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Volume 4(5); October 2013
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Editorial
How to Manage a Public Health Crisis and Bioterrorism in Korea
Hae-Wol Cho, Chaeshin Chu
Osong Public Health Res Perspect. 2013;4(5):223-224.   Published online October 31, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.09.010
  • 1,235 View
  • 20 Download
  • 2 Citations
PDF
Original Articles
Investigation of Biofilm Formation and its Association with the Molecular and Clinical Characteristics of Methicillin-resistant Staphylococcus aureus
Jeong-Ok Cha, Jae Il Yoo, Jung Sik Yoo, Hae-Sun Chung, Sun-Hee Park, Hwa Su Kim, Yeong Seon Lee, Gyung Tae Chung
Osong Public Health Res Perspect. 2013;4(5):225-232.   Published online October 31, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.09.001
  • 1,578 View
  • 13 Download
  • 43 Citations
AbstractAbstract PDF
Objectives
To investigate the biofilm-forming related factors against MRSA bloodstream isolates and evaluates their clinical features and treatment outcomes by biofilm production.
Methods
We collected 126 consecutive methicillin-resistant Staphylococcus aureus (MRSA) causing blood stream infections (BSIs) at 10 tertiary hospitals from 2007 to 2009. We investigated biofilm-forming ability using a microtiter plate assay, and molecular characteristics including multilocus sequence typing, staphylococcal cassette chromosome mec and accessory gene regulator types. We compared the clinical characteristics and outcomes of patients infected with biofilm-forming and non-biofilm-forming MRSA isolates.
Results
Of the 126 samples, 86 (68.3%), including 5 strong level (OD570 ≥ 1.0) and 81 weak level (0.2 ≤ OD570 < 1.0), had biofilm-forming capacity. Detection of fibronectinbinding protein in biofilm-forming strains was significantly higher than biofilm non-forming ones (p = 0.001) and three enterotoxin genes (sec-seg-sei) islands had a high frequency regardless of biofilm production. However, biofilm-forming strains were more likely to be multidrug resistant (three or more non-β-lactam antibiotics) than biofilm non-forming ones [79.2% vs. 59.2%, p = 0.015, odds ratio (OR) 2.629, 95% confidence interval (CI) 1.92–5.81]. Clinical features of patients with BSIs caused by biofilm-forming MRSA strains were more likely to be hospital onset [77.9% vs. 60.0%, p = 0.024, OR 2.434, 95% CI 1.11–5.33) and more frequently occurred in patients with use of invasive devices [85.7% vs. 61.2%, p = 0.002, OR 3.879, 95% CI 1.61–8.97]. The other clinical features were compared with the clinical outcomes of the two groups and were not significant (p > 0.05).
Conclusion
Biofilm-forming MRSA strains showed higher frequency of fnbB gene than biofilm non-forming ones and more incidence rates on particular genotypes. And, their patient's features were not significantly different between two groups in this study, except for several clinical factors.
Community-Based Home Healthcare Project for Korean Older Adults
TaeBum Lee
Osong Public Health Res Perspect. 2013;4(5):233-239.   Published online October 31, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.09.002
  • 1,260 View
  • 15 Download
  • 5 Citations
AbstractAbstract PDF
Objectives
The aim of this study was to identify the effects of community-based home healthcare projects that influence service performances with regard to Korean national long-term care insurance services in older adults.
Methods
The project's applicants were 18 operational agencies in national long-term care institutions in Korea, and participants were care recipients (n = 2263) registered in long-term care institutions. We applied our healthcare system to the recruited participants for a 3-month period from October 2012 to December 2012. We measured the community-based home healthcare services such as long-term care, health and medical service, and welfare and leisure service prior to and after applying the community-based home healthcare system.
Results
After the implementation of community-based home healthcare project, all community-based home healthcare services showed an increase than prior to the project implementation. The nutrition management service was the most increased and its increase rate was 628.6%. A comparison between the long-term care insurance beneficiaries and nonbeneficiaries showed that health and medical services’ increase rate of nonbeneficiaries was significantly higher than beneficiaries (p < 0.001).
Conclusion
Our community-based home healthcare project might improve the service implementation for older adults and there was a difference in the increase rate of health and medical services between Korean national long-term care insurance beneficiaries and nonbeneficiaries.
The Impact of Emergency Room Utilization by Depression Patients on Medical Treatment Expense in Korea
Hyun Sook Lee
Osong Public Health Res Perspect. 2013;4(5):240-245.   Published online October 31, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.09.007
  • 1,230 View
  • 13 Download
  • 2 Citations
AbstractAbstract PDF
Objectives
To investigate the determinants of total medical expense for depression patients admitted through the emergency room (ER).
Methods
Data were selected from the Korean National Health Insurance sample data for 2009. SPSS version 18 was used for the statistical analysis such as descriptive analysis, correlation analysis, and multiple regression analysis. Data included 1203 cases admitted through the ER with ICD-10 codes (F31–F39).
Results
In the multiple regression analysis, significant variables affecting total payment were gender (p < 0.001), age (p < 0.001), main illness (p < 0.001), course of admission to the ER (p < 0.05), and length of stay (p < 0.001).
Conclusion
It is necessary to build a long-term program and system for high-risk depression groups.
Assessment of Antioxidant Potential, Total Phenolics and Flavonoids of Different Solvent Fractions of Monotheca Buxifolia Fruit
Shumaila Jan, Muhammad Rashid Khan, Umbreen Rashid, Jasia Bokhari
Osong Public Health Res Perspect. 2013;4(5):246-254.   Published online October 31, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.09.003
  • 1,726 View
  • 15 Download
  • 64 Citations
AbstractAbstract PDF
Objectives
This study was conducted to investigate the antioxidant potential of methanol extract and its derived fractions (hexane, ethyl acetate, butanol, and aqueous) of fruits of Monotheca buxifolia (Falc.) Dc., a locally used fruit in Pakistan.
Methods
Dried powder of the fruit of M. buxifolia was extracted with methanol and the resultant was fractionated with solvents having escalating polarity; n-hexane, chloroform, ethyl acetate, n-butanol and the residual soluble aqueous fraction. Total phenolic and total flavonoid contents were estimated for the methanol and various fractions. These fractions were also subjected to various in vitro assays to estimate the scavenging activity for 2,2-diphenyl-1-picrylhydrazyl (DPPH), 2,2-azino-bis-(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), superoxide, hydroxyl, hydrogen peroxide and reductive ability for ferric ions and phosphomolybdate assay.
Results
The n-butanol, aqueous and methanol fractions possessed high amount of phenolics and flavonoids compared with other fractions, and subsequently showed a pronounced scavenging activity on DPPH, ABTS, superoxide, hydroxyl and hydrogen peroxide radicals and had a potent reductive ability on ferric ion and phosphomolybdate assay. There was a found significant correlation between total phenolic and flavonoid contents and EC50 of DPPH, superoxide, hydrogen peroxide radical and phosphomolybdate assays, whereas a nonsignificant correlation was found with the hydroxyl radical and ABTS radical assay.
Conclusion
M. buxifolia fruit can be used as natural antioxidant source to prevent damage associated with free radicals.
Dynamic Integration of Mobile JXTA with Cloud Computing for Emergency Rural Public Health Care
Rajasekaran Rajkumar, Nallani Chackravatula Sriman Narayana Iyengar
Osong Public Health Res Perspect. 2013;4(5):255-264.   Published online October 31, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.09.004
  • 10,367 View
  • 15 Download
  • 11 Citations
AbstractAbstract PDF
Objectives
The existing processes of health care systems where data collection requires a great deal of labor with high-end tasks to retrieve and analyze information, are usually slow, tedious, and error prone, which restrains their clinical diagnostic and monitoring capabilities. Research is now focused on integrating cloud services with P2P JXTA to identify systematic dynamic process for emergency health care systems. The proposal is based on the concepts of a community cloud for preventative medicine, to help promote a healthy rural community. We investigate the approaches of patient health monitoring, emergency care, and an ambulance alert alarm (AAA) under mobile cloud-based telecare or community cloud controller systems.
Methods
Considering permanent mobile users, an efficient health promotion method is proposed. Experiments were conducted to verify the effectiveness of the method. The performance was evaluated from September 2011 to July 2012. A total of 1,856,454 cases were transported and referred to hospital, identified with health problems, and were monitored. We selected all the peer groups and the control server N0 which controls N1, N2, and N3 proxied peer groups. The hospital cloud controller maintains the database of the patients through a JXTA network.
Results
Among 1,856,454 transported cases with beneficiaries of 1,712,877 cases there were 1,662,834 lives saved and 8,500 cases transported per day with 104,530 transported cases found to be registered in a JXTA network.
Conclusion
The registered case histories were referred from the Hospital community cloud (HCC). SMS messages were sent from node N0 to the relay peers which connected to the N1, N2, and N3 nodes, controlled by the cloud controller through a JXTA network.
Evaluation and Selection of Multilocus Variable-Number Tandem-Repeat Analysis Primers for Genotyping Brucella abortus Biovar 1 Isolated from Human Patients
Subok Lee, Kyu-Jam Hwang, Mi-Yeoun Park, Seon-Do Hwang, Hee-Youl Chai, Hyuk Chu, Sang-Hee Park
Osong Public Health Res Perspect. 2013;4(5):265-270.   Published online October 31, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.09.005
  • 1,308 View
  • 15 Download
  • 1 Citations
AbstractAbstract PDF
Objectives
Brucellosis is the most common bacterial zoonosis in the world. Multilocus variable-number tandem-repeat (VNTR) analysis (MLVA) is a molecular method for genotyping bacterial species. Brucella abortus biovar I was isolated from most of the brucellosis-suspected patients in Korea. This study was conducted to investigate the ability of various MLVA primers that are used for molecular typing B. abortus isolates and for analyzing their epidemiological data.
Methods
A total of 80 human isolates of B. abortus biovar I isolated from human patients and the reference strain were used for MLVA. Genetic diversity was determined by calculating the Simpson's diversity index (DI) of each VNTR locus. The Brucella strains were subcultured 30 times to determine the stability of each locus. The DNA of the strains cultivated in each passage was extracted and subjected to MLVA for further investigation.
Results
The 15 VNTR loci were selected based on high DI values. The DIs of the 15 VNTR loci showed considerable discrimination power ranging from 59% for Bruce 43 to 87% for Bruce 22. Bruce 09, Bruce 11, Bruce 16, Bruce 42, and Bruce 43 were confirmed to remain stable in vitro among the 15 VNTR loci selected.
Conclusion
The results of this study suggest that the five loci subsets may be a useful epidemiological tool for investigating B. abortus biovar 1 outbreak.
Gastroprotective Potential of Dalbergia sissoo Roxb. Stem Bark against Diclofenac-Induced Gastric Damage in Rats
Muhammad Israr Khan, Muhammad Rashid Khan
Osong Public Health Res Perspect. 2013;4(5):271-277.   Published online October 31, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.09.006
  • 1,500 View
  • 23 Download
  • 14 Citations
AbstractAbstract PDF
Objectives
Dalbergia sissoo Roxb. stem bark possesses anti-inflammatory, antipyretic, and antioxidant properties. This plant is used traditionally in the Indian system of medicine to treat emesis, ulcers, leucoderma, dysentery, stomach complaints, and skin disorders. This study was conducted to evaluate the antiulcer effects of D. sissoo stem bark methanol extract (DSME) against the diclofenac sodium-induced ulceration in rat.
Methods
The DSME (200 mg/kg and 400 mg/kg body weight) was orally administered to rats once a day for 10 days in diclofenac-treated rats. The gastroprotective effects of DSME were determined by assessing gastric-secretory parameters such as volume of gastric juice, pH, free acidity, and total acidity. Biochemical studies of gastric mucosa were conducted to estimate the levels of nonprotein sulfhydryls (NP-SHs), lipid peroxidation [thiobarbituric acid reactive substances (TBARSs)], reduced glutathione (GSH), hydrogen peroxide (H2O2), levels of scavenging antioxidants, catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), glutathione-S-transferase (GST), and myeloperoxidase (MPO). Moreover, adherent mucus content and histological studies were performed on stomach tissues.
Results
Administration of DSME significantly decreased the ulcer index, TBARSs, H2O2, and MPO activity in gastric mucosa of the ulcerated rats. Activities of enzymic antioxidants, CAT, SOD, GSH-Px, GST and GSH, and NP-SH contents were significantly increased with DSME administration in the gastric mucosa of diclofenac-treated rats. Volume of gastric juice, total and free acidity were decreased, whereas pH of the gastric juice was increased with the administration of DSME + diclofenac. Our results show that DSME administration is involved in the prevention of ulcer through scavenging of free radicals. Results of histopathological studies supported the gastroprotective activities of DSME.
Conclusion
The results of this study showed that DSME exhibit potential gastroprotective activity probably due to its antioxidant and cytoprotection ability.
Brief Reports
Public Health Crisis Preparedness and Response in Korea
Hye-Young Lee, Mi-Na Oh, Yong-Shik Park, Chaeshin Chu, Tae-Jong Son
Osong Public Health Res Perspect. 2013;4(5):278-284.   Published online October 31, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.09.008
  • 1,383 View
  • 17 Download
  • 19 Citations
AbstractAbstract PDF
Since the 2006 Pandemic Influenza Preparedness and Response Plan according to the World Health Organization’s recommendation, the Republic of Korea has prepared and periodically evaluated the plan to respond to various public health crises including pandemic influenza. Korea has stockpiled 13,000,000 doses of antiviral drugs covering 26% of the Korean population and runs 519 isolated beds in 16 medical institutions. The division of public health crisis response in Korea Centers for Disease Control and Prevention are in charge of responding to public health crises caused by emerging infectious diseases including severe acute respiratory syndrome, avian influenza human infection, and pandemic influenza. Its job description includes preparing for emerging infectious diseases, securing medical resources during a crisis, activating the emergency response during the crisis, and fortification of capabilities of public health personnel. It could evolve into a comprehensive national agency to deal with public health crisis based on the experience of previous national emerging infectious diseases.
Introduction of the Republic of Korea–the United States of America's Joint Exercise Against Biothreats in 2013: Able Response 13
Seong Sun Kim, Dong Whan Oh, Hyun Jung Jo, Chaeshin Chu
Osong Public Health Res Perspect. 2013;4(5):285-290.   Published online October 31, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.09.009
  • 1,363 View
  • 13 Download
  • 8 Citations
AbstractAbstract PDF
The Republic of Korea (ROK) and the the United States of America (USA) has held joint exercises to respond to biothreats in the Korean Peninsula since 2011. The exercise was called Able Response (AR) and it aims to coordinate interministerial procedures inside Korea and international procedures in requesting the medical resources urgently between ROK and USA, and among ROK and the United Nations, and nongovernmental organizations. AR13 was a functional exercise with a scenario that presumed a series of attack by terrorists, dispersing Bacillus anthracis in Seoul. The participants conducted exercises with action cells and using point-to-point communication system. It was followed by Senior Leadership Seminar participated by high-ranking officials in ROK and USA to discuss possible collaboration in advance. AR and its following actions will fortify collaboration between ROK and USA and enhance the capability of countermeasures against biothreats in Korea.

PHRP : Osong Public Health and Research Perspectives