• Title/Summary/Keyword: The cause of the accident

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Spur-like Lesion on the Lateral Tibial Condyle - A Sign of Chronic ACL tear - (경골 외과의 골극 유사 병변 - 만성 전방 십자 인대 파열의 징후 -)

  • Cho Sung-Do;Ko Sang-Hun;Hwang Su-Yeon;Yang Jung-Hun
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.201-205
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    • 2003
  • Purpose : Authors experienced cases of chronic ACL tear with spur-like lesion on the tibial condyle which is different from the lateral capsular sign and degenerative change and evaluated the significance of 'spur-like lesion' in relations with chronic ACL injury. Material and Method : We have 5 patients with spur-like lesion on the lateral tibial condyle in simple radiogram. The location, shape and size of the lesion were studied using radiogram and MRI. Cause of injury, associated injury and chronicity of the ACL tear were analyzed. All 5 patients were male, and mean age was 33.8 $(17\~46)$ years. Result : The spur-like lesion was located from 3.8 mm(avg.) below the articular surface of the lateral tibial condyle to the apex of the fibular head and protruded laterally or inferolaterally from just posterior to the Gerdy's tubercle with a round or sharp-end triangular shape. Average length was 6 mm and average width ortho base was 9.2 mm. The cause of injury were sports jnjury 4 cases and traffic accident in one. The chronicity of the ACL tear was average 10.7(8 months$\~$23 years) years and medial meniscus tear was shown in all cases and lateral meniscus tear in three. Conclusion : We suggest that a patient who has a history of trauma with spur-like lesion on the lateral tibial condyle of the knee is expected to have chronic ACL tear.

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Sensitivity Analysis of Depletion Parameters for Heat Load Evaluation of PWR Spent Fuel Storage Pool (경수로 사용후핵연료 저장조 열부하 평가를 위한 연소조건 인자 민감도 분석)

  • Kim, In-Young;Lee, Un-Chul
    • Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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    • v.9 no.4
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    • pp.237-245
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    • 2011
  • As necessity of safety re-evaluation for spent fuel storage facility has emphasized after the Fukushima accident, accuracy improvement of heat load evaluation has become more important to acquire reliable thermal-hydraulic evaluation results. As groundwork, parametric and sensitivity analyses of various storage conditions for Kori Unit 4 spent fuel storage pool and spent fuel depletion parameters such as axial burnup effect, operation history, and specific heat are conducted using ORIGEN2 code. According to heat load evaluation and parametric sensitivity analyses, decay heat of last discharged fuel comprises maximum 80.42% of total heat load of storage facility and there is a negative correlation between effect of depletion parameters and cooling period. It is determined that specific heat is most influential parameter and operation history is secondly influential parameter. And decay heat of just discharged fuel is varied from 0.34 to 1.66 times of average value and decay heat of 1 year cooled fuel is varied from 0.55 to 1.37 times of average value in accordance with change of specific power. Namely depletion parameters can cause large variation in decay heat calculation of short-term cooled fuel. Therefore application of real operation data instead of user selection value is needed to improve evaluation accuracy. It is expected that these results could be used to improve accuracy of heat load assessment and evaluate uncertainty of calculated heat load.

A Study on the Legislative Guidelines for Airline Consumer Protection (항공소비자 보호제도의 입법방향)

  • Lee, Chang-Jae
    • The Korean Journal of Air & Space Law and Policy
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    • v.32 no.1
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    • pp.3-51
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    • 2017
  • From a historical point of view, while the Warsaw Convention was passed in 1924 to regulate the unified judicial responsibility in the global air transportation industry, protection of airline consumers was somewhat lacking in protecting air carriers. In principle, the air carrier does not bear any obligation or liability when the aircraft is not operated normally due to natural disasters such as typhoon or heavy snowfall. However, in recent years, in developed countries such as the US and Europe, there has been a movement in which regulates the air carriers' obligation to protect their passengers even if there is no misconduct or negligence. Furthermore, the legislation of such advanced countries imposes an obligation on the airlines to compensate the loss separately from damages in case the abnormal operation of the aircraft is not caused by force majeure but caused by their negligence. Under this historical and international context, Korea is also modifying the system of aviation consumer protection by referring to other foreign legislation. However, when compared with foreign countries, our norm has a few drawbacks. First, the airline's protection or care obligations are mixed with the legal liability for damages in the provision, which seems to be due to the lack of understanding of the airline's passenger protection obligation. The liability for damages, which is governed by the International Convention or the Commercial Act, shall be determined by judging the cause of the airline's liability in respect of the damage of the individual passenger in the course of the air transportation. However, the duty to care and the burden for compensation shall be granted to all passengers who feel uncomfortable with the abnormal operation regardless of the cause of the accident. Also, our compensation system for denied boarding due to oversale is too low compared to the case of foreign countries, and setting the compensation amount range differently based on the time for the re-routing is somewhat unclear. Regarding checked-baggage claim, it will be necessary to refund the fee only from the fact that the baggage is delayed without asking whether there is any damage occurred from the delayed baggage. This is the content of the duty to care, which is different from the current Commercial Act or the international convention, in which responsibility is different depending on whether the airline takes all the necessary measures in order to prevent delaying of the baggage. The content of force majeure, which is a requirement for exemption from the obligation to care passengers on the airplane, shall be reconsidered. Maintenance for safe navigation is not considered to be included in force majeure, and connection to airplanes, airport conditions are disputable. According to the EC Regulation, if the cause of the abnormal operation of the airline is force majeure, the airline's compensation obligation is exempted but the duty to care of airline company is still meaningful. Furthermore, even if the main role of aviation consumer protection is on an airline, it is the responsibility of government agencies to supervise the fulfillment of such protection obligations. Therefore, it is necessary for the Korean government to actively take measures such as enforcing incentives for airlines that faithfully fulfill their obligation to care and imposed penalties on the contrary.

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The Effect of the Simple Fogarty Thromboembolectomy (단순 Fogarty 혈전색전 제거술의 효과)

  • Oh, Joong-Hwan;Park, Il-Hwan;Lee, Chong-Kookk
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.480-486
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    • 2009
  • Background: The Fogarty thromboembolectomy catheter technique was devised to extract distal arterial emboli and it represents a milestone for the treatment of patients with acute arterial occlusion since the 1960s. The major causes of arterial occlusion have changed from emboli of a heart origin to atherosclerosis over the past 30 years. Accordingly, questions have been raised about the effectiveness of simple Fogarty thromboembolectomy. Material and Method: During the period from March 1990 through August 2008, 156 patients who requiring Fogarty thromboembolectomy were analyzed. The patients were divided into two groups: those with simple Fogarty thromboembolectomy (Group 1, 79 patients) and those with additional vascular bypass graft surgery (Group 2, 77 patients). The duration of symptoms, the cause of thrombi, admission via the emergency room, a history of acupuncture or misdiagnosis, combined diseases, the anatomic occlusion site and the cause of death were analyzed using T-tests, cross tab tests, Chi square tests and Kaplan-Meier tests, respectively. Result: The mean age was 64$\pm$10 years in the 2 groups. The duration of symptoms (pain) in Group 1 vs Group 2 was 12$\pm$4 days vs 71$\pm$14 days (p=0.001). 50 (63%) patients in Group 1 were admitted via the emergency room vs 18 (23%) patients in Group 2 (p=0.005). Misdiagnosis and the treatment for herniated intervertebral disc or acupuncture were given to, 20 (25%) patients in Group 1 vs 30 (39%) patients in Group 2. Anticoagulation treatment before admission was performed in 22 (28%) patients in Group 1 vs 11 (14%) patients in Group 2. The causes of thrombi were heart disease in, 24 (30%) patients in Group 1 vs 6 (8%) patients in Group 2 (p=0.001), atherosclerosis in 46 (58%) patients in Group 1 vs 67 (87%) patients in Group 2 (p=0.001) and trauma in 9 (11%) patients in Group 1 vs 6 (8%) patients in Group 2. The combined diseases were cerebrovascular accident, hypertension and diabetes mellitus in 22 $\sim$ 37% of the total patients. The occlusion sites were mainly in the iliac and femoral arteries. Endarterectomy was performed in 7 (9%) patients in Group 1 vs 18 (23%) patients in Group 2 (p=0.012). Treatment was successful in 27 (34%) patients in Group 1 and in 40 (52%) patients in Group 2 (p=0.019). Reocclusion occurred in 37(47%) patients in Group 1 vs 20 (26%) patients in Group 2 (p=0.000), Amputation was done in 4 (5%) patients in Group 1 vs 12 (16%) patients in Group 2 (p=0.012) and death occurred in 10 (13%) patients (Group 1) vs 3(4%) patients (Group 2) (p=0.044). Conclusion: The recent past has shown a decline in the effectiveness of simple Fogarty thromboembolectomy with a changing pattern of acute arterial occlusion from a rheumatic heart origin to atherosclerosis. Additional bypass procedures play a role for the treatment of arterial occlusion instead of always performing simple Fogarty thromboembolectomy.

The status of care satisfactions of the disabled persons with community-based rehabilitation plan (장애인의 치료만족도에 따른 지역사회중심재활에 관한 연구)

  • Lee In-Hak;Park Rae-Joon;Kim Mi-Ran
    • The Journal of Korean Physical Therapy
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    • v.10 no.2
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    • pp.13-32
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    • 1998
  • A questionaire was conducted to obtain ran satisfactions in information of the 325 disabled persons among the total 9,314 handicapped people in Taejon area, and was surveyed during the period of June 1 to August 31, 1997. The results are as follows: 1. Among the studied disabled persons, $54.5\%$ of male, and $45.5\%$ of female. 2. Before disabled in occupation, $32.0\%$ of out of work group were high, $6.5\%$ of farm, student group were low. Before disabled in occupation by gender, male group is $29.9\%$ of out of work group were high, $0.6\%$ of housework group were low. female group is$34.5\%$ of out of work group were high, $4.7\%$ of student group were low(P<0.001). 3. After disabled in occupation, $75.1\%$ of out of work group wert high, $10.8\%$ of in working group were low. After disabled in occupation by gender, male group is $87.6\%$ of out of work group were high, $1.7\%$ of housework group were low. female group is $60.1\%$ of out of work group were hgh, $10.8\%$ of in working group were low(P<0.001). 4. Medical security status, $64.9\%$ of medical aid group wore high, $35.1\%$ of medical insurance group were low. Medical security status by gender, male group is $71.2\%$ of medical aid group were high, $28.8\%$ of medical insurance group were Iew. female group is $57.4\%$ of medical aid group wan high, $42.6\%$ of medical insurance were low(P<0.01). 5. Disabled record status, $68.6\%$ of record group were high, $31.4\%$ of non group were low. Disabled record status by gender, male group is $78.5\%$ of record group were high, $21.5\%$ of non record group were low. female group is $56.6\%$ of record group were high, $43.4%$ of non record group were low(P<0.001). 6. Disabled duration status, $42.2\%$ of loss than 9 year group were high, $10.2\%\;of\;20-29,\;30-39$ year group were low. Disabled duration status by gender,'male group is $44.6\%$ of less than 9 year group were high, $6.2\%$ of 20-29 year group wert low. female group is $39.2\%$ of less than 9 year were high, $39.2\%$ of 30-39 year group were low (P<0.05). 7. Cause of disabled status, $26.5\%$ of other group, $23.7\%$ of congenital group were high. $9.2\%$ of unknown group, $6.8\%$ of industry accident, $2.5\%$ of drug poisoning group were low. Cause of disabled status by gender, male group is $27.7\%$ of other group, $23.7\%$ of congenital group were high, $2.3\%$ drug poisoning group were low. female group is $25.0\%$ of other group, $20.9\%$ of congenital group were high, $2.5\%$ of drug poisoning group were low (P<0.001). 8. Disabled type status, $19.4\%$ of double disabled group were high, $2.2\%$ of muscle paralysis group were low. Disabled type status by gender, male group is $22.0\%$ of double disabled group were high, $2.3\%$ of muscle paralysis group were low. female group is $23.3\%$ of rheumatism group were high, $0.7\%$ of amputation group were low(P<0.001). 9. Smoking status, $73.2\%$ of non smoking group were high, $26.8\%$ of smoking group were low. Smoking status by gender, male group is $59.9\%$ of double non smoking group were high, $40.1\%$ of Smoking group were low, female group is $89.2\%$ of non smoking group were high, $10.8\%$ of smoking group were low(P<0.001). 10. Drinking status, $80.0\%$ of non drinking group were high, $20.0\%$ of drinking group were low. Drinking status by gender, male group is $72.3\%$ of non drinking group were high, $27.7\%$ of drinking group were low. female group is $89.2\%$ of non drinking group were high, $10.8\%$ of drinking group were low(P<0.001). 11. Stress level status, $52.9\%$ of high stress group were high, $1.8\%$ of very severe stress group were low. Stress level status by gender, male group is $50.8\%$ of high stress group were high, $2.3\%$ of very severe stress group were low. female group is $55.4\%$of high stress group were high, $1.4\%$ of very severe stress group were low. 12. Heed status, $28.0\%$ of economic support were high, $4.6\%$ of speech therapy, brace group were low. Need status by Sender, male group is $2i2\%$ of economic support group were high, $4.5\%$ of bracegroup were low. female group is$27.7\%$ of economic support group were high, $3.4\%$ of speech therapy group were low. 13. Care satisfaction comparision, 3.09, 0.55 point of IBR, 4.01, 0.45 point of CHR(P<0.001). 14. The variables which had positive correlation with IBR were gender(r=0.1406, P<0.01), age(r=0.1872, p<0.001), economic level(r=0.1246, P<0.05), disabled record(r=0.1137, P<0.05), education level(r=-0.1122. p<0.05). 15. The variables which had positive : correlation with CBR were gender(r=0.1613, P<0.01), age(r=0.2255, P<0.001). list of family(r=0.12i3, P<0.01), disabled record(r=0.1273, P<0.05). education level(r=-0.1294, P<0.01).

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Influences of the devastated forest lands on flood damages (Observed at Chonbo and the neighbouring Mt. Jook-yop area) (황폐임야(荒廢林野)가 수해참상(水害慘狀)에 미치는 영향(影響) (천보산(天寶山)과 인접(隣接) 죽엽산(竹葉山)을 중심(中心)으로))

  • Chung, In Koo
    • Journal of Korean Society of Forest Science
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    • v.5 no.1
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    • pp.4-9
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    • 1966
  • 1. On 13 September 1964 a storm raged for 3 hours and 20 minutes with pounding heavy rainfalls, and precipitation of 287.5 mm was recorded on that day. The numerous landslides were occured in the eroded forest land neighbouring Mt. Chunbo, while no landslides recorde at all on Mt. Jookyup within the premise of Kwangnung Experiment Station, the Forest Experiment Station. 2. Small-scalled Landslides were occured in 43 different places of watershed area (21.97 ha.) in which the survey had already been done, in and around Mt. Chunbo (378 m a.s.l.). The accumulated soil amount totaled $2,146,56m^3$ due to the above mentioned landslides, while soil accumulated from riverside erosion has reached to $24,168.79m^3$, consisting of soils, stones, and pebbles. However, no landslides were reported in the Mt. Jook yup area because of dense forest covers. The ratio of the eroded soil amount accumulated from the riversides to that of watershed area was 1 to 25. On the other hand, the loss and damage in the research area of Mt. Chonbo are as follows: 28 houses completly destroyed or missing 7 houses partially destroyed 51 men were dead 5 missing, and 57 wounded. It was a terrible human disaster However, no human casualties were recorded at all, 1 house-completly destroyed and missing, 2 houses-partially destroyed. Total:3 houses were destroyed or damaged, in The area of Mt. Jookyup 3. In the calculation of the quanty of accumulated soil, the or mula of "V=1/3h ($a+{\sqrt{ab}}+b$)" was used and it showed that 24, 168.79m of soil, sands, stones and pebbles carried away. 4. Average slope of the stream stood 15 at the time of accident and well found that there was a correlation between the 87% of cross-area sufferd valley erosion and the length of eroded valley, after a study on regression and correlation of the length and cross-area. In other works, the soil erosion was and severe as we approached to the down-stream, counting at a place of average ($15^{\circ}1^{\prime}$) and below. We might draw a correlation such as "Y=ax-b" in terms of the length and cross-area of the eroded valley. 5. Sites of char-coal pits were found in the upper part of the desert-like Mt. Chunbo and a professional opinion shows that the mountain was once covered by the oak three species. Furthermore, we found that the soil of both mountains have been kept the same soil system according to a research of the soil cross-area. In other words, we can draw out the fact that, originally, the forest type and soil type of both Mt. Chunbo (378m) and Mt. Jookyup (610m) have been and are the same. However, Mt. Chunbo has been much more devastated than Mt. Jookyup, and carried away its soil nutrition to the extent that the ratios of N. $P_2O_5K_2O$ and Humus C.E.C between these two mountains are 1:10;1:5 respectively. 6. Mt. Chunbo has been mostly eroded for the past 30 years, and it consists of gravels of 2mm or larger size in the upper part of the mountain, while in the lower foot part, the sandy loam was formulated due to the fact that the gluey soil has been carried and accumulated. On the hand, Mt. Jookyup has consitantly kept the all the same forest type and sandy loam of brown colour both in the upper and lower parts. 7. As for the capability of absorbing and saturating maximum humidity by the surface soil, the ratios of wet soil to dry soil are 42.8% in the hill side and lower part of the eroded Mt. Chunbo and 28.5% in the upper part. On the contrary, Mt. Jookyup on which the forest type has not been changed, shows that the ratio in 77.4% in the hill-side and 68.2% in the upper part, approximately twice as much humidity as Mt. Chunbo. This proves the fact that the forest lands with dense forest covers are much more capable of maintaining water by wood, vegitation, and an organic material. The strength of dreventing from carring away surface soil is great due to the vigorous network of the root systems. 8. As mentioned above, the devastated forest land cause not only much greater devastation, but also human loss and property damage. We must bear in mind that the eroded forest land has taken the valuable soil, which is the very existance of origin of both human being and all creatures. As for the prescription for preventing erosion of forest land, the trees for furtilization has to be planted in the hill,side with at least reasonable amount of aertilizer, in order to restore the strength of earth soil, while in the lower part, thorough erosion control and reforestation, and establishments along the riversides have to be made, so as to restore the forest type.

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Analysis of the Risk Factors Influencing the Severity of Injury in Pediatric Multiple Trauma Patients (소아 다발성 외상 환자의 중증도에 영향을 미치는 위험인자에 관한 분석)

  • Lee, Gang-Wook;Kim, Sun-Pyo;Kim, Seong-Jung;Cho, Soo-Hyung;Cho, Nam-Soo
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.68-74
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    • 2010
  • Purpose: The purpose of this study is, first, to analyze the risk factors that influence the severity of injury in pediatric multiple trauma patients and, second, to present solutions for the problems related to the treatment of such patients. Our living situations are so complicated that the danger of accidents is truly open to children who are not prepared. We need to draw attention to the increased numbers of various accidents involving children. Methods: We studied patients who visited the Emergency Medical Center at Chosun University Hospital from January 1, 2006, to December 31, 2008. Using medical records, we evaluated the general characteristics: the mechanism of injury, the vital signs, the revised trauma score (RTS), the injury severity score (ISS), and the hemoglibin value, which was checked at the time of visit, and the presence or the absence of emergent on regular surgery. We divided the level of injury as follows: light level (1-8 points), mid level (9-15 points), and serious level (above 16 points). We analyzed the medical data by using SPSS 17.0 for windows. Results: The average age of the patients examined was 8.6 years. The number of 6- to 11-year-old patients was 96, which was the largest, but the degree of injury severity was the highest among infant (0-2 years), according to ISS 7.95(${\pm}6.85$). The frequency of accidents was highest on sunny days, and most accidents occurred from 16:00 to 20:00. The cause of multiple trauma for children was the greatest in the traffic accident, (95 patients, 49.0%). In addition, the trauma caused by traffic accidents showed the highest ISS value ($9.02{\pm}6.42$) and the most serious degree (P=0.004). The ISS level of injury ($8.40{\pm}6.64$) for patients moved from a secondary hospital was higher than that ($6.49{\pm}5.57$) for patients who visited the medical center directly. The severity of injury was highest for patients who used a 119 ambulance ($8.84{\pm}5.80$). According to the injured parts of body, Injuries to the arms and the feet most frequent (79 patients, 40.7%), but the level of injury was the highest for internal organs and chest, $16.42{\pm}8.56$ and $11.23{\pm}6.97$, respectively. Conclusion: We used Abbreviated Injury Scale (AIS) in order to examine the characteristics by injured body part for pediatric multiple trauma patients. Because the degree of injury was the highest for internal organs or the chest, we need to more seriously examine and provide for patients who are suspected of having injuries to the internal organs or the chest. We need to quickly determine the need for surgery in patients with serious injuries to the arms and the feet, which is the greatest in frequency. In particular, we need to consider the surgical care of patients who are not very high in the severity of injury to their brains.

Current Status and the Future Prospect of Rehabilitation Nursing in Korea (한국 재활간호 현황과 전망)

  • Kang, Hyun-Sook;Suh, Yeon-Ok;Lee, Hae-Sook
    • The Korean Journal of Rehabilitation Nursing
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    • v.4 no.2
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    • pp.240-247
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    • 2001
  • The history of rehabilitation of disabilities in Korea began with the foreigners and missionaries who were interested in it after Korean War. In 1981, Disabled Persons Welfare Act was enacted and the 88 Paralympics brought the nations attention to the welfare and rehabilitation of persons with disabilities. Since then, the facilities and the services for the disabled persons have expanded rapidly and the rehabilitation treatment and nursing intervention are drawing more attention. Against this background, the survey on the current status of disabilities, welfare service, facilities, and rehabilitation nursing was conducted. The results of this survey are as follows. 1. According to the 2000 census of disabilities, the number of persons with disabilities in Korea is estimated at 1,449,500, or 3.09% of the entire Korean population, 0.74% up from 2.35% in 1995. 2. Disability Types in 2000 The 2000 census showed that the persons with disabilities numbered 1,449,496 out of the total population and 1,024,371 persons are registered for disability, making up 70.7% of the estimated disabled population. Among them, physically disabled persons accounted for the largest 41.7% (605,127) and mentally retarded persons stood at the smallest 9% (13,481). 3. Percentage of Disability Presence The survey showed that more than 90% of disability were acquired. However, 44.8% of mental disability and 61.4% of hearing/speaking disability were not acquired after birth. This means that these disabilities happened by congenital cause or birth accident. 4. Yearly Figure of Registered Disabled Persons In 1989, 218,601 persons registered for disability and, in 2000, the number increased by 4.7 times to 1,024,371. These figures are different from the actual number of disabled persons. According to the 1995 census, 1,053,486 were disabled persons but only 378,323registered for disability. And, in the 2000 census, 1,024,371 out of the 1,449,496 of disabled persons registered for disability. 5. Welfare Service for Persons with Disability 62.6% of the total disabled people are registered and physically disabled persons accounted for the highest percentage of 96.7%. 26.5% of non-registered disabled people said that they didnt know the registration procedure. The rest of them replied that they didnt think they were disabled or that registration didnt seem to give any benefits. 6. Welfare Policies for Disabled Persons The welfare benefits given to the disabled are as follows: Issuance of disabled sign for car drivers, Permission to use LPG fuel, Communication fee reduction, Tax exemption related to cars, Reduction of public facility fees, Household allowance, Tax reduction or exemption, Medical allowance and education subsidy for children, and Housing. 7. Current Condition of Welfare Facilities by Disability Type The welfare institutions for disabilities numbered 188 in total and they can accommodate 16,823 persons. Categories of these institutions are physical disability(37), visual disability(10), hearing/speaking disability(14), mental retardation(59), and sanatoriums(68). 8. Human Resource of Rehabilitation of Disabilities Advanced education programs include rehabilitation nursing in its curriculum and this was selected as the program of Korean Academic Society of Nursing in 1990. In November 1997, Korean Academic Society of Rehabilitation Nursing was launched and many academic meeting and seminars were held. This organization is also making efforts to develop the education program for qualified rehabilitation nursing professionals and to develop the standards of rehabilitation nursing practice. In the professionals of the rehabilitation, there are rehabilitation specialist, physical therapist, speech therapist, occupational therapist. It is needed to come up with the measures to supply stable human resources following the demand of disabled persons and to recognize the private certificates for rehabilitation professionals as official ones after reviewing the education and training programs of private institutions. 9. Rehabilitation Nursing 1) Rehabilitation nursing was taught as an independent subject in 11 undergraduate programs and 9 graduate programs. 2) Research on rehabilitation nursing in Korea were 24 experimental research and 11 non-experimental research. The intervention of experimental research were mostly education and exercise rehabilitation programs. 3) In the three rehabilitation hospitals, nursing is divided into two categories, direct nursing and education & counseling. Direct nursing includes tracheostomy or nasogastric tube care, urination and defication, skin care, pain control, complication prevention and care, prevention of injury from a fall, etc.

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Legislative Study on the Mitigation of the Burden of Proof in Hospital Infection Cases - Focusing on the revised Bürgerliches Gesetzbuch - (병원감염 사건에서 증명책임 완화에 관한 입법적 고찰 - 개정 독일민법을 중심으로 -)

  • Yoo, Hyun Jung
    • The Korean Society of Law and Medicine
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    • v.16 no.2
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    • pp.159-193
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    • 2015
  • Owing to causes such as population aging, increased use of various medical devices, long-term hospitalization of various patients with reduced immune function such as cancer, diabetes, and organ transplant patients, and the growing size of hospitals, hospital infections are continuing to increase. As seen in the MERS crisis of 2015, hospital infections have become a social and national problem. In order to prevent damage due to such hospital infections, it is necessary to first strictly implement measures to prevent hospital infections, while, on the other hand, providing proper relief of damage suffered due to hospital infections. However, the mainstream attitude of judicial precedents relating to hospital infection cases has been judged to in fact shift responsibility over damages due to hospital infections on the patient. In light of the philosophy of the damage compensation system, whose guiding principle if the fair and proper apportionment of damages, there is a need to seek means of drastically relaxing the burden of proof on the patient's side relative to conventional legal principles for relaxing the burden of proof, or the theory of de facto estimation. In relation to such need, the German civil code (Burgerliches Gesetzbuch), which defines contracts of medical treatment as typical contracts under the civil code, and has presumption of negligence provisions stipulating that, in cases such as hospital infections which were completely under the control of the medical care providers, if risks in general medical treatment have been realized which cause violations of the life, body, or health of patients, error on the part of the person providing medical care is presumed, was examined. Contracts of medical treatment are entered into very frequently and broadly in the everyday lives of the general public, with various disputes owing thereto arising. Therefore, it is necessary to, by defining contracts of medical treatment as typical contracts under the civil code, regulate the content of said contracts, as well as the proof of burden when disputes arise. If stipulations in the civil code are premature as of yet, an option may be to regulate through a special act, as is the case with France. In the case of hospital infection cases, it is thought that 'legal presumption of negligence' relating to 'negligence in the occurrence of hospital infections,' which will create a state close to equality of arms, will aid the resolution of the realistic issue of the de facto impossibility of remedying damages occurring due to negligence in the process of occurrence of hospital infections. Also, even if negligence is presumed by law, as the patient side is burdened with proving the causal relationships, such drastic confusion as would occur if the medical care provider side is found fully liable if a hospital infection occurs may be avoided. It is thought that, alongside such efforts, social insurance policy must be improved so as to cover the expenses of medical institutions having strictly implemented efforts to prevent hospital infections in the event that they have suffered damages due to a hospital infection accident, and that close future research and examination into this matter will be required.

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A RETROSPECTIVE STUDY OF THE TRAUMATIC INJURIES IN THE PRIMARY AND PERMANENT TEETH (유치와 영구치의 외상에 관한 연구)

  • Heo, Su-Kyung;Choi, Nam-Ki;Kim, Seon-Mi;Yang, Kyu-Ho;Park, Ji-il
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.4
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    • pp.642-651
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    • 2008
  • This study was carried out to give basic information of traumatic injuries of primary and permanent teeth which can be used for diagnosis and management of injured teeth. From January 2003 to July 2007, 570 children with 1394 teeth who came to pediatric dentistry and emergency center of Chonnam National University Hospital due to the traumatized teeth participated in this study. The following data were investigated. : age, sex, causes and places of trauma, position of injured teeth, types of injury, and treatment at the first visit. 1. Trauma prevailed at the age of 1, $6{\sim}8$, $17{\sim}18$ and the rate of males was more likely to be higher than the rate of females(1.9 : 1). 2. The main cause of injury is a fall-down injury for primary and mixed dentition, but is a traffic accident and fighting for permanent dentition, respectably. The place of injury for primary dentition is mainly home(45.3%), while street for mixed and permanent dentition. 3. The position of injured teeth according to the area in the mouth is mainly maxillary anterior teeth in both case of primary and permanent teeth and especially, the ratio of central incisors is high. 4. The periodontal tissue injury occurred the most frequently in the primary and the permanent teeth, but the ratio of hard tissue injury in the permanent teeth increased, compared with the primary teeth. 5. Among treatments at the first visit, observation without actual treatment comprised 75.6% in the primary teeth and 55.4% in the permanent teeth, respectably. The pulp necrosis occurred in 20.3% of the primary teeth and 26.6% of the permanent teeth in the case of the periodontal tissue injuries, respectably.

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