• Journal of Preventive Medicine and Public Health
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• v.44 no.2
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• pp.65-73
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• 2011

Objects: In July 2 2010, a diarrhea outbreak occurred among the workers in a company in Gyeungju city, Korea. An epidemiological investigation was performed to clarify the cause and transmission route of the outbreak. Methods: We conducted a questionnaire survey among 193 persons, and we examined 21 rectal swabs and 6 environmental specimens. We also delegated the Daegu Bukgu public health center to examine 3 food service employees and 5 environmental specimens from the P buffet which served a buffet on June 30. The patient case was defined as a worker of L Corporation and who participated in the company meal service and who had diarrhea more than one time. We also collected the underground water filter of the company on July 23. Results: The attack rate of diarrhea among the employees was 20.3%. The epidemic curve showed that a single exposure peaked on July 1. The relative risk of attendance and non-attendance by date was highest for the lunch of June 30 (35.62; 95% CI, 2.25 to 574.79). There was no specific food that was statistically regarded as the source of the outbreak. $Bacillus$ $cereus$ was cultured from two of the rectal swabs, two of the preserved foods and the underground water filter. We thought the exposure date was lunch of June 30 according the latency period of $B.$ $cereus$. Conclusions: We concluded the route of transmission was infection of dishes, spoons and chopsticks in the lunch buffet of June 30 by the underground water. At the lunch buffet, 50 dishes, 40 spoons, and chopsticks were served as cleaned and wiped with a dishcloth. We thought the underground water contaminated the dishes, spoons, chopsticks and the dishcloth. Those contaminated materials became the cause of this outbreak.

• Journal of Environmental Health Sciences
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• v.45 no.5
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• pp.434-442
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• 2019

Objectives: This study was performed in order to report the epidemiological features of a food poisoning outbreak caused by multiple pathogens in a high school in Chungcheongnam-do Province, Korea in April 2019 and to suggest measures to prevent a similar incidence. Methods: A total of 39 patients with diarrhea were examined. Environmental samples were obtained from 6 food handlers, 4 food utensils, 72 preserved foods served during the food poisoning outbreak, 9 door handles, 10 drinking water samples from water dispensers, and 6 ground water samples from water taps. These analyzed to detect viruses and bacteria. Results: Among the 39 patients, 21 cases (53.8%) of enteroaggregative E. coli (EAEC), 7 cases of Staphylococcus aureus (17.9%), and 17 cases of norovirus (43.6%) were positive, and in 16 of the cases a co-infection with at least one other pathogen were observed. EAEC was assumed to be transmitted from contaminated drinking water because it was also detected in the water sample from a water dispenser in the dormitory. Staphylococcus aureus was isolated only in the fecal samples of patients, meaning it was not possible to trace its origin. The genotype of norovirus detected in the drinking water and ground water was consistent with that isolated from patients, and it was determined that the norovirus infection originated from the school's water environment. Conclusions: These findings indicate that a lack of environmental hygiene management related to school meals caused the food poisoning incident. In particular, a lack of management of drinking water, water supply, and personal hygiene should be pointed out. This should be urgently addressed and continuous monitoring should be carried out in the future. In addition, students and staff should be educated and trained to improve their personal hygiene.

• Journal of Life Science
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• v.33 no.2
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• pp.199-207
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• 2023

To prepare for the threat of a future epidemic in the post-COVID-19 era, research based on the one-health concept (i.e., the health of humans, animals, and the environment as "one") is essential. Cross-species infections are being identified as a result of the high infection rate and viral load of SARS-CoV-2 in humans. The possibility of transmission of SARS-CoV-2 from humans to mink has been determined. In addition, the transmission of SARS-CoV-2 from humans to cats through contact has been considered possible. The data so far show that livestock and poultry are less likely to be infected with SARS-CoV-2. However, if infections are established through a new mutation, the resulting diseases are expected to have enormous ripple effects on various fields, such as human food security, the economy, and trade. In addition, there are concerns about the endemic prospect of SARS-CoV-2 and the high accessibility of companion animals. This is because the evolution of the virus likely occurs in animal hosts. Once SARS-CoV-2 is established in other species, they might serve as intermediate hosts for the re-emergence of the virus in the human population. Thus, it is necessary to ensure a rapid response to future outbreaks by accumulating research data on the animal infection of SARS-CoV-2. These data can have implications for the development of animal models for vaccines and therapeutics against SARS-CoV-2. Therefore, in this study, epidemiological reviews were analyzed, and response strategies against SARS-CoV-2 infection in animals were presented using the One-health approach.

• Journal of Food Hygiene and Safety
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• v.39 no.2
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• pp.134-151
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• 2024

Salmonella spp. is among the most important water-borne and food-borne pathogens and is one of the most common causes of human gastroenteritis and diarrheal diseases globally. In this study, Salmonella spp. isolated from food, environmental samples, and patients with food poisoning or diarrhea were investigated Salmonella serovars, antibiotic resistance using Vitek2, and genetic characteristics through pulsed-field gel electrophoresis (PFGE). Salmonella spp. of 339 strains, including 26 strains from food or environmental samples and 313 strains from patients, were isolated from Jeju Island of South Korea between 2020 and 2023. The monthly number of isolated Salmonella spp. gradually increased from March, with the highest number being in August. No significant differences in Salmonella spp. isolated from patients according to gender was observed. However, Salmonella spp. was most frequently isolated from people aged 70 years or older and least frequently isolated from those between ages 10 and 19 years. Salmonella spp. isolated from food or environmental samples were distributed among eight different serovars and the main serovars were identified in the order of S. Bareilly (26.9%), S. Rissen (23.1%), and S. Thompson (19.3%). Salmonella spp. isolated from patients were distributed among 27 different serovars and the main serovars were identified in the order of S. Bareilly (31.0%), S. Typhimurium (24.6%), and S. Enteritidis (11.5%). The main cause serovars of Salmonella spp. outbreaks are S. Bareilly, S. Enteritidis, S. Thompson. Antibiotic resistance tests indicated resistance to various antibiotics and some Salmonella spp. exhibited multidrug resistance. Salmonella spp. showed various genetic correlations among the 17 serovars. These results indicate that they can be used as basic data for epidemiological investigations by predicting the appearance of Salmonella spp. and providing a scientific basis.

• Journal of Food Hygiene and Safety
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• v.14 no.4
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• pp.319-326
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• 1999

Recently, it is continuously rising to concern about the health risk being induced by microorganisms in food such as Escherichia coli O157:H7 and Listeria monocytogenes. Various organizations and regulatory agencies including U.S.FPA, U.S.DA and FAO/WHO are preparing the methodology building to apply microbial quantitative risk assessment to risk-based food safety program. Microbial risks are primarily the result of single exposure and its health impacts are immediate and serious. Therefore, the methodology of risk assessment differs from that of chemical risk assessment. Microbial quantitative risk assessment consists of tow steps; hazard identification, exposure assessment, dose-response assessment and risk characterization. Hazard identification is accomplished by observing and defining the types of adverse health effects in humans associated with exposure to foodborne agents. Epidemiological evidence which links the various disease with the particular exposure route is an important component of this identification. Exposure assessment includes the quantification of microbial exposure regarding the dynamics of microbial growth in food processing, transport, packaging and specific time-temperature conditions at various points from animal production to consumption. Dose-response assessment is the process characterizing dose-response correlation between microbial exposure and disease incidence. Unlike chemical carcinogens, the dose-response assessment for microbial pathogens has not focused on animal models for extrapolation to humans. Risk characterization links the exposure assessment and dose-response assessment and involve uncertainty analysis. The methodology of microbial dose-response assessment is classified as nonthreshold and thresh-old approach. The nonthreshold model have assumption that one organism is capable of producing an infection if it arrives at an appropriate site and organism have independence. Recently, the Exponential, Beta-poission, Gompertz, and Gamma-weibull models are using as nonthreshold model. The Log-normal and Log-logistic models are using as threshold model. The threshold has the assumption that a toxicant is produce by interaction of organisms. In this study, it was reviewed detailed process including risk value using model parameter and microbial exposure dose. Also this study suggested model application methodology in field of exposure assessment using assumed food microbial data(NaCl, water activity, temperature, pH, etc.) and the commercially used Food MicroModel. We recognized that human volunteer data to the healthy man are preferred rather than epidemiological data fur obtaining exact dose-response data. But, the foreign agencies are studying the characterization of correlation between human and animal. For the comparison of differences to the population sensitivity: it must be executed domestic study such as the establishment of dose-response data to the Korean volunteer by each microbial and microbial exposure assessment in food.

• Tuberculosis and Respiratory Diseases
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• v.49 no.4
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• pp.412-420
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• 2000

Background : There is increasing concern in many countries about the problem of drug-resistant tuberculosis. Prevalence of primary drug-resistant tuberculosis is the optimal epidemiological indicator for long term monitoring of national tuberculosis control program. Our purpose was The purpose of our study is to assess clinical characteristics and socioeconomic status of patients with drug-resistant tuberculosis. Method : We studied 68 cases with drug-resistant Mycobacterium tuberculosis infection diagnosed at the Ewha Womans University Mokdong Hospital from March, 1995 to February, 2000. Results : Patients with primary drug-resistant tuberculosis(PDR) were younger (39.6$\pm$16.3 years vs. 48.2$\pm$16.5 years ; p<0.05), had more population of less than more were under the age of 40 years aged -group(62.9% vs. 36.4% ; p<0.05) and were more highly educated than those with acquired drug-resistant tuberculosis(ADR)(38.9% vs. 11.1% ; p<0.05). In patients with ADR, the rates of familial history of tuberculosis and living in a rented house residence in a rented house were increased higher than compared with to those of patients with PDR. Patients with ADR had more involved lobes(2.0$\pm$0.8 vs. 1.4$\pm$0.7 ; p<0.01) and longer treatment duration than those with PDR(18.3$\pm$7.2 months vs. 10.6$\pm$6.3 months ; p<0.05). Patients with ADR showed larger numbers of resistant were resistant to more number of drugs, lower hospitalization rate and higher rate of self-interruption of medication than those with PDR. In patients with PDR, mono-drug resistance was increased, whereas poly- and multi-drug resistances were decreased compared with those with ADR. Resistance to isoniazid was the highest among antituberculosis drugs, and resistance to isoniazid in patients with ADR was higher than that in patients with PDR(90.9% vs. 71.4% ; p<0.05). Conclusions : Patients with ADR were more likely to include more population be of lower socioeconomic class, and patients with PDR seem seemed to be young and socially active population. For control of drug-resistant Mycobacterium tuberculosis infection, proper isolation and prevention of patient with drug-resistant tuberculosis are needed.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.4
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• pp.280-286
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• 2009

Purpose: The aim of this study was to evaluate the hemodynamic changes after endovascular stenting in patients with unilateral middle cerebral artery (MCA) stenosis using statistical probabilistic anatomical mapping (SPAM) analysis of basal/acetazolamide (ACZ) Tc-99m ECD brain perfusion SPECT. Materials and Methods: Eight patients (3 men and 5 women, 64.8$\pm$10.5 years) who underwent endovascular stenting for unilateral MCA stenosis were enrolled. Basal/ACZ Tc-99m ECD brain perfusion SPECT studies were performed by one-day protocol before and after stenting. Using SPAM analysis, we compared basal cerebral perfusion (BCP) counts and cerebrovascular reserve (CVR) index of the MCA territory before stenting with those after stenting. Results: After stenting, no patient had any complication nor additional stroke. In SPAM analysis, 7 out of the 8 patients had improved BCP counts of the MCA territory and 7 out of the 8 patients had improved CVR index of the MCA territory after stenting. Before stenting, the mean BCP counts and CVR index in the affected MCA territory were 47.1$\pm$2.2 ml/min/100 g and -2.1$\pm$2.9%, respectively. After stenting, the mean BCP counts and CVR index in the affected MCA territory were improved significantly (48.3$\pm$2.9 ml/min/100 g, p =0.025 and 0.1$\pm$1.3%, p =0.036). Conclusion: This study revealed that SPAM analysis of basal/ACZ brain perfusion SPEG would be helpful to evaluate hemodynamic efficacy of endovascular stenting in unilateral MCA stenosis.

• Phonetics and Speech Sciences
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• v.11 no.3
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• pp.69-76
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• 2019

This study aimed to investigate the effects of vocal aerobic treatment (VAT) on the improvement of voice in patients with voice disorders. Twenty patients (13 males, 7 females) were diagnosed with voice disorders on the basis of videostroboscopy and voice evaluations. Acoustic evaluation was performed with the Multidimensional voice program (MDVP) and Voice Range Profile (VRP) of Computerized Speech Lab (CSL), and aerodynamic evaluation with PAS (Phonatory Aerodynamic System). The changes in F0, Jitter, Shimmer, and NHR before and after treatment were measured by MDVP. F0 range and Energy range were measured with VRP before and after treatment, and the changes in Expiratory Volume (FVC), Phonation Time (PHOT), Mean Expiratory Airflow (MEAF), Mean Peak Air Pressure (MPAP), and Aerodynamic Efficiency (AEFF) with PAS. Videostroboscopy was performed to evaluate the regularity, symmetry, mucosal wave, and amplitude changes of both vocal cords before and after treatment. Voice therapy was performed once a week for each patient using the VAT program in a holistic voice therapy approach. The average number of treatments per patient was 6.5. In the MDVP, Jitter, Shimmer, and NHR showed statistically significant decreases (p < .001, p < .01, p < .05). VRP results showed that Hz and semitones in the frequency range improved significantly after treatment (p < .01, p < .05), as did PAS, FVC, and PHOT (p < .01, p < .001). The results for videostroboscopy, functional voice disorder, laryngopharyngeal reflux, and benign vocal fold lesions were normal. Thus, the VAT program was found to be effective in improving the acoustic and aerodynamic aspects of the voice of patients with voice disorders. In future studies, the effect of VAT on the same group of voice disorders should be studied. It is also necessary to investigate subjective voice improvement and objective voice improvement. Furthermore, it is necessary to examine the effects of VAT in professional voice users.

• Journal of the Korean Society of Radiology
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• v.17 no.2
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• pp.257-265
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• 2023

The purpose of this study was to vaccinate every year according to the general characteristics of COVID-19, whether to vaccinate every year according to the vaccination experience, whether to vaccinate every year according to knowledge/attitude about vaccination, and negative responses to the vaccinate every year In order to understand the factors affecting the vaccination physician every year by identifying the factors of Statistical analysis is based on general characteristics, variables based on vaccination experience, and knowledge/attitudes related to vaccination. The doctor calculates the frequency and percentage, A square test (-test) was performed, and if the chi-square test was significant but the expected frequency was less than 5 for 25% or more, a ratio difference test was performed with Fisher's exact test. Through multiple logistic regression analysis using variables that were significant in simple analysis, a predictive model for future vaccination and the effect size of each independent variable were estimated. As statistical analysis software, SAS 9.4 (SAS Institute Inc., Cary, NC, USA) was used, and because the sample size was not large, the significance level was set at 10%, and when the p-value was less than 0.10, it was interpreted as statistically significant. In the simple logistic regression analysis, the reason why they answered that they would not be vaccinated every year was that they answered 'to prevent infection of family and hospital guests' rather than 'to prevent my infection' as the reason for the vaccination. It was 11.0 times higher and 3.67 times higher in the case of 'for the formation of collective immunity of the local community and the country'. The adverse reactions experienced after the 1st and 2nd vaccination were 8.42 times higher in those who did not experience pain at the injection site than those who did not, 4.00 times higher in those who experienced swelling or redness, and 5.69 times higher in those who experienced joint pain. There was a 5.57 times higher rate of absenteeism annually than those who did not. In addition, the more anxious they felt about vaccination, the more likely they were to not get the vaccine every year by 2.94 times.

• Journal of agricultural medicine and community health
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• v.42 no.1
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• pp.13-23
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• 2017

Objectives: This study was conducted to evaluate a relationship between the blood concentrations of toxic metals and the blood pressure in people living near the copper smelter. Methods: The study included 570 adults living within 4km of the smelter. We compared systolic and diastolic blood pressure between tertiary groups for blood cadmium, mercury and lead levels, respectively. Multiple regression analysis was performed to identify risk factors affecting systolic and diastolic blood pressures. Results: In male subjects, there is a significant difference in the mean of systolic and diastolic blood pressure between tertiary groups of blood cadmium and mercury levels, but in women, there was no significant difference in the mean systolic and diastolic blood pressures in all tertiary groups of heavy metals. The results of multiple regression analysis showed that age, BMI, and cadmium concentration in men were risk factors for blood pressure. In women, age and BMI, drinking and smoking, and blood mercury were significantly influenced to blood pressure. Conclusions: Residents living near the Janghang smelter showed high concentrations of blood lead and cadmium, suggesting that they were exposed to high concentrations of heavy metals released from the smelter in the past. Such exposure may have caused some blood pressure increase. Especially, the concentration of cadmium in the case of men and the concentration of mercury in blood in the case of women were found to be significantly related to the increase of blood pressure. The local population should be advised to make efforts to reduce exposure to environmental contaminants, in order to minimize cardiovascular disease, and to pay close attention to any health problems possibly related to toxic metal exposure.