Republic Of Korea Army Research Articles

Pharmacokinetics of hydroxychloroquine and its clinical implications in chemoprophylaxis against malaria caused by Plasmodium vivax.

Hydroxychloroquine (HCQ) is an antimalarial drug used as chemoprophylaxis against malaria caused by Plasmodium vivax in the Republic of Korea Army (ROKA). In this study, we evaluated the pharmacokinetics (PK) of HCQ and its metabolites and the relationship between the PK of HCQ and the effect of treatment of HCQ on vivax malaria in South Koreans. Three PK studies of HCQ were conducted with 91 healthy subjects and patients with vivax malaria. Plasma concentrations were analyzed by noncompartmental and mixed-effect modeling approaches. A two-compartment model with first-order absorption best described the data. The clearance and the central and peripheral volumes of distribution were 15.5 liters/h, 733 liters, and 1,630 liters, respectively. We measured the plasma concentrations of HCQ in patients with prophylactic failure of HCQ and compared them with the prediction intervals of the simulated concentrations for HCQ from the final PK model built in this study. In 71% of the patients with prophylactic failure, the plasma concentrations of HCQ were below the lower bounds of the 95% prediction interval, while only 8% of them showed higher levels than the upper bounds of the 95% prediction interval. We report that a significant cause of prophylactic failure among the individuals in ROKA was ascribed to plasma concentrations of HCQ lower than those predicted by the PK model. However, prophylactic failure despite sufficient plasma concentrations of HCQ was confirmed in several individuals, warranting continued surveillance to monitor changes in the HCQ susceptibility of Plasmodium vivax in the Republic of Korea.

Recurrence rate of vivax malaria in the Republic of Korea

In the Republic of Korea (ROK), military antimalarial chemoprophylaxis was initiated in 1997. Although chemoprophylaxis reduces malaria cases, long-term chemoprophylaxis could increase resistance. In this study, the recurrence rate of vivax malaria was investigated. All vivax malaria cases that occurred before 31 December 2003 among soldiers and veterans who entered the ROK army between 1 January 1998 and 28 February 2001 were reviewed. Of the 3881 reported cases (2375 soldiers and 1506 veterans), 62 (1.6%) experienced a second attack and 2 (0.05%) experienced a third attack. Fifteen cases (24.2%) recurred < or =60 days and 43 cases (69.4%) recurred >180 days after the start of initial treatment. Most of the second attacks (54/62) were exposed to malaria risk after initial treatment. Among 1506 veterans, 5 (0.3%) recurred and they had not been exposed to malaria risk after retirement; 1 recurred 43 days and 4 recurred >180 days after the start of initial treatment. All recurring cases were completely cured using the same dosage and regimen used for the first or second treatments. In conclusion, few cases of vivax malaria recurred after standard treatment. It is suggested that recurrences of vivax malaria are effectively prevented by the current treatment regimen and dosage.

Evaluation of Anti-Malarial Effects of Mass Chemoprophylaxis in the Republic of Korea Army

Vivax malaria was endemic on the Korean peninsula for many centuries until the late 1970's when the Republic of Korea (ROK) was declared "malaria free". Since its re-emergence in 1993, the number of malaria cases in the military increased exponentially through 2000 near the demilitarized zone. Chemoprophylaxis with chloroquine and primaquine has been used in the ROK Army since 1997 in an attempt to reduce the number of the malaria cases throughout the ROK. Data show that chemoprophylaxis contributed, in part, to the decrease in the number of malaria cases among military personnel. However, mass chemoprophylaxis on a large scale in the ROK Army is unprecedented and extensive supervision and monitoring is warranted to determine its effectiveness and to monitor the appearance of chloroquine tolerant/resistant strains of Plasmodium vivax.

Effectiveness of primaquine terminal prophylaxis against late primary attacks of Plasmodium vivax malaria: a case-control study among troops of the Republic of Korea Army

Plasmodium vivax malaria is an important cause of morbidity among troops operating in endemic areas near the Demilitarized Zone in the Republic of Korea (ROK). The ROK Army has been administering antimalarial chemoprophylaxis to those troops at greatest risk of malaria since 1997. The number of recipients increased from 15 000 in 1997 to 90 000 in 2001. We undertook a case—control study to estimate the effectiveness of primaquine prophylaxis against late primary attacks of P. vivax malaria in ROK Army troops. Microscopically confirmed cases of P. vivax malaria were identified through hospital-based surveillance. Controls were matched by unit. Between 1 November 2001 and 31 May 2002, 68 cases and 137 matched controls with confirmed chemoprophylaxis status were enrolled. The estimated effectiveness of primaquine prophylaxis was 32% (95% CI 23–63%). Our results suggest that the effectiveness of primaquine prophylaxis against late primary attacks of P. vivax malaria may be insufficient for soldiers of the ROK Army.

Quality improvement of barrack life in the Republic of Korea army

The Republic of Korea Army (ROKA) has been making every effort to improve the quality of the barrack-life environment. Recently, ROKA introduced a new scheme that allows soldiers to spend their free time on learning a foreign language and enhancing their computer skills, as well as enjoying more leisure time. In this paper, we use SERVQUAL in order to analyse the effect of the new scheme. The results indicated that the largest gap appears in the basic infrastructure (e.g. space and equipment) to support such free time activities. We learn from the structural equation model based on SERVQUAL that strict commitment from the top management level is necessary to accomplish the goal of the new system. In order to drive strategies to be employed by the top level, we use a hierarchical QFD. The results of QFD imply that it is necessary to allow soldiers to carry more personal property, such as portable cassette players, into barracks and to re-establish both the responsibility and authority of the squad leader and enlisted men. This study result is expected to improve effectively the quality of the barrack-life environment in ROKA.

North Korean Military Tactics

In 1985 the Republic of Korea (ROK) military, with the assistance of a North Korean defector and thirty procured North Korean related reference materials, began a revision of it’s perceived understanding of North Korean military tactics. In 1997 with the procural of many important North Korean reference materials, the ROK military refined its interpretation of North Korean tactics, and with the publication of 30-7 Reference Manual series, dated 2000.1.31, Understanding the Enemy, the ROK Army College revised its teachings on North Korean tactics. This research paper, written while I was a student at the ROK Army College, is predominately based on Reference Manual 30-7-1, Understanding the Enemy (volume 1) – North Korean Military Tactical Doctrine, Regiment Level and Higher.

Prevalence Of Intestinal Parasites In Roka Solidiers

A survey of intestinal parasites was performed during the period from April 1970 to December 1971 in ROKA (Republic of Korea Army) soldiers. Samples were collected from 591 Army troops(enlisted men), 1,755 recruits at completion of 6 weeks basic training, 304 recruits during basic training and 245 stool specimens of students of ROKA Nursing School at Taegu area. Each of the specimens was examined one time or twice under the microscope, one for protozoan cysts stained with iodine solution and the other for helminth eggs. Findings were summerized as follows: 1. A positive rate of intestinal parasites was 88.0 % by Formalin-Ether concentration method and 89.2 % by Kato's method. 2. Of the 541 soldiers examined by Formalin-Ether concentration method, the infection rate of A. lumbricoides was 28.1 %, T. trichiurus 79.3 %, hookworm 14.2 %, T. orientalis 30.7 %, C. sinensis 7.8 % and M. yokogawai 0.6 %. 3. Of the 1,532 soldiers examined by Kato's method A. lumbricoides showed positive rate of 45.8 %, T. trichiurus 78.3 %, T. orientalis 1 4.5 %, hookworm 7.5 %, C. sinensis 6.6 % and Taenia sp. 0.6 %. 4. The incidence of E. vermicularis out of 822 samples was 19.8 % from the anal swabs. 5. E. histolytica was recovered in 4.2 % among 541 samples, E. coli 6.1 % and also infected G. lamblia, E. nana, I. butschlii and Chilomastix mesnili. 6. Most of the infected cases revealed single or double infections.

An Introduction to the Medical Field Service School, Republic of Korea Army

An Introduction to the Medical Field Service School, Republic of Korea Army