Forty three patients with disease of the aorta were admitted in this department during the period from beginning of 1956 to the end of 1976. They consisted of eighteen cases of aortic aneurysms, eight cases of Takayasu's arteritis, eight Leriche syndromes, six dissecting aneurysms, two aortic coarctations and one case of vascular ring. Of eighteen aortic aneurysms, twelve were operated resulting in eight survivors. Three of four mortalities were in shock preoperatively because of aneurysmal rupture. Among six dissecting aortic aneurysms, four were type III and two were type I according to DeBakey's classification. For the purpose of relief of acute arterial insufficiency in the lower extremities, a re-entry operation grafting a Y-shaped dacron vessel between abdominal aorta and common iliac arteries was performed. The patient regained consciousness soon after the operation and was well until postoperative second day, when severe convulsion developed abruptly and died. And in a chronic case of type III dissecting aneurysm, a dacron graft bypass shunt between ascending aorta and lower descending thoracic aorta with resection of the aneurysm was performed, but acute severe aortic insufficiency developed soon after the operation and fell into intractable heart failure resulting in death. The cause of the aortic insufficiency seems to be retrograde dissection from the proximal anastomosis site in the ascending aorta. Three cases were treated medically with Wheat's regimen. Two of them survived with relief of symptoms. Eight patients of Takayasu's arteritis were all females and aged between twenty and forty-four averaging twenty nine. Bypass graft operation between aortic arch and carotid arteries using Y-shaped nylon prostheses were performed in three patients resulting in death in two cases postoperatively due to severe cerebral arterial insufficiency during the procedure. All the patients with Leriche syndrome were males and over forty. In two cases, bypass graft with Y-shaped dacron vessel between terminal aorta and common iliac or femoral arteries were performed with good result. Thromboembolectomy or thromboendarterectomy was employed in three patients, of whom one was aggravated in sexual problem postoperatively. One out of two aortic coarctations and a vascular ring were treated surgically with excellent results.
This project is planned to grasp the present situation of traditional medicine part in our country and to study protection method about this by the intellectual property which is the international concerning point recently. Through this, we will be able to devise means to deal with protection method of traditional medicine being developed by WIPO now. Traditional medicine field In our country Is organized with specific condition separated into the part of institution and the part of non-institution. So, because of the closed peculiarity, we have experienced the difficulties to understand the real facts about traditional medicine. We cannot be indifferent to the matter anymore. Because the expectation of object people is high, we could expect the realization of research content. In 1 detail project, we investigated the situation of traditional medicine in our country through various collecting methods for excavation of oriental treatment technique and herb medicine which is worth protecting. With it, we sorted again into 56 kinds of 11 parts through analysis of validity in the way of oriental medicine. And we tried to link this up 2 detail project which is about legal and institutional guarantee concerning protection. furthermore, we tried to find approach ways for security of objectivity into 4 steps with the example of model disease. we could complete practical classification of traditional medicine in our country. In 2 detail project, we studied the protection method by the intellectual property through research result in 1 detail project. For this, we observed an outline of the intellectual property including a patent application analysis in folk traditional medicine part, and problems of traditional medicine protection and world trend by traditional knowledge protection tendency and the patent law In domestic traditional medicines, the aspects unprotectable with the patent law now were remained. So, we suggested supplementary plan. And we also suggested the freedom of utilization between traditional medicine possession countries (in-situ utilization) and the demand compensation payment for a third country (ex-situ utilization) in connection with international movement.
Min, Sally;Lee, Tae Young;Kwak, Yoobin;Kwon, Jun Soo
Korean Journal of Biological Psychiatry
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v.25
no.2
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pp.38-43
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2018
Objectives Dopamine dysregulation has been regarded as one of the core pathologies in patients with schizophrenia. Since dopamine synthesis capacity has found to be inconsistent in patients with schizophrenia, current classification of patients based on clinical symptoms cannot reflect the neurochemical heterogeneity of the disease. Here we performed new subtyping of patients with first-episode psychosis (FEP) through biotype-based cluster analysis. We specifically suggested basal ganglia structural changes as a biotype, which deeply involves in the dopaminergic circuit. Methods Forty FEP and 40 demographically matched healthy participants underwent 3T T1 MRI. Whole brain parcellation was conducted, and volumes of total 6 regions of basal ganglia have been extracted as features for cluster analysis. We used K-means clustering, and external validation was conducted with Positive and Negative Syndrome Scale (PANSS). Results K-means clustering divided 40 FEP subjects into 2 clusters. Cluster 1 (n = 25) showed substantial volume decrease in 4 regions of basal ganglia compared to Cluster 2 (n = 15). Cluster 1 showed higher positive scales of PANSS compared with Cluster 2 (F = 2.333, p = 0.025). Compared to healthy controls, Cluster 1 showed smaller volumes in 4 regions, whereas Cluster 2 showed larger volumes in 3 regions. Conclusions Two subgroups have been found by cluster analysis, which showed a distinct difference in volume patterns of basal ganglia structures and positive symptom severity. The result possibly reflects the neurobiological heterogeneity of schizophrenia. Thus, the current study supports the importance of paradigm shift toward biotype-based diagnosis, instead of phenotype, for future precision psychiatry.
Lee, Eun Jee;Lee, GeunWoo;Park, Juhee;Kim, Dong-Sook;Ahn, Hyeong Sik
Journal of the Korean Medical Association
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v.61
no.11
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pp.687-698
/
2018
Inappropriate antibiotic use significantly contributes to antibiotic resistance, resulting in reduced antibiotic efficacy and an increased burden of disease. The objective of this study was to investigate the characteristics of prescribers whose antibiotics use was high and to explore factors affecting the use of antibiotics by medical institutions. This study analyzed the National Health Insurance claims data from 2015. Antibiotic prescription data were analyzed in terms of the number of defined daily doses per 1,000 patients per day, according to the World Health Organization anatomical-therapeutic-chemical classification and methodologies for measuring the defined daily dose. We investigated the characteristics of prescribers and medical institutions with high antibiotic use. Multivariate regression analyses were performed on the basis of characteristics of the medical institution (number of patients, type of medical institution [hospital or clinic], age of the physician, etc.). The number of patients and number of beds were found to be significant factors affecting antibiotic use in hospitals, and the number of patients, region, and medical department were significant factors affecting antibiotic use at the level of medical institutions. These findings are expected to help policy-makers to better target future interventions to promote prudent antibiotic prescription.
Risk assessment techniques are processes used to evaluate hazardous risk factors in construction sites, facilities, raw materials, machinery, and equipment, and to estimate the size of risk that could lead to injury or disease, and establish countermeasures. The most important thing in assessing risk is calculating the size of the risk. If the size of the risk cannot be calculated objectively and quantitatively, all members who participated in the evaluation would passively engage in establishing and implementing appropriate measures. Therefore, this study focused on predicting accidents that are expected to occur in the future based on past occupational accident statistics, and quantifying the size of the risk in an overview. The technique employed in this study differs from other risk assessment techniques in that the subjective elements of evaluators were excluded as much as possible by utilizing past occupational accident statistics. This study aims to calculate the size of the risk, regardless of evaluators, such as a manager, supervisor, safety manager, or employee. The size of the risk is the combination of the likelihood and severity of an accident. In this study, the likelihood of an accident was evaluated using the theory of Bud Accident Chainability, and the severity of an accident was calculated using the occupational accident statistics over the past five years according to the accident classification by the International Labor Organization.
Neck mass is common neoplasms, but it poses a diagnostic dilemma for the physician. The differential diagnosis include neoplastic, inflammatory and developmental causes. The FNAC is one of the most valuable tests in the initial assessment and differential diagnosis of the neck mass. FNAC was performed with 267 cases of the neck mass, during the period from April, 1988 to October, 1990 at the department of General Surgery, Soon Chun Hyang. University Hospital. Thyroid lesions were excluded from this analysis. Final diagnosis was based on resection histology in 58 cases, and surgical specimens were compared with FNAC. The following results were obtoired ; 1) Of 267 cases, there we re 9 cases(3.4%) of congenital lesion, 74 cases(27.7%) of inflammatory lesion, 40 cases(15.0%) of benign tumor, 12 cases(4.5%) of primary malignant tumor, 37 cases(13.8%) of metastatic tumor, 75cases(28.1%) of reactive hyperplasia, 20 cases(7.5%) of unsatisfactory. In the pathologic classification, inflammatory lesion was the most common. 2) In the 58 cases of excisional biopsy, sensitivity 93.8%, specificity 95.2%, false positive 11.8%, false negative 2.4%, positive predictive value 88.2%, negative predictive value 97.6%, accuracy 94.8%. 3) The most common disease was the tuberculous lymphadenitis (53 cases, 19.8%). sensitivity 57.9%, specificity 100.0%, false positive 0.0%, false negative 17.0%, positive predictive value 100.0%, negative predictive value 83.0%, accuracy 86.2%.
The Journal of Korea Assosiation for Disability and Oral Health
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v.8
no.2
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pp.109-112
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2012
Epidermolysis bullosa (EB) is an inherited skin disease characterized by blister formation of the skin following just minor trauma or spontaneously. The main classification of EB is based on the localization of the blistering. In epidermolysis bullosa simplex, the blister formation is intraepidermal; in epidermolysis bullosa junctionalis the blister formation in the epidermal-dermal junction; in the dystrophic forms of EB blister formation is intradermal. Oral manifestations of recessive dystrophic EB are characterized by rampant caries, crowding, microstomia, ankyloglossia, vestibular obliteration. Dental therapy may be well provided to patient with recessive dystrophic EB by using general anesthesia especially in case of poor cooperation. A two years old girl with recessive dystrophic EB visited our clinic for rampant caries. She was hospitalized for severe anemia and fever, and we provided dental therapy under general anesthesia. Extraction of incisors and stainless steel crown restoration of primary molars were performed.
The objective of this article is to induce that the conception of 'Qi-jul(氣質) and Qi-pum(氣稟)' was introduced to the Sasang(四象) Constitutional Medicine from bibliographic study on the theory of 'Qi-pum(氣稟)'. The conclusions summerized as followings. 1. In the oriental medicine, qualitative difference of 'zheng-qi(正氣)' among the individuals, the opposing power against a disease, is regarded as constitution. Having been used as 'nature(素)', 'quality(質)' and 'character(氣質)' in the oriental medical book, the word of 'Che-Jil(體質)' was used in good earnest at the end of 'Qing(情)' dynasty. 2. The nature(性) is divided into two, original nature(本然之性) and charicteristic nature(氣質之性) in the 'New confucianism(新儒學)' and the former means a principle(理), is a pure and good thing and used as a conception of universality, the latter is a principle of character and a imperfect imitation of principle(理). 3. It was repeatedly confirmed that 'Qi-jil and Qi-pum' meant the difference among the individuals by the dispute of 'Li-Qi(理氣)' caused by Lee Hwang(李滉) and Lee Yi(李耳) and by that of 'Ho-Rak(湖洛)' in the Ch'o-son(朝鮮) dynasty. 4. Han Sok-Ji, based on Meng-Zi(孟子)'s doctrine that man's inborn nature is good, criticized the theory of 'Qi-pum' which was 'Zhu-Zi(朱子)'s opinion and his opinion about the life(命) was thought to clue to the classification of the 'Sasang(四象)' invented by Lee Je-Ma as Park Se-Dang's theory that everyone has common nature but has different life(命). 5. By introducing the theory of 'Qi-pum' and the conception of life(命) which was understood as a special character by Han Sok-Ji and Park Se-Dang to Sa-sang constitutional medicine, Lee Je-Ma explained the reason why each man who was classified four constitutions, 'Taiyang'(太陽), 'Taiyin'(太陰), 'Shaoyang'(少陽), 'Shaoyin'(少陰), had the different formation of the visceral department(臟局).
This paper is a study on the life and clinical reasoning of Kim Goo Young (1958-2014). Offering a new perspective through his interpretation of Donguibogam (東醫寶鑑), Kim introduced his unique theory of Korean medicine, 'The Theory of Byeongin (病因論)'. Kim recognized the confusing situation of communication between people studying Korean medicine and tried to make a new standard based on the principle that many people can share. 'The Theory of Byeongin' offers a newly constituted "Donguibogam" focusing on 'Byeongin' (病因, pathologic origin) which can be translated as the cause of a disease. In so doing Kim recognized 'Byeongin' as the most important factor in 'Byeonjeung' (辨證, classifying the origin), or the classification method of symptoms. In addition, Kim recognized how 'Byeongin' was considered to be a diseased lifestyle, and tried interpreting. The patient's lifestyle to treat diseases. As a result, 'The Theory of Byeongin' is a theory consisting of an intuitive structure, reducing notable elements like Yin Yang Five Movement theory. The theory's significant characteristic is its easy application in clinical settings due the established core principles which are based on Kim's insight and clinical experience. This study contributes to the understanding of the theoretical and clinical development of Korean medicine through deeper studies on 'The Theory of Byeongin' and Kim's medical theory.
Soo Hyun Lee;Hakyung Kim;In-bo Han;Seung Hun Sheen;Je Beom Hong;Seil Sohn
Journal of Cerebrovascular and Endovascular Neurosurgery
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v.25
no.2
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pp.143-149
/
2023
Objective: The purpose of this nationwide age- and sex- matched longitudinal study was to determine the pyogenic spondylitis (PS) increases the incidence of ischemic stroke (IS) in Korea. Methods: From the National Health Insurance Service (NHIS), we collected the patient data for the period from January 1, 2004 to December 31, 2015. PS was classified according to the International Classification of Disease codes M46.2-M46.8, M49.2, and M49.3. By using a 1:5 age- and sex- stratified matching, a total of 628 patients and 3140 control subjects were included in the study. The IS incidence rates in PS and control group was calculated by using the Kaplan-Meier method. The outcome of hazard ratio of IS was estimated by Cox proportional hazards regression analyses. This study did not exclude PS as a result of postoperative complications. Results: According to the study, 51 patients (8.12%) in the PS group and 201 patients (6.4%) in the control group experienced IS. The adjusted hazard ratio of IS in the PS group was 3.419 (95% CI: 2.473-4.729) after adjusting individual medical condition and demographics. Following the results of subgroup analysis, the risk ratio of IS was greater in most of the subgroup categories (male, female, age <65, age >65, non-diabetic, hypertensive, non-hypertensive, dyslipidemic and non-dyslipidemic subgroup). However, the risk of IS did not differ significantly in diabetic subgroup (95% CI: 0.953-4.360). Conclusions: The risk rate of IS increased in patient with pyogenic spondylitis.
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