• Journal of Chest Surgery
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• 제47권4호
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• pp.344-349
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• 2014

Background: The Damus-Kaye-Stansel (DKS) procedure is a method for mitigating the risk of systemic ventricular outflow tract obstruction (SVOTO). However, there have been few reports on which surgical technique shows a better outcome. The objective of this study was to compare the outcome of the DKS procedure according to the surgical technique used. Methods: We retrospectively reviewed 12 consecutive patients who underwent the DKS procedure from March 2004 to April 2013. When the relationship of the great arteries was anterior-posterior, the double-barrel technique (group A) was performed. If the relationship was side-by-side, the ascending aortic flap technique (group B) was performed. Results: There was no early mortality and 1 late mortality in group B. There was no statistically significant difference in the median peak pressure gradient of preoperative subaortic stenosis in both groups: 14 mmHg (range, 4 to 53 mmHg) in group A and 15 mmHg (range, 0 to 30 mmHg) in group B (p=0.526). Further, a significant postoperative pressure gradient was not observed in either group A or group B. More than moderate postoperative neoaortic regurgitation was observed in 1 patient of group B; this patient underwent neoaortic valve replacement 66 months after the DKS procedure. No one had a recurrent SVOTO during follow-up. Conclusion: The DKS procedure is an effective way to minimize the risk of SVOTO, and there is little difference in the outcomes of the DKS procedure according to the surgical technique used.

• 한국안전학회지
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• 제33권5호
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• pp.21-27
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• 2018

The purpose of this study is to develop a SOP (Standard Operating Procedure) for a distribution board that can monitor the leakage current of a load distribution line in real time. The developed distribution board was fabricated by applying IEC 61439-1. It consists of the distribution board and an alarm device. The work process for making the distribution board was compliant with the KEMC (Korea Electrical Manufacturers Cooperative) regulations. And the AC distribution board range is 1,000 V. In addition, the voltage in DC is less than 1500 V. The distribution board receives a 3-phases and 4-wires power supply system and can supply power to the load of a maximum of 32 single or three phase distribution circuits. Also, leakage current measured on the power distribution board was used by sensors installed. The SOP of the developed distribution board consists of the installation standards for the short circuit alarm device and sensor, the surge protection device, switches and indication lamps, and other devices. The operation procedure was prepared so that each manufacturing step of the distribution board must be confirmed by the persons in charge of preparation, production, quality control and approval before moving forward to the next step.

• 산업경영시스템학회지
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• 제42권4호
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• pp.126-134
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• 2019

Nowadays, since there are so many big data available everywhere, those big data can be used to find useful information to improve design and operation by using various analysis methods such as data mining. Especially if we have event log data that has execution history data of an organization such as case_id, event_time, event (activity), performer, etc., then we can apply process mining to discover the main process model in the organization. Once we can find the main process from process mining, we can utilize it to improve current working environment. In this paper we developed a new method to find a final diagnosis of a patient, who needs several procedures (medical test and examination) to diagnose disease of the patient by using process mining approach. Some patients can be diagnosed by only one procedure, but there are certainly some patients who are very difficult to diagnose and need to take several procedures to find exact disease name. We used 2 million procedure log data and there are 397 thousands patients who took 2 and more procedures to find a final disease. These multi-procedure patients are not frequent case, but it is very critical to prevent wrong diagnosis. From those multi-procedure taken patients, 4 procedures were discovered to be a main process model in the hospital. Using this main process model, we can understand the sequence of procedures in the hospital and furthermore the relationship between diagnosis and corresponding procedures.

• Advances in pediatric surgery
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• 제7권2호
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• pp.130-136
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• 2001

The aim of this study was to evaluate the short-term outcomes of the trans anal one-stage pull-through procedure(TOP) in Hirschsprung's disease. Eight patients aged 3 weeks to 8 months with Hirschsprung's disease underwent this procedure. A rectal mucosectomy was performed from just proximal to dentate line to the level of peritoneal reflexion, where muscle layer was incised circumferentially. Rectosigmoid was mobilized out through the anus, and full-thickness frozen biopsy was taken for confirmation of ganglionic cells. After the rectal muscular cuff was divided longitudinally in the posterior aspect, aganglionic bowel was removed and ganglionic colon was anastomozed to the anus. The mean operating time was 161 minutes, and the mean hospital stay after operation was 3.8 days. Five patients had three to four bowel movement per day without other therapy at mean postoperative 39.2 days. Although long-term follow-up will be required, the TOP might be the new alternative surgical procedure for Hirschsprung's disease.

• Archives of Reconstructive Microsurgery
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• 제9권1호
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• pp.80-87
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• 2000

Acute high speed accidents that results in full thickness skin defect and exposure of tendon, nerve, vessel and periosteum over denuded bone demands soft tissue coverage. Exposed bone often ensues chronic infection and requires free flap transplantation which surely covers defects in one stage operation and enhances transport of oxygen-rich blood and converts a non-osteogenic or partially osteogenic site into a highly osteogenic site, but exposed bone which had performed free flap transplantation sometimes necroses and needs secondary bone procedure. Scar contracture limits joint motion should be excised and covered with normal soft tissue to restore normal range of motion. Authors have performed the large latissimus dorsi myocutaneous free flap in 8 cases of extensive soft tissue defect and exposed bone lesion in the leg and 1 case of the flap was failed. The secondary ilizarov bone procedure was performed in 3 of 8 cases. 2 cases of large burn scar contracture and 1 case of posttraumatic scar contracture in lower extremity were restored with the large latissimus dorsi myocutaneous free flap. Authors concluded that large latissimus dorsi myocutaneous free flap is the most acceptable microvascular procedure in large soft tissue defect combined with exposed periosteum and bone requiring secondary bone procedure and in large burn scar contracture limiting knee joint motion.

• Nuclear Engineering and Technology
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• 제47권2호
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• pp.187-195
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• 2015

Human-induced initiating events, also called Category B actions in human reliability analysis, are operator actions that may lead directly to initiating events. Most conventional probabilistic safety analyses typically assume that the frequency of initiating events also includes the probability of human-induced initiating events. However, some regulatory documents require Category B actions to be specifically analyzed and quantified in probabilistic safety analysis. An explicit modeling of Category B actions could also potentially lead to important insights into human performance in terms of safety. However, there is no standard procedure to identify Category B actions. This paper describes a systematic procedure to identify Category B actions for low power and shutdown conditions. The procedure includes several steps to determine operator actions that may lead to initiating events in the low power and shutdown stages. These steps are the selection of initiating events, the selection of systems or components, the screening of unlikely operating actions, and the quantification of initiating events. The procedure also provides the detailed instruction for each step, such as operator's action, information required, screening rules, and the outputs. Finally, the applicability of the suggested approach is also investigated by application to a plant example.

• 대한두경부종양학회지
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• 제19권2호
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• pp.137-141
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• 2003

Introduction: A routine superficial parotidectomy with facial nerve dissection in parotid tumor surgery often results in facial dysfunction, Frey syndrome and defect in operation site. Formal facial nerve dissection has been a recommended procedure, because pleomorphic adenoma is a commonly recurrent tumor in case of inadequate surgical management, however it can not be always reasonable in aspect of postoperative sequelae. Patients and Methods: Through retrospective review of 245 cases parotidectomies and follow up for more than three years, clinicophathologic factors influencing to the selection of surgical procedure were considered to be age, sex, and preoperative pathology confirmed by preoperative MRI and FNA. Results: Five categories were established as follow for surgical decision in parotid tumor surgery. Category 1. Superficial lobe adenoma -- Superficial parotidectomy -- 124 Category 2. Deep lobe adenoma -- Deep parotidectomy -- 39 Category 3. Non pleomorphic adenoma -- Tumorectomy 1.5cm adenoma in young female -- Tumorectomy -- 25 Category 4. Recurrent multicentric tumor -- Parotidectomy+RT -- 9 Category 5. Parotid cancer; Parotidectomy + UND (RND) + RT -- 48 ; CORE (Composite Regional Ear Resection) -- 2 Conclusion: Surgical morbidity and recurrence rate could be minimized by individualizing the surgical procedure according to the category principle based on the clincopathologic features.

• 한국안전학회지
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• 제35권1호
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• pp.87-96
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• 2020

The purpose of this paper is to develop a fire HRA (Human Reliability Analysis) procedure for full power operation of domestic NPPs (Nuclear Power Plants). For the development of fire HRA procedure, the recent research results of NUREG-1921 in an effort to meet the requirements of the ASME/ANS PRA Standard were reviewed. The K-HRA method, a standard method for HRA of a domestic level 1 PSA (Probabilistic Safety Assessment) and fire related procedures in domestic NPPs were reviewed. Based on the review, a procedure for the fire HRA required for a domestic fire PSA based on the K-HRA method was developed. To this end, HRA issues such as new operator actions required in the event of a fire and complexity of fire situations were considered. Based on the four kinds of HFE (Human Failure Event) developed for a fire HRA in this research, a qualitative analysis such as feasibility evaluation was suggested. And also a quantitative analysis process which consists of screening analysis and detailed analysis was proposed. For the qualitative analysis, a screening analysis by NUREG-1921 was used. In this research, the screening criteria for the screening analysis was modified to reduce vague description and to reflect recent experimental results. For a detailed analysis, the K-HRA method and scoping analysis by NUREG-1921 were adopted. To apply K-HRA to fire HRA for quantification, efforts to modify PSFs (Performance Shaping Factors) of K-HRA to reflect fire situation and effects were made. For example, an absence of STA (Shift Technical Advisor) to command a fire brigade at a fire area is considered and the absence time should be reflected for a HEP (Human Error Probability) quantification. Based on the fire HRA procedure developed in this paper, a case study for HEP quantification such as a screening analysis and detailed analysis with the modified K-HRA was performed. It is expected that the HRA procedure suggested in this paper will be utilized for fire PSA for domestic NPPs as it is the first attempt to establish an HRA process considering fire effects.

• 대한후두음성언어의학회지
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• 제25권2호
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• pp.90-95
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• 2014

Background and Objectives : Arytenoid adduction procedure is one of the main surgical options addressed for the correction of glottal incompetence in patients with unilateral vocal cord paralysis. Traditionally, a midline approach is used for identifying and suturing around the muscular process, which often needs over-traction of the thyroid cartilage and results in patient's discomfort as well as surgeon's distress. The authors investigated the advantage of a modified procedure, lateral approach, in which the arytenoid cartilage is exposed through the space between strap muscles and sternocleidomastoid muscle. Materials and Methods : Retrospective chart review was performed for 66 patients who received arytenoid adduction surgery at Samsung Medical Center, between the year 1997 and 2014. Operation time, types of anesthesia, voice outcomes and complications were compared between the midline (n=22) and the lateral (n=44) approach group. Results : Operation time was shorter in the lateral approach group ($125{\pm}24min$) than in the midline group ($144{\pm}24min$). Arytenoid adduction was proceeded under local anesthesia in 66% (n=29/44) and 14% (n=3/22) of patients with lateral and midline approach group, respectively. Voice outcomes and complication rates were comparable between the two groups. Injection laryngoplasty in conjunction with arytenoid adduction resulted in more favorable voice outcomes. Conclusion : A lateral approach for the arytenoid adduction procedure showed comparable voice outcomes and similar complication rates with those of a midline approach. However, lateral approach provided less discomfort to the patients and less distress to a surgeon, and therefore, shorter operation time was needed and local anesthesia could be more frequently applied for this modified procedure.

• 대한디지털의료영상학회논문지
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• 제14권2호
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• pp.33-38
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• 2012

In EVAR procedure using long time C-arm, we studied exposure dose reduction and effeciency through measuring surgical staff's ESD by installing lead curtain operating table next to. The height 3 the spot (50cm, 100cm, 150cm) dose was measured on 2 locations for 600sec in the X-ray radiation considering the surgical staff's movement. To install the curtains, we compared before and after the dose. As a result, it can confirm that dose of the installation former of 50cm height and after is reduced about 75% and 91% in 2 locations. In 100cm height, the reduction of the dose was a bit confirmed. There as to dose value, measured on 150cm height the installation former and after was nearly no change. This research examined the exposure dose about the radiation of the surgical staff during EVAR procedure in which the operation time is the long time. It was implemented in the object that it reduces the radiation exposure. It could confirm the certain effect of the experimental result exposure dose reduction In EVAR procedure using long time C-arm, we studied exposure dose reduction and effeciency through measuring surgical staff's ESD by installing lead curtain operating table next to. The height 3 the spot (50cm, 100cm, 150cm) dose was measured on 2 locations for 600sec in the X-ray radiation considering the surgical staff's movement. To install the curtains, we compared before and after the dose. As a result, it can confirm that dose of the installation former of 50cm height and after is reduced about 75% and 91% in 2 locations. In 100cm height, the reduction of the dose was a bit confirmed. There as to dose value, measured on 150cm height the installation former and after was nearly no change. This research examined the exposure dose about the radiation of the surgical staff during EVAR procedure in which the operation time is the long time. It was implemented in the object that it reduces the radiation exposure. It could confirm the certain effect of the experimental result exposure dose reduction.