• Korean Journal of Health Education and Promotion
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• v.1 no.1
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• pp.21-36
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• 1983

It is assumed that menarche is affected not only by the biological factors such as nutrition and genetic heritage, but also it is affected by other socio-cultural environmental factors including weather, geographic location, education and level of modernization. Also recent trend of menarche in Korea indicates that a lot of discussion are being generated to the need of sex education as a part of formal school education. The purpose of this study is to develop the school health education program by determine the age of menarche, the factors relavant to time of menarche and psycho-mental state of students at the time in menarche and investigate the present state of school health education relate to menarche of adolescents. The total number of 732 girls was drown from first, second and third grades of 4 middle schools in Seoul. For the data collection the survey was conducted during the period from May 1 to May 20, 1982 by using prepared questionair. The major results are summarized as follow; 1. Mean age at menarche and the percent distribution of menarche experienced. It was observed that about 68.7% of sampled students have been experienced menarche at the time interviewed. For the each group, age at menarche is revealed that among the students about 37.8% are experienced menarche for under 12 years old group, 62.1% for 13 year-old group, 80.6％ for 14 year-old group and 95.5% for over 15 years old. In sum it was found that the mean age at menarche was 12.3 years old, ranged from age at 10 as earlist the age at 15 as latest. 2. Variables associated with age at menarche. 1) There was tendency those student who belong to upper class economic status have had menarche earlier than those student who belong to lower class. Therefore, economic status is closely related to age at menarche. 2) In time of mother's education level, it is also found that those students whose mother's education levels from high school and college are experienced menarche earlier than those students whose mother's education levels from primary school and no-education. 3) However, in connection with home discipline, there was no significant relationship between age at menarche and home disciplines which are being treated "Rigid", "Moderated ", "Indifferent". 4) Degree of communication between parents and daughter about sex matters was found to be associated each others in determination of age at menarche. 5) It was found that high association between mother's menarche age and their daughter's menarche age was observed. Mother's age at menarche earlier trend to be shown also as earlier of their daughters. 6) Those students belong to "D & E" of physical substantiality index are trend to be earlier in menarche than those students in the index "A & B". 3. Psycho-mental state at the time of menarche. Out of the total students 68.2% had at least one or more than one of subjective symptoms. Shyness was shown as most higher prevalent symptom and others are fear, emotional instability, unpleasant feeling, depression, radical behavior, inferior complex and satisfaction appeared. Very few cases are appeared be guilty and stealing feeling. 4. The present status of school health education program related to menarche. As to the source of information about menarche, teacher was a main source with average index 5.88 and the other informants were mother & family member, friends, books and magagines, movies, television, and radio. For the problem solving at menarche, mother & family members were subject to discussion with an average index 6.02 as high. The others for discuss and knowledge about menarche were books, magagine, friends, teachers, and self-learning based on own experienced. The time of learning about menarche, it was learned as highest percentage with 43.2% at a 6 grades of primary school, middle school with 34.4%, 5 grade of primary school with 18.2%, and 4 grade of primary school with 4.0% respectively.

• The Korean Journal of Nuclear Medicine
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• v.36 no.4
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• pp.271-276
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• 2002

Purpose: To measure reliable glomerular filtration rate by using the representative values of transplanted renal depths, which are measured with ultrasonography. Materials and Methods: We included 54 patients (26 men, 28 women), with having both renal scintigraphy and ultrasonography after renal transplantation. We measured GFR with Gates' method using the renal depth measured by ultrasonography, and median and mean ones in each patient. We compared GFR derived from ultrasonography-measured renal depth with GFR derived from median and mean renal depths. The correlation coefficients were obtained among GFR derived from ultrasonography-measured renal depths, median and mean renal depths under linear regression analysis. We determined whether GFR derived from median or mean renal depth could substitute GFR derived from ultrasonography-measured renal depth with Bland-Altman method. We analyze the expected errors of the GFR using representative renal depth in terms of age, sex, weight, height, creatinine value, and body surface. Results: The transplanted renal depths range from 3.20 cm to 5.96 cm. The mean value and standard deviation of renal depths measured by ultrasonography are $4.09{\pm}0.65cm$ in men, and $4.24{\pm}0.78cm$ in women. The median value of renal depths measured by ultrasonography is 4.36 cm in men and 4.14 cm in women. The GFR derived from median renal depth is more consistent with GFR derived from ultrasonography-measured renal depth than GFR derived from mean renal depth. Differences of GFR derived from median and ultrasonography-measured renal depth are not significantly different in the groups classified with creatinine value, age, sex, height, weight and body surface. Conclusion: When median value is adapted as a representative renal depth, we could obtain reliable GFR in transplanted kidney simply.

• The Korean Society of Law and Medicine
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• v.19 no.2
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• pp.235-261
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• 2018

The Medical law stipulates regulations about the physician's duty to inform to contribute to patient's self-determination. This law was most recently revised on December 20, 2016, and came into effect on June 21, 2017. There has been much controversy about this, and it has been questioned whether or not it will be effective for physicians to comply with the duty to inform. Therefore, this study investigated perceptions of physicians of whether they observed the duty to inform and their legal judgment about that duty, and analyzed how the revision of the medical law may have affected the legal cognition of physician's duty to inform. This study was conducted through an online questionnaire survey involving 109 physicians over 2 weeks from March 29 to April 12, 2018, and 108 of the collected data were used for analysis. The questionnaire was developed by revising and supplementing the previous research (Lee, 2004). It consisted of 41 items, including 26 items related to the experience of and legal judgment about the duty to inform, 6 items related to awareness of revised medical law, and 9 items on general characteristics. The data were analyzed using SAS 9.4 program and descriptive statistics, Chi-square test, Fisher's exact test and Binary logistic regression were performed. The results are as follows. • Out of eight situations, the median number of situations that did not fulfill the duty to inform was 5 (IQR, 4-6). In addition, 12 respondents (11%) answered that they did not fulfill the duty to inform in all eight cases, while only one (1%) responded that he/she performed explanation obligations in all cases. • The median number of the legal judgment score on the duty to inform was 8 out of 13 (IQR, 7-9), and the scores ranged from a minimum of 4 (4 respondents) to a maximum of 11 (3 respondents). • More than half of the respondents (n=26, 52%) were unaware of the revision of the medical law, 27 (25%) were aware of the fact that the medical law had been revised, 20(18%) had a rough knowledge of the contents of the law, and only 5(5%) said they knew the contents of the law in detail. The level of awareness of the revised medical law was statistically significant difference according to respondents' sex (p<.49), age (p<.0001), career (p<.0001), working type (p<.024), and department (p<.049). • There was no statistically significant relationship between the level of awareness of the revised medical law and the level of legal judgment on the duty to inform. These results suggest that efforts to improve the implementation and cognition of physician's duty to inform are needed, and it is difficult to expect a direct positive effect from the legal regulations per se. Considering the distinct characteristics of medical institutions and hierarchical organizational culture of physicians, it is necessary to develop a credible guideline on the duty to inform within the medical system, and to strengthen the education of physicians about their duty to inform and its purpose.

• Journal of Nutrition and Health
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• v.7 no.3
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• pp.1-13
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• 1974

The relative state of human iron storage may be ascertained more reliably through determination of the serum iron, iron binding capacity, transferrin saturation and absorption of radioactive iron in conjunction with studies of red cell morphology than from the study of red cell morphology alone. Recent investigations have shown that there is an increase in red cell protoporphyrin concentration in iron deficiency anemia. The significance of the red cell protoporphyrin has been discussed greatly during the years since its discovery. Two of the main factors which appear to influence the amaunt of protoporphyrin are increased erythropoiesis and factors interfering with the utilization of iron in the synthesis of hemoglobin, and iron deficiency. Recently Heller et al. have described a simplified method for blood protoporphyrin assay and this technique could be used assess nutritional iron status, wherein even minor insufficiencies are detectable as increased protoporphyrin concentrations. Based on the evaluation of the relationship between nutritional iron status and red cell protoporphyrin as an index suitable for the detection of the iron deficiency is described in this paper. RESULTS 1. Hemoglobin Concentrations and Anthropometric Measurements. The mean and standard deviations of the various anthropometric measurements of different age and sex groups are shown in table 1. There measurements have been compared with the Korean Standard. In the absence of local standards for arm circumference and skin-fold thickness over triceps, they have been compared with the standard from Jelliffe. Table 2,3, and 4 give anthropometric measurements and frequency (%) of anemia in children surveyed. The mean height of the children studid was 10 to 20 percent; below the Korean Standard. The distribution of height below 80 percent of the Standard was 21.2 percent, however, among anemic group this percentage was 27.7 percent. In general, the mean weight of the children was 10 to 15 percent below the Korean Standard. The percentage of children with weight less than 80 percent of the Standard was about 35 percent. But in the anemic group of the children, this percentage was 44 percent. The mean arm circumference was about 15 percent lower than the Jelliffe's standard. 61.2 percent of the children had values of arm circumference below 80 percent of the standard. Children with low hemoglobin levels, this percentage was 80 percent. The mean skinfold thickness over the triceps of the children studied was about 25 Percent lower than the Jelliffe's standard and 61.2 percent of the children had the value less than 80 percent of the standard. Among anemic children, this percentage was 70.8%. As may be seen from table 5, the mean hemoglobin concentration of the total group was 11.3g/100ml. Hemoglobin concentration was less than 11.0g/100ml. in 65(36.5%) of the 178 children. The degree of anemia in most of these children was mild with a hemoglobin level of less than 8.0g/100ml. found in only one child. In general, the prevalence of anemia was high in female children than male and decreased its frequency with increasing age. Relatively close relationship was observed between hemoglobin level and anthrophometric measurements especially high between arm circumference and skinfold thickness and hemoglobin but very low in height and low in weight and hemoglobin level, estimated by chi-square value. II. Serum iron, Transferrin saturation (1) Serum iron, and transferrin saturation Serum iron, transferrin saturation and red cell protoporphyrin concentrations were estimated in sub-sample of 84 children from 1 to 6 years and 24 older children between 7 and 13 years of age. The findings are presented in table 6. The mean serum iron concentration of the total group was 59ug/100ml. However, the level incrased with age from 36.6ug/100ml. (1-3years) to 80.8ug/100ml. (7-13 years). 60 percent of these children had a serum iron level less than 50ug/10ml. in the 1-3 years age group and 31.4 percent for 4-6 years group. These contrast with the finding of 12.5 percent anemic children in the 7-13 years age group. The mean transferrin saturation for the total group was 18.1 percent and frequency of anemia by transferrin saturation was observed same pattern as serum iron concentration. (2) Red cell protoporphyrin concentrations. (a) Red cell protoporphrin levels of children: Red cell protoporphyrin and other biochemical data are shown in table 4. The mean concentration in red cell of all children was fround 46.3ug/100ml. RBC. and differences with age groups were observed; in the age group 1-3 years, the mean concentration was $59.5{\pm}32.14$ ug/100ml. RBC; 4-6 years $44.1{\pm}22.57$ ug/100ml. RBC. and 7-13 years, $39.0{\pm}13.56$ ug/100ml. RBC. (b) Normal protoporphyrin values in adults: It was observed that in 10 normal adult males studied here the level of protoporphyrin in red cell ranged from 18 to 54 ug/100ml. RBC. and the mean concentration was $47.5{\sim}14.47$ ug/100ml. RBC. Other biochemical determination made on the same subjects are presented in table 8. (c) Red tell protoporphyrin concentration of occupational blood donors: The results of analyses for red cell protoporphyrin as well as serum iron, transferrin saturation and hemoglobin in the 76 blood donors are presented in table 7 and 8. In this experiment, donors were selected at random, however, most of them bled repeatedly because of poor economic situation, I doubt. Table 9 shows the distribution of red cell protoporphyrin concentration and hemoglobin concentration of occupational donors. The mean hemoglobin value for the total was 11.9 g/100 ml. When iron deficiency anemia is defined as a transferrin saturation below 15%, prevalence of anemia was 47.4 percent and the mean serum iron was 27.1ug/100ml. and red cell protoporphyrin, 168.3ug/100ml. RBC. However, mean serum iron and protoporphyrin concentration of above 15% transferrin saturation were 11.6 ug/100 ml. and 58.8 ug/100 ml. RBC. respectively. The mean Protoporphyrin concentration of non-anemic (above 15% transferrin saturation) donors was slightly higher than the results of normal adult males.

• Tuberculosis and Respiratory Diseases
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• v.63 no.3
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• pp.235-241
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• 2007

Background: Airway mucus hypersecretion plays an important role in the pathogenesis of asthma, and is associated with the induction of MUC5AC expression in airway secretion. The MUC5AC gene is highly polymorphic; however, there are few studies about the association between the polymorphisms of the MUC5AC gene and asthma susceptibility or asthma phenotypes. We have investigated the association of MUC5AC promoter polymorphisms with the risk of asthma and asthma phenotypes. Methods: We determined the genotypes of the MUC5AC promoter (-1274G>A) in 78 asthma patients and in 78 age, sex-matched control individuals in the Korean population. Genomic DNAs from blood were analyzed by PCR and RFLP (restriction fragment length polymorphism) determination. We examined $FEV_1$, total eosinophil count, serum IgE level, $PC_{20}$ and the presence of atopy (by a skin test) in asthma patients. Results: The mean age of the patients was $47.7{\pm}16.1$ years and 38.5% were men, and the mean $FEV_1$ was $84.4{\pm}22.3%$ of predicted in the asthma patients. The -1274G>A polymorphism of the MUC5AC promoter in asthma patients was not significantly different as compared with normal individuals (GG 57.7%, AG 34.6% and AA 7.7% in asthma patients vs. GG 56.4%, AG 38.5% and AA 5.1% in control subject, p = 0.752, Cod). Several clinical parameters in asthma patients such as $FEV_1$, total eosinophil count, serum IgE level, $PC_{20}$ and the presence of atopy, were not associated with the -1274G>A polymorphism of the MUC5AC promoter. Conclusion: The -1274G>A single nucleotide polymorphism (SNP) frequency of the MUC5AC promoter was not associated with asthma in a Korean population.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.3
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• pp.430-437
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• 2007

The probability table of Moyers and prediction equation of Tanaka and Johnston that have been the most frequently used, cannot produce accurate prediction when used in Korean because they are based on the Caucasian popularity of the Northern European race. The method of Moyers or Tanaka and Johnston predicts sizes of the unerupted canine and premolars on the basis of the sizes of mandibular incisors. However, some of the recent papers raise a question as to whether the mandibular incisors are the best combination to predict the sizes of the unerupted canine and premolars. The purpose of this study is to determine which sum or combination of sums of permanent tooth widths present the best prediction for the unerupted canine and premolars in a Korean sample, to calculate a specific linear regression equation for this population, and to evaluate the clinical significance. A new linear regression equation was calculated based on the data of 178 Korean young adults(70 women, 108 men, mean age 21.63 years) with complete permanent dentitions. Fifty three more children(28 girls, 25 boys, mean age 14.22 years) were used as a validation sample for the application of the multiple linear regression equation. The conclusions were as follows: 1. The combination of the sums of permanent upper central incisors, lower lateral incisors and upper first molars was the best predictor for the unerupted canine and premolars in this sample($r=0.65{\sim}0.80$). 2. The multiple linear regression equation was calculated including sex and arch as additional predictor variables. male, upper: $Y\;=\;0.332{\times}X_0\;+\;6.195$ male, lower: $Y\;=\;0.332{\times}X_0\;+\;5.269$ female, upper: $Y\;=\;0.332{\times}X_0\;+\;5.929$ female, lower: $Y\;=\;0.332{\times}X_0\;+\;5.003$. The determination coefficient of the equation was 64% and a standard error of the estimate was 0.71mm. 3. In about 97% of the validation sample, the estimation of the tooth width sums of unerupted canine and premolars using the new multiple linear regression equation was smaller than 1mm compaired with the actual values.

• Clinical and Experimental Pediatrics
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• v.50 no.9
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• pp.848-854
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• 2007

Purpose : The present study examined the etiology and risk factors of the early breast-feeding jaundice and the usefulness of auditory brainstem response test as early predictor of kernicterus. Methods : Medical records of neonatal jaundice in newborn admitted to Daegu Fatima Hospital between September 2005 and May 2006 were analyzed prospectively. Infants were grouped according to feeding method : breast feeding group (breast feeding only, n=23), mixed feeding group (breast feeding mainly plus addition of fomula feeding, n=13). Results : There were no significant differences in gestational age, birth weight, sex, duration of phototherapy, serum bilirubin and hemolytic evidence between the two study groups. First visiting day of life at out patient department was significantly delayed in breast feeding group ($8.7{\pm}3.6day$) compared to mixed feeding group ($6.0{\pm}1.9$) (P=0.009). Weight loss was significantly severe in breast feeding group compared to mixed feeding group (P<0.05). In auditory brainstem response test, loss of Wave V in 3 cases was observed and recoverd after blood exchange transfusion in follow up test.Wave III latency had significant correlation to serum bilirubin in auditory brainstem response test (70 dB) (P=0.002). Conclusion : Our study suggest that further education about breast feeding and follow up within the first postnatal week would be necessary for early detection and prevention of early breast-feeding jaundice. Test of serum bilirubin and auditory brainstem response would be helpful in determination of blood exchange transfusion.

• Korea journal of population studies
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• v.12 no.2
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• pp.1-21
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• 1989

For the analysis of mortality differentials by socioeconomic factors based on death registration data, we have considered four variables : place of residence, educational attainment, marital status and occupation. The age range adopted were 5 to 64 years of age for place of residence, and 25 to 64 years of age for the other factors. The mortality differentials by socioeconomic variables were clear and in the expected direction: mortality levels among urban residents, better educated groups, and non- agricultural workers were lower than among the other sub- groups. The average mortality level in rural areas is much higher than in urban areas : the rural mortality levels were at least double the urban levels at ages below 40 years, but became smaller after age 40, and no clear differentials by urban I rural residence increased until 1974~76 for the both sexes, but since the then differentials have declined slowley for both sexes. This changing pattern of mortality differentials by place of residence can be explained by historical socioeconomic development : the development generally started in urban areas, and rural areas followed : in the course of socioeconomic development the differences between the death rates in the two areas became smaller and finally the mortality levels in the two areas became nearly the same, as is found in the developed countries nowadays. The inverse relationships between mortality and educational level became stronger between the periods 1970~72 and 1984~86, but showed the same atterns of mortality differentials in both period : larger differences among the younger age groups, and for males, than among the older age groups, and for females. The increasing mortality differentials in the fourteen-year period between 1970~72 and 1984~86 were caused by inadequate living standards of the non- educated, whose proportion in the total population, however, dropped sharply during that period. Also, the much lower proportions of low - educated groups or of persons with no formal education among males than females helped to establish the clearly pronounced differentials. The mortality differentials by marital status in Korea showed the usual pattern : the mortality rates of the married in each age and sex group were clearly lower than those of others during the fourteen-year period between 1970~72 and 1984~86. In Korean society which remotes universal marriage, the never married recorded especially high death rates, presumably mainly because of ill - health, but also possibly because of the stigma attached to celibacy. However, the mortality differentials by marital status changed with the changes in the proportionate distribution by marital status during the period : the differences between the death rates of the married and never married groups became smaller, the proportion of the never married group increased : in contrast, the differences between mortalities of the married and widowed / divorced / separated groups widened, with the decrease in the proportion of the later group ; this tendency was perticularly marked for females. Occupational groups also showed clear mortality differences : among four occupational groups mortality of males was highest among agricultural workers and lowest among 'professional, admi-nistrative and clerical workers, However, when the death rates were standardized by educational level, the death rates by occupation in age group 45~64 years were nearly the same (excet for the mixed group consisting of unemployed, students, military servicemen and unknown). Therefore, the clear mortality dfferentials by occupation in Korea resulted mainly from the differences in educational level between different occupation groups. Since socioeconomic characteristics are related to each other, the net effect of each variable was examined. Each of the three variables - ducational level, marital status and urban / rural residence affected significantly Korean adult mortality when the effects of the other variables were controlled. Among the three variables educational level was the most important factor for the determination of the adult mortality level. When male's occupation was added to the above three variables, the effects of occupation on adult mortality were notably smaller after control for the effects of the other three variables while the net effects of these three variables were nearly the same irrespectively whether occupation was included or not. Thus, the differences in educational level (mainly), place of residence and marital status bring out the clear differences in observed mortality levels by occupation.