• Title/Summary/Keyword: One Health

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A Study on the Perception Changes of Physicians toward Duty to Inform - Focusing on the Influence of the Revised Medical Law - (설명의무에 대한 의사의 인식 변화 조사 연구 -의료법 개정의 영향을 중심으로-)

  • Kim, Rosa
    • The Korean Society of Law and Medicine
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    • v.19 no.2
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    • pp.235-261
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    • 2018
  • The Medical law stipulates regulations about the physician's duty to inform to contribute to patient's self-determination. This law was most recently revised on December 20, 2016, and came into effect on June 21, 2017. There has been much controversy about this, and it has been questioned whether or not it will be effective for physicians to comply with the duty to inform. Therefore, this study investigated perceptions of physicians of whether they observed the duty to inform and their legal judgment about that duty, and analyzed how the revision of the medical law may have affected the legal cognition of physician's duty to inform. This study was conducted through an online questionnaire survey involving 109 physicians over 2 weeks from March 29 to April 12, 2018, and 108 of the collected data were used for analysis. The questionnaire was developed by revising and supplementing the previous research (Lee, 2004). It consisted of 41 items, including 26 items related to the experience of and legal judgment about the duty to inform, 6 items related to awareness of revised medical law, and 9 items on general characteristics. The data were analyzed using SAS 9.4 program and descriptive statistics, Chi-square test, Fisher's exact test and Binary logistic regression were performed. The results are as follows. • Out of eight situations, the median number of situations that did not fulfill the duty to inform was 5 (IQR, 4-6). In addition, 12 respondents (11%) answered that they did not fulfill the duty to inform in all eight cases, while only one (1%) responded that he/she performed explanation obligations in all cases. • The median number of the legal judgment score on the duty to inform was 8 out of 13 (IQR, 7-9), and the scores ranged from a minimum of 4 (4 respondents) to a maximum of 11 (3 respondents). • More than half of the respondents (n=26, 52%) were unaware of the revision of the medical law, 27 (25%) were aware of the fact that the medical law had been revised, 20(18%) had a rough knowledge of the contents of the law, and only 5(5%) said they knew the contents of the law in detail. The level of awareness of the revised medical law was statistically significant difference according to respondents' sex (p<.49), age (p<.0001), career (p<.0001), working type (p<.024), and department (p<.049). • There was no statistically significant relationship between the level of awareness of the revised medical law and the level of legal judgment on the duty to inform. These results suggest that efforts to improve the implementation and cognition of physician's duty to inform are needed, and it is difficult to expect a direct positive effect from the legal regulations per se. Considering the distinct characteristics of medical institutions and hierarchical organizational culture of physicians, it is necessary to develop a credible guideline on the duty to inform within the medical system, and to strengthen the education of physicians about their duty to inform and its purpose.

A Seroepidemiologic Study of Hepatitis A Virus in the Healthy Children and Adolescent in Kyonggi-do Province (경기도 지역의 건강한 소아와 청소년에서 A형 간염 바이러스의 항체 보유율에 대한 역학 조사)

  • Roh, Hye Ok;Sohn, Young Mo;Park, Min Soo;Choi, Boyoul;Bang, Keum Nie;Ki, Moran;Kim, Ji Hee
    • Pediatric Infection and Vaccine
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    • v.4 no.2
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    • pp.232-239
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    • 1997
  • Purpose: The incidence of hepatitis A virus(HAV) infection has markedly decreased in the last 20 years due to industrialization and improvements in the standard of living and hygiene in Korea. The reduction in seroprevalence rates indicates infection potential for young adult population, and a need for vaccinations in high-risk adults and children groups has been suggested. In this study we evaluated the seroprevalence rates and natural infection rates of hepatitis A in children and adolescent to obtain the basic data for vaccination of hepatitis A. Methods: A total of 334 children and adolescent subjects below 20 years old in Kyonggi-do province were examined for HAV antibody and seroprevalence rates in each age group was investigated. In 584 elementary school students residing in Kyonggi-do province, serum samples collected in 1993 and 1996 from the same subjects for investigation of natural seroconversion rates. Method of testing antibody was enzyme immunoassay. Results: 1) The seropositive rate of HAV in 334 subjects aged below 20 years old was 5.4%. According to age, the seropositive rates were 27.3% in infant group, 0.0% in 1~4 year-old group, 0.0% in 5~9 year-old group, 2.9% in 10~14 year-old group and 15.0% in 15~19 year-old group. 2) In the study of 584 elementary school children, only one subject showed seropositive in 1993, and in 1996 three different subjects showed seropositive results(0.5%); the natural seroconversion rate during 3 years was 0.5%. 3) The seroprevalence rates of below 20 year-old subjects reported in previous studies were 63.8% in 1979 and 47.3% in 1989 while the present study showed the rate at 5.4%. Conclusion: Since natural antibody formation is rarely occurring, there is a high risk for apparent hepatitis A infection in adults. Therefore vaccination in high risk groups is essential at present, and in order to reduce the chance for hepatitis A infection in adults, vaccination in children may be needed.

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Study on the Indoor-Outdoor $NO_2$ Levels and Related Factors in Urban Apartments (도시아파트의 실내외 $NO_2$ 농도와 관련요인에 관한 연구)

  • Suh, Byung-Seong;Kim, Sung-Hwan;Kim, In-Shik;Hur, Yun-Young;Do, Sou-Young;Kim, Jung-Man;Kim, Joon-Youn
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.3 s.58
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    • pp.609-622
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    • 1997
  • Nitrogen dioxide $(NO_2)$ has been regarded as one of the main elements among air pollutants, and we measured $NO_2$ levels of near gas range, kitchen, living room and outdoor on 489 apartments in Pusan area. $NO_2$ were sampled by using Palmes tubes (diffusion tube sampler) during August 16-25, 1995 (summer) and January 15-29, 1996 (winter), respectively. Authors wanted to know comparison of $NO_2$ levels in summer and winter, $NO_2$ levels categorized by variables, and variables affected to $NO_2$ levels. According to this study, we conducted to establish the degree of indoor-outdoor air pollution of urban apartments in Korea and methods to reduce indoor air pollution. The results of this study were summarized as follows: 1) Mean $NO_2$ levels of near gas range, kitchen, living room, and outdoor were $25.9{\pm}10.0ppb,\;23.3{\pm}8.0ppb,\;19.9{\pm}6.1ppb,\;and\;19.0{\pm}6.0ppb$ in summer, and $34.5{\pm}16.8ppb,\;28.2{\pm}13.4ppb,\;25.3{\pm}12.5ppb,\;21.8{\pm}9.8ppb$ in winter, respectively. 2) Mean $NO_2$ levels according to the floor levels were not significantly different in summer, and in winter, $NO_2$ levels were decreased as the floor levels were increasing, but those were increased above 16th floor. 3) Variables showing significant correlation(p<0.05) with $NO_2$ levels were as follows; Summer: floor level, family size, number of family during a meal, number using gas range during rice cooking per day, and natural ventilation. Winter: floor level, family size, number of person who have been respiratory disease in a house, number of family during a meal, total number of meals, and number using gas range during rice or side-dish cooking per day. 4) We suggest that the methods of reducing indoor $NO_2$ levels are ventilation during cooking, complete combustion, decreasing number and time of cooking, and substitution of fuels.

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Effects of Glue Sniffing on Weight Increase or Central Nervous System of Young Rat (반복된 본드 흡입이 백서의 정상발육에 의한 체중증가와 중추신경계에 미치는 영향)

  • Kim, Heon;Kim, Sun-Min;Cho, Soo-Hun
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.2 s.42
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    • pp.222-230
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    • 1993
  • Industrial glues, known as 'Bonds' in Korea, contain many kinds of organic solvents, and glue sniffing of youths became one of the social problems in Korea. Mixed exposures to solvents by glue sniffing may induce chronic toxicities different from those by exposures to solvents of single component. To test effects of the glue sniffing on weight gain or central nervous system, two groups of 20 male Sprague-Dawley rats were exposed to air(control group) or vapors of the glues to narcotic status(exposed group), and weight check, tail flick test, hot plate test, rotarod treadmill test were done on the 14th,24th, 36th, 45th, 53rd, 86th, 102nd, 117th, 134th and 151st days after the first exposure. On the 188th day, their brains were excised and examined by a pathologist. Weight gain, controlled against time change, showed significant difference between the groups, but response times in tail flick test, hot plate tests, and rotarod treadmill test didn't. In pathological examination with blind method, no macroscopic or microscopic differences were found between the two groups. These results suggests that organic lesion in central nervous system may not ensue glue sniffing, but, before firm conclusion, more studies in various exposure conditions should be followed.

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Prevalence Rate of Lead Related Subjective Symptoms in Lead Workers (연취급 근로자의 연폭로 수준에 따른 주관적 자각증상 호소율)

  • Jeong, Du-Shin;Kim, Hwa-Sung;Ahn, Kyu-Dong;Lee, Byung-Kook
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.2 s.42
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    • pp.251-267
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    • 1993
  • The relationship between lead related subject symptoms and lead exposure indices was studied in 435 male lead workers in thirteen lead using industries. 212 male office workers who were not exposed to lead occupationally were also studied as a control group. Fourteen lead related symptoms were selected. They were further subdivied into 4 sub-symptom groups such as 1) gastrointestinal, 2) neuromuscular and joint 3) constitutional, and 4) psychological symptoms. Symptom questionnaires were provided to the workers and filled up by themselves and reconfirmed by interviewer(doctor). The test used fer the evaluation of lead exposure were blood lead(PbB), zinc protoporphyrin in whole blood(ZPP), hemoglobin(Hb), hematocrit (Hct), delta-aminolevulinic acid in urine(DALA). The results obtained were as follows; 1. The higher prevalence rate in the sub-group of neuromuscular and joint symptoms was observed in occupationally lead exposed subjects than non-exposed subjects. Among the sub-groups, the most frequent symptom was 'numbness of finger, hands or feet', and the prevalence of the symptom of 'arthralgia', 'weakness of fingers, hands or feet' and 'myalgia' were higher in order. 2. While the symptom which showed the biggest difference of prevalence rate among the 14 symptoms between exposed and non-exposed subjects was 'numbness of fingers, hands or feet', the symptom which showed the highest prevalence rate was 'feeling tired generally' in exposed and non-exposed subjects, but no statistical difference of symptom prevalence were observed. 3. In total study population, PbB and ZPP had dose-response relationship with 4 symtoms of neuromuscular and joint symptoms ('numbness of finger, hands or feet', 'arthralgia', 'weakness of fingers, hands or feet' and 'myalgia') and one symptom of gastrointestinal group('intermittent pains in lower abdomen'). 4. In lead exposed workers, only neuromuscular and joint symptoms group showed dose-response relationship with PbB and ZPP, 5. In lead exposed workers, the prevalance rate of overall symptoms of lead workers with age below 39 years was higher than that of lead workers with age above 40. While neuromuscular and joint symptoms group had a dose-response relationship with PbB in former group, it had a dose-response relationship with ZPP in latter group. 6. Age adjusted odds ratios of symptoms of non-exposed with exposed and odds ratios of low exposed with high exposed workers showed the dose-response relationship of lead exposure with neuromuscular and joint symptoms group('numbness of fingers, hands or feet', 'arthralgia', 'weakness of fingers, hands or feet' and 'myalgia') and gastrointestinal symptoms group('intermittent pains in lower abdoman').

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Comparative Evaluation of 25-OH-VitD and 25-OH-VitD3 by Radioimmunoassay (방사면역 측정법에 의한 25-OH-VitD와 25-OH-VitD3의 비교 평가)

  • Lee, Young-ji;Park, Ji-hye;Lim, Soo-yeon;Cheon, Jun-hong;Lee, Sun-ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.24 no.1
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    • pp.33-38
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    • 2020
  • Purpose Vitamin D is essential for maintaining bone health, controling cell proliferation or differentiation, strengthening immune function by controlling calcium metabolism in the body. Vitamin D deficiency can lead to increase the risk of rickets, osteoporosis, cardiovascular disease, diabetes and cancer. Especially, South Korea is one of the highest population proportion of vitamin D deficiency. Accurate determination of levels of 25-OH-VitD or 25-OH-VitD3 in blood serum is required for the diagnosis and treatment of vitamin D deficiency. In this study, radioimmunoassay of 25-OH-VitD and 25-OH-VitD3 was performed and compared to evaluate the effectiveness of Vitamin D radioimmunoassay. Materials and Methods Serum 25-OH-VitD and 25-OH-VitD3 levels were measured using radioimmunoassay. The interrelationship, reproducibility and population distribution rate were evaluated. In addition, the internal quality control was performed at Asan Medical Center from April 2017 to June 2019 and the result of external quality control (Interagency proficiency evaluation) of first and second half of 2018 hosted by the Korean Society of Nuclear Medicine Technology (KSNMT). Both tests were measured by same manufacturer's reagent. Results 25-OH-VitD showed a strong positive correlation on 97 samples, as 25-OH-VitD3 x 0.9 + 0.3 (R>0.9). In repeated measurement, the average Diff(%) value of the reproducibility evaluation of 25-OH-VitD and 25-OH-VitD3 were 7.7% and 7.4%, respectively. Population distribution results showed no statistically significant differences(p>0.05). The resultant value of internal quality control, which measured from April, 2017 to June 2019 in Blood test room of Nuclear Medicine at Asan Medical Center, showed average (CV%) 6.2% and 6.8%, respectively. As a result of the external quality control (interagency proficiency evaluation) Z value obtained under 2.0, as shown below; Conclusion The interrelationship, reproducibility, population distribution rate, internal quality control and external quality control between 25-OH-VitD and 25-OH-VitD3 radioimmunoassay shows superior outcome. Radioimmunoassay, which can be alone measured in the blood as 25-OH-VitD or 25-OH-VitD3, is considered suitable screening tests for the diagnosis of vitamin D deficiency.

Comparison of Weekly and Batch Management System for Sows (모돈의 주간관리와 그룹관리 비교)

  • Jang, Young-Dal;Ju, Won-Seok;Long, Hong-Feng;Piao, Long-Guo;Jang, Sung-Kwon;Chung, Chung-Soo;Kim, Yoo-Yong
    • Journal of Animal Environmental Science
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    • v.15 no.2
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    • pp.171-182
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    • 2009
  • Conventionally, many pig producers have utilized a continual sow managements system that the matings, farrowings and weanings are done weekly basis. But this transitional method is not able to cut the cycle of diseases and fully apply all-in/all-out system because of the continuous flow of sows and pigs. Conventional weekly management system is currently limiting in small farm to work efficiently both for workers and pigs. Therefore, pig producers have found novel management methods for applying all-in/all-out system, improving pig health, leading to better growth, lowering mortality and reducing medication costs nowadays. Moreover, all-in/all-out pig management system has known as a strategy for improving productivity in swine farm. The batch system is one of the best management methods to adopt all-in/all-out pig management system that prevent spreading diseases in pig and remove cycle of diseases. Batch farrowing system is a concept for providing a group of sows that delivery within a specific farrowing interval and inducing a large enough scale of piglets to fill the weaner facilities. There are different types of batch farrowing system with batch size and interval of farrowing when several factors at the swine farm are considered such as total number of sows, available facilities in the farm, and the efficiency of workforce. Sow managements such as farrowing, weaning and breeding, every 3 weeks rather than weekly, 2 or 5-week interval have advantages for workers and reproductive cycle of sows as well as pig flow. Because there are several pros and cons both in weekly and batch management system, various factors should be considered to apply the most suitable management system in each individual farm. To improve poor swine productivity in Korea compared to ED, batch system for sows will be an alternative choice which is able to prevent high incidence of diseases in swine farm such as PMWS, PRRS, PRDC and PED because all-in/all-out pig management can be also applied automatically by using this management system.

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Contents and Estimated Intakes of Trans Fatty Acids in Korean Diet (한국인의 식품 중 트란스 지방산의 함량과 섭취량 추정)

  • Kim, Jong-Hee;Jang, Kyung-Won;Shin, Hyo-Sun
    • Korean Journal of Food Science and Technology
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    • v.32 no.5
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    • pp.1002-1008
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    • 2000
  • The purpose of this study was to provide the fundamental information for establishing the database needed to estimate total intakes of trans fatty acids in Korea. The amounts of trans fatty acids contained in 164 samples including 25 samples of margarines, 21 samples of shortenings, 19 samples of vegetable salad and cooking oils, 53 samples of confectionery products, 18 samples of bakery products, 19 samples of dairy products, and 9 samples of animal fats and meats were analyzed by capillary gas liquid chromatography. The average amounts of trans fatty acids in those foods were calculated and expressed as gram per one serving. Then, the average daily intakes of trans fatty acids per capita were estimated using the analyzed amounts of trans fatty acids and the amount of yearly production for those foods. The amounts of trans fatty acids per 100 g of lipids were $2.11{\sim}33.83%$ (14.66% on average) in margarines, $1.47{\sim}44.48%$ (14.21% on average) in shortenings, $0.18{\sim}3.82$ (1.54% on average) in vegetable salad and cooking oils, $0{\sim}45.81%$ (10.92% on average) in confectionery products, $0{\sim}18.32%$ (7.87% on average) in bakery products, $0.90{\sim}4.54%$ (2.27% on average) in dairy products, and $0.61{\sim}6.07%$ (2.24% on average) in animal fats and meats. Major isomers of trans fatty acid in the sample foods were $C_{18:1}$ and $C_{18:2}$. As a result, the korean average daily intake of trans fatty acids in korea was estimated to be 2.3 g per capita. The amounts of trans fatty acids consumed from each selected food were as follows: 0.35 g from margarines, 0.57 g from shortenings, 0.11 g from vegetable salad and cooking oils, 0.65 g from confectionery products, 0.07 g from bakery products, 0.14 g from dairy products and 0.21 g from animal fats and meats.

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Incorporation of $Acetate-1-^{14}C$ into Lipid of Rats Fed High Fat Diet (고지방식이(高脂肪食餌)에 따른 $Acetate-1-^{14}C$이 흰쥐의 체내지질(體內脂質)에의 편입도(編入度))

  • Rhee, Soon-Jae;Park, Hong-Koo
    • Journal of Nutrition and Health
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    • v.17 no.2
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    • pp.126-136
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    • 1984
  • The long-term effects of vegetable and animal high fat diet on the lipid metabolism were investigated in male weaning rats. The rats were fed one of four semipurified diet ad libitum : control diet supplied 12% of calories as fat(control group), low fat diet supplied 3% of calories as fat (3% F group), 45% corn oil diet supplied 45% calories from corn oil (45% C group) and 45% butte. fat diet supplied 45% calories from butter fat (45 % B group). Incorporation of $acetate-1-^{14}C$ into lipid of liver, serum and adipose tissue as well as exhalation of $^{14}CO_{2}$ from $acetate-1-^{14}C$ were observed in rats fed for 4,8 and 12 weeks. The weigh of epididymal adipose tissue of rats, fed 45% corn oil and 45% butter fat . from 4 weeks to 8 weeks were higher, but not different at 12 weeks, compared with those of control group. The weight of abdominal adipose tissue appeared to be similar to those of epididymal adipose tissue. Incorporations of $acetate-1-^{14}C$ into lipid of liver were remarkably decreased in high fat diet groups, especially in 45% C group, but in 3% F group were increased more than those of control group. Incorporations of $acetate-1-^{14}C$ into epididymal adipose tissue in 3% F, 45% C and 45% B group at 8 weeks were remarkably increased but not different at 12 weeks, compared with those of control group. The incorporation of {acetate-1-}^{14}C into abdominal adipose tissue appeared to be similar to those of epididymal adipose tissue. Incorporations of $acetate-1-^{14}C$ into lipid of serum in 45% C and 45% B group were reduced reasonably at 4 and 8 weeks of diet as compared with those of control group. Exhalation of $^{14}CO_{2}$ was increased to maximum level at 10 minutes after injection of $acetate-1-^{14}C$. Expiration of $^{14}CO_{2}$ in 45% C and 45% B group were higher than those in 3% F and control group for initial 5 minutes after injection, but expirations of $^{14}CO_{2}$ did not have significant difference among groups of diet since 10 minutes.

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Changes of Lipid Content and Histochemical Observation in Liver of Rats Fed High Fat Diet (고지방식이(高脂肪食餌)에 따른 흰쥐의 간장내(肝臟內) 지질함량변화(脂質含量變化)와 병리조직학적(病理組織學的) 소견(所見))

  • Rhee, Soon-Jae;Park, Hong-Koo
    • Journal of Nutrition and Health
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    • v.17 no.2
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    • pp.113-125
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    • 1984
  • The long-term effects of vegetable and animal high fat diet on the lipid metabolism were investigated in male weaning rats. The rats were fed one of four semipurified diet ad libitum : control diet supplied 12% of calories as fat(control group), low fat diet supplied 3% of calories as fat(3% F group), 45% corn oil diet supplied 45% calories from corn oil(45% C group) and 45% butter fat diet supplied 45% calories from butte. fat(45% B group). The weights of liver, content of triacylglycerol(TG), total cholesterol and phospholipid(PL) in liver were investigated. The weight of liver of rats, fed 45% corn oil at 12 weeks and fed 45% butter fat for all period of diet were higher than that of control group. The contents of TG in liver of rats, fed 45% corn oil from 8 weeks and fed 45% butter fat for all period of diet were higher than that of control group. The levels of TG in liver of rats fed 45% butter fat were higher than those of rats fed 45% corn oil. The contents of total lipid and cholesterol in liver of rats were increased with similar trend of TG level, but contents of PL in liver had no relation with the levels and types of dietary fat and feeding periods. The liver of rats were observed histochemically by light microscope. Mild to severe level of fatty changes in liver of 45% C and 45% B group were observed at 8 and 12 weeks of diet. The liver of rats in control group appeared to be healthy and normal electron-microscopically, but in fatty degenerated hepatocytes of 45% C and 45% B group, nuclear membranes were irregular and a great number of intracytoplasmic fat vacuoles in cells were variable in size and low in electon density. The numbers of lysosome were increased and secondary lysosomes among them were observed on electron microscope.

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