• The Korean Society of Law and Medicine
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• v.8 no.1
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• pp.61-105
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• 2007

The Hospitalized Acquired Infection is defined as the case where the hidden infection or not found at the time of hospitalization occurs during the hospitalized period or, within 30 days to those who performed the surgery operation and then left the hospital. About 2/3 of the Hospitalized Acquired Infection are found as having the internal infection cases that are occurred by the patients' own virus due to the lowered immune system, while about 1/3 are found as having the external infection. The latter 1/3 of the external infection cases can be prevented through the infection management. And in case the new Hospitalized Acquired Infection case occur to the patient who was treated in the hospital, its responsibility issue will matter. As well in the disputes over the Hospitalized Acquired Infection cases, the cause-result relation between the damages and the medical staff's fault and as to whether there is failure of the medical staff or not. personnel should be proved in the medical-malpractice cases. In addition, the difficulties in proving such as expertise, secrecy propensity, discrete propensity and incompleteness will be considered to ease the burden of patient side's proving. Probability theory, Fact based assumption theory, Most adequate plaintiff preassumption or Expressed evidence theories are being discussed as the theories of eased burden of proof. In the result of gathering and reviewing Korea's precedent cases concerning the Hospitalized Acquired Infection, there are only a few accumulated prece dent cases and the attitude of the court also are also not consistent. Therefore, there are the precedents where the cause-result relation and the failure are immediately assumed when (1) timely proximity between the medical behavior and malpractice results, (2) proximity between the medical behavior-applied parts and the malpractice results-found parts, and (3) lack of other causes are separately evidenced; while the are the precedents only when 'the existence of the medical faults based on the common sense' is separately evidenced. It was found that the former and latter cases coexisted. The former is considered as based on the theory that separates the fault and cause-result relation not to consider them together, or regarded as based on the doubts that assumes the medical staff's neglect even though the Hospitalized Acquired Infection might be completely prevented by their efforts. However, the modern medical technology has the limitation as far as the prevention of the Hospitalized Acquired Infection. In conclusion, the assumption of the cause-result relation and that of the fault should be separately reviewed. Therefore, the latter precedents are considered as more reasonable, in the point the faulty behavior may be proved based on the common sense.

• Wind and Structures
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• v.38 no.1
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• pp.15-42
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• 2024

A flexible-base coupled-two-beam (CTB) discrete model with equivalent tuned mass dampers is used to assess the effect of soil-structure interaction (SSI) and different types of lateral resisting systems on the design of passive dynamic absorbers (PDAs) under the action of along-wind and across-wind loads due to vortex shedding. A total of five different PDAs are considered in this study: (1) tuned mass damper (TMD), (2) circular tuned sloshing damper (C-TSD), (3) rectangular tuned sloshing damper (R-TSD), (4) two-way liquid damper (TWLD) and (5) pendulum tuned mass damper (PTMD). By modifying the non-dimensional lateral stiffness ratio, the CTB model can consider lateral deformations varying from those of a flexural cantilever beam to those of a shear cantilever beam. The Monte Carlo simulation method was used to generate along-wind and across-wind loads correlated along the height of a real shear wall-frame building, which has similar fundamental periods of vibration and different modes of lateral deformation in the xz and yz planes, respectively. Ambient vibration tests were conducted on the building to identify its real lateral behavior and thus choose the most suitable parameters for the CTB model. Both alongwind and across-wind responses of the 144-meter-tall building were computed considering four soil types (hard rock, dense soil, stiff soil and soft soil) and a single PDA on its top, that is, 96 time-history analyses were carried out to assess the effect of SSI and lateral resisting system on the PDAs design. Based on the parametric analyses, the response significantly increases as the soil flexibility increases for both type of lateral wind loads, particularly for flexural-type deformations. The results show a great effectiveness of PDAs in controlling across-wind peak displacements and both along-wind and across-wind RMS accelerations, on the contrary, PDAs were ineffective in controlling along-wind peak displacements on all soil types and different kind of lateral deformation. Generally speaking, the maximum possible value of the PDA mass efficiency index increases as the soil flexibility increases, on the contrary, it decreases as the non-dimensional lateral stiffness ratio of the building increases; therefore, there is a significant increase of the vibration control effectiveness of PDAs for lateral flexural-type deformations on soft soils.

• Korean Journal of Social Welfare
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• v.60 no.2
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• pp.99-129
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• 2008

This study analyzed the resilience process of persons with disabilities using the grounded theory approach. To conduct this study, the researcher conducted in-depth interviews with 8 persons with disabilities. In data analysis, this study identified 393 concepts on the resilience process of persons with disabilities and the concepts were categorized into 45 sub-categories and 18 primary categories. In the paradigm model on the resilience process of persons with disabilities, it was identified that casual conditions included 'unawareness of disability before being disability', 'extreme pain', 'repressing psychological pain', and the contingent conditions were 'dis-empowerment by staying in home', 'isolation by himself with difficulty in accepting the disability', 'experience of frustration from social barriers with prejudice against persons with disabilities'. Also, it was identified that the resilience process could be dependent on the type and the degree of the disability, the gender, and the length of time being disability. In spite of the casual and contingent conditions, the central way in which persons with disabilities could acquire resilience was identified as 'enhancement of the power of positive thinking'. The control conditions which accelerate or retard central phenomenon were 'the awareness of not being alone through family, friends, neighborhood and the social system' externally and 'finding purpose in life through religion and help from other persons with disabilities', internally. The action/interactional sequences enhanced the efforts, self searching and active acting, and as a result, persons with disabilities could find comfort in life, participate in society and change the perspective of disability in society. The core categories of resilience process in persons with disabilities were a belief in affirmation and choice of life by initiative. In the process analysis, stages developed in the following: 'pain', 'strangeness', 'reflection', 'daily life'. This stage was more continuous and causal than discrete and complete. In this process, the types of resilience of persons with disabilities are divided into 'existence reflection', 'course development', 'implicit endeavor', and 'active execution'. This study showed the details of the paradigm models, the process and types with an in-depth understanding of the resilience process of persons with disabilities using grounded theory as well as theory construction and policy and clinical involvement on the study of persons with disabilities.

• Proceedings of the KOSOMBE Conference
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• v.1992 no.05
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• pp.27-47
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• 1992

Engineers have developed new instruments that aid in diagnosis and therapy Ultrasonic imaging has provided a nondamaging method of imaging internal organs. A complex transducer emits ultrasonic waves at many angles and reconstructs a map of internal anatomy and also velocities of blood in vessels. Fast computed tomography permits reconstruction of the 3-dimensional anatomy and perfusion of the heart at 20-Hz rates. Positron emission tomography uses certain isotopes that produce positrons that react with electrons to simultaneously emit two gamma rays in opposite directions. It locates the region of origin by using a ring of discrete scintillation detectors, each in electronic coincidence with an opposing detector. In magnetic resonance imaging, the patient is placed in a very strong magnetic field. The precessing of the hydrogen atoms is perturbed by an interrogating field to yield two-dimensional images of soft tissue having exceptional clarity. As an alternative to radiology image processing, film archiving, and retrieval, picture archiving and communication systems (PACS) are being implemented. Images from computed radiography, magnetic resonance imaging (MRI), nuclear medicine, and ultrasound are digitized, transmitted, and stored in computers for retrieval at distributed work stations. In electrical impedance tomography, electrodes are placed around the thorax. 50-kHz current is injected between two electrodes and voltages are measured on all other electrodes. A computer processes the data to yield an image of the resistivity of a 2-dimensional slice of the thorax. During fetal monitoring, a corkscrew electrode is screwed into the fetal scalp to measure the fetal electrocardiogram. Correlations with uterine contractions yield information on the status of the fetus during delivery To measure cardiac output by thermodilution, cold saline is injected into the right atrium. A thermistor in the right pulmonary artery yields temperature measurements, from which we can calculate cardiac output. In impedance cardiography, we measure the changes in electrical impedance as the heart ejects blood into the arteries. Motion artifacts are large, so signal averaging is useful during monitoring. An intraarterial blood gas monitoring system permits monitoring in real time. Light is sent down optical fibers inserted into the radial artery, where it is absorbed by dyes, which reemit the light at a different wavelength. The emitted light travels up optical fibers where an external instrument determines O2, CO2, and pH. Therapeutic devices include the electrosurgical unit. A high-frequency electric arc is drawn between the knife and the tissue. The arc cuts and the heat coagulates, thus preventing blood loss. Hyperthermia has demonstrated antitumor effects in patients in whom all conventional modes of therapy have failed. Methods of raising tumor temperature include focused ultrasound, radio-frequency power through needles, or microwaves. When the heart stops pumping, we use the defibrillator to restore normal pumping. A brief, high-current pulse through the heart synchronizes all cardiac fibers to restore normal rhythm. When the cardiac rhythm is too slow, we implant the cardiac pacemaker. An electrode within the heart stimulates the cardiac muscle to contract at the normal rate. When the cardiac valves are narrowed or leak, we implant an artificial valve. Silicone rubber and Teflon are used for biocompatibility. Artificial hearts powered by pneumatic hoses have been implanted in humans. However, the quality of life gradually degrades, and death ensues. When kidney stones develop, lithotripsy is used. A spark creates a pressure wave, which is focused on the stone and fragments it. The pieces pass out normally. When kidneys fail, the blood is cleansed during hemodialysis. Urea passes through a porous membrane to a dialysate bath to lower its concentration in the blood. The blind are able to read by scanning the Optacon with their fingertips. A camera scans letters and converts them to an array of vibrating pins. The deaf are able to hear using a cochlear implant. A microphone detects sound and divides it into frequency bands. 22 electrodes within the cochlea stimulate the acoustic the acoustic nerve to provide sound patterns. For those who have lost muscle function in the limbs, researchers are implanting electrodes to stimulate the muscle. Sensors in the legs and arms feed back signals to a computer that coordinates the stimulators to provide limb motion. For those with high spinal cord injury, a puff and sip switch can control a computer and permit the disabled person operate the computer and communicate with the outside world.

• Journal of Soil and Groundwater Environment
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• v.14 no.3
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• pp.40-46
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• 2009

The applicability of a well-type autotrophic sulfur-oxidizing reactive barrier (L $\times$ W $\times$ D = $3m\;{\times}\;4\;m\;{\times}\;2\;m$) as a long-term treatment option for nitrate removal in groundwater was evaluated. Pilot-scale (L $\times$ W $\times$ D = $8m\;{\times}\;4\;m\;{\times}\;2\;m$) flow-tank experiments were conducted to examine remedial efficacy of the well-type reactive barrier. A total of 80 kg sulfur granules as an electron donor and Thiobacillus denitrificans as an active bacterial species were prepared. Thiobacillus denitrificans was successfully colonized on the surface of the sulfur granules and the microflora transformed nitrate with removal efficiency of ~12% (0.07 mM) for 11 days, ~24% (1.3 mM) for 18 days, ~45% (2.4 mM) for 32 days, and ~52% (2.8 mM) for 60 days. Sulfur granules attached to Thiobacillus denitrificans were used to construct the well-type reactive barrier comprising three discrete barriers installed at 1-m interval downstream. Average initial nitrate concentrations were 181 mg/L for the first 28 days and 281 mg/L for the next 14 days. For the 181 mg/L (2.9 mM) plume, nitrate concentrations decreased by ~2% (0.06 mM), ~9% (0.27 mM), and ~15% (0.44 mM) after $1^{st}$, $2^{nd}$, and $3^{rd}$ barriers, respectively. For the 281 mg/L (4.5 mM) plume, nitrate concentrations decreased by ~1% (0.02 mM), ~6% (0.27 mM), and ~8% (0.37 mM) after $1^{st}$, $2^{nd}$, and $3^{rd}$ barriers, respectively. Nitrate plume was flowed through the flow-tank for 49 days by supplying $1.24\;m^3/d$ of nitrate solution. During nitrate treatment, flow velocity (0.44 m/d), pH (6.7 to 8.3), and DO (0.9~2.8 mg/L) showed little variations. Incomplete destruction of nitrate plume was attributed to the lack of retention time, rarely transverse dispersion, and inhibiting the activity of denitrification enzymes caused by relatively high DO concentrations. For field applications, it should be considered increments of retention time, modification of well placements, and intrinsic DO concentration.