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.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

이면성 및 도플러 심초음파도를 이용하여 진단한 선천성 거대 좌회선지-좌심실 관동맥루

진승원,박준철,이영중,유병현,박현옥,김용주,윤호중,김재형,홍순조,최규보,권종범,원용순,박건 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.4

水素化된 非晶質 게르마늄의 特性調査(Ⅰ)

梁承勳,李原鎭,朴奉斗 慶北大學校 1985 論文集 Vol.39 No.-

Reactive thermal evaporation(RTE) was developed as a new method to deposit hydrogenated amorphous germanium films. RTE was carried out by the evaporation of high purity polycrystalline germanium in an atmosphere of hydrogen plasma produced by high voltage AC discharge of molecular hydrogen. Electrical conductivity and its annealing behavior, electron probe micro-analyzer and scanning electron microscopy were used to characterize the samples. Optimal conditions of sample preparation (from electronic point of view) were determined to be substrate temperature of 200℃ and hydrogen pressure of 1 Torr. Crucible type was proved to have an influence on the sample properties. The sample prepared at the optimum conditions shows the activated type conduction above room temperature.

골다공증의 동통에 대한 엘시토닌의 효과

양인명,김성운,김진우,김영설,김광원,최영길 최신의학사 1993 最新醫學 Vol.36 No.10

도말층 및 상아질 접착 강화제가 근관폐쇄 효과에 미치는 영향

양진석,오원만 전남대학교 치과대학 2000 전남치대논문집 Vol.12 No.1

The purpose of this study was to evaluate the sealing ability of smear layer removal and 4 dentin primers of dentin bonding agents to obturate the root canal. 126 extracted human teeth with single, straight canal and mature apices were used. Samples were classified into six groups(presence of smear layer, absence of smear layer, Scotchbond Bond Multi-Purpose, All Bond 2, Mac Bond 2 and Clearfil Liner Bond 2) and positive control. All teeth except positive control were obturated with thermoplasticized gutta-percha and AH26. Electrochemical and dye penetration technique were used to evaluate the degree of microleakage through root canal. Seventy teeth were immersed in a 1 percent potassium chloride solution and applied external power supply(DC 10 V) to the circuit for electrochemical microleakage test. Microleakage was determined over period of 28 days and evaluated. Forty eight teeth were used in dye infiltration technique. All specimen were suspended in 2 percent methylene blue dye for 1 week and then longitudinally split. The value of dye infiltration was measured under a stereomicroscope at ×10 magnification and evaluated. The results were as follows : 1. All groups showed that apical microleakage increased throughout the test period and a group having smear layer was especially increased in electrochemical test(p<0.05). In a group having smear layer, the degree of apical microleakage was the highest, and the microleakage was much higher than in smear layer removed group in electrochemical test(p<0.05). Scotchbond Multi-Purpose. All Bond 2, Mac Bond 2 and Clearfil Liner Bond 2 showed lower microleakage than a groups having smear layer, especially All Bond 2 and Clearfil Liner Bond 2 treated groups were the lowest microleakage in electrochemical test(p<0.05). 2. There was no significant difference among experimental groups in dye penetration technique.

CINEFLUOROSCOPY를 이용한 Ⅲ급 부정교합환자의 연하시 구강인두의 운동에 관한 연구

진익재,양원식,유동수 대한치과교정학회 1987 대한치과교정학회지 Vol.17 No.1

This study was undertaken to find out oropharyngeal movement of the class III malocclusion patients during swallowing by using the cinefluoroscopic method. The experimental group was composed of fifteen male adults with class III malocclusion whose mean age was 24.4 yrs. The control group was composed of fifteen male adults with normal occlusion whose mean age was 24.8 yrs. The results were as follows: 1. The horizontal position of the tongue tip was more anterior in the class III malocclusion group than in the normal group through all stages. 2. The tongue level was lower in the class III malocclusion group than in the normal group during stage 1, stage 3, and stage4. 3. The horizontal position of the hyoid bone was more anterior in the class III malocclusion group than in the normal group during stage 1 only. 4. The tip of the soft palate was lower in the class III malocclusion group than in the normal group during stage 1 only, and there was no significant difference in the velar movement between the class III malocclusion group and the normal group during swallowing. 5. There was a significant difference in the interincisal distance, but no significant difference in the intermolar distance between the class III malocclusion group and the normal group through all stages. 6. Among 4 stages of each group, there was a significant difference in the movements of the dorsum of the tongue, the hyoid bone, and the soft palate. And there was a significant difference in the movement of the tongue tip of the normal group, but no significant difference in the movement of the tongue tip of the class III malocclusion group.

근관 밀폐도에 미치는 도말층 및 상아질 접착강화제의 영향

양진석,김원재,황인남,오원만 대한치과보존학회 2000 Restorative Dentistry & Endodontics Vol.25 No.4

The purpose of this study was to evaluate effects of smear layer and dentin primers on the sealing ability of root canals. 126 extracted human teeth with single, straight canals and mature apices were used. The Samples were first classified into six groups as follows : presence of smear layer; absence of smear layer; Scotchbond Bond Multi-Purpose; All Bond 2; Mac Bond 2; Clearfil Liner Bond 2. A Positive control was also established. All teeth except the control group were then obturated with thermoplasticized gutta-per-cha and AH26. Electrochemical and dye penetration technique were later used to evaluate the degree of microleakage through the root canal. Seventy teeth were then immersed in a 1 % potassium chloride solution and An external power supply(DC 10 V) was then applied to the circuit for the electrochemical microleakage test. The degree of Microleakage was determined over period of 28 days before being evaluated. In total, 48 teeth were submitted to the dye infiltration technique. All specimen were suspended in 2 % methylene blue dye for 1 week before being longitudinally split. The degree of dye infiltration was measured under a stereomicroscope at×10 magnification and evaluated. The results were as follows: 1.Apical microleakage increased throughout the test period in all group and one group having a smear layer showed a dramatic increase under electrochemical test (p<0.05). In the group having smear layer, the degree of apical microleakage was the highest, and the microleakage was much higher than in the smear layer removed group in electrochemical test (p<0.05). Scotchbond Multi-Purpose, All Bond 2, Mac Bond 2 and Clearfil Liner Bond 2 showed lower microleakage than one group having smear layer. The All Bond 2 and Clearfil Liner Bond 2 treated groups showed the lowest microleakage in electrochemical test (p<0.05). 2.There was no significant difference between the experimental groups in dye penetration technique. These results suggested that the removal of the smear layer from root canal and concomitantly the application of dentin primer into root canal could improve the sealing ability of root canal obturation, 1

비강 구조에 대한 임펄스 응답 추정 방법에 관한 연구

양진원,최민주,이용학 濟州大學校 情報通信硏究所 2000 情報通信硏究所論文集 Vol.3 No.-

In this paper. the new method of estimating impulse response by modified Wiener filter is presented. The modified Wiener filter is composed of the noise-to-signal power ratio so that the bias in modified Wiener filter depends on the power spectrum of input signal and noise. Hence. in estimating impulse response. noise is effectively suppressed at the band where the frequency content of input signal is becoming less and less. Simulation shows that error is less in the presented method than in the conventional method. In experiments using the Acoustic Rhinometry. the presented method can acquire the more exact geometry from the estimated impulse response.

수소화된 비정질 규소에서 바이어스에 의한 실리사이드 형성

梁承勳,金鐵河,李原鎭 慶北大學校 1990 論文集 Vol.49 No.-

We show that biased annealing of a-Si:H contacted with metal gives rise to silicide growth and the creation of metastable states that can be to some extent removed by unbiased annealing. This paper gives the first report of a direct correlation of Ⅰ-Ⅴ characteristics to silicide growth in a-Si: H. Variations of Ⅰ-Ⅴ characteristics with annealing biases are analysed by the two series-connected diodes model.