King Jungjo who introduced the advent of cultural renaissance of Chosun Dynasty as little been known about his work in medicine. With a wide knowledge in medicine, he was the only one among the kings who wrote a book on medicine, called "SueMinMyoJeon". In this paper, his perspective on medicine will be looked into based on "The Annals of the Chosun Dynasty", "Seungjeongwon Ilgi", "Hong Je jun Se", "KukGoBoGam", "Ildkrok", "JeJungShinPyun", "SueMinMyoJeon" etc. King Jungo valued empiricism in the field of medicine. He deepened understandings in medicine while taking care of King Youngjo, the late king. And it led him to author "SueMinMyoJeon" himself, and further ordered the publications of "JeJungShinPyun" "MaGuaHeoiTong". These two books were conducted to include empirical cases of folklore remedy. King Jungjo's medical philosophy can be epitomized in filial piety and realization of people-serving politics, which are the essentials of Confucianism. His filial piety towards the late king, Youngjo and his mother is shown in his devotion when taking care of them. Especially the way he examined the differentiation of diseases and corresponding treatments is well described in "The Annals of the Chosun Dynasty". "JeJungShinPyun" was also published and it came handy for folk villagers in times of medical needs. Later this book influenced "BangYakHaepPyun" by Hwang Do Yeon. King Jungjo emphasized pragmatism in spreading medical knowledges, thus removing the theoretical contents that are related to Taoism, especially the ones on alchemy from "DongEuiBoGam", when publishing "SueMinMyoJeon". Even the excerpts from "SoMun" were taken out, if not practical. King Jungjo, however, discussed the importance of healthy regimen and mentioned himself practicing it from the book "IlDeukLok", which seems to be the only book that derailed from the pragmatistic track. King Jungjo put emphasis on consistency between diagnosis and treatment. In diagnosing, Meridian pulse was taken important as a means of finding the origin of disease, while deploring how doctors then neglected to study.
History, 18th Century ; Humans ; Korea ; Medicine, Korean Traditional/*history ; Philosophy, Medical/*history ; Reference Books, Medical

No abstract available.
Adult* ; Hernia* ; Humans

No abstract available.
Angiolipoma*

The objective of this study is to identify the difference in attitude toward medical care between patients who visited a university hospital or an oriental medical hospital of oriental medical college, and physicians who engaged in the same hospitals. The subjects of this study were 397 cases who agreed to respond the prepared questionnaire, including 288 patients(146 university hospital utilizers and 142 utilizers for an oriental medical hospital) and 109 physicians(76 physicians and 33 oriental medical doctors). The attitude toward medical care was measured by the structured questionnaire developed for this study, which had high validity and reliability according to factor analysis, item discriminant validity, and Cronbach's alpha coefficients. On the criteria of mean value of care and cure score, the attitude toward medical care was classified into 4 groups encompassing a group with dependent attitude on medical care, a group with skeptical attitude toward it, a group with cure-oriented attitude, and a group with care- preferred attitude. The results of chi-square test, discriminant analysis, and logistic regression analysis were as follows; patients who visited a university hospital, patients who visited an oriental hospital, physicians, and oriental medical doctors included in the group with dependent attitude, the group with cure-oriented attitude, the group with skeptical attitude, and the group with care-preferred attitude, retrospectively. Among the subdomains of care and cure domains, which classified in reference to the result of factor analysis on pilot study, those that patients ranked more importantly than physicians were 'the importance of medical equipment for diagnosis and treatment', 'authority of physician, 'aggressiveness of treatment', 'information giving', 'personal interest' in the case of western medicine. In the case of oriental medicine, those were 'the importance of equipment for diagnosis and treatment', 'aggressiveness of treatment', 'amenities and accessibility', 'coordination of medical staff'. Both physicans and patients put the subdomain, 'physicians' medical knowledge and skillfulness' on the highest rank. The differences in ranking the important attributes of medical care between patients and physicians were apparent in the area of an 'importance of medical equipment for diagnosis and treatment' and so on. It meant that patient had over-expectation on medical care and suggested that the policy on demand side such as the development and dissemination of an evidence-based recommendation protocol for health care consumers might be important in Korea. In addition, regarding the attitude of physicians, during the medical education and training it may be necessary to emphasize the aspect of 'care' of medical care rather than 'cure'. In planning on heath care delivery system, it should be considered that there is a difference in the attitude toward medical care between western medicine and oriental medicine as well as between health care providers and consumers. We expect that more valid measurement tool be developed in this area, which may be major limitation of this study and that this kind of research be expanded into the non-academic settings.
Delivery of Health Care ; Diagnosis ; Education, Medical ; Health Personnel ; Humans ; Korea ; Logistic Models ; Medicine, East Asian Traditional ; Pilot Projects ; Surveys and Questionnaires ; Reproducibility of Results ; Retrospective Studies

No abstract available.

Criss-cross heart which is a cardiac malformation caused by abnormal rotation of the ventricles early in embryonic development, is rare but a double outlet of right ventricle in criss-cross heart is very rare. We experienced a case of criss-cross heart which is situs solitus, concordant atrioventricular connection and double outlet of right ventricle with remote ventricular septal defect of perimembranous inlet type. A 4-years old female was diagnosed as a double outlet of right ventricle in criss-cross heart after echocardiography, cardiac catheterization and cardiac angiography. The surgical correction was a intraventricular reconstruction of left ventricular outflow with 3/4 circle of 20 mm Hemashield vascular graft from the ventricular septal defect to the aorta. The patient had a temporary atrioventricular block but was recovered uneventfully, and a postoperative echocardiogram showed no left ventricular outflow obstruction, no intracardiac shunt.
Angiography ; Aorta ; Atrioventricular Block ; Bays ; Cardiac Catheterization ; Cardiac Catheters ; Child, Preschool ; Crisscross Heart* ; Double Outlet Right Ventricle ; Echocardiography ; Embryonic Development ; Female ; Heart Septal Defects, Ventricular ; Heart Ventricles* ; Humans ; Pregnancy ; Transplants ; Ventricular Outflow Obstruction

Saccular aneurysm of the external jugular vein presenting as a neck mass is very rare. We report the surgical treatment of an external jugular venous aneurysm in a 48-year-old female patient due to the cosmetic problem of neck engorgement, concomitant with thyroidectomy for cancer.
Aneurysm* ; Female ; Humans ; Jugular Veins* ; Middle Aged ; Neck ; Thyroidectomy ; Vascular Diseases

The concept of intensive care has developed from experience in recovery rooms, in anesthetic work, and in early specialized units in different fields of medicine. Between the First and the Second World Wars special units were created in some German hospitals. Intensive care often means a combination of recovery-room service and intensive therapy. Intensive care, especially respiratory care is an important part of the responsibility of the anesthesiologist. So, we have analyzed statistically 3, 072 I.C.U. patients who were admitted during a period of 7 years beginning October 18, 1968 when the I.C.U. at Severance Hospital was opened, The results are as follows: I. Cases admitted to the I.C.U. (March,1970-August, 1975 ) 1) For 5 and a half years, the total number of patients was 2, 479. These patients were 2.7% of 91,400 patients who were admitted into Severance Hospital. 2) The mortality rate was 20.0% . Mortality rate was highest in 1970 (23. 7%) and lowest in 1975 (13. 5%). It has gradually decreased every year. 3) Total occupied bed days were 9,840 days (average 4,0 days). The occupied bed days of the majority of the patients (83.6%) were below 5 days comprising 88.3% of the total expired patients. 4) 50% of the patients were in the 21 to 50 year age group. The highest mortality rate occurred in the 51 to 60 age group (24.3%). 5) The number of patients admitted in the department of internal medicine was 702 cases (28.3%) which was the highest among all departments. The mortality rates of the departments of pediatric and neurosurgery were 40. 3% and 34. 7% respectively and those were relatively high values. 6) All I.C.U. patients have been divided into two categories, operative and non-operative. The operative cases were 1, 264 (51. 0%) and non-operative 1, 215 (49. 0%,). The mortality ,The Journal of The Korean Society of Anesthesiologists VoI. 9, No. 2, 1976 rate of the non-operative cases (22. 5%) was higher than operative (17. 6%). 73 Cardiovascular disease was the commonest cause of death of I.C.U, patients (107 cases) admitted from March, 1974 to August, 1975 (30 cases, 28. 0%). Respiratory support cases (October 18, 1968-August 31, 1975) ;. During the 7 year period, of all I.C.U. admission cases (3,072) 423 cases (13.8%) received respiratory support. These patients gradually increased every year. 2) The mortality rate was 44. 0% which was more than twice the over-all mortality rate of. I.C.U. admission patients. 3) The mortality rate was highest in the 21 30 age group (18. 7%). 4) The department of internal medicine admitted the largest number of cases (153 cases, 36. 2%). 5) Of all conditions, cardiovascular disease was most frequent (126 cases, 29. 8%). Here we have discussed the definition of I.C.U., the responsibility and important role of the anesthesiologist in the I.C.U. by illustrating present situations and presenting problems at the I.C.U. in Severance Hospital.
Cardiovascular Diseases ; Cause of Death ; Critical Care* ; Humans ; Intensive Care Units* ; Internal Medicine ; Mortality ; Neurosurgery ; Recovery Room ; World War II

BACKGROUND: Brother of the regulator of imprinted sites (BORIS) is a putative new oncogene that is classified as a cancer germline gene; however, its role in the development of cancer is unclear. This study investigated the expression of BORIS in lung cancer and its clinical implications. METHODS: The expression of BORIS messenger ribonucleic acid (mRNA) in the sputum of 100 patients with lung cancer (50 with squamous cell carcinoma, 36 with adenocarcinoma, and 14 with small-cell carcinoma) was evaluated by reverse transcription polymerase chain reaction. RESULTS: The overall expression rate of BORIS in patients with lung cancer was 36.0%: 19 of 50 squamous cell carcinomas (38.0%), 13 of 36 adenocarcinomas (36.1%), and 4 of 14 (28.6%) small-cell carcinomas. There was no significant difference in the BORIS expression according to age, gender, or histologic type. However, the mRNA expression of BORIS was significantly related to the pathologic cancer stage (p=0.004) and lymph node metastasis (p=0.001). The expression of the melanoma antigen gene family A1-6 was not associated with the expression of BORIS. CONCLUSION: Our results suggest that the expression of BORIS might be a negative prognostic factor in lung cancers and implicate BORIS as a molecular target for immunotherapy.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Humans ; Immunotherapy ; Lung Neoplasms* ; Lymph Nodes ; Melanoma ; Neoplasm Metastasis ; Oncogenes ; Polymerase Chain Reaction ; Reverse Transcription ; RNA ; RNA, Messenger ; Siblings* ; Sputum*

PURPOSE: The recent introduction of targeted therapy for non-small cell lung cancer (NSCLC) has changed the paradigm of lung cancer chemotherapy. However, only a small portion of NSCLC patients received the benefit of these new drugs. A proteasome inhibitor (bortezomib) and a histone deacetylase inhibitor (SAHA) were approved for clinical use for treating some hematologic malignancies. In this study, we investigated the combination treatment of bortezomib and SAHA in NSCLC cell lines. MATERIALS AND METHODS: The combined effects of bortezomib and SAHA on lung cancer cell lines were measured by Calcusyn software. Induction of apoptosis was examined by performing an Annexin V assay. Generation of reactive oxygen species (ROS) and protection by N-acetylcysteine were measured by flow cytometry after staining with DCFH-DA. The effect of the combination of drugs on apoptosis and autophagy was investigated by Western blot assay. RESULTS: Strong synergism was found for the combination of bortezomib and SAHA. The synergistic interaction was mediated by strong apoptosis. Increased ROS generation was partly responsible for the induction of apoptosis, and this was suppressed by the ROS scavenger N-acetylcysteine. Combined treatment induced the strong activation of caspase-3 and the breakdown of the antiapoptotic molecule Bcl-2. Furthermore, increased breakdown of beclin-1, which is known to be an autophagic molecule, was also found. CONCLUSION: Combination therapy with bortezomib and SAHA showed a strong synergistic antitumor effect on human lung cancer cell lines. Enhanced induction of apoptosis was a responsible mechanism, and this was partly mediated by ROS generation. Further studies are warranted for determining the role of apoptosis and autophagy for this combination therapy.
Acetylcysteine ; Annexin A5 ; Apoptosis ; Autophagy ; Blotting, Western ; Boronic Acids ; Carcinoma, Non-Small-Cell Lung ; Caspase 3 ; Cell Line ; Flow Cytometry ; Fluoresceins ; Hematologic Neoplasms ; Histone Deacetylase Inhibitors ; Humans ; Lung Neoplasms ; Proteasome Inhibitors ; Pyrazines ; Reactive Oxygen Species ; Bortezomib