Unfortunately, we have poor knowledge of medical technology in North Korea. This study has thus attempted to identify the level and status of medical technology development through analyzing the contents of medical textbooks currently in use. This study has assumed that three factors are influencing the level and status of medical technology in a society ; the level of socio-economic development in general, the level of scientific technology revolution and health policy. Forty textbooks are collected for this purpose. The main findings are summarized as follows: 1) North Korea has strengths in that (1) its herb drugs, which are in a broad use, are cheaper, more safe and more attainable than bio-equivalent chemical ones, and (2) the development of its medical technology was carried out with emphasis on the practical and basic health needs. 2) North Korea has weaknesses in that (1) its medical diagnostic method largely depends on manual procedures, (2) the R & D investment in the development of chemical drugs, especially antibiotics, is very small, (3) the amount of medical equipments is in a absolute shortage, and (4) the medical technology is destitute of specialty, caused mainly by the overemphasis on Juche-Uihak or herb medicine. 3) Medical technology has two faces, positive and negative so that it cannot be successfully evaluated by one. It eventually acts a positive function for public health through developments of drug, equipment and new medical treatment method. But it is also true that it has negative effects such as the dehumanization of high cost medical technology, cost hike due to over-investments in expensive equipments, and the absence of wholistic care from overspecialization. 4) We have to consider economic status and the social needs of medical care in order to evaluate the medical technology of a society. It is also the ease with North Korea. A whole picture of the North Korean medical technology could be understood only if further comprehensive studies of medical technology are to be carried out for North Korea.
Anti-Bacterial Agents ; Dehumanization ; Democratic People's Republic of Korea* ; Health Policy ; Herbal Medicine ; Investments ; Public Health

BACKGROUND: Although one hair usually arises from a single follicular opening in normal healthy subjects, we can see two or more hairs emerging from the single opening through close inspection. The latter is called "compound hair", described by Lowenthal in 1946, however, few reports on this have been made since. Histopatholoigcally two or more hairs which have an independant external root sheath arise from one follicular opening like its clinical appearance. We examined the distribution and density of compound hair in order to define its difference according to anatomical sites and aging process. OBJECTIVE AND METHOD: We counted the number of hairs in the circle(2 cm in diameter) at te frontal, temporal and occipital scalp of 24 old young men(22.5+/-2.0 years old) and 24 old men(64.4+/-12.9 years old), respectively. RESULTS: The summated number of grouped hair, which was mostly regarded at compound hair, was greater in the young group than in old group in the frontal area, but was smaller in young group than in old group in from the temporal and occipital areas. The proportion of grouped hair to total hair in the older group was lower in the frontal area, but higher in the temporal and occipital areas(p<0.05, p<0.01) according to aging process, however, no significant change was seen between the frontal area and the sum of single hair to compound hair was significantly decreased in the temporal and occipital areas(p<0.05, p<0.01) according to aging process, however, no significant change was seen between the frontal area and the sum of the three tested areas. CONCLUSION: Compound hairs are observed frequently on the scalp of normal healthy subjects and are most frequently seen on the occipital scalp in both of the young and old.
Aging ; Hair* ; Scalp* ; Tuberculosis, Cutaneous

No abstract available.
Arm* ; Dyskinesias* ; Hand* ; Multiple Sclerosis*

BACKGROUND: Because primary care is the cornerstone of an effective health care system, many developed countries have striven to establish and strengthen their primary care systems. However, the primary care system in South Korea is not well established, and primary care research is still in its infancy. This study aimed to show the benefits of regular doctors as primary care providers in South Korea by analyzing the effect of regular doctor visits on emergency room (ER) visits. METHODS: We analyzed cross-sectional data on 11,293 adults aged 18 years and over collected from the 2013 Korea Health Panel Survey (beta version 1.0). We classified those participants with and without regular doctors into the treatment and control groups, respectively, and estimated the average treatment effect (ATE) of having a regular doctor on ER visits. We used counterfactual framework and propensity score analysis to adjust for unevenly distributed confounding covariates between treatments and control groups. RESULTS: The estimated conditional ATE of a regular doctor on ER visits was statistically insignificant in the general population (-0.4%; 95% confidence interval [CI], -2.0 to 1.2) and in the subgroup of patients with hypertension (-1.8%; 95% CI, -4.5 to 0.9). However, in patients with diabetes mellitus (DM), the estimated ATE was statistically significant (-5.0; 95% CI, -9.2 to -0.7). CONCLUSION: In the total study population, having a regular doctor did not result in a significant difference in ER visits. However, there was a decrease in ER visits in patients with DM in South Korea.
Adult ; Delivery of Health Care ; Developed Countries ; Diabetes Mellitus ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Hypertension ; Korea* ; Primary Health Care* ; Propensity Score ; Treatment Outcome

Beta-fluoroethylacetate has been extensively used as the rodenticide in Korea. In some patients with acute poisoning, beta-fluoroethylacetate caused cerebellar dysfunction as a single and persistent neurologic sequela after a period of an acute neurological disorder which is characterized by mental deterioration, seizures, and respiratory failure. But there has been no report of pathological findings to explain neurological deficit. We tried to verify the histologic changes of the central nervous systems in beta-fluoroethylacetate poisoned rats. Silver staining(Gallyas) was used to evaluate the histology. In acute intoxication experiment with LD50(7mg/Kg), beta-fluoroethylacetate elicited acute onset of consciousness deterioration, generalized tonic-clonic seizures and large amplitude tremulous activity involving whole body with full recovery after 24 hours. There was no discernible pathologic change in CNS in acutely poisoned rats. However, when poisoned with sublethal dose(5mg/Kg) daily for five days, a moderate degree of nerve cell degeneration was found selectively in dentate nucleus, Purkinie cell layer, vestibulo-cochlear nucleus and striatum. This change was not seen in hippocampus, cerebral cortex or cerebellar cortex. These findings were well correlated with the previous reports of selective pathology in human 5-FU intoxication cases. Our preliminary results suggest that beta-fluoroethylacetate, a kind of cellular metabolism inhibitor may induce selective neuropathology mainly involving cerebellar output pathway in rats.
Humans ; Rats ; Animals ; Poisons

Angioleiomyoma(ALM) of the cavernous type is a rare subtype of leiomyomas arising from the smooth muscle of veins. ALM of this type invariably shows clinically and histopathologically distinctive features, compared with the classical solid or venous type. However, no case of ALM of this type has been yet reported in Korea although there have been several reported cases of other types. We herein present the case of a 39-year-old man with a 7-year history of a painless ALM of the cavernous type on his buttock with the histological features of markedly ectatic vascular channels and thin intervascular bundles of smooth muscles.
Adult ; Angiomyoma ; Buttocks* ; Humans ; Korea ; Leiomyoma ; Muscle, Smooth ; Veins

PURPOSE: We wanted to objectively evaluate the anatomy of the neonatal brain on ultrasound images, and so we reconstructed several oblique magnetic resonance images that corresponded with the oblique ultrasound images by using MRI and a multiplanar reconstruction program. MATERIALS AND METHODS: MRI 3D-SPGR axial scans of the brain were performed for two neonates and then we obtained the reconstructed MR images that were parallel with the direction of the sonographic oblique scanning plane. We made the anatomic models of the neonatal cranial ultrasound images by using axial MRI as the standard reference on the same screen. RESULTS: We created an anatomic atlas, with the representative six oblique coronal scans and six oblique sagittal scans that corresponded to the neonatal brain ultrasound images. CONCLUSION: This objective anatomic research with using MRI and a multiplanar reconstruction program for creating the ultrasound oblique brain images of a neonate will be very helpful for evaluating the ultrasonographic anatomy and to apply it to clinical practice.
Brain ; Humans ; Infant, Newborn ; Magnetic Resonance Spectroscopy ; Models, Anatomic

Naive CD4 T cells activated by antigen-presenting cells (APCs) undergo terminal differentiation in the periphery. Multiple mechanisms determine their fates, that is, whether they differentiate into conventional T (Tconv) cells or regulatory T (Treg) cells. The key event during Treg generation is expression of the transcription factor Foxp3, which is the lineage-determining regulator for Treg differentiation and function. Here we show that the transcription factor Batf3 acts as a fate-decision factor with respect to Tconv versus Tregs by restraining Treg differentiation. Batf3 was preferentially expressed in effector CD4 T cells but not in Treg cells, and ectopic expression of Batf3 inhibited Foxp3 induction. Batf3-deficient CD4 T cells favorably differentiated into Treg cells in vitro and in colonic lamina propria. Batf3 KO mice also showed enhanced Treg function in gut-associated immune disease models (for example, ovalbumin tolerance and inflammatory bowel disease models). Batf3 bound to the CNS1 region of the Foxp3 locus and reduced expression of the gene. Thus, Batf3 is a transcriptional suppressor of Treg differentiation.
Animals ; Antigen-Presenting Cells ; Colon ; Ectopic Gene Expression ; Immune System Diseases ; In Vitro Techniques ; Inflammatory Bowel Diseases ; Mice ; Mucous Membrane ; Ovalbumin ; T-Lymphocytes ; T-Lymphocytes, Regulatory* ; Transcription Factors*

Thirty-one distal femoral and nine proximal tibial primary bone tumor patients who had prosthetic replacements were reviewed retrospectively. Average follow-up was thirty-eight months(range: 12- 109 months). There were thirty-two(osteosarcoma: 29, chondrosarcoma: 3) stage IIB lesions and eight 1B lesions(giant cell tumor). Twenty-nine patients were surviving at final follow-up. Overall prosthetic survival was 81%, 27% at 2 and 5 year respectively. Eleven prostheses were revised. The causes of revisions were infection(7), metal failure(2), fracture of host bone(1), and loosening(1). Eight revisions were successful, one was fair, and two patients needed an amputation. Prognostic factors which were analyzed for survival of prostheses were age, sex, location of primary lesion, percent of bone resected, and stage. Only the location of primary lesion showed statistical significance and diabolic pattern of survival curve was noted between two groups in resection length(<40% versus >40%). Average functional score was 26. The tibial side had worse prosthetic survival and a major threat to this procedure was due to infection.
Amputation ; Chondrosarcoma ; Follow-Up Studies ; Humans ; Knee Joint* ; Knee* ; Prostheses and Implants ; Prosthesis Failure ; Retrospective Studies ; Sarcoma

BACKGROUND: Inflammatory bowel disease(IBD) such as ulcerative colitis or Croln's disease is often related with varied diseases including pyoderma gangrenosum, erythema nodosum, ankylosing arthritis and psoriasis. To date, however, a cIinical observation of IBD accompanied by psoriasis has been sparcely accomplished although an immunogenetic mechanism explaining a coexistence of IBD and psoriasis has been proposed. OBJECTIVE: We estimated the prevalence of IBD in patients with psoriasis in Korea and investigated the clinical characteristics of IBD accompanied by psoriasis. METHODS: 92 psoriatic patients and 389 non-psoriatic control subjects were enrolled in this study. Colonoscopic biopsy and barium series were performed in 47 psoriatic patients and 110 control subjects showing irritative intestinal symptoms. RESULTS: 1. The prevalence of IBD in psoriatic patients(14.1%) was significantly greater than in the control group(1.0%). 2. In the temporal relationship, psoriasis developed several years prior to the onset of IBD in 84.6% of psoriatic patients. 3. The frequency of arthropathies in the psoriatic patients possessing IBD(84.6%) was significantly higher than that of non-psariatic counterparts with IBD(25.0%) or that of psoriatics without lBD(2.5%), 4. The psoriatir. patients with IBD demonstrated much more frequently diffuse colonal extension than in non-psoriatic subjects with IBD. CONCLUSION: Our findings of an increased prevalence of IBD in the psoriatic population present further evidence of an association between IBD and psoriasis. In the psoriatic patients showing acute or chronic gastrointestinal symptoms, colonoseopic evaluation might be mandatory for the evaluation of IBD.
Arthritis ; Barium ; Biopsy ; Colitis, Ulcerative ; Colon ; Erythema Nodosum ; Humans ; Immunogenetics ; Inflammatory Bowel Diseases* ; Korea ; Prevalence ; Psoriasis* ; Pyoderma Gangrenosum