• Title/Summary/Keyword: knowledge levels

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Awareness of Major Zoonoses among Dairy Farmers in Gyeonggi Province (경기도 낙농업자의 주요 인수공통감염증 인지도)

  • Choi, Kum-Bal;Lim, Hyun-Sul;Lee, Kwan;Min, Young-Sun
    • Journal of agricultural medicine and community health
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    • v.35 no.4
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    • pp.339-349
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    • 2010
  • Objective: We surveyed awareness levels of brucellosis, Q fever and enterohemorrhagic Escherichia coli (EHEC) among dairy farmers in Gyeonggi Province to suggest directions for public education and public relations. Methods: We designed questionnaires to evaluate awareness of 3 major zooneses. We conducted a questionnaire survey to assess knowledge of the general characteristics of them, information sources for the awareness of zooneses, and the mode of transmission. Subjects were 716 workers from 482 dairy farms in Gyeonggi province. Results: The awareness levels for brucellosis, Q fever, and EHEC were 90.2%, 2.5% and 56.6%, respectively. Awareness of brucellosis and EHEC were tended to increase with higher number of school years. Television was the most common route of information for these zoonoses. Most common responses for questions concerning the method of transmission for each zoonoses, 'Contact with parturient fluid or placenta of animal' was 63.2% for brucellosis, 'Ingestion of raw meat or residual product' was 66.7% and 64.2% for Q fever and EHEC, respectively. The most common reason why dairy farmers think that it is difficult to prevent zoonoses was the inconvenience of wearing protection. Conclusions: Education programs for zoonoses, especially Q fever, are needed for dairy farmers. In addition, publicity information activities about prevention of zoonoses are needed for high risk groups, such as the dairy farmers surveyed.

Related Factors to Handwashing with Soap in Korean Adults (우리나라 성인의 비누로 손씻기 실천 관련요인)

  • Lee, Youn-Hee;Lee, Moo-Sik;Hong, SuJin;Yang, Nam-Young;Hwang, Hae-Jung;Kim, Byung-Hee;Kim, Hyun-Soo;Kim, Eun-Young;Park, Yun-Jin;Lim, Go-Un;Kim, Young-Tek
    • The Journal of Korean Society for School & Community Health Education
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    • v.17 no.1
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    • pp.89-99
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    • 2016
  • Objectives: This cross-sectional study aims to investigate the prevalence and factors relating to handwashing with soap among Korean adults. Methods: Study subjects consist of 755 adults who have been contacted in September 2013 via telephone surveys. The data collected has been analyzed using descriptive statistics, a chi-square test and a logistic regression analysis. A primary purpose is to understand the prevalence of handwashing with soap more than 8 times daily and for 30 seconds per wash among adults. Independent variables include socioeconomic levels, the participants' perception and knowledge of handwashing and their educational experiences relating to handwashing. Results: The overall percentile of people who wash their hands with soap 8 time per day for 30 seconds or more per wash was 16.0%, which is 121 people out of 755 study subjects. In univariate analysis, age, education levels, monthly average income, handwashing habits, perceptions relate to the importance of handwashing, self-assessment of handwashing, environment of public toilet, and the completion of handwashing education shows significant result. Significant differences also appear (p<0.05) in logistic regression analysis on binary variables. There is a strong correlation between daily frequency of handwashing and willingness to wash hands while outside. For example, people who wash their hands very often while outside are 2.24 times (95% C.I. 1.29-3.87) more likely to practice handwashing with soap 8 times per day for 30 seconds or more per wash than those people who only intermittently wash their hands while outside. Furthermore, people with general unwillingness to wash their hands while outside are 4.61 times (95% C.I. 1.22-3.28) less likely to practice handwashing with soap 8 times per day for 30 seconds or more per wash than those with general willingness. Conclusions: This study has been carried out to identify the decision factors in practicing handwashing with soap for Korean adults. In univariate analysis, age, education level, monthly average income, handwashing habits, handwashing self-assessment, public toilet environment, completion of handwashing education and so forth have been identified to be the decision factors. This study result shows that the overall level of cleanliness of public toilet perceives to be poor and it suggests that the environment of public toilet needs to be enhanced. As the handwashing habits and handwashing-self assessment have been identified to be the significant decision factors for handwashing, there search and approach in these factors need to be developed further.

Consumers' attitude to purchase irradiated foods and analysis of factors to distinguish acceptor groups (소비자의 방사선조사 식품 수용도 및 수용집단분류에 영향을 미치는 변수 분석)

  • Kim, Hyo-Chung;Kim, Mee-Ra
    • Journal of the Korean Society of Food Culture
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    • v.14 no.4
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    • pp.289-304
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    • 1999
  • The purpose of this study was to examine the consumers' acceptance of irradiated foods according to sociodemographic characteristics and the factors to distinguish subjects with differential levels of their willingness to buy them. Data were collected from the 365 women living in Youngnam area by the self-administered questionnaire. The results from this study were as follows. First, consumers were concerned regarding food safety issues in general and particularly preservatives. Second, many subjects had not heard of the irradiated foods and showed wait-and-see attitude in the willingness to accept them. Consumers' willingness to purchase them were higher than any other cases if radiation would not remain in foods. Third, the results from the discriminant analyses showed that the concern toward food safety, perceived innovativeness, willingness to pay more for organic foods, and knowledge of irradiation were the factors to distinguish groups with differential levels of willingness to purchase the irradiated foods. The results from the study imply that accurate and scientific information about food irradiation should be given to the consumers.

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Current Wheat Quality Criteria and Inspection Systems of Major Wheat Producing Countries (밀 품질평가 현황과 검사제도)

  • 이춘기;남중현;강문석;구본철;김재철;박광근;박문웅;김용호
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.47
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    • pp.63-94
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    • 2002
  • On the purpose to suggest an advanced scheme in assessing the domestic wheat quality, this paper reviewed the inspection systems of wheat in major wheat producing countries as well as the quality criteria which are being used in wheat grading and classification. Most wheat producing countries are adopting both classifications of class and grade to provide an objective evaluation and an official certification to their wheat. There are two main purposes in the wheat classification. The first objectives of classification is to match the wheat with market requirements to maximize market opportunities and returns to growers. The second is to ensure that payments to glowers aye made on the basis of the quality and condition of the grain delivered. Wheat classes has been assigned based on the combination of cultivation area, seed-coat color, kernel and varietal characteristics that are distinctive. Most reputable wheat marketers also employ a similar approach, whereby varieties of a particular type are grouped together, designed by seed coat colour, grain hardness, physical dough properties, and sometimes more precise specification such as starch quality, all of which are genetically inherited characteristics. This classification in simplistic terms is the categorization of a wheat variety into a commercial type or style of wheat that is recognizable for its end use capabilities. All varieties registered in a class are required to have a similar end-use performance that the shipment be consistent in processing quality, cargo to cargo and year to year, Grain inspectors have historically determined wheat classes according to visual kernel characteristics associated with traditional wheat varieties. As well, any new wheat variety must not conflict with the visual distinguishability rule that is used to separate wheats of different classes. Some varieties may possess characteristics of two or more classes. Therefore, knowledge of distinct varietal characteristics is necessary in making class determinations. The grading system sets maximum tolerance levels for a range of characteristics that ensure functionality and freedom from deleterious factors. Tests for the grading of wheat include such factors as plumpness, soundness, cleanliness, purity of type and general condition. Plumpness is measured by test weight. Soundness is indicated by the absence or presence of musty, sour or commercially objectionable foreign odors and by the percentage of damaged kernels that ave present in the wheat. Cleanliness is measured by determining the presence of foreign material after dockage has been removed. Purity of class is measured by classification of wheats in the test sample and by limitation for admixtures of different classes of wheat. Moisture does not influence the numerical grade. However, it is determined on all shipments and reported on the official certificate. U.S. wheat is divided into eight classes based on color, kernel Hardness and varietal characteristics. The classes are Durum, Hard Red Spring, Hard Red Winter, Soft Red Winter, Hard White, soft White, Unclassed and Mixed. Among them, Hard Red Spring wheat, Durum wheat, and Soft White wheat are further divided into three subclasses, respectively. Each class or subclass is divided into five U.S. numerical grades and U.S. Sample grade. Special grades are provided to emphasize special qualities or conditions affecting the value of wheat and are added to and made a part of the grade designation. Canadian wheat is also divided into fourteen classes based on cultivation area, color, kernel hardness and varietal characteristics. The classes have 2-5 numerical grades, a feed grade and sample grades depending on class and grading tolerance. The Canadian grading system is based mainly on visual evaluation, and it works based on the kernel visual distinguishability concept. The Australian wheat is classified based on geographical and quality differentiation. The wheat grown in Australia is predominantly white grained. There are commonly up to 20 different segregations of wheat in a given season. Each variety grown is assigned a category and a growing areas. The state governments in Australia, in cooperation with the Australian Wheat Board(AWB), issue receival standards and dockage schedules annually that list grade specifications and tolerances for Australian wheat. AWB is managing "Golden Rewards" which is designed to provide pricing accuracy and market signals for Australia's grain growers. Continuous payment scales for protein content from 6 to 16% and screenings levels from 0 to 10% based on varietal classification are presented by the Golden Rewards, and the active payment scales and prices can change with market movements.movements.

Monitoring and Risk Assessment of Heavy Metals in Edible Mushrooms (국내 유통 버섯 중 중금속 함량 조사 및 위해성 평가)

  • Kim, Ji-Young;Yoo, Ji-Hyock;Lee, Ji-Ho;Kim, Min-Ji;Kang, Dae-Won;Ko, Hyeon-Seok;Hong, Su-Myeong;Im, Geon-Jae;Kim, Doo-Ho;Jung, Goo-Bok;Kim, Won-Il
    • Korean Journal of Environmental Agriculture
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    • v.31 no.1
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    • pp.37-44
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    • 2012
  • BACKGROUND: Many edible mushrooms are known to accumulate high levels of heavy metals. This research was focused on health risk assessment to investigate the mushrooms in Korea, arsenic (As), cadmium (Cd), lead (Pb) and mercury (Hg) contaminations in edible mushrooms in cultivated areas were investigated, and health risk was assessed through dietary intake of mushrooms. METHODS AND RESULTS: The heavy metals in mushrooms were analyzed by ICP/MS after acid digestion. Probabilistic health risk were estimated by Monte-Carlo simulation techniques. The average contents of As, Cd, Pb, and Hg were $0.035{\pm}0.042$ mg/kg, $0.017{\pm}0.020$ mg/kg, $0.043{\pm}0.013$ mg/kg, and $0.004{\pm}0.004$ mg/kg, respectively. The results showed that contents of Cd and Pb did not exceed maximum residual levels established by European Uion regulation (Cd 0.20 mg/kg and Pb 0.30 mg/kg). For health risk assessment, estimated intakes in all age populations did not exceed the provisional tolerable daily intake of As and Hg, provisional tolerable monthly intake of Cd, provisional tolerable weekly intake of Pb. The Hazard Index (HI) were ranged from $0.03{\times}10^{-4}{\sim}0.01{\times}10^{-3}$ for As, $0.02{\times}10^{-3}{\sim}0.81{\times}10^{-3}$ for Cd, $0.06{\times}10^{-3}{\sim}0.38{\times}10^{-3}$ for Pb, and $0.08{\times}10^{-4}{\sim}0.14{\times}10^{-3}$ for Hg at general population. CONCLUSION: The HI from the ratio analysis between daily exposure and safety level values was less than 1.0. This results demonstrated that human exposure to heavy metals through dietary intake of mushrooms might not cause adverse effect.

A study on the menarche of middle school girls in Seoul (여학생의 초경에 관한 조사 연구 (서울시내 여자중학생을 대상으로))

  • Kim, Mi-Hwa
    • Korean Journal of Health Education and Promotion
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    • v.1 no.1
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    • pp.21-36
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    • 1983
  • It is assumed that menarche is affected not only by the biological factors such as nutrition and genetic heritage, but also it is affected by other socio-cultural environmental factors including weather, geographic location, education and level of modernization. Also recent trend of menarche in Korea indicates that a lot of discussion are being generated to the need of sex education as a part of formal school education. The purpose of this study is to develop the school health education program by determine the age of menarche, the factors relavant to time of menarche and psycho-mental state of students at the time in menarche and investigate the present state of school health education relate to menarche of adolescents. The total number of 732 girls was drown from first, second and third grades of 4 middle schools in Seoul. For the data collection the survey was conducted during the period from May 1 to May 20, 1982 by using prepared questionair. The major results are summarized as follow; 1. Mean age at menarche and the percent distribution of menarche experienced. It was observed that about 68.7% of sampled students have been experienced menarche at the time interviewed. For the each group, age at menarche is revealed that among the students about 37.8% are experienced menarche for under 12 years old group, 62.1% for 13 year-old group, 80.6% for 14 year-old group and 95.5% for over 15 years old. In sum it was found that the mean age at menarche was 12.3 years old, ranged from age at 10 as earlist the age at 15 as latest. 2. Variables associated with age at menarche. 1) There was tendency those student who belong to upper class economic status have had menarche earlier than those student who belong to lower class. Therefore, economic status is closely related to age at menarche. 2) In time of mother's education level, it is also found that those students whose mother's education levels from high school and college are experienced menarche earlier than those students whose mother's education levels from primary school and no-education. 3) However, in connection with home discipline, there was no significant relationship between age at menarche and home disciplines which are being treated "Rigid", "Moderated ", "Indifferent". 4) Degree of communication between parents and daughter about sex matters was found to be associated each others in determination of age at menarche. 5) It was found that high association between mother's menarche age and their daughter's menarche age was observed. Mother's age at menarche earlier trend to be shown also as earlier of their daughters. 6) Those students belong to "D & E" of physical substantiality index are trend to be earlier in menarche than those students in the index "A & B". 3. Psycho-mental state at the time of menarche. Out of the total students 68.2% had at least one or more than one of subjective symptoms. Shyness was shown as most higher prevalent symptom and others are fear, emotional instability, unpleasant feeling, depression, radical behavior, inferior complex and satisfaction appeared. Very few cases are appeared be guilty and stealing feeling. 4. The present status of school health education program related to menarche. As to the source of information about menarche, teacher was a main source with average index 5.88 and the other informants were mother & family member, friends, books and magagines, movies, television, and radio. For the problem solving at menarche, mother & family members were subject to discussion with an average index 6.02 as high. The others for discuss and knowledge about menarche were books, magagine, friends, teachers, and self-learning based on own experienced. The time of learning about menarche, it was learned as highest percentage with 43.2% at a 6 grades of primary school, middle school with 34.4%, 5 grade of primary school with 18.2%, and 4 grade of primary school with 4.0% respectively.

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Interpreting Bounded Rationality in Business and Industrial Marketing Contexts: Executive Training Case Studies (집행관배훈안례연구(阐述工商业背景下的有限合理性):집행관배훈안례연구(执行官培训案例研究))

  • Woodside, Arch G.;Lai, Wen-Hsiang;Kim, Kyung-Hoon;Jung, Deuk-Keyo
    • Journal of Global Scholars of Marketing Science
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    • v.19 no.3
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    • pp.49-61
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    • 2009
  • This article provides training exercises for executives into interpreting subroutine maps of executives' thinking in processing business and industrial marketing problems and opportunities. This study builds on premises that Schank proposes about learning and teaching including (1) learning occurs by experiencing and the best instruction offers learners opportunities to distill their knowledge and skills from interactive stories in the form of goal.based scenarios, team projects, and understanding stories from experts. Also, (2) telling does not lead to learning because learning requires action-training environments should emphasize active engagement with stories, cases, and projects. Each training case study includes executive exposure to decision system analysis (DSA). The training case requires the executive to write a "Briefing Report" of a DSA map. Instructions to the executive trainee in writing the briefing report include coverage in the briefing report of (1) details of the essence of the DSA map and (2) a statement of warnings and opportunities that the executive map reader interprets within the DSA map. The length maximum for a briefing report is 500 words-an arbitrary rule that works well in executive training programs. Following this introduction, section two of the article briefly summarizes relevant literature on how humans think within contexts in response to problems and opportunities. Section three illustrates the creation and interpreting of DSA maps using a training exercise in pricing a chemical product to different OEM (original equipment manufacturer) customers. Section four presents a training exercise in pricing decisions by a petroleum manufacturing firm. Section five presents a training exercise in marketing strategies by an office furniture distributer along with buying strategies by business customers. Each of the three training exercises is based on research into information processing and decision making of executives operating in marketing contexts. Section six concludes the article with suggestions for use of this training case and for developing additional training cases for honing executives' decision-making skills. Todd and Gigerenzer propose that humans use simple heuristics because they enable adaptive behavior by exploiting the structure of information in natural decision environments. "Simplicity is a virtue, rather than a curse". Bounded rationality theorists emphasize the centrality of Simon's proposition, "Human rational behavior is shaped by a scissors whose blades are the structure of the task environments and the computational capabilities of the actor". Gigerenzer's view is relevant to Simon's environmental blade and to the environmental structures in the three cases in this article, "The term environment, here, does not refer to a description of the total physical and biological environment, but only to that part important to an organism, given its needs and goals." The present article directs attention to research that combines reports on the structure of task environments with the use of adaptive toolbox heuristics of actors. The DSA mapping approach here concerns the match between strategy and an environment-the development and understanding of ecological rationality theory. Aspiration adaptation theory is central to this approach. Aspiration adaptation theory models decision making as a multi-goal problem without aggregation of the goals into a complete preference order over all decision alternatives. The three case studies in this article permit the learner to apply propositions in aspiration level rules in reaching a decision. Aspiration adaptation takes the form of a sequence of adjustment steps. An adjustment step shifts the current aspiration level to a neighboring point on an aspiration grid by a change in only one goal variable. An upward adjustment step is an increase and a downward adjustment step is a decrease of a goal variable. Creating and using aspiration adaptation levels is integral to bounded rationality theory. The present article increases understanding and expertise of both aspiration adaptation and bounded rationality theories by providing learner experiences and practice in using propositions in both theories. Practice in ranking CTSs and writing TOP gists from DSA maps serves to clarify and deepen Selten's view, "Clearly, aspiration adaptation must enter the picture as an integrated part of the search for a solution." The body of "direct research" by Mintzberg, Gladwin's ethnographic decision tree modeling, and Huff's work on mapping strategic thought are suggestions on where to look for research that considers both the structure of the environment and the computational capabilities of the actors making decisions in these environments. Such research on bounded rationality permits both further development of theory in how and why decisions are made in real life and the development of learning exercises in the use of heuristics occurring in natural environments. The exercises in the present article encourage learning skills and principles of using fast and frugal heuristics in contexts of their intended use. The exercises respond to Schank's wisdom, "In a deep sense, education isn't about knowledge or getting students to know what has happened. It is about getting them to feel what has happened. This is not easy to do. Education, as it is in schools today, is emotionless. This is a huge problem." The three cases and accompanying set of exercise questions adhere to Schank's view, "Processes are best taught by actually engaging in them, which can often mean, for mental processing, active discussion."

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A Study on Chinese Traditional Auspicious Fish Pattern Application in Corperate Identity Design (중국 전통 길상 어(魚)문양을 응용한 중국 기업의 아이덴티티 디자인 동향)

  • ZHANG, JINGQIU
    • Cartoon and Animation Studies
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    • s.50
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    • pp.349-382
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    • 2018
  • China is a great civilization which is a combination of various ethnic groups with long history change. As one of these important components of traditional culture, the lucky shape has been going through the ideological upheaval of the history change of China. Up to now, it has become the important parts which can stimulate the emotion of Chinese nation. The lucky shape becomes the basis of the rich traditional culture by long history of the Chinese nation. Even say it is the centre of this traditional culture resource. The lucky shape is a way of expressing the Chinese history and national emotions. It is the important part of people's living habits, emotion, as well as the cultural background. What's more, it has the value of beliefs of Surname totem. Meanwhile, it also has the function of passing on information. The symbol of information finally was created by the being of lucky shape to indicate its conceptual content. There are various kinds of lucky shapes. It will have its limitations when researching all kinds of them professionally. So, here the lucky shape of FISH will be researched. The shape of fish is the first good shape created by the Chinese nation. It is about 6000 years. Its special shape and lucky meaning embody the peculiar inherent culture and intension of the Chinese nation. It's the important component of the Chinese traditional culture. The traditional shape of fish was focused on the continuation of history and the patterns recognition, etc. It seldom indicated the meaning of the shape into the using of the modern design. So by searching the lucky meaning & the way of fish shape, the purpose of the search is to explore the real analysis of value of the fish shape in the modern enterprise identity design. The way of search is through the development of the history, the evolvement and the meaning of lucky of the traditional fish shape to analyse the symbolic meaning and the cultural meaning from all levels in nation, culture, art and life, etc. And by using the huge living example of the enterprise identity design of the traditional shape of the fish to analyse that how it works in positive way by those enterprise which is based on the trust with good image. In the modern Chinese enterprise identity design, the lucky image will be reinterpreted in the modern way. It will be proofed by the national perceptual knowledge of the consumer and the way of enlarge the goodwill of corporate image. It will be the conclusion. The traditional fish shape is the important core of modern design.So this search is taken through the instance of the design of enterprise image of the traditional fish shape to analysis the idea of the majority Chinese people of the traditional luck and the influence of corporation which based on trust and credibility. In modern image design of Chinese corporation, the auspicious sign reappear. The question survey is taken by people through the perceptual knowledge of the consumer and the cognition the enterprise image. According the result, people can speculate the improvement of consumer's recognition and the possibility of development of traditional concept.

A Study on the Determinants of Patent Citation Relationships among Companies : MR-QAP Analysis (기업 간 특허인용 관계 결정요인에 관한 연구 : MR-QAP분석)

  • Park, Jun Hyung;Kwahk, Kee-Young;Han, Heejun;Kim, Yunjeong
    • Journal of Intelligence and Information Systems
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    • v.19 no.4
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    • pp.21-37
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    • 2013
  • Recently, as the advent of the knowledge-based society, there are more people getting interested in the intellectual property. Especially, the ICT companies leading the high-tech industry are working hard to strive for systematic management of intellectual property. As we know, the patent information represents the intellectual capital of the company. Also now the quantitative analysis on the continuously accumulated patent information becomes possible. The analysis at various levels becomes also possible by utilizing the patent information, ranging from the patent level to the enterprise level, industrial level and country level. Through the patent information, we can identify the technology status and analyze the impact of the performance. We are also able to find out the flow of the knowledge through the network analysis. By that, we can not only identify the changes in technology, but also predict the direction of the future research. In the field using the network analysis there are two important analyses which utilize the patent citation information; citation indicator analysis utilizing the frequency of the citation and network analysis based on the citation relationships. Furthermore, this study analyzes whether there are any impacts between the size of the company and patent citation relationships. 74 S&P 500 registered companies that provide IT and communication services are selected for this study. In order to determine the relationship of patent citation between the companies, the patent citation in 2009 and 2010 is collected and sociomatrices which show the patent citation relationship between the companies are created. In addition, the companies' total assets are collected as an index of company size. The distance between companies is defined as the absolute value of the difference between the total assets. And simple differences are considered to be described as the hierarchy of the company. The QAP Correlation analysis and MR-QAP analysis is carried out by using the distance and hierarchy between companies, and also the sociomatrices that shows the patent citation in 2009 and 2010. Through the result of QAP Correlation analysis, the patent citation relationship between companies in the 2009's company's patent citation network and the 2010's company's patent citation network shows the highest correlation. In addition, positive correlation is shown in the patent citation relationships between companies and the distance between companies. This is because the patent citation relationship is increased when there is a difference of size between companies. Not only that, negative correlation is found through the analysis using the patent citation relationship between companies and the hierarchy between companies. Relatively it is indicated that there is a high evaluation about the patent of the higher tier companies influenced toward the lower tier companies. MR-QAP analysis is carried out as follow. The sociomatrix that is generated by using the year 2010 patent citation relationship is used as the dependent variable. Additionally the 2009's company's patent citation network and the distance and hierarchy networks between the companies are used as the independent variables. This study performed MR-QAP analysis to find the main factors influencing the patent citation relationship between the companies in 2010. The analysis results show that all independent variables have positively influenced the 2010's patent citation relationship between the companies. In particular, the 2009's patent citation relationship between the companies has the most significant impact on the 2010's, which means that there is consecutiveness regarding the patent citation relationships. Through the result of QAP correlation analysis and MR-QAP analysis, the patent citation relationship between companies is affected by the size of the companies. But the most significant impact is the patent citation relationships that had been done in the past. The reason why we need to maintain the patent citation relationship between companies is it might be important in the use of strategic aspect of the companies to look into relationships to share intellectual property between each other, also seen as an important auxiliary of the partner companies to cooperate with.

Studies on Ancylostomiasis I. An Experimental Study on Hookworm Infection and Anemia (구충증(鉤蟲症)에 관(關)한 연구(硏究) 제1편(第1篇) 구충(鉤蟲)의 감염(感染) 및 구충성빈혈(鉤蟲性貧血)에 관(關)한 고찰(考奈))

  • Lee, Mun-Ho;Kim, Dong-Jip;Lee, Jang-Kyu;Seo, Byong-Sul;Lee, Soon-Hyung
    • The Korean Journal of Nuclear Medicine
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    • v.1 no.1
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    • pp.55-66
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    • 1967
  • In view of its prevalence in the Far East area, a more detailed knowledge on the hookworm infection is one of the very important medical problems. The present study was aimed to; determine the infectivity of the artificially hatched ancylostoma duodenale larvae in man after its oral administration, evaluate the clinical symptomatology of such infection, determine the date of first appearance of the ova in the stool, calculate the blood loss per worm per day, assess the relation-ships between the ova count, infectivity(worm load), blood loss and severity of anemia. An erythrokinetic study was also done to analyse the characteristics of hookworm anemia by means of $^{59}Fe\;and\;^{51}Cr$. Materials and Methods Ten healthy male volunteers(doctors, medical students and laboratory technicians) with the ages ranging from 21 to 40 years were selected as the experimental materials. They had no history of hookworm infection for preceding several years, and care was taken not to be exposed to reinfection. A baseline study including a through physical examinations and laboratory investigations such as complete blood counts, stool examination and estimation of the serum iron levels was done, and a vermifuge, bephenium hydroxynaphoate, was given 10 days prior to the main experiment. The ancylostoma duodenale filariform larvae were obtained in the following manner; The pure ancylostoma duodenale ova were obtained from the hookworm anemia patients and a modified filter paper method was adopted to harvest larger number of infective larvae, which were washed several times with saline. The actively moving mature larvae were put into the gelatine capsules, 150 in each, and were given to the volunteers in the fasting state with 300ml. of water. The volunteers were previously treated with intramuscular injection of 15mg. of chlorpromazine in order to prevent the eventual nausea and vomiting after the larvae intake. The clinical symptoms and signs mainly of the respiratory and gastrointestinal tracts, appearance of the ova and occult blood in the stool etc. were checked every day for the first 20 days and then twice weekly until the end of the experiment, which usually lasted for about 3 months. Roentgenological survey of the lungs was also done. The hematological changes such as the red blood cell, white blood cell and eosinophil cell counts, hemoglobin content and serum iron levels were studied. The appearance of the ova in the stool was examined by the formalin ether method and the ova were counted in triplicate on two successive days using the Stoll's dilution method. The ferrokinetic data were calculated by the modified Huff's method and the apparent half survival time of the red blood cells by the modified Gray's method. The isotopes were simultaneously tagged and injected intravenously, and then the stool and blood samples were collected as was described by Roche et al., namely, three separate 4-day stool samples with the blood sample drawing before each 4-day stool collection. The radio-activities of the stools ashfied and the blood were separately measured by the pulse-height analyser. The daily blood loss was calculated with the following formula; daily blood loss in $ml.=\frac{cpm/g\;stool{\times}weight\;in\;g\;of\;4-day\;stool}{cpm/ml\;blood{\times}4}$ The average of these three 4-day periods was given as the daily blood loss in each patient. The blood loss per day per worm was calculated by simply dividing the daily blood loss by the number of the hookworm recovered after the vermifuge given twice a week at the termination of the experiment. The iron loss in mg. through the gastrointestinal tract was estimated with the daily iron loss in $mg=\frac{g\;Hgb/100ml{\times}ml\;daily\;blood\;loss{\times}3.40}{100}$ 3.40=mg of iron per g Hgb following formula; Results 1. The respiratory symptoms such as cough and sputum were noted in almost all cases within a week after the infection, which lasted about 2 weeks. The roentgenological findings of the chest were essentially normal. A moderate degree of febril reaction appeared within 2 weeks with a duration of 3 or 4 days. 2. The gastrointestinal symptoms such as nausea, epigastric fullness, abdominal pain and loose bowel appeared in all cases immediately after the larvae intake. 3. The reduction of the red blood cell count was not remarkable, however, the hemoglobin content and especially the serum iron level showed the steady decreases until the end of the experiment. 4. The white blood cells and eosinophil cells, on the contrary, showed increases in parallel and reached peaks in 20 to 30 days after the infection. A small secondary rise was noted in 2 months. 5. The ova first appeared in the stool in 40. 1 days after the infection, ranging from 29 to 51 days, during which the occult blood reaction of the stool became also positive in almost cases. 6. The number of ova recovered per day was 164, 320 on the average, ranging from 89,500 to 253,800. The number of the worm evacuated by vermifuge was in rough correlation with the number of ova recovered. 7. The infectivity of ancylostoma duodenale was 14% on the average, ranging from 7.3 to 20.0%, which is relatively lower than those reported by other workers. 8. The mean fecal blood loss was 5.78ml. per day, with a range of from 2.6 to 11.7ml., and the mean blood loss per worm per day was 0.30ml., with a range of from 0.13 to 0.73ml., which is in rough coincidence with those reported by other authors. There appeared to exist, however, no correlation between the blood loss and the number of ova recovered. 9. The mean fecal iron loss was 2.02mg. per day, with a range of from 1.20 to 3.89mg., which is less than those appeared in the literature. 10. The mean plasma iron disappearance rate was 0.80hr., with a range of from 0.62 to 0.95hr., namely, a slight accerelation. 11. The hookworm anemia appeared to be iron deficiency in origin caused by continuous intestinal blood loss.

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