• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.62-67
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• 2012

Purpose : At this time, the sentinel lymph node mapping using radioisotope and blue dye is preceded for breast cancer patient's sentinel lymph node biopsy. But all patients were applied the same protocol without consideration of physical specific character like the breast sizes and body mass indexes. The purpose of this study is search the optimized scan time in breast sentinel lymphangiography by observing how much the body mass index and breast size influence speed of lymphatic flow. Materials and Methods : The Object of this study was 100 breast cancer patients(Female, 100 persons, average age $50.34{\pm}10.26$ years old)at Severance hospital from October 2011 to December 2011. They were scanned breast sentinel lymphangiography before operation. This study was performed on Forte dual heads gamma camera (Philips Medical Systems, Nederland B.V.). All patients were intra-dermal injected $^{99m}Tc$-Phytate 18.5 MBq, 0.5 ml. For 80 patients, we have scanned without limitation of scan time until the lymphatic flow from the lymph node since injection. We measured how long the lymphatic flow time between departures from injects site and arrival to lymph node using stopwatch. After we calculated patient's Body mass Index and classified as 4 groups. And we measured patient's breast size and classified 3 groups. The modified breast lymphangiography that changing scan time according to comparison study's result was performed on 20 patients and was estimated. Results : The mean scan time as breast size was A group 2.48 minutes, B group 7.69 minutes, C group 10.43 minutes. The mean scan time as body mass index was under weight 1.35 minutes, normal weight 2.56 minutes, slightly over 5.62 minutes, over weighted 5.62 minutes. The success rate of modified breast lymphangiography was 85%. Conclusion : As the Body mass index became higher and breast size became bigger, the total scan time is increased. Based on the obtained information, we designed modified breast lymphangiography protocol. At the cases applying that protocol, most of sentinel lymph nodes were visualized as lymphatic pool. In conclusion, we found that the more success rate in modified protocol considering physical individuality than study carrying out in the same protocol.

• Tuberculosis and Respiratory Diseases
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• v.66 no.4
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• pp.300-308
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• 2009

Background: The quality of care for patients with community acquired pneumonia needs to be improved; the factors affecting this care need to be analyzed. The objectives of this study were used to measure the performance of care processes of for patients with pneumonia and to determine those patient and hospital characteristics are associated with quality care. Methods: The analysis was performed using data from 21 hospitals that had over 500 beds for 1,001 patients, who were sampled randomly. All patients were born before 31 December 1989, and discharged between the two months' August 2006 and October 2006. Performance process indicators were measured by respective hospital, and multivariate logistic regression was used to calculate associations between patients and hospital characteristics using 4 process indicators. Results: Performance rates in timely assessment of oxygenation assessments and blood cultures, correct administration of antibiotic medications, and blood culture performed prior to initial antibiotics were 69.4%, 79.1%, 82.5% and 60.5%, respectively. Age had a positive affect on oxygenation assessment within 24 hours. Bed number, number of nurses per bed, annual number of emergency department visits, average percentage of beds filled, location and arrival time, and site were factors associated with process indicators. Conclusion: It is necessary to make up for the weak points in the process of care for patients with community acquired pneumonia, by enforcing quality assurance. To reduce performance rate variation among hospitals, improvement in care protocols is required for hospitals that have poor quality of care levels.

• The Korean Journal of Emergency Medical Services
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• v.9 no.2
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• pp.111-128
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• 2005

Background: Cardiac arrest is one of the most critical diseases which can likely lead to severe cerebral disability or brain death when the cases can not recover their circulation within 10 minutes. Saving out-of-hospital cardiac arrest cases is a recent concern in Korea. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. The best survival can be achieved if all the following links have been optimized : rapid access, and early CPR, defibrillation and ACLS, Since the "Utstein Style" was advocated in 1991, many reports about out-of-hospital cardiac arrest have been published based on this guideline. These differences prevent valid inter-hospital and international comparisons. However, it is not known how effective resuscitation has become to the patients. In other words, there are no guidelines for reviewing, reporting, and conducting research on resuscitation in Korea. This dissertation aims to provide the basic data for a unified reporting guideline of resuscitation in Korea and evaluating the out-of-hospital factors associated with survival discharge of out-of-hospital cardiac arrest. Methods: As for this study, uses the collected data about Out-of-hospital cardiac arrests at 4 area, from January, 2005 to April. 2005. With a retrospective study, 174 cases were analyzed. The data was recorded based on the Out-of-Hospital Utstein Style. Results: Resuscitation was performed on 174 out-of-hospital cardiac arrest cases at the 4 area 14 patients(8.1%) recovered their spontaneous circulation. Overall, the ROSC of the out-of-hospital cardiac arrest patients was 8.1%, which was poorer than that of western countries. Gender distribution was 50 females(28.7%) and 124 males(71.3%), approximately twice as many males as females. ROSC of witnessed arrests was found out to be 97.7%. The ratio of the witnessed arrest groups showed higher results than that of unwitnessed arrest groups in the above-examined cases. Cardiac etiology consisted of cardiac(33.5%), non-cardiac(45.7%), trauma(20.1%), and unknown(6.0%). Cardiac was the best performance. Initial rhythm showed Ventricular Tachycardia/pulseless Ventricular Fibrillation in 8 patients(6.0%), asystole in 100(75.2%) and unknown in 25(18.8%). The results of the Ventricular Tachycardia/pulseless Ventricular Fibrillation showed higher results than the others cases, The proportion of the cardiogenic cause was 33.5%, which was only half of western countries. Ventricular Tachycardia/pulseless Ventricular Fibrillation is relatively rare. These differences were due to the prevalent pattern of Out-of-hospital cardiac arrest as well as prematurity of the EMSS. Bystander CPR was practiced on 13 patients(7.52%). ROSC was shown in 46.2% cases. CPR by EMT was carried out on 167 cases(96.5%). ACLS by EMf was rare. From collapse, 4 cases(2.6%) arrived to ED within 6 minutes. 13 (8.6%) within 10 minutes, and 49(32.5%) over 31 minutes. The sooner the patients arrived, the greater the ratio of ROSC and discharged alive became, and the same with collapse time to ROSC. As the results of the logistic regression analysis, ROSC was found out to be highly influenced by the time of ED arrival from collapse and Ventricular Tachycardia/pulseless Ventricular Fibrillation. Therefore, the ratio of ROSC depends on not any single factor but various intervention factors. Conclusion: This dissertation presents the following suggestions and directions of the study hereafter. First, the first step for a chain of survival should be taken to activate EMSS early with a phone as soon as cardiac arrests are witnessed. Second, it is keenly needed that emergency medical technicians should be increased through emergency education for living. Third, it is necessary to establish the emergency transportation system. Fourth, most of the Koreans have little understanding of EMT and the present operation systems have many problems, which should be fundamentally changed. Fifth, it is required to have an active medical control over Out-of-hospital CPR, And proper psychological supports should be given not only to patients themselves and their family but also individuals who are engaged in emergency situation. Finally, through studies hereafter on nationwide, comprehensive, and standard forms, it is needed to examine into the biological figures of human body, causes and trends of cardiac arrests, and then, to enhance the survival rate of Out-of-hospital cardiac arrests. Korean guidelines for Cardiopulmonary resuscitation need to be made.

• The Korean Journal of Air & Space Law and Policy
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• v.4
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• pp.65-85
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• 1992

The air waybill is supposed to be made out by the consignor. If the carrier makes it out, he is deemed, subject to proof to the contrary, to have done so on behalf of the consignor. The air waybill shall be made out in three original parts. The first part shall be marked "for the carrier", and shall be signed by the consignor. The second part shall be marked "for the consignee", it shall be signed by the consignor and by the carrier and shall accompany the goods. The third part shall be signed by the carrier and handed by him to the consignor, after the goods have been accepted. According to the original Warsow Convention article 8, the air waybill must contain 17 particulars or items. However, the Hague Protocol reduced to three the number of particulars required to appear on the air waybill. Only one item is obligatory, namely, the notice that the carriage is subject to the rules of the Warsaw Convention. The absence of the air waybill entails unlimited liability of the carrier because it deprives him of the right to avail himself of the provisions of the Warsaw Convention which exclude or limit his liability. The consignor shall be liable for all damages suffered by the carrier or any other person by reason of the irregularity, incorrectness or incompleteness of the particulars and statements in the air waybill. Although the contract of the carriage of goods by air is not a formal contract, the document of carriage is issued. The issue of air wayhill is not essential for the existence or validity of the contract, but serves merely as a means of proof. The Hague Protocol has lessened the consequences of the carrier's neglect to faithfully accomplish the required formalities. Henceforth, these formalities no longer constitute legal obligations. The air waybill is the consignment note used for the carriage of goods by air. It is often called an air consignment note and is not a document of title or transferable/negotiable instrument. It is basically a receipt for the goods for despatch and is prima facie evidence of the conditions of carriage. Each of the original parts of the air waybill has evidential value and possession of his part is a condition for the exercise by the consignor or cosignee of his rights under the contract of carriage. Oveall, it is an usage that under a documentary letter of credit, the consignee on the air waybill is the opening bank of the letter of credit, and the notify party is the importer who applied for the letter of credit. In Korea there is an usage as to process of cargo delivery in air transportation as follows: The carrier carries the cargo into the bonded area of the airport and gives both the notice of arrival of the cargo and the consignee's air waybill to the notify party who is the importer. Then the notify party obtains the Letter of Guarantee from the opening bank in exchange for reimbursing the amount of the letter of credit or tendering the security therefor to the opening bank. The notify party then presents this document to the customs authorities for the process of customs clearance. The opening bank becomes a consignee only to ensure repayment of the funds it has expended, and the only interest of the opening bank as consignee is the reimbursement of the money paid to the exporter under the documentary letter of credit. Just as the bill of lading in maritime law, the air waybill has always been considered negotiable although the Warsaw Convention does not emphasize this aspect of negotiability. However, the Hague Protocol article 4 corrected the situation by stating that "nothing in this Convention prevents the issue of a negotiable air waybill." This provision officially recognizes that the air waybill must meet the needs of the present day business circles by being a negotiable instrument. Meanwhile, Montreal Additional Protocol no. 4 has brought important changes. Registration by computer is acceptable and the parties to the contract of carriage are allowed to replace the air waybill with a receipt for the goods. In conclusion, as the Warsaw Convention has not details of provisions relating to the issuing of the negotiable air waybill, it is hoped that there should be supplement to the Warsaw Convention and establishment of international commercial usage with regard to the negotiable air waybill.

• Journal of the Korean Geographical Society
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• v.40 no.4 s.109
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• pp.428-440
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• 2005

There is currently no agreement among archaeologists, environmental historians, and paleoecologists as to the relative significance of pre- and post-Conquest human impact on the environments of Highland Mexico. This paper presents the results of pollen, microscopic charcoal, dung fungal spore, isotope, and magnetic susceptibility analyses on ca. 4m sediment core. The coring site is Hoya Rincon de Parangueo, one of the seven maar lakes in the Valle do Santiago. Amaranthaceae pollen, one of important disturbance indicators and Zea mays pollen obviously indicate two periods of agricultural activities. The first period begins ca. 400 B.C. and ends ca. A.D. 850. The second begins around A.D. 1550 and continues to the present. During the first period, the degree of agricultural activities was related to periodical sunspot cycles and the most intense activities were present between ca. A.D. 150-ca. A.D. 400. The abrupt increase of $\delta^{18}O$ around 280cm may reflect that an important transition to a dry phase took place around A.D. 450. People probably stopped cultivating crops due to dry conditions prevailing since ca. A.D. 450. The second period, the post-Conquest, exhibits a dramatic increase of sporormiella, dung fungal spores resulted fron the introduction of cattle. Low Poaceae frequency and charcoal production and high $\delta^{13}C$ values, magnetic susceptibility, and organic contents all indicate the arrival of the Spanish. Most importantly, it seems that mesquite (Prosopis juliflora) could have benefits from declined fire frequencies caused by cattle grazing. The study area is now entirely dominated by woody plants like mesquite, which clearly demonstrates that serious vegetation change occurred in the study area.

• Journal of Preventive Medicine and Public Health
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• v.22 no.1 s.25
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• pp.146-152
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• 1989

To test the validity of referral of high risk pregnancy in the MCH Center, 6,017 pregnant women who visited MCH Center of South District Health Center for delivery between 1 April 1985 and 31 March 1987 were interviewed on arrival to obtain the data for demographic characteristics and obsteric history and traced to check the delivery outcome. Out of 5,820 women whose delivery outcomes were confrmed, 704 women(12.1%) were referred to other hospital or clinic for high risk factors. The proportion of poor delivery outcome(stillbirth, low birth weight and neonatal death) among referred cases was 4.4% while that of the women delivered at the MCH Center was 2.2% (p<0.01). Decision of the midwives for the referral of high risk pregnancy based on their clinical assessment was consistent with the delivery outcome (good or poor) in 86.5%. Major reasons for referral were premature rupture of membrane(46.5%) and cephalopelvic disproportion(20.0%) and the C-section rates for these cases were 10.1%, 17.6%, respectively. Discriminant analysis of the demographic characteristics and obstertric history for the discrimination of delivery outcome showed that gestational age had the highest discriminant function coefficient(0.88) and it was followed by parity(0.37) and maternal education(0.30). Referral of high risk pregnancy by the midwives based on their clinical assessment was considered to be reasonably valid. However, a risk scoring system for an MCH Center which can improve the validity may be developed if one applies the discriminant analysis for more comprehensive independent variable(including clinical assessment of midwife, demographic characteristics and obstetric history) and dependent variable (including medically indicated C-section, complication of pregnancy and delivery, stillbirth, low birth weight, neonatal death and maternal death).

• Journal of Chest Surgery
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• v.29 no.6
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• pp.599-605
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• 1996

A total of 249 patients undergoing isolated coronary revascularization were studied for the occurrence of postoperative atrial fibrillation(AF). Possible associations of this arrhythmia with various preoperative, intraoperative and postoperative factors were studied by univariate and multivariate analysis. The overall incidence of postoperative AF was 15%, with the median time occurence of 48 hours(mean time : 59.1 $\pm$ 56.9 hours) after arrival to the intensive care unit. Cardiac index decreased significantly after occurence of AF(p=0.001). There were no in-hospital complications in those patients with AF. Univariate studies indicated preoperative ejection fract on(EF), triglyceride level, postoperative peak CKMB isoenzpme and atrial pacing to be the dominant factor promoting postoperative AF, with an increasing prevalence in lower EF(p=0.025), triglyceride(p=0.006) and peak CKMB isoenzyme(p=0.002), and in patients with atrial pacing(p=0.001). Hospital stay(p=0.001) and late mortality(p=0.003) were significantly increased in patients with postoperative AF Multivariate analysis showed that body weight and postoperative atrial pacing to be the dominant factor promoting postoperative AF, with an increasing prevalence in over- weight patients(p=0.011) and patients with atrial pacing(p=0.001). Both univariate and multivariate analy- sis showed that the age was not a significant factor but tended to promote postoperative AF respectively (p=0.053, 0.064). After 30.1 $\pm$ 11.4 months gfollow-up, those patients with AF had sinus rhythm. We think that we must try to prevent postoperative AF after ccoronary artery bypass grafting because of its deleterio s hemodynamic effect, prolonged hospital stay, and increased late mortality.

• The Korean Journal of Air & Space Law and Policy
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• v.30 no.2
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• pp.249-277
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• 2015

Regulation (EC) No 261/2004 ("Regulation") is a common rule on compensation and assistance to passengers in the event of denied boarding and of cancellation or long delay of flights. In some recent cases of European nations, passengers sued the air carrier in order to obtain monetary compensation under Article 7(1) of the Regulation. Some courts dismissed the actions on the grounds that, unlike denied boarding or cancellation of the flight, the Regulation provides no compensation in relation to delayed flights. However, Court of Justice of the European Union(CJEU) ruled that Regulation 261/2004 must be interpreted to mean that passengers whose flights are delayed have a right to compensation in cases when the loss of time is equivalent to, or is in excess of three hours - where the passengers eventually reached their final destination three hours or more later than the originally scheduled arrival time. It is true that a strict interpretation of the regulation would suggest that passengers whose flight has merely been delayed are not entitled to compensation. They should only be offered assistance in accordance with the Articles 6 and 9. Nevertheless, the Court recognized the same right to the same compensation for passengers of flights delayed by more than three hours as that explicitly provided for passengers of cancelled flights. On the one hand, the Court bases this ruling on the recitals of the Regulation, in which the legislature links the question of compensation to that of a long delay, while indicating that the Regulations seek to ensure a high level of protection for passengers regardless of whether they are denied boarding or their flight is cancelled or delayed. On the other hand, the Court interprets the relevant provisions of the Regulation in light of the general principle of equal treatment. Furthermore, the Court delivered a ruling that the loss of time inherent in a flight delay, which constitutes an inconvenience within the intention of Regulation No 261/2004 and which cannot be categorized as 'damage occasioned by delay' within the meaning of Article 19 of the Montreal Convention, cannot come within the scope of Article 29 of that convention. Consequently, under this view, the obligation under Regulation No 261/2004 intended to compensate passengers whose flights are subject to a long delay is in line with Article 29 of the Montreal Convention. Although the above interpretation of the Court can be a analogical interpretation, the progressive attitude of the Regulation and the view of Court forward to protect passengers' interest is a leading role in the area of international air passenger transportation. Hopefully, after the model of the positive support in Europe, Korea can establish a concrete rule for protecting passengers' right and interest.

• Korean Journal of Environment and Ecology
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• v.30 no.2
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• pp.146-154
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• 2016

In this study, understanding the habitats on spot-billed duck that wintering-breed in the korea, which using the GPS-Mobile based Telemtry (WT-200), I tried to take advantage as the basic data of the protection and management of the habitats of the waterbirds of Korea. Study area is Gyeonggi-do Bokhacheon, Chonmichon, Chungcheongnam-do Gokugyochon, Chungcheongbuk-do Byeongcheoncheon, Jeollabuk-do Mangyunggang, which Five rivers and Jeju Island reservoir, I have attached the tracking of the location(WT -200) to the twenty-five spot-billed ducks. among twenty five ducks, twelve ducks moved to overseas countries, the arrival site was China, North Korea, Russia. Moving average distance was 683km, the largest distance was 1,238km. The average northbound starting date was April 26. The average daily movement distance of thirteen ducks remaining in the domestic country is $1.0{\pm}0.89km$, maximum travel distance was 23.8km. The average daily movement distance of wintering prior to average going north dating is a 0.9km, is the largest 14.6km, the breeding season is an average 1.3km, maximum was 14.4km. Spot-billed duck used the rivers in domestic country most frequently, following was rice field, a filed, reservoir. It used the river most frequently during the wintering period, in the breeding season it used paddy paddies most frequently. While wintering, during the day and night's utilization rate was the highest in the river, but utilization rate was incleased on filed, paddy filed at night. During breeding season, daytime and night's utilization rate was the highest but, utilization rate was increased on river and utilization rate was decreased on river. In accordance with time change, spot-billed duck showed different tendency in paddy fields, and they utilized the filed adjacent to rivers mostly.

• Journal of Korea Water Resources Association
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• v.41 no.12
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• pp.1219-1230
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• 2008

Stream inflows induced by flood runoffs have a higher density than the ambient reservoir water because of a lower water temperature and elevated suspended sediment(SS) concentration. As the propagation of density currents that formed by density difference between inflow and ambient water affects reservoir water quality and ecosystem, an understanding of reservoir density current is essential for an optimization of filed monitoring, analysis and forecast of SS and nutrient transport, and their proper management and control. This study was aimed to quantify the characteristics of inflow density current including plunge depth($d_p$) and distance($X_p$), separation depth($d_s$), interflow thickness($h_i$), arrival time to dam($t_a$), reduction ratio(${\beta}$) of SS contained stream inflow for different flood magnitude in Daecheong Reservoir with a validated two-dimensional(2D) numerical model. 10 different flood scenarios corresponding to inflow densimetric Froude number($Fr_i$) range from 0.920 to 9.205 were set up based on the hydrograph obtained from June 13 to July 3, 2004. A fully developed stratification condition was assumed as an initial water temperature profile. Higher $Fr_i$(inertia-to-buoyancy ratio) resulted in a greater $d_p,\;X_p,\;d_s,\;h_i$, and faster propagation of interflow, while the effect of reservoir geometry on these characteristics was significant. The Hebbert equation that estimates $d_p$ assuming steady-state flow condition with triangular cross section substantially over-estimated the $d_p$ because it does not consider the spatial variation of reservoir geometry and water surface changes during flood events. The ${\beta}$ values between inflow and dam sites were decreased as $Fr_i$ increased, but reversed after $Fr_i$>9.0 because of turbulent mixing effect. The results provides a practical and effective prediction measures for reservoir operators to first capture the behavior of turbidity inflow.