Cultural Difference in Applicants for FAA Physical Performed in Korea 1997~2008 / 항공우주의학회지

BACKGROUND: There have been some reports that under-reporting of pilots concerning their medical history and current use of medications resulted in fatal accidents. From the AME (Aviation Medical Examiner)'s perspective, accurate documentation of the application forms with careful examination of the applicant is necessary to avoid errors and any mishaps that may be contributed by falsification by the pilot. This article examines FAA (Federal Aviation Administration) physicals performed in Korea from 1997 to 2008 to show how Korean and foreign applicants differ in terms of making statements concerning their medical history and current use of medications and to see what can be done to overcome such differences. METHODS: From 1997 to 2008, all FAA physicals performed in one medical institution, was examined. Using the SPSS, the data was analyzed to compare the two groups, the Korean and the expatriate pilots. RESULTS: The total number of applicants was 811 with 785 (96.7%) males and 26 (3.2%) females. Some of the astounding results found among the group of applicants with different citizenship, basically between the Korean applicants and those out of the country including the U.S. and other nations, was that the reporting of any current use of medication (prescription or nonprescription) and of the medical history was vastly different. In reporting the current use of any medication, 13 among 429 (3.0%) Koreans reported yes, whereas for expatriates 82 among 382 (21.5%) reported the current use of medicine. In describing the medical history of the past and present, only 86 (20.0%) Koreans described yes, whereas 217 (56.8%) expatriates did so (Fig. 3). In any visits to a health professional within the last 3 years, only 48 (11.2%) Koreans described yes, whereas there were 188 (49.2%) expatriates. CONCLUSION: In this study, the difference between Korean pilots and the expatriates concerning the disclosure of applicants' medical history, the current use of medication(s), and recent visit to a health professional is obvious. Issues of debate may be that Korean applicants comprise of young age pilots as opposed to relatively older group of expatriates, and so age-related factor cannot be disregarded. In conclusion, proper documentation and examination of pilots may prevent many mishaps related to medical conditions and the use of medication(s) that were not initially recognized and the failure to do will result in fatal accidents.

Treatment of Helicobacter pylori associated gastrointestinal disorder

BACKGROUND: Helicobacter pylori a worldwide infection in which over 50% of the general population is estimated to be affected. The association of Helicobacter pylori infection with various gastrointestinal disorders is well known. Many dyspeptic patients infected with H. pylori can be treated in primary care. One of the non-invasive means of detecting H. pylori is serology IgG antibody test (GAP). The aim of this study was to investigate the association between the serologic H. pylori IgG antibody response to antibiotic regimen in patients infected with H. pylori. METHODS: A total of 44 patients (21 males, 23 females) who underwent health screening in a university hospital during the period from May 1996 to July 1998 and diagnosed positive by H. pylori serologic IgG antibody test and confirmed to have H. pylori infection on biopsy from endoscope procedure were selected. All the patients had dyspeptic symptoms and were diagnosed as having chronic superficial gastritis on endoscopy. Serological determination of the IgG antibodies against H. pylori was carried out before starting treatment for H. pylori eradication and 6 month after treatment. RESULTS: The number of patients was 44 with 21 (47.7%) males and 23 (52.3%) females. In both males and females. Among those with positive H. pylori antibody who were treated with antimicrobial therapy the rate of seroconversion to negative was 28.6% in males and 39.1% in females. Those who were checked positive for H. pylori antibody and were shown to be still positive but with lower titers after eradication therapy was 57.1% for males and 47.8% for females. Those with positive H. pylori antibody who had shown seroconversion or decreased antibody titers after antimicrobial therapy were 85.7% for males and 86.9% for females. The number of subjects who failed to result in seroconversion or conversely had increased titers for H. pylori antibody after antimicrobial therapy was 14.3% for males and 13.1% for females. Overall, among those treated with BMT regimen, 11 out of 28 (39.3%) seroconverted and 12 out of 28 (42.9%) resulted in lower antibody titers. Among those treated with BMA regimen, 4 out of 16 (25.0%) seroconverted and 11 out of 16 (68.8%) resulted in lower antibody titers. Failure rates of BMT and BMA regimens were 5 out of 28 (17.8%) and 1 out of 16 (6.2%), respectively. CONCLUSION: Based on above results, antimicrobial therapy of patients infected with H. pylori clearely indicate improvement of serologic IgG antibody resulting in seroconversion and/or decrease in titers with high rates. More accurate results may be obtained if the follow-up period is extended with the use of more reliable non-invasive techniques to detect H. pylori infection before and after treatment.

Diagnostic value of serologric test for detection of Helicobacter pylori infection

BACKGROUND: Ever since Helicobacter pylori was discovered in 1983 by Warren and Marshall, many studies were conducted resulting in drastic change of the previous concept of gastrointestinal disorders and its treatment. Most people in developing countries are considered to be exposed to the organism at a very early age, being more susceptible to infection. This study was done to find out the diagnostic value of serology antibody test for Helicobacter pylori infection by comparing differences in those checked positive for H. pylori relative to their symptoms and findings on endoscopy, biopsy, and barium swallow. METHODS: Subjects totaling 1240 who visited the Health Promotion Center of a university hospital were surveyed with questionnaire and were performed serology antibody test for H. pylori. 532 subjects underwent endoscopy and biopsy and in 708 subjects barium swallow was performed. All subjects were compared with respect to gastrointestinal symptoms, findings of pathology from the endoscopic and radiologic procedures with their antibody test results and titration. RESULTS: Among 1240 patients, 804 (64.8%) were positive for Helicobacter pylori antibody. There were 449 males (68%), and 355 females (61%), which was statistically significant (p< 0.05).There was no difference in the positive rates of H. pylori according to smoking, drinking, and exercise. Higher prevalence of family history for gastric cancer was shown among those positive for H. pylori (p< 0.01). There was no difference noted in relation to gastric symptoms or past history of gastrointestinal disorders in the two groups. Relative to the gastric symptoms complained by the patients, the findings on endoscopy, biopsy and radiologic study, most of those checked positive for H. pylori were shown to have antibody titers in the range of 20 to 40 units/mL with 83.1% for symptoms, 83.6% for endoscopy, 84.8% for biopsy, 81.7% for barium swallow. CONCLUSION: There was no significant difference among those positive and negative for serology antibody test with respect to gastrointestinal symptoms, findings on endoscopy, biopsy, and barium swallow in this study. But because H. pylori is associated with most of the gastrointestinal pathology, testing H. pylori with serology antibody method can be beneficial and useful for its accuracy in primary care setting where further investigation is not possible.

Survey on Adult Immunization

BACKGROUND: The importance of immunization has never been overemphasized. Immunization has provided protection from diseases that were fatal and inevitable and has allowed human beings to escape from the burden of suffering. Although infant and childhood immunization was rapidly implemented since the availability of vaccines in Korea, those of adults have not been stressed enough. The purpose of this study was to find out about the attitude and knowledge of patients relating to adult immunization. METHODS: Patients who visited two family practice clinics located in Seoul were surveyed. Questionnaire consisted of 30 items including general questions relating to immunization and specific questions concerning hepatitis B, influenza, and tetanus. RESULTS: 515 patients (133 males, 382 females) were surveyed. The average age was 34. Among those surveyed, 91.3% lived in Seoul, 96.5% were high school graduates and over, and about one third consisted of housewives. Most chose to go to hospitals for vaccination (47.8%), learned of available vaccines through mass media (32.4%), family and relatives (39%). The vaccination rate for hepatitis B was highest with 63.9%, whereas for Japanese encephalitis 36.9%, varicella 19.8%, rubella 16.9%, influenza 30.5%, hepatitis A 4.1%, typhoid 36.9%, tetanus 8.9%, and Korean hemorrhagic fever 4.9%. Overall, 95.5% considered vaccination to be safe and 76.7% thought it necessary to receive the required vaccines. Among questions relating to hepatitis B, influenza, and tetanus, most patients, in general, did not specifically know what was the purpose of the immunization, the type of vaccines being delivered, the follow up period of booster immunization, the coverage of protection from particular diseases, and their protection rate. CONCLUSIONS: Many vaccines are available today. With minimum costs, they are an effective way of prevention. Indications of each vaccine, and their safety, effectiveness and duration of protection must be considered to meet the individual needs. More emphasis to provide immunization to adults in primary care setting is necessary.

The Relationship of Helicobacter pylori Infection and Upper Gastrointestinal Diseases in Korean Adults

Helicobacter pylori infection is associated with various gastrointestinal disorders. It has been proved that those who are infected leads to gastritis in 100% and that there is no natural recovery. Therefore, treatment to cradicate the organism is essential to block the natural course of many disorders of the gastrointestinal tract, that may lead to gastric cancer which is the number one leading cause of death among cancer in Korea. The study was conducted in order to find out the prevalence of H. pylori infection in Inchon area and the relationship between H. pylori infection and its diverse pathology. The study involved 1,872 applicants screened for Helicobacter pylori infection by serology antibody test in the Health Promotion Center at Inha University Hospital in Inchon, Among them, 1,203(64.3%) were positive including 651 males(67.2%), and 524 females(61,0%). There was no significant statistical difference among age groups. In males of age group 40-49 years of age, and females of age group 50-59, H. pylori infection were most common. There were no differences among the H. pylori positive and negative group with respect to fatally history, past history, lob, lifestyle behavior (including smoking, drinking, and exercise), Epigastaic pain, diarrhea, rectal bleeding were more common and statistically different in H pylori positives compared to those of negatives. In the findings of upper gastrointestinal barium swallow, there were no differences between the two groups. H. pylori positive group showed more endoscopic findings compared to negative group, Out of the 1,239 total findings H pylori positive group showed 873 endoscopic findings as opposed to 366 in the negative group. Among the H pylori positive group, chronic superficial gastritis was most common with 338, followed by gastric crosion 134, duodenal ulcer 53. In the negative group, chronic superficial gastritis was also the most common with 160, followed by gastric crosion 79, and hiatal hernia 32 Gastric subepithelial hemorrhage(p<0.001), duodenal ulcer(p<0.022), intestinal metaplasia(p<0.024) were found to be significantly common in H pylori positive group compared to those of the negative group. Hiatal hernia(p<0.001) was found to be higher in the negative group. The sensitivity and specificity of CLO test performed during the endoscopy procedure were 79.9% and 100%, respectively. The sensitivity and specificity of endoscopic diopsy were 51.9% and 100%, respectively.