• 의료법학
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• 제20권2호
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• pp.43-82
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• 2019

치료행위 등 의료적 침습행위가 이루어지는 경우 환자의 자기결정권이 보장될 수 있도록 설명에 의한 동의가 요구된다. 그런데 우리 의료 실무에서는 환자의 소위 '보호자'에게 의료행위에 대해 설명하고 동의를 받는 일이 매우 빈번하다. 보호자 개념은 의료법에서 여러 번 등장하지만, 정작 보호자의 자격이나 범위는 명확하게 규정하지 않으며, 병원에서 사용하는 수술동의서 등에서도 어느 범위의 사람을 보호자로 포섭할 것인지는 정의하고 있지 않다. 보호자가 문제된 사건들로부터, 환자의 법률상 배우자나 친족관계에 있는 사람을 의료기관이 보호자로 인정하고 있음은 짐작할 수 있으나, 설령 그렇다 하더라도 환자의 가족이 당연히 그를 위한 법정대리인이 되는 것은 아니다. 이 논문에서는, 환자의 소위 보호자가 환자의 의료행위 결정에 관여하는 경우, 환자에게 동의능력이 없는 경우와 있는 경우를 나누어 보호자에게 어떤 법적 지위를 부여할 수 있는지 검토하였다. 환자 스스로 동의능력이 없어 의료행위에 대해 동의 여부를 결정할 능력이 결여되어 있는 경우, 비교법적으로 다양한 해결책이 제시되고 있지만 크게 환자와 일정한 관계에 있는 사람을 법정 의료행위 대행결정권자로 규정하는 방법과 의료행위 대행결정권자를 규정하지 않고 의사가 의료행위 여부를 결정하되 환자의 가족이나 친구와 상담을 하거나 그에게 설명하는 방법이 있다. 본 글에서는 전자의 해법을 택하는 경우의 문제점을 논증하고, 후자의 접근에서는 주치의가 단독으로 결정함으로써 우려되는 권한 남용이나 경솔한 결정의 문제를 회피하기 위해 주치의 외의 다른 의사나 위원회의 동의를 얻는 해결책을 제시하였다. 더 나아가 환자가 스스로 의료행위에 대해 동의 여부를 결정할 능력이 있음에도 불구하고 환자의 가족에게 환자의 상태를 설명하는 일도 실무에서 자주 일어난다. 환자와 가족 모두에게 설명하고 그로부터 동의를 받는 경우는 환자의 가족이 심리적으로 약해진 환자의 이해능력을 보충해주고 그의 결정을 심리적으로 지지해주는 긍정적인 효과가 기대되지만, 반대로 가족 본인의 이익을 위해 환자에게 불리한 결정을 하도록 연약한 상태의 환자를 조종할 가능성도 배제할 수 없다. 후자의 위험을 최대한 억제하기 위해서는 환자의 가족과 환자가 분리된 상태에서 환자의 의료행위에 대한 동의 여부를 다시 한번 확인하는 방법을 생각해 볼 수 있다. 환자와 환자의 가족 사이의 공동의사결정에서, 환자의 자기결정권의 실질적 보장 문제는 법학계에서는 다소 생소한 주제이기는 하나, 우리 사회처럼 의료행위 동의여부 결정에 가족의 관여도가 높은 사회에서는 앞으로도 계속 고민해야 할 주제일 것이다.

• Bulletin of the Korean Chemical Society
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• 제32권2호
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• pp.716-718
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• 2011

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.4049-4057
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• 2016

Background: High-risk human papillomaviruses (HR-HPV), particularly types 16 and 18, have been found to play an important role in head and neck cancer, including oropharyngeal squamous cell carcinoma (OPSCC) and oral squamous cell carcinoma (OSCC). p16, a cell cycle inhibitor, has been postulated as a surrogate marker for HR-HPV, since p16 is aberrantly overexpressed in such lesions, especially in HR-HPV-positive OPSCC. However, p16 as a surrogate marker for HR-HPV infection in cancers of the oral cavity remains controversial. Objective: The objectives of the study were to investigate the expression of p16 and the presence of HR-HPV in OSCC and oral verrucous carcinoma (VC) and to determine if p16 could be used as a surrogate marker for HR-HPV. Materials and Methods: Forty one formalin-fixed, paraffin-embedded tissues of OSCC (n=37) or VC (n=4) with clinical and histopathologic data of each case were collected. Expression of p16 was determined by immunohistochemistry, focusing on both staining intensity and numbers of positive cells. The presence of HPV types 16 and 18 was detected by polymerase chain reaction (PCR). Descriptive statistics were employed to describe the demographic, clinical, and histopathologic parameters. Associations between p16 overexpression, HR-HPV and all variables were determined by Fisher's exact test, odds ratios (ORs) and corresponding 95% confidence intervals (CIs). In addition, the use of p16 as a surrogate marker for HR-HPV was analyzed by sensitivity and specificity tests. Results: p16 was overexpressed in 8/37 cases (21.6%) of OSCC and 2/4 cases (50%) of VC. HPV-16 was detected in 4/34 OSCC cases (11.8%) and HPV-18 was detected in 1/34 OSCC cases (2.9%). Co-infection of HPV-16/18 was detected in 1/4 VC cases (25%). Both p16 overexpression and HR-HPV were significantly associated with young patients with both OSCC and VC (p<0.05, OR 20, 95% CI 1.9-211.8; p<0.05, OR 23.3, 95% CI 2.4-229.7, respectively). p16 was able to predict the presence of HPV-16/18 in OSCC with 40% sensitivity and 79.3% specificity and in VC with 100% sensitivity and 66.7% specificity, respectively. Conclusions: p16 overexpression was found in 24.4% of both OSCC and VC. HR-HPV, regardless of type, was detected in 15.8% in cases of OSCC and VC combined. The results of sensitivity and specificity tests suggest that p16 can be used as a surrogate marker for HR-HPV in OSCC and VC.

• 한국수산과학회지
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• 제42권3호
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• pp.232-237
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• 2009

Norovirus surrogate (feline calicivirus) was inactivated by treatment at 50,000 psi for 60 sec by 6.8-$log_{10}TCID_{50}mL^{-1}$. Tissue obtained from oyster (digestive gland, gill and mantle) was qualitatively destroyed and distorted by treatment at pressure greater than 5,000 psi for 60 sec. High pressure treatment induced progressive changes in the color of the oyster adductor muscle. High pressure treatment effectively reduced norovirus surrogate but induced conformational changes in the tissue and color of oyster flesh.

• 품질경영학회지
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• 제37권2호
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• pp.46-57
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• 2009

The traditional approach to economic design of control charts is based on the assumption that a process is monitored using a performance variable. However, various types of automatic test equipments recently introduced as a part of factory automation usually measure surrogate variables instead of performance variables that are costly to measure. In this article we propose a model for economic design of a control chart which uses a surrogate variable that is highly correlated with the performance variable. The optimum values of the design parameters are determined by maximizing the total average income per cycle time. Numerical studies are performed to compare the proposed $\bar{X}$ control charts with the traditional model using the examples in Panagos et al. (1985).

• 소성∙가공
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• 제27권1호
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• pp.28-36
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• 2018

Electromagnetic forming is a type of high-speed forming process to deform a workpiece through a Lorentz force. As the high strain rate in an electromagnetic-forming simulation causes infeasibility in determining constitutive parameters, we employed inverse parameter estimation in the previous study. However, the inverse parameter estimation process required us to spend considerable time, which leads to an increase in computational cost. To overcome the computational obstacle, in this research, we applied two types of surrogate modeling methods and compared them to each other to evaluate which model is best for the electromagnetic-forming simulation. We exploited an artificial neural network and we reduced-order modeling methods. During the construction of a reduced-order model, we extracted orthogonal bases with proper orthogonal decomposition and predicted basis coefficients by utilizing an artificial neural network. After the construction of the surrogate models, we verified the artificial neural network and reduced-order models through training and testing samples. As a result, we determined the artificial neural network model is slightly more accurate than the reduced-order model. However, the construction of the artificial neural network model requires a considerably larger amount of time than that of the reduced-order model. Thus, a reduced order modeling method is more efficient than an artificial neural network for estimating the electromagnetic forming and for the rapid approximation of structural simulations which needs repetitive runs.

• 한국유체기계학회 논문집
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• 제16권6호
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• pp.32-39
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• 2013

In the present study, three-dimensional aerodynamic optimization of high pressure turbine nozzle for turbofan engine was performed. For this, Kriging surrogate model was built and refined iteratively by supplying additional experimental points until the surrogate model and CFX result has effective difference on objective function. When the surrogate model satisfied this reliability condition and developed enough, optimum point was investigated. Commercial program PIAnO was used for optimization process and evolutionary algorithm was used for searching optimum point. As a result, difference between estimated value from Kriging surrogate model and CFD result converges within 0.01% and the optimized nozzle shape has 0.83% improved aerodynamic efficiency.

• 제어로봇시스템학회논문지
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• 제12궈1호
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• pp.1-8
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• 2006

The home network system guarantees families a safe, economical, socially integrated and healthy life by using information appliances. And it provides a family with domestic safety, control of instruments, controllable energy and health monitoring by connecting to home appliances. This study designs the broadband PLC home controller using broadband PLC(Power Line Communication) technology which can save much cost at a network infrastructure by using the existing power line at home. The broadband PLC home controller consists of the broadband PLC module, the embedded main controller module and I/O module. The broadband PLC home controller can control various domestic appliances such as an auto door-lock, a boiler, an oven, etc., because it has various I/O specifications. In this study, selected home network middleware for the broadband PLC home controller is Jini surrogate using Jini technology designed by means of access to easily a home network system without a limitation of the devices. And a client application program is supported java servlet program to manage and monitor the broadband PLC home controller via web browser of a PC or a PDA, etc. Finally, for an application, we implemented and tested a home security system using one broadband PLC home controller.

• Ocean Systems Engineering
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• 제9권2호
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• pp.111-133
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• 2019

Flow through a scaled horizontal axis marine current turbine was numerically simulated after validation and the turbine design was optimized. The computational fluid dynamics (CFD) code Ansys-CFX 16.1 for numerical modeling, an in-house blade element momentum (BEM) code for analytical modeling and an in-house surrogate-based optimization (SBO) code were used to find an optimal turbine design. The blade-pitch angle (${\theta}$) and the number of rotor blades (NR) were taken as design variables. A single objective optimization approach was utilized in the present work. The defined objective function was the turbine's power coefficient ($C_P$). A $3{\times}3$ full-factorial sampling technique was used to define the sample space. This sampling technique gave different turbine designs, which were further evaluated for the objective function by solving the Reynolds-Averaged Navier-Stokes equations (RANS). Finally, the SBO technique with search algorithm produced an optimal design. It is found that the optimal design has improved the objective function by 26.5%. This article presents the solution approach, analysis of the turbine flow field and the predictability of various surrogate based techniques.

• Structural Engineering and Mechanics
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• 제83권2호
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• pp.167-178
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• 2022

Surrogate models aim to approximate the performance function with an active-learning design of experiments (DoE) to obtain a sufficiently accurate prediction of the performance function's sign for an inexpensive computational demand in reliability analysis. Nevertheless, many existing active-learning methods are limited to the Kriging model, while the uncertainties of the Kriging itself affect the reliability analysis results. Moreover, the existing general active-learning methods may not achieve a fully satisfactory balance between accuracy and efficiency. Therefore, a novel active-learning method GLM-CM is constructed to yield the issues, which conciliates several merits of existing methods. To demonstrate the performance of the proposed method, four examples, concerning both mathematical and engineering problems, were selected. By benchmarking obtained results with literature findings, various surrogate models combined with the proposed method not only provide an accurate reliability evaluation while highly alleviating the computational burden, but also provides a satisfactory balance between accuracy and efficiency compared to the other reliability methods.