• Journal of Trauma and Injury
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• v.20 no.2
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• pp.57-64
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• 2007

Purpose: Clinically, acute respiratory distress syndrome (ARDS) occurs within 72 hours after acute exposure of risk factors. Because of its high fatality rate once ARDS progresses, early detection and management are essential to reduce the mortality rate. Accordingly, studies on early changes of ARDS were started, and serum ferritin, as well the as injury severity score (ISS), which has been addressed in previous studies, thought to be an early predictive indicator for ARDSMethods: From March 2003 to March 2005, we investigated 50 trauma patients who were admitted to the intensive care unit in Dongguk University Medical Center, Gyeongju. The patients were characterized according to age, sex, ISS, onset of ARDS, time onset of ARDS, serum ferritin level (posttraumatic $1^{st}\;&\;2^{nd}$ day), amount of transfused blood, and death. Abdominal computed topography was performed as an early diagnostic tool to evaluate the onset of ARDS according to its diagnostic criteria. The serum ferritin was measured by using a $VIDAS^{(R)}$ Ferritin (bioMeriux, Marcy-1' Etoile, France) kit with an enzyme-linked fluorescent assay method. For statistical analysis, Windows SPSS 13.0 and MedCalc were used to confirm the probability of obtaining a predictive measure from the receiver operating characteristics (ROC) curve. Results: The ISS varied from 14 to 66 (mean: 33.8) whereas the onset of ARDS could be predicted with the score above 30 (sensitivity: 90.0%, specificity: 60.0%, p<0.05). On the posttraumatic $1^{st}$ day, the serum ferritin levels were measured to be from 31 mg/dL to 1,200 mg/dL (mean: 456 mg/dL), and the onset of ARDS could be predicted when the value was over 340 mg/dL (sensitivity: 80.0%, specificity: 65.0%, p<0.05). On the posttraumatic $2^{nd}$ day, the serum ferritin levels were measured to be from 73 mg/dL to 1,200 mg/dL (mean: 404 mg/dL), and the onset of ARDS could be predicted when the value was over 627 mg/dL (sensitivity: 60.0%, specificity: 92.5%, p<0.05). The serum ferritin levels and the ISS were significantly higher on the posttraumatic $1^{st}$ and $2^{nd}$ day in the ARDS group, suggesting that they are suitable indices predicting the onset of ARDS, however relationship between the serum ferritin levels and the ISS was not statistically significant. Conclusion: In this study, we discovered increasing serum ferritin levels in multiple- trauma patients on the posttraumatic $1^{st}$ & $2^{nd}$ day and concluded that both the serum ferritin level and the ISS were good predictors of ARDS. Although they do not show statistically significant relationship to each other, they can be used as independent predictive measures for ARDS. Since ARDS causes high mortality, further studies, including the types of surgery and the methods of anesthesia on a large number of patients are essential to predict the chance of ARDS earlier and to reduce the incidence of death.

• Journal of Chest Surgery
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• v.39 no.7 s.264
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• pp.527-533
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• 2006

Background: A retrospective study was conducted to analyze the results of St. Jude Medical mitral valve replacement at the Chonbuk National University Hospital since the initial implant in May 1984. Material and Method: Between May of 1984 and December of 1996, 95 patients underwent MVR with the St. Jude Medical mechanical valve prosthesis at Department of Medical Science of Chonbuk National University Hospital and follow-up ended in May of 2004. Result: Age ranged from 19 to 69 years. Follow-up (mean${\pm}$standard deviation) averaged $10.6{\pm}4.2\;year$. Thirty-day operative mortality was 4.2% (4/95). Nine late deaths have occurred and actuarial survival was $90.5{\pm}3.0%,\;87.9{\pm}3.4%\;and\;83.2{\pm}4.6%$ at 5, 10 and 20 years, respectively. Probability of freedom from valve-rotated death was $95.5{\pm}2.1%,\;94.3{\pm}2.4%\;and\;91.0{\pm}3.9%$ at 5, 10 and 20 years, respectively. Seven patients have sustained thromboembolic events (1,05%/patient-year). Fifteen patients had anticoagulation related hemorrhage (3.56%/patient-year). There was no structural valve deterioration. Probability of freedom from all complications was $82.0{\pm}3.9%,\;71.3{\pm}4.8%\;and\;42.4{\pm}10.5%$ at 5, 10 and 20 years, respectively. Conclusion: We confirm the effective and excellent durability of the St. Jude Medical prosthesis in the mitral position with a low event rate at long-term follow-up. It also demonstrates the commonly encountered practical difficulty of adjusting the anti-coagulation protocol in patients with prosthetic mitral valves.

• Journal of the Korean Society of Radiology
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• v.12 no.3
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• pp.403-407
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• 2018

Currently, the highest cancer death rate in Korea is lung cancer, which is a typical cancer that is difficult to detect early. Low-dose chest CT is being used for early detection, which has a greater lung cancer diagnosis rate of about three times than regular chest x-ray images. However, low-dose chest CT not only significantly reduces image resolution but also has a weak signal and is sensitive to noise. Also, air filled lungs are low-density organs and the presence of noise can significantly affect early diagnosis of cancer. This study used Visual C++ to set a circle inside a large circle with a density of 2.0, with a density of 1.0, which is the density of water, in which five small circle of mathematics have different densities. Gaussian noise was generated by 1%, 2%, 3%, and 4% respectively to determine the effect of noise on the mean value, the standard deviation value, and the relative noise ratio(SNR). In areas where the density difference between the large and small circles was greatest in the event of 1 % noise, the SNR in the area with the greatest variation in noise was 4.669, and in areas with the lowest density difference, the SNR was 1.183. In addition, the SNR values can be seen to be high if the same results are obtained for both positive and negative densities. Quality was also clearly visible when the density difference was large, and if the noise level was increased, the SNR was reduced to significantly affect the noise. Low-density organs or organs in areas of similar density to cancers, will have significant noise effects, and the effects of density differences on the probability of noise will affect diagnosis.

• Journal of Korean Classical Literature and Education
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• no.34
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• pp.41-74
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• 2017

This study aimed to investigate the narrative strategy and meaning of fantasy in classic novels and to derive the educational meaning from the fantasy of Sukhyangjeon. This study selected Sukhyangjeon because is considered a suitable literary text that embodies characteristics of fantasy inherent in classical novels through its successful portrayal of the fantasy genre and its high popularity during its time. Specifically, this study observed that the "notice of hardships" which repeatedly appears in the narration of Sukhyangjeon reinforces the fantasy of the novel as it serves as an advance notice of intervention from heaven. Therefore, this study investigated the relationship between the notice of hardships and fantasy by focusing on Sukhyang's life. The way in which the "notice of hardships" is a form of illusion realized it evident in the plot when heaven saves Sukhyang from her hardship even though it was heaven that had granted her those forms of hardship. Firstly, the "notice from heaven" constitutes the macro structure of Sukhyangjeon. Through it, readers realize the enormous power of heaven by seeing how Sukhyang's life has been realized in accordance with heaven's notice with that, it evokes a sense of respect to heaven. In addition, heaven saves Sukhyang from different forms of danger. It enhances a miraculous feeling, which the omnipotent power of heaven shows, against the innocent appearance of Sukhyang during her times of danger. Meanwhile, when heaven notifies Sukhyang and the surrounding people of their fate and subsequently realizes it through dreams, this act creates a mysterious atmosphere and improves the probability of the narrative. If so, the narrative meaning in reinforcing the fantasy of the novel by the use of "notice of hardships" could be revealed through Sukhyang's real life. First, the hardship in which Sukhyang has gone through is so realistic and detailed that the readers' feelings of empathy are evoked with the fear of the coming hardship, wailing together, and trying to resolve the inner anxiety through Sukhyang's happiness. Second, the heavenly beings who are touched by the good behaviors of Sukhyang save her from the dangers of death. This creates the belief in readers that heaven intervenes for the good people. Third, the active attitude that Sukhyang and Leesun show in the process of marriage helps them overcome their earthly hardship and preserve their relationship in heaven. This gives readers hope that they could go to a "higher life" after going through suffering. This fantasy of Sukhyangjeon helps readers overcome their anxieties of reality through fantasy and recognizes the importance of relationships to enhance a sense of unity and solidarity with others. Because of these elements, it is expected that the fantasy of Sukhyangjeon will have a meaningful value to modern readers.

• The Journal of The Korea Institute of Intelligent Transport Systems
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• v.22 no.5
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• pp.53-73
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• 2023

Although it is mandatory to wear a seat belt that can minimize human injury when traffic accident occurs, the number of traffic accident casualties not wearing seat belts still accounts for a significant proportion.The seat belt wearing detection system for all seats is a system that identifies whether all seat passengers wear a seat belt and encourages their usage, also it can be a useful technical countermeasure. Firstly, this study established the viability of system implementation by assessing the factors influencing the severity of injuries in traffic accidents through the development of an ordered probit model. Analysis results showed that the use of seat belts has statistically significant effects on the severity of traffic accidents, reducing the probability of death or serious injury by 0.054 times in the event of a traffic accident. Secondly, a meta-analysis was conducted based on prior research related to seat belts and injuries in traffic accidents to estimate the expected reduction in accident severity upon the implementation of the system.The analysis of the effect of accident severity reduction revealed that wearing seat belts would lead to a 63.3% decrease in fatal accidents, with the front seats showing a reduction of 75.7% and the rear seats showing a reduction of 58.1% in fatal accidents. Lastly, Using the results of the meta-analysis and traffic accident statistics, the expected decrease in the number of traffic accident casualties with the implementation of the system was derived to analyze the traffic safety effects of the proposed detection system. The analysis demonstrated that with an increase in the adoption rate of the system, the number of casualties in accidents where seat belts were not worn decreased. Specifically, at a system adoption rate of 60%, it is anticipated that the number of fatalities would decrease by more than three times compared to the current scenario. Based on the analysis results, operational strategies for the system were proposed to increase seat belt usage rates and reduce accident severity.

• The Korean Society of Law and Medicine
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• v.24 no.4
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• pp.3-36
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• 2023

The main issue in medical malpractice civil litigation is medical negligence and the causal relationship between medical negligence and damages. Regarding the presumption of causality in cases where medical negligence is proven, there is a previous Supreme Court decision 93da52402 on February 10, 1995, but it is difficult to find a case that satisfies the textual requirements of the above decision, and yet, in practice, the above decision is cited. In many cases, causal relationships were assumed, and criticism was consistently raised that it was inconsistent with the text of the above judgment. In its ruling, the Supreme Court reorganized and presented a new legal principle regarding the presumption of causality when medical negligence is proven in a civil lawsuit. According to this, If the patient proves ① the existence of an act that is assessed as a medical negligence, that is, a violation of the duty of care required of an ordinary medical professional at the level of medical care practiced in the field of clinical medicine at the time of medical practice, and ② that the negligence is likely to cause damages to the patient, the burden of proving the causal relationship is alleviated by presuming a causal relationship between medical negligence and damage. Here, the probability of occurrence of damage does not need to be proven beyond doubt from a natural scientific or medical perspective, but if recognizing the causal relationship between the negligence and the damage does not comply with medical principles or if there is a vague possibility that the negligence will cause damage, causality cannot be considered proven. Meanwhile, even if a causal relationship between medical negligence and damage is presumed, the party that performed the medical treatment can overturn the presumption by proving that the patient's damage was not caused by medical negligence. Meanwhile, unlike civil cases, the standard is 'proof beyond reasonable doubt' in criminal cases, and the legal principle of presuming causality does not apply. Accordingly, in a criminal case of professional negligence manslaughter that was decided on the same day regarding the same medical accident, the case was overturned and remanded for not guilty due to lack of proof of a causal relationship between medical negligence and death. The above criminal ruling is a ruling that states that even if 'professional negligence' is recognized in a criminal case related to medical malpractice, the person should not be judged guilty if there is a lack of clear proof of 'causal relationship'.