Analysis of Judicial Precedents Cases Regarding Skin Cancer from 1997 to 2017 in Republic of Korea

( Su Hwan Shin ),( Won Lee ),( So Yoon Kim ),( Gwanghyun Jo ),( Je-ho Mun ),( Soo Ick Cho ) 대한피부과학회 2019 Annals of Dermatology Vol.31 No.3

Background: Both medical disputes and the incidence of skin cancer are increasing in Korea. Objective: The aim of this study was to figure out the medical litigation related to skin cancer and propose a method to prevent the medical disputes. Methods: Skin cancer-related judgments were searched by The Supreme Court of Korea’s Written Judgment Management System based on the keywords for skin cancer. The search system included sentenced cases at the Lower Courts, the Appellate Courts, and the Supreme Court from 1997 to 2017. Results: Seven cases were selected as the litigation cases related to skin cancer. Four cases (57.1%) presented malignant melanoma, while the rest presented squamous cell carcinoma, metastatic skin cancer, and peripheral T cell lymphoma (1 case in each). Four cases resulted in death from cancer metastasis, and 3 cases presented as sequelae. The legal issues related to the medical disputes could be categorized as follows: misdiagnosis, delayed diagnosis, performance error, and lack of informed consent. Delayed diagnosis and lack of informed consent were the most common issues (n=4) in the precedents. Five cases (71.4%) were sentenced the awarded amounts to the plaintiff, including 2 cases of settlement decision. The average awarded amount was 42,553,644±27,567,455 Korean won. Conclusion: Physicians should pay attention to the cases of the skin cancer to prevent medical malpractice and disputes. The practices pertaining to proper diagnosis, treatment plans, and obtaining an informed consent should be followed during the course of treating skin cancer. (Ann Dermatol 31(3) 300∼306, 2019)

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.

Analysis of judicial precedents cases regarding skin cancer from 1997 to 2017 in Republic of Korea

( Gwanghyun Jo ),( Su Hwan Shin ),( Won Lee ),( So Yoon Kim ),( Je-ho Mun ),( Soo Ick Cho ) 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.2

Background: Both medical disputes and the incidence of skin cancer are increasing in Korea. Objectives: To figure out the medical litigation related to skin cancer and propose a method to prevent the medical disputes Methods: Skin cancer-related judgments were searched by The Supreme Court of Korea’s Written Judgment Management System based on the keywords for skin cancer. The search system included sentenced cases at the Lower Courts, the Appellate Courts, and the Supreme Court from 1997 to 2017 Results: Seven cases were selected as the litigation cases related to skin cancer. Four cases (57.1%) presented malignant melanoma, while the rest presented squamous cell carcinoma, metastatic skin cancer, and peripheral T cell lymphoma (1 case in each). Four cases resulted in death from cancer metastasis, and 3 cases presented as sequelae. The legal issues related to the medical disputes could be categorized as follows: misdiagnosis, delayed diagnosis, performance error, and lack of informed consent. Delayed diagnosis and lack of informed consent were the most common issues (n=4) in the precedents. Five cases (71.4%) were sentenced the awarded amounts to the plaintiff, including 2 cases of settlement decision. The average awarded amount was 42,553,644±27,567,455 Korean Won. Conclusion: Physicians should pay attention to the cases of the skin cancer to prevent medical malpractice and disputes.

Analysis of acne-related judicial precedents from 1997 to 2018 in South Korea

( Ji Hoon Yang ),( Soo Ick Cho ),( Su Hwan Shin ),( Won Lee ),( So Yoon Kim ),( Dae Hun Suh ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.2

Background: Medicolegal disputes are increasing in practical medicine. Acne is a common problem but is usually related to cosmetic problems such as acne scars. Medications or procedures related to acne could lead to medical malpractice. Objectives: To analyze medical litigation associated with acne or acne scar in South Korea. Methods: Acne-related judgements were searched using the Supreme Court of Korea’s Written Judgment Management System based on the keywords “acne” or “acne scar.” Results: Eleven cases were selected as litigated cases of acne or acne scar. Eight cases (72.7%) were related to acne scar and three (27.3%) were related to acne. Treatment modalities such as peeling (n = 6), laser treatment (n = 3), photodynamic therapy (n = 1), and antibiotic (n = 1) resulted in lawsuit. Claimed sequelae of the treatment were hyperpigmentation (n = 5), scar worsening (n = 5), erythema (n = 3), skin bumps (n = 1), and liver transplant (n = 1). Eight cases (72.7%) were awarded to the plaintiff, and the others were dismissed. The average awarded amount was 16,801,324± 24,452,486 (mean±standard deviation) Korean Won. Conclusion: Various treatments for acne or acne scar can cause medical disputes. Unnecessary litigation could be prevented if simple measures such as history taking, choosing proper procedure, and adequate management after the procedure along with sufficient informed consent were performed.

Brush-Like Cobalt Nitride Anchored Carbon Nanofiber Membrane: Current Collector-Catalyst Integrated Cathode for Long Cycle Li–O₂ Batteries

Yoon, Ki Ro,Shin, Kihyun,Park, Jiwon,Cho, Su-Ho,Kim, Chanhoon,Jung, Ji-Won,Cheong, Jun Young,Byon, Hye Ryung,Lee, Hyuk Mo,Kim, Il-Doo American Chemical Society 2018 ACS NANO Vol.12 No.1

<P>To achieve a high reversibility and long cycle life for lithium–oxygen (Li–O<SUB>2</SUB>) batteries, the irreversible formation of Li<SUB>2</SUB>O<SUB>2</SUB>, inevitable side reactions, and poor charge transport at the cathode interfaces should be overcome. Here, we report a rational design of air cathode using a cobalt nitride (Co<SUB>4</SUB>N) functionalized carbon nanofiber (CNF) membrane as current collector-catalyst integrated air cathode. Brush-like Co<SUB>4</SUB>N nanorods are uniformly anchored on conductive electrospun CNF papers via hydrothermal growth of Co(OH)F nanorods followed by nitridation step. Co<SUB>4</SUB>N-decorated CNF (Co<SUB>4</SUB>N/CNF) cathode exhibited excellent electrochemical performance with outstanding stability for over 177 cycles in Li–O<SUB>2</SUB> cells. During cycling, metallic Co<SUB>4</SUB>N nanorods provide sufficient accessible reaction sites as well as facile electron transport pathway throughout the continuously networked CNF. Furthermore, thin oxide layer (<10 nm) formed on the surface of Co<SUB>4</SUB>N nanorods promote reversible formation/decomposition of film-type Li<SUB>2</SUB>O<SUB>2</SUB>, leading to significant reduction in overpotential gap (∼1.23 V at 700 mAh g<SUP>–1</SUP>). Moreover, pouch-type Li-air cells using Co<SUB>4</SUB>N/CNF cathode stably operated in real air atmosphere even under 180° bending. The results demonstrate that the favorable formation/decomposition of reaction products and mediation of side reactions are hugely governed by the suitable surface chemistry and tailored structure of cathode materials, which are essential for real Li–air battery applications.</P><P><B>Graphic Abstract</B> <IMG SRC='http://pubs.acs.org/appl/literatum/publisher/achs/journals/content/ancac3/2018/ancac3.2018.12.issue-1/acsnano.7b03794/production/images/medium/nn-2017-03794x_0007.gif'></P><P><A href='http://pubs.acs.org/doi/suppl/10.1021/nn7b03794'>ACS Electronic Supporting Info</A></P>

A Theoretical Calculation of Photon Dose Equivalent Conversion Factor For Extremity Dosimeter

Yoon,Suk-Chul,Lee, Won-Keun,Kim, Kwang-Pyo,Kim,Jong-Su,Yoon, Yeo-Chang 대한방사선 방어학회 1996 방사선방어학회지 Vol.21 No.1

중성자 및 전자 그리고 광자수송코드인 MCNP 4A코드를 이용하여 ANSI N13.32에 제안된 말단팬텀과 한국원자력연구소 제작한 말단팬텀 각각에 대하여 감마선량당량환산인자를 커마근사법에 근거하여 계산하였다. 본 계산은 15keV-1.5keV 에너지 영역에 대해 단일광자에너지 선원을 고려하였으며 이러한 단일광자에너지함수로서 계산한 공기커마에 대한 선량당량의 비로서 선량당량환산인자를 이론적으로 도출하였다. 본 연구에서 이론적 방법으로 도출한 ANSI 와 KAERI의 말단팬텀 각각에 대한 광자선량당량환산인자를 ANSI N13.32의 실험적 방법에 의해 제시된 값들과 비교한 결과 50 keV 이상의 단일광자에너지영역에서는 실험적 방법에 의한 값들과 최대차이 5.7%내에서 잘 일치함을 보였다. 그러나 40keV 이하의 에너지영역에서는 본 연구의 계산결과가 최대 13.6%까지 낮게 평가됨을 알 수 있었으며, 이러한 차이는 낮은 에너지영역에서 두드러지는 단일에너지의 생성과 관련된 실험의 불확실성과 MCNP 코드에서 모사한 Geometry의 영향에 기인하는 것으로 사료된다. In this study, the theoretical calculation of the air kerma-to-dose equivalent conversion factors was prformed with a Monte Carlo N-Particle transport code fot the two types of extremity phantom of the ANSI and the KAERI, respectively. Considering the distribution of absorbed does due to the interaction of homogeneous parallel broad beam of monoenergetic primary photons in the range between 15keV and 1.5 MeV, the air kerma-to-does equivalent conversion factors based on the kerma approximation were calculated. It is showed that all the theoretical convesion factors of the two types of the extremity phantom for the ANSI and the KAERI agree well with the experimental values of the ANSIN13.32 draft(1995) for each energywithin 5.7%, maximum difference ratio, except for 13.6% difference ratio in the case for the energy of less than 40keV. It is due to uncertainties of experiment occurred in the low X-ray energy range and geometry considered in the MCNP code.

Hypertrophic cardiomyopathy secondary to severe right and left ventricular outflow tract obstruction in a Maltese dog

Yoon, Won-Kyoung,Suh, Sang-Il,Oh, Yeon-Su,Hyun, Changbaig The Korean Society of Veterinary Science 2015 大韓獸醫學會誌 Vol.55 No.3

An 8-year-old spayed female Maltese (2.5 kg of body weight) presented with the primary complaint of loud heart murmur and exercise intolerance. Diagnostic imaging revealed severe pulmonic stenosis (peak velocity 5.2 m/s) with right ventricular hypertrophy. The dog revisited after 2 years, at which time, diagnostic imaging revealed severe biventricular hypertrophy, dynamic left ventricular outflow tract obstruction, left atrial dilation and pulmonary hypertension with worsened pre-existing pulmonic stenosis. Postmortem investigation revealed hypertrophic cardiomyopathy and regional myocardial infarction. The case was diagnosed as hypertrophic cardiomyopathy secondary to severe right and left ventricular outflow tract obstruction.

Slow-Wave Sleep Estimation for Healthy Subjects and OSA Patients Using R–R Intervals

Yoon, Heenam,Hwang, Su Hwan,Choi, Jae-Won,Lee, Yu Jin,Jeong, Do-Un,Park, Kwang Suk IEEE 2018 IEEE Journal of Biomedical and Health Informatics Vol.22 No.1

<P>We developed an automatic slow-wave sleep (SWS) detection algorithm that can be applied to groups of healthy subjects and patients with obstructive sleep apnea (OSA). This algorithm detected SWS based on autonomic activations derived from the heart rate variations of a single sensor. An autonomic stability, which is an SWS characteristic, was evaluated and quantified using R–R intervals from an electrocardiogram (ECG). The thresholds and the heuristic rule to determine SWS were designed based on the physiological backgrounds for sleep process and distribution across the night. The automatic algorithm was evaluated based on a fivefold cross validation using data from 21 healthy subjects and 24 patients with OSA. An epoch-by-epoch (30 s) analysis showed that the overall Cohen's kappa, accuracy, sensitivity, and specificity of our method were 0.56, 89.97%, 68.71%, and 93.75%, respectively. SWS-related information, including SWS duration (min) and percentage (%), were also calculated. A significant correlation in these parameters was found between automatic and polysomnography scorings. Compared with similar methods, the proposed algorithm convincingly discriminated SWS from non-SWS. The simple method using only R–R intervals has the potential to be utilized in mobile and wearable devices that can easily measure this information. Moreover, when combined with other sleep staging methods, the proposed method is expected to be applicable to long-term sleep monitoring at home and ambulatory environments.</P>

Metal ion-complexed zwitterionic polyurethanes synthesis for enhancing anti-fouling and -bacterial properties

( Su Yeon Choi ),( Jong Hee Kang ),( Won-gun Koh ),( Yoon Ki Joung ) 한국공업화학회 2018 한국공업화학회 연구논문 초록집 Vol.2018 No.1

Alteration of DNA Methylation in Gastric Cancer with Chemotherapy

( Su Jin Choi ),( Seok Won Jung ),( Sora Huh ),( Yoon-seok Chung ),( Hyosun Cho ),( Hyojeung Kang ) 한국미생물생명공학회(구 한국산업미생물학회) 2017 Journal of microbiology and biotechnology Vol.27 No.8

Epigenetic alterations such as DNA methylation, histone acetylation, and chromatin remodeling can control gene expression by regulating gene transcription. DNA methylation is one of the frequent epigenetic events that play important roles in cancer development. Cancer cells can gain significant resistance to anticancer drugs and escape programmed cell death through major epigenetic changes, including DNA methylation. To date, several research groups have identified instances of both (i) hypermethylation of tumor suppressor genes, and (ii) global hypomethylation of oncogenes. These changes in DNA methylation status could be used as biomarkers for the diagnosis and prognosis of cancer patients undergoing chemotherapies or other clinical therapies. Herein, we describe genes for which methylation is dependent upon anticancer drug resistance in patients with gastric cancer; we then suggest a significant epigenetic target to focus on for overcoming anticancer drug resistance.