Journal of Preventive Medicine and Public Health

Reimbursement for Preventive Health Services.: Davis Karen; Korean J Prev Med. 1989;22(1):1-7.

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Abstract PDF: This paper examines the failure to promote adequate preventive health care in the U.S. It focuses specifically on the preventive health services of screening, counseling, and immunization. It explores evidence on their effectiveness, as well as coverage under current private and public health insurance plans. It concludes with a proposal to expand health insurance coverage for preventive services and to reimburse physicians directly for preventive health services provided to patients.; Summary

Epidemiology and control of hypertension in Japan Epidemiology and control of hypertension in Japan.: Naosuk Sasaki; Korean J Prev Med. 1989;22(1):8-13.

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Abstract PDF: No abstract available.; Summary

The Demographic Position of the Koreans in China.: Chai Bin Park; Korean J Prev Med. 1989;22(1):14-24.

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Abstract PDF: No abstract available.; Summary

The Relationship between the Cause of Death and Life Expectancy by FEV in Coal Workers Pneumoconiosis.: Yong Hee Cheon, Kyung Yong Koh; Korean J Prev Med. 1989;22(1):25-28.

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Abstract PDF: Sixty-two medical records of patients with coal workers' pneumoconiosis who died in hospital as coal workers' pneumoconiosis were analyzed for study of the relationship between forced expiratory volume in one second(FEV1) and life expectancy in coal workers' pneumoconiosis. In the group who died of asphyxia from hemoptysis, life expectancy were well fitted with FEV1 (p<0.05). But others were not well fitted to simple linear regression equation. The prevalence of ECG sign of cor pulmonale was more in the group of cardiorespiratory failure than asphyxia group. So, in the case of far advanced cor pulmonale, it was difficult to predict life expectancy by simple linear regression equation.; Summary

Utilization Rate of Medical Facility and Its Related Factors in Taegu.: Seok Beom Kim, Pock Soo Kang; Korean J Prev Med. 1989;22(1):29-44.

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Abstract PDF: A household survey was conducted to determine the utilization rate of medical facilities and to identify the factors related with the utilization in the South District of Taegu from July 3 to July 15, 1988. Study population included 1,723 family members of 431 households which were selected by one-stage simple cluster random sampling. Well trained medical college students interviewed mainly housewives with a structurized questionnaire. Morbidity rate of acute illness during the 2-week period was 101 per 1,000 persons and it was highest in the age group of 9 years below. The rate for chronic illness was 77 per 1,000 persons, increasing with age, low income and medicaid benefit. During the 2-week period, 689 of 1,000 persons utilized the medical facilities, Of the facilities, most number, 294, used hospital and clinic, and the order ran as pharmacy, health center, and herb medical clinic. The utilization rate was higher in the female, 70-year and older group, medicaid group, the lowest income class and self-employed group than other groups. The average number of visits among users of medical facilities during the 2-week period was 3.25. those who visited medical facilities most frequently were females, the 70-year and older group, the lowest income class and blue collar worker group. During one-year period, admission rate of 1,000 persons was 27.6 and that of female was 38.9, higher than that of male. the eldest group had the highest admission rate. Admission rate of medical insurance beneficiaries was twice or higher than non-beneficiaries. The higher the family monthly income, the more frequently they admitted. During one-year period, average admission days of the persons hospitalized were 22.5 days and males were hospitalized longer than females. The groups which were hospitalized longest were those between the ages of 40 and 49, medical insurance beneficiaries, the lowest income group and unemployed group. During one-year period, average admission days of 1,000 persons were 560 days and those of female were 661 days, more than those of male. The guoups which had the longest admission days were those above 70 years of age, the lowest income and unemployed groups. The medical insurance beneficiaries were three times or longer than non-beneficiaries. In logistic regression analysis of utilization of physician, significant independent variables were the 9-year and younger group(+), the 70-year and older group(+), acute illness episode(+), chronic illness episode(+), medical insurance beneficiary(+) and white collar workers(-). Acute and chronic illness episode(+), and medical insurance for government employees and private school teacher(-) were significant variables in analysis of utilization of pharmacy. In multiple regression analysis of the number of physician visits, siginificant variables were acute illnes episode(+), chronic illness episode(+), industrial, occupational and regional medical insurance beneficiary(+), white collar workers(-). Acute and chronic illness episode(+), and medical insurance beneficiary() were significant variables in analysis of the number of pharmacy visits. In logistic regression analysis of admission event, significant independent variables were the 9-year and younger group(+), the 70-year and older group(+), chronic illness episode(+), and medical insurance beneficiary(+).; Summary

Periodic Health Examination.: Seung Hum Yu, Jae Hoon Roh, Hae Jong Lee, Sang Hyuk Jung; Korean J Prev Med. 1989;22(1):45-50.

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Abstract PDF: The purpose of this study was to select the manageable diseases which are prevalent in Korea for periodic health examinations and to evaluate the sensitivity and specificity of periodic health examination in detecting these diseases. The data was derived from reimbursement data of the Korea Medical Insurance Corporation over a two year period (April 15, 1986 to April 14, 1988) and interviews with Yonsei Medical School professors. This study demonstrated that: 1. The manageable diseases which were selected for periodic health examinations are pulmonary tuberculosis, viral hepatitis, diabetes mellitus, syphilis groups, essential hypertension, renal disease groups, and iron deficiency anemia. 2. The sensitivity of the health screening for each disease was as follows: pulmonary tuberculosis 51.5%, viral hepatitis 60.3%, diabetes mellitus 64.7%, syphilis groups 63.3%, essential hypertension 49.9%, renal disease groups 44.0%, and iron deficiency anemia 80.9%. We conclude that peiodic health esaminations should focus on the manageable diseases that we have defined. The number of items in periodic health screening tests and hospital quality control should be increased for the diseases with a demonstrated low sensitivity.; Summary

Effect of Hyperbaric Oxygenation on Pulmonary Superoxide Dismutase Activity in Neonatal and Adult Rats.: Hyeong Sik Ahn, Soo Hun Cho, Dork Ro Yun, Dong Ryool Lee, Yong Sik Kim; Korean J Prev Med. 1989;22(1):51-56.

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Abstract PDF: To investigate the effect of hyperbaric oxygenation on superoxide dismutase activity, neonatal rats (7-10 days old) and adult rats (approximately 100 days old) were continuously exposed to hyperbaric oxygen environment of 2.4ATA for 8 hours and their superoxide dismutase activity were measured. Neonatal rats, all survived through exposure, showed significant increases in the pulmonary superoxide dismutase activity at immediately and 24 hours after exposure. Adult rats, whose 8 hour survival rates were 14 %, did not show any significant increase in the activity of pulmonary superoxide dismutase as compared to the control adult rats. These findings are indicating that increased tolerance to oxygen toxicity in neonatal animals during exposure may be attributed to the increase in activity of superoxide dismutase in neonatal rats.; Summary

A Clinical Decision Support System for Diagnosis of Hearing Loss.: Young Moon Chae, In Yong Park, Seung Kyu Jung, Tae Young Chang; Korean J Prev Med. 1989;22(1):57-64.

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Abstract PDF: A decision support system (DSS) was developed to support doctor's decision-making in diagnosing hearing loss. The final diagnosis encompassed 41 diseases with the problem of hearing loss. The system was developed by integrating model-oriented DSS technique and artificial intelligence technology. The system can be used as both diagnosis tool and teaching tool for medical students. Furthermore, the Al technology obtained from this study may also be used in developing DSS for hospital management.; Summary

Association between Serum HBeAg Status and Tuberculosis Infection.: Jang Rak Kim, Jung Han Park; Korean J Prev Med. 1989;22(1):65-70.

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Abstract PDF: To examine the association between serum HBeAg status and tuberculosis infection, we reviewed medical records of 579 inpatients who had serum HBeAg test with RIA method at the Department of Nuclear Medicine of Kyungpook University Hospital from January 1, 1985 to December 31, 1987. HBeAg positive patients had lower tuberculosis infection rate (5.0%) than that of HBeAg negative patients(9.8%) and the odds ratio of HBeAg associated with tuberculosis was 0.48(95% C.I.:0.22-1.08). Similar relationship was found in the patients of hepatobiliary diseases; tuberculosis infection rate was 4.4% in HBeAg positive patients, 8.1% in HBeAg negative patients, and the odds ratio was 0.52(95% C.I.:0.17-1.35). Although the association did not reach the statistical significance level of 0.05, the negative association was consistent with other study done on Southeast Asian population of Philadelphia. A cohort study in general population is warranted to confirm above findings because of the limitations on hopital-based data.; Summary

Effect of Hyperoxia on Pregnancy in the Rat.: Seung Chul Lee, Soo Hun Cho, Hyeong Sik Ahn, Dork Ro Yun; Korean J Prev Med. 1989;22(1):71-80.

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Abstract PDF: The adverse effect of diving on the fetus may extend beyond n gestational process and outcome. Primiparous Sprague-Dawley rats were assigned to one of ten exposure schedules during gestatred PO2 level, the following question about the effect of exposing a pregnant female to high partial pressure of inspired oxygen has been raised. "What effect does an increased maternal PIO2 have on fetal arterial PO2 and therefore on possible fetal oxygen poisoning?" This study was carried out to observe the effects of maternal hyperoxia on gestational process and outcome. Primiparous Sprague-Dawley rats were assigned to one of ten exposure schedules during gestation. The treatment groups were subjected to either the high concentration of oxygen, or the high atmospheric pressure. On day 21 of gestation, laparotomy was performed to examine for number and distribution of implantations and live and resorbing embryos. Fetuses were weighed, and examined for gross malformations. Subsequently, they were fixed, measured in physical parameters, and examined for visceral anomalies. Minor visceral anomalies and anatomical variation was not found. Similarily, there were no significant differences when number of resorptions, mean fetal weights, pregnancy interruption rate were compared by analysis of variance. These results indicate that exposing rats to oxygen at increased atmospheric pressure doese not affect fetal health or survival.; Summary

Survival Rate of Hospitalized Coal Workers' Pneumoconiosis Patients: According to Characteristics at the Time of Hospitalization.: Kyoung Yong Rhee, Ho Keun Chung; Korean J Prev Med. 1989;22(1):81-89.

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Abstract PDF: The authors investigated mortality rate of hospitalized CWP(coal workers' pneumoconiosis) patients. Date, which was composed of age, date of hospitalization, date of death, and radiological findings(profusion of small opacity, type of large opacity, tuberculosis, emphysema, pneumothorax, and cardiac abnormality), was gathered from medical charts and chest x-ray films at the time of hospitalization of CWP patients. Among 738 CWP patients, that were entered survey differently and have followed different period, 160 CWP patients were died during different observational period. Mean value of observational period was 203 weeks, and mean age at hospitalization was 51 years. Because of short observational period, mean survival time could not found. There was statistically significant difference of mortality rate between group of small opacity and that of large opacity. In group of small opacity 5 year survival rate was 0.80 and in group of large opacity that was 0.73. And 80 percentile survival time was 57 months in group of small opacity and that was 40 months in group of large opacity.; Summary

Research on work stress and mental health status of the industrial workers.: Bong Suk Cha, Sei Jin Chang, Myung Keyn Lee, Jong Ku Park; Korean J Prev Med. 1989;22(1):90-101.

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Abstract PDF: Recently concerns on work stress and mental health status of industrial workers were increased. The purpose of this study was to investigate the work stress measured by PSI (psychiatric symptom index) according to socio-demographic variables. The study population was consisted with two types of group; manual and clerical workers. The, major findings of this study were as follows; Mean scores of psychiatric symptom in manual workers were higher in female, youth, educated, unmarried and divorced, noisy condition, that in clerical workers was higher in aged. Mean scores of psychiatric symptom were highly affected by degree of work autonomy, self-esteem, and self-efficacy in both groups. The higher the work autonomy, self-esteem, and self-efficacy, the lower the mean scores of work stress it showed. Psychiatric symptom index was explained with the work autonomy, self-esteem, self-efficacy through multiple stepwise regression. The annual admission rates were high in highly ranked groups on each psychiatric symptom dimension.; Summary

Morbidity Rate and Medical Care Utilization of Sailors during the Voyage.: Jae Yong Park, Jung Won Jun; Korean J Prev Med. 1989;22(1):102-115.

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Abstract PDF: The purpose of this study was to find out morbidity rate and utilization pattern of medical services of sailors on a voyage. The subjects of this study were 470 sailors who are sailors' trainee and safety-trainee for embarkation in a ship. Data were collected by means of personal survey conducted from September 5 to October 30, 1988. The subjects were sailed 12.6 months on the average. During the voyage, 49.4% of the sailors had sickness more than once, and 24.7%' was unable to work more than a day because of illness. The average monthly morbidity rate was 85.7 per 1,000 and the monthly prevalence rate of disease that was unable to work more than a day was 21.2 per 1,000. The sailors of 40-49 years old had the highest morbidity rate of 103.6 per 1,000/month. The number of days activity restricted due to sickness was 93.4 days per 1,000 persons, and the average duration of illness was 11.2 days per sickness. The proportion of treatment days to sickness days was 48.8%. Considering morbidity unable to work more than a day, the number of those who had traumatic injury were 17.2%, which revealed the highest rate, influenza or cold were 15.5%, and the digestive disease 11.2%. Less than half(42.1%) of patients were treated with medicine kept in the cabin. However, 2.1% was transferred by helicopter and 29L% was treated at hospitals or clinics in nearby port. In the cabin, 67.4% of patients was cured completely.; Summary

Effect of Several Heavy Metals on the Frequencies of Sister Chromatid Exchanges and Chromosomal Aberrations in Human Lymphocytes.: Chae Deuk Jung, Jeong Sang Lee, Dai Ha Koh, No Suk Ki, In Dam Hwang; Korean J Prev Med. 1989;22(1):116-124.

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Abstract PDF: To assay the cytogenetic toxicity of NiCl, K2Cr2O7CdC12, and HgC12, the frequencies of sister chromatid exchanges(SCEs) and chromosomal aberrations were observed in the metaphase chromosomes of the human lymphocytes which were cultured with above materials. The frequencies of SCEs are dose-dependently increased by all materials in this experiment. Chromosomal aberrations, especially gap and break, are increased by the nickel and chromic compounds, while not significantly increased by the cadmium and mercurial compounds. This results indicate the dose dependent relationship between the frequencies of SCEs and the concentrations of the heavy metals, but the increasing rates of the SCEs induced by the heavy metals are less sensitive than other mutagens or carcinogens which were confirmed.; Summary

Hair Heavy Metal Contents in Mentally Retarded Children I: In Association with Lead.: Doohie Kim, Ock Bae Kim, Bong Ki Chang; Korean J Prev Med. 1989;22(1):125-135.

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Abstract PDF: This paper was carried out to study on correlation between mentally retardation and lead and zinc. The subjects were 297 mentally retarded children: 132 of Bomyung special school and Sunmyung, which were located in Taegu city of Korea. The former had their parents but the latter had not. The control group 63 children were randomly seleted from the Dong-in primary school near to Medical School of Kyungpook National University. Atomic absorption spectrophotometer, model IL-551 connected with CTF atomizer(IL. 655) was used for the analysis of lead and zinc. The mean value of lead in hair of mentally retarded children was 14.97 3.71ppm which is significantly higher than that of control group, 11.36 2.83ppm. But the content of zinc was not significant in both groups. In the lead there was no significant correlation to age but significant negative correlation to IQ. Zinc showed significant correlation to age but not to IQ. Among the handicapped children, no signigicant correlation between orphan group and non orphan group. Handicaps of mentally-retarded children were speech impairment, emotional disturbance, double and triple handicaps, sensory impairment and abnormal dietary patterns. There were significantly higher contents of lead compared with normal group, except the latter two groups. The disease conditions of mentally retarded children were mongolism, autism, cerebral palsy, epilepsy and microcephaly. In comparing with mongolism, significant difference were existent only on the cerebral palsy and group of unknown etiology. We attempted to divide their past history into external etiology and internal etiology, but could not find significant difference. In view of the whole results, the relationship between mentally-retarded children and lead was presumed to be the early time exposure rather than long interval exposure during growth and the contact opportunity was considered important subject in maternal and child health care.; Summary

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