• Journal of Hospice and Palliative Care
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• v.5 no.2
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• pp.94-100
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• 2002

Purpose : The system to refer terminally ill patients to palliative or hospice care which ultimately give them emotional, psychological, and social support hasn't been fully developed and organized yet in Korea. The controversies concerning the current referral system are being analyzed to present the improvements. Methods : The questionnaires were asked to be filled out by family members of the 76 patients by phone interview, who were referred from the Seoul National University Hospital between April, 2001 to March, 2002. They were referred to the 35 palliative and hospice care-giving institutes and hospitals which were given questionnaires by mail. Results : Of the 76 patient's family members, 47 family members accepted to answer the questionnaire. The first thing that influence to family to determine the referral of patient was solicitation of doctors or nurses (44%). And they were influenced by allowance for the other things such as convenience of patients (32%), convenience of caring family members (24%). In the course of determining of referred institutes, responders had considered at first their dwelling area, and then fame of institutes, the place which patent had wanted to spend last hours or which is suitable for patient's funeral service, and their financial condition. Thirty-eight the 47 responders answered that they had experienced difficulties in referral procedure. The worst among difficulties was unwanted discharge, and followings were lack of information about the referred institutes, concern about patient's suffering, resistance of patient and opposition of other family members, etc. Although they expressed dissatisfaction in referral procedure, most of them answered they had been satisfied with hospice care at referred institute after referral. Merits of referral which responders counted were patient's peace, caring family's comfort and reduced cost in order. Of the 35 referred institutes, 24 institutes' staffs responded mail questionnaires and sent to us in return. Except one responder, the rest approved the referral system and thought that referred patients had been satisfied with their hospice care. And they claimed that systemic support of the government is definitely necessary. The most difficult thing which responders experienced in care of referred patients was lack of information about patients. Besides, there were patient's financial problems, lack of understanding about their institutes of patients or family, and inconvenience of terminal cancer patient's pain control. Conclusion : The development and support of the organized referral system is needed to alleviate the troubles which patients, family members, and palliative or hospice institutes and hospitals have to face through the procedure of the referral.

• Journal of Chest Surgery
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• v.34 no.9
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• pp.653-661
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• 2001

Background: Retrograde cerebral perfusion(RCP) is one of the methods used for brain protection during aortic arch surgery. The author previously published the data, however, for the safety of it, there still remains many controversies. The author performed RCP and checked various parameters to clarify the possibility of early detection of cerebral injury. Material and Method: The author used pigs(Landrace species) weighing 25 to 30kg and performed RCP for 120 minutes. After weaning of cardiopulmonary bypass, we observed pigs for another 120 minutes. Rectal temperature, jugular venous oxygen saturation, central venous pressure were continuously monitored, and the hemodynamic values, histological changes, and serum levels of neuron-specific enolose(NSE) and S100$\beta$ protein were checked. Central venous pressure during RCP was maintained in the range of 20 to 25 mmHg. Result: Flow rates(ml/min) during RCP were 224.3$\pm$87.5(20min), 227.1$\pm$111.0(40min), 221.4$\pm$119.5(60min), 230.0$\pm$136.5(80min), 234.3$\pm$146.1(100min), and 184.3$\pm$50.5(120min). Serum levels of NSE did not increase after retrograde cerebral perfusion. Serum levels of S100$\beta$ protein(ng/ml) were 0.12$\pm$0.07(induction of anesthesia), 0.12$\pm$0.07(soon after CPB), 0.19$\pm$0.12(20min after CPB), 0.25$\pm$0.06(RCP 20min), 0.29$\pm$0.08(RCP 40min), 0.41$\pm$0.05(60min), 0.49$\pm$0.03(RCP 80min), 0.51$\pm$0.10(RCP 100min), 0.46$\pm$0.11(RCP 120min), 0.52$\pm$0.15(CPBoff 60min), 0.62$\pm$0.15(60min after rewarming), 0.76$\pm$0.17(CPBoff 30min), 0.81$\pm$0.20(CPBoff 60min), 0.84$\pm$0.23(CPBoff 90min) and 0.94$\pm$0.33(CPBoff 120min). The levels of S100$\beta$ after RCP were significantly higher than thosebefore RCP(p<0.05). The author could observe the mitochondrial swellings using transmission electron microscopy in neocortex, basal ganglia and hippocampus(CA1 region). Conclusion: The author observed the increase of serum S100$\beta$ after 120 minutes of RCP. The correlation between its level and brain injury is still unclear. The results should be reevaluated with longterm survival model also considering the confounding factors like cardiopulmonary bypass.

• Journal of Chest Surgery
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• v.37 no.10
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• pp.833-838
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• 2004

Background: Despite the excellent early results after the repair of congenital bicuspid aortic valve (BAV) disease, the mid-term durability of the repaired valve has still controversies. Material and Method: To evaluate the mid-term results of BAV repair, retrospective review of medical records and echocardiographic data were done. Between 1994 and 2003, twenty-two patients underwent reparative procedure for either regurgitant or stenotic congenital bicuspid aortic valve (BAV). Result: Mean age was $41\pm14$ years with male predominance (Male=17, Female=5). The pathophysiologies of the BAV were regurgitation-dominant in 20 (91%) and stenosis-dominant in 2 (9%) cases. Various repair techniques were used for raphe, prolapsed leaflet, thickened leaflet, and commissures; 1) release of raphe in 19 (86%), 2) wedge resection and primary repair in 11 (50%), pericardial patch reinforcement after plication of the leaflet in 6 (27%), and plication of the leaflet in 3 (14%), 3) slicing of thickened leaflet was used in 12 (55%) cases, 4) commissuroplasty in 8 (36%), and commissurotomy in 6 (27%) cases. There was no in-hospital mortality. During the mean follow-up of $38\pm17$ months, one patient underwent aortic valve replacement after developing acute severe regurgitation from dehiscence of the suture on postoperative 2 months. New York Heart Association functional class was improved from $1.9\pm0.6$ to $1.2\pm0.5$ (p<0.01). Left ventricular end-systolic and diastolic dimension (LVESD/LVEDD) were also improved from $45\pm9$ and $67\pm10$ to $37\pm10$ and $56\pm10,$ respectively (p<0.01). The grade of aortic regurgitation (AR) was improved from preoperative $(3.1\pm1.2)$ to post-bypass $(0.9\pm0.7).$ However, the grade at last follow-up $(1.7\pm1.1)$ was deteriorated during the follow-up period (p<0.01). Freedom from grade III and more AR at one, three, and four year were 89.7%, 89.7%, and 39.9% respectively. Conclusion: Midterm clinical result of the BAV repair was favorable. But, the durability of the repaired valve was not satisfactory.

• Tuberculosis and Respiratory Diseases
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• v.41 no.4
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• pp.397-404
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• 1994

Background: To decide the optimal antibiotics and application of chest tube, examination of pleural fluid is fundamental in the management of empyema. Some criteria for drainage of pleural fluid have been recommended but some controversies have been suggested. Recently, newer radiologic methods including ultrasound and computed tomography scanning, have been applied to the diagnosis and management of pleural effusions. We undertook a retrospective analysis of 30 patients with pleural effusion who had CT scans of the chest in order to apply the criteria of Light et al retrospectively to patients with loculation and to correlate the radiologic appearance of pleural effusions with pleural fluid chemistry. Method: We analyzed the records of 30 out of 147 patients with pleural effusion undergoing chest CT scans. Results: 1) Six of the pleural fluid cultures yielded gram negative organisms and three anaerobic bacterias and one Staphylococcus aureus and one non-hemolytic Streptococci. No organism was cultured in ninteen cases(63.0%). 2) The reasons for taking chest CT scans were to rule out malignancy or parenchymal lung disease(46.7%), poor response to antibiotics(40.0%), hard to aspirate pleural fluid(10.0%) and to decide the site for chest tube insertion(3.3%). 3) There was no significant correlations between ATS stages and loculation but there was a tendency to loculate in stage III. 4) There was a significant inverse relationship between the level of pH and loculation(p<0.05) but there appeared to be no relationship between pleural fluid, LDH, glucose, protein, loculation and pleural thickening. 5) In 12 out of 30, therapeutic measures were changed according to the chest CT scan findings. Conclusion: We were unable to identify any correlations between the plerual fluid chemistry, ATS stages and loculations except pH, and we suggest that tube thoracotomy should be individualized according to the clinical judgement and serial observation. All patients with empyema do not need a chest CT scan but a CT scan can provide determination of loculation, guiding and assessing therapy which should decrease morbidity and hospital stay.

• Journal of Korean society of Dental Hygiene
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• v.2 no.2
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• pp.175-186
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• 2002

Fluoride has been one of the most widely studied caries-preventive agents. But the effect of prenatal administration had been controversies for many years. The results showed that there were no influence on reproductive rate of rats with administration of fluoride from 0 to 20 ppm during pregnancy(p>0.05). There was a trend towards slightly increased the mean ash weight in the 1, 5 and 20 ppm groups, as compared with the control group. However, there was no significant differences among groups (p>0.05). The contents of calcium, magnesium and phosphorus in the total bone were increased with the administrated fluoride concentration were increased, but there were no statistically significant differences among groups(p>0.05). The mean fluoride level of 1 ppm group was significantly higher than that of control group, but the concentrations of fluoride in total carcass pups of 5 and 20 ppm groups were significantly less than that of 1 ppm group(p>0.05). The results of this study indicate that the amount of fluoride transferred to the offspring, which may produce anticariogenic effects in the primary teeth of their effects in the primary teeth of their offspring.

• The Korean Journal of Air & Space Law and Policy
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• v.33 no.1
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• pp.147-174
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• 2018

The air transportation industry is a field where control and interference of the state are generalized compared to other industries. However, the premise for national intervention in the air transportation industry is the determination of the nationality of the aircraft or airline company concerned. This is because it is necessary to clarify the distinction between the domestic and foreign carriers so that they can exercise airspace sovereignty. The purpose of this paper is to compare the current status and contents of Korean law and regulations on the determination of nationality with the foreign legal system. To this end, the starting point of the discussion is to look at the history of nationality restrictions on the US air transport industry and the issues that arise in the content and operation of the system today. In addition, this paper examined the provisions of the Japanese aviation law, which is very similar to that of Korea, and then compared the current legal provisions of the United States, Japan and Korea. As a conclusion, this paper sought the direction of revision of the Korean law on the basis of the foreign status of the restriction of nationality in the air transportation industry. Compared with our law, the US and Japan are generally regarded to be more concerned with the contents of their own airline companies than those of foreigners or non-citizen. In spite of the fact that there are many laws and regulations in the United States regarding the de facto dominance of domestic airline companies by foreigners, there have been a lot of controversies in this matter. By the way, Japan has been stipulating regulations on holding companies and affiliated companies. In the global era, it would be meaningful to check the status of the nationality restrictions in the aviation industry, which is based on internationality. I hope that this study will be able to build a legal institutional basis for Korea's aviation industry development from a reasonable protectionist point of view rather than a narrow nationalism in a rapidly changing era.

• Journal of Science and Technology Studies
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• v.8 no.1
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• pp.97-129
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• 2008

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.

• Tuberculosis and Respiratory Diseases
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• v.45 no.1
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• pp.116-127
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• 1998

Background: The natural course of sarcoidosis is variable from spontaneous remission to significant morbidity or death. So the assessment of disease activity is important but no single parameter was generally accepted as a good marker. Recently several studies suggested that adhesion molecules, especially ICAM-1 can be a marker, but there are some controversies. And only few data are available about the relationship of ICAM-1 with clinical follow-up course. Methods: We measured the expression of adhesion molecules on BAL cells by flow cytometry and the level of soluble ICAM-1(sICAM-1) in serum and BALF at the time of diagnosis in 12 patients with active disease and 7 inactive sarcoidosis(5 male, 14 female, mean age: $39.4{\pm}10.7$ years, mean follow-up : $20{\pm}15$ months). Follow-up clinical course were compared with the changes in serum sICAMA-1 level and the adhesion molecule on BAL cells. Results: In the patients with active disease, the ICAM-1 on AM(RMFI: $3.68{\pm}1.71$) and sICAM-1 level in serum($582{\pm}193$ng/ml) and BAL fluid($47.8{\pm}16.5$ng/ml) were all higher than those of 7 inactive disease(RMFI: $1.89{\pm}0.75$, p=0.0298, serum: $294{\pm}117$ ng/ml, p=0.0049, BALF: $20.9{\pm}8.3$ ng/ml). In the active sarcoidosis, ICAM-1 on AM(RMFI : $1.51{\pm}0.84$) and serum sICAM-1 were decreased after the therapy($250{\pm}147$ ng/ml) but no significant change was noted in inactive disease. Also we found the initial ICAM-1 on AM and serum sICAM-1 had a significant correlation with the degree of improvement in PFT after the therapy. During the follow-up, the disease relapsed in 4 patients after the discontinuation of steroid and the serum sICAM-1 level went-up again at the time of relapse. Conclusion: Our data suggest that the serum sICAM-1 level and the ICAM-1 expression on AM can be a good marker of disease activity and also a predictor of outcome in sarcoidosis.

• Journal of Legislation Research
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• no.44
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• pp.611-653
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• 2013

An whistle-blowing is recognition of acts of misconduct or corruption by individuals(laborers) or party which belongs to a certain organization and it refers to the act of informing to the senior organization or to the outside public agency to avoid jeopardies that could be potentially lead against benefit of the public. These whistle-blowings can be a Ansatz that improve corporation's transparency and accountability by prevention of enterprise's misconduct as well, it has been recognized as an important role for the establishment of corporate ethics, moreover, social justice. What to be treated primarily as labor law problem is arousing some controversies of the possibility that the public announcement could be whether a disciplinary punishment or not because it brings some mischievous effects for the honor and the reputation to the company which conducted the illegal actions and the action of the contrary to the social value. And futhermore, recently, the matter of compensational responsibility according to the arrangement conversion, bullying followed by the informant has been brought up. The fundamental standpoint of precedent related with the judgement of justification for the punishment as reason of the whistle-blowing ought to do the sincere duty for the labor contract which is the employees are supposed to consider the employer's profits. For that reason, if the emploee release the inside fact to the public and give any damages to employer's secret or confidence or honor, it will be a causing reasong of the disciplinary punishment, but in specific cases, the relevant and level of punishment limitation can be judged by the contents of public announcement and the truth, the purpose of the acts and details and the way of announcement. Precisely, on the assumption that there are necessity of the characteristic profit or the freedom of expression for the informant, with overall consideration whether or the basis part of the informant is true or there is a fair reason which make the informant believe is true or the purpose of informant has the public profit or the contents of the whistle-blowing are important for relevant organization or the means and the way was suitable, if the whistle-blowing are approved to be resonable, the organization are not permitted the reprimand or dismiss Futhermore, to find the solution for the issues of the disciplinary punishment and the treatment of all sorts of disadvantages, for the reason of whistle-blowing, since the protection law for public declarer which was enacted in last 2011 have the position as the general law, the purport of the equal law has to be considered sytematically and also the judicial precedent which is related to the justification of whistle-blowing are needed to be considered as well.

• Journal of Christian Education in Korea
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• v.67
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• pp.301-337
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• 2021

The researcher looked at the differences in views and various controversies surrounding Korean youth sexuality education in the wake of the Nth Room incident, which had a great impact on modern Korean society. Sex education for adolescents in Korea can be divided into public sex education through school sex education and the Youth Sexuality Center, and conservative/traditional Protestant sex education. Public sex education is partly influenced by feminist sexual ethics and comprehensive sex education abroad. Based on gender sensitivity and the right to sexual self-determination, four major projects are prevention of sexual harassment, prostitution, sexual violence, and domestic violence. However, the school sex education standard was criticized for stereotypes of gender roles and gender-discriminatory content, reinforced distorted myths about sexual violence, and exclusion of sexual diversity and various family types. Conservative/traditional Protestantism is based on the normal family ideology such as bisexual marriage, premarital chastity, and sexual ethics recognized only within marital relationships. It is a form of confrontation with public sex education while strongly opposing it. The researcher first analyzed the characteristics of public sex education, conservative/traditional Protestant sexual ethics and sex education, feminist sex ethics and sex education, and overseas youth sex education, respectively, while composing the curriculum for Korean youth sexuality education. And as a more fundamental solution to youth sexuality education, I pointed out that there are limits to asceticism, premarital chastity, gender sensitivity and sexual self-determination education, and found an alternative to the concept of body and sex in feminist theology. The researcher pointed out that it is necessary to reconceptualize the body and sex under the recognition that the most fundamental cause of distorted sexual culture is dualistic sex and understanding the body, centering on the research of various feminist theologians. And this was conceptualized into three concepts: holistic sexuality, mutual solidarity understood in relationships with others, and sexuality as a spirituality that extends to the global community. And with each curriculum, 1) Holistic Sexuality: Breathing, Narrative, Making the Shape of One's Body and Mind 2) mutual solidarity : Feeling the Breath of Others, Media Literacy through Conscientization, Sending a Good Wind 3) Sexuality as a spirituality that extends to global concern: It was proposed to pay attention to nature and to co-cultivate it, to listen to the earth's moans and create a new way of life, and to write a prayer with the earth and fellow living beings.