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The Concept of 'Risk' and the Proportionality Review of Infectious Disease Prevention Measures (감염병 팬데믹에서의 '리스크' 개념과 방역조치에 대한 비례성 심사의 구체화 -집합제한조치에 대한 국내외 판결을 중심으로-)

  • You, Kihoon
    • The Korean Society of Law and Medicine
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    • v.23 no.3
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    • pp.139-207
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    • 2022
  • As various state restrictions on individual freedom were imposed during the COVID-19 pandemic, concerns have been raised that excessive infringements on fundamental rights were indiscriminately permitted based on the public interest of preventing infectious diseases. Therefore, the question of how to set acceptable limits of liberty restrictions on individuals has emerged. However, since the phenomenon of infections spreading to the population is only predicted statistically, how to deal with the risk of the infected individual as a subject of legal analysis has become a problem. In the absence of a theoretical framework of legal analysis of risk, the risk of infected individuals during the pandemic was not analyzed strictly, and proportionality review of infection prevention measures was often only an abstract comparison of the importance of public interest and individual rights. Therefore, this research aims to conduct a theoretical review on how risk can be conceptualized legally in a public health crisis, and to develop a theoretical framework for proportionality review of the risk of liberty-limiting measures during a pandemic. Chapter 2 analyzes the legal philosophical concepts of risk, which are the basis for liberty restrictions during a public health crisis, and applies and extends them to the pandemic. Chapter 3 reviews previous studies related to liberty restriction measures in the context of the COVID-19 pandemic, and points out they have a limitation that specific criteria for the proportionality review of public health measures in the pandemic have not been presented. Accordingly, Chapter 3 specifies the methodological framework for proportionality review, referring to the theoretical discussion on risks in Chapter 2. Chapter 4 reviews the legitimacy of gathering restriction orders, applying the theoretical discussion in Chapter 2 and the criteria for proportionality review established in Chapter 3. In particular, Section 4 examines logic of proportionality review in judicial precedents over the ban on gathering restrictions implemented in the COVID-19 pandemic. In analyzing the precedents, the logic of proportionality review in each case is critically reviewed and reconstructed based on the theoretical framework presented in this research.

Early Failure of Cortical-Bone Screw Fixation in the Lumbar Spinal Stenosis (요추부 협착에서의 피질골 궤도 나사못 고정의 초기 실패 사례에 대한 고찰)

  • Kwon, Ji-Won;Kim, Jin-Gyu;Ha, Joong-Won;Moon, Seong-Hwan;Lee, Hwan-Mo;Park, Yung
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.405-410
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    • 2020
  • Purpose: Pedicle screw insertion has been traditionally used as a surgical treatment for degenerative lumbar spine disease. As an alternative, the cortical-bone trajectory screw allows less invasive posterior lumbar fixation and excellent mechanical stability, as reported in several biomechanical studies. This study evaluated the clinical and radiological results of a case of early failure of cortical-bone screw fixation in posterior fixation and union after posterior decompression. Materials and Methods: This study examined 311 patients who underwent surgical treatment from 2013 to 2018 using cortical orbital screws as an alternative to traditional pedicle screw fixation for degenerative spinal stenosis and anterior spine dislocation of the lumbar spine. Early fixation failure after surgery was defined as fixation failure, such as loosening, pull-out, and breakage of the screw on computed tomography (CT) and radiographs at a follow-up of six months. Results: Early fixation failure occurred in 46 out of 311 cases (14.8%), screw loosening in 46 cases (14.8%), pull-out in 12 cases (3.9%), and breakage in four cases (1.3%). An analysis of the site where the fixation failure occurred revealed the following, L1 in seven cases (15.2%), L2 in three cases (6.5%), L3 in four cases (8.7%), L4 in four cases (8.7%), L5 in four cases (8.7%), and S1 in 24 cases (52.2%). Among the distal cortical bone screws, fixation failures such as loosening, pull-out, and breakage occurred mainly in the S1 screws. Conclusion: Cortical-bone trajectory screw fixation may be an alternative with comparable clinical outcomes or fewer complications compared to conventional pedicle screw fixation. On the other hand, in case with osteoporosis and no anterior support structure particularly at L5-S1 fusion sites were observed to have result of premature fixation failures such as relaxation, pull-out, and breakage.

Preliminary Result of Revision Fusion Surgery for Thoracolumbar Spine Using Revision Rod (Revision Rod를 이용한 흉요추 유합 재수술 예비 결과)

  • Youn, Yung-Hun;Cho, Kyu-Jung;Park, Ye-Su;Park, Jae-Woo;Park, Jin-Sung;Kwon, Won-Hwan
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.6
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    • pp.520-526
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    • 2020
  • Purpose: The need for revision fusion surgery after spinal fusion has increased. A revision rod that connects to the previous rod was newly developed for revision surgery. The purpose of this study was to analyze the clinical and radiological results after spinal fusion revision surgery using revision rods. Materials and Methods: Twenty-one patients who underwent revision fusion surgery after spinal fusion in two university hospitals with minimum 1 year follow-up were reviewed. This study assessed 16 cases of adjacent-segment disease, four cases of thoracolumbar fracture, and one case of ossification of ligament flavum. The Oswestry Disability Index (ODI) and numerical rating scale (NRS) were evaluated as clinical outcomes, and the union rate, lordosis or kyphosis of the revision level, lumbar lordosis, T5-12 kyphosis, and proximal junctional kyphosis angle were evaluated as the radiological outcomes. Results: The average ODI was 54.6±12.5 before surgery and improved to 29.8±16.5 at the final follow-up. The NRS for back pain and leg pain was 5.0±1.7 and 6.4±2.0 before surgery, which changed to 2.9±1.6 and 2.9±2.2 at the final follow-up. Lumbar lordosis was 18.1°±11.9° before surgery and 21.1°±10.3° at the final follow-up. Proximal junctional kyphosis was 10.8°±10.1° before surgery, and 9.2°±10.5° at the final follow-up. These angles were not changed significantly after surgery. Bony union was successful in all cases except for one case who underwent posterolateral fusion. Conclusion: Revision surgery using a newly developed revision rod on the thoracolumbar spine achieved good clinical outcomes with successful bony union. No problems with the newly developed revision rod were encountered.

The effect of health related characteristics on the use of information and communication technology of older adults (노인의 정보화 수준에 영향을 미치는 건강특성 연구)

  • Koo, Bon Mi;Joo, Ik Hyun
    • 한국노년학
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    • v.40 no.4
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    • pp.729-746
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    • 2020
  • For the development and better use of information and communication technology(ICT) for promoting health and quality of life in older people, it is important to understand personal factors associated with ICT use. The aims of this study were to describe the pattern of ICT use according to health characteristics of elderly and to investigate significant factors related to ICT use among three age groups. The data of 2017 National Survey of Older Koreans was used for analysis and 10,058 of older adults aged 65 and over were included for study participants. As results, first, the young old(65~74) used more functions of ICT than the middle-old(75~84) and the old-old(85 and over). Second, ICT was more used among older people with good conditions in chronic disease, subjective health, cognition, depression, vision, hearing, walking and IADL. Third, higher prevalence of ICT use was significantly associated with age, education, household income, subjective health, depression, cognitive function, vision limitation and walking limitation. Fourth, factors influencing the use of ICT were a little different among three age groups. For the young-old(65~74), subjective health, depression, cognitive decline, walking limitation, and IADL disability were significant factors affecting on ICT use. For the middle-old(75-84), subjective health, depression, cognitive decline, vision, hearing, and walking limitation were related with their ICT use. For the old-old(85 and over), only cognitive function and depression were associated with their ICT use. Based on these results, this study suggested the need to consider multiple health conditions for developing and using ICT for older adults.

Inhibitory effect of water-soluble mulberry leaf extract on hepatic lipid accumulation in high-fat diet-fed rats via modulation of hepatic microRNA-221/222 expression and inflammation (고지방식이 급여 쥐에서 수용성 뽕나무 잎 추출물의 간 microRNA-221/222 발현 및 염증 조절을 통한 간 지질 축적억제 효과)

  • Lee, Mak-Soon;Kim, Cheamin;Ko, Hyunmi;Kim, Yangha
    • Journal of Nutrition and Health
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    • v.55 no.2
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    • pp.227-239
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    • 2022
  • Purpose: This study investigated the effects of water-soluble mulberry leaf extract (ME) on hepatic lipid accumulation in high-fat diet-fed rats via the regulation of hepatic microRNA (miR)-221/222 and inflammation. Methods: Male Sprague-Dawley rats (4 weeks old) were randomly divided into 3 groups (n = 7 each) and fed with 10 kcal% low-fat diet (LF), 45 kcal% high-fat diet (HF), or HF + 0.8% ME for 14 weeks. Lipid profiles and cytokine levels of the liver and serum were measured using commercial enzymatic colorimetric and enzyme-linked immunosorbent assay, respectively. The messenger RNA (mRNA) and miR levels in liver tissue were assayed by real-time quantitative reverse-transcription polymerase chain reaction. Results: Supplementation of ME reduces body weight and improves the liver and serum lipid profiles as compared to the HF group. The mRNA levels of hepatic peroxisome proliferator-activated receptor-gamma, sterol regulatory element binding protein-1c, fatty acid synthase, and fatty acid translocase, which are genes involved in lipid metabolism, were significantly downregulated in the ME group compared to the HF group. In contrast, the mRNA level of hepatic carnitine palmitoyl transferase-1 (involved in fatty acid oxidation) was upregulated by ME supplementation. Furthermore, administration of ME significantly downregulated the mRNA levels of inflammatory mediators such as hepatic tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), monocyte chemoattractant protein-1, and inducible nitric oxide synthase. The serum levels of TNF-α, IL-6, and nitric oxide were also significantly reduced in ME group compared to the HF group. Expression of hepatic miR-221 and miR-222, which increase in the inflammatory state of the liver, were also significantly inhibited in the ME group compared to the HF group. Conclusion: These results indicate that ME has the potential to improve hepatic lipid accumulation in high-fat diet-fed rats via modulation of inflammatory mediators and hepatic miR-221/222 expressions.

Ventilation at Supra-Optimal Temperature Leading High Relative Humidity Controls Powdery Mildew, Silverleaf Whitefly, Mite and Inhibits the Flowering of Korean Melon in a Greenhouse Cultivation (참외 시설 재배 시 고온에서의 환기 처리에 의한 상대습도 상승과 흰가루병, 담배가루이, 응애 방제 및 개화 억제)

  • Seo, Tae Cheol;Kim, Jin Hyun;Kim, Seung Yu;Cho, Myeong Whan;Choi, Man Kwon;Ryu, Hee Ryong;Shin, Hyun Ho;Lee, Choung Keun
    • Journal of Bio-Environment Control
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    • v.31 no.1
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    • pp.43-51
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    • 2022
  • This study was conducted to investigate the effect of ventilation at high temperature on the control of powdery mildew, silverleaf whitefly two-spotted spider mite occurred at Korean melon cultivation greenhouse, and on leaf rolling and flowering of the plant in summer season. 'Alchanggul' grafted onto 'Hidden Power' rootstock was planted on soil bed with the distance of 40 cm. Three ventilation temperatures of 45℃, 40℃, and 35℃ as set points were compared. Ventilation treatment was done by control of side window operation from 18th June to 13th July when silverleaf whitefly, mite, and powdery mildew were occurred in all greenhouses. The temperature inside greenhouse was increased up to the set temperature point on sunny days and maintained for about 9 hours with high relative humidity at 45℃ condition. The differences of day maximum air temperature and day minimum RH were the highest at 45℃ treatment. After 11 days of treatments, the damage by powdery mildew and two-spotted spider mite was almost recovered at 45℃ treatment but not at 40 and 35℃. The population of silverleaf whitefly and two-spotted spider mite were significantly decreased at 45℃ treatment at 14 days after treatment, while powdery mildew symptom was not significantly decreased. Leaf rolling was observed at high temperature but not severe at 45℃ treatment. After 26 days of treatments, female flowers did not bloom at all at 45℃ treatment, and the number of male flowers was 1.2 among 15 nodes of newly grown shoots. As the result, it indicates that ventilation at the high temperature of 45℃ for about 2 to 3 weeks can be an applicable method to control above mentioned pests and disease, and to recover the vegetative growth of Korean melon by reducing flowering of the plant.

Quantitative Assessment of Coronary Artery Diameter in Patients with Atrial Fibrillation and Normal Sinus Rhythm (심방세동 환자와 정상 심전도 환자의 관상동맥 직경 정량적 평가)

  • Seo, Young-Hyun
    • Journal of the Korean Society of Radiology
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    • v.16 no.5
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    • pp.567-574
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    • 2022
  • Coronary artery disease (CAD) and atrial fibrillation (AF) are known to share many risk factors. In particular, in the case of acute coronary syndrome, it may be difficult to clearly determine the diameter of the vessel due to complete occlusion of the vessel and thrombus. Thus, the relationship between the diameter of the coronary arteries was evaluated to be used as a reference data before the treatment of coronary arteries and drug selection in patients with AF. From January 2020 to August 2022, images of coronary angiography (CAG) with AF and normal sinus rhythm (NSR) on electrocardiography were target. In both subjects, images of normal coronary artery without lesions as a result of CAG were used. For all vessels, the diameters of the vessels were measured by dividing them into proximal, middle, and distal parts, and the measured diameters were divided by the average for evaluation. As a result of analyzing the left anterior descending artery diameter, the vessel diameter of the AF patient was 2.24±0.26 mm, which was smaller than that of the NSR patient, 2.86±0.38 mm, and was statistically significant. (p<0.001) As a result of analyzing the left circumflex artery diameter, the vessel diameter of the AF patient was 2.34±0.28 mm, which was smaller than the vessel diameter of the NSR patient, 2.87±0.29 mm, and was statistically significant. (p<0.001) As a result of analyzing the diameter of the right coronary artery, the vessel diameter of the AF patient was 2.68±0.5 mm, which was smaller than the vessel diameter of the NSR patient, 3.35±0.4 mm, and was statistically significant. (p<0.001) Considering that the coronary artery size of AF patients is significantly smaller than the coronary vessel size of NSR patients, it is considered as a useful study to be used as a reference for evaluating coronary artery diameter when the arrhythmia is AF. In particular, it is considered to be a study that can be helpful in diagnosing lesions, using drugs before and after surgery, and choosing to use auxiliary devices such as intravascular ultrasound.

Comparison of the Efficacy of Disinfectants to Control Caseous Lymphadenitis in Korean Black Goat Farms (흑염소의 건락성 림프절염 제어를 위한 소독제 효능 비교)

  • Cho, Hyeunwoo;Kim, Yeona;Jang, Beomsoon;Kim, Chan-Lan;Park, Kun Taek
    • Journal of Food Hygiene and Safety
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    • v.37 no.5
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    • pp.317-322
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    • 2022
  • Corynebacterium pseudotuberculosis is the causative agent of caseous lymphadenitis (CLA), a chronic contagious disease in small ruminants. The prevalence of CLA has been reported to be >50% in Korean black goats. CLA is difficult to control due to a lack of efficient vaccines and treatment methods. Effective disinfection of the farm environment may be an alternative strategy for reducing the spread of C. pseudotuberculosis. The objective of this study was to evaluate the efficacy of commercial disinfectants against CLA. The six commercial disinfectants, largely composed of sodium dichloroisocyanurate, sodium hypochlorite, potassium monopersulfate triple salt, quaternary ammonium, citric acid, and copper sulfate, were tested against five different genotypes of C. pseudotuberculosis isolated from goat farms in Korea. Efficacy tests were performed in accordance with the disinfectant efficacy test guidelines recommended by the Animal and Plant Quarantine Agency of Korea with slight modifications. All disinfectants except for copper sulfate exhibited >99.99% killing efficacy under hard water conditions following 30 min of incubation, which is the recommended standard treatment time according to guidelines. The minimum bactericidal treatment time was evaluated by employing treatments for durations of 1, 5, and 15 min. The most effective compounds under hard water conditions were sodium dichloroisocyanurate, potassium monopersulfate triple salt, and sodium hypochlorite, exhibiting >99.99% killing efficacy after 1 min of treatment. In the aqueous solution forms, citric acid and the quaternary ammonium compound were the most effective, but required at least 5 min to kill >99.99% of the bacteria. The current study characterizes the killing efficacy of six commercial disinfectant active compounds against C. pseudotuberculosis. Thus, this study provides essential information regarding the efficacy of the disinfectants used to control CLA in goat farms.

The Association between HbA1c and the Biological Exposure Index for Heavy Metals in Community (지역사회 주민의 당화혈색소와 중금속 생체표지자와의 관련성)

  • Min, Young-Sun;Lee, Kwan
    • Journal of agricultural medicine and community health
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    • v.47 no.3
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    • pp.181-188
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    • 2022
  • Objectives: The prevalence of diabetes mellitus was approximately 16% in populations of over age 30 years, and deaths from diabetes mellitus became the sixth most prevalent cause of death by disease. To assess the relationship between HbA1c and heavy metal level in blood and urine, targeted residents were evaluated in a vast steel industrial complex. Methods: We selected 414 subjects for analysis after applying the following exclusion criterion: 18 persons with diabetes mellitus. They took part in a questionnaire survey and underwent blood and urinary assessments. HbA1c and lead (Pb) level were measured in blood and, cadmium (Cd), inorganic arsenic (iAs) and mercury (Hg) were evaluated in urine. Two subgroups were divided by HbA1c 6.5%. Each subgroup was divided by 10th, 20th, 30th, 40th, 50th, 60th, 70th, 80th and 90th percentile levels of biological exposure index of the heavy metals for logistic regression. Results: Odd ratios have a tendency to increase as they go from the 90th to the 10th percentile of cadmium. However, lead, arsenic and mercury did not have significant relationships with HbA1c. In correction of age, region, gender and smoking history, a higher distribution in the subgroup with cadmium above 0.8318 ㎍/g creatinine (30th percentile) was demonstrated in the subgroup with HbA1c levels above the 6.5%, with an odds ratio of 5.26 (95% C.I. ; 1.44~19.17). Conclusion: This study found a significant correlation between urinary levels of cadmium and HbA1c in correction of several factors. It is meaningful that this outcome may be used as a basis for a study to establish the acceptable limit of urinary cadmium in Korea.

African Swine Fever Outbreak in North Korea and Cooperation between South and North Korea (북한지역에서 ASF발병 현황 및 남북수의협력에 관한 연구)

  • Cho, Chung Hui
    • Journal of Appropriate Technology
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    • v.6 no.1
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    • pp.21-27
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    • 2020
  • The ASF, which originated in Africa and threatens the world, landed in Asia in 2018 in China, and became a stern threat to the security of the Korean Peninsula when North Korea officially reported the ASF to the OIE in May 2019. In 1921, Montgomery, a British veterinary pathologist, made headlines by naming the African swine fever "African Swine Fever," or ASF, a disease caused by a high fatality virus that existed in East Africa. The ASF, which was a pandemic of endemic diseases in Africa, landed in Portgal around 1957 and swept through farms in Lisbon, Portugal. The ASF continued to settle in Spain and Portugal, causing 40 years of damage until the end of the 1990s, and is now in progress after landing on the Italian island of Sardinia in 1978. The virus, which landed in Portiport of Georgia on the Black Sea coast of the Black Sea in 2007, spread to Russia and caused massive damage to China in 2018, then rapidly spread to Vietnam, Laos and Myanmar in May 2019 and spread across the country, causing massive damage to the pork industry and is now in progress. Just three months after confirming the outbreak in North Korea, the outbreak at farms in Paju and Yeoncheon was confirmed on Sept. 16, 2019, leaving South Korea with the stigma of ASF-causing countries, and although the ASF's nationwide expansion has been blocked, it is currently underway in wild boars. If the ongoing ASF in the two Koreas becomes indigenous, it would be a major disaster not only for the pork industry but also for the Korean Peninsula economy. Under the current circumstances, it is impossible to focus only on veterinary areas limited to South Korea, ruling out risk factors from the ASF outbreak. Currently, it is difficult to prevent damage to the pork industry due to the ASF outbreak due to the poor water defense reality in North Korea, and as it is adjacent to China, which has a high risk of developing various epidemic diseases, there is a need for the two Koreas to jointly conduct quarantine and quarantine on the border areas. First of all, I think rapid exchange of information and education on ASF and other diseases is necessary before establishing a joint defense system on the Korean Peninsula. It is important to conduct thorough quarantine and disinfection of ASF-generated areas in North Korea, and areas bordering China and Russia, and jointly conduct thorough quarantine and control of livestock and livestock products in circulation. Cooperation by the South and North Korean water defense industries to prevent the protracted ASF on the Korean Peninsula by all means and methods is essential.