• Tuberculosis and Respiratory Diseases
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• v.84 no.2
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• pp.115-124
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• 2021

Background: This study aimed to determine the parameters for worsening oxygenation in non-severe coronavirus disease 2019 (COVID-19) pneumonia. Methods: This retrospective cohort study included cases of confirmed COVID-19 pneumonia in a public hospital in South Korea. The worsening oxygenation group was defined as that with SpO₂ ≤94% or received oxygen or mechanical ventilation (MV) throughout the clinical course versus the non-worsening oxygenation group that did not experience any respiratory event. Parameters were compared, and the extent of viral pneumonia from an initial chest computed tomography (CT) was calculated using artificial intelligence (AI) and measured visually by a radiologist. Results: We included 136 patients, with 32 (23.5%) patients in the worsening oxygenation group; of whom, two needed MV and one died. Initial vital signs and duration of symptoms showed no difference between the two groups; however, univariate logistic regression analysis revealed that a variety of parameters on admission were associated with an increased risk of a desaturation event. A subset of patients was studied to eliminate potential bias, that ferritin ≥280 ㎍/L (p=0.029), lactate dehydrogenase ≥240 U/L (p=0.029), pneumonia volume (p=0.021), and extent (p=0.030) by AI, and visual severity scores (p=0.042) were the predictive parameters for worsening oxygenation in a sex-, age-, and comorbid illness-matched case-control study using propensity score (n=52). Conclusion: Our study suggests that initial CT evaluated by AI or visual severity scoring as well as serum markers of inflammation on admission are significantly associated with worsening oxygenation in this COVID-19 pneumonia cohort.

• Journal of The Korea Institute of Healthcare Architecture
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• v.28 no.4
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• pp.89-97
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• 2022

Purpose: Because of the recent COVID-19 pandemic, there have been many cases of using portable negative pressure unit to convert general wards into temporary negative pressure isolation wards. The purpose of this study is to analyze the indoor environment of the switching type wards. Methods: Field measurements and experiments were conducted in a medical facility. Air volume, wind speed and pressure difference were measured in non-occupant state. Dispersion tests were performed with gas and particle matter. Results: The pressure difference between the wards and the corridor was higher than -2.5 Pa in normal situation. However, in the gas and particle dispersion tests, it was found that there were concerns about the spread through leakages in low-airtight walls or ceilings. In addition, it was confirmed that the pressure imbalance in ducts through the non-sealed diffusers could cause back flow during portable unit operation. Furthermore, when there was a pressure difference between adjacent wards planned to be at same pressure level, the possibility of the spread through the leakages was found. Implications: When using portable units for making switching type wards, it is necessary to create airtight space and seal the non-operation diffusers. In case of operating the air handling unit, T.A.B must be performed to adjust the duct balancing.

• The Journal of Internal Korean Medicine
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• v.32 no.1
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• pp.136-143
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• 2011

Priapism is a persistent penile erection that continues for more than 4 hours beyond, or is unrelated to, sexual stimulation. Because priapism is a medical emergency, all patients with priapism should be evaluated and treated urgently. Subtypes of priapism are ischemic, non-ischemic and stuttering priapism. Stuttering type is a recurrent form of ischemic priapism in which unwanted painful erections occur repeatedly with intervening periods of detumescence. The etiology of this type is often idiopathic and the treatments are still not clearly established. We present one case of stuttering priapism which occurred after suppression of his sexual desire. A 23-year-old man visited our clinic complaining of recurrent pain and erections persisting for about 5 weeks. We performed evaluation and confirmed the diagnosis of Rigid swollen penis. Jibaekjihwang-tang gamibang (ZhiBaiDihuang-Tang Jiaweifang) was administerd to the patient for 9 days. After the treatment, duration of erections and pain showed remarkable improvements. This will be recorded as the first case report of treating priapism with a Korean medical approach and suggests that Korean medicine therapy can be efficient to treat priapism.

• Journal of Fisheries and Marine Sciences Education
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• v.28 no.1
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• pp.221-234
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• 2016

Open port has the designated course and traffic jam of ships happens often. This fact may connect to ship crash easily. And the accident happens due to violation of navigation mainly. In ship crash between Neoblue and Shinkwang 7 at incheon open port, the Korean incheon maritime safety tribunal shows that the violation of navigation and duty of attention at the open port would produce ship crash directly. Wherefore, the interpretation and application of navigation are important to protect future ship crash accident. The points of navigation as objects of study are divided into two categories, interpretation and application of navigation on crashing between the ship which navigate the designated course and the ship which enter into the designated course from the another course or outside the course, interpretation and application of navigation on crashing between two or more ships, which navigate violating the navigation every ships and violating agreement rule each other. And as conclusion, I refer the legal responsibility both Neoblue and Shinkwang 7 in detail. The results of this study as follows : First, in case of crashing between the ship which navigate the designated course and the ship which enter into the designated course from the another course or outside the course, public order in open port act can be applied by priority. However, in applying the public order the principle of trust and reasons of crew, cause and effect, the time of navigation application are mandatory considerations. Second, in case of crashing between two or more ships, which navigate violating the navigation every ships and violating agreement rule each other, we should focus on the reasons of crew. Also, the reasons of crew need strict conditions. These means that the awareness of crash danger and recognition of special circumstance including limit state of ships, existence of emergency danger, non escaping crash danger by only observance of navigation. And in case of this state the public order the principle of trust and reasons of crew, cause and effect, the time of navigation application should be considered by priority, too.

• Quality Improvement in Health Care
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• v.7 no.1
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• pp.46-58
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• 2000

Background : Despite favorable effects of guidelines on patient care, guidelines often fail to achieve their objectives. Poorly implemented medical practice guidelines can produce only weak effects on the process of health care delivery. Therefore, we performed this study to investigate barriers related development of clinical practice guidelines. Methods : Cardiopulmonary resuscitation was selected as a target problem. Self questionnaires about management of cardiopulmonary resuscitation were developed by a researcher with advisory 8 experts. The questionnaires were designed as a unstructured methods. The data were collected from March 1 to May 31, 1999. A total 50 death case admitted inpatient to Inha University Hospital were subjected to evaluate the development and application of clinical practice guidelines for cardiopulmonary resuscitation. The data were examined by frequency, t-test with SPSS. Result : The article reviewed several common barriers that might limit successful implementation of guidelines in clinical practice, as illustrated by evaluating recommendations for cardiopulmonary resuscitation clinical practice guidelines. Some major problems with guidelines were characterized as follows (1) ethical problem : euthanasia, (2) occurrence on various emergency event and setting, (3) non-medical problems (4) unreliable of medical record etc. Conclusion : Careful analysis of guideline attributes, anticipated effect on medical care, and organizational factors revealed several barriers to successful guideline implementation that should be addressed in the design of future guideline-based interventions.

• Journal of Navigation and Port Research
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• v.34 no.4
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• pp.293-298
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• 2010

The residential comfort and safety on ship are more focused than ever, in accordance with the increase of the crews' onboard time and interest in cruiser sailing. To grasp the safety characteristics on ships against various scenarios of evacuations, this study performed experiments and simulations for the evacuation times on a training ship. Through the experiments, the average walking speed is 3.0m/s on 100% visibility, and 1.2m/s on 8% visibility, but the speeds go down 1.3m/s and 0.7m/s, respectively, when obstacles are happened without any previous notification. From the simulation, it is clearly reconfirmed that the worse visibility and many people make evacuation time comparatively longer. And unlike the common expectation of the effect of emergency announcement, the difference of evacuation times between cases of announcement and non-announcement is negligible on this study. From the survey after experiments, it is known that experiment participants feel unsafe and fear when the evacuation routes are longer in bad visible condition, even if they know the perfect evacuation route. And the survey results also show that the evacuees give more careful consideration to make a evacuation route decision under bad visibility.

• Journal of Trauma and Injury
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• v.27 no.2
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• pp.33-37
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• 2014

Central venous catheterization through a subclavian approach is indicated for some special purposes but it may cause many complications such as infection, bleeding, pneumothorax, thrombosis, air embolization, arrhythmia, myocardial perforation, and nerve injury. A case involving a mistaken central venous catheterization into the right vertebral artery through the subclavian artery is presented. A 33-year-old man who had deteriorated mentality after head injury underwent an emergency craniotomy for acute epidural hematomas on the right frontal and temporal convexities. His mentality improved rapidly, but he complained of continuous severe pain in the right posterior neck even though he had no previous symptom or past medical history of such pain. Three-dimensional cervical spine computed tomography (3D-CT) was performed first to rule out unconfirmed cervical injuries and it revealed a linear radiopaque material intrathoracically from the level of the 1st rib up to the level of C6 in the right vertebral foramen. An additional neck CT was performed, and the subclavian catheter was indwelling in the right vertebral artery through right subclavian artery. For the purpose of proper fluid infusion and central venous pressure monitoring, the subclavian vein catheterization had been performed in the operation room after general anesthesia induction before the craniotomy. Sufficient anatomical consideration and prudence is essential because inadvertent arterial cannulation at a non-compressible site is a highly risky iatrogenic complication of central venous line placement.

• The Transactions of The Korean Institute of Electrical Engineers
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• v.65 no.1
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• pp.40-50
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• 2016

In order to recover the power system during the wide power outage or power failure in the power plant, black start system should be properly operated without any problem. Especially power for black start in the geographically isolated areas of electric island is supplied from small emergency start-up generator, and loads are aux systems of gas turbines such as SFC(Static frequency converter). This paper introduces the international practices to overcome the voltage drop problem with harmonics of the system having the DC output such as SFC during black start in weak feed system and analyzes the relationship between house load inputs and harmonics. By varying the house load and input of power supply, this paper identified boundaries between weak feed and strong feed power. In order to verify the theory of stable condition in weak feed power system with DC output, house load is simulated using ETAP. Additionally MATLAB was used for harmonic analysis between the load inertia moment and non load inertia moment.

• Journal of the Korean Society of Safety
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• v.21 no.1 s.73
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• pp.35-40
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• 2006

A study on fire phenomena in a subway transit mass station has been carried out as a part of disaster prevention plan at the subway station. The ventilation facilities installed in both the platform and the trackway are designed to convert into a smoke exhaust system in emergency situation, creating such an environment as necessary for evacuation. 3 dimensional Numerical Simulations based on the CFD are carried out using a simulation tool, Fire Dynamic Simulator. Additionally, four different vent modes are made and performances are compared with the original design mode and each other to find better operation of vents at both the platform and the trackway in case of fire. From the result, an vent operational characteristics under the condition of installed PSD is clarified for the effective smoke and heat removal from the platform area compared with non installed PSD.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.4
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• pp.473-482
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• 2021

The introduction of automated flight systems has greatly improved aviation safety, but aircraft pilots continue to face new challenges. The pilot's stress from an aeronautical perspective can be distinguished by the 'Startle and Surprise' responses. 'Startle' is a short, strong physiological response to sudden or threatening stimuli such as unexpected gunfire. 'Surprise' is a cognitive-emotional response to an event that goes beyond one's expectations. In Martin et al.'s (2012) Startle Effect Experiment, the pilot identified physiological responses in the 'Startle' state, including delayed response and increased heart rate. In the Rahim (2020) Startle/Surprise experiment, the pilot's breathing rate and pulse rate did not change due to pre-planned emergency training. On the other hand, it was confirmed that the pilot's respiratory and heart rate were greatly increased due to the complicated aircraft and unplanned emergencies. Based on the results of these experiments, domestic pilots need to be trained to handle non-technical and various unexpected emergencies that could arise in an aircraft, rather than be just put through courses for enhancing technical capabilities or simple repetitive training as required by aviation law.