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Five Year Experience of Preexposure and Postexposure Rabies Prophylaxis in Korean Children at the National Medical Center (소아청소년에서 공수병 예방접종 및 교상 후 조치 현황: 최근 5년간 국립중앙의료원에서의 경험)

  • Noh, Jin Chul;Park, Hyang Mi;Park, Jong Hyun;Won, Youn Kyung;Lee, Chang Hyu;Kim, Jae Yoon
    • Pediatric Infection and Vaccine
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    • v.20 no.1
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    • pp.9-16
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    • 2013
  • Purpose : This study aims to investigate preexposure prophylaxis and postexposure prophylaxis of rabies that the National Medical Center (NMC) handled and to check whether appropriate measures were performed according to the recent domestic and overseas guidelines after animal bites. Methods : This study surveyed 41 people who were 18 years or under and received preexposure and postexposure prophylaxis of rabies at the NMC from November 2006 to December 2011. Their medical records were reviewed for their age, gender, the reason for preexposure prophylaxis, the body sites of animal bite, the kind of the animal that bit children, the region where the biting occurred and rabies vaccination and inoculation of immunoglobulin. Results : Eleven children took rabies vaccination for preexposure prophylaxis and 30 children received post exposure prophylaxis of rabies. Of patients who were bitten by unvaccinated animals including wild animals or by animals which were not certain to be vaccinated, 50% (13 of 26 children) received postexposure prophylaxis, while 75% (3 of 4 children) of patients who were bitten by vaccinated animals received postexposure prophylaxis of rabies. Ten of 30 bitten patients knew whether or not the biting animals had received rabies vaccination. Of them, four people (40%) were bitten by animals which had received rabies vaccination. Conclusion : To prevent the occurrence of rabies, people and health care providers need to correctly understand latest guideline for rabies preexposure and postexposure prophylaxis and the information for bitten patient, biting animal and area at bitten by animal should be accurately recorded.

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Relationship of between blood lead level and lead related symptoms in low level lead exposure (저농도 연폭로에서 혈중 연농도와 자각증상과의 관계)

  • Hwang, Kyu-Yoon;Ahn, Jae-Eog;Ahn, Kyu-Dong;Lee, Byung-Kook;Kim, Joung-Soon
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.2 s.34
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    • pp.181-194
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    • 1991
  • This study intended to obtain an useful information on the prevalence of subjective symptoms, and to clarify the interrelationships between blood lead and lead related symptoms in low level lead exposure. The 93 male workers exposed to lead and 56 male nonexposed workers were examined for their blood lead(PBB), Zinc-protoporphy(ZPP), hemoglobin(HB) and personnal history, and completed 15 questionnaires related to symptoms of lead absorption : also measured lead concentration in air (PBA) in the workplace. The results obtained were as follows ; 1. The means of blood lead (PBB), blood ZPP and hemoglobin (HB) among workers exposed to lead were $26.1{\pm}8.8{\mu}g/dl,\;28.3{\pm}26.0{\mu}g/dl$ and $16.2{\pm}1.2g/dl$ : whereas those of nonexposed workers were $18.7{\pm}5.1{\mu}g/dl,\;20.6{\pm}8.7{\mu}g/dl$ and $17.3{\pm}1.1g/dl$. The means of above three indicies between two groups showed significant difference statistically (p<0.05). 2. The means of blood lead (PBB), blood ZPP and hemoglobin of workers exposed .to different lead concentration in air were as follows : When it was below $25{\mu}g/m^3$, the indices were $24.7{\pm}79,\;26.1{\pm}26.8{\mu}g/dl\;and\;16.4{\pm}1.1g/dl$ respectively : These indices were $27.1{\pm}8.5,\;23.9{\pm}10.92{\mu}g/dl\;and\;16.2{\pm}1.3g/dl$ when the lead concentration in air was $25{\sim}50{\mu}g/m^3$ : and they were $3.4{\pm}9.3,\;42.3{\pm}31.3{\mu}g/dl\;and\;15.5{\pm}1.2g/dl$ when the concentration of lead was above $50{\mu}g/m^3$. Although there were statistical difference in blood lead and hemoglobin among three different lead concentration in air, there was no statistical difference of blood ZPP among the three groups with different exposure levels (p>0.05). 3. The most frequent by complained symptom was 'Generalized weakness and fatigue', and fewest symptom was 'Intermittent pains in abdomen' 4. Only two symptoms out of fifteen symptoms checked by themselves revealed significant difference between exposed and nonexposed groups. These were 'Intermittent pains of abdomen' and 'Joint pain or arthralgia' (p<0.05), No positive correlation was found between the levels of blood lead and symptom groups categorized as gastrointestinal, neuromuscular and constitutional symptoms, 5. Blood lead (r=0.3995) and ZPP (r=0.2837) showed statistically significant correlation with mean lead concentration in air, whereas correlations were not demonstrated between blood lead and lead related symptoms or blood ZPP and lead related symptoms. 6. Blood lead (PBB) and ZPP showed association (r=0.2466) and the equation PBB=23.75+0.0842 ZPP was derived. 7. On stepwise multiple regression, using blood lead level as a dependent variable and ZPP, hemoglobin (HB), age, work duration (WD) and symptom prevalence as a independent variables, only ZPP significantly contributed a lot to blood lead level. 8. While the ZPP measurement was found to be a good indicator in evaluating health effect of lead absorption in low level lead exposure, lead related symptoms were not sensitive enough to evaluate of lead absorption in low level exposure.

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A Survey on the Effect of Consumer's Social-Economic Status on Beef Purchase Attitude (소비자의 사회 경제적 위치가 쇠고기 구매 태도에 미치는 영향)

  • Lee, Seong-Kap;Yang, Seok-Jin;Kim, Dong-Hoon;Cho, Bong-Jae;Jang, Jung-Young;Lee, Hyo-Ku;Yoon, Bo-Ra;Lee, Young-Jun;Lee, Ok-Hwan
    • The Korean Journal of Food And Nutrition
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    • v.25 no.1
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    • pp.132-141
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    • 2012
  • This current survey was conducted to examine consumer attitudes toward factors determining beef purchasing and improving distribution systems. The frequency of beef purchasing was shown to reflect social and economic status, where inhabitants in large cities, such as Seoul, with higher salaries showed a higher frequency. In addition, consumers that were in their forties bought beef more frequently than consumers that were in their twenties. Consumers in Seoul and the megalopolis with a monthly income of higher than 200 million won preferred to purchase meat from department stores and discount markets. In contrast, people in small cities with lower incomes tended to buy meat from butcher shops and brand shops. In a question regarding unsatisfaction factors of retail beef, individuals that were in their thirties with a high income had concerns associated with packaging problems. For people under thirty with low income, the consistency of quality and price were the prime concerns. In regards to the beef grading system, consumer response varied between inhabitants, monthly income and age group, where consumers from small cities that were in their twenties and forties with a low income had a negative viewpoint. For the differential beef distribution system, housewives between the ages of 30 and 40 from a small city with an income higher than 200 million won had a positive response; however, a large number of consumers were not familiar with this system. The most demanding beef cuts were in the following order: loin, flank and rib. In addition, the most important factors determining purchasing beef were as follows: price, breed and portion.

Comparison of Gefitinib and Erlotinib for Patients with Advanced Non-Small-Cell Lung Cancer (진행성 비소세포폐암 환자에서 Gefitinib와 Erlotinib의 비교)

  • Lee, Jin Hwa;Lee, Kyoung Eun;Ryu, Yon Ju;Chun, Eun Mi;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.4
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    • pp.280-287
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    • 2009
  • Background: The epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), became an attractive therapeutic option for advanced non-small-cell lung cancer (NSCLC). Several studies suggested that there might be some different efficacy or response predictors between gefitinib and erlotinib. We compared the efficacy and toxicity of gefitinib and erlotinib in Korean patients with advanced NSCLC and evaluated specific predictors of response for both gefitinib and erlotinib. Methods: We collected the clinical information on patients with advanced NSCLC, who were treated with gefitinib or erlotinib at the Ewha Womans University Hospital, between July 2003 and February 2009. Median survival times were calculated using the Kaplan-Meier method. Results: Eighty-six patients (52 gefitinib vs. 34 erlotinib) were enrolled. Patient median age was 64 years; 53 (62%) subjects were male. Out of the 86 patients treated, 83 received response evaluation. Of the 83 patients, 35 achieved a response and 12 experienced stable disease while 36 experienced progressive disease, resulting in a response rate of 42% and a disease control rate of 57%. After a median follow-up of 502 days, the median progression-free and overall survival time was 129 and 259 days, respectively. Comparing patients by treatment (gefitinib vs erlotinib), there were no significant differences in the overall response rate (44% vs. 39%, p=0.678), median survival time (301 days vs. 202 days, p=0.151), or time to progression (136 days vs. 92 days, p=0.672). Both EGFR-TKIs showed similar toxicity. In a multivariate analysis using Cox regression model, adenocarcinoma was an independent predictor of survival (p=0.006; hazard ratio [HR], 0.487; 95% confidence interval [CI], 0.292-0.811). Analyses of subgroups did not show any difference in response predictors between gefitinib and erlotinib. Conclusion: Comparing gefitinib to erlotinib, there were no differences in the response rate, overall survival, progression-free survival, or toxicity. No specific predictor of response to each EGFR-TKI was identified.

A Study on The Status of Health Examination and Health Management of Industrial Companies in the Taegu and Kyungbook Areas (일부 경북지역 산업장의 제특성에 따른 건강진단과 보건관리 실태)

  • Kim, Sang-Soon;Kim, Jung-Nam;Park, Jung;Kim, Ok-Ran;Cha, Kyung-Mi;Kwak, Ou-Ke;Park, Kyung-Min;Choi, Yoon-Hee;Bak, Kyung-Shin
    • Research in Community and Public Health Nursing
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    • v.4 no.1
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    • pp.67-76
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    • 1993
  • The purpose of this study was to find the status of health examination and health management of industrial companies located in Taegu and Kyung book areas. It will provide basic information for the provision of effective health management of industrial workers. 49 companies were selected as a study sample group, and data was collected by using a structured Questionnaire which was developed by the members of the Community Health Nursing Academy of Korean Nursing. The health managers of the companies filled out the Questionnaire. The data was gathered from Dec 20, 1992 to Jan 20. The results of the study was as follows : 1. The Study sample showed 85.7% manufacturing companies having 300 or more workers. 2. All the companies had health managers, and companies which had 1,000 or more workers had industrial physicians and nurses. Only 12.2% of the industrial physicians were full time employees, and almost all industrial nurses were full time employees. Except for industrial physicians and nurses, the proportion of hygienists (6.1%), nurses aids (4.1%), and environmental engineers (22.4%) with full time employment statuss was very low. The mean age of industrial physicians was 49.2 while that of industrial nurses was 27.2. The length of work experiences currently ranges for 1 to 3 years for all health workers: physicians, nurses, hygienists, and environmental engineers. 3. Health examination and follow up care 94.31% took general health examinations. Of those, the proportion of the workers, who were determined as C grade(in need of close examination) was 43.86%. The proportion of the workers who were determined as D grade was 22.19%. 13.28% of the workers evaluated at the D grade were taken as a gauge for temporary leave from work. While 8.7% and .09% of them were taken as gauge for a change in job, and or shortening work hours respectively. The proportion of workers who must have taken special examination was 65.04% and of those the proportion of the workers who actually took, the examination was 98.55%. 75% of the workers who were recommended for follow up care were given follow up care. The special examinations were done the most frequently to detect the effects of physical agents (59.2%). Direct notice to individual workers was used the most frequently as a method of notification after a special examination (61.2%). The length of time taken to receive the result of a special examination was less than 1 month (38.9%) and 36.7% had taken up to two months (36.7%.). Most results of special examination were obtained within 2 months. The referral rate of consulting special examination by health managers was estimated at 95.9%. 4. 89.8% of the companies had. their own company dispensaries and 75.5% of those. had separate dispensaries. 32.7% of the companies designated local clinics for health management of workers. Industrial nurses performed health examination the most frequently(1.4 points). Health appraisal for work places were. done the least(0.83 points).

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A Study of Job Satisfaction and Related Factors of the National Hospital Nurses (국립병원 간호사의 직무만족과 관련요인 연구)

  • Suh Gil-Hee;Kim Ok-Hee
    • Journal of Korean Public Health Nursing
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    • v.7 no.2
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    • pp.53-66
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    • 1993
  • By this time, a few of previous studies of factors related to separation from their jobs and job satisfaction only have dealt with the separation rate. the cause of separation and related factors that induce job satisfaction and incentive factors, the actualities of morale some suggestions for reduction of the separation rate. This study is attempted to determine factors that have effect on job satisfaction of national hospital nurses. and to proide information and materials for the development of the administration of nursing through the appreciation of factors influencing on job satisfaction between isolated ward nurses and general ward nurses working at national hospitals. 185 nurses of national hospitals responsed th this study, and were divided into two groups. Group 1: 57 nurses working at isolated wards for tuberculosis patients and Group 2 : 128 nurses at general wards. Relevant data were collected from August, 5, 1992 through August 20, 1992. The questionnaire consisted of 8 genalized items and 4 items concerning job satisfaction. The collected data were processed with SPSS, and the relationship among vaviables was analyzed by means of $X^2-test$, Pearson Correlation, Multiple Regression. The results of this study are as follows: 1. There is no significant difference between two groups in terms of generalized items. Age distributions show $44.3\%$ under the category of less than 34. and $55.7\%$ under the category more than 35, $19.3%$ was single and $74.6\%$ was married respectively. 2. $79.4\%$ of the nurses have the desire to have in-service education under the satisfactory physical environments such as welfare system, accommodating structures and facilities, instruments or management systems of the hospital, but under the category of unsatisfactory circumstances, $60.3\%$ have the intention of having in- service education. The concern in terms of in-service education shows statistically significant difference between two groups $(X^2=8.85,\;p<0. 05)$. This result accepts the hypothesis that good physical environments could intensify interests in service education. 3. The extent of satisfaction related to psychological environments is heightend according to good physical environments. In result, the hypothesis that the extent of satisfaction in terms of physical environments could raise satisfaction about psychological environment is accepted. 4. In the light of the extent of satisfaction about physical environments, $33.3\%$ of isolated ward nurses are satisfied with physical environments, but only $11.7\%$ of general ward nurses are satisfied. $(X^2=10.88,\; p<0.01)$. This result shows that the satisfaction degree about phusicalenvironments of isolated war nurses was higher than that of general ward nurses in spite of high physical and psychological risks due to exposure to infection. Consequently. the hypothesis was rejected that the satisfaction degree about physical environments would be lower in isolated ward nurses than in general ward nurses. 5. The fact that $87.7%$ of isolated ward nurses took interest in service education and $53.19\%$ of general ward nurses took interest in service education demonstrats that isolated ward nurse have more interest in service education than gerneral ward nurses. The result shows that the hypothesis is accepted that isolated ward nurses would have mor interests in service education than general ward nurses. 6. In the extent of satisfaction about physical environments such as morale human relationship promotion, there is no significant difference between two groups in terms of statistics. The hypothesis is rejected that satisfaction about psychologic environments would be high in isolated ward nurses than in general ward nurses. In conclusion. factors influencing on job satisfaction are considered to have effect on. another, and also interdisciplinary amelioration of factors accompanied with systematic inter cooperative investigation is necessary.

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Dental Care Utilization Patterns and Its Related Factors of the Rural Residents (경상북도 일부 농촌지역 주민의 치과의료이용양상 및 관련요인)

  • Chang, Bun-Ja;Kim, Ji-Young;Song, Keun-Bae;Kam, Sin;Lee, Sung-Kook
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.171-182
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    • 2003
  • Objectives: This study was conducted to analyze the dental care utilization patterns and related factors of the rural residents. Methods: The data collected by interview and self-administered questionnaire survey of 524 peoples of Seongju county in Gyeongsanbuk-do. The summarized results are as follows. Results: The rate of persons who experienced the oral disease was 52.5% during 1 year and it was at most in the age group of 40-49. The rate of persons who had experienced the oral disease were investigated according to general characteristics, perception of oral health, being of regular treatment facility. Therefore the rate of persons who had experienced the oral disease was significantly higher the younger peoples, worse oral health status and being of the regular treatment source than the other groups. During 1 year period, 64.0% of the cases had treated the perceived oral disease, 36.0% did no action at all during last year. Among respondents, 49.4% had treated their oral disease at dental clinics, 8.0% had treated at community health center or subcenter and remains did not treated at all. The results of logistic regression analysis suggested that statistically significant factors in dental health care utilization were educational level, degree of pain, oral health status and regular treatment facility. Therefore the dental health care utilization rate was higher at groups with the high educational level, serious pain, better oral health status and being of the regular treatment source than other groups. 45.5% of the rural residents did not treat their oral disease immediately due to the no identified need, limitation of time(19.2%), economic limitation(19.2%), and geographical limitation(9.0%). Conclusions: In consideration of above findings, we may conclude that oral health community program to prevent oral diseases should be intensified, oral health education to raise oral health knowledge should be performed periodically.

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The Influence of Private Health Insurance on Admission among Some Patients with Cervical or Lumbar Sprain (민영의료보험 가입이 일부 경·요추부 염좌 환자의 입원에 미치는 영향)

  • Jang, Dong-Ryul;Kang, Myung-Geun
    • Journal of agricultural medicine and community health
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    • v.37 no.2
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    • pp.84-95
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    • 2012
  • Background: In Korea, private health insurance has neglected to induce externality on national health insurance by moral hazard. Therefore, we conducted this study in order to explore the influence of private health insurance on unnecessary medical utilization among patients with cervical or lumbar sprain. Method: The study examined a population of 449 patients (admission, 384; out-patient; 85) diagnosed with simple cervical or lumbar sprain without neurological symptoms at 20 small hospitals or clinics in Gwangju and Jeollanam provinces from Jul. 1 to Aug. 31 2008. The data were collected using structured, self-administrated questionnaire which collected information such as whether or not the patient was admitted (as a dependent variable), whether or not they had private health insurance (as a independent variable), and covariates such as socio-demographic characteristics, the factors related to the sprain, and characteristics of the insurance provider. Results: From hierarchical multiple logistic regression analysis, it was found that the admission rate of patient with private health insurance was higher than that those without it (Odds ratio=3.31, 95% Confidence interval; 1.14-9.58), meaning that private health insurance was an independent factor influencing the admission of patients with these conditions. Other determinants of admission were patient age and physician referral. Conclusions: This study is the first empirical study to explore the influence of private health insurance on inducing moral hazard in admission services, specifically among patients with cervical or lumbar sprain. Regulation of benefits provided by private health insurance may be necessary, as the effect of this moral hazard may mean existence of externality.

Diastolic Function in Patients with Hypertrophic Cardiomyopathy: Evaluation Using the Phase-contrast MRI Measurement of Mitral Valve and Pulmonary Vein Flow Velocities (비대성심근증 환자의 이완기능평가: 승모판과 폐정맥 유속을 측정한 위상차 MRI의 이용)

  • Kim, Eun Young;Choe, Yeon Hyeon;Kim, Sung Mok;Lee, Sang-Chol;Chang, Sung-A;Oh, Jae K.
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.4
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    • pp.314-322
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    • 2014
  • Purpose: Diastolic dysfunction is a common problem in patients with hypertrophic cardiomyopathy (HCM). The purpose of this study was to assess the role of MRI in the assessment of diastolic function using mitral valve and pulmonary vein flow velocities in HCM patients. Methods and Results: Phase-contrast MRI (mitral valve and pulmonary vein) and transthoracic echocardiography was successfully performed for 59 HCM patients (44 men and 15 women; mean age, 51 years). Forty-nine patients had a diastolic dysfunction; grade 1 (n = 20), grade 2 (n = 27), and grade 3 (n = 2) using echocardiography, and ten patients had normal diastolic function. The transmitral inflow parameters (E, A, and E/A ratios) obtained by MRI showed positive correlation with the same parameters measured by echocardiography (Pearson's r values were 0.47, 0.60, and 0.75 for E, A, E/A, respectively, all P < 0.001). With the flow information of the pulmonary vein from cardiac MRI, pseudo-normalized pattern (n = 8) could be distinguished from true normal filling pattern (n = 17), and the diastolic function grades by cardiac MRI showed moderate agreement with those of echocardiography (kappa value = 0.45, P < 0.001). Conclusions: Assessment of left ventricle diastolic function is feasible using phase-contrast MRI in HCM patients. Analysis of pulmonary vein flow velocity on MRI is useful for differentiating pseudo-normal from normal diastolic function in HCM patients.

Consumer Perceptions and Attitudes towards Reducing Sugar Intake (당류 저감화에 대한 소비자 인식 및 태도)

  • Kim, Eunmi;Ahn, Jee Ahe;Jang, Jong Keun;Lee, Min A;Seo, Sang Hee;Lee, Eun-Jung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.44 no.12
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    • pp.1865-1872
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    • 2015
  • This study attempted to investigate consumer perceptions and attitudes towards reducing sugar intake by providing data to develop guidelines for the government and food-related industries to encourage Korean consumers to maintain appropriate levels of sugar intake. A survey was conducted on 238 adult consumers regarding their purchasing power for products with high sugar content in Seoul and Bundang, Gyeonggi area from September 1~30, 2013. Nutritional information on sugary products had a greater impact than media and others' recommendations on consumer awareness regarding need to reduce sugar intake. External factors such as health and weight control were stronger reasons for consuming reduced amounts of sugar or sugar-free products than internal factors such as sweetness. However, internal factors-such as taste-did not have a greater effect on consuming reduced amounts of sugar or sugar-free products than environmental factors-such as absence of purchase channels. Consumers indicated higher acceptance for 50% reduction in sweetness of existing commercial products. Regarding methods of lowering sugar intake, sugar replacement and reducing sugar consumption both generally and at home were preferred. In addition, consumers were likely to pay 10~14% more for sugar-reduced products than for existing products. Overall, consumers expressed positive attitudes towards reducing sugar intake in the future, although those in their twenties tended to be more passive than other age groups.