• Journal of Chest Surgery
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• 제57권2호
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• pp.225-229
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• 2024

Venovenous (VV) extracorporeal membrane oxygenation (ECMO) is a lifesaving technique for patients experiencing respiratory failure. When VV ECMO fails to provide adequate support despite optimal settings, alternative strategies may be employed. One option is to add another venous cannula to increase venous drainage, while another is to insert an additional arterial return cannula to assist cardiac function. Alternatively, a separate ECMO circuit can be implemented to function in parallel with the existing circuit. We present a case in which the parallel ECMO method was used in a 63-year-old man with respiratory failure due to coronavirus disease 2019, combined with cardiac dysfunction. We installed an additional venoarterial ECMO circuit alongside the existing VV ECMO circuit and successfully weaned the patient from both types of ECMO. In this report, we share our experience and discuss this method.

• Journal of Korean Neurosurgical Society
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• 제30권3호
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• pp.278-283
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• 2001

Objective : Massive cerebral infarction could be accompanied by severe brain swelling and death secondary to transtentorial herniation. Approximately 10% to 15% of middle cerebral artery infarctions are associated with this phenomenon. However, the effectiveness and timing of decompressive surgery are still controversial. In this study, we present our results on the effect of decompressive craniectomy in life threatening cerebral infarction. Method : We retrospectively analyzed 15 patients who underwent decompressive craniectomy for massive cerebral infarction from January 1997 to April 1999. Surgical indication was based on the clinical signs such as neurological deterioration, pupillary reflex, and radiological findings. Clinical outcome was assessed by Glasgow Outcome Scale (GOS). Results : All 15 patients(five men, ten women ; mean age, 52.3 years ; right 11, left 4) were treated with wide craniectomy and duroplasty. The average time interval between onset of symptom and surgical decompression was 2.9 days. Clinical signs of uncal herniation(anisocoria, or fixed and dilated pupils) were presented in 13 of 15 patients. Mean Glasgow coma scale(GCS) was 12.4 points on admission, 8.1 points on preoperative state and 11.8 points postoperatively. Overall outcomes were favorable in 5 cases(Glasgow outcome scale : GOS I, II), unfavorable in 6 cases(Glasgow outcome scale : GOS III, IV) and dead in 4 cases. Conclusion : Early decompressive craniectomy before brain stem compression is considered as an effective lifesaving procedure for massive cerebral infarction unresponsive to aggressive medical therapy.

• 한국안전학회지
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• 제35권4호
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• pp.74-83
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• 2020

In Korea, about 110,000 LPG small storage tanks of less than three tons have been installed in restaurants, houses and factories, and are used as LPG supply facilities for cooking, heating and industrial use. In the case of combustible liquefied gas storage tanks, the tank may rupture due to the temperature increase of the tank steel plate (approximately 600℃) even when the safety valve is operating normally, causing large-scale damage in an instant. Therefore, in the event of a fire near the LPG small storage tank, it is necessary to accurately predict the timing of the BLEVE(Boiling Liquid Expanding Vapour Explosion) outbreak in order to secure golden time for lifesaving and safely carry out fire extinguishing activities. In this study, we have first investigated the results of a prior study on the prediction of the occurrence of BLEVE in the horizontal tanks. And we have developed thermodynamic models and simulation program on the prediction of BLEVE that can be applied to vertical tanks used in Korea, have studied the effects of the safety valve's ability to vent, heat flux strength of external fires, size of tanks, and gas remaining in tanks on the time of BLEVE occurrence and have suggested future utilization measures.

• 한국응급구조학회지
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• 제9권1호
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• pp.33-41
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• 2005

In Korea, the number of those who were drowned of the dead by 'accident and injury' ranked the third of causes of death is over 2,300 people a year. So the Ministry of Home Affairs arranged '119 drowning rescue team' at frequent occurrence regions of drowning temporarily as a part of drowning rescue measures during every summer season and made perfection more perfect for safety control and rescue services at prevention areas of accidents. However, considering that the number of professional drowning rescuers is small and it is managed temporarily only for summer, the placement of special rescue team equipped with professional education and qualification should be ensured and quick lifesaving and first-aid treatment should be conducted, since much time is required to arrive at accident place after receiving accident report at 119 office, rapid rescue and relief have not been achieved. Therefore, the placement of special rescue team should be increased for reducing the personal damages by considering regional characteristics and in particular placement of more drowning rescue teams in Jeonnam region which has more seas and rivers is needed This study aims at analyzing relief activities and statistics to cope with water accidents and achieve qualitative growth of first-aid services, examining actual conditions of water accident relief team and personnel assignment, providing first-aid services of good quality and establishing improvement methods to increase operation of relief team.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1979년도 제13차 학술대회 연제순서 및 초록
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• pp.8.2-8
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• 1979

상부기도가 갑자기 폐쇄증을 일으켜 심한 호흡곤란증을 호소하는 환자에 대하여 응급으로. 기도 및 호흡을 재확보하여야하며 이와같은 예를 임상에서 가끔 직면하게 된다. 이러한 환자에게 적절한 기도확보는 생명을 유지시킬 수 있다. 저자는 토끼를 대상으로 기존 기관의 직경을(약 3.4mm) 약 1/3(1.2mm), 1/4(0.8mm) 및 1/6(0.6mm)로 협소시켜 생리적 변화를 추적하였다. 결과는 다음과 같았다. 1) 혈액가스의 분석결과 직경을 약 1/3로 감소시켰던 군에서 생리적 변동이 별로 없었다. 2) 직경을 약 1/4, 1/6로 감소시켰던 군에서는 $PaO_2,$ $PaCO_2$ 및 pHa에 뚜렷한 변화를 나타내어 저산소혈증, 과탄산혈증 및 대사성산증을 나타내었다. 3) 호흡저항은 모든 군에서 뚜렷하게 증가하여 1회 호흡량도 현저하게 감소하였는데 16G(직경 1.2mm 호흡로)에서는 호흡수의 증가로 폐포환기가 적당하게 영위됨에 따라서 혈액가스 및 vital signs의 변동이 별로 없던 것으로 보아 토끼에서는 이 정도의 호흡로 폐쇄에는 1시간까지 견딜 수 있음을 알았다.

• 한국정보통신학회논문지
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• 제22권7호
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• pp.1001-1008
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• 2018

본 논문은 인명구조, 사고방지, 시설관리 등 수상환경에서 위치정보가 필요한 상황에서 무선 신호를 활용한 효율적인 위치 추적 기술을 제안한다. 제안하는 기법은 유저의 배터리 파워 소모량을 고려하여 제한된 전력 내에서 위험도를 최소화한다. 수상의 일정 반경 내에서 유저의 송수신 신호 세기를 이용하여 유저의 위치를 알 수 있는데, 이 때 유저가 일정 반경을 벗어나는 것을 사전에 방지할 필요가 있다. 이 논문에서는 먼저 유저가 일정 반경을 벗어나는 것을 방지하기 위해 위험도 함수를 정의한다. 위험도 함수는 위치정확도, 수심, 유속 등 수상 환경 위험에 관련된 다양한 요인들을 고려한다. 본 논문은 finger printing 기법을 이용한 효율적인 무선 측위 기술을 활용하여 일정 지역 내에 위치한 유저의 평균 위험도를 최소화하는 것을 목표로 하고 있다.

• 정보처리학회논문지:소프트웨어 및 데이터공학
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• 제10권7호
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• pp.263-270
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• 2021

강화학습은 학습을 통해 최적의 행동정책을 탐색하는 기법으로써, 재난 상황에서 효과적인 인명 구조 및 재난 대응 문제 해결을 위해 많이 활용되고 있다. 그러나, 기존 재난 대응을 위한 강화학습 기법은 상대적으로 단순한 그리드, 그래프와 같은 환경 혹은 자체 개발한 강화학습 환경을 통해 평가를 수행함에 따라 그 실용성이 충분히 검증되지 않았다. 본 논문에서는 강화학습 기법을 실세계 환경에서 사용하기 위해 기존 개발된 재난 시뮬레이션 환경의 복잡한 프로퍼티를 활용하는 강화학습 환경 구성과 활용 결과를 제시하고자 한다. 본 제안 강화학습 환경의 구성을 위하여 재난 시뮬레이션과 강화학습 에이전트 간 강화학습 커뮤니케이션 채널 및 인터페이스를 구축하였으며, 시뮬레이션 환경이 제공하는 고차원의 프로퍼티 정보의 활용을 위해 비-이미지 피쳐 벡터(non-image feature vector)에 이미지 변환방식을 적용하였다. 실험을 통해 본 제안 방식이 건물 화재 피해도를 기준으로 한 평가에서 기존 방식 대비 가장 낮은 건물 화재 피해를 기록한 것을 확인하였다.

• 대한응급의학회지
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• 제29권6호
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• pp.595-602
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• 2018

Objective: The Korean Triage and Acuity Scale (KTAS), which was implemented in 2016, needs to be assessed for its validity and reliability. Here we evaluate the relevance of emergency level assessment by analyzing the validity of KTAS as a Korean standardized triage system. Methods: We retrospectively analyzed the medical records of adults who presented to a local emergency room (ER) during an 18-month period. We compared medical resources used, life-saving interventions performed, length of stay (LOS) in ER, admission rate, and mortality at each KTAS level. Results: Among a total of 40,339 patients, most patients were at KTAS 4 (n=19,532, 48.4%) and the longest median LOS in ER was 450 minutes at KTAS 2. As the KTAS level increased, the percentage of medical resources used and lifesaving interventions performed increased significantly. The odds of total admission and intensive care unit admission were significantly higher at KTAS 1 through 4 compared to those at KTAS 5. The odds related to admission and mortality were also significantly higher at KTAS 3 than at KTAS 4. Conclusion: We concluded that the KTAS, as a Korean standardized triage system of emergency level assessment, is relevant. Further, KTAS 1-3 and KTAS 4-5 are appropriate criteria to distinguish emergency and non-emergency patients.

• 대한간학회지
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• 제24권4호
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• pp.358-366
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• 2018

Severe acute alcoholic liver disease (SAAH) unresponsive to medical therapy shows one-year-mortality rates of up to 90%. Most transplant centers request six months of alcohol abstinence prior to transplantation, the so-called "6-month rule." This regulation is not based on strong evidence, repeatedly making it a topic of controversial debates. The majority of patients with SAAH will die before fulfilling the 6-month rule. Therefore, liver transplantation (LT) protocols are becoming more flexible towards the rigid abstinence regulation, especially concerning SAAH patients. We conducted a literature review regarding LT in SAAH and its outcomes, including post-transplant mortality and recidivism. We studied available data on PubMed from 2011 and onwards whilst including articles dealing with genetic components, medical therapy and historic snapshots of alcoholism. Emerging studies recommend LT in SAAH not responding to medical therapies even without realizing the required abstinence period, since the majority of these patients would die within 6 months. SAAH without response to medical therapy has one-year-mortality rates of up to 90%. The 6-month rule is not based on strong evidence and is repeatedly a topic of controversial debates. There is genetic linkage to alcoholism and medical therapy is not as effective as estimated, yet. The 6-months-regulation has not shown to evidently decrease the risk of recidivism post-LT, which is a lifesaving treatment in SAAH patients. Insisting on rigid sobriety rules results in excluding patients with a low risk of recidivism from being transplanted. Moreover, the genetic linkage of alcoholism must be recognized.

• 한국전자통신학회논문지
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• 제16권6호
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• pp.1205-1212
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• 2021

재난상황이나 인명 구조, 위험물 처리와 위험지역 정찰 등 사람들이 하기 어려운 위험작업을 대신 처리해 실질적으로 많은 도움을 줄 수 있는 로봇들이 지속적으로 이슈가 되고 있다. 따라서 본 논문에서는 사람의 모션 의지를 로봇팔에 구현하여 상황에 따른 능동적인 대응이 가능하도록 한다. 또한 손동작에 따라 차량을 제어하여 이동성을 부여할 수 있는 이동형 로봇팔을 구현하고자 한다. 플렉스 센서와 자이로센서를 활용하여 컨트롤러를 제작하고 자이로센서 2개의 Roll과 Pitch 값을 조절하여 로봇팔의 각도를 제어하며 차량의 방향을 지정한다. 또한 플렉스 센서 3개의 레벨을 지정함으로써 손동작에 따라 모터가 동작되며 물체를 집고 이동할 수 있도록 로봇팔을 구현하였다.