• 한국군사과학기술학회지
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• 제11권6호
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• pp.142-147
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• 2008

The current study investigated the causality between the musculoskeletal injuries of the patients who visited our military hospital and their military-related activities. The surgeon diagnosed the patients and let them answer the questionnaire on pain and causes from April 1, 2008 to May 30, 2008. The included 287 male patients were mean 21 years old(mean height 175 cm and mean weight 69.4Kgf). The visiting time after injury was mean 53 days. The visual analog scale of pain was mean 5.1 points. The 30% of visiting patients answered the most common cause of injury was the military training. The Most common site of injury was the knee, in 38% of patients(111 of 287). Seventy two percent of patients suspected the causality between their injuries and military activities. In military activities, a special stretching program before training, especially for the knee, is required to reduce musculoskeletal injuries. And, the injured military people have to access the medical treat as soon as possible.

• 의료법학
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• 제17권2호
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• pp.57-81
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• 2016

환자가 의사를 상대로 의료사고에 대한 민사책임을 추궁하기 위하여 소송을 제기하게 될 때, 의사의 의료과실과 환자에게 발생한 손해 사이에 인과관계가 존재하는지 여부는 소송의 승패를 좌우한다. 의료과실소송에서는 의료가 지니는 특수성으로 인하여 다른 민사사건과 달리 인과관계의 존부의 판단이 쉽지 않다. 또한 의료과실소송에서는 진료기록을 비롯한 정보가 의사에게 집중되어 있고, 환자의 의료지식은 의사에 비하여 상대적으로 부족하다. 따라서 원고인 환자가 부담하는 인과관계에 관한 증명책임의 완화가 판례를 통하여 인정되고 있다. 이에 본고에서는 우리나라에서 의료민사책임에서 인과관계를 어떻게 인정하는지에 관한 법리를 살펴보고자 한다. 그리고 우리나라 판례의 태도를 인과관계가 문제되는 유형별 - 일반적 의료행위의 경우, 설명의무의 경우, 의료과실과의 인과관계가 없는 경우 - 로 나누어 고찰하기로 한다.

• 한국환경보건학회지
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• 제47권3호
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• pp.193-204
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• 2021

Objectives: In January 2021, the former heads of the manufacturer SK Chemical and the vendor Aekyung were acquitted for manufacturing and selling humidifier disinfectant (HD) containing 5-chloro-2-methylisothiazol-3(2H)-one/2-methylisothiazol-3(2H)-one (CMIT/MIT). In this article, we analyzed the rationale used in this judgement in the light of scientific consideration. Methods: The sentencing document for the judgements was obtained from the Korea Supreme Court Service. In particular, the judgements made by the court related to the toxicological and individual association with HD perspectives were discussed based on scientific evidence. Results: The ruling stated that the necessary conditions for causality between CMIT/MIT and such diseases were not met based on the fact that asthma and lung damage were not found in the inhalation exposure animal experiments. The judgment overlooked the inevitable limitations of using animal experiments for verifying health effects in humans, which are often inconsistent with the observations in animals. Among 11 governmentaffirmed lung injury cases with CMIT/MIT usage, three patients' humidifier disinfectant-associated lung injury (HDLI) pathology proved that CMIT/MIT could cause lung injury similar to that caused by PHMG and PGH. In addition, five children showed decreased lung function related to damage caused by humidifier disinfectant exposure. Conclusions: We conclude that there is sufficient evidence supporting the assertion that HDs containing CMIT/MIT cause lung injuries, including asthma, contrary to the court's decision.

• 의료법학
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• 제9권2호
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• pp.383-422
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• 2008

Considering above, It might be efficient that medical disputes would be settled by the intervention, the agreement, and the administrative relief that reflect mediators' opinion, who have rich social experience as well as specialized knowledge. Therefore, KCA needs to strengthen its function of mediation and improve relevant systems to become an effective settlement institution. And although Oriental medicine disputes have mainly given ex post facto explanations so far, administrative efforts such as policy development or legislation should be made for the high quality of Oriental medical services offered because an efficient way saving social or economic costs caused by the dispute would be precautionary measures. The traditional Oriental medicine is featured with the lack of baseline examination, the uncertainty of medical mistakes, the difficulty in clarifying and proving facts, the hardship of injury conformation and causality because of the characteristics of Oriental medicine, and the relative lightness of physical damages. Actually, there has been few legal settlements in Oriental medical disputes since the compensation, itself, compared to the lawsuit cost, is relatively much lower without practical benefits.

• Journal of Yeungnam Medical Science
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• 제37권1호
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• pp.2-12
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• 2020

Drug-induced liver injury (DILI), including herbal and dietary supplement hepatotoxicity, is often passed lightly; however, it can lead to the requirement of a liver transplant or may even cause death because of liver failure. Recently, the American College of Gastroenterology, Chinese Society of Hepatology and European Association for the Study of the Liver guidelines for the diagnosis and treatment of DILI have been established, and they will be helpful for guiding clinical treatment decisions. Roussel Uclaf Causality Assessment Method scoring is the most commonly used method to diagnose DILI; however, it has some limitations, such as poor validity and reproducibility. Recently, studies on new biomarkers have been actively carried out, which will help diagnose DILI and predict the prognosis of DILI. It is expected that the development of new therapies such as autophagy inducers and various other technologies of the fourth industrial revolution will be applicable to DILI research.

• 대한한방내과학회지
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• 제40권6호
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• pp.1035-1042
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• 2019

Background: Herbal medication is widely used in the Korean Medicine Hospital, and drug-induced liver injury (DILI) in Korea has increased proportionally. Herb-induced liver injury now accounts for approximately 40% of cases of hepatotoxicity in Korea, according to research data. Currently, however, the component responsible for the toxicity is usually unknown or can only be suspected. Objective: To study the hepatotoxicity of Cheongsimyeonja-tang in DILI. Methods: A retrospective review was conducted of 82 inpatients between April 2010 and March 2017 with suspected drug-induced liver injury (n=5). The standard criteria (RUCAM scale) for drug-induced liver injury (DILI) were applied. The electronic medical records (EMRs) were retrospectively reviewed to identify the relevant database. Aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and total bilirubin (T. Bili) were analyzed in blood samples before and after the administration of Cheongsimyeonja-tang. Results: Five cases out of 82 patients had a criterion-referenced probable (RUCAM) score ranging from 6 to 8 points DILI. However, statistical analysis of the liver function parameters results of the 82 patients did not show a statistically meaningful elevation after taking Cheongsimyeonja-tang. Conclusions: These data suggest a relationship between Cheongsimyeonja-tang and DILI. More studies are needed to validate these observations and to explore their implications.

• 사상체질의학회지
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• 제21권3호
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• pp.209-215
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• 2009

1. Objects: This case study reports a liver injury in treatment of constipation with Yeoldahanso-tang plus Rheum rhabarbarum. 2. Methods: The patient's subjective symptoms and the laboratory data including aspartate transaminase(AST), alanine transaminase(ALT), alkaline phosphatase(ALP), and gamma($\gamma$)-glutamyl transpeptidase(GGT) were observed before and after liver injury. We used the Roussel Uclaf Causality Assessment Method(RUCAM) scale in order to find out whether if Yeoldahanso-tang plus Rheum rhabarbarum was related with the liver injury. 3. Results: The patient's AST and ALT were elevated more than twice after a 3week administration period of herbal medicine. After discontinuation of the herbal medicine and administration of hepatic protective medication, AST and ALT decreased. The patient's general condition improved during hospitalization. The RUCAM score was estimated at 8. 4. Conclusions: This case is presented to bring more attention to the toxicity of herbal medicine.

• 대한한방내과학회지
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• 제30권1호
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• pp.181-190
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• 2009

It is important to establish the safety of herbal medicine because of its frequent and widespread use in Korea. Several studies on the safety of herbal medicine have been performed and there have been rare serious adverse drug reactions from those reports in Korea. However, the results are not strongly supported because of not adopting appropriate enough research methodology as to make the safety issue clear. For improving the quality of the safety research on herbal medicine. including investigations of drug induced liver injury (DILl). the aim of this study was to suggest herbal medicine-induced liver injury investigation forms for performing reasonable safety research. After a systematic review of the preceding studies regarding herbal safety in Korea was performed in 2008, we assessed the quality and the limitations of the primary studies. Two investigation forms for herbal safety research were made as a following step. one a basic investigation form for herbal safety research and the other an advanced investigation form for suspected DILl cases, Those forms include the essential informations and data needed to make an appropriate assessment of whether DILl occurred during or after the use of herbal medicine. Guidelines for using those forms and other recommendations were also suggested. More rigorous studies are required for answering the safety issue of herbal medicine as well as the efficacy issue. We hope for wide use and improvement of those investigation forms in the study of herbal safety by many researchers for establishing better evidences in Korea.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권5호
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• pp.288-298
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• 2017

Craniomaxillofacial injuries produce complex wound environments involving various tissue types and treatment strategies. In a clinical setting, care is taken to properly irrigate and stabilize the injury, while grafts are molded in an attempt to maintain physiological functionality and cosmesis. This often requires multiple surgeries and grafts leading to added discomfort, pain and financial burden. Many of these injuries can lead to disfigurement and resultant loss of system function including mastication, respiration, and articulation, and these can lead to acute and long-term psychological impact on the patient. A main causality of these issues is the lack of an ability to spatially control pre-injury morphology while maintaining shape and function. With the advent of additive manufacturing (three-dimensional printing) and its use in conjunction with biomaterial regenerative strategies and stem cell research, there is an increased potential capacity to alleviate such limitations. This review focuses on the current capabilities of additive manufacturing platforms, completed research and potential for future uses in the treatment of craniomaxillofacial injuries, with an in-depth discussion of regeneration of the periodontal complex and teeth.

• 대한한의학회지
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• 제26권2호
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• pp.152-165
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• 2005

Background: The use of herbal preparations as remedies for various medical conditions has continuously increased in Korea Large proportions of Korean patients use herbal medicinal products, folk remedies, and food supplements. However, studies on the safety of herbal products arc conducted on a less than sufficient basis even in the countries like Korea where herbal medicine is being used extensively. Some of the reports on the safety of herbs were done by the doctors of western medicine but lack of knowledge and misclassification led to misunderstandings. Objecitves: This study aims to review the recent evidences on hepatotoxic events associated with the use of herbal medicinal products, folk remedy, and food supplements. In the process, this review will grasp trends in this field of studies and will direct further researches into the right direction. Methods: Systematic literature searches were performed on MedRic and MEDLIS in Korea. Screening and selection of the articles and the extraction of data were performed independently by two of authors. There were no restrictions regarding the published date. In order to avoid bias, the articles written by medical doctors, not by oriental doctors were selected. 43 journals were chosen for the review. Results: Analyzing the number of journals, studies on the drug-induced liver injury were increased after the year 2000. The proportion of herbal and folk remedy associated hepatotoxic injuries in all drug-induced liver injury was $21.0\%-30.0\%$. But criterion for herbal medicine is rather vague and limited objective data hindered objectiveness. Few of single medicinal herbs and combination preparations were associated with hepatotoxic injuries. But because of lack of objectivity, further researches must be conducted to yield more concrete results. Conclusions: yield more concrete results. Incidence figures are largely unknown, and in most cases a causal attribution is not established. The challenge for the future is to systematically research this area, educate all parties involved, and minimize patient risks.