• Title/Summary/Keyword: Safety Management

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Characteristics of Intravenous Midazolam Sedation with Nitrous Oxide in Pediatric Dental Treatment (소아환자에서 midazolam 정주 및 아산화질소 흡입진정법 하 치과치료의 특성)

  • Kim, Hyuntae;Song, Ji-Soo;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Shin, Teo Jeon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.47 no.1
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    • pp.53-61
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    • 2020
  • Midazolam is a short-acting benzodiazepine that is widely used in pediatric dental sedation. However, its clinical effectiveness as an intravenous sedative agent in children has not been widely documented. A retrospective study was conducted to evaluate the efficacy and safety of intravenous midazolam and nitrous oxide inhalation sedation in pediatric dental treatment. The subjects were 115 patients (118 cases) who received dental treatment under intravenous midazolam and nitrous oxide inhalation sedation. Demographic factors, general health status, sedation time, midazolam and nitrous oxide dosage, and success rate of sedation were evaluated from electronic medical records. Behavioral management was the main reason of choosing sedation. Mean duration of sedation was 56.7 minutes for surgical treatment, and 74.4 minutes for restorative treatment. The initial dosage of intravenous midazolam was 0.051 ± 0.019 mg/kg. In 34 cases (28.8%), additional midazolam of 0.036 ± 0.057 mg/kg was delivered during the treatment. The concentration of nitrous oxide was maintained between 40% and 50%. The success rate of sedation was 99% (n = 117). In 1 case, laryngospasm occurred and the patient was reversed with benzodiazepine antagonist, flumazenil. Intravenous midazolam sedation with nitrous oxide was shown to be clinically effective for the dental treatment in children, if administered by trained personnel and patients are carefully selected in accordance with guidelines.

Video Assisted Thoracic Surgery(VATS) of Pericardial Window Operation (비디오 흉강경을 이용한 심낭막 개창술)

  • 윤석원;김동관;김정원;박창률;김용희;박기성;박승일
    • Journal of Chest Surgery
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    • v.35 no.11
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    • pp.812-816
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    • 2002
  • Pericardial effusions result from various conditions such as inflammation, malignancies, open heart surgery and uremia. Recently, video assisted thoracic surgery (VATS) has been used for diagnostic and therapeutic purposes in the management of pericardial effusion and intrathoracic lesions due to its ability to provide outstanding visibility of intrathoracic structures with less pain, superior cosmetic effects, and shorter hospital stay Material and Method: From April 1995 to October 2001, 51 patients received pericardial window operation via either thoracoscopic(Group A, n=37, m:f=18:19, mean age=56.4 yrs)or thoracotomy approach(Group B, n=14, m:f=8:6, mean age=58.4 yrs). Result: In group A, the operation time, duration of chest tube insertion, recurrence rate of pericardial effusion, and postoperative hospital stay were 61.2 minutes, 9.3 days, 2.7%, 16.2 days, respectively while in group B these values were 58.4 minutes, 12.2 days, 7.1, and 17.3 days. The number of injections for pain control in group A were 4.2 times, whereas in group B it was 6.3 times. Although there was a tendency for the mean hospital stay and duration of chest tube insertion to be shorter in group A than in group B, these differences did not reach statistical significance. There was also no significant difference in the operation time and recurrence rate between the two groups. Conclusion: The safety and effectiveness of VATS in the management of pericardial effusion is comparable to the open thoracotomy method. It allows for a shorter hospital stay, duration of chest tube insertion, lesser postoperative pain and a smaller skin incision.

How to Reflect Sustainable Development, exemplified by the Equator Principles, in Overseas Investment (해외투자(海外投資)와 지속가능발전 원칙 - 프로젝트 파이낸스의 적도원칙(赤道原則)을 중심으로 -)

  • Park, Whon-Il
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.31
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    • pp.27-56
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    • 2006
  • Today's financial institutions usually take environmental issues seriously into consideration as they could not evade lender liability in an increasing number of cases. On the international scene, a brand-new concept of the "Equator Principles" in the New Millenium has driven more and more international banks to adopt these Principles in project financing. Sustainable development has been a key word in understanding new trends of the governments, financial institutions, corporations and civic groups in the 21st century. The Equator Principles are a set of voluntary environmental and social guidelines for sustainable finance. These Principles commit bank officers to avoid financial support to projects that fail to meet these guidelines. The Principles were conceived in 2002 on an initiative of the International Finance Corporation(IFC), and launched in June 2003. Since then, dozens of major banks, accounting for up to 80 percent of project loan market, have adopted the Principles. Accordingly, the Principles have become the de facto standard for all banks and investors on how to deal with potential social and environmental issues of projects to be financed. Compliance with the Equator Principles facilitates for endorsing banks to participate in the syndicated loan and help them to manage the risks associated with large-scale projects. The Equator Principles call for financial institutions to provide loans to projects under the following circumstances: - The risk of the project is categorized in accordance with internal guidelines based upon the environmental and social screening criteria of the IFC. - For Category A and B projects, borrowers or sponsors are required to conduct a Social and Environmental Assessment, the preparation of which must meet certain requirements and satisfactorily address key social and environmental issues. - The Social and Environmental Assessment report should address baseline social and environmental conditions, requirements under host country laws and regulations, sustainable development, and, as appropriate, IFC's Environmental, Health and Safety Guidelines, etc. - Based on the Social and Environmental Assessment, Equator banks then make agreements with borrowers on how they mitigate, monitor and manage the risks through a Social and Environmental Management System. Compliance with the plan is included in the covenant clause of loan agreements. If the borrower doesn't comply with the agreed terms, the bank will take corrective actions. The Equator Principles are not a mere declaration of cautious banks but a full commitment of lenders. A violation of the Principles in the process of project financing, which led to an unexpected damage to the affected community, would not give rise to any specific legal remedies other than ordinary lawsuits. So it is more effective for banks to ensure consistent implementation of the Principles and to have them take responsible measures to solve social and environmental issues. Public interests have recently mounted up with respect to environmental issues on the occasion of the Supreme Court's decision (2006Du330) on the fiercely debated reclamation project at Saemangeum. The majority Justices said that the expected environmental damages like probable pollution of water and soil were not believed so serious and that the Administration should continue to implement the project seeking ways to make it more environment friendly. In this case, though the Category A Saemangeum Project was carried out by a government agency, the Supreme Court behaved itself as a signal giver to approve or stop the environment-related project like an Equator bank in project financing. At present, there is no Equator bank in Korea in contrast to three big banks in Japan. Also Korean contractors, which are aggressively bidding for Category A-type projects in South East Asia and Mideast, might find themselves in a disadvantageous position because they are generally ignorant of the environmental assessment associated with project financing. In this regard, Korean banks and overseas project contractors should care for the revised Equator Principles and the latest developments in project financing more seriously. It's because its scope has expanded to the capital cost of US$10 million or more across all industry sectors regardless of developing countries or not. It should be noted that, for a Korean bank, being an Equator bank is more or less burdensome in a short-term period, but it must be conducive to minimizing risks and building up good reputation in the long run.

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Success Factors of the Supdari(A Wooden Bridge) Restoration in Jeonju-River through Citizens' Initiative (적극적 주민참여를 통한 전통문화시설 복원 성공요인 분석 - 전주천 섶다리 놓기 사업을 중심으로 -)

  • Kim, Sang-Wook;Kim, Gil-Joong
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.28 no.1
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    • pp.93-101
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    • 2010
  • This paper aims to analyze success factors for the construction of Supdari(a traditional wooden bridge to connect small streams temporarily), which is a citizens' initiative project to revitalize local community in Jeonju-River, Jeonju City. Recently Supdari has been restored for the use of belongings in local festivals. But Jeonju-River Supdari was designed and built to unite local citizens and connect river-divided villages. This project shows how investing social capital like Supdari makes the community vitalize through citizen's active participation. As a citizen leading project, there were several critical factors for sucess. At first, there were some noticeable ways to encourage local citizen's participation in online and offline. In the online, the Supdari internet cafe introduced what is a Supdari, how to make it and where we build using various media of UCCs and photos. In the offline, the small scaled model of Supdari was made and exhibited in the entrance of the village and related several seminars were hosted to discuss how to construct Supdari with citizens, local assembly men and public officials together. The Second is the movement to restore traditional and cultural resources for the community recovery triggered the supports from local councils and many civic groups. Civic groups supported ecological and structural expertise to guarantee environment friendly and stable construction. And local councils mediated citizen's and administrative office's opinions. The third is flexible administrative management to help citizen's ideas to be realized. Officials extended setting period of Supdari on the condition with the civic-control safety management.

A Study on the Necessity of Verification and Certification System of Inspection and Diagnostic Equipment for Infrastructure using Advanced Technologies (첨단 시설물 점검 및 진단장비 검·인증제도 도입 필요성에 대한 연구)

  • Hong, Sung-Ho;Kim, Jung-Gon;Cho, Jae-Young;Kim, Twae-Hwan
    • Journal of the Society of Disaster Information
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    • v.16 no.1
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    • pp.163-177
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    • 2020
  • Purpose: While it is very important to maintain facilities recently, the introduction and its application of high technology in the facility maintenance industry has increased. It is necessary for high technology to secure reliability through the verification and certification system of diagnostic equipment to have an effective impact in the field, but there is difference between the industry's perspective and realistic level of technology apart from social demand for the system of the system. This paper dealt with the introduction of a verification and certification system for rational facility diagnostic equipment with the opinion survey on managers about the current situation. Method: Survey is carried out targeting managers in the maintenance and construction regarding the necessity and urgency of introducing a verification and certification system to promote the introduction and its application of high technology of diagnostic equipment and facility inspection. Also, the introduction to a verification and certification system was reviewed for advanced facility diagnostic equipment through foreign research about similar systems and comparative analysis of similar systems related to the certification of 21 domestic equipment. Result: It showed that, regarding the application of high technology, it is necessary for most managers to introduce high technology such as drones, robots, etc., in the maintenance industry, and when high technology is introduced, it will have a considerable effect in the field. On the other hand, the current technology level in Korea is relatively low, so it turned out to take a certain amount of time for the application of technology. Also, it was found that the management of reliable facility diagnostic equipment will be possible through the introduction of the verification and certification system for facility diagnosis equipment. Meanwhile, the survey is conducted on similar systems about foreign and domestic diagnosis and measuring equipment, etc., but there is no system to verify and certify equipment applied with high technology directly to facility diagnosis maintenance. However, because Japan has a system of verifying the performance of diagnostic equipment and South Korea has 21 similar inspection and diagnostic equipment certification systems among 186 certification systems, it is considered to be possible to design systems which utilize them. Conclusion: According to the managers' opinion, it seems that the introduction of the system supporting the application of 4th industrial technology for the equipment and the use of the equipment with high reliability has sufficient validity. However, because our high technology level is undervalued compared to the urgency, the system for checking high technology facilities and certifying diagnostic equipment should be to be implemented in form of escalation considering technical use and verification level. Apart from the introduction of the verification and certification system, it is necessary for special investment, support and efforts to promote advanced facility diagnostic equipment.

A Study on the RFID's Application Environment and Application Measure for Security (RFID의 보안업무 적용환경과 적용방안에 관한 연구)

  • Chung, Tae-Hwang
    • Korean Security Journal
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    • no.21
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    • pp.155-175
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    • 2009
  • RFID that provide automatic identification by reading a tag attached to material through radio frequency without direct touch has some specification, such as rapid identification, long distance identification and penetration, so it is being used for distribution, transportation and safety by using the frequency of 125KHz, 134KHz, 13.56MHz, 433.92MHz, 900MHz, and 2.45GHz. Also it is one of main part of Ubiquitous that means connecting to net-work any time and any place they want. RFID is expected to be new growth industry worldwide, so Korean government think it as prospective field and promote research project and exhibition business program to linked with industry effectively. RFID could be used for access control of person and vehicle according to section and for personal certify with password. RFID can provide more confident security than magnetic card, so it could be used to prevent forgery of register card, passport and the others. Active RFID could be used for protecting operation service using it's long distance date transmission by application with positioning system. And RFID's identification and tracking function can provide effective visitor management through visitor's register, personal identification, position check and can control visitor's movement in the secure area without their approval. Also RFID can make possible of the efficient management and prevention of loss of carrying equipments and others. RFID could be applied to copying machine to manager and control it's user, copying quantity and It could provide some function such as observation of copy content, access control of user. RFID tag adhered to small storage device prevent carrying out of item using the position tracking function and control carrying-in and carrying-out of material efficiently. magnetic card and smart card have been doing good job in identification and control of person, but RFID can do above functions. RFID is very useful device but we should consider the prevention of privacy during its application.

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A Program of Water Quality Management for Agricultural Reservoirs by Trophic State (농업용 저수지의 부영양화와 수질관리방안)

  • Lee, Kwang-Sik;Yoon, Kyung-Sup;Kim, Ho-Il;Kim, Hyung-Joong
    • Korean Journal of Environmental Agriculture
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    • v.22 no.2
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    • pp.166-171
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    • 2003
  • A total of 498 agricultural reservoirs ranging from $164{\times}10^3\;m^3$ to $253{\times}10^6\;m^3$ in storage volume were investigated from 1990 to 2001 with respect to Chl-${\alpha}$, COD concentration and pollutant loading of BOD, TN, and TP. The lakes and reservoirs could be classified to 4 types using the relationships between the ratio of storage volume per water surface area(ST/WS) and Chl-${\alpha}$ concentration. It is recommended that the improvement of polluted lakes should be performed in the order of integrated consolidation type ${\rightarrow}$ watershed consolidation type ${\rightarrow}$ in-lake consolidation type ${\rightarrow}$ Management type and reservoir should be constructed to be over $5{\sim}6\;m$ in depth(ST/WS ratio) for preventing the eutrophication of agricultural reservoirs. We propose that water quality criteria for agricultural water is changed from less than 8 mg/L to less than 6 mg/L for safety value, $6{\sim}10\;mg/L$ for concern value, and more than 10 mg/L for countermeasure value in COD concentration, respectively.

Actual Condition of Quality Control of X-ray Imaging System in Primary Care Institution: focused on Gwangju Metropolitan City (1차 의료기관의 엑스선 발생장치 정도관리에 관한 현황조사:광주광역시 지역을 중심으로)

  • Dong, Kyung-Rae;Lee, Seun-Joo;Kweon, Dae-Cheol;Goo, Eun-Hoe;Jung, Jae-Eun;Lee, Kyu-Su
    • Journal of Radiation Protection and Research
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    • v.35 no.1
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    • pp.34-42
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    • 2010
  • With the expanded use of radiation in modern medical practices, the most important issue in regards to efforts to reduce individual exposure dose is quality assurance. Therefore in order to study the present condition of quality assurance, the Gwangju Metropolitan City area was divided into five districts each containing ten hospitals. Four experiments were conducted: a reproducibility experiment for kVp, mA, and examination time (sec) intensity of illumination; half-value layer (HVL) measurement; and beam perpendicularity test matching experiment. The tube voltage reproducibility experiment for all fifty hospitals resulted in a 95.33% passing rate and mA and examination time both resulted in a 77.0% passing rate. The passing rate for intensity of illumination was 86.0% and 52.0% for HVL, which was the lowest passing rate of all four factors. For the beam perpendicularity test matching experiment, generally the central flux is matched to within $1.5^{\circ}$. Of all fifty hospitals 30.0% were beyond $3^{\circ}$. The results of the survey showed that 58% responded that they knew about quality assurance cycle. All fifty respondents stated that they have not received any training in regards to quality assurance at their current place of employment. Although quality assurance is making relative progress, the most urgent issue is awareness of the importance of quality assurance. Therefore, the implementation of professional training focusing on safety management and accurate quality assurance of radiation will reduce the exposure to radiation for radiologists and patients and higher quality imaging using less dosage will also be possible.

EFFECTS OF SEDATIVE DRUGS FOR MANAGEMENT IN CHILDREN (약물 투여시 아동의 행동조절 효과)

  • Choi, Nam-Ki;Jeong, Byung-Cho;Yang, Kyu-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.3
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    • pp.304-312
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    • 2002
  • The purpose of this study was to assess the sedative effects of four kinds of medication for management in the uncooperative 64 children aged from 18 to 92 months(ASA class I) and weighting between 10 and 32 kg. They were given randomly a dose of chloral hydrate 75mg/kg and hydroxyzine 25mg orally(group 1), midazolam 0.1mg/kg intramuscularly and $N_2O$(group 2), group 1 with additional $N_2O$(group 3) and group 1 with additional midazolam 0.5cc intranasally(group 4), respectively. According to rating scale, sleep, crying, movement and overall behavior were checked for evaluation of the clinical sedative effects. They were restraind with Pediwrap and were monitored by pulse oximeter for safety during treatment period. The results were as follows : 1. In the evaluation of sleep, rating scale of chloral hydrate and hydroyzine combination group was superior to midazolam and $N_2O$ combination group(p<0.001), but there was no significant difference between chloral hydrate, hydroxyzine and $N_2O$ combination group and chloral hydrate, hydroxyzine and midazolam combination group. 2. In the evaluation of crying, movement and overall behavior, there were significant differences between chloral hydrate and hydroxyzine combination group and midazolam and $N_2O$ combination group(p<0.05), but no significant difference between chloral hydrate, hydroxyzine and $N_2O$ combination group and chloral hydrate, hydroxyzine and midazolam combination group. 3. In the evaluation of overall behavior, the mean score of chloral hydrate and hydroyzine combination group was 2.94, midazolam and $N_2O$ combination group 2.07, chloral hydrate, hydroxyzine and $N_2O$ combination group 2.47 and chloral hydrate, hydroxyzine and midazolam combination group 2.24, respectively. 4. Evidence of adverse effect was not detected or reported during and/or after dental treatment.

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Research Trend Analysis of Publications in the Journal of Home Economics Education Association Using Network Text Analysis (네트워크 텍스트 분석을 이용한 한국가정과교육학회지 논문의 연구 동향 분석)

  • Lee, Yoon-Jung;Kim, Eun Jeung;Kim, Ji sun
    • Journal of Korean Home Economics Education Association
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    • v.31 no.4
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    • pp.1-18
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    • 2019
  • The purpose of this study was to analyze the research trend in home economics education using network text analysis method. The 586 research articles published in the Journal of Home Economics Education Association between July, 2003 and December 2018 were examined using Neckinger 4, a social network analysis software. The frequency and centrality measures(degree centrality, closeness centrality, and betweenness centrality) were calculated for the words appeared throughout the whole period, and the centrality analysis and LAD(Latent Dirichlet Allocation) were conducted for the four sub-periods. The results are as follows: first, the most frequently appeared words are parents, culture, unit, health, career, consumption, practicality, etc. The words such as parents and management scored high in degree centrality; parents and male students in closeness centrality; and male students and units in betweenness centrality. Second, when divided into four periods, the words such as education, family, purpose, class, middle school, and school appeared most frequently across the periods; but some words such as 'purpose' (in period 3 and 4), or 'process' (in period 4) were salient only in certain periods. Third, the words with high centrality were consistent regardless of the types of centrality within each period. Fourth, the topic analysis using LAD showed that curriculum, textbook, family healthiness, teaching-learning, evaluation, dietary life, appearance management, and consumption were the topics consistently appeared across all periods. The topics have become diversified and deepened. New topics such as teacher training and safety appeared in later periods, possibly due to the curriculum and national policy changes, and housing as a less represented topic is suggested as an area that needs further research attention. This study has implication in that it allows researchers to identify the major research interests and the trends in research by researchers in home economic education.