• Title/Summary/Keyword: Observed discharge

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Temporal and Spatial Variability of Phytoplankton Communities in the Nakdong River Estuary and Coastal Area, 2011-2012 (2011-2012년 낙동강 하구 및 연안역에서 식물플랑크톤 군집의 시·공간적 변화)

  • Chung, Mi Hee;Youn, Seok-Hyun
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.18 no.4
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    • pp.214-226
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    • 2013
  • To understand the changing patterns in phytoplankton communities, we conducted 12 surveys along the Nakdong River, its estuary, and adjacent coastal areas between January 2011 and October 2012 (during the period of barrage construction and sediment dredging). Monthly precipitation ranged from 0 to 502 mm during the survey period, and salinity ranged between 0.1 psu and 0.3 psu in the Nakdong River, regardless of the depth, indicating no seawater influence, while salinity showed large seasonal fluctuations in the estuarine and coastal station, ranging from 0.1 psu to 34.8 psu. A total of 402 phytoplankton species were identified, 178 species from the river and 331 species from the estuary and coastal areas. Phytoplankton standing crop increased in 2012 compared to that in 2011, and was found to be highest in the river, followed by the estuary and coastal areas. Among the top 20 species in frequency of occurrence and dominance, Stephanodiscus spp., Aulacoseira granulata, and Aulacoseira granulata var. angustissima and Pseudo-nitzschia spp. were important species along the river-estuary-coastal areas. Diatoms were the major taxonomic group inhabiting the Nakdong river-estuary-coastal areas. A comparison of seasonal dominant phytoplankton species revealed a slight decrease over the years, from 13 species in 2011 to 10 species in 2012. However, no significant difference was found in the diversity of phytoplankton species between the two survey years, although lightly greater diversity was observed in the coastal areas than in the river and estuary. Cluster analysis with community composition data revealed that the community structure varied significantly in 2011 depending on the time of survey, while in 2012, it hardly showed any variation and was simpler. An increase in the phytoplankton standing crop, fewer dominant species, and simpler community structure in 2012 compared to those in 2011 are probably due to the rapid environmental changes along the Nakdong River. To investigate these ecological relationships, it is necessary to conduct further studies focusing on integrated analyses of biocenosis, including phytoplankton with respect to the changes in nutrient distribution, variation of freshwater discharge, and effect area of freshwater in the Nakdong estuary and adjacent coastal areas.

Hydro-meteorological Effects on Water Quality Variability in Paldang Reservoir, Confluent Area of the South-Han River-North-Han River-Gyeongan Stream, Korea (남·북한강과 경안천 합류 수역 팔당호의 수질 변동성에 대한 기상·수문학적 영향)

  • Hwang, Soon-Jin;Kim, Keonhee;Park, Chaehong;Seo, Wanbum;Choi, Bong-Geun;Eum, Hyun Soo;Park, Myung-Hwan;Noh, Hye Ran;Sim, Yeon Bo;Shin, Jae-Ki
    • Korean Journal of Ecology and Environment
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    • v.49 no.4
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    • pp.354-374
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    • 2016
  • This study explored spatiotemporal variability of water quality in correspondence with hydrometeorological factors in the five stations of Paldang Reservoir located in the Han River during 4 years from May 2012 to December 2015. Variability of basic water quality factors were largely related with seasonal fluctuations of hydrology. Temperature stratification occurred in the deep dam station, and prolonged hypoxia was observed during the draught year. Nitrogen nutrients were increased with decreasing inflow in which changing pattern of $NH_4$ reversed to $NO_3$ by the effect of treated wastewater effluent. Phosphorus increase was manifest during the period of high inflow or severe drought. Chl-a variation was reversely related with both flow change and AGP(algal growth potential) variations. Our study demonstrated that water quality variability in Paldang Reservoir was largely attributed to both natural and operational changes of inflow and outflow (including water intake) based on major pollution source of the treated wastewater (total amount of $472{\times}10^3m^3d^{-1}$) entering to the water system from watershed. In the process of water quality variability, meteorological (e.g., flood, typhoon, abnormal rainfall, scorching heat of summer) and hydrological factors (inflow and discharge) were likely to work dynamically with nutrients pulse, dilution, absorption, concentration and sedimentation. We underline comprehensive limnological study related to hydro-meteorolology to understand short- and long-term water quality variability in river-type large reservoir and suggest the necessity of P-free wastewater treatment for the effective measure of reducing pollution level of Paldang drinking water resource.

Distribution characteristics of chemical oxygen demand and Escherichia coli based on pollutant sources at Gwangyang Bay of South Sea in Korea (남해 광양만에서 오염원에 따른 화학적 산소요구량과 대장균의 해역별 분포특성)

  • Baek, SeungHo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.5
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    • pp.3279-3285
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    • 2014
  • This study aimed to understand seasonal and geographical characteristic of chlorophyll-${\alpha}$ (chl-${\alpha}$), COD (chemical oxygen demand) and Escherichia coli at Gwangyang Bay during the period from February 2010 to November 2012. The bay is divided into three different zones based on the pollutant levels and geographical characteristics. During the study periods, water temperature, salinity, Chl. ${\alpha}$, and chemical oxygen demand (COD) varied in the range of $4.68-28.63^{\circ}C$, 1.94-33.84 psu, 0.31-35.10 ${\mu}gL^{-1}$, and 0.70-13.35 $mgL^{-1}$, respectively. Total chl-a concentration were high at the zone I, which can be characterized as a semi-enclosed eutrophic area, and it were low at the zone III, which is influenced by low nutrients of surface warm water current from offshore of the bay. The high concentration of COD was observed at inner bay during the four seasons and the water quality level was kept to be bad condition during spring season at the zone II, which is influenced by Seomjin River water. The highest colony form of E. coli was recorded to be 3550 $cfuL^{-1}$ during summer at station 1 (zone I), whereas it was relatively kept low level during all seasons at the zone III. As a result, the E. coli was correlated with water temperature (r=0.31 p<0.05) and salinity (r=-0.55 p<0.05), implying that those parameters have play an important crucial role in proliferation of E. coli. Consequently, our results indicated that the E. coli can be significantly promoted within pollutant sources including the high nutrients supplied by rive discharge during spring and summer rainy seasons in semi-enclosed area of Gwangyang Bay.

A Study on the Construction method of Stamped earthen wall (판축토성(版築土城) 축조기법(築造技法)의 이해(理解) - 풍납토성(風納土城) 축조기술(築造技術)을 중심(中心)으로 -)

  • Shin, Hee-kweon
    • Korean Journal of Heritage: History & Science
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    • v.47 no.1
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    • pp.102-115
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    • 2014
  • The stamped earth method is a typical ancient engineering technique which consists of in-filling wooden frame with layers of stamped earth or sand. This method has been universally used to construct earthen walls and buildings, etc. The purpose of this article is to understand the construction method and principles of the stamped earthen wall through analysis of various construction techniques of Pungnaptoseong Fortress(Earthen Fortification in Pungnap-dong). First of all, the ground was leveled and the foundations for the construction of the earthen wall were laid. The underground foundation of the earthen walls was usually constructed by digging into the ground and then in-filling this space with layers of mud clay. Occasionally wooden posts or paving stones which may have been used to reinforce the soft ground were driven in. The method of adding layers of stamped earth at an oblique angle to either side of a central wall is the most characteristic feature of Pungnaptoseong Fortress. Even though the traces of fixing posts, boards, and the hardening of earth - all signatures of the stamped earth technique - have not been identified, evidence of a wooden frame has been found. It has also been observed that this section was constructed by including layers of mud clay and organic remains such as leaves and twigs in order to strengthen the adhesiveness of the structures. The outer part of the central wall was constructed by the anti-slope stamped earth technique to protect central wall. In addition a final layer of paved stones was added to the upper part of the wall. These stone layers and the stone wall were constructed in order to prevent the loss of the earthen wall and to discharge and drain water. Meanwhile, the technique of cementing with fire was used to control damp and remove water in stamped earth. It can not be said at present that the stamped earth method has been confirmed as the typical construction method of Korean ancient earthen walls. If we make a comparative study of the evidence of the stamped earth technique at Pungnaptoseong Fortress with other archeological sites, progress will be made in the investigation of the construction method and principles of stamped earthen wall.

Spatiotemporal and Longitudinal Variability of Hydro-meteorology, Basic Water Quality and Dominant Algal Assemblages in the Eight Weir Pools of Regulated River(Nakdong) (낙동강 8개 보에서 기상수문·기초수질 및 우점조류의 시공간 종적 변동성)

  • Shin, Jae-Ki;Park, Yongeun
    • Korean Journal of Ecology and Environment
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    • v.51 no.4
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    • pp.268-286
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    • 2018
  • The eutrophication and algal blooms by harmful cyanobacteria (CyanoHAs) and freshwater redtide (FRT) that severely experiencing in typical regulated weir system of the Nakdong River are one of the most rapidly expanding water quality problems in Korea and worldwide. To compare with the factors of rainfall, hydrology, and dominant algae, this study explored spatiotemporal variability of the major water environmental factors by weekly intervals in eight weir pools of the Nakdong River from January 2013 to July 2017. There was a distinct difference in rainfall distribution between upstream and downstream regions. Outflow discharge using small-scale hydropower generation, overflow and fish-ways accounted for 37.4%, 60.1% and 2.5%, respectively. Excluding the flood season, the outflow was mainly due to the hydropower release through year-round. These have been associated with the drawdown of water level, water exchange rate, and the significant impact on change of dominant algae. The mean concentration (maximum value) of chlorophyll-a was $17.6mg\;m^{-3}$ ($98.2mg\;m^{-3}$) in the SAJ~GAJ and $29.6mg\;m^{-3}$ ($193.6mg\;m^{-3}$) in the DAS~HAA weir pools reaches, respectively. It has increased significantly in the downstream part where the influence of treated wastewater effluents (TWEs) is high. Indeed, very high values (>50 or $>100mg\;m^{-3}$) of chlorophyll-a concentration were observed at low flow rates and water levels. Algal assemblages that caused the blooms of CyanoHAs and FRT were the cyanobacteria Microcystis and the diatom Stephanodiscus populations, respectively. In conclusion, appropriate hydrological management practices in terms of each weir pool may need to be developed.

Water quality characteristics and spatial distribution of phytoplankton during dry and rainy seasons in Bunam Lake and Cheonsu Bay, Korea (부남호·천수만의 갈수기와 강우기 수질 오염 특성과 식물플랑크톤의 공간 분포 특성)

  • Lee, Minji;Seo, Jin Young;Baek, Seung Ho
    • Korean Journal of Environmental Biology
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    • v.39 no.2
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    • pp.184-194
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    • 2021
  • Since the construction of a dike in 1983, the water quality in the Bunam Lake has continued to deteriorate due to algal bloom caused by agricultural nutrient loading. Therefore, we evaluated the change in water quality and phytoplankton ecological characteristics in Bunam Lake and Cheonsu Bay, Korea. Water temperature, salinity, dissolved oxygen, chemical oxygen demand (COD), chlorophyll, and phytoplankton community were surveyed in April during the dry season and in July during the rainy reason. As a result, during the dry period, phytoplankton proliferated greatly and stagnated in the Bunam Lake while a very high population of cyanobacteria Oscillatoria spp. (8.61×107 cells L-1) was recorded. Most of the nutrients, except, nitrate and nitrite, were consumed due to the large growth of phytoplankton. However, during the rainy period, concentrations of ammonia, phosphate, silicate, nitrate, and nitrite, were very high towards the upper station due to the inflow of fresh water. Cyanobacteria Oscillatoria and Microcystis spp. were dominant in the Bunam Lake during the rainy period. Even in the Cheonsu Bay, cyanobacteria dominated due to the effect of discharge and diatoms, such as, Chaetoceros spp. and Eucampia zodiacus, which also proliferated significantly due to increased levels of nutrients. Since the eutrophication index was above 1 in Bunam Lake, it was classified as eutrophic water and the Cheonsu Bay was classified as eutrophic water only during the rainy season. In addition, a stagnant seawater-derived hypoxia water mass was observed at a depth of8m in the Bunam Lake adjacent to the tide embankment and the COD concentration reached 206 mg L-1 in the bottom layer at B3. Based on this result, it is considered that the water quality will continue to deteriorate if organic matters settle due to continuous inflow of nutrients and growth of organisms while the bottom water mass is stagnant.

Analysis of Fish Utilization and Effectiveness of Fishways Installed at Weirs in Large Rivers (대하천 보에 설치된 어도의 어류 이용 현황 및 효과 분석)

  • Jeong-Hui Kim;Sang-Hyeon Park;Seung-Ho Baek;Namjoo Lee;Min-Ho Jang;Ju-Duk Yoon
    • Korean Journal of Ecology and Environment
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    • v.56 no.4
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    • pp.348-362
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    • 2023
  • This study analyzed the monitoring results of fishways at 16 weirs constructed on four large Rivers to provide data helpful for the operation and management of fishways. The average utilization rate of the fishways at the weirs was confirmed to be 64.9%. When comparing the dominant species in the mainstream and fishway monitoring results, differences were observed in 9 weirs (56.3%). This indicated that the species prevalent in the mainstream were not necessarily the ones most frequently using the fishways. The average number of individuals using the fishways per day was 336. When classifying the fish species using the fishway by life type, 92.3% were primary freshwater fish, and migratory species accounted for only 5.6%. Analysis based on the season of fishway usage revealed that an average or higher number of fish species used the fishways from May to October, with the highest number of individual users occurring from June to August. Between May and July, 80% of the fish species using the fishways were in their spawning period, while during other season, less than 40% were species that move during the spawning period. The fishways that showed a significant alignment between the spawning period and the fishway passage period were Rhinogobius brunneus, Leiocassis nitidus, Squalidus chankaensis tsuchigae, Pseudogobio esocinus, Acheilognathus rhombeus, and Pungtungia herzi, in that order. When comparing the fishway monitoring results of the Gangjeong-Goryeong Weir and the Dalseong Weir with the upper part water level of the weir, both the number of fish species and individuals using the fishway showed positive correlations with the upper part water level of the weir. This suggests that a higher water level of the weir increases the inflow discharge within the fishway, leading to increased use by fish (number of individuals in Gangjeong-Goryeong Weir, P<0.001; number of species in Dalseong Weir, P<0.05). This study summarized and analyzed the results of fishway monitoring at 16 weirs built on four large Rivers, considering fishway efficiency, operation and management, monitoring period, and regulation of water level in the upper part of the weir. It is thought that this will help understand the status of fish use in fishways on large River and aid the construction, operation, and management of fishways in the future.

Clinical Outcomes of Off-pump Coronary Artery Bypass Grafting (심폐바이패스 없는 관상동맥우회술의 임상성적)

  • Shin, Je-Kyoun;Kim, Jeong-Won;Jung, Jong-Pil;Park, Chang-Ryul;Park, Soon-Eun
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.34-40
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    • 2008
  • Background: Off-pump coronary artery bypass grafting (OPCAB) shows fewer side effects than cardiopulmonary by. pass, and other benefits include myocardial protection, pulmonary and renal protection, coagulation, inflammation, and cognitive function. We analyzed the clinical results of our cases of OPCAB. Material and Method: From May 1999 to August 2007, OPCAB was performed in 100 patients out of a total of 310 coronary artery bypass surgeries. There were 63 males and 37 females, from 29 to 82 years old, with a mean age of $62{\pm}10$ years. The preoperative diagnoses were unstable angina in 77 cases, stable angina in 16, and acute myocardial infarction in 7. The associated diseases were hypertension in 48 cases, diabetes in 42, chronic renal failure in 10, carotid artery disease in 6, and chronic obstructive pulmonary disease in 5. The preoperative cardiac ejection fraction ranged from 26% to 74% (mean $56.7{\pm}11.6%$). Preoperative angiograms showed three-vessel disease in 47 cases, two-vessel disease in 25, one-vessel disease in 24, and left main disease in 23. The internal thoracic artery was harvested by the pedicled technique through a median sternotomy in 97 cases. The radial artery and greater saphenous vein were harvested in 70 and 45 cases, respectively (endoscopic harvest in 53 and 41 cases, respectively). Result: The mean number of grafts was $2.7{\pm}1.2$ per patient, with grafts sourced from the unilateral internal thoracic artery in 95 (95%) cases, the radial artery in 62, the greater saphenous vein in 39, and the bilateral internal thoracic artery in 2. Sequential anastomoses were performed in 46 cases. The anastomosed vessels were the left anterior descending artery in 97 cases, the obtuse marginal branch in 63, the diagonal branch in 53, the right coronary artery in 30, the intermediate branch in 11, the posterior descending artery in 9 and the posterior lateral branch in 3. The conversion to cardiopulmonary bypass occurred in 4 cases. Graft patency was checked before discharge by coronary angiography or multi-slice coronary CT angiography in 72 cases, with a patency rate of 92.9% (184/198). There was one case of mortality due to sepsis. Postoperative arrhythmias or myocardial in-farctions were not observed. Postoperative complications were a cerebral stroke in 1 case and wound infection in 1. The mean time of respirator care was $20{\pm}35$ hours and the mean duration of stay in the intensive care unit was $68{\pm}47$ hours. The mean amounts of blood transfusion were $4.0{\pm}2.6$ packs/patient. Conclusion: We found good clinical outcomes after OPCAB, and suggest that OPCAB could be used to expand the use of coronary artery bypass grafting.

Phytoplankton Diversity and Community Structure Driven by the Dynamics of the Changjiang Diluted Water Plume Extension around the Ieodo Ocean Research Station in the Summer of 2020 (2020년 하계 장강 저염수가 이어도 해양과학기지 주변 해역의 식물플랑크톤 다양성 및 개체수 변화에 미치는 영향)

  • Kim, Jihoon;Choi, Dong Han;Lee, Ha Eun;Jeong, Jin-Yong;Jeong, Jongmin;Noh, Jae Hoon
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.27 no.7
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    • pp.924-942
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    • 2021
  • The expansion of the Changjiang Diluted Water (CDW) plume during summer is known to be a major factor influencing phytoplankton diversity, community structure, and the regional marine environment of the northern East China Sea (ECS). The discharge of the CDW plume was very high in the summer of 2020, and cruise surveys and stationary monitoring were conducted to understand the dynamics of changes in environmental characteristics and the impact on phytoplankton diversity and community structure. A cruise survey was conducted from August 16 to 17, 2020, using R/V Eardo, and a stay survey at the Ieodo Ocean Research Station (IORS) from August 15 to 21, 2020, to analyze phytoplankton diversity and community structure. The southwestern part of the survey area exhibited low salinity and high chlorophyll a fluorescence under the influence of the CDW plume, whereas the southeastern part of the survey area presented high salinity and low chlorophyll a fluorescence under the influence of the Tsushima Warm Current (TWC). The total chlorophyll a concentrations of surface water samples from 12 sampling stations indicated that nano-phytoplankton (20-3 ㎛) and micro-phytoplankton (> 20 ㎛) were the dominant groups during the survey period. Only stations strongly influenced by the TWC presented approximately 50% of the biomass contributed by pico-phytoplankton (< 3 ㎛). The size distribution of phytoplankton in the surface water samples is related to nutrient supplies, and areas where high nutrient (nitrate) supplies were provided by the CDW plume displayed higher biomass contribution by micro-phytoplankton groups. A total of 45 genera of nano- and micro-phytoplankton groups were classified using morphological analysis. Among them, the dominant taxa were the diatoms Guinardia flaccida and Nitzschia spp. and the dinoflagellates Gonyaulax monacantha, Noctiluca scintillans, Gymnodinium spirale, Heterocapsa spp., Prorocentrum micans, and Tripos furca. The sampling stations affected by the TWC and low in nitrate concentrations presented high concentrations of photosynthetic pico-eukaryotes (PPE) and photosynthetic pico-prokaryotes (PPP). Most sampling stations had phosphate-limited conditions. Higher Synechococcus concentrations were enumerated for the sampling stations influenced by low-nutrient water of the TWC using flow cytometry. The NGS analysis revealed 29 clades of Synechococcus among PPP, and 11 clades displayed a dominance rate of 1% or more at least once in one sample. Clade II was the dominant group in the surface water, whereas various clades (Clades I, IV, etc.) were found to be the next dominant groups in the SCM layers. The Prochlorococcus group, belonging to the PPP, observed in the warm water region, presented a high-light-adapted ecotype and did not appear in the northern part of the survey region. PPE analysis resulted in 163 operational taxonomic units (OTUs), indicating very high diversity. Among them, 11 major taxa showed dominant OTUs with more than 5% in at least one sample, while Amphidinium testudo was the dominant taxon in the surface water in the low-salinity region affected by the CDW plume, and the chlorophyta was dominant in the SCM layer. In the warm water region affected by the TWC, various groups of haptophytes were dominant. Observations from the IORS also presented similar results to the cruise survey results for biomass, size distribution, and diversity of phytoplankton. The results revealed the various dynamic responses of phytoplankton influenced by the CDW plume. By comparing the results from the IORS and research cruise studies, the study confirmed that the IORS is an important observational station to monitor the dynamic impact of the CDW plume. In future research, it is necessary to establish an effective use of IORS in preparation for changes in the ECS summer environment and ecosystem due to climate change.

A Study Concerning Health Needs in Rural Korea (농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究))

  • Lee, Sung-Kwan;Kim, Doo-Hie;Jung, Jong-Hak;Chunge, Keuk-Soo;Park, Sang-Bin;Choy, Chung-Hun;Heng, Sun-Ho;Rah, Jin-Hoon
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.1
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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