Recently, it was revealed that Jong-Ha Kim was the first self-employed Korean physician in Daejeon city of South Korea during the Japanese colonial period. However, little is known about him. In this paper, the author aimed to search for historical records of his activities as the first Korean physician in Daejeon city.Current Concepts: Kim’s clinic in Daejeon city was called Chung-Ang Clinic. This is all that has ever been confirmed about Jong-Ha Kim. The author has been searching for his medical record for the last year. Kim’s medical records were collected from journal papers on the modern history of Korea, National Institute of Korean History database, Naver news library archive, official gazette of the Japanese government-general of Korea, database of Seoul National University alumni, and a resume of a professor at the Hamhung Medical School. The results are as follows. He was born in Shinchang-ri Hamheung city Hamgyeongnam-do on August 9, 1900. He graduated from the missionary school established by Canadian missionaries and was admitted to Kyungseong (Keijo) Medical School in 1918. It was recently discovered that he participated in the Independence movement on March 1, 1919. His picture, an old leaflet for his clinic which he had used, and his resume as a professor at the Hamhung Medical School were discovered for the first time.Discussion and Conclusion: The historical records of Jong-Ha Kim’s life provide insight into the lives of contemporary doctors in modern Korea. During the period of 1900 to 1950, which encompasses his historical records, significant events took place in Korean history, and he actively participated in these events. Despite facing numerous difficulties as a doctor in modern Korea, Jong-Ha Kim made decisions that had a great impact. He was a great doctor who served as a good role model.

The gut microbiota has an important role in the gut barrier, inflammation and metabolic functions. Studies have identified a close association between the intestinal barrier and metabolic diseases, including obesity and type 2 diabetes (T2D). Recently, Akkermansia muciniphila has been reported as a beneficial bacterium that reduces gut barrier disruption and insulin resistance. Here we evaluated the role of A. muciniphila-derived extracellular vesicles (AmEVs) in the regulation of gut permeability. We found that there are more AmEVs in the fecal samples of healthy controls compared with those of patients with T2D. In addition, AmEV administration enhanced tight junction function, reduced body weight gain and improved glucose tolerance in high-fat diet (HFD)-induced diabetic mice. To test the direct effect of AmEVs on human epithelial cells, cultured Caco-2 cells were treated with these vesicles. AmEVs decreased the gut permeability of lipopolysaccharide-treated Caco-2 cells, whereas Escherichia coli-derived EVs had no significant effect. Interestingly, the expression of occludin was increased by AmEV treatment. Overall, these results imply that AmEVs may act as a functional moiety for controlling gut permeability and that the regulation of intestinal barrier integrity can improve metabolic functions in HFD-fed mice.

Intracranial hypertension is a clinical syndrome of raised intracranial pressure with various etiologies. The possible pathogenic mechanisms of intracranial hypertension are excess CSF production, reduced CSF absorption and increased cerebral venous pressure. CSF glucose in intracranial hypertension is at usually normal levels and hypoglycorrhachia in intracranial hypertension has yet to be reported. We report a 23-year-old woman, who had intracranial hypertension with hypoglycorrhachia caused by a bilateral transverse sinus stenoses.
Absorption ; Constriction, Pathologic* ; Female ; Glucose ; Humans ; Intracranial Hypertension* ; Intracranial Pressure ; Venous Pressure ; Young Adult

PURPOSE: The increased detection of hypercalcemia during health screening has been increased the diagnosis of hyperparathyroidism. The surgical treatment of primary hyperparathyroidism has been changing from standard exploration for all 4 parathyroid glands to minimally invasive surgery focused to abnormal gland. For the latter, exact preoperative localization is necessary. The aims of this study were to evaluate clinical features of patients with primary hyperparathyroidism and the preoperative localization methods. METHODS: A retrospective study was performed for 61 patients with primary hyperparathyroidism in Samsung Medical Center. RESULTS: There were 19 males and 42 females whose ages ranged from 12 to 76 years. Among 61 patients with primary hyperparathyroidism, there were 51 adenomas, 7 hyperplasias and 3 adenocarcinomas. Preoperative parathyroid hormone (PTH) level was increased in all patients except in a MEN IIA associated patient. Among the methods for preoperative localization, ultrasonography detected 47 of 55 cases (85.5%), (99m)Tc-sestamibi scan 40 of 49 cases (81.6%), MRI 3 of 5 cases (60.0%), CT 9 of 18 cases (50.0%) and Tl-Tc subtraction scan 6 of 9 cases (66.7%). In 26 patients who have been diagnosed as single nodular lesion in the same area by the parathyroid scan and ultrasonography, we could find a single parathyroid adenoma in that area during exploration. Postoperative PTH level of all patients but one were normalized. CONCLUSION: Single gland disease detected by both parathyroid scan and ultrasonography was mostly due to adenoma which can be treated safely by unilateral exploration or minimally invasive surgery.
Adenocarcinoma ; Adenoma ; Diagnosis ; Female ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperparathyroidism, Primary* ; Hyperplasia ; Magnetic Resonance Imaging ; Male ; Mass Screening ; Minimally Invasive Surgical Procedures ; Multiple Endocrine Neoplasia Type 2a ; Parathyroid Glands ; Parathyroid Hormone ; Parathyroid Neoplasms ; Retrospective Studies ; Ultrasonography

PURPOSE: The authors analyzed the characteristics of papillary thyroid microcarcinomas less than 0.5 cm in diameter to investigate an optimal extent of surgical resection. METHODS: Between October 1994 and October 2003, out of 635 cases of papillary thyroid microcarcinomas, 229 cases less than 0.5 cm in diameter were reviewed retrospectively to analyze their clinical and pathological characteristics. RESULTS: Mean diameter of the carcinomas was 3.9±1.2 mm for carcinomas less than 0.5 cm in diameter (group 1) and 7.7±1.4 mm for carcinomas between 0.5 and 1.0 cm in diameter (group 2). Total thyroidectomy, subtotal thyroidectomy, lobectomy & isthmectomy in group 2 were carried out in 308 (75.9%), 72 (17.7%) and 26 (6.4%) cases. Follow by group 1 were carried out in 109 (47.6%), 84 (36.7%) and 36 (16.7%)cases respectively. Between the two groups, perithyroidal invasion was 29.3% and 49.0%, multifocality was 24.9% and 32.8%, bilaterality was 13.1% and 21.4%, lymph node metastasis was 10.1% and 18.3% respectively with each data showing statistical significance (P<0.05). Completion thyroidectomy was carried out in 14 cases, of which 8 cases revealed carcinomas in the residual thyroid lobe. The group 1 required completion thyroidectomy more than the group 2 (P=0.026). There were less cases of lymph node metastasis among the group 1. Nine out of the 36 cases (25%) of the group 1 which underwent lobectomy & isthmectomy needed completion thyroidectomy, among them 6 cases (66.7%) revealed papillary carcinoma in the residual thyroid lobe. CONCLUSION: Micropapillary cancer was discovered more frequently by increasing the use of ultrasonography. Multifocality, bilateraluty and perithyroidal invasion were observed higher in group 2 rather than group 1. However, the relation between these facts and prognosis will need long term follow up.
Carcinoma, Papillary ; Follow-Up Studies ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Ultrasonography

PURPOSE: Childhood acute immune thrombocytopenic purpura (ITP) is a benign hematologic disease. Therapy does not affect the natural history of the illness. We evaluated the clinical and laboratory findings, treatment and prognosis of childhood acute ITP in Korea through a retrospective multicenter study. METHODS: We analyzed retrospectively the data of 1, 829 children with acute ITP through survey of 33 hospitals among 43 hospitals in Korea from Sep. 1992 to Aug. 2001. RESULTS: Male to female ratio was 1.3: 1 and the median age at the diagnosis of ITP was 2.9 (0.1 17) years. Median duration of follow up was 6 months. One hundred and forty nine cases of the total 1, 829 patients (8.1%) received no treatment. The initial median platelet count of the non-treated group was 42, 500/mm3. Among the 861 cases who were followed up over 6 months, 315 cases (36.6%) progressed into chronic ITP. Associated with this high rate of chronicity of childhood acute ITP patients in Korea, we must consider the fact that acute ITP patients with fast improvement in the first episode tend not to follow up. Considering that fact, the rate of chronicity becomes 17.2% of the 1, 829 acute ITP patients. The treated group used many kinds of treatment methods. Intravenous immunoglobulins (IVIG) with or without prednisolone (PD) (67.5%) were the most commonly used regimens. In the group treated with IVIG alone, the platelet count began to rise above 50, 000/mm3 at 2.6 days, 100, 000/mm3 at 3.7 days and 150, 000/mm3 at 4.9 days. Four hundred and twenty two cases of the 1, 686 (25.0%) cases followed up after first episode of ITP relapsed. The relapse rate was significantly higher in older patients and in girls than in younger patients and in boys (P< 0.05). The chronicity of ITP statistically increased with age (P< 0.05) and that was the only valuable factor. CONCLUSION: Despite the fact that childhood acute ITP is a pretty common disaese, there is no agreement on the best treatment method for this disease. The establishment of Korean treatment guideline of childhood acute ITP, based on an analysis of multicenters, seems to be needed.
Child ; Diagnosis ; Female ; Follow-Up Studies ; Hematologic Diseases ; Humans ; Immunoglobulins, Intravenous ; Korea* ; Male ; Natural History ; Platelet Count ; Prednisolone ; Prognosis ; Purpura, Thrombocytopenic, Idiopathic* ; Recurrence ; Retrospective Studies

Perinatal transmission and infection of hepatitis B virus (HBV) in early childhood were observed in the offsprings of hepatitis B surface antigen (HBsAg)-positive mothers who had been vaccinated against HBV immediately after giving birth. This prophylaxis failure of perinatal HBV infection is likely due to the interplay of the virus and host immune response. To investigate whether the HLA polymorphism affected the outcome of the perinatal prophylaxis, HLA class I (HLA-A, B and Cw) and class II (HLA-DRB1, DQA1, DQB1 and DPB1) were typed using serology, PCR-SSOP (polymerase chain reaction-sequence specific oligonucleotide probe), and PCR-ARMS (amplification refractory modification system) methods in 22 HBeAg-positive mothers and their 10 prophylaxis-succeeded and 12 prophylaxis- failed children. The HLA types of the mothers and their children were compared with 198 HBsAg-negative healthy controls in a Korean population. HLA-B35 (relative risk=4.2, p<0.01), B51 (relative risk=3.2, p<0.02), DRB1*07 (relative risk=3.8, p<0.03), and DQA1*02 (relative risk=3.8, p<0.03) alleles were more frequent in HBeAg-positive mothers than in the controls. Also, HLA-DRB1*13 (relative risk=0.1, p<0.02) and DPB1*0401 (relative risk=0.1, p<0.02) alleles were less frequent in HBeAg-positive mothers. However, HLA alleles did not affect the outcome of the perinatal prophylaxis against HBV. These results suggest that the reported influences of some HLA alleles on the natural chronic HBV infections may not operate in the HBV infections in children received perinatal prophylaxis.
Alleles* ; Child ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; HLA-B35 Antigen ; Humans ; Mothers ; Parturition

Laboratory diagnosis of respiratory viral infection has traditionally been based upon virus isolation and/or viral antigen identification. Recently, more sensitive and specific nucleic acid detection methods by reverse transcription- polymerase chain reaction (RT-PCR) have been developed, however, conventional RT-PCR can identify only a single suspected virus. To identify the causative agents which belong to Paramyxoviridae of respiratory virus infections, we have developed a single-tube multiplex RT-PCR using four primer sets which can amplify respiratory syncytial virus and parainfluenza virus type 1, 2 and 3 simultaneously. Assay sensitivity of single-tube multiplex RT-PCR allowed a detection in the range of 3~500 TCID50 and there were no cross amplification among other respiratory viral agents based on the test using reference virus stocks. The single-tube multiplex RT-PCR was able to directly detect viruses in respiratory specimens, with virus being detected 11 of 80 samples as compared to 9 of 80 samples detected by indirect immunofluorescence or antigen detection following shell vial culture. This result suggests that the single-tube multiplex RT-PCR can be established as a more sensitive and rapid diagnostic application than shell vial assay for the detection of respiratory infection of Paramyxoviridae.
Clinical Laboratory Techniques ; Fluorescent Antibody Technique, Indirect ; Humans* ; Parainfluenza Virus 1, Human* ; Paramyxoviridae ; Paramyxoviridae Infections* ; Polymerase Chain Reaction* ; Respiratory Syncytial Virus, Human* ; Respiratory Syncytial Viruses ; Reverse Transcription*

BACKGROUND: The population is aging and life expectancy is increasing. It is important to evaluate the functional ability of elderly for optimal care for elderly. This study was conducted to assess functional disability of elderly and to find out the factors having an effect on the disability. METHODS: It surveyed 1,541 individuals aged 65 years and older in Cluing-Yang province. Six ADL categories (bathing, dressing, feeding, transferring, toileting, and walking) were assessed and related factors were analyzed. RESULTS: ADL was independent in 85.2% of elderly and dependent in 14.8% of elderly. 55.1% of dependent elders were living without family. Bathing was the most common disable AI)L category. The factors having an effect on the disability of ADL were brain disease, self-rated health status, dyspnea, constipation, heart disease, diabetic mellitus, and living status. CONCLUSION: In a rural area, special prevention programs for brain disease, heart disease, and diabetic mellitus and a rehabilitation health service may improve ADL status of elders.
Activities of Daily Living* ; Aged* ; Aging ; Bandages ; Baths ; Brain Diseases ; Constipation ; Dyspnea ; Health Services ; Heart Diseases ; Humans ; Life Expectancy ; Rehabilitation

Cyclosporin A is a cyclic polypeptide produced by the metabolism of fungi. It is widely used at present as immunosuppressive treatment following organ transplants. It is also used to deal with autoimmune diseases such as rheumatoid arthritis or type II diabetes. Gingival hyperplasia is one of the most frequent side-effects associated with the prescription of Cyclosporin A. The mechanisms involved in Cyclosporin A induced gingival hyperplasia are not yet clear. In vitro Cyclosporin A promotes proliferation of gingival fibroblasts, that Cyclosporin A act as a mitogen. Its action is based on mitosis of gingival fibroblasts regulated by cell cycle regulatory proteins. It was the purpose of the present study to examine the effects of Cyclosporin A on human gingival fibroblasts by means of biological and biochemical criteria. In this present study, we examined change of cell proliferation, cell activity, cell viability and cell cycle progression after application of Cyclosporin A. We also examined expression of cell cycle regulatory proteins by western blot analysis. Human gingival fibroblasts were cultured for 48 hours with application of Cyclosporin A at concentrations of 0.01, 0.1, 1, and 10 ng/ml. Cyclosporin A(1 ng/ml) significantly increased the cell activity of gingival fibroblast. Proliferation and viability of gingival fibroblasts were also increased in group treated with 1 ng/ml of Cyclosporin A compared to control group. In the cell cycle analysis, S phase was increased and G1 phase was decreased in the group treated with 1 ng/ml of Cyclosporin A. Cyclosporin A increased the expression of cdk4 and inhibited the expression of pRB and p21. These results suggest that 1 ng/ml of Cyclosporin A may increase the cell cycle progression of human gingival fibroblasts, and its mechanisms may increase the expression of cdk4 and decrease the expression of pRB and p21.
Arthritis, Rheumatoid ; Autoimmune Diseases ; Blotting, Western ; Cell Cycle Proteins ; Cell Cycle* ; Cell Proliferation ; Cell Survival ; Cyclosporine* ; Fibroblasts* ; Fungi ; G1 Phase ; Gingival Hyperplasia ; Humans* ; Metabolism ; Mitosis ; Prescriptions ; S Phase ; Transplants