• Journal of Chest Surgery
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• v.57 no.2
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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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• v.30 no.3
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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.

• Journal of the Korean Society of Safety
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• v.35 no.4
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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.

• The Korean Journal of Emergency Medical Services
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• v.9 no.1
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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.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1979.05a
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• pp.8.2-8
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• 1979

Acute obstruction of the upper airway from trachea, a foreign body or Iaryngospasm may lead to death in a few minutes. The immediate restoration of an adequate airway in these patients may be lifesaving. Spontaneous respiration by means of a needle inserted into the trachea was studied in 21 rabbits using 16, 18, and 20 gauge extrcatheters. The results are as follows; 1) Airway resistance was markedly increased in all experimental animals. consequently tidal volume was also significantly decreased, but this seems to be compensatory by increased of respiratory frequency in l6G group. 2) Blood gas analysis revealed adequate pulmonary ventilation through the constricted airway (about 1/3 of normal sized trachea) during 60 minutes. In the other hand, hypercarbia, hypoxemia, and metabolic acidosis were developed in the group with severe constriction of the upper airway (about 1/4-1/6 of normal sized trachea). 3) The further study is postulated to confirm the the possibility of application of needle trcheostomy in man, but the rabbits were tolerable to the constricted airway with a small sized needle (l6G) into the trachea for 60 minutes.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.22 no.7
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• pp.1001-1008
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• 2018

In this paper, we propose an efficient location tracking scheme using wireless signals for various situations in marine environment that requires location information for many reasons such as lifesaving, accident prevention, and facility management. Our proposed location tracking scheme not only monitors user's location, but also minimizes the risk under the user's limited battery power budget. The position of a user can be obtained at base stations from the strengths of the received signals from the user. In this case, it may require to prevent the user from getting out of the predetermined safe area. For each location in the safe area, we define a risk function, which is influenced by many factors such as location accuracy, depth, flow rate, and geometry. Our proposed scheme is based on finger printing technique and aims at minimizing the average risk of each user in the safe area.

• KIPS Transactions on Software and Data Engineering
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• v.10 no.7
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• pp.263-270
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• 2021

Reinforcement learning(RL) is the method to find an optimal policy through training. and it is one of popular methods for solving lifesaving and disaster response problems effectively. However, the conventional reinforcement learning method for disaster response utilizes either simple environment such as. grid and graph or a self-developed environment that are hard to verify the practical effectiveness. In this paper, we propose the design of a disaster response RL environment which utilizes the detailed property information of the disaster simulation in order to utilize the reinforcement learning method in the real world. For the RL environment, we design and build the reinforcement learning communication as well as the interface between the RL agent and the disaster simulation. Also, we apply the dimension reduction method for converting non-image feature vectors into image format which is effectively utilized with convolution layer to utilize the high-dimensional and detailed property of the disaster simulation. To verify the effectiveness of our proposed method, we conducted empirical evaluations and it shows that our proposed method outperformed conventional methods in the building fire damage.

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.6
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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.

• Clinical and Molecular Hepatology
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• v.24 no.4
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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.

• The Journal of the Korea institute of electronic communication sciences
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• v.16 no.6
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• pp.1205-1212
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• 2021

Robots that can actually help people a lot by dealing with dangerous tasks that are difficult for people to do, such as disaster situations, lifesaving, handling dangerous goods, and reconnaissance of dangerous areas, continue to become an issue. Therefore, in this paper, we intend to implement a mobile robot arm that can implement a human motion will on the robot arm to enable active response according to the situation and control the vehicle according to hand movements to give mobility. A controller is manufactured using a flex sensor and agyro sensor, and the roll and pitch values of the two gyro sensors are adjusted to control the angle of the robot arm and specify the vehicle direction. In addition, by designating the levels of the three flex sensors, the motor is operated according to hand movements, and a robot arm is implemented so that objects can be picked up and moved.