• Journal of agricultural medicine and community health
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• v.9 no.1
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• pp.56-66
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• 1984

Giardia lamblia is a pathogenic flagellate causing intestinal disorders such as diarrhea, abdominal pain and malabsorption of nutrients. Giardia is mainly infected by the ingestion of contaminated foods per os. Craun (1979) has recently reported that mass infection of this flagellate through the contaminated water supply systems is one of public health hazards. Also, so-called traveller's diarrhea is sometimes caused by Giardia infection (CDC, U.S.A., 1971). However, a few epidemiological studies figuring out the mode of infection or control measures of Giardia infection has been done so far in Korea. The present study was aimed to know the prevalence of Giardia infection in several Korean populations, detectability of this flagellate in water systems and the viability of the cysts against sewages and disinfectants applying to drinking water. In the present study, 388 stool specimens from orphanage children in Chun-joo, Chung-joo, On-yang and Chun-an areas and 538 stool specimens from inhabitants in Woo-do, In-chon, and Chun-joo were examined by formalin-ether concentration technique to detect out Giardia cysts. On the other hand, water samples from 14 sites of Han River and its tributaries were collected in May through July, 1984. Fifty liter of water sample in each sampling site was then filtered through water filtering system deviced by U.S. Environmental Proutection Agency and the sediments rinsed out from the thread rolls, a part of water filtering system, were examined to detect out the Giardia cysts. In order to observe the viability of Giardia cysts in the sewage samples, the cysts were treated in it at $4^{\circ}C$ or $25^{\circ}C$ for 7 through 28 days. For this purpose, the cysts were also exposed to various concentrations of disinfectants such as chlorine, iodine and ozone gas for proper time intervals. After treatment, the viability test of the Giardia cysts were carried out by method of Rice and Schaefer (1981) with minor modification. The results obtained in this study were as follows : 1) The detection rates of G lamblia cysts in the stool specimens were 18.3% in orphans and 4.3% in general examinees. 2) The prevalences of Giardia Infection were higher in the young age groups than in-adults. The highest positive rate was 18.4% in the age group less than 10. 3) Of 14 water specimens sampled from Han River system and its tributaries around the Seoul area, the Giardia cysts were detected from 4 samples, and no cyst was found in the water supply systems. 4) The cysts treated in the sewage survived for 28 days at $4^{\circ}C$ and for 13 days at $25^{\circ}C$. 5) The cysts were completely destroyed within 60 minutes by exposure to 8 mg/l of residual chlorine at 4g and within 30 minutes by exposure to the same concentration of chlorine at $25^{\circ}C$. 6) The cysts were all dead when exposed to 1 mg/1 of iodine for 60 minutes at $4^{\circ}C$ or $25^{\circ}C$. 7) The cysts were destroyed after 10 minute exposure in 0.15 mg to 0.25mg of residual ozone gas per liter. Summarizing the above results, it is considered that Giardia infection is regarded as water-borne disease and the cysts are able to be controlled by the application with the disinfectants in the water supply systems.

• Journal of Preventive Medicine and Public Health
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• v.22 no.2 s.26
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• pp.290-301
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• 1989

This is preliminary report on anthrax epidemic occurred in an island with about 100 residents. Since 1982 there had been sudden deaths among all kinds of domestic animals including cattle, dogs, ducks, chicken and goat but only a few among cats in an isolated island about three hours distance away by ferry boat from Mokpo city. From 1986 through 1988 nine human deaths and four patients occurred, which made the government intervene for investigation on June 25 1988. The epidemiological investigation consisted of interview survey and medical examination, medical record analysis, laboratory work to isolate the pathogens under the direction of hypothesis derived from the study and further confirmation of the pathogens by international institute. The summarized results are as followings: 1. According to the interview survey there were many deaths among domestic animals usually in cold and dry season such as January through March and September through November; 36 heads of cattle leaving one head, more than 40 hogs(all), hundreds of chicken leaving few alive, goats that had taken home from mountain and two or three cats out of around 40 had sudden deaths from 1982 till 1985, when the residents stopped to purchase and take them into the island anymore. Also there were eleven persons who had experienced the similar syndrome complex to those of admitted and expired patients and four of them revealed typical chest X-ray findings; from one of these four patients(Rho) B. anthracis is isolated. 2. Medical record on patients who had been admitted, showed common characteristics of the disease course. On admission they had either gastrointestinal or upper respiratory infection symptoms which invariably progressed to septicemic nature with pulmonary interstitial infiltration and mediastinal widening/bulging, and then to deadly acute respiratory distress syndrome. At the end stage chest X-ray revealed multiple bullous emphysema. One of another characteristics was oral ulceration with bleeding occurred in about 50% of the patients. Laboratory test results in common were leukocytosis with left shift and abnormal liver and kidney functions, particularly at the later stage of the illness. 3. Epidemiological characteristics was striking in that both mortality and incidence rates were high: the mortality rate was 8.7% average, male being three times higher than females but there was no distictive clustering by age group. The incidence rate for both sexes was 28.2% and there was no sex difference although a tendency of higher incidence among older ages was noticed. The highest mortality and incidence were observed in Won village where the first death of animal occurred and with the highest frequency among three villages of the island. 4. Among twelve bacilli species isolated from various specimens, two strains, one from patient and the other from soil where the recently died cow is hurried, were confirmed as B. anthracis by Pasteur Institute and CDC of USA(strain from soil). CDC reported that the strain did not produce capsule in bicarbonate media but reacted with the bacteriophage and one of five sera taken from the patients. Mode of transmission as well as incubation period of the agent has not been established yet, which needs further investigation in relation to the antigenic structure of the variant when it is confirmed.

• Journal of agricultural medicine and community health
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• v.11 no.1
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• pp.44-54
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• 1986

This study was aimed at investigating the health seeking behaviors of patients; For the purpose of analyzing the research theme we classified the study into two phase. First, the types of patients' health seeking behavior were categorized into a scheme according to what medical care resources were utilized in patients' coping process. Second, from patients' first visits to third visits to medical resources, we analyzed variations of factors which noted as crucial elements in constituting the patients' sickness career. To grasp the generalized characteristics from complicated empirical data, we limited the scope of our analysis to third stage of health seeking. A total of 121 persons who had beer suffering from chronic diseases more than 3 months was sampled among the residents of Banwol-Eup, the target Area of Korea University Health Project. The findings are as follows ; 1) In the course of visiting medical care resources, 34 different types of health seeking Behavior were found. From this result we inferred the idea that patients in Banwol-Eup had not any stable norms to cope with their pains. Clinics, hospital, pharmacy, Herb-doctors', folkways (self-treatment) were accessed by patients in orders. But more than half of patients who had utilized clinics or hospitals from their first to third visits, changed medical care resources to others, for example herb doctors or folkways, which had fundamentally different treatment models. Upon these two facts, the diversified types and capricious patterns in the health seeking behavior of Banwol patients, we observed a typical Shopping-Around phenomenon. 2) Factors which influenced patients' to their sickness career were changed along the courses of health seeking, from first to third visits as follows ; $\cdot$ Perceived seriousness of diseases were tended to decrease. $\cdot$ Professional medical personnel tended to be influencial in the patients' sickness career, (5.0%, 25.0% and 65.7%). The influence of the primary interaction groups such as parents, friends, neighbours, tended to decrease ; (90.9%, 71.2% and 30.0%). $\cdot$ The subjective reasons why to choose such a medical care resource were related to economic affordability and disease-itself as main motives. Credibility of health resources tended to increase 14.9%, 24.0% and 31.4 sequently. $\cdot$ Geographic accessibility factors did not change significantly. Most of patients had utilized health resources in Banwol and Anyang area. 3) Cultural inclination in the shopping-around phenomenon has shown difference among age groups. The age group' over 50 years' preferred traditional health resources to modern health resources. 4) Consistency of health seeking behavior on the shopping around phenomenon has shown difference according to the degrees of patients' economic affordability and those of psychological satisfaction toward modern health services. However, there were some restrictions in this thesis ; a) the study was limited to the 3rd health seeking career so it did not allow us to collect more informations after that, b) the study was not able to carry out causal analysis on patients health behavior determinated by explanatory model of health resources, and c) the study was not able to take into consideration of factors connected with social structural circumstances. Despite of restrictions described above, we are sure that this thesis would promote health providers' understanding toward patients' inclinations, through which they could provide efficient and accurate medical service.

• Clinical and Experimental Pediatrics
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• v.48 no.10
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• pp.1061-1067
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• 2005

Purpose : We studied a clinical analysis of pediatric patients who visited the emergency medical center of Yeungnam University Hospital to compare the characteristics of pediatric emergency patients after year 2000 with the previous studies. Methods : We reviewed 7,034 children under the age of 15 years who visited the emergency medical center of Yeungnam University Hospital during the 2 year period from January 2001 to December 2002, and then we performed a clinical and statistical analysis. We analyzed the pediatric patients according to gender, age, season, day of the week, time of the visit, the disease classification and the final disposition of the patients. Results : Among the patients who visited the emergency room, 15.6% of the total emergency patients were under the age of 15. The male to female ratio was 1.6 : 1. Among the 7,034 pediatric patients, the most common age group was between 1 year and under 3 years of age(26.9%). The peak seasonal incidence was early summer and spring, especially during June(11.2%) and May(10.6 %). The peak incidence day of the week was Sunday(24.8%) and the peak time when the emergency pediatric patients visited the emergency room was between 20 and 24 o'clock(28.8%). The distribution of diseases, according to ICD-10 system, were injury and poisoning(30.4%), diseases of the respiratory system(22.8%), and diseases of the digestive system(14.6%). 30% of total pediatric patients were admitted to the hospital. Conclusion : After year 2000, as compared with the previous studies, the proportions of emergency pediatric patients has decreased. The distribution of diseases was not much different from the previous studies and the proportions of non-urgent diseases, such as acute nasopharyngitis or acute gastroenteritis, were still high. These result have come about due to the declining birth rate and changes of the medical system in Korea.

• Journal of Chest Surgery
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• v.40 no.6 s.275
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• pp.435-440
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• 2007

Background: Primary malignant lymphoma of the lung is a very rare neoplasm. Although the prognosis of lymphoma is favorable, the clinical features, prognostic factors and management have not been clearly defined. Material and Method: We retrospectively reviewed the records of 8 patients we managed between 1994 and 2000. They all had malignant lymphoma on the pathologic examination of the lung wit no evidence of mediastinal adenopathy and extrathoracic disease, and no past history of lymphoma. Result: The study group consisted of 3 males and 5 female patients with a mean age of 53.9 years. Three patients were asymtomatic and 5 patients were seer with pulmonary or systemic symptoms. The diagnostic methods were 3 CT needle aspiration biopsies, 1 bronchoscopic biopsy and 4 surgical methods (wedge resection, lobectomy). There were 3 patients with MALT lymphoma, two with diffuse large B-cell lymphoma, two with small lymphocytic lymphom, and one with follicular lymphoma. The 8 patients were treated with a variety of modalities, including surgery, chemotherapy, radiotherapy and combination therapy. The 8 patients have survived for a median follow-up of 38 months. Conclusiian: Although this entity of lymphoma appears to have a good prognosis, further clinical experience and long-term follow-up are needed to identify its clinical features, prognostic factors and management.

• Journal of dental hygiene science
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• v.18 no.6
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• pp.357-366
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• 2018

The purpose of this study was to evaluate the validity of dental hygienist job according to judgment standard of medical practice in medical law. In this study, we conducted a self-administered questionnaire survey to evaluate the validity of dental hygienist job for 12 professors of dental college in Gangneung-Wonju National University from November 10 to 20, 2017. We investigated whether the dental hygienist job conforms to the three criteria of medical practice such as disease prevention and treatment, patient care, and health hazard. The response rates were scored and classified into four categories according to the final score. As a result of this study, dental hygienist job are classified into four categories according to judgment standard of medical practice. The higher the level of the category, the higher the degree of difficulty, and the higher the level of expertise and skills required. More than 50% of respondents answered that measuring the gingival pocket, bleeding on probing, professional tooth cleaning, oral health education, counseling after dental treatment are all three criteria for medical treatment. And these were classified into Level 4 group which requires the difficulty and expertise in the final score 4.3. It is necessary to develop and utilize standardized guidelines on the level of knowledge, education, and qualification standards required for dental practice in order to effectively allocate work among the dental personnel while ensuring the health rights of patients in the dental clinic field in Korea. In addition, there is a need to evaluate the various aspects of cost effectiveness, dental health service productivity, and health promotion contribution to dental hygienist jobs, And based on this evidence, it is necessary to continue to expand and adjust the dental hygienist job and to reorganize the dental workforce system.

• Clinical and Experimental Pediatrics
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• v.49 no.3
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• pp.258-267
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• 2006

Purpose : We have done this retrospective study to know the relative incidence and clinical manifestations of organic acidopathies in Korea during 8 years(from Jul. 1997 to May 2005). This results of organic acid analysis of 1,787 patients were compared with the results of organic acid analysis that were published three years ago. Methods : The results of quantitative organic acid analysis of samples of 1788 patients, referred from Jul. 1997 to May 2005, were analyzed retrospectively according to four age group(-2 mon, 3 mon-2 years, 3-12 years) and major clinical manifestations. Quantification of 83 organic acids was done with gas chromatography and mass spectometry. Results : We diagnosed 470 patients with 27 diseases of organic acid metabolism during this study period. Diseases found more than 10 cases are cytosolic 3-ketothiolase deficiency, mitochondrial respiratory chain disorders, PDHC deficiency, mitochondrial 3-ketothiolase deficiency, glutaric aciduria type II, biotinidase deficiency, methylmalonic aciduria and propionic aciduria. Other diseases were diagnosed in less than 10 cases. Conclusion : Though the incidence of individual organic acidemia is low, the overall incidence of organic acidemia as a whole seems to be relatively high in Korea. Compared with the results of organic acid analysis that were reported three years ago, we couldn't find a new disease and the difference of the relative incidences of high incident diseases. We were apprehensive of the errors that was owing to the short study period(3 years), but the relative incidences of our study(8 years) were similar to the results of organic acid analysis that were reported three years ago.

• Journal of Korean society of Dental Hygiene
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• v.2 no.1
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• pp.63-83
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• 2002

The purpose of this study was to serve as a basis for more efficient dental hygienist human resources utilization and for determining some of the right directions for supplementary education for dental hygienists, by examining how they actually worked and what they thought of job-related things. The subjects in this study were 537 dental hygienists who participated in a seminar by the Korea Dental Hygienist Association. After a survey was conducted, the following findings were given: 1. 50.2% of the dental hygienists investigated completed legally required eight-class education. Those who worked in clinics took less supplementary education classes than the others in the other types of dental institutions. The main reason they didn't receive supplementary education was financial burden and uncooperative employers. 73.2% took supplementary education at the association or its branches. The association was most favored by those in clinical sector as a place that provides supplementary education, followed by its branch and university in the order named. And the dental hygienists in public health sector preferred university most, and the next best favored one was the association and its branch in the order named. Those in clinical sector hoped to acquire clinical information on patient management, implant or aesthetics, and the dental hygienists in public health sector wanted to learn about health administration, public oral health operations and oral health education, which were different from what those in clinical sector wanted. 2. Regarding the period of service, 492% had worked for three years or more. This fact suggested that their service term and average age continued to grow. And they thought they would decide the retirement time on their own. 3. The most common yearly income ranged from 12 million won to 16 million won(40.7%). For-those in clinics, yearly income was 14.36 million won, and that of the dental hygienists who had worked for less than 3 years was 12.90 million won. 4. The Korea Dental Hygienist Association was most required to protect the rights and interests of the members and offer new knowledge and technology. 5. The largest group of them were engaged in patient management, and this type of job also was the most favored one for them to do. The greatest number of the dental hygienists in public health sector were in charge of dental treatment. 6. Concerning their turnover rate, 492% had never changed their occupation. Specifically, 70.0% of the respondents who had worked for less than 3 years had have no experience to do that. The time constraints for self-development and conflicts with other workers were the cause of their turnover. Those in dental hospital and general hospital changed their occupation chiefly due to the lack of time for self-development, and for the dental hygienists in clinics, the conflicts with other workers were the main reason. The above-mentioned findings suggested that the way the dental hygienists looked at things was undergoing change. The service area made a difference to their preference for the type of supplementary education and institution in charge of it, as those in public health and clinical sectors had a different opinion. And the dental hygienists in clinical sector had a different opinion as well, according to service area, about salaries, reason of not taking supplementary education, preferred type of supplementary education, cause of turnover, and type of occupation to which they hoped to change employment. To utilize and supply human resources in a more stabilized manner, job description should be more segmented, standardized and classified clearly, and dental hygienists should be motivated to perform their substantial jobs, including oral disease prevention, oral prophylaxis and oral health education. To make it happen, it seems that dentists are required to have a clear understanding of dental hygienist job and to change the way they look at it.

• Journal of Gastric Cancer
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• v.5 no.3 s.19
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• pp.152-157
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• 2005

Purpose: A total gastrectomy is generally peformed for the treatment of upper third gastric cancer. However, the optimal extent of resection for early-stage upper third gastric cancer is still controversial. In this research, we compared the nutritional status and the quality of life in patients who underwent a total gastrectomy with uncut Roux en Y esophagojejunostomy with those in patients who underwent a proximal gastrectomy with esophagogastrostomy for treatment of upper third gastric cancer. Materials and Methods: We reviewed 50 patients with no evidence of recurrent disease following curative surgery for upper third gastric cancer. Among this group, 25 patients underwent a total gastrectomy (TG) and 25 patients a proximal gastrectomy (PG). 8 TG and 4 PG patients were excluded from this study because of death, refusal to interview etc. The nutritional status was assessed by measuring body weight, serum albumin, serum hemoglobin, and serum total protein. The gastrointestinal function and the quality of life were assessed by Cuschieri grading and modified Visick qrading. Results: In analysis of covariance of age and preoperative serum albumin, PG patients demonstrated lower weight loss (P=0.038), elevated serum albumin (P=0.049), and better outcome based on modified Visick grading (P=0.016) than TG, but there were no significant differences in the serum hemoglobin change (P=0.165), serum total protein change (P=0.435), and Cuschieri grading (P=0.064) between the preoperative and the postoperative data. Conclusion: In this study, a proximal gastrectomy led to a better nutritional status and quality of life than a total gastrectomy, as judged from the low weight loss, elevated serum albumin and better modified Visick grade.

• Tuberculosis and Respiratory Diseases
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• v.50 no.5
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• pp.568-578
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• 2001

Background : Lung cancer is frequently cited as an example of a disease caused solely by exposure to environmental carcinogens. However, there is a growing realization that the genetic constitution is also important in determining individual's susceptibility to lung cancer. This genetic susceptibility may result from functional polymorphims of the genes involved in carcinogen metabolism. In this study, the association between GSTM1 and CYP1A1 polymorphisms and the lung cancer risk in Korean males was investigated. Materials and Method : The study population consisted of 153 male lung cancer patients and 143 healthy male controls. The GSTM1 and CYP1A1 genotypes were determined by multiplex PCR and PCR-RFLP analysis. Result : There were no significant differences in the frequency of the GSTM1 null genotype between the cases and the controls. When the cases were categorized by their histologic type, the frequency of the GSTM1 null genotype in the small cell carcinoma group was higher than those of the controls(67.2% vs 55.9%), but the difference was not statistically significant(OR=1.772 ; 95% CI=0.723-4.340). The distribution of the CYP1A1 MspI genotypes among the cases were similar to those among the controls. When the cases were grouped by their histologic type, the ml/m1, ml/m2, m2/m2 genotypes frequencies among the small cell carcinomas(23.0%, 38.5%, and 38.5%, respectively) were significantly different from those of the controls(36.4%, 46.2%, and 7.4%, respectively, p<0.05). When the m1/m1 genotype was used as a reference, the ml/m2 and m2/m2 genotypes were associated with an increased risk for small cell lung cancer(ml/m2 genotype : OR=1.337, 95% CI=0.453-3.947 ; m2/m2 genotype : OR=3.374, 95% CI=1.092-10.421). Conclusion : These results suggest that the GSTM1 and CYP1A1 genotypes may be a genetic determinant of the risk for lung cancer, particlulary small cell carcinoma. Further investigation is needed to confirm these results.