This study examines how Choe Han-gi (崔漢綺, 1803–1879) developed his medical discourse which integrated the concepts of traditional Chinese medicine with modern Western anatomy, based on the philosophy of Seo Gyeong-deok (徐敬德, 1489–1546), a scholar of the Neo-Confucianism of Joseon (1392–1910). Seo emphasized gi (氣, C. qi, vital, material force) rather than yi (理, C. li, the principle of things) as a way of understanding the world. Since Choe's early academic interests pertained to Neo-Confucianism, it is reasonable to examine his philosophy in this context. Similar to Seo, Choe assumed that the most essential component of the world was the intrinsic and mysterious gi. Although Seo spoke of gi as a damil cheongheo ji gi (湛一淸虛之氣, the gi which is profound, uniform, clear, invisible, and empty), Choe preferred to use the word singi (神氣, C. shenqi, the intrinsic, invisible, and mysterious gi). He believed that the earth, moon, and stars operated through the action of singi and that all creatures could only exist by relying on it. Singi was the most important premise in Choe's medical discourse, a fact demonstrating that although he could be very critical of traditional Chinese medicine, his perspective was part of that tradition. He believed that singi integrated and operated the entire human body and that it perceived external objects. He also emphasized the role of hyeongjil (形質, C. xingzhi, a visible object with a form and quality; here it means all human bodies). This was the medium through which singi could appear in reality. Choe thought that singi could not reveal itself in reality without hyeongjil, and that hyeongjil became a dead thing without singi. His perception of the role of hyeongjil was expressed in his interest in modern Western anatomy, an interest that complemented his focus on singi. In light of his understanding of the singi-hyeongjil relationship, Choe criticized both modern Western anatomy and traditional Chinese medicine. He thought that modern Western anatomy lacked awareness of singi and that traditional Chinese medicine lacked accurate knowledge of human anatomy. Although he was not completely sympathetic toward any forms of medicine, he was open to ideas from both Western and Chinese medicine. Choe could not accept Western anatomy as fully as Japanese intellectuals did. The study of anatomy in Japan had developed in relation to the idea of Ancient Learning (古學, C. guxue), which denied such theories of systematic correspondence as Yin and Yang and the Five Elements (陰陽 五行, C. yinyang wuxing) and tended to focus on the action of hyeongjil itself. Because Choe accepted modern Western anatomy without accepting Ancient Learning, his perspective was unique in the history of East Asian anatomy. From a medical history perspective, how does Choi Han-gi's medical discourse distinguish itself from other medical discourses, and what are its characteristics? In addition to other explanations, focusing on the political imagination associated with medicine can help illuminate the differences between the medical discourse of Choe and those of others. Discussion of medicine and the human body was tied to political thought, manifesting the political imagination of the society in which that discussion took place. The development of Western and Japanese anatomy reflected a vertical and hierarchical political order, exemplified by the belief that the brain was the center of the body. However, Choe doubted that organs like the brain or heart dominated the body. In his view, the singi ruled the body; it was not a specific organ, and it was equally inherent in all people. His political thought also emphasized the horizontal and equal order among people. His view of singi simultaneously influenced both his perspective on medicine and his perspective on society. Choe Han-gi's belief in this horizontal and equal political order was inherent in his singi-centered medical discourse.
Asian Continental Ancestry Group ; Brain ; Clothing ; Complement System Proteins ; Heart ; Human Body ; Humans ; Imagination ; Japan ; Learning ; Medicine, Chinese Traditional ; Moon ; Philosophy ; Qi

This study will determine the ways in which the ancient learning (gu xue) scholarship of the Seongho School, and its interest in the materia medica (ben cao xue) were related during the late Joseon period. The Seongho School centered its studies mainly on classical Chinese texts of the Han (206 BC-AD 220) and pre-Han (?-221 BC) (xian-qin liang-han) periods rather than those of the Tang and Song dynasties (618-1279). Gu xue scholarship emerged during the Ming dynasty era (1368-1644) as an alternative to the scholarly trends of the Song dynasty, which were dependent on Zhu Xi's (1130-1200) Neo-Confucianism and its interpretation of Han and pre-Han classical Chinese texts. This scholarly trend influenced Korean and Japanese literature, philosophy, and even medicine from the seventeenth through the nineteenth centuries. Focusing on Korean scholarship, we find a great deal of research regarding the influence of gu xue on Korean classical Chinese literature and Confucian philosophy in the late Joseon period; however, no study has examined how this style of scholarship influenced the field of medicine during the same period. This study will investigate how the intellectuals of the Seongho School, who did the most to develop gu xue among Joseon intellectuals, were influenced by this style of scholarship in their study of the materia medica. Jeong Yak-yong (1762-1836), the representative intellectual of the Seongho School, did not focus on complicated metaphysical medical theories, such as the Yin-Yang and Five Elements theory (yin yang wu xing shui) or the Five Movements and Six Atmospheres theory (wu yun liu qi shui). Instead, his interests lay in the exact diagnoses of diseases and meticulous herbal prescriptions which formed an essential part of the Treatise on Exogenous Febrile Disease (Shang han lun) written by Zhang Zhungjing (150-219) in the Han dynasty. The Treatise was compatible with the scholarly purpose of gu xue in that they both eschewed metaphysical explanations. The Seongho School's interest in the materia medica stemmed from a desire to improve the delivery and quality of medical practices in rural communities, where metaphysical theories of medicine did not prevail and the cost of medicine was prohibitive.
Delivery of Health Care ; History, 18th Century ; History, 19th Century ; Korea ; Materia Medica/*history ; Medicine, Chinese Traditional/*history ; Medicine, Korean Traditional/*history ; Physicians/*history ; Quality of Health Care

No abstract available.

OBJECTIVES: We investigated the validity of the dipstick method (Mossman Associates Inc. USA) and the expired CO method to distinguish between smokers and nonsmokers. We also elucidated the related factors of the two methods. METHODS: This study included 244 smokers and 50 exsmokers, recruited from smoking cessation clinics at 4 local public health centers, who had quit for over 4 weeks. We calculated the sensitivity, specificity and Kappa coefficient of each method for validity. We obtained ROC curve, predictive value and agreement to determine the cutoff of expired air CO method. Finally, we elucidated the related factors and compared their effect powers using the standardized regression coefficient. RESULTS: The dipstick method showed a sensitivity of 92.6%, specificity of 96.0% and Kappa coefficient of 0.79. The best cutoff value to distinguish smokers was 5-6ppm. At 5 ppm, the expired CO method showed a sensitivity of 94.3%, specificity of 82.0% and Kappa coefficient of 0.73. And at 6 ppm, sensitivity, specificity and Kappa coefficient were 88.5%, 86.0% and 0.64, respectively. Therefore, the dipstick method had higher sensitivity and specificity than the expired CO method. The dipstick and expired CO methods were significantly increased with increasing smoking amount. With longer time since the last smoking, expired CO showed a rapid decrease after 4 hours, whereas the dipstick method showed relatively stable levels for more than 4 hours. CONCLUSIONS: The dipstick and expired CO methods were both good indicators for assessing smoking status. However, the former showed higher sensitivity and specificity and stable levels over longer hours after smoking, compared to the expired CO method.
Adult ; Carbon Monoxide/*analysis/metabolism ; Cotinine/metabolism/*urine ; Female ; Humans ; Male ; Middle Aged ; ROC Curve ; Sensitivity and Specificity ; Smoking/*metabolism/urine

The purpose of this paper is to review the colonoscopic fingings of twenty two patients with colonic tuberculosis which were diagnosed by colonoscopic finding, histopathology, and follow-up observation after antituberculosis chemotherapy at Pusan National University Hospital from January 1992 to December 1994. The results were as follows: 1) The male to female ratio was 1: 1.2, and the average age of the patients was 39.4 years with a slight predominance in women. The age of peak incidence was the 4th decade 40.9%). 2) Abdominal pain(95%), diarrhea(63%), and weight loss(50%) were the most common clinical findings. Others were constipation, melena, and palpable abdominal mass. The location of the pain was right lower abdomen, epigastrium, central abdomen, and left lower abdomen in decreasing order. 3) Hematologic findings showed decrease in hemoglobin level, increase in ESR, and positive CRP(61.5%). The white blood cell counts were mostly normal. 4) The stool examination showed positive occult blood in 7 cases among 18 cases (38.9%). Acid-fast bacteria was observed in stool of one case. 5) On colonoscopy, the lesion sites were ileoeecal valve(75%), ascending colon(72.7 %), terminal ileum(52.6%), cecum(42.9%), transverse colon(31.8%), descending colon (27.3%), sigmoid colon(9%), and rectum(9%) in decreasing order of frequency. Most of them involved ileocecal area. 6) On colonoscopy, the shape of ulcer revealed circular(41%), fusion(36%), and irregular pattern(18%). It found skipped area in 9 cases, pseudopolyp in 8 cases, patency of ileocecal valve in 5 cases, and severe deformity of ileocecal valve in 6 cases. 7) Microscopic finding of biopsy specimens revealed noncaseating granulomatous inflammation in 12 cases, and nonspecific ulcerative inflammation in 10 cases. In conclusion the diagnostic yield may be greatly enhanced by obtaining multiple target biopsies frorn tbe deep portion of the ulcer bed and margins. Judged from the colonoscopic finding and clinical improvement after antituberculosis chemotherapy, more accurate diagnosis can be acquired.
Abdomen ; Bacteria ; Biopsy ; Busan ; Colon* ; Colon, Descending ; Colon, Sigmoid ; Colonoscopy ; Congenital Abnormalities ; Constipation ; Diagnosis ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Ileocecal Valve ; Incidence ; Inflammation ; Leukocyte Count ; Male ; Melena ; Occult Blood ; Tuberculosis* ; Ulcer

PURPOSE: Radical prostatectomy is the gold standard treatment for clinically localized prostate cancer, a disease whose incidence is increasing. Erectile dysfunction(ED) after radical prostatectomy influences a patient's quality of life significantly. So we evaluated the correlation of preoperative and postoperative factors with postoperative ED and its treatment. MATERIALS AND METHODS: Hospital records of 27 patients who underwent radical prostatectomy by one surgeon at our department were retrospectively reviewed. We performed univariate analyses to correlate preoperative prognostic factors with intaoperative factors and postoperative variables. RESULTS: Excluding 10 patients who had preoperative ED, erectile dysfunction developed in 10 of 17 patients, and the rate was higher in the older age group(p=0.02). Patients underwent non-nerve sparing radical prostatectomy maintained their potency in 0.0% (0/1) comparative with 44.4% (4/9) in unilateral nerve sparing and 42.9% (3/7) in bilateral nerve sparing surgery. Patients with preexisting comorbidity, such as cardiovascular disease(OR=2.38) and margin positivity(OR=4.67) had greater risk of postoperative ED. In 8 erectile dysfunction patients, 3 sildenafil-treated and 2 alprostadil-treated patients showed improvement one year after the operation. CONCLUSIONS: Older patients have greater risk of postoperative ED, and they have more preexisting risk factors including hypertension, cardiovascular disease, diabetes mellitus, and margin positivity.
Cardiovascular Diseases ; Comorbidity ; Diabetes Mellitus ; Erectile Dysfunction* ; Hospital Records ; Humans ; Hypertension ; Incidence ; Male ; Prostatectomy* ; Prostatic Neoplasms ; Quality of Life ; Retrospective Studies ; Risk Factors ; Urinary Incontinence

PURPOSE: Radical prostatectomy is the gold standard treatment for clinically localized prostate cancer, a disease whose incidence is increasing. Erectile dysfunction(ED) after radical prostatectomy influences a patient's quality of life significantly. So we evaluated the correlation of preoperative and postoperative factors with postoperative ED and its treatment. MATERIALS AND METHODS: Hospital records of 27 patients who underwent radical prostatectomy by one surgeon at our department were retrospectively reviewed. We performed univariate analyses to correlate preoperative prognostic factors with intaoperative factors and postoperative variables. RESULTS: Excluding 10 patients who had preoperative ED, erectile dysfunction developed in 10 of 17 patients, and the rate was higher in the older age group(p=0.02). Patients underwent non-nerve sparing radical prostatectomy maintained their potency in 0.0% (0/1) comparative with 44.4% (4/9) in unilateral nerve sparing and 42.9% (3/7) in bilateral nerve sparing surgery. Patients with preexisting comorbidity, such as cardiovascular disease(OR=2.38) and margin positivity(OR=4.67) had greater risk of postoperative ED. In 8 erectile dysfunction patients, 3 sildenafil-treated and 2 alprostadil-treated patients showed improvement one year after the operation. CONCLUSIONS: Older patients have greater risk of postoperative ED, and they have more preexisting risk factors including hypertension, cardiovascular disease, diabetes mellitus, and margin positivity.
Cardiovascular Diseases ; Comorbidity ; Diabetes Mellitus ; Erectile Dysfunction* ; Hospital Records ; Humans ; Hypertension ; Incidence ; Male ; Prostatectomy* ; Prostatic Neoplasms ; Quality of Life ; Retrospective Studies ; Risk Factors ; Urinary Incontinence

PURPOSE: We tried to determine how many patients comply with semen analysis recommendations after vasectomy and how often the operation is followed by surgical failure or recanalization. MATERIALS AND METHODS: We determined the percentage of patients who underwent vasectomy from 1995 to 2003 who had follow-up semen analysis. To determine the vasectomy failure or recanalization rate, we evaluated the rates of sperm appearance in patients who were preparing for vasovasostomy and those with chronic prostatitis who had undergone vasectomy in the past. RESULTS: Among the 130 vasectomized patients, 29(22.3%) had received semen analysis, and in 120 healthy vasectomized patients, only 19(9.9%) received semen analysis. Of the 8 semen samples examined before vasovasostomy, 2(25%) had sperm. In the 121 chronic prostatitis patients, 9(7.4%) had sperm in their semen despite earlier vasectomy. Overall, 11 of 129 vasectomized patients(8.5%) were potentially fertile. CONCLUSIONS: The vasectomy failure or recanalization rate is higher than we generally think. Vasectomy failure or recanalization is usually followed by unwanted pregnancy and abortion. Unfortunately, physicians as well as patients are indifferent to the need for post-vasectomy semen analysis, and we need to emphasize its importance.
Female ; Follow-Up Studies ; Humans ; Infertility ; Pregnancy ; Pregnancy, Unwanted ; Prostatitis ; Semen Analysis* ; Semen* ; Spermatozoa ; Vasectomy* ; Vasovasostomy

This report documents a case of myeloid erythrophagocytosis in a patient with myeloproliferative disorder. The patient had pancytopenia and his marrow was hyperplastic with erythrophagocytosis by myeloid cells of various stages, including myeloblasts. He was diagnosed to have a prefibrotic stage of chronic idiopathic myelofibrosis. The erythrophagocytosis by myeloid cells persisted even after 2 months of treatment for the primary disorder.
Erythrocytes/*pathology ; Human ; Male ; Middle Aged ; Myeloid Cells/*pathology ; Myeloproliferative Disorders/*pathology ; Pancytopenia/pathology ; *Phagocytosis

In this study, the distribution of the mec regulator genes and the presence of the mutation in mecI gene and mec promoter region among 50 MRSA clinical isolates derived from a single university hospital in Korea were analyzed. Among 50 MRSA strains, 13 strains had a deletion of mecI gene, and 37 strains were found to have mutations in mecI gene or mecA promoter region corresponding to a presumptive operator of mecA, i.e., the binding site of the repressor protein. Furthermore, in order to track the evolution of methicillin-resistant Staphylococcus aureus (MRSA) distributed in Korea, we determined the MRSA clonotype by combined use of genetic organization patterns of mec regulator genes, ribotype, and coagulase type. As the result, 48 of 50 MRSA strains could be classified into four distinct clones. Clonotype I is characterized by the coagulase type 3, deletion of mecI gene, and ribotype 1 shared by NCTC10442, the first reported MRSA isolate in England (9 strains). Clonotype II is characterized by the coagulase type 4, C to T substitution at position 202 of mecI gene, and ribotypes 2, 3 and 4 shared by 85/3619 strain isolated in Austria (10 strains). Clonotype III is characterized by the coagulase type 2, mutations of mecA promoter region and/or mecI, and ribotypes 4, 5, and 6 shared by N315 strain isolated in Japan (25 strains). Clonotype IV is characterized by the coagulase type 4, deletion of mecI gene, and ribotype 7 (4 strains). The clonality of two strains could not be determined due to their undefined ribotype.
Austria ; Binding Sites ; Clone Cells ; Coagulase ; England ; Genes, Regulator ; Japan ; Korea* ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Promoter Regions, Genetic ; Ribotyping