness of punishment for members who commit immoral and unethical behaviors, and doctors’ alternative ideas to CCTV installation in operating rooms. Methods: The online survey was conducted for a week from July 9, 2021, to July 16, 2021, by the Korean Medical Association Doctors News, and 2,345 doctor members responded to the investigation. Results: According to the survey, the following alternatives to CCTV installation in operating rooms were proposed: strengthening punishment for performing ghost surgery (38.3%), placing cameras at the entrance of the operating room (21.8%), mandatory written consent (pledge) (13.7%) to prevent ghost surgery for medical staff participating in the surgery, promoting self-purification (whistle-blowing) (11.5%), and a biometrics function for entering operating rooms (8.8%). Conclusion The revised medical law delegated legislative devices to subordinate statutes for minimizing infringement. Thus, new regulations should be set to reduce infringement of fundamental rights. It is hoped that doctors’ consciousness on new law could be preliminary data to regulate new rules in discussing lower statutes.

Background: On September 25, 2023, the law requiring the mandatory installation and operation of closed circuit television (CCTV) in the operating room went into effect. In this study, doctors’ perceptions of the law were re-examined on September 23, 2023 (just prior to the law’s enforcement), following a survey conducted on July 21, 2021 (before the re-examination of the bill). This study aimed to confirm doctors’ perceptions of the infringement of fundamental rights of this law, the collapse of essential medical services due to the avoidance of surgery, and other concerns and priority solutions ahead of the law’s enforcement. Methods: The survey was conducted from 8 to 18 September, 2023, by the Korean Medical Association Doctor Survey; a total of 1,267 doctors responded to the survey. Results: Out of 1,267 respondents, 1,156 (91.2%) said “yes,” and 111 (8.8%) said “no” to issue concerning constitutional violations of fundamental rights–such as the freedom of medical personnel to practice their profession–and moral rights. A total of 1,149 (90.7%) respondents agreed with the concern regarding the collapse of essential medical care due to the avoidance of surgeons. Conclusion Sufficient guidance should be provided, along with guidelines that provide explicit standards for the installation and operation of the CCTV systems, along with safety management measures. Medical disputes and the heavy legal responsibility of medical personnel are the main reasons as to why essential medical care collapses, given the avoidance of surgery. Medical disputes should be avoided in order to prevent essential medical care collapse, as the video is used as evidence for criminal sanctions.

Elastofibroma is a rare benign tumor-like condition manifesting as firm and spherical mass with poorly circumscribed margins of fibroelastic tissue, occuring in the subscapular region or the chest wall of elderly persons. It is not a true neoplasm but rather a reactive or degenerative process causing abnormal elastogenesis. It is unilateral in the majority of cases and the right side is affected more commonly than the left. We report a case of bilateral elastofibromas removed from both subscapular regions of a 73-year-old female farmer. She was presented with tender masses on the bilateral subscapular areas for seven years. Microscopically, it consisted of a mixture of intertwining broad eosinophilic collagen bundles and elastic fibers associated with a few fibroblasts and mature fat cells. The elastic fibers had a degenerated beaded appearance or were fragmented into serrated globules in a linear arrangement.
Adipocytes ; Aged ; Collagen ; Elastic Tissue ; Eosinophils ; Female ; Fibroblasts ; Humans ; Thoracic Wall

OBJECTIVE: Human embryonic stem (ES) cells have a great potential in regenerative medicine and tissue engineering. The human ES cells could be differentiated into specific cell types by treatments of growth factors and alterations of gene expressions. However, the efficacy of guided differentiation and isolation of specific cells are still low. In this study, we characterized isolated cells from differentiated human ES cells by magnetic activated cell sorting (MACS) system using specific antibodies to cell surface markers. METHODS: The undifferentiated hES cells (Miz-hESC4) were sub-cultured by mechanical isolation of colonies and embryoid bodies were spontaneously differentiated with DMEM containing 10% FBS for 2 weeks. The differentiated cells were isolated to positive and negative cells with MACS system using CD34, human epithelial antigen (HEA) and human fibroblast (HFB) antibodies, respectively. Observation of morphological changes and analysis of marker genes expression were performed during further culture of MACS isolated cells for 4 weeks. RESULTS: Morphology of the CD34 positive cells was firstly round, and then it was changed to small polygonal shape after further culture. The HEA positive cells showed large polygonal, and the HFB positive spindle shape. In RT-PCR analysis of marker genes, the CD34 and HFB positive cells expressed endodermal and mesodermal genes, and HEA positive cells expressed ectodermal genes such as NESTIN and NF68KD. The marker genes expression pattern of CD34 positive cells changed during the extension of culture time. CONCLUSION: Our results showed the possibility of successful isolation of specific cells by MACS system from undirected differentiated human ES cells. Thus, MACS system and marker antibodies for specific cell types might be useful for guided differentiation and isolation of specific cells from human ES cells.
Antibodies ; Ectoderm ; Embryoid Bodies ; Endoderm ; Fibroblasts ; Gene Expression ; Humans* ; Intercellular Signaling Peptides and Proteins ; Mesoderm ; Nestin ; Regenerative Medicine ; Tissue Engineering

No abstract available.
Humans ; Quality of Life* ; Renal Dialysis* ; Renal Insufficiency*

No abstract available.

A 49 year-old male was scheduled for a cholecystectomy, thereafter a 37 year-old female scheduled for removal of a epidural hematoma in the same operating room. Both of them had no specific medical problems and past medical histories for anesthesia. For those reasons, anesthesia was induced with thiopental sodium and succinylcholine with endotracheal intubation. After induction, vital signs including body temperatures were stable. But moisture dew in the unidirectional valves and corrugated tubes, and color changes of soda lime were discovered. At that time, severe hypercarbia was recognized by arterial blood gas analysis in both cases. In both cases, there were no malfunctions in unidirectional valves, expiratory valves, corrugation tubes, soda lime, ventilators and there connection parts in the anesthetic machines. Also there were no abnormalities of blood pressures, electrocardiograms, pulse oxymeters, temperatures and the pulse in the patient monitoring systems except capnography. At first, we thought that medical signs revealed malignant hyperthermias. But vital signs, air way pressures and functions of all kinds of anesthetic machine components including ventilators were normal. After discontinuing N2O gas deliveries in the operation room, hypercarbias disappeared. Thus, anesthetic gas delivery systems via central piping systems were checked and it was discovered that CO2 gas was in the N2O gas tank instead of N2O.
Adult ; Anesthesia ; Blood Gas Analysis ; Body Temperature ; Capnography ; Carbon Dioxide* ; Carbon* ; Cholecystectomy ; Electrocardiography ; Female ; Hematoma ; Humans ; Intubation, Intratracheal ; Male ; Malignant Hyperthermia ; Middle Aged ; Monitoring, Physiologic ; Nitrous Oxide* ; Operating Rooms ; Succinylcholine ; Thiopental ; Ventilators, Mechanical ; Vital Signs

This reabstracting study was initiated to estimate accuracy and reliability of quality control for the Daegu Cancer Registry data in 1997-1998. The study population was 7,837 incident cases registered as malignant primary tumor in the Daegu Cancer Registry and two samples were selected for agreement study of the tumor and demographic information and for usual residence survey, separately. The 10 items reabstracted from medical records of 696 cases were compared to original data and classified as major and minor disagreement by the Centralized Cancer Patient Data System. The usual residence of 143 cases of one district was traced back actually through the computerized personal identification system of the government. The highest rate of major disagreements, 12%, was for morphology, followed by 12.0% for date of diagnosis and 5.6% for site. Demographic items had good reproducibility (exact agreement rates > 95%). Usual residence of 13 cases (9.1%) was out of Daegu. These results suggest that periodic assessment of the validity is necessary for quality control of the Daegu cancer registration data by the standardization of the cancer registration method including data collection method.
Daegu* ; Data Collection ; Diagnosis ; Humans ; Information Systems ; Medical Records ; Quality Control ; Records as Topic