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.

온수배관을 이용한 온실의 난방성능

윤용철(Yong Cheol Yoon),신익수(Yik Soo Shin),김현태(Hyeon Tae Kim),배승범(Seoung Beom Bae),최진식(Jin Sik Choi),서원명(Won Myung Suh) (사)한국생물환경조절학회 2012 생물환경조절학회지 Vol.21 No.2

본 연구는 온실의 난방 에너지 절감을 목적으로 온실 내부에 알루미늄 온수배관을 설치하여 난방효과에 대한 기초자료를 구축하고자 수행되었다. 그 연구결과를 요약하면 다음과 같다. 전체 실험을 포함하여 온실내의 높이별 온도편차는 4.0~7.0℃ 정도의 범위로서 그 차이가 크게 나타났다. 팬코일유니트(FCU)를 작동시킨 경우가 작동시키지 않은 경우에 비해 유출입수의 온도차가 3.3℃ 정도 크고, 소비전력량은 36.2~40.1% 정도 증가하였으며, 시간당 방열량은 44.6~52.0% 정도 증가하는 것으로 나타났다. 실험기간동안 순환유량은 0.48~0.49L · s<SUP>?1</SUP> 정도의 범위에 있었고, 평균유속은 1.53~1.56m · s<SUP>?1</SUP> 정도였다. 유출입수의 평균 온도차는 6.24~11.50℃이었다. 최저 외기온 ?14.0~?0.6℃ 범위에서 설정온도별 방열량은 135,930~307,150㎉ 정도의 범위로서 시간당 9,610~19,630㎉ · h<SUP>?1</SUP> 정도의 범위에 있었다. 이것은 최대난방부하의 약 23~53% 정도의 난방에너지를 공급할 수 있을 것으로 나타났다. 전체 방열량과 소비전력량은 각각 2,548,306㎉ 및 3,075.7㎾h이다. 화석연료인 경유로 난방할 경우, 소요되는 경유의 총 소비량은 281.6L 정도이고 비용은 321,000won인 것으로 나타났다. 농가용 전력요금을 적용하면 전력사용에 대한 총비용은 110,730won 정도로서 경유 소비 비용의 33.5% 정도로 나타났다. 실험구의 온도가 대조구보다 약 8.3~14.6℃ 정도 높게 나타났다. This research was conducted to obtain basic data with regard to the heating performance that would be produced by installing an aluminum hot water pipe inside the greenhouse with the goal of reducing the heating energy in greenhouse. The research results are summarized as follows. The degree of difference in relation to the temperature by height within the greenhouse during the entire experiment was significant - within the range of 4.0~7.0℃. The temperature difference between incoming and outgoing water was about 3.3℃ greater when FCU was activated compared to when it was not activated. Meanwhile, the amount of energy consumed increased about 36.2~40.1%. The amount of pyrexia per hour also increased by 44.6~52.0%. During the experiment period, circulated flux was within the range of 0.48~0.49 L · s<SUP>?1</SUP> while average fluid speed was 1.53~1.56 m · s<SUP>?1</SUP>. The average temperature difference between incoming and outgoing water was 6.24~11.50℃. The amount of heating value by each set temperature within the minimum outdoor temperature range of ?14.0~?0.6℃ was 135,930~307,150 ㎉, and the range was within the 9,610~19,630 ㎉ · h<SUP>?1</SUP> per hour. This demonstrated that about 23~53% heating energy of the maximum heating load could be supplied. Total radiating value and amount of energy consumed were 2,548,306 ㎉ and 3,075.7 ㎾h, respectively. When heating takes place using oil, which is a fossil fuel, the total amount of light oil consumed was 281.6 L while the cost was 321,000 won. When the electricity cost for farms is applied, the total cost was about 110,730 won, which is about 33.5% of the cost required compared to oil consumption. The temperature at in the experiment area was about 8.3~14.6℃ higher compared to that of the control area.

산업장 근로자의 스트레스에 대한 한의계 연구경향

차윤엽 ( Yun Yeop Cha ),고연석 ( Youn Seok Ko ),이정한 ( Jung Han Lee ),정원석 ( Won Suk Chung ),신병철 ( Byung Cheul Shin ),전찬용 ( Chan Yong Jeon ),고호연 ( Ho Yeon Go ),선승호 ( Seong Ho Sun ),장보형 ( Bo Hyoung Jang ),송윤경 한방재활의학과학회 2013 한방재활의학과학회지 Vol.23 No.2

Objectives : The purpose of this study is to explore the trends of Korean medical study on stress in the industrial worker. Methods : We received numbers of the studies about stress in the industrial worker from 6 Korean web databases, using key words such as ‘Industry AND Stress’, ‘Oriental medicine AND Stress’, ‘Worker AND Stress’, ‘Workplace AND Stress’. We received 12 research papers and they were analyzed and the journals, the authors, the contents of 3 classification of those research papers. Results : Among them, we had 6 reviews of Dept. of preventive medicine and Dept. of third medicine, college of Korean Medicine, Won-kwang University, and the rest of them were 6 reviews. We had 4 reviews of Korean Journal of Oriental Preventive Medical Society, 2 reviews of the Journal of Traditional Korean Medicine, 2 reviews of Journal of Oriental Neuropsychiatry and so on. According to the contents of reviews, we had 7 reviews of correlation of industrial worker and stress, 4 reviews of cause on the industrial worker’s stress and 1 case report. Conclusions : We reviewed the trends of Korean medical study on stress in the industrial worker. The stress in the industrial workers were related with the type of occupation, social psychology, drinking, smoking, the satisfaction of job, the harmony of organization.And we knew that the musculoskeletal pain was related to the industrial worker’s stress. In the future, abundant case studies, follow-up trials and RCTs should be done about the industrial worker’s stress.

Fabrication System for Large-Area Seamless Nanopatterned Cylinder Mold Using the Spiral Laser Interference Exposure Method

Yong-Won Ma,Jun Han Park,Sung Jae Lee,Jeonghoon Lee,Suchan Cho,Bo Sung Shin 한국정밀공학회 2023 International Journal of Precision Engineering and Vol.10 No.1

With the advancement in the field of nanotechnology, nanopatterning finds extensive application not only in high value-added products but also in inexpensive products. In addition, the technology required for the mass production of inexpensive products, such as the continuous roll-to-roll (R2R) process, is rapidly emerging. Extensive research has been conducted on the manufacture of submicron- and nano- molds. In this study, we have proposed a laser interference exposure for fabricating nanopatterned cylindrical molds that can be used in continuous roll-to-roll patterning. Additionally, we have demonstrated spiral exposure process to fabricate a seamless patterning on a cylinder (length of 300 mm and diameter of 100 mm) using a prism. The pattern was transferred to the flat mold using UV resin and measured using a field emission scanning electron microscope; the pattern was measured to have a uniform with nano pattern line width (75 nm) and a sub-micron period (286 nm). It was observed that the proposed method for fabrication of the roll mold using laser interference lithography is a fast and reliable seamless patterning.

Modulation of Interleukin Production in Anthrax Lethal Toxin-treated Macrophages by Melatonin and Dehydroepiandrosterone

Shin, Sung-Ho,Hur, Gyeung-Haeng,Yeon, Kyu-Baek,Kim, Yun-Bae,Park, Kyung-Jin,Park, Young-Min,Lee, Woo-Sung,Cho, Bong-Huey,Kim, Won-Yong,Chung, Sang-In,Choi, Chul-Soon Korean Society for Biochemistry and Molecular Biol 2000 Journal of biochemistry and molecular biology Vol.33 No.6

Anthrax lethal toxin, which consists of two separate protein, protective antigen (83 KDa) and lethal factor (85 KDa) is responsible for major symptoms and death from systemic infection of Bacillus anthracis. High concentrations of this toxin are cytolytic to macrophages, whereas sublytic concentrations of lethal toxin induce these cells to produce interleukin $1{\beta}$ ($IL-1{\beta}$). It is proposed that melatonin and dehydroepiandrosterone (DHEA) may play an important role in modifying immune dysfunction. In this study, we investigated whether or not melatonin and DHEA could prevent $IL-1{\beta}$ production that is induced by anthrax lethal toxin in mouse peritoneal macrophages. Treatment of melatonin or DHEA alone, as well as together, prevented the production of $IL-1{\beta}$ caused by anthrax lethal toxin. We found that melatonin at a concentration of $10^{-6}-10^{-7}$ M inhibits $IL-1{\beta}$ production induced by anthrax lethal toxin. As expect, treatment of DHEA at a concentration $10^{-6}-10^{-7}$ M also suppressed production of $IL-1{\beta}$ by lethal toxin stimulated macrophages. The results of these studies suggest that melatonin and DHEA, immunomodulators, may have an important role in reducing the increase of cytokine production in anthrax lethal toxin-treated macrophages.

Standardized surgical techniques for adult living donor liver transplantation using a modified right lobe graft

Shin Hwang,Tae-Yong Ha,Chul-Soo Ahn,Deok-Bog Moon,Ki-Hun Kim,Gi-Won Song,Dong-Hwan Jung,Gil-Chun Park,Sung-Gyu Lee 한국간담췌외과학회 2016 한국간담췌외과학회지 Vol.20 No.3

After having experienced more than 2,000 cases of adult living donor liver transplantation (LDLT), we established the concepts of right liver graft standardization. Right liver graft standardization intends to provide hemodynamics-based and regeneration-compliant reconstruction of vascular inflow and outflow. Right liver graft standardization consists of the following components: Right hepatic vein reconstruction includes a combination of caudal-side deep incision and patch venoplasty of the graft right hepatic vein to remove the acute angle between the graft right hepatic vein and the inferior vena cava; middle hepatic vein reconstruction includes interposition of a uniform-shaped conduit with large-sized homologous or prosthetic grafts; if the inferior right hepatic vein is present, its reconstruction includes funneling and unification venoplasty for multiple short hepatic veins; if donor portal vein anomaly is present, its reconstruction includes conjoined unification venoplasty for two or more portal vein orifices. This video clip that shows the surgical technique from bench to reperfusion was a case presentation of adult LDLT using a modified right liver graft from the patient’s son. Our intention behind proposing the concept of right liver graft standardization is that it can be universally applicable and may guarantee nearly the same outcomes regardless of the surgeon’s experience. We believe that this reconstruction model would be primarily applied to a majority of adult LDLT cases.

Photochromic Polysiloxanes Substituted with 1,2-Bis(2-methyIbenzo[b]thiophene-3-yl)hexafluorocyclopentene

Shin, Hee-Won,Kim, Yong-Rok,Kim, Eun-Kyoung The Polymer Society of Korea 2005 Macromolecular Research Vol.13 No.4

Photochromic diarylethene polymers (DPs) in which 1,2-bis(2-methylbenzo[b ]thiophene-3-yl)hexafluorocyclopentene (BTF6) were covalently grafted onto the polymer main chain as pendant photochromic units were newly synthesized and their photochromic properties were investigated using steady-state and picosecond timeresolved spectroscopies. Polysiloxanes substituted with BTF6 molecules were prepared by sol-gel process using a mixture of tetraethoxysilane (TEOS), a silylated BTF6, and an organically modified silane precursor in the presence of HCl. The polysiloxane film (DP1) prepared from $\omega-methoxy$ poly(ethylene glycol) 3-(triethoxysilyl) propylcarbainate (MPGSC) as the silane precursor showed a much lower glass transition temperature than that (DP2) from heptadecafluorodecyltrimethoxysilane (HDFTMS). The ring-closure quantum yields of DP1 and DP2 were determined to be 0.20 and 0.02, respectively. Such a large difference in the quantum yield was attributed to the polymer matrix environment of the free inner volume.

Construction of Retrieval-Based Medical Database

Yong-Won Shin,Bong-Oh Koo,Byung-Rae Park 대한의생명과학회 2004 Biomedical Science Letters Vol.10 No.4

In the current field of Medical Informatics, the information increases, and changes fast, so we can access the various data types which are ranged from text to image type. A small number of technician digitizes these data to establish database, but it is needed a lot of money and time. Therefore digitization by many end-users confronting data and establishment of searching database is needed to manage increasing information effectively. New data and information are taken fast to provide the quality of care, diagnosis which is the basic work in the medicine. And also It is needed the medical database for purpose of private study and novice education, which is tool to make various data become knowledge. However, current medical database is used and developed only for the purpose of hospital work management. In this study, using text input, file import and object images are digitized to establish database by people who are worked at the medicine field but can not expertise to program. Data are hierarchically constructed and then knowledge is established using a tree type database establishment method. Consequently, we can get data fast and exactly through search, apply it to study as subject-oriented classification, apply it to diagnosis as time-depended reflection of data, and apply it to education and precaution through function of publishing questions and reusability of data.

French Foreign Policy towards Africa under Jacques Chirac

( Won Yong Shin ) 부산외국어대학교 지중해연구소 2010 The Mediterranean Review Vol.3 No.2

Over the main changes that have occurred in Chirac`s last 12 years in office, some important patterns of French policy towards the African continent can be highlighted. First, Chirac`s attitude to Africa for the most part has been consistent, although perforce it has adapted to specific conditions. These included ``cohabitation`` (the cabinet led by Prime Minister Lionel Jospin in 1997-2002); the reassertion of United States influence in Africa after the World Trade Centre attack in September 2001; and the trauma in France that followed the Rwandan genocide of 1994. Secondly, there has been a growing discrepancy between French economic interests and development aid. While such aid is still mostly directed to the former French colonies, economic interests have evolved in a different direction, with stronger emphasis on countries such as South Africa and Nigeria that have no colonial or linguistic relationship with France. Thirdly, the institutions that were supposed to frame and implement African policy are undergoing a reform process that as yet is incomplete and the efficiency and consistency of which is doubtful.

Nutritional and Hormonal Regulation of Fatty Acid Synthase Gene Expression

Shin, Dong-Hoon,Kim, Byung-Yong,Hahm, Young-Tae,Kim, Eunki,Cho, Won-Dai The Korean Society of Food Science and Nutrition 1997 Preventive Nutrition and Food Science Vol.2 No.3

The maximum 30-fold level of fatty acid synthase (FAS) mRNA was achieved by 6hr after intraperitoneal injection of insulin. The kinetics and maximum effect of insulin were most evident on he 7.2 kb mRNA. In six hors after insulin administration there was about 100-fold increase in stead-state mRNA level. We observed a sharp decrease in 7.2kb mRNA by 8hr after insulin administation while there was no change in FAS mRNA content between the 6hr and 8hr-sampling periods. In contrast, a maximum induction of 4-fold was shown in the level of 5.1kb mRNA after insulin injection in streptozotocin-diabetic mice.