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The e-health infrastructure in Korea has come a long way within a short period since the establishment of the Korea e-Health Association in 2003 by the Korean Ministry of Commerce, Industry and Energy. Since then, four related government departments in the Ministry of Health and Welfare, Ministry of Information and Communication, Ministry of National Defense, and the Ministry of Science and Technology have also started planning and promoting their own strategies for e-Health applications. We have defined standardization, law and policy planning, human resources development, research and development for e-health products, and international collaboration as the five core pillars for the development of a successful e-health industry. In 2008, through the reorganization of government ministries, e-health has become an even more important growth industry for the Korean economy. Consequently, relevant government ministries have more concrete and robust action plans for realization of e-health in effect.

PoKuNyoKwan was established in 1887 by Meta Howard, a female doctor who was dispatched from Woman's Foreign Missionary Society, an evangelical branch affiliated with U.S. North Methodist Church. PoKuNyoKwan was equipped with dispensaries, waiting rooms, pharmacies, warehouses, operating rooms, and wards for about 30 patients. It used a traditional Korean house, which was renovated for its medical purpose, in Ewha Haktang. Residing in Chung Dong, the medical institution had taken care of women's mental and physical health for about 25 years, until it was merged with East Gate Lillian Harris Memorial Hospital in 1912, and then its dispensary function was abolished in 1913. Medical missionaries (Meta Howard, Rosetta Sherwood, Mary M. Cutler, Emma Ernsberger, Esther K. Pak, Amanda F. Hillman) and nurse missionaries (Ella Lewis, Margaret J. Edmunds, Alta I. Morrison, Naomi A. Anderson), who were professionally trained in the United States, and their helpers, who were trained by those missionaries, managed PoKuNyoKwan. Nurses who were educated in Nurses' Training School, which was also established by PoKuNyoKwan, helped to run the institution as well. At the beginning, they usually had worked as a team of one medical missionary and three helpers. Since its establishment in 1903, however, the helpers began to enter the Nurses' Training School to become professional nurses, and the helpers eventually faded out because of the proliferation of those nurses. PoKuNyoKwan did not only offer medical services but also executed educational and evangelical activities. Medical missionaries struggled to overcome Koreans' ignorance and prejudice against westerners and western medical services, while they took care of their patients at office, for calls, and in hospital dispensaries. Enlightening the public by criticizing Korean traditional medical treatments including fork remedies, acupuncture, and superstitions, they helped modernization of medical systems in Korea. In the area of education, Rosetta Sherwood taught helpers basic medical science to make them regular medical staff members, and Margaret J. Edmunds established the Nurses' Training School in PoKuNyoKwan for the first time in Korea. The nurses who graduated from the school worked at PoKuNyoKwan and some other medical institutions. Evangelical activities included Bible study in the waiting rooms of PoKuNyoKwan and prayer meeting on Sunday for those who were treated in PoKuNyoKwan. The institution in the end worked as a spot for spreading Christianity in Korea. As the first women's hospital, PoKuNyoKwan attempted to educate female doctors. Eventually, it played a role as a cradle to produce Esther K Pak, who was the first female doctor in Korea. The hospital also ran the first nurse training center. It was, in a real sense, the foundational institution to raise professional practitioner undertaking medical services in Korea. Therefore, it is reasonable to say that PoKuNyoKwan provided sound basis for the development of modem medical services for women in Korea.

In a clinic-based, cross-sectional study of 320 type 2 diabetic patients, we staged the level of diabetic nephropathy (normoalbuminuric, microalbuminuric and macroalbuminuric stage) and estimated GFR based on serum creatinine and cystatin C (CysC). Serum creatinine and CysC levels were 0.91+/-0.21 mg/dL and 0.87+/-0.26 mg/L, respectively. Correlation coefficients between CysC-GFR and each of the creatinine-based GFR measurements (MDRD-GFR, Cockcroft-Gault-GFR, and CLcr) were 0.589, 0.569, and 0.479 (p<0.001). Serum CysC was significantly lower in normoalbuminurics (0.83+/-0.22) than in microalbuminurics and macroalbuminurics (0.94+/-0.33 and 1.05+/-0.28; p=0.004 and p<0.001). Of the estimations of GFR, significant differences among the groups were found on CysC-GFR and CLcr. CysC-GFR (mL/min) was statistically lower in macroalbuminurics (79.5+/-30.5) than in normoalbuminurics (104.3+/-30.9, p=0.01). The logistic regression analyses showed that retinopathy, A1C, CysC, diabetic duration, and CysC-GFR were indicators to predict the development of microalbuminuria. Serum CysC seems to be more accurate serum marker than serum creatinine in evaluating a prognostic stage of type 2 diabetic nephropathy. Our study suggests that, in Korean type 2 diabetic patients, CysC-based GFR might be more valuable than creatinine-based GFR in the prediction of the microalbuminuric stage.

To investigate the characteristics of incidental pituitary microadenomas, we examined 120 pituitary glands from Korean forensic autopsy cases, from which eight tumors were identified (incidence 6.7%). The average age of the affected subjects was 50 yr (range: 33-96 yr) with a female predominance. The maximum diameters of the tumors ranged from 0.4 to 5.4 mm (mean: 2.8 mm). Immunohistochemical analysis of pituitary hormones revealed three growth hormone-secreting adenomas, one prolactin-producing adenoma, one gonadotropin-producing adenoma, one plurihormonal adenoma, and two null cell adenomas. MIB-1 staining for Ki-67 antigen showed no positive expression. The microvessel density (MVD) of the pituitary microadenomas ranged from 2.3 to 11.6% (mean: 5.3%) and was significantly lower than that of nonneoplastic pituitary glands (11.9-20.1%, mean: 14.8%). Our study provides reference data on incidental pituitary microadenomas in the Korean population.

A recent report of the Korean Intellectual Property Office (KIPO) showed that the number of biological sequence-based patents is rapidly increasing in Korea. We present biological features of Korean patented sequences though bioinformatic analysis. The analysis is divided into two steps. The first is an annotation step in which the patented sequences were annotated with the Reference Sequence (RefSeq) database. The second is an association step in which the patented sequences were linked to genes, diseases, pathway, and biological functions. We used Entrez Gene, Online Mendelian Inheritance in Man (OMIM), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Gene Ontology (GO) databases. Through the association analysis, we found that nearly 2.6% of human genes were associated with Korean patenting, compared to 20% of human genes in the U.S. patent. The association between the biological functions and the patented sequences indicated that genes whose products act as hormones on defense responses in the extra-cellular environments were the most highly targeted for patenting. The analysis data are available at http://www.patome.net.

Despite the documented health benefits of physical activity, the mechanism whereby physical activity prevents cardiovascular disease is incompletely understood. In the present study, we investigated the relationship between white blood cell (WBC) count and cardiorespiratory fitness (V o(2)max) after adjusting for several well-known cardiovascular risk factors. Subjects who visited our health promotion center for a medical checkup and treadmill test (n=8241; age: median, 48 years; range, 16-79 years) were classified into 3 groups based on their WBC counts (group 1, 2200-5300 microL, n=2823; group 2, 5301-6500 microL, n=2709; group 3, 6501-10000 microL, n=2709). After adjusting for age, body mass index, body fat percentage, smoking history, systolic blood pressure, diastolic blood pressure, serum lipid profile, and fasting plasma glucose, V o(2)max still showed a significant association with WBC count (partial r=-0.11, P<.001). In logistic regression analyses, subjects in the highest WBC tertile showed lower V o(2)max compared with those in the lowest WBC tertile after adjusting for age and cardiovascular risk factors (odds ratio, 0.42; 95% confidence interval, 0.36-0.49 for the highest V o(2)max tertile). These results suggest that a WBC count in the normal concentration range is independently related to cardiorespiratory fitness in Korean men.

Familial adenomatous polyposis (FAP) is a clinically well-defined hereditary disease caused by germline mutations in the adenomatous polyposis coli (APC) gene. FAP is characterized by polyposis in the large bowel and variable extracolonic manifestations. With an increase of reported APC germline mutations, many reports have investigated genotype-phenotype correlations in FAP patients. Here, we analyzed the APC gene for germline mutations in 83 unrelated Korean FAP patients and investigated genotype-phenotype correlations. We identified germline APC mutations in 59 (71%) of the cases, including 34 frameshift mutations, 19 nonsense mutations, and six splice site mutations. Among 59 patients with the identified germline mutation of the APC gene, 37 had been reported previously and were included in the genotype-phenotype analysis. In the other 22 patients, we identified seven novel mutations: c.1438C>T, c.2232&#95;2233dupCT, c.3426delT, c.3739&#95;3769del31, c.3931&#95;3935delATTGG, c.4332dupA, and c.4722&#95;4725delACTA. Desmoid tumors were identified in six of the examined FAP patients, five of whom had APC germline mutations; these mutations involved codons 849, 864, 1309, 1444 and 1464, respectively (c.2547&#95;2548delTA, c.2592&#95;2593insCT, c.3927&#95;3931delAAAGA, c.4332dupA and c.4391-4394delAGAG). Four of the included FAP patients had papillary thyroid cancers; all were female and had germline APC mutations (c.1863&#95;1865delTTAincCT, c.2805C>A, c.3183&#95;3187delACAAA and c.3927&#95;3931delAAAGA).

The new isoprenylated tetrahydroxyxanthone, 2,3,6,8-tetrahydroxy-1-(3-methylbut-2-enyl)-5-(2-methylbut-3-en-2-yl)-9H-xanthen-9-one (1), was isolated from the root bark of Cudrania tricuspidata together with macluraxanthone B (2) and cudraxanthone L (3), which were fully characterized by NMR spectroscopic and X-ray crystallographic analyses.