Prevention of medical malpractice and disputes through analysis of lawsuits related to coronary angiography and intervention

Cheol Won Hyeon,Won Lee,So Yoon Kim,Ji Yong Park,Su Hwan Shin 대한내과학회 2020 The Korean Journal of Internal Medicine Vol.35 No.3

Background/Aims: Possible fatal complications arising from coronary angiography (CAG), percutaneous coronary intervention (PCI), and coronary artery disease itself, are likely to cause medical disputes. Presenting the current status and reasons for judgments given in lawsuits related to CAG/PCI, this study aimed to identify ways to prevent unnecessary disputes and medical malpractice suits related to CAG/PCI through lawsuit analysis. Methods: A total of 13 cases (20 judgments) found in the Supreme Court of Korea’s Written Judgment Management System from 1998 to 2017 were analyzed. Results: Coronary artery injury was the most common causative complication that led to lawsuits (n = 6, 46%). Six cases (46%) were ruled in favor of the plaintiff for violation of duty of care (n = 4) and duty of explanation (n = 2), respectively. Cases that violated duty of care included two errors in intra-procedure device manipulation, one in pre-procedure diagnosis, and one in management of post-procedure complication. Lack of explanation regarding the risk of complications was pointed out in both cases that violated duty of explanation. The average awarded amount for the damages was 114,436,064 Korean won. Conclusions: Physicians need not fear unfair judgments so long as they follow standard of care because the Court consistently looked at the probability, the foreseeability, and the evidence. Therefore, maintaining standard of care is important. Besides, specific, detailed, and comprehensible explanations, including the risk of complications in addition to the necessity of procedures, are important to ensure the patient clearly understands the possible risk of adverse outcomes.

부산.경남지역의 일부 고등학교 교사들의 물리치료에 대한 인식도 조사

김지원,박상현,주성희,김용권,안덕현,Kim, JI-Won,Park, Sang-Hyeon,Joo, Sung-Hui,Kim, Yong-Kwon,Ahn, Duck-Hyun 대한물리치료과학회 2003 대한물리치료과학회지 Vol.10 No.2

This study randomly chose 10 humanity high schools, which are located in Busan and KyoungNam province. We then examined the recognition rate of physical therapy among 378 teachers who were and still are working in the schools. 1. The recognition grade of physical therapeutics between men and women was significantly different with results of 80.7% of men and 69.7% of women(p<0.05). In the case of experiencing physical therapy, 83.6% of people said they knew the physical therapeutics and in the case of the opposite side, the result was also significantly different with a result of 67.8%(p<0.05). 2. We ranked the people on how much they knew about the physical therapeutics among men and women. With men, the actual experience of physical therapeutic came before what they heard from other people. In the case of women, what they heard from other people came first and the actual experience of physical therapeutic came after. According to the public information from Inje University, the recognition grade is recorded in the 3rd grade department as 21.5% while in the case of experiencing treatment from a physical therapist, the result was 39.1%. In the other department (the 1st grade department), what men and women heard from mass media was recorded at 17.5% and what they heard from other people, it was recorded at 33.8%(p<0.05). 3. The research about the recognition of academic ability of being a physical therapist was that 55.6% of teachers thought that 3-year-college was the best, which made the results different from the recognition grade of the experience of education(p<0.05). 4. In the recognition grade of physical therapeutics, there were significantly differences from 50.2% of men and 45.2% of women were expecting about 1mil ion won to 1.99million won. In case of 25.2% of people who have experience less than 15years at work, they expected about 2million to 2.99million won. The figures were higher than 10.1% of people who have experiences over 15years. About the recognition grade of physical therapists social level in the future is 48.8% of people who had experienced of physical therapy and 63.8% of people who never had experienced of it said it would be better in the future. From these results, the recognition about physical therapeutics and the view of its social status are optimistic and they know well about the level of academic ability of physical therapists. On the other hand, most teachers don't know exactly about physical therapists work. So we have to inform them aggressively for enhancing the recognition of physical therapy because high school students are well affected by their teachers when they face their future or major in university.

열대 지역에서 통일형 초다수성 벼 품종의 생육 및 수량성 비교

이지윤,준현,성환,손영보,송유천,한상익,박동수,권영업,이철원,이종희 忠北大學校 農業科學硏究所 2015 農業科學硏究 Vol.31 No.2

골수염으로 발현된 재발성 콕시디오이데스 진균증 1예

백지현,박은영,정윤숙,홍재원,채윤태,진성준,최희경,신소연,한상훈,진범식,김창오,최준용,송영구,조남훈,김준명 대한감염학회 2009 감염과 화학요법 Vol.41 No.4

Coccidioidomycosis is a fungal infection that results from inhaling the airborne arthroconidia of the Coccidioides species. It is an endemic disease in the southwest part of North America and rarely diagnosed in Korea. As tourism to endemic areas and the number of immunocompromised patients have been increasing, the incidence of this infection has increased in non-endemic areas. Treatment is usually successful with antifungal agents; however, recurrence is common. It is difficult to decide when to discontinue the antifungal treatment especially in non-endemic areas where doctors are not familiar with the disease. We report a case of recurrent coccidioidomycosis manifesting as osteomyelitis after the treatment of the patient for disseminated coccidioidal infection. The complement fixation test was a useful tool for the assessment of patient response and to evaluate suspected recurrence.

국내·외 누설률에 관한 기준 분석을 통한 국내 연기제어 기준 개선에 관한 연구

김혜원 ( Kim Hye-won ),한지우 ( Han Ji-woo ),이병흔 ( Lee Byeong-heun ),진승현 ( Jin Seung-hyeon ),권영진 ( Kwon Young-jin ) 한국건축시공학회 2018 한국건축시공학회 학술발표대회 논문집 Vol.18 No.2

On this Study, it conducts the Standards investigation about air leakage of Buildings for performance improvement of Smoke control in Fire. In domestic standards, it is incomplete the Criteria standards of air leakage. Therefore it is considered that won’t limit the smoke spread due to stack effect. But in the case of the United States, it conducts the Hot smoke air-Leakage test and it consider that can prevent the Smoke Spread in Compartment.

숙잠 함유 복합물의 알코올 대사 및 숙취개선 효능평가

우미선(Miseon Woo),차지현(Ji Hyeon Cha),김용환(Yonghwan Kim),강희택(Hee-Taik Kang),김현덕(Hyeondok Kim),조경원(Kyong Won Cho),박성선(Sung Sun Park),이종훈(Jong Hun Lee) 한국식품과학회 2021 한국식품과학회지 Vol.53 No.1

숙취를 해결하기 위해서는 숙취를 직접적으로 유발하는 물질인 아세트알데하이드의 조절이 가장 중요한 인자로 작용한다. 숙잠을 함유하는 복합물인 시험식품(CKDHC)의 섭취로 혈중 아세트알데하이드 농도가 대조식품 대비 통계적으로 유의하게 감소하여 숙취개선 효능을 확인하였다. 특히, 30분부터 각 시간별(mg/L), 혈중 아세트알데하이드 농도-시간곡선하 면적(AUC), 최고 혈중 아세트알데하이드 농도(C<SUB>max</SUB>)의 감소를 통해 30분부터 빠른 숙취개선 효능을 확인하였다. 본 연구의 주원료로 사용된 숙잠은 Ji등(2016a)에 따르면 18종의 아미노산 및 무기질을 모두 함유하며, 고단백 식용곤충으로 간에 좋은 주요 아미노산인 Alanine, Arginine 등을 많이 함유하여 간의 효소활성에 긍정적인 영향을 줄 수 있음을 알수있다. 본 연구결과를 통해 숙잠을 함유하는 시험식품이 숙취해소제로 작용할 수 있으며, 특히 음주 전 섭취시 아세트알데하이드를 빠르게 분해하여 30분부터 숙취 개선에 효과가 있음을 입증하였다. Silkworms have traditionally been used to produce silk and textiles. However, steamed and freeze-dried mature silkworm larval powder (SMSP) contain large amounts of amino acids, vitamins, and essential minerals. In this study, we investigated the potential of SMSP as a hangover-relieving agent. Thirty individuals who met the selection criteria and exclusion criteria were included in the study and subsequently underwent a double-blind, randomized, placebo-controlled, cross-design human application test. Importantly, the test product containing SMSP (CKDHC) was proven to alleviate hangovers through a significant reduction in the plasma concentration of acetaldehyde in the context of an alcohol-induced hangover model. In particular, from 0.5 h after SMSP intake, the blood acetaldehyde concentration (mg/L), area under the time curve (AUC; indicating the degree of bioabsorption of blood acetaldehyde), and the highest blood acetaldehyde concentration (Cmax) were reduced. Altogether, these results suggest that the test product (CKDHC) exhibits an accelerated hangover-relieving effect.

식품영양학 전공자를 위한 인턴십 교육 프로그램 개선방안

주나미,윤지영,김옥선,정현아,박상현,고영주,조기원 한국식생활문화학회 2005 韓國食生活文化學會誌 Vol.20 No.1

This study was conducted to evaluate the effect of current dietetic internship program. The survey sample was dietetic practitioners who were charged with a training for dietetic students. The questionnaire requested information about demographic information, experience of guidance for the dietetic student, self evaluation as trainer, fortification items in university education, and difficulties of the internship program. Data was analyzed using SAS for windows(version 6.12), Descriptive statistics were used such as means. standard deviations. frequency distribution and percentages. Comparison of mean differences was analyzed using t-test and ANOVA. Participants identified how effective the current internship program was. Result indicated that the effectiveness was not high(2.81), and under 29 years old age group, under 6 years work experience group. and contracted foodservice group had positive opinion of the program significantly. Under 29 years old age group, evaluated themselves as a good trainer. The results revealed that respondents wanted to be fortified the practical training courses in school curriculum.

제조합 대장균에서 과발현된 Citrobacter freundii KCTC2006 유래의 β-Tyrosinase를 이용한 3,4-Dihydroxyphenyl-L-alanine의 생산

이승구,노현수,홍승표,이규종,왕지원,태동년,엄기남,방상구,김영준,성문희 한국미생물생명공학회 ( 구 한국산업미생물학회 ) 1996 한국미생물·생명공학회지 Vol.24 No.1

재조합 대장균에서 대량발현 시킨 Citrobacter freundii KCTC 2006 유래이 효소 β-tyrosinase를 이용하여 pyrocatechol, sodium pyruvate, ammonium acetate로부터 3,4-dihydroxy phenyl-L-alanine을 생산하기 위한 연구를 수행하였다. 이 효소반응에 적합한 온도 및 pH 조건은 각각 18℃와 8.5로 결정되었고, 반응액 중의 ammonium acetate와 sodium pyruvate의 농도는 각각 300 mM, 50 mM 이상으로 조절하는 것이 적합하였다. Pyrocatechol의 경우는 20 mM에서 가장 높은 반응성을 나타냈으나, 기질을 반복적으로 첨가하며 장시간 동안 효소반응을 수행하는 경우에는 pyrocatechol의 고갈을 피하기 위하여, 20 mM에서 50 mM 사이로 조절하였다. 한편, 반응액 중에 ethanol을 10% 첨가한 경우에는 반응속도가약 20% 증가하였다. 이상과 같은 효소반응특성에 기초하여 조제한 기질용액에 β-tyrosinase를 1 unit/㎖ 농도로 가하고, pyrocatechol과 pyruvate가 고갈되지 않도록 간헐적으로 첨가하면서 효소반응을 수행한 결과, 24시간 만에 85.2%의 수율로 31.6g/ℓ의 3,4-dihydroxyphenyl-L-alanine를 생산할 수 있었다. By using the β-tyrosinase of Citrobacter freundii KCTC2006, which was cloned and overexpressed in Escherichia coli, 3,4-dihydroxy phenyl-L-alanine (L-DOPA) was synthesized efficiently from pyrocatechol, sodium pyruvate, and ammonium acetate. Optimal temperature and pH for the reaction were determined to be about 18℃ and 8.5, respectively. The effects of substrate concentrations were also examined at different concentrations of ammonium acetate, sodium pyruvate, and pyrocatechol. Ammonium acetate and sodium pyruvate increased the reaction rate until the concentrations reached to 300 mM and 50 mM, respectively. Although pyrocatechol showed the optimal concentration at 20 mM, it was controlled between 20 mM and 50 mM to avoid the depletion of substrate during the enzymatic synthesis. Based on above results, a reaction medium for the production of L-DOPA was prepared and incubated with 1 unit/㎖ of β-tyrosinase. Pyrocatechol and sodium pyruvate was added to the reaction solution intermittently to avoid the substrate depletion during the enzymatic reaction. After 24 hour of reaction, 31.6 g/ℓ L-DOPA was accumulated in the reaction solution as soluble and precipitated ones and the conversion yield was about 85.2%.

정신장애인의 재활의 위한 사회기술훈련의 효과성에 관한 연구

황태연,손덕순,백형의,박종원,김지현,이경화 용인정신의학연구소 1999 용인정신의학보 Vol.6 No.2

레트로바이러스의 표면단백질 : 인슐린의존형 당뇨병의 동물모델인 NOD 쥐의 혈청과 반응하는 새로운 자가항원 A New Autoantigen Reactive with Non Obese Diabetic (NOD) Mice Sera

김경수,김기환,김현만,윤지원,강엽 아주대학교 1997 아주의학 Vol.2 No.2

IDDM (Insulin dependent diabetes mellitus) is believed to be an autoimmune disease and characterized by the immune activation against insulin-producing pancreatic beta cell. The identification and characterization of new autoantigens reactive with an activated immune System would heip to elucidate the pathogenic mechanism of this disease. Several autoantigens are trying to apply for diagnosis and prevention of IDDM. The NOD (non obese diabetic) mice have been the best model for studying the pathogenesis of human IDDM. To identify new autoantigens reactive with activated humoral immunity of NOD mice, the lambda gt11 cDNA library was constructed from NOD-derived pancreatic beta cell (MIN6N8a: mouse insulinoma cell) and screened with prediabetic NOD sera. Mine positive dones were selected from 2x10^(5) phage plaques. The 5'-end sequencing and homology searching showed that six clones from nine clones had over 98% sequence homolgy with the retroviral envelope gene. Full sequendng reveated that the cloned gene was a fragment of ecotropic retrovirus (emv-3) envelope gene. To confirm the immunoreactivity of doned retroviral envelope protein, the cloned gene fragment was expressed in an E.coli expression vector System. Western blotting showed that the recombinant envelope protein fragment also reacted with prediabetic NOD sera.