• The Korean Society of Law and Medicine
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• v.24 no.3
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• pp.105-124
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• 2023

Modern society is facing an unstable environment due to unexpected accidents and hazardous situations. For example, incidents such as the collapse of the Bundang Bridge and the crushing accident in Itaewon could serve as examples. In addition to these, critical emergencies like sudden cardiac arrests and strokes frequently occur, requiring swift actions and smooth transfers to specialized medical institutions for effective responses. In response to these risks, the country has been establishing various systems to protect the lives and safety of its citizens. Among these, the 119 First Aid Activities plays a crucial role within the emergency medical system. Its goal is to promptly respond to critical emergency situations involving severe trauma patients or patients with serious illnesses, minimizing damage and safeguarding lives by swiftly transferring them to emergency medical institutions for specialized treatment. The core activity related to this is emergency rescue operations. In particular, the 119 First Aid system serves as a crucial institution responsible for the hospital transportation of emergency patients. However, rescue personnel still encounter cases of interference with their activities during their duties. Despite efforts from the police, these interference cases persist, and they share similarities with the crime of obstructing official duties. Interference with emergency activities exhibits a comparable nature to instances such as physical assaults and equipment damage against emergency medical practitioners working within the emergency medical system. Therefore, a comprehensive understanding and improvement efforts regarding the issues of interference that arise during the process of emergency medical activities, including the 119 First Aid system, are necessary. The solution to these problems is to establish and improve the conditions for obstruction of first aid activities, focusing on the "Framework Act on Firefighting" and the "Act on 119 Rescue and Emergency."

• The Korean Society of Law and Medicine
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• v.16 no.1
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• pp.3-82
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• 2015

This paper is concerned in the theme of the liability for the breach of duty to inform(Haftungszurechnung der $Aufkl{\ddot{a}}rungspflichtverletzung$) and the malpractice of cosmetic surgery. Here, the terms, treatments for healing purposes and purely medical-technical cosmetic operations are well integrated in the category of "medical conduct(medizinische Handlung)" within the meaning of the public and administrative 'Medical Law'. In the judgment of 6. 13. 2013 Az. 2012DA94865 provides the KHGH(Korean Highest Court of Justice) to inform the patient about the prospects and risks of cosmetic surgery(Infrabrow Excision Blepharoplasty) stringent requirements, similar to the judicature of BGH(cf. BGH, Urt. v. 6. 11. 1990, Az.: VI ZR 8/90). Even in the judgment of 5. 12. 2014 Az. 2013GASO865646 the SZLG(Seoul Central Regional Court) recognizes the physician contract for 'cosmetic septoplasty' as a sort of contract for work. The medical treatment(${\ddot{a}}rztliche$ Heilbehandlung) is still regarded as a prototype of the medical activity, therefore in the meaning of the 'Civil Law(KBGB)', its term needs to be used immediately for healing purposes. The cosmetic operation, desired by a patient, differs from the healing treatment by the element of "indication" and the fact that the "healing purpose(Heilzweck)" itself is missing. In comparative context - methodically fully aware that the unreflective term transfer between different laws might contradict their legal purposes - a series of judgments BSG(BSGE 63, 83, BSGE 72, 96, BSGE, 82, 158, BSGE 93, 252 etc.) and some judgments of LSG are reviewed. In addition, also the dogmatic topic for the "legal natur of a medical treatment contract" is to reconsider by comparative introducing BGHZ 63, 306. Now in view of the current state of greater popularity of artificial cosmetic surgery still indeed is the sentences: The doctor is minister naturae, a helper of nature. A doctor promises regularly only the proper treatment of the patient, but the contractual liability for work should not be excluded in medical conditions for cosmetic surgeries altogether. "With cosmetic operations, seeking to eliminate the external deformities, the doctor may miss the medical profession entirely." - A. Laufs, Medical Law, 5th ed. P. 18.

• Journal of Chest Surgery
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• v.38 no.3 s.248
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• pp.197-203
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• 2005

Homograft aortic valve replacement (AVR) has many advantages such as excellent hemodynamic performance, faster left ventricular hypertrophy regression, resistance to infection and excellent freedom of thromboembolism. To find out the results of homograft AVR, we reviewed our surgical experiences. Material and Method: Eighteen patients (male female=16 : 2, mean age=39.3$\pm$16.2 years, range: 14$\~$68 years) who underwent homo-graft aortic valve replacement between May 1995 and May 2004 were reviewed. The number of homografts was 20 (17 aortic and 3 pulmonic homografts) including two re-operations. Ten patients had a history of previous aortic valve surgery. Indications for the use of a homograft were native valve endocarditis (n=7), prosthetic valve endocarditis (n=5), or Behcet's disease (n=8). The homograft had been implanted predominantly as a full root except in one patient in the subcoronary position. Result: Mean follow-up was 41.3 $\pm$ 26.2 months. There was one operative mortality. Postoperative complications included postoperative bleeding in 3 patients, and wound infection in 1. There was no late death. Three patients underwent redo-AVR. The etiology of the three reoperated patients was Behcet's disease (p=0.025). Freedom from reoperation was $87.5\pm8.3\%$, $78.8\pm11.2\%$ at 1, 5 years respectively, In patients with infective endocarditis, there was no recurrence of endocarditis. There was no thromboembolic complication. Conclusion: Although longer term follow-up with larger numbers of patients is necessary, the operative and mid-term results for homograft AVR was good when we took into account the operative risks of Behcet's disease or infective endocarditis. Behest's disease was a risk factor for reoperation after the homograft AVR. We think homograft AVR is the procedure of choice, particularly in patients with infective endocarditis.

• Asia pacific journal of information systems
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• v.22 no.2
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• pp.21-38
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• 2012

Until recently, successful implementation of ERP systems has been a popular topic among ERP researchers, who have attempted to identify its various contributing factors. None of these efforts, however, explicitly recognize the need to identify disparities that can exist between organizational information requirements and ERP systems. Since ERP systems are in fact "packages" -that is, software programs developed by independent software vendors for sale to organizations that use them-they are designed to meet the general needs of numerous organizations, rather than the unique needs of a particular organization, as is the case with custom-developed software. By adopting standard packages, organizations can substantially reduce many of the potential implementation risks commonly associated with custom-developed software. However, it is also true that the nature of the package itself could be a risk factor as the features and functions of the ERP systems may not completely comply with a particular organization's informational requirements. In this study, based on the organizational memory mismatch perspective that was derived from organizational memory theory and cognitive dissonance theory, we define the nature of disparities, which we call "mismatches," and propose that the mismatch between organizational information requirements and ERP systems is one of the primary determinants in the successful implementation of ERP systems. Furthermore, we suggest that customization efforts as a coping strategy for mismatches can play a significant role in increasing the possibilities of success. In order to examine the contention we propose in this study, we employed a survey-based field study of ERP project team members, resulting in a total of 77 responses. The results of this study show that, as anticipated from the organizational memory mismatch perspective, the mismatch between organizational information requirements and ERP systems makes a significantly negative impact on the implementation success of ERP systems. This finding confirms our hypothesis that the more mismatch there is, the more difficult successful ERP implementation is, and thus requires more attention to be drawn to mismatch as a major failure source in ERP implementation. This study also found that as a coping strategy on mismatch, the effects of customization are significant. In other words, utilizing the appropriate customization method could lead to the implementation success of ERP systems. This is somewhat interesting because it runs counter to the argument of some literature and ERP vendors that minimized customization (or even the lack thereof) is required for successful ERP implementation. In many ERP projects, there is a tendency among ERP developers to adopt default ERP functions without any customization, adhering to the slogan of "the introduction of best practices." However, this study asserts that we cannot expect successful implementation if we don't attempt to customize ERP systems when mismatches exist. For a more detailed analysis, we identified three types of mismatches-Non-ERP, Non-Procedure, and Hybrid. Among these, only Non-ERP mismatches (a situation in which ERP systems cannot support the existing information needs that are currently fulfilled) were found to have a direct influence on the implementation of ERP systems. Neither Non-Procedure nor Hybrid mismatches were found to have significant impact in the ERP context. These findings provide meaningful insights since they could serve as the basis for discussing how the ERP implementation process should be defined and what activities should be included in the implementation process. They show that ERP developers may not want to include organizational (or business processes) changes in the implementation process, suggesting that doing so could lead to failed implementation. And in fact, this suggestion eventually turned out to be true when we found that the application of process customization led to higher possibilities of failure. From these discussions, we are convinced that Non-ERP is the only type of mismatch we need to focus on during the implementation process, implying that organizational changes must be made before, rather than during, the implementation process. Finally, this study found that among the various customization approaches, bolt-on development methods in particular seemed to have significantly positive effects. Interestingly again, this finding is not in the same line of thought as that of the vendors in the ERP industry. The vendors' recommendations are to apply as many best practices as possible, thereby resulting in the minimization of customization and utilization of bolt-on development methods. They particularly advise against changing the source code and rather recommend employing, when necessary, the method of programming additional software code using the computer language of the vendor. As previously stated, however, our study found active customization, especially bolt-on development methods, to have positive effects on ERP, and found source code changes in particular to have the most significant effects. Moreover, our study found programming additional software to be ineffective, suggesting there is much difference between ERP developers and vendors in viewpoints and strategies toward ERP customization. In summary, mismatches are inherent in the ERP implementation context and play an important role in determining its success. Considering the significance of mismatches, this study proposes a new model for successful ERP implementation, developed from the organizational memory mismatch perspective, and provides many insights by empirically confirming the model's usefulness.

• Journal of Chest Surgery
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• v.43 no.4
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• pp.375-380
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• 2010

Background: Primary cardiac tumors are extremely rare. The most common type are benign myxomas, and these are almost completely curable with early surgery. Malignant tumors, however, such as sarcomas, are difficult to remove surgically, and their prognosis is known to be poor. In this study, data on patients who had undergone surgical treatment of cardiac tumor in the authors' hospital were collected and analyzed. Material and Method: The subjects included 28 patients who had undergone surgical treatment of cardiac tumor from August 1993 to December 2008. Their medical records were reviewed and retrospectively analyzed. Result: The patients were aged from 20 to 76 years (mean age: $54.2{\pm}15.6$), and 11 were male (39%) and 17 female (61%). Fifteen of them (54%) underwent emergency surgery to improve heart failure symptoms. The most common preoperative symptom was dyspnea (15 cases, 54%). Preoperative echocardiography was performed on all the patients. The average size of the tumor as measured during the operation was $7.0{\pm}6.9cm$ (the average length of the long axis was 2∼40 cm), and the sites of tumor attachment were the interatrial septum (18 cases, 64%), the left atrium (9 cases, 32%), the mitral valve annulus (2 cases, 7%), and the left ventricle (2 cases, 7%). The operation was performed with an incision through both atria in all the patients, and a complete excision was made in 25 cases (89%). According to the biopsy results, there were 4 cases of sarcoma (14%), 1 case of lipoma (4%), and 23 cases of myxoma (82%). The three cases in which the tumors were not completely excised were sarcomas. No operative deaths occurred after the operations. Outpatient follow-up was possible for 24 cases (86%), with a mean follow-up period of $46.8{\pm}42.7$ months. Late death occurred in 3 of the 24 patients; each of these patients had sarcomas. Of these patients, the first had undergone two repeat surgeries, the second had metastatic sites removed, and the last had only chemotherapy. The average recurrence time was $12.7{\pm}10.8$ months, and the average metastasis time was $20.5{\pm}16.8$ months. Conclusion: Most cardiac tumors are benign myxomas. In principle, they should be surgically treated because they can create risks such as embolism, and can be radically treated when surgically removed. In most cases, however, malignant sarcomas are already considerably advanced with severe infiltration into the neighboring tissues at the time of diagnosis. The surgical removal of malignant sarcomas is known to be difficult because of the advanced stage and degree of infiltration. We suggest that excision of the removable portion of the tumor sites to alleviate symptoms such as heart failure can improve quality of life.

• Journal of Chest Surgery
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• v.32 no.5
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• pp.471-479
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• 1999

Background: Patients with tetralogy of Fallot(TOF), pulmonary atresia(PA) and major aortopulmonary collateral arteries(MAPCAs) have been managed by heterogenous surgical strategies. We have taken 5 different surgical approaches to this lesion. In this study, relative advantages and disadvantages of each strategy were discussed by analyzing our surgical results. Material and Method: Between January 1986 and June 1998, 50 patients aged 1 to 177(39${\pm}$31) months at a various morphologic spectrum of this lesion were treated at our institution. The groups, which were classified according to the initial approaches, consisted of one-stage unifocalization(A-1, n=9), staged unifocalization(A-2, n=11), right ventricle to pulmonary artery connection(RV-PA)(B-1, n=11), one-stage RV-PA plus unifocalization (B-2, n=11), and one-stage definitive repair(C, n=8). Morphologic charateristics, operative mortalities, and probabilities of definitive repair were compared between the groups and the causes of death, complications and the follow-up results were described. Result: Mean ages at the first operation were 57${\pm}$18(A-1), 42${\pm}$48(A-2), 18${\pm}$14(B-1), 52${\pm}$55(B-2), and 32${\pm}$34(C) months (p<0.05). Mean numbers of MAPCAs were least in group C (A-1=4.3${\pm}$1.0, A-2=4.5${\pm}$1.3, B-1=4.1${\pm}$1.9, B-2=4.1${\pm}$1.6, C=3.4${\pm}$1.8 : p<0.05). The ratios of the direct and the indirect MAPCAs in each group were not different between the grousps (A-1=91%/9%, A-2=78%/22%, B-1=80%/20%, B-2=80%/20%, C=81%/19% : p>0.05). Nineteen patients had more than 1 dependent MAPCAs. True pulmonary arteries were not present 13 patients and they were confluent in 29. A total of 101 operations were performed. Operative mortalities of initial procedures were 33%(3/9, A-1), 18%(2/11, A-2), 0%(0/11, B-1), 36%(5/11, B-2) and 13%(1/8, C) (p<0.05). Percentages of the definitive repair among the patients of each group were 22%(2/9, A-1), 18%(2/11, A-2). 45%(5/11, B-1), 27%(4/11, B-2), and 100%(8/8, C)(p<0.05). Hypoxic respiratory and cardiac failure(6), hypoxic encephalopathy(2) and sepsis(4) were the major causes of death. Phrenic nerve palsy occured in 5 patients. Thirty-one patients among the survivals have been followed up for a mean duration of 74${\pm}$42(3-145) months. One and five year actuarial survival rates were 73% and 73 %. Conclusion: In conclusion, Right ventricle to pulmonary artery connection used in patients with TOF/PA/MAPCA as an inital procedure appeared to be highly successful in enhancing the chance of satisfactory definitive repair without the significant surgical risks. One-stage total repair at an ealier age group could be performed safely with the resonable outcomes. Unifocalization approach, whether it was performed in a single stage or in the multiple stages, resulted in the high operative mortality and the lowest chance of definitive repair, however more tailored selection of the patients and the long follow-up is mandatory to prove the usefulness of this approach.

• Asia pacific journal of information systems
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• v.20 no.3
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• pp.139-166
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• 2010

The supply chain management (SCM) systems have emerged as strong managerial tools for manufacturing firms in enhancing competitive strength. Despite of large investments in the SCM systems, many companies are not fully realizing the promised benefits from the systems. A review of literature on adoption, implementation and success factor of IOS (inter-organization systems), EDI (electronic data interchange) systems, shows that this issue has been examined from multiple theoretic perspectives. And many researchers have attempted to identify the factors which influence the success of system implementation. However, the existing studies have two drawbacks in revealing the determinants of systems implementation success. First, previous researches raise questions as to the appropriateness of research subjects selected. Most SCM systems are operating in the form of private industrial networks, where the participants of the systems consist of two distinct groups: focus companies and vendors. The focus companies are the primary actors in developing and operating the systems, while vendors are passive participants which are connected to the system in order to supply raw materials and parts to the focus companies. Under the circumstance, there are three ways in selecting the research subjects; focus companies only, vendors only, or two parties grouped together. It is hard to find researches that use the focus companies exclusively as the subjects probably due to the insufficient sample size for statistic analysis. Most researches have been conducted using the data collected from both groups. We argue that the SCM success factors cannot be correctly indentified in this case. The focus companies and the vendors are in different positions in many areas regarding the system implementation: firm size, managerial resources, bargaining power, organizational maturity, and etc. There are no obvious reasons to believe that the success factors of the two groups are identical. Grouping the two groups also raises questions on measuring the system success. The benefits from utilizing the systems may not be commonly distributed to the two groups. One group's benefits might be realized at the expenses of the other group considering the situation where vendors participating in SCM systems are under continuous pressures from the focus companies with respect to prices, quality, and delivery time. Therefore, by combining the system outcomes of both groups we cannot measure the system benefits obtained by each group correctly. Second, the measures of system success adopted in the previous researches have shortcoming in measuring the SCM success. User satisfaction, system utilization, and user attitudes toward the systems are most commonly used success measures in the existing studies. These measures have been developed as proxy variables in the studies of decision support systems (DSS) where the contribution of the systems to the organization performance is very difficult to measure. Unlike the DSS, the SCM systems have more specific goals, such as cost saving, inventory reduction, quality improvement, rapid time, and higher customer service. We maintain that more specific measures can be developed instead of proxy variables in order to measure the system benefits correctly. The purpose of this study is to find the determinants of SCM systems success in the perspective of vendor companies. In developing the research model, we have focused on selecting the success factors appropriate for the vendors through reviewing past researches and on developing more accurate success measures. The variables can be classified into following: technological, organizational, and environmental factors on the basis of TOE (Technology-Organization-Environment) framework. The model consists of three independent variables (competition intensity, top management support, and information system maturity), one mediating variable (collaboration), one moderating variable (government support), and a dependent variable (system success). The systems success measures have been developed to reflect the operational benefits of the SCM systems; improvement in planning and analysis capabilities, faster throughput, cost reduction, task integration, and improved product and customer service. The model has been validated using the survey data collected from 122 vendors participating in the SCM systems in Korea. To test for mediation, one should estimate the hierarchical regression analysis on the collaboration. And moderating effect analysis should estimate the moderated multiple regression, examines the effect of the government support. The result shows that information system maturity and top management support are the most important determinants of SCM system success. Supply chain technologies that standardize data formats and enhance information sharing may be adopted by supply chain leader organization because of the influence of focal company in the private industrial networks in order to streamline transactions and improve inter-organization communication. Specially, the need to develop and sustain an information system maturity will provide the focus and purpose to successfully overcome information system obstacles and resistance to innovation diffusion within the supply chain network organization. The support of top management will help focus efforts toward the realization of inter-organizational benefits and lend credibility to functional managers responsible for its implementation. The active involvement, vision, and direction of high level executives provide the impetus needed to sustain the implementation of SCM. The quality of collaboration relationships also is positively related to outcome variable. Collaboration variable is found to have a mediation effect between on influencing factors and implementation success. Higher levels of inter-organizational collaboration behaviors such as shared planning and flexibility in coordinating activities were found to be strongly linked to the vendors trust in the supply chain network. Government support moderates the effect of the IS maturity, competitive intensity, top management support on collaboration and implementation success of SCM. In general, the vendor companies face substantially greater risks in SCM implementation than the larger companies do because of severe constraints on financial and human resources and limited education on SCM systems. Besides resources, Vendors generally lack computer experience and do not have sufficient internal SCM expertise. For these reasons, government supports may establish requirements for firms doing business with the government or provide incentives to adopt, implementation SCM or practices. Government support provides significant improvements in implementation success of SCM when IS maturity, competitive intensity, top management support and collaboration are low. The environmental characteristic of competition intensity has no direct effect on vendor perspective of SCM system success. But, vendors facing above average competition intensity will have a greater need for changing technology. This suggests that companies trying to implement SCM systems should set up compatible supply chain networks and a high-quality collaboration relationship for implementation and performance.

• Maritime Security
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• v.5 no.1
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• pp.1-53
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• 2022

One manifestation of the contemporary era of renewed great power competition has been the deepening relationship between China and Russia. Their strengthening military ties, notwithstanding their lack of a formal defense alliance, have been especially striking. Since China and Russia deploy two of the world's most powerful navies, their growing maritime cooperation has been one of the most significant international security developments of recent years. The Sino-Russian naval exercises, involving varying platforms and locations, have built on years of high-level personnel exchanges, large Russian weapons sales to China, the Sino-Russia Treaty of Friendship, and other forms of cooperation. Though the joint Sino-Russian naval drills began soon after Beijing and Moscow ended their Cold War confrontation, these exercises have become much more important during the last decade, essentially becoming a core pillar of their expanding defense partnership. China and Russia now conduct more naval exercises in more places and with more types of weapons systems than ever before. In the future, Chinese and Russian maritime drills will likely encompass new locations, capabilities, and partners-including possibly the Arctic, hypersonic delivery systems, and novel African, Asian, and Middle East partners-as well as continue such recent innovations as conducting joint naval patrols and combined arms maritime drills. China and Russia pursue several objectives through their bilateral naval cooperation. The Treaty of Good-Neighborliness and Friendly Cooperation Between the People's Republic of China and the Russian Federation lacks a mutual defense clause, but does provide for consultations about common threats. The naval exercises, which rehearse non-traditional along with traditional missions (e.g., counter-piracy and humanitarian relief as well as with high-end warfighting), provide a means to enhance their response to such mutual challenges through coordinated military activities. Though the exercises may not realize substantial interoperability gains regarding combat capabilities, the drills do highlight to foreign audiences the Sino-Russian capacity to project coordinated naval power globally. This messaging is important given the reliance of China and Russia on the world's oceans for trade and the two countries' maritime territorial disputes with other countries. The exercises can also improve their national military capabilities as well as help them learn more about the tactics, techniques, and procedures of each other. The rising Chinese Navy especially benefits from working with the Russian armed forces, which have more experience conducting maritime missions, particularly in combat operations involving multiple combat arms, than the People's Liberation Army (PLA). On the negative side, these exercises, by enhancing their combat capabilities, may make Chinese and Russian policymakers more willing to employ military force or run escalatory risks in confrontations with other states. All these impacts are amplified in Northeast Asia, where the Chinese and Russian navies conduct most of their joint exercises. Northeast Asia has become an area of intensifying maritime confrontations involving China and Russia against the United States and Japan, with South Korea situated uneasily between them. The growing ties between the Chinese and Russian navies have complicated South Korean-U.S. military planning, diverted resources from concentrating against North Korea, and worsened the regional security environment. Naval planners in the United States, South Korea, and Japan will increasingly need to consider scenarios involving both the Chinese and Russian navies. For example, South Korean and U.S. policymakers need to prepare for situations in which coordinated Chinese and Russian military aggression overtaxes the Pentagon, obligating the South Korean Navy to rapidly backfill for any U.S.-allied security gaps that arise on the Korean Peninsula. Potentially reinforcing Chinese and Russian naval support to North Korea in a maritime confrontation with South Korea and its allies would present another serious challenge. Building on the commitment of Japan and South Korea to strengthen security ties, future exercises involving Japan, South Korea, and the United States should expand to consider these potential contingencies.