• 제목/요약/키워드: Discontinuance

검색결과 69건 처리시간 0.027초

양식장 플랫폼을 활용한 실시간 해양환경 정보제공시스템 개발연구 (Development of Real-time Oceanographic Information System using Platforms of Aquaculture Farms)

  • 양준용;서영상;최용규;정규귀;정희동;박종수
    • 한국지리정보학회지
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    • 제10권2호
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    • pp.47-57
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    • 2007
  • 연안 해양환경의 급격한 변동에 의하여 매년 발생하고 있는 양식생물의 대량폐사의 원인을 규명하고 피해를 저감하기 위하여 양식장 플랫폼을 활용한 실시간 해양환경 정보제공시스템의 개발연구를 수행하였다. 일반적으로 실시간 관측시스템에 활용되고 있는 외양의 계류부이에 비해 관측정보가 직접 필요한 양식장에서 관측하여 제공함으로써 생산한 정보의 활용도가 높았으며, 양식장은 접근이 용이하고 상주인원이 있어 관측 장비의 유지보수가 유리한 점이 개발한 시스템의 특징이었다. 연속적 정보 수집을 위하여 관측치의 이상발생에 대한 긴급정비와 주기적인 예방정비 및 관측현황 모니터링을 시스템화하였으며, 과거 자료를 이용하여 통계적인 방법으로 구한 신뢰구간을 적용하여 관측 자료의 신뢰도 제고와 관측 중단을 최소화하도록 하였다. 또한 정보를 최종 이용자에게 효과적인 방법으로 전달하기 위하여 시스템의 개발내용에 홈페이지와 전자우편, 양식장의 현장에서 정보를 직접 확인할 수 있는 소형전광판과 어시장의 대형전광판을 통한 정보 제공체계를 구축하였다. 이를 통하여 어업인의 과학적인 어업활동을 지원하였고, 양식장 적지선정과 관련된 어장환경연구를 수행하였다. 양식생물의 대량폐사와 같은 경제적인 피해를 저감하며, 장기적으로 연안 해양환경의 변화와 이와 관련된 해양연구에 본 연구를 통한 기술개발의 결과를 활용할 수 있다.

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상용 부품 비정형 데이터와 인공 신경망을 이용한 부품 단종 예측 방안 연구 (Study on predicting the commercial parts discontinuance using unstructured data and artificial neural network)

  • 박연경;이익도;이강택;김두정
    • 한국산학기술학회논문지
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    • 제20권10호
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    • pp.277-283
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    • 2019
  • 기술의 발전으로 다양한 부품의 개발 및 상용화는 가능 하였으나, 이에 따라 부품의 단종 주기는 단축 되었다. 이는 수천 품목 이상의 부품을 활용하여 개발하고, 장기간 운영하는 무기체계의 수리 부속 보급을 어렵게 하였으며, 무기체계 운용 가용도 저하의 주요 원인으로 작용하였다. 이러한 문제를 해결하기 위하여 미국 등은 전담 기구를 만들어 대응하고 있으며, 국내에서는 상용 부품단종 예측도구를 활용하여 단종을 예측하고 관리하고 있다. 하지만 상용 부품단종 예측도구에서 단종 정보가 제시되지 않는 부품에 대한 대응 및 관리는 부재한 실정이다. 이에 본 연구에서는 상용 부품단종 예측도구에서 제공하는 부품에 대한 정형, 비정형 빅데이터를 수집하고, 데이터 전처리 및 Embedding 과정을 거쳐, 신경망 학습 알고리즘을 적용하여, 상용 부품에 대한 단종 정보 (LC Risk, YTEOL)를 예측하는 방안을 제시하였다. 또한 제시된 모델의 예측 성능을 데이터 기술 통계량과 비교 평가 하여, 본 연구에서 제시한 학습 모델의 타당성을 검증 하였다. 결론에는 본 연구의 활용 방안과 한계점 및 발전 방향에 대하여 기술 하였다.

병원정보탐색 어플리케이션의 지속적 이용에 관한 연구 (A Study on the Continuous Use of Hospital Information Seeking Applications)

  • 장정인;이용정
    • 정보관리학회지
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    • 제38권1호
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    • pp.243-262
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    • 2021
  • 본 연구는 후기수용모델을 통해 병원정보탐색 어플리케이션(이하 병원 앱)의 지속적인 이용과 이용 중단에 영향을 미치는 요인을 파악하고자 하였다. 병원 앱을 사용한 경험이 있는 이용자를 대상으로 2019년 10월 11일부터 18일까지 설문조사를 실시하여 125개의 유효한 데이터를 수집하였고 구조방정식 모형을 사용하여 데이터를 분석하였다. 연구 결과, 병원 앱 사용자의 만족도와 기대일치도는 지속적 이용의도와 지각된 유용성에 각각 유의미한 영향을 미치는 것으로 나타났다. 하지만 지각된 유용성은 지속적 이용의도에 유의미한 영향을 미치지 않는 것으로 나타났다. 본 연구는 기존에 많이 조명되지 않았던 병원 앱에 관한 연구를 통해 이러한 혁신적 기술의 지속적 사용여부에 영향을 미치는 변인들을 파악하였다. 연구 결과는 병원앱의 수용과 이용을 관찰하여 후기수용모델을 재검증하였으며, 응급상황과 같은 긴급한 도움탐색이나 신속함이 강조되는 정보요구를 만족시키는 병원앱의 특수성을 논의함으로써 이론적 확장을 도모하였다. 또한 소비자가 보고한 병원 앱의 유익성과 한계점을 바탕으로 병원 앱 개발자나 운영자들에게 보다 이용자 친화적인 앱을 제공하기 위한 실질적인 시사점을 제공하였다.

한국가족계획사업(韓國家族計劃事業)의 문제점(問題點) (Problems in the Korean National Family Planning Program)

  • 홍종관
    • Clinical and Experimental Reproductive Medicine
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    • 제2권2호
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    • pp.27-36
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    • 1975
  • The success of the family planning program in Korea is reflected in the decrease in the growth rate from 3.0% in 1962 to 2.0% in 1971, and in the decrease in the fertility rate from 43/1,000 in 1960 to 29/1,000 in 1970. However, it would be erroneous to attribute these reductions entirely to the family planning program. Other socio-economic factors, such as the increasing age at marriage and the increasing use of induced abortions, definitely had an impact on the lowered growth and fertility rate. Despite the relative success of the program to data in meeting its goals, there is no room for complacency. Meeting the goal of a further reduction in the population growth rate to 1.3% by 1981 is a much more difficult task than any one faced in the past. Not only must fertility be lowered further, but the size of the target population itself will expand tremendously in the late seventies; due to the post-war baby boom of the 1950's reaching reproductive ages. Furthermore, it is doubtful that the age at marriage will continue to rise as in the past or that the incidence of induced abortion will continue to increase. Consequently, future reductions in fertility will be more dependent on the performance of the national family planning program, with less assistance from these non-program factors. This paper will describe various approaches to help to the solution of these current problems. 1. PRACTICE RATE IN FAMILY PLANNING In 1973, the attitude (approval) and knowledge rates were quite high; 94% and 98% respectively. But a large gap exists between that and the actual practice rate, which is only 3695. Two factors must be considered in attempting to close the KAP-gap. The first is to change social norms, which still favor a larger family, increasing the practice rate cannot be done very quickly. The second point to consider is that the family planning program has not yet reached all the eligible women. A 1973 study determineded that a large portion, 3096 in fact, of all eligible women do not want more children, but are not practicing family planning. Thus, future efforts to help close the KAP-gap must focus attention and services on this important large group of potential acceptors. 2. CONTINUATION RATES Dissatisfaction with the loop and pill has resulted in high discontinuation rates. For example, a 1973 survey revealed that within the first six months initial loop acceptance. nearly 50% were dropouts, and that within the first four months of inital pill acceptance. nearly 50% were dropouts. These discontinuation rates have risen over the past few years. The high rate of discontinuance obviously decreases the contraceptive effectiveness. and has resulted in many unwanted births which is directly related to the increase of induced abortions. In the future, the family planning program must emphasize the improved quality of initial and follow-up services. rather than more quantity, in order to insure higher continuation rates and thus more effective contraceptive protection. 3. INDUCED ABORTION As noted earlier. the use of induced abortions has been increase yearly. For example, in 1960, the average number of abortions was 0.6 abortions per women in the 15-44 age range. By 1970. that had increased to 2 abortions per women. In 1966. 13% of all women between 15-44 had experienced at least one abortion. By 1971, that figure jumped to 28%. In 1973 alone, the total number of abortions was 400,000. Besides the ever incre.sing number of induced abortions, another change has that those who use abortions have shifted since 1965 to include- not. only the middle class, but also rural and low-income women. In the future. in response to the demand for abortion services among rural and low-income w~men, the government must provide and support abortion services for these women as a part of the national family planning program. 4. TARGET SYSTIi:M Since 1962, the nationwide target system has been used to set a target for each method, and the target number of acceptors is then apportioned out to various sub-areas according to the number of eligible couples in each area. Because these targets are set without consideration for demographic factors, particular tastes, prejudices, and previous patterns of acceptance in the area, a high discontinuation rate for all methods and a high wastage rate for the oral pill and condom results. In the future. to alleviate these problems of the methodbased target system. an alternative. such as the weighted-credit system, should be adopted on a nation wide basis. In this system. each contraceptive method is. assigned a specific number of points based upon the couple-years of protection (CYP) provided by the method. and no specific targets for each method are given. 5. INCREASE OF STERILIZA.TION TARGET Two special projects. the hospital-based family planning program and the armed forces program, has greatly contributed to the increasing acceptance in female and male sterilization respectively. From January-September 1974, 28,773 sterilizations were performed. During the same time in 1975, 46,894 were performed; a 63% increase. If this trend continues, by the end of 1975. approximately 70,000 sterilizations will have been performed. Sterilization is a much better method than both the loop and pill, in terms of more effective contraceptive protection and the almost zero dropout rate. In the future, the. family planning program should continue to stress the special programs which make more sterilizations possible. In particular, it should seek to add the laparoscope techniques to facilitate female sterilization acceptance rates. 6. INCREASE NUMBER OF PRIVATE ACCEPTORS Among the current family planning users, approximately 1/3 are in the private sector and thus do not- require government subsidy. The number of private acceptors increases with increasing urbanization and economic growth. To speed this process, the government initiated the special hospital based family planning program which is utilized mostly by the private sector. However, in the future, to further hasten the increase of private acceptors, the government should encourage doctors in private practice to provide family planning services, and provide the contraceptive supplies. This way, those do utilize the private medical system will also be able to receive family planning services and pay for it. Another means of increasing the number of private acceptors, IS to greatly expand the commercial outlets for pills and condoms beyond the existing service points of drugstores, hospitals, and health centers. 7. IE&C PROGRAM The current preferred family size is nearly twice as high as needed to achieve a stable poplation. Also, a strong boy preference hinders a small family size as nearly all couples fuel they must have at least one or more sons. The IE&C program must, in the future, strive to emphasize the values of the small family and equality of the sexes. A second problem for the IE&C program to work. with in the: future is the large group of people who approves family planning, want no more children, but do not practice. The IE&C program must work to motivate these people to accept family planning And finally, for those who already practice, an IE&C program in the future must stress continuation of use. The IE&C campaign, to insure highest effectiveness, should be based on a detailed factor analysis of contraceptive discontinuance. In conclusion, Korea faces a serious unfavorable sociodemographic situation- in the future unless the population growth rate can be curtailed. And in the future, the decrease in fertility will depend solely on the family planning program, as the effect of other socio-economic factors has already been maximumally felt. A second serious factor to consider is the increasing number of eligible women due to the 1950's baby boom. Thus, to meet these challenges, the program target must be increased and the program must improve the effectiveness of its current activities and develop new programs.

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소아의 B형 만성 활동성 간염에서 저용량 ${\alpha}$-Interferon과 Thymodulin의 병용 치료 효과 (Combined Therapy of Alfa-Interferon and Thymodulin on Children with Chronic Active Hepatitis B)

  • 최병호;고철우
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제1권1호
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    • pp.79-89
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    • 1998
  • 목 적: 만성 B형 간염 환자의 치료에 많은 항바이러스제와 면역조절 물질이 시도되었지만 현재까지는 ${\alpha}$-interferon만이 일정한 효과가 있는 것으로 보고되고 있다. 또 면역조절제 중에는 현재thymodulin 등의 면역증강 물질이 시도되어지고 있다. 저자들은 interferon 치료시 thymodulin을 병용하면 소아의 B형 만성 활동성 간염에 interferon 단독 치료보다 효과가 있는지를 조사해 보았다. 대상 및 방법: 1990년 3월부터 1996년 2월까지 경북대학교병원 소아과에 입원하였던 환아 중 6개월 이상 HBsAg과 HBeAg 및 HBV DNA가 양성(1+~4+)이고, 혈청 AST와 ALT치가 상승되어 있으며 간조직 검사상 만성 활동성 간염으로 확진된 환아 23명($9.8{\pm}2.8$세)을 대상으로 recombinant ${\alpha}$-interferon 300 MU($280\;MU/m^2{\pm}68$; 범위: $189{\sim}448\;MU/m^2$)를 주 3회씩 6개월간 피하 주사하였다. 그 중 10명에게는 thymodulin 60 mg을 매일 복용시켰고 13명은 ${\alpha}$-interferon만 투여하였으며 치료 종료 후 최소 12개월 이상 추적 검사를 하였다. 양군간의 모든 변수에서 통계학적 유의차는 없었다. 결 과: 1) 23명 전예에서 interferon 치료 중에 AST, ALT 및 HBV DNA의 감소가 있었고 12개월째 추적 검사상 9명(39%)에서 평균 3.1개월째에 HBeAg과 anti-HBe의 혈청전환 및 HBV DNA의 음전이 생겼으며 18개월째 추적검사에서는 이 중 2명에서 ${\alpha}$-interferon 중단 후 8개월과 9개월에 HBeAg이 다시 나타났고 또 다른 2명에서 추가로 혈청전환이 생겨서 전체적으로는 23명의 환아 중 11명(48%)에서 혈청전환이 생겼고 재발한 2명을 빼면 최종 성적은 9명(39%)이 된다. 2) 수직 감염이 있는 7례 중 2례(29%)에서 혈청 전환이 생긴 반면 수직 감염이 없는 12례 중 6례(50%)에서 혈청전환이 생겨 수직 감염 유무는 혈청전환과의 상관 관계가 밀접하다고 생각한다. 3) ${\alpha}$-interferon 치료 전의 ALT치가 정상치의 2배 이하인 경우 8례 중 3례(38%)에서 혈청전환이 있었는데 비해 2배 이상이었던 경우는 15예 중 8례(53%)에서 혈청전환이 있어서 ${\alpha}$-interferon 치료전의 높은 ALT치가 좋은 치료 효과를 예측하는데 도움이 될 수 있을 것으로 생각한다. 4) ${\alpha}$-interferon 치료 전의 HBV DNA가 3+ 이상이었던 경우는 12례 중 5례(42%)에서 혈청전환이 있었는데 비해 1+ 이었던 경우는 11례 중 6례(55%)에서 혈청전환이 있어서 ${\alpha}$-interferon 치료전의 낮은 HBV DNA가 좋은 치료 효과를 예측하는데 도움이 될 수 있을 것으로 생각한다. 5) B형 만성 활동성 간염 환아 23례 중 10례에게 thymodulin을 병용하여 투여하였으나 10례 중 5례(50%)에서 혈청전환이 있었으며 이는 대조군인 ${\alpha}$-interferon 단독 치료 시의 13례 중 6례(46%)와 비교할 때 통계적인 의의를 찾을 수 없었다. 결 론: 면역조절 물질인 thymodulin의 투여로써 숙주 면역계의 기능을 증강시켜 바이러스의 제거를 촉진하고자 소아의 B형 만성 활동성 간염에 ${\alpha}$-interferon 치료시 thymodulin을 병용하여 치료하였으나 ${\alpha}$-interferon 단독 치료보다 더 효과가 있다고 볼 수는 없었으며 향후 더 많은 환아를 대상으로 한 interferon과 다른 종류의 항바이러스제 및 면역조절제 등과의 병용 치료 연구가 더 좋은 결과를 얻기 위해 필요할 것으로 생각한다.

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가상 공동체 사용자의 전자상거래 수용에 대한 연구 (A Study on EC Acceptance of Virtual Community Users)

  • 이형용;안현철
    • Asia pacific journal of information systems
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    • 제19권1호
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    • pp.147-165
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    • 2009
  • Virtual community(VC) will increasingly be organized as commercial enterprises, with the objective of earning an attractive financial return by providing members with valuable resources and environment. For example, Cyworld.com in Korea uses several community services to enable customers of Cyworld to take control of their own value as potential purchasers of products and services. Although initial adoption is important for online network service success, it does not necessarily result in the desired managerial performance unless the initial usage is continuously related to the continuous usage and purchase. Particularly, the customer who receives relevant online services and is well equipped with online network services, will trust the online service provider and perceive less risk and experience more activities such as continuous usage and purchase. Thus, how to promote continued online service usage or, alternatively, how to prevent discontinuance is a critical issue for VC service providers to consider. By aggregating a wide range of information and online environments for customers and providing trust to its members, the service providers of virtual communities help to reduce the perceived risk of continuous usage and purchase. Drill down, online service managers realize that achieving strong and sustained customers who continuously use online service and purchase on it is crucial. Therefore, the research into this online service continuance will identify the relationship between the initial usage and the continuous usage and purchase. The research of continuous usage or post adoption has recently emerged as an important issue in the IS literature. Individuals' information systems(IS) continuous usage decisions are congruent with consumers' repeat purchase decisions. The TAM(Technology Acceptance Model) paradigm has been strongly confirmed across a wide range from product purchase on EC to online service usage contexts. The analysis of IS usage based on TAM has proven to be successful across almost online service contexts. However, most of previous studies have focused on only an area (i.e., VC or EC). Just little research has tried to analyze the relationship between VC and EC. The effect of some factors on user intention, captured through several theories such as TAM, has been demonstrated. Yet, few studies have explored the salient relationships of VC users' EC acceptance. To fill this gap between VC and EC research, this paper attempts to develop a research model that extends the TAM perspective in view of the additional contributions of trust in the service provider and trust in members on some factors that affect EC and VC adoption. In this extension, we applied the TAM-to-TAM(T2T) model, and analyzed the transfer effect of trust between these two TAMs. The research model was empirically tested on the context of a social network service. The model was to extend TAM with the trust concept for the virtual community environment from the perspective of tasks. By building an extended model of TAM and examining the relationships between trust and the existing variables of TAM, it is aimed to explain a user's continuous intention to use VC and purchase on EC. The unit of analysis in this paper is an individual user of a virtual community. The population of interest is the individual with the experiences in virtual community. The data for this paper was made available via a Web survey of VC users. In total, 281 cases were gathered for about one week, but there were some missing values in the sample and there were some inappropriate cases. Thus, only 248 cases were finally analyzed. We chose the structural equation analysis to test the hypotheses and it is better suited for explaining complex relationships than the other methods. In this test, AMOS was used to test the Structural Equation Model (SEM). Noticeable results have been found in the T2T model regarding the factors affecting the intention to use of virtual community and loyalty. Our result showed that trust transfer plays a key role in forming the two adoption beliefs. Overall, this study preliminarily confirms the salience of trust transfer in online service.

간질환자(癎疾患者)에 대(對)한 보건학적(保健學的) 조사연구(調査硏究) (A Survey on Epilepsy Patients from Public Health Aspects)

  • 김명호;경영후;박종구;서신영
    • 농촌의학ㆍ지역보건
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    • 제4권1호
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    • pp.41-61
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    • 1979
  • Two interview surveys (1976 for 800 patients, 1978 for 200 patients) and an inventory survey through medical records(1978) for epileptic patients who have registered with the Korean Epilepsy Association (Rose Club) since 1971 were carried out by trained health workers in advance of survey. The data obtained from the analysis showed as follows: 1) 35.2% of patients were born in Seoul and 70. 6% of patients born elsewhere have lived in Seoul. 2) 50-60% of patients were 15-30 years cid. 3) 33.4%, 24,6 and 24.6 of all pupils and students went to elementary, junior and senior high schools respectively. 4) 21.2% of all pupils and students had dropped out of school and 51.4% of them were away from school because of epilepsy. 5) 3.1% of all patients had no job at all and students comprised 20.9% of patients followed by clerical work, commercial business and farming with about 6% in each group.6) Reasons given for unemployment such as dismissal (4.3%), quit (27.7%), hesitation to employ (42.5%)and discontinuance of job (25.5%) were basically due to epilepsy. 7) About half(46.2%) of all patients have become Christian since the Rose Club was a voluntary agency which has been sponsored by Christians. 8) 82. 6% of patients were diagnosed as having grand mal as the most. 9) 29.4% of patients explained aura with psychomotor disturbances and 13.8% with sensory disorders. 10) 46.3% of patients were attacked with seizures when they were tired and others(11.6% and 4.9%) after excessive eating and hunger. 11) Patients suffered more seizures in spring and summer rather than in autumn and winter and most patients had attacks 1-5 times a month. 12) For etiologic reasons of epilepsy, 35.5% of patients considered it was caused by psychological stress and 11.5% by trauma. Only 1.1% of patients considered it as having hereditary components. 13) 51% of patients were slow in caring for their own illnesses. They started to reat epilepsy after spending 5 years of time from the initial seizure. Only 5.4% of patients had received the modern anti-epileptic therapy right after the nitial seizure. 14) 62.1% of patients had no therapy or irregular or incomplete treatment before registration at the Rose Club Clinic. 15) Before registration at the Rose Club, 42.4% of patients received medical care. On the other hand, 25.6% went to herb doctors and 12.5% used to go to the drugstore in order to get anti-epileptic drugs. 16) 41. 6% of patients who took anti-epileptic drugs had more or less side-effects. Indigestion was the most common. 17) For continuation of treatment, 30.3% have received treatment for more than 5 years and the evident showed that epilepsy took a longer time to be cured. 18) Regarding the medical care received 44.2% of patients were very satisfied with effective care and 26.5% felt as good. 19) For attitudes toward epilepsy. 27.0% of patients and 68.2% of patients family were pessimistic. 20) 65.9% of patients had optimistic attitudes toward effectiveness of medical care of epilepsy. 21) 64.8% of wives and husbands had better understanding and cooperative for their spouses who had epilepsy. 22) 33.3% of patients were under-treated at the place of work. 23) 70.2% of patients wished to marry when they reach childbearing age and 63% wished to have children. Through the above results it is recommended for nation-wide epilepsy control that the sound and correct health education not only from health aspect but also from welfare aspect should be planned and implemented as soon as possible.

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자본시장법상 외부자거래의 규제와 개선방안 (Outsider Trading Regulation under the Capital Markets Act)

  • 장근영
    • 법제연구
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    • 제41호
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    • pp.367-399
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    • 2011
  • 현행 자본시장법 제174조는 상장법인을 중심으로 정보접근의 우월적 지위가 있는 자들에 한정하여 미공개중요정보의 이용을 금지하고 있다. 아울러 규제대상정보의 범위도 상장법인의 업무 등에 관한 정보에 한정하며, 시장정보는 예외적으로 규제하고 있다. 그러나 현행법상 규제되지 않는 미공개정보의 이용행위 중에는 정보 비대칭의 이용이라는 불공정한 속성을 가진 경우가 상당하며, 특히 외부자에 의한 정보이용의 경우가 그러하다. 본 논문은 이와 같이 현행법상 규제의 범위에 포섭되지 않는 외부자거래의 다양한 유형을 그 이용대상정보가 내부정보인가 외부정보인가에 따라 구분한 뒤, 각각 규제의 필요성을 검토하고 개선안을 모색하였다. 현재 규제되지 않는 외부자거래의 유형으로는 (i) 불법적으로 지득한 내부정보를 이용한 거래, (ii) 합법적으로 우연히 지득한 내부정보를 이용한 거래, (iii) 정보생성자 및 그 관련자의 외부정보에 기한 거래 등을 들 수 있다. 이 가운데 (i)과 (iii)의 경우는 자본시장법상 포괄조항인 제178조 제1항 제1호의 적극적 해석을 통해 규제가 가능할 것으로 판단된다. 우연히 지득한 정보를 이용하는 (ii)의 경우는 규제의 필요성이 그리 크지 않은 것으로 보인다. 향후 입법자가 자본시장법의 미공개정보이용 규제의 틀을 회사관계 중심규제에서 완전한 정보보유 중심규제로 바꾸게 되면 규제의 공백 없이 미공개정보를 '이용'한 모든 경우가 규율될 수 있을 것이다. 그렇지만 정보보유 중심규제로의 전환을 선택하기 위해서는 그로 인한 장단점을 충분히 검토해야 하며, 결국 미공개정보이용의 규제 목적이 무엇인가를 염두에 두어야 할 것이다. 그리고 이러한 규제 체계의 전환이 있을 때까지는 현행법상의 적용 가능한 조문을 적극적으로 활용할 것이 요청된다.

간흡충증(肝吸虫症)의 역학(疫學) - I. 고도유행지(高度流行地) 김해지방(金海地方)에 있어서의 간흡충감염(肝吸虫感染)의 현황(現況)과 자연추이(自然推移) (Epidemiological Studies of Clonorchiasis. - I. Current Status and Natural Transition of the Endemicity of Clonorchis sinensis in Gimhae Gun and Delta, a High Endemic area in Korea)

  • 김동찬;이온영;이종수;안장수;장영미;손성창;문익상
    • 농촌의학ㆍ지역보건
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    • 제8권1호
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    • pp.44-65
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    • 1983
  • As a part of the epidemiological studies of clonorchiasis, this study was conducted to evaluate the current endemicity and the natural transition of the Clonorchis infection in Gimhae Gun and delta area a high endemic area in Korea in recent years, prior to the introduction of praziquantel which will eventually influence the status of the prevalence. The data obtained in this study in 1983 were evaluated for natural transition of the infection in comparison with those obtained 16 years ago in 1967 by the author(Kim, 1974). The areas of investigation, villages and schools surveyed, methods and techniques used in this study were the same as in 1967, except for the contents of the questionnaire for raw freshwater fish consumption by the local inhabitants. 1) The prevalence rate of clonorchiasis in the general population of the villages was 48.1% on the average out of a total of 484 persons examined. The average of those of the riverside-delta area was 65.2% and 43.0% in the inland area. Among the schoolchildren, the prevalence rate was 8.2% on the average out of a total of 1,423 examined. By area, the prevalence rate was 10.8% in the riverside delta area and 2.8% in the inland area. By sex, difference in the prevalence was seen only in the inhabitants of the inland area showing 52.4% in the male and 33.5% in the female. 2) In the natural transition of the infection, the prevalence rate among the inhabitants has decreased from 68.8% in 1967 to 48.1% in 1983, and in the schoolchildren from 56.4% in 1967 to 8.2% in 1983. The reduction rate was higher in the riverside-delta area than in the inland area. 3) In the prevalence rate by age, 11.9% was first seen in the 5-9 age group and the rate gradually increased up to 75.0% in the 50-59 age group. By sex, the rate was higher in the male than in the female in the 20-29 age group and over. 4) In the natural transition of the prevalence rate by age, the reduction rate of the infection during the past 16 years was greater in the younger age groups up to the 40-49 age group and reached the same level in the age group 50-59. Reduction was seen again in the age group over 60s. By sex, the reduction rate was greater in the female than in the male in the 20-29 age group and over. By area, the reduction rate was greater in the riverside delta area than in the inland area, particularly in the young age groups. 5) In the intensity of the infection among the cases, the mean egg out-put per mg feces per infected cases(EPmg) in the inhabitants was 6.3. EPmg of those of the river-side-delta area was 15.4 and that of the in-land was 2.8. On the other hand, in the schoolchildren, EPmg was 3.2, and no difference was seen between the two areas, the river-side-delta area and the inland area. 6) In the transition of the intensity of the infection by area, EPmg among the inhabitants inexplically increased from 7.8 in 1967 to 15.4 in 1983. This was probably caused by uneven specimen collection in the process of sampling the population. EPmg of the inhabitants in the inland area and those of the schoolchildren of both riverside delta and inland areas showed a similar decrease in the past 16 years. 7) The intensity of the infection by age showed a relatively low level in the 20-29 age group and below, and EPmg 5.1-9.5 was seen in the 30-39 age group and over. Sex, Epmg was 5.8 in the male and 4.7 the female. By in 8) In the transition of the intensity of the infection, EPmg decreased from 6.2 in 1967 to 5.4 in 1983. By age, in contrast to the figures of 1967 in which EPmg gradually increased with some fluctuation from 1.1 in the 0-4 age group to peak 10.5 in the 50-59 age group, in 1983 lower intensity of the infection was seen in the age group from 10-14 to 20-29 with the EPmg range of 0.6-2.7. 9) In the distribution of the clonorchiasis cases by the range of EPmg value, 43.2% of the cases were in 0.1 0.9 and 34.6% in 1.0-4.9. As a whole by cumulative percent, 44.6% of them were under 0.9 as light infection and 86.1% of them under 9.9 up to moderate infection. By sex, no difference was seen in Epmg. 10) In the transition of the distribution by the range of Epmg, the cases were distributed up to the range 80.0-99.9 in 1967 and to 60.0-79.9 in 1983. By cumulative percent, in the range of 0.1-0.9 and less, light infection, 34.3% of them were distributed in 1967 and 44.6% in 1983 with about 10% increase. In the range of 5.0-9.9 and less, up to moderate infection, 83.2% in 1967 and 86.1% in 1983 of the cases were seen, respectively. 11) The practice of raw freshwater fish consumption among the inhabitants seems to have decreased in recent years. Those who admitted to raw freshwater fish consumption in the last two years among the infected inhabitants were 59.3%, although 86.8% of them professed to have experience with raw freshwater fish consumption. 31.7% of those who have had experience of the raw freshwater fish consumption denied any further consumption in recent years. From an interview of 543 school-children, 24.1% of them admitted to an experience of raw freshwater fish consumption. However, those who have practised in the past two years comprized 17.9%. Those who denied raw freshwater fish consumption in recent years among those who had such experience were 26.0% out of 131 interviewed. The rate of raw freshwater fish consumption in both inhabitants and schoolchildren were higher in the male than in the female. On the contrary, the rate of those who did not practise in recent years among those who had experience of raw freshwater fish consumption was higher in the female than in the male. 12) The major reason for the reduction of raw freshwater fish consumption among the local inhabitants was the risk of the fluke infection. However, it has become apparent that such change of taste has resulted from water pollution impact which has affected throughout the areas of the freshwater systems in this locality since last several years. 13) In animal survey, Clonorchis infection was seen in 14.8% of 88 dogs examined and 3.7% of 27 house rats examined. It was noted that populations of dogs and cats have increased in the villages surveyed. Although the prevalence rate was lower in the present survey than those of 1967, the significance of the animals as the reservoir host has not changed. 14) Prevalence rate of Clonorchis infection by cercariae in the first intermediate host, Parafossarulus manchouricus, was 0.6% out of 517 snails examined. The infection rate was lower in comparison with 2.3% out of 2,124 examined in 1967. Moreover, sharp decreases in number and distribution of the intermediate host snails in many watershed areas of the huge freshwater systems in this locality seemed to reduce transmission of Clonorchis in connection with the intermediate host stage of its life cycle. 15) Clonorchis infection in the second intermediate fish hosts was relatively low. The mean number of Clonorchis metacercaria per fish in Pseudorasbora parva was 517 in 1983, whereas it was 1943 in 1968 through 1969. Environmental water pollution has also caused the decreased fish population density in these areas, and this has also apparently affected to the practice of raw freshwater fish consumption among the local inhabitants. 16) In conclusion, endemicity of Clonorchis infection in Gimhae Gum and delta area of the Nagdong River has sharply decreased during the past 16 years. The major cause of the regressive transition of the infection was the water pollution of the land water systems of this locality. The pollution has upset the ecosystems comprizing of the intermediate hosts of Clonorchis in many areas, and also affected to a significant extent to the discontinuance of the local inhabitants for raw freshwater fish consumption.

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