• 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.

• The Journal of the Korean Society for Microbiology
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• v.20 no.1
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• pp.1-11
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• 1985

A total of 211 strains of Staphylococcus aureus which included 118 strains isolated from various clinical specimens of admitted patients of University Hospital with systemic or severe cases of infection and 93 strains from infected skin diseases of out-patients of dermatology clinic located in rural area, were tested for the antimicrobial susceptibility to the 12 drugs of common use and the phage typing. An these were subjected to the study of plasmid profile analysis for the molecular epidemiology of nosocomial infections. University Hospital(UH) isolates showed higher frequency of resistance than local clinic(LC) isolates against 10 drugs excluding tetracycline(Tc), and trimethoprim(Tp). The MIC of UH isolates were above than $128{\mu}g/ml$ against 9 drugs except Tc, gentamicin(Gm), and Tp, but LC isolates did not show such a high level of MIC. There was difference of MIC needed to inhibit 90% of strains(MIC90) against each drugs tested between two groups of UH and LC isolates. UH isolates showed 2 to 4 times higher value of MIC90 by two-fold serial dilution of drug concentration than LC isolates. Tp was considered as an effective drug in treatment of staphylococcal infections whereas ampicillin and Gm were appeared to be ineffective. Seventy-three strains(61.9%) of UH isolates and 70(69.9%) of LC were typable with phages from Colindale Reference Laboratory. The prevailing phage type of UH isolates belonged to lytic group II were 27 strains(22.9%) and those of LC isolates belonged to lytic group II were 23 strains(24.7%). Thirteen strains(11.0%) of UH isolates were multiply resistant to more than 5 drugs to 10 drugs but none of LC isolates. Through the lysis method of Kado and Liu followed by agarose gel electrophoresis, none of 211 strains showed plasmid profile. These results were confirmed by re-examination through the method of Birnboim and Doly.

• Journal of Korea Multimedia Society
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• v.19 no.2
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• pp.163-169
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• 2016

In Korea, prostate cancer accounted for generating growth rate second the following thyroid cancer, because of western dietary habits. Survival rate of prostate cancer after clinical behavior is changed depend on follow-up management. A telemedicine have been applied to replacement of medical specialist in rural area, and a quick reaction to emergency situation. Our study developed prostate 3-dimensional (3D) visualization program and designed prostate aftercare system architecture, called smart care, using a device that can access the Internet. Region of interest (ROI) in prostate was manually segmented by physicians and visualized to 3D objects and sent to PACS Server as DICOM images. So, medical personnel could confirm patients' data along with 3D images not only PACS system, but also portable device like a smart phone. As a result, we conducted the aftercare service to 98 patients and visualize 3D prostate images. 3D images had advantage to instinctively apprehend where lesion is and make patients to understand state of their disease easily. In the future, should conduct an aftercare service to more patients, and will obtain numerical index through follow-up study to an accurate analysis.

• Journal of Preventive Medicine and Public Health
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• v.33 no.3
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• pp.271-279
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• 2000

Objectives : To assess the seroprevalence and risk factors of toxoplasmosis in high school students in Cheju Province, Korea. Methods : A total of 4,570 high school students from 18 schools in Cheju Province were investigated for Toxoplasma gondii antibodies(IgG) by enzyme linked immunosorbent assay (ELISA). Risk factors for toxoplasmosis, such as place of residence, type of house, contact with cats and other pets, and rare meat consumption, were examined by questionnaire. Results . The overall antibody positive rate was 5.5% and ranged from 2.6 to 11.5% by school. There was no significant difference between males and females. Statistical analyses of the questionnaire data indicated that the risk factors for seropositivity were: (1) birth place (Cheju/others), (2) place of residence (rural/urban), (3) dietary habits (vegetarian/non vegetarian), (4) eating rare meat, (5) exposure to pets and (6) hepatitis B. Conclusion : We confirmed that the prevalence of the anti-Toxoplasma gondii antibody in a population of high school students in Cheju Province was to the previously reported prevalence.

• The Korean Journal of Pesticide Science
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• v.20 no.2
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• pp.172-180
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• 2016

This study was conducted to evaluate the relations between the exposure level of organophosphates (OPs) pesticide and application factors among rural farmers. The urinary dialkylphosphates, metabolites of organophosphorus pesticides, including DMP, DEP, DMTP and DETP were analyzed by GC/MSD and GC/MS/MS. The DMP and DMTP were detected more in the use of a speed sprayer without cap than with a capped one. Also, the less farmers wore the personal protective equipment (PPE), the more these were detected. The amount of organophosphorus exposure was the highest in the use of a power sprayer. However, it was low when a farmer applied pesticides with a speed sprayer with cap and wore more PPE. In this study, the detection rate was analyzed by chi-square test, the exposure level of OPs was analyzed by a generalized linear model.

• Journal of agricultural medicine and community health
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• v.43 no.2
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• pp.108-113
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• 2018

목적 글루포시네이트암모늄은 비선택성 제초제로 1984년 일본에서 개발되었으며, 급성 중독시에는 위장관계 증상뿐만 아니라 의식변화, 경련, 호흡부전 및 기억소실 등과 같은 다양한 임상증상을 보이는 것으로 알려져 있다. 한국에는 1994년 소개된 이후로 널리 사용되고 있으며, 사용량의 증가와함께 음독환자가 점점 증가하여 사회적 문제가 되고 있다. 저자들은 최근 글로포시네이트 중독 환자에서 초기치료 후 지연성 악화를 보였던 2례를 문헌고찰과 함께 보고하고자 한다. 방법 및 결과 첫 번째 증례는 62세의 남자환자로 음주상태에서 글루포시네이트암모늄 음독 후 의식 저하 상태로 발견되어 응급실로 이송되었다. 응급 위세척을 시행 후 보존적 치료 및 집중모니터링을 유지하였고, 의식수준은 6시간 후에 거의 명료한 상태로 호전되었다. 지연성 악화의 가능성에 대해설명하고 지속적인 경과관찰 및 치료를 위해 집중치료실 입원이 필요함에 대해 설명하였으나, 환자와 보호자는 타상급병원으로의 전원을 원하였다. 환자는 이송 중에 발생한 심폐정지로 심폐소생술을 시행하였으나, 회복되지 못하고 사망하였다. 두 번째 증례는 54세의 남자 환자로 글루포시네이트암모늄 음독 후 발생한 의식 변화로 응급실로 이송되었다. 내원시 의식은 혼미한 상태였으며 앞의 증례와 같이 응급 위세척을 시행하였다. 본 환자는 초기치료 후 본원 집중치료실에서 지속적인 혈액 및 생화학적 검사를 시행하였으며, 집중모니터링 및 치료를 유지하였다. 입원 2일째 혈액검사 소견은 호전 중이었으나, 경련이 발생하였으며 의식은 혼미한 상태가 지속되었다. 신경과 협진하여 뇌파검사를 시행 후 항경련제를 증량한 후로 경련은 발생하지 않았다. 입원 7일째에는 의식 수준은 거의 명료한 상태까지 호전되었다. 입원 13일째 혈액 및 생화학검사에서 약간의 혈색소 감소 외에는 정상소견을 보였으며, 뚜렷한 신경학적 합병증 없이 퇴원하였다. 결론 급성 글루포시네이트중독 환자는 매우 다양한 임상증상을 보이며 초기치료 후에 상태가 안정적이더라도 지연성으로 임상적 또는 신경학적 악화가 발생할 가능성이 있으므로 치료에 유의하여야 한다.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6067-6072
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• 2012

Background: Breast cancer in developing countries is on the rise. There are currently no guidelines to screen women at risk in India. Since mammography in the western world is a well-accepted screening tool to prevent late presentation of breast cancer and improve mortality, it is intuitive to adopt mammography as a screening tool of choice. However, it is expensive and fraught with logistical issues in developing countries like India. Materials and Methods: Our breast cancer screening camp was done at a local district hospital in India after approval from the director and administrators. After initial training of local health care workers, a one-day camp was held. Clinical breast examination, mammograms, as well as diagnostic evaluation with ultrasound and fine needle aspiration biopsy were utilized. Results: Out of total 68 women screened only 2 women with previous history of breast cancer were diagnosed with breast cancer recurrence. None of the women in other groups were diagnosed with breast cancer despite suspicious lesions either on clinical exam, mammogram or ultrasound. Most suspicious lesions were fibroadenomas. The average cost of screening women who underwent mammography, ultrasound and fine needle aspiration was $30 dollars, whereas it was $16 in women who had simple clinical breast examination. Conclusions: Local camps act as catalysts for women to seek medical attention or discuss with local health care workers concerns of discovering new lumps or developing breast symptoms. Our camp did diagnose recurrence of breast cancer in two previously treated breast cancer patients, who were promptly referred to a regional cancer hospital. Further studies are needed in countries like India to identify the best screening tool to decrease the presentation of breast cancer in advanced stages and to reduce mortality.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.3949-3953
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• 2012

Head and neck cancers are amongst the commonest malignancies, accounting for approximately 20% of the cancer burden in India. The major risk factors are tobacco chewing, smoking and alcohol consumption, which are all preventable. This retrospective study presents data from the histopathology register for a five year period from 2002-2006 at Patna Medical College and Hospital, a tertiary care hospital drawing patients from the entire Bihar state, the 3rd most populous state of India with the majority of the population residing in rural areas. Incidence rates based on sex, age, site of lesion, including age standardized incidence rates for males and females, with mean age of presentation, distribution of histological variants and year wise trend were calculated. Out of 455 head and neck neoplasias, 241 were benign while 214 were malignant. The most common age group for all malignant biopsies was 7th decade for males and the 5th decade for females. Malignant cases were commoner in males than females with the male:female ratio of 3.1:1, which was found to be statistically significant by the chi-square (${\chi}^2$) test. The crude rate and age standardized incidence rate was 0.05 and 0.06 per 100,000 population respectively. Squamous cell carcinoma (SCC) contributed about 96% of all cases, with grade I being the most common. Larynx was the most common site for malignancy, the supraglottic region being its most commonly affected sub-site. This observed incidence patterns in the region are a reminder of widespread unawareness, low healthcare utilization with virtually non-existent cancer programs. It also underlines the need to advocate for reliable cost-effective programs to create awareness, for early detection and plan appropriate management strategies. There is a compelling demand for a cancer registry in this region as well as proper implementation of preventive measures to combat this growing threat of cancer, many of whose risk factors are preventable.

• Korean Journal of Health Education and Promotion
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• v.24 no.2
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• pp.77-91
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• 2007

Purpose: The purpose of this study was to investigate the relationship among health behavior, obesity and QOL, and to identify factors affecting QOL of University Students in rural area, to provide the basic data for health promoting program in order to improve the QOL. Methods: The subjects of this study were 991 university students. The collected data was analyzed using descriptive statistics, t-test, ANOVA, Scheffe's test, Pearson correlation coefficient and Stepwise multiple regression with SAS. Results: In the degree of the obesity were 13.4% of the underweight group, 48.9% of the normal weight group, and 37.6% of the overweight group. The average item score for the QOL was 3.19; the highest score on the subscale was physical domains(M=3.25) with the lowest environmental domains. In the degree of health behavior performance were 15.3% of regular health check, 27.5% of exercise, 45.1% of no-smoking, 32.4% of no-drinking alcohol, 53.1% of sleeping 7-hour, 49.7% of weight care, 56.1% of stress management, and 44.4% of breakfast. The score of QOL was statistically significant difference according to age, occupation of father, the number of brothers, total income, level of life, perceived health status, and admission of hospital. The score of QOL correlated positively with health behavior(r=.2521, p<.0001), and the scores of health behavior correlated positively with obesity(r=.0915, p=.0039). Stepwise multiple regression analysis for QOL revealed that the most powerful predictor was level of life. Stress management, perceived health status, sleeping 7-hour, regular health check, admission of hospital, total income, and weight care explained 13.2% of the variance. Conclusions: Therefore, it is necessary to develop health behavior promotion program in order to enhance the quality of life of university students. Future studies need to be pursued to find significant influencing factors for QOL of university students.

• Journal of agricultural medicine and community health
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• v.23 no.1
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• pp.51-64
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• 1998

This study was carried out during 3 years from March 1992 to March 1995, 140 healthy people and 140 C.V.A patients were investigated, at an oriental clinic in Taejon. The data collected was analysed using a SAS. The results are as follows. 1. The Relationships between patients who have undergone one or more abortion procedures and C.V.A occurrence. A statistical significant difference was recorded between the control group and the outpatients group of P<0.05 2. Number of years after initial C.V.A diagnosis before C.V.A symptom onset. within 1 years 52% (2-3 years, 3-4 years, 4-5 years, 5 years and over) 3. Additional diseases occurring after initial stroke 1 disease 50.7% (2, 3, 4, 5 or more) 4. Alcohol Consumption "A statistical significant difference was recorded between the control group and the outpatients group of" P<0.01 5. Previous Treatment Experience for stoke outpatients Oriental Hospital, clinic 64.3% (General Hospital, clinic, a public health center drug store, home remedies, etc) 6. Exercise Frequency Outpatients Regular 28.6%, Irregular 71.4% Control sample Regular 27%, Irregular 72.9% 7. Degree of Appetite "A statistical significant difference was recorded between the control group and the outpatients group of" P<0.01 8. People who include fish in their diet "A statistical difference was recorded between the control group and the outpatients group of" P<0.01.