• The Korean Society of Law and Medicine
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• v.13 no.1
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• pp.11-40
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• 2012

National Health Insurance Act has been enforced all over the People as part of the effort to assure the minimum constitutional human worth and dignity in the aspect of the right to pursue health for preventing misfortune that comes to death without even a chance to be received treatment for illness or injury. Meanwhile auto insurance is compulsory in certain parts in order to promote benefits of everyday life and the rapid recovery of the damage caused by traffic accident when one have negligently driven a car which has become the necessities in daily life. Any injured driver in a traffic accident can be treated by National Health Insurance without getting an auto insurance in various circumstances, but Article 3 paragraph 2 of Traffic Accident Act don't allow exception of criminal punishment when he has driven a car without license, drunken, or tresspassing the centerline, etc. When the injury occured by his own certain negligence is judged to 'when he has intentionally or through gross negligence caused a criminal conduct or intentionally contributed to the occurrence of an accident' of National Health Insurance Act, insurance benefits can be restricted. Such a restriction could harm the right to pursue happiness and health of People by depriving the poor, who cannot afford to pay, of chances to get treatment. Here we will see benefit restriction by 'gross negligence' of National Health Insurance Act Article 48 paragraph 1, which has largest portion of such restriction. It is desirable to delete 'gross negligence' clause from above paragraph and to interpret 'when' clause restrictively for diminishing confusion of interpreting and guaranteeing the right of health.

• Journal of Chest Surgery
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• v.25 no.3
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• pp.335-340
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• 1992

Truamatic aortic rupture is usually fatal if left untreated. Prompt diagnosis is the cornerstone of suscessful management. But the usual screening tests are non specific and the accuracy of computerized tomography is low, Aortography which is a time consuming procedure may result in false-positive interpretations and significant morbidity. Recently transesophageal echocardiography provides a rapid, effective and relatively safe means of evaluating the distal aortic arch and also affords the opportunity to evaluate the heart during the same study, which may be of benefit in cases of suspected cardiac injury. The experience with the traumatic aortic ruptured patient and a critical review of the literature suggests that transesophageal echocardiography is a useful technique for the diagnosis of ruptured aorta following blunt chest trauma.

• The Journal of Korean Physical Therapy
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• v.14 no.3
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• pp.145-173
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• 2002

This study was performed to investigate the effect of ultrasound irradiation on $TGF-\beta_1$ expression in the surgically injured achilles tendons of rats. The results of this study were as following: 1. The control group (3 days after injury) expressed little immunoreactivity for $TGF-\beta_1$. 2. In the experimental groups, $TGF-\beta_1$ immunoreactivity of group 11(applied US for 3 days) was increased markedly than that of group 1(applied US for 1 day). 3, The experimental group 11(applied US for 3 days) expressed higher immunoreactivity for $TGF-\beta_1$ than control group. These findings suggest that ultrasound irradiation on the injured Achilles tendon may be of benefit such as increasing $TGF-\beta$ release in the inflammatory phase of heal ins process.

• Korean Journal of Occupational Health Nursing
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• v.16 no.2
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• pp.188-196
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• 2007

Purpose: The objective of this study was to evaluate long-term care needs using RAI MDS-HC and MI-CHOICE among the disabled workers. Methods: Data were obtained from 45 personal care recipients with the disability of mental and nervous system, and analyzed using SAS 9.1 by applying t-test, ${\chi}^2$ test, or fisher's exact test. Results: Only 'bed mobility' and 'indoor ambulation' items of ADL and problem activity were statistically significant factors by the level of personal care benefit. By MICHOICE grouping, 20.0 percent of subjects belonged to nursing home group, 51.5 percent were home care service, 28.9 percent were intermittent personal care. Conclusion: Personal care services in industrial accident compensation insurance have been categorized with two groups according to level of disability. But our results could contribute to provide personal care service according to the long term care needs.

• 한국사회정책
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• v.23 no.1
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• pp.203-225
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• 2016

The permanent disability benefit(PDB) system whose purpose lies in helping affected workers with their self-realization through compensating them for their work-related injury or disease and facilitating their timely return to work is very important in terms of social welfare. Actually, the portions of PDB's in all WCI expenditures have been on the sharp increase. In spite of its positive aspects like this, however, an excessive amount of PDB's may have negative impacts on the affected workers' will to work or return to work, and increasing trends in the amount of PDB's payable in annuity will remain in an aging or aged society a potentially risky factor posing a threat to the soundness of WCI budgets. In this respect, the author attempted herein to identify the long-term reality of trends in the number of claimants entitled to PDB's and the amount of PDB's payable to them through making the long-term budget projections of PDB's; address problems with PDB's payable in annuity, which are or will potentially be one of the gravest burdens in securing the soundness of WCI budgets; and discuss how to optimize the amount of PDB's through studying & analyzing overseas cases and income replacement rates and what kinds of improvements are thinkable. It's recommended to reduce the absolute amount of benefits payable in annuity in a phased way considering claimants' life-cycle instead of sticking to the current system, which takes the form of lifelong pension plan.

• Journal of Veterinary Clinics
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• v.19 no.3
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• pp.299-302
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• 2002

Selectins are differentially expressed carbohydrate binding proteins involved in the initiation of tissue inflammation by mediating the rolling and tethering of leukocytes on the vascular endothelium. This primary event in initiation of inflammation, as occurs during reperfusion injury, can be therapeutically targeted using selectin inhibitors, which generally block binding of sLex to E-, P-, and L-selectins. The objective of this study was to determine the role of selectins in renal ischemia/reperfusion injury after kidney transplantation. Canine kidneys were subjected to 60-min warm ischemia, flushed with UW solution, cold stored for 24 h, and autotransplanted into the nephrectomized donor. Renal autografts were monitored for 7 days by serum creatinine in the first study and by histology and myeloperoxidase activity after 4-hour reperfusion in the second study. In each study, one group of animals received TBC1269 (selectin inhibitor) and the other received saline vehicle. Serum creatinine rose quickly after transplantation and was not different between the groups. TBC1269 abolished a reperfusion-induced 2-fold increase in renal cortex neutrophil infiltration and improved histologic signs of ischemia after 4 hours of reperfusion. Selectin blockade does not improve the course of injury caused by warm renal ischemia. A minor benefit associated with the inhibition of early inflammation during reperfusion after kidney transplantation seems to occur.

• Journal of Trauma and Injury
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• v.35 no.3
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• pp.173-180
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• 2022

Purpose: The use of surgical stabilization of rib fractures (SSRF) has steadily increased over the past decade. Recent literature suggests that a larger population may benefit from SSRF, and that the geriatric population-as the highest-risk population-may receive the greatest improvement from these interventions. We sought to determine the overall utilization of SSRF in the United States. Methods: The National Trauma Database was analyzed between 2016 and 2017. The inclusion criteria were all patients ≥65 years old with rib fractures. We further stratified these patients according to age (65-79 vs. ≥80 years old), the presence of coding for flail chest, three or more rib fractures, and intervention (surgical vs. nonoperative management). The main outcomes were surgical interventions, mortality, pneumonia, length of stay, intensive care unit length of stay, ventilator use, and tracheostomy. Results: Overall, 93,638 patients were identified. SSRF was performed in 992 patients. Patients who underwent SSRF had improved mortality in the 65 to 79 age group, regardless of the number of ribs fractured. We identified 92,637 patients in the age group of 65 to 79 years old who did not undergo SSRF. This represents an additional 20,000 patients annually who may benefit from SSRF. Conclusions: By conservative standards and the well-established Eastern Association for the Surgery of Trauma clinical practice guidelines, SSRF is underutilized. Our data suggest that SSRF may be very beneficial for the geriatric population, specifically those aged 65 to 79 years with any rib fractures. We hypothesize that roughly 20,000 additional cases will meet the inclusion criteria for SSRF each year. It is therefore imperative that we train acute care surgeons in this skill set.

• Journal of Chest Surgery
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• v.22 no.4
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• pp.698-704
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• 1989

We experienced the seven cases of penetrating and non-penetrating cardiac injuries combined with cardiac tamponade from June 1986 to June 1989 at Seoul and Chun-An Hospital of SOONCHUNHYANG medical college. The results were as follows. l. In sex distribution, 7 cases were male. In age distribution, The fourth decades occupied about 58 % of all cases. 2. In mode of injury, 4 cases were stab wounds, 1 case penetration by metallic fragment, 2 cases blunt chest trauma. 3. We routinely checked the CVP with subclavian vein catheterization in case of suspicious cardiac tamponade. Significant increments were showed in 4 cases. 4. Becks triad [low blood pressure, raised central venous pressure, distant heart sound] were recorded in 43 % of the cases with proven tamponades. 5. The sites of injury included RV in 4 cases, LV in 1 case, RA in 1 case and branch of RCA in 1 case. The RV injuries were the most common. 6. Coronary artery damage occurred in 2 cases. LADA was severed in 1 case combined with RV rupture and branch of RCA was torn 1 case. 7. Pericardiocentesis was performed 1 case at another hospital before referring to our hospital. We have never used the procedure because we think that it is potentially dangerous with no clear benefit. 8. Subxyphoid pericardial window was performed in 2 cases of severe cardiac tamponade. We have employed this method to stabilize the patients who had systolic hypotension. 9. Surgical approaches were performed with median sternotomy in 3 cases, thoracotomy in 4 cases. 10. We undertook the simple closure in 6 penetrating cardiac wounds. The removal of impacted metallic fragment was performed under the cardiopulmonary bypass. Simple ligation was performed in 2 cases of coronary artery severance 11. One patient with no sign of life was urgently intubated and undertaken an emergency room thoracotomy on the stretch car without antiseptic preparation. The cardiorrhaphy in 6 cases were performed in the operating theater 12. One patient undertaken emergency room thoracotomy did not survive due to refractory hypovolemic shock. But the remaining 6 patients recovered.

• The Korean Journal of Physiology and Pharmacology
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• v.13 no.3
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• pp.257-263
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• 2009

This study aimed to investigate whether selective serotonin reuptake inhibitors (SSRIs) attenuate brain injury and facilitate recovery following photothrombotic cortical ischemia in mice. Male ICR mice were anesthetized and systemically administered Rose Bengal. Permanent focal ischemia was induced in the medial frontal and somatosensory cortices by irradiating the skull with cold light laser. The animals were treated with fluoxetine or sertraline once a day for 14 d starting 1 h after ischemic insult. Treatment with fluoxetine and sertraline significantly reduced the infarct size. The Evans blue extravasation indices of the fluoxetine- and sertraline-treated groups were significantly lower than that of the vehicle group. Treatment with fluoxetine and sertraline shifted the lower limit of the mean arterial blood pressure for cerebral blood flow autoregulation toward normal, and significantly increased the expression of heme oxygenase-1 (HO-1) and hypoxia-inducible factor-1 ${\alpha}$ (HIF-1 ${\alpha}$) proteins in the ischemic region. These results suggest that SSRIs, such as fluoxetine and sertraline, facilitate recovery following photothrombotic cortical ischemia via enhancement of HO-1 and HIF-1 ${\alpha}$ proteins expression, thereby providing a benefit in therapy of cerebral ischemia.

• Journal of Yeungnam Medical Science
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• v.17 no.1
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• pp.12-20
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• 2000

The memory of pain can be more damaging than its initial experience. Several factors arc related the directions of pain memory: current pain intensity, emotion, expectation of pain, and peak intensity of previous pain. The possible mechanisms behind the memory of pain are neuroplastic changes of nervous system via peripheral and central sensitization. Peripheral sensitization is induced by neurohumoral alterations at the site of injury and nearby. Biochemicals such as K+, prostaglandins, bradykinin, substance P, histamine and serotonin, increase transduction and produce continuous nociceptive input. Central sensitization takes place within the dorsal horn of spinal cord and amplifies the nociceptive input from the periphery. The mechanisms of central sensitization involve a variety of transmitters and postsynaptic mechanisms resulting from the activations of NMDA receptors by glutamate. and activation of NK-1 tachykinnin receptors by substance-P and neurokinnin. The clinical result of peripheral and central sensitization is hyperalgesia, allodynia, spontaneous pain, referred pain, or sympathetically maintained pain. These persistent sensory responses to noxious stimuli arc a form of memory. The hypothesis of preemptive analgesia is that analgesia administered before the painful stimulus will prevent or reduce subsequent pain and analgesic requirements in comparison to the identical analgesic intervention administered after the painful stimulus, by preventing or reducing the memory of pain in the nervous system. Conventionally, pain management was initiated following noxious stimuli such as surgery. More recently, however many have endorsed preemptive analgesia initiated before surgery. Treatments to control postsurgical pain are often best started before injury activates peripheral nociceptors and triggers central sensitization. Such preemption is not achieved solely by regional anesthesia and drug therapy but also requires behavioral interventions to decrease anxiety or stress. Although the benefit of preemptive analgesia may not be obvious in every circumstance, and in many cases may not sufficient to abolish central sensitization, it is an appropriate and human goal of clinical practice.