• Title/Summary/Keyword: Medical

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The Changes in the Outbreak of Rotavirus Gastroenteritis in Children after Introduction of Rotavirus Vaccines: A Retrospective Study at a Tertiary Hospital (로타바이러스 백신 도입 후 로타바이러스 위장관염의 추이: 일개 3차 병원의 후향적 연구)

  • Park, Dong Kyu;Chung, Ju-Young
    • Pediatric Infection and Vaccine
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    • v.21 no.3
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    • pp.167-173
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    • 2014
  • Purpose: This study aimed to examine the changes in the outbreak of acute gastroenteritis, rotavirus gastroenteritis after the introduction of the rotavirus vaccine in Korea. Methods: The current study investigated the number of inpatients in the pediatric ward of Inje University Sanggye Paik Hospital during the periods of 2005-2006 and 2011-2012. A retrospective analysis was conducted on the medical records of 2,840 patients <5 years of age who were hospitalized at Inje University Sanggye Paik Hospital in these time periods. Results: When we compared 2 separate sets of data from before (2005-2006) and after (2011-2012) vaccine introduction, there were statistically significant decreases in the number of patients who were hospitalized for acute gastroenteritis across all of the groups of patients <5 years of age except those <2 months of age. The number of patients with rotavirus gastroenteritis in all age groups declined except for children <2 months of age and those 2-5 months of age. Conclusion: These results show that after the introduction of a rotavirus vaccine in Korea, the incidence of rotavirus gastroenteritis decreased in 6-59-month-old patients hospitalized for acute gastroenteritis.

Clinical characteristics of Kikuchi disease in children (소아 Kikuchi 병의 임상 양상)

  • Chung, Sunghoon;Park, Sungsin;Lee, Kyuha;Song, Junhyuk;Han, Miyoung;Choi, Yongmook;Cha, Sungho;Park, Yongkoo
    • Pediatric Infection and Vaccine
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    • v.14 no.2
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    • pp.129-135
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    • 2007
  • Purpose : Kikuchi disease is a subacute necrotizing lymphadenitis characterized by fever, cervical lymphadenopathy and benign self-limiting course in young women especially, but rare in children. Their etiopathology is still unknown, but involved viruses and autoimmune mechanism were proposed. We investigated the clinical and laboratory characteristics of Kikuchi disease in children. Methods : Five patients were diagnosed of Kikuchi disease from January 2001 to June 2006 in Kyunghee University Hospital. We reviewed their medical records retrospectively and analyzed clinical and laboratory findings. Results : The mean age of 5 patients (male to female ratio; 2:3) was 9 yr 9 mon(range: 8 yr 2 mon-12 yr 6 mon). The chief complaints were sustained fever and cervical lymph node that was unilateral, tender and swollen. All patients were treated with antibiotics before diagnosis was made, and rash developed in 2 patients. One patient showed necrotic change in ultrasound with which we suspected Kikuchi disease. Three patients were examined by CT scan additionally. The interval between admission and cervical lymph node excisional biopsy ranged from 6 days to 15 days, and mean period was 9.6 days. All pathological findings were compatible to necrotizing lymphandenitis. Conclusion : Unnecessary laboratory and imaging studies, and treatment with antibiotics tend to be done before making diagnosis, and that caused prolonged hospitalization. Therefore we studied the clinical and laboratory characteristics of Kikuchi disease in children.

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The Relationship of Psychosocial Factors to Blood Pressure (사회심리학적인 요인과 혈압의 관계)

  • Lee, Choong-Won;Lee, Sung-Kwan
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.1 s.23
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    • pp.99-112
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    • 1988
  • Questionnaires and blood pressure measurements were administered to 279 medical school undergraduates in 1987 to investigate the relationship between psychosocial factors and blood pressure as well as reliability and validity of the Framingham Type A Behavior Scale(FTA). The reliability coefficients of SCL-90-R and nh measured by Spearman-Brown haves split test were $0.57{\sim}0.91$. The factors of FTA extracted by principal component analysis were hard-driving competitiveness factor and impatience factor(2-factor solution) . The total score of nh was positively correlated with relative weight and place raised but the correlations were insignificant, and had significantly positive but weak correlations with depression, anxiety, hostility, paranoid, and psychoticism subscales of SCL-90-R. In the univariate analysis of blood pressures, relative weight and family history were significant in systolic pressure in males and economic status was significant in blood pressures in both sexes. For diastolic pressure, relative weight and frequency of alcohol intake were significant in males and relative weight was in females. After controlling relative weight, the frequency of alcohol intake for diastolic pressure and economic status for systolic pressure were significant in males. The important variables selected by stepwise regression analysis were relative weight and economic status for systolic pressure of males and relative weight and the frequency of alcohol intake for diastolic pressure. At the level of alpha 0.1, depression subscale was added to the model, changing coefficient of determination 0.206 to 0.217. In females, economic status and relative weight were selected for systolic pressure and for diastolic pressure body mass index alone, but the model of blood pressure for females was considered to be unstable due to small sample size(56). FTA was unrelated to the blood pressures in both sexes.

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Development of the Standard Blood Inventory Level Decision Rule in Hospitals (병원의 표준 혈액재고량 산출식 개발)

  • Kim, Byoung-Yik
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.1 s.23
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    • pp.195-206
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    • 1988
  • Two major issues of the blood bank management are quality assurance and inventory control. Recently, in Korea blood donation has gained popularity increasingly to allow considerable improvement of the quality assurance with respect to blood collection, transportation, storage, component preparation skills and hematological tests. Nevertheless the inventory control, the other issue of blood bank management, has been neglected so far. For the supply of blood by donation barely meets the demand, the blood bank policy on the inventory control has been 'the more the better.' The shortage itself by no means unnecessitate inventory control. In fact, in spite of shortage, no small amount of blood is outdated. The efficient blood inventory control makes it possible to economize the blood usage in the practice of state-of-the-art medical care. For the efficient blood inventory control in Korean hospitals, this tudy is to develop formulae forecasting the standard blood inventory level and suggest a set of policies improving the blood inventory control. For this study informations of $A^+$ whole bloods and packed cells inventory control were collected from a University Hospital and the Central Blood Bank of the Korean Red Cross. Using this informations, 1,461 daily blood inventory records were formulated.48 varieties of blood inventory control environment were identified on the basis of selected combinations of 4 inventory control variables-crossmatch, transfusion, inhospital donation and age of bloods from external supply. In order to decide the optimal blood inventory level for each environment, simulation models were designed to calculate the measures of performance of each environment. After the decision of 48 optimal blood inventory levels, stepwise multiple regression analysis was started where the independent variables were 4 inventory control variables and the dependent variable was optimal inventory level of each environment. Finally the standard blood inventory level decision rule was developed using the backward elimination procedure to select the best regression equation. And the effective alternatives of the issuing policy and crossmatch release period were suggested according to the measures of performance under the condition of the standard blood inventory level. The results of this study' were as follows ; 1. The formulae to calculate the standard blood inventory level($S^*$)was $S^*=2.8617X(d)^{0.9342}$ where d is the mean daily crossmatch(demand) for a blood type. 2. The measures of performace - outdate rate, average period of storage, mean age of transfused bloods, and mean daily available inventory level - were improved after maintenance of the standard inventory level in comparison with the present system. 3. Issuing policy of First In-First Out(FIFO) decreased the outdate rate, while Last In-First Out(LIFO) decreased the mean age of transfused bloods. The decrease of the crossmatch release period reduced the outdate rate and the mean age of transfused bloods.

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A study on the properities of the paralytic shellfish poison (마비성 패류 중독의 독성에 관한 연구)

  • Lee, J.T.;Shon, H.S.;Moon, D.H.;Lee, C.U.;Kim, S.C.;Pae, K.T.;Kim, J.Y.;Kim, Y.W.;Paik, N.W.
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.1 s.23
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    • pp.163-171
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    • 1988
  • The paralytic shellfish poisoning was occurred among 25 laborers who worked at breaking-up of ships in Pusan for 5 days from March 29 to April 2 of 1956. For the purpose of accurately defining the paralytic shellfish poison(PSP) , the authors carried out mouse bioassay and chemical analysis. The results were summarized as follows: 1. The mean amount of Paralytic shellfish toxin was $1,207.8{\mu}g$ Per 100gm meat, and the mean death time of mouse was 5 minutes 16 second. 2. The properties of the PSP were mainly gonyautoxin group by chemical analysis(TLC, IR, $^{1}H-NMR$).

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Seroepidemiology of Hepatitis B Virus Infection in Healthy Korean Adults in Seoul (정상 성인에 있어서의 B형 간염 바이러스 감염에 관한 혈청역학적 연구)

  • Yoo, Keun-Young;Park, Byung-Joo;Ahn, Yoon-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.1 s.23
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    • pp.89-98
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    • 1988
  • While there have been not a few reports on the seroepidemiological characteristics of hepatitis B virus (HBV) infection in Korea, most of them, however, have had several limitations; operational definition of HBV infection, validity of detection methods of HBV serologic markers, size of the study population, and confirmation of the vaccination history against HBV, etc. In order to avoid such limitations, authors randomly selected 1,495 healthy adults among the 217,511 insured (target population) of Korean Medical Insurance Corporation, living in seoul, and tested HBV serologic markers by RIA method and conducted direct interview to them. Although HBV serologic markers (HBsAg, anti-HBs and anti-HBc) of all the subjects were tested, 392(26.2%) of interview failure cases and 361 vaccinee were excluded from the actual population. Finally, the serologic markers tested of 742 nonvaccinee (study population) only were analysed for the seroepidemiologic observation of the natural infection of HBV. The seroepidemiological characteristics of HBV infection in Korea were as follows ; 1. Point prevalence of HBs antigenemia was 11.7(9.1{\sim}14.3)% in male, which was slightly higher than that of female, 9.5($3.7{\sim}15.3$)%. This level was one of the highest among those of Asian-Pacific countries. Decreasing tendency of HBsAg prevalence alter the age of 50 was observed, which seems to be due to selective attrition of HBV chronic carriers among the healthy adults and/or to the limited-lasting duration of the HBs antigenemia, in part. 2. Point prevalence of anti-HBc(78.8% in male,50.9% in female) was higher than that of anti-HBs(65.2% in male,46.6% in female), respectively. And both of them were higher in male than in female. Increasing tendency of the prevalence of both antibodies was observed by age, which seems to be largely due to recurrent infection in adults and to some cumulative effect, in part, of their relatively longer-lasting duration. 3. The level of HBV infection defined by positive for at least one of the 3 serologic markers of HBV by RIA method was 84.7($81.8{\sim}87.6$)% in male and 61.2($51.9{\sim}70.5$)% in female, which was also one of the highest among those of Asian-Pacific countries. The proportion of susceptible population to HBV infection among healthy adults was 15.3% in male and 38.8% in female. 4. The relative frequency of current or past infection and chronic carrier among HBV infected person was estimated. The currently or past infected was estimated 75.7% in male and 71.8% in female, and chronic carrier state, 13.8% in male and 14.1% in female. The analysis of the geometric mean of the antibody titer in anti-HBs positive sera indicated also to be compatible with the above findings, suggesting that active, even though inapparent, infection of HBV occur so frequently among healthy adults in Korea.

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Impact of Changes in Maternal Age and Parity Distribution on Low Birth Weight Incidence Rate (모성연령과 출산순위의 변화가 저체중아 출생률에 미친 영향)

  • Kim, Young-Ae;Park, Jung-Han
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.2 s.26
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    • pp.276-282
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    • 1989
  • The objective of this study was to examine the impact of changes in maternal age and parity distribution on birth weight. The study population included 7,786 single live births in 1977 and 8,671 single live births in 1987 delivered at 9 medical facilities in Pusan. Data were obtained from the delivery record. The proportion of infants born to the mothers of 25-29 years increased from 56.475 in 1977 to 65.1% in 1987 and the proportion to the mothers of 30-34 years increased from 18.8% in 1977 to 21.6% in 1987. In the same period, the proportions of 1st and 2nd birth order were increased from 56.9% and 28.8% to 59.9% and 36.8%, respectively. The proportion of infants born to the age group of ${\leq}24\;and\;35{\leq}$ years were decreased in 1987. The proportion of births of the third or higher birth order was decreased from 14.2% in 1977 to 3.3% in 1987. Low birth weight (<2500gm) incidence rate was 5.3% in 1977 and it was decreased to 4.0% in 1987. It was estimated that changes in maternal age-parity distribution accounted for 10.7% of the decreased in low birth weight incidence rate. Rest of the change (89.3%) was attributed to the reduction of age-parity specific low birth weight incidence rate. Application of the direct adjustment method was considered to be an adequate tool for evaluating the impact of family planning on neonatal health.

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Cost-benefit Analysis of Health Screening Test for the Insured (피보험자 건강진단의 비용-편익 분석)

  • Yu, Seung-Hum;Sohn, Myong-Sei;Cho, Woo-Hyung;Park, Eun-Cheol;Lee, Young-Doo;Lee, Kyu-Sik;Chun, Ki-Hong
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.2 s.26
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    • pp.248-258
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    • 1989
  • As a result of cost-benefit analysis by making a macroscopic approach to the health screening projects conducted 4 times since 1950 for the insured people of the Korea Medical Insurance Corporation, the following conclusions were reached. 1. The direct costs put into the health screening project, and the time costs which were paid by examinees or calculated in terms of social costs have been estimated. The results is that the lowest estimation was 10,337 million won and the highest 15,141 million won when a minimum of 1.5 hours of time spent and a maximum 4 hours were applied. 2. In terms of the psychiatric benefits, the lowest estimation was 5,341 million won while the highest was 5,585 million won. 3. In terms of the benefits for each kind of diseases, the lowest estimation of 37,188 million won and highest estimation of 74,383 million won have been calculated for the liver diseases. And for the cardiovascular diseases, the minimum estimation was 14,475 million won while the maximum was 20,532 million won. In case of pulmonary tuberculosis, with external effect benefits being included, the estimation ranged from the minimum of 1,649 million won to the maximum of 1,832 million won. And the estimation of benefits for diabetes mellitus and renal diseases ranged from 89 million won to 92 million won and from 4,567 million won to 7,598 million won respectively. 4. In comparing costs and benefits, as a results of comparing each highest and lowet estimation a range of minimum 46,708 million won and maximum 98,071 million won of benefits has been gained.

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A Study on Occupational Hydrofluoric Acid Burns in a Hydrofluoric Acid Manufacturing Factory (불산제조업체에서 발생한 불산화상에 관한 조사연구)

  • Lim, Hyun-Sul;Cheong, Hae-Kwan;Kim, Ji-Young
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.4 s.44
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    • pp.587-598
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    • 1993
  • Hydrofluoric acid is one of the strongest irritating, corrosive and poisonous inorganic chemicals. Hydrofluoric acid burns are occurring with ever-increasing frequency due to the wide use of this acid in industries. Hydrofluoric acid burns are characterized by severe progressive tissue destruction and excruciating pain due to the unique properties of the freely dissolvable fluoride ion. The authors reviewed medical records of 32 cases (36 spells) of hydrofluoric acid burns which occurred in a hydrofluoric acid manufacturing factory from Sep. 1, 1990 to June 30, 1993. The results are as follows; 1. Eleven measurements of air concentrations of hydrofluoric acid by detection tube method from 1990 to 1992 were all below TLV (Department of Labor, R.O. K). 2. There were 19 cases (22 spells) of hydrofluoric acid burns which occurred during the study period among regular employees. The overall incidence density of hydrofluoric acid was 17.8 cases (20.6 spells) per 100 person-year. Incidence density was 19.0 cases (22.0 spells) per 100 person-year among male workers and there were no female cases. Incidence density was 32.9 cases (38.3 spells) per 100 person-year among production workers and 1.9 cases (1.9 spells) per 100 person-years among management workers with the difference being statistically significant (P<0.01). 3. Of 32 cases (36 spells) of hydrofluoric acid burns among workers who were regularly employed or temporarily employed, 26 spells (81.2%) were between age 20 to 39. In 15 spells(41.7%) burns occurred between 12:00 and 17:59 with 16 spells(44.3%) having arrived at hospital within 2 hours after the accident. 4. Of 36 spells, the main cause of hydrofluoric acid burns were by splashes (8 spells, 22.2 %). The most frequent site of burns were fingers and pain was the most frequent symptom. Thirty spells (83.3%) of the hydrofluoric acid burns were treated with local injection of antidote (calcium gluconate). Complete recovery without scarring were observed in most of the cases (34 out of 36 cases, 94.4%). The study results suggest that to prevent hydrofluoric acid burns, environmental control and the wearing of hydrofluoric acid resistant protective clothes and gloves are important. It is also stressed that establishment of an emergency management and a transfer system for hydrofluoric acid burn victims is necessary.

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Seroepidemiologic Study of Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) Infection among Koreans in Rural Area, Korea (농촌지역의 B형, C형 간염에 관한 혈청역학적 연구)

  • Shin, Hai-Rim;Kim, Joon-Youn;Song, Jue-Bok;Suh, Byung-Seong;Kim, Jung-Man;Lee, Bu-Ok;Kim, Su-Yang;Ryang, Mu-Guan;Lee, Chae-Un;Chun, Jin-Ho;Yoo, Keun-Young;Ahn, Yoon-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.1 s.56
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    • pp.17-29
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    • 1997
  • To estimate the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection and to determine associated risk factors, a population-based seroepidemiologic study was carried out. In 1993, a health examination survey of the population was carried out in rural area known to have a high incidence of liver cancer. The study population were those who volunteered to participate in a health survey over 10 years of age. Examinees were interviewed by specially trained staffs. Sera from 1,033 study subjects were tested for hepatitis B surface antigen (HBsAg) by .everse passive hemagglutinin (RPHA) estimation and for hepatitis C virus antibody (anti-HCV) by 2nd generation passive hemagglutinin (PHA) estimation. The age and sex standardized prevalence of HBsAg was 6.3% which was similar to national average, but that of anti-HCV was 5.1% which was 4 to 5 times higher than that of blood donors or other health examinees in Korea. In a multivariate analysis, transfusion history, surgical operative history, and acupuncture history were not associated with HBsAg positivity. In contrast, acupuncture history (adjusted odds ratio[OR]=2.2 : 95% Confidence interval[CI] 1.0-4.7) and surgical operative history(adjusted OR=2.0 : 95% CI 1.0-4.1) were associated with anti-HCV positivity. The present study suggest that there is an highly endemic area of HCV infection in Korea and probably this endemicity is associated with a parenteral source of HCV infection other than blood transfusion.

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