Since bioterrorism has become reality after its occurrence in USA, our goverment is preparing and conducting strategic plans for preparedness and response to bioterrorism. The major plans consist of reinforcement of surveillance of notifiable communicable diseases, construction of supplementary surveillance systems, organization of emergency department and infection specialists networks, strengthening of laboratory capacity and network, and establishment of a stepwise response plan according to risk assessment. For the preparedness for bioterrorism, we are preparing a national pharamaceutical stockpile (antibiotics, smallpox vaccine, etc) and strengthening the organization, law, epidemiologic capacity, research, and management of critical infectious agents. It is very difficult to predict the risk of bioterrorism, which may be very low. Nevertheless, the complete preparedness is necessary to prevent social confusion by bioterrorism. Especially, phisician's role in response to bioterrorism such as case detection, report, management, and treatment is very important.
Bioterrorism* ; Communicable Diseases ; Emergency Service, Hospital ; Jurisprudence ; Risk Assessment ; Smallpox Vaccine ; Specialization

Communicable diseases are a continuing menace to all people. Although some diseases have been conquered by antibiotics and vaccines, new ones are constantly emerging (such as HIV/AIDS, Legionnaires' disease), while others re-emerging (such as malaria, shigellosis). In 2000, the communicable disease control law had been amended to cope with emerging and re-emerging infectious diseases. The important amendatory contents are revision of statutory communicable diseases (3 class, 29 → 5 groups,63), shortening of the reporting time(group I,II,IV, immediately ; group III, V, within 7 days), and introduction of sentinel surveillance system, EDI reporting system, and reporting criteria.
Anti-Bacterial Agents ; Communicable Disease Control ; Communicable Diseases* ; Communicable Diseases, Emerging ; Jurisprudence ; Malaria ; Sentinel Surveillance ; Vaccines

Despite the increasing numbers of patients in need of organ transplantation following the increasing prevalence of chronic diseases such as CRF, chronic liver disease, disparities between the supply and demand of transplantable organs are getting increasingly widened. After the "Organ transplatation act" is enacted in 2000, brain death organ is equitably allocated by KONOS and illegal organ bargains are nearly eradicated. But unfortunately, brain death organ donation is not sufficiently activated, because of immature organ donation culture, absence of notification of potential brain death and active organ procurement system, and inflexibe organ donation processes. Ministry of Health and Welfare had made the comprehensive activation plan to solve the organ shortage problems, to increase organ procurments and transplantations at Oct. 2005. The major measures are strengthening the PR and education about organ donation, introduction of notification of potential brain death, and establishment of active organ procurement system through organ procurement organizations, strengthening of national responsibility and support.
Brain Death ; Chronic Disease ; Education ; Humans ; Liver Diseases ; Organ Transplantation* ; Prevalence ; Tissue and Organ Procurement ; Transplants*

The Korea national blood services has been established since 1970 when the "Blood management law" was enacted. National blood services grew fast through 1980~1990 and the voluntary non-remunerated blood donation system was introduced successfully. However, blood-transmissible infections such as HIV, HCV, and HBV were documented since 2000, which compromised the confidentiality of national blood services. In 2004, the Korean government established the? National Blood Safety Plan? for the provision of safe and adequate blood supply. The major measures include the expansion of blood collection centers, improvement of blood screening laboratories, introduction of an investigation and compensation system of blood transfusion-related adverse events, introduction of blood transfusion guidelines and hospital blood services commitment, evolution of a national blood services organization, and the strengthening of national responsibility and support.
Blood Donors ; Blood Safety ; Blood Transfusion ; Compensation and Redress ; Confidentiality ; HIV ; Humans ; Korea ; Mass Screening

Culture of human peripheral T lymphocytes with irnmobilized anti-CD3 rnAb plus IL-2 resulted in a marked proliferation and the enhancing IL-2Ra mRNA expression. The process of the T cell activation involves a series of biochemical events which ultimately lead to the proliferation and IL-2Ra mRNA expression. Although the above results have been observed, the celluar signal mechanisms between the proliferative response and the IL-2Ra mRNA expression through T cell receptor and IL-2 receptor remains unresolved. In the present study, We have used genistein (the selective PTK inhibitor) or chronic PMA treatment (depletion of intracelluar PKC activity), to investigate the role of PTK or PKC both in a synergistic proliferation and in the enhancing IL-2Ra mRNA expression by IL-2/anti-CD3. Genistein (30 ug/ml) completely blocked IL-2 induced T cell proliferation, and inhibited anti-CD3 induced T cell proliferation (93.4%). But genistein downregulated the IL-2Ra mRNA expression by IL-2, anti-CD3 and IL-2/anti-CD3. The chronic PMA treatment failed to inhibit the proliferation and the IL-2R#u mRNA expression by IL-2 alone. But PKC depleted T cells stimulated with anti-CD3 mAb showed the decrease of the proliferation (68.6%) and IL-2Ra mRNA expression. In activated with IL-2/anti- CD3, the proliferative response showed a half of reduction, but the IL-2Ra mRNA expression were not regulated. These results demonstrate that proliferative response to IL-2 appears to be dependent on PTKs activity and independent of PKC involvement, but the IL-2Ra mRNA expression may be required another signals. PTKs and PKC activity may be important in TCR/CD3 signaling. But IL-2/anti-CD3 are coupled up different signal transduction pathways responsible for the synergistic T cell proliferation and the enhancing IL-2Ru mRNA expression.
Cell Proliferation ; Genistein ; Humans ; Interleukin-2* ; Receptors, Antigen, T-Cell ; Receptors, Interleukin-2 ; RNA, Messenger* ; Signal Transduction ; T-Lymphocytes

It is well known that a physician's personal characteristic affects his practice pattern. Furthermore, a physician's specialty has powerful influences on his practice pattern. However, despite the fact specialization has received the most attention for its influence on physician's service behavior, few studies have been conducted on the variations of contents and volume of physician's services. This study has intended to identify factors influencing the practice variations according to various physician characteristics. There are some other evidences that medical care providers are different in using of health services and resources in Korea. Four physician characteristics were selected for the analysis, two demographical factors, age and sex, and two practice factors, place of practice and medical specialty. Also, three indicators of service amount(total amount of insurance claim bill, number of visits per case, number of prescriptions per case) were selected. From the pool of insurance claims for ambulatory care received by the Korean National Federation of Medical Insurance(NFMI), 84,898 cases were randomly sampled. In the meantime using physician database of NFMI, 613 general practitioners(GP), 107 regular family physicians(FP), 483 'grandfather' family physicians(GFP), and 1,157 specialist practitioners(SP) were randomly sampled. Their different practice contents were compared concerning the specialty, age groups, sex, and practice sites(urban-rural). Specialist physicians tend to provide more costly care than do generalists. General practitioners and family physicians usually make fewer following visits and prescriptions. Age is also the important factor in determining the amount of services, which is highest at the physician's age group of 40's. Female doctors and urban practitioners use much more resources than their counterparts respectively. Research findings suggest that physician's characteristics particularly the specialty can affect practice patterns and resource utilizations. Other characteristics such as age and sex are not controllable but physician's specialty is relatively easily controllable during the entire phases of policy implementation. This is all the more true in the individual's initial decision of his specialty. Specialization therefore should receive policymaker's attention for its potential influence on medical care utilization and health care expenditure.
Age Factors ; Ambulatory Care ; Delivery of Health Care ; Female ; General Practitioners ; Health Expenditures ; Health Services ; Humans ; Insurance ; Korea ; Physicians, Family ; Prescriptions ; Specialization

The alert regarding the emergence of novel influenza was issued by the WHO on April 24th, and the government has taken immediate actions to respond to the situation since then. Based on the presumption that a pandemic was imminent, countermeasures for the H1N1 influenza pandemic have been prepared by establishing and implementing effective public health crisis strategies over the past few years. Our main strategy during the pandemic influenza crisis has shifted in accord with the corresponding National Disaster Phases. In the Caution (Containment) Phase, our main goal was to contain the influx of disease from overseas. We focused on measures such as entry screening and quarantine inspection while monitoring travelers arriving from affected countries. In the Alert Phase I, our aim was deceleration and prevention of secondary community outbreaks through enhanced early detection. We intensified our surveillance and response system for possible mass outbreaks. During Alert Phase II, as the influenza had spread widely, our tactics switched to minimizing social and economic impact and preventing severe cases with early administration of antiviral agents, especially among high-risk patients. In the current Severe Phase, we are trying to reduce mortality cases with intensive care. Since we have implemented mass vaccination, we predict an early termination of the pandemic.
Antiviral Agents ; Critical Care ; Containment of Biohazards ; Deceleration ; Disasters ; Disease Outbreaks ; Humans ; Influenza, Human ; Mass Screening ; Mass Vaccination ; Pandemics ; Public Health ; Quarantine ; Vaccination

Some of the proteins of mycobacteria are preferentially associated with the cell wall and are powerful immunogens, and humoral antibody responses to these mycobacterial antigens may occur in patients with tuberculosis. In this study, Triton X-100 solubilized protein (TSP) antigen was isolated from Mycobacterium tuberculosis H37Rv by overnight shaking with 1% Triton X- 100/PMSF and 10-90% ammonium sulfate precipitation. IgG and IgM antibody levels against TSP, crude protein from the unheated cultrue filtrate (CF#) and 30 kDa antigens were determined in the sera of 80 patients with pulmonary tuberculosis and 99 healthy controls with PPD (+) and (-). High IgG reactivity to TSP and CF antigen was observed in tuberculosis patients. Mean IgG antibody titers against all of three mycobacterial antigens were differed significantly (P<0.01) between patients and controls but IgM showed no difference. By the cut-off value adding 2 standard deviation to the mean absorbance of controls, the sensitivity and specificity of the IgG antibody to TSP antigen were 93.9% and 77.5%. The specificity to TSP antigen was a litttle higher than those obtained by CF and 30 kDa antigen. From the above results, the TSP antigen may be useful for the serodiagnosis of tuberculosis.
Ammonium Sulfate ; Antibody Formation ; Cell Wall ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Mycobacterium tuberculosis* ; Mycobacterium* ; Neptune* ; Octoxynol* ; Sensitivity and Specificity ; Serologic Tests ; Tuberculosis ; Tuberculosis, Pulmonary*

Tumor-draining lymph node (TDLN) lymphocytes contain immunologically sensitized to tumor but functionally deficient T cells. The 30 kDa protein antigen, a major secreted protein antigen of Mycobacterium tuberculosis, exhibits strong T cell stimulatory effect. In this study, it examined that the feasibility of using M tuberculosis 30 kDa antigen to stimulate tumor-draining lymph node cells for the generation of specific immune effector cells. Freshly isolated TDLN lymphocytes could directly respond to the 30 kDa antigen alone and their proliferative responses were markedly augmented by stimulation with rIL-2. TDLN cells were stimulated with the 30 kDa antigen for various time intervals and examined for the induction of IFN-r and IL-4 mRNA using RT-PCR. The expression of IFN-r mRNA was greatly augmented after 1 wk, whereas IL-4 mRNA is markedly decreased after 1 wk. Cytotoxic T cell activities induced by the 30 kDa antigen was also evaluated. TDLN cells stimulated with the 30 kDa antigen alone were able to generate remarkable cytotoxic response to K562 or Daudi cell lines after 6 days of culture. And their cytotoxic effects were highly augmented by stirnulation with rIL-2. These results suggest that the 30 kDa antigen of M. tuberculosis may selectively activate Thl cells of TDLN lymhocytes and induce the cytotoxic T cell activities. In conclusion, the 30 kDa antigen can be used as a biologic response modifier in tumor immunology.
Allergy and Immunology ; Cell Line ; Interleukin-4 ; Lymph Nodes* ; Lymphocytes* ; Mycobacterium tuberculosis* ; Mycobacterium* ; RNA, Messenger ; T-Lymphocytes ; Th1 Cells* ; Tuberculosis

From January 1995 to December 1997, a total of 219 cases pelviscopic surgery was performed at Il Sin Christian Hospital. To evaluate the safty and efficacy of pelviscopic surgery, we reviewed indication of operation, mean age, parity, history of abdominal operation, type of operation, duration of hospitalization and complication retrospectively. The number of pelviscopic surgery have risen from 33 cases in 1995 to 53 cases in 1996 and 133 cases in 1997. The most common indications were 118 cases for ectopic pregnancy (53.9%) and 42 cases for ovarian cyst (19.2%), 20 cases for infertility (9.1%) in order. Among the ovarian cyst, endometrioma was the most common. The mean age of patients was 31+/-6.7 years old and mean parity was 0.77. In most cases, mean blood loss was lesser than 100 cc except 500 cc in LAVH, 150 cc in CISH, 106.7 cc in ectopic mass removal. The postoperative hospital stay was varied from 0 day to 10 days, but usually 2 days. The 26 cases had complicated and the most common complication was fever above 38degrees C. In conclusion, it is evident that pelviscopic surgery is lesser invasive technique, has lower complication rate and shorter the length of hospitalization. So, we expect the number and indication of pelviscopic surgery will be increased in future.
Endometriosis ; Female ; Fever ; Hospitalization ; Humans ; Infertility ; Length of Stay ; Ovarian Cysts ; Parity ; Pregnancy ; Pregnancy, Ectopic ; Retrospective Studies