This study considers the social class and social role of the entering students of Jejoongwon at that time in light of its very first medical graduate, Kyum-Rae Lee. Foremost, Kyum-Rae Lee was confirmed to have been from a middle-class family. However, unlike other chungin-class families, his family belonged to the minority. He seemed to have entered medical school to seek opportunity to move up in social class by taking advantage of special government provisions, which allowed him to learn English and Western medicine. Afterwards, he performed heroic services in the peasant-war, proceeded up to administration and participated in the modernization of Great Han Empire. With his knowledge of Western concepts, he became involved in numerous social activities, such as organizing the Enlightenment Society and leading the Enlightenment Movement. In much the same way, most early students were from low-class background with exceptional personal abilities and were able to pass aptitude examinations. Such achievements allowed them to apply for positions in the military and administrative management. Ten years later, medical education to train medical professionals was revived with changes in attitudes of people of Chosun Dynasty toward Western medicine and with creation of formal medical study.
Education, Medical/*history ; English Abstract ; History of Medicine, Modern ; Korea ; *Social Class ; Students, Medical/*history ; Western World/*history

PURPOSE: The prevalence of obesity in children is increasing rapidly. Epidemiologic studies suggest that obesity induced atherosclerosis may start in childhood. We investigated whether obese children show early abnormalities of the arterial wall and endothelial dysfunction. METHODS: Thirty-eight obese children(14-16 years old of age, male, body mass index 29.40+/-3.18 kg/m2) and forty-five age and sex-matched healthy control children(body mass index 18.43+/-1.01 kg/ m2) were enrolled. Their carotid artery intima-media thickness(IMT) and brachial artery flow-mediated dilation(FMD) response were measured by high-quality ultrasound system, and compliance, distensibility, stiffness index, incremental elastic modulus and wall stress were calculated by equation. In addition, we looked at the relations between these arterial features and metabolic cardiovascular risk factors. RESULTS: The obese children had significantly increased IMT(0.52+/-0.09 mm vs 0.40+/-0.07 mm, P< 0.001) and markedly impaired FMD(7.35+/-7.78 percent vs 20.34+/-16.81 percent, P<0.001) than the healthy controls. But the compliance and distensibility were lower, and the stiffness index, incremental elastic modules and wall stress were higher in the obese group than the control group, but not statistically significantly. Body mass index was highly associated with increased IMT(r=0.612, P< 0.001) and reduced FMD(r=-0.414, P<0.001). CONCLUSION: We showed the deleterious effect of child obesity on both early functional and structural atherosclerotic markers. The ultrasonic findings will be used for screening and follow up markers to identify high-risk patients among obese children.
Atherosclerosis ; Body Mass Index ; Brachial Artery ; Carotid Arteries ; Child* ; Compliance ; Elastic Modulus ; Epidemiologic Studies ; Humans ; Male ; Mass Screening ; Obesity ; Pediatric Obesity ; Prevalence ; Risk Factors ; Ultrasonics ; Ultrasonography

PURPOSE: The practice of early discharge of healthy term and near-term newborns is growing worldwide. For this reason, early identification of newborn at risk for developing significant hyperbilirubinemia has become a public health issue. We therefore investigated prospectively 1) the pattern of bilirubin levels of healthy newborn by measuring transcutaneous bilirubin in the first postnatal week, 2) the predictive ability of a predischarge transcutaneous bilirubin measurement to screen for risk of subsequent significant hyperbilirubinemia in healthy newborn. METHODS: The study population consisted of 218 healthy term and near-term babies in the newborn unit at the Konyang University hospital during from August 2004 to June 2005. Transcutaneous bilirubin (TcB) measurements on the midsternum were initially made at the 24 hours of life, repeated daily until discharge, each measurement was performed just at the 24 hours after the previous measurement. And a postdischarge TcB was measured on the 7th day of life. The accuracy of the predischarge TcB as a predictor of subsequent hyperbilirubinemia was determined. RESULTS: The mean bilirubin level is 4.51+/-1.63 mg/dL on the 1st day of life (n=218), 6.71+/-1.92 mg/dL on the 2nd day of life (n=186), 8.04+/-2.05 mg/dL on the 3rd day of life (n=118), 8.60+/-2.33 mg/dL on the 4th day of life (n=88) and 8.60+/-2.79 mg/dL on the 5th day of life (n=41). A total of 16/218 (7.3%) had significant hyperbilirubinemia. Predischarge, 5.5% of the population (12/218) had TcB values in the high risk zone (> or =95 percentile) at the 24 hours of life; of these, 66.7% (8/12) developed significant hyperbilirubinemia. Predischarge, 38% of the population (83/218) was in the low risk zone (<40 percentile) and there was no measurable risk for significant hyperbilirubinemia. CONCLUSION: By measuring noninvasive transcutaneous bilirubin at the 24 hours of life, we can predict which newborn is at high risk of significant hyperbilirubinemia.
Bilirubin* ; Humans ; Hyperbilirubinemia* ; Infant, Newborn ; Prospective Studies ; Public Health

Childhood obesity seems to contribute to the development of vascular inflammation and the progression of arterial wall changes. High-sensitivity C-reactive protein (hs-CRP) has recently emerged as a useful biomarker for vascular inflammation associated with atherosclerosis. The objectives of this study were to evaluate the association of the serum hs-CRP level with ultrasonic findings of early atherosclerosis, carotid intima-media wall thickness (IMT) and brachial flow-mediated dilation (FMD), in obese children. Thirty eight obese children and 45 sex/age-matched healthy control children were recruited. Serum CRP levels were measured by the high-sensitive latex turbidimetric immunoassay, and we measured carotid IMT and brachial FMD using high-resolution B-mode ultrasonography. Obese children had significantly higher hs-CRP levels (1.40+/-0.74 mg/L vs. 0.55+/-0.49 mg/L, p<0.01), as well as increased IMT (0.52+/-0.09 mm vs. 0.41+/-0.07 mm, p<0.01) and impaired FMD (7.35+/-7.78% vs. 20.34+/-16.81%, p<0.01) compared to healthy controls. Serum hs-CRP correlated positively with IMT (r=0.413, p<0.05) and inversely with FMD (r=-0.350, p<0.05) in the obesity group. Measurement of the serum hs-CRP level is a simple, cheap, and highly reproducible assay and correlates with IMT and FMD in obese children. Thus, it would be a useful marker for evaluating and estimating the degree of atherosclerosis in children.
Sensitivity and Specificity ; Risk Factors ; Risk Assessment/*methods ; Reproducibility of Results ; Prognosis ; Obesity/*blood/*complications/diagnosis ; Male ; Humans ; Female ; C-Reactive Protein/*analysis ; Biological Markers/blood ; Atherosclerosis/*blood/complications/*diagnosis ; Adolescent

We experienced a case of malignant mucinous tumor of ovary developed in 17-year-oldnulliparous women and brief review of the case and its literature are presented.
Adenocarcinoma, Mucinous* ; Adolescent* ; Female* ; Humans ; Mucins* ; Ovarian Neoplasms ; Ovary

Congenital absence of the gall bladder without extrahepatic biliary atresia is an extremely rare congenital malformation with a reported incidence ranging between 0.01 and 0.02%. It is thought to be occurred from failure of the gallbladder bud to develop in utero and frequent association with other malformations. Agenesis can be randomly discovered at autopsy or operations for symptoms suggestive of biliary tract disease. The authors report a case of agenesis of the gallbladder without extrahepatic biliary atresia in a neonate which was incidentally found at laparotomy for presumed duodenal obstruction, with a review of the literature.
Autopsy ; Biliary Atresia* ; Biliary Tract Diseases ; Duodenal Obstruction ; Gallbladder* ; Humans ; Incidence ; Infant, Newborn ; Laparotomy ; Urinary Bladder

PURPOSE: Coexistence of different classes of beta-lactamases in a single bacterial isolate may pose diagnostic and therapeutic challenges. We investigated a spread of Klebsiella pneumoniae isolates co-producing an AmpC beta-lactamase and an extended-spectrum beta-lactamase (ESBL) in a university hospital. MATERIALS AND METHODS: Over a three-month period, a total of 11 K. pneumoniae isolates, which exhibited resistance to cefotaxime, aztreonam, and cefoxitin, were isolated. These isolates showed positive to ESBLs by double disk tests. Minimal inhibitory concentrations (MICs) were determined by broth microdilution testing. All isolates were examined by isoelectric focusing, PCR and sequence analysis to identify bla(SHV) and bla(DHA), and molecular typing by pulsed-field gel electrophoresis (PFGE). RESULTS: All 11 isolates were highly resistant (MIC, > or = 128microngram/ml) to ceftazidime, aztreonam, and cefoxitin, while they were susceptible (MIC, < or = 2microngram/ml) to imipenem. The bla(SHV-12) and bla(DHA-1) genes were detected by PCR and sequence analysis. PFGE revealed a similar pattern in 10 of the 11 strains tested. CONCLUSION: This is the first outbreak report of K. pneumoniae in Korea which co-produced SHV-12 and DHA-1 beta-lactamase, and we suggest a clonal spread of multidrug-resistant K. pneumoniae at a hospital.
Adult ; Aged ; Aged, 80 and over ; *Disease Outbreaks ; Disease Susceptibility ; *Drug Resistance, Multiple, Bacterial ; Female ; Genotype ; Hospitals ; Humans ; Klebsiella Infections/*epidemiology/*microbiology ; Klebsiella pneumoniae/classification/*enzymology/genetics/isolation & purification ; Korea ; Male ; Middle Aged ; Phenotype ; beta-Lactamases/*classification/genetics/*metabolism

PURPOSE: Recently, incidences of chronic cough with allergic disease have been increased. The identification of specific allergens for chronically coughing children is significant for diagnosis, proper treatment and prevention. The aim of this study was to identify significant contributors for sensitization in chronically coughing children. METHODS: A total of 106 children, aged 1-6 years, visiting for chronic cough(>3 weeks), were tested for inhalant multiple allergosorbent assay(MAST), eosinophil count and total IgE. Parents completed a questionnaire on past history of atopy(infantile eczema) and bronchiolitis, family history of allergy, breastfeeding, smoking, pets and floor coverings at home. RESULTS: Significant contributors for sensitization were:age(4-6 years), infantile eczema, positive family history of allergy and smoking by family. CONCLUSION: We were able to identify significant contributors for sensitization in chronically coughing children.
Allergens ; Breast Feeding ; Bronchiolitis ; Child* ; Cough* ; Dermatitis, Atopic ; Diagnosis ; Eosinophils ; Humans ; Hypersensitivity ; Immunoglobulin E ; Incidence ; Parents ; Surveys and Questionnaires ; Smoke ; Smoking

Less than 2% of patients with primary esophageal cancers have synchronous primary lung cancers and many patients with these synchronous tumors are deemed ineligible for radical resection by surgeons due to the poor prognoses of both the diseases. However, we believe that carefully selected patients could benefit from one stage curative resection for these synchronous tumors. We experienced a case of synchronous double cancer of the lung and esophagus and performed bilobectomy and Ivor Lewis operation simultaneously. To the best of our knowledge, this is the first report on the good result of one stage curative resection for these synchronous serious tumors in Korea.
Esophageal Neoplasms ; Esophagus* ; Humans ; Korea ; Lung Neoplasms* ; Prognosis

Infection cases of diphyllobothriid tapeworms are not much in the below teen-age group. We report a case of Diphyllobothrium nihonkaiense infection in a 13-year-old boy. He presented with severe fatigue, occasional abdominal pain at night time. He also had several episodes of tapeworm segment discharge in his stools. By his past history, he had frequently eaten raw fish including salmon and trout with his families. Numerous eggs of diphyllobothriid tapeworm were detected in the fecal examination. We introduced amidotrizoic acid as a cathartic agent through nasogastroduodenal tube and let nearly whole length (4.75 m) of D. nihonkaiense be excreted through his anus. After a single dose of praziquantel, the child's stool showed no further eggs, and his symptoms disappeared. The evacuated worm was identified as D. nihonkaiense by mitochondrial cox1 gene analysis. Here we report a successful extracorporeal worm extraction from an infection case of D. nihonkaiense by the injection of amidotrizoic acid.
Adolescent ; Animals ; Antiparasitic Agents/*therapeutic use ; Cyclooxygenase 1/genetics ; Diatrizoate Meglumine/*therapeutic use ; Diphyllobothriasis/*drug therapy/parasitology/pathology ; Diphyllobothrium/classification/*drug effects/genetics/*isolation & purification ; Feces/parasitology ; Humans ; Male ; Praziquantel/therapeutic use ; Sequence Analysis, DNA