The Three Ethical Theories Behind Patient-clinician Communication:Focusing on Natural Law Ethics, Utilitarian Ethics, and Kant’s Ethics / 의료커뮤니케이션

Purpose@#: Patients-clinician communications are not only about information, but also ethical themes. This is because, as medical care is directed at humans. Therefore, medical decisions must be made based on moral considerations. It goes beyond exchanging information and starts with meeting and communication with the interlocutor. In other word, in order to meet each other in existence, it is necessary to continue researching on the basic ideas that constitute ethical dialogue. @*Methods@#: In this Study, there are many points that are not directly revealed in the superficial dialogue between patients and clinician, but there are various factors that lie underneath. The three ethical theories, natural law ethics, utilitarian ethics, and Kant’s ethics, that reveal the principles and actions of ethics under the external dialogue will be examined, focusing on the primary literature, which is important in each theory. Through this study, it es possible to examine in what aspects these ethical views reveal their principle and various ethical positions. Based on the analysis of each ethical theory, it is examined which direction of the three theories could contribute to high-quality communication between patients and clinician. @*Conclusion@#: As a common part of the three ethical theories, it can be seen that the principle of “being ethical” is being universally explored. In addition to the common parts, each ethical theory has its own explanation of the basis of ethics and each has its own direction. Based on three different ethical theories, we can examine the differences under the natural and the source of the differences by understanding the ethical theories that are under the ethical view that the other person accepts without question in the patients-clinician communications. And this can be used as a starting point for ethical dialogue to meet each other as a whole, as existence.

A study on pain and suffering for effective communication by health care provider and non-medical practitioner / 의료커뮤니케이션

Background@#There is a Korean expression for ‘painful’ such as suffering and pain. The Purpose of this study was to define two Korean concepts: “Go-tong(suffering)” and “Tong-jeung(pain)”. @*Methods@#First of all, it is necessary to organize the considerations on the whole-person in the humanities. Then, the two commonly used terms, “Go-tong” and “Tong-jeung”, were humanistically and contextually. Furthermore, a distinction between the two concepts was attempted for improved communication by health care provider and non-medical practitioner. @*Conclusion@#There is an intersecting element between Go-tong and Tong-jeung. Both of them also their own conceptually distinctive features. The term, Go-tong, focuses on causing damage and impairing physical discomfort, whereas Tong-jeung focuses more on damage to the integrity of the soul or mind. Through the way of using these two terms, i.e., these two conceptions, more improved communication can be achieved between health care provider and non-medical practitioner.

Immunomodulatory effect of captopril and local irradiation on myeloid-derived suppressor cells

PURPOSE: This study is to investigate the effect of captopril when combined with irradiation. MATERIALS AND METHODS: 4T1 (mouse mammary carcinoma) cells were injected in the right hind leg of Balb/c mice. Mice were randomized to four groups; control (group 1), captopril-treated (group 2), irradiated (group 3), irradiated and captopril-treated concurrently (group 4). Captopril was administered by intraperitoneal injection (10 mg/kg) daily and irradiation was delivered on the tumor-bearing leg for 15 Gy in 3 fractions. Surface markers of splenic neutrophils (G-MDSCs) and intratumoral neutrophils (tumor-associated neutrophils [TANs]) were assessed using flow cytometry and expression of vascular endothelial growth factor (VEGF) and hypoxia-inducible factor 1 alpha (HIF-1α) of tumor was evaluated by immunohistochemical (IHC) staining. RESULTS: The mean tumor volumes (±standard error) at the 15th day after randomization were 1,382.0 (±201.2) mm³ (group 1), 559.9 (±67.8) mm³ (group 3), and 370.5 (± 48.1) mm³ (group 4), respectively. For G-MDSCs, irradiation reversed decreased expression of CD101 from tumor-bearing mice, and additional increase of CD101 expression was induced by captopril administration. Similar tendency was observed in TANs. The expression of tumor-necrosis factor-associated molecules, CD120 and CD137, are increased by irradiation in both G-MDSCs and TANs. Further increment was observed by captopril except CD120 in TANs. For IHC staining, VEGF and HIF-1α positivity in tumor cells were decreased when treated with captopril. CONCLUSION: Captopril is suggested to have additional effect when combined to irradiation in a murine tumor model by modulation of MDSCs and angiogenesis.

Netrin Inhibits Regenerative Axon Growth of Adult Dorsal Root Ganglion Neurons in Vitro

Netrin is a neuronal guidance molecule implicated in the development of spinal commissural neurons and cortical neurons. The attractive function of netrin requires the receptor, Deleted in Colorectal Cancer (DCC), while the receptor Unc5h is involved in the repulsive action of netrin during embryonic development. Although the expression of netrin and its receptor has been demonstrated in the adult nervous system, the function of netrin in adult neurons has not yet been elucidated. Here, we show that netrin treatment inhibited neurite outgrowth of adult dorsal root ganglion (DRG) neurons in explant and dissociated cultures. In addition, unc5h1-3 mRNAs, but not the dcc mRNA, are abundantly expressed in the adult DRG. An in situ hybridization study demonstrated that unc5h mRNAs were expressed in DRG neurons. This finding indicates that netrin/Unc5h signaling may play a role in the neurite outgrowth of adult DRG neurons and that netrin may be involved in the regulation of peripheral nerve regeneration.