• Journal of Oral Medicine and Pain
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• v.31 no.4
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• pp.283-296
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• 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 Gastric Cancer
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• v.5 no.1
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• pp.10-15
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• 2005

Purpose: Recently the role of vitamins, folate in particular, has been emphasized in the maintenance of health. Folate deficiency is known to give rise to developmental delay, immature vascular disease, neural tube defect, acute leukemia, atherosclerotic vascular disease, delivery defects, breast cancer, and particularly gastrointestinal neoplasia. Methylenetetrahydrofolate reductase (MTHFR) is an essential enzyme in folate metaboism, and influences DNA synthesis and DNA methylation. Generally, folate deficiency is associated with gastrointestinal neoplasms. The amino-acid- changing and enzyme-activity-reducing nucleotide polymorphism (766C$\rightarrow$T/ Ala222Val) has been described in the MTHFR polymorphism and leads to low enzyme activity that may reduce the capacity of DNA methylation and possibly uracil mis-incorporation into DNA. These processes may be critical in the oncogenic transformation of human cells, especially in colorectal carcinomas. We investigated the relationship between the MTHFR polymorphism in gastric cancer and the tumor site, the smoking history, and the alcoholic history. Materials and Methods: Ninety-six (96) individuals with gastric cancer and 287 healthy persons were analyzed. Blood sampling was performed, PCR-RFLP was analyzed, and MTHFR polymorphism genotypes of C/C, C/T, and T/T were obtained and analyzed statistically for their correlation. Results: In the gastric cancer group there were 69 ($72\%$) males and 27 ($28\%$) females. There were also 58 cases ($60\%$) involving the gastric lower body, 20 cases ($21\%$) the gastric mid-body, and 18 cases ($19\%$) the gastric upper body. In the control group there were 169 ($59\%$) males and 118 ($41\%$) females. Among the gastric cancer, 56 ($61\%$) smoking patients, 40 ($39\%$) non-smoking patients, 45($47\%$) alcoholic patients, 51 ($53\%$) non-alcoholic patients. In the gastric cancer group, MTHER polymorphisms were C/C in 18 ($19\%$) cases, C/T in 59 ($61\%$) cases, T/T in 19 ($20\%$) cases. In the control group polymorphisms were C/C 116 ($40\%$) cases, C/T 103 ($36\%$) cases, and T/T 68 ($24\%$) cases (P=0.045). In cases of lower gastric body cancer, polymorphisms were C/C in 16 ($24\%$) C/C in 16 ($24\%$) cases and C/T or T/T in 42 ($72\%$) cases. In cases of upper and mid-body cancer, polymorphisms were C/C in 2 ($5\%$) cases and C/T or T/T 36 ($95\%$) cases (P=0.006). In the non-smoking patient group, polymorphisms were C/C in 5 (12%) cases and C/T or T/T in 35 ($88\%$) cases. In the smoking patient group, C/C in 13 ($23\%$) cases and C/T or T/T in 43 ($77\%$) cases (P=0.189). In the non-alcoholic patient group, polymorphisms were C/C in 6 ($12\%$) cases and C/T or T/T in 45 ($88\%$) cases. In the alcoholic patient group, polymorphisms were C/C in 12 ($26\%$) cases and C/T or T/T in 33 ($74\%$) cases (P=0.063) Conclusion: MTHFR polymorphisms are associated with gastric cancer and tumor site, but not with smoking and alcohol drinking.

• Tuberculosis and Respiratory Diseases
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• v.44 no.2
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• pp.391-400
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• 1997

Background : Bronchoscopy is an essential procedure for identifying the bleeding site and evaluating cause of hemoptysis. However, it is controversial regarding to the timing of bronchoscopy in patients with hemoptysis. Early bronchoscopy, which was performed during hemoptysis or with 48hour after cessation of bleeding, was better for identifying the site of bleeding compared with delayed bronchoscopy, which was performed 48 hours after cessation of bleeding. The diagnostic yield of identifying the bleeding site by bronchoscopy was variable in reported literature and the safety of early bronchoscopy was not mentioned in previous literature. Therefore, we evaluated the efficacy and safety of early bronchoscopy in patients with hemoptysis. Method : From October 1994 to August 1996 in Samsung Medical Center, bronchoscopy was performed in patients with hemoptysis. Early bronchoscopy was performed prospectively during hemoptysis or within 48 hours after cessation of bleeding from May 1995 to August 1996. Delayed bronchoscopy group included patients who did not received early bronchoscopy at the same period or in whom bronchoscopy was performed 48 hour after cessation of bleeding from October 1994 to May 1995. Results : Early bronchoscopy group was performed 73 times in 71 patients. Delayed bronchoscopy was performed in 57 times in 55 patients. There was no difference as to amount and underlying cause of hemoptysis between both groups. Indentification of bleeding site by visualizing active bleeding was significantly higher in early bronchoscopy (38.3%) than delayed bronchoscopy group (8.7%)(p < 0.05). Indentification of bleeding site by bleeding after clot removal was 8 in early and 10 in delayed bronchoscopy. Indentification of bleeding site by visualizing active bleeding and bleeding after clot removal was 36 in early and 15 patients in delayed bronchoscopy(p > 0.05). Causes of hemoptysis was found in 18 patients in early and 16 patients in delayed bronchoscopy group. patients who had early bronchoscopy underwent surgery. We diagnosed the site of bleeding in 4 patients preoperatively. In 3 patients we made a treatment plan promptly right after bronchoscopy. Among early bronchoscopy group, bleeding over 100cc during bronchoscopy occurred in 2 patients. In early bronchoscopy group there was no other major complication during bronchoscopy. Conclusion : In patients with hemoptysis, early bronchoscopy which performed within 48 hours after cessation of bleeding was more effective procedure for identifying the bleeding site than delayed bronchoscopy which was performed after 48 hour cessation of bleeding.

• Tuberculosis and Respiratory Diseases
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• v.43 no.6
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• pp.882-893
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• 1996

Background : Over one-third of solitary pulmonary nodules are malignant, but most malignant SPNs are in the early stages at diagnosis and can be cured by surgical removal. Therefore, early diagnosis of malignant SPN is essential for the lifesaving of the patient. The incidence of pulmonary tuberculosis in Korea is somewhat higher than those of other countries and a large number of SPNs are found to be tuberculoma. Most primary physicians tend to regard newly detected solitary pulmonary nodule as tuberculoma with only noninvasive imaging such as CT and they prefer clinical observation if the findings suggest benignancy without further invasive procedures. Many kinds of noninvasive procedures for confirmatory diagnosis have been introduced to differentiate malignant SPNs from benign ones, but none of them has been satisfactory. FOG-PET is a unique tool for imaging and quantifying the status of glucose metabolism. On the basis that glucose metabolism is increased in the malignant transfomled cells compared with normal cells, FDG-PET is considered to be the satisfactory noninvasive procedure which can differentiate malignant SPNs from benign SPNs. So we performed FOG-PET in patients with solitary pulmonary nodule and evaluated the diagnostic accuracy in the diagnosis of malignant SPNs. Method : 34 patients with a solitary pulmonary nodule less than 6 cm of irs diameter who visited Samsung Medical Center from Semptember, 1994 to Semptember, 1995 were evaluated prospectively. Simple chest roentgenography, chest computer tomography, FOG-PET scan were performed for all patients. The results of FOG-PET were evaluated comparing with the results of final diagnosis confirmed by sputum study, PCNA, fiberoptic bronchoscopy, or thoracotomy. Results : (I) There was no significant difference in nodule size between malignant (3.1 1.5cm) and benign nodule(2.81.0cm)(p>0.05). (2) Peal SUV(standardized uptake value) of malignant nodules (6.93.7) was significantly higher than peak SUV of benign nodules(2.71.7) and time-activity curves showed continuous increase in malignant nodules. (3) Three false negative cases were found among eighteen malignant nodule by the FDG-PET imaging study and all three cases were nonmucinous bronchioloalveolar carcinoma less than 2 em diameter. (4) FOG-PET imaging resulted in 83% sensitivity, 100% specificity, 100% positive predictive value and 84% negative predictive value. Conclusion: FOG-PET imaging is a new noninvasive diagnostic method of solitary pulmonary nodule thai has a high accuracy of differential diagnosis between malignant and benign nodule. FDG-PET imaging could be used for the differential diagnosis of SPN which is not properly diagnosed with conventional methods before thoracotomy. Considering the high accuracy of FDG-PET imaging, this procedure may play an important role in making the dicision to perform thoracotomy in diffcult cases.

• Journal of Global Scholars of Marketing Science
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• v.18 no.1
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• pp.59-80
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• 2008

Recently, e-sports are growing with potentiality as a new industry with conspicuous profit model. But studies that dealing with e-sports are not enough. Hence, proposes of this paper are both to establish basic model that is for the design of e-sport marketing strategy and to contribute toward future studies which are related to e-sports. Recently, the researches to explain sports-sponsorship through the identification theory have been discovered. Many researches say that somewhat proper identification is a requirement for most sponsors to improve the their images which is essential to sponsorship activity. Consequently, the research for sponsorship associated with identification in the e-sports, not in the physical sports is the core sector of this study. We extracted the variables from online's major characteristics and existing sport sponsorship researches. First, because e-sports mean the tournaments or leagues in the use of online game, the main event of the game is likely to call it online game. Online media's attributes are distinguished from those of offline. Especially, interactivity, anonymity, and expandibility as a e-sport game attributes are able to be mentioned. So, these inherent online attributes are examined on the relationship with flow. Second, in physical sports games, Fisher(1998) revealed that team similarity and team attractivity were positively related to team identification. Wann(1996) said that the result of former game influenced the evaluation of the next game, then in turn has an effect on the identification of team supporters. Considering these results in the e-sports side, e-sports gamer' attractivity, similarity, and match result seem to be important precedent variables of the identification with a gamer. So, these e-sport gamer attributes are examined on the relationship with both flow and identification with a gamer. Csikszentmihalyi(1988) defined the term flow as feeling status for him to be making current positive experience optimally. Hoffman and Novak(1996) also said that if a user experienced the flow he would visit a website without any reward. Therefore flow might be positively associated with user's identification with a gamer. And, Swanson(2003) disclosed that team identification influenced the positive results of sponsorship, which included attitude toward sponsors, sponsor patronage, and satisfaction with sponsors. That is, identification with a gamer expect to be connected with corporation identification significantly. According to the above, we can design the following research model. All variables used in this study(interactivity, anonymity, expandibility, attractivity, similarity, match result, flow, identification with a gamer, and identification with a sponsor) definitely were defined operationally underlying precedent researches. Sample collection was carried out to the person who has an experience to have enjoyed e-sports during June 2006. Much portion of samples is men because much more men than women enjoy e-sports in general. Two-step approach was used to test the hypotheses. First, confirmatory factor analysis was committed to guarantee the validity and reliability of variables. The results showed that all variables had not only intensive and discriminant validity, but also reliability. Then, research model was examined with fully structural equation using LISREL 8.3 version. The fitness of the suggested model mostly was at the acceptable level. Shortly speaking about the results, first of all, in e-sports game attributes, only interactivity which is called a basic feature in online situation affected flow positively. Secondly, in e-sports gamer's attributes, similarity with a gamer and match result influenced flow positively, but there was no significant effect in the relationship between the attractivity of a gamer and flow. And as expected, similarity had an effect on identification with a gamer significantly. But unexpectedly attractivity and match result did not influence identification with a gamer significantly. Just the same as the fact verified in the many precedent researches, flow greatly influenced identification with a gamer, and identification with a gamer continually had an influence on the identification with a sponsor significantly. There are some implications in these results. If the sponsor of e-sports supports the pro-game player who absolutely should have the superior ability to others and is similar to the user enjoying e-sports, many amateur gamers will feel much of the flow and identification with a pro-gamer, and then after all, feel the identification with a sponsor. Such identification with a sponsor leads people enjoying e-sports to have purchasing intention for products produced by the sponsor and to make a positive word-of-mouth for those products or the sponsor. For the future studies, we recommend a few ideas. Based on the results of this study, it is necessary to find new variables relating to the e-sports, which is not mentioned in this study. For this work to be possible, qualitative research seems to be needed to consider the inherent e-sport attributes. Finally, to generalize the results related to e-sports, a wide range of generations not a specific generation should be researched.

• Journal of Global Scholars of Marketing Science
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• v.18 no.1
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• pp.1-31
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• 2008

Trust is central to human relationships, at all times and places. The importance of trust is fundamental in all areas of human life, not only in the area of business administration. 2,500 years ago in China, Confucius taught that the foundation of politics was the trust of the people, more important even than military strength or the supply of food. Shakespeare's play, "Much Ado about Nothing' is about trust and deception. These days, trust and transparency in a commercial organization's business culture form the basis of the 'social capital' by which that organization increases its productivity. A successful company raises productivity by the accumulation of social capital, derived from a trust relationship between business partners, and between the company and consumers. Trust is the crucial factor. At the national level, building trust determines a nation's competitiveness. For a company, long term trust relationships with customers are essential for its survival in a business environment of rapid change. Such relationships, based on trust, are important assets to ensure a company's competitive advantage, and need to be organic to that company's business culture. Because of this importance, trust relationships have been studied in diverse areas within business administration, and especially within marketing, where they form the basis of a successful relationship between producer and consumer. However, what has been lacking is a unified definition of trust. Research has been conducted on the basis of various definitions and models. The majority of researchers have not considered the multidimensional character of the concept of trust until now. Approaches based on a one dimensional model have undermined the value of research results. Furthermore, researchers have only considered trust and trustworthiness as a single component. The majority of research has explored the consequences of perceived trust for outcomes such as loyalty or cooperation, but has neglected the effects of trustworthiness upon the mechanisms of consumer trust. This study focuses on the dimension of trust from such a perspective. It seeks to verify the effect of trust on customer intentions by breaking it down into three separate components: 1) the salesperson, 2) the product/service, and 3) the company. The purposes of this paper are as follows: Firstly, we review the multidimensional nature of trust objects: the salesperson, the product/service, and the company. Secondly, we analyze the relationship between multidimensional trust and trustworthiness. Thirdly, we analyze the connection between trust and repeat purchase intentions for the maintenance of long term relationships. For these purposes the author has developed several hypotheses as follows: H1-1: The competence of a salesperson is positively associated with the trust given by the consumer to the salesperson. H1-2: The benevolence of a salesperson is positively associated with the trust given by the consumer to the salesperson. H2-1: The competence of product/service is positively associated with the trust given by the consumer to the product/service. H2-2: The benevolence of product/service is positively associated with the trust given by the consumer to the product/service. H3-1: The reputation of a company is positively associated with the trust given by the consumer to the company. H3-2: The physical environment of a company is positively associated with the trust given by the consumer to the company. H4-1: Trust in a salesperson is positively associated with repeat purchase intentions. H4-2: Trust in a product/service is positively associated with repeat purchase intentions. H4-3: Trust in a company is positively associated with repeat purchase intentions. The data was compiled from 366 questionnaires. 500 questionnaires were collected, but some of the data was considered unsuitable and inappropriate. The subjects of the survey were male and female customers purchasing products at department stores in Seoul, Daegu and Gyeongbuk. It was carried out between Oct. 25 and 29, 2007. The data was analyzed by frequency analysis using SPSS 12.0 and structural equation modeling using LISREL 8.7. The result of the overall model analysis is as follows: Chi-Square=445.497, d.f.=185, p-value=0.0, GFI=.901, RMSEA=.0617, NNFI=.986, NFI=.981, CFI=.989, AGFI=.864, RMR=.0872. The results of the overall model analysis were coherent. It was found that trust is a multi-dimensional construct, that each of the dimensions of trust are meaningful influences on customer's repurchase intention. Trust in a company may be the most relevant, while trust in a product/service and a salesperson may be less relevant to repurchase intentions. The effective factors in determining trust in a salesperson and a company's product/service were found to be competence and benevolence. Factors in determining trust in a company were its reputation and physical environment, and the relationship of each effective trust factor has been verified in this research. As a result, it was found that competence and benevolence have a meaningful influence on trust in a salesperson and in product/service. It was also found that a company's reputation influences the overall trust in the company significantly but a company's physical environment does not have much effect.

• Progress in Medical Physics
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• v.23 no.2
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• pp.91-98
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• 2012

Verification of internal organ motion during treatment and its feedback is essential to accurate dose delivery to the moving target. We developed an offline based internal organ motion verification system (IMVS) using cine EPID images and evaluated its accuracy and availability through phantom study. For verification of organ motion using live cine EPID images, a pattern matching algorithm using an internal surrogate, which is very distinguishable and represents organ motion in the treatment field, like diaphragm, was employed in the self-developed analysis software. For the system performance test, we developed a linear motion phantom, which consists of a human body shaped phantom with a fake tumor in the lung, linear motion cart, and control software. The phantom was operated with a motion of 2 cm at 4 sec per cycle and cine EPID images were obtained at a rate of 3.3 and 6.6 frames per sec (2 MU/frame) with $1,024{\times}768$ pixel counts in a linear accelerator (10 MVX). Organ motion of the target was tracked using self-developed analysis software. Results were compared with planned data of the motion phantom and data from the video image based tracking system (RPM, Varian, USA) using an external surrogate in order to evaluate its accuracy. For quantitative analysis, we analyzed correlation between two data sets in terms of average cycle (peak to peak), amplitude, and pattern (RMS, root mean square) of motion. Averages for the cycle of motion from IMVS and RPM system were $3.98{\pm}0.11$ (IMVS 3.3 fps), $4.005{\pm}0.001$ (IMVS 6.6 fps), and $3.95{\pm}0.02$ (RPM), respectively, and showed good agreement on real value (4 sec/cycle). Average of the amplitude of motion tracked by our system showed $1.85{\pm}0.02$ cm (3.3 fps) and $1.94{\pm}0.02$ cm (6.6 fps) as showed a slightly different value, 0.15 (7.5% error) and 0.06 (3% error) cm, respectively, compared with the actual value (2 cm), due to time resolution for image acquisition. In analysis of pattern of motion, the value of the RMS from the cine EPID image in 3.3 fps (0.1044) grew slightly compared with data from 6.6 fps (0.0480). The organ motion verification system using sequential cine EPID images with an internal surrogate showed good representation of its motion within 3% error in a preliminary phantom study. The system can be implemented for clinical purposes, which include organ motion verification during treatment, compared with 4D treatment planning data, and its feedback for accurate dose delivery to the moving target.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.7 no.1
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• pp.5-28
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• 2001

Objectives: The objective of this study was to investigate analysis of bone mineral density according to Women with low back pain women. Methods: The data were collected from women who visited Physical Examination Center of a Catholic university hospital located in Daegu. Questionnaires were completed by 50 women during the period from July 20, 2000 to January 12, 2001. The sample was divided into three groups(the normal group of 16 cases and the osteopenia group of 12cases and the osteoporosis group of 22 cases). Bone mineral density(BMD) of lumbar spine was measured using energy absorptiometry. Results: The bone mineral density of the lumbar spine decreased with aging. The bone mineral density of the lumbar spine decreased with the serum Calcium and Phosphorus and Alkaline phosphatase increased. The mean bone mineral density of the lumbar spine of healthy women in age(50~59) was 0.87g/$cm^2$, the lumbar spine of women with low back pain in age(50~59) was 0.77g/$cm^2$. In the multiple regression of risk factors to bone mineral density(BMD) of lumbar spine were correlated with age, marriage existence, exercise time, the loving food of taste, calcium, bone mineral density standard T scores(p<0.05). The experience for LBP increased as weight increased(Odds ratio=999.000). The experience for LBP increased as number of Exercise decreased(Odds ratio=999.000). The experience for LBP increased as menopause existence increased(Odds ratio=999.000). The experience for LBP increased as serum Calcium and Phosphorus increased (Odds ratio=999.000). however all four variables had significant no relationship. The correlation in variables in relation to low back pain and bone mineral density, age showed contra-correlation with low back pain existence, Alkaline phosphatase(p<0.01). Weight showed contra-correlation with body mass index(BMI)(p<0.01). Exercise time showed correlation with number of exercise(p<0.01). The loving food of taste showed contra-correlation with Alkaline phosphatase(p<0.05). Bone mineral density showed correlation with menopause existence(p<0.05). Conclusions: Results from this study indicated that a statistically significant association between bone mineral density of the lumbar spin and age, marriage existence, exercise time, the loving food of taste, calcium, bone mineral density standard T scores. In logistic regression test, there were no related variables. The combination of bone mineral density measurement and assessment of the bone turnover rate by measuring biochemical would be helpful for the treatment of patients with risks of osteoporosis. The more precise study for risk factors to osteoporosis is essential.

• Journal of agricultural medicine and community health
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• v.28 no.1
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• pp.93-106
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• 2003

Objectives: This study was conducted to investigate the treatment status and its related factors of the rural hypertensives. Methods: A questionnaire survey was performed to 618 rural hypertensives during September, 2002. Results: The proportion of those who were compliant to the antihypertensive medication was 68.9%. The compliance rate to the antihypertensive medication was significantly related with sex and economic status(p<0.05). That is, if they were female, higher economic level, the regular antihypertensive medication rate was higher. The regular antihypertensive medication rate was higher when they had higher knowledge for hypertension, higher severity for hypertension of him or her(p<0.01). And the compliance rate to the antihypertensive medication was significantly related with hypertensives' own explanatory model for hypertension(p<0.01). The rate of drug use except antihypertensives was 12.5%. The rate of drug use except antihypertensives was higher when they experienced side effects of antihypertensive drug and when they had irregular medication for antihypertensive drug(p<0.01). The rate of medical equipment use was 18.9%. The utilization rate of medical equipment such as jade mat, germanium material was significantly related with age, experience of side effects of antihypertensive drug, medication status for antihypertensive drug(p<0.05). The rate of folk therapy use was 16.2%. The rate of folk therapy use was higher when they had no family, when they had knowledge about hypertension on the average, when they had hypertension over 10 years(p<0.05), and when they experienced side effects of antihypertensive drug and when they had irregular medication for antihypertensive drug(p<0.01). The rates of drug use except antihypertensives, medical equipment use, and folk therapy were significantly related with hypertensives' own explanatory model for hypertension(p<0.05). Conclusions: On consideration of above findings, it would be essential to provide knowledge about hypertension and its treatment, and severity of hypertension complications through health education.

• The Korean Journal of Air & Space Law and Policy
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• v.32 no.2
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• pp.101-127
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• 2017

Even with the most advanced aviation technology benefits, aircraft accidents are constantly occurring while air passenger transportation volume is expected to double in the next 15 years. Since it is not possible to secure aviation safety only by the post aircraft accident safety action of accident investigations, it has been recognized and consensus has been formed that proactive and predictive prevention measures are necessary. In this sense, the aviation safety management system (SMS) was introduced in 2008 and has been carried out in earnest since 2011. SMS is a proactive and predictive aircraft accident preventive measure, which is a mechanism to eliminate the fundamental risk factors by approaching organizational factors beyond technological factors and human factors related to aviation safety. The methodology is to collect hazards in all the sites required for aircraft operations, to build a database, to analyze the risks, and through managing risks, to keep the risks acceptable or below. Therefore, the improper implementation of SMS indicates that the aircraft accident prevention is insufficient and it is to be directly connected with the aircraft accident. Reports of duty performance related hazards including their own errors are essential and most important in SMS. Under the policy of just culture for voluntary reporting, the guarantee of information providers' anonymity, non-punishment and non-blame should be basically secured, but to this end, under-reporting is stagnant due to lack of trust in their own organizations. It is necessary for the accountable executive(CEO) and senior management to take a leading role to foster the safety culture initiating from just culture with the safety consciousness, balancing between safety and profit for the organization. Though a Ministry of Land, Infrastructure and Transport's order, "Guidance on SMS Implementation" states the training required for the accountable executive(CEO) and senior management, it is not legally binding. Thus it is suggested that the SMS training completion certificates of accountable executive(CEO) and senior management be included in SMS approval application form that is legally required by "Korea Aviation Safety Program" in addition to other required documents such as a copy of SMS manual. Also, SMS related items are missing in the aircraft accident investigation, so that organizational factors in association with safety culture and risk management are not being investigated. This hinders from preventing future accidents, as the root cause cannot be identified. The Aircraft Accident Investigation Manuals issued by ICAO contain the SMS investigation wheres it is not included in the final report form of Annex 13 to the Convention on International Civil Aviation. In addition, the US National Transportation Safety Board(NTSB) that has been a substantial example of the aircraft accident investigation for the other accident investigation agencies worldwide does not appear to expand the scope of investigation activities further to SMS. For these reasons, it is believed that investigation agencies conducting their investigations under Annex 13 do not include SMS in the investigation items, and the aircraft accident investigators are hardly exposed to SMS investigation methods or techniques. In this respect, it is necessary to include the SMS investigation in the organization and management information of the final report format of Annex 13. In Korea as well, in the same manner, SMS item should be added to the final report format of the Operating Regulation of the Aircraft and Railway Accident Investigation Board. If such legal and institutional improvement methods are complemented, SMS will serve the purpose of aircraft accident prevention effectively and contribute to the improvement of aviation safety in the future.