Journal of Preventive Medicine and Public Health

Volume 29(4); December 1996

Original Articles

Analysis on the Relationships among the Total Cholesterol, Fasting Blood Sugar, Hypertension and Ischemic heart disease on EKG Findings.: Soo Keun Kim, Sang Chul Roh, Jung Il Son, Boyoul Choi; Korean J Prev Med. 1996;29(4):705-720.

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Abstract PDF: Since the 1960's, Korea has achieved rapid economic growth, longer life expectancy, accelerated urbanization and a westernization of diet. Cardiovascular disease has become the leading cause of death; however the prevalence of ischemic heart disease(IHD) remains low. A cross-sectional multiphasic screening service for 18,426 persons aged 30 64 years in a Medical Aid Program in Kyonggi-do Province was conducted from 1991 to 1993. Total cholesterol(TC), Fasting blood glucose(FBG), blood pressure(BP), and electrocardiographic(EKG) data were collected. The result as follows; 1. On the EKG findings, the age-adjusted prevalence of myocardial ischemia and myocardial infarction was 1.45% in men and 2.06% in women. 2. The mean blood pressure was 122.9/78.8mmHg. The age-adjusted prevalence of hypertension was 11.05% in men and 9.02% in women. The prevalence of hypertension showed increasing tendency according to age increase. In all age group, the prevalence of hypertension was higher in men than women. 3. The mean total cholesterol level was 184.4mg/dl in men and 189.2mg/dl in women. The age-adjusted prevalence of hypercholesterolemia was 4.88% in men and 5.67% in women. The total cholesterol level showed increasing tendency according to age increase, except 55 64 age group in men. 4. The prevalence of hyperglycemia is 5.8%. The age-adjusted prevalence of hyperglycemia is 6.72% in men and 4.50% in women. The prevalence of hyperglycemia showed increasing tendency according to age increase. 5. On the EKG findings, the prevalence of myocardial ischemia and myocardial infarction was higher in hypertension than normal, in all age group of men and women less than 40 years-old. Only in women more than 40 years-old, the prevalence of myocardial ischemia and myocardial infarction was higher in hypercholesterolemia and hyperglycemia. Nevertheless there is not statistical association between ischemic heart disease and previous risk factors in other age group, the prevalence of myocardial ischemia and myocardial infarction was higher in hypertension, hypercholesterolemia and hyperglycemia than normal. The result of this study suggest that relationships between major risk factor of ischemic heart disease and ischemic heart disease is similar to existing theory.; Summary

A Survey on Status of Pregnancy and Delivery at a Rural Village, Napal(Dolakha Bazar Area).: Young Woo Ahn, Yune Sik Kang, Sin Kam, Jong Young Lee; Korean J Prev Med. 1996;29(4):721-732.

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Abstract PDF: This study was conducted to investigate the status of pregnancy and delivery and relationship among knowledge, attitude and practice about pregnancy and delivery in poor country, Nepal. A questionnaire survey by interviewer was conducted to examine the general characteristics, knowledge about pregnancy and delivery, attitude about pregnancy and delivery, the rate of prenatal care and delivery condition of women who had an experience of delivery during last year(1994. 4. 13~1995. 4. 12) at a rural area, nepal(Dolakha Bazar Area). The major findings are as follows; Among respondents, 87.5 percentage never had health education and the degree of knowledge about pregnancy and delivery was low. Among respondents, 56.6 percentage had the attitude that they didn't want antenatal care, 42.8% of respondents answered that they wouldn't visit hospital or health center when vaginal bleeding occurred and 82.9% thought that the delivery itself was dirty. The proportion of women who experienced antenatal care was 28.3%, the proportion of health facilities delivery was 5.3%, which was very low and 82.6% of home delivery case didn't sanitate the tool to cut the umbilical cord. The women who had positive attitude about antenatal care and health facility utilization experienced more antenatal care and health facilities delivery. On consideration of above findings, health education for pregnancy and delivery is required to improve mother-child health status in poor country. To make efficient health education, the target population group, such as the uneducated, inhabitants far from health center or medical facility, must be chosen. To help the poor countries in medical field, the study on health status and its related factors on these countries like this article would be required.; Summary

Follow-up Management State of Lead Battery Workers in Periodic Health Examination.: Gap Soo Lee, Young Hwangbo, Yong Bae Kim, Hwa Sung Kim, Jung Oh Ham, Sung Soo Lee, Kyu Dong Ahn, Byung Kook Lee, Jung Hur; Korean J Prev Med. 1996;29(4):733-746.

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Abstract PDF: To evaluate the follow-up management state and related factor of lead battery workers in periodic health examination as part of program of group occupational health service, author studied 293 workers with questionnaire on knowledge of results and follow-up management state and related factors, and compared the responses to their periodic health examination result charts. The results were as follows: 1. 252(86%) workers responsed that they had received the health examination result chart, but only 116(39.6%) workers responsed that they had been educated or explained about the result of health examination, and 11(57.9%) workers among 19 workers with non-occupational disease D, 101(44.3%) workers among 228 workers with non-occupational disease C, and 19(28.4%) workers among 67 workers with occupational disease C knew accurately their health examination results. 2. 78(24.8%) of the workers responsed that they had follow-up management, and contents of follow-up management were follow-up(36.6%), out-patient treatment(31%), change worksite(8.5%), temporary retirement(7.0%) and others(16.9%). 3. Most of the workers responsed that the health examination were necessary, but three-fourths of the workers responsed that the health examination had been superficial or that they didn't know. 4. In this study, follow-up management show significant association with only explanation or education about health examination result chart.; Summary

A study on lead exposure indices of male workers exposed to lead less than 1 year in storage battery industries.: Young Hwangbo, Yong Bae Kim, Gap Soo Lee, Sung Soo Lee, Kyu Dong Ahn, Byung Kook Lee, Joung Soon Kim; Korean J Prev Med. 1996;29(4):747-764.

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Abstract PDF: This study intended to obtain an useful information for health management of lead exposed measuring the lead exposure indices and workers and determine biological monitoring interval in early period of exposure by work duration in all male workers (n=433 persons) exposed less than 1 year in 6 storage battery industries and in 49 males who are not exposed to lead as control. The examined variables were blood lead concentration(PBB), Zinc-protoporphyrin concentration(ZPP), Hemoglobin(HB) and personal history; also measured lead concentration in air(PBA) in the workplace. According to the geometric mean of lead concentration in the air, the factories were grouped into three categories: A; When it is below 0.05mg/m3, B; When it is between 0.05 and 0.10mg/m3, and C; When it is above 0.10mg/m3. The results obtained were as follows: 1. The means of blood lead concentration(PBB), ZPP concentration and hemoglobin(HB) in all male workers exposed to lead less than 1 year in storage battery industries were 29.5+/-12.4 microgram/100ml, 52.9+/-30.0 microgram/100ml and 15.2+/-1.1 gm/100ml. 2. The means of blood lead concentration(PBB), ZPP concentration and hemoglobin(HB) in control group were 5.8+/-1.6 microgram/100ml, 30.8+/-12.7 microgram/100ml and 15.7+/-1.6 microgram/100ml, being much lower than that of study group exposed to lead. 3. The means of blood lead concentration and Zpp concentration among group A were 21.9+/-7.6 microgram/100ml, 41.4+/-12.6 microgram/100ml; those of group B were 29.8+/-11.6 microgram/100ml, 52.6+/-27.9 microgram/100ml; those of group C were 37.2+/-13.5 microgram/100ml, 66.3+/-40.7 microgram/100ml. Significant differences were found among three factory group(P<0.01) that was classified by the geometric mean of lead concentration in the air, group A being the lowest. 4. The mean of blood lead concentration of workers who have different work duration(month) was as follows; when the work duration was 1-2 month, it was 24.1+/-12.4 microgram/100ml,; When the work duration was 3-4 month, it was 29.2+/-13.4 microgram/100ml; and it was 28.9+/-34.5 microgram/100ml for the workers who had longer work duration than other. Significant differences were found among work duration group(P<0.05). 5. The mean of ZPP concentration of workers who have different work duration(month) was as follows; When the work duration was 1 2 month, it was 40.6 18.0 g/100ml, When the work duration was 3-4 month, it was 53.4+/-38.4 microgram/100ml; and it was 51.5+/-60.4 microgram/100ml for the workers who had longer work duration than other. Significant differences were found among work duration group(P<0.05). 6. Among total workers(433 person), 18.2% had PBB concentration higher than 40 microgram/100ml and 7.1% had ZPP concentration higher than 100 microgram/100ml; In workers of factory group A, those were 0.9% and 0.0%; In workers of factory group B, those were 17.1% and 6.9%; In workers of factory group C, those were 39.4% and 15.4%. 7. The proportions of total workers(433 person) with blood lead concentration lower than 25 microgram/100ml and ZPP concentration lower than 50 microgram/100ml were 39.7% and 61.9%, respectively; In workers of factory group A, those were 65.5% and 82.3%; In workers of factory group B, those were 36.1% and 60.2%; In workers of factory group C, those were 19.2% and 43.3%. 8. Blood lead concentration (r=0.177, P<0.01), ZPP concentration (r=0.135, P<0.01), log ZPP (r=0.170, P<0.01) and hemoglobin (r=0.096, P<0.05) showed statistically significant correlation with work duration (month). ZPP concentration (r=0.612, P<0.01) and log ZPP(r=0.614, P<0.01) showed statistically significant correlation with blood lead concentration. 9. The slopes of simple linear regression between work duration(month, independent variable) and blood lead concentration(dependent variable) in workplace with low air concentration of lead was less steeper than that of poor working condition with high geometric mean air concentration of lead. The study result indicates that new employees should be provided with biological monitoring including blood lead concentration test and education about personal hygiene and work place management within 3~4 month.; Summary

An Epidemiologic Study on Death Caused by Cancer in Pusan.: Hwi Dong Kim, Hye Won Koo, Moon Suk Kwak, Jong Ryul Kim, Byung Chul Son, Deog Hwan Moon, Jong Tae Lee, Kyu Il Lee, Sang Hwa Ohm, Kui Oak Jung, Jin Ho Chun, Chae Un Lee; Korean J Prev Med. 1996;29(4):765-784.

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Abstract PDF: This study surveyed and measured the level and structure of cancer deaths and their trends over time for offering the fundamental data of the cancer prevention and control in Pusan city in the future. Authors conducted the study of descriptive epidemiology using materials derived from the computerized data of total 3,722 certified cancer deaths in Pusan city from January 1 to December 31, 1993 registered on the National Statistical Office, the Republic of Korea. The obtained results were as follows: 1. According to the total registered cases of deaths(16,331 cases) in Pusan city during 1993, cancer(3,722 cases) and cerebrovascular disease(2,718 cases) were the first and second cause of deaths as 23.1% and 16.9%, respectively. These pattern showed the change between cancer(14.7%) and cerebrovascular disease(18.5%) in order of frequency in comparison to 1982. Also, the total number of cancer deaths was increased in comparison to 1982. The rate of death certification by physicians was 87.1% of all registered deaths, which was increased to 6.8% in comparison to 1982(80.3%). 2. Crude death rate and cancer specific death rate was 4.06 per 1,000 populations and 93.8 per 100,000 populations(male:117.8, female:70.0), respectively. The former was similar to that of 1982, but the latter was increased to 1.6 times as that of 1982. 3. Age-adjusted cancer specific death rate by standardization with whole country population was 111.9(male:141.5, female:106.7) per 100,000 populations, higher than not age-adjusted cancer specific death rate(93.8), and the sex difference was statistically significant with male predominance(p<0.05). 4. Cancer specific death rate by age was generally increased with age and most of cancer deaths(male:91.8%, female:88.5%) occurred since 40 years old. 5. The major cancer(cancer specific death rate per 100,000 populations) in male was liver(30.6) followed by stomach(25.6), lung(21.9), and GB and EHBD(5.7), in female stomach(15.7), liver(9.9), lung(7.3), and uterus(6.9). The relative frequency of the leading three cancer among total cancer deaths marked 66.3% in male and 47.1% in female, and decreased in comparison to 1982(male:72.2%, female:54.5%). 6. The total ratio of male to female cancer specific death rate showed 1.68 to 1 with male predominance. And the ratio was above 2.0 in larynx, oral cavity & pharynx, esophagus, liver, lung, bladder cancer and the ratio was 1.0~1.9 in stomach, pancreas, gall bladder and EHBD, brain, rectum and anus cancer, leukemia, but the ratio was reversed in thyroid and colon cancer. In conclusion, cancer was the first cause of deaths. The proportion of lung cancer was increased, that of stomach & uterine cancer was decreased relatively, and liver cancer was constantly higher proportion. In the future, it is necessary to conduct the further investigations on the cancer risk factors considering areal specificity.; Summary

A study on dermatologic diseases of workers exposed to cutting oil.: Byung Chul Chun, Hee Ok Kim, Soon Duck Kim, Chil Hwan Oh, Yong Tae Yum; Korean J Prev Med. 1996;29(4):785-800.

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Abstract PDF: We investigated the 1,004 workers who worked in a automobile factory to study the epidemiologic characterist of dermatoses due to cutting oils. Among the workers, 667(66.4%) answered the questionnaire. They are belong to 5 departments of the factory-the Engine-Work(86), Power train Assembly(17). We measured the oil mist concentration in air of the departments and examined the workers who had dermatologic symptoms. The results were follows; 1) Oil mist concentration; Of all measured points(52), 9 points(17.2%) exceeded 5mg/m3-the time-weighed PEL- and one department had a upper confidence limit(95%) higher than 5mg/m3. 2) Dermatologists examined 213 workers. 172 of them complained any skin symptoms at that time-itching(32.5%), papule(21.6%), scale(15.7%), vesicle(12.5%) in order. The abnormal skin site found by dermatologist were palm(29.3%), finger & nail(24.6%), forearm(16.2%), back of hand(8.4%) in order. 3) As the result of physical examination, we found that 160 workers had skin diseases. Contact dermatitis was the most common; 69 workers had contact dermatitis alone(43.1%), 11 had contact dermatitis with acne(6.9%), 10 had contact dermatitis with folliculitis(6.3%), 1 had contact dermatitis with acne & folliculitis, and 1 had contact dermatitis with abnormal pigmentation. Others were folliculitis(9 workers, 5.6%), acne(8, 5.0%), folliculitis & acne(2, 1.2%), keratosis(1, 0.6%), abnormal pigmentation(1, 0.6%), and non-specific hand eczema(47, 29.3%). 4) The prevalence of any skin diseases was 34.0 per 100 in cutting oil users, and 13.3 per 100 in non-users. Especially, the prevalence of contact dermatitis was 23.0 per 100 in cutting oil users and 4.3 per 100 in non-users. 5) We tried patch test(standard series, oil series, organic solvents) on 49 patients to differentiate allergic contact dermatitis from irritant contact dermatitis and found 20 were positive. 6) In a multivariate analysis(independent=age, tenure, kinds of cutting oil), the risk of skin diseases was higher in the water-based cutting oil user and both oil user than non-user or neat oil user(odds ratio were 2.16 and 2.78, respectively). And the risk of contact dermatitis was much higher at the same groups(odds ratio were 5.16 and 6.82, respectively).; Summary

Association of Liver Dysfunction with Self-Medication History in Korean Healthy Male Adults.: Jong Myon Bae, Byung Joo Park, Moo Song Lee, Dong Hyun Kim, Myung Hee Shin, Yoon Ok Ahn; Korean J Prev Med. 1996;29(4):801-814.

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Abstract PDF: BACKGROUND
Korean people could abuse healthy foods as well as medications, which might cause serious side effects. The aim of this study was elucidating liver dysfunction due to the self-medications of hepatotonics, healthy foods and herb medications by nested case-control study. METHODS: Study subjects were drawn from male members of seoul Cohort Study who were recruited by self-administered structured questionnaire survey through mailing to the healthy men between the age of 40 and 59 years through the program of biennial health check-up offered by Korea Medical Insurance Corporation(KMIC). The liver dysfunction was defined as the level of serum AST and ALT above 40 IU/L and increased in more than one hundred per-cent during the 2 year follow-up period. To estimate the odds ratio between self-medication and liver dysfunction after controlling for potential confounders, logistic regression was performed. RESULTS: During the follow-up period, 30 members were identified to fit into case criteria and 2,625 members were selected as control. In logistic regression analyses, history of healthy foods intake, age under 45 years, obesity, and habit of regular exercise were significantly associated with liver dysfunction. The following factors exhibited no statistical significance: intake of hepatotonics, of herb medicine; history of disease in family, of operation, and of radiologic examination; smoking habits and drinking amounts. CONCLUSION: The significant association between the intake of healthy foods and the liver dysfunction illustrates that chronically optional overuse of healthy foods might bring to hazards to health. As the increasing trend of the size of purchasing healthy foods in Korea, pharmacoepidemiologic studies evaluating the safety and efficacy of the widely used healthy foods should be performed in the near future.; Summary

A study on a hospital services evaluation method b physician survey.: Won Gi Jhang, Ok Ryun Moon; Korean J Prev Med. 1996;29(4):815-830.

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Abstract PDF: A physician survey was done by mailing for the purpose of performing hospital services evaluation and ranking. A slightly over one thousand samples were drawn from the list of professional societies, and 324 physicians(about 32 percent) replied. This study has focused on developing easy and simple method to evaluate hospital services, and providing patients with useful information. Hospital service structure and process were evaluated without outcome evaluation, because it is difficult to obtain reliable data regarding health services outcome indicators. Clinical specialty was targeted to evaluate, and three specialties were chosen, that is obstetrics & gynecology, cardiology, and proctology. Among 16 structural indicators, four indicators were finally chosen in each specialty by respondent specialists. And then using these indicators, structural score was calculated for study hospitals. For process evaluation, physicians were requested to nominate five most famous hospitals. The nomination score and structural score were summed up to produce final score and hospital ranking. This method is very easy to conduct rather than other hospital services evaluation methods prevailing in Korea. And it is more useful for patients to choose hospitals, according to his/her own purpose, because it gives high ranking hospitals with specific clinical specialty.; Summary

The Economic Impact of a Rural Hospital to local Economy.: Im Ok Kang, Sun Hee Lee, Han Joong Kim; Korean J Prev Med. 1996;29(4):831-842.

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Abstract PDF: Demand for high quality medical care has recently been increasing in step with high level of income and education. Patients prefer the use of large general hospitals to small community hospitals. Large hospitals, usually located at urban area, expand their capacities to cope with the increasing demand, therefore, they easily secure revenue necessary for growth and development of hospitals. However, small community hospitals are facing with serious financial difficulties caused from the reduction of patients in one hand and the inflation of cost in another. If small rural hospitals were closed, the closure would have negative impacts on local economies in addition to the decrease in access to medical care. Community leaders should have an insight on the contribution of community hospitals to local economies. They could make a rational decision on the hospital closure only with the understanding of hospital's contribution to the community. This study is designed to develop an economic model to estimate the contribution of rural hospital to local economies, and also to apply this model with a specific hospital. The contribution of a hospital to local economies consists of two elements, direct effect and multiplier effects. The direct impacts include hospital's local purchasing power, employee's local purchasing power, and the consumption of patients coming from outside the community. The direct impact induces multiplication effect in the local economy. The seed money invested to other industries grows through economic activities in the economy. The seed money invested to other industries grows through economic activities in the region. This study estimated the direct effect with the data of expenditure of the case hospital. The total effect was calculated by multiplied the direct effect with a multiplier. The multiplier was drown from the ratio of marginal propensity of income and expenditure. Beside the estimation of the total impacts, the economic effect from the external resources was also analyzed by the use of the ratio of patients coming outside the region. The results are as follows. 1. The direct economic contribution of the hospital to the local economy is 1,104 million won. 2. The value of multiplier in the region is 2.976. 3. The total economic effect is 3,286 million won, and the multiplication effect is 2,182 million won. 4. The economic contribution from the external resources is 245 million won which is 7.5% of the total economic effect.; Summary

Nationwide Incidence Estimation of Uterine Cervix Cancer among Korean Women.: Byung Joo Park, Moo Song Lee, Yoon Ok Ahn, Young Min Choi, Yeong Su Ju, Keun Young Yoo, Hun Kim, Ha Seung Yew, Tae Soo Park; Korean J Prev Med. 1996;29(4):843-852.

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Abstract PDF: To estimate the incidence of uterine cervix cancer among Korean women, we have conducted a study using the claim data on the beneficiaries of Korea Medical Insurance Corporation(KMIC). All medical records of the potential cases with diagnosis of ICD-9 180, 181, 182, 199, 219, 233 in the claims sent by medical care institutions in the whole country to the KMIC from January 1988 to December 1989, were abstracted and Gynecology specialist reviewed the records to identify the new cases of uterine cervix cancer among the potential cases during the corresponding period. Using these data, the incidence of uterine cervix cancer among Korean women was estimated as of July 1, 1988 to June 30, 1989. The crude rate was estimated to be 17.34(95% CI: 16.76~17.92) per 100,000 and the cumulative rates for the ages 0~64 and 0~74 were 1.7% and 2.2%, respectively. The age-adjusted rate for the world population was 19.93 per 100,000 which was higher than those of other Asian countries including China and Japan in 1983~1987. The truncated rate for ages 35~64 was 52.05 per 100,000 which was one of the highest in the world. With increasing age, the incidence rate increased to 78.11 per 100,000 in women aged 55~59 years, then it decreased in the older groups. This finding suggests that detecting rate of uterine cervix cancer may decrease in women aged 60 years or older due to detecting rate of uterine cervix cancer may decrease in women aged 60 years or older due to inadequate medical care seeking behavior. In the geographical area, the SIR of Jeju province was significantly low but it might be due to statistical unstability by small case numbers.; Summary

Diagnostic Meaning of High Resolution Computed Tomography Compared with Chest Radiography for Screening of Welder's lung.: J H Kang, J H Chun, H W Gu, K S Ko, B C Yu, H S Sohn, J T Lee; Korean J Prev Med. 1996;29(4):853-862.

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Abstract PDF: Pneumoconiosis is one of the major problem in the field of occupational health at Korea. Therefore, the efficient diagnosis of pneumoconiosis is a hot issue on the occupational health program. The author executed this study to estimate the diagnostic value of high resolution computed tomography(HRCT) compared with chest radiography for screening of welder's lung. HRCT was introduced very recently for the diagnosis of pneumoconiosis, however, the diagnostic value for screening of welder's lung-principally nonfibrogenic and reversible-has not been evaluated. The subjects were fifty cases of welder's lung or suspected cases who had been collected between 1989 and 1994 from one shipyard and continuously followed-up on the basis of in-plant periodic health check program. We applied both chest radiography and HRCT on the same subjects from May 1 to 30, 1996. The images were evaluated by two careered radiologists independently. The findings of chest radiography were classified into four category by ILO classification, and the findings of HRCT according to the criteria of Bergin et al. The concordance between two radiologists expressed with Kendall's tau-b was 0.72 by chest radiography and 0.44 by HRCT- that is, interobserver variation of HRCT was bigger than that of chest radiography. The concordance between the two different methods was highly variable as 0.44 by radiologist A and 0.06 by radiologist B- that is, interobserver variation was very big. However, HRCT looked more detectable for the minor parenchymal change. These findings suggested that it is not appropriate to use HRCT routinely for screening of welder's lung due to lack of diagnostic criteria, and feasibility, acceptability and economic aspects. Nevertheless, HRCT might be recommendable in the case of equivocal parenchymal features on the chest radiography, unexplained respiratory symptoms, and/or lung function abnormalities suggestive of interstitial fibrosis.; Summary

Urinary Metabolites and Neurobehavioral Test on Styrene Exposure Workers.: Chang Hee Lee, Deog Hwan Moon, Hun Lee, Jun Han Park, Dae Hwan Kim, Jong Tae Lee, Jin Ho Chun, Hwi Dong Kim, Chae Un Lee; Korean J Prev Med. 1996;29(4):863-876.

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Abstract PDF: In order to prepare the fundamental data for the health promotion by assessing the exposure level of styrene, the author determined the concentration of mandelic acid and phenylglyoxylic acid in urine of 42 workers who were exposed to styrene by high performance liquid chromatography and surveyed 16 symptoms, by questionnaire and also tested neurobehavioral test(digit symbol, benton visual retention) in 2 FRP plants of Kyung Nam area from July to September, 1995. Control was sampled by age sex matching method. The concentration of styrene in air was determined by gas chromatography. The results were as follows; 1. Geometric mean concentration of styrene in air was 17.4ppm, geometric mean concentration of mandelic acid(MA) in urine were 404.3mg/g creatinine for exposure group, 46.4mg/g creatinine for control group, geometric mean concentration of phenylglyoxylic acid(PGA) in urine were 57.5mg/g creatinine for exposure group, 9.5mg/g creatinine for control group. Mean concentration of MA and PGA showed statistically significant difference between exposure group and control group(p<0.01). 2. Number of symptom were 2.9 for exposure group, 3.3 for control group, number of digit symbol were 24.1 for exposure group, 32.5 for control group, number of Benton visual retention test were 6.1 for exposure group, 6.0 for control group, respectively. As result of adjusting the education year, number of Benton visual retention test showed statistically significant difference between exposure group and control group(p<0.05). 3. Excellent correlation were observed between environmental styrene exposure and urinary MA(r=0.80), PGA(r=0.73), and MA+PGA(r=0.81).; Summary

The Development of Classification System of Medical Procedures in Korea.: Hyoung Wook Park, Myongsei Sohn, Han Joong Kim, Eun Cheol Park, Seung Hum Yu; Korean J Prev Med. 1996;29(4):877-897.

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Abstract PDF: In recent years, the Korean Medical Association has undertaken the feat of establishing the Korean Standard Terminology of Medical Procedures with the dedicated help of 32 medical academic societies. However, because the project is being conducted by several different circles, it has yet to see a clear system of classification. This thesis, therefore, proposes the three principles of scientific properties, usefulness and ideology as the basis for classification system and has developed the Classification System of Medical Procedures in Korea upon their foundation. The methodology and organization of this thesis as follows. First, by adopting scientific classification system of Feinstein(1988), an analysis of the classification systems of the medical procedures in the United States, Japan, Taiwan, Who Was carried out to reveal the framework and the basic principles in each system. Second, the direction of classification system has been constructed by applying the normative principle of medical field in order to show the future direction of the medical field and realize its ideology. Third, a finalized framework for the classification system will be presented as based on the direction of classification system. Of the three basis principles mentioned above, the analysis on the principles of usefulness was left out of this thesis due to the difficulty of establishing specific standards of analysis. The results of the study are as follows. The overall structure of the thesis is aimed at showing the 'Prevention-Therapy-Rehabilitation' quality of comprehensive health care and consists of six chapters; I. Prevention and Health Promotion. II. Evaluation and Management . III. Diagnostic Procedures. IV. Endoscopy. V. Therapeutic Procedures. VI. Rehabilitation. Chapter three Diagnostic Procedures is divided into four parts; Functional Diagnosis, Visual Diagnosis, Pathological Diagnosis, Biopsy and Sampling. Chapter five Therapeutic Procedures is divided into Psychiatry, Non-Invasive Therapy, Invasive Therapy, Anaesthesia and Radiation Oncology. Of these sub-divisions, Functional Diagnosis, Biopsy and Sampling, Endoscopy and Invasive Therapy employs the anatomical system of classification. On the other hand, Visual Diagnosis, Pathological Diagnosis, Anesthesia and Diagnostic Radiology, namely those divisions in which there is little or no overlapping in services with other divisions, used the classification system of its own division. The classification system introduced in this thesis can be further supplemented through the use of the cluster analysis by incorporating the advice and assistance of other specialists.; Summary

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