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.

통풍형 방음벽 개발 및 적용에 관한 연구

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.

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.

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)

AN EXPERIMENTAL STUDY OF NEWLY DESIGNED IMPLANT WITH RBM SURFACE IN THE RABBIT TIBIA : RESONANCE FREQUENCY ANALYSIS AND REMOVAL TORQUE STUDY

Won Mi-Kyoung,Park Chan-Jin,Chang Kyoung-Soo,Kim Chang-Whe,Kim Yung-Soo,Isa Zakiahbt Mohd,Ariffin Yusnidar Tajul The Korean Academy of Prosthodonitics 2003 대한치과보철학회지 Vol.41 No.6

Statement of problem. The importance of fixture design and surface treatment. Purpose. The clinical success of dental in plants is affected by many factors such like as degree of osseointegration, the effective load dispersion for the prostheses, and a lot of attempts have been made to overcome the difficulties. In this study, efforts were made to find the possibility of clinical acceptance of the dental implants of newly designed surface and resorbable blast media surcace. Materials and methods. In this study, two groups of custom-made, screw-shaped implants were prepared. The first with the consisting of Branemark clone design and the other with the new design. These implants were divided into four groups according to the kinds of surface treatment. Four implants($AVANA^{(R)}$, Osstem, Busan, Korea)of each group were installed in twenty rabbits. Group A was consisted of Branemark done implant left as machined, Group B with Branemark clone implants with RBM(Resorbable blast media) surface, Group C with newly designed implants left as machined and Group D with newly designed implants with RBM surface. One of the twenty rabbits died from inflammation and the observation was made for six weeks. Specimens from four groups were observed using scanning electron microscopy with 40, 100, 1000 magnification power and microsurface structures were measured by white-light scanning interferometry for three dimensional surface roughness measurements(Accura $2000^{(R)}$, Intek-Plus, Korea.). Removal torque was measured in 17 rabbits using digital torque gauge(MGT 12R, Mark-10 corp., NY, U.S.A.) immediately after the sacrifice and two rabbits were used for the histologic preparation(EXAKT $310^{(R)}$, Heraeus Kulzer, wehrheim, Germany) of specimens and observed under light microscope. Resonance frequency measurement($Osstell^{(R)}$) was taken with the 19 rabbits at the beginning of the implant fixation and immediately after the sacrifice. Results. Following results were taken from the experiment. 1. The surface of the RBM implants as seen with SEM had rough and irregular pattern with reticular formation compared to that of fumed specimens showing different surface topographies. 2. The newly designed implant with RBM surface had high removal torque value among four groups with no statistical significance. The average removal torque was $49.95{\pm}6.70Ncm$ in Group A, $51.15{\pm}4.40Ncm$ in Group B, $50.78{\pm}9.37Ncm$ in Group C, $51.09{\pm}4.69Ncm$ in Group D. 3. The RFA values were $70.8{\pm}4.3Hz$ in Group A, $71.8{\pm}3.1Hz$ in Group B, $70.9{\pm}2.5Hz$, $72.7{\pm}2.5Hz$ in Group D. Higher values were noted in the groups which had surface treatment compared to the untreated groups with no statistical significance. 4. The results from the histomorphometric evaluation showed a mean percentage of bone-to-implant contact of $45{\pm}0.5%$ in Group A, $55{\pm}3%$ in Group B, $49.5{\pm}0.5%$ in Group C, and $55{\pm}3%$ in Group D. Quite amount of newly formed bone were observed at the surface RBM-treated implants in bone marrow space.

α-Synuclein in the colon and premotor markers of Parkinson disease in neurologically normal subjects

Kim, Joong-Seok,Park, In-Seok,Park, Hyung-Eun,Kim, Su-Young,Yun, Jung A,Jung, Chan Kwon,Sung, Hye-Young,Lee, Jin-Kwon,Kang, Won-Kyung Springer 2017 NEUROLOGICAL SCIENCES Vol.38 No.1

Recombinant human epidermal growth factor for the treatment of chronic wound in recessive dystrophic epidermolysis bullosa patients: a prospective, placebo- controlled pilot study

( Won Jin Hong ),( In Kyung Jeon ),( Soo Chan Kim ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.2

Background: Recessive dystrophic epidermolysis bullosa (RDEB) is an inherited skin disease with a gene defect in type VII collagen メ chains, which results in widespread bullae and erosive skin wounds. Epidermal growth factor (EGF) interacts with epidermis and particularly in the basal layer, promoting epithelial growth. Local EGF application has been used in several clinical situations, but there has been no report of using EGF for RDEB chronic wounds. Objectives: A prospective pilot clinical trial to evaluate the use of EGF in patients with RDEB Methods: A Pilot study was performed in 10 cases for 6 patients with RDEB and full thickness ulcer with more than 3 months of evolution. Two different chronic wounds are selected and patients were educated to apply the topical 0.005% rh-EGF (Easyef三; DaeWoong Pharm., Seoul, Korea) and placebo (normal saline) daily, respectively, for 4 weeks. Wound sizes are measured before, after 2 and 4 weeks of treatment and compared. Dermatology life quality index (DLQI) is done for each patient. Results: After 4-week treatment, all wounds healed more rapidly with EGF comparing with placebo, with a mean area decrease of 81.3% (range: 36.5% - 100%), although it was statistically not significant (p=0.063). DLQIs also improved (Mean score decreased from 27 to 19.2). Conclusion: Topical EGF treatment accelerates wound healing without any evidence of safety limitations for chronic wounds in RDEB patients. A large controlled study is needed to confirm these results.

Comparison of changes in retentive force of three stud attachments for implant overdentures

Kim, Su-Min,Choi, Jae-Won,Jeon, Young-Chan,Jeong, Chang-Mo,Yun, Mi-Jung,Lee, So-Hyoun,Huh, Jung-Bo The Korean Academy of Prosthodonitics 2015 The Journal of Advanced Prosthodontics Vol.7 No.4

PURPOSE. The aim of this study was to compare the changes in retentive force of stud attachments for implant overdentures by in vitro 2-year-wear simulation. MATERIALS AND METHODS. Three commercially available attachment systems were investigated: Kerator blue, O-ring red, and EZ lock. Two implant fixtures were embedded in parallel in each custom base mounting. Five pairs of each attachment system were tested. A universal testing machine was used to measure the retentive force during 2500 insertion and removal cycles. Surface changes on the components were evaluated by scanning electron microscopy (SEM). A Kruskal-Wallis test, followed by Pairwise comparison, was used to compare the retentive force between the groups, and to determine groups that were significantly different (${\alpha}$<.05). RESULTS. A comparison of the initial retentive force revealed the highest value for Kerator, followed by the O-ring and EZ lock attachments. However, no significant difference was detected between Kerator and O-ring (P>.05). After 2500 insertion and removal cycles, the highest retention loss was recorded for O-ring, and no significant difference between Kerator and EZ lock (P>.05). Also, Kerator showed the highest retentive force, followed by EZ lock and O-ring, after 2500 cycles (P<.05). Based on SEM analysis, the polymeric components in O-ring and Kerator were observed to exhibit surface wear and deformation. CONCLUSION. After 2500 insertion and removal cycles, all attachments exhibited significant loss in retention. Mechanism of retention loss can only be partially explained by surface changes.

Endoscopy and Imaging Modalities/Basic Science of Gastrointestinal Disorders/Miscellaneous : The Usefulness Of CT Colonography As Postoperative Follow-Up Surveillance Study In Stomach Cancer Patients

( 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.

Clinical practice guideline for endoscopic resection of early gastrointestinal cancer

( Chan Hyuk Park ),( Dong-hoon Yang ),( Jong Wook Kim ),( Jie-hyun Kim ),( Ji Hyun Kim ),( Yang Won Min ),( Si Hyung Lee ),( Jung Ho Bae ),( Hyunsoo Chung ),( Kee Don Choi ),( Jun Chul Park ),( Hyuk L 대한장연구학회 2021 Intestinal Research Vol.19 No.2

Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected. (Intest Res 2021;19:127-157)