• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6955-6959
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• 2013

The incidence of hepatocellular carcinoma (HCC) is relatively high in Southeast Asia. Globally, HCC has a high fatality rate and short survival. The objectives of this retrospective cohort study were to review the epidemiology and survival of HCC patients at a tertiary centre in north-east of Peninsular Malaysia. Subjects were adult HCC patients diagnosed by histopathology or radio-imaging. Secondary liver carcinoma was excluded. Kaplan Meier and multiple Cox proportional hazard survival analyses were used. Only 210 HCC cases from years 1987-2008, were included in the final analysis. The number of cases was increasing annually. The mean age was 55.0 (SD 13.9) years with male:female ratio of 3.7:1. Approximately 57.6% had positive hepatitis B virus, 2.4% hepatitis C virus, 20% liver cirrhosis and 8.1% chronic liver disease. Only 2.9% had family history and 9.0% had frequently consumed alcohol. Most patients presented with abdominal pain or discomfort and had hepatomegaly, 47.9% had an elevated ${\alpha}$-fetoprotein level of 800 IU/ml or more, 51.9% had multiple tumors and 44.8% involved multiple liver lobes. Approximately 63.3% were in stage 3 and 23.4% in stage 4, and 82.9% did not receive any treatment. The overall median survival time was 1.9 months (95% confidence interval (CI): 1.5, 2.3). The 1-month, 6-month, 1-year and 2-year survival rates were 71.8%, 23.3%, 13.0% and 7.3% respectively. Significant prognostic factors were Malay ethnicity [Adjusted hazard ratio (AHR) 1.6; 95%CI: 1.0, 2.5; p=0.030], no chemotherapy [AHR 1.7; 95%CI: 1.1, 2.5; p=0.017] and Child-Pugh class C [AHR 2.6; 95%CI: 1.4, 4.9; p=0.002]. HCC in our study affected a wide age range, mostly male, in advanced stage of disease, with no treatment and very low survival rates. Primary prevention should be advocated in view of late presentation and difficulty of treatment. Vaccination of hepatitis virus and avoidance of liver toxins are to be encouraged.

• 한국임상수의학회지
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• 제22권4호
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• pp.365-370
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• 2005

Enzootic pneumonia caused by Mycoplasma hyopneumoniae is responsible for major economic losses in pig herds of world wide. Mycoplasma hyopneumoniae can also act as a primary pathogen of porcine respiratory disease complex followed by bacterial or viral infection. This study was carried out to investigate the prevalence of mycoplasmal pneumonia of slaughtered pigs in Jeju for two years. The lungs and sera of 214 cases were examined for gross and microscopic lesions of the lungs, immunohistichemistry test for Mycoplasma hyopneumoniae antigen and enzyme-linked immunohistichemistry assay (ELISA) for serum antibody titer. Pulmonary consolidation was observed in the lungs of 163 pigs $(76.1\%)$ with average gross lesion score of $6.0\%$., Bronchointerstitial pneumonia was most frequently observed $(78.5\%)$. The incidence of pulmonary consolidation was decreased in vaccinated pigs compared to that of non-vaccinated pigs. The rate of consolidation in the lungs was significantly decreased in the vaccinated pigs (P<0.05). Antigen of Mycoplasma hyopneumoniae was identified by immunohistichemistry test in the lungs of 174 pigs $(81.3\%)$. ELISh antibodies to Mycoplasma hyopneumoniae were detected in 154 pigs $(72.0\%)$. These results showed the prevalence of swine pneumonia and the incidence of Mycoplasma hyopneumoniae in slaughtered pigs of Jeiu province. We expect that these results would be helpful for the control of swine mycoplasmal pneumonia and porcine respiratory disease complex in Jeju.

• Clinical and Experimental Pediatrics
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• 제57권9호
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• pp.396-402
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• 2014

Purpose: The introduction of the mumps vaccine has dramatically reduced the number of mumps cases, but outbreaks have recently occurred among highly vaccinated populations in developed countries. Epidemiological and clinical characteristics of patients with mumps admitted between 1989 and 2012 in a single hospital in Korea are described in the present study. Methods: We retrospectively evaluated inpatients with mumps between 1989 and 2012 and outpatients and inpatients with mumps in 2011-2012. Results: A total of 152 patients with mumps were admitted between 1989 and 2012, and 163 patients were recorded in 2011-2012. The highest number of admitted cases occurred in 1998 and 2012 (35 and 34 cases, respectively). Among the patients admitted in 2011-2012, the highest frequency was observed among people aged 15-19 years, and low frequency was observed in those aged <4 years and >20 years, compatible to the city data and national data. In patients admitted to our department in 1998 (35 cases) and in 2010-2012 (27 cases), there were significant differences in the mean age and the rate of secondary measles-mumps-rubella (MMR) vaccination, but had similar clinical features, including complications, except aseptic meningitis. Antimumps immunoglobulin (Ig) G was positive in 83% and 100%, and IgM was positive in 67% and 41%, respectively, in the two periods. Conclusion: In Korea, recent mumps outbreaks have occurred mainly among secondary school students who received two doses of the MMR vaccine. The vaccinees might have a modified immune reaction to viral insults, manifesting modified epidemiological and clinical features.

• Journal of Preventive Medicine and Public Health
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• 제48권4호
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• pp.203-215
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• 2015

Objectives: This study was performed to investigate the relationship between the incidence of national notifiable infectious diseases (NNIDs) and meteorological factors, air pollution levels, and hospital resources in Korea. Methods: We collected and stored 660 000 pieces of publicly available data associated with infectious diseases from public data portals and the Diseases Web Statistics System of Korea. We analyzed correlations between the monthly incidence of these diseases and monthly average temperatures and monthly average relative humidity, as well as vaccination rates, number of hospitals, and number of hospital beds by district in Seoul. Results: Of the 34 NNIDs, malaria showed the most significant correlation with temperature (r=0.949, p<0.01) and concentration of nitrogen dioxide (r=-0.884, p<0.01). We also found a strong correlation between the incidence of NNIDs and the number of hospital beds in 25 districts in Seoul (r=0.606, p<0.01). In particular, Geumcheon-gu was found to have the lowest incidence rate of NNIDs and the highest number of hospital beds per patient. Conclusions: In this study, we conducted a correlational analysis of public data from Korean government portals that can be used as parameters to forecast the spread of outbreaks.

• 보건행정학회지
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• 제8권2호
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• pp.110-124
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• 1998

Determining of Strategic Business Units in the organization is a major critical process for improving the organizational performance. On increasing the demands for extension in function of health center, many health centers are trying to provide the various services. But most health center determined the kind and level of service without scientific considerations. The purposes of this study are to develope the model for determination of strategic business units in health center and to test the availability of implementation for it. Our model is rooted from the McKinsey matrix analysis of Product Portfolio Analysis which used widely in marketing field. We modified the evaluation criteria of the McKinsey matrix analysis for health care field appropriately. Our evaluation criteria are categorized into two concepts; contribution of service, availability of service. At first, in terms of contribution of service, market size, market growth rate, needs and demands of regional people, existences of alternative services in that region, correspondence with health policy. The other component, availability of service are included the availability of manpower, financial availability, the level of knowhow on service, acceptance of health care manpower. In the result of analysis, we could conclude that antismoking and antialcoholics education programs, health screening program are important strategically in that aspects of contributions and availability of services. Also, vaccination program is important in that aspect of service availability and diet and exercise program, health library are meaningful in the aspect of service contribution. Therefore, we think that efforts to investigate the evaluation criteria for priority setting or determination of service area in health center are useful challenges.

• 한국학교ㆍ지역보건교육학회지
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• 제14권3호
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• pp.67-76
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• 2013

Objectives: This study was intended to provide the base of developing countries' Health Partnership Strategy by investigating the Paraguay's awareness level of health and analyzing the actual state. Methods: The data was collected from 11 government employees, 20 hospital staffs, 26 local residents on Asunci$\acute{o} $n, Paraguay in February, 2012. The method of the study was the questionnaires consisting of 62 questions including 7 questions of general features, 3 questions of awareness on maternal health care, child health care, planned parenthood program, 52 questions of awareness on health. The questionnaires was translated into Spanish which is local language in Paraguay. Results: The results of this study are summarized as follows; 1) The most important awareness on maternal healthcare, child healthcare, planned parenthood program was providing child health care. 2) The most important awareness to prevent non-health behavior was sufficient nutrition. The most important awareness to reduce the rate of chronic disease was diabetes. The most important awareness to eradicate communicable disease was HIV/AIDS. 3) The most important awareness to provide healthcare service was vaccination. 4) The most important awareness on healthcare delivery system was policy. The most important awareness on health education was student's health education. 5) The most important awareness to strength healthcare capacity was developing domestic economy. Conclusion: The results of this study suggest that awareness levels on health are high against low health behavior status in Paraguay. But awareness on health can lead to health behavior by healthcare system. Therefore, it has to induce the healthcare network and system by injecting public health funds, infrastructure, human resources on prevention of disease and healthcare management.

• 의학교육논단
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• 제18권2호
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• pp.58-64
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• 2016

The birth of the scientific revolution, brought forth by Vesalius and Copernicus in 1543, marked the beginning of a new age. However, the changes such as treatment effectiveness, survival rate, prevalence of specific diseases, etc. had not yet become clear during the 16th century. In the early 17th century, Boerhaave emphasized bedside teaching and practice. His attitude influenced numerous students and educators, so many medical students visited hospital wards where he worked. From the late 18th to 19th centuries, Jenner's smallpox vaccination, Pasteur's anthrax and rabies vaccinations, and Koch's four postulates used to detect pathogens were developed using the scientific research method, which initiated big changes for medicine. Flexner, credited for reporting the new medical education system, adopted scientific medicine. He believed medical students must study basic medical science since it could be the foundation of clinical medicine and lead to a revolution in the field. He proposed a new medical curriculum composed of two-years of basic medicine and two-years of clinical medicine, which has been used more than 100 years. During the late 20th century, bedside teaching rounds decreased gradually as scientific medicine has become popular. Many medical educators in many articles have proposed bedside education as an effective method for medical learning. Despite the advent of the age of artificial intelligence and the changing of medical environments in the near future, bedside education will be more useful and important for medical students, educators, and patients as it is a traditional method and essential for patients who desire a more personal approach.

• Journal of Korean Medical Science
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• 제33권50호
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• pp.321.1-321.7
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• 2018

Background: Pertussis is highly contagious respiratory disease. Healthcare workers (HCWs) can be an important mediator of the disease. A seroprevalence of pertussis was investigated in HCWs to determine the immune status against pertussis and to detect the unidentified pertussis. Methods: This study was conducted for HCWs at a hospital located in Korea in 2011. After obtaining written informed consent for HCWs voluntarily participating in the study, 10 mL of blood was collected from each subject. Demographic and medical data were collected using questionnaire. Data on the underlying disease and vaccination history were reviewed again through medical records. The presence of anti-pertussis toxin (anti-PT) immunoglobulin G (IgG), and immunoglobulin A (IgA) was detected by quantitative analysis using a commercially available ELISA kit (EUROIMMUN, $L{\ddot{u}}beck$, Germany). Results: A total of 412 HCW participated in the study. Among them, 14 were excluded due to the inadequate sample amount or medical history not secured. Of the 398 HCWs analyzed, 16.6% (66/398) were men and the mean age was $33.82{\pm}9.10years$ (range, 21-67). The mean anti-PT IgG titer was $8.32{\pm}20.40IU/mL$ (range, 0.4-287.5 IU/mL). The overall seroprevalence (rate of anti-PT IgG antibody [Ab] titer > 5 IU/mL) was 33.7%. Three (0.8%) HCWs had the Ab level > 100 IU/mL indicated acute infection. There was no statistically significant difference in the seroprevalence and mean titer of anti-PT IgG Ab according to age group, type of occupation, patient-facing position, or working in the pediatric department. Conclusion: The seroprevalence of pertussis of the HCWs of a university hospital in Korea was low, and there were some unrecognized acute infections. Therefore, booster immunization of pertussis to HCWs should be actively considered.

• Journal of Preventive Medicine and Public Health
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• 제52권3호
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• pp.170-178
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• 2019

Objectives: To determine the epidemiological features of patients and animals after bites/scratches from rabies-suspected animals in Zenica-Doboj Canton, Bosnia and Herzegovina. Methods: Data from all patients (and the causative animals) admitted to the Antirabies Service of the Institute for Health and Food Safety Zenica in the 2009-2017 period were analyzed, including age, sex, anatomical site of the bite/scratch, animal type (stray/owned/wildlife), veterinary observations of the animal, and whether antirabies post-exposure prophylaxis (PEP) was indicated and/or administered. Results: In total, 1716 patients were admitted. Bites/scratches were most frequently recorded during April and May (n=181, 10.5% and n=163, 9.5%, respectively). The persons admitted were mostly from the Zenica municipality (n=1278, 74.5%; incidence: 11.55/1000), which is 66.6% urbanized. Males were more frequently represented (n=1089, 63.6%). The patients were mostly 50-64 and 25-49 years of age (n=425, 24.7% and n=390, 22.7%, respectively). Dog bites were the most common cause (n=1634, 95.1%, of which n=1258, 77.0% were caused by stray dogs). PEP was indicated for 997 (58.1%) patients. Only 340 (19.9%) animals underwent veterinary observations (3.1% of stray and 76.1% of owned animals). The largest number of injuries were presented at lower extremities, 1044 (60.8%) cases. Conclusions: Zenica-Doboj Canton is a rabies-free region. Due to the high rate of stray animals not undergoing veterinary observations, the non-existence of a unique dog registry, and the consequent lack of information about stray animals in terms of number, vaccination, neutering, and euthanasia, there is an urgent need for improving the prevention and control of rabies within the One Health framework.

• 한국동물위생학회지
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• 제45권3호
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• pp.145-153
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• 2022

Pathogens such as feline herpesvirus, feline calicivirus, Bordetella bronchiseptica, Chlamydia felis, Mycoplasma felis and Pasteurella multocida usually cause feline upper respiratory tract disease (URTD). Real-time PCR was used to analyze the detection and prevalence of the most common respiratory pathogens in cats with (n=69) and without respiratory signs (n=31). Pathogens were detected in 53 cats, divided into 37 (69.8%) with a single pathogen, 15 (28.3%) with two pathogens, and 1 (1.9%) with three pathogens. M. felis had the highest detection rate in 29 (42.0%) cats, P. multocida was detected in 18 (26.1%), FHV in 10 (14.5%), FCV in 7 (10.1%), B. bronchiseptica in 3 (4.3%), and C. felis in 2 (2.9%). M. felis was the most frequently detected pathogen in cats living outdoors without vaccination. Of the 37 cats infected with single pathogen, nasal discharge was observed in 13 (35.1%), ocular signs in 6 (16.2%), drooling in 5 (13.5%), dyspnea in 3 (8.1%), and asymptomatic in 10 (27.0%). In 51 outdoor and 49 indoor cats, pathogens were detected in 35 (68.6%) and 18 (36.7%) cats, respectively. Of the 29 cats infected with M. felis, 22 (75.9%) showed respiratory signs, and 7 (24.1%) were healthy. In the age of the 53 positive cats, 10 (18.9%) were under the age of 1 year, 26 (49.1%) were aged 1~3 years, and 17 (32.1%) were aged 3 years or older. Although the number of cats in the study was small, the results can provide valuable data on the prevalence of URTD in Korean cats.