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Renal Lymphoma with Mesenteric Lymphomatosis in a Cat
전진하,송두원,노웅빈,김형석,이가원,조준호,정우창,김수현,서정향,박희명 한국임상수의학회 2020 한국임상수의학회지 Vol.37 No.4
A 6-year-old castrated male Russian Blue cat was presented for evaluation of dyschezia. Abdominal ultrasound revealed hyperechoic nodules in both kidneys, heterogeneous mass in abdomen, and extensive mesenteric thickening with multiple hypoechoic nodules. Computed tomography showed multiple hypodense lesions in both kidneys and diffuse nodular infiltration around the mesentery. Fine needle aspirates (FNA) acquired under ultrasound guidance from the mesentery consisted of large lymphocytes which have round to irregular nuclei with granular chromatin, prominent nucleoli and a small amount of basophilic cytoplasm. Polymerase chain reaction (PCR) for antigen receptor gene rearrangement result of FNA sample revealed a T-cell malignancy. The cat died from acute renal failure after 1 cycle of modified Madison-Wisconsin L-CHOP protocol. Postmortem examination revealed bilaterally enlarged lumpy-bumpy shaped kidneys. Histopathologic examination showed an infiltration of malignant lymphocytes into the renal parenchyma and mesentery. Immunohistochemical staining of the renal sample displayed a negative expression of CD3, PAX5, MUM-1, and CD79. The clinical features and prognosis of the cat with renal lymphoma with mesenteric lymphomatosis have been described in this report.
의료법 제17조 제1항의 ‘직접 진찰’의 의미와 의료법상 원격의료 부분의 개정방향 - 대법원 2013. 4. 11. 선고 2010도1388 판결을 중심으로 -
전진하 ( Jin Ha Jun ) 연세대학교 법학연구원 의료·과학기술과 법센터 2015 연세 의료·과학기술과 법 Vol.6 No.2
이 논문은 의료법 제17조 제1항의 ‘직접 진찰’의 의미를 고찰하고 현행 의료법상 원격 의료 부분의 개정방향을 제안하는 것을 목적으로 한다. 의료법 제17조 제1항은 직접 진찰한 의사가 아니면 처방전을 작성하여 환자에게 교부하지 못하도록 규정하고 있다. 의사가 대면 진찰 없이 전화로 진찰하여 환자에게 처방전을 발행한 것이 ‘직접 진찰’에 해당하는지에 대해 대법원과 헌법재판소는 상반된 결론을 내렸다. 대법원과 헌법재판소의 법률 해석이 달라진 이유는 의료영역에서 과학 발전과 사회여건, 국민의 의식변화 등이 법규에 반영되지 못하고 행정형벌의 구성요건 내용이 애매모호하거나 불명확하기 때문이다. 본 논문에서는 대법원과 헌법재판소가 ‘직접 진찰’의 의미를 해석한 논리와 그에 따른 논증을 비교 검토하여 대법원의 판단이 더 타당하다는 결론을 이끌어낼 것이다. 다만 대법원의 해석에 따르면 현행 의료법상 규정하지 않은 의료인과 환자 간의 원격의료를 인정하게 되어 현행 의료법상 충돌될 위험이 있으므로 보건복지부 개정안과 원격의료에 대한 각국의 실태를 살펴본 후 의료법의 개정방향을 제안하고자 한다. 원격의료의 확대는 거스를 수 없는 변화의 흐름이다. 하지만 의료인과 환자 간 원격의료에서는 아직 의학적 안전성이 검증되지 않은 점에서 의료법에 대면 진료 원칙을 규정하고 원격의료가 반드시 필요한 지역, 원격의료가 필요한 대상, 원격의료의 제공 방식을 보다 명확하게 정해야 할 것이다. The main purpose of this paper is to consider the meaning of ‘Directly examining patients’ in Medical Services Law Article 17section 1 and to suggest how to revise telemedicine section of Medical Services Law in force. According to Medical Services Law Article 17section 1, the doctor who did not examine patients directly can not write prescription. Supreme court and the constitutional court had contradictory conclusion about if ‘Directly examining patients’ means ‘face-to-face medical’ treatment or not. The reason why this difference occur is law does not reflect development of science and national consciousness. Also elements of administrative penal law is unclear. This thesis will examine how the Supreme Court and the Constitutional court interpret the meaning of ‘Directly examining patients’. And then it will check why conclusion of Supreme court is more reasonable. However, according to construction of Supreme court it is to acknowledge telemedicine between health professionals and patients which is not provided in current medical law. Therefore this paper will suggest the Medical Services Laws`s revision direction after checking revised bill of Ministry of Health and Welfare and status of telemedicine in each country. Expansion of telemedicine is irreversible trend. However, safety of telemedicine is not verified yet so ‘face-to-face medical’ should be ruled in the Medical Services Law. Also essential area of telemedicine and object which necessarily needs telemedicine should be specific as well as method of telemedicine should be clearly determined.
Application of Topical Madecassoside Cream in Dogs and Cats with Skin Diseases
노웅빈,강민희,송두원,김형석,이가원,강현민,김종원,박수빈,전진하,금종선,박원근,고진,심수경,이현정,박희명 한국임상수의학회 2021 한국임상수의학회지 Vol.38 No.2
Madecassoside, an active ingredient extracted from Centella asiatica, is used for treatment of various skin disorders in humans. However, the effect of madecassoside on the skin of dogs and cats has not been studied yet. The purpose of this study was to evaluate clinical efficacy of topical madecassoside cream in dogs and cats with skin diseases. A total of twenty-one dogs and ten cats with various skin diseases were included in the study. The 1% topical madecassoside cream was applied to the animal’s skin lesion at least once a day for 7 days, and the skin condition was evaluated before the application of madecassoside cream (day 0) and 7 days after the application (day 7). The skin condition was scored by five clinical indices: canine atopic dermatitis extent and severity index-4 (CADESI- 4), coat condition, pruritus, scale, and general condition. In dogs, all five clinical indices (CADESI-4, coat condition, pruritus, scale, and general condition) were significantly decreased on day 7 compared to those on day 0 (p < 0.0001, p < 0.05, p < 0.001, p < 0.01, and p < 0.05, respectively). In cats, the CADESI-4 and scale were significantly decreased on day 7 compared to those on day 0 (p < 0.01 and p < 0.05, respectively). No adverse effects were observed during the trial period in the dogs and cats included in this study. The results of this study demonstrate that the topical madecassoside cream is applicable to skin lesions in dogs and cats.