• Pediatric Infection and Vaccine
• /
• v.4 no.2
• /
• pp.210-217
• /
• 1997

Purpose: To prevent residual physical disability and chronic infection, prompt diagnosis and adequate treatment are important in the skeletal infections in children. Although radioisotope scanning is knwon as the method of choice for early diagnosis of bone infection, we conducted a study on twenty nine children who had skeletal infections to reevaluate the most appropriate way in diagnosis and management. Methods: A retrospective study was conducted on twenty nine children, who were admitted to the departments of Pediatrics and Orthopedic Surgery and who had acute osteomyelitis or septic arthritis, through review of medical records, radiologic & radioisotope study results. Their diagnoses were confirmed by bacteriologic cultures on the aspirated specimens from suspected bony lesions. Results: 1) Among twenty nine patients, there were 6 infants including 5 newborn infants, and 23 children were aged between 1 and 15 years. Male to female ratio was 1.4 to 1. 2) Point tenderness was noted in all cases, and the common physical signs were swelling, limitation of motion, fever and local heat in the order of frequency. 3) Fifty two percents of the patients were diagnosed within a week after onset of symptoms and all cases were within 15 days. 4) Leukocytosis was noted in only 58.6% of cases but erythrocyte sedimentation rate was increased in all cases except only one case. Staphylococcus aureus was revealed as the most common etiologic agent. 5) Radioisotope scans showed hot uptake in five of six cases(83.3%) who had no abnormal finding on plain skeletal radiolograms. Conclusions: Although radioisotope scan and MRI are helpful in early diagnosis before radiologic finding was detected on plain X-ray film, the antimicrobial therapy can be started after bacteriologic study of the aspirated specimens from the suspected skeletal lesions if skeletal infection is highly suspected clinically.

• Pediatric Infection and Vaccine
• /
• v.4 no.2
• /
• pp.265-270
• /
• 1997

Purpose: Rapid diagnosis and prompt treatment remain the cornerstone of management of patients with meningitis. Examination of cerebrospinal fluid(CSF) for glucose, protein, cells, and organisms is necessary for accurate diagnosis, but in many parts of the world facilities do not exist to do so. We tested CSF samples from 69 children with suspected meningitis with urinary reagent strips and analyzed the results to know the usability of urinary reagent strips in diagnosis of meningitis. Methods: 69 CSF samples obtained from children with suspected meningitis were analysed. Each sample was divided into two; one was sent to the laboratory for routine diagnostic evaluation, and the other was tested with the reagent strip(Combur10 Test M). Laboratory values of CSF glucose, protein, and leucocytes for each CSF sample were plotted against the corresponding reagent-strip category. Results: There was good agreement between the dipstick and laboratory values for CSF protein and cell count but not for glucose. Conclusion: Rapid diagnosis of meningitis could be made with three component of the Combur10 test strip. It is easy to do and would be of particular value to those working in parts of the world where no laboratory facilities exist.

• Pediatric Infection and Vaccine
• /
• v.18 no.2
• /
• pp.124-134
• /
• 2011

Purpose : We have tried to search all concerning data on the policies of hepatitis B vaccination or surveillance of medical equipments that can transmit blood mediated diseases, including disposable syringe, in Republic of Korea, to propose references to other medical professionals. Methods : Data from domestic journals, government websites, computerized newspapers, etc. were reviewed. The data were arranged into four categories (governmental policies on hepatitis B control, hepatitis B mass immunization program in school, using process of hepatitis B vaccine, and policies on medical equipments surveillance, including disposable syringes, which is considered as source of blood mediated infection), and the periodic changes on each subjects in policies were reviewed. Results : Due to growing social concerns on hepatitis B in early 1980s, swift introduction and production of hepatitis B vaccine was made. After establishment of "5 year project for eradication of hepatitis B" in late 1983, number of vaccinated population jumped up to 6 million within 2 years (1984-85). However, since the immunization targets were mainly adult, not infant, this project was annulled in late 1985. Following this project, hepatitis B mass immunization program in school was carried out. In year 1995, hepatitis B vaccine was included in national immunization program. The use of disposable syringe was recommended from year 1980 but legislated in year 1985, finally. Conclusion : The mainstay in controlling hepatitis B in Republic of Korea was coordination of prompt introduction of vaccine, mass immunization, high vaccination coverage rate, or use of disposable syringes. However, since there is lack of official data available, it is urgent to arrange and computerize all government data related to infectious diseases.

• Journal of Preventive Medicine and Public Health
• /
• v.16 no.1
• /
• pp.135-152
• /
• 1983

Emergency medical service is an important part of the health care delivery system, and the optimal allocation of resources and their efficient utilization are essentially demanded. Since these conditions are the prerequisite to prompt treatment which, in turn, will be crucial for life saving and in reducing the undesirable sequelae of the event. This study, taking the hyperbaric chamber for carbon monoxide poisoning as an example, is to develop a stochastic approach for solving the problems of optimal allocation of such emergency medical facility in Korea. The hyperbaric chamber, in Korea, is used almost exclusively for the treatment of acute carbon monoxide poisoning, most of which occur at home, since the coal briquette is used as domestic fuel by 69.6 per cent of the Korean population. The annual incidence rate of the comatous and fatal carbon monoxide poisoning is estimated at 45.5 per 10,000 of coal briquette-using population. It offers a serious public health problem and occupies a large portion of the emergency outpatients, especially in the winter season. The requirement of hyperbaric chambers can be calculated by setting the level of the annual queueing rate, which is here defined as the proportion of the annual number of the queued patients among the annual number of the total patients. The rate is determined by the size of the coal briquette-using population which generate a certain number of carbon monoxide poisoning patients in terms of the annual incidence rate, and the number of hyperbaric chambers per hospital to which the patients are sent, assuming that there is no referral of the patients among hospitals. The queueing occurs due to the conflicting events of the 'arrival' of the patients and the 'service' of the hyperbaric chambers. Here, we can assume that the length of the service time of hyperbaric chambers is fixed at sixty minutes, and the service discipline is based on 'first come, first served'. The arrival pattern of the carbon monoxide poisoning is relatively unique, because it usually occurs while the people are in bed. Diurnal variation of the carbon monoxide poisoning can hardly be formulated mathematically, so empirical cumulative distribution of the probability of the hourly arrival of the patients was used for Monte Carlo simulation to calculate the probability of queueing by the number of the patients per day, for the cases of one, two or three hyperbaric chambers assumed to be available per hospital. Incidence of the carbon monoxide poisoning also has strong seasonal variation, because of the four distinctive seasons in Korea. So the number of the patients per day could not be assumed to be distributed according to the Poisson distribution. Testing the fitness of various distributions of rare event, it turned out to be that the daily distribution of the carbon monoxide poisoning fits well to the Polya-Eggenberger distribution. With this model, we could forecast the number of the poisonings per day by the size of the coal-briquette using population. By combining the probability of queueing by the number of patients per day, and the probability of the number of patients per day in a year, we can estimate the number of the queued patients and the number of the patients in a year by the number of hyperbaric chamber per hospital and by the size of coal briquette-using population. Setting 5 per cent as the annual queueing rate, the required number of hyperbaric chambers was calculated for each province and for the whole country, in the cases of 25, 50, 75 and 100 per cent of the treatment rate which stand for the rate of the patients treated by hyperbaric chamber among the patients who are to be treated. Findings of the study were as follows. 1. Probability of the number of patients per day follows Polya-Eggenberger distribution. $$P(X=\gamma)=\frac{\Pi\limits_{k=1}^\gamma[m+(K-1)\times10.86]}{\gamma!}\times11.86^{-{(\frac{m}{10.86}+\gamma)}}$$ when$${\gamma}=1,2,...,n$$$$P(X=0)=11.86^{-(m/10.86)}$$ when $${\gamma}=0$$ Hourly arrival pattern of the patients turned out to be bimodal, the large peak was observed in $7 : 00{\sim}8 : 00$ a.m., and the small peak in $11 : 00{\sim}12 : 00$ p.m. 2. In the cases of only one or two hyperbaric chambers installed per hospital, the annual queueing rate will be at the level of more than 5 per cent. Only in case of three chambers, however, the rate will reach 5 per cent when the average number of the patients per day is 0.481. 3. According to the results above, a hospital equipped with three hyperbaric chambers will be able to serve 166,485, 83,242, 55,495 and 41,620 of population, when the treatmet rate are 25, 50, 75 and 100 per cent. 4. The required number of hyperbaric chambers are estimated at 483, 963, 1,441 and 1,923 when the treatment rate are taken as 25, 50, 75 and 100 per cent. Therefore, the shortage are respectively turned out to be 312, 791. 1,270 and 1,752. The author believes that the methodology developed in this study will also be applicable to the problems of resource allocation for the other kinds of the emergency medical facilities.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.21 no.1
• /
• pp.60-64
• /
• 2017

Purpose Westgard multi-rules application based on test quality improvement and commercialized international standard has been widely used in quality control. However, it is difficult to applicate the Westgard multi-rules in nuclear medicine in vitro tests due to the larger sample sizes and the simultaneous measurement of quality control material and patient sample. This study investigated the usefulness of Westgard multi-rules application in nuclear medicine in vitro tests. Materials and Methods A total of 282 systematic error multi-rules (22s, 101s) recorded in the samsung medical center computer system from January 2013 to June 2016 along with 117 cases of corrective measure record was analyzed. The Quality control implementation is recorded in Hospital information system were divided into 4 high-level areas including quality control material error, experimental procedural error, Kit lot number management error, and others. To prevent quality control material error, the existing method that each staff used their own method was changed. The staff who in charge of managing the quality control material was designated and daily consumption amount of every test was strictly controlled by one person. To prevent other errors, every test step was standardized so that the entire test procedures are identically implemented. Results The total quality control implementation was 117 cases; As a result, 62 quality control material errors were 62 cases, experimental process errors were 24 cases, Kit lot number control errors were 18 cases, and other errors were 13 cases. The quality control material error was corrected and could be used fresh materials within 2 days after thawing. The cases of systemic error were decreased to causes as quality control material error. The quality control materials were reduced above 10 vials to a monthly average. In addition, these errors of experimental processing and Kit lot number were improved by test standardization. Consequently, the cases of 101s and 22s in systematic error rules decreased at least 2 cases to a monthly average. Conclusion To confirm of systematic error through multi-rules application quickly, it is necessary to base on management of the QC material, target values and standard deviation. Moreover, in the event of a systematic error, it was found important to record measures based on test cause analysis. The experiment results are expected to contribute to internal quality control improvement and prompt and accurate result reporting through error recording and causal analysis based on Westgard multi-rules analysis.

• Korea journal of population studies
• /
• v.11 no.1
• /
• pp.58-75
• /
• 1988

1.Objectives of the Study It is a well known fact that a prompt and reliable data on demographic information is essential in a proper planning and evaluation of any program of national or community level. Especially vital statistics are an important demographic component among demographic information. Realizing the importance of vital statistics, the government has made some efforts for years to improve the vital registration system which has a close relationship with the production of vital statistics. However, it is still observed that there are some limitations in utilizing vital registration data due to considerable amount of vital events which are never registered and registered but not in time or inaccurately, even though vital registration system in Korea has sound legal basis. In this connection, the objectives of the study is as follows :(1) To examine some problems of the vital registration system in various aspects, (2) To make improvement programme of continuous Demographic Survey as a supplementary source of vital statistics, and (3) To find out some alternatives for making it possible to produce and utilize the reliable vital statistics by developing analytical methodologies on that. 2. Current Situation of Vital Registration System All the vital events, i.e. births, deaths, marriages and divorces, are to be registered in time under the Civil Registration Law, Statistics Law and Regulation on Vital Statstics as a duty of people. Some recent tendencies in each of recent registration are summarized as below: (1) The completeness of vital registration .Out of all births which are occurred during a year, around 75% of those compared to the estimates are registered in the year of occurrence. .In case of death registration, the percentage of registration in the year of occurrene has been gradually increased from 86.2% in the year of 1980, but it is still below the level of 90% compared to the estimates. .The percentage of registration for marriages and divorces in the year of occurrence out of total registered numbers was revealed to be 69% and 73% respectively in 1985. (2) Continuous Demographic Survey .It is a kind of sample survey for the purpose of producing reliable vital statistics which could not be provided by the vital registration. .It covers about 17, 000 sample households at national level and important information for vital events are collected in every month by 323 expertized enumerators who are regular staff of the government. .Although the result of the survey seems to be more reliable than of vital registration, the reliability of the data is still bellow the acceptable level if compared with relevant information from other sources such as population census or special surveys. 3. Problems of Vital Registration System There are four major obstacles in improving vital registration system in Korea; (1) In general, policy priority is not given on any programme of improving vital registration system. It is, therefore, very difficult to formulate comprehensive programme through having cooperation from related authorities and sufficient financial assistance. (2) In all the laws related and system itself, there is substantial degree of overlap and irrationality. Registration of each vital event is maintained according to several laws and regulation such as Civil Registration Law, Statistics Law, Resident Registration Law and Regulation on Vital Statistics. However they are mutually overlapped and overall supervision can not be done systematically due to lack of co-operation among the authorities concerned. (3) The administration of vital registration system seems to be working inefficiently, because of most of civil servants who are in charge of vital registration are lacking of conception on vital statistics and also there is a certain extent of regidity in handling the works. Therefore, they are doing their jobs in a passive way. (4) A substantial proportion of vital events occurred is not registered within the legal time limit (i.e. within one month after the occurrence in case of birth and death) or not registered forever. Some of social customs and superstitution seem to be the potential causes especially in case of births and deaths. 4. Recommendations for the Improvement of Vital Statistics (1) Reporting systems such as civil registration, vital statistics and resident registration should be integrated under the single law. Also, administrative supervision, personnel and budget with regard to the registration system should be under the control of a single ministry. (2) It is necessary to simplify the procedures and methods of reporting vital events, i.e., reducing number of sheets of the form, making corrections easily, reducing registration items, etc. (3) Continuous Demographic Survey as a supplementary source of vital registration should be improved and special ad-hoc surveys should be conducted wth regular interval. (4) In-depth analysis should be done using various sources of data on vital statistics. 5. Concluding Remarks From this study, we can notice that temporary campaign and motivation programs are not sufficient to improve the quality of vital statistics. Strong intentions and continuous efforts of the government are needed for the improvement of the vital registration system. Furthermore, most of the data collected through the registration are not properly analyzed and utilized, partly due to the lack of appreciation among high-level governmental officials of the need for vital statistics. It is, therefore, requested that long-term improvement programs of vital statistics be implemented with policy priority and continuous efforts be given to this purpose as a long-term goal of development in Korea.

• Korean Journal of Soil Science and Fertilizer
• /
• v.34 no.1
• /
• pp.33-41
• /
• 2001

Enormous volumes of mining wastes from the abandoned and closed mines are disposed without a proper treatment in the upper Okdong River basin at Southeastern part of Kangwon Province. Erosion of these wastes contaminates soil, surface water, and sediments with heavy metals. Objectives of this research were to fractionate heavy metals in the mine tailing stored in the Sangdong Tungsten tailing dams and to assess the potential pollution index of each metal fraction. Tailing samples were collected from tailing dams at different depth and analyzed for physical and chemical properties. pH of tailings ranged from 7.3 to 7.9. Contents of total N and organic matter were in the ranges of 3.2~5.5%, and 1.3~9.1%, respectively. Heavy metals in the tailings were higher in the newly constructed tailing dam than those in the old dam. Total concentrations of metals in the tailings were in the orders of Zn > Cu > Pb > Ni > Cd, exceeded the corrective action level of the Soil Environment Conservation Law and higher than the natural abundance levels reported from uncontaminated soils. Relative distribution of heavy metal fractions was residual > organic > reducible > carbonate > adsorbed, reversing the degree of metal bioavailability. Mobile fractions of metals were relatively small compared to the total concentrations. Distribution of metals in the tailing dam profiles was metal specific. Concentrations of Cu at the surface of tailing dams were higher than those at the bottom. Pollution index (PI) values of each fraction of metals were ranged from 4.27 to 8.51 based on total concentrations. PI values of mobile fractions were lower than those of immobile fractions. Results on metal fractions and PI values of the tailing samples indicate that tailing samples were contaminated with heavy metals and had potential to cause a detrimental effects on soil and water environment in the lower part of the stream. A prompt countermeasure to prevent surface of tailings in the dams from water and wind erosions is urgently needed.

• Korean Journal of Heritage: History & Science
• /
• v.52 no.1
• /
• pp.64-81
• /
• 2019

Jeju Island is located at a strategic position, making it an important waypoint on the sea routes of East Asia. As a result, the island suffered many foreign invasions throughout history. Especially, it is widely known that Japanese pirates frequently invaded the island as the island was located on their way as they were sailing to China. Therefore, they built various defensive structures across the island. Fortresses, where a small number of defenders may fend off an enemy, were built in multiple places on the island. This was a strategy for the island to defend itself, as it was almost impossible to get prompt support in an emergency from the mainland due to the long distance. Fortresses, or walled cities, were the center of politics, culture, and economy of many areas. Therefore, they are a valuable resource to study the history and geographical characteristics of a place. For this reason, studies on fortresses started quite early on. However, studies on such relics in Jeju Island began very late. The research on fortresses was launched during the Japanese occupation for most mainland areas. However, studies on the relics on Jeju Island began as late as the 1970s. This was because scholars did not understand the importance of the city walls and fortresses on Jeju Island, and there were no researchers who specialized in city walls or fortresses on the island, as well. As archeological research on Jeju Island began to gain momentum, the studies on city walls and fortresses saw progress; however, these studies are still of an elementary level. In this study, the author summarized the status of studies on the city walls and fortress relics in Jeju Island and their preservation/maintenance status by era. According to the findings of this study, there were two Corean-era city wall/fortress relics and thirteen from the Chosun era., The researcher analyzed and presented the status of studies and the current condition of the relics. The status of attached structures was also documented.Furthermore, a short review of the maintenance work performed so far was provided. Also, the researcher mentioned the problems that accompanied the maintenance process of these relics, along with suggestions for improvement that could be referred to in future restoration/maintenance projects.

• Journal of The Korean Society of Inherited Metabolic disease
• /
• v.18 no.2
• /
• pp.43-49
• /
• 2018

Maple syrup urine disease (MSUD, OMIM#248600) is a rare and autosomal recessively-inherited metabolic disorder that is caused by mutations in the branched-chain ${\alpha}$-ketoacid dehydrogenase (BCKDH) genes. It prevents the normal breakdown of branched-chain amino acids (BCAAs), such as leucine, isoleucine, and valine, and leads to poor feeding, lethargy, abnormal movements, seizure, and death if untreated. Here, we report the case of a Korean newborn of biochemically- and genetically-confirmed MSUD manifesting lethargy and central apnea, the acute state of which was successfully treated. The molecular genetic investigation revealed two novel heterozygous mutations (p.Ala32Phefs*48 and p.Val 130Phe) in BCKDHB, and both parents were confirmed as carriers. We emphasize the importance of early diagnosis and prompt introduction of specific treatment for MSUD in life saving and prognosis.

• The Korean Journal of Air & Space Law and Policy
• /
• v.33 no.2
• /
• pp.315-343
• /
• 2018

In the event of an air accident, the media and members of the general public pay attention to the victim of the accident and are deeply concerned about their actions and rewards. However, through the accident of Air China(CCA) Flight 129, which occurred in 2002, we were able to confirm that it is a real problem that the victims of the air accident as well as the victims suffer much suffering and serious aftermath. Nevertheless, Korea's system for assistance the families of victims of air accident is very poor. On the other hand, when Trans-World Airlines(TWA) Flight 800 exploded and crashed over the Atlantic Ocean in 1996, the United States enacted a law to assistance the families of the victims of the accident. According to this law, systematic assistance and management of not only the victims of the accident but also their families, minimize the additional damage of victims and victims' families and help them to get rid of the accident after the accident. In particular, the measures taken by the US authorities in response to an accident in which an Asiana Airlines flight(AAR) 214 crashed during a landing at San Francisco International Airport in 2013, made a lot of suggestions for us to assistance the victims and their families in an air accident. The purpose of this paper is to suggest the necessity of improving the system for victims and victim's family assistance in air accident. In this paper, we analyze the domestic and foreign legal systems and related cases in past accidents, identify the deficiencies of the Korean system, and derive the necessity to improve the related system. It is also important to make sure that victims' families are relieved from early psychological and economic shocks and that the results of accident investigations are reliable. Relevant ministries, airlines, and related agencies should recognize that prompt and systematic assistance and cooperation is needed to ensure that victims and families are relieved of the impact and confidence in the investigation, as is the case in the United States. In addition, efforts should be made to supplement the related laws for the assistance of aircraft victims and victims' families, to establish manuals for implementation, to plan and to implement them promptly in the event of an accident. To achieve this, it is necessary to establish regulations for the legal institutionalization of the roles and responsibilities of national and state agencies on victims of aviation accidents and family assistance. And the victim and family assistance plan that the airline has to submit to it, as specified in the current law, need to specify that item. In addition, new and supplemented contents should be integrated into a single clause or proposed as a separate special law for the purpose of applying a clear law.