The exchange of medicine with Japan during the Koryo Dynasty era and its characteristics -A case of ‘East Asian Medicine’- / 의사학

In this article, I reviewed the exchange of medicine between the Koryo Dynasty and Japan during the Koryo Dynasty. Compared to the exchange of medicine during the Three Kingdoms or the early Joseon Dynasty, medicine between Korea and Japan was loosely affected each other during the Koryo Dynasty. This characteristic of medical history with Japan during the Koryo Dynasty corresponded to the overall low density of exchanges between the two countries.In this paper, the exchange of medicine during the entire Koryo period was divided into 4 periods, and medical records in Korea and Japan were discussed in terms of medical personnel, medical knowledge, and pharmaceutical materials. During the Koryo Dynasty, Korea was interested in Japan’s medical personnel and pharmaceutical materials, and Japan was interested in Korea’s medical knowledge and pharmaceutical materials.When limited to the Koryo Dynasty, it is difficult to determine the superiority or inferiority of pharmaceutical materials, medical personnel, and medical knowledge between Korea and Japan. Without frequent contact to compare the level of medical care, each country only accepted the other country’s medical care within the necessary range. This means that the exchange of medicine between Koryo and Japan did not flow only in one direction.In addition, I proposed to understand the pre-modern East Asian world, including Korea-Japan relations, by using the concept of political bodies instead of the concept of state. In other words, it is necessary to call the subject of action that independently judges and executes foreign relations while maintaining a high degree of autonomy in decision-making as ‘political bodies’, and utilizes this concept to interpret the pre-modern East Asian world complexly. The concept of political bodies is also useful for understanding the exchange of medicine among the three East Asian countries.

The Character and Meaning of the Reorganization of the Medical Institutions in the Early Chosun Dynasty / 의사학

In this article, I first explored the process and its characteristics of the reorganization of the medical institution in the early Chosun Dynasty. In the early Chosun Dynasty, medical institutions of Naeuiwon(內 醫院), Jeonuigam(典醫監), Hyeminseo(惠民署), Hwalinseo(活人署), Jesaengwon(濟生院) were operated. From the examining the history, members, and roles of these institutions, it can be said that Chosun was aimed at Minbon Thought(For the people) of Neo-Confucianism and a one-sided centralized system.To understand the meaning of the change process of these medical institutions, we should pay attention to the social structure and ruling ideology of the late Koryo period. In other words, the autonomy and publicness of the people expanded in the land system of Koryo, while on the other hand, it became important to overcome the inefficiency of Buddhism, which was a dominant ideology. The movement to reflect the strengthened status of the people into the public national system by taking the Neo-Confucianism as the dominant ideology has been strengthened, and the medical rights of all the people have been guaranteed.But it did not mean that the Minbon Thought(For the people) of NeoConfucianism put the people first. The reason why the medical institution was organized in the order of Naeuiwon(內醫院) → Jeonuigam(典醫監) → Hyeminseo(惠民署) → Hwalinseo(活人署) was because the theory of essence and end(本末論) of Neo-Confucianism was projected. At the same time, this hierarchical structure was also coincided with the statusclass structure of Chosun, which peaked at the royal family as the highest ruling class. For this reason, the status of the medical institutions for the people, Hyeminseo(惠民署) and Hwalinseo(活人署) was low.

Effect of different grinding burs on the physical properties of zirconia

PURPOSE: Grinding with less stress on 3Y-TZP through proper selection of methods and instruments can lead to a long-term success of prosthesis. The purpose of this study was to compare the phase transformation and physical properties after zirconia surface grinding with 3 different grinding burs. MATERIALS AND METHODS: Forty disc-shaped zirconia specimens were fabricated. Each Ten specimens were ground with AllCeramic SuperMax (NTI, Kahla, Germany), Dura-Green DIA (Shofu Inc., Kyoto, Japan), and Dura-Green (Shofu Inc., Kyoto, Japan). Ten specimens were not ground and used as a control group. After the specimen grinding, XRD analysis, surface roughness test, FE-SEM imaging, and biaxial flexural strength test were performed. RESULTS: After surface grinding, small amount of monoclinic phase in all experimental groups was observed. The phase change was higher in specimens, which were ground with Dura-Green DIA and AllCeramic SuperMax burs. The roughness of surfaces increased in specimens, which were ground with Dura-Green DIA and AllCeramic SuperMax burs than control groups and ground with Dura-Green. All experimental groups showed lower flexural strength than control group, but there was no statistically significant difference between control group and ground with Dura-Green DIA and AllCeramic SuperMax burs. The specimens, which were ground with Dura- Green showed the lowest strength. CONCLUSION: The use of dedicated zirconia-specific grinding burs such as Dura-Green DIA and AllCeramic SuperMax burs decreases the grinding time and did not significantly affect the flexural strength of zirconia, and therefore, they may be recommended. However, a fine polishing process should be accompanied to reduce the surface roughness after grinding.

Clinical Course of Intestinal Behcet's Disease according to the Characteristics of Ulcer in Colonoscopy

BACKGROUND/AIMS: Intestinal involvement with bleeding and perforation is one of the main causes of morbidity and mortality in patients with Behcet's disease (BD); however, the clinical course of intestinal BD has not been defined. The aim of this study was to determine the clinical course of intestinal BD based on the characteristics of ulcers visualized during colonoscopy. METHODS: We retrospectively reviewed the medical records and colonoscopic findings of 41 patients with intestinal BD. All patients were classified into subgroups according to ulcer depth, size, and number, and we analyzed the clinical manifestations, subset type of BD, medications, surgical procedures, and relapse rate among the subgroups. RESULTS: The median age at the time of diagnosis was 38 years (range, 18-74 years); 25 patients were females (M:F=1:1.56). Abdominal pain (n=40), diarrhea (n=27), and RLQ tenderness (n=21) were common symptoms. The number of complete, incomplete, and suspected types was 3, 17, and 21, respectively. In an analysis according to ulcer depth, the rate of steroid use and intestinal surgeries was more frequent in the deep ulcer group compared with the aphthous and shallow ulcer groups (50.0% vs. 0% vs. 17.6%; P=0.012; 42.9% vs. 0% vs. 23.5%: P=0.013) The rate of steroid use and relapse tended to be higher as the size of the ulcer increased; however, there was no difference in the rates of steroid use, surgeries, and relapse based on the number of intestinal ulcers. CONCLUSIONS: The prognosis was worse in patients with intestinal BD who have deeper and larger ulcers. Therefore, we suggest that such patients need to be treated aggressively.

Clinical Course of Intestinal Behcet's Disease according to the Characteristics of Ulcer in Colonoscopy

BACKGROUND/AIMS: Intestinal involvement with bleeding and perforation is one of the main causes of morbidity and mortality in patients with Behcet's disease (BD); however, the clinical course of intestinal BD has not been defined. The aim of this study was to determine the clinical course of intestinal BD based on the characteristics of ulcers visualized during colonoscopy. METHODS: We retrospectively reviewed the medical records and colonoscopic findings of 41 patients with intestinal BD. All patients were classified into subgroups according to ulcer depth, size, and number, and we analyzed the clinical manifestations, subset type of BD, medications, surgical procedures, and relapse rate among the subgroups. RESULTS: The median age at the time of diagnosis was 38 years (range, 18-74 years); 25 patients were females (M:F=1:1.56). Abdominal pain (n=40), diarrhea (n=27), and RLQ tenderness (n=21) were common symptoms. The number of complete, incomplete, and suspected types was 3, 17, and 21, respectively. In an analysis according to ulcer depth, the rate of steroid use and intestinal surgeries was more frequent in the deep ulcer group compared with the aphthous and shallow ulcer groups (50.0% vs. 0% vs. 17.6%; P=0.012; 42.9% vs. 0% vs. 23.5%: P=0.013) The rate of steroid use and relapse tended to be higher as the size of the ulcer increased; however, there was no difference in the rates of steroid use, surgeries, and relapse based on the number of intestinal ulcers. CONCLUSIONS: The prognosis was worse in patients with intestinal BD who have deeper and larger ulcers. Therefore, we suggest that such patients need to be treated aggressively.

A Case of Jejunogastric Intussusception that was Diagnosed by Gastroscopy in a Patient who had Undergone Subtotal Gastrectomy / 대한소화기내시경학회지

Jejunogastric intussusception is a rare, but potentially lethal complication after gastrectomy or gastrojejunostomy. In the acute condition, early diagnosis and prompt surgical treatment are mandatory to reduce the incidence of mortality. We present here a case of jejunogastric intussusception that was diagnosed by gastroscopy in a patient with a history of subtotal gastrectomy, and she had experienced increasing epigastric pain and vomiting for 1 day.

A Case of an Eosinophilic Granuloma Mimicking a Submucosal Tumor in the Ascending Colon Probably Caused by Anisakis / 대한소화기내시경학회지

Anisakiasis in the gastrointestinal tract is caused by the ingestion of raw marine fish that contain Anisakis lavae. In rare cases, Anisakiasis is found as an eosinophilic granuloma that mimics a submucosal tumor. The diagnosis is usually made after surgical resection. Several cases of gastric anisakiasis imitating a submucosal lesion have been reported. However, colonic anisakiasis forming a submucosal lesion is very rare and only a few cases have been reported. All of the cases were confirmed after surgery. Recently, we encountered a male patient with a submucosal lesion on the ascending colon during a health screening. Several biopsies were performed on the same site as the lesion. The pathological finding was eosinophilic granuloma. We tentatively diagnosed the patient with eosinophilic granuloma due to Anisakis as the patient consumed raw seafood and eosinophilia was detected on a laboratory test. We decided not to perform any procedure. One month later, the eosinophilic granuloma disappeared as seen on a follow-up colonoscopy.

Prevalence of diabetes mellitus in the elderly of Namwon county, South Korea / 대한내과학회지

BACKGROUND: Significant ethnic and geographic differences exist in the prevalence of diabetes mellitus, which has increased dramatically in South Korea. But a few population-based studies were performed in South Korea. The purpose of this study was to determine the prevalence of diabetes mellitus, impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) by the World Health Organization (WHO) and the American Diabetic Association (ADA) diagnostic categories, and to investigate their associated risk factors. METHODS: Between march 22, 1999 and July 14, 1999, a random sampling of 1445 residents over 40 year of age in five villages in the Namwon county of South Korea was carried out. Among these subjects, 665 (46.0%) participants completed 75 g OGTT. WHO and ADA diagnostic criteria were used for the diagnosis of diabetes mellitus, IGT and IFG. Detailed questionnaire were performed and anthropometric data were collected. RESULTS: After age-adjustment for population projection for Korea (1999), the prevalence of diabetes and IGT were 13.7% and 13.8% with WHO criteria, while the prevalence of diabetes, IGT and IFG were 15.8%, 12.8% and 5.7% with ADA criteria. The age-adjusted prevalence of previously diagnosed diabetes was 5.8%. The level of agreement between WHO and ADA diagnostic criteria except IFG was high (K=0.94; p<0.001). The ROC curve analysis determined FSG of 114.5 mg/dL (6.4 mmol/L) to yield optimal sensitivity and specificity corresponding to a PP2SG 200 mg/dL (11.1 mmol/L). The prevalence of diabetes and IGT with ADA diagnostic criteria rose with increasing age (p<0.05). The difference in the prevalence of diabetes, IGT and IFG by BMI was not significant. The prevalence of diabetes rose with increase in the waist-hip ratio. The prevalence of diabetes was increased in subjects with dyslipidemia (Odds ratio 2.29, 95% CI: 1.16-3.49). CONCLUSION: The age-adjusted prevalence of Diabetes Mellitus in populations over 40 year of age in the Namwon county was substantially higher than previously observed. Ethnic differences in obesity with BMI and in the effect on diabetes risk of obesity may exist in the Korean population. The adequate cut-off point for fasting serum glucose was lower than that by the ADA diagnostic category. These results may show that not only fasting serum glucose but also postprandial 2-h serum glucose are important for diagnosing diabetes in Korean.

The effect of patient education on correct use of metered dose inhalers in patients with asthma / 천식및알레르기

BACKGROUND: Medications for asthma can be administered either by inhaled or systemic routes. The major advantages of delivering drugs directly into the lungs via inhalation are that higher concentrations can be delivered more effectively to the airways and that systemic side effects are avoided or minimized. Inhaled medications, or aerosols, are available in a variety of devices that differ in required technique and quantity of drugs delivered to the lung. OBJECTIVE: The purpose of this study was to determine the effects of patient education on correct use of metered dose inhaler in patients with asthma. METHODS: Twenty patients with asthma were instructed three times on proper inhaler usage by a physician at two-week intervals. Practical performance and theoretical knowledge were assessed (ten-item assessment). Scoring was done by one physician using a score of 1-3 for each item. RESULTS: The practical performance and theoretical knowledge scores were higher in patients after being instructed three times compared with those who were instructed once (26.2+/-2.2 vs 18.1+/-3.6, p< 0.01). The scores were higher in patients with higher education level com- pared with those with lower education level after three lessons (27.3+/-1.94 vs 24.3+/-1.80, p< 0.05). The most common errors included inadequate actuation time and breath holding, and insufficient activations. CONCLUSION: These findings suggest that patients with asthma be instructed in inhaler use and that their technique be checked regularly and repeatedly depending on education level.

A Case of Bacillus Cereus Infection with Pneumonia and Bactermia / 결핵

Bacillus species are aerobic, gram-positive, spore forming rods that are widely distributed in soil, dust, stream, and other environmental sources and are regarded as natural organism. But certain species of the genus Bacillus, most notably B.cereus, which is associated with food-borne illness, occasionally have been implicated in the occurrence of fatal illness and complication in a compromised host. We roport a case of pneumonia and bacteremia caused by B.cereus in an 81 year-old man, who had no obvious immunologic compromise. The condition was treated with combination of roxithromycin and gentamicin.

A Clinical Analysis of an Esophageal Hiatal Hernia and Reflux Esophagitis - The relationship with weight, alcohol, smoking, coffee, H. pylori infection / 대한소화기내시경학회지

BACKGROUND AND AIMS: The importance of esophageal hiatal hernias in the pathogenesis of gastroesophageal reflux disease has been debated. It has been reported that a variety of factors are associated with hiatal hernias and esophagitis. The purpose of this study was to determine the correlation between hiatal hernia, reflux esophagitis and weight, alcohol, smoking, coffee and H. pylori infection. METHODS: 660 consecutive patients who had undergone an esophagogastroduodenoscopy due to upper gastrointestinal symptoms were reviewed. A diagnosis of hital hernia was made when the distance between the diaphragmatic crus and the tubular esophagus exceeded 1.5 cm, and the presence of a hernia sac at the U turn of the scope. RESULTS: Among the 660 cases, 71 cases (10.8%) of hiatal hernia and 30 cases (4.5%) of reflux esophagitis were noted. The male-to-female ratio was 1.6:1 and 4.3:1, respectively. The most common age group involved the fifth decade and sixth decade. Reflux esophagitis was found in 13 (18.3%) of 71 patients with hiatal hernias. Hiatal hernias were found in 36 (17.9%) of 201 patients who were overweight (BMI>23) and in 43 (23%) of 187 patients who were smokers. Reflux esophagitis was found in 23 (11.9%) of 194 patients who were alcohol drinkers and in 21 (11.2%) of 187 patients who were smokers. H. pylori infection was present in 36 (50.7%) of 71 patients with hiatal hernias, and 17 (56.2%) of 30 patients with reflux esophagitis. CONCLUSIONS: The rate of the hiatal hernia was significantly higher in patients who were overweight and smokers. The rate of reflux esophagitis was significantly higher in patients who were alcohol drinkers and smokers. But in multivariate analysis, none were risk factors associated with hiatal hernias or reflux esophagitis.

Neurovascular injuries in supracondylar fractures of the humerus in children / 대한정형외과학회잡지

No abstract available.