The number of physicians in Japan has been and will continue to be lower than that in other the Organization for Economic Co-operative and Development (OECD) countries. The admission capacity of medical schools, which has the greatest impact on the number of physicians, has been determined through discussions among the Ministry of Health, Labour and Welfare, medical associations, medical organizations, universities, and academics, depending on the medical supply-demand status on that era. In recent years, the maldistribution of medical specialties and regions has become an issue. For the involving this issue, Japanese government takes from multiple perspectives to address this problem, including “regional quotas” in admission quotas for university medical school and, setting a ceiling on the number of residency positions available in each prefecture as well as on recruitment capacity in the specialist physician system. The implementation of “work style reform” for physicians, focuses on shortening physicians’ working hours and has raised concerns regarding a shortage and regional maldistribution of physicians. The government’s policy is based on a key concern: rising healthcare costs could seriously threaten the country’s financial health. Therefore, the government has limited the increase in the number of physicians. Conversely, this year, the government has begun to argue that a regulatory approach is necessary to address the uneven distribution of physicians. Our proposition is to achieve a number of physicians comparable to that of other OECD countries and to create an environment that enables physicians to voluntarily address their regional and departmental maldistribution.
{"title":"Supply, Demand and Distribution of Physicians in Japan","authors":"Hiroyasu Nishiyama, Yoshihiro Mizuma, Nobuo Handa, Ryong-moon Shin","doi":"10.46308/kmj.2024.00087","DOIUrl":"https://doi.org/10.46308/kmj.2024.00087","url":null,"abstract":"The number of physicians in Japan has been and will continue to be lower than that in other the Organization for Economic Co-operative and Development (OECD) countries. The admission capacity of medical schools, which has the greatest impact on the number of physicians, has been determined through discussions among the Ministry of Health, Labour and Welfare, medical associations, medical organizations, universities, and academics, depending on the medical supply-demand status on that era. In recent years, the maldistribution of medical specialties and regions has become an issue. For the involving this issue, Japanese government takes from multiple perspectives to address this problem, including “regional quotas” in admission quotas for university medical school and, setting a ceiling on the number of residency positions available in each prefecture as well as on recruitment capacity in the specialist physician system. The implementation of “work style reform” for physicians, focuses on shortening physicians’ working hours and has raised concerns regarding a shortage and regional maldistribution of physicians. The government’s policy is based on a key concern: rising healthcare costs could seriously threaten the country’s financial health. Therefore, the government has limited the increase in the number of physicians. Conversely, this year, the government has begun to argue that a regulatory approach is necessary to address the uneven distribution of physicians. Our proposition is to achieve a number of physicians comparable to that of other OECD countries and to create an environment that enables physicians to voluntarily address their regional and departmental maldistribution.","PeriodicalId":166951,"journal":{"name":"Keimyung Medical Journal","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141921221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Estimates of Physicians Supply in Korea","authors":"Daehyun Kim","doi":"10.46308/kmj.2024.00031","DOIUrl":"https://doi.org/10.46308/kmj.2024.00031","url":null,"abstract":"","PeriodicalId":166951,"journal":{"name":"Keimyung Medical Journal","volume":"5 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141336767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to analyze the correlation between smoking and coronavirus disease 2019 (COVID-19) severity by region and gross domestic product (GDP). The regions were categorized by continent and GDP rankings. Studies conducted be-tween June 3, 2020 and March 27, 2023 were searched to compare the severity of COVID-19 between smokers and non-smokers according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Compared with never-smokers, the smokers’ COVID-19 severity scores were 1.48 (confidence interval [CI]: 1.25-1.75) in Asia, 1.24 (CI: 1.05-1.46) in the Middle East, 1.32 (1.21-1.45) in Europe, 1.39 (1.30-1.49) in North America, 1.69 (1.22-2.34) in South America, and 2.87 (1.82-4.53) in Africa. By GDP, the smokers’ COVID-19 severity scores were higher than those of never-smokers: 1.42 (1.32-1.53) in high-GDP countries, 1.33 (1.25-1.41) in middle-GDP countries (11th-50th), and 1.53 (0.85-2.76) in low-GDP countries. The COVID-19 severity in smokers was significantly higher in low-GDP countries than in high-and middle-income countries. The high COVID-19 death rate among smokers in the African continent and low-GDP countries is thought to stem from the lack of medical management systems compared with other countries. In addition to medical treatment, environmental or socioeconomic factors can increase the severity.
本研究旨在按地区和国内生产总值（GDP）分析吸烟与 2019 年冠状病毒病（COVID-19）严重程度之间的相关性。各地区按大洲和 GDP 排名进行分类。根据《系统综述和荟萃分析首选报告项目》指南，对2020年6月3日至2023年3月27日期间进行的研究进行了检索，以比较吸烟者和非吸烟者的COVID-19严重程度。与从不吸烟者相比，亚洲吸烟者的COVID-19严重程度得分为1.48（置信区间[CI]：1.25-1.75），中东为1.24（CI：1.05-1.46），欧洲为1.32（1.21-1.45），北美为1.39（1.30-1.49），南美为1.69（1.22-2.34），非洲为2.87（1.82-4.53）。按国内生产总值计算，吸烟者的 COVID-19 严重度得分高于从不吸烟者：高 GDP 国家为 1.42（1.32-1.53）分，中等 GDP 国家（第 11 至 50 位）为 1.33（1.25-1.41）分，低 GDP 国家为 1.53（0.85-2.76）分。低 GDP 国家吸烟者的 COVID-19 严重程度明显高于高收入和中等收入国家。与其他国家相比，非洲大陆和低 GDP 国家吸烟者 COVID-19 死亡率高的原因被认为是缺乏医疗管理系统。除医疗外，环境或社会经济因素也会加重病情。
{"title":"International Difference of Tobacco Related COVID-19 Severity","authors":"BangBu Youn, Junchae Lee, Sungho Ko, JinYoung Lee, SoHyeon Cheon, Seongwan Hong, Daehyun Kim","doi":"10.46308/kmj.2024.00045","DOIUrl":"https://doi.org/10.46308/kmj.2024.00045","url":null,"abstract":"This study aimed to analyze the correlation between smoking and coronavirus disease 2019 (COVID-19) severity by region and gross domestic product (GDP). The regions were categorized by continent and GDP rankings. Studies conducted be-tween June 3, 2020 and March 27, 2023 were searched to compare the severity of COVID-19 between smokers and non-smokers according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Compared with never-smokers, the smokers’ COVID-19 severity scores were 1.48 (confidence interval [CI]: 1.25-1.75) in Asia, 1.24 (CI: 1.05-1.46) in the Middle East, 1.32 (1.21-1.45) in Europe, 1.39 (1.30-1.49) in North America, 1.69 (1.22-2.34) in South America, and 2.87 (1.82-4.53) in Africa. By GDP, the smokers’ COVID-19 severity scores were higher than those of never-smokers: 1.42 (1.32-1.53) in high-GDP countries, 1.33 (1.25-1.41) in middle-GDP countries (11th-50th), and 1.53 (0.85-2.76) in low-GDP countries. The COVID-19 severity in smokers was significantly higher in low-GDP countries than in high-and middle-income countries. The high COVID-19 death rate among smokers in the African continent and low-GDP countries is thought to stem from the lack of medical management systems compared with other countries. In addition to medical treatment, environmental or socioeconomic factors can increase the severity.","PeriodicalId":166951,"journal":{"name":"Keimyung Medical Journal","volume":" 37","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141364959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Utility of Next-Generation Sequencing Panel Including Hereditary Breast and Ovarian Cancer-Related Genes for Pathogenic Variant Detection","authors":"Jae Hee Lee, Do-Hoon Kim","doi":"10.46308/kmj.2023.00283","DOIUrl":"https://doi.org/10.46308/kmj.2023.00283","url":null,"abstract":"","PeriodicalId":166951,"journal":{"name":"Keimyung Medical Journal","volume":"56 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141102193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Case of Huge Metastatic Diaphragmatic Leiomyoma with Right Atrial Thrombosis","authors":"Sang-Hyun Kang","doi":"10.46308/kmj.2023.00255","DOIUrl":"https://doi.org/10.46308/kmj.2023.00255","url":null,"abstract":"","PeriodicalId":166951,"journal":{"name":"Keimyung Medical Journal","volume":"24 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141099898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Chirotherapy Associated Vertebral Artery Dissection: Case Illustration and Literature Review","authors":"El Kim","doi":"10.46308/kmj.2024.00017","DOIUrl":"https://doi.org/10.46308/kmj.2024.00017","url":null,"abstract":"","PeriodicalId":166951,"journal":{"name":"Keimyung Medical Journal","volume":"62 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141112117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Long coronavirus disease (COVID) syndrome is persistent symptoms and complications that occurs in at least 10% of severe acute respiratory syndrome coronavirus 2 infections. Symptoms associated with long COVID can vary widely from person to person but commonly include: fatigue, shortness of breath, chest pain or discomfort, joint pain, difficulty concentrating (brain fog), headache, loss of taste or smell, sleep disturbances, palpitations, persistent cough. Possible pathophysiologic theories are viral persistence, dysregulated immune response, autoimmune response, endothelial dysfunction, gut dysbiosis, damage to organs and tissues, neurological involvement, post-viral syndrome. Although current diagnostic and treatment options are insufficient, the management aim to alleviate symptoms, improve quality of life, and support recovery. The possible therapies and interventions that may be considered are symptomatic management, rehabilitation and exercise, respiratory support, cognitive and psychological support, sleep management, nutritional support, support groups and patient education, anti-inflammatory drugs, immuno-modulatory therapies. For patients enduring prolonged suffering from this long COVID syndrome, a multidisciplinary approach is essential for comprehensive management.
{"title":"Long COVID Syndrome: Clinical Presentation, Pathophysiology, Management","authors":"Y. Cho, Daehyun Kim","doi":"10.46308/kmj.2023.00269","DOIUrl":"https://doi.org/10.46308/kmj.2023.00269","url":null,"abstract":"Long coronavirus disease (COVID) syndrome is persistent symptoms and complications that occurs in at least 10% of severe acute respiratory syndrome coronavirus 2 infections. Symptoms associated with long COVID can vary widely from person to person but commonly include: fatigue, shortness of breath, chest pain or discomfort, joint pain, difficulty concentrating (brain fog), headache, loss of taste or smell, sleep disturbances, palpitations, persistent cough. Possible pathophysiologic theories are viral persistence, dysregulated immune response, autoimmune response, endothelial dysfunction, gut dysbiosis, damage to organs and tissues, neurological involvement, post-viral syndrome. Although current diagnostic and treatment options are insufficient, the management aim to alleviate symptoms, improve quality of life, and support recovery. The possible therapies and interventions that may be considered are symptomatic management, rehabilitation and exercise, respiratory support, cognitive and psychological support, sleep management, nutritional support, support groups and patient education, anti-inflammatory drugs, immuno-modulatory therapies. For patients enduring prolonged suffering from this long COVID syndrome, a multidisciplinary approach is essential for comprehensive management.","PeriodicalId":166951,"journal":{"name":"Keimyung Medical Journal","volume":"10 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138997939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The formation of cysts in the parameatal area has been reported as rare. A parameatal urethral cyst is a congenital anomaly and has been reported even more rarely in adults. In this study, we present two cases of parameatal urethral cyst and aim to investigate their causes and treatment methods. The extent of cyst spread was assessed using a urethroscope prior to cyst excision, and the excision range was determined accordingly. Complete excision of the cyst was performed as the treatment for parameatal urethral cyst. Both patients were adults who presented with urinary symptoms related to the cyst, necessitating the excision of the congenital parameatal urethral cyst.
{"title":"Parameatal Urethral Cyst in Adult: Should be Excised","authors":"W. H. Cha, T. Jang, J. Ha","doi":"10.46308/kmj.2023.00108","DOIUrl":"https://doi.org/10.46308/kmj.2023.00108","url":null,"abstract":"The formation of cysts in the parameatal area has been reported as rare. A parameatal urethral cyst is a congenital anomaly and has been reported even more rarely in adults. In this study, we present two cases of parameatal urethral cyst and aim to investigate their causes and treatment methods. The extent of cyst spread was assessed using a urethroscope prior to cyst excision, and the excision range was determined accordingly. Complete excision of the cyst was performed as the treatment for parameatal urethral cyst. Both patients were adults who presented with urinary symptoms related to the cyst, necessitating the excision of the congenital parameatal urethral cyst.","PeriodicalId":166951,"journal":{"name":"Keimyung Medical Journal","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132702475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Chae, Eunbyul Cho, Seon Kyoung Kim, Dahye Choi, Seul Lee
{"title":"Analysis on Validity and Academic Competency of Mock Test for Korean Medicine National Licensing Examination Using Item Response Theory","authors":"H. Chae, Eunbyul Cho, Seon Kyoung Kim, Dahye Choi, Seul Lee","doi":"10.46308/kmj.2023.00094","DOIUrl":"https://doi.org/10.46308/kmj.2023.00094","url":null,"abstract":"","PeriodicalId":166951,"journal":{"name":"Keimyung Medical Journal","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114992904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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