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A Study on the Operation Plan of the Gangwon-do Disaster Management Resources Integrated Management Center (강원도 재난관리자원 통합관리센터 운영방안에 관한 연구)

  • Hang-Il Jo;Sang-Beom Park;Kye-Won Jun
    • Journal of Korean Society of Disaster and Security
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    • v.17 no.1
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    • pp.9-16
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    • 2024
  • In Korea, as disasters become larger and more complex, there is a trend of shifting from a focus on response and recovery to a focus on prevention and preparedness. In order to prevent and prepare for disasters, each local government manages disaster management resources by stockpiling them. However, although disaster management resources are stored in individual warehouses, they are managed by department rather than by warehouse, resulting in insufficient management of disaster management resources due to the heavy workload of those in charge. In order to intensively manage these disaster management resources, an integrated disaster management resource management center is established and managed at the metropolitan/provincial level. In the case of Gangwon-do, the subject of this study, a warehouse is rented and operated as an integrated disaster management resource management center. When leasing an integrated management center, there is the inconvenience of having to move the location every 1 to 2 years, so it is deemed necessary to build a dedicated facility in an available site. To select a location candidate, network analysis was used to measure access to and use of facilities along interconnected routes of networks such as roads and railways. During network analysis, the Location-Allocation method, which was widely used in the past to determine the location of multiple facilities, was applied. As a result, Hoengseong-gun in Gangwon-do was identified as a suitable candidate site. In addition, if the integrated management center uses our country's logistics system to stockpile disaster management resources, local governments can mobilize disaster management resources in 3 days, and it is said that it takes 3 days to return to normal life after a disaster occurs. Each city's disaster management resource stockpile is 3 days' worth per week, and the integrated management center stores 3 times the maximum of the city's 4-day stockpile.

Treament of Sternal Dehiscence or Infection Using Muscle Flaps (근육편을 이용한 흉골열개 및 감염의 치료)

  • 최종범;이삼윤;박권재
    • Journal of Chest Surgery
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    • v.34 no.11
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    • pp.848-853
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    • 2001
  • Background: Sternal infection or dehiscence after cardiac surgery through median sternotomy is rare. If suitable treatment is not performed for the complication, however, the mortality is high. For 12 patients with sternal dehiscence or infection, we performed wide excision of the infected and necrotic tissue and covered with muscle flap(s) to obliterate the mediastinal dead space. Material and method: Sternal infection or dehiscence occurred in 13 of patients who underwent cardiac surgery One patient, who died of cerebral infarction before the sternal complication was treated, was excluded in this study. The sternal wound complication occurred in 6 of patients with valve replacement and 6 of patients with coronary bypass surgery, respectively. Since 1991, 9 patients underwent definite surgical debridement and muscle transposition as soon as fever was controlled with closed irrigation and drainage. The necrotic tissue and bone was widely excised and the sternal dead space was eradicated with the single flap or the combined flaps of right pectoralis flap(turnover flap), left pectoralis flap(turnover flap or rotation-advancement flap), and right rectus muscle flap. Result : There was no mortality in 12 patients with coverage of muscle flap(s) for sternal infection or dehiscence The mean interval between the diagnosis of sternal complication and the myoplasty was 6.6$\pm$3.9 days. In 4 patients, one pectoralis muscle flap was used, and in 8 patients both pectoralis muscle flaps were used. For each 1 patient and 2 patients in each group, right rectus muscle flap was added. For the last 3 patients, a single pectoralis flap was used to eradicate the mediastinal dead space and the longer placement of the mediastinal drain catheter was needed. One patient, who had suffered from necrosis of left pectoralis flap(rotation-advancement flap) with subsequent chest wall abscess after coverage of both pectoralis flaps, was managed with reoperation using right rectum flap. Conclusion : Sternal dehiscence or infection after cardiac operation can be readily managed with wide excision of necrotic infected tissue(including bone) and muscle flap coverage after short-term irrigation of sternal wound. The sternal(mediastinal) dead space may be completely eradicated with right pectoralis major muscle flap alone.

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The Properties of Beam Intensity Scanner (BInS) for Dose Verification in Intensity Modulated Radiation Therapy (방사선 세기 조절 치료에서 선량을 규명하는 데 사용된 BlnS System의 특성)

  • 박영우;박광열;박경란;권오현;이명희;이병용;지영훈;김근묵
    • Progress in Medical Physics
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    • v.15 no.1
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    • pp.1-8
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    • 2004
  • Patient dose verification is one of the most Important responsibilities of the physician in the treatment delivery of radiation therapy. For the task, it is necessary to use an accurate dosimeter that can verify the patient dose profile, and it is also necessary to determine the physical characteristics of beams used in intensity modulated radiation therapy (IMRT) The Beam Intensity Scanner (BInS) System is presented for the dosimetric verification of the two dimensional photon beam. The BInS has a scintillator, made of phosphor Terbium-doped Gadolinium Oxysulphide (Gd$_2$O$_2$S:Tb), to produce fluorescence from the irradiation of photon and electron beams. These fluoroscopic signals are collected and digitized by a digital video camera (DVC) and then processed by custom made software to express the relative dose profile in a 3 dimensional (3D) plot. As an application of the BInS, measurements related to IWRT are made and presented in this work. Using a static multileaf collimator (SMLC) technique, the intensity modulated beam (IMB) is delivered via a sequence of static portals made by controlled leaves. Thus, when static subfields are generated by a sequence of abutting portals, the penumbras and scattered photons of the delivered beams overlap in abutting field regions and this results in the creation of “hot spots”. Using the BInS, inter-step “hot spots” inherent in SMLC are measured and an empirical method to remove them is proposed. Another major MLC technique in IMRT, the dynamic multileaf collimator (DMLC) technique, has different characteristics from SMLC due to a different leaf operation mechanism during the irradiation of photon and electron beams. By using the BInS, the actual delivered doses by SMLC and DMLC techniques are measured and compared. Even if the planned dose to a target volume is equal in our experimental setting, the actual delivered dose by DMLC technique is measured to be larger by 14.8% than that by SMLC, and this is due to scattered photons and contaminant electrons at d$_{max}$.

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Clinical Analysis of Video Assisted Thoracic Surgery for the Treatment of Thoracic Empyema (비디오 흉강경을 이용한 농흉수술의 임상분석)

  • Oh, Sang-Gi;Song, Sang-Yun;Yun, Chi-Hyeong;Na, Kook-Ju;Kong, Kang-Eun;Park, Song-Ran;Kim, Sang-Hyung
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.139-143
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    • 2010
  • Background: Thoracic empyema remains a serious problem despite the availability of modern diagnostic methods and appropriate antibiotics. The condition presents in many different forms and stages that require different therapeutic options. Video-assisted thoracic surgery (VATS) has become increasingly popular for use in the treatment of empyema. Material and Method: From January 2005 to May 2009, VATS was performed in 36 patients with pleural empyema and for whom chest-tube drainage and antibiotic therapy had failed or the CT scan showed multiseptate disease. The perioperative clinical factors were analyzed for all the study patients. Result: All the patients underwent VATS, but it was necessary to convert to thoracotomy in one patient. The mean operation time was $90{\pm}38.5\;min$. For the operative evaluation, 11 patients were compatible with ATS stage III. The duration of chesttube insertion was $11.9{\pm}5.8$ (3~24) days. One patient did not improve and therefore this patient underwent additional open drainage. At discharge, costophrenic angle blunting was observed in 22 patients, pleural thickening was noted in 20 patients, both were noted in 17 patients and neither was noted in 11 patients. However, at follow-up, each of these changes was observed in 9, 7, 4 and 24 patients, respectively. All except one patient showed radiographic improvement. Conclusion: VATS is suitable for the treatment of early and fibrinopurulent thoracic empyema, and even in selected patients with stage III disease.

Transhiatal Esophagectomy in Cardia and Esophageal Cancer (위분문부 및 식도암 환자에서 경열공 식도절제술)

  • Choi Dong-Hui;Jung Kyoung-Won;Kim Dong-Heon
    • Journal of Gastric Cancer
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    • v.5 no.1
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    • pp.1-9
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    • 2005
  • Purpose: The debate is still on-going as to whether a transthoracic esophagectomy (TTE) or a transhiatal esophagectomy(THE) is the proper treatment for patients with cardia and esophageal cancers. This study tries to demonstrate and assess the efficacy and the validity of both surgeries. Materials and Methods: In a retrospective study, data from 52 cases of patients with esophageal and/or cardia cancer who received a surgical operation during the last decade were analyzed. Results: A TTE was done in 20 cases and a THE in 32 cases. The average times for the operations were 558.0 min for a TTE and 451.7 min for a THE (P>0.05). The estimated blood loss was 1,825.0 ml in a TTE and 1459.4 ml in a THE (P>0.05). The amounts of transfusion during the operations were 3.9 units in a TTE and 2.6 units in a THE (P<0.05). Post-operative complications occurred in 15 cases of TTE and 23 cases of THE. The average length of stay in the hospital was 25.6 days for a TTE and 20.6 days for a THE. The 5-year survival rate was $10\%$ for TTE patients and $28\%$ for THE patients (P>0.05). Conclusion: For most factors, including morbidity and mortality, there was no statistically significant difference between a TTE and a THE. However, a THE is expected to be more convenient, leading to a shorter operative duration, a shorter post-operative hospitalization and lesser amounts of hemorrhage and transfusion. Hence, the THE may be a more valid or efficient surgical method for those patients with cardia and esophagus cancer who require a resection of the esophagus. (J Korean Gastric Cancer Assoc 2005;5:1-9)

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A Study on the Establishment of Optimal Transportation Networks in Busan New Port (부산항 신항 최적의 교통망 수립에 관한 연구)

  • Park, Ho-Kyo;Choi, Yang-Won
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.37 no.1
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    • pp.125-132
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    • 2017
  • The development project of Busan New Port aims to be Logistics Hub Port but there are too many things to deal with ; enlargement of harbour, interport competition, modernization of harbour loading equipment and so on. At present, 23 berths of North and South container quay are in operation and 22 berths will be constructed on west and south-side by 2020. Namely, Busan New Port will operate 45 berths in 2020. When it comes to port distripark, a large-scale of Port distripark project is underway, such as Ung-Dong district 1,2 phase, West container 1,2phase, North distripark and so on. This study is to deduce traffic system problem of Busan New Port which is caused by the development project through predicting traffic need considering the development project. According to study, there are three main problems of traffic system : 1. traffic congestion caused on main crossroad, connecting second harbour back road. 2. It has been predicted that South-North road and traffic capacity of New Port road would lack compared to traffic volume-to-be-increased. Moreover, the detour volume of traffic is caused because New Port's 1st avenue and route 2 were not connected directly. Thus, this study suggests three kinds of improvement plan for smoother traffic flow. 1st. Operate roundabout on major intersection, for example, second harbour back road, west container wharf's subway corridors(South to North), and permit only right turn on sub-intersection. 2nd. Extend New Port road(North container's port road) by utilizing side walk and median. 3rd. Install exit ramp which utilizes Route 2 connecting New Port's 1st avenue and local road 1042. The method we used to analyze the effect of improvement is Vissim of Mircro Simulation Package.

Clinical Result of Aortic Arch Replacement using Antegrade Brain Perfusion Via Right Axillary Artery (우액와동맥을 통한 순행성 뇌관류법을 이용한 대동맥궁 치환의 임상성적)

  • Kim, Dong-Jin;Na, Yong-Jun;Jeong, Dong-Seop;Kim, Kyung-Hwan
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.25-31
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    • 2007
  • Background: Cerebral protection is one of the most important procedures during aortic arch surgery. We can minimize neurological complications through short period of total circulatory arrest and resuming of brain perfusion. We evaluated 11 patients who underwent arch replacement using antegrade brain perfusion via right axillary artery. Material and Method: Between July 2004 and July 2006, 11 patients (male 9, female 2) underwent aortic arch replacement with antegrade brain perfusion via right axillary artery. Preoperative diagnosis was listed; 5 type A aortic dissections (5/11, 45.5%), 5 aortic aneurysms (5/11, 45,5%) and 1 type A IMH (intramural hematoma, 1/11, 9%). The mean age at the time of operation was $60.3{\pm}12.8$ years. For antegrade brain perfusion, we performed right axillary artery cannulation in all patients. Retrograde brain perfusion was used briefly during total circulatory arrest. Result: The mean total circulatory arrest time was $31.1{\pm}16.9$ minutes and the mean retrograde brain perfusion time was $21{\pm}17.8$ minutes. Mean antegrade brain perfusion time was $77.9{\pm}17.5\;(43{\sim}101)$ minutes. We had neither operative mortality nor permanent neurological complications. Conclusion: By means of antegrade brain perfusion via right axillary artery, that could lead to decrease circulatory arrest time and minimize damages to severely atheromatous arch vessels, we can expect to reduce neurological complications after aortic arch replacement. Further investigation with iarge patient populations will be required.

Comparison of the Mid-term Changes at the Remnant Distal Aorta after Aortic Arch Replacement or Ascending Aortic Replacement for Treating Type A Aortic Dissection (A형 급성대동맥박리증에서 대동맥궁치환술과 상행대동맥치환술 후 잔존 원위부 대동맥의 변화에 대한 중기 관찰 비교)

  • Cho, Kwang-Jo;Woo, Jong-Su;Bang, Jung-Hee;Choi, Pill-Jo
    • Journal of Chest Surgery
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    • v.40 no.6 s.275
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    • pp.414-419
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    • 2007
  • Background: Replacing the ascending aorta is a standard surgical option for treating acute type A aortic dissection. But replacing the aortic arch has recently been reported as an acceptable procedure for this disease. We compared the effects of aortic arch replacement for treating acute type A aortic dissection with the effects of ascending aortic replacement. Material and Method: From 2002 to 2006, 25 patients undewent surgical treatment for acute type A aortic dissection, 12 patients undewent ascending aortic replacement and 13 patients underwent aortic arch replacement. Among the aortic arch group, an additional distal stent-graft was inserted during the operation in 5 patients. 19 patients (11 arch replaced patients and 8 ascending aortic replaced patients) were followed up at the out patient clinic for an average of $756{\pm}373$ days. All the patients undewent CT scanning and we analyzed their distal aortic segments. Result: 4 patients who underwent ascending aortic replacement died, so the overall mortality rate was 16%. Among the 11 long term followed-up arch replacement patients, 2 patients (18.1 %) developed distal aortic dilatation and one of them underwent thoracoabdominal aortic replacement later on. However, among the 8 the ascending aortic replaced patients, 5 patients (62.5%) developed distal aortic dilatation. Conclusion: Aortic arch replacement is one of the safe options for treating acute type A aortic dissection. Aortic arch replacement for treating acute type A aortic dissection could contribute to a reduced distal aortic dilatation rate and fewer secondary aortic procedures.

Grouting Improvement through Correlation Analysis of Hydrogeology and Discontinuity Factors in a Jointed Rock-Mass (절리 암반의 수리지질 및 불연속면 특성 간 상관분석을 통한 그라우팅 계획 수립의 개선 방안)

  • Kwangmin Beck;Seonggan Jang;Seongwoo Jeong;Minjune Yang
    • The Journal of Engineering Geology
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    • v.34 no.2
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    • pp.279-294
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    • 2024
  • Large-scale civil engineering structures such as dams require a systematic approach to jointed rock-mass grouting to prevent water leakage into the foundations and to ensure safe operation. In South Korea, rock grouting design often relies on the experience of field engineers that was gained in similar projects, highlighting the need for a more systematic and reliable approach. Rock-mass grouting is affected mainly by hydrogeology and the presence of discontinuities, involving factors such as the rock quality designation (RQD), joint spacing (Js), Lugeon value (Lu), and secondary permeability index (SPI). This study, based on data from field investigations of 14 domestic sites, analyzed the correlation between hydrogeological factors (Lu and SPI), discontinuity characteristics (RQD and Js), and grout take, and systematically established a design method for rock grouting. Analysis of correlation between the variables RQD, Js, Lu, and SPI yielded Pearson correlation (r) values as follows: Lu-SPI, 0.92; RQD-Lu, -0.75; RQD-Js, 0.69; RQD-SPI, -0.65; Js-Lu, -0.47; and SPI-Js, -0.41. The grout take increases with Lu and SPI values, but there is no significant correlation between RQD and Js. The proposed approach for grouting design based on SPI values was verified through analysis and comparison with actual curtain-grouting construction, and is expected to be useful in practical applications and future studies.

The Research on the Life-safety Implementation using the Natural Light LED Lamp in the Disaster Prevention and Safety Management (방재안전 자연광 LED 조명을 이용한 생활안전 개선에 관한 연구)

  • Lee, Taeshik;Seok, Gumcheul;So, Yooseb;Choi, Byungshik;Kim, Jaekwon;Cho, Woncheol
    • Journal of Korean Society of Disaster and Security
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    • v.9 no.2
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    • pp.53-62
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    • 2016
  • This paper is shown the new method using LED Light, which the light environment is upgraded the natural LED light in the area of Disaster Prevention and Safety Management (PDSD), which the events of deaths is reduced on the Suicide, the Infectious diseases, the safety accidents, the Traffic Accident, the crime, the fire, the Nature Disaster, and which the health and the environment and the safety is implemented using the value of the color LED Light. Research findings include,during 3 weeks in the November 2016, in the ten residents (average living 28.7 years, age 67.5 years) with depressive symptoms in the northern part of Seoul, according to the request of the user, the PDSD natural light LED lighting was installed in the home bedroom or the living room, expectations for the ability to restore physical and mental stability were high (88%), in the same way, after 1 week and 3 weeks, the physical and mental changes were compared and the results,84% in the first week and 90% in the third week and thereafter, the effect of relieving depression was high. We conclude that patients with depression have a good sleep, an uneasy feeling, a sense of security, a good night's sleep, and a good feeling. The PDSD LED Light is expected to contribute in the various areas, which reduced the suicides, which give increased immunity from infectious diseases, which give a crash to reduce accidents caused by negligence, which improve the safe operation of heavy vehicles in which a traffics accident incidence installed on the highest point, which improve the safety function on the 'safety way home' for the safety of the community, which due to fire gives alleviate the emotional anxiety of firefighters, which improve the environment for long-term control room working during decision making caused by natural disasters.