• 대한간호학회지
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• 제10권1호
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• pp.41-55
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• 1980

The medical care insurance system, being put into practice nearly for three years, seem to have brought about some considerable problems as serious for the government as to consider a revision of that system. As one of the most serious problems of present system, the treatment cost of insurance patients is so remarkably low in comparison with than of non-insurance cases that normal operation of hospitals is threatened and care services of low quality are induced. The researcher carried out this survey to analyze and bring to light several aspects of treatment cost of non-insurance patients as a material for a re-assessment of the cost of insurance cases which shows a a considerable difference in amount at the standpoint of hospitals with than of non-insurance cases and further, hoping the significant blind spot of present insurance system(that is, the absence of regulations' for cost assessment by patterns or types of health care treatment) will be mended in near future. The survey was carried out with the treatment invoice sheets of total 902 in-hospital Patients of a general hospital in Seoul during the period of the 2 nd quarter of the year(1979). Among total 902 patients, 694 cases were used for analysis, because those disease or syndromes shared by less than 10% of the patients were put aside before procession. The data were analyzed by kinds or types of diseases, demographic characteristics of patients, hospitalization patterns, types of nursing treatment, etc. The result of analysis was as follows 1. Among all the non-insurance cases, those who received one or more kinds of nursing treatment mounted up to 96. 7 ％. The invoice issue frequency per person was 7.2 times, while that frequency per day for a person was 0.8, : the treatment cosr per person was ￦22,650 while its daily average was ￦2,430, due to the average 9.3 in-hospital days per person. 2. As to the nursing treatment types by the demographic characteristics of patients and hospitalization patterns. a. The unit cost female patients was generally more expensive them that of males, and independent nursing service was more given than other types of treatment. As to age, higher age groups received independent nursing service most, while the youngest group received instrumental and integrated nursing services. b. As to room grade, the unit cost of I.C.U. cases was the highest : and the cast of private room patients was higher than that of public room patients. By in-hospital days, the curve of function showed L. type : that is, the longer stay, the lower function. 3. State of treatment types by kinds of disease were ; a. Dependent nursing service showed comparatively high availability in surgical and neurologic disease and independent nursing service was most received by medical, obstetrical and urological patients, while instrumental and integrated services were most available for respiratory disease and obstetrical and neurologic diseases next. b. The invoice issue frequency per day for a patient was highest in obstetrical disease 3.8 times, and the unit cost(per one invoice sheet) was also highest in obstertrical disease(￦10,880) and next in neurologic cases(￦ 4,690 ). 4. As to the pertained departments. a. Cost amount per person was highest in department of Psychiatries daily cost was highest in obstetrical cases : while the invoice issue frequency was highest in obstetrics and next in pediatrics. b. In departments in need of surgical operation, dependent nursing care was highly availabl : while in internal medicine and obstetrics, independent service was higher. Psychiatrics showed the highest the of integrate nursing while pediatrics and obstetrics higher of instrumental services. The variation co-efficien of treatment cost came out to be relatively in high in special surgery, opthalmology and internal medicine. 5. State of treatment cost by types of nursing behavior was. a. The average frequency of invoice issue was 3.5 (times). Among the type four types of treatment, instrumetal service (4.3) and independent nursing behavior(3.9) showed higher frequency than average respectively. But as to unit cost (per invoice). dependent (￦5,200) and integrated (￦5,340) nursing care services were higher than average and considerably higher than the other two types. b. In repect patient distribution. independent nursing behavior(80.3% ) was the highest and depend ent nursing (31.7% ) the lowest. The variation co-efficient of treatment cost appeared highest in dependent nursing be havior as a whole, and among that, doctor's diagnosis showed the highest coefficient value (100.7). In conclusion, the variaty of treatment cost(treatment itself ) by various characteristics and treatment types pro- that treatment various sort of patients and treatment cost of various types of nursing behavior cannot be uniform. Therefore, to attain the equalization of health care service and its cost both for insurant and non-insurant patients, a more specific provision for assessment of cost should be added to the present medical care insurance system and, in addition, the cost of nursing treatment is desired to be inserted into the treatment invoice.

• 치위생과학회지
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• 제3권1호
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• pp.5-10
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• 2003

치과의료 종사자의 연봉제 도입에 대한 의식 고찰을 통하여 연봉제에 대한 바람직한 방향 설정과 활성화 방안을 모색하는 계기를 마련하고자 문헌과 자료를 조사하고, 전국 치과 병, 의원에 종사는 구성원 95명을 대상으로 2002년 4월부터 8월까지 약 5개월 동안 설문조사를 실시하여 분석한 결과 다음과 같은 결론을 얻었다. 1. 근무하는 병원의 형태에 따라 연봉제에 대한 인식을 살펴본 결과, 치과병원의 종사자가 치과의원의 종사자보다 연봉제 실시로 인한 경영참여의식(p<.001)과 업무생산성의 향상(p<.01), 목표달성에 대한 사명감(p<.01), 장래에 대한 불안감(p<.05)에 대해 더 높은 인식을 보였다. 2. 연봉제에 대한 치과의사와 치과위생사의 인식을 살펴본 결과, 치과의사가 치과위생사보다 연봉제 실시로 인한 성과평가의 공정성(p<.01)과 능력발휘 풍토변화(p<.01), 업무생산성의 향상(p<.001), 목표달성에 대한 사명감(p<.001), 그리고 연봉제에 대해 높은 인식(p<.01)을 보이고 있음을 알 수 있다. 3. 근무경력에 따라 연봉제에 대한 인식을 살펴본 결과, 근무경력이 오래될수록 업무의 엄격성 강화정도(p<.05)와 단기 업적주의 치중 가능성(p<.05)에 대해 높은 인식을 보였으며, 3~5년 종사자가 다른 종사자보다 근무시간의 변화(p<.01)에 대해 높은 인식을 보였고, 2년 이하의 종사자가 연봉제에 대해 가장 높은 인식(p<.05)을 보이고 있음을 알 수 있다. 4. 연봉제가 성과를 거두기 위한 전제조건으로 평가결과의 공정성이 전제되어야 한다고 인식하는 치과의료 종사자가 31.6%로 가장 많았으며, 다음으로 노사 상호간의 이해와 신뢰구축 26.3%, 연봉제의 구성원들에 대한 긍정적인 태도 16.8%, 연봉제에 대한 최고경영자(주체)의 확고한 신념 12.3%, 연봉산정의 기준이 되는 목표치의 달성가능 10.5% 순으로 나타났다. 또한 치과의원 종사자가 치과병원 종사자보다 연봉제가 성과를 거두기 위해서는 연봉제의 구성원에 대한 긍정적인 태도(p<.05)가 전제되어야 한다고 인식하였고, 치과의사가 치과위생보다 연봉산정의 기준이 되는 목표치의 달성가능(p<.001)이 전제되어야 한다고 인식하였다.

• Smart Structures and Systems
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• 제10권2호
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• pp.131-154
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• 2012

In this paper, it is aimed to determine the seismic behaviour of highway bridges by nondestructive testing using ambient vibration measurements. Eynel Highway Bridge which has arch type structural system with a total length of 216 m and located in the Ayvaclk county of Samsun, Turkey is selected as an application. The bridge connects the villages which are separated with Suat U$\breve{g}$urlu Dam Lake. A three dimensional finite element model is first established for a highway bridge using project drawings and an analytical modal analysis is then performed to generate natural frequencies and mode shapes in the three orthogonal directions. The ambient vibration measurements are carried out on the bridge deck under natural excitation such as traffic, human walking and wind loads using Operational Modal Analysis. Sensitive seismic accelerometers are used to collect signals obtained from the experimental tests. To obtain experimental dynamic characteristics, two output-only system identification techniques are employed namely, Enhanced Frequency Domain Decomposition technique in the frequency domain and Stochastic Subspace Identification technique in time domain. Analytical and experimental dynamic characteristic are compared with each other and finite element model of the bridge is updated by changing of boundary conditions to reduce the differences between the results. It is demonstrated that the ambient vibration measurements are enough to identify the most significant modes of highway bridges. After finite element model updating, maximum differences between the natural frequencies are reduced averagely from 23% to 3%. The updated finite element model reflects the dynamic characteristics of the bridge better, and it can be used to predict the dynamic response under complex external forces. It is also helpful for further damage identification and health condition monitoring. Analytical model of the bridge before and after model updating is analyzed using 1992 Erzincan earthquake record to determine the seismic behaviour. It can be seen from the analysis results that displacements increase by the height of bridge columns and along to middle point of the deck and main arches. Bending moments have an increasing trend along to first and last 50 m and have a decreasing trend long to the middle of the main arches.

• 한국산학기술학회논문지
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• 제21권4호
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• pp.226-235
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• 2020

연구목적은 당뇨성 안질환 및 신장질환 합병증 검사 수검여부에 영향을 주는 요인을 알아보기 위함이다. 본 연구는 2017년 지역사회 건강조사 전국 자료를 이용하였으며, 연구대상은 의사에게 당뇨병을 진단받은 적이 있다고 응답한 사람 25,829명이다. 당뇨병 환자의 당뇨성 안질환 및 신장질환 합병증 검사 수검여부에 영향을 주는 요인을 알아보기 위해 로지스틱 회귀분석을 실시하였다. 연구결과는 당뇨병 환자 중 당뇨성 안질환 합병증 검사 수검율은 35.6%, 당뇨성 신장질환 합병증 검사 수검률은 39.8%이었다. 걷기실천을 할수록(OR=1.03, OR=1.02), 당화혈색소(OR=2.33, OR=2.33) 및 혈당수치(OR=1.61, OR=1.71)를 인지하는 사람과 현재 당뇨병 치료(OR=2.67, OR=3.05) 및 당뇨병 관리교육(OR=1.45, OR=1.47)을 받는 사람의 당뇨성 안질환 및 신장질환 합병증 검사를 받을 가능성이 많았다. 결론적으로 당뇨성 합병증 검사 수검율을 높이기 위해서는 당뇨병 환자를 대상으로 당뇨성 합병증 검사의 종류와 검사 시기가 포함된 당뇨병 관리 교육체계와 당화혈색소 및 혈당수치를 인지시킬 수 있는 다양한 홍보 방법 등이 개발되어야 할 것으로 생각된다. 그리고 당뇨병 관리를 위한 가이드라인 개발하고, 국가차원에서 국가검진제도에 당뇨성 합병증 검사 선별검사항목을 포함하는 등 시스템이 필요할 것으로 보인다.

• 대한예방한의학회지
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• 제8권1호
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• pp.89-107
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• 2004

This study was conducted to analyze community residents' behavior of Oriental medicine utilization and its related factors in order to provide basic data for formulation of policies on Oriental medicine. The subjects of this study was 500 residents who lived in big or medium sized cities and towns or villages Data were collected from March, 2002 to June, 2002. The results of this study can be summarized as follows. 1) According to socio-demographic characteristics of the respondents, female was 50.3%; 'over 50 years old' 29.9%, 'over college graduate' 39.7%, 'housewife' 23.0%, 'having spouse' 62.1%, 'Buddhist' 50.8%, 'living in big cities' 59.0%, 'middle economic class' 88.1%. 2) The highest proportion of frequency of Oriental medicine utilization was over 10 times(32.5%). The respondents visited Oriental medicine institutions for taking invigorant(51.1%), treatment of diseases in muscle or bone system(30.8%), treatment of diseases in digestive system(6.3%), etc. 3) According to the reasons of utilizing Oriental medicine, the proportion of good effect was highest(36.3%). 66.8% of the respondents replied that Oriental medical fee was expensive, while 0.8% of them replied that it was not expensive. 33.3% of them thought it was proper. 4) 35.5% of the respondents replied that treatment by Oriental medicine could cause side effect and 40.3% of them replied that the side effect could be caused by taking herb medicine. 5) 62.8% of the respondents replied that they would continuously receive opinions on Oriental medicine. The score of knowledge level of treatment by Oriental medicine $6.25{\pm}2.82$ points on the basis of 14 points. 6) The variables significantly influencing utilization of Oriental medicine includes taking diseases, living in big cities, male, upper (economic class, having religion, and effect of Oriental medicine. 7) The factors affecting effect of herb medicine were effect of treatment by Oriental medicine, marital status, knowledge level of Oriental medicine, having diseases, and frequency of receiving the treatment.

• 융합신호처리학회논문지
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• 제20권1호
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• pp.16-23
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• 2019

PM 2.5로 불리는 초미세먼지는 인간의 건강을 해치는 2.5 ㎛ 이하 직경의 입자크기를 갖는 공기 중의 미세먼지를 말하며, 미세먼지 집중도는 공기 질 정보로 사용할 수 있다. 사람은 일반적으로 90% 이상을 실내에서 거주하며 실내에 대한 공식적인 먼지 집중도 자료는 제공되지 않기 때문에, 본 연구는 실내의 관점에서 공기 질 측정에 초점을 두었다. 실내 먼지데이터 모니터링은 병원과 같은 환경에서 매우 중요할 뿐만 아니라 교실, 시멘트 공장, 컴퓨터 서버 룸, 석유화학 저장고 등의 장소에서도 유용하게 사용할 수 있다. 본 논문에서는 전자기파로부터 자유로운 실내 먼지 모니터링을 위해 맨체스터 코딩기법을 이용한 가시광 통신 시스템을 제안한다. 넓은 범위의 먼지 집중도를 포함한 중요한 실내 환경정보가 가시광 채널을 통해 전송된다. 강력한 주변광 및 저주파 잡음 제거를 위해 평균전압트레킹 기법을 사용한다. 입력광은 광다이오드에 의해 수신되고, 동시에 수신 마이크로콘트롤러에 의해 신호처리 한다. 사용자는 실시간으로 실내 공기 질 정보를 모니터링 할 수 있으며, 공기 질 정보에 따라 미리 적합한 대처를 할 수 있다.

• Journal of Ginseng Research
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• 제43권2호
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• pp.305-311
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• 2019

Background: Gintonin is a ginseng-derived exogenous ligand of the G protein-coupled lysophosphatidic acid (LPA) receptor. We previously reported that gintonin stimulates gliotransmitter release in primary cortical astrocytes. Astrocytes play key roles in the functions of neurovascular systems. Although vascular endothelial growth factor (VEGF) is known to influence the normal growth and maintenance of cranial blood vessels and the nervous system, there is little information about the effect of gintonin on VEGF regulation in primary astrocytes, under normal and hypoxic conditions. Methods: Using primary cortical astrocytes of mice, the effects of gintonin on the release, expression, and distribution of VEGF were examined. We further investigated whether the gintonin-mediated VEGF release protects astrocytes from hypoxia. Results: Gintonin administration stimulated the release and expression of VEGF from astrocytes in a concentration- and time-dependent manner. The gintonin-mediated increase in the release of VEGF was inhibited by the LPA1/3 receptor antagonist, Ki16425; phospholipase C inhibitor, U73122; inositol 1,4,5- triphosphate receptor antagonist, 2-APB; and intracellular $Ca^{2+}$ chelator, BAPTA. Hypoxia further stimulated astrocytic VEGF release. Gintonin treatment stimulated additional VEGF release and restored cell viability that had decreased due to hypoxia, via the VEGF receptor pathway. Altogether, the regulation of VEGF release and expression and astrocytic protection mediated by gintonin under hypoxia are achieved via the LPA receptor-VEGF signaling pathways. Conclusion: The present study shows that the gintonin-mediated regulation of VEGF in cortical astrocytes might be neuroprotective against hypoxic insults and could explain the molecular basis of the beneficial effects of ginseng on the central nervous system.

• 한국식품과학회지
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• 제53권3호
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• pp.304-312
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• 2021

참당귀로부터 열수추출 및 에탄올 침전법을 이용해 조다당을 분리하고 DEAE-Sepharose FF와 Sephadex G-100을 이용하여 얻은 정제 다당 AGE-2c-I을 대상으로 선천 면역 활성 및 항종양 전이 효과를 확인하고자 하였다. 인체의 초기 면역 반응에 있어 중추적인 역할을 수행하는 보체계 활성화 및 활성화 경로를 확인한 결과, AGE-2c-I은 운지버섯 유래 시판 면역증강제인 PSK에 준하는 우수한 활성을 나타내는 것으로 확인되었으며. 본 활성은 주로 고전경로를 통하여 활성화되며 일부 부경로를 경유하는 것으로 최종 확인되었다. 또한 AGE-2c-I은 mouse 복강 유래 대식세포에 대해 직접적인 독성을 나타내지 않으며 종양세포주 YAC-1 및 B16BL6에 대한 직접적인 독성 또한 나타나지 않음을 확인함으로써 시료의 직접적인 독성에 근거한 항암 효과는 없는 것으로 확인되었다. 반면에 비장으로부터 분리한 림프구는 8 ㎍/mL의 AGE-2c-I 처리에 의해 증식능이 관찰되었다. AGE-2c-I이 대식세포의 cytokine 분비능에 미치는 효과를 확인한 결과, 우수한 IL-6, IL-12 및 TNF-α 분비능을 보였으며 시료를 200 ㎍ 및 1,000 ㎍의 고농도로 처리한 실험군에서 IL-10이 분비된 것으로 보아 AGE-2c-I은 immune-stimulator의 역할뿐만 아니라 immune-suppressor로서의 작용 또한 가능한 것으로 확인되었다. 한편 종양 및 암세포에 대하여 직접적인 살해 활성을 나타내는 NK cell 활성을 확인한 실험에서는 농도 의존적인 종양 세포 살해능을 확인할 수 있었으며 100 ㎍/mouse 농도에서 NC 대비 약 1.5배 높은 NK cell 활성을 나타냈을 뿐만 아니라, 폐에 대한 고전이성 종양세포주인 B16BL6 melanoma 세포를 이용한 실험동물 종양 전이 모델에선 100 ㎍/mouse 농도로 처리한 실험군이 NC 대비 58%의 colony가 감소한 것을 확인할 수 있었다. 이상의 결과로 부터 참당귀 유래 RG-I 구조의 다당은 높은 선천면역계 자극 활성, 특히 보체계, 대식세포, 림프구 증식, NK cell의 활성화를 통해 우수한 항종양 전이 효과를 갖는 것으로 최종 확인되었으며 건강기능성식품 소재로의 개발가치가 우수한 것으로 판단되었다.

• 한국노년학
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• 제37권2호
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• pp.281-291
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• 2017

본 연구의 목적은 한국의 65세 이상 노인의 의료요구 미충족 경험률을 알아보고, 고용형태와 의료요구 미충족 경험률 및 경제적 이유로 인한 의료요구 미충족 경험률의 관련성을 분석하는 것이다. 연구방법은 2013년 한국의료패널자료를 이용하여 65세 이상인구 5,528명을 대상으로 고용형태에 따른 의료요구 미충족 경험률과 경제적 이유로 인한 의료요구 미충족 경험률의 관련성을 알아보기 위해 로지스틱 회귀분석을 실시하였다. 연구결과, 65세 이상 노인의 의료요구 미충족 경험률은 18.9%로 유렵연합국 노인인구집단보다 의료요구 미충족 경험률이 2-3배 높았다. 그리고, 의료요구 미충족을 경험한 노인 중 의료요구 미충족을 경험한 이유가 경제적 이유라고 응답한 노인은 42.8%였으므로 경제적 이유로 인한 의료요구 미충족 경험률은 8.1%이다. 임시직으로 경제활동을 하는 노인은 은퇴로 경제활동을 하지 않는 노인보다 의료요구 미충족 경험률이 높았고(ORs=1.75), 일용직으로 경제활동을 하는 노인은 경제적 이유로 인한 의료요구 미충족 경험률이 높았다(ORs=1.92). 경제활동 상태에 따른 의료요구 미충족 경험률의 차이는 '질병과 손상'을 가진 노인을 제외하고는 종사상의 지위에 따른 차이가 크지 않았다. 의료요구 미충족 경험 이유가 높은 의료비 부담이라고 응답한 경우에도 경제활동 상태에 따른 의료요구 미충족 경험률의 차이는 '질병과 손상'을 가진 노인을 제외하고는 종사상 지위에 따른 차이가 크지 않았다. 다만, 경제활동자 중에서는 '일용직' 노인의 경제적 이유로 의료요구 미충족 경험률이 가장 높았다. 또한, 소득이 적을수록 의료요구 미충족을 경험할 가능성이 높았다. 결론적으로 한국 노인의 의료요구 미충족을 해결하기 위해서는 노후소득보장제도의 개선뿐만 아니라 평균수명 증가에 따른 경제활동에 참여하는 노인의 일자리 형태 및 임금수준에 대한 개선방안이 필요할 것으로 보이며, 더불어 의료비를 해결할 수 있는 건강보험의 보장성이 강화되어야 할 것으로 보인다.

• 대한치과보철학회지
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• 제36권1호
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• pp.64-80
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• 1998

The risk of cross-contamination in dental clinic is very high. Those who are engaged in dental clinic are exposed to various microorganisms in saliva and blood of patient. Potential possibility of cross-contamination of patient to patient, patient to dentist, dentist to laboratory technician always exist, which is important in the view of public health. It is well known that microorganisms may cause cross-contamination by suck-back of microorganisms into the water supply line or air supply line of dental unit and sprayed back into the next patient's oral cavity. The majority of microorganisms coming from dental unit are water microorganisms from the main water supply which have colonized the tube within the units and multiplied in the relatively warm and stagnant conditions. The purpose of this study is to measure the extent of microbial contamination of dental unit and ultrasonic scaler, to evaluate that dental unit water supply is suitable for drinking water, and to assess the effect of flushing on reduction of microbial contamination of dental unit and ultrasonic scaler. In the first experiment, water samples(50ml) from 20 dental units and 10 ultrasonic scalers in Seoul National Univ. Hosp. were tested for the presence of coliform. The samples were filtered by membrane filtration technique.(Microfil system, Millipore Co. U. S. A.) The filter was then placed onto MacConkey agar plate and the plates with filter on it were incubated aerobically at $37^{\circ}C$ for 5 days. The colors and shapes of colonies were examined if those were coliform. To verify the presence of coliform, the colonies were inoculated into phenol red lactose broth and incubated aerobically at $37^{\circ}C$ for 2 days. The fomation of gas was observed. In the second experiment, water samples from 20 handpieces, 10 ultrasonic scalers and 30 A/W syringes after 0, 2, 4, 6 min. flushing respectively were taken. $200{\mu}l$ water samples were spreaded on Brain Heart Infusion agar plate and the plates were incubated aerobically at $37^{\circ}C$ for 5 days. The number of colony was counted. The results obtained were summarized as follows 1. The water from dental unit and ultrasonic scaler was not suitable for drinking water. 2. No coliform was founded in dental unit and ultrasonic scaler water supply. 3. The number of colony of dental unit and ultrasonic scaler was highest in the group of o min. flushing(p<0.05). 4. There was no statistically significant difference in the extent of microbial contamination among handpiece, ultrasonic scaler and A/W syringe (p>0.05). 5. The number of colony was lowest in the group of 4 min. flushing, but there was no statistically significant difference among 2, 4, 6 min. flushing groups.(p>0.05) 6. It is recommended to flush dental unit water line for 4 min. after use on each patient.