• Tuberculosis and Respiratory Diseases
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• v.52 no.2
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• pp.137-144
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• 2002

Background: Hemoptysis is an often alarming presenting symptom and VEGF is a major regulator of both normal and abnormal angiogenesis, including many inflarrunatory diseases. In this report the clinical significance of the serum VEGF level in patients with hemoptysis was investigated. Methods: Thirty-two patients with hemoptysis were evaluated. The estimated amount of hemoptysis, etiology and serum VEGF level was examined at admission and bronchial angiography was performed in 22 patients. In order to objectify the neovascularization status, one point for the presence of the A-V shunt, hypervascularity, vascular tortuosity was designated for a total of 0-3 points. Results: Mean quantity of hemoptysis was $172.4{\pm}270.4ml$. The mean angiographic neovascularization score was $1.23{\pm}0.75$. The serum VEGF level correlated with the quantity of hemoptysis(r=0.524, p=0.002) and with the angiographic neovascularization score(r=0.441, p=0.04). Using the standard diagnostic criterion for massive hemoptysis, the serum VEGF level of patients with massive hemoptysis($642.4{\pm}545.6$ pg/ml, n=13) was found to be higher than that of patients with non-massive hemoptysis($394.6{\pm}225.8$ pg/ml, n=19) (p=0.069). Conclusion: Regardless of the etiology, the serum VEGF may contribute to abnormal neovascularization in patients with hemoptysis. Therefore, it is suggested that serum VEGF measurements may help in predicting a massive hemoptysis.

• The Korean Journal of Physiology
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• v.2 no.2
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• pp.33-43
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• 1968

Histamine, 0.5 mg as histamine base in 4 ml of normal saline solution, was injected into rabbits anesthetized with nembutal and the mean blood pressure was kept in the range of $52{\sim}80\;mmHg$ for over one hour by supplemental additions. Following the injection of the test substances, 300 mg of urea and 200 mg of antipyrine intravenously, serial blood samples were obtained from the femoral artery and the internal jugular vein at $0.5{\sim}3$ minutes interval. The decreasing patterns in the concentrations of arterial and venous blood plasma samples were compared with each other. The ratio of the concentration of brain tissue to that of the final arterial plasma was also studied. By these measures the degrees of penetration of the test substances in the brain in the control and in the histamine treated rabbits were observed. The concentrations of antipyrine and urea in the arterial blood plasma were decreasing exponentially with respect to the time elapsed. The venous concentrations were anticipated to increase initially and to cross the arterial concentration curve in the point of equlibrium between the plasma and the tissue. On the contrary to the expectation venous concentration also revealed the decreasing tendency similar to that of arterial plasma. The similarity between these two curves, arterial and venous, would be atributable to the fact that the cerebral blood flow rate was large enough and the rising phase in the venous concentration curve was instantly over before serial blood samples were taken. Inspite of some similarity in the decreasing tedency in both concentration curves there were appreciable discrepancies between the arterial and venous plasma which would reflect the situation far from the equlibria among several compartments in the brain. Changes in plasma potassium levels caused by the injection of histamine or bleeding were observed, too. Using 8 rabbits as the control and 12 rabbits for the histamine treated group following results were obtained: 1. Both of the concentration curves, arterial and venous, declined rapidly at_first and slowly later on and approached same equilibrium concentration with the passage of time after a single injection. The time at which attained the same concentration was $2.0{\pm}0.54\;min.$ in the control and $4.3{\pm}1.92\;min.$ in the histamine treated group with respect to antipyrine. On the other hand in the case of urea they were $2.4{\pm}0.59\;min.$ in the control and $4.4{\pm}1.31\;min.$ in the histamine group, respectively. In the histamine treated group enlarged spaces for distribution of test substances were postulated. 2. The concentration of antipyrine in the brain tissue water revealed no significant differences between the control and experimental groups, showing $212{\pm}40.2\;mg/l$ in the control and $206{\pm}64.1\;mg/l$ in the histamine treated group. On the other hand urea revealed higher value in the histamine treated group than in the control, showing an enhanced penetration of urea into the tissue after injection of histamine. Urea concentration in the brain water was $32.3{\pm}3.36\;mg%$ in the control and $39.2{\pm}4.25\;mg%$ in the histamine treated group. 3. The distribution ratio of antipyrine in the brain tissue was very close to unity in the histamine treated animals as well as in the control. 4. The average of the distribution ratio of urea in the control animals was 0.77 and it showed the presence of blood-brain barrier with regard to urea. However in the histamine treated animals the distribution ratios climbed up to 0.86 and they were closer to unity than in the control animals. Out of 12 cases 5 were greater than 0.9 and 8 exceeded 0.85. It appeared that histamine enhanced the penetration of urea through the barrier. 5. Histamine injection and or hemorrhage caused an elevation of the concentration of potassium in plasma. In the event that histamine and hemorrhage were applied together the elevation of potassium exceed the elevation seen at the histamine alone. There was no evidence that the leakage of potassium from the brain tissue was dominant in comparison with the general leakage from the whole body.

• Korean Journal of Agricultural and Forest Meteorology
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• v.11 no.4
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• pp.162-173
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• 2009

Information on the expected geographical shift of suitable zones for growing crops under future climate is a starting point of adaptation planning in agriculture and is attracting much concern from policy makers as well as researchers. Few practical schemes have been developed, however, because of the difficulty in implementing the site-selection concept at an analytical level. In this study, we suggest site-selection criteria for quality Fuji apple production and integrate geospatial data and information available in public domains (e.g., digital elevation model, digital soil maps, digital climate maps, and predictive models for agroclimate and fruit quality) to implement this concept on a GIS platform. Primary criterion for selecting sites suitable for Fuji apple production includes land cover, topography, and soil texture. When the primary criterion is satisfied, climatic conditions such as the length of frost free season, freezing risk during the overwintering period, and the late frost risk in spring are tested as the secondary criterion. Finally, the third criterion checks for fruit quality such as color and shape. Land attributes related to these factors in each criterion were implemented in ArcGIS environment as relevant raster layers for spatial analysis, and retrieval procedures were automated by writing programs compatible with ArcGIS. This scheme was applied to the A1B projected climates for South Korea in the future normal years (2011-2040, 2041-2070, and 2071-2100) as well as the current climate condition observed in 1971-2000 for selecting the sites suitable for quality Fuji apple production in each period. Results showed that this scheme can figure out the geographical shift of suitable zones at landscape scales as well as the latitudinal shift of northern limit for cultivation at national or regional scales.

• Korean Security Journal
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• no.28
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• pp.103-130
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• 2011

This study is the research of enterprise security for raising the profitability and stability of Korean companies in global business environment and strategic cooperation of business. As the scientific technology gets complicated as day goes by and new competitors appear regardless the border in the modern business environment, the situation happens frequently which the huge company hands over their market to the new one armed with the innovative thinking overnight. To survive such new environment, the answer is the change of paradigm regarding business management method at the new point of view. With the low level of security risk management of Korean companies which stick to old habit, the security management which helps the companies secure profits is not affordable. The global village where the population of 7 billions live in 21st century is facing up to the rapid ecological adaptation. The rapid change of climatic environment creates the hundreds of thousands of sufferers in a moment, and we have been watching the millions of livestock are buried alive due to new contagious disease everyday. Such change encourages the humans in global village to change the basic way of living. The business ecosystem which is the basic root for economic life cannot be an exception. To survive the business environment of 21st century, the security risk management at management level is required and the reporting line of companies should be established newly for raising business competing power through security risk management. The companies should bear in mind that they can be disappeared into our old memories overnight if they are not sensitive to the changing environment. Out of new risks for the modern companies, the field especially Korean companies are dealing easily is the security risk. Not like past, the security risk which's size is much more massive and its propagation velocity is very fast is the one of important business risks which the management should take care. Out of security risks which influence on the modern companies significantly, the brand of companies, protection of their reputation, continuity of production and operation and keeping customer's trust are prior to the others. This study offered the suggestion regarding enterprise security and the strategic cooperation of business to deal with such security risk effectively.

• Journal of Korean Society of Steel Construction
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• v.23 no.4
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• pp.417-428
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• 2011

Depending on the plastic deformation capacity required, structural steel design under the current codes can be classified into three categories: elastic, plastic, and seismic design. Most of the current steel codes explicitly forbid the use of a steel material with a yield strength higher than 450 MPa in the plastic design because of the concerns about its low plastic deformation capacity as well as the lack of test data on local and lateral torsional buckling behavior. In this study, flexural tests on full-scale H-shape members built with SM490A (ordinary steel or benchmark material) and HSB800 (high-strength steel) were carried out. The primary objective was to investigate the appropriateness of extrapolating the local buckling criterion of the current codes, which was originally developed for normal-strength steel, to the case of high-strength steel. All the SM490A specimens performed consistently with the current code criteria and exhibited sufficient strength and ductility. The performance of the HSB800 specimens was also very satisfactory from the strength perspective; even the specimens with a noncompact and slender flange developed the plastic moment capacity. The HSB800 specimens, however, showed an inferior plastic rotation capacity due to the premature tensile fracture of the beam bottom flange beneath the vertical stiffener at the loading point. The plastic rotation capacity that was achieved was less than 3 (or the minimum level required for a plastic design). Although the test results in this study indicate that the extrapolation of the current flange local-buckling criterion to the case of high-strength steel is conservative from the elastic design perspective, further testing together with an associated analytical study is required to identify the causes of the tensile fracture and to establish a flange slenderness criterion that is more appropriate for high-strength steel.

• Journal of Christian Education in Korea
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• v.67
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• pp.301-337
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• 2021

The researcher looked at the differences in views and various controversies surrounding Korean youth sexuality education in the wake of the Nth Room incident, which had a great impact on modern Korean society. Sex education for adolescents in Korea can be divided into public sex education through school sex education and the Youth Sexuality Center, and conservative/traditional Protestant sex education. Public sex education is partly influenced by feminist sexual ethics and comprehensive sex education abroad. Based on gender sensitivity and the right to sexual self-determination, four major projects are prevention of sexual harassment, prostitution, sexual violence, and domestic violence. However, the school sex education standard was criticized for stereotypes of gender roles and gender-discriminatory content, reinforced distorted myths about sexual violence, and exclusion of sexual diversity and various family types. Conservative/traditional Protestantism is based on the normal family ideology such as bisexual marriage, premarital chastity, and sexual ethics recognized only within marital relationships. It is a form of confrontation with public sex education while strongly opposing it. The researcher first analyzed the characteristics of public sex education, conservative/traditional Protestant sexual ethics and sex education, feminist sex ethics and sex education, and overseas youth sex education, respectively, while composing the curriculum for Korean youth sexuality education. And as a more fundamental solution to youth sexuality education, I pointed out that there are limits to asceticism, premarital chastity, gender sensitivity and sexual self-determination education, and found an alternative to the concept of body and sex in feminist theology. The researcher pointed out that it is necessary to reconceptualize the body and sex under the recognition that the most fundamental cause of distorted sexual culture is dualistic sex and understanding the body, centering on the research of various feminist theologians. And this was conceptualized into three concepts: holistic sexuality, mutual solidarity understood in relationships with others, and sexuality as a spirituality that extends to the global community. And with each curriculum, 1) Holistic Sexuality: Breathing, Narrative, Making the Shape of One's Body and Mind 2) mutual solidarity : Feeling the Breath of Others, Media Literacy through Conscientization, Sending a Good Wind 3) Sexuality as a spirituality that extends to global concern: It was proposed to pay attention to nature and to co-cultivate it, to listen to the earth's moans and create a new way of life, and to write a prayer with the earth and fellow living beings.

• Journal of Aquaculture
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• v.2 no.2
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• pp.53-90
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• 1989

Feeding proper level of ration matchable with the appetite of fish will enhance production and also prevent waste of food and its consequence, side effects such as pollution of culture medium. To pursue this goal, elaborate studies on dissolved oxygen concentrations- as the major force in inducing appetite and the growth outcome are necessary. The growth of common carp of 67, 200, 400, 600, and 800 gram size groups was studied at oxygen concentrations ranging from 2.0 to 6 mg/$\iota$ in relation to rations from 1 to as many percent of the initial body weight as could be consumed under constant temperature of $25^{\circ}C$. The results from the experiments are summarized as followings; 1. Appetite: The smaller fish exhibited higher degree of appetite than the bigger ones at the same oxygen concentrations. The bigger the fish the less tolerant it was to the lower oxygen thersholds, and the degree of tolerence decreased as ration level increased. 2. Growth : Growth rate (percent per day) increased - unless consumption was suppressed by low oxygen levels- as the ration was increased to maximum. In case of 67 g fish, it reached the highest point of $5.05\%$ / day at $7\%$ ration under 5.0 mg/$\iota$ of oxygen. In case of 200 g fish, the maximum growth rate of $3.75\%$/day appeared at the maximum ration of $6\%$ under 5.5 mg/$\iota$ of oxygen. In 400 g fish, the highest growth of $3.37\%$/day occurred at the maximum ration of $5\%$ and 6.0 mg/$\iota$ of oxygen. In 600 g fish, the highest growth rate of $2.82\%$ /day was at the maximum ration of $4\%$ under 5.5 mg/$\iota$ oxygen. In case of 800g fish, the highest growth rate of $1.95\%$/day was at maximum tested ration of $3\%$ under 5.0 mg/$\iota$ oxygen. 3. Food Conversion Efficiency: Food conversion efficiency ($\%$ dry feed converted into the fish tissue) first increased as the ration was increased, reached maximum at certain food level, then started decreasing with further increase in the ration. The maximum conversion efficiency stood at higher feeding rate for the smaller fish than the larger ones. In case of 67 g fish, the maximum food conversion efficiency was at $4\%$ ration within 3.0-4.0 mg/$\iota$ oxygen. In 200g fish, the maximum efficiency was at $3\%$ ration within 4.0-4.5 mg/$\iota$ oxygen. In 400g fish, the maximum efficiency was at $2\%$ ration within 4.0 - 4.5 mg/$\iota$ oxygen. In 600 and 800g fish, the maximum conversion efficiency shifted to the lowest ration ($1\%$) and lower oxygen ranges. 4. Behaviour: The fish within uncomfortably low oxygen levels exhibited suppressed appetite and movements and were observed to pass feces quicker and in larger quantity than the ones in normal condition; in untolerably low oxygen the fish were lethargic, vomited, and had their normal skin color changed into pale yellow or grey patches. All these processes contributed to reducing food conversion efficiency. On the other hand, the fish within relatively higher oxygen concentrations exhibited higher degree of movement and their food conversion tended to be depressed when compared with sister groups under corresponding size and ration within relatively low oxyen level. 5. Suitability of Oxygen Ranges to Rations: The oxygen level of 2.0- 2.5 mg/$\iota$ was adequate to sustain appetite at $1\%$ ration in all size groups. As the ration was increased higher oxygen was required to sustain the fish appetite and metabolic activity, particularly in larger fish. In 67g fish, the $2\%$ ration was well supported by 2.0-2.5 mg/$\iota$ range; as the ration increased to $5\%$, higher range of 3.0-4.0 mg/$\iota$ brought better appetite and growth; from 5 till $7\%$ (the last tested ration for 67 g fish) oxygen levels over 4.0 mg/$\iota$ could sustain appetite. In 200 g fish, the 2 and $3\%$ rations brought the best growth and conversion rates at 3.5-4.5 mg/$\iota$ oxygen level; from 3 till $6\%$ (the last tested ration at 200 g fish) oxyge groups over 4.5 mg/$\iota$ were matchable with animal's appetite. In 400, 600, and 800 g fish, all the rations above $2\%$ had to be generally supported with oxygen levels above 4.5 mg/$\iota$.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.3-8
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• 2010

Purpose: $^{11}C$-Acetate PET/CT is useful in detecting lesions that are related to livers in the human body and leads to a sensitivity of 87.3%. On the other hand, $^{18}F$-FDG PET/CT has a sensitivity of 47.3% and it has been reported that if both $^{18}F$-FDG and $^{11}C$-Acetate PET/CT are carried out together, their cumulative sensitivity is around 100%. However, the normal intake of the pancreas and the spleen in $^{11}C$-Acetate PET/CT can influence the $^{18}F$-FDG PET/CT leading to an inaccurate diagnosis. This research was aimed at the verification of the usefulness of how much influence these two radioactive medical supplies can cause on the medical images through comparative analysis between the one-day and two-day protocol. Materials and Methods: This research was carried out based on 46 patients who were diagnosed with liver cancer and have gone through the PET/CT (35 male, 11 female participants, average age: $54{\pm}10.6$ years, age range: 29-69 years). The equipment used for this test was the Biograph TruePoint40 PET/CT (Siemens Medical Systems, USA) and 21 participants who went through the one-day protocol test were first given the $^{11}C$-Acetate PET/CT and the $^{18}F$-FDG PET/CT, the latter exactly after one hour. The other 25 participants who went through the two-day protocol test were given the $^{11}C$-Acetate PET/CT on the first day and the $^{18}F$-FDG PET/CT on the next day. These two groups were then graded comparatively by assigning identical areas of interest of the pancreas and the spleen in the $^{18}F$-FDG images and by measuring the Standard Uptake Value (SUV). SPSS Ver.17 (SPSS Inc., USA) was used for statistical analysis, where statistical significance was found through the unpaired t-test. Results: After analyzing the participants' medical images from each of the two different protocol types, the average${\pm}$standard deviation of the SUV of the pancreas carried out under the two-day protocol were as follows: head $1.62{\pm}0.32$ g/mL, body $1.57{\pm}0.37$ g/mL, tail $1.49{\pm}0.33$ g/mL and the spleen $1.53{\pm}0.28$ g/mL. Whereas, the results for participants carried out under the one-day protocol were as follows: head $1.65{\pm}0.35$ g/mL, body $1.58{\pm}0.27$ g/mL, tail $1.49{\pm}0.28$ g/mL and the spleen $1.66{\pm}0.29$ g/mL. Conclusion: It was found that no statistical significant difference existed between the one-day and two-day protocol SUV in the pancreas and the spleen (p<0.05), and nothing which could be misconceived as false positive were found from the PET/CT medical image analysis. From this research, it was also found that no overestimation of the SUV occurred from the influence of $^{11}C$-Acetate on the $^{18}F$-FDG medical images where those two tests were carried out for one day. This result was supported by the statistical significance of the SUV of measurement. If $^{11}C$-Acetate becomes commercialized in the future, the diagnostic ability of liver diseases can be improved by $^{18}F$-FDG and one-day protocol. It is from this result where tests can be accomplished in one day without the interference phenomenon of the two radioactive medical supplies and furthermore, could reduce the waiting time improving customer satisfaction.

• Journal of the Korean Society of School Health
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• v.5 no.2
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• pp.42-65
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• 1992

A survey was made of 976 students who were selected among students of 5 middle schools at Taegu so that it could furnish basic knowledge about sex education of adolescents by analyzing students recognition of sex, acquaintance with the opposite-sex, sex-education, The survery took a month from Nov. 1, to Nov 30, 1991. The results of this study are summarized as follows. 1. The general characteristics of the surveyed students. The survey consisted of 332 boys middle school student & 325 girls middle school students, 157 male & 162 female students of coeducational middle schools. 32.9% of them were from the first grade, 33.2% from the second grade & 33.9% from the third grade. 35.7% of them believed in Buddhism, 19% Christianism and the mode of their living standard, 86.7%, fell on 34.7% of their parents engaged in commerce and they were followed by salary man and public officals, 93.1 % of the students, parents were alive. 44.9% of their fathers were graduates of high school and 42.2% of their mothers middle school. 2. Sexual maturity 89.1 % of the surveyed girls had experienced menstruation. The mode of first menstruation, 48.2%, was at the age of 13 and the mean of it was 12.9, 3.7% the surveyed boys had exprienced a wet drem before. The mode of the first wet dream, 40.0%, was at the age of 14 and the mean was 13.4. 21.3% of surveyed students had the experience of masturbation but the number of girls fell far short of that boys. The mode of the first masturbation, 37.0%, was at the age of 14 and the mean was 13.4. 3. The acquaintance and sexual relations with the opposite sex 1) Analyzing the students actual conditions with the opposite, I found out that 52.3% of them wanted to have any kind of relations with the opposite and that 30.25 had already had some kind of relations. 73.2% of the students having relations with the opposite thought the other sex merely as a friend and the number of students who were thinking that way was distributed evenly among schools. 28.8% of the students had got acquainted with the other sex through their frieds and there were not much difference between boys and girls in the method of getting acquainated with the opposite. About 35.2% of the students having relations with the opposite came from the third grade. 47.8% of them answered that the meeting place was not fixed and 26.4% answered that they were meeting their parthers outdoors. 60.7% replyed that they were not disturbed in their studies by the relations with the other sex. 2) Most of the students 79.4%, answered that they had never had sexual relations and 16.3% of the rest said that thery were expressing their feelings by grasping each other's hand. 3) 16.6% of the surveyed students asid that they had the exprience of smoking, 1.1 % of an illusion caused by inhaling chemical addhesives, 44.0% of drinking and 41.4% of warching pornographic films. 4. The knowledge and attitude about the sex 1) The distribution and analysis according to schools and grades : 64.8% of the surveyed students answered correctly to the questions about mensturation, 49.3 % did so about wet dreams, 94.3 % did so about conception, 60.6% did so about child birth, 73.9% did so about AIDS and 50.1 % did so about sexual diseases. Roughly speaking, they had not much knowledge of sexual diseases. 2) The recognition of sex according to schools and grades : 39.0% of the students said that they had worries about sex. 33.1 % of what they worried was concerned with their bodies and 26.8% was about the acqaintance and relationship with the opposite sex. The girls were much more concerned about the former and the boys the latter. 51.1 % of the students asid that they had no specific opinion of masturbation but 19.2% said that's alright if self-restrained. About the sexual intercourse before marriage, 75.7% said negatively. 5. The need for sex education most of the students, 99.4% said they needed sex education and there was not much difference in that thought among schools. And 49.7% answered that schools, families, and societies were equlally important in sex education. About half of the students, exactly 50.2%. considered it as the main reason of sex education to prevent accidents cauesd by ignorance of sex. 81.4% said that they had had some kind of sex education. Most of the educations, 87.0%, had taken place at schools but 5.2% said they were getting most of the knowledge about sex from therir friednds, juniors and seniors. 59.5% of the students who had ever had a sex education said "Just so, so" when asked of the level of their contentment but the number of students who said "satisfied" was only a few, 16.1 %. 20.7% of the survered answered that thery wanted sex education to be made in the course of home life, and 26.6 % of the students most wanted to know about the acquaintance and relationship with the oppostie sex, 29.0% preferred nurse teachers as proper councellors of sex education. The mode of their present councellors, 42.0%, was friends but only 7.6% answered they dicussed with teachers. 6. The correlation analysis between general characteristcs and sexual behaviors of the surveyed students revealed that sex had a signigicant(P<0.001) positive correlation with parents' love toward students(P<0.01), the experience of masturbation, smoking, an illusion caused by inhaling chemical adhesives and the experience of watching pornographic films. And the standard of living had a significant(P<0.01) positive correlation(P<0.01) with grade point average, parents' existence(P<0.01) and parents' love, but a significant(P<0.01) negative correlation with sexual worries. grade point average had a significant(P<0.01)negative correlation with the experience of an illusion caused by chemical adhesives(P<0.01) and smoking. Parents' existence had significant(P<0.01) positive correlations with parents' love and smoking but a significant(P<0.01) negative correlation with the experience of an illusion by chemical adhesives. There was a significant(P<0.01) negative correlations between parents' love and the experience of an illusion by chemical adhesives, and a significant(P<0.001) positive correlation among masturbation and sexual worries, smoking, an illusion by chemical adhesives and the experience of watching pornographic films. There was a significant(P<0.001) positive correlation among acquaintance with the opposite sex, smoking, the experience of an illusion by chemical adhesives and watching pornographic films. Sexual worries had significant(P<0.01) positive correlations with smoking, the experience of an illusion by chemical adhesives and watching pornographic films. smoking had a significant positive correlation with drinking the experirence of, an illusion by chemical adhesives and watching pornographic films. Finally, there was a significant(P<0.01) positive correlation between the drinking experience and the illusion experience by chemical adhesives. According to the results mentioned above, the fact is certain that there is a great need for sex education of adolescents. Therefore, it is desirable that the schools teach sexual physiology and normal positively and that sex education including hygien education be an independant course in the curriculums. Furthermore, it is essential that the schools should have enough nurse teachers to take up sex education, expand training opportunities for them and that they develop educational materials. Considering the unbalance of the level of sex educations between boys and girls, I want to suggest that all boys and girls have sex education evenly and lead happy lives by correction irrational thought about sex, that is to say, sex discrimination, Sex education programs, especially of middle school students, should be reexamined if it is to give the students effective and profitable knowledge about sex. In addition, the government should establish a policy of adolescents' sex education to have healthy opinions of sex settled nationwide.

• Journal of agricultural medicine and community health
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• v.1 no.1
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• pp.29-36
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• 1976

Introduction Recently, changes in the patterns and concepts of maternity care, in both developing and developed countries have been accelerating. An outstanding development in this field is the number of deliveries taking place in hospitals or maternity centers. In Korea, however, more than 90% of deliveries are carried out at home with the help of untrained relatives or even without helpers. It is estimated that less than 10% of deliveries are assisted by professional persons such as a physician or a midwife. Taking into account the shortage of professional person i11 rural Korea, it is difficult to expect widespread prenatal, postnatal, and delivery care by professional persons in the near future, It is unrealistic, therefore, to expect rapid development of MCH care by professional persons in rural Korea due to economic and sociological reasons. Given these conditions. it is reasonable that an educated village women could used as a "maternity aid", serving simple and technically easy roles in the MCH field, if we could give such a women incentive to do so. The midwife and physician are assigned difficult problems in the MCH field which could not be solved by the village worker. However, with the application of the village worker system, we could expect to improve maternal and child hoalth through the replacement of untrained relatives as birth attendants with educated and trained maternity aides. We hope that this system will be a way of improving MCH care, which is only one part of the general health services offered at the local health centre level. Problems of MCH in rural Korea The field of MCH is not only the weakest point in the medical field in our country hut it has also dropped behind other developing countries. Regarding the knowledge about pregnancy and delivery, a large proportion of our respondents reported having only a little knowledge, while 29% reported that they had "sufficient" knowledge. The average number of pregnancies among women residing in rural areas was 4.3 while the rate of women with 5 or more pregnancies among general women and women who terminated childbearing were 43 and 80% respectively. The rate of unwanted pregnancy among general women was 19.7%. The total rate for complications during pregnancy was 15.4%, toxemia being the major complication. The rate of pregnant women with chronic disease was 7%. Regarding the interval of pregnancy, the rates of pregnancy within 12 months and within 36 months after last delivery were 9 and 49% respectively. Induced abortion has been increasing in rural areas, being as high as 30-50% in some locations. The maternal death rate was shown 10 times higher than in developed countries (35/10,000 live births). Prenatal care Most women had no consultation with a physician during the prenatal period. Of those women who did have prenatal care, the majority (63%) received such care only 1 or 2 times throughout the entire period of pregnancy. Also, in 80% of these women the first visit Game after 4 months of gestation. Delivery conditions This field is lagging behind other public health problems in our country. Namely, more than 95% of the women deliveried their baby at home, and delivery attendance by a professional person occurred only 11% of the time. Attendance rate by laymen was 78% while those receiving no care at all was 16%. For instruments used to cut the umbilical corn, sterilized scissors were used by 19%, non-sterilized scissors by 63% and 16% used sickles. Regarding delivery sheets, the rate of use of clean sheets was only 10%, unclean sheets, vinyl and papers 72%, and without sheets, 18%. The main reason for not using a hospital as a place of delivery was that the women felt they did not need it as they had previously experience easy deliveries outside hospitals. Difficult delivery composed about 5% of the total. Child health The main food for infants (95%) was breast milk. Regarding weaning time, the rates within one year, up to one and half, two, three and more than three years were 28,43,60,81 and 91% respectively, and even after the next pregnancy still continued lactation. The vaccination of children is the only service for child health in rural Korea. As shown in the Table, the rates of all kinds of vaccination were very low and insufficient. Infant death rate was 42 per 1,000 live births. Most of the deaths were caused by preventable diseases. Death of infants within the neonatal period was 83% meaning that deaths from communicable diseases decreased remarkably after that time. Infant deaths which occurred without medical care was 52%. Methods of improvement in the MCH field 1. Through the activities of village health workers (VHW) to detect pregnant women by home visiting and. after registration. visiting once a month to observe any abnormalities in pregnant women. If they find warning signs of abnormalities. they refer them to the public health nurse or midwife. Sterilized delivery kits were distributed to the expected mother 2 weeks prior to expected date of delivery by the VHW. If a delivery was expected to be difficult, then the VHW took the mother to a physician or call a physician to help after birth, the VHW visits the mother and baby to confirm health and to recommend the baby be given proper vaccination. 2. Through the midwife or public health nurse (aid nurse) Examination of pregnant women who are referred by the VHW to confirm abnormalities and to treat them. If the midwife or aid nurse could not solve the problems, they refer the pregnant women to the OB-GY specialist. The midwife and PHN will attend in the cases of normal deliveries and they help in the birth. The PHN will conduct vaccination for all infants and children under 5, years old. 3. The Physician will help only in those cases referred to him by the PHN or VHW. However, the physician should examine all pregnant women at least three times during their pregnancy. First, the physician will identify the pregnancy and conduct general physical examination to confirm any chronic disease that might disturb the continuity of the pregnancy. Second, if the pregnant woman shows any abnormalities the physician must examine and treat. Third, at 9 or 10 months of gestation (after sitting of the baby) the physician should examine the position of the fetus and measure the pelvis to recommend institutional delivery of those who are expected to have a difficult delivery. And of course. the medical care of both the mother and the infants are responsible of the physician. Overall, large areas of the field of MCH would be served by the VHW, PHN, or midwife so the physician is needed only as a parttime worker.