• Environmental Analysis Health and Toxicology
• /
• v.16 no.1
• /
• pp.1-8
• /
• 2001

The main purpose of applying the chlorination process during water treatment is for disinfection. Research results, however, indicate that disinfection by-products including trihalomethanes, haloacetic acids, haloacetonitriles, haloketones, and chloropicrin can be produced by chlorination process. Some of these disinfection by-products are known to be potential human carcinogens. This three-year project is designed to establish a standard analysis procedure for disinfection by-products in drinking water and investigate the distribution and sources of specific disinfection by-products. The occurrence level of DBPs in drinking water was below 50$\mu\textrm{g}$/L in most cases. THMs in plant effluent accounted for 48% of all DBPs measured, whereas HAAs accounted for 24%, HANs 14%, haloketones 5%, chloral hydrate 7%, and chloropicrin 2%. Chloroform was found to be the major THMs compound (71%), followed by bromodichloromethane (21%), dibro-mochloromethane (7%), and bromoform (3%), The concentration of DBPs formed in distribution systems increased from those detected in plant effluent. Results would play an important role in exposure assessment as a part of the risk assessment process, and would give basic information for establishment of disinfection by-products reduction and management procedures.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.24 no.4
• /
• pp.823-829
• /
• 1997

The patients visiting pediatric dental office have been being younger than the previous, and they were often combined with systemic disease. But, we aren't able to perform the verbal communication, because of their impediment and youthfullness. And, we can't carry out the behavior control via physical restraint, as the developed social structure and the attitude of children and their parents. So, the importance and concerning of conscious sedation using sedative medicine are increased by time and time. Among the various conscious sedation, Chloral Hydrate and Nitrous Oxide inhalation are most popularly used, and barbiturates, benzodiazepine, opioids and hydroxyzine are used often. But, these medications have some side-effects and adverse reactions, may be failed to sedate the children. And limited use of medically compromised patients, especially for ASA class III, IV or more dangerous patients. We, the Department of Pediatric Dentistry, Chosun University have met some dangerous situation due to unfavorable pharmacogenic reactions, but we can control the situation and get well healed results. The below results are common situations and their solutions during conscious sedation. 1. By the intravenous administration, thrombophlebitis is the most common side-effects, but it may be healed with time without any special treatment. 2. Under the definitive guidelines about conscious-sedation, we can perform a safe conscious sedation for ASA class III patients. 3. When adversed reaction of Benzodiazepine is occured, it could be cared effectively with benzodiazepine antagonist, named Flumazenil.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.25 no.3
• /
• pp.525-532
• /
• 1998

The autism is a complex disorder, characterized language impairment, perceptual-motor difficulties, and social disturbance. The autistic children have hyperactivity, lack of communication' lack of cooperation, inappropriate patient/dentist interaction, so they require professionally recognized behavioral management technique during dental treatment such as behavior modification, phamacological agents, and general anesthesia. A behavior management technique can be chosen by factors such as the severity of autism and possible accompanying disabilities, degree of cooperation, oral and general conditions of children. A non-pharmacological behavior modification may be selected for the autistic children who are able to communicate with dentist with mild dental caries, without compromised medical history. In case of excessively hyperactive, destructive, antisocial, and/or severe communicative disorder, a sedation technic with chloral hydrate, hydroxyzine, midazolam or nitrous oxide gas might to be performed. General anesthesia is preferred for severe communicative and/or behavioral disorder, elder age, excessive dental care need, and living a remote area.

• Journal of Korean Society on Water Environment
• /
• v.27 no.1
• /
• pp.110-114
• /
• 2011

In this paper, in order to eliminate Limnoperna fortunei inhabiting the water conduction pipeline, prechlorination at the intake station was employed to improve the degradation of water quality due to the high pH of raw water taken at the downstream of Paldang Dam, algal growth, etc.. With the prechlorination concentration of 1.0mg/L at the intake station, the pH in the water well at the treatment plant decreased by 0.4, and with 1.5mg/L, by 0.6. Also, it eliminated Chlorophyll-a by about 95%, and the population of algae by about 49%. Such disinfection by-products (DBPs) as Trihalomathanes (THMs), Haloacetic Acids (HAAs), and Chloral Hydrate (CH) were under the quality standard for potable water, showing no change by the prechlorination, while raising the prechlorination rate from 1.0 up to 1.5mg/L, the DBPs in the water well increased by 1.5 to 3.1 times. As a consequence of testing Kyungan Stream, a branch stream flowing into Lake Paldang, the prechlorination (0.57mg/L, 1.14mg/L, 1.71mg/L) had no effect of eliminating the taste and odor compounds and total organic carbon (TOC) which is the DBPs precursor. As for the efficiency of Geosmin elimination by the rates of prechlorination and powder activated carbonation (PAC), it was found that the higher the concentration of PAC was (30ppm>20ppm>10ppm), the higher the efficiency was; the higher the rate of prechlorination was, the lower the efficiency by PAC was. Therefore, when taste and odor occur from raw water, suspending prechlorination at the intake or lowering the rate was proved to be more effective in eliminating the taste and odor compounds by PAC.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.41 no.3
• /
• pp.257-265
• /
• 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.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.32 no.3
• /
• pp.444-453
• /
• 2005

Sometimes the dentists encounter a child who can not be treated with traditional behavior management techniques (for example, reward, restraint, Tell-Show-Do, familialization). In such a case, the dentists use sedation technique. Recently, in Korea, the use of sedation by pediatric dentists is increased. But, the guideline and survey of sedation is very insufficient. Now, we need a survey of sedation practice in Korea. We carried out research on the actual condition about sedation with a questionaire to pediatric dentists in Korea. Followings are the conclusions 1. Sixty six percent of pediatric dentists use sedative agents in their practice. In this study, using sedation shows an increase as compared with the past. 2. Determinative factors of using sedation were orderly behavior management, number of visiting, guidian's opinion, amount of treatment, general condition. 3. Distribution of ages in patients sedated with agents was orderly 3 years, 4-5 years, under 2 years, 6-10 years, more than 10 years. 4. Particular sedative drugs were chloral hydrate 60-70mg/kg, hydroxyzine 10-40mg/kg(25mg/kg), and oral route was the most favorable route. 5. Observation of skin and nail color, pulse oximeter were the most frequently utillized monitoring method during sedation. 6. Only fifty six percent of pediatric dentists complete the cardiopulmonary resuscitation course.

• Environmental Analysis Health and Toxicology
• /
• v.14 no.1_2
• /
• pp.35-43
• /
• 1999

A number of disinfection by-products (DBPs) are formed as a result of the addition of chlorine into the public water supply and some of them have been suggested to cause adverse health effects on humans. However, the estimation of human ingestion exposure to each DBP has been performed simply by multiplying the concentration of a chemical in the cold tap water by the volume of water consumed during a given period of time. However, a questionnaire concerning water consumptions administered to sixty people residing in Chunchon showed that the volume of tap water consumed accounted for approximately 70% of the total volume of water consumed and that of heated water represented approximately 94% of tap water ingested. Heating durations for water-containing foods (e. g., soups and pot stews) and heated beverages (e. g., barley tea) were grouped into 10, 20, 30, and 35 minutes. Based on these time frames, an aluminum pot containing one liter of tap water was heated for the above respective time periods using a gas range to determine the variations of the concentrations of individual DBPs by heating. The pH and total residual chlorine were measured before and after heating. Collected water samples were carried to the laboratory and analyzed for eight DBPs and total organic carbon. Chloroform, bromodichloromethane, chloral hydrate, 1, 2-dichloro-2-propanone, 1, 1, 1-trichloropropanone, and dichloroacetonitrile were not detected following heating for 10 minutes and longer. The concentration of dichloroacetic acid (DCAA) was elevated with heating duration, resulting in the averages of 2.0, 3.1, 4.7, and 12 times the initial concentration, respectively, for 10, 20, 30, and 35 minute heating periods. On the other hand, the concentration of trichloroacetic acid (TCAA) decreased with heating duration, with 0.65, 0.40, 0.34, and 0.19 times lower than the initial concentration. Therefore, it is suggested that ingestion exposure to DCAA increases with heating duration but that ingestion exposure to TCAA decreases. In addition, while the amount of DCAA was elevated at the initial time periods (10 or 20 minutes) and then slowly decreased, that of TCAA was rapidly decreased. In conclusion, water-heating processes during cooking influence the concentrations of individual DBPs in the tap water, with lower levels for volatile DBPs and TCAA, and higher levels for DCAA. Therefore, concentration change needs to be taken into consideration in the estimation of human ingestion exposure to DBPs.

• Journal of Korean Public Health Nursing
• /
• v.16 no.1
• /
• pp.176-189
• /
• 2002

The purpose of this study were to illustrate the various medication error types and causes and identified to related drugs to provide basic data for preventing nurses' medication error by analysing 73 cases of AJN 'medication Error' column(1993, Oct -2000, Nov). Nurses' types of medication error were classified into 7 types. The most frequent error types are wrong medication$(21.9\%)$ and the wrong dose$(21.9\%)$ together. The others are wrong $time(4.1\%)$, $omission(2.7\%)$, mechanical $error(2.7\%)$, incorrect IV $rate(1.4\%)$. wrong route $administration(1.4\%)$ in order. Nurses' causes of medication error were 9 kinds. The most frequent type is confusing between similar drug shape, color, size, name, injection devices and patient's $name(43.9\%)$ and the others are lack of knowledge about $drugs(26.8\%),\; slips(7.3\%),\; miscalculating\;dose(4.9\%)$, incorrect adjusts $devices(4.9\%)$, difficulty to read or illegible decimal $point(4.9\%),$ $abbreviation(2.4\%)$, fatigue with $overwork(2.4\%)$ and no communication with $patient(2.4\%)$ in order. Related drugs with medication error are as follows. - dose unit(IU. minims. mcg/min. mEq) : Heparin. insulin. synthetic calcitonin, some enzymes and hormones, vitamins, some antibiotics, tuberculin injection. MgSO4 injection. nitroglycerin - similar size, color and shape drug : $0.9\%$ N/S and acetic acid $0.25\%$ for irrigation. premixed 2mg lidocaine sol. and $0.9\%$ N/S, gentamycin 20mg/2mL for children and 80mg/2mL for adult, dextroamphetamine 5mg and 10mg capsule. sedatives chloral hydrate 250mg/5mL and 500mg/5mL - similar name :Aredia(pamidronate disodium) and Adriamycin(doxorubicin), Lamictal (lamotrigine) and Lamisil 250mg. Elderpryl and enalapril, cefotaxime and cefoxitin, carboplatin and cisplatin, sumatriptan and zolmitriptan, Celebrex and Celexa, Humulin and Humalog, Percodan and Percocet, Diabeta and Diabinese, Epivir and Retrovir, Xanax(alprazolam) and Zantac(ranitidine) - decimal point : low molecular weight warfarin, methotrexate - unfamiliar drug uses of familiar drug ; methotrexate. droperidol, imipramine, propranolol - number of drug name(misleading chemical name) : 6-thioguanine, 6-mercaptopurine, 5-fluorouracil - type of administration route : Oxycodone(OxyContin). - administration time : acarbose(Precose). - injection way (Z-track method): hydroxyzine - epidural cathether : LMWHs(enoxaparin, dalteparin), - ADD Vantage self contained delivery system : ceftriaxone(Rocephin)

• Korean Chemical Engineering Research
• /
• v.44 no.2
• /
• pp.216-226
• /
• 2006

Total trihalomethanes (THMs), dichloroacetic acid (DCAA) and trichloroacetic acid (TCAA) that are the major disinfection byproducts (DBPs) are monitored continuously in drinking water in Seoul. Study on characteristics of DBPs is crucial to judge the safety of drinking water in Seoul. Analysis of THMs, haloacetonitriles (HANs), chloral hydrate (CH), and haloacetic acids (HAAs) was carried out in several distribution systems from January 2002 to December 2004. The concentration of THMs was 0.015 mg/L in purified water, 0.019 mg/L in tapwater by direct service, and 0.023 mg/L in tapwater through watertank, respectively. It might be due to the increased contact time with chlorine by a process of the distribution system. And the other DBPs show a tendency to increase in its concentration by a process of the distribution system. Also, in summer, the concentration of DBPs was higher than in spring and winter. It might be due to the higher temperature of water in summer. In all cases, the quantities of detected DBPs were 4-6 times lower than those of regulation limits of drinking water in Seoul. In view of these results, the tapwater in Seoul is good to drink it all the times.

• Journal of Acupuncture Research
• /
• v.17 no.2
• /
• pp.231-246
• /
• 2000

Acupuncture has been used for treatment of numerous diseases, especially for pain control in the oriental culture. However, the mechanism of pain control by acupuncture was not clear so far. The present study was examined that the effects of electro-acupuncture (EA) applied to the acu-point of extra-segmental area on modulation of formalin induced pain in Sprague - Dawley rats. In order to apply EA to acu-points in the plantar area of right fore paws, a pair of teflon - coated stainless steel wires were implanted in HT 7 (shin-mun) and PC 7 (dae-neong) 5 days before behavioral test. A behavioral test was performed by means of video camera after injection of 5% formalin ($50{\mu}l$) into the lateral plantar region of left hind paw. EA was delivered by a constant current stimulator at 4~5 mA, 2 ms, and 10 Hz for 30 min. The electromyographic activities were recorded in the biceps femoris muscle under chloral hydrate anesthesia. Test stimuli with 1~9mA were applied to the sural nerve territory including the medial portion of the 4th toe and the lateral portion of the 5th toe. Behavioral responses including favoring, flinching and bitting were occured in the biphasic pattern, such as the lst phase (0~5 min) and the 2nd phase (20~45 min) after formalin injection. However, EA (4~5 mA, 2 ms, 10 Hz) significantly inhibited Che behavioral responses. EMG activities of flexor reflex had a latency of 100~300 ms and thresholds of test stimuli for EMG were 4~5 mA in normal rats. Injection of formalin decreased threshold of test stimuli and increased EMG activities for 2hrs after injection. However, EA significantly inhibited EMG activities of flexor reflex increased by formalin and recovered EMG evoked thresholds. These results suggest that contralateral extra-segmental EA inhibits the first and second phases of formalin induced pain but their mechanism be needed to examine additionally.