• Journal of Korean Neurosurgical Society
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• v.60 no.5
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• pp.604-609
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• 2017

Objective : An adjustable Ghajar guide is presented to improve the accuracy of the original Ghajar guide technique. The accuracy of the adjustable Ghajar guide technique is also investigated. Methods : The coronal adjustment angle from the orthogonal catheter trajectory at Kocher's point is determined based on coronal head images using an electronic picture archiving and communication system. For the adjustable Ghajar guide, a protractor is mounted on a C-shaped basal plate that is placed in contact with the margin of a burrhole, keeping the central $0^{\circ}$ line of the protractor orthogonal to the calvarial surface. A catheter guide, which is moved along the protractor and fixed at the pre-determined adjustment angle, is then used to guide the ventricular catheter into the frontal horn adjacent to the foramen of Monro. The adjustable Ghajar guide technique was applied to 20 patients, while a freehand technique based on the surface anatomy of the head was applied to another 47 patients. The accuracy of the ventricular catheter placement was then evaluated using postoperative computed tomography scans. Results : For the adjustable Ghajar guide technique (AGT) patients, the bicaudate index ranged from 0.23 to 0.33 ($mean{\pm}standard$ deviation [SD] : $0.27{\pm}0.03$) and the adjustment angle ranged from $0^{\circ}$ to $10^{\circ}$ ($mean{\pm}SD:5.2^{\circ}{\pm}3.2^{\circ}$). All the AGT patients experienced successful cerebrospinal fluid diversion with only one pass of the catheter. Optimal placement of the ventricular catheter in the ipsilateral frontal horn approximating the foramen of Monro (grade 1) was achieved in 19 patients (95.0%), while a suboptimal trajectory into a lateral corner of the frontal horn passing along a lateral wall of the frontal horn (grade 3) occurred in 1 patient (5.0%). Thus, the AGT patients experienced a significantly higher incidence of optimal catheter placement than the freehand catheterized patients (95.0% vs. 68.3%, p=0.024). Moreover, none of the AGT patients experienced any tract hemorrhages along the catheter or procedure-related complications. Conclusion : The proposed adjustable Ghajar guide technique, using angular adjustment in the coronal plane from the orthogonal trajectory at Kocher's point, facilitates accurate freehand placement of a ventricular catheter for hydrocephalic patients.

• The Korean Journal of Emergency Medical Services
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• v.13 no.3
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• pp.77-90
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• 2009

Civil complaints and lawsuits filed in the process of providing emergency medical service include fall accident on the way of carrying the patient, transfer consent, refusal and rejection of rescue request, range and behavior restriction of emergency medical technicians, false registry of logbook, neglect of duty and emergency patient, and violation of traffic laws on the way of dispatch to the scene of accident. This study suggested the measures by cases as follows. 1. The accidents on the way of carrying a patient could be divided into fall of patient and fall by paramedic's mistake. In the former case, damages caused by the ambulance's shaking must be notified to the patient and guardian and recommended to fasten seat belt, in the latter case, the plan of patient's posture, route of transport, rescue and equipments should be comfirmed before fixing the patient. 2. Transfer consent must be made as implied when the patient is unconscious under delusion and was not able to consent physically, and paramedic must take an action by his judgment and record details of services on logbook. 3. When a patient refused to transfer, get 'confirmation of transfer refusal' and inform him of refusal. Paramedic should receive the signature. In addition, in case of refusal, transfer request should be made after hearing doctor's opinion and it should be notified to transfer request and superintendent of fire station after making 'confirmation of transfer refusal'. 4. Emergency medical technicians should perform their duties within the range of services prescribed by Article 41 of Law of Emergency Medical Service and Article 33 of Its Enforcement Regulations and shall not make announcement of death. In case of reporting the death to guardian, it is desirable to use record data like ECG results. 5. The best way to have protection from legal problems is making and keeping the exact records of accident and patient. Paramedic should not mention his subjective opinion about the accident-related matter. He must record correctly and keep the original medical records. 6. As emergency medical technicians are responsible for taking care of emergency patients, they must contact a briefing room when they meet a difficult situation suddenly due to vehicle stop or treatment of other patients and then must have support from neighboring hospital and other safety centers. 7. Since the ambulance operator is responsible for safety and careful driving of ambulance, he must be careful when he violates traffic regulations unavoidably. The operator should drive slowly below 10km/h at an intersection and pass it after getting way from general vehicles driving from all directions.

• Journal of Radiation Protection and Research
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• v.23 no.1
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• pp.49-57
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• 1998

Domestic intercomparison study of the neutron personnel dosemeters was performed for the first time in Korea. Thirteen types of neutron dosemeters from twelve institutions took part in this intercomparison study and the $D_2O$ moderated Cf-252 source of KAERI was used for irradiation. Eight of the fifteen dosemeters submitted by each participant were divided into two groups and each group was irradiated with different doses of the simulated mixed fields of neutron and gamma. The participants assessed their dosemeter reading in terms of the personal dose equivalent, Hp(10), for both neutron and gamma dose. The ratio of the reported dose equivalent to the delivered dose equivalent for comparison between participants ranged from 0.55 to 1.34 for neutron, from 0.54 to 1.32 for gamma and from 0.75 to 1.20 for total dose. This intercomparison results show that all dosemeter processors, especially for neutron category, are able to pass the personnel dosemeter performance test which shall be enforced according to the ordinance of the MOST, No. 96-6.

• Journal of Korean Tunnelling and Underground Space Association
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• v.22 no.3
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• pp.277-291
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• 2020

Shield TBM is a tunnelling method that has a wider range of applications in the poor ground condition compared to conventional tunnels (Drill and Blast). Currently, a 13.3 m large-diameter slurry shield TBM is preparing for construction to pass under the Han River. Shield TBM is divided into slurry and EPB shield TBM, and management items during construction are different depending on each characteristic. In this paper, the equipment type, origin, application case and trouble case were analyzed for slurry shield TBM, which is mainly constructed in soft ground. In addition, 2D and 3D model tests were conducted on the condition of soil depth for the possibility of slurry leakage into front of the equipment, with appropriate chamber pressure. Based on this paper, it proposed to provide basic and reference data for proper excavation surface pressure and chamber pressure during construction of slurry shield TBM under soft ground conditions, and proposed measures to minimize stability and environmental decline due to slurry ejection.

• Journal of Yeungnam Medical Science
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• v.18 no.1
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• pp.39-50
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• 2001

Background: Power spectrum analysis method is a powerful noninvasive tool for quantifying autonomic nervous system activity. In this paper, we developed a data acquistion system for estimating the activity of the autonomic nervous system by the analysis of heart rate and respiratory rate variability using power spectrum analysis. Materials and methods: For the detection of QRS peak and measurement of respiratory rate from patient's ECG, we used low-pass filter and impedence method respectively. This system adopt an isolated power for patient's safety. In this system, two output signals can be obtained: R-R interval heart rate) and respiration rate time series. Experimental ranges are 30-240 BPM for ECG and 15-80 BPM for respiration. Results: The system can acquire two signals accurately both in the experimental test using simulator and in real clinical setting. Conclusion: The system developed in this paper is efficient for the acquisition of heart rate and respiration signals. This system will play a role in research area for improving our understanding of the pathophysiologic involvement of the autonomic nervous system in various disease states.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.12 no.5
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• pp.815-820
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• 2008

Recently the frequency assignment and the technical specifications of UWB systems for communications are completed. Therefore many UWB systems have been developed. In our country $3.1{\sim}4.8GHz$ and $7.2{\sim}10.2GHz$ are assigned for UWB systems for communications. When we consider RF technologies and the easy implementation of UWB systems, UWB systems used in the low band are more developed than high band systems. In this paper we design and implement a BPF for low band UWB systems by means of considering the easy implementation of UWB systems. The designed and implemented BPFs are low band filter and low band channel filters. The measured results of the low band filter show that the filter has 21.85dB and 17.91dB attenuation at 3.1GHz and 4.8GHz, 1.53GHz of -10dB bandwidth and 2dB of insertion loss. Low band can be divided into 3 channels with 500MHz of the channel bandwidth. The channel filter for channel number 1 has the characteristics of 24.85dB attenuation at 3.1GHz, 0.61GHz of -10dB bandwidth and 1.87dB of insertion loss. The filter for channel 3 in low band has 19.2dB of attenuation at 4.8GHz, 0.49GHz of -10dB bandwidth and 2.49dB of insertion loss.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.11 no.10
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• pp.1852-1857
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• 2007

The SSB modem performs the modulation process which converts the digital voltage level to the audible frequency band signal and the demodulation process which converts reversely the audible frequency signal to the digital voltage level. The modulator and the demodulator are implemented with a single DSP chip. Because of the SSB specific character, the distortion occurs when the frequency is changed. This distortion has no effect on voice communication but it has an significant effect on data communication. In other words, it is impossible to send data stream with adjacent 2 periods. Therefore, in case of using 2-tone FSK, it is needed to send at least 3 periods to transmit 1 bit. Therefore we implemented the modem using modified phase-delay shift keying to transmit 1 tone signal for high speed transmission. In the 1200[bps] mode, it generates 0, $187{\mu}s$, delay time at 1.3kHz symbol frequency, and in the 2400[bps] mode, 0, $70{\mu}s\;130{\mu}s\;200{\mu}s$, delay time at 1.5kHz symbol frequency. Finally, in the maximum 3600[bps] mode, it generates 0, $100{\mu}s\;160{\mu}s\;250{\mu}s$ 2.0kHz symbol frequency. The measured results of the implemented SSB modem shows a good transfer functional characteristic by spectrum analyzer, almost same bandwidth in pass band and 20dB higher SNR comparing the emu FACTOR and American CLOVER and in the experimental transmitting test, we verified the transmitted data is received correctly in platform.

• Gut and Liver
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• v.12 no.6
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• pp.722-727
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• 2018

Background/Aims: Although endoscopic bilateral stent-instent placement is challenging, many recent studies have reported promising outcomes regarding technical success and endoscopic re-intervention. This study aimed to evaluate the technical accessibility of stent-in-stent placement using large cell-type stents in patients with inoperable malignant hilar biliary obstruction. Methods: Forty-three patients with inoperable malignant hilar biliary obstruction from four academic centers were prospectively enrolled from March 2013 to June 2015. Results: Bilateral stent-in-stent placement using two large cell-type stents was successfully performed in 88.4% of the patients (38/43). In four of the five cases with technical failure, the delivery sheath of the second stent became caught in the hook-cross-type vertex of the large cell of the first stent, and subsequent attempts to pass a guidewire and stent assembly through the mesh failed. Functional success was achieved in all cases of technical success. Stent occlusion occurred in 63.2% of the patients (24/38), with a median patient survival of 300 days. The median stent patency was 198 days. The stent patency rate was 82.9%, 63.1%, and 32.1% at 3, 6, and 12 months postoperatively, respectively. Endoscopic re-intervention was performed in 14 patients, whereas 10 underwent percutaneous drainage. Conclusions: Large cell-type stents for endoscopic bilateral stent-in-stent placement had acceptable functional success and stent patency when technically successful. However, the technical difficulty associated with the entanglement of the second stent delivery sheath in the hook-cross-type vertex of the first stent may preclude large cell-type stents from being considered as a dedicated standard tool for stent-in-stent placement.

• Journal of Radiation Industry
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• v.10 no.1
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• pp.29-35
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• 2016

Radiation generating devices must be properly shielded for their safe application. Although institutes such as US National Bureau of Standards and National Council on Radiation Protection and Measurements (NCRP) have provided guidelines for shielding X-ray tube of various purposes, industry people tend to rely on 'Half Value Layer (HVL) method' which requires relatively simple calculation compared to the case of those guidelines. The method is based on the fact that the intensity, dose, and air kerma of narrow beam incident on shielding wall decreases by about half as the beam penetrates the HVL thickness of the wall. One can adjust shielding wall thickness to satisfy outside wall dose or air kerma requirements with this calculation. However, this may not always be the case because 1) The strict definition of HVL deals with only Intensity, 2) The situation is different when the beam is not 'narrow'; the beam quality inside the wall is distorted and related changes on outside wall dose or air kerma such as buildup effect occurs. Therefore, sometimes more careful research should be done in order to verify the effect of shielding specific radiation generating device. High energy X-ray tubes which is operated at the voltage above 400 kV that are used for 'heavy' nondestructive inspection is an example. People have less experience in running and shielding such device than in the case of widely-used low energy X-ray tubes operated at the voltage below 300 kV. In this study, Air Kerma value per week, outside concrete shielding wall of various thickness surrounding 450 kVp X-ray tube were calculated using MCNP simulation with the aid of Geometry Splitting method which is a famous Variance Reduction technique. The comparison between simulated result, HVL method result, and NCRP Report 147 safety goal $0.02mGy\;wk^{-1}$ on Air Kerma for the place where the public are free to pass showed that concrete wall of thickness 80 cm is needed to achieve the safety goal. Essentially same result was obtained from the application of HVL method except that it suggest the need of additional 5 cm concrete wall thickness. Therefore, employing the result from HVL method calculation as an conservative upper limit of concrete shielding wall thickness was found to be useful; It would be easy, economic, and reasonable way to set shielding wall thickness.

• Journal of Korean language education
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• v.28 no.3
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• pp.1-24
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• 2017

This article explores the developmental history of TOPIK over the last 20 years and its recent trends. Over the last two decades, TOPIK underwent two major systematic reforms, achieving both quantitative and qualitative growth over the course of its 52 testing sessions. TOPIK has utilized a six-level evaluation system from its inception to the present. The evaluation system was amended from the earlier six-test set - whereby each level corresponded with a separate test (1997~2005: the $1^{st}{\sim}9^{th}$) - to the three-test set (2006~2014: the $10^{th}{\sim}34^{th}$), and finally to the two-test set (2014~present: the $35^{th}{\sim}42^{nd}$). In the earlier exams, abilities in Vocabulary Grammar, Writing, Listening, and Reading were assessed. However, beginning with the $35^{th}$ TOPIK, abilities in Listening, Reading, and Writing (only in TOPIK II) were assessed and the evaluation of the writing section was changed to a task-based process, improving TOPIK into a more qualified analysis of proficiency. Over the last 20 years, the number of countries TOPIK is administered in has greatly increased from 4 to 73 countries, and the annual number of test-takers has also significantly increased from 2,692 to 250,141. The distribution of proficiency levels of the test-takers has shifted over time - initially "Beginner>Intermediate>Advanced" in the earlier exams, to "Intermediate>Advanced>Beginner" after the mid 2000s - as the number of those studying the Korean language for specific purposes and continuing education increased. Test-takers have indicated a shift in their purpose for taking the exam, initially citing "to assess proficiency" and more recently selecting "to study abroad," and this could also correlate with changes in the proportion of test-takers' proficiency level. In general, 85~95% of beginner, 50~65% of intermediate, and 45~60% of advanced test applicants passed the respective proficiency level. To date, no practices have yet been implemented to standardize the difficulty level longitudinally across test sets.