A Great Teacher of Neurosurgery in Korea: Hun Jae Lee (1921-1983)

No abstract available.

Analysis of Biliary Stricture after ABO Incompatible Adult Living Donor Liver Transplantation / 대한이식학회지

BACKGROUND: Despite recent improvements in survival outcome after ABO incompatible (ABOi) adult living donor liver transplantation (ALDLT), concerns about the incidence of biliary stricture (BS) still exist. However, reports on the actual incidence of BS have been scarce. METHODS: From November 2008 to August 2011, 77 cases of ABOi ALDLTs have been performed. We compared patient and graft survival and BS-free survival rates (BSFSR) between these ABOi ALDLTs and 734 ABO compatible (ABOc) ALDLTs performed during the same period. We also analyzed characteristics of BS in ABOi ALDLT. RESULTS: There was one mortality (1.3%) and one re-transplantation (due to small-for-size graft syndrome) among 77 cases of ABOi ALDLTs. Overall, 1-, 2-, and 3-year patient survival rates were 94.8%, comparable to ABOc ALDLTs (93.7%, 90.1%, 90.1%, P=0.20). BS occurred in 11 (13.8%) ABOi ALDLT patients. There were no significant differences in 1-, 2-, and 3-year BSFSR between ABOi and ABOc ALDLT patients (87.5% vs. 88.1%, 83.4% vs. 87.5%, and 83.4% vs. 86.4%, P=0.55). Among 10 patients with BS, four patients showed diffuse multiple intrahepatic strictures, which were linked to the death of two patients. CONCLUSIONS: The survival outcome of ABOi ALDLT is comparable to ABOc ALDLT. The incidence of BS of ABOi ALDLT was not superior to that of ABOc ALDLT. However, ABO incompatibility is related to the development of diffuse multiple intrahepatic BSs (rarely seen in ABOc ALDLT) and can cause graft failure and patient death.

Hong Seok-hoo's Translation of "New Edition of Physiology Textbook"(1906) and its Meanings / 의사학

Hong Seok-hoo, who took charge of Jejungwon, was successful in translating Jiro Tsuboi's book titled "Sinpyeonsaengnigyogwaseo (1897)" and publishing it with a title of "New Edition of Physiology Textbook" in 1906. Jiro Tsuboi, the original author of that book, was a doctor having majored in Hygienics in Germany and was also known to have done pioneering work in Hygienics and Occupational and Environmental Medicine in Japan. At that time, he wrote that book for the purpose of teaching his students at Ordinary Middle School and Normal School. Therefore, it was not intended as a Physiology textbook for medical students, but an introductory book explaining Physiology with a wide range of subjects including hygienic matters in a broader sense. Hong Seok-hoo made an almost complete translation of the "New Edition of Physiology Textbook." While editing the book, however, he changed some of the most Japanese-style contents to meet the Korean conditions then, and made up for some insufficient contents with reference to the original author's other books. Although it was not included in an original version of that book, he also compiled a physiology dictionary in order to help Korean readers acquire medical terms in a more systematic way. Just like other textbooks of Jejungwon, the "New Edition of Physiology Textbook" was also put into Korean only. Hong Seok-hoo accepted Japanese-style medical terms, but also changed some of them or coined new words, considering the Korean circumstances then. He seemed to do so in an effort to introduce Western medicine in a more independent way while overcoming his limitations of translation. In particular, this book criticized that a long-term use of cosmetics might cause a serious lead poisoning from a Christian viewpoint, saying that a God-created human body should be kept intact as it is. In addition, in the course of reediting premodern books, the term "Lord" was changed into "God," which is considered a kind of fusion between traditional values and missionary medicine. While translating books, Jejungwon could put such fusion into practice because it was a hospital established under the banner of the propagation of Christianity. Besides the "New Edition of Physiology Textbook," at least five physiology textbooks were also translated into Korean in the last years of Daehan Empire for the purpose of teaching students modern subjects like Physiology, Health and Hygienics in educational institutions including Boseong School, Hwimun School and Soongsil School. On the other hand, the "New Edition of Physiology Textbook" was first translated at the end of Daehan Empire in order to foster more professional doctors in medical schools compared to those schools. In this respect, by translating the "New Edition of Physiology Textbook," Jejungwon can be considered as playing a pioneering role in translating Physiology textbooks in the late Daehan Empire.

Life and Activities of Chu Hyun Chik / 의사학

Chu Hyun Chik was one of those who graduated first from Jejungwon Medical School in 1908, and had carried on an independence movement as well as religious, educational, and social movement both as a doctor and a Christian. He opened the Inje Hospital in Sunchon, North Pyeongan Province in 1909, and was put in prison on charges of being involved in Incident of '105 People' as he joined in Sinminhoe in which christians(Christians) from Gwanseo showed their initiative. With 3.1 Movement as a momentum, he started to raise funds for an independence movement mainly in North Pyongan Province, as a councilor of the Ministry of Finance of Shanghai Provisional Government of Korea. After he moved into Andong, Manchuria, he continued to support the spread of an independence movement by connecting Shanghai Provisional Government of Korea with the country. In October, 1919, he came to Sanghai as an exile and lead diverse activities as a member of Shin Han young man party and one of the leading men of Korean Christendom, especially related to An Chang Ho and christians around him and joining in Hungsadan. In 1925 when he returned home, he opened the Dongje Hospital and devoted himself to the developments of religious, educational, and social movement as a president of YMCA, Sunchon and an executive of a branch of Suyang Donguhoe in Sunch'?n. By Incident of Suyang Donguhoe he was put in prison, resisting Japanese Imperialism and died in 1942.

Life and Medical Activities of Yun Ti Wang / 의사학

Yun Ti Wang studied medicine in England, different from other Korean medical doctors in early days. Yun, who entered medical school at Glasgow University in England in March 1919, graduated with a Bachelor of Medicine in October 1925, along with an England medical license. Yun began working as an instructor at Severance Medical College from November 1927, and received Doctor of Medicine from the College of Obstetricians and Gynecologists at Kyoto Imperial University in August 1936. After the Liberation, Yun began working as a faculty member at the medical school at Seoul University, and he also worked as a Chief of the Second Medical Clinic of the school from 1946. Yun made a great effort in order to build an integrated committee, eventually contributing to the launching of Joseon Medical Associates in 1947. He was also elected as a first president at Joseon Obstetrics and Gynecology Associates, which was organized at the same year as the Joseon Medical Associates. Yun entered military as an army surgeon in April 1949 and has worked there until he was appointed as a principal at the Army Medical School in September 1953. His contributions to the development of military medical services include the following: expansion of medical facilities in army, stable system of workforce in military medical service, launching of Medical Aid and establishment of Department of Medical Care, and introduction of new medical technologies in anesthesiology and neurosurgery, etc. The career of Yun can be largely divided into the field of gynecology and military medical services. In the gynecological field, Yun contributed to the settlement of obstetrics in Korea, by taking in charge of the obstetrics class at Severance following medical missionaries. As for the military medical services, he has contributed to the establishment of military medical system as well as to the opening of new academic areas. The impact of his activities on the establishment of military medical services is especially significant, since it was a field that no Korean citizens had access to during the colonization era.

Membrane transducing activity of recombinant Hoxc8 protein and its possible application as a gene delivery vector

In order to examine whether the Hoxc8 protein can deliver nucleic acid into mammalian cells, we designed several Hoxc8-derived recombinant proteins to be synthesized as glutathione S-transferase (GST) fused forms in E.coli (GST-Hoxc8(1-242), containing a full length of Hoxc8; GST-Hoxc8(152-242), possessing a deletion of the acidic N-terminus of Hoxc8; GST-Hoxc8(149-208), which contained the homeodomain only). After labeling these proteins with Oregon 488, we examined their membrane transduction ability under the fluorescence microscope and verified that all three proteins showed similar transduction efficiency. The ability of the proteins to form in vitro protein-DNA complexes was analyzed on agarose gel; both GST-Hoxc8(1-242) and GST- Hoxc8(149-208) formed complexes. In contrast, the GST- Hoxc8(152-242) protein did not form a complex. The GST-Hoxc8(149-208) protein formed a complex with DNA at a mass ratio of 1 1 (DNA protein), and GST- Hoxc8(1-242) formed a complex at a mass ratio of 1 5. When the DNA (pDsRed1-C1) and protein complexes were added to culture media containing mammalian cells, the cells uptook the complexes, which was indicated by red fluorescence expression under the fluorescent microscope. These results indicate that recombinant Hoxc8 derivatives that harbor a homeodomain are able to traverse the mammalian cellular membrane. DNA that is bound to the recombinant derivatives can be carried across the membrane as well. This process could be applied in the development of a useful delivery vector for gene therapy in the future.

Effect of Retinoic Acid on Palate Formation during Rat Embryogenesis / 대한해부학회지

In order to understand the effect of retinoic acid (RA) on the craniofacial pattern formation during embryogenesis, we injected RA intraperitoneally into the pregnant female rat on day 11 post coitum (p.c.) and then embryos of day 13 to day 17 p.c. were isolated consequently. The overall morphology and the differential gene expression patterns were analyzed by the microscopic and (DD) RT-PCR methods, respectively. For the morphological study, the retardation of craniofacial region, the shortage of crown rump length and limbs were analyzed in the RA-treated embryos. In the RA-treated embryos of day 17, it was observed that the palatogenesis was completely finished just like in the normal embryos. However, the cleft plate was observed in 36 out of 52 total samples with the distance of cleft palate being 0.80+/-0.36 mm in average. The temporal expression pattern of Hox genes through RT-PCR revealed that the expression of Hoxa7 reached its peak on day 13 then slowly declined in the normal embryos. Whereas in the RA-treated embryos, the expression peak was observed on day 15, then declined subsequently. With the Hoxc8 gene, its expression was low in all stages until the day 16 of normal embryogenesis. On the other hand, Hoxc8 gene expression was detected slightly early on day 15 in the RA-treated embryos. In the study of Bcl-2 family genes, uniformly strong expression of anti-apoptotic and pro-apoptotic genes was observed from day 13 to day 17 of normal embryos, whereas anti-apoptotic gene expressions were decreased after day 16 in the RAtreated embryos. Additionally, a dramatic decline of pro-apoptotic gene expression was observed from day 13 to day 15 of the RA-treated embryos. Therefore, we believe that RA is a potential factor that is actively involved in the cleft palate formation. Moreover, it is profoundly linked with the regulation of Hox and Bcl-2 family gene expression pattern that leads to the embryonic malformation.

The First Textbook of Anatomy in Korea / 대한해부학회지

The first hospital to practice western medicine in Korea, Chejungwon, was opened on April 10, 1885. Then on March 29, 1886, Chejungwon Medical School, Korea's first school to teach western medicine, opened. While anatomy was taught at that time by missionary doctors, there was no Korean translation of an Anatomy textbook. Therefore, Dr. O.R. Avison, who reopened and took charge of Chejungwon Medical School on November 1, 1893, began translating the popular "Gray's Anatomy" with the aid of Korean assistants. Although the text was translated twice, it was not published due one of the manuscripts having gone missing and the other having been lost in a fire. It wasn't until 1906 when the first "Textbook of Anatomy" was translated and published in 3 volumes by Dr. Avison and Mr. Pil Soon Kim (the first graduate of Chejungwon Medical School in 1908). This translation was not based on Gray's Anatomy, but rather on Imada Tsukane's "Practical Anatomy", which had been written in Japanese. During a previous translation, Dr. Avison and Mr. Kim referred to many Chinese and Japanese textbooks, especially for choosing the proper medical terms expressed in Chinese characters. With a basic understanding of how medical terms were expressed in Chinese characters, they decided to translate Imada's textbook. The translation was completed within several months. When comparing the translated textbook with Imada's original one, several pictures were deleted or replaced with others by the translators. Also, much of the narrative was reinforced in detail and new subtitles were used throughout the text. By modifying its contents, they evidently wanted to make this new translation more complete than Imada's original. The text was republished in 1909, but could not be maintained or updated in successive editions due to the Japanese annexation of Korea in 1910.

Suh Yang Park, who Became a Doctor as a Son of a Butcher / 의사학

Dr. Suh Yang Park was born in 1885 as a son of a butcher, which was the lowest class at that time in Korea. However, contact with western missionaries, including Dr. O. R. Avison, provided him with an understanding of western civilization. After entering Chejungwon Medical School in 1900, Dr. Park learned basic sciences, basic medical sciences like anatomy and physiology, and other Western medical specialties such as internal medicine and surgery. He graduated from medical school in 1908 and received Government Certificate from Home Office, the first in Korea in this field, which granted the right to practice medicine. His certificate number was 4th overall. As both a doctor and a talented musician, Dr. Park actively participated in the social enlightenment movement. He was quite progressive in his time, having surpassed the social limitations as a son of a butcher, as well as actively propagating his knowledge of Western civilization onto others. After graduation, he had served as a professor at the school he graduated from, until he went into exile in Manchuria in 1917 due to the annexation of Korea by Japan in 1910. There, he opened a hospital and provided medical treatment for Koreans. He also established a school for young Koreans, inspiring them with a sense of nationalism. Also, Dr. Park was an active member of various Independence Movement Organizations in Manchuria. Then in 1932, at the time when Japan took control of Manchuria, his school was closed down. As a result, Dr. Park couldn't help but stop his anti-Japanese activities. In 1936, he returned to his homeland and passed away in 1940, just five years before the liberation of Korea from Japanese occupation.

Early Development of the Nose in Human Embryo: A Stereomicroscopic and Histologic Analysis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: We aimed to analyze the morphologic features of the nose in the human embryo from 4th to 8th developmental weeks according to the Carnegie stage. MATERIALS AND METHOD: A total of 27 cases of embryos, ranging from Carnegie stage of 13 to 23, were analyzed. The external morphology was observed with a stereomicroscope, photographed and analyzed. The histologic features were observed with a light microscope in the horizontally-transected specimens stained with hematoxylin-eosin staining. RESULTS: The nasal placode was observed at the stage 13, and it became flat or even concave at the stage 14. At the stage 15, the nasal pit was formed. At the stage 16, the nasal sac and nasal fin were observed. At the stage 17, the oronasal membrane was formed by thinning of the nasal fin. At the stage 18, the primitive choana was established by rupture of the oronasal membrane. At the stage 19, the lateral palatine process projected vertically below the level of the tongue. The cartilaginous nasal capsule was formed at the stage 20. At the stage 21, the olfactory area was localized to the upper portion of the lateral nasal wall and the nasal septum. At the stage 22, the lateral palatine process developed in a somewhat horizontal orientation. At the stage 23, the premaxilla and primitive choana were formed. CONCLUSION: The development of the nose is most active from the Carnegie stage of 13 to 19, which corresponds to the end of the 4th embryonic week to the end of the 7th week. Thus, this period is considered to be the most important period in human nasal embryonic development.

Cloning of TLR3 Isoform

Toll-like receptor (TLR) 3 is a member of the TLR family that confers innate immunity by recognizing viral pathogens. Herein, we report that the TLR3 isoform is expressed on human primary cells and cell lines. This isoform has 2, 520 bp cDNAs compared to the 2, 712 bp of full cDNA, is produced by deletion of an intron-like sequence within exon 4 and is co-expressed with wild type TLR3 in primary human astrocytes and glioblastoma cell lines. This finding suggests the TLR3 isoform in astrocytes may have a different immunological role for binding ligands during the immune response in brain.

A History of Medical License in Korea / 의사학

Medical license is to qualify a person for medical practice and to attribute him/her a privileged right in the practice. This privileged and exclusive right asks for protection from the side of a state and the state in turn needs qualified medical personnel in order to carry out her task of public health, one of the main duties of modern states. In Europe, physicians succeeded in obtaining medical license that guarantees the privileged right in a highly competitive medical market against other practitioners. The first regulation for medical license in Korea was made in 1900 when few Korean doctors trained in Western medicine was in practice. The regulation aimed at controlling traditional medical practitioners who had been practicing medicine without any qualification as a physician. The regulation was very brief, consisting of only seven articles. A newly revised regulation appeared in 1913 when Korea was under the occupation of Japan. The Japanese Government-General enacted a series of regulations about medical personnel, including dentists and traditional medical practitioners. This heralds its full-scale engagement in medical affaires in Korea. Unlike the case of European countries where medical license was obtained after a long struggle with other practitioners, in Korea, medical license was given to doctors too easily from the state. And this experience played a very important role in the formation of identity of Korean doctors.

Development of Model System for Radiation Induced Congenital Malformations by Whole Embryo Culture / 체질인류학회지

It is known that radiation can induce various kind of mutations, cancers and congenital malformations. Day 9 rats embryos were cultured by whole embryo culture method and irradiated 0.1, 0.5, 2 and 5 Gy at day 10 to study the effect of radiation on the development of rat embryos. Haversting after 48 hours culture, the morphological changes and apoptosis were investigated. In addition, we assessed the expression patterns of p53, WAF1, Bcl -2, Bcl -x and Bax. Compared to the control group, no remarkable morphological changes were observed in the low dosage group (0.1 and 0.5 Gy). But at high dosage group (2 and 5 Gy), growth was retarded and the heart beats were weak. The crown rump length, the number of somites, and branchial arch were decreased and the rotation of embryo and development of otic pit and lens pit, and upper limb bud was delayed significantly. Especially in the 5 Gy group the most of external morphology were difficult to discriminate. In histological observations, high dosage group showed marked increase in the number of apoptotic bodies in the optic cup, trigeminal ganglion, pharyngeal arches, heart and small intestine. In western blot analysis, Bcl -x and Bax were not expressed in all groups. Expression level of Bcl -2 was constant regardless of the amount of radiation. Expression level of p53 and WAF1 increased significantly in accordance with the increasing amount of radiation. Especially, WAF1 was expressed 7.2, 6.3, 9.9 and 11.3 folds more than the control groups when embryos were exposed to 0.1, 0.5, 2 and 5 Gy, respectively. Considering WAF1 arrests cell cycle, we concluded that cell cycle was affected most sensitively to radiation injury. From these results, radiation showed growth retardation, decrease in protein synthesis, increase in apoptosis and expression of related genetic materials. These results may be used as a standard to test the effect of drugs for reducing and protecting agents against deterious effect of radiation in developing embryo and fetus.

A Study on the Early Development of the Hip Joint in Staged Human Embryos and Fetuses in Korean / 체질인류학회지

The author has studied 33 cases of Korean embryos of Carnegie stage 11 ~23 and 18 cases of fetuses to demonstrate the development of the hip joint. The external feature of the lower extremity was observed by stereoscope and digital camera, and the internal structures were studied by light microscopic observation. The results obtained were as follows: In stage 13 lowerlimb buds were appeared. In stage 17 mesenchymal condensation for femur and hip bone, and one -layered interzone were observed. In stage 18 cartilage models for ilium and ischium were visible. In stage 22 three -layered interzone between the head of femur and hip bone was formed. In stage 23 acetabular labrum and distinct three -layered interzone was visible. In the 9th weeks mesenchymal ligamentum capitis femoris and transverse acetabular ligament are appeared, and acetabular labrum was reacted tracely to trichrome stain. In the 10th week the joint space was formed between the femoral head and hip bone, and shallow depression in acetabulum is found. In the 12th week the articular capsule was directed lateral to acetabular labrum, and numerous blood vessels were found in acetabular fossa and ligamentum capitis femoris, and cartilage canal were developed in femoral neck. In the 14th week cartilage canal was found in middle of femoral head, and synovial fold were developed, and ligamentum capitis femoris was shown strongly positive reaction. In the 16th week cartilage canals were more found, and numerous blood vessels were observed in fovea capitis. In the 18nd week the neck of femur was narrow, and femoral head was lied deeply in acetabulum with acetabular labrum. Consequently the lower extremity of Korean embryos and fetuses was first appeared in stage 13, and hip joint development was started at stage 17. The articular cavity was first formed at the 9th week of development, the acetabulum labrum was developed at stage 23. The mesenchymal ligamentum capitis femoris was appeared at the 9th week. At the same time the transverse acetabular ligament fully encircled the femoral head. The articular capsule has lined the articular cavity at the 12th week, and synovium was formed at the 14th week of development. At the 18th week the hip joint has attained its final shape.

Social status and role of students entering Jejoongwon: focus on Kyum-Rae Lee / 의사학

This study considers the social class and social role of the entering students of Jejoongwon at that time in light of its very first medical graduate, Kyum-Rae Lee. Foremost, Kyum-Rae Lee was confirmed to have been from a middle-class family. However, unlike other chungin-class families, his family belonged to the minority. He seemed to have entered medical school to seek opportunity to move up in social class by taking advantage of special government provisions, which allowed him to learn English and Western medicine. Afterwards, he performed heroic services in the peasant-war, proceeded up to administration and participated in the modernization of Great Han Empire. With his knowledge of Western concepts, he became involved in numerous social activities, such as organizing the Enlightenment Society and leading the Enlightenment Movement. In much the same way, most early students were from low-class background with exceptional personal abilities and were able to pass aptitude examinations. Such achievements allowed them to apply for positions in the military and administrative management. Ten years later, medical education to train medical professionals was revived with changes in attitudes of people of Chosun Dynasty toward Western medicine and with creation of formal medical study.

Embryological background for fetal surgery

Congenital malformations are one of the main topics, which must be addressed in the 21st century. Fetal surgery is expected to become a routine procedure for malformed fetal patients in the near future. This paper presents some important aspects of the embryological background required for fetal surgery and shows normal human embryos between the 4th and the 8th week of development.

Intestinal Rotation, Luminal Obstruction and Recanalization in the Human Embryos and Fetuses / 체질인류학회지

The development of intestine can be characterized by the following two traits. First, at the beginning of its development, the intestine is temporarily herniated into the umbilical cord, then reduced into the abdominal cavity, and finally reaches its adult location, rotating along the way. Nevertheless, no time table is yet available as to show, in a precise manner, when the intestine is herniated, when it is reduced, or to what extent the rotation occurs. Secondly, it is known that in the course of intestinal development, the lumen is temporarily obstructed by epithelial proliferation and then undergoes the recanalization. However, it is not yet certain whether there is practically a complete luminal obstruction, even by supposing that there is a complete obstruction, no theory has yet been established to determine the time, location, or the extent of the obstruction, and the time of the recanalization. In this study, 2 ~12 week old human embryos and fetuses have been used which were microdissected under a surgical microscope and were subsequently observed in an ordinary tissue slide. We have obtained the following results. 1. The intestine was first formed at Carnegie stage 5. Together with the folds of the embryos, three parts of the primitive gut were observed for the first time at stage 10. At stage 12, the primitive gut was located on the midline. 2. At stage 15, the intestine rotated to 90 counterclockwise, and at the next stage, it started herniation. There was another 90 counterclockwise rotation at stage 20, and at the beginning of the 9th week, with the rapid reduction into the abdominal cavity, the cecum was located in the proper adult position, and the rotation completed. 3. Although epithelial proliferation was recognizable in the esophagus, duodenum and other parts of the intestine of the developing embryo, we could not find any cases in which the lumen was completely obstructed.

Medical Education System in North and a Proposal for Qualifying the Doctoral Licenses after Unification

No abstract available.

Medical Education System in North and a Proposal for Qualifying the Doctoral Licenses after Unification

No abstract available.

The Gurhigae Jejoongwon: its size and activities / 의사학

This article explores the location, size of the site, and medical activities of the Gurhigae Jejoongwon. Relevant documents such as reminiscences, diplomatic notes, newspaper accounts, maps, and photographs were referred for this study. The Gurhigae Jejoongwon located on a hill that, at present, covers the area from Ulchi-ro to MyungDong Cathedral. Its main entrance was towards Ulchi-ro. Real estate including the buildings of the Gurhigae Jejoongwon was returned to the Chosun government in 1905, and the estimated size of its site varied from 1,810 pyung to 5,036 pyung. The site of the Gurhigae Jejoongwon was 2 - 5 times larger than the 862.16-pyung-site of the Jejoongwon in its Jaedong days. With such larger size, the Jejoongwon could take care of more patients. Dr. Avison started medical education again. The Gurhigae Jejoongwon took the central part in medical treatment activities for public in Seoul, as it carried out the prevention activities against Cholera in 1895. The Chosun government highly recognized its medical treatment activities for the common people.