Analysis of acne-related judicial precedents from 1997 to 2018 in South Korea

( Ji Hoon Yang ),( Soo Ick Cho ),( Su Hwan Shin ),( Won Lee ),( So Yoon Kim ),( Dae Hun Suh ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2

Background: Medicolegal disputes are increasing in practical medicine. Acne is a common problem but is usually related to cosmetic problems such as acne scars. Medications or procedures related to acne could lead to medical malpractice. Objectives: To analyze medical litigation associated with acne or acne scar in South Korea. Methods: Acne-related judgements were searched using the Supreme Court of Korea’s Written Judgment Management System based on the keywords “acne” or “acne scar.” Results: Eleven cases were selected as litigated cases of acne or acne scar. Eight cases (72.7%) were related to acne scar and three (27.3%) were related to acne. Treatment modalities such as peeling (n = 6), laser treatment (n = 3), photodynamic therapy (n = 1), and antibiotic (n = 1) resulted in lawsuit. Claimed sequelae of the treatment were hyperpigmentation (n = 5), scar worsening (n = 5), erythema (n = 3), skin bumps (n = 1), and liver transplant (n = 1). Eight cases (72.7%) were awarded to the plaintiff, and the others were dismissed. The average awarded amount was 16,801,324± 24,452,486 (mean±standard deviation) Korean Won. Conclusion: Various treatments for acne or acne scar can cause medical disputes. Unnecessary litigation could be prevented if simple measures such as history taking, choosing proper procedure, and adequate management after the procedure along with sufficient informed consent were performed.

Combination Effects of Essential Oils from Thymus species with Norfloxacin against Streptococcus pneumoniae

Kim, Ji-Hyun,Sim, Youn,Shin, Seung-Won 덕성여자대학교 약학연구소 2005 藥學論文誌 Vol.16 No.1

The combination effects of essential oils from Thymus quinquecostatus and T. magnus with norfloxacin were evaluated against three strains of Streptococcus pneumoniae. The checkerboard titer test results demonstrated significant combined effects of norfloxacin and the two Thymus oils or thymol, the main component of this oil, against the susceptible and resistant strains of S. pneumoniae, with FICIs ranging from 0.14 to 1.00. Additionally, the anti-Streptococcus effects of the oils were dose-dependent on Tryptic soy agar plates containing 5% defibrinated sheep blood.

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.

GG-38 : Minimal invasive surgery (LESS) for huge cystic adnexal tumors in whole abdomen

( In Young Choi ),( Ji Hye Lee ),( Mi Hyun Park ),( Ji Kwoun Park ),( Jeong Kyu Shin1 ),( Won Jun Choi1 ),( Soon Ae Lee ),( Jong Hak Lee ),( Won Young Paik ) 대한산부인과학회 2014 대한산부인과학회 학술대회 Vol.100 No.-

Laparoendoscopic single-site surgery (LESS) is helpful if not an evidence of suspicious malignancy in huge adnexa tumors. This approach might be reasonable alternative to conventional laparoscopic surgery. We report two cases with LESS for huge cystic adnexal tumors in whole abdomen. A 58 years old multigravida woman in menopause underwent removal of a huge cystic adnexal mass that occupied her entire abdomen by LESS.(ca.5200ml aspiration) A 15 years old single nulligravida woman had a huge cystic adnexal tumor in whole abdomen reaching to the level of the xyphoid process. A needle through the transumbilical single port was inserted directly under the mass. Subsequently, 8000 ml of cystic fluid was aspirated without spillage.

Identification of Driving <i>ALK</i> Fusion Genes and Genomic Landscape of Medullary Thyroid Cancer

Ji, Jun Ho,Oh, Young Lyun,Hong, Mineui,Yun, Jae Won,Lee, Hyun-Woo,Kim, DeokGeun,Ji, Yongick,Kim, Duk-Hwan,Park, Woong-Yang,Shin, Hyun-Tae,Kim, Kyoung-Mee,Ahn, Myung-Ju,Park, Keunchil,Sun, Jong-Mu Public Library of Science 2015 PLoS genetics Vol.11 No.8

<▼1><P>The genetic landscape of medullary thyroid cancer (MTC) is not yet fully understood, although some oncogenic mutations have been identified. To explore genetic profiles of MTCs, formalin-fixed, paraffin-embedded tumor tissues from MTC patients were assayed on the Ion AmpliSeq Cancer Panel v2. Eighty-four sporadic MTC samples and 36 paired normal thyroid tissues were successfully sequenced. We discovered 101 hotspot mutations in 18 genes in the 84 MTC tissue samples. The most common mutation was in the ret proto-oncogene, which occurred in 47 cases followed by mutations in genes encoding Harvey rat sarcoma viral oncogene homolog (N = 14), serine/threonine kinase 11 (N = 11), v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog (N = 6), mutL homolog 1 (N = 4), Kiesten rat sarcoma viral oncogene homolog (N = 3) and MET proto-oncogene (N = 3). We also evaluated anaplastic lymphoma kinase (<I>ALK</I>) rearrangement by immunohistochemistry and break-apart fluorescence <I>in situ</I> hybridization (FISH). Two of 98 screened cases were positive for <I>ALK</I> FISH. To identify the genomic breakpoint and 5’ fusion partner of <I>ALK</I>, customized targeted cancer panel sequencing was performed using DNA from tumor samples of the two patients. Glutamine:fructose-6-phosphate transaminase 1 (<I>GFPT1)-ALK</I> and echinoderm microtubule-associated protein-like 4 (<I>EML4</I>)<I>-ALK</I> fusions were identified. Additional PCR analysis, followed by Sanger sequencing, confirmed the <I>GFPT1</I>-<I>ALK</I> fusion, indicating that the fusion is a result of intra-chromosomal translocation or deletion. Notably, a metastatic MTC case harboring the <I>EML4-ALK</I> fusion showed a dramatic response to an ALK inhibitor, crizotinib. In conclusion, we found several genetic mutations in MTC and are the first to identify <I>ALK</I> fusions in MTC. Our results suggest that the <I>EML4-ALK</I> fusion in MTC may be a potential driver mutation and a valid target of ALK inhibitors. Furthermore, the <I>GFPT1-ALK</I> fusion may be a potential candidate for molecular target therapy.</P></▼1><▼2><P><B>Author Summary</B></P><P>Little is known about the molecular biology of medullary thyroid cancer (MTC), which is a rare disease. Genomics are increasingly being used to improve our knowledge about disease biology and to identify therapeutic targets in many cancers. Here, we report the largest genomic results of MTC to date. MTC tissue frequently included several mutations. For the first time, anaplastic lymphoma kinase (<I>ALK</I>) rearrangements were detected in MTC: one case with a glutamine:fructose-6-phosphate transaminase 1 (<I>GFPT1</I>)<I>-ALK</I> fusion, and another case with an echinoderm microtubule-associated protein-like 4 (<I>EML4</I>)<I>-ALK</I> fusion. The fusion mechanism of the novel <I>GFPT1-ALK</I> fusion was successfully investigated using molecular biology techniques. In addition, an inhibitor of ALK (crizotinib) dramatically decreased the number of metastatic MTC lesions harboring the <I>EML4-ALK</I> fusion, thus verifying the fusion as a promising target in MTC. Our findings suggest that using rapidly improving sequencing techniques and accumulated genomic data to comprehensively perform genetic analyses on rare tumors, such as MTC, will help to improve the poor prognosis of orphan diseases.</P></▼2>

Targeting LAG-3 Reinvigorates Anti-Tumor Function of Intratumoral MAIT Cells in Hepatocellular Carcinoma

( Ji Won Han ),( Min-seok Rha ),( June Young Koh ),( Seung Kew Yoon ),( Jun Yong Park ),( Dong Jin Joo ),( Eui-cheol Shin ),( Dai Hoon Han ),( Su-hyung Park ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

Aims: MAIT cells are major T-cell population in the liver, but whether they contribute to the anti-tumor immunity in hepatocellular carcinoma (HCC) is controversial. Methods: We characterized intratumoral MAIT cells using MR1-tetramer, compared to the intrahepatic MAIT cells. Phenotypic analyses were performed by flow cytometry, and transcriptome analyses using sorted MAIT cells were performed by RNA sequencing. To evaluate their function, co-culture assays using hepatoma cell lines were performed. Results: Upon tumor cell-stimulation, MAIT cells produced anti- tumor cytokines and cytotoxic molecules, and could kill the hepatoma cells. Intratumoral MAIT cells had a gene signature which is associated with the T-cell exhaustion and poor patients’ survival. Intratumoral MAIT cells more expressed CTLA-4 and LAG-3 compared to the intrahepatic MAIT cells. They also had poor cytokine and cytotoxic molecule production upon tumor cell-stimulation. Interestingly, the relative frequency of CD8- subpopulation among intratumoral MAIT cells was increased, and this subpopulation significantly expressed LAG-3 compared to the CD8+ subpopulation. The anti-tumor function of CD8- intratumoral MAIT cells was improved by LAG-3 blockade, resulting in the reinvigoration of the function of total MAIT cell-population. Conclusions: Our results suggest that MAIT cells and LAG-3 should be considered as cellular and molecular targets for the immunotherapy of HCC, and future experimental and clinical studies are needed.

Risk of nontuberculous mycobacterial infection from the use of inhaled corticosteroid in obstructive lung disease

( Ji-hoon Kim ),( So-jin Kwak ),( Sae Byol Kim ),( Beomsu Shin ),( Seok Jeong Lee ),( Myoung Kyu Lee ),( Sang-ha Kim ),( Won-yeon Lee ),( Suk Joong Yong ),( Ji-ho Lee ) 대한결핵 및 호흡기학회 2019 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.127 No.-

Purpose: While inhaled corticosteroid (ICS) is an effective drug for the treatment of obstructive lung disease (OLD), there has been a concern for the occurrence of side effect, such as pneumonia. However, it was not fully investigated whether use of ICS is associated with the development of nontuberculous mycobacteria (NTM) lung disease. This study aimed to find the association between the ICS and NTM disease in OLD. Method: We performed a population based case-control study using Korean National Health Insurance database. Among population taken national health checkups at least 2 times during 2009 to 2012, those with new diagnosis of OLD and treated with respiratory medicine during 2009 to 2012 were regarded as having OLD. They consisted of asthma, chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap (ACO). NTM was defined as new diagnosis of NTM plus at least 2 times of medication prescribed for NTM during 2013 to 2017. Result Total patients with OLD were 91,066 (asthma 35.5%, COPD 57.3% and ACO 7.2%, respectively). Among them, ICS user were 21,828 (24.0%) and non-ICS user were 69,238 (76.0%). NTM case were identified in 219 patients. Risk of NTM decreased with the presence of asthma (Odds ratio 0.34, 95% CI 0.24-0.49), but increased with the presence of COPD (1.85, 1.38-2.48), ACO (1.91, 1.28-2.84), bronchiectasis (8.39, 6.24-11.27) and prior tuberculosis history (15.95, 11.69-21.76). In all patients with OLD, NTM increased in ICS user compared to non-ICS user (2.15, 1.37-3.35). While ICS did not increase the risk of NTM in asthma (1.60, 0.59-4.35) and ACO (1.24, 0.34-4.50), ICS was significantly associated with the development of NTM in COPD (3.86, 2.21-6.76). Conclusion: ICS use is associated with the development of NTM disease. When ICS is prescribed for patients with COPD in particular, the risk of NTM should be considered with caution.

Fabrication of dye-sensitized solar cells using ordered and vertically oriented TiO2 nanotube arrays with open and closed ends

Ji Won Lee,Ki Sang Hong,Kyusoon Shin,조재영 한국공업화학회 2012 Journal of Industrial and Engineering Chemistry Vol.18 No.1

Highly ordered and vertically oriented TiO2 nanotube arrays were prepared and applied to dye sensitized solar cell (DSSC) as working electrodes. The nanotube arrays were fabricated using atomic layer deposition and AAO template. The two types of nanotube’s end, closed-end and open-end, were produced by reactive ion etching (RIE) process. The structure of nanotube arrays was characterized by FE-SEM,TEM, and XRD. DSSCs using the TiO2 nanotube arrays as working electrodes were fabricated and characterized. The DSSCs prepared from the TiO2 nanotubes with open end exhibited higher power conversion efficiency of 1.17% than that with closed end. This result is attributed to that the open-ended TiO2 nanotubes provided larger surface area, leading to more amount of dye molecules to adsorb followed by the higher light absorption.

Comparison of clinical, laboratory, and radiologic features of undiagnosed pleural effusion and malignant pleural effusion with cytology- negative results

( Ji Eun Park ),( Sunji Park ),( Sun Ha Choi ),( Yong Hoon Lee ),( Hye Won Seo ),( Seung Soo Yoo ),( Shin Yup Lee ),( Seung Ick Cha ),( Jae Yong Park ),( Chang Ho Kim ),( Jaehee Lee ) 대한결핵 및 호흡기학회 2019 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.127 No.-

Background: Undiagnosed pleural effusion (UPE) even after video-assisted thoracoscopic surgery (VATS) pleural biopsy is challenging because there is concern about missing malignant pleural effusion (MPE) with inconclusive cytology results. Better understanding of clinical characteristics of patients with UPE and cytology-negative MPE may improve differential diagnosis. However, little is known about the clinical factors that can help distinguish patients with UPE from those with cytology-negative MPE. Methods: Patients who were diagnosed with UPE and MPE, respectively, between January 2010 and December 2017, were enrolled in this retrospective study. Clinical, laboratory, and radiologic characteristics were compared between patients with UPE and cytology-negative MPE. Diagnostic performances of predictors for UPE were assessed using receiver-operating characteristic curves. Results: During the study period, 223 patients with confirmed MPE (pleural fluid cytology-positive [n=169] and -negative [n=54]) were enrolled. During the same study period, 22 patients with UPE were identified. Multivariate analysis demonstrated that minimal amount of pleural effusion (odds ratio [OR] = 12.41, p=0.039), presence of pleural nodularity (OR = 0.01, p < 0.001), and pleural fluid carcinoembryonic antigen (CEA) levels less than 14 ng/mL (OR = 87.59, p=0.002) were independent factors for identifying UPE among cytology-negative cases. Combination of absence of pleural nodularity and pleural fluid CEA levels less than 14 ng/mL yielded the area under the curve of 0.94 and had a sensitivity of 91% and a specificity of 96%. Conclusions: A significant portion of patients undergoing VATS pleural biopsy fail to get a definite diagnosis. Amount of pleural effusion, pleural nodularity, and pleural fluid CEA levels may help guide differentiation of UPE from cytology-negative MPE.

[P8-241] Isolation and Characterization of Active Compound from KOCAT-D1 on Type 2 Diabetes

JI-hee Yang,Hyun-sun Lee,Jong-tak Kim,Chung-oui Hong,Yun-chang Koo,Dong-chul Shin,Mi-hyun Nam,Kwang-won Lee 한국식품영양과학회 2008 한국식품영양과학회 학술대회발표집 Vol.2008 No.10