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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 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.

Riparian Vegetation Monitoring and Health Assessment by Pilot Opening of Nakdonggang River Estuary (낙동강하구 시범개방에 따른 수변식생 모니터링 및 건강성 평가)

  • Choi, Hyun-Gu;Kim, Hwa-Young;Lee, Jun-Yeol;Sohn, Byeong-Yong;Lee, Ji-Young
    • Korean Journal of Environment and Ecology
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    • v.36 no.5
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    • pp.445-459
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    • 2022
  • In this study, we investigated current vegetation and assessed the health of vegetation through the KERVI (Korea Estuary Riparian Vegetation Index) to monitor vegetation changes near estuaries due to the opening of the Nakdong River estuary. As the first investigation of the long-term monitoring, six areas near the Nakdong River estuary were surveyed twice in July and October 2021, and vegetation monitoring and a survey of species composition and distribution density of aquatic, riparian, and land plants were carried out. The survey identified 262 taxa, 82 families, 192 genera, 196 species, 3 subspecies, 26 varieties, and 1 form of vascular plants in the surveyed area. The results of the vegetation health assessment through KREVI showed that sites 1 and 6 were rated "Very good" in both surveys, sites 2 and 4 were rated "Very good" in the first survey and then "Good"in the second survey, and site 3 and 5 were rated one grade higher in the second survey than the first survey. The assessment showed that the health grades of most species in the survey area were generally high. Most of the potential natural vegetation after the opening of estuary gates to create a brackish water area is expected to consist of reed (Phragmites communisTrin.) communities. The area of the willow (Salix koreensisAndersson) community adjacent to the water area may be somewhat narrower, but the community will be maintained. In the case of freshwater areas in inland areas with very low salinity, reeds (Phragmites communisTrin.) are expected to occupy most of them, and some communities such as amur silver-grass (Miscanthus sacchariflorusBenth.) and cattails (Typha orientalisC. Presl) are expected to be distributed. We suggest establishing measures such as estuary gate operation to create healthy brackish water regions through long-term monitoring.

A Study of Masterplot of Disaster Narrative between Korea, the US and Japan (한·미·일 재난 서사의 마스터플롯 비교 연구)

  • Park, In-Seong
    • Journal of Popular Narrative
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    • v.26 no.2
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    • pp.39-85
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    • 2020
  • This paper examines the aspects of disaster narrative, which makes the most of the concept of 'masterplot' as a narrative simulation to solve problems. By analyzing and comparing the remnants of 'masterplots' operating in the disaster narratives of Korea, the United States, and Japan, the differences between each country and social community problem recognition and resolution will be discussed. Disaster narrative is the most suitable genre for applying the 'masterplot' toward community problem solving in today's global risk society, and the problem-solving method has cognitive differences for each community. First, in the case of American disaster narratives, civilian experts' response to natural disasters tracks the changes of heroes in today's 'Marvel Comic Universe' (MCU). Compared to the past, the close relationship between heroism and nationalism has been reduced, but the state remains functional even if it is bolstered by the heroes' voluntary cooperation and reflection ability. On the other hand, in Korea's disaster narratives, the disappearance of the country and paralysis of the function are foregrounded. In order to fill the void, a new family narrative occurs, consisting of a righteous army or people abandoned by the state. Korea's disaster narratives are sensitive to changes after the disaster, and the nation's recovery never returns to normal after the disaster. Finally, Japan's disaster narratives are defensive and neurotic. A fully state-led bureaucratic system depicts an obsessive nationalism that seeks to control all disasters, or even counteracts anti-heroic individuals who reject voluntary sacrifices and even abandon disaster conditions This paper was able to diagnose the impact and value of a 'masterplot' today by comparing a series of 'masterplots' and their variations and uses. In a time when the understanding and utilization of 'masterplots' are becoming more and more important in today's world where Over-the top(OTT) services are being provided worldwide, this paper attempt could be a fragmentary model for the distribution and sharing of global stories.

Comparison of the Video Dramas Based on Yoon Sim-duk, Kim Woo-jin and Reconsidering the Movie Praise of Death(1991) (윤심덕과 김우진 소재 영상물 비교 및 영화 <사의 찬미>(1991) 재론)

  • Chung, Woo-Suk
    • Journal of Popular Narrative
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    • v.26 no.4
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    • pp.43-76
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    • 2020
  • After comparing three video dramas based on Yoon Sim-duk and Kim Woo-jin, this paper intensively explores the movie Praise of Death(1991), which has the most meaningful traits in embodying the characters, focusing on the relationship with the previous works of the director or an actress. The movie Yoon Sim-duk(1969) focuses on meiodramatic narrative around the issue like love triangle or a relationship between out-of-wedlock woman and the wife of one man. The TV drama Praise of Death(2018) is pursuing ideal youth genre between attractive two lovers adorning even the suffering of the Japanese occupation with customary visual image. In comparison, the movie Praise of Death(1991) focuses on visual beauty, while overlaps the agony of two characters as pioneering artists with frustrated love narrative. In the process, this film reveals two-sided characteristics, especially the heroine, compared to the other two. She shows a rift between the passivity for the salvation of man and the activity of choosing even the fall of her own life. In order to examine this trait, we have to explore the other works which affect the movie Praise of Death. This came from the tendency director Kim Ho-sun and actress Jang Mi-hee had built in 1970s films. It also relates in the movies Jang Mi-hee had worked with director bae Chang-ho in the 1980s. The tendency to show a pursuit of classical cultures in the field of popular movies, and to overlap the problems of desire, including sexuality, with mental and intellectual issues, continues from the previous films to the movie Praise of Death for shaping a main female character. This study results in examining the movie Praise of Death in two contexts. One is the context of three video dramas having same materials, Yoon Sim-duk and Kim Woo-jin. And other is the context of the works that director Kim Ho-sun and actress Jang Mi-hee have continued together, or the works that Jang Mi-hee have continued with director Bae Chang-ho. Until now, Yoon Sim-duk and Kim Woo-jin has been used as a material for cultural contents in the various genres over and over again. Under this circumstance, by looking at this movie, one of representative case dealing with Yoon and Kim, in the complex context, it can reaffirm the effect and difficulty in fictionalisation of them as a subject matter.

Exploring A Research Trend on Entrepreneurial Ecosystem in the 40 Years of the Asia Pacific Journal of Small Business for the Development of Ecosystem Measurement Framework (「중소기업연구」 40년 동안의 창업생태계 연구 동향 고찰 및 측정모형 개발을 위한 탐색적 연구)

  • Seo, Ribin;Choi, Kyung Cheol;Byun, Youngjo
    • Korean small business review
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    • v.42 no.4
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    • pp.69-102
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    • 2020
  • Shedding new light on the research trend on entrepreneurial ecosystems in the 40-year history of the Asia Pacific Journal of Small Business, this study aims at exploring a potential measurement framework of ecological inputs and outputs in an entrepreneurial ecosystem that promotes entrepreneurship at geographical and spatial levels. As a result of the analysis of research on the entrepreneurial ecosystem in the journal, we found that prior studies emphasized the managerial importance of various ecological factors on the premise of possible causalities between the factors and entrepreneurship. However, empirical research to verify the premised causality has been underexplored yet. This literature gap may lead to unbalanced development of conceptual and case studies that identify requirements for successful entrepreneurial ecosystems based on experiential facts, thereby hindering the generalization of the research results for practical implications. In that there is a growing interest in creating and operating productive entrepreneurial ecosystems as an innovation engine that drives national and regional economic growth, it is necessary to explore and develop the measurement framework for ecological factors that can be used in future empirical research. Hereupon, we apply a conceptual model of 'input-output-outcome-impact' to categorize individual environmental factors identified in prior studies. Based on the model. We operationalize ecological input factors as the financial, intellectual, institutional, and social capitals, and ecological output factors as the establishment-based, innovation-based, and performance-based entrepreneurship. Also, we propose several longitudinal databases that future empirical research can use in analyzing the potential causality between the ecological input and output factors. The proposed framework of entrepreneurial ecosystems, which focuses on measuring ecological input and output factors, has a high application value for future research that analyzes the causality.

The Research Trend and Narrative Expandability of Borderlands Studies in Europe and North America -A Review Article: Globalizing Borderlands Studies in Europe and North America (유럽과 북미에서의 접경지대 연구 동향과 서사의 확장성 -『유럽과 북미 지역 접경지대 연구의 세계화』 읽기)

  • Ban, Kee-Hyun
    • Journal of Popular Narrative
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    • v.26 no.2
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    • pp.251-276
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    • 2020
  • The purpose of this article is to critically read Globalizing Borderlands Studies in Europe and North America to examine trends in border studies conducted so far in Europe and North America and to discuss the expandability and limitations of the narrative. It introduces a variety of case studies covering the borderlands of Europe and North America from ancient to modern times. It consists of a total of 10 chapters, in addition to the introduction chapter to clarify the purpose and definition of the collaboration and the short conclusion chapter on the prospects for the future of borderlands studies. This volume has some important implications for current borderland research in two main respects. First, it can introduce us we the areas and targets that the leading researchers from European and North American academia (usually the United States') have paid attention to. It also examines the current status of borderland research and predicts whether it will be possible to study various border areas where exist in other regions (especially in Asia) based on accumulating academic achievements, as well as the possibility of expansion of so-called 'globalization'. Second, it introduces the borderland as a conceptual space, beyond the border area as a physical space that is commonly thought of when it comes to 'border'. Cases of "conceptual borderlands" can be applied to a number of topics ranging from an individual's identities to the methods of governance, religions, economies, social institutions, families, labor issues, public health services and gender issues. There are, however, also some questions to be noted in the volume: the lack of consistent use of terminology, which can be considered general problems of collaboration studies; the fact that the authors still tend to understand borderlands within the imperialist discourse, perhaps because of their academic background is situated mainly in Europe and North America; the borderlands cases described here as the areas of conflict and struggle only. Nevertheless, the book is of significance in that it suggests a possibility of various borderlands studies and helps us to have better understanding of the current geopolitical situation imposed on the Korean Peninsula, which is located on the borderland between the continental and maritime powers.

Comparison of Anti-inflammatory, Skin Barrier Improvement, and Anti-aging Efficacy of Eleutherococcus divaricatus var. chiisanensis and various Eleutherococcus Genus Extract (지리산오갈피, 가시오갈피, 오갈피나무, 오가나무 추출물의 항염증, 피부장벽개선, 항노화 효능 비교)

  • Jiwon, Han;Bomi, Nam;Beom seok, Lee;Jin-A, Ko;Jiyoung, Hwang
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.48 no.4
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    • pp.373-383
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    • 2022
  • Inflammation caused by active oxygen and the resulting barrier damage have been consistently pointed out as the cause of wrinkle formation. In this study, effective index ingredient search and efficacy analysis were performed to verify the value of use as a functional cosmetic material related to antioxidant, anti-inflammatory and skin barrier improvement, and anti-aging for extracts of four types of Eleutherococcus divaricatus var. chiisanensis (ED), Eleutherococcus senticosus (EN), Eleutherococcus sessiliflorus (ES), and Eleutherococcus sieboldianus (EI) belonging to the Eleutherococcus genus. To identify the effective index composition, the content of the ingredients was measured by high-performance liquid chromatography. The content of eleutheroside E and chlorogenic acid was the highest in ED among the Eleutherococcus genus. As for anti-oxidant activity, DPPH radical scavenging activity was the highest in ED. In anti-inflammatory effects, ED extracts inhibited nitric oxide generation in inflammatory macrophage cells due to lipopolysaccharide by 40% at 100 ㎍/mL. In the case of IL-6 inhibition, which is known as a pro-inflammatory cytokine, ED showed 41% inhibition at 100 ㎍/mL. In addition, filaggrin and involucrin, which are skin barrier-related factors, were increased by 2.5 times and 1.6 times, respectively, in 100 ㎍/mL of ED extracts, and as for the collagenase, which is a wrinkle-related factor, ED extract showed 29% efficacy at 100 ㎍/mL. Thus, these result suggested that ED extract, among the four Eleutherococcus genus, can be used as a cosmetic ingredient for suppressing inflammation in the skin, reinforcing the skin barrier, and reducing wrinkles.

Effect of Chlorine Dioxide, Cold Plasma Gas Sterilization and MAP Treatment on the Quality and Microbiological Changes of Paprika During Storage (이산화염소 및 저온 플라즈마 가스 살균 및 MAP 처리가 파프리카의 저장 중 품질과 미생물학적 변화에 미치는 영향)

  • In-Lee, Choi;Joo Hwan, Lee;Yong Beom, Kwon;Yoo Han, Roh;Ho-Min, Kang
    • KOREAN JOURNAL OF PACKAGING SCIENCE & TECHNOLOGY
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    • v.28 no.3
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    • pp.223-229
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    • 2022
  • This study was conducted to investigate the effect of packaging methods and sterilization treatment on storability and microbial control in paprika fruits. When treated with chlorine dioxide gas for 3, 6, and 12 hours and cold plasma gas for 1, 3, and 6 hours, and then packed in a carton box and stored in a 8 ± 1℃ chamber for 7 days, chlorine dioxide treated 12 hours and plasma treated 6 hours was prevented the development of E·coli and YM(yeast and mold). Accordingly, the control was treated with chlorine dioxide for 12 hours and plasma for 6 hours, packed using a carton box and 40,000 cc·m-2·day-1·atm-1 OTR film (MAP), and stored in a 8 ± 1℃ chamber for 20 days. Fresh weight loss rate during storage was less than 1% in the MAP treatments, and the visual quality of the MAP treatments was above the marketability limit until the end of storage. There was no difference in the contents of oxygen, carbon dioxide, and ethylene in the film. In the case of firmness, the chlorine dioxide treatments was low, and the Hunter a* value, which showed chromaticity, was highest in the Plasma 6h MAP treatment. Off-odor was investigated in the MAP treatments, but it was very low. The rate of mold growth on the fruit stalk of paprika was the fastest and highest in the chlorine dioxide treated box packaging treatments, and the lowest in the chlorine dioxide treated MAP treatments at the end of storage. The aerobic count in the pulp on the storage end date was the lowest in the plasma treated box packaging treatments, the lowest number of E·coli in the chlorine dioxide treated MAP treatments, and the lowest yeast & mold in the chlorine dioxide treated box packaging treatments. As a result, for the inhibition of microorganisms during paprika storage, it is considered appropriate to treat plasma for 6 hours before storage regardless of the packaging method.