No abstract available.

Lack of historical records causes some difficulties in the historical studies of ancient Korea. It is the same case as that of the history of medicine. We imagine what the situation of medicine was like in ancient Korea with a bit of historical records. In ancient times, medicine had very close relation with religions. In ancient Korea, it had very close relation with Buddhism. According to {Sam Kuk Sa Ki and {Sam Kuk Yu Sa buddhists monks treated patients with the religious rituals. In this article, the authors would like to present a record which had been unnoticed until now. It is the commentary of Wonhyo on a certain Buddhistic cannon called {Kum Kwang Myung Kyung. A chapter of this cannon is on the theory of medicine, causes of diseases and treatments. We can presume Wonhyo's knowledge of medicine at that time through his commentary on this chapter.
Buddhism/*history ; English Abstract ; History of Medicine, Ancient ; Korea ; Religion and Medicine

Increased death rate resulted from cardiovascular disease called for the study on the autonomic nervous system and cardiovascular system. It is known that an HRV (heart rate variability) spectrum analysis based on ECG (electrocardiograph) signals could be used to define activity of sympathetic and parasympathetic nervous system noninvasively. However, it is important to prove whether suggested HRV analysis method could provide the useful information for observing autonomic nervous system quantitatively and objectively before clinical application. In this study, 14 rats were used and divided into two groups, sympathectomy group and vagotomy group, respectively. During the experiment, ECGs of rats were collected three times at each experimental condition. After the application of Berger's series algorithm to the ECG raw data, HRV spectrum was obtained via FFT (fast Fourier transform). Power contents for each frequency bands were calculated from HRV waveforms. Two peak values, HF (high frequency) and LF(low frequency), representing autonomic nervous system status were used to extract the parameter, HF/LF ratio. Results showed that HF/LF values were increased for the sympathectomy group and decreased for the vagotomy group. It implies that the variations in HF/LF components exhibits the information for the classification of ANS(autonomic nervous system) function quantitatively. HRV analysis algorithm developed from this study could be expanded for the observation of autonomic nervous system variations in human.
Animals ; Autonomic Nervous System ; Cardiovascular Diseases ; Cardiovascular System ; Classification ; Electrocardiography ; Humans ; Mortality ; Parasympathetic Nervous System ; Rats ; Spectrum Analysis ; Sympathectomy* ; Vagotomy*

Dr. Allen, the first Protestant missionary in Korea, had an opportunity of saving the life of the queen's nephew shortly after his arrival in Korea in 1884. In gratitude the King established the Royal Korean Hospital (Jejoong Won), the first hospital in Korea, and appointed Dr. Allen in charge of the medical affairs of the hospital. After Dr. Allen's resignation from the mission, the work was successively carried on by Drs. JW Heron, RA Hardie, CC Vinton and OR Avison, the last of whom arrived in 1893. In 1894 the connection of the Hospital with the Korean Government was severed and the work taken over by the Northern Presbyterian Mission. Since then, it has been a distinctly mission institute. In 1900, while attending the Ecumenical Conference of Foreign Missions in Carnegie Hall, New York, Dr. Avison made the acquaintance of a philanthropist LH Severance, who made a gift of $10,000 for a new hospital. This building, the first modern hospital in Korea, was opened and dedicated in 1904. It was named the Severance Hospital. As the new hospital was built, the old hospital building was to be returned to the Korean Government according to the agreement made in 1894. On retaking the old hospital, the Korean Government paid $30,289.99 won for the renovation of the original building and new buildings established in the site during the period of Avison's entire charge of Jejoong Won. The old hospital building was used as an official residence for a diplomatic adviser Stevens, who was assassinated for his pro-Japan activities, and as a social club for Japanese officials.
Christianity/*history ; English Abstract ; History of Medicine, 19th Cent. ; History of Medicine, 20th Cent. ; Hospitals, Public/*history ; Hospitals, Religious/*history ; Korea ; Missions and Missionaries/*history ; United States

Objective: Machine learning is emerging as a new alternative in various scientific fields and is potentially a new method of interpretation. Using the Light Gradient Boosting Machine (LightGBM), we analyzed the factors that influence the rechoice of emergency medicine responders. The survey is a cross-sectional study which provides an accurate understanding of a responder's current status. However, the results may vary depending on the composition, format, and question, and the relationship between the answers may be unclear. Methods: This study evaluated the modified 2020 Korean Emergency Physician Survey raw data. We applied the preferred model for random relationship check, random forest, support vector machine, and LightGBM models. The stacking ensemble model was used for the final decision process. Results: ‘It is fun working in an emergency room’was the most selected response factor for re-choice, followed by ‘interesting major’. The physical burden of age and lack of identity had a negative impact, whereas burnout and emotional stress factors had a lesser effect. Anxiety caused by the coronavirus disease 2019 (COVID-19) is thought to have a significant impact on this decision making. Conclusion Establishing the identity of emergency medicine and being faithful to its fundamental mission is a way to increase the rate of re-choice. Decreasing the burden of workload modified according to age is recommended to establish career longevity. The method of machine learning presents us with a new possibility of checking the relevance of survey results quickly and easily.

Objective: It has been reported that emergency physicians experience high levels of depression and psychological burnout due to night shifts and tend to consider early retirement. This study intended to check working hours and intensity, individual health, satisfaction, and overall welfare, given the increase in the numbers of emergency physicians. Methods: The study used the results of the ‘2020 Korean Emergency Physician Survey (KEPS)’ conducted from January 15 to February 26, 2021, which targeted 2,138 emergency physicians registered with the Korean Society of Emergency Medicine. The survey was conducted online through the web and mobile application. Results: One thousand three hundred seven out of the 2,167 emergency physicians (60.3%) registered at the society responded. The average age of the respondents was 42.6 years, and there were 1,148 male emergency physicians and 158 female emergency physicians. The average professional experience was 8.2 years, with 325 professors, 122 commissioned doctors, 648 public servants of which 90 had military service, and 45 medical practitioners. Conclusion In conclusion, the number of working hours of emergency physicians showed a decreasing trend compared to 2010 and 2015. However, emergency physicians often expected early retirement. This suggests that, while the absolute working hours are decreasing, the actual working intensity has not decreased. For the proper development of the emergency medical system, it is necessary to establish a stable working environment for emergency physicians. A systematic study is needed on the working hours and work intensity of emergency physicians.

Objective: As the history of emergency medicine grows longer, emergency medicine specialists are observed to comprise various age groups. There have been no prior studies on the generation shift analysis of emergency medicine specialists. Our study is designed to identify the characteristics of each generation and predict the generation shift in emergency medicine physicians. Methods: The analysis was based on the results of the 2020 survey of emergency medicine specialists. The study was conducted on 1,307 respondents and finally, the responses of 967 people were analyzed after excluding 199 who were not in charge of emergency room treatments and 141 who gave incomplete responses. The respondents were divided into four groups based on the following generations: first generation (1996-1999), second generation (2000-2008), third generation (2009-2014), and fourth generation (2015-2020), classified by the year in which they acquired their emergency medicine board license. The intergenerational difference analysis was done using the Kruskall-Wallis test. Results: The first generation was characterized by a high proportion of university hospital professors, large non-clinical activity hours, a few night shifts, higher social contributions, low satisfaction with the training and education environment, and a high retirement age compared to the later generations. In the second generation, the characteristics of the first, third, and fourth generations were generally mixed. The third and fourth generations showed similar characteristics overall, though there were differences in some categories. Conclusion There were significant differences by generation in the working environments, motivation for application, and retirement age. This is the first study that quantifies generational differences. Considering these trends, a discussion about the work environment needs to be initiated.

Objective: Emergency physicians are constantly exposed to night shifts and stress due to the nature of their work, resulting in health problems such as substance abuse, depression, and suicidal ideation. To date, depression in Korean emergency physicians has never been investigated. The present study endeavors to identify the prevalence and factors related to depression in emergency physicians in Korea. Methods: The present study retrospectively analyzed data from the 2020 Korean Emergency Physician Survey. The prevalence of depression was evaluated using the PHQ-9 (Patient Healthcare Questionnaire-9). Multivariable logistic regression analysis was used to identify the factors related to depression and other variables. Results: The overall response rate of the survey was 61.3% (1,307/2,138). A total of 1,102 respondents completed the PHQ- 9 and were analyzed. The prevalence of depression was 27.0% (95% confidence interval [CI], 27.8-33.6). Following factors were found to be associated with depression: military service as the type of position (odds ratio [OR], 0.316; 95% CI, 0.126- 0.794), schedule satisfaction (OR, 0.523; 95% CI, 0.356-0.769), health perspective (OR, 0.408; 95% CI, 0.252-0.662), weekly exercise (OR, 0.879; 95% CI, 0.774-0.998), sleep quality (OR, 4.728; 95% CI, 3.329-6.715), regular diet (OR, 0.380; 95% CI, 0.239-0.605), nighttime snacking (OR, 1.607; 95% CI, 1.124-2.298), and job satisfaction (OR, 0.456; 95% CI, 0.305-0.682). Conclusion More than a quarter of respondents had depression. Job satisfaction, schedule satisfaction, and a healthy lifestyle were negatively related to depression. However, poor sleep quality showed a significantly positive association, which suggests the necessity for a long-term follow-up.

Objective: Unlike the temporary nature of an emergency resident's job, the position of an emergency physician is one of a lifelong commitment requiring stability and persistence. However, it is hard to pursue a healthy lifestyle because of the 24 hours a day, 7 days a week (24/7) working schedule. The emergency room environment demands high physical and mental stamina, and hence the health problems of emergency physicians have a significant impact on the patient’s outcome. Our study was designed to analyze the emergency physician’s health status and influencing factors based on the data from the 2020 Korean Emergency Physician Survey. Methods: Based on the results of the survey, the factors affecting health were classified into several categories, such as personal character, working conditions, lifestyle, and emotional status. Statistical methods have been used to determine whether these factors can affect self-rated health. Results: The self-rated health worsened for emergency physicians in their 40s rather than in their 30s. However, drinking, smoking, and eating patterns had no effect on self-rated health. Also, the actual number of shifts was observed to bear no relationship with health. Sleeping, wellness, and mood affected self-rated health. Physicians who felt they were unhealthy, expected an early retirement because of the burden of night shifts. Conclusion Emergency physicians in Korea have a low self-rated health status. Mental stress, exercise, and sleep had an impact on the status. Physicians who served long-term night shifts saw a deleterious effect on their sleep and mood, and this damage was cumulative. The career longevity of an emergency physician thus requires a reasonable night shift schedule and age-modified adjustments.

Objective: In this study, we compared differences based on the gender of Korean emergency physicians to provide basic data for future emergency medicine development plans. Methods: We used data from the emergency physician survey (2020) conducted by the Korean Society of Emergency Medicine. A total of 1,303 emergency physicians responded to the survey. We adjusted demographic data relating to age, position, and work duration as an emergency physician, which could affect the differences based on gender. After propensity score matching, we compared working hours, work burden, income, motives for applying for emergency medicine, and future plans of the emergency physicians by sex. Results: The total working hours per month and night shifts per month were higher in men compared to the women. The women felt more pressure in the following areas: number of emergency patients, relationships with administrative agencies, insufficient emergency medical technician manpower, patients’ compliance, and relationships with other emergency physicians. Monthly income was higher in men. Women placed a higher value on ‘Acquiring a range of knowledge’ and ‘Degree of interest in working in the emergency room’ than men as motivation for applying for positions in emergency medicine. Regarding future plans, women placed less value on income and more on having enough free time and avoiding burnout. The retirement age was about 3 years lower for women than for men. Conclusion This study revealed gender differences in working hours, income, motivation for applying for emergency medicine, work burden, and future plans. It is expected that these differences are caused by physical limitations and socio-cultural backgrounds. It is recommended that more detailed investigations be carried out through qualitative research. These results could help in gender considerations while hiring emergency physicians.