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Long-Term Outcomes of Stenting on Non-Acute Phase Extracranial Supra-Aortic Dissections

  • Jiang, Yeqing;Di, Ruoyu;Lu, Gang;Huang, Lei;Wan, Hailin;Ge, Liang;Zhang, Xiaolong
    • Journal of Korean Neurosurgical Society
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    • v.65 no.3
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    • pp.422-429
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    • 2022
  • Objective : Extracranial supra-aortic dissections (ESADs) with severe stenosis, occlusion and/or pseudoaneurysm presents potential risk of stroke. Endovascular stenting to reconstruct non acute phase ESADs (NAP-ESADs) is an alternative to anticoagulant or antiplatelet therapy. However, its feasibility, safety and efficacy of stenting in NAP-ESADs is unclear. This study aims to investigate the long-term outcomes of the feasibility, safety and efficacy of stenting in NAP-ESADs. Methods : Seventy-four patients with 91 NAP-ESAD vessels with severe stenosis, occlusion and/or pseudoaneurysm presents potential risk of stroke who underwent stent remodeling were enrolled into this respective study from December 2008 to March 2020. Technical success rate, complications, clinical and angiographic results were harvested and analyzed. Results : Success rate of stent deployment was 99% (90/91) with no procedural mortality or morbidity. Transient ischemic attack occurred in three patients during operation (4.1%, 3/74). Asymptomatic embolisms of distal intracranial vessels were found in two patients (2.7%, 2/74). One hundred and forty-two stents deployed at 85 carotid (135 stents) and six vertebral (seven stents) vessels. Six stent types (Wingspan, 28/135, 20.7%; Solitaire, 10/135, 7.4%; Neuroform, 8/135, 5.9%; LVIS, 2/135, 1.5%; Precise, 75/135, 55.6%; Acculink, 12/135, 8.9%) were deployed at carotid arterial dissection while two types (Wingspan, 5/7, 71.4%; Solitaire 2/7, 28.6%) at vertebral arterial dissection. Digital subtracted angiography (56%, 51/91), computational tomography angiography (41.8%, 38/91) and high resolution magnetic resonance imaging (2.2%, 2/91) were adopted for follow up, with a mean time of 17.2±15.4 months (5-77). All patient modified Rankin Scale scores showed no increase at discharge or follow-up. Angiographically, dissections in 86 vessels in 69 patients (94.5%, 86/91) were completely reconstructed with only minor remnant dissections in four vessels in four patients (4.4%, 4/91). Severe re-stenosis in the stented segment required re-stenting in one patient (1.1%, 1/91). Conclusion : Stent remodeling technique provides feasible, safe and efficacious treatment of ESADs patients with severe stenosis, occlusion and/or pseudoaneurysm.

Market in Medical Devices of Blockchain-Based IoT and Recent Cyberattacks

  • Shih-Shuan WANG;Hung-Pu (Hong-fu) CHOU;Aleksander IZEMSKI ;Alexandru DINU;Eugen-Silviu VRAJITORU;Zsolt TOTH;Mircea BOSCOIANU
    • Korean Journal of Artificial Intelligence
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    • v.11 no.2
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    • pp.39-44
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    • 2023
  • The creativity of thesis is that the significance of cyber security challenges in blockchain. The variety of enterprises, including those in the medical market, are the targets of cyberattacks. Hospitals and clinics are only two examples of medical facilities that are easy targets for cybercriminals, along with IoT-based medical devices like pacemakers. Cyberattacks in the medical field not only put patients' lives in danger but also have the potential to expose private and sensitive information. Reviewing and looking at the present and historical flaws and vulnerabilities in the blockchain-based IoT and medical institutions' equipment is crucial as they are sensitive, relevant, and of a medical character. This study aims to investigate recent and current weaknesses in medical equipment, of blockchain-based IoT, and institutions. Medical security systems are becoming increasingly crucial in blockchain-based IoT medical devices and digital adoption more broadly. It is gaining importance as a standalone medical device. Currently the use of software in medical market is growing exponentially and many countries have already set guidelines for quality control. The achievements of the thesis are medical equipment of blockchain-based IoT no longer exist in a vacuum, thanks to technical improvements and the emergence of electronic health records (EHRs). Increased EHR use among providers, as well as the demand for integration and connection technologies to improve clinical workflow, patient care solutions, and overall hospital operations, will fuel significant growth in the blockchain-based IoT market for linked medical devices. The need for blockchain technology and IoT-based medical device to enhance their health IT infrastructure and design and development techniques will only get louder in the future. Blockchain technology will be essential in the future of cybersecurity, because blockchain technology can be significantly improved with the cybersecurity adoption of IoT devices, i.e., via remote monitoring, reducing waiting time for emergency rooms, track assets, etc. This paper sheds the light on the benefits of the blockchain-based IoT market.

Analysis of the Chinese Navy's Offensive Strategy for the West Sea and the Development Direction of the Korean Navy's Response Strategy (중국해군의 공세적 서해(西海) 진출 전략 분석과 한국해군의 대응전략 발전방향)

  • Kim, Nam-su
    • Maritime Security
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    • v.6 no.1
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    • pp.1-35
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    • 2023
  • The purpose of this study is to present the direction of development of our navy's response strategy through analysis at the ends, ways, and means level of the Chinese navy's offensive strategy for the West Sea. As a result of the analysis, at the ends level, the Chinese Navy's offensive strategy for the West Sea strategy is being linked to a grand strategy to protect maritime rights and achieve maritime power between the U.S. and China competition, at the ways level, the Chinese Navy is expected to create a foundation for the international community to recognize the West Sea as China's inland sea through "routine entry" and "exercise authority", and in case of emergency, it will try to secure sea control in the West Sea in a short period of time by blocking Korea's maritime transportation route based on the overwhelming preemptive attack capability of aircraft carriers. At the means level, it is accelerating the construction of aircraft carrier warfare units and improving its ability to engage long-range missiles. As a direction of development of the Korean Navy's response strategy in response to this, first, Establishment and Development of National Maritime Security Strategy in conjunction with the Korean Indo-Pacific Strategy. Second, it proposes the development of the concept of effective security operations for the east sea area of the West Sea intermediate line, and third, the development of the concept of combat performance and capacity building to strengthen survival and lethality.

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On the Hydraulic Characteristics of Efficient Long Wave Energy Absorber-Eco-breaker 2 (장파 제어체 Eco-breaker 2의 수리특성)

  • Cho, Yong Jun;Kim, Ho Min
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.28 no.5B
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    • pp.547-558
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    • 2008
  • With the advent of super cargo ship due to the explosive increase in the amount of cargo shipped via seas, some mega ports are under construction in South Korea, to accommodate the super cargo ship, and some of them already enter their final phase. To sustain the harbor tranquility, mega ports usually comprise huge vertical type breakwaters which are intrinsically vulnerable to the attack of long waves. In this rationale, we present the chamber type breakwater with a circular curtain wall - Eco-breaker 2, to alleviate the reflection of long waves and numerically investigate the hydraulic characteristics of Eco-breaker 2. As a wave driver, we use the Navier-Stokes eq., the most robust wave driver, using SPH (Smoothed Particle Hydrodynamics) and LES (Large Eddy Simulation). For the verification of numerical results, we also carried out hydraulic model test. It is shown that Eco-breaker 2 can effectively alleviate the reflection of long waves with its inherited large organized eddies encompassing the water chamber and some region off the curtain wall of varying size. It is also shown that the scope and strength of large organized eddies strongly depends on the incident wave period, and the reflection coefficient can be lowered to 0.18 by tuning the size of water chamber such that resident time at the chamber is just short of the half period of incident waves. Based on these results, we present the specification of Eco-breaker 2 to boost its use on the development of water environment friendly harbor worldwide.

Bullying Behaviors among Senior Women at Senior Center (경로당 이용 여성 노인의 친구·이웃 집단따돌림 현상 연구)

  • Lee, Changsook;Ha, Jung-Hwa
    • 한국노년학
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    • v.39 no.3
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    • pp.485-515
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    • 2019
  • The purpose of this study was to explore bullying among senior women at a senior center. Using ethnographic research technique, we examined the process in which members of the senior center engaged in and responded to bullying. Purposive sampling method was used to choose a senior center as the subject of this study. Within the center, 16 senior women participated in the study. In-depth interviews and participatory research methods were used to collect data. We analyzed the transcripts of the interviews based on the ethnographic analysis method presented by Spradley (1979). Themes that emerged from these participatory research and interviews include: members of the senior center creating loners, people being bullied causing damages to the group, taking actions to respond to bullying, and failing to solve the bullying problems. First, the victims of bullying became loners with no one to rely on through other members' verbal attacks, discrimination, isolation, and stopping the victim to use the senior center. Second, the victims were under attack but also caused troubles at the senior center and harmed others at the same time. Third, while engaging in bullying, senior women attempted to deal with bullying problems in many ways. These attempts include: avoiding the conflict, withstanding, attempting to mediating, and so on. Finally, bullying remained to be a recurring phenomenon at the senior center. New victims of bullying continuously appeared and the influence of bullying was felt not only within the senior center but outside as well. Based on the findings of this study, we suggest that practitioners and researchers take into account factors that affect bullying among senior women.

Event Log Analysis Framework Based on the ATT&CK Matrix in Cloud Environments (클라우드 환경에서의 ATT&CK 매트릭스 기반 이벤트 로그 분석 프레임워크)

  • Yeeun Kim;Junga Kim;Siyun Chae;Jiwon Hong;Seongmin Kim
    • Journal of the Korea Institute of Information Security & Cryptology
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    • v.34 no.2
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    • pp.263-279
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    • 2024
  • With the increasing trend of Cloud migration, security threats in the Cloud computing environment have also experienced a significant increase. Consequently, the importance of efficient incident investigation through log data analysis is being emphasized. In Cloud environments, the diversity of services and ease of resource creation generate a large volume of log data. Difficulties remain in determining which events to investigate when an incident occurs, and examining all the extensive log data requires considerable time and effort. Therefore, a systematic approach for efficient data investigation is necessary. CloudTrail, the Amazon Web Services(AWS) logging service, collects logs of all API call events occurring in an account. However, CloudTrail lacks insights into which logs to analyze in the event of an incident. This paper proposes an automated analysis framework that integrates Cloud Matrix and event information for efficient incident investigation. The framework enables simultaneous examination of user behavior log events, event frequency, and attack information. We believe the proposed framework contributes to Cloud incident investigations by efficiently identifying critical events based on the ATT&CK Framework.

Effects of Electrodeposition Parameters on Electrochemical Hydroxyl Radical Evolution of PbO2 Electrode (이산화납 전극 제조 시 전기화학적 증착인자가 수산화라디칼 발생에 미치는 영향)

  • Shim, Soojin;Yoon, Jeyong
    • Journal of Korean Society of Environmental Engineers
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    • v.38 no.12
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    • pp.647-655
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    • 2016
  • Lead dioxide ($PbO_2$) is an electrode material that is effective for organic pollutant degradation based on hydroxyl radical ($^{\bullet}OH$) attack. Representative parameters for $PbO_2$ electrodeposition are summarized to current, temperature, reaction time, concentration of Pb(II) and electrolyte agent. In this study, $Ti/PbO_2$ electrodes were fabricated by electrodeposition method under controlled reaction time, current density, temperature, concentration of $HNO_3$ electrolyte. Effects of deposition parameters on $^{\bullet}OH$ evolution were investigated in terms of electrochemical bleaching of p-Nitrosodimethylaniline (RNO). As major results, the $^{\bullet}OH$ evolution was promoted at the $PbO_2$ that was deposited in longer reaction time (1-90 min), lower current density ($0.5-50mA/cm^2$), higher temperature ($5-65^{\circ}C$) and lower $HNO_3$ concentration (0.01-1.0 M). Especially, the $PbO_2$ which was deposited in 0.01 M of lowest $HNO_3$ concentration by applying $20mA/cm^2$ for above 10 min was most effective on $^{\bullet}OH$ evolution. The performance gap between $PbO_2$s that was best and worst in $^{\bullet}OH$ evolution was about 41%. Among the properties of $PbO_2$ related on $^{\bullet}OH$ evolution performance, conductivity of $Ti/PbO_2$ significantly influenced on $^{\bullet}OH$ evolution. The increase in conductivity promoted $^{\bullet}OH$ evolution. In addition, the increase in crystal size of $PbO_2$ interfered $^{\bullet}OH$ evolution at surface of some $PbO_2$ deposits.

Sports Injuries in College Taekwondo Players: Retrospective Analysis of 47 Players (대학 태권도 선수들에서의 스포츠 손상: 47명에 대한 후향적 연구)

  • Jung, Hong-Geun;Park, Hee-Gon;Kim, Jong-Phil;Kim, You-Jin;Kim, Ki-Choul;Kim, Young-In;Lee, Sang-Min
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.1
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    • pp.69-74
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    • 2006
  • Purpose: To perform the retrospective analysis of the sports injuries sustained by the college Taekwondo athletes in the respect of the injury patterns, mechanism of injury and clinical outcome Materials and Methods: This study is based on 47 out of 49 college Takwondo athletes, who had experienced the Takwondo related musculoskeletal injuries severe enough to visit the clinic for medical treatment. The mean age at the time of injury was 18.8 years and 39 were males and 8 females. The Taekwondo career was average 9.6 years and the injuries were sustained at average 6.7 years of their career. The injuries were analyzed by the detailed interview with thorough physical examination. Results: Forty-seven Taekwondo athletes in the study experienced average 1.8 injury/person (total 85 cases) with 26 persons of one time experience(55.3%), 11 persons of 2 times(23.4%),4 persons of 3 times (8.5%),5 persons of 4 times (10.6%) and 1 person of 5 times (2.2%). Injuries occurred during training in 50 cases (58.8%), while during match in 35 cases (41.2%). Injuries occurred during the attack phase of the match are 26 cases (31.7%) while 49 cases (57.6%) during the defense phase. As for the pattern of injury, fracture was the most common with 49 cases (57.6%), followed by ligament injury with 21 cases (24.7%). The upper extremity injuries were 32 cases (37.7%) while the lower extremity injuries were 44 cases (51.8%) Mode of medical treatment were operation in 15cases(17.7%), cast in 21 cases(24.7%), splint in 33 cases (38.8%), physical therapy in 15cases(17.7%) and acupuncture in 1 case(1.1%) Conclusion: Almost all the college Taekwondo athletes (96%) experienced sports injuries severe enough to receive medical treatments with the fracture being the most common injury pattern. The injuries occurred more commonly during the defense phase of the competition.

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Discussion on the Strategic Priorities and Navy's Coping in the Interwar Period Britain, 1919?1939 (「전간기 영국의 전략 우선순위 논의와 영국해군의 대응, 1919-1939」)

  • Jeon, Yoon-Jae
    • Strategy21
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    • s.32
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    • pp.123-159
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    • 2013
  • The purpose of this research paper is to re-valuate the factors that affected the Royal Navy's rearmament and preparation for war by conducting analysis on the discussion held in the Britain on the strategic priorities and Navy's coping measures adopted during the interwar period. After the end of the WWI, each of the military arms of the Britain faced significant difficulty in securing budget and increasing their military power all throughout the interwar period, and the Navy was not an exception. The WWII that got started on September 1939 was the turning point in which this difficulty led to full-fledged crisis. Immensely many criticisms followed after the war and problems were identified when it comes to the Royal Navy's performance during the war. This type of effort to identify problem led to the attempt to analyze whether Royal Navy's preparation for war and rearmament policy during interwar period were adequate, and to identify the root causes of failure. Existing studies sought to find the root cause of failed rearmament from external factors such as the deterioration of the Britain itself or pressure from the Treasury Department to cut the budget for national defense, or sought to detect problems from the development of wrong strategies by the Navy. However, Royal Navy's failed preparation for the war during interwar period is not the result of one or two separate factors. Instead, it resulted due to the diverse factors and situations that the Britain was facing at the time, and due to intricate and complex interaction of these factors. Meanwhile, this research paper focused on the context characterized by 'strategic selection and setting up of priorities' among the various factors to conduct analysis on the Navy's rearmament by linking it with the discussion held at the time on setting up strategic priorities, and sought to demonstrate that the Navy Department's inadequate counter-measures developed during this process waned Royal Navy's position. After the end of WWI, each of the military arms continued to compete for the limited resources and budget all throughout the interwar period, and this type of competition amidst the situation in which the economic situation of Britain was still unstable, made prioritization when it comes to the allocation of resources and setting up of the priorities when it comes to the military power build-up, inevitable. Amidst this situation, the RAF was able to secure resources first and foremost, encouraged by the conviction of some politicians who were affected by the 'theory of aerial threat' and who believed that curtailing potential attack with the Air Force would be means to secure national security at comparatively lower cost. In response, Navy successfully defended the need for the existence of Navy despite the advancement of the aerial power, by emphasizing that the Britain's livelihood depends on trade and on the maintenance of maritime traffic. Despite this counter-measuring logic, however, Navy's role was still limited to the defense of overseas territory and to the fleet run-off instead of sea traffic route production when it comes to the specific power build-up plan, and did not understand the situation in which financial and economic factors gained greater importance when it comes to the setting up of strategic priorities. As a result, Navy's plan to build its powers was met with continual resistance of the Treasury Department, and lost the opportunity to re-gain the status of 'senior service' that it had enjoyed in the past during the competition for strategic prioritization. Given that the strategic and economic situation that Korea faces today is not very different from that of the Britain during the interwar period, our Navy too should leverage the lessons learned from the Royal Navy to make the effort to secure viable position when it comes to the setting of priorities in case of national defense strategy by presenting the basis on why maritime coping should be prioritized among the numerous other threats, and by developing the measures for securing the powers needed effectively amidst the limited resources.

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A Study on the Clauses of the Work-Related Disease due to Overwork in the Workmen's Compensation Law (과로로 인한 업무상 질병의 산재보상 인정기준에 관한 연구)

  • Kim, Eun Hee
    • Korean Journal of Occupational Health Nursing
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    • v.6 no.1
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    • pp.23-43
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    • 1997
  • The work-related diseases due to continuous overwork are mainly cerebro- and cardio-vascular ones, which is commonly called 'Karoshi', death from overwork. Many factors are capable for Karoshi : occupational stress in relation to technological renovation and industrial rationalization, competitive social structure, and accumulated fatigue accured to long time or irregular working. And its occurence is on the rise. The World Labor Report 1993 released by ILO, pointed out the diseases related to overwork and stress as one of the most important occupational health problem. In Korea, social awareness of Karoshi is at an infant stage, and reliable statistics for its occurence are not compiled in a convenient manner. Despite the rising Karoshi, there are no reliable clauses in workmen's compensation enough to settle down the disputes. Therefore, it is not uncommon that the Labour Ministry and Civil Court find difficulties in reaching an agreement. This study was intended to provide proper compensation and prevention program for workers by suggesting reasonable compensation clauses for the death from overwork. This study consists of two comparative reviews on the compensaton clauses for the death from overwork. One is to review legal standards of Karoshi among three countries, such as Korea, Japan and Taiwan. The other is to investigate the cases of Karoshi in Korea, 121 cases identified at the Labor Welfare Corperation and the Labour Ministrial process of examination and reexamination, and 73 leading cases at the High Court of Justice. The main findings of the study are as follows : 1. Comparisons of comperative review on compensation clauses for the death from overwork among three countries. 1) All of three countries have the same kinds of disease for compensation, which were cerebro-and cardiao-vascular diseases, while for cardiac disease group, Korea has the smaller number of diseases for compensation than Japan. 2) As for the definition of overwork, the three countries share equally that overload for one week prior to collapse is considered as an important factor, but accumulated chronic fatigue is disregarded. 3) As the basis of overwork, in Japan, there is a tendency to move from the conditions of an ordinary healthy adult to those of the individual concerned in Japan, whereas there is no such concern yet in Korea. 4) All the three countries use a common standard of medical judgement in demonstrating causal relationship between a job and a disease. However, Korea is progressive in the sense that in the case of CVA at worksite, the worker himself has no obligation to prove the cause. 2. The results of a comparative review on excutive decisions by Labor Ministry and judicial decisions by the Court in Korea : A judicial decision is based on the legalistic probability, but a excutive decision is not. Therefore, excutive decisions have such restrictions that : 1) TIA (transitory ischemic cerebral attack) and myocarditis are excluded from compensation, and there is little consistency of decision in the case of cause-unknown death. 2) There is a tendency not to compensate for the death from overwork since the work terms such as repeated long-time working, shift work or night-shift work are not considered as overloading. 3) There is a tendency to regard the conditions of a ordinary healthy adult rather than those of the individual concerned(age, existing diseases, health state, etc.) as the comparative basis of overload. 4) There remains a tendency not to compensate for the death from overwork in the case of collapse occuring out of workplace, on the ground of 'on the course of working' and 'in the cause of accident'. Through the study, the fact manifests itself that Korea's compensation clauses for work-related diseases due to overwork are very restrictive. So, it is necessary to extend the Labor Ministry's clauses of compensation for the death from overwork following to the recent changes of other countries and internal judicial decisions. This is very important in the perspective of occupational health that aims at health promotion of workers including prevention of the Karoshi.

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