• The Korean Society of Law and Medicine
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• v.22 no.2
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• pp.111-138
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• 2021

'Unlicensed medical practice by a non-medical practitioner' often represented by surrogate surgery or so-called 'ghost surgery,' causes irreparable damage to life or body, and therefore calls for very strict and effective controls. The 'bill on installment of CCTVs in an operating room' to prevent unlicensed surrogate surgery has been discussed for a long time, but due to numerous issues and heated confrontations, it has been pending in the National Assembly. Nevertheless, it is expected that the bill will be discussed again in earnest in the National Assembly because surrogate surgery and factory-type cosmetic surgery, which has been performed mainly in the field of cosmetic surgery, has also been occurring in the field of therapeutic surgery. In general, an operating room is considered as being locked or closed, as well as disallowing implicit complicity among insiders. Hence, if the insiders conspire to commit or cover up an illegal act, or if a surgeon performs rapid cosmetic surgery and then leaves the recipient (or medical institution) so as to perform more operations for profit - even if it is legitimate practice - it may result in serious consequences in terms of the recovery of a patient. In this case, installation of CCTVs can be of great help in identifying an illegal act and assessing any occurrence of negligence. On the other hand, while the fundamental purpose of therapeutic surgery is to restore a patient's life or body - that is, lifesaving - installation of CCTVs may base the relationship between a surgeon and a patient on distrust and surveillance, so it may increase the number of requests for CCTV footage or lead to more disputes, as well as placing a burden on the surgeon when best results are not achieved for a patient. As a result, the surgeon may choose non-invasive treatment contrary to conscience instead of risky but necessary surgery, or he/she may have significant difficulty in determining the timing of surgery, which may limit the provision of effective surgical medical care. Then, in terms of the relationship between a surgeon and patient, and in the long run, there could be significant disadvantages for the public and patients if CCTV footage is allowed. In this paper, we review domestic and overseas cases and issues regarding installation of CCTVs in an operating room, and present various viewpoints and suggestions to promote legislation with minimized legal problems and side effects, thereby contributing to protection of the lives and health of the public, patients, and recipients of surgery.

• Journal of Chest Surgery
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• v.55 no.2
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• pp.126-142
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• 2022

Background: Thymic epithelial tumors (TETs) are rare, and information regarding their surgical outcomes and prognostic factors has rapidly changed in the past few decades. We analyzed surgical treatment practices for TETs and outcomes in terms of overall survival (OS) and freedom from recurrence (FFR) during a 13-year period in Korea. Methods: In total, 1,298 patients with surgically resected TETs between 2000 and 2013 were enrolled retrospectively. OS and FFR were calculated using the Kaplan-Meier method and evaluated with the log-rank test. Prognostic factors for OS and FFR were analyzed with multivariable Cox regression. Results: A total of 1,098 patients were diagnosed with thymoma, and 200 patients were diagnosed with thymic carcinoma. Over the study period, the total number of patients with surgically treated TETs and the proportion of patients who underwent minimally invasive thymic surgery (MITS) increased annually. The 5-year and 10-year survival rates of surgically treated TETs were 91.0% and 82.1%, respectively. The 5-year and 10-year recurrence rates were 86.3% and 80.0%, respectively. The outcomes of surgically treated TETs improved over time. Multivariable Cox hazards analysis for OS, age, tumor size, and Masaoka-Koga stage were independent predictors of prognosis. The World Health Organization classification and tumor-node-metastasis (TNM) staging were also related to the prognosis of TETs. Conclusion: Surgical treatment of TETs achieved a good prognosis with a recent increase in MITS. The M-K stage was the most important prognostic factor for OS and FFR. The new TNM stage could also be an effective predictor of the outcomes of TETs.

• Korean Journal of Environment and Ecology
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• v.36 no.3
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• pp.220-256
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• 2022

The most important thing for conserving plant diversity in an area is to make an overall inventory of the plant species inhabiting the area. In particular, limestone areas are known for their high plant diversity and distribution of specific plants. Despite that, only a few have been designated as protected areas. This study investigated the vascular plants distributed in Goyangsan Mtn. and Munraesan Mtn., located in limestone areas of the central part of the Korean Peninsula. A field survey was conducted eight times from April to October 2021. As a result, we identified a total of 654 taxa comprising 113 families, 357 genera, 592 species, 15 subspecies, 44 varieties, and 3 formulas. They included four endangered wild plant species: Astilboides tabularis, Eleutherococcus senticosus, Cypripedium macranthos, and Epilobium hirsutum. Endemic plants in Korea were identified as 32 taxa. Floristic target plants were identified as 168 taxa, specifically 5 taxa of grade V, 41 taxa of grade IV, and 36 taxa of grade III. The red data plants included 2 taxa as "Endangered (EN)", 7 taxa as "Vulnerable (VU)", and 7 taxa as "Near threatened (NT)". A total of 41 taxa of naturalized plants were identified, and 4 of them were invasive alien plants. The surveyed vicinity of Goyangsan Mtn. and Munraesan Mtn. showed high plant diversity and contained core habitats for distribution of an endangered wild plant, Astilboides tabularis,in the limestone area. Moreover, both mountains contained a small population of Cotoneaster integerrimus. These findings confirm that the area has conservation values. Therefore, we propose to identify areas with high plant diversity and designate them as special protected areas.

• Journal of Nutrition and Health
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• v.55 no.4
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• pp.506-520
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• 2022

Purpose: Physical activity (PA) has a beneficial effect on the prevention of arteriosclerosis in healthy adults. The purpose of this study was to analyze the relationship between PA measured using an accelerometer and arterial stiffness in healthy Korean adults. Methods: This study involved 87 subjects (36.8% women) aged 20-64 years. PA was evaluated using an accelerometer (wGT3X-BT, ActiGraph, Florida, USA) for 7 days. Based on the results of the accelerometer measurement, subjects were classified into active and inactive groups according to the World Health Organization (WHO) PA guidelines. The brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI) to assess arterial stiffness were measured by a non-invasive vascular screening device (VP-1000 Plus, Omron). Results: The average age of the study subjects was 47.7 ± 11.3 years and the WHO PA guideline achievement rate was 29.9%. There was no significant difference in arterial stiffness (baPWV and ABI) between the active and inactive groups. In females, the time spent in light PA were positively correlated with ABI (r = 0.396; p < 0.05) and the number of sedentary bouts over 50 minutes was inversely correlated with ABI (r = -0.402; p < 0.05). However, there was no significant correlation between PA and arterial stiffness in males. Conclusions: The results of this study suggest that light PA and sedentary behavior have a positive correlation with arterial stiffness in females.

• Journal of Radiopharmaceuticals and Molecular Probes
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• v.9 no.1
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• pp.9-16
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• 2023

Liposomes as drug delivery system have proved useful carrier for various disease, including cancer. In addition, perfluorocarbon cored microbubbles are utilized in conjunction with high-intensity focused-ultrasound (HIFU) to enable simultaneous diagnosis and treatment. However, microbubbles generally exhibit lower drug loading efficiency, so the need for the development of a novel liposome-based drug delivery material that can efficiently load and deliver drugs to targeted areas via HIFU. This study aims to develop a liposome-based drug delivery material by introducing a substance that can burst liposomes using ultrasound energy and confirm the ability to target tumors using PET imaging. Liposomes (Lipo-DOX, Lipo-DOX-Au, Lipo-DOX-Au-RGD) were synthesized with gold nanoparticles using an avidin-biotin bond, and doxorubicin was mounted inside by pH gradient method. The size distribution was measured by DLS, and encapsulation efficiency of doxorubicin was analyzed by UV-vis spectrometer. The target specificity and cytotoxicity of liposomes were assessed in vitro by glioblastoma U87mg cells to HIFU treatment and analyzed using CCK-8 assay, and fluorescence microscopy at 6-hour intervals for up to 24 hours. For the in vivo study, U87mg model mouse were injected intravenously with 1.48 MBq of ⁶⁴Cu-labeled Lipo-DOX-Au and Lipo-DOX-Au-RGD, and PET images were taken at 0, 2, 4, 8, and 24 hours. As a result, the size of liposomes was 108.3 ± 5.0 nm at Lipo-DOX-Au and 94.1 ± 12.2 nm at Lipo-DOX-Au-RGD, and it was observed that doxorubicin was mounted inside the liposome up to 52%. After 6 hours of HIFU treatment, the viability of U87mg cells treated with Lipo-DOX-Au decreased by around 20% compared to Lipo-DOX, and Lipo-DOX-Au-RGD had a higher uptake rate than Lipo-DOX. In vivo study using PET images, it was confirmed that ⁶⁴Cu-Lipo-DOX-Au-RGD was taken up into the tumor immediately after injection and maintained for up to 4 hours. In this study, drugs released from liposomes-gold nanoparticles via ultrasound and RGD targeting were confirmed by non-invasive imaging. In cell-level experiments, HIFU treatment of gold nanoparticle-coupled liposomes significantly decreased tumor survival, while RGD-liposomes exhibited high tumor targeting and rapid release in vivo imaging. It is expected that the combination of these models with ultrasound is served as an effective drug delivery material with therapeutic outcomes.

• Korean Journal of Environment and Ecology
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• v.36 no.6
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• pp.582-591
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• 2022

This study was conducted to eliminate Myocastor coypusMolina, 1782 (Nutria) from Jeju Special Self-Governing Province, South Korea. Habitat identification and eradication were carried out from September to November 2013, and a survey was carried out until June 2022 to check whether the eradication was successful. The habitat was identified with unmanned cameras, interviews, and literature surveys, and the capture was performed using the trapping method with food to attract nutria to the habitat area. The study area for the follow-up survey, which was set relatively wide considering nutria's home range, included wetlands and rivers within 4.0 km² of the habitat area (eradication area). As a result, nutria's habitat was confirmed only at Songdang Ranch, Songdang-ri, of Jeju Island, with traces of habitat (footprints, excrement, and burrows) confirmed in waterways and ponds within the pasture. Eight individuals were captured, including four females, three males, and one individual in too advanced a state of decay to identify the sex. The follow-up survey thoroughly investigated the habitat and its surroundings, focusing on three areas with permanent water, Seongeup Reservoir, Cheonmi Creek, and Molsuni Pond, but no signs of habitat were identified. Therefore, it is determined that nutria inhabiting Jeju Island has been completely eradicated. It is believed that the successful eradication of nutria in the Jeju Special Autonomous Region was possible due to a synergy between 1) the eradication of nutria at the beginning of the settlement phase through rapid capture after confirming the nutria habitat and 2) the delayed expansion period because of rare presence of wetlands, where water is constantly stagnant, on Jeju Island. These results imply that quickly identifying the ecological characteristics of the species and preventing disturbances before they or at the beginning of the ecological disturbance through control and eradication at the initial stage of settlement before the expansion stage is an effective measure to cope with the influx of alien species.

• Korean Journal of Environment and Ecology
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• v.36 no.6
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• pp.566-574
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• 2022

Heavy metals are one of the dangerous pollutants that threaten urban biodiversity due to their accumulation over a long period without being decomposed in vivo. Accordingly, there is a need for biological monitoring to compare accumulation concentrations in living organisms according to the degree of heavy metal exposure to evaluate heavy metal contamination in the air in urban areas. This study aims to examine the possibility of using nesting materials as heavy metal monitoring samples and determine the effects of heavy metals on Paridae. We installed 54 artificial nest boxes in the research areas that included campus green spaces (14), urban forests (11), and urban parks (29) on a university campus in Cheonan City, Chungcheongnam Province. The birds' use rate of artificial nest boxes was 11/14 (78.57%) in campus green spaces, 8/11 (72.72%) in urban forests, and 6/29 (20.68%) in urban parks. Moss materials were collected from collected nests, and the heavy metal accumulation characteristics of each type of urban green space and the effects of heavy metals on the success of fledging of Paridae were compared through heavy metal analysis. The analysis showed that the average concentrations of zinc and lead were 228.08±209.62 ㎍/dry g and 17.67 ± 6.72 ㎍/dry g, respectively. There was no significant difference in zinc concentration for each type of urban green space (Kruskal-Wallis test, p-value=0.28), but lead concentration showed a significant difference (Kruskal-Wallis test, p<0.05^*). Of the 21 Paridae, nests analyzed for heavy metals, fledging of birds was observed in 11 nests (52.38%). Fledging of birds observed in each urban green space type was 7 campus green spaces (77.78%), 6 in urban forests (85.71%), and 1 in urban park (20%), mainly in urban forests and green spaces on campus. Heavy metal concentrations were compared to check the effect of heavy metal accumulation on the successful fledging of Paridae, but there was no statistically significant difference (Zn: W=44, p-value=0.74, Pb: t=0.64676, df =7.2422, p-value=0.54). This study is a basic study using the nesting materials of Paridae as heavy metal monitoring samples, and it is determined that it can be used as basic data for non-invasive biological monitoring.

• Korean Journal of Environmental Biology
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• v.40 no.2
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• pp.164-171
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• 2022

Frankliniella occidentalis is an invasive pest insect, which affects over 500 different species of host plants and transmits viruses (tomato spotted wilt virus; TSWV). Despite their efficiency in controling insect pests, pesticides are limited by residence, cost and environmental burden. Therefore, a fixed-precision level sampling plan was developed. The sampling method for F. occidentalis adults in pepper greenhouses consists of spatial distribution analysis, sampling stop line, and control decision making. For sampling, the plant was divided into the upper part(180 cm above ground), middle part (120-160 cm above ground), and lower part (70-110 cm above ground). Through ANCOVA, the P values of intercept and slope were estimated to be 0.94 and 0.87, respectively, which meant there were no significant differences between values of all the levels of the pepper plant. In spatial distribution analysis, the coefficients were derived from Taylor's power law (TPL) at pooling data of each level in the plant, based on the 3-flowers sampling unit. F. occidentalis adults showed aggregated distribution in greenhouse peppers. TPL coefficients were used to develop a fixed-precision sampling stop line. For control decision making, the pre-referred action thresholds were set at 3 and 18. With two action thresholds, N_max values were calculated at 97 and 1149, respectively. Using the Resampling Validation for Sampling Program (RVSP) and the results gained from the greenhouses, the simulated validation of our sampling method showed a reasonable level of precision.

• Journal of the Korean Orthopaedic Association
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• v.54 no.1
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• pp.30-36
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• 2019

Purpose: This study examined the effects of gender, age, underlying disease, duration after onset of symptoms, preoperative invasive procedures, bacterial culture of joint fluid, and stage of infection by the Gachter classification on the prognosis of patients with infectious knee arthritis who underwent arthroscopic surgery. Materials and Methods: From June 2014 to December 2016, 51 patients who underwent arthroscopic surgery for infective knee arthritis were enrolled in this study. The average follow-up period was 14.2±2.1 months (range, 12-20 months). The subjects were 27 men (52.9%) and 24 women (47.1%), with an average age of 55.1±17.6 years (range, 13-84 years). A preoperative evaluation of the joint aspiration with a count of more than 50,000 leukocytes and a polymorphonuclear leukocyte count of 95% or more was performed. All patients underwent arthroscopic surgery and postoperative continuous joint irrigation. Results: The initial mean value of the C-reactive protein decreased from 9.55±6.76 mg/dl (range, 1.51-31.06 mg/dl) to a final mean of 0.74±1.26 mg/dl (range, 0.08-6.77 mg/dl); the mean duration of C-reactive protein normalization was 27.6±18.9 days (range, 8-93 days). Among the 51 patients who received arthroscopic surgery and antibiotics, 44 patients (86.3%) with infectious knee arthritis completed treatment with improved clinical symptoms, such as fever, pain, and edema, and the C-reactive protein decreased to less than 0.5 mg/dl. Finally, 5 cases were treated with two or more arthroscopic operations, and 2 cases were converted to arthroplasty after prosthesis of antibiotic-loaded acrylic cement. Conclusion: The duration of surgery after the onset of symptoms and the stage according to the Gächter classification are important prognostic factors for predicting the successful treatment of infectious knee arthritis. On the other hand, the other factors were not statistically significant. Nevertheless, patients with bacteria cultured from the joint fluids appear to reflect the treatment period because the period of normalization of the C-reactive protein is shorter than that of the control group.

• Journal of the Korean Orthopaedic Association
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• v.52 no.1
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• pp.15-24
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• 2017

Purpose: The aim of this study was to determine the effectiveness of arthroscopic debridement with mini-open ulnar nerve decompression in primary osteoarthritis of the elbow with ulnar neuropathy. Materials and Methods: Between May of 2006 and July of 2014, a total of 43 patients who had undergone surgery for primary osteoarthritis of the elbow with ulnar neuropathy were included in this study. We divided the subjects into two groups according to the method of surgery: group 1 (n=18) received mini-open ulnar nerve decompression only, and group 2 (n=25) received arthroscopic debridement with mini-open ulnar nerve decompression. Patients were assessed for the following clinical outcomes: visual analogue scales (VAS) score, range of motion of the elbow joint, Mayo elbow performance score (MEPS), and disabilities of the arm, shoulder and hand (DASH) at the time before surgery and 6 months after surgery. We analyzed the recovery of the ulnar nerve by the McGowan grade and Bishop rating score preoperatively and at 6 months after the surgery. Results: The VAS score, range of motion of the elbow joint, MEPS, and DASH showed significant statistical difference after the surgery (p<0.05). However, between the 2 groups, there was no significant difference. For the McGowan grade, all cases of both groups-except one case each group-showed at least one grade improvement. Moreover, group 2 showed a greater significant difference than group 1 (p=0.001). At the final follow-up, according to the Bishop rating score, group 2 had a greater significant difference than group 1 (p=0.036). Conclusion: Arthroscopic debridement with mini-open ulnar nerve decompression in primary osteoarthritis of the elbow with ulnar neuropathy is a useful technique, which has several advantages, including the benefits associated with a minimally invasive surgery and also the improvement of elbow joint function and excellent recovery of the ulnar nerve.