Of the more than two hundred collections of pildamchanghwa scattered around the world that are being catalogued and translated, more than forty are medical in nature. This paper organizes and charts the medical written conversations by their dates of publication and examine the various aspects of their publication. Medical written conversations have been collected since the Fourth Envoy. There are no records of medical written conversations or poetry exchange in Tsushima even though that was the first port of arrival for the Tongsinsa. Instead, sources show that written conversations and poetry exchanges mostly took place in Kyoto, Tokyo, and Osaka; indeed, these three cities, in that order, also have yielded the highest volumes of publication. The first commercially published collection of medical written conversations was Sanghaneuidam, published in 1713 following the Eighth Envoy. Though Gyerimchanghwajip was published two years earlier in 1711, it is clear from the usage of the word changhwa in the title that this collection was not strictly limited to medical written conversations. Sanghaneuidam was an attempt by Japanese medicine to collect questions and answers in order to publish as medical textbooks. The Japanese medicine that was involved in the most written conversations was Kawamura Shunko, who was the editor of Sanghaneuimundap and Joseonpildam following the Tenth Envoy. Publications with titles containing 'eui' explicitly contemplates the targeted readership. Kitao Shunpo was one Japanese medicine who was less interested in meeting a literary scrivener, but instead sought to converse with a respected medicine. When the Eighth Envoy of 1711 arrived in Ogaki, Kitao followed around the Joseon medicines and attempted written conversations. He enlisted the aid of his second son Shunrin in organizing the written conversations, and published the collection, complete with preface, postscript, and appendices-an editorial decision that fully contemplated his audience. Prior to meeting Gi Du-mun, Kitao meticulously planned out the order of questions-that is, the table of contents for Sanghaneuidam. Kitao drafted his questions to serve the purpose of a medical textbook, edited the contents of the written conversations, and added illustrations before presenting the collection to the public. Seomulyuchan, one of the most famous leishu in Japan, contains a preface by Lee Hyeon, a scrivener of Joseon. Kitao, who had studied Dongeuibogam, had already possessed a vast and systematic knowledge of materia medica; however, he sought Lee's contributions, hoping that a preface written by a renowned Joseon scholar would lend his publication more credibility. As such, it can be inferred that the preface to Seomulyuchan was created as an extension of the medical written conversations.
History, 18th Century ; Humans ; Japan ; Medicine, Traditional/history ; Publishing/history/*statistics & numerical data ; Travel ; Writing

No abstract available.
Fingers*

Postpartum thyroiditis is a common but frequently unrecognized disorder, affecting approximately 5% of women during the first 12 months after delivery. It is characterized by transient hyperthyroidism occurring about 14 weeks postpartum followed by transient hypothyroidism at 19 weeks postpartum. Our aim is to investigate the prevalence of positive antimicrosomal antibody in women 3 months postpartum and an association of antimicrosomal antibody with symptomatic and biochemical thyroid disorders. We used data collected from 205 women who visited Dankook University Hospital in 3 months postpartum, Our results showed that the rate of positive antithyroid microsomal antibody was 12.7% in women 3 months postpartum and the prevalence of biochemical hyperthyroidism and biochemical hypothyroidism with positive antithyroid microsomal antibody women 3 months postpartum were 26.9% and 19.2%, respectively. The prevalence of postpartum biochemical thyroid dysfuncion 3 months postpartum was 13.7%. There was no relationship between any of the following factors and thyroid antibody status: fetal distress, birth weight and infant sex, matemal age, experiences and mode of delivery, previous medical disease(such as pstrointestinal and psychotic diseases), experiences of previous abortions, gestational age and past history of thyroid diseases.
Abortion, Induced ; Birth Weight ; Female ; Fetal Distress ; Gestational Age ; Humans ; Hyperthyroidism ; Hypothyroidism ; Infant ; Postpartum Period* ; Postpartum Thyroiditis* ; Prevalence ; Thyroid Diseases ; Thyroid Gland

PURPOSE: The introduction of a mesh to ventral herniorrhaphy ensures abdominal wall strength without tension, and this procedure has shown a decreased recurrence rate, a shorter hospital stay and less use of analgesics. However, the extensive tissue dissection required for mesh placement leads to increased postoperative complications. Yet with the development of laparoscopic ventral herniorrhaphy, we expect earlier recovery, fewer complications and decreased recurrence rates. This study was done to compare the outcomes after open and laparoscopic ventral herniorrhaphy with using mesh through a retrospective review. METHODS: The outcomes for 20 consecutive patients who underwent laparoscopic ventral herniorrhaphy were compared with those of 20 consecutive patients who underwent open herniorrhaphy. The laparoscopic repairs were performed using the intraperitoneal onlay mesh (IPOM) repair with transfascial fixation method in all the cases. RESULTS: The forty patients (24 women and 16 men) had a mean age of 57.48 years (range, 33~82). The mean follow-up time was 63.4 months. The mean surgery duration (67.4 min vs 142.3 min, respectively, p=0.003) and postoperative stay (4.7 vs 16.2 days, respectively, p<0.0001) were shorter for the laparoscopic group. The number of shots of analgesics during the first 3 days after surgery was 1.9 vs 2.4 shots, respectively (p=0.019). There were fewer complications (30%) and recurrences (5%) among the patients who underwent laparoscopic repair than those for the patients who underwent open repair (65% and 10 %, respectively). CONCLUSION: Those findings shows that laparoscopic ventral herniorrhaphy with transfascial fixation seems to be safe and effective and it showed a shorter operative time, fewer complications, a shorter hospital stay and less recurrence than did open ventral herniorrhaphy.
Abdominal Wall ; Analgesics ; Female ; Follow-Up Studies ; Hernia, Ventral ; Herniorrhaphy ; Humans ; Inlays ; Length of Stay ; Operative Time ; Postoperative Complications ; Recurrence ; Retrospective Studies

Maffucci's syndrome is a congenital, non-hereditary mesodermal d splasia manifested by multiple enchondromas and hemangiomas. Several case reports and reviews indicate that there is a tendency toward malignant transformation of the enchondroma. The incidence of malignancy may be as high as 30%. We report a case of 10-year-old female with multiple hemangiomas on the face, palms, and soles and skeletal chondromatoses of the multiple bones.
Child ; Chondroma ; Chondromatosis ; Enchondromatosis ; Female ; Hemangioma ; Humans ; Incidence ; Mesoderm

No abstract available.
Purpura, Thrombocytopenic* ; Rifampin*

Acral lentiginous melanoma is a rare variant of malignant melanoma and is characterized by a lentiginous (radial) growth phase that evolves over months or years to a dermal (vertical) invasive stage. Clinical and pathological features were reviewed in 3 cases of acral lentiginous melanoma of the soles. The first case was a 59-year-old female. On gross examination, there was a black, nodular, round, and ulcerated mass, 1.5 x 1.5 cm, on the posterior portion of the left sole. This mass was accompanied by peripheral pigmented macules. Histologically, the macular lesion revealed the pattern of a lentiginous growth phase, with a diffuse hyperplasia of atypical melamocytes in the basal layer of the epidermis. In the vertical growth component, atypical melanocytes (predominantly spindle cell) infiltrated the dermis, showing level 3 invasion. The second case was a 47-year-old male. On gross examination, there was a dark brown to black, nodular, hemorrhagic and ulcerated mass, 7x7 cm, on the middle portion of the right sole. This mass grew radially into neighboring tissue. Histologically, the radial growth component revealed atypical melanocytes which were distributed in the basal portion of epidermis. In the vertical growth component, atypical melanocytes (spindle, round, or polygonal cells) infiltrated the dermis, showing level 4 invasion. The third case was a 87-year-old female. There was a formation of satellite pigmented macules, up to 2x0.5 cm, on the right sole. The color of macules was usually not uniform but was likely to be scattered radially, being grayish brown, bluish black, or black. Histologically, the peripheral, macular, hyperpigmented lesion revaled the pattern of a lentiginous growth phase. In the vertical growth component, atypical melanocytes (predominently polygonal cells) infiltrated the dermis, showing level 13 invasion.
Female ; Humans

The authors analyzed 5 cases of renal carcinomas confirmed by operation and pathologically, which wereselected from all the cases of selective angiography performed recently at the department of radiology, Busan National University Hospital. The result obtained were as follows; 1. Among the 5 cases of malignant tumors of thekidney, 4 cases were renal cell carcinomas, and 1 case was transitional cell carcinoma. 2. In the sexdistribution, male to female was 3:2. And all cases were over 51 years of age. 3. All the 5 cases were discoveredat the left kidney; 1 case, in upper pole; 2 cases, in mid-portion; and 2 cases, in lower pole. 4. Clinicalmanifestations were hematuria in all 5 cases; flank pain in 4 cases. But no palpable mass was demonstrated in anycases. 5. The renal angiographic findings; Of 4 cases of renal cell carcinomas, 2 cases revealed markedhypervascularity, 1 case mild hypervascularity with multiple mulbery-like aneruysms, and 1 case avascularity withwell demarcated margin. 1 case of transitional cell carcinoma showed hypovascularity with perivascular pooling anddisplacement of the upper dorsal branch of renal artery.
Angiography ; Busan ; Carcinoma, Renal Cell ; Carcinoma, Transitional Cell ; Female ; Flank Pain ; Hematuria ; Humans ; Kidney ; Male ; Renal Artery

PURPOSE: Despite advancements in surgery, laparoscopic totally extraperitoneal (TEP) repair for inguinal hernia in patients with previous lower abdominal surgeries has been a burden to surgeons. This study was conducted in order to assess the feasibility of laparoscopic intraperitoneal onlay m esh (IPOM) hernia repair as an alternative method for these cases. METHODS: From May 2006 to November 2010, 48 IPOM repairs were performed in 43 patients. All medical records were reviewed retrospectively. RESULTS: Mean age of patients was 61 years old and male to female ratio was 37:6. Five were direct and 43 were indirect hernias. There were 15 recurrent inguinal hernias after either open or laparoscopic hernia repair, and five of 15 were recurrent cases more than two times. Mean operative time was 44.5 minutes, and mean postoperative hospital stay was 1.41 days. There were two cases of postoperative swelling at the groin area and two patients complained of pain that required oral pain-killers during out-patient follow-ups. Recurrence developed in one case. CONCLUSION: Even though laparoscopic IPOM repair is not a preferred m ethod for inguinal hernia, it can be applied as an alternative method in specific cases involving difficulties in approaching the usual plane of repair.
Female ; Follow-Up Studies ; Groin ; Hernia ; Hernia, Inguinal* ; Herniorrhaphy ; Humans ; Inlays* ; Laparoscopy ; Length of Stay ; Male ; Medical Records ; Operative Time ; Outpatients ; Recurrence ; Retrospective Studies

PURPOSE: Despite acceptance of laparoscopic totally extraperitoneal (TEP) repair for repair of inguinal hernia, it is still considered to require a prolonged learning curve. We hypothesized that there would be differences in the learning curve for laparoscopic TEP repair among beginner surgeons with or without a supervisor. The current study was conducted to observe the learning curve for laparoscopic TEP repair performed by a surgeon without a supervisor. METHODS: A retrospective analysis of the consecutive 143 patients was conducted to document patients' demographics, hernia types, operative time, and operative outcomes after the operation. Patients were divided into 7 consecutive groups, each comprising 20 patients. RESULTS: The mean age of the study population was 52.5 years (+/- 18.9 SD), ranging from 16 to 89 years. The learning curve of this technique was almost horizontal throughout the time course. The mean operative time was quite stable among each group. Comparison of the mean operation time and the length of hospital stay among each group did not show significant differences. There was one recurrence in group V. CONCLUSION: The learning curve for laparoscopic TEP repair is not that prolonged if there is an experienced specialized supervisor and opportunities to observe the entire procedure performed by the supervisor are available. It is not the laparoscopic instrument skills but the way the procedure is performed that is important for successful outcomes.
Demography ; Hernia ; Hernia, Inguinal ; Humans ; Learning Curve* ; Learning* ; Length of Stay ; Operative Time ; Recurrence ; Retrospective Studies