• Proceedings of the Korean Institute of Navigation and Port Research Conference
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• 2013.06a
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• pp.34-36
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• 2013

부산항 및 부산신항 개발의 특징은 매립으로 인하여 가항수역은 협소화되는 반면에 선박은 대형화되면서 흘수가 증가함으로 인하여 점점 더 깊은 수심을 필요로 하게 되었다. 따라서 초대형선들은 출입항선 상호간의 간섭이 증가하고, 심흘수화로 인한 조종성능의 저하와 비상시 대응책의 한계를 드러내는 등의 문제점을 안고 있다. 또한 전반적인 선박 통항량의 증가는 거대형 컨테이너선이 부두전면에서 회두하거나 감속, 접근하는데 소요되는 시간에 따라서 항만의 효율성뿐만 아니라 주변수역의 안전에도 크게 영향을 미치고 있다. 따라서 본 연구에서는 항만의 안전과 효율성을 제고하기 위하여 초대형 선박의 조종특성과 주변 여건을 다각도로 고려한 최적의 표준 조선방법 및 응급조선을 2D베이스로 개발된 선박조종시뮬레이터를 이용하여 모색해 보고자 한다.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.2
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• pp.165-171
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• 2018

An overdose of antihypertensive agents, such calcium channel blockers (CCBs) and angiotensin II receptor blocker (ARBs), and the antihyperglycemic agent, metformin, leads to hypotension and lactic acidosis, respectively. A 40-year-old hypertensive and diabetic man with hyperlipidemia and a weight of 110 kg presented to the emergency room with vomiting, dizziness, and hypotension following an attempted drug overdose suicide with combined CCBs, ARBs, 3-hydroxy-3-methylglutaryl-coemzyme A reductase inhibitors, and metformins. A conventional medical treatment initially administered proved ineffective. The treatment was then changed to simultaneous extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT), which was effective. This shows that simultaneous ECMO and CRRT can be an effective treatment protocol in cases of ineffective conventional medical therapy for hypotension and lactic acidosis due to an overdose of antihypertensive agents and metformin, respectively.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.2
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• pp.124-130
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• 2018

Purpose: The number of glyphosate and glufosinate intoxication cases are increasing in Korea. This study was undertaken is to compare the clinical manifestations of poisoning by these two herbicides and to document severities and clinical outcomes. Methods: We retrospectively evaluated cases of glyphosate or glufosinate intoxication among patients that visited our emergency department between January 1, 2013, and December 31, 2017. Incidences of intoxications were analyzed over this five year period, and underlying diseases, transportation, mental state, shock occurrence, inotropics, gastric lavage, charcoal administration, intubation and ventilator therapy, and hemodialysis were investigated. In addition, we included transfer to the intensive care unit, incidences of pneumonia and of other complications, death, and hopeless discharge. Results: There were 119 cases of glyphosate intoxication and 42 of glufosinate intoxication. Levels of consciousness were lower for glufosinate and vasopressor usage was higher due to a high shock rate (p=0.019). In addition, many patients were referred to the ICU for intubation and ventilation. The incidences of pneumonia and of other complications were significantly higher for glufosinate. Conclusion: Overall glufosinate intoxication was found to be more severe than glyphosate intoxication as determined by complication and ICU admission rates.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.2
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• pp.108-115
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• 2018

Purpose: Glehnia littoralis has been reported to have several pharmacological properties but no in vivo reports describing the protective effects of this plant on${\alpha}$-amanitin-induced hepatotoxicity have been published. ${\alpha}$-Amanitin is a peptide found in several mushroom species that accounts for the majority of severe mushroom poisonings leading to severe hepatonecrosis. In our previous in vitro study, we found that ${\alpha}$-amanitin induced oxidative stress, which may contribute to its severe hepatotoxicity. The aim of this study was to investigate whether Glehnia littoralis acetate extract (GLEA) has protective antioxidant effects on ${\alpha}$-amanitin-induced hepatotoxicity in a murine model. Methods: Swiss mice (n=40 in all groups) were divided into four groups (n=10/group). Three hours after giving ${\alpha}$-amanitin (0.6 mg/kg, i.p.) to the mice, they were administered silibinin (50 mg/kg/d, i.p.) or Glehnia littoralis ethyl acetate extract (100 mg/kg/d, oral) therapies once a day for 3 days. After 72 hours of treatment, each subject was killed, cardiac blood was aspirated for hepatic aminotransferase measurement, and liver specimens were harvested to evaluate the extent of hepatonecrosis. The degree of hepatonecrosis was assessed by a pathologist blinded to the treatment group and divided into 4 categories according to the grade of hepatonecrosis. Results: GLEA significantly improved the beneficial functional parameters in ${\alpha}$-amanitin-induced hepatotoxicity. In the histopathological evaluation, the toxicity that was generated with ${\alpha}$-amanitin was significantly reduced by GLEA, showing a possible hepatoprotective effect. Conclusion: In this murine model, Glehnia littoralis was effective in limiting hepatic injury after ${\alpha}$-amanitin poisoning. Increases of aminotransferases and degrees of hepatonecrosis were attenuated by this antidotal therapy.

• The Korean Journal of Emergency Medical Services
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• v.25 no.1
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• pp.159-175
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• 2021

Purpose: This study aimed to obtain, categorize, and analyze baseline data regarding the subjective perception of ambulances from the consumers' perspective, which can be utilized for improving emergency medical service systems. Methods: Fifty people aged 20 to 40 years old were selected as P samples. Data from 35 statements of Q-cards and Q-sample distribution plots were gathered using Q-sort and analyzed using the PC-QUANL program for major factor analysis. Results: We found four unique characteristics which accounted for 57.57% of the total variation: "Considerate of emergency situations," "Identifying emergency patients," "Trusting emergency vehicles," and "Sympathizing with emergency patients." Conclusion: Organizations that provide emergency medical services using ambulances should plan and render patient care according to the four types of public perception of ambulances.

• The Korean Journal of Emergency Medical Services
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• v.25 no.3
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• pp.63-70
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• 2021

Purpose: The study aimed to collect data from patients who were rejected by emergency requests for transfer to a tertiary hospital through 119 EMT and to analyze the data in the hospital to improve the plan. Methods: We analyzed 4,702 cases of emergency requests made by patients who were rejected by 119 emergency assistance out of the 22,568 patients who visited the emergency medical center in the C area of G metropolitan city from January 2018 through December 2020. The collected data were analyzed using IBM SPSS Statistics Version XX (IBM Corp., Armonk, N.Y., USA). Results: The major medical department with the largest number of such cases was the department of emergency medicine, with 2,519 cases (53.6%). Simple bruises were the most common diagnosis, with 2,819 cases (61.2%). KTAS classification was the highest with 3,562 patients (75.8%) in grade 4. As for the results, 4,084 patients (86.9%) were discharged from the hospital. Conclusion: Most of the patients who were rejected by emergency requests were non-emergency patients and were discharged from the hospital. emergency requests must be rejected at public relations and sites. In addition, the law should be amended to specifically present the reasons for refusal of emergency requests.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.2
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• pp.259-266
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• 2019

This study aimed to identify factors that had an influence on preventive behaviors of Emergency Medical Service students against tuberculosis to promote their preventive behavior. The subjects of the study were 314 students studying emergency medical service from one 4-year college and two 3-year colleges in Jeollabukdo and they were researched with the use of a questionnaire from June 25, to July 6, 2018. For a statistical analysis of the data obtained, this study used SPSS 18.0 and conducted a t-test, an ANOVA, a Pearson's correlation coefficient and a multi-regression test to analyze the data. Pearson's correlation coefficient analysis showed that the preventive behavior levels was significantly correlated with knowledge of tuberculosis (r = 0.268, p <0.001) and attitude (r = 0.394, p<0.001). As results of the multi-regression test, the higher the knowledge of tuberculosis(${\beta}=0.152$, p<0.001) and the higher the attitude(${\beta}=0.052$, p<0.001), the higher the preventive behavior levels. In addition, Students who have experienced tuberculosis in their own or relative's relatives have a high level of prevention behavior(${\beta}=-0.186$, p=0.001). Therefore, it is suggested that organized and consistent education programs to promote knowledge on tuberculosis, change negative perception on it and improve preventive behavior levels should be developed and provided.

• Journal of The Korean Society of Clinical Toxicology
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• v.20 no.1
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• pp.8-14
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• 2022

Purpose: This study was undertaken to investigate how sedative-hypnotics affect the occurrence and severity of the patient's symptoms. In addition, we conducted a study to determine the type of patients who reacted severely and required hospitalization; patients were accordingly classified as hospitalized patients and patients discharged from the emergency room. Methods: From January 2017 to December 2019, we investigated the demographics, drug information, history, laboratory tests, and severity of patients who visited our emergency department and were diagnosed with benzodiazepine, zolpidem, and doxylamine succinate overdose. We further compared details of hospitalized patients and discharged patients. Results: Subjects who had overdosed and visited the ED included 120 for benzodiazepine, 147 for zolpidem, and 27 for doxylamine succinate. Comparisons between the three groups revealed differences in their early diagnosis, psychiatric history, and sleep disturbance. Differences between groups were also determined for mental state, poisoning history, treatment received in the intensive care unit, and intubation and ventilator support. In cases of benzodiazepine overdose, we obtained a high hospitalization rate (40.0%), admission to the intensive care unit (24.2%), and intubation rate (18.3%). Comparisons between hospitalized patients and discharged groups showed differences in transferred patients, early diagnosis, and mental state. Conclusion: Patients poisoned by sedative-hypnotics are increasing every year. In cases of benzodiazepine and zolpidem, the hospitalization rates were high, and benzodiazepine overdose resulted in hospitalization, intensive care unit admission, and pneumonia in a majority of cases. Therefore, active treatment and quick decisions in the emergency room are greatly required.

• The Korean Journal of Emergency Medical Services
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• v.25 no.1
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• pp.85-103
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• 2021

Purpose: This study measured the mental health levels of 119 paramedics, and identified the association of mental health levels with safety environments, personal protective equipment, and coronavirus risk awareness. Methods: A total of 119 out of 428 from Daegu and Gyeongbuk took part in this study. The statistical analysis methods were the t-test, ANOVA, Pearson's correlation analysis and multiple regression analysis. Results: In a multiple regression analysis, females (β=-.137, p=<.001) showed a higher relevance to negative mental health than males. The moderate satisfied (β=-.088, p=.014) and dissatisfied (β=-.147, p=.006) showed a higher relevance to negative mental health than higher satisfied. Moderate stress perception (β=-.199, p=<.001) and higher stress perception (β=-.414, p=<.001) showed a higher relevance to negative mental health than lower stress perception. Corona-virus risk awareness (β=-.050, p=.045) was related to negative mental health and safety environment (β=.136, p=<.001). Personal protective equipment (β=.147, p=<.001) were related to positive mental health. Conclusion: Conclusively, it is necessary to develop and implement high-quality intervention programs using significantly influencing variables to impact the mental health of 119 paramedics.

• Journal of Convergence for Information Technology
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• v.10 no.12
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• pp.126-131
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• 2020

This study analyzed the inflow and outflow patterns of emergency department patients, to identify changes in regional types in cities, counties, and districts in Jeonlado, Korea. Data of areas in Jeonlado for 2014 to 2018 were extracted from the National Emergency Department Information System. The extracted data includes the patients' and emergency medical institution addresses, which were used to calculate the relevance index (RI) and commitment index (CI). The calculated indices were classified into regional types by applying cluster analysis. A non-parametric method, Kruskal-Wallis test, was employed to examine the differences between years for RI and CI by regional types. The results of cluster analysis using the relevance and commitment indices revealed three regional types. Regions in cluster 1 were classified as outflow type, in cluster 2 as inflow type, and in cluster 3 as self-sufficient. RI and CI were calculated for each cluster or regional type. There were no significant differences between years in cluster 2 (inflow type) and cluster 3 (self-sufficient type). In cluster 1 (outflow type), there were no significant differences in CI between the years; however, there were significant differences in RI between 2014 and 2017, and 2014 and 2018. It is difficult to see that the emergency medical environment has improved due to the increased concentration of emergency medical care.