• Journal of the Korean Orthopaedic Association
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• v.54 no.1
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• pp.52-58
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• 2019

Purpose: Fungal periprosthetic joint infection (PJI) is a rare but devastating complication following total knee arthroplasty (TKA). On the other hand, a standardized procedure regarding an accurate treatment of this serious complication of knee arthroplasty is lacking. The clinical progress of staged reimplantation in patients who had fungus-related PJI after TKA was reviewed retrospectively. Materials and Methods: Ten patients who had a fungal related PJI after TKA between 2006 and 2017 using staged reimplantation surgery were reviewed. These patients were compared with 119 patients who had a PJI in the same period. The failure rate of infection control, intravenous antimicrobial using the period, and the clinical results were evaluated by comparing the range of motion and Korean knee score (KKS) between pre-staged reimplantation and the last follow-up. Results: In the fungal infection group, 7 out of 10 cases (70.0%) had failed in infection control using staged reimplantation and in the non-fungal group, 7 out of 119 cases (5.9%) had failed (p=0.04). In the non-fungal group, the mean duration of antibiotics was 6.2 weeks. In the fungus group, the mean duration of antibiotics was 15.3 weeks, which was 9.1 weeks longer (p<0.001). The range of motion of the knee was increased in the two groups (p=0.265). At the last follow-up, the KKS was 71.01 points in the non-fungal group and 61.3 points in the fungal group (p=0.012). Erythrocyte sedimentation rate and C-reactive protein (CRP) decreased in the two groups, but the CRP was significantly different in the two groups (p=0.007). Conclusion: The treatment of fungus-related PJIs using staged reimplantation showed uneven clinical progress and unsatisfactory clinical improvements compared to non-fungal PJI. Therefore, it is necessary to consider the use of an antifungal mixed cement spacer at resection arthroplasty and oral antifungal agent after reimplantation.

• Journal of the Korean Society of School Health
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• v.8 no.2
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• pp.219-232
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• 1995

This study was conducted to examine both usage rate of standard sized desks and chairs for the middle and high school students and pain complant of students who use standard-size desk & chair in Taegu, Korea, by means of questionnaires with 1,201 students of both male and female middle and high schools in Taegu area from March 20 to April 19, 1995. The result of this study is summarized as follows. It was mostly shown that the desks and chairs used by those middle and high school students were 1-3 higher than their standard sizes, and that they also preferred a little higher size with respect to their desired sizes. The rate of students who use the standard size showed that the desk accounted for 30.5%, and chair for 21.0%, that the size bigger than the standard accounted for 61.3%, respectively, and 65.2, and that the size smaller than the standard accounted for 8.2%, respectively, and 13.8%. The using rate of the standard sized for the middle school students indicated that their desk accounted for 44.1%, and their chair for 26.0% which were higher than 16.1% and 14.7% for the high school students. Then, the rate of the male students indicated that their desk accounted for 31.5% and their chair for 24.5% which were higher than 29.6% and 17.6% of the female students. In addition, the using rate of the standard size for the public schools showed that the desk accounted for 34.2% and chair for 24.5% which were also higher than 27.1% and 17.5% of the private schools. It was shown, however, that the using rate of the standard size for both groups was lower. The most inconvenient factor in the usage of their desks appeared in such orders as their wear, narrow drawers, too low height and uneven face, while the factor in their chairs did in such orders as too hard chair body the surface and back part, wear, lower and higher height and narrow width. Their physical pains resulting from usage of those desks and chairs showed that the male and female middle school students' complaint rate of pains in their neck and shoulder accounted for 32.1%, respectively, and 36.0% which were highest, while those high school students' complaint rate in their waist accounted for 37.9%, respectively, and 44.1% which were hight. It was also shown that the bigger their height, the higher their complaint rate of pain in the waist, and that their complaint rate in the shoulder and neck was totally higher. When using the standard-sized desks and chairs, their complaint rate of pain in the shoulder and neck accounted for 25.4%, respectively, and 23.8%. As compared with them, when using the desks or chairs bigger than the standard size, their complaint rate accounted for 31.5%, respectively, and 31.8% which were high while it did 26.5% and 28.9% when using them smaller than the standard size which were also high, the usage of those standard-sized desks and chairs indicated lower complaint rate of pain in their waist than used the desks and chairs bigger or smaller than the standard size. The rate of the middle and high school students who use their standard size is very low and the size of their desks and chairs are quite different from those they hope to use and many students appeal their discomfort with their desks and chairs. Therefore, the school should try to provide the desks and chairs of the various students' standard sizes in consideration of their physical condition and it also should try to get extra desks and chairs of various sizes according to the students' standard size and their preference.

• Radiation Oncology Journal
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• v.19 no.4
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• pp.327-334
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• 2001

Purpose : To find out the role of postoperative adjuvant radiotherapy in the treatment of rectal cancer by comparing survival, pelvic control, complication rate, and any prognostic factor between surgery alone and postoperative radiotherapy group. Materials and methods : From Feb. 1982 to Dec. 1996 total 212 patients were treated by radical surgery with or without postoperative radiotherapy due to rectal carcinoma of modified Astler-Coiler stage $B2\~C3$. Of them, 18 patients had incomplete radiotherapy and so the remaining 194 patients were the database analyzed in this study. One hundred four patients received postoperative radiotherapy and the other 90 patients had surgery only. Radiotherapy was peformed in the range of $39.6\~55.8\;Gy$ (mean: 49.9 Gy) to the whole pelvis and if necessary, tumor bed was boosted by $5.4\~10\;Gy$. Both survival and pelvic control rates were calculated by Kaplan-Meier method and their statistical significance was tested by Log-rank test. Multivariate analysis was peformed by Cox proportional hazards model. Results : 5-year actuarial survival rate (5YSR) and 5-year disease-free survival rate (5YDFSR) of entire patients were $53\%\;and\;49\%$, respectively. 5YSRs of surgery alone group and adjuvant radiotherapy group were $63\%\;vs\;45\%$, respectively (p=0.03). This difference is thought to reflect uneven distribution of stages between two treatment groups (p<0.05 by $\chi^2-test$) with more advanced disease patients in adjuvant radiotherapy group. 5YSRs of surgery alone vs adjuvant radiotherapy group in MAC B2+3, C1, C2+3 were $68\%\;vs\;55\%$ (p=0.09), $100\%\;vs\;100\%$, $40\%\;vs\;33\%$ (p=0.71), respectively. 5YDFSRs of surgery alone vs adjuvant radiotherapy group in above three stages were $65\%\;vs\;49\%$ (p=0.14), $100\%\;vs\;100\%$, $33\%\;vs\;31\%$ (p=0.46), respectively. 5-year pelvic control rate (5YPCR) of entire patients was $72.5\%$. 5YPCRs of surgery alone and adjuvant radiotherapy group were $71\%\;vs\;74\%$, respectively (p=0.41). 5YPCRs of surgery alone vs adjuvant radiotherapy group in B2+3, C1, C2+3 were $79\%\;vs\;75\%$ (p=0.88), $100\%\;vs\;100\%$, $44\%\;vs\;68\%$ (p=0.01), respectively. Multivariate analysis showed that only stage was significant factor affecting overall and disease-free survival in entire patients and also in both treatment groups. In view of pelvic control, stage and operation type were significant in entire patients and only stage in surgery alone group but in adjuvant radiotherapy group, operation type instead of stage was the only significant factor in multivariate analysis as a negative prognostic factor in abdominoperineal resection cases. Conclusion : Our retrospective study showed that postoperative adjuvant radiotherapy could improve the pelvic control in MAC C2+3 group. To improve both pelvic control and survival in all patients with MAC B2 or more, other treatment modality such as concurrent continuous infusion of 5-FU, which is the most standard agent, with radiotherapy should be considered.

• Journal of Preventive Medicine and Public Health
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• v.26 no.1 s.41
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• pp.1-19
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• 1993

Mail questionnaire was administrated to 370 practising physicians and 388 pharmacists in Taegu city selected by systematic sampling to examine utilization states and opinion of pharmacy under medical care insurance programme and the attitude to the functional division between physicians and pharmacists from April to May 1992. Regarding the opinion on the outcome of drug-store under medical insurance, 71.2 percent of practicing physician answered faliure but 13.4 percent of practicing pharmacists answered failure in contrast. Fifty percent of practicing physician asserted introducing functional division between physician and pharmacist while 66.9 percent of practicing pharmacist answered drug-store under medical insurance itself is sucessful programme. Average daily numbers of preparation of medicine was 32.2 case. Percentage of utilization of drug-store under medical issurance to average daily cases of preparing of medicine was 20 percent, percentage of utilization with physician's prescription was 0.7 percent. And 58.7 percent of practicing physician experienced outside the institute prescription. Regarding the opinion on the pros and cons of enforcing functional division between physician and pharmacist, 59.2 percent of practicing physician prefered pros and 17.7 percent cons, but 38 percent of practicing pharmacist prefered pros and 45.5 percent cons. And pharmacist knew better the content of functional division between physician and pharmacist than physician. As a reason for pros of enforcing functional division between physician and pharmacist, practicing physician emphasized to prevent misuse or abuse of medicine but practicing pharmacist emphasized to display physician and pharmacist's professional ability. And as an opinion on implementation style of functional division between physician and pharmacist in pros respondents, practicing physician favored mandatory enforcement (52.3%), while practicing pharmacist favored partial incomplete functional division (81.7%). As the method of prescription if functional division between physician and pharmacist will be enforced, both practicing physician and pharmacist prefered generic name (44.0%, 89%) mostly, but physician prefered brand name (35.3%) secondly. Regarding the reason for not implementing functional division between physician and pharmacist up to date, both physician and pharmacist answered problem of business right between physician and pharmacist, followed by lack of recognition, and interest of people and lack of the govermental willness. Regarding the opinion on prior decision of condition for enforcing functional division between physician and pharmacist, practicing physician and pharmacist named uneven distribution of medical facilities and drug-store between rural and urban, inequality of physician and pharmacist manpower and the problem of manpower demand and supply mostly, and practicing physician pointed out establishing attitude of acceptance on the part of pharmacist and practicing pharmacist favored establishing attitude of acceptance on the part of physician, which was different attitudes between physician and pharmacist. Following conclusion was reached ; 1. Current drug-store under medical insurance program yield insufficient outcome, so we should consider program conversion from drug-store under medical insurance program to functional division between physician and pharmacist. 2. There were problem of business right and conflicts between physician and pharmacist at enforcing functional division between physician and pharmacist, so the goverment should search for formulating plan to resolve the problem and have neutral willness for the protection of the national health.

• Korean Journal of Agricultural Science
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• v.3 no.1
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• pp.95-104
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• 1976

This study was conducted to test the harvesting operation of two kinds of rice varieties such as Milyang #15 and Tong-il with a imported two furrow Japanese combine and was performed to find out the operational accuracy of it, the adaptability of this machine, and the feasibility of supplying this machine to rural area in Korea. The results obtained in this study are summarized as follows; 1. The harvesting test of the Milyang #15 was carried out 5 times from the optimum harvesting operation was good regardless of its maturity. The field grain loss ratio and the rate of unthreshed paddy were all about 1 percent. 2. The field grain loss of Tong-il harvested was increased from 5.13% to 10.34% along its maturity as shown in Fig 1. In considering this, it was needed that the combine mechanism should be improved mechanically for harvesting of Tong-il rice variety. 3. The rate of unthreshed paddy of Tong-il rice variety of which stem was short was average 1.6 percent, because the sample combine used in this study was developed on basisof the long stem variety in Japan, therefore some ears owing to the uneven stem of Tong-il rice could nat reach the teeth of the threshing drum. 4. The cracking rates of brown rice depending mostly upon the revolution speed of the threshing drum(240-350 rpm) in harvesting of Tong-il and Milyang #15 were all below 1 percent, and there was no significance between two varieties. 5. Since the ears of Tong-il rice variety covered with its leaves, a lots of trashes was produced, especially when threshed in raw materials, and the cleaning and the trashout mechanisms were clogged with those trashes very often, and so these two mechanisms were needed for being improved. 6. The sample combine of which track pressure was $0.19kg/cm^2$ could drive on the soft ground of which sinking was even 25cm as shown in Fig 3. But in considering the reaping height adjustment, 5cm sinking may be afford to drive the combine on the irregular sinking level ground without any readjustment of the resaping height. 7. The harvesting expenses per ha. by the sample combine of which annual coverage area is 4.7 ha. under conditions that the yearly workable days is 40, percentage of days being good for harvesting operation is 60%, field efficiency is 56%, working speed is 0.273m/sec, and daily workable hours is 8 hrs is reasonable to spread this combine to rural area in Korea, comparing to the expenses by the conventional harvesting expenses, if mechanical improvement is supplemented so as to harvest Tong-il rice. 8. In order to harvest Tong-il rice, the two furrow combine should be needed some mechanical improvements that divider can control not to touch ears of paddy, the space between the feeding chain and the thrshing drum is reduced, trash treatment apparatus must be improved, fore and rear adjust-interval is enlarged, and width of track must be enlarged so as to drive on the soft ground.

• Journal of the Korean Geographical Society
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• v.28 no.2
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• pp.77-98
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• 1993

The intent of this study is to analyze the characteristics of distribution, patter, and deposits of the exposed debris slope landform by aerial photography interpretation, measure-ment on the topographical maps and field surveys in the southern part Taebaek mountains. It also aims to research the arrangement types of mountain slope and the landform development of debris slopes in this area. In conclusion, main observations can be summed up as follows. 1. The distribution characteristics 1)From the viewpoint of bedrocks, the distribution density of talus is high in case of the bedrock with high density of joints, sheeting structures and hard rocks, but that of the block stream is high in case of intrusive rocks with the talus line. 2)From the viewpoint of bedrocks, the distribution density of talus is high in case of the bedrock with high density of joints, sheeting structures and hard rocks, but that of the block stream is high in case of inrtusive rocks with the talus line. 2) From the viewpoint of distribution altitude, talus is mainly distributed in the 301~500 meters part above the sea level, while the block stream is distributed in the 101~300 meters part. 3) From the viewpoint of slope oriention, the distribution density of talus on the slope facing the south(S, SE, SW) is a little higher than that of talus on the slope facing the north(N, NE, NW). 2. The Pattern Characteristics 1) The tongue-shaped type among the four types is the most in number. 2) The average length of talus slope is 99 meters, especially that of talus composed of hornfels or granodiorite is longer. Foth the former is easy to make free face; the latter is easdy to produce round stones. The average length of block stream slope is 145 meters, the longest of all is one km(granodiorite). 3) The gradient of talus slope is 20~45${^\circ}$, most of them 26-30${^\croc}$; but talus composed of intrusive rocks is gentle. 4) The slope pattern of talus shows concave slope, which means readjustment of constituent debris. Some of the block stream slope patterns show concave slope at the upper slope and the lower slope, but convex slope at the middle slope; others have uneven slope. 3. The deposit characteristics 1) The average length of constituent debris is 48~172 centimeters in diameter, the sorting of debris is not bad without matrix. That of block stream is longer than that of talus; this difference of debris average diameter is funda-mentally caused by joint space of bedrocks. 2) The shape of constituent debris in talus is mainly angular, but that of the debris composed of intrusive rocks is sub-angular. The shape of constituent debris in block stream is mainly sub-roundl. 3) IN case dof talus, debris diameter is generally increasing with downward slope, but some of them are disordered and the debris diameter of the sides are larger than that of the middle part on a landform surface. In block stream, debris diameter variation is perpendicularly disordered, and the debris diameter of the middle part is generally larger than that of the sides on a landform surface. 4)The long axis orientation of debris is a not bad at the lower part of the slope in talus (only 2 of 6 talus). In block stream(2 of 3), one is good in sorting; another is not bad. The researcher thinks that the latter was caused by the collapse of constituent debris. 5) Most debris were weathered and some are secondly weathered in situ, but talus composed of fresh debris is developing. 4. The landform development of debris slopes and the arrangement types of the mountain slope 1) The formation and development period of talus is divided into two periods. The first period is formation period of talus9the last glacial period), the second period is adjustment period(postglacial age). And that of block stream is divided into three periods: the first period is production period of blocks(tertiary, interglacial period), the second formation period of block stream(the last glacial period), and the third adjustment period of block stream(postglacialage). 2) The arrangement types of mountain slope are divided into six types in this research area, which are as follows. Type I; high level convex slope-free face-talus-block stream-alluvial surface Type II: high level convex slope-free face-talus-alluvial surface Type III: free face-talus-block stream-all-uvial surface Type IV: free face-talus-alluval surface Type V: talus-alluval surface Type VI: block stream-alluvial surface Particularly, type IV id\s basic type of all; others are modified ones.

• Korean Journal of Heritage: History & Science
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• v.49 no.2
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• pp.172-189
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• 2016

In this research, literature research on the Odong material, mixture ratio, casting method and casting facility was conducted on contemporary documents, such as Cheongong Geamul. Also, a long sword was produced using the Odong inlay technique. The sword reproduction steps were as follows; Odong alloying, silver soldering alloying, Odong plate and Silver plate production, hilt and sheath production, metal frame and decorative elements, such as a Dugup (metal frame), production, Odong inlay assembly and final assembly. For the Odong alloy production, the mixture ratio of the true Odong, which has copper and gold ratio of 20:1, was used. This is traditional ratio for high quality product according to $17^{th}$ century metallurgy instruction manual. The silver soldering alloy was produced with silver and brass(Cu 7 : Zn 3) ratio of 5:1 for inlay purpose and 5:2 ratio for simple welding purpose. The true Odong alloy laminated with silver plate was used to produce hilt and sheath. The alloy went through annealing and forging steps to make it into 0.6 mm thick plate and its backing layer, which is a silver plate, had the matching thickness. After the two plates were adhered, the laminated plate went through annealing, forging, engraving, silver inlaying, shaping, silver welding, finishing and polishing steps. During the Odong colouring process, its red surface turns black by induced corrosion and different hues can be achieved depending on its quality. To accomplish the silver inlay Odong techniques, a Hanji saturated with thirty day old urine is wrapped around a hilt and sheath material, then it is left at warm room temperature for two to three hours. The Odong's surface will turn black when silver inlay remains unchanged. Various scientific analysis were conducted to study composition of recreated Odong panel, silver soldering, silver plate and the colouring agent on Odong's surface. The recreated Odong had average out at Cu 95.57 wt% Au 4.16wt% and Cu 98.04 wt% Au 1.95wt%, when documented ratio in the old record is Cu 95wt% and Au 5wt%. The recreated Odong was prone to surface breakage during manufacturing process unlike material made with composition ratio written in the old record. On the silver plate of the silver and Odong laminate, 100wt% Ag was detected and between the two layers Cu, Ag and Au were detected. This proves that the adhesion between the two layers was successfully achieved. The silver soldering had varied composition of Ag depending on the location. This shows uneven composition of the silver welding. A large quantities of S, that was not initially present, was detected on the surface of the black Odong. This indicates that presence of S has influence on Odong colour. Additional study on the chromaticity, additional chemical compounds and its restoration are needed for the further understanding of the origin of Odong colour. The result of Odong alloy testing and recreation, Odong silver inlay long sword production, scientific analysis of the Odong black colouring agent will form an important foundation of knowledge for conservation of Odong artifact.

• Korean Journal of Soil Science and Fertilizer
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• v.10 no.3
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• pp.103-134
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• 1977

The physiological and biochemical role of potassium for upland crops according to recent research reports and the nutritional status of potassium in Korea were reviewed. Since physical and chemical characteristics of potassium ion are different from those of sodium, potassium can not completely be replaced by sodium and replacement must be limited to minimum possible functional area. Specific roles of potassium seem to keep fine structure of biological membranes such as thylacoid membrane of chloroplast in the most efficient form and to be allosteric effector and conformation controller of various enzymes principally in carbohydrate and protein metabolism. Potassium is essential to improve the efficiency of phoro- and oxidative- phosphorylation and involve deeply in all energy required metabolisms especially synthesis of organic matter and their translocation. Potassium has many important, physiological functions such as maintenance of osmotic pressure and optimum hydration of cell colloids, consequently uptake and translocation of water resulting in higher water use efficiency and of better subcellular environment for various physiological and biochemical activities. Potassium affects uptake and translocation of mineral nutrients and quality of products. potassium itself in products may become a quality criteria due to potassium essentiality for human beings. Potassium uptake is greatly decreased by low temperature and controlled by unknown feed back mechanism of potassium in plants. Thus the luxury absorption should be reconsidered. Total potassium content of upland soil in Korea is about 3% but the exchangeable one is about 0.3 me/100g soil. All upland crops require much potassium probably due to freezing and cold weather and also due to wet damage and drought caused by uneven rainfall pattern. In barley, potassium should be high at just before freezing and just after thawing and move into grain from heading for higher yield. Use efficiency of potassium was 27% for barley and 58% in old uplands, 46% in newly opened hilly lands for soybean. Soybean plant showed potassium deficiency symptom in various fields especially in newly opened hilly lands. Potassium criteria for normal growth appear 2% $K_2O$ and 1.0 K/(Ca+Mg) (content ratio) at flower bud initiation stage for soybean. Potassium requirement in plant was high in carrot, egg plant, chinese cabbage, red pepper, raddish and tomato. Potassium content in leaves was significantly correlated with yield in chinese cabbage. Sweet potato. greatly absorbed potassium subsequently affected potassium nutrition of the following crop. In the case of potassium deficiency, root showed the greatest difference in potassium content from that of normal indicating that deficiency damages root first. Potatoes and corn showed much higher potassium content in comparison with calcium and magnesium. Forage crops from ranges showed relatively high potassium content which was significantly and positively correlated with nitrogen, phosphorus and calcium content. Percentage of orchards (apple, pear, peach, grape, and orange) insufficient in potassium ranged from 16 to 25. The leaves and soils from the good apple and pear orchards showed higher potassium content than those from the poor ones. Critical ratio of $K_2O/(CaO+MgO)$ in mulberry leaves to escape from winter death of branch tip was 0.95. In the multiple croping system, exchangeable potassium in soils after one crop was affected by the previous crops and potassium uptake seemed to be related with soil organic matter providing soil moisture and aeration. Thus, the long term and quantitative investigation of various forms of potassium including total one are needed in relation to soil, weather and croping system. Potassium uptake and efficiency may be increased by topdressing, deep placement, slow-releasing or granular fertilizer application with the consideration of rainfall pattern. In all researches for nutritional explanation including potassium of crop yield reasonable and practicable nutritional indices will most easily be obtained through multifactor analysis.

• Journal of agricultural medicine and community health
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• v.8 no.1
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• pp.44-65
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• 1983

As a part of the epidemiological studies of clonorchiasis, this study was conducted to evaluate the current endemicity and the natural transition of the Clonorchis infection in Gimhae Gun and delta area a high endemic area in Korea in recent years, prior to the introduction of praziquantel which will eventually influence the status of the prevalence. The data obtained in this study in 1983 were evaluated for natural transition of the infection in comparison with those obtained 16 years ago in 1967 by the author(Kim, 1974). The areas of investigation, villages and schools surveyed, methods and techniques used in this study were the same as in 1967, except for the contents of the questionnaire for raw freshwater fish consumption by the local inhabitants. 1) The prevalence rate of clonorchiasis in the general population of the villages was 48.1% on the average out of a total of 484 persons examined. The average of those of the riverside-delta area was 65.2% and 43.0% in the inland area. Among the schoolchildren, the prevalence rate was 8.2% on the average out of a total of 1,423 examined. By area, the prevalence rate was 10.8% in the riverside delta area and 2.8% in the inland area. By sex, difference in the prevalence was seen only in the inhabitants of the inland area showing 52.4% in the male and 33.5% in the female. 2) In the natural transition of the infection, the prevalence rate among the inhabitants has decreased from 68.8% in 1967 to 48.1% in 1983, and in the schoolchildren from 56.4% in 1967 to 8.2% in 1983. The reduction rate was higher in the riverside-delta area than in the inland area. 3) In the prevalence rate by age, 11.9% was first seen in the 5-9 age group and the rate gradually increased up to 75.0% in the 50-59 age group. By sex, the rate was higher in the male than in the female in the 20-29 age group and over. 4) In the natural transition of the prevalence rate by age, the reduction rate of the infection during the past 16 years was greater in the younger age groups up to the 40-49 age group and reached the same level in the age group 50-59. Reduction was seen again in the age group over 60s. By sex, the reduction rate was greater in the female than in the male in the 20-29 age group and over. By area, the reduction rate was greater in the riverside delta area than in the inland area, particularly in the young age groups. 5) In the intensity of the infection among the cases, the mean egg out-put per mg feces per infected cases(EPmg) in the inhabitants was 6.3. EPmg of those of the river-side-delta area was 15.4 and that of the in-land was 2.8. On the other hand, in the schoolchildren, EPmg was 3.2, and no difference was seen between the two areas, the river-side-delta area and the inland area. 6) In the transition of the intensity of the infection by area, EPmg among the inhabitants inexplically increased from 7.8 in 1967 to 15.4 in 1983. This was probably caused by uneven specimen collection in the process of sampling the population. EPmg of the inhabitants in the inland area and those of the schoolchildren of both riverside delta and inland areas showed a similar decrease in the past 16 years. 7) The intensity of the infection by age showed a relatively low level in the 20-29 age group and below, and EPmg 5.1-9.5 was seen in the 30-39 age group and over. Sex, Epmg was 5.8 in the male and 4.7 the female. By in 8) In the transition of the intensity of the infection, EPmg decreased from 6.2 in 1967 to 5.4 in 1983. By age, in contrast to the figures of 1967 in which EPmg gradually increased with some fluctuation from 1.1 in the 0-4 age group to peak 10.5 in the 50-59 age group, in 1983 lower intensity of the infection was seen in the age group from 10-14 to 20-29 with the EPmg range of 0.6-2.7. 9) In the distribution of the clonorchiasis cases by the range of EPmg value, 43.2% of the cases were in 0.1 0.9 and 34.6% in 1.0-4.9. As a whole by cumulative percent, 44.6% of them were under 0.9 as light infection and 86.1% of them under 9.9 up to moderate infection. By sex, no difference was seen in Epmg. 10) In the transition of the distribution by the range of Epmg, the cases were distributed up to the range 80.0-99.9 in 1967 and to 60.0-79.9 in 1983. By cumulative percent, in the range of 0.1-0.9 and less, light infection, 34.3% of them were distributed in 1967 and 44.6% in 1983 with about 10% increase. In the range of 5.0-9.9 and less, up to moderate infection, 83.2% in 1967 and 86.1% in 1983 of the cases were seen, respectively. 11) The practice of raw freshwater fish consumption among the inhabitants seems to have decreased in recent years. Those who admitted to raw freshwater fish consumption in the last two years among the infected inhabitants were 59.3%, although 86.8% of them professed to have experience with raw freshwater fish consumption. 31.7% of those who have had experience of the raw freshwater fish consumption denied any further consumption in recent years. From an interview of 543 school-children, 24.1% of them admitted to an experience of raw freshwater fish consumption. However, those who have practised in the past two years comprized 17.9%. Those who denied raw freshwater fish consumption in recent years among those who had such experience were 26.0% out of 131 interviewed. The rate of raw freshwater fish consumption in both inhabitants and schoolchildren were higher in the male than in the female. On the contrary, the rate of those who did not practise in recent years among those who had experience of raw freshwater fish consumption was higher in the female than in the male. 12) The major reason for the reduction of raw freshwater fish consumption among the local inhabitants was the risk of the fluke infection. However, it has become apparent that such change of taste has resulted from water pollution impact which has affected throughout the areas of the freshwater systems in this locality since last several years. 13) In animal survey, Clonorchis infection was seen in 14.8% of 88 dogs examined and 3.7% of 27 house rats examined. It was noted that populations of dogs and cats have increased in the villages surveyed. Although the prevalence rate was lower in the present survey than those of 1967, the significance of the animals as the reservoir host has not changed. 14) Prevalence rate of Clonorchis infection by cercariae in the first intermediate host, Parafossarulus manchouricus, was 0.6% out of 517 snails examined. The infection rate was lower in comparison with 2.3% out of 2,124 examined in 1967. Moreover, sharp decreases in number and distribution of the intermediate host snails in many watershed areas of the huge freshwater systems in this locality seemed to reduce transmission of Clonorchis in connection with the intermediate host stage of its life cycle. 15) Clonorchis infection in the second intermediate fish hosts was relatively low. The mean number of Clonorchis metacercaria per fish in Pseudorasbora parva was 517 in 1983, whereas it was 1943 in 1968 through 1969. Environmental water pollution has also caused the decreased fish population density in these areas, and this has also apparently affected to the practice of raw freshwater fish consumption among the local inhabitants. 16) In conclusion, endemicity of Clonorchis infection in Gimhae Gum and delta area of the Nagdong River has sharply decreased during the past 16 years. The major cause of the regressive transition of the infection was the water pollution of the land water systems of this locality. The pollution has upset the ecosystems comprizing of the intermediate hosts of Clonorchis in many areas, and also affected to a significant extent to the discontinuance of the local inhabitants for raw freshwater fish consumption.

• Journal of the Korean association of regional geographers
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• v.3 no.2
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• pp.163-193
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• 1997

Medical services are a fundamental and essential service in all urban areas. The location and accessibility of medical service facilities and institutions are critical to the diagnosis, control and prevention of illness and disease. The purpose of this paper is to present the results of a study on the location of medical facilities in Kwangju and the utilization of these facilities by the inhabitants. The following information is a summary of the findings: (1) Korea, like many countries, is now witnessing an increase in the age of its population as a result of higher living standards and better medical services. Korea is also experiencing a rapid increase in health care costs. To ensure easy access to medical consultation, diagnosis and treatment by individuals, the hierarchical efficient location of medical facilities, low medical costs, equalized medical services, preventive medical care is important. (2) In Korea, the quality of medical services has improved significantly as evident by the increased number of medical facilities and medical personnel. However, there is still a need for not only quantitative improvements but also for a more equitable distribution of and location of medical services. (3) There are 503 medical facilities in Kwangju each with a need to service 2,556 people. This is below the national average of 1,498 inhabitants per facility. The higher locational quotient and satisfactory population per medical facility showed at the civic center. On the other hand, problem regions such as the traditional residential area in Buk-Gu, Moo-deung mountain area and the outer areas of west Kwangju still maintain rural characteristics. (4) In the study area there are 86 general medicine clinics which provide basic medical services. i. e. one clinic per every 14,949 residents. As a basic service, its higher locational quotient showed in the residential area. The lower population concentration per clinic was found in the civic center and in the former town center, Songjeong-dong. In recently build residential areas and in the civic center, the lack of general medicine clinics is not a serious medical services issue because of the surplus of medical specialists in Korea. People are inclined to seek a consultation with a specialist in specific fields rather than consult a general practitioner. As a result of this phenomenon, there are 81 internal medicine facilities. Of these, 32.1% provide services to people who are not referred by a primary care physician but who self-diagnose then choose a medical facility specializing in what they believe to be their health problem. Areas in the city, called dongs, without any internal facilities make up 50% of the total 101 dongs. (5) There are 78 surgical facilities within the area, and there is little difference at the locational appearance from internal medicine facilities. There are also 71 pediatric health clinics for people under 15 years of age in this area, represents one clinic per 5,063 people. On the quantitative aspect, this is a positive situation. Accessibility is the most important facility choice factor, so it should be evenly located in proportion to demander distribution. However, 61% of 102 dongs have no pediatric clinics because of the uneven location. (6) There are 43 obstetrical and gynecological clinics in Kwangju, and the number of residents being served per clinic is 15,063. These services need to be given regularly so it should increase the numbers. There are 37 ENT clinics in the study area with the lower concentration in Dong-gu (32.4%) making no locational differences by dong. There are 23 dermatology clinics with the largest concentration in Dong-Gu. There are 17 ophthalmic clinics concentrated in the residential area because of the primary function of this type of specialization. (7) The use of general medicine clinics, internal medicine clinics, pediatric clinics, ENT clinics by the inhabitants indicate a trend toward primary or routine medical services. Obstetrics and gynecology clinics are used on a regular basis. In choosing a general medicine clinic, internal medicine clinic, pediatric clinic, and a ENT clinic, accessibility is the key factor while choice of a general hospital, surgery clinic, or an obstetrics and gynecology clinic, thes faith and trust in the medical practitioner is the priority consideration. (8) I considered the efficient use of medical facilities in the aspect of locational and management and suggest the following: First, primary care facilities should be evenly distributed in every area. In Kwangju, the number of medical facilities is the lowest among the six largest cities in Korea. Moreover, they are concentrated in Dong-gu and in newly developed areas. The desired number of medical facilities should be within 30 minutes of each person's home. For regional development there is a need to develop a plan to balance, for example, taxes and funds supporting personnel, equipment and facilities. Secondly, medical services should be co-ordinated to ensure consistent, appropriate, quality services. Primary medical facilities should take charge of out-patient activities, and every effort should be made to standardize and equalize equipment and facility resources and to ensure ongoing development and training in the primary services field. A few specialty medical facilities and general hospitals should establish a priority service for incurable and terminally ill patients. (9) The management scheme for the inhabitants' efficient use of medical service is as follows: The first task is to efficiently manage medical facilities and related services. Higher quality of medical services can be accomplished within the rapidly changing medical environment. A network of social, administrative and medical organizations within an area should be established to promote information gathering and sharing strategies to better assist the community. Statistics and trends on the rate or occurrence of diseases, births, deaths, medical and environment conditions of the poor or estranged people should be maintained and monitored. The second task is to increase resources in the area of disease prevention and health promotion. Currently the focus is on the treatment and care of individuals with illness or disease. A strong emphasis should also be placed on promoting prevention of illness and injury within the community through not only public health offices but also via medical service facilities. Home medical care should be established and medical testing centers should be located as an ordinary service level. Also, reduced medical costs for the physically handicapped, cardiac patients, and mentally ill or handicapped patients should be considered.