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Ethnography of Caring Experience for the Senile Dementia (노인성 치매 환자의 돌봄경험에 대한 문화기술지)

  • 김귀분;이경희
    • Journal of Korean Academy of Nursing
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    • v.28 no.4
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    • pp.1047-1059
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    • 1998
  • Senile Dementia is one of the dispositional mental disorder which has been known to the world since Hippocratic age. It has become a wide-spread social problem all over the world because of chronic disease processes and the demands of dependent care for several years as well as improbability of treatment of it at the causal level. Essentially, life styles of the older generation differ from those of the younger generation. While the fomer is used to the patriarchal system and the spirit of filial piet and respect, the latter is pragmatized and individualized under the effects of the Western material civilization. These differences between the two generations cause conflict between family members. In particular, the pain and conflict of care-givers who take care of a totally dependent dementia patient not only is inciting to the collapse of the family union, but is expanding into a serious social problem. According to this practical difficulty, this study has tried to compare dementia care-givers' experiences inter-culturally and to help set up more proper nursing interventions, describing and explaining them through ethnographies by participant observation and in-depth interviews that enable seeing them in a more close, honest and certain way. It also tries to provide a theoetical model of nusing care for dementia patients which is proper to Korean culture. This study is composed of 12 participants (4 males, 8 females) whose ages range from 37-71 years. The relations of patients are 5 spouses(3 husbands, 2 wives), 4 daughters-in-law, 2 daughters, and 1 son-in-law. The following are the care-givers' meaning of experiences that results of the study shows. The first is "psychological conflict". It contains the minds of getting angry, reproaching, being driven to dispair, blaming oneself, giving up lives, and being afraid, hopeless, and resigned. The second is "physical, social and psychological pressure" . At this stage, care-givers are shown to be under stress of both body and soul for the lack of freedom and tiredness. They also feel constraint because they hardly cope with the care and live through others' eyes. The third is "isolation". It makes the relationship of patient care-giver to be estranged, without understanding each other. They, also, experience indifference such as being upset and left alone. The forth is "acceptance" They gradually have compassion, bear up and then adapt themselves to the circumstances they are in. The fifth is "love". Now they learn to reward the other with love. It is also shown that this stage contains the process of winning others' recognition. The final is "hope". In this stage they really want situations to go smoothly and hope everything will be O.K. These consequences enable us to summarize the principles of cue experience such as, in the early stage, negative response such as physical·psychological confusion, pain and conflict are primary. Then the stage of acceptance emerges. It is an initial positive response phase when care-givers may admit their situations. As time passes by a positive response stage emerges. At last they have love and hope. Three stages we noted above : however, there are never consistent situations. Rather it gradually comes into the stage of acceptance, repeating continuous conflict, pressure and isolation. If any interest and understanding of families or the support of surrounding society lack, it will again be converted to negative responses sooner or later. Otherwise, positive responses like hope and love can be encouraged if the family and the surroundings give active aids and understanding. After all, the principles of dementia care experiences neither stay at any stage, nor develop from negative stages to positive stages steadily. They are cycling systems in which negative responses and positive responses are constantly being converted. I would like to suggest the following based on the above conclusions : First, the systematic and planned education of dementia should be performed in order to enhance public relations. Second, a special medical treatment center which deals with dementia, under government's charge, should be managed. Third, the various studies approaching dementia care experiences result in the development of more reasonable and useful nursing guidelines.

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Behaviors of the High-profile Arch Soil-steel Structure During Construction (높은 아치형 지중강판 구조물의 시공 중 거동 분석)

  • 이종구;조성민;김경석;김명모
    • Journal of the Korean Geotechnical Society
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    • v.19 no.6
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    • pp.71-84
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    • 2003
  • The metallic shell of soil-steel structures are so weak in bending moment that it should sustain the applied load by the interaction of the backfill soil around the structures. The shell can be subjected to excessive bending moment during side backfilling or under live-load when the soil cover is less than the minimum value. The current design code specifies the allowable deformation and Duncan(1979) and McGrath et al.(2001) suggested the strength analysis methods to limit the moments by the plastic capacity of the shell. However, the allowable deformation is an empirically determined value and the strength analysis methods are based on the results of FE analysis, hence the experimental verification is necessary. In this study, the full-scale tests were conducted on the high-profile arch to investigate its behaviors during backfilling and under static live-loads. Based on the measurements, the allowable deformation of the tested structure could be estimated to be 1.45% of rise, which is smaller than the specified allowable deformation. The comparison between the measurements and the results of two strength analyses indicate that Duncan underestimates the earth-load moment and overestimates the live-load moment, while McGrath et al. predicts both values close to the actual values. However, as the predicted factors of safeties using two methods coincide with the actual factor of safety, it can be concluded that both methods can predict the structural stability under live-loads adequately when the cover is less than the minimum.

Current Status and Future Perspective of PET (PET 이용 현황 및 전망)

  • Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.1
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    • pp.1-7
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    • 2002
  • Positron Emission Tomography (PET) is a nuclear medicine imaging modality that consists of systemic administration to a subject of a radiopharmaceutical labeled with a positron-emitting radionuclide. Following administration, its distribution in the organ or structure under study can be assessed as a function of time and space by (1) defecting the annihilation radiation resulting from the interaction of the positrons with matter, and (2) reconstructing the distribution of the radioactivity from a series of that used in computed tomography (CT). The nuclides most generally exhibit chemical properties that render them particularly desirable in physiological studies. The radionuclides most widely used in PET are F-18, C-11, O-15 and N-13. Regarding to the number of the current PET Centers worldwide (based on ICP data), more than 300 PET Centers were in operation in 2000. The use of PET technology grew rapidly compared to that in 1992 and 1996, particularly in the USA, which demonstrates a three-fold rise in PET installations. In 2001, 194 PET Centers were operating in the USA. In 1994, two clinical and research-oriented PET Centers at Seoul National University Hospital and Samsung Medical Center, was established as the first dedicated PET and Cyclotron machines in Korea, followed by two more PET facilities at the Korea Cancer Center Hospital, Ajou Medical Center, Yonsei University Medical Center, National Cancer Center and established their PET Center. Catholic Medical School and Pusan National University Hospital have finalized a plan to install PET machine in 2002, which results in total of nine PET Centers in Korea. Considering annual trends of PET application in four major PET centers in Korea in Asan Medical Center recent six years (from 1995 to 2000), a total of 11,564 patients have been studied every year and the number of PET studies has shown steep growth year upon year. We had 1,020 PET patients in 1995. This number increased to 1,196, 1,756, 2,379, 3,015 and 4,414 in 1996,1997,1998,1999 and 2000, respectively. The application in cardiac disorders is minimal, and among various neuropsychiatric diseases, patients with epilepsy or dementia can benefit from PET studios. Recently, we investigated brain mapping and neuroreceptor works. PET is not a key application for evaluation of the cardiac patients in Korea because of the relatively low incidence of cardiac disease and less costly procedures such as SPECT can now be performed. The changes in the application of PET studios indicate that, initially, brain PET occupied almost 60% in 1995, followed by a gradual decrease in brain application. However, overall PET use in the diagnosis and management of patients with cancer was up to 63% in 2000. The current medicare coverage policy in the USA is very important because reimbursement policy is critical for the promotion of PET. In May 1995, the Health Care Financing Administration (HCFA) began covering the PET perfusion study using Rubidium-82, evaluation of a solitary pulmonary nodule and pathologically proven non-small cell lung cancer. As of July 1999, Medicare's coverage policy expanded to include additional indications: evaluation of recurrent colorectal cancer with a rising CEA level, staging of lymphoma and detection of recurrent or metastatic melanoma. In December of 2001, National Coverage decided to expand Medicare reimbursement for broad use in 6 cancers: lung, colorecctal, lymphoma, melanoma, head and neck, and esophageal cancers; for determining revascularization in heart diseases; and for identifying epilepsy patients. In addition, PET coverage is expected to further expand to diseases affecting women, such as breast, ovarian, uterine and vaginal cancers as well as diseases like prostate cancer and Alzheimer's disease.

Effects of Cyanobacterial Bloom on Zooplankton Community Dynamics in Several Eutrophic Lakes (부영양호수에서 남조류 bloom이 동물플랑크톤 군집변화에 미치는 영향)

  • Kim, Bom-Chul;Choi, Eun-Mi;Hwang, Soon-Jin;Kim, Ho-Sub
    • Korean Journal of Ecology and Environment
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    • v.33 no.4 s.92
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    • pp.366-373
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    • 2000
  • Toxin production and low digestibility of cyanobacteria are known to cause low exploitability of cyanobacteria by zooplankton. In this study, we compared relative tolerance and compatibility of zooplankton taxa in eight eutrophic lakes, exposed to frequent cyanobacterial blooms, uring the summer season of 1999. Microcystis, Anabaena, Oscillatoria and Phormidium were common cyanobacteria in all lakes. with relatively lower $NO_3-N$ concentration (<0.2 mgN/l) and TN/TP ratio (<20), compared with other lakes where colonial cyanobacteria dominated. Rotifers were dominant zooplankton in most lakes, and among them, Keratella, Polyarthra and Hexathra were common. The laboratory feeding experiment showed that relative copepods that greatly decreased (90%) after 4 day when cyanobacteria were used as the food source of zooplankton, while rotifers gradually increased with the change of dominant taxa from Keratella through Pompholyx to Monostyla. These results suggest that rotifers may be capable of coexisting with cyanobacteria by exploiting them for the food source.

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Study on Exfoliation and Recovery of Anesthetized Yound Abalones, Haliotis discus hannai Treated with Ethy-p-aminobenzoate and Freshwater in Different Temperatures of Sea water (온도구간별 파라아미노안식향산에틸과 담수에 의한 양식산 참전복 (Haliotis discus hannai) 치패의 박리 및 마취회복에 관한 연구)

  • 최상덕;정성채;김호진;공용근;백재민;최규정
    • Journal of Aquaculture
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    • v.10 no.3
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    • pp.281-288
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    • 1997
  • We investigated the optimal concentratin of ethyl-p-aminobenzoate for the exfoliation and recovery of young abalone, Haliotis discus hannai in according to different water temperatures, for the purpose of preventing the damage of shell and muscle to ecfoliated from shelter. In the 14$^{\circ}C$ water temperature, young abalones were exfoliated after 16, 35, 35 and 35 minutes in 150, 100, 75 and 50ppm concentration of ethyl-p-aminobenzoate, and were recovered after 100, 60, 30 and 30 minutes, respectively. Exfoliation rate of abalone were 100% except for 50 ppm (80%) and recovery rate were 100% of all concentration. In the $18^{\circ}C$ water temperature, young abalones were exfoliated after 4, 4, 6, 8, 8 and 12 munutes in 300, 200, 150, 100, 75 and 50ppm concentration of ethyl-p-aminobenzoate, and were recovered after 210, 180, 90, 60, 30, 20 and 20 minutes, respectively. Exfoliation rate of abalone were 100%, and recovery rate were 100% except for 200 and 300ppm (90%). In the $24^{\circ}C$ water temperature, young abalones were exfoliated after 8, 10, 10 and 12 minutes in 150, 100, 75 and 50ppm concentration of ethyl-p-aminobenzoate, and were recovered after 70, 50, 30 and 20 minutes, respectively. Exfoliation and recovery rate of abalone were 100%. In the 18$^{\circ}C$water temperature, exfoliation rate that treated with freshwater during 20 minute were 80, 50, 30 and 5% in 100, 75, 50 and 25% of fresh water, and recovery after 60, 15, 10 and 2 minutes, respectively and recovery arate were 100% except of r 100% freshwater. In this study, we suggest the reslults that the exfoliation and recovery by ethly-p-aminobenzoate were more effected in $18^{\circ}C\;and\;24^{\circ}C$ of sea water temperature than those of $14^{\circ}C$. The optimal concentration of ethyl-p-aminobenzoate was 50ppm at those water temperature. We raised 20 individual of young abalones at water temperature of $16^{\circ}C$ in the 1$\ell$ o ftnk and checked the variatin of dissolved oxygen (DO) by respiration of abalones that treated with 75ppm of ethyl-p-aminobenzoate. Before anesthetizion, DO were 6.17~6.20mg/$\ell$ and slowly decreased. But after 60 minutes, DO decreasing were stopped in 5.42~5.46mg/$\ell$. On the other hand, the control was continuously decreased and 5.27mg/$\ell$ after 60 minutes. The heartbeats of abalones were 33~45/minute in the water temperature of $18^{\circ}C$, but that treated with 100 ppm concentration of ethyl-p-aminobenzoate during 60 minutes, was 0/minute. And heartbeats of recovered abalones from anesthetizion were 29~43/minute.

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Analysis on Efficiency of Hierarchical Structure for a Grid Transit Network (격자형 대중교통 노선망의 위계구조 효율성 분석)

  • Park, Jun-Sik;Go, Seung-Yeong;Jeon, Gyeong-Su
    • Journal of Korean Society of Transportation
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    • v.25 no.4
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    • pp.123-133
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    • 2007
  • This study analyzed whether a transit network with hierarchy is efficient or not, and if transit network hierarchy has cost efficiency, then which condition guarantees the efficiency of the transit network hierarchy. The authors modeled the total cost of the transit network and suggested the conditions in which the transit network hierarchy has cost efficiency through comparing the cost of the transit network with and without hierarchy. The efficiency of transit network hierarchy is guaranteed when the travel cost savings induced by using a higher hierarchy transit network is larger than the increasing non-travel cost, which is the sum of access cost, waiting cost, and operating cost, induced by the introduction of a higher hierarchy transit network. This result is consistent with common sense and with the concept of cost and benefit analysis. If a passenger traveling within the area divided by a higher hierarchy transit network uses only a lower hierarchy transit network and the passenger traveling out of the area divided by the higher hierarchy transit network uses both lower and higher hierarchy transit networks, the travel demand using the higher hierarchy transit network is inversely proportional to the square of the line spacing. This means that the transit network becomes more efficient and small increases of travel demand guarantee the efficiency of the transit network hierarchy as the connectivity of the network becomes higher. This result shows that transit networks have economies of aggregation. This study is the first analytical research on transit network hierarchy and is expected to be a basis for numerical research. However, numerical research should complement this study, since analytical research has some limitations for considering a real network.

Analysis of Price competitiveness of Asian Hub Airports (아시아권 허브 공항의 가격 경쟁력 분석)

  • Yeo, Hyeong-Gu;Gang, Gyeong-U;Jang, Hye-Jin
    • Journal of Korean Society of Transportation
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    • v.25 no.5
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    • pp.125-133
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    • 2007
  • Through open-sky policy, USA and European selected market principle of multiuser. However, in Asian case, major airlines monopolize airports. It is purpose that analyzes fare competition of Asian Hub Airport and the position of Incheon airport in Asia. Passengers required longer time and distance to go to the destination because direct flights decreases. But passengers increased in airport every year. Because of routes that decrease, airlines provide more services of flights. So airlines prefer to Hub Airports. As a result, both passengers and airlines are profitable by various routs and the increased frequency. On the assumption that distance and fare are related, the final formula is as following that defined the air fare from hub(H) to destination(Z) by logarithm. Analysis showed that log Rdist is not 1 but 0.08. As distance increases, fare doesn't increase. If distance from hub to destination airports is longer, Log dist_HZ is negative. It is that fare decreases from origin to destination via hub or that fare increases from hub to destination. HHI_HZ and HHI_AZ are negative. It means that if the degree of monopolization of hub and origin airports is lager, fare decreases from origin to destination via hub. Or fare increases from hub to destination. And it compares the Incheon airport with the other Asian hub airports and it examines the competitive fare by market division. As compared with the Incheon airport, Singapore, Beijing and Narita airports are higher fares. They compete with the other ones by Asian hub airports. But Hong Kong and Taipei airports must have more passengers through fare competition yet.

The Influences of Obstructive Apneas on Changes of Cardiovascular Function in Anesthetized Dogs with $\alpha$-chloralose ($\alpha$-chloralose로 마취한 개에서 폐쇄성 무호흡이 심혈관계 기능변화에 미치는 영향)

  • Jang, Jae-Soon;Kang, Ji-Ho;Lee, Sang-Haak;Choi, Young-Mee;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Song, Jeong-Sup;Park, Sung-Hak;Moon, Hwa-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.3
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    • pp.347-356
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    • 2000
  • Background : Patients with obstructive sleep apnea syndrome are known to have high long-term mortality compared to healthy subjects because of their cardiovascular dysfunction. The observation of hemodynamic changes by obstructive apneas is helpful when attempting to understand the pathophysiological mechanism of the development of cardiovascular dysfunction in those patients. Therefore, we studied the changes in cardiovascular function with an animal model and tried to obtain the basic data for an ideal experimental model (this phrase is unclear), a requirement for a more advanced study. Methods : Sixteen anesthetized dogs with ${\alpha}$-chloralose delete were divided into two groups : 8 dogs of room air breathing group and 8 dogs of oxygen breathing group. We measured $PaO_2$, $PaCO_2$, heart rate, cardiac output, mean femoral artery pressure, and mean pulmonary artery pressure at specified times during the apnea-breathing cycle before endotracheal tube occlusion (baseline), 25 seconds after endotracheal tube occlusion (apneic period), 10 seconds (early phase of postapneic period, EPA) and 25 seconds (late phase of postapneic period, LPA) after spontaneous breathing. Results : In room air breathing group, the heart rate significantly decreased during the apneic period compared to that at baseline (P<0.01) and increased at EPA and LPA compared to that during the apneic period (P<0.01). But, the heart rate showed no significant changes during apneic and postapneic periods in the oxygen breathing group. Cardiac output tended to decrease during apneic period compared to that at baseline, but was statistically significant. Cardiac output significantly decreased at LP A compared to at baseline (P<0.01). Mean femoral artery pressure was significantly decreased at during apneic period compared to that at baseline (P<0.05). Conclusion : Through this experiment, we were partially able to understand the changes of cardiovascular function indirectly, but delete new experimental animal model displaying physiological mechanism close to natural sleep should be established, and the advanced study in the changes of cardiovascular function and their causes should be continued.

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Clinical and Radiographic Characteristics of 12 Patients with Mycobacterium abscessus Pulmonary Disease (Mycobacterium abscessus 폐질환 환자 12명의 임상적, 방사선학적 특징)

  • Koh, Won-Jung;Kwon, O Jung;Kang, Eun Hae;Jeon, Ik Soo;Pyun, Yu Jang;Ham, Hyoung Suk;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Han, Daehee;Kim, Tae Sung;Lee, Kyung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.1
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    • pp.45-56
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    • 2003
  • Background : Mycobacterium abscessus is the most common respiratory pathogen in rapidly growing mycobacteria and is resistant to all of the first-line antituberculosis drugs. This report describes the clinical and radiographic characteristics in patients with pulmonary disease caused by M. abscessus. Materials and Methods : Twelve patients with pulmonary disease caused by M. abscessus who fulfilled the 1997 American Thoracic Society diagnostic criteria for a nontuberculous mycobacterial pulmonary infection were observed over a five-and-a-half year period. The clinical characteristics and chest radiographic findings were analyzed, retrospectively. Results : The patients were predominantly female(11/12, 92%) and nonsmokers(12/12, 100%). Coughing (10/12, 83%), sputum(10/12, 83%) and hemoptysis(10/12, 83%) were the common symptoms and they had prolonged periods from the onset of symptoms to the diagnosis of their disease(median 6.5 years). Eleven (92%) patients had a previous history of being treated for pulmonary tuberculosis. The sputum specimens were acid-fast bacilli smear-positive in all patients. All patients were administered antituberculosis drugs. Six (50%) patients were treated with second-line antituberculosis drugs on account of persistent smear-positive sputum specimens. The chest radiographs showed that reticulonodular opacities(11/12, 92%) were the most common pattern of abnormality, followed by cavitary lesions(5/12, 42%). The computed tomography findings suggested bronchiolitis from the centrilobular nodules with a tree-in-bud appearances(9/10, 90%) and bronchiectasis (9/10, 90%) were the most common, followed by well-defined nodules smaller than 10-mm in diameter(7/10, 70%). Conclusions : M. abscessus pulmonary disease should be recognized as a cause of chronic mycobacterial lung disease, and respiratory isolates should be assessed carefully.

The essay of Bijeung by chinese doctors in 20th century - Study of - (20세기(世紀) 중의사(中醫師)들의 비증(痺證)에 대(對)한 논술(論述) 연구(硏究) - 《비증전집(痺證專輯)》 에 대(對)한 연구(硏究) I -)

  • Kim, Myung Wook;Oh, Min Suk
    • Journal of Haehwa Medicine
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    • v.9 no.1
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    • pp.547-594
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    • 2000
  • I. Introduction The essence of Oriental medicine consists of ancient books, experienced doctors and succeeded skills of common society. Many famous doctors studied medical science by their fathers or teachers. So the history of medical science is long. $\ll$DangDaeMyeongIImJeungJeongHwa(當代名醫臨證精華)$\gg$ written by SaWoogWang(史宇廣) and DanSeoGeon(單書健) has many medical experience of famous doctors. So it has important historical value. Bi(痺) means blocking. BiJeung is one kind of symptoms making muscles, bones and jonts feel pain, numbness or edema. For example it can be gout or SLE etc. So I studied ${\ll}BiJeungJuJip{\gg}$. II. Final Decision Following decisions of Chinese doctors of 20th century are as follows ; 1. JuYangChun(朱良春) emphasized on IkSinJangDok(益腎壯督) to treat BiJeong. And he devided WanBi(頑痺) as PungHanSeup(風寒濕), DamEo(痰瘀), YeolDok(熱毒), SinHeo(腎虛). He used insects for medicine. 2. ChoSuDoek(焦樹德) introduced past prescription. He used ChiBiTang(治痺湯) to treat HaengBi(行痺), TongBi(痛痺), ChakBi(着痺). He insisted that Han(寒; coldness) and Seup(濕; dampness) be Eum(陰) and Pung(風; wind) can change his character to be Eum. After all BiJeung is usually EumJeung. So he used GaeJi(桂枝) and BuJa(附子). By the way he used ChungYeolSanBiTang(淸熱散痺湯) for YeolBi, BoSinGeoHanChiWangTang SaBok(王士福) emphasized on the importance of medicine. He introduced many treatments like CheongYeol(情熱) for YeolBi and YiO(二烏) for HanBi. And he divided BiJeung period for three steps. At 1st step, we must use GeoSa(祛邪), at 2nd step, we must use BuJeong(扶正) and at 3rd step, we must use BoHyeol(補血), he insisted. And he introduced many herbs to treat BiJeung. 4. JeongGwangJeok(丁光迪) said that GaeJi(桂枝), MaHwang(麻黃), OYak(烏蘖) and BuJa(附子) are very important for TongRak(通絡). And pain usually results from Han(寒), so he liked to use hot-character herbs. 5. MaGi(馬志) insisted that BiJeung usually result from ChilJeong(七情). And he liked to use insects for treatment of BiJeung. 6. WeolSeokMu(越錫武) introduced 8 kinds of treatments and divided BiJeung period. Also he divided BeJeung for PungBi(風痺), HanBi(寒痺) and SeupBi(濕痺). 7. SeoGeaHam(徐季含) observed many patients and concluded that 86.7% of BiJeung is HeuJeung(虛症). 8. YuJiMyeong(劉志明) said that YeolBi is important and CheongYeol is also important. So he emphasized on DangGyuiJeomTongTang(當歸拈痛湯) and SeonBiTang(宣痺湯). 9. WangLiChu(汪履秋) studied cause of WanBi. Internal cause is GiHyeolHeo(氣血虛) and GanSinHeo(肝腎虛) and external cause is SaGi(邪氣) he insisted. 10. WangSaSang(王士相) said that YeolBi can be SeupYeolBi or EumHeuYeolBi(陰虛熱痺) and HanSeupBi(寒濕痺) is rare. He use WooBangJaSan(牛蒡子散) and BangPungHwan(防風丸) for SeupYeolBi, DangGyuiSaYeokTang(當歸四逆湯) for HanSeupBi. 11. JinTaekGang(陳澤江) treated YeolBi with BaekHoGaGyeJiTang(自虎加桂枝湯) and SaMyoSan(四妙散). If they don't have effect, he tried to cure BiJeung step by step. And he used e term of GeunBi(筋痺) and BangGiMogwaEIInTang(防己木瓜薏苡仁湯) was good for GeunBi. 12. MaSeoJeong(麻瑞亭) said that PungSeupYeokJeul(風濕歷節) is BiJeung and it is related to GanBinSin(肝脾腎; liver, Spleen, Kindey). And he emphasized on balance WiGi(衛氣) and YoungHeul(營血). 13. SaJeJu(史濟桂) said that GeunGolBi(筋骨痺) is similar to arthritis and sometimes called ChakBi. And SinBi(腎痺) is terminal stage of ChakBi, he said. He also used insects for treatment. 14. JeongJeNam(丁濟南) tried to cure SLE and used GyeJi, CheonCho(川椒), SinGeunCho(伸筋草), SunRyeongBi(仙靈脾), HyconSam(玄蔘) and GamCho(甘草). 15. JinGYungHwa(陳景和) emphasized on diagnosis of tongue. If the color of tongue is blue, it usually has EoHyeol(瘀血), for example. And he also used insects. 16. JuSongI(朱松毅) tried to devide YeolBi with OnByeong(溫病), Wi(衛), Gi(氣) and Hyeol(血). 17. RuDaBong(蔞多峰) said that JyeongHeo(正虛), OiSa(外邪) and EoHyeol are closely related. And he explained BiJeung by deviding the body into the part, for example head, neck, shoulder, waist, upper limb and lower limb. 18. YuMuBo(劉茂甫) defined PungHanSyubBi as chronic stage and YeolBi as acute stage.

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