• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.2
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• pp.133-138
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• 1998

Choanal atresia may be membrane or bony, unilateral or bilateral. Approximately 90% of the choanal atresia are bony type. Unilateral choanal atresia often eludes the diagnosis because of the absence of subjective symptoms in the neonatal period. However, bilateral choanal atresia presents at birth with cyclic respiratory distress aggravated by feedings. So complete bilateral choanal atresia is considered as a neonatal emergency. Examinations for the diagnosis of chonal atresia include 1) attempt at passing a rubber catheter or probe through the patient s nose, 2) mirror examination of the nasopharynx, 3) digital examination of the nasopharynx, 4) X-ray examination after installation of radiopaque materal into the nasal cavity. But, computed tomography has become accepted method for evaluation of choanal atresia. Surgical repair of choanal atresia is accomplished via transnasal or transpalatal approach. Advantages of the transpalatal approach are improved exposure and the preservation of mucosal flap along the newly formed apertures. On the other hand, the transpalatal approach carries the risk of injury to the greater palatine neurovascular complex, and requires longer operative time. After careful physical and radiographic examinations, we accomplished the surgical repair of the complete bony bilateral choanal atresia via transpalatal approach without complications.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.2
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• pp.209-216
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• 2009

The purpose of this retrospective study was to examine twenty four hour postsedation events after discharge in children sedated for dental treatment. The sedation sheets of 355 children were selected. Selection criteria excluded no midazolam or nasal route of midazolam, no ASA class I, absent or incomplete questionnaire. Children received orally chloral hydrate and hydroxyzine, nitrous oxide was maintained during the sedation. Midazolam was injected to buccal submucosa with titration. Parents were interviewed via telephone within twenty four hours after sedation. Questionnaire included sleeping response, sleeping time, sleeping behavior, vomiting response at home. Two hundred twenty four (67.8%) children slept and twenty one(6.3%) children had abnormal sleeping behavior. One hundred four(31.0%) children had abnormal behavior after sleep and ten(3.0%) children had vomiting response. In the children took the higher dose of midazolam, there were the great tendency to sleep after discharge (p<0.05), the more negative response to sleeping behavior(p = 0.055), the longer sleeping time(p=0.054). In this study many children slept after sedation and a few children showed negative response. However there were not any considerable emergency events. Further study is required to determine the postsedation safety for the use of submucosal midazolam combination with chloral hydrate and hydroxyzine.

• The Korean Society of Law and Medicine
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• v.9 no.1
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• pp.319-382
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• 2008

As a withdrawing care's study, the purpose of this study is searching about withdrawing care's acceptance and circumstances through Bora-mae hospital case(chapter 1). Withdrawing life-sustaining treatment has various forms. Though the meaning of euthanasia, death with dignity, natural death, physician assisted suicide are duplicated, the meaning of those are different slightly. Firstly, this study looks about the difference of the those meaning and acceptance range(condition) by withdrawing care's forms(chapter 2). Bora-mae hospital case sentenced guilty about physician who discharged incompetent patient who was after surgery by patient's wife determination. This Bora-mae case that sentenced guilty about discharge against medical advise(DAMA) that is regarded to custom has brought intensive confliction of legal, social, medical aspect, Bora-mae hospital case has many legal problems. First, as to criminal law rule 250(murder), the problem is whether discharge and withdrawing life-sustaining treatment is commission or omission. this study concluded omission(district court: omission, appeal, supreme court: commission). Because legal denounce point of discharge and medical treatment withdrawing is omission that physician who is obligatory on patient to cure. If physician's act is regarded omission, it is necessary to determine whether he has guardian status and obligation. Without guardian status and obligation, omission crime can't exist. This study decided that physician had guardian status and obligation and foundation of guardian status was pre-action or acceptance of emergency patient. Physician's medical treatment duty finished when patient(or patient's guardian) demands discharge. But when patient death is foreseen and other possible treatment does not exist, his duty of life prolonging treatment does not finish. This originate from physician's social responsibility and public status that limits patient's private liberty. This study regarded physician's action as accomplice about whether physician's discharging action is accomplice or the principal offender(district court: the principal offender, appeal, supreme court: accomplice). Though the principal offender needs criminal determination and action, there is no this common determination and functional action control of physician in Bora-mae case(chapter 3). Bora-mae hospital case partly originated from deficiency of legal, institutive system including medical security system shortage, the instruction is 1. medical security system strengthening, 2. hospital ethical committee's activity strengthening, 3. institutionalization of withdrawing life-sustaining treatment, 4. acceptance of pre-decision making system, 5. sufficient persuasion of physician for patient and faithful writing of medical paper, 6. respect for patients' self-determination and rights, 7. consciousness's changing for withdrawing life-sustaining treatment and persistent education about medical ethics(chapter 4). Considering Bora-mae case, medical sector is not the dead ground of a criminal punishment. Intervention of criminal law in medical sector give rise to ill effect, that is, excess medical examination and treatment, safeguard treatment, delay of discharge from a hospital. Because sufficient guarantee of life becomes mere empty slogan under situation that impose a burden of heavy cost to family or hospital, public and systematic solution should be given(chapter 5).

• Journal of Korean society of Dental Hygiene
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• v.10 no.2
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• pp.283-295
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• 2010

Objectives : It surveyed the recognition level of oral health in class teachers who have influence of students' oral health knowledges and behaviors in our country, developed a program available for supplementing reinforcement in school oral health education, and planned the knowledge contents necessary for school oral health education hereafter. Methods : To arrange the basic data necessary for school oral health program, it carried out questionnaire survey by personal self-administration targeting 460 teachers for 19 elementary schools where are located in Jinhae city from May 7, 2007 to June 13. The following conclusions were obtained. Results : 1. The path of acquiring oral health knowledge was shown the high frequency with 23.9% and 23.3%, respectively, through publicity brochure and dental clinic. As for the opinion about the aim of maintaining dental hygiene, the prevention of dental caries was the highest with 53.7%. 2. The opinion about which the regular visit to the dentist is very effective for preventing dental caries accounted for 56.7%. The opinions about which the limit to sugar intake and the use of dental floss are effective for preventing dental caries accounted for 52.2% and 46.3%, respectively. 3. The opinion about which the fluoridation beverage intake and the sealant are effective for preventing dental caries accounted for 33.9% and 33.0%, respectively. 4. The opinion about which the regular toothbrushing without toothpaste has a little effect and has no effect on preventing dental caries accounted for 42.6% and 38.5%, respectively. Conclusions : The elementary-school age period, which is the most core field out of the whole oral health, is the important period that is formed the basis of lifelong oral health care. It surveyed the recognition level of oral health in class teachers who are in charge of direct health care while making continuous life with students, and developed program available for supplementing reinforcement in school oral health education. Through this, there will be necessity for cultivating ability available for properly managing oral health for the whole life by allowing elementary-school students, who will be led to future adults' oral health, to be formed the attitudes toward the rationally oral health care.

• Quality Improvement in Health Care
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• v.20 no.1
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• pp.42-57
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• 2014

Objective: The objective of this research was to develop a guideline for more effective use of physical restraint on patients in the intensive care unit and training the nurses on it and applying it on clinical practice to assess its effectiveness. Method: This research analyzed the before and after effect of the development of a guideline for physical restraint by dividing the category into nurse and patient. In the case of nurse, a comparison of knowledge and nursing service regarding the use of physical restraint from before the training on physical restraint guideline(Jan. 2011) and after the training on physical restraint guideline(Dec. 2011) was made. In the case of patient, a comparison of physical restraint usage rate and average usage time, the number of unplanned extubation cases were compared from before the use of physical restraint (Jan.~Apr. 2011) and after the use of physical restraint (Sep.~Dec. 2011) were made. Result: After the training on the physical restraint guideline, the knowledge of the nurse and the nursing practice showed notable improvement by (p<0.000) and (p<0.048) respectively and in patient, physical restraint usage rate and average time of usage decreased by (p<0.001) and (p<0.001) respectively. And despite the decrease in the number of cases in which the physical restraint was used, the number of unplanned extubation cases remained the same. Conclusion: Physical restraint guideline training and guideline usage can be stated to have brought out positive effect in both the nurse and patient. In order to maintain such positive effects, continuous training is necessary and continuous revaluation is necessary, regarding knowledge and nursing practices.

• Journal of agricultural medicine and community health
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• v.43 no.2
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• pp.63-73
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• 2018

Objectives: The purpose of this study was to review the disaster preparation and response programs and the status of disaster preparation in public health center. Methods: In depth interview was performed in September 2017 using 5 open questions to the persons who are in charge of disaster response services in 5 public health centers of different levels in Korea. The questions included general characteristics of public health center, disaster programs and future issues. The research hired a quality method. Results: In general, the persons in charge recognized the cooperative agency of local government in disaster management. There were no disaster preparation programs developed by the public health centers. Most of the preparation were passive activities such as emergency support, crisis management on communicable disease and quarantine, participation in biological disaster response training, and education etc. The persons in charge emphasized necessity of disaster preparation programs. Conclusions: Disaster preparation and responsiveness is an evolving issue in public health centers in Korea. Medical support system and communicable disease management system are being set up in the national level. A comprehensive system covering health management, nutritional support, mental health, environment management of shelter, and volunteers supports on public health center level needs to be developed along with a easy-to-follow manual.

• Journal of the Institute of Electronics Engineers of Korea SC
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• v.44 no.5
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• pp.45-54
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• 2007

Time/frequency analysis has been extensively used in biomedical signal processing. By extracting some essential features from the electro-physiological signals, these methods are able to determine the clinical pathology mechanisms of some diseases. However, this method assumes that the signal should be stationary, which limits its application in non-stationary system. In this paper, we develop a new signal processing method using Hilbert-Huang Transform to perform analysis of the nonlinear and non-stationary ventricular fibrillation(VF). Hilbert-Huang Transform combines two major analytical theories: Empirical Mode Decomposition(EMD) and the Hilbert Transform. Hilbert-Huang Transform can be used to decompose natural data into independent Intrinsic Mode Functions using the theories of EMD. Furthermore, Hilbert-Huang Transform employs Hilbert Transform to determine instantaneous frequency and amplitude, and therefore can be used to accurately describe the local behavior of signals. This paper studied for Return Of Spontaneous Circulation(ROSC) and non-ROSC prediction performance by Support Vector Machine and three parameters(EMD-IF, EMD-FFT) extracted from ventricular fibrillation ECG waveform using Hilbert-Huang transform. On the average results of sensitivity and specificity were 87.35% and 76.88% respectively. Hilbert-Huang Transform shows that it enables us to predict the ROSC of VF more precisely.

• Journal of the Korean Chemical Society
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• v.61 no.2
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• pp.51-56
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• 2017

N-nitrosamines are the nitroso compounds which are produced by nitrosation reactions of the secondary amine and nitrite under acidic conditions. Approximately 300 species of N-nitrosamine have been tested for carcinogenicity in laboratory experiments, with 90% of them demonstrated carcinogenic effects different animal species, including higher primates. In 1978, IARC classified NDMA and NDEA as Group 2A, and NDPA, NDBA, NPIP, NPYR and NMOR as Group 2B. In this study, we established pretreatment and analytical method for N-nitrosamines (NDMA, NDEA, NMEA, NDPA, NDBA, NPIP, NPYR and NMOR) in human urine for biological monitoring of N-nitrosamines. The analytes were extracted using solid phase extraction (SPE), then quantitative analysis was performed by LC-(APCI)-MS/MS. The accuracies of the established method were between 85.8~108.7% and precisions were lower than 20%. The limit of detection (LOD) were between 0.0002 (NDBA) and 0.0793 (NDMA) ng/ml. The linearity obtained was satisfying for the 8 N-nitrosamines, with a coefficient of determination ($r^2$) higher than 0.999. The mean concentrations of N-nitrosamines in the urine were 2.645 mg/g creatinine for NDMA, 0.067 mg/g creatinine for NDEA, 0.009 mg/g creatinine for NMEA, 0.011 mg/g creatinine for NDBA, 0.271 mg/g creatinine for NPIP and 0.413 mg/g creatinine for NPYR. NDPA and NMOR were not detected. It can be used as a instrumental methodology for evaluation and risk assessment of human exposure to N-nitrosamines for the further research.

• The Korean Society of Law and Medicine
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• v.8 no.2
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• pp.205-290
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• 2007

In Korea, abortion in the Criminal Law is an illegal act in exception of limited cases stated in the Mother and the Child Health Law. There are grounds on which abortion may be carried out - though the grounds are very limited and related such as emergency situation of woman's physical health, rape, incest and genetic diseases. The Criminal Law regulates the mother's act of abortion and the doctor's surgical performance of abortion. The Mother and the Child Health Law prescribes the medical, ethical, and genetic grounds for the legal permission of abortion. Many people tend to abuse of abortion even though they are fully aware of its illegality. The law lead to be inconsistent with its enforcement. In this paper, I would like to suggest some proposals about the legal analysis of the Abortion Regulations to reform the existing regulations and increase the effectiveness of the regulations. A national survey was carried out using telephone interview with Korean citizens from August 1th to August 31th in 2005. A total of 1,025 citizens (male: female = 49.2%:50.8%) were randomly sampled in proportion to the number of population of 17 regions. The major findings of this survey were as follows. First, 91.4% of the respondents approved of abortion based on the medical grounds. Second 83.3% of the respondents perceived that abortion may be carried out based on ethical grounds for example rape. Third, 74.3% were agreed to abortion based on genetic diseases. Forth, 64.7% were approved the abortion that unmarried woman may be carried out. In contrast 45.0% were approved the abortion that girls may be carried out, whereas 46.4% were perceived that the abortion may not be permitted. Fifth, 58.3% were disagreed the permission of abortion based on social and economic grounds. According to the survey Korean citizens seem to have positive perception on the abortion that may be carried out based on medical, ethical and genetic grounds. Whereas they worried about the abortion based on social and economic grounds. Now the Mother and the Child Health Law prescribes the medical, ethical, and genetic grounds for the legal permission of abortion. But this law does not include social and economic grounds. In cases of when the mother has a impossibility to breed her child because of her social situations and financial conditions, we should accepted the legal acceptance of abortion due to social and economic grounds.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.2
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• pp.199-209
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• 2020

Purpose : This study used a sarcopenia diagnostic algorithm proposed by the Asia working group in adults over 50 to diagnose sarcopenia and analyze body function. The purpose of this study is to prepare basic data for the management and prevention of sarcopenia. Methods : We performed a diagnostic evaluation of sarcopenia in 97 adults over the age of 50 years with the cooperation of the Seongnam senior experience complex in Seongnam-si, Gyeonggi-do. As a result of the diagnostic process, 24 subjects were placed into the sarcopenia group, while 73 subjects were placed into the normal group. We measured each subject's body, performed the timed up and go test to evaluate functional mobility, and conducted a questionnaire on the pre-symptom of locomotive syndrome and locomotive syndrome. Results : There were statistically significant differences in height, weight, and skeletal muscle mass between the two groups. There was also a statistically significant difference in the timed up and go test, which confirmed the difference in functional mobility between the two groups. In addition, there was a statistically significant difference between the two groups in the proportion and the mean score of subjects with pre-symptom of locomotive syndrome and locomotive syndrome. In the correlation analysis, grip strength was statistically significantly correlated with height, weight, skeletal muscle mass, waist circumference, timed up and go test, pre-symptom of locomotive syndrome and locomotive syndrome. Gait speed was significantly correlated with the timed up and go test and locomotive syndrome. Appendicular skeletal muscle index was significantly correlated with height, weight, waist circumference, hip circumference, and the pre-symptom of locomotive syndrome. Conclusion : In conclusion, sarcopenia is closely related to height, weight, skeletal muscle mass and functional mobility, as well as the pre-symptom of locomotive syndrome and, locomotive syndrome. In consideration of this, the prevention and management of sarcopenia should be made accordingly.