• Journal of Korean Neurosurgical Society
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• 제65권1호
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• pp.22-29
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• 2022

Objective : Despite many advancements in endovascular treatment, the benefits of mechanical thrombectomy (MT) in patients with large infarctions remain uncertain due to hemorrhagic complications. Therefore, we aimed to investigate the efficacy and safety of recanalization via MT within 6 hours after stroke in patients with large cerebral infarction volumes (>70 mL). Methods : We retrospectively reviewed the medical data of 30 patients with large lesions on initial diffusion-weighted imaging (>70 mL) who underwent MT at our institution within 6 hours after stroke onset. Baseline data, recanalization rate, and 3-month clinical outcomes were analyzed. Successful recanalization was defined as a modified treatment in cerebral ischemia score of 2b or 3. Results : The recanalization rate was 63.3%, and symptomatic intracerebral hemorrhage occurred in six patients (20%). The proportion of patients with modified Rankin Scale (mRS) scores of 0-3 was significantly higher in the recanalization group than in the non-recanalization group (47.4% vs. 9.1%, p=0.049). The mortality rate was higher in the non-recanalization group, this difference was not significant (15.8% vs. 36.4%, p=0.372). In the analysis of 3-month clinical outcomes, only successful recanalization was significantly associated with mRS scores of 0-3 (90% vs. 50%, p=0.049). The odds ratio of recanalization for favorable outcomes (mRS 0-3) was 9.00 (95% confidence interval, 0.95-84.90; p=0.055). Conclusion : Despite the risk of symptomatic intracerebral hemorrhage, successful recanalization via MT 6 hours after stroke may improve clinical outcomes in patients with large vessel occlusion.

• Korean Journal of Acupuncture
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• 제36권1호
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• pp.1-18
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• 2019

Objectives : The purpose of this study was to evaluate the effectiveness and safety of acupuncture treatment for recovery of patients with vertebral compression fracture(VCF). Methods : We searched ten English and Chinese and seven Korean database up to April 2018. Randomised controlled trials(RCTs), quasi-RCTs, non-radomised Controlled Trials(CCTs) were eligible. Quasi-RCTs and CCTs were assessed only for safety assessment. Pain and adverse events were primary outcome of this review. Quality of life, dysfunction, patient satisfaction, incidence of new vertebral compression fracture were regarded as secondary outcomes. The risk of bias was assessed by two independent authors using the Cochrane risk of bias tool. Level of evidence was tabulated using the GRADE methods. Results : Of 1656 screened, 15 RCTs, 1 quasi-RCT and 3 CCTs were included. Number of participants per study ranged from 45 to 135. Most of the studies had unclear or high risk of bias and considerable heterogeneity in terms of type of intervention, comparison and time-points for outcome measurement. Compared to usual care alone, acupuncture combined with usual care showed short-term favorable results for pain relief in patients with VCF(5 studies, n=252, MD -1.05 point on a 0 to 10 point scale, 95% CI -1.45 to -0.65, $I^2=74%$). Four studies reported mild and temporary adverse events, and no serious adverse events were reported. One study descriptively reported that acupuncture was effective for improving quality of life without providing numerical outcomes. There were no reports of patient satisfaction and incidence of new VCF. Conclusions : Level of evidence is very low for the effectiveness and safety of acupuncture for pain, harms and other clinical outcomes in patients with VCF. Included studies suffered from incomplete reporting, high or unclear risk of bias and substantial heterogeneity between studies. Future high-quality RCTs are needed to assess whether acupuncture is beneficial for recovery of patients with VCF.

• Journal of Gastric Cancer
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• 제17권3호
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• pp.193-203
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• 2017

The implementation of national cancer screening has increased the detection rates of early gastric cancer (EGC) in Korea. Since the successful introduction of laparoscopic gastrectomy for gastric cancer in the early 1990s, this technique has demonstrated improved short-term outcomes without compromising long-term oncologic results. It is associated with reduced pain, shorter hospitalization, reduced morbidity rates, better cosmetic outcomes, and equivalent mortality rates as those for open surgery. Laparoscopic gastrectomy improves patients' quality of life (QOL) and provides favorable prognosis. Single-incision laparoscopic gastrectomy (SILG) is one extremely minimally invasive method, theoretically offering improved cosmetic results, less postoperative pain, and earlier recovery after surgery than conventional multiport laparoscopic gastrectomy. In this context, SILG is thought to be an optimal method to promote and maximize patients' QOL in the acute postoperative phase. However, the technical difficulties of this procedure have limited its use. Since the first report describing single-incision distal gastrectomy in 2011, only 16 studies to date have evaluated SILG. Most of these studies have focused on the technical feasibility and safety of SILG because its long-term outcomes have not been reported. This article reviews the advantages and limitations of SILG.

• 한국간담췌외과학회지
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• 제26권2호
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• pp.125-132
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• 2022

Backgrounds/Aims: It is generally accepted that non-anatomical resection (NAR) in colorectal liver metastasis (CRLM) has comparable safety and efficacy compared to anatomical resection (AR); however, there are reports that AR may have better outcomes in KRAS mutated CRLM. This study aimed to determine the effects of KRAS mutations and surgical techniques on survival outcomes in CRLM patients. Methods: Two hundred fifty patients who underwent hepatic resection of CRLM with known KRAS mutational status between 2007 and 2018 were analyzed. A total of 94 KRAS mutated CRLM and 156 KRAS wild-type CRLM were subdivided by surgical approach and compared for short- and long-term outcomes. Results: In both KRAS wild-type and mutated type, there was no difference in estimated blood loss, postoperative complications, and 30-day mortality. There was no difference in disease-free survival (DFS) between AR and NAR in both groups (p = 0.326, p = 0.954, respectively). Finally, there was no difference in intrahepatic DFS between AR and NAR groups in both the KRAS groups (p = 0.165, p = 0.516, respectively). Conclusions: The presence of KRAS mutation may not be a significant factor when deciding the approach in simultaneous resection of CRLM.

• 대한안전경영과학회지
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• 제24권4호
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• pp.33-39
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• 2022

Safety has once again emerged as a social issue due to the enforcement of the Serious Disasters Punishment Act and the occurrence of major disasters recently. As such, the safety culture related to unsafe human behavior is drawing attention as various discussions about the importance of safety and accident prevention are currently being undertaken. This study aims to determine whether changes in the level of safety culture in companies affect the accident rate. To this end, we targeted three workplaces in the same company in the domestic manufacturing industry, and 2,790 people were surveyed using DNV's Safety Will(ISRS-C version 4.0) for safety culture level diagnosis. The change in safety culture level and accident rate were compared and analyzed after carrying out safety culture level improvement activities for 5 years. As a result, the level of safety culture increased by 5.8 points, an overall improvement of 9.5%, while the total number of accidents decreased by 20%, from 5 to 4, indicating a general decreasing trend in accident occurrence. Results confirmed that the change in the level of safety culture affects the accident rate, and the improvement in the level of safety culture affects a reduction in accidents. Therefore, this study suggests that efforts to improve the level of safety culture within a company can be associated with accident reduction and accident prevention outcomes.

• Safety and Health at Work
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• 제9권3호
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• pp.257-264
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• 2018

Background: This paper presents the findings of a pilot research survey which assessed the degree of balance between safety and productivity, and its relationship with awareness and communication of human factors and safety rules in the aircraft manufacturing environment. Methods: The study was carried out at two Australian aircraft manufacturing facilities where a Likert-scale questionnaire was administered to a representative sample. The research instrument included topics relevant to the safety and human factors training provided to the target workforce. The answers were processed in overall, and against demographic characteristics of the sample population. Results: The workers were sufficiently aware of how human factors and safety rules influence their performance and acknowledged that supervisors had adequately communicated such topics. Safety and productivity seemed equally balanced across the sample. A preference for the former over the latter was associated with a higher awareness about human factors and safety rules, but not linked with safety communication. The size of the facility and the length and type of employment were occasionally correlated with responses to some communication and human factors topics and the equilibrium between productivity and safety. Conclusion: Although human factors training had been provided and sufficient bidirectional communication was present across the sample, it seems that quality and complexity factors might have influenced the effects of those safety related practices on the safety-productivity balance for specific parts of the population studied. Customization of safety training and communication to specific characteristics of employees may be necessary to achieve the desired outcomes.

• 한국재난정보학회 논문집
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• 제18권4호
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• pp.786-794
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• 2022

건설현장에서는 사후적 안전관리를 벗어나 실효성 있는 예방적 안전관리가 요구되고 있다. 연구목적: 본 연구는 자율적이고 예방적 안전관리를 위한 안전관리 활동, 안전문화 핵심요소, 안전, 불안전 행동관리, 안전성과의 관계모형을 제시하고 그 관계를 분석하는 것이 목적이다. 연구방법:설문조사 데이터를 구조방정식에 적용하여 관계를 분석하고, 검증된 가설이 시사하는 부분을 해석하여 외생변수로부터 안전성과에 도달하는 경로를 탐색하고 주요 논점을 제시하였다. 연구결과: 예비모형과 경로모형을 분석한 결과, 적합한 모형적합도를 확인하였고 외생변수가 내생변수에 미치는 유의한 결과를 확인하였다. 결론: 안전관리 활동, 안전, 불안전 행동관리, 안전문화 핵심요소관리로 안전사고 발생 전에 지속적인 안전성과 향상에 효과가 있을 것으로 판단된다.

• Safety and Health at Work
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• 제13권3호
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• pp.343-349
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• 2022

Background: In the United States, the dairy product manufacturing industry has consistently had higher rates of work-related nonfatal injuries and illnesses compared to the national average for industries in all sectors. The selection and implementation of appropriate safety performance indicators are important aspect of reducing risk within safety management systems. This study examined the leading safety indicators implemented in the dairy product-manufacturing sector (NAICS 3115) and their perceived effectiveness in reducing work-related injuries. Methods: Perceptions were collected from individuals with safety responsibilities in the dairy product manufacturing facilities. OSHA Incident Rate (OIR) and Days away, restricted and transferred (DART) rates from 2013 to 2018 were analyzed. Results: The perceived most effective leading were safety observations, stop work authority, near miss reporting, safety audits, preventative maintenance, safety inspections, safety training attendance, and job hazard analysis/safety analysis, respectively. The 6-year trend analysis showed that those implementing all eight top indicators had a slightly lower rates than those that did not implement all eight. Production focused mentality, poor training, and lack of management commitment were perceived as the leading causes of injuries in this industry. Conclusion: Collecting leading indicators with the unique interest to meet the regulatory requirements and to document the management system without the actual goal of using them as input to improve the system most probably will not lead to an effective reduction of negative safety outcomes. For leading indicators to be effective, they should be properly selected, executed, periodically evaluated and actions are taken when necessary.

• Safety and Health at Work
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• 제3권2호
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• pp.104-109
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• 2012

Singapore, an island republic of over 5 million inhabitants, has 3.1 million workers. Most are employed in the service, finance and tourist/transport industry. Significant numbers work in manufacturing, construction and heavy industry. Following a series of construction and shipyard accidents with multiple deaths in 2004, the government announced its intention to reduce workplace fatalities from 4.9 to 2.5 per 100,000 by 2015. There was strong political will to achieve this target. The strategic approaches were to build workplace safety and health (WSH) capabilities; implement legislative changes with enforcement; promote benefits of WSH and recognize best practices, and enhance partnership with stakeholders. The anticipated outcomes were to reduce workplace fatality and injury rates; have WSH as an integral part of business; and establish a progressive and pervasive WSH culture. With these measures, the workplace fatality rate declined from 4.9/100,000 in 2004, to 2.2/100,000 in 2010. However, other confounding factors could also account for this decline, and have to be considered. The next target, announced by Singapore's Prime Minister in 2008, is to further reduce the workplace fatality rate to 1.8/100,000 by 2018, and to have "one of the best workplace safety records in the world".

• Nuclear Engineering and Technology
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• 제55권5호
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• pp.1577-1586
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• 2023

Safety qualification of a steam generator is a crucial issue related to faulted condition design loads, including earthquake loads, and it should be ensured that the structural integrity of a steam generator does not exceed its design load. Using data from the Gyeongju and Pohang earthquakes, the two most powerful recorded seismic events in Korea, seismic analyses of a typical steam generator are conducted in this study. The modal characteristics are used to develop an input deck for these analyses. With a time history analysis, the responses of the steam generator in the event of an earthquake are obtained. In particular, the displacement, velocity, and acceleration responses are obtained in the time domain, with these outcomes then used for a detailed structural analysis as part of the ensuing assessment. The response spectra are also generated to determine the response characteristics in the frequency domain, focusing on the response comparisons between the Gyeongju and Pohang earthquakes. Structural integrity can be ensured by performing additional analysis using results obtained from the time history analysis considering the input excitations of various earthquakes considered in the design.