국내 정형외과 의료소송 현황 파악

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.

동북아 피더네트워크의 Win-win전략에 관한 연구

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.

간경변 환자에서 Oro-cecal Transit Time의 측정

원경준,이준,변유미,조민근,조주연,서정균,김영대,박찬국,김만우 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2

Background: Neurotransmitter like substances in the gut have been proposed to contribute to the overall portal systemic encephalopathy (PSE). The source of the ammonia in patients with PSE is mainly the small bowel, as a result of the conversion of glutamine in the diet to glutamate and ammonia. PSE is highly responsive to changes in diet, to antibiotic therapy and to ingestion of nondigestible disaccharides such as lactulose. This study was performed to evaluate the relationship between PSE and oro-cecal transit time. In addition, performed to evaluate the effect of severity, cause, complications of liver cirrhosis on oro-cecal transit time. Methods: Between August 2006 and February 2007, 48 cirrhotic patients consecutively was enrolled in study their oro-cecal transit time after informed consent was obtained. A non-invasive hydrogen breath test was used to study oro-cecal transit time (OCTT). Result: The OCTT were delayed in cirrhotic patients with PSE compared without PSE (123.3 ± 42.7 min vs 170.0 ± 58.3 min, p<0.05). OCTT tended to prolongate further as the damage in the liver got worse, nevertheless the result was statistically meaningless (p<0.111). Neither presence of ascites or cause of PSE had any influence on gastrointestinal transit. Conclusions: Cirrhotic patients with PSE have more delayed OCTT than without PSE. Further research is needed to find out the relationship between OCTT and severity of liver cirrhosis.

제 1형 신경섬유종증 환자에서 발생한 위장관 간질종양 1예

원경준,이준,변유미,조민근,한경택,김원,홍란,임성철,김경종,김영대,박찬국,김만우 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.2

Gastrointestinal stromal tumor (GIST) is the most common non-epithelial neoplasm arising in the gastrointestinal tract, but this tumor is rarely seen in association with type l neurofibromatosis (NFl) Generally, the majority of GISTs are isolated neoplasm and they are sporadically found in the stomach, but the GISTs in NFl patients are usually multiple and usually found in the small intestine. We report a case of multiple GISTs in the jejunum of a 63-year-old woman diagnosed as NFl accompanied by complication of gastrointestinal bleeding, In this case, Patient had multiple cafe-au lait spots and neurofibroma on skin and had freckling on axilla and groin, and then, we made a diagnosis of NFl. Gastrointestinal bleeding is controlled by resection of multiple GISTs. Generally, only 3-5% of all gastrointestinal bleeding comes from the small bowel. Causes of small intestinal bleeding are angiodysplasia, neoplasm, NSAIDs induced ulcer etc. but, If patients have NFl accompanied by complication of gastrointestinal bleeding, GISTs on small bowel must be considered.

철 환원법에 의한 엣칭용 염화철폐액 처리에서 볼밀에 의한 철의 재생

朴贊友,鄭又元,李萬浩,李尙昱 경북대학교 산업기술연구소 1996 産業技術硏究誌 Vol.24 No.-

We compared the regeneration effects of iron powders with ball-mill treatment at various conditions in the treatment of the waste FeCl_3 solution. And sludges formed during the reaction of Ni^2+ removal were analyzed with X - ray diffractometer and particle size analyzer.

旋削時 떨림振動抑制用 動吸振器에 관한 硏究

成洛元,安贊祐,金賢洙 東亞大學校 大學院 1984 大學院論文集 Vol.8 No.2

This searched for conditions of the optimum absorber to eliminate the chatter vibration by the computer and its effects were confirmed experimentally. The results are as follows. 1. The amplitude ratio of workpiece according to mass ratio was obtained in the optimum absorber by computer. 2. The forced frequency ratio at maximum amplitude ratio according to mass ratio was obtained in the optimum absorber by computer. 3. By direct contact between workpiece and absorber the effects on the elimination of chatter vibration were confirmed.

Diels-Alder 반응을 통한 Cycloadducts of Bicyclolactone의 입체 이성질체 구조 연구

서찬우,원호식 한양대학교 이학기술연구소 2005 이학기술연구지 Vol.8 No.-

3.3-dibromo-2-pyrone의 Diels-Alder cycloaddition 으로 부터 얻은 Bicyclokactone은 다양 palladium 촉매 하에서 aryclolaction으로 반응 시킬 수 있다, N-Et maleimide(NEM)를 사용한 Bromo-cycloaddition으로 endo-fro, (38%)의 두개의 다른 입체 이성질체를 생성하고 두 물질은 NMR에 의해 분석된다. 이연구 에서 COSY,TOCSY, NOESY, ROESY를 이용하여 각각의 isomer에 대한 NMR 시그널을 지정하였다, 여러 종류의 수소의 거리는 NOE cross peak를 이용하여 얻을수 있었다, 이 distance data를 기반으로 distace geometry(DG)와 molecular dynamics(MD)를 이용하여 두개의 endo-form,exo-form isomer들의 구조를 결정하였다. Bicyclactones obtained from the Diels-Alder cycloaddition of 3,5-dibromo-2-pyrone can be changed into aryl bicyclolactones by cross coupling reactions under various palladium catalyst Bromo-bicyclic diene furnished two different diastereomers endo-form(62%)and exo-from(38%) upon cycloadditions with N-Et maleimide (NEM) and their stereochemistries were identified with NMR In this study The NMR signal assignments of each isomer was completely accomplished with COSY, TOCSY, NOESY and ROESY Distance of numerous protons were obtained based on the NOE cross peak intensities of NOESY spectrum. On the basis of these distance data distance geometry(DG) and molecular dynamics(MD) were carried out to determine the isomer structures of endo-from and exo-from

종이상자포장기의 개발에 관한 연구

권경우,권병철,류봉조,명태식,박찬호,이광원 한밭대학교 산업과학기술연구소 1994 논문집 Vol.2 No.-

The paper describes the development of a new automatic wrapping machine using paper films as it has not been used so far. The most of the automatic wrapping machine have used the vinyl film causing environmental pollution, the paper films, however, have a weak point in the aspect of high temperature adhesion. Therefore, the mechanism of the existing wrapping machine should be altered to prevent it from curling effect through the technical know-how. A new method and technology reducing the curling effect in the automnatic wrapping machine are demonstrated by using developed blower. Thus it is exqection and will decrease environmental pollution.

갈륨액체금속 이온원과 인듐액체금속 이온원의 빔 특성에 대한 연구

현정우,임연찬,정강원,정원희,박철우,이종향,강승언 한국공작기계학회 2005 한국공작기계학회 춘계학술대회논문집 Vol.2005 No.-

본 연구에서는 인듐 액체금속이온원을 제작하여 빔 특성에 대해 연구를 하였으며, 기존에 연구를 하였던 갈륨 액체금속이온원의 빔특성과 비교 분석 하였다. 빔특성 분석을 위해 빔 안정도, 전류-전압특성곡선, 에너지 퍼짐을 측정하였다. 액체금속이온원에 사용되는 액체금속 저장소 및 바늘전극(tip)은 500μm의 직경을 갖는 텅스텐을 사용하였으며, 국내에서 제작된 제품을 사용하였다. 액체금속 저장소의 구조는 이전에 구상하여 연구가 이루어진 6개의 pre-etching된 텅스텐와이어(wire)가 묶여진 형태를 사용하였다.

실리카흄을 흔입한 고강도 콘크리트 개발

홍창우,김태경,김경진,김성환,김남윤,심도식,이정호,윤청호,백민경,원치문,박제선,이주형,정경일 강원대학교 석재복합신소재제품연구센터 1996 석재연 논문집 Vol.1 No.-

콘크리트 구조물이 대형화됨에 따라 설계단면이 증대되어 상대적으로 많은 경제적 손실을 부담하게 된다. 따라서 단면을 감소시키면서도 소요의 하중에 안전한 구조물을 건설하기 위해서는 우선적으로 구조물 건설에 기초가 되는 고품질, 고내구성의 고강도 콘크리트 개발이 절실히 요구된다 본 연구에서는 일정 시멘트비 및 혼화재 비율하에서 소요의 워커빌리티가 확보되는 고강도 콘크리트를 시간과 온도의 변화에 따라 증기 양생하여, 압축, 인장, 휨강도 뿐만 아니라 파괴특성을 실험적으로 연구하였다. 시료 제작시 시멘트 입자 사이의 공극 및 불연속 영역을 충전하여 고밀도화하기 위한 콘크리트용 혼화재로 시멘트 비표면적이 상당히 작은 초미립 분말인 실리카흄을 이용하였다. 또한 AE감수제 및 고성능 유동화제를 사용하여 혼화재의 첨가에 의하여 발생될 수 있는 워커빌리티의 감소를 방지하였다. 실험결과에 의하면 일정 양생 지속 시간하에서 온도의 증가에 따라 콘크리트의 압축, 인장 및 휨강도가 전반적으로 증가하였다. 동일하게 일정 온도하에서 양생 지속시간이 커짐에 따라 강도들이 증가됨을 알 수 있었다. 따라서 상대적으로 높은 온도와 긴 지속 양생 조건하에서 파괴에 대한 저항력이 크게 나타났다. The compressible, tensible, and flexibleresistance of the high strength concrete is analyzed by the experimentation in the present study. For the test, we cure several samples with the silica fume as a mixture being become dense the spaces between the particle of cement under the variation of both the temperature and the curing-interval. Then, the superplasticizer and the ezcon are also used to satisfy the required workability for construction. The compressible, tensible, and flexible resistances to a stress are increased as increasing the temperature and the time interval for the curing. Therefore it is concluded that the overal fractural and mechanical properties is improved by mixing the silica fume into the cement.