• 제목/요약/키워드: Complication

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내부자 거래의 윤리적 문제점에 대한 연구 (A Study on Ethical Problem of Insider Trading)

  • 윤혜진
    • 철학연구
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    • 제126권
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    • pp.213-233
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    • 2013
  • 내부자 거래란 내부자, 즉 회사의 기업 비밀이나 영업 비밀을 다루고 있는 회사에 속한 관리직 또는 경영의 위치에 있는 특수 관계자들이 자신들의 지위를 이용하여 일반 대중에게 공표되지 않은 이런 기밀을 통해 사전에 주식을 매수하거나 매도함으로써 특별한 이득을 얻는 것을 뜻하다. 여기에는 회사가 공개하지 않고 비밀리에 진행하고 있는 기업 인수합병, 증자 및 감자 계획, 신주 발행, 자산재평가 실시, 회사의 신규투자 계획, 회사의 강제 폐업 등과 같은 비밀 정보들이 포함될 수 있다. 그리고 이들은 이런 정보를 선점하여 주식 거래를 하거나 회사의 지분을 확보함으로써 상당한 부당 이득을 실현할 수 있다. 이런 까닭에 비내부자, 즉 내부 정보를 알고 있지 못하는 회사 고용인 및 일반 투자자는 커다란 손실을 입을 수도 있다. 왜냐하면 통상의 일반 투자자는 이들보다 훨씬 더 숫자는 많겠지만 정보 입수 면에 있어서 아주 열악한 위치에 있는 게 보통이며, 특히 그것이 영업 비밀이나 기업 비밀에 속하는 회사의 내부 정보일 경우 이를 인지하기란 사실상 불가능할 것이기 때문이다. 이 논문은 내부자 거래의 이러한 윤리적 문제점들을 적극 조명하는 일에 관심을 두고 있다. 그리고 그러한 것들이 왜 문제인지에 대한 윤리적 근거를 밝혀 내부자 거래의 부당함을 드러내는 일에 초점을 맞추고 있다. 다시 말해, 이 논문은 내부자 거래를 불공정 거래 행위로 규정할 만한 분명한 윤리적 근거를 제시하고, 이를 통해 내부자 거래를 불법으로 규정하는 데 하등 문제가 없음을 공론화하는 데 그 목적이 있다. 내부자 거래의 부당함에 대한 이 같은 논의를 이끌고 있는 윤리적 문제는 다음과 같다. 즉, 내부자 거래는 부당하게 누군가의 이득을 편취한 것이며, 자유 시장의 공정한 경쟁을 허물어뜨린 것이며, 정보 입수의 기회에 대한 불공정성 문제를 일으키는 사안이다.

$\ll$소문(素問).영추(靈樞)$\gg$에 나타난 이명(耳鳴)에 대한 연구(硏究) (A Study on the Tinnitus of Huangdi's Internal Classic $\ll$황제내경(黃帝內經)$\gg$)

  • 변석미;탁명림;강나루;고우신;윤화정
    • 한방안이비인후피부과학회지
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    • 제23권1호
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    • pp.224-252
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    • 2010
  • Objective : The purpose of this study is to investigate tinnitus of Plain Questions $\ll$素問$\gg$ and Miraculous Pivot $\ll$靈樞$\gg$. Methods : We conducted a study on the original text paragraphs of Internal Classic $\ll$內經$\gg$ containing the tinnitus and analysis of Yang, Ma, Zhang, Wang etc. We drew a parallel between tinnitus from Internal Classic $\ll$內經$\gg$ and matching diagnoses from western medicine. Results : The results were as follows. 1. Tinnitus in Plain Questions $\ll$素問$\gg$Tong Pyeong Heo Sil Ron <通評虛實論> was similar to the symptoms of diabetes mellitus complication and schizophreniform disorder in western medicine. 2. Liver fire tinnitus in Plain Questions $\ll$素問$\gg$ Yuk Won Jeong Gi Dae Ron <六元正紀大論> was similar to the symptoms of psychological distress in western medicine. 3. Phlegm fire tinnitus in Plain Questions $\ll$素問$\gg$ Ji Jin Yo Dae Ron <至眞要大論> was similar to the symptoms of meniere's disease and malfunction of autonomic nervous system in western medicine. 4. Blood deficiency tinnitus in Miraculous Pivot $\ll$靈樞$\gg$ Sa Gi Jang Bu Byeong Hyeong <邪氣藏府病形> was similar to the symptoms of anemia in western medicine. 5. Tinnitus in Miraculous Pivot $\ll$靈樞$\gg$ Gyeong Geun <經筋> was similar to the myofacial pain syndrome of the sternocleidomastoid muscle and the masseter muscle in western medicine. 6. Gallbladder deficiency tinnitus in Miraculous Pivot $\ll$靈樞$\gg$ Gwol Hyeong <厥病> was similar to the symptoms of otitis media and labyrinthitis in western medicine. 7. Kidney deficiency tinnitus in Miraculous Pivot $\ll$靈樞$\gg$ Gyeol Gi <決氣> and Hai Ron <海論> was similar to the symptoms of degenerative auditory organ in western medicine. 8. Tinnitus in Internal Classic $\ll$內經$\gg$ showed close relations with the symptoms of the wind character. Conclusion : We analyzed the original text paragraphs of Internal Classic $\ll$內經$\gg$ and explanations about tinnitus. Further studies are needed to compare oriental medicine and western medicine diagnoses to develop better treatments for tinnitus.

유한 물체 거리를 갖는 2 반사경계의 곡률 선형 방정식 (Curvature Linear Equation of a Two-Mirror System with a Finite Object Distance)

  • 이정기;임천석
    • 한국광학회지
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    • 제16권5호
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    • pp.423-427
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    • 2005
  • 본 연구는, 원리적인 다양한 장점에도 불구하고 현실적인 제약으로 인해 실제 설계과정에서 잘 적용되지 않는, 자이델 3차 수차를 간편하게 다룰 수 있는 방안을 제안한다. 먼저 유한 물체거리를 갖는 2 반사경계에 대해 자이델 3차의 구면수차계수를 유도한다. 여기서, 유도된 구면수차계수는 고차의 비선형 방정식으로 표현되는데, 그 구성은 설계변수(물체거리, 주경 및 부경의 곡률, 주경과 부경 사이의 거리)와 유효초점거리로 이루어진다. 해석적으로 표현된 고차의 비선형 구면수차 방정식은 컴퓨터를 이용한 수치기법에 의해 근사적인 제로조건을 만족하도록 풀려진다. 이렇게 구해진 다양한 수치 해들을 주의 깊게 통찰하면 주경과 부경의 곡률 간에 선형성이 존재함을 파악할 수 있다. 즉, 결과적으로 주경과 부경의 곡률들을 선형맞춤(linear fitting)하면 곡률선형방정식이 얻어지는데, 이의 의미는 약간의 대수적인 계산으로 최적화의 초기 입력 데이터를 손쉽게 얻을 수 있는 가능성을 제시한 것이다. 한편, 응용외의 순수 수차론적인 관점에서 본다면, 본 연구의 특징은 유한 물체거리를 갖는 2 반사경계의 주경 및 부경의 곡률들이 구면수차가 거의 제로가 되는 조건 하에서 상호간에 선형 관계가 존재하였다는 것이다.

독실라민 중독시 발생할 수 있는 발작의 특성과 위험인자 (The Clinical Features and Risk Factors of Seizure After Doxylamine Intoxication)

  • 송범수;이기만;김선욱;유제성;정태녕;박유석;정성필;구홍두;박인철
    • 대한임상독성학회지
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    • 제8권2호
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    • pp.88-96
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    • 2010
  • Purpose: Doxylamine is antihistamine drug that is used as a hypnotic. It is also used for suicidal attempts because it can be easily purchased at the pharmacy without a prescription. There were many articles about the complications after doxylamine intoxication such as a rhabdomyolysis, but only a few articles have reported on seizure. We reviewed the cases of doxylamine intoxication with seizure that were treated in the emergency department. Methods: We reviewed the medical records of the patients who were over 15 years old and who were intoxicated by doxylamine at 3 emergency medical centers from January 2006 to June 2010. We reviewed the patients' age, gender, the dose of doxylamine ingested, if gastrointestinal decontamination was done, the time from intoxication to hospital arrival, the seizure history, treatment of seizure, the electroencephalography (EEG) results, the brain computed tomography (CT) results and the blood test results. Results: There were 168 patients who were intoxicated by doxylamine during the study period. Twelve patients had a seizure episode. The differences between the patients who developed seizure and the patients who did not were the dose and the serum levels of sodium and creatinine. The only clinically meaningful difference was the amount of doxylamine. The amount of doxylamine ingested (>29 mg/kg) predicted the development of seizure with a sensitivity of 75% and a specificity of 92% on the ROC curve. One patient among the seizure patients expired in the emergency department. Conclusion: In case of doxylamine intoxicated patients, there is close relationship between seizure and ingested amount, so close observation needs to be done for the patients who ingest too much because doxylamine can cause death. Further prospective studies are needed for doxylamine intoxicated patients with a seizure episode.

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부식제 중독 환자에서 시간에 따른 내시경 합병증 비교 (Comparing the Possible Complications of Endoscopy Dependent on Time in Caustic Poisoned Patients)

  • 최진걸;김오현;김현;이동건;고진;김태훈;차경철;이강현;황성오;차용성
    • 대한임상독성학회지
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    • 제12권2호
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    • pp.70-76
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    • 2014
  • Purpose: Endoscopy has been recommended as a primary procedure for determining the extent of damage and prognosis in patients with caustic ingestions. Endoscopy within the first 24 hours has been suggested, however, such immediate endoscopy is not always possible. Therefore, we wanted to determine complications and possible delayed sequelae after the endoscopy performed dependent on time, including less than 24 hours and more than 24 hours, after ingestion of relatively high toxic caustic agents. Methods: From January 2005 to May 2013, 105 consecutive patients were diagnosed with caustic poisoning in the emergency department of the Wonju Severance Christian Hospital. Out of 95 patients who underwent endoscopy, while excluding 49 patients who ingested sodium hypochlorite and 15 patients due to insufficient data, 41 patients were ultimately included. We compared general characteristics, complications related to endoscopy, late sequelae, total admission length, and mortality between two groups. Results: Twenty eight patients (68.3%) were diagnosed with acid ingestion. Median endoscopy time was 17.8 (IQR 9.7-36.9) hours and performed in 16 patients (39%) after 24 hours. There were no complications, such as perforation and bleeding in either endoscopy within 24 hours group or endoscopy after 24 hours group. In addition, no difference in ingested materials, endoscopy grade, or late sequelae was observed between endoscopy within 24 hours group and endoscopy after 24 hours group. Conclusion: No difference in complications and late sequelae was observed between endoscopy within 24 hours group and endoscopy after 24 hours group when endoscopy was performed based on a clinician's assessment.

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Effect of Chlorhexidine Mouthrinse on Prevention of Microbial Contamination during EBUS-TBNA: A Study Protocol for a Randomized Controlled Trial

  • Kim, Na Young;Park, Jae Hyeon;Park, Jimyung;Kwak, Nakwon;Choi, Sun Mi;Park, Young Sik;Lee, Chang-Hoon;Cho, Jaeyoung
    • Tuberculosis and Respiratory Diseases
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    • 제84권4호
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    • pp.291-298
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    • 2021
  • Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a standard diagnostic method for mediastinal and hilar lymphadenopathy. Although rare, fatal infectious complications can occur following EBUS-TBNA. However, to date, there is a lack of effective preventive strategies to reduce these complications. We started a trial to investigate the effect of chlorhexidine mouthrinse on the prevention of microbial contamination during EBUS-TBNA. Methods: This study is a single-center, parallel-group, assessor-blinded randomized controlled trial (RCT). We will enroll 112 adult participants undergoing EBUS-TBNA using a convex probe, and randomly assign them to two groups at a 1:1 ratio. The intervention group will gargle for 1 minute with 100 mL of 0.12% chlorhexidine gluconate before EBUS-TBNA, while the control group will have no mouthrinse before the procedure. Immediately after completion of EBUS-TBNA on all targeted lesions with an aspiration needle, a needle wash sample will be taken by instilling 5 mL of sterile saline into the used needle. The primary outcome is colony forming unit (CFU) counts in aerobic cultures of the needle wash samples. Secondary outcomes are CFU counts in anaerobic cultures, fever within 24 hours after EBUS-TBNA, and infectious complications within 4 weeks after EBUS-TBNA. Conclusion: This trial was designed as the first RCT to investigate the effect of chlorhexidine mouthrinse on the prevention of microbial contamination during EBUS-TBNA. Results from this trial can provide clinical evidence for a simple, safe, and cost-effective strategy to prevent infectious complications following EBUS-TBNA (ClinicalTrials.gov ID: NCT04718922, registered on 22 January 2021).

Radial Probe Endobronchial Ultrasound Using Guide Sheath-Guided Transbronchial Lung Biopsy in Peripheral Pulmonary Lesions without Fluoroscopy

  • Hong, Kyung Soo;Ahn, Heeyun;Lee, Kwan Ho;Chung, Jin Hong;Shin, Kyeong-Cheol;Jin, Hyun Jung;Jang, Jong Geol;Lee, Seok Soo;Jang, Min Hye;Ahn, June Hong
    • Tuberculosis and Respiratory Diseases
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    • 제84권4호
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    • pp.282-290
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    • 2021
  • Background: Radial probe endobronchial ultrasound-guided transbronchial lung biopsy (RP-EBUS-TBLB) has improved the diagnostic yield of bronchoscopic biopsy of peripheral pulmonary lesions (PPLs). The diagnostic yield and complications of RP-EBUS-TBLB for PPLs vary depending on the technique, such as using a guide sheath (GS) or fluoroscopy. In this study, we investigated the utility of RP-EBUS-TBLB using a GS without fluoroscopy for diagnosing PPLs. Methods: We retrospectively reviewed data from 607 patients who underwent RP-EBUS of PPLs from January 2019 to July 2020. TBLB was performed using RP-EBUS with a GS without fluoroscopy. The diagnostic yield and complications were assessed. Multivariable logistic regression analyses were used to identify factors affecting the diagnostic yields. Results: The overall diagnostic accuracy was 76.1% (462/607). In multivariable analyses, the size of the lesion (≥20 mm; odds ratio [OR], 2.06; 95% confidence interval [CI], 1.27-3.33; p=0.003), positive bronchus sign in chest computed tomography (OR, 2.30; 95% CI, 1.40-3.78; p=0.001), a solid lesion (OR, 2.40; 95% CI, 1.31-4.41; p=0.005), and an EBUS image with the probe within the lesion (OR, 6.98; 95% CI, 4.38-11.12; p<0.001) were associated with diagnostic success. Pneumothorax occurred in 2.0% (12/607) of cases and chest tube insertion was required in 0.5% (3/607) of patients. Conclusion: RP-EBUS-TBLB using a GS without fluoroscopy is a highly accurate diagnostic method in diagnosing PPLs that does not involve radiation exposure and has acceptable complication rates.

Central Sarcopenia, Frailty and Comorbidity as Predictor of Surgical Outcome in Elderly Patients with Degenerative Spine Disease

  • Kim, Dong Uk;Park, Hyung Ki;Lee, Gyeoung Hae;Chang, Jae Chil;Park, Hye Ran;Park, Sukh Que;Cho, Sung Jin
    • Journal of Korean Neurosurgical Society
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    • 제64권6호
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    • pp.995-1003
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    • 2021
  • Objective : People are living longer and the elderly population continues to increase. The incidence of degenerative spinal diseases (DSDs) in the elderly population is quite high. Therefore, we are facing more cases of DSD and offering more surgical solutions in geriatric patients. Understanding the significance and association of frailty and central sarcopenia as risk factors for spinal surgery in elderly patients will be helpful in improving surgical outcomes. We conducted a retrospective cohort analysis of prospectively collected data to assess the impact of preoperative central sarcopenia, frailty, and comorbidity on surgical outcome in elderly patients with DSD. Methods : We conducted a retrospective analysis of patients who underwent elective spinal surgery performed from January 1, 2019 to September 30, 2020 at our hospital. We included patients aged 65 and over who underwent surgery on the thoracic or lumbar spine and were diagnosed as DSD. Central sarcopenia was measured by the 50th percentile of psoas : L4 vertebral index (PLVI) using the cross-sectional area of the psoas muscle. We used the Korean version of the fatigue, resistance, ambulation, illnesses, and loss of weight (K-FRAIL) scale to measure frailty. Comorbidity was confirmed and scored using the Charlson Comorbidity Index (CCI). As a tool for measuring surgical outcome, we used the Clavien-Dindo (CD) classification for postoperative complications and the length of stay (LOS). Results : This study included 85 patients (35 males and 50 females). The mean age was 74.05±6.47 years. Using the K-FRAIL scale, four patients were scored as robust, 44 patients were pre-frail and 37 patients were frail. The mean PLVI was 0.61±0.19. According to the CD classification, 50 patients were classified as grade 1, 19 as grade 2, and four as grade 4. The mean LOS was 12.35±8.17 days. Multivariate stepwise regression analysis showed that postoperative complication was significantly associated with surgical invasiveness and K-FRAIL scale. LOS was significantly associated with surgical invasiveness and CCI. K-FRAIL scale showed a significant correlation with CCI and PLVI. Conclusion : The present study demonstrates that frailty, comorbidity, and surgical invasiveness are important risk factors for postoperative complications and LOS in elderly patients with DSD. Preoperative recognition of these factors may be useful for perioperative optimization, risk stratification, and patient counseling.

주사기를 이용한 상악동 거상술 시 발생한 실신 및 종격동기종에 관한 증례보고 (Syncope and pneumomediastinum during the maxillary sinus elevation with an air-syringe: a case report)

  • 김수완;이종근;송지영
    • 구강회복응용과학지
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    • 제37권3호
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    • pp.171-176
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    • 2021
  • 종격동기종은 치과 영역에서 매우 드물고 잠재적으로 위험한 합병증이다. 이의 흔한 원인으로는 핸드피스와 고압 공기/물 주사기를 사용하는 발치, 근관치료, 잇몸 밑 치은연하 소파술 등이 있다. 본 증례는 임플란트 식립을 위한 전 치료로 주사기를 이용하여 상악동에 골이식을 시행받은 61세 여자에게서 발생한 대량의 종격동기종과 피하기종의 증례이다. 환자는 치료 도중 갑작스럽게 발생한 구강 통증과 함께 의식 소실이 발생하였고, 응급실로 전원 되었다. 영상학적 검사상 종격동기종과 함께 얼굴과 목부위 전체에 피하기종이 발견되었다. 예방적 항생제, 산소 흡입, 금식 등의 보존적 치료가 이루어졌고, 합병증 없이 7일 만에 퇴원하였다. 환자의 실신은 시술 중 상악동 천공 후 과량의 공기유입으로 인해 발생한 종격동기종에 의해 순간적인 강한 흉부 압박으로 혈압 감소와 통증 쇽에 의한 것으로 생각된다. 치과 치료 중 환자가 의식을 잃었다면 기도 폐쇄의 위험성이 있기 때문에 종격동기종을 즉각적으로 감별하고 치료해야 한다.

Initial Experience of Transperineal Biopsy After Multiparametric Magnetic Resonance Imaging in Korea; Comparison With Transrectal Biopsy

  • Yoon, Sung Goo;Jin, Hyun Jung;Tae, Jong Hyun;No, Tae Il;Kim, Jae Yoon;Pyun, Jong Hyun;Shim, Ji Sung;Kang, Sung Gu;Cheon, Jun;Lee, Jeong Gu;Kim, Je Jong;Sung, Deuk Jae;Lee, Kwan Hyi;Kang, Seok Ho
    • 대한비뇨기종양학회지
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    • 제16권3호
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    • pp.110-118
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    • 2018
  • Purpose: The aim of this study is to confirm the detection rate of transperineal biopsy after multiparametric magnetic resonance imaging (mpMRI) and compared it to that of transrectal biopsy. We also examined the role of mpMRI and the rate of complications for each method. Materials and Methods: In a retrospective study, we analyzed 147 patients who underwent mpMRI before prostate biopsy because of elevated serum prostate-specific antigen and/or abnormal digital rectal examination findings at Korea University Hospital, Seoul, Korea from March 2017 to April 2018. Regions on the mpMRI that were suggestive of prostate cancer were categorized according to the Prostate Imaging-Reporting and Data System (PI-RADS v2). For transperineal biopsy, a 20-core saturation biopsy was performed by MRI-TRUS cognitive or fusion techniques and a 12-core biopsy was performed in transrectal biopsy. Results: Sixty-three and 84 patients were enrolled in transperineal group and transrectal group, respectively. The overall detection rate of prostate cancer in transperineal group was 27% higher than that in transrectal group. Classification according to PI-RADS score revealed a significant increase in detection rate in all patients, as the PI-RADS score increased. Frequency of complications using the Clavien-Dindo classifications revealed no significant differences in the total complications rate, but two patients in transrectal group received intensive care unit care due to urosepsis. Conclusions: Our results confirmed that transperineal biopsy is superior to transrectal biopsy for the detection of prostate cancer. From the complication point of view, this study confirmed that there were fewer severe complications in transperineal biopsy.