• Title/Summary/Keyword: Medical safety

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Survey of Sedation Practices by Pediatric Dentists (소아치과의사의 진정법 사용에 대한 실태조사)

  • Yang, Yeonmi;Shin, Teojeon;Yoo, Seunghoon;Choi, Seongchul;Kim, Jiyeon;Jeong, Taesung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.3
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    • pp.257-265
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    • 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.

A SURVEY OF DENTAL TREATMENT UNDER OUTPATIENT GENERAL ANESTHESIA IN DEPARTMENT OF PEDIATRIC DENTISTRY AND CLINIC FOR DISABLED AT YONSEI UNIVERSITY DENTAL HOSPITAL (연세대학교 치과대학병원 소아치과 및 장애인 클리닉에서 시행된 외래 전신마취하의 치료에 대한 연구)

  • Lee, Dong-Woo;Song, Je-Seon;Choi, Hyung-Jun;Kang, Jeong-Wan;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.1
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    • pp.65-72
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    • 2010
  • General anesthesia has been researched and developed in dentistry as on type of management technique to sedate patients who may be uncontrollable or require medical consideration. There has been continuous research into this area, but analysis of large set of patients over a sustained period of time is lacking. Thus, this study analyzes the records of patients who received general anesthesia at the Yonsei University Dental Hospital Department of Pediatric and Clinic for the Disabled. 1. Patient's age ranged from 1 to 66, with under 5 being the largest group with 410 members(38.5%). The study included more men than women, with 695 male members(65.3%). 2. Type of dental procedure performed were as follows(per person) : 5.6 Dental restoration; 2.3 Endodontic treatment of deciduous and primary teeth; 2.5 preformed crowning; and 1.6 extractions. Procedures took an average of 100 minutes. 3. 1022 patients(95.9%) received dental care under general anesthesia once and 43 patients(4.1%) received dental care under general anesthesia two or more times. Dentistry under general anesthesia has the many benefit. However, without appropriate post-treatment care, it is difficult to maintain good oral health. Therefore, it is important to improve the efficiency and safety of general anesthesia through future research.

A Study on The Records of [The Book of Supernumerary Embryo Preservation] and [The Book of Supernumerary Embryo Donation] Enacted by "The Law on Bioethics and Safety" ("생명윤리 및 안전에 관한 법률"이 정해준 [잔여배아보관실적대장]과 [잔여배아제공실적대장]의 작성에 관한 연구)

  • Yoon, San-Hyun;Ko, Yong;Lim, Jin-Ho
    • Clinical and Experimental Reproductive Medicine
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    • v.34 no.4
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    • pp.253-273
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    • 2007
  • Objective: This study was to find ways to let a manager or superintendent rationally and consistently inspect as well as let a embryologist precisely record [The Book of Supernumerary Embryo Preservation] and [The Book of Supernumerary Embryo Donation]. Methods: Based on the data collected between 1994 and 2004 in Clinic 44 (Maria Fertility Hospital), [The Present State about Production and Use of Embryos], [The Preservation of Supernumerary Embryos and Their Thaw State], [The Present State about Thaw and Use of Frozen Embryos], [The Present State about Donation and Charge of Frozen Embryos], [The Book about Frozen Embryo Discard], and [The Summarization Book about Management and Use of Frozen Embryos] were designed and recorded. Results: The production, use, preservation, discard and donation quantity of human embryos, the use and discard quantity of thawed embryos, and the cumulative embryo preservation quantity could be totalized in [The Present State about Production and Use of Embryos in Clinic 44]. Also, [The Preservation of Supernumerary Embryos and Their Thaw State in Clinic 44] supported "the supernumerary embryo preservation quantity" etc. In addition, [The Present State about Thaw and Use of Frozen Embryos in Clinic 44] or [The Book about Frozen Embryo Discard in Clinic 44] supported "the use and discard quantity of thawed embryos" etc. Moreover, "The embryo donation quantity" could be totalized in [The Present State about Donation and Charge of Frozen Embryos in Clinic 44]. Finally, [The Summarization Book about Management and Use of Frozen Embryos in Clinic 44] could be used for rational and consistent management or inspection. Conclusion: The present results suggest that the documents not only be standard data to record [The Book about Supernumerary Embryo Preservation in Clinic] and [The Book about Supernumerary Embryo Donation in Clinic] but can also be preserved as treatment references.

Changes in phytoestrogen contents and antioxidant activities during fermentation of soybean-powder milks prepared from different soybean cultivars by Lactobacillus plantarum P1201 (Lactobacillus plantarum P1201에 의한 콩 품종별 콩-분말 두유 발효 과정에서의 식물성 에스트로젠 함량과 항산화 활성의 변화)

  • Hwang, Chung Eun;Haque, Md. Azizul;Lee, Jin Hwan;Ahn, Min Ju;Lee, Hee Yul;Lee, Byong Won;Lee, Yu-Young;Lee, Choonwo;Kim, Byung Joo;Park, Ji-Yong;Sim, Eun-Yeong;Lee, Dong Hoon;Ko, Jong Min;Kim, Hyun Tae;Cho, Kye Man
    • Korean Journal of Microbiology
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    • v.52 no.2
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    • pp.202-211
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    • 2016
  • This study evaluated the changes of phytoestrogen contents and antioxidant activities of soybean-powder milk (SPM) prepared from yellow soybean during fermentation with Lactobacillus plantarum P1201. In consequence, the levels of total phenolic and isoflavone-aglycone contents, ABTS and DPPH radical-scavenging activities, and FRAP assay values increased, while isoflavone-glycoside contents decreased during fermentation. The highest levels of daidzein, glycitein, and genistein were present in the Daepung SPM at concentrations of 177.92, 20.64, and $106.14{\mu}g/g$, respectively after 60 h of fermentation. Moreover, Daepung SPM showed the highest DPPH radical-scavenging activity of 48.54%, an ABTS radical-scavenging activity of 99.25%, and a FRAP assay value of 0.84 at the end of fermentation. The fermented Daepung SPM possessed highest isoflavone aglycone contents and antioxidant activities, which can be utilized for the development of functional foods.

Failure Properties of Common Tendon Origins at the Human Elbow after Static and Repetitive Loading (정적 및 반복하중 시의 주관절 Tendon의 파괴 물성치 측정)

  • Han, Jeong-Su;Lee, Gwan-Hui;Yu, Jae-Yeong
    • Journal of Biomedical Engineering Research
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    • v.19 no.4
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    • pp.393-401
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    • 1998
  • Based on clinical observations, it is suspected that the bone-tendon origin is the site where piratical failure, leading to pathophysiological changes in the humeral epicondyle after repetitive loading, is initiated Mechanical properties and failure patterns of the common extensor and flexor tendons of the humeral epicondyle under static and repetitive loading have not been well documented. Our goal was to determine mechanical properties of failure strength and strain changes, to correlate strain changes and the number of cyclic repetitions, and to identify the failure pattern of bone-tendon specimens of common extensor and flexor tendons of the humeral epicondyle. Mechnaical properties of human cadaver bone-tendon specimens of the common extensor and flexor tendons of the humeral epicondyle were tested under two different loading rates. No statistically significant difference in ultimate tensile strength was found between male and female specimens or between slow (10 mm/sec) and fast elongation (100 mm/sec) rates. However, a statistically significant difference in ultimate tensile strength between the common extensor (1190.0 N/$cm^2{\pm}$388.8) and flexor 1922.0 N/$cm^2{\pm}$764.4)tendons was found (p<0.05). When loads of 25%, 33%, and 41% of the ultimate tensile strength of their contralateral sides were applied, the number of cycles required to reach 24% strain change for the common extersor and flexor tendons were approximately 8,893, 1,907, and 410, respectively. The relationship between cycles and loads was correlated ($R^2$=0.46) Histological observation showed that complete or partial failure after tensile or cyclic loadings occurred at the transitional zone, which is the uncalcified fibrocartilage zone between tendon and bone of the humeral epicondyle. Sequential histological sections revealed that failure initiated at the upper, medial aspect of the extensor carpi radialis brevis tendon origin. Biomechanical and hstological data obtained in this study indicated that the uncalcified fibrocartilage zone at the bone-tendon origin of the common extensor and flexor tendons is the weak anatomical structure of the humeral epicondyle.

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College-bound Curriculum Developement for Training of Atomic Industry Technician (원자력산업 중견전문인력 양성을 위한 전문대학 교육과정 개발)

  • Lyu, Kwang-Yeul;Kim, Sung-Soo;Ahn, Sung-Min
    • Journal of radiological science and technology
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    • v.28 no.1
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    • pp.33-44
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    • 2005
  • The objective of this study is to supply the good quality of experts the radiation industries in Korea and develop the major subject matter needed in the radiation industries and the curriculum in order to execute it for the variation of fields of employment at the department of radiation in the junior college and the development of the percentage of employment. In addition, this study is to improve the level of radiation experts engaged in the industries in quality, and it is to improve the social recognition of radiation rather negative now because of the development of radiation industry. As for the core results of this research, it was to suggest the detailed choice method curriculum proper to the service fields of radiation industries, but it may be subject to change due to each college's property and the educational objectives. From the result of this research above, it may be summed up as follows. First, as for the detailed curriculum by the service field, this study was to organize two subject matters: 1. the subject matter proper to the field of using the radiation, and 2. the subject matters proper to the safety control field of radiation. Second, as for the detailed curriculum by the pattern of industries, this study was to organize the four subject matters: 1. the subject matter needed in the manufactures, 2. the subject matter needed in the nondestructive testing industries, 3. the subject matter needed in the sales agencies, and 4. the subject matter needed in the laboratories. This study was to suggest the operational model about the curriculum in order to execute these subject matters. It could be executed as two methods below. First, one method is to execute the major systems by the medical field and industrial field in the third course at the department of radiation in the junior college now. Second, the other method is to make them specialize the industrial radiation in the Advanced Course(one year course) after the graduation of junior college. To operate these curricula successively it needs to assume the deeper research and the development of materials about the subject matters related to the nuclear radiation industries hereafter. In addition, it needs to solve the security of finance like the manpower of professor, space for practice, and the educational appliances, etc. needed in the operation of subject matters. Finally, the effect and result from the development or revision of college curriculum did not come out in a short time. It will require considerable time until the undergraduates at the department in the junior college finish a set of curriculum newly developed, and graduate the university, and can get the results while they engage in their works in the industrial sites. Accordingly, all the interested parties have to anticipate the results of this research with the patience in long-standing point of view. Also, this researcher considers it as it is willing to give them the continuous interest and support.

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Study of External Radiation Expose Dose on Hands of Nuclear Medicine Workers (핵의학 종사자에서 손 부위의 외부 피폭선량 연구)

  • Park, Jun-Chul;Pyo, Sung-Jae
    • Journal of radiological science and technology
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    • v.35 no.2
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    • pp.141-149
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    • 2012
  • The aims of this study are to assess external radiation exposed doses of body and hands of nuclear medicine workers who handle radiation sources, and to measure radiation exposed doses of the hands induced by a whole body bone scan with high frequency and handling a radioactive sources like $^{99m}Tc$-HDP and $^{18}F$-FDG in the PET/CT examination. Skillful workers, who directly dispense and inject from radiation sources, were asked to wear a TLD on the chest and ring finger. Then, radiation exposed dose and duration exposed from daily radiation sources for each section were measured by using a pocket dosimeter for the accumulated external doses and the absorbed dose to the hands. In the survey of four medical institutions in Incheon Metropolitan City, only one of four institutions has a radiation dosimeter for local area like hands. Most of institutions uses radiation shielding devices for the purpose of protecting the body trunk, not local area. Even some institutions were revealed not to use such a shielding device. The exposed doses on the hands of nuclear medicine workers who directly handles radioactive sources were approximately twice as much as those on the body. The radiation exposure level for each section of the whole body bone scan with high frequency and that of the PET/CT examination showed that radiation doses were revealed in decreasing order of synthesis of radioactive medicine and installation to a dispensing container, dispensing, administering and transferring. Furthermore, there were statistically significant differences of radiation exposure doses of the hands before and after wearing a syringe shielder in administration of a radioactive sources. In this study, although it did not reach the permissible effective dose for nuclear medicine, the occupational workers were exposed by relatively higher dose level than the non-occupational workers. Therefore, the workers, who closely exposed to radioactive sources should be in compliance with safety management regulations, and take actions to maximally reduce locally exposed dose to hands monitoring with ring TLD.

A Study on Mechanical Errors in Cone Beam Computed Tomography(CBCT) System (콘빔 전산화단층촬영(CBCT) 시스템에서 기계적 오류에 관한 연구)

  • Lee, Yi-Seong;Yoo, Eun-Jeong;Kim, Seung-Keun;Choi, Kyoung-Sik;Lee, Jeong-Woo;Suh, Tae-Suk;Kim, Joeng-Koo
    • Journal of radiological science and technology
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    • v.36 no.2
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    • pp.123-129
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    • 2013
  • This study investigated the rate of setup variance by the rotating unbalance of gantry in image-guided radiation therapy. The equipments used linear accelerator(Elekta Synergy TM, UK) and a three-dimensional volume imaging mode(3D Volume View) in cone beam computed tomography(CBCT) system. 2D images obtained by rotating $360^{\circ}$and $180^{\circ}$ were reconstructed to 3D image. Catpan503 phantom and homogeneous phantom were used to measure the setup errors. Ball-bearing phantom was used to check the rotation axis of the CBCT. The volume image from CBCT using Catphan503 phantom and homogeneous phantom were analyzed and compared to images from conventional CT in the six dimensional view(X, Y, Z, Roll, Pitch, and Yaw). The variance ratio of setup error were difference in X 0.6 mm, Y 0.5 mm Z 0.5 mm when the gantry rotated $360^{\circ}$ in orthogonal coordinate. whereas rotated $180^{\circ}$, the error measured 0.9 mm, 0.2 mm, 0.3 mm in X, Y, Z respectively. In the rotating coordinates, the more increased the rotating unbalance, the more raised average ratio of setup errors. The resolution of CBCT images showed 2 level of difference in the table recommended. CBCT had a good agreement compared to each recommended values which is the mechanical safety, geometry accuracy and image quality. The rotating unbalance of gentry vary hardly in orthogonal coordinate. However, in rotating coordinate of gantry exceeded the ${\pm}1^{\circ}$ of recommended value. Therefore, when we do sophisticated radiation therapy six dimensional correction is needed.

Association of Liver Dysfunction with Self-Medication History in Korean Healthy Male Adults (건강한 한국 성인남성의 자가약물복용력에 따른 간기능 장애 발생여부 조사)

  • Bae, Jong-Myon;Park, Byung-Joo;Lee, Moo-Song;Kim, Dong-Hyun;Shin, Myung-Hee;Ahn, Yoon-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.4 s.55
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    • pp.801-814
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    • 1996
  • Background: Korean people could abuse healthy foods as well as medications, which might cause serious side effects. The aim of this study was elucidating liver dysfunction due to the self-medications of hepatotonics, healthy foods and herb medications by nested case-control study. Methods: Study subjects were drawn from male members of Seoul Cohort Study who were recruited by self-administered structured questionnaire survey through mailing to the healthy men between the age of 40 and 59 years through the program of biennial health check-up offered by Korea Medical Insurance Corporation(KMIC). The liver dysfunction was defined as the level of serum AST and ALT above 40 IU/L and increased in more than one hunderd per-cent during the 2 year follow-up period. To estimate the odds ratio between self-medication and liver dysfunction after controlling for potential confounders, logistic regression was performed. Results: During the follow-up period, 30 members were identified to fit into case criteria and 2,625 members were selected as control. In logistic regression analyses, history of healthy foods intake, age under 45 years, obesity, and habit of regular exercise were significantly associated with liver dysfunction. The following factors exhibited no statistical significance: intake of hepatotonics, of herb medicine; history of disease in family, of operation, and of radiologic examination; smoking habits and drinking amounts. Conclusion: The significant association between the intake of healthy foods and the liver dysfunction illustrates that chronically optional overuse of healthy foods might bring to hazards to health. As the increasing trend of the size of purchasing healthy foods in Korea, pharmacoepidemiologic studies evaluating the safety and efficacy of the widely used healthy foods should be performed in the near future.

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The Factors Affecting the Population Outflow from Busan to the Seoul Metropolitan Area (지역별 수도권으로의 인구유출에 영향을 미치는 요인 연구: 부산시 사례를 중심으로)

  • LIM, Jaebin;Jeong, Kiseong
    • Land and Housing Review
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    • v.12 no.2
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    • pp.47-59
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    • 2021
  • This study aims to review the trends of the population outflows in the metropolitan area of Busan and to investigate the factors that affect population out-migration to the Seoul metropolitan area. The following variables are considered for analysis: traditional population movement variables and quality of life variables, such as population, society, employment, housing, culture, safety, medical care, greenery, education, and childcare. The 'domestic population movement data', provided by the MDIS of the National Statistical Office, was used for this research. Out of the total of 57 million population movement data in the period 2012 - 2017, population outmigration from Busan to the Seoul metropolitan area was extracted. Independent variables were drawn from public data sources in accordance with the temporal and spatial settings of the study. The multiple linear regression model was specified based on the dataset, and the fit of the model was measured by the p-value, and the values of Adjusted R2, Durbin-Watson analysis, and F-statistics. The results of the analysis showed that the variables that have a significant effect on population movement from Busan to the Seoul metropolitan area were as follows: 'single-person households', 'the elderly population', 'the total birth rate', 'the number of companies', 'the number of employees', 'the housing sales price index', 'cultural facilities', and 'the number of students per teacher'. More positive (+) influences of the population out-movement were observed in areas with higher numbers of single-person households, lowers proportions of the elderly, lower numbers of businesses, higher numbers of employees, higher numbers of housing sales, lower numbers of cultural facilities, and lower numbers of students. The findings suggest that policies should enhance the environments such as quality jobs, culture, and welfare that can retain young people within Busan. Improvements in the quality of life and job creation are critical factors that can mitigate the outflows of the Busan residents to the Seoul metropolitan area.