$F{\ddot{u}}r$ den Schadensersatzhaftung des Arztes, sog. die Arzthaftung, ist es vornehmlich vorauszusetzen: die $Sch{\ddot{a}}digungsbehandlung$ des Arztes, die Rechtswidrigkeit und das Verschulden. Zur Problematik der $Fahrl{\ddot{a}}ssigkeit$ in der Stufe des Verschuldens handelt sich es in dieser Beitrag um die Kritisierung der Rechtsprechung. $F{\ddot{u}}r$ die Entscheidung des Verschulden im medizinischen Fehler kommt es darauf an, ob die Sorgfaltspflicht des Arztes verletzt wird. $Daf{\ddot{u}}r$ wird der medizinische Standard rekurriert, den die Rechtsprechung nicht aus materieller, sondern aus normativer Sicht begreift. Erstaunlich $un{\ddot{u}}bereinstimmend$ mit deren Leitsatz wird der medizinische Standard als $Ma{\ss}stab$ der Sorgfaltspflicht materiell - zutreffend nur im Ergebnis - behandelt. Die Sorgfaltspflicht in der Medizin bedeutet nicht die natur-wissenschaftliche Erkenntnisse, sondern eine "Best-$M{\ddot{u}}ssen$" Pflicht. Demnach ist der Standpunkt der Rechtsprechung, wonach den med. Standard normativ bewertet und die Sorgfaltspflicht darduch wieder normativ entscheidet, nicht anders als eine $w{\ddot{o}}rtliche$ Wiederholung. Die Arzthaftung in der Rechtsprechung ist aufgrund mit der Verneinung von der Sorgfaltspflichtverletzung nicht angenommen, welche in der Tat jedoch aus verschiedenen $Gr{\ddot{u}}nden$, wie die Rechtswidrigkeit, die $Fahrl{\ddot{a}}ssigkeit$ oder $Kausalit{\ddot{a}}t$, nicht angenommen. Der $Fahrl{\ddot{a}}ssigkeitsbeweis$ in der Rechtsprechung entwickelt sich mit dem Beweis nach objektivem $Ma{\ss}stab$, der Vermutung nach Anschein-Beweis und der $Beschr{\ddot{a}}nkung$ mit der Wahrscheinlichkeit. Bei Letzterem $geh{\ddot{o}}rt$ es $schlie{\ss}lich$ zum medizinischen Bereich. Ein Eintritt in den fachliche Bereich im Rahmen der Beweislast stellt der Beweiserleichterung $gegen{\ddot{u}}ber$. Aus diesem Hintergrund ist ${\S}630$ h Abs. 5 BGB bemerkenswert, wonach das Vorliegen eines groben Behandlungsfehler $regelm{\ddot{a}}{\ss}ig$ zur Vermutung von der $Kausalit{\ddot{a}}tszusammenhang$$f{\ddot{u}}hrt$. Dieser Paragraph ist inhaltlich als Beweislastumkehr angesehen. Damit ist es von Nutzen im Fall des groben Fehler, der beim - elementaren - kunstgerechten Verhalten nicht entstanden $h{\ddot{a}}tte$, wie $Hygienem{\ddot{a}}ngel$, ${\ddot{U}}berdosierung$ des Narkotikum.
Purpose: Hearing loss is one of the common birth defects in humans, with a reported prevalence of 1-3 per 1000 newborns. We investigated the incidence of hearing loss and evaluated the use of neonatal hearing screening test in neonatal intensive care unit (NICU) graduates who are at greater risk for hearing loss than normal newborns. Methods: The neonates admitted to the NICU of Asan Medical Center from 1 March, 2003 to 30 March, 2008 who were available for follow-up were included. Those who failed the first auditory brainstem response prior to discharge were retested with the stapedial reflex test, auditory brainstem response and tympanometry in the Otolaryngology department. Results: Of 2,137 neonates, 2,000 (93.5%) neonates were tested prior to discharge. Sixty-seven neonates (3.4%) failed the first newborn hearing screening test. Of 67 infants, 52 infants were retested for a second hearing test. Excluding 10 infants (19.2%) who were lost during follow-up, 16 infants were confirmed to have hearing impairment of which 12 and 4 infants had unilateral and bilateral hearing loss, respectively. Of 16 infants, 5 did not meet the criteria set by the Korean National Health Insurance Corporation. Conclusion: The prevalence of hearing impairment in NICU graduates is about 0.8%, excluding those who were lost for follow up, necessitating a systemic and effective hearing assessment program among these high risk infants and more generous national insurance coverage.
Background: Vocabularies originating from Chinese characters constitute an important common factor in the medical terminologies used 3 eastern Asian countries; Korea, China and Japan. This study was performed to comparatively analyze the medical terminologies of these 3 countries in the field of cardiopulmonary bypass (CPB) and; thereby, facilitate further understanding among the 3 medical societies. Material and Method: A total of 129 English terms (core 85 and related 44) in the field of CPB were selected and translated into each country's official terminology, with help from Seoul National University Hospital (Korea), Tokyo Michi Memorial Hospital(Japan), and Yanbian Welfare Hospital and Harbin Children Hospital (China). Dictionaries and CPB textbooks were also cited. In addition to the official terminology used in each country, the frequency of use of English terms in a clinical setting was also analyzed. Result and Conclusion: Among the 129 terms, 28 (21.7%) were identical between the 3 countries, as based on the Chinese characters. 86 terms were identical between only two countries, mostly between Korea and Japan. As a result, the identity rate in CPB terminology between Korea and Japan was 86.8%; whereas, between Korea and China and between Japan and China the rates were both 24.8%. The frequency of use of English terms in clinical practices was much higher in Korea and Japan than in China. Despite some inherent limitations involved in the analysis, this study can be a meaningful foundation in facilitating mutual understanding between the medical societies of these 3 eastern Asian countries.
The purpose of this study is to develop a on-line design tool for effectively coping with e-Business environment, or product design process into a Cyber model for traditional manufacturers which attempts new product development under such environment. It was finally developed as a model named $\ulcorner$Design Vortal Site; e-BVDS) that was based on the structure and style of internet web site. Results of the study can be described as follows ; \circled1 e-Business is based on the Internet. All processes in the context of e-Business require models whose structure and method of use are on-line styles. \circled2 In case that a traditional manufacturing business is converted into e-Business, it is better to first consider Hybrid Model that combines resources and advantages of both such traditional and digital businesses. \circled3 The product design process appropriate for e-Business environment has to have a structure and style that ensure utilization of the process as an Internet web site, active participation by product developers and interactive communication between participants in designing and designers. \circled4 $\ulcorner$e-BDVS) makes possible the use of designers around the wend like in-house designers, overcoming lack in creativity, ideas and human resources traditional business organizations face. However, the operation of $\ulcorner$e-BDVS$\lrcorner$ requires time and budget investments in securing related elements and conditions. \circled5 Cyber designers under $\ulcorner$e-BDVS$\lrcorner$ can easily perform all design projects in cyber space. But they have some limits in playing a role as designers and they have difficulty in getting rewards if such projects completed by them are not finally accepted. \circled6 $\ulcorner$e-BDVS) ensures the rapid use of a wide range of design information and data, reception of a variety of solutions and ideas and effective design development, all of which are not possible through traditional processes. However, this process may not be suitable to be used routine process or tool. \circled7 $\ulcorner$e-BDVS$\lrcorner$ makes it possible for out-sourcing or partners businesses to overcome restrictions in time and space and improve productivity and effectiveness. But such they may have to continue off-line works that can not be treated on-line.
In order to explain geomorphological characteristics of the Korean Peninsula, it is necessary to understand the spatial distribution of tectonic movements and its causes. Even though geomorphological elements which might have been formed by tectonic movements(e.g. tilted overall landform, erosion surface, river terrace, marine terraces, etc.) have long been considered as main geomorphological research topics in Korea, the knowledge on the spatial distribution of tectonic movement is still limited. This research aims to identify the spatial distributions of tectonic movement via sequential analyses of Digital Elevation Model(DEM). This paper first developed a set of terrain analysis techniques derived from theoretical interrelationships between tectonic uplifts and landsurface denudation processes. The terrain analyses used in this research assume that elevations along major drainage basin divides might preserve original landsurfaces(psuedo-landsuface) that were formed by tectonic movement with relatively little influence by denudation processes. Psuedo-landsurfaces derived from a DEM show clear spatial distribution patterns with distinct directional alignments. Lines connecting psuedo-landsufaces in a certain direction are defined as psuedo-landsurface axes, which are again categorized into two groups: the first is uplift psuedo-landsurface axes that indicate the axis of landmass uplift; and the second is denudational psuedo-landsurface axes that cross step-shaped pusedo-landsurfaces formed via surface denudation. In total, 13 axes of pusedo-landsurface are identified in the Korean Peninsula, which show distinct direction, length, and relative uplift rate. Judging from the distribution of psudo-landsurfaces and their axes, it is concluded that the Korean Peninsula ran be divided into four tectonic regions, which are named as the Northern Tectonic Region, Center Tectonic Region, Southern Tectonic Region, and East Sea Tectonic Region, respectively. The Northern Tectonic Region had experienced a regional uplift centered at the Kaema plateau, and the rate of uplift gradually decreased toward southern, western and eastern directions. The Center Tectonic Region shows an arch-shaped uplift. Its uplift rate is the highest along the East Sea and the rate decreases towards the Yellow sea. The Southern Tectonic Region shows an asymmetric uplift centered a line connecting Dukyu and Jiri Mountains in the middle of the region. The eastern side of the Southern Regions shows higher uplift rate than that of the western side. The East Sea Tectonic Region includes south-eastern coastal area of the peninsula and Gilju-Myeongchun Jigudae, which shows relatively recent tectonic movements in Korea. Since this research visualizes the spatial heterogeneity of long-term tenonic movement in the Korean peninsula, this would provide valuable basic information on long-term and regional differences of geomorphological evolutionary processes and regional geomorphological differences of the Korean Peninsula.
We are living in the time of high probability of technological risk due to increased rate of technology development and diffusion of new technologies. Resolving uncertainties, the basic attribution of risk, by accumulating knowledge over the risk factors of certain technology is critical to management of technological risk. In many cases of technological risks, high uncertainty of knowledge is commonly mentioned reason for public controversies on risk management. However, the type of technological risk with low social agreement and low uncertainty of knowledge, the main reason for public controversy is absence of social agreement. Public debates on the risks of mobile phones electromagnetic fields(EMF) to human health comes under this category. The knowledge uncertainty on human health effect of mobile phones EMF has been lowered increasingly by accumulating enormous volume of knowledge though scientists have not reached a final conclusion whether it pose a risk to the physical and mental health of the general population or not. In contrast with civil organizations calling for precautionary approach based regulation, the mobile phone industry is cling to the position of no-regulation-needed by arguing no clear evidence to prove health risks of mobile phone EMF has found. In Korea, government set exposure standards based on a measurement called the 'specific absorption rate'(SAR) and require the mobile phone industry to open SAR information to the public by their own decision. From the view of pro-regulation side based on precautionary approach, technology risk managament of mobile phones EMF in Korea is highly limited and formalized one with limited measuring of SAR on head part only and problematic self-regulated opening of information about SAR to the public. As far as the government keeps having priority on protecting interest of mobile phone industry over precautionary regulation of mobile phones EMF, the disagreement between civil organizations and the government will not resolved. The risk of mobile phones EMF to human health have high probability of being underestimated in the rate and damage of risk than objectively estimated ones due to familiarity of mobile phone technology. And this can be the cause of destructive social dispute or devastating disaster. To prevent such disastrous results, technology risk management, which integrating the goals of safety with economic growth in public policy and designing and promoting risk communication, is required.
Journal of the Korean Institute of Landscape Architecture
/
v.44
no.6
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pp.13-25
/
2016
This study aims to analyze the change process in order to set the improvement strategies for the zoo in the Seoul Children's Grand Park. The zoo can be reviewed through three significant time periods with noticeable changes. As a framework to analyze the major changes that happened in the zoo, this study looks at the changes in terms of the planning aspect as well as the animal welfare and program operation aspect. The findings are as follows: first, the era of general theme park turned out to have focused on exhibiting animals to meet visitor demands by expanding the zoo area of the zoo without enlarging stockyards for the animals. Second, the environmental park era created a zoo having entertaining and educational functions by arranging animal houses with the concept of zoological taxonomy and introducing animal behavioral enrichment, animal welfare programs and visitor participatory programs. The era of the zoo as an Urban Cultural Park improved old animal houses and facilities for the welfare of the animals and increased educational programs to preserve species and provide environmental education. The current status of the zoo turns out not to meet the conditions for creating an ecological zoo, which is the overall goal for contemporary zoos. The improvement strategies based on the analysis through three different eras are three-fold. First, the zoo needs to improve the boundary conditions of the animals to showcase animal wildness through landscape immersion. Second, the zoo should provide a shared environment for animals from the same habitats by changing the classification methods from the existing polyphyletic taxon to a classification that considers ecological habitat. Third, the zoo needs to develop various ecological education programs by supplementing specialists in professional education.
Purpose : To evaluate the changes of differential counts and lymphocyte subsets in cancer patients' leukocyte before and after radiotherapy. Materials and Methods : From Dec. 1994 to Mar 1995, the changes of leukocyte and its subsets in 16 patients who received radiotherapy in the Dept. of Radiation Oncology of Dong-A University Hospital were investigated. Radiation was delivered from 2700 cGy to 6660 cGy with median dose of 5400 cGy. The results of pre- and Post-radiotherapy were analyzed by paired T-test. The results of patients Who received < 50 Gy and $\geq$ 50 Gy were analyzed by Wilcoxon test. Results : Before and after radiotherapy, there was not any significant differences in the counts of leukocyte, granulocyte and monocyte. A remarkable decrease was noted in lymphocyte counts after radiotherapy(p=0.015). T cells, B cells and natural killer cells were also decreased in number after radiotherapy but it was not significant statistically. 1 helper cells and T suppressor cells were also decreased in number(p>0.05). The ratio of T helper/suppressor cell was decreased from 1.52 to 1, 11 and it was significant statistically(p=0.016). The portion of T suppressor cell among all T cells was increased after radiotherapy (p=0.0195). No significant difference was observed in the analysis of leukocyte and its subsets between patients who received < 50 Gy and $\geq$ 50 Gy, Conclusion : Radiotherapy caused remarkable decrease in lymphocyte count and its subsets. Among all lymphocyte subsets, T helper cell might be the most vulnerable to radiation, considering decreased ratio of T helper/suppressor cell count after radiotherapy.
Recently released a top secret document explicitly shows that the early development plan for an earth observation satellite in the USA has a hidden and more important purpose for a concept of 'free space' than the scientific purpose. At that time, the hidden and secret concept imbedded within the early space development plan prevail other national policies of the USA government for purpose of the national security. Under these circumstances, it is quite reasonable to accept a possibility that the meteorological satellites which play a key role in the every area of meteorology and climatology was also born for the hidden purposes. Even it is so, it is quite amazing that the first meteorological satellite is launched in the USA despite of the facts that the major users of the meteorological satellites were not very enthusiastic with the meteorological satellite and the program was not started as a formal meteorological satellite project. This was only possible because of the external socio-political impact caused by the successful launch of the Russian Sputnik satellite and a few key policy developers who favored the meteorological satellite program. It is also interesting to note that the beginning of the first Korean meteorological satellite program was initiated by a similar socio-political influence occurred by the launch of a North Korean satellite.
Eun, Baik-Lin;Moon, Jin Soo;Eun, So-Hee;Lee, Hea Kyoung;Shin, Son Moon;Seong, In Kyung;Chung, Hee Jung
Clinical and Experimental Pediatrics
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v.53
no.3
/
pp.300-306
/
2010
Purpose : Recent changes in the population structure of Korea, such as rapid decline in birth rate and exponential increase in old-aged people, prompted us to prepare a new health improvement program in children and adolescents. Methods : We reviewed current health screenings applied for children and adolescents in Korea and other developed countries. We collected and reviewed population-based data focused on mortality and morbidity, and other health-related statistical data. We generated problem lists in current systems and developed new principles. Results : Current health screening programs for children and adolescents were usually based on laboratory tests, such as blood tests, urinalysis, and radiologic tests. Almost all of these programs lacked evidence based on population data or controlled studies. In most developed countries, laboratory tests are used only very selectively, and they usually focus on primary prevention of diseases and health improvement using anticipatory guidance. In Korea, statistics on mortality and morbidity reveal that diseases related to lifestyle, such as obesity and metabolic syndrome, are increasing in all generations. Conclusion : We recommend a periodic health screening program with anticipatory guidance, which is focused on growth and developmental surveillance in infants and children. We no longer recommend old programs that are based on laboratory and radiologic examinations. School health screening programs should also be changed to meet current health issues, such as developing a healthier lifestyle to minimize risk behaviors—or example, good mental health, balanced nutrition, and more exercise.
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