• 항공우주정책ㆍ법학회지
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• 제1권
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• pp.47-85
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• 1989

The Fundamental purpose of the Warsaw Convention was to establish uniform rules applicable to international air transportation. The emphasis on the benefits of uniformity was considered important in the beginning and continues to be important to the present. If the desire for uniformity is indeed the mortar which holds the Warsaw system together then it should be possible to agree on a worldwide liability limit. This liability limit would not be so unreasonable, that it would be impossible for nations to adhere to it. It would preclude any national supplemental compensation plan or Montreal Agreement type of requirement in any jurisdiction. The differentiation of liability limits by national requirement seems to be what is occurring. There is a plethora of mandated limits and Montreal Agreement type 'voluntary' limits. It is becoming difficult to find more than a few major States where an unmodified Warsaw Convention or Hague Protocol limitation is still in effect. If this is the real world in the 1980's, then let the treaty so reflect it. Upon reviewing the Warsaw Convention, its history and the several attempts to amend it, strengths become apparent. Hijackings of international flights have given rise to a number of lawsuits by passengers to recover damages for injuries suffered. This comment is concerned with the liability of an airline for injuries to its passengers resulting from aviation terrorism. In addition, analysis is focused on current airline security measures, particularly the pre-boarding screening system, and the duty of air carriers to prevent weapons from penetrating that system. An airline has a duty to exercise a high degree of care to protect its passengers from the threat of aviation terrorism. This duty would seemingly require the airline to exercise a high degree of care to prevent any passenger from smuggling a weapon or explosive device aboard its aircraft. In the case an unarmed hijacker who boards having no instrument in his possession with which to promote the hoax, a plaintiff-passenger would be hard-pressed to show that the airline was negligent in screening the hijacker prior to boarding. In light of the airline's duty to exercise a high degree of care to provide for the safety of all the passengers on board, an acquiescene to a hijacker's demands on the part of the air carrier could constitute a breach of duty only when it is clearly shown that the carrier's employees knew or plainly should have known that the hijacker was unarmed. A finding of willful misconduct on the part of an air carrier, which is a prerequisite to imposing unlimited liability, remains a question to be determined by a jury using the definition or standard of willful misconduct prevailing in the jurisdiction of the forum court. Through the willful misconduct provision of the Warsaw Convention, air carrier face the possibility of unlimited liability for failure to implement proper preventive precautions against terrorist. Courts, therefore, should broadly construe the willful misconduct provision of the Warsaw Convention in order to find unlimited liability for passenger injuries whenever air carrier security precautions are lacking. In this way, the courts can help ensure air carrier safety and prevention against terrorist attack. Air carriers, therefore, would have an incentive to increase, impose and maintain security precautions designed to thwart such potential terrorist attacks as in the case of Korean Air Lines Flight No.858 incident having a tremendous impact on the civil aviation community. The crash of a commercial airliner, with the attending tragic loss of life and massive destruction of property, always gives rise to shock and indignation. The general opinion is that the legal system could be sufficient, provided that the political will is there to use and apply it effectively. All agreed that the main responsibility for security has to be borne by the governments. I would like to remind all passengers that every discovery of the human spirit may be used for opposite ends; thus, aircraft can be used for air travel but also as targets of terrorism. A state that supports aviation terrorism is responsible for violation of International Aviation Law. Generally speaking, terrorism is a violation of international law. It violates the soverign rights of the states, and the human rights of the individuals. I think that aviation terrorism as becoming an ever more serious issue, has to be solved by internationally agreed and closely co-ordinated measures. We have to contribute more to the creation of a general consensus amongst all states about the need to combat the threat of aviation terrorism.

• Journal of Trauma and Injury
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• 제29권3호
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• pp.93-97
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• 2016

Hepatic duct confluence injury, which is developed by blunt abdominal trauma, is rare. Conventionally, bile duct injury was treated by surgical intervention. In recent decades, however, there had been an increase in radiologic or endoscopic intervention to treat bile duct injury. In a hemodynamically stable patient, endoscopic intervention is considered as the first-line treatment for bile duct injury. A 40 year-old man was transferred to the emergency department of ${\bigcirc}{\bigcirc}$ trauma center after multiple blunt injuries. Contrast-enhanced abdominal computed tomography performed in another hospital showed a liver laceration with active arterial bleeding, fracture of the sacrum and left inferior pubic ramus, and intraperitoneal bladder rupture. The patient presented with hemorrhagic shock because of intra-peritoneal hemorrhage. After resuscitation, angiographic intervention was performed. After angiographic embolization of the liver laceration, emergency laparotomy was performed to repair the bladder injury. However, there was no evidence of bile duct injury on initial laparotomy. On post-trauma day (PTD) 4, the color of intra-abdominal drainage of the patient changed to a greenish hue; bile leakage was revealed on magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography (ERCP). Bile leakage was detected near the hepatic duct confluence; therefore, a biliary stent was placed into the left hepatic duct. On PTD 37, contrast leakage was still detected but both hepatic ducts were delineated on the second ERCP. Stents were placed into the right and left hepatic ducts. On PTD 71, a third ERCP revealed no contrast leakage; therefore, all stents were removed after 2 weeks (PTD 85). ERCP and biliary stenting could be effective treatment options for hemodynamically stable patients after blunt trauma.

• Journal of Trauma and Injury
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• 제23권1호
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• pp.21-28
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• 2010

Purpose: In Korea, most abdominal penetrating wounds are caused by stab wounds rather than gun-shot wounds. However, not many studies have been performed on stab injuries and their epidemiologic characteristics. Disagreements of opinions of obligatory surgical exploration and conservative treatment exist, and this subject is still being debated. Therefore, the authors studied the epidemiologic characteristics of abdominal stab wound patients visiting the emergency department and reviewed the proportion of patients that received nontherapeutic surgery and conservative treatment. Methods: This study included patients visiting the emergency department with abdominal stab wounds. A retrospective chart review was done on the abdominal stab wound patients. Sex, age, cause of injury, location of wound, initial vital signs, operation results, injured organs and CT & LWE results were reviewed. Results: The median age of the 121 patients was 40.9 years, of these patients, 88 were males, of which 52 (43.0%) were drunken. Of the patients that received non-therapeutic operations, only 3 patients (15.0%) were drunken, significantly lower than the therapeutic operation group. For the location of the wound, most patients were injured in the right and left upper quadrants, 27 patients each. The most common injured organ was the small bowel; 13 patients were injured in the small bowel. With abdominal CT scans and local wound explorations together, the results exhibited a sensitivity of 97%, a specificity of 44%, a positive predictive value of 56%, and a negative predictive value of 95%. Conclusion: In our study, the sensitivity was 97% when CT & LWE were performed together; thus we can conclude that CT and LWE can be used together to select the treatment method. Although in our study, the surgical indications in abdominal stab wound patients is not sufficient, our results showed a higher rate of nontherapeutic surgery compared to previous studies. Therefore, more research is needed to prevent unnecessary laparotomies in hemodynamically-stable patients without symptoms.

• Journal of Chest Surgery
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• 제13권1호
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• pp.60-65
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• 1980

We have experienced 2 cases of the hunshot wound sof the chest involving cardiac injuries at department of the thoracic surgery, Capital Armed Forces General Hospital during I year from April I 1979 to Jan. 1980. In one case of two patients , he was a 22 years old man who was transported to this emergency room 4 hour 10 minutes after having gunshot wound of the left chest by helicopter. Physical examination showed small inlet in left 3rd ICS and left parasternal border, large outlet in left 8th ICS and left scapular line, no breath sound on left side and distant heart sound. chest roentgenography demonstrated marked pleural effusion in left side and mediastinum shifted to right. As soon as chest X-ray was taken, the bleeding through penetrating wound became profuse and cardiac arrest ensued. Closed chest cardiac massage was started and vigorous transfusion continued, but no effective cardiac activity could not be obtained. The patient was pronounced dead due to exsanguinating hemorrhage from wuwpected cardiac wounds. In this critically injured patient with evidence of intrathoracic hemorrhage and suspected cardiac penetration, only emergency thoracic exploration and immediate surgical control of bleeding points might offer the maximum possibility of survival. The other case was a 23 years old man who was transferred to the emergency room 4 hours 50 minutes after having kmultiple communicated fractures of sternum and linear fracture of right mandible by a missile. Examination revealed about 30% skin loss of the anterior chest wall, weak pulse of 96 beats/min., distant heart sound and decreased breath sounds bilaterally. finding on the chest X-ray films showed multiple sternal fractures, marked pericardial effusion indicating hemopericardium. So, the patient was moved immediately to the operation room where, after endotracheal tube inserted, a median sternotomy was performced. A hemorrhagic congestion of the right upper lobe and marked bulging pericardium were disclosed. The pericardium was opened anterior to right phrenic nerve and exsanguinating hemorrhage ensued from the 0.5cm lacerated wound in the auricle of right atrium. The rupture site of right atrium was occluded with non-crushing vascular clamps and then was over sewn with interrupted sutures. It was thought to be highly possible that he was alive long enough to have cardiorrhaphy because of cardiac tamponade, which prevented exsanguinating hemorrhage. He was taken closed reduction for linear fracture of right mandible 2 weeks after repair of ruptured right auricle in dental clinic. This patient's post-operative course was not eventful.

• 대한의용생체공학회:의공학회지
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• 제32권2호
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• pp.165-176
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• 2011

The femoral nerve innervates the quadriceps muscles and its dermatome supplies anteromedial thigh and medial foot. Paralysis of the quadriceps muscles due to the injury of the femoral nerve results in disability of the knee joint extension and loss of sensory of the thigh. A child could walk independently even though he had injured his femoral nerve severely due to the penetrating wound in the medial thigh. We measured and analyzed his gait performance in order to find the mechanisms that enabled him to walk independently. The child was eleven-year-old boy and he could not extend his knee voluntarily at all during a month after the injury. His gait analysis was performed five times (GA1~GA5) for sixteen months. His temporal-spatial parameters were not significantly different after the GA2 or GA3 test, and significant asymmetry was not observed except the single support time in GA1 results. The Lower limb joint angles in affected side had large differences in GA1 compared with the normal normative patterns. There were little knee joint flexion and extension motion during the stance phase in GA1 The maximum ankle plantar/dorsi flexion angles and the maximum knee extension angles were different from the normal values in the sound side. Asymmetries of the joint angles were analyzed by using the peak values. Significant asymmetries were found in GA1with seven parameters (ankle: peak planter flexion angle in stance phase, range of motion; ROM, knee: peak flexion angles during both stance and swing phase, ROM, hip: peak extension angle, ROM) while only two parameters (maximum hip extension angle and ROM of hip joint) had significant differences in GA5. The mid-stance valleys were not observed in both right and left sides of vertical ground reaction force (GRF) in the GA1, GA2. The loading response peak was far larger than the terminal stance peak of vertical ground reaction curve in the affected side of the GA3, GA4, GA5. The measured joint moment curves of the GA1, GA2, GA3 had large deviations and all of kinetic results had differences with the normal patterns. EMG signals described an absence of the rectus femoris muscle activity in the GA1 and GA2 (affected side). The EMG signals were detected in the GA3 and GA4 but their patterns were not normal yet, then their normal patterns were detected in the GA5. Through these following gait analysis of a child who had selective injuries on the knee extensor muscles, we could verify the actual functions of the knee extensor muscles during gait, and we also could observe his recovery and asymmetry with quantitative data during his rehabilitation.