강원도(江原道) 횡성군(橫城郡) 일부지역(一部地域) 간(肝) 및 폐(肺) 디스토마 감염상황(感染狀況)

최원영,Choe, Won-Yeong 한국농촌의학지역보건학회 1978 농촌의학·지역보건 Vol.3 No.1

이제까지 알려진 바에 의(依)하면 우리 나라에서 간(肝) 및 폐(肺)디스토마 분포양상(分布樣相)은 강원도지역(江原道地域)이 가장 저율(低率)로 나타난 것을 볼 수 있다. 그 이유(理由)로서는 이들 양흡충은 반드시 제(第)1 및 제(第)2중간숙주(中間宿主)를 통한 生活環(생활환)이 완성(完成)되어야만 하는데, 이들 중간숙주분포(中間宿主分布)가 강원도지역(江原道地域)이 낮은 까닭인듯 하다. 우연(偶然)한 기회(機會)에 저자(著者)는 강원도(江原道)의 일부지역(一部地域)은 폐(肺)디스토마의 감염(感染)이 적지 않다는 정보(情報)를 입수(入手)하고 이에 흥미(興味)를 갖게 되었으며, 특(特)히 농후감염지역(濃厚感染地域)으로 예상(豫想)되는 횡성군(橫城郡)의 일부지역(一部地域), 폐(肺), 청일면(廳日面) 신대리(里) 일대(一帶)와 서원면(面) 유현리(里)에서의 간(肝) 및 폐(肺)디스토마의 감염상(感染相)을 파악(把握)할 목적(目的)으로 본(本) 조사(調査)를 전도(全圖)하였다. 검사방법(檢査方法)으로는 일단(一旦) 간(肝) 및 폐(肺)디스토마의 VBS 항원(抗原)으로 피내반응검사(皮內反應檢査)를 실시(實施)하여 간(肝)디스토마 피내반응검사(皮內反應檢査)에 대(對)해서는 객담검사(喀痰檢査)와 면역혈청반응으로 보체결합반응(補體結合反應), 간접형광항체반응(間接螢光抗體反應) 및 Ouchterlony 반응(反應)을 하여 좀더 정확(正確)한 감염상황(感染狀況)을 파악(把握)하고저 하였다. 그 결과(結果)의 개요(槪要)는 아래와 같다. 1. 횡성군(橫城群) 신대리(里)와 우현리(里)의 주민(住民) 680명(名)에 대(對)한 폐(肺)디스토마의 VBS항원(抗原)에 의(依)한 피내반응양성율(皮內反應陽性率)은 12.4%이었고 간(肝)디스토마의 피내반응양성율(皮內反應陽性率)은 12.5%이었다. 2. 성별(性別)에 따른 피내반응양성율(皮內反應陽性率)의 차이(差異)는 간(肝)디스토마의 경우, 여자(女子) 7.4%에 비(比)하여 남자(男子)가 17.1%이었고, 폐(肺)디스토마의 경우는 여자(女子)가 20.7%인데 반(反)하여 남자(男子)가 42.9%로서 2배(倍) 이상(以上)의 고율(高率)이었다. 3. 연령별(年令別)로 보면, 간(肝)디스토마 피내반응양성율(皮內反應陽性率)은 31~40재(才)가 22.1%로 가장 고율(高率)이었고, 폐(肺)디스토마 양성율(陽性率)은 21~30재(才) 사이가 58.5%로서 가장 높았다. 4. 폐(肺)디스토마 피내반응양성자(皮內反應陽性者)에 대(對)하여 객담검사(喀痰檢査)를 실시(實施)한 바 105명(名) 중 11명(名)(10.5%)의 충란검출자(蟲卵檢出者)를 볼 수 있었다. 또 이들에 대(對)한 면역혈청반응(免疫血淸反應)으로 보체결합반응(補體結合反應), 간접형광항체반응(間接螢光抗體反應) 및 Ouchterlony 반응(反應)을 실시(實施)한 바, 각각 42.5%, 50.3% 및 45.8%로서 거의 일치(一致)된 성적(成績)을 나타내어 피내반응양성자(皮內反應陽性者)의 약반수(約半數)에서 이들 혈청반응(血淸反應)이 양성(陽性)으로 나타났다.

국민학교(國民學校) 및 집단주거시설(集團住居施設) 아동(兒童)의 요충감염현황(蟯蟲感染現況)

김종성,이준상,주경환,임한종,Kim, Jong-Seong,Lee, Joon-Sang,Joo, Kyoung-Hwan,Rim, Han-Jong 한국농촌의학지역보건학회 1988 농촌의학·지역보건 Vol.13 No.1

본 조사에서는 서로 다른 주거환경에서 생활하는 집단군에 대해 셀로판테이프항문주위도말법으로 요충감염현황에 대하여 조사한 결과 다음과 같은 결론을 얻었다. 1) 국민학교 및 집단시설거주아동 2,966명을 조사하여 484명이 요충란 양성자로 나타나 16.3%의 양성률을 보였다. 2) 지역별 조사에서 대도시지역의 경우 총 1,144명을 조사하여 79명이 양성자로 나타나 6.9%의 양성률을 보였고, 농촌지역에서는 총 1,268명을 조사하여 193명이 양성자로 나타나 15.2%의 양성률을 보여 대도시지역보다 농촌지역에서 터 높은 감염양상을 보였다. 3) 남, 여별 조사에서는 남자, 1,528명을 조사하여 240명이 양성자로 나타나 15.7%의 양성률을 보였으며, 여자의 경우 1,438명을 조사하여 244명이 양성자로 나타나 16.9%의 양성률을 보여 남, 여별 감염률은 큰 차이를 타나내지 않았다. 4) 국민학교 아동의 학년별 조사성적을 보면 대도시지역 국민학교 아동의 경우 저학년에서 고학년으로 올라갈수록 감염률이 저하되었으나 농촌지역 국민학교 아동의 경우 감염률에 있어서 학년별로 현저한 차이를 나타내지 않았다. 5) 주거환경별 조사에서는 국민학교 아동 2,412명을 조사하여 272명이 양성자로 나타나 11.3%의 양성률을 보였고, 고아원(영아원, 육아원) 아동 416명을 조사하여 136명을 조사하여 76명이 양성자로 나타나 55.1%의 높은 양성률을 보여 국민학교보다 집단거주시설 아동에서 더 높은 감염양상을 보였다. An epidemiological study was undertaken to evaluate the prevalence of E. vermicularis infestation among children in primary schools and orphanages. A total of 2,966 children in primary schools and orphanages was examined for F. vermicularis by means of cellotape anal swab technique. The purpose of the present studies is to determine the prevalence of enterobiasis among children and to make a comparison with the rate of infestation by survey areas. The result could be summarized as follows : 1) The egg positive rate of cellotape anal swab method was 16.3% out of 2,966 children. 2) The egg positive rate of urban area was 6.9% out of 1,144 children and the egg positive rate of rural area was significantly higher than that of urban area. 3) The egg positive rate of boys and girls were 15.7% out of 1,528 children and 16.9% out of 1,438 children. 4) The egg positive rate of primary schools, orphanages and mental retardation child group was 11.3% (out of 2,412), 32.7% (out of 416) and 55.1% (out of 138) respectively. There was noted a tendency of decrease in prevalence by increase of the age.

농어촌(農漁村) 의료보험사업(醫療保險事業)의 당면과제(當面課題)

문옥륜,Mun, Ok-Ryun 한국농촌의학지역보건학회 1977 농촌의학·지역보건 Vol.15 No.1

Albendazole의 폐흡충에 미치는 영향에 관한 전자현미경적 연구

황의정,김수진,주경환,임한종,Hwang, Eui-Jung,Kim, Soo-Jin,Joo, Kyoung-Hwan,Rim, Han-Jong 한국농촌의학지역보건학회 1991 농촌의학·지역보건 Vol.16 No.2

Albendazole is a broad spectrum anthelmintics with high activity against intestinal nematodes as well as tremtodes and cestodes infections. But so far wormicidal effect of albendazole against Paragonimus westermani is uncertain. The present study undertaken to observe the morphological changes of Paragonimus westermani which was obtained from experimentally infected with metacercariae isolated from Cambaroides similis and 9 of them were given albendazole 2 doses of 25mg/kg daily for the 2 days and 4 days from the day of 20 weeks after infection. The Paragonimus werms were collected from the lung of the cats which were autopsied at 24 hours after treatment. The fine structures of the collected worms were studied by means of scanning and transmission electron microscopy. The findings of the observations were compared with those of untreated worms. The results are as follows : 1) In the scanning electron microscopic(SEM) observations, the worms obtained from 2 days treated group showed many blebs which were formed on the surface of damaged tegument in between two suckers. Protrusion of oral sucker typically observed and surrounding tegumental ridges were damaged. 2) The worms obtained from 4 days treated group showed marked contraction revealing half size of normal worms. 3) The transmission electronmicroscopic(TEM) observations indicated that large blebs of irregular shapes were formed by the destruction of tegumental ridge of tegumental syncytium and also showed degeneration of mitochondriae. 4) Destruction of tegumental syncytium formation of blebs were usually observed in the ventral side of the worms. 5) Differentiation of tegumental layer and basement layer muscular layer and parenchymal layer around two suckers of worms obtained at 4 days treated group was difficult. 6) Many host cells invaded and destroyed the degenerated tegument by the occurrence of blebs or the exposed muscular layer of the worm after exfoliation of the tegument.

주민(住民)의 전통의술(傳統醫術) 이용도(利用度) 조사연구(調査硏究) - 민속요법(民俗療法) 이용(利用)을 중심(中心) 으로 -

김진순,Kim, Jin-Soon 한국농촌의학지역보건학회 1988 농촌의학·지역보건 Vol.13 No.1

The general objective of this research is to study behavioral pattern of health care utilization and to measure the level of utilization of the traditional medicine. The specific objective is to study utilization pattern and content of folk medicine which is the indegenous medical technology recognized part of traditional medicine. This research was under taken to generate valid information that will provide basis data for formulating general direction for health education activities and for designing service package for general population. A social survey method was employed to obtain required information for the research activities, The survey field team consisted of 20 surveyors who all participated is an intensive 2 day training course. A total of 3091 households were visited and interviewed by the field team during the period 7 September to 6 October 1987. The major findings obtained from the information collected by the field survey are as follows ; 1) General characteristics of the study households 2562 households out of 3091 households visited were selected for final data process, 80.2 of the selected households were nuclear families ; 17.4%, extended families ; others 2.4%. Only 4.3 percent of the study population in the urban households indicated "no schooling" whereas 14.2% of the rural household members falls within this category. Study population in the urban areas are more protected against diseases by the national medical insurance system than those in rural areas. In their self appraisal of living standard, those who responded with low group are 39.6% and 50.3% respectively by urban and rural households. 2) Morbidity status Period prevalence rate for all diseases during the preceding 15 days before the date of the household interview v as 243,0 per 1,000 study population. For cases with the illness duration of within 15 days, the initial points of medical entry were diversied ; 56.9%, drug stores ; 30.9%, clinics and hospitals ; 4.6% folk medicine ; 1.7% clinics of Korean oriental medicine. Among the chronic case; with illness duration of over 90 days, 34.6% of these people utilized clinics and hospitals of modern medicine ; 31.6%, drug stores ; 18.6% clinics of Korean oriental medicine ; 6.8% folk medical techniques. Noticeable is the almost ten fold increase from the mere 0.9% in the utilization of Korean oriental medicine, whereas in the utilization of folk medicine, it is short of two-fold increase. 3) Folk medicine and its utilization Households that use folk medicine for relief and care of signs and symptoms commonly encountered in daily life, number 1969 households, which accounts for 76.9% of all the study households. This rather high level use of folk medicine is not different from rural to urban areas. The order of frequency of utilizing folk medicine among the study people are : the highest 14.3% for the relief of indigestion ; 8.6% for burns ; 5.1% for common cold ; 4.7% for hiccough ; and 4.2% for hordeolum. A present various procedures of folk medicine is being used to relieve all kinds of symptoms. 192 symptoms are identified at present. The most frequently used procedures of folk medicine appear to be based either on principles of the Korean oriental medicine or of scientific knowledge. Based on these survey findings, proposals for utilizing folk medicine are as follows First, this survey's findings will be feed back to both on the job training and on the spot guidance of community health practitioners, public health nurses and other peripheral work force in the health field, who are in daily contacts with community. This feed back will assure that the health personnel carry out their health education and information activities that are based on the utilization pattern of folk medicine as found in the survey result. Second, studies will be soon implemented that are designed to measure the efficiency and potency of these procedures and to improve these procedures of folk medicine were most freque

농부중의 정신적 원인에 대한 연구

박태진,이가영,Park, Tae-Jin,Lee, Ka-Young 한국농촌의학지역보건학회 1997 농촌의학·지역보건 Vol.22 No.1

Backgrounds : There has been many studies investigating the causes of farmers' syndrome. In some studies, psychologic stress is related to farmer's syndrome. And the diagnostic criteria of farmer's syndrome is similar to those of generalized anxiety disorder. So we carried out this study to investigate the psychiatric causes of farmers' syndrome. Methods : This study was done in some rural and urban areas of Kyoungsangnam Province, July, August, October and November of 1996. Those who came to free medical service and completed interview, medical examination and laboratory examination and 20-59 years old were 150 persons. And those who came to health center for health examination and completed only interview and 20-59 years old were 94 persons. The questionnaire was composed of sociodemographic factors, health risk factors, farmer's syndrome, work load, BEPSI(inventory to measure stress), Spielberger's state-trait anxiety inventory, self-rating depression scale. To examine statistical significance, we used X2-test, Mantel-Haenszel test for linear association, t-test, ANCOVA, correlation, multiple regression, logistic regression. Results : The prevalence of farmer's syndrome, adjusted for age and sex with population of Kyungsangnam Province of 1993 was 208 per 1,000(90 per 1,000 in men and 329 per 1,000 in women). In bivariate analysis, farmer's syndrome was significantly related to age, sex, job, income, smoking, alcohol drinking, work load, BEPSI, state anxiety, trait anxiety, depression, body mass index, Hwa-Byung, hypertension, anemia. However, when age and sex were adjusted, job was not significantly related to farmer's syndrome. The score of farmer's syndrome was significantly related to age, sex, work load, BEPSI, trait anxiety by multiple regression. Farmer's syndrome was significantly related to increasing age(odd ratio 1.079, 95% C.I. 1.060 - 1.099), sex(odds ratio of male 0.434, 95% C.I. 0.349 - 0.540), and BEPSI(odds ratio 1.231, 95% C.I. 1.148 - 1.320) by logistic regression. Results of logistic regression analysis of the component symptoms of farmer's syndrome were as follows. Shoulder stiffness was significantly related to increasing age, female sex and BEPSI. Lumbago was significantly related to increasing age, female sex and trait anxiety. Numb limbs and nocturia was significantly related to increasing age and female sex. Breathlessness was significantly related to work load, sleeplessness was significantly related to depression, dizziness was significantly related to job and state anxiety, and abdominal fullness was significantly related to female sex. Conclusion : Farmers' syndrome was related to work load, but was more related to psychiatric factors such as BEPSI and trait anxiety. And the occupation was not risk factor of farmers' syndrome in this study, so further study is needed to investigate the cause of farmers' syndrome.

한국의 지역사회 의학 - 의료인의 의학 및 의료에 관한 의식구조, 의료체제의 기본구조 및 이를 위한 의료 전달 기능 -

이태준,Lee, Tae-Jun 한국농촌의학지역보건학회 1977 농촌의학·지역보건 Vol.15 No.1

한국농촌의학(韓國農村醫學)의 장래(將來)

정해식,Chung, Hae-Sik 한국농촌의학지역보건학회 1977 농촌의학·지역보건 Vol.15 No.1

As, in Korea, rural economy has a rapid growth and medical health care becomes more necessary for rural inhabitants, we are planning to enlarge the medical care networks and aid childbirth free of charge and perform lower cost medical care in order that more inhabitants are benefited and more available for medical care in rural society. Further, we will make it a basement of the policy to equalize benefits of medical care and medical insurance system.

광범위(廣範圍) 구충제(駒蟲劑) Albendazole의 인체연충류감염(人體??類感染)에 대한 구충효과

임한종,주경환,이준상,왕진성,Rim, Han-Jong,Joo, Kyoung-Hwan,Lee, Joon-Sang,Wang, Jin-Sung 한국농촌의학지역보건학회 1984 농촌의학·지역보건 Vol.9 No.1

Albendazole, a new broad spectrum anthelmintic drug, was evaluated for anthelmintic effects in 74 patients with single or mixed infections of Ascaris lumbricoides, Trichuris trichiura. Enterobius vermicularis, Metagonimus yokogawai, Clonorchis sinensis and Taenia spp. Albendazole was administered as a single dose of 400 mg. The cure rate for A. lumbricoides and E. vermicularis was 91.4% and 98.1% respectively at day 30 post-treatment: for T. trichiura it was 51.1% and for M. yakogawai and C. sinensis it was 33.3% and 13.3% respectively. The egg reduction rate at day 30 was 98.5% in A. lumbricoides, 76.5% for T. trichiura : 60.0% for M. yokogawai and 59.6% for C. sinensis However it was not cured in all 5 cases of taeniasis at three months follow-up examination. On the other hand, the various dosages of albendazole were given to the patients infected with C. sinensis and Taenia spp. respectively. The follow-up examinations were carried out at 30 days after treatment in clonorchiasis and at 3 months after treatment in taeniasis. In the results, the recommended dosage of albendazole for clonorchiasis is $3{\times}400mg$ for 3 consecutive days and for taeniasis $2{\times}400mg$ for 3 consecutive days. There were no side effects with the above dosages except only a mild abdominal pain and dizziness in a few patients. Albendazole appears to be more effective than the other available broad spectrum anthelmintic drugs.

Immunoblot 법을 이용한 간흡충항원(肝吸蟲抗原)의 발육단계별(發育段階別) 항원성분석(抗原性分析)에 관한 연구(硏究)

이선경,주경환,정명숙,임한종,Lee, Seon-Kyung,Joo, Kyoung-Hwan,Chung, Myung-Sook,Rim, Han-Jong 한국농촌의학지역보건학회 1991 농촌의학·지역보건 Vol.16 No.1

Serodiagnosis of Clonorchis sinensis infections will probably be a first choice tool for screening of clonorchiasis in a future because of increasing difficulties in collection and examination of stools. The sensitive test such as ELISA can he used effectively. However there are some limitations in serological diagnosis for the detection of serum antibody. One of the major problems is the non-specificity of the antigens which produce cross reaction with other helminthic infection sera. To solve this problem. many investigators have tried to purify the antigens used. In this study, we determined the antigenic profile of the crude saline extract antigen of C. sinensis at early developmental stage based on SDS-PAGE and immunoblotting techniques for the purpose of understanding the nature of C. sinensis worm antigen The following results were obtained : 1) The SDS-PAGE showed many protein hands ranging from 10Kd to 91Kd relative molecular weight. Among them, 66, 46, 40, 33, 27, 24, 16, 14 and 10Kd bands were observed as a principle bands. The protein components of C. sinensis changed chronologically during their early developmental period. 44Kd band was stained unclearly in antigen of 2 weeks worm, but changed to concentrated state in antigen of 5 weeks worm. 35Kd band was found in antigen of 2 weeks worm, however this band was disappeared in antigen of 5 weeks worm. 22Kd band also lost its staining property gradually. 2) In spite of differences in antigenic profile, there was no differences in the data obtained by microplate ELISA using each antigen preparation. Absorbance value began to rise in between 2 to 3 weeks after infection. 3) By EITB. serum antibody recognized major protein bands with molecular weight of 91, 85, 63, 46, 40, 33, 24, 14 and 10Kd hand respectively. Among them 66, 33, 17 and 14Kd bands were observed as non-specific band because they reacted even in normal control sera. Generally, gradual increase of positive reactions were observed as the infection period of C. sinensis was prolonged. In other hand, the reaction of 10Kd hand did not occurred when 26th week sera was tested. 4) The positive reactions using antigens of 2 weeks worm, especially on 40 and 24Kd bands, were most strong and sharply demarcated compared to those of 3~5 weeks worm antigen.