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.
Education, Medical* ; Evidence-Based Medicine*

No abstract available.
Violence*

No abstract available.
Wilms Tumor*

No abstract available.
Aged* ; Humans

Congenital hypopituitarism is a rare disorder with absence or reduction of hormones produced by the pituitary gland. The clinical manifestations are hypoglycemia, prolonged jaundice, hyponatremia, micropenis, underdeveloped clitoris, lethargy, convulsion, pallor, cyanosis, apnea, hypotension, temperature instability etc. in neonates and growth failure, delayed or absent puberty in older infants and children. We experienced a case of congenital hypopituitarism who was a 20-year-old male patient with short stature and delayed puberty. Combined pituitary function test revealed panhypopituitarism and magnetic resonance imaging of brain showed anterior pituitary aplasia and ectopic posterior pituitary gland.
Adolescent ; Apnea ; Brain ; Child ; Clitoris ; Cyanosis ; Female ; Humans ; Hypoglycemia ; Hyponatremia ; Hypopituitarism* ; Hypotension ; Infant ; Infant, Newborn ; Jaundice ; Lethargy ; Magnetic Resonance Imaging ; Male ; Pallor ; Pituitary Function Tests ; Pituitary Gland ; Pituitary Gland, Posterior* ; Puberty ; Puberty, Delayed ; Seizures ; Young Adult

Congenital hypopituitarism is a rare disorder with absence or reduction of hormones produced by the pituitary gland. The clinical manifestations are hypoglycemia, prolonged jaundice, hyponatremia, micropenis, underdeveloped clitoris, lethargy, convulsion, pallor, cyanosis, apnea, hypotension, temperature instability etc. in neonates and growth failure, delayed or absent puberty in older infants and children. We experienced a case of congenital hypopituitarism who was a 20-year-old male patient with short stature and delayed puberty. Combined pituitary function test revealed panhypopituitarism and magnetic resonance imaging of brain showed anterior pituitary aplasia and ectopic posterior pituitary gland.
Adolescent ; Apnea ; Brain ; Child ; Clitoris ; Cyanosis ; Female ; Humans ; Hypoglycemia ; Hyponatremia ; Hypopituitarism* ; Hypotension ; Infant ; Infant, Newborn ; Jaundice ; Lethargy ; Magnetic Resonance Imaging ; Male ; Pallor ; Pituitary Function Tests ; Pituitary Gland ; Pituitary Gland, Posterior* ; Puberty ; Puberty, Delayed ; Seizures ; Young Adult

This quasi -experimental study was intended to test the effect of self-help group program, which is one of the way to enhance adaptation and quality of life to mastectomy patients. Data was collected from July 14, 1998 to Oct. 31, 1998 at two Medical Center in Seoul. The subjects for this study were the patients who had undergone mastectomy and were follow-up: 14 in experimental group and 14 in control group matched with age and treatment. The instruments for this study were adaptation in Lee(1994)'s physical symptom questionnaire, Zung's Self-rating Depression Scale (SDS, 1965), and Self-rating Anxiety Scale (SAS, 1970), quality of life in Spranger(1996)'s and No(1988)'s Quality of Life Questionnaire. The self-help group program for mastectomy patients was developed based on literature review and pilot study by the investigator. The subjects of experimental group were participated in 6 weeks self - help group program and were received arm and shoulder exercise, informational support, and interpersonal support by group members. The control group were received no intervention. Both group answered questionnaires prior to intervention and 6 weeks later. The data analyzed by frequency, chi-test, Mann-Whitney U test, Wilcoxon Signed Rank test, Pearson's Correlation Coefficient and Stepwise Multiple Regression using SPSS WIN. The results are as follows; Hypothesis 1, The experimental group with the self-help group program will have a higher score on adaptation state than control group. was not supported. But the posttest score of anxiety and depression in experimental group were declined and the depression score was reduced relatively. Hypothesis 2, The experimental group with the selp-help group program will have a higher score on quality of life than control group. was not supported. But the posttest score of quality of life in experimental group was reduced relatively. Hypothesis 3, The higher adaptation state of mastectomy patients, the higher quality of life. was supported(r=.80, p .001). Additionally, the lower physical symptom, depression and anxiety, the higher quality of life. And depression, which was the main predictor of quality of life, accounted for 59.5%, depression and anxiety accounted for 65.5% of the variance in quality of life. In conclusion, when the self-help group program was intervened to mastectomy patients, it was tended to increase quality of life and to reduce depression and anxiety. So self-help group program can be considered useful nursing intervention effect on adaptation and quality of life of mastectomy patients. With discussion, I suggest repeated further research on self-help group with appropriate sample size and longitudinal study. Also during adjuvant therapy, it is needed to develop convenient method to be supported from peer group and family, such as computer mediated support group.
Anxiety ; Arm ; Depression ; Follow-Up Studies ; Humans ; Longitudinal Studies ; Mastectomy* ; Nursing ; Peer Group ; Pilot Projects ; Quality of Life* ; Surveys and Questionnaires ; Research Personnel ; Sample Size ; Self-Help Groups* ; Seoul ; Shoulder

PURPOSE: This study was undertaken to identify the frequencies and the risk factors of microvascular complications in subjects with type 1 diabetes mellitus METHODS: The frequencies and their relation to risk factors of microvascular complications were analyzed in 29 type 1 diabetes mellitus subjects with duration of disease more than 5 years. Microvascular disease was defined as the presence of either retinopathy, microalbuminuria or neuropathy. RESULTS: The overall prevalence rate of microvascular disease was 8/29(27.6%). Retinopathy has developed in 3 patients(10.3%), microalbuminuria in 7 patients(24.0 %) and neuropathy in 5 patients(17.2%). The mean HbA1C was significantly higher in the patients with microvascular complications(11.6+/-.2% in microvascular complication group vs 9.3+/-.6% in control group). CONCLUSION: In childhood onset type 1 diabetes mellitus, poor glycemic control is an important risk factor for microvascular complications.
Diabetes Mellitus, Type 1* ; Humans ; Prevalence ; Risk Factors*

An experimental study was done to evaluate factors influencing guided regeneration of bone in standardized calvarial bony defect. An 8 mm circular transosseous calvarial bony defect was made. Various material such as demineralized freeze-dried bone (DFDB), BioMesh , Millipore filter and its combination was placed in the bony defect. A sequential histopathologic, histochemical, immunohistochemical, and histomorphometric studies were done on the guided bone regeneration in the calvarial bony defect. Bone formation was sigificantly enhanced when the DFDB was retained within the bony defect with a protective bioabsorbable membrane. Inframembranous DFDB-filling was required to prevent collapse of the membrane and preserve spaces for bone regeneration. The bioabsorbable membrane should presumably remain intact for longer than at least 5 weeks to facilitate bone regeneration. The new bone formation was dependent on the barrier-effect (preserving secluded spaces) and inflammation-inducing property of membrane, and guiding bone regeneration of the grafts. Macrophages recruited by grafts were partly involved in decrease of bone regeneration via the sequential events of release of fibronectin, chemotactic effect of the fibronectin to fibroblasts, and collagen lay-down.
Animals ; Bone Regeneration ; Collagen ; Fibroblasts ; Fibronectins ; Macrophages ; Membranes ; Micropore Filters ; Osteogenesis ; Rats* ; Regeneration* ; Transplants