Epidemiologic Study for the Association between Phenol Contaminated Drinking Water and Poor Pregnancy Outcomes in Taegu City / 한국역학회지

From 14 to 17 March 1991 the Nakdong River which is a major source of drinking water for Taegu was contaminated with phenol that was spilled out of a factory in Gumi industrial park. Many people who drank the contaminated water complained of various symptoms and were apprehensive of possible adverse effect to the fetus. This study was conducted to examine the effect of drinking water contaminated with phenol on pregnancy outcome in Taegu. All of livebirths and stillbriths delivered in the 5 General Hospitals in Taegu during 1 year from 1 April 1991 were included for this study. For this duration, total number of babies delivered in the 5 General Hospitals was 21,196. Among them, 77.7%(16,468) were delivered from women living in Taegu and it accounted for 47.5% of 34,688 livbirths registered in Taegu during the same period. The babies born to the women living in Taegu were divided into phenol-exposed and unexposed groups. Exposed group was the residents of the area where contaminated water was supplied and they accounted for 81.4% of the women included for this study. Unexposed group was the residents of the area where drinking water was not contaminated with phenol and they accounted for 18.6% of the study subjects. Data were abstracted from the hospital records. All the rates were adjusted for the maternal age and parity by direct method. The abortion rates for the exposed group was 1.7 per 1,000 abortions and livebirths and 1.6 for the unexposed group. The stillbirth rate for the exposed group was 10.5 per 1,000 livebirths and stillbirths 20 weeks of gestation and 9.5 for unexposed group. The early neonatal death rate(within the 1st week after birth) for the exposed group was 7.8 per 1,000 livebirths and 5.4 for the unexposed group. The perinatal death rate for the exposed group was higher as 14.1 per 1,000 livebirths and stillbirths 28 weeks of gestation than 10.8 for the unexposed group. The proportions of intrauterine growth retardation(IUGR) were 2.7% for the exposed group and 3.3% for the unexposed group. Congenital anomaly incidence rates per 1,000 livebirths was 7.4 for the exposed group and 8.4 for the unexposed group. The low birthweight incidence rate for the exposed group was 6.6% and 6.5% for the unexposed group. These differences between two groups were not statistically significant. The premature birth rate(< 37 completed gestational week) was 6.0% for the exposed group and 4.8% for the unexposed group and the difference was statistically significant(p<0.05). Monthly variation of these indices did not show any clue that suggested concurrent change with the phenol contamination of the drinking water. There were no sufficient evidence that could support the hypothesis of adverse effects of phenol contaminated water on pregnancy outcome, such as abortion, stillbirth, premature birth, IUGR, congenital anomalies and early neonatal death.

Analysis of the Taegu Regional EMSS and Suggestions Improving the System

BACKGROUND: The EMSS can be defined as the complete chain of human and physical resources that provides patient care in cases of sudden illness and injury. To provide effective emergency care through the EMSS in a region, the organized EMSS should be periodically evaluated and improved in both aspects of quality and number on the detected portions of defect. The EMSS in Taegu has been systematically developed since the gas explosion disaster happened at Sangin Dong, on 28th April, 1995. After then, many institutes have been organized, and various plans for improving Taegu regional EMSS have been suggested. The training of EMTs for operating the systems and various equipments which are needed for performing prehospital care and transporting the patient to hospital also has been undertaken. METHOD: We reviewed the effectiveness and problems of each EMSS elements established and operated during the past five years in Taegu by looking over the documents related to EMSS in the institutes concerned and accomplishing written survey from prehospital care providers belonged to Fire-Fight department. RESULT: Although the regional EMSS in Taegu has been well developed since 1995 in all its aspects, such as manpower, equipment and control system, but some ineffectiveness in the operation of EMSS and deficits of resources, especially manpower, are found. CONCLUSION: The emergency physicians should have to analyze the problems of their regional EMSS that involved in personally, and reestablish the long term plans for improving the regional EMSS at this point.

Restriction fragment length polymorphism analysis of Mycobacterium tuberculosis isolated from Taegu / 대한임상병리학회지

BACKGROUND: To investigate epidemiology of a specific strain, and evaluate correlation between Mycobacterium tuberculosis restriction fragment length polymorphism (RFLP) and antimicrobial susceptibility, we studied about Mycobacterium tuberculosis RFLP isolated from Taegu area. METHODS: From Oct. 1997 and Mar. 1999, we isolated 54 strains of M. tuberculosis from the patients visiting Catholic University of Taegu Hyosung, Taegu, Korea. We studied their drug susceptibility and analyzed the Pvu treated RFLP using digoxigenin labeled IS6110 probe. RESULTS: Fifty-three had more than 6 bands of RFLP and strains with 10 bands were predominant (15 strain). Cluster analysis reveals eleven distinct clusters showing 57.4% of clustered rate (31 strains from A to K) and 35 independent patterns showing 64.8% of the diversity rate at 70% similarity level. Cluster A was the largest group (7 strains) and the next was cluster B (5 strains). Most of the patients with cluster A lived in Taegu city (85.7%) and all of 2 cluster K patients lived in Euisung area. There was no correlation between RFLP pattern and antimicrobial susceptibility, but all two strains of cluster H were resistant to isoniazid. Strains of clustered were also prevalent in the people of middle class. CONCLUSIONS: Compared to the RFLP analysis in the developed countries, Korea disclosed lower rate of diversity and higher clustered patterns of M. tuberculosis. The clustered strains were also prevalent among the people of middle class.

An overview on reality of Dong-In Uywon(Hospital) and effects on culture of medicine / 의사학

From a review on the reality of Dong-In Hospital which was a hospital founded by Dong-Aa Dong-In-Hywe Foundation which was a corporation of governmental patron around Ulsa(1905) protective treaty between Japan and Korea, and this hospital seemed to be dissoluted just before the annexation signing of Korea to Japan. The building with site of Dong-In Hospital in Taegu was sold to Kyung-Sang Pook-Do province and Jaa-Hye Hospital was constructed instead as a virtual conscience. So it is impossible to say this Jaa-Hye Hospital as the predecessor of Dong-In Hospital although Jaa-Hye Hospital which was belonging to Kyung-Sang Pook-Do province as Kyung-Sang Pook-Do Hospital had changed the name several times until being Taegu Medical School Hospital by using as Taegu Medical Institute College Hospital which was absorbed to U.S. military government after the restoration of independence from Japan. Since 1953 Kyungpook National University absorbed Taegu Medical School, it is possible to use Taegu Medical School Hospital as the predecessor of Kyungpook National University Hospital whereas it is impossible to use Jaa-Hye Hospital as the predecessor with nationality on the basis of the health and medical administrative system.

Epidemiologic Investigation of Childhood Cancer in Taegu, Kyungpook Area / 대한소아혈액종양학회지

PURPOSE: This study was carried to examine the temporal trend and geographical distribution of the childhood cancers in Taegu and Kyungpook province and to postulate an etiological hypothesis for development of the childhood cancer. METHODS: A total of 799 childhood cancer patients whose addresses were either Taegu or Kyungpook province were diagnosed at 5 major hospitals in Taegu from January 1982 to December 1996. The types, sexes, years, and frequencies of the childhood cancer and regional distributions were analyzed, based on the hospital records of these patients. RESULTS: The most common childhood cancer was leukemia that accounted for 49.2% of all childhood cancer cases and it was followed by CNS tumor (12.3%), lymphoma (8.4%), neuroblastoma (7.4%), Wilms tumor (3.9%), retinoblastoma (3.4%), rhabdomyo sarcoma (2.7%), bone tumor (2.4%), embryonal carcinoma (1.9%), hepatoblastoma (1.3%) and others (7.1%). Male to female ratio of the cases was 1.5:1. The changes of the annual incidence rates over 15 years in Taegu and Kyungpook area were not consistently increasing but rather variable. Cancer incidence rate of Taegu was significantly higher than that of Kyungpook province (P<0.005). The incidence rates of industrialized cities around Taegu were significantly higher than those of agricultural regions of northern Kyungpook (P<0.05). CONCLUSION: Geographical difference in cancer incidence rate suggested that certain environmental factors may be associated with the childhood cancer. To identify such factors an analytical epidemiologic study is warranted. For the analytical epidemiologic study, a detailed history of residential area and occupational history of parents should be recorded uniformly for all the new childhood cancer cases.

Medical Education in Taegu(1980-1991) / 의사학

In Taegu, the Yaknyongshi was established as early as the 9th year of King Hyojong(1658) of the Chosen Dynasty, and in the 10th year of King Hyojong(1659) the 'Tonguibogam' was published as a Yongyongbon edition by the Kyongsang Provincial Government In fact, it may not be an exaggeration to say that Taegu was the base of the traditional medicine in Korea. In the meantime the general public began to become aware of the importance of Western medicine when Dr. Woodbridge O Johnson of the Northern Presbyterian Church introduced Western medicine by opening the 'Miguk Yakpang'(American dispensary) and began to teach Western medicine to Korean youths. At that time, while constructing the Kyong for a war against Russia, Japanese began to establish hospitals in several major cities and towns along the railway line and mobilized Tonginhae doctors. However, those medical facilities were solely for the benefit of Japanese people residing in Korea and had nothing to do with ordinary Koreans. The attached medical school of the Taegu Tonginuiwon failed, contrary to expectation, to turn out even a single Korean medical doctor. This hospital was later reorganized into Taegu Chahyeuiwon and was soon closed according to the policy of educational unification of the Government General Korea. The keen interest in the Western medicine shown by the people of Taegu resulted from the long history of this area as a base of Oriental medicine. More than 10 years after the abolition of the institute far Western medicine in Pyongyang a Western medical training center was inaugurated as a night school in January 1923 by the Chahyeuiwon and the school began to be operated under the name of the Pyongyang Provincial Medical Training Institute. In July 1923, in Taegu, the Taegu Medical Training Institute was inaugurated in the compound of the Chahyeuiwon as a night school in imitation of the institute in Pyongyang. In march 1924, this institute, following the example of that in Pyongyang was renamed the Taegu Provincial Medical Training Institute with the promulgation of a decree of Kyongsangbukdo regarding the regulation on the Taegu Medical Training Institute. Thanks to the strong demand by the population of the Kyongsanbukdo, fund-raising and other campaigns by Koreans and Japanese, and active efforts by the local governmental authorities, the Taegu Provincial Medical Training Institute was approved as an institute of a semimedical college level by the Government-General in Korea with the promulgation of the regulations on the Kyongsangbuk-do Medical Training Institute in May 1929. In March 1930, both the Taegu Provincial Medical Training Institute and Pyongyang Provincial Medical Training Institute were designated as "Uihakkyo(medical school)" by the Government-General in Korea. By this designation, the graduates of the schools were given a medical license permitting them to practice medicine in korea. That is to say, the graduates enjoyed the same privilege to exercise professional right within Korea as those of other medical colleges. Three years later, on March 4 1933, the regulations on public schools in Korea were revised and, on March 6, the establishment of medical colleges were permitted. Thus, in Kyongsangbukdo, the regulations on the Taegu Medical College were proclaimed in the form of a decree of the provincial government and, in accordance with the regulations, professors were nominated and students were recruited. In the meantime, with the timely completion of construction of the college building in August 1933, the college moved to the new compound in November of the same year. Thus, the Taegu Medical College, equipped with new facilities, emerged and satisfied the long-cherished desire of the people in this area. Unlike the Pyongyang Medical College, the Taegu Medical College had some Korean teaching staff members. They were: Pak Jae-Hwan(professor) ; Seo Sung-Hae, Chung He-Taek, Lee Myeng-Hun, Kwon Kil-Chae, Choe Duk-Saeng, Pae Chong-Ho, Lee Chil-Hui(assistant professor) ; and Cha Ham-Su, Kee Yong-Suk(instructors). They taught and conducted research in various departments of clinical and basic medicine. However, there were few Korean graduates of the Taegu Medical College who continued study and research at their alma mater. It is known that Korean graduates of this medical college did their study and research mostly at medical colleges in Japan or at the Medical Department of the Kyongsuong Imperial University. The author wishes to pay his tribute of sincere praise to the painstaking efforts and diligence of the small number of graduates of this medical college who, in spite of the haughtiness and prejudice by the Japanese, conducted study and research that later led to the foundation of the Kyongbuk University Medical College.

Mycological features of trichophyton verrucosum isolated in Taegu area / 대한피부과학회지

Trichophyton verrucosum is a worldwide zoophilic dermatophye. The human infection was first reported in t.he South western part of Korea in 1986 and Fas been increasing in Taegu area. Thirty-one strains of T. verrucosum isolated from the patients in Taegu area were investigated for their mycological features. Gross observation on Sabot rauds dextrose agar, microscopic examination by scotch tape method and slide culture or Sabourauds dextrose agar and potato dextrose agar, and hair perforation test were perforn ed at 37C. The averages of the largest dimensions of the colonies were .9mm at 2 weeks and 59mm at 4 weeks. The morphologic features of the colonies were clasified into three types. Eighteen of 31 strains showed flatwhitish, disc-like colonies with suvmerging hyphae, 11 strains had large radiating follows on the center of the colonies, and 2 strains showed colonies having diffuse fine folds on their surfaces with well-defined borders. On microscopic exaniination, many chlamydospores, antlerlive hyphae, oval and clavate microconidia, and rat tail or string bean shaped macroconidia were observed. It seemed that observation on potato dextrose agar during 10 to 14 days af er inoculation was suitable method for microscopic examination of T. verrucosum. All 31 strains showed positive reaction on hair perforation test.

An Outbreak of Tsutsugamushi Disease in Vicinity of Taegu City and Kyungpook Province in 1988 / 영남의대학술지

Since the first cases of tsutsugamushi disease reported in Korea in 1986, many cases has been reported and its occurrence has been increasing. Only 2 cases has been reported in Taegu city and Kyungpook area. We experienced an outbreak of 26 cases of tsutsugamushi disease in this area and their clinical manifestations are; 1. The outbreak occurred in September to November in 1988 and its peak occurrence was in October. 2. Mean age was 52 years old (18 to 69 years old) and peak incidence was in the 6th decade. 3. Major symptoms and abnormal signs are fever/chills (88%), myalgia (65%), headache (54%), nausea and vomiting (31%), and abdominal pain (27%). The eschar was detected on lower part of body in most of cases, and more frequently in male (M:F 100 vs 58%). 4. Patients were treated with tetracyclines (TC) and/or chlorampenicol (CM) and mean duration of defervescence from initiation of antibiotic therapy was 2.1days with TC and 2.5 days with CM. 5. Complications are 2 cases of meningitis and 1 case of shock, and all cases were recovered without any sequelae. As above, tsutsugamushi disease occurs in Taegu city and Kyung Pook area as other part of Korea and clinical manifestations are similar to other reports.

Causes of Childhood Injuries Observed at the Emergency Rooms of Five Hospitals in Taegu / 예방의학회지

To determine the causes of and related factors to childhood injuries, the emergency room records and inpatient medical records were reviewed for 4,849 injured children out of 15,790 pediatric patients(<15 years old) who visited the emergency rooms of 3 university hospitals and 2 general hospitals in Taegu from 1 January to 31 December 1987. Out of total injured children, 54.6% were 3-8 years old and the male to female ratio of the total injured children was about 2 : 1. The leading causes of injury were falls and slips (29.1%) and traffic accident(28.2%). The frequency of injury was higher in May-October than the rest of months and 51.6% of the injuries occurred between 15 and 20 o'clock. Falls and slips took place most frequently at the stairway(25.7%). The most common interpersonal violence was inflicted injuries(85.6%) and there were 11 child rapes. Dog bites accounted for 67.6% of all biting injuries and it occurred 2.9 times more in male than in female. CO intoxication was the most common cause of poisoning (45.3%) and scalding accounted for 85.2% of all burns. Common places of drownings were river (32.2%), swimming pool (22.6%) and construction site(19.3%). To prevent childhood injuries, it is recommended to eliminate the hazardous environmental factors, to provide safe playgrounds, to educate the children for safety from kindergarten and the general public through mass communication, to establish a strict safety standard for houses, public buildings and facilities, and playgrounds.

Causes of Burn and Emergency Care on the Spot for the Patients Admitted to Three Hospitals in Taegu / 예방의학회지

This study was conducted to investigate the causes of burn and emergency cares taken on the spot for the burn patient. study population included 161 burn patients admitted to 2 university hospitals and 1 general hospital in Taegu from November 1, 1987 to April 30, 1988. Patients or guardians were interviewed with a structured questionnaire. Out of 161 burn patients 111(69.8%) were males and 50(31.1%) females. Preschool children of 1-4 years old accounted for 29.8% of the total patients. Burns of children under 15 years of age took place at home in 91.0%, while 48.3% of burns of adult (15 years and over) males occurred at the working place, and 68.0% of adult females occurred at the home. Out of total burns occurred at home 39.8% took place at kitchen/dining room and 24.1% in the room. The most common cause of burns in children was the boiling water or hot food (74.3%). In adults the common causes were electrical burn(22.4%), hot water or food(19.0%) and explosion(12.1%) for males, and hot water or food(32.0%) and explosion(20.0%) for females. Common emergency cares for the burn taken on the spot were undressing(64.6%), pouring Soju(liquor)(13.7%), and pouring cold water(5.0%). There were a few cases who applied ash, soy or salt. To prevent burn, it is recommended to remodel the traditional kitchen and coal-briquet hole, to strengthen the safety control of LP Gas and LN Gas supply, to educate the public for the handling method for such gases, to strengthen the occupational safety control, to improve the safety device for the electric wire and socket, and to limit the temperature of hot water at home and public baths.