Evaluation of the Public Health Emergency Response to the COVID-19 Pandemic in Daegu, Korea During the First Half of 2020

Hwa-Jin Lee,Keon Yeop Kim,Jong-yeon Kim,Sin Kam,Kyeong Soo Lee,Jung Jeung Lee,Nam Soo Hong,Tae-Yoon Hwang 대한예방의학회 2022 예방의학회지 Vol.55 No.4

Objectives: This study evaluated the response in Daegu, Korea to the first wave of the coronavirus disease 2019 (COVID-19) pandemic according to a public health emergency response model. Methods: After an examination of the official data reported by the city of Daegu and the Korea Centers for Disease Control and Prevention, as well as a literature review and advisory meetings, we chose a response model. Daegu’s responses were organized into 4 phases and evaluated by applying the response model. Results: In phase 1, efforts were made to block further transmission of the virus through preemptive testing of a religious group. In phase 2, efforts were concentrated on responding to mass infections in high-risk facilities. Phase 3 involved a transition from a high-intensity social distancing campaign to a citizen participation–based quarantine system. The evaluation using the response model revealed insufficient systematic preparation for a medical surge. In addition, an incorporated health-related management system and protection measures for responders were absent. Nevertheless, the city encouraged the participation of private hospitals and developed a severity classification system. Citizens also played active roles in the pandemic response by practicing social distancing. Conclusions: This study employed the response model to evaluate the early response in Daegu to the COVID-19 pandemic and revealed areas in need of improvement or maintenance. Based on the study results, creation of a systematic model is necessary to prepare for and respond to future public health emergencies like the COVID-19 pandemic.

Involvement of Purα Gene in Neuroprotection Effects of Estrogen in Rat Ischemic Brain Model

Seong Jin Yu,Ju Ran Kim,Chae Kwan Lee,Jeong Ho Kim,Kyung Yoon Kam,Jeong Hwa Hong,Sung Goo Kang 한국유전학회 2006 Genes & Genomics Vol.28 No.4

Stroke is a debilitating and prevalent disease in the world in which ischemic injury results from vascular occlusion in the brain. 17β-estradiol valerate (E2) has been reported to exert neuroprotective effects when administered before an ischemic insult. Purine-rich element binding protein α (Purα), which is involved in diverse aspects of cellular function and also in neural regeneration, is strongly expressed in the neuronal cytoplasm. This study was conducted to evaluate the effects of E2 on brain injury and on the transcriptional level of Purα?gene after transient focal ischemia in the rat brain. Focal cerebral ischemia was induced in rats by middle cerebral artery occlusion (MCAO). All animals underwent 1 h-ischemia, followed by 24 h-reperfusion. The brains were sliced coronally for staining with 2,3,5-triphenyltetrazolium chloride for measuring the ischemic area or subjected to total RNA extraction for the analysis of Purα gene expression. Histopathological analysis revealed that MCAO produced significant infarction in the cortex and striatum of the vehicle-treated group compared with the sham-operated group. In the E2-treated group, the infarct volume was decreased significantly in the both areas compared with the vehicle-treated group. The preventing effect of E2 on the brain damage was disappeared by treatment of ICI-182,780 (ICI), an E2 antagonist. The injury induced ischemia/reperfusion significantly decreased the levels of Purα gene expression in the ipsilateral cortex measured by RT-PCR and in situ hybridization (P<0.05 vs. sham group). Interestingly, Purα gene expression was increased by E2 pre-treatment and this effect was partially antagonized by ICI cotreatment. This study, therefore, suggests that upregulation of Purα gene by E2 is partially involved in the action mechanisms for the neuroprotective effect of E2 in ischemic brain.

農村地域 老人의 訪問保健醫療 要求度

곽화순(Hwa-Soon Kwag),감신(Sin Kam),김종연(Jong-Yeon Kim),안순기(Soon-Gi Ahn),진대구(Dae-Gu Jin),이경은(Kyung-Eun Lee),차병준(Byung Jun Cha) 한국농촌의학 지역보건학회 2002 농촌의학·지역보건 Vol.27 No.1

O⁶-alkylguanine-DNA alkyltransferase gene polymorphisms and the risk of primary lung cancer

Chae, Myung Hwa,Jang, Jin-Sung,Kang, Hyo-Gyoung,Park, Jae Hyung,Park, Jung Min,Lee, Won Kee,Kam, Sin,Lee, Eung Bae,Son, Ji-Woong,Park, Jae Yong Wiley Subscription Services, Inc., A Wiley Company 2006 Molecular Carcinogenesis Vol.45 No.4

<P>O<SUP>6</SUP>-alkylguanine-DNA alkyltransferase (AGT) plays an important role in the repair of O<SUP>6</SUP>-alkylguanine adducts, which are major mutagenic lesions produced by environmental carcinogens. Polymorphisms in the AGT gene may affect the capacity to repair DNA damage and thereby have influence on individual's susceptibility to smoking-related cancer. To test this hypothesis, we investigated the potential association of AGT polymorphisms (485C > A, Leu53Leu (C > T) and Leu84Phe] with the risk of lung cancer in a Korean population. The AGT genotypes were determined in 432 lung cancer patients and in 432 healthy controls who were frequency-matched for age and gender. The 485 AA genotype was associated with a significantly increased risk for overall lung cancer as compared with the 485 CC genotype and the combined 485 CC + CA genotype, respectively (adjusted odds ratio (OR) = 1.83, 95% confidence interval (CI) = 1.12–2.99, P = 0.02, and Bonferroni corrected P-value (Pc) = 0.04; and adjusted OR = 1.67, 95% CI = 1.05–2.66, P = 0.03, respectively). When the lung cancer cases were categorized by the tumor histology, the 485 AA genotype was associated with a significantly increased risk of adenocarcinoma (AC) and small cell carcinoma (SmCC), respectively, as compared with the combined 485 CC + CA genotype (adjusted OR = 2.54, 95% CI = 1.39–4.66, P = 0.003; and adjusted OR = 2.19, 95% CI = 1.06–4.55, P = 0.04, respectively). However, the genotype distributions of the Leu53Leu and Leu84Phe polymorphisms were not significantly different between the lung cancer cases and the controls. On a promoter assay, the 485C > A polymorphism did not have an effect on the promoter activity of the AGT gene. These results suggest that the effect of the AGT 485C > A polymorphism on the risk of lung cancer may be secondary to linkage disequilibrium (LD) with either another AGT variant or with a true susceptibility gene, and that the AGT 485C > A polymorphism could be used as a marker for the genetic susceptibility to lung cancer. © 2005 Wiley-Liss, Inc.</P>

정사영상을 이용한 연속지적도 편집의 신뢰성 향상 방안

김감래(Kim, Kam Lae),라용화(Ra, Yong Hwa),안병구(Ahn, Byung Gu),박세진(Park, Se Jin) 한국측량학회 2004 한국측량학회지 Vol.22 No.3

후두암과 동시성으로 발견된 원발성 양측성 신세포암

김우진(Woo Jin Kim),최재훈(Jea Hoon Choi),정행기(Heung Ky Chung),정재훈(Jea Hoon Chung),감성철(Sung Cheol Kam),화정석(Jeong Seok Hwa),정기현(Ky Hyun Chung) 대한비뇨기종양학회 2004 대한비뇨기종양학회지 Vol.2 No.1

XPC polymorphisms and lung cancer risk

Lee, Ga Young,Jang, Jin-Sung,Lee, Sin Yeob,Jeon, Hyo-Sung,Kim, Kyung Mee,Choi, Jin Eun,Park, Jung Min,Chae, Myung Hwa,Lee, Won Kee,Kam, Sin,Kim, In-San,Lee, Jae-Tae,Jung, Tae Hoon,Park, Jae Yong Wiley Subscription Services, Inc., A Wiley Company 2005 International journal of cancer: Journal internati Vol.115 No.5

<P>Polymorphisms in DNA repair genes may be associated with differences in the capacity to repair DNA damage and thereby influence an individual's susceptibility to smoking-related cancer. To test this hypothesis, we investigated the potential association of 7 XPC polymorphisms (–449G→C, –371G→A, –27G→C, Val499Arg, PAT–/+, IVS11-5C→A and Lys939Gln) and their haplotypes with lung cancer risk in a Korean population. XPC genotypes were determined in 432 lung cancer patients and 432 healthy controls frequency-matched for age and sex. XPC haplotypes were predicted using a Bayesian algorithm in the Phase program. The combined –27CG+CC genotype was associated with a significantly increased risk for overall lung cancer compared to the –27GG genotype (adjusted OR = 1.97, 95% CI 1.22–3.17, p = 0.005). The other 6 polymorphisms were not significantly associated with overall risk of lung cancer. When lung cancer cases were categorized by tumor histology, the –371AA genotype was associated with a significantly increased risk of squamous cell carcinoma compared to the combined –371GG and GA genotype (adjusted OR = 2.08, 95% CI 1.09–4.00, p = 0.03). The PAT–/+, IVS11-5C→A and Lys939Gln polymorphisms were associated with a significantly decreased risk of small cell carcinoma (SM) under a dominant model for the polymorphic allele (adjusted OR = 0.49, 95% CI 0.29–0.82, p = 0.006; adjusted OR = 0.60, 95% CI 0.36–1.00, p = 0.05; and adjusted OR = 0.58, 95% CI 0.35–0.97, p = 0.04, respectively). Consistent with genotyping analyses, haplotype 4 (1112222) containing the PAT+/IVS11-5A/939Gln alleles was associated with a significantly decreased risk of SM (adjusted OR = 0.56, 95% CI 0.37–0.85, p = 0.007 and Bonferroni-corrected p = 0.049), whereas haplotype 5 (1122111) containing the –27C allele was associated with a significantly increased risk of SM (adjusted OR = 2.88, 95% CI 1.41–5.87, p = 0.004 and Bonferroni-corrected p = 0.028). These results suggest that XPC polymorphisms/haplotypes may contribute to genetic susceptibility for lung cancer. © 2005 Wiley-Liss, Inc.</P>

장기간 비스포스포네이트 복용중인 환자에서의 경골에 발생한 비전형 골절 양상의 부전골절 - 증례 보고 -

박민정 ( Min Jung Park ),이수진 ( Su Jin Lee ),감진화 ( Jin Hwa Kam ),이윤태 ( Yun Tae Lee ),유주형 ( Ju Hyung Yoo ),오현철 ( Hyun Cheol Oh ),하중원 ( Joong Won Ha ),박융 ( Yung Park ),박상훈 ( Sang Hoon Park ),김성훈 ( Seong Hoo 대한골절학회 2017 대한골절학회지 Vol.30 No.3

장기간 비스포스포네이트를 복용한 환자에게서 다양한 증례의 비전형적 대퇴골 골절의 발생이 보고되어 왔으나 대퇴골 이외의 부위에서 비전형적 골절은 보고된 증례가 많지 않았다. 저자들은 장기간 비스포스포네이트를 복용한 환자에게서 외상 없이 경골 간부의 전외측 부위에서 발생한 비전형적 골절 양상의 부전골절을 경험하여 국내에서 처음으로 이의 치료 결과를 문헌 고찰과 함께 보고하고자 한다. Atypical femoral fracture related to a long-term bisphosphonate therapy has commonly been reported; however, a fracture at the site other than the femur has rarely been reported to date. Herein, we report a case of a patient on long-term bisphosphonate therapy who presented atypical tibial insufficiency fracture at the anterolateral aspect of diaphysis, without trauma. We, for the first time in Korea, present this case with a literature review.

Does Simultaneous Computed Tomography and Quantitative Computed Tomography Show Better Prescription Rate than Dual-energy X-ray Absorptiometry for Osteoporotic Hip Fracture?

( Jae Han Ko ),( Suhan Lim ),( Young Han Lee ),( Ick Hwan Yang ),( Jin Hwa Kam ),( Kwan Kyu Park ) 대한고관절학회 2018 Hip and Pelvis Vol.30 No.4

Purpose: This study aimed to evaluate the efficacy of simultaneous computed tomography (CT) and quantitative CT (QCT) in patients with osteoporotic hip fracture (OHF) by analyzing the osteoporosis detection rate and physician prescription rate in comparison with those of conventional dual-energy X-ray absorptiometry (DXA). Materials and Methods: This study included consecutive patients older than 65 years who underwent internal fixation or hip arthroplasty for OHF between February and May 2015. The patients were assigned to either the QCT (47 patients) or DXA group (51 patients). The patients in the QCT group underwent QCT with hip CT, whereas those in the DXA group underwent DXA after surgery, before discharge, or in the outpatient clinic. In both groups, the patients received osteoporosis medication according to their QCT or DXA results. The osteoporosis evaluation rate and prescription rate were determined at discharge, postoperative (PO) day 2, PO day 6, and PO week 12 during an outpatient clinic visit. Results: The osteoporosis evaluation rate at PO week 12 was 70.6% (36 of 51 patients) in the DXA group and 100% in the QCT group (P<0.01). The prescription rates of osteoporosis medication at discharge were 70.2% and 29.4% (P<0.001) and the cumulative prescription rates at PO week 12 were 87.2% and 60.8% (P=0.003) in the QCT and DXA groups, respectively. Conclusion: Simultaneous CT and QCT significantly increased the evaluation and prescription rates in patients with OHF and may enable appropriate and consistent prescription of osteoporosis medication, which may eventually lead to patients’ medication compliance.

급성 비특이성 장간막 림프절염의 임상 소견과 급성 충수돌기염과의 감별 인자

신경화,김갑철,이정권,이영환,감신,황진복,Shin, Kyung Hwa,Kim, Gab Cheol,Lee, Jung Kwon,Lee, Young Hwan,Kam, Sin,Hwang, Jin Bok 대한소아소화기영양학회 2004 Pediatric gastroenterology, hepatology & nutrition Vol.7 No.1

Purpose: Although acute nonspecific mesenteric lymphadenitis (ANML) is probably common cause of abdominal pain in children, which can be severe enough to be an abdominal emergency, the clinical features of mesenteric lymphadenitis are not clear. Also, a differential diagnosis with acute appendicitis (APPE) is indispensable to avoid serious complications. The clinical features of ANML were determined, and the risk factors for differential diagnosis with APPE were analyzed. Methods: Between November 2000 and May 2001, data from 26 patients (aged 1 to 11 years) with ANML and 21 patients (aged 2 to 13 years) with APPE were reviewed. ANML was defined as a cluster of five or more lymph nodes measuring 10 mm or greater in their longitudinal diameter in the right lower quadrant (RLQ) without an identifiable specific inflammatory process on the ultrasonographic examination. There were risk factors on patient's history, physical examination, and laboratory examination; the location of abdominal pain, abdominal rigidity, rebound tenderness, fever, nocturnal pain, the vomiting intensity, the diarrhea intensity, the symptom duration, and the peripheral blood leukocytes count. Results: Of the 26 ANML patients and 21 APPE patients, abdominal pain was noted on periumbilical (76.9% vs 14.2%), on RLQ (11.5% vs 71.4%), with abdomen rigidity (7.6% vs 80.9%), with rebound tenderness (0.0% vs 76.1%)(p<0.05), in the lower abdomen (11.5% vs 14.2%), and at night (80.8% vs 100.0%) (p>0.05). The clinical symptoms were vomiting (38.4% vs 90.4%), the vomiting intensity ($1.5{\pm}0.7$ [1~3]/day vs $4.5{\pm}2.9$ [1~10]/day), diarrhea (65.3% vs 28.5%) (p<0.05), and fever (61.5% vs 76.2%)(p>0.05). The period to the subsidence of abdominal pain in the ANMA patients was $2.5{\pm}0.5$ (2~3) days. The laboratory data showed a significant difference in the peripheral blood leukocytes count ($8,403{\pm}1,737[5,900{\sim}12,300]/mm^3\;vs\;15,471{\pm}3,749[5,400{\sim}20,800]/mm^3$)(p<0.05). Discriminant analysis between ANML and APPE showed that the independent discriminant factors were a vomiting intensity and the peripheral blood leukocytes count and the discriminant power was 95.7%. Conclusion: The clinical characteristics of ANML were abrupt onset of periumbilical pain without rigidity or rebound tenderness, a mild vomiting intensity, normal peripheral leukocytes count, and relatively short clinical course. If the abdominal pain persist for more than 3 days, and/or the vomiting intensity is more than 3 times/day, and/or the peripheral leukocytes count is over $13,500/mm^3$, abdominal ultrasonography is recommended to rule out APPE. 목 적: 급성 비특이성 장간막 림프절염(acute nonspecific mesenteric lymphadenitis, ANML)은 타 질환이 적절히 배제되었을 때 임상적 추정으로 진단하는 경우가 많아 그 실체에 대하여는 잘 알려져 있지 않다. 특히 급성 충수 돌기염(acute appendicitis, APPE)과의 감별에 혼란을 주어 복막염 등으로 이행되는 경우가 드물지 않다. ANML의 임상 소견을 보고하고, 특히 APPE와의 감별시 도움을 줄 수 있는 접근 방식을 연구하고자 한다. 방 법: 2000년 11월부터 2001년 5월까지 대구시 한영한마음연합소아과의원으로 급성 복통을 주소로 내원하여 ANML로 진단된 26명(남녀비 13:13)을, APPE 환자는 같은 기간 대구가톨릭대학병원을 방문하여 수술받은 21명(남녀비 12:9)을 대상으로 하였다. ANML 환자들은 복부 초음파 검사상 10 mm 이상, 5개 이상의 장간막 림프절이 관찰되면서 회장, 대장의 장벽 비후 소견이 5 mm를 넘지 않고 염증성 충수돌기가 관찰되지 않으며, 말초 혈액 검사, 소변 검사, 대변 검사상 타 질환을 의심할 소견이 없는 등을 진단기준으로 설정하였다. 결 과: 1) ANML군의 진단 당시 연령은 1~11세, $5.2{\pm}2.3$세였다. 2) ANML군의 복통 양상은 21례(80%)에서 야간 복통이 있었고, 위치는 배꼽 주위부 20례(76%), 우하복부 3례(11%), 하복부 3례(11%)였다. 2례(7%)에서 복부 강직이 있었고, 반발 압통은 전례에서 없었다. APPE군에서는 전례에서 야간 복통이 있었고, 17례(80%)에서 복부 강직이, 16례(76%)에서 반발 압통이 관찰되어 ANML군과 각각 유의한 차이를 보였다(p<0.05). 3) ANML군에서 복통의 회복까지 걸린 시간은 2~4일, $2.5{\pm}0.5$일이었다. 4) ANML군 10례(38%)에서 구토를 보였고 1~3회/일, $1.5{\pm}0.7$회/일이었다. 설사는 17례(65%)에서 있었고 1~4회/일, $1.6{\pm}0.8$회였다. APPE군 19례(90%)에서 구토가 있었으며 1~10회/일, $4.5{\pm}2.9$회로 ANML군과 유의한 차이를 보였다(p<0.05). APPE군의 설사는 6례(28%)에서 있었으며 1~5회/일, $2.1{\pm}1.6$회이었다. 5) ANML군에서 열은 19례(73%)에서 있었고, 말초혈액 백혈구 수는 $5,900{\sim}12,300/mm^3$이었으며 평균 $8,403{\pm}1,737/mm^3$이었다. APPE군에서는 열은 16례(76%)에서 관찰되었으며 백혈구 수는 $5,400{\sim}20,800/mm^3$으로 평균 $15,471{\pm}3,749/mm^3$이었으며 ANML군과는 유의한 차이를 보였다(p<0.05). 6) 판별분석을 이용하여 하루 구토의 강도와 백혈구 수를 독립변수로 하였을 때 ANML과 APPE는 95.7% 수준으로 분류되었다. 결 론: ANML과 APPE의 감별 시 복부강직, 반동압통 등 급성복증의 소견이 의심될 때 뿐만 아니라, 복통이 3일을 초과하여 지속되거나, 하루 구토가 3회를 초과하는 경우, 말초혈액검사상 백혈구 수가 $13,500/mm^3$ 이상을 보일 때에도 반드시 복부초음파 검사를 이용하여 APPE를 확인하여야 한다.