BACKGROUND: Although the clinical importance of the immunological benefits of breastfeeding has been emphasized for decades, their direct relationship with acute pyelonephritis (APN) is still not clear. Our goal was to determine whether breastfeeding truly provides protection against APNs, while investigating the effects of other factors such as sex, age, mode of delivery, and birth weight on APN.METHODS: A total of 62 infants under 6 months of age who had both microbiologically and radiologically-confirmed APN were enrolled in the case group. Healthy infants (n = 178) who visited the hospital for scheduled vaccinations were enrolled in the control group. The following participant characteristics were compared between the case and control groups: age, sex, birth order among siblings, feeding methods, weight percentile by month, birth weight percentile by gestational age, gestational age at birth, and mode of delivery.RESULTS: Babies exclusively fed with manufactured infant formulae before 6 months of age had significantly higher risk for APN than breastfed or mixed-fed infants (odds ratio [OR], 3.4; 95% confidence interval [CI], 1.687–7.031; P = 0.001). Firstborn babies had lower risk for APN than 2nd- or 3rd-born babies (OR, 0.43; 95% CI, 0.210–0.919). Other factors that increased the risk for APN were low birth weight percentiles (OR, 8.33; 95% CI, 2.300–30.166) and birth via caesarean section (OR, 2.32; 95% CI, 1.097–4.887). There were more preterm births in the case group (10.9% vs. 1.7%; P = 0.002), but this did not increase the risk for APN (OR, 4.47; P = 0.063).CONCLUSION: Feeding exclusively with formula before 6 months of age was related to higher risk for APN, which demonstrates that breastfeeding has a protective effect against APN. The other risk factors for APN were birth order (≥ 2nd-born), low birth weight, and birth via caesarean section.
Birth Order ; Birth Weight ; Breast Feeding ; Cesarean Section ; Feeding Methods ; Female ; Gestational Age ; Humans ; Infant Formula ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Parturition ; Pregnancy ; Premature Birth ; Pyelonephritis ; Reproductive History ; Risk Factors ; Siblings ; Urinary Tract Infections ; Vaccination

No abstract available.
History, Modern 1601- ; Korea ; Smallpox ; Vaccination

This study discusses the historical significance of the Natural Cure Movement of Germany, centering on the Kneipp Cure, a form of hydrotherapy practiced by Father Sebastian Kneipp (1821-1897). The Kneipp Cure rested on five main tenets: hydrotherapy, exercise, nutrition, herbalism, and the balance of mind and body. This study illuminates the reception of the Kneipp Cure in the context of the trilateral relationship among the Kneipp Cure, the Natural Cure Movement in general, and modern medicine. The Natural Cure Movement was ideologically based on naturalism, criticizing industrialization and urbanization. There existed various theories and methods in it, yet they shared holism and vitalism as common factors. The Natural Cure Movement of Germany began in the early 19th century. During the late 19th century and the early 20th century, it became merged in the Lebensreformbewegung (life reform movement) which campaigned for temperance, anti-tobacco, and anti-vaccination. The core of the Natural Cure Movement was to advocate the world view that nature should be respected and to recognize the natural healing powers of sunlight, air, water, etc. Among varied natural therapies, hydrotherapy spread out through the activities of some medical doctors and amateur healers such as Johann Siegmund Hahn and Vincenz Prieβnitz. Later, the supporters of hydrotherapy gathered together under the German Society of Naturopathy. Sebastian Kneipp, one of the forefathers of hydrotherapy, is distinguished from other proponents of natural therapies in two aspects. First, he did not refuse to employ vaccination and medication. Second, he sought to be recognized by the medical world through cooperating with medical doctors who supported his treatment. As a result, the Kneipp cure was able to be gradually accepted into the medical world despite the “quackery” controversy between modern medicine and the Natural Cure Movement. Nowadays, the name of Sebastian Kneipp remains deeply engraved on the memories of German people through various Kneipp spa products, as well as his books such as My Water Cure and Thus Shalt Thou Live! Wörishofen, where Kneipp had served as catholic priest as well as hydrotherapist for 42 years from 1855, changed its name to “Bad Wörishofen” (“Wörishofen Spa” in German). The Kneipp Cure and the Natural Cure Movement became a source of ecologica l thought which is currently gaining more and more sympathy from German people. It is regarded as a lieu de mémoire (site of memory) reflecting the collective identity of German people.
Clergy ; Fathers ; Germany* ; Herbal Medicine ; History, Modern 1601-* ; Humans ; Hydrotherapy ; Naturopathy ; Quackery ; Sunlight ; Temperance ; Urbanization ; Vaccination ; Vitalism ; Water

Pancreatic cancer is still one of the most devastating cancers with less than 5% of 5-year survival even though the advances in modern medicine. Considering effective screening strategies and vaccinations has been improving clinical outcomes in other gastrointestinal malignancies, there is not yet effective tools for pancreatic cancer in earlier stage. Thus, about 80% of patients of pancreatic cancer are diagnosed as unsuitable for curative resection. Furthermore, recent experimental data suggest metastasis of pancreatic cancer can be developed in remarkably earlier stage during carcinogenesis. Based on these findings, systemic chemotherapy is the main therapeutic option for treating pancreatic cancer. However, the outcome of systemic chemotherapy is still disappointing even though recent data with FOLFIRINOX and nab-paclitaxel showed relatively promising. With advances in molecular technologies including next generation sequencing, the therapeutic paradigm for handling malignancies has been rapidly changing. The new wave of tailored or precision medicine leads to develop several novel therapeutic options like immune check point inhibitor or novel adoptive cell therapy. Herein, we will discuss the current status and perspectives of targeted therapy for pancreatic cancer.
Carcinogenesis ; Cell- and Tissue-Based Therapy ; Drug Therapy ; History, Modern 1601- ; Humans ; Mass Screening ; Neoplasm Metastasis ; Pancreatic Neoplasms* ; Precision Medicine ; Vaccination

Pancreatic cancer is still one of the most devastating cancers with less than 5% of 5-year survival even though the advances in modern medicine. Considering effective screening strategies and vaccinations has been improving clinical outcomes in other gastrointestinal malignancies, there is not yet effective tools for pancreatic cancer in earlier stage. Thus, about 80% of patients of pancreatic cancer are diagnosed as unsuitable for curative resection. Furthermore, recent experimental data suggest metastasis of pancreatic cancer can be developed in remarkably earlier stage during carcinogenesis. Based on these findings, systemic chemotherapy is the main therapeutic option for treating pancreatic cancer. However, the outcome of systemic chemotherapy is still disappointing even though recent data with FOLFIRINOX and nab-paclitaxel showed relatively promising. With advances in molecular technologies including next generation sequencing, the therapeutic paradigm for handling malignancies has been rapidly changing. The new wave of tailored or precision medicine leads to develop several novel therapeutic options like immune check point inhibitor or novel adoptive cell therapy. Herein, we will discuss the current status and perspectives of targeted therapy for pancreatic cancer.
Carcinogenesis ; Cell- and Tissue-Based Therapy ; Drug Therapy ; History, Modern 1601- ; Humans ; Mass Screening ; Neoplasm Metastasis ; Pancreatic Neoplasms* ; Precision Medicine ; Vaccination

Vaccination is regarded as one of the biggest triumphs in the history of medicine. We are living in the most successful period of vaccine development. The accumulation of multidisciplinary knowledge and the investment of massive funding have enabled the development of vaccines against many infectious diseases as well as other diseases including malignant tumors. The paradigm of clinical vaccine evaluation and licensure has also been modernized based on scientific improvements and historical experience. However, there remain a number of hurdles to overcome. Continuous efforts are focused on increasing the efficacy and reducing the risks related to vaccine use. Cutting-edge knowledge about immunology and microbiology is being rapidly translated to vaccine development. Thus, physicians and others involved in the clinical development of vaccines should have sufficient understanding of the recent developmental trends in vaccination and the diseases of interest.
Allergy and Immunology ; Communicable Diseases ; Financial Management ; History of Medicine ; Investments ; Licensure ; Vaccination ; Vaccines

BACKGROUND/AIMS: There is an increased risk for inflammatory bowel disease (IBD) patients to develop infections due to the use of immunomodulators and biologics. Several infections are preventable by immunizations. This study investigated the knowledge and awareness of Korean gastroenterologists regarding the vaccination of patients with IBD. METHODS: A self-reported questionnaire was sent by e-mail to the faculty members of tertiary hospitals. Gastroenterologists were asked ten questions regarding the immunization of patients with IBD. A total of 56 gastroenterologists completed the questionnaire. RESULTS: A majority of gastroenterologists (>60%) had rarely or never recorded an immunization history from their patients with IBD. Moreover, 50% to 70% of the gastroenterologists did not know that live vaccines should be avoided in immunosuppressed patients. The most commonly mentioned resistance to vaccinations was "the lack of concern and knowledge regarding vaccination." Gastroenterologists more frequently asked about the immunization history of influenza, pneumococcal, hepatitis A, and hepatitis B vaccines and recommended these vaccines more often than others. CONCLUSIONS: Korean gastroenterologists' awareness and knowledge regarding the vaccination of patients with IBD were very poor. Intensive educational programs on immunization guidelines directed toward gastroenterologists who care for patients with IBD are required to ensure that these patients receive the necessary vaccinations.
Clinical Competence/*standards ; Female ; Gastroenterology/*standards ; Health Knowledge, Attitudes, Practice ; Humans ; Immunocompetence/physiology ; Immunocompromised Host/physiology ; Inflammatory Bowel Diseases/*complications ; Male ; Medical History Taking/standards ; Questionnaires ; Republic of Korea ; Vaccination/*standards

Free medical care is currently a highly debated issue in Korea. However, from a practical point of view, 'completely free' medical care is impossible. Last year the National Health Insurance Corporation (NHIC) reported a huge deficit of up to 1.3 trillion in Korean won, which is the largest deficit in the past 10 years. NHIC expenditures are skyrocketing for many reasons: drug overuse, very expensive new drugs or devices increasing geriatric population and survivors of cancer or chronic illnesses, expanding insurance coverage for new diagnostic tests, drugs, neonates, rare diseases, disabilities, and cancer, occurrence of new diseases, increasing number of doctors, moral hazard, and wasting of resources due to the duplication and counteraction between modern medicine and Oriental medicine. What, then, should we do to provide partially free medical care? We need to reduce expenditures for drugs and increase health insurance premiums. Korean health insurance premium currently low compared to that of other countries in Organization for Economic Co-operation and Development. It is also necessary to introduce the concept of a health tax, in which healthy individuals with a high income pay higher premiums while sick or low-income individuals pay lower premiums. Expanding public health coverage such as vaccinations, regular health surveillance programs, and education on health promotion should be implemented. Private health care insurance can be introduced carefully with close monitoring. The last and most important recommendation is that society must become more ethical and transparent. Korea is entering a new era as a developed country and as a result a welfare system, including medical care is notoptional but is mandatory in some part. However, even a partially free medical care is going to be possible only if the entire health care system is operated in an ethical and efficient way for maximal utilization of limited resources while avoiding moral hazard and waste.
Chronic Disease ; Delivery of Health Care ; Developed Countries ; Diagnostic Tests, Routine ; Health Expenditures ; Health Promotion ; History, Modern 1601- ; Humans ; Infant, Newborn ; Insurance ; Insurance Coverage ; Insurance, Health ; Korea ; Medicine, East Asian Traditional ; National Health Programs ; Public Health ; Rare Diseases ; Survivors ; Taxes ; Vaccination

The article "Pandemic influenza in Korea with special references to its etiology," published in JAMA in April, 1919 by Dr. Frank William Schofield, is a valuable material reflecting the influenza pandemic situation in 1918 in Korea. It contains the case reports of influenza infected patients and the results of the bacteriological experiments. Dr. Schofield worked as a bacteriology professor in Severance Union Medical College in Seoul from 1916 to 1920. His academic activities are lesser-known than the role of contributor of Korean independent movement. However, he was a remarkable veterinarian and scientist. According to Dr. Schofield, the number of Influenza infected population in Korea in 1918 was supposed to be 4,000,000 to 8,000,000, which corresponds with other resources(6.7 per 1,000 in Gangwon province). Considering the cases which were not registered as influenza infection by misdiagnosis of pneumonia complication the sum should be higher. However, the estimated crude influenza death rate from the reports by the Japanese colonial government was only 2.38(per 1,000). Dr. Schofield and his colleague tried to culture "Pfeiffer Bacillus" from the sputum and blood specimens of patients showing typical influenza symptoms. The bacterium was mistakenly considered as the influenza agent till the virological nature of influenza was discovered in the 1930s. From the results of his study he seemed to agree that "filterable virus" was the influenza agent and the secondary infection of the bacillus caused respiratory symptoms. He also reported on the influenza vaccination during the epidemics. Dr. Schofield's article confirms that the damage caused by the influenza outbreak in Korea was as great as in other Asian countries or even worse. It also gives information about the researches and education on the etiology and vaccination of influenza based on the germ theory in the medical colleges in Korea, which adopted the western medical educational system in the early 20th century.
Disease Outbreaks/*history ; History, 20th Century ; Humans ; Influenza Vaccines/history ; Influenza, Human/epidemiology/*history/mortality ; Korea/epidemiology ; Vaccination/history

Human Papilloma Virus (HPV) infection is most important in the carcinogenesis of the cervical cancer. More than 100 types of HPV have been identified, among which 15 subtypes were revealed to be related with cervical cancers. Ninety percent of these high-risk HPV infections are removed naturally within 1-2 years, however, women with persistent infection have more than 100 times higher risk of developing cervical intraepithelial neoplasia, the precursor of cervical cancers. In high-risk HPV infection, the integration of viral DNA into host DNA results in the overexpression of E6 and E7 genes. The E6, E7 oncoproteins interfere with the function of tumor suppressor genes, p53 and pRb resulting in the abnormal cell proliferation. In order to diagnose HPV infections, Hybrid Capture IITM (Microplate System, Digene, USA) with FDA approval is most widely used, and the DNA chip method developed in Korea is expected to be useful for identification of subtypes in the future. HPV vaccines have been developed for the prevention of HPV infection. Recently, the quadrivalent HPV 6, 11 16, 18 vaccine of Merk and the bivalent HPV 16, 18 vaccine of GSK, are shown to be effective to prevent persistent HPV infection and cytologic abnormality. In order to improve the efficacy of HPV vaccines, it is necessary to set up national recommendations, regarding vaccine groups, the age of vaccination, tests before and after vaccination and the need for catch-up vaccine.
Carcinogenesis* ; Cell Proliferation ; Cervical Intraepithelial Neoplasia ; DNA ; DNA, Viral ; Female ; Genes, Tumor Suppressor ; Human papillomavirus 16 ; Human papillomavirus 6 ; Humans ; Korea ; Natural History* ; Oligonucleotide Array Sequence Analysis ; Oncogene Proteins ; Papilloma ; Papillomavirus Vaccines ; Uterine Cervical Neoplasms* ; Vaccination