- Association between Myofascial Pain Syndrome and the Assessment of Pain and the related Function tests in female telephone directory assistance operators using BDT.
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Sang Chul Roh, Soo Jin Lee, Jae Cheol Song, Hung Bae Park
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Korean J Prev Med. 1997;30(4):779-790.
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- The Association between myofascial pain syndrome and some tests was assessed in a cross-sectional study of 904 female telephone operators using video display terminals(VDTs). 105 cases were diagnosed as Myofascial pain syndrome with symptom questionnaire, laboratory examination and physician's physical examination and 550 controls were defined to show only musculoskeletal symptoms using NIOSH symptom criteria. Data on demographics, musculoskeletal symptom and visual analogue scale(VAS) were obtained by questionnaire. Anthropometric measurements, pressure pain threshold, Grip and Pinch strength and laboratory test were conducted. No significant difference between case and control at comparing of demographics, occupational history and body measurements were observed. But, Grip strength, pressure pain threshold and VAS showed the statistical difference between case and control. Age, pressure pain threshold of Rt. Upper trapezius and VAS were associated with myofascial pain syndrome in multivariate logistic regression analysis. This results suggest that, to diagnose of myofascial pain syndrome, the consideration of the objective aspects among patients' subjective symptom complaints through the VAS and pressure pain threshold is required.
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Summary
- Correlation between Obesity Indices and Cardiovascular Risk Factors and Usefullness of Abdominal Obesity Indices.
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Hunyoung Ha, Bo Youl Choi, Hung Bae Park
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Korean J Prev Med. 1997;30(2):327-341.
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- It is a well known fact that obesity is an important cause of cardiovascular disease, emphasized by many studies. Recently, cardiovascular diseaase has been found to correlate not only to the extent of obesity, but also the fat distribution of the individual; especially, focusing on obesity of the abdomen. Unfortunately, the proposed indices for abdominal obesity are numerous, and the results vary according to the index chosen. Three-hundred and twelve bus drivers in November, 1995, were chosen as subjects of this study. The author chose to measure serum lipid levels, fasting blood sugar levels and blood pressure, that are thought to be important risk factors of cardiovascular diseases. Obesity indices were calculated using anthropometric measurements. We were able to evaluate the significance of obesity indices by examining correlations between these indices and the risk factors of cardiovascular disease. The results obtained were as follows: 1. The abdominal obesity indices and risk factors of cardiovascular disease, the levels of total cholesterol in the serum, fasting blood sugar levels, and diastolic blood pressure, increased significantly according to age. 2. There was a significant difference in the abdominal obesity indices according to drinking and smoking habits controlled for age. Among the risk factors of cardiovascular disease, triglyceride and diastolic pressures had significant differences according to the presence or absence of a drinking history controlled for age. 3. Although all obesity indices showed significant correlations, the weakest correlation was between BMI and abdominal diameter index and the strongest correlation was between sagittal diameter and sagittal diameter matched for height. 4. There was a negative correlation between HDL-cholesterol and obesity indices. The weakest correlation was between fasting blood sugar levels and both SD and SDH showed correlations with the risk factors. 5. There was a significant correlation between SD and total cholesterol in the serum and fasting blood sugars controlled for age, drinking, and BMI. 6. After categorizing the subjects into 2 separate age groups at the 40 year mark, in the less than 40 year old age group, controlled for drinking and BMI, the results of comparitive studies have shown correlations between total cholesterol serum levels and waist-hip ratio, conicity-index, and SD. There were correlations between fasting blood sugar levels and SD, ADI, and SDH. There were no correlations between obesity indices and both total cholesterol serum levels and fasting blood sugar levels in the greater than 40 year old age group. There were significant correlations between abdominal obesity indices and total serum cholesterol or fasting blood sugar levels in the less than 40 year old age group, but no correlations in the age group over 40. These correlated factors between abdominal obesity and cardiovascular disease are assumed to exist in Korea as well. Furthermore, in this study a high correlation was found between SD, SDH and the risk factors of cardiovascular disease. Even when controlled for age, drinking, smoking, and BMI, the correlations between risk factors of cardiovascular disease and these indices exist. Therefore, the obesity indices, SD and SDH may prove to be important prognostic indicators or risk factors of cardiovascular disease
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Summary
- A Seroepidemiologic Study on Rubella Antibody in Pregnant Women in Kyonggi Do.
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Moran Ki, Boyoul Choi, Young Jeon Shin, Hung Bae Park, Bae Joong Youn, Joong Surk Hahn
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Korean J Prev Med. 1997;30(2):279-292.
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- The vaccinations of susceptible children and postpubertal females are the major means to prevent congenital rubella syndrome(CRS). Another means for reducing the CRS is therapeutic abortion or fetal monitoring for women who are infected in the first four months of pregnancy. We couldnt estimate the incidence of CRS in Korea, because there was no surveillance system for rubella and CRS. Nationwide vaccination program for 15months infant had been started early 1980s. So, most women at childbearing age during study period were not received rubella vaccination. We set forth CRS management system for pregnant women in two rural county of Kyonggi province, Korea. In this system, the presence of rubella IgG and IgM antibodies for early pregnant women were examined with MEIA(Microparticle Enzyme Immunoassay) method by IMx automated analyzer Abbott. The infected pregnant women followed up in order to confirm their children CRS. This study was carried out from Mar.1993 to Jun.1994, and pregnant women examined were 874 persons. The results were summarized as follows. The overall positive rate of rubella IgG antibody was 94.5%(826/874). The positive rate was significantly increase as the age increased, and reached 100% in pregnant women who were over 35 years old. This results suggest that a meaningful number of women are infected during childbearing years. The geometric mean titer of IgG of sero-positive subjects was significantly declined as the age increased. On the question about history of URI symptoms and rash in pregnancy, 20.7% of respondents checked on URI symptoms with rash, 13.5% only URI symptoms without rash, and 65.8% no symptoms. However there was no demonstrable association between the rubella like infection history in pregnancy and the rubella IgG and IgM antibody status. Rubella infection rate in pregnant women was 0.9%(95% CI 0.4-1.8%). Two of these 8 infected pregnancies were terminated by therapeutic abortion. One of them was not followed. Five babies had no gross anomalies at birth. In Dec.1996, three of five babies were normal appeared infants. Two of them were not followed. Throughout this study results, we confirmed the need of CRS management system for pregnant women, in Korea.
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Summary
- A Study on the Relationship between Subjective symptoms and Psychological Symptoms on some VDT workers.
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Jeong Il Son, Soo Jin Lee, Jaecheol Song, Hung Bae Park
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Korean J Prev Med. 1995;28(2):433-449.
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- The study subjects in this study are 295 workers who work on one electronics industry, and they were composed of 93 VDT and 202 non-VDT workers. This study was carried out to obtain the prevalence of subjective symptoms and to compare psychological symptom scores from SCL-90-R between VDT and non-VDT work groups. And to verify the relationship between VDT work related symptoms and psychological symptoms, the author compared scL-90-R T scores between symptom complaining and non-complaining groups. The results are summarized as follows: 1. Throughout the prevalence study of VDT work related symptoms according to VDT work state, the author could select the final 10 symptoms by sex; 'eye fatigue', 'foggy vision', 'neck discomfort or pain'. 'shoulder discomfort and pain', 'light headedness', 'dizziness', 'aene`, 'itching sensation on face', 'difficulty in concentration', 'memory disturbance' in males, and 'blurred vision`, 'foggy vision', 'neck discomfort or pain', 'shoulder discomfort and pain`, 'abdominal distention','indigestion', 'acne', 'pricking sensation on face', 'difficulty in concentration', 'memory disturbance` in females. 2. Throughout comparison of psychological symptom scores from SCL-90-R between VDT and non-VDT workers' except `interpersonal sensitivity` in female, Mean T score were higher in VDT workers, but not significantly different between the two groups. These results indicate that the relation between VDT work status and psychological symptoms are not strongly correlated. 3. Because of the nonspecific characteristics of VDT work related symptoms, from the 40 subjective symptoms, the author selected the final 10 symptoms by sex, especially correlated to VDT, and divided the study subjects into symptom complaining and non-complaining groups. The mean SCL-90-R T score between the two groups were compared. Except for the opthalmologic symptoms in females, the scores were significantly different between the two groups in all symptoms. And this indicates that the VDT work related symptoms strongly correlated with the present individual psychological conditions. 4. Due to understand that which of the 9 psychological symptom dimensions are strongly correlated with the subjective symptoms, the author excuted multiple logistic regression analysis, and the result were as follows; 'depression' and 'somatization', in male, and 'obsessive-compulsive' and 'somatization' in female.
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Summary
- Cost-Benefit Analysis on Rubella Vaccination Policy.
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Young Jeon Shin, Bo Youl Choi, Hung Bae Park, Ok Ryun Moon, Bae Joong Yoon
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Korean J Prev Med. 1994;27(2):337-365.
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- Rubella is a viral disease with mild constitutional symptoms and generalized rashes ln childhood, it is an inconsequential illness, but when it occurs during early pregnant period, there are significant risks of heart defects, cataract, mental retardation to the fetus. The series of congenital defects induced by rubella is called 'congenital rubella syndrome'. Many research have been performed to find out more effective prevention program on rubella. The objectives of this study are, first, to calculate the incidence rate of acute rubella infection and congenital rubella syndrome in korea, second, to evaluate economic efficiency of several rubella vaccination policies and to offer data for the most reasonable decision on vaccination policy. Study populations are 663,312 children of one year-old in 1992. The author has performed cost-benefit analyses according to the three vaccination policies-U.S.A.'s. U.K's and Sweden's. In this study, the author got the incidence rate of acute rubella infection using the catalytic model. In the meantime, the author used 50 per 100,000 live births as the incidence rate of congenital rubella syndrome. The discount rate used in this study was 5 percent per annum. The sensitivity analyses were done with different discount rates (4%, 7%) and different incidence rate of congenital rubella syndrome (10,100 per 100,000 live births): The study results are as follows: 1. Without vaccination, lifetime expenditures per patient for acute rubella infection amount to 14,822 won and the total expenditures to about 3.1 billion won. Meanwhile, lifetime expenditures per patient for congenital rubella syndrome amount to about 91 million won and the total expenditures to about 16.3 billion won without vaccination. 2. The cost of vaccination for a child of one year old was 2,322 won and the total cost for the one year old children was about 1.5 billion won(American style). The cost for vaccination of female children at fifteen was about 339 million won (British style). And the cost of vaccination at one for both sex and female children at fifteen was about 1.9billion won (Swedish style). 3. The benefit to cost ratios of vaccination or female children at fifteen that is the british mode of rubella vaccination, was 60.0 at the level of 80 % population coverage and 48.6 at 100% coverage. It shows much higher benefit to cost ratio than those of the other two vaccination policies. 4. Both net benefits of vaccination at one (American style) and that of vaccinations at one and fifteen (Swedish style) range from about 17.0 billion to 17.8 billion won, those were larger than that of vaccinations of female children at fifteen(British style, about 16.0 billion). 5. In marginal cost-benefit analysis of only additional program or revaccination, the benefit to cost ratios were 3.6(80% coverage rate) or 0.6 (100% coverage rate). It implies that additional program was less efficient or inefficient 6. In sensitively analysis with different discount rates (4% or 7%) and different incidence rates of congenital rubella syndrome (l0 or 100 per 100,000 live births), the benefit to cost ratios has fluctuated in wide range. However, all the ratios of vaccination of female children at fifteen were higher than those of the others. Even under the most conservative assumption, the benefit to cost ratios of all the rubella vaccination policies were higher than 3.3. In conclusion all the rubella vaccination policies found to be cost-effective and particularly the vaccination of female children at fifteen was strongly recommended.
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Summary
- Epidemiologic investigation to identify the cause of an infant methemoglobinemia.
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young Yeul Kim, Bo Youl Choi, Hung Bae Park, Min Young Kim, In Hak Yeo
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Korean J Prev Med. 1993;26(2):192-201.
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- Epidemiologic investigation was conducted on January, 1993 in Seoul to identify the cause of an infant methemoglobinemia. Field investigation of the area of outbreak, survey of household and family members, analysis of ground water, and blood tests of involved family members were performed. Following results were obtained. On analyzing the quality of the ground water on patients's household high levels of nitrate was found indicating contamination of water as the cause of a methemoglobinemia outbreak. On analyzing the quality of the ground waters on seven other places within the neighborhood five were contaminated by nitrate in concentration that exceeded the permissible limit implying presence nearby source of contamination. Sources of contamination were thought to be originating from human waste in conventional bathroom facilities, chicken manure used in nearby orchards and plant fields or fertilizers. But the results of water analysis with presence of bacteria or E.coli, concentration of potassium, phosphate and the past history of diarrhea among family members, chicken manure suggested the most possible source of contamination. To evaluate the health status of members in the neighborhood past history was reviewed revealing no prior existence of patient with cyanosis and 65 people in the neighborhood had normal levels of methemoglobin concentration in their blood. Conclusively, the ground water on patient's household was contaminated with nitrate and despite provision of adequate water supply, family members of the patient along with distrust in the water supply system had used ground water as their source of drinking water resulting of methemoglobinemia. Many suburban area of Seoul and country side thought to be having similar problems concerning contaminated ground water supply and dormant outbreak of patients as a result of the drinking of the contaminated water. Epidemiologic investigation and water analysis of ground waters are advised.
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Summary
- A Study on The Effect of Hyperoxia on EKG Findings of Rabbits.
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Soo Jin Lee, Jae Cheol Song, Hung Bae Park
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Korean J Prev Med. 1992;25(1):34-43.
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- To investigate the effect of hyperoxia on EKG findings and to evaluate the applicability of EKG as noninvasive monitoring index of oxygen toxicity, 38 rabbits were continuously exposed to 6 different conditions-3 hyperbaric oxygenations (HBO-2.5, 3.5 and 5ATA, 100% O2), normobaric oxygenation (NBO, 100% O2), hyperbaric aeration (HBA-5ATA, 21% O2) and normobaric aeration (NBA, 21% O2)-for 120 minutes and their EKG and time to dyspnea and convulsion were recorded. Dyspnea and death were observed in exposure conditions of HBO-3.5 and HBO-5 (Positive rate of dyspnea; 10%, 100%, death; 10%, 25%, respectively) only, and convulsion in 4 oxygenation groups (NBO; 20%, HBO-2.5; 20%, HBO-3.5; 20%, HBO-5; 88%). Abnormal EKG findings included arrhythmia and ST-T changes and the incidences was increasing with doses(partial pressure of oxygen). In addition to EKG change, findings observed during exosure were dyspnea and convulsion in the order of appearence and when non specific ST-T change was accepted as positive (abnormal) finding, the frequency of abnormal EKG was statistically significant(p<0.01), but when it was excluded from positive results, the frequency of EKG change was not significant(p>0.05). These results suggest that the effect of hyperoxia on heart is myocardial ischemia and arrhythmia, that oxygenation more than 3.5ATA causes myocardial damage in 120 minutes exposure, and that EKG is valuable as monitoring index of oxygen toxicity.
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Summary
- A Study on the Distributions of Paraoxonase Activity and the Factors affecting Paraoxonase Activity of a Rural opulation.
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Jaecheol Song, Hung Bae Park
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Korean J Prev Med. 1990;23(2):194-200.
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- The paraoxonase (E. C. 3.1.1.2.) is a major enzyme to detoxicate the organophosphorus and carbamate which are the most widely used as the agricultural spraying insecticides. To investigate the distributions of plasma paraoxonase activity and the fators affecting the enzyme activity, the plasmas of 945 Korean rural population were analyzed with the modified Krisch's direct sphectro;hotometry method. Three indices of the enzyme activity-basal activity, stimulated activity (by NaCl), % stimulation -were obtained from the analysis. Three indicies suggested unimodal distributions, so we couldn't identify the low activity group; risk group to organophosphorus & carbamate insecticides poisoning. There is no significant relation between 3 activity and the stimulated activity have significant relationship and high coefficient of determination with the activities of their parents (r2=0.30, 0.24; p<0.05), but the % stimulation does not (r2=0.02; p<0.05). These results suggest that the activity of paraoxonase is determined mainly by the genetic factor.
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Summary
- A Study on the Mobile Medical Service Program.
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Hung Bae Park, Dong Wook Choi
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Korean J Prev Med. 1978;11(1):86-97.
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- The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limited that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical service program through the community diagnosis of a village (Ope-Myun, Kwangju-gun) to obtain the information which may be helpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Nevertheless, due to limitations in budget, time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most(72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few(practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) was 3.5 and 4.0% respectively. Prevalence rate of all diseases and injuries experienced during one month(July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness(performance) of present mobile medical team is quite limited. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.
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