• 대한방사선기술학회지:방사선기술과학
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• 제45권2호
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• pp.127-134
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• 2022

In order to overcome the image quality limitations of the conventional C-arm, a flat panel detector (FPD) is used to enhance spatial resolution, detective quantum efficiency, frame rate, and dynamic range. Three-dimensional (3D) visualized information can be obtained from C-arm computed tomography (CT) equipped with an FPD, which can reduce patient discomfort and provide various medical information to health care providers by conducting procedures in the interventional procedure room without moving the patient to the CT scan room. Unlike a conventional C-arm device, a C-arm CT requires different basic safety and essential performance evaluation criteria; therefore, in this study, basic safety and essential performance evaluation criteria to protect patients, medical staff, and radiologists were derived based on International Electrotechnical Commission (IEC) standards, the Ministry of Food and Drug Safety (MFDS) standards in Korea, and the rules on the installation and operation of special medical equipment in Korea. As a result of the study, six basic safety evaluation criteria related to electrical and mechanical radiation safety (leakage current, collision protection, emergency stopping device, overheating, recovery management, and ingress of water or particulate matter into medical electrical (ME) equipment and ME systems: footswitches) and 14 essential performance evaluation criteria (accuracy of tube voltage, accuracy of tube current, accuracy of loading time, accuracy of current time product, reproducibility of radiation output, linearity and consistency in radiography, half layer value in X-ray equipment, focal size and collimator, relationship between X-ray field and image reception area, consistency of light irradiation versus X-ray irradiation, performance of the mechanical device, focal spot to skin distance accuracy, image quality evaluation, and technical characteristic of cone-beam computed tomography) were selected for a total of 20 criteria.

• 한국항공운항학회지
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• 제30권4호
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• pp.105-116
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• 2022

Domestic and foreign aviation industries showed steep growth along with rapid increase in aviation demand, but the industries got directly hit by COVID-19. Now, with the recovery of daily life, aviation demand is gradually increasing, too. However, the risk of aviation accidents also increases proportionally to the increasing demand for aviation. Although it is a point that safety management needs to be actively conducted to prevent safety accidents resulted from the growth of aviation industries, research on safety culture and organizations is not sufficiently done in terms of the depth and scope of it despite the importance of the discussion. Studies in various areas have reported that an organization's safety culture forms the group's safety atmosphere and then results in the workers' safety behavior. Accordingly, this study examined the effects of safety culture in an organization on the safety behavior of its members who are aircraft maintenance technicians. The results of this research can be summed up as follows: first, it has been found that the roles of the person in charge grounded on clear goals and guidelines for the organization's safety policy influence the technicians' attitudes. Second, the important factor in the technicians' safety observance is that the attitude to follow safety rules when performing aviation maintenance raises their awareness of safety, for instance, following standard operation procedures or wearing personal equipment for protection. Third, their attitudes have positive effects on safety participation, and consequently, their intention to comply with safety rules is shown as an active action to achieve the ultimate goal of safety behavior.

• Journal of Trauma and Injury
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• 제37권1호
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• pp.74-78
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• 2024

Inferior vena cava (IVC) injuries can have fatal outcomes and are associated with high mortality rates. Patients with IVC injuries require multiple procedures, including prehospital care, surgical techniques, and postoperative care. We present the case of a 67-year-old woman who stabbed herself in the abdomen with a knife, resulting in an infrarenal IVC injury. We shortened the transfer time by transporting the patient using a helicopter and decided to perform direct-to-operating room resuscitation by a trauma physician in the helicopter. The patient underwent laparotomy with IVC ligation for damage control during the first operation. The second- and third-look operations, including previous suture removal, IVC reconstruction, and IVC thrombectomy, were performed by a trauma surgeon specializing in cardiovascular diseases. The patient was discharged without major complications on the 19th postoperative day with rivaroxaban as an anticoagulant medication. Computed tomography angiography at the outpatient clinic showed that thrombi in the IVC and both iliac veins had been completely removed. Patients with IVC injuries can be effectively treated using a trauma system that includes fast transportation by helicopter, damage control for rapid hemostasis, and expert treatment of IVC injuries.

• 항공우주시스템공학회지
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• 제14권1호
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• pp.54-61
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• 2020

군용항공기 운용을 위해서는 군 감항당국으로부터 감항인증서를 획득해야 한다. 군 일반감항인증 절차 중, 항공기 설계가 군의 감항인증기준에 적합함을 입증하는 형식인증 절차가 있다. 수리온 헬기는 군용항공기로서 국내에서 최초로 형식인증과 생산확인, 감항인증을 획득하였고, 수리온파생형 항공기는 특수 임무를 위해 개조되어 관용으로 운용 중이다. 항공안전법에 따르면, 군용항공기인 수리온파생형 항공기를 개조하여 민간의 특수목적으로 운용(응급환자 수송, 소방활동 등)하기 위해서는 민간 감항당국으로부터 제한분류 특별감항증명을 획득해야 하며, 제한형식증명 획득은 특별감항증명을 용이하게 할 수 있는 설계에 관한 인증에 해당한다. 본 연구에서는 우리나라에서 최초로 계획하고 있는 수리온파생형 항공기에 대한 민간의 특수목적 운용을 위한 제한형식증명 획득 방안에 대해 논하였고, 국내 제한형식증명 관련 제도의 발전 방향에 대해 제언하였다.

• Journal of Trauma and Injury
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• 제26권3호
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• pp.111-124
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• 2013

Purpose: We should prepare proper medical service for disaster control as South Korea is not free from terrorism and war, as we experienced through the two naval battles of the Yeonpyeong, one in 1999 and the other in 2002, the sinking of Cheonan in 2010, and the attack against the border island of Yeonpyeong in 2010. Moreover, North Korea's increasingly bellicose rhetoric and mounting military threats against the world demand instant action to address the issue. The aim of this article is to describe our experience with three patients with combat-related gunshot and explosive injuries to their extremities and to establish useful methods for the management of patients with combat-related injuries. Methods: Three personnel who had been injured by gunshot or explosion during either the second naval battle of the Yeonpyeong in 2002 or the attack against the border island of Yeonpyeong in 2010 were included in our retrospective analysis. There were one case of gunshot injury and two cases of explosive injuries to the extremities, and the injured regions were the left hand, the right foot, and the right humerus. In one case, the patient had accompanying abdominal injuries, and his vital signs were unstable. He recovered after early initial management and appropriate emergency surgery. Results: All patients underwent emergent surgical debridement and temporary fixation surgery in the same military hospital immediately after their evacuations from the combat area. After that, continuous administration of antibiotics and wound care were performed, and definite reconstructions were carried out in a delayed manner. In the two cases in which flap operations for soft tissue coverage were required, one operation was performed 5 weeks after the injury, and the other operation was performed 7 weeks after the injury. Definite procedures for osteosynthesis were performed at 3 months in all cases. Complete union and adequate functional recovery were achieved in all cases. Conclusion: The patient should be stabilized and any life-threatening injuries must first be evaluated and treated with damage control surgery. Staged treatment and strict adherence to traditional principles for open fractures are recommended for combat-related gunshot and explosive injuries to the extremities.

• 한국위성정보통신학회논문지
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• 제2권1호
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• pp.35-40
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• 2007

COSPAS-SARSAT 시스템은 위성체와 지상 설비를 이용하여 항공기 또는 선박 등이 조난 시에 탐색구조 (SAR: Search and Rescue) 활동을 도울 수 있도록 조난경보와 위치정보를 제공하는 시스템이다. COSPAS-SARSAT 서비스의 경우, 조난신호 접수에서 구조시작까지 평군 1사간 이상이 소요되고, 위치정확도가 5Km 정도로 범위가 넓은 편이다. 이러한 문제점을 개선하기 위해서 중궤도 위성을 이용한 차세대 탐색구조 시스템 개발이 추진 중에 있으며 EU에서 2011년 FOC(Full Operation Capability)를 목표로 개발중인 갈릴레이 항법위성 프로젝트의 경우 SAR 중계기를 탐재하여 탐색구조 서비스를 제공할 계획에 있다. 갈릴레오 탐색구조(SAR/Galileo)서비스는 수 m급의 위치정확도, 10분 이내의 조난신호 접수에서 구조까지 소요실간. 및 조난자에게 회신링크 서비스 제공 등 보다 향상된 탐색구조 성능을 제공하기 위해 개발 중에 있으므로, 갈릴레오 위성 서비스가 시작되면 탐색구조시스템 체계에 보다 신속하고 정확한 구조가 가능할 것으로 예상된다. 우리나라도 날로 더해가는 다양한 재난에 대한 인명구조를 신속하고 효과적으로 대처하기 위해 차세대 갈릴레오 탐색구조 지상국 도입이 필요하며, 탐색구조 단말기를 포함한 지상국 인프라의 구축 등 갈릴레오 탐색구조 지상시스템 개발 방안에 관한 연구는 매이 시기적절하고 중요한 연구이다. 본 논문은 우리나라가 차세대9 갈릴레오 탐색구조 지상시스템 개발을 위해 필요한 갈릴레오 프로젝트의 참여절차 및 참여전략을 수립하고, 현실적으로 개발이 가능한 개발 범위를 도출하며 개발을 위한 추진체계에 대해서 제안한다.

• 안보군사학연구
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• 통권5호
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• pp.1-45
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• 2007

Reserved forces of ROKA are in charge of replacement of TOE in the wartime and mission of rear area operation. But there is institutional inertia in the law and organization oriented to fill human resources rather than take mission. We need to prepare for the investment and arrangement of reserved forces as military power that would be replaced standing forces. In this portion, to reinforce reserve forces elite, First, efficient mobilization regulations and systems are suggested. I covered a maintenance of relevant mobilization ordinances which need to legislated and approved by national assembly for wartime and development of mobilization system which might lose the appropriate time for mobilization due to complicated declaration procedures and measures to overcome the panic at the initial stage of the war and organization and employment of nationwide transportation system and mobilization center. To ensure efficient resource management and mobilization of reserve forces with a number of approximately 3 million, there's a necessity of organization for integration and conciliation. To make it real, I suggested establishing and employing the mobilization center, on first phase, employ the mobilization center focusing on homeland divisions, on second phase, it is advisable to convert to national level mobilization system and develop to central mobilization center focusing on national emergency planning committee. During peacetime, in conjunction with Mobilization Cell, mobilization center can conduct resource survey and integrate and manage mobilization resources and take charge of mobilization training of subordinate units, and during wartime, in conjunction with mobilization coordination team and Cell, can ensure the execution of mobilization. Second, Future oriented reserve forces management system such as service system of reserve forces and support system of homeland defense operations. Current service and trainings of reserve forces by the year have very low connection, as it is very complex to manage the resources and trainings, and service and training lack the equity, re-establishment of service system is required. Also in an aspect of CSS and cultivation support for reserve forces, as the scope and limitation of responsibility between the armed forces and autonomous organization is obscure, conditions to conduct actual-fighting exercises are limited. Concentrated budgetting is extremely difficult because reserve forces training fields are scattered nationwide, and facilities and equipments are rapidly getting older. To improve all these, I suggest the organization of homeland defense battalion with a unit of "City-Gun-District" and supporting the local reserve forces. Conduct unit replacement or personal replacement for those who have finished their 1 or 2 years and homeland defense operation duty for those with 3-5 years for consistency and simplification. Third, I suggest Future oriented Reserved Training(FRT) and Training Center oriented training management to establish a reliable reserve training. Reserves carry out expansion of unit, conventional combat mission, homeland defense and logistics support during wartime, and actual-fighting exercise, and disaster relief, peace keeping activities. Despite diverse activities and roles, their training condition still stays definitely poor. For these reasons, Modernization of weapons and facilities through gradual replacement and procurement is essential to enhance mobilization support system.

• Journal of Chest Surgery
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• 제36권8호
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• pp.583-589
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• 2003

흉골절개술 후에 발생하는 흉골 감염과 종격동염의 유의한 위험인자를 확인하기 위해 지난 2년간 본원에서 개심술을 시행한 환자들을 대상으로 후향적 분석을 시행하였다. 방법 뜻 대상: 2001년 3월부터 2003년 3월까지 본원 흉부외과에서 정중 흉골 절개술을 이용하여 개심술을 시행받은 123명의 환자 중 12명의 환자에게서 흉골 감염 및 종격동염이 발생하였으며 이에 대한 위험인자들을 분석하였다. 환자들을 연령, 성별, 당뇨, 만성 폐쇄성 폐질환, 비만의 유무로 나누었고 입원 후 수술까지의 기간, 수술 술기의 종류, 응급 수술의 여부, 재수술의 여부. 수술 시간, 체외 순환 시간, 수혈량, 수술 후 출혈량, 응급 재개흉의 여부, 흉골 재봉합의 여부, 기계 호흡 보조 시간, 그리고 중환자실 재원일수를 분석하였다 결과: 분석 결과 환자의 나이, 성별, 당뇨의 유무, 수술 술기의 종류, 재수술의 여부, 수술 시간이나 체외 순환 시간, 그리고 입원 후 수술까지의 기간 등은 창상 감염과는 유의한 연관이 없었다. 그 외 다른 변인들은 p-value가 .05 이하로 유의한 인자로서 나타났다. 조기에 응급 재개흉을한 경우, 흉골의 재봉합, 환자가 비만이거나 만성 페쇄성 폐질환을 진단 받은 경우, 수술 후 출혈량과 수혈량, 기계호흡 보조시간과 중환자실 재원일수 등의 나머지 인자들은 수술 후 감염과 유의한 연관이 있었다. 결론: 창상오염은 수술 전, 수술 중 그리고 수술 후에 발생할 수 있으며, 수술 후 환자에게 부수적인 수술적 처치를 시행하는 것은 환자의 수술 후 창상 감염에 유발 인자로 작용한다고 할 수 있다.

• Archives of Reconstructive Microsurgery
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• 제14권1호
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• pp.1-13
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• 2005

Purpose: The purpose of this study is to present extended indications for the use of arterialized venous flaps in reconstructing soft tissue, tendon, nerve, blood vessel, and composite tissue defects of the hand of various sizes based on researches and clinical experiences of the authors. Moreover, procedures to achieve complete flap survival and postoperative results are presented. Materials & methods: This study is based on 154 cases of arterialized venous flaps performed to reconstruct the hand during the past 11 years. The most common cause of injury was industrial accidents with 125 cases. One hundred thirty patients or 84% of the cases had emergency operation within 2 weeks of the injury. The flaps were categorized depending on the size of the flap. Flaps smaller than $10\;cm^2$ were classified as small (n=48), those larger than $25\;cm^2$ classified large (n=42) and those in between medium (n=64). Classified according to composition, there were 88 cases (57.1 %) of venous skin flaps, 28 cases of innervated venous flaps, 15 cases of tendocutaneous venous flaps, which incorporated the palmaris longus tendon, for repair of extensor tendons of the fingers, and 17 cases of conduit venous flaps to repair arterial defect. There were 37 cases where multiple injuries to multiple digits were reconstructed. Moreover, there were 6 cases of composite tissue effects that involved soft tissue, blood vessels and tendons. The donor sites were ipsilateral forearm, wrist and thenar area, foot dorsum, and medial calf. The recipient sites were single digit, multiple digits, first web space, dorsum and palm of hand, and wrist. Results: There were seven cases (4.5%) of emergent re-exploration due to vascular crisis, and 3 cases of flap failure characterized by more than 50% necrosis of the flap. The survival rate was 98.1 % (151/154). In small flaps, an average of 1.01 afferent arteries and 1.05 efferent veins were microanastomosed, and in large flaps, an average of 1.88 afferent arteries and 2.19 efferent veins were anastomosed. In 8 cases where innervated flaps were used for reconstructing the palm of the hand, the average static two-point discrimination was $10\;(8{\sim}15)\;mm$. In 12 cases where tenocutaneous flaps were used, active range of motion at the proximal interphalangeal joint was 60 degrees, 20 degrees at the distal interphalangeal joint, and 75 degrees at the metacarpophalangeal joint. Conclusion: We conclude that the arterialized venous flap is a valuable and effective tool in the reconstruction of hand injuries, and could have a more comprehensive set of indications.

• Journal of Chest Surgery
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• 제43권1호
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• pp.47-52
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• 2010

배경: 외상성 횡격막 파열은 흔하지는 않지만 응급을 요하는 손상이다. 이 연구에서는 외상성 횡격막 파열의 원인, 동반된 손상의 종류, 진단 방법, 수술 후 예후 인자 등을 알아 보고자 하였다. 대상 및 방법: 2001년 1월부터 2008년 12월까지 본원 응급실을 통해서 내원한 외상 환자들 중에서 수술을 통해서 외상성 횡격막 파열로 진단된 37명의 환자를 대상으로 하였다. 외상의 종류, 동반된 손상, 술 전 활력 징후, Injury Severity Score (ISS), 진단 방법 및 수술까지 걸린 시간, 수술 시 접근 방법, 파열부위 및 파열 정도, 파열된 횡격막을 통한 장기의 이탈 정도 등이 수술 후 사망률에 미치는 영향을 분석하였다. 결과: 둔상에 의한 경우가 30명(81.1%), 관통상에 의한 경우가 7명(18.9%)이었다. 34명 (91.9%)에서 횡격막 파열 이외에 동반된 손상이 있었으며, ISS는 평균 20.8이었다. 술 후 합병증은 총 11명(29.7%)에서 발생하였으며, 술 후 사망은 6명(16.2%)에서 발생하였다. 술 후 사망에 영향을 미치는 인자로는 술 전 기관 삽입, 술 전 저혈압, 20점 이상의 ISS 등이 있었다. 결론: 외상성 횡격막 파열은 다발성 손상의 한 부분으로 발생하는 손상이며, 수술 후 예후는 횡격막 손상 자체보다는 동반된 손상 정도에 따라 결정되었다.