조선통신사 사행원과 기록 연구

함정식(Ham Jeong Sik),차웅석(Cha Wung Seok),유원준(Yoo Won Joon),김남일(Kim Nam Il) 한국의사학회 2007 한국의사학회지 Vol.20 No.1

In 1607 a delegation was dispatched from Chosun to Japan (under the condition that prisoners of war were returned) to restore the destroyed relationship between the nations due to a war and to restore economic profits. This delegation later on became a delegation representing faith in each other. It contributed greatly to the Korea-Japan cultural exchanges in the 17th and 18th centuries. It was also a cornerstone for the exchange of Korea’s distinguished studies as well as medical technology and Japan’s results of international trade such as sweet potatoes, pepper, and tobacco. This thesis is one that discusses the study of documents produced during this process.

무진사행 의학문답 및 치험 사례 기록 연구

咸晸植(Ham Jeong Sik),車雄碩 동양한문학회(구 부산한문학회) 2010 동양한문학연구 Vol.30 No.-

지금까지 한국의학사의 많은 부분이 중국과의 관계 속에서 언급되어 왔다. 상대적으로 간과되었던 일본과의 관련 속에서도 균형 있는 시각으로 한국의학사를 새롭게 조명해야 할 시점이다. 자료가 많지는 않지만 江戶時代 조선통신사 교류에 직․간접적으로 참여한 의가들의 관련 기록은 귀중한 의학사적 산물이다. 그 가운데 조선통신사 무진사행(1748년)은 의사학적으로 이전 사행과 다른 몇 가지 특색을 지니고 있다. 무진사행이 이루어진 18세기 중반이 되면 일본의학은 조선의학과 사뭇 다른 길을 걷는다. 이러한 일본의 의학적 경향의 변화는 18세기 초반 조선통신사 신묘사행(1711년)과 기해사행(1719년) 때의 의학문답 기록을 살펴보면 어느 정도 예견된 결과였다. 하지만 18세기 중반에 이르면 이전과 상황이 달라진다. 18세기 초반 조선의학을 전수 받고자하던 일본의 열정이 시간이 경과하면서 서서히 식어갔다. 儒學界에서 일어난 변화와 비슷하게 醫學界에서도 소위 ‘古方醫學’이라는 思潮가 일어나 金元四大家로 대표되는 기존 ‘後世方醫學’을 대체하게 되었다. 宋儒로 일컬어지던 성리학이 伊藤仁齋가 古學을 주창하던 무렵에 이르러 그 세력이 약화된 것처럼 의학방면 역시 변화가 일어났다. 일본은 後世方醫學의 색채가 짙은 조선의학을 전수받으려는 노력 보다 오히려 古學과 성격이 비슷한 古方醫學을 발전시켜 나갔다. 여기에 더하여 네덜란드 의학을 받아들이는 등 일본의학은 그들 특유의 의학으로 변화되어 갔다는 것이 기존 의학사 연구자들의 주장이다 본 연구에서 무진사행 때의 의학문답 기록에 투영된 조선과 일본의가들의 의학적 경향과 주된 관심사를 살펴보았다. 무진사행 당시 일본의학이 이전 시대와 어떠한 면에서 차이점 내지 공통점을 가지는지 의학문답 기록을 통해 고찰하였다. 18세기 조선과 일본의 의학적 경향에 대한 종전의 연구와 일본의학사 관련내용들을 참고하면서 무진사행 때의 의학문답 기록 가운데 의학적 개성이 뚜렷이 드러난다고 판단한 󰡔대려필어󰡕, 󰡔한객치험󰡕, 󰡔상한의문답󰡕의 일부 내용을 연구하였다. ‘18세기’ 혹은 ‘18세기 중반’의 일본의학은 ‘고방의학이 성행하였다’거나 ‘성행하기 시작하였다’는 것이 대체로 정설로 받아들여지고 있다. 이러한 점들을 염두에 두고 무진사행 때에 의학문답 기록에 보이는 양국의가들의 의학적 경향을 살펴본 바, 『대려필어』의 경우 앞서 언급한 정설을 적용하기에 무리가 없었지만, 『한객치험』과 『상한의문답』은 이러한 정설을 그대로 반영하기 어려운 기록이었다. 다만, 세 건의 기록에 한정된 연구였기에 아직까지 이를 무진사행 의학문답 기록의 일반적인 성격이라고 확대 해석하는 것은 곤란하다. Until now, The majority of Korea medical history has been referred to relationship between Korea and China. Relatively, a medical history between Korea and Japan has been overlooked. Now that, we must focus on Korea medical history connected with Japan medical history with the sense of balance and new angle. There are few data on related to medical exchange in Joseon Tongsinsa(朝鮮通信使), but records by doctors of a direct or indirect joined in a medical exchange between Korea and Japan are valuable historic documents. Especially, Mu-jin(戊辰) envoys have distinctive feature different from a former envoys. Up to the mid 18th century, when Mu-jin(戊辰) envoys took place, Japan medicine was going the other way compared to Korea medicine. If we examined medical conversation records in SinMyo(辛卯) envoys and GiHae(己亥) envoys, in the early 18th century, the change of Japan medical trend would be predicted up to a certain point. But, in the mid 18th century, there were different from an early situation. A enthusiasm of Japan for accepting the Korea medical had cooled down in length of time. Similarily to Confucianism, it was occurred an ideology of Go-bang(古方) medicine in Japan medical field. The ideology of Japan medicine had changed a Hu-se-bang(後世方) medicine represented by Gum-won-sa-dae-ga(金元四大家) to Go-bang(古方) medicine. As if Sung Confucianism represented by Song-yu(宋儒) was weaken by I-dung-in-jae(伊藤仁齋)'s Go-hak(古學), medical part was also changed. Japan developed Go-bang(古方) medicine Similar to Go-hak(古學) instead of receiving Korea medical. In addition, the researchers who had studied medical history insisted that Japan accepted Dutch medicine and changed unique medicine of Japan. In this studies, we examined a medical trend and matter of concern of Korea and Japan doctors reflective on medical conversation records which were born in Mu-jin(戊辰) envoys. We inquired a point of sameness or difference of Japan medicine in Mu-jin(戊辰) envoys compared to former envoys through medical conversation records. We consulted early studies and a document relevant to Korea and Japan medical trend in the 18th century, and then studied Dae-Ryeo-Pil-yeo(對麗筆語), Han-gaek-chi-heom(韓客治驗), Sang-han-ui-mun-dab(桑韓醫問答) which are judged to have medical speciality. A theory which Go-bang(古方) medicine was prevailed or started prevailing in the 18th century or the mid 18th century had been generally accepted. Bearing this point in mind, when we founded out medical trend and matter of concern of two country doctors, Dae-Ryeo-Pil-yeo(對麗筆語) can be applicated to an established theory. But Han-gaek-chi-heom(韓客治驗)and Sang-han-ui-mun-dab(桑韓醫問答) could not be accepted to forenamed theory. Because of only limited study on three records, We must not broadly interpretate that these are general character of Mu-jin(戊辰) envoys in the medical conversation records.

『衛生寶鑑』의 醫案 연구

함정식(HAM JEONG SIK),김남일, 유원준 한국의사학회 2005 한국의사학회지 Vol.18 No.1

The study is written for the purpose of examining Na Cheon Ik(羅天益)′s medical ideology mentioned in Euian(醫案) of 『Wi-saeng-bo-gam 衛生寶鑑』. The publication of this book is reflected in the 13th century perplexed conditions. In this thesis, after the writer analyzed Na Cheon Ik(羅天益)′s medical theory in 『Wi-saeng-bo-gam 衛生寶鑑』, knew that he emphasized practical use on all occasions. So far, Na Cheon Ik(羅天益)′s medical ideology in 『Wi-saeng-bo-gam 衛生寶鑑』 is hardly studied.『Wi-saeng-bo-gam 衛生寶鑑』is a medical book which was written in the process of systemic recognized of medical theories of various and special academic parties in the period JinYuan(金元). The medical theory that appears in 『Wi-saeng-bo-gam 衛生寶鑑』 is rooted in Li Dong Yuan(李東垣)′s theory, but also Na Cheon Ik(羅天益)′s medical ideology is distinguished from Li Dong Won(李東垣)′s ideology. First of all, Na Cheon Ik(羅天益) recognized the importance of discerning not only On-Bo(溫補) but also Han-Ha-To(汗下吐) and various ways in medical treatment. Secondly, the fact that Na Cheon Ik(羅天益) made good use of moxibustion tells the difference between the two. In conclusion, 『Wi-saeng-bo-gam 衛生寶鑑』 holds systemic medical information which was originated with Na Cheon Ik(羅天益)’s various and special experience. He had contributed in the clinical experience and medical information by having an effect on the ages to come.

군병원에서 수술중 신경생리검사장비 운용의 경험 및 유용성에 대한 연구

윤상훈 ( Sang Hoon Yoon ),함정식 ( Jeong-sik Ham ),박호영 ( Ho-young Park ),이건영 ( Gunyoung Lee ),정재환 ( Jaehwan Chung ),조현준 ( Hyun Jun Jo ),김현빈 ( Hyunbin Kim ),김새롬 ( Sae Rom Kim ),조병규 ( Byung-kyu Cho ) 국군의무사령부 2016 대한군진의학학술지 Vol.47 No.1

Objectives; The authors aimed to introduce the clinical experience and efficacy using intraoperative neurophysiologic monitoring (IONM) system for neurological surgery from January 2015 to August 2016 in Armed Forces Capital Hospital. Methods; Retrospective observational study was performed. This system was used in 17 operations above the periods. Every operation and monitoring result were reviewed in electronic medical records. Three patients with brain lesions (1 AVM, 2 brain tumor) underwent surgical resection with IONM. Two brain tumor were a facial schwannoma and a frontal neuronal tumor. Fourteen spinal operations consisted with nine benign degenerative compressive lesions, two neurogenic tumor, a intramedullary cavernous hemangioma, two neurogenic tumors, a vertebral fracture and tumor. IONM was tailored to the single patient, and consisted in transcranial MEP monitoring, cortical MEP monitoring, SSEP monitoring and direct electrical stimulation. Results; None of patients suffered from permanent motor deficits; a patient had a transient peripheral type facial nerve palsy requiring rehabilitation. None of the patients had intraoperative seizures and postoperative IONM related complication. Seven cases (41.2%) met the criteria of neurophysiologic changes during operation. Of these, six cases were restored to normal during operation spontaneously or with surgical manipulation. An unrestored neurophysiologic cases showed new post-operative neurological deficits (peripheral type facial palsy; H-B grade 4). No patients showed neurological deficits without any changes in IONM. Conclusions; Proper application of IONM may be useful to detect intraoperative neurological injury during all neurosurgical operations and improve surgical outcomes especially in subgroup of invasive brain surgery. Larger series of patients are required to confirm this preliminary data. More expert clinical neurophysiologists and neurologists should be recruited to enlarge opportunity to perform surgery under IONM for patient’s safety and good surgical outcome.

Line maintenance work과 관련된 천식 1예

이채용(Chae-Yong Lee),함정식(Jeong-Sik Ham),김건엽(Keon-Yeop Kim),이무훈(Moo-Hoon Lee) 한국항공우주의학협회 2001 항공우주의학회지 Vol.11 No.1

중국 보험소비자 특성이 인터넷보험 선호도와 구매의도에 미치는 영향

조강필 ( Kang Pil Cho ),조혜진 ( Hye Jin Cho ),함정식 ( Jeong Sik Ham ),웅하모 ( Xia Mu Xiong ) 한중사회과학학회 2014 한중사회과학연구 Vol.12 No.2

In today`s world, the internet and related advances in information technology significantly affect financial services in general and insurance markets and institutions in particular. Therefore the purpose of this research is to investigate the Chinese consumers` characteristics influence the preference and purchase intention of internet insurance. Survey questionnaire was administered in China and the responses, living in major cities including, Beijing, Shanghai, Guangdong, Xiamen were collected from May 17 to May 20, 2013. A total of 632 questionnaires were used in the statistical analysis. For the data analysis, various statistical techniques were used including, frequency analysis, T-test, ANOVA analysis, simple regression analysis, multiple regression and correlation analysis. The result of this study can be summarized as follows: First, internet insurance has to pay attention to age at 20-40, highly educated young unmarried women. Second, Chinese consumers`s lack of awareness of insurance and the law of internet insurance is not perfect. In order to make the internet insurance more popular government should strengthen the legal ethics.

간경변증 환자에서 복수의 양에 따른 위 전기적 활성도의 변화

조주영,이준성,김진오,이문성,장재영,김연수,심찬섭,조영덕,최우봉,홍수진,문종호,함정식 대한소화기학회 1999 대한소화기학회지 Vol.33 No.5

Backgraound/Aims: The pathogenic mechanism of gastrointestinal symptom such as nausea, vomi ting, postprandial bloating in cirrhotic patients with ascites were not well documented until now. We evaluated the relationship between the gastric dysrhythmia and the severity of ascites in patients with liver cirrhosis. Methods: Electrogastrogram (EGG) was recorded during fasting and fed states in 57 patients diagnosed as liver cirrhosis. Sex, age, symptom score, aspartate aminotransferase, alanine aminotransferase, bilirubin, albumin, modified Child classification score and ratio of congestive gastropathy were also evaluated during EGG recording. After EGG recording, the patients were classified according to the amount of ascites by the abdominal ultrasonography. Results: Symptom score and ratio of congestive gastropathy were significantly higher in ascites group than in non-ascites group (p$lt;0.05). Postprandial normal slow wave was decreased but postprandial tachygastria was increased significantly in ascites group (p$lt;0.05). In comparing large volume-ascites group with non-ascites group, postprandial bradygastria was increased significantly in large volume-ascites group (p$lt;0.05). On the other hand, postprandial normal slow wave and dysrhythmia did not differ significantly according to the amount of ascites. Conclusions: The fed gastric dysrhythmia was dominant in cirrhotic patients with ascites. We suggest that gastric electrical dysrhythmia is a potential component in the pathogenesis of gastrointestinal symptoms in liver cirrhotic patients with ascites due to delaying gastric emptying time.

일차성 식도 이완 불능증에서 내시경적 보툴리늄 독소 주입 치료의 평가

조주영,이준성,김진오,이문성,장재영,심찬섭,조영덕,최우봉,홍수진,문종호,함정식,임희혁,김연수,황성규 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.6

Primary achalasia is a disorder of swallowing in which the lower esophageal sphincter fails to relax. Traditional treatment methods are balloon dilatation and myotomy, but these methods have critical complications and even fatal including esophageal perforation, gastroesophageal reflux, and continuing dysphagia. Botulinum toxin, which has been used for dystonias of skeletal muscles, is presented as a new alternative treatment method for achalasia, aimed to lowering of LES pressure by Pasricha et al. They also reported that endoscopic botulinum toxin injection into LES was effective, safe, and simple method without any significant complication. We report 7 cases of primary achalasia treated with endoscopic botulinum toxin injection, who showed clinical improvement without any complication. We compared results of pre-treatment with those of post-treatment using botulinum toxin in the aspects of clinical, radiological, manometrical recording in these cases. Symptomatic improvement was shown in 4 cases(57.1%), symptom score was decreased from 7.43+- 0.53 to 4.43+- 2.51(p=0.03), The luminal diameter at esophagogastric junction increased from a mean of 3.21+-$gt; 0,99 mm to 5.14+- 0.90 mm (p=0.015), and luminal diameter at esophageal body decreased from a mean of 40.29+- 19.37 mm to 32.71+-15.45 mm (p=0.015). In follow up manometric recording, peristaltic waves at the body were recovered in 2 cases(28.6%), gastroesophageal pressure gradient(AP) was non-significantly decreased from 6.30+-4.0 mmHg to 3.12+-4.47 mmHg (p=0.45). One patient complained of transient chest pain within one hour after the botulinum toxin injection, but she did not need any medication. We concluded that botulinum injection was a simple, safe, and effective therapeutic method for primary achalasia, even though further evaluatian should be performed in the much more cases and the results of long term follow-up, and cost-effectiveness of this method.

췌장 가성낭종에 발생한 십이지장낭종루 및 대장낭종루

조주영,이준성,김진오,이문성,장재영,심찬섭,조영덕,최우봉,함정식 대한소화기학회 1999 대한소화기학회지 Vol.33 No.5

Spontaneous rupture of pancreatic pseudocyst occurs in less than 5 % of the cases. Rupture has been reported to occur in free peritoneal cavity, stomach, duodenum, colon, portal vein, pleural cavity and abdominal wall. The precise pathophysiologic mechanism of rupture is unknown. However, the increased intracystic pressure has been suggested as a factor leading to rupture. The wall gives way at the weakest point of it when the pressure reaches a critical level, or increased intracystic pressure may compromise the wall vasculature with subsequent necrosis and rupture. Enzymatic activity on the wall might also produce vascular damage with subsequent necrosis of the wall and subsequent rupture. The reported case of spontaneous rupture into more than one hollow viscus is very rare in our country. We report a case of cystoduodenal and cystocolic fistula complicated after endoscopic internal drainage of pancreatic pseudocyst in acute pancreatitis. The patient has been treated completely by endoscopic nasogastric drainage.

거대 위정맥류출혈에 있어서 Detachable Snares 와 O-형 고무밴드를 이용한 내시경적 결찰요법

조주영,이준성,박철호,이종태,김진오,이문성,황성규,김연수,심찬섭,조영덕,함정식,봉형근 대한소화기내시경학회 1995 Clinical Endoscopy Vol.15 No.4

Bleeding from gastric varices greater than 2cm in diameter represents a major limitation for endoscopic hemostasis. The endoscopic injection sclerotherapy (EIS) using conventional sclerosing agents is not satisfactory for the control of acute bleeding from gastric varices which have large diameter, fast blood flow and abundant collateral circulations. Endoscopic ligation using small rubber bands, known to be alternative to EIS, never obliterate large gastric varices greater than 2 cm in diameter. Obliteration therapy using Histoacryl (n-buty1-2-cyanoacrylate), known to be more satisfactory, has some drawback such as embolization. We per formed endoscopic ligation using detachable snares and rubber bands in 22 patients who had recently bleeding from gastric varices larger than 2 cm in diameter. For ligation of gastric varices larger than 2 cm in diameter, the detachable snares were used, and then for ligation of adjacent small gastric varices, rubber bands were used. In seven patients active bleedings were noted at initial endoscopy; 6 of them were successfully controlled by endoscopic ligation using detachable snares and rubber bands, but one patient who was uncontrolled by it died from bleeding and multiple organ failure. In remaining 15 patients, there were no active bleeding but red color signs on large gastric varices; all of them were successfully controlled by endoscopic ligation using detachable snares and rubber bands. Early rebleeding, fol lowing initial treatment, occurred in two patients (9.5%). So overall hemostatic rate of endoscopic ligation using the detachable snares and the rubber bands was 86.4% (19/22). Varices were nearly eradicated in 18 (85.7%) of the 21 survivors by ligation of 1-3 detachable snares (mean, l.3 snares) and 4-30 rubber bands (mean, 16,2 bands) in 2-6 sessions (mean, 3.2 sessions). During or after ligation, there were no serious complications, except transient epigastric pain or discomfort in 14.7% and fever in 1.3%. These results suggest that endoscopic ligation therapy with detachable snares and rubber bands is a safe and effective method for treatment of acute bleeding of gastric varices, especially gastric varices larger than 2 cm in diameter, which can not he controlled by conventional scleratherapy or variceal band ligation. (Kor J Gastrolntest Endosc 15: 670-677, 1995)