[A life of Ryu Sang-Kyu, a colonial modernized intellectual].

Many of the Korean intellectuals resisted against suppression of Japanese Imperialism with the people during the Japanese occupation period. Ryu Sang-Kyu was also one of those intellectuals. Ryu Sang-Kyu was born in Gang-gye of North Pyongan-do on 10th November, 1897. He entered Keijo Medical College as one of the first entering students in 1916. However, at the end of his third year, he participated in the 3.1 Independence Movement of Korea and was suspended from the college which was run by the Japanese on account of his participation. Then moving to Shanghai, he joined Heung Sa Dan, an active patriotic group fighting for independence of Korea. He initiated the provisional government of Korea as a network investigator and he played second string to Ahn Chang-Ho, one of major Korean independence activists for four years. In 1923, following Ahn Chang-Ho's advice, he returned to Keijo Medical College to complete the course. Even in colonial Korea, he continued independence movement and was involved in Dong Woo Hoe, the branch of Heung Sa Dan in Korea. After the graduation of Keijo Medical College in 1927, he had served at the department of surgery in Keijo Medical College. In 1930, he participated in founding of the Korean Medical Association. He also raised public awareness by writing to many articles on hygiene and public health issues in public journals and newspapers. In short, he did his best as an intellectual, a medical doctor, an activist of independence movement until he died from streptococcal infection on 7th July, 1936.

[New trends of medicine manifested at Naeuiwon in the late Chosun period].

Tonifying method has been used to treat various types of deficiency syndrome in traditional Korean medicine. Tonifying medicinal including ginseng and deer horns is one of the various methods of the treatments, but they are recognized as a representative of traditional Korean remedies nowadays in Korea. That is concerned with the new trends of medicine manifested at Naeuiwon (Royal Infirmary) in the late Chosun period. The period that manifested the tonifying method obviously was the reign of King Youngjo (r.1724-1776). King Youngjo who lived longest among Chosun kings considered tonifying yang very important in keeping him healthy. He had taken a large quantity of ginseng, he and others considered the reason for his longevity as taking ginseng. From that time, the method of tonifying yang became one of the principles in health care and treatment as well. In the 19th century, the theory of tonifying method had been changed, in that tonifying yin was considered more important among Naeuiwon physicians. Tonifying yang alone was thought to be harmful because of its warm and dry nature. The main cause of prevalence of tonifying method in Naeuiwon was the fact that it was safe and had little side effects. The method of health care and treatments of the kings was considered as an ideal model by the ordinary people at that time. The new trends of medicine manifested at Naeuiwon in the late Chosun period had a strong influence on traditional Korean medicine, which emphasized the importance of tonifying method.

[The health care in North Korea during the period (1945-1948) between liberation from Japanese occupation and establishment of North Korean government].

This paper, mainly based on literature and documents from North Korea and Russia, described how health care system had been formulated during the period of between liberation from Japanese Occupation and formation of its own government in North Korea, which is so-called 'the Period of People's Democracy'. North Korea authorities, by themselves, address that their health care system is characterized by state medicine, universal free medical care, emphasis on preventive medicine, community(ho) doctors in charge, provisions of modern medical services in parallel with traditional ones, imposed high value on ideologies of medical personnel, and mass participation of health programs so on, taken rise since this period. Under North Korea's socialistic regime, authorities started to restructure health care system through national health care organizations and institutes, which partially provided medical service free. Also, they emphasized preventive medicine against 'capitalistic' treatment-oriented medicine, and community(ho) doctor in-charge was derived from this period. It showed that the mass participation on health program was equal hereafter and they had under bias toward more emphasis on ideology of medical personnel rather than their professionalism. The attempt to develop traditional medicine had been made during this period, however, much funding and support was not observed. In this period, it showed that a series of action to restructure health care system had been gradually carried out.

[The influence of the devotion movement on the health care in North Korea].

Since the early 1960s, North Korea has conducted 'devotion movement' under the directorship of Kim Il Sung across the nation. As a matter of fact, the movement was not a novel invention at all. When North Korean Temporary People's Polity was established in 1946, North Korea emphasized the importance of the devoted care of health personnel. It meant to reform the people's thought and mind along with complementing the lack of human and material resources. Thought reform was not a peculiar phenomenon observed in North Korea only. It was particularly stressed out among communist countries, including the Soviet Union. However any other communist country stresses the importance of thought reform. Devotion movement should be viewed as part of this process. As shown in many cases, the extent and degree of devotion movement and care are beyond our imagination, which does not intend to mean that North Korean health personnel's attitude towards patients is superior to the counterparts in South Korea. Indeed human being's behavior cannot be understood without taking account of society in general. The question can be raised as to whether or not North Korean health personnel's devoted care is really voluntary. To put aside the testimony that the most powerless group in a society can fall prey to victims, if social environment, whether directly or indirectly, is action on the people's thought and mind even in a subtle way and thus influence one's decision power, it is hard to highly evaluate the devoted care in North Korea. Moreover it seems like that the internal conflict exists surrounding devotion. In conclusion, I think that North Korean devotion movement has enforced health personnel to reform their thought and mind to adapt to North Korean regime and has played an important role to accomplish the purpose of North Korean Labor Party to realize essential constituents of its health system, in such a situation in which essential medical supplies are severely lacking. But it seems like that it plays reverse action to develope sound North Korean health system.

Non-small cell lung cancer initially presenting with intracardiac metastasis.

Intracardiac metastasis as the initial presentation of malignant neoplasm is very rare. We report here on a 64-year-old man with non-small cell lung cancer (NSCLC) initially presenting with intracardiac metastasis which was identified with 18-F fluorodeoxyglucose positron emission tomography (FDG PET). The patient was admitted with complaints of exertional dyspnea and vague chest discomfort that had developed a few weeks ago. Two-dimensional echocardiography revealed a heart mass attached to its akinetic wall in the right ventricular chamber. CT and MRI demonstrated a large tumor involving the epicardium and myocardium in the right ventricle, and there was a mass in the right lower lobe of the lung along with multiple lymphadenopathies. Cytologic examination of the percutaneous needle aspiration of a lymph node in the anterior mediastinum revealed malignant epithelial cell nests, and this was strongly suggestive of squamous cell carcinoma. Subsequent FDG PET confirmed that the intracardiac mass had an abnormally increased FDG uptake, and again this was strongly suggestive of malignancy. By systemically considering these imaging studies, we were able to diagnose the mass as intracardiac metastasis of NSCLC.

[Hemorrhagic fever with renal syndrome: historical aspects].

A mysterious disease was first reported from Korea when it had been observed during late spring 1951 in UN Forces operating in the central area close to the 38th parallel. The disease showed distinctive features which included high fever, low blood pressure, hemorrhagic tendency and acute renal failure. Historically it was apparently a similar disease to a clinical entity designated as Epidemic hemorrhagic fever in Manchuria or Hemorrhagic nephrosonephritis in Far Eastern Russia. After Lee Ho-Wang succeeded in demonstrating Hantaan virus which caused hemorrhagic fever with renal syndrome (HFRS), many studies has revealed various biological and epidemiological aspects of the disease. But the origin of the disease in Korea still remains unknown. This article tests some hypotheses which explain the origin of the disease and reviews the relation between the Korean War and HFRS. It is concluded that the emerging of HFRS would be closely related with the establishment of the munitions supply network in early 1951 in Chinese troop.

[A study on the medical care of the royal family in the Chosun period in 1898 - as recorded in the Taeuiwon Ilgi].

Taeuiwon was in charge of the medical care of the royal family in the Chosun period of 1898. The Taeuiwon Ilgi is the document which was recorded by Taeuiwon officials. In this study, the authors studied the contents of Taeuiwon Ilgi of 1898 in order to understand the medical care of the royal family of the Chosun Kingdom. In 1898, Taeuiwon took some careful measures to take good care of the royal family. Taeuiwon physicians made regular inquiry about their health through the format called Moonan. The Moonan was to check out the health conditions of them. When Taeuiwon carried out Moonan, Emperor Kojong was asked to take a medical examination called Ipjin by the court physicians of Taeuiwon, even if he were in good condition. Taeuiwon physicians also regularly prescribed Insamsokmium when the royal family performed the religious service or went into mourning. Insamsokmium is a kind of restorative food containing ginseng. From the above, we conclude that Taeuiwon provided the preventative care to them. It was considered the proper way to such kind of high personage in that period.

[Establishment of transsphenoidal approach in skull base surgery: a historical analysis].

Many approaches are being used for exposure of the anterior cranial base regions, ranging from extracranial to intracranial, such as transsphenoidal approach. This intracranial approach, developed in the beginning of the twentieth century, has recently become one of the most commonly used approaches after many incremental improvements. This thesis aims at examining the development of the approach and those who contributed to this procedure. The author also contemplate problems which may occur in the historical analysis. From the nineteenth century, advances have been made in anesthesiology, sterilization, cerebral localization and knowledge of anatomical and physiologic aspects of the skull base. The development of new knowledge and technique has helped to overcome obstacles, making surgery of the skull base through extracranial approach both technically feasible and therapeutically effective. To avoid serious postoperative complications after the extracranial approach, transsphenoidal approach had been developed in the beginning of the twentieth century. Transsphenoidal approach had been widely used right after its introduction. But it had not been used popularly since late 1920s in the United States. In early 1960s, this technique, spread from Europe, has regained popularity and become one of the most widely-used approaches. In the history of the transsphenoidal approach, it has been though that the effort of Harvey Cushing and Oskar Hirsch, the endeavor of Cushing's scholars, several new attempts of otolaryngologists played an important role. However, comparing to great appreciation of neurosurgeons, especially Harvey Cushing on their significant contribution to the further development of this technique, the role of other pioneering doctors have been underestimated in previous historical studies on the transsphenoidal approach. It was because dynamical relationships among several specialties had influence on the historical analysis. This cases shows that historical analysis is influenced not only by past figures bu also by current situations.