Analysis of lawsuit cases in the Department of Surgery in Korea

Ji Yun Jung,김소윤,Dong Gyu Kim,Choong Bai Kim,Kyong-Choun Chi,강원경,Won Lee 대한외과학회 2018 Annals of Surgical Treatment and Research(ASRT) Vol.94 No.3

Purpose: The aim of this study is to prepare medical staff in order to prevent medical malpractice litigation through analysis of litigation cases related to the department of surgery in Korea. Methods: A total of 94 litigation cases related to the department of surgery, where a certain amount of payment was ordered to the defendant between 2005 through 2010, were analyzed. We examined time of occurrence, amount claimed and awarded in damages, plaintiff claims, and court opinion. Results: An average of 3.2 years was spent from the date of the incident occurring to the end of the litigation procedures. The average amount awarded in judgments for damages was 59,708,983 ± 67,307,264 (range, 1,700,000–365,201,482) Korean won. Cases were found involving the following opinion of the court: violation of duty of care (49 cases), violation of informed consent (7 cases), violation of duty of care and informed consent (5 cases), and settlement, reconciliation, and others (32 cases). By analyzing defendants’ negligence in court opinions, diagnosis (30.8%) was the most common, followed by post-operation management (27.7%). Conclusion: Physicians have to conduct treatment and surgery based on exact diagnosis and be careful to observe patients’ conditions and symptoms after surgery. It is essential to identify the current status and characteristics of medical litigation for reducing further litigation and improving patient safety. In order to create a safe medical environment, national efforts should be made not only by individuals but also at the national level.

부산·울산·경남지역 직업병 감시체계

김정일,김병권,김정원,채창호,이철호,강동묵,김지홍,김진하,김영욱,이영하,이지호,김정호,윤형렬,유철인,정백근,장태원,김운규,윤동영,강진욱,김종은,안진홍,이동준,장준호,이광영,송혜란,최영희,이용환,조병만,최홍렬,고상백,김은아,이유진,홍영습,정갑열,김정만,김준연 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.1

Objective: Occupational medicine specialists in the Busan, Ulsan and Kyung-Nam areas established an area-based occupational disease surveillance system and used this system to collected case information for the purpose of preventing occupational diseases Methods: l l hospital participated in this system. The authors selected five main diseases, which were hand-arm vibration syndrome (HAVS), work-related musculoskeletal disorder (WRMSD), occupational asthma, occupational skin disease and occupational and occupational lung cancer and established their case definitions. All cases were reported on the web, and real time analysis was conducted. Results: Between April 2001 and April 2003, 192 cases of HAVS, 118 cases of WRMSD, 33 cases of occupational asthma, 17 cases of occupational skin disease and 17 cases of occupational lung cancer (for a total of 377 cases of these five main diseases) were reported. most of the HAVS cases came from shipbuilding, and 172 of them (92.7%) were associated with grinding. Of the four main types of WRMSD, carpal tunnel syndrome (CTS) was the most prevalent with 46 cases and shipbuilding was also the main industry involved (83.9%). The ergonomic risk factors involved mainly associated with the hand. In 19 (57.6%) and 4 (12.1%) cases of occupational asthma, the agents involved. The causative agents of occupational lung cancer included Cr, welding fume, PAH, Ni, etc. 10(58.8%) of the cases were diagnosed as squamous cell carcinoma and 5(29.4%) as adenoma. Conclusion: This result showed that an area-based occupational disease surveillance system might provide an effective method of evaluating the prevalence of such diseases, however the Busan, Ulsan and Kyung-Nam provinces are too large to be treated as individual areas. Therefore, the authors suggest that each province should establish its own surveillance system.

하악 제1대구치 이소맹출의 치험례

소정원,이광희,라지영,안소연,김윤희,반재혁 大韓小兒齒科學會 2010 大韓小兒齒科學會誌 Vol.37 No.1

Ectopic eruption is caused by an abnormal direction of eruptive path, most common in maxillary first molar, mandibular lateral incisor, and maxillary canine, and sometimes mandibular first molar. Ectopic eruption of first molar leads to abnormal root resorption of second deciduous molar, which, if left untreated, could cause premature loss of second deciduous molar; mesial tilting and rotation of first permanent molar; lack of space for eruption of second premolar; and occlusal problems. Therefore early treatment is advised when diagnosed as ectopic eruption. Treatment of ectopic eruption in the first permanent molar involves providing proper guidance for the direction of eruption using interproximal wedging and distal tipping methods while preserving second deciduous molar. This case report shows satisfactory results of the ectopic eruption of mandibular first molars in young patients who were treated with Humphrey appliance and Halterman appliance. 이소맹출은 치아가 비정상적인 위치로 맹출하는 경우를 말하며, 주로 상악 제1대구치, 하악 측절치, 상악 견치에서 발생하며 하악 제1대구치에서는 드물게 발생한다. 제1대구치의 이소맹출은 흔히 제2유구치의 비정상적인 치근흡수를 야기하며, 이를 방치하게 되면 제2유구치의 조기상실, 제1대구치의 근심경사 및 회전, 제2소구치의 맹출 공간 부족 및 교합문제 등을 야기하게 되므로 이소맹출로 진단될 경우 조기 치료가 추천된다. 이소맹출은 대개 통상적인 방사선검사를 통해 발견되나, 간혹 제2유구치의 치근흡수가 심할 경우 치수가 감염되어 동통을 야기하는 경우도 있다. 이소맹출의 치료는 제2유구치를 보존하면서 제1대구치의 맹출 방향을 바로 잡아 주는 것으로 크게 치간이개(interproximal wedging)와 원심경사이동(distal tipping)을 이용한 방법을 사용한다. 본 증례들은 하악 제1대구치의 이소맹출을 보이는 환아들로, Humphrey appliance와 Halterman appliance를 이용하여 양호한 치료 결과를 얻었기에 보고하는 바이다.

AB 슬라이드, 크런치 및 윗몸일으키기 운동이 복직근 근활성도에 미치는 효과 : Comparison of It `s Myoelectrical Activities with Crunch and Sit-Up

지송운,김호성,양윤준,장재원 대한스포츠의학회 2004 대한스포츠의학회지 Vol.22 No.1

The purpose of this study was to compare the effect of AB slide™ on abdominal muscles with Crunch and Sit-up. Myoelectrical activities of Rectus abdominis muscles produced by AB slide™, Crunch and Sit-up were recorded. Healthy male aged from 17 to 36 years(23.0±5.9 yrs) were included fo the test. Surface electrodes were attached to upper and lower part of Rectus abdominis of the study subjects. Averaged integrated electromyography(AIEMG) and Normalized integrated electromyography(NIEMG) were recorded. The results are summarized as follows; First, the AIEMG of Sit-up were highest among them with insignificant difference statistically. Second, the NIEMG of upper part of Rectus abdominis were higher than the one of lower part with significant difference statistically(p<0.05). This phenomenon was same irrespective of the type of exercises. AB slide™ was not more effective than Sit-up and Crunch for strengthening of Rectus abdominis muscle. The upper part of Rectus abdominis was more activated than the lower part by all three exercises.

편측 협응훈련에 의한 운동신경망의 재조직 및 교차훈련의 효과

박지원,김종만,서정환,김연희 한국전문물리치료학회 2002 한국전문물리치료학회지 Vol.9 No.3

We report the reorganization of motor network resulted from intensive unilateral coordination training and the effect of cross education on the untrained side in patient with traumatic brain injury using functional magnetic resonance imaging (fMRI). A 22 year-old male patient who had suffered from diffuse axonal injury for 58 months showed coordination deficit in the left hand at initial examination. Intensive motor training including complex finger movements and coordination activities using a metronome was introduced to the patient 4 hours per day for a week. FMRI was performed on a 3T ISOL Forte scanner. All functional images were analyzed using SPM-99 software. Hand function was improved after training not only in the trained lefr hand, but also in the untrained right hand. There was no activation in the right primary motor area (M1) during left hand movement before training whereas robust activation of left M1 was demonstrated by the right hand movement. Profuse activation of bilateral prefrontal lobes was seen during both hand movements before training. After training of left hand, right M1 became prominently activated during the left hand motion. The activation of bilateral prefrontal lobes disappeared after training not only for the left hand movement but also for the right, which clearly demonstrated the effect of cross education. This case report demonstrated the learning-dependent reorganization of the M1 and the effect of cross education.

반복적 경두부 자기자극이 운동학습과 뇌 운동영역 활성화에 미치는 영향 : 예비연구

박지원,김종만,김연희 한국전문물리치료학회 2003 한국전문물리치료학회지 Vol.10 No.3

구치의 1급, 2급 와동에 은 아말감, 구치용 복합레진, 복합레진 인레이로 수복시 치아의 파절저항성

안연실,김미자,이광원,손호현 全北大學校 齒醫學硏究所 1991 전북치대논문집 Vol.9 No.1

The purpose of this study was to evaluate the fracture resistance of the marginal ridge of posterior teeth with class Ⅰ & Ⅱ silver amalgam, posterior composite, and composite resin inlay. The seventy-two extracted caries free human upper premolars were divided into six groups. Class Ⅰ and Class Ⅱ cavities were prepared and filled with amalgam, light curing composite resin, and resin inlay. Fracture strength was measured at the marginal ridge with "Instron". The results were as follows ; 1. Class Ⅰ restorations were stronger than Class Ⅱ in amalgam and composite resin filled group(P<0.05). There was no statistically significant difference in strength between Class Ⅰ resin inlay and Class Ⅰ resin inlay. 2. In the Class Ⅰ and the Class Ⅱ restorations, the best fracture resistance obtained in resin inlay, followed by composite resin, amalgam(P<0.05). In the Class Ⅰ restorations, result was the same but had no significant difference. 3. Class Ⅰ composite resin and Class Ⅰ resin inlay were stronger than Class Ⅱ amalgam(P<0.05). 4. In the Class Ⅰ restorations, when the marginal ridge was fractured, only enamel or enamel/material were involved. In the Class Ⅱ composite resin and Class Ⅱ resin inlay, enamel/material or only material were involved. In the Class Ⅱ amalgam, only material was fracture.

가상현실을 이용한 뇌졸중 환자의 균형장애 평가와 임상평가 지수와의 상관성 연구

김연희,박지원,정준용,우영근,최종덕,김남균 최신의학사 2003 最新醫學 Vol.46 No.11-12

Flavobacterium meningosepticum에 의한 균혈증 1예

장성원,유진홍,진승원,김선우,김연식,박순민,이대훈,최민호,최주연,신완식,강문원,강지민 대한화학요법학회 1997 대한화학요법학회지 Vol.15 No.1

1996년 6월 카톨릭대학교 부천성가병원에 뇌경색으로 입원했던 61세 남자 환자의 혈액에서 Flavobacterium meningosepticum을 분리하였다. 환자는 폐렴을 동반한 패혈증의 예로 ceftriaxone과 metronidazole을 투여하였으나 입원 48시간만에 사망하였다. Flabovacterium meningosepticum is a rae cause of nosocomial infection which shows multi-drug resistance. It mainly invades patients with impaired immunity. Recently, we experienced a case of F. meningosepticum bacteremia in a patient with chronic debilitated state owing to stroke. The clinical progress was so rapid that he died within 48 hours. Blood culture revealed F. meningosepticum which showed characteristic yellow colony in blood agar plate.

정신분열병 환자의 유ㆍ소아기 발달 및 소아 청소년기의 병전 사회 적응에 대한 연구

문지현,우행원,김영철,연규월,김종원,임원정 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6

연구목적: 주요 정신 질환 가운데 하나인 정신분열병은 병의 증상이 나타나기 훨씬 이전인 유아기 및 소아기 때부터 앉기, 서기, 걷기, 말하기, 대소변 가리기 등의 발달 양상과 언어 기능, 운동 기능 등의 양상에서 차이가 나며, 소아 청소년기의 적응 정도도 좋지 않다고 알려져 왔다. 본 연구에서는 대조군과 정신분열병환자군의 발병 전 과거 발달 과정과 병전 적응 정도를 비교하여 그 차이를 알아보고자 하였다. 방 법: 연구 대상은 이대부속 동대문병원 정신과에 입원하였던 환자들 중 정신과 진단 편람 제4판 진단 기준에 의거하여 정신분열병으로 진단 받은 환자군 56명(남자 26명, 여자 30명)과 대조군 51명(남자 25명, 여자 26명)이었다. 연구 방법은 환자와 환자 가족과의 직접 면담 및 병록지 검토를 통해 유아기 발달 과정의 주요 이정표 획득 시기, 소아기의 언어 기능과 운동 기능을 평가하였고, Lewis의 산과적 합병증 척도를 이용하여 출산 합병증을 평가하였으며, 병전 사회 적응 척도를 이용하여 소아 청소년기의 병전 적응 정도를 평가하였다. 사춘기 이차 성징 획득에 관한 정보는 Tanner stage에 기초하여 수집하였다. 결 과: 1) 출산시의 산과적 합병증은 환자군과 대조군에서 유의한 차이가 없었다. 유아기 발달 과정 상 환자군에서 처음 앉은 시기, 걸음마를 시작한 시기, 처음 문장을 말한 시기가 대조군에 비해 유의하게 지연되었다(p<0.05). 2) 소아기 발달 과정을 보면 언어 발달상의 문제는 환자군에서 유의하게 많았으나(p<0.05). 운동 기능 장애의 빈도는 두 군 사이에 차이가 없었다. 읽고 쓰기 시작한 연령은 환자군에서 지연되었다(p<0.05). 환자군에서 언어 기능 장애 및 운동 기능 장애의 빈도는 성별간의 차이를 보이지 않았다. 3) 소아기의 병전 적응 정도는 환자군에서 대조군에 비해 좋지 않은 편이었으나 유의하지 않았다(p=0.06). 반면 청소년기의 적응 정도는 환자군이 유의하게 좋지 않았다(p<0.05). 소아기와 청소년기 동안의 병전 적응 정도를 사회성 영역과 학업 영역으로 나누어 보았을 때 두 영역 모두 환자군에서 유의하게 좋지 않은 것으로 나타났다(p<0.05). 환자군에서 발병 연령이 빠를수록 병전 적응 정도가 좋지 않은 경향이 있었으나 통계적 유의성에는 이르지 못했다(Spearman`s coeff=-0.27, p=0.07). 4) 성별에 따라 살펴보았을 때 남자 환자가 여자 환자보다 학업 영역에서 좋지 않은 적응 정도를 보였다(p<0.05). Tanner Stage에 기초한 이차 성징의 발현은 두 군 사이에 차이가 없었다. 결 론: 이상의 결과를 종합하면, 환자군에서 유아기 발달 과정상 처음 앉는 시기와 걸음마를 시작한 시기 등의 운동 발달 영역과 처음 문장을 말한 시기 등 인지 발달 영역이 대조군에 비해 지연되며, 소아기의 언어 발달 과정에 문제가 있는 경우가 많았고, 읽고 쓰기 시작한 연령이 늦어지며, 발병 전 청소년기의 적응 정도가 대조군에 비하여 좋지 않았다. Objectives: Schizophrenia, one of the major mental illnesses, shows abnormal developmental patterns such as delayed developmental milestones, impaired language and motor function, and poor premorbid social adjustment long before the onset of clinical symptoms of illness. In this study, we tried to find out developmental patterns and premorbid adjustment during childhood and adolescence in schizophrenic patients. Methods: The subjects were 56 inpatients(26 male patients and 30 female patients) who met the diagnostic criteria for schizophrenia by DSM-Ⅳ and 52 healthy control subjects(25 male patients and 26 female patients). Interview with subjects and their families and the review of medical records were done to assess sociodemographic factors, timing of developmental milestones, language and motor function of childhood, and timing of sexual maturational events. Obstetrical Complication Scale of Lewis was used to get information on the subjects prenatal and perinatal history, and Premorbid Social Adjustment Scale(PSAS) to assess premorbid adjustment. Results: 1) There were no significant differences in the rates of obstetrical complications. The developmental milestones during infancy such as sitting, walking, age of first sentence were significantly delayed in the schizophrenics than in the controls(p<0.05). 2) Disturbances of speech and language development were significantly more common in the schizophrenics than in the controls(p<0.05), but there were no significant differences in the rates of disturbance in motor development. Mean ages of reading and writing were significantly delayed in schizophrenics than in the controls(p<0.05). No significant differences were found between males and females for either language disturbance or motor disturbance in the schizophrenics. 3) During adolescence, premorbid adjustment was poorer in schizophrenic patients(p<0.05). The schizophrenic patients scored significantly worse than the controls on both sociability and schooling domains(p<0.05). There was a trend for correlation between poor premorbid functioning and early age of onset, but it failed to achieve statistical significance(Spearman`s coeff=-0.27, p=0.07). 4) Male schizophrenic subjects showed poorer premorbid functioning on schooling domain than female schizophrenic subjects(p<0.05). No significant difference was recognized in timing of sexual maturational events between schizophrenics and controls. Conclusion: In summary, the schizophrenics were significantly delayed in infantile developmental milestones, impaired in development of language, delayed mean age of reading and writing, and showed poorer premorbid social adjustment than the controls.