• 의료법학
• /
• 제23권3호
• /
• pp.3-44
• /
• 2022

2020. 2.경 대한민국에서 코로나19 감염증의 대유행이 시작될 당시 문제가 되었던 대구 지역 A종교단체의 역학조사 방해 사건을 중심으로 면밀히 검토한 결과, 역학조사관이 특정 단체에게 명단 제출을 요구하였을 때, 이에 불응하거나 편집된 누락 명단을 제출한 행위에 대하여 역학조사에 해당하지 아니한다는 취지로 선고된 사례가 있는 반면, B열방센터 행사 출입자명단 미제출 사건의 경우 '출입자 명단' 등을 요구받았음에도 정당한 이유 없이 거부한 사실에 대하여 '출입자 명단의 제공은 역학조사에 수반되는 역학조사 간의 연결 과정을 형성하는 핵심적 사실행위로, 이를 거부하는 것도 역학조사 거부, 방해행위에 해당'하므로 적법하게 명단을 요구할 수 있어 처벌이 가능하다는 사례도 있다. 교인명단 제출요구가 역학조사에 해당하는지 여부와 관계없이 교인명단 제출 거부 또는 누락 행위가 곧 역학조사 거부·방해행위에 해당하는 경우도 있는데, 역학조사와 직접 관련성, 역학조사를 위한 것임이 외부적으로 표시되어 인식되었는지 여부, 명단의 역학조사 외의 목적으로 전용될 가능성 등을 종합적으로 고려하여 역학조사에 수반되는 사실행위를 방해함으로써 결과적으로 역학조사가 거부 내지 방해되는 결과가 발생한 경우에는 역학조사 방해가 된다는 하급심 판결의 논리가 설득력이 있다. 역학조사 결과 확인된 각 감염병환자등이나 접촉자 등에 대해 설문조사나 인체검체 채취 및 시험과 같은 역학조사가 실시되지만, 개별적인 사람에 대해 실시되는 역학조사가 서로 독립하여 존재할 수 없으며 역학조사의 연결 과정을 확인하고 추적하는 과정이 역학조사에 필수적으로 수반되며 이러한 연결고리를 확인하는 과정을 누군가 고의로 방해하거나 거부하게 되면, 역학조사가 직접적이고 현실적으로, 광범위하게 방해되는 결과가 발생하기 때문이다. 이 글에서는 주로 ① 감염병예방법상 역학조사와 정보 제공 요청은 차이점이 있으나 정보 제공 요청의 경우에도 역학조사에 해당되는 영역이 있다는 점, ② 코로나19의 의학적 특성과 역학조사의 연속성을 감안하면 역학조사관의 명단요구 행위가 역학조사에 해당할 여지가 있다는 점, ③ 특정한 경우에는 역학조사 방해죄가 위계공무집행방해에 해당할 수 있다는 점, ④ 2020. 9. 29.부터 감염병예법상 정보제공요청을 거부하는 경우에 징역형 또는 벌금형의 처벌규정이 신설되어 운용되고 있다는 점 등을 지적하여, 향후 감염병예방법의 적용 및 역학조사 실무 운용에 있어 도움이 되고자 한다.

• 한국콘텐츠학회논문지
• /
• 제17권1호
• /
• pp.113-119
• /
• 2017

본 연구의 목적은 5대 암(위암, 대장암, 간암, 유방암, 자궁경부암)을 중심으로 5대 암에 대한 대중의 5년 생존율 인식을 조사하여 그 결과를 역학적 사실과 비교하고 암 생존율 인식에 미치는 요인을 규명하는 것이다. 자료는 2016년 4월 19일부터 24일까지 단면 인터넷 설문 조사를 수행하여 총 354명의 설문 응답을 수집하였다. 연구대상자의 특성을 파악하기 위한 빈도분석, 연구대상자의 5년 생존율 인식과 역학적 사실과의 비교를 위한 히스토그램 제시, 연구대상자의 5년 생존율에 미치는 요인을 검증하기 위한 다중회귀분석을 실시하였다. 분석결과, 위암, 대장암, 유방암, 자궁경부암의 생존율에 대한 대중의 인식은 역학적 사실보다 낮게, 간암의 생존율에 대한 대중의 인식은 역학적 사실보다 높게 인식하였다. 마지막으로 암 진단유무, 연령, 규칙적인 운동유무가 5년 생존율 인식에 유의한 영향을 주는 요인으로 나타났다.

• Journal of Microbiology
• /
• 제39권3호
• /
• pp.219-225
• /
• 2001

Phage typing is currently used for typing of Staphylococcus aureus strains beyond the species level in epidemiological studies. A total of 168 Staphylococcus aureus isolates from chicken meat and chicken by-products were phage-typed using the international bacteriophage set for typing Staphylococcus aureus of human origin. One hundred and forty-eight (88.79%) strains were phage-typeable (at least one phage produced 20 or more plaques of lysis). Lysis by phages of group Ⅲ was the mast frequent with 99 (58.93%) sensitive strains. This fact coincides with results of other authors. Twenty-nine different phage patterns were observed and three (95, 75/84 and 6/1030/W57) were most common. One hundred and thirty-two (89.19% of typeable strains) skewed these or indistinguishable (only one phage reaction difference) patterns. Twenty-six out of seventy chicken samples (37.14%) harboured more than one phage type of Staphylococcus aureus. This fact emphasizes the convenience of subtyping several Staphylococcus aureus isolates from the same sample in epidemiological studies. 80% of sausages and hamburgers contained the same Staphylococcus aureus phage types, which wore not found in any of the other food types. This fact suggests a cross contamination during the processing of these foods. Phages 6, 75, 84, 1030 and W57 skewed the greatest activity. None of the Staphylococcus aureus strains were sensitive to phages 47, 81 and 94.

• Asian Pacific Journal of Cancer Prevention
• /
• 제13권7호
• /
• pp.3061-3064
• /
• 2012

Aim: An epidemiological shift has resulted in increase in the prevalence of non-communicable diseases (NCD). Unlike other NCDs which are easily and definitely preventable, the knowledge of cancer prevention is still limited at present. Various aetiological factors are difficult to control since those are habit forming. Hence an available remedy remains its secondary and tertiary prevention for which appropriate planning is of paramount importance. Evidence based planning requires careful analysis of data with a view to prioritize various cancers. Keeping in view the fact that the adaptation of smoking free status in Chandigarh city might have a far reaching positive effect on the cancer related morbidity of the people, the following study was undertaken to provide base line data to be used for future comparisons. Methods: The registers maintained in the Department of Radiotherapy were checked and those belonging to the years 1999 to 2009 were utilized to analyze the cancer morbidity in respect to age, sex, and year of presentation to health care facility. Results: A total of 4,600 cancer patients (males=2276, females=2324) demonstrated a gradual increase in the number of cancer cases from 150 in the year 1999 to 783 in the year 2009. The most common cancers amongst males were cancer of gastro-intestinal tract (GIT) and lung (including larynx) constituting 37.3% and 27.1% of the total, respectively. In females these were cancers of breast and cervix representing 33.3% & 17.6% of total cancer cases, respectively, and lung cancer constituted 5.3%. The maximum cases of bone cancer (53.8% of all bone cancers) were observed amongst children aged less than 20 years and lung cancer (48.2% of all lung cancers) among the elderly aged 60-69 years. The.

• 한국환경성돌연변이발암원학회지
• /
• 제23권4호
• /
• pp.115-130
• /
• 2003

Idiopathic Parkinson's disease (IPD) represents a common neurodegenerative disorder. While epidemiological studies have suggested a number of risk factors including age, gender, race, and inherited disorder, the cumulative evidence supports the view that environmental or occupational exposure to certain chemicals may contribute to the initiation and progress of Parkinsonism. More recently, clinical and laboratory investigations have led to the theory that dysregulation of iron, an essential metal to body function, may underlie IPD by initiating free radical reaction, diminishing the mitochondrial energy production, and provoking the oxidative cytotoxicity. The participation of iron in neuronal cell death is especially intriguing in that iron acquisition and regulation in brain are highly conservative and thus vulnerable to interference from other metals that bear the similar chemical reactivity. Manganese neurotoxicity, induced possibly by altering iron homeostasis, is such an example. In fact, the current interest in manganese neurotoxicology stems from two primary concerns: its clinical symptoms that resemble Parkinson's disease and its increased use as an antiknock agent to replace lead in gasoline. This article will commence with addressing the current understanding of iron-associated neurodegenerative damage. The major focus will then be devoted to the mechanism whereby manganese alters iron homeostasis in brain.

• Journal of Preventive Medicine and Public Health
• /
• 제9권1호
• /
• pp.123-127
• /
• 1976

It is recognized not only by the health experts but also by the public that venereal diseases are remarkably increasing in these days. Therefore, every available measure for declining of the diseases are planned and implemented through case-finding, diagnosis, treatment, education and research. The author intended to compare and analyse infection rates of venereal diseases between reporting from the Ministry of Health and author's private V.D. clinic during 1961-1971. The following results are obtained through the study: 1. According to the report of the Ministry of Health, 45.0% of total examinees were sick with gonorrhea and 6.5% with syphilis, in one hand, on the other hand 78.7% with gonorrhea and 16.3% with syphilis at the author's clinic. 2. By both the report of the ministry and author, highest infection rates were found in 1966-1968, and this fact was considered by the higher infection rate of G.I. in same years. 3. Contrarily, the lowest infection rates were found out in 1970-1971 through both reports.

• 비만대사연구학술지
• /
• 제1권1호
• /
• pp.33-38
• /
• 2022

Although it has been confirmed that excessive body fat increases health risks and all-cause mortality, several epidemiological studies have reported that overweight or obesity in patients with chronic diseases and in older adults is advantageous with respect to mortality. Several mechanisms have been proposed to explain the biological basis of this obesity paradox. The marked heterogeneity of findings observed across studies and the possibility of systematic errors in these studies have cast doubt on the actual existence of the obesity paradox. However, the obesity paradox questioned the validity of body mass index as the best indicator for obesity in terms of predicting its comorbidities and urges clinicians to focus more on changes in body composition and related metabolic derangements, rather than body weight per se.

• Journal of Preventive Medicine and Public Health
• /
• 제49권2호
• /
• pp.80-96
• /
• 2016

최근 담배제조회사의 불법행위법상 손해배상책임을 둘러싼 소송이 계속되고 있다. 이미 대법원 판결이 나온 사건도 있고, 현재 소송이 계속 중인 사건도 있는데, 원고가 증거로 제출한 역학 자료에 의하여 흡연과 질병 사이의 인과관계가 증명되었다고 볼 수 있는지가 이 사건들의 공통된 주요 쟁점이다. 담배소송에서 인과관계의 증명이 쟁점으로 부각되는 까닭은 흡연에 따른 질병의 발생이 흡연 외의 다양한 요인의 영향을 받을 뿐만 아니라 흡연과 발병 사이의 시간적 간격도 길어 원고가 인과관계의 증명에 곤란을 겪기 때문이다. 흡연자 담배소송의 대법원 판결(대판 2014. 4. 10, 2011다22092)은 역학적 증거에 의한 인과관계의 증명 여부에 관하여 비교적 신중한 입장을 취하고 있는데, 몇 가지 아쉬움이 남는다. 첫째, 대법원은 질병을 특이성 질환과 비특이성 질환으로 2분하여 양자 사이에 인과관계의 증명방법을 달리 보았다. 그러나 특이성 질환의 개념은 발병요인에 관하여 의학계와 보건학계에서 확립된 학설인 다요인설에 배치된다. 더구나 불법행위법의 영역에서 특이성 질환 개념을 새로 도입하여야 할 필요성도 발견하기 어렵다. 둘째, 대법원은 비특이성 질환의 경우에 역학적 상관관계가 인정된다고 하더라도 원고가 위험인자에 노출된 시기와 노출 정도, 발병시기, 그 위험인자에 노출되기 전의 건강상태, 생활습관 등을 증명하여 그 위험인자에 의하여 비특이성 질환이 유발되었을 개연성을 증명하여야 한다고 하였다. 하지만 질병과 위험인자와의 역학적 관련성이 상당한 강도에 이른 경우에도 여전히 원고에게 추가적 증명책임을 부과하는 것은 권리구제의 범위를 지나치게 좁힐 우려가 있다. 셋째, 대법원이 이처럼 역학적 증거의 가치를 인정하는 데에 소극적인 까닭은 역학적 연구가 개인이 아닌 특정인구집단을 대상으로 한 것이기 때문으로 보인다. 그러나 역학적 증거가 집단의 구성원인 개인(들)에 대하여 가치 있는 정보를 제공하지 못한다고 단정하기에는 이르다. 예컨대, 역학에서 산출하는 인과확률은 집단 내에서 무작위로 뽑아낸 환자의 질병 발생이 위험인자에 의해 발생하였을 확률을 나타내는데, 이는 집단 차원의 확률을 구성원인 개인의 확률로 전환하는 유용한 지표이므로 역학적 증거만으로도 인과관계의 개연성을 증명할 여지가 있다고 생각된다.

• 대한간호학회지
• /
• 제7권2호
• /
• pp.1-10
• /
• 1977

Personalized Patient centered nursing care is increasingly difficult to achieve despite the fact that it remains one of our consistent goals. So, we must find away to individualized nursing care. One means, to achieve this is by use of the nursing history form, which has been developed to help the nurse make maximum use of her limited time with the patient, by obtaining systematically the information needed to plan his nursing care. The nursing history form can be used to collect data about individual nursing needs but also it lends itself to the collection of epidemiological data relevant to the needs of patient population. So this study was undertaken in an attempt to describe the general characteristics of the population studied, to find out their perceptions and expectations related to their illness and hospitalization, to find out specific basic needs and to examine the relationship between the patients nursing needs and demographic characteristics through the responses to the nursing history questions. The study population defined and selected was all the patients (70) who were admitted to Yonsei University Hospital from October 1 - 15, 1975. The direct interview method was used and the data were categorized by the investigator, according to the nature of responses to each question and were subjected to the percentile and the chi- square tests. The findings can be summarized as follows 11. General characteristics of the study population ; The population was made up mainly of urban patients who were highly educated. The age was equally distributed. 2. Patients, perceptions and expectations related to illness and hospitalization ; 88.6% of the patients knew about the reason for hospitalization but 64. 5% could state symptoms only. 37.5% recognized the cause of illness. Approximately three fourth of the patients expressed on expectation for early recovery. 60.0% of the patient responses indicated, that they expected less than 10 days of hospitalization. Of the total responses regarding hospitalization, 45.7% were negative about the post -hospitalization expectation, 45.7% expected to return to work. As a result of these findings, we can see that there is a great educational need, a psychological need and environmental need for adaptation to the hospital and a socio- economic need for the post - hospitalization period. 3. Specific basic needs : The physical needs include the problem of getting sufficient sleep (50.0%), difficulty in food intake(47.1%), problems with hospital diet (47.0%), abnormal condition of the skin(44.3%), problems with bowel elimination(35.7%), assistance with bathing(35.7%), pain(30.0%), difficulty in walking(30.0%) , difficulty in seeing(30.0%) problems in urinary elimination(20.0%) , and difficulty in hearing(10.0%), 4. Nursing needs and epidemiological characteristics ; Age distribution was related to the rendition of the mouth but no significant differences were observed statistically with the patients responses to the other nursing history questions according to the epidemiological variables of age, sex, education and residence.

• The Plant Pathology Journal
• /
• 제33권1호
• /
• pp.21-33
• /
• 2017

Citrus blast caused by bacterium Pseudomonas syringae is a very important disease of citrus occuring in many areas of the world, but with few data about genetic structure of the pathogen involved. Considering the above fact, this study reports genetic characterization of 43 P. syringae isolates obtained from plant tissue displaying citrus blast symptoms on mandarin (Citrus reticulata) in Montenegro, using multilocus sequence analysis of gyrB, rpoD, and gap1 gene sequences. Gene sequences from a collection of 54 reference pathotype strains of P. syringae from the Plant Associated and Environmental Microbes Database (PAMDB) was used to establish a genetic relationship with our isolates obtained from mandarin. Phylogenetic analyses of gyrB, rpoD, and gap1 gene sequences showed that P. syringae pv. syringae causes citrus blast in mandarin in Montenegro, and belongs to genomospecies 1. Genetic homogeneity of isolates suggested that the Montenegrian population might be clonal which indicates a possible common source of infection. These findings may assist in further epidemiological studies of this pathogen and for determining mandarin breeding strategies for P. syringae control.