Recently, various health associations have been attempting to establish separate bills favorable to their societies. A separate bill governing physical therapists was proposed at the 20th National Assembly in May 2019. The Korean Medical Association expressed strong concern about the introduction of the bill, while the Korean Physical Therapy Association welcomed it. Fortunately, the bill is currently pending in the National Assembly. Given the variety of opinions that coexist in the bill, this paper aims to point out the problems of separate bills and to suggest a proper response strategy by the medical community to the bill. First, we look at the original tasks of physical therapists throughout history. Second, we focus on legal problems regarding the physical therapist bill, based on the Constitutional Court's past rulings. Third, we seek response strategies of the medical community. In conclusion, the bill does not reflect the reality of medical care and makes many dangerous public health provisions. The National Assembly should carefully review the bill and listen to the opinions of the medical community.

Recently, various health associations have been attempting to establish separate bills favorable to their societies. A separate bill governing physical therapists was proposed at the 20th National Assembly in May 2019. The Korean Medical Association expressed strong concern about the introduction of the bill, while the Korean Physical Therapy Association welcomed it. Fortunately, the bill is currently pending in the National Assembly. Given the variety of opinions that coexist in the bill, this paper aims to point out the problems of separate bills and to suggest a proper response strategy by the medical community to the bill. First, we look at the original tasks of physical therapists throughout history. Second, we focus on legal problems regarding the physical therapist bill, based on the Constitutional Court's past rulings. Third, we seek response strategies of the medical community. In conclusion, the bill does not reflect the reality of medical care and makes many dangerous public health provisions. The National Assembly should carefully review the bill and listen to the opinions of the medical community.
Humans ; Physical Therapists ; Public Health

Recently, various health associations have been attempting to establish separate bills favorable to their societies. A separate bill governing physical therapists was proposed at the 20th National Assembly in May 2019. The Korean Medical Association expressed strong concern about the introduction of the bill, while the Korean Physical Therapy Association welcomed it. Fortunately, the bill is currently pending in the National Assembly. Given the variety of opinions that coexist in the bill, this paper aims to point out the problems of separate bills and to suggest a proper response strategy by the medical community to the bill. First, we look at the original tasks of physical therapists throughout history. Second, we focus on legal problems regarding the physical therapist bill, based on the Constitutional Court's past rulings. Third, we seek response strategies of the medical community. In conclusion, the bill does not reflect the reality of medical care and makes many dangerous public health provisions. The National Assembly should carefully review the bill and listen to the opinions of the medical community.

Purpose: This study was conducted to effectively apply the nutrition and hygiene education program for improving the nutritional status of the elderly aged 65 years and above. Methods: The first study was conducted by enrolling 121 willing elderly subjects from welfare centers in four regions of Chungbuk. The second study included 347 people from 10 regions of Chungbuk. Data were analyzed using the SPSS (version 12.0) and SAS (version 9.2) programs. Results: Most participants in both studies were women, ranging from 70-79 years of age. In the first study, the performance rates of subjects, after imparting the education on hygiene, eating habits, and nutritional knowledge, were significantly increased for all factors. Goesan and Boeun areas were highly effective in hygiene practice and eating habits after education.In the second study, Chungju had the most educational effect on hygiene education, with a score of 6.41 points before education and 7.68 points after education. The greatest impact of education on eating habits was obtained at Goesan, with 9.23 points and 11.26 points before and after education, respectively. Large regional differences were determined for the effect of the education program. For nutritional knowledge, the combined average score of Boeun and Goesan showed a maximum increase after education. When considering satisfaction, the scores of Cheongju and Jeungpyeong increased the most after education, whereas Goesan showed that the average scores before and after education were close to perfect. Surprisingly, the Okcheon area, where there was no significant difference in the educational effect after the education program in the first study, showed significant improvement for all factors after the second education program. The current study indicates that continuous education programs are essential for improving the nutritional status of the elderly. Conclusion Therefore, continuous nutrition and hygiene education programs are recommended to improve the nutritional status of the elderly.

PURPOSE: Concurrent chemoradiation (CRT) with 3-weekly doses of cisplatin is a standard treatment for loco-regionally advanced head and neck squamous cell carcinoma (HNSCC). However, treatment with 3-weekly doses of cisplatin is often associated with several adverse events. Therefore, we conducted this retrospective analysis to determine the efficacy and tolerance of CRT with a low weekly dose of cisplatin in stage IV HNSCC patients. MATERIALS AND METHODS: Medical records of patients who were diagnosed with stage IV HNSCC and received concurrent CRT were analyzed. All patients were treated weekly with cisplatin at 20-30 mg/m2 until radiotherapy was completed. RESULTS: A total of 35 patients were reviewed. Median follow up was 10.7 months (range, 1.7 to 90.5 months), the median radiation dose was 7,040 cGy, and the median dose of cisplatin received was 157 mg/m2. Eleven patients received docetaxel combination chemotherapy. Overall, 25 patients (71.4%) achieved complete response (CR), eight (22.9%) showed partial response. The median overall survival was 42.7 months, the 3-year survival rate was 51.2% and the 3 year disease-free survival rate was 72.8%. Overall survival was improved in patients who achieved CR relative to others (59.7 months vs. 13.4 months; p=0.008). There were significant differences in survival between patients who received docetaxel combination and cisplatin alone (51.8 months vs. 7.9 months; p=0.009). Grade 3-4 adverse events included stomatitis (82.9%), dermatitis (22.9%), infection (11.4%), dysphagia (8.6%), and neutropenia (5.7%). CONCLUSION: CRT with low dose weekly cisplatin is likely effective and tolerable, even in patients with locally advanced-stage IV HNSCC.
Carcinoma, Squamous Cell* ; Chemoradiotherapy ; Cisplatin* ; Deglutition Disorders ; Dermatitis ; Disease-Free Survival ; Drug Therapy, Combination ; Follow-Up Studies ; Head and Neck Neoplasms ; Head* ; Humans ; Medical Records ; Neck* ; Neutropenia ; Radiotherapy ; Retrospective Studies ; Stomatitis ; Survival Rate

PURPOSE: Acute care surgery (ACS) models have evolved worldwide over the last decade. However, South Korea has an established trauma system and does not consider the ACS model. This study compares the management and outcome of emergency cholecystectomy in the ACS model to those of traditional on-call attending surgeon model for emergency surgery. METHODS: Retrospectively collected data for patients who underwent emergency cholecystectomy from May 2013 to January 2015 was analyzed to compare data from a traditional on-call system (OCS) and ACS. RESULTS: One hundred and twenty-four patients were enrolled in the study (62 patients ACS vs. 62 patients OCS). Hospital stay (days) (ACS=4.29±2.49 vs. OCS=4.82±4.48, p=0.46) and stay in emergency room (minutes) (ACS=213.10±113.99 vs. OCS=241.10±150.73, p=0.20) did not differ significantly between groups. Operation time (minutes) was significantly shorter in the ACS than OCS group (389.97±215.21 vs. 566.35±290.14, p<0.001). Other clinical variables (sex, open-conversion rate, whether the operation was performed at night/holiday, intensive care unit admission rate) did not differ between groups. There was no mortality and readmission. CONCLUSION: The implementation of the ACS led to shorter operation time and no increase of postoperative mortality and complication.
Cholecystectomy* ; Emergencies* ; Emergency Service, Hospital ; Humans ; Intensive Care Units ; Korea ; Length of Stay ; Mortality ; Retrospective Studies ; Wounds and Injuries

PURPOSE: Recommended dietary allowance of vitamin C was determined on the basis of preventing the scurvy without considerations of the important function of the vitamin C as a first line antioxidant. So we measured the whole blood and plasma vitamin C concentrations of the contemporay healthy elementary school children in Chinju for the establishment of the optimal daily vitamin C requirment in the elementary school children. METHODS: Whole blood and plasma vitamin C concentrations were measured by the 2,4-dinitrophenylhydrazine method in 338 children from the 1st to the 6th grade of one elementary school in Chinju. RESULTS: Whole blood and plasma vitamin C concentrations were 1.36+/-0.34mg/dL and 1.07+/-0.33mg/dL respectively. There existed an close relationship between whole blood and plasma vitamin C concentrations (r=0.77, p=0.0001). Whole blood vitamin C concentration decreased as the age became older (r=-0.22 p=0.0001), but plasma vitamin C concentration did not change. There were no sex differences in the whole blood and plasma vitamin C concentrations except in the 3rd grade (p<0.05). Twenty-three of 338 elementary school children (6.8%) had the plasma vitamin C concentration less than 0.6mg/dL. CONCLUSIONS: We produced the blood and plasma vitamin C concentrations of the contemporay elementary school children in Chinju. These values were not satisfactory in consideration of the importance of the childhood health.
Ascorbic Acid* ; Child* ; Gyeongsangnam-do* ; Humans ; Plasma* ; Recommended Dietary Allowances ; Scurvy ; Sex Characteristics ; Vitamins*

BACKGROUND: Prophylaxis for hepatitis B virus (HBV) recurrence is essential after liver transplantation (LT) in HBV-associated recipients. We conducted real-world analysis of HBV prophylaxis after LT in the Korean population.METHODS: Korean Organ Transplantation Registry (KOTRY) database and additionally collected data (n = 326) were analyzed with special reference to types of HBV prophylaxis.RESULTS: The study cohort comprised 267 cases of living-donor LT and 59 cases of deceased-donor LT. Hepatocellular carcinoma (HCC) was diagnosed in 232 (71.2%) of these subjects. Antiviral agents were used in 255 patients (78.2%) prior to LT. HBV DNA was undetectable in 69 cases (21.2%) and detectable over wide concentrations in the other 257 patients (78.8%) prior to LT. Polymerase chain reaction analysis of the store blood samples detected HBV DNA in all patients, with 159 patients (48.9%) showing concentrations > 100 IU/mL. Post-transplant HBV regimens during the first year included combination therapy in 196 (60.1%), hepatitis B immunoglobulin (HBIG) monotherapy in 121 (37.1%), and antiviral monotherapy in 9 (2.8%). In the second post-transplant year, these regimens had changed to combination therapy in 187 (57.4%), HBIG monotherapy in 112 (34.4%), and antiviral monotherapy in 27 (8.3%). Trough antibody to hepatitis B surface antigen titers > 500 IU/mL and >1,000 IU/mL were observed in 61.7% and 25.2%, respectively. The mean simulative half-life of HBIG was 21.6 ± 4.3 days with a median 17.7 days. Up to 2-year follow-up period, HCC recurrence and HBV recurrence developed in 18 (5.5%) and 6 (1.8%), respectively. HCC recurrence developed in 3 of 6 patients with HBV recurrence.CONCLUSION: Combination therapy is the mainstay of HBV prophylaxis protocols in a majority of Korean LT centers, but HBIG was often administered excessively. Individualized optimization of HBIG treatments using SHL is necessary to adjust the HBIG infusion interval.
Antiviral Agents ; Carcinoma, Hepatocellular ; Cohort Studies ; DNA ; Follow-Up Studies ; Half-Life ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B ; Hepatitis ; Humans ; Immunoglobulins ; Korea ; Liver Transplantation ; Liver ; Organ Transplantation ; Polymerase Chain Reaction ; Recurrence ; Transplants

BACKGROUND: Prophylaxis for hepatitis B virus (HBV) recurrence is essential after liver transplantation (LT) in HBV-associated recipients. We conducted real-world analysis of HBV prophylaxis after LT in the Korean population. METHODS: Korean Organ Transplantation Registry (KOTRY) database and additionally collected data (n = 326) were analyzed with special reference to types of HBV prophylaxis. RESULTS: The study cohort comprised 267 cases of living-donor LT and 59 cases of deceased-donor LT. Hepatocellular carcinoma (HCC) was diagnosed in 232 (71.2%) of these subjects. Antiviral agents were used in 255 patients (78.2%) prior to LT. HBV DNA was undetectable in 69 cases (21.2%) and detectable over wide concentrations in the other 257 patients (78.8%) prior to LT. Polymerase chain reaction analysis of the store blood samples detected HBV DNA in all patients, with 159 patients (48.9%) showing concentrations > 100 IU/mL. Post-transplant HBV regimens during the first year included combination therapy in 196 (60.1%), hepatitis B immunoglobulin (HBIG) monotherapy in 121 (37.1%), and antiviral monotherapy in 9 (2.8%). In the second post-transplant year, these regimens had changed to combination therapy in 187 (57.4%), HBIG monotherapy in 112 (34.4%), and antiviral monotherapy in 27 (8.3%). Trough antibody to hepatitis B surface antigen titers > 500 IU/mL and >1,000 IU/mL were observed in 61.7% and 25.2%, respectively. The mean simulative half-life of HBIG was 21.6 ± 4.3 days with a median 17.7 days. Up to 2-year follow-up period, HCC recurrence and HBV recurrence developed in 18 (5.5%) and 6 (1.8%), respectively. HCC recurrence developed in 3 of 6 patients with HBV recurrence. CONCLUSION Combination therapy is the mainstay of HBV prophylaxis protocols in a majority of Korean LT centers, but HBIG was often administered excessively. Individualized optimization of HBIG treatments using SHL is necessary to adjust the HBIG infusion interval.

BACKGROUND: Malnutrition is associated with many adverse clinical outcomes. The present study aimed to identify the prevalence of malnutrition in hospitalized patients in Korea, evaluate the association between malnutrition and clinical outcomes, and ascertain the risk factors of malnutrition. METHODS: A multicenter cross-sectional study was performed with 300 patients recruited from among the patients admitted in 25 hospitals on January 6, 2014. Nutritional status was assessed by using the Subjective Global Assessment (SGA). Demographic characteristics and underlying diseases were compared according to nutritional status. Logistic regression analysis was performed to identify the risk factors of malnutrition. Clinical outcomes such as rate of admission in intensive care units, length of hospital stay, and survival rate were evaluated. RESULTS: The prevalence of malnutrition in the hospitalized patients was 22.0%. Old age (≥ 70 years), admission for medical treatment or diagnostic work-up, and underlying pulmonary or oncological disease were associated with malnutrition. Old age and admission for medical treatment or diagnostic work-up were identified to be risk factors of malnutrition in the multivariate analysis. Patients with malnutrition had longer hospital stay (SGA A = 7.63 ± 6.03 days, B = 9.02 ± 9.96 days, and C = 12.18 ± 7.24 days, P = 0.018) and lower 90-day survival rate (SGA A = 97.9%, B = 90.7%, and C = 58.3%, P < 0.001). CONCLUSION: Malnutrition was common in hospitalized patients, and resulted in longer hospitalization and associated lower survival rate. The rate of malnutrition tended to be higher when the patient was older than 70 years old or hospitalized for medical treatment or diagnostic work-up compared to elective surgery.
Cross-Sectional Studies ; Hospitalization ; Humans ; Intensive Care Units ; Korea ; Length of Stay ; Logistic Models ; Malnutrition ; Multivariate Analysis ; Nutrition Assessment ; Nutritional Status ; Prevalence ; Risk Factors ; Survival Rate