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이원(Won Lee),이미진(Mi Jin Lee),김용민(Yong Min Kim),우찬명(Chan Myung Woo),김소윤(So Yoon Kim),김양수(Yang-Soo Kim) 대한정형외과학회 2016 대한정형외과학회지 Vol.51 No.3
목적: 국내 정형외과 관련 의료소송 판결문의 분석을 통하여 정형외과 의료소송의 현황과 원인이 된 과정을 파악하고자 함이다. 대상 및 방법: 소송시작이 2005년부터 2010년인 정형외과 의료소송 판결문 341건을 대상으로 하여 빈도분석을 실시하였다. 결과: 사건 발생 시점에서 소송 종결 시점까지의 평균 소요기간은 4.22년이었다. 의료소송의 원인이 된 과정은 수술이 46.3%였고, 수술의 종류는 척추 수술이 가장 많았다. 사고의 결과는 장애가 가장 많았고, 최종심 결과는 원고일부승이 40.5%, 원고패(기각)가 34.3%였다. 감염은 전체 중 26.1%에서 발생하였고, 손해배상 청구금액은 평균 181,998,036원이었으며 인용금액은 평균 58,897,161원이었다. 결론: 정형외과 의료소송으로 이어진 의료사고의 주요 원인 과정은 수술이 가장 많았고, 그 중에서도 척추 수술이 가장 많았다. 추후 의료사고의 근본 원인분석을 통해 의료사고를 줄이고 재발을 방지하기 위한 후속 연구가 이루어져야 할 것이다. Purpose: Through the analysis of orthopedics lawsuit rulings, the purpose of this study is to understand the current trends of medical lawsuits in orthopedics in Korea. Materials and Methods: An analysis of medical lawsuits in orthopedics was conducted. As the study method, a quantitative analysis was performed on 341 cases. Results: The average period of lawsuits, from the occurrence of the medical accident to end of the ruling, took an average of 4.22 years. The most frequent procedure that was the main cause of the medical accidents was surgery, at 46.3%. When surgery is the main procedure that caused the medical accidents, the result of examining the types of surgeries showed that spine surgery had the highest percentage. For the outcome of the accident, the highest number of cases resulted in disability and for the final court outcome, 40.5% ruled partially in favor of the plaintiff (the patient) with acknowledgement of only the damage incurred due to medical error of the total sum claimed, and dismissal of the claim made by the plaintiff (patient) accounted for 34.3%; 26.1% of cases develop infection. For the amount of claim for damage, the average amount of claim was 181,998,036 won; in the judgement amount, the average amount of judgement was 58,897,161 won. Conclusion: The most frequent procedure in orthopedics was surgery and spine surgery comprised a large proportion of these surgeries. Future studies to determine root causes of medical accidents should be conducted to reduce medical lawsuits and to plan against the repeating of medical accidents.
장우준(Woo-jun jang),전찬용(Chan-Yong jeon),김태원(Tae-Won Kim),곽규석(Kyu-Seok Kwak),남기찬(Ki-Chan Nam) 한국항해항만학회 2006 한국항해항만학회 학술대회논문집 Vol.3 No.1
최근 중국은 양산항을 개장하여 선사 유치를 위한 다양한 혜택을 제공하고, 일본은 "수퍼중추항만 육성계획“을 세워 항만의 효율성을 바탕으로 비용을 낮추려는 노력을 하고 있다. 또한 선박의 대형화에 의한 중심항만(Hub Port) 위주의 기항과 북중국의 대량 물량 발생지역에 대한 직기항 경향으로 동북아 항만간의 경쟁이 더욱더 치열해 지고 있으며 동북아 역내 피더네트워크 강화의 필요성이 제기되고 있다. 따라서, 본 연구에서는 유럽 피더네트워크 전략 사례를 바탕으로 동북아 피더시장 현황을 파악하고 동북아 피더네트워크 구조를 분석함으로써 동북아 역내 항만 및 선사간의 과당경쟁을 지양하고 서로 Win-Win할 수 있는 터미널의 전략적 활용, 선사간 제휴 확대, 항만간 협력 강화를 위한 구체적인 전략을 제시하였다. Recently, China opened Yangshan port and provides a variety of benefits for shipping companies. Japan plans to reduce logistics costs and improve efficiency through the established "super major ports" project. According to the "hub and spokes" system, the number of direct calls toward North-Chinese ports are increasing. This changing environment has negative effects on the amount of transshipment cargos in Korean ports. In order to make a hub port of a domestic port, it is necessary to develop northeast Asian feeder networks. Therefore, this paper analyzes the structure of northeast Asian feeder networks through the case study of European feeder networks strategy. Finally, we suggests the plans to reinforce feeder networks, which are strategic terminal operation, strategic alliances between shipping companies and port co-operation, for win-win strategy in the competitive northeast Asian market.
윤제원(Je-Won Yoon),김영찬(Young-Chan Kim),김금모(Keum-Mo Kim),장강석(Kang-Seok Jang),구본성(Bon-Sung Ku),엄주용(Joo-Yong Eom) 한국소음진동공학회 2011 한국소음진동공학회 학술대회논문집 Vol.2011 No.10
The purpose of this study is to develop an air-passing soundproofing panel with more improved structure to reduce the CO2 emission and installation cost. To reduce the emission of CO2 ; it is suggested to choose low CO2 emission material relative to the aluminum and to reduce the materials by developing a specially designed air-passing soundproofing panel structure. First of all, we performed the flow analysis to predict the wind pressure according to the open angle of the air-passing soundproofing panel and the noise level analysis at the receiver point. To verify the simulation, a prototype of the soundproofing panel was made. The flow test in the wind tunnel and load test were performed. The economic evaluation for the installation of the air-passing soundproofing panel was performed and specifications of the installation was prepared. As the results of this research, it was verified that the wind load was reduced about 40% to that of the conventional one at 25m/s wind speed in the wind tunnel test. By applying the 4m span soundproofing wall with air-passing soundproofing panel and under the cost of 250 thousand won/m2 instead of the conventional 2m span panel, the installation cost will always be lowered than the conventional one in the combination of (60:40~50:50) conventional to air-passing soundproofing panel from the economic evaluation. The 20% reduction of CO2 was found by changing the 50% of aluminum soundproof panel to air-passing soundproofing panel.
모발로 분화하는 종양에 대한 임상 및 병리조직학적 소견 -대한피부과학회 피부병리 연구분과위원회 공동연구-
김유찬 ( You-Chan Kim ),강원형 ( Won-Hyoung Kang ),고재경 ( Jai-Kyoung Koh ),김낙인 ( Nack-In Kim ),김방순 ( Bang-Soon Kim ),김상원 ( Sang-Won Kim ),김수남 ( Soo-Nam Kim ),김수찬 ( Soo-Chan Kim ),노영석 ( Young-Suck Ro ),명기범 ( 대한피부과학회 2003 대한피부과학회지 Vol.41 No.9
Background : Data on the clinicopathologic features of hair follicle tumors in Korea are limited. Objective : The purpose was to investigate the clinical and histopathologic characteristics of hair follicle tumors in Korea. Methods : Two hundred sixty four cases of hair follicle tumors seen from 1999 to 2001 in Korea were analyzed clinically and histopathologically. Results and Conclusion : 1. The most common hair follicle tumor in Korea was pilomatricoma(81.0%), followed by trichoepithelioma(6.4%), dilated pore of Winer(3.8%), and proliferating trichilemmal tumor(2.2%). 2. Hair follicle tumors usually occurred as a solitary skin-colored nodule. The most commonly involved site was the face, and the peak age of presentation was 10 to 19. 3. Pilomatricoma usually occurred as a solitary skin-colored nodule. The most commonly involved site was the arm, and more than 50% of tumors occurred before the age of 20. Histopathologically, the tumor was often surrounded by fibrous capsule and was composed of basophilic and shadow cells. It was usually located in the dermis and extended into the subcutis. Retraction spaces between tumor nests and stroma were frequently observed. 4. Trichoepithelioma usually occurred as multiple skin-colored papules on the face. Histopathologically, the tumor was usually located in the dermis with sometimes connected to the epidermis. It frequently showed peripheral palisading. 5. Dilated pore of Winer usually occurred as a solitary brownish to pigmented papule on the face in middle-aged persons. 6. Proliferating trichilemmal tumor occurred as a solitary or multiple tumors. Histopathologically, the tumor was usually surrounded by incomplete fibrous capsule. Tumor cells frequently showed clear cell formation, nuclear atypia, mitosis, peripheral palisading, trichilemmal keratinization, and individual keratinization. (Korean J Dermatol 2003;41(9) : 1177~1186)
( Won Seok Kang ),( Joon Seok Lim ),( Jae Hee Cheon ),( Yong Chan Lee ),( Won Ho Kim ),( Sang Kil Lee ) 대한소화기학회 2007 SIDDS Vol.9 No.-
Background/Aims: Stomach cancer is the most common from of cancer, and is the second leading cause of cancer related death in Korea. 3.4% of stomach cancer patients have synchronous of metachronous cancer with colorectal cancer as the most common type (0.6%). Patients with stomach cancer might carry a high risk for colorectal cancer that requires surveillance colonoscopy. CT colonography (CTC) provides for effective and relatively noninvasive risk stratification as a method for colon cancer screening. This study aims at determining the usefulness of CTC as a postoperative follow-up surveillance study after stomach cancer surgery. Methods: From May 2006 to April 2007, contrast-enhanced CTC was performed in Yonsei University severance Hospital for detection of recurrent lesions in 410 consecutive patients (275 male, 135 female) who have had surgery for stomach cancer CTC interpretation was performed with primary three-dimensional polyp detection. Patients with polyp(s) measuring 6mm or larger were referred for optical colonoscopy (OC). Results: Of 410 stomach cancer postoperative patients, recurrence of stomach cancer was not noted and 45 colorectal polyp(s) were detected on CTC in 36 (8.8%) patients. OC was recommended in these patients and concordant lesions were identified in 27 (60.0%) of 45 polyps. Eighty-six polyps were detected on OC in 31 patients, and no polyps were detected on OC in 5 patients. Four colorectal carcinomas were detected in 4 patients CTC. Sensitivity and positive predicitive value of CTC for polyp detection were 60.0% and 62.8%, respectively. Total 46 polyps were missed on CTC. The most common site of missed polyps was sigmoid colon. Eighteen (39.1%) were larger than 6 mm and 1 carcinoma was included in the missed polyps. Conclusion: For patients who have undergone surgical treatment for stomach cancer, CTC is clinically useful as their follow-up surveillance study. However, more efforts are needed to find the ways to improve the low sensitivity of CTC.
KIM, Byung Chang,HAN, Kyung Su,HONG, Chang Won,SOHN, Dae Kyung,PARK, Ji Won,PARK, Sung Chan,KIM, Sun Young,BAEK, Ji Yeon,CHOI, Hyo Seong,CHANG, Hee Jin,KIM, Dae Yong,OH, Jae Hwan Blackwell Publishing Asia 2012 Journal of digestive diseases Vol.13 No.5
<P><B>OBJECTIVE: </B> Self‐expanding metallic stents (SEMS) are useful palliative option and a bridge to surgery in malignant colorectal obstruction. The aim of this study was to evaluate the clinical outcomes of SEMS to palliate colorectal malignant obstruction.</P><P><B>METHODS: </B> Malignant colorectal obstructive patients who underwent SEMS insertion at the National Cancer Center, Korea from January 2004 to June 2008 were enrolled in the study. Patients' clinical characteristics, outcomes and complications for palliative SEMS insertion were retrospectively analyzed.</P><P><B>RESULTS: </B> A total of 54 patients were enrolled in the palliative SEMS group and 48 patients with obstructive CRC were included in the SEMS as the bridge to surgery group. Obstruction of the left colon occurred in 52 patients of the palliative SEMS group and all patients in SEMS as bridge to surgery group. For primary SEMS insertion, the technical success (TS) rate was 87.0% and the clinical success (CS) rate 89.4%, while the rates of early and late complications were 24.1% and 23.4%, respectively. There was no procedure‐related mortality. Stent migration rate was higher in the cases treated with small diameter and covered type of stents. Median time to reobstruction and migration were 85 and 101 days, respectively. TS and CS rates for SEMS reinsertion were comparable to those for primary SEMS insertion.</P><P><B>CONCLUSIONS: </B> Palliative SEMS are effective and favorable procedures for malignant colorectal obstruction but with some complications. Stent migration is associated with covered type and small diameter stents while other factors including length of stent and chemotherapy do not affect stent complications in the present study.</P>
Kim, Joon Hyub,Lee, Jun-Yong,Jin, Joon-Hyung,Park, Chan Won,Lee, Cheol Jin,Min, Nam Ki Kluwer Academic Publishers 2012 Biomedical microdevices Vol.14 No.3
<P>We present an integration process to fabricate single-walled carbon nanotube (SWCNT) three-electrode systems on glass substrate for electrochemical biosensors. Key issues involve optimization of the SWCNT working electrode to achieve high sensitivity, developing an optimal Ag/AgCl reference electrode with good stability, and process development to integrate these electrodes. Multiple spray coatings of the SWCNT film on glass substrate enabled easier integration of the SWCNT film into an electrochemical three-electrode system. O??? plasma etching and subsequent activation of spray-coated SWCNT films were needed to pattern and functionalize the SWCNT working electrode films without serious damage to the SWCNTs, and to remove organic residues. The microfabricated three-electrode systems were characterized by microscopic and spectroscopic techniques, and the electrochemical properties were investigated using cyclic voltammetry and chrono-amperometry. The fully-integrated CNT three-electrode system showed an effective working electrode area about three times larger than its geometric surface area and an improved electrochemical activity for hydrogen peroxide decomposition. Finally, the effectiveness of miniaturized pf-SWCNT electrodes as biointerfaces was examined by applying them to immunosensors to detect Legionella(L) pneumophila, based on a direct sandwich enzyme-linked immunosorbent assay (ELISA) format with 3,3',5,5'-tetramethylbenzidine dihydrochloride/hydrogen peroxide(TMB/H???O???) as the substrate/mediator system. The lower detection limit of the pf-SWCNT-based immunosensors to L. pneumophila is about 1500 times lower than that of the standard ELISA assay.</P>