• Journal of Environmental Health Sciences
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• v.43 no.1
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• pp.1-22
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• 2017

'The worstest environment disaster', 'World's first biocide massacre', 'Home-based Sewol ferry disaster' are all phrases attached to the recent humidifier disinfectant disaster. In the spring of 2011, four of 8 pregnant women including 1 adult man passed away at a university hospital in Seoul due to breathing failure. Epidemiologic investigation conducted by the Korean CDC soon revealed the inhalation of humidifier disinfectant, which had been widely used in Korea during the winter, to be responsible for the disease. As well as lung fibrosis hardening of the lungs, other diseases including asthma, rhinitis, skin disease, liver disease, fetal disease or cancers have been researched for their relation with exposure to the products. By February 9, 2017, 5,342 cases had registered for health problems and 1,131 of them were already dead (20.8% mortality rate). Based on studies by government agencies and a telephone survey of the general population by Seoul National University and civic groups, around 20% of the general public of Korea has used these products. Since the market release of the first product by SK Chemical in 1994, over 7.1 million items from around 20 brands were sold up to 2011. Most of the products were manufactured by well-known large conglomerates such as SK, Lotte, Samsung, Shinsegye, LG, and GS, as well as some European companies including UK-based Reckitt Benckiser and TESCO, the German firm Henkel, the Danish firm KeTox, and an Irish company. Even though this disaster was unveiled in 2011 by the Korean government, the issue of the victims was neglected for over five years. In 2016, an unexpected but intensive investigation by prosecutors found that Reckitt Benckiser manipulated and concealed animal tests for its own brand and brought several university experts and company employees to court. The matter was an intense social issue in Korea from May to June with a surge in media coverage. The prosecutor's investigation and a nationwide boycott campaign organized by victims and environmental groups against Reckitt Benckiser, whose product had been used by more than 70% of victims, led to the producer's official apology and a compensation scheme. A legislative investigation organized after the April 2016 national election revealed the producers' faults and the government's responsibility, but failed to meet expectations. A special law for the victims passed the National Assembly in January 2017 and a punitive system together with a massive environmental epidemiology investigation are expected to be the only solutions for this tragedy. Sciences of medicine, toxicology and environmental health have provided decisive evidence so far, but for the remaining problems the perspectives of social sciences such as sociology and jurisprudence are highly necessary, similar to with the Minamata disease and Wonjin Rayon events. It may not be easy to follow this issue using unfamiliar terminology from medical and chemical science and the long, complicated history of the event. For these reasons the author has attempted to write this article in a question and answer format to render it easier to follow. The 17 questions are: Q1 What is humidifier disinfectant? Q2 What kind of health problems are caused by humidifier disinfectant? Q3 How many victims are there? Q4 What is the analysis of the 1,112 cases of death? Q5 What is the problem with the government's diagnostic criteria and the solution? Q6 Who made what brands? Q7 Has there been a recall? What is still on sale? Q8 Was safety not checked by any producers? Q9 What are the government's responsibilities? Q10 Is it true that these products were sold only in Korea? Q11 Why and how was it unveiled only in 2011 after 17 years of sales? Q12 What delayed the resolution of the victim issue? Q13 What is the background of the prosecutor's investigation in early 2016? Q14 Is it possible to report new victim cases without evidence of product purchase? Q15 What is happening with the victim issue? Q16 How does it compare with the cases of Minamata disease and Wonjin Rayon? Q17 Are there prevention measures and lessons?

• Clinical and Experimental Pediatrics
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• v.45 no.7
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• pp.862-874
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• 2002

Purpose : We tried to evaluate whether the detection rate of Helicobacter pylori in gastric biopsy specimens could be improved by using pre-embedding immunoelectron microscopy. Methods : A total of 119 children who complained of upper gastrointestinal symptoms were endoscoped at the Gyeongsang National University Hospital from July, 1996 to July, 1999. Five biopsy specimens(three for urease test, one for hematoxylin-eosin(H & E) staining, and one for preembedding immunoelectron microscopy) were obtained from each antrum and body. Immunoblotting analysis were also performed. Results : Among the 119 patients, H. pylori were found in 116 patients(97.5%) by the immunoelectron microscopy. Among three patients who were found H. pylori negative in immunoelectron microscopy, two patients showed H. pylori in H & E stained slides and one patient was urease test positive(color change within six hours). Urease tests were positive in 107 patients(89.9 %). The positive rate of immunoblotting tests was 81.5%. However, only 13 patients(10.9%) showed H. pylori on the H & E stained antrum or body tissue. Conclusion : In this study, we found H. pylori histopathologically in most of the pediatric patients who complained of upper gastrointestinal symptoms. This study showed that pre-embedding immunoelectron microscopic examinations can be used as a gold standard in the diagnosis of childhood H. pylori infection. However, this method also has limited capacity to detect widely scattered H. pylori compared to the other histopathologic diagnostic methods.

• Analytical Science and Technology
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• v.28 no.6
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• pp.436-445
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• 2015

Amomi Fructus with anti-oxidative activity was chosen and essential oil was obtained by SDE (simultaneous distillation extraction), and 39 constituents were determined by GC-MS (gas chromatography-mass spectrometry). Major components were camphor, borneol acetate, borneol, D-limonene and camphene. Three solvent extracts such as hexanes, diethyl ether and methylene chloride from Amomi Fructus were obtained. These were analyzed by GC-MS and 4 more constituents were identified in addition to 39 components discovered in essential oil. Five major components such as camphor, borneol acetate, borneol, D-limonene and camphene were also detected, however the relative peak percents of those components were different from those of constituents in essential oil. To estimate the kind and the amount of materials evaporated at certain temperature and conditions from essential oil and solvent extracts, dynamic headspace apparatus was used and materials evaporated and trapped at certain conditions were analyzed by GC-MS. Recovery yield of SDE method from Amomi Fructus was measured by using camphor and standard calibration solution of camphor methanol solution and, the yield was 82.0%. Content of Hg was measured by mercury analyzer and contents of Cd, Pb, Cr, Mn, Co, Ni, Cu and Zn in Amomi Fructus, essential oils and solvent extracts were determined by ICP-MS (Inductively coupled plasma-mass spectrometer). Pb, Cd and Hg were measured in the concentration of 0.72 mg/kg, <0.10 mg/kg and 0.0023 mg/kg, respectively and these were below permission level of purity test. Contents of Mn, Cu and Zn in Amomi Fructus were 213 mg/kg, 8.29 mg/kg and 31.0 mg/kg, respectively and which were relatively higher than other metals such as Cr, Co and Ni. Metals such as Mn (0.65 ~ 9.08 mg/kg), Cu (1.16 ~ 4.40 mg/kg) and Zn (1.10 ~ 3.80 mg/kg) in essential oil and solvent extracts were detected. At this point it is not clear that the metals were cross-contaminated in the course of treating Amomi Fructus or metals were contained in Amomi Fructus. The influence evaluation toward biological model study of these metals in essential oil and solvent extracts will be needed.

• Journal of Korean Academy of Nursing
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• v.4 no.3
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• pp.63-79
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• 1974

1. The purpose of this study. The purpose of this study is to plan and investigate short-term nursing education of two-years associate degree program to produce middle-level professional nurses which are needed by-society and nation. Current nursing education in Korea is divided into four years degree program, three years diploma program Even (though) there are differences in the aims of their education, the curriculums are not much different between the education for producing leaders which is its basic purpose and training middle-level professional nurses. Therefore the purpose of associate degree program lies in minimizing the waste of time and finance which are invested for long-term education for middle-level professional nurses. And also this coincide with the policy of national technical training and definite supply of nurse manpower according to health policy for effective role and ability of nurse. 2. The method of study. This is based on the study of literature, research on the actual condition and investigation of opinion- through questionnaire. L) The study of literature: Domestic and foreign literatures for two years associate degree program were studied and investigated. 2) Research on the actual condition : Current three years nursing education program was collected and analysed. 3) Investigation of opinion. The problem of curried nursing education system and the possibility of two years associate degree program were investigated through questionnaire. 3. The result of the study. 1) The trend of recent nursing education. a. The aims of nursing in past chiefly taking care of physical disease of patient has recently changed to nursing of character including physical, mental, socio-economic, educational and psychological condition. b. For the performing systematic and effective nurse's duty according to her role, the-change of educational system which is classified as a range of education the period of education and certificate after graduation has been enforced or fulfilled. c. Nursing education also has a trend to become a collage or two years associate degree program which can get same legal protection as other educational institutions whose basic purpose is education. Attached nursing school to hospital is getting disappeared because of disadvantage of educational system. 2) Problems. Depending upon research on actual condition of current 3 years nursing education program. a. There are too many subjects. b. Contents of education could be doubled because major subjects are subdivided in detail. c. The credits for graduation are too heavy comparing to the period of study or the ability of students. (The necessary credits are 150.8 for three years according to actual investigation 4. There is no certain standard in organizing curriculum therefore there are too much differences between schools. 4. Basic Plan. The plan for two years associate degree program in nursing education depending on demand of professional nursing field of society is based on following items. 1) Training middle-level professional nurse lay emphasis on liberal arts and basic major field. 2) Liberal arts are divided into required and optional subjects and students could take courses by choice. 3) Major subjects are compound together by fields and they become the sciences of nursing Ⅰ,Ⅱ,Ⅲ,Ⅳ and every items has its educational purposes and contents major study includes laboratory practice and clinical experience. 4) The required credits for graduation are to which means 17-18 credits a semester. The above has been planned to solve the problems of current three years nursing education program. In conclusion for the achievement of this system, following items are needed. 1) It is necessary to change educational administration and system such as amendment of educational law or order of educational application of law. 2) Qualified professors should be available to understand and develope the idea or purpose of this educational system. 3) Local medical institutions should be opened widely and educational for clinical training. 4) The job after graduation should he secured positively.

• Research in Community and Public Health Nursing
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• v.10 no.1
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• pp.53-69
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• 1999

A descriptive correlation study was done to provide a basic data for comprehensive nursing care by analyzing the relationship between spiritual wellbeing, hope and perceived health status of the elderly. 195 respondents who lived at their homes and 148 respondents who lived at the facilities for elders such as nursing homes and elder's rehabilitation centers were selected and their age was over 60 years old. Paloutzian and Ellison(1982)'s spiritual wellbeing scale, Nowotny(1989)'s hope scale and Northern Illinois University's health self rating scale was used. From August 10th to August 25th, 1998, ready made questionnaires were handed out by researcher to those who can fill it out and for those who cannot fill out the questionnaires alone, the researcher read it and finished by interview. This study used Pearson's correlation coefficient for the hypothetic test and the average point and standard deviation of spiritual wellbeing, hope, and perceived health status were checked. To find out the difference between spiritual wellbeing, hope, and perceived health status by general characteristics ANOVA and Tukey test were used. The results are as follows : 1. The mean score for spiritual wellbeing of the elders was 42.27($SD{\pm}9.67$) in a possible range of 20-80. The average point of spiritual wellbeing was 2.11($SD{\pm}0.97$) point to 4 point full marks. The mean score of religious wellbeing was 21.37($SD{\pm}7.02$) and that of existential wellbeing was 20.90($SD{\pm}4.63$) in a possible range of 10 - 40. The average point of religious wellbeing was 2.14($SD{\pm}0.70$)points and existential wellbeing was 2.09($SD{\pm}0.46$) points to 4 point full marks. 2. The mean score for hope was 67.16($SD{\pm}12.28$) in a possible range of 29-116. The average point of hope was 2.31($SD{\pm}0.42$) points to 4 point full marks. 3. The mean score for perceived health status was 8.72($SD{\pm}2.49$) in a possible range of 4-14. 4. In testing the hypothesis concerning the relationship between spiritual wellbeing and hope, there was a statistically positive correlation(r=0.5209, p=0.0001). 5. In testing the hypothesis concerning the relationship between spiritual wellbeing and perceived health status, there was a statistically positive correlation(r=0.1427, p=0.0081). 6. In testing the hypothesis concerning the relationship between hope and perceived health status, there was a statistically positive correlation(r=0.2797, p=0.0001). 7. There were significant differences in spiritual wellbeing according to sex, religion, and present occupation. 8. There were significant differences in hope according to residential places, age, religion, educational level, family status, average monthly pocket money. 9. There were significant differences in perceived health status according to residential places, sex, age, educational level, present occupation and family status. From the above results it can be concluded that: There was a positive correlation between spiritual wellbeing and hope, spiritual wellbeing and perceived health status, hope and perceived health status. When the nurse implicate the nursing intervention which can be promote the spiritual wellbeing and hope, elder's perceived health status also can be improved.

• Korean Journal of Occupational Health Nursing
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• v.6 no.2
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• pp.110-127
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• 1997

The aim of this study is to present the basic datum for the promotion of effectiveness and improvement of nursery tasks, by grasping the situation of operating room nurses tasks and the degree of their fatigue. For these researches, 70 nurses out of the operating rooms of 3 university-affiliated hospitals-two in Seoul and one in Pusan, were chosen at random by a non-probability sampling method. These researches were done from April 14 to April 26 in 1997 by questionairing method. The questionaire was composed of 30 items, which asks the examinees of their physical, mental, and neurosensory symptoms, with 10 items respectively. The reliability of the research instrument was turned out very high with Cronbach's ${\alpha}=.9376$. The datum were electronically processed using Statistics Program for Social Sciences(SPSS). The analysis of datum in this study has a general character, in which the demosociological character and the special ex-officio character was calculated by frequency and percentage. The situation of tasks in operating rooms was calculated by frequency and percentage. The fatigue of operating room nurses was calculated by average and standard deviation. To compare the fatigue with regard to the character of operating room nurse's tasks, t-test and F-test(ANOVA) were used after the character of variations, and the variations at the level of P<.05 which might have some meaning was verified after the fact with Duncan's Multiple Range(DMR). The results of this research are as follows : 1) The nurses working in operating rooms show their fatigue in three fields-in Group I physical symptoms 3.28, in Group III neurosensory symptoms 2.85, and in Group II mental symptoms 2.73, which shows I Dominant type (general type). 2) They complain, in Group I they are "feeling the heavy legs," 3.28 and in Group II they "occasionally forget soon what to do," 3.09. and in Group III, they "feel lumbago," 3.47, which is the highest rate of the three. The highest rate results from the character of their tasks, in which they have to move rapidly the heavy appliances and do their jobs standing many hours, especially wearing heavy radiation protector. 3) As to transportation, subway using group feel the greatest fatigue, 3.18(F=4.315, P=.008). 4) As to department, nurses in the orthopedic's surgery part feel the greatest fatigue, 3.26(F=2.040, P=.050). 5) As to the change of physical symptoms, the group answering that they found physical abnormality after working in operating rooms show the greatest fatigue, 3.12(t=-3.13, P=.003). 6) At to the general circumstances, the group answering that they receive insufficient consideration on their physical abnormality in their department, show the greatest fatigue, 3.10(F=3.200, P=0.47). 7) As to the relation with superior officers, the group answering that their superior officer has an impetuous temperament, show great fatigue, 3.11(F=4.855, P=.011). 8) As to the time of feeling fatigue, the fatigue reaches the highest point 1~2 hours after operations, 3.04(F=2.703, P=.046). 9) When they feel fatigue after scrub nurse duties, they feel the greatest fatigue 2 hours after the duties, 3.09( F=2.841, P=.038). 10) As to the operation instruments, when they use complex instruments borrowing from the outside in addition to the basic instruments, their fatigue becomes the greatest, 3.09(F=7.831, P=.000). 11) As to the kind of operation, when they participate in orthopedic's surgery operations, they feel the greatest fatigue, 3.18(F=4.362, P=.000). With the above results, it is proved that the degree of operating room nurses' fatigue is considerably high. So it may be concluded that the measure for lessening the fatigue should be find immediately, not on the level of personal matters but on the level of hospital nursing administration.

• Progress in Medical Physics
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• v.20 no.4
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• pp.317-323
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• 2009

The standard dosimetry systems based on an absorbed dose to water recommend to use a planeparallel chamber for the calibration of such a low-megavoltage electron beam as a nominal energy of 6 MeV. For this energy ranges of an electron beam a cylindrical chamber should not be used for the routinely regular beam calibration, but the feasibility of the temporary use of a cylindrical chamber was studied to give temporary solutions for special situations users meet. The PTW30013 chambers and the electron beam quality of $R_{50}=2.25\;g/cm^2$ were selected for this study. 10 PTW30013 chambers, a cylindrical type of chamber, were calibrated in KFDA, the secondary standards dosimetry laboratories, and given the absorbed dose-to-water calibration factors, respectively. A "temporary" $k_{Q,Q_0}$ for each chamber were calculated using the absorbed dose determined by a cross-calibrated planeparallel chamber, with the result of an average 0.9352 for 10 chambers. This value for PTW30013 chamber was used to determine an absorbed dose to water at the reference depth. The absorbed doses determined by PTW30013 chambers were in an agreement within 2% with that by ROOS chamber. In a certain situation where a cylindrical chamber be used instead of a planeparellel chamber, the value of 0.9352 might be useful to determine an absorbed dose to water in the same beam quality of electron beam as this study.

• Neonatal Medicine
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• v.18 no.2
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• pp.310-319
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• 2011

Purpose: The aim of this study was to investigate the effect of perinatal risk factors on brain maturation and the relationship of brain maturation and neurodevelopmental outcomes with brain maturation scoring system in brain MRI. Methods: ELBWI infants born at the Seoul National University Children's Hospital from January 2006 to December 2010 were included. A retrospective analysis was performed with their medical record and brain MR images acquired at near full term. We read brain MRI and measured maturity with total maturation score (TMS). TMS is a previously developed anatomic scoring system to assess brain maturity. The total maturation score was used to evaluate the four parameters of maturity: (1) myelination, (2) cortical infolding, (3) involution of glial cell migration bands, and (4) presence of germinal matrix tissue. Results: Images from 124 infants were evaluated. Their mean gestational age at birth was 27.1${\pm}$2.1 weeks, and mean birth weight was 781.5${\pm}$143.9 g. The mean TMS was 10.8${\pm}$2.0. TMS was significantly related to the postmenstrual age (PMA) of the infant, increasing with advancing postmenstrual age (P<0.001). TMS showed no significance with neurodevelopmental delay, and with brain injury, respectively. Conclusion: TMS was developed for evaluating brain maturation in conventional brain MRI. The results of this study suggest that TMS was not useful for predicting neurodevelopmental delay, but further studies are needed to make standard score for each PMA and to re-evaluate the relationship between brain maturation and neurodevelopmental delay.

• Tuberculosis and Respiratory Diseases
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• v.45 no.3
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• pp.503-508
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• 1998

Background: Tuberculous cervical lymphadenitis is one of the common causes of cervical mass in adult (especially in woman) in korea. Sometimes it appears to be difficult in defining the role of surgery and duration of antituberculous chemotherapy. Method: To clarify the proper duration and/or combination of regimens, we analyzed the clinical data of 31 patient with cervical lymphadenitis diagnosed at Chungnam National University Hospital from March 1996 to December 1996 and all patients were prospectively randomized into two groups(2HREZ/4HRE and 6HREZ) by treatment method. Result: Prevalent age, male to female ratio, association with pulmonary tuberculosis and history of previous antituberculous medication were not statistically different between two groups. The average size of the largest lymph node before teatment was $2.43{\pm}0.98cm$ and $3.15{\pm}1.74cm$, respectively and was 0.63cm and 0.6cm after treatment, respectively. In both groups, 2 patients have engrowing node or not changed node during tratment and no recurrence was found during follow up period upto 12 months. In both groups, no significant side reaction resulting in discotinuation or changing the regimens was noticed. Conclusion: Short course antituberculosis therapy(2HREZ/4HRE) could be recommanded as effective standard therapy for superficial lymph node tuberculosis. Longterm follow up at least 36 months to observe recurrence might be needed to confirm this conclusion.

• Clinical and Experimental Pediatrics
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• v.48 no.1
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• pp.40-47
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• 2005

Purpose : S. pneumoniae is one of major pathogens of community-acquired respiratory infections. The rate of antibiotic resistance to this organism has increased, and resistance to multiple antimicrobial agents in a single strain of S. pneumoniae may compromise the efficacy of empiric antimicrobial treatment commonly used for respiratory infections. We did this study to find out the penicillin resistant distributions and oral antibiotics susceptibility patterns against S. pneumoniae, isolated from pediatric patients with community-acquired respiratory infections in Korea. Methods : One hundred fifty six pneumococcal isolates obtained from pediatric patients with community-acquired respiratory infections such as acute otitis media(AOM), sinusitis and pneumonia between May 2000 to June 2003. And MICs of penicillin and oral antibiotics(amoxicillin, amoxicillin-clavulanate, cefaclor) were performed by broth microdilution methods according to the NCCLS(2003a). Results : Seventy eight percent of the isolates were resistant to penicillin. The isolates, collected from AOM patients showed the highest penicillin resistance(92.7%). The resistant rates of amoxicillin (16.7%) and amoxicillin-clavulanate(9.6%), based on susceptibility breakpoints established by the NCCLS, were markedly lower than these of penicillin. But, the resistant rate of cefaclor was very high, above 95%. Conclusion : We concluded that pneumococci isolated from study cases may be one of the world's highest penicillin resistant rates. But, amoxicillin and amoxicillin-clavulanate can be used as a first-line antibiotics. Finally, we hope that a continuous surveillance study to monitor resistant patterns of pneumococcal respiratory infections will be needed for the standard guidelines of empiric antibiotic treatment.