• Journal of Preventive Medicine and Public Health
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• v.29 no.2 s.53
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• pp.239-254
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• 1996

Health services on industrial noisy environment have been provided only for noise-induced hearing loss management until now. But gradually, modem diseases and death have come to be related to stress and mental health deeply, therefore noise-induced mental disorder, like a stress became very important. In this point, the purpose of this study was to analyze the relationship between noise exposure level in worksite and workers' stress symptoms. This study included a survey of 786 manual workers selected from 89 worksites in 21 factories in Puchon. The results were as follows: 1. For demographic characteristics, most of the workers were males(80.8%), the $20\sim29years$ old were 34.5% and those who graduated from high school were 65.3%. The workers whose monthly income ranged from 100,000 to 800,000 won were 37.5% and who have a religion were 47.9%. 2. For occupational characteristics, workers who had worked $1\sim5$ years in the factories were 33.0%. Those who were much for them workload were 43.9% and who worked more than 8 hours a day were 73.9%. Those who were disatisfied with their job and pay were 31.9% and 50.6%. The workers who responsed ventilation condition of their worksites were bad were 51.9% and the dissatisfed with working environment of their worksites were 45.9%. 3. Workers who were suffering from tinnitus were 53.3% and those who perceived hearing loss were 50.1%. Persons who reported they always wore earplugs at work were 35.4%. Those who felt earplugs bigger than their ears were 30.6% and those who experienced eardiseases caused by earplugs were 25.6%. 4. For the noise exposure level in worksite, workers who were exposed to $80\sim90dB$ were 30.3%, $90\sim100dB$ were 26.4% and $50\sim70dB$ were 19.2%. 5. Workers' stress symptoms were significantly related to marital status and their monthly income(p<0.05). Workers who were single and had lower monthly income showed higher PSI (Psychiatric Symptom Index) scores than those who were married and had higher monthly income. Higher PSI scores were also significantly related to $1\sim2$ days hight-work per week, much for them workload, dissatisfaction with their job, and bad relationship with their bosses and coworkers. 6. Higher PSI scores were significantly related to severe tinnitus and perceived hearing losso(p<0.001). Workers who felt the earplugs they use did not fit their ears showed significantly higher PSI scores(p<0.01). Workers who reported that they did not feel they need earplugs showed. significantly higher PSI scores (p<0.05). Increased experience of eardisease caused by earplugs that did not fit were also significantly related to higher PSI scores(p<0.01). 7. The higher noise exposure level in worksite from 80dB was, the more severe stress symptoms including PSI subparts were reported; Anxiety, Anger, Depression, and Cognitive disorder(p<0.001). 5. According to the results of stepwise multiple regression analysis, factors affecting workers' PSI scores were perceived hearing loss$(R^2=0.160)$, noise exposure level in worksite$(R^2=0.110)$, realtionship with coworkers, amount of workload, monthly income and relationship with bosses orderly and the total $R^2$ of this 6 factors was 0.371. 9. The most significant factors that have impact on manual workers' stress symptoms were perceived hearing loss and noise exposure level in worksite, especially noise exposure level in the worksite was the most affective factor on the depression symptom.

• Journal of agricultural medicine and community health
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• v.21 no.1
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• pp.97-105
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• 1996

This study conducted to determine the evaluation and improvement for enforcement of the waste recycling system in Pohang city and surveyed 4 areas at the southern and northern districts respectively by a team of two officials during the period 6 February 7 February 1995. The rates of the use for waste recycling system's envelope from home trash were 94.2% at the northern district and 92.8% at the southern district by areas, 95.6% at the group houses (apartments and tenement houses) and 91.3% at the separate houses by patterns of house, the low economic class 96.4%, the middle economic class 96.3% and the upper economic class 87.5% by the economic levels, and the bell method 96.5%, the container method 95.6%, door take method 86.1% in order, respectively. The trash from houses were garbage 57.4%, paper 18.7%, plastic 10.3%, fiber 7.9%, bottle 2.7%, metal and can 1.4%, and wood and rubber 0.7% in order. The rates of the reuse trash(reuse possible paper, plastic, bottle, can and metal) were 20.2% of the total, 21.8% at the southern district and 18.5% at the northern district by areas, 25.7% at the separate houses and 14.7% at the group houses(apartments and tenement houses) by patterns of house, and the door take method 34.3%, the bell take method 17.1% and the container take method 14.7% in order, respectively. There were the double envelopes of the plastic bag from stories 46.3% and the clear plastic bag 29.5% in the waste cycling system's envelopes. There were 1.9 double envelopes in the waste cycling system's envelopes. Garbage occupied more than half of the total trash, so it is need to be compost and provender.

• Journal of agricultural medicine and community health
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• v.21 no.1
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• pp.75-84
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• 1996

This study was conducted to reveal the relationship between the oral health status and their Knowledges about the oral health of the freshman of colleges in Taegu city. The evaluation for the oral health status through the oral examinations and their analysis of their knowledges on the periodontal disease were done on 216 males and 205 females from 1st to 30th April, 1993. The obtained results were as follows: The oral health status of 421 subject showed that 35.7% was good, 59.1% fair, and 6.2% poor, respectively. In case of the oral health status of females, 41.9% was good and 4.4% poor, and then in males 27.8% was good, 7.8% poor. The oral health status of the females was better than that of the males(p=0.006). The 52.1% among the good oral health status group answered that the dental plaque is the bacterial membrane causing dental disease, and the 23.1% among the poor oral health status group answered same as the above. The 91.8% among the good oral health status group answered that the periodontal diseases can be prevented, and the same answer came out from 15.4% of the poor group. It was found that the better oral health status group had the better knowledges about periodontal disease(p=0.001). For the question about their experiences in scaling the 30.1% of good oral health status group and the 23.1% of poor group answered that scaling is very helpful to periodontal health(p=0.001). About the experience of the education for tooth brushing, the 53.2% of good oral health status group and the 7.6% of poor group had the experiences to receive the education for tooth brushing(p=0.001). About the frequency and the time of tooth brushing, the 53.4% of good oral health status group brushed their teeth more then 3 times a day and 41.8% of good group brushed their teeth after every meal(p=0.001). The result of multiple regression analysis according to the simplified oral health index indicated that the variable having an effect on the oral health status was the tooth brushing frequency, knowledge of periodontal disease prevention, experience in education of tooth brushing and time of tooth brushing(p=0.001).

• Journal of Hospice and Palliative Care
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• v.18 no.2
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• pp.128-135
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• 2015

Purpose: As the National Health Insurance Service (NHIS) began to cover home oxygen therapy (HOT) services from 2006, it is expected that the new services have contributed to overall positive outcome of patients with chronic obstructive pulmonary disease (COPD). We examined whether the usage of HOT has helped slow down the progression of COPD. Methods: We examined hospital claim data (N=10,798) of COPD inpatients who were treated in 2007~2012. We performed ${\chi}^2$ tests to analyze the differences in the changes to respiratory impairment grades. Multiple logistic regression analysis was used to identify factors that are associated with the use of HOT. Finally, a generalized linear mixed model was used to examine association between the HOT treatment and changes to respiratory impairment grades. Results: A total of 2,490 patients had grade 1 respiratory impairment, and patients with grades 2 or 3 totaled 8,308. The OR for use of HOT was lower in grade 3 patients than others (OR: 0.33, 95% CI: 0.30~0.37). The maintenance/mitigation in all grades, those who used HOT had a higher OR than non-users (OR: 1.41, 95% CI: 1.23~1.61). Conclusion: HOT was effective in maintaining or mitigating the respiratory impairment in COPD patients.

• Journal of radiological science and technology
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• v.32 no.4
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• pp.461-469
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• 2009

To predict the tumor grading, various imaging modalities have been applied clinically. This study determines clinical usefulness of perfusion MRI, using relative cerebral blood volume in grading of the gliomas. We did a retrospective review of 17 patients (mean age, 57.5 years; 11 male, 6 female) who underwent perfusion MR and conventional MRI, and then correlated pathologically after operation. Statistical analysis of regional cerebral blood volume and relative cerebral blood volume(rCBV) was performed by using softwares such as PAT by SIEMENS and Xmap ver 2.0 developed by ourselves. Six patients out of 13 were low-grade gliomas while eleven patients were the high-grade gliomas. Mean relative CBV (m_rCBV/white matter) in the low-grade gliomas was 1.62, and mean relative CBV(m_rCBV/cortex) was 0.12. In the high-grade gliomas, mean relative CBV(m_rCBV/white matter) and mean relative CBV(m_rCBV/cortex) were 33.53 and 0.96. Mean relative CBV of gliomas were elevated with a statistical difference(P<.05), compared with contralateral white matter(P=.019) or cortex(P=.025). Furthermore mean relative CBV(m_rCBV/white matter) was much higher than mean relative CBV(m_rCBV/cortex). Perfusion MRI using regional cerebral blood volume and rCBV is very useful imaging modality for grading the glioma.

• The Korean Society of Law and Medicine
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• v.16 no.1
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• pp.3-82
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• 2015

This paper is concerned in the theme of the liability for the breach of duty to inform(Haftungszurechnung der $Aufkl{\ddot{a}}rungspflichtverletzung$) and the malpractice of cosmetic surgery. Here, the terms, treatments for healing purposes and purely medical-technical cosmetic operations are well integrated in the category of "medical conduct(medizinische Handlung)" within the meaning of the public and administrative 'Medical Law'. In the judgment of 6. 13. 2013 Az. 2012DA94865 provides the KHGH(Korean Highest Court of Justice) to inform the patient about the prospects and risks of cosmetic surgery(Infrabrow Excision Blepharoplasty) stringent requirements, similar to the judicature of BGH(cf. BGH, Urt. v. 6. 11. 1990, Az.: VI ZR 8/90). Even in the judgment of 5. 12. 2014 Az. 2013GASO865646 the SZLG(Seoul Central Regional Court) recognizes the physician contract for 'cosmetic septoplasty' as a sort of contract for work. The medical treatment(${\ddot{a}}rztliche$ Heilbehandlung) is still regarded as a prototype of the medical activity, therefore in the meaning of the 'Civil Law(KBGB)', its term needs to be used immediately for healing purposes. The cosmetic operation, desired by a patient, differs from the healing treatment by the element of "indication" and the fact that the "healing purpose(Heilzweck)" itself is missing. In comparative context - methodically fully aware that the unreflective term transfer between different laws might contradict their legal purposes - a series of judgments BSG(BSGE 63, 83, BSGE 72, 96, BSGE, 82, 158, BSGE 93, 252 etc.) and some judgments of LSG are reviewed. In addition, also the dogmatic topic for the "legal natur of a medical treatment contract" is to reconsider by comparative introducing BGHZ 63, 306. Now in view of the current state of greater popularity of artificial cosmetic surgery still indeed is the sentences: The doctor is minister naturae, a helper of nature. A doctor promises regularly only the proper treatment of the patient, but the contractual liability for work should not be excluded in medical conditions for cosmetic surgeries altogether. "With cosmetic operations, seeking to eliminate the external deformities, the doctor may miss the medical profession entirely." - A. Laufs, Medical Law, 5th ed. P. 18.

• The Journal of Korean Academy of Prosthodontics
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• v.48 no.2
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• pp.101-110
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• 2010

Purpose: This study has been conducted in order to examine the oral health status and dental prostheses status, and the effects of dental prostheses to the oral health related quality of life among the elderly using social welfare centers. Material and methods: For this purpose, the researcher conducted a questionnaire survey and oral examination of 275 samples of old persons using 7 social welfare centers located in Daejeon metropolitan city. The oral health related quality of life was measured by GOHAI (Geriatric Oral Health Assessment Index). Results: 1. The less age and the more education and the more subjective economic status and living with spouse of family status, the higher GOHAI showed. 2. Mean age of first using of removable denture is 62.11 years old and average life cycle of removable denture is 10.76years. 57.5% of study subjects use removable denture and complete denture user of study subjects are 13.8%. 3. In the case that they use fixed prostheses rather than removable ones and in the complete denture they use both sides (upper and lower) rather than single side, showed higher GOHAI. 4. In the case that they showed higher degrees of satisfaction with dental prostheses and can use them always and showed no necessity for new dental prostheses and denture adaptation is good, GOHAI showed higher. Conclusion: In order to improve oral health related quality of life among the elderly who have many missing teeth, it is required to restore their masticatory ability to the normal level by restoring the missing teeth which has lost its function through providing proper dental prostheses.

• The Korean Society of Law and Medicine
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• v.15 no.1
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• pp.335-373
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• 2014

According to one Medicare report, in the US, total federal spending on health care expends almost 18 percent of the nation's GDP, about double what most industrialized nations spend on health care. And in 2011, Medicare spending reached close to $554 billion, which amounted to 21 percent of the total spent on U.S. health care in that year. Of that $554 billion, Medicare spent 28 percent, or about $170 billion, on patients' last six months of life. So what are the reasons of this high cost in EOL care and its possible solutions? Much spendings of Medicare on End-of-Life care for the terminally ill/chronically ill in the US has led health economics experts to assess the characteristics of the care. Decades of study shows that EOL care is usually supply-sensitive and poor in cost-effectiveness. The volume of care is sensitively depending on the supply of resources, rather than the severity of illness or preferences of patients. This means at the End-of-Life care, the medical resources are being overused. On the other hand, opposed to the common assumption, "The more care the better utility", the study shows that the outcome is very poor. Actually the patient preference and concerns are quite the opposite from what intense EOL care would bring about. This study analyzes the reasons for the supply-sensitiveness of EOL care. It can be resulted from the common misconception about the intense care and the outcome, physicians' mission for patients, lack of End-of-Life Care Decision which helps the patients choose their own preferred treatment intensity. It also could be resulted from physicians' fear of legal liabilities, and the management strategy since the hospitals are also seeking for financial benefits. This study suggests the possible solutions for over-treatment at the End-of-Life resulting from supply-sensitiveness. Solutions can be sought in two aspects, legal implementation and management strategy. In order to implement advance directive properly, active ethics education for physicians to change their attitude toward EOL care and more conversations about end-of-life care between physicians and patients is crucial, and incentive system for the physicians who actively have the conversations with patients will also help. Also, the general education towards the public is also important in the long run, and easy and official advance directive registry system-such as online registry-has to be built and utilized more widely. Alternative strategies in management are also needed. For example, the new strategic cost management and management education, such as cutting unnecessary costs and resetting values as medical providers have to be considered. In order to effectively resolve the problem in EOL care for the terminally ill/chronically ill and provide better experience to the patients, first of all, the misconception and the wrong conventional wisdom among doctors, patients, and the government have to be overcome. And then there should be improvements in systems and cultures of the EOL care.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.173-192
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• 1984

On the basis of the study intended to research by crosssectional study keeps pace with semilongitudinal study the growthaccelerating phenomena that Maximum Growth age in teenager's body-height. By the random sampling method, the subject of study are 12659 persons(male; 6355, female; 6304) that they are from 7 ages to 17 ages in the whole country including the rural community. The measurement period passed three month days, the statistical data became electronic data processing system with computer. The other side, body-height and MGA of Koreans who had been for during the period from 1925 to 1966 proved transition of the growth-accelerating phenomena by research data reported between 1913 and 1983. The results are as follows; 1. The Growth and Development-Value of Body-height An age bracket the growth and development-value of body-height were, respectively, male is $123.88{\pm}5.05cm$ and female is $123.29{\pm}5.54cm$ for 7 ages group. these indices increased with age. the top-value reach, respectively. $169.08{\pm}5.62cm$ and $157.57{\pm}6.13cm$. The intersecting ages of male and female were the age $8.5{\sim}12.5$, during these periods, female excelled male but after these periods, male excelled female again. In case of body-height, MGA's are 7.0cm for male between 12 and 13 ages, and 7.01cm for female between 8 and 9 ages. As a rule, body-height of male excelled female but intersection phenomena of male and female appeared between 8.5 and 12.5 ages. By reginal groups, it is most prevailing is Seoul, and medium size cities and rural community rome in order. By regional groups, intersection phenomena of male and female are. a region of Seoul; $$8.5{\sim}11.5$$ ages a region of Daejeon; $$7.5{\sim}9.5$$ ages rural community; $$11.5{\sim}14.5$$ ages the whole country's average; $$8.5{\sim}12.5$$ ages By regional groups, the rate of maximum increase in a year are a region of Seoul; male is 7.23cm as 13 ages female is 7.65cm as 9 ages. a region of Daejeon; male is 7.85cm as 11 ages. female is 8.39cm as 9 ages. rural community; male is 7.65cm as 14 ages. female is 6.25cm as 12 ages. the whole country's average; male is 7.0cm as 13 ages. female is 7.01 as 9 ages. 2. Maximum Growth Age (M.G.A.) By reginal groups, maximum Growth Age's are as below in a region of Seoul, MGA's are 12.63 for male and 9.01 for female, which shows that MGA for female appears about 3.5 years earlier than that for male. In a region of Daejeon, MGA's are 9.20 for male and 8.93 for female, which. show that they are all much the same in M.G.A. In rural community, MGA's are 14.00 for male and 11.89 for female, which shows that MGA for female apperars about 2 years earlier than that for male. In the whole average, MGA's are 13.01 for male and 8.97 for femal, which shows that for female appears about 4 years earlier than that for male. For boy, M.G.A. shows fastest-growing in Daejeon, and Seoul and rural commonly come in order. For girl, It shows equal growth in Seoul and Daejeon, rural community comes later. 3. The M.G.A's in body height of male are respectively the age 15.02 in 1913, 14.23 in 1956, 13.86 in 1967, 13.62 in 1975, and 12.82 in 1981, while those of female are the age 12.0 in 1940, 11.52 in 1965, 9.53 in 1975, and 11.16 in 1980; these data show that the MGA of the Koreans has been getting younger. 4. The equation of linear regression of all the MGA's in body height are as follow; Male: Y(M.G.A)=$-0.020{\times}$ (the year)+15.19: female:Y(MGA)=$-0.028{\times}$(the year)+13.2549. 5. The corelation of all the MGA's in body height are as below; male; r=-0.329 female;r=-0.252 6. From the transition of the growth-accelating phenomena in 1980 we can capture the fact that the MGA's has been getting younger by 0.2 year per 10 years. 7. The MGA's in bodyheight are shown in table 4... 8. The future growth-accelating phenomena in body height are expected to show the similar tendency like that of the past, in 1910's but it should by more precisely reviewed after investigating the phenomena of the years directly ahead.

• Journal of Preventive Medicine and Public Health
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• v.24 no.1 s.33
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• pp.8-15
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• 1991

This study was carried out in order to examine the urinary excretion of electrolytes (Na, K) and their relationship with blood pressure, and to estimate the amount of daily salt intake in a rural community. From January to March in 1987, a mobile screeing team visited 40 villages, and carried out health screening of 537 adult volunteers whose age were over 30 years and collected 12-hours overnight urine. To determine the completeness of collection, the urinary creatinine was measured. If the creatinine excretion was beyond the range given to the age group, the sample was excluded from the analysis as an incomplete collection : 345 samples were remained for analysis. This study revealed the following results. 1. The mean excretion amounts of urinary electrolytes for 12 hours were Na 193.5 mEq, K 20.8 mEq, creatinine 1.0 g. The mean ratio of electrolytes were Na/K 9.84, Na/creatinine 0.44, K/creatinine 0.046. 2. Both the mean excretion amount of K and the mean ratio of K/creatinine were less in hypertensives than in normotensives. K excretion also showed a tendency towards a decrease in inverse proportion to systolic blood pressure when it exceeded 120 mmHg. There was no significant difference between the hypertensives and normotensives in Na excretion. The sodium to potassium ratio increased in poportion to systolic blood pressure. 3. The mean daily salt excretion amount was 22.4 g. Assuming that 90% of the intake was excreted, the estimated amount of daily salt intake was 24.9 g.