• The Korean Journal of Medicine
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• v.99 no.2
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• pp.84-95
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• 2024

In Harrison's Principles of Internal Medicine, human understanding is emphasized as one of three necessary characteristics that a physician must have. Inflammation, which is caused by inflammatory inducers (inf-ids), is a fundamental feature of disease at the cellular and molecular levels. Inflammation protects the body, but excessive or prolonged inflammation can be damaging and can cause disease. Humans are repeatedly exposed to external and internal environmental factors that generate inf-ids throughout their lives. External environmental factors include microbial and non-microbial inf-ids, as well as stressors that inevitably arise during social interactions. Internal environmental factors include the adaptive physiological response that is present from birth. Inf-ids may also be produced by the four-step habit loop, which consists of a cue (e.g., stressor), emotions, routine act (adaptive response), and a reward. Immune cells in the circulatory system and in tissues may have positive and negative effects in inflammatory responses. However, low-grade inflammation may be difficult to detect. We propose a model of disease development that integrates external and internal environmental factors from the perspective of human understanding.

• Journal of the Society of Naval Architects of Korea
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• v.61 no.4
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• pp.267-277
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• 2024

The Sortie Generation Rate (SGR) is a critical performance indicator for carrier-based aircraft and is a key factor for the carrier design process. This study aims to analyze the factors that affect SGR and establish a representative Sortie Generation Process (SGP) along with simulation results to calculate SGR for a naval ship equipped to carry aircraft. Detailed SGR factors are identified from the perspectives of the aircraft, aviation personnel, and aircraft carrier during the flight preparation stage, and the SGP is established accordingly. As a representative, Korean Navy's CVX basic design is chosen for detailed analysis. The physical dimension and spots for the deck design with time and probabilistic data of SGP are considered to develop a queueing network model for SGR calculation. To consider the specific probabilistic features, the model was solved with discrete event simulation tools(SimPy and AnyLogic) where the results show great agreement. Such findings on SGR factors and calculation are expected to be incorporated in the future development of SGR calculation algorithms and also present guidelines for proper design of aircraft carrier based on concrete operation concept.

• The Korean Society of Law and Medicine
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• v.11 no.1
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• pp.331-393
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• 2010

Psychiatrists who treat violent or potentially violent patients may be sue for failure to control aggressive outpatients and for the discharge of violent inpatients. Psychiatrists may be sued for failing to protect society from the violent acts of their patients if it was reasonable for the psychiatrists to have known or should have known about the patient's violent tendencies and if the psychiatrists could have done something that could have safeguarded in public. The courts of a number of jurisdictions have imposed a duty to protect the potential victims of a third party on persons or institutions with a special relationship to that party. In the landmark case of Tarasoff v Regents of University of California, the California Supreme Court held that the special relationship between a psychotherapist and a patient imposes on the therapist a duty to act reasonably to protect the foreseeable victims of the patient. Under Tarasoff, when a therapist has determined, or under applicable professional standards should determine, that a patient poses a serious threat of violence to another, he incurs an obligation to use reasonable care to protect the intended victim against such danger. In addition to a Tarasoff type of action based on a duty to warn or protect foreseeable victims of psychiatric outpatients, courts have also imposed liability on mental health care providers based on their custody of patients known to have violent propensities. The legal duty in such a case has been stated to be that where the course of treatment of a mental patient involves an exercise of "control" over him by a physician who knows or should know that the patient is likely to cause bodily harm to others, an independent duty arises from that relationship and falls on the physician to exercise that control with such reasonable care as to prevent harm to others at the hands of the patient. After going through a period of transition, from McIntosh, Thompson and Brady case, finally, the narrow rule of requiring a specific or foreseeable threat of violence against a specific or identifiable victim is the standard threshold or trigger element in the majority of states. Judgements on these kinds of cases are not enough yet in Korea, so that it may be too early to try find principles in these cases, however it is hardly wrong to read the same reasons of Tarasoff in the judgements of Korea district courts. To specific, whether a psychiatric institute was liable for violent behavior toward others depends upon the patients conditions, circumstances and the extent of the danger the patients poses to others; in short, the foreseeability of a specific or identifiable victim. In this context if a patient exhibit strong violent behavior toward others, constant observation should be required. Negligence has been found not exist, however, when a patient abruptly and unexpectedly attack others or unidentifiable victim. And the standard of conduct that is required to meet the obligation of "due care" is based on what the "reasonable practitioner" would do in like circumstances. The standard is not one of excellence or superior practice; it only requires that the physician exercise that degree of skill and care that would be expected of the average qualified practitioner practicing under like circumstances. All these principles have been established in cases of the U.S.A and Japan. In this article you can find the reasons which you can use for psychotherapist's liability for failure to protect third person in Korea as practitioner.

• Journal of Preventive Medicine and Public Health
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• v.49 no.1
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• pp.23-34
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• 2016

South Korea's state health insurer, the National Health Insurance Service (NHIS), is in the process of a compensation suit against tobacco industry. The tobacco companies have habitually endeavored to ensure favorable outcomes in litigation by misusing scientific evidence or recruiting scientists to support its interests. This study analyzed strategies that tobacco companies have used during the NHIS litigation, which has been receiving world-wide attention. To understand the litigation strategies of tobacco companies, the present study reviewed the existing literature and carried out content analysis of petitions, preparatory documents, and supporting evidence submitted to the court by the NHIS and the tobacco companies during the suit. Tobacco companies misrepresented the World Health Organization (WHO) report's argument and misused scientific evidence, and removed the word "deadly" from the title of the citation. Tobacco companies submitted the research results of scientists who had worked as a consultant for the tobacco industry as evidence. Such litigation strategies employed by the tobacco companies internationally were applied similarly in Korean lawsuits. Results of tobacco litigation have a huge influence on tobacco control policies. For desirable outcomes of the suits, healthcare professionals need to pay a great deal of attention to the enormous volume of written opinions and supporting evidence that tobacco companies submit. They also need to face the fact that the companies engage in recruitment of scientists. Healthcare professionals should refuse to partner with tobacco industry, as recommended by Article 5.3 of the WHO Framework Convention on Tobacco Control.

• The Korean Journal of Air & Space Law and Policy
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• v.30 no.1
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• pp.3-29
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• 2015

In case of C-410/11, Pedro Espada $S\acute{a}nchez$ and Others v Iberia $L\acute{i}neas$ $A\acute{e}reas$ de $Espa\tilde{n}a$ SA., ECLI:EU:C:2012:747, the passengers of a flight between Barcelona and Paris, whose baggage had been lost, lodged a claim before a Spanish court, asking for compensation. More specifically, the claimants were a family of four (two adults and two children), and had stored all their personal items in two suitcases, which had been checked in and tagged but never returned to the passengers in question. The four claimants relied on the Montreal Convention, ratified by the EU, which provides that each passenger can claim up to 1,000 SDRs in compensation (i.e. ${\euro}1,100$) in case his or her baggage is lost; thus, they sought to recover ${\euro}4,400$ (4,000 SDRs, i.e. 1,000 SDRs x4). The preliminary reference issue raised by the Spanish court to the CJEU regarded the $Montr\acute{e}al$ Convention's correct interpretation; in particular, it asked whether compensation should be available only to passengers whose lost baggage had been checked in "in their own name" or whether it is also available to passengers whose personal items had been stored in the (lost) baggage of a different passenger. The CJEU held that compensation had to be granted to all passengers whose items had been lost, regardless of whether these had been stored in baggage checked in "in their own name." In fact, it maintained that the real aim of the $Montr\acute{e}al$ convention is to provide passenger-consumers with protection for the loss of their personal belongings, so the circumstance of where these were being carried is not relevant. Nevertheless, the CJEU clarified that it is for national courts to assess the evidence regarding the actual loss of an item stored in another passenger's baggage, and maintained that the fact that a group of people were travelling together as a family is a factor that may be taken into account.

• Journal of Hospice and Palliative Care
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• v.13 no.1
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• pp.24-31
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• 2010

Purpose: A central venous catheterization (CVC) is frequently used for delivering anti-cancer chemotherapeutic agents, blood products, parenteral nutrition, and other intravenous therapy in patients with cancer. Major complications of CVC use are thrombosis, infection, and mechanical complications. The aim of this study was to evaluate the frequency of CVC complications and related factors. Methods: The records of cancer patients who received a CVC at our university hospital from March 2001 to October 2006 were retrospectively investigated. Chi square test was used to determine whether there was a related factor for thrombosis or infection, and Kaplan-Meier analysis for univariate analysis, or Cox-regression analysis for multivariate analysis was used for catheter life span. Results: Three hundred and ten CVCs (235 nontunneled, 75 tunneled) were inserted in 310 patients (157 males, 153 females). Among them, 104 had hematologic cancers and 206 had solid cancers. The mean age of the patients was 52 years (range, 19~82 years). CVC complications occurred in 60 cases (19%). CVC-related thrombosis occurred frequently in patients with infection (P=0.003), whereas diagnosis, catheter type, transfusion, and TPN history did not affect infection or thrombosis. The mean duration of the catheter was 102 days (range, 2~1,330 days), and the duration was prolonged in patients with tunneled catheters (P=0.000), or without transfusion through CVC (P=0.030). Conclusion: The major complications for long-term use of a CVC were infectionand thrombosis. Tunneled catheter was effective tool for long term use, especially in cases without transfusion through CVC. The studies on the prevention or treatment ofthrombosis and infection are, therefore, warranted by using CVC for an extended period of time.

• The Korean Journal of Air & Space Law and Policy
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• v.20 no.1
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• pp.45-85
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• 2005

The purpose of this paper is to examine the concept of "accident" under the Warsaw system including the Warsaw Convention for the Unification of certain Rules for International Carriage by Air of 1929 and the Montreal Convention of 1999. Most leading case on this subject is Air France v. Saks(470 U.S. 392 (1985)). In the Saks case, it was held that the definition of an accident must be applied flexibly, and most courts have adhered to the definition of accident in Saks case, the application of accident has been less than consistent. However, most cases have held that if the event is usual and expected operation of the aircraft, then no accident has occurred. Courts have also held that where the injury results from passenger's own internal reaction to the usual, normal, and expected operations of the aircraft, it is not caused by an accident. As the Warsaw drafters intended to create a system of liability rules that would cover all hazards of air travel, the carrier should liable for the inherent risks of air travel. It is right in that the carrier is in a better position than the passenger to control the risks during air travel. Most US courts have held that carriers are not liable for one passenger's assault on the other passenger. The interactions between passengers are not part of the normal operations of the aircraft and are therefore not covered by the word "accident" under Art 17 of the Warsaw Convention. It is regretful that the Montreal Convention did not attempt to clarify the concepts of accident in itself. In the light of an emerging tendency to hold the air carrier liable for occurrences that do not exactly go to the operation of the aircraft, it is desirable to regulate that the carrier is liable for an "event" instead of an "accident" in accordance with the Guatemala City protocol.

• The Korean Journal of Air & Space Law and Policy
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• v.35 no.2
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• pp.169-195
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• 2020

With the increase in air transportation, air delays are inevitable, and the damage of air consumers is also increasing. In Korea, the Ministry of Land, Infrastructure and Transport announced 「the Criteria for Protection of Users of Air Transportation」, but the Criteria does not include aviation delays except Tarmac delay, but this criteria is a only public notice, not an Act. Lately, a clause about Tarmac delay was newly established as Article 61bis of the Aviation Business Act, and was enacted from May 27, 2020. The Air carriers' Tarmac delay are subject to mandatory regulations. This research showed how lawsuits were implemented for the protection of aviation consumers related to aviation delays prior to the imposition of this article. In addition, the study examined at the public law level, whether the protection rights of aviation consumers is the fundamental right under the Constitution and whether the government should be the main subjects of consumer protection. And then we studied the effect of enforcement about the Tarmac Delay Rule of the United States. This rule acts as a federal regulation. Subsequently, the Biscone case presented that it was not easy for the US court to accept a lawsuit against the passengers for tarmac delay. There are limitations in remedying the damages of airline consumers due to delays either in Korea trial or the U.S. trial. Finally it needs strengthening the penalty to secure the effectiveness of the Tarmac delay clause regulations. In order to protect airline consumers, it was proposed that the protection of aviation consumer law should be established through the revision as the Enforcement Rules of the Airline Business Act.

• The Korean Journal of Nuclear Medicine
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• v.34 no.1
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• pp.22-29
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• 2000

Purpose: We compared the first postoperative diagnostic and post-therapy scans of patients who received therapeutic doses of I-131, to investigate the difference in clinical outcomes between patients with concordant findings of diagnostic and post-therapy scans and patients with discrepant (more lesions in post-therapy scan) findings. Materials and Methods: The first postoperative diagnostic and post-therapy radioiodine scans of one hundred forty three patients with well differentiated thyroid carcinoma were reviewed. Diagnostic scans were obtained following ingestion of 185 MBq of I-131 and post-therapy scans were obtained after therapeutic dose of $3.7{\sim}9.3$ GBq of I-131. Successful ablation was defined as no radioiodine uptake on diagnostic radioiodine scan and normal range of serum thyroglobulin level (<10 ng/ml) during serum TSH elevation. Results: Discrepant scan findings were noted in 25 (17.5%) patients. Twenty-two patients (15.4%) showed more lesions in post-therapy scan and 3 patients (2.1%) showed stunning effect. Nine (64.3%) of 14 patients with distant metastasis revealed metastatic lesion(s) only on post-therapy scan. Stunning effect was considered as sublethal damage in 1 patient and treatment by a diagnostic dose in 2 patients. Ablation was achieved in 52.4% (75/143) of all patients. Ablation rate and mean cumulative radioiodine dose were not different statistically between concordant and discrepant groups. Conclusion: There were 17.5% difference between diagnostic and post-therapy scan findings when using 185 MBq of I-131 as a diagnostic dose. However, 64.3% of distant metastases were revealed only on post-therapy scan. Ablation rate and mean cumulative radioiodine dose were not different statistically between concordant and discrepant groups. The stunning effect was considered as not only sublethal damage but also treatment by a small diagnostic dose of radioiodine.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.6
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• pp.435-443
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• 2008

Purpose: Gated myocardial perfusion SPECT provides not only myocardial perfusion status but also various functional parameters of left ventricle. We compared left ventricular ejection fraction, end-diastolic volume, LV mass by cardiac SPECT using Quantitative Gated SPECT (QGS), 4D-MSPECT software and standard 2D-echocardiography. Materials and Methods: One hundred fourteen patients (male 51, female 63; 29-85 years old, mean $61.3\;{\pm}\;13.3$ years old) with normal perfusion status on Tc-99m tetrofosmin gated myocardial perfusion SPECT were analyzed retrospectively. Ejection fraction (LVEF), End-diastolic volume (LVED), LV mass (LVM) were calculated using QGS, 4D-MSPECT, and LVEF, LVM using 2D-echocardiography. Statistical analysis including Bland-Altman plot was performed using $MedCalc^{(R)}$ (MedCalc software, Mariakerke, Belgium). Results: The correlation of LVEF between methods was good: 0.95/0.96 (stress/rest) between QGS and 4D-MSPECT, 0.79 between QGS and echocardiography, 0.79 between 4D-MSPECT and echocardiography (p<0.001). Using Bland-Altman plot, the 95% confidence interval of agreement between QGS and 4D-MSPECT ranged from -12.7% to 7.3% / from -12.2% to 6.5% (stress/rest). The agreement between QGS and echocardiography, 4D-MSPECT and echocardiography ranged from -17.4% to 24.0%, and -14.8% to 27.0% respectively. The correlation of LVM between methods was also good: 0.95 between QGS and 4D-MSPECT, 0.76 between QGS and echocardiography, 0.73 between 4D-MSPECT and echocardiography (p<0.001). The 95% confidence interval of agreement between QGS and 4D-MSPECT ranged from -33.8g to 14.1g (stress/rest), The 95% confidence interval of agreement between QGS and echocardiography, 4D-MSPECT and echocardiography ranged from -148.7 g to 21.8. g, and -142.8 g to 35.5 g, respectively. Conclusion: There was a good correlation for LVEF, LVEO, LVM among methods (QGS, 4D-MSPECT, echocardiography), but the variance between methods was big. Therefore, the functional parameters by each method cannot be used interchangeably.