• The Korean Journal of Emergency Medical Services
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• v.15 no.3
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• pp.31-44
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• 2011

Purpose : The purpose of emergency medical services(EMS) is to save human lives and assure the completeness of the body in emergency situations. Those who have been qualified on medical practice to perform such treatment as there is the risk of human life and possibility of major physical and mental injuries that could result from the urgency of time and invasiveness inflicted upon the body. In the emergency medical activities, 119 emergency medical technicians mainly perform the task but they are not able to perform such task independently and they are mandatory to receive medical direction. The purpose of this study is to examine the recognition and request for medical direction by 119 emergency medical technicians in order to provide basic information on the development of medical direction program suitable to the characteristics of EMS as well as for the studies on EMS for the sake of efficient operation of pre-hospital EMS. Method : Questionnaire via e-mail was conducted during July 1-31, 2010 for 675 participants who are emergency medical technicians, nurses and other emergency crews in Gyeongbuk. The effective 171 responses were used for the final analysis. In regards to the emergency medical technicians' scope of responsibilities defined in Attached Form 14, Enforcement regulations of EMS, t-test analysis was conducted by using the means and standard deviation of the level of request for medical direction on the scope of responsibilities of Level 1 & Level 2 emergency medical technicians as the scale of medical direction request. The general characteristics, experience result, the reason for necessity, emergency medical technicians & medical director request level, medical direction method, the place of work of the medical director, feedback content and improvement plan request level were analyzed through frequency and percentage. The level of experience in medical direction and necessity were analyzed through ${\chi}^2$ test. Results : In regards to the medical direction experience per qualification, the experience was the highest with 53.3% for Level 1 emergency medical technicians and 80.3% responded that experience was helpful. As for the recognition on the necessity of medical direction, 71.3% responded as "necessary" and it turned out to be the highest of 76.9% in nurses. As for the reason for responding "necessary", the reason for reducing the risk and side-effects from EMS for patients was the largest(75.4%), and the reason of EMS delay due to the request of medical direction was the highest(71.4%) for the reason for responding "not necessary". In regards to the request level of the task scope of emergency medical technicians, injection of certain amount of solution during a state of shock was the highest($3.10{\pm}.96$) for Level 1 emergency rescuers, and the endotracheal intubation was the highest($3.12{\pm}1.03$) for nurses, and the sublingual administration of nitroglycerine(NTG) during chest pain was the highest($2.62{\pm}1.02$) for Level 2 emergency medical technicians, and regulation of heartbeat using AED was the highest($2.76{\pm}.99$) for other emergency crews. For the revitalization of medical direction, the improvement in the capability of EMS(78.9%) was requested from emergency crew, and the ability to evaluate the medical state of patient was the highest(80.1%) in the level of request for medical director. The prehospital and direct medical direction was the highest(60.8%) for medical direction method, and the emergency medical facility was the highest(52.0%) for the placement of medical director, and the evaluation of appropriateness of EMS was the highest(66.1%) for the feedback content, and the reinforcement of emergency crew(emergency medical technicians) personnel was the highest(69.0%) for the improvement plan. Conclusion : The medical direction is an important policy in the prehospital EMS activity because 119 emergency medical technicians agreed the necessity of medical direction and over 80% of those who experienced medical direction said it was helpful. In addition, the simulation training program using algorithm and case study through feedback are necessary in order to enhance the technical capability of ambulance teams on the item of professional EMS with high level of request in the task scope of emergency medical technicians, and recognition of medical direction is the essence of the EMS field. In regards to revitalizing medical direction, the improvement of the task performance capability of 119 emergency medical technicians and medical directors, reinforcement of emergency medical activity personnel, assurance of trust between emergency medical technicians and the emergency physician, and search for professional operation plan of medical direction center are needed to expand the direct medical direction method for possible treatment beforehand through the participation by medical director even at the step in which emergency situation report is received.

• Journal of Korean Dental Hygiene Science
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• v.2 no.2
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• pp.31-39
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• 2019

Background: The purpose of this study was to investigate the effect of self-perception of halitosis on oral health behaviors of college students according to whether they worked in a non-service or service-related job. Methods: A self-reporting questionnaire of 150 university students working in service jobs and 150 university students working in non-service jobs in the metropolitan area was conducted from 26th April to 5th May 2018. The survey tool consisted of 3 general topic areas. There were 5 questions on oral health awareness behavior, 3 questions related to their self-perception of halitosis, and 8 questions on their oral health care practice. All were measured on the Likert 5-point scale. The frequency of their oral health behaviors and their self-perception of halitosis were analyzed according to the subjects' occupation. Pearson's correlation analysis and a linear regression analysis were conducted to confirm the influence of the two. The significance level for the statistical significance test was set to α = 0.05 (two-tailed). Results: In both the service and non-service groups, a coated tongue and food debris were found to influence halitosis(x²=10.95, p=0.027). According to the t-test, taking into account the self-perception of halitosis and oral health behaviors, both were higher in those that had a service job. Self-perception of halitosis and oral health behaviors were found to have a negative correlation(γ=-0.11, p<0.05). As the self-perception of halitosis increased, oral health care practices also increased(Beta=-0.185, p=0.020). Conclusions: Systematic interventions such as oral health programs and health promotion are needed to improve the oral health of service workers.

• Clinical and Experimental Pediatrics
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• v.46 no.2
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• pp.173-177
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• 2003

Purpose : Recently, different results about factors affecting accurate quantitation of 24-hr urinary protein(24UP) amount using spot urine protein/creatinine ratio(PCR) have been reported. The current study was designed to evaluate correlation between 24UP amounts and PCR in children, and the effect of 24UP amounts, age, sex, and glomerular filtration rate(GFR) on this correlation. Methods : Among 94 patients who visited the department of pediatrics in Busan Paik Hospital from March 2002 to August 2002, 68 patients whose urinary creatinine excretion was ${\geq}15mg/kg/day$ were included in this study. All the patients were divided into I, II/A, B group(I : 24UP<500 mg/day, II : $24UP{\geq}500mg/day$, A : <10 years of age, B : ${\geq}10years$ of age). Pearson correlation analysis was performed between 24UP and PCR to evaluate the relationship. We defined fractional difference between 24UP and PCR, and then performed multiple regression analysis with 24UP amount, age, GFR and fractional difference. Results : There was a strong positive linear correlation between 24UP and PCR(R=0.936, P<0.0001) in all patients, and the correlation was also good in each group. Using PCR cutoff values of 0.5, the PCR provided high sensitivity, specificity, positive and negative predictive value in predicting 24UP amount ${\geq}500mg$. The factors affecting accurate quantitation of proteinuria using spot urine PCR was age, not 24UP amount, GFR or sex. Conclusion : Spot urine PCR is a useful test but has limitations in predicting 24UP amount. Therefore, it should be used only as screening method. Age-adjusted PCR cutoff values may be necessary to predict 24UP amount in children with proteinuria.

• Tuberculosis and Respiratory Diseases
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• v.60 no.5
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• pp.523-531
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• 2006

Background : Cervical tuberculous lymphadenopathy is a very common disease with a similar incidence to pulmonary tuberculosis. Dendritic cells play a role of initial antigen presentation of this illness. Nevertheless, the precise role of these antigen-presenting cells according to the clinical features in unclear. The aim of this study was to determine the clinical implication of dendritic cell infiltration in the cervical lymph nodes. Methods : A review of the clinical characteristics was carried out retrospectively based on the clinical records and radiography. Immunohistochemical staining was performed on the available histology specimens of 72 cases using the S-100b polyclonal antibody for dendritic cells. The number of dendritic cells with tuberculous granuloma were determined. A $X^2$ test, unpaired T test and multiple logistic regression analysis were performed. Results : Thirty percent of subjects had previous or concurrent pulmonary TB. Twenty one percent of cases showed a positive reaction on the AFB stain. Within a granuloma, the number of infiltrated dendritic cells was $113.0{\pm}7.0$. The incidence of fever and cough decreased with increasing infiltration of dendritic cells Multivariate regression analysis showed that the infiltration of dendritic cells could significantly contribute to fever. Conclusion : Overall, dendritic cells can control a Mycobacterium tuberculosis infection and modulate the immune response, as well as resolve the clinical manifestations of TB lymphadenopathy.

• Korean Journal of Health Education and Promotion
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• v.12 no.2
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• pp.109-119
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• 1995

As the population of elderly in Korea is increasing rapidly since the 1990's and will more rapidly in the 21st Century, the demand of their health care would be a great burden to health care expenditure. Then it would be necessary to contemplate the functional status and life satisfaction for elderly to make them live more independently. The objectives of this study were find out the functional status in life and life satisfaction for the elderly aged 65 or over who had resided in urban area of two Gus in Pusan and rural area of two Myuns in Haman Gun in Kyeognam Province, and to provide basic data for planning systematic health care programme. The study period was two weeks from February 6 to February 18, 1995 and the subjects were 274 elderly of which 143 were urban residents, 131 were rural residents, and the study method was by structured questionnaire. The data were analyzed with SAS/PC/sup +/ programme using Chi-square test, t-test, ANOVA, Pearson's correlation coefficients, and multiple regression analysis. The results were as follows; 1. To see the pattern of living together, those living with partners were the most common, 39.1% ; 37.8% of urban elderly lived with married sons, 32.2% of them lived with partners, but 46.6% of rural elderly lived with partners, 16.8% of them lived with married sons, which showed difference between residence(p<0.005). 2. Elderly who had jobs were 64.1% in rural residents, and 7.7% in urban residents, which showed significant difference(p<0.05). 3. The score of cognitive function of total subjects was 24.7, that of urban elderly was 23.8, and that of rural elderly was 25.7, then it was higher in rural ones and low for old-elders and those who had no jobs. 4. The score of PADL was 26.8 for urban elderly, 30.1 for rural elderly, and that of IADL was 22.2 for urban elderly, 25.6 for rural elderly, which showed higher activities of daily living for rural elderly than urban elderly(p<0.001). 5. The score of domestic performance was 21.9 for urban elderly, and 30.5 for rural elderly, which showed higher score for rural elderly(p<0.001). 6. The score of life satisfaction was 20.7 for urban elderly, 29.8 for rural elderly, then it was higher for rural elderly(p<0.01). 7. As a result of ANOVA for functional status in living by general characteristics; the score of cognitive function differed by age, job; that of PADL differed by age, job, education, and the pattern of living together, that of IADL differed by age, job, and the pattern of living together. The score of domestic role performance differed by age, job, marital status, and the pattern of living together. 8. ANOVA for life satisfaction showed that the score of life satisfaction differed by job(p<0.001) and the pattern of living together(p<0.01). 9. The correlations between functional status in living and life satisfaction showed that the higher the score of cognitive function was(r=0.39), the higher the score of activities of daily living was(r=0.50), and the higher the score of domestic role performance was(r=0.41), the higher the score of life satisfaction. 10. Stepwise multiple regression analysis for life satisfaction pointed out that residence was responsible for 39.9% of the variance. cognitive function was for 5.3%, and domestic role performance was for 1.2%.

• Journal of the Korean Society of Food Science and Nutrition
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• v.43 no.11
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• pp.1766-1773
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• 2014

The purpose of this research was to scrutinize dieticians' perspective of seafood ingredients prices in school food-service. Suppliers' contract status, seafood ingredient usage and satisfaction, expectations regarding prices of seafood ingredients, and willingness to pay when HACCP is taken into account were studied. Through random sampling, the survey was conducted on 231 dieticians in 11 different educational districts and 12 elementary, six middle, and three high schools. Ultimately, 142 survey responses were taken into account. Data analysis was performed using SPSS v15.0 by descriptive analysis, ${\chi}^2$-test, and t-test. For contracts regarding seafood ingredients, competitive contracts composed 79.7%. Exactly 42.1% responded that contracts were breached, and 60.1% testified that product returns were due to excessive glazing of ingredients. The satisfaction rate of 'hygiene & sanitation of product' was the highest, whereas 'price of product' was the lowest. For 'recontracting intention', 'informal purchasing' showed higher rates compared to 'competitive bidding'. Reflecting upon the six main price factors, 'designation and maintenance of HACCP', 'price of raw seafood ingredients', 'processing costs', 'margin', 'logistic costs', and 'cost of standardizing seafood ingredients', dieticians' perceived 'impact on the anticipated price' on total cost was lower than present counterparts. This implicates that 'impact on the present price' of the six price factors is too excessive, suggesting that many dieticians are unsatisfied with the current prices of seafood ingredients. Furthermore, 52.8% of dieticians stated that the maximum additional payment of HACCP seafood ingredients should be less than 5%. Consequently, this research serves as basic information for reasonable pricing of seafood ingredients and contributes to increased seafood usage by school food-services.

• Clinical and Experimental Reproductive Medicine
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• v.21 no.1
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• pp.31-41
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• 1994

Morphological estimation of human spermatozoa is complicated by the fact that there is great natural variation in shape. This natural variation in shapes makes it difficult to say which forms are associated with infertility and which are normal variations. Possibly post coital test or in vitro cervical mucus penetration tests will help to clarify this question by showing which sperm are capable of penetration. The purpose of this investigation was performed to assess distribution of various morphological abnormalities according to the ability of sperm to penetrate cervical mucus. The sperm-mucus penetration using hen's egg white as substituting mucus for human cervical mucus was done in 45 fertile men with normal semen analysis and 122 infertile men with abnormal seminal parameters more than one. The female partners of 122 infertile couples showed normal results in the female fundamental test for fertility. Conventional semen analysis was evaluated according to the WHO standard normal(l980). The detailed classification of the abnormal sperm was made according to David et al(l975). The vitality of the sperm samples determined by eosin yellow-nigrosin stainig according to the method of Eliasson(l977). Results were as follw; 1. The patients had significantly lower total sperm count, motility (%), normal morphology (%), viability and total functional sperm fractions(TFSF) than fertile donors. 2. The mean value of sperm penetration distance of the patients(28.69${\pm}$11.02mm) showed significantly lower than fertile donors(37.33${\pm}$5.49mm). And 43/45 fertile donors(95.5%) as well as 57/122 patients(46.7%) had over 30mm in sperm penetration distance respectively. While 2/45 fertile donors(4.5 %) and 65/122 patient(53.3%) had under 30mm in sperm penetration distance respectively. 3. The morphological abnormalities in fertile donors were significantly lower 23.04${\pm}$5.83% (head = 12.89${\pm}$4.98, neck=6.11${\pm}$3.83%, and tail=3.43${\pm}$2.65%), compared to 36.03${\pm}$14. 40% in patients(head = 15.98 8.60%, neck 11.20${\pm}$6.56% and tail=8.70${\pm}$6.55%). Also, 3 types of sperm abnormalities including head, neck and tail were significantly lower in patient than fertile donors, respectively. Both the patients and fertile donors showed higher distribution of sperm with abnormal head than abnormal neck and tail. 4. The mean morphological abnormalities(SP>30mm) of the patients(30.68 11.64%; head = 15.95${\pm}$9.35%, neck=8.14${\pm}$4.21 %, tail=6.56${\pm}$5.64%) were significantly lower compared to patients(40.72${\pm}$15.01 %; head=16.02${\pm}$7.69%, neck 13.89${\pm}$7.82%, tail=1O.58${\pm}$6.75%) under 30mm in sperm penetration distance. Also, both groups over 30mm and under 30mm in sperm penetration showed distance higher distribution of sperm with abnormal head than abnormal neck and tail. The morphological abnormalities of head did not show significant difference but abnormal neck and tail were significant difference between the over 30mm and under 30mm group in sperm penetration distance.

• Journal of Nutrition and Health
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• v.48 no.3
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• pp.248-257
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• 2015

Purpose: The aim of this study was to estimate total sugar intake and sugar intake-related dietary habit and nutrient intake of middle school students. Methods: Subjects included 1,184 middle school students (476 males and 708 females) residing in Jeju. This research analyzed daily dietary intakes of subjects using the 24 hour recall method and surveyed the dietary habit related to total sugar intake using questionnaires. Descriptive analysis, chi-square test, t-test, and ANOVA, using the SAS program were used for analysis of data. Results: The average daily total sugar intake was 60.3 g (male 50.5 g, female 66.9 g). Total sugar intake per meal was 6.5 g (10.8%) from breakfast, 9.0 g (14.9%) from lunch, 11.8 g (19.6%) from dinner, and 33.0 g (54.7%) from snacks. Food groups that contribute to the majority of total sugar intake were grains and their products (23.0 g), milk (11.0 g), fruits and their products (7.3 g), sugars and sweets (6.1 g), and vegetables and their products (5.8 g). In terms of total sugar intakes by cooking methods, desserts showed a greater amount than main and side dishes, and indicated in order of amount as follows: bread and cookies (11.5 g), dairy products (7.5 g), ice cakes (6.2 g), beverages (5.3 g), and fruits (4.5 g). Total sugar consumption was high for rice and side dishes such as noodles (10.2 g), fried foods (2.9 g), stir-fried foods (2.0 g), and cooked rice with seasoning (1.7 g). The daily intake of natural sugar, added sugar, and natural and added sugar was 18.3 g, 35.8 g, and 6.2 g, respectively. The high sugar intake group, which was over 20% of the energy from total sugar intakes, consumed significantly less Fe, Zn, vitamin B6, niacin, and vitamin E than the low sugar intake group, which was below 20%. Conclusion: Total sugar intake of second graders of middle schools on Jeju Island was 60.3 g/day, mostly obtained from snacks (54.7%). Therefore, nutritional education for proper selection of better snacks and for reduction of dietary sugar intake is needed for middle school students.

• Proceedings of the Materials Research Society of Korea Conference
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• 2011.05a
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• pp.14-14
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• 2011

W (tungsten)-alloys will be the most promising plasma facing armor materials in highly loaded plasma interactive components of the next step fusion reactors due to its high melting point, high sputtering resistance and low deuterium/tritium retention. The bonding technology of tungsten to Cu alloy was one of the key issues. In this paper, W/CuCrZr diffusion bonding has been performed successfully by inserting pure metal interlay. The joint microstructure, interfacial elements migration and phase composition were analyzed by SEM, EDS, XRD, and the joint shear strength and micro-hardness were investigated. The mock-ups were fabricated successfully with diffusion bonding and the cladding technology respectively, and the high heat flux test and thermal fatigue test were carried out under actively cooling condition. When Ni foil was used for the bonding of tungsten to CuCrZr, two reaction layers, Ni4W and Ni(W) layer, appeared between the tungsten and Ni interlayer with the optimized condition. Even though Ni4W is hard and brittle, and the strength of the joint was oppositely increased (217 MPa) due primarily to extremely small thicknesses (2~3 ${\mu}m$). When Ti foil was selected as the interlayer, the Ti foil diffused quickly with Cu and was transformed into liquid phase at $1,000^{\circ}C$. Almost all of the liquid was extruded out of the interface zone under bonding pressure, and an extremely thin residual layer (1~2 ${\mu}m$) of the liquid phase was retained between the tungsten and CuCrZr, which shear strength exceeded 160 MPa. When Ni/Ti/Ni multiple interlayers were used for bonding of tungsten to CuCrZr, a large number of intermetallic compound ($Ni_4W/NiTi_2/NiTi/Ni_3T$) were formed for the interdiffusion among W, Ni and Ti. Therefore, the shear strength of the joint was low and just about 85 MPa. The residual stresses in the clad samples with flat, arc, rectangle and trapezoid interface were estimated by Finite Element Analysis. The simulation results show that the flat clad sample was subjected maximum residual stress at the edge of the interface, which could be cracked at the edge and propagated along the interface. As for the rectangle and trapezoid interface, the residual stresses of the interface were lower than that of the flat interface, and the interface of the arc clad sample have lowest residual stress and all of the residual stress with arc interface were divided into different grooved zones, so the probabilities of cracking and propagation were lower than other interfaces. The residual stresses of the mock-ups under high heat flux of 10 $MW/m^2$ were estimated by Finite Element Analysis. The tungsten of the flat interfaces was subjected to tensile stresses (positive $S_x$), and the CuCrZr was subjected to compressive stresses (negative $S_x$). If the interface have a little microcrack, the tungsten of joint was more liable to propagate than the CuCrZr due to the brittle of the tungsten. However, when the flat interface was substituted by arc interfaces, the periodical residual stresses in the joining region were either released or formed a stress field prohibiting the growth or nucleation of the interfacial cracks. Thermal fatigue tests were performed on the mock-ups of flat and arc interface under the heat flux of 10 $MW/m^2$ with the cooling water velocity of 10 m/s. After thermal cycle experiments, a large number of microcracks appeared at the tungsten substrate due to large radial tensile stress on the flat mock-up. The defects would largely affect the heat transfer capability and the structure reliability of the mock-up. As for the arc mock-up, even though some microcracks were found at the interface of the regions, all microcracks with arc interface were divided into different arc-grooved zones, so the propagation of microcracks is difficult.

• Journal of dental hygiene science
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• v.14 no.1
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• pp.7-14
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• 2014

This study aims to evaluate the impact of varying exposure to dental amalgam on urinary mercury levels in children by measuring the number of amalgam-filled teeth and the variance of mercury concentration in urine over a period of 2 years. A total of 317 (male 158, female 159) elementary school children (1st~4th graders) attending 2 schools in urban regions participated in this study. At 6-month intervals, 4 oral examinations were conducted to check any variance in the conditions of dental caries and the status of dental fillings. Also, urine tests were conducted followed by a questionnaire survey. To elucidate the factors potentially affecting the mercury concentration in urine, t-test, ANOVA, chi-square test and a mixed model were used for the analysis. Regarding the status of dental fillings in line with examination time periods, deciduous teeth had more amalgam-filled surfaces than those filled with resin, whereas permanent teeth had more resin-filled surfaces than those filled with amalgam. A significant relevance was found between the exposure to dental amalgam and urinary mercury levels. Specifically, subjects whose teeth surfaces had been filled with dental amalgam showed higher urinary mercury levels than those who had no dental amalgam fillings. Based on the analysis using the mixed model, the increase in the number of teeth surfaces filled with amalgam was found to be the factor affecting the increase in urinary mercury levels. The urinary mercury levels were found to be highly associated with the exposure to dental amalgam. The more the teeth surfaces filled with amalgam, the higher the urinary mercury levels. Hence, even a trace of dental amalgam fillings can liberate mercury, affecting the variance in the urinary mercury levels. These findings suggest that some criteria or measures should be developed to minimize the exposure to dental amalgam. Moreover, relevant further studies are warranted.