• 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.

• The Korean Journal of Nuclear Medicine Technology
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• v.12 no.1
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• pp.19-26
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• 2008

Purpose: In general, We discharged radioactive wastewater and sewages less than $8.1{\times}10^{-13}$ Ci/ml in a exclusive water-purifier tank. Our hospital operating three exclusive water-purifier tank for radioactive wastewater and sewages of 60 tons capacity respectively. In order to meet the criteria it need a enough decay more than 125 days per each exclusive tank. However, recently we fell into the serious situation that decay period was decreased remarkably, owing to the wastewater amount increased rapidly by enlarge the therapy ward. For that reason, in this article, I'd like to say the way that reducing of radioactive wastewater and sewages rationally. Materials and Methods: From January, 2006 to October, four hundred and two cases were analyzed. They were all hospitalized during 3 days and 2 nights. We calculated the average amount of water used (include toilet water used, shower water used, washstand water used, $\cdots$), each exclusive water-purifier tank's decay period, as well as try to search the increased factors about water-purifier tank inflow flux by re-analysis of the procedure of radioisotope therapy step by step. Results: We could increase each exclusive water-purifier tank's decay period from 84 days to 130 days through the improvement about following cause: (1) Improvement of conventional toilet stool for excessive water waste $\rightarrow$ Replacement of water saving style toilet stool (2) Prevention of unnecessary shower and wash (3) Stop the diuretics taking during hospitalization (4) Analysis of relationship between water intakes and residual dose of body (5) Education about outside toilet utilization before the administration (6) Changed each water-purifier tank's maximum level from85% to 90% Conclusion: The originality of our efforts are not only software but hardware performance improvements. Incidentally the side of software's are change of therapy procedures and protocols, the side of hardware's are replacement of water saving style toilet stool and change of each water-purifier tank's maximum level. Thus even if a long lapse of time, problem such as return to the former conditions may not happen. Besides, We expect that our trials become a new reasonable model in similar situation.

• Journal of Embryo Transfer
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• v.20 no.3
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• pp.317-322
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• 2005

This study was conducted to improve the efficiency of embryo recovery and to establish the protocols of superovulation in Holstein cows. Sixteen Holstein cows were used the test the efficacy of three superovulation regimens using Folltropin. In the case of regimen 1, CIDR plus with E2 capsule was inserted in cows at the random stage of estrous cycle and the total of 400 mg Folltropin V was adminstered twice a day for 4 days(Folltropin V group). In regimen 2, CIDR was inserted and 3.0 mg estradiol benzoate was administered i.m. next day and the total of 400 mg Folltropin was adminstered twice a day for 4 days(Folltropin V+EB group). For regimen 3, CIDR insertion was same as in the regimen 2 and the total of 400 mg Folltropin diluted with $10\%$ PEG 8,000 was administered once(Folttropin V+PEG 8,000 group). In all the regimens, CIDR were removed on 12th day and 45 mg dinoprost was administered i.m. simultaneously. The heat detected donors were administered 200 ug LH-RH and inseminated twice with 2 straws of frozen semen 12 hours apart. Embryo were collected using Foley catherter in each uterine homs on 6${\~}$8 days after inseminations. The evaluation of collected embryos were according to the IETS manual. The CL responses according to the superovulation treatments were 5.8, 20.6, 24.0 in the Folltropin V, Folltropin+EB and Folltropin V+PE 8,000 groups, respectively and there were significant different among the treatments(p<0.01). Transferable embyos collected were 3.6$\pm$2.4, 3.3$\pm$l.8 and 2.8$\pm$2.3, in the Folltropin V, Folltropin+EB and Folltropin V+PE 8,000 groups, respectively. Degenerated and unfertilized embryos in regimen 2 and 3 than regimen 1. These results indicates that superovulation treatments with both multiple injections and a single injection using PEG of Folltropin combined with CIDR insertion at the random stage of estrus cycle can be used to produce Holstein embryos.

• Journal of Embryo Transfer
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• v.16 no.2
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• pp.107-115
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• 2001

Development of effective activation protocols is of great importance for improving the success of cloning and subsequent transgenic. Three methods for oocyte activation, including 5$\mu$M ionomycin (5 min) alone, ionomycin + 1.9 mM 6-dimetylaminopurine (DMAP, 3 hrs) and ionomycin + 10 $\mu\textrm{g}$/ml cycloheximide (CHX, 3 hrs) were compared for their effects of pronuclei (PN) formation, development, developmental velocity and ploidy of parthenotes to IVF control in bovine. In group of ionomycin + DMAP, the oocytes having more 3PN were significantly (P<0.05) higher than in groups of ionomycin alone and of ionomycin + CHX (45.5% vs. 0 and 0%, respectively). Activation with the ionomycin alone, ionomycin + DMAP and ionomycin + CHX resulted in cleavage rates of 30, 85.5 and 57.9%, respectively. The blastocysts rate of parthenotes activated by ionomycin + DMAP treatment was significantly higher (12.3%. p<0.05) than those of other treated groups. Chromosome analysis shows that ionomycin + DMAP treatment greatly enhances the incidence of chromosomal abnormality of the parthenotes. From the results, we may conclude that DMAP treatment to the oocytes accelerates developmental velocity resulting in both the higher incidence of chromosome abnormality and of PN formation, and strongly suggest that CHX combined with ionomycin is better than DMAP for the purpose of successful nuclear transplantation. Developmental velocity of parthenotes activated by ionomycin + DMAP treatment was significantly (P<0.05) faster than others.

• Pediatric Infection and Vaccine
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• v.25 no.2
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• pp.72-81
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• 2018

Purpose: This prospective study aimed to investigate the therapeutic efficacy of lamivudine in children with chronic hepatitis B virus (HBV) infection. Methods: During July 2003 through October 2015, children with chronic hepatitis B who visited our institution were included in this study. Fifty-five patients, who received first-line treatment of lamivudine (3 mg/kg, 100 mg maximum) for over three months, were enrolled. After initiating lamivudine, alanine aminotransferase (ALT), HBV-DNA, and HBV markers were followed up at 1 month, 3 months, and every 3 months, thereafter. The treatment endpoint was determined as 1) normalization of ALT, 2) HBeAg seroconversion, and 3) anti-HBe positivity for twelve consecutive months. Results: Thirty-one male (56.4%) and 24 female (43.6%) patients were included. The mean age at treatment initiation was 8.1 years. The mean duration of treatment was 23.4 months. ALT normalization was found in 98.2% (54 of 55). Anti-HBe seroconversion was found in 70.6% (36/51). Loss of HBsAg was found in 10.9% (6/55). All biochemical responses occurred under age seven. The rate of virologic response (defined as HBV-DNA <2,000 IU/mL) at six months after treatment initiation was 78.7% (37/47). At twelve months after reaching treatment endpoint, 87.2% (34/39) maintained their virologic response. Resistance to lamivudine was found in 16.4% (9/55). Conclusions: Lamivudine treatment in Korean pediatric patients with chronic hepatitis B showed better outcomes compared with other studies that implemented similar protocols in foreign populations. Further studies are needed to investigate the efficacy of newly recommended antiviral drugs on the Korean pediatric population.

• The Korean Journal of Nuclear Medicine
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• v.30 no.1
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• pp.77-85
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• 1996

Radioiodine($^{131}I$) has been used for the treatment of Graves' hyperthyroidism since the late 1940's and is now generally regarded as the treatment of choice for Graves' hyperthyroidism who does not remit following a course of antithyroid drugs. But for the dose given, several different protocols have been described by different centers, each attempting to reduce the incidence of long-term hypothyroidism while maintaining an acceptable rate control of Graves' hyperthyroidism. Our goals were to evaluate effective half-life and predict absorbed dose in Graves' hyperthyroidism patients, therefore, to calculate and readminister radioiodine activity needed to achieve aimed radiation dose. Our data showed that the mean effective $^{131}I$ half-life for Graves' disease is 5.3 days(S.D=0.88) and mean biologic half-life is 21 days, range 9.5-67.2 days. The mean admininistered activity and the mean values of absorbed doses were 532 MBq(S.D.=254), 112 Gy (S.D.=50.9), respectively. The mean activity needed to achieve aimed radiation dose were 51MBq and marked differences of $^{131}I$ thyroidal uptake between tracer and therapy ocurred in our study. We are sure that the dose calculation method that uses 5 days thyroidal $^{131}I$ uptake measurements after tracer and therapy dose, provides sufficient data about the effective half-life and absorbed dose of $^{131}I$ in the thyroid and predict the effectiveness of $^{131}I$ treatment in Graves' hyperthyroidism.

• The Korean Journal of Nuclear Medicine
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• v.30 no.1
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• pp.112-117
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• 1996

Objective: Standard stress/rest Tc-99m MIBI and T1-201 myocardial perfusion study have some limitations such as stress/rest image overlap for Tc-99m-MIBI, low energy for T1-201 and long period of study time for two separate studies. Separate acquisition rest T1-201/stress Tc-99m MIBI dual isotope study is a potentially efficient myocardial perfusion imaging protocol that combines the high resolution of Tc-99m for stress perfusion assessment and T1-201 for viability assessment. This study assessed the usefulness and diagnostic accuracy for this new approach. Methods: We tried to evaluate sensitivity and specificity of dual isotope separate acquisition protocol in 67 patients. Immediately after resting T1-201 SPECT data was acquired, dipyridamole stress Tc-99m MIBI myocardial perfusion study was performed. Visual analysis was carried out qualitatively with 0 to 3 scoring system for 17 segments of left ventricle in the reconstructed horizontal long axis and short axis slices. Results: Total study was completed within 3 hours. In angiographic correlation, dual isotope SPECT demonstrated high sensitivity(85%) and in a small group of patients, high specificity was also observed (100%). Conclusion: Combined thallium-201/stress Tc-99m MIBI SPECT displayed similiar diagnostic accuracy to protocol using stress/rest Tc-99m MIBI SPECT. This protocol was completed in shorter period than the previous protocols and therefore enhance laboratory throughput and patients convenience.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.89-93
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• 2014

Purpose: We investigated the quantitative evaluation of PET/CT images for evaluation after treatment in the treatment of liver metastasis of cancer with $^{90}YSIR$-Sphere. Materials and Methods: Confirmed the correlation between the measured counts was expressed by setting a region of interest from the image and a measure of the dose calibrator to see a correlation diagram of an image in a PET of $^{90}Y$. A portion uptake coefficients between PET images were acquired for 20 minutes LIST mode in 15 patients treated for liver metastasis of cancer using $^{90}Y$ SIR-Spheres high, intermediate portion, a lower portion, three measuring the coefficient of the region of interest is divided into parts, we studied the conditions for proper image acquisition. Results: Coefficient of sites that set the region of interest of the PET image and the measured counts of $^{90}Yappears$ that there is a correlation diagram statistically, ($R^2=0.956$), correlation diagram from the PET image of $^{90}Yis$, PET coefficient the coefficients of all regions of interest were increased in proportion to the image acquisition time, partial ROI coefficients of the PET image is higher about 10 minutes on average, about 14 minutes on average, the central portion is lower part 19 minute average in, confirmed the equilibrium of the standard deviation. Conclusion: Using the isotope $^{90}Y$, it is suitable to obtain a PET image, to obtain the time of proper image, the evaluation of PET/CT images, using the $^{90}Y$ SIR-Spheres and that in the treatment of liver metastases of cancer, it is useful for assessing treatment.

• KOREAN JOURNAL OF CROP SCIENCE
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• v.50 no.6
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• pp.406-410
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• 2005

This study was conducted to establish the efficient protocols of the germination and cryopreservation of dehisced Korean ginseng seeds for long-term germ­plasm conservation. $GA_3$ and BA treated on seed for 24 hr facilitated germination at 5 and $10^{\circ}C$. Germination percentage of desiccated seeds was decreased under moisture content (MC) of below $7.2\%$. Dehisced ginseng seeds were dried under airflow of laminar floor cabinet and seed drying room. The high levels (more than $90\%$) of germination after cryogenic exposure were obtained after drying under vertical airflow of laminar floor for 12-30 hours (MC $10.6{\~}7.2\%$). Decrease in germination percentage of ginseng seeds due to desiccation damage and freezing injury was observed at MC of below $7.2\%$ and of above $12.1\%$, respectively. Therefore, MC of ginseng seeds need to be controlled with a range of $8{\~}10\%$ to avoid damages from both desiccation and freezing.

• Restorative Dentistry and Endodontics
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• v.34 no.1
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• pp.42-50
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• 2009

Deterioration of long-term dentin adhesion durability is thought to occur by hydrolytic degradation within hydrophilic domains of the adhesive and hybrid layers. This study investigated the hypothesis that priming the collagen network with an organic solvent displace water without collapse and thereby obtain good bond strength with an adhesive made of hydrophobic monomers and organic solvents. Three experimental adhesives were prepared by dissolving two hydrophobic monomers, bisphenol-A-glycidylmethacrylate (Bis-GMA) and triethyleneglycol dimethacrylate (TEGDMA), into acetone, ethanol or methanol. After an etching and rinsing procedure, the adhesives were applied onto either wet dentin surfaces (wet bonding) or dentin surfaces primed with the same solvent (solvent-primed bonding). Microtensile bond strength (MTBS) was measured at 48 hrs, 1 month and after 10,000 times of thermocycles. The bonded interfaces were evaluated using a scanning electron microscope (SEM). Regardless of bonding protocols, well-developed hybrid layers were observed at the bonded interface in most specimens. The highest mean MTBS was observed in the adhesive containing ethanol at 48 hrs. With solvent-primed bonding, increased MTBS tendencies were seen with thermo cycling in the adhesives containing ethanol or methanol. However, in the case of wet bonding, no increase in MTBS was observed with aging.