Anatomical study of the sacrotuberous ligament and the hamstring muscles: A histomorphological analysis

The sacrotuberous ligament (STL) and the hamstrings are important structures that are mutually connected and influenced by the pelvis. However, the anatomical connectivity and histological characteristics of these structures remain unclear. The present study aimed to comprehensively investigate the relationship between the STL and the proximal hamstrings through histological analysis. Sixteen specimens were obtained from eight fresh cadavers (mean age at death, 73.4 years). Verhoeff Van Gieson, Masson's trichrome, and immunohistochemical staining were used to analyze the connectivity between the STL and the hamstrings and to verify the ratios of collagen and elastic fibers. Dense connective tissue that overlapped tightly between the STL and hamstrings was observed. The relative ratios of collagen and elastic fibers between the STL and hamstrings characteristically identified regional differences. The ratio of elastic fibers to collagen in the biceps femoris (BF) was ~38.6 ± 4.7%, and the lowest ratio was 5.9 ± 2.6% observed in the semimembranosus (SM). In the case of the BF, contractibility is well-regulated due to a high content of elastic fibers; however, the muscular structure of the BF is relatively fragile due to the low content of collagen. In the SM, collagen content is higher than that in the STL. This ratio of elastic fibers in the collagen analysis could provide crucial information for understanding the differences in hamstring contractility and maintaining the morphology of these structures.

Infraspinatus-teres minor (ITM) interfascial block: a novel approach for combined suprascapular and axillary nerve block

BACKGROUND

Combined suprascapular and axillary nerve block could be an analgesic option for shoulder pain control. The current description of this technique requires performing the block procedures at two different sites without consideration for catheter placement. We hypothesized that a single site injection to the interfascial plane between the infraspinatus and teres minor would result in an injectate spread to the suprascapular and axillary nerves.

METHODS

We performed 10 injections with this approach using 25 mL dye solution in 10 shoulders of five unembalmed cadavers. Also, we described three case reports, two single-injection cases and one catheter-placement case, using this approach in patients with acute postsurgical pain and chronic pain in their shoulder region.

RESULTS

In cadaveric evaluations, dye spreading to the suprascapular nerves on the infraspinatus fossa and the spinoglenoid notch cephalad and axillary nerves in the quadrilateral space caudally were observed in all injections. In addition, the most posterolateral part of the joint capsule was stained in 8 out of 10 injections. There was no dye spreading on the nerves to the subscapularis or lateral pectoral nerves. Clinically successful analgesia with no adverse events was achieved in all three cases.

CONCLUSION

Our anatomical and clinical observations demonstrated that an injection to the interfascial plane between the infraspinatus and teres minor consistently achieved injectate spreading to both suprascapular and axillary nerves, which innervate the glenohumeral joint.

Intramuscular innervation of the tensor fasciae latae: Application to total hip arthroplasty

The aims of this study were to clarify the extra- and intramuscular branching patterns of the tensor fasciae latae (TFL) with reference to surface landmarks on the thigh and to thus suggest a safe approach for total hip arthroplasty. Sixteen fixed and four fresh cadavers were dissected and subjected to the modified Sihler's staining method to reveal the extra- and intramuscular innervation patterns, and the findings were matched with surface landmarks. The landmarks were measured from the anterior superior iliac spine (ASIS) to the patella and divided into 20 parts along the total length. The average vertical length of the TFL was 15.92 ± 1.61 cm, which was 38.79 ± 2.73% when converted to a percentage. The entry point of the superior gluteal nerve (SGN) was an average of 6.87 ± 1.26 cm (16.71 ± 2.55%) from the ASIS. In all cases, the SGN entered parts 3-5 (10.1%-25%). As the intramuscular nerve branches traveled distally, they had a tendency to innervate more deeply and inferiorly. In all cases, the main SGN branches were intramuscularly distributed in parts 4 and 5 (15.1%-25%). Most tiny SGN branches were found inferiorly in parts 6 and 7 (25.1%-35%). In three of 10 cases, very tiny SGN branches were observed in part 8 (35.1%-38.79%). We did not observe SGN branches in parts 1-3 (0%-15%). When information on the extra- and intramuscular nerve distributions was combined, we found that the nerves were concentrated in parts 3-5 (10.1%-25%). We propose that damage to the SGN can be prevented if parts 3-5 (10.1%-25%) are avoided during surgical treatment, particularly during the approach and incision.

Lateral branches of the facial artery and its clinical implications

The facial artery is the main artery supplying blood to the face and is known to have facial branches of the inferior labial, superior labial, lateral nasal and angular arteries. These known major branches of facial artery run medially, however, there are sometimes branches of the facial artery heading laterally. The purpose of the present study was to investigate the lateral branches of the facial artery in face. We dissected facial branches of the facial artery in 74 cadaveric hemifaces. We investigated the presence of the lateral branches of the facial artery. Following parameters were investigated: lateral branch presence, the location of its origin, and the lateral branch diameter. Among the lateral branches, we evaluated the prevalence and diameter of the premasseteric branch. Lateral branches were observed in 48 of the 74 hemifaces (64.9%). The total number was 81 in the 48 hemifaces. The most common origin was between the inferior border of the mandible and inferior labial artery origin (42 of 81, 51.9%). The mean diameter of all lateral branches of the facial artery was 0.7 mm. Among the lateral branches, the premasseteric branches were present in 38 of 74 specimen (51.4%) and the mean diameter was 0.8 mm. The lateral branches of the facial artery may be registered in Terminologia Anatomica based on their prevalence. Accurate knowledge of the anatomy of the lateral branches of the facial artery is helpful for clinicians to avoid complications during facial procedures or maxillofacial surgeries.

Three-dimensional linear and volumetric computed tomography analysis of the frontal sinus

The frontal sinus is one of the four paranasal sinuses in humans, and knowledge of its anatomy is important when performing surgery involving the frontal bone or sinus. Although many studies have measured the frontal sinus using radiography and computed tomography (CT), few studies have evaluated by using three-dimensional (3D) analysis. The purpose of this study was to analyze the frontal sinus using 3D reconstruction analysis and determine the differences in linear and volumetric measurements between sexes, sides, and ages. The sample comprised 281 facial CT scans: 173 and 108 from males and females, respectively. The width, height, and length of each frontal sinus and total volume were all larger in males than in females. Almost all linear and volumetric measurements were larger in young adults than in older for both sexes, but not all of the differences were statistically significant. Linear and volumetric measurements were larger for males than females regardless of age group. There were no statistically significant differences between the right and left sides except the width in males. The size of the frontal sinus was strongly influenced by sex and age. The measurements reported here might be useful for improving surgical procedures involving the frontal sinus.

Search for Sub-eV Sterile Neutrinos at RENO

We report a search result for a light sterile neutrino oscillation with roughly 2200 live days of data in the RENO experiment. The search is performed by electron antineutrino (ν[over ¯]_{e}) disappearance taking place between six 2.8 GW_{th} reactors and two identical detectors located at 294 m (near) and 1383 m (far) from the center of the reactor array. A spectral comparison between near and far detectors can explore reactor ν[over ¯]_{e} oscillations to a light sterile neutrino. An observed spectral difference is found to be consistent with that of the three-flavor oscillation model. This yields limits on sin^{2}2θ_{14} in the 10^{-4}≲|Δm_{41}^{2}|≲0.5  eV^{2} region, free from reactor ν[over ¯]_{e} flux and spectrum uncertainties. The RENO result provides the most stringent limits on sterile neutrino mixing at |Δm_{41}^{2}|≲0.002  eV^{2} using the ν[over ¯]_{e} disappearance channel.

Three-dimensional reconstruction of the luminal structure of human seminal vesicle

The seminal vesicles are the glands of male reproductive organs that produce the fluid and nutrient constituents of semen. It has been believed for a long time that the lumen of a seminal vesicle was a single-coiled tubular structure with irregular diverticula. There are several previous reports on the symmetry, differences in morphological sizes and classification of the seminal vesicles. However, a three-dimensional-coiled tubular structure is difficult to understand using a classical anatomical methodology, and hence, three-dimensional reconstruction is needed to understand the structure of the lumen. Thirty-one seminal vesicles harvested from 21 formalin-embalmed cadavers were investigated. The seminal vesicle along with the ampulla of the ductus deferens was separated, and the length and width of each seminal vesicle were measured. The vesicles were then embedded in coloured paraffin, and the resulting paraffin block was sectioned transversely and photographed at an interval of 500 μm, with the sectioned surfaces then utilized in three-dimensional reconstruction performed by 'Reconstruct' software. The mean length and width of the seminal vesicles were 39.4 mm and 13.4 mm, respectively, and the right seminal vesicle was a little larger than the one on the left. The size differed from previous reports, while the luminal structure was similar to the classification of Aboul-azm (Archives of Andrology, 3, 1979, 287-292) but differed from that of Pereira (AJR. American Journal of Roentgenology, 69, 1953, 361-379). The seminal vesicles typically comprised about 9 curls and had about 12 diverticula. The seminal vesicles resembled a skein of coral rather than comprising a single strand. These findings will help in improving the understanding of pathophysiologies of the seminal vesicles, such as recurrent inflammation of the gland.

Observation of Energy and Baseline Dependent Reactor Antineutrino Disappearance in the RENO Experiment

The RENO experiment has analyzed about 500 live days of data to observe an energy dependent disappearance of reactor ν[over ¯]_{e} by comparing their prompt signal spectra measured in two identical near and far detectors. In the period between August of 2011 and January of 2013, the far (near) detector observed 31 541 (290 775) electron antineutrino candidate events with a background fraction of 4.9% (2.8%). The measured prompt spectra show an excess of reactor ν[over ¯]_{e} around 5 MeV relative to the prediction from a most commonly used model. A clear energy and baseline dependent disappearance of reactor ν[over ¯]_{e} is observed in the deficit of the observed number of ν[over ¯]_{e}. Based on the measured far-to-near ratio of prompt spectra, we obtain sin^{2}2θ_{13}=0.082±0.009(stat)±0.006(syst) and |Δm_{ee}^{2}|=[2.62_{-0.23}^{+0.21}(stat)_{-0.13}^{+0.12}(syst)]×10^{-3}  eV^{2}.

Observation of reactor electron antineutrinos disappearance in the RENO experiment

The RENO experiment has observed the disappearance of reactor electron antineutrinos, consistent with neutrino oscillations, with a significance of 4.9 standard deviations. Antineutrinos from six 2.8  GW(th) reactors at the Yonggwang Nuclear Power Plant in Korea, are detected by two identical detectors located at 294 and 1383 m, respectively, from the reactor array center. In the 229 d data-taking period between 11 August 2011 and 26 March 2012, the far (near) detector observed 17102 (154088) electron antineutrino candidate events with a background fraction of 5.5% (2.7%). The ratio of observed to expected numbers of antineutrinos in the far detector is 0.920±0.009(stat)±0.014(syst). From this deficit, we determine sin(2)2θ(13)=0.113±0.013(stat)±0.019(syst) based on a rate-only analysis.

The influence of carotid artery catheterization technique on the incidence of thromboembolism during carotid artery stenting

BACKGROUND AND PURPOSE

Thromboembolic events related to CAS continue to be the main limitation to the widespread use of this technique as a first-line treatment for carotid occlusive disease. Our aim was to evaluate thromboembolism during CAS using DWI for catheterization techniques of the carotid artery.

MATERIALS AND METHODS

Thirty-two consecutive patients with symptomatic carotid stenosis underwent CAS involving 1 of 2 carotid artery catheterization techniques: One used a 7F or 8F catheter (group 1, n = 16) and the other used a coaxial system in which a 7F or 8F catheter was used in conjunction with a 4F or 5F catheter (group 2, n = 16). DWI was performed before and after CAS. Clinical variables, the number and location of NES on DWI after CAS, were compared between the 2 groups.

RESULTS

NES on DWI occurred in 53% of all patients. The incidence of NES was significantly higher in patients 65 years of age and older versus those younger than 65 years of age (P = .013). All NESs were asymptomatic, and their rate of occurrence did not differ significantly between groups 1 and 2. The incidence of NES in the other territories that were outside that of the treated carotid artery (P = .004) and the incidence of multiple NESs (P = .04) were significantly higher in group 1.

CONCLUSIONS

NES in the other territories mainly arises from the atherosclerotic aortic arch and arch vessels during the manipulation of endoluminal devices. The carotid artery catheterization technique using the coaxial system with a 7F or 8F catheter in conjunction with a 4F or 5F catheter reduced the incidence of NES in the other territories.

[Medical education in Je Joon Won]

Medical education in Je Joong Won was proposed and initiated by Dr. HN Allen. In his proposal of building a new hospital, submitted to the king in 1885, he expressed his wish to teach Western medicine to young Koreans at the hospital. The king welcomed his proposal and the plan was soon realized. Je Joon Won, the first modern hospital in Korea, opened on April 10th, 1885. The following year, on March 29th, Dr. Allen began medical school attached to the hospital. Many applicants were recruited by the government and 16 students were selected through the entrance examination. At first, they were taught English and finally 12 students out of them were selected after three months of teaching. The selected students were taught arithmetic, physics, chemistry, anatomy and physiology. The medical education at this period cannot be evaluated entirely successful since none of the 12 students was presumed to have worked as a practitioner.

[The fate of the old Jejoong Won following the establishment of the new Jejoong Won (Severance Hospital)]

Dr. Allen, the first Protestant missionary in Korea, had an opportunity of saving the life of the queen's nephew shortly after his arrival in Korea in 1884. In gratitude the King established the Royal Korean Hospital (Jejoong Won), the first hospital in Korea, and appointed Dr. Allen in charge of the medical affairs of the hospital. After Dr. Allen's resignation from the mission, the work was successively carried on by Drs. JW Heron, RA Hardie, CC Vinton and OR Avison, the last of whom arrived in 1893. In 1894 the connection of the Hospital with the Korean Government was severed and the work taken over by the Northern Presbyterian Mission. Since then, it has been a distinctly mission institute. In 1900, while attending the Ecumenical Conference of Foreign Missions in Carnegie Hall, New York, Dr. Avison made the acquaintance of a philanthropist LH Severance, who made a gift of $10,000 for a new hospital. This building, the first modern hospital in Korea, was opened and dedicated in 1904. It was named the Severance Hospital. As the new hospital was built, the old hospital building was to be returned to the Korean Government according to the agreement made in 1894. On retaking the old hospital, the Korean Government paid $30,289.99 won for the renovation of the original building and new buildings established in the site during the period of Avison's entire charge of Jejoong Won. The old hospital building was used as an official residence for a diplomatic adviser Stevens, who was assassinated for his pro-Japan activities, and as a social club for Japanese officials.

[Ethnics of the body - a study on the ethical meanings of body in Spinoza and Yi Jae-Ma]

Michel Foucault has brought some considerable changes in our way of seeing the human body. He argued that the body is not merely a natural object, but a medium of numerous social messages and even the most favorable habitat of power. According to him, the birth of social institutions, such as asylums, clinics, and jails, have been closely linked to the process of modernization and further that the very process through which the body becomes an object of social control has been an important part of our modernization. He proposed a new concept, viz., the social stigma carved on the body and provided us certain clues that makes us think newly of the boundary between nature and culture. Although his arguments opened a new perspective on our body, it did have a premise of so-called "the passivity of body" as its limitation. The body is not just a purely natural object, nor a purely social construction. It resides at both sides simultaneously and the disease, an incident happened within the body, reveals subtle relationship between these two. Those who see the body as an object of power as such or a medium of certain social messages tend to consider it only as an objective being, yet on the other side of this standpoint, the Cartesian dualism is hidden as a premise. Deleuze defined, in his book on Spinoza, the ethics of Spinoza as a practical study mainly dealing with the mode of existence. Provided that this definition is correct enough, we may term this practical study for the mode of existence of the body as the ethics of the body. Spinoza proposed a very unique view with regard to the body, which differs from that of the Cartesian Dualism. It is based on the entire system of his philosophy, viz., the system of the univocity of substance and the immanence of being which finally appears in the form of ethics. In the later half of this article, a very unique medicine whose starting point is none other than this kind of ethics, a practical study for the mode of existence, was dealt with. It is named Sasang(Four Symbol) medicine which was founded upon the long tradition of one of the most profound ethical teachings of mankind, Confuciaism. Sasang medicine of Yi Jae-ma is in a sense a continuation of the Neo-Confucianism tradition of Korea in the field of medicine.

[Kim Doo-jong: a life for the history of Korean medicine]

Kim Doo-jong, the founder of the history of medicine in Korea, was born on 2nd March, 1896. After finishing his primary education in his home town, he went to Seoul to receive a higher education. He entered Keijo Medical College in 1918. However, at the end of his first year, he participated in the 3 . 1 movement which protested against Japanese harsh rule over Korea. On account of his participation in the movement, he was forced to leave the college which was run by the Japanese colonial government. Then he went to Japan to enter Kyoto Municipal Medical College, from which college he graduated in 1924. After the graduation, he went to Beijing to work in a hospital run by Japanese. Having felt uncomfortable about the situation in Beijing, he moved to Manchuria, where he opened his private clinic and saw patients for 7 years. As the life as a clinician did not satisfy him, he gave up his practice, and determined to devote himself to the study of history of medicine. He was 43 years old when he started studying history of medicine at the Dong Ah Institute, an affiliated research institute of Manchuria Medical College founded by Japanese. The institute had a large and magnificent collection of ancient texts of oriental medicine. He set on historical studies on the oriental medicine from the perspective of the Western medicine. His doctorial dissertation was about anatomy in oriental medicine. He intended to continue his study on organology, myology, etc., but the sudden end of the World War II made him return to Korea. This meant that he could not make access to the large collection of the institute, and his themes of the research had to be changed. On returning to Korea, he established the Department of the History of Medicine in Seoul National University, which was the only and the first one of its kind. He wrote History of Korean Medicine, which still remains one of the most important works on the history of Korean medicine. He was very energetic and active in his academic activities even during his late years. He passed away on 18th May 1988 at the age of 92.

[Medical books published in North Korea]

In those days, commercial and cultural exchanges between South Korea and North Korea become more active than before. But in medicine, there has been no activities of exchange and we don't know much about medicine in North Korea. We have some information on medical systems in the North, but we know little about how the medical activities are, what achievements they have made and what kind of medical books have been published. The authors classified 575 books according to their specialties and publishing years and analysed the characteristics and tendencies of medical books publishing in North Korea.

[An aspect of Buddhistic medicine in ancient Korea: Wonhyo and medicine]

Lack of historical records causes some difficulties in the historical studies of ancient Korea. It is the same case as that of the history of medicine. We imagine what the situation of medicine was like in ancient Korea with a bit of historical records. In ancient times, medicine had very close relation with religions. In ancient Korea, it had very close relation with Buddhism. According to Sam Kuk Sa Ki and Sam Kuk Yu Sa buddhist monks treated patients with the religious rituals. In this article, the authors would like to present a record which had been unnoticed until now. It is the commentary of Wonhyo on a certain Buddhistic cannon called Kum Kwang Myung Kyung. A chapter (Je Byung Poom) of this cannon is on the theory of medicine, causes of diseases and treatments. We can presume Wonhyo's knowledge of medicine at that time through his commentary on this chapter.

[The pathologic theory of the oriental medicine]

The oriental medicine differs from the western medicine in many aspects. Especially they show great differences in their understanding of diseases as the object of medical science. But their differences were often exaggerated and accentuated. In this article I would like to reveal various aspects of oriental medicine which have often been ignored by schematic comparison with the western medicine. They are as follows. 1) The pathologic theory of the oriental medicine has changed as the time has gone by. 2) The pathologic theory of the oriental medicine is not based on single paradigm. 3) Nosologic problems in oriental and western medicine.

Serodiagnosis of human sparganosis by a monoclonal antibody-based competition ELISA

Competition ELISA test using sparganum specific monoclonal antibodies (Mab) was investigated to improve the diagnostic specificity of sparganosis. By cell fusion, one hybridoma clone secreting anti-sparganum specific Mab was selected (Sp-20), which reacted on bands of 32 kDa and 38 kDa. Sp-20 reacted on calcium corpuscles on IFA. By micro-ELISA, 16 of 17 sparganosis cases (95%) were found positive, but 1 of 18 clonorchiasis cases (5%), 4 of 16 cysticercosis cases (25%) and 2 of 16 normal controls (11%) showed false positive reactions. On the other hand, by competition ELISA using a sparganum specific Mab (Sp-20), 16 out of 17 (95%) of sparganosis cases were found positive, but 2 of 18 clonorchiasis cases (10%), 2 of 16 cysticercosis cases (12%), 3 of 16 paragonimiasis cases (18%) and 1 of 16 normal controls (6%) showed false positive reactions.

[A historical study on the introduction and development of anatomy in Japan]

Japan received the Western medicine through Portuguese, Spanish and Netherlanders. Especially Netherlanders established House of Trade in Nagasaki, where doctors from their homeland stayed for several years for the health care of their tradesmen, and taught Japanese Western medicine (mainly surgery). By them Anatomy books written in western languages were introduced into Japan and some Japanese had the eager to identify the real structures of human body. At last Yamawaki Toyo became the first dissector of human body in Japan (1754) and he made his own dissection records. In 1774 Sukita Kenpaku translated the Anatomy book of Kulmus into the classic Chinese. From that time on Japanese translated a lot of Anatomy books in western languages and they themselves wrote Anatomy books of their own.

Serodiagnosis of human paragonimiasis by ELISA-inhibition test using monoclonal antibodies

ELISA-inhibition test using Paragonimus westermani specific monoclonal antibody (Mab) was investigated to improve the diagnostic specificity of paragonimiasis. By cell fusion, one hybridoma clone secreting anti-P. westermani specific Mab was selected (Pwa-14), which reacted on bands of 28 kDa, 42.5 kDa, 89 kDa and 120.5 kDa. IFA showed Pwa-14 was located at the vitelline follicles. By micro-ELISA, 100% of 22 paragonimiasis cases were found positive, but 5 of 40 clonorchiasis cases (12.5%), 3 of 26 cysticercosis cases (7.7%) showed false positive. None of 10 sparganosis patients or 28 normal controls reacted positively. On the other hand, by ELISA-inhibition test using a P. westermani specific Mab, 100% of paragonimiasis cases were found positive, and there were no positive in cysticercosis, sparganosis cases or normal controls, except 2 (5.0%) false-positive sera of 40 clonorchiasis cases. The ELISA-inhibition test using a Mab showed higher specificity in comparison with micro-ELISA for serodiagnosis of human paragonimiasis.

Serodiagnosis of cysticercosis by ELISA-inhibition test using monoclonal antibodies

Monoclonal antibodies (Mabs) were produced against crude scolex extract of T. solium metacestodes, and applied to ELISA-inhibition test for improving the specificity of serodiagnosis of human cysticercosis. Four hybridomas secreting species-specific anticysticercal Mabs (Cya-1, Cya-7, Cya-28 and Cya-31) were selected. Each Mab reacted on antigenic components of 25.5 kDa (Cya-1), 28 kDa (Cya-7), 87.5 kDa (Cya-28), and 12.5 kDa (Cya-31). IFA showed that Cya-1 was located at the calcium corpuscles, and Cya-7 at the loose connective tissue of T. solium metacestode scolex. Cya-28 and Cya-31 reacted on the tegument of the scolex. By conventional ELISA, 23 out of 28 (82.1%) cysticercosis patients were found serologically positive, but 1 out of 9 (11.1%) sparganosis cases and 6 out of 31 (19.4%) paragonimiasis cases showed false positives. By ELISA-inhibition test using species-specific anti-cysticercal Mab Cya-7, 19 out of 28 (67.9%) cysticercosis cases were found serologically positive, but there were no false positives in other parasitic infections.

[Parasitic diseases in Dong-Eui-Bo-Kam]

Dong-Eui-Bo-Kam is a medical book of Korean traditional medicine, which is of encyclopedic characteristics. Its contents imply almost every field of medicine. There are also descriptions of human parasites in this book under the title of 'Worms'. Worms described in the book are Sam-Shi-Choong, Ku-Choong (nine worms) and Oh-Jang-Choong (worms of five organs). Among these Sam-Shi-Choong are not real worms, but quite mythological ones which have been mentioned in the religious Taoism. It is well-known that Dong-Eui-Bo-Kam has Taoistic characteristics. We can verify this characteristics by the fact that it mentions Sam-Shi-Choong on the top of the title 'Worms'. Dominant pathologic theory in the traditional medicine is a kind of balance theory, which defines the healthy state as the harmonious equilibrium of body elements. On the contrary parasitic diseases suppose real agents as the causes of diseases. This point of view appeares to be quite different from traditional pathologic view.

[The medical philosophy of Choe Han-Ki]

Choe Han-Ki was a philosopher of the 19th century who resided in Seoul. He accumulated vast amount of knowledge of Western science and on the basis of them he built his own philosophical system different from those of the philosophers before him. Not only has he wrote books on philosophy, but many books on science as well. Among them Shin-Ki-Chon-Hum is a very unique medical book which reveals his original medical philosophy. He acquired medical knowledge through the medical books put into Chinese by missionary doctor Hobson and on the basis of them he criticized traditional medicine. He criticized traditional medicine because it explained vital phenomenon through the reductionist theory, such as Oh-Haeng (theory of five phases). And he also criticized it because it lacked in exact anatomical knowledge and that the exact origin of the disease was not known and it had limitations on treatment. He also criticized Western Medicine because it supposed God as a creator. He saw the possibility of communication between Western Medicine and traditional medicine. He didn't regard medicine as concerning disease and health only, but it included everything in it. His philosophy of medicine is just a part of his original system of science, Ki-Hak.

[Dr. Choi Myung-Hak, the first modern Korean anatomist]

Though it is known that the concept of anatomy was introduced in the age of Three Kingdoms, anatomy in modern sense meaning was introduced in late Chosun Dynasty by western missionary doctors. From that time on the lecture of anatomy was not given by anatomists until early 1910s. The first Korean anatomist of medical school graduates was Choi Myung Hak, graduated from Severance Union Medical College (SUMC) in 1926. He was born in 1898 at Ham Heung (Ham Gyung Nam Do Province), and entered SUMC in 1922 and graduated in 1926. He was in charge of anatomy for two years after graduation, and then he went to Kyoto Imperial University Medical College (KIUMC) and reserched under the direction of Dr. Ogawa in the field of experimental embryology and histology. He returned to Korea in 1930 and then became a lecturer in January 1931. His Doctorial thesis was recepted by KIUMC on April 18th 1932. So he became the first Korean Doctor of anatomy. He promoted to professor in February 1922. His publications can be seen in Folia anatomica Japonica. In 1934 he became a councillor of the Japanese Association of Anatomist. He resigned SUMC because of some kind of problem of the school. From that time on Chung, Il-Chun who was appointed as a lecturer in 1934 was in charge of department of anatomy.

[On Hansung Physicians Association]

Hansung Physicians Association was organized in Dec. 1915. Its members were medical practitioners residing in Kyungsung (Seoul). It was apposed to Kyungsung Physicians Association, of which members were Japanese. After the foundation of Hansung Physicians Association some other local physicians associations were begining to be founded. Hansung Physicians Association's social activities were fee-free round practice and improving sanitary conditions. It was basically gathering-meeting or interest group for doctors, which is reflected in the fact that Hansung Physicians Association limited its members as medical practitioners. It is contrasted with the Chosun Medical Association which was founded in 1930. Chosun Medical Association differs from Hansung Physicians Association in that it was a academic association. The first issue of Bulletin of Hansung Physicians Association was published in August 1933. But it came to be the last issue. Hansung Physicians Association was disorganized compulsarilly in 1941 by Japanese Government-General of Korea.

[An analytic study of medical records in Sam-Kuk-Sa-Ki]

In Sam-Kuk-Sa-Ki there are several types of records which are associated with medicine. They are of the plagues, delivery of twins, drugs in use of the time, religious healing and names of some diseases. Records of plagues are most frequently described and they are described associated with climate and natural disasters. Those who delivered twins were awarded by the nation. Because at that time when population was not so large, the population was the power of the nation. As Buddhism was the ruling religion of the time, records of religious healing were mostly associated with the Buddhism. Medical records in Sam-Kuk-Sa-Ki gives us valuable clues to the understanding of the medicine of the time, the ancient Koreans' concept of diseases and the way how they confronted them.