The direction of restructuring of a Korea field epidemiology training program through questionnaire survey among communicable disease response staff in Korea / 한국역학회지

We used a survey about the need for an educational training of infectious disease response staff in Korea Centers for Disease Control and Prevention (KCDC) and officer in metropolitan cities and provincial government to conduct field epidemiological investigation. The survey was conducted from January 25 to March 15, 2016. A total of 173 participants were selected from four different groups as follows: 27 clinical specialists, 22 Epidemic Intelligence Service (EIS) officers, 82 KCDC staff, and 42 local health department officials. Results revealed that 83% of KCDC staff and 95% of local health department officials agreed on the need for educational training to strengthen capability of personnel to conduct epidemic research and investigation. The level of their need for training was relatively high, while self-confidence levels of individuals to conduct epidemic research and investigation was low. It was concluded that there was a need to develop training programs to enhance the ability of public health officials, EIS officers, KCDC staff, and local health department personnel to conduct epidemic research and investigation.

The direction of restructuring of a Korea field epidemiology training program through questionnaire survey among communicable disease response staff in Korea / 한국역학회지

We used a survey about the need for an educational training of infectious disease response staff in Korea Centers for Disease Control and Prevention (KCDC) and officer in metropolitan cities and provincial government to conduct field epidemiological investigation. The survey was conducted from January 25 to March 15, 2016. A total of 173 participants were selected from four different groups as follows: 27 clinical specialists, 22 Epidemic Intelligence Service (EIS) officers, 82 KCDC staff, and 42 local health department officials. Results revealed that 83% of KCDC staff and 95% of local health department officials agreed on the need for educational training to strengthen capability of personnel to conduct epidemic research and investigation. The level of their need for training was relatively high, while self-confidence levels of individuals to conduct epidemic research and investigation was low. It was concluded that there was a need to develop training programs to enhance the ability of public health officials, EIS officers, KCDC staff, and local health department personnel to conduct epidemic research and investigation.

Up-to-date or Complete Immunization Coverage and Their Related Factors / 農村醫學 地域保健

OBJECTIVES: Understanding the predictor of immunization status in childhood is critical issue to improve National Immunization Program (NIP). The aims of this study were to verify the status of up-to-date or complete immunization coverage and to investigate its related factors. METHODS: As of 2005, according to local residence registry data, there were 2,188 children who aged 12 to 35 months in Nonsan city, Korea. We conducted household survey for aged 12 to 35 months children, using questionnaires to obtain data on the status of immunization such as BCG, DTaP (diphtheria, tetanus, and pertussis), Polio, and MMR (mump, measles, rubella). Finally 1,472 participated in the survey. The operating definitions used in this study were following; "Complete immunization rate" refers to the rate of children who received all immunization within recommended age intervals fully "on-time"; "The 4:3:1 series" means status of receiving the fourth diphtheria-tetanus-pertussis (4 DTP), the third Polio (3 Polio), and the first measles-mumps-rubella (1 MMR) doses. Multivariate logistic regression analyses were used to determine factors affecting complete vaccination coverage of children. RESULTS: Immunization rates of vaccine based on the vaccination card were from 92.7% to 96.4% except 4th DTaP (79.3%). Complete immunization rate of Korea NIP was 74.0% and that of the 4:3:1 series was 77.1%. A parent as primary caregiver (OR 0.59, 95% CI 0.39-0.87 at 19-35 months of children's age) and first-born children (OR 1.79, 95% CI 1.05-3.03 at 24-35 months of children's age) were significantly related to complete immunization coverage of Korea NIP. And a parent as primary care giver (OR 0.58, 95% CI 0.38-0.88 at 19-35 months of children's age) and first-born children (OR 1.94, 95% CI 1.21-3.14 at 19-35 months, OR 2.23, 95% CI 1.27-3.91 at 24-35 months of children's age) were significantly related to complete immunization rate of 4:3:1 series. CONCLUSIONS: Government should take actions to increase complete immunization rate. In particular, intervention on the secondary caregiver and non-first-born children should be needed.

White blood cell differential count and adnexal mass size may predict potential malignancies in laparoscopic surgery / 대한산부인과내시경학회지

OBJECTIVE: We investigated the clinical value of using preoperative differential white blood cell (WBC) count to predict the potential for malignancy of adnexal masses in laparoscopic surgery. METHODS: The electronic medical records of 1325 patients who underwent laparoscopic surgery for adnexal masses between July 2005 and December 2008 were analyzed retrospectively. RESULTS: Of 1325 patients, 30 (2.3%) had adnexal masses with malignant potential. Analysis of differential WBC count, neutrophil to lymphocyte ratio (NLR), neutrophil to monocyte ratio (NMR), serum CA 125, mass size showed that only cyst size was significantly different between patients with potentially malignant adnexal masses, those with benign disease (averages of 9.45 cm vs. 6.23 cm, p=0.001). Further analysis was performed using a combination of various markers and multiplication of cyst size and NMR yielded the highest area under the curve, at 0.711(95% confidential interval 0.619~0.806, p<0.001), with a sensitivity and specificity of 86.7% and 48.3% respectively, at a cut off value of 67.23. These values were also significantly different between patients with potentially malignant adnexal masses, and dermoid cyst or endometrioma (p=0.038 and 0.002 respectively, by analysis of variance, post hoc test). CONCLUSION: Preoperative measurement of NMR in conjunction with cyst size may be used as a simple, non invasive marker for predicting the malignant potential of adnexal masses before laparoscopic surgery.

Splenic Preservation in Rats

Despite the recognized desirability of spenic salvage,forced splenectomy remains the rule in many operative situations,including trauma and pancreatic cancer. The aim of this study was to evaluate the phagocytic function,histologic finding and anatomic change when the perfusion of preserved spleen was done only through short gastric vessels after splenic vessel ligation. In this situation, we evaluate the necessity of mass reduction to improve the perfusion into the residual spleen by 2/3 patial splenectomy. We studied 41 Sprague-Dawley rats by subdiving them into 3 main groups.In HL(;Hilar ligation)group, splenic vessel ligation was done(n=18). In HLS(Hilar ligation + 2/3partial splenectomy), splenic vessel ligation and partial splenectomy were done(n=18), and the others(n=5) were used as a control group. The changes of anatomy,histologic findings, and phagocytic functions in the preserved splenic tissue were observed at 1hour,2weeks, and 5months postoperatively,based on results of the India ink technique for demonstrating phagocytic function and on results of regular histologic examination. In all rats,at least 1 upper short gastric vessel was noted without direct connection to splenic vessel.In HL group,at 2weeks postoperatively,the size and weight of the preserved spleens were severely decreased to 1/3 of those of control group(p=0.0002). But,after 5months,the size and weight recovered to about 70-80% of those of initial spleen parameters.In HLS group,the size and weight changes were not found.At 1hour postoperatively phagocytic activity decreased to 35% in the control group,10% at 2weeks and not improved at 5months in both groups.The white pulps didn't show any specific change. We concluded that in spite of splenic mass reduction,the white pulp did not change, and phagocytic function was not improved.Therefore,the splenic mass reduction is not essential for the recovery of phagocytic function at the preserved spleen.