A Point of View toward Medical Crisis

No abstract available.

Facing the Needs of New Leaders in Academic Medical Communities (I): A Role Shift towards the Actice Chance Development-Discovery from Present Problem Shooting / 한국의학교육

No abstract available.

Effectiveness of Short-Term Educational Workshop Programs for Newly Appointed Medical School facuty Members: Analysis of 30 programs with 9-year experiences / 한국의학교육

The National Teacher Training Center for Health Personnel (NTTC) / Korea, administrated jointly by Seoul National University College of Medicine, is a resource to conduct programs on fundamental and applied problems in Korean medical education, to assist faculty of health professions to gain increased knowledge of the methods of teaching, educational evaluation and curriculum planning. Of varieties of educational services given for health profession faculty since its establishment in 1975, faculty development program has been one of the major activities to provide educational experiences to the faculty members to improve their teaching effectiveness by conducting workshops, seminars and conferences. A total of 30 short-term educational workshop programs, designed for newly appointed medical school faculty members were implemented during a period from 1981 to 1989, and their postworkshop questionnaires were analysed together with summary reports from convertors in view of evaluating immediate effectiveness. The number of participants was 655 from 27 out of 31 medical schools. They attended a 3-day promotional workshop under the same workshop objectives and format with a class size of no more than 30/workshop. The selection procedure was mostly relied on the recommendation through the dean's office. The workshop format was generally well accepted among the participants as a necessary mechanism for reclarification of the faculty roles in teaching-learning process, especially in professional educational programs. Teaching strategies including small group discussions and various group dynamics techniques were the integral parts of the workshop format aiming for the active participation throughout the educational activities in development of lecturing and test-item construction skills. Impeding and enhancing factors identified during the workshop were listed and recommendations to NTTC, medical schools and related organizations were made with regard to further improvement in faculty development programs.

A Comparative Study on Responses to Korean Version Questionaires on Respiratory Symptoms / 예방의학회지

Korean versions of British Medical Research Council (MRC), Cornell 1V, Mgdical Index(CMI), and American Thoracic Society 78 (ATS-DLD-78) respiratory questionaires were compared with each other, and were tested the stability, in terms of test-retest reliability, of each questions by self-administration of those to 156 medical students. The results obtained and conclusions drawn are as follow: 1. The degree of agreements between responses to the comparable questions of CMI vs MRC, and of CMI vs ATS-DLD-78 were not satisfactory. There were, however, 71~100 per cent of agreement between responses to the questions on Cough, Wheezing, Phlegm, Breathlessness, and Chest illness of ATS-DLD-78 vs MRC questionaire. And the ATS-DLD-78 tended to yield greater number of positive responses than MRC (See Table 4). 2. All of the coefficient of stability of each questions in 3 questionaires were statistically significant, ranged 77~100 per cent, except that of the question on episode' of cough and phlegm in ATS-DLD-78 questionaire (See Table 5-1). The question is composed of two collateral conditions, "lasting for 3 weeks or more" and "each year". 3. It can be insisted that the Section-B questions of CMI is not proper for use in epidemiologic survey on respiratory illness. And rather than MRC, the ATS-DLD-78 questionaire deserves to prefer to be used in epidemiologic studies on respiratory illness. 4. In question-wording, especially, of inquiring past experience, it is possible to Iessen the reliability of the question that including collateral conditions such as 'the duration lasted of symptoms', and moreover, of which words are not common usage. For example, for Korean '10-days' or 'half a month' is more familiar time unit rather than 'week'.

A Study on Development of Questionaire for Use in Epidmiologic Survey on Respiratory Illness in Korea / 예방의학회지

Questionaires on symptoms of respiratory disease have been used in Korea to elicit the probable health effects of air pollution in epidemiologic studies. The objectives of such studies often include comparing prevalence of symptoms of respiratory system between different population groups or between the same population groups at different times. Unfortunately, little attention has been paid to standardization of those questionaires, whether those are Korean versions or not. Furthermore, no attempt to develop Korean questionaire on respirator symptoms and relevant information has been made. Followed by 'a comparative study on responses to Korean version questionaires (English origin) of CMI, MRC, and ATS-DLD-78' two types of questionaires on respiratory symptoms and relevant information for Korean adult, which are short form (SUN=81-AS) and long forms (optional questions are added to the short one, SUN-81-AL), have been designed suitable to Korean background by authors (see Annex). The self-administered and closed-question questionaire were tested their validity and reliability by administration to 180 normal adults(medical and nursing students) and 60 clinical patients of Seoul National University Hospital, with spirometric exam. The results obtained and conclusions drawn are as follow: 1. It took less than 10 minutes to complete the questionaire SNU-81-AS and SNU-81-AT. 2. The test-retest reliability of each questions in AS and AL were observed as 92.7% and 92.1%, respectively. And all of the level of agreement are statistically significant with kappa statistic. 3. In addition to higher prevalence rate of symptoms in patients group compared with normal group, the correlations between FEV 1.0/FVC predictive value(%) and number of symptoms were statistically significant in patients group (See Fig. 1 and Table 7). 4. The answer rate to optional questions in AL form among those who are not to do was about 10%, while the no-answer rate among who are to do was about 15% in Normal (medical and nursing students) group. 5. From the viewpoints of validity and reliability, the new Korean questionaire (SNU-81-AS and AL) developed by authors are to be recommendable to use in epidemiologic studies on respiratory illness in Korea. The self-administration, however, of opthional questions in AL form may not assure the quality of data gathered.

The Effect of an Oral Contraceptive (Eugynon) Upon Lactation / 예방의학회지

There are a number of published reports aimed at clarifying the effect of hormonal contracept -ives upon the quantity and quality of breast milk during postpartum and lactation periods. As to the volume of milk produced by breast feeding mothers, many authors seem to have agreed on a decrease as an established pattern in the periods following regular administration of oral contraceptives containing estrogen in varying dosage. The quality of milk following administration of hormonal contraceptives, however, remsins a controversial issue. Korea's experience in oral contraceptive is rather a brief one, but use of Eugynon has been widespread and frequent since this hormonal contraceptive was introduced into the national program in 1967. The authors have reviewed the potential significance of data concerning regular use of an oral contraceptive as affecting lactation, and have sought to clarify the interrelationship between the administration of Eugynon and quantity and quality of breast milk from mothers contracepting. with Eugynon in different periods following confinement. A total of 85 women, who were at different periods following deliveries, have been divided into, two groups, one comprising 28 women regularly taking oral pills and the other (57 women) not resorting to hormonal contraceptives if they were contracepting at all. 1. Milk Volume. In view of the possible influence of suckling on the amount of milk produced, efforts were made in this study to standardize the technique by extracting breastmilk by applying manual pressures on one side of the maw-nae, While the nipple on the other side was being sucked by the mother's own baby. The effetct of an exogenic ovarian hormone on the quantity as well as quality of breastmilk is generally understood to be inapparent until the drug is administered to women whose milk secreting function has been normalized. ") In the present study, it was observed that the decrease in the ammount of milk obtained from mothers in the periods following the 4th cycle of oral contraceptives or thereafter has turned out to be statistically insignificant. This result conforms i.u the findings by Tubari and others. It is assumed that it takes at lest 2 to 3 cycles of use before mammary glands are functionally adjusted to the use of exogenic hormonal contraceptives. 2. Specific Gravity and Composition of Milk There was no noticeable change in the protein and chloride content following continuous administration of ore.l contraceptives, while meaningful changes were observed in fat (increase) and calcium (decrease up to the 5th cycle use) contents. Also, there was a rather significant decrease in the specific gravity in the period following administration of the first cycle of the oral contraceptive. The findings from the present study partially conforms the results published by Ramadan and others, who reported that little change was noticed in the contents of total solids. ash, chlorides and lactose in the breast milk of women who had taken 4 cycles of ovosiston, although in our study lactose was not measured. Ramaden, however, reported that fat content did increase in the same milk, as in our study. A definitive conclusion, however, could not be made unless measures are taken to rule out the physiological changes of the maternal body affecting the composition of milks.

On Pattern of Birth and Death in Seoul City / 예방의학회지

A survey was conducted by the staff of the College of Medicine and School of Public Health, Seoul National University in cooperation with Seoul Special City from 1 December 1967 through 28 February 1968, on such events as delivery, death, abortion and pregnancy. The survey directed to a total population of 47,811 residing in 9,157 households led us to the following findings: 1. Two year averages of crude birth rate, crude death rate and natural increase rate were 30.1, 5.6 and 24.5, respectively. 2. Of all deliveries, home and hospital deliveries constituted 61.1 per cent and 35.5 per cent, respectively. 3. Deliveries other than hospital deliveries were found to be attended more often by mother-in-laws(26.5 per cent) than by doctors or midwives(23.4 per cent). 4. About 52 per cent of all women having experiences in pregnancy during the last two years had an experience of consulting a doctor at least one time throughout whole period of pregnancy. 5. In most cases scissors were used to cut umbilical cords, of which 71.0 per cent were not sterilized and only 28.3 per cent sterilized. 6. In many cases placenta was incinerated(48,2 per cent) and on many other occasions it was thrown away into water(28.3 per cent). 7. Cement page(37.4 per cent), gauze and absorbent cotton(29.8 per cent)were found to be most frequently used to receive new-born babies. 8. In 1966 8.8 per cent of the women had at least one abortion induced and in 1967 the percentage was 9.2 per cent. 9. Nearly all(95.8 per cent) of the induced abortions reportedly were done at doctor's clinics. 10. Of all the abortions induced 65.3 per cent were done by specialists in obstetrics, 30.3 per cent by general practitioners and 2.7 per cent by midwives. 11. Those who experienced spontaneous abortions were 1.9 per cent of all women both in 1966 and 1967. 12. About 9.2 per cent of women investigated were found to be currently pregnant. 13. Age specific death rate turned out to be highest among those under 1 year of age. 14. Ten major causes of death in their order of frequency were: 15. Places of death can be classified into homes(75.3 per cent) and hospitals(13.2 per cent). 16. Method of disposing of corpses comprised burials(54.2 per cent) and cremations(44.6 per cent). 17. Infant, neonatal and hebdomadal mortality rates have been computed at 32.2, 18.9 and 13.7, respectively. 18. Infants were found to have died either at homes(81.5 per cent) or at hospitals(18.5 per cent). 19. Birth registrations had been done for about 18.5 per cent of the dead infants.

A Study on the Physical Growth and Health Status in University Students / 예방의학회지

For the purpose of ascertaining the status of physical growth and health status of the University students, a intensive survey was conducted by the authors towards a total of 2,638(male; 2,228, female;410) who passed the written entrance examination at the Seoul National University. The items included the measurements on physical growth, various physical indexes, visual acuity, tuberculosis and dental status. The findings and results can be summarized as follows : 1. Physical Growth. No signigicant difference was found in the physical growth between classes(literature and science) and by ages. In males, the means of body height, body weight, chest-girth and sitting height were 168.0+/-5.07cm, 55.7+/-5.71kg, 85.8+/-4.4cm and 91.5+/-2.21cm, respectively. In females, these were 157.4+/-4.57cm, 00.4+/-5.75kg, 80.3+/-4.51cm and 86.1+/-3.30cm, respectively. Basing on the above measurements several physical indexes were calculated as follows ; Relative body weigh 33.15 in males and 32.02 in females. Relative chest-girth 51.07 and 51.01, relative sitting-height 54.46 and 54.70 Rohrer index 1.00 and 1.02, Kaup index 1.97 and 2.04, Vervaeck index 83.63 and 83.03, and Pelidisi index 89.94 and 92.45. 2. Visual Acuity. Among the students of science classes those of 0.8 and below in vision on left and right occupied 46.4% and 45.0%, those of 0.6 and below 39.1% and 41.2%, respectively. Among the students of literature classes those of 0.8 and below occupied 46.3% and 42.9%, and those of 0.6 and below occupied 41.4% and 39.0, respectively. In males those of 0.8 and below occupied 46.8% and 44.5% and 0.6 and below occupied 41.9% and 39.7%, while in females 0.8 and below occupied 43.9%, and 42.4%, and 0.6 and below occupied 38.3%% and 37.3%, respectively. In males those of 0.8 and below in corrected vision occupied 12.1% and 10.3%, while in females 12.9% and 12.2%, respectively. More students of abnormal vision were found among science classes and the proportions of corrected vision were 38.9% and 37.4% in males, and 33.9% and 33.2% in females, respectively. 3. Tuberculosis. Among the total, 55 students were diagnosed as tuberculosis, of whom 50 were minimal cases, 2 were moderately advanced cases and 3 were far advanced cases. 4. Dental Status. Among the total, 81.2% were of decayed teeth, 20.8% filled, 9.5% missed, 5.0% extraction needed, 9.1% sunplatinum bridges, 3.3% golden bridges and 5.5% golden inaly. Regarding tartar on teeth moderate, heavy and light grades occupied 49.5%, 29.7% and 20.3%, respectively and 0.8% had none. 5. Comprehensive evaluation. According to the criteria 4 grades were applied to comprehensive evaluation as follows : A---excellent in physical status B---with some physical defects but no difficulties in study C---need treatment D---need treatment and rest. Out of the total, A grade occupied 21.6%, B 76.2% and C. and D 2. 2.