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PRESENT SITUATION AND PROSPECT OF PEDIATRIC DENTISTRY IN KOREA - FOCUSED ON MANAGEMENT OF DENTAL CARIES - (한국 소아치과의 현재와 전망 - 치아우식증관리 분야를 중심으로 -)

  • Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.2
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    • pp.206-225
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    • 2012
  • General status of pediatric dentistry in Korea is to conduct vigorous academic activities and specialized medical care centering the Korean Association of Pediatric Dentistry (KAPD) that has about 1,000 pediatric dentists as members, pediatric dentistry departments of 11 Colleges of Dentistry, numbers of pediatric dentistry training institutions and private clinics specialized in children. From 1996, the accredited pediatric dentists were produced by the KAPD and from 2008, the state began to produce the accredited pediatric dentists. Since then, doctors with expertise in pediatric care had opened private clinics in addition to the university hospitals, it became the basis of a momentum to deepen the specialty of pediatric dentistry. The Dentistry community of Korea is going through rapid and profound changes recently, and the underlying reasons for such changes can be classified largely into a few categories: (1) Decreasing population and structural changes in population (2) Increase in numbers of dentists, (3) Changes in the pattern of dental diseases and (4) Changes in medical environment. In Korea, the children population in the age range of 0 ~ 14 years old had been decreased by 2 million in 2010 compared to that of 2000 due to reduction of birth rate. The current population of children in the age range of 0 ~ 4 years old in 2010 takes up 16.2% of the total population, but it is estimated that such percentage would decrease to 8.0% by 2050. Such percentage is largely behind the estimated mean global population of 19.6% by 2050. On the other hand, the number of dentists had been largely increased from 18,000 in 2000 to 25,000 in 2010. And it is estimated that the number will be increased to 41,000 by 2030. In addition, the specialized personnel of Pediatric dentistry had been shown as increased by 2.5 times during past 10 years. For the changes in the pattern of dental diseases, including dental caries, each df rate of 5 years old children and 12 years old children had been decreased by 21.9% and 16.7% respectively in 2010 compared to 2000. Each df Index also had been decreased by 2.5 teeth and 1.2 teeth respectively. The medical expenditure of Korea is less than that of OECD and more specifically, the expenditure from the National Health Plan is less than OECD but the expenditure covered by households is larger than OECD. These facts indicate that it is considered as requiring the coverage of the national health plan to be reinforced more in the future and as such reinforcement needs continuous promotion. In medical examination pattern of Pediatric dentistry, the preventive and corrective treatment were increased whereas the restorative treatment was decreased. It is considered that such change is caused from decrease of dental caries from activation of the prevention project at national level. For the restorative treatment, the restorations in use of dental amalgam, pre-existing gold crowning and endodontic treatment had been decreased in their proportion while the restorative treatment in use of composite resin had been increased. It is considered that such changes is caused by the change of demands from patients and family or guardians as they desired more aesthetic improvement along with socio-economic growth of Korean society. Due to such changes in dentistry, the pediatric dentistry in Korea also attempts to have changes in the patterns of medical examination as follows; It tends to implement early stage treatment through early diagnosis utilizing various diagnostic tools such as FOTI or QLF. The early stage dental caries so called white spot had been included in the subjects for dental care or management and in order to do so, the medical care guidelines essentially accompanied with remineralization treatment as well as minimally invasive treatment is being generalized gradually. Also, centering the Pediatric dentists, the importance of caries risk assessment is being recognized, in addition that the management of dental caries is being changed from surgical approach to internal medicinal approach. Recently, efforts began to emerge in order to increase the target patients to be managed by dentists and to expand the application scope of Pediatric dentistry along with through such changes. The interest and activities of Pediatric dentists which had been limited to the medical examination room so far, is now being expanded externally, as they put efforts for participating in the preventive policy making process of the community or the state, and to support the political theories. And also opinions are being collected into the direction that the future- oriented strategic political tasks shall be selected and researches as well as presentations on the theoretical rationale of such tasks at the association level.

Developing National Science Assessment System:Scientific Knowledge Domain (국가 수준의 과학 지식 평가 체제 개발)

  • Kwon, Jae-Sool;Choi, Byung-Soon;Kim, Chan-Jong
    • Journal of The Korean Association For Science Education
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    • v.18 no.4
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    • pp.601-615
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    • 1998
  • Establishing and evaluating science education policies and revising and monitoring the effectiveness of science curriculum should be based upon the results of systematic and scientific research studies. Advanced nations have already been administering and developing national level science assessments for these purposes. The science assessments administered in Korea have been reported having many limitations and problems, and not succeeded in providing data for science education policy making and curriculum reform. The major purpose of the study is developing national level science knowledge assessment system in order to identify longitudinal trends of elementary and secondary school students science knowledge achievements. The research team consisted of science education experts and teachers from various school levels, decided the directions and major elements of national level science knowledge assessment with the consultation of educational evaluation experts. Item developing ability of the researchers was improved by seminars? and workshops on national assessment in advanced nations and developing skills of writing science items. Nearly 500 items were developed and revised. Pilot test was administered with 958 students at various school levels. 380 items were selected and tested with 8766 students, and the characteristics were analyzed in terms of item response theory. The target populations for national level science knowledge assessment are 5th-grade of elementary school, 2nd-grade of middle school, 1st and 2nd-grade of high school students. The proper period for the assessment is February every year. Multi-stage clustered sampling method is desirable and rotated forms are recommendable for the test format. Bridge items should be introduced to compare the results of multiple tests, and various grades. Anchor items should also be used for longitudinal interpretations of the results. The items for elementary school require low to medium abilities, for middle school and first grade of high school require medium to high abilities and for 2nd-grade of high school high abilities. The discrimination ability of the items developed is high.

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The Characteristics of the Exhibits in Science Centers and Students' Perceptions About the Exhibits -In the Case of 3 Science Centers in Seoul- (과학관 전시물의 특징과 학생들의 전시물에 대한 인식 -서울시 소재 3개 과학관을 중심으로-)

  • Kim, So-Hee;Song, Jin-Woong
    • Journal of The Korean Association For Science Education
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    • v.23 no.5
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    • pp.544-560
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    • 2003
  • The purposes of this study were (1) to investigate the characteristics of the exhibits at three representative science centers or museums in Seoul, and (2) to analyse students' perceptions about the most and the least favorite exhibits selected by students as visitors. Three science centers investigated were Seoul National Science Museum, Seoul Education & Science Research Institute, LG Science Hall. The subjects for students' perception survey were 290 middle school students who visited the three science centers. The investigation of the exhibits showed that the goals, the contents, the visitors' viewing and manipulating activity types, and the explanation types of the exhibits depended on the purposes and the target visitors of each science center. Students' responses indicated that they most favored hands-on exhibit. And students preferred the exhibits that had new and comprehensible contents and the were related to what they had learned in school. Students said that they felt that science was exciting and that they came to experience what they did not do in school. Students said that reading or hearing given explanations was helpful to understand the exhibits, but about 20% of the students responded that they did not read explanation on panels at all. Students also said that guide's oral explanations were more understandable than written explanations on panels. Some of the students commented that having to wait for access because of crowds or because of the resetting time required for hands-on activities was inconvenience.

Legal Review on the Regulatory Measures of the European Union on Aircraft Emission (구주연합의 항공기 배출 규제 조치의 국제법적 고찰)

  • Park, Won-Hwa
    • The Korean Journal of Air & Space Law and Policy
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    • v.25 no.1
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    • pp.3-26
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    • 2010
  • The European Union(EU) has recently introduced its Directive 2008/101/EC to include aviation in the EU ETS(emissions trading system). As an amendment to Directive 2003/87/EC that regulates reduction of the green house gas(GHG) emissions in Europe in preparation for the Kyoto Protocol, 1997, it obliges both EU and non-EU airline operators to reduce the emission of the carbon dioxide(CO2) significantly in the year 2012 and thereafter from the level they made in 2004 to 2006. Emission allowances allowed free of charge for each airline operator is 97% in the first year 2012 and 95% from 2013 and thereafter from the average annual emissions during historical years 2004 to 2006. Taking into account the rapid growth of air traffic, i.e. 5% in recent years, airlines operating to EU have to reduce their emissions by about 30% in order to meet the requirements of the EU Directive, if not buy the emissions right in the emissions trading market. However, buying quantity is limited to 15% in the year 2012 subject to possible increase from the year 2013. Apart from the hard burden of the airline operators, in particular of those from non-European countries, which is not concern of this paper, the EU Directive has certain legal problems. First, while the Kyoto Protocol of universal application is binding on the Annex I countries of the Climate Change Convention, i.e. developed countries including all Member States of the European Union to reduce GHG at least by 5% in the implementation period from 2008 to 2012 over the 1990 level, non-Annex I countries which are not bound by the Kyoto Protocol see their airlines subjected to aircraft emissions reductions scheme of EU when operating to EU. This is against the provisions of the Kyoto Protocol dealing with the emissions of GHG including CO2, target of the EU Directive. While the Kyoto Protocol mandates ICAO to set up a worldwide scheme for aircraft emissions to contribute to stabilizing GHG concentrations in the atmosphere at a level that would prevent dangerous anthropogenic interference with the climate system, the EU ETS was drawn up outside the framework of the international Civil Aviation Organization(ICAO). Second, EU Directive 2008/101 defines 'aviation activities' as covering 'flights which depart from or arrive in the territory of a Member State to which the [EU] Treaty applies'. While the EU airlines are certainly subject to the EU regulations, obliging non-EU airlines to reduce their emissions even if the emissions are produced during the flight over the high seas and the airspace of the third countries is problematic. The point is whether the EU Directive can be legally applied to extra-territorial behavior of non-EU entities. Third, the EU Directive prescribes 2012 as the first year for implementation. However, the year 2012 is the last year of implementation of the Kyoto Protocol for Annex I countries including members of EU to reduce GHG including the emissions of CO2 coming out from domestic airlines operation. Consequently, EU airlines were already on the reduction scheme of CO2 emissions as long as their domestic operations are concerned from 2008 until the year 2012. But with the implementation of Directive 2008/101 from 2012 for all the airlines, regardless of the status of the country Annex I or not where they are registered, the EU airlines are no longer at the disadvantage compared with the airlines of non-Annex I countries. This unexpected premium for the EU airlines may result in a derogation of the Kyoto Protocol at least for the year 2012. Lastly, as a conclusion, the author shed light briefly on how the Korean aviation authorities are dealing with the EU restrictive measures.

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Comparison of vowel lengths of articles and monosyllabic nouns in Korean EFL learners' noun phrase production in relation to their English proficiency (한국인 영어학습자의 명사구 발화에서 영어 능숙도에 따른 관사와 단음절 명사 모음 길이 비교)

  • Park, Woojim;Mo, Ranm;Rhee, Seok-Chae
    • Phonetics and Speech Sciences
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    • v.12 no.3
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    • pp.33-40
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    • 2020
  • The purpose of this research was to find out the relation between Korean learners' English proficiency and the ratio of the length of the stressed vowel in a monosyllabic noun to that of the unstressed vowel in an article of the noun phrases (e.g., "a cup", "the bus", etcs.). Generally, the vowels in monosyllabic content words are phonetically more prominent than the ones in monosyllabic function words as the former have phrasal stress, making the vowels in content words longer in length, higher in pitch, and louder in amplitude. This study, based on the speech samples from Korean-Spoken English Corpus (K-SEC) and Rated Korean-Spoken English Corpus (Rated K-SEC), examined 879 English noun phrases, which are composed of an article and a monosyllabic noun, from sentences which are rated on 4 levels of proficiency. The lengths of the vowels in these 879 target NPs were measured and the ratio of the vowel lengths in nouns to those in articles was calculated. It turned out that the higher the proficiency level, the greater the mean ratio of the vowels in nouns to the vowels in articles, confirming the research's hypothesis. This research thus concluded that for the Korean English learners, the higher the English proficiency level, the better they could produce the stressed and unstressed vowels with more conspicuous length differences between them.

Comparison of PCR-Line Probe and PCR-SSCP Methods for the Detection of Rifampicin Resistant Mycobacterium Tuberculosis (Rifampicin 내성 결핵균의 검출에 있어서 PCR-line Probe법과 PCR-SSCP법의 비교)

  • Kim, Ho-Joong;Suh, Gee-Young;Chung, Man-Pyo;Kim, Jong-Won;Shim, Tae-Sun;Choi, Dong-Chull;Kwon, O-Jung;Rhee, Chong-H;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.714-722
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    • 1998
  • Background: Rifampicin (RFP) is a key component of the antituberculous short-course chemotherapy and the RFP resistance is a marker of multi-drug resistant (MDR) tuberculosis. RPoB gene encodes the $\beta$-subunit of RNA polymerase of M. tuberculosis which is the target of RFP. And the mutations of rpoB gene have been found in about 96% of rifampicin resistant clinical isolates of M. tuberculosis. So in order to find a rapid and clinically useful diagnostic method in identifying the RFP resistance, we compared the PCR -line probe method with PCR-SSCP for the detection of the rpoB gene mutation in cultured M. tuberculosis. Methods: 45 clinical isolates were collected from patients who visited Sung Kyun Kwan University Hospital. The RFP susceptibility test was referred to the referral laboratory of the Korean Tuberculosis Institute. 33 were rifampicin resistant and 12 were rifampicin susceptible. The susceptibility results were compared with the results of the PCR-BSCP and PCR-line probe method. Results: We could find rpoB mutations in 27/33(81.8%) RFP-resistant strains by PCR-line probe method, and in 23/33 (69.7%) by PCR-SSCP and there was no significant difference between two methods. There was no mutation in rifampicinn susceptible strains by both methods. Conclusion: PCR-line probe method would be a rapid, sensitive and specific method for the detection of rifampicin resistant Mycobacterium tuberculosis.

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Newly Revised Lung Cancer Staging System and Survival in Non-Small Cell Lung Cancer Patients (새로 개정된 폐암 병기 판정에 따른 비소세포폐암 환자의 생존 분석)

  • Kim, Byeong-Cheol;Moon, Doo-Seop;Yoon, Su-Mi;Yang, Seok-Chul;Yoon, Ho-Yoo;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.3
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    • pp.339-346
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    • 1999
  • Background : Non-small cell lung carcinoma is a common tumor with a poor prognosis. Of all malignancies, it is the main cause of death for male and female patients in the Western world. Resection remains the most effective treatment when feasible. Accurate description and classification of the extent of cancer growth are important in planning treatment, estimating prognosis, evaluating end results of therapy, and exchanging information on human cancer research. Until effective systemic therapy is available for non-small cell lung cancer, development of new treatment strategies depends on knowledge of the end results achieved for carefully staged groups of patients in the lung cancer populations. For these reasons, we investigated the survival rate in radically resected non-small cell lung cancer patients by newly revised staging system adopted by the American Joint Committee on Cancer and the Union Internationale Contre le Cancer. Methods: Clinical, surgical-pathologic and follow-up informations on 84 consecutive, previously untreated, patients who received their primary treatment for non-small cell lung cancer were investigated. Staging definitions for the T(primary tumor), N(reginal lymph node), and M(distant metastasis) components were according to the International Staging System for Lung Cancer. Death from any causes was the primary target of the evaluation. Results: The median survival rates were as follows; stage I ;79.1 months, stage II ;47.3 months, stage IIIa; 22.7 months, stage IIIb; 16.1 months, and stage IV;15.2 months versus newly revised stage Ia;58.5 months, stage I b;76.0 months, stage IIa; not available, stage IIb;43.0 months, stage IIIa;22.5 months, stage IIIb; 16.1 months, and stage IV;15.2 months. The survival rates were not significantly different between old and newly revised staging system. Cumulative percent survival at 36months after treatment was 100% in stage Ia, 80% in stage Ib, not available in stage IIa, 26 % in stage IIb, and 21 % in stage m a respectively. Conclusions: Although these data were not significantly different statistically, the newly revised lung cancer staging system might be more promising for the accurate evaluation of the prognosis in the non-small cell lung caner patients.

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Rapid detection of Rifampicin- resistant M, tuberculosis by PCR-SSCP of rpoB gene (결핵균의 rpoB유전자 PCR-SSCP법에 의한 Rifampicin 내성의 신속 진단)

  • Shim, Tae Sun;Yoo, Chul-Gyu;Han, Sung Koo;Shim, Young-Soo;Kim, Young Whan
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.842-851
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    • 1996
  • Background : Rifampicin(RFP) is a key component of the antituberculous shon-course chemotherapy and the RFP-resistance is a marker of multi-drug resistant(MDR) M. tuberculosis. rpoB gene encodes the ${\beta}$-subunit of RNA polymerase of M. tuberculosis which is the target of RFP. Recent reports show that rpoB gene mutations are the cause of RFP resistance of M. tuberculosis and the main mechanism of rpoB gene mutation is point mutation. And PCR-SSCP is a rapid and easy method for detecting point mutations. So we performed PCR-SSCP of rpoB gene of M. tuberculosis and compared the result with traditional RFP sensitivity test. Method : The 27 RFP sensitive M. tuberculosis culture isolates and 25 RFP resistant isolates were evaluated. The RFP sensitivity test was done at the Korean Tuberculosis istitute. The DNA was extracted by bead beater method and was amplified with primers TR-8 and TR-9 in a 20ul PCR reaction containing 0.1ul(luCi) [${\alpha}-^{32}P$] - dCTP. After amplification, SSCP was done using non-denaturaring polyacrylamide gel electrophoresis. Then direct sequencing was done in cases of different eletrophoretic mobility compared with that of H37Rv. In 19 cases, we compared PCR-SSCP results with patient's clinical course and the results of traditional RFP sensitivity test. Results : 1) All 27 RFP sensitive M. tuberculosis isolates showed the same electrophoretic mobility compared with that of H37Rv. And all 25 RFP resistant M. tuberculosis isolates showed different electrophoretic mobility. 2) The mechanism of rpoB gene mutation of M. tuberculosis is mainly point mutation. 3) The PCR-SSCP results correlate well with traditional RFP sensitivity and patient's clinical response to antituberculous treatment. Conclusion: The PCR-SSCP of rpoB gene is a very sensitive and rapid mehod in detecting RFP- resistant M. tuberculosis.

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Multiplex PCR of Endotracheal Aspirate for the Detection of Pathogens in Ventilator Associated Pneumonia (기계환기폐렴의 원인균 진단에서 인공기도 흡인액을 이용한 Multiplex PCR과 세균배양 결과의 비교)

  • Song, Ju Han;Myung, Soon Chul;Choi, Song Ho;Jeon, Eun Ju;Kang, Hyung Gu;Lee, Hye Min;Cho, Sung Keun;Choi, Jae Chol;Shin, Jong Wook;Park, In Won;Choi, Byoung Whui;Kim, Jae Yeol
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.3
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    • pp.194-199
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    • 2008
  • Background: Early identification of pathogens can improve the prognosis of patients with ventilator associated pneumonia (VAP). In the present study, we evaluated the feasibility of performing multiplex PCR for endotracheal aspirates to detect three important pathogens (P. aeruginosa, K. pneumoniae and MRSA) in patients with VAP. Methods: The endotracheal aspirates of 24 patients were collected within 24 hours of the diagnosis of VAP for performing multiplex PCR. Forward and reverse primers were designed to target the specific site of each pathogen (the oprL gene for P. aeruginosa, 16S rRNA for K. pneumoniae and the mec gene for MRSA). We analyzed the clinical data of the VAP patients, including the culture reports for the endotracheal aspirates. Results: Twenty-four patients (M:F=18:6, mean age=$70{\pm}11$) with VAP were enrolled. Pathogens were isolated from 11 patients (P. aeruginosa in 2, K. pneumoniae in 1, MRSA in 2, other enteric Gram negative bacilli in 3, S. pneumoniae in 2 and mixed infection in 1). Multiplex PCR detected three cases of P.aeruginosa (2 cases coincided with the culture reports) and four cases of K. pneumoniae (1 matched with the culture report). PCR detected two MRSA cases, which did not coincide with the culture reports. Conclusion: Multiplex PCR of the endotracheal aspirate showed some ability to detect Gram negative bacilli, although caution is required when interpreting the results.

Mutations of katG and inhA in MDR M. tuberculosis (국내에서 분리된 다제 내성 결핵균의 katG 와 inhA 변이 다양성 및 그 빈도)

  • Lin, Hai Hua;Kim, Hee-Youn;Yun, Yeo-Jun;Park, Chan Geun;Kim, Bum-Joon;Park, Young-Gil;Kook, Yoon-Hoh
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.2
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    • pp.128-138
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    • 2007
  • Backgrounds: Mutations of katG and inhA (ORF and promoter) are known to be related to isoniazid (INH) resistance of Mycobacterium tuberculosis. Because reports on these mutations in Korean isolates are limited (i.e. only the frequency of katG codon 463 was evaluated.), we tried to know the kinds of mutations of two genes and their frequencies in INH resistant Korean M. tuberculosis strains. Methods: PCR was performed to amplify katG (2,223 bp), inhA ORF (-77~897, 975 bp), and inhA promoter (-168~80, 248 bp) from 29 multidrug resistant M. tuberculosis (MDR-TB) DNAs prepared by bead beater-phenol method. Their sequences were determined and analyzed by ABI PRISM 3730 XL Analyzer and MegAlign package program, respectively. Results: All of the isolates had more than one mutation in katG or inhA gene. Twenty seven (93%) of 29 tested strains had katG mutations, which suggests that katG is a critical gene determining INH resistance of M. tuberculosis. Amino acid substitutions, such as Arg463Leu and Ser315Thr, due to point mutations of the katG were the most frequent (62.1% and 55.2%) mutations. In addition, deletion of the katG gene was frequently observed (17.2%). Analyzed Korean MDR-TB isolates also had variable inhA mutations. Point mutation of inhA promoter region, such as -15 ($C{\rightarrow}T$) was frequently found. Substitution of amino acid (Lsy8Asn) due to point mutation ($AAA{\rightarrow}AAC$) of inhA ORF was found in 1 isolate. Interestingly, 14 point mutated types that were not previously reported were newly found. While four types resulted in amino acid change, the others were silent mutations. Conclusions: Although it is not clear that the relationship of these newly found mutations with INH resistance, they show marked diversity in Korean MDR-TB strains. It also suggests their feasibility as a molecular target to supplement determining the INH resistance of clinical isolates because of the possible existence of low-level INH resistant strains.