• Journal of the korean academy of Pediatric Dentistry
• /
• v.41 no.3
• /
• pp.257-265
• /
• 2014

The aim of this study was to establish the appropriate guidelines in the sedation techniques and to organize the continuing education programs for the sedation in future under the direction of Committee on Sedation, Education and Research under the Korean Academy of Pediatric Dentistry(KAPD). The surveys on the sedation technique were performed on 111 organizations which practices the sedation and responded to the survey via online and e-mail by February 2014. The collected survey were analyzed. The purpose of sedation was mainly to manage the children's behavior and its uses were primarily on 3~4 years old children. The most frequent duration of treatment was 1~2 hours to treat both maxillary and mandible. The preferred dosages of sedative drugs were chloral hydrate(CH) 50~70 mg/kg, hydorxyzine(Hx) 1~2 mg/kg, and intramuscular midazolam(Mida IM) 0.1~0.2 mg/kg. The preferred combination of the sedative drugs were CH + Hx + $N_2O/O_2$(67.6%), CH + Hx + Mida submucosal administration (SM) + $N_2O/O_2$(29.7%), and Mida IM + $N_2O/O_2$(23.4%). The administration of additional sedatives was carried out at 48%, mainly using Midazolam. 87.5% of the respondents experienced the adverse effects of the sedation such as vomiting/retching, agitation during recovery, subclinical respiratory depression, staggering, and etc. Among them, only 20% periodically retrain the emergency management protocol. About the discharge criteria for patients after the sedation, the respondents either showed a lack of clear criteria or did not follow the recommended discharge criteria. 86% of the respondents expressed the interests in taking a course on the sedation and they wanted to learn mostly about the sedation-related emergency management, the safe dosage of the sedative drugs, and etc. The use of sedation in pediatric dentistry must be consider a patient's safety as top priority and each dentist must show the evidence of sound practices for the prevention of any possible medical errors. Therefore, KAPD must establish the proper sedation guidelines and it needs to provide the systematic technical training program of sedation-related emergency management for pediatric dentists.

• The Korean Journal of Air & Space Law and Policy
• /
• v.23 no.2
• /
• pp.115-136
• /
• 2008

The development of the aviation technology is beyond the people's imagination. For example, with some exaggeration, If the autopilot engage upon take off, You will realize that you are on the centerline of the foggy JFK runway 13R after 15 hours with only once or twice of intervention. But the more aviation technology develops, the more responsible the pilot will be who has the final authority of the aviation safety. In the JAL 706 accident caused by unidentified reason, the pilot increased pitch abruptly and overrode the control from the autopilot. The result of this process made the death of a flight attendant and some injuries of a few passengers. The district court found the pilot not guilty at the first trial on the ground that the control override was not connected to the possibility of foresight and avoidance of the human death. The pilot was proved to be innocent through the analysis of the DFDR and ADAS that the override did not precede the unidentified pitch up motion. The judicial precedent related to aviation accidents in Korea requires pilots' absolute and extended care compared to the ordinarily prudent or reasonably careful behaviors in the vehicle and medical accidents. Although there is some controversy about the standard care, the care required in the actual operation of high tech aircraft by a pilot should include objective and standard care and be judged by analysis of the scientific data. Although the pilot maintained the unusual hi speed that doesn't have safety margin and descended under turbulence in case of the JAL 706 accident, the court negatived its relation to the cause of pitch up. Also, the override of the control after initial pitch up might have caused the possibility of the death and injury, but the court denied it. Because of this complex cause of the aviation accidents, it is important for a court to figure out the core reason of the event and casual relationship with the pilot Now, It is required that the judgement of negligence in the aviation accidents should include an objective care with scientific data from simulated circumstances(or a simulator) as the Japanese court not from the theory of vehicle's negligence.

• The Korean Journal of Air & Space Law and Policy
• /
• v.28 no.2
• /
• pp.63-96
• /
• 2013

Recently, U.S. Department of Transportation (DOT) expanded the "Enhancing Airline Passenger Protections" on August 23, 2011 and October 24, 2011. The Rule regulates tarmac delays, denied boarding compensation, customer service plans, and fare advertising. The adopted rule is to protect passengers by improving passenger service requirements on U.S. national or domestic carriers and foreign air carriers as well. The major issues are as follows: First, regarding to so called Tarmac Delay, carriers must establish a Tarmac Delay Contingency Plan setting forth the number of hours the carrier will permit an aircraft to remain on the tarmac at U.S. airports before allowing passengers to deplane. Carriers also must provide passengers with food and water in the event the aircraft remains on the tarmac for two or more hours and must provide operable lavatories and medical attention while the aircraft remains on the tarmac, irrespective of the length of the delay. Carriers also must create and retain records regarding tarmac delays lasting more than three hours. Also they need to update passengers every 30 minutes during a tarmac delay of the status of the flight and the reason for the delay, allow passengers to deplane if the aircraft is at the gate or another disembarkation area with the door open. Second, carriers now must adopt a "Customer Service Plan" that addresses offering customers the lowest fares available, notifying customers about delays, cancellations, and diversions; timely delivery of baggage; accommodating passengers' needs during tarmac delays and in "bumping cases"; and ensuring quality customer service. Third, the new regulations also increase minimum denied boarding compensation limits to $650 / $1,300 or 200% / 400% of the fare, whichever is less. Last, the DOT also has modified its policies related to enforcement of Rules pertaining to full fare advertising. The Rule states that the advertised price for air transportation must be the entire price to be paid by the customer. Similarly, Korea revised the passenger protection clauses within Aviation Act. However, it seems to be required to include various more issues such as Tarmac Delay, oversales of air tickets, involuntary denied boarding passengers, advertisements, etc.

• Tuberculosis and Respiratory Diseases
• /
• v.49 no.2
• /
• pp.179-188
• /
• 2000

Background : The decision to institute mechanical ventilation for patients with COPD is very difficult. The accurate information regarding weaning success and long-term survival will improve communication with patients and family and enhance informed consent. The aims of this study are to describe outcomes and identify variables associated with survival for patients experiencing mechanical ventilation with an acute respiratory failure of COPD. Methods : The 53 cases of mechanical ventilation in the intensive care unit in the National Medical Center from 1989 to 1998 were included. Data were collected retrospectively from medical records. Weaning success rate and 3 month and 1 year survival rates were estimated. Factors associated with weaning success and survival were determined. Results : Weaning sucess was 55%. For success group with 29 cases, 3 months survival rate was 61% and 1 year survival rate 37%. APACHE II scores in weaning success group were significantly lower than those in the failure group. Factors such as age, sex, comorbid-illnes. previous steroid use, causes of respiratory failure, RVH or arrhythmia on EKG, serum albumin level, arterial blood pH, $PaO_2$, $PaCO_2$, $FEV_1$ duration of mechanical ventilation and steroid use during mechanical ventilation were not associated with weaning success. Only age and serum albumin level were associated with 3 month and 1 year survival. No COPD patients of age more than 75 years and serum albumin level less than 3g/dl had survived at 1 year after weaning success. Conclusion : While weaning success from mechanical ventilation can be predicted by APACHE II score in COPD patients, long-term outcomes of survivors may be influenced by nutritional status and age.

• Tuberculosis and Respiratory Diseases
• /
• v.47 no.4
• /
• pp.460-470
• /
• 1999

Background : In 1993, American Thoracic Society (ATS) recommended a guideline for the initial management of adults with community-acquired pneumonia(CAP). However, etiologic organisms and medical system in Korea seem to be different from those in Western countries. Retrospective analysis was done to evaluate the efficacy of antibiotics chosen by ATS guideline in the treatment of Korean patients with CAP admitted to a tertiary university medical center. Methods : Hospitalized patients with CAP at Samsung Medical Center from April 1997 through March 1998 were retrospectively reviewed. Patients who fulfilled all of the following criteria were included in this study : (1) fever ${\geq}38^{\circ}C$ (2) purulent sputum (3) pulmonary infiltrates on chest X-ray. Patients were classified as : 1) ATS group ; patients whose initial antibiotics were chosen by ATS guideline 2) Non-ATS overuse group ; additional antibiotics administered more than those of ATS guideline, and 3) Non-ATS underuse group ; initial antibiotics were insufficient to ATS guideline. Response of empirical antibiotics and etiologic organisms of 3 groups were identified. Results : Sixty-four patients were enrolled. Thirty-six patients were classified into ATS group, 10 patients Non-ATS overuse group, and 18 patients Non-ATS underuse group. Thirty-three patients of 36 ATS group, 9 patients of 10 Non-ATS overuse group, and 14 patients of 18 Non-ATS underuse group showed improvement by initial empirical antibiotics. There was no statistical difference in antibiotic response between 3 groups (p>0.05). S. pneumoniae (12.5%), K. pneumoniae (9.4%), and P. aeruginosa (4.7%), Mycoplasma (3.1%) were the most commonly isolated organisms. In 18 patients with severe CAP, P. aeruginosa was isolated only in 1 patient and Legionella organism not isolated. Conclusion : Initial empirical antibiotics chosen by ATS guideline were effective in the management of Korean patients with CAP admitted to a tertiary hospital. However, well-designed large-scale prospective study is needed to identify etiologic organisms and choose an adequate initial empirical antibiotics in Korean adults patient with severe CAP.

• Tuberculosis and Respiratory Diseases
• /
• v.50 no.5
• /
• pp.599-606
• /
• 2001

Background : Since the advent of AIDS, tuberculosis has become a major public health problem in the western society. Therefore, it is essential that pulmonary tuberculosis be rapidly diagnosed. Light microscopic detection of acid-fast organisms in sputum has traditionally been used for rapidly diagnosing tuberculosis. However positive smears are only observed in about one-half to three-quarters of cases. Studies using PCR for diagnosing pulmonary tuberculosis disclosed several shortcomings suggesting an inability to distinguish between active and treated or inactive tuberculosis. In this study, the clinical significance of a PCR-based rapid technique for detecting Mycobacterium tuberculosis DNA in peripheral blood was investigated. Materials and Methods : From July 1, 1998 through to August 30, 1999, 59 patients with presumed tuberculosis, who had no previous history of anti-tuberculosis medication use within one year prior to this study were recruited and followed up for more than 3 months. AFB stain and culture in the sputum and/or pleural fluids and biopsies when needed were performed. Blood samples from each of the 59 patients were obtained in order to identify Mycobacterium Tuberculosis DNA by a PCR test. Results : 1) Forty five out of 59 patients had a final diagnosis of tuberculosis ; Twenty eight were confirmed as having active pulmonary tuberculosis by culture or biopsy. Four were clinically diagnosed with pulmonary tuberculosis. The other 13 patients were diagnosed as having tuberculous pleurisy (9) and extrapulmonary tuberculosis (4). 2) Fourteen patients showed a positive blood PCR test. The PCR assay correctly identified active tuberculosis in 13 out of 14 patients. The overall sensitivity and specificity of this blood peR assay for diagnosing tuberculosis were 29% and 93%, respectively. The positive predictive value was 93%, the negative predictive value was 29% and the diagnostic accuracy was 44%.3) Six out of 14(43%) patients with blood PCR positive tuberculosis were immunologically compromised hosts. 4) A simple chest radiograph in blood PCR positive tuberculosis patients showed variable and inconsistent findings. Conclusion : A peripheral blood PCR assay for Mycobacterium tuberculosis is not recommended as a screening method for diagnosing active tuberculosis. However, it was suggested that the blood PCR assay could contribute to an early diagnostic rate due to its high positive predictive value.

• Proceedings of The Korean Society of Health Promotion Conference
• /
• 2004.10a
• /
• pp.1-16
• /
• 2004

This paper considers the possibilities of health promotion from the following perspectives; (1) IUHPE, (2) socio-cultural similarities, (3) action research, and (4) learning from our past. 1. The IUHPE values decentralized activities through regions, and countries such as Japan, Korea, Hong Kong, Taiwan and China belong to NPWP region. Since IUHPE World Conference was held in Japan in 1995, Japan used to occupy more than 60% of NPWP membership. After 2001, membership is increasing rapidly in Chinese speaking sub-region. The transnational collaboration is still in its beginning phase. 2. Confucianism is one of key points. Confucian tradition should not be seen only as obstacles but as advantages to seek a form of health promotion more acceptable in East Asia. 3. Within the new public health framework, people are expected to create and live their health. However, especially in Japan, the tendency of 'lacking of face-to-face explicit interactions' is still common at health-promotion settings as well as academic settings. Therefore, the author tried participatory approaches such as asking WlFY (interactive questions designed for subjects to review their daily life and environment) and as introducing round table interactions. So far, majority of participants welcome new trials. 4. The following social phenomena are comparatively discussed after Japanese invasion and occupation of Korea ended in 1945; ·status of oriental medicine, ·separation of dispensary services, and ·health promotion specialist as a national license. In contrast to Japanese' tendency of maintaining the status quo and postponing of substantial social change, trend toward rapid and dynamic social changes are more commonly observed in Korea. Although all of above possibilities are still in their beginning stages, they are going to offer interesting directions waiting for further challenges and accompanying researches.

• Journal of Korean Medical Ki-Gong Academy
• /
• v.4 no.2
• /
• pp.153-186
• /
• 2000

Jigam(止感), Josik(調息), Kumchock(禁觸), from the lecture on Truth of ${\ll}Samilshingo{\gg}$(三一神誥) treat three elements of Kigong, regulation of mental activties, regulation of breathing and adjustment of posture and there are some similar mentions with the view of human body based on oriental medicine like those Samjin(三眞), Sammang(三妄), Samdo(三途) and Sippalkyoung(十八境) ect. Thus as a result of comparison and observation about the interrelationships between principle of Kigong in the lecture on Truth of ${\ll}Samilshingo{\gg}$(三一神誥) and oriental medicine. I have conclusion as follows. 1. According to the lecture on Truth, the components of human body are the one and only Samjin(三眞), Sammang(三妄) and Samdo(三途) resulted from facing Samjin(三眞) to Sammang(三妄) and Sippalkyoung(十八境). This fact presents the principle of human change. 2. the principle of Kigong mentioned in the lecture on Truth shows the original Ilshin(一神) on the basis of Samjin(三眞), Sammang(三妄), Samdo(三途) and Sippalkyoung(十八境). This makes common, unity and sound Sim(心), Ki(氣) and Shin(身), Sammang(三妄) through Jigam(止感), Josik(調息) and Kumchock(禁觸), be versed, intellected and guaranteed Sung(性), Myoung(命) and Jung(精), Samjin(三眞) and emit Kyun(見), Mun(聞), Ji(知) and haeng(行), Sadaeshingi(四大神機) and finally all these are harmonized into Duk(德), Hye(慧) and Ryuk(力), Samdae(三大) which is the entity of God. 3. Samsipyookjongmyowhasang(三十六種妙化相) is an ascetic practice done after a chulin(哲人) deduce Ji(止), Jo(調) and Kum(禁), Sambup(三法) on the basis of the lecture on Truth. So I suppose it correlates nature's six elements. Kong(空)(Chun(天)). Yol(熱)(Wha(火)). Jin(震(Jeon(電)), Seup(濕)(Shoo(水)), Han(寒)(Poong(風)) and Ko(固)(Ji(地)), human's Samjin(三眞), Sung(性), Myoung(命) and Jung(精) and Sammang(三妄), Sim(心), Ki(氣) and Shin(身) and makes clear the principle of discipline. 4. In comparison with Samjin(三眞) and Sammang(三妄) says from the lecture on Truth and the Three Essential Elements of the body construction(三寶) from oriental medicine, Samjin(三眞) and Sammang(三妄) as factors of human body in the concept of practical knowledge. That is the one and only Samjin(三眞) in terms of the Three Essential Elements of the body construction(三寶) is considered a structural principle for every single person and Sammang(三妄) is considered a functional form for each individual. And it can be Sung(性)+Sim(心)=Spirit(神), Myoung(命)+Ki(氣)=Vital Force(氣) and Jung(精)+Shin(身)=True Essence(精). 5. In comparison with Sippalkyoung(十八境) of Samdo(三途) from the lecture on Truth and three medical causes of disease, Gamdoyookkyoung(感途六境) is similar with endopathic cause caused by Naesangchiljung(內傷七情), Sikdoyukkyoung(息途六境) is similar with exopathic cause by six climatic conditions in excess as pathogenic factors(六淫) and Yoegi(?氣) and Chokdoyukkyoung(觸途六境) is similar with non-endo-exopathogenic causes by diet imbalance, fatigue, intemperance in sexual life and trauma etc. 6. In the lecture on Truth, the Chulin(哲人) who discipline Sambup(三法), Sangchul(上哲), Choongchul(中哲) and Hachul(下哲) can be compared with Kigong expert(health preserving expert) such as the Spiritual Men(眞人), the Sapients(至人), the Sages(聖人) and the Men of Exellent Virtue(寶人) in the Sang Gu Tian Zhen Lun of the Huang Ti Nei Ching Su Wen(素問 上古天眞論) and then Sangchul(上哲) is the Spiritual Men(眞人), Choongchul(中哲) is the Sapients(至人) and Hachul(下哲) is the Sages(聖人) while the men of Exellent Virtue(賢人) is inferior to Chulin(哲人) when he goes to extremes.

• Journal of dental hygiene science
• /
• v.11 no.6
• /
• pp.573-581
• /
• 2011

The purpose of this study was to examine the professionalism of dental hygienists in dental institutions and the influential factors for their professionalism in an attempt to seek ways of enhancing the professionalism of dental hygienists. The subjects in this study were 172 dental hygienists who worked in dental institutions in Busan and Gimhae. A self-administered survey was conducted to gather data, and an experimental analysis was carried out to analyze the collected data. The major findings of the study were as follows: First, concerning professionalism, self-regulation belief(3.70) ranked highest(3.42), followed by service belief(3.65), autonomy belief(3.31), a sense of vocational calling(3.30) and utilization of the professional organization as a standard(3.12). Second, the professionalism of the dental hygienists was significantly better when their title was higher, when they were older, when they got a larger monthly pay and when they intended to work for a longer time. Third, as for the influential factors for their professionalism, age, marital status, the estimated term of working at the workplace and opinion on reemployment were also identified as the significant variables that were up to the standard level of significance(p=0.05). The findings of the study suggest that in order to boost the professionalism of dental hygienists, it's required to take institutional measures to give them more responsibility, autonomy and authority, and how to improve personnel administration by providing strong motivation for them to look at their workplaces more favorably and keep on working for a long time should discreetly be considered.

• Journal of dental hygiene science
• /
• v.10 no.4
• /
• pp.241-250
• /
• 2010

The purpose of this study, which was processed from March $22^{nd}$ to April $9^{th}$ of 2010, was to figure out recognition, well-formed instructions, and Practical application about dental hygiene devices based on the dental health characteristics of 350 adults who dwell in Busan and Gyeongnam regions. Also, this study recommended the adults to use dental hygiene devices and provided such devices to help individuals take care of their dental health at home. The collected data was statistically processed with a statistics SPSS (Statistical Packages for Social Science 14.0. SPSS Inc. USA) program. First of all, in order to demonstrate the characteristics of the sample population statistics and that of the descriptive data, frequency analysis was performed and to find out the relationship between variations of the dental health, Chi-squared test through Crosstabs was operated. According to the study, recognition and Practical application of dental hygiene devices were very low. Therefore, public announcement about necessity and effectiveness of such devices should be reinforced nationwide and instructions on choosing the right device and using of the dental hygiene devices based on patients' conditions by dental hygienic human efforts gathered from dental health organization should be carried out.