• Title/Summary/Keyword: Risk situation

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The Clinical Effects of Surgical Treatment for Hemoptysis due to Inflammatory Lung Disease (염증성 폐질환에 의한 객혈에 대한 수술적 치료 효과)

  • Yun, Ju-Sik;Na, Kook-Joo;CheKar, Jay-Key;Jeong, In-Seok;Song, Sang-Yun;Oh, Sang-Gi
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.144-149
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    • 2010
  • Background: Many studies have demonstrated the various therapeutic options for treating hemoptysis caused by inflammatory lung disease. However, there is debate over the surgical management of the ongoing hemoptysis. Therefore, we evaluated the clinical results of pulmonary resection that was done due to hemoptysis in patients with concomitant inflammatory lung disease. Material and Method: We performed a retrospective analysis of 75 patients who received pulmonary resection for hemoptysis and concomitant inflammatory lung disease between 2001 and 2007. The mean age was $52.1{\pm}12.5$ years old, and the male; female ratio was 52:23. Result: The underlying disease was aspergilloma in 30 patients (40%), pulmonary tuberculosis in 20 patients, bronchiectasis in 18 patients and other causes in 7 patients. The surgical treatment included lobectomy in 55 patients, bilobectony in 2 patients, pneumonectomy in 17 patients and wedge resection in 1 patient. There were 3 early deaths, and the causes of death were pneumonia in 1 patient and BPF in 2 patients. The early mortality was statistically higher for such risk factors as a preoperative Hgb level <10 g/dL, COPD and an emergency operation. Conclusion: In conclusion, pulmonary resection for treating hemoptysis showed the acceptable range of mortality and it was an effective method for the management of hemoptysis in patients with inflammatory lung disease. However, relatively high rates of mortality and morbidity were noted for an emergency operation, and so meticulous care is needed in this situation.

Regional Analysis on the Incidence of Preterm and Low Birth Weight Infant and the Current Situation on the Neonatal Intensive Care Units in Korea, 2009 (2009년 한국 시도별 미숙아, 저체중출생아의 빈도 및 신생아중환자실의 현황)

  • Kang, Byung-Ho;Jung, Kyung-A;Hahn, Won-Ho;Shim, Kye-Shik;Chang, Ji-Young;Bae, Chong-Woo
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.70-75
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    • 2011
  • Purpose: Recently, the incidence of preterm and low birth weight infants (LBWI) is increasing, even though the birth rate is continuously low in Korea. Despite that change, there continues to be a deficit of beds in the neonatal intensive care unit (NICU). This study is based on the 2009 Korean Statistical Information Service that examined the development of a Korean NICU service and the survival rate of preterm infants by regionally analyzing the rate of total live births, preterm infants, LBWI, and NICU beds in Korea. Methods: Data were obtained from the Korean Health Insurance Review and Assessment Service and Korean Statistical Information Service. We confirmed the regional total live birth rate, number of LBWI, and preterm infants and NICU numbers, and all of the results were compared to the average value to determine deficient areas of NICU beds. Results: There were 25,374 (5.7%) preterm infants and 21,954 (4.9%) LBWI in the total number of live births (444,849) in 2009, and regions of high proportion compared to the mean value were Busan, Daegu, and Ulsan. Total NICU beds totaled 1,284, and regions of high rates preterm infants and LBWI per 1 NICU bed compared to the mean value were Incheon, Daegu, Ulsan, etc. The NICU holding rate was 87.5% (1,284/1,468), which was increased from 2005. However, there were still shortages of 184 NICU beds (12.5%), especially in Gyeonggi-do, which lacked 157 beds. Conclusion: High risk neonates difficult to transfer, and they need immediate and continuous treatment. As a result, a foundation of well-balanced, national NICU regionalization is necessary. This study suggested that more NICU facilities must be implemented, and clinicians should realize the continuing deficiency of NICU beds in cities and provinces.

Breakthrough Urinary Tract Infection: A Clinical Study of Experience of a Single Center (예방적 항생제 사용중에 발생한 요로감염: 단일 병원에서 경험한 임상연구)

  • Bae, Sang-In;Cheon, Chong-Kun;Kim, Su-Young
    • Childhood Kidney Diseases
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    • v.14 no.2
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    • pp.203-209
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    • 2010
  • Purpose : It has been a common medical practice to use prophylactic antibiotics to prevent recurrent urinary tract infections (UTI) in high risk situations such as urinary tract obstruction, vesicoureteral reflux, neurogenic bladder, or urinary stones. But sometimes, we meet difficult situation of breakthrough infections (BI) which might cause new or progressive renal scarring. The clinical characteristics of children contracting breakthrough UTI experienced in a single center were studied. Methods : The study was done retrospectively through medical records of 150 pediatric patients who had been cared in pediatric and urologic clinics of Pusan National University Hospital from Jan. 2001 till June 2006 and had prophylactic antibiotics to prevent recurrent UTI. Results : The starting age of prophylactic antibiotics of 150 patient was 1-76 months, and median age was 5 months. The BI developed 61 times in 43 patients (28.7%), 1.5 times per 100 patient-months. The BI occurred more frequently in patients with higher grade of VUR, and in the cases with abnormal DMSA scan. Co-trimoxazole was more effective than 2nd and 3rd generation cephalosporins to prevent UTI. The distribution of causative organisms was more diverse than usual UTI. The causative organisms were sensitive to the antibiotics used for prophylaxis in 29.5%, and resistant in 59.1%. After experience of BI, 40 percents of patients went to the surgical treatment including endoscopic injection of Deflux, 35% to new antibiotics for prophylaxis, 26% remain on the same antibiotics as the previous one. Conclusion : Based on our study results, preexisting renal scar might be one of the factors which should be considered in favor of early surgical interventions of VUR. Poor compliance and wrong selection of antibiotics such as cephalosporins are important underlying causes of breakthrough UTIs.

Patient's 'Right Not to Know' and Physician's 'Duty to Consideration' (환자의 모를 권리와 의사의 배려의무)

  • Suk, HeeTae
    • The Korean Society of Law and Medicine
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    • v.17 no.2
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    • pp.145-173
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    • 2016
  • A patient's Right to Self-Determination or his/her Right of Autonomy in the Republic of Korea has traditionally been understood as being composed of two elements. The first, is the patient's Right to Know as it pertains to the physician's Duty to Report [the Medical Situation] to the patient; the second, is the patient's Right to Consent and Right of Refusal as it pertains to the physician's Duty to Inform [for Patient's Consent]. The legal and ethical positions pertaining to the patient's autonomous decision, particularly those in the interest of the patient's not wanting to know about his/her own body or medical condition, were therefore acknowledged as passively expressed entities borne from the patient's forfeiture of the Right to Know and Right to Consent, and exempting the physician from the Duty to Inform. The potential risk of adverse effects rising as a result of applying the Informed Consent Dogma to situations described above were only passively recognized, seen merely as a preclusion of the Informed Consent Dogma or a denial of liability on part of the physician. In short, the legal measures that guarantee a patient's 'Wish for Ignorance' are not currently being understood and acknowledged under the active positions of the patient's 'Right Not to Know' and the physician's 'Duty to Consideration' (such as the duty not to inform). Practical and theoretical issues arise absent the recognition of these active positions of the involved parties. The question of normative evaluation of cases where a sizable amount of harm has come up on the patient as a result of the physician explaining to or informing the patient of his/her medical condition despite the patient previously waiving the Right to Consent or exempting the physician from the Duty to Inform, is one that is yet to be addressed; that of ascertaining direct evidence/legal basis that can cement legality to situations where the physician foregoes the informing process under consideration that doing so may cause harm to the patient, is another. Therefore it is the position of this paper that the Right [Not to Know] and the Duty [to Consideration] play critical roles both in meeting the legal normative requirements pertaining to the enrichment of the patient's Right to Self-Determination and the prevention of adverse effects as it pertains to the provision of [unwanted] medical information.

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A Study on the Australian Law Regarding RPAS (Remotely Piloted Aircraft System): Need for an International Approach

  • Wheeler, Joseph;Lee, Jae-Woon
    • The Korean Journal of Air & Space Law and Policy
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    • v.30 no.2
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    • pp.311-336
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    • 2015
  • This article surveys the current international law with respect to RPAS from both the public air law and private air law perspectives. It then reviews current and proposed Australian domestic RPAS regulation while emphasizing the peculiar risks in operation of RPAS; and how they affect concepts of liability, safety and privacy. While RPAS operations still constitute only a small portion of total operations within commercial aviation, international pilotless flight for commercial air transport remains a future reality. As the industry is developing so quickly the earlier the pursuit of the right policy solutions begins, the better the law will be able to cope with the technological realities when the inevitable risks manifest in accidents. The paper acknowledges that a domestic or regional approach to RPAS, typified by the legislative success of the Australian experience, is and continues to be the principal measure to deal with RPAS issues globally. Furthermore, safety remains the foremost factor in present and revised Australian RPAS regulation. This has an analogue to the international situation. Creating safety-related rules is imperative and must precede the creation or adoption of liability rules because the former mitigates the risk of accidents which trigger the application of the latter. The flipside of a lack of binding airworthiness standards for RPAS operators is potentially a strong argument that the liability regime (and particularly strict liability of operators) is unfair and unsuited to pilotless flight. The potential solutions the authors raise include the need for revised ICAO guidance and, in particular, SARPs with respect to RPAS air safety, airworthiness, and potentially liability issues for participants/passengers, and those on the ground. Such guidance could then be adapted swiftly for appropriate incorporation into domestic laws bypassing the need for or administrative burden and time it would take to activate the treaty process to deal with an arm of aviation that states know all too well is in need of safety regulation and monitoring.

SON PREFERENCE AND FAMILY BUILDING DURING FERTILITY TRANSITION (IMPLICATIONS ON CHILD SURVIVAL) (출산력 전환기의 남아선호와 출산형태)

  • Kim, Minja -Choe;Kim, Seung-Kwon
    • Korea journal of population studies
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    • v.21 no.1
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    • pp.184-228
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    • 1998
  • This study reviews the relationship between son preference and fertility behavior, and infant and chlid mortality in the context of fertility and mortality decline. In Korea the situation reveals that fertility can decline to a very low level even in the presence of strong son preference, but son preference has certain effects on fertility and childhood mortality. The effect of son preference on fertility increased as the level of fertility declined. Our findings show that son preference causes excess female childhood mortality both directly and indirectly through fertility. Also, in Korea, the analysis reveals that female children suffer excessively high level of mortality and part of the excess mortality is due to parents' behavior on family building related to the effort to secure the birth of a son.

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A Study on Improvement of the police disaster crisis management system (경찰의 재난위기관리 개선에 관한 연구)

  • Chun, Yongtae;Kim, Moonkwi
    • Journal of the Society of Disaster Information
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    • v.11 no.4
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    • pp.556-569
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    • 2015
  • With about 75% of the population of Korea criticizing the government's disaster policy and a failure to respond to large-scale emergency like the Sewol ferry sinking means that there is a deep distrust in the government. In order to prevent dreadful disasters such as the Sewol ferry sinking, it is important to secure a prime time with respect to disaster safety. Improving crisis management skills and managerial role of police officers who are in close proximity to the people is necessary for the success of disaster management. With disaster management as one of the most essential missions of the police, as a part of a national crisis management, a step by step strengthening of the disaster safety management system of the police is necessary, as below. First, at the prevention phase, law enforcement officers were not injected into for profit large-scale assemblies or events, but in the future the involvement, injection should be based on the level of potential risk, rather than profitability. In the past and now, the priortiy was the priority was on traffic flow, traffic communication, however, the paradigm of traffic policy should be changed to a safety-centered policy. To prevent large-scale accidents, police investigators should root out improper routines and illegal construction subcontracting. The police (intelligence) should strengthen efforts to collect intelligence under the subject of "safety". Second, with respect to the preparatory phase, on a survey of police officers, the result showed that 72% of police officers responded that safety management was not related to the job descriptions of the police. This, along with other results, shows that the awareness of disaster safety must be adopted by, or rather changed in the police urgently. The training in disaster safety education should be strengthened. A network of experts (private, administrative, and police) in safety management should be established to take advantage of private resources with regard to crisis situtions. Third, with respect to the response phase, for rapid first responses to occur, a unified communication network should be established, and a real-time video information network should be adopted by the police and installed in the police situation room. Fourth, during the recovery phase, recovery teams should be injected, added and operated to minimize secondary damage.

PRESENT SITUATION AND PROSPECT OF PEDIATRIC DENTISTRY IN KOREA - FOCUSED ON MANAGEMENT OF DENTAL CARIES - (한국 소아치과의 현재와 전망 - 치아우식증관리 분야를 중심으로 -)

  • Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.2
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    • pp.206-225
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    • 2012
  • General status of pediatric dentistry in Korea is to conduct vigorous academic activities and specialized medical care centering the Korean Association of Pediatric Dentistry (KAPD) that has about 1,000 pediatric dentists as members, pediatric dentistry departments of 11 Colleges of Dentistry, numbers of pediatric dentistry training institutions and private clinics specialized in children. From 1996, the accredited pediatric dentists were produced by the KAPD and from 2008, the state began to produce the accredited pediatric dentists. Since then, doctors with expertise in pediatric care had opened private clinics in addition to the university hospitals, it became the basis of a momentum to deepen the specialty of pediatric dentistry. The Dentistry community of Korea is going through rapid and profound changes recently, and the underlying reasons for such changes can be classified largely into a few categories: (1) Decreasing population and structural changes in population (2) Increase in numbers of dentists, (3) Changes in the pattern of dental diseases and (4) Changes in medical environment. In Korea, the children population in the age range of 0 ~ 14 years old had been decreased by 2 million in 2010 compared to that of 2000 due to reduction of birth rate. The current population of children in the age range of 0 ~ 4 years old in 2010 takes up 16.2% of the total population, but it is estimated that such percentage would decrease to 8.0% by 2050. Such percentage is largely behind the estimated mean global population of 19.6% by 2050. On the other hand, the number of dentists had been largely increased from 18,000 in 2000 to 25,000 in 2010. And it is estimated that the number will be increased to 41,000 by 2030. In addition, the specialized personnel of Pediatric dentistry had been shown as increased by 2.5 times during past 10 years. For the changes in the pattern of dental diseases, including dental caries, each df rate of 5 years old children and 12 years old children had been decreased by 21.9% and 16.7% respectively in 2010 compared to 2000. Each df Index also had been decreased by 2.5 teeth and 1.2 teeth respectively. The medical expenditure of Korea is less than that of OECD and more specifically, the expenditure from the National Health Plan is less than OECD but the expenditure covered by households is larger than OECD. These facts indicate that it is considered as requiring the coverage of the national health plan to be reinforced more in the future and as such reinforcement needs continuous promotion. In medical examination pattern of Pediatric dentistry, the preventive and corrective treatment were increased whereas the restorative treatment was decreased. It is considered that such change is caused from decrease of dental caries from activation of the prevention project at national level. For the restorative treatment, the restorations in use of dental amalgam, pre-existing gold crowning and endodontic treatment had been decreased in their proportion while the restorative treatment in use of composite resin had been increased. It is considered that such changes is caused by the change of demands from patients and family or guardians as they desired more aesthetic improvement along with socio-economic growth of Korean society. Due to such changes in dentistry, the pediatric dentistry in Korea also attempts to have changes in the patterns of medical examination as follows; It tends to implement early stage treatment through early diagnosis utilizing various diagnostic tools such as FOTI or QLF. The early stage dental caries so called white spot had been included in the subjects for dental care or management and in order to do so, the medical care guidelines essentially accompanied with remineralization treatment as well as minimally invasive treatment is being generalized gradually. Also, centering the Pediatric dentists, the importance of caries risk assessment is being recognized, in addition that the management of dental caries is being changed from surgical approach to internal medicinal approach. Recently, efforts began to emerge in order to increase the target patients to be managed by dentists and to expand the application scope of Pediatric dentistry along with through such changes. The interest and activities of Pediatric dentists which had been limited to the medical examination room so far, is now being expanded externally, as they put efforts for participating in the preventive policy making process of the community or the state, and to support the political theories. And also opinions are being collected into the direction that the future- oriented strategic political tasks shall be selected and researches as well as presentations on the theoretical rationale of such tasks at the association level.

The Key Success Factors of University Entrepreneurship Education: Implication from USA University Cases (대학 창업교육 핵심 성공요인: 미국 대학 사례의 시사점)

  • Choi, Jong-In;Park, Chygwan
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.8 no.3
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    • pp.85-96
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    • 2013
  • Entrepreneurship courses and programs in Korean universities tend to increase steadily but seem to have some limitations. They are usually recognized as another domain of Business Administration. Entrepreneurship program is practical like Business Administration but should be much more interdisciplinary than that. Because Korean Entrepreneurship programs are in the early stage, they must be reinforced with factors such as education culture, faculties, curriculum and relationships with communities. This study aims to get some implications from Entrepreneurship programs have been run by universities in America in order to facilitate Entrepreneurship program in Korean universities. Based on 11 success factors found by our case universities' Entrepreneurship programs and Kauffman Campus, this study has drawn implications of critical success factors of Entrepreneurship programs as follow. First of all, because Entrepreneurship programs should focus on Entrepreneurship mind sets such as innovative idea generation and courage to overcome risk, it is more desirable that Entrepreneurship programs are introduced in all departments of universities such as Arts, Science and Engineering. These programs also need to take interdisciplinary approach and required to be opened from liberal arts course. In order to be sustained during all their academic careers, vision, mission and strategy for Entrepreneurship programs should be based on strong leadership and support of top leaders. Entrepreneurship culture of each university is also one of the most important success factors. Entrepreneurship programs not only as major programs but also as specific Entrepreneurship minors designed for departments such as Arts, Science and Engineering could be considered according to each university's situation. This study also suggest to make a motivation system for Entrepreneurship faculties, Ph d. programs for Entrepreneurship, communication network for Entrepreneurship programs and mentor system in community. To begin Entrepreneurship programs, it also needs to develop good education contents as many as possible. When it concerned with teaching method, project based 4 year program can be suggested to be effective and efficient. To introduce project based program that should be consistent till participants' graduation, university must prepare regulations to support team teaching, mentor and interdisciplinary cooperation. To dissipate the concept that Entrepreneurship is another version of management, this study support the idea that Entrepreneurship programs should be designed and run by independent and central-focused governance system, Entrepreneurship education center.

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An Empirical Study of Discontinuous Use Intention on SNS: From a Perspective of Society Comparison Theory (사회비교이론 관점에서 살펴본 SNS 이용중단 의도)

  • Cha, Kyung Jin;Lee, Eun Mok
    • The Journal of Society for e-Business Studies
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    • v.20 no.3
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    • pp.59-77
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    • 2015
  • Social networking sites (SNS), such as Facebook, provide abundant social comparison opportunities. Given the widespread use of SNSs, the purpose of the present study was to examine the impact of exposure to social media-based social comparison on user's negative emotions and discontinuous use intention on SNS. We present evidence that under the use of SNS, social comparison activities diverge into three patterns, with explicit self-evaluation desire made against similar target (lateral comparison), self-defense desire made against less fortunate target (downward comparison), and self-enhancement desire made with more fortunate target (upward comparison). Such social comparison processes frequently arise, as people are increasingly using on SNSs, the downward contacts ameliorating self-esteem with positive emotions, but the upward contacts and standard contacts with lateral status enabling a person to compare his or her situation with others and simultaneously increase negative emotions due to its differences with others. In other words, as people increasingly relying on SNSs for a variety of everyday tasks, they risk overexposure to upward or standard social comparison information that may have a cumulative detrimental impact on future intention on SNS use. This study with survey with 209 SNS users found that these negative emotions lead to negative fatigue (attitude) and then discontinuous use intention (behavior) on SNS. Our findings are among the first to explicitly examine discontinuous use intention on SNS using social comparison theory and our results are consistent with those of past research showing that upward social comparisons can be detrimental.