Born in Pyongyang in 1914, Choe Ung-sok was a physician who lived through the Japanese colonial era (1910-1945), rule by the United States Army Military Government in Korea (USAMGIK; 1945-1948), and national division (1948). Influenced by socialism and social hygiene/social medicine during his studies in Japan, he played the role of representing the socialist camp in the discussions related to the construction of a heath care system immediately following the Liberation (1945). His key arguments were: first, the nationalization of the medical system and the implementation of nationwide programs to eradicate diseases; second, the provision of free medical services through the expansion of social insurance; third, the reeducation of the medical personnel; fourth, the provision of social sciences education to the medical personnel and the reorganization of medicine into preventive medicine; fifth, the nationalization of pharmaceutics; sixth, the laborers' establishment of autonomous medical organs (affordable clinics, medical consumers' unions through cooperatives); and seventh, the reduction of work hours to 6-8 hours, technical improvement, respite from research, and guarantee of economic life for the medical personnel. Influenced by the medical systems of the Soviet Union and Japan, such arguments stood in opposition to the right wing's plan for the construction of a relatively passive health care system at the time but, in the end, failed to be realized in southern part of Korea under the USAMGIK. Subsequently, he defected to northern part of Korea and came to participate in the task of constructing North Korea's health care system. Choe's life and design for a health care system provide examples through which one can confirm the nature of social hygiene/social medicine both during the Japanese colonial era and before and after the Liberation and the contents of the design related to a health care system as held by the socialist faction. In addition, they show that, immediately after the Liberation, there existed a broad spectrum of imagination and arguments concerning the desirable health care system. Following the division of the Korean Peninsula, South Korea witnessed the instatement of a regime that established anti-communism as the state policy and the strong influence of the United States in politics, economy, and culture. The consequent frustration of Choe's design for a health care system and his defection to North Korea frustrated the creation of a National Heath Service (NHS) in South Korea, reinforced the tendency to view NHS and social insurance as "socialist" or "communist" methods, and led to the restriction of the scope of subsequent discussions related to health care system. In conclusion, the course of Choe's life and thought went beyond the life of an individual during a period in which diverse ideologies collided through the Japanese colonial era, Liberation, and national division and symbolically demonstrates one important path of the process of constructing a health care system on the Korean Peninsula.
Delivery of Health Care/*history ; Democratic People's Republic of Korea ; History, 20th Century ; Physicians/*history ; *Politics ; Republic of Korea

The purpose of this study was to evaluate the long term tooth-brushing effect on the color change of specially treated IPS Empress porcelain surface. Staining technique with blue stain and liquid was used. The surfaces of the specimen were treated with 5% and 10% Hydrofluoric acid, 50mm and 250mm alumina sandblast, and then blue stain and liquid were used for external stain. After 29,200, 58,400, 87,600, 116,200 brushing strokes (equivalent to 2, 4, 6, 8 years each), color changes of the stained layer were measured with spectrophotometer(CM-3500d, MINOLTA, Thkyo, Japan). The result of this study was obtained as follows : 1. The color changes were great after 29,200 tooth brushing strokes in every group, but from 29,200 strokes to 116,800 strokes, there were no significant color changes in each group.(p>0.05) 2. The greatest color changes were observed in 5% HF treated group and the least color changes were observed in 50 micrometer aluminar sandblast treated group in every stroke(p<0.05), but no ststistical difference between groups compared with control group(p>0.05). According to these results, pretreatment of I.P.S. Empress porcelain with alumina sandblast improved the color of IPS Empress porcelain significantly on this condition, but long term follow-up will be needed.
Aluminum Oxide ; Dental Porcelain* ; Hydrofluoric Acid ; Stroke ; Tooth ; Toothbrushing*

BACKGROUNG AND OBJECTIVES: To evaluate the clinical and prognostic significance of precordial ST segment depression in precordial leads on admission electrocardiogram (ECG) in acute inferior myocardial infarction treated with intravenous thrombolytic therapy. We analysed about clinical and angiographic characters. MATERIALS AND METHOD: ECG findings in 50 patients with acute inferior myocardial infarction were retrospectively studied with results of coronary angiography and clinical informations. We classified all patients in two group according to the admissional ECG. Twenty nine patients (Group A) had no or <1.0 mm ST depression in precordial lead and Twenty one patients (Group B) had > or =1.0 mm ST depression in two or more precordial (V1-V6) leads were included in this group. RESULTS: In precordial ST segment depression in acute inferior myocardial infarction patients had higher plasma peak mean CK levels (1945+/-1419 vs 3547+/-2728 IU/L, p=0.027) and lower LV ejection fraction (62+/-10% vs 53+/-11%, p=0.008) and lower left ventricle global chordal shortening (0.89+/-0.71 vs -1.39+/-0.94, p=0.046) and inferior wall chordal shortening (-1.68+/-1.11 vs -2.43+/-0.74, p=0.014) and higher Killip class (1.3+/-0.8 vs 2.4+/-1.4, p=0.002) than without precordial ST segment depression patients. CONCLUSION: In conclusion acute inferior myocardial infarction with precordial ST depression patients had more extensive myocardial damage with global and inferior left ventricle severe wall motion dysfunction. Therefore, this suggests a worse prognosis in acute inferior myocardial infarction with precordial ST depression than without precordial ST depression patients. We need more aggressive diagnosis and treatment in this patients to prevent extending myocardial damage.
Coronary Angiography ; Depression* ; Diagnosis ; Electrocardiography ; Heart Ventricles ; Humans ; Inferior Wall Myocardial Infarction* ; Plasma ; Prognosis ; Retrospective Studies ; Thrombolytic Therapy

BACKGROUND: The results and restenosis after long stent implantation for diffuse long coronary lesion has not been fully evaluated. We evaluated immediate and follow-up results of single long coronary stenting for long coronary disease. METHODS: This study report on the use of follow-up examination is possible 48 patients with 50 lesions after stenting in total 70 patients with 72 lesions with long lesion. Diffuse long coronary lesion was defined as a lesion length longer than 20mm. Mean follow-up duration was 8.7+/-2.9 months and mean patients age was 58+/-10 years. Total patients was infused 8000-10000IU heparin and added bolus 3000-5000IU heparin for activating clotting time(ACT) was over 250 seconds during procedure. Restenosis was defined over 50% diameter stenosis in 6 months follow-up angiographic study. RESULTS: Angiographic success was achieved 68/70 patients(97.1%) in this study. Mean reference diameter was 3.14+/-0.1mm and baseline, final, follow-up minimal luminal diameter(MLD) was 0.6+/-0.4mm, 3.0+/-0.4mm, 1.6+/-0.3mm on each occasion and each % diameter stenosis(% DS) was 78.7+/-0.4%, 4.9+/-0.4%, 47.4%+/-0.5% present. The overall significantly increased in diabetics patients(7/21 vs 3/29 p=0.04) and in long lesion length patients(33.9+/-4mm vs 30.4+/-0.4mm p=0.02) but, clinical diagnosis and indication of stenting, lesional location, stent length, stent size, reference diameter size were not associated with restenosis rate. CONCLUSION: Single long stent implantation for diffuse long coronary lesion shown excellent success rate but high restenosis rate present. The restenosis rate was significantly associated with diabetics and lesion length Some further study for improving restenosis rate is needed.
Constriction, Pathologic ; Coronary Disease ; Diagnosis ; Follow-Up Studies* ; Heparin ; Humans ; Phenobarbital ; Stents*

BACKGROUND/AIMS: Hyperplastic polyps (HPs) are the most common cause of all benign epithelial gastric polyps, constituting 30 to 93%. Although gastric HPs are usually considered as benign lesions compared with adenoma, neoplastic transformation has been known to occur rarely. We aimed to identify the clinical factors of gastric HPs predicting for neoplastic transformation. METHODS: Between January 2002 to August 2010, a total of 274 gastric HPs, which had been removed by endoscopic polypectomy or surgical resection from 210 patients, were analyzed retrospectively. RESULTS: Neoplastic transformation was found in 15 cases (5.5%) of 274 HPs including 10 cases of low grade dysplasia (3.7%), 2 cases of high grade dysplasia (0.7%) and 3 cases of adenocarcinoma (1.1%). Neoplastic transformations were significantly associated with >1 cm in size (n=10 [66.7%] vs. n=91 [35.1%], p=0.024), with pedunculated shape (n=9 [60.0%] vs. n=62 [23.9%], p=0.002), with previous history of gastrectomy (n=3 [20.0%] vs. n=3 [1.2%], p=0.002) and with synchronous neoplastic lesions occurring elsewhere in the gastric mucosa (n=5 [33.3%] vs. n=31 [12.0%], p=0.021). However, no significant difference was found between HPs with and without neoplastic transformation in terms of age, sex, number of polyps detected per patient, location, macroscopic appearance such as erosion, hyperemia. CONCLUSIONS: Neoplastic transformation of gastric HPs had significant relationships with >1 cm in size, pedunculated shape, postgastectomy state, and synchronous neoplastic lesion. Therefore, endoscopic polypectomy should be considered in these HPs to avoid the risk of missing HPs with neoplastic potential.
Adenocarcinoma/*pathology/surgery ; Age Factors ; Aged ; Cell Transformation, Neoplastic ; Female ; Gastroscopy ; Humans ; Hyperplasia ; Male ; Middle Aged ; Polyps/*pathology/surgery ; Predictive Value of Tests ; Retrospective Studies ; Sex Factors ; Stomach Neoplasms/*pathology/surgery

Hiccup can be regarded as a failure of the usual alternating excitation-inhibition between glottis closure and inspiration. The coordinating center is located in the brain-stem reticular formation. A wide variety of pathological conditions can cause intractable hiccup: myocardial infarction, brain tumor, renal failure, prostate cancer, abdominal surgery, etc. Stroke is an unusual cause of intractable hiccup. Intractable hiccup is rare but disabling condition which can induce depression, weight loss, sleep deprivation, and even death. Etiological treatment is not always available and intractable hiccup treatment has classically relied on metoclopramide and chlorpromazine. We experienced a case of intractable hiccup induced by multiple cerebral infarct, and we present this rare case with the review of literature.
Brain Neoplasms ; Chlorpromazine ; Depression ; Glottis ; Hiccup* ; Metoclopramide ; Myocardial Infarction ; Prostatic Neoplasms ; Renal Insufficiency ; Reticular Formation ; Sleep Deprivation ; Stroke ; Weight Loss

PURPOSE: Living donor liver transplantation (LDLT) has several difficulties in biliary reconstruction of the small and thin bile duct, the short stump, and multiple openings. METHODS: 76 cases of LDLT performed in Asan Medical Center from Jan. 1999 to Feb. 2000 were reviewed retrospectively. RESULTS: The causative diseases in this group were hepatitis B associated cirrhosis 47, hepatoma 16, fulminent hepatic failure 6, secondary biliary cirrhosis 3, alcoholic cirrhosis 2, hepatitis C associated cirrhosis 1, and Wilson's disease 1cases. Right lobe graft was done in 54 cases, and a left lobe graft was done in 22. All bile duct reconstructions were done as Roux-en-Y hepaticojejunostomy, single anastomosis in 59, a double anastomosis in 15, and a triple anastomosis in 2cases. Biliary leakage occurred in 7 cases (10.4%), and percutaneous drainage subsequently being done. Post leakage bile duct stricture occurred in 2 cases (2.6%). Delayed bile duct stricture occurred in 3 cases. All stricture cases were treated with PTBD and repeated balloon dilatation. There was no difference between the right and left lobe graft in terms of bile leakage. However, stricture, occurred only in the right lobe graft. Bile duct stricture occurred more frequently in the multiple bile ducts (5% in single duct, 13.3% in double ducts, but there's no significance). CONCLUSION: The prevalence of biliary complication of LDLT was about 10%. In addition, there were more complicationsin the right lobe and multiple bile duct openings. Therefore, careful design and delicate hepatic parenchymal dissection is important to obtain a single duct and safe cut surface of the graft. To avoid severe complications such as an intrahepatic abscess or stone, early diagnosis and treatment of biliary complications is essential.
Abscess ; Bile ; Bile Ducts ; Carcinoma, Hepatocellular ; Chungcheongnam-do ; Constriction, Pathologic ; Dilatation ; Drainage ; Early Diagnosis ; Fibrosis ; Hepatitis B ; Hepatitis C ; Hepatolenticular Degeneration ; Humans ; Liver Cirrhosis, Alcoholic ; Liver Cirrhosis, Biliary ; Liver Failure ; Liver Transplantation ; Liver* ; Living Donors* ; Prevalence ; Retrospective Studies ; Transplants

The uterus is an unusual site for metastasis from an extrapelvic neoplasm. Metastasis of gastric cancer to the uterus is rare. We experienced a patient who underwent a gastrectomy and chemotherapy due to gastric cancer and who subsequently suffered a solitary metastatic adenocarcinoma of the uterus from the primary gastric cancer. Similar to Krukenberg tumors of the ovary, lymphatic dissemination is regarded as the route of metastasis from the stomach to the uterine. We report this case with a brief review of literature.
Adenocarcinoma* ; Drug Therapy ; Female ; Gastrectomy ; Humans ; Krukenberg Tumor ; Neoplasm Metastasis ; Ovary ; Stomach ; Stomach Neoplasms* ; Uterus*

The uterus is an unusual site for metastasis from an extrapelvic neoplasm. Metastasis of gastric cancer to the uterus is rare. We experienced a patient who underwent a gastrectomy and chemotherapy due to gastric cancer and who subsequently suffered a solitary metastatic adenocarcinoma of the uterus from the primary gastric cancer. Similar to Krukenberg tumors of the ovary, lymphatic dissemination is regarded as the route of metastasis from the stomach to the uterine. We report this case with a brief review of literature.
Adenocarcinoma* ; Drug Therapy ; Female ; Gastrectomy ; Humans ; Krukenberg Tumor ; Neoplasm Metastasis ; Ovary ; Stomach ; Stomach Neoplasms* ; Uterus*