Humans ; State Medicine ; United Kingdom

This paper explores historical backgrounds and contents of Treatise on Medicine written by King Sejo (r.1455-1468) including his views on traditional medicine and pharmacy in the early Chosen period. The Treatise declared by King Sejo in 1463 has been considered as an important and unique manual of medicine because it was the exclusive example written by the king of Chosen. It was the King Sejo's era when the medical milieu in both social and medical aspects was highly encouraged thanks to the previous achievements by King Sejong the Great (r.1418-1450). King Sejo, in particular, who was much interested in practical learning called 'Miscellaneous Studies' emphasized on court medicine. His writing can be understood in such historical frame. Another reason why he wrote the Treatise can be said that he felt necessary for establishing the medical ethic codes for inefficient court medicine-officials. In personal background, he tried to find available remedies since he had been suffered from some chronic diseases. The contents of the Treatise can be broadly fallen to the clinical and ethical aspects, In the former one, the Treatise focuses on treatment without hesitation through the sharp and exact diagnosis by medical doctors. In the latter one, eight categories of medical doctors are discussed according to their moral degrees, sim'eui, sik'eui, yak'eui, hon'eui, kwang'eui, mang'eui, sa'eui, and sal'eui. Finally, musim'ji-eui was supplemented. Among them, sal'eui, medicine-official laking both medical ability and ethical attitude, was classified as the lowest degree, sim'eui, medicine-official sincerely making his all efforts for patients, was thought to be a paragon of medical morality. In conclusion, the Treatise on Medicine by King Sejo played an important role as a manual for the principle of medical practice and for the instruction to enhance ethical attitude among medicine-officials.
English Abstract ; *Famous Persons ; History of Medicine, 15th Cent. ; History of Medicine, Early Modern ; Korea ; *Medicine ; State Medicine/*history ; Textbooks/*history

This paper, mainly based on literature and documents from North Korea and Russia, described how health care system had been formulated during the period of between liberation from Japanese Occupation and formation of its own government in North Korea, which is so-called 'the Period of People's Democracy'. North Korea authorities, by themselves, address that their health care system is characterized by state medicine, universal free medical care, emphasis on preventive medicine, community(ho) doctors in charge, provisions of modern medical services in parallel with traditional ones, imposed high value on ideologies of medical personnel, and mass participation of health programs so on, taken rise since this period. Under North Korea's socialistic regime, authorities started to restructure health care system through national health care organizations and institutes, which partially provided medical service free. Also, they emphasized preventive medicine against 'capitalistic' treatment-oriented medicine, and community(ho) doctor in-charge was derived from this period. It showed that the mass participation on health program was equal hereafter and they had under bias toward more emphasis on ideology of medical personnel rather than their professionalism. The attempt to develop traditional medicine had been made during this period, however, much funding and support was not observed. In this period, it showed that a series of action to restructure health care system had been gradually carried out.
Delivery of Health Care/*history ; History, 20th Century ; Humans ; Korea ; State Medicine/history

This study focuses on the formation of medical education in North Korea from 1945 to 1948 in terms of the centralization of medical education, and on the process and significance of the systemization of medical education. Doctors of the past trained under the Japanese colonial system lived and worked as liberalists. More than half of these doctors who were in North Korea defected to South Korea after the country was liberated. Thus the North Korean regime faced the urgent task of cultivating new doctors who would 'serve the state and people.' Since the autumn of 1945, right after national liberation, Local People's Committees organized and implemented medical education autonomously. Following the establishment of the Provisional People's Committee of North Korea, democratic reform was launched, leading to the centralized administration of education. Consequently, medical educational institutions were realigned, with some elevated to medical colleges and others shut down. The North Korean state criticised the liberalistic attitude of doctors and the bureaucratic style of health administration, and tried to reform their political consciousness through political inculcation programs. The state also grant doctors living and housing privileges, which show its endeavor to build 'state medicine'. By 1947, a medical education system was established in which the education administration was put in charge of training new doctors while the health administration was put in charge of nurturing and retraining health workers. In this way, the state was the principal agent that actively established a centralized administrative system in the process of the formation of medical education in North Korea following national liberation. Another agent was deeply involved in this process - the faculty that was directly in charge of educating the new doctors. Studying the medical faculty remains another research task for the future. By exploring how the knowledge, generational experience, socio-political consciousness and world views adopted by these teachers during the colonial era were manifested in their pedagogy after national liberation will shed more light on the 'prototype' of North Korean medical education.
Democratic People's Republic of Korea ; Education, Medical/*history ; History, 20th Century ; Physicians/*history ; Politics ; State Medicine

Developments in science and technology include the use of laser as an auxiliary device in treating oral diseases. Nd:YAG laser is convenient and safe to use. Nd:YAG laser irradiation leaves no scabby area on the wound surface, causes a mild reaction postoperation, and promotes high comfort. Therefore, this treatment has attracted increasing attention in the clinical setting. This review enumerates the applications of water-cooled pulsed Nd:YAG laser in hard and soft tissues in oral medicine. Nd:YAG laser in hard tissues can be applied in cavity preparation, acid etching, root canal preparation and sterilization, and dentin desensitization therapy. Meanwhile, the applications of this laser in soft tissues include adjunctive therapy in basic periodontitis treatment, gingival aesthetic treatment, and resection. This review suggests the importance of Nd:YAG laser as an auxiliary device in the clinical diagnosis and treatment of oral diseases.
Dental Cavity Preparation ; Dentin ; Humans ; Lasers, Solid-State ; Oral Medicine ; instrumentation ; methods ; Root Canal Preparation

OBJECTIVE: To explore the genetic basis for a pedigree affected with Nance-Horan syndrome. METHODS: Clinical manifestation of the patients was analyzed. Genomic DNA was extracted from peripheral blood samples of the pedigree members and 100 unrelated healthy controls. A panel of genes for congenital cataract was subjected to next-generation sequencing (NGS), and candidate variant was verified by Sanger sequencing and bioinformatic analysis based on guidelines of American College of Medical Genetics and Genomics (ACMG). mRNA expression was determined by reverse transcriptase-PCR (RT-PCR). Linkage analysis based on short tandem repeats was carried out to confirm the consanguinity. RESULTS: A small insertional variant c.766dupC (p.Leu256Profs*21) of the NHS gene was identified in the proband and his affected mother, but not among unaffected members and the 100 healthy controls. The variant was unreported in Human Gene Mutation Database (HGMD) and other databases. Based on the ACMG guideline, the variant is predicted to be pathogenic (PVS1+PM2+PM6+PP4). CONCLUSION The novel variant c.766dupC of the NHS gene probably underlay the X-linked dominant Nance-Horan syndrome in this pedigree.
Cataract/genetics* ; Genetic Diseases, X-Linked ; Humans ; Mutation ; Pedigree ; State Medicine ; Tooth Abnormalities

This study analyzed the molecular mechanism of Huangjing Qianshi Decoction(HQD) in the treatment of prediabetes based on network pharmacology and molecular docking. The active components of HQD were identified and screened based on Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP, http://Lsp.nwu.edu.cn/tcmsp.php) and then the targets of the components and the genes related to prediabetes were retrieved, followed by identifying the common targets of the decoction and the disease. The medicinal component-target network was constructed by Cytoscape to screen key components. The protein-protein interaction(PPI) network was established by STRING and hub genes were identified by Cytoscape-CytoNCA, followed by Gene Ontology(GO) term enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG) of the hub genes with R-clusterProfi-ler. Thereby, the possible signaling pathways were predicted and the molecular mechanism was deduced. A total of 79 active components of HQD and 785 diabetes-related targets of the components were screened out. The hub genes mainly involved the GO terms of tricarboxylic acid cycle, peptide binding, amide binding, hydrolase activity, and kinase activity regulation, and the KEGG pathways of AGE-RAGE signaling pathway, TNF signaling pathway, AMPK signaling pathway, IL-17 signaling pathway, and insulin signaling pathway. Western blot result showed that HQD-containing serum significantly reduced the expression of AKT1, AGE, and RAGE proteins in insulin resistance model cells. HQD's treatment of prediabetes is characterized by multiple pathways, multiple targets, and multiple levels. The main mechanism is that the components zhonghualiaoine, baicalein, kaempferol, and luteolin act on AKT1 and inhibit the AGE-RAGE axis.
Drugs, Chinese Herbal/pharmacology* ; Humans ; Medicine, Chinese Traditional ; Molecular Docking Simulation ; Network Pharmacology ; Prediabetic State/genetics*

PURPOSE: The COVID-19 pandemic has caused 1.4 million deaths globally and is associated with a 3-4 times increase in 30-day mortality after a fragility hip fracture with concurrent COVID-19 infection. Typically, death from COVID-19 infection occurs between 15 and 22 days after the onset of symptoms, but this period can extend up to 8 weeks. This study aimed to assess the impact of concurrent COVID-19 infection on 120-day mortality after a fragility hip fracture. METHODS: A multi-centre prospective study across 10 hospitals treating 8% of the annual burden of hip fractures in England between 1st March and 30th April, 2020 was performed. Patients whose surgical treatment was payable through the National Health Service Best Practice Tariff mechanism for "fragility hip fractures" were included in the study. Patients' 120-day mortality was assessed relative to their peri-operative COVID-19 status. Statistical analysis was performed using SPSS version 27. RESULTS: A total of 746 patients were included in this study, of which 87 (11.7%) were COVID-19 positive. Mortality rates at 30- and 120-day were significantly higher for COVID-19 positive patients relative to COVID-19 negative patients (p < 0.001). However, mortality rates between 31 and 120-day were not significantly different (p = 0.107), 16.1% and 9.4% respectively for COVID-19 positive and negative patients, odds ratio 1.855 (95% CI 0.865-3.978). CONCLUSION Hip fracture patients with concurrent COVID-19 infection, provided that they are alive at day-31 after injury, have no significant difference in 120-day mortality. Despite the growing awareness and concern of "long-COVID" and its widespread prevalence, this does not appear to increase medium-term mortality rates after a hip fracture.
COVID-19 ; Hip Fractures/surgery* ; Humans ; Pandemics ; Prospective Studies ; Retrospective Studies ; State Medicine ; United Kingdom/epidemiology*

Persistent vegetative state (PVS) is described as one of the complications of brain damage in the current forensic science literatures. PVS unrelated to brain damage, however, is not uncommon in daily forensic practice. Currently, only "Assessment for Body Impairment of the Injured in Road Traffic Accident" designates PVS as one of its items under the section of "Brain, Spinal Cord, and Nerves Injury." Therefore, it is difficult to assess the damage and disability in PVS, especially PVS due to non-brain damage. Based on a case of PVS caused by chest injury in combination with relevant literature review, this paper provides a summary on the general information, etiology, pathogenesis, clinical manifestation, diagnosis and differential diagnosis of PVS, as well as a guideline for its forensic assessment.
Adolescent ; Back Injuries/complications* ; Forensic Medicine ; Humans ; Male ; Multiple Trauma/complications* ; Persistent Vegetative State/etiology* ; Thoracic Injuries/complications*

The state-running medical institutions which had been instituted in the earlier period of the Chosun dynasty substantially downsized during the reconstructing process after the major wars with Japan and Qing dynasty. The downsizing was mainly due to the malfunctioning public financial system; but it was also due to the growth of the private medical market. The growth of the private medical market reoriented the focus of the public health system of the Chosun dynasty from providing treatment for every minor disease to providing the more efficient policy against epidemic. Hwal-in Seo (a temporary local public health center established for epidemic) became a new core of the dynasty's health policy under the phrase of "Ae Rye (saving the rituals)." As the changes of the dynasty's public health policy, the growing private medical market had been admitted into the public domain. Chosun government once had declared Sa Yak Gye (a private mutual-aid group for medicine) illegal and prohibited the private groups to be organized. Instead, with the policy change mentioned above, the government tried to support the private mutual-aid group for medicine while forbidding sales of fake medicine, restraining rise of price of medicine. Especially the Do go merchants often caused the sudden rise of price of medicine by bulk purchasing. Medical practice was reassessed as the period when it was considered as one of the lowest professions had been over. Although the Yangban class still refused to be a professional medical practitioner themselves, they also well understood the value of medicine as a field of study to save human and dismissed negative perception on medicine. Medicine as a field of study and medical practice, which had been underestimated under the ruling system influenced by the Song Confucianism and the status system of the Chosun dynasty, faced a new era. The whole society guaranteed more free practices of the medical practitioners and they were recognized for their works. With the change of social environment, the government officials gradually realized needs to discuss how they could educate and recruit medical practitioners to provide advanced medical treatment and what provisions they had to legislate to ensure the stable supply of the medicine. It is certain that the transformation developed in the medical environment and the changes of the public health policy up to 18th century Chosun dynasty accompanied the emergence of the commercial society. However, the overall social urge was still not enough to induce the actual law-making process. The change of the public health policy and the growth of the private medical market were surely the evidence of the transforming Chosun society; at the same time, they also revealed the immaturity of the medical environment which was not able to lead new health policies.
Health Policy/history ; History, 16th Century ; History, 17th Century ; History, 18th Century ; Humans ; Korea ; Medicine, Korean Traditional/*history ; Private Sector/*history ; Public Health/*history ; State Medicine/history