• Journal of Korean Neurosurgical Society
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• v.64 no.5
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• pp.791-798
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• 2021

Objective : The period of mechanical ventilator (MV)-dependent respiratory failure after cervical spinal cord injury (CSCI) varies from patient to patient. This study aimed to identify predictors of MV at hospital discharge (MVDC) due to prolonged respiratory failure among patients with MV after CSCI. Methods : Two hundred forty-three patients with CSCI were admitted to our institution between May 2006 and April 2018. Their medical records and radiographic data were retrospectively reviewed. Level and completeness of injury were defined according to the American Spinal Injury Association (ASIA) standards. Respiratory failure was defined as the requirement for definitive airway and assistance of MV. We also evaluated magnetic resonance imaging characteristics of the cervical spine. These characteristics included : maximum canal compromise (MCC); intramedullary hematoma or cord transection; and integrity of the disco-ligamentous complex for assessment of the Subaxial Cervical Spine Injury Classification (SLIC) scoring. The inclusion criteria were patients with CSCI who underwent decompression surgery within 48 hours after trauma with respiratory failure during hospital stay. Patients with Glasgow coma scale 12 or lower, major fatal trauma of vital organs, or stroke caused by vertebral artery injury were excluded from the study. Results : Out of 243 patients with CSCI, 30 required MV during their hospital stay, and 27 met the inclusion criteria. Among them, 48.1% (13/27) of patients had MVDC with greater than 30 days MV or death caused by aspiration pneumonia. In total, 51.9% (14/27) of patients could be weaned from MV during 30 days or less of hospital stay (MV days : MVDC 38.23±20.79 vs. MV weaning, 13.57±8.40; p<0.001). Vital signs at hospital arrival, smoking, the American Society of Anesthesiologists classification, Associated injury with Injury Severity Score, SLIC score, and length of cord edema did not differ between the MVDC and MV weaning groups. The ASIA impairment scale, level of injury within C3 to C6, and MCC significantly affected MVDC. The MCC significantly correlated with MVDC, and the optimal cutoff value was 51.40%, with 76.9% sensitivity and 78.6% specificity. In multivariate logistic regression analysis, MCC >51.4% was a significant risk factor for MVDC (odds ratio, 7.574; p=0.039). Conclusion : As a method of predicting which patients would be able to undergo weaning from MV early, the MCC is a valid factor. If the MCC exceeds 51.4%, prognosis of respiratory function becomes poor and the probability of MVDC is increased.

• Journal of Korean Clinical Nursing Research
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• v.20 no.3
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• pp.337-347
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• 2014

Purpose: Deep Vein Thrombosis (DVT) is the cause of fatal diseases such as pulmonary embolism, due to a prolonged immobility, surgery, paralysis, and injuries. This study aimed to develop an evidence-based practice guideline for DVT prevention and apply it to patients with surgery in diverse nursing sites in South Korea. Methods: A 24-staged processes of adaptation was carried out on the basis of "adaptation of nursing practical guidelines" developed by Gu et al., in 2012. Results: Developed nursing guidelines of DVT prevention are composed of 79 recommendations in 8 domains. The extent and ratings of each recommendation with its evidence were addressed along with the background information. Conclusion: The developed DVT prevention guideline is necessary to be added to the evidence-based practice guidelines for the fundamentals of nursing practice. The developed guideline is needed to be disseminated to diverse nursing clinical settings in order to prevent DVT and enhance the quality nursing care.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.37 no.3
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• pp.603-610
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• 2017

Various type of pavement deterioration such as crack, bumpy, pothole is rapidly increasing according to the accelerated environmental changes like heavy rainfall, frequent snowing, difference temperature, etc. Accident related to pothole that cause fatal traffic accidents has been increased more than five times over the next five years starting from 2008. As direct or indirect damage by pothole which caused injuries and car damages increases every year, quicker and more efficient management measures are necessary. This study presents the algorithm for materials quantity take-off. The algorithm was suggested by correlation in pothole size and area. Suggested algorithm were confirmed the validity through the 15 field survey in capital area. According to the results of survey, usually the residual materials at which 5~7 kg was generated decreased to 1~2 kg. It showed that automatic pothole detection system is expected not only to reduce materials and resources, but also to contribute to quality improvements of pavement through more accurate material take-off from the situation of constructing rely on their own judgement.

• Journal of Biomedical Engineering Research
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• v.38 no.4
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• pp.183-189
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• 2017

Electrosurgical Unit(ESU) is medical equipment that cut or coag tissues using electrical energy. It is used in hospitals' outpatient clinic room and operating room. Improper use of an ESU may cause fatal injuries to the patient, such as burns. So, before using an ESU, make sure that it is supplying enough energy for cut and coag by measuring the output power and checking the output power cable. In this study, we developed a simple ESU power measurement system PW100 that allows anyone to check the basic output power. And PW100 can check the state of the cable associated with the output power before using ESU. Then, we compared the measured output power of the PW100 with an ESU Analyzer which was commercialized, and compared the performance. In the experiment, the output power measured by the PW100 was lower value than an ESU Analyzer's that. However, the PW100's output power measured in the 5% error range and showed stable reproducibility by a low %RSD value.

• Safety and Health at Work
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• v.6 no.3
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• pp.227-232
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• 2015

Background: In comparison with other industries, the construction industry still has a higher rate of fatal injuries, and thus, there is a need to apply new and innovative approaches for preventing accidents and promoting safe conditions at construction sites. Methods: In this study, the effectiveness of a new incentive system-the surprising incentive system-was assessed. One year after the implementation of this new incentive system, behavioral changes of employees with respect to seven types of activities were observed. Results: The results of this study showed that there is a significant relationship between the new incentive system and the safety performance of frontline employees. The new incentive system had a greater positive impact in the first 6 months since its implementation. In the long term, however, safety performance experienced a gradual reduction. Based on previous studies, all activities selected in this study are important indicators of the safety conditions at workplaces. However, there is a need for a comprehensive and simple-to-apply tool for assessing frontline employees' safety performance. Shortening the intervals between incentives is more effective in promoting safety performance. Conclusion: The results of this study proved that the surprising incentive would improve the employees' safety performance just in the short term because the surprising value of the incentives dwindle over time. For this reason and to maintain the surprising value of the incentive system, the amount and types of incentives need to be evaluated and modified annually or biannually.

• Molecules and Cells
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• v.37 no.3
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• pp.241-247
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• 2014

Sudden cardiac death (SCD), which is primarily caused by lethal heart disorders resulting in structural and arrhythmogenic abnormalities, is one of the prevalent modes of death in most developed countries. Myocardial ischemia, mainly due to coronary artery disease, is the most common type of heart disease leading to SCD. However, postmortem diagnosis of SCD is frequently complicated by obscure histological evidence. Here, we show that certain mRNA species, namely those encoding hemoglobin A1/2 and B (Hba1/2 and Hbb, respectively) as well as pyruvate dehydrogenase kinase 4 (Pdk4), exhibit distinct postmortem expression patterns in the left ventricular free wall of SCD subjects when compared with their expression patterns in the corresponding tissues from control subjects with non-cardiac causes of death. Hba1/2 and Hbb mRNA expression levels were higher in ischemic SCD cases with acute myocardial infarction or ischemic heart disease without recent infarction, and even in cardiac death subjects without apparent pathological signs of heart injuries, than control subjects. By contrast, Pdk4 mRNA was expressed at lower levels in SCD subjects. In conclusion, we found that altered myocardial Hba1/2, Hbb, and Pdk4 mRNA expression patterns can be employed as molecular signatures of fatal cardiac dysfunction to forensically implicate SCD as the primary cause of death.

• Neonatal Medicine
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• v.28 no.3
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• pp.133-138
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• 2021

Osteopetrosis refers to a group of genetic skeletal disorders characterized by osteosclerosis and fragile bones. Osteopetrosis can be classified into autosomal dominant, autosomal recessive, or X-linked forms, which might differ in clinical characteristics and disease severity. Autosomal recessive osteopetrosis, also known as malignant osteopetrosis, has an earlier onset, more serious clinical symptoms, and is usually fatal. We encountered a 1-day-old girl who was born full-term via vaginal delivery, which was complicated by meconium-stained amniotic fluid, cephalo-pelvic disproportion, and nuchal cord. Routine neonatal care was provided, in addition to blood tests and chest radiography to screen for sepsis, as well as skull radiography to rule out head injuries. Initial blood tests revealed hypocalcemia, which persisted on follow-up tests the next day. Radiographic examinations revealed diffusely increased bone density and a "space alien" appearance of the skull. Based on radiographic and laboratory findings, the infantile form of osteopetrosis was suspected and genetic testing for identification of the responsible gene. Eventually, a heterozygous mutation of the T cell immune regulator 1, ATPase H+ transporting V0 subunit a3 (TCIRG1) gene (c.292C>T) was identified, making this the first reported case of neonatal-onset malignant osteopetrosis with TCIRG1 mutation in South Korea. Early-onset hypocalcemia is common and usually results from prematurity, fetal growth restriction, maternal diabetes, perinatal asphyxia, and physiologic hypoparathyroidism. However, if hypocalcemia persists, we recommend considering 'infantile of osteopetrosis' as a rare cause of neonatal hypocalcemia and performing radiographic examinations to establish the diagnosis.

• Safety and Health at Work
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• v.10 no.3
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• pp.305-313
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• 2019

Background: The oil and gas industry is one of the riskiest industries for confined space injuries. This study aimed to understand an overall picture of the causal factors of confined space accidents through analyzing accident reports and the use of a qualitative approach. Methods: Twenty-one fatal occupational accidents were analyzed according to the Human Factors Analysis and Classification System approach. Furthermore, thirty-three semistructured interviews were conducted with employees in different roles to capture their experiences regarding the contributory factors. The content analyses of the interview transcripts were conducted using MAXQDA software. Results: Based on accident reports, the largest proportions of causal factors (77%) were attributed to the organizational and supervisory levels, with the predominant influence of the organizational process. We identified 25 contributory factors in confined space accidents that were causal factors outside of the original Human Factors Analysis and Classification System framework. Therefore, modifications were made to deal with factors outside the organization and newly explored causal factors at the organizational level. External Influences as the fifth level considered contributory factors beyond the organization including Laws, Regulations and Standards, Government Policies, Political Influences, and Economic Status categories. Moreover, Contracting/Contract Management and Emergency Management were two extra categories identified at the organizational level. Conclusions: Preventing confined space accidents requires addressing issues from the organizational to operator level and external influences beyond the organization. The recommended modifications provide a basis for accident investigation and risk analysis, which may be applicable across a broad range of industries and accident types.

• Journal of Trauma and Injury
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• v.34 no.4
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• pp.248-256
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• 2021

Purpose: Laparoscopy has various advantages over laparotomy in terms of postoperative recovery. The number of surgeons using laparoscopy as a diagnostic and therapeutic tool in abdominal trauma patients is increasing, whereas open conversion is becoming less common. This report summarizes a single surgeon's experience of laparoscopy at a level I trauma center and evaluates the feasibility of laparoscopy as a diagnostic and therapeutic tool for abdominal trauma patients. Methods: In total, 30 abdominal trauma patients underwent laparoscopy by a single surgeon from October 2014 to May 2020. The purpose of laparoscopy was categorized as diagnostic or therapeutic. Patients were classified into three groups by type of surgery: total laparoscopic surgery (TLS), laparoscopy-assisted surgery (LAS), or open conversion (OC). Univariate analysis was performed to determine the advantages and disadvantages. Results: The mechanism of injury was blunt in 19 (63.3%) and penetrating in 11 patients (36.7%). Eleven (36.7%) and 19 patients (63.3%) underwent diagnostic and therapeutic laparoscopy, respectively. The hospital stay was shorter for patients who underwent diagnostic laparoscopy than for those who underwent therapeutic laparoscopy (5.0 days vs. 13.0 days), but no other surgical outcomes differed between the groups. TLS, LAS, and OC were performed in 12 (52.2%), eight (34.8%), and three patients (13.0%), respectively. There was no significant difference in morbidity and mortality among the three groups. Conclusions: Laparoscopic surgery for selected cases of abdominal trauma may be feasible and safe as a diagnostic and therapeutic tool in hemodynamically stable patients due to the low OC rate and the absence of fatal morbidity and mortality.

• The Journal of The Korea Institute of Intelligent Transport Systems
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• v.21 no.4
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• pp.30-38
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• 2022

As of 2020, 1,564 roundabouts have been installed and operated to prevent major traffic accidents and promote safe and smooth passage over the past 10 years. According to the Korea Transportation Research Institute, the number of accidents decreased by an average of 43.8% per year, fatal accidents by 50%, and serious injuries by 48.1%, confirming the safety effect. However, most intersections with high pedestrian traffic, such as children's protection areas near elementary schools, operate signal intersections. Therefore, in this study, a simulation was performed through the VISSM program to conduct a study on the pedestrian-centered roundabout installation method. This study was conducted to ensure that pedestrians can have the right of way safely by installing and operating traffic lights at crosswalks on roundabouts located in urban areas or child protection zones.