Epidemiological Aspects of Hepatitis E Virus Infections between South Korea and Japan

Abstract : Purpose: Hepatitis E outbreaks are a serious public health concern in the world. The pilots or air traffic controllers can be incapacitated by severe hepatitis symptoms. If the symptoms of acute hepatitis do not improve, it is not suitable for aviation duties. In this study, we compare of incidence status of hepatitis E virus (HEV) infections, and epidemic aspects between South Korea (from here on, ‘Korea’) and Japan. Methods: The raw data on confirmed of HEV infection cases were obtained from the National Notified Disease Surveillance System of Korea Diseases Control and Prevention Agency, the Ministry of Health and Welfare in Korea, and the National Epidemiological surveillance of Infectious Diseases surveillance system, administered by the National Institute of Infectious Diseases in Japan. Statistically significant differences between the epidemiological aspects and risk factors were determined using the Pearson’s chi-squared test or paired t-test. All data analyses were performed in Microsoft Excel 2010 (Microsoft, Redmond, WA, USA). Results: There were 191 cases of HEV infected cases with a prevalence rate (PR) of 0.37 per 100,000 populations of Korea in 2020. During the same year in Japan, there were 454 cases with a PR of 0.36. When compared, there is statistically none significantly differences. Moreover, both PR per 100,000 populations of HEV infections in habitat of two countries were compared, in the provinces (0.39) of Korea were much higher than that in capital city of Seoul (0.27; P

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항공 피로위험관리를 위한 생체수리적 모델 접근 방안

A Study on the Biomathematical Model Approach for Aviation Fatigue Risk Management

Abstract : In the aviation sector, it is recommended to adopt an aviation safety management system (SMS) from international organizations (International Civil Aviation Organization, Federal Aviation Administration, etc.) and to apply a related system in each organization. Among them, fatigue management recommends fatigue risk management system (FRMS) operating as part of SMS proactive risk management. Advanced aviation organizations are developing and applying various related risk assessment techniques that consider characteristics in order to apply scientific and systematic FRMS. Among which the biomathematical fatigue model (BFM) are representative. The Bio-mathematical Model is designed to represent the level by converting it into a simple numerical score, taking into account various related factors for the measurement object. The BFM is tool to predict the level of fatigue of the crew based on scientific understanding of the factors that contribute to fatigue. The Biomathematical Model is used as a scientific approach that promotes the transition to a performance-based safety management. In this study, the recent trends and implications for the BFM developed and applied in the aviation field are to be reviewed. First, FRMS was considered within the SMS framework, then the characteristics and application methods of the BFM were examined, and finally, the direction of the development of the BFM was suggested.

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기내 심폐소생술과 COVID-19

In-Flight Cardiopulmonary Resuscitation and COVID-19

Abstract : As the number of passengers using aircraft increases around the world, there may be more medical measures needed within the aircraft. These medical measures may also include measures against serious situations such as cardiopulmonary resuscitation (CPR). However, since the environment is different from the hospital in the aircraft, it may be difficult to cope with such a situation. Moreover, such in-flight CPR may become more difficult at a time when the proportion of out-of-hospital CPR is decreasing due to the recent COVID-19 pandemic. In this paper, I would like to summarize how in-flight CPR is performed and review the main discussions on CPR in the COVID-19 pandemic, and finally suggest how to perform a safe CPR in the COVID-19 situation.

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코로나19 팬데믹과 조종사 정신건강 관리

COVID-19 Pandemic and Pilot Mental Health Care

Abstract : When the COVID-19 crisis hit air transport, the whole aviation industry was affected. The change in the behavior of passengers following the COVID-19 crisis, travel restrictions and the ensuing economic crisis have resulted in a dramatic drop in demand for airline services. The COVID-19 pandemic, with all its associated consequences, has had a significant impact on the mental health and well-being of pilots, which could impact operational safety. As the number of international flights has decreased, pilots are exposed to high levels of psychological stress such as job instability, reduced income and increased risk of infection during flight work. Psychological stress lowers work performance and threatens aviation safety. The pilot needs mental health management during the COVID-19 pandemic, but psychological support is weak. For pilot mental health management, it is important to raise awareness about mental health and to continuously respond. To this end, it is necessary to foster a safe and trustworthy culture in which mental health issues are discussed freely and solved together without hiding them. They should also support the establishment of a peer support program that is easily accessible and that allows pilots to discuss their issues with confidence.

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The Enhancing Error Management of Pilot and Line Operation Safety Audit

Abstract : The human factors become the most important factor in aviation safety. In order to prevent accident, pilots should manage errors in the cockpit. International Civil Aviation Authority (ICAO) recommends airlines to implement line operation safety audit (LOSA) to identify the management of errors by pilots and understand real errors and the competencies. The LOSA may provide metrics of the prevalence of errors by each types and rate of trapping errors to management enhancing errors. Airlines may understand how crew respond and manage errors. The operator may enhance safety once they identify errors and train crew how they manage to reduce the most mismanagement errors. This study is to provide operators eight recommendations on how to enhance errors and LOSA understanding human errors collected through LOSA and enhancing the implementation of LOSA with guidance according to ICAO and Federal Aviation Administration.

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최근 6년간 일개 병원의 외국인 환자 현황과 코로나19의 영향

Current Status of Foreign Patients in a Hospital over the Past 6 Years and the Impact of COVID-19

Abstract : Purpose: As it becomes difficult to move between countries due to the spread of COVID-19, it can be expected that the number of foreign patients entering Korea for treatment will decrease significantly. The purpose of this study is to investigate the current status of hospitalization of foreign patients over the past 6 years and the impact of COVID-19. Methods: The sex, age, nationality, and histories of foreign patients who visited the International Medical Center from 2016 to 2021 were collected. A total of 25,569 subjects were analyzed. Results: For six years from 2016 to 2021, the number of foreign patients increased steadily before COVID-19 but decreased significantly after COVID-19. Overall, it was analyzed that the average annual growth rate of foreign patients from 2016 to 2019 was about 6%. However, due to the impact of COVID-19, the number of patients in 2020 decreased by about 57% compared to the previous year and by about 1% in 2021 compared to the previous year. Conclusion: It is believed that the decrease in foreign patients in a situation such as Corona 19 is due not only to the risk of infection, but also to the difficulty of moving between countries. In other words, it can be said that the driving force for the movement due to the medical skill gap still exists. Therefore, if this situation improves, it is judged that the phenomenon of moving abroad in search of medical care is inevitable.

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편집자 주: 32권 1호

Editorial for Vol. 32, No. 1

Abstract : In Vol. 32, No. 1, our journal prepared 1 review article, 4 original articles, and 2 case reports. First, the Biomathematical Models for Aviation Fatigue Risk Management were introduced. Among the four original articles, it is possible to get insights into the management of cancer diseases in aviation workers, and it is expected to solve various problems in aerospace medicine through a research case using machine learning techniques. A similar trend was observed in the medical tourism along with the decrease of the aviation industry due to COVID-19. Hepatitis E infection can be occurred in both the public and aviation workers, and the management system was established in 2020 as a second-grade legal infectious disease in Korea. In two case reports, we introduced a case of the Phakic intraocular lenses insertion and a case of the acute myocardial infarction and pericardial effusion.

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한국형 기내 의학적 상황 대처 방안 안내서

Korean Guideline for Managing In-flight Medical Events

Abstract : In Vol. 32, No. 1, our journal prepared 1 review article, 4 original articles, and 2 case reports. First, the Biomathematical Models for Aviation Fatigue Risk Management were introduced. Among the four original articles, it is possible to get insights into the management of cancer diseases in aviation workers, and it is expected to solve various problems in aerospace medicine through a research case using machine learning techniques. A similar trend was observed in the medical tourism along with the decrease of the aviation industry due to COVID-19. Hepatitis E infection can be occurred in both the public and aviation workers, and the management system was established in 2020 as a second-grade legal infectious disease in Korea. In two case reports, we introduced a case of the Phakic intraocular lenses insertion and a case of the acute myocardial infarction and pericardial effusion.

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Epidemiological Aspects of Hepatitis E Virus Infections between South Korea and Japan

Abstract : In Vol. 32, No. 1, our journal prepared 1 review article, 4 original articles, and 2 case reports. First, the Biomathematical Models for Aviation Fatigue Risk Management were introduced. Among the four original articles, it is possible to get insights into the management of cancer diseases in aviation workers, and it is expected to solve various problems in aerospace medicine through a research case using machine learning techniques. A similar trend was observed in the medical tourism along with the decrease of the aviation industry due to COVID-19. Hepatitis E infection can be occurred in both the public and aviation workers, and the management system was established in 2020 as a second-grade legal infectious disease in Korea. In two case reports, we introduced a case of the Phakic intraocular lenses insertion and a case of the acute myocardial infarction and pericardial effusion.

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항공종사자와 코로나바이러스감염증-19 백신 예방 접종

COVID-19 Vaccination for Pilots and Air Traffic Controllers

Abstract : In Vol. 32, No. 1, our journal prepared 1 review article, 4 original articles, and 2 case reports. First, the Biomathematical Models for Aviation Fatigue Risk Management were introduced. Among the four original articles, it is possible to get insights into the management of cancer diseases in aviation workers, and it is expected to solve various problems in aerospace medicine through a research case using machine learning techniques. A similar trend was observed in the medical tourism along with the decrease of the aviation industry due to COVID-19. Hepatitis E infection can be occurred in both the public and aviation workers, and the management system was established in 2020 as a second-grade legal infectious disease in Korea. In two case reports, we introduced a case of the Phakic intraocular lenses insertion and a case of the acute myocardial infarction and pericardial effusion.

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항공종사자 건강증진활동계획에 반영되어야 할 근거자료: 3년간의 항공신체검사 결과 분석

Analysis of Three Years of Airmen Medical Certificate for Preparing Aviation-related Health Promotion Plan

Abstract : In Vol. 32, No. 1, our journal prepared 1 review article, 4 original articles, and 2 case reports. First, the Biomathematical Models for Aviation Fatigue Risk Management were introduced. Among the four original articles, it is possible to get insights into the management of cancer diseases in aviation workers, and it is expected to solve various problems in aerospace medicine through a research case using machine learning techniques. A similar trend was observed in the medical tourism along with the decrease of the aviation industry due to COVID-19. Hepatitis E infection can be occurred in both the public and aviation workers, and the management system was established in 2020 as a second-grade legal infectious disease in Korea. In two case reports, we introduced a case of the Phakic intraocular lenses insertion and a case of the acute myocardial infarction and pericardial effusion.

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피로위험관리를 위한 조종사 피로측정방법 고찰

A Study on the Pilot Fatigue Measurement Methods for Fatigue Risk Management

Abstract : In Vol. 32, No. 1, our journal prepared 1 review article, 4 original articles, and 2 case reports. First, the Biomathematical Models for Aviation Fatigue Risk Management were introduced. Among the four original articles, it is possible to get insights into the management of cancer diseases in aviation workers, and it is expected to solve various problems in aerospace medicine through a research case using machine learning techniques. A similar trend was observed in the medical tourism along with the decrease of the aviation industry due to COVID-19. Hepatitis E infection can be occurred in both the public and aviation workers, and the management system was established in 2020 as a second-grade legal infectious disease in Korea. In two case reports, we introduced a case of the Phakic intraocular lenses insertion and a case of the acute myocardial infarction and pericardial effusion.

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최근 5년간 국적항공사 조종사의 항공신체검사 부적합 판정결과

Survey of Medically Disqualified Airline Pilots in Korea: 2015~2019

Abstract : In Vol. 32, No. 1, our journal prepared 1 review article, 4 original articles, and 2 case reports. First, the Biomathematical Models for Aviation Fatigue Risk Management were introduced. Among the four original articles, it is possible to get insights into the management of cancer diseases in aviation workers, and it is expected to solve various problems in aerospace medicine through a research case using machine learning techniques. A similar trend was observed in the medical tourism along with the decrease of the aviation industry due to COVID-19. Hepatitis E infection can be occurred in both the public and aviation workers, and the management system was established in 2020 as a second-grade legal infectious disease in Korea. In two case reports, we introduced a case of the Phakic intraocular lenses insertion and a case of the acute myocardial infarction and pericardial effusion.

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말초성 어지럼의 이해 및 항공업무 적합성 평가

Understanding Peripheral Dizziness and Evaluating Suitability for Aviation Work

Abstract : In Vol. 32, No. 1, our journal prepared 1 review article, 4 original articles, and 2 case reports. First, the Biomathematical Models for Aviation Fatigue Risk Management were introduced. Among the four original articles, it is possible to get insights into the management of cancer diseases in aviation workers, and it is expected to solve various problems in aerospace medicine through a research case using machine learning techniques. A similar trend was observed in the medical tourism along with the decrease of the aviation industry due to COVID-19. Hepatitis E infection can be occurred in both the public and aviation workers, and the management system was established in 2020 as a second-grade legal infectious disease in Korea. In two case reports, we introduced a case of the Phakic intraocular lenses insertion and a case of the acute myocardial infarction and pericardial effusion.

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5년간의 미국 이민 비자 신체검사 결과 분석

Analysis of Five Years of US Immigration Medical Exams

Abstract : Purpose: The United States of America have pre-migration screening program are mandated through legislation. The one of purpose of this program is to prevent the importation of certain communicable diseases. Examinations of migration applicants are performed by panel physicians who are licensed physicians in the countries of origin that have agreements with the government departments of the country of destination to undertake this activity. In recent decades, the number of US migrants has increased, however COVID-19 impacted this trend of international migrants. The Aim of this study is to examine trends of US applicants and outcomes of tuberculosis and sexual transmitted infections (STIs) screening in South Korean applicants for US visa. Methods: A total of 4,442 applicants participated in US visa health check-up in 2016 to 2020. Results: The numbers of applicant for US visa in males and females was 1,814 and 2,628. The positive results in tuberculosis and STIs screening was noted with 0.66% in nontuberculous mycobacteria (NTM), 0.03% in tuberculosis, 0.03% in gonorrhea, 0.08% in syphilis, and 0.74% in chlamydia. The age groups of 2 to 14 years showed higher positive rate (13.89%) in tuberculin skin test (TST) tests compared to the rate of interferon gamma release assay (IGRA) tests (0.44%, P

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항공 피로위험관리를 위한 생체수리적 모델 접근 방안

A Study on the Biomathematical Model Approach for Aviation Fatigue Risk Management

Abstract : In the aviation sector, it is recommended to adopt an aviation safety management system (SMS) from international organizations (International Civil Aviation Organization, Federal Aviation Administration, etc.) and to apply a related system in each organization. Among them, fatigue management recommends fatigue risk management system (FRMS) operating as part of SMS proactive risk management. Advanced aviation organizations are developing and applying various related risk assessment techniques that consider characteristics in order to apply scientific and systematic FRMS. Among which the biomathematical fatigue model (BFM) are representative. The Bio-mathematical Model is designed to represent the level by converting it into a simple numerical score, taking into account various related factors for the measurement object. The BFM is tool to predict the level of fatigue of the crew based on scientific understanding of the factors that contribute to fatigue. The Biomathematical Model is used as a scientific approach that promotes the transition to a performance-based safety management. In this study, the recent trends and implications for the BFM developed and applied in the aviation field are to be reviewed. First, FRMS was considered within the SMS framework, then the characteristics and application methods of the BFM were examined, and finally, the direction of the development of the BFM was suggested.

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기내 심폐소생술과 COVID-19

In-Flight Cardiopulmonary Resuscitation and COVID-19

Abstract : As the number of passengers using aircraft increases around the world, there may be more medical measures needed within the aircraft. These medical measures may also include measures against serious situations such as cardiopulmonary resuscitation (CPR). However, since the environment is different from the hospital in the aircraft, it may be difficult to cope with such a situation. Moreover, such in-flight CPR may become more difficult at a time when the proportion of out-of-hospital CPR is decreasing due to the recent COVID-19 pandemic. In this paper, I would like to summarize how in-flight CPR is performed and review the main discussions on CPR in the COVID-19 pandemic, and finally suggest how to perform a safe CPR in the COVID-19 situation.

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코로나19 팬데믹과 조종사 정신건강 관리

COVID-19 Pandemic and Pilot Mental Health Care

Abstract : When the COVID-19 crisis hit air transport, the whole aviation industry was affected. The change in the behavior of passengers following the COVID-19 crisis, travel restrictions and the ensuing economic crisis have resulted in a dramatic drop in demand for airline services. The COVID-19 pandemic, with all its associated consequences, has had a significant impact on the mental health and well-being of pilots, which could impact operational safety. As the number of international flights has decreased, pilots are exposed to high levels of psychological stress such as job instability, reduced income and increased risk of infection during flight work. Psychological stress lowers work performance and threatens aviation safety. The pilot needs mental health management during the COVID-19 pandemic, but psychological support is weak. For pilot mental health management, it is important to raise awareness about mental health and to continuously respond. To this end, it is necessary to foster a safe and trustworthy culture in which mental health issues are discussed freely and solved together without hiding them. They should also support the establishment of a peer support program that is easily accessible and that allows pilots to discuss their issues with confidence.

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우주에서의 외과수술

Surgery in Space

Abstract : For Mars exploration, spaceflight is advancing with the goal of sending manned spacecraft to Mars. Mars is 54.6 million kilometers away when it is closest to Earth. If a surgical emergency occurs during Mars exploration, it could take months or years to transport patients. Research estimates that an average of one surgical emergency will occur every 2.4 years during the Mars expedition for a crew of seven. Considering the astronomical cost of space travel and astronaut training, surgical treatment needs to be considered. There are various problems in performing surgery in space, but typically, physiological changes in the body due to microgravity, difficulty in performing surgery due to an unfamiliar environment, and difficulty in maintaining sterility can be considered. Also, since an experienced surgeon cannot ride on all spaceships, tele-surgery is required. As an alternative to overcome these problems, robot assisted minimal invasive surgery has been proposed. However, it is necessary to solve the signal delay caused by the longer distance. Other alternatives, such as the development of Robot technology, rapid transport due to trauma pod, and performing surgery while notifying the crew medical officer, have been suggested.

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머신러닝 알고리즘을 이용한 A형 간염 항체 여부 판별의 정확도

Diagnostic Accuracy of Machine Learning Algorithms for Hepatitis A Antibody

Abstract : Purpose: The objective of this study was to develop a model for predicting the positivity of hepatitis A antibody based on nationwide health information using a machine learning technique. Methods: We used a data set that included the records of 4,626 samples. the data was randomly divided into a training set 80% (3,701) and validation set 20% (925). Customized sequential convolutional neural network (CNN) model was used to predict the positivity of hepatitis A antibody. The loss and accuracy of this model was calculated. Results: This model has 12-input and 2-concatenate and 3-dense layers. The total parameters of this model were 1,779. The accuracy quickly reached to over 85% validation accuracy in 50 epochs. The train loss, train accuracy, validation loss and validation accuracy of this model were 25.4%, 89.5%, 29.0%, and 87.2%, respectively. Conclusion: The model derived from the sequential CNN model exhibited a high level of accuracy. This model is a useful tool for predicting the positivity of hepatitis A antibody.

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Epidemiological Aspects of Hepatitis E Virus Infections between South Korea and Japan

Abstract : Purpose: Hepatitis E outbreaks are a serious public health concern in the world. The pilots or air traffic controllers can be incapacitated by severe hepatitis symptoms. If the symptoms of acute hepatitis do not improve, it is not suitable for aviation duties. In this study, we compare of incidence status of hepatitis E virus (HEV) infections, and epidemic aspects between South Korea (from here on, ‘Korea’) and Japan. Methods: The raw data on confirmed of HEV infection cases were obtained from the National Notified Disease Surveillance System of Korea Diseases Control and Prevention Agency, the Ministry of Health and Welfare in Korea, and the National Epidemiological surveillance of Infectious Diseases surveillance system, administered by the National Institute of Infectious Diseases in Japan. Statistically significant differences between the epidemiological aspects and risk factors were determined using the Pearson’s chi-squared test or paired t-test. All data analyses were performed in Microsoft Excel 2010 (Microsoft, Redmond, WA, USA). Results: There were 191 cases of HEV infected cases with a prevalence rate (PR) of 0.37 per 100,000 populations of Korea in 2020. During the same year in Japan, there were 454 cases with a PR of 0.36. When compared, there is statistically none significantly differences. Moreover, both PR per 100,000 populations of HEV infections in habitat of two countries were compared, in the provinces (0.39) of Korea were much higher than that in capital city of Seoul (0.27; P

Abstract

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