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A Study on the Cooperation between Medical Care and Law - Focusing on the discussion of the role of clinical practice guideline in Japan - (의료와 사법(司法)의 협력 -일본에서의 진료가이드라인의 역할에 대한 논의를 중심으로-)

  • Song, young-min
    • The Korean Society of Law and Medicine
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    • v.23 no.2
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    • pp.39-65
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    • 2022
  • There are two aspects of clinical practice guidelines that act as non-legal control before medical practice and as legal control standards after medical practice. The essential purpose of clinical practice guidelines is the former, but the latter action cannot be excluded. The clinical practice guidelines are a means of linking law and medical care. The negative perception of clinical practice guidelines that medical professionals' autonomy can be violated by the enactment of clinical practice guidelines is an excessive negative evaluation of clinical practice guidelines. Rather, judicial judgment based on clinical practice guidelines plays a role in respecting the autonomy of medical professionals. In other words, the clinical practice guidelines suppress legal regulations on medical care as much as possible and are based on doctors' professional ethics and self-discipline, and patient awareness and cooperation. In order to establish an ideal relationship of cooperation between doctors and patients, 'medical ethics' must be incorporated as a legal means. Clinical practice guidelines are the most appropriate means for incorporating such medical ethics into legal procedures. The lawyer solves the case with a legal syllogism that establishes a norm and applies facts to it to conclude. For the resolution of medical disputes, Clinical practice guidelines are used to establish norms that doctors should perform for specific diseases, and conclusions are drawn by applying the established norms to specific medical practices. When it is not easy to apply the established norms to specific medical practices, medical judgments by experts, such as emotions, expert testimony, and explanations by expert members, are used. As such, the Law respects the autonomy of medical care even in the establishment of norms and the application of norms. In particular, Clinical practice guidelines prepared independently by the medical community are referred to in establishing norms, which are the prerequisites for legal syllogism. This shows that doctors participate in the formation of precedents and contribute to the formation of norms. The use of clinical practice guidelines in trials is respect and consideration for the autonomy of medical care. Although there may be an aspect in which the autonomy of individual doctors is limited by clinical practice guidelines, it should be considered that the autonomy of doctors as a group is respected. In this way, the clinical practice guidelines play a role in protecting the autonomy of the "medical" group from the logic of the "law."

A Study on the Correlation between Marine Industry Cluster and Port Regeneration - Focused on the Busan North Port - (해양산업 클러스터와 항만도시재생의 상관성에 관한 연구 - 부산 북항을 중심으로 -)

  • Li, Yun-Zhang;Yang, Ming-Yin;Tian, Xue-Qin;Yu, Yong-Hao;Choi, Tae-Yeong
    • Journal of Korea Port Economic Association
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    • v.38 no.1
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    • pp.101-111
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    • 2022
  • As Asia's leading advanced country, Korea has an absolute advantage over foreign trade routes and maritime economies over inland countries. Following the change in social background, the original port area is for various reasons, and some ills are gradually revealing people's private interests. Due to this, it is the economic interest and future development space of the marine industry cluster in the port area that are directly affected and damaged. This study studied the relationship between marine industry clusters and port urban regeneration. It is intended to present the necessity and importance of activating the marine industry cluster through port urban regeneration while analyzing the regenerative design from the quantitative analysis angle. Therefore, first of all, the theoretical backgrounds were considered, and the cases of port cities that did well worldwide were analyzed according to the current status of the northern port of Busan, the research target site, through analysis. In addition, in order to increase the reliability of this study, the data of marine industry clusters and port city regeneration were reviewed using empirical analysis. Looking at the results of this study's case study and empirical analysis, it is a relationship that actually improved and interacted between the marine industry cluster and the port city regeneration. Through the study, it is expected that the Busan North Port Redevelopment Project will be promoted at the design, environmental, and economic level, and at the same time, it will be able to enhance its status as a marine city in Busan. The results show that, no matter which country or port city, the development of economy, society, culture and will inevitably promote the vigorous development of the marine industrial cluster, also, the port area development to a certain degree. will naturally the physical conditions of regional development obstacle through the port city of regeneration. This promotion will overcome.

A Study on the Major Issues and Legislative Considerations of CCTV Installation in an Operating Room (수술실 CCTV 설치의 쟁점과 입법방향에 관한 소고(小考))

  • Kim, Sungeun;Choe, A Reum;Bae, Kyounghee
    • 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.

Analysis of the influence of existing parallel tunnels according to the location of the new tunnel (신설터널의 위치에 따른 기존 병렬터널의 영향 분석)

  • Yun, Ji-Seok;Kim, Han-Eol;Nam, Kyoung-Min;Jung, Ye-Rim;Cho, Jae-Eun;Yoo, Han-Kyu
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.24 no.2
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    • pp.193-215
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    • 2022
  • Recently, ground structures have reached saturation, and underground construction using underground structures such as tunnels has been in the spotlight as a way to solve increasing traffic difficulties and environmental problems. However, due to the increasing number of underground structures, close construction is inevitable for continuous underground development. When a new underground structure is constructed closely, stability may become weak due to the influence on the existing tunnel, which may cause collapse. Therefore, analyzing the stability of existing tunnels due to new structures is an essential consideration. In this study, the effect of excavating new tunnels under parallel tunnels on existing parallel tunnels was analyzed using numerical analysis. Using the Displacement Control Model (DCM), the volume loss generated during construction was simulated into three case (0.5%, 1.0%, and 1.5%). Based on the center of the pillar, the distance where the new tunnel is located was set to 5 m, 6 m, 7 m, 8 m, 9 m, and the space for each distance were set to 5 (0D1, 0.37D1, 0.75D1, 1.13D1, 1.5D1). In general, as the volume loss increased and the distance approached, the maximum displacement and angular displacement increased, and the strength/stress ratio to evaluate the stability of the pillar also decreased. As a result, when the distance between the new tunnel and the center of the pillar is 5 m, the space is 0D1, and the volume loss is 1.5%, the stability of the existing parallel tunnel is the weakest.

A Study on Infiltration Process and Physicochemical Influence in the Unsaturated and the Saturated Zone of the Bottom Ashes from Thermal Power Plant (화력발전소 배출 바닥재의 불포화대와 포화대 침투과정과 물리화학적 영향에 대한 연구)

  • Park, Byeong-Hak;Joun, Won-Tak;Ha, Seoung-Wook;Kim, Yongcheol;Choi, Hanna
    • Economic and Environmental Geology
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    • v.55 no.1
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    • pp.97-109
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    • 2022
  • This study focused on the physicochemical effects of bottom ash dissolved precipitation on the soil and groundwater environment. The iced column and percolation experiments showed that most of the bottom ash particles were drained as the ash-dissolved solution, while the charcoal powder was filtered through the soil. Ion species of Al, As, Cu, Cd, Cr, Pb, Fe, Mn, Ca, K, Si, F, NO3, SO4 were analyzed from the eluates collected during the 24 h column test. In the charcoal powder eluates, a high concentration of K was detected at the beginning of the reaction, but it decreased with time. The concentrations of Al and Ca were observed to increase with time, although they existed in trace amount. In the bottom ash eluates, the concentrations of Ca and SO4 decreased by 30 mg·L-1 and 67 mg·L-1, respectively, over 24 h. It is regarded that the infiltration patterns of the bottom ash and biochar in the unsaturated zone were different owing to their particle sizes and solvent properties. It is expected that a significant amount of the bottom ash will mix with the precipitation and percolate below the water table, especially in the case of thin and highly permeable unsaturated zone. The biochar was filtered through the unsaturated zone. The biochar did not dissolve in the groundwater, although it reached the saturation zone. For these reasons, it is considered that the direct contamination by the bottom ash and biochar are unlikely to occur.

A Qualitative Case Study of Service Learning in Small Christian Universities : Focusing on service learning effect and learning emotion (소규모 기독교 대학의 서비스러닝 질적사례 연구: 서비스러닝 효과와 학습정서를 중심으로)

  • Kim, Hyun Woo;Lee, Jeong Mee
    • Journal of Christian Education in Korea
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    • v.71
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    • pp.61-96
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    • 2022
  • This study tried to explore the ways to operate service learning more effectively by analyzing the educational effects of service learning and changes in learning sentiments that appeared in the service learning operation process established for the realization of the Christian educational philosophy at a small local Christian university. The analysis was conducted using NVivo11, focusing on the reflection journals of students who participated in service learning in the first semester of 2022 at J University. As a result of the study, through service learning, personal competence growth, self-reflection and will to change, self-esteem and self-efficacy, social and civic aspects, social responsibility enhancement, community (community) empathy and awareness of participation, and helping others There were educational effects such as an increase in the breadth of understanding. In addition, learning emotions that appeared in the service learning process included positive emotions such as gratitude, challenge recognition, pride, confidence, and responsibility, and negative emotions such as worry (difficulty), upset, regret, and awkwardness. It is a measure to increase the educational effect based on the learning emotion shown in the service learning process. When operating service learning, the service period at the visiting institution is increased to 6 weeks or more, and based on close interaction and detailed analysis of the educational environment in the planning stage, Suggest to develop and operate a plan. In addition, if you have the opportunity to receive feedback from your professors and colleagues through demonstrations and mock presentations in the classroom before visiting the institution, and finally have the opportunity to visit the institution again after the results of service learning are announced, more quality service learning education will be operated. Based on the results of this study, it is expected that more valuable and meaningful service learning education opportunities will be provided to learners by designing and operating a practical and sophisticated service learning curriculum.

Quantitative Assessment of Coronary Artery Diameter in Patients with Atrial Fibrillation and Normal Sinus Rhythm (심방세동 환자와 정상 심전도 환자의 관상동맥 직경 정량적 평가)

  • Seo, Young-Hyun
    • Journal of the Korean Society of Radiology
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    • v.16 no.5
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    • pp.567-574
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    • 2022
  • Coronary artery disease (CAD) and atrial fibrillation (AF) are known to share many risk factors. In particular, in the case of acute coronary syndrome, it may be difficult to clearly determine the diameter of the vessel due to complete occlusion of the vessel and thrombus. Thus, the relationship between the diameter of the coronary arteries was evaluated to be used as a reference data before the treatment of coronary arteries and drug selection in patients with AF. From January 2020 to August 2022, images of coronary angiography (CAG) with AF and normal sinus rhythm (NSR) on electrocardiography were target. In both subjects, images of normal coronary artery without lesions as a result of CAG were used. For all vessels, the diameters of the vessels were measured by dividing them into proximal, middle, and distal parts, and the measured diameters were divided by the average for evaluation. As a result of analyzing the left anterior descending artery diameter, the vessel diameter of the AF patient was 2.24±0.26 mm, which was smaller than that of the NSR patient, 2.86±0.38 mm, and was statistically significant. (p<0.001) As a result of analyzing the left circumflex artery diameter, the vessel diameter of the AF patient was 2.34±0.28 mm, which was smaller than the vessel diameter of the NSR patient, 2.87±0.29 mm, and was statistically significant. (p<0.001) As a result of analyzing the diameter of the right coronary artery, the vessel diameter of the AF patient was 2.68±0.5 mm, which was smaller than the vessel diameter of the NSR patient, 3.35±0.4 mm, and was statistically significant. (p<0.001) Considering that the coronary artery size of AF patients is significantly smaller than the coronary vessel size of NSR patients, it is considered as a useful study to be used as a reference for evaluating coronary artery diameter when the arrhythmia is AF. In particular, it is considered to be a study that can be helpful in diagnosing lesions, using drugs before and after surgery, and choosing to use auxiliary devices such as intravascular ultrasound.

Effect of Terephthalaldehyde to Facilitate Electron Transfer in Heme-mimic Catalyst and Its Use in Membraneless Hydrogen Peroxide Fuel Cell (테레프탈알데하이드의 전자전달 강화효과에 따른 헴 단백질 모방 촉매의 성능 향상 및 이를 이용한 비분리막형 과산화수소 연료전지)

  • Jeon, Sieun;An, Heeyeon;Chung, Yongjin
    • Korean Chemical Engineering Research
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    • v.60 no.4
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    • pp.588-593
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    • 2022
  • Terephthalaldehyde (TPA) is introduced as a cross liker to enhance electron transfer of hemin-based cathodic catalyst consisting of polyethyleneimine (PEI), carbon nanotube (CNT) for hydrogen peroxide reduction reaction (HPRR). In the cyclic voltammetry (CV) test with 10 mM H2O2 in phosphate buffer solution (pH 7.4), the current density for HPRR of the suggested catalyst (CNT/PEI/hemin/PEI/TPA) shows 0.2813 mA cm-2 (at 0.2 V vs. Ag/AgCl), which is 2.43 and 1.87 times of non-cross-linked (CNT/PEI/hemin/PEI) and conventional cross liker (glutaraldehyde, GA) used catalyst (CNT/PEI/hemin/PEI/GA), respectively. In the case of onset potential for HPRR, that of CNT/PEI/hemin/PEI/TPA is observed at 0.544 V, while those of CNT/PEI/hemin/PEI and CNT/PEI/hemin/PEI/GA are 0.511 and 0.471 V, respectively. These results indicate that TPA plays a role in facilitating electron transfer between the electrodes and substrates due to the π-conjugated cross-linking bonds, whereas conventional GA cross-linker increases the overpotential by interrupting electron and mass transfer. Electrochemical impedance spectroscopy (EIS) results also display the same tendency. The charge transfer resistance (Rct) of CNT/PEI/hemin/PEI/TPA decreases about 6.2% from that of CNT/PEI/hemin/PEI, while CNT/PEI/hemin/PEI/GA shows the highest Rct. The polarization curve using each catalyst also supports the superiority of TPA cross liker. The maximum power density of CNT/PEI/hemin/PEI/TPA (36.34±1.41 μWcm-2) is significantly higher than those of CNT/PEI/hemin/PEI (27.87±0.95 μWcm-2) and CNT/PEI/hemin/PEI/GA (25.57±1.32 μWcm-2), demonstrating again that the cathode using TPA has the best performance in HPRR.

Acoustic characteristics of speech-language pathologists related to their subjective vocal fatigue (언어재활사의 주관적 음성피로도와 관련된 음향적 특성)

  • Jeon, Hyewon;Kim, Jiyoun;Seong, Cheoljae
    • Phonetics and Speech Sciences
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    • v.14 no.3
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    • pp.87-101
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    • 2022
  • In addition to administering a questionnaire (J-survey), which questions individuals on subjective vocal fatigue, voice samples were collected before and after speech-language pathology sessions from 50 female speech-language pathologists in their 20s and 30s in the Daejeon and Chungnam areas. We identified significant differences in Korean Vocal Fatigue Index scores between the fatigue and non-fatigue groups, with the most prominent differences in sections one and two. Regarding acoustic phonetic characteristics, both groups showed a pattern in which low-frequency band energy was relatively low, and high-frequency band energy was increased after the treatment sessions. This trend was well reflected in the low-to-high ratio of vowels, slope LTAS, energy in the third formant, and energy in the 4,000-8,000 Hz range. A difference between the groups was observed only in the vowel energy of the low-frequency band (0-4,000 Hz) before treatment, with the non-fatigue group having a higher value than the fatigue group. This characteristic could be interpreted as a result of voice abuse and higher muscle tonus caused by long-term voice work. The perturbation parameter and shimmer local was lowered in the non-fatigue group after treatment, and the noise-to-harmonics ratio (NHR) was lowered in both groups following treatment. The decrease in NHR and the fall of shimmer local could be attributed to vocal cord hypertension, but it could be concluded that the effective voice use of speech-language pathologists also contributed to this effect, especially in the non-fatigue group. In the case of the non-fatigue group, the rhamonics-to-noise ratio increased significantly after treatment, indicating that the harmonic structure was more stable after treatment.

A Study on the Policy Direction of Space Composition of the Future School in Old High School - Focused on The Judgment of Space Relocation for the Application of the High School Credit System - (노후고등학교의 미래학교 공간구성 정책방향에 관한 연구 - 고교학점제 적용을 위한 공간 재배치 판단을 중심으로 -)

  • Lee, Jae-Lim
    • The Journal of Sustainable Design and Educational Environment Research
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    • v.21 no.3
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    • pp.1-13
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    • 2022
  • This study is a case study to identify the spatial composition and structural problems of existing schools for spatial innovation as a future school that can operate a credit system for old high schools and establish a mid-to-long-term arrangement plan as a credit system operating school capable of various teaching and learning in the future. The study results are as follows: First, most of the problems of the old high schools entailed that there was very poor connectivity between buildings as most of them were arranged in a single, standard design-type unit building and distributed in multiple buildings. In addition, the floor plan of each building is suggested to be a structure in which student exchange and rest functions cannot be achieved during the break period due to the spatial composition of the classroom and hallway concepts. Second, in the direction of the high school space configuration for future school space innovation, the arrangement plan should be established by reflecting the collective arrangement in consideration of the shortening of the movement route and the expansion of subject areas due to the movement of students on the premise of the subject classroom system. Moreover, it is desirable to provide a square-type space for rest and exchange in the central area where communication and exchange are possible according to the moving class. Third, as the evaluation criteria for relocating old high schools, a space program is prepared based on the number of classes in the future, and legal analysis of school land use and land use efficiency analysis considering regional characteristics are conducted. Based on such analysis data, mid-to-long-term land use plans and space arrangement plans for the entire school space such as the school facility complex are established.