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Won Young Lee 10 Articles
Discriminant analysis on symptoms and signs and HFRS in Korea for early diagnosis
Joung Soon Kim, Young Joon Kim, Yong Heo, Won Young Lee, Cheong Dae Suh, Hae Kong Byun
Korean J Epidemiol. 1988;10(2):246-253.
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The major diseases causing hemorrhagic feb rile syndrome in Korea are Leptospirosis, Scrul Typhus, and HFRS (Hemorrhagic Fever with Renal Syndrome). Therefore, methods to provide a correct differ ential diagnosis is urgently required for the selection of adequate treatment in the early stage of infection, which will definitely help to reduce the mortality and/or the occurance of complications and duration of illness. At present, a differential diagnosis in early stage in very difficult because the epidemiological and clinical characteristics of them are much alike. Although the only reliable way of differentiation is antibody test, it is not applicable for those in early stage since a rise in specific antibody levels to be detectable requires 1 week after infection. The purpose of this study is to provide criteria which may help to specify Leptospirosis, Scrub Typhus, and HFRS for the early diagnosis and selection of proper treatment. One hundred and forty eight hospitalized patients because of high fever (more than 38°C) and similar symptoms with above mentioned diseases were studied for one year (Sep. 1987-Oct. 1988). Isolation of Leptospire and serologic test were done. Serologic test results for HFRS was obtained from medical record. Micro Agglutination Test(MAT) for Leptospirosis and Indirect Fluorescent Antibody test(IFAT) for Scrub Typhus were employed. The major findings are summarized as follows; 1) Four strains of leptospire were isolated. Sero-positive rates were 32.5 for Leptospire and 12.2% for Scrub Typhus. Among 148 patients, 24 cases (16.2%) were confirmed to be leptospiral infection by the bacterial isolation and/or serology. And 13 cases (8.8%) were confirmed to be R. tsutsugamushi infection by the serologic test. Among 25 patients who were transfered because of their suspicious symptoms of HFRS, only 9 patients were identified as Korea Antigen positives. 2) The majority (69%) of the Leptospiral positive sera reacted with locally isolated L. icterohamorragiae and canicola. The majority (77%) of the Rickettsial positive sera reacted with Gilliam strain. Among positive sera for Gilliam strain, 18% were found to cross-react with Kato strain. 3) The average duration of illness due to the infections were 71 days by HFRS (the longgest), 36 days by Leptospirosis, and 20 days scrub typhus, which was statistically significant. 4) Chi-square analysis and discriminant analysis were done to clarify the differences in clinico-physical findings of these infections which may differ from each other. Discriminant analysis was done by use of 37 symptoms, 27 physical signs and 4 vital signs as independent variables and 3 groups (Leptospirosis, scrub typhus, HFRS) as dependent variables. Chi-square analysis revealed that sputum and hemathemesis in Leptospirosis, abdominal reflect¬ed tenderness in scrub typhus and oliguria in HFRS were selected as the significant variables. Discriminant analysis also revealed that chest pain in Leptospirosis, CVA tenderness and high respiration rate in scrub typhus and oliguria, flask pain and peak diastolic blood pressure in HFRS were the significant variables.
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A study on epidemiology of leptospirosis in military personnel in Korea: bacterial isolation and serologic analysis
Joung Soon Kim, Yong Heo, Won Young Lee, Sang Soo Bae, Hae Kong Byun
Korean J Epidemiol. 1988;10(2):259-262.
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This report is a part of study results on Leptospirosis Control Campaign in Army. Total number of persons subjected in this study was 1, 889 which were studied in two seasons, 860 in autumn (October-November 1987) and 1029 in early summer (May-June 1988). The studies were mainly divided in two parts which includes epidemiological analysis and char acterization of the subjected population by interview survey and microbiological analysis including serologic studies on the same subjects to provide base line data for the Leptospirosis control which is an important health problem not only in military but also in general population in this country. The results are summarized as follows; 1) In bacterial isolation studies only 2 isolates were confirmed to be Leptospire and these two isolates demonstrated strong reaction with anti-L. icterohaemorrhagiae lai serum. 2) The percent of antibody positives serum to Leptospire confirmed by microagglutination tests(MAT) were 10.1% in autumn (1987) and 9.3% in early summer (1988). The difference in two study periods was not significant. 3) The seroconversion rate after the exposure to the field (military trainings) was 8.4%, which were tested a month after the exposure. No significant changes in seroconversion rates observed in 3 consecutive years since 1986(7.6%) were recognized. 4) The differences in antibody positive rates by their ranks, duration in military, their specialties and present military activities were not significant. Especially, those who served in military for a long time were found to have almost the same antibody positive rate compare to those served for shorter period of time.
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Current status of cancer research and future goals
Won Young Lee, Joung Soon Kim
Korean J Epidemiol. 1988;10(1):64-74.
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The current status of cancer research have been briefly summarized to clarify the problems remained to be solved for the cancer control. Cancer control program can be divided into three steps which are the general principle of disease control; the primary, the secondary, and the tertiary prevention. For the primary prevention, it is neccessary to iden¬tify the etiologic agent for the desease to be controlled. It has been reported that the agents associated with human cancers cannot be singled out. Furthermore, the genes which act a critical role(s) in pathways of tumorigenesis are our own in every normal cells. Thus, the primary prevention for the cancer can not be applicable at present except for the public health education especially when a certain risk factors are avoidable by changing human behaviors and working environments(eg; smoking and lung cancer). The tertiary prevention provides measures to help the persons recovered from the cancer to adapt to the society. However, this is applicable only when the secondary prevention measures are satisfactory and successful. Therefore, the only step we have to put our major efforts for the cancer control today may be the field of research for the secondary prevention. Since the secondary prevention depend upon the measures for the diagnosis and therapy for the patients suffering from the cancer, this is the urgently needed field not only for the patients but also the medical workers in this fields. Chemotherarpy and radiotherapy except surgery are the methods of cell killing by use of cytotoxic effect of the chemotherapeutics and radiation. The others are hyperthermia and photodynamic therapy which are not widely used at present. All of these methods have the limitation in use mainely due to the lack of the specificty. One of the methods to increase the specificity of these method were the introduction of the immunologic tools including monoclonal antibodies which can be used independently or in combinatory ways. However, practical value of the methods were not so much appreciated due to the heterogeneic nature of the tumor cells in various aspects. Also the use of the various types of the biological response modifiers have been extensively studied for the clinical applications. Those have been proved to be strong immune-adjuvants in vitro. Their role(s) in vivo especially for the tumor control remained to be analized. Emergence of the resistant cells, especially the fraction of the stem cell population following tumor therapy regardless the types of the therapy, chemotherapy or radiotherapy is the major problem to be solved. Thus, it is necessary to develope highly sensitive and specific chemotherapeutic method which may kill only the tumor cells leaving the normal cells alive. Efforts must be focused on the search and development of new agents. This may be the primary task in cancer control today. Because the development of new agents includes not only the new source of chemeotherapeutics but also the agents which can provide a certain complementary fuctions to the defects found in chemotherapy, radiotherapy, immunotherapy, and hyperthermia to maximize the efficiency of the therapy.
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HTLV-III / LAV that causes AIDS
Won Young Lee
Korean J Epidemiol. 1985;7(2):168-176.
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The newly identified HTLV-III /LAV that causes AIDS was reviewed. The virus shares many of the biological and physicochemical properties common to a family of retroviruses, HTLV which had discovered by Dr. Gallo et. al. The common properties are as follows: 1. tropism for T-lymphocytes(especially OKT4/leu3a positives) 2. presence of Mg++ requiring RNA dependent DNA polymerase 3. induction of multinucleated giant cells 4. structural proteins similar in size to HTLV-II antigens 5. homologous nucleotide sequences across entire genome of HTLV-I and HTLV-II except minor differences in X sequence. These findings clearly indicate HTLV-III/LAV as a member of the HTLV family. The pathobiological properties include: 1. At present, all of the cases with antibody to HTLV-III/LAV shoule be considered as possible virus carriers. 2. Other than T-cells can be infected(e.g. brain cells). 3. All of the people exposed to the virus are susceptible to the infection not necessarilly sexual intercourse). 4. HTLV-III/LAV viral positive without serum antibody can be existed. 5. All of the blood preparation for human infections must be screened for the possible existance of HTLV-III/LAV. 6. Asymptomatic HTLV-III/LAV carriers(antibody positive cases) are the most important cases to be traced for the public health.
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Panel discussion : AIDS control
Il Soon Kim, Yong Ik Kim, Joung Soon Kim, Taik Sung Nam, Hak Kyun Shin, Yoon Ok Ahn, Won Ha Yoo, Won Young Lee, Jung Bock Lee
Korean J Epidemiol. 1985;7(2):187-191.
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An epidemiological study on HBsAg and anti-HBs prevalence in relation to liver function tests among farmers in Korea
Joung Soon Kim, Won Young Lee, S.W Lee, Hee Sup Yoon, Sook Ja Yang, D.H Lee, H.C. Kim
Korean J Epidemiol. 1985;7(1):16-27.
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This study was carried out in a rural area for the adult population older than 20 years of age to find out the prevalence of HBsAg and Anti-HBs among the population, and particularly the relationship between the presence of HBsAg and liver function tests during November 1984. Six hundred fourteen persons were interviewed according to structured questionnaire, examined by physician, and blood was drawn for the tests. For the detection of HBsAg and Anti-HBs Eliza method was used. The liver function test including SGOT, SGPT, alkaline phosphatase, total bilirubin and albumin was done in an university hospital laboratory of clinical pathology. The results summarized are as followings: 1. The prevalence rate of HBsAg positive was 13.0% and Anti-HBs positive was 43.6% among the population studied. The age adjusted positive rate by sex showed higher rate in males(14.6%) than females(12.7%) for HBsAg, whereas the positive rate was higher in females than males for anti-HBs although these differences by sex were not statistically significant (p〉0.05). 2. The age specific positive rate for both HBsAg and anti-HBs revealed peaks on 30~39 yrs. age group even though the Anti-HBs showed a slight increase for the age group older than 60 years. 3. The HBsAg positive rate was the highest (17.6%) among simple labourers accompanied by the highest positive rate of anti-HBs (58.8%) and then farmers, sales worker, clerical workers showed higher positive rate in order when the positive rates were compared by occupation. Also the lower socioeconomic class revealed higher positive rate. 4. The positive rates of both HBsAg and Anti-HBs were not different statistically between alcohol drinkers and non-drinkers, cigarette smokers and non-smokers, and the group with past history of liver disease and that without the history. 5. The HBsAg positive group when compared with HBsAg and Anti-HBs negative group showed 1.9 times more in family history of liver disease, 1.5 times in surgical operation, 1.4 times in blood transfusion. 6. The abnormal liver function test was found to be much more frequent among persons with past or present history of liver disease than those without; 84.2% versus 17.9%. By each item of the liver function test the HBsAg positive group had 1.6 times more abnormal value of bilirubin, 1.3 times of SGPT, and 1.2 times of SGPT than those who were negative for both HBsAg and Anti-HBs. The SGOT/SGPT ratio was not statistically different between two groups HBsAg positive and negative.
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Biological characteristics of hepatitis A and B viruses
Won Young Lee
Korean J Epidemiol. 1982;4(1):1-10.
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A study on heterogeneity of chromosome and tumorigenicity in a mouse tumor cell line
Hai Won Chung, Joung Soon Kim, Won Young Lee
Korean J Epidemiol. 1982;4(1):158-174.
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The effects of culture conditions on the distribution of chromosome number in mouse Sarcoma 180 Y.S. cells were studied in respect to heterogeneity of their chromosome number and their tumorigenicity; four subpopulations separated by ficoll gradient centrifugation from in vivo cultured tumor cells demonstrated different tumorigenic properties and the hypotetraploid cells were found to be the most tumorigenic. The results summarized are as follows 1. The tumor cell populations were heterogeneous in their chromosome number and their tumorigenicity, and these heterogeneity could be changed by different culture conditions. The chromosome numbers of tumor cells cultured in vivo were varied from 15 to 140 with modal number of 110-120, while those cultured in vitro ranged from 60 to over 300 with modal number of 121-130. Frequency distribution of hypotetraploid cells in in vivo cultures was 22.3% whereas it was 2.4% in in vitro cultures. 2. When the tumor cells were cultured in vitro and inoculated into the peritoneum of mice, the frequency of cells with high chromosome number of more than 300 (15n) was increased from 1.2% to 8.6% and 33.1% as the passage number increased. Hypotetraploid cells were increased along with serial in vitro to in vivo passage. 3. Tumor producing ability in cells cultured in vitro was increased from 20% to 25% and 40% in accordance with serial in vivo passage thereafter. It is, therefore, suggested that altered characteristics of tumor cells cultured in vitro appeared to be reversed into their original properties by maintaining them in vivo. 4. When the tumor cells were separated by 10%, 15% and 20% ficoll concentration gradient, the highest relative frequency of hypotetraploid cells were found in 10% ficoll concentration. Fifty percent survival days of mice inoculated with these subpopulations were 25.3 days, 28.7 days and 29.4 days for each subpopulation separated by the concentration of 10%, 15% and 20% ficoll respectively. From the above results it is suggested that cells with high hypotetraploid among the heterogeneous tumor cell population appeared to be an important factor responsible for tumor producing ability.
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A study of the effect of radiation on chromosome number and tumorigenicity in a mouse tumor cell line
Hai Won Chung, Joung Soon Kim, Won Young Lee
Korean J Epidemiol. 1982;4(1):175-188.
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The effects of radiation on the distribution of chromosome number in mouse Sarcoma 180 Y.S. cells were studied in respect to heterogeneity of their chromosome number and their tumorigenicity. The results summarized are as follows: 1. Modal chromosome number were shifted from 111-120 to 101-110 when the tumor cells were irradiated with 300 rad - 700 rad of γ-rays, which is in the range within the sublethal irradiation dose (700 rad). The overall distribution of chromosome number, however, was not much different from that of control ceils. Frequency distribution of hypofcetraploid cells decreased gradually by increased radiation dose, for example in control the proportion of hypotetraploid cells was 22.3% whereas the proportion decreased to 16.4% in 100 rad irradiation group, 14.5% in 200 rad, 14.8% in 300 rad, 12.9% in 500 rad, and 5.9% in 700 rad irradiation group. 2. The tumorigenicity measured by the fifty percent survival day of inoculated mice, was also reduced according to the increased radiation dose; fifty percent survival days of mice inoculated with irradiated tumor cells (104 cells/mouse) in vivo by probit analysis were 25.2, 27.2 and 30.8 days with rariation dose of 0, 300 and 700 rad respectively on day 1 after irradiation. Similar results were obtained on day 6 after irradiation and fifty percent survival days were 23.0, 27.3 and 29.8 days at 0, 300 and 700 rad respectively. Tumorigenicity of the cells was proportional to the dose of cells inoculated, but it was proportionally decreased to the radiation dose. Moreover these results were consistent with Sarcoma producing ability in syngenic mice and the DNA synthetic ability in irradiated tumor cells. Considering these findings in relation to the chromosome number of the tumor cells, the reduction of tumorigenicity by γ-radiation seems to be correlated with reduction of hypotetraploid cells. Meanwhile when tumor cells were cultured in vitro, the proportions of cells with more than 200 chromosomes were increased in accordance as the radiation dose increased; 14.3% in control, 18.4% in 500 rad and 23.6% in 700 rad irradiation group. 3. Proportions of hypotetraploid tumor cells cultured in vivo after in vivo irradiation with 700 rad were 5.4% and 6% on day 1 and 6 after irradiation respectively, and 12.7%, 10% and 9% according to serial vivo passage thereafter. On the other hand the proportions of cells with more than 200 chromosomes in in vitro cultures after in vitro irradiation with 700 rad were increased to 23.6% from 14.3% on day 2, which was then decreased to 11% on day 20 after irradiation. 4. It may be concluded that repeated sampling of tumor cells and follow-up studies are necessary during the entire clinical course from early stage of the disease in the same patient because cytogenetic feature of tumor ceil population varied all the time according to their varying culture conditions and irradiation. Furthermore the tumor cell study may be of great help in determination of the subsequent treatment method after radiotherapy and/or chemotherapy for an effective and efficient management of cancer patient.
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Leptospira interrogans "Korea" isolated from patients with epidemic pulmonary hemorrhagic fever
Won Young Lee, Bong Ki Lee, Joo Deuk Kim, Joung Soon Kim, Sang Ok Kim
Korean J Epidemiol. ;6(1):36-46.
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Eight strains of Leptospira were isolated from patients with epidemic pulmonary hemorrhagic fever and natural rice field water samples. Sera from 23 out of 35 patients were strongly reacted with the isolated bacteria by slide agglutination test, immunofluorescent test and ELISA test. The major reacting immunoglobulins were IgM and IgG in the sera. All of the strains were equally pathogenic for guinea pig and mice, which were confirmed by pathology, immune-pathology and bacterial analysis of the sacrificed and dead animals with febrile symptom following the bacterial inoculation. The representative pathologic feature was massive hemorrhage due to diapedesis in the lung and intracellular existence of the bacterial antigens in liver and kidney, which were equally fluorescent positive for IgM, IgA, IgG and C3. The characteristics of the bacteria examined by pathogenicity, morphology and some of cultural behavior in artificial media were matched with Leptospira interrogans. Three strains electron microscope and the bacteria were found to be tightly coiled and the helix handedness was counter clock-wise (left). It is generally accepted that pathogenic spiral bacteria reported up to date are coiled clockwise (right). Therefore, it was concluded that the bacteria isolated from the patients via animal inoculation were the responsible agent for the human infection. They can be characterized as Leptospira interrogans according to pathogenicity, cultural behavior except the fact that their left handed coil. Thus, the bacteria were tentatively named as Leptospira "Korea”.
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Epidemiol Health : Epidemiology and Health