• Journal of Korean Medicine Rehabilitation
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• v.19 no.2
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• pp.125-156
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• 2009

Objectives : To research the trend of studies related to rheumatoid arthritis and to indicate the hereafter direction for its study in oriental medicine and its treatment. Methods : I reviewed 75 domestic oriental medical journals, and 50 medical journals about rheumatoid arthritis published after 2004, and comparative analysis was made. And these theses were classified by college, year, field of study, subject. Results : The following are the results of this study. 1. Classified by oriental medical college, Dae-jeon college published the most theses, followed by Dong-guk, Kyung-hee, Se-myung and Dong-shin college. Han-yang college published the most theses among college of medicine. 2. Classified by type of thesis, experimental theses(70 pieces, 94%) showed higher rate than that of clinical theses(4 pieces, 5%) in oriental medical studies. However, in medical studies, clinical theses(34 pieces, 68%) showed higher rate than that of experimental theses(15 pieces, 30%). 3. Analyzed by subject, the most dealt subject in oriental medicine was herb medication, followed by herbal acupuncture, single herb, electroacupuncture, sasang & gene, acupuncture & moxibustion, complex accordingly. The most dealt subject in medical clinical journals was standards of diagnosis & prognosis, followed by medication, gene analysis, pathogenesis, clinical pattern, operative treatment and complication accordingly. 4. In theses related to herb medication, most of the subject was to evaluate anti-inflammatory and immunoregulatory effects of herb medication with geopungseup, jibitong, hwalhyeolgeoer function. The tendency of experimental methods was focusing on understanding anti-inflammatory and immunoregulatory mechanisms through molecular biologic methods by analyzing cytokine and gene. 5. Most of theses related to herbal acupuncture were experimental studies verifying ant-inflammatory and immnoregulatory effects through methods observing change of cytokine and immunoregulatory factors. Regarding remedies for herbal acupuncture, Ulmus davidiana Planch was most preferred, followed by bee venom. 6. In theses related to single herb, Boik-yak was most prefered, followed by Geopungseup-yak and Hwalhyeolgeoer-yak. Regarding methods of research, there were tendency of shifting from methods verifying travail, anti-inflammatory and anti-pyretic effects through a test of behavior, morphometry, serology and temperature measurement of the rectum and the skin into verifying anti-inflammatory and immunoregulatory effects through observing inflammatory cytokine in the joint and cells of spleen. 7. In theses related to electroacupuncture, ST36 and adjuvant were most preferred as acupoints and induced factor. The tendency of experimental methods was turning from verifying mechanism of travail effect to analyzing inflammation and pain inducing factors. 8. Diverse medical clinical studies were published. Subjects such as diagnosis and prognosis, medication, gene analysis, clinical pattern, operational treatment, complication and pathogenesis were published. Especially, studies about standards of early diagnosis, and research on possible parallel medications with methotrexate were actively inquired. 9. Most of theses related to medical experimental studies was about mediators and receptors related to inflammatory induction and osteoclasia mechanism. Also, it was presented blockage of them can be effective on rheumatoid arthritis. Conclusions : The oriental medicine studies have merit in its diversity of treatment, but it clinical studies is lacking compared to experimental studies. Also, more diversity of subjects is necessary. Therefore, complementary measures are needed. Hereafter, oriental medicine research about rheumatoid arthritis needs more clinical research verifying the effectiveness and safety in clinical field. Also, we require oriental medical standard of diagnosis and researches on pathological generation which would make early checkup and prognosis possible.

• KDI Journal of Economic Policy
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• v.14 no.2
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• pp.55-75
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• 1992

At the outset of import liberalization, most economists expected a significant drop in the prices of domestic goods that faced foreign competition. However, it is now generally acknowledge that a significant drop in prices of those goods has not occurred. A common claim is that the prices did not drop significantly because the major importers of many imported goods were also the domestic producers of competing goods. The objective of this paper is to analyze the welfare effect of importation by domestic firms that produce competing goods, to identify the factors that facilitate such business practices, and to formulate a policy that could improve the welfare. We proved that importation by competing domestic firms definitely raises the prices of both imported and domestic goods compared to the situation where foreign goods are imported by non-producers, ceteris paribus. The intuition behind this result is that since a producer-importer is essentially a cartel, its overall profit maximization requires reduced competition between the products that it sells. On the other hand, if a producer-importer is more efficient at distrinbution than a simple importer, the comparison between the two cases is a priori indeterminate. We also find that the industries in which domestic producers are actively involved in importing competing goods are the ones in which the distribution channels are tightly controlled by importer-producers. This finding suggests that exclusive dealing contracts, which work as an entry barrier, may be the source of importing by domestic producers. We argue that in a country such as Korea, where financial market is highly incomplete, tight control of the distribution channels by oligopolistic manufacturers is likely to be an effective entry barrier that leads to importing by domestic producers of similar goods. We further argue that seemingly superior distribution costs of importer-producers is likely to be a result of market foreclosure which would disappear once the entry barrier of exclusive dealing contracts is removed. Above findings suggest that market imperfections are the source of importation by domestic competitors, which in turn constitutes a market imperfection in itself and reduces consumer welfare. As potential remedies, we considered three alternatives; direct price control by the government over the imported goods sold by major domestic producers, regulation of trade itself between major producers, and regulation of exclusive dealing contracts. For reasons both theoretical and pratical, we find that the last alternative is the most attrative. Prohibiting exclusive contracts between manufacturers and dealers in industries where exclusive dealing contracts are a significant entry barrier is expected to break up the importer-producer cartel and improve the welfare.

• Proceedings of the Ginseng society Conference
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• 1978.09a
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• pp.149-157
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• 1978

Ginseng is the English common name for the species in the genus Panax. This article gives a broad botanical review including the morphological characteristics, ecological amplitude, and the ethnobotanical aspect of the genus Panax. The species of Panax are adapted for life in rich loose soil of partially shaded forest floor with the deciduous trees such as linden, oak, maple, ash, alder, birch, beech, hickory, etc. forming the canopy. Like their associated trees, all ginsengs are deciduous. They require annual climatic changes, plenty of water in summer, and a period of dormancy in winter. The plant body of ginseng consists of an underground rhizome and an aerial shoot. The rhizome has a terminal bud, prominent leafscars and a fleshy root in some species. It is perennial. The aerial shoot is herbaceous and annual. It consists of a single slender stem with a whorl of digitately compound leaves and a terminal umbel bearing fleshy red fruits after flowering. The yearly cycle of death and renascence of the aerial shoot is a natural phenomenon in ginseng. The species of Panax occur in eastern North America and eastern Asia, including the eastern portion of the Himalayan region. Such a bicentric generic distributional pattern indicates a close floristic relationship of the eastern sides of two great continental masses in the northern hemisphere. It is well documented that genera with this type of disjunct distribution are of great antiquity. Many of them have fossil remains in Tertiary deposits. In this respect, the species of Panax may be regarded as living fossils. The distribution of the species, and the center of morphological diversification are explained with maps and other illustrations. Chemical constituents confirm the conclusion derived from morphological characters that eastern Asia is the center of species concentration of Panax. In eastern North America two species occur between longitude $70^{\circ}-97^{\circ}$ Wand latitude $34^{\circ}-47^{\circ}$ N. In eastern Asia the range of the genus extends from longitude $85^{\circ}$ E in Nepal to $140^{\circ}$ E in Japan, and from latitude $22^{\circ}$ N in the hills of Tonkin of North Vietnam to $48^{\circ}$ N in eastern Siberia. The species in eastern North America all have fleshy roots, and many of the species in eastern Asia have creeping stolons with enlarged nodes or stout horizontal rhizomes as storage organs in place of fleshy roots. People living in close harmony with nature in the homeland of various species of Panax have used the stout rhizomes or the fleshy roots of different wild forms of ginseng for medicine since time immemorial. Those who live in the center morphological diversity are specific both in the application of names for the identification of species in their communication and in the use of different roots as remedies to relieve pain, to cure diseases, or to correct physiological disorders. Now, natural resources of wild plants with medicinal virtue are extremely limited. In order to meet the market demand, three species have been intensively cultivated in limited areas. These species are American ginseng (P. quinquefolius) in northeastern United States, ginseng (P. ginseng) in northeastern Asia, particularly in Korea, and Sanchi (P. wangianus) in southwestern China, especially in Yunnan. At present hybridization and selection for better quality, higher yield, and more effective chemical contents have not received due attention in ginseng culture. Proper steps in this direction should be taken immediately, so that our generation may create a richer legacy to hand down to the future. Meanwhile, all wild plants of all species in all lands should be declared as endangered taxa, and they should be protected from further uprooting so that a. fuller gene pool may be conserved for the. genus Panax.

• Journal of the Korean Institute of Oriental Medical Informatics
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• v.14 no.1
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• pp.19-42
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• 2008

Blood-Letting Therapy is a rational and ecological medical treatment by which we can heal most of the diseases by removing the static blood which precipitates in the blood vessel and blocks the flowing of blood. And the static blood is the generic term for the injurious, bad, dead and precipitated blood which is blocked the capillary vessel. The Yellow Emperor's Canon of Internal Medicine says that "the patient is treated with drugs internally and stone acupuncture externally. "In the old texts, the blood-letting therapy is mentioned as blood-letting, network vessel pricking, bloodletting, pricking, and arousing pulses etc and it is noted down as the method of network vessel pricking in 'On the Application of Needles' of Spiritual Pivot. Nine-pricking therapy, twelve-pricking therapy and five-pricking therapy are recorded in the methods of network vessel pricking and among them, the method of squeezing blood after pricking the affected part is explained as the network vessel pricking. There are four methods of network vessel pricking, pricking, picking, cluster needling and scatter-pricking and they are fluidly applied to the various symptoms of diseases. In 'On Discriminative Treating for Patients of Different Regions' in Elementary Questions, Ki-baek emphasizes "most of the local people, there are black in skin and loose in striate, and their diseases are mostly of carbuncle kind. It is suitable to treat the disease with stone therapy to prick with stone, so the stone therapy is transmitted from the east. "And in 'On the Corresponding Relation Between the Eum and Yang of Man and All Things' in Elementary Questions, when the Emperor asked Ki-Back, he answered "sthenia means the sthenia of evil, and deficiency means the deficiency of healthy energy. When the blood is sthenic, the evil should be discharged by pricking when out letting the blood; deficiency of vital energy is the asthenia of channels and network vessels, so the energy should drain from the channel which is not deficient, to replenish. "And in this case we can use the methods of 'Breaking out the static bloods', 'driving out the static bloods', blood-letting'. With this we can infer that the blood-letting therapy is made use of the important medical treatments from the ancient times. Especially in referring to the principles of treatment in The Yellow Emperor's Canon of Internal Medicine, it mostly alluded to acupuncture therapies and only eleven times to medicinal treatments. This is to verify that the blood-letting therapy formed the foundation of the medical art. In Dong's Therapy of Acupuncture-Moxibustion and Bloodletting, Dong Kyeong-Chang gave emphasis on the points that there must be extravasated bloods without exception in the serious illnesses which is old, unnatural, accompanying acute pains and so we can revive our body‘s sprit by circulating 'gi' and static blood piled up in the network vessel, regulating the weakness and strength, and controling the disharmony of the internal organs. The blood-letting therapy has effect on the orifice in emergency, such as fore draining, freeing network vessels, harmonizing gi and blood, relieving pain, dispersing swelling and concretion, sedation, resolving toxin as well as strengthening the heart, relieving itching. So it has distinguished effect on all kinds of medical treatment to the modern people. But by the change of social customs and the confucianism of confucius - it is widely spread on the period of North and South Dynasties, 'Wi' and 'Jin' in china and the period of the Three States in korea - The blood-letting therapy which was regarded as the most important medicinal treatment withered rapidly. And Confucius accentuated the importance of our body and all its members, loyalty and filial piety and banned any damage of our body under no circumstances. As a result of it, the therapy of blood-letting had a rapid decrease and barely kept itself in existence in both countries. What is worse, at the period of Japanese colonial rule of korea and our nation's founding of early stage, it has been withered by the high-handed policy to change Oriental Medicine into modern medical science. So the therapy of blood-letting barely kept itself in existence in some Buddhist temples. Another case, it has handed down as a old-fashioned quick fix in folk remedies. But all kinds of the contamination of heavy metals and the misuses of antibiotics are widely spread nowadays, which increased diseases of adult people and incurable diseases as modern society unavoidably made its way into a highly industrial society. To make us more miserable, the western medical science - the antibiotics and surgical operation medical science - already reveals itself into a limit. The necessity of a new medical science which can give a security to the patients who are suffering from the diseases of adult people and the incurable diseases is especially come into the force nowadays. In view of the results after bibliographically studying on the blood-letting Therapy in Elementary Questions of the Yellow Emperor's Canon of Internal Medicine, the blood-letting therapy has acted for the important Oriental medicinal science and has been clarified the prominent effects on the diseases of adult people and the incurable diseases. So it is regarded as an appropriate thing that we lay out a determined theory of the blood-letting therapy and of course prevent the unwanted side effects from inappropriate medicinal treatments, and make full use of clinic by elevating the curative value and that we win back our self-respect of medical treatment which is dominated from the western medical science and ultimately contribute to national medical welfare.

• The Korean Society of Law and Medicine
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• v.19 no.2
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• pp.139-171
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• 2018

The 「Act on Remedies for Injuries from Medical Malpractice and Mediation of Medical Disputes」(hereinafter referred to as 'the Act on Mediation of Medical Disputes') provides that the state should compensate the victims of medical accidents occurred irresistibly in childbirth despite that health and medical service personnel fulfilled their duty of care for their damage within the range of its budget(Article 46 of the Act on Mediation of Medical Disputes). Given that victims of medical accidents could expect demage recovery only through lawsuits thus far, this act can be said to be a groundbreaking act. However, However, as 30% of the costs for such medical accident compensation projects are borne by those who have records of childbirth among the founders of health and medical institutions (Article 21 of the Act on Mediation of Medical Disputes), there has been a question about whether doctors are held responsible despite that the accidents such as the deaths of mothers and newborn babies occurred irresistibly without doctors' fault. However, recently, the Constitutional Court ruled that 'the range of founders of health and medical institutions' and 'share ratios of finances for compensation' in Article 46 (3) of the Act on Mediation of Medical Disputes' related to the imposition of the share of costs are institutional (Constitutional Court ruling dated April 26, 2018, 2015Heonga13, hereinafter referred to as 'the ruling in the case'). Although the ruling in the case was made based on only the principle of statutory reservation and the principle of ban on comprehensive authorization, this paper added a practical judgment. This paper proved that the share of costs in this case has the nature of burden charges in pursuit of study and does not infringe on the property rights of the founders of health medical institutions even in light of the principle of proportionality because there is a legitimate reason for imposing the burden charge. The imposition of the share of costs in the system for compensation for medical accidents occurred irresistibly is against the principle of liability with fault in part. However, the medical accident compensation projects are rational a national policy for the victims of medical accidents and the medical world clearly gains some benefits from the effect to terminate medical disputes. The expansion of finances for compensation through the payments of the share of costs will reduce the suffering and misunderstanding of victims of medical accidents occurred in the process of childbirth and will be very helpful to the construction of stable treatment environments of medical workers by quickly establishing the medical accident compensation projects as such.

• Journal of Legislation Research
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• no.44
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• pp.757-799
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• 2013

Ever since Korea and Vietnam reestablished diplomatic relations, the two countries'bond has become stronger than ever, augmenting the range of exchange between them in almost every possible field including politics, economy, society, and culture at such a high speed. Among many, an increase in number of Vietnamese immigrant women in international marriage is worthy of close attention. Since 2010, Vietnamese has topped the proportion of total foreign women married to Korean men, having surpassed Chinese. Nonetheless, the quick international marriage between Korean men and Vietnamese women, which usually happens without sufficient time to get to know about different cultures and languages, has not only raised problems for people concerned, but numerous social issues as well. Recognizing these problems, a number of government departments have provided various support on policies and legal issues toprotect multicultural families as a means of social integration and settlement support. Nevertheless, the support policies until now have been generalizing all of the immigrant women in international marriage as people subject to protection. Thus, considering every immigrant women as people in need, and trying to help them with various social issues have caused the government a high cost and low efficiency. This thesis emphasizes the point that through the cases of Vietnamese immigrant women in international marriage, there should be a specific support plan for specific people in need, reflecting various traits of different cultures and societies, in order to ease their settlement in Korea. Moreover, it suggests detailed plans for improvements on legal and institutional problems. Although the Vietnamese government forbids commercial agents for international marriage, many of agencies are still active and to help the immigrant women, who desire to return and resettle in Vietnam in case of divorce, this thesis suggests legal and institutional remedies for Korean and Vietnamese government. The composition of the thesis follows below: Part II on social and cultural traits of international marriage between Korean men and Vietnamese women. Part III on institutional problems and plans for improvements regarding settlement of immigrant women in international marriage. Part IV on legal and institutional problems and plans for improvements regarding divorced immigrant women and their return to Vietnam. Part V on conclusion. Divorce is not a flaw anymore nowadays, but in case of Vietnamese immigrant women ininternational marriage, an inadequate legal system hampers their resettlement process. Cases of not being ableto remove their own names from the family register due to poor financial and legal abilities are often identified and it is both the Vietnamese and Korean governments'duty to acquit their ethical responsibilities by seeking ways to institutionally and financially support them.

• Journal of Legislation Research
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• no.41
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• pp.401-434
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• 2011

The discussion on the adoption of the horizontal regulatory framework is underway to overcome the problems regarding the vertical regulatory framework resulting from a convergence of broadcasting and telecommunications services. Recently, however, the horizontal regulatory framework shows its limitation to regulate the ecosystem established mainly by Google and Apple. The existing horizontal regulatory framework does not fully reflect the characteristics of the two-sided market and the change in the competition structure in the broadcasting and telecommunications sector. What is important to note is that if the existing horizontal regulatory framework is simply applied to the ecosystem, a regulatory imbalance can be caused among ecosystems. The existing horizontal regulatory framework, which is subject to a value chain structure, categorizes business entities into either contents layer or transmission layer and applies the same regulation to all business entities in the same category. However, in the ecosystem, a keystone-player can be categorized into different layers depending on its strategy. Therefore, if the existing horizontal regulatory framework is applied as it is, the regulatory imbalance between keystone-players located in less regulated areas and keystone-players located in more regulated areas occurs resulting in a distortion of competition. There are two possible ways to establish a new regulatory framework to prevent the distortion of competition likely to be caused by the adoption of a horizontal regulatory system. First, a new ecosystem regulatory framework different from the existing one can be established. Second, the horizontal regulatory framework can be modified to reflect the ecosystem elements. The first approach is hard to adopt given the current situation as the approach requires the analysis of all broadcasting and telecommunications ecosystems including mobile and wired services; currently research and study on the competition conditions in the ecosystems is not enough. Therefore, this paper supports the second approach proposing a modified horizontal regulatory framework through the improvement of institutions and remedies suitable for accommodating the ecosystem elements. This paper intends to propose a way to regulate broadcasting and telecommunications ecosystems taking into consideration the ecosystem elements on top of the Telecommunications Business Act, Broadcasting Act, IPTV Act, the competition condition evaluation system of the Basic Act on Broadcasting and Telecommunications Development, and regulation on common carriers under the Telecommunications Business Act.

• The Korean Society of Law and Medicine
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• v.24 no.3
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• pp.59-104
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• 2023

This essay attempts to analyze the public health welfare conception within the text of the Beveridge Report and its realization via the NHS in Great Britain. Once referring to the influence of the Report to create the foundations of the 20th-century welfare system, the quest to scrutinize the original intentions of the Report and its succession to the NHS is certainly intriguing. Furthermore, when regarding the significance of public health policy for a modern state, the effort to engage in Beveridge's conception and its realization is more than timely. In light of such a premise, this paper indulges in its study by the following methods. First, the historical background of the Report - namely, the role of the spirit of the age and the experience of the Emergency Medical Service are to be analyzed to identify the origins of the welfare policies proposed by Beveridge. Furthermore, the public health welfare conception of the Report conceived from its time is reflected upon by engaging on the goal towards social welfare and public health scheme. Lastly, the aims of the NHS and its management, treatment classification, and rehabilitation program are reviewed for comparative analysis with the Report to survey the realization of Beveridge's design. In this process, this paper not only takes into account the original text of the Report - but also other essential works of law and public policy, including the NHS Constitution for England and the National Health Service Act of 1946. The intentions of this study are not bound by merely coinciding with the Report, but resonate significance via reflecting upon the Beveridgian legacy on the modern welfare state from the current perspective. The structured analysis to research the aims and policies of the Report and to compare them to the reality of the NHS may provide an opportunity to confirm the realization of Beveridge's scheme in British society. In addition, this essay is part of an academic endeavor to critically assess the past and the present of the welfare institution in the public health sector. As such, it is hopeful that the essay sheds light on further studies concerning the constructive remedies of the Korean welfare system as well.

• Journal of agricultural medicine and community health
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• v.1 no.1
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• pp.5-9
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• 1976

The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.

• Childhood Kidney Diseases
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• v.5 no.1
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• pp.51-58
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• 2001

Purpose : Treatment of primary nocturnal enuresis (PNE) includs folk remedies and various treatments based on pathogenesis. We assessed the therapeutic effect of nocturnal water restrict ion as the primary treatment of PNE. Materials and methods : From October 1998 to June 1999, 41 children with PNE (>3 wet nights per week) who visited Ewha Womans University Mokdong hospital and who had good compliances to nocturnal water restriction for 2 months were included. Before and during nocturnal water restriction, daily fluid intake and urine volume were recorded for 2 days every 2 weeks. Responses to nocturnal water restriction were classified according to the decrease of wet nights as complete (>90$\%$), partial (50-90$\%$) and no (<50$\%$) response. Predictors such as age, sex, daytime voiding dysfunction, fluid intake, urine volume, maximum urine volume per void and fasting urine osmolality were evaluated. Results . The response rate to nocturnal water restriction fir 2 month was 82.9$\%$(34/41) [complete response 39.0$\%$(16/41), partial response : 43.9$\%$(18/41)]. The response rate to nocturnal water restriction was significantly higher in monosymptomatic PNE than polysymptomatic PNE and more effective in PNE with or nocturnal fluid intake, nocturnal urine volume, and maximum urine volume than lower nocturnal fluid intake, nocturnal urine volume and maximum urine volume per void (P<0.05). Nocturnal urine volume, maximum urine volume per void and luting urine osmolality after nocturnal water restriction has significantly increased higher in complete response and partial response group than in no response group (P<0.05). Conclusion : The nocturnal water restriction was effective in monosymptomatic PNE with nocturnal polydypsia, nocturnal polyuria and high bladder capacity. (J, Korean Soc Pediatr Nephrol 5 : 51- 8, 2001)