• Korean Journal of Biological Psychiatry
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• v.8 no.1
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• pp.53-61
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• 2001

The authors, in this paper, addressed a variety of problems and difficulties which Korean psychiatrists should cope with. The surprising development of neurosciences, splitting of neuropsychiatry into neurology and psychiatry, easygoing attitude of psychiatrists, changes in the delivery system of health care and ill-balanced education of psychiatry were listed as causes of or contributors to them. Social bias to psychiatry and regulations from outside are also considered as contributors. Psychiatric education, including medical school, residency training, continuing medical education and psychiatric textbooks, need to be changed in order to enlarge the boundary of psychiatry. Reestablishment of identity of psychiatry and psychiatrist is unavoidable, considering far-reaching new knowledge of neuroscience and gradually invisible borderzone between neurology and psychiatry. The other ways worth while to consider are : the expansion of psychiatrists' activities, development of medical behavioral science to a clinical specialty, creation of new psychiatric subspecialties, and additional training of psychiatric residencies in the primary medical care.

• The Korean Society of Law and Medicine
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• v.11 no.2
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• pp.181-208
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• 2010

Maternity services is often perceived as a troublesome business and obstetric litigation is on the increase in Western countries. Overall, the number of claim and cost of litigation to the NHS Litigation Authority (NHSLA) from maternity services in the UK is increasing every year. Maternity services account for 60-70% of the total sum paid. This has widespread implications for both the individual practitioners and the institutions where they work, due to increasing malpractice insurance premiums. Fear of litigation is also attracting fewer medical graduates into the specialty, leading to a recruitment crisis in obstetrics and gynaecology. The litigation process can cause pain, suffering and distress to clinicians as well as to the patients and their families. Litigation in maternity services is the result of a complex of events when malpractice (presumed or real) impacts on the attitude of pregnant women and their environment. In such complexity, information is mandatory but may often be misinterpreted. If messages are not tailored to the receiver's capacity, communicating well with the pregnant patient becomes crucial. Therefore, to reduce medicallegal issues in obstetrics, increasing attention and an applicable standard of obstetric care to avoid negligence and medical errors should go along with other measures. Considering UK's experiences, NHS redress scheme make it easier to pursue small claims and birth related claims, without necessarily reducing the number of claims processed through the conventional legal system and perhaps encouraging even more of them. The task of dealing with the greater number of inquiries into their practice would inevitably create an added burden for clinicians and hospital managers. Thus further proposals are required to limit the cost of processing inflated claims and to consider whether clinicians should be given some protection from litigation alleging a failure to prevent birth related impairment.

• The Korean Journal of Pain
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• v.31 no.3
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• pp.147-154
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• 2018

Fibromyalgia (FM) is a contested illness with ill-defined boundaries. There is no clearly defined cut-point that separates FM from non-FM. Diagnosis of FM has been faced with several challenges that occur, including patients' health care-seeking behavior, symptoms recognition, and FM labeling by physicians. This review focuses on important but less visible factors that have a profound influence on under- or over-diagnosis of FM. FM shows different phenotypes and disease expression in patients and even in one patient over time. Psychosocial and cultural factors seem to be a contemporary ferment in FM which play a major role in physician diagnosis even more than having severe symptom levels in FM patients. Although the FM criteria are the only current methods which can be used for classification of FM patients in surveys, research, and clinical settings, there are several key pieces missing in the fibromyalgia diagnostic puzzle, such as invalidation, psychosocial factors, and heterogeneous disease expression. Regarding the complex nature of FM, as well as the arbitrary and illusory constructs of the existing FM criteria, FM diagnosis frequently fails to provide a clinical diagnosis fit to reality. A physicians' judgment, obtained in real communicative environments with patients, beyond the existing constructional scores, seems the only reliable way for more valid diagnoses. It plays a pivotal role in the meaning and conceptualization of symptoms and psychosocial factors, making diagnoses and labeling of FM. It is better to see FM as a whole, not as a medical specialty or constructional scores.

• Quality Improvement in Health Care
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• v.9 no.2
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• pp.148-163
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• 2002

Background : The personnel of emergency department have been under tremendous pressure to manage unexpected emergency situations and excited patients. And interpersonal conflict has existed always, because emergency department was consisted of various personnel of their own specialty. The patient's satisfaction has to come from the personnel's satisfaction. The purpose of this study was to evaluate emergency department personnel's job satisfaction and its related factors and to improve quality of emergency medical service Methods : A self-administered questionnaire survey to the emergency department personnel was conducted between September 1 and October 31, 2001. The response rate was 90.2%. Using SAS program (Version 6.12), the collected data was analyzed by frequency, ANOVA, multiple comparison, Pearson correlation procedure, and stepwise multiple regression analysis. Result : The analysis of related factors of job satisfaction showed high score of interpersonal interaction (3.246), professional prestige (3.095), autonomy (2.916), task requirements (2.701), organizational requirements (2.444), and pay (1.953) in order of item mean. Professional prestige (0.498), task requirements (0.464), and organizational requirements (0.408) were highly positive correlated with overall level of job satisfaction. The factors influencing the job satisfaction were professional prestige and task requirements which explaining efficacy were 37.6% and 32.2% respectively. The total explaining efficacy was 33.6%. Conclusion : It was found out that emergency department personnel's job satisfaction can be raised by promoting professional prestige and task requirements. The personnel of emergency department have to be satisfied through their job, and the administration of the hospital has to pay more attention to their employees' job satisfaction and it related factors.

• YAKHAK HOEJI
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• v.47 no.4
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• pp.244-251
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• 2003

Asthma is a chronic inflammatory disease of the airway and the prevalence rate is increasing. As the burden of asthma to the society is significant due to the increasing hospital admissions and emergency visits, National Heart, Lung and Blood Institute (NHLBI, USA) and World Health Organization (WHO) have developed comprehensive guidelines to help clinicians and patients make appropriate decisions about asthma care. The aim of study was to analyze the pattern of asthma prescriptions based on the national asthma guidelines for the patients visiting primary health care providers. Prescription data for asthma were obtained from the Korean National Health Insurance claims database of January 2002. Ten percent of the primary health care providers were sampled based on their specialty areas, and 20％ of the claim cases were randomly chosen. Study results showed that prescription rate for oral beta-2 agonists was 44.3％, and that for oral theophylline was 46.9％. Oral steroids were prescribed for the 28.2％ of the claims. Utilization of inhalers was low for both bronchodilators (20.3％, beta-2 agonists inhalers), and steroids (8.4％ steroids inhalers). Bronchodilators were more preferred to the longterm anti-inflammatory controllers among the primary health care providers. Prescription rate for antibiotics was 46.0％ for asthmatic patients. Also gastrointestinal drugs were prescribed for 59.0％, antitussives 65.3％, antihistamines 25.3％ and analgesics 29.4％, respectively. This study presented that the prescribing pattern of the primary health care providers for the asthma was quite different from the national and international guidelines. More efforts need to be made to reduce the gap between the present pattern of asthma prescription and the guidelines.

• The Journal of the Korean dental association
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• v.55 no.3
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• pp.215-228
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• 2017

The topic of academic integrity is an important public concern that has emerged in higher education. Recent surveys at U.S. and Canadian dental schools revealed that cheating and plagiarism were significant problems in dental schools. In addition, some schools stated that cheating had increased compared to a decade ago. Various institutional rituals have been implemented to enhance the academic integrity environment of U. S. and Canadian dental schools. Furthermore, the application of honor code which is dealing with ethical issues has been reported to improve the attitudes and behaviors of students. Since there have been no reported studies regarding ethics curricula in Korean dental schools, further studies should be needed to assess academic integrity policies, violations, and the results of the measures in Korean dental schools. Additionally, the challenge to provide professional ethics curricula for dental students must be conducted with respect and humanity for our students and thus, students will be more likely to respond positively to expectations in terms of ethical behaviors. Therefore, the outcome is clearly and undoubtedly link to better care for patients.

• Annals of Laboratory Medicine
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• v.38 no.6
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• pp.545-554
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• 2018

Background: The increasing morbidity and mortality rates associated with Acinetobacter baumannii are due to the emergence of drug resistance and the limited treatment options. We compared characteristics of colistin-resistant Acinetobacter baumannii (CR-AB) clinical isolates recovered from patients with and without prior colistin treatment. We assessed whether prior colistin treatment affects the resistance mechanism of CR-AB isolates, mortality rates, and clinical characteristics. Additionally, a proper method for identifying CR-AB was determined. Methods: We collected 36 non-duplicate CR-AB clinical isolates resistant to colistin. Antimicrobial susceptibility testing, Sanger sequencing analysis, molecular typing, lipid A structure analysis, and in vitro synergy testing were performed. Eleven colistin-susceptible AB isolates were used as controls. Results: Despite no differences in clinical characteristics between patients with and without prior colistin treatment, resistance-causing genetic mutations were more frequent in isolates from colistin-treated patients. Distinct mutations were overlooked via the Sanger sequencing method, perhaps because of a masking effect by the colistin-susceptible AB subpopulation of CR-AB isolates lacking genetic mutations. However, modified lipid A analysis revealed colistin resistance peaks, despite the population heterogeneity, and peak levels were significantly different between the groups. Conclusions: Although prior colistin use did not induce clinical or susceptibility differences, we demonstrated that identification of CR-AB by sequencing is insufficient. We propose that population heterogeneity has a masking effect, especially in colistin non-treated patients; therefore, accurate testing methods reflecting physiological alterations of the bacteria, such as phosphoethanolamine-modified lipid A identification by matrix-assisted laser desorption ionization-time of flight, should be employed.

• Journal of Periodontal and Implant Science
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• v.49 no.1
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• pp.25-38
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• 2019

Purpose: This study evaluated differences in bone healing and remodeling among 3 implants with different surfaces: sandblasting and large-grit acid etching (SLA; IS-III $Active^{(R)}$), SLA with hydroxyapatite nanocoating (IS-III $Bioactive^{(R)}$), and SLA stored in sodium chloride solution ($SLActive^{(R)}$). Methods: The mandibular second, third, and fourth premolars of 9 dogs were extracted. After 4 weeks, 9 dogs with edentulous alveolar ridges underwent surgical placement of 3 implants bilaterally and were allowed to heal for 2, 4, or 12 weeks. Histologic and histomorphometric analyses were performed on 54 stained slides based on the following parameters: vertical marginal bone loss at the buccal and lingual aspects of the implant (b-MBL and l-MBL, respectively), mineralized bone-to-implant contact (mBIC), osteoid-to-implant contact (OIC), total bone-to-implant contact (tBIC), mineralized bone area fraction occupied (mBAFO), osteoid area fraction occupied (OAFO), and total bone area fraction occupied (tBAFO) in the threads of the region of interest. Two-way analysis of variance (3 types of implant $surface{\times}3$ healing time periods) and additional analyses for simple effects were performed. Results: Statistically significant differences were observed across the implant surfaces for OIC, mBIC, tBIC, OAFO, and tBAFO. Statistically significant differences were observed over time for l-MBL, mBIC, tBIC, mBAFO, and tBAFO. In addition, an interaction effect between the implant surface and the healing time period was observed for mBIC, tBIC, and mBAFO. Conclusions: Our results suggest that implant surface wettability facilitates bone healing dynamics, which could be attributed to the improvement of early osseointegration. In addition, osteoblasts might become more activated with the use of HA-coated surface implants than with hydrophobic surface implants in the remodeling phase.

• Journal of Periodontal and Implant Science
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• v.52 no.5
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• pp.370-382
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• 2022

Purpose: The aim of this study was to evaluate the preclinical results of 2 types of commercially available deproteinized bovine bone mineral (DBBM) when applied to alveolar bone defects in dogs. Methods: This study was conducted using 6 beagles. Alveolar defects in the mandible were formed and filled with 2 DBBMs produced by a similar procedure. Defects were randomly assigned to be filled using DBBM 1 or 2. All defects were covered with a collagen membrane and had a healing period of 12 weeks. After the dogs were sacrificed, histological, histomorphometric, and linear/volumetric analyses were performed. Results: Both DBBM groups showed similar histological findings, demonstrating that bone remodeling had occurred and new bone had formed. The residual bone particles were surrounded by newly formed vital bone. In the histomorphometric analysis, the ratio of the area of vital bone and residual bone substitute in DBBM 2 (38.18% and 3.47%, respectively) was higher than that of DBBM 1 (33.74% and 3.41%, respectively), although the difference was not statistically significant. There were also no statistically significant differences between both groups in linear and volumetric analyses using micro-computed tomography scans and digitized images of dental casts. Conclusions: In the present study, DBBM 1and 2, which were produced by similar processes, showed similar results in histological, histomorphometric, and volumetric analyses. Further studies are needed to identify more specific differences between the 2 DBBMs.

• Journal of Korean society of Dental Hygiene
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• v.2 no.1
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• pp.97-113
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• 2002

This research is an attempt to establish a basic material in discovering the subjective types of the dental coordinators occupational consciousness, utilizing the Q-Method Theory, which is capable of measuring the subjective nature of human being by scientific and systematic method. The characteristics of each type were analyzed so as to have the dental coordinator to possess the desirable understanding of the occupational view together for them to have self-confidence as a lifetime specialty occupation. Upon completion of the study, it was found that there are three types of subjective views pertaining to the occupational consciousness on the dental coordinator. The result on the analysis of the characteristics is as follows : Type 1 is the Taking Serious View on the Patient Service, which priority is placed on kindness and looking after any difficulties of the patient, namely, it is the type that puts the importance on the high level medical examination and treatment based on good service. Because of the kind service to the patient, those under this category considered their job satisfaction have been improved. It goes without saying that they were developing the services, which satisfy themselves, and it was confirmed that they thought that they should make things smooth for any development of problems that may arise between the patient and the dentist. Type 2 is the Taking Serious View on Career and Organizational Strength. This is a type that aims on the systematic nature of the internal job, namely, organizational strength itself viewed from the stand point thai either self-confident or work merit is proportional to experience. This type is to actively treat the problem and endeavor to solve the issue when dissatisfaction is held by the dental hospital system, which is either followed according to the work responsibility or by an organization having an appropriate system on remuneration, Type 3 is the Placing of Importance on the Overall Circumstances. This is the type that places importance on the overall now of the dental hospital, and it is the type, that most greatly recognizes the importance of the role of the dental coordinator. The dental coordinator should provide the sense of reliability to both the dentist and to the staff of the medical examination and treatment and should be able to adjust smoothly the overall now of the medical treatment. The dental coordinator is expected to be a medical service specialist, who is capable to solve the problems of the staff of the medical treatment intuitively and to adjust the relation between the employees. With the above result, it was found that although there was no mutual exclusiveness between the respective types, there are particular characteristics among each type. Therefore, this research has discovered and analyzed the subjective view types relative to the occupational consciousness of the dental coordinator for the proper understanding on the characteristics of each type to enable the dental sanitary students and the graduates of the Dental Sanitary Department, who are aspiring to become dental coordinator, as the basic guide material to be actively utilized.