The purpose of this paper is to analyze discussions on the matter of priority in treatment and prevention that took place in the medical community, the government and social hygiene associations to tuberculosis referred to as one of the national calamity in France at the turn of the 20th century. In other words, it is to show that treatment and prevention have complementary properties in France’s anti-tuberculosis movement, considering the discussions on which institutions should preferably be expanded - between the Sanatorium that values medical treatment and the anti-tuberculosis dispensary that values social prevention.
Tuberculosis, which is known to have existed from the ancient times, spread to the era of industrialization and urbanization, resulting in a large loss of lives in the second half of the 19th century following cholera in the first half of the century. Starting in Germany in the middle of this century, Sanatorium established a treatment for tuberculosis patients with air therapy, proper exercise or rest, and diet. In France, a public Sanatorium was built for the lower class, not like a luxury resort style Sanatorium for the wealthy class, from the 1890s. The spread was slow, however, due to financial problems. In the 1900s, anti-tuberculosis dispensary as a health center were increasingly built in working class quarters. The debate over whether to support the sanatorium or the dispensary was ignited at first, but since the mid-to-late 1900s, the two institutions’ roles, namely, medical treatment and social prevention, have been recognized as complementary. The Anti-tuberculosis dispensary Act of 1916 and the Sanatorium Act of 1919 systematically supported the complementary relationship between treatment and prevention in fighting against tuberculosis.

The humanitarian motivation of medical support from the three Scandinavian countries during the Korean War cannot be doubted, but the countries also had to be politically sensitive during this period. The fact that these countries only dispatched medical support, and that the team was not only for military purpose but also intended to help the civilians is a different point from the U.S. military medical support, which distinguished military medical support that is the U.S. Eighth Army, from the civilian treatment and relief, which is the UNCACK. In addition, medical support activities from the Scandinavian countries were bound to be flexible depending on the rapidly changing trend of war, active regions, and their support methods. At a time when the battle was fierce and the number of wounded soldiers increased, they had no choice but to concentrate on treating wounded soldiers, whether in Busan or Incheon. However, even while treating these wounded soldiers, they tried to treat and rescue civilians around the base area whenever they had chance. It is easily imaginable that in the urgent situation of war, the nature of medical support cannot be clearly divided into military or civilian if there is only one team that is operating. It is clear, however, that the common humanitarian purpose of rescuing and treating civilians affected the establishment of the National Medical Center in Seoul after the war. The Scandinavians had indeed remained even after the end of the war in to provide full support of establishing modern medical system in Korea. This suggests that modern Korean medical or public health system did not start to be developed in the 1960s like some researchers argue, but started a few years earlier during the time of the war with the support from the countries world-wide.

BACKGROUND: Accuracy of laboratory test results is an important issue. New guidelines for specimen delivery systems are needed for appropriate pretreatment of specimens and accuracy of results. METHODS: We evaluated various laboratory profiles, comparing the effects of specimen rack holders and coolants within transport containers. The hematology profiles (complete blood cell count [CBC], erythrocyte sedimentation rate [ESR]), chemistry profiles (aspartate aminotransaminase [AST], alanine aminotransaminase [ALT], gamma-glutamyl transferase [gamma-GT], electrolytes [Na, K, Cl], glucose, lactate dehydrogenase [LD], creatinine kinase [CK]), and coagulation profiles (prothrombin time [PT], activated partial thromboplastin time [aPTT], fibrinogen level). We also investigated the effects of transportation time including the presence or absence of hemolyzation. We received from 9 different university hospital laboratories using conventional transporation methods. RESULTS: Hemolytic features were seen in short drawn specimens. Fewer result variations were observed in specimens transported with coolants. Average specimen transportation time was 11.3 hours, and average temperatures of container was 10.9degrees C with coolant and 25.0degrees C without coolants. Non-centrifuged specimens transported with coolants showed increased serum K levels than centrifuged specimens. Coagulation tests showed less than a 10% differences. Centrifuged specimen prior to transportation showed no hemolyzation and no differences in results. CONCLUSIONS: Appropriate temperatures for each analyte should be defined to ensure the accuracy of results. To reduce hemolyzation, appropriate temperature and rack holder should be used. Temperature of the transport container should be monitored in objectively. Coagulation tests should be added as referral tests, if appropriate specimen transport monitoring system for time and temperature could be adopted.
Alanine ; Blood Cell Count ; Blood Sedimentation ; Creatinine ; Dietary Sucrose ; Electrolytes ; Fibrinogen ; Glucose ; Hematology ; Hemolysis ; L-Lactate Dehydrogenase ; Laboratories, Hospital ; Partial Thromboplastin Time ; Phosphotransferases ; Referral and Consultation ; Transferases ; Transportation

PURPOSE: This study was undertaken to determine the adequate cutoff value of the neonatal screening test to decrease recall and false-positive rates. METHODS: During the period of January 1999 through December in Asan Medical Center, newborn screening tests for phenylketonuria, congenital hypothyroidism, congenital adrenal hyperplasia, and galactosemia were performed in 3,775, 3,707, 3,783, and 3,806 newborns respectively using commercial ELISA kits. We reviewed and analyzed the recall rate at currently used cutoff values. RESULTS: 1)In neonatal screening test for congenital hypothyroidism, using a current cutoff value, 17 microIU/mL, the recall rate was 0.9% and using a 99.7% cutoff value, 21.3 microIU/mL, the predictive recall rate was 0.4%. There were no significant differences in the other reports that suggest adequate recall rate. 2)In neonatal screening test for phenylketonuria, using a current cutoff value, 3.6 mg/dL, the recall rate was 1.5% which was no significant difference compared with expected presumptive positive rate, 1.44%. 3)In neonatal screening test for congenital adrenal hyperplasia and galactosemia, the recall rate was high when using current cutoff value. But all results were within normal limits in reevaluation. CONCLUSION: The cutoff values of screening test which are currently recommended by manufacturers of commercial kits for congenital hypothyroidism, congenital adrenal hyperplasia and galactosemia, are needed to be reset to decrease the recall rate by false-positive results on the basis of data from an individual newborn screening laboratory.
Adrenal Hyperplasia, Congenital ; Chungcheongnam-do ; Congenital Hypothyroidism ; Enzyme-Linked Immunosorbent Assay ; Galactosemias ; Humans ; Infant, Newborn ; Mass Screening ; Neonatal Screening* ; Phenylketonurias

Bile* ; Child, Preschool* ; Female* ; Humans

Hyaluronic acid (HA) is an almost essential component of extracellular matrices. Early in embryogenesis mesenchymal cells migrate, proliferate and differentiate, in part, because of the influence of HA. Since the features of embryogenesis are revisited during wound repair, including bone fracture repair, this study was initiated to evaluate whether HA has an effect on calcification and bone formation in an in vitro system of osteogenesis. Mouse calvaria Pre-osteoblast (MC3T3-E1) cells were cultured in alpha-MEM medium with microorganism-derivative hyaluronic acid that was produced by Strep. zooepidemicus which of molecular weight was 3 million units. The dosages were categorized in each 0.5, 1.0 and 2.0 mg/ml concentration experimental groups. After 2 and 4 days cultures in expeirmental and control groups, the tendency of cell proliferation, MTT assay, protein synthesis ability, collagen synthesis and alkaline phosphatase activity were analysed and bone nodule formation capacity were measured with Alizarin Red S stain after 29 days cultures. The cell proliferation was increased in time, especially the group of 0.5 and 1.0 mg/ml concentration of HA were showed prominent cell proliferation. After 2 and 4 days culture, experimental groups in general were greater cell activity in MTT assay. The protein synthesis was increased in all experimental groups compared to control group, especially most prominent in 1.0 mg/ml concentration group. The collagen synthesis capacity were increased in HA experimental groups, especially prominent in 1.0 mg/ml group and the activity of alkaline phosphatase were increased, especially also prominent in 1.0 mg/ml group, compared to control group. Above these, the activity of mouse carvarial pre-osteoblast cells was showed greater bone osteogenesis activity in all applied HA experimental group, especially group of 1.0 mg/ml concentration of HA.
Alkaline Phosphatase ; Animals ; Cell Proliferation ; Collagen ; Embryonic Development ; Extracellular Matrix ; Female ; Fractures, Bone ; Hyaluronic Acid* ; Mice* ; Molecular Weight ; Osteogenesis* ; Pregnancy ; Skull* ; Wounds and Injuries

BACKGROUND/AIMS: The aim of the study was to investigate the gastric involvement of Orientia tsutsugamushi and the relationship between the clinical features and gastritis in patients with scrub typhus. METHODS: The study included 98 patients who had been diagnosed with scrub typhus between January 2003 and December 2006. Sixteen patients were selected to undergo gastroduodenoscopy with endoscopic biopsy for molecular study. The clinical severity index score (CSIS) was evaluated. Rickettsial DNA was amplified using the paraffin- embedded biopsy tissue by performing nested PCR. The expressions of ICAM-1 and VCAM-1 were investigated by immunohistochemistry to evaluate their roles in the pathogenesis of scrub typhus. RESULTS: The endoscopic findings were gastritis (n=1), erosion (n=4) and ulcer (n=11). The average CSIS was 3.65+/-1.09. Four cases of nested PCR of the 16 gastric mucosal biopsies were positive. The gastric samples that were taken earlier after therapy tended to be PCR-positive (2.00+/-00 days vs. 3.83+/-1.27 days, p<0.001). There was no difference of the clinical features and the CSISs between the PCR-positive and PCR-negative patients. The biopsied tissue revealed no vasculitis findings. Staining for ICAM-1 was more expressed in the scrub typhus group as compared with the normal control group. Staining for VCAM-1 was sporadically expressed in the scrub typhus group and normal control group. In comparison with the patients with Helicobacter pylori-associated gastritis, the immunohistochemical staining showed no difference of expression in the patients with O. tsutsugamushi-infected gastritis. CONCLUSIONS: The gastritis seen in scrub typhus patients could be typhus that is related to the direct involvement of O. tsutsugamushi. The increased expression of ICAM-1 may be related with gastric mucosal endothelial injury due to direct infection.
Biopsy ; DNA ; Gastritis ; Helicobacter ; Humans ; Immunohistochemistry ; Intercellular Adhesion Molecule-1 ; Orientia tsutsugamushi ; Polymerase Chain Reaction ; Scrub Typhus ; Typhus, Epidemic Louse-Borne ; Ulcer ; Vascular Cell Adhesion Molecule-1 ; Vasculitis

PURPOSE: Some studies report a role of leukotrienes in the pathogenesis of atopic dermatitis and suggest a rationale for the use of leukotriene receptor antagonist (LTRA) in the treatment of atopic dermatitis. This study aimed to evaluate the treatment effectiveness of montelukast in children with atopic dermatitis. METHODS: Fifty-four children between the ages of 2 and 6 years with moderate to severe atopic dermatitis were enrolled. Group A received montelukast for 8 weeks, followed by a crossover to 8 weeks of placebo after a 2-week washout period. Group B reversed the administration according to a randomized, double-blind, placebo-controlled, crossover design. The SCORing atopic dermatitis (SCORAD) index, urinary leukotriene E4 (LTE4), and eosinophil-derived neurotoxin (EDN) were assessed at every visit. RESULTS: Forty-three patients (21 males) completed the study. Although the SCORAD index was decreased in both groups, there was no statistically significant difference between montelukast and placebo (-3.0±11.2 vs -5.7±11.3, P=0.43). The level of urinary LTE4 was decreased after taking montelukast when compared to placebo, but there was no statistically significant difference (-65.9±556.2 vs 87.7±618.3, P=0.26). The changes in urinary EDN after taking montelukast and placebo had no significant difference (37.0±1,008.6 vs -195.8±916.7, P=0.10). When analyzing SCORAD indices, urinary LTE4, and EDN, we could not prove the effectiveness of montelukast in the atopic, non-atopic or high ECP (ECP ≥15 µg/L) subgroups. CONCLUSIONS: There was no statistically significant difference in clinical improvement or biomarkers between montelukast and placebo treatment. Therefore, conventional treatments with skin care and infection control might be more important strategies in the treatment of atopic dermatitis.
Biological Markers ; Child* ; Cross-Over Studies* ; Dermatitis, Atopic* ; Eosinophil-Derived Neurotoxin ; Humans ; Infection Control ; Leukotriene E4 ; Leukotrienes ; Receptors, Leukotriene ; Skin Care ; Treatment Outcome

OBJECTIVES: The aim of this study was to develop search filters able to retrieve the South Korean scientific output and relating the fields of public health, preventive medicine, and physical education, activity, fitness, exercise and sport in MEDLINE between 2000 and 2007. METHODS: The search filters were constructed and applied in MEDLINE accessed through PubMed according to the affiliation and subject. The language and place of publication were identified and the evaluation of the geographical filter performance was done. RESULTS: The search format was successfully elaborated and applied, and the articles originated, published in Korea and/or abroad focusing on the fields of public health, preventive medicine, physical education, activity, fitness, exercise and sport, added to MEDLINE between 2000 and 2007 were retrieved. Publications in six languages originated in South Korea were detected. CONCLUSIONS: A geographic search filter determined the South Korean research output, and combined with additional filters focused on specific areas. The dynamics of the scientific output followed an increased evolution in all categories. Articles were written mainly in English/Korean. Further research is recommended on developing search strategies in order to retrieve precise and reliable information.
Humans ; Korea ; Physical Education and Training ; Preventive Medicine/*methods ; Public Health/*methods ; *Sports

BACKGROUNDS/AIMS: The aim of this study was to compare operative versus non-operative management of patients with liver injury and to ascertain the differences of the clinical features. METHODS: From April 2000 to July 2012, 191 patients were admitted to Seoul St. Mary's Hospital and St. Vincent's Hospital for liver injuries. Of these, 148 patients were included in this study. All patients were diagnosed using computed tomography (CT). The liver injury was graded in accordance with the American Association for the Surgery of Trauma liver injury scoring scale. Patients were divided into two groups: those who underwent surgery and those treated with non-operative management (NOM). There was a comparison between these two groups concerning the clinical characteristics, grade of liver injury, hemodynamic stability, laboratory findings, and mortality. RESULTS: According to the 148 patient records evaluated, 108 (72.9%) patients were treated with NOM, and 40 (27.1%) underwent surgery. Patients treated with NOM had significantly fewer severe injuries as rated using the Revised Traumatic Injury Scale, Injury Severity Score, and Glasgow Coma Scale. Grade of liver injury and number of patients with extravasation of contrast dye on CT and hemoperitoneum were higher in the operative group than in the NOM group. There were significant differences between the two groups for: heart rate, respiratory rate, systolic blood pressure, and mean hemoglobin levels at admission and after 4 hours. The operative group experienced a significantly higher mortality than the NOM group. CONCLUSIONS: The results of our study suggest that hemodynamic stability and the following should be considered for deciding the treatment for liver injuries: grade of liver injury, amount of blood loss, and injury scales scores.
Abdominal Injuries ; Blood Pressure ; Glasgow Coma Scale ; Heart Rate ; Hemodynamics ; Hemoperitoneum ; Humans ; Injury Severity Score ; Liver* ; Mortality ; Respiratory Rate ; Seoul ; Weights and Measures