• Korean Chemical Engineering Research
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• v.57 no.5
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• pp.637-651
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• 2019

In the event of a major accident such as an explosion in a refinery or a petrochemical plant, it has caused a serious loss of life and property and has had a great impact on the insurance market. In the case of catastrophic incidents occurring in process industries such as refinery and petrochemical plants, only the proximate causes of loss have been drawn and studied from inspectors or claims adjustors responsible for claims of property insurers, incident cause investigators, and national forensic service workers. However, it has not been done well for conducting root cause analysis (RCA) and identifying the factors that contributed to the failure and establishing preventive measures before leading to chemical plant's catastrophic incidents. In this study, the criteria of warning signs on CCPS catastrophic incident waning sign self-assessment tool which was derived through the RCA method and the contribution factor analysis method using the swiss cheese model principle has been reviewed first. Secondly, in order to determine the major incident warning signs in an actual chemical plant, 614 recommendations which have been issued during last the 17 years by loss control engineers of global reinsurers were analyzed. Finally, in order to facilitate the assessment index for catastrophic incident warning signs, the criteria for the catastrophic incident warning sign index at chemical plants were grouped by type and classified into upper category and lower category. Then, a catastrophic incident warning sign index for a chemical plant was developed using the weighted values of each category derived by applying the analytic hierarchy process (pairwise comparison method) through a questionnaire answered by relevant experts of the chemical plant. It is expected that the final 'assessment index for catastrophic incident warning signs' can be utilized by the refinery and petrochemical plant's internal as well as external auditors to assess vulnerability levels related to incident warning signs, and identify the elements of incident warning signs that need to be tracked and managed to prevent the occurrence of serious incidents in the future.

• Journal of the Society of Disaster Information
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• v.16 no.4
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• pp.813-823
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• 2020

Purpose: In order to maximize the stability and productivity of the work through simulation prior to high-risk facilities and high-cost work such as dismantling the facilities inside the reactor, we intend to use digital twin technology that can be closely controlled by simulating the specifications of the actual control equipment. Motion control errors, which can be caused by the time gap between precision control equipment and simulation in applying digital twin technology, can cause hazards such as collisions between hazardous facilities and control equipment. In order to eliminate and control these situations, prior research is needed. Method: Unity 3D is currently the most popular engine used to develop simulations. However, there are control errors that can be caused by time correction within Unity 3D engines. The error is expected in many environments and may vary depending on the development environment, such as system specifications. To demonstrate this, we develop crash simulations using Unity 3D engines, which conduct collision experiments under various conditions, organize and analyze the resulting results, and derive tolerances for precision control equipment based on them. Result: In experiments with collision experiment simulation, the time correction in 1/1000 seconds of an engine internal function call results in a unit-hour distance error in the movement control of the collision objects and the distance error is proportional to the velocity of the collision. Conclusion: Remote decomposition simulators using digital twin technology are considered to require limitations of the speed of movement according to the required precision of the precision control devices in the hardware and software environment and manual control. In addition, the size of modeling data such as system development environment, hardware specifications and simulations imitated control equipment and facilities must also be taken into account, available and acceptable errors of operational control equipment and the speed required of work.

• Korean Journal of School Psychology
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• v.16 no.3
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• pp.433-451
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• 2019

This study aimed to develop and validate the Classroom Problem Behavior Scale - Elementary School Version (CPBS-E) measure which is unique to classroom problem behavior exhibited by Korean elementary school students. The focus was on developing a universal screening instrument designed to identify and provide intervention to students who are at-risk for severe social-emotional and behavioral problems. Items were initially drawn from the literature, interviews with elementary school teachers, common office discipline referral measures used in U.S. elementary schools, penalty point systems used in Korean schools, 'Green Mileage', and the Inventory of Emotional and Behavioral Traits. The content validity of the initially developed items was assessed by six classroom and subject teachers, which resulted in the development of a preliminary scale consisting of 63 two-dimensional items (i.e., Within Classroom Problem Behavior and Outside of Classroom Problem Behavior), each of which consisted of 3 to 4 factors. The Within Classroom Problem Behavior dimension consisted of 4 subscales (not being prepared for class, class disruption, aggression, and withdrawn) and the Outside of Classroom Problem Behavior dimension consisted of 3 subscales (rule-violation, aggression, and withdrawn). The CPBS-E was pilot tested on a sample of 154 elementary school students, which resulted in reducing the scale to 23 items. Following the scale revision, the CPBS-E was validated on a sample population of 209 elementary school students. The validation results indicated that the two-dimensional CPBS-E scale of classroom problem behavior was a reliable and valid measure. The test-retest reliability was stable at above .80 in most of the subscales. The CPBS-E measure demonstrated high internal consistency of .76-.94. In examining the criterion validity, the scale's correlation with the Teacher Observation of Classroom Adaptation-Checklist (TOCA-C) was high and the aggression and withdrawn subscales of the CPBS-E demonstrated high correlations with externalization and internalization, respectively, of the Child Behavior Checklist - Teacher Report Form CBCL-TRF). In addition, the factor structure of the CPBS-E scale was examined using the structural equation model and found to be acceptable. The results are discussed in relation to implications, contributions to the field, and limitations.

• Journal of the Korean Society of Radiology
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• v.82 no.3
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• pp.562-574
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• 2021

MRI has the advantages of having excellent soft-tissue contrast and providing functional information without any harmful ionizing radiation. Although previous technical limitations restricted the use of chest MRI, recent technological advances and expansion of insurance coverage are increasing the demand for chest MRI. Recognizing the need for guidelines on appropriate use of chest MRI in Korean clinical settings, the Korean Society of Radiology has composed a development committee, working committee, and advisory committee to develop Korean chest MRI justification guidelines. Five key questions were selected and recommendations have been made with the evidence-based clinical imaging guideline adaptation methodology. Recommendations are as follows. Chest MRI can be considered in the following circumstances: for patients with incidentally found anterior mediastinal masses to exclude non-neoplastic conditions, for pneumoconiosis patients with lung masses to differentiate progressive massive fibrosis from lung cancer, and when invasion of the chest wall, vertebrae, diaphragm, or major vessels by malignant pleural mesothelioma or non-small cell lung cancer is suspected. Chest MRI without contrast enhancement or with minimal dose low-risk contrast media can be considered for pregnant women with suspected pulmonary embolism. Lastly, chest MRI is recommended for patients with pancoast tumors planned for radical surgery.

• Radiation Oncology Journal
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• v.25 no.1
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• pp.16-25
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• 2007

[ $\underline{Purpose}$ ]: Breast conserving surgery (BCS) followed by chemotherapy (CTx.) and radiation therapy (RT) is widely performed for the treatment of early breast cancer. This retrospective study was undertaken to evaluate our interim results in terms of failure patterns, survival and relative risk factors. $\underline{Materials\;and\;Methods}$: From January 1999 through December 2003, 129 patients diagnosed with invasive breast cancer and treated with BCS followed by RT were subject to retrospective review. The median age of the patients was 45 years (age distribution, $27{\sim}76$ years). The proportions of patients according to their tumor, nodes, and metastases (TNM) stage were 65 (50.4%) in stage I, 41 (31.7%) in stage IIa, 13 (10.1%) in stage IIb, 9 (7.0%) in stage III, and 1 patient (0.8%) in stage IIIc. For 32 patients (24.8%), axillary node metastasis was found after dissection. BCS consisted of quadrantectomy in 115 patients (89.1%) and lumpectomy in 14 patients (10.6%). Axillary node dissection at axillary level I and II was performed for 120 patients (93%). For 7 patients (5.4%), only sentinel node dissection was performed with BCS. For 2 patients (1.6%) axillary dissection of any type was not performed. Postoperative RT was given with 6 MV X-rays. A tumor dose of 50.4 Gy was delivered to the entire breast area using a tangential field with a wedge compensator. An aditional dose of $9{\sim}16\;Gy$ was given to the primary tumor bed areas with electron beams. In 30 patients (23.3%), RT was delivered to the supraclavicular node. Most patients had adjuvant CTx. with $4{\sim}6$ cycles of CMF (cyclophosphamide, methotrexate, 5-fluorouracil) regimens. The median follow-up period was 50 months (range: $17{\sim}93$ months). $\underline{Results}$: The actuarial 5 year survival rate (5Y-OSR) was 96.9%, and the 5 year disease free survival rate (5Y-DFSR) was 93.7%. Local recurrences were noted in 2 patients (true: 2, regional node: 1) as the first sign of recurrence at a mean time of 29.3 months after surgery. Five patients developed distant metastases as the first sign of recurrence at $6{\sim}33$ months (mean 21 months). Sites of distant metastatic sites were bone in 3 patients, liver in 1 patient and systemic lesions in 1 patient. Among the patients with distant metastatic sites, two patients died at 17 and 25 months during the follow-up period. According to stage, the 5Y-OSR was 95.5%, 100%, 84.6%, and 100% for stage I, IIa, IIb, and III respectively. The 5Y-DFSR was 96.8%, 92.7%, 76.9%, and 100% for stage I, IIa, IIb, and III respectively. Stage was the only risk factor for local recurrence based on univariate analysis. Ten stage III patients included in this analysis had a primary tumor size of less than 3 cm and had more than 4 axillary lymph node metastases. The 10 stage III patients received not only breast RT but also received posterior axillary boost RT to the supraclavicular node. During the median 53.3 months follow-up period, no any local or distant failure was found. Complications were asymptomatic radiation pneumonitis in 10 patients, symptomatic pneumonitis in 1 patient and lymphedema in 8 patients. $\underline{Conclusion}$: Although our follow up period is short, we had excellent local control and survival results and reaffirmed that BCS followed by RT and CTx. appears to be an adequate treatment method. These results also provide evidence that distant failure occurs earlier and more frequent as compared with local failure. Further studies and a longer follow-up period are needed to assess the effectiveness of BCS followed by RT for the patients with less than a 3 cm primary tumor and more than 4 axillary node metastases.

• Journal of Chest Surgery
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• v.36 no.1
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• pp.1-6
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• 2003

Currently, atrial septal defect repair has been considered low risk operation duo to the development of open heart surgery Not only the operation itself, but also the cosmetic aspect is now focused. Though many methods exist as minimally invasive cardiac surgery in atrial septal defect repair, some surgeons advocate that right anterolateral thoracotomy is better than the others in the cosmetic aspect and we compared right anterolateral thoracotomy with median sternotomy. Material and Method: From January 1999 to August 2002, 43 patient underwent atrial septal defect repair by one operator, including 15 patients through right anterolateral thoracotomy(group A) and 15 patients through median sternotomy(group B) in Hanyang university Hospital. The data were randomized and operation outcomes were analyzed between these two groups. Result: The mean weight of group A was 38.77$\pm$15.57kg and 38.21$\pm$21.82kg in group B. In group A, mean operation (OP) time was 197.6$\pm$61.40min, mean cardiopulmonary bypass(CPB) time was 48.66$\pm$13.02min and mean fibrillation time or aortic cross clamp(ACC) time was 30$\pm$11.64min. In group B, mean OP time was 212.33$\pm$31.95min, mean CPB time was 55$\pm$12.10min, and mean fibrillation or ACC time was 29.33$\pm$9.04min. There was no significant differences in these two groups. In group A, mean mechanical ventilation time was 3.78$\pm$0.78 hours, mean postoperative ICU stay was 1.2$\pm$0.47 days and mean postoperative hospital stay was 10.20 41.08 days. In group B, mean mechanical ventilation time was 5.95$\pm$3.73 hours, mean post operative ICU stay was 1.41$\pm$0.61 days, and mean postoperative hospital stay was 12.20$\pm$3.55 days. There was no any significant difference in two groups. Group A had significantly lower mean thoracic and pleuropericardial drainage than group B (175.33$\pm$90.54cc vs 352.33$\pm$239.43cc, p<0.05). Complication was seen in one case in group B, transient 2nd degree A-V block. Conclusion: Right anterolateral thoracotomy was better than median sternotomy not only in cosmetic aspect but also in postoperative thoracic and pleuropericardial drainage, using the same instrument(p.0.05). But, right anterolateral thoracotomy was more technically difficult due to narrow operative field and we should be careful of aortic cannulation.

• Radiation Oncology Journal
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• v.16 no.4
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• pp.485-495
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• 1998

Purpose : The major goal of the therapy in the soft tissue sarcoma is to control both local and distant tumor. However, the technique of obtaining local control has changed significantly over the past few decades from more aggressive surgery to combined therapy including conservative surgery and radiation and/or chemotherapy. We retrospectively analyzed the treatment results of the postoperative radiation therapy of soft tissue sarcoma and its prognostic factor. Materials and Methods : Between March 1983 and June 1994, 50 patients with soft tissue sarcoma were treated with surgery and postoperative radiation therapy at Kang-Nam St. Mary's hospital. Complete follow up was possible for all patients with median follow up duration 50 months (range 6-162 months). There were 28 male and 32 female patients. Their age ranged from 6 to 83 with a median of 44 years. Extremity (58$\%$) was the most frequent site of occurrence followed by trunk (20$\%$) and head and neck (12$\%$). Histologically malignant fibrous histiocytoma (23$\%$), liposarcoma (17$\%$), malignant schwannoma (12$\%$) constitute 52$\%$ of the patients. Daily radiation therapy designed to treat all areas at a risk for tumor spread upto dose of 4500-5000 cGy. A shrinking field technique was then used and total 55-65 Gy was delivered to tumor bed. Twenty-five patients (42$\%$) received chemotherapy with various regimen in the postoperative period. Results : Total 41 patients failed either with local recurrence or with distant metastasis. There were 29 patients (48$\%$) of local recurrence. Four patients (7$\%$) developed simultaneous local recurrence and distant metastasis and 8 patients (13$\%$) developed only distant metastasis. Local recurrence rate was rather higher than of other reported series. This study included patients of gross residual, recurrent cases after previous operation, trunk and head and neck Primary This feature is likely explanation for the decreased local control rate. Five of 29 Patients who failed only locally were salvaged by re-excision and/or re-irradiation and remained free of disease. Factors affecting local control include histologic type, grade, stage, extent of operation and surgical margin involvement, lymph node metastasis (p<0.05). All 21 patients who failed distantly are dead with progressive disease at the time of this report. Our overall survival results are similar to those of larger series. Actuarial 5 year overall survival and disease free survival were 60.4 $\%$, 30.6$\%$ respectively. Grade, stage (being close association with grade), residual disease (negative margin, microscopic, gross) were significant as a predictor of survival in our series (p<0.05). Conclusion : Combined surgery and postoperative radiation therapy obtained 5 year survival rate comparable to that of radical surgery.