• Progress in Medical Physics
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• v.26 no.3
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• pp.160-167
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• 2015

Radiation exposure from medical diagnostic imaging procedures to patients is one of the most significant interests in diagnostic x-ray system. A miniature x-ray intraoral tube was developed for the first time in the world which can be inserted into the mouth for imaging. Dose evaluation should be carried out in order to utilize such an imaging device for clinical use. In this study, dose evaluation of the new x-ray unit was performed by 1) using a custom made in vivo Pig phantom, 2) determining exposure condition for the clinical use, and 3) measuring patient dose of the new system. On the basis of DRLs (Diagnostic Reference Level) recommended by KDFA (Korea Food & Drug Administration), the ESD (Entrance Skin Dose) and DAP (Dose Area Product) measurements for the new x-ray imaging device were designed and measured. The maximum voltage and current of the x-ray tubes used in this study were 55 kVp, and 300 mA. The active area of the detector was $72{\times}72mm$ with pixel size of $48{\mu}m$. To obtain the operating condition of the new system, pig jaw phantom images showing major tooth-associated tissues, such as clown, pulp cavity were acquired at 1 frame/sec. Changing the beam currents 20 to $80{\mu}A$, x-ray images of 50 frames were obtained for one beam current with optimum x-ray exposure setting. Pig jaw phantom images were acquired from two commercial x-ray imaging units and compared to the new x-ray device: CS 2100, Carestream Dental LLC and EXARO, HIOSSEN, Inc. Their exposure conditions were 60 kV, 7 mA, and 60 kV, 2 mA, respectively. Comparing the new x-ray device and conventional x-ray imaging units, images of the new x-ray device around teeth and their neighboring tissues turn out to be better in spite of its small x-ray field size. ESD of the new x-ray device was measured 1.369 mGy on the beam condition for the best image quality, 0.051 mAs, which is much less than DRLs recommended by IAEA (International Atomic Energy Agency) and KDFA, both. Its dose distribution in the x-ray field size was observed to be uniform with standard deviation of 5~10 %. DAP of the new x-ray device was $82.4mGy*cm^2$ less than DRL established by KDFA even though its x-ray field size was small. This study shows that the new x-ray imaging device offers better in image quality and lower radiation dose compared to the conventional intraoral units. In additions, methods and know-how for studies in x-ray features could be accumulated from this work.

• Journal of Radiation Protection and Research
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• v.21 no.4
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• pp.273-284
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• 1996

Embryos and fetuses are more sensitive to various environmental agents than are adults or children. The biological effects such as intrauterine death and malformation are closely connected with prenatal exposure very various agents. The sensitivity of these embryonic/fetal effects depends on the stage of pregnancy. From the viewpoint of fetal development, embryonic and fetal stages can be divided into three stages : Preimplantation, organogenetic and fetal. Each stage corresponds to 0 to 4.5days, 4.5 to 13.5days, and 13.5days of gestation in mice, respectively. Many studies on the biologcal effects of mice irradiated by ${\gamma}-rays$ at various stages during organogenesis and fetal period have been performed. Based on these results, the dose-effect and dose-response relationships in malformations, intrauterine death, or retardation of the physical growth have been practically modeled by the ICRP(International Commission on Radiological Protection) and other international bodies for radiation protection. Many experimental studies on mice have made it clear that mice embryos in the preimplantation period have a higher sensitivity to radiation for lethal effects than the embryos/fetuses on other prenatal periods. However, no eratogenic effects of radiation at preimplantation stages of mice have been described in many textbooks. It has been believed that 'all or none action results' for radiation of mice during the preimplantation period were applied. The teratogenic and lethal effects during the preimplantation stage are one of the most important problems from the viewpoint of radiological protection, since the preimplantation stage is the period when the pregnancy itself is not noticed by a pregnant woman. There are many physical or chemical agents which affect embryos/fetuses in the environment. It is assumed that each agents indirectly effects a human. Then, a safety criterion on each agent is determined independently. The pregnant ICR mice on 2, 48, 72 or 96 hours post-conception (hpc), at which are preimplantation stage of embryos, were irradiated whole body Cesium-gamma radiation at doses of 0.1, 0.25, 0.5, 1.5, and 2.5 Gy with dose rate of 0.2 Gy/min. In the embryos from the fetuses from the mice irradiated at various period in preimplantation, embryonic/fetal mortalities, incidence of external gross malformation, fetal body weight and sex ratio were observed at day 18 of gestation. The sensitivity of embryonic mortalities in the mice irradiated at the stage of preimplantation were higher than those in the mice irradiated at the stage of organogenesis. And the more sensitive periods of preimplantation stage for embryonic death were 2 and 48 hpc, at which embryos were one cell and 4 to 7 cell stage, respectively. Many types of the external gross malformations such as exencephaly, cleft palate and anophthalmia were observed in the fetuses from the mice irradiated at 2, 72 and 96 hpc. However, no malformations were observed in the mice irradiated at 48 hpc, at which stage the embryos were about 6 cell stage precompacted embryos. So far, it is believed that the embryos on preimplantation stage are not susceptible to teratogens such as radiation and chemical agents. In this study, the sensitivity for external malformations in the fetuses from the mice irradiated at preimplantation were higher than those in the fetuses on stage of organogenesis.

• Journal of agricultural medicine and community health
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• v.27 no.2
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• pp.87-105
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• 2002

In order to find out the knowledge, attitude, and experience of community health practitioners(CHP) on complementary therapy, 393 community health practitioners who provide primary health care service in Busan, Kyeongnam, and Daegu, Gyeongbuk regions were interviewed or surveyed by mail from February 1st to March 31st, 2002. In terms of interest of CHPs toward 11 different hinds of complementary therapy, the rate of interest for soojichim was the highest with 75.3%. Aroma therapy had the interest of 71.0% of the CHPs, oriental medicine had 67.4%, and massage had 67.4%. The interest for shiatsu was 64.6%, while homeopath had the lowest rate of interest of 18.1%. In terms of reliance on the treatment results, oriental medicine scored the highest with 92.6%, and soojichim, massage, and shiatsu followed with 85.5%, 83.7%, and 81.7% respectively. Homeopath had the lowest reliance of 18.1%. The 65.1% of the CHPs had the experience of recommending oriental medicine to patients. 50.4% indicated that they had recommended soojichim, and 44.8% had recommended massage before. Shiatsu and aromatherapy followed with 34.4% and Homeopath had the lowest rate of 2.80%. When CHPs were asked if they had received any training in complementary therapy, 33.1% indicated that they had studied soojichim and 13.2%stated that they had learned oriental medicine. Aromatherapy, massage, and shiatsu followed with 11.2%, 8.4%, and 5.6% respectively On the other hand, none of the CHPs had received training in homeopath. In terms of using complementary therapy during the past 5 years, 23.9% had been treated with oriental medicine, and 18.896 had received soojichim. 5.9% had received aromatherapy, 5.3% had used massage, and 5.1% had experience with shiatsu. None of the practitioners had used homeopath during the past 5 years. Significantly many number of practitioners indicated that they had excellent treatment results with all hinds of complementary therapy, and there were rare cares of side effects. When they were asked if they wanted complementary therapy to become part of the curriculum during re-training or training for public service personnels, 78100 wanted soojichim, 69.2% wanted oriental medicine, and 67.9% wanted aroma therapy. 63.9% wanted shiatsu to be included, and 63.1% wanted massage. When CHPs were asked if they wanted to use complementary therapy during primary health care, 63.6% wanted to use soojichim, 52.9% wanted massage, and 51.9% wanted to use aroma therapy. Oriental medicine also showed a high rate of 50.1%. On the other hand, only a small percentage wanted to use chiropractic or homeopath with 17.0% and 12,2% respectively. Among the CHPs, there were some who had administered complementary therapy during the past 5 years. 84% had administered soojichim, 4.6% had administered oriental medicine, and 2.5% had administered massage 2.5% of the CHPs answered that they had administered aromatherapy. However, none of them had administered apitherapy or homeopath. Most of patients showed positive responses, and the rate of side effect was very low. As shown in the above results, although CHPs have a high rate of interest, reliance, and experience in recommending complementary therapy, only a low percentage of them had received any training in complementary therapy. In addition, since there were little side effects when they received or administered complementary therapy, they hoped complementary therapy, which can be beneficial to health, to be introduced to the curriculum. Therefore, in order to provide community members with complementary therapy and the correct information regarding the selection of complementary therapy that could be beneficial to health, a policy of continuous interest and support is needed so that CHPs can he provided with a systemic and rational curriculum of complementary therapy.

• Journal of agricultural medicine and community health
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• v.44 no.4
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• pp.165-184
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• 2019

Objectives: The purpose of this study was to identify and compare the difference and related factors with general characteristic and health behaviors, a experience of diagnosis and treatment of chronic diseases between rural and urban among elderly in Korea. Methods: We used the data of Community Health Survey 2017 which were collected by the Korean Center for Disease Control and Prevention. The study population comprised 67,835 elderly peopled aged 65 years or older who participated in the survey. The chi-square test, univariate and multivariate logistic regression analysis were used to analyze data. Results: We identified many significant difference of health behaviors, an experience of diagnosis and treatment with chronic diseases between rural and urban. Compared to urban elderly, the odds ratios (ORs) (95% confidence interval) of rural elderly were 1.136 (1.092-1.183) for diagnosis of diabetes, 1.278 (1.278-1.386) for diagnosis of dyslipidemia, 0.940 (0.904-0.977) for diagnosis of arthritis, 0.785(0.736-0.837) for treatment of arthritis, 1.159 (1.116-1.203) for diagnosis of cataracts, and 1.285(1.200-1.375) for treatment of cataracts. In the experience of diagnosis and treatment of chronic diseases, various variables were derived as contributing factors for each disease. Especially, there were statistically significant difference in the experience of diabetes diagnosis, arthritis diagnosis, cataract diagnosis and dyslipidemia except for hypertension diagnosis (p <0.01) between urban and rural elderly. There were statistically significant differences in the experience of treatment for arthritis and cataract (p <0.01), but there was no significant difference in the experience of treatment for hypertension, diabetes, dyslipidemia between urban and rural elderly. Conclusion: Therefore, it would be necessary to implement a strategic health management project for diseases that showed significant experience of chronic diseases with diagnosis and treatment, reflecting the related factors of the elderly chronic diseases among the urban and rural areas.

• Tuberculosis and Respiratory Diseases
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• v.59 no.3
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• pp.286-297
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• 2005

Background : Non-small cell lung cancer (NSCLC) is a common cause of cancer-related death in North America and Korea, with an overall 5-year survival rate of between 4 and 14%. The TNM staging system is the best prognostic index for operable NSCLC . However, epidermal growth factor receptor (EGFR), matrix metalloproteinase-9(MMP-9), and C-erbB-2 have all been implicated in the pathogenesis of NSCLC and might provide prognostic information. Methods : Immunohistochemical staining of 81 specimens from a resected primary non-small cell lung cancer was evaluated in order to determine the role of the biological markers on NSCLC . Immunohistochemical staining for EGFR, MMP-9, and C-erbB-2 was performed on paraffin-embedded tissue sections to observe the expression pattern according to the pathologic type and surgical staging. The correlations between the expression of each biological marker and the survival time was determined. Results : When positive immunohistochemical staining was defined as the extent area>20%(more than Grade 2), the positive rates for EGFR, MMP-9, and C-erbB-2 staining were 71.6%, 44.3%, and 24.1% of the 81 patients, respectively. The positive rates of EGFR and MMP-9 stain for NSCLC according to the surgical stages I, II, and IIIa were 75.0% and 41.7%, 66.7% and 47.6%, and 76.9% and 46.2%, respectively. The median survival time of the EGFR(-) group, 71.8 months, was significantly longer than that of the EGFR(+) group, 33.5 months.(p=0.018, Kaplan-Meier Method, log-rank test).. The MMP-9(+) group had a shorter median survival time than the MMP-9(-) group, 35.0 and 65.3 months, respectively (p=0.2). The co-expression of EGFR and MMP-9 was associated with a worse prognosis with a median survival time of 26.9 months, when compared with the 77 months for both negative-expression groups (p=0.0023). There were no significant differences between the C-erbB-2(+) and C-erbB-2 (-) groups. Conclusion : In NSCLC, the expression of EGFR might be a prognostic factor, and the co-expression of EGFR and MMP-9 was found to be associated with a poor prognosis. However, C-erbB-2 expression had no prognostic significance.

• Journal of the Korean Society of Radiology
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• v.6 no.4
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• pp.281-290
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• 2012

The difference of radiation dose of MDCT due to different protocols between hospitals was analyzed by CTDI, DLP, the number of Slice and the number of DLP/Slice in 30 cases of the head, the abdomen and the chest that have 10 cases each from MDCT examination of the department of diagnostic imaging of three general hospitals in Gyeongsangbuk-do. The difference of image quality, CTDI, DLP, radiation dose in the eye and radiation dose in thyroid was analyzed after both helical scan and normal scan for head CT were performed because a protocol of head CT is relatively simple and head CT is the most frequent case. Head CT was significantly higher in two-thirds of hospitals compared to A hospital that does not exceed a CTDI diagnostic reference level (IAEA 50mGy, Korea 60mGy) (p<0.001). DLP was higher in one-third of hospitals than a diagnostic reference level of IAEA 1,050mGy.cm and Korea 1,000mGy.cm and two-thirds exceeded the recommendation of Korea and those were significantly higher than A hospital that does not exceed a diagnostic reference level (p<0.001). Abdomen CT showed 119mGy that was higher than a diagnostic reference level of IAEA 25mGy and Korea 20mGy in one-third. DLP in all hospitals was higher that Korea recommendation of 700mGy.cm. Among target hospitals, C hospital showed high radiation dose in all tests because MPR and 3D were of great importance due to low pitch and high Tube Curren. To analyze the difference of radiation dose by scan methods, normal scan and helical scan for head CT of the same patient were performed. In the result, CTDI and DLP of helical CT were higher 63.4% and 93.7% than normal scan (p<0.05, p<0.01). However, normal scan of radiation dose in thyroid was higher 87.26% (p<0.01). Beam of helical CT looked like a bell in the deep part and the marginal part so thyroid was exposed with low radiation dose deviated from central beam. In addition, helical scan used Gantry angle perpendicularly and normal scan used it parallel to the orbitomeatal line. Therefore, radiation dose in thyroid decreased in helical scan. However, a protocol in this study showed higher radiation dose than diagnostic reference level of KFDA. To obey the recommendation of KFDA, low Tube Curren and high pitch were demanded. In this study, the difference of image quality between normal scan and helical scan was not significant. Therefore, a standardized protocol of normal scan was generally used and protective gear for thyroid was needed except a special case. We studied a part of CT cases in the local area. Therefore, the result could not represent the entire cases. However, we confirmed that patient's radiation dose in some cases exceeded the recommendation and the deviation between hospitals was observed. To improve this issue, doctors of diagnostic imaging or technologists of radiology should perform CT by the optimized protocol to decrease a level of CT radiation and also reveal radiation dose for the right to know of patients. However, they had little understanding of the situation. Therefore, the effort of relevant agencies with education program for CT radiation dose, release of radiation dose from CT examination and addition of radiation dose control and open CT contents into evaluation for hospital services and certification, and also the effort of health professionals with the best protocol to realize optimized CT examination.

• Journal of Hospice and Palliative Care
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• v.5 no.2
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• pp.111-124
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• 2002

Purpose : Although the average life expectancy has increased due to advances in medicine, mortality due to cancer is on an increasing trend. Consequently, the number of terminally ill cancer patients is also on the rise. Predicting the survival period is an important issue in the treatment of terminally ill cancer patients since the choice of treatment would vary significantly by the patents, their families, and physicians according to the expected survival. Therefore, we investigated the prognostic factors for increased mortality risk in terminally ill cancer patients to help treat these patients by predicting the survival period. Methods : We investigated 31 clinical parameters in 157 terminally ill cancer patients admitted to in the Department of Family Medicine, National Health Insurance Corporation Ilsan Hospital between July 1, 2000 and August 31, 2001. We confirmed the patients' survival as of October 31, 2001 based on medical records and personal data. The survival rates and median survival times were estimated by the Kaplan-Meier method and Log-rank test was used to compare the differences between the survival rates according to each clinical parameter. Cox's proportional hazard model was used to determine the most predictive subset from the prognostic factors among many clinical parameters which affect the risk of death. We predicted the mean, median, the first quartile value and third quartile value of the expected lifetimes by Weibull proportional hazard regression model. Results : Out of 157 patients, 79 were male (50.3%). The mean age was $65.1{\pm}13.0$ years in males and was $64.3{\pm}13.7$ years in females. The most prevalent cancer was gastric cancer (36 patients, 22.9%), followed by lung cancer (27, 17.2%), and cervical cancer (20, 12.7%). The survival time decreased with to the following factors; mental change, anorexia, hypotension, poor performance status, leukocytosis, neutrophilia, elevated serum creatinine level, hypoalbuminemia, hyperbilirubinemia, elevated SGPT, prolonged prothrombin time (PT), prolonged activated partial thromboplastin time (aPTT), hyponatremia, and hyperkalemia. Among these factors, poor performance status, neutrophilia, prolonged PT and aPTT were significant prognostic factors of death risk in these patients according to the results of Cox's proportional hazard model. We predicted that the median life expectancy was 3.0 days when all of the above 4 factors were present, $5.7{\sim}8.2$ days when 3 of these 4 factors were present, $11.4{\sim}20.0$ days when 2 of the 4 were present, and $27.9{\sim}40.0$ when 1 of the 4 was present, and 77 days when none of these 4 factors were present. Conclusions : In terminally ill cancer patients, we found that the prognostic factors related to reduced survival time were poor performance status, neutrophilia, prolonged PT and prolonged am. The four prognostic factors enabled the prediction of life expectancy in terminally ill cancer patients.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.1
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• pp.133-137
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• 2010

Purpose: The main function of vitamin D is the mineralization of the brain by increase of calcium and phosphorus, in case it is insufficient in children, lime deposition on cartilage cannot occur so it leads to rachitis, and in adults, it leads to osteomalacia or osteoporosis. It is also strongly believed in the academic world that vitamin D can restrict the growth of cancer cells and prevent heart diseases, which is also somewhat proven in epidemiological researches. While the right density of vitamin D is still being studied, 20-32 ng/mL is believed to be the most ideal density. Therefore, I wanted analyze how much density of 25-Hydroxyvitamin D3 that Koreans possess. Materials and Methods: From February 20th, 2008 to April 21st, 2009, the collection of 2800 serums, from medical examination treated subjects by Neodin Medical Institute, have been tested. The targets were tested by 25-Hydroxyvitamin D (125I Kit: Diasorin, USA), and were analyzed by dividing into many different categories (gender, age, season, region). Results: The average density of male were 20 ng/mL, female 17.08 ng/mL. Per age groups, the density of males were as follows: 10~20-18 ng/mL, 21~30-17 ng/mL, 31~40-19 ng/mL, 41~50-21 ng/mL, 51~60-22 ng/mL, 61~70-22 ng/mL, 71~80-22 ng/mL and 81~90-19.9 ng/mL. Average density of females per age groups, were as follows: 10~20-16 ng/mL, 20~30-15.26 ng/mL, 30~40-16 ng/mL, 40~50-17 ng/mL, 50~60-19 ng/mL, 60~70-19 ng/mL, 70~80-19 ng/mL, and 80~90-17 ng/mL. Per seasons, From December to May, the subjects showed the density of 15.97 ng/mL, while from June to November, it showed 21.60 ng/mL. On density of males from January to April regionally, Seoul+Gyeonggi-Do-15.52 ng/mL, Gangwon-Do-15.33 ng/mL, Choongchung-Do-18.03 ng/mL, Jeonla-Do-18.68 ng/mL, Gyungsang-Do-18.76 ng/mL and Cheju Do-21.23 ng/mL. Conclusions: The vitamin D of Koreans is has been insufficient compared to the suggested amount. Ultraviolet rays, which is the main source of vitamin D is critical, therefore it is suggested that more outdoor activities can definitely help.

• Journal of the Korean Society of School Health
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• v.4 no.2
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• pp.176-192
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• 1991

School nurses, in service of 102 special schools in Korea, were urveyed by mail questionnaires from February to March, 1991 and 77 of hem responded. Collected data were analyzed to establish the direction of health management in special school and to provide basic reference data for improving the quality of the management of school-nurses' services. The major findings are as follows: Out of special schools surveyed, 67.5% is private school and 83.2% is located in city. The average number of classes, students, and educational personnels per special school is 17.2, 194, and 28 respectively. The average age of school-nurses surveyed is 32.7. The proportion of graduates from the junior college and upward was 97.4%, the proportion of the married was 71.4%. Out of respondents, 71.4% has religion : 79.2% has past career in the fields of clinics or public health: 62.3% accompanishes independent services: 77.9% belongs to primary school. About 69% of nursing room in special schools surveyed is located at the first floor. Out of special school surveyed, 90.9% has no organization for school health programms: Only 18.2% entrusted everyone of school doctor, school dentist, and school pharmacists with school health. 46.8% of respondents didn't know about the annual budget for school health programmes. The average annual expenditure for school health programme per special school was 317,000F26. won and the purchase cost for medical supplies accounted for the larger part of them. The monthly average number of students utilizing school nursing room was 71 per school, annual utilization times of school nursing room was 4.4 per student and utilization due to injury was prevalent by 26.6% and there is some differences in using the school nursing room according to disabled area. Rate of referral to medical facilities was 1.4%. The leading reason of referral to medical facilities was high fever among those who have visual handicaps, fracture among those who have emotional disturbance, injury by trauma among others. Nine hundred fifty six students of students in special school surveyed have sufferd from epilepsy and prevalence rate of epilepsy was 6.4%. Only 22.6% of respondents replied that they had physical examination more than 2 times per year. Out of respnodents, 98.7% answered that they had health education and 67.1% of them ansered that they educated in a classroom, 98.7% of respondents emphasized need of sex education. Respondents put the most emphasis on the personal hygiene when they performed health education and they used broadcasting education in the area of visual handicaps, OHP or VTR in hearing handicaps, home correspondence or OHP VTR in other area importantly. About 47% of repondents answered that health education was the most difficult and they emphasized that definite guide on health management was requested. Respondents had self-confidence and high perfomance rate in most of school-nurses' services completely, but so they was not in area of evaluation of school health programmes, an examination of physical strength, evaluation of health education, management of school purification area, suture of wounds. In consideration of above findings, we may conclude that special education for school-nurse in special schools as well as improvement of definite guiding principles are requested to establish direction for health management in special schools and to improve the degree of quality for school-nurses' sevices in special schools.

• Journal of agricultural medicine and community health
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• v.18 no.2
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• pp.141-151
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• 1993

This study was done about 371 tuberculosis(TB) patients composed 195 newly registered at Kyungju Gun Health Center from May 1989 to April 1990 (Group A) and 176 being treated at hospitals or private clinics from January 1988 to November 1989(Group B). When Group A patients visited and newly registered at Health Center, data was obtained by interviewing with a prepared questionnaire paper. And well trained inquirer visited Group B patients and obtained data by the same method from February 1990 to April 1990. The results are as follows ; Group A was generally lower than Group B in socioeconomic status and in family history of TB, the rate of Group A was 24.1% and higher than 11.9% in Group B(p<0.05). Knowledge about TB was improved more than past, but those who answered that TB is 'a communicable disease' were 59.5% in Group A and 51.7% in Group B(p<0.05). Those answered that TB is 'a inherited disease' were 9.2% and 11.4% each. And 1.7% of Group B answered that TB is 'a incurable disease'. Knowledge about TB treatment also was improved more than past, but in the rate of those who answered that TB is a curable disease provided by well treatment Group B(77.8%) was worse than Group A(91.3%). The rate of those who answered that TB were been able to cure by regularly anti-TB medication were 98.0% in Group A and 89.8% in Group B. Its difference was statistically significant. The rate that patients took the first diagnosis and wanted to receive treatments at the same organ were 34.9% of Group A at Health Center and 72.2% of Group B at hospitals or private clinics. And its difference was statistically significant. In the reasons that Group B knew Health Center treated pulmonary TB but they was treated at hospitals or private clinics, unreliability to Health Center was 48.1%. The reasons that Group A was treated at Health Center were 'because of trust' 63.1%, 'because of low cost' 50.3%, 'because of low cost except trust' 9.3%, 'no specific reasons' 27.7%. In the courses of knowing that TB was controlled at Health Center, 'by neighborhood, health worker and doctors' were 84.9% in Group A and 69.0% in Group B. But 'by TV or radio' were 8.2% in Group A and 14.7% in Group B, 'by school education' 2.5% in Group A and 6.2% in Group B. Conclusively, Group A patients were lower than Group B in socioeconomic status, but better than in knowledge about TB. Its reasons was suggested that Health Center had controlled TB patients better than hospitals and private clinics. But considering, that difference in the rate of the same organ for the first diagnosis and treatment, that the only 63.0% of Group A have treated due to 'reliability to Health Center', and that 48.1% of Group B knew that Health Center treated pulmonary TB but didn't visit it due to 'unreliability to Health Center', that public relations(PR) about use Health Center for pulmonary TB and health education for TB was thought to have to strengthened.