Problems and Reconsideration of the Concept of Public Health Care (Public Health and Medical Services) in South Korea / 의학교육논단

The concept of “public health care (public health and medical services)” as discussed in South Korea is used in an unclear sense, with a meaning unlike the terminology used worldwide. The terms “public health care (public health and medical services)” and “health care (health and medical services)” have the same legal definition in Korea. Globally, “public health care (public health and medical services)” refers to medical services provided to the public that are operated as publicly funded resources, but in Korea, this term is confined to limited medical services prescribed by the government. The following considerations regarding “public health care (public health and medical services)” in Korea are proposed: All medical services performed by the state, regional governments, health care institutions, or health care workers to protect and promote the health of the people should be clearly established as “public health care (public health and medical services)” by definition. The financial burden borne by the state through national health insurance should be increased to an appropriate level to clarify the state's responsibility. Improving public health is an urgent priority in Korea, and this goal can be achieved by improving regional public health through systematic relationships between the state and regional governments, establishing a Ministry of Health, and efficiently allocating public health doctors who are important for providing regional medical care in rural and remote areas. It will be possible to actively deal with infectious diseases at the national level through establishment of a Ministry of Disease Control and Prevention.

Role of Protein kinase C in Desensitization of Somatostatin-induced Calcium Signalling in NG108-15 Cells / 대한내분비학회지

BACKGROUND: Activation of G-protein coupled-somatostatin receptors induces the release of calcium from inositol 1, 4, 5-trisphosphate-sensitive intracelluar stores. G-protein-coupled receptor signaling decreases with prolonged exposure to an agonist. SEBJECTS and METHODS: Fura-2-based digital Ca2+ imaging was used to study the effects of prolonged exposure to an agonist on the somatostatin-induced intracellular Ca2+ concentration([Ca2+]i) increases in NG108-15 cells, which were differentiated with CO2-independent medium and 10micrometer forskolin. RESULTS: Exposure to somatostatin(1micrometer) for 30 min completely desensitized the NG108-15 cells to a second somatostatin-induced response. The cells recovered gradually over 20 min following washout of the somatostatin. The desensitization was not due to depletion of the intracellular Ca2+ stores, and pretreatment for 30 min with bradykinin(100nM), which activates phospholipase C, or DADLE(D-Ala2-D-Leu5 enkephalin, 1microM), which activates phospholipase C, failed to cross-desensitize the somatostatin-evoked [Ca2+]i increases. Treatment with 8-cpt-cAMP(0.1mM) for 30min did not influence the somatostatin-induced[Ca2+]i increases. Phorbol 12, 13-dibutyrate(PdBu, 1microM) blocked the response completely. Down-regulation of PKC due to 24 h exposure of PdBu (1microM) inhibited the somatostatin-induced desensitization. CONCLUSION: Prolonged exposure of somatostatin to NG108-15 cells desensitized the somatostatin-induced release of Ca2+ from the intracelluar store, with protein kinase C also involved in the desensitization.

Emotional and Behavioral Factors Relating Adolescent Delinquency in Community / 신경정신의학

OBJECTIVES: This study aimed to investigate predictive emotional and behavioral factors of adolescent delinquents among students. METHODS: We assessed and analyzed 1377 students aged 13-18 using the following instruments: Center for Epidemiologic Study for Depression (CES-D), Revised Children's Manifest Anxiety Scale (RCMAS), Youth Self Report (YSR), Psychological self-1 of Offer's Self Image Questionnaire (PS-1 of OSIQ) and Suicide Ideation Questionnaire (SIQ). With collected data we compared the delinquent group with the control group. RESULTS: The prevalence of delinquent adolescents was 4.7%. The prevalence among of high school students was higher (8.7%) than that of middle school students (3.4%). Comparing with the control group, delinquent group showed significantly higher scores of CES-D (Delinquent 25.55 vs Control 13.07), RCMAS (Delinquent 15.60 vs Control 9.17), PS-1 of OSIQ (Delinquent 33.70 vs Control 28.87), SIQ (Delinquent 88.89 vs Control 46.89) and all subscales of YSR. Adolescent delinquency can be predicted in the order of RCMAS, Somatic complaints, CES-D and Withdrawn. CONCLUSION: We found that both emotional and behavioral factors could predict adolescent delinquency in school community. Most potent predictor was anxiety. Additional predictors were neurotic characteristics such as somatic complaints, depressive symptoms and social withdrawal. It is hypothesized that early intervention of adolescent neuroticism may be able to prevent adolescent delinquency.

Altered Cholecystokinin-induced Calcium Signal in Streptozotocin-induced Diabetic Rat Pancreatic Acini / 대한소화기학회지

BACKGROUND/AIMS: Pancreatic acini of streptozotocin (STZ)-induced diabetic rats release amylase less than normal acini on cholecystokinin (CCK) stimulation. Pancreatic enzyme secretion has been closely related to the intracellular calcium concentration ([Ca2+]i) of the acinar cell. In the present study, sequential changes of the intracellular calcium signal which probably underlie the altered enzyme secretion in response to CCK-8 were investigated using pancreatic acini from diabetic rats. METHODS: Diabetic rats were prepared by single intravenous injection of STZ (70 mg/kg). Stimulating experiments with CCK-8 were performed 7 days later. Pancreatic acini were isolated by collagenase digestion. Amylase release and [Ca2+]i were measured by colorimethod and calcium imaging, respectively. The geometry of intracellular calcium signal was analyzed. RESULTS: Normal acini exhibited concentration-dependent [Ca2+]i increase and regular oscillatory calcium signal on CCK-8 stimulation. Amylase release was also concentration-dependent. However, diabetic acini showed significantly less [Ca2+]i increase, prolonged time to peak [Ca2+]i, decreased calcium spikes number, and decreased amylase release compared with normal acini. The decreased [Ca2+]i in diabetic acini was restored significantly by insulin treatment. CONCLUSIONS: Relatively decreased amylase release in diabetic pancreatic acini in response to CCK, appears to be associated with altered calcium signal due to insulin deficiency.

Effect fo Nitric Oxide on Control of Insulin Secretion in Rat Pancreas / 대한내분비학회지

BACKGROUND: NO (nitric oxide), derived from L-arginine through the action of nitric oxide synthase (NOS), is a short-lived free radical transmitting cellular signals for vasodilation, neurotransmission, and cytotoxicity. Recently, this molecule has been reported to be involved in the various glandular secretion. Although the relationship between NO and the pancreatic endocrine secretion has been widely investigated, the role of NO on insulin secretion has not been elucidated. Therefore, the present study was designed to reveal the precise action of NO on the secretion and synthesis of insulin following administration of NAME (L-NG -nitroarginine methyl ester) or L-arginine using immunocytochemistry and in situ hybridization techniques. METHODS: NAME or L-arginine was administered into jugular vein of the male Sprague-Dawley rat (180~200 g, b,w.) exhibiting normoglycemia (80~120mg/dL). Blood glucose concentrations were measured at intervals of 30 minutes for 2 hours after drug treatment. The pancreatic tissues were taken out at 30 and 90 minutes following drugs administration for insulin immunocytochemistry and in situ hybridization. RESULTS: Both NAME and L-arginine treatments diminished blood glucose levels. The decrease of blood glucose level was more prominent in NAME-treated rats than that of L-arginine. Insulin immunoreactivity in drugs-treated rat pancreas decreased compared to that in normal control, while the expression of insulin mRNA was significantly increased. CONCLUSION: On the basis of present study, it is concluded that the transient changes of NO con-centration, regardless of increase or decrease, in Langerhans islet might act as a potent stimulant in insulin secretion and its synthesis.

Individual and Socioenvironmental Factors Affecting Test Anxiety in Adolescents / 신경정신의학

OBJECTIVES: This study was done to investigate the relationship between test anxiety and individual, socioenvironmental factors in adolescents. Also, this study assessed whether two components, worry and emotionality, of test anxiety were distinctly distinguished or not, and whether test anxiety was specific state anxiety limited to test situation or a part of general trait anxiety. METHODS: The subjects of this study were 880 middle and high school students in Seoul. To evaluate test anxiety level, we used Spielberg's Test Anxiety Inventory. For the evaluation of individual psychological factors, Rosenberg's self-esteem scale, Maudsley's Obsessive-Compulsive Inventory, Lee's the Korean version of Fear-Anxiety Survey Schedule for Children, and Ellis' Demand for Approval scale were applied. RESULTS: The results were as follows. 1) Test anxiety level was higher in girls, first grade middle school students, offspring's of high school graduate mother, and high economic class but there was no significant difference in school characteristics and residence location. 2) Test anxiety was correlated negatively with self-esteem, I.Q. and correlated positively with obsessive-compulsiveness, demand for approveness, especially general fear-anxiety(r=0.47). So although test anxiety occurs in test situation, test anxiety is a part of general trait anxiety affected by individual psychologic factors. 3) The better school achievement subjects showed the lower worry component of test anxiety. 4) Two components, worry and emotionality, of test anxiety were not distinctly distinguished in this study. CONCLUSION: In summary, first, Worry and Emotionality of test anxiety were not markedly different from according to adolescent's psychological factor, sociodemographic factor but performance achievement was significantly correlated with Worry of test anxiety. Second, although test anxiety was occurred in specific situations as test, test anxiety was affected individual psychological factor so defined by a series of anxiety disorder. Third, only Worry of test anxiety was correlated with performance achievement and Wory and Emotionality were correlated with psychological factor. Forth, mother's education level was significantly correlated with test anxiety, this means that mother has the wish to compensate the her inferiority through her offspring and mother strongly affect to adolescent's psychological state.

Mechanical Ventilation in Newborn Infants

No abstract available.