• The Journal of Korean Medical History
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• v.23 no.1
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• pp.55-65
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• 2010

The narration of "Donguibogam" is focused on humans whilst medical books before it focused on diseases. This is shown from the first subtitle of External Body(身形門) chapter, [The Origin of Hyung-Ki(形氣之始)]. The contents of [The Origin of Hyung-Ki] explains that the human body is composed of 'Hyung(形)' and 'Ki(氣)' This perspective is shown throughout "Donguibogam". First, in the aspect of construction, the viewpoint is shown from the JipRye(集例). It divides the body into inside and outside, which is a result of Hyung-Ki perspective. This continues in the table of contents. Naegyeongpyeon(內景) and Oehyeongpyeon(外形) describes the inside and outside of the body, in other words 'Hyung-Ki'. Japbyeongpyeon(雜病) describes complex illnesses with mixed insides and outsides. Tangaekpyeon(湯液) and Chimgupyeon(鍼灸) can be understood as division of treatment methods into inside and outside. When we look at the contents, the human body is created on the basis of the essence and vital energy of the world. Cheon-Ki becomes the 'Ki' that forms the functions of the body, while Ji-Ki becomes the 'Hyung' that constructs the bodily structure. It is considered that 'Hyung' is composed of SaDae(the body essence, vital energy, mentality and blood), and 'Ki' is composed of OSang(the five Jang organs and six Bu organs). 'Hyung' and 'Ki' show various appearances according to physiology and pathology. 'Hyung' is especially shown by obesity or thinness, 'Ki' by color. The obese may have Ki deficiency, coldness, dampness or phlegm. The thin could have blood deficiency, heat, fire or dryness. The color could show the pathology of the five Jang organs by the five colors, but it can simply be divided into black and white, where black means Eum deficiency, and white means Yang deficiency. It is said that the distinctive feature of traditional Korean medicine is that it is a constitutional medicine. In this perspective, further study on 'Hyung-Ki' is of value. If "Donguibogam" was the foundation of the Sasang Constitutional Medicine(四象醫學), study on 'Hyung-Ki' means searching for the origin of the Sasang Constitutional Medicine. Also, the study on Sasang Constitutional Medicine and Hyungsang medicine(形象醫學) will show the modern image of "Donguibogam". Hence, interchange study between "Donguibogam", Sasang Constitutional Medicine and Hyungsang medicine through the term 'Hyung-Ki' could hopefully lead to academic progression.

• The Journal of Korean Medicine
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• v.31 no.4
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• pp.38-48
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• 2010

Objectives: Moxa treatment has outstanding effects that are frequently facilitated in a clinical setting, and it is also known to have positive effects for immunity and relief of pain through various studies. Currently, moxa treatment has become diversified in many ways. One of the moxa treatment techniques that was frequently used during the Joseon Dynasty was Woogakgubeop (牛角灸法, horn-shaped moxa treatment). This articles aims to disclose the fact that the Woogakgubeop is the technique applicable to the origin of the Large moxa treatments of today. Also, the writings of Woogakgubeop recorded in the royal medical documentations, such as the Chronicles of the Royal Families of the Joseon Dynasty, the Seungjeonwonilgi (The Daily Records of Royal Secretariat) and others, are analyzed and the characteristics of the Woogakgubeop are cleared through it. Methods: From the royal medical documents, the Chronicles of the Royal Families of the Joseon Dynasty and the Seungjeonwonilgi, articles related Woogakgubeop were extracted and analyzed. Records of each document were facilitated for the DB search. In addition to these two documents, the records of written literature were surveyed as well. The written literature are appropriate to express the experiences of intellectuals at the time. Results and Conclusions: 1. Considering that Woogakgubeop is a single therapy, there exists relatively many records in addition to the specialized medical documents, and through them, it is known that Woogakgubeop was a widely known therapy in the middle to later parts of Joseon in general. 2. Woogakgubeop is a method that addresses problems contained within the existing moxa treatment techniques. By enlarging the size of the mugwort wick, it strengthens the heat energy of the moxa treatment to reduce the frequency of applying moxa treatment. When undertaking the method to empty the wick inside the mugwort, the pain of a fever patient will be reduced and burn damage to the skin is minimized. 3. Wind-cold type weakness and other general moxa treatment techniques have been used for various symptoms detailed, including chest pain, tinnitus, carbuncle, cellulites, cold sense of leg, colic, diarrhea and other illnesses. In addition, it may generate strong fever, and was used to implement the Yeonjebeop (煉臍法). 4. Woogakgubeop is applicable to the origin of Large moxa treatment of today and it provides important bibliographic base thereof.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.1
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• pp.26-34
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• 2018

Objectives : This study tried to explore the prevalence of chronic physical diseases in patients with schizophrenia and its effects on total medical costs. Methods : The Health Insurance Review and Assessment Service data in 2014-2015 was employed. Only the injuries and diseases, identically diagnosed 3 times or more as a major or minor injury and disease, were classified into chronic physical diseases to improve data accuracy. Total medical costs included out-of-pocket and insurer's costs from health care system perspective. Results : It was shown that 24.5%, 17.3% and 23.4% of schizophrenia patients had one, two and three or more chronic physical diseases, respectively. There was a high prevalence of not only metabolic, but also musculoskeletal, diseases in those patients. The amount of 2015 total medical costs of patients with schizophrenia in 2014 was about 1.08 trillion won. The factors affecting the costs included sex, age, number of chronic physical diseases, and health insurance status. Conclusions : It is considered that clinical practice guidelines based on personal diseases may not sufficiently solve the problems for comorbidities in schizophrenia patients. Accordingly, it should be required to develop models for new types of medical systems capable of treating and caring varied illnesses at the same time.

• Korea Journal of Hospital Management
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• v.13 no.4
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• pp.27-45
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• 2008

This research focused on a total of 378 patients with external injuries under the age of 14 who visited the emergency center at a university hospital in Korea, during the months of January, April, August and November between January and December of 2007. In addition, the survey was conducted only on even number days and ranged across the whole year to reflect the impact of seasonal characteristics on the collected data. The research focused on determining the characteristics and inflicting cause of these patients with external injuries, analyzed the total time spent in the emergency room and obtained the following results. 1. When classifying the patients into different genders, the proportion of males (67.5%) was higher than that of females (32.5%). According to the different age groups, the highest ratio, at 61.1 %, was patients under the age of six. 2. Looking at the total number of minutes spent in the emergency room, the longest amount of time occurred during April with 162.7 minutes, followed by 121.9 minutes in January and 92.4 minutes in November. August had the shortest period of time spent in the emergency room, a significant statistical difference from the other periods of the year (p<0.001). 3. Regarding the amount of time required for each examination, patients required to provide a urine test spent an average of 204.7 minutes while those who did not spent 113.5 minutes on average. This is a 5% statistical difference among the two groups (p>0.05). 4. Looking at the five most commonly diagnosed problems in the emergency room, the total number of people with these top five commonly diagnosed illnesses comprised 55.6%, or 210 patients out of 378. 5. Utilizing the Decision Tree Model to estimate the total number of minutes required per visit, the first classifications were made using a chemical examination factor. People subject to chemical classification spent an average of 177.7 minutes, which was longer than the overall average of 115.2 minutes, and those exempt from chemical examination spent an average of 103.8 minutes, which was shorter than the average Conclusion; Effort to curtail the total time spent in emergency rooms is vital in guaranteeing efficient management of hospitals and providing medical services. The delay experienced by many comprehensive professional medical centers must be resolved through the establishment of effective delivery of medical services, increased supply of patient rooms and other policy oriented implementations. However, for now, this problem must be resolved by increasing the level of patient satisfaction and guaranteeing effective operation of patient rooms, which will significantly contribute to the general management and success of hospitals and institutions.

• The Journal of Korean Medical History
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• v.23 no.1
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• pp.23-41
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• 2010

Greater yang disease(太陽病) is a syndrome induced by peripheral obstruction. One of them is "wind stroke(中風)" with the obstruction in lymphatic system. The other obstruction appearing on circulatory system is called "cold damage(傷寒)." Kyejitang(桂枝湯) is the formula prescribed for greater yang wind stroke pattern(太陽中風證) which is caused by peripheral lymphatic duct obstruction. Ramulus Cinamoni acts as a vasodilator and Radix Paeoniae relieves the abdominal tension. They make blood move to the internal organ and this can remove the retention of peripheral lymphatic system. Covering the patient with a blanket and getting him/her to have hot and thin rice gruel causes slight Diaphoresis, contributing to relieving the retention of lymphatic system. Disharmony between nutrient and defense(營衛不和) means that pressure becomes different between lymphatic system and vascular system. Kyejitang(桂枝湯) is called releasing muscles formula(解肌劑) because it can resolve such pressure difference. Diaphoresis is not a means to eliminate pathogenic qi(邪氣) from the body. That is the syndrome proving that the body fluid has moved around when disordered fluid distribution is corrected. Therefore, diaphoresis should be induced weakly all the time. If diaphoresis is induced excessively, body fluid will move more than desired and then illness cannot be cured. In Sanghanlun(傷寒論), dispersing drugs aim at addressing the retention in the exterior field, but it actually applies to the entire exterior and interior to make body fluid move. Therefore, diaphoresis does not just act on exterior field, and freeing the stool does not only apply to interior field. Distribution of body fluid changed by pathogenic qi(邪氣) influences the whole body because the human body has a closed circulatory system. Sanghanlun(傷寒論) has included treatments for pathogenic disease. However, its value should not be limited to pathogenic disease. It is because controlling blood flow by sending body fluid to the place a doctor wants is certainly worth using for treatment of non-exogenous disease or chronic illnesses.

• Journal of Preventive Medicine and Public Health
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• v.45 no.2
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• pp.90-97
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• 2012

Objectives: While there have been many quantitative studies on the public's attitude towards mental illnesses, it is hard to find quantitative study which focused on the contextual effect on the public's attitude. The purpose of this study was to identify factors that affect the public's beliefs and attitudes including contextual effects. Methods: We analyzed survey on the public's beliefs and attitudes towards mental illness in Korea with multi-level analysis. We analyzed the public's beliefs and attitudes in terms of prejudice as an intermediate outcome and social distance as a final outcome. Then, we focused on the associations of factors, which were individual and regional socioeconomic factors, familiarity, and knowledge based on the comparison of the intermediate and final outcomes. Results: Prejudice was not explained by regional variables but was only correlated with individual factors. Prejudice increased with age and decreased by high education level. However, social distance controlling for prejudice increased in females, in people with a high education level, and in regions with a high education level and a high proportion of the old. Therefore, social distance without controlling for prejudice increased in females, in the elderly, in highly educated people, and in regions with a high education and aged community. Conclusions: The result of the multi-level analysis for the regional variables suggests that social distance for mental illness are not only determined by individual factors but also influenced by the surroundings so that it could be tackled sufficiently with appropriate considering of the relevant regional context with individual characteristics.

• The Korean Nurse
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• v.33 no.4
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• pp.86-98
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• 1994

We have examined the development and conceptual definition of shamanism and divination through significant characteristics of various illnesses. However, the terrminology has been inconsistent and its real conceptual meaning is not well defined. Divination is a historically dominant religious practice which represents the core of Korean folk culture. Despite prevalent prejudice toward its primitive nature, we cannot deny its profound relationship to our unconscious, especially our reliance on its religious role whenever we face crisis or conflict. It is therefore appropriate to use the term divination in this context. Shamanism originated as humanity's oldest mode of communication with divine - a religion, The shaman is not a sorceress but a priestess, a healer, a spritual guide, a leader, a mystic, traditionally having a different significance from that of the contemporary diviner or "shaman". The traditional concept of illness has been profoundly altered to serve new functions: while the shamanistic view is based upon spiritual abduction, divination on the other hand invokes concepts of spiritual invasion phenomena such as spirit intrusion, taboo violations, soul loss, object instrusion, deviations from the appropriate spiritual path besiegement, and curess or predestination (the idea that the sufferer is born with his fate), We should therefore try to understand divination from a more holistic point of view, rather than attempting to fit it into the standrd medical illness. We must recognize divination as a phenomenon within our culture, since most people have a mixed conception of illness arising from a combination of divinational and modem concepts, Since divination's humanistic approach is ingrained in our people, to irresponsibly ignore the spiritual aspects of treatment would exert a negative influence on our culture, Especially now, while attraction is focused on Korean culture and its influence on every aspect of our livies, it is important for nurses to expand our horizons in order to create a way of nursing more suitable to Korean culture. Increased importance is now being given to the opinions of patients themselves about their own illness and health, so nurses should seek to understand how patients accept their illness and what particular kinds of help they expect to receive. Consequently, an understanding of traditional divinations will enable us to utilize these characteristics on the job in order to enhance nursing care.

• Clinical and Experimental Pediatrics
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• v.53 no.10
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• pp.886-891
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• 2010

Purpose: This study aims to investigate the clinical characteristics of children diagnosed with the novel influenza A (H1N1) in the winter of 2009 at a single medical institution. Methods: Out of 545 confirmed cases of influenza A (H1N1) in children, using the real time RT-PCR method at Kosin University Gospel Hospital from September to December of 2009, 149 patients and their medical records were reviewed in terms of symptoms, laboratory findings, complications and transmission within a family. Results: Median age of subjects was 7 years (range: 2 months-18 years). New cases increased rapidly from September to reach a peak in November, then declined rapidly. Most frequently observed symptoms were fever (96.7%), cough (73.2%), rhinorrhea (36.9%) and sore throat (31.5%). Average body temperatures on the 1st, 2nd and 3rd hospital day were $38.75{\pm}0.65^{\circ}C$, $38.08{\pm}0.87^{\circ}C$ and $37.51{\pm}0.76^{\circ}C$, respectively. Complete blood counts and biochemical tests performed on the first admission day showed within the reference values in most cases. Of the 82 patients with simple chest radiography, 18 (22%) had pneumonic lesions; multi-focal bronchopneumonia in eleven, single or multi-segmental lobar pneumonia in five, and diffuse interstitial pneumonia in two patients. All of the 149 patients improved from their symptoms and discharged within 9 days of admission without any late complication. Conclusion: Children with 2009 pandemic influenza A (H1N1) at our single institution displayed nonspecific symptoms and laboratory findings, resembling those of common viral respiratory illnesses, and did not appear to develop more severe disease.

• Health Policy and Management
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• v.21 no.4
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• pp.527-540
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• 2011

Some patients tend to visit tertiary hospitals instead of non-tertiary hospitals for minor illnesses, which is a chronic problem within the Korean health care delivery system. In order to reduce the number of patients with minor severity diseases unnecessarily utilizing the tertiary medical services in Korea, the Ministry of Health and Welfare raised the outpatient co-insurance rate for the tertiary hospitals in July, 2009. Another increase in the prescription drug co-insurance rate by the general and tertiary hospitals is scheduled to take place in the second half of 2011. An increase in copayments may discourage the utilization rate of medical services among the underprivileged or patients who require complicated procedures. This study aims to analyze the diabetic patients' utilization rates of tertiary hospitals according to the Comorbidity score. Diabetic patients' data was gathered from the Health Insurance Claims Records in the Health Insurance Review & Assessment Service between 2007-2009. Comorbidity scores are measured by the Charlson Comorbidity Index and the Elixhauser Index. Chi-square and logistic regressions were performed to compare the utilization rates of both insulin-dependents (n=94,026) and non-insulin-dependents (n=1,424,736) in tertiary hospitals. The higher Comorbidity outcomes in the insulin-dependent diabetic patients who didn't visit tertiary hospitals compared to those who did, was expected. However, after adjusting the gender, age, location, first visits and complications, the groups that scored >=1 on the comorbidity scale utilized the tertiary hospitals more than the O score group. Non-insulin-diabetic patients with higher Comorbidity scores visited tertiary hospitals more than patients who received lower grades. This study found that patients suffering from severe diabetes tend to frequently visit the tertiary hospitals in Korea. This result implied that it is important for Korea to improve the quality of its primary health care as well as to consider a co-insurance rate increase.

• Journal of Korean Academy of Nursing
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• v.7 no.1
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• pp.73-79
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• 1977

This study was carried on between June first and July thirty-first 1976 using as subjects women living in the areas of Pusan, Kyoung Sang Buk Do and Kyoung Sang Nam Do. The subjects were divided into 3 groups according to different environments and styles of life, namely married life, widowhood and religious life and according to ages ranging between 45 and 55. Each of these 3 groups of women of .menopausal age consisted of 50 persons and totalling a group of 150. The subjects were chosen according to random sampling and the Cornell Medical Index was applied to discover physical and mental health status with the following results : 1. The total mean scores for complaints in the group of widows was 46.00, in the group of Married women was 37.10 and in the Sisters was 34.30 showing highest scores for the widows and lowest for the Sisters. 2. The mean score percentages for physical and mental complaints 28.80 and 16.50 respectively for the Widows:27.00 and 10.80 for the Married and 24.30 and 10.20 for the Sisters. 3. The highest number of mean scores for physical items was for digestive system complaints which showed a score of 5.04, 4.78 and 4.90 respectively for Widows, Married women and Sisters among the psychic status items all 3 groups showed highest scores for complaints of inadequacy: 5.52, 3.40 and 3.64 respectively. 4. In comparing the 2 groups of Married women and Widows, the highest significant differences appeared in the items of depression and sensitivity but there was also some significant difference in the items of inadequacy, anger, miscellaneous diseases and genito-urinary system complaints. 5. In comparing the Married women and Religious groups the highest significant differences according from the highest were as follows : cardiovascular system, sensitivity, tension, nervous system, frequent illnesses and anxiety.