• 대한한의학원전학회지
• /
• 제36권1호
• /
• pp.79-107
• /
• 2023

Objectives : This study aims to improve the diagnosis and treatment of contemporary insomnia by examining Zhang Jiebin's discussion on treating insomnia. Methods : The classical texts from the 'Insomnia' chapter of the Jingyue Quanshu were examined threefold in terms of symptom, treatment, and prescription analysis, after which the treatment discussion part was examined within the historical context of discussions on insomnia in major medical texts starting from the Huangdineijing. Results : According to Zhang, the cause of insomnia could be divided into two, after which criteria for diagnosis and treatment were set as excess pathogen and vital qi deficiency. He argued that insomnia could be naturally resolved through improvement of various pathogenic situations. Discussions on insomnia from various medical texts since the Huangdineijing suggest that pathology related to psychological function and emotions gradually increased and expanded over time. Conclusions : Zhang's discussion on symptom, treatment and prescriptions of insomnia suggests a new framework that could improve treatment effects through a Korean Medical Mind-Body approach, rather than the contemporary classification of organic insomnia and non-organic insomnia.

• 한국의사학회지
• /
• 제34권1호
• /
• pp.11-22
• /
• 2021

In this study, we examine Cho Heon-yeong's medical theory in obstetrics and gynecology by looking at the contents and prescriptions of 『Buinbyeongchiryobeob (婦人病治療法)』. This book is a clinical text on obstetrics and gynecology written in the 1940's. This book consists of an Introduction, Jeungchi (證治), Yangjinhanchi (洋診漢治), Cheobangnonhae (處方論解) and refers to 『Donguibogam(東醫寶鑑)』, 『Keongakjeonseo (景岳全書)』, 『Junguihaksajeon (中醫學辭典)』, 『Jejungsinpyeon (濟衆新編)』, 『Uihakipmun (醫學入門)』 and 『UijongKeumkam (醫宗金鑑)』. Cho Heon-yeong's theory in this book has the following characteristics. First, his medical eclecticism is centered on Korean Medicine, with incidental use of Western medicine. Second, he regarded weakness (虛證) as a vital factor in obstetrics and gynecology. Third, he added "mental state" to the list of basic physiological characteristics of women. Fourth, he presented a new diagnostic standard based on a spectrum of fire (火) and cold (冷). There are 363 prescriptions in this book, and 171 of them are from 『Donguibogam (東醫寶鑑)』. The books frequently used prescriptions are all designed to supplement (補藥). There are 48 prescriptions that original to Cho Heon-yeong. Additionally, this book contains eopsaeng (攝生) and pretended stimulation therapies and exercise methods.

• 한국병원경영학회지
• /
• 제6권1호
• /
• pp.62-84
• /
• 2001

The purpose of the study was to compare patient's satisfaction on the pharmacy services after introducing the new system of separation of dispensing from prescribing medicines, between those filling their prescriptions from the pharmacy nearby hospitals and those from the pharmacy in their resident areas. To measure patient's satisfaction, a questionnaire survey was conducted with 354 outpatients who received prescriptions from any of the three university hospitals located in In-Cheon city. Study results showed that geographic accessibility to pharmacy was a main attribute to select pharmacy. Size of the pharmacy and availability of prescription drugs are the second major reasons for pharmacy selection for the patients from the pharmacy nearby hospital, whereas patronage is the second major reason for those from the pharmacy in resident areas. Overall satisfaction was higher among the patients from the pharmacy in resident areas than those from the pharmacy nearby hospitals, mainly due to better facilities(waiting area, public telephone, etc), kindness, cleanliness, shorter waiting time, and pharmacist's concern about patient's health. On the other hand, the patients of the pharmacy nearby hospitals showed low satisfaction because of long waiting time and the lack of pharmacist's knowledge and information about patients' health status and medication history. Patients visiting the hospital that has pharmacy-hospital cooperation system showed higher satisfaction as compared to those visiting the hospital without such system. This study provided an empirical evidence that it would be more advantageous for patients to receive pharmacy services from pharmacies located in their living areas than from pharmacies nearby hospitals. This implies that there is a strong need for adequate strategies to enhance the role of pharmacies in resident areas under the new system of separation of dispensing from prescribing medications.

• 한국안광학회지
• /
• 제14권2호
• /
• pp.35-39
• /
• 2009

목적: 본 연구는 각막지형검사기의 각막형상을 이용하여 각막수차를 구현하는 프로그램을 개발하고자 하며, 개발된 프로그램을 이용하여 저니케 다항식(Zernike Polynomial)으로 파면과 각막수차를 구현하고자 한다. 방법: 각막지형검사기인 ORBSCAN의 각막형상 데이터로부터 각막의 형상을 재구성하기 위해 저니케 다항식을 사용하였으며, 이때 동공의 유효구경은 6 mm를 고려하였다. 구현된 각막형상으로부터 광선추적을 사용하여 동일한 광학적 거리의 파면을 구현하는 프로그램을 개발하였으며, 파면으로부터 6차 28항의 저니케 계수로 각막수차를 구현하였다. 결론: 본 연구에서는 각막지형검사기의 각막형상으로부터 각막의 수차와 파면을 구현하는 프로그램을 개발하였으며, 이러한 결과는 각막지형검사기 개발과 콘택트렌즈 및 OK렌즈 처방에 유용하게 적용될 수 있으리라 사료된다.

• 대한한의학원전학회지
• /
• 제30권3호
• /
• pp.95-108
• /
• 2017

Objectives : The concept of hidden Yin in summer by Zhu Danxi deals with the relationship between summer heat disease and hidden yin inside of human body. This paper attempts to ponder upon the clinical issues around which the discussions regarding the topic unfolded, and upon the texts on which the doctors of the discussions based their opinions. Methods : First, Danxi's argument as discussed in $G{\acute{e}}zh{\grave{i}}y{\acute{u}}l{\grave{u}}n$ is analyzed to find out his understandings of clinical issues and his textual sources on which he based his new perspective. Moreover, the prescriptions that Danxi thought was problematic and the concept of hidden yin as it existed before the time of Danxi are reviewed, and these findings are used understand Zhangjingyue's ground of criticism against Danxi. Lastly, this paper contemplates how these opposing opinions may be helpful to the general principles of medical theories. Results & Conclusions : There was a trend before the time of Danxi of abusing drugs as prescription based on warm-heat, understanding that a human body has yin-cold during summer. However, Danxi brought forth a new concept of yin deficiency in order to correct people's misunderstanding. Despite his effort, Zhangjingyue and other doctors contemporary to Danxi emphasized on one hand that human body is placed on a state of external heat inside the cold, and on the another, criticized Danxi of failing to fully understand the principle of "Abandon the time and follow the symptoms", a principle which asserts that the cold and warm of medicine should be decided by the symptom itself and not by the season. The value of these contradicting assertions seems to hold true even to this day because it helps us understand that the principles of "Counting Season as a Treatment Factor" and "Abandon the time and follow the symptoms" could be applied with balance in conjunction with each other.

• Journal of Korean Neurosurgical Society
• /
• 제52권2호
• /
• pp.98-102
• /
• 2012

Objective : To study the clinical significance and relevant factors of radiation-induced intratumoral necrosis (RIN) and peritumoral edema (PTE) after Gamma knife radiosurgery (GKRS) for intracranial meningiomas. Methods : We retrospectively analyzed the data of 64 patients who underwent GKRS for intracranial meningioma. The mean lesion volume was 4.9 cc (range, 0.3-20), and the mean prescription dose of 13.4 Gy (range, 11-18) was delivered to the mean 49.9% (range, 45-50) isodose line. RIN was defined as newly developed or enlarged intratumoral necrosis after GKRS. Results : RIN and new development or aggravation of PTE were observed in 21 (32.8%) and 18 (28.1%) cases of meningioma, respectively during the median follow-up duration of $19.9{\pm}1.0$ months. Among various factors, maximum dose (>25 Gy) and target volume (>4.5 cc) were significantly related to RIN, and RIN and maximum dose (>24 Gy) were significantly related to the development or aggravation of PTE. In 21 meningiomas with development of RIN after GKRS, there was no significant change of the tumor volume itself between the times of GKRS and RIN. However, the PTE volume increased significantly compared to that at the time of GKRS (p=0.013). The median interval to RIN after GKRS was $6.5{\pm}0.4$ months and the median interval to new or aggravated PTE was $7.0{\pm}0.7$ months. Conclusion : A close observation is required for meningiomas treated with a maximum dose >24 Gy and showing RIN after GKRS, since following or accompanying PTE may deteriorate neurological conditions especially when the location involves adjacent critical structures.

• 한국의료질향상학회지
• /
• 제2권1호
• /
• pp.68-84
• /
• 1995

Background: Guideline for practice is useful because it can be the standard for assessment and way to improve quality. We need to take account of expert opinion and consensus as well as scientific evidences to develope practice guideline because it should be practical. Delphi method has been developed to gather opinions from experts fairly. This study was designed to develop practice guideline and apply it to practices as a method to improve quality in primary medical care. Methods: Hypertension(in adults over 18 years old) was selected as a target problem. Self questionnaires about management of hypertensive patients were developed by a researcher with advice of 11 experts. The questionnaires were designed to response as a 5 pont scale. The results of previous questionary were given to respondents in second and third questionnaires. If needed, the questionnaires were changed on the previous responses. The items with medium greater than or equal to 4 point in 1st and 2nd responses were accepted in guideline. The items with medium lesser than or equal to 3 point were questioned again about whether they can be excluded or not. The criteria for assessment was made with reference to guideline and applied to 85 hypertensive patients of 9 family practitioners. At 3 months after practice guideline had been given to family practitioners, performance of same practitioners was assessed with 36 new hypertensive patients. Results: 23 professors in family medicine, 22 family practitioners and 6 cardiologists, responded among 50, 50, 15 respectively. Practice guideline with 33 items was developed as a result of 3 times questionaires. The difference of responses between professors in family medicine, family practitioners and cardiologists was not significant. Performance of practice was improved in diagnosis, history taking about 6 fields, laboratory examination and decision making about time of pharmaceutical prescription. It was not improved in physical examination, life style modification, method of pharmaceutical prescription, choice of initial antihypertensives and history taking about duration of disease and diet habit. It was decreased in history taking about psychosocial factors. The assessment scores were low in history taking, physical examination and life style modification before and after use of practice guideline. Conclusion: Practice guideline for hypertension could be developed by Delphi method. Performance of practice improved partially after use of guideline.

• 한국의사학회지
• /
• 제33권1호
• /
• pp.31-41
• /
• 2020

Purpose : This study compares prescriptions in the 1901 edition of the Donguisusebowon (東醫壽世保元) and the 1901 edition of 24 Revised Tae-eum constitution prescriptions (新定太陰人病應用要藥二十四方) (1901PCDT) with medical herbs found in classical texts. This study also examines whether to include patterns which compose medical herbs for the person of Tae-eum constitution (太陰人). Method : The prescriptions for Tae-eum-in in the Shinchukbon and the ingredients of medical herbs of the prescriptions of the Complete Works of Zhang Jingyue (景岳全書), Secret Works of Universal Benefit (廣濟秘笈), Treasured Mirror of Eastern Medicine (東醫寶鑑), Comprised Edition for Formulas (方藥合編), Protecting Essence for Longevity (壽世保元), Introduction to Medicine (醫學入門), New Book for Saving People (濟衆新編 ENGLISH), and Compendium of Local Medicinals and Formulas (鄕藥集成方) were input into a database. The prescriptions were examined and combinations of medical herbs used to treat the person of Tae-eum constitution were noted. Result : Among the prescriptions for the person of Tae-eum constitution, similar examples of the 17 prescriptions of Kudzu Decoction to Relieve the Muscles (葛根解肌湯), Regulate the Stomach and Coordinate the Purity Decoction (調胃升淸湯), Clear the Heart and Lotus Pip Decoction (淸心蓮子湯), Decoction for Stabilizing Asthma with Ephedra (麻黃定喘湯), Profuse Heat and Sparse Cold Decoction (熱多寒少湯), Decoction for Coordinating Qi with Kudzu (葛根承氣湯), Major Decoction for Coordinating Qi with Kudzu (葛根大承氣湯), Minor Decoction for Coordinating Qi with Kudzu (葛根小承氣湯), Decoction for Dispersing the Exterior with Ephedra (麻黃發表湯), Boost the Lung Essence Decoction (補肺元湯), Major Supplementing Decoction with Deer Antler Velvet (鹿茸大補湯), Boosting Black Essence Pill (拱辰黑元丹), Honeylocust Fruit and Rhubarb Decoction (皂角大黃湯), Kudza and Duckweed Decoction (葛根浮萍湯), Sweet Flag and Polygala Powder (石菖蒲遠志散), Liriopis and Polygala Decoction Powder (麥門冬遠志散), and Cattle Gallstone Formula to Clear the Heart (牛黃淸心元) were found in important ancient literature and Dried Chestnut and Holotrichia Decoction (乾栗蠐螬湯) and Dried Chestnut and Tree of Heaven Root Bark Decoction (乾栗樗根皮湯) are the combination originally set by Lee Jema. Conclusion : Because 70.8% of the prescriptions in 1901PCDT could be found in literature which were pervasive in the period of the Joseon Dynasty (the period of Ming and Qing), it corresponds with Lee Jema's view that medical men in the Song, Yuan, and Ming Dynasties disclosed half of the prescriptions for Tae-eum person by studying these texts more.

• 대한한의정보학회지
• /
• 제21권2호
• /
• pp.11-23
• /
• 2015

Objectives : Through a comparative study between Sasang constitutional medicine and Syndrome identification and treatment medicine about the theory of diagnosis, the theory of herbal medicine, the theory of prescription, the theory of acupuncture and constitutional medicine to put forward a complementary perfect solution which has good clinical utility. Methods : We compared and sorted out the textbook of Korean Sasang constitutional medicine which named Sasang medicine, and also the textbook of Chinese TCM which was including Basic theory of TCM, Diagnostics of TCM, Science of Chinese materia medica, Pharmacology of traditional Chinese medical formulae, Science of acupuncture and moxibustion, Constitution of TCM, and also related papers. Results : (1) Through a comparative study between Sasang constitutional medicine and Syndrome identification and treatment medicine about diagnosis, herbal medicine, prescription and acupuncture, Sasang constitutional medicine is a medical system which gives priority to balance of organs, when Syndrome identification and treatment medicine is a medical system that gives priority to improve symptom. (2) The prescriptions of Sasang constitutional medicine are used for the treatment of basic pathogenesis in the chronic stage of the disease, which can recover vital qi, when Syndrome identification and treatment medicine are used for the treatment of stage pathogenesis in the acute stage of the disease, which can get rid of pathogenic factors. (3) There are two kind of complementary perfect solution between Sasang constitutional medicine and Syndrome identification and treatment medicine. One perfect complementary medicine is that Sasang constitutional medicine plays a major role when Syndrome identification and treatment medicine plays a supporting role. The other one is that Syndrome identification and treatment medicine plays a major role when Sasang constitutional medicine plays a supporting role. It determined by the usual symptoms and the symptoms now, vital qi and pathogenic factors, symptom and the root cause, acute stage and chronic stage, and the state of pathogenesis. Conclusion : A new perfect complementary medicine can be created which is based on the setting that Sasang constitutional medicine primarily treat the usual symptoms, vital qi, the root cause, chronic stage and basic pathogenesis when Syndrome identification and treatment medicine primarily treat the symptoms now, pathogenic factors, symptom, acute stage and stage pathogenesis.

• 동의생리병리학회지
• /
• 제20권6호
• /
• pp.1431-1441
• /
• 2006

Following conclusions were drawn from the examination of the usage of semen persicae and fols carthami from the view of Hyungsang Medicine. Semen persicae is used to vitalize the blood flow and eliminate the blood stagnation of the whole body in ${\ulcorner}$Donguibogam${\lrcorner}$, and therefor it is used for the blood flow of the heptal meridian and sometimes the intestinal meridian. Flos carthami is applied to vitalize the blood flow, remove obstructions in meridians, eliminate the blood stagnations, and stop the pain in ${\ulcorner}$Donguibogam${\lrcorner}$, therefore used in such symptoms of blood flow of the heptal meridian as amenorrhea, spasm of muscles, and coldness of the genitals. Also is applied in those cases of exhaustion, perspiration, and in digestive remedies which belong to the symptoms of cardiac blood flow. And it is used for dryness of the skin in which case the blood should be developed and malaria for the elimination of the blood stagnation and production of new blood. The combination of semen persicae and flos carthami is applied to eliminate the blood stagnation and stimulate menstrual discharge in uterus, as well as in the cases of lumbago and stomachache due to blood stagnation, blood stasis, mass in the abdomen, and abdominal distention. This combination is also used for the eyes, ears, numbness, and paralysis of hands and feet for the purpose of making the flow of the meridian smooth, and for diabetes, dryness of the skin, malaria, anal itching and pain for the purpose of eliminating the mass and renewing the tissues. The combination is diversly used in the book of ${\ulcorner}$Special lectures on clinical cases${\lrcorner}$ for the aftereffects of traffic accident, constipation, diabetes, dryness of the skin, paralysis of hands and feet, numbness of finger of hand and foot, and especially used frequently with prescription of Yijintang and Samultang combined in the cases of numbness. The prescription is used in Hyungsang medicine when the uterus, the external appearance(axis), hands and feet, heart, and the stomach is not good for the vitalization of the flow of the 12 meridians. It was though difficult to find extinguishing differences between the two herbs in the clinical cases applied in the book of ${\ulcorner}$Special lectures on clinical cases${\lrcorner}$.