• The Korean Society of Law and Medicine
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• v.20 no.3
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• pp.143-174
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• 2019

Our Constitution obliges the state to protect the health of the people, and the Medical Law, which embodied Constitution, sets out in detail the matters related to open the medical institution, and one of them is to prohibit the operation of multiple medical institutions. By the way, virtually multiple medical institutions could be opened and operated because the Supreme Court had interpreted that several medical institutions could be opened if medical activities were not performed directly at the additional medical institution which was opened under the another doctor's license. However, some health care providers opened the several medical institutions with another doctor's license for the purpose of the maximization of profit, and did illegal medical cares like the unfair luring of patients, over-treatment, and commission treatment. Also, realistic problems such as the infringed health rights have arisen. Accordingly, lawmakers had come to amend the Medical Law to readjust the system of opening for medical institution so that medical personnel could not open or operate more than one medical institution for any reason. For this reason, the Constitutional Court recently declared a constitutional decision through a long period of in-depth deliberation because the constitutional petition and the adjudication on the constitutionality of statutes had been filed on whether Article 33 paragraph 8 of the revised medical law is unconstitutional. The Constitutional Court acknowledged the "justice of purpose" in view of the importance of public medical institutions, of the prevention from seduction of for-profit patients and from over-treatment, and of the fact that health care should not be the object of commercial transactions. Given the risk that medical personnel might be subject to outside capital, the concern that the holder of the medical institution's opening certificate and the actual operator may be separated, the principle that the human body and life should not be just a means, and the current system's inability to identify over-treatment, it also acknowledged the 'minimum infringement'. Furthermore, The Constitutional Court judged it is constitutional in compliance with the principle of restricting fundamental rights, such as 'balance of legal interests'. In this regard, legislative complements are needed in order to effectively prevent the for-profit management and the over-treatment the Constitutional Court is concerned about. In this regard, consumer groups actively support the need for legislation, and health care providers groups also agree on the need for legislation. Therefore, the legislators should respect the recent Constitutional Court's decision and in the near future complete the complementary legislation to reflect the people's interests.

• Journal of Chest Surgery
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• v.32 no.7
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• pp.637-647
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• 1999

Background: Ischemia-reperfusion injury is one of the major contributing causes of early graft failure in lung transplantation. It has been suggested that triiodothyronine (T3) may ameliorate ischemia-reperfusion injury to various organs in vivo and in vitro. Predicting its beneficial effect for ischemic lung injury, we set out to demonstrate it by administering T3 into the in situ canine ischemia-reperfusion model. Material and Method: Sixteen adult mongrel dogs were randomly allocated into group A and B. T3 $(3.6\mug/kg)$ was administered before the initiation of single lung ischemia in group B, whereas the same amount of saline was administered in group A. Ischemia was induced in the left lung by clamping the left hilum for 100 minutes. After reperfusion, various hemodynamic parameters and blood gases were analyzed for 4 hours while intermittently clamping the right hilum in order to allow observation of the injured left lung function. Result: Arterial oxygen partial pressure $(PaO_2)$ decreased 30 minutes after reperfusion and recovered gradually thereafter in both groups. In group B the decrease of $PaO_2$ was less marked than in group A. The recovery of $PaO_2$ was faster in group B than in group A. The differences between the two groups were statistically significant from 30 minutes after reperfusion $(125\pm34$ mmHg and $252\pm44$ mmHg, p<0.05) until the end of the experiment $(178\pm42$mmHg and $330\pm37$ mmHg, p<0.05). The differences in the arterial carbon dioxide pressure, airway pressure and lung compliance showed no statistical significance. The malondialdehyde (MDA) level, measured from the tissue obtained 240 minutes after reperfusion, was lower in group B $(0.40\pm0.04\mu$M) than in group A $(0.53\pm0.05\mu$M, p<0.05). The ATP level of group B $(0.69\pm0.07\mu$M/g) was significantly higher than that of group A $(0.48\pm0.07\mu$M/g, p<0.05). The microscopic exami nation revealed varying degrees of injury such as perivascular neutrophil infiltration, capillary hemorrhage and interstitial congestion. There were no differences in the microscopic findings between the two groups. CONCLUSION T3 has beneficial effects on the ischemic canine lung injury including preservation of oxygenation capacity, less production of lipid peroxidation products and a higher level of tissue ATP. These results suggest that T3 is effective in pulmonary allograft preservation.

• Journal of the Korean Institute of Landscape Architecture
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• v.37 no.2
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• pp.26-35
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• 2009

This study is an analysis of the design changes of children's play facilities and the related rules and regulations which causes these changes. Accordingly, it is noticed that a site's change of design by legislation and by yearly alternation influences playground design. First, after revising the provisions for the distance from roads and parking lots, the constructing of safety fences between play facilities and the using of durable materials, alterations of the designs have been made a reality. Second, the design changes after the period of regulation transitions were caused by provisions related to the shelter of evergreens and conditions of the sun. Third, the changes of the playgrounds were related to the substitution of exercise facilities for the local residents and in carrying out a hygiene exam more than twice a year. Because a lack of regulatory standards for the design of playgrounds resulted in compliance based on individual interpretation and because a substitution of exercise facilities is part of the way to alleviate these regulations, the conditions of the site under investigation could be projeced. By such changes of regulations and analysis of alterations of playground design, programs for improvement were suggested. It turned out that the composition of the concrete standard in conformity with regulations required closer observance. Moreover, design standards for children's playgrounds are needed, such as the provision of variation in external appearance, the creation of more flexible layouts and the outlining of spaces by themes.

• Pediatric Infection and Vaccine
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• v.10 no.1
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• pp.95-101
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• 2003

Objective : To determine the clinical and bacteriologic efficacy and safety of Cefdinir in acute pharyngitis and pharyngotonsillitis caused by group A beta hemolytic streptococci in pediatric patients. Methods : Children aged 3 through 12 years who visited the hospitals enrolled in this study with signs and symptoms of pharyngitis or pharyngotonsillitis since May to December 2002, were taken throat culture and given Cefdinir(12 mg/kg/day, in three divided doses) for 7 days. Two hundred thirty five patients were enrolled and 90 patients who showed positive culture results were followed up for the signs and symptoms during the treatment to determine clinical efficacy. Follow-up culture were done at the end of the study and bacteriologic efficacy was determined Results : Ninety out of 235 patients who visited the hospitals with the signs and symptoms of pharyngitis showed positive growth on throat culture. Seventy nine patients were clinically and microbiologically assessable. The bacteriologic eradication rates of S. pyogenes were 100% in all the children treated with Cefdinir. Clinical cure rates were not different between less than 7 days-treated group(75%) and just 7 days-treated group(98.6%)(P=0.077). Two patients reported adverse reaction during Cefdinir treatment. Antimicrobial sensitivity of Cefdinir against S. pyogenes was 100% with range of MIC being less than 0.5 ${\mu}g/mL$. Conclusion : It seems that Cefdinir is one of reliable and well-tolerated drugs for the treatment of group A beta hemolytic streptococcal pharyngotonsillitis in children. It needs to be investigated short term efficacy in terms of improving drug compliance and impact of economic point of view. We can recognized that still high rate of the erythromycin resistant group A streptococci in our community should be monitored every year.

• Tuberculosis and Respiratory Diseases
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• v.43 no.1
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• pp.14-21
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• 1996

Objectives: Although outbreak of MDR Tb has been a recent problem in western countries, it has been a longstanding problem in Korea. The poor outcome of MDR Tb is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. Thus, to improve the outcome of MDR Tb, it is crucial to make individualized adequate prescription based on the knowledge of the patterns of resistance to each drugs in the community as well as the natural history. The purpose of present study is to evaluate the clinical features of Korean MDR Tb patients including patterns of drug resistance and success rate of treatment which was prescribed according to the sensitivity tests. Methods: Retroscpective analysis of 71 Korean patients with MDR Tb was made. All strains isolated from patients showed resistence to at least two first line drugs. Patients profile, previous treatment history, patterns of drug resistance, outcome of treatment was analysed. Initial treatment regimen was selected according to the previous treatment history and was modified according to the sensitivity reports. The regimen was composed to include at least 4 sensitive drugs when possible. Results: The patients showed resistance to 4.1 drugs on average. 90% of them were resistant to INH and RFP. Among 71 patients, 35 patients(49%) had cavitary lesions in CXR. Treatment outcome was analysed in 55 patients. 35 patients(67%) were improved after treatment and 18 patients(33%) showed treatment failure. 5 patients showed primary resistance. Treatment outcome could be evaluated in 4 of them and all showed improvement after treatment. 14 patients(20%) had to change their regimens due to drug side effects. The most frequent side effect was elevation of liver enzymes(6 patients). Others included dizziness, hyperuricemia, tinnitus, skin rash, GI troubles. More than 50% of side effects developed within 3 months. In repeated drug sensitivity test, the concordance rate of resistance to INH was 100% and RFP 98%. EMB, PZA showed 80% concordance rate. But in the other drugs, the concordances were less than 50%. Operation was done in 5 patient - 1 patients as a adjunctive means of chemotherapy -. In that case, negative conversion of sputum AFB was done. Conclusion: 2/3 patients of multidrug-resistant tuberculosis were improved by appropriate prescription and regular medication suggesting that more aggressive management and monitoring is indicated in multidrug-resistant tuberculosis.

• Korean Chemical Engineering Research
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• v.49 no.2
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• pp.187-194
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• 2011

In compliance with an international law about the ocean dumping of the sludge, the proper sewage treatment process which occurs from the wastewater treatment process has been becoming problem. Generally the sewage and the sludge are controlled from anaerobic condition when the sewage is treated and land filled, where the methane$(CH_{4})$ and the nitrous oxide $(N_{2}O)$ from this process are discharged. Because these gases have been known as one of the responsible gases for global warming, the wastewater treatment process is become known as emission sources of green house gases(GHG). This study is to suggest a new approach of estimate and environmental assessment of greenhouse gas emissions and sludge emissions from wastewater treatment processes. It was carried out by calculating the total amounts of GHG emitted from biological wastewater treatment process and the amount of the sludgegenerated from the processes. Four major biological wastewater treatment processes which are Anaerobic/Anoxic/Oxidation$(A_{2}O)$, Bardenpho, Virginia Initiative Plant(VIP), University of Cape Town(UCT)are used and GPS-X software is used to model four processes. Based on the modeling result of four processes, the amounts of GHG emissions and the sludge produced from each process are calculated by Intergovernmental Panel on Climate Change(IPCC) 2006 guideline report. GHG emissions for water as well as sludge treatment processes are calculated for environmental assessment has been done on the scenario of various sludge treatments, such as composting, incineration and reclamation and each scenario is compared by using a unified index of the economic and environmental assessment. It was found that Bardenpho process among these processes shows a best process that can emit minimum amount of GHG with lowest impact on environment and composting emits the minimum amount of GHG for sludge treatment.

• Journal of Environmental Policy
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• v.8 no.2
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• pp.83-118
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• 2009

Clean Development Mechanism(CDM) projects under the Kyoto Protocol have two objectives. One is to assist the Parties included in Annex I in achieving compliance with their quantified emission limitation and reduction commitments in cost-effective ways by allowing them to implement emission reduction projects in Non-Annex I countries and receive CERs, which will offset their reduction commitments. The other is to assist Parties not included in Annex I in achieving sustainable development and technology transfers through investments by Annex I countries. However, in reality, it is said that the former objective is achievable but the latter is not. In this light, this article suggests sustainability appraisal criteria applicable for Korea. Among various methodologies, we used the 'multi-attributes utility theory(MAUT)'; one of the 'multi-criteria analysis (MCA)' methodologies judged to be the most practical and relevant. Based on the guidelines of the MAUT methodology, we identified sustainability criteria that meet the guidelines. We took two tracks, the first to find the preferences of Korean experts, and the other to check foreign cases. In all, 37 preliminary criteria were suggested to Korean experts and each criterion was scored, from between 1 and 3, in terms of relevance, possibility of real improvement, easiness of data collection, and preferences. We combined foreign cases and the results of a survey conducted in Korea and selected 12 core criteria and 10 additional criteria. After that, all the criteria were converted into indicators. The indicators were applied to a CDM project for case study. We chose the "Sihwa Tidal Power Project", which is currently the biggest tidal power plant in the world. Twelve core indicators and 3 additional indicators were applied. In order to weight each indicator, the 'analytical hierarchy process (AHP)' was used. A total of 30 experts were asked to suggest weights and 21 answered. Among them, only 14 respondents were proven to meet the consistency ratio. We analyzed the 14 responses through Expert Choice and the CDM project was scored (+)53.082. In addition, sensitivity analysis was undertaken with the result of (+)44.667 to (+)65.522. As a result of this study, it was proven that this project would contribute to the sustainable development of Korea.

• Tuberculosis and Respiratory Diseases
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• v.47 no.4
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• pp.507-516
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• 1999

Background : Patients with lung cancer and their relatives often ask the advice of relative or friends who are doctors on the treatment and prognosis of the disease. Therefore a doctor's opinion may play a role in determining the treatment modality and affect therapeutic compliance of patients. The purpose of this study was to find the opinion of general practitioners on lung cancer treatment. Method : A mail survey for general practitioners in Taegu City and Northern Kyungsang Province was performed. Each individual was sent a written questionnaire in which he or she was asked for ten questions about management and prognosis of lung cancer. Results : Two hundred and twenty eight doctors filled in the questionnaire. Of the respondents, 68% had the experience of being asked about lung cancer by their friends or relatives. About 52% replied that it was better to tell the patient of his or her disease. And about 22% considered it better to follow the relatives' opinion. On the question about choosing the treatment modality, following the doctors' plan was most appropriate in 86.9%, showing that most respondents favored actively recommending doctors. Nonsurgical treatment was preferable in patients over 80 years old with resectable lung cancer and with an increase in age, significant increase was observed in respondents recommending nonsurgical treatment. Most respondents said that they would actively recommend or advise following the doctors' plan about radiotherapy and chemotherapy. But a large percent of the respondents had a negative view on the effect of radiotherapy and chemotherapy. Conclusion : The opinions of general practitioners on the treatment and prognosis of lung cancer was variable. And they did not prefer active treatment for patients with old age or advanced lung cancer.

• The Journal of Korea Institute of Information, Electronics, and Communication Technology
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• v.14 no.5
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• pp.394-402
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• 2021

The entry of an aging society and the extension of human life expectancy, the increasing interest in women's social advancement and men's appearance, and the natural interest in K-culture through media media, while receiving worldwide attention, Focus on K-Bueaty. Recently, looking at the occupation of the medical tourism field, in the case of aesthetic medicine tourism such as molding and dermatology, it has gained popularity not only in Asia such as China and Japan, but also in North America and Europe. The first external confirmation of human aging is the wrinkles on the skin of the face. Clean, wrinkle-free, elastic and healthy skin is a desire of most people. Skin condition and condition such as focused ultrasonic stimulation (HIFU: High Intensity Focused Utrasound) and low frequency, high frequency (RF: Radio Frequency), galvanic therapy using microcurrent, cryotherapy using rapid cooling, etc. Depending on the method of management, the effect of the treatment differs depending on the output and the stimulation site, etc., even in the treatment of medical equipment and beauty equipment using the same mechanism. In this research, in order to develop invasive high-frequency dermatological devices using a large number of beauty medical devices and microneedles of beauty devices, the international standards IEC 60601-2 (standards for individual medical devices) and MFDS (Ministry of) We designed and developed a high-frequency output device in compliance with the high-frequency stimulation standard announced in the Food and Drug Safety (Ministry of Food and Drug Safety). The circuit design consists of an amplifier (AMP: Amplifier) using Class-A Topology and a power supply device using Half-Bridge Topology. As a result of measuring the developed high-frequency output device, an average efficiency of 63.86% was obtained, and the maximum output was measured at 116.7W and 50.67dBm.

• The Korean Journal of Air & Space Law and Policy
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• v.33 no.2
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• pp.345-366
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• 2018

Article 37 of the International Convention on Civil Aviation requires that rules should be adopted to keep in compliance with international standards and recommended practices established by ICAO. As SARPs are revised annually, each ICAO Member State needs to reflect the new content in its national aviation Acts in a timely manner. In recent years, data-driven international standards have been developed because of the important roles of aviation safety data and information-based legislation in accident prevention based on human factors. The Safety Management System and crew Fatigue Risk Management Systems were reviewed as examples of the result of data-driven rulemaking. The safety management system was adopted in 2013 with the introduction of Annex 19 and Chapter 5 of the relevant manual describes safety data collection and analysis systems. Through analysis of safety data and information, decision makers can make informed data-driven decisions. The Republic of Korea introduced Safety Management System in accordance with Article 58 of the Aviation Safety Act for all airlines, maintenance companies, and airport corporations. To support the SMS, both mandatory reporting and voluntary safety reporting systems need to be in place. Up until now, the standard of administrative penal dispensation for violations of the safety management system has been very weak. Various regulations have been developed and implemented in the United States and Europe for the proper legislation of the safety management system. In the wake of the crash of the Colgan aircraft, the US Aviation Safety Committee recommended the US Federal Aviation Administration to establish a system that can identify and manage pilot fatigue hazards. In 2010, a notice of proposed rulemaking was issued by the Federal Aviation Administration and in 2011, the final rule was passed. The legislation was applied to help differentiate risk based on flight according to factors such as the pilot's duty starting time, the availability of the auxiliary crew, and the class of the rest facility. Numerous amounts data and information were analyzed during the rulemaking process, and reflected in the resultant regulations. A cost-benefit analysis, based on the data of the previous 10 year period, was conducted before the final legislation was reached and it was concluded that the cost benefits are positive. The Republic of Korea also currently has a clause on aviation safety legislation related to crew fatigue risk, where an airline can choose either to conform to the traditional flight time limitation standard or fatigue risk management system. In the United States, specifically for the purpose of data-driven rulemaking, the Airline Rulemaking Committee was formed, and operates in this capacity. Considering the advantageous results of the ARC in the US, and the D4S in Europe, this is a system that should definitely be introduced in Korea as well. A cost-benefit analysis is necessary, and can serve to strengthen the resulting legislation. In order to improve the effectiveness of data-based legislation, it is necessary to have reinforcement of experts and through them prepare a more detailed checklist of relevant variables.