• The Korean Society of Law and Medicine
• /
• v.23 no.1
• /
• pp.37-80
• /
• 2022

By analyzing informed consent and the refusal of emergency medical treatment (called patient dumping) under the current Emergency Medical Service Act, this study suggests that an emergency medical professional is only liable for patient dumping if their duty to protect the patient's life takes precedence over the patient's right to self-determination. In emergency medical situations, as in general medical situations, medical treatment should be performed after the emergency medical professional informs the patient about the medical treatment, including its necessity and methods, and obtains consent from the patient. Refusing or evading the performance of emergency medical services on the excuse of the informed consent not considering a waiver or alteration of informed consent requirements without reasonable reasons violates the Emergency Medical Service Act and thus makes an emergency medical professional liable to administrative disposition or criminal penalty. In other words, depending on the existence of a waiver of alteration of the informed consent, patient dumping may be established. If the patient is a minor or has no decision-making ability, and their legal representative makes a decision against the patient's medical interests, the opinion of the legal representative is not unconditionally respected. A minor also has the right to decide over their body, and the decisions of their legal representatives should be in the patient's best interests. If the patient refuses treatment, in principle, the obligation of life protection of emergency medical professionals is the top priority. However, making these decisions in the aforementioned situations in the emergency medical field is difficult because of the absence of explicit regulations regarding these exceptional problems. This study aims to organize the following precedents of the Supreme Court of Korea. The court states that, when balancing the conflicting interests between the duty to provide emergency medical service and the duty to inform is unavoidable for emergency medical professionals, they should put the duty to protect the patient's life ahead of the duty to inform if the patient's life matters. Exceptionally, when a patient has seriously considered whether they should receive treatment before the emergency medical situation, their right to self-determination can be considered equal to the obligation of emergency medical professionals to provide emergency medical treatment. This research also suggests that an amendment of the Emergency Medical Service Act should include the following. First, the criteria for determining the decision-making ability of emergency patients should consist of medical content. Second, additional consent from a medical professional is unnecessary for first-aid treatment. Finally, new provisions for emergency medical obligations for minors, new provisions for the decision standard when there are conflicting opinions about the treatment of a patient, and new penalty provisions for professionals who suspend emergency medical examinations and treatments need to be established.

• Journal of Nutrition and Health
• /
• v.41 no.7
• /
• pp.621-633
• /
• 2008

Diabetes mellitus (DM) is a well-established independent risk factor for cerebral infarction (CI). Additionally, the DM as well as CI are influenced significantly by health-related behaviors and diets. The aim of this study was to compare the food habits, nutrient intakes, and dietary patterns and quality in DM patients with CI (DM-CI) and without CI. This study was accomplished with 68 subjects (DM-CI group = 28, DM group = 40). Health-related behaviors, food habits, nutrient intakes and dietary quality were investigated. As a result, the mean ages and durations of diabetes in DM-CI and DM groups were $65.6{\pm}9.2$, $10.9{\pm}8.5$ and $69.2{\pm}3.0$, $9.7{\pm}8.4$ years, respectively. The health-related behaviors such as, smoking, alcohol drinking, and regular exercising in both groups were significantly different (p < 0.05) showing the number of subjects who were smoking and drinking alcohol was significantly higher in DM-CI group and the opposit result was seen for exercise. In male subjects, the intake of carbohydrate and sodium of DM-CI group were significantly higher than those of DM group (p < 0.05). In female subjects, the intake of calorie, carbohydrate, fat, sodium, and cholesterol were significantly higher in the DM-CI group (p < 0.05). Daily intake of vitamin $B_1$, vitamin $B_2$, folate, vitamin C, and calcium were significantly higher in DM group (p < 0.05). In the comparison with the dietary reference intake for Koreans (KDRI), vitamin $B_1$, vitamin $B_2$, folate, and calcium intakes were lower in DM-CI group whereas calcium and zinc intakes were in DM group. Moreover, index of nutritional quality (INQ) of vitamin $B_1$, vitamin $B_2$, vitamin C, folate, and calcium were lower significantly in DM-CI group (p < 0.05). Dietary quality including dietary diversity score (DDS), GMVDF (grain, meat, vegetable, dairy, fruit), and dietary quality index (DQI) was significantly lower in DM-CI group (p < 0.05). According to the results, diabetic mellitus patients accompanied by cerebral infarction had poorer eating patterns and dietary quality in accordance with poorer health-related behaviors compared with the DM patients without CI.

• Trans-
• /
• v.3
• /
• pp.109-135
• /
• 2017

The purpose of this thesis is to analyze characteristics of everyday movement showed in performances of Steve Paxton. A work of art has been realized as a special object enjoyed by high class people as high culture for a long time. Therefore, a gap between everyday life and art has been greatly existed, and the emergence of everyday elements in a work of art means that public awareness involving social change is changed. The postmodernism as the period when a boundary between art and everyday life is uncertain was a postwar society after the Second World War and a social situation that rapidly changes into a capitalistic society. Changes in this time made scholars gain access academically concepts related to everyday life, and affected artists as the spirit of the times of pluralistic postmodernism refusing totality. At the same period of the time, modern dance also faced a turning point as post-modern dance. After the Second World War, modern dance started to be evaluated as it reaches the limit, and at this juncture, headed by dancers including the Judson Dance Theatre. Acting as a dancer in a dance company of Merce Cunningham, Steve Paxton, one of founders of the Judson Dance Theatre, had a critical mind of the conditions of dance company with the social structure and the process that movement is made. This thinking is showed in early performances as an at tempt to realize everyday motion it self in performances. His early activity represented by a walking motion attracted attention as a simple motion that excludes all artful elements of existing dance performances and is possible to conduct by a person who is not a dancer. Although starting the use of everyday movement is regarded as an open characteristic of post-modern dance, advanced researches on this were rare, so this study started. In addition, studies related to Steve Paxton are skewed towards Contact Improvisation that he rose as an active practician. As the use of ordinary movement before he focused on Contact Improvisation, this study examines other attempts including Contact Improvisation as attempts after the beginning of his performances. Therefore, the study analyzes Satisfyin' Lover, Contact at 10th & 2nd and Bound that are performances of Steve Paxton, and based on this, draws everyday characteristics. In addition, related books, academic essays, dance articles and reviews are consulted to consider a concept related to everyday life and understand dance historical movement of post-modern dance. Paxton attracted attention because of his activity starting at critical approach of movement of existing modern dance. As walking of performers who are not dancers, a walking motion showed in Satisfyin' Lover gave esthetic meaning to everyday movement. After that, he was affected by Eastern ideas, so developed Contact Improvisation making a motion through energy of the natural laws. In addition, he had everyday things on his performances, and used a method to deliver various images by using mundane movement and impromptu gestures originating from relaxed body. Everyday movement of his performances represents change in awareness of performances of the art of dancing that are traditionally maintained including change of dance genre of an area. His activity with unprecedented attempt and experimentation should be highly evaluated as efforts to overcome the limit of modern dance.

• Journal of Oral Medicine and Pain
• /
• v.31 no.4
• /
• pp.283-296
• /
• 2006

Along with the development of scientific technologies, health care has been growing remarkably, and as the social life quality improves with increasing interest in health, the demand for medical service is rapidly increasing. However, medical accident and medical dispute also are rapidly increasing due to various factors such as, increasing sense of people's right, lack of understanding in the nature of medical practice, over expectation on medical technique, commercialize medical supply system, moral degeneracy and unawareness of medical jurisprudence by doctors, widespread trend of mutual distrust, and lack of systematized device for solution of medical dispute. This study analysed 30 cases of civil suit in the year between 1994 to 2004, which were selected among the medical dispute cases in dental field with the judgement collected from organizations related to dentistry and department of oral medicine, Yonsei university dental hospital. The following results were drawn from the analyses: 1. The distribution of year showed rapid increase of medical dispute after the year 2000. 2. In the types of medical dispute, suit associated with tooth extraction took 36.7% of all. 3. As for the cause of medical dispute, uncomfortable feeling and dissatisfaction with the treatment showed 36.7%, death and permanent damage showed 16.7% each. 4. Winning the suit, compulsory mediation and recommendation for settlement took 60.0% of judgement result for the plaintiff. 5. For the type of medical organization in relation to medical dispute, 60.0% was found to be the private dental clinics, and 30.0% was university dental hospitals. 6. For the level of trial, dispute that progressed above 2 or 3 trials was of 30.0%. 7. For the amount of claim for damage, the claim amounting between 50 million to 100 million won was of 36.7%, and that of more than 100 million won was 13.3%, and in case of the judgement amount, the amount ranging from 10 million to 30 million won was of 40.0%, and that of more than 100 million won was of 6.7%. 8. For the number of dentist involved in the suit, 26.7% was of 2 or more dentists. 9. For the amount of time spent until the judgement, 46.7% took 11 to 20 months, and 36.7% took 21 to 30 months. 10. For medical malpractice, 46.7% was judged to be guilty, and 70% of the cases had undergone medical judgement or verification of the case by specialists during the process of the suit. 11. In the lost cases of doctors(18 cases), 72.2% was due to violence of carefulness in practice and 16.7% was due to missing of explanation to patient. Medical disputes occurring in the field of dentistry are usually of relatively less risky cases. Hence, the importance of explanation to patient is emphasized, and since the levels of patient satisfaction are subjective, improvement of the relationship between the patient and the dentist and recovery of autonomy within the group dentist are essential in addition to the reduction of technical malpractice. Moreover, management measure against the medical dispute should be set up through complement of the current doctors and hospitals medical malpractice insurance which is being conducted irrationally, and establishment of system in which education as well as consultation for medical disputes lead by the group of dental clinicians and academic scholars are accessible.

• Journal of the Korean Society of Radiology
• /
• v.5 no.5
• /
• pp.303-308
• /
• 2011

Background/Aims : The increasing use of diagnostic and therapeutic interventional radiology calls for greater consideration of radiation exposure risk to radiologist and radiological technician, and emphasizes the proper system of radiation protection. This study was designed to assess the effect of a protective grass shield. Methods : A protective grass was following data depth, 0.8 cm; width, 100 cm; length, 100 cm, lead equivalent, 1.6 mmPb. The protective shield was located between the patient and the radiologist. Thirty patients (13 male and 17 female) undergoing interventional radiology between September 2010 and December 2010 were selected for this study. The dose of radiation exposure was recorded with or without the protective grass shield at the level of the head, chest, and pelvis. The measurement was made at 50 cm and 150 cm from the radiation source. Results : The mean patient age was 69 years. The mean patient height and weight was $159.7{\pm}6.7$ cm and $60.3{\pm}5.9$ kg, respectively. The mean body mass index (BMI) was $20.5{\pm}3.0$ kg/m2. radiologists received $1530.2{\pm}550.0$ mR/hr without the protective lead shield. At the same distance, radiation exposure was significantly reduced to $50.3{\pm}85.2$ mR/hr with the protective lead shield (p-value<0.0001). The radiation exposure to radiologist and radiological technician was significantly reduced by the use of a protective lead shield (p value <0.0001). The amount of radiation exposure during interventional radiology was related to the patient' BMI (r=0.749, p=0.001). Conclusions : This protective shield grass is effective in protecting radiologist and radiological technician from radiation exposure.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.36 no.11
• /
• pp.1391-1398
• /
• 2007

We performed a randomized double-blind placebo-controlled trial to determine whether Laminaria japonica extract (LJE) supplement modulates blood glucose, serum lipids and antioxidant systems in type II diabetic patients. We also measured critical parameters assessing safety in liver and kidney functions after LJE supplement. A total of 37 patients (18 males and 19 females) were randomized to either LJE group or placebo group. The treatment group received four 350 mg of LJE capsules (1.4 g, total) per day for 12 weeks. The placebo group received the same dose of cellulose capsules. Baseline characteristics regarding general life style and dietary intake pattern were similar between the two groups. There were no significant influences of LJE supplement except for waist circumference on anthropometric parameters. As the whole, 12 weeks of LJE supplement resulted in a little decrease in fasting blood glucose (FBG) and glycated hemoglobin (HbA1c), but a significant decrease was not observed. Total cholesterol, LDL-cholesterol and triglyceride concentrations were significantly (p<0.05) lowered in LJE group. The antioxidant enzymes, glutathion peroxidase (GSH-px) and superoxide dismutase (SOD) levels were elevated in the LJE group (p<0.05) compared to the placebo. The increase of these enzymes was associated significantly with the decrease of MDA concentration (p<0.05). Furthermore, LJE supplement showed no adverse effects on the functions of liver and kidney. Findings from this study suggest that LJE supplement can help improve serum lipid status in type II diabetic subjects without adverse effects.

• Childhood Kidney Diseases
• /
• v.4 no.1
• /
• pp.69-76
• /
• 2000

Purpose: The Pathogenesis of primary noctllrnal enuresis(PNE) is still controversial. Genetic factor and maturational delay of micturition reflex including arousal disorder, lack of nocturnal Arginine Vasopressin(AVP) release and functional bladder capacity have been suggested. We analyzed the risk factors of PNE. Methods: Fifty five children with PNE (20 enuretics diagnosed at school physical examination of the first grade students at Mok-Dong Elementary School and 35 enuretics (Age 6-7 year) diagnosed at Ewha Womans University Mok Dong Hospital) and 221 control students without PNE at school physical examination were included. Genetic, stress and developmental factors, arousability, water intake, urine volume, maximun voiding volume and daytime voiding dysfunction were compared. Results: 1) There was no significant difference between PNE and control group in sex ratio, birth order, percentage of working mothers, parental and child personality, age to start walking, school record and duration of sleep. 2) Family history in the PNE group was significantly higher than control group ($20.0\%\;vs\;2.7\%$)(P<0.05). 3) The difficulty in arousal in the PNE group was significantly more common than the control group ($70.9\%\;vs\;54.3\%$)(P<0.05). 4) Nocturnal water intake in the PNE group was significantly greater than the control group ($330{\pm}158.2\;mL\;vs\;235{\pm}129.5\;mL$). Nocturnal urine volume in the PNE group was significantly greater than the control group ( $390{\pm}61.5\;mL\;vs\;140{\pm}43.2\;mL$)(P<0.05). Daily water intake and daily urine volume did not significantly differ between the two groups. 5) Maximum urine volume per void in the PNE group was significantly lower than the control group ($107{\pm}35.9\;mL\;vs\;236{\pm}41.3\;mL$). Daytime voiding dysfunction in the PNE group was significantly more common than the control group ($80.0\%\;vs\;57.9\%$). The voiding frequency in the PNE group was significantly greater than the control group ($7.0{\pm}3.6\;vs\;5.4{\pm}1.6$)(P<0.05). Conclusion: In addition to genetic factors and maturational delay of micturition reflex (difficulty in arousal, nocturnal polyuria and decreased functional bladder capacity) nocturnal polydypsia was found to be the important risk factors fur PNE. So nocturnal fluid restriction should be encouraged as the first-line management of PNE.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.1 no.1
• /
• pp.107-114
• /
• 1998

Purpose: The purpose of our study is to provide useful information for me-asurement methods of childhood obesity and to provide clinical significance of bioelectrical impedance analysis. Methods: We measured height, weight, waist to hip ratio, skinfold thickness and bioelectrical impedance from 206 elementary students in Kwangju from May to July 1997. Results: In males; 1) There were statistically high correlations between tri-ceps skinfold thickness and body mass index (BMI), percentage of body fat (%BF), weight, Rohler index (RI), total fat weight (TFW), waist to hip (W/H) ratio, height, lean body mass (LBM) (all, p<0.001). 2) There were statistically high correlations between subscapular skinfold thickness and BMI, RI, weig-ht, %BF, TBW (all, p<0.001). 3) There were statistically high correlations between %BF and BMI, triceps skinfold thickness, RI, TFW, subscapular skinfold thickness, weight (all, p<0.001). In females; 4) There were statistically high correlations between triceps skinfold thickness and BMI, weight, LBM, height, %BF (all, p<0.001). 5) There were statistically significant correlations between subscapular skinfold thickness and BMI, weight, LBM, RI, height. 6) There were statistically high correlations between percentage of body fat and BMI, RI, triceps skinfold thickness. The percentage of body fat according to the bioelectrical impedance analysis highly correlated with that calculated by skinfold thickness in males (r＝0.57, p<0.01) and in females (r＝0.30, p<0.01). Conclusion: The results of our study suggests that bioelectrical impedance analysis is a useful method of estimating body fat in the childhood obesity.

• Korean Security Journal
• /
• no.13
• /
• pp.423-449
• /
• 2007

This research is to investigate the detention facilities of police stations and their real operations through the perceptions of detainees at police station cells and to present the policy suggestions for them. To fulfill the research, a questionnaire was made out on the basis of 'the Regulation on Detention and Escort for Suspects'. 'the Regulation on a Standard Plan for Detention Facilities' and 'the Regulation on the Lowest Standard to Treat Detainees' ; and detainees at 23 police station cells under the jurisdiction of Kyungbuk Local Police Agency were asked to answer it. Policy suggestions following from the result of the investigation of detainees' perceptions of the detention facilities of the police stations are as follows; Firstly, the structure of police station cells should be arranged in straight lines in order to take their human rights into consideration and more detention facilities are needed to be built in order to separate male, female, handicapped and juvenile inmates. Secondly, shower rooms and washrooms outside the cells should always be open to detainees whenever they need to be used. Thirdly, any detention facilities deficient in fire fighting equipment should have exit doors installed as soon as possible in case of an emergency and provide sufficient fire extinguishers considering the number of detainees and the size of the facilities. Fourthly, the detention facilities should have sufficient windows for ventilation and take necessary measures to obtain natural lighting instead of electric lighting. Fifthly, air conditioners should be equipped properly taking account of the number of detainees and the dimensions of the facilities. Policy suggestions according to the result of the investigation of detainees' perceptions of the operation of detention facilities of police stations are as follows; Firstly, the problem of operating the detention facilities must deal with worn-out facilities and measures to secure the budget should be taken as soon as possible. Secondly, considering that most detained suspects have difficulties in livelihood, daily necessaries must be issued to them. Thirdly, personal belongings deposited by inmates must be properly managed with the same documentation throughout the police station detention facilities. The number of female guards to take exclusive charge of the physical checkups and processing of female detainees should be increased. Also the facilities for handicapped detainees must be expanded, improved and managed properly. Fourthly, except for handcuffs and ropes to bind detainees in the detention facilities, helmets to prevent self-harm must be withdrawn. The budget to improve the quality of meal issued by the government must be urgently secured and the price of private food sent to detainees must be readjusted to be in line with the consumer price. Health and medical care and sanitation for detainees must be substantial, and also sunbathing and outdoor exercises should be allowed to detainees.

• Applied Biological Chemistry
• /
• v.46 no.2
• /
• pp.123-129
• /
• 2003

This study is to investigate consequent nutrient intake status, Influences of body mass index (BMI) and serum lipid composition, and fat distribution on the cocoon hydrolysate, green tea leaves and dietary fiber supplementation. During 2 months of this research (April to May, 2002), 47 women aged 20 yr-30 yr (average age 26.2 yr) were selected as subjects. Nutrient intake was investigated by questionnaire and 24-hr recall method. Antropometric assessments of the subjects were investigated by SBIA method (Segmental bioimpedance assay, Inbody 3.0). The results were as follows: mean body weight was 60.7 kg, mean body height 161.7 cm and mean BMI 23.4. Status of energy intakes significantly decreased (p<0.01) and dietary fiber intakes significantly increased (p<0.001) after supplementation. BMI and WHR (waist-hip ratio) significantly decreased (p<0.01) and body fat significantly decreased after supplementation (p<0.001). Total cholesterol and LDL-cholesterol significantly decreased after supplementation (p<0.05). HDL-cholesterol was negatively correlated with BMI and WHR (p<0.01). LDL/HDL ratio was positively correlated with BMI (p<0.01) and WHR (p<0.05). Above results of this study show that low-molecule peptide, green tea leaves and dietary fiber supplementation-added routine diet improves lessening body fat distribution, total cholesterol, LDL-cholesterol. Especially, decrease of abdominal fat and WHR were notable. That meant decrease of risk factors.