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Characteristics of Intravenous Midazolam Sedation with Nitrous Oxide in Pediatric Dental Treatment (소아환자에서 midazolam 정주 및 아산화질소 흡입진정법 하 치과치료의 특성)

  • Kim, Hyuntae;Song, Ji-Soo;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Shin, Teo Jeon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.47 no.1
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    • pp.53-61
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    • 2020
  • Midazolam is a short-acting benzodiazepine that is widely used in pediatric dental sedation. However, its clinical effectiveness as an intravenous sedative agent in children has not been widely documented. A retrospective study was conducted to evaluate the efficacy and safety of intravenous midazolam and nitrous oxide inhalation sedation in pediatric dental treatment. The subjects were 115 patients (118 cases) who received dental treatment under intravenous midazolam and nitrous oxide inhalation sedation. Demographic factors, general health status, sedation time, midazolam and nitrous oxide dosage, and success rate of sedation were evaluated from electronic medical records. Behavioral management was the main reason of choosing sedation. Mean duration of sedation was 56.7 minutes for surgical treatment, and 74.4 minutes for restorative treatment. The initial dosage of intravenous midazolam was 0.051 ± 0.019 mg/kg. In 34 cases (28.8%), additional midazolam of 0.036 ± 0.057 mg/kg was delivered during the treatment. The concentration of nitrous oxide was maintained between 40% and 50%. The success rate of sedation was 99% (n = 117). In 1 case, laryngospasm occurred and the patient was reversed with benzodiazepine antagonist, flumazenil. Intravenous midazolam sedation with nitrous oxide was shown to be clinically effective for the dental treatment in children, if administered by trained personnel and patients are carefully selected in accordance with guidelines.

Clinical Application of in Vivo Dosimetry System in Radiotherapy of Pelvis (골반부 방사선 치료 환자에서 in vivo 선량측정시스템의 임상적용)

  • Kim, Bo-Kyung;Chie, Eui-Kyu;Huh, Soon-Nyung;Lee, Hyoung-Koo;Ha, Sung-Whan
    • Journal of Radiation Protection and Research
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    • v.27 no.1
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    • pp.37-49
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    • 2002
  • The accuracy of radiation dose delivery to target volume is one of the most important factors for good local control and less treatment complication. In vivo dosimetry is an essential QA procedure to confirm the radiation dose delivered to the patients. Transmission dose measurement is a useful method of in vivo dosimetry and it's advantages are non-invasiveness, simplicity and no additional efforts needed for dosimetry. In our department, in vivo dosimetry system using measurement of transmission dose was manufactured and algorithms for estimation of transmission dose were developed and tested with phantom in various conditions successfully. This system was applied in clinic to test stability, reproducibility and applicability to daily treatment and the accuracy of the algorithm. Transmission dose measurement was performed over three weeks. To test the reproducibility of this system, X-tay output was measured before daily treatment and then every hour during treatment time in reference condition(field size; $10 cm{\times} 10 cm$, 100 MU). Data of 11 patients whose pelvis were treated more than three times were analyzed. The reproducibility of the dosimetry system was acceptable with variations of measurement during each day and over 3 week period within ${\pm}2.0%$. On anterior- posterior and posterior fields, mean errors were between -5.20% and +2.20% without bone correction and between -0.62% and +3.32% with bone correction. On right and left lateral fields, mean errors were between -10.80% and +3.46% without bone correction and between -0.55% and +3.50% with bone correction. As the results, we could confirm the reproducibility and stability of our dosimetry system and its applicability in daily radiation treatment. We could also find that inhomogeneity correction for bone is essential and the estimated transmission doses are relatively accurate.

The Effects of Global Entrepreneurship and Social Capital Within Supply Chain on the Export Performance (글로벌 기업가정신과 공급사슬 내 사회적 자본이 수출성과에 미치는 영향)

  • Yoon, Heon-Deok;Kwak, Ki-Young;Seo, Ri-Bin
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.7 no.3
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    • pp.1-16
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    • 2012
  • Under the international business circumstance, global supply chain management is considered a vital strategic challenge to small and medium-sized enterprises(SMEs) suffering from deficient resources and capabilities to exploit overseas markets comparing with large corporations. That is because they can expand their business domains into overseas markets by establishing strategic alliances with global supply chain partners. Although a wide range of previous researches have emphasized the cooperative networks in the chain, most are ignoring the importance of developing relational characteristics such as trust and reciprocity with the partners. Besides, verifying the relational factors influencing firms' export performances, some studies proposed different and inconsistent factors. According to the social capital theory, which is the social quality and networks facilitating close cooperation of inter-individual and inter-organization, provides the integrated view to identify the relational characteristics in the aspects of network, trust and reciprocal norm. Meanwhile, a number of researchers shows that global entrepreneurship is the internal and intangible resource necessary to promote SMEs' internationalization. Upon closer examination, however, they cannot explain clearly its influencing mechanism in the inter-firm cooperative relationships. This study is to verify the effect of social capital accumulated within global supply chain on SMEs' qualitative and quantitative export performance. In addition, we shed new light on global entrepreneurship expected to be concerned with the formation of social capital and the enhancement of export performances. For this purpose, the questionnaires, developed through literature review, were collected from 192 Korean SMEs affiliated in Korean Medium Industries Association and Global Chief Executive Officer's Club focusing on their memberships' international business. As a result of multi-regression analysis, the social capital - network, trust and reciprocal norm shared with global supply chain partner - as well as global entrepreneurship - innovativeness, proactiveness and risk-taking - have positive effect on SMEs' export performances. Also global entrepreneurship affects positively social capital which has mediating effect partially in the relationship between global entrepreneurship and performances. These results means that there is a structural process - global entrepreneurship(input), social capital(output), and export performances(outcome). In other words, a firm should consistently invest in and develop the social capital with global supply chain partners in order to achieve common goals, establish strategic collaborations and obtain long-term export performances. Furthermore, it is required to foster the global entrepreneurship in an organization so as to build up the social capital. More detailed practical issues and discussion are made in the conclusion.

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Quality Characteristics of Muhwakwa-pyun with Various Starches (전분 종류를 달리한 무화과편의 품질 특성)

  • 김병숙;정미란;이영은
    • Korean journal of food and cookery science
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    • v.19 no.6
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    • pp.783-793
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    • 2003
  • The effects of various kinds of starch (mungbean, potato, corn and a blend of potato and com starch) on the quality characteristics of muhwakwa-pyun were studied according to the storage duration. The sweetness, pH and total acidity of muhwakwa extract were analyzed, as were the Visco/Amylograph viscosity profile and DSC thermodynamic characteristics of starches. For quality characteristics, color difference, instrumental texture characteristics and sensory characteristics were compared. The sweetness of muhwakwa extract was satisfactory but the total acidity was low for Kwa-pyun manufacture. Therefore, its pH was adjusted to 3.4 by adding 10% citric acid with an amount of 1% of total liquid. From the Visco/Amylograph viscosity profile and DSC thermodynamic characteristics of starches, a blend of potato and com starch was found to be easy to cook and form a gel but a little more resistant than the other starches in terms of retrogradatin. Lightness (L) and yellowness (b) of Kwa-pyun increased while its redness (a) decreased by the storage. The color became whiter and the clarity decrease regardless of the kinds of starch, which became obvious after 3 days of storage. The hardness, springiness, adhesiveness and cohesiveness tended to decrease with storage, which was weak in a blend starch. The overall acceptability of Kwa-pyun made with a blend of potato and com starch was evaluated as being the best among the samples tested. Therefore, for traditional kwa-pyun manufacture manufacture mungbean starch might be replaced with a blend of potato and corn starch which is less expensive and easily available in the market nowadays.

A Case of Adult-onset Type II Citrullinemia Confirmed by Mutation of SLC25A13 (SLC25A13 유전자 돌연변이로 확진된 성인형 제 2형 시트룰린혈증 1례)

  • Jeung, Min Sub;Yang, Aram;Kim, Jinsup;Park, Hyung-Doo;Lee, Heon Ju;Jin, Dong-Kyu;Cho, Sung Yoon
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.16 no.1
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    • pp.34-41
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    • 2016
  • Adult-onset type II citrullinemia (CTLN2) is characterized by episodes of neurologic symptoms associated with hyperammonemia leading to disorientation, irritability, seizures, and coma. CTLN2 is distinct from classical citrullinemia, which is caused by a mutation of the argininosuccinic acid synthetase (ASS) gene. The serum citrulline level is elevated, while the activity of ASS in liver tissue is decreased. CTLN2 is known to have a poor prognosis if the proper treatment is not taken. We reported a female aged 37 years who developed recurrent attacks of altered consciousness, aberrant behavior, and vomiting. We initially suspected the patient had CTLN2 because of the signs of hyperammonemic encephalopathy, such as altered mentality, memory disturbance, and aberrant behaviors provoked by exercise-induced stress and excessive intravenous amino acid administration. Through her peculiar diet preferences and laboratory findings that included hyperammonemia and citrullinemia, we diagnosed the patient as CTLN2, and SLC25A13 sequencing revealed known compound heterozygous mutations (IVS11+1G>A, c.674C> A). Her parents were heterozygous carriers, and we identified that her older sister had the same mutations. The older sister had not experienced any episodes of hyperammonemia, but she had peculiar diet preferences. The patient and her sister have been well with conservative management. When considering the clinical course of CTLN2, it was meaningful that the older sister could be diagnosed early in an asymptomatic period and that preemptive treatment was employed. Through this case, CTLN2 should be considered in adults who present symptoms of hyperammonemic encephalopathy without a definite etiology. Because of its rare incidence and similar clinical features, CTLN2 is frequently misdiagnosed as hepatic encephalopathy, and it shows a poor prognosis due to the lack of early diagnosis and proper treatment. A high-carbohydrate diet, which is usually used to treat other urea cycle defects, can also exaggerate the clinical course of CTLN2, so proper metabolic screening tests and genetic studies should be performed.

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The effects of superovulatory doses of pregnant mare serum gonadotropin on uterine microenvironment of the rat (다배란 용량의 임마혈청성 고나도트로핀(PMSG)이 랫트의 자궁내 미세환경에 미치는 영향)

  • Yun, Young-won
    • Korean Journal of Veterinary Research
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    • v.34 no.4
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    • pp.745-757
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    • 1994
  • Superovulatory treatment with exogenous gonadotropins adversely affects the uterus through the disruption of the delicate balance of ovarian steroids (estrogens, progestins, androgens). To examine the uterine effects of this treatment, 189 rats were given 4IU, 20IU or 40IU pregnant mare',s serum gonadotropin(PMSG) at 28 days of age and sacrificed every 24h until day 10(D10) post injection. Long term uterine effects were examined in 12 rats treated with 4IU or 40IU PMSG and killed on D30. Adult rat uteri were examined to provide a reference for comparisons. Morphological and histological changes of control (4IU) uteri mimicked those of the adult on a comparable time-course form D2 to D5. Administration of superovulatory doses(20IU, 40IU) of PMSG produced stromal hypertrophy by D2 and focal papillary hyperplasia of the luminal epithelia by D3. Levels of $17{\beta}$-estradiol following 20IU and 40IU PMSG treatment were significantly(p<0.05, p<0.005) elevated above those of controls after D1. Androgen levels of both groups(20IU, 40IU) significantly p<0.05, p<005 increased from baseline on D1 and were maximum between D2 and D3. In the 20IU PMSG group, the hyperplasia gradually regressed after D3 and was absent by D10. The hyperplasia in the 40IU PMSG group, however, had become extensive by D6. It is suspected that preceding elevated levels of estrogen may be responsible for this progressive change. On D 4, the levels of $17{\beta}$-estradiol reached a maximum, which was significantly(p<0.001) greater than both the controls and 20IU PMSG-treated rats. Between D6 and D10, the hyperplasia in 40IU PMSG-treated rats partially regressed. Examination of uteri from D30 revealed no evidence of the hyperplasia. It is suggested that previous exposure to high levels of estrogen and androgens, secondary to superovulation, is possible cause for the observed hyperplasia.

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The Importance-Performance Analysis of Bakery Cafe Choice Attributes Perceived by Customers in Seoul (베이커리카페 선택속성의 중요도 및 수행도 분석: 서울지역을 중심으로)

  • Choi, Mi-Kyung;Jung, Jae-Chan
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.35 no.4
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    • pp.456-463
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    • 2006
  • The purposes of this study were to extract choice attributes of bakery cafe customers and to conduct important- performance analysis (IPA) of choice attributes perceived by bakery cafe customers. The questionnaire was developed through literature review and focus group interview, and modified after pilot test. The questionnaires for main survey were distributed to 320 males and females aged 20 and over in Seoul. A total of 275 questionnaires were used for analysis (85.9%) and the statistical analyses were conducted using SPSS Win (12.0) for descriptive analyses, exploratory factor analysis, reliability analysis, and correlation analyses. The main results were as follows. 'Products', 'convenience to use', 'services and price', 'interior environments' 'brand' and 'location' dimensions were extracted as choice attributes dimensions of bakery cafe customers and customers of bakery cafe regarded 'sanitation and cleanness', 'kindness of employees', 'quality of products', 'comfortable and pleasant facilities' and 'taste of bakery products' as more important than other attributes. In addition, the results of IPA showed that marketing managers of bakery cafes should focused on the dimension of 'services and price' in the reason that this dimension was low at performance although customers regarded it very important. Overall, researchers and managers of bakery cafes should understand unique choice attributes of bakery cafe customers, and make efforts to establish marketing strategies that meet bakery cafe customers' needs.

The Stakeholder's Response and Future of Mountain Community Development Program in Rep. of Korea (한국 산촌개발사업에 대한 이해관계자의 의식과 향후 발전방안)

  • Yoo, Byoung Il;Kim, So Heui;Seo, Jeong-Weon
    • Journal of Korean Society of Forest Science
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    • v.94 no.4 s.161
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    • pp.214-225
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    • 2005
  • The mountain village development program in Korea started in the mountain villages, the 45.9% of total land and one of the typical marginal region, from 1995 to achieve the equilibrium development of national land and the sustainable mountain development in Chapter 13 in Agenda 21, and it has been accelerated to increase the happiness and the quality of life of mountain community residents through the expansion by province and the improvement of related laws and regulations. This study has been aimed to analyze the response of main stakeholder's -mountain village residents and local government officials - on mountain villages development, and to provide the future plan as community development. The survey and interview data were collected from the mountain villages which already developed 59 villages and developing 15 villages in 2003. The mountain village development program has achieved the positive aspects as community development plan in the several fields, - the voluntary participation of residents, the establishment of self-support spirit as the democratic civilians, the development of base of income increasement, the creation of comfortable living environment, the equilibrium development with the other regions. Especially the mountain residents and local government officials both highly satisfy with the development of base of income increasement and the creation of comfortable living environment which are the main concerns to both stakeholder. However through the mountain development program, it is not satisfied to increase the maintenance of local community and the strengthening of traditional value of mountain villages. Also to improve the sustainable income improvement effects, it is necessary to develop the income items and technical extension which good for the each region. In the decentralization era, it is necessary for local government should have the more active and multilateral activities for these. With this, the introduction of methods which the mountain community people and the local government officials could co-participate in the mountain villages' development from the initial stages and the renovation of related local government organizations and the cooperatives will be much helpful to the substantiality of mountain development program. Also it is essential for the assistance of central government to establish the complex plan and the mountain villages network for all mountain area and the exchange of information, the education and training of mountain villages leader who are the core factor for the developed mountain villages maintenance, the composition of national mountain villages representatives. In case the development proposals which based on the interests of the main stakeholder's on mountain community could be positively accepted, then the possibility of the mountain village development as one of community development will be successfully improved in future.

Evaluation of Construction Operation and Design Properties of CLSM for Corrugated Pipe in Underground (파형강관을 이용한 지하매설물용 뒤채움재 설계 및 시공성 평가)

  • Lee Kwan-Ho;Park Jae-Heon
    • International Journal of Highway Engineering
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    • v.8 no.2 s.28
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    • pp.63-74
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    • 2006
  • During the construction of circular underground pipe, the non-proper compaction along the pipe and the decrease of compaction efficiency have been the main problems to induce the failure of underground pipe or facility. The use of CLSM (controlled low strength materials) should be one of the possible applications to overcome those problems. In this research, the full-scaled field test and the numeric analysis using PENTAGON-3D FEM program were carried out for three different cases on the change of backfill materials, including the common sand, the soil from construction site, and the CLSM. From the full-scaled test in field, the use of in-situ CLSM as backfill materials reduced the vertical and lateral deformation of the pipe, as well as the deformation of the ground surface. The main reason for reducing the deformation would be the characteristics of the CLSM, especially self-leveling and self-hardening properties. The measured earth pressure at the surround of the corrugated pipe using the CLSM backfills was the smaller than the other cases, and the absolute value was almost zero. Judging from the full-scaled field test and FEM analysis, the use of CLSM as backfill materials should be one of the best choices reducing the failure of the underground pipes.

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Prediction of Concrete Temperature and Its Effects on Continuously Reinforcement Concrete Pavement Behavior at Early Ages (초기재령에서 연속철근콘크리트포장 거동에 콘크리트 온도의 영향과 예측)

  • Kim Dong-Ho;Choi Seong-Cheol;Won Moon-Cheol
    • International Journal of Highway Engineering
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    • v.8 no.2 s.28
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    • pp.55-62
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    • 2006
  • Transverse cracks in continuously reinforced concrete pavement (CRCP) occur at early ages due to temperature and moisture variations. The width and spacing of transverse cracks have a significant effect on pavement performance such as load transfer efficiency and punchout development. Also, crack widths in CRCP depend on 'zero-stress temperature,' which is defined as a temperature where initial concrete stresses become zero, as well as drying shrinkage of concrete. For good long-term performance of CRCP, transverse cracks need to be kept tight. To keep the crack widths tight throughout the pavement life, zero-stress temperature must be as low as practically possible. Thus, temperature control at early ages is a key component In ensuring good CRCP performance. In this study, concrete temperatures were predicted using PavePro, a concrete temperature prediction program, for a CRCP construction project, and those values were compared with actual measured temperatures obtained from field testing. The cracks were also surveyed for 12 days after concrete placement. Findings from this study can be summarized as follows. First, the actual maximum temperatures are greater than the predicted maximum temperature in the ranges of 0.2 to 4.5$^{\circ}C$. For accurate temperature predictions, hydration properties of cementitious materials such as activation energy and adiabatic constants, should be evaluated and accurate values be obtained for use as input values. Second, within 24 hours of concrete placement, temperatures of concrete placed in the morning are higher than those placed in the afternoon, and the maximum concrete temperature occurred in the concrete placed at noon. Finally, from the 12 days of condition survey, it was noted that the rate of crack occurrence in the morning placed section was 25 percent greater than that in the afternoon placed section. Based on these findings, it is concluded that maximum concrete temperature has a significant effect on crack development, and boner concrete temperature control is needed to ensure adequate CRCP performance.

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