Artificial abortion and euthanasia are serious ethical Issues in medical field. However, the ways to solve them would be different according to the culture and customs of a country. In Korea, the rate of artificial abortion is so high that many people tend to consider it as a personal misfortune rather than an ethical mischief. National policy to control the population and souety's traditional preference for sons over daughters have fostered the tendency. For euthanasia, especially "passive euthanasia", most Korean people think it acceptable if under proper condition, and many doctors consent to it. In such circumstances, it is not much of necessity to debate on the ethical righteousness of artificial abortion or woman's right to choose it. More important thing is how we can reduce the number of abortion cases and protect woman's health against the side effects of "unnecessary" abortion. Proper education, public relation, and cooperation with civil or religious groups will be helpful to achieve this goal, and we physicians should try to do it. "Passive euthanasia" is thought to be ethically acceptable in the view of traditional customs, social justice, and welfare of the patient. However, "active euthanasia" harbors great ethical risks in current situation. Therefore, we should prepare and establish a proper process and system that patients, doctors, and the whole society can accept. "Advance directives" or "living will" would be good options if well modified to our culture. For all these, the education and training of professinals in this area is urgent.
Education ; Ethics ; Ethics, Medical ; Euthanasia* ; Humans ; Korea* ; Nuclear Family ; Social Justice ; Women's Health ; Women's Rights

Respiration has been well known as a basic phenomenon of life since the ancient times, but the explanation of which was varied. In most theories the respiration and the body heat of animal had been different phenomena until the early 19th century. After the Lavoisier's experiments in the late 18th century, combustion and respiration came to be considered as the same phenomenon. Through many discoveries and efforts of scientists in the field of chemistry, physics and biology, Justus Liebig, a German organic chemist, established the modern theory of the respiration of animal in the mid 19th century, where respiration was viewed as the origin of all energy of animal. The more detailed biochemical mechanisms were found in the 20th century.

Epidemic diseases in the early Choson period were big problems to the people and society. However, the weapons to the epidemic diseases were very limited at that time. There were few drugs and well-trained practitioners for people. Most people could only depend on religious means and simple folklore medicine including inhalation of specific flavor. People tried to overcome or prevent the epidemics by praying, sorcery, ornaments, runaway and isolation. In most cases, the epidemic diseases came with or broke out from the famine, severe labour (especially in civil engineering) imposed by the ruling class. The epidemics of that time are thought to be typhoid fever, epidemic typhus, or similar febrile diseases.
Communicable Disease Control/*history ; Disease Outbreaks/*history ; English Abstract ; History of Medicine, Medieval ; Human ; Korea

The introduction and practice of smallpox(cowpox) vaccination was officially done in 1879 by Chi Seok-young, but we know that already in 1835 Cheong Yak-yong, a great scholar and politician of the late period of Chos?n, got a small pamphlet about cowpox vaccination named New Treatise on the Smallpox Vaccination from Beijing. The second edition of the pamphlet was published in 1828 in Beijing. According to Kim Du Jong and Miki Sakae, Cheong Yak-yong might have got it through Korean Roman Catholic group corresponding with the French Catholic Missionary in Beijing but hided it secretly for the official oppression to the Catholicism. Cheong was a member of the group of young scholars that introduced Catholicism into Korea in 1784 and leaded this movement for a time, but officially betrayed his faith since 1791. So there is little historical documents to support the claim that two conflicting groups of scholars continue to debate. One group argues that Cheong betrayed his faith completely and left the Church since the persecution of Sinyu year(1801), but the other claims that he remained as believer in heart, only to hide his faith for the fear of official oppression. In such a horror of terrible persecution did he really communicate with Catholic group who often went to Beijing? We don't know what really was. Therefore the purpose of this article is to collect the circumstantial evidences for the assumption about 'the introduction of smallpox vaccination by Catholic group' and to evaluate the possibility. From the documents of the Church of that time we can know that a few of Catholic believers actively communicated with missionaries in Beijing for the employment of priests. The agents of Korean Catholic Church visited Beijing almost annually disguised in the official diplomatic visit, where they met French missionaries, discussed their route to Korea, sent letters, and traded of the bibles, holy books and religious materials from 1828(the publication year of the pamphlet) to 1835(the year Cheong Yak-yong died). It was a most active period in the History of Korean Catholic Church. Especially Cheong Ha-sang, nephew of Cheong Yak-yong, was the central figure leading this movement with Yu Jin-kil who was an official translator in a high position and a very erudite man. They often visited Beijing, and where they could have seen the pamphlet about smallpox vaccination and taken it to Cheong secretly. The Church of that time valued medical activity as an effective mean of their mission, which is well illustrated in the letters and documents of the missionary in Korea. Smallpox was a very severe health problem in Korea and the mortality of children was extremely high. The first Korean priest Father Kim asked the missionary in Beijing to send a prescription for smallpox. Cheong Yak-yong had a great interest in medicine, especially in smallpox, wrote some books devoting this subject. He also asserted continual study and introduction of new knowledge, which we can know from the statement that he rewrote MagwaHoetong for seven times. He knew and trusted the Western science and technology as other Korean Roman Catholics. It can not be completely confirmed that he really reacted religious practices after returned from his 18 year exile as the claim of Church, but at least he recorded the history of Korean Catholic Church and was interested in the affairs of it, that known from the notes of Bishop Daveluy who preached gospel in Korea, to be martyred in 1866. He said repeatedly in the notes and letters that Cheong wrote and provided the basic material necessary to construct the history of Korean Catholic Church. On the basis of that information Bishop Daveluy tried to edit the History, but the task was finally accomplished by his successor Father Dallet, who wrote History of Korean Catholic Church(1874). From his statement Cheong hided his records of Korean Catholic Church and showed it to very few number of selected people, small group of friends and relatives. The similar situation is shown in the statement of Yi Kyu-kyoung, a scholar of Silhak school of 19th century, about smallpox vaccination in Korea in mid 19th century. He said Cheong had a book of the vaccination but hided it and showed to some limited people. Cheong also wrote secretly memorial addresses for some of his friends died in Sinyu Persecution. His son Hak-sang was baptized too. From those facts we can assume that Cheong Yak-yong was not totally disconnected from the Church as officially documented but continued works relating with it secretly under the severe persecution. In this small pamphlet the phrases suggesting its own origin from the West were carefully erased, which might have disguised its relation with the Catholicism. Yi Kyu-kyoung also said he had heard about smallpox vaccination from Nam Sang-kyo, who was a sincere catholic. It is suggested that small group of Roman Catholics knew the method but it could not be widely practiced. Because it seemed to be strange and odd to general Korean people and the Catholic believers were generally isolated in the deep mountain valley or so from the general population to escape the persecution. Chos?n government rigorously prohibited the import of foreign(Western) books and materials from China for protecting the country from the invasion of 'Western barbarians' since late 18th century. The ones committing this regulation were destined to get severe punishments. So were the related. Thousands of people were tortured and sentenced to death under the accusation of "believing foreign superstition and betraying his mother country". In such a condition who dared to get foreign materials and expose it except Catholics? We can think other routes. For example Hong Seok-joo, a high ranking official of the Chos?n government, secretly asked a Chinese official to get some books including Western books when he visited Beijing in 1831. He was an editor of MabangTonghwi, medical book about smallpox edited on the base of MagwaHoetong of Cheong. It is possible that he introduced New Treatise on the Smallpox Vaccination to Cheong. He was a relative of Cheong and some of Catholic martyrs, so he might have understanding of Catholicism. If he did, it was also done in the context of Western culture imported by Korean Catholic Church. Considering the above facts we can suggest the higher possibility of the introduction of smallpox vaccination through Catholic groups with Cheong Yak-yong. Of course other routes could have been available, but its possibility seems to be comparatively low.

No abstract available.
Humans ; Male ; Nursing* ; Urinary Incontinence*

The development of Korean medical journals is summarized as the following: 1) Until the early 1960s there were not basic medical journals except Journal of the Korean Society for Microbiology (first issued in the year of 1958), so researchers of basic medical science had difficulty in publishing their articles. 2) Many of the basic medical journals made their first appearance around the mid-1960s, but the progress was not striking until the mid-1980s. 3) From the mid-1980s most of the journals rapidly developed in the aspect of quality as well as quantity. The increase in the number of issues per year and articles per an issue, and the increment of the articles written in English are remarkably found. The increase in the number of researchers, appropriate education and training, improvement of the research facilities, the growth of research fund, and increment of the international academic exchange are thought to be the main factors of such development. Besides those factors, the devotion of the editors of the journals played the important role.
English Abstract ; History of Medicine, 20th Cent. ; Korea ; Periodicals/*history ; Research/*history ; Science/*history

PURPOSE: The objective of this study is to ascertain whether the positive relationship exists among the frenum length, the tongue movement and the speech and to present the normal range of tongue movement and guidelines for the choice of surgery, observation if necessary. MATERIALS AND METHODS: 180 patients were evaluated. We divided 180 patients into 6 groups by age. Each group was separated as follows; the age of 2.5-4, 5-6, 7-9, 10-12, 13-15, 16-18. We measured the frenal length, the range of tongue motion and evaluated the speech so that we really questioned about the positive relationship between the tongue-tie and speech. We let the patient exercise the protrusive, both(right, left) laterotrusive, superior movement of the tongue. During these movements, we measured the distance between the vermilion border and the tongue tip. We also measured the distance from the tongue tip to the point contacting the upper lip with dorsum of the tongue during the maximal protrusive movement of the tongue. Three linear measurements of the anterior, inferior segment of the tongue, including the lingual frenum, are made. These measurements are as follows: 1. Distance A. Free anterior portion of the tongue from the point of frenular insertion to the tongue tip. 2. Distance B. The distance from the initiating point of the lingual frenum to the point connecting the two sublingual caruncles to the lingual frenum perpendicularly. 3. Distance C. The distance from the point contacting the line crossing the sublingual caruncles with the lingual frenum to the terminating point of the lingual frenum. We transform three linear measures into a statistical ratio, A/(A+B+C), representing the length of the free portion of the tongue compared with the total sublingual dimensions. In addition, we assessed the speech through Picture Consonant Articulation Test (PCAT) and tried to find out the relationship between the length of the lingual frenum and speech. CONCLUSION: As people are born, they have small and restricted tongue. As people grow old, tongue motions are more liberate, and unrestricted and they can speak so freely. Therefore we suggest that until age 5, oral and maxillofacial surgeons postpone the surgery if not urgent, evaluate the maximal lingual motions and PCAT according to this article and observe their changes.
Humans ; Linear Energy Transfer ; Lingual Frenum* ; Lip ; Reference Values ; Tongue*

PURPOSE: Expression levels of tumor necrosis factor (TNF)-alpha expression on the mucosa of the small intestine is increased in patients with villous atrophy in food protein-induced enterocolitis syndrome (FPIES). TNF-alpha has been reported to induce apoptotic cell death in the epithelial cells. We studied the TNF family and TNF-receptor family apoptosis on the duodenal mucosa to investigate their roles in the pathogenesis of FPIES. METHODS: Fifteen infants diagnosed as having FPIES using standard oral challenge test and 5 controls were included. Terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) staining was performed to identify the apoptotic cell death bodies. Immunohistochemical staining of TNF-alpha, Fas ligand (FasL) for TNF family and TNF-related apoptosis-including ligand (TRAIL) receptor 1 (DR4), TRAIL receptor 2 (DR5), and Fas for TNF-receptor family were performed to determine the apoptotic mechanisms. RESULTS: TUNEL+ was significantly more highly expressed in the duodenal mucosa of FPIES patients than in controls (P=0.043). TNF-alpha (P=0.0001) and DR4 (P=0.003) were significantly more highly expressed in FPIES patients than in controls. Expression levels of FasL, Fas, and DR5 were low in both groups and were not significantly different between the 2 groups. CONCLUSION: These results suggest that FPIES pathogenesis is induced by apoptosis, and that TNF-alpha expression and DR4 pathway may have an important role in apoptosis.
Apoptosis ; Atrophy ; Cell Death ; Enterocolitis ; Epithelial Cells ; Fas Ligand Protein ; Humans ; Infant ; Intestine, Small ; Mucous Membrane ; Receptors, TNF-Related Apoptosis-Inducing Ligand ; Tumor Necrosis Factor-alpha ; Up-Regulation

BACKGROUND: Toenail onychomycosis still remains difficult to treat. Pulse therapy of itraconazole is frequently prescribed to lighten the patient's burden of economical problems, frequent side effects, resulting in good compliance. OBJECTIVE: The purpose of this study is to evaluate the clinical efficacy and adverse reactions of pulse therapy of itraconazole. METHODS: From March to September 1996, a total of 108 patients with onychomycosis of toenail diagnosed at Department of Dermatology of 5 university hospitals, were enrolled in a subject group for the study. Itraconazole was administered, 200 mg twice daily, in every first week of 3 consecutive months. Clinical symptoms and sings with or without mycologic findings were assessed at baseline, at the end of 4, 8, 12, 24, 36 and 48 weeks after the start of therapy. RESULTS: Fifty six patients (male 22, female 34; mean age 44.0+/-13.3) completed the follow-ups. As causative agents, Trichophyton(T.) rubrum was isolated in 51 of them, T. mentagrophytes 2, and yeast 3. Decrease in initial percentages of patients showing pathologic changes in target nail at the last follow-up 12 months after starting therapy : for onycholysis, from 51.8% to 21.4%; for subungual hyperkeratosis, from 96.4% to 39.3%; for nail discoloration, from 100.0% to 50.0%. Mycological cure rate was 82.1% at the last follow-up. Overall clinical responses evaluated at the last follow-up were cured in 28 patients (50.0%), 'markedly improved' in 15 (26.8%), 'moderately improved' in 9 (16.1%), and 'deteriorated' in 4 (7.1%), making a clinical response rate of 92.9%. During therapy, transient epigastric pain and indigestion developed in 2 patients (3.6%), respectively. CONCLUSION: With these results, itraconazole pulse therapy is considered an effective and safe treatment modality for onychomycosis of toenail.
Compliance ; Dermatology ; Dyspepsia ; Female ; Follow-Up Studies ; Hospitals, University ; Humans ; Itraconazole* ; Nails* ; Onycholysis ; Onychomycosis* ; Yeasts

PURPOSE: The purpose of this study is to compare the two prosthesis that used for total ankle arthroplasty. MATERIALS AND METHODS: From Sept. 2003 to Jun 2006, 13 patients and 14 ankles that could be follow up more than 1 months. Semiconstrained type (Group I, 7 cases) and Unconstrained type (Group II, 7 cases) were used for total ankle arthroplasty. Mean age was 63.2 year-old, 12 ankles are men and 2 ankles were women. Mean follow up periods were 29 months. The criteria to compare the clinical result were postoperative range of motion, AOFAS score and residual bone stock of medial malleolus. RESULTS: Postoperative range of motion of group I was 43.6+/-9.4 degrees and of group II was 50.7+/-7.3 degrees (p=0.115). Postoperative AOFAS score of group I was 77.1+/-13.0 points and of group II was 86.0+/-5.7 points (p=0.094). Resected bone stock in medial malleolus of group I was 10.7+/-2.5 mm and of group II was 5.1+/-1.2 mm (p=0.003). Total number of complication in our study was 9 cases. 3 cases were a malleolar fracture, two occurred at intra-operation, the other at follow-up period. Re-operation was done in 6 cases, 3 cases were calcaneal corrective osteotomy, 2 cases were resection of a heterotopic bone and one case was pedicular flap operation for skin problem. CONCLUSION: In our hospital, mobile bearing type prosthesis shows good result than a semiconstrained type in respect of residual bone stock in medial malleolus. Postoperative range of motion and AOFAS score between two groups shows no significant difference. But small number of patients and short term follow up period is a defect in our study, afterward more population and long term follow up period are needed.
Ankle* ; Arthroplasty* ; Female ; Follow-Up Studies* ; Humans ; Male ; Mobile Health Units ; Osteotomy ; Prostheses and Implants ; Range of Motion, Articular ; Skin