Journal of Preventive Medicine and Public Health

Chang Yoon Kim

13 Articles

Reference Interval of Serum Thyroid Hormones in Healthy Korean Adults.: Yoon Young Jang, Chang Yoon Kim, Tae Yoon Hwang, Kyung Dong Kim, Chae Hoon Lee; J Prev Med Public Health. 2008;41(2):128-134.; DOI: https://doi.org/10.3961/jpmph.2008.41.2.128

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OBJECTIVES
This study was conducted to determine the reference interval of serum thyroid hormones (TSH, FT(3), FT(4)) in healthy Korean adults. METHODS: Health examination data from 1,591 healthy Korean adults who visited an university hospital were analyzed. Patients with specific health conditions capable of altering laboratory results were excluded from the study. Serum thyroid hormones were measured using IMMULITE 2000 (DPC, USA, 2002). Subjects were 18-65 years old; 911 were male, and 690 were female. RESULTS: The arithmetic means of TSH, FT(3), and FT(4) values for male subjects were 1.28+/-1.84 micronIU/ml, 3.23+/-0.57 pg/ml, and 1.42+/-0.22 ng/dl, respectively. In female subjects, the arithmetic means of TSH, FT3, and FT4 values were 1.49+/-2.08 micronIU/ml, 3.08+/-0.54 pg/ml, and 1.29 +/-0.24 ng/dl, respectively. The arithmetic mean FT(4) value for males decreased with age (p<0.01). The arithmetic mean FT(3) value for females increased with age (p<0.01). The arithmetic mean thyroid hormone values of all study subjects differed significantly based on season. The arithmetic mean of male FT(4) decreased with increasing BMI (p<0.01). The arithmetic mean of female FT(3) increased with increasing BMI (p<0.01). The reference intervals recommended by the IMMULITE 2000 manufacturer are 0.40-4.00 micronIU/ml for TSH, 1.80-4.20 pg/ml for FT(3), and 0.80-1.90 ng/dl for FT(4) (same values for both genders). CONCLUSIONS: There was a significant difference in the interval of thyroid hormones between males and females, but the reference interval of IMMULITE 2000 was not established by gender. There is a need to reestablish the reference interval for thyroid hormones in Korean healthy adults.

Summary

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Diagnosis and Management of Subclinical Hypothyroidism: The 2023 Clinical Practice Guideline, Korean Thyroid Association
Hyun-Kyung Chung
The Korean Journal of Medicine.2024; 99(3): 127. CrossRef
LEVELS OF SERUM TSH AND ITS IMPLICATIONS IN DEVELOPMENT OF METABOLIC SYNDROME – TIP OF THE ICEBERG: IN YOUNG ADULTS OF GUWAHATI CITY.
Arijit Mazumdar
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH.2023; : 19. CrossRef
2023 Korean Thyroid Association Management Guidelines for Patients with Subclinical Hypothyroidism
Hyun Kyung Chung, Eu Jeong Ku, Won Sang Yoo, Yea Eun Kang, Kyeong Jin Kim, Bo Hyun Kim, Tae-Yong Kim, Young Joo Park, Chang Ho Ahn, Jee Hee Yoon, Eun Kyung Lee, Jong Min Lee, Eui Dal Jung, Jae Hoon Chung, Yun Jae Chung, Won Bae Kim, Ka Hee Yi, Ho-Cheol Ka
International Journal of Thyroidology.2023; 16(1): 32. CrossRef
Management of Subclinical Hypothyroidism: A Focus on Proven Health Effects in the 2023 Korean Thyroid Association Guidelines
Eu Jeong Ku, Won Sang Yoo, Hyun Kyung Chung
Endocrinology and Metabolism.2023; 38(4): 381. CrossRef
A Systematic Review and Meta-Analysis of Free Triiodothyronine (FT3) Levels in Humans Depending on Seasonal Air Temperature Changes: Is the Variation in FT3 Levels Related to Nonshivering Thermogenesis?
Alena Nikanorova, Nikolay Barashkov, Vera Pshennikova, Fedor Teryutin, Sergey Nakhodkin, Aisen Solovyev, Georgii Romanov, Tatiana Burtseva, Sardana Fedorova
International Journal of Molecular Sciences.2023; 24(18): 14052. CrossRef
Seasonal Fluctuations of Blood Pressure and Heart Rate in Healthy People: A Meta-Analysis of Panel Studies
N. V. Kuzmenko, V. A. Tsyrlin, M. G. Pliss, M. M. Galagudza
Human Physiology.2022; 48(3): 313. CrossRef
Factors influencing the reference interval of thyroid‐stimulating hormone in healthy adults: A systematic review and meta‐analysis
Dongyang Xing, Delong Liu, Ri Li, Qi Zhou, Jiancheng Xu
Clinical Endocrinology.2021; 95(3): 378. CrossRef
Seasonal variations in levels of human thyroid-stimulating hormone and thyroid hormones: a meta-analysis
N. V. Kuzmenko, V. A. Tsyrlin, M. G. Pliss, M. M. Galagudza
Chronobiology International.2021; 38(3): 301. CrossRef
An exploratory study of the association between thyroid hormone and survival of amyotrophic lateral sclerosis
Zhenzhen Zheng, Xiaoyan Guo, Rui Huang, Xueping Chen, Huifang Shang
Neurological Sciences.2014; 35(7): 1103. CrossRef
The Change of Thyroid Stimulating Hormone Values of Healthy Subjects According toTemperature and Aging
Sung Su Kim, Dong Hoon Lew, Ja Yoon Choi, Eun Ju Lee, Min Gyo Kim, Kyong Young Kim, Soo Kyoung Kim, Jung Hwa Jung, Jae Hoon Jung, Jong Ryea l Hahm
Kosin Medical Journal.2014; 29(2): 125. CrossRef
Clinical implications of preoperative thyrotropin serum concentrations in patients who underwent thyroidectomy for nonfunctioning nodule(s)
Dongju Kim, Jin-Woo Park
Journal of the Korean Surgical Society.2013; 85(1): 15. CrossRef
Serum thyrotropin as a risk factor for thyroid malignancy in euthyroid subjects with thyroid micronodule
Seong‐Su Moon, Young‐Sil Lee, In‐Kyu Lee, Jung‐Guk Kim
Head & Neck.2012; 34(7): 949. CrossRef
Serum TSH Level in Healthy Koreans and the Association of TSH with Serum Lipid Concentration and Metabolic Syndrome
Yeo Kyung Lee, Jo Eun Kim, Hyun Ju Oh, Kyung Sun Park, Soo Kyung Kim, Seok Won Park, Moon Jong Kim, Yong Wook Cho
The Korean Journal of Internal Medicine.2011; 26(4): 432. CrossRef

Effects of the Personal Stereo System on Hearing in Adolescents.: Jong Seo Park, Sean Hee Oh, Pock Soo Kang, Chang Yoon Kim, Kyeong Soo Lee, Tae Yoon Hwang, Joon Sakong; J Prev Med Public Health. 2006;39(2):159-164.

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Abstract PDF: OBJECTIVES
This study was conducted to evaluate the effects of the personal stereo system on the hearing in adolescents. METHODS: A total of 68 adolescents(age: 13-18 years) who visited the ENT Department at a University Hospital in Daegu were personally interviewed. The questionnaires were about general characteristics of the subjects, the time of personal stereo system use(year, hour) and place. Cumulative exposure to the personal stereo system was calculated by the product of the total years and the daily hours of their use. Pure tone audiometry was performed and the hearing threshold was measured at 500, 1000, 2000, 4000 and 8000 Hz. RESULTS: The average time of using a personal stereo system a day was about 3 hours and 75% of the subjects used a personal stereo system for 2-5 years. The elevation of threshold was more prominent in the subjects who used personal stereo systems for 4 years and more compared with those subjects who used them for 3 years and under. The elevation of hearing threshold was also more prominent in the subjects who used personal stereo systems for 4 hours and more a day compared with those subjects who used personal stereo systems for 3 hours and under a day. The elevation of hearing threshold was more prominent in the subjects who used personal stereo systems for 13 hour..years and more compared to the subjects who used them 12 hour..years and under. CONCLUSIONS: These results suggest that the elevation of hearing threshold can happen to adolescents who used personal stereo systems for a long time. In order to prevent hearing loss, we need to teach adolescents appropriate usage of the personal stereo system and hearing tests should be included in the periodic school-based physical examination for the adolescents.; Summary

Reformation of Residency Trainingship for the Future of Preventive Medicine in Korea.: Chang Yoon Kim; J Prev Med Public Health. 2006;39(2):110-114.

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Abstract PDF: From the start of the residency trainingship in 1963, the residency training programs have been contributed much on the establishment and development of preventive medicine in Korea. But these programs are now have several problems to update the changes in health service needs of the population that were caused by a rapid epidemiologic transition from the acute infectious diseases to chronic diseases in last a few decades. Strengthening in medical practice, not just in knowledge is urgently required. Must have more concentrate on preventive service for the individual, as in clinical preventive medicine. Training residents by the systematic and well scheduled programs, not just 'teacher's assistant' in the academic facilities. Trying the change in the system of Specilty of Preventive Medicine to the well established several subspecialty, so more specific competency can be gained through the training. These approach and reformation may not only contribute for the better future of the preventive medicine, but also improve in disease prevention and health promotion, which required by the society in Korea.; Summary

Development of Korean Neurobehavioral Test Battery - Assessment of the Validity of Traditional and Computerized Neurobehavioral Tests.: Jong Hak Chung, Chang Yoon Kim, Joon Sa Kong, Man Joong Jeon, Park Chin Hong; Korean J Prev Med. 1998;31(4):692-707.

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Abstract PDF: Aim. A neurobehavioral test for workers exposed to organic solvents in the workplace can be affected by many factors : age, education, motivation, ethnicity, etc. To apply more suitable neurobehavioral test for Korean workers, we evaluated the validity of several items of computerized and traditional neurobehavioral tests. Methods. We have applied eleven tests : four items of computerized neurobehavioral test(Swedish Performance Evaluation System) including Addition, Symbol-Digit, Digit Span, and Finger tapping speed, and seven items of traditional neurobehavioral test consisting of Addition, Digit-Symbol , Digit Span, Benton visual retention test, Pursuit aiming, Pegboard, and Tapping. These tests were performed on 96 workers exposed to solvents, and 100 reference workers. The concurrent and construct validities were evaluated by group difference, correlation with age, educational level, hippuric acid level, neurotoxic symptom, current exposure level, multitrait-multimethod matrix, factor analysis, and discriminant analysis. Results. Statistically significant differences were observed between the workers exposed to solvents and referents in computerized Symbol-Digit, Finger tapping speed, traditional Digit-Symbol and Pegboard. The computerized Symbol-Digit, traditional Digit-Symbol, Addition, Benton visual retention test, and Pegboard were found to be related to the age. The performance of computerized Symbol-Digit, Addition, and traditional Digit-Symbol were found to be related to the educational level significantly. The computerized Symbol-Digit, Finger tapping speed, and traditional Digit-Symbol were found to be related to hippuric acid, and neurotoxic symptom. The discriminability of Finger tapping speed, and Pegboard was better than the other tests. In discriminant analysis, the model with two variables, the computerized Symbol-Digit and Pegboard, classified almost 70 percent of the workers correctly. Conclusions. These results suggest that the computerized Symbol-Digit, Finger tapping speed, and Pegboard are more satisfactory for our purpose, and the Addition, Tapping, Benton visual retention test, and Pursuit aiming are less valid than other items. These may allow the reasonable selection of core neurobehavioral tests for workers exposed to solvents in Korea.; Summary

The Incidence Rate of Coronary Heart Disease in City Area.: Byung Yeol Chun, Kwon Bae Kim, Kee Sik Kim, Young Jo Kim, Yoon Nyun Kim, Chang Yoon Kim, Wee Hyun Park, Dong Gu Shin, Bong Sub Shin, Jong Joo Lee, Choong Won Lee, Sung Gug Chang, Jae Eun Jun, Yong Keun Cho, Shung Chuil Chae, Gi Yong Choi, Young Ae Ha, Young Sook Lee; Korean J Prev Med. 1998;31(3):395-403.

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Abstract PDF: To estimate the incidence rate of coronary heart disease in Korea, of all residents of the Taegu city aged 25 or above, those who had an acute MI or fatal coronary event between 1 July 1996 and 30 June 1997 were registered. Seven hundreds and eight patients were registered during the study period(685 were identified at hospital and 23 were autopsy cases). Age-standardized annual incidence rate of men in city area was 93 per 100,000(95% CI; 61-142) and 33(95% CI; 16-67) in women(100 in men and 20 in women aged 35-64). The incidence was rapidly increased after age 40 in men, however, in women after age 60. Twenty-eight-days case fatality rate was 45% in men and 47% in women. However, in the age group of 45-59 case fatality rate in women was two times higher than that in men. In conclusion, crude annual incidence rate of CHD in city area was 73 per 100,000 in men and 33 in women. The age-standardized annual incidence of CHD in men(93 per 100,000) was 3.2 times higher than that in women (33 per 100,000) in Korea.; Summary

A cohort study on blood zinc protoporphyrin concentration of workers in storage battery factory.: Man Joong Jeon, Joong Jeong Lee, Joon Sakong, Chang Yoon Kim, Jung Man Kim, Jong Hak Chung; Korean J Prev Med. 1998;31(1):112-126.

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Abstract PDF: To investigate the effectiveness of the interventions in working environment and personal hygiene for the occupational exposure to the lead, the blood zinc protoporphyrin(ZPP) concentrations of 131 workers ( 100 exposed subjects and 31 controls ) of a newly established battery factory were analyzed. They were measured in every 3 months up to 18 months. Air lead concentration (Pb-A) of the workplaces was also checked for 3 times in 6 months interval from August 1987. Environmental intervention included the local exhaust ventilation and vacuum cleaning of the floor. Intervention of the personal hygiene included the daily change of clothes, compulsory shower after work and hand washing before meal, prohibition of cigarette smoking and food consumption at the work site and wearing mask. Mean blood ZPP concentration of the controls was 16.45+/-4.83 microgram/dashliter at the preemployment examination and slightly increased to 17.77+/-5.59 microgram/dashliter after 6 months. Mean blood ZPP concentration of the exposed subjects who were employed before the factory was in operation (Group A) was 17.36+/-5.20 microgram/dashliter on employment and it was increased to 23.00+/-13.06 microgram/dashliter after 3 months. The blood ZPP concentration was increased to 27.25+/-6.40 microgram/dashliter on 6 months (p<0.01) after the employment which was 1 month after the initiation of intervention program. It did not increase thereafter and ranged between 25.48 microgram/dashliter and 26.61 microgram/dashliter in the subsequent 4 results. Mean blood ZPP concentration of the exposed subjects who were employed after the factory had been in operation but before the intervention program was initiated (Group B) was 14.34+/-6.10 microgram/dashliter on employment and it was increased to 28.97+/-7.14 microgram/dashliter (p<0.01) in 3 months later(1 month after the intervention). The values of subsequent 4 tests were maintained between 26.96 microgram/dashliter and 27.96 microgram/dashliter. Mean blood ZPP concentration of the exposed subjects who were employed after intervention program had been started (Group C) was 21.34+/-5.25 microgram/dashliter on employment and it was gradually increased to 23.37+/-3.86 microgram/dashliter (p<0.01) after 3 months, 23.93+/-3.64 microgram/dashliter after 6 months, 25.50+/-3.01 microgram/dashliter (p<0.01) after 9 months, and 25.50+/-3.10 microgram/dashliter after 12 months. Workplaces were classified into 4 parts according to Pb-A. The Pb-A of part I, the highest areas, were 0.365 microgram/m4, and after the intervention the levels were decreased to 0.216 microgram/m4 and 0.208 microgram/m4 in follow-up test. The Pb-A of part II which was resulted in lower value than part I was decreased from 0.232 microgram/m4 to 0.148 microgram/m4, and 0.120 microgram/m4 after the intervention. The Pb-A of part III was tested after the intervention and resulted in 0.124 microgram/m4 in January 1988 and 0.081 microgram/m4 in August 1988. The Pb-A of part IV was also tested after the intervention and resulted in 0.110 microgram/m4 in August 1988. There was no consistent relationship between Pb-A and blood ZPP concentration. The blood ZPP concentration of the group A and B workers in the part of the highest Pb-A were lower than those of the workers in the parts of lower Pb-A. The blood ZPP concentration of the workers in the part of the lowest Pb-A increased more rapidly. The blood ZPP concentration of the group C workers was the highest in part III. These findings suggest that the intervention in personal hygiene is more effective than environmental intervention, and it should be carried out from the first day of employment and to both the exposed subjects, blue color workers and the controls, white color workers.; Summary

Serum HBsAg and Anti-HBs Positive Rate among a City Health Center Visitors.: Mal Sook Shin, Tae Yoon Hwang, Chang Yoon Kim; Korean J Prev Med. 1997;30(3):508-517.

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Abstract PDF: Hepatitis B virus(HBV) infection is one of the major health problems in Korea and HBsAg positive rate was known to be about 5~15% in general population. This study was conducted to identify the positive rates of serum HBsAg and anti-HBs among community population regared as having high HBV vaccination rate than in previous decade, using EIA(Enzyme immunoassay) method, in Seo-Gu, Taegu, Korea. The study subjects were 1,160 who visited Seo-Gu Health Center for check-up serologic markers of hepatitis B. The data were obtained from the serologic test for hepatitis markers and questionnaire survey was conducted to obtain the general characteristics, vaccination history, past history of hepatitis and other liver disease , and exposure history to risk factors of hepatitis of the study subjects. The positive rates of HBsAg and anti-HBs were 5.2% and 62.4% respectively. The positive rates of HBsAg for male and female were 6.6% and 4.3% respectively. The age was divided into two groups as group I(less than 15 years old), group II(more than 16years old) according to the hypothesis that these two groups might be different in HBV vaccination rate. HBV vaccination rates for group I and II were 83.1% and 52.3%. The positive rates of HBsAg for group I and II were 2.6% and 6.5%. The positive rates of HBsAg for the vaccinated people of the group I and II were 2.2% and 3.5%, the positive rates of anti-HBs for the vaccinated people of the group I and II were 70.1% and 71.1% respectively. The most significant factor in positive rate of HBsAg was 'hepatitis carrier in family'. Multiple logistic regression analysis revealed that 'hepatitis history' and 'hepatitis carrier in family' were significant variables for positivity of HBsAg, and 'hepatitis B vaccination' was only a significant variable for positivity of anti-HBs.; Summary

Referral Patterns and Needs for Specialist Care among Patient Referred from Health Center.: Tae Yoon Hwang, Chang Yoon Kim, Pock Soo Kang; Korean J Prev Med. 1996;29(1):133-143.

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Abstract PDF: This study was conducted to assess the referral patterns to specialist from general practitioners in health center and perceived needs of referred patients for specialist care in health center. The study subjects were 249 patients who visited to health centers and were referred to other medical facilities. The data were obtained from questionnaire survey which was conducted in Kyongjuu-city Health center, Seongju-Gun Health center and Koryong-Gun Health center in Kyongsangbuk-Do, from June 10 to october 17, 1995. The total referral rate was 2.7%. The proportion of patients who wished to be referred to medical specialists was 85.9%, and the proportion of patients referred by general practitioners in health centers was 14.1%. Among the patients who wished to be referred to medical specialists, 45.9% visited directly to health centers, 34.6% visited health centers via local clinics and 19.5% visited health centers to get referral permission only. The reasons for getting referral permission in health centers were easy geographical accessibility(34.6 %), easy to get referral permission in health centers(27.l%), and very difficult to get referral permission in local clinics(l6.4%). Among the diseases of referred patients, diseases of the musculoskeletal system and connective tissue were most prevalent on a whole, but diseases of nervous system and sensory organs were comparatively high among the patients who wished to be referred to medical specialists and infectious and parasitic diseases were comparatively high among the patients referred by general practitioners in health centers. The most favorable medical facility was general hospital including university hospital in both groups of patients who wished to be referred to medical specialist and the patient referred by general practitioners in health centers. Regarding the needs for specialist care in health center, 75.2% patients who wished to be referred to medical specialists and 74.3% of patients referred by general practitioners in health center wanted the specialist care. The most frequently requested speciality is internal medicine(47.1%), and then orthopedics and general surgery. Based on above results, this study revealed that the majority of patients referred from health center wished to be referred to medical specialists at their own will, so, referral system at health center level should be changed. And if specialist care in health center be provided, the medical care by internist could be provided first, and then that of orthopedics and general surgery could be provided. These kinds of medical cares could be covered by local clinicians as a part-time job on a voluntary basis.; Summary

Lead Concentrations of Pigeon's Tissue as Indicator of Lead pollution in Air and Soil.: Yung Woo Byun, Tae Yoon Hwang, Jung Jeung Lee, Chang Yoon Kim, Jong Hak Chung; Korean J Prev Med. 1996;29(1):15-26.

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Abstract PDF: It has been studied that a variety of fauna and flora are sensitive biological indicators which reflect the severity of regional pollution of heavy metals, but in the center of part of Taegu city the controversial issue of lead poisoning attributable to the atmosphere which contains an increased concentrations of lead has been raised recently, it is usually hard to find suitable plants or animal in the areas with heavy traffic. Pigeons are ubiquitous in and around Taegu city area, inhabiting even the most densely populated areas with heavy traffic with its small body size, high metabolic turnover, and rather limited mobility, a pigeon, as a biological indicator is expected. This study was conducted to monitor lead pollution in the Taegu and kyongju city in Korea. We measured the lead content of the various tissue of three groups of feral pigeon(Columbia livia) and soil and atmospheric lead concentration. First group was obtained io heavy traffic area in Taegu City, the second group was obtained a park in Taegu city and the third group was obtained light traffic area in kyongju city. The air and soil lead concentration of heavy traffic area in Taegu city was 0.11 microgram/m2, 4.96 microgram/g, that of park in Taegu city was 0.05 microgram/m3, 2.65 microgram/g and that of light traffic area in kyonngju city was 0.03 microgram/m3, 0.01 microgram/g. The lead content of lung, blood, kidney, femur and liver of feral pigeons in heavy traffic area in Taegu city was significantly higher than pigeons obtained in a park in Taegu city and low traffic density area in Kyonfju city(p<0.01). But stomach lead content of three group did not reflect a significant difference. In this study positive correlation was found between atmospheric lead concentrations and the concentration of lead in the pigeon's lung(r=0.5040, p<0.001), blood(r=0.3322, p<0.01), kidney(r=0.4824, p<0.001), femur(r=0.7214, p<0.001) and liverer (r=0.4836, p<0.01). we can also found positive correlation between soil lead concentrations and the concentration of lead in the pigeon's femur(r=0.4850, p<0.001), kidney(r=0.4850, p<0.001) and liver(r=0.4386, p<0.01). In the pigeon`s tissue there were significant correlations between concentration of lead in the blood and kidney(r=0.4818, p<0.001), femur(r= 0.6157, p<0.001) and liver(r=0.3889, p<0.001). In conclusion, at the heavy traffic area in Taegu city, lead concentrations found in the atmosphere and soil are reflected in the lead concentrations of different tissue of urban pigeons. It is suggested that the tissue of pigeons can be good biological indicators of environmental lead pollution.; Summary

Relationship of Body Fat Percent with Serum Lipid Level and Blood Pressure in Adults.: Seock Whan Lee, Tae Yoon Hwang, Chang Yoon Kim; Korean J Prev Med. 1995;28(4):783-794.

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Abstract PDF: This study was conducted to clarify the relationship of body fat percent with serum lipid level and blood pressure in adults. The study subjects were 472 men and l89 women who visited Multiphasic Health screening center of Yeungnam university Hospital in Taegu from May 20 to September 30, 1994. The relationship of serum lipid and blood pressure with BMl, Katsura index, atherogenic index, which calculated from the health screening data and body fat percent measured by impedance fat meter(model SIF-819) were analyzed. Three groups were classified as Group I(men: body fat percent > or= 20, women: body fat percent > or= 25, Group II (men: 15 < or = body fat percent <20, women: 20 < or = body fat percent<25, Group III(men: body fat percent <15. women: body fat percent<20) In this study, Group I accounted for 3.2%in men, 3.7%in women. Weight was significantly different among three groups in both sexes(p<0.01) and height was not significantly different among three groups. In men, serum total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein. atherogenic index were significantly different(p<0.01). In women, serum total cholesterol and low density lipoprotein were significantly different(p<0.05 but there was no differences in triglyceride and high density lipoprotein among three groups. BMl and Katsura index were significantly different among three groups in both sexes(p<0.01). In men, body fat percent was positively correlated with weight, BMl, Katsura index, total cholesterol, triglyceride, low density lipoprotein, atherogenic index and systolic and diastolic blood pressures, and negatively correlated with high density lipoprotein. In women, body fat percent was positively correlated with age, height, weight, BMl, Katsura index, total cholesterol, triglyceride, low density lipoprotein and atherogenic index, and negatively correlated with high density lipoprotein. But there was no significant correlation between body fat percent and blood pressure in women. In multiple regression analysis for total cholesterol, fat percent, age and BMl were significant independent variables in men(p<0.05, R2=0.1286), and body fat percent and age in women(p<0.05, R2=0.3399). In case of LDL/HDL ratio, only BMl was a significant independent variable in men(p<0.01, R2=0.0954), and body fat percent, age and BMl in women(p<0.05, R2=0.3164). In multiple regression analysis, age, low density lipoprotein and total cholesterol were significant independent variables on systolic blood pressure in men(p<0.05, R2=0.1297), age and total cholesterol in women(p<0.055, R2=0.1705). On diastolic blood pressure, only age was a significantly independent variable in men(p<0.01, R2=0.0972) and women(p<0.01, R2=0..1218). From the result of this study, it could concluded that body fat percent was significantly associated with other obesity indices and serum lipid, but had no significant association with blood pressure. To establish the relationship of body fat percent with blood pressure, further study which consider other variables that may have an effect on blood pressure should be performed.; Summary

Lead Level in Blood, Scalp Hair and Toenail of Elementary Schoolchildren.: Jae Uk Kim, Jung Jeung Lee, Chang Yoon Kim, Jong Hak Chung; Korean J Prev Med. 1995;28(1):73-84.

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Abstract PDF: This study was conducted to measure the lead level in the blood, scalp hair and toenail of the elementary schoolchildren and assess the relationship among those samples. Lead concentration of the blood, scalp hair and toenail was measured for l00(male 50, female 50) fourth grade elementary schoolchildren in Taegu city. The mean lead level in the blood, scalp hair and toenail was 6.00+/-2.44 microgram/dl, 6.28+/-3.54 microgram/dl 6. 68 and 7.33+/-3.18 microgram/g. The mean lead level in the blood of schoolboys was 6.43+/-2.77 microgram/dl and that of schoolgirls was 5.59+/-2.01 microgram/dl. The mean lead level in the scalp hair of schoolboys was 7.66+/-2.97 microgram/dl and that of schoolgirls was 6.88+/-3.54 microgram/g. The mean lead level in the toenail of schoolboys was 8.19+/-3.5 microgram/g and that of schoolgirls was 6.47+/-2.52 microgram/g and their difference was statistically significant. In schoolboys, the correlation coefficient between the lead level in the blood and scalp hair was 0.4909, and the data were fitted best by the regression equation Y=0.5255X+4.2810, where Y and X are scalp hair and blood concentration. In schoolgirls the correlation coefficient between the lead level in the blood and scalp hair was 0.3778, and the data were fitted best by the regression equation Y=0.6655X+2.9632, where Y and X are scalp hair and blood concentration. In schoolboys. the correlation coefficient between the lead level in the blood and in the toenail was 0.5533, and the data were fitted best by the regression equation Y=0.7076X+3.6472, where Y and X are toenail and blood concentration. In schoolgirls the correlation coefficient between the lead level in the blood and in the toenail was 0.2738, and the data were fitted best by the regression equation Y=0.3431X+4.5570 where Y and X are toenail and blood concentration. In schoolboys, the correlation coefficient between the lead level in the scalp hair and in the toenail, in the schoolboys was 0.4148, and the data were fitted best by the regression equation Y=0.4956X+4.3986, where Y and X are toenail and scalp hair concentration. In schoolgirls the correlation coefficient between the lead level in the scalp hair and in the toenail 0.1159, and the data were fitted best by the regression equation Y=0.0825X+5.9214 here Y and X are toenail and scalp hair concentration. Correlation among lead concentration in the blood, scalp hair and toenail of schoolchildren were statistically significant except between scalp hair and toenail in schoolgirls. These finding suggest that blood, scalp hair and toenail can be used substitutive samples between each others.; Summary

A Comparative Study on the Pattern of Outpatient Department Utilization at a Tertiary Level Hospital before and after Implementation of the Patient Referral System.: Kyeong Soo Lee, Chang Yoon Kim, Pock Soo Kang; Korean J Prev Med. 1992;25(1):88-100.

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Abstract PDF: This study was conducted to assess the effects of implementation of the patient referral system started July 1st, 1989. A comparison on the pattern of outpatient services of the Departments of Internal Medicine, General Surgery, and Pediatrics at the Yeungnam University Hospital was conducted for each one year period before and after implementation of the patient referral system. The pre-implementation period was from July 1. 1988 to June 30, 1989 and the post-implementation period was from July 1. 1989 to June 30, 1990. The information used for this study was obtained from official forms, prepared by the Yeungnam University Hospital, and submitted to the Korean Medical Insurance Cooperatives. After implementation of the patient referral system, the number of outpatient cases in the Department of Internal Medicine decreased 36.1% from 9,669 cases to 6,181 cases a year. Cases in the Department of General Surgery decreased 23.7% from 1,864 cases to 1,422 cases a year. The number of cases in the Department of General Surgery decreased 23.7% from 1,864 cases to 1,422 cases a year. The number of cases in the Department of Pediatrics decreased 36.9% from 3,372 cases to 2,128 cases a year. After implementation of the patient referral system, the average age of cases in the Departments of Internal Medicine and General Surgery was 52.5 and 49.7 years old, respcetively. This was a significant increase in comparison with the pre-implementation period. After implementation of patient referral system, the proportion of new outpatients in the Department of Internal Medicine decreased form 24.1% to 14.6%, the Department of General Surgery from 36.0% to 23.4%, and the Department of Pediatrics from 15.5% to 8.3%. The number of visits per case decreased significantly in the Department of Internal Medicine(from 1.74 to 1.61), but there was no significant change in the Department of General Surgery and Pediatrics. The length of treatment per case increased significantly in all three departments (form 16.1 days to 19.3 days in the Department of Internal Medicine, from 12.0 days to 15.2 days in the Department General Surgery, and 8.9 days to 11.2 days in the Department of Pediatrics). The number of clinical tests per case increased significantly in the Department of Internal Medicine (from 22. to 2.5), in the Department of Pediatrics(from 0.8 to 1.1) and increased in the Department of General Surgery(from 6.4 to 6.6). The average medical cost per case decreased form 43,900 Won to 42,500 Won in the Department of Internal Medicine, while the cost increased from 75,900 Won to 78,500 Won in the Department of General Surgery and from 12,700 Won to 13,500 Won in the Department of Pediatrics. In case-mix, the chronic degenerative disease(i. e. hypertension, diabetes mellitus, angina pectoris, malignant neoplasm, and pulmonary tuberculosis) ranked higher and acute infectious diseases and simple cases(i. e. gastritis and duodenitis, haemorrhoids, anal fissure, carbuncle, acute URI, and bronchitis) ranked lower after implementation of the patient referral system compared to before implementation.; Summary

Cohort Observafion of Blood Lead Concentration of Storage Battery Workers.: Chang Yoon Kim, Jung Man Kim, Gu Wung Han, Jung Han Park; Korean J Prev Med. 1990;23(3):324-337.

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Abstract PDF: To assess the effectiveness of the interventions in working environment and personal hygiene for the occupational exposure to the lead, 156 workers (116 exposed subjects and 40 controls) of a newly established battery factory were examined for their blood lead concentration (Pb-B) in every 3 months up to 18 months. Air lean concentration (Pb-A) of the workplaces was also checked for 3 times in 6 months interval from August 1987. Environmental intervention included the local exhaust ventilation and vacuum cleaning of the floor. Intervention of the personal hygiene included the daily change of clothes, compulsory shower after work and hand washing before meal, prohibition of cigarette smoking and food consumption at the work site and wearing mask. Mean Pb-B of the controls was 21.97 +/- 33.6 microgram/dl at the preemployment examination and slightly increased to 22.75 +/- 3.38 microgram/dl after 6 months. Mean Pb-B of the workers who were employed before the factory was in operation (Group A) was 20.49 +/- 3.84 microgram/dl on employment and it was increased to 23.90 +/- 5.30 microgram/dl after 3 months <(P<0.01). Pb-B was increased to 28.84 +/- 5.76 microgram/dl 6 months after the employment which was 1 month after the initiation of intervention program. It did not increase thereafter and ranged between 26.83 microgram/dl and 28.28 microgram/dl in the subsequent 4 tests. Mean Pb-B of the workers who were employed after the factory had been operation but before the intervention program was initiated (Group B) was 16.58 +/- 4.53 microgram/dl before the exposure and it was increased to 28.82 +/- 5.66 microgram/dl (P<0.01) in 3 months later (1 month after the intervention). The values of subsequent 4 tests remained between 26.46 and 28.54 microgram/dl. Mean Pb-B of the workers who were employed after intervention program had been started (Group C) was 19.45 +/- 3.44 microgram/dl at the preemployment examination and gradually increased to 22.70 +/- 4.55 microgram/dl after 3 months (P<0.01), 23.68 +/- 4.18 microgram/dl after 6 months, and 24.42 +/- 3.60 microgram/dl after 9 months. Work stations were classified into 4 parts according to Pb-A. The Pb-A of part I, the highest areas, were 0.365 mg/m3, and after intervention the levels were decreased to 0.216 mg/m3 and 0.208 mg/m3 in follow-up tests. The Pb-A of part II was decreased from 0.232 mg/m3 to 0.148 mg/m3, and 0.120 mg/m3 after the invention. Pb-A of part III and IV was tested only after intervention and the Pb-A of part III were 0.124 mg/m3 in January 1988 and 0.081 mg/m3 in August 1988. The Pb-A of part IV, not stationed at one place but moving around, was 0.110 mg/m3 in August 1988. There was no consistent relationship between Pb-B and Pb-A. Pb-B of the group A and B workers in the part of the highest Pb-A were lower than those of the workers in the parts of lower Pb-A. Pb-B of the workers in the part of the lowest Pb-A increased more rapidly. Pb-B of group C workers was the highest in part I and the lowest in part IV. These findings suggest that Pb-B is more valid method than Pb-A for monitoring the health of lead workers and intervention in personal hygiene is more effective than environmental intervention.; Summary

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