• KSCE Journal of Civil and Environmental Engineering Research
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• v.30 no.3A
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• pp.297-307
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• 2010

Recently, maintenance engineering and technology for civil and building structures have begun to draw big attention and actually the number of structures that need to be evaluate on structural safety due to deterioration and performance degradation of structures are rapidly increasing. When stiffness is decreased because of deterioration of structures and member cracks, dynamic characteristics of structures would be changed. And it is important that the damaged areas and extent of the damage are correctly evaluated by analyzing dynamic characteristics from the actual behavior of a structure. In general, typical measurement instruments used for structure monitoring are dynamic instruments. Existing dynamic instruments are not easy to obtain reliable data when the cable connecting measurement sensors and device is long, and have uneconomical for 1 to 1 connection process between each sensor and instrument. Therefore, a method without attaching sensors to measure vibration at a long range is required. The representative applicable non-contact methods to measure the vibration of structures are laser doppler effect, a method using GPS, and image processing technique. The method using laser doppler effect shows relatively high accuracy but uneconomical while the method using GPS requires expensive equipment, and has its signal's own error and limited speed of sampling rate. But the method using image signal is simple and economical, and is proper to get vibration of inaccessible structures and dynamic characteristics. Image signals of camera instead of sensors had been recently used by many researchers. But the existing method, which records a point of a target attached on a structure and then measures vibration using image processing technique, could have relatively the limited objects of measurement. Therefore, this study conducted shaking table test and field load test to verify the validity of the method that can measure multi-point displacement responses of structures using image processing technique.

• Journal of the Daesoon Academy of Sciences
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• v.21
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• pp.199-254
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• 2013

대순사상은 인간의 행위와 정신적 틀, 즉 몸과 마음을 닦고 세상을 다스리며 백성을 평안하게 하는 도리를 설파하고 있다. 우주 공간의 질서와 깊은 연관을 맺는 이러한 도리는 인간 자신의 인지(認知)와 심신 수양의 내용을 포함하며, 사람이 사회와 우주자연과의 관계를 어떻게 처리해 나갈 것인지에 관한 문제도 다루고 있다. 따라서 대순사상을 인문이라는 관점에 입각하여 분석해 볼 필요가 있다. 이탈리아에서 시작된 서양의 인문주의와 비교해 볼 때, 중국 전통의 인문정신은 인류 개체의 창조력과 그 성과를 인정하고, 인격적 수양과 개선을 주장하며, 사회의 조화를 강조하는 한편, 인류가 반드시 천지인의 조화로운 관계 속에서 개체와 전체의 생존을 파악해야 함을 강조한다. 이러한 인문정신은 『전경』에서도 찾아볼 수 있다. 그 하나가 모악산과 단주(丹朱)에 대한 서술인데, 모악산은 산 즉 '간'(艮)괘이며 단주는 적색에 상응하니 곧 '리'(離)괘가 된다. 이 두 괘가 서로 조합하면 '비(比)'괘가 되며, 『주역』의 비괘와 연관하여 서로 간의 모순을 없애고, '바둑'을 두는 기법을 거울삼아 심성을 다스리며, 인격을 완성하고, 인신이 조화를 이루도록 하며, 사회를 안정시킬 것을 말한다. 대순 신앙의 최종 목표는 지상천국을 건설하는 것인데, 이런 목표를 실현하기 위해서는 인격수양을 그 출발점으로 삼아야 한다. 인격수양의 목표는 바른 도인이 되기 위한 것이며, 이를 위해서는 수도 공부를 해야만 한다. 수도는 춘추시기 노자 이래로 유구한 문화적 전통을 지닌 것이지만, 대순진리회는 한국사회 역사의 경향과 현실의 필요에 부응하여 수도 이론을 새롭게 수립하였다. 이를 살펴보면, 대순진리회는 수도자가 '성(誠), 경(敬), 신(信)'에 힘쓰는 품격 함양을 매우 중시한다. 또 도인들이 가정의 화목에 힘써야 하며, 솔선수범하는 도인으로서 사회의 모범이 되어야 한다고 말한다. 이렇게 볼 때, 대순진리회는 '인도'(人道)를 함양함을 강조하고 있으며, 이것은 전통적인 유가에서 말하는 '수신, 제가' (修身, 齊家)의 정신과 그 의미가 맞닿아 있다. 또한 중국 도교의 '선도(仙道)를 이루고자 하면 먼저 인도(人道)를 행하라'는 사상적 취지와도 일치한다. 대순진리회에서 수도의 최종 목표는 도통이다. 도통은 수도자가 매우 높은 경지에 이르게 되었을 때 가지는 특수한 능력과 정신의 경지이다. '도통'에 대한 기록은 『장자·제물론』, 『문자』의 「부언편>(符言篇) 등에서 찾아볼 수 있는데, 대순진리회가 말하는 도통은 중국의 도가 전통에 보이는 도통과도 연관되지만 강한 인륜수양(人倫修養)적 특색을 지니고 있다는 점에서 차이가 있다. 이것은 대순진리회가 가지는 중요한 인문적 함의라 하겠다. 대순진리회는 수도 공부로써 광제창생·보국안민·지상천국건설의 사회적 이상을 실현하고자 한다. 조화로운 사회적 관계를 수립하기 위한 토대는 대순진리회의 종지 첫 번째인 음양합덕이다. 음양합덕은 대순진리의 인문 취지의 이론적 기초를 형성하는 사상이다. 음양합덕의 철학적 사고는 종지 두 번째인 신인조화(神人調化)의 이상으로 이어진다. 신인조화는 『상서·순전』(尙書·舜典)의 신인이화(神人以和)에서 그 사상적 연원을 찾아 볼 수 있다. 다만 신인이화가 율려 조화의 '결과'를 표현한 것이라면, 신인조화에서 중시하는 것은 '과정'이며 인간과 신의 상호작용이라는 점에 그 특징이 있다. 신인조화를 이루기 위해서는 공부를 해야 하며, 그 배후에는 인본(人本)의 사상이 깃들어 있다. 그것은 종지 세 번째인 '해원상생'의 내용에서 더욱 명확하게 드러난다. 신인조화가 인간과 신의 관계를 조화롭게 하는 것을 말한다면, 해원상생은 인간과 인간의 관계를 조화롭게 하는 것을 말한다. 또 다른 한편으로는 긴 역사의 과정 속에서 맺힌 원을 풀어 우주의 기운을 잘 통할 수 있게 하고 인간 사회의 정상적인 교류를 이루도록 한다. 이러한 내용은 사회적인 인문적 관심과 배려를 다분히 포함하고 있는 것이다. 대순진리회의 종지 네 번째인 도통진경은 수도의 가장 높은 경지를 말하는데, 이러한 이념은 노장 일파의 도가 학자들이 말한 순박한 본성으로 회귀하자는 정신에서 그 원류를 찾을 수 있을 것이다. 또한 이는 한진(漢晉)시대 이래 중국 도교가 추구했던 '진경' 의 의미와도 합치된다. 그러나 시대와 환경이 다름으로 인해, 대순진리회의 '진경'은 사회생활의 의미까지 내포한다. 비록 대순진리회의 경전이 인본(人本)을 명확히 밝히고 있지는 않으나, 대순진리회의 요의(要義) 중 하나인 인존사상은 대순진리회의 인문정신을 말해주는 것이다. 인존사상의 직접적인 기능은 평안(平安)으로서 삶을 이롭게 하는 것이다. 대순진리회는 우주대원의 진리를 '도'라 하였는데 이러한 '도'는 중국의 도가에서 말하는 '도'와 동일하며, 여기에는 '안(安)'의 의미가 포함되어 있다. 대순진리회의 신조 중 '안심', '안신'은 마음을 정(靜)하게 하고, 몸을 편하게 하는 것으로 볼 수 있지만, 심신의 공포와 두려움을 떨쳐내어 안전과 보호를 얻는다는 의미도 있으므로 결국 평안이 전제가 된다. 이렇듯 대순진리회에서는 '평안에 대한 희구'를 근본으로 하여 신앙인들이 열심히 수도에 정진하고 있다. 대순진리회가 인류 평안을 기본으로 하는 종교라는 점에서, 반드시 세인들의 환영을 받을 것임을 믿어 의심치 않는다.

• Korean Journal of Psychosomatic Medicine
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• v.32 no.1
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• pp.43-51
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• 2024

Objectives : This study aims to explore the prevalence of depressive symptoms among elderly residents in the relatively stable rural areas of Jeju and to examine the relationships between levels of depression, sociodemographic factors, and health habits. Methods : The study site was within rural Jeju, where elderly individuals aged 65 and older were randomly selected from the 'Agricultural Cohort' registered at the Centers for Farmers' Safety and Health Center. Trained interviewers conducted surveys using the Short Form Geriatric Depression Scale (sGDS-K), defining those with scores of 6 or above as experiencing depressive symptoms for the analysis. Other variables such as sex, age, educational level, marital status, annual income, subjective health status, underlying disease, perceived stress levels, smoking, and drinking status were also recorded Results : Out of 533 subjects, the prevalence of depressive symptoms was 35.3%, with 28.5% in male and 45.6% in female (p<0.001). Factors significantly associated with the prevalence of depressive symptoms included marital status (p=0.014), educational level (p<0.001), annual income (p=0.034), subjective health status (p<0.001), perceived stress level (p<0.001), feeling of despair (p<0.001) and suicidal ideas (p<0.001). Multivariate logistic regression analysis revealed that subjective health status, perceived stress level, and feelings of despair were associated with the prevalence of depressive symptoms. Conclusions : The high prevalence of depressive symptoms among the rural elderly in Jeju highlights the need for targeted mental health interventions. Addressing sociocultural factors and improving early detection and intervention strategies can help reduce the socioeconomic impact of depression in this population.

• Journal of Plant Biotechnology
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• v.50
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• pp.275-289
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• 2023

Since the implementation of the Living Modified Organisms (LMOs) Act in 2008, approximately 10 million tons of genetically modified corn, soybean, potato, canola, and other crops have been imported into South Korea. The import approval procedures have been completed for approximately 191 cases that include seven crops. Of these, approximately 90 cases, excluding crossbreeds of approved LMOs, were reviewed via consultation risk evaluation in four areas: human health, crop culture, natural ecology, and marine fishery environment. LMO developers in South Korea, who are major stakeholders in the import of LMO crops produced overseas, have raised concerns regarding procedural inefficiency in consultation reviews and the need of excessive reviews that are unsuitable for food-feed processing purposes. These procedures reflect the perspective of consultation agencies that deviate from the nature of risk assessment and demand specific supplementary data that do not reflect familiarity and substantial equilibrium. Based on frequent instances of unintentional environmental release of LMO crops imported into Korea, the ministries responsible for consultation insist on a review that considers the climate and natural environment of Korea. In addition, the ministries mandate that their reviews reflect the expertise of competent ministries and are based on risk assessment principles and methods in accordance with international guidelines. In this regard, considering that traits introduced into LMO crops involving familiar agricultural crops have been considered safe for more than two decades, we have suggested reasonable alternatives to several risk assessment items for agricultural LMOs. These alternatives can mitigate conflicts of interest among key stakeholders within the scope of the current LMO regulations.

• The Journal of the Convergence on Culture Technology
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• v.10 no.4
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• pp.175-181
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• 2024

The U.N. Security Council's North Korea Sanctions Committee estimated that the amount of North Korea's cyberattacks on virtual asset-related companies from 2017 to 2023 was about 4 trillion won. North Korea's cyberattacks have secured funds through cryptocurrency hacking as it has been restricted from securing foreign currency due to economic sanctions by the international community, and it also shows the form of technology theft against defense companies, and illegal assets are being used to maintain the Kim Jong-un regime and develop nuclear and missile development. When North Korea conducted its sixth nuclear test on September 3, 2017, and declared the completion of its national nuclear armament following the launch of an intercontinental ballistic missile on November 29 of the same year, the U.N. imposed sanctions on North Korea, which are considered the strongest economic sanctions in history. In these difficult economic situations, North Korea tried to overcome the crisis through cyberattacks, but as a result of analyzing the changes through the North's cyber attack cases, the strategic goal from the first period from 2009 to 2016 was to verify and show off North Korea's cyber capabilities through the neutralization of the national network and the takeover of information, and was seen as an intention to create social chaos in South Korea. When foreign currency earnings were limited due to sanctions against North Korea in 2016, the second stage seized virtual currency and secured funds to maintain the Kim Jong-un regime and advance nuclear and missile development. The third stage is a technology hacking of domestic and foreign defense companies, focusing on taking over key technologies to achieve the five strategic weapons tasks proposed by Chairman Kim Jong-un at the 8th Party Congress in 2021. At the national level, security measures for private companies as well as state agencies should be established against North Korea's cyberattacks, and measures for legal systems, technical problems, and budgets related to science are urgently needed. It is also necessary to establish a system and manpower to respond to the ever-developing cyberattacks by focusing on cultivating and securing professional manpower such as white hackers.

• KOREAN JOURNAL OF CROP SCIENCE
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• v.36 no.5
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• pp.407-428
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• 1991

The eastern coastal area having variability of climate is located within Taebaek mountain range and the east coast of Korea. It is therefore ease to cause the wind damages in paddy field during rice growing season. The wind damages to rice plant in this area were mainly caused by the Fohn wind (dry and hot wind) blowing over the Taebaek mountain range and the cold humid wind from the coast. The dry wind cause such as the white head, broken leaves, cut-leaves, dried leaves, shattering of grain, glume discolouration and lodging, On the other hand the cold humid wind derived from Ootsuku air mass in summer cause such symptom as the poor rice growth, degeneration of rachis brenches and poor ripening. To minimize the wind damages and utilize as a preparatory data for wind injury of rice in future, several experiments such as the selection of wind resistant variety to wind damage, determination of optimum transplanting date, improvement of fertilizer application methods, improvement of soils and effect of wind break net were carried out for 8 years from 1982 to 1989 in the eastern coastal area. The results obtained are summarized as follows. 1. According to available statisical data from Korean meteorological services (1954-1989) it is apperent that cold humid winds frequently cause damage to rice fields from August 10th to September 10th, it is therefore advisable to plan rice cultivation in such a way that the heading date should not be later than August 10th. 2. During the rice production season, two winds cause severe damage to the rice fields in eastern coastal area of Korea. One is the Fohn winds blowing over the Taebaek mountain range and the other is the cold humid wind form the coast. The frequency of occurrence of each wind was 25%. 3. To avoid damage caused by typhoon winds three different varieties of rice were planted at various areas. 4. In the eastern coastal area of Korea, the optimum ripening temperature for rice was about 22.2$^{\circ}C$ and the optimum heading date wad August 10th. The optimum transplanting time for the earily maturity variety was June 10th., medium maturity variety was May 20th and that of late maturity was May 10th by means of growing days degree (GDD) from transplanting date to heading date. 5.38% of this coastal area is sandy loamy soil while 28% is high humus soil. These soil types are very poor for rice cultivation. In this coastal area, the water table is high, the drainage is poor and the water temperature is low. The low water temperature makes it difficult for urea to dissolve, as a result rice growth was delayed, and the rice plant became sterile. But over application of urea resulted in blast disease in rice plants. It is therefore advise that Ammonium sulphate is used in this area instead of urea. 6. The low temperature of the soil inhibits activities of microorganism for phosphorus utilization so the rice plant could not easily absorb the phosphorus in the soil. Therefore phosphorus should be applied in splits from transplanting to panicle initiation rather than based application. 7. Wind damage was severe in the sandy loamy soil as compared to clay soils. With the application of silicate. compost and soil from mointain area. the sand loamy soil was improved for rice grain colour and ripening. 8. The use of wind break nets created a mocro-climate such as increased air. soil and water temperature as well as the reduction of wind velocity by 30%. This hastened rice growth, reduced white head and glume discolouration. improved rice quality and increased yield. 9. Two meter high wind break net was used around the rice experimental fields and the top of it. The material was polyethylene sheets. The optimum spacing was 0.5Cm x 0.5Cm. and that of setting up the wind break net was before panicle initiation. With this set up, the field was avoided off th cold humid wind and the Fohn. The yield in the treatment was 20% higher than the control. 10. After typhoon, paddy field was irrigated deeply and water was sprayed to reduce white head, glume discolouration, so rice yield was increased because of increasing ripening ratio and 1, 000 grain weight.

• Journal of Distribution Research
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• v.17 no.5
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• pp.1-23
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• 2012

The conflict between major corporations and small and medium-sized businesses is being aggravated, the trickle down effect is not working properly, and, as the controversy surrounding the effectiveness of the business limiting system continues to swirl, the plan proposed to protect the business domain of small and medium-sized businesses, resolve polarization between these businesses and large corporations, and protect small family run stores is the suitable business type designation system for small and medium-sized businesses. The current status of carrying out this system of selecting suitable business types among small and medium-sized businesses involves receiving applications for 234 items among the suitable business types and items from small and medium-sized businesses in manufacturing, and then selecting the items of the consultative group by analyzing and investigating the actual conditions. Suitable business type designation in the service industry will involve designation with priority on business types that are experiencing social conflict. Three major classifications of the service industry, related to the livelihood of small and medium-sized businesses, will be first designated, and subsequently this will be expanded sequentially. However, there is the concern that when designated as a suitable business type or item, this will hinder the growth motive for small to medium-sized businesses, and designation all cause decrease in consumer welfare. Also it is highly likely that it will operate as a prior regulation, cause side-effects by limiting competition systematically, and also be in violation against the main regulations of the FTA system. Moreover, it is pointed out that the system does not sufficiently reflect reverse discrimination factor against large corporations. Because conflict between small to medium sized businesses and large corporations results from the expansion of corporations to the service industry, which is unrelated to their key industry, it is necessary to introduce an advanced contract method like a master franchise or local franchise system and to develop local small to medium sized businesses through a franchise system to protect these businesses and dealers. However, this method may have an effect that contributes to stronger competitiveness of small to medium sized franchise businesses by advancing their competitiveness and operational methods a step further, but also has many negative aspects. First, as revealed by the Ministry of Knowledge Economy, the franchise industry is contributing to the strengthening of competitiveness through the economy of scale by organizing existing individual proprietors and increasing the success rate of new businesses. It is also revealed to be a response measure by the government to stabilize the economy of ordinary people and is emphasized as a 'useful way' to revitalize the service industry and improve the competitiveness of individual proprietors, and has been involved in contributions to creating jobs and expanding the domestic market by providing various services to consumers. From this viewpoint, franchises fit the purpose of the suitable business type system and is not something that is against it. Second, designation as a suitable business type may decrease investment for overseas expansion, R&D, and food safety, as well negatively affect the expansion of overseas corporations that have entered the domestic market, due to the contraction and low morale of large domestic franchise corporations that have competitiveness internationally. Also because domestic franchise businesses are hard pressed to secure competitiveness with multinational overseas franchise corporations that are operating in Korea, the system may cause difficulty for domestic franchise businesses in securing international competitiveness and also may result in reverse discrimination against these overseas franchise corporations. Third, the designation of suitable business type and item can limit the opportunity of selection for consumers who have up to now used those products and can cause a negative effect that reduces consumer welfare. Also, because there is the possibility that the range of consumer selection may be reduced when a few small to medium size businesses monopolize the market, by causing reverse discrimination between these businesses, the role of determining the utility of products must be left ot the consumer not the government. Lastly, it is desirable that this is carried out with the supplementation of deficient parts in the future, because fair trade is already secured with the enforcement of the franchise trade law and the best trade standard of the Fair Trade Commission. Overlapping regulations by the suitable business type designation is an excessive restriction in the franchise industry. Now, it is necessary to establish in the domestic franchise industry an environment where a global franchise corporation, which spreads Korean culture around the world, is capable of growing, and the active support by the government is needed. Therefore, systems that do not consider the process or background of the growth of franchise businesses and harm these businesses for the sole reason of them being large corporations must be removed. The inhibition of growth to franchise enterprises may decrease the sales of franchise stores, in some cases even bankrupt them, as well as cause other problems. Therefore the suitable business type system should not hinder large corporations, and as both small dealers and small to medium size businesses both aim at improving competitiveness and combined growth, large corporations, small dealers and small to medium sized businesses, based on their mutual cooperation, should not include franchise corporations that continue business relations with them in this system.

• Journal of the Korean Society of Food Science and Nutrition
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• v.38 no.6
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• pp.694-708
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• 2009

The principal objective of this study was to determine the effects of smoking & drinking on the diet, nutrient intake, and overall health. A sample of 262 youths, aged 16 to 18 year-old, was randomly selected from Seoul and its vicinity. The subjects participated by answering survey questions including general questions, questions regarding health, smoking & drinking habits, dietary habits, nutrient intake, physical characteristics, and smoking cessation plans. The average height, weight, and BMI of the subjects were $173.5{\pm}6.8\;cm$, $64.8{\pm}11.8\;kg$, and $21.4{\pm}3.7\;kg/m^2$, respectively. Among the subjects, 88% appeared to be interested in health and 43.5% of youth asserted that the best way to keep healthy was to engage in regular exercise. Among 63 smokers, 52 students (82.5%) used alcoholic beverages while 11 students (17.5%) did not use alcoholic beverages, meaning that smoking was a causative factor in drinking. 55.6% of youth reported beginning to smoke in middle school, and 38.1% of them asserted that curiosity was the motive for smoking. The youth reported that the craving for smoking was highest when hungry, and the best place to smoke was the restroom. 20 students (69.0%) answered that the only way to quit smoking was just to stop. 12 students (44.4%) reported that the main reason for failures in smoking cessation attempts was a lack of intention or willpower. 87.1% of all subjects answered that they were inclined to quit smoking, and 56.7% of them would be interested in attending a smoking cessation program if they had the opportunity. Among the smoking and drinking group, 50% of drinkers began to drink in high school, and the reason for drinking given was peer pressure-40% of drinkers answered that they wished to quit drinking. 34.4% of students appeared to have breakfast everyday, but 16.4% of students answered that they had quit eating breakfast. 52.5% of all students reported that the principal reason for overeating was the presence of one's favorite food, and the smoking and drinking group reported overeating more frequently than other groups (p<0.05). 72.6% of all subjects reported eating interim meals $1{\sim}2$ times daily, 36.4% of smokers ate carbonated beverages, 38.5% ate ice cream as a interim meal, and 38.5% of the drinking and smoking groups ate fruits, 26.9% of them ate fried foods, and some of them ate fast foods as a interim meal. Among smokers, the ratio of eating fat-rich foods, and meats such as kalbi and samgyupsal more than two times per week was higher, and 54.3% of smokers ate ice cream, cookies, and carbonated beverages more than two times per week (p<0.05). The total nutrient intake of the $15{\sim}19$-year youth group was much higher than the standard value. The energy intake of the smoking group and the drinking and smoking group was significantly higher than that of the normal group (p<0.05). Intakes of phosphorus (p<0.05), cholesterol (p<0.05), and sodium (p<0.05) were the highest among all groups. Accordingly, it is recommended that practical education programs be implemented to teach young students to resist peer pressures to smoke and drink. Additionally, education that acknowledges the importance of nutrition is necessary to avoid preferential eating and overeating due to smoking and drinking.such education can also teach students to eat a balanced diet and improve their physical development.

• Journal of Oral Medicine and Pain
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• v.30 no.2
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• pp.163-199
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• 2005

Dentistry had been considered to be a relatively safe zone from the risk of medical accidents for there are less number of emergency cases. However, in these days, the number of medical dispute is increasing that the dentists would not be able to overlook it as if it is none of their matters. Hence, researches on various medical accidents and analyses on related matters to seek proper management have been carried out recently, but the datas are not enough yet. This study analysed the actual conditions of medical accidents as well as disputes and the general awareness of dental practitioners in local clinics with the purpose of understanding the general situation and to suggest counterplan. The study was conducted by analysing 1,882 questionnaires collected from total of 3,684 dentists belonging to Seoul Dental Association and where Doctors and Hospitals Medical Malpractice Insurance for dentists is administered. The results were as follows: 1. 98.47% of the respondents doubted the risk of medical accident and dispute. 2. 27.42% of the respondents experienced medical dispute, and there was no significant difference between the rate of medical disputes and the resident training. 3. Among the cases of medical accidents, those related to the periodontal/operative treatment showed the highest rate of 20.50%, and that related to implant treatment was 6.17%. 4. 43.02% of the respondents explained about the treatment procedure before the treatment while 25.90% started the treatment without consent of the patients. 5. Medical dispute resulted from not having any explanation or consent of the patients were of 16.55%. 10.26% had difficulties in solving the problem for missing the medical records. 6. 49.73% responded to be capable of administering first aid treatment. Among them, 23.60% were equipped with accurate knowledge regarding the emergency care. 7. During medical dispute, 88.09% sought counsel from other dentists, and Local district dental association was found to be the most frequently asked group. 8. In cases of medical dispute, 5.26% of the respondents were asked to submit relevant data from customer protection organization, and among them, 75.61% acceded the demand sincerely. 9. After the settlement of the dispute, 83.63% recovered relatively stable state of mind. 10. 99.46% of the respondents felt the necessity of medical dispute management organization, and 78.58% responded that it was urgent. 11. 66.70% of the respondents joined Doctors and Hospitals Medical Malpractice Insurance, although they had not experienced medical dispute. However, 73.36% of the respondent were not aware of it, and 93.36% of the members were not aware of the procedure of the dispute settlement. 12. 79.0% of the respondents who joined the Doctors and Hospitals Medical Malpractice Insurance still felt confused when medical dispute occured, but relatively safer than before. 13. When medical dispute was settled through Doctors and Hospitals Medical Malpractice Insurance, 71.92% of the dentists were contented more than moderately, however, 35.16% of the patients were contented. 14. For complement of Doctors and Hospitals Medical Malpractice Insurance, 53.22% of the respondents felt that insurance company, dentist, and patient should all participate in bringing mutual agreement for quick settlement of the dispute. In addition, 29.08% of the respondents wanted insurance company to prevent patients from disturbing their practices. From the above results, improvement of the general awareness on increasing rate of medical disputes, and education as well as complementary measures for settlement of the disputes are required.

• Tuberculosis and Respiratory Diseases
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• v.47 no.3
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• pp.321-330
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• 1999

Background : Early diagnosis and proper antibiotic treatment are very important in the management of ventilator-associated pneumonia (VAP) because of its high mortality. Bronchoscopy with a protected specimen brush (PSB) has been considered the standard method to isolate the causative organisms of VAP. However, this method burdens consumer economically to purchase a PSB. Another useful method for the diagnosis of VAP is quantitative cultures of aspirated specimens through bronchoscopic bronchoalveolar lavage (BAL), for which the infusion of more than 120 m1 of saline has been recommended for adequate sampling of a pulmonary segment. However, occasionally it leads to deterioration of the patient's condition. We studied the diagnostic efficacy of minibronchoalveolar lavage (miniBAL), which retrieves only 25 ml of BAL fluid, in the isolation of causative organisms of VAP. Methods: We included 38 consecutive patients (41 cases) suspected of having VAP on the basis of clinical evidence, who had received antibiotics before the bronchoscopy. The two diagnostic techniques of PSB and miniBAL, which were performed one after another at the same pulmonary segment, 'were compared prospectively. The cut-off values for quantitative cultures to define causative bacteria of VAP were more than $10^3$ colony-forming units (cfu)/ml for PSB and more than $10^4$ cfu/ml for BAL. Results: The amount of instilled normal saline required to retrieve 25 ml of BAL fluid was $93{\pm}32 ml$ (mean${\pm}$SD). The detection rate of causative agents was 46.3% (19/41) with PSB and 43.9% (18/41) with miniBAL. The concordance rate of PSB and miniBAL in the bacterial culture was 85.4% (35/41). Although arterial blood oxygen saturation dropped significantly (p<0.05) during ($92{\pm}10%$) and 10 min after ($95{\pm}3%$) miniBAL compared with the baseline ($97{\pm}3%$), all except 3 cases were within normal ranges. The significantly elevated heart rate during ($l25{\pm}24$/min, p<0.05) miniBAL compared with the baseline ($1l1{\pm}22$/min) recovered again in 10 min after ($111{\pm}26$/min) miniBAL. Transient hypotension was developed during the procedure in two cases. The procedure was stopped in one case due to atrial flutter. Conclusion: MiniBAL is a safe and effective technique to detect the causative organisms of VAP.