• Archives of Plastic Surgery
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• v.42 no.6
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• pp.741-745
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• 2015

Background Microvascular complications after free-flap breast reconstructions are potentially devastating problems that can increase patient morbidity and lead to flap loss. To date, no comprehensive study has examined the rates of salvage and the methods of microvascular revision in breast reconstruction. We reviewed the treatment of microvascular complications of free-flap breast reconstruction procedures over a seven-year period. Methods A retrospective review of all patients who underwent microvascular breast reconstruction at our institution between April 2006 and December 2013 was conducted. Based on their surgical records, all patients who required emergency re-exploration were identified, the rate of flap salvage was determined, the factors associated with flap salvage were evaluated, and the causes and methods of revision were reviewed. Results During the review period, 605 breast reconstruction procedures with a free lower abdominal flap were performed. Seventeen of these flaps were compromised by microvascular complications, and three flaps were lost. The overall salvage rate was 82.35%. No significant differences between the salvaged group and the failed group were observed with regard to age, BMI, axillary dissection, number of anastomotic arteries and veins, recipient vessel types, or use of the superficial inferior epigastric vein in the revision operation. Successful salvage of the flap was associated with a shorter time period between recognizing the signs of flap compromise and the take-back operation. Conclusions The salvage rate of compromised lower abdominal flaps was high enough to warrant attempting re-exploration. Immediate intervention after the onset of flap compromise signs is as important as vigilant postoperative monitoring.

• Proceedings of the Korean Nuclear Society Conference
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• 1995.10a
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• pp.191-196
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• 1995

The intelligent human-machine interface (HMI) has been developed to enhance the safety and availability of a nuclear power plant by improving operational reliability The key elements of the HMI are the large display panels which present synopsis of the plant status and the compact, digital work stations for the primary operator control and monitoring functions. The work station consists of four consoles such as a dynamic alarm console (DAC), a system information console (SIC), a computerized operating-procedure console (COC), and a safety related information console (SRIC). The DAC provides clean alarm pictures, in which information overlapping is excluded and alarm impacts are discriminated, for quick situation awareness. The SIC covers a normal operation by offering all necessary plant information and control functions. In addition, it is closely linked with the DAC and the COC to automatically display related system information under the request of these consoles. The COC aids the operator with proper emergency operation guidelines so as to shutdown the plant safely, and it also reduces his physical/mental burden by automating the operating procedures. The SRIC continuously displays safety related information to allow the operator to assess the plant status focusing on plant safety. The proposed HMI has been validated and demonstrated with on-line data obtained from the full-scope simulator for Yonggwang Units 1,2.

• Journal of Chest Surgery
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• v.28 no.12
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• pp.1139-1143
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• 1995

We experienced 29 cases of patients with a chief complaint of hemoptysis who were performed pulmonary resection at the Department of Thoracic and Cardiovascular Surgery, Pusan Medical Center Hospital for 3 years from May 1990 to April 1993. The mean age of hemoptysis patients was 34.7 year old, and hemoptysis was most prevalent in third and fourth decades. The underlying lung diseases of hemoptysis patients were tuberculosis in 12[41.4% , bronchiectasis in 9[31.0% , lung cancer in 4[13.8% , aspergyllosis in 3[10.3% and pneumonia in 1[3.5% . Modes of hemoptysis were blood tinged in 7[24.1% , massive in 22[75.9% . Operation times were elective in 7[24.1% of all blood tinged hemoptysis, delayed in 20[69.0% , emergency in 2[6.9% out of massive hemoptysis. The cases of the definite bleeding focus found by bronchoscopy were 19 cases[65.5% . The operative procedures of hemoptysis were single lobectomy in 14[48.3% , pneumonectomy in 6[20.7% , lobectomy with segmentectomy in 5[17.2% , bilobectomy in 3[10.3% and segmentectomy in 1[3.5% . The postoperative results of hemoptysis were complete recovery in 27[93.0% , rehemoptysis in 1[3.5% which was treated by anti-Tbc medication completely, and hospital death in 1[3.5% which was brain metastasis of lung cancer. It was concluded that definitive diagnosis, preoperative control of hemoptysis and operation were important in the management of hemoptysis patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.4
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• pp.2335-2342
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• 2014

If you want to use the unmanned quad rotor for emergency information provision and information about the traffic situation of real-time and moving information is included in the car to help in emergency vehicle operation of the city and in the distribution future innovation the need to consider to have enough safety of the use of silent quad rotor. Therefore, in this study, the unmanned quad rotor system research of safe landing control from the center for the improvement of safety of unmanned quad rotor system you have a motor of four, has taken a good structural balance system based on the dynamic model and motion considering the nonlinear characteristics, and attempts to proceed via non-linearity and system disturbances, tough Fuzzy controller, and analyzed through a computer simulation result.

• Journal of Trauma and Injury
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• v.37 no.2
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• pp.106-113
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• 2024

Purpose: Helicopter transport with medical teams has been proven to be effective, with improvements in patient survival rates. This study compared and analyzed the clinical characteristics and treatment outcomes of trauma patients transported by doctor helicopters according to whether patients were transferred after a clinical evaluation or without a clinical evaluation. Methods: This study retrospectively reviewed data from the Korean Trauma Data Bank of trauma patients who arrived at a regional trauma center through doctor helicopters from January 1, 2014, to December 31, 2022. The patients were divided into two groups: doctor helicopter transport before evaluation (DHTBE) and doctor helicopter transport after evaluation (DHTAE). These groups were compared. Results: The study population included 351 cases. At the time of arrival at the trauma center, the systolic blood pressure was significantly lower in the DHTAE group than in the DHTBE group (P=0.018). The Injury Severity Score was significantly higher in the DHTAE group (P<0.001), and the accident to trauma center arrival time was significantly shorter in the DHTBE group (P<0.001). Mortality did not show a statistically significant between-group difference (P=0.094). Surgical cases in the DHTAE group had a longer time from the accident scene to trauma center arrival (P=0.002). The time from the accident to the operation room or from the accident to angioembolization showed no statistically significant differences. Conclusions: DHTAE was associated with significantly longer transport times to the trauma center, as well as nonstatistically significant trends for delays in receiving surgery and procedures, as well as higher mortality. If severe trauma is suspected, air transport to a trauma center should be requested immediately after a simple screening test (e.g., mechanism of injury, Glasgow Coma Scale, or Focused Assessment with Sonography in Trauma), which may help reduce the time to definitive treatment.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.159-165
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• 2012

Purpose: For trauma patients, an early-transport and an organized process which are not delayed in hospital stage are necessary. Our hospital developed a procedure, the trauma Critical Pathway (CP), through which a traumatic patient has the priority over other patients, which makes the diagnostic and the therapeutic processes faster than they are for other patients. Methods: The records of patients to whom Trauma CP were applied from January 1, 2011 through April 15. 2012. were reviewed. We checked several time intervals from ER visiting to decision of admission-department, to performing first CT, to applying angio-embolization, to starting emergency operation and to discharging from ER. In addition, outcomes such as duration of ICU stay, hospital stay and mortality were checked and analyzed. Results: The trauma CP was applied to a total of 143 patients, of whom, 48 patients were excluded due to pre-hospital death, ER death, transferring to other hospital and not severe injury. Thus 95 patients (male 64, 67.3%) were enrolled in this study. Fifty-nine patients(62.1%) were injured by the traffic accident. The mortality rate was 10.5% and the mean Revised Trauma Score (RTS) of the patients was $6.4{\pm}2.0$. After visiting ER, decision making for admission was completed, on average, in 3 hours 10 seconds. The mean time intervals for the first CT, angio-embolization, surgery and discharge were 1 hour 20 minutes, 5 hours 16 minutes, 7 hours 26 minutes and 6 hours 13 minutes, respectively. Conclusion: The trauma CP did not show the improvement of time interval outcome, as well as mortality rate. However, this test did show that the trauma CP might be able to reduce delays in procedures for managing trauma patients at the university-based hospitals. To find out the benefit of CP protocol, a large scaled data is required.

• The Journal of KAIRB
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• v.5 no.1
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• pp.21-32
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• 2023

Purspose: The purpose of this study is to examine the meaning and definition of vulnerable subjects in clinical trials in light of domestic and international regulations and guidelines, to analyze the contents of standard operation procedures (SOPs) among advanced general hospitals in Korea that conduct clinical trials, and to examine deliberation procedures for operation plans. Methods: The study examined how vulnerable research subjects were defined and described in related regulations and the classification of vulnerable research subjects presented in the IRB/HRPP SOPs of 18 clinical trial institutions, including 11 AAHRPP-accreditated general hospitals in Korea, as well as the operation of the IRB deliberation. Results: Among all domestic and international regulations and guidelines, only the The Council for International Organization of Medical Sciences (CIOMS) guidelines explain why vulnerability is related to judgments on the severity of physical, psychological, and social harm, why individuals are vulnerable, and for what reasons. However, the classification of vulnerable subjects by institutions differed from the classification by the International Conference on Harmonization-Good Clinical Practice (ICH-GCP). A total of the 16 institutions classified children and minors as vulnerable research subjects. 14 institutions classified subjects who cannot consent freely were classified as vulnerable subjects. 15 institutions classified sujects who can be affected by the organizational hierarchy were classified as vulnerable subjects. Subjects in emergency situations were regarded as vulnerable research subjects in 8 of institutions, while people in wards, patients with incurable diseases, and the economically poor including the unemployed were categorized as vulnerable research subjects in 7, 4, and 4 of institutions, respectively. Additionally, some research subjects were not classified as vulnerable by ICH-GCP but were classified as vulnerable by domestic institutions 15 of the institutions classified pregnant women and fetuses as vulnerable, 11 classified the elderly as vulnerable, and 6 classified foreigners as vulnerable. Conclution: The regulations and institutional SOPs classify subjects differently, which may affect subject protection. There is a need to improve IRBs' classifications of vulnerable research subjects. It is also necessary to establish the standards according to the differences in deliberation processes. Further, it is recommended to maintain a consistent review of validity, assessment of risk/benefit, and a review using checklists and spokeperson. The review of IRB is to be carried out in a manner that respects human dignity by taking into account the physical, psychological, and social conditions of the subjects.

• Journal of the Korean Institute of Gas
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• v.28 no.2
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• pp.17-23
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• 2024

As interest in sustainable and eco-friendly energy increases due to various problems in the carbon economy, a hydrogen economy that utilizes hydrogen as a main energy source is emerging. Among the methods of producing hydrogen, the water electrolysis method based on renewable energy produces environmentally friendly green hydrogen because it produces hydrogen from water. The water electrolysis facility currently under development produces hydrogen by receiving electricity directly from renewable energy and uses KOH(potassium hydroxide) as an electrolyte. In this study, HAZOP(Hazard and Operability Study), a qualitative risk assessment, was conducted on alkaline water electrolysis facilities to find problems and risk factors in the design and operation of water electrolysis facilities. Risks related to oxygen and KOH, an electrolyte, were identified as major risks, and it is believed that the safety of facilities and workers can be secured based on emergency action plans and safe operation procedures.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.40 no.4
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• pp.429-435
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• 2020

North Korea declared itself complete with nuclear force after its sixth nuclear test in 2017. Despite efforts at home and abroad to denuclearize the Korean Peninsula, the prospects for the denuclearization are not bright. Along with political and diplomatic efforts to deter NK's WMD threats, the government is required to strengthen its consequence management capabilities against 'catastrophic situations' expected in case of emergency. Accordingly, this study was conducted to present measures to strengthen follow-up management against CBRN threats. The research model was partially supplemented and utilized by the THIRA process adopted and utilized by the U.S. Department of Homeland Security among national-level disaster management plan development models. Korea's consequence management (CM) system encompasses risk and crisis management on disaster condition. The system has been carried out in the form of a civil, government and military integrated defense operations for the purpose of curbing the spread or use of CBRNs, responding to threats, and minimizing expected damages. The preventive stage call for the incorporation of CBRN concept and CM procedures into the national management system, supplementing the integrated alarm systems, preparation of evacuation facilities, and establishment of the integrated training systems. In the preparation phase, readjustment of relevant laws and manuals, maintenance of government organizations, developing performance procedures, establishing the on-site support systems, and regular training are essential. In the response phase, normal operations of the medical support system for first aid and relief, installation and operation of facilities for decontamination, and development of regional damage assessment and control guidelines are important. In the recovery phase, development of stabilization evaluation criteria and procedures, securing and operation of resources needed for damage recovery, and strengthening of regional damage recovery capabilities linked to local defense forces, reserve forces and civil defense committees are required.

• Proceedings of the KSR Conference
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• 2004.10a
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• pp.250-257
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• 2004

Typical railway systems are composed of the various sub-systems, such as tracks, structures, electricity supplying systems, signal systems and vehicles. The roles of the sub-systems are clarified in the railway regulations in terms of their whole life cycle, as like design, operation and disposal stages. The regulations express clearly the basic specifications and requirements that need to accomplish their own performance and also state the standards and procedures for the normal operations and emergency conditions. In this paper the current railway regulation systems are analyzed and average revision periods are presented as the results of the analysis on revision history of railway safety regulations. This paper also presents the requirements for national safety standards based on Railway Safety Act and the necessity of application of system computer aided system engineering (CASE) tool for the improvement of legislation tasks. By exemplifying the cases of high speed rail system and Japanese cases that had developed softwares for supporing regulation revision management, the methodologies was studied for reconstruction of railway safety regulation system. As the results, it was presented such as the considerations for actual implementation and systematic safety regulation revision.