- Recognition and attitude to fundtional division between physicians and pharmacists of practising physicians and pharmacists in Taegu city.
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Moo Sik Lee, Nung Ki Yoon, Suk Kwon Suh, Jae Yong Park
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Korean J Prev Med. 1993;26(1):1-19.
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- Mail questionnaire was administrated to 370 practising physicians and 388 pharmacists in Taegu city selected by systematic sampling to examine utilization states and opinion of pharmacy under medical care insurance programme and the attitude to the functional division between physicians and pharmacists from April to May 1992. Regarding the opinion on the outcome of drug-store under medical insurance, 71.2 percent of practicing physician answered failure but 13.4 percent of practicing pharmacists answered failure in contrast. Fifty percent of practicing physician asserted introducing functional division between physician and pharmacist while 66.9 percent of practicing pharmacist answered drug-store under medical insurance itself is successful programme. Average daily numbers of preparation of medicine was 32.2 case. Percentage of utilization of drug-store under medical insurance to average daily cases of preparing of medicine was 20 percent, percentage of utilization with physician's prescription was 0.7 percent. And 58.7 percent of practicing physician experienced outside the institute prescription. Regarding the opinion on the pros and cons of enforcing functional division between physician and pharmacist, 59.2 percent of practicing physician preferred pros and 17.7 percent cons ,but 38 percent of practicing pharmacist preferred pros and 45.5 percent cons. And pharmacist know better the content of functional division between physician and pharmacist, practicing emphasized to prevent misuse or abuse of medicine but practicing pharmacist emphasized to display physician and pharmacist's professional ability. And as an opinion on implementation style of functional division between physician and pharmacist in pros respondents, practicing physician favored mandatory enforcement (52.3%), while practicing pharmacist favored partial incomplete functional division (81.7%). As the method of prescription if functional division between physician and pharmacist will be enforced, both practicing physician and pharmacist preferred generic name (44.0%, 89%) mostly, but physician preferred brand name (35.3%) secondly. Regarding the reason for not implementing functional division between physician and pharmacist up to date, both physician and pharmacist answered problem of business right between physician and pharmacist, followed by lack of recognition, and interest of people and lack of the governmental willness. Regarding the opinion on prior decision of condition for enforcing functional division between physician and pharmacist, practicing physician and pharmacist named uneven distribution of medical facilities and drug-store between rural and urban, inequality of physician and pharmacist manpower and the problem of manpower demand and supply mostly, and practicing physician pointed out establishing attitude of acceptance on the part of pharmacist and practicing pharmacist favored establishing attitude of acceptance on the part of physician, which was different attitudes between physician and pharmacist. Following conclusion was reached; 1. Current drug-store under medical insurance program yield insufficient outcome, so we should consider program conversion from drug-store under medical insurance program to functional division between physician and pharmacist. 2. There were problem of business right and conflicts between physician and pharmacist at enforcing functional division between physician and pharmacist, so the government should search for formulating plan to resolve the problem and have neutral willness for the protection of the national health.
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Summary
- Association of Serum Copper and Zinc Levels with Liver Cirrhosis and Hepatocellular Carcinoma.
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Myung Soo Hyun, Suk Kwon Suh, Nung Ki Yoon, Jong Young Lee, Seoung Hoon Lee, Mu Sik Lee
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Korean J Prev Med. 1992;25(2):127-140.
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- This study was done to identify the association between serum copper and zinc levels and the cirrhosis and hepatocellular carcinoma(HCC), and to evaluate its diagnostic value on liver diseases. Sixty-three healthy persons, 60 patients with cirrhosis and 33 patients with hepatocellular carcinoma were rendomly selected and investigated for their general characteristics from October 1990 to August 1991. For analysis of the biochemical markers in liver function test and the serum copper and zinc levels, their fasting venous blood were sampled at 9:00 to 11:00 in the morning and centrifuged to separate the serum within one hour. All the samples were immediately analysed for biochemical markers and stored at -20 C in polypropylene tubes further copper and zinc analysis. Mean of serum copper levels was 91.97+/-4.76 microgram/dl in control, 106.21+/-2.73 microgram/dl in cirrhosis and 127.05+/-0.77 microgram/dl in HCC. The value of HCC was statistically significantly higher than that of the control and cirrhosis(p<0.05). Serum zinc levels were 110.82+/-7.24 microgram/dl in control, 68.10+/-5.43 microgram/dl in cirrhosis and 63.78+/-2.20 microgram/dl in HCC. The values of cirrhosis and HCC were statistically significantly different among three groups(p<0.05). Test total protein, albumin, ALP and total bilirubin of biochemical markers of liver function were statistically significantly different among three groups(p<0.05). Differences between cirrhosis and HCC for ALT and AST, and between the control and HCC for direct bilirubin were not statistically significant. Biochemical markers statistically significantly correlated with serum copper and zinc levels and Cu/Zn ratio(p<0.05), were variable in three groups. In multiple logistic regression, odds ratio of serum copper level and Cu/Zn ratio had no statistically significance on the cirrhosis and the HCC, but that of serum zinc was statistically significant as 0.951 and 0.952 (p<0.05). Serum copper and zinc levels and Cu/Zn ratio were not statistically significantly different between the cirrhosis and HCC. Albumin, ALP, zinc, total bilirubin and age among all variables were selected as main variables for three-group discriminant analysis. Percentage of "grouped" cases correctly classified by these five variables was 98.4 for control, 73.4 for cirrhosis, 75.7 for HCC and 84.0 for all subjects. This study suggests that zinc may has an independently inhibitory effect on the liver disease and serum zinc level is considered to play a role as diagnostic marker on the hepatic disorders and be more useful than serum copper level and Cu/Zn ratio in diagnosis of the liver diseases.
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Summary
- Psychiatric symptoms of workers exposed to organic solvents.
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Seoung Hoon Lee, Nung Ki Yoon, Jong Young Lee, Suk Kwon Suh
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Korean J Prev Med. 1992;25(1):1-12.
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- To assess the pattern of psychiatric symptoms and to evaluate the relationship between exposure related variables(duration of work and urinary hippuric acid concenturation) and psychiatric symptoms in organic solvent exposed workers, case control study of forty-two solvent exposed workers and ninety-six non-exposed workers was conducted. The general health questionnaire 28(GHQ28) was administered to evaluate psychiatric symptoms and urinary hippuric acid concenturations was measured to estimate the present status of solvent exposure in exposed group and to estimate normal level in non-exposed group. The meand concenturation of urinary hippuric acid was significantly higher in exposed group (2.953g/creatinine g) than non-exposed group (0.395g/creatinine g) (P<0.01). The total positive rates of symptoms were significantly higher in exposed group(28.2%) than non-exposed group(17.5%) (P<0.05). The positive rates of symptoms for four sub-scales of GHQ 28 in exposed group were in the order of somatic symptoms, anxiety, social dysfunction, depression and in the order of social dysfunction, anxiety, depression, somatic symptoms in non-exposed group.The positive rates of symptoms for somatic symptoms and anxiety were significantly higher in exposed group than non-exposed group (P<0.05) and the proportion of workers with six or more positive symptoms(dysthymic states) in exposed group were significantly higher than non-exposed group (P<0.01). After the effect of age, sex, level of income, level of education, and duration of work were controlled, the total score of GHQ28 was still significantly different between exposed and non-exposed group(P<0.01). In multiple logistic regression analysis on the dysthymic state, the odds ratio of level of income was statistically significant in both group. The odds ratios of exposure related variables such as duration of work and hippuric acid concenturations were not statistically significant but there was a tendency that exposure related variables had an effect on dysthymic state in exposed group.In future, comtinuous evaluation of psychiatric symptoms on organic solvent exposed workers and studies to detect the factors that affect on psychiatric symptoms are required.
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Summary
- Leukocyte count and hypertension in the health screening data in some rural and urban residents.
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Choong Won Lee, Nung Ki Yoon, Sung Kwan Lee
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Korean J Prev Med. 1991;24(3):363-372.
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- We used the health screening data of some rural and urban residents to examine the cross-sectional association between leukocyte count and hypertension. The 206 male and 203 female rural residents were selected by multi-stage cluster sampling method in Kyungsan-Kun area of Kyungbuk province in 1985 and 600 urban residents were selected by the same sampling method as the rural residents in Daegu city of the same province in 1986 compatible with age-sex distribution of Daegu city of 1985 census, but of whom 384 actually responded. The rest of 600 were replaced by age and sex with those who were members of the medical insurance plan visiting the health management department of the university hospital to get the biannual preventive medical checkups. Excluded in the analysis were those having hypertensive history, diseases and extreme outlying values of the screening tests, leaving 373 rural and 571 urban residents. Leukocyte count was measured with ELT-8 Laser shadow method and the unit cells/mm3. Blood pressures were determined with an aneroid sphygmomanometer with pre-standardized method and hypertensives were defined as those showing systolic blood pressure more than 140 mmHg and / or diastolic blood pressure more than 90 mmHg. Total residents pooled (N=944) showed a significant difference between hypertensives and normotensives (6965.93+/-1997.01 vs 6490.61+/-1941.32, P=0.00) and in rural residents was noted the similar significant difference (P=0.03). None of significant differences were noted in any stratum stratified by residency and sex. Compared to the lowest quintile of WBC, 2/5 quintile showed odds ratio 0.99 (95% CI 0.90-2.21), 4/5 quintile 1.76 (95% CI 1.14-2.72), and highest quintile 1.80 (1.15-2.82) in the total residents. Likelihood ratio test for linear trend for in indicated a significant trend (x2 trend=5.53, df=1, P<0.05). There were no other significant odds ratios compared to the lowest quintile of WBC in strata stratified by residency and sex. The odds ratios in total residents which had showed significant odds ratios became nonsignificant and of reduced magnitude after controlling age, frequency of smoking and drinking with multiple logistic regression. In each stratum, it changed magnitudes of odds ratios slightly and unstably. None of the trend tests showed any significant trend. These results suggest that the Friedman et al's finding of association between leukocyte count and hypertension may be due to an statistical type I error result in from the data dredging in an exploratory study, in which more than 800 variables were screened as possible predictors of hypertension.
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Summary
- Body fat distribution and hypertension.
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Choong Won Lee, Nung Ki Yoon
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Korean J Prev Med. 1991;24(1):57-69.
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- This study examined the cross-sectional association of body fat distribution with hypertension as well as the superiority of medical calf skinfold measured as peripheral fat distribution over the conventional triceps skinfold using 450 Korean Navy divers selected by authors' convenience in 1990. Their mean age was 27.9 and range of it was 19-51. The centrally located body fat was approximated by subscapular from these skinfold measures to reflect central versus peripheral fat distribution pattern: 2 ratios and 2 differences. After controlling age and overall obesity (body mass index), prevalence odds ratios of the 2/4, 3/4, 4/4 quartiles of subscapular skinfold comparing with lowest 1/4 quartile were 2.05 (95% confidence interval, CI 1.18-3.59), 2.02 (95% CI 1.06-3.86), 4.00 (95% CI 1.99-8.06) respectively. The difference of subscapular and medical calf skinfolds was associated with hypertension (odds ration 2.45, 95% CI 1.28-4.68 comparing highest with lowest quartiles). Triceps and medical calf skinfolds alone did not show any odds ratio not including unity. The adjusted odds ratios were generally reduced in small magnitude compared with crude odds ratios not adjusted for age and overall obesity. The medical calf skinfold appeared to be more representative of peripheral body fat distribution than triceps skinfold. These findings suggest that central fat distribution rather than peripheral distribution is associated with hypertension independent of age and overall level of obesity and medical calf skinfold may replace conventional triceps skinfold in predicting peripheral distribution of body fat.
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Summary
- Sister Chromatid Exchanges in Lymphocytes of Some Workers Exposed to Hexavalent Chromium.
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Dong Hoon Shin, Nung Ki Yoon, Suk Kwan Suh, Min Hae Yeh
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Korean J Prev Med. 1990;23(3):358-368.
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- To investigate the possibility of utilizing of sister chromatid exchange(SCE) analysis in lymphocytes as an indicator which could evaluate the effects of mutagenicity after in vivo exposure to hexavalent chromium, this study was conducted using some of chromium plating workers occupationally exposed to hexavalent chromium, chromium trioxide (CrO3) in Taegu city. The study population was 12 Cr platers with perforation of nasal septum, 12 Cr platers without perforation of nasal septum and 20 controls. The SCE in peripheral blood lymphocytes of the subjects was analyzed and blood chromium concentration was estimated using the atomic absorption spectrophotometer (IL 551) equipped with furnace atomizer (IL 755). The mean SCE frequencies for Cr platers with and without perforation of nasal septum were statistically higher than those for control. The difference in SCE frequencies by age, smoking habits were not statistically significant both in Cr platers and controls. There was no difference in SCE frequencies by career of Cr platers workers. In Cr platers, the correlation between the mean SCE frequencies and chromium concentration in blood was not statistically significant. Using the transformation y=(sum SCE)1/2+(sum SCE+1)1/2, when the data was studied by multiple regression, it appeared that the influence of the occupation was the most important. Age, smoking, occupation and CrB(blood chromium concentration) together explain only 32.3% of interpersonal variation on SCE. The results in this study suggest that a genetic risk due to occupationally exposure to hexavalent chromium is clearly inferable and thus, SCE analysis in human lymphocytes may be used indicator of biological toxic effects of chromium. Further, populatio analysis studies are required before SCE frequency can be used as a mutagenic indicator in human population.
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Summary
- Type A behavior pattern and social control of parents.
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Choong Won Lee, Nung Ki Yoon, Suk Kwon Suh, Dong Hoon Shin
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Korean J Prev Med. 1990;23(1):22-32.
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- Associations between type A behavior pattern (TABP) and parental social control were examined by a questionnaire survey in a sample of 803 undergraduates of the three universities in Daegu city in 1988. TABP was assessed by the Student Jenkins Activity Survey (SJAS, short from) and social control of parents by Bernstein and Brandis' Index of control and communication which were both dichotomized by median. The mean age of the sample was 20.7 (standard deviation, 2.2) and mean of total score of SJAS was 5.6 with it standard deviation and median, 2.7 and 5, respectively. In stratified analysis for TABP-social control association by the native place, sex and socioeconomic status (SES), males of rural origin with low SES showed odds ratio (OR), 2.49 but those with high 0.40. For females of rural origin, those with low SES showed OR, 1.02, whereas those with high SES did 0.35. For those who was of urban origin, males with low SES had OR 1.27, and those with high SES did 1.29. Females with high SES showed 0.85 and those with low SES 0.67. None of the TABP-social control associations among the strata showed confidence intervals not including unity. In multiple logistic regression by native place, for those with rural origin the only term showed a statistically significance was the social control-SES of parents interaction, OR 3.99 (95% confidence interval, 1.03-15.46). For those of urban origin, none of the terms are statistically significant. These results suggest a social upward mobility by education of the rural disadvantaged group and a Confucian idea that regards academic achievement as one of social virtues, both of which may reflect the different sociocultural structures from the West.
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Summary
- The Diet and Physical Exercise Patterns of Bank Personnel for the Health Maintenance.
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Nung Ki Yoon
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Korean J Prev Med. 1983;16(1):105-112.
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- To characterize the diet and physical exercise patterns of bank personnel for the health maintenance, a questionnaire was administered to all the employees (1,249) of Daegu Bank in June 1983 among which 78.1% (976) responded. Three quarters of the respondents were between 20 and 34 years old. About 30% of 20-24 years old group were male compared with 73.1% of 25-39 years old group. Major findings of the survey are as follows: 1) The most concerned chronic disease of the respondents were in the order of cancer (27.4%), psychiatric disease (15.1%), hypertension (14.1%), heart disease (13.7%) and tuberculosis (7.9%). 2) For the prevention of adulthood disease and obesity, 53.4% of the respondents were restricting sugar intake; 40.9%, salt; and 35.1%, fat-rich food. 3) Among all the respondents 36.9% were making effort to reduce body weight and 17.7% were trying to gain body weight. 4) The proportion of respondents who practice physical exercise for the health maintenance was 82.9% in male and 62.5% in female.
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Summary
- A Result on the Physical Checkup of Public Officals and Schools.
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Nung Ki Yoon
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Korean J Prev Med. 1981;14(1):59-64.
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- Korean Medical Insurance Cooperation executed the physical checkup intended for all the members of public officials, school personnel in private schools, and the insured as a national-wide event in 1980. This is the result of a part of Taegu district and its contiguous country this hospital took change of. Physical checkup method was divided into the first health examination and the second health examination. The second health examination was executed for those who needed reexamination according to the result of the first health examination. After that, we passed judgment on the result finally. The total number of the first health examination was 10,779 ; 4,606 in public officials, 2,327 in police constables, 3,976 in school personnel in private schools. The classification of physical checkup is as follows; A group: normal groups. B group: those who do not require immediate medical care but require preventive measure or who are doubtful of disease or who had undetermined diagnosis (attention) C group: those who require immediate medical care but who are able to be on duty (simple recuperation). D group: those who require immediate medical treatment and recuperation (suggestion from office and recuperation). Total B group to the in the first health examination was 4.73%, that of total C,D groups 2.21%. That of total C,D groups to the total in the first health examination by occupation was 2.30% in public officials, 2.19% in police constables, 2.04% in school personnel. Consequently there was no different among occupations. Total C,D groups of hypertension to the total in the first health examination was 1.68% and hypertension was 76.05% to all disease. These rates mentioned to above were higher than any other rate in disease. Subsequently, being low, the rate of diabetes was 15.54%. From the view point of age, the higher rate appeared in men and women over 35 years old of B group and over 45% years old of C,D groups in three occupation in comparison with other ages and the older men were, the higher men who took a disease were.
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Summary
- About Family Planning Status in Today.
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Nung Ki Yoon
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Korean J Prev Med. 1980;13(1):67-75.
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- Natural increase rate in population is reached to 1.7% in 1975 from 2.55 in 1996 because of the effect of Governmental Family Planning Program. The average number of present children and ideal children is just the same, 2.4 people, in this investigation. So, I assume that the number of present and ideal children is approaching each other. The rate of unmarried female workers who don't know even one thing about the knowledge of contraception was 23.9%, and especially that of rural women was 31.5% and 41.3% of them has never experienced contraception. "Boy-preference" presented 60.1% of unmarried female workers and 79.1% of married women. "Connection of a family line" related to "Transfer to next generation of a family line" presented 38.0% and "Trustworthiness" related to "Leadership of a family" presented 26.0%( total 64.0%). As this point, we can find that this rate reveals the traditional sense of patriarchal system in society and family. The rate of women of experienced artificial abortion has been 52.1% and that of women using it as birth control caused by "Many children" and "Short birth-interval" 46.6% of women of experienced pregnancy. So, we can that artificial abortion is a main cause of Maternal Health destruction.
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KSPM
