정형외과 수술 관련 의료행위에 대한 법적 고찰

신호식 대한족부족관절학회 2024 대한족부족관절학회지 Vol.28 No.3

This study examined the levels of satisfaction from medical staff and patients by analyzing 691 Supreme Court precedents on medical practice from legal disputes in Korea, which are developing into a dual medical system. In addition, the issues that can be prevented in the medical field through the flow and judgment of legal disputes in medical practice after the revision of the medical law are discussed. The concept of medical practice not specified in the Medical Law was examined and compared with the medical-legal systems of Germany, Japan, and the USA through international comparative analysis to assess the illegal factors occurring in the medical field by analyzing the legal approach, medical practice, and medical personnel qualifications of each country. An analysis of the Supreme Court’s case law revealed the timing analysis of issues in legal disputes related to medical practice, the incidence rate among the subjects of the cases, and medical personnel to be significant. The meaning was studied by finding the law that applied to it. Important cases were identified, and their meaning was reviewed. The legal issues of medical practice in orthopedics were divided into five sections based on precedents, such as problems in consent to information at the start of treatment, problems in prior radiography before treatment, explanation of the consent process for surgical treatment, problems related to the qualification of operators in the operating room, and the responsibility for postoperative results. In the wake of the recent major crisis in the government’s medical reform policy (Essential medical package), procedural problems and legal reviews

선장의 리더십과 의사결정에 관한 연구

신호식,윤대근,Sin, Ho-Sig,Youn, Dae-Gwun 해양환경안전학회 2011 海洋環境安全學會誌 Vol.17 No.2

해상에서 인명과 재산을 보호하기 위해서는 해양사고를 예방하고 긴급상황 시에 신속하게 대처하는 능력이 중요시된다. 해양사고의 80%가 선박의 운항과 관리에 관련된 인적요인으로 발생한다. 그것은 대부분의 해양사고가 한 개인의 순간적인 실수에서 유발되는 것이 아니라 그 배경에는 인적과실을 유발하는 잠재적인 요인들이l 복합적으로 작용한다는 것을 나타낸다. 따라서 본 연구에서는 선박에서 선상의 리더십이 선박에 미치는 영향과 선박의 의사결정 과정을 알아보고 특히, 선박의 긴급상황 시에 발생할 수 있는 행동특성의 이해를 통하여 특정선박에서 인적과실을 줄이기 위한 해결방안 및 대응전략을 제시하였다. It is very important for ability to be treated to protect and secure the loss of life and property in emergency situation at sea. 80% of maritime casualty are incurred by human factors rather than a mechanical reason, which means that most maritime incident does not come from only one factor by mistake, but multiple potential factors causing a fault and error. Therefore, after research of the leadership effect to the ship, decision making process and behavior characteristics occurred in emergency situation, this paper presents settlement scheme and strategy in order to reduce human error in the ship.

신장 이식 후 발생한 침습성 아스페르길루스 부비동염을 수술과 Voriconazole로 치료한 1예

신호식,이신준,정연순,임 학 고신대학교 의과대학 2011 고신대학교 의과대학 학술지 Vol.26 No.2

Invasive fungal sinusitis is a rare, severe disease, most commonly presenting in immunocompromised patients who have impaired neutrophil function or who have received long term immunosuppressive therapy. The gold standard for treatment has been wide surgical debridement, intravenous administration of antifungal agents such as amphotericin B (AMB), and correction of the underlying immunocompromised state. A 51-year-old female was admitted to our hospital with fever and headache who had received renal transplantation 14 years ago in the other hospital. Paranasal sinus CT scan revealed hyperplasia and soft tissue density of the left maxillary sinus. Histological examination of the fungus ball and edematous mucosa of the left maxillary sinus revealed suspicious invasion of Aspergillus in the mucosa. Clinical improvement occurred after a combination of surgery and post-operative systemic antifungal therapy with voriconazole. We think that voriconazole as initial treatment may be initiated for invasive sinonasal aspergillosis, if the infection is known to be due to Aspergillus species.

肝 X­線照射時 唾液腺의 變化에 關한 病理組織學的 硏究

申昊湜,崔日薰 우석대학교 의과대학 1970 우석의대잡지 Vol.7 No.1

The mouse liver was exposed to the X-ray of 1,500, 1,000 and 500 R., then the liver and salivary glands were examined chronologically. H.E., PAS and mucicarmine stain were carried out for the histopathological study. Results obtained were as follows : 1. Degeneration and necrosis of the liver tissue were most pronounced at 10-15 hours in the group exposed to 1,500 R., and definite regenerating figures were observed in 1-2 days. In the group exposed to 1,000 R., degeneration and necrosis of the liver tissue were at the peak at 10 hours and marked regenerative figures were seen at 20-24 hours. The group exposed to 500 R. showed mild changes in the liver. 2. Changes of the salivary glanduiar epithelium reached their peak in 1-2 days in the group exposed to 1,500R , similar changes were noted at 20-24 hours in the group exposed to 1,000 R,, and changes were very mild in the group exposed to 500 R. The group received l,500 R. showed more severe changes in the liver than those of 1,000 R. group. 3. L ver injury followed by X-ray irradiation accompanied degenerative changes in the salivary gland.

肝 X­線照射時 唾液腺의 變化에 關한 病理組織學的 硏究

申昊湜 우석대학교 의과대학 1970 우석의대잡지 Vol.7 No.1

목포항의 항만현황과 개발방향에 관한 연구

김형근,신호식 木浦海洋大學校 1997 論文集 Vol.5 No.2

In this study the writer analyzed and suggested the situation of the port and development project of the Port of Mokpo which attaining 100th anniversary of opening a port. The important contents of the study can be summarized as follows: Firstly, The total length of wharf of Mokpo Port is composed of 4,964 meters. Among them, the length of cargo ships wharf is 3,962 meters and the length of passenger ships wharf is 351 meters and the length of fishing boats wharf is 633 meters. Secondly, For the last three years(1994-1996) the amount of harbour materials and the income of cargo work of the Port of Mokpo is analyzed as the lowest rank in the principal ports of the whole country. Thirdly, The development project of No.1 Wharf is suggested as a international passenger wharf and position wharf of international exchanges, and the development project of No.2,3 Wharf is suggested as a leisure wharf, and the development project of No.4,5 Wharf is suggested as a coasting passengers and tourists wharf, and the development project of Southern Port is suggested as a port of environmental fraternization, and the development project of Northern Port is suggested as a fishing port. Finally, In the municipal organization of Mokpo, the new establishment of the Department of the Ocean & Fisheries is suggested.

일부 농촌지역에서의 음독에 의한 급성 약물중독에 관한 조사연구

신호식,김종일,최회영,황혜헌 대한가정의학회 1994 Korean Journal of Family Medicine Vol.15 No.6

두 종류의 CAD/CAM 지르코니아 전부도재관의 도재 축성 전후의 변연적합도 비교

신호식,김석규,Shin, Ho-Sik,Kim, Seok-Gyu 대한치과보철학회 2008 대한치과보철학회지 Vol.46 No.5

연구목적: 변연적합도는 보철수복물의 성공을 좌우하는 중요한 요소 중의 하나이다. McLean과 von Fraunhofer등에 의하면 120 ${\mu}m$ 이하를 임상적으로 허용할 수 있다고 했는데, 이를 넘는 정확하지 않은 변연은 지각과민을 일으키거나 이차 우식을 일으키고, 치태 축적을 용이하게 하여 보철물의 수명을 단축시키게 된다. 이에 최근에 우리나라에 소개되어 임상적으로 사용되고 있는 CAD-CAM 전부도재 수복물 중 $LAVA^{(R)}$ 시스템 (3M ESPE, St. Paul, MN)과 $EVEREST^{(R)}$ 시스템 (KaVo Dental GmbH, Biberach, Germany)으로 제작한 지르코니아 전부 도재관들이 도재전장 금속주조 수복물과 비교해 보아 코핑 상태일 때와 도재축성 후 각각 변연적합도의 차이가 있는지를 살펴보고자 하였다. 재료와 방법: 상악 제1소구치 덴티폼 치아를 high speed diamond bur 로 교합면 2.0 mm, 순설면 1.0 mm, 그리고 변연은 chamfer margin을 6도 측면 경사 절삭 기계로 균일하게 제작해서 이를 인상 채득하여 금속 지대치를 제작하였다. 이를 덴티폼 모형상에 장착한 후 전악인상을 채득하여 $LAVA^{(R)}$ 수복물 코핑, $EVEREST^{(R)}$ 수복물 코핑, 그리고 도재전장 금속주조 수복물 코핑을 각각 8개씩 제작하였다. 이들 코핑을 염색제를 섞은 Fit-checker $II^{(R)}$ (GC Cor., Tokyo, Japan)를 이용하여 금속 지대치에 접합시킨 뒤, $Microhiscope^{(R)}$ system (HIROX KH-1000 ING Plus, Seoul, Korea)을 이용하여 300배율로 관찰하면서 변연 간격을 ${\mu}m$단위로 측정하였다. 도재축성 후에도 마찬가지 방법으로 모든 수복물의 변연간격을 측정하여 통계 처리를 하였다. 결과: 코핑 상태에서의 평균 변연간격 값은 $EVEREST^{(R)}$ 에서 $52.00{\pm}11.94\;{\mu}m$, $LAVA^{(R)}$ 는 $ 56.97{\pm}10.00\;{\mu}m$, 그리고 도재 전장 금속 주조 수복물은 $97.38{\pm}18.54\;{\mu}m$를 보였고, 도재축성 후에 평균 변연 간격값은 $EVEREST^{(R)}$ 는 $61.69{\pm}19.33\;{\mu}m$, $LAVA^{(R)}$ 는 $70.81{\pm}12.99\;{\mu}m$, 그리고 도재 전장 금속 주조 수복물은 $115.25{\pm}23.86\;{\mu}m$를 보였다. 결론: 1. $LAVA^{(R)}$ 와 $EVEREST^{(R)}$ 수복물은 도재 전장 금속 주조 수복물과 비교하여 각각 코핑상태일 때와 도재 축성 후 모두 유의성 있는 (P < .05) 차이를 보이는 우수한 변연 적합도를 나타내었다. 2. $LAVA^{(R)}$ 와 $EVEREST^{(R)}$ 수복물 간의 평균 변연 간격 비교에서 코핑 상태일 때와 도재 축성 후에 모두 유의성 있는 차이는 없었다 (P > .05). 3. $LAVA^{(R)}$과 $EVEREST^{(R)}$ 그리고 PFM 은 각각 코어 상태일 때와 비교하여 도재 축성 후 변연 간격에서 약간 증가되었으나 유의성 있는 차이를 보이지는 않았다 (P > .05). Purpose: Marginal fit is one of the important components for the successful prosthodontic restoration. Poor fitting margin of the restoration causes hypersensitivity, secondary caries, and plaque accumulation, which later result in prosthodontic failure. CAD/CAM zirconia all-ceramic restorations, such as $LAVA^{(R)}$ (3M ESPE, St.Paul, MN) and $EVEREST^{(R)}$ (KaVo Dental GmbH, Biberach, Germany) systems were recently introduced in Korea. It is clinically meaningful to evaluate the changes of the marginal fit of the CAD/CAM zirconia systems before and after build-up. The purposes of this study are to compare the marginal fit of the two CAD/CAM all-ceramic systems with that of the ceramometal restoration, before and after porcelain build-up Material and methods: A maxillary first premolar dentiform tooth was prepared with 2.0 mm occlusal reduction, 1.0 mm axial reduction, chamfer margin, and 6 degree taperness in the axial wall. The prepared dentiform die was duplicated into the metal abutment die. The metal die was placed in the dental study model, and the full arch impressions of the model were made. Twenty four copings of 3 groups which were $LAVA^{(R)}$, $EVEREST^{(R)}$, and ceramometal restorations were fabricated. Each coping was cemented on the metal die with color-mixed Fit-checker $II^{(R)}$ (GC Cor., Tokyo, Japan). The marginal opening of each coping was measured with $Microhiscope^{(R)}$ system (HIROX KH-1000 ING-Plus, Seoul, Korea. X300 magnification). After porcelain build-up, the marginal openings of $LAVA^{(R)}$, $EVEREST^{(R)}$,and ceramometal restorations were also evaluated in the same method. Statistical analysis was done with paired t-test and one-way ANOVA test. Results: In coping states, the mean marginal opening for $EVEREST^{(R)}$ restorations was $52.00{\pm}11.94\;{\mu}m$ for $LAVA^{(R)}$ restorations $56.97{\pm}10.00\;{\mu}m$, and for ceramometal restorations $97.38{\pm}18.54\;{\mu}m$. After porcelain build-up, the mean marginal opening for $EVEREST^{(R)}$ restorations was $61.69{\pm}19.33\;{\mu}m$, for $LAVA^{(R)}$ restorations $70.81{\pm}12.99\;{\mu}m$, and for ceramometal restorations $1115.25{\pm}23.86\;{\mu}m$. Conclusion: 1. $LAVA^{(R)}$ and $EVEREST^{(R)}$ restorations in comparison with ceramometal restorations showed better marginal fit, which had significant differences (P < 0.05) in coping state and also after porcelain build-up . 2. The mean marginal opening values between $LAVA^{(R)}$ and $EVEREST^{(R)}$ restorations did not showed significant differences after porcelain build-up as well as in coping state (P > .05). 3. $EVEREST^{(R)}$, $LAVA^{(R)}$ and ceramometal restorations showed a little increased marginal opening after porcelain build-up, but did not show any statistical significance (P > .05).

혈액투석 환자에서 영양 지표로서의 투석 간 체중 증가

신호식,정연순,임학 KOSIN UNIVERSITY COLLEGE OF MEDICINE 2006 高神大學校 醫學部 論文集 Vol.21 No.1

Background: Interdialytic weight gain (IDWG) is mainly resulted from salt and water retension between two dialysis sessions. The consequences of IDWG have been interpreted in two different ways. While a high interdialytic weight gain is considered to be an indicator of noncompliance, it could also be interpreted as an index of appetite. Water and salt retension give rise to a volume overload, which may lead to high blood pressure and left ventricle hypertrophy. On the other hand, the water and saline intake can be done along with caloric and protein foods, which may result in a better nutritional status. In the latter case, the interdialytic weight gain (IDWG) can be an index of appetite. The objective of the this study was to investigate the relationships between the IDWG and indicators of malnutrition, and hypertension in hemodialysis (HD) patients. Methods: We conducted a retrospective study in which 74 HD patients with ages between 22 and 74 were involved (36 males and 38 females) and collected average values of %IDWG accordings to dry weight (%IDWG/DW), nutritional parameters, and mean blood pressure (MBP) during the initial 4 week-period of dialysis. Patients were divided into 2 groups according to %IDWG/DW (group Ⅰ%IDWG/DW ≥3, group Ⅱ %IDWG/DW <3). Student t test, linear regression analysis, and Kaplan-Meier survival curves compared with log-rank test were used for statistical evaluation of data. Results: In group Ⅰ, blood urea nitrogen (BUN) (P=0.037), plasma K+(P=0.025), and normalized protein catabolic rate (nPCR) (P=0.024) were significantly higher than those of group Ⅱ. MBP, albumin, hemoglobin, phosphate, calcium and total cholesterol levels in the plasma showed no significant difference between the two groups. Survival rate showed no statistical difference between the two groups. Survival rate in diabetic group tended to be lower than the non-diabetic group. Conclusion: These results suggest that a greater IDWG may be associated with a better nutritional status as reflected by a higher nPCR, BUN and serum K level, although it is not associated with albumin, hemoglobin and total cholesterol levels. This, in turn, suggest a possible risk developing a malnutrition in HD patients with low IDWG.

위탁선사 실습생의 만족도에 관한 연구

신호식,임명환 해양환경안전학회 2013 해양환경안전학회 학술발표대회 논문집 Vol.2013 No.11