• Journal of the Korean Society of Safety
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• v.36 no.4
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• pp.88-98
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• 2021

Korean industry has achieved dramatic growth in a short time through continuous technical innovations. However, safety consciousness and management have not kept pace with industry growth. The characteristics of industrial accidents in socio-technical systems have become so complicated that it has been challenging for safety professionals to implement effective preventive measures because it is difficult to determine what is happening in the complex workplace. Thus far, they have focused on technical improvements and the requirements of OSH regulations to avoid legal responsibility. Accordingly, this study has used the systemic analysis method to explain the emergence of something unexpected in complex and multi-layered business structures, which is usually related to the variabilities of humans and organizations. This study chose a shipyard where a few fatal accidents had occurred because the shipbuilding industry includes numerous variabilities, including obtaining orders, manpower supply, procurement, etc. Systemic analysis progressed using FRAM based on two accident cases related to the truss platform used in LNG vessels. The outcome shows that each function within the system has its variabilities and has become coupled or dependent on other functions, increasing the possibility of accidents. This analysis method can provide OSH professionals with practical techniques for explaining what is happening in a complex socio-technical system and how to take proper measures.

• Korean Journal of Acupuncture
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• v.33 no.3
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• pp.121-130
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• 2016

Objectives : Recently, people who have normal brachial blood pressure(BP) are being threatened by high-risk disease such as stroke. The aim of this study is to suggest that new method to assess systemic circulation. It can be performed by analyzing optimal blood pulse wave on 3 sites belonging to subjects that have normal BP. Methods : We respectively extracted main peaks(h1) of optimal blood pulse wave on left/right temporal artery(LR1=h1), radial artery(LR2=h1) and dorsalis pedis artery(LR3=h1). We obtained h1 from 30 subjects who are discreetly chosen and have normal BP. Main peak(h1) can be extracted by using 3D pulse imaging analyser(DMP-1000+, DAEYOMEDI Co., Korea) that has 5-level pressure method. We analyzed the ratio of [LR1/LR2] and [LR3/LR2]. Results : In the case of male group, the results are [LR1/LR2=0.7100.177] and [LR3/LR2=0.9290.317]. In the case of female group, the results are [LR1/LR2=0.6680.121] and [LR3/LR2=0.7050.195]. Especially, it is statistically verified that the result of ratio [LR3/LR2] is much higher in male group than in female group(p<0.05). Conclusions : We suggested the standard ratio of [LR1/LR2] and [LR3/LR2] for normal subjects, respectively. It can be adopted as a new method to evaluate the systemic circulation.

• Korean Journal of Clinical Pharmacy
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• v.21 no.4
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• pp.319-331
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• 2011

Purpose: The purpose of this study is to evaluate current criteria for insurance coverage by Health Insurance Review & Assessment Service (HIRA) on the systemic therapy used in the treatment of advanced or metastatic renal cell carcinoma (RCC), by reviewing all available clinical evidences including a variety of clinical practice guidelines. Methods: We searched clinical databases and collected data from published phase 1 through 3 randomized clinical trials on all systemic therapies used in RCC, including novel targeted therapies. Additionally, current clinical practice guidelines on the management of kidney cancer or RCC were reviewed. Based on the collected data we evaluated the appropriateness of the HIRA criteria for insurance coverage on the systemic therapy of RCC whether they are evidence-based and up to date. Results: On the basis of the collected data we concluded that there was a need for a revision in HIRA criteria for systemic therapy of RCC. Despite recent emerging therapeutic advances and changes in therapeutic strategies of management of RCC, some of anticancer regimens were inappropriately listed even though they were not proven to provide efficacy or safety superior to those of other therapies. We thus proposed an updated recommendation based on current clinical evidences. Conclusion: Systemic therapy of RCC is being rapidly changed with the advancement of understanding of the molecular biology of cancer. Consequently newly developed targeted therapies are becoming the standard therapy in the management of medically or surgically unresectable advanced or metastatic RCC. To provide effective and safe therapy to patients with RCC, the criteria for insurance coverage should be made carefully taking into consideration of most up-to-date and high-quality clinical evidences, and should be continuously reviewed so as to reflect evidence-based clinical practice.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5923-5931
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• 2015

Background: Registry data from four major public hospitals indicate trends over three decades from 1980 to 2010 in treatment and survival from colorectal cancer with distant metastases at diagnosis (TNM stage IV). Materials and Methods: Kaplan-Meier product-limit estimates and Cox proportional hazards models for investigating disease-specific survival and multiple logistic regression analyses for indicating first-round treatment trends. Results: Two-year survivals increased from 10% for 1980-84 to 35% for 2005-10 diagnoses. Corresponding increases in five-year survivals were from 3% to 16%. Time-to-event risk of colorectal cancer death approximately halved (hazards ratio: 0.48 (0.40, 0.59) after adjusting for demographic factors, tumour differentiation, and primary sub-site. Survivals were not found to differ by place of residence, suggesting reasonable equity in service provision. About 74% of cases were treated surgically and this proportion increased over time. Proportions having systemic therapy and/or radiotherapy increased from 12% in 1980-84 to 61% for 2005-10. Radiotherapy was more common for rectal than colonic cases (39% vs 7% in 2005-10). Of the cases diagnosed in 2005-10 when less than 70 years of age, the percentage having radiotherapy and/or systemic therapy was 79% for colorectal, 74% for colon and 86% for rectum (&RS)) cancers. Corresponding proportions having: systemic therapies were 75%, 71% and 81% respectively; radiotherapy were 24%, 10% and 46% respectively; and surgery were 75%, 78% and 71% respectively. Based on survey data on uptake of offered therapies, it is likely that of these younger cases, 85% would have been offered systemic treatment and among rectum (&RS) cases, about 63% would have been offered radiotherapy. Conclusions: Pronounced increases in survivals from metastatic colorectal cancer have occurred, in keeping with improved systemic therapies and surgical interventions. Use of radiotherapy and/or systemic therapy has increased markedly and patterns of change accord with clinical guideline recommendations.

• Journal of Digital Convergence
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• v.19 no.2
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• pp.315-322
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• 2021

The purpose of this study was to examine the correlations of oral myofunction and oral environment for the elderly with systemic diseases and to suggest need to improve oral health for the elderly. Data were collected from 64 elderly over the age of 65, from April to June 2019. Data were surveyed on general characteristics, oral myofunction, oral health-related quality of life, oral bacteria. Analysis was performed using PASW Statistics ver 18.0. The subjects were 43.8% systemic diseases, among them 40.6 percent of the people with more than two. The number of functional teeth was 18.6. Age was negatively correlated with functional teeth(r=-.384, p<.01) and tongue pressure (r=-).104, p<.001). Tongue pressure was a positive correlation with lip force(r=.279, p<.05). Age and total number of bacteria was negative correlation(r=-.336, p<.01). The functional teeth and total number of bacteria was positive correlation(r=.551, p<.001). The number of systemic diseases and total number of bacteria was positive correlation(r=.327, p<.01) the analysis of oral myofunction and oral bacteria in older patients with systemic diseases It was meaningful in suggesting a plan to improve oral health for the elderly. A practical policy plan was required to improve the quality of oral health life in a super-aged society.

• Journal of the Korean Society of School Health
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• v.29 no.2
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• pp.63-70
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• 2016

Purpose: The purpose of this study was to find the factors influencing adolescents' adult media engagement. The study is based on Agnew's General Strain Theory (GST) and a micro-systemic perspective. Methods: The study examined 479 middle school freshmen who participated in the fourth wave of the Korean Children & Youth Panel Survey (KCYPS) conducted by National Youth Policy Institute. Data were analyzed through descriptive statistics, factor analysis, and reliability analysis using SPSS 22.0 Ver. Also, hypothesis testing was performed via covariance-based structure equation modeling (CB-SEM) using Amos 21.0 Ver. Results: Strain factors had positive effects on adolescent depression, and depression had a positive effect on adult media engagement. Also, cell-phone dependency had a positive mediation effect between depression and adult media engagement. Conclusion: The study's result identified the factors affecting adult media engagement. Therefore, we suggest intervention programs considering adolescents' strains, depression and cell-phone dependency to improve their health.

• The Journal of the Korean dental association
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• v.48 no.1
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• pp.20-26
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• 2010

The fundamental goal of dental treatment is rehabilitation of oral health thus various dental treatment are done. Most of the dental procedures are not life threatening but patients who are medically compromised are exceptional. Fortunately systemic disease can be easily diagnosed by medical insurance(medicare) or annual medical check examination in Korea. Diseases which were fatal at the past are successfully treated nowadays and consequently the population of the elder increases. As the population of elder increases, patients who need medical care as well as dental patient with compromised medical condition increases. It is essential to find out if the patient has any systemic disease. Consultant to the appropriated physician of medically compromised patients? is demanded and also for a successful dental treatment, deep knowledge of the systemic disease is necessary.

• Journal of Preventive Medicine and Public Health
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• v.53 no.2
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• pp.82-88
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• 2020

Objectives: The objective of this study was to identify individual and institutional factors associated with the prescription of systemic steroids in patients with acute respiratory infections and to investigate the role of a policy measure aimed to reduce inappropriate prescriptions. Methods: We used data from the National Health Insurance Service-National Sample Cohort from 2006 to 2015 and focused on episodes of acute respiratory infection. Descriptive analysis and multiple logistic regression analysis were performed to identify individual-level and institution-level factors associated with the prescription of systemic steroids. In addition, steroid prescription rates were compared with antibiotic prescription rates to assess their serial trends in relation to Health Insurance Review and Assessment Service (HIRA) Prescription Appropriateness Evaluation policy. Results: Among a total of 9 460 552 episodes of respiratory infection, the steroid prescription rate was 6.8%. Defined daily doses/1000 persons/d of steroid increased gradually until 2009, but rose sharply since 2010. The steroid prescription rate was higher among ear, nose and throat specialties (13.0%) than other specialties, and in hospitals (8.0%) than in tertiary hospitals (3.0%) and other types of institutions. Following a prolonged reduction in the steroid prescription rate, this rate increased since the HIRA Prescription Appropriateness Evaluation dropped steroids from its list of evaluation items in 2009. Such a trend reversal was not observed for the prescription rate of antibiotics, which continue to be on the HIRA Prescription Appropriateness Evaluation list. Conclusions: Specialty and type of institution are important correlates of steroid prescriptions in cases of acute respiratory infection. Steroid prescriptions can also be influenced by policy measures, such as the HIRA Prescription Appropriateness Evaluation policy.

• Journal of Environmental Health Sciences
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• v.45 no.1
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• pp.9-17
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• 2019

Objectives: This study examined the safety of tattoo ink by analyzing the phenol contents in tattoo inks and its risk assessment of selected phenol. Methods: A sample of 30 tattoo inks was purchased, the phenol contents were analyzed, and a risk assessment on dermal exposure from tattooing was carried out. Hazard identification was collected from toxicity data on systemic effects caused by dermal exposure to phenol, and the most sensitive toxicity value was adopted. Exposure assessment ($Exposure_{phenol}$) was calculated by applying phenol contents and standard exposure factors, while dose-response assessment was based on the collected toxicity data and skin absorption rate of phenol, assessment factors (AFs) for derived no-effect level ($DNEL_{demal}$). In addition, the risk characterization was calculated by comparing the risk characterization ratio (RCR) with $Exposure_{phenol}$ and $DNEL_{dermal}$ Results: The phenol concentration in the 30 products was from 1.4 to $649.1{\mu}g/g$. The toxicity value for systemic effects of phenol was adopted at 107 mg/kg. $Exposure_{phenol}$ in tattooing was from 0.000087 to 0.040442 mg/kg. $DNEL_{dermal}$ was calculated at 0.0072 mg/kg (=toxicity value 107 mg/kg ${\div}$ AFs 650 ${\times}$ skin absorption rate 4.4%). Thirteen out of 30 products showed an RCR between 1.02 and 5.62. The RCR of all red inks was above 1. Conclusions: Phenol was detected in all of the 30 tattoo inks, and the RCR of 13 products above 1 indicates a high level of risk concern, making it necessary to prepare safety management standards for phenol in tattoo inks.

• Journal of Society of Preventive Korean Medicine
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• v.6 no.1
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• pp.51-95
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• 2002

1. As a point at issue of occidental medicine examination, followings have been indicated, 1) Occidental medical examination is performed by mainly test and instrument and therefore, role of doctors could be excluded and it could be diagnosed only for target disease and 2) in Korea, it could not be conducted in public medical system and therefore improvement effect of public health promotion could not be made due to increase of total medical expenses and infirmity of post management. These points are substantial limit of paradigm resided in occidental medicine and also problem caused by unique characteristics of medical system of Korea. In Korea, result of occidental medical examination show increased health risk from aged thirties and major diagnosed diseases are circulatory disease or chronic disease such as hepatic, hyperlipemic, hypertensional disease and diabetes, etc. Accounting that those chronic disease make a role as major public health risk, it is difficult that medical examination by only occidental medicine make effect on public health promotion. 2. Characteristics of oriental medicine examination could be summarized as diagnosis (information acquisition based on the facts) and demonstration (speculation based on acquired information) and in addition, quadruple diagnosis, as a medical examination method, include test as well as basic examination. Accounting on oriental medical examination, principally it is performed by independent herbalist and therefore, herbalist could acquire systemic result during first medical examination. Based on the theory of inner-outer examination, oriental medical examination has a principle of universe theory, systemic analysis of quadruple diagnosis, demonstration & reasoning. In addition, root of oriental medical examination could be found in pre-disease theory, a principal theory of oriental medicine. Pre-disease service could prove the advantage of oriental medicine in medical examination activities and therefore, it is needed that content of oriental medical examination should be actualized in current medical system. 3. In this study, oriental medical examination program, comprised of pulse-diagnosis, contrast muscular taking and medical consultation of herbalist is progressed communally with occidental medical examination. As pre-examination, questionary was given of general characteristics, health promoting life style, physical constitution and subjective symptom of musculoskeletal system. In addition, post-examination notification was given to subjects about health promoting control, physical constitution regimen and management of musculoskeletal system. During this study program, verification was conducted for input of acquired information and difference of each information after analysis and in addition, performed was analysis of factor influencing health promoting life style and musculoskeletal subjective symptom and evaluation of relationship of physical constitution and health promoting life study. In addition, it was verified of difference between musculoskeletal subjective symptom and result of muscle contrast picture evaluation. 4. Evaluation of oriental medical examination model is divided into 2 categories of oriental medical examination-consultation and result evaluation -post management. Oriental medical examination-consultation demands establishment of examination system, standardization of examination and establishment of examination form and in addition, it should be admitted as enlarged examination assists systemic quadruple diagnosis of herbalist not a key of oriental medical examination. In addition, information acquisition for research purpose should be performed according to the systemic research plan based on the separation of questionary for examination purpose and research purpose. For evaluation of the result, it was concluded that needed are result evaluation meets oriental medical system and post-notification system, informing health management information, based on examination result. 5. Accounting on satisfaction for oriental medical examination model, affirmative reply was much higher (66%) than negative (8.64%). Satisfaction of each area was in order of consultation of herbalist, systemic muscle contrast taking, pulse examination, post-notification and questionary fill-up and dissatisfaction was in order of post-notification, questionary fill-up, consultation of herbalist, systemic muscle contrast taking and pulse measurement. Satisfaction for collaborative examination of occidental and oriental medicine was over 60% and over 75% hope oriental examination would be included in later medical examination program. Based on this result, collaborative examination including occidental and oriental medicine could increase satisfaction of subjects for medical examination program.