• The Journal of KAIRB
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• v.2 no.1
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• pp.6-22
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• 2020

Purpose: Clinical studies require institutional review board (IRB) approval based on the ethical principle and regulations. While the number of clinical studies has been increased and diversified, duplicated IRB review for multi-center studies has become a major issue. Therefore, single IRB system has been suggested in revised Common Rule. This study aimed to identify and assess the current status of single IRB in Korea and the anticipated needs of single IRB from researchers and IRB member or administrators. Methods: We developed 14 questions including perceived advantages and disadvantages of single IRB, and anticipated problems. The online survey collected opinions on single IRB from researchers, IRB members and IRB administrators. We also interviewed five IRB administrators who have an experience of single IRB. Results: A total of 80 responses were analyzed in this study. Although efficiencies were suggested for the advantages of single IRB in terms of reducing burden of duplicated review, respondents also perceived that the different review criteria between single IRB and each IRB would be a major hurdle for adopting single IRB system. Therefore, the standardization of standard of procedures (SOP) and the standardization of IRB submission materials should be preceded. According to the small group experiences of single IRB in Korea, we also observed the similar anticipated problems of single IRB. Conclusion: Single IRB system has many advantages for conducting multi-center trial. However, many specialists still have a lot of concerns about introducing a single IRB system in Korea. Therefore, a gradual, step-by-step process for conducting a single IRB system in Korea will be needed. Many studies for improving currently suggested single IRB system and the improvement of awareness about the essential of single IRB system would be needed.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.6
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• pp.317-325
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• 2023

Background: Local anesthetic injections may induce pain in children, leading to fear and anxiety during subsequent visits. Among the various approaches recommended to reduce pain, one is the use of a Buzzy Bee^TM device that operates on the concept of gate control theory and distraction. The literature regarding its effectiveness during the deposition of local anesthesia remains limited; hence, the aim of the present study was to determine the efficacy of extraoral cold and vibrating devices in reducing pain perception during the deposition of local anesthesia. Methods: A split-mouth crossover study in which 40 children aged 3-12 years requiring maxillary infiltration or inferior alveolar nerve block for extractions or pulp therapy in the maxillary or mandibular posterior teeth were included. The control intervention involved the application of topical anesthetic gel for one minute (5% lignocaine gel), followed by the administration of local anesthetic (2% lignocaine with 1:80,000 adrenaline) at a rate of 1 ml/ minute. Along with the control protocol, the test intervention involved using the Buzzy Bee^TM device for 2 minutes before and during the deposition of the local anesthetic injection. The heart rate and face, legs, arms, cry, and consolability revised (FLACC-R) scale scores were recorded by the dentist to assess the child's pain perception. Results: The mean age of the participants in Group A and Group B was 7.050 ± 3.12 years and 7.9 ± 2.65 years respectively. A reduction in the mean heart rate and FLACC-R score was observed during the deposition of local anesthetic solution in the tissues when the Buzzy Bee^TM was used in both groups at different visits in the same subjects (P < 0.05) The Buzzy Bee^TM device was effective in reducing the heart rate and FLACC-R scores when used during maxillary infiltration and inferior alveolar nerve block local anesthesia techniques (P < 0.05). Conclusion: The use of extraoral cold and vibrating devices significantly reduces pain perception during local anesthetic deposition in pediatric patients. Considering the results of this study, the device may be incorporated as an adjunct in routine dental practice while administering local anesthesia in children.

• Journal of agricultural medicine and community health
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• v.15 no.2
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• pp.97-106
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• 1990

1. Background Women's health and their involvement in health care are essential to health for everyone. If they are ignorant, malnourished or over-worked, the health &-their families as well as their own health will suffer. Women's health depends on broad considerations beyond medicine. Among other things, it depends upon their work in farming. their subordination to their families, their accepted roles, and poor hygiene with poorly equipped housing and environmental sanitation. 2. Objectives and Contents a. The health status of rural women : physical and mental complaints, experience of pesticides intoxication, Farmer's syndrome, experiences of reproductive health problems. b. participation in and attitudes towards housework and farming c. accessibility of medical care d. status of maternal health : fertility, family planning practice. induced abortion, and maternal care 3. Research method A nationwide field survey, based on stratified random sampling, was conducted during July, 1986. Revised Cornell Medical index(68 out of 195 items). Kawagai's Farmers Syndrome Scale, and self-developed structured questionnaires were used to rural farming wives(n=2.028). aged between 26-55. 4. Characteristics of the respondents mean age : 40.2 marital status : 90.8% married mean no. of household : 4.9 average years of education : 4.7 yrs. average income of household : \235,000 average years of residence in rural area : 36.4 yrs average Working hours(household and farming) : 11 hrs. 23 min 5. Health Status of rural women a. The average number of physical and mental symptoms were 12.4, 4.7, and the rate of complaints were 22.1%, 38.8% each. revealing complaints of mental symptomes higher than physical ones. b. 65.4% of rural women complained of more than 4 symptoms out of 9, indicating farmer's syndrome. 11.9 % experienced pesticide overdue syndrome c. 57.6% of respondents experienced women-specific health problems. d. Age and education of respondents were the variables which affect on the level of their health 6. Utilization of medical services a. The number of symptoms and complaints of respondents were dependent on the distance to where the health-care service is given b. Drug store was the most commonly utilized due to low price and the distance to reach. while nurse practitioners were well utilized when there were nurse practitioner's office in their villages. c. Rural women were internalized their subordination to husbands and children, revealing they are positive(93%) in health-care demand for-them but negative(30%) for themselves d. 33.0% of respondents were habitual drug users, 4.5% were smokers and 32.3% were alcohol drinkers. and 86.3% experienced induced-abortion. But most of them(77.6%) knew that those had negative effects on health. 7. Maternal Health Care a. Practice rate of contraception was 48.1% : female users were 90.9% in permanent and 89.6% in temporary contraception b. Induced abortions were taken mostly at hospital(86.3%), while health centers(4.7%), midwiferies(4.3%). and others(4.5%) including drug stores were listed a few. The repeated numbers of induced abortion seemed affected on the increasing numbers of symptoms and complaints. c. The first pre-natal check-up during first trimester was 41.8%, safe delivery rate was 15.6%, post-natal check-up during two months after delivery. Rural women had no enough rest after delivery revealing average days of rest from home work and farming 8.3 and 17.2. d. 86.6% practised breast feeding, showing younger and more educated mothers depending on artificial milk 8. Recommendations a. To lessen the multiple role over burden housing and sanitary conditions should be improved, and are needed farming machiner es for women and training on the use of them b. Health education should begin at primary school including health behavior and living environment. c. Women should be encouraged to become policy-makers as well as administrators in the field of women specific health affairs. d. Women's health indicators should be developed and women's health surveillance system too.

• Journal of Chest Surgery
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• v.44 no.5
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• pp.348-354
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• 2011

Background: Traumatic rupture of the diaphragm is an unusual type of trauma. In addition, it is difficult to diagnose because it can be accompanied by injuries to other organs. If it is not detected early, the mortality rate can increase due to serious complications. Diaphragmatic rupture is an important indicator of the severity of the trauma. The aim of this study was to investigate the factors affecting the incidence of complications and mortality in patients who had surgery to treat traumatic rupture of the diaphragm. Materials and Methods: The subjects were patients who had undergone a diaphragmatic rupture by blunt trauma or stab wounds except patients who were transferred to other hospitals within 3 days of hospitalization, from January 2000 to December 2007. This study was a retrospective study. 43 patients were hospitalized, and 40 patients were included during the study period. Among them, 28 were male, 12 were female, and the average age was 42 (from 18 to 80). Outcome predictive factors including hypoxia, ventilator application days, revised trauma score (RTS), injury severity score (ISS), age, herniated organs, complications, and the mortality rate were investigated. Results: Causes of trauma included motor vehicle crashes for 20 patients (50%), falls for 10 (25%), stab wounds for 8 (20%), and agricultural machinery accidents for 2 (5%). Most of the patients (36 patients; 90%) had wound sites on the left. Diagnosis was performed within 12 hours for most patients. The diaphragmatic rupture was diagnosed preoperatively in 27 patients (70%) and in 12 patients (30%) during other surgeries. For surgical treatment, thoracotomy was performed in 14 patients (35%), laparotomy in 11 (27.5%), and a surgery combining thoracotomy and laparotomy in 15 patients (37.5%). Herniated organs in the thoracic cavity included the stomach for 23 patients (57.5%), the omentum for 15 patients (37.5%), the colon for 10 patients (25%), and the spleen for 6 patients (15%). Accompanying surgeries included splenectomy for 13 patients (32.5%), lung suture for 6 patients (15%), and liver suture for 5 patients (12.5%). The average hospital stay was $47.80{\pm}56.72$ days, and the period of ventilation was $3.90{\pm}5.8$ days. The average ISS was $35.90{\pm}16.81$ (11~75), and the average RTS was $6.46{\pm}1.88$ (1.02~7.84). The mortality rate was 17.5% (7 patients). Factors affecting complications were stomach hernia and age. Factors affecting the mortality rate were ISS and RTS. Conclusion: There are no typical symptoms of the traumatic rupture of the diaphragm by blunt trauma. Nor are there any special methods of diagnosis; in fact, it is difficult to diagnose because it accompanies injuries to other organs. Stab wounds are also not easy to diagnose, though they are relatively easy to diagnose compared to blunt trauma because the accompanying injuries are more limited. Suture of the diaphragm can be performed through the chest, the abdomen, or the thoracoabdomen. These surgical methods are chosen based on accompanying organ injuries. When there are many organ injuries, there are a great number of complications. Significant factors affecting the complication rate were stomach hernia and age. ISS and RTS were significant as factors affecting the mortality rate. In the case of severe trauma such as pelvic fractures, frequent physical examinations and chest X-rays are necessary to confirm traumatic rupture of the diaphragm because it does not have specific symptoms, and there are no clear diagnosis methods. Complications and the mortality rate should be reduced with early diagnosis and with treatment by confirming diaphragmatic rupture in the thoracic cavity and the abdomen during surgery.

• Sleep Medicine and Psychophysiology
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• v.24 no.1
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• pp.46-54
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• 2017

Objectives: Domestic violence is related to many psychiatric diseases, such as depression, anxiety disorder, and PTSD. Heart rate variability (HRV) is an index of autonomic control of the heart and is related to cardiovascular and emotional disorders. Although there have been some studies on the effects of domestic violence on women's mental health, relatively little information is available on HRV in this population. The aim of this study is to investigate demographic data, psychological features, and HRV in female victims of domestic violence and difference between Korean and foreign female victims. Methods: A total of 210 female victims of domestic violence (166 Korean women and 44 foreign women) were recruited for this study. Psychological symptoms were measured using the Hamilton Rating Scale for Anxiety (HAM-A), Hamilton Rating Scale for Depression (HAM-D), and Impact of Event Scale-Revised (IES-R). HRV measures were assessed by time-domain and frequency-domain analyses. Results: The mean score of HAM-A was 13.81, that of HAM-D was 12.92, and that of IES-R was 33.61 ; there were no significant differences between Korean and foreign women in these measures. In HRV time domain analyses, approximate entropy (ApEn) was significantly increased in foreign women compared to the Korean women. The square root of the mean of the sum of the squares of differences between adjacent NN intervals (RMSSD) was significantly decreased in foreign women compared to Korean women. There were no significant differences in the other HRV variables between Korean and foreign women. Conclusion: Female victims of domestic violence in Korea are associated with depression, anxiety, and PTSD symptoms. The physiologic factors of a female victim's nationality could be related to higher ApEn and lower RMSSD in foreign female victims. These findings have important implications for future study to study the relationships among ethnic and environmental factors and HRV variables.

• Korean Journal of Psychosomatic Medicine
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• v.8 no.2
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• pp.201-211
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• 2000

Objectives : The purpose of this study was to determine the validity and reliablity of the Korean version of the Global Assessment of Recent Stress(GARS) Scale developed for assessing the severity of current perceived stressors, and then to use the scale in clinical practice. Methods : The questionnaire was completed by 215 healthy subjects. A comparison was made regarding the perception of stressors among 242 patients(71 with anxiety disorder, 73 with depressive disorder, 47 with somatoform disorder, and 51 with psychosomatic disorder) and 215 healthy subjects. Factor analysis was done using oblique rotation after maximum-likelihood factor analysis. Results : Factor analysis yielded 1 subscale. Reliability was computed by administering the GARS Scale to 69 healthy subjects during a 2-week interval. Test-retest reliability for 8 items and the total score was significantly high, ranging between 0.85-.95. Internal consistency was significant(Cronbach's a for 7 items : .86). Convergent validity was computed by correlating the 8 items and the total score with the total score of the stress response inventory(SRI), the perceived stress questionnaire(PSQ), and the somatization, anxiety, depression, hostility subscales and general indices of the symptom checklist-90-revised(SCL-90-R). The correlations were all at significant levels. Discriminant validity was computed by comparing the 8 item scores of the patient and control groups. Significant differences were found in area relevant to sickness or illness and the overill global area. The patients with anxiety disorder were significantly higher in area relevant to sickness or illness than the healthy group, whereas the patients with depressive disorder was significantly higher in the overall global score than healthy group. The depressive disorder group was the highest in overall global score of the GARS scale among 4 patient groups, and showed a significant higher scores in interpersonal relationship and overall global area than the psychosomatic disorder group. Conclusions : These results indicate that the Korean version of the GARS scale is highly reliable and valid, and that it can be utilized as an effective measure of perceived stressors for research in stress-related fields. It is suggested that depressive disorder patients are more likely to perceive recent stressors than psychosomatic disorder patients.

• Journal of The Korean Dental Society of Anesthesiology
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• v.14 no.1
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• pp.17-27
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• 2014

Background: Various medical emergency situations can occur during dental practices. Cardiac arrest is known to comprise approximately 1% of emergency situation. Thus, it is necessary for dentists to be able to perform cardiopulmonary resuscitation (CPR) to increase the chance of saving patient's life in emergency situation. In this paper, we conducted a survey study to evaluate to what extent dentists actually understood CPR practice and if they had experience in handling emergency situations in practice. Method: The survey was done for members of the Korean Dental Society of Anesthesiology (KDSA), who had great interest in CPR and for whom survey-by-mail was convenient. We had selected 472 members of the KDSA with a dental license and whose office address and contact information were appropriate, and sent them a survey questionnaire by mail asking about the degree of their CPR understanding and if they had experience of handling emergency questions before. Statistical analyses -frequency analysis, chi-square test, ANOVA, and so on- were performed by use of IBM SPSS Statistics 19 for each question. Result: Among 472 people, 181 responded (38.4% response rate). Among the respondents were 134 male and 47 female dentists. Their average age was $40.4{\pm}8.4$. In terms of practice type, there were 123 private practitioners (68.0%), 20 professors (11.0%), 16 dentists-in-service (8.8%), 13 residents (specialist training) (7.2%) and 9 military doctors (5%). There were 125 dentists (69.1%) who were specialists or receiving training to be specialist, most of whom were oral surgeon (57, 31.5%) and pediatric dentists (56, 30.9%). There were 153 people (85.0%) who received CPR training before, and 65 of them (35.9%) were receiving regular training. When asked about the ratio of chest pressure vs mouth-to-mouth respiration when conducting CPR, 107 people (59.1%) answered 30:2. However, only 27.1% of them answered correctly for a question regarding CPR stages, C(Circulation)- A(Airway)- B(Breathing)- D(Defibrillation), which was defined in revised 2010 CPR practice guideline. Dentists who had experience of handling emergency situations in their practice were 119 (65.6%). The kinds of emergency situations they experienced were syncope (68, 37.6%), allergic reactions to local anesthetic (44, 24.3%), hyperventilation (43, 23.8%), seizure (25, 13.8%), hypoglycemia (15, 8.3%), breathing difficulty (14, 7.8%), cardiac arrest (11, 6.1%), airway obstruction (6, 3.3%), intake of foreign material and angina pectoris (4, 2.2%), in order of frequency. Most respondents answered that they handled the situation appropriately under the given emergency situation. In terms of emergency equipment they had blood pressure device (70.2%), pulse oximetry (69.6%), Bag-Valve-Mask (56.9%), emergency medicine (41.4%), intubation kit (29.8%), automated external defibrillator (23.2%), suction kit (19.3%) and 12 people (6.6%) did not have any equipment. In terms of confidence in handling emergency situation, with 1-10 point scale, their response was $4.86{\pm}2.41$ points. The average point of those who received regular training was $5.92{\pm}2.20$, while those who did not was $4.29{\pm}2.29$ points (P<0.001) Conclusion: The result showed they had good knowledge of CPR but the information they had was not up-to-date. Also, they were frequently exposed to the risk of emergency situation during their dental practice but the level of confidence in handling the emergency situation was intermediate. Therefore, regular training of CPR to prepare them for handling emergency situation is deemed necessary.

• The Korean Society of Law and Medicine
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• v.19 no.1
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• pp.113-142
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• 2018

In recent years, there have been opinions in which physicians are liable to the revocation of their medical license if they are sentenced to above a certain level for criminal charges regardless of the types of offenses. Accordingly, a revised bill of law was submitted in the National Assembly, and related discussions are thus expected to commence. Considering the morality and ethics or the level of the rule of law that the general public expects of physicians, as well as the license revocation system in other professional sectors, it is assessed that medical license revocation due to criminal convictions of physicians is appropriate to some degree. However, if a poorly devised system is established based on unrefined inferences or emotional judgements, unexpected side-effects are likely to arise. With regard to serious criminal acts that society generally perceives as unacceptable, it can be assessed that the revocation of physicians' licenses would appropriately protect the general public from threats. However, given the life-saving characteristics of high-risk medical practices, higher malpractice exposures, and social values, it is difficult to assess charges of professional negligence resulting in death(or in injury) and minor offences in the same manner as anti-social criminal offences are handled. Physicians need to be treated the same as any other professions. At the same time, they are engaged in administering medical treatment to patients in the face of great risks as professionals. Under the circumstances, a discussion on the introduction of a more specific and empirical system is needed by considering the intrinsic characteristics of medical treatment and the need for an equitable health and medical policy. Accordingly, based on the above judgment and perception, this study explores the code of ethics for physicians and medical license revocation related to criminal offences at home and abroad, and examines various legislative alternatives appropriate for the Republic of Korea. In doing so, the purpose of the study is to contribute to the development of a reasonable system for handling criminal offences by physicians.

• Journal of Sasang Constitutional Medicine
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• v.11 no.2
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• pp.119-150
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• 1999

In spite of recent remarkable recent development in both western and oriental medical sciences, there is still only a shallow understanding of individual differences for various prognoses of incurable diseases and immunopathy diseases. Nevertheless, the care, cure and prevention methods of Sasang Constitutional Medicine are broadly used as an effective treatment of incurable diseases like immunopathy diseases and stress-related diseases and diseases due to aging. In this sense, the establishment of classification norms is urgent and essential for the worldwide application of Sasang Constitutional Medicine(SCM). This study began with the confirmation process of whether Sasang Constitutional types exist in Americans. To accomodate for cultural differences, the distinguishing tool was readjusted so that Sasang Constitutional Types in Americans could be determined. Hence, the selected tool is the new QSCCII+, which is a newly revised English version of the QSCCII. QSCCII was made and standardized by Dept. of SCM in Kyung Hee Medical Center and Dr. Kim7). The evaluation methods of the old version were improved in the new QSCCII+ through necessary statistical manipulation. The original QSCCII was officially authorized by the Korean Society of Sasang Constitutional Medicine as the only computerized version of Sasang diagnostics. This study is the first attempt to design a new diagnostic tool for the classification of Sasang Constitutional types in North Americans with the revision of QSCCII. The subjects of this study were selected from the cooperative people among the students and staffs of the University of Bridgeport and the patients who visited the Clinic in the Health Science Center. This study takes for about 1 year from 1998. 8 to 1999. 8 The conclusions of the study can be summarized as follows: 1. Sasang constitutional types also exist in Americans. It can also naturally be inferred that Sasang Constitutional types exist in all human beings, for there are many different human races in America. 2. There are more So-Yang In's than any other types in American white people. This result confirms the hypothesis that there also exist Sasang Constitutional types in westerners. 3. The result of repetitive tests suggests that the new QSCCII+ is an effective diagnostic tool for westerners when we consider the constant diagnostic results of the QSCCII+. 4. Sasang Constitutional types exit in the sample group regardless of racial difference. 5. The question items that were not often checked by Americans need to be modified into more understandable expressions. 6. The standardization of diagnosis for Americans should be established by use of the QSCCII+ 7. It can be guessed that there are many Tae-yang In's among the 71 persons who could not be clearly classified by the QSCCII+. Due to the scarcity of Tae-yang-In in general, it is important to improve upon the discernability of the QSCC II+. 8. The results of the Sasang Constitutional distribution in North Americans are as follows: The percentage of So-yang In distribution in the sample group is 36.25%(87persons), that of Tae-eum In is 13.75%(33persons), and that of So-eum In is 20.41%(49persons).

• The Korean Society of Law and Medicine
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• v.20 no.3
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• pp.143-174
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• 2019

Our Constitution obliges the state to protect the health of the people, and the Medical Law, which embodied Constitution, sets out in detail the matters related to open the medical institution, and one of them is to prohibit the operation of multiple medical institutions. By the way, virtually multiple medical institutions could be opened and operated because the Supreme Court had interpreted that several medical institutions could be opened if medical activities were not performed directly at the additional medical institution which was opened under the another doctor's license. However, some health care providers opened the several medical institutions with another doctor's license for the purpose of the maximization of profit, and did illegal medical cares like the unfair luring of patients, over-treatment, and commission treatment. Also, realistic problems such as the infringed health rights have arisen. Accordingly, lawmakers had come to amend the Medical Law to readjust the system of opening for medical institution so that medical personnel could not open or operate more than one medical institution for any reason. For this reason, the Constitutional Court recently declared a constitutional decision through a long period of in-depth deliberation because the constitutional petition and the adjudication on the constitutionality of statutes had been filed on whether Article 33 paragraph 8 of the revised medical law is unconstitutional. The Constitutional Court acknowledged the "justice of purpose" in view of the importance of public medical institutions, of the prevention from seduction of for-profit patients and from over-treatment, and of the fact that health care should not be the object of commercial transactions. Given the risk that medical personnel might be subject to outside capital, the concern that the holder of the medical institution's opening certificate and the actual operator may be separated, the principle that the human body and life should not be just a means, and the current system's inability to identify over-treatment, it also acknowledged the 'minimum infringement'. Furthermore, The Constitutional Court judged it is constitutional in compliance with the principle of restricting fundamental rights, such as 'balance of legal interests'. In this regard, legislative complements are needed in order to effectively prevent the for-profit management and the over-treatment the Constitutional Court is concerned about. In this regard, consumer groups actively support the need for legislation, and health care providers groups also agree on the need for legislation. Therefore, the legislators should respect the recent Constitutional Court's decision and in the near future complete the complementary legislation to reflect the people's interests.