• Development and Reproduction
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• v.10 no.2
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• pp.85-92
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• 2006

Progesterone(P4) is an important intermediate in the synthesis of androgens and estrogens. Furthermore, P4 itself plays a crucial role in ovulation, atresia and luteinization, and is essential for the continuation of early pregnancy in all mammalian species. In spite of the hormone's physiological importance, the exact action mechanism(s) of P4 in mammalian ovary has not been fully understood yet. In this context, a decades-long controversy regarding the identity of receptors that mediate non-genomic, transcription-independent cellular responses to P4 is presently attracting huge scientific interests. P4 may exert its action in mammalian ovary by several ways: 1) the well-documented genomic pathway, involving hormone binding to so-called classic cytosolic receptor(PGR) and subsequent modulation of gene expression by the ligand-receptor complex as transcription factor. 2) pathways are operating that do not act on the genome, therefore refered to as non-genomic actions. The prominent characteristics of the non-genomic P4 actions are: (i) rapid, (ii) insensitive to transcription inhibitors, (iii) transduced by membrane associated molecules. In particular, the non-genomic P4 actions could be mediated by: (a) classic genomic P4 receptor(PGR) that localizes at or near the plasma membrane, (b) a family of membrane progestin receptors(MPR $\alpha$, MPR $\beta$ and MPR $\gamma$), (c) progesterone receptor membrane component I(PGRMC1), and (d) a membrane complex composed of serpine I mRNA binding protein(SERBP1). The present review summarized these rapid signaling pathways of P4 in the mammalian ovary.

• Clinics in Shoulder and Elbow
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• v.4 no.1
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• pp.17-23
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• 2001

There has been considerable controversy concerning the methods for treatment of dislocation of the acromioclavicular joint, especially in grade III injury. The authors have treated 24 cases of the complete dislocation of the acromioclavicular joint from January 1990 to July 2000. We performed 14 cases of coracoclavicular wiring operation, 10 cases of modified Phemister operation and compared the results and complication of wiring operation with modified Phemister. The clinical results in modified phemister operation were excellent in 8 cases(80%), good in 1 case(l0%), fair 1 case(10%). In wiring operation, excellent is 11 case(78%), good is 2 case(14%), fair is 1 case(14%). The complications of modified Phemister operation were breakage and migration of K-wire in 2 cases. In wiring operation, breakage of wire was in 2 cases but migration was not showed. We prefered coracoclavicular wiring operation for dislocation of acromioclavicular joint of active young adults because of the following advantages: 1) violation of acromioclavicular joint can be avoided but rotation of the clavicle was not restricted. 2) The operation is simple to perform. 3) Postoperative immobilization is minimal. 4) Removal of the wire is easy because wire was not migrated when breakage of wire was occured.

• The Korean Society of Law and Medicine
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• v.14 no.1
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• pp.85-116
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• 2013

Korea Medical Dispute Mediation and Arbitration Agency, "K-MEDI" in abbr. herein-after, is established on Apr. 9, 2012 according to the law cited in the title above for the purpose of settling medical disputes in a prompt, fair and efficient manner. Two special professional organizations are established in K-MEDI, one of them is Medical Dispute Mediation and Arbitration Committee(hereinafter referred to as the "Mediation Committee") and the other Medical Malpractice Appraisal Board(hereinaf-ter referred to as the "Appraisal Board"), the mission of the latter is to investigate the facts concerning the disputed medical conduct and to research as to and apprai-se whether the medical conduct was negligent and whether a causal relationship exists. Each panel organized in the Mediation Committee or the Appraisal Board shall be comprised of five mediators or appraisers, including necessarily a judge or a prose-cutor respectively and any disputed case regardless of the scale, the importance or the complicacy shall be handled by a panel. As the system is not thought efficient or economic, the number of the members comprising a panel or total members com-prising the Mediation Committee or the Appraisal Board shoud be adjusted, and the process shoud be versified, including the "Rapid Process," for instance. A petition for the mediation of a medical dispute shall be rejected if the respondent fails to notify K-MEDI of his/her intention to accede to the mediation within 14days from the day on which the petition for the mediation was served(Art. 27 Cl. 7). As the option of an arbitrary decision whether the mediation proceedings shall be commenced or not given to the respondent by the clause is thought unfair, making the process unstable, and moreover, diminishing the purpose of the system established by the law cited above for solving the medical disputes, the clause shoud be amended not to allow the respondent the option of such an arbitrary deci-sion. K-MEDI shall conduct the "Program for Compensation of Medical Accidents"(Art 46) according to which unavoidable injuries caused by the medical accidents in the cour-se of childbirth and the "Advances for Damages"(Art. 47) that are the compensating moneys paid to victims in medical malpractice cases who fail to receive money at all or partly from the operator or the professional of a public health or medical institution although he/she has a final and conclusive right to be paid by them. Some operators or professionals of such institutions claim that both the programs violate their fundamental rights assured by the constitution, and that it be a justifica-tion of refusal to accede to the mediation. As any of the programs needs not to be conducted by K-MEDI, it may be a proper solution to change the conductor of the programs to avoid the unproductive controversy.

• The Korean Society of Law and Medicine
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• v.18 no.1
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• pp.265-295
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• 2017

Breast tissue is composed of skin, mammary gland(including lactiferous duct), subcutaneous fat layer. The anatomical position is on the anterior chest wall(the outside of the chest cavity) but not on the inside of the thorax. Therefore, when the internal organs in the thoracic cavity are defined and expressed as 'organs' and the internal organs of each are labeled for a long time, for the breast located outside the thoracic cavity, it is thought that there is considerable difficulty in defining and recognizing the breast tissue as organs. For this reason, it is necessary to discourage the controversy over whether or not the breast is contained in the chest(or intra-thoracic cavity). In order to completely exclude it, it is assumed that the "chest-abdomen" can be called the "intra-thoraxic or intra-abdominal." But it is difficult to change the terms in various laws and regulations, I think that it would be necessary to insert only the clue clause "Breasts are excluded" in the detailed criteria for grading. In order to include it, it is necessary to change the terms of the ordinance or to say that the breast is exceptionally included.

• Journal of Chest Surgery
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• v.35 no.5
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• pp.381-386
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• 2002

Background: Bronchial carcinoids account for approximately 2% of all pulmonary tumor and consist of typical carcinoids and atypical carcinoids. An atypical carcinoids is considered to be an intermediate form of tumor between a low-grade malignant typical carcinoid and a high-grade malignant small cell lung carcinoma. There is still controversy with regard to the extent of resection and the value of systemic adjuvant therapy in atypical carcinoids. We performed a retrospective review of our experiences at Severance Hospital. Material and Method: Between 1990 and 2000, 15 patients with bronchial carcioids were operated, and 5 of these had atypical carcinoids. Histologic diagnosis was established un the criteria of WHO/IASLC(1999). Result: There were 3 pneumonectomies, 11 lobectomies, and 1 segmentectomy. In typical carcinoids, one patient had regional lymph node metastasis, and 3 patients in atypical carcinoids had mediastinal lymph node metastases. Distant metastases developed in one patient of typical carcinoid, but developed in 4 patients of atypical carcinoids(p=0.0017). The 5-year survival rate in patients with atypical carcinoids was 20%, versus the 100% 5-year survival rate observed in patients with topical carcinoids(p=0.0039). Conclusion: In atypical carcincids, because of many lymph node metastases on diagnosis and a low long-term survival rate, lobectomy constitutes a mininal procedure. Adjuvant systemic therapy is recommended fur patients with lymph node and distant metastasis.

• Korean Journal of Social Welfare
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• v.57 no.2
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• pp.143-164
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• 2005

The study is to analyze support-related issues, particularly associated with elderly and children care, which have been a fundamental agenda of family welfare policy. We are expected for societal-level controversy on the relationship of family support and social security in the near future because of rapid increase in ageing and divorce rate. Accordingly, we need to establish social consensus on the extent to which both family support system and social support system are responsible for the life maintenance of the elderly and the children from divorced family. We also clarify the various characteristics(including scope, degree, period of time, and need/manageability) of support provided by family members. Considering the changes of family structure and population composition, the policy of supporting the old and children should go for social responsibility. Findings show that civil law and social welfare law have unclear application on the relationship between family support and social security, and contents in family support. In particular, public assistance law strongly emphasizes the principle of family support while social insurance laws provide only limited and insufficient family maintenance. The suggestions of further study on support-related issues are given in the rapidly changing society and the increasing economic instability.

• Physical Therapy Korea
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• v.25 no.4
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• pp.9-18
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• 2018

Background: Leg length discrepancy (LLD) leads to many musculoskeletal disorders and affects daily activities such as walking. In the majority of the population, mild LLD is a common condition. Nevertheless, it is still controversy among researchers and clinicians on the effects of mild LLD during gait, and available studies have largely overlooked this issue. Objects: The purpose of the present study is to investigate the effects of mild LLD on the gait parameters and trunk acceleration. Methods: A total of 15 female and male participants with no evidence of LLD of >.5 ㎝ participated in the present study. All participants walked under the following two conditions: (1) The non-LLD condition, where the participants walked in shoes of the same heel height; (2) A mild LLD condition induced by wearing a 1.5 ㎝ higher heel on the right shoe. The GAITRite system and tri-axial accelerometer were used to measure gait parameters and trunk acceleration. To compare the variation of each variable, a paired t-test was performed. Results: Compared to the non-LLD condition, step time and swing phase were significantly increased in the mild LLD condition, while stance phase, single support phase, and double support phase significantly decreased in the short limb (p<.05). In the long limb of the mild LLD condition, single support phase significantly increased, while swing phase significantly decreased (p<.05). Furthermore, significant decrease in the gait velocity and cadence in the mild LLD condition were observed (p<.05). In the comparison between both limbs in the mild LLD condition, the step time and swing phase of the short limb significantly increased compared with the long limb, while step length, stance phase, and single support phase of the long limb significantly increased compared with the short limb (p<.05). Additionally, trunk acceleration of all directions (anterior-posterior, medial-lateral, vertical) significantly increased in the mild LLD condition (p<.05). Conclusion: The results of the present study demonstrate that mild LLD causes altered and asymmetrical gait patterns and affects the trunk, resulting in inefficient gait. Therefore, mild LLD should not be overlooked and requires adequate treatment.

• Journal of Arbitration Studies
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• v.15 no.3
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• pp.55-84
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• 2005

The arbitral award is the decision of the arbitrators on the dispute that had been submitted to them by the parties, either under the arbitration clause providing for the determination of future disputes or under submission of an existing controversy. The arbitral award has the same effect between the parties as a final and binding court judgment. The arbitration award shall acquire, as soon as it is given and delivered to each parties, the authority of res judicata in respect of the dispute it settles. The validity of an award is a condition precent for its recognition or enforcement. The validity of an award depends on the provisions of the arbitration agreement including any arbitration rules incorporated in it, and the law which is applicable to the arbitration proceedings. Such provisions usually address both the form and the content of the award. As the 'form', requires article 32 of Arbitration Act of Korea that an arbitral award should, at least, (1) be made in writing and be signed by all arbitrators. (2) state the reasons upon which it is based unless the parties have agreed that it should not, (3) state its date and place of arbitration. There are some further requirement which may have to be observed before an award which has been made by a tribunal can be enforced. (4) The duly authenticated award signed by the arbitrators shall be delivered to each of the parties and the original award shall be sent to and deposited with the competent court, accompanied by a document verifying such delivery. This rule can be interpreted as if the deposit of an arbitral award with the competent court is always required as a condition for its validity or as a preliminary to its enforcement in Korea. However, we must regard this rule which requires the deposit of an arbitral award with court, as rule of order, but not as condition of its validity. Because that the date on which the award is delivered to each party is important as it will generally determine the commencement of time limits for the making of any appeal which may be available. Furthermore, the party applying for recognition or enforcement merely has to supply the appropriate court with the duly authenticated original award or a duly certified copy thereof, not any document which proves that an the arbitral award is sent to and deposited with the competent court. In order to avoid some confusion which can be caused by its interpretation and application, the Article 32 (4) of Arbitration Act of Korea needs to be abolished or at least modified.

• Journal of Arbitration Studies
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• v.24 no.2
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• pp.109-136
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• 2014

The separability of an arbitration clause is generally recognized throughout the world, but there are no provisions of it under the Federal Arbitration Act(FAA) of the United States. As such, the controversy over the recognition of separability has developed with the rise of certain cases. The Supreme Court recognized this separability based on section 4 of the FAA in the decision of the Prima Paint case. The Court ruled that courts must decide the claim about the fraudulent inducement of an arbitration agreement itself, but they must not decide the claim about the fraudulent inducement of a contract involving a broad arbitration clause, and they have to proceed with the arbitration. The Court said that the subject of an arbitral award is set by the agreement of the parties, and thereby arbitrators can decide the issues about the fraudulent inducement of a contract on the basis of the arbitration clause when it is broad to the point of including the issues. Many courts have extended the separability beyond the fraud context to include other defenses to contract formation in the federal courts such as the occurrence of mistake, illegality, and frustration of purpose. In interpreting the parties' intention of ensuring arbitrator competence, the Supreme Court has treated differently the issues about whether the arbitration agreement exists or not and the issues about whether the preconditions for dispute resolution by a valid arbitration agreement is fulfilled or not. The Court holds that the federal policy in favor of arbitration does not apply to the former issues, and arbitrators can decide theses issues only when parties assign them clearly and unmistakably to them. However, the later issues receive a presumption in favor of arbitration; i.e., when the interpretation of a valid arbitration clause is contested, the arbitrators can decide these issues. In the First Options case, the former issue was questioned. The question of the separability of an arbitration clause is where the validity of the main contract involving the arbitration clause is contested. Therefore, the doctrine of separability did not operate in the First Options case in which the validity of the arbitration clause itself was questioned, and the decision in the First Options was irrelevant to the separability. I think that the Prima Paint case and the First Options case have different issues, and there is no tension between them.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.8
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• pp.4529-4532
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• 2013

Background: Acute normovolemic hemodilution (ANH) has been widely used to prevent the massive blood loss during hepatic carcinoma. The influences of ANH on coagulation function are still controversy, especially in elderly patients. The study observed ANH effects on coagulation function and fibrinolysis in elderly patients undergoing the disease. Materials and Methods: Thirty elderly patients (aged 60-70 yr) with liver cancer (ASA I or II) taken hepatic carcinectomy from February 2007 to February 2008 were randomly divided into ANH group (n=15) and control group (n=15). After tracheal intubation, patients in ANH group and control group were infused with 6% hydroxyethyl starch (130/0.4) and Ringer's solution, respectively. Blood samples were drawn from patients in both groups at five different time points: before anesthesia induction (T1), 30 min after ANH (T2), 1 h after start of operation (T3), immediately after operation (T4), and 24 h after operation (T5). Then coagulation function, soluble fibrin monomer complex (SFMC), prothrombin fragment (F1+2), and platelet membrane glycoprotein (CD62P and activated GP IIb/GP IIIa) were measured. Results: The perioperative blood loss and allogeneic blood transfusion were recorded during the surgery. The perioperative blood loss was not significantly different between two groups (p>0.05), but the volume of allogeneic blood transfusion in ANH group was significantly less than in control group ($350.0{\pm}70.7$) mL vs. ($457.0{\pm}181.3$) mL (p<0.01). Compared with the data of T1, the prothrombin time (PT) and activated partial thromboplastin time (APTT) measured after T3 were significantly longer (p<0.05) in both groups, but within normal range. There were no significant changes of thrombin time (TT) and D-dimer between two groups at different time points (p>0.05). SFMC and F1+2 increased in both groups, but were not statistically significant. PAC-1-positive cells and CD62P expressions in patients of ANH group were significantly lower than those at T1 (p<0.05) and T2-T5 (p>0.05). Conclusions: ANH has no obvious impact on fibrinolysis and coagulation function in elderly patients undergoing resection of liver cancer. The study suggested that ANH is safe to use in elderly patients and it could reduce allogeneic blood transfusion.