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A Study on the Administrative Enhancement for Health Center Activities (보건소(保健所) 행정(行政)의 기선을 위(爲)한 연구(硏究))

  • Moon, Ok-Ryun
    • Journal of Preventive Medicine and Public Health
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    • v.3 no.1
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    • pp.97-110
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    • 1970
  • This survey was conducted to evaluate not only the present status of health center directors-their personal histories, their will to private practice in the future, their responses to governmental policies, -but also the distribution of doctorless myons, budget and subsidy, and director's opinions to the enhancement of health center activities. This survey questioned 116 health center directors and 16 health personnel from August to October of 1970 and obtained the following results; 1) The average ages of directors of kun, city, and total health centers were $43.2{\pm}7.8,\;42.1{\pm}7.7,\;and\;42.9{\pm}10.3$ respectively. 2) The average family sizes of directors of kun, city, and total health centers were $5.6{\pm}2.7,\;5.6{\pm}2.1,\;and\;5.6{\pm}2.6$ respectively. 3) Directors holding M. D. degrees were 79.3%, those holding qualified M. D. degrees ('approved director') were 20.7%. 4) M. P. H., M. S., and Ph. D. holders were 6.0%, 6.1%, and 4.3% respectively. 5) The average duration of present directorship in kun and city were 30.2 months and 20.4 months respectively. 6) The majority of directors had been employed in related fields before assuming current position : directorship at other health center 26.7%, army 22.4%, health subcenter 21.6%, private practice 19.0%. 7) Average length of directorship is 41.8 months. Average length of public health career, including health subcenter and present position, is 56.5 months. 8) Both rural and urban experience in health centers for regular directors is 16.3% and for approved directors, 12,5%. A total of 15.5% of all survey directors had experience in both rural and urban health center. 9) A total of 70.7% of health center directorships were staffed by local doctors. 10) Nearly 40% wanted to quit the directorships within 3 years and 60.3% had already experienced private practice. 11) Of the regular directors 17.4% felt strongly about devoting their lives to public health fields, but only 4.1% of the approved approved directors felt so. 12) There wire 432 doctorless myons among 996 respondent myons and 4.5 doctorless myons per kun. 13) The percentage of doctorless myon by Province are as follows, Cholla buk-do 57.2%, Cholla nam-de 55.0%, Kyungsang nam-do 52.0%, Kyungsang buk-do 49.7%, Chungchong but-do 42.4%, Kyonggi-do 32.9%. Cheju-do 30.8%, Kangwon-do 25.8%. 14) Two thirds of health critters have experienced the abscence of the director for a certain period since 1966 and the average span of the abscence was 18.2 months. 15) The percentage of doctorless myons increased proportionally with the span of the director's abscence. 16) The average budgets of health centers, kun, city and ku, were $W15.03\;million{\pm}W4.5\;million,\;W22.03\;million{\pm}W17.80\;million,\;W13.10\;million{\pm}W7.9\;million$ respectively. 17) Chunju city had the highest health budget per capita(W344) while Pusan Seo ku had the lowest(W19). 18) Director's medical subsidies are W30,000-50,000 in kun, and roughly W20,000 in city. 19) The older of priority in health center activities is T.B. control(31.1%), Family Planning and M. C. H.(28.0%), prevention of acute communicable disease and endemic disease (18.2%) and clinical care of patients(14.3%). 20) Nearly 32% opposed in principle the governmental policy of prohibiting medical doctors from going abroad. 21) Suggestions for immediate enhancing the position of director of health centers and subcenters: (1) Raise the base subsidy (48.2%), (2) Provide more opportunities for promotion (20.7%), (3) Exemption from army services(12.1%), (4) Full scholarship to medical students for this purpose only (7.8%). 22) A newly established medical school was opposed by 56.9% of the directors, however 33.6% of them approved. 23) Pertaining to the division of labor in Medicine and Pharmacy, the largest portion (31.9%) urged the immediate partial division of antibiotics and some addictive drugs to be given only by prescription. 24) More than half wanted a W70,000 level for the director's medical subsidies, white 36.2% stated W50,000. 25) Urgently needed skills in the kun are clinical pathologist (38.6%) and doctor (health center director) (25.5%); while in the city nurse (37.1%), doctors(clinical)(31.4%) and health educators(14.4%) are needed. 26) Essential treatment for the better health center administration; raising the base subsidy (22.7%), obtaining the power of personal management (19.3%) and the establishment of a Board of Health (14.3%). etc.

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A research on Hyang-Yack-Ku-Keup-Bang(鄕藥救急方) (Restoration and Medico-Historic Investigation) (향약구급방(鄕藥救急方)에 대(對)한 고증(考證))

  • Sheen, Yeong-Il
    • Korean Journal of Oriental Medicine
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    • v.2 no.1
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    • pp.71-83
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    • 1996
  • Hyang-Yack-Ku-Keup-Bang(鄕藥救急方) is our own, medical work written about the middle of the time of Korea Dynasty. I restored and researched this book because it needed to be illuminated about its medico-historic value and then I came to some conclusions as follows. 1. Hyang-Yack-Ku-Keup-Bang was published in Dae-jang-do-kam(大藏都監) of Kanghaw island(江華島) about the middle of Korea Dynasty. Choi Ja-ha(崔自河) republished it on original publication ground in Euiheung(義興) of Kyungsang-Province(慶尙道) in July, Taejong's(太宗) 17th year of Chosen Dynasty (A.D.1417) and this book was published again in Chungcheng Province(忠淸道) in Sejong's(世宗) 9th year(A.D.1427). The book published in Taejong's days was in the possession of books department of Kung-nae-cheng(宮內廳) in Japan and was the oldest medical book of existing ones. 2. Bang-Jung-Hyang-Yack-Mock-Cho-Bu(方中鄕藥目草部) of this book was originally intended to be adjusted in each division with the title of Bang-Jung-Hyang-Yack-Mock(方中鄕藥目). But Herb part(草部) only followed editing progress of Jeung-Lew-Bon-Cho(證類本草), the rest is not divided into each part and is together arranged at the below of Herb part with the title of Bang-Jung-Hyang-Yack-Mock-Cho-Bu. The Korean inscriptions on some drugstuffs in this book are different between Native Name(鄕名) of three volumes of provisions and general-spoken(俗云) of Bang-Jung-Hyang-Yack-Mock-Cho-Bu. In this, it is estimated that the publishing time and editor of tile volume of provisions and Bang-Jung-Hyang-Yack-Mock-Cho-Bu are different. I think Choi Ja-ha compiled this behind three volumes of provisions when he published. 3. This book picked some prescriptions which consisted of obtainable drugs with ease in Korea in the books of Chell-Keum-Yo-Bang(千金要方), Oi-Dae-Bi-Yo(外臺秘要), Tae-Peong-Sung-Hye-Bang(太平聖惠方), Ju-Hu-Bang(?後方), Kyung-Hum-Yang- Bang(經驗良方) Bo-Je-Bon-Sa-Bang(普濟本事方) Bi-Ye-Baik-Yo-Bang(備預百要方) and so on and got together our own prescriptions. On the whole Bi-Ye-Baik-Yo-Bang was a chief referrence book, On this, other books referred to and corrected. 4. In provisions quoted from Hyang-Yack-Jip-Sung-Bang(鄕藥集成方), there are seven provisions; leg-paralysis part, coughing part, headache part, obstetrics part, etc. don't show in this book. This is why Choi Ja-ha published only certain texts on Dae-jang-do-kam edition his own posession. So we can think the existing edition has a little misses compared with original edition. 5. This book recorded only names of drugstuffs in animal drug department like fowls, crab, goldbug, earthworm, etc. and didn't tell us ways of taking those. This is effect of Buddhist culture on medicine. This is efforts to practice 'Don't murder';one of Five Prohibition of Buddhism. 6. Beacause this book was published at the time, when our originative medicine would be set forth. This followed the Chinese ways in Theory, Treatment, Prescription and used 'Hyang Yack' in Medication out of theory of Korean medicine, which was a transitional form. So this is all important material which tell us aspects of development of 'Hyang Yack' the middle of Korea Dynasty.and this is also the beginning of originative, medical works like Dong-Eui-Bo-Kam(東醫寶鑑), Dong-Eui-Su-Bo-Won(東醫壽世保元). 7. There are few contents based on 'Byen-Jeung-Lon-Chi(辨證論治)'in this book. So we can see this book is not for doctors who study medical thoughts but for general public who suffer from diseases resulted from war. Because this book was written for a first-aid treatmeant, this is an index of medical service for the people those days. And this is also an useful datum for first-aid medicine or military medicine in these modern days. 8. Nowadays, parts of learned world of Korean medicine disregard essential theories and want to explain Korean medicine only by the theories or the methods of Western medicine. Moreover they don't adopt Chinese and Japanese theorys & thoughts about Oriental medicine in our own style and just view in there level. What was worse, there is a growing tendency for them to indulge in a trimming policy of scholarship and to take others' ideas. I think these trends to ignore our own medical thoughts involving growth of 'Hyang Yack' in the middle of Korea Dynasty, Dong-Eui-Bo-Kam and Dong-Eui-Su-Se-Bo-Won. So we, as researchers of Korean medicine, must get out of this tendency, and take over brilliant tradition and try to develop originative Korean medicine.

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A Literal Study of Feature of the Preventive Medicine in Oriental Medical Science (한의(韓醫) 예방의학(豫防醫學)의 특징(特徵)에 관(關)한 문헌적(文獻的) 고찰(考察))

  • Lee Sang-Woon;Lee Sun-Dong
    • Journal of Society of Preventive Korean Medicine
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    • v.1 no.1
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    • pp.85-104
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    • 1997
  • As the concern about health is increased, the importance of preventive medicine that prevent disease in advance to overcome boundary of disease remedy gets emphasized in the whole world. The fundamental thoughts of oriental medicine are the harmony between the human body and nature, the unified idea regarding mind in the same light with body, and the symmetry of the cosmo dual forces. And oriental medicine is a kind of study that has developed on the ground of prevention thought. from old days, it has been developed the preventive medicine at is called 'Yangseng(養生; recuperation)' etc. with the clinical medicine. The preventive medicine of oriental medicine was taking a serious of the first preventive medicine of an incurable disease thought and the prevention thought that belongs to the second and third preventive medicine is described through the whole oriental medicine. Also the clinical and preventive medicine to apply to the clinics have an in- separable relation. Therefore I inspected the part of the preventive medicine described in some oriental medicine books and studied the characteristics of preventive medicine of oriental medicine as follows; First, the preventive medicine of oriental medicine has the characteristics that is emphasized generally in the first preventive medicine and wholly it is composed in the system of the first, second and third preventive medicine. It has the presentative theory such as 'Jungkijonae sabulkaghan(正氣存內 邪不可干; If good energy is in body, a disease. dosen't occur)', 'Husajukpung Phijeyushi(虛邪賊風 避之有時; When e infectious disease like plague break out, they must avoid the place occurring the disease)', 'Chuninsangeung(天人相應; The harmony of nature and human)' etc.. This is intimately related to the incurable disease thought of the inside diameter and oriental medicine has pursued that. Second, due to the most prerequisite theory of disease production, the balanced condition of environment, the cause of a disease and host is called the health. As oriental medicine has the system of aetiology like that, we can see the host and environments are importance most of all. Namely we can think of the relation of host >> environment > the cause a disease Up to date Jungkijonae Sabulkaghan(正氣存內 邪不可干) that the most oriental medicine doctors have had a knowledge is not whole theory but a pan of oriental medicine science and it is included in oriental medicine theory to avoid infectious disease such as Husajukpung Phijeyushi(虛邪賊風 避之有時). Third, according to the natural result of the first and second contents, we can know that its characteristics stress the remedy without drugs. Because Jungkijonae Sabulkaghan(正氣存內 邪不可干), Husasukpung Phijeyushi(虛邪賊風 避之有時), and Chuninsangeung(天人相應) mean that they prevent disease in condition of freedom from ailment, We can prevent the disease production through the positive preventive methods such as exercise, spirit, food and innate prevention etc.. fourth, the preventive medicine of oriental medicine has developed with therapeutics and it contains all oriental medical methods such as host, environment, exercise, acupuncture and moxibustion, innate or postnatal methods. Also it is the general preventive medicine that has fundamental philosophy of oriental medicine; for examples, the unified idea, the harmony of nature and human, and the unity of mind and body. fifth, to develope the above scientific merit and special features, the preventive medicine of Oriental medicine must be objectified and reemergent stud? gets more and more essential from now on. Especially we need to have the scientific concern of Oriental medicine about the cause of a disease, environmental hygiene, industrial sanitation, and personal hygiene etc..

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Prevention of thromboembolism with ticlopidine and aspirin after cardiac valve replacement (심장변막치환후 Ticlopidine과 Aspirin의 혈전방지 효과)

  • Kim, Gwang-Taek;Kim, Hak-Je;Kim, Hyeong-Muk
    • Journal of Chest Surgery
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    • v.19 no.1
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    • pp.35-42
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    • 1986
  • Prevention of thrombombolism after rosthetic cardiac valve replacement is essential for the patients. About 90% of patients are free of major and minor thromboembolic complications 5 year after replacement of cardiac valves with prosthetic devices when they are under control of anticoagulant therapy. Ticlopidine is a drug that alter platelet function to have an antithrombotic effect. It is an antiaggregating agent which inhibits primary platelet function to have an antithrombotic effect. It is an antiaggregating agent which inhibits primary platelet aggregation induced by ADP and increases the production of prostaglandin $D_{2}$. Aspirin in small doses inhibits platelet synthesis of prostaglandins by irreversibly blocking the enzyme cyclo-oxygenase. Platelet secretion and aggregation are impaired with Ticlopidine and Aspirin. the thromboembolic event sof 54 patient s who were treated with Ticlopidine and Aspirin after cardiac valve replacement were evaluated and compared with that of 79 patients who were treated with Wafarin and Aspirin after the same type of operation. The follow-up period ranged from 4 to 110 months (mean of 48 months). there were 11 major thromboembolic episodes including three deaths in the warfarin goup during mean follow-up period of 56 months. two cases of CVA and one hemoarthrosis were noted due to overdose of Warfarin. Inticlopidine group, there was only one fatal thromboembolic epdisode three month after mitral valve replacement during mean follow-up period of 18 months. Two episodes of hypermenorrhea resulting anemia ere noted in the ticlopidine group. We measured the parameters of platelet function in aggreagation curve of platelet with platelet aggregometer (chrono-log Aggregometer, Model No. 430) Aggregation test was performed with three final concentrations of epinephrine in 10 uM/L, ADP in 5uM/L. 28 patients with prosthetic cardiac valves and 35 healthy volunteers were subgrouped as follows to analyze the effect of antithrombotic drugs used. Group I ; 11 patients treated with 250-500 mg of ticlopidine and 0.5gm of Aspirin as a daily single dose after cardiac valve replacement (14 St. Jude Medical and 1 Carpentier-Edwards, 9 patients with atrial fibrillation among them) Group II ; 10 patients treated with 3-5 mg of Warfarin and 0.75 gm of Aspirin daily to prolong prothrombin time around 20 seconds for more than 6 months and single Aspirin dose was maintained afterward as a life-long regimes(3 St. Jude Medical, 1 Hall-Kaster and 7 Carpentier-Edwards valve, 9 patients in atrial fibrilation). Group III ; 7 patients who quit anticoagulant treatment (Warfarin + Aspirin) 6-12 months after the regime as group II (3 St. Jude Medical. 1 bjork-Shiley, 1 Hall-Kaster, 3 Carpentier-Edwards valve, 2 of them are with atrial fibrillation). Group IV ; 35 healthy vounteers (28 males and 7 females). The following results were obtained. 1. The mean maximal platelet aggregability in Group I induced by 10uM/L epinephrine was 15.6%, and 17.5 and 18.7% in BM in proportion to the induction by 5 and 10 uM/L ADP. 2. The mean maximal platelet aggregability in Group II induced by 10uM/L epinephrine was 16.5%, and 27.4 and 44.7% in BM in proportion to the induction by 5 and 10uM/L ADP. 3. The mean maximal platelet aggregability in group III induced by 10uM/L epinephrine was 65%, and 56.5 and 51.8% in BM in proportion to the induction by 5 and 10 uM/L ADP. 4. The mean maximal platelet aggregability in the normal subjects induced by 10 uM/L epinephrine was 64%, and 65 and 69% in Bm inproportion to the induction by 5 and 10 uM/L ADP. 5. Reversible change of platelet aggregation curve induced by 5 and 10uM/L was noted all of the patients in Group I. conclusion : Ticlopidine is an antiaggregating agent which inhibits primary platelet aggregation induced by ADP, and increases the production of prostaglandin $D_{2}$. Ticlopidine and Aspirin produced a significant inhibition of platelet in the presence of ADP and epinephrine in our study. Acccording to our brief experience, 250 mg of ticlopidine and low dose of Aspirin resulted synergistic superior effect to each drug alone in prevention of thromboembolism after prosthetic cardiac valve replacement.

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Analysis of Aminoglycoside Antibiotics in Meat and Cell Culture Medium Coupled with Direct Injection of an Ion-pairing Reagent (이온쌍 시약 직접 주입법을 활용한 육류 및 세포배양액 내 아미노글리코사이드계 항생제 분석)

  • Kyung-Ho Park;Song-Yi Gu;Geon-Woo Park;Jong-Jib Kim;Jong-soo Lee;Sang-Gu Kim;Sang-Yun Lee;Hyang Sook Chun
    • Journal of Food Hygiene and Safety
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    • v.38 no.5
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    • pp.319-331
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    • 2023
  • Aminoglycoside antibiotics, also known as aminoglycosides (AGs), are veterinary drugs effective against a wide range of gram-negative and gram-positive bacteria. Owing to their recent use in cultured meats, it has become essential to establish an analytical method for safety management. AGs are highly polar compounds, and ion-pair reagents (IPRs) are used to ensure component separation. Owing to the high possibility of potential mechanical problems resulting from IPR addition to the mobile phase, an analytical method in which IPRs are added directly to the vial was explored. In this study, methods for analyzing 10 AGs via liquid chromatography-tandem mass spectrometry (LC-MS/MS) with the addition of two IPRs were validated for selectivity, detection limit, quantitation limit, recovery, and precision. The detection limit was 0.0001-0.0038 mg/kg, the quantification limit was 0.004-0.011 mg/kg, and the linearity (R2) within the concentration range of 0.01-0.5 mg/kg was over 0.99. Recovery and precision (expressed as relative standard deviation) evaluated in the two matrices (beef and cell culture media) ranged from 70.7% to 120.6% and 0.2% to 24.7%, respectively. The validated AG analytical method was then applied to 15 meats prepared from chicken, beef, and pork, and 6 culture media and additives used in cultured meat. No AGs were detected in any of the 15 meats distributed in Korea; however, streptomycin and dihydrostreptomycin were detected at levels ranging from 695.85 to 1152.71 mg/kg and 6.35 to 11.11 mg/kg, respectively, in the culture media additives. The LC-MS/MS method coupled with direct addition of IPRs to the vial can provide useful basic data for AG analysis and safety evaluation of meats as well as culture media and additives for cultured meats.