• Tuberculosis and Respiratory Diseases
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• v.43 no.5
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• pp.671-682
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• 1996

Background : Endobronchial tuberculosis is definded as tuberculous infection of the tracheobronchial tree with microbiological and histopathological evidence. Endobronchial tuberculosis has clinical significance due to its sequela of cicatrical stenosis which causes atelectasis, dyspnea and secondary pneumonia and may mimic bronchial asthma and pulmanary malignancy. Method : The authors carried out, retrospectively, a clinical study on 201 patients confirmed with endobronchial tuberculosis who visited the Department of Pulmonary Medicine at Hangyang University Hospital from January 1990 10 April 1996. The following results were obtained. Results: 1) Total 201 parients(l9.5%) were confirmed as endobronchial tuberculosis among 1031 patients who had been undergone flexible bronchofiberscopic examination. The number of male patients were 55 and that of female patients were 146. and the male to female ratio was 1 : 2.7. 2) The age distribution were as follows: there were 61(30.3%) cases in the third decade, 40 cases(19.9%) in the fourth decade, 27 cases(13.4%) in the sixth decade, 21 cases(10.4%) in the fifth decade, 19 cases(9.5%) in the age group between 15 and 19 years, 19 cases(9.5%) in the seventh decade, and 14 cases(7.0%) over 70 years, in decreasing order. 3) The most common symptom, in 192 cases, was cough 74.5%, followed by sputum 55.2%, dyspnea 28.6%, chest discomfort 19.8%, fever 17.2%, hemoptysis 11.5%, in decreasing order, and localized wheezing was heard in 15.6%. 4) In chest X-ray of 189 cases, consolidation was the most frequent finding in 67.7%, followed by collapse 43.9%. cavitary lesion 11.6%, pleural effusion 7.4%, in decreasing order, and there was no abnormal findings in 3.2%. 5) In the 76 pulmanary function tests, a normal pattern was found in 44.7%, restrictive pattern in 39.5 %, obstructive pattern in 11.8%, and combined pattern in 3.9%. 6) Among total 201 patients, bronchoscopy showed caseous pseudomembrane in 70 cases(34.8%), mucosal erythema and edema in 54 cases(26.9%), hyperplastic lesion in 52 cases(25.9%), fibrous s.enosis in 22 cases(10.9%), and erosion or ulcer in 3 cases(1.5%). 7) In total 201 cases, bronchial washing AFB stain was positive in 103 cases(51.2%), bronchial washing culture for tuberculous bacilli in 55 cases(27.4%). In the 99 bronchoscopic biopsies, AFB slain positive in 36.4%. granuloma without AFB stain positive in 13.1%, chronic inflammation only in 36.4%. and non diagnostic biopsy finding in 14.1%. Conclusions : Young female patients, whose cough resistant to genenal antitussive agents, should be evaluated for endobronchial tuberculosis, even with clear chest roentgenogram and negative sputum AFB stain. Furthermore, we would like to emphasize that the bronchoscopic approach is a substantially useful means of making a differential diagnosis of atelectasis in older patients of cancer age. At this time we have to make a standard endoscopic classification of endobronchial tuberculosis, and well designed prospective studies are required to elucidate the effect of combination therapy using antituberculous chemotherapy with steroids on bronchial stenosis in patients with endobronchial tuberculosis.

• Tuberculosis and Respiratory Diseases
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• v.43 no.5
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• pp.701-708
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• 1996

Background : To evaluate the effect of the balloon dilatation in tuberculous bronchial stenosis, we performed balloon dilatation in 13 cases which had airway obstruction in main bronchus with the impairment of pulmonary function. Material and Methods: Thirteen women with tuberculous bronchial stenosis(9cases : left main bronchus, 4 cases: right main bronchus) underwent fluoroscopically guided balloon dilatation under the local anesthesia. Among the these patient, 9 cases were active endobronchial tuberculosis, and 4 cases were inactive. Immediate and long term follow-up(average 15.6months) assessments were done focused on change on PIT. The increase of FVC or FEV1 more than 15% after the procedure was considered effective. Complications after dilatation were evaluated in all patients. Result : 1) There were an decrease of self-audible wheezing in 75%(6/8), improvement of dyspnea in 62.5%(5/8), improvement of cough and expectoration in 50%(3/6), and improvement of chest discomfort in 50%(1/2). 2) Significant improvement of PFT was noted in 42.9%(3/7) of which respiratory symptoms duration was below 6 months. 8m, significant improvement of PFT was noted in only 25%(1/4) of which respiratory symptoms duration was above 12 months. 3) Active stage was 69.2%(9/13) and inactive was 30.8%(4/13). There was an significant improvement of PFT in 44.4%(4/9) of active stage, but, only 25%(1/4) of inactive stage was improved. 4) In 61.5%(8/13), FVC and FEV1 were increased to 35.5%, and 22.2% at post-dilatation 7 days. After 1 month later, FVC and FEV1 were increased to 54.7%, and 31.8% in 5 cases(38.5%). 4 cases in which long-term follow-up(average 19.8months) was possible the improvement of FVC, and FEV1 were 30.5%, and 10.1%. 5) Just after balloon dilatation therapy, transient leukocytosis or fever was noted in 30.8%(4/13), and blood-tinged sputum was noted in 30.8%(4/13). However, serious complication, such as pneumothorax, pneumomediastinum or mediastinitis, was not noted. Conclusion : We conclude that tuberculous bronchial stenosis, which is on active stage, and short dulation of respiratory symptoms was more effective on balloon dilatation than inactive stage or long duration of respiratory symptoms. Furthermore, balloon dilatation is easier, much less invasive and expensive than open surgery. and cryotherapy or photoresection. Because of these advantage, we think that balloon dilatation could be the first choice for treating bronchial stenosis and could be done at first in early stage if unresponsiveness with steroid therapy is observed.

• Tuberculosis and Respiratory Diseases
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• v.45 no.5
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• pp.1012-1021
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• 1998

Background : It is known that airway inflammation is present in most patients with asthma, but the relationship between symptoms and the severity and nature of airway inflammation has not been established. Cough variant asthma is defined as an asthma in which the dominant symptom is cough, and the condition can be successfully treated with inhaled steroids. This study was performed to evaluate the time course of bronchial responsiveness according to an inhaled anti-inflammatory therapy and the factors which affect the resolution of bronchial responsiveness, and an efficacy of nedocromil to cough asthma. Method: A prospective study for the investigation of bronchial responsiveness according to an inhaled anti-inflammatory treatment in sixty-one cough asthmatics was performed. Twenty-three entered budesonide ($400{\mu}g{\times}2/day$), twenty-two entered nedocromil ($4mg{\times}2/day$) and sixteen patients entered combined group. The bronchial hyperresponsiveness (BHR) was estimated by methacholine challenge test using counted breath method. The symptom was estimated by 'symptom score'. Reevaluation of BHR and symptom was performed at 2 month after treatment, and if BHR was not resoluted at this time, regarded as a non-responder, and then follow-up of BHR and symptom was performed at 4- and/or 6 month after treatment. Results: The improvement of BHR and symptom was significant in 2 month (p<0.05), but there was no change of them during follow-up period of 4- and/or 6 month in non-responders. In comparison of allergic markers such as serum total IgE, peripheral eosinophil count and skin test reactivity between responders and non-responders, there was no difference in each other. However, in comparison of other factors such as cumulative pack-years, symptom duration, age, gender, and the initial degree of PC20, there was a significant difference in each other(p<0.05). The percent of patients with the resolution of BHR in 2 month was not different in each group(p=0.95). There was no significant difference in the degree of improvement of BHR and symptom in each group. Conclusion: Bronchial responsiveness and symptom was not significantly improved in non-responders during follow-up period of 4- and/or 6 month. The effect of inhaled nedocromil was equivalent to that of inhaled steroid in cough asthmatics, and the response to combined treatment is not superior to that achieved by either of these agents used alone.

• MISULJARYO - National Museum of Korea Art Journal
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• v.100
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• pp.140-170
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• 2021

This paper investigates the Wooden Seated Tri-kaya Buddha Images(三身佛像) of Vairocana, Rushana, and Sakyamuni enshrined in Daeungjeon Hall of Hwaeomsa temple(華嚴寺) in Gurae, South Cheolla Province. They were produced in 1634 CE and placed in 1635 CE, about forty years after original images made in the Goryeo period were destroyed by the Japanese army during the war. The reconstruction of Hwaeomsa was conducted by Gakseong, one of the leading monks of Joseon Dynasty in the 17th century, who also conducted the reconstructions of many Buddhist temples after the war. In 2015, a prayer text (dated 1635) concerning the production of Hwaeomsa Tri-kaya Buddha images was found in the repository within Sakyamuni Buddha. It lists the names of participants, including royal family members (i.e., prince Yi Guang, the eighth son of King Seon-jo), and their relatives (i.e., Sin Ik-seong, son-in-law of King Seonjo), court ladies, monk-sculptors, and large numbers of monks and laymen Buddhists. A prayer text (dated 1634) listing the names of monk-sculptors written on the wooden panel inside the pedestal of Rushana Buddha was also found. A recent investigation into the repository within Rushana Buddha in 2020 CE has revealed a prayer text listing participants producing these images, similar to the former one from Sakyamuni Buddha, together with sacred relics of hoo-ryeong-tong copper bottle and a large quantity of Sutra books. These new materials opened a way to understand Hwaeomsa Trikaya images, including who made them and when they were made. The two above-mentioned prayer texts from the repository of Sakyamuni and Rushana Buddha statues, and the wooden panel inside the pedestal of Rushan Buddha tell us that eighteen monk-sculptors, including Eungwon, Cheongheon and Ingyun, who were well-known monk artisans of the 17th century, took part in the construction of these images. As a matter of fact, Cheongheon belonged to a different workshop from Eungwon and Ingyun, who were most likely teacher and disciple or senior and junior colleagues, which means that the production of Hwaeomsa Tri-kaya Buddha images was a collaboration between sculptors from two workshops. Eungwon and Ingyun seem to have belonged to the same community studying under the great Buddhist priest Seonsu, the teacher of Monk Gakseong who was in charge of the reconstruction of Haweonsa temple. Hwaeomsa Tri-kaya Buddha images show a big head, a squarish face with plump cheeks, narrow and drooping shoulders, and a short waist, which depict significant differences in body proportion to those of other Buddha statues of the first half of 17th century, which typically have wide shoulders and long waists. The body proportion shown in the Hwaeomsa images could be linked with images of late Goryeo and early Joseon period. Rushana Buddha, raising his two arms in a preaching hand gesture and wearing a crown and bracelets, shows unique iconography of the Bodhisattva form. This iconography of Rushana Buddha had appeared in a few Sutra paintings of Northern Song and Late Goryeo period of 13th and 14th century. BodhaSri-mudra of Vairocana Buddha, unlike the general type of BodhaSri-mudra that shows the right hand holding the left index finger, places his right hand upon the left hand in a fist. It is similar to that of Vairocana images of Northern and Southern Song, whose left hand is placed on the top of right hand in a fist. This type of mudra was most likely introduced during the Goryeo period. The dried lacquer Seated Vairocana image of Bulheosa Temple in Naju is datable to late Goryeo period, and exhibits similar forms of the mudra. Hwaeomsa Tri-kaya Buddha images also show new iconographic aspects, as well as traditional stylistic and iconographic features. The earth-touching (bhumisparsa) mudra of Sakymuni Buddha, putting his left thumb close to the middle finger, as if to make a preaching mudra, can be regarded as a new aspect that was influenced by the Sutra illustrations of the Ming dynasty, which were imported by the royal court of Joseon dynasty and most likely had an impact on Joseon Buddhist art from the 15th and 16th centuries. Stylistic and iconographical features of Hwaeomsa Tri-kaya Buddha images indicate that the traditional aspects of Goryeo period and new iconography of Joseon period are rendered together, side by side, in these sculptures. The coexistence of old and new aspects in one set of images could indicate that monk sculptors tried to find a new way to produce Hwaeomsa images based on the old traditional style of Goryeo period when the original Tri-kaya Buddha images were made, although some new iconography popular in Joseon period was also employed in the images. It is also probable that monk sculptors of Hwaeomsa Tri-kaya Buddha images intended to reconstruct these images following the original images of Goryeo period, which was recollected by surviving monks at Hwaeomsa, who had witnessed the original Tri-kaya Buddha images.

• Journal of the Daesoon Academy of Sciences
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• v.32
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• pp.77-108
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• 2019

The purpose of this paper is to clarify the characteristics of 'Podeok' in Daesoon Jinrihoe. The term Podeok can cause some misunderstanding as the same word Deok (德 virtue) has long been used in the Eastern Tradition. In other words, for most people who are used to traditional thought, Podeok may be conflated with the similar word 'Deok (virtue)' as used within Confucianism. People who are familiar with Confucian culture might thereby misunderstand the term Podeok as an aspect of Confucian moral ethics, or they could misconstrue Daesoon Jinrihoe as having appropriated and misused Confucian ideas. Furthermore, there are other problems that could arise if people compare Daesoon Jinrihoe's 'Podeok' with 'Deok (virtue)' as used by Laozi. While Deok in Laozi's usage represents the ability of an individual who can exercise his or her rationality with excellence, Deok in Daesoon Jinrihoe indicates the idea of actualizing Mutual Beneficence and the conditions that enable Mutual Beneficence. If one understands Deok as used by Laozi to contain the meaning of Mutual Beneficence, then it is possible to think that the two tradition share a similar meaning of Deok as Podeok in Daesoon Jinrihoe pursues Mutual Beneficence as its ultimate value. In order to preemptively correct these misunderstandings, I need to clarify how the idea of Deok was born out of traditional thought and what meanings it embodies. Additionally, it is necessary to examine how it became meaningful in Confucianism, and how it was criticized and ascribed new meanings in Laozi's thought. Through these clarification, it will become clear that Deok originally indicated a religious ritual that the king of the Zhou Dynasty performed after receiving the heavenly mandate and assuming rule over the nation. Later, this idea was transformed into a moral virtue and norm by Confucius. This moral virtue and norm was criticized by Laozi as an unnatural form of control as it was understood by Laozi as a teleological argument justifying whether or not lives were to be saved or sustained based on the perceived merits of each individual. On the contrary, Deok in Daesoon Jinrihoe and traditional thought stand on a totally different theological bases. Deok in Daesoon Jinrihoe is a means to practice and realize the truth of the earthly paradise of the Later World and the truth of Mutual Beneficence which were posited to the world through Kang Jeungsan's Works of Haewon (grievance resolution) that resolved the pattern of mutual conflict that characterized the Former World. Therefore, the idea of Podeok in Daesoon Jinrihoe gains completion only on the premises of Haewon Sangsaeng (resolution of grievances for mutual beneficence) and Boeun Sangsaeng (reciprocation of favors for mutual beneficence), and the way to practice Podeok is to practice Haewon Sangsaeng and Boeun Sangsaeng. In addition, the subordinate virtues such as loyalty, filial piety, and faithfulness that exist within Daesoon Jinrihoe's religious practice are not same as those of traditional thought. They are new concepts of virtues drawn from the cosmological laws of Daesoon Jinrihoe. To be specific, the virtues of Daesoon Jinrihoe are not rules that create discrimination and mutual conflict, but are instead ethical rules established upon the basis of Heaven and Earth having been newly organized, and thus, they will bring virtuous concordance, harmonious union, and mutual beneficence. The idea of 'Podeok' in Daesoon Jinrihoe can be understood as a religious practice that requires doctrinal understanding and tangible practice in daily life of followers. In other words, it is not the same Deok of earlier traditional thought in East Asia, but is instead a religious truth by which practitioners realize the truth of Sangje's Works of Haewon in human world as they practice Haewon Sangsaeng and Boeun Sangsaeng.

• The Southeast Asian review
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• v.27 no.2
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• pp.37-76
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• 2017

$Nguy{\tilde{\hat{e}}}n$ Cư Trinh has two faces in the history of territorial expansion of Vietnam into the Mekong delta. One is his heroic contribution to the $Nguy{\tilde{\hat{e}}}n$ family gaining control over the large part of the Mekong delta. The other is his role to make the eyes of readers of Vietnamese history be fixed only to the present territory of Vietnam. To the readers, $Nguy{\tilde{\hat{e}}}n$ Cư Trinh's achievement of territorial expansion was the final stage of the nam $ti{\acute{\hat{e}}n$ of Vietnam. In fact, however, his achievement was partial. This study pays attention to the King $V{\tilde{o}}$ instead of $Nguy{\tilde{\hat{e}}}n$ Cư Trinh in the history of the territorial expansion in the Mekong delta. King's goal was more ambitious. And the ambition was propelled by his dream to build a new world, and its order, in which his new capital, $Ph{\acute{u}}$ $Xu{\hat{a}}n$ was to be the center with his status as an emperor. To improve my assertion, three elements were examined in this article. First is the nature of $V{\tilde{o}}$ Vương's new kingship. Second is the preparation and the background of the military operation in the Mekong Delta. The nature of the new territory is the third element of the discussion. In 1744, six years after this ascending to the throne, $V{\tilde{o}}$ Vương declared he was a king. Author points out this event as the departure of the southern kingdom from the traditional dynasties based on the Red River delta. Besides, the government system, northern custom and way of dressings were abandoned and new southern modes were adopted. $V{\tilde{o}}$ Vương had enough tributary kingdoms such as Cambodia, Champa, Thủy $X{\tilde{a}}$, Hoả $X{\tilde{a}}$, Vạn Tượng, and Nam Chưởng. Compared with the $L{\hat{e}}$ empire, the number of the tributary kingdoms was higher and the number was equivalent to that of the Đại Nam empire of the 19th century. In reality, author claims, the King $V{\tilde{o}}^{\prime}s$ real intention was to become an emperor. Though he failed in using the title of emperor, he distinguished himself by claiming himself as the Heaven King, $Thi{\hat{e}}n$ Vương. Cambodian king's attack on the thousands of Cham ethnics in Cambodian territory was an enough reason to the King $V{\tilde{o}}^{\prime}s$ military intervention. He considered these Cham men and women as his amicable subjects, and he saw them a branch of the Cham communities in his realm. He declared war against Cambodia in 1750. At the same time he sent a lengthy letter to the Siamese king claiming that the Cambodia was his exclusive tributary kingdom. Before he launched a fatal strike on the Mekong delta which had been the southern part of Cambodia, $V{\tilde{o}}$ Vương renovated his capital $Ph{\acute{u}}$ $Xu{\hat{a}}n$ to the level of the new center of power equivalent to that of empire for his sake. Inflation, famine, economic distortion were also the features of this time. But this study pays attention more to the active policy of the King $V{\tilde{o}}$ as an empire builder than to the economic situation that has been told as the main reason for King $V{\tilde{o}}^{\prime}s$ annexation of the large part of the Mekong delta. From the year of 1754, by the initiative of $Nguy{\tilde{\hat{e}}}n$ Cư Trinh, almost whole region of the Mekong delta within the current border line was incorporated into the territory of $V{\tilde{o}}$ Vương within three years, though the intention of the king was to extend his land to the right side of the Mekong Basin beyond the current border such as Kampong Cham, Prey Vieng, and Svai Rieng. The main reason was $V{\tilde{o}}$ Vương's need to expand his territory to be matched with that of his potential empire with the large number of the tributary kingdoms. King $V{\tilde{o}}^{\prime}s$ strategy was the variation of 'silkworm nibbling' and 'to strike barbarians by barbarians.' He ate the land of Lower Cambodia, the region of the Mekong delta step by step as silkworm nibbles mulberry leave(general meaning of $t{\acute{a}}m$ thực), but his final goal was to eat all(another meaning of $t{\acute{a}}m$ thực) the part of the Mekong delta including the three provinces of Cambodia mentioned above. He used Cham to strike Cambodian in the process of getting land from Long An area to $Ch{\hat{a}}u$ Đốc. This is a faithful application of the Dĩ Man $C{\hat{o}}ng$ Man (to strike barbarians by barbarians). In addition he used Chinese refugees led by the Mạc family or their quasi kingdom to gain land in the region of $H{\grave{a}}$ $Ti{\hat{e}}n$ and its environs from the hand of Cambodian king. This is another application of Dĩ Man $C{\hat{o}}ng$ Man. In sum, author claims a new way of looking at the origin of the imperial world order which emerged during the first half of the 19th century. It was not the result of the long history of Đại Việt empires based on the Red River delta, but the succession of the King $V{\tilde{o}}^{\prime}s$ new world based on $Ph{\acute{u}}$ $Xu{\hat{a}}n$. The same ways of Dĩ Man $C{\hat{o}}ng$ Man and $T{\acute{a}}m$ Thực Chi $K{\acute{\hat{e}}}$ were still used by $V{\tilde{o}}^{\prime}s$ descendents. His grandson Gia Long used man such as Thai, Khmer, Lao, Chinese, and European to win another man the '$T{\hat{a}}y$ Sơn bandits' that included many of Chinese pirates, Cham, and other mountain peoples. His great grand son Minh Mạng constructed a splendid empire. At the same time, however, Minh Mạng kept expanding the size of his empire by eating all the part of Cambodia and Cham territories.