The Outcome of Multiple Slit on Plaque with Plication Technique for the Treatment of Peyronie’s Disease

신수환,정형국,박종진,채지윤,김종욱,오미미,박홍석,김제종,문두건 대한남성과학회 2016 The World Journal of Men's Health Vol.34 No.1

Purpose: To evaluate the postoperative outcome of the multiple slit on plaque plication technique for the treatment of Peyronie’s disease.Materials and Methods: We retrospectively evaluated 22 patients who underwent plaque incision with penile plication for the surgical treatment of Peyronie’s disease, who had failed medical treatment between 2009 and 2014. Patients were grouped by preoperative degree of penile curvature into Group I: mild (n=5, 22.7%), Group II: moderate (n=11, 50.0%), and Group III: severe (n=6, 27.3%). After a thorough review of the medical records, we evaluated (a) the correction of the curvature; (b) sexual function; and (c) any penile shortening or other complications.Results: The mean postoperative follow-up period was 39 months. Complete correction of the curvature was attained in 21 patients (95.5%). As an inevitable complication, minimal penile shortening (<1.5 cm) was reported by 14 patients (82.4%) but did not adversely affect sexual intercourse (0%), and all patients found the extent of penile shortening to be acceptable. Nineteen patients had good erectile function (International Index of Erectile Function >21). The most frequent complication was subcutaneous penile edema in three patients (13.6%), which was resolved within about 3 months following surgery.Conclusions: As a modified technique, multiple slit on plaque with plication is a simple, minimally-invasive and effective technique for correcting penile curvature regardless of curvature severity. The degree of penile curvature does not significantly predict the amount of penile length loss.

족삼리 침구요법이 정상 백서의 체중, 혈중 지질상태 및 위 점막내 leutin 면역반응에 미치는 영향

신수환,김정연,이창현,유윤조 대한동의병리학회 2003 동의생리병리학회지 Vol.17 No.3

The effects of acupuncture and moxibustion at ST 36 (足三里) acupoint on the changes of body weight, related serum lipids and leptin density of the stomach were investigated. 3 groups of male, 7 animals each, were ad libitum standard diet for 5 days. Body weight was effective decreased for 5 days after moxibustion at ST 36 acupoint and the density of leptin which was related food intake and body weight deficiency was decreased remarkerbly in the mucosa of stomach. Moxibustion on ST 36 affected the levels of total cholesterol, glucose, HDL-cholesterol, but acupuncture on ST 36 affected only the levels of total lipid, triglyceride, HDL cholesterol. It is considered that the treatment of acupuncture and moxibustion at ST 36 (足三里) have different effect actively on body weight, serum lipids and leptin density and moxibustion of ST 36 (足三里) can be applied as effective therapy for obesity.

The Legal Doctrine on the Liability of Physicians in Medical Malpractice Lawsuits Involving Complex Regional Pain Syndrome

신수환,장승경,민경태,이원,김소윤 대한의학회 2018 Journal of Korean medical science Vol.33 No.9

Background: Complex regional pain syndrome (CRPS) involves severe pain and it is difficult to identify the exact cause or pathogenesis. Therefore, there are controversies regarding legal issues related to the establishment of damage in medical malpractice lawsuits involving CRPS. This study aimed to analyze malpractice lawsuits involving CRPS, which occurred after the disputed medical treatment, to provide information on the courts' opinion and characteristics of the cases. Methods: This study analyzed 23 lawsuit judgments involving CRPS that were sentenced from 2005 to 2015. Results: A total of 12 of the 23 cases were partially ruled in favor of the plaintiff. The average amount (KRW) claimed was 470,638,385 ± 860,634,092 (21,000,000 to 4,020,000,000), and that awarded was 72,906,843 ± 53,389,367 (15,000,000 to 181,080,803). Sixteen of the 23 cases had CRPS type I. In 11 of 23 cases, the site of the pain was located in the lower limb and in 14 cases there was no presence of trauma or event prior to medical treatment. Conclusion: Nerve injury was the most frequent reason for taking responsibility in compensating damage in malpractice cases involving CRPS. Physicians should consider various possibilities of such complications in medical practices. It is important to identify and improve areas which need to be improved for patient safety through analyzing the lawsuit judgment cases.

판례 분석을 통한 복합부위통증증후군의 업무관련성

신수환 대한직업환경의학회 2017 대한직업환경의학회 학술대회 논문집 Vol.2017 No.11

Defining the Degree of Intravesical Prostatic Protrusion in Association With Bladder Outlet Obstruction

신수환,김종욱,김진욱,오미미,문두건 대한비뇨의학회 2013 Investigative and Clinical Urology Vol.54 No.6

Purpose: The present study was done to define the degree of intravesical prostatic protrusion (IPP) causing bladder outlet obstruction (BOO) in patients with benign prostatic hyperplasia (BPH)/lower urinary tract symptoms. Materials and Methods: We retrospectively evaluated 239 patients with BPH, analyzing age, IPP, prostate volume, International Prostate Symptom Score (IPSS), and the results from a pressure-flow study. Urethral resistance was quantified by using the BOO index (BOOI), according to the formula BOOI=PdetQmax-2×Qmax (where Pdet is detrusor pressure at the peak flow rate and Qmax is peak flow rate). BOO was defined by a BOOI above 40. Patients with a BOOI below 20 were excluded. Patients were classified into two groups (obstructed and unobstructed groups) by the BOOI. Correlations were determined by logistic regression analysis, and receiver operating characteristic curves were plotted to estimate the optimal cutoff for IPP. Results: There were significant differences in total prostate volume, postvoiding residual urine (PVR), IPP, and Qmax (p<0.001, p<0.001, p<0.001, and p=0.026, respectively)between the obstructed and unobstructed groups, but there were no significant differences in age (p=0.653), IPSS total score (p=0.624), or quality of life score (p=0.138). IPP had a significant prognosis (p<0.001) but was weakly correlated with prostate volume (p=0.026). The correlation coefficients between IPP and Qmax, PVR,prostate volume, and BOO were 0.551, -0.159, 0.225, and 0.391, respectively. For IPP,the area under the curve was 0.759 (95% confidence interval, 0.657 to 0.861) and the cutoff to indicate BOO was 5.5 mm with 66.7% sensitivity and 80.5% specificity. Conclusions: An IPP exceeding 5.5 mm was significantly associated with BOO.

과학 영농을 위한 자동 재배 시스템 (ACS)

신수환,허창호,권장욱,이정익 한국기계기술학회 2022 한국기계기술학회 학술대회논문집 Vol.2022 No.11

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

신수환,이원,김소윤,조광현,문제호,조수익 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.

Analysis of closed medical litigation in urology

신수환,김소윤,장승경,이원 대한비뇨의학회 2017 Investigative and Clinical Urology Vol.58 No.5

Purpose: The objective of this study was to provide a descriptive understanding of the characteristics of malpractice litigation related to urology by examining court cases. Materials and Methods: A total of 6,074 court cases related to medical malpractice litigation filed between 2005 and 2010 were received from the Lower Courts, the Appellate Courts, and the Supreme Court of Korea. Of the received cases, 34 urology-related civil proceedings were analyzed. The following information was compiled and investigated from the cases: background, age and sex of patient, categorization of the defendant, opinion of the court, amount claimed and awarded in damages, type of medical treatment involved, and negative effects resulting from the medical accident. Results: The average amount in damages paid out to plaintiffs in this research was 27,186,504±32,371,008 Korean won (KRW) (range, 1,000,000–100,000,000 KRW). A total of 9 of the 34 analyzed cases (26.5%) ruled in favor of the plaintiff, with all 9 cases involving a surgery. An analysis of the surgery sites further revealed that the penis was the most frequently litigated over site of surgery, making up 14 of the 35 sites (40.0%). Conclusions: Information regarding urology malpractice lawsuits should be made available to help prevent further disputes and litigation. Continuous efforts must be expended in the prevention of accidents and disputes, alongside research into urology-related cases beyond 2010. Extensive cause analysis and recurrence prevention methods must also be researched to enhance overall patient safety.

족삼리 침구요법이 정상 백서의 체중, 혈중 지질상태 및 위 점막내 leptin 면역반응에 미치는 영향

신수환,김정연,이창현,유윤조 한의병리학회 2003 동의생리병리학회지 Vol.17 No.3

국내 민형사 판례로 확인한 피부미용사의 불법시술 사례 고찰

신수환 ( Suhwan Shin ),최성준 ( Sungjun Choi ),양성규 ( Seong Gyu Yang ),조수익 ( Soo Ick Cho ) 대한피부과학회 2020 대한피부과학회지 Vol.58 No.10

Background: Although the rates of illegal cosmetic procedures performed by beauticians are increasing, there is a dearth of relevant information in the literature regarding these procedures. Objective: This study was aimed to investigate illegal cosmetic procedures that were performed by beauticians with the help of judicial precedents. Methods: The Supreme Court of South Korea’s Written Judgement Management System was searched for judicial precedents regarding illegal cosmetic procedures performed by beauticians. This system included cases that were sentenced in the lower courts, the appellate courts, and the supreme court from the year 1997 to 2019. Results: Twenty-three litigation cases related to these illegal cosmetic procedures were selected. There were 21 criminal cases and two civil cases. Common illegal procedures included tattooing (n=11), use of laser and intense pulsed light device (n=6), administration of intradermal injection (n=3), and application of topical agents (n=2). Two civil cases reported facial deformity and accidental macular damage caused by illegal use of lasers by the beauticians. Conclusion: In this study, illegal cosmetic procedures performed by beauticians were identified. Continuous monitoring of these illegal procedures is necessary as they can cause adverse effects in patients. (Korean J Dermatol 2020;58(10):669∼673)