• Journal of Advanced Marine Engineering and Technology
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• 제40권7호
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• pp.655-662
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• 2016

본 연구에서는 산업 잠수 분야의 현장 책임자 겸 관리 감독자 역할을 할 수 있는 잠수기능장 직책을 국가자격제도로 도입할 것을 제안하였다. 이를 위해 수중전문건설업체 현황, 산업 잠수 장비 운용 실태, 잠수사 근로시간, 인력 수급 현황, 수중전문건설업 시장 현황 등 산업 잠수 분야의 전반적인 현황을 조사하였고, 국가자격체계와 NCS(National Competency Standards) 체계를 분석하여 잠수기능장의 직무 정의와 범위를 도출하였다. 그 결과 산업 잠수 분야의 잠수기능장 자격은 '산업 잠수에 관한 최상급 숙련 기능을 가지고 산업현장에서 공정관리, 소속 기능 인력의 지도 및 감독, 현장교육, 사업주와 기능 인력을 유기적으로 연계시켜주는 현장 관리자로서의 역할을 수행하는 직무'로 정의하고, 잠수기능장의 직무 내용은 '잠수계획수립 및 잠수팀 운영', '표면공급식 공기 혼합기체잠수', '기압조절실 운용', '수중토목', '해난구조' 로 구성하도록 제안하였다. 이 종목이 도입되면 그 동안 관련 분야 종사자들 사이에서 이슈가 되어 왔던 경력 개발을 비롯하여 직급의 관리 감독 등 많은 문제점들을 해소할 수 있을 것으로 기대된다.

• Journal of Chest Surgery
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• 제47권4호
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• pp.350-357
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• 2014

Background: Conservation of blood during cardiac surgery is important because of the shortage of donor blood, risks associated with transfusion, and the costs of allogeneic blood products. This retrospective study explored the feasibility of off-pump coronary artery bypass (OPCAB) without transfusion. Methods: One hundred and two consecutive patients underwent OPCAB from January 2007 to June 2012 at Hallym University Sacred Heart Hospital. Excluding 10 chronic renal failures patients, 102 patients were enrolled. Their characteristics, clinical data, and laboratory data were analyzed. We investigated the success rate of OPCAB without transfusion according to preoperative hemoglobin (Hb), and the cutoff point of the Hb level and the risk factors for transfusion. We implemented multidisciplinary blood-saving protocols. Results: The overall operative mortality and the success rate of OPCAB without transfusion were 2.9% (3/102) and 73.5% (75/102). The success rates in patients with Hb<11, 11 70 years, diagnosis of acute myocardial infarction, preoperative Hb and creatinine levels, and operation time. The events precipitating the need for transfusion were low Hb level in 9 patients and hypotension or excessive bleeding in 18 patients. Conclusion: The preoperative Hb level of >11 facilitates OPCAB without transfusion. These results suggest that transfusion-free OPCAB can be performed by modifying the risk factors and correctable causes of transfusion and improving various blood salvage methods.

• Archives of Plastic Surgery
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• 제37권3호
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• pp.277-280
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• 2010

Purpose: The resection of locally advanced or recurred breast cancers frequently result in large chest wall defects and it leads to a great challenges to cover. Generally simple skin grafts are not a practical option for patients because of their poor cosmetic appearance and prognosis. The latissimus dorsi and rectus abdominis musculocutaneous flap have traditionally been recommended for closure of these large defects. Though the cosmetic result of reconstruction using these flaps is often excellent, but has significant drawbacks. Therefore, we thought that chest wall reconstruction using the external oblique musculocutaneous flap can be an alternative method for extensive chest wall defect related to large, locally advanced breast carcinoma. Methods & Results: We present a case of a 50-year-old Korean female, refered to our department with a left breast tumor for 10 months. CT demonstrate a large tumor on the left anterior chest wall and multiple nodules of varying size in the cervical areas and liver. FDG-PET showed areas of hot uptake throughout the left chest wall, mediastinum and liver. Biopsy was consistent with invasive ductal carcinoma (Grade III). The initial tumor was considered inoperable, so a series of chemotherapy was initiated. Though the size of the breast mass was slightly decreased, the patient continued to suffer from purulent discharge, unpleasant odor and contact bleeding of the mass, the salvage mastectomy was performed. Conclusion: We could reconstruct $23{\times}16\;cm$ sized large chest wall defect, resulting from the resection of a locally advanced breast carcinoma, using an external oblique musculocutaneous flap successfully. Immediate postoperatively checked flap was healthy. Overall result was good without any significant complications and discharged 3 weeks after operation.

• 대한골관절종양학회지
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• 제2권1호
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• pp.27-32
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• 1996

Recent advances in imaging techniques, surgery and combination anti-cancer chemotherapy have brought high survival rates in osteosarcoma. To investigate the survival rate, local recurrence and complications in treatment, we analysed 25 osteosarcoma cases who had been treated with preoperative neo-adjuvant chemotherapy, surgery and post operative chemotherapy at Department of Orthopedic Surgery, Catholic University. From May 1988 to April 1995, 42 cases of stage IIB osteosarcoma were admitted in Department of Orthopedic Surgery. Among them, 17 cases who didn't follow our treatment guidance were excluded in this study. The average age were 19 years. There were 21 males and 4 females. The involved sites were 4 humerus, 10 femur, 10 tibia and 1 talus. Eleven cases had received intraarterial cisplatin and intravenous adriamycin chemotherapy, and 7 T-10 protocol and 7 intravenous ifosfamide, ADR, methotrexate, cisplatin. Twenty-three cases were treated with limb salvage surgery, and 2 amputation. The average follow-up was 35 months(3~82). There were 14 cases of continuous disease free, 9 cases of died of disease, 1 case of alive with disease, and 1 case of no evidence of disease at final follow-up. There were three cases of local recurrence at 6,8 and 12 months after operation. The estimated Kaplan-Meier's 5 year survival rates for all, ADR-cisplatin group, T-10 protocol group, and ifosfamide regimen group were 6%, 73%, 44% and 72%, respectively.

• Journal of Chest Surgery
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• 제25권3호
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• pp.232-239
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• 1992

Acute renal failure is a well known serious complication following open heart surgery and is associated with a significant increase in morbidity and mortality rate. From 1984 to 1990, 33 patients who had acute renal failure following cardiopulmonary bypass received renal replacement therapy. PD[Peritonial dialysis] was employed in 11 patients and CAVH[continous arteriovenous hemofiltration] was employed in 22 patients. Their age ranged from 3 months to 64 years[mean 25.5$\pm$7.8 years]. The disease entities included congenital cardiac anomaly in 18, valvular heart disease in 15 and aorta disease in 2 cases. Low cardiac output was thought as a primary cause of ARF except two redo valve cases who showed severe Aemolysis k depressed renal function preoperatively. Mean serum BUN and creatinine level at the onset renal replacement therapy were 65$\pm$8 mg/dl and 3.5$\pm$0.4 mg/dl respectively, declining only after reaching peak level 7&10 days following the onset of therapy. Overall hospital mortality was 72.7%[24/33]; 81%[9/11] in PD group and 68.2% [15/22] in CAVH group respectively. The primary cause of death was low cardiac output & hemodynamic depression in all the cases. The fatal complications included multiorgan failure in 7, disseminated intravascular coagulation and sepsis in 6, neurologic damage in 4 and mediastinitis in 3 cases. No measurable differences were observed between CAVH and PD group upon consequence of acute renal failure and disease per se. The age at operation, BUN/Cr level at the onset of bypass and highest BUN/Cr level and the consequence of low output status were regarded as important risk factors, determining outcome of ARF and success of renal replacement therapy. Thus, we concluded that althoght the prognosis is largely determined by severity of low cardiac output status and other organ complication, early institution of renal replacement therapy with other intensive supportive measures could improve salvage rate in established ARF patients following CPB.

• 대한두경부종양학회지
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• 제12권2호
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• pp.201-205
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• 1996

이상의 성적에서 레이저 성대 절제술은 초기 성문암종에 대한 일차 치료법으로 유용하다고 생각되었으며, 일차 절제가 가장 중요하고 그후 성대를 포함한 전체 후두점막에 대하여 주기적으로 현수후두경하에 수술현미경을 이용한 추적관찰과 원격전이 및 이차암의 발생 유무에 대하여 적극적인 추적검사가 필요할 것으로 사료된다.

• 대한골관절종양학회지
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• 제8권1호
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• pp.32-37
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• 2002

고등급 표면(high grade surface) 골육종은 골의 표면에서 발생하는 골육종의 희귀한 아형으로, 발생빈도는 전체 골육종의 1%에 못 미친다고 한다. 몇 편의 증례 보고와 연구 논문에서 이 고등급 표면 골육종을 소개하였는데, 국내의 경우 127예의 골육종 중 1예가 고등급 표면 골육종이었음을 기술한 논문이 있으나, 환자 및 진단과 치료에 대한 정보가 포함되어 있지 않았다. 저자들은 66세 여자 환자의 대퇴골 전자하부에서 발생한 고등급 표면 골육종 1예를 진단하고, 수술 전 항암 화학 요법, 광범위 절제술과 사지 구제술 및 수술 후 항암 화학 요법을 시행하였다. 이 종양은 위치만 골 표면에서 발생할 뿐 조직학적으로 전형적인 골수강내 골육종과 같으며, 다른 표면 골육종과는 달리 치료나 예후에 있어 전형적인 골수강 내 골육종과 같기 때문에, 진단과 치료에 있어 방골성 골육종이나 골막성 골육종 등의 표면 골육종과 구별하여야 할 것으로 생각한다.

• 대한골관절종양학회지
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• 제4권1호
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• pp.65-70
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• 1998

Osteosarcoma is the most common primary bone tumor except for multiple myeloma. Hematogenous spread of osteosarcoma presents the t1susal route of dissemination. Lung metastasis is the most common, however the lymph node involvement is quite rare. In addition, according to Mirra, radiologically detectable involvement of lymph node is an extremely rare manifestation of osteosarcoma. The authors had experienced a patient with an osteosarcoma of the right distal femur which spread to the right inguinal lymph node and lung. After preoperative chemotheraphy, a limb salvage operation was performed around the lesion of right distal femur and the right inguinal lymph nodes were dissected. A adjuvant postoperative chemotheraphy was performed. After the treatment, there was no recurrence of osteosarcoma or any other metastatic evidence for two years and 8 months.

• 대한족부족관절학회지
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• 제5권1호
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• pp.43-54
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• 2001

Treatment of calcaneal fraclure is difficult and full of controversy still and choice of treatment of the displaced intracalcaneal fracture is not available yet. Furthermore, the treatment of old calcaneal fracture with displaced subtalar joint or malunited calcaneal fracture is really difficult and painful to solve the problem other than subtalar arthrodesis, ignoring conservative treatment, excision of bone mass and/or adhesiolysis, which is/are a kind of palliative or salvage treatment in stead of definitive treatment that restores smooth articular surface of the subtalar joint as far as we can. Authors had some experiences treating this difficult old and displaced calcaneal fractures. Some of them were malunited already. Hereby we report our favorable results to treat the fractures with surgical reduction (reconstruction) and internal fixation without bone graft. We recommend reconstruction of the displaced subtalar joint even though it is not congruent and partly gone to get subtalar motion insead of palliative operation such as subtalar fusion, which can be done later and long term potential cause of mid tarsal arthrosis of the foot.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2019년도 춘계학술대회
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• pp.27-31
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• 2019

건설 현장에서는 건설 기계의 운전 미숙, 안전 설비 미비 등으로 인해 각종 안전사고가 빈번하게 일어나고 있다. 그 중 타워크레인에 대한 안전사고는 막대한 인명 및 재산 피해가 발생하고 있다. 따라서 본 연구에서는 타워크레인의 안전 사고를 예방하기 위한 안전 장치를 개발하는데 그 목적이 있다. 이를 위해 기존의 안전 장치를 탐색한 후 아두이노를 활용하여 타워크레인 모형을 제작하였다. 물건의 무게, 추의 무게 그리고 중심 축과의 거리를 변인으로 한 실험과 돌림 힘 공식에 따라 기존 안전 장치의 문제점을 파악하고 이를 해결할 수 있는 안전장치로서 이동형 추를 제안하였다. 이는 타워 크레인의 인양거리 범위 제한을 최소화할 수 있어 안전사고의 위험에서 벗어나 보다 안전한 작업 환경을 제공해줄 수 있으리라 기대한다.