Objective : The present study is aimed at providing basic data to help oriental medical hospitals devise efficient operational plans by analyzing the medical expenses of in-patients in an oriental medical hospital and the factors affecting such expenses. Methods : PASW 18.0 was used to analyze the medical insurance program data of 929 patients who were discharged from a university oriental medical hospital(with 105 sick-beds) during the period from January 1 to December 31, 2010 after treatment under the coverage of health insurance and medical aid. Results : 1) Of all the patients hospitalized, 63.3% were females, their mean age was 52.73 years old, and 87.7% was covered by the health insurance program. The biggest number or 31.2% of the patients were treated by the department of acupuncture, 31.5% suffered mainly from the diseases of musculoskeletal system and connective tissues, and the average length of stay at the hospital was 19.49 days. 2) There were statistically significant differences in total medical expenses by age, clinical department in charge, principal diagnosis, and number of days hospitalized while daily average medical expenses differed depending on age, type of medical security, clinical department, principal diagnosis, and number of days staying at the hospital. 3) Total medical expenses were found significantly influenced by age, type of medical security, clinical department, principal diagnosis, and number of days hospitalized(explanatory power : 95.9%), whereas type of medical security, clinical department and principal diagnosis turned out to exercise significant influence on the daily average medical expenses(explanatory power : 26.9%). Conclusion : Oriental medical hospitals are suggested to make efforts to ensure geographical and economical accessibility for their main clients, the elderly and middle-aged, as well as to improve satisfaction of the clients with the medical service provided. They are also encouraged to work out systems to specialize in treatment with a focus on chronic degenerative and adult diseases. In addition, they are expected to try to enhance people's awareness of oriental medicine in an attempt to diversify the brackets of clients and increase frequency of their utilization.
The Korean system of health and medical care has been organized with both Oriental and Western medical sciences. To get complete clinical treatment results is not possible with only one-sided medical care, therefore we need to formulate an interdisciplinary plan for better health care, that is to say our ultimate purpose is the cooperative medical care for the promotion of social welfare and health. Hereupon, I made a searching inquiry into the present condition of cooperative medical care and its problems and also took a consideration into the medical state of other countries like China. Japan and North Korea where the Oriental medical care is used. The results of this investigation are as follows. There are some problems in both Oriental and Western(general) medical care, such as a lack of mutual confidence, a severance of interdisciplinary study, a shortage of professional human resources and so on. There also used to be problems of the system such as, the responsibility of medical care, the double charge for medical treatment, the governmental passive participation and policy, the private-oriented study system and so on. The solutions of these problems are that the mutual understanding and coexistence between both Oriental and Western medical sciences should be preceded and the interdisciplinary study, identified terminology and cooperative medical specialists would be necessary. Furthermore, the government has to seek some policies and legislation for the cooperative medical system and needs to support the public research institutes and centers of the cooperative medical care. After all, we have to train the cooperative medical specialists for the mutual aid of both Oriental and Western medical sciences and the government also has to support it with some policies and legislation for the better medical care system.
Seungjeongwon Ilgi["承政院日記"], the Diaries of Royal Secretariat of the Joeson Dynasty is the most massive compilation of records in Korean history. Medical records in Seungjeongwon Ilgi have been studied but the procedures of clinical discussion[議藥] have not yet been studied. In this paper, main agents of clinical discussion, formation of participant doctor system, particularity of clinical discussion in Royal Court and problems derived from it will be discussed. Main agents of clinical discussion were court doctors[內醫], royal doctors[御醫] and participant doctors[議藥同參]. The king himself decided ultimately as a matter of form. Head of the Medical Dpt. of the Palace[藥房都提調] was in charge of attending to king, but head of the court doctor[首醫] led the actual discussion of deciding treatment. The Medical Dpt. of the Palace[內醫院] was divided into three sectors-court doctor division, acupuncture doctor division and participant doctor division. Palace doctors payed a great attention to avoid serious error. This tendency led them occasionally to passive management. Sometimes aggressive treatment is needed in the course of treating disease, but palace doctors tended to choose slow and gradual methods. It induced minor conflict between palace doctors and participant doctors from outside palace, because doctors from outside palace subordinated effectiveness. Their opinion had not been always recognized by court doctors. However, their role was meaningful because they provided flexibility to the rigidity of clinical discussion in the palace. It is important to evaluate clinical records in Seungjeongwon Ilgi["承政院日記"]. If we have broader eye on the clinical procedure in the palace, we can estimate the value of the contents more objectively and accurately.
The Special Method of Prescription, written by Ka-keum(柯琴) has scientific research for JungKyeong prescription. He takes charge of disease, syndrom, diagnotics of Exogenic febrile maladies(傷寒) and the level of doctors. There are six basic prescription with method of medical treatment; Kyejitang(桂枝湯) for persipiration, Chijashitang(梔子鼓湯) for vomiting, Seungkitang(承氣湯) for evaculation, Shihotang(柴胡湯) for harmanical progression, Sasimtang(瀉心湯) for cooling, Sayeoktang(四逆湯) for warming. In the first stage of exogenic febrile maladies. Kyejitang treat the flowing sweat, Mawhangtang(麻黃湯) treat the superficial fever and Daecheongryongtang(大靑龍湯) treat the anxious gitation About hydral-distention treatment, Sacheongryongtang(小靑龍湯) aim at vent hydral-distention with fever, Shipjotang(十棗湯) for cool hydral-distention without fever, Socheongryangtang(小靑龍湯) for moving hydral-distention, Oryeongsan(五苓散) for unmoving hydral-distentian and Jinmutang(眞武湯) far hydral-distentian with four extremities feel weight. The Special Method of Prescription discuss seven classification of herbo-prescription, the method acupuncture & moxibustion and other treatment.
The late Prof. Kyeok Boo Han (1913-2005) was one of the pioneers in the early stages of the establishment of thoracic surgery in Korea. He was in charge of thoracic surgery at Seoul National University Hospital from 1948 to the outbreak of the Korean War in 1950. He presented a thoracic surgical case entitled "Adhesive (constrictive) pericarditis: one surgical case" at the first academic meeting of the Chosun (an old name for Korea) Medical Association, held in 1947. This presentation is considered to be the first thoracic surgical case presented by a Korean surgeon at a domestic medical meeting after the National Liberation from Japanese colonial rule in 1945. In this regard, this study was intended to analyze the content and the meaning of the case, published in a journal in 1948.
In the present study, we investigated effects of extracellular zinc (Zn$\^$2+/) on T-type Ca$\^$2+/ channel isoforms (${\alpha}$lG, ${\alpha}$lH, and ${\alpha}$lI) stably expressed in HEK 293 cells. Ca$\^$2+/ currents were measured using 10 mM Ca$\^$2+/ as a charge carrier under whole cell-ruptured patch configuration. Zn$\^$2+/ blocked the ${\alpha}$lH currents with a 100- and 200-fold higher potency (IC$\sub$50/ = 2.5 ${\mu}$M) when compared with those for blockade of the ${\alpha}$1G and ${\alpha}$1I currents, respectively.(omitted)
Objectives: The purpose of this study was to examine the effect of the field practice of health science majors on their career attitude maturity in our country in an effort to determine influential factors. Methods: The subjects in this study were 220 selected health science majors in three different colleges located in North Gyeongsang Province and South Chungcheong Province. A survey was conducted with structured questionnaires from September 1 to 10, 2016. As for statistical analysis. a statistical package SPSS 20.0 was used. Results: The factors of the field practice of the health science majors that affected their career attitude maturity were the career of people in charge(${\beta}=.145$, p-.034) and the content of field practice(${\beta}=.233$, p=.015), which were the factors of the institution for field practice, and the relationship between people in charge and trainees(${\beta}=.299$, p=.008) and satisfaction with field placement(${\beta}=-.262$, p=.013) that were the factors of field practice tasks were also influential. The influence of these factors were statistically significant. Conclusions: Institutions that provide health science majors with the opportunity of field practice should try to improve the competencies of people in charge, to ensure the substantiality of field practice in content and to develop standardized manuals for field practice. In schools, professors who are in charge of field practice should offer intensive guidance and feedback on problems with field practice. These efforts are expected to elevate the career attitude maturity of students.
The effects of membrane surface charge originated from lipid head groups on ion channels were tested by analyzing the activity of single large conductance $Ca^{2+}-activated\;K^+$ (maxi K) channel from rat skeletal muscle. The conductances and open-state probability ($P_o$) of single maxi K channels were compared in three types of planar lipid bilayers formed from a neutral phosphatidylethanolamine (PE) or two negatively-charged phospholipids, phosphatidylserine (PS) and phosphatidylinositol (PI). Under symmetrical KCl concentrations $(3{\sim}1,000\;mM)$, single channel conductances of maxi K channels in charged membranes were $1.1{\sim}1.7$ times larger than those in PE membranes, and the differences were more pronounced at the lower ionic strength. The average slope conductances at 100 mM KCl were $251{\pm}9.9$, $360{\pm}8.7$ and $356{\pm}12.4$$(mean{\pm}SEM)$ pS in PE, PS and PI membranes respectively. The potentials at which $P_o$ was 1/2, appeared to have shifted left by 40 mV along voltage axis in the membranes formed with PS or PI. Such shift was consistently seen at pCa 5, 4.5, 4 and 3.5. Estimation of the effect of surface charge from these data indicated that maxi K channels sensed the surface potentials at a distance of $8{\sim}9\;{\AA}$ from the membrane surface. In addition, similar insulation distance ($7{\sim}9\;{\AA}$) of channel mouth from the bilayer surface charge was predicted by a 3-barrier-2-site model of energy profile for the permeation of $K^+$ ions. In conclusion, despite the differences in structure and fluidity of phospholipids in bilayers, the activities of maxi K channels in two charged membranes composed of PS or PI were strikingly similar and larger than those in bilayers of PE. These results suggest that the enhancement of conductance and $P_o$ of maxi channels is mostly due to negative charges in the phospholipid head groups.
The early Joseon era was a period when various medical systems were established and many medical literatures were published. Hwang Ja-hu(黃子厚) was a civil minister and medical professional who worked hard for maintaining government administrative system and medical regime during the Taejong and Sejong reign. Hwang Ja-hu followed his father and made MiReukWon(彌勒院) prosperous for the homeless people around Chungcheong-do Hoedeok. Hwang Ja-hu was talented in policy development as a government official. He was also learned in medicine, thus always doubled as head of JeonUiGam(典醫監). Hwang Ja-hu reformed the irrationalities in medical regime. He legalized JeonUiGam duties such as the presenting of the medicine or the preparation of the medicine and had the doctors take charge. He also suggested training acupuncture specialists(鍼灸專門醫). Hwang Ja-hu played a leading role in spreading HyangYak(鄕藥) throughout the country and reissuing [HyangYakGuGeupBang(鄕藥救急方)] due to personal philanthropism and service. He tried to defeat illnesses by letting the common people understand the symptoms and use medicine accordingly. Also he intended [HyangYakGuGeupBang(鄕藥救急方)] which was written focused on 'easiness book'(簡易方), 'experience book'(經驗方) to be used for the common people because [HyangYakJipSungBang(鄕藥集成方)] was made up a huge volume andused for training medical professionals and for accumulating knowledge. Hwang Ja-hu pursed subdivision of medical systems and specialization of medicine but also promoted medical rights. We should continue to discover and introduce medical figures who understood medicine and improved the medical systems.
Ki-Hyun Jeon;Jong-Hwan Jang;Sora Kang;Hak Seung Lee;Min Sung Lee;Jeong Min Son;Yong-Yeon Jo;Tae Jun Park;Il-Young Oh;Joon-myoung Kwon;Ji Hyun Lee
Korean Circulation Journal
/
제53권11호
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pp.758-771
/
2023
Background and Objectives: Paroxysmal atrial fibrillation (AF) is a major potential cause of embolic stroke of undetermined source (ESUS). However, identifying AF remains challenging because it occurs sporadically. Deep learning could be used to identify hidden AF based on the sinus rhythm (SR) electrocardiogram (ECG). We combined known AF risk factors and developed a deep learning algorithm (DLA) for predicting AF to optimize diagnostic performance in ESUS patients. Methods: A DLA was developed to identify AF using SR 12-lead ECG with the database consisting of AF patients and non-AF patients. The accuracy of the DLA was validated in 221 ESUS patients who underwent insertable cardiac monitor (ICM) insertion to identify AF. Results: A total of 44,085 ECGs from 12,666 patient were used for developing the DLA. The internal validation of the DLA revealed 0.862 (95% confidence interval, 0.850-0.873) area under the curve (AUC) in the receiver operating curve analysis. In external validation data from 221 ESUS patients, the diagnostic accuracy of DLA and AUC were 0.811 and 0.827, respectively, and DLA outperformed conventional predictive models, including CHARGE-AF, C2HEST, and HATCH. The combined model, comprising atrial ectopic burden, left atrial diameter and the DLA, showed excellent performance in AF prediction with AUC of 0.906. Conclusions: The DLA accurately identified paroxysmal AF using 12-lead SR ECG in patients with ESUS and outperformed the conventional models. The DLA model along with the traditional AF risk factors could be a useful tool to identify paroxysmal AF in ESUS patients.
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