• Journal of Preventive Medicine and Public Health
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• v.7 no.1
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• pp.29-94
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• 1974

Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

• Management & Information Systems Review
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• v.23
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• pp.41-74
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• 2007

In Korea, corporate merger activities were activated since 1980, and nowadays(particuarly since 1986) the changes in domestic and international economic circumstances have made corporate managers have strong interests in merger. Korea and America have different business environments and it is easily conceivable that there exists many differences in motives, methods, and effects of mergers between the two countries. According to recent studies on takeover bids in America, takeover bids have information effects, tax implications, and co-insurance effects, and the form of payment(cash versus securities), the relative size of target and bidder, the leverage effect, Tobin's q, number of bidders(single versus multiple bidder), the time period (before 1968, 1968-1980, 1981 and later), and the target firm reaction (hostile versus friendly) are important determinants of the magnitude of takeover gains and their distribution between targets and bidders at the announcement of takeover bids. This study examines the theory of takeover bids, the status quo and problems of merger in Korea, and then investigates how the announcement of merger are reflected in common stock returns of bidding firms, finally explores empirically the factors influencing abnormal returns of bidding firms' stock price. The hypotheses of this study are as follows ; Shareholders of bidding firms benefit from mergers. And common stock returns of bidding firms at the announcement of takeover bids, shows significant differences according to the condition of the ratio of target size relative to bidding firm, whether the target being a member of the conglomerate to which bidding firm belongs, whether the target being a listed company, the time period(before 1986, 1986, and later), the number of bidding firm's stock in exchange for a stock of the target, whether the merger being a horizontal and vertical merger or a conglomerate merger, and the ratios of debt to equity capital of target and bidding firm. The data analyzed in this study were drawn from public announcements of proposals to acquire a target firm by means of merger. The sample contains all bidding firms which were listed in the stock market and also engaged in successful mergers in the period 1980 through 1992 for which there are daily stock returns. A merger bid was considered successful if it resulted in a completed merger and the target firm disappeared as a separate entity. The final sample contains 113 acquiring firms. The research hypotheses examined in this study are tested by applying an event-type methodology similar to that described in Dodd and Warner. The ordinary-least-squares coefficients of the market-model regression were estimated over the period t=-135 to t=-16 relative to the date of the proposal's initial announcement, t=0. Daily abnormal common stock returns were calculated for each firm i over the interval t=-15 to t=+15. A daily average abnormal return(AR) for each day t was computed. Average cumulative abnormal returns($CART_{T_1,T_2}$) were also derived by summing the $AR_t's$ over various intervals. The expected values of $AR_t$ and $CART_{T_1,T_2}$ are zero in the absence of abnormal performance. The test statistics of $AR_t$ and $CAR_{T_1,T_2}$ are based on the average standardized abnormal return($ASAR_t$) and the average standardized cumulative abnormal return ($ASCAR_{T_1,T_2}$), respectively. Assuming that the individual abnormal returns are normal and independent across t and across securities, the statistics $Z_t$ and $Z_{T_1,T_2}$ which follow a unit-normal distribution(Dodd and Warner), are used to test the hypotheses that the average standardized abnormal returns and the average cumulative standardized abnormal returns equal zero.

• Journal of Korean Public Health Nursing
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• v.14 no.2
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• pp.246-259
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• 2000

The purpose of this study was to assess the provided home health care services and to evaluate the patient's satisfaction level of received home health care services. Well trained two home health care nurses interviewed with 138 respondents who received home health care by Keimyung University Hospital from January 1st to August 31st 1999. The results were summarized as follows : 1) Among 138 respondents, $55.8\%$ were mail and $44.2\%$ were female and $70.3\%$ of them were over sixty years old. Respondents main family care givers were spouse$(53.6\%)$, daughters and sons$(36.2\%)$ and parents$(7.2\%)$. 2) $60.2\%$ of cancer patients received home health care services, $23.3\%$ of cerebral­cardiovascular patients, $7.5\%$ of endocrine disorder patients, $2.3\%$ of those who have indwelling foley catheter patients, $1.5\%$ of those who have respiratory problems and others$(5.2\%)$. 3) $88.1\%$ of respondents were satisfied with the number of home visits they received. $50.5\%$ of respondents' were received 1 to 3 times of home visits by home health care nurse per month. $48.6\%$ of respondents answered they were introduced by attending doctors or nurses to home health care services. $55.8\%$ of respondents answered registration to home health care services was simple and easy. $97.4\%$ of respondents answered home health care payment system was adequate. $64.9\%$ of respondents answered the cost of home health care per visit was adequate and comfortable. 4) Health education, counselling, physical assessment was provided to most of the patients. Those who suffered with cerebral-cardiovascular disease was needed hands on direct care most of all. The least home health care service provided was medication. 5) The satisfaction measurement tool was composed with 13 items and 3 score scale. The mean score of satisfaction on provided home health care services was 2.67 out of 3. Among 13 items. 'home health care service was kind enough' was highest(2.84). 'nurse use precise word to understand and communicate'. 'nurse gave home visiting notice ahead of time and kept the home visiting promise on time' was 2.83. 'whenever I need home health care nurse I can give a call and meet the nurse' was lowest 2.41. Special Home Health care programs such as comprehensive hospice care programs for elders over sixty years old should be organized. Adequate and standardized home health care payment system should be developed as soon as possible. In korean family situation. when family members are getting sick and stay at home. family members were taking care of the patients. special program such as counselling family members are needed.

• Korean Journal of Ichthyology
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• v.26 no.4
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• pp.310-321
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• 2014

Change in fish species composition after the Hebei Spirit oil spill in December 2007 off Taean were determined by analysis of samples collected in Mailpo beach, 10 km south from the oil spill site and polluted by the crude oil. Fish samples were collected by a beach seine in the shallow water at Malipo beach during the low tide of the new moon from February 2008 to December 2009. Five seine hauls were made during the day and the night in each sampling time. Monthly day and night samples did not show the significant differences in species composition. A total of 21 species, 1,032 individuals and 6,544 g of fish were collected in 2008, and 31 species, 4,206 individuals and 35,659 g of fish in 2009. The species collected were composed of the small-sized fish or juveniles. Abundant fishes were the resident species in coastal water, and the migrants were low in abundance. Among the fish occurred, Chelon haematochelius, Sebastes schlegelii, Takifugu niphobles and Pleuronectes yokohamae were predominated in abundance of both years. Monthly fish abundance and species diversity in 2008 were significantly lower than those in 2009. A few number of resident fish were collected from February to June 2008 showing the lowest in May 2008, and fish abundance increased from July 2008. The number of species and abundance of fish in 2009 were increased in spring as the temperature raised, showed a peak in summer and decreased in autumn. This monthly variation in fish species composition and abundance was similar to those in the non-polluted water in other temperate waters. Low fish abundance during several months after oil spill was considered to be related to the residual oil in the water and habitat disturbance due to oil cleaning activity in the beach. Monthly fish species compositions after September 2008 were similar to those of 2009 suggested that the impact on the shallow water fish by the oil residuals was not too significant at least to the fish species composition after September 2008.

• The Korean Journal of Air & Space Law and Policy
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• v.24 no.1
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• pp.153-194
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• 2009

The resources of outer space are for the common exploitation of mankind, and it is a common responsibility of mankind to protect the outer space environment. With the rapid development of space science and technology, and especially with the busy space activities of some major space powers, environmental contamination or space debris is steadily increasing in quantity and has brought grave potential threats and actual damage to the outer space environment and human activities in space. Especially We must mitigate and seek out a solution to remove space debris which poses a threat directly to man's exploitation and use of outer space activities in the Low Earth Orbit (LEO) and in the Geostationary Orbit (GEO), through international cooperation and agreement in the fields of space science, economics, politics and law, in order to safeguard the life and property of mankind and protect the earth's environment. While the issue of space debris has been the subject of scientific study and discussion for some time now, it has yet to be fully addressed within the context of an international legal framework. During the earlier stages of the space age, which began in the late 1950s, the focus of international lawmakers and diplomats was the establishment of basic rules which sought to define the legal nature of outer space and set out the parameters for space activities and the nature and scope of activities carried out in outer space were quite limited. Consequently, environmental issues and the risks that might arise from the generation of space debris did not receive priority attention within the context of the development international space law. In recent years, however, the world has seen dramatic advances in technology and increases in the type and number of space-related activities which are being carried out. In addition, the number of actors in this field has exploded from two highly developed States to a vast array of different States, intergovernmental and nongovernmental organizations, including private industry. Therefore, the number of artificial objects in the near-Earth space is continually increasing. As has been previously mentioned, COPUOS was the entity that created the existing five treaties, and five sets of legal Principles, which form the core of space law, and COPUOS is clearly the most appropriate entity to oversee the creation of this regulatory body for the outer space environmental problem. This idea has been proposed by various States and also at the ILA Conference in Buenos Aires. The ILA Conference in Buenos Aires produced an extensive proposal for such a regulatory regime, dealing with space debris issues in legal terms This article seeks to discuss the status of international law as it relates to outer space environmental problem and space debris and indicate a course of action which might be taken by the international community to develop a legal framework which can adequately cope with the complexity of issues that have recently been recognized. In Section Ⅱ,Ⅲ and IV of this article discuss the current status of international space law, and the extent to which some of the issues raised by earth and space environment are accounted for within the existing United Nations multilateral treaties. Section V and VI discuss the scope and nature of space debris issues as they emerged from the recent multi-year study carried out by the ILA, Scientific and Technical Subcommittee, Legal Subcommittee of the United Nations Committee on the Peaceful Uses of Outer Space ("COPUOS") as a prelude to the matters that will require the attention of international lawmakers in the future. Finally, analyzes the difficulties inherent in the future regulation and control of space debris and the activities to protect the earth's environment. and indicates a possible course of action which could well provide, at the least, a partial solution to this complex challenge.

• Korean Journal of Poultry Science
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• v.30 no.4
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• pp.235-244
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• 2003

This study was carried out to estimate the effects of strain and generation on the major production performances of Korean native chicken. The data were collected from 11,583 birds of the 7 generations over the year 1995 through 2001 at National Livestock Research Institute, Korea. Results obtained were summarized as follows: The body weights at 150 and 270 days of age were 1,557.7 and 1880.7, 1,471.7 and 1,738.2, 1,393.5 and 1,694.9, 1,591.2 and 1,910.0, 1,545.6 and 1,763.6g in Red Brown, Yellow Brown, Gray Brown, Black, and White strains, respectively. The Coefficient of Variations (CVs) of the body weights at 150 and 270 days of age were 9.65~13.79% and 13.29~15.16%. The ages at first egg were 150.0, 148.3, 149.5, 152,8 and 147.7 days in Red Brown, Yellow Brown, Gray Brown, Black and White strains, respectively and the CVs were between 9.33 and 10.11%. The egg weights at the first egg and 270 days of age were 33.2 and 50.8, 32.2 and 49.2, 32.2 and 49.1, 33.0 and 50.0, 30.7 and 47.8g respectively. The CVs of the egg weights of the first egg and at 270 days of age were 13.54~15.27% and 6.93~7.36%. The numbers of eggs produced by 270 days of age were 77.0, 79.3, 77.3, 73,7, 75.4, respectively, and observed CVs were between 29.98~36.99%. The significant strain effects were investigated in all the major economic traits in Korean native chicken. The significant strain effects were investigated in all the major economic traits in Korean native chicken. The highest least square (LS) means of the body weights at 150 and 270 days of age were observed in Black strain as 1,594.38 and 1,911.57g. The earliest LS mean of the ages at first egg was 146.88days in White strain. The heaviest LS means of egg weights at the first egg and 270 days of age were observed in Red Brown strain as 32.20 and 50.74g. The LS mean of the largest number of egg production was 79.50 eggs in Yellow Brown strain. Also, The significant generation effects were investigated in all the major economic traits. The highest LS means of the body weights at 150 and 270 days of age were observed in the generation 3 as 1,599.74 and 1,905.01g. The earliest LS mean of the age at first egg was 143.31 days in 4th generation. The heaviest LS means of egg weights at the first egg and 270 days of age were observed in 7th and 5th generation as 35.68 and 50.42g. The LS means of the largest number of egg production was 78.53 eggs in generation 6. In general, light body weight, short time for the age at first egg, heavy egg weight, and large number of egg production were observed as the generation proceeded.

• Economic and Environmental Geology
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• v.44 no.5
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• pp.413-431
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• 2011

An Epithemal Au-Ag mineralized zone is developed in the Moisan area of Hwangsan-myeon, Haenam-gun, Jeol-lanam-do, Korea, which is located in the southwestern part of the Ogcheon metamorphic zone. It is hosted in the Hwangsan volcaniclastics of the Haenam Formation of the Late Cretaceous Yucheon Group. This research investigated the characteristics of bedding arrangement, fold, fault, fracture system, quartz vein and the time-relationship of the fracture system to understand the geological structure related to the formation of the mineralized zone. On the basis of this result, the tectonic environment at the time of the mineralization was considered. Beds mainly trend east-northeast and gently dip into north-northwest or south-southeast. Their poles have been rearranged by subhorizontal-upright open fold of (east)-northeast trend as well as dip-slip fault. Fracture system was formed through at least 6~7 different deformation events. D1 event; formation phase of the main fracture set of EW (D1-1) and NS (D1-2) trends with a good extensity, D2 event; that of the extension fracture of NW trend, and conjugate shear fracturing of the EW (dextral) and NS (sinistral) trends, D3 event; that of the extension fracture of NE trend, and conjugate shear refracturing of the EW (sinistral) and NS (dextral) trends, D4 event; that of the extension fracture of NS trend showing a poor extensity, D5 event; that of the extension fracture of NW trend, and conjugate shear refracturing of the EW (dextral) and NS (sinistral) trends, D6 event; that of the extension fracture of EW trend showing a poor extensity. Frequency distribution of fracture sets of each deformation event is D1-1 (19.73 %)> D1-2 (16.44 %)> D3=D5 (14.79 %)> D2 (13.70 %)> D4 (12.33 %)> D6 (8.22 %) in descending order. The average number of fracture sets within 1 meter at each deformation event is D6 (5.00)> D5 = D4 (4.67)> D2 (4.60)> D3 (4.13)> D1-1 (3.33)> D1-2 (2.83) in descending order. The average density of all fractures shows 4.20 fractures/1 m, that is, the average spacing of all fractures is more than 23.8 cm. The frequency distribution of quartz veins at each orientation is as follows: EW (52 %)> NW (28 %)> NS (12 %)> NE (8 %) trends in descending order. The average density of all quartz veins shows 4.14 veins/1 m, that is, the average spacing of all quartz veins is more than 24.2 cm. Microstructural data on the quartz veins indicate that the epithermal Au-Ag mineralization (ca. 77.9~73.1 Ma) in the Moisan area seems to occur mainly along the existing D1 fracture sets of EW and NS trends with a good extensity not under tectonic stress but non-deformational environment directly after epithermal rupture fracturing. The D1 fracturing is considered to occur under the unstable tectonic environment which alternates compression and tension of NS trend due to the oblique northward subduction of the Izanagi plate resulting in the igneous activity and deformation of the Yucheon Group and the Bulguksa igneous rocks during Late Cretaceous time.

• Korean journal of applied entomology
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• v.26 no.4 s.73
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• pp.221-228
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• 1987

The optimum temperature range for conidial germination of Pyriculacia oryzae on a slide glass was $26{\sim}30^{\circ}C$, at which at least four hours of leaf wetness period was required to germinate. Conidial germination was significantly reduced under dry conditions (relative humidity<85%) at $34^{\circ}C$ but not at lower temperature (18, 22, 26, $30^{\circ}C$). Number of lesions developed were greater at $26^{\circ}C$ than at other temperature tested. The average leaf wetness period required for production of a lesion per plant was 22 hours at $18^{\circ}C$, 16 hours at $22^{\circ}C$, 10 hours at $26^{\circ}C$, and 8 hours at $30^{\circ}C$. Less than one lesion per plant occurred at $34^{\circ}C$ even under 24 hours of leaf wetness period. The time period between inoculation and lesion appearance was $7{\sim}8$ days at $18^{\circ}C$, $4{\sim}5$ days at $22^{\circ}C$ and $26^{\circ}C$, and $3{\sim}4$ days at $30^{\circ}C$. The time period required for lesion appearance after inoculation was not affected by leaf wetness period and relative humidity. Lesion length increased most rapidly at $30^{\circ}C$ during the first four days after lesion appearance. Thereater, the rate of increase in lesion length was geratest at $26^{\circ}C$. The average increment of lesion length per day when relative humidity was greater than 90% was 0.7mm at $18^{\circ}C\;and\;22^{\circ}C$, 1mm at $26^{\circ}C$, and 0.8mm at $30^{\circ}C$. When relative humidity was less than 85%, the increments of lesion length per day were approximately $50{\sim}60%$ of those under humid conditions (relative humidity>90%) at all temperature regimes except $30^{\circ}C$. Relative humidity did not significantly affected lesion length at $30^{\circ}C$.

• Tuberculosis and Respiratory Diseases
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• v.57 no.4
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• pp.329-335
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• 2004

Background : The Sequential Organ Failure Assessment (SOFA) score can help to assess organ failure over time and is useful to evaluate morbidity. The aim of this study is to evaluate the performance of SOFA score as a descriptor of multiple organ failure in critically ill patients in a local unit hospital, and to compare with APACHE III scoring system. Methods : This study was carried out prospectively. A total of ninety one patients were included who admitted to the medical intensive care unit (ICU) in Chuncheon Sacred Heart Hospital from May 1 through June 30, 2000. We excluded patients with a length of stay in the ICU less than 2 days following scheduled procedure, admissions for ECG monitoring, other department and patients transferred to other hospital. The SOFA score and APACHE III score were calculated on admission and then consecutively every 24 hours until ICU discharge. Results : The ICU mortality rate was 20%. The non-survivors had a higher SOFA score within 24 hours after admission. The number of organ failure was associated with increased mortality. The evaluation of a subgroup of 74 patients who stayed in the ICU for at least 48 hours showed that survivors and non-survivors followed a different course. In this subgroup, the total SOFA score increased in 81% of the non-survivors but in only 21% of the survivors. Conversely, the total SOFA score decreased in 48% of the survivors compared with 6% of the non-survivors. The non-survivors also had a higher APACHE III score within 24 hours and there was a correlation between SOFA score and APACHE III score. Conclusion : The SOFA score is a simple, but effective method to assess organ failure and to predict mortality in critically ill patients. Regular and repeated scoring enables patient's condition and clinical course to be monitored and better understood. The SOFA score well correlates with APACHE III score.

• Journal of agricultural medicine and community health
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• v.1 no.1
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• pp.29-36
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• 1976

Introduction Recently, changes in the patterns and concepts of maternity care, in both developing and developed countries have been accelerating. An outstanding development in this field is the number of deliveries taking place in hospitals or maternity centers. In Korea, however, more than 90% of deliveries are carried out at home with the help of untrained relatives or even without helpers. It is estimated that less than 10% of deliveries are assisted by professional persons such as a physician or a midwife. Taking into account the shortage of professional person i11 rural Korea, it is difficult to expect widespread prenatal, postnatal, and delivery care by professional persons in the near future, It is unrealistic, therefore, to expect rapid development of MCH care by professional persons in rural Korea due to economic and sociological reasons. Given these conditions. it is reasonable that an educated village women could used as a "maternity aid", serving simple and technically easy roles in the MCH field, if we could give such a women incentive to do so. The midwife and physician are assigned difficult problems in the MCH field which could not be solved by the village worker. However, with the application of the village worker system, we could expect to improve maternal and child hoalth through the replacement of untrained relatives as birth attendants with educated and trained maternity aides. We hope that this system will be a way of improving MCH care, which is only one part of the general health services offered at the local health centre level. Problems of MCH in rural Korea The field of MCH is not only the weakest point in the medical field in our country hut it has also dropped behind other developing countries. Regarding the knowledge about pregnancy and delivery, a large proportion of our respondents reported having only a little knowledge, while 29% reported that they had "sufficient" knowledge. The average number of pregnancies among women residing in rural areas was 4.3 while the rate of women with 5 or more pregnancies among general women and women who terminated childbearing were 43 and 80% respectively. The rate of unwanted pregnancy among general women was 19.7%. The total rate for complications during pregnancy was 15.4%, toxemia being the major complication. The rate of pregnant women with chronic disease was 7%. Regarding the interval of pregnancy, the rates of pregnancy within 12 months and within 36 months after last delivery were 9 and 49% respectively. Induced abortion has been increasing in rural areas, being as high as 30-50% in some locations. The maternal death rate was shown 10 times higher than in developed countries (35/10,000 live births). Prenatal care Most women had no consultation with a physician during the prenatal period. Of those women who did have prenatal care, the majority (63%) received such care only 1 or 2 times throughout the entire period of pregnancy. Also, in 80% of these women the first visit Game after 4 months of gestation. Delivery conditions This field is lagging behind other public health problems in our country. Namely, more than 95% of the women deliveried their baby at home, and delivery attendance by a professional person occurred only 11% of the time. Attendance rate by laymen was 78% while those receiving no care at all was 16%. For instruments used to cut the umbilical corn, sterilized scissors were used by 19%, non-sterilized scissors by 63% and 16% used sickles. Regarding delivery sheets, the rate of use of clean sheets was only 10%, unclean sheets, vinyl and papers 72%, and without sheets, 18%. The main reason for not using a hospital as a place of delivery was that the women felt they did not need it as they had previously experience easy deliveries outside hospitals. Difficult delivery composed about 5% of the total. Child health The main food for infants (95%) was breast milk. Regarding weaning time, the rates within one year, up to one and half, two, three and more than three years were 28,43,60,81 and 91% respectively, and even after the next pregnancy still continued lactation. The vaccination of children is the only service for child health in rural Korea. As shown in the Table, the rates of all kinds of vaccination were very low and insufficient. Infant death rate was 42 per 1,000 live births. Most of the deaths were caused by preventable diseases. Death of infants within the neonatal period was 83% meaning that deaths from communicable diseases decreased remarkably after that time. Infant deaths which occurred without medical care was 52%. Methods of improvement in the MCH field 1. Through the activities of village health workers (VHW) to detect pregnant women by home visiting and. after registration. visiting once a month to observe any abnormalities in pregnant women. If they find warning signs of abnormalities. they refer them to the public health nurse or midwife. Sterilized delivery kits were distributed to the expected mother 2 weeks prior to expected date of delivery by the VHW. If a delivery was expected to be difficult, then the VHW took the mother to a physician or call a physician to help after birth, the VHW visits the mother and baby to confirm health and to recommend the baby be given proper vaccination. 2. Through the midwife or public health nurse (aid nurse) Examination of pregnant women who are referred by the VHW to confirm abnormalities and to treat them. If the midwife or aid nurse could not solve the problems, they refer the pregnant women to the OB-GY specialist. The midwife and PHN will attend in the cases of normal deliveries and they help in the birth. The PHN will conduct vaccination for all infants and children under 5, years old. 3. The Physician will help only in those cases referred to him by the PHN or VHW. However, the physician should examine all pregnant women at least three times during their pregnancy. First, the physician will identify the pregnancy and conduct general physical examination to confirm any chronic disease that might disturb the continuity of the pregnancy. Second, if the pregnant woman shows any abnormalities the physician must examine and treat. Third, at 9 or 10 months of gestation (after sitting of the baby) the physician should examine the position of the fetus and measure the pelvis to recommend institutional delivery of those who are expected to have a difficult delivery. And of course. the medical care of both the mother and the infants are responsible of the physician. Overall, large areas of the field of MCH would be served by the VHW, PHN, or midwife so the physician is needed only as a parttime worker.