• The Korean Journal of Pain
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• 제10권1호
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• pp.58-63
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• 1997

Background : Endotracheal intubation is one of the methods most securely establishing airway. But accompanying hemodynamic responses are harmful to coronary or cerebral vascular disease patients. These hemodynamic responses are regarded as the results of sympathetic stimulation due to pharyngolaryngeal stimulation, and sympathetic blocking method-stellate ganglion block- may be obtundate these hemodynamic responses. Methods : 75 patients of ASA physical status I-II were selected. There were 40 patients normotensive (Group I), 35 patients hypertensive (Group II) Group I, steliate ganglion block was performed on 20 patients (Group I-S) the remainder had no procedure (Group I-O). Group II, 18 patients received SG3 (Group II-S), 17 patients had no procedure (Group II-O). SGB was performed with 1% lidocaine 8 ml on right stellate genglion after patient's consent. Blood pressure (IIP) and pulse rate(PR) were first measured in the pre-anesthesia room. Follow up BP and PR are checked immediately following SGB and every 5 minutes for subsequent 20 minutes, then after arrival at operatig room, then immediately after intubation and at 3, 5, 10, 15 and 20 minutes after incubation. Results : All group experienced significantly increased blood pressure and pulse rate upon arrival at the pre-anesthesetic and opeating rooms, as compared to when patients rates in the ward. After intubation and for subsequent 5 minutes, significant changes were measured. Patients then recovered to preblock value. In Group I, no statistical significance was recorded between subgroup I-S and I-O. However in Group II, there were significant differences between sub-group II-S and II-O. In evaluating pulse rate changes, there were no significant differences between Group I-S and I-O; nor II-S and II-O. Conclusion : The proper diagnosis of Stellate Ganglion Block had some measure of protective effect on hemodynamics following endotracheal intubation, especially in hypertensive patients.

• Journal of Preventive Medicine and Public Health
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• 제15권1호
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• pp.17-31
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• 1982

A physician assumes toward his patient the obligation to use such reasonable care and skill as is commonly possessed and exercised by physicians in the same general line of practice in the same or similar localities and to use his best judgment at the times. Medical disputes between physicians and patients are, ever more increased in these days as human body, happens to cause a variety of changes in body unlike the function of machine. Such increased trends of medical disputes became a problem in common across the word under the influence of affluent living standard, high consciousness of life value and right by today's people. The aim of this dissertation is oriented to forming a physician's responsibilities in medicalcare accidents arising between physicians and patients. A general physician, for example, has not been negligent merely because, a specialist might have treated the patient with greater skill and knowledge. However, the fact that a physician may have acted to the best of his ability will not avoid legal problems for damages resulting from substandard treatment, that is the degree of care and skill which is to be expected of the ordinary practitioner in his field of practice. The duty of a physician who is, or holds himself out to be, a specialist is greater in the field of his specialty than one who is a general physician. A patient's consent to routine medical procedures is implied from the fact that patient comes to the physician with a medical problem and voluntarily submits to the procedures. For the more serious medical procedures and for major operations, however, it is preferable for the physician to have the patient's consent in writing, to facilitate proof of the consent in the event of a dispute or litigation. Suppose that mistakes on the part of physicians are likely to be blamed in all cases of malpractice. Then it will create a sort of shrinkage in activities of medical treatment. There should be some limitation on excessive application of 'The thing speaks for itself' on mistakes by physicians and availablity of cause and effect. It is a matter of complicity as well as a matter of importance to draw a definite boundary on responsibilities of physician. A series of further research on this particular aspect is strongly urged.

• 대한기관윤리심의기구협의회지
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• 제4권1호
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• pp.16-22
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• 2022

Purpose: The traditional ethical study only suggests a blurred insight on the research using medical big data, especially in this rapid-changing and demanding environment which is called "4th Industry Revolution." Current institutional/ethical issues in big data research need to approach with the thoughtful insight of past ethical study reflecting the understanding of present conditions of this study. This study aims to examine the ethical issues that are emerging in recent health care big data research. So, this study aims to survey the public perceptions on of health care big data as part of the process of public discourse and the acceptance of the utility and provision of big data research as a subject of health care information. In addition, the emerging ethical challenges and how to comply with ethical principles in accordance with principles of the Belmont report will be discussed. Methods: Survey was conducted from June 3th August to 6th September 2020. The online survey was conducted through voluntary participation through Internet users. A total of 319 people who completed the survey (±5.49%P [95% confidence level] were analyzed. Results: In the area of the public's perspective, the survey showed that the medical information is useful for new medical development, but it is also necessary to obtain consents from subjects in order to use that medical information for various research purposes. In addition, many people were more concerned about the possibility of re-identifying personal information in medical big data. Therefore, they mentioned the necessity of transparency and privacy protection in the use of medical information. Conclusion: Big data on medical care is a core resource for the development of medicine directly related to human life, and it is necessary to open up medical data in order to realize the public good. But the ethical principles should not be overlooked. The right to self-determination must be guaranteed by means of clear, diverse consent or withdrawal of subjects, and processed in a lawful, fair and transparent manner in the processing of personal information. In addition, scientific and ethical validity of medical big data research is indispensable. Such ethical healthcare data is the only key that will lead to innovation in the future.

• 한국콘텐츠학회논문지
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• 제11권7호
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• pp.508-518
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• 2011

정비사업에 있어서 사업시행자가 사업을 시행하기 위해서는, 사업구역 내 부동산을 직접 취득 하거나 소유자들로부터 사업시행에 대한 동의를 받아야만 한다. 주택재건축사업의 경우 조합과 미동의자 사이에 부동산에 대한 협의가 이루어지지 아니할 때 원활한 사업진행을 위해 매도청구제도가 사용된다. 그러나 매도청구권 행사 절차에 대한 규정이 명확하지 않아 재건축사업의 이해관계자들 간의 분쟁이 다발하고 있으며, 이러한 법적분쟁은 사업기간 연장 및 사업비용 증가와 같은 재정적 문제로 직결 되며, 극단적인 경우에는 사업성이 상실되어 재건축사업을 포기해야 하는 사태를 유발하기도 한다. 따라서 본 연구는 매도청구권의 행사 절차와 관련된 법적분쟁에 있어서의 판례 및 실제 재건축 사업 사례를 살펴보고, 재건축사업의 이해관계자들에게 설문조사를 실시하여, 이해관계자 입장별 인식의 차이 및 매도청구권 행사 절차의 문제점을 도출한다. 그 결과를 바탕으로 이해관계자 다수가 원하는 매도청구권제도의 개선 방안을 제시함으로써, 법적 분쟁을 미연에 방지하여, 재건축 사업의 성공에 일조하는데 그 목적이 있다.

• 대한정형도수물리치료학회지
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• 제27권2호
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• pp.17-25
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• 2021

Background: The purpose of this study is to investigate basic data about the effects of muscle energy technique on the shoulder complex range of motion and posture alignment in the round shoulder posture. Methods: The subjects included 15 women that gave consent to participate in the study voluntarily. They performed the muscle energy technique for 30 minutes twice. The round shoulder posture was measured with a straight edge ruler. The shoulder complex range of motion was measured with the apley scratch test. The forward head posture was measured with ImageJ. The pectoralis minor muscle length was measured with a tape measure. Results: There were statistically significant differences in the round shoulder posture both right and left (p<.05). The experiment group showed statistically significant differences in the pectoralis minor muscle length (p<.05). There were significant differences in the shoulder complex range of motion including flexion, left lateral flexion, right lateral flexion, left side bending, and right side bending (p<.05), but no significant differences were found in extension (p>.05). The forward head posture showed significant differences in CVA changes (p<.05) and no significant differences in CRA changes (p>.05). Conclusion: These findings demonstrate that the muscle energy technique relaxed muscles around the shoulders and increased the shoulder complex range of motion. The technique is also expected to prevent pain in the neck and shoulders and lower injury risk. In conclusion, the muscle energy technique can be applied as an effective intervention for round shoulder posture.

• 한국임상수의학회지
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• 제17권1호
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• pp.270-274
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• 2000

A seven-year-old female Jindo-dog was presented with a history of progressive abdominal distension. Except for severe bilateral abdominal swelling, other abnormal signs were not detected. The patient showed normal appetite and defecation. In the radiographic examination, the abdomen was filled with large masses. Suspected a certain neoplastic disease, laparotomy was taken through the cranial abdominal midline. Large pale-yellow masses were proliferated to fill the abdomen. In the masses, grey-brown or black portion presumed hemorrhagic or necrotic spots were found. Even though neoplastic tissues were not detected in the right kidney, they were infiltrated in the left kidney except for a part of the cortex. Obtaining the owner's consent, the patient was euthanized and samples were collecte for further study. In microscopic examination, the parenchyma of the medulla was substituted with tumor cells and the cortex was impressed by the expansive proliferation of the neoplastic tissues. This neoplasm was estimated as renal carcinoma originated from tubular epithelium, being based upon that tumor cells were largely cuboidal cells and they had obscure tubular forms.

• 한국임상수의학회지
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• 제29권1호
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• pp.82-86
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• 2012

5년령 중성화된 수컷 치와와가 수개월간의 오른쪽 후지 파행 증상으로 내원하였다. 신체 검사에서 통증을 동반한 4등급의 슬개골 내측 탈구를 확인 하였고 오른쪽 왼쪽 후지 파행등급 2 와 0을 각각 확인 하였다. 일반 방사선 사진에서 골증식체와 연골하 병변을 확인 하였고 오른쪽과 왼쪽 후지 골관절증 점수 20 과 12를 각각 확인하였다. 슬개골 탈구 정복술과 자가지방 유래 줄기세포 치료를 보호자의 동의 하에 결정 하였다. $1{\times}10^6$ 개의 줄기세포를 PBS, 인공 괄절액과 함께 슬개골 탈구 정복술 후에 주입 하였다. 주입 후 19개월에 오른쪽 왼쪽 후지 파행등급 0 와 0, 골관절증 점수 19 와 13을 각각 확인 하였고, 5년후에 파행등급 0 와 0, 골관절증 점수 14 와 15를 각각 확인 하였다. 본 증례를 통해 자가지방 유래 줄기 세포치료를 받은 관절에서 골관절증이 감소 된 것을 확인 할 수 있었다.

• 의료법학
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• 제18권2호
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• pp.105-138
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• 2017

이 글은 환자의 자기결정권에 관한 몇몇 대표적인 판례들을 연혁적으로 검토한 논문이다. 대법원은 과거 음주상태에서 농약을 음독하여 자살을 시도한 환자가 치료를 거부하자 치료를 포기한 의료진에게 특정 의학적 상태(응급상황)에서 의사의 생명보호의무가 환자의 자기결정권 존중보다 우선한다고 판단하여 의료과실을 인정하였다. 이후 대법원은 가족들의 요청에 의해 지속적 식물인간 상태인 환자에게 해당 환자의 의학적 상태(회복불가능한 사망의 단계 등)를 고려하고 환자의 의사를 추정하여 연명의료를 중단하게 하였다. 최근 대법원은 종교적 신념과 관련하여 수혈과 같은 필수적인 치료를 거부한 환자에 대하여 대법원은 환자의 생명 보호에 못지않게 환자의 자기결정권을 존중하여야 할 의무가 대등한 가치를 가지는 것으로 평가할 수 있는 판단 기준을 제시하였다. 인간의 존엄성에 근거한 환자의 자기결정권과 의사의 생명보호의무가 충돌하는 상황에 대하여 연혁적 판례 검토를 통해 법원의 입장이 우리 사회에서 환자의 주체적 역할과 자율성을 존중하는 방향을 반영하여 함께 변화되어 왔음을 확인할 수 있었다. 법원이 생명권이라는 최고의 가치만을 환자의 의사보다 더욱 우선하여 판단해오다가 적어도 명시적인 환자의 의사 또는 그렇지 못할 경우에 추정적 의사까지도 고려한 치료의 유보나 중단에 대하여 고려하기 시작한 것, 종교적 신념에 근거한 자기결정권의 행사로서의 수혈거부와 같은 치료거부에 대하여 충분한 정보에 근거한 치료거부의 몇 가지 적법한 요건들을 인정하기 시작했다는 것은 이후 우리나라 의료 환경에 적잖은 영향을 줄 것이고 의료현장에서 의료행위를 하는 의사들에게도 직 간접적인 지침이 될 것이다.

• 시큐리티연구
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• 제10호
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• pp.215-242
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• 2005

현대범죄의 특징인 지능화, 광역화, 폭력화 등의 범죄 형태에 효율적인 범죄예방 및 진압을 하기 위한 방안의 하나인 기계경비시스템을 이용한 공공장소에서 CCTV의 감시는 일상생활에서 널리 사용되고 있다. 이는 급속히 발달하고 있는 과학기술을 이용한 경찰활동으로 증가하는 범죄사건을 효율적으로 대응할 수 있는 대안점이기도 하다. 그러나, 이러한 CCTV의 폭넓은 활용은 범죄예방이라는 긍적적인 점과 시민의 기본권 침해라는 양자간의 가치가 충돌하는 문제가 발생되고 있다. 공공부문에 있어서 경찰의 CCTV활용은 그 효과성에 대한 명확한 논의가 계속되고 있음에도 불구하고 계속적으로 증대하고 있다. 이것은 시민의 기본권에 대한 침해의 소지가 많아 생겨날 수 있다는 것이다. 기본권의 침해는 쉽지만 그 회복은 많은 비용과 시간이 투입되어야 한다. 또한, 현재 한국에서는 CCTV 운용에 대한 구체적인 법적 규제도 없는 현실에서는 자칫 시민의 기본권 침해에 대한 사실을 무감각하게 만들 수 있다는 것이 문제가 될 수 있다. 본 연구에서는 경찰의 CCTV활용에 대한 선행연구를 기초로 한 법적 문제점, 설문조사를 통한 인식적측면을 고찰하고, 선진국들의 CCTV활용에 대한 현황을 기초로 하여 법적측면과 인식적측면 운영적측면을 중심으로 한국 경찰의 CCTV 운영에 대한 개선방안을 제시하고자 하였다.

• 의료법학
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• 제8권2호
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• pp.69-118
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• 2007

In providing general medical treatments, the medical service contract between the patient and the doctor is the mutually responsible onerous contract. However, the nature of the mutually assumed contract standings of the patient and the doctor has been changing since the implementation of the national health insurance program. For instance, besides the cases of beyond excessive medical charges and medical negligence, if the doctor charged for his/her medical treatments violating the post-treatment/nursing cover criteria, the overpaid medical charge, regardless of being collected with the patient's consent, has to be refunded back to the patient. Medically needed aspects, treatment results, and unfair benefits favoring the patient are not at all taken into consideration in the health insurance scheme. This makes it easier for patients to get refunds for their share of the medical payments by involving the Health Insurance Review & Assessment Service or the National Health Insurance Corporation, without engaging in civil law suits (for reimbursement claim) against doctors. In other words, the doctor's responsibility to provide medical treatments and the patient's responsibility to pay for the medical treatment provided within the contractual realm are being demolished by the administrational arbitration of the National Health Insurance system. The basic rights of medical service providers, and the patient's right to choose are as important constitutional rights, as the National Health Insurance program, which is essential in the social welfare system. Furthermore, the development of the medical fields should not be prevented by the National Health Insurance system. If the medical treatment services can be divided into necessary treatments, general treatments, and high quality treatments, the National Health Insurance is supposed to guarantee the necessary and general treatments to provide medical treatments equally to all the insured with limited financial resources. However, for the high quality treatments, it is recommended that they should not be interfered by the National Health Insurance system, and that they should be left to the private contract between the patient and the doctor.