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Clinical Experiences of Continuous Warm Blood Cardioplegia ; Valvular Heart Surgery (연속 온혈 심정지액의 임상경험 - 심장 판막 수술 환자 대상 -)

  • 이종국;박승일;조재민;원준호
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.353-361
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    • 1998
  • Hypothermia is widely acknowledged as fundamental component of myocardial protection during cardiac operations. Although it prolongs the period of ischemic arrest by reducing oxygen demands, hypothermia is associated with a number of major disadvantages, including its detrimental effects on enzymatic function, energy generation, and cellular integrity. The ideal way to rotect the heart is to electromechanically arrest it and perfus it with blood that is aerobic arrest. However alternative technique has been developed, based on the principles of electromechanical arrest and normothermic aerobic perfusion using continuous warm blood cardioplegia. To determine if continuous warm blood cardioplegia was beneficial in clinical practice during valvular surgery, we studied two groups of patients matched by numbers and clinical characteristics. Group included is 31 patients undergoing valvular surgery who received intermittent cold crystalloid cardioplegia. Group II included 30 patients undergoing valvular surgery who received continuous warm blood cardioplegia. Our results suggest that the heartbeat in 100% of patients treated with continuous warm blood cardioplegia converted to normal sinus rhythm spontaneously after the removal of the aortic cross-clamp, compared to only 31% of the cold cardioplegia group. After operation, pericardial closure rate was 90% area in the warm group, compared to 35% area in the cold group. 12 hours after the operation, the total amount of urine output in the warm group was greater than that in the cold group(2863${\pm}$127 ml versus 2257${\pm}$127 ml; p<0.05). After the operation, left diaphragmatic elevation developed in 55% of the cold group but in 0% of the warm group. CK-MB level in the warm group was significantly lower than cold group(2.28${\pm}$0.62 versus 9.96${\pm}$2.12; p<0.01) 1 hour after operation and CK-MB level in the warm group was significantly lower than cold group(1.80${\pm}$1.01 versus 6.00${\pm}$1.74; p<0.05) 12hours after operation. Continuous warm blood cardioplegia is at least as safe and effective as hypothermic technique in patients undergoing cardiac valvular surgery. Conceptually, this represents a new approach to the problem of maintaining myocardial preservation during cardiac operations.

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Particulate Matter and CO2 Improvement Effects by Vegetation-based Bio-filters and the Indoor Comfort Index Analysis (식생기반 바이오필터의 미세먼지, 이산화탄소 개선효과와 실내쾌적지수 분석)

  • Kim, Tae-Han;Choi, Boo-Hun;Choi, Na-Hyun;Jang, Eun-Suk
    • Korean Journal of Environmental Agriculture
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    • v.37 no.4
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    • pp.268-276
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    • 2018
  • BACKGROUND: In the month of January 2018, fine dust alerts and warnings were issued 36 times for $PM_{10}$ and 81 times for PM2.5. Air quality is becoming a serious issue nation-wide. Although interest in air-purifying plants is growing due to the controversy over the risk of chemical substances of regular air-purifying solutions, industrial spread of the plants has been limited due to their efficiency in air-conditioning perspective. METHODS AND RESULTS: This study aims to propose a vegetation-based bio-filter system that can assure total indoor air volume for the efficient application of air-purifying plants. In order to evaluate the quantitative performance of the system, time-series analysis was conducted on air-conditioning performance, indoor air quality, and comfort index improvement effects in a lecture room-style laboratory with 16 persons present in the room. The system provided 4.24 ACH ventilation rate and reduced indoor temperature by $1.6^{\circ}C$ and black bulb temperature by $1.0^{\circ}C$. Relative humidity increased by 24.4% and deteriorated comfort index. However, this seemed to be offset by turbulent flow created from the operation of air blowers. While $PM_{10}$ was reduced by 39.5% to $22.11{\mu}g/m^3$, $CO_2$ increased up to 1,329ppm. It is interpreted that released $CO_2$ could not be processed because light compensation point was not reached. As for the indoor comfort index, PMV was reduced by 83.6 % and PPD was reduced by 47.0% on average, indicating that indoor space in a comfort range could be created by operating vegetation-based bio-filters. CONCLUSION: The study confirmed that the vegetation-based bio-filter system is effective in lowering indoor temperature and $PM_{10}$ and has positive effects on creating comfortable indoor space in terms of PMV and PPD.

Detection of flash drought using evaporative stress index in South Korea (증발스트레스지수를 활용한 국내 돌발가뭄 감지)

  • Lee, Hee-Jin;Nam, Won-Ho;Yoon, Dong-Hyun;Mark, D. Svoboda;Brian, D. Wardlow
    • Journal of Korea Water Resources Association
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    • v.54 no.8
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    • pp.577-587
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    • 2021
  • Drought is generally considered to be a natural disaster caused by accumulated water shortages over a long period of time, taking months or years and slowly occurring. However, climate change has led to rapid changes in weather and environmental factors that directly affect agriculture, and extreme weather conditions have led to an increase in the frequency of rapidly developing droughts within weeks to months. This phenomenon is defined as 'Flash Drought', which is caused by an increase in surface temperature over a relatively short period of time and abnormally low and rapidly decreasing soil moisture. The detection and analysis of flash drought is essential because it has a significant impact on agriculture and natural ecosystems, and its impacts are associated with agricultural drought impacts. In South Korea, there is no clear definition of flash drought, so the purpose of this study is to identify and analyze its characteristics. In this study, flash drought detection condition was presented based on the satellite-derived drought index Evaporative Stress Index (ESI) from 2014 to 2018. ESI is used as an early warning indicator for rapidly-occurring flash drought a short period of time due to its similar relationship with reduced soil moisture content, lack of precipitation, increased evaporative demand due to low humidity, high temperature, and strong winds. The flash droughts were analyzed using hydrometeorological characteristics by comparing Standardized Precipitation Index (SPI), soil moisture, maximum temperature, relative humidity, wind speed, and precipitation. The correlation was analyzed based on the 8 weeks prior to the occurrence of the flash drought, and in most cases, a high correlation of 0.8(-0.8) or higher(lower) was expressed for ESI and SPI, soil moisture, and maximum temperature.

An Exercise Rehabilitation Field Revitalization Plan for Promoting Elderly Sport for All (노인생활체육 진흥을 위한 운동재활분야 활성화 방안)

  • Cho, Kyoung-Hwan
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.4
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    • pp.305-319
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    • 2020
  • A The purpose of this study was to determine the present state of the exercise rehabilitation field, promote elderly sport for all, and present a revitalization program for higher quality of life for the elderly in the coming era of the Fourth Industrial Revolution and aged society. Literature review was performed to analyze the actual conditions of the activities for elderly sport for all and the relevant field of exercise rehabilitation, analyze the elderly health and welfare and elderly sport for all programs, and present a plan for revitalizing the field of exercise rehabilitation to promote elderly sport for all. First, it is necessary to reinforce the awareness and promotion of the need and importance of exercise rehabilitation in inducing seniors to participate in sport for all. Second, it is necessary to make it compulsory to place sport leaders for seniors at such places as elderly leisure and welfare centers and promote expertise in managing elderly health guidance efficiently through cooperation with welfare workers. Third, it is necessary to make it compulsory to take exercise rehabilitation and similar subjects in the curriculums of sport for all, elderly sport welfare, and silver welfare sport as well as the subject of volunteering activities at such places as elderly leisure and welfare centers with the aim of giving opportunities for career choice. Fourth, it is necessary to develop characterized exercise rehabilitation programs at senior welfare centers, community centers for the elderly, and elderly classes and employ experts equipped with exercise event and exercise rehabilitation capabilities as itinerant lecturers to contribute to the government's job creation policies through cooperation between the Ministry of Culture, Sports, and Tourism (MOCST) and the Ministry of Health and Welfare (MOHW). Fifth, it is necessary to make a greater investment in research and development required for elderly sport for all. Sixth, it is necessary to develop and distribute various exercise rehabilitation treatment videos and guidelines that seniors can use for themselves. This is associated with the fifth one; in particular, it is urgent to devise measures against Coronavirus 19. Seventh, it is necessary to reduce inefficiency and budget waste caused by overlapped tasks by establishing a new elderly sports promotion organization through adjustment by MOCST and MOHW; it is also necessary to increase the functions of organization establishment with the aim of reinforcing the education area, which involves post-retirement health care, exercise rehabilitation, safety accident prevention, and virus.

Analysis of Soil Changes in Vegetable LID Facilities (식생형 LID 시설의 내부 토양 변화 분석)

  • Lee, Seungjae;Yoon, Yeo-jin
    • Journal of Wetlands Research
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    • v.24 no.3
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    • pp.204-212
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    • 2022
  • The LID technique began to be applied in Korea after 2009, and LID facilities are installed and operated for rainwater management in business districts such as the Ministry of Environment, the Ministry of Land, Infrastructure and Transport, and LH Corporation, public institutions, commercial land, housing, parks, and schools. However, looking at domestic cases, the application cases and operation periods are insufficient compared to those outside the country, so appropriate design standards and measures for operation and maintenance are insufficient. In particular, LID facilities constructed using LID techniques need to maintain the environment inside LID facilities because hydrological and environmental effects are expressed by material circulation and energy flow. The LID facility is designed with the treatment capacity planned for the water circulation target, and the proper maintenance, vegetation, and soil conditions are periodically identified, and the efficiency is maintained as much as possible. In other words, the soil created in LID is a very important design element because LID facilities are expected to have effects such as water pollution reduction, flood reduction, water resource acquisition, and temperature reduction while increasing water storage and penetration capacity through water circulation construction. In order to maintain and manage the functions of LID facilities accurately, the current state of the facilities and the cycle of replacement and maintenance should be accurately known through various quantitative data such as soil contamination, snow removal effects, and vegetation criteria. This study was conducted to investigate the current status of LID facilities installed in Korea from 2009 to 2020, and analyze soil changes through the continuity and current status of LID facilities applied over the past 10 years after collecting soil samples from the soil layer. Through analysis of Saturn, organic matter, hardness, water contents, pH, electrical conductivity, and salt, some vegetation-type LID facilities more than 5 to 7 years after construction showed results corresponding to the lower grade of landscape design. Facilities below the lower level can be recognized as a point of time when maintenance is necessary in a state that may cause problems in soil permeability and vegetation growth. Accordingly, it was found that LID facilities should be managed through soil replacement and replacement.

KANO-TOPSIS Model for AI Based New Product Development: Focusing on the Case of Developing Voice Assistant System for Vehicles (KANO-TOPSIS 모델을 이용한 지능형 신제품 개발: 차량용 음성비서 시스템 개발 사례)

  • Yang, Sungmin;Tak, Junhyuk;Kwon, Donghwan;Chung, Doohee
    • Journal of Intelligence and Information Systems
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    • v.28 no.1
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    • pp.287-310
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    • 2022
  • Companies' interest in developing AI-based intelligent new products is increasing. Recently, the main concern of companies is to innovate customer experience and create new values by developing new products through the effective use of Artificial intelligence technology. However, due to the nature of products based on radical technologies such as artificial intelligence, intelligent products differ from existing products and development methods, so it is clear that there is a limitation to applying the existing development methodology as it is. This study proposes a new research method based on KANO-TOPSIS for the successful development of AI-based intelligent new products by using car voice assistants as an example. Using the KANO model, select and evaluate functions that customers think are necessary for new products, and use the TOPSIS method to derives priorities by finding the importance of functions that customers need. For the analysis, major categories such as vehicle condition check and function control elements, driving-related elements, characteristics of voice assistant itself, infotainment elements, and daily life support elements were selected and customer demand attributes were subdivided. As a result of the analysis, high recognition accuracy should be considered as a top priority in the development of car voice assistants. Infotainment elements that provide customized content based on driver's biometric information and usage habits showed lower priorities than expected, while functions related to driver safety such as vehicle condition notification, driving assistance, and security, also showed as the functions that should be developed preferentially. This study is meaningful in that it presented a new product development methodology suitable for the characteristics of AI-based intelligent new products with innovative characteristics through an excellent model combining KANO and TOPSIS.

A Study on the Influence of the Selective Attributes of Home Meal Replacement on Perceived Utilitarian Value and Repurchase Intention: Focus on Consumers of Large Discount and Department Stores (HMR(Home Meal Replacement) 선택속성이 지각된 효용적 가치, 재구매 의도에 미치는 영향에 관한 연구: 대형 할인마트와 백화점 구매고객을 대상으로)

  • Seo, Kyung-Hwa;Choi, Won-Sik;Lee, Soo-Bum
    • Journal of the East Asian Society of Dietary Life
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    • v.21 no.6
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    • pp.934-947
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    • 2011
  • The purpose of this study is to analyze products for good taste and convenience, which become an engine to constantly create customers. In addition, this study is aimed at investigating the relationship between the selective attributes of Home Meal Replacement, the perceived utilitarian value, and the repurchase intention, and drawing new suggestions on the Home Meal Replacement market from a new marketing perspective. Based on a total of 215 samples, this study reviewed the reliability and fitness of the research model and verified a total of 5 hypothesized using the Amos program. The result of study modeling was GFI=0.905, AGFI=0.849, NFI=0.889, CFI=0.945, and RMR=0.0.092 at the level of $x^2$=230.22 (df=126, p<0.001). First, the food quality (${\beta}$=0.221), convenience (${\beta}$=0.334), packing (${\beta}$=0.278), and employee service (${\beta}$=0.204) of home meal replacement consideration attributes had a positive (+) influence on perceived utilitarian value. Second, perceived utilitarian value (${\beta}$=0.584) had a positive (+) influence on repurchase intention. The factors to differentiate one company from other competitors in terms of the utilitarian value are the quality of food, convenience, wrapping, and services by employees. This study has illustrated the need to focus on the development of a premium menu to compete with other companies and to continue to research and develop nutritious foods that are easy to cook. Moreover, the key factors to have a distinct and constant competitive edge over other companies are the alleviation of consumer anxiety over wrapping container materials, the development of more designs, and the accumulation of service know-how. Therefore, it is necessary for a company to strongly develop the key factors based on its resources as a core capability.

A Survey on the Status of Health Examination among Farmers in a Rural Area (일부 농촌지역 농업종사자들의 건강진단 수검 실태)

  • Park, Soon-Woo
    • Journal of agricultural medicine and community health
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    • v.22 no.1
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    • pp.1-18
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    • 1997
  • This study was carried out to reveal the status of health examination among farmers and to attract more attention to the health care system for farmers. Ten pre-trained medical students interviewed the rural residents 18 years of age and older in eight villages which were randomly selected from a county near Taegu city in Korea, in August 1996. Finally 751 persons were interviewed of whom the percentages of male and female were 41.8%, 58.2% respectively. Among the subjects, 361(48.3%) were fully engaged in farming, 184(24.4%) were partly engaged, and the remaining 206(27.3%) were not engaged in farming at all. The overall prevalence of farmer's disease was 23.0% and there was no significant difference between the group of fully engaged in farming(23.3%) and the group of not-fully engaged(22.9%). But the prevalence of farmer's disease in female subjects(27.8%) was significantly higher than that in male(16.2%)(p<0.01). Among the 288 farmer engaged in spraying pesticide, 113(39.2%) had experienced one or more pesticide related symptoms during last one year, but only 18(15.9%) of them had visited medical facilities due to their symptoms. The experience of receiving education about pesticide was significantly correlated with the degree of wearing protectors during pesticide spraying(p<0.001). Among the 736 persons excluding non-respondents, 281(38.2%) received health examination during last one year ; 176(62.6%) of them received free health examination, and 105(37.4%) received charged one. Among the 533 persons 40 years age and older, only 124(23.3%) had received the 'health examination for the elderly' during last one year, which is provided for the 40 years age and older by Korea medical insurance corporation and medical insurance societies. Most of all beneficiaries of self-employed medical insurance thought the imposed contributions as very expensive(77.4%) or moderately expensive(13.2%). The great majority of farmers are exposed to various health risk factors including pesticide, high temperature, overwork etc. comparable to industrial workers. But farmers are excluded from the regular yearly worker's health examination because of not belonging to a company despite they pay relatively more medical insurance contributions compared with the industrial workers and the urban self-employed medical insureds. It is necessary to develop special health management program for farmers such as the special health examination for the industrial workers exposed harmful agents.

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A Study on the Legislative Guidelines for Airline Consumer Protection (항공소비자 보호제도의 입법방향)

  • Lee, Chang-Jae
    • The Korean Journal of Air & Space Law and Policy
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    • v.32 no.1
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    • pp.3-51
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    • 2017
  • From a historical point of view, while the Warsaw Convention was passed in 1924 to regulate the unified judicial responsibility in the global air transportation industry, protection of airline consumers was somewhat lacking in protecting air carriers. In principle, the air carrier does not bear any obligation or liability when the aircraft is not operated normally due to natural disasters such as typhoon or heavy snowfall. However, in recent years, in developed countries such as the US and Europe, there has been a movement in which regulates the air carriers' obligation to protect their passengers even if there is no misconduct or negligence. Furthermore, the legislation of such advanced countries imposes an obligation on the airlines to compensate the loss separately from damages in case the abnormal operation of the aircraft is not caused by force majeure but caused by their negligence. Under this historical and international context, Korea is also modifying the system of aviation consumer protection by referring to other foreign legislation. However, when compared with foreign countries, our norm has a few drawbacks. First, the airline's protection or care obligations are mixed with the legal liability for damages in the provision, which seems to be due to the lack of understanding of the airline's passenger protection obligation. The liability for damages, which is governed by the International Convention or the Commercial Act, shall be determined by judging the cause of the airline's liability in respect of the damage of the individual passenger in the course of the air transportation. However, the duty to care and the burden for compensation shall be granted to all passengers who feel uncomfortable with the abnormal operation regardless of the cause of the accident. Also, our compensation system for denied boarding due to oversale is too low compared to the case of foreign countries, and setting the compensation amount range differently based on the time for the re-routing is somewhat unclear. Regarding checked-baggage claim, it will be necessary to refund the fee only from the fact that the baggage is delayed without asking whether there is any damage occurred from the delayed baggage. This is the content of the duty to care, which is different from the current Commercial Act or the international convention, in which responsibility is different depending on whether the airline takes all the necessary measures in order to prevent delaying of the baggage. The content of force majeure, which is a requirement for exemption from the obligation to care passengers on the airplane, shall be reconsidered. Maintenance for safe navigation is not considered to be included in force majeure, and connection to airplanes, airport conditions are disputable. According to the EC Regulation, if the cause of the abnormal operation of the airline is force majeure, the airline's compensation obligation is exempted but the duty to care of airline company is still meaningful. Furthermore, even if the main role of aviation consumer protection is on an airline, it is the responsibility of government agencies to supervise the fulfillment of such protection obligations. Therefore, it is necessary for the Korean government to actively take measures such as enforcing incentives for airlines that faithfully fulfill their obligation to care and imposed penalties on the contrary.

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Analysis of dose reduction of surrounding patients in Portable X-ray (Portable X-ray 검사 시 주변 환자 피폭선량 감소 방안 연구)

  • Choe, Deayeon;Ko, Seongjin;Kang, Sesik;Kim, Changsoo;Kim, Junghoon;Kim, Donghyun;Choe, Seokyoon
    • Journal of the Korean Society of Radiology
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    • v.7 no.2
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    • pp.113-120
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    • 2013
  • Nowadays, the medical system towards patients changes into the medical services. As the human rights are improved and the capitalism is enlarged, the rights and needs of patients are gradually increasing. Also, based on this change, several systems in hospitals are revised according to the convenience and needs of patients. Thus, the cases of mobile portable among examinations are getting augmented. Because the number of mobile portable examinations in patient's room, intensive care unit, operating room and recovery room increases, neighboring patients are unnecessarily exposed to radiation so that the examination is legally regulated. Hospitals have to specify that "In case that the examination is taken out of the operating room, emergency room or intensive care units, the portable medical X-ray protective blocks should be set" in accordance with the standards of radiation protective facility in diagnostic radiological system. Some keep this regulation well, but mostly they do not keep. In this study, we shielded around the Collimator where the radiation is detected and then checked the change of dose regarding that of angles in portable tube and collimator before and after shielding. Moreover, we tried to figure out the effects of shielding on dose according to the distance change between patients' beds. As a result, the neighboring areas around the collimator are affected by the shielding. After shielding, the radiation is blocked 20% more than doing nothing. When doing the portable examination, the exposure doses are increased $0^{\circ}C$, $90^{\circ}C$ and $45^{\circ}C$ in order. At the time when the angle is set, the change of doses around the collimator decline after shielding. In addition, the exposure doses related to the distance of beds are less at 1m than 0.5m. In consideration of the shielding effects, putting the beds as far as possible is the best way to block the radiation, which is close to 100%. Next thing is shielding the collimator and its effect is about 20%, and it is more or less 10% by controlling the angles. When taking the portable examination, it is better to keep the patients and guardians far enough away to reduce the exposure doses. However, in case that the bed is fixed and the patient cannot move, it is suggested to shield around the collimator. Furthermore, $90^{\circ}C$ of collimator and tube is recommended. If it is not possible, the examination should be taken at $0^{\circ}C$ and $45^{\circ}C$ is better to be disallowed. The radiation-related workers should be aware of above results, and apply them to themselves in practice. Also, it is recommended to carry out researches and try hard to figure out the ways of reducing the exposure doses and shielding the radiation effectively.