Journal of Preventive Medicine and Public Health

Volume 8(1); October 1975

Original Articles

An Epidemiological Study of 100 Cases of Lung Cancer in Korean.: Dong Joon Lew, Yang Won Park; Korean J Prev Med. 1975;8(1):1-6.

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Abstract PDF: An epidemiological study is to observe and analyse 100 cases of lung cancer in Korean, which had been diagnosed actually at the general hospitals in Korea from 1970 through 1974, to discover the tendency of the lung cancer by sex, age, occupation, duration of clinical symptoms before diagnosis, site of cancer in lung, size of cancer, occurrence, treatment, prognosis, smoking and pathological findings as follows. 1. Males were affected 5.7 times more than females, the peak incidence of lung cancer were 50 years old age group. 2. The occupations of the cases were commerce, agriculture, industry, laborers and teachers, etc. in thht order. 3. The average duration symptoms from onset to diagnosis were 5.5 months. 4. The cancers were affected more right side than left side of the lungs, Particularly the most of them were affected in the upper lobes of the lungs. 5. The average diameter of the tumors was 5.5crX6.5cm, However the largest of them was 10cm X 13cm. 6. The most cases of the lung cancers were occurred primarily. 7. Out of the 100 cases, 58 cases had no treatment, 23 cases had palliative-symptomatic treatment, of cases by special chemo-therapy, 7 cases by surgery, and 5 cases by cobalt 60 or X-gay. 8. In the view point of prognosis, the most cases of the lung cancers died within one year atfer diagnosis. 9. The smoking was one of the causative factor of lung cancer, but there was no significant diferentiation by means of the amount of smoking. 10. The most cases of the lung cancers diangosed histo-pathologically, were epidermoid(squamous) type.; Summary

The Bactericidal Activity of Serum of Leprosy Patients.: Kyu Bong Kim; Korean J Prev Med. 1975;8(1):7-14.

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Abstract PDF: The bactericidal activity of 96 sera, to Staphylococci and E.coli, of leprosy patients classified as sever, mild, and negative grade by bacterial index was investigated. The results obtained were as follows; The killing activity to E. coli, in general, was stronger than that to Staphylococci. The bactericidal activity of serum was variable by serum itself, and these variations were more remarkablh in Ei coli than in Staphylococci. In case to E. coli, the higher bactericidal activity was observed in the serum of mild and negative grade patients rather than sever, while no relationship was found between activity and disease grade in Staphylococci. The per oral administration of DDS and Lampren did not give any influence to the bactericidal activity of serum.; Summary

The Effect of an Oral Contraceptive (Eugynon) Upon Lactation.: E Hyock Kwon, Tae Ryong Kim, Kil Won Kang, Jae Woong Hong, Yoon Ok Ahn; Korean J Prev Med. 1975;8(1):15-24.

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Abstract PDF: There are a number of published reports aimed at clarifying the effect of hormonal contracept -ives upon the quantity and quality of breast milk during postpartum and lactation periods. As to the volume of milk produced by breast feeding mothers, many authors seem to have agreed on a decrease as an established pattern in the periods following regular administration of oral contraceptives containing estrogen in varying dosage. The quality of milk following administration of hormonal contraceptives, however, remsins a controversial issue. Korea's experience in oral contraceptive is rather a brief one, but use of Eugynon has been widespread and frequent since this hormonal contraceptive was introduced into the national program in 1967. The authors have reviewed the potential significance of data concerning regular use of an oral contraceptive as affecting lactation, and have sought to clarify the interrelationship between the administration of Eugynon and quantity and quality of breast milk from mothers contracepting. with Eugynon in different periods following confinement. A total of 85 women, who were at different periods following deliveries, have been divided into, two groups, one comprising 28 women regularly taking oral pills and the other (57 women) not resorting to hormonal contraceptives if they were contracepting at all. 1. Milk Volume. In view of the possible influence of suckling on the amount of milk produced, efforts were made in this study to standardize the technique by extracting breastmilk by applying manual pressures on one side of the maw-nae, While the nipple on the other side was being sucked by the mother's own baby. The effetct of an exogenic ovarian hormone on the quantity as well as quality of breastmilk is generally understood to be inapparent until the drug is administered to women whose milk secreting function has been normalized. ") In the present study, it was observed that the decrease in the ammount of milk obtained from mothers in the periods following the 4th cycle of oral contraceptives or thereafter has turned out to be statistically insignificant. This result conforms i.u the findings by Tubari and others. It is assumed that it takes at lest 2 to 3 cycles of use before mammary glands are functionally adjusted to the use of exogenic hormonal contraceptives. 2. Specific Gravity and Composition of Milk There was no noticeable change in the protein and chloride content following continuous administration of ore.l contraceptives, while meaningful changes were observed in fat (increase) and calcium (decrease up to the 5th cycle use) contents. Also, there was a rather significant decrease in the specific gravity in the period following administration of the first cycle of the oral contraceptive. The findings from the present study partially conforms the results published by Ramadan and others, who reported that little change was noticed in the contents of total solids. ash, chlorides and lactose in the breast milk of women who had taken 4 cycles of ovosiston, although in our study lactose was not measured. Ramaden, however, reported that fat content did increase in the same milk, as in our study. A definitive conclusion, however, could not be made unless measures are taken to rule out the physiological changes of the maternal body affecting the composition of milks.; Summary

Differential Effects of Communication Media on Family Planning Behavior.: T G Park; Korean J Prev Med. 1975;8(1):25-36.

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Abstract PDF: No abstract available.; Summary

Differential Effects of Communication Media on Family Planning Behavior.: Hyung Jong Park, Kyung Kyoon Chung, Dal Sun Han; Korean J Prev Med. 1975;8(1):37-52.

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Abstract PDF: The use of communication media suitable for the audience and message is important in conducting effective family planning IEC activities. This study 'intended to assess differential effects of various media used by the Korean program on rural women's family planning knowledge, attitude, and practice. Data for the study were collected originally for the study of family planning mothers' clubs by the School of Public Health, Seoul National University in 1973. The sample was drawn according to the principle usually employed in obtaining a small sample from a large area. Initially, a sample of 25 Gun's was selected from a total of 138 Gun's by systematic random sampling on the basis of the list of number of mother's clubs in each Gun. Secondly, from each of these primary units(Gun) selected, two second stage units(Myon) were drawn by a systematic random sampling method based on the list of the number of Li's -in each Myon. Finally, a sample of nine Li's was drawn by a simple random sampling method from each Myon selected in the second stage sampling. In this way, a total of 450 Li's, 18 Li's from each of 25 Gun's, were selected. In one of thess 18 Li's of each Gun, all the married women with a living husband, up to age 49, were interviewed. out of 1.052 women interviewed, 145 women were naturally sterile or beyond menopause, and were excluded from thib study. Thus, the analytical population consists of 90 fecundable wives, including those with tubal ligation. A series of analyses were made to examine the relationships between family planning status and selected socio-demographic and communication variables. The family planning status was measured by three indicators, one for each of family planning knowledge, attitude, and practice. The variable for family planning knowledge was created by classifying the respondents into two groups: 1) those who professed to know in detail at least one contraceptive method out of a total of five, including the loop, oral pill, vasectomy, condom, and rhythm, and 2) those who had no professed knowledge about any method. The variable for family planning attitude was dichotomized into those who had favorable attitude toward at least one method among the same list of five, and those who did not have a favorable attitude toward any method. Contraceptive status was classified into two categories of current users and non-users. The independent variables, applied to explain the family planning status, include four sociode-mographie variables and six communication variables. The socio-demographic variables are age, education, number of living children and sons, and ideal number of sons. Communication variables are frequency of exposure to family planning messages through each of the following channels: radio and/or TV, newspaper and/or magazine, 'Happy Home' and/or leaflet, public meeting and/or lecture, family planning worker, and neighbor. Major findings obtained from the analysis are summarized as follows: 1. It was observed that about 33% of the eligible women did not want to have additional children but were not practicing contraception(pong-eem). About half of these women were ever-users and the other half were never-users. They have at least perceived the need for family planning, and thus, should be a primary target population for family planning IEC activities. 2. Socio-demographic variables showed a'closer association with practice than with knowledge or attitude. 3. The communication variables affected family planning status over and above the effects of the socio-demographic variables. When the communication variables were added to the socio-demographic variables as independent variables in the multiple classification analysis, the explained variance was increased by 6.3% in knowledge, 8.7% in attitude, and 4.3% in practice. This also suggests that the communication variables exert larger effects on knowledge and attitude than on practice. Family planning adoption decisions may be influenced by many other factors as well as by family planning knowledge and attitude. 4. The Beta-coefficient was computed for each of the independent variables in multiple classification analysis. Among the media considered in this study, 1) neighborhood communication, radio and/or TV, and 'Happy Home' and/or leaflet had significant effect on family planning knowledge:2) public meetings and/or lecture, radio and/or TV, and neighborhood communication had significant effect on family planning attitude: and 3) radio and/or TV, Happy Home and/or leaflet, and home visit had significant effect on family planning practice. Although program media, neighborhood communication, and radio and/or TV appeared to be more effective than other media, no definite pattern emerged. In the interpretation of these data, however, it should be remembered tha t the frequency of contact varies with the media. 5. When women were exposed to family planning messages more frequently, they tended to have more detailed knowledge about, and more favorable attitudes toward family planning, and were more likely to he practicing family planning. 6. Media behavior differed with age and educational level. It was found that the younger the women and the higher their educational level, the more frequently they were exposed to family planning messages through radio, TV, or printed materials. On the other hand, the older the women and the lower their educational level, the more frequently they were exposed to family planning messages through meetings, home visits, and neighborhood communication. This implies that the audiences' characteristics, such as age and educational level, should be taken into account in the selection of appropriate media.; Summary

Survey on Fertility Rate and Family Planning in Sub-urban Area, Taegu.: Sung Kwan Lee, Kwan Yun Kim, Hae Kun Chung, Jung Wan Kim; Korean J Prev Med. 1975;8(1):53-69.

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Abstract PDF: It is very desirable to clarify the situation of fertility, family planning and attitude toward family size of the women residing in the sub-urban slum area because of underprivilege of socio-economiccondition of the residents and negligible health services (especially MCH and family planning) to the people in the area. The study area was selected a slum and primary fixation place of the people immigrated from rural area: Taegu, Dong Ku, Shin Chun Dong, 2 Ka and Taegu, Suh Ku, Ri San Dong, 1 Ka The survey was conducted by family planning workers at Health Center from December 1974 to February 1975. The results were obtained as follows: Thirty-eight percent of residents immigrated from rural area and most of there consist of nuclear family. Average monthly income per family was 38,000 won and 74 percent of them haven't their own houses. Number of pregnancy and live births per womon were 3.8 and 3.0 respectively. The rates of spontaneous and induced abortion to total married women were 9.5% and 36% respectively. Regarding delivery conditions, 86% of deliveries were performed at home and 70% of them were cared by non-professional person or without helpers. Ideal number of children account for 1.58 for sons, 1.08 for. daughters 2.655 for both, but the rate of 2 children regardless sex difference was only 3.4%. The factors influencing to family size were age and educational level of women and economic status of the hosehold. Regarding family planning, the rate of experience of contraception in the past was 48 percent while the rate of present contraception was 24%. Most frequent pregnancy order at the first contraception was 4th and most frequent age group of the women was 35-39 years in the past while the most frequent pregnancy order and the age of women were 3rd and 30-34 years at the first contraception in the present. Average fertility rate per year to total eligible women for 5 years 20.8% indicating somewhat higher than those of oter places. Age specific marital fertility rate showed higher in younger age groups than those of other places, and total fertility rate accounts for 1548.4 showing similar to rural total fertility rate in 1970 and higher than those of other urban areas.; Summary

A Medical Care Utilization Study of a Private Medical Clinic in Rural Korea.: B M Lee, S H Yu, I S Kim; Korean J Prev Med. 1975;8(1):71-82.

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Abstract PDF: This research is to explore medical care utilization of local private medical clinic which covers most of medical care in rural area in Korea. The local private medical clinics usally staffed with one physician are fairly well distributed even to rural area and they take care of the most primary care. However, the pattern of medical care in these clinic have never been explored systemactically previously. The Gangwha Christ King Clinic, a non-proprietary care unit without bed run by Meryknoll sisters, was used for this study. Records of 17,853 patients during the past 11 years (1964-1974) were analyzed and interpreted. Followings are the result of the study: 1. The utilization rate was higher among those who lived in areas near the clinic. However, this tendency were getting less prominent by the progress of year. 2. The highest utilization rate was shown in ages between 0-4. When adjusted by the population structure, the utilization rate in this age showed 3.5 times higher than other ages. Male was more dominant ages under 20, however ages over 20 femalc outnumbered male. 3. The utilization rates were highest in April and August which are non-busy months in rual area, however the rate was the lowest in December and January. 4. The most common disease seen at the clinic was pulmonary tuberculosis and gastrointestinal diseases came next. 5. While the proportion of pulmonary tuberculosis had markedely decreased during the past 11 years, the skin diseases had increased substantially. Other diseases showed only minor changes. 6. The average number of visit to the clinic per disease decreased from 5.2 in 1964 to 2.4 in 1974. 7. The medical care cost per disease in 1964 was w986 and it increased to w2,555 in 1974. This is about 2.6 times increase. However, considering general inflation during the past 11 years the increase was not impressive. (Increment of national during that period was 2.5-3 times. ) 8. The average drug cost per disease increased 2.4 times and average laboratory fee about 5 times during the 11 years. 9. Only 0.8% of total patients was classified as unable to afford the medical care financially and also only 0.8% of total patients was necessitated discount. 10. About 30% of patients were not able to pay the fee at the time of visit, and about 50% of them payed back the fee within two months.; Summary

Bacteriological Mass Survey on Prostitutes for American Soldiers.: Doo Hie Kim, Young Shik Kim; Korean J Prev Med. 1975;8(1):83-88.

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Abstract PDF: This survey was carried out on about 240 prostitutes for American soldiers in Bong-Deok Venereal Diseases Clinic, Daegu Korea, through 2 times for two months from October and November 1974. The culture method was used identifing Neisseria and Mimeae species carbohidrate fermentation test was ferformed with phenol red broth base added human serum. Resistance test was informed with disc method in chocholete agar plate. The discs were made by Jong-Geon Dang Pham. Co.. Seoul, Korea. The carrierate of Neisseria genorrheae was 9.8% and there were relatively many carriers of Mimeae. If the direct smear is used only in microscopic diagnosis, it is easily confused to differentiate Gonococcus and Mima, a kind of coccobacilli. Gonococcus resistance to penicillin G was found in one out of 5 cases tested. The most of Mimeae was resist to penicillin G, but the broad spectrum antibiotics such as chloramphenico1 and gentamycin etc was moderatly sensitive.; Summary

A Study on Medical Care Utilization of Private Clinic in Korean Rural Area.: Yong Joon Kim; Korean J Prev Med. 1975;8(1):89-106.

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Abstract PDF: This research was undertaken to explore the degree of clinic utilization, medical cost, and disease patterns in a Korean rural area. The Kojedo Project was selected because it is one of many 'Front Line' medical facility, offering readily accessable primary care to the logical population, but with a particular emphasis on simple treatment and public health measures. During 1973, 14,808 patients visited the clinic from which 3,621 were selected as a sample for analyzation, the result was as follows; 1. Utilization, by geographical distribution, was highest in 'A Zone' the area closest to the clinic, with 46 percent of the population of that area making use of the facilities. 2. Utilization, by sex and age distribution, was higher for males less than one year old (50 males: 37 females), one to four year (17 riales: 7 females) and over 55 years(19 males: 15 females), and higher for females in the 15-34 years age bracket(12 female: 10 male). 3. Utilization, per two month period, was highest in August-September (19 percent of toal), 4 and lowest in the coldest and least busy months, December and January (14 percent). 4. The average charge per visit was W780; average payment was W686 (88% of the charge). The charge increased in proportion to the distance between the patient's home and the clinic: D Zone; W 1,108, C Zone; W 1,030, B Zone; W 970, A Zone; W769. 5. Medical charge by sex and age distribution, was higher for males in all but the less than one year and one to four year brackets, charges(W1,145) weme highest in the 35-54 years age bracket, lowest (W 401) in the less than one year bracket. 6. Disease patterns, by major division, showed highest frequency (16.8%) in the infection and parasitic category, folinwed, consecutively, by Respiratory System, Digestive System and Skin, Nail, Hair and Subcutaneous Tissues. 7. The most common cause of clinic visits based on the WHO Classification, was Pulmonary Tuberculosis, followed by, consecutively, Common TCold and Preventive Inoculation and Vaccination. 60.3% of the total clinic visits involved the twenty most common disease of the WHO List. 8. Medical charge, by disease category, was highest for 'Other disease of GUT' (W927), followed by Pulmonary Tuberculosis (W921), and lowest for Preventive nIoculation and Vaccinatioir (W259). 9. Continous visits were most common for Pulmonary Tuberculosis, Hypertensive Diseases and Peptic Ulcer and Complications.; Summary

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