• Journal of Preventive Medicine and Public Health
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• v.26 no.2 s.42
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• pp.251-267
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• 1993

The relationship between lead related subject symptoms and lead exposure indices was studied in 435 male lead workers in thirteen lead using industries. 212 male office workers who were not exposed to lead occupationally were also studied as a control group. Fourteen lead related symptoms were selected. They were further subdivied into 4 sub-symptom groups such as 1) gastrointestinal, 2) neuromuscular and joint 3) constitutional, and 4) psychological symptoms. Symptom questionnaires were provided to the workers and filled up by themselves and reconfirmed by interviewer(doctor). The test used fer the evaluation of lead exposure were blood lead(PbB), zinc protoporphyrin in whole blood(ZPP), hemoglobin(Hb), hematocrit (Hct), delta-aminolevulinic acid in urine(DALA). The results obtained were as follows; 1. The higher prevalence rate in the sub-group of neuromuscular and joint symptoms was observed in occupationally lead exposed subjects than non-exposed subjects. Among the sub-groups, the most frequent symptom was 'numbness of finger, hands or feet', and the prevalence of the symptom of 'arthralgia', 'weakness of fingers, hands or feet' and 'myalgia' were higher in order. 2. While the symptom which showed the biggest difference of prevalence rate among the 14 symptoms between exposed and non-exposed subjects was 'numbness of fingers, hands or feet', the symptom which showed the highest prevalence rate was 'feeling tired generally' in exposed and non-exposed subjects, but no statistical difference of symptom prevalence were observed. 3. In total study population, PbB and ZPP had dose-response relationship with 4 symtoms of neuromuscular and joint symptoms ('numbness of finger, hands or feet', 'arthralgia', 'weakness of fingers, hands or feet' and 'myalgia') and one symptom of gastrointestinal group('intermittent pains in lower abdomen'). 4. In lead exposed workers, only neuromuscular and joint symptoms group showed dose-response relationship with PbB and ZPP, 5. In lead exposed workers, the prevalance rate of overall symptoms of lead workers with age below 39 years was higher than that of lead workers with age above 40. While neuromuscular and joint symptoms group had a dose-response relationship with PbB in former group, it had a dose-response relationship with ZPP in latter group. 6. Age adjusted odds ratios of symptoms of non-exposed with exposed and odds ratios of low exposed with high exposed workers showed the dose-response relationship of lead exposure with neuromuscular and joint symptoms group('numbness of fingers, hands or feet', 'arthralgia', 'weakness of fingers, hands or feet' and 'myalgia') and gastrointestinal symptoms group('intermittent pains in lower abdoman').

• The Korean Journal of Nuclear Medicine Technology
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• v.20 no.2
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• pp.9-13
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• 2016

Purpose PET-CT examinations using $^{18}F-FDG$ to treat urinary system cancer are limited in terms of anatomical structure and excretion route of $^{18}F-FDG$. But one of the ongoing examinations utilizing $^{11}C-Acetate$ can compensate for such defects. We would like to introduce a clinical application of $^{11}C-Acetate$ PET-CT in urinary cancer patients. Materials and Methods We conducted a clinical survey of 22 patients diagnosed with urinary cancer at our hospital, 10 prostate cancer patients, 10 renal cell carcinoma patients, and 2 bladder cancer patients. All patients were performed $^{18}F-FDG$ PET-CT examinations, $^{11}C-Acetate$ examinations were performed after two weeks on average. The equipment used to D-710 PET-CT in GE Company and we performed PET-CT procedures 15 minutes after injecting $^{11}C-Acetate$, and a medical doctor from the department of nuclear medicine appraised and compared images between $^{18}F-FDG$ and $^{11}C-Acetate$. Results According to our survey, prostate cancer patients generally had lower uptake of $^{18}F-FDG$ than other cancer patients did. In 2 out of 10 prostate cancer patients, metastasized cancer showed greater uptake in $^{11}C-Acetate$ than $^{18}F-FDG$. In renal cell carcinoma cases, 8 out of 10 patients displayed evidently greater uptake in $^{11}C-Acetate$ than $^{18}F-FDG$. We excluded bladder cancer cases in this study because uptake of $^{18}F-FDG$ in the bladder was too hot, the number of patients was insufficient, and the cases did not meet criteria such as the use of diuretics. Conclusion It is too premature to draw solid conclusions from the survey, since it involved only a small number of participants. However, there are a number of studies conducted abroad that prove the effectiveness of the $^{11}C-Acetate$ PET-CT examinations in treating urinary system cancer, and this study is still ongoing at our hospital. If the tests were to be conducted on a larger number of participants, this study could lead to numerous other potential research topics, such as the correlation between Prostatic specific antigen (PSA) values and $^{11}C-Acetate$ PET-CT, Gleason sum values from biopsy before surgery, Specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV) between $^{18}F-FDG$ PET-CT examinations and $^{11}C-Acetate$ PET-CT examinations in other urinary system cancers.

• Journal of Society of Preventive Korean Medicine
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• v.7 no.1
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• pp.17-28
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• 2003

We met results like the followings through the literatures and questionnaires about the tasks and solutions about the insurance fee of packed medical herbs. 1) It's turned out that 74.8% of herb doctors agrees to the insurance fee of packed medical herbs. However, in comparison with the same survey of the herb doctor association the percentage of general approval went somewhat lower, and especially the percentage of 'positive approval' became notably lower$(43.7%{\rightarrow}26.5%)$ and the percentage of 'active objection' raised about 2 times$(6.8%{\rightarrow}12.9%)$. Inquiring into the approval reasons on the insurance fee application of packed medical herbs some heads such as 'development toward treatment medical science' and 'decrease of publics burden' were higher than the one of 'management income and expenditure.' 2) As a result of the research, 36.0% of the patients and 42.8% of the residents recognized that the pay range of Chinese herb health insurance is narrow. They recognized that less people have the experiences of Chinese medical hospital use and internal application of the packed medical herbs as they are older, men rather than women. 85.4% of the patients and 74.9% of the residents agreed on the insurance pay of packed medical herbs. It's shown that they agree on the Chinese medical hospital use more as the economic standard is lower, on the insurance pay as they have ever taken the packed medical herbs. In the aspect of increase of insurance fee, 66.7% of the patients and 44.3% of the residents agreed on the insurance pay of packed medical herbs, and 18.1% and 36.1% disagreed on the insurance pay of packed medical herbs. The main objective reason why they disagree on the insurance pay of packed medical herbs was 'because the insurance fee goes up higher,' which answered 95.2% of the patients and 78.8% of the residents. 7.22% of the patients and 1.80% of the residents answered that they can pay more insurance fee in case of the insurance pay of packed medical herbs. However, in the priority order of the insurance pay, it hold the 5th position between 2 target research groups which was less than medical examination, charges for hospital accommodation and taking MRI. 3) According to the result of analysis about the cost of packed medical herbs, current practice price is 115,000 won and the average prime cost of a packed medical herb is 73,000 to 106,000 won. It's examined that the herb doctors regard that 95,000 won will be reasonable when the packed medical herb is payed in insurance. However, it was found out that the public generally thinks that the price would be appropriate on the level of 30,000 to 40,000 won and the percentage of the answers of 20,000 won to 30,000 was fairly high. 4) the central system of a prescription should be change into the central system of demonstration and the sick and wounded. 5) To solve this problem, the government should regulate it to pass by the circulation gradation of [importer, $peasantry{\rightarrow}manufacturer{\rightarrow}wholesaler{\rightarrow}distributor$(Chinese medical hospital, pharmacy dispensary of Chinese medicine)]And it should intervene into the quality and the circulation steps of Chinese medicine through 'the office or organization which is in charge of certification of Chinese medicine' and 'the office or organization which is in charge of the circulation of Chinese medicine.' And some actions such as simple severance, lavation, drying should be included into the conception of manufacture and the boundary between food and medical supplies should be made at a manufactory. And the regulation of standardized goods at one's own house should be improved so that, the peasantry can sell the materials of Chinese medicine only to the manufacturer. 6) In company with the insurance pay of packed medical herbs, the study about the separation of dispensary from medical practice in the Chinese medicine should be accomplished.

• Tuberculosis and Respiratory Diseases
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• v.53 no.4
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• pp.401-408
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• 2002

Background : Tuberculin skin test is a method to examine M. tuberculosis infection and has been used all over the world. But various factors make it difficult to understand testing results. In 2000, the American Thoracic Society recommended that skin test results should be decided by considering risk factors of the tested. In Korea, high tuberculosis infection rate and BCG vaccination rate make it difficult to differentiate current infection, past infection, and no infection by the skin test. This study was attempted to examine a negative predictive value of the skin test to understand how the skin test acts on deciding administration of anti-tuberculosis drug. Methods : From Mar. 1 to Jul. 31 in 2001, the test was performed for patients hospitalized in Department of Internal Medicine, Hallym University College of Medicine, Chunchon, Korea by administering Tuberculin PPD RT23 2 TU (0.1 ml)to them that has been currently used in Korea based on Mantoux method. They were decided to be infected with tuberculosis bacilli by following diagnostic standard: 1) tuberculosis bacilli was cultured in sputum by microbiological diagnostic standard or Acid-fast bacilli was proven on a microscopic examination or 2) tuberculosis bacilli was not proven in the aforesaid microbiological test by clinical diagnostic standard, while there was opinion or symptom suitable for tuberculosis by radiographic or histological standard so the doctor decided to apply the tuberculosis treatment. Results : In this study, total 210 patients except 20 patients (8.7%) among 230 hospitalized patients were evaluated. Their average age was 60±16.8 years, and male-female rate was 1.28 : 1 (male: 118, female: 92). Number of patient, who was diagnosed and decided as tuberculosis, was 53(25.2%). Pulmonary tuberculosis was found in 45 patients (84.9%); 22 patients were decided to be positive in the Acid-fast bacilli smear test by microbiological examination (culture positive: 13, culture negative: 9), and 23 patients were decided to be tuberculosis patients by clinical diagnosis standard. Tuberculosis pleuritis was found in 8 patients (15.1%); 4 patients were diagnosed and decided by histological standard, and 4 patients were decided and treated by clinical standard. In differentiating patients into 'Negative' and 'Positive' by the skin test standard of the American Thoracic Society, negative predictive value 92.3%, positive predictive value 47.3%, sensitivity and specificity were 83%, 68.8%, respectively. Conclusion : In hospitalized respiratory patients, there was high negative predictive vlaue 92.3% by tuberculin skin test, therefore skin test would be a important factor for deciding administration of anti-tuberculosis drug on negative skin test patient.

• Korea Journal of Hospital Management
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• v.22 no.3
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• pp.1-17
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• 2017

Purposes: Diabetes is a metabolic disorder that requires continuous care in order to prevent complications, as it can impose a critical burden on families and society due to various complications, including terminal renal failure, non-traumatic lower extremity amputation, and adult blindness. The usual sources of care are "specified private clinics, public health centers, or other facilities to visit when ill or when health-related advice is needed". These usual sources of care offer preventative services, have a high overall satisfaction rate in terms of public health care, and decrease the inpatient rates and medical costs of medical aid recipients. This study analyzed the current status of diabetic patients over 20 years of age based on their possession of a usual source of care, and the effects of this possession on the frequency of their medical service usage and its costs. Methodology: Based on data from the 7th Korea Health Panel, a Tobit analysis was used to analyze the different factors that can affect the frequency of medical service usage and its costs for diabetic patients with and without a usual source of care. Findings: The medical costs of diabetic patients with a usual source of care decreased in terms of inpatient, and the outpatient visits and inpatient costs of the group with a usual source of care in the form of a mainly-visiting doctor decreased more than those of the group with a mainly-visiting medical institution only. Practical Implications: Having a usual source of care can increase the treatment continuity, leading to reduced inpatient, and having a mainly-visiting doctor as the usual source of care further increases the treatment continuity. Based on these results, a new policy is needed to increase and strengthen diabetic patients? possession of a usual source of care.

• Korea Journal of Hospital Management
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• v.23 no.1
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• pp.78-86
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• 2018

Purposes: This study identifies local Chinese consumers' standard for selecting medical care provider and their standard for choosing medical staff, as well as their expectations and concerns regarding Korean medical care providers. Methodology: A survey was conducted in China, to identify Chinese medical care consumers' standards for selecting a medical provider and the factors that influence their use of general hospitals. A total of 1,500 people across three cities, between the ages 18 and 60 participated in the survey. Moreover, a multiple logistic regression analysis was used to analyze the factors that affect Chinese medical care consumers' use of general hospitals. Findings: A total of 75.5 percent respondents chose general hospitals as their most frequently-used medical provider. Those who have health insurance, visit general hospitals as outpatients or are hospitalized more frequently than those who do not have a health insurance. Furthermore, those who have private insurance visit general hospitals as outpatients or are hospitalized more frequently than those who are not signed up for private insurance. Major standards for selecting a hospital included: the doctor's skills, word-of-mouth regarding the hospital, and distance to the hospital from the respondents' home. Standards for choosing medical personnel included word-of-mouth regarding the medical team, recommendations from family members or acquaintances, and medical team's notoriety. Friends and neighbors, family members, television and other media outlets were the channels for acquiring information on a hospital. It was found that Chinese people mostly visit the cardiovascular department of Korean hospitals for treatment. For using Korean hospitals in China, the majority of respondents answered that they were concerned about the cost. Practical Implications: Backed by highly skilled medical experts and cutting-edge technology, Korean medical care providers are attempting to enter China's medical care market. To succeed in China's medical care market, it is vital to conduct a clear and precise analysis.

• Journal of Acupuncture Research
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• v.17 no.1
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• pp.27-41
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• 2000

The meridian system is the most essential and basic connecting structure that maintains the vital activities of viscera and bowels by connecting them with each part of body's surface. Doctors can understand the healthy condition, and the region and deficiency-excessiveness of disease by observing the condition of Qi flowing. Deficiency and excessiveness could be differentiated by various symptoms expressed in meridian system. Especially there could be several clues like pain, heat-cold, protuberance-depression, change of color and shine in the line of channel leads to the judgment of deficiency-excessiveness The diagnosis of deficiency and excessiveness can be generalized by quantification of elastic status in skin surface along the meridian system. By comparing data from measurement of elastic condition with those from traditional deficiency and excessiveness, it could be utilized for the development of oriental medicine. All biological activities in the human body are based on meridian system according to the oriental medicine. Also the meridian system is viewed as basic and essential structure connecting internal viscera and each part of body. The areas of expressed channel phenomena are muscle to bone, muscle to muscle and bone to bone. These areas are called depression where meridian system is present and any changing state on those points can be measured. It could be difficult in diagnosing the reaction of meridian system because doctor can depend on his own judgment. Therefore, it is necessary to quantify and indexate channel reactions. To quantify the channel reactions, specially manufactured instrument was used to quantify the protuberance and depression to differentiate the deficiency and excessiveness. The results follow as below; 1. The elastic index measurement by the equipment proved a pattern of agreement showing the values that ranged within standard deviation 0.05kgf/cm throughout the experiment except few cases' measurement in CV-17. 2. To evaluate the state of deficiency & excessiveness of elastic index measurements in frontal point, elastic index measurements in the front paint were compared to the elastic index measured surrounding the point within 2.5 cm. Such result of indexing procedure was closely matched to the concept of palpitation. 3. If the elastic index values in the surrounding front point closely located to the elastic index values in the front point, the judgement on the state of deficiency and excessiveness was delayed. Otherwise, it was judged as deficiency or excessiveness. 4. Out of total 12 cases of comparing the elastic index values to the elastic index values in the surrounding front point, Three to nine front points were judged as either in the state of deficiency or excessiveness. 5. Among the nine front points judged as either in the state of deficiency or excessiveness, Four cases were matched to the electric index measured by EAV that evaluating the internal organs by five different phases. If more clinical cases are accumulated, it is expected to systematically theorize and improve the concept of deficiency and excessiveness in the internal organs using the front point.

• Journal of Acupuncture Research
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• v.25 no.2
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• pp.151-164
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• 2008

Objectives : This study was designed to compare the effects on Korean Western Ontario and McMaster Universities Osteoarthritis Index(KWOMAC), 36-ltems Short-Form Health Survey(SF-36), Visual Analog Scale(VAS) and Nine Point Scale between 'Intramuscular Bee Venom Herbal Acupuncture' and 'Intracutaneous Bee Venom Herbal Acupuncture' in knee osteoarthritis patients for 4weeks. Methods : All the voluntary subject were diagnosed as knee osteoarthritis. Patients were randomly assigned either to two groups : Intramuscular bee venom herbal acupuncture treatment group(IM-BV group) or Intracutaneous bee venom herbal acupuncture treatment group(IC-BV group). The IM-BV group received bee venom herbal acupuncture intramuscularly on muscles closest to the pathologic site on ultrasonography. The IC-BV group received bee venom herbal acupuncture intracutaneously on $LE_{110}$, $LE_{201}$, $ST_{35}$, $ST_{36}$ and $LR_8$. Bee venom herbal acupuncture was applied twice a week for 4 weeks by an oriental medical doctor at Kyung-hee Oriental Medical Hospital. Both groups were checked of pathologic site by ultrasonography before treatment and follow up after four-week treatment. The patients were assessed by KWOMAC and SF-36 before and after four-week treatment. The changes in patients' pain was measured by VAS before treatment and after one-, two-, three- and four-week treatment. The patients' overall treatment outcome assesment was measured by Nine Point Scale after four-week treatment. Results : The results were as follows ; 1. The IM-BV group showed significant improvement on total, pain, stiffness and physical function in KWOMAC, and the IC-BV group showed significant improvement on total and physical function in KWOMAC after 4weeks compared to the pre-treatment. In KWOMAC, the IM-BV group showed more improvement on average compared to the IC-BV group, but there were no significant difference between two groups. 2. The IM-BV group showed significant improvement on VAS after one-week treatment. The IC-BV group showed significant improvement on VAS after two-week treatment. But there were no significant difference between two groups. 3. The IM-BV group showed significant improvement on physical functioning(PF) and bodily pain(BP) in SF-36, and the IC-BV group showed significant improvement on vitality(VT) and bodily pain(BP) in SF-36 after 4weeks compared to the pre-treatment. But there were no significant difference between two groups. 4. 88.2% of IM-BV group and 93.3% of IC-BV group graded their improvement as 'Fair' or better on Nine Point Scale. But there were no significant difference between two groups. Conclusions : This study suggests that in the treatment of knee osteoarthtitis patients, effects of 'Intramuscular Bee Venom Herbal Acupuncture' were not different from 'Intracutaneous Bee Venom Herbal Acupuncture' statistically. But both treatment showed effects on pain and physical function in knee osteoarthtitis patients.

• The Korean Journal of Nuclear Medicine Technology
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• v.22 no.2
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• pp.84-87
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• 2018

Purpose The radiopharmaceutical used in the nuclear medicine department is used only for the specific patient according to the prescription or instruction of the doctor without selling, so it is dispensed and it is distributed and used for the examination. Radiopharmaceuticals administered to patients should be managed appropriately as well as radiation safety management during dispensation. The purpose of this study is to investigate microbial contamination during dispensation of radiopharmaceuticals Materials and Methods This study distinguished between general workbench and clean workbench and performed three tests. First, microbial cultivation test of radiopharmaceutical prepared and dispensed in general workbenches and sterile workbenches were carried out five times, respectively. The second test was performed settle plate method three times before and after the use of the exhaust filter. Finally, Adenosine Triphosphate (ATP) measurement was performed in each workbench to measure bacterial counts. In addition, ATP measurement were carried out by designating locations and items that may be contaminated during dispensation. Results In the microbial culture test, no microorganisms were detected in both samples. In the settle plate method, it was detected without using of the exhaust filter in a general workbench once. In the ATP measurement test, it was measured at the level of 400 RLU or less, which is the standard value of contamination, in both workbenches surface. In additional ATP measurement test, the refrigerator handle in the distribution room was measured above the reference value of 1217 RLU, the vacuum vial shield of the Tech Generator at 435 RLU, and the syringe holder at 1357 RLU. After environmental disinfection, the results were reduced to 311 RLU, 136 RLU, and 291 RLU. Conclusion No contamination by bacteria was found in both workbenches. However, microbial contamination may occur if the use of an exhaust filter or proper hand hygiene is not achieved. Regular inspections and management for aseptic processing themselves will be necessary.

• The Korean Society of Law and Medicine
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• v.8 no.2
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• pp.205-290
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• 2007

In Korea, abortion in the Criminal Law is an illegal act in exception of limited cases stated in the Mother and the Child Health Law. There are grounds on which abortion may be carried out - though the grounds are very limited and related such as emergency situation of woman's physical health, rape, incest and genetic diseases. The Criminal Law regulates the mother's act of abortion and the doctor's surgical performance of abortion. The Mother and the Child Health Law prescribes the medical, ethical, and genetic grounds for the legal permission of abortion. Many people tend to abuse of abortion even though they are fully aware of its illegality. The law lead to be inconsistent with its enforcement. In this paper, I would like to suggest some proposals about the legal analysis of the Abortion Regulations to reform the existing regulations and increase the effectiveness of the regulations. A national survey was carried out using telephone interview with Korean citizens from August 1th to August 31th in 2005. A total of 1,025 citizens (male: female = 49.2%:50.8%) were randomly sampled in proportion to the number of population of 17 regions. The major findings of this survey were as follows. First, 91.4% of the respondents approved of abortion based on the medical grounds. Second 83.3% of the respondents perceived that abortion may be carried out based on ethical grounds for example rape. Third, 74.3% were agreed to abortion based on genetic diseases. Forth, 64.7% were approved the abortion that unmarried woman may be carried out. In contrast 45.0% were approved the abortion that girls may be carried out, whereas 46.4% were perceived that the abortion may not be permitted. Fifth, 58.3% were disagreed the permission of abortion based on social and economic grounds. According to the survey Korean citizens seem to have positive perception on the abortion that may be carried out based on medical, ethical and genetic grounds. Whereas they worried about the abortion based on social and economic grounds. Now the Mother and the Child Health Law prescribes the medical, ethical, and genetic grounds for the legal permission of abortion. But this law does not include social and economic grounds. In cases of when the mother has a impossibility to breed her child because of her social situations and financial conditions, we should accepted the legal acceptance of abortion due to social and economic grounds.