• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.3
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• pp.263-269
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• 2001

Median cleft of the lower lip and/or mandible is a rare congenital anomaly, first mentioned by Couronne in 1819. Monroe(1966), Fujino(1970), Ranta(1984) and Oostrom(1996) conducted comprehensive reviews and list cases in literature. Median cleft varies greatly, from a simple vermilion notch to a complete cleft of the lip involving the tongue, the chin, the mandible, the supporting structures of the median of the neck, and the manubrium sterni. The associated anomalies include ankyloglossia, cleft tongue, neck contraction, heart lesion, absence of hyoid bone, and so on. The etiology of median cleft is unknown. Various possibilities, such as failure of mesodermal penetration into the midline, failure of fusion of mandibular processes, external factors apart from the embryogenic pattern such as pressure, position in utero, circulatory failure caused placental adhesion, diseases in pregnancy, and so on, have been discussed. A 8-year-old girl was referred to the Dept. of Oral & Maxillofacial Surgery, Kyungpook National University Hospital and had been aware of the fact that at birth "she had something wrong with her mouth." Shortly after birth she had been examined by a plastic surgeon and at that time surgical procedure had been performed to release the tongue from the lower jaw and lip at local hospital. On admission, she had a slight notching of lower lip and two fibrous frenum ran from the lip along the ventral surface of the tongue, diastema between her mandibular central incisors, and slightly constricted bifid mandible associated independent movement of the two halves of mandible. The patient had autogenous iliac bone graft to reconstruct the mandibular midline defect. The postoperative result was uneventful. In future, the correction of the soft tissue deformities such as notching of the lower lip and partial ankyloglossia will be required for the esthetic and functional improvement.

• Journal of the Korean Institute of Landscape Architecture
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• v.37 no.1
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• pp.28-42
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• 2009

In the wake of categorizing the design changes occurred during the period from 2004 till the first half of 2006 in Choongcheong province area, based on purpose and reason of design changes identified by the Korea National Housing Corp, it included 11 types such as the image of the apartment complex, scenic elements, consideration by the user, prevention of the defect, constructability, site conditions, incompatibility between the activities, superordinate standard, prevention of civic complaints, design details and others, along with 47 subordinate elements. And the evaluation intended to identify the corelation between the number and time of design change approval, frequency and scale of design change by type and the cost variations indicated that; firstly, enhancing the image of the apartment complex proved to be the main reason for design changes, accounting for 22% in terms of frequency and 54.9% in terms of cost variation. Secondly, the higher the increase in cost by design change aimed at improving the image of the complex, the lower the decrease in cost by design change for uncertain reasons, dubbed the inverse proportional relations, indicating that the design changes for uncertain reasons were mostly aimed at reducing the construction cost. Thirdly, with regard to the number of design change approval and the time of the initial approval, twice or less and 90 days or less before completion of the construction work, respectively, accounted for $52{\sim}53%$, indicating the design change deliberation and approval tended to have been carried out collectively in the form of ex post facto approval, which seemed to be attributable to the attempt of reducing the construction cost or budget problem, as a result of comparing with the cases in which the cost was reduced.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.75-103
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• 2017

There are three types of benefits in the National Health Insurance Act of Korea. Those are the treatment benefit, statutory uninsured medical benefits and arbitrary uninsured medical benefits. Recently the Korea Supreme Court changed its past legal theory and permitted the arbitrary uninsured medical benefits under the strictly exceptional conditions. According to the Supreme Court's decision, the existence of procedural difficulty, the medical necessity and the patient's consent are necessarily required in order to allow the legal exceptions in arbitrary uninsured medical benefits. Among the three requirements, the doctor's explanation and the patient's fully informed consent are the most important essentials in this legal conflict. The requirement concerning the doctor's explanation and the patient's consent roles like a hole in the ice as a breathing hole in the arbitrary uninsured medical benefits. The most cases dismissed after Supreme Court Decision 2010DU27639, 27646 Decided June 18, 2012. were due to the defect of three requirements.

• Archives of Plastic Surgery
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• v.33 no.3
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• pp.289-293
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• 2006

By means of microsurgical free-tissue transfer providing a large amount of required tissue, the surgeon can resect tumoral tissue more safely, which allows tumor-free margins and enhances the reliability of the ablative surgery that otherwise could not be performed radically. The morbidity of elective free-tissue transfer seems to be quite low, carrying acceptable risks for most patients. But the elderly patients are at risk for cardiac and respiratory problems, deep vein thrombosis, pulmonary emboli and infection merely as a function of age. This study was undertaken to define further risks of the elderly population with regards to free-tissue transfer. We retrospectively reviewed our experience with 110 microsurgical free-tissue transfers for head and neck reconstruction in patients greater than 60 years of age. Microsurgical procedures in all cases were preformed by the plastic and reconstructive department at Yonsei medical center. The investigated parameters were patient demographics, past medical history, American Society of Anesthesiologists(ASA) status, site and cause of defect, the free tissue transferred and postoperative complication including free-flap success or failure. There were 46 patients in the age group from 60 to 64 years, 34 patients from 65 to 70 years, and 30 patients 70 years or older. There happened 3 flap losses, resulting in a flap viability rate of 97%. Patients with a higher ASA designation experienced more medical complication(p=0.05, 0.01, 0.03 in each age group I, II, III) but not surgical complication p=0.17, 0.11, 0.54 in each age group I, II, III). And the relationship between postoperative complication and age groups was not significant. These observations suggest that major determinant for postoperative medical complication be the patient's American Society of Anesthesiologists score, and chronologic age alone should not be an exclusion criterion when selecting patients for free-tissue transfer

• THE INTERNATIONAL COMMERCE & LAW REVIEW
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• v.62
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• pp.135-178
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• 2014

The Uniform Commercial Code (UCC) sets the standards of good faith in a commercial transaction for the sale of goods. With every sales contract, there is an implied obligation for both the seller and the buyer to negotiate the contract and perform under the terms of the contract in good faith. The agreement between both parties and the customs in the industry determine how the good faith standard should be applied to a particular transaction. Generally, the meaning of good faith, though always based on honesty, may vary depending on the specific context in which it is used. A person is said to buy in good faith when he or she holds an honest belief in his or her right or title to the property and has no knowledge or reason to know of any defect in the title. In section 1-201 of the UCC good faith is defined generally as "honesty in fact in the conduct or transaction concerned." Article 2 of the UCC says "good faith in the case of a merchant means honesty in fact and the observance of reasonable commercial standards of fair dealing in the trade." The sales contract will generally determine which party is required to perform first. This provision helps to determine if the buyer or the seller is in breach of the agreement due to failing to perform as stated by the contract. Either the seller must deliver the items before the buyer is required to accept and pay or the buyer must pay for the items before the seller has the duty to act in good faith and deliver the items in a reasonable manner. If the contract does not specifically define who is required to perform, industry customs and fair trade may determine what is acceptable for the transaction. Under the UCC, the buyer is required to pay for the goods when they are delivered, unless the contract states otherwise. Therefore, the UCC imposes an obligation of good faith on the performance of every contract or duty under its purview. The law also generally requires good faith of fiduciaries and agents acting on behalf of their principals. This article discusses problems of the principles of good faith under the UCC. Specifically, this paper focuses on the interpretation of UCC sections and analysis of various cases. By comparing, also, UCC and Korean law, the paper proposes some implications of good faith issues for Korean law.

• Clinical and Experimental Pediatrics
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• v.50 no.7
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• pp.665-671
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• 2007

Purpose : The purpose of this study was to investigate the clinical features and outcome in newborns undergoing cardiac surgery. Methods : Eighty two neonates underwent heart surgery for congenital heart defect at Kyungpook National University Hospital between March 2000 and February 2006. Patient characteristics (sex, age, diagnosis), pre-operative conditions, operation type, postoperative complications and mortality were reviewed retrospectively. Results : In 82 patients, 41 (50%) were male. The mean age and weight at operation were 12 days and 3.2 kg, respectively. The common cardiac anomalies were complete transposition of the great arteries (TGA), Tetralogy of Fallot (TOF), pulmonary atresia with intact ventricular septum, and single ventricle variants. Fifty seven operations were performed with cardiopulmonary bypass and corrective surgery was done on 54 patients. Arterial switch operation and modified Blalock-Taussig shunt were most frequently performed as corrective and palliative operations, respectively. The early hospital mortality rate was 7%; the late mortality was 3.9%. Complications were acute renal insufficiency, delayed sternal closure, wound infection, arrhythmia, and brain hemorrhage. Conclusion : During the last 6 years, the outcomes of cardiac surgery for congenital heart defects in neonates improved by progress in perioperative, anaesthetic, surgical, and postoperative care.

• THE INTERNATIONAL COMMERCE & LAW REVIEW
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• v.17
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• pp.251-293
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• 2002

The study is a comparative and analytical study which comprises of the analysis of the rules of the buyer's right to withhold performance where the seller delivers defective goods or documents of three legal systems; the CISG, English law and Korean law. The purposes underlying this study are twofold. The first is to clarify the current position as to the right of withholding performance in the event of the seller's tender of defective goods or documents in Korean law, CISG and English law so that it may assist the parties in drafting the buyer's right to withhold performance in their own contract. The second is to compare the rules of one jurisdiction with those of other jurisdictions and to evaluate the rules in light of the practical functions and benefits of the right to withhold performance and the discipline of comparative law the basic question of which is whether a solution from one jurisdiction may facilitate the systematic development and reform of another jurisdiction. It shows that each jurisdiction does not have any provision or case law specifically dealing with the buyer's right to withhold performance where the seller delivers the goods which are defective in terms of quality or quantity. The absence of such provision or case in each jurisdiction has resulted in either disputes or uncertainty. However, the study executed in light of the primary functions and benefits of the right in practice and the discipline of comparative law reveals that, first, the view in English law which is against recognizing the right may not be justified when one considers the practical importance of having the right and the position taken by the CISG as a well developed and modernized law, second, the view in Korean law which argues that the principle of specific goods dogma on which it is based is extended even to substitutable or repairable goods cannot be also justified on the ground of one's ordinary expectation and the position under the CISG and English law which imposes a contractual duty to deliver non-defective goods on the seller insofar as the buyer's payment is deemed to be made in exchange for the seller's delivery of non-defective goods and they are substitutable or repairable. Regarding the right to withhold performance in the event of the seller's tender of defective documents, the study shows that the relatively detailed rules in English law may be utilized as a guideline to fill the gap in the CISG and Korean law in terms of the practicability and appropriateness to govern documentary sales. Furthermore, it is found that the position in English law which confers on the buyer the right to withhold performance for a trivial defect in documents may be unreasonable in terms of one's need to enable justice to be done in individual cases.

• Archives of Plastic Surgery
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• v.34 no.3
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• pp.279-284
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• 2007

Purpose: The vein graft was considered as a useful conduit for nerve defect. But the problem is that it might be collapsed in long vein graft state. A new experimental model using vein graft filled with hyaluronic acid was considered. Methods: Thirty rats were used for the experimental animal. In group I, one side of the femoral nerve was exposed and a segment was removed about 15mm. The neural gap was connected with nerve graft. In group II, the nerve gap was connected with vein graft only. In group III, the nerve gap was connected with vein graft filled with hyaluronic acid. A walking track analysis was made periodically for 2 months and NCV(nerve conduction velocity) was executed at the end of the experiment. And morphologic studies were also done for all groups Results: In a walking track analysis, the toe-spread was widen and the foot-length was lengthened. The recovery of the toe-spread and foot length was checked 2 weeks interval, periodically for two months. The SFI (sciatic function index) was $-52.5{\pm}8.2$ in group I, $-68.1{\pm}4$ in group II, $-55.3{\pm}7.9$ in group III. In electrophysiological study, NCV(nerve conduction velocity) was $26.71{\pm}3.11m/s$ in group I, $17.94{\pm}4.35m/s$ in group II, $25.69{\pm}2.81m/s$ in group III. The functional recovery in group I and III was superior to that the group II statistically(p < 0.05) Under electromicroscopic study, the number of the myelinated axons were $1419.1{\pm}240$ in group I, $921.7{\pm}176.8$ in group II, $1322.2{\pm}318$ in group III. The number of the myelinated axons were much more in group I and III than group II statistically (p<0.05). Conclusion: This study suggested that the vein graft filled with hyaluronic acid is more effective than vein graft only for the conduit of the nerve gap. It was thought that the technique could be used in clinical cases with nerve defects as an alternative method to classical nerve grafts.

• Journal of Society of Preventive Korean Medicine
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• v.7 no.2
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• pp.121-130
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• 2003

The Musculoskeletal Disease has been ignored or turned away due to the difficulty of diagnosis and the vagueness of judgement up to now. Contrary to other diseases, there were many cases where the character of the Musculoskeletal Disease wasn't revealed through the objective inspection. And that's because the Musculoskeletal Disease appears for the most part due to muscular defect so it is impossible to diagnose the muscle by X-ray diagnosing the bone and it is also impossible to diagnose the fine damage of the muscle or tendon even by advanced device like MRI. As the nervous blood vessels or acupunctures pass through or are next to the muscle, the tension of the muscle put pressure on these so can become the direct or indirect causes of various kinds of pains or intern diseases. But in spite of that, for lack of proper equipment diagnosing the state of the muscle(Shortened.. Relaxed... or Hardened...) the muscle has been disregarded or neglected intentionally or unintentionally. While many people think themselves to be a muscular expert, if they don't see the shape of the muscle, that is just like blind treatment. But as now the equipment diagnosing the state of the muscle is developed, it seems that this problem can be settled. It was attempted in this study that the muscle or skeleton of the Musculoskeletal disease patients was diagno the treatment order and method were decided by a questionnaire survey and simple inspection, and the Musculoskeletal correction exercise using the muscle management and sling system made them escape from the Musculoskeletal disease, turning their muscle into more flexible and stronger muscle. As a result notwithstanding the limited treatment period '12 times', the improvement rate was as high as 74%, which showed that the muscle management and Musculoskeletal correction exercise had a great effect on the symptom improvement of the patients. If the treatment times had increased, the improvement rate also would have increased more.

• Journal of Chest Surgery
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• v.22 no.2
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• pp.220-224
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• 1989

In candidates for aortic valve replacement [AVR]it is our primary intention to implant the largest possible vale prosthesis of at least 23 mm in diameter in patients with severe valvular aortic stenosis. However, in many patients there is an additional subvalvular asymmetric septal hypertrophy which in some cases may cause an postextrasystolic increase of the LV-aortic gradient. Another component of the aortic stenosis syndrome is a narrow valvular ring, or a combination of both. After complete removal of the diseased valve and decalcification the narrow aortic ring [< 23 mm] can be widened firstly by transaortic subvalvular septal myectomy- [TSM] thus unfolding the left ventricular outflow tract[LVOT]and secondly by extending the oblique aortic incision into the aortic valve ring or further down into the anterior leaflet of the mitral valve. The sub-and supra-valvular defect will be closed by patch enlargement of the aortic root [PEAR] using autologous pericardium. These techniques allow a considerable enlargement of the valvular ring of about 4 to 10 mm in circumference. In a retrospective study using a computerized program, 847 patients with AVR [1980-1984]were reviewed to evaluate the intraoperative hemodynamic results mainly concerning relief of the transvalvular gradient. In 626 patients AVR was performed, 151 patients had double valve replacement [AVR+MVR], and 70 patients had AVR plus additional surgical procedures. Concentrating on the AVR-group [n=626] there were 103 patients with TSM, 24 patients with PEAR and 20 patients with TSM+PEAR which demonstrated that in a total, of 147 patients of this groups [23.5%] an additional procedure was necessary. The Statistical evaluation of the intraoperative pressure measurements before and after AVR in relation to the size of the implanted prostheses indicated the lowest preoperative mean gradient in patients with AVR alone, the highest in patients who afforded TSM plus PEAR. However, after AVR the mean gradients in all three groups were very low [mean 5 to 10 mmHg]. These data indicate that in patients with a narrow aortic ring and additional considerable ASH, TSM and PEAR are suitable techniques to enlarge the aortic root to enable the implantation of an adequate aortic valve prosthesis. Long-term controls have shown that autologous pericardium is a qualified graft material for the ascending aorta.