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Neuroprotective Effect of Phenytoin and Hypothermia on a Spinal Cord Ischemic Injury Model in Rabbits (토끼의 척수 허혈 손상 모델에서 페니토인과 저체온의 신경 보호 효과의 비교)

  • Oh, Sam-Sae;Choe, Ghee-Young;Kim, Won-Gon
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.405-416
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    • 2008
  • Background: Spinal cord ischemic injury during thoracic and thoracoabdominal aortic surgeries remains a potentially devastating outcome despite using various methods of protection. Neuronal voltage-dependent sodium channel antagonists are known to provide neuroprotection in cerebral ischemic models. This study was designed to compare the neuroprotective effects of phenytoin with those of hypothermia in a rabbit model of spinal cord ischemia. Material and Method: Spinal cord ischemia was induced in New Zealand white rabbits by means of infrarenal aortic cross clamping for 25 minutes. Four groups of 8 animals each were studied. The control group and the hypothermia group received retrograde infusion of saline only ($22^{\circ}C$, 2 mL/min); the normothermic phenytoin group and the hypothermicphenytoin group received retrograde infusion of 100 mg of phenytoin at different rectal temperatures ($39^{\circ}C$ and $37^{\circ}C$, respectively) during the ischemic period. The neurologic function was assessed at 24 and 72 hours after the operation with using the modified Tarlov criteria. The spinal cords were harvested after the final neurologic examination for histopathological examination to objectively quantify the amount of neuronal damage. Result: No major adverse effects were observed with the retrograde phenytoin infusion during the aortic ischemic period. All the control rabbits became severely paraplegic, Both the phenytoin group and the hypothermia group had a better neurological status than did the control group (p < 0.05). The typical morphological changes that are characteristic of neuronal necrosis in the gray matter of the control animals were demonstrated by means of the histopathological examination, whereas phenytoin or hypothermia prevented or attenuated these necrotic phenomena (p < 0.05). The number of motor neuron cells positive for TUNEL staining was significantly reduced, to a similar extent, in the rabbits treated with phenytoin or hypothermia. Phenytoin and hypothermia had some additive neuroprotective effect, but there was no statistical significance between the two on the neurological and histopathological analysis. Conclusion: The neurological and histopathological analysis consistently demonstrated that both phenytoin and hypothermia may afford significant spinal cord protection to a similar extent during spinal cord ischemia in rabbits, although no significant additive effects were noticed.

Interpretation of the Umbrella Clause in Investment Treaties (국제투자조약상 포괄적 보호조항(Umbrella Clauses)의 해석에 관한 연구)

  • Jo, Hee-Moon
    • Journal of Arbitration Studies
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    • v.19 no.2
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    • pp.95-126
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    • 2009
  • One of the controversial issues in investor-state investment arbitration is the interpretation of "umbrella clause" that is found in most BIT and FTAs. This treaty clause requires on Contracting State of treaty to observe all investment obligations entered into with foreign investors from the other Contracting State. This clause did not receive in-depth attention until SGS v. Pakistan and SGS v. Philippines cases produced starkly different conclusions on the relations about treaty-based jurisdiction and contract-based jurisdiction. More recent decisions by other arbitral tribunals continue to show different approaches in their interpretation of umbrella clauses. Following the SGS v. Philippines decision, some recent decisions understand that all contracts are covered by umbrella clause, for example, in Siemens A.G. v. Argentina, LG&E Energy Corp. v. Argentina, Sempra Energy Int'l v. Argentina and Enron Corp. V. Argentina. However, other recent decisions have found a different approach that only certain kinds of public contracts are covered by umbrella clauses, for example, in El Paso Energy Int'l Co. v. Argentina, Pan American Energy LLC v. Argentina and CMS Gas Transmission Co. v. Argentina. With relation to the exhaustion of domestic remedies, most of tribunals have the position that the contractual remedy should not affect the jurisdiction of BIT tribunal. Even some tribunals considered that there is no need to exhaust contract remedies before bringing BIT arbitration, provoking suspicion of the validity of sanctity of contract in front of treaty obligation. The decision of the Annulment Committee In CMS case in 2007 was an extraordinarily surprising one and poured oil on the debate. The Committee composed of the three respected international lawyers, Gilbert Guillaume and Nabil Elaraby, both from the ICJ, and professor James Crawford, the Rapportuer of the International Law Commission on the Draft Articles on the Responsibility of States for Internationally Wrongful Acts, observed that the arbitral tribunal made critical errors of law, however, noting that it has limited power to review and overturn the award. The position of the Committee was a direct attack on ICSID system showing as an internal recognition of ICSID itself that the current system of investor-state arbitration is problematic. States are coming to limit the scope of umbrella clauses. For example, the 2004 U.S. Model BIT detailed definition of the type of contracts for which breach of contract claims may be submitted to arbitration, to increase certainty and predictability. Latin American countries, in particular, Argentina, are feeling collectively victims of these pro-investor interpretations of the ICSID tribunals. In fact, BIT between developed and developing countries are negotiated to protect foreign investment from developing countries. This general characteristic of BIT reflects naturally on the provisions making them extremely protective for foreign investors. Naturally, developing countries seek to interpret restrictively BIT provisions, whereas developed countries try to interpret more expansively. As most of cases arising out of alleged violation of BIT are administered in the ICSID, a forum under the auspices of the World Bank, these Latin American countries have been raising the legitimacy deficit of the ICSID. The Argentine cases have been provoking many legal issues of international law, predicting crisis almost coming in actual investor-state arbitration system. Some Latin American countries, such as Bolivia, Venezuela, Ecuador, Argentina, already showed their dissatisfaction with the ICSID system considering withdrawing from it to minimize the eventual investor-state dispute. Thus the disagreement over umbrella clauses in their interpretation is becoming interpreted as an historical reflection on the continued tension between developing and developed countries on foreign investment. There is an academic and political discussion on the possible return of the Calvo Doctrine in Latin America. The paper will comment on these problems related to the interpretation of umbrella clause. The paper analyses ICSID cases involving principally Latin American countries to identify the critical legal issues arising between developing and developed countries. And the paper discusses alternatives in improving actual investor-State investment arbitration; inter alia, the introduction of an appellate system and treaty interpretation rules.

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Experimental Evaluation of Bi-directionally Unbonded Prestressed Concrete Panel Impact-Resistance Behavior under Impact Loading (충돌하중을 받는 이방향 비부착 프리스트레스트 콘크리트 패널부재의 충돌저항성능에 대한 실험적 거동 평가)

  • Yi, Na-Hyun;Lee, Sang-Won;Lee, Seung-Jae;Kim, Jang-Ho Jay
    • Journal of the Korea Concrete Institute
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    • v.25 no.5
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    • pp.485-496
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    • 2013
  • In recent years, frequent terror or military attacks by explosion or impact accidents have occurred. Examplary case of these attacks were World Trade Center collapse and US Department of Defense Pentagon attack on Sept. 11 of 2001. These attacks of the civil infrastructure have induced numerous casualties and property damage, which raised public concerns and anxiety of potential terrorist attacks. However, a existing design procedure for civil infrastructures do not consider a protective design for extreme loading scenario. Also, the extreme loading researches of prestressed concrete (PSC) member, which widely used for nuclear containment vessel, gas tank, bridges, and tunnel, are insufficient due to experimental limitations of loading characteristics. To protect concrete structures against extreme loading such as explosion and impact with high strain rate, understanding of the effect, characteristic, and propagation mechanism of extreme loadings on structures is needed. Therefore, in this paper, to evaluate the impact resistance capacity and its protective performance of bi-directional unbonded prestressed concrete member, impact tests were carried out on $1400mm{\times}1000mm{\times}300mm$ for reinforced concrete (RC), prestressed concrete without rebar (PS), prestressed concrete with rebar (PSR, general PSC) specimens. According to test site conditions, impact tests were performed with 14 kN impactor with drop height of 10 m, 5 m, 4 m for preliminary tests and 3.5 m for main tests. Also, in this study, the procedure, layout, and measurement system of impact tests were established. The impact resistance capacity was measured using crack patterns, damage rates, measuring value such as displacement, acceleration, and residual structural strength. The results can be used as basic research references for related research areas, which include protective design and impact numerical simulation under impact loading.

A Qualitative Study on Facilitating Factors of User-Created Contents: Based on Theories of Folklore (사용자 제작 콘텐츠의 활성화 요인에 대한 정성적 연구: 구비문학 이론을 중심으로)

  • Jung, Seung-Ki;Lee, Ki-Ho;Lee, In-Seong;Kim, Jin-Woo
    • Asia pacific journal of information systems
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    • v.19 no.2
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    • pp.43-72
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    • 2009
  • Recently, user-created content (UCC) have emerged as popular medium of on-line participation among users. The Internet environment has been constantly evolving, attracting active participation and information sharing among common users. This tendency is a significant deviation from the earlier Internet use as an one-way information channel through which users passively received information or contents from contents providers. Thanks to UCCs online users can now more freely generate and exchange contents; therefore, identifying the critical factors that affect content-generating activities has increasingly become an important issue. This paper proposes a set of critical factors for stimulating contents generation and sharing activities by Internet users. These factors were derived from the theories of folklores such as tales and songs. Based on some shared traits of folklores and UCC content, we found four critical elements which should be heeded in constructing UCC contents, which are: context of culture, context of situation, skill of generator, and response of audience. In addition, we selected three major UCC websites: a specialized contents portal, a general internet portal, and an official contents service site, They have different use environments, user interfaces, and service policies, To identify critical factors for generating, sharing and transferring UCC, we traced user activities, interactions and flows of content in the three UCC websites. Moreover, we conducted extensive interviews with users and operators as well as policy makers in each site. Based on qualitative and quantitative analyses of the data, this research identifies nine critical factors that facilitate contents generation and sharing activities among users. In the context of culture, we suggest voluntary community norms, proactive use of copyrights, strong user relationships, and a fair monetary reward system as critical elements in facilitating the process of contents generation and sharing activities. Norms which were established by users themselves regulate user behavior and influence content format. Strong relationships of users stimulate content generation activities by enhancing collaborative content generation. Particularly, users generate contents through collaboration with others, based on their enhanced relationship and specialized skills. They send and receive contents by leaving messages on website or blogs, using instant messenger or SMS. It is an interesting and important phenomenon, because the quality of contents can be constantly improved and revised, depending on the specialized abilities of those engaged in a particular content. In this process, the reward system is an essential driving factor. Yet, monetary reward should be considered only after some fair criterion is established. In terms of the context of the situation, the quality of contents uploading system was proposed to have strong influence on the content generating activities. Among other influential factors on contents generation activities are generators' specialized skills and involvement of the users were proposed. In addition, the audience response, especially effective development of shared interests as well as feedback, was suggested to have significant influence on contents generation activities. Content generators usually reflect the shared interest of others. Shared interest is a distinct characteristic of UCC and observed in all the three websites, in which common interest is formed by the "threads" embedded with content. Through such threads of information and contents users discuss and share ideas while continuously extending and updating shared contents in the process. Evidently, UCC is a new paradigm representing the next generation of the Internet. In order to fully utilize this innovative paradigm, we need to understand how users take advantage of this medium in generating contents, and what affects their content generation activities. Based on these findings, UCC service providers should design their websites as common playground where users freely interact and share their common interests. As such this paper makes an important first step to gaining better understand about this new communication paradigm created by UCC.

The Occurrence of Degenerative Change in the Mandibular Condyles of Korean Patients with Temporomandibular Disorders (측두하악장애 환자에서 하악과두의 퇴행성 변화의 발생 양상에 대한 연구)

  • Jo, Jung-Hwan;Park, Min-Woo;Kim, Young-Ku;Lee, Jeong-Yun
    • Journal of Oral Medicine and Pain
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    • v.36 no.1
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    • pp.53-63
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    • 2011
  • Osteoarthritis (OA), the most common form of arthritis, is a result of both mechanical and biological events that destabilize the normal coupling of degradation and synthesis of articular cartilage chondrocytes and extracelluar matrix, and subchondral bone. Although it is likely that the molecular basis of pathogenesis is similar to that of other joints, additional study of the temporomandibular joint (TMJ) is required due to its unique structure and function. This study was carried out to evaluate the epidemiologic characteristics of TMJ osteoarthritis. The purpose of this study was to investigate the prevalence of TMJ OA in Patients with temporomandibular disorders (1405 men and 2922 women whose mean age was $30.2\; {\pm}\; 15.4$ and $33.1\;{\pm}\;15.2$ years, respectively) who had visited the TMJ and Orofacial Pain Clinic of Seoul National University Dental Hospital in 2007. Orthopantomograms, TMJ tomograms and transcranial radiographs were used to evaluate degenerative change of the mandibular condyle. The obtained results were as follows: 1. Degenerative change of the mandibular condyle was observed in 883 (20.4%) of 4327 subjects. The prevalence was significantly higher in women (706 patients, 24.1%) than in men (177 patients, 12.6%), and this significant difference between genders was observed in all age groups. 2. The prevalence of degenerative change of the mandibular condyle in TMD patients showed a gentle increase along with age. Such increase was statistically significant in women (P < 0.001), but not in men. 3. Sclerosis was observed the most frequently in all age groups and the mean age of the patients with osteophyte was the highest among four types of degenerative change. 4. Although men showed degenerative change in the left side more often and women showed degenerative change more frequently in both sides, the difference of distribution in sides between genders was not significant. In conclusion, the prevalence of degenerative change of the mandibular condyle in TMD patients is higher in women than in men, and increases steadily with aging, but not as dramatically as in other joints that show a steep increase in prevalence around the age of 45 years. It can be suggested that the epidemiologic characteristic of OA of the TMJ differs from those of other joints, and that a more extensive study based on the general population is necessary.

The Impact on the Business Effectiveness of the Educational Satisfaction in Elderly Employment Program: The Mediating Effect of Job Satisfaction (노인일자리 사업의 교육 만족도가 사업효과성에 미치는 영향 : 일자리 만족도의 매개효과)

  • Shin, Gye Soo;Kwon, Seung Sug
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.10 no.5
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    • pp.105-115
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    • 2015
  • This study examined what effect the educational satisfaction level in the grey job project had on the business effectiveness and verified the effect the participant education satisfaction level had on the project business effectiveness ultimately by influencing the job satisfaction. This study utilized the source data of the senior job project old participant status survey of the Korea senior manpower development center which was conducted in 2013, and the non-proportional stratification sample extracting method was used which considered the project type, regional size, and cities/provinces. Sejong City was excluded from the survey target and the survey targeted 2,005 persons except for non-response or response-irrelevant persons concerning this study question. The collected material was analyzed by using SPSS WIN 21.0 program. The frequency and percentage were calculated to apprehend the general characteristic of the study target. Also, the regression analysis was conducted to examine the effect the educational satisfaction level had on the business effectiveness of the senior job project, and the hierarchical regression analysis was conducted in order to examine the mediated effect of the job satisfaction level in the effect the educational satisfaction level had on the business effectiveness of the senior job project. The main result of this study is as follows. First, among the effects the educational satisfaction level had on the business effectiveness, both interest level of educational contents and the job utilization of education had a significant effect on the psychological effect, and the interest level of the educational contents had a significant level on the physical/social effect, and the job utilization of education had a significant effect on the economic effect. Second, in the effect the educational satisfaction level had on the business effectiveness, the job satisfaction level was confirmed the job satisfaction level had a partial mediated effect in the effect the educational satisfaction level had on the psychological/physical/social effect. The job satisfaction level was confirmed the job satisfaction level had a complete mediated effect in the effect the educational satisfaction level had on the economic effect. Also, The job satisfaction level was confirmed the job satisfaction level had a partial mediated effect in the effect the educational satisfaction level had on the business effectiveness. Consequently, the educational contents according with the demand of job participants will have to be developed and the exclusive manpower must be arranged to conduct the education effectively. Also, making participants feel a pride on the job fully will largely contribute to raising the business effectiveness because the job satisfaction level has a positive effect on the business effectiveness.

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A Study of the Japanese Colonial Era Rock-Carved Seated Avalokiteśvara Statue at Ganghwa Bomunsa Temple (일제강점기 강화 보문사 마애관음보살좌상 연구)

  • Lee, Jumin
    • Korean Journal of Heritage: History & Science
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    • v.53 no.3
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    • pp.62-79
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    • 2020
  • The rock-carved seated Avalokiteśvara statue at Ganghwa Bomunsa Temple is a giant rock-carved Buddhist statue that was built in 1928 during the Japanese colonial era. Although it is a year-recorded Buddhist statue that occupies a prominent place in modern Korean Buddhist sculpture history, it has not been the subject of in-depth discussion due to weak research on modern Buddhist sculptures. In this study, to examine the various significant aspects of the rock-carved Seated Avalokiteśvara statue at Bomunsa Temple as a modern Buddhist sculpture, I have managed to determine its construction year, artificers, and patrons by deciphering the inscription around the rock-carved statue; in addition I have researched the effects of the rock shapes and landforms on the formation of the Buddhist statue by comparing and analyzing the points of view of both artificers and worshipers. I have also identified the specific circumstances of the time of construction from interviews with the descendants of artificers. A monk from Geumgangsan Mountain, Lee Hwaeung, took the role of sponsor and chief painter to construct the rock-carved seated Avalokiteśvara statue at Bomunsa temple. In the beginning of its construction in 1928, more than 100 donators jointly sponsored the construction of the statue. Gansong Jeon Hyoungphil sponsored alone at the time of the place of worship's expansion in 1938. Bomunsa Temple has been regarded as one of the top-three sacred places of Avalokiteśvara Bodhisattva together with Naksansa Temple in Yang Yang and Boriam in Nam Hae, due to the construction of the rock-carved statue. It took about three months to construct the statue. Lee Hwaeung drew a rough sketch and then Un Songhag and five masons from Ganghwa Island took part in the carving process. We can observe the line drawing technique around the rock-carved statue because the statue was carved based on the rough sketch of the monk painter. The aspect of Lee Hwaeung as a painter is revealed; therefore, we can identify the clue of painting pattern leading to Seogongchulyou- Hwaunghyoungjin- Ilonghyegag. The rock-carved seated Avalokiteśvara statue at Bomunsa Temple is a typical Avalokiteśvara that wears a jeweled crown and holds Kundica. It makes a strong impression as it has a big square-shaped face and a short neck and is unsophisticated in general. The artificers solved the issue of visual distortion of the rock-carved statue caused by carving on a 10-meter high and 40-degree sloping rock by controlling motion to its maximum, omitting detailed expression by emphasizing symmetry, and adjusting the head-to-body proportion to be almost one-to-one. In this study, especially, I presume the unified form of sacred sculptures and Buddhist altars, without making a Buddhist altar like the rock-carved seated Avalokiteśvara statue at Bomunsa Temple, to be a key characteristic of modern Buddhist sculptures. Furthermore, I make newly clear that the six letters of Sanskrit carved on nimbus, which had been interpreted as a Six-Syllable Mantra, are a combination with Jeongbeopgye and Sabang Mantras. In addition, three iron rings driven on eaves rock were used as a reference point, and after construction they were used as a decoration for the Bodhisattva with hanging wind chimes.

Performance effectiveness of pediatric index of mortality 2 (PIM2) and pediatricrisk of mortality III (PRISM III) in pediatric patients with intensive care in single institution: Retrospective study (단일 병원에서 소아 중환자의 예후인자 예측을 위한 PIM2 (pediatric index of mortality 2)와 PRIMS III (pediatric risk of mortality)의 유효성 평가 - 후향적 조사 -)

  • Hwang, Hui Seung;Lee, Na Young;Han, Seung Beom;Kwak, Ga Young;Lee, Soo Young;Chung, Seung Yun;Kang, Jin Han;Jeong, Dae Chul
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1158-1164
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    • 2008
  • Purpose : To investigate the discriminative ability of pediatric index of mortality 2 (PIM2) and pediatric risk of mortality III (PRISM III) in predicting mortality in children admitted into the intensive care unit (ICU). Methods : We retrospectively analyzed variables of PIM2 and PRISM III based on medical records with children cared for in a single hospital ICU from January 2003 to December 2007. Exclusions were children who died within 2 h of admission into ICU or hopeless discharge. We used Students t test and ANOVA for general characteristics and for correlation between survivors and non-survivors for variables of PIM2 and PRISM III. In addition, we performed multiple logistic regression analysis for Hosmer-Lemeshow goodness-of-fit, receiver operating characteristic curve (ROC) for discrimination, and calculated standardized mortality ratio (SMR) for estimation of prediction. Results : We collected 193 medical records but analyzed 190 events because three children died within 2 h of ICU admission. The variables of PIM2 correlated with survival, except for the presence of post-procedure and low risk. In PRISM III, there was a significant correlation for cardiovascular/neurologic signs, arterial blood gas analysis but not for biochemical and hematologic data. Discriminatory performance by ROC showed an area under the curve 0.858 (95% confidence interval; 0.779-0.938) for PIM2, 0.798 (95% CI; 0.686-0.891) for PRISM III, respectively. Further, SMR was calculated approximately as 1 for the 2 systems, and multiple logistic regression analysis showed ${\chi}^2(13)=14.986$, P=0.308 for PIM2, ${\chi}^2(13)=12.899$, P=0.456 for PRISM III in Hosmer-Lemeshow goodness-of-fit. However, PIM2 was significant for PRISM III in the likelihood ratio test (${\chi}^2(4)=55.3$, P<0.01). Conclusion : We identified two acceptable scoring systems (PRISM III, PIM2) for the prediction of mortality in children admitted into the ICU. PIM2 was more accurate and had a better fit than PRISM III on the model tested.

The Evaluation of Radiation Therapy and Combined-modality Therapy for Non-small-cell Lung Cancer in Elderly (고령의 비소세포성폐암 환자의 방사선 및 병용치료에 대한 효과 평가)

  • Yoon, Won-Sup;Yang, Dae-Sik;Kim, Chul-Yong
    • Radiation Oncology Journal
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    • v.25 no.2
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    • pp.101-108
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    • 2007
  • [ $\underline{Purpose}$ ]: To compare radiation therapy alone to combined modality therapy about survival rate and tolerance of elderly patients ($70=or{\geq}$) with non-small-cell lung cancer (NSCLC). $\underline{Materials\;and\;Methods}$: Between 1998 and 2002, 57 patients given radiation therapy due to NSCLC (Stage III) were analysed retrospectively. Radiation therapy alone (RT), concurrent chemoradiation (CRT), and sequential chemoradiation (SCRT) was done to 33, 16 and 8 patients, respectively. Patients' median age was 74 (range $70{\sim}85$). Male and female are 51 patients and 6 patients, respectively. 23 patients were stage IIIa and 34 were stage IIIb. Patients' characteristic distribution of RT and CRT was not significantly different except mass size that RT has a bigger than CRT. The fraction size of radiation therapy was 1.8 Gy in CRT and $1.8{\sim}3\;Gy$ in other groups. Total radiation dose was $51{\sim}63\;Gy$ according to the fraction size. If the prescribed total radiation dose was successfully irradiated, we stated that it was completion of radiation therapy. $\underline{Results}$: 52 patients were dead. Median period of radiation therapy was as follow: RT, 35 days, CRT, 60.5 days and SCRT, 35 days. Overall median survival time (MST) was 10.1 months. The 1 yr- and 2 yr-overall survival rate was 39.8% and 17.6%, respectively. MST of RT, CRT and SCRT was 8.9, 8.2 and 11.7 months, respectively. The 1 yr survival rate of RT, CRT and SCRT was 38.4%, 37.5% and 50% (not significant). Patients given incomplete radiation therapy were 12 (RT, 5 CRT, 6 SCRT, 1). N stage (p=0.081) and the difference of treatment methods (p=0.079) were the factors affecting incompletion of radiation therapy, but it was not significant. In case of combined-agents chemotherapy, 4 of 8 ceased radiation therapy. T stage ($T{\geq}3$), mass size (${\geq}5\;cm$), Karnofsky performance scale (${\leq}70$) and completion of radiation therapy were the prognostic factors in uni- and multi-variate analysis. $\underline{Conclusion}$: In elderly patients with NSCLC, radiation therapy alone was a treatment method with similar survival period compared with other methods. Generally, patients given radiation therapy alone was tolerable to a treatment. Before planning concurrent chemoirradiation in elderly patients with NSCLC, physicians pay attention to a selection of patients and chemotherapy agents considering general condition and toxicity.

A Study on the Dental Service Statifation of Cityizens in Deajeon (대전시 시민의 치과의료서비스에 관한 만족도 조사연구)

  • Sung, Bo-Kyun
    • Journal of Korean society of Dental Hygiene
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    • v.8 no.4
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    • pp.19-30
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    • 2008
  • This study reached the following conclusions as a result of carrying out the questionnaire survey of self-descriptions for the satisfaction after the citizens of Daejon uses the dental clinics, in order to identify the factors of satisfaction to the medical services of such dental clinics to be utilized in the patient management by dental hygienists, provide the basic data to provide the medical services desired by patients. 1. 43.9% men responded to the facilities and 56.1% women to the atmosphere for the standards of selection of dental clinics by general characteristic, and the college graduates or more to the kindness (38.2%), high-school graduates (43.2%) and middle-school graduates (25.9%) or less to the close distance for the level of educational attainment (p=0.009), which was meant to have a statistical significance. 2. The execution of reservation system for the dental clinics showed 54.7%, the reserved time was observed upon the execution of such reservation system, the dental clinics where they practice such system were 40.6%, and the confirmation methods was done through the telephone with 62.5%. 3. The experience of fear upon the dental treatment showed 74.6%. The type of fear showed the machine sound (48.7%) for men and cry of others for women (70.8%) at the highest. 70% of those under 30 at the age responded to the sharp instruments at the highest. 83.3% of Yousung-gu showed the highest by responding to the cry of others for the residential areas. The statistically significant difference was shown in both the age and residential area (p=0.000). 4. Women showed higher in the distribution of gender for the sterilization of instruments for the external satisfaction of dental clinics(p=0.000) and those under 30 at the age showed the highest with 2.98${\pm}$0.95(p=0.001). Seo-gu (3.48${\pm}$0.77) was the highest for the residential area (p=0.000), and there was statistically significant differences in the gender, age and residential area. 5. Men showed higher satisfaction than women in the clean state and the statistically significant differences were shown (p=0.000) at the age as the high satisfaction was shown for those under 30 at the age (2.35${\pm}$0.79), those having the income not less than 10 million won and not more than 20 million won (2.43${\pm}$0.78), and Seo-gu (2.63 ${\pm}$0.69) for the residential area. 6. For the internal satisfaction of dental clinic by users for the medical services in the dental clinics, 61.1% women responded to no in the ability of solving the inconvenience in the service process, and showed low ability of solving the inconvenience from 30 at the age (26.2%) and by responding to Dong-gu (22.1%) for the residential area, showing statically significant differences(p=0.000). For the re-use of dental clinics, 46.6% men (p=0.043) for the gender, 24.3% under 30 at the age and 22.9% of Dong-gu for the residential area responded to the re-use, showing statistically significant differences for the gender and residential area (p=0.000). 7. The dissatisfaction showed a high rate of 69.5% for the satisfaction to the medical services of dental clinics. 46.2% men responded to the pain and women to the feeling of foreign substance for the reason of dissatisfaction while those under 30 at the age showed 55.6% for others, those between 50 and 59 41.7% for the feeling of foreign substance. 86.3% carried out the education for cautions after the treatments and most people turned out that they do not carry out the continuous health management of mouth as 20.5% responded to that they carry out such health management.

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