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PubMed1999

[An overview on reality of Dong-In Uywon(Hospital) and effects on culture of medicine].

From a review on the reality of Dong-In Hospital which was a hospital founded by Dong-Aa Dong-In-Hywe Foundation which was a corporation of governmental patron around Ulsa(1905) protective treaty between Japan and Korea, and this hospital seemed to be dissoluted just before the annexation signing of Korea to Japan. The building with site of Dong-In Hospital in Taegu was sold to Kyung-Sang Pook-Do province and Jaa-Hye Hospital was constructed instead as a virtual conscience. So it is impossible to say this Jaa-Hye Hospital as the predecessor of Dong-In Hospital although Jaa-Hye Hospital which was belonging to Kyung-Sang Pook-Do province as Kyung-Sang Pook-Do Hospital had changed the name several times until being Taegu Medical School Hospital by using as Taegu Medical Institute College Hospital which was absorbed to U.S. military government after the restoration of independence from Japan. Since 1953 Kyungpook National University absorbed Taegu Medical School, it is possible to use Taegu Medical School Hospital as the predecessor of Kyungpook National University Hospital whereas it is impossible to use Jaa-Hye Hospital as the predecessor with nationality on the basis of the health and medical administrative system.

History, 20th Century↗
PubMed1997

[Drugs in artistic works of Stanislaw Ignacy Witkiewicz (1885-1939) on the Background of polish modernism at the turn of XIX and XX century].

At the turn of XIX and XX century in the Polish artistic circles it became widespread a modernist moral model, created among other by Baudelair's, Mallarme's Rimbaud's and Verlain's works. One of its elements was striving for getting into different status of conscience with help of narcotics and alcohol. A strong presence of narcotics in life of the Polish artistic circles at a time of mocernism has been a subject to analysis carried out by Tadeusz Boy-Zeleénski in his work "Cyganeria krakowska" [Crakow Bohemians]. He has shown their role of easing emotional tensions connected with striving for fame and with a competition. Underestimation, misery and social alienation of some artists have been inducing them to search in narcotics the way to artificial reality. In some Polish artistic circles the narcotics have become a stimulant of cult character (see Antoni Lange "Ballady pijackie", Stanisław Przybyszewski "Synowie ziemi", "Moi współcześni", Henryk Sienkiewicz "Bez dogmatu"). Stanisław Ignacy Witkiewicz (1885-1939), Polish painter and dramatist, creating in the first half of XX century, has continued a tradition of modernist customs, taken over by him from the artistic circle he was brought up. He used narcotics as direct creative stimulus, inspiring creation of his paintings, including a superb series of portraits. In paintings made under influence of the drugs, Witkiewicz was placing the symbols of stimulants taken earlier. He has specially appreciated cocaine, though he has been using also opium, morphine, hashish and mixes of various psychotropic agents. Paintings of Witkacy are characterised by original colouring of a very strong artistic expression. ...

History, 20th Century↗
PubMed1992

It never dies: assessing the Nazi analogy in bioethics.

... As should be evident from the foregoing analysis, I have significant reservations about the moral utility of the Nazi analogy in debates over bioethics issues. Nevertheless, I am unable to dismiss its force entirely. I want to suggest that the real threat to the moral and human values expressed by the analogy will come not from responsibly formulated and clearly articulated proposals that undergo debate and scrutiny in the public forum, and whose practical impact in a democratic society is limited by institutional review and procedural safeguards. My concern instead is with the psychology of moral distancing, in which moral conscience is compartmentalized from vocational interests, such as the pursuit of scientific knowledge through biomedical research. It is the kind of psychology that Robert Jay Lifton has referrred to as "doubling: the division of the self into two functioning wholes, so that a part-self acts as an entire self," and which Lifton believes enabled the transformation of physicians from healers to killers in Nazi Germany....

Bioethical Issues↗
PubMed2001

[Between sancticity and value of human life: in perspective of human cloning].

The more we know, the more duties and greater responsibility we have. The dynamic development of biology carries a lot of hope for the freeing of mankind from genetic diseases. But the introduction of scientific thought necessarily has to be bound with the development of technology. It is wrong when technology dictates science a direction of development; when technique comes before ethics; and when technology does not respect the essence of a human being. The uncritical introduction of eugenics, especially cloning of people and rejecting all moral arguments, recalls inglorious acts of science when the ideology of progress determined the range of problems that researchers focused on. The same ideology of progress, although originating from other sources, pushes science toward a second extreme, into utilitarianism. In the article the author wishes to substantiate the necessity for researchers to respect ethical norms. Recognition of natural laws alone does not provide science with full development if the rights of conscience are violated.

Bioethics↗
PubMed2001

[Could human cloning make us happy?].

The idea of making mankind happy by cloning is entertained only by who reduce anything alive first to ,, a self-organizing system of cells", then to ,, a set of elements" and finally to ,,the material for something". Such ontological blindness justifies all cases of manipulating what ever is alive including human life in its initial stages. From a biological point of view, cloning involves manipulating living genetic material. When judging this procedure, one must not solely consider the technical possibilities; we need to take into account the moral point of view as well. Tampering with genetic material - the human genome especially - is morally disputable as it distorts the values of natural biological order, which has not been created by man himself. The value of this natural order, and, in the case of man, human dignity - though invisible, unmeasurable, and unobservable at its beginning- constitutes the boundaries no scientist should transgress especially if he/she is a person with a moral conscience.

Bioethics↗
PubMedDate not supplied

Jehovah's Witnesses and blood transfusion revisited: a review of the benefits and risks.

Physicians face a special challenge when treating Jehovah's witnesses. As a result of Jehovah's witnesses rigorous pursuit of medical alternatives to blood, many cardiac, obstetric and gynaecological, orthopaedic and urological surgeries that traditionally require blood transfusion can now be performed successfully without using blood or blood products. Despite the obvious advantages of this bloodless surgery, blood transfusion remains are important life saving procedure. Respecting the religious consciences of Jehovah's witnesses may challenge our skills. Though their reason for refusing blood transfusion may seem controversial, physicians should be careful to avoid being held liable in view of the laws that accommodate their belief. This paper attempts to give an overview on this issue.

Anemia↗
PubMedDate not supplied

[Study of dissociative disorders and depersonalization in a sample of young adult French population].

UNLABELLED: Questioned by several researches about dissociative disorders, the authors study differences established on the nosographic register, through a quantitative study and a psychodynamic argumentation in a sample of french population. From the utilisation of the Dissociative Experiences Scale (DES) created by Bernstein E and Putnam FW (1986), which is an excellent screening tool for dissociative disorders and constructed on DSM II diagnostic criterions, the authors will show the interest of a psychodynamic analysis of dissociative disorders, in the face of the diagnostic difficulty in relation to several approaches of this concept. This difficulty is studied giving the background to dissociative disorders and depersonalization. Ionescu (1999) shows that between 1890 and 1910 dissociation represents one of major themes of psychology, psychopathology and psychiatry. Then, this interest about dissociation decreases and will be almost non-existent in the middle of the twentieth century. The interest for dissociative disorder will grow in the eighties with north-american studies about multiple personality disorders. Until 1980, dissociative disorders exist in DSM II as a list of symptoms included into hysterical neurosis, among the conversive disorders. In 1980, the publication of DSM III replaces the notion of hysteria with the notion of dissociative disorder. In this way, we can see on the one hand somatoform disorders quarterly corresponding to the ancient version of conversive hysteria, and on the other hand dissociative disorders characterized by a perturbation of consciousness, memory, identity or perception of environment. In 1994, The DSM IV delete the notion of hysteria and neurosis and keeps only the notion of dissociative disorders. They include now the five following categories: dissociative amnesia, dissociative fugue, depersonalization disorder, dissociative identity disorder, dissociative disorder not otherwise specified (including derealization). Depersonalization disorders consist of "persistent or recurrent episodes of depersonalization characterized by a feeling of detachment or estrangement from one's self. The individual may feel like an automation or like he or she is living in a dream or movie" (DSM IV). Depersonalization disorder cannot be diagnosed if it is part of schizophrenia, panic disorder, acute stress disorder or dissociative identity disorder. Various depressive disorders, hypocondriasis or obsessive-compulsive disorders can accompany depersonalization disorder. The first purpose of this study will search the frequency of dissociative disorders and depersonalization in a sample of normal population. Further, the inclusion of depersonalization amongst dissociative disorders seems not so evident: depersonalization belongs to self-consciousness disorder in french psychiatry. This fact seems more logical insofar as dissociative disorders have all together a memory and consciousness perturbation, and this perturbation is missing from depersonalization's feeling. The second purpose will be to clarify and specify the particularity of depersonalization among dissociative diorders, from the psychopathological point of view. METHODOLOGY: The sample (n = 248) is made up of french young adults aged 17 to 30 (mean age = 20, SD = 15 and 24% is male population). Subjects were streamming from universities. The screening tool which was used is the Dissociative Experiences Scale, a 28-item patient questionnaire regarding various dissociative symptoms. The subject is asked to indicate the percentage of time, to the nearest 5%, that particular symptom is experienced. The score is made by adding the various percentages and finding a mean that is expressed in numbers from 0 to 100. Normal scores are in the range of 5 to 15 in american adults. RESULTS: The utilization of principal component analysis (PCA) with varimax rotation is justified by the will to compare this study with American's studies. The mean score obtained is 17.44%, and 13.3% of the scores exceed a psychiatric threshold at 30%. The descriptive analysis shows that the component 1 (PCA without varimax rotation) represents 33.02% of total explained variance. This result demonstrates that the structure of the DES is based on one concept, the same as the american population, it is the concept of dissociation. The Principal Component Analysis with varimax rotation of the DES ratings yielded a tree-factor solution: imaginative absorption (F1), depersonalization-derealization (F2) and dissociative amnesia (F3). Mean score for each factor is respectively: F1 = 21.56%, F2 = 13.95%, F3 = 11.04%. DES reliability was studied through computation of Cronbach's coefficient (0.92). The PCA with varimax rotation brings to the fore a full dissociative disorder without any trouble of memory and consciousness. This fact questions again once more the link between hysteria and dissociative disorders. There is here a clinical distinction between depersonalization-derealization and other dissociative disorders. Indeed, the absence of significant alteration of memory and conscience is specific of depersonalization and derealization in this study. CONCLUSION: Finally, this study concurs with DSM IV dissociative criterions. At last, one factor of PCA is composed by the association of depersonalization and derealization, in contradiction with DSM IV definition. This result shows that, into the french population, we cannot divide the two concepts.

Adult↗
PubMed2001

[The characteristics of official and personal formulary in the Song dynasty].

The development of prescription books reached its peak in the Song dynasty. There were two kinds of the book: official and personal. The former was characterized by its abundant contents, authentication and rich set -- prescriptions, while the latter was characterized by paying attention to practices, conscience and careful classification in different special areas. The two types of formulary embody the sense of splendor stage in the Song dynasty from various viewpoints. So it is useful to the development of modern pharmacology of TCM by studying the two types of formularies.

China↗
PubMed2002

[Pedro Laín Entralgo, physician and humanist].

This speech of the president of the Chilean Academy of Medicine, Dr Alejandro Goic, is a tribute to the memory of the Spanish physician, scholar, historian, writer and intellectual Dr. Pedro Laín Entralgo, who died in Madrid on June 4, 2001, at the age of 93. On that occasion, the Spanish newspaper "El Pais" defined him as the last humanist. The Spanish civil war started when Laín was 28 years old and he aligned with Franco's supporters. In 1940, when he founded the magazine "El Escorial", he was separated from the official party. He and other intellectuals declared themselves in an "interior exile". His autobiographical book, "Lightening the burden on the conscience" refers to his painful personal history. He obtained the History of Medicine chair, at the Complutense University, at the age of 34 and remained at that post until his retirement in 1978. His intellectual production is magnificent and calls to a mutual understanding, hope, friendship and love. Outstanding, among others, are his books "The wait and hope", "Theory and reality of the other", "Spain as a problem", "Medicine and history", "The clinical history", "Patient physician relationship", "Medical anthropology". He directed the collective work composed of seven volumes, called "Universal History of Medicine". He was a member of the Royal Academies for Language, History and Medicine. In Chile, he was named honorary member of the Faculty of Medicine of the University of Chile and of the Academies of Language, History and Medicine. He dictated a course of Medical Anthropology that had a profound impact on the thought of Chilean physicians. In 1949 he wrote that Chile was the most solid state of Latin America and that "Chile needs to leave his traditional calm, through a historical gesture, and create the river beds required by his magnificent spiritual and geographical gifts. There is a lack of a beautiful craziness". It was an invocation for an understanding with our neighboring countries "for ever and ever".

Anthropology↗
PubMed2002

[The importance of interdisciplinary staff in the diagnosis of developmental dyslexia: case report].

We describe the work of the interdisciplinary staff of FCM/UNICAMP for the diagnosis of developmental dyslexia, evaluating a 9 years old boy from the second year of a first grade public school. The procedure consisted of four stages: 1) Interview with the mother (anamnesis); 2) neuropsychological evaluation; 3) specific evaluation for reading and writing skills; 4) complementary exams. The results revealed that the child presented normal intelligence, normal auditory and visual function but difficulties in reading specific test, in auditory short-term memory (specially in auditory sequences), and in phonological conscience, as well as slowness, lack of concentration, slight neurological signs and hypoperfusion of the mesial portion of the temporal lobe. These data suggest that the child has developmental dyslexia of mixed type, requiring psychopedagogic follow-up.

Auditory Threshold↗
PubMed2002

The role of public exposure in moral and nonmoral shame and guilt.

Although scholarly traditions assume that shame results more from the public exposure of a transgression or incompetence than guilt does, this distinction has little empirical support. Four studies, using either undergraduate participants' responses to hypothetical scenarios, their remembered experiences, or the coding of literary passages, reexamined this issue. Supporting traditional claims, public exposure of both moral (transgressions) and nonmoral (incompetence) experiences was associated more with shame than with guilt. Shame was also more strongly linked with nonmoral experiences of inferiority, suggesting 2 core features of shame: its links with public exposure and with negative self-evaluation. The distinctive features of guilt included remorse, self-blame, and the private feelings associated with a troubled conscience.

Female↗
PubMed2002

Do we need a "Chair of alternative methods", and where?

During the last two decades, the field of in vitro technology has been successfully developed and its use is continuously growing. Advanced tests avoiding animal experiments will be increasingly required for routine industrial applications e.g. for pharmacological high-throughput screening. Moreover and even more importantly, the availability of human cell based methods is essential for future quality assurance and risk assessment in the fields of health and consumer protection as well as environmental protection. Thereby, the potential of such advanced in vitro methods extends far beyond the mere replacement of regulated tests. In practice, the introduction and expansion of this technology has been achieved predominantly by offering funding and awards to the scientific community. After this initiation phase, the next consequent step to exploit this knowledge clearly consists in academic promotion of this new scientific culture in an institutionalised form. The tasks of such a chair focussed on advanced in vitro tests - most probably the first of its kind world-wide - would cover in addition to (a) research and (b) teaching, (c) the sharpening of social conscience for the topic. (a) While the validation of alternative methods was formally established by founding institutions like ZEBET in Berlin on the national and ECVAM in Ispra on the European level, the development of further new and more sophisticated in vitro methods to date emerge predominantly as a by-product of basic research. A considerable push might now be given by the structured search for new methods with a spill-over for research-based up-to-date teaching. (b) The field of alternative methods is more than a panel of advanced in vitro techniques: A culture of systematic evaluation and validation of in vitro tests has been developed, which has bearing far beyond the replacement of animal experiments. In vitro systems inherently prone to artefacts require the highest level of quality control and assurance. A successful initiative to establish a Good Cell Culture Practice (GCCP) in analogy to Good Laboratory Practice (GLP) has evolved out of the field of in vitro alternatives. The concept of validating the relevance of an in vitro test in comparison to the respective in vivo situation represents a consequent translation of evidence-based medicine into in vitro biomedicine. In other words: It does no longer suffice that an in vitro model is plausible - it has to prove its suitability and quality. (c) The broad implementation of advanced in vitro technology into curricula implies development of lectures, courses and other teaching materials including virtual education offers. Such a basis will allow efficient spreading of knowledge and ease transnational acceptance. Last but not least, taking over the leadership for erecting a chair for alternative methods represents a major political signal that demonstrates to the public the willingness to adapt academic education to modern social awareness. A location for such an initiative needs to be found that is in the centre of Europe, has the necessary infrastructure of surrounding biomedical research, international networks for the evaluation and validation of tests, technology transfer to industrial use and access to relevant publication organs. The unequivocal answer to the question in the heading is therefore: we need a chair for in vitro alternatives because (i) the patient is our primary concern but the animal is not just secondary (ii) man's responsibility for the integrity of all creatures including the own species makes it mandatory.

Animal Testing Alternatives↗
PubMedDate not supplied

[Persistent vegetative state. Paradigm of current discussion on alterations of consciousness].

INTRODUCTION: The vegetative state is the current paradigm of discussions about the alterations of conscience. DEVELOPMENT: Although accepted by most investigators, it is still controversial. The dilemma starts with the denomination itself. In this paper we propose the denomination persistent vegetative state . We start with a historical review of the integration of consciousness. We also give epidemiological data and point out the clinical features, complementary tests and anatomical findings. The patients are classified into three grades for prognosis. Grade III includes those with the worst prognosis, who have no sleep waking cycles with or without opening their eyes. This section emphasises cases of prolonged survival and of late recovery who made almost complete recovery of their intellectual functions. We state that treatment is based on two aspects: treatment of the underlying disease and general measures and emphasise the need for a multidisciplinary team. From the bio ethical point of view, it should be remembered that the patients are alive and cannot be considered in the same group as the brain dead, in whom all encephalic function has been lost. CONCLUSIONS: It is not ethical to decide to suspend medical treatment when it is known that there is a possibility of recovery of the structural anatomy and function. We are morally obliged to maintain qualified medical attention. It has been shown scientifically that we not only should, but can, obtain the recovery of these patients, in spite of the serious damage suffered by their nervous system

Brain↗
PubMed2002

[Not Available].

BACKGROUND: In this review we wanted to explane of opinions of The Turkish Association for Trauma and Emergency Surgery monthly inter-hospital meetings results. METHODS: Opinions of meetings participants about blunt abdominal trauma were reviewed. RESULTS: Haemodynamic stability and conscience situation are the main factors to determine the approach to blunt abdominal trauma patients. We generally prefer ultrasonography (USG) to first step diagnostic technique for haemodynamica/ly stable patients. IfUSG is not possible, diagnostic peritoneallavage (DPL) could be perform. We propose that DPL or USGcould be perform when the focus isnot known in the haemodynamica/ly unstable, multi-traumatised patients. But we don 't agree to perform any diagnostic techniques if we know that haemodynamic unstability is caused from intraperitoneal injury. CONCLUTION: We prefer and propose resuscitation and emergency laparotomy for a/l patients of whom focus of the haemodynamica/ly un-stability is i1itra-abdominal damage. But ifthe haemodynamica/ly un-stable patients have pelvic bone fractures we don't propose the emergency laparotomy, because the probablefocus ofthe serious bleeding is pelvic vessels. In our opinion that patients must be resuscitated aggressively and evaluated with C1; because in this situations false positivity of the DPL is often. Surgeons must not take shelter the laparotomy for the name of life rescue, because negative and non- therapeutic laparotomy has high morbidity.

Abdomen↗
PubMedDate not supplied

[One hundred years old and under haemodialysis treatment for 5 years...a case to ponder].

BACKGROUND: The average age of the patients, introduced in the dialytic programme, is progressively increasing in relation to the prolonging of life and to the technological progresses. All this places the nephrologist to ask himself if the age has to be considered a limiting factor for the introduction of a patient in the dialytic programme. CASE REPORT: We report on a patient who started her dialytic programme when she was 95. After 5 years, at the age of 100, she uneventfully completed 60 months of haemodialytic treatment. Right from the start we decided to use as vascular access a double Tesio catheter, which was never replaced because it was the most appropriate for the patient's age. During the follow-up period the patient was not hospitalised and her clinical condition was satisfactory. DISCUSSION: According to the latest epidemiological and clinical data, this case emphasises the concept that it would be wrong to refuse the haemodialytic treatment to such patients only because of their frailty. Moreover, the lack of either univocal prognostic indications, based on scientific criteria, or special national laws confirm that the decision to treat the patient depends exclusively on the physician's ethical and professional background as well as the patient's autonomy and conscience.

Aged↗
PubMed2002

[Toward integrated dengue control ].

Dengue is the most important arthropod-borne viral disease, it is characterized by mild symptoms to hemorrhagic manifestations and shock syndrome (DHF/DSS). Dengue and DHF/DSS have become major public health problems worldwide. In the urban areas of tropical and subtropical regions approximately 50 million infections occur annually. In Venezuela the situation is similar to the rest of the Americas. The impact of dengue points out the necessity of very organized and effective control programs. The emergency measures to combat the epidemics have had limited effects. There is not a specific management of dengue infections, no vaccine is commercially available and vector control is one of the alternatives to stop the spread of the disease, but an integral control program is needed, with each population's particularities and the state of epidemic risk in that it is. In the practice, it is to combine the environmental reparation with the changes in the human behavior taken place by the sanitary education and the necessary laws for it, integrated with the biological fight against the vector in the way and more appropriate moment and the chemical control in epidemic situations. This last aspect is fundamental as message of change toward an active attitude and of conscience, without which we can affirm with all security that doesn't exist government neither system of health able to solve this problem.

Aedes↗
PubMed1985

[Sociopsychological aspects of demographic propaganda].

"This article treats the basic socio-psychological aspects of...demographic propaganda as a process of scientifically planned influence on society, family, and personality with a view to realize a specific demographic policy. The main aim of the demographic propaganda is to influence the reproductive behaviour and conscience. The spheres of demographic propaganda and its motivational basis are also discussed." (summary in ENG, RUS)

Behavior↗
PubMed1975

[Emergencies in internal medicine. General management in coma situations].

One of the most important aspects of the Emergency Medicine is the coma status as much as intra and extrahospitalary ambient. The interest of om study is based according the hardness of anamnesis, and the severity of symptoms induced by a altered conscience and by the need of a emergency therapy. This work summarized the general semiology of the patient in order to diagnostic, severity and etiology of the coma. The general behaviour therapeutic and some criterions about an irreversibility is also studied.

Coma↗