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.
This study performed to examine the genuineness of Kyung-Jong's poison hypothesis which was the one of the biggest topic in the history of Joseon Dynasty. Kyung-Jong's poison hypothesis is that Kyung-Jong who was the 20th king of the Joseon Dysansty was poisoned by the next king Young-Jo who became the 21st king. This theory was hyphosized by Sim-Yoohyun and was widely known in the 4th year of Young-jo through the revolt. Kyung-Jong suffered with severe diarrhea for 5 days which finally took his life away right after he had have marinated raw crab and persimmon. Some insist the poison must had been in those foods. However, the symptoms that Kyung-jong had were not matched with the poisons which used in those days and also poison was not the reasonable way of murder, so it is hard to say there is little possibility of poison. On the other hand, considering of Kyung-jong's health, marinated raw crab and persimmon could result of severe diarrhea. In the mean time, the possibility of Young-Jo's intention of killing Kyung-Jong is very low. Rather, he blame the royal doctors who scout the outside doctors, because he believed that it led Kyung-jong's death since the treatment was chaotic with all those different doctors. Even after the Kyung-Jong's death, Young-jo was always strict to scout the outside doctors and missed Kyung-jong consistently. On this basis, it is hard to say that king Kyung-Jong was murdered by poisoning.
Objectives: To research Korean oriental medical doctors' use of uninsured herbal extracts and how to bring about the insurance coverage of such herbal extracts. Methods: We surveyed Korean oriental doctors about the following issues from October 17th to November 15th, 2008: (1) Korean oriental medical doctors' knowledge about herbal extract insurance and the circumstances of oriental medicine in Korea, (2) their opinion on the coverage of currently uninsured herbal extracts and the dispensing of herbal extracts from pharmacies rather than from their clinics, (3) their use of herbal extracts, and (4) how to bring about insurance coverage of uninsured herbal extracts. Results: Over 70% of the respondents said that herbal medicine prescriptions have been reduced recently and that the existence of herbal medicine is in danger. In addition, 63.64% respondents agreed with expanding insurance coverage to include currently uninsured herbal extracts in spite of the fact that patients might have to obtain herbal extracts from pharmacies rather than from Korean oriental medical clinics. The average patient number per month of uninsured herbal extracts was 13.64 people, the average dosage was 5.64g, the average cost per day was 3,859 won, and the average prescription period was 2.65 days. Korean oriental medical doctors asked an average of 12,486 won for the medical examination-prescription fee and 3,292 won in fees for prescriptions obtained outside the hospital. If insurance coverage expands to include these herbal extracts, their usage is expected to increase 2.31 times. Conclusions: This study shows Korean oriental medical doctors' use of herbal extracts and their opinions about execution of herbal extracts' insurance. A periodic study such as this one will hopefully aid in establishing polices for uninsured herbal extracts' insurance.
Purpose: The purpose of current study was to explore the positive outcomes of advanced practice nurse who have experienced the roles in their clinical settings. Methods: This study adopted a qualitative research design based on conventional content analysis. Participants were 16 nurse practitioners have been worked at hospitals or community centers. Data were collected via focus group interviews and analyzed using thematic analysis method. Results: Patients' aspect outcomes were "client-centered care in providing continuity", "providing trust based on expertise", "promoting skilled intervention in patient recovering", "blocking the negative consequences", "quality improvement: nursing becoming tighter", "providing total care for cases that require intensive care", "improving patients outcomes by total management", "increasing confidence in evidence-based professional nursing", "rising the satisfaction by cost-effective services", "providing skilled professional practice", and "providing comprehensive care related to covering various aspects". Other themes elicited also included "promoting efficacy by inter-related health professions supervising", "the expansion of specialized practice areas increase business efficiency", "formation of outside customers due to increasing the satisfaction with skilled nursing care", "filling in the emptying spaces of doctors by practicing reliable role to bridge", "attracting external customers through successful management of subjects", "increasing staff's satisfaction on the role to make a bridge between inside and outside doctors", "24 hours medical expertise of professional staff ready secured", and "low cost, same results, that is, cost-effective" in reference to health care resources aspect. Conclusion: These findings suggested that advanced practice nurses perceived various positive outcomes and provided basic data for outcome indicators of advanced practice nurses' role.
In medicine, rapid changes in information, technology, socio-economic interests, and globalization affect the medical education focused on the competencies of doctors, and the number of medical schools that are adopting an outcome-based curriculum (OBC) is increasing worldwide. This paper introduces the OBC model of 5 trailblazing medical schools from the UK, US, and Australia, comparing their unique features, followed by brief comment about Canada and the EU as well. On developing an OBC, the process of establishing the top outcomes for graduates is similar and the outcomes comprise knowledge, skills, and attitudes about science, patients, colleagues, society, and themselves. Implementing the outcomes down into the sub-levels of the curriculum is much more complicated and time-consuming. Assessing the achievement of every outcome is essential and requires the use of many tools in addition to the traditional written examination. From the perspective of adult learning theory, self-directed learning, team-learning, and individual and flexible achievement are tested and executed in an OBC. The gradual expansion and further innovation of an OBC is expected so that tomorrow's doctors will be able to meet the challenges of the future.
KSII Transactions on Internet and Information Systems (TIIS)
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v.14
no.3
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pp.1104-1120
/
2020
The chest X-rays are a common way to diagnose lung cancer or pneumonia. In particular, the finding of a lung nodule is the most important problem in the early detection of lung cancer. Recently, a lot of automatic diagnosis algorithms have been studied to find the lung nodules missed by doctors. The algorithms are typically based on segmentation network like U-Net. However, the occurrence of false positives that similar to lung nodules present outside the lungs can severely degrade performance. In this study, we propose a multi-task learning method that simultaneously learns the lung region and nodule-labeled data based on the prior knowledge that lung nodules exist only in the lung. The proposed method significantly reduces false positives outside the lung and improves the recognition rate of lung nodules to 83.8 F1 score compared to 66.6 F1 score of single task learning with U-net model. The experimental results on the JSRT public dataset demonstrate the effectiveness of the proposed method compared with other baseline methods.
By studying the portions and layers(分部), left and right, superior and inferior, location of yin and yang, and beginning and end of diseases of skin, which is the core point of the theory of cutaneous region(皮部論) in "Naejing(內經)", in the physiological and pathological perspective, based on opinion of historic memorial doctors, arrived to the conclusion as below. Cutaneous region means not only the distribution of three yin and three yang(三陰三陽) of the surface, but also inside and outside, shallowness and depth, and it is the system which unites meridians, networks, and vessels. It is divided into portions and layers. The origin and beginning of diseases and the rule of favorable pattern and unfavorable pattern can be known through it. The portion of skin is not only the area that meridian vessels belongs to skin, but also the area that activation of twelve meridian vessels are expressed in the surface. The layer of skin is consisted in order of skin-tertiary collateral vessel-collateral vessel-meridian vessel-bone. In "Naejing", there are two preconditions to divide three yin and three yang into yin and yang. The first is standing while looking the south, and second is the quotation "outside is side of yang(外者爲陽 內者爲陰)." According to this preconditions, yang of outside of yang brightness, lesser yang, and greater yang is the whole body, except inside of hand and foot which yin of lesser yin, pericardium, and greater yin. Superior and inferior of the portions and the layers is designated as hand and foot, theological basis of which superior and inferior work in same diagnostic method can be found in the root and the basis(標本) and the origin and the insertion(根結). In conclusion, cutaneous region not only manages layer of the skin, but also it is divided into layers and portions, so it has close relations between meridian vessels and collateral vessels. The in-depth study of cutaneous region and meridians should be progress, in order to practice of diagnosis and acupuncture and moxibustion more.
Times are changing in Italian healthcare and Traditional and Non Conventional Medicine has become increasingly relevant to medical practice. With this comes an increasing need for guidelines. As the use of Traditional and Non Conventional Medicine has increased in Italy, so has the need for high standards in education in this field (outside of biomedicine and the dominant health system) among medical students, medical doctors and medical educators. The rise of Traditional and Non Conventional Medicine is so relevant for medical practice and health care in Italy; the time calls for a change. The article describes this new setting in regards to education in Acupuncture within the field of Traditional Chinese Medicine in Italy's oldest private school.
Journal of Physiology & Pathology in Korean Medicine
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v.22
no.1
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pp.60-81
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2008
This thesis is written about the causes, the processes and the treatments of edema. It consists of 31 chapters. Covering 11 chapters, there are prescriptions and constructions. When one of the organs fails to work metabolizing water, you can have edema. It is the result of the accumulation of excess fluid under the skin. Edema most commonly occurs in the head facial, the palpebral portion, the feet and legs or all the body. Sometimes it is accompanied with ascites. There are three classifications in the thesis. First, according to the cause and the symptom of disease, it is divided into 5 types. Type 1. The swelling caused by the disorder of the lungs from the troubling wind. Type 2. The swelling caused by the weak spleen. Type 3. The swelling caused by abnormal condition between the kidneys and the lungs. Type 4. The swelling in abdomen caused by the weak kidneys. Type 5. The swelling (Yellow sweat) caused by the heat inside body as water outside. Second, the swelling and the abnormal symptom of five viscera. Third, the swelling accompanied with menstruation in female and with chilliness. In short, the original textbook is showed that the treatment of edema focuses on the cause and the region of fluid accumulation. When the swelling is in the upper body or the cause of diseaseis outside, the useless humidity can be expelled through sweating. On the other hand, when the swelling is in the lower body or the cause of disease is inside, it is pushed out by urination. In this book, the author presents further treatments. And these treatments are often cited by doctors after ages. Even one of them suggested that the swelling be divided by cosmic dual forces. In spite of many researches, it is too complicate for us to understand the writer’s intend. For that reason, comparing with other medical books and referring to guides explained by doctors, I have studied the textbook to help understand.
Kang, Min-Seo;Kim, Min-Hee;Jang, Bo-Hyoung;Choi, In Hwa
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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v.31
no.2
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pp.24-39
/
2018
Objectives : The purpose of this survey is to examine Korean medical doctor's prescription status of Jaungo. Methods : The questionnaire was distributed via e-mail to Korean medical doctors who were registered in the association of Korean medicine from December 26th 2017 to February 5th 2018. We screened out respondents who didn't meet screening criteria. Results : Total 325 respondents completed answers, and the computerized data were analyzed. 74.7% of respondents were provided Jaungo from outside (extramural herbal dispensaries, pharmaceutical company). Almost all of the respondents (98.2%) were prescribing Jaungo in the form of ointment, and the cream container was the most commonly used container. In chief Indications of Jaungo were skin dryness (83.1%), pruritus (67.7%), burns (64.0%), and atopic dermatitis (60.9%). More than 60% of the respondents were prescribing Jaungo without additional herbs or additives. Most of patients were educated to apply Jaungo thinly to the affected area once or twice a day or frequently. Reason for dissatisfaction about Jaungo of patient were due to staining clothes (59.1%), offensive smell (44.0%), and poor texture (26.5%). Conclusions : Jaungo is a topical herbal agent frequently used in the Korean medicine. This is the first survey figure out current status of topical herbal agent in Korean medical doctors. The result of this study would contribute to progressing treatment method using topical herbal agent.
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