• The Korean Society of Law and Medicine
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• v.16 no.1
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• pp.155-190
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• 2015

The court sentenced meaningful decisions related to the medical service in 2014. The court assumed the negligence of medical staff in the accident if being broken while using the medical equipment for not an original purpose at the time of surgery and ruled that the compensation for damage can be recognized in recognition of the causal relationship between the explanation duty violation and side effect's happening when unproven surgery on safety is implemented regarding the duty of explanation, that in the case of cosmetic surgery, the subject on the duty of explanation needs to be expanded compared to the general medical practice and that the duty of explanation cannot be accepted for the range that cannot be expectable. Also, the court has provided the requirement and limitation of self-determination exercise in case of the crash between patient's self-determination and doctor's duty of care and has ruled that as automobile insurance contract is a contract with the insurance company to pay regarding liability for car accidents, treating patients and taking the insurance money is not illegal activity even for the unlicensed hospital violating the medical law while established. The judgment stating the opinion that medical practitioners cannot be punished according to the medical law prohibiting the receiving of rebate in case that medical practitioners did not receive benefit while the medical institution itself gained an unfair economic benefit also stands out. And the court has ruled that even if the medical institution who received a business suspension is closed, the suspension is still effective in case that the same operator opens a new medical institution in the same place, ruled on the requirement to conduct a medical service outside of the medical institution that the doctor opened and ruled that the administrative penalty cannot be conducted prior to the conviction on charge of violating the medical law.

• Journal of Oral Medicine and Pain
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• v.32 no.1
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• pp.9-33
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• 2007

In the field of dentistry, there existed relatively few emergency patients or patients who need intensive care and thus had low medical dispute rates. However, these days, there is a general tendency of increased medical disputes. Although many medical disputes are caused by medical accidents of the dentists, because dental assistants are also lawfully involved in practicing dentistry, there is a possibility of medical disputes or medical accidents caused by dental assistants. Therefore, the role of the dental assistants cannot be ignored. This study consists of a survey given to dental hygienists currently working in general hospitals, dental hospitals and private dental clinics. Following is the results of the analysis of 275 respondents' backgrounds, medical disputes rates including patients' complaints, their understanding of medical regulations and their general understanding of overall dental practice and medical disputes. 1. 251 of 274(91.6%) respondents doubted the risk of medical accident and dispute. 2. 81(29.5%) dental hygienist experienced complaint from patients. They have been working in the private dental clinic, the rate of this experience was high. 3. 349 case of 1805(19.3%) the complaints by patients, highest percentage among its category, were those regarding dental fees and poor service. 4. 129 case of 1805(7.1%) patients' complaints, highest percentage among it's subcategory, were those regarding the absence of explanations of precautions or request of agreements before dental treatment. 5. 252 of 267 (94.4%) dental hygienists chart after a scaling treatment. However, only 55(20.7%) dental hygienists chart the fact of explaining the precautions. 6. 6(2.2%) dental hygienists do not inspect patients' medical history, if patients don't mention it. 7. 104 of 274(38.0%) dental hygienists responded to be capable of administering first aid treatment. 8. 115(41.8%) dental hygienists have a first aid kit and equipment. 9. In case of medical dispute, 268(97.8%) dental hygienists respond that, charting plays a big role in resolving the dispute. 10. In case of medical dispute, 272(93.3%) dental hygienists respond that, explanation and agreement before treatment have an important role in settlement of dispute 11. Only 160(58.4%) dental hygienists responded correct answer that the duration of keeping medical records is 10 years. 12. 124(45.3%) respondents thought that it is legal for a dental hygienist to take a panoramic dental X-ray, 71(25.9%) respondents thought that it is legal practice cervical resin treatment by dental hygienist, and 37(13.5%) respondents thought that it is legal extract primary teeth by dental hygienist. 13. 24(18.76%) respondents thought that it doesn't matter to tell patient's state to others 14. 272(99.27%) responded that receiving education for the prevention of medical disputes was needed and of them, 61.0% thought it was urgent. 15. 186(64.2%) has never had classes regarding the prevention of medical disputes while in school and 212(77.4%) has not had the same type of classes after graduating from school. 16. 256(93.4%) responded that there will be even more of an increased number of medical disputes. Among them, 83.3% of respondents though that due to the increased opportunity of acquiring information through the internet and mass media. The study shows that 29.5 percentage of dental hygienists have experienced the medical disputes and complaints and they are lack of recognition of medical regulations and dental hygienist's official duty. So, there is a big potential of the percentage to increase. Therefore, the correct understanding of explaining precautions and requesting agreement before dental treatments and performing them are mandatory. Moreover, classes regarding the prevention and counterplans of medical disputes need to be widely offered.

• Journal of agricultural medicine and community health
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• v.20 no.2
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• pp.157-168
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• 1995

This study was carried out, through analyzing the annual reports(year of 1973-1993) on health status of Su Dong-Myun, and specific survey data of 332 households(Su Dong-Myun 209, Byul Nae-Myun 123), located in Nam Yang Ju-Si, Kyung Gi-Do, from July 20 to July 31, 1995, to find out more effective means for primary medical care in a rural area. The results were as fellows : 1. Number of population in Su Dong-Myun was 5,419 in 1973, 4,591(the lowest) in 1987 and 5,707 in 1995. In the composition rate of population, "0-14" of age group showed markedly decreasing tendency from 43.1% in 1975, to 19.1% in 1995, however "65 and over" markedly in creasing tendency form 5.3% in 1975 to 9.8% in 1995. 2. Annual utilization rate per 1,000 inhabitants in Su Dong-Myun showed markedly increasing tendency from 1973 to 1977 such as 343 in 1973, 540 in 1975, 900 in 1977. However, since 1979, the rate showed rapidly decreasing tendency, such as 846 in 1979, 519 in 1985, 190 in 1991 and 1993. 3. The morbid household rate per year was 53.6% of respondents and the rate per 15 days was 48.2%. In disease classification rate of morbid household per year, Arthralgia & Neuralgia was the highest rate(33.9%) and gastro-intestinal disorder(19.3%), Cough(11,9%), Hypertension(7.8%), Accident(3.2%) in next order. 4. In the utilizing facilities for Primary Medical Care, Medical facilities was showed the highest rate(58.1% of respondents) and Pharmacy and Drug Shp(33.1%), Tradition Method(4.0%) in next order. In the Medical facilities, General private clinic was showed the highest rate(34.3%) and specific private Clinic(22.3%), Hospital(19.0%), Health (Sub)center(16.3%), Nurse practitioner (3.3%), Oriental hospital and clinic(2.7%) in next order. 5. Experience rate, utilizing health subcenter was 51.8% of the respondents, and it was 55.0% in Su Dong-Myun and 46.3% in Byul Nae-Myun. In utilization times of health subcenter, times-rate showed next orders such as 1-2 times/6months(31.6%), 1-2 times/year (22.1%), 1-2 times/months(19.2%), 1-2 times/3months(15.6%). 6. In objectives, visiting Health Subcenter, Medical Care was the highest rate(59.8% of the respondents) and health control(23.3%) was in next order. In Medical Care, Primary Care by general physician was higher rate(51.1%) almost all. In the Health control, Immunization too was high rate(18.0%) in health control activities. 7. The reasons rate, utilizing health subcenter showed next order, such as distance to Medical facilities(33.0% of the respondents), Medical Cost(28.1%), Simple process of consultation (10.8%), Effectiveness of cure(7.6%), Function of primary medical care(7.0%) and Attitude of physician(6.5%). 8. In the affecting factors to utilization of primary medical facilities, medical needs was showed the highest rate(29.5% of the respondents) and medical cost(15.4%), distance to medical facilities(14.2%), traffic vehicle(14.2%) and farm work(6.9%) in next order. 9. In the priority between 'daily farm work,' and 'primary medical care', only 46.4% of respondents answered that primary health care is more important than the daily farm work The 22.6% of respondents answered 'daily farm work', and the 12.3% answered 'the equal of the both'. 10. In the criterion of medical facilities choice, medical knowledge and technical quality was showed the highest rate(56.3%), distance or time to medical facilities(10.9%), sincerity and kindness of physician(9.4%), medical cost(8.7%) and traffic vehicle(6.5%) in next order 11. In the advise for improvement of health subcenter function, the 36.1% of respondents answered that 'enforcement of medical personnel and equipment' was required, and then 'improved medical technology'(25.5%), 'good attitude of physician'(14.9%), 'improved medical system'(13.3%), 'enforced drug'(6.7%) in next order. 12. The study on affecting factors to utilization of primary medical facilities was very difficult subject to systematize the analyzed results, due to a prejudice of protocol planner, surveyer and respondent, and variety and overlapping of subject matter.

• Land and Housing Review
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• v.8 no.1
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• pp.1-11
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• 2017

The government has been constructing and supplying public rental housing to ordinary people in order to stabilize housing since 1989. However, the public rental houses initially supplied to ordinary people are at high risk for safety accidents due to the deterioration of the facilities. Therefore, this study is aimed to propose a solution to solve the life safety hazards of the old rental housing complex as a follow-up study of Analysis of Accident Patterns and Hazard Factor for Life Safety in Rental Housing Complex. Types of life safety accidents that occur in public rental housing complexes are sliding, falling, crash, falling objects, breakage, fire accidents, traffic accidents and criminal accidents. The types of safety accidents that occur in rental housing complexes analyzed in this study are sliding, crashes, falling objects, and fire accidents. Although the incidence of safety accidents such as falling, breakage, traffic accidents and crime accidents in public rental housing complexes is low, these types are likely to cause safety accidents. The method of this study utilized interviews and seminar results, and it suggested ways to solve the life safety hazards in rental housing complexes. Interviews were conducted with residents and managers of rental housing complexes. Seminars were conducted twice with experts in construction, maintenance, asset management, housing welfare and safety. Through interviews and seminars, this study categorizes the life safety hazards that occur in rental housing complexes by types of accidents and suggests ways to resolve them as follows. (1) sliding ; use of flooring materials with high friction coefficient, installation of safety devices such as safety handles, implementation of maintenance, safety inspections and safety education, etc. (2) falling ; supplementation of safety facilities, Improvement of the design method of the falling parts, Safety education, etc. (3) crash ; increase the effective width of the elevator door, increase the effective width of the lamp, improve the lamp type (U type ${\rightarrow}$ I type), etc. (4) falling objects and breakage ; design of furniture considering the usability of residents, replacement of old facilities, enhancement of safety consciousness of residents, safety education, etc. (5) fire accidents ; installation of fire safety equipment, improvement by emergency evacuation, safety inspection and safety education, etc. (6) traffic accidents ; securing parking spaces, installing safety facilities, conducting safety education, etc. (7) criminal accidents; improvement of CCTV pixels, installation of street lights, removal of blind spots in the complex, securing of security, etc. The roles of suppliers, administrators and users of public rental housing proposed in this study are summarized as follows. Suppliers of rental housing should take into consideration the risk factors that may arise not only in the design and construction but also in the maintenance phase and should consider the possibility of easily repairing old facilities considering the life cycle of rental housing. Next, Administrators of rental housing should consider the safety of the users of the rental housing, conduct safety checks from time to time, and immediately remove any hazardous elements within the apartment complex. Finally, the users of the rental housing needs to form a sense of ownership of all the facilities in the rental housing complex, and efforts should be made not to cause safety accidents caused by the user's carelessness. The results of this study can provide the necessary information to enable residents of rental housing complexes to live a safe and comfortable residential life. It is also expected that this information will be used to reduce the incidence of safety accidents in rental housing complexes.

• Journal of Korean Orthopaedic Sports Medicine
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• v.10 no.2
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• pp.94-99
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• 2011

Purpose: As the number of people enjoying skiing and snowboarding which are two popular winter sports has been increasing, wearing helmet during doing these sports has been needed for safety. The rates of head or face injury have decreased after using helmet. However the effect that wearing helmet has on cervical damage is not yet to be known. So through this research we intend to be helpful in developing effective program and safety equipment. Materials and Methods: During two seasons from December 2009 to march 2011, cased 658 cervical injuries within 14538 admittance in medical center of major resort due to skiing and snow-boarding injuries. For survey and research model, one year before the research year conducted a pilot study. Admittance were 432 male and 226 female, advanced 273 and 385 novice. We divided them into two groups depending on wearing helmet, measured cervical damage ratio and injury mechanism, and researched the severity of damage and diagnosed injury. Each group used SPSS 12.0 (SPSS Inc., Chicago, IL, USA) to process data statistically. Results: The number of patients was 312 in skier and 346 in snow boarder. Patients wearing helmet were 146 in skier and 127 in snow boarder. Classification of each injuries were confirmed as 292 cases of simple sprain, 359 bruising, 6 cervical fractures and 1 case of dislocation. Classification of injury mechanisms were 287 of human collision, 212 material collision, 108 of slip down by oneself, 39 of falling and 12 cases of etc. In cases wearing helmet ski 78/ snow board 70 were simple sprain, ski 64/ snowboard 68 were shown as bruising, ski 1/ snow board 2 had cervical fracture or dislocation. The ratio of cervical sprain increased in cases of wearing helmet compared to non-wearing cases and there was a statistical significance (p<0.001). The ratio of cervical contusion increased significantly in non-wearing helmet user (p<0.05). However, there was no significant increase in fracture and dislocation compared between helmet user and non-user (p> 0.05). Conclusion: In this study, wearing helmet had no relation to additional cervical injury occurrence or severity among skiers and snow boarders. The ratio of cervical sprain increased significantly in helmet user with person to person accident. However, the cervical contusion decreased. On this ground, further biomechanical studies are required and modified helmet will be necessary.

• Journal of agricultural medicine and community health
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• v.27 no.1
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• pp.115-123
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• 2002

Objective: The aim of this study was to evaluate the patterns of helicopter emergency medical services (HEMS) in Ullung Island. Methods : The authors reviewed the records from emergency room diaries and the lists of helicopter transfers in the Ullung Public Health Medical Center over the 5-year period from Jan 1, 1997 to Dec 31, 2001. Results : One hundred thirteen cases were transferred by helicopters in 88 flights. According to year, the number of flights was 13(14.8%) and the number of cases was 15(13.3%) in 1997; 17(19.3%) and 21(18.6%) in 1998; 18(20.5%) and 20(17.7%) in 1999; 17(19.3%) and 20(17.7%) in 2000; and 23(26.1%) and 37(32.7%) in 2001. According to the kind of helicopter, the number of flights was 46(52.3%) and the number of cases was 60(53.1%) by Maritime police; and 19(21.6%) and 28(25.1%) by 119 rescue. According to time zone, there were no night flights. According to sex and age, there were 75 male cases(66.4%) and 28 cases(28.3%) of patients aged sixty years and over. The number of flights was 11(12.5%) and the number of cases was 15(13.3%) in November; 10 flights(11.4%) and 14 cases(12.4%) in March; and 7 cases(8.0%) in each of September, October and April. The most common season of helicopter transfer cases was autumn. According to transfer area, there were 48 cases (42.5%) in Pohang city, Gyeonsangbukdo; 35(31.0%) in Gangnung city, Gangwondo; and 17(15.0%) in Daegu metropolitan city. According to condition, there were 27 cases(23.9%) of cerebro-vascular accident, 13(11.5%) of fracture and 11(9.7%) of head injury. According to admission department, there were 42 cases(37.2%) in Neurosurgery, 21(18.6%) in Internal Medicine and 13(11.5%) in Orthopedic Surgery. According tothe Korea Standard Classification of Disease(3-KSCD), circulatory systemic disease(IX) and injury, intoxication and others (XIX) were the two most frequent categories with 34 cases(30.1%) each, followed by digestive system disease (XI) with 23 cases(20.4%). Conclusions : HEMS in Ullung Island leave much to be desired. Helicopters cannot make a night flight and are not equipped with medical facilities. HEMS in islands such as Ullung Island are essential. We hope that night flights, equipment-monitoring systems for emergency patients in the helicopters, and a law related to HEMS in the island will all be established.

• Journal of the Korean Society of Radiology
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• v.11 no.7
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• pp.627-635
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• 2017

Brachytherapy is generally performed in conjunction with external radiation therapy, and the treatment course is very complicated, which can lead to radiation accidents. In order to solve this problem, we designed the process map by applying the failure mode and effects analysis (FMEA) method to the Brachytherapy and scored the risk priority number (RPN) for each treatment course based on this process map. The process map consisted of five steps, Patient consulting", "Brachytherapy simulation", "CT simulation", "Brachytherapy treatment planning" and "Treatment". In order to calculate the RPN, doctor, medical physicist, dose planners, therapist, and nurse participated in the study and evaluated occurrence, severity, and lack of detectability at each detail step. Overall, the process map is preceded by a patient identification procedure at each treatment stage, which can be mistaken for another patient, and a different treatment plan may be established to cause a radiation accident. As a result of evaluating the RPN for the detailed steps based on the process map, overall "Patient consulting" and "Brachytherapy treatment planning" step were evaluated as high risk. The nurses showed a tendency to be different from each other, and the nurses had a risk of 55 points or more for all the procedures except "Treatment", and the "Brachytherapy simulation" step was the highest with 88.8 points. Since the treatment stage differs somewhat for each medical institution performing radiotherapy, it is thought that the risk management should be performed intensively by preparing the process map for each institution and calculating the risk RPN.

• Journal of Trauma and Injury
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• v.23 no.2
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• pp.107-112
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• 2010

Purpose: Recently, the change to a more complex social structure has led to an increased frequency of traumas due to violence, accident and so on. In addition, the severity of the traumas and the frequency of penetrating injuries have also increased. Traumas to cervical and abdominal areas, what are commonly seen by general surgeons, can have mild to fatal consequences because in these areas, various organs that are vital to sustaining life are located. The exact location and characteristics of the injury are vital to treating patients with the trauma to these areas. Thus, with this background in mind, we studied, compared, and analyzed clinical manifestations of patients who were admitted to Wonju Christian hospital for penetrating injuries inflicted by themselves or others. Methods: We selected and performed a retrospective study of 64 patients who had been admitted to Wonju Christian Hospital from January 2005 to December 2009 and who had cervical or abdominal penetrating injuries clearly inflicted by themselves or others. Results: There were 51 male (79.7%) and 13 female (20.3%) patients, and the number of male patients was more dominant in this study, having a sex ratio of 3.9 to 1. The range of ages was between 20 and 86 years, and mean age was 43.2 years. There were 5 self-inflicted cervical injuries, and 19 self-inflicted abdominal injuries, making the total number of self-inflicted injury 24. Cervical and abdominal injuries caused by others were found in 11 and 29 patients, respectively. The most common area involved in self-inflicted injuries to the abdomen was the epigastric area, nine cases, and the right-side zone II was the most commonly involved area. On the other hand, in injuries inflicted by others, the left upper quadrant of the abdomen was the most common site of the injury, 14 cases. In the neck, the left-side zone II was the most injured site. In cases of self-inflicted neck injury, jugular vein damage and cervical muscle damage without deep organ injury were observed in two cases each, making them the most common. In cases with abdominal injuries, seven cases had limited abdominal wall injury, making it the most common injury. The most common deep organ injury was small bowel wounds, five cases. In patients with injuries caused by others, six had cervical muscle damage, making it the most common injury found in that area. In the abdomen, small bowel injury was found to be the most common injury, being evidenced in 13 cases. In self-inflicted injuries, a statistical analysis discovered that the total duration of admission and the number of patients admitted to the intensive care unit were significantly shorter and smaller, retrospectively, than in the patient group that had injuries caused by others. No statistically significant difference was found when the injury sequels were compared between the self-inflicted-injury and the injury-inflicted-by-others groups. Conclusion: This study revealed that, in self-inflicted abdominal injuries, injuries limited to the abdominal wall were found to be the most common, and in injuries to the cervical area inflicted by others, injuries restricted to the cervical muscle were found to be the most common. As a whole, the total duration of admission and the ICU admission time were significantly shorter in cases of self-inflicted injury. Especially, in cases of self inflicted injuries, abdominal injuries generally had a limited degree of injury. Thus, in our consideration, accurate injury assessment and an ideal treatment plan are necessary to treat these patients, and minimally invasive equipment, such as laparoscope, should be used. Also, further studies that persistently utilize aggressive surgical observations, such as abdominal ultrasound and computed tomography, for patients with penetrating injuries are needed.

• Journal of the Korean Society of Safety
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• v.10 no.3
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• pp.81-95
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• 1995

Now, safety assurance in construction sites should be accomplished by its own organization rather than control of the code or government. It is believed that the safety assurance can be considerably improved by a lecture or an education using the existing theories or literatures up to now, but it is thought that fundamental safety assurance we not able to be accomplished without developing safety devices '||'&'||' equipment or taking fundamental measures, based on the result analyzed from workers behaviors. There are various behaviors of the workers showed in construction site, but only tests for hammerusing works such as form, re-bar, stone workers directly related to the grip strength are mainly performed, investigated and measured here for the study. The above works are similar to power grip, 7th picture on seven items which are categorized for hand grip types(Ammermin 1956 ; Jones ; Kobrick 1958). Measurements of grip strength are commonly taken in anthropometric surveys. They are easy to administer but unfortunately it is rather dubious whether they yield any data that are of interest to the engineer. Very fewer controls of tools are grasped and squeesed studies showed very little overall correlation between grip strength and other measures of bodily strength (Laubach, Kromer, and Thordsen 1972), but hammer-using work which is practically progressed in construction site are mainly influenced with grip strength. According to the investigation on work measurement, it is shown that 77% of form worker are using hammer to be related to grip strength. In this study, it is particularly noticed that wearing safety gloves in construction site is required for workers safety but 20% difference between grip strength with safety gloves and without ones are commonly neglected in the site(Fig. 1). Nevertheless, safety operation with consideration of the above 20% difference is not considered in the construction site. Factors of age, kinds of work, working time, with or without safety gloves are in vestigated '||'&'||' collected at the sites for this study. Test, not at each working hour but at 14 : 00 when the almost all of the workers think the most tired, resulting from the questionaires, also when it is shown on the research report has been performed and compared for main kinds of works : form '||'&'||' re-bar work. Tests were performed with both left SE rightand of the workers simultaneously in construction site using Rand Dynamometer(Model 78010, Lafayette Instrument Co., Indiana, U.S.A) by reading grip strength on the gauge while they are pulling, and then by interviewing on their ages, works, experiences and etc., directly. The above tests have been performed for the dates of 15th march-26th May '95 with consideration of site condition. And even if various factors of ambient temperature on the testing date, working condition, individual worker's habit and worker's condition of the previous ate are concerned with the study. Those are considered as constants in this study. Samples are formwork 53, rebar 62, electrician 5, plumber 4, welding 1 from D construction Co., Ltd, ; formwork 12, re-bar 5, electrician 2, from S construction Co., Ltd, , formwork 78, re-bar 18, plumber 31, electrician 13, labor 48, plumber 31, plasterer 15, concrete placer 6, water proof worker 3, maisony 5 from B construction Co., Ltd. As In the previously mentioned, main aspect to be investigated in this study will be from '||'&'||' re-bar work because grip strength will be directly applied to these two kinds of works ; form '||'&'||' re-bar work, eventhough there are total 405 samples taken. It is thought that a frequency of accident occurrence will be mainly two work postures "looking up '||'&'||' looking down" to be mainly sorted, but this factor is not clarified in this study because It will be needed a lot of work more. Tests has been done at possible large scale of horizontally work-extended sites within one hour in order to prevent or decrease errors '||'&'||' discrepancies from time lag of the test. Additionally, the statistical package computer program SPSS PC＋has been used for the study.

• Journal of the Korea institute for structural maintenance and inspection
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• v.16 no.2
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• pp.19-30
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• 2012

Due to the fact that the social environment is improved and the urban development is stabilized, the demand of new construction of apartment becomes slowdown. Accordingly, there are many researches to lengthen the service life of the existing apartment through the remodeling and its importance is continuously rising. However, reliable design specifications and guidelines for the design of remodeling with partial demolition are not provided yet in Korea. Specially, in the apartment remodeling, slab collapse accidents take major portion in all accidents that reported by Korean Government. It is very important to prevent intial crack of slab because intial crack could cause severe accident like collapse of all structure in a short period of time. The purpose of this study is to develop structural guidelines that could guarantee the structural safety and serviceability of slab structure and could be adopted in Korean remodeling with partial demolition. There are mainly two components to determine structural behavior of slab structure. One is the shape of slab structure and the other is load which is resisted by the slab structure. In this study, the weight per unit volume of concrete debris and concrete strength are estimated through the analysis of previous researches to recognize the relationship between the shape of slab and load that loaded on the slab. Accordingly, approximately 300 pieces of floor plan are collected and analyzed. The finite element analysis is conducted using these analyzed and estimated results. From the finite element analysis results, the limited stacking height of debris is suggested and the stacking method is also discussed. In addition, to find the relationship between movement of demolition equipment and structural behavior of slab, the static and dynamic loading tests are conducted. From the results of loading tests, the impact factor which will be considered in the remodeling design could be estimated.