• 대한응급의학회지
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• 제29권5호
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• pp.509-518
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• 2018

Objective: The evidence that hyperbaric oxygen (HBO) therapy is more effective for improving the acute neuropsychological status (ANS) of carbon monoxide poisoning than normobaric oxygen (NBO) therapy is not convincing. This is because the levels of carboxyhemoglobin (COHb) do not correlate with the clinical severity of carbon monoxide poisoning and there is no universally accepted severity scale of carbon monoxide poisoning. This paper suggests a new scale for the clinical and neurological severity of carbon monoxide poisoning, called the ANS, and assesses the effect of HBO therapy for each level of ANS compared to NBO therapy. Methods: A total of 217 patients who had been hospitalized because of carbon monoxide poisoning from January 2009 to July 2013 were studied. ANS was suggested as a new severity scale of carbon monoxide poisoning considered in the Glasgow Coma Scale, acute neuro-psychologic signs and symptoms, or cardiac ischemia on the initial medical contact. HBO therapy is indicated in those who have a loss of consciousness, seizure, coma, abnormal findings on a neurological examination, pregnancy, persistent cardiac ischemia, level of COHb >25%, or severe metabolic acidosis (pH <7.2). The end point is the day of discharge, and recovery is defined as a normal neuro-psychological status without any sequelae. Results: The levels of troponin T and creatinine increased significantly with increasing ANS score. In the moderate to severe group (ANS 2 and 3), the recovery rate was significantly higher when treated with HBO therapy than with NBO therapy (P=0.030). On the other hand, the development of delayed neuro-psychological sequelae (DNS) did not correlate with any level of ANS, type of oxygen therapy, or recovery on discharge. Conclusion: In the moderate to severe poisoned group, HBO therapy is more effective for improving the ANS from carbon monoxide poisoning than NBO therapy. On the other hand, the development of DNS of HBO therapy is no more preventable than with NBO therapy. Although the level of ANS is low, the patient needs to be provided with sufficient information and a follow-up visit is recommended for any abnormal symptoms because the ANS does not correlate with the development and degree of DNS.

• 한국융합학회논문지
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• 제13권5호
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• pp.531-539
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• 2022

정부는 COVID-19 확산을 방지하기 위해 사회적 거리두기 및 영업시간 제한 등의 정책을 시행하였고, COVID-19 장기 유행에 따라 소상공인들의 피해는 커지고 있다. 정부는 긴급재난지원금을 편성해 소상공인들의 경영압박을 해소하고자 하였다. 긴급재난지원금은 소상공인들에게 일시적인 도움이 되었지만, COVID-19 장기유행에 따라 경영 어려움은 커져갔다. 따라서 본 논문은 시스템 사고의 원형 중(Systme Archetype) 처방의 실패와 짐떠넘기기 원형을 활용하여 소상공인들의 회복력을 효과적으로 높일 수 있는 정책 지렛대로서의 정책 대안들을 탐색적으로 도출하고자 하였다. 소상공인들의 회복력을 높이기 위해 소상공인들의 긴급재정지원과 함께 소상공인들의 자생력을 높일 수 있는 지원이 필요하다.

• 한국콘텐츠학회논문지
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• 제11권10호
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• pp.267-273
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• 2011

이 논문은 재난 복구에 대한 이론적 고찰을 통해 재난 복구의 유형화와 사전 복구 계획의 설계에 관한 주요 내용을 살펴보는데 목적이 있다. 복구는 재난 발생 직후부터 피해 지역이 재난 발생 이전 상태로 회복 될 때까지의 장기적이고 지속적인 활동이다. 그리고 복구 단계는 비상대책 기간, 복원 기간, 재건 기간, 개발 재건 기간으로 구분할 수 있다. 복구 대책 또한 구호와 재활 활동으로 이루어지는 단기 복구 대책과 재건 활동으로 이루어지는 장기 복구 대책으로 구분하여 실시하는 것이 요구된다. 그리고 사전 복구 계획을 설계하는 경우, 재난 복구 조직의 명확한 설정과 주요 이해관계자의 확인, 임시 주거지의 위치 선정, 중요한 과업 수행 방식의 사전 결정, 피해자들이 이용당하지 않도록 계약자 허가 부여와 모니터링, 소매가격의 통제, 역사적 유물 유적이 있는 장소에서의 복구 작업 수행 방안, 그리고 복구 기간 동안 재난 피해 완화를 위한 법률 제정의 목표 구현 인식이 요구된다.

• Journal of Trauma and Injury
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• 제37권1호
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• pp.60-66
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• 2024

Purpose: This study investigated changes in interpersonal violence and utilization of trauma recovery services during the COVID-19 pandemic. At an urban level I trauma center, trauma recovery services (TRS) provide education, counseling, peer support, and coordination of rehabilitation and recovery to address social and mental health needs. The COVID-19 pandemic prompted considerable changes in hospital services and increases in interpersonal victimization. Methods: A retrospective analysis was conducted between September 6, 2018 and December 20, 2020 for 1,908 victim-of-crime patients, including 574 victims of interpersonal violence. Outcomes included length of stay associated with initial TRS presentation, number of subsequent emergency department visits, number of outpatient appointments, and utilization of specific specialties within the year following the initial traumatic event. Results: Patients were primarily female (59.4%), single (80.1%), non-Hispanic (86.7%), and Black (59.2%). The mean age was 33.0 years, and 247 patients (49.2%) presented due to physical assault, 132 (26.3%) due to gunshot wounds, and 76 (15.1%) due to sexual assault. The perpetrators were primarily partners (27.9%) or strangers (23.3%). During the study period, 266 patients (mean, 14.9 patients per month) presented before the declaration of COVID-19 as a national emergency on March 13, 2020, while 236 patients (mean, 25.9 patients per month) presented afterward, representing a 74.6% increase in victim-of-crime patients treated. Interactions with TRS decreased during the COVID-19 period, with an average of 3.0 interactions per patient before COVID-19 versus 1.9 after emergency declaration (P<0.01). Similarly, reductions in length of stay were noted; the pre-COVID-19 average was 3.6 days, compared to 2.1 days post-COVID-19 (P=0.01). Conclusions: While interpersonal violence increased, TRS interactions decreased during the COVID-19 pandemic, reflecting interruption of services, COVID-19 precautions, and postponement/cancellation of elective visits. Future direction of hospital policy to enable resource and service delivery to this population, despite internal and external challenges, appears warranted.

• Journal of Trauma and Injury
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• 제27권4호
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• pp.211-214
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• 2014

A 34-year-old woman experienced a sudden cardiac arrest after complaining of abdominal pain. The cause of that serious event was a hidden hemorrhagic shock. On computed tomography of her pelvic area, we found that her left common iliac artery had been ruptured. No bone fractures were observed. Her angiography showed neither atherosclerosis nor an aneurysm of the artery. Because spontaneous ruptures of the common iliac artery are rare, we suspected, based on her husband's statement, that a hidden blunt trauma to the artery had occurred via an endo-vaginal route due to dildo masturbation. Unfortunately, she died without recovery, in spite of our having controlled the bleeding by using an angiographic endovascular stent-graft.

• 대한임상독성학회지
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• 제11권1호
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• pp.23-27
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• 2013

Zoletil is a non-opioid, non-barbiturate animal anesthetic and proprietary combination of two drugs, a dissociative anesthetic drug, tiletamine, with the benzodiazepine anxiolytic drug, zolazepam. Zoletil has greater potency than ketamine. Zoletil is abused for recreational purposes, especially by people with easy access to medicine. However, in Korea, it is available over-the-counter. Here we report on a case of an 83-year-old woman who received injection of seven vials of "Zoletil 50" by her daughter and presented with an altered mental change. Her mental state was stupor and vital sign was hypotension, bradycardia. Her blood tests indicated metabolic and respiratory acidosis and hyperkalemia. She was treated with intravenous naloxone and flumazenil but was not responsive. She was admitted to the ICU and treated with supportive therapy. Her mental state showed transient recovery, however, her clinical manifestation worsened and she expired.

• 한국문헌정보학회지
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• 제40권4호
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• pp.85-110
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• 2006

최근 세계 각 지역에서 지진과 태풍 및 쓰나미와 같은 각종 재난과 재해에 관한 뉴스가 보도되는 가운데 우리나라에서도 역시 지진이나 테러 등의 영역에서 자유롭지 못한 것으로 여겨진다. 도서관 역시 많은 이용자가 출입하는 장소로 각종 재난의 대책을 미리 준비하여야할 기관이다. 이에 연구자는 서울. 대전, 전북지역의 공공도서관 75곳을 대상으로 비상시 재난대책에 관한 현 실정을 분석하였다. 각 도서관마다 재난의 유형별 발생 원인과 복구방안 등을 검토하였고, 도서관 운영 중 재난관리상의 요소와 시설 및 장비요구 인적담당요원의 고용과 배정실태 및 이용자를 위한 안전강좌의 시행과 교육방법등 4가지요소를 기초로 면밀히 조사 분석하였다. 검토 후 각 요소별에 따른 문제점 분석과 함께 그 해결방안 및 미래 재난대책을 위한 개선점과 제안점 등을 정리하였다.

• 성인간호학회지
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• 제23권1호
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• pp.87-99
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• 2011

Purpose: The study was designed to identify the factors that influence the length of stay of elderly people in the recovery room. Methods: The design of the study was descriptive correlation. The subjects were 196 general anesthesia patients. The data were analyzed by SPSS/WIN 17.0 program. Results: The average length of stay in the recovery room was 62.62 minutes. The length of stay in the recovery room was influenced by age (27.50%); number of diseases (12.97%) and albumin level (6.75%). Other related post operative factors (30.98%) were abnormal ABGA, shivering, PAR score, pain, arrhythmia, amount of bleeding, cardiovascular complication, hypertension and delirium. Those factors explained 78.2% out of the total variance of the length of stay. The strongest effector was the abnormal ABGA (${\beta}$=.226) and then shivering (${\beta}$=.222). Conclusion: The influencing factors should be assessed and monitored for the aged before and after surgery. Further research is needed to find the exact factors for ICU transfer elderly from recovery room and emergency surgery target.

• 제어로봇시스템학회논문지
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• 제14권3호
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• pp.307-317
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• 2008

Relaxed static stability(RSS) concept has been applied to improve aerodynamic performance of modem version supersonic jet fighter aircraft. Therefore, flight control system are necessary to stabilize an unstable aircraft and provides adequate handling qualities. Also, flight control systems of modem version aircraft employ a safety system to support emergency situations such as a pilot unknown attitude flight conditions of an aircraft in night flight-testing. This situation is dangerous because the aircraft can lose if the pilot not take recognizance of situation. Therefore, automatic recovery system is necessary. The system called the "Pilot Activated Recovery System" or PARS, provided a pilot initiated automatic maneuver capable of an aircraft recoveries in situations of unusual attitudes. This paper addresses the concept of PARS and designed using nonlinear control law design process based on model of supersonic jet trainer. And, this control law is verified by nonlinear analysis and real-time pilot evaluation using in-house software. The result of evaluation reveals that the PARS support recovery of an aircraft unusual attitude and improve a safety of an aircraft.

• 한국가스학회지
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• 제19권6호
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• pp.105-109
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• 2015

본 연구는 해상 유류오염사고가 발생한 경우 효율적인 방재 작업을 수행하기 위하여 개발된 오일 회수장치로서, 오일 회수장치를 통하여 해상에 유출된 기름을 높은 회수율로 신속하게 처리하는 것을 목표로 한다. 오일 회수장치는 기존의 흡착포 및 유류처리제를 이용한 정화 방식에서 발생하는 2차 오염을 방지할 수 있으며 오일 회수율 또한 우수한 특징을 가진다. 또한 유증기에 의한 폭발 방지 기구를 채택하여 오일 회수 작업시 발생할 수 있는 위험 요소를 제거 하였다.