• Title/Summary/Keyword: Accident event

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Cardiac Intracoronary Stenting vs CABG: Prevention of Medical Accident (심장 스텐트 시술과 의료사고 예방)

  • Kim, Kyoung Reay;Park, Kook Yang
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.163-194
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    • 2017
  • Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

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Intelligent Optimal Route Planning Based on Context Awareness (상황인식 기반 지능형 최적 경로계획)

  • Lee, Hyun-Jung;Chang, Yong-Sik
    • Asia pacific journal of information systems
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    • v.19 no.2
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    • pp.117-137
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    • 2009
  • Recently, intelligent traffic information systems have enabled people to forecast traffic conditions before hitting the road. These convenient systems operate on the basis of data reflecting current road and traffic conditions as well as distance-based data between locations. Thanks to the rapid development of ubiquitous computing, tremendous context data have become readily available making vehicle route planning easier than ever. Previous research in relation to optimization of vehicle route planning merely focused on finding the optimal distance between locations. Contexts reflecting the road and traffic conditions were then not seriously treated as a way to resolve the optimal routing problems based on distance-based route planning, because this kind of information does not have much significant impact on traffic routing until a a complex traffic situation arises. Further, it was also not easy to take into full account the traffic contexts for resolving optimal routing problems because predicting the dynamic traffic situations was regarded a daunting task. However, with rapid increase in traffic complexity the importance of developing contexts reflecting data related to moving costs has emerged. Hence, this research proposes a framework designed to resolve an optimal route planning problem by taking full account of additional moving cost such as road traffic cost and weather cost, among others. Recent technological development particularly in the ubiquitous computing environment has facilitated the collection of such data. This framework is based on the contexts of time, traffic, and environment, which addresses the following issues. First, we clarify and classify the diverse contexts that affect a vehicle's velocity and estimates the optimization of moving cost based on dynamic programming that accounts for the context cost according to the variance of contexts. Second, the velocity reduction rate is applied to find the optimal route (shortest path) using the context data on the current traffic condition. The velocity reduction rate infers to the degree of possible velocity including moving vehicles' considerable road and traffic contexts, indicating the statistical or experimental data. Knowledge generated in this papercan be referenced by several organizations which deal with road and traffic data. Third, in experimentation, we evaluate the effectiveness of the proposed context-based optimal route (shortest path) between locations by comparing it to the previously used distance-based shortest path. A vehicles' optimal route might change due to its diverse velocity caused by unexpected but potential dynamic situations depending on the road condition. This study includes such context variables as 'road congestion', 'work', 'accident', and 'weather' which can alter the traffic condition. The contexts can affect moving vehicle's velocity on the road. Since these context variables except for 'weather' are related to road conditions, relevant data were provided by the Korea Expressway Corporation. The 'weather'-related data were attained from the Korea Meteorological Administration. The aware contexts are classified contexts causing reduction of vehicles' velocity which determines the velocity reduction rate. To find the optimal route (shortest path), we introduced the velocity reduction rate in the context for calculating a vehicle's velocity reflecting composite contexts when one event synchronizes with another. We then proposed a context-based optimal route (shortest path) algorithm based on the dynamic programming. The algorithm is composed of three steps. In the first initialization step, departure and destination locations are given, and the path step is initialized as 0. In the second step, moving costs including composite contexts into account between locations on path are estimated using the velocity reduction rate by context as increasing path steps. In the third step, the optimal route (shortest path) is retrieved through back-tracking. In the provided research model, we designed a framework to account for context awareness, moving cost estimation (taking both composite and single contexts into account), and optimal route (shortest path) algorithm (based on dynamic programming). Through illustrative experimentation using the Wilcoxon signed rank test, we proved that context-based route planning is much more effective than distance-based route planning., In addition, we found that the optimal solution (shortest paths) through the distance-based route planning might not be optimized in real situation because road condition is very dynamic and unpredictable while affecting most vehicles' moving costs. For further study, while more information is needed for a more accurate estimation of moving vehicles' costs, this study still stands viable in the applications to reduce moving costs by effective route planning. For instance, it could be applied to deliverers' decision making to enhance their decision satisfaction when they meet unpredictable dynamic situations in moving vehicles on the road. Overall, we conclude that taking into account the contexts as a part of costs is a meaningful and sensible approach to in resolving the optimal route problem.

Stressful Life Events, Physical Symptoms, and Anxiety in Adolescents (청소년의 스트레스 생활사건, 신체적증상과 불안에 관한 연구)

  • Yun, Kyu-Wol
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.1
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    • pp.20-30
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    • 2000
  • Objective : This study was designed to investigate the frequencies and the relation of stressful life events and health problems and evaluate the influence of stressful life events on the physical symptoms and anxiety in adolescents. Method : Newcomb's 39-item life-event questionnaire and Newcomb's 19-item health problems questionnaire were administered to 475 adolescents. The frequencies of stressful life events and health problems which had actually occurred to them during the previous 12 months were investigated. Items of stressful life events were classified in 8 dimensional scaling factors(Family/parents, Accident/Illness, Sexuality, Autonomy, Deviance, Relocation, Distress, Items not in scales) and items of health problems were classified in 5 health problems(General, Heart and Lung, Nervous system, Anxiety, Psychosomatic symptoms) and the correlation between them was analyzed. Result : 1) The average number of events occurring during the past year for the 475 adolescents is 3(7.7%). The most frequent item of stressful life events was 'Thought about suicide' and dimensional factors of "Distress" and "Autonomy" were the most frequent life events in multidimensional sacling analysis. There were more factors of "Family/Illness" and " Autonomy" in male, while there was more factor of "Distress" in female. There were more factors of "School violence" and "Deviance" in younger students, while there were more factors of "Sexuality" and "Autonomy" in older students. 2) The most frequent item of health problem was 'excessive fatigue' and "anxiety" was most frequent health problem in multidimensional scaling analysis. There were more health problems in female than those in male. The higher grades the students became, the more health problems they have reported. 3) There was significant relationship between 7 factors of stressful life events except one factor of "Relocation" and 5 health problems. Conclusions : These findings suggest that as adolescents grow older, they are engaging in more controllable behaviors related to autonomy and sexuality and at the same time are experiencing increased difficulty with distressful or discomforting events, and their stressful life events are significantly related to decreased health and psychological functiong.

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Legislative Study on the Mitigation of the Burden of Proof in Hospital Infection Cases - Focusing on the revised Bürgerliches Gesetzbuch - (병원감염 사건에서 증명책임 완화에 관한 입법적 고찰 - 개정 독일민법을 중심으로 -)

  • Yoo, Hyun Jung
    • The Korean Society of Law and Medicine
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    • v.16 no.2
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    • pp.159-193
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    • 2015
  • Owing to causes such as population aging, increased use of various medical devices, long-term hospitalization of various patients with reduced immune function such as cancer, diabetes, and organ transplant patients, and the growing size of hospitals, hospital infections are continuing to increase. As seen in the MERS crisis of 2015, hospital infections have become a social and national problem. In order to prevent damage due to such hospital infections, it is necessary to first strictly implement measures to prevent hospital infections, while, on the other hand, providing proper relief of damage suffered due to hospital infections. However, the mainstream attitude of judicial precedents relating to hospital infection cases has been judged to in fact shift responsibility over damages due to hospital infections on the patient. In light of the philosophy of the damage compensation system, whose guiding principle if the fair and proper apportionment of damages, there is a need to seek means of drastically relaxing the burden of proof on the patient's side relative to conventional legal principles for relaxing the burden of proof, or the theory of de facto estimation. In relation to such need, the German civil code (Burgerliches Gesetzbuch), which defines contracts of medical treatment as typical contracts under the civil code, and has presumption of negligence provisions stipulating that, in cases such as hospital infections which were completely under the control of the medical care providers, if risks in general medical treatment have been realized which cause violations of the life, body, or health of patients, error on the part of the person providing medical care is presumed, was examined. Contracts of medical treatment are entered into very frequently and broadly in the everyday lives of the general public, with various disputes owing thereto arising. Therefore, it is necessary to, by defining contracts of medical treatment as typical contracts under the civil code, regulate the content of said contracts, as well as the proof of burden when disputes arise. If stipulations in the civil code are premature as of yet, an option may be to regulate through a special act, as is the case with France. In the case of hospital infection cases, it is thought that 'legal presumption of negligence' relating to 'negligence in the occurrence of hospital infections,' which will create a state close to equality of arms, will aid the resolution of the realistic issue of the de facto impossibility of remedying damages occurring due to negligence in the process of occurrence of hospital infections. Also, even if negligence is presumed by law, as the patient side is burdened with proving the causal relationships, such drastic confusion as would occur if the medical care provider side is found fully liable if a hospital infection occurs may be avoided. It is thought that, alongside such efforts, social insurance policy must be improved so as to cover the expenses of medical institutions having strictly implemented efforts to prevent hospital infections in the event that they have suffered damages due to a hospital infection accident, and that close future research and examination into this matter will be required.

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A Study on the Development of Assessment Index for Catastrophic Incident Warning Sign at Refinery and Pertrochemical Plants (정유 및 석유화학플랜트 중대사고 전조신호 평가지표 개발에 관한 연구)

  • Yun, Yong Jin;Park, Dal Jae
    • 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.

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.

Study on Governance Legislation for Responses to Maritime Ship Disasters (해양 선박재난 대응을 위한 거버넌스 법제 연구)

  • Bang, Hosam;Ha, Minjae
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.28 no.2
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    • pp.334-345
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    • 2022
  • The Enforcement Decree of the Framework Act on the Management of Disasters and Safety Article 3-2 specifies two 'disaster management supervision agencies' for responding to shipping disasters. These are the Korea Coast Guard, which is an on-scene disaster-responding and coordinating agency, and the Ministry of Ocean and Fisheries, which is a government department, thereby leading to possibilities for confusion. In the case of shipping disasters, where a personnel entitled full power to deal with shipping disasters is designated and his/her powers and duties are clearly made, relationship of leading and supporting agencies is made clear, and command system is simplified, an efficient response to shipping disasters is made possible. In the management of shipping disasters, all the disaster management processes, that is, prevention-preparedness-response-recovery, should be dealt with systematically and consistently. Notably, to swiftly and efficiently cope with a disastrous situation, the decision-making and command system must be simplified. The establishment of a command system and decision-making must be made independently, based on expertise. In the US, irrespective of the type of disasters, the FEMA plays a leading role and the USCG responds a response to maritime disasters by establishing the Incident Command System or Unified Command System that is an incident management system. In the UK, the MCA supervises an event and responds to it, and the SOSREP has full power to work with command and coordination independently. SOSREP, among others, is necessary to prevent an inefficient dealing of a shipping disaster owing to confrontation between participants. With reference to such leading States' practice, the Korean government should make a standardized and simplified response to maritime disasters. This study deals with a new maritime disaster responding system and provides an idea of the revision of the existing legal regime.

Development of tracer concentration analysis method using drone-based spatio-temporal hyperspectral image and RGB image (드론기반 시공간 초분광영상 및 RGB영상을 활용한 추적자 농도분석 기법 개발)

  • Gwon, Yeonghwa;Kim, Dongsu;You, Hojun;Han, Eunjin;Kwon, Siyoon;Kim, Youngdo
    • Journal of Korea Water Resources Association
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    • v.55 no.8
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    • pp.623-634
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    • 2022
  • Due to river maintenance projects such as the creation of hydrophilic areas around rivers and the Four Rivers Project, the flow characteristics of rivers are continuously changing, and the risk of water quality accidents due to the inflow of various pollutants is increasing. In the event of a water quality accident, it is necessary to minimize the effect on the downstream side by predicting the concentration and arrival time of pollutants in consideration of the flow characteristics of the river. In order to track the behavior of these pollutants, it is necessary to calculate the diffusion coefficient and dispersion coefficient for each section of the river. Among them, the dispersion coefficient is used to analyze the diffusion range of soluble pollutants. Existing experimental research cases for tracking the behavior of pollutants require a lot of manpower and cost, and it is difficult to obtain spatially high-resolution data due to limited equipment operation. Recently, research on tracking contaminants using RGB drones has been conducted, but RGB images also have a limitation in that spectral information is limitedly collected. In this study, to supplement the limitations of existing studies, a hyperspectral sensor was mounted on a remote sensing platform using a drone to collect temporally and spatially higher-resolution data than conventional contact measurement. Using the collected spatio-temporal hyperspectral images, the tracer concentration was calculated and the transverse dispersion coefficient was derived. It is expected that by overcoming the limitations of the drone platform through future research and upgrading the dispersion coefficient calculation technology, it will be possible to detect various pollutants leaking into the water system, and to detect changes in various water quality items and river factors.

Evaluation of Application Possibility for Floating Marine Pollutants Detection Using Image Enhancement Techniques: A Case Study for Thin Oil Film on the Sea Surface (영상 강화 기법을 통한 부유성 해양오염물질 탐지 기술 적용 가능성 평가: 해수면의 얇은 유막을 대상으로)

  • Soyeong Jang;Yeongbin Park;Jaeyeop Kwon;Sangheon Lee;Tae-Ho Kim
    • Korean Journal of Remote Sensing
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    • v.39 no.6_1
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    • pp.1353-1369
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    • 2023
  • In the event of a disaster accident at sea, the scale of damage will vary due to weather effects such as wind, currents, and tidal waves, and it is obligatory to minimize the scale of damage by establishing appropriate control plans through quick on-site identification. In particular, it is difficult to identify pollutants that exist in a thin film at sea surface due to their relatively low viscosity and surface tension among pollutants discharged into the sea. Therefore, this study aims to develop an algorithm to detect suspended pollutants on the sea surface in RGB images using imaging equipment that can be easily used in the field, and to evaluate the performance of the algorithm using input data obtained from actual waters. The developed algorithm uses image enhancement techniques to improve the contrast between the intensity values of pollutants and general sea surfaces, and through histogram analysis, the background threshold is found,suspended solids other than pollutants are removed, and finally pollutants are classified. In this study, a real sea test using substitute materials was performed to evaluate the performance of the developed algorithm, and most of the suspended marine pollutants were detected, but the false detection area occurred in places with strong waves. However, the detection results are about three times better than the detection method using a single threshold in the existing algorithm. Through the results of this R&D, it is expected to be useful for on-site control response activities by detecting suspended marine pollutants that were difficult to identify with the naked eye at existing sites.