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Effect of Sterilization Conditions on Microbial Reduction in Cleaning Tools (살균 조건이 세척 도구 중 미생물 저감화에 미치는 영향)

  • Im, Ji-Yu;Kim, Chae-Young;Kim, Eun-yeong;Kim, Min-jin;Kim, Jung-Beom
    • Journal of Food Hygiene and Safety
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    • v.37 no.5
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    • pp.310-316
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    • 2022
  • In this study, we compared the microbial reduction effects of drying, hot water, and microwave sterilization in scourers and dishcloths to suggest a most suitable sterilization method. Three scourer types (silver, copper, and mesh) were used, and three dishcloth types (silver, bamboo, and cotton) were used. Drying time dependent reduction in Escherichia coli was high in silver and copper scourers, but minimal bacterial reduction was obtained against Bacillus cereus in all scourers and dishcloths. In scourers, E. coli was not detected after ≥30 s of hot water sterilization at 77℃, and B. cereus was not detected after ≥60 s of hot water sterilization at 100℃. In dishcloths, E. coli was not detected after hot water sterilization at 77℃ for ≥30 s, but B. cereus was detected after hot water sterilization at 100℃ for ≥60 s. In scourers, E. coli was not detected after microwave sterilization at 700 W for 3 min, but B. cereus was detected. In dishcloths, E. coli was not detected after microwave sterilization with 700 W for ≥1 min, but B. cereus was detected in the cotton dishcloth even after sterilization for 3 min. In conclusion, the use of antimicrobial scourers (silver and copper) and dishcloths (silver and bamboo) are not sufficient to reduce the microbial contamination. The guideline provided by the Ministry of Food and Drug Safety suggesting dishcloth sterilization via hot water at 100℃ for 30 s was also found to be insufficient. Based on our research, we suggest that the most effective methods of microbial management are submerging scourers in hot water at 100℃ for ≥1 min, and sterilizing dishcloths for ≥3 min using a 700 W microwave.

Quantitative Assessment of Coronary Artery Diameter in Patients with Atrial Fibrillation and Normal Sinus Rhythm (심방세동 환자와 정상 심전도 환자의 관상동맥 직경 정량적 평가)

  • Seo, Young-Hyun
    • Journal of the Korean Society of Radiology
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    • v.16 no.5
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    • pp.567-574
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    • 2022
  • Coronary artery disease (CAD) and atrial fibrillation (AF) are known to share many risk factors. In particular, in the case of acute coronary syndrome, it may be difficult to clearly determine the diameter of the vessel due to complete occlusion of the vessel and thrombus. Thus, the relationship between the diameter of the coronary arteries was evaluated to be used as a reference data before the treatment of coronary arteries and drug selection in patients with AF. From January 2020 to August 2022, images of coronary angiography (CAG) with AF and normal sinus rhythm (NSR) on electrocardiography were target. In both subjects, images of normal coronary artery without lesions as a result of CAG were used. For all vessels, the diameters of the vessels were measured by dividing them into proximal, middle, and distal parts, and the measured diameters were divided by the average for evaluation. As a result of analyzing the left anterior descending artery diameter, the vessel diameter of the AF patient was 2.24±0.26 mm, which was smaller than that of the NSR patient, 2.86±0.38 mm, and was statistically significant. (p<0.001) As a result of analyzing the left circumflex artery diameter, the vessel diameter of the AF patient was 2.34±0.28 mm, which was smaller than the vessel diameter of the NSR patient, 2.87±0.29 mm, and was statistically significant. (p<0.001) As a result of analyzing the diameter of the right coronary artery, the vessel diameter of the AF patient was 2.68±0.5 mm, which was smaller than the vessel diameter of the NSR patient, 3.35±0.4 mm, and was statistically significant. (p<0.001) Considering that the coronary artery size of AF patients is significantly smaller than the coronary vessel size of NSR patients, it is considered as a useful study to be used as a reference for evaluating coronary artery diameter when the arrhythmia is AF. In particular, it is considered to be a study that can be helpful in diagnosing lesions, using drugs before and after surgery, and choosing to use auxiliary devices such as intravascular ultrasound.

Evaluation of Microbial Contamination in the Manufacturing Process of Non-Heated Frozen Rice Cakes (비가열 냉동떡의 제조공정에 대한 미생물 오염도 평가)

  • Yong-Sik, Yoon;Eun-In, Yang;Young-Soo, Kim
    • Journal of Food Hygiene and Safety
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    • v.37 no.6
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    • pp.400-410
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    • 2022
  • This study was performed to analyze the microbial contamination levels of three non-heated rice cake manufacturers in terms of seasonal manufacturing process and to investigate the effects of summertime soaking on contamination levels and temperature-controlled soaking in water on reduction in microbial levels. The total aerobic bacteria (TAB) ranged from 2.69 log CFU/g to 5.08 log CFU/g in the produce, but the microbial contamination increased sharply during soaking. The levels of TAB and coliforms during summer soaking were 7.01 and 3.96 log CFU/g, respectively, and this was significantly higher than those in other seasons. The contamination level was high in the subsequent freezing, with the TAB level (6.24 log CFU/g) exceeding the legal standard. The temperature of soaking water in summer increased from 19.1℃ to 26.8℃ after 12 h of soaking. The microbial contamination was significantly high commensurate with increased soaking time, and the TAB level in the frozen process exceeded the legal standard from 9 h of soaking. The use of ice packs to prevent the increase in temperature of the soaking water in summer resulted in maintenance of temperature at 20.1℃ for up to 12 h. The average TAB value in the freezing process was 4.42 log CFU/g after 12 h of soaking, and this is 1.77 log CFU/g lower than that before. Based on these results, it was determined that controlling the soaking time and water temperature are essential for the production of a safe unheated frozen rice cake. The safety of the HACCP system could be established by applying these preventive management standards.

Increase in Neurogenesis of Neural Stem Cells Cultured from Postnatal Mouse Subventricular Zone by Nifedipine (L-type 칼슘 채널을 저해하는 저해제, nifedipine에 의한 쥐 뇌실하 영역 신경줄기세포의 신경세포로의 분화 촉진)

  • Park, Ki-Youb;Kim, Man Su
    • Journal of Life Science
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    • v.32 no.2
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    • pp.108-118
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    • 2022
  • The subventricular zone (SVZ) in the brain contains neural stem cells (NSCs) that generate new neurons throughout one's lifetime. Many extracellular and intracellular factors that affect cell proliferation and neuronal differentiation of NSCs are already well-known. Recently, L-type calcium channels have been reported to regulate neural development and are present in NSCs, differentiating neuroblasts, and mature neurons in the SVZ. Nifedipine, a blocker of L-type calcium channels, has been long used as a therapeutic drug for hypertension. However, studies on the use of nifedipine to inhibit L-type calcium channels of NSCs are lacking. Herein, we treated NSCs cultured from mouse postnatal SVZ with nifedipine during neuronal differentiation. Nifedipine increased the number of Tuj1-positive neurons but did not significantly change the number of Olig2-positive oligodendrocytes. Nifedipine increased cell division during early differentiation, which was detected using the 5-ethynyl-2'-deoxyuridine incorporation assay and immunocytochemistry assessment by staining the cells with phosphorylated histone H3, a mitosis marker. Nifedipine increased the transcription of Dlx2, a neurogenic transcription factor, and the level of Mash1, a marker for early neurogenesis. In addition to nifedipine, verapamil, which is also an L-type calcium channel blocker, showed a slight increase in neurogenesis, but its statistical significance was very low. In contrast, pimozide, a T-type calcium channel blocker, did not affect neurogenesis, although T-type calcium channel genes Cav3.1, Cav3.2, and Cav3.3 were expressed. In summary, nifedipine might promote the neuronal fate of NSCs during early differentiation and calcium signaling through L-type calcium channels might be involved in neuronal differentiation, especially during the early stages of differentiation.

The Use of Analgesics in the Last 24 hours of Life of Patients with Advanced Cancer : A Comparison of Medical Physicians and Surgeons (말기 암 환자의 마지막 24시간 동안 진통제 사용의 분석 : 내과의사와 외과의사의 비교)

  • Choi, Youn-Seon;Kim, Jong-Min;Lee, Young-Mee;Lim, Jong-Kuk;Lee, Tai-Ho;Hong, Myung-Ho
    • Journal of Hospice and Palliative Care
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    • v.1 no.1
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    • pp.47-55
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    • 1998
  • Background : It is almost important therapy modality to control pain for the terminal cancer patients for the last 24 hours because those terminally illed patient deserved to have pain free and peaceful time before death. Physician who is deal with terminal cancer patients for their last 24 hours does not need to worry about drug addiction or other untoward side reactions of pain medications. The purpose of this study was to evaluate if terminally illed cancer patient was given pain medication properly and sufficiently and if there was any different behavior to control pain of terminal cancer patients between medical physicians and surgeons in terms of type, amount and administration route and frequency. Methods : A retrospective chart audit of analgesic type, amount and administration route was performed on the medical recorders of 160 hospitalized terminal cancer patients who had died in the Korea University Medical Center Anam Hospital during the period of July 1, 1994 to June 30, 1995. Patients were classified into 103 patients were cared for by medical physicians and 57 patients were cared for by surgeons. After then, we analysed the difference of pain control pattern between them. Different types and amount of analgesics were converted to a common standard, an oral morphine equivalents(OME) relative to 1mg of oral morphine. Results : 1) The total number of patients was 160, male 102 cases(63.8%), and the female was 58 cases(36.2%) respectively. 2) The mean age was 56.4(${\pm}14.62$) years old and mean admission period was 27.8 days(${\pm}34.85$). 3) The frequent cancer site was stomach 42 cases(26.315), lung and liver 29 cases(18.1%) each, pancreas 10 cases(6.2%) in order 4) 125 out of 160 subjects (78.13%) complained pain, and 66 out of 103(64.08%) and 31 out of 57(54.39%) were treated with analgesics to relieve pain. 50 out of 97(51.55%) were able to continue on oral medication. 5) 86 cases(53.75%) were well oriented 24 hours prior to death. 6) The frequent analgesics for regular basis were long acting form of oral morphine 34 cases(Medical phsicians 24, Surgeons 10), intravenous morphine 26 cases(Medical physicians 20, Surgeons 6) in order, and the most common p.r.n.(pro re nata) analgesics used was intravenous morphine. 7) The mean amount of analgesics on regular basis was 115.41 OME by medical physicians and 52.7 OME by surseons(P<0.05). The mean amount of p.r.n. analgesics was significantly larger in patients are for by surgeons(66.64 OME) than medical physicians 23.49 OME(P<0.01). 8) The mean frequency of administrated number of p.r.n. analgesics was 0.62 times/day on medical part and 1.88 times/day on surgical part (P<0.001). Conclusion : Of the 97 patients with advanced cancer, 51.55% were able to take oral medications in the last day of life. The parenteral analgesics were more frequently used in the patients cared for by surgeons than medical physicians. Over the half of terminal cancer patients were well oriented in the last day of life. Doctor's knowledge and attitude towards pain is very important to mange the pain, effectively.

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A Study on the Extraction Rate of Brain Tissues from a $^{99m}Tc$-HMPAO Cerebral Blood flow SPECT Examination of a Patient ($^{99m}Tc$-HMPAO 뇌혈류 SPECT 검사 시 환자에 따른 뇌조직 추출률에 대한 고찰)

  • Kim, Hwa-San;Lee, Dong-Ho;Ahn, Byeong-Pil;Kim, Hyun-Ki;Jung, Jin-Yung;Lee, Hyung-Nam;Kim, Jung-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.1
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    • pp.17-26
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    • 2012
  • Purpose: This study mainly focuses on the patients treated with chemically stable radiopharmaceutical product $^{99m}Tc$-HMPAO (d,l-hexamethylpropylene amine oxime) which yielded reduced image quality due to a decreased brain extraction rate. $^{99m}Tc$-HMPAO will be examined further to determine whether this product may be accounted as a factor for this cause. Material and Methods: From January 2010 until December 2010, out of 272 patients who were all subjected to $^{99m}Tc$-HMPAO brain blood flow SPECT scans resulting from Cerebral Infarction; 23 patients(ages $55.3{\pm}9$, 21 males, 3 females) with decreased tissue extraction rate were examined in detail. The radiopharmaceutical product $^{99m}Tc$-HMPAO was used on patients with normal brain tissue exchange rate as well as those with reduced rate in order to prove its' chemical stability. The patients' age, sex, blood pressure, existence of diabetes, drug use, current health status, known side effects from CT/MRI, examination of the patients' past SPECT before/after images were accounted to determine the factors and correlations affecting the rate of blood tissue extractions. Result: After multiple linear regression analysis, there were no unusual correlations between the 6 factors excluding sex, and before/after examination images. Male subjects showed reduced brain tissue extraction rate than the females ($p$ > 0.05) 91.3% male, 8.7% female. Wilcoxon Matched-Pairs Signed-Ranks Test was used on the before/after images which yielded a value of 0.06, which did not indicate a significant amount of difference on the 2 tests ($p$ > 0.05). As a result, the before/after images indicated similar brain tissue extraction rates, and there were variations depending on the individual patient. Conclusion: The effects of the chemically stable radiopharmaceutical product $^{99m}Tc$-HMPAO depended on the patient's personal characteristics and status, therefore was considered to be a factor in reducing brain tissue extraction rate. The related articles of $^{99m}Tc$-HMPAO cerebral blood flow SPECT speculates a cerebrovascular disease and factors resulting from portal veins, and it was not possible to pin point the exact cause of decreasing brain tissue extraction rate. However, the $^{99m}Tc$-HMPAO cerebral blood flow SPECT scan proved to be extremely useful in tracking and inspecting brain diseases, as well as offering accurate results from patients suffering from reduced brain tissue extraction rates.

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Serogroup and Antimicrobial Resistance of Streptococcus pneumoniae Isolated from Oropharynx in Children Attending Day Care Center (유아원 소아의 구인강에서 분리된 폐구균의 혈청군과 항균제 내성에 관한 연구)

  • Kim, Kyung Hyo;Lee, Jong Eun;Whang, Il Tae;Ryu, Kyung Ha;Hong, Young Mi;Kim, Gyoung Hee;Lee, Keun;Kang, Eun-Suk;Hong, Ki-Sook
    • Clinical and Experimental Pediatrics
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    • v.45 no.3
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    • pp.346-353
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    • 2002
  • Purpose : Penicillin- and multidrug-resistant S. pneumoniae poses a serious threat to clinicians because the rate of resistance of S. pneumoniae to penicillin in Korea has surged up to the world's highest level. This study was performed to assess the carriage rate, serogroups and antimicrobial susceptibility of S. pneumoniae isolated from oropharynx in children. Methods : From March to July 1998, 209 children under 5 years of age were recruited from five day care centers. The carriage rate for pneumococci was obtained. Antimicrobial susceptibilities were determined with the E-test and agar dilution methods. Serogrouping was performed on 48 of the pneumococcal isolates by the Quellung reaction. Results : The carriage rate of S. pneumoniae was 30.1%. Antimicrobial susceptibility profiles were available for 59 of the isolates. Sixty-six percent of isolates were not susceptible to penicillin, and multidrug-resistance was observed in 76.3% of the isolates. A high proportion of the penicillin-resistant strains showed associated resistance to trimethoprim-sulfamethoxazole, tetracycline, erythromycin, and oxacillin. The most prevalent oropharyngeal serogroups were 19, 6, 3, 23, and 29. Resistance of the pneumococcal isolates to penicillin was different according to the serogroups. All of the strains of serogroup 19, 23, and 29 was resistant to penicillin but 87.5% of serogroup 3 strains were susceptible to penicillin. Conclusion : The resistance rate of S. pneumoniae isolated from oropharynx in children was very high to penicillin and other antimicrobial agents. For the reduction of the drug-resistant rate of S. pneumoniae, clinicians should be required to be more judicious in their use of antimicrobial agents.

The Changes in Patients and Medical Services by Separation of Prescribing and Dispensing Practice in Health Center (의약분업 실시 전후 보건소 내소환자 진료내용 변화)

  • Chun, Jae-Kyung;Kam, Sin;Han, Chang-Hyun
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.75-86
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    • 2002
  • This study was conducted to investigate the changes in patients and medical services before and after the Separation of Prescription and Dispensing in Health Center. For the purpose of this study, prescription data of 5,890 prescribed patients in March 2000(before the Separation of Prescription and Dispensing) and 3,496 prescribed patients in March 2001(after the Separation) in 4 Health Centers located in Gyeongsangbuk-do and Gyeongsangnam-do were collected. For investigation of the change of character of prescribed patients and the disease, sex, age, chief diagnosis, the hind of medical insurance, days of visit, days of prescription were investigated by using National Health Insurance claim data. And for investigation of change of prescription, prescribed drugs per each claim, the use rate of antibiotics, injection, and high-price antiphlogistic drug were investigated for acute respiratory disease and musculoskeletal disease. The major results were as follows: For the changes of prescribed patients of each disease, patients with acute respiratory disease were decreased by 49.7% after the Separation of Prescription and Dispensing than before the Separation of Prescription and Dispensing and patients with hypertension(18.1%), patients with musculoskeletal disease(70.5%), patients with diabetes(8.5%), patients with digestive organ disease(71.2%), patients with chronic respiratory disease(76.4%) were decreased. But patients with urethritis were increased by 66.7%. The mean Health Center visited days of prescribed patients decreased significantly after the Separation of Prescription and Dispensing than before in both male and female(p<0.01) and in health insurance patients(p<0.01). For the each of the disease, hypertension, diabetes, musculoskeletal disease decreased. The mean prescribed days increased after the Separation of Prescription and Dispensing than before(p<0.01). According to the kine of disease, the mean prescribed days increased after the Separation of Prescription and Dispensing than before in all the diseases except the urethritis(p<0.01). For acute respiratory diseases, number of prescribed drugs per each claim decreased significantly after the Separation of Prescription and Dispensing(4.7 drugs) than before(4.9 drugs) and the prescription rate of injection decreased significantly from 63.8% to 7.70%, and the prescription rate of antibiotics decreased significantly from 337% to 19.1%(p<0.01). For musculoskeletal diseases before and after Separation of Prescription and Dispensing, number of prescribed drugs per each claim decreased significantly from 3.7 to 3.2 and the prescription rate of injection decreased significantly from 64.9% to 1.7%, and the prescription rate of high-price antiphlogistic drugs increased significantly from 29.1% to 397%(p<0.01). In consideration of above findings, the mean visited days decreased and on the contrary, the mean prescribed days per each prescription increased after Separation of Prescription and Dispensing than before in health centers. For the prescription pattern of physicians, number of prescribed drugs and the prescription rates of injection and antibiotics per each claim decreased, but the prescription rate of high-price antiphlogistic drugs increased after Separation of Prescription and Dispensing.

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Global Cosmetics Trends and Cosmceuticals for 21st Century Asia (화장품의 세계적인 개발동향과 21세기 아시아인을 위한 기능성 화장품)

  • T.Joseph Lin
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.23 no.1
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    • pp.5-20
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    • 1997
  • War and poverty depress the consumption of cosmetics, while peace and prosperity encourage their proliferation. With the end of World War II, the US, Europe and Japan witnessed rapid growth of their cosmetic industries. The ending of the Cold War has stimulated the growth of the industry in Eastern Europe. Improved economies, and mass communication are also responsible for the fast growth of the cosmetic industries in many Asian nations. The rapid development of the cosmetic industry in mainland China over the past decade proves that changing economies and political climates can deeply affect the health of our business. In addition to war, economy, political climate and mass communication, factors such as lifestyle, religion, morality and value concepts, can also affect the growth of our industry. Cosmetics are the product of the society. As society and the needs of its people change, cosmetics also evolve with respect to their contents, packaging, distribution, marketing concepts, and emphasis. In many ways, cosmetics mirror our society, reflecting social changes. Until the early 70's, cosmetics in the US were primarily developed for white women. The civil rights movement of the 60's gave birth to ethnic cosmetics, and products designed for African-Americans became popular in the 70's and 80's. The consumerism of the 70's led the FDA to tighten cosmetic regulations, forcing manufacturers to disclose ingredients on their labels. The result was the spread of safety-oriented, "hypoallergenic" cosmetics and more selective use of ingredients. The new ingredient labeling law in Europe is also likely to affect the manner in which development chemists choose ingredients for new products. Environmental pollution, too, can affect cosmetics trends. For example, the concern over ozone depletion in the stratosphere has promoted the consumption of suncare products. Similarly, the popularity of natural cosmetic ingredients, the search of non-animal testing methods, and ecology-conscious cosmetic packaging seen in recent years all reflect the profound influences of our changing world. In the 1980's, a class of efficacy-oriented skin-care products, which the New York Times dubbed "serious" cosmetics, emerged in the US. "Cosmeceuticals" refer to hybrids of cosmetics and pharmaceuticals which have gained importance in the US in the 90's and are quickly spreading world-wide. In spite of regulatory problems, consumer demand and new technologies continue to encourage their development. New classes of cosmeceuticals are emerging to meet the demands of increasingly affluent Asian consumers as we enter the 21st century. as we enter the 21st century.

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Study on Medical Records In ${\ulcorner}$the Historical Records of the Three Kingdoms${\lrcorner}$ ("삼국사기(三國史記)"에 기록된 의약내용(醫藥內容) 분석)

  • Shin, Soon-Shik;Choi, Hwan-Soo
    • Journal of The Association for Neo Medicine
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    • v.2 no.1
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    • pp.35-54
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    • 1997
  • We tried to observe the features of ancient medical practice by analysing the records related to medicine in the book, ${\ulcorner}$the Historical Records of the Three Kingdom${\lrcorner}$ of which content includes the features of medicine in mythology, plague, delivery of twins, drugs, medical system, shamanism, constitutional medicine, psychiatry, forensic medicine, deformity, a spa, medical phrase, health and welfare work, religion, death. physiological anatomy, Taoist medicine, acupuncture, the occult af of transformation and etc. Our initial concern was about where to draw line as of medical field and we defined medicine in more broad meaning. The book ${\ulcorner}$the Historical Records of the Three Kingdoms${\lrcorner}$ describes the world of mythology by way of medicine which is not clearly a conventional one. There appears records of birth of multiple offsprings 7 times in which cases are of triplets or more. Delivering multiple offsprings were rare phenomenon though such fertility was highly admired. This shows one aspect of ancient country having more population meant more power of the nation. Of those medical records conveyed in that book includes stories of childbirth such as giving birth to a son after praying, giving birth to Kim Yoo-shin after 20 months after mother's dream of conception, and a song longing for getting a laudable child. Plagues were prevalent throughout winter to spring season and one can observe various symptoms of plagues in the record. Of these epidemic diseases, cold type might have been more common than the heat one. Appearance of epidemic diseases frequently coincided with that of natural disasters that this suggests a linkage between plague and underlying doctrine on five elements' motion and six kinds of natural factors. There exists only a few names of diseases such as epidemic disease, wind disease, and syndrome characterized by dyspnea. Otherwise there appeared only afflictions that were not specified therefore it remains cluless to keep track of certain diseases of prevalence. Since this ${\ulcorner}$Historical Records of the Three Kingdoms'${\lrcorner}$ wasn't any sort of medical book, words and terms used were not technical kind and most were the ones used generally among lay people. Therefore any mechanisms of the diseases were hardly mentioned. Some of medicinal substances such as Calculus Bovis, Radix Ginseng, Gaboderma Luciderm, magnetitum were also in use in those days. 53 kinds of dietary supplies appears in the records and some of these might have been used as medicinal purpose. Records concerning dicipline of one's body includes activities such as hunting, archery, horseback riding etc. In Shilla dynasty there were positions such as professor of medicine, Naekongbong(內供奉), Kongbong's doctor(供奉醫師), Kongbong's diviner(供奉卜師). As an educational facility, medical school was built at the first year of King Hyoso's reign and it's curricula included various subjects as ${\ulcorner}$Shin Nong's Herbal classic${\lrcorner}$, ${\ulcorner}$Kabeul classic of acupuncture and moxbustion${\lrcorner}$, ${\ulcorner}$The Plain Questions of the Yellow Emperor's Classic of Internal Medicine${\lrcorner}$, ${\ulcorner}$Classic of Acupuncturer${\lrcorner}$, ${\ulcorner}$The Pulse Classic${\lrcorner}$, ${\ulcorner}$Classic of Channels and Acupuncture Points${\lrcorner}$ and ${\ulcorner}$Difficult Classic${\lrcorner}$. There were 2 medical professors who were in charge of education. To establish pharmacopoeia, 2 Shaji(舍知), 6 Sha(史), 2 Jongshaji(從舍知) were appointed. In Baekje dynasty, Department of Herb was maintained. Doing praying for the sake of health, doing phrenology also can be extended to medical arena. Those who survived over 100 years of age appear 3 times in the record, while 98 appears once. The earliest psychiatrist Nokjin differentiated symptoms to apply either therapies using acupuncture and drug or psychotherapy. There appears a case of rape, a case of burying alive with the dead, 8 cases of suicide that can characterize a prototype of forensic medicine. Deformity-related records include phrases as follow: 'there seems protrudent bone behind the head', 'a body which has two heads, two trunks, four arms.', 'a body equipped with two heads' In those times spa can be said to be used as a place for he리ing, convalescence, and relaxation seeing the records describing a person pretended illness and went to spa to enjoy with his friends. Priest doctors and millitary surgeons were in charge of the medical sevice in the period of the Three Kingdoms by the record written by Mookhoja(墨胡子) and Hoonkyeom(訓謙). Poor diet and regimen makes people more vulnerable to diseases. So there existed charity services for those poor people who couldn't live with one's own capacity such as single parents, orphans, the aged people no one to take care and those who are ill. The cause of affliction was frequently coined with human relation. There appeared the phenomenon of releasing prisoners and allowing people to become priests at the time of king's suffering. Besides, as a healing procedure, sutra-chanting was peformed. There appears 10 cases of death related records which varies from death by drowning, or by freezing, death from animals, death from war, death from wightloss and killing oneself at the moment of spouse's death and etc. There also exist certain records which suggest the knowledge of physiology and anatomy in those times. Since the taoist books such as ${\ulcorner}$Book of the Way and Its Power(老子道德經)${\lrcorner}$ were introduced in the period of Three Kingdoms, it can be considered that medicine was also influenced by taoism. Records of higher level of acupuncture, records which links the medicine and occult art of transformation existed. Although limited, we could figure out the medical state of ancient society.

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