• Title/Summary/Keyword: medical law

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Evaluating the Impact of Attenuation Correction Difference According to the Lipiodol in PET/CT after TACE (간동맥 화학 색전술에 사용하는 Lipiodol에 의한 감쇠 오차가 PET/CT검사에서 영상에 미치는 영향 평가)

  • Cha, Eun Sun;Hong, Gun chul;Park, Hoon;Choi, Choon Ki;Seok, Jae Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.1
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    • pp.67-70
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    • 2013
  • Purpose: Surge in patients with hepatocellular carcinoma, hepatic artery chemical embolization is one of the effective interventional procedures. The PET/CT examination plays an important role in determining the presence of residual cancer cells and metastasis, and prognosis after embolization. The other hand, the hepatic artery chemical embolization of embolic material used lipiodol produced artifacts in the PET/CT examination, and these artifacts results in quantitative evaluation influence. This study, the radioactivity density and the percentage error was evaluated by the extent of the impact of lipiodol in the image of PET/CT. Materials and Methods: 1994 NEMA Phantom was acquired for 2 minutes and 30 seconds per bed after the Teflon, water and lipiodol filled, and these three inserts into the enough to mix the rest behind radioactive injection with $20{\pm}10MBq$. Phantom reconfigure with the iterative reconstruction method the number of iterations for two times by law, a subset of 20 errors. We set up region of interest at each area of the Teflon, water, lipiodol, insert artifact occurs between regions, and background and it was calculated and compared by the radioactivity density(kBq/ml) and the% Difference. Results: Radioactivity density of the each region of interest area with the teflon, water, lipiodol, insert artifact occurs between regions, background activity was $0.09{\pm}0.04$, $0.40{\pm}0.17$, $1.55{\pm}0.75$, $2.5{\pm}1.09$, $2.65{\pm}1.16 kBq/ml$ (P <0.05) and it was statistically significant results. Percentage error of lipiodol in each area was 118%, compared to the water compared with the background activity 52%, compared with a teflon was 180% of the difference. Conclusion: We found that the error due to under the influence of the attenuation correction when PET/CT scans after lipiodol injection performed, and the radioactivity density is higher than compared to other implants, lower than background. Applying the nonattenuation correction images, and after hepatic artery chemical embolization who underwent PET/CT imaging so that the test should be take the consideration to the extent of the impact of lipiodol be.

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Study on the Patterns of Helicopter Emergency Medical Services in Ullung Island (울릉도 지역의 헬리콥터를 이용한 응급환자 후송 실태)

  • Kim, Tae-Hun;Lim, Hyun-Sul;Lee, Kwan
    • 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.

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Can Lufthansa Successfully Limit its Liability to the Families of the Victims of Germanwings flight 9525 Under the Montreal Convention?

  • Gipson, Ronnie R. Jr.
    • The Korean Journal of Air & Space Law and Policy
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    • v.30 no.2
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    • pp.279-310
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    • 2015
  • The Montreal Convention is an agreement that governs the liability of air carriers for injury and death to passengers travelling internationally by air. The Montreal Convention serves as the exclusive legal framework for victims and survivors seeking compensation for injuries or death arising from accidents involving international air travel. The Montreal Convention sets monetary liability caps on damages in order to promote the financial stability of the international airline transport industry and protect the industry from exorbitant damages awards in courts that would inevitably bankrupt an airline. The Convention allows a litigant suing under the Convention to avoid the liability caps in instances where the airline's culpability for the injury or death is the direct result of negligence, another wrongful act, or an omission of the airline or its agents. The Montreal Convention identifies specific locations as appropriate venues to advance claims for litigants seeking compensation. These venues are closely tied to either the carrier's business operations or the passenger's domicile. In March 2015, in an act of suicide stemming from reactive depression, the co-pilot of Germanwings flight 9525 intentionally crashed the aircraft into the French Alps killing the passengers and the remaining crew. Subsequent to the crash, there were media reports that Lufthansa made varying settlement offers to families of the passengers who died aboard the flight ranging from $8,300 USD to $4.5 Million USD depending on the passengers' citizenship. The unverified offers by Lufthansa prompted outcries from the families of the decedent passengers that they would institute suit against the airline in a more plaintiff friendly jurisdiction such as the United States. The first part of this article accomplishes two goals. First, it examines the Montreal Convention's venue requirement along with an overview of the recoverable damages from countries comprising the citizenship of the passengers who were not American. The intentional crash of Germanwings flight 9525 by its First Officer encompasses the possibility that Lufthansa may be exposed to unlimited compensatory damages beyond the liability caps contained in the Convention. The second part of this article explores the application of the Convention's liability limits to the Germanwings flight to demonstrate that the likelihood of escaping the liability limits is slim.

The Study of Effectiveness of MERS on the Law and Remaining Task (국내 메르스(MERS) 사태가 남긴 과제와 법률에 미친 영향에 대한 소고(小考))

  • Yoon, Jong Tae
    • The Korean Society of Law and Medicine
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    • v.16 no.2
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    • pp.263-291
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    • 2015
  • In May, 2015, a 68 years old man, who has been Middle East Saudi Arabia and the United Arab Emirates, had high fever, muscle aches, cough and shortness of breath. he went two local hospital near his house and the S Medical Center emergency center. He was diagnosed MERS(Middle East respiratory syndrome) and the diseases had put South Korea the fear of epidemics for three months. Especially, this disease has firstly reported in Middle East Asia in September 2012 and spreaded to twenty-six countries. In 21, July, 2015, European Center for disease prevention and control reported 533 people were died and in South Korea, 186 people were infected, 36 people were died and 16,693 people were isolated from MERS. South Korea government were faced into epidemic control and blamed from public. Especially, hospital acquired infection, disease control chain, opening of information, ventilation, lack of isolation bed, the problem of function of local health center, the issue of reparation for hospital and insurance cover rate, the classification of disease, the role of Korea Centers for disease control and prevention, the culture of visiting hospital to see sick people, the issue of hospital multiple room and other related social support policy. it is time to study and discuss to solve these problems. South Korea citizens felt fear and fright from MERS. What is wore, they thought the dieses were out of their government control. It was unusual case for word except Middle East Asia. numerous tourists canceled visiting korea. South korea economic were severly damaged especially, tourism industry. South korea government should admit that they had failed initial action against MERS and take full reasonability from any damages. The government have to open information to public in terms of epidemic diseases and try to prevent any other epidemic diseases and try to work with local governments.

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Medicolegal Problems in Pediatric Area (소아과 영역에서 의료분쟁)

  • Kwon, Soo Jeong;Jang, Ji Young;Kim, Nam Su;Yum, Myung Kul;Seol, In Joon;Jung, Ku Won
    • Clinical and Experimental Pediatrics
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    • v.48 no.8
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    • pp.813-819
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    • 2005
  • Purpose : Medicolegal problems start when the patient asserts the mistake of doctor and doctor does not accept it. The purpose of this study is to assess the actual condition of medicolegal problems and to provide solutions of medicolegal problems in the pediatric field. Methods : There is not official statistical data about medicolegal problems in our country. We gathered data of legal insurance program of Korean Medical Association(KMA) and court cases and other fragmentary data. Results : Between 1981 and 1995, of total 2,338 cases reported to legal problem insurance program of KMA, most common ones were 748 cases of obstetrics and gynecology. Pediatric case was ranked at the 5th, 74 cases(3.1%). According to analysis of 41 medicolegal cases' after 1990, maltreatment of patient had the highest incidence of 14 cases, injection and medication were related to 12 cases, misdiagnosis was 9 cases, patient management were related to 4 cases, and others were 2 cases. The trial result of the medicolegal cases was that 31 cases were compensated, and 8 cases were defeated, and 2 cases were still in the process. Conclusion : The aspect of medical legal problem has the tendency of radicalism and systematization. This brings an economic destitution in the patient and gives damage to a doctor. In order to reduce medicolegal problem, doctor should offer a duty of explanation and efforts to his best to satisfy patient and endeavor to make an intimate doctor-patient relationship.

A Study on Improvement of Laws regarding Welfare for the Aged (노인복지 관련법제의 발전방향)

  • Park, Ji-Soon
    • Journal of Legislation Research
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    • no.41
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    • pp.87-123
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    • 2011
  • Korea is expected to become an 'aged society' with more than 14 percent of the public aged 65 years or more by 2018. The rapid aging is giving rise to various problems within the society along with falling birthrate in a short period of time. In this context, the role and function of laws on welfare for the aged must be particularly emphasized. Also the Senior Citizens Welfare Act is of great importance as it provides social welfare service on the basis of functional connection with social insurance and public assistance. First, this paper looks into the history of laws related to welfare for the elderly such as the Senior Welfare Act, the Act on Long-term Care Insurance for Senior Citizens and the Basic Old Age Pension Act as well as the findings of earlier studies. In the second place, it will break down such laws by main components aiming to examine details of the laws and questions raised regarding them and to seek ways to achieve improvement with an emphasis on health care, old age income security, housing welfare(assisted living facilities), job security for the aged. The Senior Welfare Act offers substance of social welfare service for the elderly. Income security, health and medical care, welfare measures through long-term care and assisted living facilities, social participation by working are the key elements and all of them should be closely associated to ensure citizens get sufficient public support in their old age. For this purpose, the Senior Welfare Act is under a normative network with laws such as Act on Long-term Care Insurance for Senior Citizens and Basic Old Age Pension Act. Current laws on welfare for the aged including Senior Welfare Act are not sufficiently responsive to the aged society of the 21st century. Income security combined with decent social participation, health and medical care closely connected with long-term care system, efficient expense sharing between government and local government, enhancement of effectiveness of welfare measures can be considered as means to improve current welfare system so that the elderly can enjoy their old age with dignity and respect.

Development of 2.5D Photon Dose Calculation Algorithm (2.5D 광자선 선량계산 알고리즘 개발)

  • 조병철;오도훈;배훈식
    • Progress in Medical Physics
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    • v.10 no.2
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    • pp.103-114
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    • 1999
  • In this study, as a preliminary study for developing a full 3D photon dose calculation algorithm, We developed 2.5D photon dose calculation algorithm by extending 2D calculation algorithm to allow non-coplanar configurations of photon beams. For this purpose, we defined the 3d patient coordinate system and the 3d beam coordinate system, which are appropriate to 3d treatment planning and dose calculation. and then, calculate a transformation matrix between them. For dose calculation, we extended 2d "Clarkson-Cunningham" model to 3d one, which can calculate wedge fields as well as regular and irregular fields on arbitrary plane. The simple Batho's power-law method was implemented as an inhomogeneity correction. We evaluated the accuracy of our dose model following procedures of AAPM TG#23; radiation treatment planning dosimetry verifications for 4MV of Varian Clinac-4. As results, PDDs (percent depth dose) of cubic fields, the accuracy of calculation are within 1% except buildup region, and $\pm$3% for irregular fields and wedge fields. And for 45$^{\circ}$ oblique incident beam, the deviations between measurements and calculations are within $\pm$4%. In the case of inhomogeneity correction, the calculation underestimate 7% at the lung/water boundary and overestimate 3% at the bone/water boundary. At the conclusions, we found out our model can predict dose with 5% accuracy at the general condition. we expect our model can be used as a tool for educational and research purpose.. purpose..

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A Study on Home Care and Home Visiting Nursing in Japan (일본의 재가간호 및 방문간호 -새로운 개호보험제도의 실시를 앞두고-)

  • Kim, Jeung-Im
    • Research in Community and Public Health Nursing
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    • v.10 no.1
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    • pp.106-120
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    • 1999
  • Japan has been prepared for aging society from 1970. In 1970, the percentage of distribution of population of 65 years old and over was 7.1%. It is similar to present percentile of the elderly in Korea. Therefore, it will be needed to study about home care and home visiting nursing in Japan at present. This study was aimed to prepare the fundamental documents for home care nursing in Korea and to know the background of new health care system of Long-term Care Insurance in Japan, by studying home care and home visiting nursing in Japan. With the continuing aging of the population, especially the increase in the number of latter stage elderly, it is predicted that there will be an increase in the number of the elderly who are bedridden and suffering senile dementia. To ensure that these people will be able to continue living in the communities and homes they are accustomed to, surrounded by their families and neighbors, Japan substantially improve and expand in-home services. There were also long-term effort to reach the level of services outlined in the Gold Plan and the New Gold Plan within the decade between FY 1991 and FY 1999 in the field of health care and welfare. Under this plan, the most noticeable change was occurred in home care, home was permitted as the field of care and visiting nursing was established in law. Through this 10- Year Strategy for Promotion of Health and Welfare Services for the Aged, many problems have been improved and solved, but some problems remained such as inadequate service supply and consumption of medical insurance for the elderly. Japan will be a society composed 25% of elderly people of total population in 2020, and it will be soon faced with a shortage of welfare and medical facilities and manpower. As for equalizing the benefits and cost burdens, and other future arrangements for health care and welfare, Long-term Care insurance system was established in 1994. This system will be enforced from April 2000 and use present facilities and services. To know home care and home visiting nursing in Japan, we need to consider present conditions well and to take notice of changes and measures to cope with an aging society continuously.

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Quality Control of Radiation Dosimetry Service (개인피폭선량 측정기관의 품질관리기준 개발)

  • Lee, Jun-Haeng;Lee, Sang-Bock;Chang, Kun-Jo;Lee, Kwang-Yong;Lee, Hyun-Koo;Kim, Hyeog-Ju;Jin, Gye-Hwan
    • Progress in Medical Physics
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    • v.20 no.4
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    • pp.253-259
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    • 2009
  • We have developed standards based on international criterions for the quality control of dose tested by the measurement institutions of individual exposure doses through improving the reliability of data on the exposure dose of individuals working in radioactive environment and securing the accuracy and reliability of individual dose measurements. Laws related to radiation dose applied to domestic institutions refer to ANSI N13.11.1993, but currently, in U.S. and some other countries the measurement of radiation doses is based on ANSI N13.11.2001 that reduced test categories and tightened the standards. We made efforts to simplify the standards and to reduce the number of dosimeters required in experiment, and avoided preventing or hindering the use of future technologies not approved under the current law such as glass dosimeter and optical stimulation dosimeter. The Quality Management Manual of Radiation Dosimetry Service, Assessment Manual of Radiation Dosimetry Service Accreditation Program, and the Personnel Dosimetry Performance. Criteria for Testing are documents applicable in supervising laboratories.

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A Study on Mental Health of Single Aged Persons in Home Perceived by Daughter-in-law (재가 독신노인을 부양하는 주부가 인지하는 노인의 정신건강에 관한 연구)

  • Yun Suk-Rye
    • Journal of Korean Public Health Nursing
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    • v.7 no.1
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    • pp.31-48
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    • 1993
  • Nowaday, there have a lot of changes in the demands of the aged persons. Their problems also came to the fore with diverse forms under the influences of industrialization, urbanization and nuclear family. To make the matter worse, the aged population is mounting rapidly. Also, such structure as nuclear family is widely disseminating uncomfortable to the aged. People is mainly being guided by self interest above everything else. Indeed, they had, all together, bad effects on our traditional value system regarding 'respect for the aged and devotion to patients'. It seems unfortunately obvious that the family responsibility is gradually weakening to support the old who is a dependent family. The result is that the aged must have suffered all sorts of hardships in lightenning psychological, physical and economical difficulties. First, to grasp the situations and conditions supporting for single aged persons from each view of psychological, emotional, family-relational, healthy, social and economical standpoints, and second, to analyze their own recognition levels thinking of their health conditions and the relationships between the supporting environments of old family dependants and their psychological healths and then finally, to propose suggestions being able to be helpful for living comfortably in an old age and thereby, building up good family relation. The statistical techniques used to analyze 115 respondents living in Puchun city are frequency, $x^2$ test, t-Jest, ANOVA, Pearson's Correlation Coefficiency and Regression analysis (SPSS package), pertnent to prove the hypothesis suggested in this paper. Of course, it is needless to say that more data are needed on this point. However, several main research findings can be summarized as follows: First, the better single aged persons may be in the habit of eating a meal and the higher they may think of their physical health conditions and movement, the more they want to participate in economic activities to be free from economical dependence upon their children and to overcome lonliness. Second, single aged women appear to have had higher ability to take care their health for themself than single aged men do. It is why signle aged women do not, in general, have big problems to manage their health. But, as shown in this paper, single aged person"s were more liable to the diseases of the aged and, thereby, requiring special medical treatment badly to be healthy. Third. single aged persons revealed potential desires to free themself from socio economic dependence upon their children even in simple labor Job which can draw a monthly salary of about W200, 000. Fourth, they are generally satisfied with their children's filial piety toward them. Nonethless, most of them appear to be reluctantly dependent upon their children and live lonly lives very much. Fifth, they seem to have some hesitation in expressing their candid opinions as that then are some others along with family environmental factors for psychological and emotiona stability. Accordingly, it is safe to conclude by saying that much attention should' be paid no only to socio-economic supports and better medical services for the aged but also to political supports of the society and towards their children for the aged's emotiona support, for improving the quality of their lives in old age and promoting efficiency in suporting for old family dependants.

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