• Parasites, Hosts and Diseases
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• v.24 no.2
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• pp.121-136
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• 1986

Recently there have been some reports on human infections of Echinostoma hortense in Korea. It was found that a few species of freshwater fishes were playing the role of the second intermediate host of E. hortense. However, molluscan intermediate host has not been identified yet in Korea. The present study aimed to establish the life cycle of E. hortense in laboratory. Experimental studies such as egg production from the rat, development of the eggs in vitro, exposure of miracidia to freshwater snails, shedding pattern of cercariae from infected snails, morphology of cercariae, cercarial infection to the second intermediate host and infection of metacercariae to the definitive hosts were done. In addition, epidemiological surveys on the infection status in inhabitants and house rats, and on the natural infection of larval echinostomes in the snails and fishes were carried out along the South Hangang-river. The results obtained were as follows: 1. The eggs deposited from adults in physiological saline were cultivated at room temperature($20{\sim}24^{\circ}C$). The miracidia were firstly observed on 8 days after cultivation, and 85.5% of the eggs contained the mature miracidia on 11 days after cultivation. More than 90% formed the miracidia when cultivated at temperature $22{\sim}27^{\circ}C$. Hatching of the miracidia began on 12 days after cultivation and continued for a week. The size of the miracidia was $103.0{{\times}}51.4{\mu}m$ in average. The motility of the miracidia were active up to 8 hours after shedding, but they were all dead within 10 hours after shedding. 2. A freshwater snail, Radix auricularia coreana was cultivated in aquaria. A hatched $F_1$ snails from the egg masses were exposed to 20 miracidia respectively. Escape of cercariae started on 15 days after infecton. Radix auricularia coreana was experimentally identified as the first intermediate host of E. hortense in Korea. 3. Cercarial shedding started on $15{\sim}20$ days after infection by snail, continued for about 10 days (8.8 days in average). Infected snails were dead within 32 days after the miracidial infection. About 1,335 cercariae($328{\sim}1,994$) per snail were shed in its life, and 119 cercariae in average per snail per day were shed. The cercariae were motile for more than 24 hours, and then squirming at the bottom until death. The body and tail sizes of cercariae were $356{\times}186{\mu}m$ and $510{\times}68{\mu}m$ in average, respectively. The rediae parasitized in the snail hosts were found mainly around the pericardial regions, and their size was $1,575{\times}258{\mu}m$ in average. The numbers of developing cercariae in a mature redia were 14 in average ($7{\sim}20$ in range). The numbers of rediae in a snail were 102 in average on 15 days after miracidial infection and 221 in average on 28 days. 4. Three uninfected Misgurnus anguillicaudatus, less than 6.5cm long were used in for the cercarial infection. They were all exposed with 755 cercariae, and examined at 5-day intervals starting from 10 days after infection. All the fishes were infected with metacercariae of E. hortense and a total of 275 was found infected(36.4%). The metacercariae were fed to rats and the adult worms were obtained on 15 days after infection. 5. The infected rats began to deposit the eggs on 11 days after infection. The number of eggs deposited per day per worm (EPD/worm) was $400{\sim}500$ on 3 weeks after infection and was increased to $1,000{\sim}1,500$ on 4 to 17 weeks, then decreased to 800 on 21 weeks after infection. 6. A total of 745 stool specimens collected from 576 male and 169 female residents of 8 different villages along South Hangang basin was examined. Out of 745 specimens, the eggs of Echinostoma sp. were found in 2 cases (0.3%). Of 34 house rats one showed egg-positive (2.9%). 7. Total 971 Radix auricularia coreana collected from 7 sampling stations were examined for shedding of cercariae. Three snails (0.3%) shed the cercariae of E. hortense. A total of 119 out of 542 freshwater fishes (22.0%) had the metacercariae of E. hortense. The fishes parasitized with the metacercariae were 4 out of 14 examined species. The infection rates of 4 species were 34.1% (106 out of 311) in Misgurnus anguillicaudatus, 30.4% (7 out of 23) in Misgurnus mizolepis, 4.3% (2 out of 46) in Moroco oxycephalus and 22.2% (4 out of 18) in Odontobutis obscura interrupta. In summarizing the above results, the first intermediate host of E. hortense was found as Radix auricularia coreana in Korea. Also, it took about 46 days for the shortest completion of a life cycle of E. hortense in summer; that is, 10 days for miracidial development in eggs, 15 days for cercarial development in the snail, about 10 days for metacercarial development in the second intermediate hosts, and 11 days for the maturation as the adults in the definitive hosts. The natural infection rates of E. hortense in the intermediate hosts were relatively high but those in the definitive hosts were low in the middle areas of South Hangang basin.

• Journal of Preventive Medicine and Public Health
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• v.20 no.1 s.21
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• pp.10-39
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• 1987

Mortality rate and causes of death are regarded as an index of strength as well as level of development of a country. However, there is no accurate data for the causes of death in Korea due to lack of systematic vital data collection system. The objective of this study was to define the causes of death of the school teachers, its changing pattern, cause-specific mortality rate, and geographic variation. The study population included all of the teachers in primary school, middle and high schools, and college who joined in Korean Teachers' Union between 1968 and 1985 that provided a total of 1,972, 069 person-years to observe (1,384,911 man-years, 587,158 woman-years). There were 3,678 deaths in this period (3,377 males, 301 females). The most common cause of death was neoplasm which was followed by the diseases of circulatory system. The proportion of death of neoplasm was 1.5 times higher than that of the general population. Causes of death were classified into 5 major groups (neoplasm, diseases of circulatory system, accidents and poisoning, diseases of liver, and all others). The mortality rates of diseases of circulatory system and all others for general population were 4 to S times higher than those for the teachers. However, mortality rates of neoplasm and diseases of liver were only about 2 times higher than those for teachers. Mortality rate of liver cancer for teachers was higher than gastric cancer mortality rate which is the reverse in general population. The crude death rate was 2.12 per 1,000 person-years for male and 1.00 for female which is one-third of the crude death rate of general population. Crude death rate of study population was higher in rural area than in urban area. However, mortality rate of neoplasm for male was higher in urban area than in rural area while mortality rates of all other causes were higher in rural area. For female, mortality rates of neoplasm and diseases of circulatory system were higher in urban area and the rates for all other causes were higher in rural area. Crude death rate was lowest in Gyeongin area and highest in Yeongnam area. The mortality of neoplasm for male accounted the highest proportion of all death in Gyeongin, Chungcheong and Yeoungnam areas while the mortality of neoplasm and mortality of circulatory system accounted the same proportion in Jeonra area. For female, the mortality of disease of circulatory system accounted the highest proportion in Gyeongin and Yeoungnam and Jeonra areas. Proportion of death due to accidents and poisoning was high in Chungcheong area and death due to all other causes was high in Yeoungnam area. The most common cause of death for male by city and province was neoplasm in Seoul, Busan, Daegu, Gyeonggi, Chungnam, Chungbuk, Gyeongnam and Gyeongbuk. Diseases of circulatory system was the leading cause of death in the rest of city and provinces. The leading cause of death for female was diseases of circulatory system in Seoul, Incheon, Chungbuk, Chungnam, and Gyeongbuk, neoplasm in Busan, and accident and poisons in all other cities and provinces. The mortality rates of male were above 2 per 1,000 person-years in Jeju, Gyeongbuk, Gyeongnam, Daegu, and Chungbuk, and it was below 1.5/l,000 in Seoul, Incheon and Gyeonggi. The mortality rate of female was above 1.2/1,000 person-years in Gyeongnam and Incheon while it was below 0.5/l,000 in Daegu, Geonggi Chungbuk and Jeju. The leading cause for male by school of employment was neoplasm in all levels of school with a remarkably higher rate in the professors of college. Leading cause of death for female was disease of circulatory system in primary schools, high schools and college but neoplasm in middle schools. There was no death due to liver diseases in middle and high school teachers and college professors and no death due to all other category in high school teachers and college professors, in females. High school teachers and the highest mortality rate and college professors showed the lowest mortality rate. Temporal trend of mortality was examined in three periods; period I ($1968{\sim}1974$), period II ($1975{\sim}1979$), and period III ($1980{\sim}1985$). The leading cause of death for male was diseases of circulatory system in period I and II but neoplasm in period III. Such trend of decreasing diseases of circulatory system and increasing neoplasm was observed in female. Overall mortality rate was decreased over the 3 periods. The mortality rates of diseases of circulatory system, liver disease and all others were decreased in male but the mortality rates of neoplasm and accident and posions was increased. Female showed a similar trend to male but the mortality rate of liver diseases was increased. Mortality rates of diseases of circulatory system, neoplasm and liver diseases increased with age of teachers up to 50 years of age but decreased in 60 years of age. Mean age at death due to each cause was higher in male than female by $4{\sim}10$ years. However, the mean age at death of the teachers was $2{\sim}5$ years lower than that of the general population in all causes of death and the sex difference in the mean a2e at death was smaller ($2{\sim}3$ years) in general population. In sex ratio of mortality, male was higher than female in almost all diseases except suicide and maintained a high ratio. The general population showed universally high ratio in male like teachers, and more or less did regular patterns in mortality with ratio smaller.

• Korean Journal of Veterinary Research
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• v.50 no.3
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• pp.213-220
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• 2010

Salmonella (S.) Enterica infection ranks among the most common food borne bacterial infections worldwide. Although there are six subspecies of S. Enterica, the vast majority of human and animal infections are caused by strains belonging to subspecies 1 serovar Typhimurium and Enteritidis. Recent reports on antibiotic resistance of Salmonella spp. are rising steadily. The increasing problem of antibiotic resistance has rekindled interest in bacteriophage to therapy. Therefore, we investigated the efficacy of bacteriophage in S. enterica serovar Enteritidis infected mice and pigs by measuring of body condition, body weight, bacterial colonization and weight of organs based on the in vitro analysis. In vitro experiment, phage cultured with S. Enteritidis showed clear lysis pattern, the plaque forming unit (PFU) of our phage culture was $1.5{\times}10^{11}PFU/mL$, and phage showed its maximum activity at 4 h post inoculation. In mouse experiment, there was no significant difference among experimental groups in the general body conditions and body weight of mice. However, there was difference in weight of liver and spleen depending on the experimental group (p < 0.05). The weight of liver and spleen were reduced by the phage treatment. Also bacterial colonization in spleen and liver were significantly reduced by the phage treatment. In pig experiment, the general body conditions and body temperature exhibited not much difference among the pigs except few pigs in group 3 which showed poor body conditions. From the feces in each group, we could isolate the S. Enteritidis only from group 3. Bacterial enrichment culture was necessary for isolating the bacteria from 5 dpi and 10 dpi, however direct isolation was possible from 15 dpi feces. In phage treated group, postmortem lesion was better than non-phage treated group. Recently, antibiotic resistance concerns on the food-borne bacterial pathogens have been increasing because of the wide spread of the antibiotics resistance genes. This concern is widely transmitted to the human related public health. As one of the alternative treatments on the bacterial pathogens, attempt using phages have been made to control the bacterial diseases. The positive possibility of the trail using phage was observed to control the S. enterica serovar Enteritidis in this study even though the further analysis has been remained.

• Journal of Food Hygiene and Safety
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• v.26 no.4
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• pp.349-354
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• 2011

Our objective in this study is to assess the safety of docosahexaenoic acid (DHA) fortified milk of dairy cows fed feeds containing protected fish oil treated with formaldehyde by analyzing formaldehyde concentration in commercial milk and DHA fortified milk of dairy cows fed formaldehyde treated feed. There are 3 milk samples in this study: Commercial milk (CM), DHA fortified milk for Kid (DHA-K) and DHA fortified milk for Baby (DHA-B). We confirm the fresh quality of these three samples by physicochemical tests. In fat content result, three groups are significantly different at the p < 0.05 by Duncan's multiple range test, but fat content of group DHA-K is about half the level of the other two groups. Protein content of group DHA-K is 1 % higher than other two groups. According to the analysis result of DHA content of DHA fortified milk, DHA content of DHA-B is two-fold higher than DHA-K. Similar pattern was seen in the intake based on age. According to HPLC analysis result of formaldehyde concentration in milk, commercial milk and DHA fortified milk are between 0.013 ppm and 0.057 ppm which is formaldehyde standard level in fresh milk settled in WHO (World Health Organization). Three groups have no significantly differences at the p < 0.05 by Duncan's multiple range test. For this reason, it can be concluded that there is no transition of formaldehyde from dairy cows fed formaldehyde treated feeds to its produced milk. Safety about formaldehyde of DHA fortified milk of dairy cows fed formaldehyde treated feeds is considered similar to commercial milk.

• The Korean Journal of Emergency Medical Services
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• v.9 no.2
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• pp.111-128
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• 2005

Background: Cardiac arrest is one of the most critical diseases which can likely lead to severe cerebral disability or brain death when the cases can not recover their circulation within 10 minutes. Saving out-of-hospital cardiac arrest cases is a recent concern in Korea. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. The best survival can be achieved if all the following links have been optimized : rapid access, and early CPR, defibrillation and ACLS, Since the "Utstein Style" was advocated in 1991, many reports about out-of-hospital cardiac arrest have been published based on this guideline. These differences prevent valid inter-hospital and international comparisons. However, it is not known how effective resuscitation has become to the patients. In other words, there are no guidelines for reviewing, reporting, and conducting research on resuscitation in Korea. This dissertation aims to provide the basic data for a unified reporting guideline of resuscitation in Korea and evaluating the out-of-hospital factors associated with survival discharge of out-of-hospital cardiac arrest. Methods: As for this study, uses the collected data about Out-of-hospital cardiac arrests at 4 area, from January, 2005 to April. 2005. With a retrospective study, 174 cases were analyzed. The data was recorded based on the Out-of-Hospital Utstein Style. Results: Resuscitation was performed on 174 out-of-hospital cardiac arrest cases at the 4 area 14 patients(8.1%) recovered their spontaneous circulation. Overall, the ROSC of the out-of-hospital cardiac arrest patients was 8.1%, which was poorer than that of western countries. Gender distribution was 50 females(28.7%) and 124 males(71.3%), approximately twice as many males as females. ROSC of witnessed arrests was found out to be 97.7%. The ratio of the witnessed arrest groups showed higher results than that of unwitnessed arrest groups in the above-examined cases. Cardiac etiology consisted of cardiac(33.5%), non-cardiac(45.7%), trauma(20.1%), and unknown(6.0%). Cardiac was the best performance. Initial rhythm showed Ventricular Tachycardia/pulseless Ventricular Fibrillation in 8 patients(6.0%), asystole in 100(75.2%) and unknown in 25(18.8%). The results of the Ventricular Tachycardia/pulseless Ventricular Fibrillation showed higher results than the others cases, The proportion of the cardiogenic cause was 33.5%, which was only half of western countries. Ventricular Tachycardia/pulseless Ventricular Fibrillation is relatively rare. These differences were due to the prevalent pattern of Out-of-hospital cardiac arrest as well as prematurity of the EMSS. Bystander CPR was practiced on 13 patients(7.52%). ROSC was shown in 46.2% cases. CPR by EMT was carried out on 167 cases(96.5%). ACLS by EMf was rare. From collapse, 4 cases(2.6%) arrived to ED within 6 minutes. 13 (8.6%) within 10 minutes, and 49(32.5%) over 31 minutes. The sooner the patients arrived, the greater the ratio of ROSC and discharged alive became, and the same with collapse time to ROSC. As the results of the logistic regression analysis, ROSC was found out to be highly influenced by the time of ED arrival from collapse and Ventricular Tachycardia/pulseless Ventricular Fibrillation. Therefore, the ratio of ROSC depends on not any single factor but various intervention factors. Conclusion: This dissertation presents the following suggestions and directions of the study hereafter. First, the first step for a chain of survival should be taken to activate EMSS early with a phone as soon as cardiac arrests are witnessed. Second, it is keenly needed that emergency medical technicians should be increased through emergency education for living. Third, it is necessary to establish the emergency transportation system. Fourth, most of the Koreans have little understanding of EMT and the present operation systems have many problems, which should be fundamentally changed. Fifth, it is required to have an active medical control over Out-of-hospital CPR, And proper psychological supports should be given not only to patients themselves and their family but also individuals who are engaged in emergency situation. Finally, through studies hereafter on nationwide, comprehensive, and standard forms, it is needed to examine into the biological figures of human body, causes and trends of cardiac arrests, and then, to enhance the survival rate of Out-of-hospital cardiac arrests. Korean guidelines for Cardiopulmonary resuscitation need to be made.

• Journal of the Korean Society of Food Science and Nutrition
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• v.36 no.6
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• pp.735-744
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• 2007

The purpose of this study was to investigate the sweets preference, food frequency, dietary habits, and nutrition knowledge of middle school students who like sweets. A survey instrument consisted of a self-administered questionnaire, a food frequency questionnaire, and anthropometric measurements. Three hundreds thirty five students aged 13 to 15 years old were divided into two groups, Sweets Liking Group (SLG) and a control group based on the subjects' scores for dietary habits, sweets preference, and food frequency. For dietary habits, the score for meal regularity was significantly lower in the SLG group compared to the control (p<0.001). In addition, the SLG group was more likely to skip breakfast (p<0.001), eat inadequate amount of meals (p<0.001), and consume yellow-green vegetables less frequently (p<0.001) than the control. The subjects' nutrition knowledge was assessed using 20 questions representing five categories, including functions of nutrients, nutrition and health, food pyramid and food groups, healthful snacking and the right dietary attitude. The total scores for nutrition knowledge indicated that the SLG had a poorer nutrition knowledge for all five categories than the control (boys p<0.05, girls p<0.01). For food frequency, the SLG consumed more sweets but less grains, cereals, fishes, beans, vegetables, and milk and milk products than the control (p<0.001). Strong positive correlations appeared between sweets preference, sweets frequency, and sweets-related dietary habits; and all were negatively correlated to nutrition knowledge. Sweets frequency was negatively related to meal regularity, breakfast consumption, meal adequacy, and balanced meals. The findings suggest that nutrition education is necessary to improve the dietary pattern, especially sweets consumption, of Korean young adolescents.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.145-172
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• 1984

In order to assess the physical growth pattern of Korean Youth, the authors measured the body height, body weight, chestgirth and sitting height of 40967 persons (24832 males and 16135 females) from primary schools, middle and high schools and colleges of metropolitan (urban) and rural areas, and calculated the mene, standard deviation, standard error and coefficient variance of the body weight chestgirth, sitting height and various pertinent index by body height to demonstrate the standard physical growth and development by body height of sex and age. The following conclusions were obtained. 1. Physical growth and development: Rapid growth of physical growth in terms of body height has been observed among males in the age $7{\sim}15$ and among female $7{\sim}13$. Growth in terms of body height turned out to be slower among students of higher age by both sexes. The age of cross over between to sexes is between 10 to 13 years where upon girls out grows boys. Maximum annual growth were upon girls out grows boys. Maximum annual growth were both of 6.16cm from 8 to 9 years old and 12 to 13 years old for boys and 7.2cm from 8 to 9 and 6.1cm from 9 to 10 for girls. This indicates that girls enter a rapidly growing stage 2 years earlier than boys. Meanwhile, prominent improvement in body height of national students over period of ten year was noticed. 2. The distribution status of body height by age: The distribution status of body height by age were as follows; 7 year of age: boys-30cm range of body height from 104.0cm to 133.9cm, girls-27cm from 104.0cm to 130.9cm 8 year of age: boys-30cm from 116.0 to 145.9cm girls-33cm from 113.0 to 145.9cm 9 year of age: boys-30cm from 116.0 to 145.9cm girls-33cm from 113.0 to 145.9cm 10 year of age: boys-39cm from 116.0 to 154.9cm girls-39cm from 119.0 to 157.9cm 11 year of age: boys-45cm from 119.0 to 163.9cm girls-39cm from 122.0 to 160.9cm 12 year of age: boys-45cm from 125.0 to 169.9cm girls-42cm from 125.0 to 166.9cm 13 year of age: boys-45cm from 128.0 to 172.9cm girls-42cm from 128.0 to 169.9cm 14 year of age: boys-48cm from 131.0 to 178.9cm girls-36cm from 134.0 to 169.9cm 15 year of age: boys-42cm from 137.0 to 181.9cm girls-33cm from 137.0 to 169.9cm 16 year of age: boys-39cm from 146.0 to 184.9cm girls-30cm from 143.0 to 172.9cm 17 year of age: boys-39cm from 146.0 to 184.9cm girls-27cm from 143.0 to 169.9cm 18 year of age: boys-36cm from 152.0 to 187.9cm girls-27cm from 146.0 to 172.9cm 19 year of age: boys-30cm from 155.0 to 184.9cm girls-24cm from 146.0 to 169.9cm 20 year of age: boys-24cm from 158.0 to 181.9cm girls-l8cm from 149.0 to 166.9cm 3. Standard values of body weight, chest-girth and sitting height by body height of age were found all age groups from 7 to 20 years old and listed in tables from3-a to 16-a. 4. Standard values of relative body weight, relative chestgirth and relative sitting height by body height of age were found all age groups from 7 to 20 years old and listed in tables from 3-b to 16-b. 5. Standard values of physical and nutritional indices (Rohrer index, Kaup index, Vervaeck index and Pelidisi index) by body height of age were found all age groups from 7 to 20 years old and listed in tables from 3-c to 16-c.

• Korean Journal of Microbiology
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• v.51 no.1
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• pp.39-47
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• 2015

Secondary metabolism in actinomycetes has been known to be controlled by a small molecule, ${\gamma}$-butyrolactone autoregulator, the binding of which to each corresponding receptor leads to the regulation of the transcriptional expression of the secondary metabolites. We expected that expression of an autoregulator receptor or a pleiotropic regulator in a non-host was to be gained insight of effective production of new metabolic materials. In order to study the function of the receptor protein (seaR), which is isolated from Saccharopolyspora erythraea, we introduced the seaR gene to Streptomyces coelicolor A3(2) as host strains. An effective transformation procedure for S. coelicolor A3(2) was established based on transconjugation by Escherichia coli ET12567/pUZ8002 with a ${\varphi}C31$-derived integration vector, pSET152, which contained int, oriT, attP and $ermEp^*$ (erythromycin promotor). Therefore, the pEV615 was introduced into S. coelicolor A3(2) by conjugation and integrated at the attB locus in the chromosome of the recipients by the ${\varphi}C31$ integrase (int) function. Exconjugant of S. coelicolor A3(2) containing the seaR gene was confirmed by PCR and transcriptional expression of the seaR gene in the transformant was analyzed by RT-PCR. In case of S. coelicolor A3(2), a phenotype microarray was used to analyze the phenotype of transformant compared with wild type by seaR expression. After that, in order to confirm the accuracy of the results obtained from the phenotype microarray, an antimicrobial susceptibility test was carried out. This test indicated that sensitivity of the transformant was higher than wild type in tetracycline case. These results indicated that some biosynthesis genes or resistance genes for tetracycline biosynthesis in transformant might be repressed by seaR expression. Therefore, subsequent experiments, analysis of transcriptional pattern of genes for tetracycline production or resistance, are needed to confirm whether biosynthesis genes or resistance genes for tetracycline are repressed or not.

• Korean Journal of Ecology and Environment
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• v.50 no.1
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• pp.1-15
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• 2017

Daecheong Reservoir was made by the construction of a large dam (>15 m in height) on the middle to downstream of the Geum River and the discharge systems have the watergate-spillway (WS), a hydropower penstock (HPP), and two intake towers. The purpose of this study was to investigate the limnological anomalies of turbid water reduction, green algae phenomenon, and oligotrophic state in the lower part of reservoir dam site, and compared with hydro-meteorological factors. Field surveys were conducted in two stations of near dam and the outlet of HPP with one week intervals from January to December 2000. Rainfall was closely related to the fluctuations of inflow, outflow and water level. The rainfall pattern was depended on the storm of monsoon and typhoon, and the increase of discharge and turbidity responded more strongly to the intensity than the frequency. Water temperature and DO fluctuations within the reservoir water layer were influenced by meteorological and hydrological events, and these were mainly caused by water level fluctuation based on temperature stratification, density current and discharge types. The discharges of WS and HPP induced to the flow of water bodies and the outflows of turbid water and nutrients such as nitrogen and phosphorus, respectively. Especially, when hypoxic or low-oxygen condition was present in the bottom water, the discharge through HPP has contributed significantly to the outflow of phosphorus released from the sediment into the downstream of dam. In addition, HPP effluent which be continuously operated throughout the year, was the main factor that could change to a low trophic level in the downreservoir (lacustrine zone). And water-bloom (green-tide) occurring in the lower part of reservoir was the result that the water body of upreservoir being transported and diffused toward the downreseroir, when discharging through the WS. Finally, the hydropower effluent was included the importance and dynamics that could have a temporal and spatial impacts on the physical, chemical and biological factors of the reservoir ecosystem.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.1
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• pp.91-98
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• 2007

The aim of this study was to examine the difference of the depth of sedation using the Bispectral index assessment with and without the added submucosal Midazolam to oral Chloral hydrate and Hydroxyzine for pediatric patients. Twenty seven sedation cases were performed in this study Selection criteria included good health(ASA I), 2 to 6 years of age, the need for sedation to receive dental treatment including anesthesia, and restorative procedure over at least two teeth. Patients were randomly classified into one group taking oral Chloral hydrate(60 mg/kg) and Hydroxyzine(1 mg/kg) and the other group recieving Chloral hydrate(60 mg/kg), Hydroxyzine(1 mg/kg) and submucosal Midazolam(0.1 mg/kg). Nitrous Oxide(50%) was used for both group during sedation. Patients were monitored using a pulse oximeter and a Bispectral monitor. A behavior scale was rated as quiet(Q), crying(C), movement(M), or struggling(S) every 2 minutes watching a recorded videotape. Analysis showed a significant difference in mean Bispectral index and SD during sedation across two groups(P<0.001). The group of patients injected with submucosal Midazolam in addition to oral Chloral hydrate and Hydroxyzine showed a lower mean Bispectral index and a narrower SD. PR and SpO2 for both groups remained within the normal values. Submucosal Midazolam improved the sedation quality by deepening sedation depth without compromising safety and enabled the sedation pattern to be kept more stable.