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Volume 26(2); June 1993
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Original Articles
A Cross-sectional Study on the Risk Factors Related to Fatty Liver.
S H Ohm, B C Yoo, S J Kim, C U Lee, K T Pai, S C Kim, H R Shin
Korean J Prev Med. 1993;26(2):179-191.
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AbstractAbstract PDF
Generally fatty liver is attributed either to chronic alcoholism, diabetes mellitus, or obesity. Based upon this commonly held clinical brief, this study was conducted to investigate the contributing factors of fatty liver and odds ratio (OR) of known contributing factors. A sample of 310 male participants, who visited at Seoul Paik Automated Multiphasic Health Testing System from November 1991 to December 1991, was separated into 112 cases and 198 controls by ultrasonographic finding. There were statistically significant difference between fatty liver and normal in triglyceride(TG), body mass index(BMI), alanine aminotransferase(ALT), high density lipoprotein cholesterol (HDL-C), fasting blood sugar (FBS), alcohol consumption, low density lipoprotein cholesterol (LDL-C), total cholesterol, gamma-glutamyl transferase (gamma-GT), duration of alcohol intake and alkaline phospahtase (Alk.P)(P<0.01, P<0.05). The statistically significant elevated odds ratio were noted for TG (4.48, confidence interval (CI) 2.66-7.55, P=0.000), alcohol consumption(3.24, CI 1.56-6.23, P=0.002), BMI(3.05, CI 1.87-4.97, P=0.000), and FBS(2.59, CI 1.53-4.40, P=0.000). In summary, it is suggested that the fatty liver could be preventive by avoiding such deleterious factors as high fat diet, alcohol and obesity.
Summary
Epidemiologic investigation to identify the cause of an infant methemoglobinemia.
young Yeul Kim, Bo Youl Choi, Hung Bae Park, Min Young Kim, In Hak Yeo
Korean J Prev Med. 1993;26(2):192-201.
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AbstractAbstract PDF
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.
Summary
Illness Associated With Contamination Of Drinking Water Supplies With Phenol.
Doo Hie Kim, Sung Kook Lee, Byung Yeol Chun, Duk Hee Lee, Sung Chul Hong, Bong Ki Jang
Korean J Prev Med. 1993;26(2):202-209.
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AbstractAbstract PDF
A accidental spills of phenol(100%) to the river Nakdong with subsequent contamination of the tap water for about two million consumers in Taegu city of Korea were occurred in March 1991. A historical cohort study of 6,913 individuals was undertaken to determine the associated with illness. Population subjects were divided into two groups of exposed and unexposed. Exposed subjects were reported to be phenol associated symptoms significantly higher than those in a nearby unexposed area(39.6% vs 9.4%, p<0.01). Especially, in the related symptoms, highly significant differences were noted in the number of subjects reporting gastrointestinal illness such as nausea, vomiting, diarrhea, or abdominal pain. During the accident, study subjects who experienced peculiar taste or odor in the tap water were significantly higher in the exposed areas(92% vs 34.3%). Chlorophenols formed from chlorination of water may have aggravated the problem.
Summary
A study to the workers exposed to organic solvents by neurobehavioral tests.
Seong Kyu Kang, Ho Keun Chung, Jeong Pyo Hong, Ki Woong Kim, Young Sook Cho
Korean J Prev Med. 1993;26(2):210-221.
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AbstractAbstract PDF
In order to evaluate the confounding factors of neurobehavioral tests and the neurobehavioral effects in the workers exposed to organic solvents, NCTB was carried out on 100 workers. 46 workers had never been exposed to neurotoxic substances, and the others were being exposed to the solvents, mainly toluene. Simple reaction time, digit symbol, Santa Ana dexterity test and persuit aiming were different with age in non exposure group. Simple reaction time was carried out well in males, and digit symbol and persuit aiming were in females. There was no difference at educational level when the subject was educated over 12 years. Santa Ana dexterity and Benton visual test differed according to exposure level to toluene, however simple reaction time didn't. The acute neurotoxic effect was not excluded in this study. But, NCTB could be used to evaluate and prevent neurobehavioral changes in workers exposed to neurotoxic solvents in Korea.
Summary
Effects Of Glue Sniffing On Weight Increase Or Central Nervous System Of Young Rat.
Heon Kim, Sun Min Kim, Soo Hun Cho
Korean J Prev Med. 1993;26(2):222-230.
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AbstractAbstract PDF
Industrial glues, known as 'Bonds' in Korea, contain many kinds of organic solvents, and glue sniffing of youths became one of the social problems in Korea. Mixed exposures to solvents by glue sniffing may induce chronic toxicities different from those by exposures to solvents of single component. To test effects of the glue sniffing on weight gain or central nervous system, two groups of 20 male Sprague-Dawley rats were exposed to air(control group) or vapors of the glues to narcotic status(exposed group), and weight check, tail flick test, hot plate test, rotarod treadmill test were done on the 14th, 24th, 36th, 45th, 53rd, 86th, 102nd, 117th, 134th and 151st days after the first exposure. On the 188th day, their brains were excised and examined by a pathologist. Weight gain, controlled against time change, showed significant difference between the groups, but response times in tail flick test, hot plate tests, and rotarod treadmill test didn't. In pathological examination with blind method, no macroscopic or microscopic difference were found between the two groups. These results suggests that organic lesion in central nervous system may not ensue glue sniffing, but, before firm conclusion, more studies in various exposure conditions should be followed.
Summary
Induction Of Metallothionein And Toxicity In Acute Cadmium Intoxicated Rat.
Kyung Joon Min, Jung Duck Park, Yeon Pyo Hong, Im Won Chang
Korean J Prev Med. 1993;26(2):231-250.
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AbstractAbstract PDF
Thirty five male Sprague-Dawley rats were treated with cadmium chloride solution ranging from 0.2 to 3.2mg CdCl2/kg by intravenous single injection. At 48 hours after administration of cadmium, total cadmium, MT bound cadmium and histopathologic finding in liver, kidney, lung, heart, testis, metallothionein in liver, kidney and total cadmium in blood were examined. Tissue cadmium concentration was highest in liver, followed by in kidney, heart, lung and testis. Cadmium bound to metallothionein(MT-Cd) and ratio of MT-Cd to total cadmium were increased in liver and kidney dependently of cadmium exposure dose, but not significantly changed in other organs. On histopathologic finding, the most susceptible organ was heart in considering cadmium exposed dose, but testis in considering cadmium concentration. Blood cadmium concentration was increased with dose-dependent pattern, and significantly correlated with tissue cadmium concentration, so that we may estimate tissue cadmium concentration by measurement of blood cadmium concentration. Metallothionein in liver and kidney was increased with dose-dependent pattern, higher in liver than in kidney, and was significantly correlated with tissue cadmium concentration. However, metallothionein induction efficiency of tissue cadmium(microgram MT/microgram Cd) was greater in liver than in kidney, and reverse to tissue concentration or exposed dose of cadmium.
Summary
Prevalence rate of lead related subjective symptoms in lead workers.
Du Shin Jeong, Hwa Sung Kim, Kyu Dong Ahn, Byung Kook Lee
Korean J Prev Med. 1993;26(2):251-267.
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AbstractAbstract PDF
The relationship between lead related subject symptoms and lead exposure indices was studied in 435 male lead workers in thirteen lead using industries. 212 male office workers who were not exposed to lead occupationally were also studied as a control group. Fourteen lead related symptoms were selected. They were further subdivided into 4 sub-symptom groups such as 1) gastrointestinal, 2) neuromuscular and joint 3) constitutional, and 4) psychological symptoms. Symptom questionnaires were provided to the workers and filled up by themselves and reconfirmed by interviewer(doctor). The test used for the evaluation of lead exposure were blood lead (PbB), zinc protoporphyrin in whole blood(ZPP), hemoglobin(Hb), hematocrit(Hct), delta-aminolevulinic acid in urine(DALA). The results obtained were as follows; 1. The higher prevalence rate in the sub-group of neuromuscular and joint symptoms was observed in occupationally lead exposed subjects than non-exposed subjects. Among the sub-groups, the most frequent symptom was "numbness of finger, hands of feet", and the prevalence of the symptom of "arthralgia", "weakness of fingers, hands or feet" and "myalgia" were higher in order. 2. While the symptom which showed the biggest difference of prevalence rate among the 14 symptoms between exposed and non-exposed subjects was "numbness of fingers, hands or feet" , the symptom which showed the highest prevalence rate was "feeling tired generally" in exposed and non-exposed subjects, but no statistical difference of symptom prevalence were observed. 3. In total study population, PbB and ZPP had dose-response relationship with 4 symptoms of neuromuscular and joint symptoms ("numbness of finger, hands or feet", "arthralgia", "weakness of fingers, hands or feet" and "myalgia") and one symptom of gastrointestinal group("intermittent pains in lower abdomen"). 4. In lead exposed workers, only neuromuscular and joint symptoms group showed dose-response relationship with PbB and ZPP. 5. In lead exposed workers, the prevalence rate of overall symptoms of lead workers with age below 39 years was higher than that of lead workers with age above 40. While neuromuscular and joint symptoms group had a dose-response relationship with PbB in former group, it had a dose-response relationship with ZPP in latter group. 6. Age adjusted odds ratios of symptoms of non-exposed with exposed and odds ratios of low exposed with high exposed workers showed the dose-response relationship of lead exposure with neuromuscular and joint symptoms group("numbness of fingers, hands or feet", "arthralgia", "weakness of fingers, hands or feet" and "myalgia") and gastrointestinal symptoms group("intermittent pains in lower abdoman").
Summary
Assessment of the Naktong river pollution after phenol spillage from the Kumi industrial estates II, Korea.
Doo Hie Kim, Bong Ki Jang, Sung Chul Hong, Hyo Jung Moon, Duck Hee Lee, Hae Ju Oh
Korean J Prev Med. 1993;26(2):268-281.
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AbstractAbstract PDF
The aquatic quality of the Naktong river after two of three months in June, 1991 with phenol spillage from a electrical factory in Kumi was investigated. The samples were collected at six sites of the Naktong river basin and Kachang and Kongsan lakes. Phenol was not detected from all water samples. Turbidity was very much increased to the down stream in the Naktong river. The BOD and COD values exceeded the 2nd grade(3 mg/l) of the Korean standard quality of Environmental Water Act at the all sampling sites of the Naktong river. Especially, the value of COD at Kaejin (12.5 mg/l) was poorly classified as to the 5th grade of water class for the environmental quality standards. Organophosphorous pesticides such as parathion, malathion, fenitrothion and diazinon were investigated but not detected. Diazinon was only detected at the Ilson bridge(1.42 ppb), Okkye stream(6.95 ppb), Waekwan bridge(0.32 ppb), Gangjung reservior(0.13 ppb), Kaejin(0.05 ppb). Of the carbamates such as carbanyl, isoprocarb and cabofuran, the carbofuran was detected all sites except tap water, and Kachang and Kongsan lakes. The content of heavy metals such ans Cd, Pb, Zn, Fe, Mn, Hg were not exceeding for drinking water standards at the all sampling region, but only mecury was detected from Okkye stream(0.018ppb) and Kaejin(0.09ppb). In the regions of Kachang and Kongsan lakes, the content of heavy metals were lower than that of reservoir of Naktong river.
Summary
A Study Of The Peripheral Neuropathy Among The Workers Exposed To Carbon Disulfide.
Dae Seong Kim, Soon Suck Kim, Chul Whan Cha
Korean J Prev Med. 1993;26(2):282-292.
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AbstractAbstract PDF
Neurotoxicity in the workplace may occur with exposure to scores of chemicals. Although large acute outbreaks of the occupational neurological disease are rare, the incidence of occupational neurotoxicity in its subtler aspects is unknown. A working knowledge of both the major occupational neurotoxic solvents and the tools used by clinical neurologists and neurotoxicologists to evaluate neurotoxicity in working population is a necessity for the occupational physician. To investigate the effects of carbon disulfide(CS2) on the peripheral nerve system using the nervous conduction study, 105 male workers working in the spinning room of a viscose rayon factory were examined and compared with a sex and age matched, unexposed 105 male controls using t-test analysis. 72.4% of CS2-exposed workers complained of neurological symptoms, and the abnormal cases in nerve conduction study were 48.6%. The abnormal cases of nerve conduction study increased in number according as the age and duration of exposure increased. In this study, asymptomatic workers were confirmed to have subclinical neuropathy by nerve conduction study. Also as there were abnormal cases even in its duration of exposure below 4 years, nerve conduction study turned out to be ways of discovering of early peripheral neuropathy. In nerve conduction study, the amplitude, velocity, F-wave latency and H-reflex of the motor and sensory nerves in both upper and lower extremities were significant different between CS2-exposed workers and the controls. From the pathological viewpoint, both segmental and axonal degenerations were assumed in this study.
Summary
Development And Evaluation Of Korean Diagnosis Related Groups: Medical Service Utilization Of Inpatients.
Young Soo Shin, Young Seong Lee, Ha Young Park, Yong Kwon Yeom
Korean J Prev Med. 1993;26(2):293-309.
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AbstractAbstract PDF
With expanded and extended coverage of the national medical insurance and fast growing health care expenditures, appropriateness of health service utilization and quality of care are concerns of both health care providers and insurers as well as patients. An accurate patient classification system is a basic tool for effective health care policies and efficient health services management. A classification system applicable to Korean medical information-Korean Diagnosis Related Groups (K-DRGs)-was developed based on the U. S. Refined DRGs, and the performance of the developed system was assessed in this study. In the process of the development, first the Korean coding systems for diagnoses and procedures were converted to the systems used in the definition of the U. S. Refined DRGs using the mapping tables formulated by physician panels. Then physician panels reviewed the group definition, and identified medical practice patterns different in two countries. The definition was modified for the difference in K-DRGs. The process resulted in 1,199 groups in the system. Several groups in Refined DRGs could not be differentiated in K-DRGs due to insufficient medical information, and several groups could not be defined due to procedures which were not practiced in Korea. However, the classification structure of Refined DRGs was retained in K-DRGs. The developed system was evaluated for its performance in explaining variations in resource use as measured by charges and length of stay(LOS), for both all and non-extreme discharges. The data base used in this evaluation included 373,322 discharges which was a random sample of discharges reviewed ad payed by the medical insurance during the five-month period from September 1990. The proportion of variance in resource use which was reduced by classifying patients into K-DRGs-r-square-was comparable to the performance of the U. S. Refined DRGs: .39 for charges and .25 for LOS for all discharges, and .53 for charges and .31 for LOS for non-extreme discharges. Another measure analyzed to assess the performance was the coefficient of variation of charges within individual K-DRGs. A total of 966 K-DRGs (87.7%) showed a coefficient below 100%, and the highest coefficient among K-DRGs with more than 30 discharges was 159%.
Summary

JPMPH : Journal of Preventive Medicine and Public Health