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양혁준,김기원,김현,조진성,노태호,윤한덕,이미진 대한의학회 2015 Journal of Korean medical science Vol.30 No.1
Sudden cardiac death (SCD) is a significant issue affecting national health policies. TheNational Emergency Department Information System for Cardiac Arrest (NEDIS-CA)consortium managed a prospective registry of out-of-hospital cardiac arrest (OHCA) at theemergency department (ED) level. We analyzed the NEDIS-CA data from 29 participatinghospitals from January 2008 to July 2009. The primary outcomes were incidence of OHCAand final survival outcomes at discharge. Factors influencing survival outcomes wereassessed as secondary outcomes. The implementation of advanced emergencymanagement (drugs, endotracheal intubation) and post-cardiac arrest care (therapeutichypothermia, coronary intervention) was also investigated. A total of 4,156 resuscitationattemptedOHCAs were included, of which 401 (9.6%) patients survived to discharge and79 (1.9%) were discharged with good neurologic outcomes. During the study period, therewere 1,662,470 ED visits in participant hospitals; therefore, the estimated number ofresuscitation-attempted CAs was 1 per 400 ED visits (0.25%). Factors improving survivaloutcomes included younger age, witnessed collapse, onset in a public place, a shockablerhythm in the pre-hospital setting, and applied advanced resuscitation care. We foundthat active advanced multidisciplinary resuscitation efforts influenced improvement in thesurvival rate. Resuscitation by public witnesses improved the short-term outcomes (returnof spontaneous circulation, survival admission) but did not increase the survival todischarge rate. Strategies are required to reinforce the chain of survival and high-qualitycardiopulmonary resuscitation in Korea.
양혁준 한국항해항만학회 2020 한국항해항만학회지 Vol.44 No.5
This paper analyzes the profitability of the Private Finance Initiative(PFI) ports and proposes the application plans of the R-project(Rehabilitate project) for old ports to attract and activate private investment in the port industry. The R-project of old ports can reduce the government’s financial budget and provide improved facilities for users more quickly than the public sector comparator. Before suggesting the R-project for old ports, the profitability of the currently operating 11 companies of the PFI ports are analyzed using the four ratios of profitability, and the results show that all the companies indicate low profitability, except for the top three companies. To apply the R-project, the three types of R-project ports are categorized as maintaining the function of the port, changing the function of the port, and mixing the function of the port. Additionally, three obstacles and improvement measures are suggested; attracting private business, legal issues, and administrative procedures. This study is conducive to the policy making for the port renewal and the activating PFI for the port industry.
화학물질 누출에 의한 대량재해 : Methyl Isocyanate 누출을 중심으로
양혁준,최중명,유동준 한국응급구조학회 1999 한국응급구조학회지 Vol.3 No.1
Background: We are in the edge of some human made disasters such as hazardous materials and air pollution, for example, the world news reported that the city of Bhopal, India had serious victims related with a leaking out of the chemical materials, Methyl Isocyanate and many people in India were killed by. These situations many people who live in this world are world are worrying about are not others, but just ours and people consider about that kind of the disasters are the possible situation to happen to all the people. Therefore, we performed this basic study to recognize the risk of Methyl Isocyanate leak accident and to prepare local disaster plan with EMS system. Method : Trace 8.0, a simulation software made by the U.S. company Safer System was used as a tool to estimate the diffusion distance, area and its victims at the concentrations of 0.02ppm, 0.2ppm 5ppm respectively for an assumed B-city of 2 hundred thousands population count in which was presumed 500kg Methyl Isocyanate gas to leak out. Results : 1. During 1 hour, maximum diffusion distances of 0.02ppm 0.2ppm and 5ppm were 5.41km, 1.61km and 0.29km respectively on the plume impact. 2. Maximum population counts influenced by Methyl Isocyanate gas at the concentrations of 0.02ppm 0.2ppm and 5ppm were 40838, 4346 and 222 on the plume impact, while those were 138238, 17261 and 1588 on the vulnerability impact, respectively. 3. Therefore, 17261 persons must put on respiratory device and 138283 persons must be evacuated to safety place within 1 hour. Conclusions : Only small amount leak of Methyl Isocyanate may cause tremendous chemical disaster in urban area so its disaster plan must be prepared with an accident simulation program and Material Safety Data Sheets(MSDS). Especially, nearby emergency center of an industrial complex must have a strong position about preparation of chemical disaster plan and perform a disaster dill of hazardous material accident annually.
글로벌 컨테이너 터미널 운영사의 자본구조 결정요인에 관한 연구
양혁준 한국로지스틱스학회 2020 로지스틱스연구 Vol.28 No.5
Most of the studies related to the GTO(global container terminal operator) have focused on terminal efficiency and competitiveness. Consequently, this paper aims to study the GTO in terms of financial perspectives by analyzing the capital structure decision. To study the capital structure, the sample consists of 7 GTO using financial statements from 2007 to 2019. The results show that the factors of tangibility, growth are positively related to the leverage and the size, however, indicates the significant negative relationship with the leverage, which means that the capital structure of GTO supports the pecking order theory. As for the capital structure model including supply-demand factors of shipping industry, the seaborne trade volume and the world fleet indicate the non-significant relationship with the leverage. In addition, the speed of adjustment is relatively low in comparison with previous studies. These results are conducive to filling the literature gap and have implications for capital structure decisions of GTO.
양혁준 대한의사협회 2009 대한의사협회지 Vol.52 No.12
Post-resuscitative induced hypothermia lowers mortality, reduces neurologic impairment after cardiac arrest, and is recommended by 2005 CPR guidelines of American Heart Association. This article reviews the mechanisms of hypothermic neuroprotection, the clinical trials that support its use after cardiac arrest, as well as the impact of hypothermia on patient management and prognosis. In caring for patients suffering ischemic brain injury after cardiac arrest, the role of the physician is no longer limited to conventional therapy but also extends to active involvement in clinical management which includes the use of therapeutic hypothermia. Therapeutic hypothermia is a feasible treatment and can be used safely and effectively at emergency department and ICU setting.