Attitudes of medical students and housestaff toward euthanasia

BACKGROUND: Medical decisions concerning the prolongation of life, the right to die and euthanasia are among the most extensively discussed issues within medicine and law today. The purpose of this study was to evaluate the attitudes of medical students and housestaff toward euthanasia. METHODS: From July 15 to September 15 of the 1998, the responses of 180 medical students and 132 housestaff to a self-administered questionnaire were analyzed to identify attitudes toward euthanasia. Over 312 respondents about attitudes toward euthanasia, the analysis of differences between proportions was made by the Chi-square test. RESULTS: About 69.9% of the respondents thought euthanasia should be legalized. The findings suggest that Buddhists (77.5%) and non-religious groups (88.1%) tend to support euthanasia more than Christians. Futhermore, medical students (74.4%) support euthanasia more than housestaffs(63.6%), male(75.1%) more often than female(57.9%). About 73.1% of the respondents said that active euthanasia is not justifiable, and 79.2% said that they do not like performing active euthanasia. In respect to passive euthanasia, 69.0% said that it is not ethically justifiable, but 63.0% would perform this as if it were legal. Housestaffs of internal medicine (76.9%) were more willing to do euthanasia than pediatrics (70.0%), surgery (63.6%), family practice (53.8%) and Ob/Gyn (33.3%). CONCLUSION: Respondents have positive attitudes toward legalization of euthanasia.. Most considered that passive euthanasia is not morally justifiable. But if it were legalized, they would be willing to do euthanasia, while they would still be disturbed by active euthanasia. The opinions of physician and medical students directly affect patient care and their attitudes must be considered if clear policies are to be developed concerning euthanasia.

Correlation between Age, Prostatic Volume and Voiding Symptoms in Randomly Selected Korean over Age 60 / 대한비뇨기과학회지

Until now, we do not have specific Korean data on the age related prostatic volume and voiding symptoms associated with prostatic volume among randomized aged population. Due to this problem, we studied the correlations on the age, prostatic volume and voiding symptom among random sampled 255 people over the age 60 from the 11 Myun in Chinyang Gun, Kyungsangnam-do from the July 12th to July 26th, 1993. The mean age of the examined people was 71.5 years. 244 people answered on questionaire for voiding symptom scoring and 224 people agreed on the transrectal ultrasonic measurement of the prostatic volume. The prolate spheroid method and elliptical method were used for the measurement of the prostatic volume with the major transverse diameter, major anteroposterior diameter and cephalocaudal diameter of each prostates as Terris. The volume of the prostate ranged from 6.2cc to 54.5cc ( Prolate spheroid method ) and 4.7cc to 44.1cc(Elliptical method ). The prostate volumes measured by the elliptical method were smaller than that measured by prolate spheroid method in each age group. The average prostatic volume measured by the elliptical volume and prolate spheroid method were 17.7/22.5cc(E/P) in age 61 to 65 group(n=17), 19.9/22.8cc in age 66 to 70 group(n= 88), 21.6/ 26.0cc in age 71 to 75 group(n=71), 24.4/27.7cc in age 76 to 80 group(n=34) and 18.1/23.7cc in age over 80 group(n =14) and the pattern of the changes in the prostatic volume related with aging was significant(p 0.05).

Hydronephrotic atrophy after partial ureteral obstruction: Experimental model and natural history / 대한비뇨기과학회지

Partial ureteral obstruction was studied in male ICR mice in an attempt to observe the natural history of hydronephrotic atrophy. The left ureter was placed into the left psoas muscle, as descried by Ulm and Miller, to create a partial ureteral obstruction. In partial ureteral obstruction group, there was significant weight reduction of hydronephrotic kidney during the first two weeks. And then there was no further weight reduction. In complete ureteral obstruction group, there was progressive weight reduction and gain in hydronephrotic and contralateral kidney, respectively. These observations lead to conclusion that hydronephrotic atrophy after partial unilateral ureteral obstruction is not a progressive disease but develops in two phases: a destructive phase and a steady state phase.

Transrectal ultrasonography in lower urinary tract for women without stress urinary incontinence / 대한비뇨기과학회지

Radiographic chain cystourethrography(CUG) for stress urinary incontinence(SUI) has several disadvantages including the risk of excessive irradiation, the time required for the test, and the discomfort of the patients. Nowadays it is widely accepted that transrectal ultrasonography for evaluating bladder and urethra provides similar information about SUI comparing with the conventional radio- graphic examination. Also some authors suggested that chain CUG is not essential any more to evaluate SUI, transrectal ultrasonography only is enough to evaluate SUI. So we try to perform tansrectal ultrasonographic examination in evaluating SUI before and after the operation but we need control parameters in normal women as a guideline of diagnostic criterial for SUI. So we analyzed the data of ultrasonographic findings in twenty women without SUI. Our data revealed that PUV angle in resting state is 127.5 degree, in stress state 145.7 degree and AIUA in resting state 40.5 degree, in stress state 54.0 degree. Those are little larger than Green`s criteria in chain CUG. Bladder neck descent was 5.7mm between resting and stress state. Interestingly amount of bladder neck descent was negaively correlated with the number of delivery and the aging. We hope that these sonographic parameters in control group will be helpful to be a guideline of diagnostic criteria in SUI.

Transrectal ultrasonography: evaluation of bladder wall inversion in cervical cancer / 대한비뇨기과학회지

Forty eight patients with cervical cancer underwent cystoscopy, computed tomography and transrectal and transvaginal ultrasonography. Transrectal ultrasonography was as accurate as computed tomography in the evaluation of the bladder wall invasion in cervical cancer. Most patients with bullous edema in cystoscopy appeared to have invasive lesions in transrectal ultrasonography. Transrectal ultrasonography was superior to transvaginal one in the evaluation of the posterior well of the bladder. In conclusion. transrectal ultrasonography is an another good diagnostic method for the evaluation of the bladder wall invasion in cervical cancer.

The study on the histopathologic changes in chorioallantoic membrane of the fertilized chicken eggs where the MBT-2 mice bladder cancer and the human bladder cancer tissue were implanted and chemosensitivity test for anticancert drugs / 대한비뇨기과학회지

The MBT-2 mice bladder cancer tissues and the human bladder cancer tissues were implanted on the chorioallantoic membrance(CAM) of the immune deficient fertilized chicken eggs and the histopathologic changes of the CAM and gross morphologic changes of the implanted cancer tissues on CAM ere studied. The chemosensitivity tests using chicken CAM were performed for the 4 human bladder cancer tissues to mitomycin C, thiotepa and adriamycin. With this study, the following results were obtained: 1. The observation of the blood vessel on the chorioallantoic membrane was possible from the post-incubation 6th day group, but for the implantation of the cancer tissues, the blood vessels from the post-incubation 8th day group was appropriate. 2. The budding oif the host capillary vessel to the implanted cancer tissue were observed from the post-implantation second day. 3. The size of the post-implantation 7th day cancer tissues were varied from 2.3 to 9.2 folds to the size of the implantation day. 4. The total failure rate in experiment within post-operative 3rd day were 71.3 percent and the total failure rates in group who had the damage on the chorioallantoic membrance during operation was 82.5 percent. The failure rate of the experiment was declined acutely after post-operative 4th day. 5. The salvage of the eggs could be maintained until post-operative 7th day in 28.1 percent among chemosensitivity test group. 6. The 4 bladder cencer tissues which had the chemosensitivity test showed 1.6 to 7.1 fold growth to the inital implanted size and this meant resistance to the test drugs and these results were corresponded with clinical course.