• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권1호
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• pp.85-92
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• 2000

Common dental procedures(dental extraction & minor operation) are potentially stress-inducing in many patients, especially medically compromised patients. The body's response to dental stress involves the cardiovascular system(an increase in cardiovascular workload), the respiratory organ and the endocrine system(change in metabolism). To minimize the stress to the medical risk patient, the stress reduction protocol was established. The obtained contents were as follows: (1) Recognize the patient's degree of medical risk (2) Complete medical consultation before dental therapy (3) Schedule the patient's appointment in the morning (4) Monitor and record preoperative and postoperative vital signs (5) Use psychosedation during therapy (6) Use adequate pain control during therapy (7) Short length of appointment : do not exceed the patient's limits of tolerance (8) Follow up with postoperative pain/anxiety control (9) Telephone the higher medical risk patient later on the same day that treatment was given Though the stress reduction protocol above was applied to the dental extraction in medically compromised patients with the advanced infected teeth, the final responsibility for the complications(syncope, bleeding & infection, etc.) in a patient rests with the dentist who ultimately treats him. For the prevention of postextraction complications & poor prognosis, the authors treated the advanced infected teeth with the pulp extirpation, opening drainage through the canal and complete occlusal reduction. The final extraction and wound closure were then done after $1{\sim}2$ weeks. The final prognosis was comfortable without common complications.

• Asian Pacific Journal of Cancer Prevention
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• 제16권7호
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• pp.2707-2712
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• 2015

Background: The human homologue of the mouse double minute 2 (MDM2) gene is a negative regulator of Tp53. MDM2-309T>G a functional promoter polymorphism was found to be associated with overexpression thereby attenuation of Tp53 stress response and increased cancer susceptibility. We have planned to evaluate the possible role of MDM2-309T>G polymorphism with risk and response to chemotherapy in AML. Materials and Methods: A total of 223 de novo AML cases and 304 age and sex matched healthy controls were genotyped for the MDM2-309T>G polymorphism through the tetra-primer amplification refractory mutation system (ARMS)-PCR method. In order to assess the functional relationship of -309T>G SNP with MDM2 expression level, we quantified MDM2 mRNA in 30 primary AML blood samples through quantitative RT-PCR. Both the (-309T>G) genotypes and the MDM2 expression were correlated with disease free survival (DFS) rates among patients who have achieved complete remission (CR) after first induction chemotherapy. Results: MDM2-309T>G polymorphism was significantly associated with AML development (p<0.0001). The presence of either GG genotype or G allele at MDM2-309 confered 1.79 (95% CI: 1.12-2.86; p<0.001) and 1.46 fold (95%CI: 1.14-1.86; p= 0.003) increased AML risk. Survival analysis revealed that CR+ve cases with GG genotype had significantly increased DFS rates (16months, p=0.05) compared to CR+ve TT (11 months) and TG (9 months) genotype groups. Further, MDM2 expression was also found to be significantly elevated in GG genotype patients (p=0.0039) and among CR+ve cases (p=0.0036). Conclusions: The MDM2-309T>G polymorphism might be involved in AML development and also serve as a good prognostic indicator.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.515-521
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• 2013

Purpose: To evaluate the efficacy and toxicity of induction chemotherapy followed by concurrent chemoradiotherapy (the treatment group) versus concurrent chemoradiotherapy with or without adjuvant chemotherapy (the control group) for locoregionally advanced nasopharyngeal carcinoma. Methods: The search strategy included Pubmed, Embase, the Cochrane Library, China National Knowledge Internet Web, Chinese Biomedical Database and Wanfang Database. We also searched reference lists of articles and the volumes of abstracts of scientific meetings. All randomized controlled trials were included for a meta-analysis performed with RevMan 5.1.0. The Grading of Recommendations Assessment, Development, and Evaluation system (GRADE) was used to rate the level of evidence. Results: Eleven studies were included. Risk ratios of 0.99 (95%CI 0.72-1.36), 0.37 (95%CI 0.20-0.69), 1.08 (95%CI 0.84-1.38), 0.98 (95%CI 0.75-1.27) were observed for 3 years overall survival, 3 years progression-free survival, 2 years loco-regional failure-free survival and 2 years distant metastasis failure-free survival. There were no treatment-related deaths in either group in the 11 studies. Risk ratios of 1.90 (95%CI 1.24-2.92), 2.67 (95%CI 0.64-11.1), 1.04 (95%CI 0.79-1.37), 0.98 (95%CI 0.27-3.52) were found for grade 3-4 leukopenia, grade 3-4 thrombocytopenia, grade 3-4 mucous membrane, and grade 3-4 hepatic hematologic and gastrointestinal toxicity, the most significant toxicities for patients. Conclusion: Compared with the control group, induction chemotherapy followed by concurrent chemoradiotherapy was well tolerated but could not significantly improve prognosis in terms of overall survival, loco-regional failure-free survival or distant metastasis failure-free survival.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.33-37
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• 2016

Skin cancer is one of the most common cancers worldwide, including in Iran. Variations in its incidence rate among geographical areas are due to various contributing factors. Since there has been a lack of studies on this topic in our country, the present spatial analysis of skin cancer incidence in Iran in 2009 was conducted using data from the cancer registry system for the country. The reported incidences of the disease were standardized on the basis of the World Health Organization population and the direct method. Then the data were inserted into the GIS software, and finally, using the analysis of hot spots (Getis-Ord Gi), high-risk areas were drawn. Provinces that were 1.9 SD higher or lower than the national average were considered hot spots or cold spots, with significance at the level of 0.05. In 2009, a total of 9,964 cases of skin cancer occurred, 3,696 in women and 6,268 in men (standardized incidence rates of 15.8 and 22.6, respectively). The results of the study showed that in men and women, the disease demonstrated high incidence in the central provinces and desert regions. In women, Yazd Province and in men, Qom Province had significant hot spots (p <0.05). While Isfahan, Markazi, Tehran and Kurdistan provinces were expected to be hot spots, the differences from the national average were not significant at the 0.05 level. As well, the provinces of Sistan Va Baluchistan, Kerman, and Hormozgan were identified as cold or low-risk disease regions (p <0.05). The central provinces of the country due to hot weather conditions, more solar radiation, and closer vicinity to the central desert of Iran demonstrated higher incidence rates for skin cancer, so further epidemiological studies into the etiology and early detection are essential in these areas.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3515-3519
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• 2016

Background: In Thailand, a national treatment protocol for childhood leukemia and lymphoma (LL) was implemented in 2006. Access to treatment has also improved with the National Health Security system. Since these innovations, survival of childhood LL has not been fully described. Materials and Methods: Trends and survival of children under 15 with childhood cancers diagnosed between 1993 and 2012 were investigated using the hospital-based data from the Khon Kaen Cancer Registry, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand. Childhood cancers were classified into 12 diagnostic groups, according to the ICCC based on the histology of the cancer. Survival rates were described by period, depending on the treatment protocol. For leukemias and lymphomas, survival was assessed for 3 periods (1993-99, 2000-5, 2006-12) while for solid tumors it was for 2 periods (before and after 2000). The impacts of sex, age, use of the national protocol, and catchment area on leukemia and lymphoma were evaluated. Overall survival was calculated using the Kaplan-Meier method while the Cox proportional hazard model was used for multivariate analysis. Trends were calculated using the R program. Results: A total of 2,343 childhood cancer cases were included. Survival for acute lymphoblastic leukemia (ALL) from 1993-9, 2000-5, and 2006-12 improved significantly (43.7%, 64.6%, and 69.9%). This was to a lesser extent true for acute non-lymphoblastic leukemia (ANLL) (28.1%, 42.0%, and 42.2%). Survival of non-Hodgkin lymphoma (NHL) also improved significantly (44%, 65.5%, and 86.8%) but not for Hodgkin disease (HD) (30.1%, 66.1%, and 70.6%). According to multivariate analysis, significant risk factors associated with poor survival in the ALL group were age under 1 and over 10 years, while not using the national protocol had hazard ratios (HR) of 1.6, 1.3, and 2.3 respectively. In NHL, only non-use of national protocols was a risk factor (HR 3.9). In ANLL and HD, none of the factors influenced survival. Survival of solid tumors (liver tumors, retinoblastomas) were significantly increased compared to after and before 2000 while survival for CNS tumors, neuroblastoma and bone tumors was not changed. Conclusions: The survival of childhood cancer in Thailand has markedly improved. Since implementation of national protocols, this is particularly the case for ALL and NHL. These results may be generalizable for the whole country.

• 한국재난정보학회 논문집
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• 제19권3호
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• pp.656-664
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• 2023

연구목적: 고용노동부에서는 사업장 내 화재·붕괴 등의 대형재난이 발생하면 사업장 대규모 인적사고 위기관리 표준매뉴얼에 근거하여 재난을 관리하고 있다. 현재 운용중인 표준매뉴얼을 점검하고 미흡한 항목에 대해 개선방안을 제시하고자 한다. 연구방법:이에 따라, 재난관리 매뉴얼 내·외부 전문가, 본부·지방관서의 재난업무 담당자 등과 함께 표준매뉴얼을 점검하였고 우선적으로 개선해야 할 항목을 도출하였다. 연구결과: 붕괴사고의 경우에는 재난관리 주관부처 선정의 논란을 제거하기 위해 행정안전부에서 선정기준을 정확히 제시할 필요가 있으며, 인파밀집사고의 경우에는 표준매뉴얼 보다는 행동·실무 매뉴얼에 구체적으로 반영하여 유사시 근로자 대피 안전성을 확보해야 할 것이다. 이 외에도 재난안전 통신망 운영 및 대피요령에 대해 상세한 내용의 추가 보완이 필요해 보인다. 결론: 향후에도 국민의 눈높이에 부응하는 재난관리 제도 개선을 위해서 해당 분야별 전문가, 재난업무 담당자, 그리고 일반시민 등의 의견수렴을 통해 근로자의 생명과 안전을 보장하고 좀 더 현장감 있는 사업장 대규모 인적사고 위기 관리 표준매뉴얼 마련을 기대한다.

• Journal of Digestive Cancer Research
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• 제8권2호
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• pp.81-90
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• 2020

배경 및 목적: Helicobacter pylori (H. pylori) 제균 치료는 위암 발병률을 줄이는 것으로 알려져 있다. 그러나 만성 위축성 위염, 장상피화생 및 이형성증이 있는 일반 집단에서도 위암의 발생 위험을 예방할 수 있는지에 대해서는 여전히 논란의 여지가 있다. 우리는 포괄적인 메타분석을 통해 이에 대한 연구를 수행해 보고자 한다. 방법: 2019년 12월까지 H. pylori 제균 치료가 위암에 미치는 영향을 평가한 논문들을 PubMed, KoreaMed, EMBASE 및 Cochrane Library에서 검색하였다. 전암성 병변(만성 위축성 위염/장상피화생/이형성증), 지역(아시아/비아시아) 및 추적관찰기간에 따라 하위 집단 분석을 수행하였다. 모든 데이터는 Review Manager 5.3으로 분석하였다. 결과: 본 연구에서는 총 6편의 전향적 무작위 연구가 최종 분석에 포함되었다. 전체 집단에서 H. pylori 제균 치료는 위암 발생 위험을 유의하게 감소시켰다(위험비[RR]=0.56; 95% 신뢰구간[CI]: 0.41-0.77, p<0.01). 또한, 하위 집단 분석을 보면, H. pylori 제균 치료는 아시아 지역과 10년 이상의 추적관찰을 시행한 집단에서 위암 발생 위험을 현저하게 감소시키는 것을 보여주었다(RR=0.54, 95% CI: 0.39-0.75, p<0.01 및 RR=0.51; 95% CI: 0.35-0.73, p<0.01). 그러나, 전암성 병변 유무에 따른 하위 집단 분석에서는 유의한 결과가 도출되지 않았다(전암성 병변이 있는 군, RR=0.86, 95% CI: 0.47-1.59, p=0.63; 전암성 병변이 없는 군, RR=0.42, 95% CI: 0.02-7.69, p=0.56). 결론: H. pylori 제균 치료는 일반 집단, 특히 아시아 지역에서 위암 발생 위험을 낮춘다. 제균 치료의 위암 예방 효과는 10년 이상 장기간 추적관찰 하였을 때 유의하다. 한편, 전암성 병변이 있는 일반 집단에서 위암 예방을 위해 H. pylori 제균 치료를 시행하는 것은 아직 근거가 명확하지 않아 권고하기 어렵다. 따라서 앞으로 이에 대한 더 많은 연구가 필요하다.

• 시큐리티연구
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• 제1호
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• pp.371-408
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• 1997

This article is the reserch on actual condition of crime of arson which occurs in Korea and its countermeasures. The the presented problem in this article are that (1) we have generally very low rate concern about the crime of arson contrary to realistic problems of rapid increase of crime of arson (2) as such criminal motives became so diverse as to the economic or criminal purpose unlike characteristic and mental deficiency of old days, and to countermeasure these problems effectively it presentation the necessity of systemantic research. Based on analysis of reality of arson, the tendency of this arson in Korea in the ratio of increase is said to be higher than those in violence crime or general fire rate. and further its rate is far more greater than those of the U.S.A. and Japan. Arson is considered to be a method of using fire as crime and in case of presently residence to be the abject, it is a public offense crime which aqccompany fatality in human life. This is the well It now fact to all of us. And further in order to presentation to the crime of arson, strictness of criminal law (criminal law No, 164 and 169, and fire protection law No. 110 and 111) and classification of arsonist as felony are institutionary reinforced to punish with certainty of possibility, Therefore, as tendency of arson has been increased compared to other nations, it is necessary to supplement strategical policy to bring out overall concerns of the seriousness of risk and damage of arson, which have been resulted from the lack of understanding. In characteristics analysis of crime of arson, (1) It is now reveald that, in the past such crime rate appeared far more within the boundary of town or city areas in the past, presently increased rate of arsons in rural areas are far more than in the town or small city areas, thereby showing characteristics of crime of arson extending nation wide. (2) general timetable of arson shows that night more than day time rate, and reveald that is trait behavior in secrecy.(3) arsonists are usually arrested at site or by victim or report of third person(82,9%).Investigation activities or self surrenders rate only 11.2%. The time span of arrest is normally the same day of arson and at times it takes more than one year to arrest. This reveals its necessity to prepare for long period of time for arrest, (4) age rate of arson is in their thirties mostly as compared to homicide, robbery and adultery, and considerable numbers of arsons are in old age of over fifties. It reveals age rate is increased (5) Over half of the arsonists are below the junior high school (6) the rate of convicts by thier records is based on first offenders primarily and secondly more than 4 time convicts. This apparently shows necessity of effective correctional education policy for their social assimilation together with re-investigation of human education at the primary and secondary education system in thier life. The examples of motivation for arosnits, such as personal animosity, fury, monetary swindle, luscious purpose and other aims of destroying of proof, and other social resistance, violence including ways of threatening, beside the motives of individual defects, are diverse and arsonic suicide and specifically suicidal accompany together keenly manifested. When we take this fact with the criminal theory, it really reveals arsons of crime are increasing and its casualities are serious and a point as a way of suicide is the anomie theory of Durkheim and comensurate with the theory of that of Merton, Specifically in the arson of industrial complex, it is revealed that one with revolutionary motive or revolting motive would do the arsonic act. For the policy of prevention of arsons, professional research work in organizational cooperation for preventive activities is conducted in municipal or city wise functions in the name of Parson Taskforces and beside a variety of research institutes in federal government have been operating effectively to countermeasure in many fields of research. Franch and Sweden beside the U.S. set up a overall operation of fire prevention research funtions and have obtained very successful result. Japan also put their research likewise for countermeasure. In this research as a way of preventive fire policy, first, it is necessary to accomodate the legal preventitive activities for fire prevention in judicial side and as an administrative side, (1) precise statistic management of crime of arson (2) establishment of professional research functions or a corporate (3) improvement of system for cooperative structural team for investigation of fires and menpower organization of professional members. Secondly, social mentality in individual prospect, recognition of fires by arson and youth education of such effect, educational program for development and practical promotion. Thirdly, in view of environmental side, the ways of actual performance by programming with the establishment of cooperative advancement in local social function elements with administrative office, habitants, school facilities and newspapers measures (2) establishment of personal protection where weak menpowers are displayed in special fire prevention measures. These measures are presented for prevention of crime of arson. The control of crime and prevention shall be prepared as a means of self defence by the principle of self responsibility Specifically arsonists usually aims at the comparatively weak control of fire prevention is prevalent and it is therefore necessary to prepare individual facilities with their spontaneous management of fire prevention instead of public municipal funtures of local geverment. As Clifford L. Karchmer asserted instead of concerns about who would commit arson, what portion of area would be the target of the arson. It is effective to minister spontaveously the fire prevention measure in his facility with the consideration of characteristics of arson. On the other hand, it is necessary for the concerned personnel of local goverment and groups to distribute to the local society in timely manner for new information about the fire prevention, thus contribute to effective result of fire prevention result. In consideration of these factors, it is inevitable to never let coincide with the phemonemon of arsons in similar or mimic features as recognized that these could prevail just an epedemic as a strong imitational attitude. In processing of policy to encounter these problems, it is necessary to place priority of city policy to enhancement of overall concerns toward the definitive essense of crime of arson.

• 한국직업건강간호학회지
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• 제12권1호
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• pp.31-38
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• 2003

This study is an attempt to analyze the physical load by the type of the nursing tasks at the neurosurgical ICU nurses through the quantitative analysis of the working postures by the type of the nursing tasks with the OWAS(Ovako Working Postures Analysis System). Data collection was conducted through the video recording of the 13 nurses working at the neurosurgical ICU. For the analysis of the work postures by the type of the nursing tasks, and were interviewed regarding the subjective degree of the difficulties with the work postures related to the tasks. Collected data was analyzed through the WinOWAS program. The results were as follows : AC3 or AC4 tasks among the 18 nursing tasks types are "occupied bed making and change of the patient gown", "back massage", "suction", "elimination management", "change of position", "adjustment of bed", "helping the patient to move","measurement of CVP"and "measurement of urine volume". It appears that these tasks are harmful to the musculoskeletal system and the improvement or change of the work is required. The results stated above indicate that improper working postures during the nursing tasks influence the musculoskeletal system. Therefore, making use of assistant devices for the improvement of the working environment at the nursing tasks, based on human technological diagnoses, is required regarding the duty types with massive work pressure known to be harmful to the musculoskeletal system among those performed by the nurses. And there is a need of the education about the employment and maintenance of the vocational back pain prevention.

• 한국산업보건학회지
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• 제21권3호
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• pp.128-138
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• 2011

Objectives: It has been pointed out that there are problems in handling and managing chemicals due to trade secrets of Material Safety Data Sheet(MSDS). To date, some company intentionally leave out of several parts and use an inaccurate expression in MSDS. In particular, with the result of the inspection of the government and labour community, it is required that the 2nd section in MSDS included the composition and information on ingredients has to be provided with comprehensive expression to secure more reliability. Methods: Therefore, this study is aimed: 1) to recognize the current status of trade secrets of MSDS in workplaces with both domestic manufacturers of chemical products and multinational corporations; 2) to make contributions to prevention of the industrial accidents by providing the accurate information of MSDS; 3) to improve the risk communication system related with chemicals; 4) to impress workers on the importance of right of known for MSDS. With the result we analyzed the status of trade secrets in MSDS in 73 companies, such as petrochemistry production, paint production, metal processing oil production, detergent production, and international company related with chemicals, we have found that 38,150 (45.5%) have the trade secrets parts in the total number of 83,832 in MSDS. Also, based on the 288 MSDS gathered by the Occupational Safety and Health Research Institute (OSHRI) from 2005 to 2009, 41.7% of the MSDS are classified into the trade secrets. Conclusions: Therefore, to procure an assurance system of MSDS, we suggest that a MSDS picking up and checking system be legislated in the Occupational Safety and Health Act to protect workers from the unidentified chemical hazards due to the secret trade of MSDS.