• Title/Summary/Keyword: Evidence Combination

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Clinical Analysis of Primary Malignant Lymphoma of the Lung (원발성 폐림프종의 임상 고찰)

  • Kim, Jae-Bum;Park, Nam-Hee;Kum, Dong-Yoon;Noh, Dong-Sub;Lee, Jae-Hoon;Han, Seung-Bum;Jung, Hye-Ra;Park, Chang-Kwon
    • Journal of Chest Surgery
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    • v.40 no.6 s.275
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    • pp.435-440
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    • 2007
  • Background: Primary malignant lymphoma of the lung is a very rare neoplasm. Although the prognosis of lymphoma is favorable, the clinical features, prognostic factors and management have not been clearly defined. Material and Method: We retrospectively reviewed the records of 8 patients we managed between 1994 and 2000. They all had malignant lymphoma on the pathologic examination of the lung wit no evidence of mediastinal adenopathy and extrathoracic disease, and no past history of lymphoma. Result: The study group consisted of 3 males and 5 female patients with a mean age of 53.9 years. Three patients were asymtomatic and 5 patients were seer with pulmonary or systemic symptoms. The diagnostic methods were 3 CT needle aspiration biopsies, 1 bronchoscopic biopsy and 4 surgical methods (wedge resection, lobectomy). There were 3 patients with MALT lymphoma, two with diffuse large B-cell lymphoma, two with small lymphocytic lymphom, and one with follicular lymphoma. The 8 patients were treated with a variety of modalities, including surgery, chemotherapy, radiotherapy and combination therapy. The 8 patients have survived for a median follow-up of 38 months. Conclusiian: Although this entity of lymphoma appears to have a good prognosis, further clinical experience and long-term follow-up are needed to identify its clinical features, prognostic factors and management.

The Role of Radiotherapy in the Treatment of Extrahepatic Bile Duct Carcinoma (간외담도종양에서 방사선치료의 역할)

  • Shin Hyun Soo;Kim Gwi Eon;Lee Hyung Sik;Suh Chang Ok;Loh John JK;Lee Jong Tae
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.253-263
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    • 1991
  • Twenty-seven patients with unresectable extrahepatic bile duct carcinoma (n=21) or with microscopic evidence of tumor rest after aggressive surgery for extrahepatic bile duct carcinoma (n=6) between 1985 and 1990 were given radiotherapy consisting intentionally external radiotherapy and/or intraluminal therapy using Gamma-Med 12i (192-Ir) high dose rate (HDR) remote control afterloading system following bile drainage procedures and Gianturco stent insertion. The objectives of this study has been to assess the feasibility and effects on survival of a combination of external radiotherapy and brachytherapy with which we hope to achieve optimal loco-regional control for patients with unresectable extrahepatic bile duct tumors. Sixteen patients were men and eleven were women, and the mean age was 58 years (34-70). 10MV X-ray was used for radiation therapy, with the total dose ranging from 45 Gy to 55 Gy, and intraluminal brachytherapy performed after external radiotherapy, with the dose of total 15 Gy. The minimum follow up was 12 months. Failure were predominantly local-regional, without distant failure. Median survival was 10 months; 2-year actuarial survival rates was $21\%$. Median survival for common hepatic duct (CHD) cancer was 9 months; for common bile duct (CBD) cancer, was 16 months. And median survival for incomplete surgery/external radiotherapy group and external/intraluminal radiotherapy group was 10 months; for external radiotherapy alone group, was 6 months. Use of chemotherapy and/or hyperthermia were not affected in survival. Therefore, our result is that the survival rates in the group of external/intraluminal radiotherapy were comparable with ones in the group of incomplete resection/external radiotherapy, and so we believe that the aggressive local and regional radiotherapy can improve the quality of life and the survival length.

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Review of 2011 Major Medical Decisions (2011년 주요 의료 판결 분석)

  • Yoo, Hyun-Jung;Seo, Young-Hyun;Lee, Jung-Sun;Lee, Dong-Pil
    • The Korean Society of Law and Medicine
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    • v.13 no.1
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    • pp.199-247
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    • 2012
  • According to the review and analysis of medical cases that are assigned to the Supreme Court and all local High Court in 2011 and that are presented in the media, it was found that the following categories were taken seriously, medical and pharmaceutical product liability, the third principle of trust between medical institutions, negligence and causation estimation, responsibility limit, the meaning of medical records and related judgment of disturbed substantiation, Oriental doctors' duties to explain the procedures, IMS events, whether one can claim for each medical care operated by non-physician health care institutions to the nonmedical domain in the National Health Insurance Corporation, and the basis of norms for each claim. In the cases related to medical pharmaceutical product liability, Supreme Court alleviated burden of proof for accidents with medical and pharmaceutical products prior to the practice of Product Liability Law and onset the point of negative prescription as the time of damage strikes to condition feasibility of the specific situation. In the cases related to the 3rd principle of trust between medical institutions, the Supreme Court refused to sentence the doctor who has trusted the judgment of the same third-party doctors the violations of the care duty. With respect to proof of a causal relationship and damages in a medical negligence case, the Supreme Court decided that it is unjust to deny negligence by the materials of causal relationship rejecting the original verdict and clarified that the causal relationship shall not deny the reasons to limit doctors' responsibilities. In order not put burden on patients with disadvantages in which medical records and the description of the practice or the most fundamental and important evidence to prove negligence and causation are being neglected, the Supreme Court admitted in the hospital's responsibility for the case of the neonate death of suffocation without properly listed fetal heart rate and uterine contraction monitor. On the other hand, the Seoul Western District Court has admitted alimony for altering and forging medical records. With respect to doctors' obligations to description, the Supreme Court decided that it is necessary to explain the foreseen risks by the combination of oriental and western medicines emphasizing the right of patient's self-determination. However, questions have arisen whether it is realistically feasible or not. In a case of an unlicensed doctor performing intramuscular stimulation treatment (IMS), the Supreme Court put off its decision if it was an unlicensed medical practice as to put limitation of eastern and western medical practices, but it declared that IMS practice was an acupuncture treatment therefore the plaintiff's conduct being an illegal act. In the future, clear judgment on this matter should be made. With respect to the claim of bills from non-physical health care institutions, the Supreme Court decided to void it for the implementation of the arrangement is contrary to the commitments made in the medical law and therefore, it is invalid to claim. In addition, contrast to the private healthcare professionals, who are subject to redemption according to the National Healthcare Insurance Law, the Seoul High Court explicitly confirmed that the non-professionals who receive the tort operating profit must return the unjust enrichment and have the liability for damages. As mentioned above, a relatively wide range of topics were discussed in medical field of 2011. In Korea's health care environment undergoing complex changes day by day, it is expected to see more diverse and in-depth discussions striding out to the development in the field of health care.

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Understanding of the Duplex Thrust System - Application to the Yeongwol Thrust System, Taebaeksan Zone, Okcheon Belt (듀플렉스트러스트시스템의이해 - 옥천대태백산지역영월트러스트시스템에의 적용)

  • Jang, Yirang
    • Economic and Environmental Geology
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    • v.52 no.5
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    • pp.395-407
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    • 2019
  • The duplex system has been considered as an important slip-transfer mechanism to evaluate the evolution of orogenic belts. Duplexes are generally found in the hinterland portion of fold-thrust belts and accommodate large amounts of total shortening. Thus, understanding its geometric and kinematic evolution can give information to evaluate the evolution of the entire orogenic belt. Duplexes are recognized as closed-loop thrust traces on map view, indicating higher connectivity than imbricate fans. As originally defined, a duplex is an array of thrust horses which are surrounded by thrust faults including the floor and roof thrusts, and imbricate faults between them. Duplexes can accommodate regional layer-parallel shortening and transfer slip from a floor thrust to a roof thrust. However, an imbricate fault is not the only mean for layer-parallel shortening (LPS) and displacement transfer within duplexes. LPS cleavages and detachment folds can also play the same role. From this aspect, a duplex can be divided into three types; 1) fault duplex, 2) cleavage duplex and 3) fold duplex. Fault duplex can further be subdivided into the Boyer-type duplex, which was firstly designed duplex system in the 1980s that widely applied most of the major fold-thrust belts in the world, and connecting splay duplex, which has different time order in the emplacement of horses from those of the Boyer-type. On the contrary, the cleavage and fold duplexes are newly defined types based on some selected examples. In the Korean Peninsula, the Yeongwol area, the western part of the Taebaeksan Zone of the Okcheon Belt, gives an excellent natural laboratory to study the structural geometry and kinematics of the closed-loops by thrust fault traces in terms of a duplex system. In the previous study, the Yeongwol thrust system was interpreted by alternative duplex models; a Boyer-type hinterland-dipping duplex vs. a combination of major imbricate thrusts and their connecting splays. Although the high angled beds and thrusts as well as different stratigraphic packages within the horses of the Yeongwol duplex system may prefer the later complicate model, currently, we cannot choose one simple answer between the models because of the lack of direct field evidence and time information. Therefore, further researches on the structural field investigations and geochronological analyses in the Yeongwol and adjacent areas should be carried out to test the possibility of applying the fold and cleavage duplex models to the Yeongwol thrust system, and it will eventually provide clues to solve the enigma of formation and its evolution of the Okcheon Belt.

Ginsenoside compound K protects against cerebral ischemia/ reperfusion injury via Mul1/Mfn2-mediated mitochondrial dynamics and bioenergy

  • Qingxia Huang;Jing Li;Jinjin Chen;Zepeng Zhang;Peng Xu;Hongyu Qi;Zhaoqiang Chen;Jiaqi Liu;Jing Lu;Mengqi Shi;Yibin Zhang;Ying Ma;Daqing Zhao;Xiangyan Li
    • Journal of Ginseng Research
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    • v.47 no.3
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    • pp.408-419
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    • 2023
  • Background: Ginsenoside compound K (CK), the main active metabolite in Panax ginseng, has shown good safety and bioavailability in clinical trials and exerts neuroprotective effects in cerebral ischemic stroke. However, its potential role in the prevention of cerebral ischemia/reperfusion (I/R) injury remains unclear. Our study aimed to investigate the molecular mechanism of ginsenoside CK against cerebral I/R injury. Methods: We used a combination of in vitro and in vivo models, including oxygen and glucose deprivation/reperfusion induced PC12 cell model and middle cerebral artery occlusion/reperfusion induced rat model, to mimic I/R injury. Intracellular oxygen consumption and extracellular acidification rate were analyzed by Seahorse multifunctional energy metabolism system; ATP production was detected by luciferase method. The number and size of mitochondria were analyzed by transmission electron microscopy and MitoTracker probe combined with confocal laser microscopy. The potential mechanisms of ginsenoside CK on mitochondrial dynamics and bioenergy were evaluated by RNA interference, pharmacological antagonism combined with co-immunoprecipitation analysis and phenotypic analysis. Results: Ginsenoside CK pretreatment could attenuate mitochondrial translocation of DRP1, mitophagy, mitochondrial apoptosis, and neuronal bioenergy imbalance against cerebral I/R injury in both in vitro and in vivo models. Our data also confirmed that ginsenoside CK administration could reduce the binding affinity of Mul1 and Mfn2 to inhibit the ubiquitination and degradation of Mfn2, thereby elevating the protein level of Mfn2 in cerebral I/R injury. Conclusion: These data provide evidence that ginsenoside CK may be a promising therapeutic agent against cerebral I/R injury via Mul1/Mfn2 mediated mitochondrial dynamics and bioenergy.

A Study on Influence of Foodservice Managers' Emotional Intelligence on Job Attitude and Organizational Performance (급식관리자의 개인적 감성지능이 직무태도 및 조직성과에 미치는 영향)

  • Jung, Hyun-Young;Kim, Hyun-Ah
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.39 no.12
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    • pp.1880-1892
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    • 2010
  • The purposes of this study were to: a) provide evidence concerning the effects of emotional intelligence on job outcomes, b) examine the impacts of emotional intelligence on employee-related variables such as 'job satisfaction', 'organizational commitment', 'organizational performance', and 'turnover intention' c) identify the conceptual framework underlying emotional intelligence. A survey was conducted to collect data from foodservice managers (N=231). Statistical analyses were completed using SPSS Win (16.0) for descriptive analysis, reliability analysis, factor analysis, t-test, correlation analysis, cluster analysis and AMOS (16.0) for confirmatory factor analysis and structural equation modeling. The concept of emotional intelligence (EI) has been on the radar screens of many leaders and managers over the last several decades. The emotional intelligence is generally accepted to be a combination of emotional and interpersonal competencies that influence behavior, thinking and interaction with others. The main results of this study were as follows. The four EI (Emotional Intelligence) dimensions correlated significantly with age. The means of job satisfaction score were above the midpoint (3.04 point) scale. The organizational commitment score was above the midpoint (3.41 point) scale and was higher at 'loyalty' factor than 'commitment' factor. The means of organizational performance score were above the midpoint (3.34) scale. The correlations among the four EI (emotional intelligence) factors were significant with job satisfaction; organizational commitment, organizational performance and turnover intention. The test of hypothesis using structural equation modeling found that emotional intelligence produced positive effects on job attitude and job performance. Emotional intelligence enhanced organizational commitment, and in turn, managers' attitude produced positive effects on organizational performance; emotional intelligence also had a direct impact on organizational performance. This study has identified the effect of emotional intelligence on organizational performance and attitudes toward one's job.

The Research on Online Game Hedonic Experience - Focusing on Moderate Effect of Perceived Complexity - (온라인 게임에서의 쾌락적 경험에 관한 연구 - 지각된 복잡성의 조절효과를 중심으로 -)

  • Lee, Jong-Ho;Jung, Yun-Hee
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.2
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    • pp.147-187
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    • 2008
  • Online game researchers focus on the flow and factors influencing flow. Flow is conceptualized as an optimal experience state and useful explaining game experience in online. Many game studies focused on the customer loyalty and flow in playing online game, In showing specific game experience, however, it doesn't examine multidimensional experience process. Flow is not construct which show absorbing process, but construct which show absorbing result. Hence, Flow is not adequate to examine multidimensional experience of games. Online game is included in hedonic consumption. Hedonic consumption is a relatively new field of study in consumer research and it explores the consumption experience as a experiential view(Hirschman and Holbrook 1982). Hedonic consumption explores the consumption experience not as an information processing event but from a phenomenological of experiential view, which is a primarily subjective state. It includes various playful leisure activities, sensory pleasures, daydreams, esthetic enjoyment, and emotional responses. In online game experience, therefore, it is right to access through a experiential view of hedonic consumption. The objective of this paper was to make up for lacks in our understanding of online game experience by developing a framework for better insight into the hedonic experience of online game. We developed this framework by integrating and extending existing research in marketing, online game and hedonic responses. We then discussed several expectations for this framework. We concluded by discussing the results of this study, providing general recommendation and directions for future research. In hedonic response research, Lacher's research(1994)and Jongho lee and Yunhee Jung' research (2005;2006) has served as a fundamental starting point of our research. A common element in this extended research is the repeated identification of the four hedonic responses: sensory response, imaginal response, emotional response, analytic response. The validity of these four constructs finds in research of music(Lacher 1994) and movie(Jongho lee and Yunhee Jung' research 2005;2006). But, previous research on hedonic response didn't show that constructs of hedonic response have cause-effect relation. Also, although hedonic response enable to different by stimulus properties. effects of stimulus properties is not showed. To fill this gap, while largely based on Lacher(1994)' research and Jongho Lee and Yunhee Jung(2005, 2006)' research, we made several important adaptation with the primary goal of bringing the model into online game and compensating lacks of previous research. We maintained the same construct proposed by Lacher et al.(1994), with four constructs of hedonic response:sensory response, imaginal response, emotional response, analytical response. In this study, the sensory response is typified by some physical movement(Yingling 1962), the imaginal response is typified by images, memories, or situations that game evokes(Myers 1914), and the emotional response represents the feelings one experiences when playing game, such as pleasure, arousal, dominance, finally, the analytical response is that game player engaged in cognition seeking while playing game(Myers 1912). However, this paper has several important differences. We attempted to suggest multi-dimensional experience process in online game and cause-effect relation among hedonic responses. Also, We investigated moderate effects of perceived complexity. Previous studies about hedonic responses didn't show influences of stimulus properties. According to Berlyne's theory(1960, 1974) of aesthetic response, perceived complexity is a important construct because it effects pleasure. Pleasure in response to an object will increase with increased complexity, to an optimal level. After that, with increased complexity, pleasure begins with a linearly increasing line for complexity. Therefore, We expected this perceived complexity will influence hedonic response in game experience. We discussed the rationale for these suggested changes, the assumptions of the resulting framework, and developed some expectations based on its application in Online game context. In the first stage of methodology, questions were developed to measure the constructs. We constructed a survey measuring our theoretical constructs based on a combination of sources, including Yingling(1962), Hargreaves(1962), Lacher (1994), Jongho Lee and Yunhee Jung(2005, 2006), Mehrabian and Russell(1974), Pucely et al(1987). Based on comments received in the pretest, we made several revisions to arrive at our final survey. We investigated the proposed framework through a convenience sample, where participation in a self-report survey was solicited from various respondents having different knowledges. All respondents participated to different degrees, in these habitually practiced activities and received no compensation for their participation. Questionnaires were distributed to graduates and we used 381 completed questionnaires to analysis. The sample consisted of more men(n=225) than women(n=156). In measure, the study used multi-item scales based previous study. We analyze the data using structural equation modeling(LISREL-VIII; Joreskog and Sorbom 1993). First, we used the entire sample(n=381) to refine the measures and test their convergent and discriminant validity. The evidence from both the factor analysis and the analysis of reliability provides support that the scales exhibit internal consistency and construct validity. Second, we test the hypothesized structural model. And, we divided the sample into two different complexity group and analyze the hypothesized structural model of each group. The analysis suggest that hedonic response plays different roles from hypothesized in our study. The results indicate that hedonic response-sensory response, imaginal response, emotional response, analytical response- are related positively to respondents' level of game satisfaction. And game satisfaction is related to higher levels of game loyalty. Additionally, we found that perceived complexity is important to online game experience. Our results suggest that importance of each hedonic response different by perceived game complexity. Understanding the role of perceived complexity in hedonic response enables to have a better understanding of underlying mechanisms at game experience. If game has high complexity, analytical response become important response. So game producers or marketers have to consider more cognitive stimulus. Controversy, if game has low complexity, sensorial response respectively become important. Finally, we discussed several limitations of our study and suggested directions for future research. we concluded with a discussion of managerial implications. Our study provides managers with a basis for game strategies.

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Structural and Compositional Characteristics of Skarn Zinc-Lead Deposits in the Yeonhwa-Ulchin Mining District, Southeastern Taebaegsan Region, Korea Part II : The Yeonhwa II Mine (연화(蓮花)-울진광산지대(蔚珍鑛山地帶) 스카른연(鉛)·아연광상(亞鉛鑛床)의 구조적(構造的) 및 성분적(成分的) 특징(特徵) 기이(其二) : 제2연화광산(第二蓮花鑛山))

  • Yun, Suckew
    • Economic and Environmental Geology
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    • v.12 no.3
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    • pp.147-176
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    • 1979
  • The Yeonhwa II zinc-lead mine is characterized by a dozen of moderately dipping tabular orebodies of skarn and zinc-lead sulfides, developed in accordance with the ENE-trending bedding thrusts and bedding planes of the Pungchon Limestone and underlying Myobong Formation, mostly along the contacts of a ENE-trending sill and a NW-trending dike of quartz mononite porphyry. The orebodies occur in three groups: (1) the footwall Wolgok orebodies with respect to the sill, (2) the hangingwall Wolgok orebodies, and (3) the Seongok orebodies extended from dike contacts into carbonate beds. Mineral compositions of these orebodies are dominated by calc-silicates (skarn) associated with ore minerals of sphalerite, galena, and chalcopyrite, as well as sulfide gangue of pyrrhotite. A pair of exo- and endo-skerns in the Wolgok footwall contact aureole between the Pungchon Limestone and quartz monzonite porphyry on the -120 level represents a well-developed symmetrical pattern of mineral zoning: a garnet/quartz zone in the center of exoskarn, two zones of pyroxene with ore minerals on both sides of the garnet/quartz zone, further outwards-an epidote/chlorite-bearing hornfelsic zone in the Myobong slate beyond a zone of unaffected limestone, and an epidote-dominated zone of endo skarn on the opposite side toward fresh quartz monzonite porphyry. These features indicate a combination of two effects on the skarn formation: (1) differences in composition of the host rocks(sedimentary and ignous), and (2) progressive outward migration of inner zones on outer zones on the course of metasomatic replacement of the pre-existing minerals. Microprobe analyses of garnet, pyroxene, pyroxenoids, epidote, and chlorite for nine major elements on a total of 23 mineral grains revealed that: the pyroxenes are hedenbergitic, in most zones, with a gradual decrease of Fe- and Mn-contents toward the central zone, whereas the garnets are andraditic in outer zones, but are grossularitic in the central zone. This indicates a reverse relationship of Fe-contents between pyroxene and garnet across the exoskarn zones. Pyroxenoids are lacking in wollastonite but are dominated by pyroxmangite, rhodonite and bustamite, indicating a Mn-rich nature in bulk chemistry. Pseudomorphic fluorite after garnet occurs abundantly reflecting a fluorine-enhanced evidence of the skarn-forming fluids. Epidote contains 0.19-0.25mole fraction of pistacite, and chlorite is Mn-rich but is Mg-poor. Sulfide mineralization took place with the most Fe-rich pyroxene rather than with garnet as indicated by the fact that the highest value of hedenbergite mole fraction occurs in the ore-bearing pyroxene zone. The Yeonhwa II ores are characterized by high zinc and low lead in metal grade, with minor quantity of copper content in almost constant grade. The hangingwall Wolgok and Seongok orebodies, that formed in a more open environment with respect to their local configurations of geologic setting, are more variable in metal grades and ratios, than are the footwall Wolgok orebodies formed in a more closed condition in a narrow interval of sedimentary beds.

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The Clinical Features of Endobronchial Tuberculosis - A Retrospective Study on 201 Patients for 6 years (기관지결핵의 임상상-201예에 대한 후향적 고찰)

  • Lee, Jae Young;Kim, Chung Mi;Moon, Doo Seop;Lee, Chang Wha;Lee, Kyung Sang;Yang, Suck Chul;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo;Lee, Jung Hee
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.671-682
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    • 1996
  • Background : Endobronchial tuberculosis is definded as tuberculous infection of the tracheobronchial tree with microbiological and histopathological evidence. Endobronchial tuberculosis has clinical significance due to its sequela of cicatrical stenosis which causes atelectasis, dyspnea and secondary pneumonia and may mimic bronchial asthma and pulmanary malignancy. Method : The authors carried out, retrospectively, a clinical study on 201 patients confirmed with endobronchial tuberculosis who visited the Department of Pulmonary Medicine at Hangyang University Hospital from January 1990 10 April 1996. The following results were obtained. Results: 1) Total 201 parients(l9.5%) were confirmed as endobronchial tuberculosis among 1031 patients who had been undergone flexible bronchofiberscopic examination. The number of male patients were 55 and that of female patients were 146. and the male to female ratio was 1 : 2.7. 2) The age distribution were as follows: there were 61(30.3%) cases in the third decade, 40 cases(19.9%) in the fourth decade, 27 cases(13.4%) in the sixth decade, 21 cases(10.4%) in the fifth decade, 19 cases(9.5%) in the age group between 15 and 19 years, 19 cases(9.5%) in the seventh decade, and 14 cases(7.0%) over 70 years, in decreasing order. 3) The most common symptom, in 192 cases, was cough 74.5%, followed by sputum 55.2%, dyspnea 28.6%, chest discomfort 19.8%, fever 17.2%, hemoptysis 11.5%, in decreasing order, and localized wheezing was heard in 15.6%. 4) In chest X-ray of 189 cases, consolidation was the most frequent finding in 67.7%, followed by collapse 43.9%. cavitary lesion 11.6%, pleural effusion 7.4%, in decreasing order, and there was no abnormal findings in 3.2%. 5) In the 76 pulmanary function tests, a normal pattern was found in 44.7%, restrictive pattern in 39.5 %, obstructive pattern in 11.8%, and combined pattern in 3.9%. 6) Among total 201 patients, bronchoscopy showed caseous pseudomembrane in 70 cases(34.8%), mucosal erythema and edema in 54 cases(26.9%), hyperplastic lesion in 52 cases(25.9%), fibrous s.enosis in 22 cases(10.9%), and erosion or ulcer in 3 cases(1.5%). 7) In total 201 cases, bronchial washing AFB stain was positive in 103 cases(51.2%), bronchial washing culture for tuberculous bacilli in 55 cases(27.4%). In the 99 bronchoscopic biopsies, AFB slain positive in 36.4%. granuloma without AFB stain positive in 13.1%, chronic inflammation only in 36.4%. and non diagnostic biopsy finding in 14.1%. Conclusions : Young female patients, whose cough resistant to genenal antitussive agents, should be evaluated for endobronchial tuberculosis, even with clear chest roentgenogram and negative sputum AFB stain. Furthermore, we would like to emphasize that the bronchoscopic approach is a substantially useful means of making a differential diagnosis of atelectasis in older patients of cancer age. At this time we have to make a standard endoscopic classification of endobronchial tuberculosis, and well designed prospective studies are required to elucidate the effect of combination therapy using antituberculous chemotherapy with steroids on bronchial stenosis in patients with endobronchial tuberculosis.

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A Study on the System of Aircraft Investigation (항공기(航空機) 사고조사제도(事故調査制度)에 관한 연구(硏究))

  • Kim, Doo-Hwan
    • The Korean Journal of Air & Space Law and Policy
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    • v.9
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    • pp.85-143
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    • 1997
  • The main purpose of the investigation of an accident caused by aircraft is to be prevented the sudden and casual accidents caused by wilful misconduct and fault from pilots, air traffic controllers, hijack, trouble of engine and machinery of aircraft, turbulence during the bad weather, collision between birds and aircraft, near miss flight by aircrafts etc. It is not the purpose of this activity to apportion blame or liability for offender of aircraft accidents. Accidents to aircraft, especially those involving the general public and their property, are a matter of great concern to the aviation community. The system of international regulation exists to improve safety and minimize, as far as possible, the risk of accidents but when they do occur there is a web of systems and procedures to investigate and respond to them. I would like to trace the general line of regulation from an international source in the Chicago Convention of 1944. Article 26 of the Convention lays down the basic principle for the investigation of the aircraft accident. Where there has been an accident to an aircraft of a contracting state which occurs in the territory of another contracting state and which involves death or serious injury or indicates serious technical defect in the aircraft or air navigation facilities, the state in which the accident occurs must institute an inquiry into the circumstances of the accident. That inquiry will be in accordance, in so far as its law permits, with the procedure which may be recommended from time to time by the International Civil Aviation Organization ICAO). There are very general provisions but they state two essential principles: first, in certain circumstances there must be an investigation, and second, who is to be responsible for undertaking that investigation. The latter is an important point to establish otherwise there could be at least two states claiming jurisdiction on the inquiry. The Chicago Convention also provides that the state where the aircraft is registered is to be given the opportunity to appoint observers to be present at the inquiry and the state holding the inquiry must communicate the report and findings in the matter to that other state. It is worth noting that the Chicago Convention (Article 25) also makes provision for assisting aircraft in distress. Each contracting state undertakes to provide such measures of assistance to aircraft in distress in its territory as it may find practicable and to permit (subject to control by its own authorities) the owner of the aircraft or authorities of the state in which the aircraft is registered, to provide such measures of assistance as may be necessitated by circumstances. Significantly, the undertaking can only be given by contracting state but the duty to provide assistance is not limited to aircraft registered in another contracting state, but presumably any aircraft in distress in the territory of the contracting state. Finally, the Convention envisages further regulations (normally to be produced under the auspices of ICAO). In this case the Convention provides that each contracting state, when undertaking a search for missing aircraft, will collaborate in co-ordinated measures which may be recommended from time to time pursuant to the Convention. Since 1944 further international regulations relating to safety and investigation of accidents have been made, both pursuant to Chicago Convention and, in particular, through the vehicle of the ICAO which has, for example, set up an accident and reporting system. By requiring the reporting of certain accidents and incidents it is building up an information service for the benefit of member states. However, Chicago Convention provides that each contracting state undertakes collaborate in securing the highest practicable degree of uniformity in regulations, standards, procedures and organization in relation to aircraft, personnel, airways and auxiliary services in all matters in which such uniformity will facilitate and improve air navigation. To this end, ICAO is to adopt and amend from time to time, as may be necessary, international standards and recommended practices and procedures dealing with, among other things, aircraft in distress and investigation of accidents. Standards and Recommended Practices for Aircraft Accident Injuries were first adopted by the ICAO Council on 11 April 1951 pursuant to Article 37 of the Chicago Convention on International Civil Aviation and were designated as Annex 13 to the Convention. The Standards Recommended Practices were based on Recommendations of the Accident Investigation Division at its first Session in February 1946 which were further developed at the Second Session of the Division in February 1947. The 2nd Edition (1966), 3rd Edition, (1973), 4th Edition (1976), 5th Edition (1979), 6th Edition (1981), 7th Edition (1988), 8th Edition (1992) of the Annex 13 (Aircraft Accident and Incident Investigation) of the Chicago Convention was amended eight times by the ICAO Council since 1966. Annex 13 sets out in detail the international standards and recommended practices to be adopted by contracting states in dealing with a serious accident to an aircraft of a contracting state occurring in the territory of another contracting state, known as the state of occurrence. It provides, principally, that the state in which the aircraft is registered is to be given the opportunity to appoint an accredited representative to be present at the inquiry conducted by the state in which the serious aircraft accident occurs. Article 26 of the Chicago Convention does not indicate what the accredited representative is to do but Annex 13 amplifies his rights and duties. In particular, the accredited representative participates in the inquiry by visiting the scene of the accident, examining the wreckage, questioning witnesses, having full access to all relevant evidence, receiving copies of all pertinent documents and making submissions in respect of the various elements of the inquiry. The main shortcomings of the present system for aircraft accident investigation are that some contracting sates are not applying Annex 13 within its express terms, although they are contracting states. Further, and much more important in practice, there are many countries which apply the letter of Annex 13 in such a way as to sterilise its spirit. This appears to be due to a number of causes often found in combination. Firstly, the requirements of the local law and of the local procedures are interpreted and applied so as preclude a more efficient investigation under Annex 13 in favour of a legalistic and sterile interpretation of its terms. Sometimes this results from a distrust of the motives of persons and bodies wishing to participate or from commercial or related to matters of liability and bodies. These may be political, commercial or related to matters of liability and insurance. Secondly, there is said to be a conscious desire to conduct the investigation in some contracting states in such a way as to absolve from any possibility of blame the authorities or nationals, whether manufacturers, operators or air traffic controllers, of the country in which the inquiry is held. The EEC has also had an input into accidents and investigations. In particular, a directive was issued in December 1980 encouraging the uniformity of standards within the EEC by means of joint co-operation of accident investigation. The sharing of and assisting with technical facilities and information was considered an important means of achieving these goals. It has since been proposed that a European accident investigation committee should be set up by the EEC (Council Directive 80/1266 of 1 December 1980). After I would like to introduce the summary of the legislation examples and system for aircraft accidents investigation of the United States, the United Kingdom, Canada, Germany, The Netherlands, Sweden, Swiss, New Zealand and Japan, and I am going to mention the present system, regulations and aviation act for the aircraft accident investigation in Korea. Furthermore I would like to point out the shortcomings of the present system and regulations and aviation act for the aircraft accident investigation and then I will suggest my personal opinion on the new and dramatic innovation on the system for aircraft accident investigation in Korea. I propose that it is necessary and desirable for us to make a new legislation or to revise the existing aviation act in order to establish the standing and independent Committee of Aircraft Accident Investigation under the Korean Government.

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