• CELLMED
• /
• v.14 no.2
• /
• pp.4.1-4.4
• /
• 2024

The development of clinical reasoning, which is the basis of medical education, is of great importance in medical universities. One of the founders of modern structural clinical reasoning, based on the knowledge of pathological physiology, is the inventor of the stethoscope Rene Laennec (1781-1826). He described the pioneering experience of clinical reasoning in the pages of his treatise A Treatise on the Diseases of the Chest and on Mediate Auscultation, which is of lasting value, since every rookie physicians in his professional development goes through the path of Laennec. Laennec's practice is of great importance for novice physicians since Laennec's treatise contains a diagnostic analysis of the most common clinical cases. Each such analysis demonstrates the algorithm of clinical reasoning. The purpose of this study was to analyze the approaches of clinical reasoning by René Laennec, which made it possible to identify two basic principles. Laennec's diagnostic reasoning involved two principles: pathogenetic analysis of clinical manifestations and a syndrome-based approach to differential diagnosis. These principles help distinguish between diseases with similar symptoms and physical findings are used to demonstrate the practical application of syndrome-based differential diagnosis. These principles can be easily mastered by understanding the pathogenesis of clinical manifestations. Thanks to the pathogenetic basis, the principles of clinical reasoning of Rene Laennec are universal and applicable to the analysis of any signs of the disease: not only physical but also laboratory and instrumental.

• Korean Medical Education Review
• /
• v.26 no.2
• /
• pp.140-154
• /
• 2024

A physician's empathy plays a crucial role in patient-centered care, and in modern medicine, patients, their caregivers, and society demand a high level of empathy from healthcare providers. The conceptualization of clinical empathy, which has emphasized cognitive empathy since the mid-20th century, has been widely accepted in medical schools and the healthcare industry without much critical ref lection. This study provides an overview of the ongoing debates on empathy versus sympathy and cognitive empathy versus affective empathy to clarify the concept of empathy. Based on recent research findings, clinical empathy is proposed to encompass three components: cognitive empathy, affective empathy, and empathic motivation. It is suggested that fully demonstrating these components requires empathic communication skills. Additionally, the cognitive characteristics of medical students and the features of the academic environment demonstrate the need for education to strengthen their empathy skills. Considering this, proposed intervention methods that medical schools can consider include utilizing tutoring programs and debriefing processes for team activities, which can facilitate problem-solving as a coping strategy for stress. Learning communities can create an environment where students can receive social support and recover from stress. Medical schools can contribute to the development of students' professional identities as practicing clinicians who embody empathy and respect by cultivating professors as positive role models. Additionally, utilizing scales to assess the empathic nature of doctor-patient communication or incorporating patients and caregivers as evaluators can actively improve empathic communication skills.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.24 no.4
• /
• pp.183-190
• /
• 2013

Objectives : 'Taegyo,' prenatal education, is steeped into Korean culture. Although there has been a traditional focus on providing education and care for the fetus in Korea, there is a lack of medical evidence for its effectiveness. Methods : The authors assessed the scientific basis for 'Taegyo' by reviewing the evidences. Results : 'Taegyo' in Korea began with the spread of Buddhist culture from China, and transmitted by word-of-mouth. The first 'Taegyo' book, the Tae-gyo-shin-gi, was published on 1803. Modern prenatal education is very diverse. However, only a few studies on its effect have been conducted. Development of medicine, especially obstetrics, fetology, pediatrics, psychiatry, and etc., has learned that many factors, including bad environmental conditions and maternal stress, influenced against the fetus and mother. As for the paternal side, occupation, smoking, and stress were also revealed to have consequences for the development of the fetus. On the contrary, adequate maternal nutrition, exercise, and music stimulation positively impact the fetal development and healthy birth. Conclusion : Traditional contents of 'Taegyo' were proved to have effectiveness from evidence-based medicine and animal experiments. We need further studies to explore the impact of prenatal education for the fetal development and maternal health.

• Journal of the Korean Institute of Oriental Medical Informatics
• /
• v.16 no.1
• /
• pp.1-8
• /
• 2010

Objective: Various controlled vocabulary such as thesaurus and classification make us to reuse and share effectively by defining different concept and linking terms each other. The UMLS(Unified Medical Language System) is one of the most universal medical terminology systems. It is needed various methods to share and reuse information of traditional Korean medicine. We will research on method that adopt SUI of the UMLS(that is de facto standard in medical terminology system) in traditional Korean medical terminology. Method: We described major problems and applying process when we tried to add traditional Korean medicine in the part of meridian into the UMLS metathesaurus. Comparing western medical terms and traditional Korean medical terms for applying UMLS metathesaurus, there is not only many consistency, but also differences. Result: We confirmed what is the differences and consistency between western medical terms and traditional Korean medical terms. And then reviewed methods that apply the CUI, LUI, SUI in traditional Korean medical terms. Traditional Korean medical terms are not discriminated by singular or plural string. In addition, traditional Korean medical terms have vary string by initial law: the law of initial sound of a syllable. Character is described with Korean, traditional Chinese, modern Chinese, etc. According to meaning, language, initial law, SUI has a distinct value respectively. Conclusion: There are many differences to apply the UMLS between western medical terms and traditional Korean medical terms. For the better implementation to traditional Korean medicine into the UMLS, further research is needed in standardization and classification of traditional Korean medical terms, medical information system, etc. We hope this study helps the implementation UMLS, EHR, knowledge based system in Oriental medicine in the future.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.16 no.4
• /
• pp.637-641
• /
• 2002

In order to convert the one ryang of Guizhi-tang into the modern weights and measures, herbs whose dose was expressed by number in Treatise on Feverile Disease of Zhongjing were measured actually. The results obtained are as follows. 1. Size of Jujubae fructus in Guizhi-tang is an average and if remove the seed, 12 Jujubae fructuses corresponds to 20g. These weights are the same as Belamcandae Rhizoma, Persicae Semen, Gleditsiae Fructus, Gardeniae Fructus and Armeniacae amarum Semen whose dose was expressed by number in Treatise on Feverile Disease of Zhongjing. If one ryang corresponds to 6.5g, 20g corresponds to three ryang. If one ryang corresponds to 15.6g, 20g corresponds to 1.3 ryang. When herbs were added in Guizhi-tang, the used weights were two more ryang. Almost unit of weights in Formulae of Zhongjing is the constantly multiplied. 2. Half sheng(升) of Pinelliae Rhizomae is 15 Pinelliae Rhizomas and corresponds to two and a half ryang. 14 Pinelliae Rhizomas are contained in 50 mL egg. 3.1 geun(斤), maximal amount of Gypsum Fibrosum and amount of one egg are the same weight supposing one ryang corresponds to 6.5g. 4. 2 ryang of Rhei Radix et Rhizoma is the 6.8 balls(碁子) of baduk and similar as 5-6 balls of baduk of Jisilchijasi-Tang. 5. General dose of Glycyrrhizae Radix is two ryang and 20mL, the size of thumb is 13g. 6. Half geun approaches the 3 flattened spoons. Consequently the presumption that one ryang in Guizhi-tang is 15.6g is wrong. One ryang is assumed as 6.5g.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.28 no.3
• /
• pp.251-262
• /
• 2014

This article is for understanding dementia with the perspective of Korean Medicine through research on syndrome differentiations of dementia clinically applied and relations between modern diseases and Korean Medicine pattern types of dementia. clinical papers were searched in China Academic Journals(CAJ) of China National Knowledge Infrastructure(CNKI) from 2012 to 2013. Conclusions are as follows. First, dementia was expressed in many ways such as imbecility, stupidity, fatuity, idiocy, vacuity, etc and was related with amnesia, forgetfulness, speech not in the right order, depressive psychosis(quiet insanity), manic psychosis, depression syndrome. Second, prescriptions such as QiFuYin and ZuoGuiWan from JingYueQuanShu, XiXinTang and ZhiMiTang from BianZhengLu, TongQiaoHuoXueTang, XueFuZhuYuTang and BuYangHaiWuTang from YiLinGaiCuo, HaiShaoDan from YiFangJiJie, HuangLianJieDuTang from WaiTaiMiYao were suggested for dementia. Third, syndrome differentiation pattern types of dementia are kidney deficiency and marrow decrease, qi-blood depletion, liver-kidney depletion, spleen-kidney depletion, heart-spleen deficiency as deficiency patterns and effulgent heart-liver fire, ascendant hyperactivity of liver yang, qi stagnation and blood stasis, phlegm turbidity obstructing orifice, phlegm-blood stasis obstructing orifice, intense heat toxin as excess patterns and qi deficiency with blood stasis, yin deficiency with yang hyperactivity as deficiency-excess complex patterns. Major pattern types are kidney deficiency and marrow decrease, phlegm-blood stasis obstructing orifice, qi stagnation and blood stasis, liver-kidney depletion, phlegm turbidity obstructing orifice.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.28 no.2
• /
• pp.129-136
• /
• 2014

The "WuQinXi" exercise, one of the medical Qi-gongs, is an exercise maximizing human's self healing power and has been confirmed to be effective significantly at several modern researches. There are many exercise therapies in western medcine, such as Willams's flexion exercise, Mckenzie's extension exercise, vertebral stabilization exercise and so on. However, there isn't a special exercise therapy which can be applied for medical practice in oriental medicine. So we selected 24 motions which are related with lumbar movements from 3 type "WuQinXi" exercises ; 20 mode, 30 mode, and 40 mode. And then, we classified them according to lumbar movements as flexion, extention, lateral bending and rotation, and also functions as stabilization and rubbing. Next, with these classifications, we assorted them by kinds of lumbar spinal disease as HIVD(herniation of intervertebral disc), spinal stenosis, spondylolysis and spondylolisthesis, facet joint syndrome, compression fracture and spondylosis. We expect that "WuQinXi" exercise be a exercise therapy for lumbar spinal disease at an oriental medical clinic in this way. Oriental medical doctors will be able to teach easily patients "WuQinXi" exercise's motions at clinic, depending on kinds of lumbar spinal disease each patient suffers from. We plan to study the effect of "WuQinXi" exercise by comparing patients who do the "WuQinXi" exercise with the patients who do the western medical exercise therapy.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.31 no.4
• /
• pp.201-212
• /
• 2017

This study draws pattern differentiations of headache disorders on the ground of modern clinical applications and Korean medical literature. Categorization and symptoms of headache disorders are based on International Classification of Headache Disorders 3rd edition(beta version). And clinical papers are searched in China Academic Journals(CAJ) of China National Knowledge Infrastructure(CNKI). In the aspect of eight principle pattern identification, primary headache occurs due to lots of yang qi and has more inner pattern rather than exterior pattern, heat pattern rather than cold pattern, excess pattern rather than deficiency pattern. And primary headache is related with liver in the aspect of visceral pattern identification and blood stasis, wind and phlegm are relevant mechanisms. Migraine without aura is associated with ascendant hyperactivity of liver yang, phlegm turbidity, sunken spleen qi, wind-heat, blood deficiency or yin deficiency. Migraine with aura is mainly related with wind and it's major mechanisms are ascendant hyperactivity of liver yang, liver fire, yin deficiency of liver and kidney, blood deficiency or liver depression and qi stagnation. High repetition rate of tension-type headache can be identified as heat pattern or excess pattern. And trigeminal autonomic cephalalgias can also be accepted as heat pattern or excess pattern when the occurrence frequency is high and is relevant to combined pattern with excess pattern of external contraction and deficiency pattern of internal damage based on facial symptoms by external contraction and nervous and anxious status by liver deficiency. This study can be expected to be Korean medical basis of clinical practice guidelines on headache by proposing pattern identifications corresponding to the western classifications of headache disorders.

• The Journal of Internal Korean Medicine
• /
• v.10 no.1
• /
• pp.105-123
• /
• 1989

Yuk Gi (六氣) in oriental medicine have influence on the body and, the body which adapt itself to the change of Yuk Gi, can maintain the activity of life, so five vital organs of the body have relation to Yuk Gi. The relation between Lung and Jo (燥) is well described from Whang Jae Nai Kyung (黃帝內經), the oldest book in oriental medicine, to the old books of Chung (淸) dynasty and modern documents. By the way, when autumn has come and the environment become dry, clear and mild ability of lung is losed. It's because dryness evil (燥邪) occured the trouble of Lung. The following results were obtained according to these facts which is considreed peviodically and bibliographically. 1. According to flourishing the functional activities of dryness (燥氣), as reducing the functional activities of water (水氣) of upper portion of the body cavity (上焦), Kidny Water (腎水) is not nutrited and Fire-Heat (火熱) is activiting, which is evoking the disease of Lung. 2. In the disease of Lung, there are many diseases because of dryness evil (燥邪), thinking that, which methods of treatment are the principal one of 'Clear up the lung and moisten dryness (淸肺潤煥)'. I found that Lung and Jo (燥) have the relation of intimacy. 3. Creating the vital essence of the kidney (腎水) to the functional activities of the lung (肺氣) is in prosperous condition, the functional activities of fire (火氣) stabilize the function of Lung become normal condition which wear said in the literary.

• The Journal of Pediatrics of Korean Medicine
• /
• v.15 no.1
• /
• pp.229-234
• /
• 2001

This article summarizes the present developing conditions and achievements in pediatrics of traditional Chinese medicine (TCM) at basic medicine, clinical medicine and preventive medicine in recent fifty years. The author thinks that the strategy goal of the development of TCM pediatrics is modernization. In the future certain years, culturing persons of ability in all kinds of administrative levels and using modern science and techniques are very necessary. In the aspect of the background of TCM pediatrics, childrens physiology and pathology characteristic, pharmacodynamics, making the four diagnostic methods objective, combining macro differentiation with micro differentiation, reforming the preparation form should be intensively researched. In the aspect of clinic, in order to improve curative effect, accumulate materials, we should go deep into the research on virus diseases, immunity diseases, nutritional diseases and neonatal diseases by taking advantage of the superiority of TCM.