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A Study on Major Safety Problems and Improvement Measures of Personal Mobility (개인형 이동장치의 안전 주요 문제점 및 개선방안 연구)

  • Kang, Seung Shik;Kang, Seong Kyung
    • Journal of the Society of Disaster Information
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    • v.18 no.1
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    • pp.202-217
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    • 2022
  • Purpose: The recent increased use of Personal Mobility (PM) has been accompanied by a rise in the annual number of accidents. Accordingly, the safety requirements for PM use are being strengthened, but the laws/systems, infrastructure, and management systems remain insufficient for fostering a safe environment. Therefore, this study comprehensively searches the main problems and improvement methods through a review of previous studies that are related to PM. Then the priorities according to the importance of the improvement methods are presented through the Delphi survey. Method: The research method is mainly composed of a literature study and an expert survey (Delphi survey). Prior research and improvement cases (local governments, government departments, companies, etc.) are reviewed to derive problems and improvements, and a problem/improvement classification table is created based on keywords. Based on the classification contents, an expert survey is conducted to derive a priority improvement plan. Result: The PM-related problems were in 'non-compliance with traffic laws, lack of knowledge, inexperienced operation, and lack of safety awareness' in relation to human factors, and 'device characteristics, road-drivable space, road facilities, parking facilities' in relation to physical factors. 'Management/supervision, product management, user management, education/training' as administrative factors and legal factors are divided into 'absence/sufficiency of law, confusion/duplication, reduced effectiveness'. Improvement tasks related to this include 'PM education/public relations, parking/return, road improvement, PM registration/management, insurance, safety standards, traffic standards, PM device safety, PM supplementary facilities, enforcement/management, dedicated organization, service providers, management system, and related laws/institutional improvement', and 42 detailed tasks are derived for these 14 core tasks. The results for the importance evaluation of detailed tasks show that the tasks with a high overall average for the evaluation items of cost, time, effect, urgency, and feasibility were 'strengthening crackdown/instruction activities, education publicity/campaign, truancy PM management, and clarification of traffic rules'. Conclusion: The PM market is experiencing gradual growth based on shared services and a safe environment for PM use must be ensured along with industrial revitalization. In this respect, this study seeks out the major problems and improvement plans related to PM from a comprehensive point of view and prioritizes the necessary improvement measures. Therefore, it can serve as a basis of data for future policy establishment. In the future, in-depth data supplementation will be required for each key improvement area for practical policy application.

Exploring the Trend of Korean Creative Dance by Analyzing Research Topics : Application of Text Mining (연구주제 분석을 통한 한국창작무용 경향 탐색 : 텍스트 마이닝의 적용)

  • Yoo, Ji-Young;Kim, Woo-Kyung
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.6
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    • pp.53-60
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    • 2020
  • The study is based on the assumption that the trend of phenomena and trends in research are contextually consistent. Therefore the purpose of this study is to explore the trend of dance through the subject analysis of the Korean creative dance study by utilizing text mining. Thus, 1,291 words were analyzed in the 616 journal title, which were established on the paper search website. The collection, refining and analysis of the data were all R 3.6.0 SW. According to the study, keywords representing the times were frequently used before the 2000s, but Korean creative dance research types were also found in terms of education and physical training. Second, the frequency of keywords related to the dance troupe's performance was high after the 2000s, but it was confirmed that Choi Seung-hee was still in an important position in the study of Korean creative dance. Third, an analysis of the overall research subjects of the Korean creative dance study showed that the research on 'Art of Choi Seung-hee in the modern era' was the highest proportion. Fourth, the Hot Topics, which are rising as of 2000, appeared as 'the performance activities of the National Dance Company' and 'the choreography expression and utilization of traditional dance'. However, since the recent trend of the National Dance Company's performance is advocating 'modernization based on tradition', it has been confirmed that the trend of Korean creative dance since the 2000s has been focused on the use of traditional dance motifs. Fifth, the Cold Topic, which has been falling as of 2000, has been shown to be a study of 'dancing expressions by age'. It was judged that interest in research also decreased due to the tendency to mix various dance styles after the establishment of the genre of Korean creative dance.

Study on nutrition, dietary and health status of middle-aged Korean men according to sedentary hours: based on the 2019 Korea National Health and Nutrition Examination Survey (중장년 한국 남성의 좌식 시간에 따른 영양, 식이 및 건강행태 연구: 국민건강영양조사 제8기 1차년도(2019년) 자료를 이용하여)

  • Jeong, Dajeong;Lee, Jeehyun;Yoon, Eunju
    • Journal of Nutrition and Health
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    • v.55 no.3
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    • pp.359-375
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    • 2022
  • Purpose: Adult Korean men belonging to the main economically active population are known to have long sedentary hours. This study was undertaken to determine the difference and relevance of sedentary hours on the nutrition, diet, and health status of adult men, and to suggest how to prevent health risk factors. Methods: Subjects (n = 1,068) were classified into 4 groups based on their sedentary hours, ranging from the first quartile (Q1) having the least hours spent sitting, to the fourth quartile (Q4) spending the longest hours. Results: Subjects belonging to Q4 had the lowest average age, the largest waist circumference, and the highest level of education. Among those engaged in economic activities, the ratio of white-collar workers was significantly higher in Q4. Accordingly, the rate of not doing high-intensity or moderate-intensity physical activity while working was also the highest in Q4. A significant difference was obtained in the drinking frequency between groups, but this was found to be associated with the average working hours rather than sedentary hours. The proportion of not doing aerobic exercise was higher with longer sitting hours. The highest diagnosis of diabetes (8.8%) was obtained in the Q4 group. Among the factors related to cardiovascular disease, only low density lipoprotein-cholesterol showed a significant difference, with Q4 being significantly higher than Q1. Considering energy and nutrient intake, vitamin B1 and calcium intake were the lowest in the group with the longest sitting hours, as well as the least consumption of vitamin C than the recommended estimated average requirement. Conclusion: The results of this study suggest that the health and nutritional status of Korean adult men are affected by sedentary hours. This should be recognized as a health risk factor and guidelines need to be developed for sedentary lifestyle management.

A Study on the Development of Environment Color Checklists for Senior Center Based on Characteristics of the elders (재가노인의 특성을 고려한 경로당 환경색채 체크리스트 개발)

  • Choi, Yerim;Park, Heykyung
    • Korea Science and Art Forum
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    • v.34
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    • pp.327-337
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    • 2018
  • Korea is rapidly becoming an aging society as much as it takes the first place among OECD countries, and as the life expectancy of Korea gradually increases, the proportion of the elders in society increases. Accordingly, the happiness of the elders is contributed to the overall social atmosphere and happiness, however, the lower quality of life of the elders due to physical, psychological and social changes can be developed into social problems such as depression and rising suicide rate. As a result, there is a social interest in improving the quality of life and satisfaction of the elders, and the senior citizen center is receiving renewed attention as a form of welfare facility that can play a pivotal role in the social activities of the elders. In recent years, efforts to improve the environment of the senior citizen center have been made due to the growing role of it, however, there is a controversy over whether the quality of the indoor environment is user-friendly or not due to the limitations of material resources and human resources. It is considered that the quality of the color environment should be improved in the senior citizen center in the way that the color environment is not only an indoor environmental factor which gives high psychological and mental effects to users but also a way to improve the environmental satisfaction at the lowest cost. Previous studies on the facilities related to the elders have been actively carried out, but they were very sporadic and there was very little information about the color environment in the related laws or in the guideline presented by cities. It is necessary to integrate guidelines that are scattered within a comprehensive range without any specific target in order to grasp the current status of the color environment and to properly evaluate it. In addition, considering that the senior citizen center is an important leisure facility for the elders that functions in a residential area with a nationwide network, the results of this study are expected to contribute to the environmental improvement of existing senior citizen center which will be activated in the future by enabling the improvement of psychological satisfaction of the elders.

Suggestion of Community Design for the Efficiency of CPTED - Focused on Community Furniture - (범죄예방환경설계(CPTED)의 효율성 증대를 위한 커뮤니티디자인 제안 - 커뮤니티퍼니쳐를 중심으로 -)

  • Lee, Ho Sang
    • Korea Science and Art Forum
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    • v.29
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    • pp.305-318
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    • 2017
  • The need for recognizing the crime in the urban spaces as a social problem and finding out specific approaches such as the study of space design and various guidelines for crime prevention is increasing. In this regard, "Crime Prevention Through Environmental Design" (marked as "CPTED") is actively underway. Yeomri-dong Salt Way is the first place to which the Seoul Crime Prevention Design Project was appled. The business objective of improving the local environment has been implemented rationally through cooperation and voluntary participation between subject of the project executives and community members. Since its efficiency has been proven, the sites have been expanded since then and becomes a benchmarking example of each local government.This kind of problem solving effort has the same context in purpose and direction of the 'Village Art Project' which has been implemented since 2009 with the aim of promoting the culture of the underdeveloped area and encouraging the participation of the residents by introducing the public art. It is noteworthy that this trend is centered around the characteristics of community functions and values. The purpose of this study is to propose the application method of community furniture as a way to increase the efficiency of CPTED to improve the 'quality of life' of residents. To do this, we reviewed CPTED, community design, public art literature and prior research, and identified the problems and implications based on the site visit Yeomri-dong of Seoul and Gamcheon Village of Pusan which is the successful model of "Seoul Root out Crime by Design" and 'Maeulmisul Art Project' respectively. The common elements of the two case places identified in this study are as follows: First, the 'lives' of community residents found its place in the center through the activation of community by collaborative activities in addition to the physical composition of the environment. Second, community design and introduction of public art created a new space, and thereby many people came to visit the village and revitalize the local economy. Third, it strengthened the natural monitoring, the territoriality and control, and the activity increase among the CPTED factors. The psychological aspect of CPTED and the emotional function of public art are fused with the 'community furniture', thereby avoiding a vague or tremendous approach to the public space through a specific local context based on the way of thinking and emotion of local people and it will be possible to create an environment beneficial for all. In this way, the possibility and implication of the fusion of CPTED and public art are expected to be able to reduce the social cost through the construction of the crime prevention infrastructure such as expansion of the CPTED application space, and to suggest a plan to implement the visual amenity as a design strategy to regenerate city.

Identify the Type of Exercise to Prevent Falls for Healthy Elderly Life (고령자의 건강한 삶을 위한 낙상 예방 운동유형 확인)

  • Park, Yang-Sun;Kim, Mi-Ye;Park, Seong-Won;Lee, Ok-Jin
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.7
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    • pp.361-373
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    • 2019
  • Falls are a threat to the physical health of the elderly as well as to their overall quality of life. The purpose of this study was to identify which type of exercise is effective for improving the balance of the elderly, and to obtain the basic data for developing the falls prevention exercise intervention program for the elderly. We compared to the differential effects between rhythmic step exercise and core muscle strengthening exercise in terms of functional balance test and self-reported balance test. Women older than 65 years and under 80 years of age were assigned to one of the step exercise group(21), core muscle exercise group(20), and control group(21), and for 8 weeks, twice per week, 20-30 minutes of exercise were treated. All participants performed one foot static balance test with open and closed eyes. And they responded to self-reported balance test, such as Fall Efficacy Scale(FES) and Activities-specific Balance Confidence(ABC) Scale. The results of statistical analysis are summarized as follows. First, rhythmic stepping exercise was more effective in improving functional balance than core muscle strengthening exercise. In particular, the effect of step exercise was obvious in the one-foot static balance test with open eyes. Second, the self-reported balance test showed better step exercise than core muscle exercise. Specifically, rhythmic step exercise was more effective in enhancing fall efficacy than core muscle exercise. In conclusion, the rhythmic step exercise was more effective in improving the balance ability of the elderly than the core muscle exercise. The rhythmic step exercise is more related to the lower extremity muscles, and especially since the rhythmic step exercise is performed in various ground changes, it seems to have a high similarity to the fall occurrence situation. For future research, we recommended the development of task-oriented ankle proprioceptive exercise intervention program and exercise equipment based on the specific motion situation in which the fall accident occurs in the elderly.

Habitat characteristics and prediction of potential distribution according to climate change for Macromia daimoji Okumura, 1949 (Odonata: Macromiidae) (노란잔산잠자리(Macromia daimojiOkumura, 1949)의 서식지 특성 및 기후변화에 따른 잠재적 분포 예측)

  • Soon Jik Kwon;Hyeok Yeong Kwon;In Chul Hwang;Chang Su Lee;Tae Geun Kim;Jae Heung Park;Yung Chul Jun
    • Journal of Wetlands Research
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    • v.26 no.1
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    • pp.21-31
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    • 2024
  • Macromia daimoji Okumura, 1949 was designated as an endangered species and also categorized as Class II Endangered wildlife on the International Union for Conservation of Nature (IUCN) Red List in Korea. The spatial distribution of this species ranged within a region delimited by northern latitude from Sacheon-si(35.1°) to Yeoncheon-gun(38.0°) and eastern longitude from Yeoncheon-gun(126.8°) to Yangsan-si(128.9°). They generally prefer microhabitats such as slowly flowing littoral zones of streams, alluvial stream islands and temporarily formed puddles in the sand-based lowland streams. The objectives of this study were to analyze the similarity of benthic macroinvertebrate communities in M. daimoji habitats, to predict the current potential distribution patterns as well as the changes of distribution ranges under global climate change circumstances. Data was collected both from the Global Biodiversity Information Facility (GBIF) and by field surveys from April 2009 to September 2022. We adopted MaxEnt model to predict the current and future potential distribution for M. daimoji using downloaded 19 variables from the WorldClim database. The differences of benthic macroinvertebrate assemblages in the mainstream of Nakdonggang were smaller than those in its tributaries and the other streams, based on the surrounding environments and stream sizes. MaxEnt model presented that potential distribution displayed high inhabiting probability in Nakdonggang and its tributaries. Applying to the future scenarios by Intergovernmental Panel on Climate Change (IPCC), SSP1 scenario was predicted to expand in a wide area and SSP5 scenario in a narrow area, comparing with current potential distribution. M. daimoji is not only directly threatened by physical disturbances (e.g. river development activities) but also vulnerable to rapidly changing climate circumstances. Therefore, it is necessary to monitor the habitat environments and establish conservation strategies for preserving population of M. daimoji.

A Study on Startups' Dependence on Business Incubation Centers (창업보육서비스에 따른 입주기업의 창업보육센터 의존도에 관한 연구)

  • Park, JaeSung;Lee, Chul;Kim, JaeJon
    • Korean small business review
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    • v.31 no.2
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    • pp.103-120
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    • 2009
  • As business incubation centers (BICs) have been operating for more than 10 years in Korea, many early stage startups tend to use the services provided by the incubating centers. BICs in Korea have accumulated the knowledge and experience in the past ten years and their services have been considerably improved. The business incubating service has three facets : (1) business infrastructure service, (2) direct service, and (3) indirect service. The mission of BICs is to provide the early stage entrepreneurs with the incubating service in a limited period time to help them grow strong enough to survive the fierce competition after graduating from the incubation. However, the incubating services sometimes fail to foster the independence of new startup companies, and raise the dependence of many companies on BICs. Thus, the dependence on BICs is a very important factor to understand the survival of the incubated startup companies after graduation from BICs. The purpose of this study is to identify the main factors that influence the firm's dependence on BICs and to characterize the relationships among the identified factors. The business incubating service is a core construct of this study. It includes various activities and resources, such as offering the physical facilities, legal service, and connecting them with outside organizations. These services are extensive and take various forms. They are provided by BICs directly or indirectly. Past studies have identified various incubating services and classify them in different ways. Based on the past studies, we classify the business incubating service into three categories as mentioned above : (1) business infrastructure support, (2) direct support, and (3) networking support. The business infrastructure support is to provide the essential resources to start the business, such as physical facilities. The direct support is to offer the business resources available in the BICs, such as human, technical, and administrational resources. Finally, the indirect service was to support the resource in the outside of business incubation center. Dependence is generally defined as the degree to which a client firm needs the resources provided by the service provider in order to achieve its goals. Dependence is generated when a firm recognizes the benefits of interacting with its counterpart. Hence, the more positive outcomes a firm derives from its relationship with the partner, the more dependent on the partner the firm must inevitably become. In business incubating, as a resident firm is incubated in longer period, we can predict that her dependence on BICs would be stronger. In order to foster the independence of the incubated firms, BICs have to be able to manipulate the provision of their services to control the firms' dependence on BICs. Based on the above discussion, the research model for relationships between dependence and its affecting factors was developed. We surveyed the companies residing in BICs to test our research model. The instrument of our study was modified, in part, on the basis of previous relevant studies. For the purposes of testing reliability and validity, preliminary testing was conducted with firms that were residing in BICs and incubated by the BICs in the region of Gwangju and Jeonnam. The questionnaire was modified in accordance with the pre-test feedback. We mailed to all of the firms that had been incubated by the BICs with the help of business incubating managers of each BIC. The survey was conducted over a three week period. Gifts (of approximately ₩10,000 value) were offered to all actively participating respondents. The incubating period was reported by the business incubating managers, and it was transformed using natural logarithms. A total of 180 firms participated in the survey. However, we excluded 4 cases due to a lack of consistency using reversed items in the answers of the companies, and 176 cases were used for the analysis. We acknowledge that 176 samples may not be sufficient to conduct regression analyses with 5 research variables in our study. Each variable was measured through multiple items. We conducted an exploratory factor analysis to assess their unidimensionality. In an effort to test the construct validity of the instruments, a principal component factor analysis was conducted with Varimax rotation. The items correspond well to each singular factor, demonstrating a high degree of convergent validity. As the factor loadings for a variable (or factor) are higher than the factor loadings for the other variables, the instrument's discriminant validity is shown to be clear. Each factor was extracted as expected, which explained 70.97, 66.321, and 52.97 percent, respectively, of the total variance each with eigen values greater than 1.000. The internal consistency reliability of the variables was evaluated by computing Cronbach's alphas. The Cronbach's alpha values of the variables, which ranged from 0.717 to 0.950, were all securely over 0.700, which is satisfactory. The reliability and validity of the research variables are all, therefore, considered acceptable. The effects of dependence were assessed using a regression analysis. The Pearson correlations were calculated for the variables, measured by interval or ratio scales. Potential multicollinearity among the antecedents was evaluated prior to the multiple regression analysis, as some of the variables were significantly correlated with others (e.g., direct service and indirect service). Although several variables show the evidence of significant correlations, their tolerance values range between 0.334 and 0.613, thereby demonstrating that multicollinearity is not a likely threat to the parameter estimates. Checking some basic assumptions for the regression analyses, we decided to conduct multiple regression analyses and moderated regression analyses to test the given hypotheses. The results of the regression analyses indicate that the regression model is significant at p < 0.001 (F = 44.260), and that the predictors of the research model explain 42.6 percent of the total variance. Hypotheses 1, 2, and 3 address the relationships between the dependence of the incubated firms and the business incubating services. Business infrastructure service, direct service, and indirect service are all significantly related with dependence (β = 0.300, p < 0.001; β = 0.230, p < 0.001; β = 0.226, p < 0.001), thus supporting Hypotheses 1, 2, and 3. When the incubating period is the moderator and dependence is the dependent variable, the addition of the interaction terms with the antecedents to the regression equation yielded a significant increase in R2 (F change = 2.789, p < 0.05). In particular, direct service and indirect service exert different effects on dependence. Hence, the results support Hypotheses 5 and 6. This study provides several strategies and specific calls to action for BICs, based on our empirical findings. Business infrastructure service has more effect on the firm's dependence than the other two services. The introduction of an additional high charge rate for a graduated but allowed to stay in the BIC is a basic and legitimate condition for the BIC to control the firm's dependence. We detected the differential effects of direct and indirect services on the firm's dependence. The firms with long incubating period are more sensitive to indirect service positively, and more sensitive to direct service negatively, when assessing their levels of dependence. This implies that BICs must develop a strategy on the basis of a firm's incubating period. Last but not least, it would be valuable to discover other important variables that influence the firm's dependence in the future studies. Moreover, future studies to explain the independence of startup companies in BICs would also be valuable.

Problems in the field of maternal and child health care and its improvement in rural Korea (우리나라 농촌(農村)의 모자보건(母子保健)의 문제점(問題點)과 개선방안(改善方案))

  • Lee, Sung-Kwan
    • Journal of agricultural medicine and community health
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    • v.1 no.1
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    • pp.29-36
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    • 1976
  • Introduction Recently, changes in the patterns and concepts of maternity care, in both developing and developed countries have been accelerating. An outstanding development in this field is the number of deliveries taking place in hospitals or maternity centers. In Korea, however, more than 90% of deliveries are carried out at home with the help of untrained relatives or even without helpers. It is estimated that less than 10% of deliveries are assisted by professional persons such as a physician or a midwife. Taking into account the shortage of professional person i11 rural Korea, it is difficult to expect widespread prenatal, postnatal, and delivery care by professional persons in the near future, It is unrealistic, therefore, to expect rapid development of MCH care by professional persons in rural Korea due to economic and sociological reasons. Given these conditions. it is reasonable that an educated village women could used as a "maternity aid", serving simple and technically easy roles in the MCH field, if we could give such a women incentive to do so. The midwife and physician are assigned difficult problems in the MCH field which could not be solved by the village worker. However, with the application of the village worker system, we could expect to improve maternal and child hoalth through the replacement of untrained relatives as birth attendants with educated and trained maternity aides. We hope that this system will be a way of improving MCH care, which is only one part of the general health services offered at the local health centre level. Problems of MCH in rural Korea The field of MCH is not only the weakest point in the medical field in our country hut it has also dropped behind other developing countries. Regarding the knowledge about pregnancy and delivery, a large proportion of our respondents reported having only a little knowledge, while 29% reported that they had "sufficient" knowledge. The average number of pregnancies among women residing in rural areas was 4.3 while the rate of women with 5 or more pregnancies among general women and women who terminated childbearing were 43 and 80% respectively. The rate of unwanted pregnancy among general women was 19.7%. The total rate for complications during pregnancy was 15.4%, toxemia being the major complication. The rate of pregnant women with chronic disease was 7%. Regarding the interval of pregnancy, the rates of pregnancy within 12 months and within 36 months after last delivery were 9 and 49% respectively. Induced abortion has been increasing in rural areas, being as high as 30-50% in some locations. The maternal death rate was shown 10 times higher than in developed countries (35/10,000 live births). Prenatal care Most women had no consultation with a physician during the prenatal period. Of those women who did have prenatal care, the majority (63%) received such care only 1 or 2 times throughout the entire period of pregnancy. Also, in 80% of these women the first visit Game after 4 months of gestation. Delivery conditions This field is lagging behind other public health problems in our country. Namely, more than 95% of the women deliveried their baby at home, and delivery attendance by a professional person occurred only 11% of the time. Attendance rate by laymen was 78% while those receiving no care at all was 16%. For instruments used to cut the umbilical corn, sterilized scissors were used by 19%, non-sterilized scissors by 63% and 16% used sickles. Regarding delivery sheets, the rate of use of clean sheets was only 10%, unclean sheets, vinyl and papers 72%, and without sheets, 18%. The main reason for not using a hospital as a place of delivery was that the women felt they did not need it as they had previously experience easy deliveries outside hospitals. Difficult delivery composed about 5% of the total. Child health The main food for infants (95%) was breast milk. Regarding weaning time, the rates within one year, up to one and half, two, three and more than three years were 28,43,60,81 and 91% respectively, and even after the next pregnancy still continued lactation. The vaccination of children is the only service for child health in rural Korea. As shown in the Table, the rates of all kinds of vaccination were very low and insufficient. Infant death rate was 42 per 1,000 live births. Most of the deaths were caused by preventable diseases. Death of infants within the neonatal period was 83% meaning that deaths from communicable diseases decreased remarkably after that time. Infant deaths which occurred without medical care was 52%. Methods of improvement in the MCH field 1. Through the activities of village health workers (VHW) to detect pregnant women by home visiting and. after registration. visiting once a month to observe any abnormalities in pregnant women. If they find warning signs of abnormalities. they refer them to the public health nurse or midwife. Sterilized delivery kits were distributed to the expected mother 2 weeks prior to expected date of delivery by the VHW. If a delivery was expected to be difficult, then the VHW took the mother to a physician or call a physician to help after birth, the VHW visits the mother and baby to confirm health and to recommend the baby be given proper vaccination. 2. Through the midwife or public health nurse (aid nurse) Examination of pregnant women who are referred by the VHW to confirm abnormalities and to treat them. If the midwife or aid nurse could not solve the problems, they refer the pregnant women to the OB-GY specialist. The midwife and PHN will attend in the cases of normal deliveries and they help in the birth. The PHN will conduct vaccination for all infants and children under 5, years old. 3. The Physician will help only in those cases referred to him by the PHN or VHW. However, the physician should examine all pregnant women at least three times during their pregnancy. First, the physician will identify the pregnancy and conduct general physical examination to confirm any chronic disease that might disturb the continuity of the pregnancy. Second, if the pregnant woman shows any abnormalities the physician must examine and treat. Third, at 9 or 10 months of gestation (after sitting of the baby) the physician should examine the position of the fetus and measure the pelvis to recommend institutional delivery of those who are expected to have a difficult delivery. And of course. the medical care of both the mother and the infants are responsible of the physician. Overall, large areas of the field of MCH would be served by the VHW, PHN, or midwife so the physician is needed only as a parttime worker.

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Studies on Ancylostomiasis I. An Experimental Study on Hookworm Infection and Anemia (구충증(鉤蟲症)에 관(關)한 연구(硏究) 제1편(第1篇) 구충(鉤蟲)의 감염(感染) 및 구충성빈혈(鉤蟲性貧血)에 관(關)한 고찰(考奈))

  • Lee, Mun-Ho;Kim, Dong-Jip;Lee, Jang-Kyu;Seo, Byong-Sul;Lee, Soon-Hyung
    • The Korean Journal of Nuclear Medicine
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    • v.1 no.1
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    • pp.55-66
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    • 1967
  • In view of its prevalence in the Far East area, a more detailed knowledge on the hookworm infection is one of the very important medical problems. The present study was aimed to; determine the infectivity of the artificially hatched ancylostoma duodenale larvae in man after its oral administration, evaluate the clinical symptomatology of such infection, determine the date of first appearance of the ova in the stool, calculate the blood loss per worm per day, assess the relation-ships between the ova count, infectivity(worm load), blood loss and severity of anemia. An erythrokinetic study was also done to analyse the characteristics of hookworm anemia by means of $^{59}Fe\;and\;^{51}Cr$. Materials and Methods Ten healthy male volunteers(doctors, medical students and laboratory technicians) with the ages ranging from 21 to 40 years were selected as the experimental materials. They had no history of hookworm infection for preceding several years, and care was taken not to be exposed to reinfection. A baseline study including a through physical examinations and laboratory investigations such as complete blood counts, stool examination and estimation of the serum iron levels was done, and a vermifuge, bephenium hydroxynaphoate, was given 10 days prior to the main experiment. The ancylostoma duodenale filariform larvae were obtained in the following manner; The pure ancylostoma duodenale ova were obtained from the hookworm anemia patients and a modified filter paper method was adopted to harvest larger number of infective larvae, which were washed several times with saline. The actively moving mature larvae were put into the gelatine capsules, 150 in each, and were given to the volunteers in the fasting state with 300ml. of water. The volunteers were previously treated with intramuscular injection of 15mg. of chlorpromazine in order to prevent the eventual nausea and vomiting after the larvae intake. The clinical symptoms and signs mainly of the respiratory and gastrointestinal tracts, appearance of the ova and occult blood in the stool etc. were checked every day for the first 20 days and then twice weekly until the end of the experiment, which usually lasted for about 3 months. Roentgenological survey of the lungs was also done. The hematological changes such as the red blood cell, white blood cell and eosinophil cell counts, hemoglobin content and serum iron levels were studied. The appearance of the ova in the stool was examined by the formalin ether method and the ova were counted in triplicate on two successive days using the Stoll's dilution method. The ferrokinetic data were calculated by the modified Huff's method and the apparent half survival time of the red blood cells by the modified Gray's method. The isotopes were simultaneously tagged and injected intravenously, and then the stool and blood samples were collected as was described by Roche et al., namely, three separate 4-day stool samples with the blood sample drawing before each 4-day stool collection. The radio-activities of the stools ashfied and the blood were separately measured by the pulse-height analyser. The daily blood loss was calculated with the following formula; daily blood loss in $ml.=\frac{cpm/g\;stool{\times}weight\;in\;g\;of\;4-day\;stool}{cpm/ml\;blood{\times}4}$ The average of these three 4-day periods was given as the daily blood loss in each patient. The blood loss per day per worm was calculated by simply dividing the daily blood loss by the number of the hookworm recovered after the vermifuge given twice a week at the termination of the experiment. The iron loss in mg. through the gastrointestinal tract was estimated with the daily iron loss in $mg=\frac{g\;Hgb/100ml{\times}ml\;daily\;blood\;loss{\times}3.40}{100}$ 3.40=mg of iron per g Hgb following formula; Results 1. The respiratory symptoms such as cough and sputum were noted in almost all cases within a week after the infection, which lasted about 2 weeks. The roentgenological findings of the chest were essentially normal. A moderate degree of febril reaction appeared within 2 weeks with a duration of 3 or 4 days. 2. The gastrointestinal symptoms such as nausea, epigastric fullness, abdominal pain and loose bowel appeared in all cases immediately after the larvae intake. 3. The reduction of the red blood cell count was not remarkable, however, the hemoglobin content and especially the serum iron level showed the steady decreases until the end of the experiment. 4. The white blood cells and eosinophil cells, on the contrary, showed increases in parallel and reached peaks in 20 to 30 days after the infection. A small secondary rise was noted in 2 months. 5. The ova first appeared in the stool in 40. 1 days after the infection, ranging from 29 to 51 days, during which the occult blood reaction of the stool became also positive in almost cases. 6. The number of ova recovered per day was 164, 320 on the average, ranging from 89,500 to 253,800. The number of the worm evacuated by vermifuge was in rough correlation with the number of ova recovered. 7. The infectivity of ancylostoma duodenale was 14% on the average, ranging from 7.3 to 20.0%, which is relatively lower than those reported by other workers. 8. The mean fecal blood loss was 5.78ml. per day, with a range of from 2.6 to 11.7ml., and the mean blood loss per worm per day was 0.30ml., with a range of from 0.13 to 0.73ml., which is in rough coincidence with those reported by other authors. There appeared to exist, however, no correlation between the blood loss and the number of ova recovered. 9. The mean fecal iron loss was 2.02mg. per day, with a range of from 1.20 to 3.89mg., which is less than those appeared in the literature. 10. The mean plasma iron disappearance rate was 0.80hr., with a range of from 0.62 to 0.95hr., namely, a slight accerelation. 11. The hookworm anemia appeared to be iron deficiency in origin caused by continuous intestinal blood loss.

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