Objectives : The aim of this study is to analyze satisfaction with clinical training in the department of oriental rehabilitation medicine and the related factors. Methods : All the students in the graduating class of school of Korean Medicine, Pusan National University must be trained for 2 weeks in the department of oriental rehabilitation medicine according to clinical training guideline including Objective Structured Clinical Examination(OSCE) and Clinical Performance Examination (CPX). After completing clinical training, we distributed questionaries to them about a reflex of the object of study, usefulness, difficulty, satisfaction and preference. And then, we analyzed the related factors including descriptive statistics, frequency analysis and correlation analysis by SPSS 18.0. Results : In general, a reflex of the aim of study($7.88{\pm}1.31$), satisfaction with contents($8.17{\pm}1.20$) and difficulty($5.53{\pm}0.99$) were evaluated respectively. The better a reflex of the aim of study is, the higher satisfaction with contents is(P<0.01, r=0.836). Chuna was highly estimated, whereas pharmacopuncture was not. In OSCE, a reflex of the aim of study($8.07{\pm}1.07$) and usefulness($8.13{\pm}1.16$) were highly evaluated. The preference for physical examination of the lumbar spine was highly estimated, whereas applying splint was not. Facilities and equipment($7.88{\pm}1.11$), contents of clinical training($7.25{\pm}1.79$), the handout($7.00{\pm}1.59$) and time scheduling($5.48{\pm}1.71$) were evaluated respectively in general composition of clinical training. There is no difference related to specialty, sex and age among students. Conclusions : Clinical training program in the department of oriental rehabilitation medicine can be highly estimated from the viewpoint of difficulty and satisfaction.

Objectives : This study was to analyse the reasons for the early termination of our clinical trials that were to know the influences of Tai-chi on non-motor symptoms of Parkinson's disease. Methods : We stopped the primary study of Tai-chi to observe the changes of non-motor symptoms of Parkinson's disease. So we carried out the survey to our participants of clinical trials. We conducted the survey about the patient's characteristics of usual exercise, experience of Tai-chi, appropriate time allocation, difficulties of proceeding the program and patient's opinion for the improvement of education. And the 4 questions about the contributiveness of Tai-chi for the Parkinson's disease, usability of supplied references, difficulties and time allocation of education were using the questionaries form of 5-point scale(Likert scale). Results : The results of survey showed that the benefits of Tai-chi program for the improvement of symptoms was $3.15{\pm}0.89$ and difficulty of lecture was $3.76{\pm}1.09$. 41% of participants answered that the motions of the Tai-chi is difficult to follow and 17% of participants felt the imbalance during the motion of Tai-chi. Conclusions : Participants replied that the Tai-chi is hard for the patients of Parkinson's disease and the time for the education was too short to keep doing exercise. Thus we have plan to educate the patients of Parkinson's disease with Tai-chi program consists of easier motion by developing ourselves or searching previous studies.

Objectives : This work is aimed to reveal the relations between concepts of subhealth(mibyung) and Korean medicine patterns. Methods : We carried out a literature searching on Oasis, RISS, DBpia, Pubmed to summarize concepts of Mibyung. CNKI Searching also was performed with keyword related to mibyung(未病), subhealth(亞健康) and syndrome. Results : Korea, China and Japan have different concepts of mibyung. China's mibyung concept is relatively broader and wide which includes healthy, subhealth, development of disease and recurrence avoid. In contrast, Korea and Japan's mibyung concepts are focused on China's subhealth. Though Mibyung's patterns are varied widely depends on studies, China's studies of subhealth and TCM patterns showed that Deficiency patterns are diagnosed at high frequency in clinical study and literature study. Conclusions : This work could contribute to further study of subhealth(mibyung) and their relations to patterns, diagnostic methods and treatment efficacy.

Objectives : This study aimed to analyze the trend of financial balance of Korean medicine clinics during 20 years, and to provide basic information for adjusting the fee schedule of Korean medicine procedures in national health insurance(NHI). Methods : We collected 6 financial analysis reports for Korean medicine clinics from the Association of Korean Oriental Medicine(AKOM). The data on incomes, costs and EBIT(earning before interests and taxes) of subject clinics were abstracted, and their long-term trends were evaluated. Results : The proportion of insurance income in total income increased from 23% to 56% during 20 years. Among 5 treatment groups, 'non-insurance medication' took up 65~67% of total incomes in 1997, but its proportion decreased to 42.4% in 2007. 'medical procedure, physical therapy and others' increased from 12.4% in 1987 to 29.2% in 2007. The labor cost was major part of total cost and its proportion maintained from 52% to 54%. Cost of 'non-insurance medication' was on the decline from 41% in 1996 to 31.6% in 2007. EBIT were -17.4 million won in 1996, and 18.4 million won in 2007. Conclusions : Financial balance of Korean medicine clinics improved until early 2000, but it became worse in 2007. Though deficits from NHI procedures has been covered up by profit from 'non-insurance medication', health insurance became a major source of income during last two decades.

Objectives : This study aimed to analyze the fundamentals of a Korea-China FTA and suggest strategies for Korean medicine market that correspond with each scenario selected from foreseen circumstances after the conclusion of the FTA through the scenario planning, which is one of management techniques. Methods : Four scenarios have been established by means of key questions : the scope of FTA, health care policies, and the combination of western medicine(WM) and Korean medicine(KM). Each scenario is defined as the Maximized Competitive Market, Neutral Market, General Completive Market, and Conservative Market. This study suggests brand marketing, extending of health insurance coverage, launching local network, and strategy for Korean medicine based health promotion programs. Results and Conclusions : Although Korean medicine could be prompted by the trade policies between countries, related studies are very limited. Therefore, more research is needed to suggest the detailed strategies for change of Korean medicine market through various strategic analysis tools.

Objective : This study aimed to analyze the utilization of Korean Medicine clinics, and high-frequent diseases by sex, age, and region of outpatients and inpatients Methods : The data for this study were "Report on Usage Patterns of Korean Medicine Clinics" issued by the Ministry of Health and Welfare in 2008. Descriptive analysis and correspondence analysis were used to find the patterns of patient's utilization by sex, age and region Results : Diagnosis and examination methods mostly consisted of the pulse for diagnosis. Treatment methods consisted of acupuncture, medical herbs in package, and insurance extract powder. Fee for consultation was paid by Korean Medicine insurance. Usage increased when people's age was over 20 and climaxed among people who were in their 40s and 50s and decreased gradually afterwards. Also, there were differences between the sexes. There were differences in high-frequent diseases by regions, and in usage of Korean Medicine clinics according to sex and age. Conclusion : It was found that there were differences in usage and patterns of Korean Medicine Clinics according to sex, age, and region.

Objectives : This study aimed to investigate the use and patterns of health care resources of local patients and to analyze the health seeking behaviors focusing on shopping around phenomenon. Methods : Questionnaires on the use of health institution were developed and administered to the residents in Yangsan city, Korea. We selected patients who were suffering from any diseases two months and over. Patients' health seeking behaviors were categorized, and the factors for selecting health institutions in each visiting stages were analyzed. Results : 139 local patients participated in the survey, and 130 completed questionnaires were analyzed. We found that there were sixty eight different types of medical utilization paths. The most frequent path was 'western clinics ${\rightarrow}$ Korean medicine hospitals or clinics ${\rightarrow}$ western clinics'. Only 6 patients started at Korean medicine, however, 16 patients(12.3%) finalized their treatment at Korean medicine hospitals or clinics. In most health seeking stages, patients tended to select health resources by their own decisions, and the geographic factor was the key reason to select health resources. Conclusions : Patients had not any stable forms to treat with their diseases, and we observed diversified patterns in the health seeking behaviors of patients, a typical shopping around phenomenon.

Objective : The water extract of Danguiyonghoihwan (DGYHW) has been traditionally used in treatment of tinnitus in Oriental Medicine. However, little is known about the mechanism by which DGYHW rescues auditory neuronal cells from injury damages. Therefore, in this study I effort to elucidate the mechanism of the cytoprotective effect of the DGYHW extract on glutamate-induced auditory sensorineuronal cell death. Methods : I determined the elevated cell viability by DGYHW extract on glutamate-induced auditory sensorineuronal cell death. Glutamate induced neuronal damage in oranotypic explant culture also, glutamate decreased cell viability on VOT-33 cells but pretreatment with DGYHW inhibited cell death. Results : One of the main mediator of glutamate-induced cytotoxicity was known to generation of reactive oxygen species (ROS). Pretreatment with DGYHW inhibited this ROS generation from glutamated-stimulated VOT-33 cells. Also, I identified that the ROS-induced DCF-DA green fluorescence is reduced by DGYHW pretreatment. The critical markers of apoptotic cell death were cleavages of procaspase-3 protease protein. So I checked the expression level and cleavage of procaspase-3 protease protein. Glutamate-treated VOT-33 cells were shown to have cleavage of procaspase-3 protease proteins and following reduction of expression of these proteins. But I found that pre-treatment with DGYHW protects glutamate-induced changes of biochemical marker protein, caspase-3. Conclusion : These findings indicated that DGYHW may prevent cell death from glutamate induced VOT-33 cell death by inhibiting the ROS generation and modulation of protein expressions in procaspase-3, catalase and Bcl-2.

The oxidative modification of low density lipoprotein(LDL) has been implicated in the development of atherosclerosis. Oxidized LDL(oxLDL) is captured into macrophage and stimulates to form macrophage foam cell. And it can induce an inflammation and smooth muscle proliferation in atherosclerotic plaque. Objective : In this study, we aimed to investigate the effect of Bupleuri radix(SH) on the foam cell formation, a critical initiation stage of atherosclerosis. Methods : To achieve the goal, we examined the effect of SH on LDL oxidation, nitric oxide production in RAW264.7, and the effect of SH on cupuric sulfate-induced cytotoxicity, LDH release, and macrophage activity. Results : SH inhibited the formation of oxidized LDL from native LDL in RAW264.7 cell culture, and decreased the release of LDH from cupric sulfate-stimulated RAW264.7 cell. In other experiments, SH activated RAW264.7 cell, and prolonged the survival time, and inhibited foam cell formation induced by oxLDL in Raw 264.7 cells. Conclusion : These results showed that SH might prevent atherosclerosis by controlling the early stages of foam cell formation.