• Title/Summary/Keyword: Safe Operation

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Mid-Term Results of Modified Hoffman Procedure for Rheumatoid Forefoot Deformity (류마티스 전족부 변형에 대한 변형 Hoffman 술식의 중기 결과)

  • Kim, Yoon-Chung;Choi, Hyun Chul;Lee, Hyo Jin;Ahn, Jae Hoon
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.484-490
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    • 2021
  • Purpose: A rheumatoid forefoot deformity includes severe hallux valgus and claw toe of the four lateral toes. The authors intended to analyze the mid-term results of the modified Hoffman procedure for a rheumatoid forefoot deformity. Materials and Methods: Twenty-two feet of eighteen patients were followed up for more than two years after the modified Hoffman procedure. The mean age was 54.7 years, and the mean follow-up period was three years and four months. Clinically visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) MP-IP score were analyzed preoperatively and postoperatively. The postoperative complications, the satisfaction of patients, and the presence of plantar callosity were also analyzed. Radiographically, the hallux valgus angle, the 1st intermetatarsal angle, the 1st interphalangeal angle, the 1st interphalangeal joint arthritic change after the operation, and the dorsiflexion angle and the time to union of the 1st metatarsophalangeal joint were analyzed. Results: Clinically, the VAS and AOFAS score were respectively improved from 7.1 points and 30.3 points preoperatively to 1.5 points and 83.1 points postoperatively (p<0.001). All patients were satisfied with the results. Plantar callosity disappeared in all cases. Radiographically, the mean hallux valgus angle, the 1st intermetatarsal angle, and the 1st interphalangeal angle changed from 52.8°, 13.3°, and 7.5° preoperatively to 16.2°, 8.7°, and 14.6° postoperatively (p<0.001). The mean dorsiflexion angle of the 1st metatarsophalangeal joint was 17.2° postoperatively. The mean time to radiographic union of the 1st metatarsophalangeal joint was 11.1 weeks. There were two cock-up deformities of the lesser toe, one wound problem, and two hallux interphalangeal joint arthritis as a complication. There were no cases of nonunion of the 1st metatarsophalangeal joint. Conclusion: The modified Hoffman procedure appears to be a safe and satisfactory procedure for a rheumatoid forefoot deformity.

Structure Analysis and Scale Model Test for Strength Performance Evaluation of Submersible Mooring Pulley Installed on Floating Offshore Wind Turbine (부유식 해상풍력발전기용 반잠수식 계류 풀리의 강도 성능평가를 위한 구조해석과 축소 모형시험)

  • Chang-Yong Song
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.29 no.5
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    • pp.479-487
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    • 2023
  • Recently, the destructive power of typhoons is continuously increasing owing to global warming. In a situation where the installation of floating wind turbines is increasing worldwide, concerns about the huge loss and collapse of floating offshore wind turbines owing to strong typhoons are deepening. A new type of disconnectable mooring system must be developed for the safe operation of floating offshore wind turbines. A new submersible mooring pulley considered in this study is devised to more easily attach or detach the floating of shore wind turbine with mooring lines compared with other disconnectable mooring apparatuses. To investigate the structural safety of the initial design of submersible mooring pulley that can be applied to an 8MW-class floating type offshore wind turbine, scale-down structural models were developed using a 3-D printer and structural tests were performed on the models. For the structural tests of the scale-down models, tensile specimens of acrylonitrile butadiene styrene material that was used in the 3-D printing were prepared, and the material properties were evaluated by conducting the tensile tests. The finite element analysis (FEA) of submersible mooring pulley was performed by applying the material properties obtained from the tensile tests and the same load and boundary conditions as in the scale-down model structural tests. Through the FEA, the structural weak parts on the submersible mooring pulley were reviewed. The structural model tests were conducted considering the main load conditions of submersible mooring pulley, and the FEA and test results were compared for the locations that exceeded the maximum tensile stress of the material. The results of the FEA and structural model tests indicated that the connection structure of the body and the wheel was weak in operating conditions and that of the body and the chain stopper was weak in mooring conditions. The results of this study enabled to experimentally verify the structural safety of the initial design of submersible mooring pulley. The study results can be usefully used to improve the structural strength of submersible mooring pulley in a detailed design stage.

Safety and Efficacy of Gemcitabine Based Chemotherapy in Elderly Patients with Advanced Pancreatic Cancer - Safety of Gemcitabine in Elderly (진행성 췌장암을 가진 노인환자에서 Gemcitabine 항암화학요법의 안정성과 효과 - 노인에서 Gemcitabine의 안정성 -)

  • You Ie Choi;Dong Uk Kim;Jae Hoon Cheong;Bong Eun Lee;Gwang Ha Kim;Geun Am Song
    • Journal of Digestive Cancer Research
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    • v.1 no.1
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    • pp.36-42
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    • 2013
  • Background/Aims: Gemcitabine is regarded as a reference regimen for advanced pancreatic cancer and shows relatively safe toxicity profiles compared with other cytotoxic agents. However, many oncologists are appeared to be still reluctant to treat elderly pancreatic cancer patients with cytotoxic chemotherapy because of predicted low response rate and potential adverse events. Methods: All patients who were received gemcitabine based chemotherapy between 2007 and 2010 were identified and clinical, laboratory, radiographic data were retrospectively reviewed. Patients were divided into two groups based on their ages: less than 65, and equal or more than 65 years old. Gemcitabine, at a dose of 1,000 mg per square meter of body surface area, was administered by intravenously over 30 minutes weekly for 3 weeks followed by 1 week rest, alone or along with other chemotherapeutic agents including cisplatin, capecitabine and erlotinib. Results: A total of 61 patients were identified and all patients were not eligible to receive operation because of advanced stage at diagnosis. Twenty three patients (37.7%) were equal or more than 65 year of age. Mean age was 56 years old and 71 years old in each group. Laboratory data including CA 19-9 were not significantly different. More gemcitabine monotherapy was delivered (56.5% vs. 26.3%, p=0.029) and less second or third line therapy was adminis- tered (17.4% vs. 50.0%, p=0.014) in elderly group. Cholangitis occurred and stent placement were performed similarly in both groups. Conclusion: Gemcitabine based chemotherapy can be administered safely to elderly pancreatic cancer patients and comparable response rate and progression free survival can be expected as young patients.

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Changes in the Behavior of Healthcare Organizations Following the Introduction of Drug Utilization Review Evaluation Indicators in the Healthcare Quality Evaluation Grant Initiative (의료질평가지원금 제도의 의약품안전사용서비스 평가지표 도입에 따른 의료기관의 행태 변화)

  • Hyeon-Jeong Kim;Ki-Bong Yoo;Young-Joo Won;Han-Sol Jang;Kwang-Soo Lee
    • Health Policy and Management
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    • v.34 no.2
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    • pp.178-184
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    • 2024
  • Background: This study aimed to determine the effectiveness of drug utilization review (DUR) evaluation indicators on safe drug use by comparing the changes in DUR inspection rates and drug duplication prescription prevention rates between the pre- and post-implementation of the DUR evaluation indicators of the Healthcare Quality Evaluation Grant Initiative. Methods: This study used DUR data from the Health Insurance Review and Assessment Service in 2018 (pre-implementation) and the evaluation results of the Healthcare Quality Evaluation Grant Initiative in 2023 (post-implementation). The dependent variables were the DUR evaluation indicators, including DUR inspection rate and drug duplicate prescription prevention rate. The independent variable was the implementation of the DUR evaluation indicators, and the control variables included medical institution characteristics such as type, establishment classification, location, DUR billing software company, and number of beds. Results: The results of the analysis of the difference in the prevention rate of drug duplicate prescriptions between the pre- and post-implementation of the DUR evaluation indicators of the Healthcare Quality Evaluation Grant Initiative showed that the prevention rate of drug duplicate prescriptions increased statistically significantly after the implementation of the DUR evaluation indicators. Conclusion: The policy implications of this study are as follows: First, ongoing evaluation of DUR systems is needed. Second, it is necessary to establish a collaborative partnership between healthcare organizations that utilize DUR system information and the organizations that manage it.

Grouting Improvement through Correlation Analysis of Hydrogeology and Discontinuity Factors in a Jointed Rock-Mass (절리 암반의 수리지질 및 불연속면 특성 간 상관분석을 통한 그라우팅 계획 수립의 개선 방안)

  • Kwangmin Beck;Seonggan Jang;Seongwoo Jeong;Minjune Yang
    • The Journal of Engineering Geology
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    • v.34 no.2
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    • pp.279-294
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    • 2024
  • Large-scale civil engineering structures such as dams require a systematic approach to jointed rock-mass grouting to prevent water leakage into the foundations and to ensure safe operation. In South Korea, rock grouting design often relies on the experience of field engineers that was gained in similar projects, highlighting the need for a more systematic and reliable approach. Rock-mass grouting is affected mainly by hydrogeology and the presence of discontinuities, involving factors such as the rock quality designation (RQD), joint spacing (Js), Lugeon value (Lu), and secondary permeability index (SPI). This study, based on data from field investigations of 14 domestic sites, analyzed the correlation between hydrogeological factors (Lu and SPI), discontinuity characteristics (RQD and Js), and grout take, and systematically established a design method for rock grouting. Analysis of correlation between the variables RQD, Js, Lu, and SPI yielded Pearson correlation (r) values as follows: Lu-SPI, 0.92; RQD-Lu, -0.75; RQD-Js, 0.69; RQD-SPI, -0.65; Js-Lu, -0.47; and SPI-Js, -0.41. The grout take increases with Lu and SPI values, but there is no significant correlation between RQD and Js. The proposed approach for grouting design based on SPI values was verified through analysis and comparison with actual curtain-grouting construction, and is expected to be useful in practical applications and future studies.

Evaluation of the Natural Vibration Modes and Structural Strength of WTIV Legs based on Seabed Penetration Depth (해상풍력발전기 설치 선박 레그의 해저면 관입 깊이에 따른 고유 진동 모드와 구조 강도 평가)

  • Myung-Su Yi;Kwang-Cheol Seo;Joo-Shin Park
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.30 no.1
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    • pp.127-134
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    • 2024
  • With the growth of offshore wind power generation market, the corresponding installation vessel market is also growing. It is anticipated that approximately 100 installation vessels will be required in the of shore wind power generation market by 2030. With a price range of 300 to 400 billion Korean won per vessel, this represents a high-value market compared to merchant vessels. Particularly, the demand for large installation vessels with a capacity of 11 MW or more is increasing. The rapid growth of the offshore wind power generation market in the Asia-Pacific region, centered around China, has led to several discussions on orders for operational installation vessels in this region. The seabed geology in the Asia-Pacific region is dominated by clay layers with low bearing capacity. Owing to these characteristics, during vessel operations, significant spudcan and leg penetration depths occur as the installation vessel rises and descends above the water surface. In this study, using penetration variables ranging from 3 to 21 m, the unique vibration period, structural safety of the legs, and conductivity safety index were assessed based on penetration depths. As the penetration depth increases, the natural vibration period and the moment length of the leg become shorter, increasing the margin of structural strength. It is safe against overturning moment at all angles of incidence, and the maximum value occurs at 270 degrees. The conditions reviewed through this study can be used as crucial data to determine the operation of the legs according to the penetration depth when developing operating procedures for WTIV in soft soil. In conclusion, accurately determining the safety of the leg structure according to the penetration depth is directly related to the safety of the WTIV.

A Legal Study on liability for damages cause of the air carrier : With an emphasis upon liability of passenger (항공운송인의 손해배상책임 원인에 관한 법적 고찰 - 여객 손해배상책임을 중심으로 -)

  • So, Jae-Seon;Lee, Chang-Kyu
    • The Korean Journal of Air & Space Law and Policy
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    • v.28 no.2
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    • pp.3-35
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    • 2013
  • Air transport today is a means of transport that is optimized for exchanges between nations. Around the world, has experienced an increase in operating and the number of airline route expansion that has entered into the international aviation agreements in order to take advantage of the air transport efficient, but the possibility of the occurrence of air transport accidents increased. When compared to the accident of other means of transport, development of air transport accidents, not high, but it leads to catastrophe aviation accident occurs. Air Transport accident many international transportation accident than domestic transportation accident, in the event of an accident, the analysis of the legal responsibility of the shipper or the like is necessary or passenger air carrier. Judgment of the legal order of discipline of air transport accident is a classification of the type of air transport agreement. Depending on the object, air transport agreements are classified into the contract of carriage of aviation of the air passenger transportation contract. For casualties occurs, air passenger transportation accident is a need more discussion of legal discipline for this particular. Korean Commercial Code, it is possible to reflect in accordance with the actual situation of South Korea the contents of the treaty, which is utilized worldwide in international air transport, even on the system, to control land, sea, air transport and welcoming to international standards. However, Korean Commercial Code, the problem of the Montreal Convention has occurred as it is primarily reflecting the Montreal Convention. As a cause of liability for damages, under the Commercial Code of Korea and the contents of the treaty precedent is reflected, the concept of accident is necessary definition of the exact concept for damages of passengers in particular. Cause of personal injury or death of passengers, in the event of an accident to the "working for the elevation" or "aircraft" on, the Montreal Convention is the mother method of Korea Commercial Code, liability for damages of air carrier defines. The Montreal Convention such, continue to be a matter of debate so far in connection with the scope of "working for the lifting of" the concepts defined in the same way from Warsaw Convention "accident". In addition, it is discussed and put to see if you can be included mental damage passenger suffered in air transport in the "personal injury" in the damage of the passenger is in the range of damages. If the operation of aircraft, injury accident, in certain circumstances, compensation for mental damage is possible, in the same way as serious injury, mental damage caused by aviation accidents not be able to live a normal life for the victim it is damage to make. So it is necessary to interpret and what is included in the injury to the body in Korea Commercial Code and related conventions, non-economic damage of passengers, clearly demonstrated from the point of view of prevention of abuse of litigation and reasonable protection of air carrier it must compensate only psychological damage that can be. Since the compensation of delay damages, Warsaw Convention, the Montreal Convention, Korea Commercial Code, there are provisions of the liability of the air carrier due to the delayed arrival of passenger and baggage, but you do not have a reference to delayed arrival, the concept of delay arrangement is necessary. The strict interpretation of the concept of delayed arrival, because it may interfere with safe operation of the air carrier, within the time agreed to the airport of arrival that is described in the aviation contract of carriage of passenger baggage, or, these agreements I think the absence is to be defined as when it is possible to consider this situation, requests the carrier in good faith is not Indian or arrive within a reasonable time is correct. The loss of passenger, according to the international passenger Conditions of Carriage of Korean Air, in addition to the cases prescribed by law and other treaties, loss of airline contracts, resulting in passengers from a service that Korean Air and air transport in question do damage was is, that the fact that Korean Air does not bear the responsibility as a general rule, that was caused by the negligence or intentional negligence of Korean Air is proof, negligence of passengers of the damage has not been interposed bear responsibility only when it is found. It is a clause in the case of damage that is not mandated by law or treaty, and responsible only if the negligence of the airline side has been demonstrated, but of the term negligence "for" intentional or negligent "Korean Air's Terms" I considered judgment of compatibility is required, and that gross negligence is appropriate. The "Korean Air international passenger Conditions of Carriage", airlines about the damage such as electronic equipment that is included in the checked baggage of passengers does not bear the responsibility, but the loss of baggage, international to arrive or depart the U.S. it is not the case of transportation. Therefore, it is intended to discriminate unfairly passengers of international flights arriving or departure to another country passengers of international flights arriving or departure, the United States, airlines will bear the responsibility for the goods in the same way as the contents of the treaty it should be revised in the direction.

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