임부(姙婦)의 산전위험요인평가연구(産前危險要因評價硏究): 일선(一線) 보건요원(保健要員)을 위한 산전관리용(産前管理用) 위험요인적용모형(危險要因適用模型) 개발(開發)

박인화 ( In-hwa Park ),주신일 ( Shyn Ii Joo ) 한국보건사회연구원 1985 保健社會硏究 Vol.5 No.1

1. Background and Purpose of Study The purpose of this study is to develop a risk factor assessment chart that is simple to use by health workers at grass-root level and predictive enough to screen and allocate limited resources to high-risk pregnancy. A risk scoring chart, currently in use by the government sector in the field of maternal and child health in Korea, is based on arbitrary criteria for selection and scoring of risk factors. Therefore this chart has considerable limitations in the statistical sense including the validity of scoring system. Against this backstop, development of a risk factor assessment chart that is valid on statistical consideration is critically indicated for manpower situation as unique in Korea where nurse-aids account for the predominant work-force engaged in the maternal and child health care service at the grass-root level in the public sector. 2. Design of Study Materials: The current study, which is the second phase one, relates to the 3,838 pregnant women reviewed and edited out of the original 4,012 women observed in the first phase of the study (Joo et al., 1982) and is intended to attempt further in-depth analysis of the information on pregnancy and labour of the population. Information on the medical charts of pregnant women who were consecutively delivered at the Busan II Shin Hospital during the first six months in 1981 are the main data source. Relevant information on these medical charts were collected in standardized questionaire that was developed by a Korea Institute for Population and Health research team. Analysis of Data: In principle, four main analyses were undertaken. First, the significance of association between maternal variables and a defined outcome variable which relates to unwanted pregnancy complications and labor/delivery outcomes, was assessed by means of the adjusted chi-square test. A list of variables that were shown statistically significant on chi-square test were selected as risk factors. Therefore, pregnancies with risk factors were categorized as high-risk pregnancy, and those without any were grouped as non-risk pregnancy which, however, were subject to further analysis of next stage. In short, all those non-risk pregnancies found without risk factors under· went analysis of each succeeding stage up 10 final one, fourth stage. Second, odds ratio as an approximation to the relative risk, was calculated to assess the potency of different risk factors associated with the defined outcome variable. Third, validity of each stage of screening scheme was tested. interms 01 sensitivity, specificity and predictability. Finally, a revised risk assessment chart to screen high-risk pregnancy was developed for the use of health workers at grass-root level. 3, Findings First stage of analysis: Six maternal variables including obstetric danger signals identified over chief complaints of the pregnant were examined in relation to the unwanted pregnancy complications and labour/delivery outcomes. The first stage analysis showed that there were significant associat ion between four danger signals of edema, blurred visionf headache, convulsion and bleeding, and the adverse outcome. Risk factors with the highest association are convulsion and edema that are highly correlated with hypertensive disorder 01 pregnancy. The prevalence of the pregnancy with single or more of the four risk factors is found to be 16.3 percent and corresponding odds ralio is 4.59, as shown in Table 8. Second stage of analysis: Non-risk pregnancies that were not exposed to anyone of the statistically Significant danger signals of the first stage of analysis were further divided into two groups, ie., primiparas and multiparas. Six independent variables including age for the group of primiparas and 15 variables for multiparas including the former six for the primiparas were examined in relation to the adverse outcomes. For primipara, age and height are found to be risk factors and for multipara, age, height and seven va riables related to previous obstet ric history are proved to be risk factors. Each prevalence of primiparas and multipa ras who are exposed to single or more of risk factors in each defined group are 4.5 percent and 50.0 percent respectively. Corresponding odds ratios for primipara and multipara thus exposed to risk factors are 4.41 and 3.45 respectively, as shown in Table 11. Third stage of analysis: Those non-risk pregnancies that were continuously left out over the process of first and second stage of analysis underwent further examination. Seven maternal variables that can be easily identified over simple clinical check-up were examined of their effect on the defined outcome variable. Statistically significant are two factors of blood pressure (140/90 mmHg or higher) and presence of pre-eclampsia/eclampsia. The prevalence of pregnancies with single or both of the two risk factors is 5.5 percent with corresponding odds ratio of 1.57, as shown in Table 13. It is comparatively weaker association in contrast with those found in the preceding stages of analysis. Fourth stage or analysis: Those non-risk pregnancies continuously left out over the three stages of analysis were further examined to find out what statistically significant risk factors were out of the 14 selected maternal variables during pregnancy of third trimester. These variables are divided into two groups. ie., one group of nine variables that are easily identifiable during clinical check-up and another group of five variables that would require examination of more skilled health personnel. Significant among the former group are found to be five risk factors including excessive weight gain and among the latter, three risk factors including abnormal size on abdominal examination. The prevalence of pregnancies with one or more of five risk factors in the former group accounts for 11.9 percent with corresponding odds ratio of 2.44, whereas the prevalence of pregnancies with single or more of the lauer`s three risk factors is 20.2 percent with corresponding odds ratio of 3.73. Thus, risk factors that would require expert examination seem to have higher degree of association, as shown in Table 15. Consequently the prevalance of pregnancies with single or more of the above eight risk factors combined. is 29.4 percent with corresponding odds ratio of 3. 19. 4. Conclusion and Recommendation Among the total of 48 maternal variables initially employed for analysis, 26 variables were selected as risk factors. Accordingly study pregnancies were screened at each stage of analysis, depending on the occurrence of the relevant risk factors. In this study, all those classified as high-risk pregnancy account for 41.5 percent-47.6 percent according to the type of screening scheme applied at fourth stage. The predictability of this screening scheme has, at all stages of screening, positive predictive power between 41.7 percent and 69.3 percent, and negative predictive power between 67.0 percent and 89.3 percent. Total correct classification which accounts for the percentage of true positive and negative cases combined among the cases observed, ranges from 67.3 percent to 73.8 percent, as shown in Table 19. High predictability is found of the fourth stage scheme with more complicated risk factors, and lower one, of the second stage scheme with risk factors of age, height, and previous obstetric histories. Positive predictive power of this screening scheme, by and large, is lower than negative predictive power. In conclusion, a risk factor assessment chart proposed in this study for the use of health workers at grass-root level is illustrated in Table 20. This revised scheme is modified out of study results in terms of statistical consideration between risk factors and the outcome variable, logical validation, and practical utility. In the future efforts, selection of risk factors and their cut-off points will be defined in view of balance between the seriousness of the false negative mistakes and the damage done to individuals by the needless use of resources on the false positives. This in turn raises a critical issue in the public health activities; how many and what kind of "mistakes" can be accomodated when resources are limited?

교통사고 상해증후군의 한의 임상진료 현황조사를 위한 웹기반 설문조사

박인화,황의형,황만석,허인,김병준,임경태,신병철,Park, In-Hwa,Hwang, Eui-Hyoung,Hwang, Man-suk,Heo, In,Kim, Byung-Jun,Lim, Kyeong-Tae,Shin, Byung-Cheul 한방재활의학과학회 2017 한방재활의학과학회지 Vol.27 No.4

Objectives The purpose of this study is to understand current status of Korean Medicine treatment practice patterns for traffic injuries by web-based survey. Methods The structured questionnaire was distributed by a web based survey to 1,630 potential respondents by email from December 19th in 2016 to February 13th in 2017. All data were statistically analysed. Results The response rate was 79.4%. According to the analysis of the outcome of the survey, 88.0% of the participants felt necessity of the development of Korean medicine clinical practice guidelines (CPGs) for traffic injuries. Survey results showed cognitive degree about Korean Medicine CPGs' necessity, individual Korean medicine treatments and requirement for extending insurance coverage for patients with traffic injuries. Conclusions This survey study helps to determine current clinical practice patterns of Korea medicine treatments for traffic injuries. These results further anticipate to provide basic data for CPGs for traffic injuries.

교통사고 상해 증후군의 한의 임상진료 현황 조사: 2차 온라인 심층 설문 조사

임경태 ( Kyeong-tae Lim ),황의형 ( Eui-hyoung Hwang ),황만석 ( Man-suk Hwang ),박인화 ( In-hwa Park ),박선영 ( Sun-young Park ),신병철 ( Byung-cheul Shin ) 한방재활의학과학회 2018 한방재활의학과학회지 Vol.28 No.4

Objectives To understand current status of clinical practice patterns on Korean Medicine treatment practice of traffic injury patients by 2nd on-line survey for developing Korean Medicine treatment clinical pratice guideline (CPG) for traffic injuries. Methods A revised questionnaire about current practice patterns of Korean Medicine treatments for traffic injuries was distributed by e-mail survey to 19,385 respondents of Korean Medicine doctors from May 21th in 2018 to June 21th in 2018. All data were statistically analysed. Results The response rate was 3.5%. Most of the respondents felt necessity of the development of Korean Medicine CPG for traffic injuries. The results showed the detailed usage and trend of current Korean Medicine treatment such as acupuncture, pharmacopuncture, moxibustion, Chuna manual therapy, cupping, Korean Medicine physiotherpy for traffic injury patients. Conclusions This survey helps to determine current Korea Medicine treatments' clinical practice patterns for traffic injury patients. All data from the survey will provide basic data for future clinical studies and adaptation for the revision of Korean Medicine CPG for traffic injuries. (J Korean Med Rehabil 2018;28(4):89-101)

보건복지예산의 투자방향과 과제

박인화,Park, In-Hwa 대한병원협회 2003 대한병원협회지 Vol.32 No.1

An Instructional Design for the Converged English-Science Teaching Method using PBL Model in Elementary School

In-Hwa Park(박인화) 한국산학기술학회 2020 한국산학기술학회논문지 Vol.21 No.7

급격히 변화하고 있는 21세기 현대 사회에서 국가 경제력을 갖춘 인재 양성을 위해 최근 미국, 영국 등 선진국을 중심으로 STEM(Science Technology Engineering Mathematics) 교육이 점차 강조되고 있으며 우리나라에서는 Arts(예술)를 추가하여 STEAM(Science Technology Engineering Arts Mathematics) 교육이 나타났다. 융합(STEAM) 교육 목표는 기존의 주입식 및 암기식 교육이 아닌 학습자들의 흥미도와 학습에 대한 동기 부여를 강화하여 체험, 탐구, 실험이 중심이 되어 융합적 사고와 실생활 문제를 해결할 수 있는 능력을 갖추어 국가 경제력을 강화하는 것이다. 본 연구가 이루어진 Y 초등학교에서는 세계 공용어로 자리매김한 영어와 4차 산업 혁명으로 인한 발전으로 거의 모든 분야에서 찾아볼 수 있는 과학을 융합하여 학습자들이 주도적으로 수업에 참여하여 문제해결능력을 향상할 수 있는 PBL 모형과 ADDIE 모형이 기반이 된 수업 모형을 설계하였다. 이 모형은 크게 5가지 절차로 분석(Analysis), 설계(Design), 개발(Development), 실행(Implementation), 평가(Evaluation)로 구성된다. 국가 경제력을 갖춘 인재 양성이라는 목표도 중요하지만, 교육 현장에 있는 교사들이 융합(STEAM)교육의 중요성을 인지하고 이에 알맞은 수업 설계에 관한 연구가 지속하며 강화되어야 한다. In order to cultivate talented people with national economic influence in the rapidly changing 21st- century modern society, STEM(Science Technology Engineering Mathematics) education has been emphasized in advanced countries such as America and England. In South Korea, STEAM(Science Technology Engineering Arts Mathematics) education is emphasized by adding Arts. The objective of STEAM education is to strengthen the interest and motivation of learners, to focus on experience, exploration, experimentation, to solve convergent thinking and real-life problems, rather than cramming method of teaching and memorization. This study identifiesan instructional design for converged English, the world"s official language, and science which is found in nearly all disciplines. With the development of the 4th industrial revolution based on the PBL model, learners participate in their lessons voluntarily for problem-solving skills. The instructional design based on the ADDIE model consists of 5 procedures: Analysis, Design, Development, Implementation, and Evaluation. The goal of fostering talented people with national economic influence is also important, and the teacher in education must recognize the importance of STEAM education and an appropriate instructional design should be studied constantly.

가족보건연구(家族保健?究)를 위한 가족주기(家族週期)의 변동추이분석(變動推移分析)

박인화 ( In-hwa Park ),김정근 ( Jong-kun Kim ) 한국보건사회연구원 1990 保健社會硏究 Vol.10 No.2

低死亡, 低出産의 人口轉換과 社會的 文化的 요인의 變化에 수반되어 小家族, 核家族化 추세에 있는 최근 결혼부인의 家族은 그 이전에 형성된 家族에 비하여 形成期 및 擴大期의 短縮, 擴大完了期의 延長, 縮小期의 短縮, 그리고 縮小完了期 및 解體期의 延長이라는 특징을 갖는 쪽으로 變化해 갈 展望이다. 한편 慢性疾患 有病狀態를 통하여 家族週期別 保健問題의 樣相을 보면, 縮小期以後 家族의 同疾患 有病水準은 形成期 및 擴大期 家族의 그것에 비하여 3~4배 정도나 높은 것으로 나타났다. 그러므로 保健部門에서는 점차 延長되고 있는 家族週期의 後期段階에 속한 가족의 保健醫療需要에 효율적으로 대처해 나갈 수 있도록 現行 地域保健事業의 方向을 再定立하여 老人保健 서비스등의 提供基盤을 擴充해 나가야 할 것이다. 더욱이 인구의 高齡化가 家族構造 뿐만 아니라 疾病構造의 變化와 더불어 진행되고 있다는 사실은 이 부문의 保健醫療 要求度에 대한 대응방안수립이 절실함을 부각시키고 있다. This study analyses the phasic changes in the family life cycle(FLC) in Korea during the most recent four decades, and examines the health implications associated with these demographic changes. Using data from the 1986 National Sample Survey on FLC, a total of 2,644 women married during the period 1945~84 and their families were studied. The analytic framework employed in this study is based on the Basic Model of Nuclear FLC proposed by WHO for use in health studies. The methods of analysis include : 1) estimation of the duration and timing of six phases in FLC by marriage cohort of women, and 2) application of life table technique and the Cox`s proportional hazards model to estimate survival function and quantify the relationship between survival and a set of explanatory variables for the early phases in FLC. The results of this study indicate that both lowered mortality and fertility have led to changes in FLC which are characterized by shortening of the formation(I). extension(Ⅱ) and contraction phases(Ⅳ), and lengthening of the completed extension(Ⅲ), completed contraction(V), and dissolution phases(VI). According to the cohort measurements, phase I/II is estimated at 14.7 years for the 1945~54 marriage cohort which has a median age of 18.1 at marriage, while it is 3.1 years for the 1975~84 marriage cohort with a median age of 23.0 at marriage. Phase Ⅲ requires 13.1 years for the 1945~54 cohort which has a median age of 32.8 at last birth, and 24.2 years for the 1975~84 cohort with a median age of 26.1 at last birth. Phase Ⅳ tends to decrease from 12.4 years for the 1945~54 cohort which has a mean age of 45.9 at the time of first child`s marriage, to 2.1 years for the 1975~84 cohort with a mean age of 50.3 at the corresponding time. Phase V/VI is estimated at 5.4 years for the 1945~54 cohort which has a mean age of 58.3 at the time of last Child`s marriage, while 22.2 years for the 1975~84 cohort with a mean age of 52.4 at the corresponding time. In survival analysis with covariates, two variables, age at marriage and family type, are associated with hazard rates on the termination of family formation phase, and three variables, family type, age at first birth and number of children ever-born, with the extension phase. As family patterns play a determining part in the health of the individual members and their use of health services, the FLC changes have important implications for the reorientation and adaptation of the health care system. Accordingly, the following are considered necessary for the effective operation and management of community health services. First, together with the decreasing trend in the family expansion period, the family planning and maternal and child health services will be changed from their present orientation on quantitative to qualitative management. Especially, in connection with the preference of the general public for the private sector under the national health insurance system, the public sector will focus its functions primarily on the provision of preventive and promotive health services that are less well provided by the private sector. Second, the provision of comprehensive health services for the aged will be expanded along with an increasing trend toward the empty nest and widowhood periods. In addition, the aging of the population and changes in major health problems strongly suggest that community health services such as chronic disease control be developed and strengthened.

남북한(南北韓) 보건의료통합(保健醫療統合)의 방향(方向)과 정책과제(政策課題)

박인화 ( In-hwa Park ),문옥륜 ( Ok Ryun Moon ) 한국보건사회연구원 1994 保健社會硏究 Vol.14 No.1

통일한국이 지향해야 할 보건의료정책의 基本方向을 ① 남북한 주민의 健康權保障, ②自由民主主義 및 市場經濟體制를 지향하는 통합추진 및 ③ 보건의료의 公益性을 감안한 政府의 收割增大라고 설정, 이를 토대로 남북한 보건의료 통합방안을 설계하였다. 「민족공동체 건설을 위한 3단계 統一方案」에 따라 漸進的이며 段階으로 統一이 추진되는 경우, 보건의료 통합과정을 예상해 보면 ①「交通協力擴大期」에서는 人的, 物的 및 技術的 교류를 통하여 상호신뢰와 협력을 증진시켜 통합고건의료의 基盤을 形成하고, ②「制度調整期」에는 남북한의 현실에 적합한 制度를 共同模索하는 시기로서 「南北韓保健醫療保障協議會」를 구성하여 통합을 준비하며, ③統合模型을 계획에 따라서 執行하게 되는 「發展的 統合期」에 이르러서는 통일한국에서의 동질적이고 발전적인 保健醫療制度가 각 부문에 걸쳐 施行되도록 한다. 한편 예기치 않은 순간 갑자기 닥쳐올 수도 있는 急進的 統一의 경우에는 ① 북한주민을 위한 緊急 救護/防疫 支援이 우선적으로 이루어지도록 하고, ② 暫定的으로 旣存北韓制度를 下部構造로서 유지하면서 북한의료체계의 전면적 崩壤를 防止하도록 하며, ③ 북한의료인에 대한 免許制度를 도입하고, ④남한으로 이동하는 북한주민을 위해서는 「緊急救護令」에 의하여 서비스를 제공토록 하는데 역점을 두고 통합방안을 제시하였다. This study has attempted to figure the basic layout of an integrated health care system for the United Korea. A set of basic directions are employed for this task: CD The integrated system is supposed to guarantee an equal right to health care of all Koreans. CID The basic idea is to maintain the system of free standing solo medical practices in the market economy. ® Roles of the united government are strengthened enough to provide adequate amount of health care through the modified financing and payment system. In order to develop the masterplan, two alternative assumptions have been made: First, the unification will gradually be made through mutual communication and trades between the North and South Korea. Second, due to a collapse of the North Korean Regime, a rapid unification will occur all of a sudden in the near future. Two plans are developed accordingly. In case of a gradual unification, it will take a rather long time to establish a integrated health care system. Because of remarkable differences in the health care system and ideology, a te-dious negotiation process is anticipated. The entire process can be broken into the three stages, CD mutual integration stage, CID institutional adjustment stage, and ® developmental integration stage. The first stage will be concerned with increasmg homogeneity and building credibility through the exchange of manpower, materials, and technology which will function as the foundation of a unified health care system. The second stage will mostly be devoted to the operation of the North and South Health Care Security Council which is to consist of public authorities, health system specialists, NGOs and people`s representatives. The idea of privatization needs to be introduced in the North and of decommercialization in the South. Obviously, the merit of preventive medicine as socialistic medicine and massive sanitary propaganda campaign needs to be maintained. The emphasis should be put on reducing the gaps in the level of health service and medical technology. The introduction of competition in the medical market is an indispensable component. Several options are recommended for the third stage development: The Ministry of Health rather than the Ministry of Health and Social Affairs and the local autonomous health care system at each province and county/city are organized. A system of private medical practice in the North and strengthening of public health sector in the South and modernization of traditional oriental medicine are recommended. The introduction of capitation payment coupled with the payment based on capability is another possibility for primary care physicians in the North. The DMZ should be used for building a medical training center and for hospitals for the care of the needy North Koreans. Finally, best cost estimates need to be made for developing a unified health care system. In the case of a rapid unification due to the collapse of the North Korean Regime, an emergency relief system should be organized to meet the emerging needs of health services. For the time being, it will be necessary to maintain the North Korean health system as it now operates. This is simply to prevent disasters facing residents in the North Korea from going without health care at the time of need. However, preparatory measures will be needed to introduce a licensing system and education system for health professionals, and to change the contents of professional education. Those migrants to the South should be eligible for the entitlement of emergency health services_ A special emergency relief law needs to be enacted. The following measures should accompany concomitantly: Like the case of East Germany, health insurance associations will be established in the North. These associations will be encouraged to construct medical facilities of their own from the surplus fund. This is to tackle the problems of health resources deficiency in the North. The Medical Care Assistance Program is also a necessity. It is recommendable to keep a free primary health care system at public facilities, apart from the paid services at private sources of care during an emergency relief period. But the existing concept of physician service district of the North needs to be adjusted to the health service district of the South. Private practitioners in the North would be allowed to serve as family physicians at the district. A simplified case payment system is recommended for both inpatient and outpatient care at the private medical sector.

A Study on the Applications of English Science Class using PBL

In-Hwa Park(박인화) 한국산학기술학회 2020 한국산학기술학회논문지 Vol.21 No.5

영어가 세계 공용어로 자리매김 됨과 더불어 다양한 방면에서 급격히 변화하고 있는 현대사회가 추구하는 인재상을 기르기 위해 본 논문은 PBL 학습법을 영어과학 수업에 적용하였다. PBL 수업을 위하여 직접 PBL 문제를 개발하여 수업에 적용하였으며 PBL 학습 효과를 확인하였다. 본 논문의 연구 대상은 외국어 특성화 교육이 중점이 되어 각 학년당 수준별로 나뉘어 분반 수업으로 진행되는 A 초등학교의 4학년 상반에 속한 7명 학습자를 대상으로 1학기 동안 5개의 PBL 문제 활동이 모두 끝난 후 PBL 학습에 대한 설문을 받았다. 연구 결과는 PBL 활동을 통해 발표력 향상 86%, 학습에 대한 흥미도 86%, 학습에 대한 이해력 향상 86%, 문제해결능력 향상 100%, 협동력 100% 효과를 학습자들이 경험할 수 있었다. 반면에 처음 접한 활동이라 이해하기 어려움, 문제에 이해에 대한 어려움, 인터넷을 통한 자료조사에 대한 어려움이 도출되었다. PBL 학습은 학습자들에게 다소 생소하였으나 활동을 통해 중요성 및 효과성을 인식하고 있었으며 큰 관심을 보인 점을 보았을 때 교육 현장에서는 더욱 PBL 적용에 힘써야 하는 큰 시사점을 준다. In order to attain the best-educated people in a rapidly changing, modern society with English is an official language, this study applies the problem-based learning (PBL) method to the English Science Class. PBL problems were developed for PBL classes, and their effectiveness has been proven. The focus of this study was five PBL questions posed during the first semester, targeting seven learners in the fourth grade of Elementary School A. The questions were divided into levels aimed at each grade, with the emphasis on specialized English education. Learners wrote journals, peer evaluations, and self-evaluations after finishing their PBL classes. Also, a survey about PBL was conducted after the first semester. The results of the study showed that learners experienced an 86% improvement in presentation skills, an 86% improved interest in learning, 86% better understanding, and 100% improvement in both problem-solving skills and cooperation. On the other hand, learners had difficulty in understanding PBL problems, and with research using the internet. PBL was somewhat unfamiliar to the students, but the survey found that learners are already aware of its effectiveness, and that they are interested in PBL.

도시저소득층(都市低所得層) 영유아(?幼兒)의 영양상태(營養狀態) 평가(評價)

박인화 ( In-hwa Park ) 한국보건사회연구원 1986 保健社會硏究 Vol.6 No.1

The nutritional status of children in an urban slum area was investigated by assessing growth performance of the children who reside in an urban primary health care (UPHC) demonstration area, one of the most economically depressed areas of Seoul City. Relevant information was collected through the community health volunteers who recorded growth measurements on the growth chart that was utilized in the project. A total of 546 growth measurements covering 106 children aged up to one year was managed from August 1984 through July 1985. Based on these data, the nutritional status of the study children was assessed with the percentage classification of weight deficit as proposed by Jelliffe. The Harvard standard was employed as a reference. This study reveals that the prevalences of undernutrition, defined as below 90 percent of standard weight-for-age, are seven percent in the first year and 26 percent in the second year of life. The first-level undernutrition, a moderate one makes up most of all the undernutrition cases with 91 percent. Further analysis indicates that the satisfactory growth shown in the early infancy takes a downward trend beginning from nine or ten months of age. In the light of the experiences gained through the UPHC demonstration project, the following are recommended to complete effective child health care services: - Systematic use of growth chart will be maintained, since the chart offers a simple and inexpensive means of monitoring child health especially in the poverty-affected areas by a manpower category such as community health volunteer. - Child growth will be monitored every two months during the first two years and thereafter at least every six months before school age. - Community-based education activities including supplementary feeding practices will be developed and implemented to prevent growth faltering during childhood.

의사 돼지콜레라 발생농장 역학조사

박노찬 ( No Chan Park ),조광현 ( Kwang Hyun Cho ),김영환 ( Young Hoan Kim ),김순태 ( Soon Tae Kim ),김성국 ( Sung Kuk Kim ),박인화 ( In Hwa Park ),조민희 ( Min Hee Cho ),오강희 ( Gang Hee Oh ),손재권 ( Jae Kweon Son ),정종식 ( Jon 한국가축위생학회 2003 韓國家畜衛生學會誌 Vol.26 No.2

This study was conducted to survey the farm which suffered from disease similar to classical swine fever(CSF) in Gyeongbuk province. Clinical signs appeared first in a few number of growing pigs which showed specific signs of diarrhea, depression, sleepiness, and reluctance to get up or to eat. Younger piglets may have appeared chilled, shiver and huddle together. As the disease progresses the affected pig`s skin went red and purple. In histopathological signs, there were many haemorrhages througout the body and larger haemorrhages in some organs such as lymph nodes. And there is a precipitous fall in the number of circulating leukocytes in the blood. In spite of insisting of farmer which did not vaccinate to classical swine fever, significant antibody production was detected in these affected pigs at enzyme-linked immuonsorbent assay. According to the above results at first glance, these affected pig suspected with CSF in clinical signs and histopathological lesions only. Because the symptoms and post-mortem picture were very similar to CSF, these false positive results would have been dangerous to diagnostician. But by reverse transcriptase polymerase chain reaction(RT-PCR) and comparative nucleotide sequence ananlysis, the disease was correctly diagnosed with post-weaning multisystemic wasting syndrome(PMWS) and porcine reproductive and respiratory syndrome(PRRS) compoundly. And the antigen which were detected the lesion similar to CSF virus, was confirmed with LOM vaccine strain of CSF. In most national CSF eradication program arid in countries which are free of the CSF virus, vaccination against CSF is not practiced and generally is not allowed. But now in Korea, routine vaccination is practiced because of outbreaking the CSF repeatedly. When CSF is diagnosed the whole herd and other in contact animal are slaughtered continuously.