The issue of cold damage is one of the major topics of orthodox medicine in East Asia. From the historical view of point, most of the medical practitioners have turned The Theory of Cold Damage to account as their grounds for justifying their own argument. However, it is rare to find a book related to The Theory of Cold Damage in Korea's traditional medicine. Therefore, people have perceived the research status of cold damage is unsatisfactory. This problem could be analyzed by dividing it into a medicinal herb problems and theory problem. First, the medicinal herbs needed for the prescription based on The Theory of Cold Damage don't grow in the Korean Peninsula. Accordingly, there were a lot of restrictions on the free use of these prescriptions. Nevertheless, Chinese medicinal herbs were essential to even the use of the prescriptions besides The Theory of Cold Damage. Accordingly, such aspects do little explain the point that there were few medicine books about The Theory of Cold Damage in Korea. On the other hand, it is hard to exclude the guess that the medical practitioners in the period of the Joseon Dynasty might have presented a theoretically different opinion about cold damage. This study did intensive research on this. As a result of examining the medical practitioners in the latter period of the Joseon Dynasty perceived 'the cold damage to positive and negative meridians' as the case where a patient got attacked by cold as a pathogenic factor in a state of the kidney deficiency. They presented the verdict that kidney deficiency was mostly incurred by sexual relations, and the cold damage to positive and negative meridians broke out when a patient got attacked by cold as a pathogenic factor after having sex. it is an original standpoint shedding light on the relationship between cold damage and the kidney deficiency. The medical practitioners in the latter period of the Joseon Dynasty used Donguibogam as a major text for study on cold damage. In other words, Donguibogam includes the well-organized theory of Yeoksu school who regarded the comparison between internal damage and external damage as important. The medical practitioners in the latter period of the Joseon Dynasty managed to form the theory of the cold damage to positive and negative meridians by deepening the relationship between internal damage and external damage, which was highlighted in Donguibogam. The medical practitioners in the Joseon Dynasty didn't show a big interest in the literature itself, or the so-called The Theory of Cold Damage, which was mainly due to not only the realistic problem of the lack of medicinal herbs needed for applying the prescription to cold damage but also the difference between their positions on cold damage. Therefore, the idea of insufficient research on The Theory of Cold Damage is no more than a kind of optical illusion. On the contrary, we may assume that the medical practitioners in the Joseon Dynasty understood and developed The Theory of Cold Damage in their own way.
Asian Continental Ancestry Group ; Cold Temperature ; Far East ; Hand ; Humans ; Kidney ; Korea ; Light ; Medicine, Traditional ; Meridians ; Optical Illusions ; Plants, Medicinal ; Prescriptions

Many medical books of the late Joseon Dynasty were based on the medical knowledge of Donguibogam. For this reason, most of the studies have explained the medicine of the late Joseon Dynasty focusing on Donguibogam. However, the appearance of medicine in the late Joseon Dynasty is more complex than that. Although the “treatment knowledge” of Donguibogam had a huge impact in the late Joseon Dynasty, the “medical thought” of Donguibogam was not easily established.
This is confirmed through the knowledge system of medical books in the late Joseon Dynasty. Jejungsinpyeon, published by the government in the late Joseon Dynasty, disassembled the contents of Dongibogam and rearranged it into a knowledge system of Uihagibmun. Injeji, which was made in the private sector, followed the same method. They tried to maintain part of the knowledge system of Donguibogam. Nevertheless, the framework of perception that extends from “human” to “disease,” the central idea of Donguibogam, was not maintained.
This shows that there was a considerable amount of respect for the medicine of Ming Dynasty in the late Joseon Dynasty. Therefore, for a more in-depth understanding of medicine in the late Joseon Dynasty, it is necessary to examine in more detail the influences of other medical books such as Uihagibmun, Bonchogangmok, and Gyeongakjeonseo in addition to Donguibogam. This should be understood as a process in which various medical knowledge and systems compete.

Many medical books of the late Joseon Dynasty were based on the medical knowledge of Donguibogam. For this reason, most of the studies have explained the medicine of the late Joseon Dynasty focusing on Donguibogam. However, the appearance of medicine in the late Joseon Dynasty is more complex than that. Although the “treatment knowledge” of Donguibogam had a huge impact in the late Joseon Dynasty, the “medical thought” of Donguibogam was not easily established.
This is confirmed through the knowledge system of medical books in the late Joseon Dynasty. Jejungsinpyeon, published by the government in the late Joseon Dynasty, disassembled the contents of Dongibogam and rearranged it into a knowledge system of Uihagibmun. Injeji, which was made in the private sector, followed the same method. They tried to maintain part of the knowledge system of Donguibogam. Nevertheless, the framework of perception that extends from “human” to “disease,” the central idea of Donguibogam, was not maintained.
This shows that there was a considerable amount of respect for the medicine of Ming Dynasty in the late Joseon Dynasty. Therefore, for a more in-depth understanding of medicine in the late Joseon Dynasty, it is necessary to examine in more detail the influences of other medical books such as Uihagibmun, Bonchogangmok, and Gyeongakjeonseo in addition to Donguibogam. This should be understood as a process in which various medical knowledge and systems compete.

In the 15th century, Joseon dynasty's goal for the stabilization of the ruling system, the ideological freedom of the era, and the necessity of medicine due to the introduction of Jin and Yuan dynasty's medicine led to the increased interest in medicine by the nobility along with tolerant practice. The practice of reading medical books is a good example of this institutional demonstration. However, by the end of the 15th century, a noticeable change had taken place. Within the nobility, there was an ideological rigidity regarding technology other than those of Confucianism, as the nobility became concentrated on the principles of Neo-Confucianism. In addition, as the publication of large-scale editions such as Ŭibangyuch'wi (the Classified Collection of Medical Prescriptions) came to an end, they have become less inclined to nurture talent at the level of the central government as in the previous period. In addition, as the discrimination against illegitimate children became stronger, technical bureaucrats such as medical officials, which were open to illegitimate children, came to be seen in increasingly disdainful and differentiated manners. From the late Sejong period to the early Seongjong period, the entrance of illegitimate sons into the medical bureaucracy solidified the negligence of medicine by the nobility. After then, the medical bureaucracy came to be monopolized by illegitimate sons. As for illegitimate sons, they were not allowed to enter society through Confucian practices, and as such, the only way for them to enter the government was by continuing to gain experience as technical bureaucrats. Technical posts that became dominated by illegitimate sons became an object of contempt by the nobility, and the cycle reproduced itself with the social perception that legitimate sons of the nobility could not become a medical official. Medical officials from the Yi clan of Yangseong had been legitimate sons and passers of the civil service examination in the 15th century. However, in the 16th century, only illegitimate sons became medical officials. The formation of Jungin (middleclass) in technical posts since the middle of the Joseon period is also related to this phenomenon. The Yi clan of Yangseong that produced medical officials for 130years over four generations since Yi Hyoji, a medical book reading official, is an exemplary case of the change in the social perception in the early Joseon period regarding medical bureaucrats.
Aptitude ; Child ; Confucianism ; Discrimination (Psychology) ; Family Characteristics ; Freedom ; Humans ; Malpractice ; Publications ; Social Perception

PURPOSE: This study was designed to evaluate the educational effects of cardiopulmonary resuscitation (CPR) instruction to elementary school children and the perspectives of students and teachers about such instruction. METHODS: A total of 34,232 5th and 6th grade students from 998 elementary schools were instructed using a two-hour CPR lesson from each school teacher using CPR Anytime(R). The school teachers also were instructed by the same lesson from BLS instructors. Survey questionnaires were distributed to students involved. CPR skills were tested using a checklist during the class. We calculated the multiply effect that how many people were instructed CPR secondarily by student after the lesson and analyzed results by grade and gender. RESULTS: Most students (82%) said that CPR was easy to learn; 81% indicated a willingness to do CPR on a stranger. CPR skills were tested in 11,529 students (34%), and 10,269 (89%) passed. Assessment of respiration was the most commonly omitted procedure. The multiply effect was 1.54, and was higher in the 5th grade and among girls. CONCLUSION: This study suggests that the CPR instruction to 5th or 6th grade students in an elementary school setting is feasible and effective. Although the quality of instruction may be low, the children performed CPR on their family and friends.
Cardiopulmonary Resuscitation ; Checklist ; Child ; Friends ; Health Education ; Heart Arrest ; Humans ; Manikins ; Surveys and Questionnaires ; Respiration

OBJECTIVE: To compare the slip reduction rate and clinical outcomes between unilateral conventional transforaminal lumbar interbody fusion (conventional TLIF) and unilateral minimal invasive TLIF (minimal TLIF) with pedicle screw fixation for treatment of one level low-grade symptomatic isthmic spondylolisthesis. METHODS: Between February 2008 and April 2012, 25 patients with low-grade isthmic spondylolisthesis underwent conventional TLIF (12 patients) and minimal TLIF (13 patients) in single university hospital by a single surgeon. Lateral radiographs of lumbar spine were taken 12 months after surgery to analyze the degree of slip reduction and the clinical outcome. All measurements were performed by a single observer. RESULTS: The demographic data between conventional TLIF and minimal TLIF were not different. Slip percentage was reduced from 15.00% to 8.33% in conventional TLIF, and from 14.15% to 9.62% in minimal TLIF. In both groups, slip percentage was significantly improved postoperatively (p=0.002), but no significant intergroup differences of slip percentage in preoperative and postoperative were found. The reduction rate also not different between conventional TLIF (45.41+/-28.80%) and minimal TLIF (32.91+/-32.12%, p=0.318). CONCLUSION: Conventional TLIF and minimal TLIF with pedicle screw fixation showed good slip reduction in patients with one level low-grade symptomatic isthmic spondylolisthesis. The slip percentage and reduction rate were similar in the conventional TLIF and minimal TLIF.
Humans ; Spine ; Spondylolisthesis*

BACKGROUND: The definition of sarcopenia focuses on muscle mass and function. Sarcopenic obesity is the relative excess of fat tissue with decreased muscle mass. We examined the association between cigarette smoking and sarcopenia according to obesity in middle-aged and elderly Koreans. METHODS: We conducted a cross-sectional study of 9,385 subjects (age ≥50 years) based on data from the fourth and fifth Korea National Health and Nutrition Examination Surveys (2008–2011). Smoking groups were categorized by smoking status and the number of cigarettes smoked daily. Sarcopenia was defined as weight-adjusted appendicular skeletal muscle mass of 2 standard deviations below the sex-specific mean for young adults. Obesity was defined as fat mass ≥30% for men and ≥40% for women. Subjects were categorized into three groups: sarcopenic obese (SO), sarcopenic non-obese (SNO), and normal. Multiple logistic regression analysis was performed to assess the association between smoking and SNO and SO. RESULTS: Among men, current smokers were more associated with SNO than never-smokers (adjusted odds ratio [OR], 3.34; 95% confidence interval [CI], 1.09–10.26). However, there was no significant association between smoking status and SNO in women or SO in either sex. Among current smokers, moderate smokers (11–20 cigarettes/d) were more likely to be SNO (adjusted OR, 5.81; 95% CI, 1.12–30.31) and heavy smokers (>20 cigarettes/d) were more likely to be SO (adjusted OR, 9.53; 95% CI, 1.65–55.01) than light smokers (<11 cigarettes/d). CONCLUSION: In men, smoking was positively associated with SNO, and heavy smokers were more likely to be SO than light smokers.
Aged ; Cross-Sectional Studies ; Female ; Humans ; Korea ; Logistic Models ; Male ; Muscle, Skeletal ; Nutrition Surveys ; Obesity ; Odds Ratio ; Sarcopenia ; Smoke ; Smoking ; Tobacco Products ; Young Adult

BACKGROUND: The donor site of abdominal flaps for breast reconstruction consists of a wide suprafascial cavity that poses a risk of seroma formation. The authors evaluated the efficacy of continuous progressive tension sutures (PTS) using unidirectional barbed absorbable sutures for decreasing the volume of fluid collection and the risk of seroma at the abdominal donor site. METHODS: Between March 2013 and February 2015, 37 consecutive patients underwent breast reconstruction using a deep inferior epigastric artery perforator flap. Two patients who underwent salvage operations were excluded. Ten patients underwent standard abdominal flap donor site closure without PTS. Seven received donor site closure with interrupted Vicryl PTS between the abdominal flap and abdominal muscle fascia. Eighteen patients underwent closure with continuous PTS using unilateral barbed absorbable sutures. Body mass index, the approximate flap area, the duration of drain maintenance, the total drained volume, and the incidence of seroma were compared across these 3 groups. The operative time and subjective difficulty perceived by the surgeon was compared between the 2 PTS groups. RESULTS: The total drained volume was lower and the duration of drain maintenance was shorter in both PTS groups than in the standard closure group. There were no cases of seroma in the PTS groups, and 2 that resolved with conservative care in the standard closure group. More time was required and the subjective difficulty score was significantly higher for interrupted PTS than for continuous PTS. CONCLUSIONS: Continuous PTS effectively reduced the duration of drain insertion, the total volume of drained fluid, and was swifter and easier to perform than interrupted PTS.
Abdominal Muscles ; Abdominoplasty ; Body Mass Index ; Breast ; Epigastric Arteries ; Fascia ; Female ; Free Tissue Flaps ; Humans ; Incidence ; Mammaplasty ; Operative Time ; Perforator Flap ; Polyglactin 910 ; Seroma ; Sutures ; Tissue Donors

Background and Objectives: The diagnosis of hearing impairment is based on repeated audiometry, including pure tone audiometry (PTA), speech reception threshold test (SRT), and speech discrimination test (SDT). SDT results particularly show a wide discrepancy upon repeated testing, while malingering is suspected when having more than 12% difference between 3 individual SDT results. Therefore, in this study, we compared the proportion of malingering found in repeated SDT with that found in other audiometric tests and analyzed the characteristics of malingering group in order to reevaluate the current criteria of defining malingering.Subjects and Method We retrospectively assessed the audiometry results of 113 patients (226 ears) with hearing impairment. Each ear was divided into a malingering group and a true hearing loss group. The proportion of ears corresponding to each malingering criterion was compared using a chi-square test. An independent sample t-test was performed to identify the differences between the characteristics between the two groups. Results: The number of ears that met the malingering criteria were 19 (8.41%) in PTA, 15 (6.64%) in SRT, and 75 (33.19%) in SDT. There was a significant difference in the proportion of malingering between the 3 hearing test modalities (p<0.001). There was no significant difference in auditory brainstem response, mean age and sex distribution between the malingering group and the true hearing loss group. Conclusion When conducting repeated SDT, there is a risk of misdiagnosing an actual hearing loss patient as a malingering patient under the current malingering criteria. Therefore, the current criteria on SDT requires reevaluation.

Purpose: This clinical study presented the effectiveness of 2-stage posterior maxillary segmental osteotomy (PMSO) under local anesthesia in gaining interarch space to restore the posterior mandibular segment with dental implants. Materials and Methods: Nine patients who received two-stage PMSO for mandibular implant placement from 2003 to 2011 were included in the study. Of the 9 patients, 7 were female and 2 were male. Ages ranged form 28 to 72 (mean 46.6). Potential complications were investigated such as sinus infection, survival of bone segment, inflammatory root resorption of adjacent teeth, relapse of bone segment and timing of implant placement, delivery of implant prosthesis and stability of bone segment.Result: None of the patients showed relapse or complication. Bone segments were stabilized by opposed implant prosthesis. Conclusion Office-based 2-stage PMSO under local anesthesia can be considered a stable and predictable procedure. Also pedicle damage can be avoided by allowing favor of blood supply to the bone segments. From these advantages, it can be concluded that this surgical procedure can decrease post-operative complications.