No abstract available.
Ethics* ; Stem Cell Research* ; Stem Cells*

Fibrous dysplasia in the orbit and cranial base may involve the optic canal. Although fibrous dysplasia is benign, it may produce a mass effect along the course of the optic nerve which can then induce visual disturbance as well as contour deformities of the skull and facial bone. The treatment of fibrous dysplasia in the orbit and cranial base is to resect the lesion as much as possible and then reconstruct immediately. As well, if there is any evidence of optic canal involvement and disease progression, the treatment of fibrous dysplasia may include optic nerve decompression. It is generally understood that some patients experience improvement of visual function after optic nerve decompression. We performed radical excision and reconstruction by means of autogenous calvarial bone graft and methylmethacrylate in 7 cases. The autogenous calvarial bone was used to reconstruct the orbit. The methylmethacrylate was used to reconstruct bony defect in the temporal area. The orbit was reconstruced into one block which was made of autogenous calvarial bone with a microplate and screw. This method is superior compared to the previous multifragment wiring method with regard to stability, operation time, and appearance. The patients in our series showed satisfactory appearance. In 6 cases, we performed optic nerve decompression. Therapeutic optic nerve decompression was done in 3 cases and prophylatic optic nerve decompression was done in the others. Following therapeutic optic nerve decompression, visual acuity was improved in 2 cases while the others showed a decrease in visual acuity. There was no change of visual acuity and visual field in 1 case after prophylactic optic nerve decompression. However, the others showed decrements in visual acuity or visual field. Therefore, we believe that more attention should be paid during optic nerve decompression procedure and strict indications to that procedure should be applied.
Congenital Abnormalities ; Decompression* ; Disease Progression ; Facial Bones ; Humans ; Methylmethacrylate ; Optic Nerve ; Orbit* ; Skull ; Skull Base* ; Transplants ; Visual Acuity ; Visual Fields

The role of the periosteum on osteointegration of Bio-Oss(R)(Geistlich, Wolhusen/Switzerland) was studied in rabbit calvarial defect. 12 New Zealand white male rabbits between 2.8 and 4 kg were included in this randomized, blinded, prospective study. Each rabbit was anesthetized with Ketamine HCl(5 mg/kg) and Xylazine HCl(1.5 ml/kg). An incision was made to the bony cranium and the periosteum was reflected. Using a 6-mm trephine bur(3i. USA), four 8-mm defects were created with copious irrigation. The defects were classified into barrier membrane(Tefgen(R), Lifecore Biomedical, Inc, U.S.A.) only group as a control, Bio-Oss(R) with barrier membrane group, Bio-Oss(R) with periosteum covering group, and Bio-Oss(R) without periosteum covering group. There were 2 rabbits in each group. The wound was closed with resorbable suture materials. Rabbits were sacrificed using phentobarbital(100 mg/kg) intravenously at 1, 2, and 4 weeks after surgery. The samples were fixed in 4% paraformaldehyde, and decalcified in hydrochloric acid decalcifying solution(Fisher Scientific, Tustin, CA) at 4degrees C for 2-4 weeks. It was embedded in paraffin and cut into 6 micrometer thickness. The sections were stained with H & E and observed by optical microscope. The results were as follows; 1. The periosteum played an important role in osteointegration of Bio-Oss(R) in bone defects. 2. When the periosteum remained intact and Bio-Oss(R) was placed on the defect, Bio-Oss(R) with periosteum covering has been incorporated into the newly formed bone from 2-week postoperatively. 3. When the periosteum was removed at the surgical procedure, invasion of connective tissue took place among the granules, and new bone formation was delayed compared to periosteum covering group. Therefore, when the bone grafting was performed with periosteal incision procedure to achieve tension-free suture, the integrity of the overlying periosteum should be maintained to avoid fibrous tissue ingrowth.
Bone Regeneration* ; Bone Transplantation ; Connective Tissue ; Humans ; Hydrochloric Acid ; Ketamine ; Male ; Membranes ; New Zealand ; Osteogenesis ; Paraffin ; Periosteum* ; Prospective Studies ; Rabbits ; Skull ; Sutures ; Wounds and Injuries ; Xylazine

No abstract in English.
History, 19th Century ; History, 20th Century ; Humans ; Neuralgia/history/surgery ; Neurophysiology/*history ; Neurosurgery/*history ; Therapeutic Human Experimentation/ethics/*history ; United States

Studies on medicine in North Korea have suffered from the lack of material and from the lack of reliability of information. So far, studies on North Korean medicine have centered on the health care system, and medical education system based upon the official data and interviews on refugees from North Korea. The author had a travel grant for archive research to National Archive Center II and Library of Congress from Association of Asian Studies in U.S.A. and photocopied volumes of a North Korean medical journal called In-Min-Bo-Gun(People's Health) published in 1949-1950, and 1957-1960 Captured by the U. S. Army during the Korean War and declassified in 1977 the journal volumes are rare and valuable resources for historical study. This study aims to analyze the form and contents of the available volumes of the journal. As an official journal of the Ministry of Health, North Korea, the primary purpose of the journal was to mobilize all the people who worked in medicine and public health, and to make them implement the public health policies of North Korean government. Accordingly, various categories of people wrote and read the journal from high officials to local public health workers. The genre of the articles published in the journal was also various including papers, declarations, speeches, reports, scientific papers, case reports, news, criticism, conte, poem, essays, and many more. This study showed that In-Min-Bo-Gun(People's Health) was at the center of the Hygiene Reform Movement during the Cultural Revolution from 1958-1959 as an important media that connected health workers and the North Korean government.
English Abstract ; Health Education/*history ; History of Medicine, 20th Cent. ; Korea ; Periodicals/*history ; Public Health/*history

No abstract available.
Diphtheria/*history ; History of Medicine, 18th Cent. ; History of Medicine, 19th Cent. ; History of Medicine, 20th Cent. ; Human

PURPOSE: This paper examines current situation of medical ethics education in the United States of America to have an overview on contents, learning methods and educational strategies for medical ethics education. METHODS: The author analyzes medical ethics courses, related integrated courses and their teaching methods published in Curriculum Directory Association of American Medical Colleges (2000) and reviewed literature relevant to the subject. RESULTS: The statistical data show that 125 medical schools in America provided 679 medical ethics classes, which were 5.4 classes per school. More than 90% of formal classes were conducted in preclinical years: 67.3% of all ethics-related classes were opened in the first academic year; 24.8 % in the second academic year. Lectures were most prevalent teaching methods, following small group discussion, case-based study, tutorial, and so on. Medical educators have hardly reached consensus over details of medical ethics, although they agree on the necessity of medical ethics education. In spite of incomplete information, this study shows a general tendency of medical ethics education in U.S.A.
Americas* ; Consensus ; Curriculum ; Education* ; Ethics, Medical* ; Humans ; Learning ; Lectures ; Schools, Medical ; Teaching ; United States*

The 19th century has been thought to be the turning point that the experimental method bean to take strong root as the core to solve many physiological subjects, and discipline of physiology got firmly fixed as the specialized one in the western Europe. Authors found of physiology got firmly fixed as the specialized one in the western Europe. Authors found the following characteristics in the process of the division and specialization of the 19th century western physiology. 1) It was the process of its separation from the discipline of anatomy that was necessary in the development of physiology as the independent, specialized division. Newly grown ideas, that there were working functions specialized study, were the important background and basis of the development of physiology as the specialized discipline. 2) It was not until the force and influence of the metaphysical concept on the living things(vitalism) grew weak that physiology could become the specialized discipline. The new materialistic concept about living things made it possible for the researchers of that time to apply the physico-chemical method in the study of physiological problems. 3) Institutionalization of the physiological research and education accelerated its development and specialization. The followings appeared in the mid-19th century: specialized professorship, division as the separated subject in the undergraduated medical school curriculum, laboratory settings for the purpose of physiological study, establishment of independent academic societies and publication of their own journals. Two main factors, namely, both the settlement of the new physiological thought and method of the very scientific nature and the institutionalization within the academic and medical societies exerted influences on each other in the ground of the 19th century western Europe. Through that process, the discipline of physiology took root deep as the independent specialized division in the societies of science and medicine.
English Abstract ; Europe ; History of Medicine, 19th Cent. ; Physiology/*history ; Science/history ; Specialties, Medical/*history

This paper deals with the theory of Ivan Petrovich Pavlov(1849-1936), a Russian physiologist, who presented for the first time the systematic theory of the function of the brain that controls the whole behavior of animals, i.e. higher nervous activity through experimental studies. This paper, principally based on Lectures on Conditioned Reflexed(1928), investigates the development of conditioned reflex theory from its beginning by dividing it into three periods. First, during the period from 1898 to 1906, the fundamental concept of conditioned reflex was established and the study of conditioned reflex became an independent discipline. From 1907 to 1916, the second period, Pavlov theorized on higher nervous activity on the basis of extensive data from his laboratory experiments of conditioned reflex. And Pavlov complemented conditioned reflex theory, during the third period from 1916 to 1928, and extended the boundaries of it through applications of conditioned reflex theory to psychopathology and typology. The study contributes to the understanding that conditioned reflex theory was historically developed, and not presented as a complete form from the beginning, and that Pavlov intended to study the higher nervous activity through the method of neurophysiology.
Animal ; English Abstract ; *Higher Nervous Activity ; History of Medicine, 19th Cent. ; History of Medicine, 20th Cent. ; Human ; Neurophysiology/*history ; *Reflex ; Russia

With uncertainty and the possibility of serious risks, stem cell based therapies should be introduced to clinical practice only after clinical trials demonstrate their efficacy and safety. The ethical issues related to current stem cell based therapies are examined based upon ethical principles. For the ethical conduct of clinical trials using stem cells, the guidelines for all clinical research should be followed. Because of highly innovative nature of such trials, special attention must be paid to rigorous scientific and ethics review in comparison of currently available treatments, assurance of voluntary informed consent and publication of findings of the clinical trial including negative results and adverse effects. International guidelines and Korean regulations are surveyed for justifiable medical use of unproven stem cell-based interventions. Key features include application of such innovative intervention only to a very small number of seriously ill patients, following a written protocol, approval from an ethics committee, informed consent, safety monitoring, follow-up data collection to evaluate effectiveness and adverse effects and transition to a formal clinical trial in a timely fashion after experiencing a few patients.
Data Collection ; Ethics Committees ; Humans ; Informed Consent ; Publications ; Social Control, Formal ; Stem Cells ; Therapies, Investigational ; Uncertainty