1.In-flight Electrocardiography Monitoring in a Pilot During Cross Country Flight
William D. KIM ; Sang-Wook KIM ; Seong-Kyu CHO ; Ju Hyeon BYEON ; GunYoung LEE ; WooSeok HYUN ; JoungSoon JANG
Korean Journal of Aerospace and Environmental Medicine 2024;34(4):101-107
Purpose:
The diagnosis and management of cardiovascular diseases are important for pilots, as well as the assessment of workload. Heart rate variability (HRV) can be evaluated from electrocardiography (ECG) signals during flight phases to assess the activation of the autonomic nervous system.
Methods:
In this study, continuous ECG activity was recorded of one pilot who flied as a pilot flying during a 4-hour long round trip using wearable ECG machine and was analyzed with MATLAB (R2020b ver. 9.9, The Mathworks Inc.). Total flight was divided into five phases: preflight, take off, cruise, landing, and postflight.
Results:
Mean heart rate (HR) was lowest in the postflight phase (76 bpm), and highest in the landing phase (86 bpm). Landing phase showed the highest values in standard deviation of NN interval (59.3 ms), triangular index (11.7), and triangular interpolation of NN interval (195 ms), while the postflight phase had highest root mean square of successive difference (20.5 ms) and proportion of successive RR interval (3.4 ms). As for frequency-domain metrics, the landing phase had the highest lowfrequency/high-frequency ratio of 5.33. Among the non-linear HRV measures, the landing phase presented the lowest SD1/SD2 ratio (0.15).
Conclusion
We observed the relative increase of mean HR and change of HRV in the landing phase, indicating elevated sympathetic nervous tone. Further studies should be considered to evaluate specific changes of ECG signals in flight phases and confirm the clinical use of the MATLAB signal analysis tools.
2.In-flight Electrocardiography Monitoring in a Pilot During Cross Country Flight
William D. KIM ; Sang-Wook KIM ; Seong-Kyu CHO ; Ju Hyeon BYEON ; GunYoung LEE ; WooSeok HYUN ; JoungSoon JANG
Korean Journal of Aerospace and Environmental Medicine 2024;34(4):101-107
Purpose:
The diagnosis and management of cardiovascular diseases are important for pilots, as well as the assessment of workload. Heart rate variability (HRV) can be evaluated from electrocardiography (ECG) signals during flight phases to assess the activation of the autonomic nervous system.
Methods:
In this study, continuous ECG activity was recorded of one pilot who flied as a pilot flying during a 4-hour long round trip using wearable ECG machine and was analyzed with MATLAB (R2020b ver. 9.9, The Mathworks Inc.). Total flight was divided into five phases: preflight, take off, cruise, landing, and postflight.
Results:
Mean heart rate (HR) was lowest in the postflight phase (76 bpm), and highest in the landing phase (86 bpm). Landing phase showed the highest values in standard deviation of NN interval (59.3 ms), triangular index (11.7), and triangular interpolation of NN interval (195 ms), while the postflight phase had highest root mean square of successive difference (20.5 ms) and proportion of successive RR interval (3.4 ms). As for frequency-domain metrics, the landing phase had the highest lowfrequency/high-frequency ratio of 5.33. Among the non-linear HRV measures, the landing phase presented the lowest SD1/SD2 ratio (0.15).
Conclusion
We observed the relative increase of mean HR and change of HRV in the landing phase, indicating elevated sympathetic nervous tone. Further studies should be considered to evaluate specific changes of ECG signals in flight phases and confirm the clinical use of the MATLAB signal analysis tools.
3.In-flight Electrocardiography Monitoring in a Pilot During Cross Country Flight
William D. KIM ; Sang-Wook KIM ; Seong-Kyu CHO ; Ju Hyeon BYEON ; GunYoung LEE ; WooSeok HYUN ; JoungSoon JANG
Korean Journal of Aerospace and Environmental Medicine 2024;34(4):101-107
Purpose:
The diagnosis and management of cardiovascular diseases are important for pilots, as well as the assessment of workload. Heart rate variability (HRV) can be evaluated from electrocardiography (ECG) signals during flight phases to assess the activation of the autonomic nervous system.
Methods:
In this study, continuous ECG activity was recorded of one pilot who flied as a pilot flying during a 4-hour long round trip using wearable ECG machine and was analyzed with MATLAB (R2020b ver. 9.9, The Mathworks Inc.). Total flight was divided into five phases: preflight, take off, cruise, landing, and postflight.
Results:
Mean heart rate (HR) was lowest in the postflight phase (76 bpm), and highest in the landing phase (86 bpm). Landing phase showed the highest values in standard deviation of NN interval (59.3 ms), triangular index (11.7), and triangular interpolation of NN interval (195 ms), while the postflight phase had highest root mean square of successive difference (20.5 ms) and proportion of successive RR interval (3.4 ms). As for frequency-domain metrics, the landing phase had the highest lowfrequency/high-frequency ratio of 5.33. Among the non-linear HRV measures, the landing phase presented the lowest SD1/SD2 ratio (0.15).
Conclusion
We observed the relative increase of mean HR and change of HRV in the landing phase, indicating elevated sympathetic nervous tone. Further studies should be considered to evaluate specific changes of ECG signals in flight phases and confirm the clinical use of the MATLAB signal analysis tools.
4.In-flight Electrocardiography Monitoring in a Pilot During Cross Country Flight
William D. KIM ; Sang-Wook KIM ; Seong-Kyu CHO ; Ju Hyeon BYEON ; GunYoung LEE ; WooSeok HYUN ; JoungSoon JANG
Korean Journal of Aerospace and Environmental Medicine 2024;34(4):101-107
Purpose:
The diagnosis and management of cardiovascular diseases are important for pilots, as well as the assessment of workload. Heart rate variability (HRV) can be evaluated from electrocardiography (ECG) signals during flight phases to assess the activation of the autonomic nervous system.
Methods:
In this study, continuous ECG activity was recorded of one pilot who flied as a pilot flying during a 4-hour long round trip using wearable ECG machine and was analyzed with MATLAB (R2020b ver. 9.9, The Mathworks Inc.). Total flight was divided into five phases: preflight, take off, cruise, landing, and postflight.
Results:
Mean heart rate (HR) was lowest in the postflight phase (76 bpm), and highest in the landing phase (86 bpm). Landing phase showed the highest values in standard deviation of NN interval (59.3 ms), triangular index (11.7), and triangular interpolation of NN interval (195 ms), while the postflight phase had highest root mean square of successive difference (20.5 ms) and proportion of successive RR interval (3.4 ms). As for frequency-domain metrics, the landing phase had the highest lowfrequency/high-frequency ratio of 5.33. Among the non-linear HRV measures, the landing phase presented the lowest SD1/SD2 ratio (0.15).
Conclusion
We observed the relative increase of mean HR and change of HRV in the landing phase, indicating elevated sympathetic nervous tone. Further studies should be considered to evaluate specific changes of ECG signals in flight phases and confirm the clinical use of the MATLAB signal analysis tools.
5.In-flight Electrocardiography Monitoring in a Pilot During Cross Country Flight
William D. KIM ; Sang-Wook KIM ; Seong-Kyu CHO ; Ju Hyeon BYEON ; GunYoung LEE ; WooSeok HYUN ; JoungSoon JANG
Korean Journal of Aerospace and Environmental Medicine 2024;34(4):101-107
Purpose:
The diagnosis and management of cardiovascular diseases are important for pilots, as well as the assessment of workload. Heart rate variability (HRV) can be evaluated from electrocardiography (ECG) signals during flight phases to assess the activation of the autonomic nervous system.
Methods:
In this study, continuous ECG activity was recorded of one pilot who flied as a pilot flying during a 4-hour long round trip using wearable ECG machine and was analyzed with MATLAB (R2020b ver. 9.9, The Mathworks Inc.). Total flight was divided into five phases: preflight, take off, cruise, landing, and postflight.
Results:
Mean heart rate (HR) was lowest in the postflight phase (76 bpm), and highest in the landing phase (86 bpm). Landing phase showed the highest values in standard deviation of NN interval (59.3 ms), triangular index (11.7), and triangular interpolation of NN interval (195 ms), while the postflight phase had highest root mean square of successive difference (20.5 ms) and proportion of successive RR interval (3.4 ms). As for frequency-domain metrics, the landing phase had the highest lowfrequency/high-frequency ratio of 5.33. Among the non-linear HRV measures, the landing phase presented the lowest SD1/SD2 ratio (0.15).
Conclusion
We observed the relative increase of mean HR and change of HRV in the landing phase, indicating elevated sympathetic nervous tone. Further studies should be considered to evaluate specific changes of ECG signals in flight phases and confirm the clinical use of the MATLAB signal analysis tools.
6.Current Status and Prospects of Korea’s Aerospace Medicine
Korean Journal of Aerospace and Environmental Medicine 2024;34(3):78-81
Many of aviation accidents are caused by human-related factors. Despite advancements in various fields related to aviation accidents caused by humanrelated factors continue. There are many unknown areas affecting aviation safety in the human factors of aviation workers, and the main task of aerospace medicine is to ensure aviation safety by appropriately managing these. Recently, with the development of the medical and aviation industries, related environments are rapidly developing and changing. In detail, it is necessary to modernize the aeromedical evaluation standards for air crews in line with international standards. As Korea is also pursuing space development, research on the space environment has also become necessary. Aviation medicine is an essential field that manages human factors in the field of aviation safety, and considering the public nature of aviation-related work, the nation's initial investment in the field of aerospace medicine must be a priority. To this end, it is necessary to establish a state-run aviation medical center and manage it under state leadership.
7.A Study on the Prevalence of Cancer Disease among Aviation Workers in Korea with Aviation Medical Examination of the Years from 2013 to 2015
Korean Journal of Aerospace and Environmental Medicine 2022;32(1):13-15
Purpose:
The medical certification for pilots is required by the aviation safety authority based with the aviation safety act.
Methods:
In this study, aeromedical decision results according to aviation medical examination of the years from 2013 to 2015 were reviewed by retrospective analysis.
Results:
Data from a cumulative total of 19,459 cases were screened. Of these, 15% were determined to be fit with condition. Among them, 259 were diagnosed with cancer. The ratios by cancer type are as follows: the most common cancer was thyroid cancer (39.7%), followed by gastric cancer (12.1%), kidney cancer (7.9%), colorectal cancer (7.9%), skin cancer (7.9%), prostate cancer (7.5%), lymphoma/leukemia (5.9%), lung cancer (5.0%), head and neck cancer (2.5%), and other cancers (2.5%).
Conclusion
The number of aircrew with cancer tends to increase slightly every year.The most common cause of thyroid cancer seems to be due to excessive diagnostic activity.
9.Investigation of the Status of Laboratory Tests Conducted during Aviation Medical Examination
JoungSoon JANG ; Byung-Seong SUH ; Young Hwan KWON ; Kyu-Sung KIM
Korean Journal of Aerospace and Environmental Medicine 2022;32(2):56-59
Purpose:
The medical certification for pilots is required by the aviation safety authority based with the aviation safety act.
Methods:
In this study, medical examination items of the year of 2021 performed during the aviation medical examination in Korea were reviewed by retrospective analysis.
Results:
Data from a total of 27 hospitals were collected. The number of inspection items ranged from a minimum of 22 items to a maximum of 57 items, showing a difference of more than double. Data from tertiary general hospitals and large airlines showed a tendency to perform more items of test compared to clinic-level institutions. The ratios for each inspection item are as follows: 1) 100% inspection items: urine test, ophthalmic test (except fundus test), fasting blood sugar, general blood test (complete blood count), electrocardiogram, electoencephalography, chest posterior anterior, pure tone audiometry, and total cholesterol; 2) 65%–74% inspection items: triglyceride, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, blood urea nitrogen/creatinine, and hepatitis B surface antigen; 3) 57% inspection items: hepatitis B surface antibody, human immunodeficiency virus, and venereal disease research laboratory; 4) 50% inspection items: urate and fundus examination.
Conclusion
There have been many changes in the medical field over the past 40 years, but in terms of examination items, the aviation physical examination does not reflect the flow of change. Over the past years, the number of pilots has increased significantly, the flight environment has changed, and medical examination methods have been developed and diversified. In accordance with this, it is necessary to change the test items.
10.A Pilot with Chronic Myeloid Leukemia: Aeromedical Assessment
Korean Journal of Aerospace and Environmental Medicine 2021;31(3):82-83
Chronic myeloid leukemia (CML) is myeloproliferative neoplasm associated with a characteristic chromosomal translocation (bcr-abl) called Philadelphia chromosome which plays a key role in the pathogenesis. Approximately 85% of patients with CML are in the chronic phase at the time of diagnosis. During this phase, patients are well tolerated and have few symptoms. But untreated, over the course of several years progresses to an accelerated phase and ultimately to a blast crisis, the terminal phase. CML is largely treated with targeted drug therapy called tyrosine-kinase inhibitors (TKIs) which have led to dramatically improved long-term survival rates since 2001. These drugs became standard treatment of this disease and allow most patients to have much better quality of life when compared to the former chemotherapy drugs and the bone marrow transplantation. Imatinib (Gleevec or Glivec, Norvatis) was the first of these TKIs and found to inhibit the progression of CML in the majority of patients (65%–75%) sufficiently to achieve remission. Since the advent of imatinib, CML has become the first neoplasm in which a medical treatment can give to the patient a normal life expectancy.

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