• Title/Summary/Keyword: Safety related

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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.

Comparison of Clinical Efficacy Between Percutaneous Dilatational Tracheostomy and Surgical Tracheostomy (경피적 확장 기관절개술 (Percutaneous Dilatational Tracheostomy)의 시술 용이성 및 합병증)

  • Ahn, Jong-Joon;Koh, Youn-Suck;Chin, Jae-Yong;Lee, Ki-Man;Park, Wann;Hong, Sang-Bum;Shim, Tae-Sun;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Lim, Chae-Man
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1277-1283
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    • 1998
  • Background : Surgical tracheostomy(ST) is usually performed by surgeons in operating room. For a patient with mechanical ventilation, however, transportation to operating room for ST could be dangerous for patients. In addition, ST is often delayed due to unavailability of operating room or surgeon. Percutaneous dilatational tracheostomy(PDT), although novel in Korea, is gaining popularity as a bedside procedure in the hospitals of western countries. We evaluated the technical ease and safety of PDT in comparison with ST. Method : Thirty-eight patients in medical intensive care unit (ICU) who were either under mechanical ventilation for more than 7 days or required airway protection, were randomly assigned to ST(18 patients) or PDT(20 patients). Between two groups, there was no significant clinical difference except that female to male ratio was higher in the ST group. ST was performed by second year residents of the department of otolaryngology while PDT was performed by third grade medical resident and pulmonologist under bronchoscopic guide using Ciaglia Percutaneous Tracheostomy Set(Cook Critical Care, Bloomington, USA) in medical ICU. The following factors were compared between two groups : number of delayed cases after the decision for tracheostomy, procedural time, complications related to tracheostomy. Results : Delayed cases were 11 in ST group and 3 in PDT group (P<0.05). Procedural time was significantly shorter in PDT group ($15.6{\pm}7.1min$) than in ST group ($29.1{\pm}11.6min$, P<0.0001). Complications related to tracheostomy occurred in 5 cases in ST group : accidental decannulation (1), subcutaneous emphysema (2) and minor bleeding (2), and in 4 cases in PDT group : minor bleeding (2), subcutaneous emphysema (1) and premature extubation (1) (P>0.05). Conclusion : Since percutaneous dilatational tracheostomy was easy to practice and its complications were not different from surgical tracheostomy, PDT can be a useful bedside procedure for mechanically ventilated patients.

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Recent Progress in Air-Conditioning and Refrigeration Research: A Review of Papers Published in the Korean Journal of Air-Conditioning and Refrigeration Engineering in 2014 (설비공학 분야의 최근 연구 동향: 2014년 학회지 논문에 대한 종합적 고찰)

  • Lee, Dae-Young;Kim, Sa Ryang;Kim, Hyun-Jung;Kim, Dong-Seon;Park, Jun-Seok;Ihm, Pyeong Chan
    • Korean Journal of Air-Conditioning and Refrigeration Engineering
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    • v.27 no.7
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    • pp.380-394
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    • 2015
  • This article reviews the papers published in the Korean Journal of Air-Conditioning and Refrigeration Engineering during 2014. It is intended to understand the status of current research in the areas of heating, cooling, ventilation, sanitation, and indoor environments of buildings and plant facilities. Conclusions are as follows. (1) The research works on the thermal and fluid engineering have been reviewed as groups of heat and mass transfer, cooling and heating, and air-conditioning, the flow inside building rooms, and smoke control on fire. Research issues dealing with duct and pipe were reduced, but flows inside building rooms, and smoke controls were newly added in thermal and fluid engineering research area. (2) Research works on heat transfer area have been reviewed in the categories of heat transfer characteristics, pool boiling and condensing heat transfer and industrial heat exchangers. Researches on heat transfer characteristics included the results for thermal contact resistance measurement of metal interface, a fan coil with an oval-type heat exchanger, fouling characteristics of plate heat exchangers, effect of rib pitch in a two wall divergent channel, semi-empirical analysis in vertical mesoscale tubes, an integrated drying machine, microscale surface wrinkles, brazed plate heat exchangers, numerical analysis in printed circuit heat exchanger. In the area of pool boiling and condensing, non-uniform air flow, PCM applied thermal storage wall system, a new wavy cylindrical shape capsule, and HFC32/HFC152a mixtures on enhanced tubes, were actively studied. In the area of industrial heat exchangers, researches on solar water storage tank, effective design on the inserting part of refrigerator door gasket, impact of different boundary conditions in generating g-function, various construction of SCW type ground heat exchanger and a heat pump for closed cooling water heat recovery were performed. (3) In the field of refrigeration, various studies were carried out in the categories of refrigeration cycle, alternative refrigeration and modelling and controls including energy recoveries from industrial boilers and vehicles, improvement of dehumidification systems, novel defrost systems, fault diagnosis and optimum controls for heat pump systems. It is particularly notable that a substantial number of studies were dedicated for the development of air-conditioning and power recovery systems for electric vehicles in this year. (4) In building mechanical system research fields, seventeen studies were reported for achieving effective design of the mechanical systems, and also for maximizing the energy efficiency of buildings. The topics of the studies included energy performance, HVAC system, ventilation, and renewable energies, piping in the buildings. Proposed designs, performance performance tests using numerical methods and experiments provide useful information and key data which can improve the energy efficiency of the buildings. (5) The field of architectural environment was mostly focused on indoor environment and building energy. The main researches of indoor environment were related to the evaluation of work noise in tunnel construction and the simulation and development of a light-shelf system. The subjects of building energy were worked on the energy saving of office building applied with window blind and phase change material(PCM), a method of existing building energy simulation using energy audit data, the estimation of thermal consumption unit of apartment building and its case studies, dynamic window performance, a writing method of energy consumption report and energy estimation of apartment building using district heating system. The remained studies were related to the improvement of architectural engineering education system for plant engineering industry, estimating cooling and heating degree days for variable base temperature, a prediction method of underground temperature, the comfort control algorithm of car air conditioner, the smoke control performance evaluation of high-rise building, evaluation of thermal energy systems of bio safety laboratory and a development of measuring device of solar heat gain coefficient of fenestration system.

Necessity of Education for Emergency Medical Technicians to Improve Awareness of Early Symptoms of Stroke and Assessment of Stroke Patients (응급구급대원에서 뇌졸중 조기증상 인지 및 환자평가 향상을 위한 교육 필요성)

  • Lee, Jeong-Mi;Lee, Jang-Yeol;Park, Seong-Bin;Lee, Young-Hoon;Oh, Gyung-Jae
    • Journal of agricultural medicine and community health
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    • v.38 no.2
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    • pp.130-141
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    • 2013
  • Objectives: The purpose of this study was to reconsider the necessity of stroke-related educational programs by investigating early symptoms of stroke that emergency medical technicians (EMTs) may experience. Methods: An interview survey was carried out, targeting all EMTs 298 people who were working at 119 fire safety centers and local units in Jeollabuk-do province, from April 1 to 30, 2011. An interviewer administered questionnaire was used to obtain data on ETMs' demographic characteristics, educational level on stroke, and awareness level about early symptoms of stroke and treatment-related characteristics of stroke patients. Results: The results showed that 63.2% of those surveyed had completed the required educational programs on stroke during the past year. The level of awareness about early symptoms of stroke and assessment of stroke patients' condition was relatively high for women, those who were 30 years under, low position people, emergency service practitioners, emergency medical technicians, and people who have completed education, respectively. It was also turned out that 82.8% of those surveyed took stroke patients to the nearest hospitals first so that they could receive appropriate treatment. The level of awareness about early symptoms of stroke and assessment of stroke patients' condition in people who have completed education were higher than non-complete. The level of awareness about early symptoms of stroke was positively correlated with confidence, satisfaction and appropriateness in treatment of stroke patients. Conclusions: These results strongly suggest that it is necessary to operate specialized educational programs to enhance EMTs' appropriate awareness of the early symptoms of stroke and assessment of stroke patient's condition.

A Study on the Cosmeceutical activities of Prunus Sargentii R. (산벚나무(Prunus sargentii R.) 수피의 화장품활성에 관한 연구)

  • Park, Jung-Mi;Lee, Jin-Young;Park, Tae-Soon;Hyun, Sok-Jun;Kim, Han-Hyuk;Cho, Young-Je;Kwon, O-Jun;Son, Ae-Ryang;Kim, Dong-Seok;An, Bong-Jeun
    • Applied Biological Chemistry
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    • v.51 no.1
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    • pp.70-78
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    • 2008
  • Prunus sargentii R. of Rosaceae familiy, has been reported to have radical scavenging activity and anti-inflammatory effect. On these facts, biological activity and safety test were conducted to evaluate biological activities of the extracts of P. sargentii R. as a potential pharmaceutical ingredient. The electron donating ability of its ethanol extracts at a 500 ppm level showed 92%, which was higher than that of hot water extract (59%), the superoxide dismutase (SOD)-like activity of the water extract of P. sargentii R. was about 50%, the ethanol extract of P. sargentii R. was about 40% at 1,000 ppm concentration. Xanthine oxidase inhibition by the water extract of P. sargentii R. was about 40% and that by the ethanol extract was 60% respectively at 500 ppm concentration. From the measurement on lipid oxidation, the $Cu^{2+}$ chelating effect of the ethanol extract was higher than that of hot water extract. The $Fe^{2+}$ chelating effect was also shown to be about 80% at a 500 ppm concentration in both hot water extract and ethanol extract. The tyrosinase inhibition effect related to skin-whitening was 26% by hot water extract and 20% by ethanol extract respectively at a 1,000 ppm. Hyaluronidase inhibition activity related to the anti-inflammation effect was 96% in ethanolic extract at a 500 ppm. Clear zones formed by P. sargentii R. against the human skin-resident micro-flora such as Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli and Propionibacterium acnes indicated that antimicrobial activity of the ethanol extract was higher than that of the hot water extract.

Hypofractionated Radiotherapy for Small-sized Hepatocellular Carcinoma as Salvage Therapy: Sustained Local Control and Safety (작은 크기의 재발성 간세포암에 대한 구제치료로 소분할 방사선치료: 국소 제어율과 안전성)

  • Bae, Sun-Hyun;Park, Hee-Chul;Lim, Do-Hoon;Lee, Jung-Ae;Choi, Moon-Seok;Lee, Joon-Hyoek;Koh, Kwang-Cheol;Paik, Seung-Woon;Yoo, Byung-Chul
    • Radiation Oncology Journal
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    • v.28 no.2
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    • pp.85-90
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    • 2010
  • Purpose: To evaluate the rate of tumor response, local control, and treatment-related complications after hypofractionated radiotherapy for recurrent hepatocelluar carcinoma (HCC) less than 5 cm in size. Materials and Methods: Among the HCC patients who were treated by radiotherapy (RT) between 2006 and 2007 after the failure of previous treatment, a total of 12 patients were treated with hypofractionated RT. The criteria for hypofractionated RT was as follows: 1) HCC less than 5 cm, 2) HCC not adjacent to a critical organ, 3) HCC without portal vein tumor thrombosis, and 4) less than 15% of normal liver volume that irradiated 50% of the prescribed dose. Hypofractionated RT was performed with 50 Gy delivered in 10 fractions, at a rate of 5 fractions per week. The evaluation of tumor response was determined by CT scans performed at 3 months after the cessation of RT, followed by the evaluation of toxicity by Common Terminology Criteria for Adverse Events version 3.0. The median follow-up period after radiotherapy was 18 months. Results: A complete response (CR) was achieved in 5 of 12 lesions (41.7%) at CT performed at 3 months after the cessation, whereas the overall complete response was observed in 7 of 12 cases (58.3%). In-field local control rate was sustained in 83.3% of patients. All patients developed intra-hepatic metastases except for 2 patients. The overall survival rate was 90.0% at 1 year and 67.5% at 2 years, respectively. Three patients developed Grade 1 nausea during RT and 1 patient showed a progression of ascites after RT. There was no grade 3 or greater treatment-related toxicities. Conclusion: Hypofractionated RT for small-sized HCC as a salvage therapy showed a 58.3% CR rate and 83.3% of local control. Fifty Gy administered in 10 fractions of partial liver irradiation is considered as a tolerable dose that does not cause severe complications.

Demand for the Radiological Technologist Independent Act for the Performance of the Duties of a Radiological Technologist (방사선사 직무수행을 위한 방사선사 단독법 제정에 대한 요구도)

  • Kim, Eun-Hye;Lim, Cheong-Hwan;Lim, Woo-Taek;Joo, Young-Cheol;Hong, Dong-Hee;Jung, Hong-Ryang;Moon, Young-Ju;Kim, Hoon;Jung, Young-Jin;Choi, Ji-Won;Yoon, Yong-Su;Cho, Pyong-Kon;Park, Myeong-Hwan;Yang, Oh-Nam;Jeong, Bong-Jae
    • Journal of radiological science and technology
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    • v.44 no.5
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    • pp.525-534
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    • 2021
  • In order to provide high-quality medical services to the public and contribute to the improvement of public health, it is necessary to enact an independent law according to the work of radiological technologists. Therefore, this study intends to review the regulations related to radiographers in the Medical Service Technologists, etc. Act. and to present opinions and directions for enactment of individual laws for radiological technologists. An online survey was conducted to 15,000 radiological technologists working in medical institutions and education sites in Korea; 1,027 people (6.85%) responded. The questionnaire consisted of 3 questions on demographic characteristics, 5 questions on the scope of work, and 12 questions on the revision of the Medical Service Technologists, etc. Act. and the establishment of the Radiological Technologist Independent Act. Reliability and factor analysis were performed on 9 questions measured on a Likert 5-point scale in "Revision of the Medical Service Technologists, etc. Act. and the establishment of the Radiological echnologist Independent Act" among the questionnaire items. Reliability for the total 9 questions was Chronbach α=0.728. There was a high perception that the regulations related to radiological technologists were insufficient in the current Medical Service Technologists, etc. Act., and the perception that examinations performed by radiological technologists at medical institutions were included in medical practice was high. If the Radiological Technologist Independent Act is enforced, a high percentage of respondents said that they could receive legal protection through the institutionalization of the scope of work, that the status of radiological technologists would be improved, and the scope of work would be expanded. The response that the scope of work of radiological technologists should be included was the highest at 96.6%. In the analysis according to demographic characteristics, it was found that 96.7% of the respondents were agreed regardless of the factors. Radiological technologists will have to work hard to secure the public health by coping with new radiology devices, procedures and treatment methods. Therefore, as the results of this study, it is expected that the enactment and implementation of the Radiological Technologist Independent Act will contribute to the improvement of the quality of treatment for patients and to the public health.

Study on relationship between caffeine intake level and metabolic syndrome and related diseases in Korean adults: 2013 ~ 2016 Korea National Health and Nutrition Examination Survey (한국 성인의 카페인 섭취 수준이 대사증후군 및 관련 질환과의 관련성 연구 : 2013~2016 국민건강영양조사 자료 활용)

  • Lee, Jung-Sug;Park, Hyoung-Seop;Han, Sanghoon;Tana, Gegen;Chang, Moon-Jeong
    • Journal of Nutrition and Health
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    • v.52 no.2
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    • pp.227-241
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    • 2019
  • Purpose: This study examined the relationship between caffeine intake and metabolic syndrome in Korean adults using the 2013 ~ 2016 Korea National Health and Nutrition Examination Survey data (KNHANES). Methods: The caffeine database (DB) developed by Food and Drug Safety Assessment Agency in 2014 was used to estimate the caffeine consumption. The food and beverage consumption of the 24 hr recall data of 2013 ~ 2016 KNHANES were matched to items in the caffeine DB and the daily caffeine intakes of the individuals were calculated. The sample was limited to non-pregnant healthy adults aged 19 years and older, who were not taking any medication for disease treatment. Results: The average daily caffeine intake was 41.97 mg, and the daily intake of caffeine of 97% of the participants was from coffee, teas, soft drinks, and other beverages. Multivariate analysis showed that the caffeine intake did not affect metabolic syndrome, hypertension, low HDL-cholesterol, and abdominal obesity. Diabetes and hypertriglyceridemia, however, were 0.76 (95% CI: 0.63 ~ 0.93), and 0.87 (95% CI: 0.77 ~ 0.98) in third quintile (Q3), and 0.66 (95% CI: 0.53 ~ 0.82) and 0.83 (95% CI: 0.73 ~ 0.94) in fourth quintile (Q4) compared to Q1, respectively. Therefore, caffeine intake of 3.66 ~ 45.81 mg per day is related to a lower risk of diabetes and hypertriglyceridemia. Conclusion: The study showed that adequate caffeine intake (approximately 45 mg) was associated with a lower prevalence of diabetes and hypertriglyceridemia. Therefore, it can be used as a guideline for the adequate level of caffeine intake for maintaining health.

Introduction of the International Standardization of ISO in the Production and Quality of Herbal Medicines and a Review of Countermeasures (한약재 생산 및 품질부문의 ISO국제표준화 등재현황 소개 및 대응방안 고찰)

  • Kim, Yong Il;Kang, Young Min;Han, Sin-Hee;Hur, Mok;Kim, Young Guk;Chang, Jae Ki
    • Journal of the Korean Society of International Agriculture
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    • v.30 no.4
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    • pp.257-268
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    • 2018
  • Recently, the international standardization of ISO in the field of Oriental Herbal Medicine has been progressing rapidly under the direction of China's promotion. China's intention to promote international standardization is to extend its influence to the world and beyond the domestic market. The Oriental medicine system in East Asia has similar roots in academic terms, but the medicines that can be supplied and received in each country are different and have developed independently. The international standardization of medicinal herbs is expected to function in a direction that weakens such differentiation and independence. From a commercial point of view, international standardization is no different from creating evaluation criteria for oriental medicinal products, and it is expected that its potential impact on domestic and overseas markets and producers will be large. In particular, the international standardization centered on China can lead to favorable evaluation criteria for China, which may further negatively affect the market competitiveness of domestic raw materials, which have been pushed back by Chinese manufacturers. If the domestic production base is weakened, not only will the farmers suffer but the supply and demand of raw materials will also be manipulated, safety management control will be reduced, and the development of oriental herbal products using domestic raw materials will be hurt. Therefore, in the promotion of international standardization, it is necessary not only to reflect the value of Korean herbal medicine but also to provide strategic responses to protect the domestic production base. However, in the case of recent initiatives, there is no precedent in analyzing influence on the production partners and the related industries. In addition, there are few related papers and reports on the subject, so the publicity process has not been done sufficiently. In response to this, this study will examine the countermeasures against the international standardization of herbal medicines through reviewing its present status and evaluating the agenda of the Korean initiative.

A Checklist to Improve the Fairness in AI Financial Service: Focused on the AI-based Credit Scoring Service (인공지능 기반 금융서비스의 공정성 확보를 위한 체크리스트 제안: 인공지능 기반 개인신용평가를 중심으로)

  • Kim, HaYeong;Heo, JeongYun;Kwon, Hochang
    • Journal of Intelligence and Information Systems
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    • v.28 no.3
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    • pp.259-278
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    • 2022
  • With the spread of Artificial Intelligence (AI), various AI-based services are expanding in the financial sector such as service recommendation, automated customer response, fraud detection system(FDS), credit scoring services, etc. At the same time, problems related to reliability and unexpected social controversy are also occurring due to the nature of data-based machine learning. The need Based on this background, this study aimed to contribute to improving trust in AI-based financial services by proposing a checklist to secure fairness in AI-based credit scoring services which directly affects consumers' financial life. Among the key elements of trustworthy AI like transparency, safety, accountability, and fairness, fairness was selected as the subject of the study so that everyone could enjoy the benefits of automated algorithms from the perspective of inclusive finance without social discrimination. We divided the entire fairness related operation process into three areas like data, algorithms, and user areas through literature research. For each area, we constructed four detailed considerations for evaluation resulting in 12 checklists. The relative importance and priority of the categories were evaluated through the analytic hierarchy process (AHP). We use three different groups: financial field workers, artificial intelligence field workers, and general users which represent entire financial stakeholders. According to the importance of each stakeholder, three groups were classified and analyzed, and from a practical perspective, specific checks such as feasibility verification for using learning data and non-financial information and monitoring new inflow data were identified. Moreover, financial consumers in general were found to be highly considerate of the accuracy of result analysis and bias checks. We expect this result could contribute to the design and operation of fair AI-based financial services.