• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.4
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• pp.331-339
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• 2015

The first priority of sedation for incorporative children in pediatric dentistry is a safety. Therefore, evidence-based practices in health care are needed for preventing medical accidents. In accordance with the rise of the evidence based medicine, the interest in Evidence-Based Dentistry is increasing in the field of dentistry. However, systematic research about Evidence-Based sedation in Korea has rarely been done. As such, the purpose of this systematic review is to critically analyze the available scientific literature regarding dental sedation and to seek the next developmental strategies about evidence based pediatric dental sedation. A broad search of the 5 databases of the systematic reviews manual of the National Evidence-based Healthcare Collaborating Agency in Korea were referenced: 1) Core search database- KMbase, KISS; 2) Academic information and portal; 3) the National Assembly Library; 4) DBpia, and 5) RISS. Of a total 470 themes limited to the search term of "dental sedation", in accordance with the PRISMA statement for reporting systematic reviews of health sciences interventions, a literature selection process, which includes the removal of overlapping down the flow chart, was performed. Of the remaining 31 articles, two authors read through articles independently and added or removed articles using the exclusion criteria. Finally, twenty published papers of acceptable quality were identified and reviewed. This systemic review of Korean pediatric dental sedation practices for the last twenty-five years was based on the objective criteria defined in the GRADE process and identified consistent evidence. The results were evidence of moderate quality. Therefore, more systemically well-designed clinical studies are needed about the safe use of a sedative medicines (drugs).

• Pediatric Infection and Vaccine
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• v.5 no.2
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• pp.245-257
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• 1998

Purpose : Although hepatitis B vaccine has been available to general population in Korea since 1983, it was difficult to compare various types of hepatitis B virus(HBV) vaccines primarily due to the differences in vaccination schedule, dosage, test methods and seropositive antibody level. In this study we reviewed the results of previous studies published in Korea, which include antibody positive rates and antibody titers of various vaccines, and examined the immunogenicity of these HBV vaccines. Methods : Studies published in medical journals, university journals concerning antibody positive rates following hepatitis B vaccination were reviewed. Inclusion criteria were those studies in which seroprotective antibody rate of 10mIU/mL or the sample ratio unit of 10 RU were used as the cut-off value and in which the test methods were RIA or ELISA. Exclusion criteria were; 1) unclear or inconsistent vaccine dosage, 2) no record of antibody titers or seroconversion rate, 3) no defined antibody rate or ratio for positive rating and 4) the vaccination schedule other than 0-1-2 months or 0-1-6 months. Results : 23 out of 52 studies were subjected for the review for seroconversion rates. 1) As for the immunogenicity in each age group, the seroconversion rates of Hepaccine(Cheil Jedang) were 85.1% in infants, 83.3% in children and 62.7% in adults, indicating higher rates in infants and children compared to adults(P<0.01). The seroconversion rates of Hepavax(Korea Green Cross) were 84.7%, 81.1% and 90.8%, indicating higher rates in infants and adults compared to children(P<0.01). 2) The seroconversion rate of Hepavax was 85.6% with 0-1-6 mo. schedule, 78.5% with 0-1-2 mo. schedule with a statistically significant difference(P<0.01). 4) There was no difference of seroconversion rates between the two doses of Hepavax, $5{\mu}g$ and $10{\mu}g$ in infants and children. 5) In adults the seroconversion rates were 62.7% with Hepaccine, 90.8% with Hepavax, and 94.8% with Engerix-B(SmithKline Beecham). Conclusion : In Korea, the incidence of chronic hepatitis B is high and changing the schedule in vaccination cannot contribute to the increase of the serocoversion rate. And in order to maximize immunogenicity, more effective vaccines as well as more proper vaccination methods should be used.

• The Korean Journal of Emergency Medical Services
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• v.22 no.1
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• pp.7-19
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• 2018

Purpose: With the purpose of educating and producing outstanding paramedics by enhancing their competencies, this study aimed to make policy suggestions to re-establish the education system and improve the national examination and the certification scheme. Methods: This study used focus group interviews and questionnaires to collect data. Totally, there were 277 subjects, including experts from the education and field. Data were collected from September 9 to 20, 2016, and analyzed using SPSS 22.0. Results: To strengthen the curriculum of paramedics, this study suggested 27 courses with 94 credits as the standardized curriculum and derived 9 core competencies of paramedics. For the national examination, this study suggested consolidating written test subjects, adding scenario questions to practical tests, and applying critical criteria to simple practical tests that performs a procedure, grading these tests on a pass/fail basis. In addition, this study suggested converting certification into license, reflecting paramedics' healthcare job characteristics. Conclusion: The quality of emergency medical services in Korea will improve when those with core competencies that originated from the standardized curriculum based on the results of this study acquire their certification through the national test scheme, and the certification management system creates a virtuous cycle to further enhance paramedics' professionalism.

• Health Policy and Management
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• v.34 no.1
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• pp.78-86
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• 2024

Background: The purpose of this study was to determine the effectiveness of the specialty hospital system by comparing the medical use of inpatients who had artificial joint replacement surgery in specialty hospitals and non-specialty hospitals. Methods: This study utilized 2021-2022 healthcare benefit claims data provided by the Health Insurance Review and Assessment Service. The dependent variable is inpatient medical use which is measured in terms of charges per case and length of stay. The independent variable was whether the hospital was designated as a specialty hospital, and the control variables were patient-level variables (age, gender, insurer type, surgery type, and Charlson comorbidity index) and medical institution-level variables (establishment type, classification, location, number of orthopedic surgeons, and number of nurses). Results: The results of the multiple regression analysis between charges per case and whether a hospital is designated as a specialty hospital showed a statistically significant negative relationship between charges per case and whether a hospital is designated as a specialty hospital. This suggests a significant low in charges per case when a hospital is designated as a specialty hospital compared to a non-specialty hospital, indicating that there is a difference in medical use outcomes between specialty hospitals and non-specialty hospitals inpatients. Conclusion: The practical implications of this study are as follows. First, the criteria for designating specialty hospitals should be alleviated. In our study, the results show that specialty hospitals have significantly lower per-case costs than non-specialty hospitals. Despite the cost-effectiveness of specialty hospitals, the high barriers to be designated for specialty hospitals have gathered the specialty hospitals in metropolitan and major cities. To address the regional imbalance of specialty hospitals, it is believed that ease the criteria for designating specialty hospitals in non-metropolitan areas, such as introducing "semi-specialty hospitals (tentative name)," will lead to a reduction in health disparities between regions and reduce medical costs. Second, it is necessary to determine the appropriateness of the size of hospitals' medical staff. The study found that the number of orthopedic surgeons and nurses varied in charges per case. Therefore, it is believed that appropriately allocating hospital medical staff can maximize the cost-effectiveness of medical services and ultimately reduce medical costs.

• The Korean Journal of Nuclear Medicine Technology
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• v.12 no.3
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• pp.235-240
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• 2008

Purpose: At the beginning of PET/CT, Computed Tomography was mainly used only for Attenuation Correction (AC), but as the performance of the CT have been increase, it could give improved diagnostic information with Contrast Media. But it was controversial that Contrast Media could affect AC on PET/CT scan. Some submitted thesis' show that Contrast Media could overestimate when it is for AC data processing. On the contrary, the opinion that Contrast Media could be possible to affect the alteration of SUV because of the overestimated AC. But it does not have a definite effect on the diagnosis. Thus, the affection of Contrast Media on AC was investigated in this study. Materials and Methods: Patient inclusion criteria required a history of a malignancy and performance of an integrated PET/CT scan and contrast- enhanced CT scan within a 1-day period. Thirty oncologic patients who had PET/CT scan from December 2007 to June 2008 underwent staging evaluation and met these criteria. All patients fasted for at least 6 hr before the IV injection of approximately 5.6 MBq/kg (0.15 mCi/kg) of $^{18}F$-FDG and were scanned about 60 min after injection. All patients had a whole body PET/CT performed without IV contrast media followed by a contrast-enhanced CT on the Discovery STe PET/CT scanner. CT data were used for AC and PET images came out after AC. The ROIs drew and measured SUV. A paired t-test of these results was performed to assess the significance of the difference between the SUV obtained from the two attenuation corrected PET images. Results: The mean and maximum Standardized Uptake Values (SUV) for different regions averaged over all Patients. Comparing before using Contrast Media and after using, Most of ROIs have the increased SUV when it did Contrast Enhanced CT compare to Non-Contrast enhanced CT. All regions have increased SUV and also their p value was under 0.05 except the mean SUV of the Heart region. Conclusion: In this regard, the effect on SUV measurements that occurs when a contrast-enhanced CT is used for attenuation correction could have significant clinical ramifications. But some submitted thesis insisted that the percentage change in SUV that can determine or modify clinical management of oncology patients is small. Because there was not much difference that could be discovered by interpreter. But obviously the numerical change was occurred and on the stage finding primary region, small change would be base line, such as the region of liver which has greater change than the other regions needs more attention.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.5
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• pp.2293-2303
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• 2013

Objective: This study aims to determine whether national patient safety indicators (PSIs) can be calculated. Methods: Using PSI criteria from Organization for Economic Co-Operation and Development (OECD) Health Technical Papers 19 based on the Agency for Healthcare Research and Quality (AHRQ), PSIs were identified in the Korean National Hospital Discharge In-depth Injury Survey (KNHDIIS) database for 875,622 inpatient admissions between 2004 and 2008. Logistic regression was used to estimate factors of variations for PSIs. Results: From 2004 to 2008, 3,084 PSI events of 8 PSIs occurred for over 80 thousands discharges. Rates per 1,000 events for decubitus ulcer (PSI3, 4.88), foreign body left during procedure (PSI5, 0.05), postoperative sepsis (PSI13, 1.32), birth trauma-injury to neonate (PSI17, 7.92) and obstetric trauma-vaginal delivery (PSI18, 32.81) are all identified between ranges from maximum to minimum of OECD rates, respectively. However, rates per 1,000 events for selected infections due to medical care (PSI7, 0.22), postoperative pulmonary embolism or deep vein thrombosis (PSI12, 0.90) and accidental puncture or laceration (PSI15, 0.71) are below the minimum of OECD range. 7 PSIs except PSI 18 showed statistically significant relationship with number of secondary diagnoses. When adjusting patient characteristics, there are statistically significant different rates according to bed size or location of hospitals. Conclusion: This is the first empirical study to identify nationally number of adverse events and PSIs using administrative database. While many factors influencing these results such as quality of data, clinical data and so on are remain, the results indicate opportunities for estimate national statistics for patient safety. Furthermore outcome research such as mortality related to adverse events is needed based on results of this study.

• Pediatric Infection and Vaccine
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• v.17 no.2
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• pp.156-168
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• 2010

Purpose : To compare immunogenicity and reactogenicity of a combined diphtheria-tetanus-acellular pertussis-inactivated poliovirus vaccine (DTPa-IPV, $Infanrix^{TM}$ IPV, GlaxoSmithKline Biologicals) with co-administration of commercially available DTPa and IPV vaccines at separate injection sites (DTPa+IPV). Methods : A total of 458 infants aged 8-12 weeks were randomized to receive three-ose primary vaccination at 2, 4 and 6 months with DTPa-IPV or DTPa+IPV. Blood samples were collected pre and post vaccination for measurement of immune responses. Reactogenicity was assessed following each dose using diary cards. Results : One month post-dose 3, seroprotection rates for anti-diphtheria, anti-tetanus and anti-poliovirus types 1, 2 and 3 were ${\geq}99.5%$ and vaccine response rates to pertussis antigens were at least 98.6% in both DTPa-IPV and DTPa + IPV groups. Non-inferiority between the groups was demonstrated based on pre-defined statistical criteria. Incidences of both local and systemic symptoms were within the same range across both groups with grade 3 symptoms reported following no more than 4.3% of DTPa-IPV doses and 4.5% of DTPa + IPV doses. Two serious adverse events (both pyrexia) after DTPa-IPV administration were considered vaccine-related. Both infants recovered fully. Conclusion : Combined DTPa-IPV vaccine was immunogenic and well tolerated when used as a three-dose primary vaccination course in Korean infants. DTPa-IPV could be incorporated into the Korean vaccination schedule, reducing the number of injections required to complete primary immunization.

• Sleep Medicine and Psychophysiology
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• v.26 no.1
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• pp.44-48
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• 2019

Objectives: Insomnia is one of the most prevalent sleep disorders. Recent studies suggest that cognitive and physical arousal play an important role in the generation of primary insomnia. Studies have also shown that information processing disorders due to cortical hyperactivity might interfere with normal sleep onset and sleep continuity. Therefore, focusing on central nervous system arousal and normalizing the information process have become current topics of interest. It has been well known that neurofeedback can reduce the brain hyperarousal by modulating patients' brain waves during a sequence of behavior therapy. The purpose of this study was to investigate effects of neurofeedback therapy on electroencephalography (EEG) characteristics in patients with primary insomnia. Methods: Thirteen subjects who met the criteria for an insomnia diagnosis and 14 control subjects who were matched on sex and age were included. Neurofeedback and sham treatments were performed in a random order for 30 minutes, respectively. EEG spectral power analyses were performed to quantify effects of the neurofeedback therapy on brain wave forms. Results: In patients with primary insomnia, relative spectral theta and sigma power during a therapeutic neurofeedback session were significantly lower than during a sham session ($13.9{\pm}2.6$ vs. $12.2{\pm}3.8$ and $3.6{\pm}0.9$ vs. $3.2{\pm}1.0$ in %, respectively; p < 0.05). There were no statistically significant changes in other EEG spectral bands. Conclusion: For the first time in Korea, EEG spectral power in the theta band was found to increase when a neurofeedback session was applied to patients with insomnia. This outcome might provide some insight into new interventions for improving sleep onset. However, the treatment response of insomniacs was not precisely evaluated due to limitations of the current pilot study, which requires follow-up studies with larger samples in the future.

• Journal of agricultural medicine and community health
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• v.48 no.2
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• pp.132-143
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• 2023

Objectives: We aimed to describe the reporting patterns of 6 notifiable surveillance diseases in the Republic of Korea, including water- and foodborne infections, from 2012 to 2021. Methods: For the 12,296 cases that met the reporting criteria, we calculated the number of reported cases, including the number of cases confirmed by lab tests or suspected by a physician, the number of cases with delayed reporting and their average days of delay, and the median days required to report the confirmatory test results. Results: The overall number of reported cases consistently increased over the ten years, with a significant rise in the reported cases of typhoid fever, paratyphoid fever, and EHEC. Ninety-five percent of all reported cases were timely reported within one day of diagnosis. Vibrio vulnificus had the highest rate of delayed reporting (6.8% delayed over 1 day, 3.0% delayed over 3 days), while cholera had the lowest rate (1.9% delayed over 1 day, 0.1% delayed over 3 days). The average days of delayed reporting was 6.1 days: the highest for paratyphoid fever (10.8 days) and the lowest for cholera (2.7 days). For typhoid fever and paratyphoid fever, there has been an increase in the proportion of cases with negative test results. For vibrio vulnificus, there has been an increase in the proportion of cases with confirmed positive test results. As for EHEC, there has been a recent increase in cases with no confirmatory tests. Conclusions: Reported cases of water- and foodborne infectious diseases increased, indicating improved surveillance system completeness. However, for paratyphoid fever, improvements are needed in terms of timely notification by healthcare facilities and timely reporting of confirmatory test results.

• The Journal of Korean Academy of Sensory Integration
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• v.21 no.2
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• pp.69-83
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• 2023

Objective : This study sought to systematically examine the intervention effect of social stories when applied in relation to children with sleep disorders. Methods : Studies available in the SCOPUS, ScienceDirect, PsycArticles, and PubMed databases that were published from 2001 to 2022 were searched. The keywords used for the search were as follows: ("social story" OR "social stories") AND ("sleep" OR "sleep disorders" OR "sleep wake disorder bedtimes" OR "sleep initiation and maintenance disorders" OR "sleep wake disorder" OR "sleep arousal disorders"). Based on the selection criteria, six experimental studies were selected and analyzed. Results : The selected studies were two randomized controlled trials, three individual trials, and one case study. The subjects were mostly children diagnosed with autism spectrum disorder who were school-aged or adolescent. The intervention types were often complex interventions, including social stories and other interventions, while the durations of the interventions varied from one day to more than 40 days. The interventions had a positive effect on the subjects' sleep quality, with night wakings, sleep onset delay, and sleep anxiety all being improved. As standardized assessment tools to evaluate the effectiveness of social stories, the Child Sleep Habits Questionnaire and the Child Behavior Checklist were used in two papers each, and were the most commonly used. As non-standardized assessment tools, each of the four papers used turbulence and sleep diaries as assessment tools. Conclusion : The effect of social story mediation can be divided into sleep quality and sleep-related behavior. In terms of sleep quality, studies showing improvements in night wakings, sleep onset delay, and sleep anxiety accounted for a large proportion of the sample. The detailed effect area of sleep quality showed a significant improvement after the interventions in most studies, and in all six studies analyzed in the present study, the continuation of the effect after the intervention was confirmed via follow-up tests. Thus, the findings of this study are expected to be helpful when applying social stories in children with sleep disorders in clinical practice due to presenting the intervention effects, outcome evaluation tools, and intervention periods in children with sleep disorders in prior investigations involving social stories.