1.Changes in Medical Students’ Opinions and Narratives in Medical Ethics Using Case-Based Discussions
Keimyung Medical Journal 2024;43(2):115-121
The importance of medical ethics education is increasingly emphasized in medical schools. To improve students’ problem-solving skills, various medical ethics cases are developed and discussed in medical ethics. In this study, based on actual cases of telemedicine and doctors’ strikes, we aim to reflect on medical students’ narratives and identify changes in shared thoughts. The study included 83 students, with responses from 75 students, excluding insincere responses, analyzed. Changes in opinion during discussions were examined using Giorgi’s phenomenological analysis. There was a significant difference in the pros and cons of telemedicine and doctors’ strikes before and after the discussion. The pros of telemedicine were analyzed as ‘expanding healthcare coverage,’ ‘preparing for emerging infectious diseases like coronavirus disease 2019,’ and ‘efficiency of care for certain conditions.’ The cons included ‘high likelihood of misdiagnosis,’ ‘premature implementation and possible abuse of the system,’ ‘risk of healthcare system collapse,’ ‘issues with rural internet and medical devices, and privacy leaks.’ The pros of the doctors’ strike included ‘the need for policies with expert inputs,’ ‘telemedicine may not benefit patients,’ and ‘Korean Medical Association endorsement.’ The cons focused on ‘lack of legitimacy, even if the system is flawed,’ ‘negative image,’ and ‘ignoring doctors’ personal opinions.’ As future doctors, today’s medical students will encounter more complex ethical issues. Medical ethics cases help determine whether they can effectively persuade others with evidence when faced with ethical dilemmas in actual practice.
2.Changes in Medical Students’ Opinions and Narratives in Medical Ethics Using Case-Based Discussions
Keimyung Medical Journal 2024;43(2):115-121
The importance of medical ethics education is increasingly emphasized in medical schools. To improve students’ problem-solving skills, various medical ethics cases are developed and discussed in medical ethics. In this study, based on actual cases of telemedicine and doctors’ strikes, we aim to reflect on medical students’ narratives and identify changes in shared thoughts. The study included 83 students, with responses from 75 students, excluding insincere responses, analyzed. Changes in opinion during discussions were examined using Giorgi’s phenomenological analysis. There was a significant difference in the pros and cons of telemedicine and doctors’ strikes before and after the discussion. The pros of telemedicine were analyzed as ‘expanding healthcare coverage,’ ‘preparing for emerging infectious diseases like coronavirus disease 2019,’ and ‘efficiency of care for certain conditions.’ The cons included ‘high likelihood of misdiagnosis,’ ‘premature implementation and possible abuse of the system,’ ‘risk of healthcare system collapse,’ ‘issues with rural internet and medical devices, and privacy leaks.’ The pros of the doctors’ strike included ‘the need for policies with expert inputs,’ ‘telemedicine may not benefit patients,’ and ‘Korean Medical Association endorsement.’ The cons focused on ‘lack of legitimacy, even if the system is flawed,’ ‘negative image,’ and ‘ignoring doctors’ personal opinions.’ As future doctors, today’s medical students will encounter more complex ethical issues. Medical ethics cases help determine whether they can effectively persuade others with evidence when faced with ethical dilemmas in actual practice.
3.Changes in Medical Students’ Opinions and Narratives in Medical Ethics Using Case-Based Discussions
Keimyung Medical Journal 2024;43(2):115-121
The importance of medical ethics education is increasingly emphasized in medical schools. To improve students’ problem-solving skills, various medical ethics cases are developed and discussed in medical ethics. In this study, based on actual cases of telemedicine and doctors’ strikes, we aim to reflect on medical students’ narratives and identify changes in shared thoughts. The study included 83 students, with responses from 75 students, excluding insincere responses, analyzed. Changes in opinion during discussions were examined using Giorgi’s phenomenological analysis. There was a significant difference in the pros and cons of telemedicine and doctors’ strikes before and after the discussion. The pros of telemedicine were analyzed as ‘expanding healthcare coverage,’ ‘preparing for emerging infectious diseases like coronavirus disease 2019,’ and ‘efficiency of care for certain conditions.’ The cons included ‘high likelihood of misdiagnosis,’ ‘premature implementation and possible abuse of the system,’ ‘risk of healthcare system collapse,’ ‘issues with rural internet and medical devices, and privacy leaks.’ The pros of the doctors’ strike included ‘the need for policies with expert inputs,’ ‘telemedicine may not benefit patients,’ and ‘Korean Medical Association endorsement.’ The cons focused on ‘lack of legitimacy, even if the system is flawed,’ ‘negative image,’ and ‘ignoring doctors’ personal opinions.’ As future doctors, today’s medical students will encounter more complex ethical issues. Medical ethics cases help determine whether they can effectively persuade others with evidence when faced with ethical dilemmas in actual practice.
4.Changes in Medical Students’ Opinions and Narratives in Medical Ethics Using Case-Based Discussions
Keimyung Medical Journal 2024;43(2):115-121
The importance of medical ethics education is increasingly emphasized in medical schools. To improve students’ problem-solving skills, various medical ethics cases are developed and discussed in medical ethics. In this study, based on actual cases of telemedicine and doctors’ strikes, we aim to reflect on medical students’ narratives and identify changes in shared thoughts. The study included 83 students, with responses from 75 students, excluding insincere responses, analyzed. Changes in opinion during discussions were examined using Giorgi’s phenomenological analysis. There was a significant difference in the pros and cons of telemedicine and doctors’ strikes before and after the discussion. The pros of telemedicine were analyzed as ‘expanding healthcare coverage,’ ‘preparing for emerging infectious diseases like coronavirus disease 2019,’ and ‘efficiency of care for certain conditions.’ The cons included ‘high likelihood of misdiagnosis,’ ‘premature implementation and possible abuse of the system,’ ‘risk of healthcare system collapse,’ ‘issues with rural internet and medical devices, and privacy leaks.’ The pros of the doctors’ strike included ‘the need for policies with expert inputs,’ ‘telemedicine may not benefit patients,’ and ‘Korean Medical Association endorsement.’ The cons focused on ‘lack of legitimacy, even if the system is flawed,’ ‘negative image,’ and ‘ignoring doctors’ personal opinions.’ As future doctors, today’s medical students will encounter more complex ethical issues. Medical ethics cases help determine whether they can effectively persuade others with evidence when faced with ethical dilemmas in actual practice.
5.The Korean Academy of Asthma Allergy and Clinical Immunology guidelines for sublingual immunotherapy
Gwanghui RYU ; Hye Mi JEE ; Hwa Young LEE ; Sung-Yoon KANG ; Kyunghoon KIM ; Ju Hee KIM ; Kyung Hee PARK ; So-Young PARK ; Myong Soon SUNG ; Youngsoo LEE ; Eun-Ae YANG ; Jin-Young MIN ; Eun Kyo HA ; Sang Min LEE ; Yong Won LEE ; Eun Hee CHUNG ; Sun Hee CHOI ; Young-Il KOH ; Seon Tae KIM ; Dong-Ho NAHM ; Jung Won PARK ; Jung Yeon SHIM ; Young Min AN ; Man Yong HAN ; Jeong-Hee CHOI ; Yoo Seob SHIN ; Doo Hee HAN ;
Allergy, Asthma & Respiratory Disease 2024;12(3):125-133
Allergen immunotherapy (AIT) has been used for over a century and has been demonstrated to be effective in treating patients with various allergic diseases. AIT allergens can be administered through various routes, including subcutaneous, sublingual, intralymphatic, oral, or epicutaneous routes. Sublingual immunotherapy (SLIT) has recently gained clinical interest, and it is considered an alternative treatment for allergic rhinitis (AR) and asthma. This review provides an overview of the current evidence-based studies that address the use of SLIT for treating AR, including (1) mechanisms of action, (2) appropriate patient selection for SLIT, (3) the current available SLIT products in Korea, and (4) updated information on its efficacy and safety. Finally, this guideline aims to provide the clinician with practical considerations for SLIT.
6.The Korean Academy of Asthma Allergy and Clinical Immunology guidelines for allergen immunotherapy
Hwa Young LEE ; Sung-Yoon KANG ; Kyunghoon KIM ; Ju Hee KIM ; Gwanghui RYU ; Jin-Young MIN ; Kyung Hee PARK ; So-Young PARK ; Myongsoon SUNG ; Youngsoo LEE ; Eun-Ae YANG ; Hye Mi JEE ; Eun Kyo HA ; Yoo Seob SHIN ; Sang Min LEE ; Eun Hee CHUNG ; Sun Hee CHOI ; Young-Il KOH ; Seon Tae KIM ; Dong-Ho NAHM ; Jung Won PARK ; Jung Yeon SHIM ; Young Min AN ; Doo Hee HAN ; Man Yong HAN ; Yong Won LEE ; Jeong-Hee CHOI ;
Allergy, Asthma & Respiratory Disease 2024;12(3):102-124
Allergen immunotherapy (AIT) is a causative treatment of allergic diseases in which allergen extracts are regularly administered in a gradually escalated doses, leading to immune tolerance and consequent alleviation of allergic diseases. The need for uniform practice guidelines in AIT is continuously growing as the number of potential candidates for AIT increases and new therapeutic approaches are tried. This updated version of the Korean Academy of Asthma Allergy and Clinical Immunology recommendations for AIT, published in 2010, proposes an expert opinion by specialists in allergy, pediatrics, and otorhinolaryngology. This guideline deals with the basic knowledge of AIT, including mechanisms, clinical efficacy, allergen standardization, important allergens in Korea, and special consideration in pediatrics. The article also covers the methodological aspects of AIT, including patient selection, allergen selection, schedule and doses, follow-up care, efficacy measurements, and management of adverse reactions. Although this guideline suggests the optimal dosing schedule, an individualized approach and modifications are recommended considering the situation for each patient and clinic.
7.2023 Clinical Practice Guidelines for Diabetes Management in Korea: Full Version Recommendation of the Korean Diabetes Association
Jun Sung MOON ; Shinae KANG ; Jong Han CHOI ; Kyung Ae LEE ; Joon Ho MOON ; Suk CHON ; Dae Jung KIM ; Hyun Jin KIM ; Ji A SEO ; Mee Kyoung KIM ; Jeong Hyun LIM ; Yoon Ju SONG ; Ye Seul YANG ; Jae Hyeon KIM ; You-Bin LEE ; Junghyun NOH ; Kyu Yeon HUR ; Jong Suk PARK ; Sang Youl RHEE ; Hae Jin KIM ; Hyun Min KIM ; Jung Hae KO ; Nam Hoon KIM ; Chong Hwa KIM ; Jeeyun AHN ; Tae Jung OH ; Soo-Kyung KIM ; Jaehyun KIM ; Eugene HAN ; Sang-Man JIN ; Jaehyun BAE ; Eonju JEON ; Ji Min KIM ; Seon Mee KANG ; Jung Hwan PARK ; Jae-Seung YUN ; Bong-Soo CHA ; Min Kyong MOON ; Byung-Wan LEE
Diabetes & Metabolism Journal 2024;48(4):546-708
8.Pediatric Extracorporeal Membrane Oxygenation in Korea: A Multicenter Retrospective Study on Utilization and Outcomes Spanning Over a Decade
Yu Hyeon CHOI ; Won Kyoung JHANG ; Seong Jong PARK ; Hee Joung CHOI ; Min-su OH ; Jung Eun KWON ; Beom Joon KIM ; Ju Ae SHIN ; In Kyung LEE ; June Dong PARK ; Bongjin LEE ; Hyun CHUNG ; Jae Yoon NA ; Ah Young CHOI ; Joongbum CHO ; Jaeyoung CHOI ; Hwa Jin CHO ; Ah Young KIM ; Yu Rim SHIN ; Joung-Hee BYUN ; Younga KIM
Journal of Korean Medical Science 2024;39(3):e33-
Background:
Over the last decade, extracorporeal membrane oxygenation (ECMO) use in critically ill children has increased and is associated with favorable outcomes. Our study aims to evaluate the current status of pediatric ECMO in Korea, with a specific focus on its volume and changes in survival rates based on diagnostic indications.
Methods:
This multicenter study retrospectively analyzed the indications and outcomes of pediatric ECMO over 10 years in patients at 14 hospitals in Korea from January 2012 to December 2021. Four diagnostic categories (neonatal respiratory, pediatric respiratory, postcardiotomy, and cardiac-medical) and trends were compared between periods 1 (2012–2016) and 2 (2017–2021).
Results:
Overall, 1065 ECMO runs were performed on 1032 patients, with the annual number of cases remaining unchanged over the 10 years. ECMO was most frequently used for post-cardiotomy (42.4%), cardiac-medical (31.8%), pediatric respiratory (17.5%), and neonatal respiratory (8.2%) cases. A 3.7% increase and 6.1% decrease in pediatric respiratory and post-cardiotomy cases, respectively, were noted between periods 1 and 2.Among the four groups, the cardiac-medical group had the highest survival rate (51.2%), followed by the pediatric respiratory (46.4%), post-cardiotomy (36.5%), and neonatal respiratory (29.4%) groups. A consistent improvement was noted in patient survival over the 10 years, with a significant increase between the two periods from 38.2% to 47.1% (P = 0.004). Improvement in survival was evident in post-cardiotomy cases (30–45%, P = 0.002).Significant associations with mortality were observed in neonates, patients requiring dialysis, and those treated with extracorporeal cardiopulmonary resuscitation (P < 0.001). In pediatric respiratory ECMO, immunocompromised patients also showed a significant correlation with mortality (P < 0.001).
Conclusion
Pediatric ECMO demonstrated a steady increase in overall survival in Korea;however, further efforts are needed since the outcomes remain suboptimal compared with global outcomes.
9.Prognostic Implication of Platelet Reactivity According to Left Ventricular Systolic Dysfunction Status in Patients Treated With Drug-Eluting Stent Implantation:Analysis of the PTRG-DES Consortium
Donghoon HAN ; Sun-Hwa KIM ; Dong Geum SHIN ; Min-Kyung KANG ; Seonghoon CHOI ; Namho LEE ; Byeong-Keuk KIM ; Hyung Joon JOO ; Kiyuk CHANG ; Yongwhi PARK ; Young Bin SONG ; Sung Gyun AHN ; Jung-Won SUH ; Sang Yeub LEE ; Ae-Young HER ; Young-Hoon JEONG ; Hyo-Soo KIM ; Moo Hyun KIM ; Do-Sun LIM ; Eun-Seok SHIN ; Jung Rae CHO ; For the PTRG Investigator
Journal of Korean Medical Science 2024;39(3):e27-
Background:
Coronary artery disease patients undergoing percutaneous coronary intervention (PCI) often exhibit reduced left ventricular ejection fraction (LVEF). However, the impact of LV dysfunction status in conjunction with platelet reactivity on clinical outcomes has not been previously investigated.
Methods:
From the multicenter PTRG-DES (Platelet function and genoType-Related long-term prognosis in DES-treated patients) consortium, the patients were classified as preserved-EF (PEF: LVEF ≥ 50%) and reduced-EF (REF: LVEF< 5 0%) group by echocardiography. Platelet reactivity was measured using VerifyNow P2Y 12 assay and high platelet reactivity (HPR) was defined as PRU ≥ 252. The major adverse cardiac and cerebrovascular events (MACCEs) were a composite of death, myocardial infarction, stent thrombosis and stroke at 5 years after PCI. Major bleeding was defined as Bleeding Academic Research Consortium bleeding types 3–5.
Results:
A total of 13,160 patients from PTRG-DES, 9,319 (79.6%) patients with the results of both PRU and LVEF were analyzed. The incidence of MACCE and major bleeding was higher in REF group as compared with PEF group (MACCEs: hazard ratio [HR] 2.17, P < 0.001, 95% confidence interval [CI] 1.85–2.55; major bleeding: HR 1.78, P < 0.001, 95% CI 1.39–2.78).The highest rate of MACCEs was found in patients with REF and HPR, and the difference between the groups was statistically significant (HR 3.14 in REF(+)/HPR(+) vs. PEF(+)/HPR(-) group,P <0.01, 95% CI 2.51–3.91). The frequency of major bleeding was not associated with the HPR in either group.
Conclusion
LV dysfunction was associated with an increased incidence of MACCEs and major bleeding in patients who underwent PCI. The HPR status further exhibited significant increase of MACCEs in patients with LV dysfunction in a large, real-world registry.Trial Registration: ClinicalTrials.gov Identifier: NCT04734028
10.Illness Experience of Glaucoma Patients
Hyeon ae LEE ; Seon Nyeo KIM ; Hwa Young KIM ; Sue Kyung SOHN
Journal of Korean Academy of Community Health Nursing 2024;35(1):99-111
Purpose:
The purpose of this study was to understand and describe the experiences of patients with glaucoma.
Methods:
Data were collected from March to April in 2023, through individual in-depth interviews with 10 glaucoma patients. Verbatim transcripts were analyzed using Colaizzi’s phenomenological analysis.
Results:
Six theme clusters were extracted that described patients’ experiences: 1) The frightening disease unexpectedly discovered; 2) A dismal life gradually trapped in darkness; 3) Fear of the unseen; 4) Following treatment without any other options; 5) Grateful for the help but feeling miserable; 6) Realizing the importance of eyes and health.
Conclusion
The results of this study provide a deep understanding and insight into the experience of Glaucoma patients. Glaucoma patients experienced physical, mental, and social pain through the disease process. Therefore, psychological nursing interventions are needed to understand and reduce mental pain along with medical treatment to relieve physical symptoms in glaucoma patients. Furthermore, it will be necessary to prepare institutional support measures to minimize various social restrictions.

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