Probing the Issue of Informed Consent in Health Care in Korea―Concept Analysis and Guideline Development

Won-Hee Lee,In-Sook Kim,Byung-Hye Kong,Sue Kim,Sunhee Lee 한국간호과학회 2008 Asian Nursing Research Vol.2 No.2

Purpose The purpose of the study was to identify how informed consent is conceptualized by patients, family members, physicians, and nurses in Korea, and to develop guidelines for clinical practice in Korea. Methods This study employed the hybrid model to define the concept of informed consent through theoretical and fieldwork phases. For the theoretical phase, attributes of informed consent were identified through a review of the literature, and in-depth interviews were conducted for the fieldwork phase to develop attributes from the data and to verify the attributes identified from the literature review. Purposive sampling was done for 48 participants (12 patients, 12 family members, 12 physicians, 12 nurses), who were interviewed from selected units (orthopedics, cardiothoracic surgery, obstetrics/gynecology) from two university hospitals in Seoul and Kwangju, Korea. Attributes and processing issues of informed consent were extracted from both phases. Results Core attributes of informed consent include the patient’s self-directed decision-making, fulfillment of legal responsibility, focusing on forging a trusting relationship, assuming active responsibility for explanations (physicians) and granting consent (patient), factors related to sufficient explanation, and the role of family. Findings were integrated into a set of guidelines for patients and family and health care professionals. Conclusion The guidelines developed in the present study offer empirical parameters for an effective process of obtaining informed consent in Korea by seeking to decrease the gap in perceptions of informed consent among patients, family members, physicians, and nurses. The importance of advocating patients and developing a trusting relationship between health care providers and patients is especially noteworthy. [Asian Nursing Research 2008;2(2):102–112] Purpose The purpose of the study was to identify how informed consent is conceptualized by patients, family members, physicians, and nurses in Korea, and to develop guidelines for clinical practice in Korea. Methods This study employed the hybrid model to define the concept of informed consent through theoretical and fieldwork phases. For the theoretical phase, attributes of informed consent were identified through a review of the literature, and in-depth interviews were conducted for the fieldwork phase to develop attributes from the data and to verify the attributes identified from the literature review. Purposive sampling was done for 48 participants (12 patients, 12 family members, 12 physicians, 12 nurses), who were interviewed from selected units (orthopedics, cardiothoracic surgery, obstetrics/gynecology) from two university hospitals in Seoul and Kwangju, Korea. Attributes and processing issues of informed consent were extracted from both phases. Results Core attributes of informed consent include the patient’s self-directed decision-making, fulfillment of legal responsibility, focusing on forging a trusting relationship, assuming active responsibility for explanations (physicians) and granting consent (patient), factors related to sufficient explanation, and the role of family. Findings were integrated into a set of guidelines for patients and family and health care professionals. Conclusion The guidelines developed in the present study offer empirical parameters for an effective process of obtaining informed consent in Korea by seeking to decrease the gap in perceptions of informed consent among patients, family members, physicians, and nurses. The importance of advocating patients and developing a trusting relationship between health care providers and patients is especially noteworthy. [Asian Nursing Research 2008;2(2):102–112]

Association of HLA-DRB1 and -DQB1 Alleles with Susceptibility to IgA Nephropathy in Korean Patients

In Ji Won,Jung Kiwook,Shin Sue,Park Kyoung Un,Lee Hajeong,Song Eun Young 대한진단검사의학회 2022 Annals of Laboratory Medicine Vol.42 No.1

Background: Associations between IgA nephropathy (IgAN) and HLA-DRB1 and -DQB1 alleles have been reported in several ethnic groups. We investigated the association of HLA-DRB1 and -DQB1 alleles with the predisposition for IgAN and disease progression to end-stage kidney disease (ESKD) in Korean patients. Methods: We analyzed HLA-DRB1 and -DQB1 genotypes in 399 IgAN patients between January 2000 and January 2019 using a LIFECODES sequence-specific oligonucleotide (SSO) typing kit (Immucor, Stamford, CT, USA) or a LABType SSO Typing Test (One Lambda, Canoga Park, CA, USA). Alleles with a significant difference in two-digit resolution were further analyzed using in-house sequence-based typing and sequence-specific primer PCR. As controls, 613 healthy hematopoietic stem cell donors were included. Kidney survival was analyzed in 281 IgAN patients with available clinical and laboratory data using Cox regression analysis. Where needed, P-values were adjusted using Bonferroni correction. Results: The allele frequencies of HLA-DRB1*04:05 (corrected P [Pc]<0.001), -DQB1 *04:01 (Pc=0.048), and -DQB1*03:02 (Pc=0.021) were significantly higher in IgAN patients than in controls, whereas those of HLA-DRB1*07:01, -DRB1*15:01, -DQB1*02:02, and -DQB1*06:02 (Pc<0.001 for all) were significantly lower in IgAN patients than in controls. The allele frequency of HLA-DQB1*05:03 (Pc=0.016) was significantly lower in the ESKD group than in the non-ESKD group; however, there was no significant difference for ESKD progression between these groups. Conclusions: We report novel associations of HLA-DRB1*15:01, DQB1*02:02, -DQB1*03:02, and -DQB1*04:01 with IgAN. Further studies of HLA alleles associated with IgAN progression in a larger cohort and in various ethnic groups are needed.

고혈압성 안저변화와 생리적 제인자간의 상관관계에 관한 연구

원인건,심운택 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2

The author investigated the correlation among physiological factors that could affect the hyperten-sive retinopathy as a line in the chain of basic investigation to prevent and manage the hypertensive disorders. The study group composed of 130 people with arteriosclerotic or hypertensive retinopathy and 260 healthy people. The results obtained were as follows: 1. Grade I was the most common in hypertensive retinopathy as 65.4%, and the distribution by age and sex showed that grade I in 50-59 year old group was the most common in male and female as 20.0% and 15.4%, respectively. 2. Grade I was the most common in arteriosclerotic retinopathy as 66.1%, and the distribution by age and sex showed that grade I in 50-59 year old group was the most common in male and female as 35.0% and 40.0%, respectively. 3. In the realtionship between hypertensive retinopathy and blood pressure, Grade I was the most common n the grade of 150-159㎜Hg, systolic blood pressure and 100-109㎜Hg, diastolic blood pressure as 22.3% and 33.8%, respectively. 4. In the case group, the level of serum cholesterol(211.26±47.53㎜g/㎗), serum triglyceride (184.05±93.3㎜Hg/㎗), low density lipoprotein(125.22±48.98㎜Hg/㎗), atherogenic index 1(3.67±1.85), and atherogenic index 2(2.86±1.64), were higher than those in the control group, however, only the level of high density lipoprotein(51.88±11.95㎜Hg/㎗) was lower. 5. The significant correlation to the grade of hypertensive and arteriosclerotic retinopathy were found in systolic and diastolic blood pressure. 6. The odds ratio between the case group and control group in serum lipid showed the significant difference in more than 200㎎/㎗ of total serum cholestrol and more than 190㎎/㎗ of serum triglyceride as 3.59 and 2.48, respectively. 7. The odds ratio between the case group and control group in atherogenic and obesity index showed the significant difference in more than 3.0 of atherogenic index 1 and more than 30% of obesity index as 2.40 and 3.67, respectively.

체외순환 없이 시행한 관상동맥우회술의 조기성적

원태희,최세용,양인숙 이화여자대학교 의과대학 2005 EMJ (Ewha medical journal) Vol.28 No.1

Background : The advances in surgical techniques and stabilizing devices have made the off-pump coronary artery bypass (OPCAB) popular, and good results have been published. We analyzed the early results of OPCAB performed in our hospital. Materials and Methods : Between January 2004 and December 2004, 23 patients underwent OPCAB. There were 14males and 9 females with mean age of 62.6± 10.3years. Preoperative diagnoses were unstable angina in 13(57%), acute myocardial infarction in 9(39%), and stable angina in 1(4%). Preoperative angiographic diagnoses were three-vessel disease in 12 (52%), two-vessel disease in 8(35%), one-vessel disease in 1(4%), and left main disease in 2(9%). Results : The mean number of grafts was 2.6 ±0.9 per patient. Vessels accessed were left anterior descending artery in 23, diagonal branch in 14, obtuse marginal branch in 9, right coronary artery in 12, and posterior descending artery in 1. Left internal mammary artery were used in 22 patients and bilateral internal mammary arteries were used in 1 patient. There was no operative mortality. Postoperative complications were cerebral vascular accident in 1, postoperative bleeding which required operative management in 2, arrhythmia including atrial fibrillation in 5, and minor operative wound problem in 1. Pre-discharge graft patency was evaluated in 11 patients. One internal mammary artery graft was occluded in 11 internal mammary artery graft evaluated. The patency rate was 91%. Seventeen saphenous vein grafts were patent in 19 saphenous vein grafts and the patency rate was 89%. Conclusion : Our result of OPCAB is promising and OPCAB is suggested to be the ideal technique with less morbidity and mortality.

<i>In vitro</i> and <i>in vivo</i> evaluation of a novel polymer-free everolimus-eluting stent by nitrogen-doped titanium dioxide film deposition

Park, Dae Sung,Bae, In-Ho,Jeong, Myung Ho,Lim, Kyung Seob,Sim, Doo Sun,Hong, Young Joon,Lee, So-Youn,Jang, Eun Jae,Shim, Jae-Won,Park, Jun-Kyu,Lim, Han Chul,Kim, Han Byul Elsevier 2018 Materials Science and Engineering C Vol.91 No.-

<P><B>Abstract</B></P> <P>Inflammation and thrombosis are linked to the use of polymer-based drug-eluting stents (DES). The aim of this study was to develop a polymer-free everolimus (EVL)-eluting stent using nitrogen-doped titanium dioxide (N-TiO<SUB>2</SUB>) and verify its efficacy by <I>in vitro</I> and <I>in vivo</I> assessment in a porcine coronary model. Various analytical approaches such as scanning electron microscopy and atomic force microscopy, electron spectroscopy, Fourier transform infrared spectrometry and contact angle measurement were employed for the characterization. As a part of biocompatibility assessment, platelet adhesion and smooth muscle cell (SMC) proliferation were examined. Bare metal stent (BMS), N-TiO<SUB>2</SUB> stent, everolimus-eluting N-TiO<SUB>2</SUB> (N-TiO<SUB>2</SUB>-EVL) stent, and commercialized EVL-eluting stent (EES) were randomly placed in forty coronary arteries in twenty pigs. After four weeks of implantation, the stents were subjected to histological and quantitative analysis. The N-TiO<SUB>2</SUB> film used in this study was well coated without any cracks or peeling. Surface hydrophilicity (88.8% of angle decrement) could be associated with the decrease in surface roughness post N-TiO<SUB>2</SUB> deposition (37.0%). The platelet adhesion on the N-TiO<SUB>2</SUB> surfaces was less than that on the BMS surface. The proliferation of SMC was suppressed in the N-TiO<SUB>2</SUB>-EVL group (30.2%) but not in the BMS group. In the animal study, the percent area restenosis was significantly decreased in the N-TiO<SUB>2</SUB>-EVL group compared to that in the BMS group. The results (BMS; 47.0 ± 11.00%, N-TiO<SUB>2</SUB>-EVL; 31.7 ± 10.50%, and EES; 29.1 ± 11.21%, <I>n</I> = 10, <I>p</I> < 0.05) were almost at par with those of the commercialized EVL-eluting stent. The introduction of N-TiO<SUB>2</SUB> deposition during fabrication of polymer-free DES may be an efficient accessorial process for preventing in-stent restenosis and thrombosis.</P> <P><B>Highlights</B></P> <P> <UL> <LI> N-TiO<SUB>2</SUB> surfaces can help to reduce the platelet adhesion. </LI> <LI> In porcine model, N-TiO<SUB>2</SUB> everolimus decreased in-stent restenosis and fibrin deposition. </LI> </UL> </P>

항 혈소판 요법을 이용한 관동맥내 Stent 삽입술의 조기 결과

손지원,김영준,손민수,오세진,안태훈,최인석,신익균 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.6

중국 이동전화단말기업계 당향과 국내업체 진출현황

현인규,손원민 순천향대학교 사회과학연구소 2004 순천향 사회과학연구 Vol.9 No.2

Since the 1990s, the electronics industry has experienced a rapid crossover from analogue to digital technologies. Digital wireless telecom was first introduced in Europe in 1992, and has rapidly replaced its analogue predecessor. Digitalization greatly improved the quality of telecom services, and the standardization enabled mass production of handsets. As a result, the number of mobile telecom subscribers in the world has skyrocketed 500 thousand in 1992 to 1.1 billion at end of 2002. Korea also witnessed a surge in subscribers from 40 thousand to 32 million during the same period. China has the largest number of mobile phone-users in the world. and Foreign Firms are localizing their products in China as they strive for as greater share of the world's largest mobile phone market. Sooner or later China's phone market will face oversupply. The over production will lead to a price war and push many companies out of the market altogether. This paper will suggest entry strateiges to China's mobile handset market. The large companies, for example Samsung and LG, have to choose the skimming pricing policy through developing new high-tech products. It is important that the medium and small companies have a price competition through the alliance with excellent domestic parts production firms. World mobile phone market has been rapidly growing due largely to the increase of mobile phone users and the revolution of communication technology. However, in 2001, the economic recession of the United States, the largest importer of mobile phone, with the slow down of world IT industry and the postponement of 3G services has happened and they caused the shrinking of the market and the fall of growth rate. During the last several years, South Korea's export of mobile phone has been remarkably growing and become its seond largest export item ahead automobile. In particular, China, which is South Korea's strong competitor in this sector, now has the largest mobile phone users in the world and marks the highest growth in mobile phone services. Moreover, it is the largest producer of mobile phone in the world. In this sense, China has a Janus faced aspect. It is our export market as well as our production base of mobile phone. On the other hand, our mobile phone producers have to compete vehemently with Chinese local mobile phone producers. The importance of Chinese market has been increasingly growing and since 2003 china has become the largest export market. Among the export items to china, telecom equipments amounts to 17 percent of the total export. In particular, due largely to the abolition of subsidy applied to mobile phone in the Korean domestic market and the decrease of new mobile phone subscribers, Korean mobile phone makers step up their efforts to export to China. However, recently, some 67 percent of Chinese market has been occupied by its local mobile phone makers, which have done business very aggresively. The Chinese government also has supported its local producers, giving them a lot of incentives. This leads to a fierce fighting between Korean mobile phone producers who try to keep the market and Chinese local producers who have strong marketing capabilities. In order for our mobile phone producers to succeed continuously in Chinese market, we have to deeply consider two things. One is that we have to consider the scale of company. For instance, big companies like Samsung Electronics and LG Electronics have to focus on the development of new items, especially expensive ones. In particular, Samsung has to prepare for the lineup for GSM phone and increase its brend power. It has to transform from cheap and reasonable market to expensive market. Moreover, it has to jump on the new market of network equipments. Small and medium companies have to focus on acquiring price competitiveness. In addition to this, they have to cooperate with Korean local part makers and produce reasonable price items with good quality.

Sarcoma 180 유발생쥐의 생존시간에 대한 Cyclophosphamide 및 Typhoid Vaccine 의 단독 및 병합투여의 영향

신인철,서대규,김윤원 漢陽大學校 環境科學硏究所 1989 環境科學論文集 Vol.10 No.-

체중 25mg내외의 ICR계 웅성생쥐에 복수암인 sarcoma 180을 유발시킨 후 48시간 경과후부터 격일로 1일 1회씩3회에 걸쳐 체중 kg당 8ml의 생리적 식염수를 복강내에 투여한 군을 대조군으로 하고,체중 kg당 100 mg의 cyclophosphamide를 복강내에 단독 투여한 군과 체중 kg당 4ml의 typhoid vaccine을 복강내에 단독 투여한 군 및 체중 kg당 100mg의 cyclophosphamide와 4ml의 typhoid vaccine을 복강내에 병합 투여한 군으로 나누었다.숙주의 수명은 잔존하는 악성종양 세포의 수와 반비례하는 것으로 알려져 있음으로 sarcoma 180 유발 생쥐의 생존시간 및 암세포수에 미치는 cyclophosphamide 및 typhoid vaccine의 단독 또는 상호 병합투여에 대한 다음과 같은 결과를 얻었다. 1. Sarcoma 180 유발생쥐의 생존일수의 평균치는 대조군에서는 13.8일이었으나, cyclophosphamide 단독 투여군에서는 20.2일, typhoid vaccine 단독 투여군에서는 18.1일 이었고, cyclophosphamide와 typhoid vaccine 병합 투여군에서는 23.4일로서 생존일수의 언장효과를 보여주었다. 2. Sarcoma 180 유발 생쥐의 복수에서의 암세포 수는 대조군에서는 암세포 수가 점차증가되었으나, cyclophosphamide 단독 투여군, typhoid vaccine 단독 투여군 및 cyclophosphamide와 typhoid vaccine 병합 투여군에서는 대조군에서 보다 적은 범위로 암세포 수가 증가되어 암세포 증식의 억제효과를 보여 주었는데 cyclophosphamide 와 typhoid vaccine 병합 투여 군에서 가장 큰 폭으로 암세포 증식의 억제효과를 보여 주었다. Sarcoma 180 bearing mice, averaging 25gm of body weight, were divided into 4 groups of animals, animals administered 8ml/kg of normal saline as control group, group administered 100mg/kg of cyclophosphamide, group administered 4ml/kg of typhoid vaccine and group administered 100mg/kg of cyclophosphamide and 4ml/kg of typhoid vaccine. Treatment was initiated 48 hours after tumor implantation and repeated three times once a day. All the agents given were administered intraperitoneally. This study was made to elucidate the effects of cyclophosphamide and typhoid vaccine on the survival days and tumor cell count in sarcoma 180 bearing mice. The results were as follows. 1. Average survival days was 13.8 days in control group, 20.2 days in group administered cyclophosphamide in alone, 18.1 days in group administered typhoid vaccine in alone and 23.4 days in group administered cyclophosphamide and typhoid vaccine in combination. 2. Tumor cellcount in ascitic fluid was increased in control group and increased to smallerextents than control group in groups administered cyclophosphamide and typhoid vaccine in alone or combination.Consequently,it is suggested that cyclophosphamide and typhoid vaccine have the effects of prolongation of survival days and inhibition of proliferation of tumor cells in sarcoma 180 bearing mice.

한국 재원 정신분열병환자의 사회경제적 특성에 관한 역학적 조사 : 일일 시정조사 Point Prevalence Study

정인원,김용식,이정균 大韓神經精神醫學會 1985 신경정신의학 Vol.24 No.1

1984년 2월 27일 현재 전국 정신과 병·의원의 입원환자를 대상으로 일일시정조사를 시행하였다. 자료분석 때까지 도착한 자료중 ICD-9의 진단기준에 의하여 정신질환의 범주에 속하는 2,895명을 1:1 쌍쌍대응법으로 분석하여 거주지별로 정신분열병군과 대조군간의 사회경제적 특성을 비교하였다. 분석결과는 다음과 같았다. 1. 정신분열병환자의 결혼상태는 두 지역 모두에서 독신이 많았고 odd ratio는 각각 5.33과 3.56이었다. 농ㆍ어촌의 정신분열병환자가 독신이 더 많았다. 2. 교육수준은 양 군에서 뚜렷한 차이는 없었다. 3. 직업은 도시의 정신분열병환자에서 무직이 많았고 odd ratio는 1.90이었다. 4. 경제수준은 도시의 정신분열병환자에서 낮은 층이 많았고 odd ratio는 1.65이었다. 5. 그외 가족구조와 종교, 부모의 결혼상태에서는 유의한 차이를 보이지 않았다. Aiming at suggestion the possible ways to improve psychiatric care, rehabilitation, and mental health services in Korea, this nation-wide hospital study was intended to explore the socioeconomical status of mental in-patients. This point prevalence study was conducted to patients who were in psychiatric wards at Feb. 27th. 1984 using mailing questionnaire. The number of hospitals and clinics answered was 88 and the patients, 3,300. Among them, we selected the 2,895 patients who were included in mental disorders (290-319) by ICD-9. Finally we compared the socioeconomical status between schizophrenia and non-schizophrenia in rural and urban area with the method of Fleiss. The results were as follows; 1. The relative proportions of single persons in schizophrenia were higher in both areas, and their odds ratios were 5.33 and 3.56, respectively. There were more single schizophrenics in rural than urban. 2. In educational levels, there were no significant differences between schizophrenia and control. 3. In urban area, the jobless persons were more in schizophrenia than control, and its odd ratio was 1.90. 4. The urban schizophrenics were significantly lower than the urban control in economical levels, and its odd ratio was 1.65. 5. About family structure, religion, and marital status of parents, there were no significant differences between schizophrenia and control.

공군사관생도의 심폐능력에 따른 심리 · 생리요인 비교

김인기(In-ki Kim),김건희(Gun-hee Kim),송성우(Sung-woo Song),최가람(Ga-ram Choi),엄장원(Jang-won Eom),곽재준(Jae-jun Kwak),유영남(Young-nam You),정덕화(Deok-hwa Jeong),강지훈(Ji-hun Kang) 육군사관학교 화랑대연구소 2019 한국군사학논집 Vol.75 No.2

The purpose of this study was to analyze the differences in psychological and physiological factors between groups by classifying groups based on the 3km running record of fourth grade Air Force Academy cadets. Among the top 46 Air Force Academy cadets who wanted to participate in the study, the study conducted an open survey of the top 13 and the bottom 15 who wanted to provide the data prior to the study. The subjects of the experiment and in-depth interview were studied by a total of 18 people, 9 of each upper and lower members who wished to participate in the study. Psychological factors were structured through inductive content analysis of data extracted from in-depth interviews, and physiological factors were conducted to verify differences between groups of body composition and cardiopulmonary function. The psychological factors of the upper and lower groups were found to be general areas of performance strategy, achievement motivation, emotional response, military spirit, situation perception, and basic physical strength. In the detailed areas, the subjects were also examined in 15 areas including physical fitness indicators, confidence, condition control, task orientation, and positive self-perception. As a result of comparison between upper and lower groups, the upper group was 2.2 times higher than the lower group and the lower group was 1.7 times higher than the upper group in the military spirit and performance strategy of the general area response rate. In general area response, the ratio of mental strength and confidence was different in the general area of military spirit. In addition, the upper group in the achievement motivation showed a high percentage of task tendency at 47%, while the lower group showed a high rate of zero motivation at 50%. In the emotional response, the upper group showed an equal ratio, while the lower group showed an 81% ratio of negative emotions. In the overall response by sub-region, the negative emotions of the subgroup were high at 28%. In the body composition, BFM showed a statistically significant difference between upper and lower groups, and Weight, FFM, and SMM did not show any significant difference between groups. In cardiopulmonary capacity, VO2max showed a statistically significant difference between upper and lower groups, and VE and LT did not show significant differences between groups.