• Clinical and Experimental Emergency Medicine
• /
• 제5권4호
• /
• pp.256-263
• /
• 2018

Objective We conducted a study to validate the effectiveness of the Korean criteria for trauma team activation (TTA) and compared its results with a two-tiered system. Methods This observational study was based on data from the Korean Trauma Data Bank. Within the study period, 1,628 trauma patients visited our emergency department, and 739 satisfied the criteria for TTA. The rates of overtriage and undertriage in the Korean one-tiered system were compared with the two-tiered system recommended by the American College of Surgery-Committee on Trauma. Results Most of the patient's physiologic factors reflected trauma severity levels, but anatomical factors and mechanism of injury did not show consistent results. In addition, while the rate of overtriage (64.4%) was above the recommended range according to the Korean criteria, the rate of undertriage (4.0%) was within the recommended range. In the simulated two-tiered system, the rate of overtriage was reduced by 5.5%, while undertriage was increased by 1.8% compared to the Korean activation system. Conclusion The Korean criteria for TTA showed higher rates of overtriage and similar undertriage rates compared to the simulated two-tier system. Modification of the current criteria to a twotier system with special considerations would be more effective for providing optimum patient care and medical resource utilization.

• 한국안전학회지
• /
• 제33권6호
• /
• pp.102-114
• /
• 2018

The Railway Safety Management System is based on risk management and the basic purpose of risk management is safety management activities to prevent railway accidents and operational obstacles in advance. In order to manage risk, an acceptable risk standard must be established. This risk criterion is used to evaluate the railway risk with both frequency and severity. In the case of overseas railway or other industrial sectors, various factors are reflected in the main variables that constitute the occurrence frequency, but this is no the case in the domestic railway sector. In particular, the current risk assessment criteria in the railway sector remain at a level that exploits the incidents that have occurred in the past and the severity of the property damage and it dose not properly reflect complex and diverse environmental and situational changes in railway operations. Therefore, in this study, it is possible to calculate the potential occurrence of future events instead of occurrence frequency as a component of the risk assessment criteria, focusing on the High-Speed Railway. In addition to the property damage to the consequence, we suggest a rational methodology, development direction, and theoretical implications for constructing accurate and reasonable risk criteria including actual damage such as human injury and time loss.

• Journal of Trauma and Injury
• /
• 제20권2호
• /
• pp.77-82
• /
• 2007

Purposes: There have been many efforts to improve the service of emergency centers. In spite of these, no evidence is showing any landmark advancement of emergency services, especially in the hospital stage, exists. We need some efficient standard criteria to evaluate emergency service in the hospital stage, and a useful method might utilize the overcrowding index. We want to know the change in the overcrowding index at a regional emergency center after injury area administration. Injury area means an area in which only an assigned duty physician manages patients with injuries such as those from traffic accidents, falls, assualts, collisions, lacerations, amputations, bums, intoxication, asphyxia, drowning, animal bites, sexual assualts, etc. Methods: We started to operate an injury area in our emergency department from late 2004, and from January to June in 2004 and in 2005, we collected patients' data, age, sex, assigned department, and result from hospital order communication system to figure out overcrowding indices and result indices. We found the daily number of patients, the turnover rate, the admission rate, the ICU admission rate, the emergency operation rate, the ED stay duration, and the ED patient volume to be overcrowding indices. Also we found the withdrawal rate, the transfer rate, and mortality to be result indices. We compared these indices between 2004 to 2005 by using a t-test. Results: There was a significant increase in the daily number of visiting patients in 2005, overcrowding indices, such as the turnover rate, the admission rate, the ICU admission rate, and the emergency operation rate, also showed statistically significant increases in 2005 (P<0.001). As for the result indices, there was a noticeable decrease in the number of withdrawals (11.77/day in 2004 to 4.53/day in 2005). Conclusion: Operating an injury area in a mildly overcrowded local emergency center is beneficial. Evaluating the effect of operating an injury area and it's impact on hospital finances by conducting a similar study analyziing patients for a longer duration would be valuable.

• 한국소음진동공학회:학술대회논문집
• /
• 한국소음진동공학회 2007년도 추계학술대회논문집
• /
• pp.421-424
• /
• 2007

Currently domestic criteria for the aircraft noise is being adapted WECPNL(weighted equivalent continuous perceived noise level), while internationally preferred method is $L_{dn}$ which is based on from $L_{eq}$ and can also evaluate environmental noise. WECPNL used in domestic as an evaluation metric is only for the aircraft noise. It is, therefore, not adequate for the evaluation of residents' injury, moreover, it is very difficult to measure the aircraft noise by WECPNL due to the complicated calculating procedures as long as automatic measuring system is not used. Accordingly, this study aims to propose alternative evaluation metric for the aircraft noise. To achieve this purpose, WECPNL, $L_{eq}$, $L_{dn}$, other metrics and criteria were compared and analyzed.

• 한국산학기술학회:학술대회논문집
• /
• 한국산학기술학회 2006년도 춘계학술발표논문집
• /
• pp.109-111
• /
• 2006

본 논문은 보행자 머리 상해치 예측을 통해 보행자 보호 법규의 만족여부를 판단하는 시스템을 구축 하는데 있다. 차량의 FE DATA와 더미 DATA를 입력하고, MADYMO solver를 이용하여 해석을 수행한다. 이를 통해 나온 결과 HIC(머리상해치)와 보행자 보호 법규에서 제시하는 HIC(머리상해치)와 비교를 통해 만족여부를 판단한다. 강화되는 보행자 보호 법규를 만족시키기 위해 차량시스템을 개선을 유도 하고 이를 통해 차량 대 보행자 사고 시 보행자의 생명을 구하는데 그 궁극적인 목적이 있다.

• 한국철도학회:학술대회논문집
• /
• 한국철도학회 1999년도 추계학술대회 논문집
• /
• pp.398-404
• /
• 1999

Safety of passengers in the Korean High Speed Train, KHST, was evaluated under the different accident scenarios. Preliminary occupant analysis has been performed based on the TGV-K train seat characteristics. The influence of the vehicle deceleration and passenger type, seating positions, effectiveness of compartmentalization have been evaluated in terms of occupant injury criteria. This study is the final result of the occupant analysis of KHST project at 1st stage 3rd year.

• The Korean Journal of Pain
• /
• 제37권2호
• /
• pp.107-118
• /
• 2024

Nociplastic pain by the "International Association for the Study of Pain" is defined as pain that arises from altered nociception despite no clear evidence of nociceptive or neuropathic pain. Augmented central nervous system pain and sensory processing with altered pain modulation are suggested to be the mechanism of nociplastic pain. Clinical criteria for possible nociplastic pain affecting somatic structures include chronic regional pain and evoked pain hypersensitivity including allodynia with after-sensation. In addition to possible nociplastic pain, clinical criteria for probable nociplastic pain are pain hypersensitivity in the region of pain to non-noxious stimuli and presence of comorbidity such as generalized symptoms with sleep disturbance, fatigue, or cognitive problems with hypersensitivity of special senses. Criteria for definitive nociplastic pain is not determined yet. Eight specific disorders related to central sensitization are suggested to be restless leg syndrome, chronic fatigue syndrome, fibromyalgia, temporomandibular disorder, migraine or tension headache, irritable bowel syndrome, multiple chemical sensitivities, and whiplash injury; non-specific emotional disorders related to central sensitization include anxiety or panic attack and depression. These central sensitization pain syndromes are overlapped to previous functional pain syndromes which are unlike organic pain syndromes and have emotional components. Therefore, nociplastic pain can be understood as chronic altered nociception related to central sensitization including both sensory components with nociceptive and/or neuropathic pain and emotional components. Nociplastic pain may be developed to explain unexplained chronic pain beyond tissue damage or pathology regardless of its origin from nociceptive, neuropathic, emotional, or mixed pain components.

• The Journal of Korean Physical Therapy
• /
• 제26권3호
• /
• pp.216-219
• /
• 2014

Purpose: We presented with a patient with traumatic brain injury who showed a transcallosal ipsilateral motor pathway from unaffected motor cortex to affected extremities, as evaluated by diffusion tensor tractography (DTT). Methods: One patient and six age-matched normal subjects were enrolled. A 42-year-old left hemiparetic male who suffered from brain injury by motor vehicle accident 9 years ago showed a leukomalactic lesion in the right corona radiata and parieto-temporal lobe. His left extremities were completely paralyzed initially, but recovered slowly over 2 years. At the time of the evaluation, he was able to grasp and release an object, and to walk with spastic gait pattern. DTT was performed using 1.5 T with a Synergy-L Sensitivity Encoding head coil. DTT was obtained with termination criteria of FA <0.2 and an angle change > $45^{\circ}c$. Results: The motor tracts of the unaffected (left) hemisphere of the patient and control subjects originated from the motor cortex and descended along the known corticospinal tract without any transcallosal tract. By contrast, the tract of the affected (right) hemisphere originated from the left premotor cortex, descended through the left corona radiata, and then crossed the mid-portion of the corpus callosum. The tract then descended through the known corticospinal tract pathway to the right medulla. Conclusion: We conclude that the transcallosal ipsilateral motor pathway from the unaffected hemisphere appeared to contribute to the motor recovery in this patient.

• Journal of Trauma and Injury
• /
• 제29권4호
• /
• pp.105-115
• /
• 2016

Purpose: While all midshaft clavicle fractures have traditionally been treated with conservative measures, recent operative treatment of displaced, communited midshaft clavicle fractures has become more common. Though a recent increase in operative treatment for midshaft clavicle fractures, we have done the operative methods in limited cases. The aim of this study is to present indications, operative techniques and outcomes of the experienced cases that have applied to this limited group over the previous 10 years. Methods: This study consists of a retrospective review of radiological and clinical data from January of 2005 to July of 2015. Operative criteria for midshaft clavicle fractures having considerable risk of bone healing process were 4 groups - a floating shoulder, an open fracture, an associated neurovascular injury, and a nonunion case after previous treatment. Results: The study consisted of 18 patients who had operative treatment for midshaft clavicle fractures in adults. The most common surgical indication was a floating shoulder (10 cases, 55.6%), followed by nonunion (5 cases, 27.8%), an associated neurovascular injury (4 cases, 22.2%), and open fracture (3 cases, 16.7%). All cases were treated by open reduction and internal fixation in anterosuperior position with reconstruction plate or locking compression plate. Bone union was achieved in all cases except 1 case which was done bone resection due to infected nonunion. Mean bone union period was 19.5 weeks. There were no postoperative complications, but still sequelae in 4 cases of brachial plexus injury. Conclusion: We have conducted an open reduction and internal fixation by anterosuperior position for midshaft clavicle fractures in very limited surgical indications for last 10 years. Our treatment strategy for midshaft clavicle fractures showed favorable radiological results and low postoperative complications.

• 한국직업건강간호학회지
• /
• 제25권1호
• /
• pp.65-74
• /
• 2016

Purpose: The purpose of this study is to predict industrial accident rate using time series analysis. Methods: The rates of industrial accident and occupational injury death were analyzed using industrial accident statistics analysis system of the Korea Occupational Safety and Health Agency from 2001 to 2014. Time series analysis was done using the most recent data, such as raw materials of Economically Active Population Survey, Economic Statistics System of the Bank of Korea, and e-National indicators. The best-fit model with time series analysis to predict occupational injury was developed by identifying predictors when the value of Akaike Information Criteria was the lowest point. Variables into the model were selected through a series of expertises' consultations and literature review, which consisted of socioeconomic structure, labor force structure, working conditions, and occupational accidents. Results: Indexes at the meso- and macro-levels predicting well occurrence of occupational accidents and occupational injury death were labor force participation rate for ages 45-49 and budget for small scaled workplace support. The rates of industrial accident and occupational injury death are expected to decline. Conclusion: For reducing industrial accident continuously, we call for safe employment policy of economically active middle aged adults and support for improving safety work environment of small sized workplace.