Gadolinium Deposition in the Brain: Current Updates

Gadolinium-based contrast agents (GBCAs) are commonly used for enhancement in MR imaging and have long been considered safe when administered at recommended doses. However, since the report that nephrogenic systemic fibrosis is linked to the use of GBCAs in subjects with severe renal diseases, accumulating evidence has suggested that GBCAs are not cleared entirely from our bodies; some GBCAs are deposited in our tissues, including the brain. GBCA deposition in the brain is mostly linked to the specific chelate structure of the GBCA: linear GBCAs were responsible for brain deposition in almost all reported studies. This review aimed to summarize the current knowledge about GBCA brain deposition and discuss its clinical implications.

Consumption of Han-sik and its Association with Socioeconomic Status among Filipino Immigrant Women: the Filipino Women's Diet and Health Study (FiLWHEL) / 대한지역사회영양학회지

OBJECTIVES: This study examined the consumption of Han-sik and its association with the years of residence in Korea and the socioeconomic status among Filipino immigrant women of the Filipino Women's Diet and Health Study (FiLWHEL). METHODS: A total of 474 Filipino women married to Korean men were included in the analysis. Their dietary intake was assessed using a single-day 24-hour recall. The participants provided information on the demographics, socioeconomic, and health-related factors through face-to-face interviews. The generalized linear model and logistic regression model were used to examine the association between the socioeconomic status and consumption of Han-sik. RESULTS: The mean age of the participants was 34.3 years old, and the average duration of residence in Korea was 8.2 years. Among 474 Filipino women, a total of 467 consumed Han-sik, with an average of 6.8 food items per day. The Han-sik foods that the participants consumed most frequently were rice, cabbage kimchi, mixed-grain rice, and fried eggs. The average ratio of Han-sik was 58.57%. The ratio of Han-sik showed no significant associations with the years of residence, years of living together with their husband, education levels, total annual family income, or linguistic competence of Korean. However, the ratio of Han-sik use was associated with cohabitation with parents-in-law; the odds ratio (95% confidence interval) was 2.41 (1.18–4.92, p-trend = 0.002) comparing the fourth quartile with the first quartile of the Han-sik ratio. CONCLUSIONS: Filipino immigrant women in the FiLWHEL study consumed a larger number of Han-sik than Philippine foods. In addition, cohabitation with their parents-in-law was associated with the consumption of Han-sik. Further epidemiologic studies will be needed to determine how the diet affects the health and wellbeing of immigrant women in Korea.

Consumption of Han-sik and its Association with Socioeconomic Status among Filipino Immigrant Women: the Filipino Women's Diet and Health Study (FiLWHEL) / 대한지역사회영양학회지

OBJECTIVES: This study examined the consumption of Han-sik and its association with the years of residence in Korea and the socioeconomic status among Filipino immigrant women of the Filipino Women's Diet and Health Study (FiLWHEL). METHODS: A total of 474 Filipino women married to Korean men were included in the analysis. Their dietary intake was assessed using a single-day 24-hour recall. The participants provided information on the demographics, socioeconomic, and health-related factors through face-to-face interviews. The generalized linear model and logistic regression model were used to examine the association between the socioeconomic status and consumption of Han-sik. RESULTS: The mean age of the participants was 34.3 years old, and the average duration of residence in Korea was 8.2 years. Among 474 Filipino women, a total of 467 consumed Han-sik, with an average of 6.8 food items per day. The Han-sik foods that the participants consumed most frequently were rice, cabbage kimchi, mixed-grain rice, and fried eggs. The average ratio of Han-sik was 58.57%. The ratio of Han-sik showed no significant associations with the years of residence, years of living together with their husband, education levels, total annual family income, or linguistic competence of Korean. However, the ratio of Han-sik use was associated with cohabitation with parents-in-law; the odds ratio (95% confidence interval) was 2.41 (1.18–4.92, p-trend = 0.002) comparing the fourth quartile with the first quartile of the Han-sik ratio. CONCLUSIONS: Filipino immigrant women in the FiLWHEL study consumed a larger number of Han-sik than Philippine foods. In addition, cohabitation with their parents-in-law was associated with the consumption of Han-sik. Further epidemiologic studies will be needed to determine how the diet affects the health and wellbeing of immigrant women in Korea.

The Study of Medical Perspectives of Korean Traditional Medicine for Treating Pigmented Skin Benign Tumor / 대한피부과학회지

Although the management of benign pigmented skin tumors are mainly conducted by dermatologists, some Korean traditional doctors provide care. We aimed to evaluate the appropriateness of the medicinal knowledge of pigmented benign skin tumors that is recorded in the Korean traditional medicinal literature, in the context of modern medicine. We defined benign pigmented skin tumors as macules, papules, or nodules with homogeneous surfaces and coloration patterns, that are round or oval in shape, exhibit regular outlines, and have relatively sharp borders. We investigated textbooks and articles in the Korean traditional medicinal field to analyze descriptions of clinical classification, pathophysiology, histologic knowledge, and treatment method. We compared them with modern medicinal facts. In Korean traditional medicine, clinical classification of pigmented skin tumors is simple and did not include histologic natures. Unique theories, such as Yin-Yang and Qi, were applied to pathophysiologic understanding of these diseases. Interestingly, oral medications were used beside surgical methods. We could not find any comment about skin tumors with worrisome clinical features that warrant excision in Korean traditional medicinal literature. There is still a gap between traditional medicine and modern medicine regarding pigmented skin tumors. Traditional Korean medicinal knowledge about benign pigmented skin tumors seemed to be insufficient in the context of modern medicinal standards.

Investigation of Knowledge, Attitudes, and Experience Regarding Suicidal Behaviors among Psychiatric Residents in Korea : A Cross-Sectional Study / 신경정신의학

OBJECTIVES: This study investigated the effects of the grade of residents, sociodemographic variables, and clinical experience with suicidal patients on the knowledge and attitudes toward suicide among psychiatric residents in Korea. METHODS: A self-reporting survey including 30 questions was conducted together with an investigation of the sociodemographic background of the research subjects. The questionnaire was composed of general knowledge questions on suicide, suicide-related personal experience, attitudes toward suicide, and the treatment experience of suicide attempt patients. Chi-square test and binary logistic regression analysis were used to determine the differences and associations among the attitudes toward suicide, clinical experience of suicide, and sociodemographic characteristics. RESULTS: A significantly higher response rate was presented in the 4th grade on general knowledge of suicide and treatment experience with suicide attempt patients than in the 1st grade. Residents with previous history of psychiatric treatment suicide plans, or attempts presented a significantly higher level of permissive attitude toward suicide. Residents who had a previous history of suicide attempt among their own patients were more likely to think that they were more capable to prevent suicide of patients. CONCLUSION: Effective clinical practices are essential considering the fact that the highest suicide risk groups will inevitably be referred to psychiatric clinical services. The authors expect that the study results regarding suicide-related knowledge, attitudes, and the experience of psychiatric residents will contribute to the development of effective resident training programs for suicide-related clinical practice in Korea.

Application of Oral History to Contemporary History of Medicine in Korea: With a Focus on Medical Scientists / 의사학

The oral history helps researchers to fill the gap in historical documents in research on the contemporary history of medicine in Korea. More and more studies in history of contemporary medicine in Korea have come out using oral history of doctors and patients. Based upon the author's research on development of neurosurgery in late 20th century Korea, this paper discusses how to apply oral history to contemporary history of medicine, focusing on oral history of doctors in Korea. In this paper the author describes how to do and use oral history of key doctors and medical scientists in the contemporary history of medicine in Korea. The oral history can be a powerful tool to complement the written documents as following. First, from their interview, doctors and medical scientists often provide valuable information which historians cannot get from documents and written sources. As intelligent interviewees, they not only understand the purpose of research but also help actively the historian-researcher-interviewer. Second, the oral history facilitates further searches and often it leads to more findings of informants, and written and image material. More often than not, doctors and medical scientists do their own research on the topic and provide the historian with valuable historical source material from their laboratories, bedsides, family and friends. Third, interviews with medical scientists and oral material produced by doctors and medical scientists helped the researcher to understand and interpret the papers and written documents. Fourth, the subjective stories told by the medical scientists provide perspectives and historical source as narrative truth. Before a historian attempts to use the oral material as complementary historial evidence, he or she needs to cross-check the validity and of objectivity of the oral material. Oral material is produced through bidirectional intersubjective interaction between the interviewer and interviewee, and critical reflection over the relationship between the two is crucial. Especially the researcher should keep an eye on the possible bias and strive for the objectivity of the oral material with discernment and reflection, when she or he found the interviewees of doctors and medical scientists closely connected together and tied together in a web of relationship with a common interest or agenda.

Carotenoids and total phenolic contents in plant foods commonly consumed in Korea

Phytochemicals are reported to provide various biological functions leading to the promotion of health as well as the reduced risk of chronic diseases. Fat-soluble plant pigments, carotenoids, are extensively studied micronutrient phytochemicals for their potential health benefits. It is noteworthy that specific carotenoids may be responsible for different protective effects against certain diseases. In addition, each carotenoid can be obtained from different types of plant foods. Considering the fact that the phytochemical content in foods can vary according to, but not limited to, the varieties and culture conditions, it is important to establish a database of phytochemicals in locally produced plant foods. Currently, information on individual carotenoid content in plant foods commonly consumed in Korea is lacking. As the first step to support the production and consumption of sustainable local plant foods, carotenoids and total phenolic contents of plant foods commonly consumed in Korea are presented and their potential biological functions are discussed in this review.

Clinical Characteristics of New Leprosy Patients for 15 Years (1992~2006) in Daegu / 대한피부과학회지

BACKGROUND: The prevalence and number of new cases of leprosy have recently markedly decreased in Korea. Therefore, the concerns about leprosy have also gradually decreased. For this reason, making the diagnosis of leprosy is not as easy as it was in the past, and it is more difficult to find new cases of leprosy. OBJECTIVE: The purpose of this study is to evaluate the epidemiologic and clinical features of recently diagnosed cases of leprosy in Daegu city, Korea. METHODS: Fifteen patients were diagnosed with leprosy according to the clinical features, histopathologic findings and bacteriologic examinations at Yeungnam University Hospital from 1992 to 2006. The epidemiological and clinical features according to age, gender, the place of residence, the duration of disease, the location of lesions, the cutaneous findings and the type of disease were evaluated retrospectively using the patients' medical records. The patients enrolled in this study were divided by the Madrid classification: the lepromatous type, the tuberculoid type and the intermediate or borderline group. RESULTS: Fifteen patients were diagnosed with leprosy during the past 15 years. The ratio of males to females was 1.5:1. Most of the patients (66.6%) were aged in their 40's and 60's. This shows that the rate of patients 40 years or older is on the increase. The male patients were younger than the female patients. The male patients were in their 20's and 40's, whereas the female patients' ages ranged from their 50's to 80's. The skin lesions showed various features and six (40%) of the 15 patients had sensory change. Eleven (73.3%) of the 15 patients were in the borderline group, followed by 3 patients with the tuberculoid type (20%) and 1 patient with the lepromatous type (6.7%). CONCLUSION: New leprosy patients have been persistently found and the findings of this study suggest that dermatologists play an important role in diagnosing and treating leprosy and they have to pay attention to diagnose new cases of leprosy.

Abilities Required for Admission to Medical School in Korea: Report on the Medical (Dental) Education Eligibility Test / 医学教育

1) The Medical (Dental) Education Eligibility Test was developed as the medical school admission test in Korea and was administered for the first time on August 29, 2004. The test evaluates reasoning abilities in language, natural sciences, and spatial relationships.<BR>2) The language section assesses cognitive and communication abilities. The natural science section assesses cognitive ability on the basis of academic knowledge in the field, whereas the spatial relationships section evaluates aptitude expected of dentists in their clinical examinations.<BR>3) Because entrance examinations have traditionally placed too much emphasis on academic knowledge and achievement, assessment of other kinds of aptitudes, such as ethics, cooperativeness, and communication skills, has recently become increasingly important. It remains to be seen how these aptitudes and interpersonal skills can be measured and scaled with admission tests.

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.

Report from ADRG: The Treatment Guideline of Korean Atopic Dermatitis / 대한피부과학회지

BACKGROUND: Atopic dermatitis is a chronic, relapsing, inflammatory skin disease, with genetic and environmental background. Successful management of atopic dermatitis requires a multipronged approach. However, standardized guidelines for the management of Korean atopic dermatitis patients do not exist. OBJECTIVE: This study was performed to provide a standardized treatment guideline for atopic dermatitis in Korea. METHODS: On the basis of treatment guidelines proposed by the ADRG (Atopic Dermatitis Research Group), we consider the characteristic provocation factors reported in previous Korean cases and the new modalities which have recently been introduced. RESULTS: Management should compromise of a disease-adapted treatment which combines adjuvant basic therapy, symptomatic relief and, if needed, anti-inflammatory treatment and the identification and avoidance of trigger factors. New therapies such as topical calcineurin inhibitors are also considered to be good alternatives for the long-term control of atopic dermatitis. CONCLUSION: The algorithm contained within the article was presented as the basis for a guideline of clinical practice that could be used to facilitate the treatment of atopic dermatitis at any stage in Korea.

The Life of Medical Historian Miki Sakae, and the (History of Korean Medicine and of Diseases in Korea) / 의사학

Miki Sakae was a Medical historian, who is well known for his studies of Korean medicine. He authored the renowned trilogy which dealt with subjects of Korean medicine and diseases, namely the (History of Korean Medicine and of Diseases in Korea), (Bibliography of Korean Medical Books), and (The Chronological Table of Medical Events in Korea), during the Japanese Occupation period. He was born in 1903 in Osaka, Japan, and graduated from the Kyushu College of Medicine. In 1928 he was assigned to the Gyeongseong Imperial University's College of Medicine as a professor, and also served as Chief of the Suweon Provincial Hospital while he was staying in Korea. During the 18-year period of his stay, he widely collected medical books of Korea and also thoroughly studied them. He returned to Japan in 1944 due to the illness of his father, but continued his studies of Korean medicine, and in 1955 published the (History of Korean Medicine and of Diseases in Korea) for the first time. Following such accomplishment, (Bibliography of Korean Medical Books) was published in 1956, the next year, and finally (The Chronological Table of Medical Events in Korea) was published a few decades later, in 1985. Since the 1950s, aside of continuing to study and author the history of Korean medicine, he had also engaged himself in a joint effort associated with the members of the Medical History Association of Japan (which also included the alumni of the Kyushu College of Medicine) in a group study of Huseya Soteki the first Japanese Experimental Physiologist. He also attempted at establishing an academic branch which could be referred to as Experimental Historical Studies of Medicine, by recreating the experiments of Huseya Sotek with his own son.Later he also expanded his interest and studies to the medical history of the world and also the area of Medical Ethics. But his ultimate interest and passion were always targeted at the Medicine of Korea, and the one consistent position he maintained during his entire life regarding the Korean medicine, was that 'One can only talk about the medicine of China and Japan when he or she is well versed in the medicine of Korea'. And his lifetime achievement, (History of Korean Medicine and of Diseases in Korea) was authored upon the basis established by such conviction and philosophy. First, in this book the perspective of Cultural Transmission, which considers the flow of cultural qualities and assets to be ordinarily flowing from highly developed regions to less developed ones, was firmly maintained.

2004 IPA Asia Pacific Regional Meeting / 신경정신의학

"2004 IPA Asia Pacific Regional Meeting" was held with successfully on 8-11 September in Seoul, Korea. 2004 IPA Seoul Meeting held in collaboration with the Korea Association for Geriatrci Psychiatry (KAGP) and sponsored by "Ministry of Health and Welfare, Korea".Moreover, the KAGP celebrated its 10th anniversary with the participation of the International Psychogeriatric Association (IPA) Members. The theme of this meeting is "Mental Health of the Elderly in Rapidly Aging Societies", which was chosen to provide an opportunity to meet IPA mission and prepare the strategies for rapidly growing aging societies all over the world in the 21st century. "Seoul Declaration of Mental Health for the Elderly in Korea" was announced.

Heart-Lung Transplantation in Korea

Heart-lung transplantation is an effective treatment for patients with various forms of congenital heart disease or pulmonary hypertension. Since the first heart-lung transplantation in 1997, five transplants have been performed in Korea. Three cases were performed in 1997, one in 1998, and the latest one in 2002. The preoperative diagnoses were complex congenital heart disease (CHD) in 2, and CHD with Eisenmenger's syndrome in 3. In this paper, we report five cases of heart-lung transplantation performed in Korea, and include a review of the relevant literature.

Antimicrobial Resistance Surveillance of Bacteria in 1999 in Korea with a Special Reference to Resistance of Enterococci to Vancomycin and Gram-Negative Bacilli to Third Generation Cephalosporin, Imipenem, and Fluoroquinolone

The trend of antimicrobial resistance of bacteria isolated from patients in 30 Korean hospitals in 1999 was analyzed with a particular attention to cefotaxime- or fluoroquinolone-resistant gram-negative bacilli, imipenem-resistant Pseudomonas aeruginosa, and vancomycin-resistant enterococci. Adequacy of susceptibility testing, and any change in the frequencies of isolated species were also analyzed. The results showed that only 20% and 30% of hospitals tested the piperacillin-tazobactam and cefoxitin susceptibility of Enterobacteriaceae, respectively, only 24% of hospitals the piperacillin-tazobactam susceptibility of P. aeruginosa, and 17% of hospitals the fusidic acid susceptibility of staphylococci. Among the isolates 26.3% were glucose-nonfermenting gram-negative bacilli, and 34.7% of Enterococcus were Enterococcus faecium. Slight decline of cefotaxime-resistance rate to 20% was noted in Klebsiella pneumoniae, while fluoroquinolone-resistantce rate was 68% in Acinetobacter baumannii. The ceftazidime- and imipenem-resistance rates were 17% and 18%, respectively in P. aeruginosa. The vancomycin-resistance rate of E. faecium rose significantly to 15.1%, but the rates varied significantly depending on hospitals suggesting presence of different degree of selective pressure or nosocomial spread. In conclusion, the prevalence of imipenem-resistant P. aeruginosa and the increase of vancomycin-resistant E. faecium were the particularly worrisome phenomena observed in this study.

Advances in Radiation Oncology in New Millennium in Korea / 대한방사선종양학회지

The objective of recent radiation therapy is to improve the quality of treatment and the after- treatment quality of life. In Korea, sharing the same objective, significant advancement was made due to the gradual increase of patient number and rapid increase of treatment facilities. The advancement includes generalization of three-dimensional conformal radiotherapy (3D-CRT), application of linac-based stereotactic radiosurgery (SRS), and furthermore, the introduction of intensity modulated radiation therapy (IMRT). Authors in this paper prospectively review the followings: the advancement of radiation oncology in Korea, the recent status of four-dimensional radiation therapy, IMRT, the concept of the treatment with biological conformity, the trend of combined chemoradiotherapy, the importance of internet and radiation oncology information management system as influenced by the revolution of information technology, and finally the global trend of telemedicine in radiation oncology. Additionally, we suggest the methods to improve radiotherapy treatment, which include improvement of quality assurance (QA) measures by developing Koreanized QA protocol and system, regional study about clinical protocol development for phase three clinical trial, suggestion of unified treatment protocol and guideline by academic or research societies, domestic generation of treatment equipment's or system, establishment of nationwide data base of radiation-oncology -related information,and finally patterns-of-care study about major cancers.

The policy of the United States Army Military Government in Korea toward public health and medicine in occupied South Korea / 의사학

After the liberation from Japanese colonial rule in August 1945, the United States of America established Military Government in Korea(USAMGIK) south the 38th parallel. The public health and medical policy of the USAMGIK was defined by the USA's general policy toward Korea, and followed national interests of USA after the end of the World War II. The basic objectives of the early occupational period were two; the protection of the occupation troops, the prevention of acute epidemic diseases and unrest in the populace. However, after the switch of occupation policy to the establishment of pro-American anti-Communist nation in Korea since June 1946, the basic objectives turned into 'the establishment of the influence of American medicine in Korean medical system.' During the occupation period, USAMGIK trained several pro-American right - wing doctors who formed the clique of policy makers in the independent government, and established many quasi - American public health and medical systems in Korea.

Medical education in Je Joon Won / 의사학

Medical education in Je Joong Won was proposed and initiated by Dr. HN Allen. In his proposal of building a new hospital, submitted to the king in 1885, he expressed his wish to teach Western medicine to young Koreans at the hospital. The king welcomed his proposal and the plan was soon realized. Je Joon Won, the first modern hospital in Korea, opened on April 10th, 1885. The following year, on March 29th, Dr. Allen began medical school attached to the hospital. Many applicants were recruited by the government and 16 students were selected through the entrance examination. At first, they were taught English and finally 12 students out of them were selected after three months of teaching. The selected students were taught arithmetic, physics, chemistry, anatomy and physiology. The medical education at this period cannot be evaluated entirely successful since none of the 12 students was presumed to have worked as a practitioner.

Korean Nationwide Surveillance of Antimicrobial Resistance of bacteria in 1997

Antimicrobial-resistant bacteria are known to be prevalent in tertiary-care hospitals in Korea. Twenty hospitals participated to this surveillance to determine the nationwide prevalence of resistance bacteria in 1997. Seven per cent and 26% of Escherichia coli and Klebsiella pneumoniae were resistant to 3rd-generation cephalosporin. Increased resistance rates, 19% of Acinetobacter baumannii to ampicillin/sulbactam, and 17% of Pseudomonas aeruginoa to imipenem, were noted. The resistance rate to fluoroquinolone rose to 24% in E. coli, 56% in A. baumannii and 42% in P. aeruginosa. Mean resistance rates were similar in all hospital groups: about 17% of P. aeruginosa to imipenem, 50% of Haemophilus influenzae to ampicillin, 70% of Staphylococcus aureus to methicillin, and 70% of pneumococci to penicillin. In conclusion, nosocomial pathogens and problem resistant organisms are prevalent in smaller hospitals too, indicating nosocomial spread is a significant cause of the increasing prevalence of resistant bacteria in Korea.

Clinical Analysis of 150 Patients with Visual Disability

Epidemiological data on visual disabilities in Korea are rare. In order to partly understand the situation of visual disability in Korea, the authore performed a retrospective study on the major causes and the degree of visual disability of patients who got the authorized document of vusual disability between January, 1993 to June, 1996. Of the 150 patients with availble clinical data, men were more than women(75.3%). The patients in their forties were most common(45 patients, 30.3%). First degree and fourth degree visual disability(4/9) were most common(43.2%, 49.1%) until 1995 and from 1996, respectivelly. Of the 300 eyes, 257 eyes were diagnosed to have visual problems. Optic neuropathy (52 eyes, 20.2%), trauma(31 eyes, 12.1%), retinitis pigmentosa(29 eyes, 11.3%), and corneal opacity (23 eyes, 8.9%) were the common causes of visual disability. These results might be helpful for partly understanding the visual disability in Korea.