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A Study of Yi cheon's Medical Ideology and Research System (이천 의학사상(醫學思想)의 학술계통(學術系統) 및 특징(特徵)에 대한 연구(硏究))

  • Cha, Wung Seok
    • The Journal of Korean Medical History
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    • v.14 no.2
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    • pp.189-248
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    • 2001
  • In this essay, following final conclusions have been drawn by analyzing medical ideology and research system of Yi cheon in Yi hak yip mun("醫學入門"). Firstly, even though the existing medical history researchers are not noting the system of Yi-cheon's medical ideology, this essay has proved the man as a doctor who succeeded the (main system) based on the content of Yi-hak-yip-mun("醫學入門") by Ju-Dan-Gae(朱丹溪). The outline of this proof is as follows. 1. Those doctors who had actively researched in Myung era(明代), were basically taking over the medical studies and result of Gum-Won era(金元代). However, depending on whose theory is to be followed, the followers are largely divided into two groups of Ju-Dan-Gae Academics(丹溪學派) and On-Boe Academics(溫補學派). In addition, both Ju-Dan-Gae Academics(丹溪學派) and On-Boe Academics(溫補學派) hold contradictory ideologies to that of the main medical system. In Yi-hak-yip-mun("醫學入門"), Yi-cheon(李?) ties The Text of Whang-Jae-Nae-Kyung("黃帝內經"), Jang-Jung-Kyung(張仲景), Yu-Ha-Gun(劉河間), Yi-Dong-Won(李東垣), Ju-Dan-Gae(朱丹溪) into one pedigree. With regard to the main system, he especially marks Ju-Dan-Gae(朱丹溪) for his efforts in gathering various medical theories into a large compilement. 2. When Yi-Cheon(李?) was writing Yi-Hak-Yip-Mun("醫學入門"), he made references to various medical publishings, among those book which he had utilized, books by Ju-Dan-Gae Academics(丹溪學派) had affected him more than anything else in terms of both quality and quantity. 3. Yi-Cheon(李?)'s "Congested Phlegm Theory(痰鬱論)" had succeeded "Congested Phlegm Theory(痰鬱論) of Ju-Dan-Gae Academics(丹溪學派). His Yi-Hak-Yip-Mun("醫學入門"), carries a more complete form of "Congested Phlegm Theroy(痰鬱論) which was made into a more systemic and widely applicable method which was by Ju-Dan-Gae Academics(丹溪學派). Secondly, Yi-Hak-Yip-Mun("醫學入門"), is a medical book which was written in the process of systemic reorganization of medical theories of various academic parties in Myung 명 era. Since this process was hearing its completion in the period of Yi-Cheon(李?), he chose specific ways of reshuffling, whilst seeking ways to efficiently utilizing existing medical information . He provided a standard to specific ways. He rearranged the existing medical theories based upon these standards. He also contributed to clinical medicine by providing description of symptoms focused upon the symptoms differentiated In Conclusion, Yi-Hak-Yip-Mun("醫學入門") holds systematic medical information which was developed by Ju-Dan-Gae Academics(丹溪學派). Also, Yi-Cheon(李?) uniformly classified the clinical experiences of existing Ju-Dan-Gae Academics(丹溪學派). He had contributed in the clinical use of Ju-Dan-Gae Academic(丹溪學派)'s clinical experience by providing main points from differentiation of symptoms.

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Iron Nutritional Status of Infants and Young Children in the Seoul Area

  • Um, Sung-Sin;Ahn, Hong-Seok;Kim, Soon-Ki;Ha, Jung-Hun
    • Journal of Community Nutrition
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    • v.4 no.1
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    • pp.3-11
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    • 2002
  • The purpose of this study is to evaluate the iron nutritional status by investigating dietary intake and analyzing the hematological iron status indices including serum transferrin receptor (sTfR) in 8 to 28 month old infants md young children taking supplementary foods. The nutrient intake of 60 healthy infants and young children from 8 to 24 months of age was investigated by means of a 24-hour recall method, and the subjects were divided into 2 groups (8- 12 months and 13-28 months) according to age. Venous blood samples from these groups were collected and measured for the following : hemoglobin(Hb), hematocrit(Hct) , mean corpuscular volume (MCV), mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration (MCHC), serum ferritin, serum iron, total iron binding capacity (TIBC), and sTfR. Anemia is defined as hemoglobin < 11g /dl , serum ferritin level < 10ng1m1 for iron deficiency , serum transferring receptor(sTfR) > 4.5mg / 1 for iron deficient erythropoiesis. Total daily calorie intake was 934.6 ${\pm}$ 284.5kcal (98.32% of RDA) on average. Average daily iron intake in infants aged 8 to 12 months was 8.92 ${\pm}$ 3.32mg. The mean daily iron intake in infants aged 13 to 28 months was 7.15 ${\pm}$ 3.35mg (90% of Recommended Dietary Allowance, RDA). Mean values for Hb, Hct sew ferritin and sTfR were 12.10 ${\pm}$ 0.77g141,36.02 ${\pm}$ 2.31%,20.91 ${\pm}$ 11.58ng/m1 and 3.78 ${\pm}$ 1.47mg /1, respectively. In the young children from 13 to 28 months of age, the prevalence of anemia was 5.6%. The prevalence of iron deficiency was 9.5% in those from 8 to 12 months of age, and 27.8% in those from 13 to 28 months of age. The prevalence of iron deficient erythropoiesis was 16.7% in infants aged 8 to 12 months and 44.4% in those aged 13 to 28 months. The prevalence of both serum ferritin level < 10ng/m1 sTfR > 4.5mg/1 was 22% in the young children aged 13 to 28 months. The measureand ment of sTfR may be a promising new tool in diagnosis of iron deficiency in early childhood when the iron deficiency is prevalent. It seems appropriate to emphasize nutritional education and evaluation to promote the iron nutritional status of infants and young children.

The study of the usage of Jiu-Zhen (九鍼) (구침(九鍼)에 관(關)한 연구(硏究))

  • Jeong Ki-Jin;Jo Hyeon-Seok;Yoon Jong-Hwa
    • Journal of Korean Medical Ki-Gong Academy
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    • v.2 no.2
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    • pp.185-199
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    • 1998
  • Going back to long chinese medical history, there were many different methods of treatment according to the origin of local chinese areas, such as Bian-Shi(?石) from east, herbal therapy from west, acupuncturing from south, moxibustion from north, and mainpulating therapy from middle china. In the midst of these therapies, acupuncture needling had developed very much both in theories, shapes, usages and also in theraputic boundray. Historical books dealing with acupuncture had introduced and used Jiu-Zhen as a tool for acupuncture needling in common. But there are some differences between each texts about in shape, use, and there are also another different point of view about the interrelationship between Bian-Shi and Ji-Zhen. So the author, in this research, tried to look for how Jiu-Zhen had took on its real kinds, adaptive usages, theraputic boundaries, many different skills of needing. By researching over ${\ulcorner}$ Ling-Shu, Jiu-Zhen(靈樞,九鍼)${\lrcorner}$, ${\ulcorner}$ Ling-Shu, Jiu-Zhen-Shi- Yi-Yuan(靈樞,九鍼十二原)${\lrcorner}$, ${\ulcorner}$ Ling-Shu, Guan-Zhen(靈樞,官鍼)${\lrcorner}$, and by compar- ing them with the contents of Jiu-Zhen in ${\ulcorner}$ Zhen-Jiu-Yi-Jing(鍼灸甲乙經)${\lrcorner}$ ${\ulcorner}$Zhen-Jiu-Da-Cheng (鍼灸大成)${\lrcorner}$, the author discovered small conclusions such as following. 1. Taking Jiu-Zhen in a narrow sense, it only repesents nine different needle used in different cases. But in large sense, this means nine different deedling methods using each different needles which is represented in the form of Wu-Ci ( 五剌 ), Shi-Yi-Ci ( 十二剌 ) in ${\ulcorner}$ Ling-Shu, Guan-Zhen ${\lrcorner}$ 2. Jin-Zhen has been first originated from stone age as a substitute for Bian-Shi and through bronze and iron age, it followed a process of it's own shape and applicating functions. As an example, the moxibustional therapies shown in ${\ulcorner}$ Zu-Bi-Shi-Yi-Mai- Jiu-Jing ( 足臂十一脈灸經 )${\lrcorner}$ ${\ulcorner}$ Yin-Yang-Shi-Yi-Mai-Jiu-Jing ( 陰陽十一脈灸經)${\lrcorner}$ in ahead of ${\ulcorner}$ Nei-Jing ( 內經 )${\lrcorner}$ era, was relationship in acupuncturing skills and shape. So Jiu-Zhen had been originated on the base of Bian-Shi in ancient times to develop into delicate shape, skill, and theraputic foundation of modern oriental medicine.

Case of Service Design Process for Medical Space Focused on Users (사용자중심 의료공간을 위한 서비스디자인 프로세스의 적용사례)

  • Noh, Meekyung
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.21 no.4
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    • pp.27-36
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    • 2015
  • Purpose: Of late, the focus of service design is moving toward emphasizing customer satisfaction and taking users' experience more seriously. In addition to the change in perspective in service design, scholars in this area are paying more attention to service design methodology and process, as well as its theory and real-world case studies. In the case of medical space, there have been few studies in attempting to apply service design methods useful for deriving user-focused results. The author of this paper believes, however, case study-oriented approaches are more needed in this area rather than ones focusing on theoretical aspects. The author hopes thereby to expand the horizon to practical application of spatial design beyond service design methodology. Methods: In order to incorporate the strengths of service design methodology that can reflect a variety of user opinions, this study will introduce diverse tools in the framework of double diamond process. In addition, it will present field cases that successfully brought about best results in medical space design. It will end with summarizing the ideal process of medical space design which is reasonable and comprehensive. Results: Medical service encompasses preventive medicine as well as treatment of existing medical conditions. A study in establishing the platform of medical service design consists of a wide range of trend research, followed by the summary of two-matrix design classification based on results of the trend research. The draft of design process is divided into five stages composed of basic tools for establishing spatial flow lines created by matching service design tools with each stage of space design processes. In all this, most important elements to consider are communication and empathy. When service design is actually applied to space design, one can see that output has reflected the users' needs very well. The service design process for user-oriented medical space can thus be established by interactions on the final outcome and feedback on the results. Implications: One can see that the service design with the hospital at its center produces the result that encompasses the user's needs best. If the user-focused service design process for medical space can be extended to other space designs, the author believes that it would enhance the level of satisfaction for users and minimize trials and errors.

Evaluation on the Practicum Using Standardized Patients for Nursing Assessment to Articular Disease (표준화 환자를 이용한 관절질환 간호사정 실습교육의 평가)

  • Yi, Yeo-Jin;Lim, Nan-Young;Lee, Eun-Hee;Han, Hye-Ja;Kim, Joo-Hyun;Son, Haeng-Mi;Park, Young-Sook;Kang, Hyun-Sook;Cho, Kyung-Sook;Kim, Dong-Oak;Kwon, Sung-Bok;Lee, In-Ok
    • Journal of muscle and joint health
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    • v.14 no.2
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    • pp.137-148
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    • 2007
  • Purpose: This study was performed to evaluate of practicum by using standardized patient(SP) for nursing assessment. Method: This study had 2 steps. The 1st-step was pre-intervention stage including selection of a learning title, formation of case scenario, training of SP and developing the evaluation tools for students' clinical competence to assessment, 6 categories 29 items. The 2nd-step consisted of intervention and evaluation stages. 34 nursing students divided 2 groups participated in assessing the SP. Evaluation of each group was performed by 2 nursing professors. All students recorded their feelings after assessing the SP. The SP also evaluated about nursing students' attitude toward the SP. Results: ICC(Interclass correlation coefficient) between 2 groups was over 0.7 all categories. Students' assessing score(range 0-1) was muscular-joint function status(0.41), nutritional status(0.39), history taking(0.38), IADL(0.18), ADL(0.15), and emotional status (0.07). The mean scores of the nursing students' attitude by SP was 4.03(range 1-6). Also most students showed positive reactions to the education using SP because they had the chance to experience what they could not practice in clinical setting. Conclusion: The evaluation tool revealed high reliability. Nursing students' clinical competence was below average. But they took a good attitude to SP. We recommended further research using SP with various disease.

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Predictors of Metabolic Syndrome in Chronic Schizophrenic Patients Followed for 5 Years(2011-2016) (5년 동안 추적한 만성 조현병 환자에서 대사증후군의 예측인자)

  • Joe, Jae-Gil;Yoon, Bo-Hyun;Jeon, Bong-Hee;Park, Su-Hee;Song, Je-Heon;Jeong, Ha-Ran;Hong, Kye Hyun
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.2
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    • pp.217-226
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    • 2016
  • Objectives : To investigate changes in, and predictors of, metabolic syndrome(MetS) status over a 5-year period in chronic schizophrenic patients and to identify factors associated with the prevention of or recovery from MetS. Methods : In total, 107 patients, all of whom provided written informed consent, were followed from 2011 to 2016 at Naju National Hospital for this study. MetS was defined according to the revised National Cholesterol Education Program-Adult Treatment Panel III guidelines. Results : During follow-up period, 22(20.5%) patients were newly diagnosed to MetS, 14(13.1%) were disappeared, 77(66.4%) were not changed[MetS : 34(31.8%), No MetS 37(34.6%)]. Common significant factors in the two changed groups were triglyceride and waist circumference, not dose and type of antipsychotic medication. Multiple logistic regression analysis revealed that female gender(odds ratio[OR]=2.846, 95% confidence interval[CI] : 1.020-7.942), attending two or more outpatient visits per month(OR=3.155, 95% CI : 1.188-8.379) and taking antidepressant medication(OR=3.991, 95% CI : 1.048-15.205) were significantly associated with MetS after controlling for other confounding variables. Type and dose of antipsychotic medication were not significantly associated with MetS. Conclusions : Triglyceride and waist circumference were important manageable indicator of MetS. Adoption of a healthy lifestyle is more important than adjusting the dose or type of antipsychotic medication in the treatment of chronic schizophrenia patients with MetS.

Melatonin for Treatment of Delirium in Hospitalized Patients : Retrospective Trial (입원 환자의 섬망 치료에서 멜라토닌의 효과에 관한 후향적 연구)

  • Yang, Jung Woo;Kim, Jong Woo;Kang, Won Sub;Lee, Sang Min;Kim, Young Jong;Paik, Jong-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.112-118
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    • 2018
  • Objectives : Delirium is one of the most common mental illnesses that can affect cognitive function. Melatonin has been shown to be effective in the treatment of insomnia, and recent studies have shown a protective effect to prevent delirium. This study was conducted to investigate the efficacy of melatonin in delirium patients. Methods : All patients were referred to psychiatric department for insomnia and symptoms of delirium, and were diagnosed delirium by the DSM-5 diagnostic criteria. We compared base line severity of delirium with K-DRS-R-98-R (Korean version of Delirium Rating Scale revised 98) and after taking 2mg of melatonin, retrospectively. The side effects were also identified by referring to the medical records. Results : A total 21 patients had taken melatonin for insomnia and delirious symptoms. The K-DRS-R-98 scores were decreased from $15.24{\pm}2.64$ before treatment to $6.57{\pm}5.42$ after treatment. And CGI-S scores were also decreased from $4.14{\pm}0.48$ before treatment to $2.81{\pm}0.93$ after treatment (p<0.05). Conclusions : This study illustrates the possibility of melatonin as an effective treatment option for delirious symptoms such as disorientation, motor agitation, lability of affect and hallucinations as well as insomnia, with less concerns of drug side effect. Further study with a larger sample and prospective design will be required to confirm these results.

Portable Low-Cost MRI System Based on Permanent Magnets/Magnet Arrays

  • Huang, Shaoying;Ren, Zhi Hua;Obruchkov, Sergei;Gong, JIa;Dykstra, Robin;Yu, Wenwei
    • Investigative Magnetic Resonance Imaging
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    • v.23 no.3
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    • pp.179-201
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    • 2019
  • Portable low-cost magnetic resonance imaging (MRI) systems have the potential to enable "point-of-care" and timely MRI diagnosis, and to make this imaging modality available to routine scans and to people in underdeveloped countries and areas. With simplicity, no maintenance, no power consumption, and low cost, permanent magnets/magnet arrays/magnet assemblies are attractive to be used as a source of static magnetic field to realize the portability and to lower the cost for an MRI scanner. However, when taking the canonical Fourier imaging approach and using linear gradient fields, homogeneous fields are required in a scanner, resulting in the facts that either a bulky magnet/magnet array is needed, or the imaging volume is too small to image an organ if the magnet/magnet array is scaled down to a portable size. Recently, with the progress on image reconstruction based on non-linear gradient field, static field patterns without spatial linearity can be used as spatial encoding magnetic fields (SEMs) to encode MRI signals for imaging. As a result, the requirements for the homogeneity of the static field can be relaxed, which allows permanent magnets/magnet arrays with reduced sizes, reduced weight to image a bigger volume covering organs such as a head. It offers opportunities of constructing a truly portable low-cost MRI scanner. For this exciting potential application, permanent magnets/magnet arrays have attracted increased attention recently. A magnet/magnet array is strongly associated with the imaging volume of an MRI scanner, image reconstruction methods, and RF excitation and RF coils, etc. through field patterns and field homogeneity. This paper offers a review of permanent magnets and magnet arrays of different kinds, especially those that can be used for spatial encoding towards the development of a portable and low-cost MRI system. It is aimed to familiarize the readers with relevant knowledge, literature, and the latest updates of the development on permanent magnets and magnet arrays for MRI. Perspectives on and challenges of using a permanent magnet/magnet array to supply a patterned static magnetic field, which does not have spatial linearity nor high field homogeneity, for image reconstruction in a portable setup are discussed.

Prescription Pattern of 1 Year Clozapine Maintenance and Augmentation Agents in Schizophrenia Spectrum Disorders (조현병 스펙트럼 장애의 1년 유지 치료에서 클로자핀과 병용 치료제의 처방 양상 분석)

  • Kim, Jaewon;Kim, Se Hyun;Jang, Jin-Hyeok;Moon, Sun-Young;Kang, Tae Uk;Kim, Minah;Kwon, Jun Soo
    • Korean Journal of Biological Psychiatry
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    • v.28 no.2
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    • pp.50-57
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    • 2021
  • Objectives Clozapine is the most effective atypical antipsychotic agent for the treatment-resistant schizophrenia (TRS), however, only 40%-70% of TRS patients respond to clozapine. Moreover, TRS encompasses various symptom dimensions. Therefore, augmentation with other medications for clozapine is frequently applied. However, the prescription pattern of clozapine and combined medications in Korea is yet to be examined. This study aims to investigate the maintenance treatment pattern of clozapine and augmentation agents in one Korean tertiary hospital. Methods The patients with schizophrenia spectrum disorders under clozapine maintenance, defined as one-year clozapine continuation, were subjected for analysis. Medication data at one-year time-point after clozapine initiation was extracted and analyzed. Results Among total 2897 patients having clozapine prescription experience from January 2000 to December 2018, 1011 patients were on clozapine maintenance. The mean age of clozapine initiation was 30.2 ± 11.3 years, and the maintenance dose of clozapine was 217.8 ± 124.3 mg/day. Combination rate of antipsychotics, mood stabilizers, and antidepressants were 43.5%, 25.3%, 38.6%, respectively. Most frequently prescribed drugs in each category were aripiprazole, valproate, and sertraline. Olanzapine equivalent dose of combined antipsychotics was 10.4 ± 7.7 mg/day. Male patients were prescribed higher dose of combined antipsychotics and higher rate of antidepressants. Female patients had later onset of clozapine prescription. Patients with two or more combined antipsychotics were prescribed higher dose of clozapine and higher rate of antidepressants compared to patients with one combined antipsychotic. Conclusions Taken together, among the patients taking clozapine, a substantial rate of patients were under polypharmacy. The present findings based on the real-world prescription pattern could provide the valuable clinical information on the treatment of TRS-related conditions.

Relationship between Lipoprotein(a) and Dyslipidemia in the Elderly over 60 Years (60세 이상 노인에서 혈중 지단백(a)와 이상지질혈증의 관련성)

  • Seo, Yo-Han;Shin, Hee-Young
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.2
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    • pp.95-102
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    • 2022
  • The relationship between lipoprotein(a) and dyslipidemia is not clear. This study was therefore undertaken to investigate the relationship between lipoprotein(a) and dyslipidemia in elderly patients over 60 years. From 2014 to 2020, a total of 2,580 adults aged 60 years or older (73.31±7.24 years, 1,954 males) were enrolled in the study. The patients had checked into a general hospital, and data were obtained for lipoprotein(a), LDL-C, TG, HDL-C, hs-CRP, HbA1c, sex, age, BMI, dyslipidemia diagnosis, and use of lipid-lowering agents. BMI and HbA1c showed no correlation with lipoprotein(a), but hs-CRP (r=0.138), LDL-C (r=0.097), HDL-C (r=-0.089), TG (r=-0.073), and age (r=0.072) were significantly correlated to lipoprotein(a). The partial correlation between lipoprotein(a) and LDL-C, which was adjusted for variables, was significant only in the male gender (r=0.158, P<0.001). As the odds ratio of the 4th quartile of lipoprotein(a) (OR=1.376, 95% CI=1.038~1.822) for dyslipidemia was found to be significant in this study when the level of LDL-C, the primary target, could not be reduced even by taking lipid-lowering drugs, we propose that lipoprotein(a) should also be included among the several factors considered as secondary targets. Our results indicate that studies on various lipid factors considering the sex, age, types and use of lipid-lowering agents, are warranted.