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.

원문 : 크레아틴-중탄산나트륨의 복합투여가 암-에르고미터 운동수행력에 미치는 영향

이철원 ( Cheol Won Lee ) 한국운동생리학회(구 한국운동과학회) 2014 운동과학 Vol.23 No.3

이철원. 크레아틴-중탄산나트륨의 복합투여가 암-에르고미터 운동수행력에 미치는 영향. 운동과학, 제23권 제3호. 257-266 2014. 본 연구는 크레아틴, 중탄산나트륨, 그리고 크레아틴과 중탄산나트륨의 복합투여가 암-에르고미터(arm-ergometer)를 이용한 상지 근기능에 미치는 효과를 알아보기 위해 경기도 소재 Y대학교 체육계열 남·여학생 17명을 대상으로 실시하였다. 무선추출법을 통해 크레아틴 투여집단(n=7), 중탄산나트륨 투여집단(n=5), 크레아틴과 중탄산나트륨의 복합투여집단(n=5), 총 3 집단으로 나누어 암-에르고미터를 이용한 상지 근기능 사전검사(pre-test) 후 집단별 로딩(loading)이 완료된 5일 후 사후검사(post-test)를 동일하게 실시하였다. 자료처리는 통계패키지 SPSS Ver. 12.0을 이용하여 모든 변인의 측정결과를 평균과 표준편차로 산출하고, 집단 및 시기 차이에 대한 주효과검정과 집단과 상호작용효과를 알아보기 위해 반복측정에 의한 이원변량분석 (Two-way repeated measured ANOVA)을 실시하였으며, 모든 통계적 유의수준은 p<.05로 설정하였다. 본 연구의 결과 암-에르고미터를 통한 검사 항목에서 최고 파워, 피로지수, 체중당 피크파워, 안정시 젖산농도 등에서 시기에 따른 유의한 차를 나타내었으나, 집단 간 유의한 차이는 나타나지 않았다. 결론적으로, 크레아틴과 중탄산나트륨 그리고 크레아틴과 중탄산나트륨의 복합투여는 암-에르고미터를 이용한 상지 운동수행력에 긍정적인 영향을 미치는 것으로 나타났으나, 복합투여의 우수성은 나타나지 않았다. Lee, Cheol-Won. The Effect of Combined Creatine and Sodium Bicarbonate Supplementation on Arm Ergometer Performance. Exercise Science. 23(3): 257-266, 2014. The purpose of this study was to assess the effects of creatine, sodium bicarbonate and combined creatine and sodium bicarbonate supplementation on upper limbs with arm-ergometer. Seventeen students majoring in physical education were randomly assigned to 3 groups [creatine (n=7), sodium bicarbonate (n=5), creatine & sodium bicarbonate (n=5)]. Pre-test consisted of muscular function of upper limbs with arm-ergometer and after 5 days later for creatine and sodium bicarbonate loading, post-test was processed with the same way as pre-test. Statistical analysis was performed by two-way repeated measured ANOVA for intervention. Significance was accepted at p<.05. The following results were obtained from this study. Peak power, fatigue index, peak power/kg and peak attainment time of arm-ergometer test were significantly (p<.05) increased by time but no difference among the groups. In conclusion, creatine, sodium bicarbonate and combined creatine & sodium bicarbonate supplementation favorably affected muscular function of upper limbs with arm-ergometer but there were no significant difference among the groups.

알레르기 환자에서 한방 이외의 대체 요법의 사용 현황에 대한 다기관 조사

이현정 ( Hyun Jung Lee ),이재현 ( Jae Hyun Lee ),이용원 ( Yong Won Lee ),김철우 ( Cheol Woo Kim ),동헌종 ( Hun Jong Dhong ),박해심 ( Hae Sim Park ),조영주 ( Young Joo Cho ),조진희 ( Jin Hee Cho ),조상헌 ( Sang Heon Cho ),편복양 ( 대한내과학회 2011 대한내과학회지 Vol.80 No.1

Background/Aims: The use of unproven complementary/alternative medicine (CAM) to treat allergies is popular in Korea. We conducted a multicenter survey of the current use of CAM other than herbal medication in Korean allergy patients. Methods: This study enrolled 510 adults with allergic diseases, including asthma, allergic rhinitis, atopic dermatitis, and chronic urticaria, from ten hospitals. They underwent a structured questionnaire interview and clinical assessment of the prevalence, motivation, costs, and subjective assessment of CAM. Results: Of the patients, 16.7% used at least one type of CAM to treat their allergic diseases. Common types of CAM were diet (48.6%), aroma therapy (23.8%), massage (14.3%), breathing exercises (7.6%), baths (5.7%), and mind control (5.7%). The therapeutic effects of CAM included improved in patients using mind control (50%), diet (50%), breathing exercises (75%), and baths (33.3%), but worse in patients using aroma therapy (28%), and massage (26.7%). About 36.4% of the patients used CAM more than four times per year, and the average cost per CAM user was 370,000 won/year. The main reason for trying CAM was `hope to improve my constitution`. Conclusions: CAM is used widely for treating allergic diseases in Korea. Detailed knowledge of CAM and patient education are important. Further studies of the clinical efficacy of CAM are needed. (Korean J Med 2011;80:68-77)

소음인(少陰人) 태음병(太陰病) 심하비증(心下?證)의 병증약리(病證藥理) 고찰

서영광,이지원,이준희,최원철,이의주,고병희,Seo, Young-Kwang,Lee, Ji-Won,Lee, Jun-Hee,Choi, Won-Cheol,Lee, Eui-Ju,Kho, Byung-Hee 사상체질의학회 2010 사상체질의학회지 Vol.22 No.3

1. Objective: Gastric Stuffiness (心下?證) in the Soeumin Taeeum symptomatology (少陰人 太陰病) in Sasang Constitutional Medicine shows an interesting evolutionary process. Originally found in the texts of Sanghanlun (傷寒論), the perspectives regarding the symptoms of Gastric Stuffiness were expanded by many medical scholars and Lee Jema. To comprehend the Jema's concept of Taeeum symptomatology and utilize his prescription clinically, it deserves to study on the Gastric Stuffiness in Donguisuseowon (東醫壽世保元). 2. Methods: Many texts including Sanghanlun (傷寒論) and Dongeuibogam (東醫寶鑑) were reviewed in order to track the evolutionary process concerning the symptoms of Gastric Stuffiness. Also, Lee Jema's works including the different versions of Donguisuseowon (東醫壽世保元) were reviewed to examine the development of Lee's concepts regarding the Gastric Stuffiness in the Soeumin Taeeum symptomatology. 3. Results and Conclusions: 1) Most of the previous concepts on Gastric Stuffiness were generally similar to those found in Sanghanlun, especially in that they addressed Yang deficiency of the middle triple energizeer as the central pathogenic process. 2) Lee Jema's views on the epigastric discomfort in the Soeumin Taeeum symptomatology evoloved over time and culminated in the finalized pathology and therapeutics appearing in his last work, the Shinchuk version of Donguisuseowon (東醫壽世保元). 3) 4 kinds of prescription which invented by Lee Jema to treat the Gastric Stuffiness in the Soeumin Taeeum symptomatology can be matched to the prescription of Sanghanlun respectively. However through evolutionary process of Jema's prescriptions, the indication of them expanded: not only to treat Gastric Stuffiness but to diverse symptoms of Soeumin.

Coupled Inductor-Based Parallel Operation of a qZ-Source Full-Bridge DC-DC Converter

Lee, Hyeongmin,Kim, Heung-Geun,Cha, Honnyong,Chun, Tae-Won,Nho, Eui-Cheol The Korean Institute of Power Electronics 2015 JOURNAL OF POWER ELECTRONICS Vol.15 No.1

This study presents a novel transformer isolated parallel connected quasi Z-source (qZ-source) full-bridge DC-DC converter that uses a coupled inductor in both the qZ-source network and output filter inductor. Unlike traditional voltage-fed or current-fed converters, the proposed converter can be open- and short-circuited without damaging switching devices. Therefore, the desired buck and boost functions can be achieved and converter reliability can be significantly improved. All the bulky inductors in the qZ-source network and output filter can also be minimized with the proposed inductor structures. A 4 kW prototype DC-DC converter is built and tested to verify the performance of the proposed converter.

첨가물질의 급여가 홀스타인 거세우의 발육, 도체특성에 미치는 영향

Won Mo Cho(조원모),Sung Hak Yang(양승학),Sang Min Lee(이상민),Sun Sik Jang(장선식),Hyeong Cheol Kim(김형철),Seong Koo Hong(홍성구),Woon Yeoul Park(박웅렬),Hyun Soo Kim(김현수) 한국생명과학회 2012 생명과학회지 Vol.22 No.2

본 연구는 육질향상을 위한 여러가지 첨가물질을 홀스타인 거세우의 성장과 도체특성에 미치는 급여효과를 구명하기 위해 수행하였다. 생후 5개월령 평균체중 176.6 ㎏, 홀스타인 거세우 24두를 3처리 8반복으로 완전 임의 배치하여 사양시험을 수행하였다. 처리구는 대조구(무첨가구), T1 (Vitamin C, 아연 및 유황 급여구) 및 T2 (콜린 및 라이신 급여구)로 배치하였다. 일당증체량은 육성기와 비육전기에서는 처리구별 차이가 없었지만, 비육후기에서는 T1처리구가 T2 처리구보다 유의적으로 높았다(p<0.05). T1 처리구의 출하체중은 다른 처리구 보다 비교적 높았지만 유의적 차이는 없었다. 첨가제는 시험기간 동안 섭취량에 있어 영향을 주지는 않았지만, 비육후기 T1 처리구의 사료요구율이 T2 처리구 보다 유의적으로 낮았다. 육량특성에 있어 도체중 및 육량지수는 그룹간 비슷한 결과를 나타내었지만, 등지방 두께 및 등심단면적은 다른 처리구에 비해 T2 처리구가 비교적 낮았다. 육질특성에서는 육색, 조직감 및 성숙도는 세 처리구에서 유의적 차이를 나타내지 않았지만, 근내지방도 및 육질1등급이상 출현율에 있어서 T2 처리구와 비교하여 T1처리구가 높았다. 따라서, 본 연구의 결과 비타민 C, 아연, 유황 첨가는 홀스타인 거세우의 성장 및 도체특성을 향상시키는 것으로 생각된다. This study was performed to investigate the feeding effects of different additives on the growth performance and carcass characteristics of Holstein steers. Twenty-four Holstein steers, five months of age and 176.6 ㎏, were randomly allocated to three experimental groups of eight animals each for an 18-month feeding trial. The groups were control (not additive), T1 (fed zinc, vitamin C, and sulfur), and T2 (fed choline and lysine). The average daily gain was no different between the treatment groups during the growing to early fattening period, but it was significantly higher in the T1 group than the T2 group in the late fattening period (p<0.05). The final BW of the T1 group was relatively high in relation to the other groups, but was not significantly different. The additives had no effects on DMI during the experimental period; however, the feed conversion ratio of the T1 group in the late fattening period was significantly lower than that of the T2 group (p<0.05). The results of yield traits, carcass weight, and yield index were similar between groups, but back fat thickness and rib eye area were relatively lower in the T2 group than in the other groups. In terms of quality traits, meat color, texture, and maturity were not significantly different between the three groups. However, marbling score and appearance rate of high quality grade (1??, 1?, and 1) were higher in the T1 group compared with the T2 group. Thus, the present results suggest that vitamin C, zinc, and sulfur supplementation may improve the growth performance and carcass characteristics of Holstein steers.

Single Oral Dose Toxicity Test of Platycodin D, a Saponin from Platycodin Radix in Mice

Won-Ho Lee,Cheol-Ou Gam,Sae-Kwang Ku,Seong-Hun Choi 한국독성학회 2011 Toxicological Research Vol.27 No.4

The object of this study was to evaluate the single oral dose toxicity of platycodin D, a saponin from the root of Platycodon grandiflorum in male and female mice. Platycodin D was administered to female and male mice as an oral dose of 2000, 1000, 500, 250 and 125 mg/kg (body wt.). Animals were monitored for the mortality and changes in body weight, clinical signs and gross observation during 14 days after treatment, upon necropsy, organ weight and histopathology of 14 principle organs were examined. As the results, no platycodin D treatment related mortalities, clinical signs, changes on the body and organ weights, gross and histopathological observations against 14 principle organs were detected up to 2000 mg/kg in both female and male mice. Therefore, LDsub{50} (50% lethal dose) and approximate LD of playtcodin D after single oral treatment in female and male mice were considered over 2000 mg/kg ? the limited dosages recommended by KFDA Guidelines [2009-116, 2009], respectively.

Production of Monoclonal Antibody Against Listeria monocytogenes and Its Application to Immunochromatography Strip Test

( Won Bo Shim ),( Jin Gil Choi ),( Ji Young Kim ),( Zheng You Yang ),( Kyu Ho Lee ),( Min Gon Kim ),( Sang Do Ha ),( Keun Sung Kim ),( Kwang Yup Kim ),( Cheol Ho Kim ),( Kwang Soo Ha ),( Sergei A. Ere 한국미생물생명공학회 2007 Journal of microbiology and biotechnology Vol.17 No.7

Purification of Odontoglossum Ringspot Virus by DEAE-Cellulose Column Chromatography

Cheol-Ho Lee(이철호),Jong-Oo Park(박종오),Hyo-Won Jung(정효원),Yong-Joon La(나용준) 한국식물병리학회 1998 Plant Pathology Journal Vol.14 No.6

Isotropic Control of Rotor Bearing System

Cheol-Soon Kim(김철순),Chong-Won Lee(이종원) 한국소음진동공학회 1993 한국소음진동공학회 학술대회논문집 Vol.1993 No.5