• Tuberculosis and Respiratory Diseases
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• v.61 no.1
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• pp.34-40
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• 2006

Background: Extubation failure was associated with poor prognosis and high hospital mortality. Cuff leak test (CLT) has been proposed as a relatively simple method for detecting laryngeal obstruction that predispose toward postextubation stridor (PES) and reintubation. We examined the risk factors of extubation failure and evaluated the usefulness and limitation of CLT for predicting PES and reintubation. Methods: Thirty-four consecutive patients intubated more than 24 hours were examined. The subjects were evaluated daily for extubation readiness, and CLT was performed prior to extubation. Several parameters in the extubation success and failure group were compared. The accuracy and limitation of CLT were evaluated after choosing the thresholds values of the cuff leak volume (CLV) and percentage (CLP). Results: Of the 34 patients studied, 6 (17.6%) developed extubation failure and 3 (8.8%) were accompanied by PES. The patients who had extubation failure were more likely to have a longer duration of intubation and more severe illness. The patients who developed PES had a smaller cuff leak than the others: according to the CLV ($22.5{\pm}23.8$ vs $233.3{\pm}147.1ml$, p=0.020) or CLP ($6.2{\pm}7.3$ vs $44.3{\pm}24.7%$, p=0.013). The best cut off values for the CLV and CLP were 50ml and 14.7%, respectively. The sensitivity, negative predictive value, and specificity of CLT were relatively high, but the positive predictive value was low. Conclusion: The likelihood of developing extubation failure increases with increasing severity of illness and duration of intubation. A low CLV or CLP (<50ml or 14.7%) is useful in identifying patients at risk of PES, but the CLT is not an absolute predictor and should not be used an indicator for delaying extubation.

• Korean Journal of Community Nutrition
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• v.28 no.1
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• pp.38-47
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• 2023

Objectives: This study examined the association between the experience of disease management education and the use of nutrition labels according to the sociodemographic characteristics and health behaviors of people diagnosed with hypertension and diabetes living in the community. Methods: Among the participants from the Community Health Survey (2018), 74,283 individuals diagnosed with hypertension or diabetes were included in the study population. According to gender, this study evaluated nutrition label use by the experience of disease management education, individual sociodemographic characteristics, and health behavior. Finally, using multiple logistic regression analysis, the association between disease management education and nutrition labels was calculated using the odds ratio (OR) and 95% confidence interval (CI). Results: Males (24.5%) experienced more disease management education than females (22.6%). In addition, younger age, higher education level, and higher equalized personal income experienced more disease management education (P < 0.001). The educational experience rate was higher in the male subjects who did not smoke or were involved in high-risk alcohol consumption (P < 0.001). In addition, the rate of disease management education experience was significantly higher for both men and women who exercised by walking (P < 0.001). The use of nutrition labels was higher in females (9.9%) than males (5.8%), and both males and females were significantly higher in young age, high education, high income, and professional and office positions (P < 0.001). The utilization rate of nutrition labels was high in non-smoking male subjects and high-risk-drinking female subjects. In addition, the utilization rate of nutrition labels was significantly higher in males and females who exercised by walking and those who experienced disease management education (P < 0.001). After adjusting for individual sociodemographic characteristics, health behavior, and disease management education, the use of nutrition labels was high among females (OR 3.19, 95% CI 2.85-3.58), high income (Q4; OR 1.62, 95% CI 1.41-1.87, Q5; OR 1.58, 95% CI 1.37-1.84) and highly educated (high school; OR 2.87, 95% CI 2.62-3.14, above college; OR 5.60, 95% CI 5.02-6.23) while it was low in the elderly (OR 0.43, 95% CI 0.40-0.47), and economically inactive (OR 0.86, 95% CI 0.76-0.96). The use of nutrition labels was high in non-smokers (OR 1.29, 95% CI 1.13-1.48), nonhigh-risk drinkers (OR 1.22, 95% CI 1.08-1.38), and subjects who exercised walking (OR 1.44, 95% CI 1.34-1.54). There was no difference in the utilization rate of nutrition labels according to obesity, and the utilization rate of nutrition labels was significantly higher in subjects who had experienced disease education (OR 1.34, 95% CI 1.24-1.44). Conclusions: Education on the use of nutrition labels, which contributes to food selection for healthy eating, might be a tool for dietary management. Moreover, the utilization rate can be a good indicator for predicting the proportion of the population practicing the guide for disease management. Improving the utilization rate of nutrition labels through disease management education can be a useful intervention for people with chronic diseases who need healthy eating habits for disease management and preventing complications, particularly those diagnosed with hypertension and diabetes.

• Korean Journal of Environmental Biology
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• v.22
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• pp.1-10
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• 2004

We conducted three experiments to estimate the toxicity of POPs (persistent organic pollutants) on two copepod species (Acartia erythraea and A. omorii) and Artemia sp.; (1) 48 h-LC$_{50}$ of A. omorii with the five PAHs [polycyelic aromatic hydrocarbons anthracene, benzo〔a〕pyrene, fluoranthene, phenanthrene, pyrene〕 which were often detected in the Gwangyang Bay, (2) toxicity of benzo〔a〕pyrene and TBT on Artemia in different temperatures (1$0^{\circ}C$, 15$^{\circ}C$, 2$0^{\circ}C$), (3) effects of benzo〔a〕pyrene and TBT on egg Production rate, hatching rate and fecal Pellet Production of two copepod species (A. erythraea and A. omorii) fed on Heterocapsa triquetra (dinoflagellate) exposed in benzo〔a〕pyrene. Toxic chemicals which were most effective to A. omorii were flueranthene (48 h-LC$_{50}$ 19.20 $\mu\textrm{g}$ L$^{-1}$ ) and benzo〔a〕pyrene (48 h-LC$_{50}$ 29.89 $\mu\textrm{g}$ L$^{-1}$ ). The toxi- city of chemicals to Artemia increased when temperature increased. The toxicity of TBT was about 100 times higher than that of benzo〔a〕pyrene at 15$^{\circ}C$. Food materials (Heterocapsa triquetra) exposed in benzo〔a〕pyrene, affected negatively the rate of egg production, hatching rate and the fecal pellet production of the copepods at the high concentration. It is suggested that an increase in the concentration of benzo〔a〕pyrene might offset the production of copepods in marine ecosystems. This study suggests that copepods may be used as n indicator for early warning of the risk of POPs in marine ecosystems.

• Journal of Chest Surgery
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• v.43 no.3
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• pp.285-291
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• 2010

Background: Thoracic trauma is one of the leading causes of morbidity and mortality in developing countries. A rib fracture that is secondary to blunt thoracic trauma is an important indicator of the severity of the trauma. The purpose of study was to determine the morbidity and mortality rates and the management of rib fractures. Material and Method: We performed a retrospective study that involved all the blunt trauma patients with rib fractures, excluding those that were transferred to other hospital within 3 days, that were seen at our hospital between May 2002 and December 2008. Of the 474 admitted patients, 454 met the inclusion criteria. There were 356 male and 98 females, and their overall mean age was 53 years (range: 5~90 years). The outcome parameters included the mechanism of injury, the number of fractured ribs, the length of stay in the ICU, the Injury Severity Score (ISS), the length of the hospital stay, the pulmonary complications and the mortality. Result: The mechanism of trauma included traffic accidents in 189 (41.7%) cases, slipping down in 103 (22.7%) cases, falls in 85 (18.7%) cases, cultivator accidents in 30 (6.6%) cases, industrial accidents in 32 (7.0%) cases and assault in 15 (3.3%) cases. Intrathoracic injury was noted such as hemothorax in 269 (59.3%) cases, pneumothorax in 144 (31.7%) cases, pulmonary contusion in 95 (20.9%) cases, subcutaneous emphysema in 29 (6.4%) cases and great vessel injury in 5 (0.1%) cases. Conservative treatment was administered to most of the patients. Tube thoracostomy was administered in 234 (51.5%) cases, whereas thoracotomy was performed in 18 (4.0%) cases. The mean duration of thoracostomy was $5.2{\pm}6.2$ days. Most of the cases with rib fracture were treated in wards and their mean duration of hospital stay was $22.5{\pm}20$ days. The mean Injury Severity Score (ISS) was $14.8{\pm}10.9$ (range: 3~75). The mortality rate was calculated to be 4.8% (n=22). The main factors correlated with an adverse outcome were the number of ribs fractured, the duration of thoracostomy and pulmonary disease. Industrial insurance affected the length of hospitalization. Pulmonary contusion and the Injury Severity Score (ISS) affected the mortality. Conclusion: Rib fractures are a indicator of severe injury. Because of the complication and associated injuries, we believe these patients should be admitted for evaluation and treatment. Recent studies on the impact of rib fractures after blunt trauma have shown that patients as young as 40 years of age demonstrate increased morbidity and mortality with similar injuries as compared to that of older patients. The ISS and pulmonary contusion influenced the mortality rate. Patients with isolated rib fractures should be hospitalized if the number of fractured ribs is one or more.

• Journal of Food Hygiene and Safety
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• v.33 no.6
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• pp.447-452
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• 2018

Water is an important component in the production of fresh produce. It is mainly used for irrigation and application of pesticides and fertilizers. Several outbreaks cases related to fresh produce have been reported and water has been identified as the most likely source. On the other hand, wildlife has been identified as a possible source of the waterborne pathogens. The purpose of this study was to investigate the effect of wildlife access on irrigation water used in the cultivation of Chinese cabbage in Goesan. The frequency of wild animals access to upstream water source and the contamination level of bacteria such as Escherichia coli and Enterococci of irrigation water used in Chinese cabbage farm was examined. A total of 37 wildlife including the wild bear and water deer were observed in upstream of water source during the cultivation of Chinese cabbage. The result indicated the presence of hygienic indicator bacteria from the upstream where there is no human access. The contamination range of coliforms, E. coli, and Enterococcus spp. Detected in the irrigation water were 2.13~4.32 log MPN / 100 mL, 0.26~2.03 log MPN / 100 mL, and 1.43~3.49 log MPN / 100 mL, respectively. Due to low water temperatures, the contamination levels of coliform bacteria and E. coli in the irrigation water during harvesting time was lower compared to those recorded during transplanting of Chinese cabbage. However, no significant difference was detected in the number of Enterococci during the cultivation of Chinese cabbage. The results indicated the need to manage the microbial risk in irrigation water to enhance safety in cultivation of Chinese cabbage.

• Korean Chemical Engineering Research
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• v.57 no.5
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• pp.637-651
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• 2019

In the event of a major accident such as an explosion in a refinery or a petrochemical plant, it has caused a serious loss of life and property and has had a great impact on the insurance market. In the case of catastrophic incidents occurring in process industries such as refinery and petrochemical plants, only the proximate causes of loss have been drawn and studied from inspectors or claims adjustors responsible for claims of property insurers, incident cause investigators, and national forensic service workers. However, it has not been done well for conducting root cause analysis (RCA) and identifying the factors that contributed to the failure and establishing preventive measures before leading to chemical plant's catastrophic incidents. In this study, the criteria of warning signs on CCPS catastrophic incident waning sign self-assessment tool which was derived through the RCA method and the contribution factor analysis method using the swiss cheese model principle has been reviewed first. Secondly, in order to determine the major incident warning signs in an actual chemical plant, 614 recommendations which have been issued during last the 17 years by loss control engineers of global reinsurers were analyzed. Finally, in order to facilitate the assessment index for catastrophic incident warning signs, the criteria for the catastrophic incident warning sign index at chemical plants were grouped by type and classified into upper category and lower category. Then, a catastrophic incident warning sign index for a chemical plant was developed using the weighted values of each category derived by applying the analytic hierarchy process (pairwise comparison method) through a questionnaire answered by relevant experts of the chemical plant. It is expected that the final 'assessment index for catastrophic incident warning signs' can be utilized by the refinery and petrochemical plant's internal as well as external auditors to assess vulnerability levels related to incident warning signs, and identify the elements of incident warning signs that need to be tracked and managed to prevent the occurrence of serious incidents in the future.

• Journal of Food Hygiene and Safety
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• v.38 no.4
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• pp.217-227
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• 2023

The consumption of ready-to-eat side dishes is rapidly growing in South Korea. These foods are particularly vulnerable to microbiological contamination as they are often cooked without any treatment, such as heating or stored at room temperature after cooking. Hence, in 2022, we analyzed the ready-to-eat side dishes sold in Gyeongsangnam-do, South Korea for microbiological contamination. We collected 100 samples from supermarkets in 7 cities, and then examined them for presence of food-borne pathogens and sanitary indicator bacteria. In the analysis of the food-borne pathogens, Bacillus cereus and Clostridium perfringens were isolated from 51 samples (51.0%) and 3 samples (3.0%), respectively. However, both quantitatively met the Korean Food Standards Codex. Genes of five different enterotoxins and one emetic toxin were analyzed from the 51 isolated B. cereus strains. We detected enterotoxin entFM (100.0%), nheA (94.1%), hblC (58.8%), cytK (56.9%), and bceT (41.2%) in 51 isolates, and emetic toxin gene, CER, in only one (2.0%) isolate. We did not detect C. perfringens toxin gene (cpe) that causes food poisoning in any one of the three C. perfringens isolates. In the case of sanitary indicator bacteria, Kimchi had the highest levels of total aerobic bacteria and coliforms, followed by Saengchae, Jeotgal, Jeolim, Namul, and Jorim, respectively. We counted total aerobic bacteria at two different storage temperatures (4℃ and 20℃) to determine the effect of storage temperature. When stored at 20℃, total aerobic bacteria count increased in most of the ready-to-eat side dishes, except for Jeotgal. This result conclusively shows the need for refrigerating the ready-to-eat side dishes after purchase. Further research is needed to assess the risk and safety of the ready-to-eat side dishes available in the market and determine appropriate safety management practices.

• The Journal of Korean Society for School & Community Health Education
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• v.25 no.2
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• pp.59-70
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• 2024

Objectives: The purpose of this study is to analyze each country's infectious disease response capacities and, based on this, find areas for improvement in Korea's infectious disease management response. Methods: First, the capacity to respond to the COVID-19 infectious disease was analyzed by country using the SPAR scores of 96 countries around the world released by WHO in 2022. Second, we analyzed each country's specific COVID-19 quarantine performance using Our World in Data and the Global Health Security Index (GHSI). Results: First, the quarantine intensity index on January 24, 2021 was the highest in the Southeast Asia branch at 67.6, which had strong quarantine measures, and the lowest at 44.5 in the Africa branch. As of December 31, 2022, the quarantine intensity index in Europe was significantly lowered to 11.6. Second, the factor that influenced the SPAR indicator on the total number of patients per million population was national laboratory (C4), p=.027, and the factor that influenced the total number of deaths per million population was infection prevention and control (C9), p=.005., Risk Communication and Community Participation (C10) p=.040. The influential factor on GDP per capita was infection prevention and control (C9) p=.009, and the influential factor on GHSI was infection prevention and control (C9) p=.002. Conclusion: The research findings indicate that it was difficult to find a correlation between the SPAR, which is each country's self-assessment of their infectious disease capacities, and the number of COVID-19 cases or the intensity of pandemic responses. However, mortality rates, as well as factors such as the Global Health Security Index (GHSI) and national income, appear to be somewhat influenced. For future improvements in infectious disease management and response in our country, it is necessary to develop pandemic strategies that can reduce socio-economic costs based on more scientific and reliable data like JEE or GHSI, especially in preparation for potential unknown emerging infectious diseases. Based on this, proactive decision-making led by a control tower of experts and effective health communication are also required to respond to public health crises at a national level.

• Health Policy and Management
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• v.19 no.2
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• pp.71-84
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• 2009

Objectives : The purpose of this study is to analyze the proportion of admission via the emergency room(the rest is ER) in an emergency medical center and to examine the factors related to admission. Methods : This study used 2005 National Health Insurance claims data for admitted patients of 112 hospitals having emergency medical centers in Korea. The study sample had 2,335,610 patients. The data was classified into emergency admission and non-emergency admission. To investigate the factors affecting the type of admission, the following were included as independent variables: type of health assurance_(national health insurance beneficiaries or medical aid beneficiaries), demographic characteristics_ (sex, age), cause of admission_ (disease or injury), whether an operation was performed or not, DRG severity level, the number of beds, and the location of the hospital. Data were analyzed using the Chi-square test for the differences in emergency admission rates for each variables, and multiple logistic regression analysis was used for identifying the factors affecting admission type. Results : The proportion of admission via the ER accounted for 40.6% of the total admission among hospitals having emergency medical centers. The risk of admission via ER was relatively high for patients who were male, the aged, the injured, the surgical patients, the patients having more severe symptoms, and the patients admitted the hospitals located in metropolitan areas, and the patients admitted the hospitals having 300-699 beds. Medical aid patients were more likely admitted through the emergency room than health insurance patients after other variables ware adjusted. Conclusions and Discussion : We analyzed the proportion of admission via the ER for the total admission rate of hospitals having an emergency medical center in Korea. And we explored the factors related to admission via the ER. This proportion may be used as an indicator of the adequacy of medical utilization or low accessibility to hospitals of patients with low socioeconomic status.

• Journal of Environmental Health Sciences
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• v.21 no.3
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• pp.38-47
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• 1995

The Bioconcentration factor (BCF) is used as an important criterion in the risk assessment of environmental contaminants. Also it can be used as indicator of biomagnification of environmentally hazardous chemicals through food-chain as well as a tool for ranking the bioconcentration potential of the chemicals in the environment. This paper reports the measured BCF value on Chlorothalonil in Carassius auratus(goldfish), under steady state, and examined correlation between the BCF value and the partition coefficient or acute toxicity or physicochemical properties. Carassius auratus(goldfish) was chosen as test organism and test period were 3-day, 5-day. Experimental concentrations were 0.005, 0.01 and 0.05 ppm. Chlorothalonil in fish tissue and in test water were extracted with n-hexane and acetonitrile. GC-ECD was used to detecting and quantitating of Chlorothalonil. Partition coefficient was determined by stir-flask method. $LC_{50}$ was determined on Chlorothalonil. Carbaryl and BPMC. The obtained results were as follows. 1. It was possible to determine short term BCFs of Chlorothalonil through relatively simple procedure in environmental concentrations. 2. $BF_3$ of Chlorothalonil in concentration of 0.005, 0.01 and 0.05 ppm were 2.1866$\pm$0.23446, 3.5269$\pm$0.23517, 10.2045$\pm$0.18053 and BCFs were 6.6543$\pm$0.55257, 6.9774$\pm$0.02500, 23.4576$\pm$2.06884, respectively. 3. Chlorothalonil concentration in fish extract and BCFs of Chlorothalonil were increased as increasing test concentration and prolonging test period. 4. Fate of test-water concentration on Chlorothalonil was greater than that of control-water con-centration. It is considered that greater fate of test-water concentration on Chlorothalonil is due to hydrolyzing nitrile group under the mild condition and substituting chloro group by some aromatic compounds in test water. 5. Determined logP of Chlorothalonil was 2.80. And determined $LC_{50}$ of Chlorothalonil in time of 24, 48, 72 and 96 hr were 0.1684, 0.1402, 0.1400, 0.1352(mg/l) respectively. And $LC_{50}$ of Carbaryl in above times were 19.918, 18.635, 18.466, 18.12(mg/l) respectively. $LC_{50}$ of BPMC were 10.248, 9.166, 9.087, 8.921(mg/l) respectively. 6. It is suggested that the BCF of Carbamates depend on partition coefficients. But BCF of Chlorothalonil, organochlorine pesticide, would be strongly influenced by steric, electronic effect of substituents than partition coefficient.