Dear EFTHA friends,
The World Medical Journal, official journal of the World Medical Association, has a full-page coverage of the Taiwan Medical Association in the issue of May, 2008. We are pleased to share this with all.
http://www.wma.net/e/publications/pdf/wmj18.pdf
Th e Taiwan Medical AssociationTh e Taiwan Medical Association (TMA)was established in 1930 to advance medicalknowledge, to uphold members’ rights,to strengthen physician-patient relations,as well as to advocate social services. Th eTMA is composed of regional medical associationsfrom 23 counties around Taiwan.Its membership is compulsory for everypracticing physician. Among the total 36991 TMA members (fi gure for the end of2007), 30% practice in medical centres, 13%in regional hospitals, 18% in local hospitals,and 39% in private clinics. Th e physicianpatientratio is 1:653.Th e TMA has formed ten committees tocarry out its various missions and duties.Th ese include Health Care Policy Committee,National Health Insurance Committee,Health Industry Advisory Committee,Medical Laws and Regulations Committee,Academic Committee, Member WelfareCommittee, Medical Ethics and DisciplineCommittee, International Aff airs Committee,Public Relations Committee, and PublicationsCommittee. In many areas, ad hoctask forces are set up to study relevant issuesand to provide policy suggestions for theExecutive Board.For more than a decade, the TMA has activelyparticipated in several key areas topromote the health of all Taiwanese, includingthe formulation and revision of apatient-centred National Health InsurancePolicy in Taiwan, the advocacy of qualityof care and patient safety, the implementationof continuing medical education, andthe uplift of moral standards of health careprofessionals. In the international forum,the TMA joins forces with the rest of theworld through the World Medical Associationand CMAAO to increase its visibility,and to express Taiwan’s good will to servethe international community. In time of disastersand emergency around the globe, theTMA has taken little time in mobilising itsmembers to provide emergency relief andmedical aid to people in need.Th e TMA has established close interactionwith the WMA in recent years by participatingin various programs and activities.Th e translation and publication of “Manualof Medical Ethics” of WMA enables TMAmembers to share WMA’s policy changes,its functions and the contribution to allphysicians around the world. By workingwith the WMA in devising declarationsand policies, the TMA acquires updated informationon medicine, ethics, and medicaleducation.Th e TMA strongly believes in the collaborationamong all national medical associationsunder the auspice of the WMA.Th e sharing of information and resources,and the joint eff ort in international medicalassistance will enable us to create a trulyglobal village.Dr. Ming-Been Lee, the President of TMATaiwan Medical Assembly in 2007
2008年6月1日 星期日
Recommendation of a website
Dear EFTHA website readers, and those concern about Taiwan, a website/blog by a Belge gentleman who now teaches in Taiwan, will be a very interesting one for all of you,
http://johangijsen.blogspot.com/
http://johangijsen.blogspot.com/
推薦文章: 我讀歐巴尼／林衡哲
我的私房書
我讀歐巴尼
文／林衡哲
在 我一生的讀書經驗中，我的私房書似乎不斷地在改變中。在小學時代，我最愛的讀物是《學友》與《東方少年》這二本雜誌。到了初中時代，傳記文學變成了我的文 學初戀情人，例如居禮夫人傳、林肯傳、華盛頓傳、富蘭克林傳、畢斯麥傳等都是在初中時代看的，同時也看了不少梁啟超、胡適和林語堂的作品，莎士比亞的羅密 歐與茱麗葉中譯本是引領我進入西洋文學的第一本書。
高 中在建中時，頗受羅曼羅蘭的《貝多芬傳》、《約翰．克利斯多夫》、托爾斯泰的《戰爭與和平》、歌德的《浮士德》、但丁的《神曲》以及朱生豪翻譯的莎翁劇本 的影響。因為對文學的興趣，而保送東海外文系。後因看了協志叢書《史懷哲傳》，而「棄文從醫」，考取台大醫學院。在台大時代，我頗受史懷哲「尊重生命」的 精神以及羅素的「懷疑精神」底影響，培養我獨立思考的能力，加上卡薩爾斯的「理想主義」和反抗獨裁者的精神，也深深地影響我的一生，另外愛因斯坦以知識份 子的良知，去反抗龐大的極權專政，這種知其不可為而為之的精神，對我也頗有影響。因此基於「有第一流的文化才能創見第一流的國度」的信念，我在1967 年催生了「新潮文庫」，並譯出了《羅素回憶集》及《羅素傳》，同時也請林宜勝先生譯出《白鳥之歌：卡薩爾斯自述傳》、張聖輝譯出菲利蒲．法蘭克所寫的《愛 因斯坦傳》，並由曹永洋先生編出一系列的「史懷哲叢書」，讓羅素、史懷哲、愛因斯坦和卡薩爾斯的精神，在台灣這塊土地上開花結果。
1968 年出國之後，我由台灣文化的文盲變成台灣文化的奉獻者，因為我到美國之後，我才讀到真正的台灣歷史以及認識多采多姿的台灣文化，其中吳濁流的《無花果》、 彭明敏的《自由的滋味》、柯喬治的《被出賣的台灣》以及黃煌雄的《蔣渭水傳》和李南衡的《賴和全集》對我都有深遠的影響，因此1983年我在美國創刊「台 灣文庫」時，馬上推出《無花果》與《自由的滋味》等，希望這些書能讓台灣人覺醒認同自己的國家與土地，在美國出版的42部「台灣文庫」建立了台灣傳記文學 的新傳統，1998年我終於落葉歸根，返台後成立了望春風出版社，繼續出版傳記名著及台灣文化名著，同時也在去年推出了「望春風世界文學名著」，其中最感 動我的一本書是：《卡羅．歐巴尼醫師傳奇》。
我第一次聽到歐巴尼醫師是在2003 年4月，那時我正擔任衛生署顧問，為台灣加入WHO而努力，同事蘇金鳳女士提供我不少有關歐巴尼為SARS而「燃燒自己、照亮全世界」的英勇事蹟，不久在 《自由時報》上看到一篇有關歐巴尼的報導，於是我整理出一篇紀念歐巴尼的文章五千字，發表在《新台灣》雜誌上。不久我去日內瓦參加第五十六屆WHO大會 時，本來想大會結束後親自坐火車去拜訪歐巴尼夫人茱莉安妮，為歐巴尼寫出一本書，想不到義大利台商會會長莊振澤及衛生署派駐日內瓦代表張武修，已經邀請歐 巴尼夫人及16歲的大兒子來參加我國在紅十字會總部主辦的「SARS國際學術研討會」，張武修臨時要我介紹歐巴尼夫人，這是我這次瑞士之行最大的光榮與收 穫，歐巴尼夫人是一位非常單純而誠樸的人，她顯得很堅強，認為她丈夫的犧牲是有價值的，他求仁得仁無怨無悔。歐巴尼16歲的大兒子已經是一位小大人，他說 他將追隨他爸爸的理想，將來也要作醫師，繼續服務人群。
能 夠出版《歐巴尼醫師傳奇》，是我一生出版事業的高潮，作者貝美穗是義大利名記者兼名作家，漢譯者古桂英，譯筆流暢，在信、雅、達三方面均達完美之境。此書 透過作者親自訪問歐巴尼的母親、家人、心靈知己及朋友、同事們，把他多采多姿的一生及內心世界娓娓道來，確實是一部動人的文學傳記，這是我在大學時代看 《史懷哲自傳》之後，令人印象最深刻也是最感人的一部醫師傳記。如果史懷哲「尊重生命」的精神和歐巴尼「視病如親」的精神，能在台灣的醫界與社會發揚光 大，相信一個充滿愛心的現代化社會便會慢慢地在台灣形成。如果每一個醫生都看過此書，也許「邱小妹事件」就不會在台灣發生，歐巴尼醫師的存在，不僅是義大 利的榮耀，也是全球醫界的榮耀，我的很多朋友包括陳永興院長、賴其萬教授、廖運範醫師等人都看了此書，而流下了感動之淚；我的眼睛雖然沒有流淚，但在我內 心的深處，我也感動得在內心流淚。
聯合國秘書長安南在為此書作序時說：「卡羅．歐巴尼醫生，一生以致力於救護他人生命為使命，然而無常的命運，殘酷弄人，竟在他盡力挽救他人性命於SARS病患時，讓病毒奪走了生命，他站在最前線對抗病毒，我們要以英雄的形象紀念他，因為他的確是名符其實的真英雄。」
我深信《歐巴尼醫師傳奇》是一部永恆價值的書，值得每一位讀者的一再閱讀與珍藏。（2005年12月10日於台北關渡）
林衡哲 小檔案
1967年畢業於本校醫學系。大學期間為了賺取學費，以筆名「林衡哲」譯介外國文史哲叢書，其主編之「新潮文庫」（志文出版社），曾激勵了無數的年輕學子，影響極為深遠。
1968年赴美，在醫師本業之外，仍不忘情文化事業，1983年創辦「台灣文庫」，先後出版近40本傳記及文化叢書。1997年回台，在花蓮門諾醫院擔任小兒科主任，不改「文化醫師」本色，成立「望春風」出版社，繼續為發揚台灣文化而努力，曾任台南市文化局局長。
Source: http://www.alum.ntu.edu.tw/read.php?num=43&sn=913
Share this Summer Program in Taiwan
| Introduction | |||
| 1.Aims | |||
The National Yang-Ming University TMTCA program is a short-term program to introduce to international students with traditional medicine and Taiwanese culture and art. This program is to accept students for 2 weeks during summer and winter break. Courses are taught in English and on-site visits after lessons. Students can benefit from this program on:
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2. Requirements | |||
To apply for the NYMU TMTCA program, applicants must meet all the following requirements:
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| 3. Number of Students Accepted | |||
| 20 students for each program | |||
| 4. Program Calendar | |||
*We also offer an optional 2 days culture program to east coast and Taroko Gorge National Park. Students could experience nature beauty and aboriginal culture of Taiwan. (NT$5,000 for 2 days’ program) | |||
| 5. Tuition | |||
| Tuition will be waived for students from the universities that have the formal academic exchange agreement or memorandum with National Yang-Ming University. The list can be found through http://issue.ym.edu.tw/cia/new/fundingfaq/sister_universities.php Students from the universities that have no agreement or memorandum with National Yang-Ming University are obliged to pay the registration fee NT$15,000 (US$500) for two weeks program. The registration fee is included the in-campus dormitory, lessons materials and site visit traveling fee. | |||
| 6. Certificate of Completion | |||
Students who complete all programs could obtain a certificate issued by National Yang-Ming University. | |||
Taiwan's scientists made great breakthrough on degue fever!
Breakthrough in hunt for dengue treatment
By Roger Highfield, Science Editor
Last Updated: 6:01pm BST 21/05/2008
A way has been found to fight a mosquito-borne virus that infects 50 million people annually, and puts another half a million in hospital, some with a lethal fever.
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Some 2.5 billion people – two fifths of the world's population – are now at risk from dengue, an infection that causes a severe flu-like illness, and sometimes a potentially lethal complication called dengue haemorrhagic fever.
The World Health Organisation estimates there may be 50 million dengue infections worldwide every year. An estimated 500 000 people require hospitalization, mostly children, and 2.5 per cent die. There is no specific treatment for the virus.
Now, in the journal Nature, Dr Shie-Liang Hsieh of National Yang-Ming University, Taipei, Taiwan, and colleagues have identified a molecule targeted by the dengue virus in mice that brings about the haemorrhagic fever associated with lethal disease.
The virus hijacks the CLEC5A molecule on immune cells to cause a massive release of potent inflammatory agents known as cytokines. TThe storm of these cytokines is are probably responsible for the extreme inflammation that causes haemorrhagic fever.
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Using antibodies to block the interaction between CLEC5A and dengue virus, the team found they could prevent inflammation without affecting the normal immune response to virus infection.
What's more, half of mice treated with these antibodies managed to clear the virus. This ability to control inflammation and simultaneously maintain natural viral immunity makes CLEC5A an exciting prospect for the development of new treatments, says the team.
The current antibody has to be "humanised" so it is not attacked by the body. "It is estimated to take two years to enter phase I clinical trial, after the humanization of the current antibody for toxicology and preclinical study," says Dr Hsieh.
He adds: "The technology we develop can also be used to identify therapeutic targets of other viruses, including members of flaviviruses, such as West Nile Virus and Japanese Encephalitis Viruses."
The spread of dengue is attributed to expanding geographic distribution of the four dengue viruses and the mosquitoes that carry them, the most important of which is the predominantly urban species Aedes aegypti.
Midday article: Royal care for some of India's patients, neglect for others
Royal care for some of India's patients, neglect for others
Sunday, June 1, 2008
BANGALORE, India: "To get the best care," Robin Steeles said gamely, "you gotta pay for it."
Steeles, 60, a car dealer from Daphne, Alabama, had flown halfway around the world last month to save his heart, at a price he could pay. He had a mitral valve repaired at a state-of-the-art private hospital here, called Wockhardt, and for 10 days, he was recuperating in a carpeted, wood-paneled room, with a view of a leafy green courtyard.
A dietician helped select his meals. A dermatologist came as soon as he complained of an itch. His Royal Suite had cable TV, a computer, a minirefrigerator, where an attendant that afternoon stashed some ice cream, for when he felt hungry later. Three days after surgery, he was sitting in a chair, smiling, chattering, thrilled to be alive.
On his bed lay the morning's paper. Dominating its front page was the story of other men, many of them day laborers who laid bricks and mixed cement for Bangalore's construction boom, who had fallen gravely ill after drinking illegally brewed liquor. All told, more than 150 died that week, here and in neighboring Tamil Nadu State.
Not for them the care of India's best private hospitals. They had been wheeled in by wives and brothers to the overstretched government-run Bowring Hospital, on the other side of town. Bowring had no intensive care unit, no ventilators, no dialysis machine. Dinner was a stack of white bread, on which a healthy cockroach crawled while a patient, named Yelappa, slept.
Wockhardt has 30 ventilators, including some that are noninvasive, so the patient does not have to have a tube rammed down his throat. At any one time, a half-dozen are in use. An elderly woman had been in its intensive care unit for a week, on dialysis; her family wanted to do whatever possible to keep her alive, no matter the cost.
At Bowring, one of the young doctors, named Harish, said a ventilator and a dialysis machine would have allowed him to keep half of his patients alive. The most severe case, Mohammed Amin, was breathing with the aid of a hand pump that his wife squeezed silently. Harish sent the relative of one man to get blood tests done at the nearest private hospital; there was no equipment to do the test here. Then the doctor rushed to the triage section in Bowring's lobby, where the newest patient, writhing, resisting, disoriented from the poison in his gut, had to be tied down with bedsheets.
Where you stand on the Indian social ladder shapes to a large degree what kind of health you're in, and what kind of health care you receive. The beds in Bowring were taken up by small skinny men. One of Wockhardt's most popular offerings is a weight loss program, and the majority of walk-ins at its outpatient clinic suffer from diabetes, closely linked to obesity.
This is no anomaly. A government-sponsored National Family Health Survey released last fall says a woman born in the poorest 20 percent of the population is more than twice as likely to be underweight than one in the richest quintile, and 50 percent more likely to be anemic.
For children, the gap is equally stark. The poorest quintile is more than twice as likely to be stunted, a function of chronic malnutrition, and nearly three times less likely to be fully immunized.
It is not as if the poor do not seek treatment, Jishnu Das, an economist who studies health and poverty for the World Bank, points out. They do, and sometimes more often than the rich. It is just that they are more likely, Das says, to land at the doorstep of a caregiver who is incompetent, ill-trained or indifferent to their needs.
"The poor are not dying and sick because they do not go to seek medical care," he said. "In fact, the poor are going to doctors in droves. There are no good options for the poor. The private hospitals and care they are able to access is of very low quality, and when they try and access government care, they receive no attention whatsoever."
The survey found that two-thirds of Indian households rely on private medical care when sick, a preference that cuts across class. Asked why they don't use public facilities, the most common answer was poor care.
India has a countrywide network of government-funded primary health centers and hospitals, but staffing, medicines and resources vary widely. Some, especially in rural India, are notorious for having staff doctors on paper at best. This is only beginning to change. The government has increased health spending in recent years, and this year began a health insurance program that would allow people in poverty access to a hospital of their choice.
The Planning Commission of India this year found that in government-run health centers, 45 percent of gynecologist posts and 53 percent of pediatric posts went unfilled, and that salaries for government doctors are a fraction of those at new private hospitals like Wockhardt.
Wockhardt struggles to fill its slots, too, but its facilities allow it to aggressively recruit, including from among Indian doctors who have worked abroad for years.
The morning papers did not let Steeles forget the vast gulf between his predicament and that of the hooch drinkers fighting for life at Bowring. Yet as far apart as they were, their tales followed a somewhat parallel plot. The American health care system could no more care for Steeles than the Indian system could for Amin.
Steeles came here because he is uninsured, and could not afford heart surgery in the United States, he said, without liquidating most of his assets. After five months of research and e-mail messages to doctors worldwide, he chose a heart surgeon here in Bangalore. "I'm over here for a fraction of what I would have paid in the United States," he said. "In my personal situation, I'm just delighted I took the road that I did."
Steele's Royal Suite, incidentally, is available to anyone, Indian or foreigner, who can pay for it. After his stay here, he would move to a room at a private club for 16 days of further recovery, before flying home. All told, he said it cost him about $20,000, a tenth of what he would have paid at a private American hospital.
Across town, among the hooch drinkers, a few of the worst cases had been transferred to private hospitals that had agreed to take them, at the government's expense.
Amin was too frail to be transferred. He died at Bowring, leaving behind a wife and two young children.
Notes:
Recommendation: "當達文西遇見華陀"
| 2004-09-14 02:40:23 | 人氣(48) |
當 達文西遇見華陀 ---神乎其技的手術機器人配合針刺麻醉進行心臟手術側記
莊振澤
2000 年11 月23日
電子科技進步日新月異，外科醫生為重症病患進行重大手術時在開刀房裡開胸剖腹之場面將不復再現。最先進的第三代手術機器人--達文西，日前在義大利巴維亞大學附屬的聖馬竇醫院為來自台灣的貴賓展示了一場神乎其技之精彩表演。
台灣輔仁大學醫學院暨耕莘醫院陸幼琴院長，偕同台東聖母醫院鄭雲院長，在梵諦岡出席國際醫學會議之後，經由中華民國駐教廷大使戴瑞明之安排，前來米蘭巴維亞大學聖馬竇醫院觀摩難得一見的機器人開刀手術。
這部最先進的手術機器人被命名為達文西，藉以紀念義大利文藝復興時期這位集建築、雕塑、繪畫、機械、水利工程、解剖醫學等傑出科學藝術成就於一身的不世出天才( Leonardo da Vinci , 1452 – 1519)。造價約四千萬台幣的達文西機器人目前全義大利僅此一部，它大約分為三部分： 手術台邊矗立著伸出三支複雜構造機械手臂的座台，一旁是上接監控Monitor的主控電腦，另有一座外觀看來好似電動遊戲機亦附有Monitor的操作台。
利用機器人開刀，避免了傳統開刀手術之開胸剖腹； 以心臟血管繞道(Bypass)手術為例，僅在左胸側穿刺三個小洞穴供機器人手臂伸入進行手術：中間洞穴插入探照燈及微型攝影機，以將手術操作過程完整呈現於Monitor。右洞穴插入手術刀，左洞穴則是夾鉗，就如同外科醫生的左右手般靈活操作。 ”主刀”的醫生則端坐在一旁的操作台，眼觀Monitor，手腳並用熟練操作，看起來就好比把玩電動遊戲機一般，實在神奇 !
除了避免開膛破肚，機器人開刀亦免除了繁複的血液體外循環設備，開刀房助手亦大大減少，確是好處多多 !
當天的Bypass心臟手術特別安排了針刺麻醉配合機器人開刀，中西醫學之頂尖技術合作無間，可謂是世紀創舉 !
中華醫學技術最精華之針刺麻醉術，其高度鎮痛效果能完全取代強烈的麻醉藥物，應用在大型而須長時間的外科手術中，能免去麻醉劑對人體免疫系統的抑制作用，手術後病體恢復極快。上述作Bypass手術病人只需三天即可出院。
這項手術負責針麻任務的潘賢義醫師來自台灣屏東，旅居義大利三十多年，目前任教於巴維亞大學醫學院外科研究所，是著名的器官移植與實驗外科權威，其參與的醫療團隊在心臟手術、肝臟自體移植手術方面居世界領導地位。
(莊振澤會長在潘賢義醫師指示下，亦獲准進入開刀房全程拍攝，留下珍貴的紀錄，可供日後教學觀摩之用。) 2000 年11 月23日
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