• Korean Journal of Head & Neck Oncology
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• v.5 no.1
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• pp.39-46
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• 1989

Kimura's Disease is a chronic inflammatory and proliferative condition producing subcutaneous masses especially in the head and neck area. This report of our experience with 5 patients with this disease is the first in the Korean surgical literature. Kimura's Disease is thought to be part of the larger spectrum of the entity known as angiolymphoid hyperplasia with eosinophilia (ALHE). It is characterized pathologically by hyperplastic lymphoid follicles, eosinophilic infiltration, and vase 비 ar proliferation. It produces masses which are most common in the area of the parotid, submandibular gland and upper neck. These masses occupy the subcutaneous tissues but also extend into salivary tissue and into upper neck nodes. One of our patients had masses in the groin. The tumors are extremely vascular due to the presence of new proliferative vessels and sinusoids. The average age of our 5 patients was 35, but all but one case were younger than 38 years of age. The male: female ratio was 3 : 2, and the average duration of symptoms was 5,2years. All patients had peripheral blood eosinophilia. All had multiple masses, sometimes symmetrical. The management was surgery alone in one case, surgery and steroids in one case, surgery and radiotherapy in two cases, and all three modalities in one case. The relationship of this entity to ALHE and our experience in the management of this disease are presented. A clinicopathological discrepancy alerted us to the existence of Kimura's Disease. A nineteen-year old male presented with subcutaneous masses over both mastoid areas present for 3 years (Case III). When biopsy on each side was reported as 'eosinophilic granuloma' we submitted the slides to an internationally expert pathologist. Symmetrically occurring tumors in the peri-parotid subcutaneous areas did not fit any category of neoplasm or granuloma known to us. The diagnosis, made by Dr. Gist Fan at the Ochsner Clinic, was Kimura's Disease. We found two additional cases in a review of soft tissue eosinophilic granuloma previously reported at Presbyterian Medical Center, and since then have diagnosed two new cases. These five cases constitute the basis for this, the largest series to be reported in Korea. These vascular, tumor-like lesions of the skin, subcutaneous areas and subjacent structures of the head and neck have been a variety of names, such as angiolymphoid hyperplasia with eosinophilia, eosinophilic hyperplastic lymphogranuloma, angioblastic lymphoid hyperplasia with eosinophilia, histioid hemangioma, and epithelioid hemangioma. The history of this disease spectrum dates back to 1937 when Kimm and Szeto (1) reported 7 cases of 'eosinophilic hyperplastic lymphogranuloma' in the Proceedings of the Chinese Medical Journal. In 1948 Kimura and his associates(2) reported additional cases in Japan under the title 'On the unusual granulation combined with hyperplastic changes of lymphatic tissue.' From then until 1966 several hundred cases were reported in China and Japan. The first report from the West was by Wells and Whimster(3) in the British Journal of Dermatology, in 1969. These authors coined the term, angiolymphoid hyperplasia with eosinophilia (ALHE). Since that time a debate has ensued as to whether Kimura's Disease and ALHE are distinct entities, or whether Kimura's is part of the larger spectrum of ALHE, perhaps a later or advanced phase. From the clinical perspective, surgeons should be aware of the diagnosis of Kimura's Disease not only as part of the differential diagnosis of head and neck tumors but also because these lesions are indolent, and generally require conservative surgical removal as part of the management program. CASE I. A 37-year-old female company employee presented in August 1982 with submental swelling of 12 years' duration and with inguinal swelling of 7 years' duration. The submental mass measured 5x5cm. and the inguinal mass was 8x4cm. in size. Peripheral eosinophilia varying from 14% to 40% was found. On August 20, 1982, the submental mass was removed and a superficial groin dissection was done. In May 1983 an intraoral lesion of the palate was removed. The patient is free of disease. CASE II. A 23-year-old unemployed man visited this hospital for the first time in July, 1984, with swelling of the right cheek present for 6 years. The mass was soft and ill-defined but measured 10x20cm. and extended from the submandibular upper neck to the zygomatic arch, and from the mastoid to the cheek, over the parotid gland. Eosinophilia varying from 27% to 29% was noted in the peripheral blood. On March 21, 1986, the lesion was resected. The procedure comprised an extended superficial parotidectomy from the temporalis fascia to the upper neck. Post-operatively radiotherapy 3000 rad tissue dose was administered using the 6 MeV linear accelerator. The patient remains free of disease. CASE III. A 19-year-old student came to the clinic with masses over both mastoid areas, present 3 years. On the right there were two adjacent lesions, one over the mastoid, the other in the upper jugular level of the neck. On the left it was a single mass over the mastoid. Eosinophilia varied from 13 to 32% in the peripheral blood, and 11.6% in the bone marrow. Incisional biopsy revealed 'eosinophilic granuloma' and a trial of predisolone was employed. The mass increased in size so a small dose of radiation (600 rads) was used, with substantial regression,. The lesion on the left was excised and follwed by 1000 rads radiotherapy. Finally recurrent tumor on the right side was removed on November 5, 1985. The patient remains free of disease. CASE N. A 29-year-old local merchant had had swelling of both upper necks since childhood. At the time of his first visit on March 17, 1986, the right submandibular mass measured 5x3.5cm. and the ,right upper neck and parotid tail mass measured 2.5cm. On the left there were masses in the upper neck, the largest of which measured 2.5cm, and of the parotid tail, 2.0cm. in size.(See Fig. 1) Peripheral eosinophilia of 39% was recorded. Left side partial parotidectomy and resection of the upper neck and subdigstric mases was done on May 2, 1986. The mass involving the right parotid tail and upper neck nodes was removed on Angust 7,1986. Postoperatively the patient was placed on prednisolone 30 mg. per day. No definite masses are palpable. CASE V. A 66-year-old housewife informed us, at the time of her first visit in May, 1986, that she had had multiple neck masses since 10 years ago. On the right side there was a 2.5cm. subcutaneous mass of the upper neck, over the upper jugular chain. On the left there was a 9x4.5cm. mass involving the entire parotid, the post-auricular area and the upper neck. A third mass presented in the submental area and measured 3.5cm. (See Fig. 2) Eosinophilia of 51% was noted in the peripheral blood. partial excision of the left upper neck lesion and complete excision of the submental mass were performed on june 6, 1986. post-operatively she was placed on 20 mg. of prednisolone daily, but when the mass re-grew after two months she was referred to Radiation Therapy for a 2500 rad course of treatment. A barely palpable thickening remains.

• Journal of Korean Society of Forest Science
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• v.41 no.1
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• pp.7-18
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• 1979

Almonds are one of the oldest sources of food and oil for man as used the ice cream, candy, roast, salting, chocolate, breads, backed, cookies, and flavoring ect. So, we wish to plant Almond in our country at the most parts of mountains. In this purpose we must be find out of both root stock of more compatibility and new techniques of grafting was rather simples as compared with the many steps of machinary involved today. This investigation has been carried out to reveral compatibility and practical controls of environment effectives involved in the occurence of each difference combination results in interspecific grafting of Almonds on the root stock of Prunus mandshurica and Prunus persica as materials during the 9 months period from March to November in 1978. With these selected scions were 4 varieties of Almond employing as the Hal1's hardy, Nonpareil, and Thompson grafted in the polyethylene green house with almost identical provision made for effective controls of automatical supplying to heating and mistsprayers as the $22{\sim}25^{\circ}C$ of temperature and 70~90% humidity. Following results have been obtained. Those environmental controls were more effective and practical to grafting unions and success by means veneer-grafting at the green house. 1. Hall's hardy Almond grafted on the root stock of Prunus persica was more compatibility than Prunus mandshurica. 2. The survival percentages as follows of the 95.33% of Hall's hardy/Prunus persica and 92.66% of Hall's hardy/Prunus mandshurica. And those were no significant between root stock of both species. 3. The 3 varieties of sweet Almond grafted on the root stock of P. mandshurica. And those were no significant between root stock of both species. 4. And the survival percentages as fellows. Thompson 92.66%, Nonpareil 90.66% and Kapareil 89.33% those grafted on the root stock of Prunus persica. 5. And then the survival percentage of interspecific grafts on the root Prunus mandshurica as follows of the materials of Thompson 89.66%, Nonpareil 87%, Kapareil 85%. 6. The analysis of variance were no significant among the interactions between 3 varieties Almond and 2 species of root stock plants. 7. And the growth of interspecific grafts of the high 161cm, diameter 12.3mm and length of roots 21.5cm growth as the Hall's hardy Almond grafted on the root stock of Prunus persica. 8. The root stock plants of Prunus mandshurica more effected to 6~8 days early developed leafing of scions and dark green colour than the Prunus persica. 9. The identical provision of automatic systems was more effective to graft unions and grafting process. 10. The veneer-grafting method at the green house was more effective and practical method for the mass production of Almond grafts.

• Korean Journal of Environmental Biology
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• v.22
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• pp.54-62
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• 2004

We examined the impacts of anthyopogenic pollutant (benzo〔a〕pyrene) on the growth and photosynthesis of five marine phytoplankton species (Skeletonema costatum, Heterosigma akashiwo, Prorocentrum dentatum, P. minimum, Aknshiwo sanguinea), which are dominant in Korean coastal water. After the 72 h exposure to benzo〔a〕pyrene, the dramatic decrease in cell numbers was observed in the range of 1 to 10 $\mu\textrm{g}$ L$^{-1}$ for S. costatum, P. minimum, P. dentatum, whereas for A. sanguinea and H. akashiwo at the low concentrations 0.1 to 1 $\mu\textrm{g}$ L$^{-1}$ . Among the 5 phytoplankton species, the highest growth inhibition concentration ($IC_{50}$/) was 6.20 $\mu\textrm{g}$ L$^{-1}$ for P. minimum, followed by 2.14 $\mu\textrm{g}$ L$^{-1}$ for P. dentatum, 1.68 $\mu\textrm{g}$ L$^{-1}$ for S. costatum, 0.74 $\mu\textrm{g}$ L$^{-1}$ for H. akashiwo, 0.10 $\mu\textrm{g}$ L$^{-1}$ for A. sanguinea. The five species exposed to the low concentration of 1 $\mu\textrm{g}$ L$^{-1}$ were recovered after transferring to new media, but the species exposed to the high concentrations of 10 and 100 $\mu\textrm{g}$ L$^{-1}$ were not recovered, with the exception of P. minimum. Those results indicate that the thecate dinoflagellate P. minimum is most tolerant to the chemical and the athecate dinoflagellate A. sanguinea is not. Geneyally, the cell-specific photosynthetic capacity of H. akashiwo exposed to the low concentrations of 0.1 and 1 $\mu\textrm{g}$ L$^{-1}$ was higher than that of the cells in the control, whereas the cells exposed to the high concentrations of 5 and 10 $\mu\textrm{g}$ L$^{-1}$ showed the negligible photosynthetic level by the first few days of the experiment. In the case of the cells exposed to the concentration of 5 $\mu\textrm{g}$ L$^{-1}$ , after 12 days of the experiment the photosynthetic capacity was increased toward the end of the experiment. This indicates that H. akashiwo may utilize the benzo〔a〕pyrene as a carton source for its growth when exposed to low concentrations. Results suggest that anthropogenic pollutants such as benzo〔a〕pyrene may have significant influence on the succession of phytoplankton species composition and the primary production in coastal marine environments.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.25 no.2
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• pp.79-92
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• 1992

This study was carried out to develop new techniques useful for cryopreservation, thawing and artificial insemination, and ultrastructural changes of cryopreserved spermatozoa in rainbow trout(Oncorhynchus mykiss) . Two extenders, such as Tyrode solution and Whittingham's $T_6$ solution, were used to preserve rainbow trout sperm in refrigerator $(-20,\;-40\;and\;-70^{\circ}C)$ or liquid nitrogen $%(-196^{\circ})$. Hand-stripped semen was diluted to 1:16 with two extenders, an then the semen were frozen after mixing semen and each extender containing 1M or 1.5M DMSO solution to 1:1. After 60 days cryopreserved semen was thawed in a $13^{\circ}$ water bath, and subsequently centrifugated. After centrifugation at 1,000 rpm for 5 min thawed semen was washed with extenders, and then fertilized with fresh eggs. The results obtained in these experiments were summarized as follows: After cryopreservation, over 75% of spermatozoa were appeared motile and the survival rate was high. Following cryopreservation by the addition of cryoprotectant such as DMSO, methanol and glycerol, the fertilization rate of the thawed spermatozoa appeared over $99\%$ compared with the control having $99\%$ of fertilization rate. There was no difference between the control and experimental groups such as $(-20^{\circ}C\;-40^{\circ}C\;and\;-70^{\circ}C)$ and $-196^{\circ}$ in fertilization rate. Following cryopreservation at $-196^{\circ}$ by the addition of 1M DMSO of cryoprotectant, each fertilization rate following 24 hours and hatching rate following 24 days showed $96\%$ and $8\%$ by the addition of BSA, but showed $98\%\;and\;10%$ by no addition of BSA. Following 2 months of cryopreservation by the addition of 1M DMSO of cryoprotectant, there were $10%$ of hatching rate at $-196^{\circ}\;and\;10\%\;and\;35\%,\;respectively,\;at\;-40^{\circ}C\;and\;-70^{\circ}C$. Following 2 months of cryopreservation by the addition of 1M methanol of cryoprotectant, there were $22\%$ of fertilization rate at $-20^{\circ}C,\;and\;28\%,\;at\;-70^{\circ}C$ Following 2 months of cryopreservation by the addition of 1M glycerol of cryoprotectant, there were $22\%$ of fertilization rate at $-20^{\circ}C$, and $33\%,\;at\;-70^{\circ}C$. pollowing 2 months of cryopreservation by the addition of 1.5M DMSO of cryoprotectant, there were $27\%$ of fertilization rate at $-20^{\circ}C,\;an\;36\%\;and \;35\%,\;respectively,\;at\;-40^{\circ}C\;and\;-70^{\circ}C$. Following 2 months of cryopreservation by the addition of 1.5M glycerol of cryoprotectant, there were $34\% \;of\;fertilization\;rate\;at\;-20^{\circ}C, \;and\;31\%\;and\;31\%,\;respectively,\;at \;-40^{\circ}C\;and\;-70^{\circ}$. Following 2 months of cryopreservation by the addition of 1.5M methanol of cryoprotectant, there were $28\%$ of fertilization rate at $-20^{\circ}C,\;and\;29\%\;and\;28\%,\;respectively,\;at\;-40^{\circ}C\;and\;-70^{\circ}C.$ From 10 days and 15 days following fertilization at $13^{\circ}C\;and\;10^{\circ}C$, respectively, the mortality rate of fertilized ova was markedly increased. The middle piece of spermatozoa had two set of central doublets, nine set of outer coarse fibres, and mitochondrial sheath. Spermatozoa went through morphological changes during storage, e.g. winding of flagella, detachment of the nuclear envelope and the plasma membrane from the nucleus of the sperm head. There were $1\%$ abnormal spermatozoa in fresh sperm and about $15\%$ during storage.

• The Journal of Dong Guk Oriental Medicine
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• v.4
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• pp.109-140
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• 1995

As we considered in the main subjects, investigations on the theory of 'Doctrine on five elements' motion and six kinds of natural factors(運氣學說)' through 'Wang Bing's Commentary(王氷 注本)' of 'The seven great chapters in The Yellow Emperor's Internal Classic Su Wen' ("黃帝內經素問 七篇大論") are as follows. (1) In The seven great chapters("七篇大論")' Wang Bing supplement theory and in the academic aspects as a interpreter, judging from 'forget(亡)' character. expressed in the 'The missing chapters("素問遺篇")', 'Bonbyung-ron("本病論")' and 'Jabeob-ron(刺法論)', 'The seven great chapters("七篇大論")' must be supplementary work by Wang Bing. Besides, he quoted such forty books as medical books, taoist books, confucianist books, miscellaneous books, etc in the commentary and the contents quoted in the 'Su Wen(素問)' and 'Ling Shu("靈樞")' scripture nearly occupy in the book. As a method of interpreting scripiure as scripture, he edited the order of 'Internal Classic("內經")' ascended from the ancient time and when he compensated for commentary, with exhaustive scholarly mind and by observing the natural phenomena practically and writing the pathology and the methods of treatment. We knew that the book is combined with the study of 'Doctrine on five elements motion and six kinds of natural factors(運氣學說)' (2) When we compare, analyze the similar phrase of 'The seven great chapters in The Yellow Emperor's Internal Classic Su Wen'("黃帝內經素問ㆍ七篇大論") through 'Wang Bing's Commentary(王氷 注本)', he tells abouts organized 'five elements(五行)' and 'heaven's regularly movement(天道運行)' rather than 'Emyangengsangdae-ron("陰陽應象大論")' in 'The seven great chapters("七篇大論")'. Also the 'Ohanunhangdae-ron("五運行大論")' because the repeated sentences with 'Emyangengsangdae-ron("陰陽應象大論")' is long they are omitted. And in the 'Youkmijidae-ron("六微旨大論")', 'Cheonjin ideology(天眞四象)' based on the 'Sanggocheonjin- ron("上古天眞論")', 'Sagijosindae-ron("四氣調神大論")' is written and in the 'Gigoupyondae-ron("氣交變大論")', the syndrome and symptom are explained in detail rather than 'Janggibeobsi-ron("藏氣法時論")', 'Okgijinjang-ron ("玉機眞藏論")' and in the 'Osangieongdae-ron("五常政大論")', the concept of 'five element(五行)' of the 'Gemgwejineon-ron("金櫃眞言論")' is expanded to 'the five elements' motion concept(五運槪念)' and in the 'Youkwonjeonggidae-ron("六元正紀大論")', explanations of 'The five elements' motion and six kinds of natural factors(運氣)' function are mentioned mainly and instead systematic pathology is not revealed rather than 'Emyangengsangdae-ron("陰陽應象大論")'. And in the 'Jijinyodae-ron("至眞要大論")', explanations of the change of atmosphere which correspond to treatment principle by 'The three Yin and Yang(三陰三陽)' as a progressed concepts are revealed. Therefore there are much similarity between the phrase of 'Emyangengsangdae-ron("陰陽應象大論")' and 'chapters of addition(補缺之篇)'. Generally, the doctrine which 'The seven great chapters("七篇大論")' are added by Wang Bing(王氷) is supported because there are more profound concepts rather than the other chapter in 'The seven great chapters("七篇大論")'. (3) When we study Wang Bing's(王氷) 'Pattern on five elements motion and six kinds of natural factors(運氣格局)' in 'The seven great chapter("七篇大論")', in the 'Cheonwongi-dae-ron("天元紀大論")', With 'Cheonjin ideology(天眞思想)' and the concepts of 'Owang(旺)'${\cdot}$'Sang(相)'${\cdot}$'Sa(死)'${\cdot}$'Su(囚)'${\cdot}$'Hu(休)' and 'Cheonbu(天符)'${\cdot}$'Sehwoi(歲會)' are measured time-spacially to the concept of 'Three Sum(三合)' the concept of 'Taeulcheonbu(太乙天符)' is explained. In the 'Ounhangdae-ron("五運行大論")', 'The calender Signs five Sum(天干五合)' is compared to the concepts of 'couples(夫婦)', 'weak-strong(柔强)' and in the 'Youkmijidae-ron("六微旨大論")', 'the relationship of obedience and disobedience(順逆關係)' which conform to the 'energy status(氣位)' change and 'monarch-minister(君相)' position is mentioned. In the 'Gikyobyeondae-ron("氣交變大論")', the concept of 'Sang-duk(相得)', 'Pyungsang(平常)' is emphasized but concrete measurement is mentioned. In the 'Osangieongdae-ron("五常政大論")', the detailed explanation with twenty three 'systemic of the five elements' motion(五運體系)' form and 'rountine-contrary treatment(正治. 反治)' with 'chill-fever-warm-cold(寒${\cdot}$熱${\cdot}$溫${\cdot}$凉)' are mentioned according to the 'analyse and differentiate pathological conditions in accordance with the eight principal syndromes(八綱辨證)'. In the 'Youkwonjeonggidae-ron("六元正紀大論")', Wang Bing of doesn't mention the concepts of 'Jungwun(中運)' that is seen in the original classic. In the new corrective edition, as the concepts of 'Jungwun, Dongcheonbu, Dongsehae and Taeulcheonbu(中運, 同天符, 同歲會, 太乙天符)' is appeared, Wang Bing seems to only use the concepts of 'Daewun, Juwun, and Gaekwun(大運, 主運, 客運)'. In the 'Jijinyodaeron("至眞要大論")', Wang Bing added detailed commentary to pathology and treatment doctrine by explaining the numerous appearances of 'Sebo, sufficiency, deficiency(歲步, 有餘, 不足)' and in the relation of 'victory-defeat(勝復)', he argued clearly that it is not mechanical estimation. (4) When we observe the Wang Bing's originality on the study of 'the theory of Doctrine on five elements' motion and six kinds of natural factors(運氣學說)', he emphasized 'The idea of Jeongindogi and Health preserving(全眞導氣${\cdot}$養生思想)' by adding 'Wang Bing's Commentary(王氷 注本)' of 'The seven great chapters("七篇大論")' and explained clearly 'The theory of Doctrine on five elements' motion and six kinds of natural factors(運氣學說)' and simpled and expanded the meaning of 'man, as a microcosm, is connected with the macrocosm(天人相應)' and with 'Atmosphere theory(大氣論)' also explained the meaning of 'rising and falling mechanism(升降氣機)'. In the sentence of 'By examining the pathology, take care of your health(審察病機 無失氣宜)'. he explained the meaning of pathology of 'heart-kidney-water-fire(心腎水火)' and suggested the doctrine and management of prescription. In the estimation and treatment, by suggesting 'asthenia and sthenia(虛實)' two method's estimation, 'contrary treatment(反治)' and treatment principals of 'falling heart fire tonifyng kidney water(降心火益腎水)', 'two class of chill and fever(寒熱二綱)' were demonstrated. There are 'inside and outside in the illness and so inner and outer in the treatment(病有中外 治有表囊)'. This sentence suggests concertedly. 'two class of superfies and interior(表囊二綱)' conforming to the position of disease. Therefore Wang Bing as an excellent theorist and introduced 'Cheoniin ideology(天眞思想)' as a clinician and realized the medical science. With these accomplishes mainly written in 'The theory of Doctrine on five elements' motion and six kinds of natural factors(運氣學說)' of 'The seven great chapters("七篇大論")', he interpreted the ancient medical scriptures and expanded the meaning of scriptures and conclusively contributed to the development of the study 'Korean Oriental Medicine(韓醫學)'.

• Journal of Korean Medical classics
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• v.9
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• pp.555-652
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• 1996

Up to the present the scholastic achievements in the history of the medical system have been rather scare despite its importance in the Korean History. Hence, this dissertation attempts to examine the significance of the institute in the Korean History, covering the period from the ancient times through the early Chosun-Dynasty. In the ancient times, the medical practice relied primarily upon human instincts and experiences at the same time, shaman's incantations were widely believed to cure diseases, the workings of evil spirits supposedly. For the period from the Old Chosun through Samhan(巫堂), Chinese refugees brought a long medical knowledge and skills of the continent. New Chinese medicine, traditional practices and incantations were generally used at this time. Medicine and the medical system were arranged by the period of the Three Countries(三國時代). No definite record concerning Koguryo remains now. As for Paekje, however, history shows that they set up the system under the Chinese influence, assigning medical posts such as Euibaksa(medical doctor), Chaeyaksa(pharmacist), and Jukeumsa(medicine man) within Yakbu(department of medicine). Scientifically advanced, they sent experts to Japan, giving a tremendous influence on the development of the science on ancient Japan. After the unification of the three countries, Shilla had their own system after the model of Dang(唐). This system of the Unified Shilla was continued down to Koryo and became the backbone of the future ones. In the ancient time religion and medicine were closely related. The curative function of the shaman was absolute. Buddhism played a notable part in medical practice, too, producing numerous medical monks. The medical system of Koryo followed the model of Dang with some borrowings from Song(宋). Sangyakkuk(尙藥局) was to deal exclusively with the diseases of the monarch whereas Taeeuigam(太醫監) was the central office to handle the national medical administration and the qualification test and education for doctors. In addition, Dongsodaebiwon(東西大悲院), Jewibo(濟危寶), and Hyeminkuk(惠民局) were public hospitals for the people, and a few aristocrats practiced medicine privately. In 987, the 6th year of Songjong(成宗), local medical operations were installed for curing the sick and educating medical students. Later Hyonjong(顯宗), established Yakjom(clinics, 藥店) throughout the country and officials were sent there to see patients. Foreign experts, mainly from Song, were invited frequently to deliver their advanced technology, and contributed to the great progress of the science in Korea. Medical officials were equipped with better land and salary than others, enjoying appropriate social respect. Koryo exchanged doctors, medicine and books mainly with Song, but also had substantial interrelations with Yuan(元), Ming(明), Kitan(契丹), Yojin(女眞), and Japan. Among them, however, Song was most influential to the development of medicine in Koryo. During Koryo Dynasty Buddhism, the national religion at the time, exercised bigger effect on medicine than in any other period. By conducting national ceremonies and public rituals to cure diseases, Taoism also affected the way people regarded illness. Curative shamanism was still in practice as well. These religious practices, however, were now engaged only when medication was already in use or when medicine could not held not help any more. The advanced medical system of Koryo were handed down to Chosun and served the basis for further progress. Hence, then played well the role to connect the ancient medicine and the modern one. The early Chosun followed and systemized the scientific and technical achievement in medicine during the Koryo Dynasty, and furthermore, founded the basis of the future developments. Especially the 70 years approximately from the reign of Sejong(世宗) to that of Songjong(成宗) withnessed a termendous progress in the field with the reestablishment of the medical system. The functions of the three medical institute Naeeuiwon(內醫院), Joneuigam(典醫監), Hyeminkuk(惠民局) were expanded. The second, particualy, not only systemized all the medical practices of the whole nation, but also grew and distributed domestic medicaments which had been continually developed since the late Koryo period. In addition, Hyeminso(惠民局, Hwarinwon(活人院)) and Jesaenwon(濟生院)(later merged to the first) played certain parts in the curing illness. Despite the active medical education in the capital and the country, the results were not substantial, for the aristocracy avoided the profession due to the social prejudice against technicians including medical docotors. During the early Chosun-Dynasty, the science was divided into Chimgueui (acupuncturist), Naryogeui(specialist in scrofula) and Chijongeui (specialist in boil). For the textbooks, those for the qualification exam were used, including several written by the natives. With the introduction on Neoconfucianism(性理學) which reinforced sexual segregation, female doctors appeared for the female patients who refused to be seen by male doctors. This system first appeared in 1406, the sixth year of Taejong(太宗), but finally set up during the reign of Sejong. As slaves to the offices, the lowest class, female doctors drew no respect. However, this is still significant in the aspect of women's participation in society. They were precedents of midwives. Medical officials were selected through the civil exam and a special test. Those who passed exams were given temporary jobs and took permanent posts later. At that time the test score, the work experience and the performance record of the prospective doctor were all taken into consideration, for it was a specialized office. Most doctors were given posts that changed every six months, and therefore had fewer chances for a goverment office than the aristocracy. At the beginning the social status of those in medicine was not that low, but with the prejudice gradully rising among the aristocracy, it became generally agreed to belong to the upper-middle technician class. Dealing with life, however, they received social respect and courtesy from the public. Sometimes they collected wealth with their skills. They kept improving techniques and finally came to take an important share in modernization process during the late Chosun-Dynasty.

• Tuberculosis and Respiratory Diseases
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• v.43 no.6
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• pp.882-893
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• 1996

Background : Over one-third of solitary pulmonary nodules are malignant, but most malignant SPNs are in the early stages at diagnosis and can be cured by surgical removal. Therefore, early diagnosis of malignant SPN is essential for the lifesaving of the patient. The incidence of pulmonary tuberculosis in Korea is somewhat higher than those of other countries and a large number of SPNs are found to be tuberculoma. Most primary physicians tend to regard newly detected solitary pulmonary nodule as tuberculoma with only noninvasive imaging such as CT and they prefer clinical observation if the findings suggest benignancy without further invasive procedures. Many kinds of noninvasive procedures for confirmatory diagnosis have been introduced to differentiate malignant SPNs from benign ones, but none of them has been satisfactory. FOG-PET is a unique tool for imaging and quantifying the status of glucose metabolism. On the basis that glucose metabolism is increased in the malignant transfomled cells compared with normal cells, FDG-PET is considered to be the satisfactory noninvasive procedure which can differentiate malignant SPNs from benign SPNs. So we performed FOG-PET in patients with solitary pulmonary nodule and evaluated the diagnostic accuracy in the diagnosis of malignant SPNs. Method : 34 patients with a solitary pulmonary nodule less than 6 cm of irs diameter who visited Samsung Medical Center from Semptember, 1994 to Semptember, 1995 were evaluated prospectively. Simple chest roentgenography, chest computer tomography, FOG-PET scan were performed for all patients. The results of FOG-PET were evaluated comparing with the results of final diagnosis confirmed by sputum study, PCNA, fiberoptic bronchoscopy, or thoracotomy. Results : (I) There was no significant difference in nodule size between malignant (3.1 1.5cm) and benign nodule(2.81.0cm)(p>0.05). (2) Peal SUV(standardized uptake value) of malignant nodules (6.93.7) was significantly higher than peak SUV of benign nodules(2.71.7) and time-activity curves showed continuous increase in malignant nodules. (3) Three false negative cases were found among eighteen malignant nodule by the FDG-PET imaging study and all three cases were nonmucinous bronchioloalveolar carcinoma less than 2 em diameter. (4) FOG-PET imaging resulted in 83% sensitivity, 100% specificity, 100% positive predictive value and 84% negative predictive value. Conclusion: FOG-PET imaging is a new noninvasive diagnostic method of solitary pulmonary nodule thai has a high accuracy of differential diagnosis between malignant and benign nodule. FDG-PET imaging could be used for the differential diagnosis of SPN which is not properly diagnosed with conventional methods before thoracotomy. Considering the high accuracy of FDG-PET imaging, this procedure may play an important role in making the dicision to perform thoracotomy in diffcult cases.

• Tuberculosis and Respiratory Diseases
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• v.44 no.3
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• pp.592-600
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• 1997

Background : The level of imposed work of breathing (WOB) is important for patient-ventilator synchrony and during weaning from mechanical ventilation. Triggering methods and the sensitivity of demand system are important determining factors of the imposed WOB. Flow triggering method is available on several modern ventilator and is believed to impose less work to a patient-triggered breath than pressure triggering method. We intended to compare the level of imposed WOB on two different methods of triggering and also at different levels of sensitivities on each triggering method (0.7 L/min vs 2.0 L/min on flow triggering ; $-1\;cmH_2O$ vs $-2cm\;H_2O$ on pressure triggering). Methods : The subjects were 12 patients ($64.8{\pm}4.2\;yrs$) on mechanical ventilation and were stable in respiratory pattern on CPAP $3\;cmH_2O$. Four different triggering sensitivities were applied at random order. For determination of imposed WOB, tracheal end pressure was measured through the monitoring lumen of Hi-Lo Jet tracheal tube (Mallincrodt, New York, USA) using pneumotachograph/pressure transducer (CP-100 pulmonary monitor, Bicore, Irvine, CA, USA). Other data of respiratory mechanics were also obtained by CP-100 pulmonary monitor. Results : The imposed WOB was decreased by 37.5% during 0.7 L/min on flow triggering compared to $-2\;cmH_2O$ on pressure triggering and also decreased by 14% during $-1\;cmH_2O$ compared to $-2\;cmH_2O$ on pressure triggering (p < 0.05 in each). The PTP(Pressure Time Product) was also decreased significantly during 0.7 L/min on flow triggering and $-1\;cmH_2O$ on pressure triggering compared to $-2\;cmH_2O$ on pressure triggering (p < 0.05 in each). The proportions of imposed WOB in total WOB were ranged from 37% to 85% and no significant changes among different methods and sensitivities. The physiologic WOB showed no significant changes among different triggering methods and sensitivities. Conclusion : To reduce the imposed WOB, flow triggering with sensitivity of 0.7 L/min would be better method than pressure triggering with sensitivity of $-2\;cm\;H_2O$.

• Tuberculosis and Respiratory Diseases
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• v.42 no.5
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• pp.646-653
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• 1995

Background: The confirmative diagnosis of pulmonary tuberculosis(Tb) can be made by the isolation of Mycobacterium Tuberculosis(MTb) in the culture of the sputum, respiratory secretions or tissues of the patients, but positive result could not always be obtained in pulmonary Tb cases. Although there are many indirect ways of the diagnosis of Tb, clinicians still experience the difficulty in the diagnosis of Tb because each method has its own limitation. Therefore development of a new diagnostic tool is clinically urgent. It was reported that silica cause some lysosomal enzymes to be released from macrophages in vitro and one of these enzymes is elevated in workers exposed to silica dust and in silicotic subjects. In pulmonary Tb, alveolar macrophages are known to be activated after ingestion of MTb. Activated macrophages can kill MTb through oxygen free radical species and digestive enzymes of lysosome. But if macrophages allow the bacilli to grow intracellularly, the macrophages will die finally and local lesion will enlarge. Then it is assumed that the lysosomal enzymes would be released from the dead macrophages. The goal of this investigation was to determine if there are differences in the plasma activities of lysosomal enzymes, ($\beta$-glucuronidase(GLU) and $\beta$-N-acetyl glucosaminidase(NAG), among the groups of active and inactive pulmonary Tb and healthy control, and to see if there is any possibility that the plasma activity of GLU and NAG can be used as diagnostic indicies of active pulmonary Tb. Methods: The plasma were obtained from 20 patients with bacteriologically proven active pulmonary Tb, 15 persons with inactive Tb and 20 normal controls. In 10 patients with active pulmonary Tb, serial samples after 2 months of anti-Tb medications were obtained. Plasma GLU and NAG activities were measured by the fluorometric methods using 4-methylumbelliferyl substrates. All data are expressed as the mean $\pm$ the standard error of the mean. Results: The activites of GLU and NAG in plasma of the patients with active Tb were $21.52{\pm}3.01$ and $325.4{\pm}23.37$(nmol product/h/ml of plasma), respectively. Those of inactive pulmonary Tb were $24.87{\pm}3.78$, $362.36{\pm}33.92$ and those of healthy control were $25.45{\pm}4.05$, $324.44{\pm}28.66$(nmol product/h/ml of plasma), respectively. There were no significant differences in the plasma activities of both enzymes among 3 groups. The plasma activities of GLU at 2 months after anti-Tb medications were increased($42.18{\pm}5.94$ nmol product/h/ml of plasma) in the patients with active pulmonary Tb compared with that at the diagnosis of Tb(P-value <0.05). Conclusion: The results of the present investigation suggest that the measurement of the plasma activities of GLU and NAG in the patients with active pulmonary Tb could not be a useful method for the diagnosis of active Tb. Further investigation is necessary to define the reasons why the plasma activities of the GLU was increased in the patients with active pulmonary Tb after Tb therapy.

• Korean Journal of Breeding Science
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• v.41 no.4
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• pp.654-659
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• 2009

"Cheongcheongjinmi" is a new japonica rice variety developed from a cross between Iri401 and Ilpumbyeo by the rice breeding team of National Institute of Crop Science, RDA. This variety is suitable for ordinary season culture of low level nitrogen application. Heading date of "Cheongcheongjinmi" is August 17, 4 days later than that of Sobibyeo in plain areas. It has culm length of 82 cm, and relatively semi-erect pubescent leaf blade and slightly tough culm tolerant to lodging with good canopy architecture. This variety has 13 tillers per hill, 126 spikelets per panicle and 90.2% of ripened grains. "Cheongcheongjinmi" showed lower spikelet fertility than Sobibyeo when exposed to cold stress. This variety showed slower leaf senescence and lower viviparous germination compared to Sobibyeo during the ripening stage. "Cheongcheongjinmi" is susceptible to blast disease, bacterial blight, virus diseases and planthoppers. The dried plant weight, total nitrogen and RuBisCO activity of "Cheongcheongjinmi" were higher than those of Sobibyeo in low level nitrogen application. The milled rice of "Cheongcheongjinmi" exhibits translucent, clear non-glutinous endosperm and medium short grain. It shows lower protein and amylose contents than those of Sobibyeo, and better palatability of cooked rice compared to Hwaseongbyeo. The milled rice yield of this cultivar is about 5.10 MT/ha at low level nitrogen application of ordinary season culture in local adaptability test for three years. Especially, "Cheongcheongjinmi" has better milling properties such as the percentage of whole grain in milled rice and milling recovery of whole grain, respectively than those of Sobibyeo. "Cheongcheongjinmi" would be adaptable to middle plain areas and middle-western coastal areas of Korea.