• Journal of radiological science and technology
• /
• v.33 no.4
• /
• pp.327-334
• /
• 2010

Exposure during childhood results in higher risk for certain detrimental cancers than exposure during adulthood. We measured entrance skin dose (ESD) under 7-year children undergoing chest imaging and compared the relationship between ESD and age, height, weight, chest thickness. Though it is important to measure chest thickness for setting up the exposure condition of chest examination, it is difficult to measure chest thickness of children. We set up exposure parameters according to age because chest thickness of children has correlation with age. In the exposure parameters, for chest A-P examination under 2 year-children, tube voltage (kVp) in hospital A was higher than that in hospital B while tube current (mAs) was higher in hospital B, thus the ESD values were about 1.7 times higher in hospital B. However, for chest P-A examination over 4 year-children, the tube voltage was 7 kVp higher in hospital B, the tube current were same in all two systems, and focus to image receptor distance (FID) in hospital B (180 cm) was longer than that in hospital A (130 cm), thus the ESD values were 1.4 times higher in hospital A. For same ages, the ESD values for chest A-P examinations were higher than those for chest P-A examinations. Comparing ESD according to age, ESD values were $154{\mu}Gy$, $194{\mu}Gy$ and $138{\mu}Gy$ for children under 1 year, 1 to under 4 years and 4 to under 7 years of age, respectively. These values were lower than reference level ($200{\mu}Gy$) recommended in JART (japan association of radiological technologists), however these were higher than reference values recommended by EC (european commission), NRPB (national radiological protection board) and NIFDS (national institute of food & drug safety evaluation). In conclusion, the values of ESD were affected by exposure parameters from radiographer's past experience more than x-ray system. ESD values for older children were not always higher than those for younger children. Therefore we need to establish our own DRLs (diagnostic reference levels) according to age of the children in order to optimize pediatric patient protection.

• Korean Security Journal
• /
• no.29
• /
• pp.163-191
• /
• 2011

Recently, the problems in school violence did not stop on the crime between the members at the school and which developed into the invasion crime of the school caused by outsiders. The school is no more the safety zone from the crime. Particularly, in the case of the elementary school, because there are nearly no people who oppose to the outside attacker and can control this, it is the place where it is vulnerable to the invasion crime. The Metropolis of Seoul implements the School Sheriff system within the jurisdiction bureau, in the public elementary school. However, actually the School Sheriff business is being managed, never applying a rule in the Security Industry Law with the main content, that is the Security Industry Law application is excluded. Because the jurisdiction on the contract of Seoul City and operating company are run, the various issues is caused. First, since it is not being considered as a security business, the commercial liability insurance for security company has no chance to applicate when the operation company and the School Sheriff have related damage generation. So the security for the indemnification of loss of the victim is weak. Second, The task of the School Sheriff is ruled just by in the individual contracts. But it is insufficient with this thing. The related duties are required some supplement like a general rule application including the obligation of the guard in the security industry law. Third, the education of the School Sheriff needs to connect with the educational programme in the security industry law. The related professional education specially needed for the prevention of school violence ought to be reserved compensation. Forth, the citizens still demand the strengthening of police patrol for the surroundings of a school in spite of the result of Seoul City's public survey. Therefore, the active relation of cooperation with the police needs to be supported legally and institutionally with the Security Industry Law application. Fifthly, the success of the School Sheriff business can be more guaranteed with the supervision of the legal and institutional device like a the Security Industry Law application or police and all sorts of administrative execution's and etc.

• Korean Security Journal
• /
• no.27
• /
• pp.129-159
• /
• 2011

Physical security has always been an extremely important facet within the security arena. A comprehensive security plan consists of three components of physical security, personal security and information security. These elements are interrelated and may exist in varying degrees defending on the type of enterprise or facility being protected. The physical security component of a comprehensive security program is usually composed of policies and procedures, personal, barriers, equipment and records. Human beings kept restless struggle to preserve their and tribal lives. However, humans in prehistoric ages did not learn how to build strong house and how to fortify their residence, so they relied on their protection to the nature and use caves as protection and refuge in cold days. Through the history of man, human has been establishing various protection methods to protect himself and his tribe's life and assets. Physical security methods are set in the base of these security methods. Those caves that primitive men resided was rounded with rock wall except entrance, so safety was guaranteed especially by protection for tribes in all directions. The Great Wall of China that is considered as the longest building in the history was built over one hundred years from about B.C. 400 to prevent the invasion of northern tribes, but this wall enhanced its protection function to small invasions only, and Mongolian army captured the most part of China across this wall by about 1200 A.D. European lords in the Middle Ages built a moat by digging around of castle or reinforced around of the castle by making bascule bridge, and provided these protections to the resident and received agricultural products cultivated. Edwin Holmes of USA in 20 centuries started to provide innovative electric alarm service to the development of the security industry in USA. This is the first of today's electrical security system, and with developments, the security system that combined various electrical security system to the relevant facilities takes charging most parts of today's security market. Like above, humankind established various protection methods to keep life in the beginning and its development continues. Today, modern people installed CCTV to the most facilities all over the country to cope with various social pathological phenomenon and to protect life and assets, so daily life of people are protected and observed. Most of these physical security systems are installed to guarantee our safety but we pay all expenses for these also. Therefore, establishing effective physical security system is very important and urgent problem. On this study, it is suggested methods of establishing effective physical security system by using system integration on the principle of security design about effective security system's effective establishing method of physical security system that is increasing rapidly by needs of modern society.

• Korean Security Journal
• /
• no.61
• /
• pp.39-57
• /
• 2019

The executive authority of the Ministry of Public Administration and Security on the 'management of security of the government complexes' is not sufficiently secured only with the organization law, the Government Organization Act. It is needed to establish an administrative actions law, an individual law that sets detailed contents and limitations of the executive authority to be stipulated. The current regulation, Regulation on the Management of the Government Complexes which is a Presidential Decree, is a legal decree that lacks a legal basis. The decree does not match with the current constitutional framework and raises the issue of its legality. The regulation may have the characteristics as a public property management law so far as it stipulates such matters as supply and maintenance management for the complexes, acquisition and disposition of complexes, facilities management of complexes, etc. However, the regulation includes high authority actions by an administrative organization, such as facilities security and order maintenance including restriction and control of access. This makes the regulation have the characteristics of a public property policy act as well. To supplement the legal framework for this situation, it is needed to level up some of the provisions relating to protection and security management to the level of an act as they stipulate high authority actions by an administrative organization. Other matters in the Regulation on the Management of the Government Complexes such as provisions relating to supply and allocation of complexes, etc. may be maintained as they are. In addition, the protection officers (general service official) does not own legal authority and have limitations on securing the capability to deal with the situations on implementing the on-site protection duty. Therefore, it is needed for the protection officers to secure protection duty-related authority by stipulating in a law. The main contents of the law on the protection and security of the government complexes may be those matters providing reservations on the implementations of laws. These may include the limitation of rights of and charging obligations on the people such as restricting the actions of personnel in the complex, rights and obligations of protection personnels relating to their duties, use of weapons, training of protection personnel, penal provisions, etc. These legal reservations should be included in an individual act.

• Journal of the Korean Society of School Health
• /
• v.22 no.1
• /
• pp.1-16
• /
• 2009

Purposes: The objective of this study was to develop a management program for Korean elementary school students suffering from asthma, which would be based on the Australian Asthma-Friendly Schools (AFS) program. Methods: On the basis of the AFS program, we designed a 6-month pilot project for asthmatic students in two elementary schools in a rural area and one elementary school in an urban area of Korea. The pilot project consisted of the following processes: identifying students with asthma in a school, educating school staffs and the parents of an asthmatic child, registering those with asthma, and installing emergency kits for asthma attacks in school health rooms. In order to evaluate these processes, group discussions were held between project team members and school staffs in each area. In addition, we conducted a postal survey of 144 households having an asthmatic child. Results: The screening process adopted in this program resulted in the early diagnosis in asthma; however, it needs to be evaluated economically due to expensive diagnostic test for asthma. For the school nurses, asthma lessons were evaluated as being very helpful for their tasks, while teachers tended to take less interest in the program with only 45% of all teachers attending these lessons. Almost all participating parents reported that such lessons would be beneficial for the care of their child, even though only 24.2% of the survey respondents (122 households) attended the lessons. Installing emergency kits in school health rooms was regarded as a key feature of this project. The introduction of a register card containing more specific health records of asthmatic students was considered necessary to replace the existing list of students with asthma. Conclusion: This study has merit in that a Korean asthma-friendly schools program was developed for the first time, despite the many obstacles to such programs becoming more common.

• Journal of Chest Surgery
• /
• v.34 no.4
• /
• pp.329-337
• /
• 2001

배경: 승포판 전엽이나 교련 또는 여러 판엽에 걸쳐 광범위한 병변으로 인한 승모판 역류의 경우 수술수기에 대한 뚜렷한 정립이 되어 있지 않은 실정이다. 최근 이러한 병변의 승모판 역류의 경우 PTEE(Polytetrafluro-ethylene)을 이용한 신건삭 형성술의 시행이 점차 늘고 있다. 이에 저자들은 PTEE를 이용한 신건삭 형성술이 승모판 성형술에 어떠한 영향을 미치는지 알아보고자 하였다. 대상 및 방법: 1994년 1월부터 1999년 12월까지 승모판막 성형술을 시행 받은 322명의 환자 중에서 신건삭 형성술을 이용하여 승모판 성형술을 시행한 144례(I군)과 신건삭 형성술 이외의 방법으로 승모판 성형술을 시행한 178례(II군)를 대상으로 하였다. 두 군에서 수술 직후ㅘ 수술 후 6개월, 1년 및 1년 단위로 주기적인 심초음파를 시행하였고 이를 통계적 검정하였다. 결과: 같은 기간 승모판 성형술은 승모판막 폐쇄 부전증으로 내원한 환자의 95%(306)에서 추적 관찰이 가능하였다. 두 구난에 수술 전 혈류 역학적인 차이를 보이지 않았고, 수술 전 평균 승모판막 폐쇄 부전의 정도는 I군이 3.8$\pm$0.4, II군이 3.6$\pm$0.3였으나 수술 후 추적 관찰에서 각각 1.3$\pm$0.9와 1.1$\pm$0.7 정도의 양호한 판막 성형술의 결과를 보였고 승모판막 면적의변화나 승모판막에서의 평균 압력차이 등 혈류 역학적인 결과에도 차이를 보이고 있지 않았다. 술 후 3명(0.9%)의 조기 사망과 4명 (1.2%)의 후기 사망이 있었으나 두 군간의 차이는 보이지 않았다. 만기 생존율( 93.7$\pm$3.3 vs 88.0$\pm$1.95) 및 판막살패가 발생하기 않을 확률( 93.7$\pm$3.6 vs 93.3$\pm$3.4%) 과 재수술이 필요치 않을 활률(99.3$\pm$0.7 vs 96.0$\pm$1.9%), 색전증, 감염성 심내막염, 판막과 관련된 합병증 발생률 등에서 두 군간에 의미 있는 차이는 없었다. 전엽과 후엽에서 신건삭 형성술을 시행한 환자에서는 통계학적인 차이가 없었다(p=0.29) 결론: 신건삭 형성술을 이용한 승모판 성형술은 승모판 성형술의 증가(r=0.98, p<0.01)를 가져 왔을 뿐만 아니라 내구성과 안정성에 있어 기존의 안전화된 수술 수기와 견줄만하다. 특히 이러한 신건삭 형성술은 승모판 전엽에 병변이 있는 경우와 교련부 및 여러 엽에 광범위한 병변으로 인하여 재건술이 어려운 경우에도 승모판 재건을 가능하게 하는 우수한 수술 수리가 사료된다.

• Journal of Chest Surgery
• /
• v.31 no.5
• /
• pp.466-471
• /
• 1998

Purpose: The safety and efficacy of minimally invasive techniques in congenital heart surgery were tested in this study. Materal and method: Between July 1997 and November 1997, a total of 46 children were underwent minimally invasive cardiac operations at Seoul National University Children's Hospital. Age and body weight of the patients averaged 34.6${\pm}$41.8 (Range: 1∼148) months and 14.5${\pm}$9.9(Range: 3.0∼40.0) kg, respectively. Twenty eight patients were male. Preoperative surgical indications included 15 atrial septal defects, 25 ventricular septal defects, 1 foreign body in aorta, 3 partial atrioventricular septal defects, 1 total anomalous pulmonary venous connection(cardiac type), and 1 tetralogy of Fallot. After creating a small lower midline skin incision starting as down as possible from the sternal notch, a vertical midline sternotomy extended from xyphoid process to the level of the second intercostal space, where one of the T-, J-, I- or inverted C-shaped lower lying mini-sternotomy was completed with a creation of unilateral right or bilateral trap door sternal opening. A conventional direct aortic and bicaval cannulation was routine. Result: A mean length of skin incision was 6.1${\pm}$1.0(range: 4.0∼9.0) cm. A mean distance between the suprasternal notch and the upper most point of the skin incision was 4.0${\pm}$1.1 (range: 2.0∼7.0) cm. Mean cardiopulmonary bypass time, aortic cross-clamp time, and the operation time were 62.9${\pm}$20.0(range: 28∼147), 29.8${\pm}$12.8(range: 11∼79), and 161.1${\pm}$34.5 (range: 100-250) minutes. A mean total amount of postoperative blood transfusion was 71.0${\pm}$68.1 (range: 0∼267) cc. All patients were extubated mean 11.3${\pm}$13.8(range: 1∼73) hours after operation. A mean total amount of analgesics used was 0.8${\pm}$1.8(range: 0∼9) mg of morphine. The mean duration of stay in intensive care unit and hospital stay were 35.0${\pm}$32.2 (range: 10∼194) hours and 6.2${\pm}$2.0(range: 3∼11) days. There were no wound complications and hospital deaths. Conclusion: This short-term experience disclosed that the minimally invasive technique can be feasibly applied in a selected group of congenital heart disease as well as is cosmetically more attractive approach.

• Journal of Chest Surgery
• /
• v.31 no.4
• /
• pp.353-361
• /
• 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.

• Journal of Chest Surgery
• /
• v.38 no.6 s.251
• /
• pp.428-433
• /
• 2005

Advanced age in Esophagectomy increases the risk of postoperative morbidity and mortality. However, the recent development of operative technique and perioperative care might have decreased the postoperative morbidity and mortality after esophagectomy. Material and Method: From March 2001 to July 2004, 174 patients underwent esophageal resection for esophageal cancer in the Center for Lung Cancer, National Cancer Center. The patients were divided into two groups : group 1 consisted of 27 patients aged 70 years or more, and group 2 consisted of 147 patients under 70 years of age. The two groups were compared according to preoperative risk factors, postoperative morbidity, operative mortality and survival. Result: The mean age was 63_4. There were 159 men. On histopathological examination, $93.1\%$ had squamous cell carcinoma. On the locations, $78.7\%$ were in mid and lower esophagus. Curative resections for esophageal cancer were possible in $162(93.1\%)$ patients. Mean hospital stay was 19.4 days with out difference between the groups. The overall postoperative morbidity were occurred in 61 patients $(35.1\%)$. The most frequent morbidity was pulmonary complication in $30(17.2\%)$. Preoperative incidence of hypertension, cardiac and pulmonary dysfunction were more common in Group I. However, there was no difference in overall postoperative morbidity, operative mortality and survival rate between the two groups. Conclusion: Esophagectomy for esophageal cancer could be carried out safely in patients over 70 years of age with satisfactory short-term results. Advanced age is no longer a risk factor for esophagectomy.

• Journal of Chest Surgery
• /
• v.29 no.12
• /
• pp.1329-1336
• /
• 1996

From January, 1994 to January. 1996, mitral valve replacement was performed in 27 patients. Among these, 17 patients underwent mitral valve replacement(MVR) with preservation of the annulo-papillary continuity(PAPCMVR) (-Group I), and 10 patients underwent conventional methods of excision of all the chordae(Group II). The operative technique for PAPCM VR consists of the division of the anterior leaflet into anterior and posterior segments, shifting and reattachment of the divided segments to the mitral ring of the respective commissural areas. This retrospective study has been designed to evalute the postoperative left ventricular function in the two groups. In the group 1, LVEF(Left Vnetricular Ejection Fraction : %) was 52 $\pm$ 3 preoperatively And 50$\pm$3 postoperatively, LVESI Vent icular End Systolic Volume Index/mL/m2) wIns 59 :6 and 51 $\pm$ 7, LVEDI Ventricular End Diastolic Volume Index/mL/m2) was 124$\pm$ 11 and 91 :8. In the group II, LVEF was 56$\pm$1 and 47:), LVESVI 62$\pm$12 and 61$\pm$15, LVEDVI 133$\pm$27 and 104$\pm$17. : the variation of the LVEF in these two group was statistically different(p(0.05). A comparison of left ventricular function data between Group I(n: 17) and Group II(n: 10) revealed better results in echocardiographic LVEF(p<0.05), LVEDVI(p<0.01) in the former group. The mean functional class(UYHA) was 2.6 preoperative and improved to 1.0 postoperatively In group 1, and 2.8 and to 1.0 in group II. We conclude that maintenance of continuity between the mitral annulus and papillary muscles is expected to have a beneficial effect on postoperative left ventricular performance.