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Review of 2015 Major Medical Decisions (2015년 주요 의료판결 분석)

  • Yoo, Hyun Jung;Lee, Dong Pil;Lee, Jung Sun;Jeong, Hye Seung;Park, Tae Shin
    • The Korean Society of Law and Medicine
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    • v.17 no.1
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    • pp.299-346
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    • 2016
  • There were also various decisions made in medical area in 2015. In the case that an inmate in a sanatorium was injured due to the reason which can be attributable to the sanatorium and the social welfare foundation that operates the sanatorium request treatment of the patient, the court set the standard of fixation of a party in medical contract. In the case that the family of the patient who was declared brain dead required withdrawal of meaningless life sustaining treatment but the hospital rejected and continued the treatment, the court made a decision regarding chargeable fee for such treatment. When it comes to the eye brightening operation which received measure of suspension from the Ministry of Health and Welfare for the first time in February, 2011, because of uncertainty of its safety, the court did not accept the illegality of such operation itself, however, ordered compensation of the whole damage based on the violation of liability for explanation, which is the omission of explanation about the fact that the cost-effectiveness is not sure as it is still in clinical test stage. There were numerous cases that courts actively acknowledged malpractices; in the cases of paresis syndrome after back surgery, quite a few malpractices during the surgery were acknowledged by the court and in the case of nosocomial infection, hospital's negligence to cause such nosocomial infection was acknowledged by the court. There was a decision which acknowledged malpractice by distinguishing the duty of installation of emergency equipment according to the Emergency Medical Service Act and duty of emergency measure in emergency situations, and a decision which acknowledged negligence of a hospital if the hospital did not take appropriate measures, although it was a very rare disease. In connection with the scope of compensation for damage, there were decisions which comply with substantive truth such as; a court applied different labor ability loss rate as the labor ability loss rate decreased after result of reappraisal of physical ability in appeal compared to the one in the first trial, and a court acknowledged lower labor ability loss rate than the result of appraisal of physical ability considering the condition of a patient, etc. In the event of any damage caused by malpractice, in regard to whether there is a limitation on liability in fee charge after such medical malpractice, the court rejected the hospital's claim for setoff saying that if the hospital only continued treatments to cure the patient or prevent aggravation of disease, the hospital cannot charge Medical bills to the patient. In regard to the provision of the Medical Law that prohibit medical advertisement which was not reviewed preliminarily and punish the violation of such, a decision of unconstitutionality was made as it is a precensorship by an administrative agency as the deliberative bodies such as Korean Medical Association, etc. cannot be denied to be considered as administrative bodies. When it comes to the issue whether PRP treatment, which is commonly performed clinically, should be considered as legally determined uninsured treatment, the court made it clear that legally determined uninsured treatment should not be decided by theoretical possibility or actual implementation but should be acknowledged its medical safety and effectiveness and included in medical care or legally determined uninsured treatment. Moreover, court acknowledged the illegality of investigation method or process in the administrative litigation regarding evaluation of suitability of sanatorium, however, denied the compensation liability or restitution of unjust enrichment of the Health Insurance Review & Assessment Service and the National Health Insurance Corporation as the evaluation agents did not cause such violation intentionally or negligently. We hope there will be more decisions which are closer to substantive truth through clear legal principles in respect of variously arisen issues in the future.

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Temporal Variations of Ore Mineralogy and Sulfur Isotope Data from the Boguk Cobalt Mine, Korea: Implication for Genesis and Geochemistry of Co-bearing Hydrothermal System (보국 코발트 광상의 산출 광물종 및 황동위원소 조성의 시간적 변화: 함코발트 열수계의 성인과 지화학적 특성 고찰)

  • Yun, Seong-Taek;Youm, Seung-Jun
    • Economic and Environmental Geology
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    • v.30 no.4
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    • pp.289-301
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    • 1997
  • The Boguk cobalt mine is located within the Cretaceous Gyeongsang Sedimentary Basin. Major ore minerals including cobalt-bearing minerals (loellingite, cobaltite, and glaucodot) and Co-bearing arsenopyrite occur together with base-metal sulfides (pyrrhotite, chalcopyrite, pyrite, sphalerite, etc.) and minor amounts of oxides (magnetite and hematite) within fracture-filling $quartz{\pm}actinolite{\pm}carbonate$ veins. These veins are developed within an epicrustal micrographic granite stock which intrudes the Konchonri Formation (mainly of shale). Radiometric date of the granite (85.98 Ma) indicates a Late Cretaceous age for granite emplacement and associated cobalt mineralization. The vein mineralogy is relatively complex and changes with time: cobalt-bearing minerals with actinolite, carbonates, and quartz gangues (stages I and II) ${\rightarrow}$ base-metal sulfides, gold, and Fe oxides with quartz gangues (stage III) ${\rightarrow}$ barren carbonates (stages IV and V). The common occurrence of high-temperature minerals (cobalt-bearing minerals, molybdenite and actinolite) with low-temperature minerals (base-metal sulfides, gold and carbonates) in veins indicates a xenothermal condition of the hydrothermal mineralization. High enrichment of Co in the granite (avg. 50.90 ppm) indicates the magmatic hydrothermal derivation of cobalt from this cooling granite stock, whereas higher amounts of Cu and Zn in the Konchonri Formation shale suggest their derivations largely from shale. The decrease in temperature of hydrothermal fluids with a concomitant increase in fugacity of oxygen with time (for cobalt deposition in stages I and II, $T=560^{\circ}C-390^{\circ}C$ and log $fO_2=$ >-32.7 to -30.7 atm at $350^{\circ}C$; for base-metal sulfide deposition in stage III, $T=380^{\circ}-345^{\circ}C$ and log $fO_2={\geq}-30.7$ atm at $350^{\circ}C$) indicates a transition of the hydrothermal system from a magmatic-water domination toward a less-evolved meteoric-water domination. Sulfur isotope data of stage II sulfide minerals evidence that early, Co-bearing hydrothermal fluids derived originally from an igneous source with a ${\delta}^{34}S_{{\Sigma}S}$ value near 3 to 5‰. The remarkable increase in ${\delta}^{34}S_{H2S}$ values of hydrothermal fluids with time from cobalt deposition in stage II (3-5‰) to base-metal sulfide deposition in stage III (up to about 20‰) also indicates the change of the hydrothermal system toward the meteoric water domination, which resulted in the leaching-out and concentration of isotopically heavier sulfur (sedimentary sulfates), base metals (Cu, Zn, etc.) and gold from surrounding sedimentary rocks during the huge, meteoric water circulation. We suggest that without the formation of the later, meteoric water circulation extensively through surrounding sedimentary rocks the Boguk cobalt deposits would be simple veins only with actinolite + quartz + cobalt-bearing minerals. Furthermore, the formation of the meteoric water circulation after the culmination of a magmatic hydrothermal system resulted in the common occurrence of high-temperature minerals with later, lower-temperature minerals, resulting in a xenothermal feature of the mineralization.

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The Geochemical and Zircon Trace Element Characteristics of A-type Granitoids in Boziguoer, Baicheng County, Xinjiang (중국 신장 위그루자치구 바이청현 보즈구얼의 A형화강암류의 지화학 및 지르콘 미량원소특징에 대한 연구)

  • Yin, Jingwu;Liu, Chunhua;Park, Jung Hyun;Shao, Xingkun;Yang, Haitao;Xu, Haiming;Wang, Jun
    • Economic and Environmental Geology
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    • v.46 no.2
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    • pp.179-198
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    • 2013
  • The Boziguoer A-type granitoids in Baicheng County, Xinjiang, belong to the northern margin of the Tarim platform as well as the neighboring EW-oriented alkaline intrusive rocks. The rocks comprise an aegirine or arfvedsonite quartz alkali feldspar syenite, an aegirine or arfvedsonite alkali feldspar granite, and a biotite alkali feldspar syenite. The major rock-forming minerals are albite, K-feldspar, quartz, arfvedsonite, aegirine, and siderophyllite. The accessory minerals are mainly zircon, pyrochlore, thorite, fluorite, monazite, bastnaesite, xenotime, and astrophyllite. The chemical composition of the alkaline granitoids show that $SiO_2$ varies from 64.55% to 72.29% with a mean value of 67.32%, $Na_2O+K_2O$ is high (9.85~11.87%) with a mean of 11.14%, $K_2O$ is 2.39%~5.47% (mean = 4.73%), the $K_2O/Na_2O$ ratios are 0.31~0.96, $Al_2O_3$ ranges from 12.58% to 15.44%, and total $FeO^T$ is between 2.35% and 5.65%. CaO, MgO, MnO, and $TiO_2$ are low. The REE content is high and the total ${\sum}REE$ is $(263{\sim}1219){\times}10^{-6}$ (mean = $776{\times}10^{-6}$), showing LREE enrichment HREE depletion with strong negative Eu anomalies. In addition, the chondrite-normalized REE patterns of the alkaline granitoids belong to the "seagull" pattern of the right-type. The Zr content is $(113{\sim}1246){\times}10^{-6}$ (mean = $594{\times}10^{-6}$), Zr+Nb+Ce+Y is between $(478{\sim}2203){\times}10^{-6}$ with a mean of $1362{\times}10^{-6}$. Furthermore, the alkaline granitoids have high HFSE (Ga, Nb, Ta, Zr, and Hf) content and low LILE (Ba, K, and Sr) content. The Nb/Ta ratio varies from 7.23 to 32.59 (mean = 16.59) and the Zr/Hf ratio is 16.69~58.04 (mean = 36.80). The zircons are depleted in LREE and enriched in HREE. The chondrite-normalized REE patterns of the zircons are of the "seagull" pattern of the left-inclined type with strong negative Eu anomaly and without a Ce anomaly. The Boziguoer A-type granitoids share similar features with A1-type granites. The average temperature of the granitic magma was estimated at $832{\sim}839^{\circ}C$. The Boziguoer A-type granitoids show crust-mantle mixing and may have formed in an anorogenic intraplate tectonic setting under high-temperature, anhydrous, and low oxygen fugacity conditions.

APPLICATION OF FUZZY SET THEORY IN SAFEGUARDS

  • Fattah, A.;Nishiwaki, Y.
    • Proceedings of the Korean Institute of Intelligent Systems Conference
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    • 1993.06a
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    • pp.1051-1054
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    • 1993
  • The International Atomic Energy Agency's Statute in Article III.A.5 allows it“to establish and administer safeguards designed to ensure that special fissionable and other materials, services, equipment, facilities and information made available by the Agency or at its request or under its supervision or control are not used in such a way as to further any military purpose; and to apply safeguards, at the request of the parties, to any bilateral or multilateral arrangement, or at the request of a State, to any of that State's activities in the field of atomic energy”. Safeguards are essentially a technical means of verifying the fulfilment of political obligations undertaken by States and given a legal force in international agreements relating to the peaceful uses of nuclear energy. The main political objectives are: to assure the international community that States are complying with their non-proliferation and other peaceful undertakings; and to deter (a) the diversion of afeguarded nuclear materials to the production of nuclear explosives or for military purposes and (b) the misuse of safeguarded facilities with the aim of producing unsafeguarded nuclear material. It is clear that no international safeguards system can physically prevent diversion. The IAEA safeguards system is basically a verification measure designed to provide assurance in those cases in which diversion has not occurred. Verification is accomplished by two basic means: material accountancy and containment and surveillance measures. Nuclear material accountancy is the fundamental IAEA safeguards mechanism, while containment and surveillance serve as important complementary measures. Material accountancy refers to a collection of measurements and other determinations which enable the State and the Agency to maintain a current picture of the location and movement of nuclear material into and out of material balance areas, i. e. areas where all material entering or leaving is measurab e. A containment measure is one that is designed by taking advantage of structural characteristics, such as containers, tanks or pipes, etc. To establish the physical integrity of an area or item by preventing the undetected movement of nuclear material or equipment. Such measures involve the application of tamper-indicating or surveillance devices. Surveillance refers to both human and instrumental observation aimed at indicating the movement of nuclear material. The verification process consists of three over-lapping elements: (a) Provision by the State of information such as - design information describing nuclear installations; - accounting reports listing nuclear material inventories, receipts and shipments; - documents amplifying and clarifying reports, as applicable; - notification of international transfers of nuclear material. (b) Collection by the IAEA of information through inspection activities such as - verification of design information - examination of records and repo ts - measurement of nuclear material - examination of containment and surveillance measures - follow-up activities in case of unusual findings. (c) Evaluation of the information provided by the State and of that collected by inspectors to determine the completeness, accuracy and validity of the information provided by the State and to resolve any anomalies and discrepancies. To design an effective verification system, one must identify possible ways and means by which nuclear material could be diverted from peaceful uses, including means to conceal such diversions. These theoretical ways and means, which have become known as diversion strategies, are used as one of the basic inputs for the development of safeguards procedures, equipment and instrumentation. For analysis of implementation strategy purposes, it is assumed that non-compliance cannot be excluded a priori and that consequently there is a low but non-zero probability that a diversion could be attempted in all safeguards ituations. An important element of diversion strategies is the identification of various possible diversion paths; the amount, type and location of nuclear material involved, the physical route and conversion of the material that may take place, rate of removal and concealment methods, as appropriate. With regard to the physical route and conversion of nuclear material the following main categories may be considered: - unreported removal of nuclear material from an installation or during transit - unreported introduction of nuclear material into an installation - unreported transfer of nuclear material from one material balance area to another - unreported production of nuclear material, e. g. enrichment of uranium or production of plutonium - undeclared uses of the material within the installation. With respect to the amount of nuclear material that might be diverted in a given time (the diversion rate), the continuum between the following two limiting cases is cons dered: - one significant quantity or more in a short time, often known as abrupt diversion; and - one significant quantity or more per year, for example, by accumulation of smaller amounts each time to add up to a significant quantity over a period of one year, often called protracted diversion. Concealment methods may include: - restriction of access of inspectors - falsification of records, reports and other material balance areas - replacement of nuclear material, e. g. use of dummy objects - falsification of measurements or of their evaluation - interference with IAEA installed equipment.As a result of diversion and its concealment or other actions, anomalies will occur. All reasonable diversion routes, scenarios/strategies and concealment methods have to be taken into account in designing safeguards implementation strategies so as to provide sufficient opportunities for the IAEA to observe such anomalies. The safeguards approach for each facility will make a different use of these procedures, equipment and instrumentation according to the various diversion strategies which could be applicable to that facility and according to the detection and inspection goals which are applied. Postulated pathways sets of scenarios comprise those elements of diversion strategies which might be carried out at a facility or across a State's fuel cycle with declared or undeclared activities. All such factors, however, contain a degree of fuzziness that need a human judgment to make the ultimate conclusion that all material is being used for peaceful purposes. Safeguards has been traditionally based on verification of declared material and facilities using material accountancy as a fundamental measure. The strength of material accountancy is based on the fact that it allows to detect any diversion independent of the diversion route taken. Material accountancy detects a diversion after it actually happened and thus is powerless to physically prevent it and can only deter by the risk of early detection any contemplation by State authorities to carry out a diversion. Recently the IAEA has been faced with new challenges. To deal with these, various measures are being reconsidered to strengthen the safeguards system such as enhanced assessment of the completeness of the State's initial declaration of nuclear material and installations under its jurisdiction enhanced monitoring and analysis of open information and analysis of open information that may indicate inconsistencies with the State's safeguards obligations. Precise information vital for such enhanced assessments and analyses is normally not available or, if available, difficult and expensive collection of information would be necessary. Above all, realistic appraisal of truth needs sound human judgment.

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Isotope Ratio of Mineral N in Pinus Densiflora Forest Soils in Rural and Industrial Areas: Potential Indicator of Atmospheric N Deposition and Soil N Loss (질소공급, 고추의 생육 및 수량에 대한 녹비작물 환원 효과)

  • Kwak, Jin-Hyeob;Lim, Sang-Sun;Park, Hyun-Jung;Lee, Sun-Il;Lee, Dong-Suk;Lee, Kye-Han;Han, Gwang-Hyun;Ro, Hee-Myong;Lee, Sang-Mo;Choi, Woo-Jung
    • Korean Journal of Soil Science and Fertilizer
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    • v.42 no.1
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    • pp.46-52
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    • 2009
  • Deposition of atmospheric N that is depleted in $^{15}N$ has shown to decrease N isotope ratio ($^{15}N/^{14}N$,expressed as ${\delta}^{15}N$) of forest samples such as tree rings, foliage, and total soil-N. However, its effect on ${\delta}^{15}N$ of mineral soil-N which is biologically active N pool has never been tested. In this study, ${\delta}^{15}N$ of mineral N($NH{_4}^+$ and $NO_3{^-}$) in forest soils from organic and two depths of mineral soil layers (0 to 20 cm and 20 to 40cm depth) of Pinus densiflora stands located at two distinct areas (rural and industrial areas) in southern Korea was analyzed to investigate if there is any difference in ${\delta}^{15}N$ of mineral N between these areas. We also evaluated potential N loss of the study sites using ${\delta}^{15}N$ of mineral N. Across the soil layers, the ${\delta}^{15}N$ of $NH{_4}^+$ ranged from +8.9 to +24.8‰ in the rural area and from +4.4 to +13.8‰ in the industrial area. Soils from organic layer (+4.4‰) and mineral layer between 0 and 20 cm (+13.8‰) of industrial area showed significantly lower ${\delta}^{15}N$ of $NH{_4}^+$ than those of rural area (+8.9 and +24.3‰, respectively), probably indicating the greater contribution of $^{15}N$-depleted $NH{_4}^+$ from atmospheric deposition to forest in the industrial area than in the rural area. Meanwhile, ${\delta}^{15}N$ of $NO_3{^-}$ was not different between the rural and industrial areas, probably because ${\delta}^{15}N$ of $NO_3{^-}$ is more likely to be altered by the N loss that causes $^{15}N$ enrichment of the remaining soil N pool. Compared with the ${\delta}^{15}N$ of soil mineral N reported by other studies (from -10.9 to +15.6‰ for $NH{_4}^+$ and -14.8 to +5.6‰ for $NO_3{^-}$), the ${\delta}^{15}N$ observed in our study was substantially high, suggesting that the study sites are more subject to the N loss. It was concluded that $NH{_4}^+$ rather than $NO_3{^-}$ can conserve the ${\delta}^{15}N$ signature of atmospheric N deposition in forest ecosystems.