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Study on the Acceptability and Effectiveness of an Oral Contraceptive Among Iud Drop-outs in Rural Korea

  • Yang, J.M.;Bang, S.;Song, S.W.;Youn, B.B.
    • Journal of Preventive Medicine and Public Health
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    • v.1 no.1
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    • pp.51-66
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    • 1968
  • During a period of about one year(November '66 to December '67), the Yonsei University College of Medicine conducted a field trial of the oral contraceptive(Ovulen) in order to study its acceptability and use-effectiveness among IUD drop-outs in Koyang county. We can summarize the outstanding findings from this investigation as follows; 1. 61.4% of the IUD drop-outs interviewed (911 women) wanted to use the pill. Most of the reasons for not wanting to use it(352 women) pertained to either use of other contraceptive methods(98) or subfecundity(150) following IUD terminations. Only 83 out of 911 women gave reasons related to the difficulty of obtaining pills. Therefore, we can state that most IUD drop-outs if still in need of a contraceptive methods are in favor of trying the pill, and especially so if this method is conveniently available. 2. The 467 women or 37% of those who terminated IUD use actually visited the clinic for medical screening, and only 11 of them or 2.4% were rejected because of pregnancy and other medical reasons such as cervical erosion, myoma, breast mass, etc. 5.5% or 25 of the 456 women who received the first cycle did not take a single pill during the study period. 3. When we defined those 431 women who accepted and took one or more tablets we found that women over age 30, with 4 or more children, and/or with a higher educational level were the best prospects for recruitment. 4. In accuracy of use, about two thirds of the users started taking the pill on the 5 th day as directed for the first three cycles, but the percentages rose sharply to about 80% in later cycles. Tardiness in starting pill use in the first cycle may have occurred partly because they had to return to the clinic monthly to get each new cycle. Among acceptors who did not quit between cycles, 80 to 90% were regular users, missing two or less tablets in each cycle. 5) More than 60% of the users felt well and sometimes lost their pre-acceptance symptoms. especially dysmenorrhea. However, 27.4% (58 women) had side effects attributable to the pill compund as nausea, vomiting, indigestion, breast tenderness, decreased lactation or breakthrough bleeding. 25.0% (53 women) also complained of medical diseases or symptoms not related to the pill, especially during the first three cycles. However, as the confidence and experience of the client and the field workers grew, the incidence of unrelated medical complaints quickly fell to a lower level in the later cycles. 6. As of the end of this study, on December 31, 1967, 49.2% (212 women) had discontinued the use of the pill for medical reasons as well as for the non medical reasons. Only one case terminated use due to a pregnancy after taking pills. The cumulative continuation rates (by the life table method), were 58.9%, 51.9%, 41.0% at the end of 3 months, 6 months and one year, respectively. These rates are lower than in the U.S. studies. Even when we add the retaking group to the first segment, the continuation rate goes up only about 5% above the first segment rates mentioned above. Possible explanations are different dosages, the newerness of the method and the use of only one point for pill distribution in the country together with a monthly return for cycle 1, 2, 3, and 4-6.

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Clinical Significance of PCR-Based Rapid Detection of Mycobacterium tuberculosis DNA in Peripheral Blood (결핵 환자에서 말초혈액 결핵균 중합효소 연쇄반응 양성의 임상적 의의)

  • Kim, Gyu-Won;Lee, Jae-Myung;Kang, Min-Jong;Son, Jee-Woong;Lee, Seung-Joon;Kim, Dong-Gyu;Lee, Myung-Goo;Hyun, In-Gyu;Jung, Ki-Suck;Lee, Young-Kyung;Lee, Kyung-Wha
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.5
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    • pp.599-606
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    • 2001
  • Background : Since the advent of AIDS, tuberculosis has become a major public health problem in the western society. Therefore, it is essential that pulmonary tuberculosis be rapidly diagnosed. Light microscopic detection of acid-fast organisms in sputum has traditionally been used for rapidly diagnosing tuberculosis. However positive smears are only observed in about one-half to three-quarters of cases. Studies using PCR for diagnosing pulmonary tuberculosis disclosed several shortcomings suggesting an inability to distinguish between active and treated or inactive tuberculosis. In this study, the clinical significance of a PCR-based rapid technique for detecting Mycobacterium tuberculosis DNA in peripheral blood was investigated. Materials and Methods : From July 1, 1998 through to August 30, 1999, 59 patients with presumed tuberculosis, who had no previous history of anti-tuberculosis medication use within one year prior to this study were recruited and followed up for more than 3 months. AFB stain and culture in the sputum and/or pleural fluids and biopsies when needed were performed. Blood samples from each of the 59 patients were obtained in order to identify Mycobacterium Tuberculosis DNA by a PCR test. Results : 1) Forty five out of 59 patients had a final diagnosis of tuberculosis ; Twenty eight were confirmed as having active pulmonary tuberculosis by culture or biopsy. Four were clinically diagnosed with pulmonary tuberculosis. The other 13 patients were diagnosed as having tuberculous pleurisy (9) and extrapulmonary tuberculosis (4). 2) Fourteen patients showed a positive blood PCR test. The PCR assay correctly identified active tuberculosis in 13 out of 14 patients. The overall sensitivity and specificity of this blood peR assay for diagnosing tuberculosis were 29% and 93%, respectively. The positive predictive value was 93%, the negative predictive value was 29% and the diagnostic accuracy was 44%.3) Six out of 14(43%) patients with blood PCR positive tuberculosis were immunologically compromised hosts. 4) A simple chest radiograph in blood PCR positive tuberculosis patients showed variable and inconsistent findings. Conclusion : A peripheral blood PCR assay for Mycobacterium tuberculosis is not recommended as a screening method for diagnosing active tuberculosis. However, it was suggested that the blood PCR assay could contribute to an early diagnostic rate due to its high positive predictive value.

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Evaluation of a Conjugate View Method for Determination of Kidney Uptake (신장 방사선 섭취량 결정을 위한 Conjugate View 방법에 대한 평가)

  • Bong, Jung-Kyun;Yun, Mi-Jin;Lee, Jong-Doo;Kim, Hee-Joung;Son, Hye-Kyung;Kwon, Yun-Youug;Park, Hae-Jeong;Kim, Yu-Seun
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.3
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    • pp.191-199
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    • 2005
  • Purpose: In order to obtain better quantitation of kidney uptake, this study is to evaluate a conjugate view method (CVM) using a geometric mean attenuation correction for kidney uptake and to compare it to Gate's method. Materials & Methods: We used a Monte Carlo code, SIMIND and a Zubal phantom, to simulate kidney uptake. SIMIND was both simulated with or without scatter for the Zubal phantom. Also, a real phantom test was carried out using a dual-head gamma camera. The activity of 0.5 mCi was infused into two small cylinder phantoms of 5 cm diameter, and then, they were inserted into a cylinder phantom of 20 cm diameter. The results by the CVM method were compared with ideal data without both of attenuation and scatter and with Gate's method. The CVM was performed with or without scatter correction. The Gate's method was performed without scatter correction and it was evaluated with regards to $0.12cm^{-1}\;and\;0.15cm^{-1}$ attenuation coefficients. Data were analyzed with comparisons of mean counts in the legions of interest (ROI), profiles drawn over kidney images and linear regression. Correlation coefficients were calculated with ideal data, as well. Results: In the case of the computer simulation, mean counts measured from ideal data, the CVM and the Gate's method were (right $998{\pm}209$, left: $896{\pm}249$), (right: $911{\pm}207$, left: $815{\pm}265$), and (right: $1065{\pm}267$, left: $1546{\pm}267$), respectively. The ideal data showed good correlation with the CVM and the correlation coefficients of the CVM, Gate's method were (right: 0.91, left: 0.93) and (right: 0.85, left: 0.90), respectively. Conclusion: The conjugate view method using geometric mean attenuation correction resulted in better accuracy than the Gate's method. In conclusion, the conjugate view method independent of renal depths may provide more accurate kidney uptake.

Validity of Long Form Assessment in Interactive Metronome® as a Measure of Children's Praxis (아동의 운동기능평가에 대한 Interactive Metronome® LFA의 타당도 연구)

  • Kim, Kyeong-Mi;Heo, Seo-Yoon;Kim, Mi-Su;Lee, Soo-Min
    • The Journal of Korean Academy of Sensory Integration
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    • v.13 no.1
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    • pp.13-22
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    • 2015
  • Objective : The aim of this study is to verify validity of Long Form Assessment, which is an Interactive Metronome $measure^{(R)}$(LFA-IM), as a measurement of praxis of children. Methods : The study was implemented from March 2015 to July 2015. Twenty-five children with Attention Deficit Hyperactivity Disorder (ADHD) and those without ADHD (age of 6~11) were selected from a local university hospital and community in Gyeoung-Nam province and Busan for this study. In order to examine discriminative validity of LFA-IM, Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2) was used to compare the difference of results with LFA-IM for both children with- and without ADHD. For concurrent validity, correlation between LFA-IM and BOT-2 was investigated using spearman correlation coefficients. Results : For the comparison between children with ADHD and children without ADHD, there were significant differences in the total scores of LFA-IM (p<.05). Regarding the concurrent validity, there was a strong negative correlation between the total scores of LFA-IM and BOT-2 (p<.05). In addition, there was high correlation between LFA-IM and BOT-2 for the area of hand control (rs=-.532), and high negative correlation for the area of fine-motor accuracy (rs=-.447), hand dexterity (rs=-.532), and balance control (rs=-.623) (p<.05). Conclusion : This study identified validities of LFA-IM as an assessment of praxis of children. The results showed that it is appropriate to evaluate praxis of children with the total score of LFA-IM and, thus, it is believed that LFA-IM has a potential clinical utility. However, there should be more researches with large number of subjects.

Evaluation of Factors Used in AAPM TG-43 Formalism Using Segmented Sources Integration Method and Monte Carlo Simulation: Implementation of microSelectron HDR Ir-192 Source (미소선원 적분법과 몬테칼로 방법을 이용한 AAPM TG-43 선량계산 인자 평가: microSelectron HDR Ir-192 선원에 대한 적용)

  • Ahn, Woo-Sang;Jang, Won-Woo;Park, Sung-Ho;Jung, Sang-Hoon;Cho, Woon-Kap;Kim, Young-Seok;Ahn, Seung-Do
    • Progress in Medical Physics
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    • v.22 no.4
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    • pp.190-197
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    • 2011
  • Currently, the dose distribution calculation used by commercial treatment planning systems (TPSs) for high-dose rate (HDR) brachytherapy is derived from point and line source approximation method recommended by AAPM Task Group 43 (TG-43). However, the study of Monte Carlo (MC) simulation is required in order to assess the accuracy of dose calculation around three-dimensional Ir-192 source. In this study, geometry factor was calculated using segmented sources integration method by dividing microSelectron HDR Ir-192 source into smaller parts. The Monte Carlo code (MCNPX 2.5.0) was used to calculate the dose rate $\dot{D}(r,\theta)$ at a point ($r,\theta$) away from a HDR Ir-192 source in spherical water phantom with 30 cm diameter. Finally, anisotropy function and radial dose function were calculated from obtained results. The obtained geometry factor was compared with that calculated from line source approximation. Similarly, obtained anisotropy function and radial dose function were compared with those derived from MCPT results by Williamson. The geometry factor calculated from segmented sources integration method and line source approximation was within 0.2% for $r{\geq}0.5$ cm and 1.33% for r=0.1 cm, respectively. The relative-root mean square error (R-RMSE) of anisotropy function obtained by this study and Williamson was 2.33% for r=0.25 cm and within 1% for r>0.5 cm, respectively. The R-RMSE of radial dose function was 0.46% at radial distance from 0.1 to 14.0 cm. The geometry factor acquired from segmented sources integration method and line source approximation was in good agreement for $r{\geq}0.1$ cm. However, application of segmented sources integration method seems to be valid, since this method using three-dimensional Ir-192 source provides more realistic geometry factor. The anisotropy function and radial dose function estimated from MCNPX in this study and MCPT by Williamson are in good agreement within uncertainty of Monte Carlo codes except at radial distance of r=0.25 cm. It is expected that Monte Carlo code used in this study could be applied to other sources utilized for brachytherapy.

Study for Residue Analysis of Herbicide, Clopyralid in Foods (식품 중 제초제 클로피랄리드(Clopyralid)의 잔류 분석법)

  • Kim, Ji-young;Choi, Yoon Ju;Kim, Jong Su;Kim, Do Hoon;Do, Jung Ah;Jung, Yong Hyun;Lee, Kang Bong;Kim, Hyo Chin
    • Korean Journal of Environmental Agriculture
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    • v.37 no.4
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    • pp.283-290
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    • 2018
  • BACKGROUND: Pesticide residue analysis is an essential activity in order to establish the food safety of agricultural products. Analytical approaches to the food safety are required to meet internationally the guideline of Codex (Codex Alimentarius Commission, CAC/GL 40). In this study, we developed a liquid chromatograph-tandem mass spectrometer (LC-MS/MS) method to determine the herbicide clopyralid in food matrixes. METHODS AND RESULTS: Clopyralid was extracted with aqueous acetonitrile containing formic acid and the extracts were mixed in a citrate buffer consisted of magnesium sulfate anhydrous, NaCl, sodium citrate dihydrate and disodium hydrogencitrate sesquihydrate followed by centrifugation. The supernatants were filtered through a nylon membrane filter and used for the analysis of clopyralid. The method was validated by accuracy and precision experiments on the samples fortified at 3 different levels of clopyralid. LC-MS/MS in positive mode was employed to quantitatively determine clopyralid in the food samples. Matrix-matched calibration curves were inearranged from 0.001 to 0.25 mg/kg with r2 > 0.994. The limits of detection and quantification were determined to be 0.001 and 0.01 mg/kg, respectively. There covery values of clopyralid for tified at 0.01 mg/kg in the control samples ranged from approximately 82 to 106% with relative standard deviations below 2 0%. CONCLUSION: The method developed in this study meets successfully the Codex guideline for pesticide residue analysis in food samples. This, the method could be applicable to determine pesticides in foods produced domestically and internationally.

Work Environment Measurement Results for Research Workers and Directions for System Improvement (연구활동종사자 작업환경측정 결과 및 제도개선 방향)

  • Hwang, Je-Gyu;Byun, Hun-Soo
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.30 no.4
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    • pp.342-352
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    • 2020
  • Objectives: The characteristics of research workers are different from those working in the manufacturing industry. Furthermore, the reagents used change according to the research due to the characteristics of the laboratory, and the amounts used vary. In addition, since the working time changes almost every day, it is difficult to adjust the time according to exposure standards. There are also difficulties in setting standards as in the manufacturing industry since laboratory environments and the types of experiments performed are all different. For these reasons, the measurement of the working environment of research workers is not realistically carried out within the legal framework, there is a concern that the accuracy of measurement results may be degraded, and there are difficulties in securing data. The exposure evaluation based on an eight-hour time-weighted average used for measuring the working environment to be studied in this study may not be appropriate, but it was judged and consequently applied as the most suitable method among the recognized test methods. Methods: The investigation of the use of chemical substances in the research laboratory, which is the subject of this study, was conducted in the order of carrying out work environment measurement, sample analysis, and result analysis. In the case of the use of chemical substances, after organizing the substances to be measured in the working environment, the research workers were asked to write down the status, frequency, and period of use. Work environment measurement and sample analysis were conducted by a recognized test method, and the results were compared with the exposure standards (TWA: time weighted average value) for chemical substances and physical factors. Results: For the substances subject to work environment measurement, the department of chemical engineering was the most exposed, followed by the department of chemistry. This can lead to exposure to a variety of chemicals in departmental laboratories that primarily deal with chemicals, including acetone, hydrogen peroxide, nitric acid, sodium hydroxide, and normal hexane. Hydrogen chloride was measured higher than the average level of domestic work environment measurements. This can suggest that researchers in research activities should also be managed within the work environment measurement system. As a result of a comparison between the professional science and technology service industry and the education service industry, which are the most similar business types to university research laboratories among the domestic work environment measurements provided by the Korea Safety and Health Agency, acetone, dichloromethane, hydrogen peroxide, sodium hydroxide, nitric acid, normal hexane, and hydrogen chloride are items that appear higher than the average level. This can also be expressed as a basis for supporting management within the work environment measurement system. Conclusions: In the case of research activity workers' work environment measurement and management, specific details can be presented as follows. When changing projects and research, work environment measurement is carried out, and work environment measurement targets and methods are determined by the measurement and analysis method determined by the Ministry of Employment and Labor. The measurement results and exposure standards apply exposure standards for chemical substances and physical factors by the Ministry of Employment and Labor. Implementation costs include safety management expenses and submission of improvement plans when exposure standards are exceeded. The results of this study were presented only for the measurement of the working environment among the minimum health management measures for research workers, but it is necessary to prepare a system to improve the level of safety and health.

A Study on Obsession & Lie in College Freshmen (대학신입생의 강박증 및 허구성 경향 조사)

  • Kim, Jin-Sung;Park, Byung-Tak;Lee, Jong-Bum;Lee, Jung-Hoon;Cheung, Seung-Douck
    • Journal of Yeungnam Medical Science
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    • v.5 no.1
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    • pp.111-125
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    • 1988
  • The authors studied obsession, using Derogatis'SCL-90, and lie tendency using MMPI, in the subjects of 2586 male and 1206 female college freshmen of Yeungnam University. The authors collected the reports of self-rating Obsession scale and Lie scale during the periods from January to February, 1988, and applied ANOVA and t-test on obsession and lie scores in order to compare than between various psychosocial factors, and sexes. The results as follows: 1. There was not significant difference in the mean average of total obsession scores between male and female students: male students scored $10.26{\pm}5.21$, female students scored $10.54{\pm}5.01$. 2. High scored items were doubting, indecisiveness, inattention, obsessive thoughts and preoccupation with accuracy. 3. 37 male students(1.4%) showed high obsession scores of 25 or higher, while 9 female students(0.7%) showed thd same scores. 4. There was strong tendency toward higher obsession scores in the students who were dissatisfied with their home atmosphere, college, department and familiarity of parents and those who had pessimistic view of self in the past, present or future in both group(respectively P<0.001). The male students who attended the department of fine arts, who grew at the Up & whose educational fees were paid by brothers & sisters showed higher level of obsession scores(respectively P<0.05, P<0.05, P<0.01). The female students who grew at the Myun & who were self-cook showed higher level of obsession scores(respectively P<0.05). 5. There was not significant difference in the mean averages of total lie scores between male and female students: male students scored $4.73{\pm}2.49$, female students scored $4.70{\pm}2.16$. 6. High scored items were NO. 14, 8, 11, 9 and 1 in the table 6. 7. 98 male students(3.7%) showed high lie scores of 70 or high, while 27 female students(2.2%) showed the same scores. 8. There was strong tendency toward higher lie scores in the students who were satisfied with their home atmosphere, college, department and familiarity of parents and those who had optimistic view of self in the past, present or future in both group(respectively P<0.001). The students who attended the department of pharmacy, music, evening programs showed higher level of lie scores(P<0.05).

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Precision evaluation of the treatment that used coordinates confirmation of couch in case of two forgets adjoined. (Couch의 좌표 확인을 이용한 치료 위치 이동의 정확성 평가)

  • Seo Jeong-min;Jeong Cheon-young;Park Young-hwan;Song Ki-won
    • The Journal of Korean Society for Radiation Therapy
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    • v.15 no.1
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    • pp.35-40
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    • 2003
  • I. Purpose Confirming an error to be able to break out in a method to move couch manually while operator sees the skin marks on patient in case of curing head who got 2 targets adjoined, so we analyze coordinates price of couch, evaluate reproducibility and precision of change movements between targets. II. Materials and Methods In radiotherapy, for confirming errors in manual movements by operators by exchanging between two targets to treat patient head, we read coordinates price(vertical, longitudinal, lateral three directions of couch) shown on a monitor of LINAC( CL 2100, Varian, USA) in order to evaluate accuracy about the length that moved in time for moving couch manually. After reading movement length of coordinates recorded in three directions of all treatment, we compared distance between targets recorded in RTP(Pinnacle, ADAC, USA) with reading coordinates price of couch, setting actually done the same patient for ten times, coordinates were recorded, treated for evaluating averages and degrees of errors and standard deviations. III. Results In method to confirm skin marks of patient by operators' view and to move couch manually, average standard deviations of movements between two targets are vertical 1.4mm, longitudinal 0.9mm, lateral 2.2mm in each direction. As for the error in straight dimension, it is about 3.6mm averages and 5.1mm maximum. The average of errors in each directions was vertical 1mm, longitudinal 0.7mm, lateral 2.7mm. The greatest error broke out in lateral direction with $25\%$ of all cases ; to exceed an error average. IV. Conclusions If operators moved manually couch for changing target points, errors about 3.6mm average degrees occur. It is important that operators confirm the errors prices of actual couch coordinates for asking a correct movement between the targets adjoined each other ; in case of treatment demanding high precision like 3D conformal therapy or IMRT. Therefore, if we apply couch coordinates confirmation to reproducibility and to precision evaluation of treatment, it's expected that we can execute high-quality radiotherapy.

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Serial Survey on Group A beta-Hemolytic Streptococcal Carrier Rate and Serotyping in Elementary School Children in 1996~1998 (3년간(1996~1998) 초등학생의 A군 연쇄구균 보균율과 혈청학적 분류에 관한 연구)

  • Kim, Ji-Hyun;Kim, Ju-Ye;Kang, Hyeon-Ho;Cha, Sung-Ho;Lee, Young-Hee
    • Pediatric Infection and Vaccine
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    • v.7 no.1
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    • pp.143-151
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    • 2000
  • Purpose : The accuracy of bacteriologic diagnosis of beta-hemolytic streptococcal pharyngotonsillitis depends on the degree of carrier rate in that area where the throat swabs are obtained and the evaluation of serological T typing as an epidemiologic marker is important to understand epidemiology of streptococcal infection. The purpose of this study is to know the carrier rates of group A streptococcus in normal children form four different areas and to find out the epidemiologic characteristic in distribution of the serotypes for 3 years. Method : Throat swabs were obtained from the tonsillar fossa of normal school children in four different areas(Uljin, Seoul, Osan, Kunsan) from March to May 1996, in Uljin in April 1997, and in Uljin in April 1998. The samples were plated on a 5% sheep blood agar plate and incubated overnight at $37^{\circ}C$ before examination for the presence of beta-hemolytic colonies. All isolated beta-hemolytic streptococcus were grouped and serotyped by T agglutination. Results : The carrier rate of beta-hemolytic streptococci and group A streptococci in 1996 were 27.6%, 18.6% at Uljin; 16.4%, 2.7% at Seoul; 33.0%, 26.0% at Osan; 20.0%, 12.3% at Kunsan, respectively. Among 1,192 normal school children from 4 different areas, we obtained 179 strains of group A streptococci. Fifty two percent of the strains were typable by T agglutination in 1996. Common T-type in 1996 were NT, T1, T3, T2 at Uljin; T12, T25 at Seoul; NT, T6, T28 at Osan; T25, T4, NT, T5 at Kunsan, in decreasing order, respectively. At Uljin, T1, T3, T25 accounted for 69% of strains in 1996, T1, T12, T25 accounted for 70% in 1997, and T12, T4 accounted for 88% in 1998. Conclusion : Higher carrier rates were found in Uljin and Osan, where there are a lower population density with scanty of medical facilities compared with another areas. We supposed that low carrier rates is likely to be related to antibiotic abuse or some epidemiologic factor. The periodic and seasonal serotyping analysis is important in monitoring and understanding the epidemiologic patterns of group A streptococci.

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