• The Korean Society of Law and Medicine
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• v.21 no.1
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• pp.153-185
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• 2020

In principle, even if serious consequences such as death or serious injury of a patient occur as a result of a medical accident, if the medical malpractice of a health care worker is not recognized, the health care worker is not held liable for said consequences. However, with the opening of the Korea Medical Dispute Mediation and Arbitration Agency on April 7, 2012, a system was established to compensate health care personnel for their medical malpractices only in the case of "injuries caused by medical accidents in the course of childbirth" (hereinafter referred to as "program for compensation of medical accidents"). Article 46 paragraph 1 of the current Medical Dispute Mediation Act, which is the basis of the Force Majeure Medical Accident Compensation System, stipulates that "medical accidents under delivery" claims are to be determined by the Medical Accident Compensation Review Committee are subject to the compensation project. And the details of the compensation, ratio of sharing financial resources for compensation, scope of compensation, and the guidelines and procedure for the payment of compensations are prescribed by Presidential Decree. In other words, the Presidential Decree requires the state to pay 70 percent of the compensation funds, and 30 percent of the above funds among health care providers. The Constitutional Court has decided on the 2015Hun-Ga13 that the scope of the health care institution's founders and the share of the compensation funds cannot be directly determined by the law, and that the portion delegated by the Presidential decree does not violate the Principle of Legal Protection nor Comprehensive Nondelegation Doctrine. However, this can be seen as an exclusion of accountability for force-induced delivery accidents even if there is no negligence of the medical staff. If the nature of the system is a type of social security system with a social compensatory nature, it could consider eliminating the health care innovator's cost-sharing provisions, leaving the full cost to the state. However, it is also necessary to review institutional protocols that strengthen the efforts of medical institutions in areas such as analysis of the causes of medical accidents and measures to prevent their recurrence. In addition, I think that the conclusion of the Act is in line with the purpose of the Comprehensive Wage Support Regulations that at minimum the law sets an upper limit of the compensation funds that are to be paid by health and medical institutions. Moreover, it is reasonable for the Medical Accident Compensation Review Committee to specify gestational age and weight of births, which are the criteria for compensation, under the Enforcement Decree of the Medical Dispute Mediation Act, in relation to the criteria for payment of contributions by the Medical Accident Compensation Review Committee, and to set the detailed criteria.

• Biomolecules & Therapeutics
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• v.20 no.1
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• pp.43-49
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• 2012

Stimulation of mast cells through the high affinity IgE receptor (Fc${\varepsilon}$RI) induces degranulation, lipid mediator release, and cytokine secretion leading to allergic reactions. Although various signaling pathways have been characterized to be involved in the Fc${\varepsilon}$RI-mediated responses, little is known about the precious mechanism for the expression of tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) in mast cells. Here, we report that rapamycin, a specific inhibitor of mammalian target of rapamycin (mTOR), reduces the expression of TNF-${\alpha}$ in rat basophilic leukemia (RBL-2H3) cells. IgE or specific antigen stimulation of RBL-2H3 cells increases the expression of TNF-${\alpha}$ and activates various signaling molecules including S6K1, Akt and p38 MAPK. Rapamycin specifically inhibits antigeninduced TNF-${\alpha}$ mRNA level, while other kinase inhibitors have no effect on TNF-${\alpha}$ mRNA level. These data indicate that mTOR signaling pathway is the main regulation mechanism for antigen-induced TNF-${\alpha}$ expression. TNF-${\alpha}$ mRNA stability analysis using reporter construct containing TNF-${\alpha}$ adenylate/uridylate-rich elements (AREs) shows that rapamycin destabilizes TNF-${\alpha}$ mRNA via regulating the AU-rich element of TNF-${\alpha}$ mRNA. The antigen-induced activation of S6K1 is inhibited by specific kinase inhibitors including mTOR, PI3K, PKC and $Ca^{2+}$chelator inhibitor, while TNF-${\alpha}$ mRNA level is reduced only by rapamycin treatment. These data suggest that the effects of rapamycin on the expression of TNF-${\alpha}$ mRNA are not mediated by S6K1 but regulated by mTOR. Taken together, our results reveal that mTOR signaling pathway is a novel regulation mechanism for antigen-induced TNF-${\alpha}$ expression in RBL-2H3 cells.

• Korean Journal of Medicinal Crop Science
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• v.9 no.2
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• pp.156-165
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• 2001

Exogeneous application of pokeweed antiviral protein (PAP), a ribosomal-inacivating protein in the cell wall of Phytolacca americana (pokeweed) protects heterologous plants from viral and fungal infection. A cDNA clone of PAP introduced into Scrophularia buergeriana Miquel by thransformation with Agrobacterium tumefaciences. For plant transformation, explants were precultured on shoot induction medium without kanamycin for 2-5 day, and then they were cocultured with Agrobacterium for 10 minutes. The explants were placed on co culture medium in dark condition, $28^{\circ}C$ for 2days. After explants were washed in MS liquid medium, they were transferred into selection medium including kanamycin 50mg/L (MS salts+1mg/ l BAP+2mg/ l TDZ+0,2mg/ l NAA+MS vitamin+3% sucrose+0.8% agar, pH5.8). From PCR analysis, NPT II band was confirmed in transgenic plant genome and showed resistance against fungi in antifungal activity test. Micro assay to which protein extracted from transgenic line were added, revealed hyphae growth inhibition and no spore germination at high concentration. The characteristics of inhibited hyphae was represented transparent and thin. Expression of PAP in transgenic plants offers the possibility of developing resistance to viral and fungal infection.

• Economic and Environmental Geology
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• v.42 no.4
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• pp.315-333
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• 2009

In this study, the hydrochemical and the isotopic characteristics of major streams in the Daejeon area were investigated during rainy and dry seasons. The stream water shows the electrical conductivity of the range of $37{\sim}527{\mu}s$/cm, and pH $6.21{\sim}9.83$. The chemical composition of stream waters can be grouped as three types: the upper streams of Ca(Mg)-$HCO_3$ type, Ca(Mg)-$SO_4(Cl)$ type of middle streams flowing through urban area, and Na(Ca)-$HCO_3$(Cl, $SO_4$) type of the down streams. Based on in-situ investigation, the high pH of stream waters flowing through urban area is likely to be caused by the inflow of a synthetic detergent discharging from the apartment complex. The electrical conductivity of stream waters at a dry season is higher than those of at a rainy season. We suggest that the hydro-chemical composition of stream waters in the Daejeon area was affected by the discharging water from the sewage treatment facilities and anthropogenic contaminants as well as the interaction with soil and rocks. ${\delta}D$ and ${\delta}^{18}O$ values of the stream waters show the relationship of ${\delta}D=6.45{\delta}^{18}O-7.4$, which is plotted at a lower area than global meteoric water line(GMWL) of Craig(1961). It is likely that this isotopic range results from the evaporation effect of stram waters and the change of an air mass. The isotope value shows an increasing trend from upper stream to lower stream, that reflects the isotopic altitude effect. The relationship between ${\delta}^{13}C$ and $EpCO_2$ indicates that the carbon as bicarbonate in stream water is mainly originated from $CO_2$ in the air and organic materials. The increasing trend of ${\delta}^{13}C$ value from upper stream waters to lower stream waters can be attributed to the following reasons: (1) an increasing dissolution of $CO_2$ gas from a contaminated air in downtown area of the Daejeon, and (2) the increment of an inorganic carbon of groundwater inflowed into stream by base flow. Based on the relationship between ${\delta}^{34}S$ and $SO_4$ of stream waters, the stream waters can be divided into four groups. $SO_4$ content increases as a following order: upper and middle Gab stream${\delta}^{34}S$ value decreases as above order. ${\delta}^{34}S$ value indicates that sulfur of stream waters is mainly originated from atmosphere, and is additionally supplied by pyrite source according to the increase of sulfate content. The sulfur isotope analysis of a synthetic detergent and sewage water as a potential source of the sulfur in stream waters is furtherly needed.

• Journal of the Korean Geographical Society
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• v.42 no.3 s.120
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• pp.368-387
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• 2007

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.

• Tuberculosis and Respiratory Diseases
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• v.53 no.2
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• pp.173-182
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• 2002

Background : Nontuberculous mycobacteria (NTM) have usually been considered to be contaminants of colonizers when isolated from respiratory specimens in Korea, where there is a high prevalence of tuberculosis and a low rate of HIV infections. Therefore, there has been few studies on the clinical significance of NTM species in immunocompetent patients were investigated. Methods : Thirty-five NTM isolates, for which species identification was requested by the treating physicians during 1999 at the Asan Medical Center, were retrospectively analyzed. They were identified to the species level by mycolic acid analysis using high-performance liquid chromatography. The medical records of the patients with the NTM isolates were reviewed to identify those patients who met the American Thoracic Society (ATS)'s criteria for mycobacterial pulmonary infection. Their antimicrobial susceptibility data were compared with the clinical outcomes. Results : The NTM were identified as M. intracellulare (6 isolates), M. avium (5), M. abscessus (5), M. gordonae (5), M. terrae complex (4), M. szulgai (2), M. kansasii (2), M. fortuitum (2), M. peregrinum (1), M. mucogenicum (1), M. celatum (1), and M. chelonae (1). All 35 patients showed clinical symptoms and signs of chronic lung disease, but none had a HIV infections; 16 (45.7%) patients were found to be compatible with a NTM pulmonary infection according to the ATS criteria, 5 and 4 cases were affected with M. intracellulare and M. abscessus, respectively; 8 patients had a history of pulmonary tuberculosis. 13 patients received antimycobacterial therapy for an average of 21 months and 9 patients were treated with second-line drugs. Only 4 patients had improved radiologically. Conclusion : A NTM should be considered a potential pathogen of pulmonary infections in immunocompetent patients with chronic pulmonary diseases. Most NTM infections were left untreated for a prolonged period and showed a poor outcome as a result, M. intracellulare and M. abscessus were the two most frequent causes of NTM pulmonary infections in this study. Species identification and antimycobacterial susceptibility tests based on the species are needed for the optimum management of a NTM pulmonary infection in patients.

• Tuberculosis and Respiratory Diseases
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• v.62 no.1
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• pp.33-42
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• 2007

Background: Heme oxygenase-1 (HO-1) is known to modulates the cellular functions, including cell proliferation and apoptosis. It is known that a high level of HO-1 expression is found in many tumors, and HO-1 plays an important role in rapid tumor growth on account of its antioxidant and antiapoptotic effects. Cisplatin is a widely used anti-cancer agent for the treatment of lung cancer. However, the development of resistance to cisplatin is a major obstacle to its use in clinical treatment. We previously demonstrated that inhibiting HO-1 expression through the transcriptional activation of Nrf2 induces apoptosis in A549 cells. The aim of this study was to determine of the inhibiting HO-1 enhance the chemosensitivity of A549 cells to cisplatin. Materials and Methods: The human lung cancer cell line, A549, was treated cisplatin, and the cell viability was measured by a MTT assay. The change in HO-1, Nrf2, and MAPK expression after the cisplatin treatment was examined by Western blotting. HO-1 inhibition was suppressed by ZnPP, which is a specific pharmacologic inhibitor of HO activity, and small interfering RNA (siRNA). Flow cytometry analysis and Western blot were performed in to determine the level of apoptosis. The level of hydrogen peroxide ($H_2O_2$) generation was monitored fluoimetrically using 2',7'-dichlorofluorescein diacetate. Results: The A549 cells showed more resistance to the cisplatin treatment than the other cell lines examined, whereas cisplatin increased the expression of HO-1 and Nrf2, as well as the phosphorylation of MAPK in a time-dependent fashion. Inhibitors of the MAPK pathway blocked the induction of HO-1 and Nrf2 by the cisplatin treatment in A549 cells. In addition, the cisplatin-treated A549 cells transfected with dither the HO-1 small interfering RNA (siRNA) or ZnPP, specific HO-1 inhibitor, showed in a more significantly decrease in viability than the cisplatin-only-treated group. The combination treatment of ZnPP and cisplatin caused in a marked increase in the ROS generation and a decrease in the HO-1 expression. Conclusion: Cisplatin increases the expression of HO-1, probably through the MAPK-Nrf2 pathway, and the inhibition of HO-1 enhances the chemosensitivity of A549 cells to cisplatin.

• Journal of the Korean Society for Marine Environment & Energy
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• v.9 no.4
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• pp.203-215
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• 2006

Field observations on the spatio-temporal distribution of organic matter of the surface sediment were carried out at 15 stations in the central parts of the South Sea of Korea from April 2002 to January 2003. The range of water temperature and salinity in bottom waters, mud content and water content of surface sediment were $8.06{\sim}23.35^{\circ}C,\;29.20{\sim}34.51\;psu,\;71.2{\sim}99.9%$ and $38.7{\sim}68.9%$, respectively. Measured parameters on the surface sediments of ignition loss (IL), chemical oxygen demand (CODs), phaeopigment, particulate organic carbon (POC) and particulate organic nitrogen (PON) also ranged in $3.9{\sim}l2.5%,\;9.60{\sim}44.05\;mgO_2/g-dry,\;1.58{\sim}29.51\;{\mu}g/g-dry,\;3.12{\sim}13.01\;mgC/g-dry$ and $0.49{\sim}2.00\;mgN/g-dry$, respectively. The spatio-temporal distribution of organic matter demonstrated higher concentrations offshore than at lesions near the coastal line. Higher concentrations occurred in the summer and spring. The results indicated that the origin of organic matter in surface sediments in the central part of the South Sea was autochthonous rather than allocthonous because the organic matter had an average C/N ratio of 6.44 (${\pm}0.51$). However, the composition of autochthonous organic matter was mainly derived from detritus rather than living phytoplankton, which was Indicated by the results of the POC/phaeopigment ratio. A principal component analysis (PCA) indicated that 73.2% of the variability in the data was described by two factors: 1) an 'environmental factor concerning the accumulation of materials (57.3%)' and 2) 'origin of organic matter and the composition by primary production (15.9%)'. The sedimentary environment in the central part of the South Sea was divided into four regions from the factor score of the PCA by the concentrations of organic matter and the composition ratio of organic matters from phytoplankton in surface sediments.

• Journal of Gastric Cancer
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• v.8 no.4
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• pp.225-231
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• 2008

Purpose: Laparoscopic gastric resection (LGR) is increasingly being used instead of open gastric resection (OGR) as the standard surgical treatment for gastric submucosal tumors. Yet there are few reports on which technique shows better postoperative outcomes. This study was performed to compare these two treatment modalities for gastric submucosal tumors by evaluating the postoperative outcomes. We also provide an analysis of the learning curve for LGR. Materials and Methods: Between 2003.4 and 2008.8, 103 patients with a gastric submucosal tumor underwent either LGR (N=78) or OGR (n=25). A retrospective review was performed on a prospectively obtained database of 103 patients. We reviewed the data with regard to the operative time, the blood loss during the operation, the time to the first soft diet, the postoperative hospital stay, the tumor size and the tumor location. Results: The clinicopatholgic and tumor characteristics of the patients were similar for both groups. There was no open conversion in the LGR group. The mean operation time and the bleeding loss were not different between the LGR group and the OWR group. The time to first soft diet (3.27 vs. 6.16 days, P<0.001) and the length of the postoperative hospital stay (7.37 vs. 8.88 days, P=0.002) were shorter in the LGR group compared to the OGR group. The tumor size was bigger in the OGR group than that in the LGR group (6.44 vs. 3.65 cm, P<0.001). When performing laparoscopic gastric resection of gastric SMT, the surgeon was able to decrease the operation time and bleeding loss with gaining more experience. We separated the total cases into 3 periods to compare the operation time, the bleeding losses and the complications. The third period showed the shortest operation time, the least bleeding loss and the fewest complications. Conclusion: LGR for treating a gastric submucosal tumor was superior to OGR in terms of the postoperative outcomes. An operator needs some experience to perform a complete laparoscopic gastric resection. Laparoscopic resection could be considered the first-line treatment for gastric submucosal tumors.

• The Korean Journal of Physiology
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• v.2 no.2
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• pp.101-135
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• 1968

As physical fitness measured was muscle strength (hand grips, leg extention, back lift, and arm pull and thrust), skinfold thickness (5 different sites), circulatory function (resting heart rate and blood pressure), speed (kinesiological analysis during 100m sprint, record, maximal and final speed), motor function (50 meter dash, ball throwing, standing broad jump, and pull-ups), maximal aerobic power (maximum oxygen intake by field running method), muscle power (leg and arm by inertia ergometer), and general endurance (maximum endurance running time on the treadmill at the speed of 5 MPH and grade of 15.5%) of 1131 Korean children (boys 572, girls 559) aged of 6 to 17 years, who were randomly sampled from 24 primary, middle and high schools at the two districts of Seoul and KyungKi. The results are summarized as follows: 1) The status (height and weight) of the children was almost same as that of the previously reported Korean and Japanese children of same ages. 2) Muscle strength was a gained linearly with geting age in the boys and girls but there was a little improvement in girls aged of 13 years or more. 3) The mean skin fold thickness was increased linearly with geting ages in both sexes, but the girls from 12 to 17 years of age were increased rapidly, and maximum value was 17mm, while boys was 7.0 mm. 4) In the circulatory function, the resting heart rate was decreased, but the blood pressure was increased with ages in both sexes within the normal limits. 5) The maximum and final speed during 100 meter sprint increases with age in boys but girls who are 12 years old or older, were not improved any mere. The patterns of running were same in both sexes, and maximum speed reached at about 30 meters from starting line. 6) The motor function was increased with age in both sexes, but there was no improvement in 12 years of age or older girls. More over records of all functions except standing broad jump was less than those of Japanese in the same age, respectively. 7) The maximum oxygen intake (MOI) was increased considerably with ages and maximum values were 2.93 L/min (boys) and 2.09 L/min (girls) at the age of 17years. This result was almost same as that of the Japanese and Easter Island population, but the value was lower than that of Europe. The average of the maximum oxygen intake per kg body weight per minute from 9 to 17 years of age were around 53 ml in the boys and 42 ml in the girls. 8) Muscle power was increased linearly with ages in boys while there was relatively a little increment in girls. The maximum values of leg muscle in boys and girls at the 17 years of age were 0.168 and 0.088 horse power, respectively. 9) The maximum endurance running time was increased considerably from the age of 9 in boys, while there was no improvement in girls. The maximum values were 6.0 min and 1.8 min, respectively.