• Journal of Korean Neurosurgical Society
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• v.29 no.12
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• pp.1555-1562
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• 2000

Objects : Surgical management of the distal anterior cerebral artery(DACA) aneurysms presents several unique problems to surgeons, such as difficulty in early identification of parent arteries, high incidence of rebleeding and premature rupture, and requirement of unfamiliar approach other than conventional frontotemporal craniotomy. Therefore, preoperative anatomical knowledge of anterior interhemispheric fissure and entry point of dissection is prerequisite. Authors utilized a frontobasal approach for DACA aneurysms by using consistent external landmark for guidance to the deep structure. Materials and Methods : From Nov. 1995 to Jun. 1999, a surgical clipping of DACA aneurysms was carried out in 9 patients among a total 131 patients with intracranial aneurysms. In each case, the clinical and aneurysmal features were carefully reviewed through the angiograms, medical records, and intraoperative findings. Results : The incidence of DACA aneurysms was 6.9% from our series. All cases were arisen from juxtacallosal por-tion ; 6 cases from pericallosal-callosomarginal(PC-CM) junction and 3 from pericallosal-frontopolar(PC-FP) junction. Associated vascular anomalies were noted in 3 cases and multiple aneurysms in 3 cases, respectively. The preoperative clinical grades were generally poor. An early surgery was performed in 7 cases and frontobasal interhemispheric approaches in 7 cases. Postoperatively, two patients died of complications ; one delayed ischemic vasospasm and one aspiration pneumonia but remaining patients recovered well. Conclusion : The frontobasal interhemispheric approach was useful for DACA aneurysms in early surgery. Division of superior sagittal sinus(SSS) enabled a minimal retraction of brain on both sides, and prevention of intraoperative rupture was possible. Authors suggest the frontopolar(first frontal bridging) vein as a constant external landmark for approaching the genu of the corpus callosum and juxtacallosal DACA aneurysms.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.13 no.2
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• pp.108-113
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• 2017

Moyamoya disease is a disorder in which certain arteries in the brain are constricted. Blood flow can be blocked by the constriction and blood clots. The patients frequently experience transient ischemic attacks (TIA), cerebral hemorrhage, or may not experience any symptoms at all. It is reported that they have a higher risk of recurrent stroke and a distinct underlying pathophysiology. A 3-year-8-month old boy with moyamoya disease experienced cerebral infarctions five times, and he underwent a cerebrovascular anastomosis surgery four years ago. He showed swallow disturbance, general delayed development, hemiplegia, and strabismus. Also he had hypocalcified teeth with or without multiple caries lesions in all dentitions. Dental treatment under general anesthesia using sevoflurane was performed due to his lack of cooperation. Moyamoya disease is associated with various medical conditions requiring a thoughtful deliberation and a careful examination before and during dental treatment. Pain and anxiety control during dental treatment is important because hyperventilation induced by crying has been seen to trigger TIA. Both isoflurane and sevoflurane are commonly used in patients with MMD, but dynamic autoregulation is better preserved during sevoflurane than isoflurane anesthesia. So sevoflurance general anesthesia may be recommendable to manage dental patients having multiple caries with moyamoya disease.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.5
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• pp.2117-2124
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• 2012

This is the study of actual condition and improvement on emergency medical treatment by 119 emergency medical service personnel. The subjects in this study were 299 emergency medical service personnel. Data were collected from May 1 to August 31 of 2010, and analyzed by SPSS 12.0 program. The major area of study of them were study of emergency medical services 41.5%, study of nursing 10.0%, fire fighting related studies 15.4%, health related studies 1.0%, and others 32.1%. The certificate of them were 1st class emergency medical technician(EMT) 38.1%, 2nd class EMT 33.8%, nurse 9.4%, first aid education 14.0%, and others 4.7%. Frequency of Prehospital emergency care, oxygen supply(274), splint apply(229), spinal immobilization(229), external bleeding control(223), medication(7), intravenous(4). Professionally trained EMT makes possible to secure high quality emergency medical treatment in the prehospital phase. Therefore, it is essential for the quality improvement of prehospital emergency care that well trained EMT ride on the ambulance together and take the responsibility for the treatment and transferring of emergency patients. In order to improve the proficiency of 119 emergency medical services personnel, it is also necessary to provide continuous job training programs for the prehospital emergency medical treatment.

• Journal of radiological science and technology
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• v.40 no.1
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• pp.27-34
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• 2017

The author investigated interventional radiology patient doses in several other countries, assessed accuracy of DAP meters embedded in intervention equipments in domestic country, conducted measurement of patient doses for 13 major interventional procedures with use of Dose Area Product(DAP) meters from 23 hospitals in Korea, and referred to 8,415 cases of domestic data related to interventional procedures by radiation exposure after evaluation the actual effectives of dose reduction variables through phantom test. Finally, dose reference level for major interventional procedures was suggested. In this study, guidelines for patient doses were $237.7Gy{\cdot}cm^2$ in TACE, $17.3Gy{\cdot}cm^2$ in AVF, $114.1Gy{\cdot}cm^2$ in LE PTA & STENT, $188.5Gy{\cdot}cm^2$ in TFCA, $383.5Gy{\cdot}cm^2$ in Aneurysm Coil, $64.6Gy{\cdot}cm^2$ in PTBD, $64.6Gy{\cdot}cm^2$ in Biliary Stent, $22.4Gy{\cdot}cm^2$ in PCN, $4.3Gy{\cdot}cm^2$ in Hickman, $2.8Gy{\cdot}cm^2$ in Chemo-port, $4.4Gy{\cdot}cm^2$ in Perm-Cather, $17.1Gy{\cdot}cm^2$ in PCD, and $357.9Gy{\cdot}cm^2$ in Vis, EMB. Dose referenece level acquired in this study is considered to be able to use as minimal guidelines for reducing patient dose in the interventional radiology procedures. For the changes and advances of materials and development of equipments and procedures in the interventional radiology procedures, further studies and monitorings are needed on dose reference level Korean DAP dose conversion factor for the domestic procedures.

• Fire Science and Engineering
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• v.26 no.5
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• pp.54-60
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• 2012

This study is the analysis of the actual state of hospital-based training in level 1 emergency medical technicians (EMTs) in fire station. The survey was carried out to 42 fire fighters having level 1 emergency medical technician certification from May 11 to 12 in 2012. The results showed 56.5 %, that the level 1 EMTs of roles had direct experienced. Level 1 EMTs performance frequency of clinical practice that endotracheal intubation 66.9 %, laryngeal mask airway 8.4 %, intravenous access 76.6 %, nitroglycerin sublingual 61.2 %, bronchodilator inhalation 50.0 %, fluid loading 73.8 %, ventilator apply 57.6 %, dextrose injection 57.6 %. It is necessary to investigate the continuous study on the education among the level 1 EMTs and the continuous evaluation and analysis of problems, supplemented of guidebook, practical education programs and regulation upon the operation and management of a hospital-based skill training.

• Proceedings of the Plant Resources Society of Korea Conference
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• 2021.04a
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• pp.33-33
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• 2021

자웅산(264.3m)은 DMZ 접경지역인 경기도 파주시 법원읍에 위치하며, 백두대간 줄기 중 한북정맥을 따라 동쪽으로는 노고산(401m), 서쪽으로는 명학산(220m) 사이에 위치하고 있다. 2020년 4월부터 10월까지 계절별로 1회씩 총 3회 식물상 조사를 진행하였고 화상자료와 증거표본을 확보하였다. 본 조사로부터 자웅산 일대에 자생하는 관속식물은 82과 208속 267종 9아종 22변종 4품종으로 총 303분류군이 확인되었다. 양치식물은 10과 18분류군, 나자식물은 2과 6분류군, 쌍자엽식물이 62과 226분류군, 단자엽식물이 8과 53분류군으로 확인되었다. 개나리(Forsythia koreana (Rehder) Nakai), 백운산원추리(Hemerocallis hakuunensis Nakai), 키버들(Salix koriyanagi Kimura ex Goerz) 등 3과 3분류군의 특산식물이 확인되었다. 침입외래식물로는 가시도꼬마리(Xanthium italicum Moretti), 단풍잎돼지풀(Ambrosia trifida L.), 미국개기장(Panicum dichotomiflorum Michx.), 서양민들레(Taraxacum officinale F.H.Wigg.), 애기망초(Conyza parva Cronquist) 등 7과 23분류군으로 조사되어 조사식물 303분류군의 7.6%를 차지하였다. 환경부 지정 식물구계학적 특정종은 V등급이 미나리냉이(Cardamine leucantha (Tausch) O.E.Schulz), IV등급이 당단풍나무(Acer pseudosieboldianum (Pax) Kom.), 산복사나무(Prunus davidiana (Carrière) Franch.) 등 2분류군, III등급이 금낭화(Dicentra spectabilis (L.) Lem.), 꽃쥐손이(Geranium platyanthum Duthie), 분비나무(Abies nephrolepis (Trautv. ex Maxim.) Maxim.) 등 7분류군이 확인되어 III등급 이상의 특정종은 10분류군으로 파악된다.

• Journal of the Korean Society of Radiology
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• v.84 no.4
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• pp.835-845
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• 2023

Traumatic pelvic injuries usually include high-energy crush injuries and are associated with significant morbidity and mortality. Mortality rates range from 6% to 15% and increase to 36%-54% in cases of fractures that result in increased pelvic volume. Therefore, retroperitoneal hemorrhage can spiral and progress to hemorrhagic shock. Pelvic hemorrhage most commonly occurs secondary to disrupted pelvic veins or fractured bones, and 10%-20% of cases involve arterial injuries. Owing to extensive bleeding and limitations of surgery for pelvic hemorrhage, interventional treatment is at the forefront of pelvic hemorrhage management. CT is an accurate indicator of active hemorrhage in patients with pelvic trauma that affects the diagnosis and management, including interventions. Identification of the site of hemorrhage is necessary for focused interventional treatment. The current trend toward a more conservative approach for treatment of pelvic trauma and advances in interventional radiology in the field of pelvic trauma may favor widespread use of interventional treatment for patients with pelvic injuries. In this review, we discuss therapeutic modalities available to the interventional radiologist and common angiographic treatment strategies and techniques.

• Journal of Chest Surgery
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• v.41 no.5
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• pp.568-572
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• 2008

Background: Minimally invasive surgery is currently popular, but this has been applied very sparingly to cardiac surgery because of some limitations. Our study evaluated the safety and efficacy of atrial septal defect (ASD) closure through a video-assisted mini-thoracotomy. Material and Method: Fifteen patients were analyzed. Their mean age was $31{\pm}6$ years. The mean ASD size was $24{\pm}5mm$ and there were 3 cases of significant tricuspid regurgitation. The working window was made through the right 4th intercostal space via a $4{\sim}5cm$ inframammary skin incision, CPB was conducted with performing peripheral cannulation. After cardioplegic arrest, the ASDs were closed with a patch (n=11) or direct sutures (n=4), and the procedures were assisted by using a thoracoscope. There were 3 cases of tricuspid repair and 1 case of mitral valve repair. The mean CPB time and aortic occlusion time were $160{\pm}47\;and\;70{\pm}26 $minutes, respectively. Result: There was no mortality, but there were 3 minor complications (one pneumothorax, one wound dehiscence and one arrhythmia). The mean hospital stay was $5.9{\pm}1.8$ days. The mean follow-up duration was $10.7{\pm}6.4$ months. The follow-up echocardiogram noted no residual ASD or significant tricuspid regurgitation. Three patients suffered from pain or numbness. Conclusion: This study showed satisfactory clinical and cosmetic results. Although the operative time is still too long, more experience and specialized equipment would make this technique a good option for treating ASD.

• Journal of Chest Surgery
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• v.29 no.7
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• pp.723-727
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• 1996

An adequate exposure is important in thoracoscopic procedures. The insufflation of $CO_2$has been demonstrated to aid in compressing lung parenchyma, and act as a retractor when combined with changes in patient's position. However, a recent study demonstrated that $CO_2$insufflation during thoracoscopy in the pig has adverse hemodynamic consequences. We prospectively studied 12 patients undergoing thoracoscopy to evaluate the effect of $CO_2$insufflation in the clinical setting. The mean arterial pressure, heart rate, central venous pressure, arterial oxygen saturation, and end-tidal $CO_2$pressure were monitored. Measurements were determined at baseline, at the initiation of one-lung ventilation, and at intrapleural pressure of 5, 10, 15 mmHg and following results were obtained. 1) The insufflation of 5 to 15 mmHg of $CO_2$had no significant effect on the mean arterial pressure, heart rate, arterial oxygen saturation. 2) The end-tidal $CO_2$pressure rose from 31.00$\pm$1.67 mmHg to 38.49$\pm$1.82 mmHg at an intrapleural pressure of 15 mmHg(p<0.05). 3) The central venous pressure rose from 7.75$\pm$0.76 mmHg to 12.83$\pm$1.64 mmHg and 16.16$\pm$l.97mmHg at an intrapleural pressure of 10 and 15 mmHg(p<0.05). 4) The low pressure (<10 mmHg) insufflation is a safe adjunct to the conduct of thoracoscopic surgical procedures.

• Proceedings of the ESK Conference
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• 1994.04a
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• pp.157-157
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• 1994

원자력발전소 운영의 중추적 역할을 담당하고 있는 운전원과 발전소시스템 사이에서 발생하는 인간공학적 요인(인적요인)은 다중방호벽의 존재와 자동화 기술의 확대에도 불구하고 원전의 가동 성 및 안전성을 위협하는 최대의 요인이다. 최근 원자력발전소 시스템에 고도화된 전자공학 및 인공 지능기술 등이 반영되고 있는 추세이나 이러한 기술의 도입이 운전원과의 복합적 상호작용관점에서 원전의 안전성과 효율성에 적합한가를 실험적으로 평가할 수 있는 실험평가기술의 확보가 필요한 실정이다. 한국원자력연구소에서는 차세대 주제어실의 설계 및 평가를 위한 실험적 자료의 생성 및 설계 대안의 평가를 위한 기술확보라는 목적을 가지고 1992년도부터 수행하고 있다. 1992년도(1차년 도)에는 새로운 주제어실에서 실험적으로 평가해야 할 평가항목을 구체화하였고, 4년간의 연구추진 내용을 설정하였다. 기존의 원자력산업계에서 요구하고 있는 인가/허가 요건, 사업자요건서, 인간 공학분야에서 제기하고 있는 문제점 등을 분석하여 10개의 실험평가항목을 도출하였으며, 실험평가 항목을 실제로 실험을 통하여 연구하기 위한 장비 및 설비 그리고 소요기술 등을 고려하여 연구방향을 설정하였다. 1993년도(2차년도)에는 차세대 주제어실의 특징을 규명하고 실험연구의 대상시스템을 설정하였다. 설정된 대상시스템을 기능별로 분석하여 설계변수를 도출하였으며, 인간공학 실험실의 구축에 필수적인 원자력발전소 시뮬레이터의 기능요건 및 실험실의 구성요건 등을 개발하고 있다. 3차년도부터는 인간공학실험을 수행하면서 자료분석체계의 개발, 원전직무 시나리오의 개발, 측정방법의 개발, 인간공학 실험실의 설계, 구축 및 검증, 평가기법 연구, 실시간 자료수집체계의 개발 등을 수행할 예정이며, 연구종료시점인 1996년도(5차년도)에는 원자력발전소 주제어실의 인간공학적 평가를 위한 실험 환경의 구축 및 실험평가기술의 확립이라는 목표가 달성된다.하는 것으로 간주된다. 2. KR 53234 10mg/kg 정맥투여후의 최고혈중농도는 1.14ug/ml, 반감기는 0.50hr, 분포용적은 2.2L이었다. 20mg/kg 경구 투여시의 최소 혈중 농도는 0.33 ug/ml, 소실반감기는 1.5시간, AUC는 0.942ug.hr/ml, 분포용적 11L, Ka는 3.05 $hr^{－1}$ 그리고 Cl는 5.3L/hr/kg이었다. 이는 KR 53170에서와 같이 매우 적은량이 흡수되고 배설되었다. 3. KR 53170의 혈청단백 결합율은 5-500 ug/ml 범위에서 78.7-86.2%이었고 KR 53234의 혈청단백결합율은 5-100 ug/ml 범위에서 79.6-71.2%이었다.이었다.tic techniques, and we have recently cloned two of the major subunits; some of the data will be presented.LIFO, 우선 순위 방식등을 선택할 수 있도록 확장하였다. SIMPLE는 자료구조 및 프로그램이 공개되어 있으므로 프로그래머가 원하는 기능을 쉽게 추가할 수 있는 장점도 있다. 아울러 SMPLE에서 새로이 추가된 자료구조와 함수 및 설비제어 방식등을 활용하여 실제 중형급 시스템에 대한 시뮬레이션 구현과 시스템 분석의 예를 보인다._3$", chain segment, with the activation energy of carriers from the shallow trap with 0.4[eV], in he amorphous regions.의 증발산율은 우기의 기상자료를 이용하여 구한 결과 0.05 - 0.10 mm/hr 의 범위로서 이로 인한 강우손실량은 큰 의미가 없음을 알았다.재발이 나타난 3례의 환자를 제외한 9례 (75%)에서는 현재까지 재발소견을 보이지 않고 있다. 이러한 결과는 다른 보고자들과 유사한 결과를 보이고 있