A theoretical study advocated for alleviating the worker's responsibility of burden of proof to establish the causality of an occupational disease, since such a responsibility is unfair to the worker. The recent judgment has adopted some of these arguments for alleviating the worker's responsibility of burden of proof, and the judgment is significant since it is the first Supreme Court decision to recognize the causality of occupational diseases. The judgment expressly confirms that it is more proactive to recognize the causal relationship between work and certain diseases, and to provide compensation for industrial accidents to employees who are exposed to harmful substances at all times. In addition, the judgment also confirms that coverage of industrial safety and health risks is in accordance with the original purpose and function of the industrial accident insurance system, which aims to share risks through public insurance.

A theoretical study advocated for alleviating the worker's responsibility of burden of proof to establish the causality of an occupational disease, since such a responsibility is unfair to the worker. The recent judgment has adopted some of these arguments for alleviating the worker's responsibility of burden of proof, and the judgment is significant since it is the first Supreme Court decision to recognize the causality of occupational diseases. The judgment expressly confirms that it is more proactive to recognize the causal relationship between work and certain diseases, and to provide compensation for industrial accidents to employees who are exposed to harmful substances at all times. In addition, the judgment also confirms that coverage of industrial safety and health risks is in accordance with the original purpose and function of the industrial accident insurance system, which aims to share risks through public insurance.
Accidents, Occupational ; Compensation and Redress ; Insurance ; Judgment ; Models, Theoretical ; Occupational Diseases ; Supreme Court Decisions

Surgical endarterectomy has been shown to be superior to medical treatment in the management of severe carotid stenosis. Endarterectomy, although effective, does have limitations, and percutaneous transluminal angioplasty with stent may offer an alternative modality of treatment. We report on a patient with severe coronary disease that femoral arterial cannulation was not possible due to aorto-femoral shunt operation and absent pulse. The transradial approach was used for aortography, bilateral carotid angiography and successful elective stent deployment in the left internal carotid artery. The transradial approach might be useful alternative in case of problems with femoral approach.
Angiography ; Angioplasty* ; Aortography ; Carotid Arteries* ; Carotid Artery, Internal ; Carotid Stenosis* ; Catheterization ; Coronary Disease ; Endarterectomy ; Humans ; Stents*

BACKGROUND: This study was aimed to investigate the perception on working conditions and utilization of clinical research coordinators (CRCs) among investigators and sponsors. METHODS: The participants of this cross-section study were 114 investigators and 138 sponsors including clinical research associates (CRAs) who have worked with CRCs. Data was collected with paper or electronic form of self-administered questionnaires and analyzed with descriptive statistics and chi2 test or t test. RESULTS: Among investigators and sponsors, 56.1 % and 95.0 % perceived regular full-time positions as proper type of CRC employment, respectively. Those who perceived monthly salary with incentive as proper payment system were 67.5 % of investigators and 68.8 % of sponsors. The proper salary for 2-year CRCs and 5-year CRCs were significantly higher in sponsors than investigators. Investigators perceived CRCs could handle 3 studies as the same time and 5 studies per year. In regard to the difficulty in utilizing CRCs, 68.4 % of investigators perceived lack of experienced CRCs and 84.8 % of sponsors did frequent turnover. Those who responded pooling CRCs by hospital or clinical trial centers as a good solution to hire CRCs easily were 81.6 % of investigators and 58.0 % of sponsors. CONCLUSION: Almost all investigators and sponsors perceived CRCs were helpful for improving the quality of clinical trials. We recommend each institution or clinical trial centers could introduce the central CRCs' employment and management with proper salary and workload based on the results to maintain experienced CRCs and lessen the turnover of CRCs.
Calcium Hydroxide ; Electronics ; Electrons ; Employment ; Humans ; Motivation ; Surveys and Questionnaires ; Research Personnel ; Salaries and Fringe Benefits ; Zinc Oxide

Coronary stent embolization is a rare event but may result in clinically relevant cardiac ischemia or peripheral embolization during the procedure. We report a case of systemic embolizations of two coil stents during the primary PTCA in acute myocardial infarction, who were treated successfully with a double wire helix technique and a gooseneck snare. Although in our experience this rare complication did not produce any clinical complications, care should be taken to prevent this possibility, especially in patients with significant vessel tortuosity, calcification, total occlusion, or mild stenosis proximal to the target lesion.
Constriction, Pathologic ; Humans ; Iliac Artery* ; Ischemia ; Myocardial Infarction ; SNARE Proteins ; Stents*

Sweet's syndrome is a rare disorder presenting with painful erythematous plaques or nodules of the skin with fever, leukocytosis, arthralgia and conjunctivitis.Sweet's syndrome occurs in association with malignant tumors in 10~20% of cases. Eighty five percent of the malignant tumors are hematologic malignancies, acute myelogenous leukemia being most common. Sweet's syndrome occurring in a patient with solid tumor is rare and pulmonary involvement of Sweet's syndrome occurring in a patient with a solid tumor has not been reported in world literature so far. We report a case of Sweet's syndrome presenting with pulmonary nodules in a patient with hepatocellular carcinoma.
Arthralgia ; Carcinoma, Hepatocellular ; Fever ; Hematologic Neoplasms ; Humans ; Leukemia, Myeloid, Acute ; Leukocytosis ; Skin ; Sweet Syndrome*

BACKGROUND AND OBJECTIVES: Despite the proven benefit of cholesterol- lowering therapy in patients with CAD, there is no consensual opinion on guideline of cholesterol-lowering therapy in patients with CAD in Korea. The aim of this study is to evaluate the risk of CAD according to the cholesterol level and to consider current guideline of cholesterol-lowering therapy for the secondary prevention in patients with CAD. MATERIALS AND METHODS: Consecutive 600 patients were assigned into two groups - coronary artery disease group (364 patients) and normal coronary artery group (236 patients) - depending on the coronary angiographic findings. Lipid profiles (total cholesterol, Triglyceride, HDL-cholesterol, LDL-cholesterol) were obtained and the odd ratio of CAD was evaluated according to the national cholesterol education program treatment guideline (NCEP: LDL cholesterol > or = 130 mg/dl) and the national heath insurance treatment guideline (NHI: total cholesterol > or = 220 mg/dl) by multi-variate logistic regression analysis. RESULTS: According to the NHI and NCEP guideline, the proportion of patients with CAD indicated on cholesterol-lowering therapy were 25%, 36.5% respectively and the odd ratio of CAD was 1.00 (95% CI 0.52 - 1.89, p=0.99), 4.89 (95% CI 2.78 - 8.60, p< 0.01) respectively . CONCLUSIONS: Our data showed that LDL-cholesterol > or = 130 mg/dl only reflected the risk of CAD in both guidelines and more proportion of the patients were indicated on cholesterol-lowering therapy in NCEP guideline than in NHI guideline.
Cholesterol ; Cholesterol, LDL ; Coronary Artery Disease* ; Coronary Vessels* ; Education ; Humans ; Insurance ; Korea ; Logistic Models ; Secondary Prevention ; Triglycerides

Abscess ; Adolescent ; Body Mass Index ; Child ; Classification ; Colonic Diseases ; Crohn Disease ; Diagnosis ; Europe ; Fistula ; Humans ; Inflammatory Bowel Diseases ; Korea ; Male ; Pediatrics ; Phenotype ; Retrospective Studies

Recombinant activated factor VII (rFVIIa, NovoSeven (R)) was initially developed for the treatment of bleeding in patients with hemophilia having antibodies against factor VIII or IX, and factor VII deficiency. Although the precise mode of action is still elusive and there are just several hypotheses, recently case reports have suggested a role of rFVIIa in the management of intractable or life-threatening bleeding in some non-hemophilic patients who do not respond to conventional treatments. We report the successful use of rFVIIa in a pediatric patient with intractable gastrointestinal bleeding.
Antibodies ; Factor VII Deficiency ; Factor VIIa* ; Factor VIII ; Gastrointestinal Hemorrhage* ; Hemophilia A ; Hemorrhage ; Humans

BACKGROUND AND OBJECTIVES: Practical concerns about transradial approach are increasing in consideration of high procedural success rate, low local complications, and patient's convenience. There was no available data about repeated-use of radial artery for coronary procedures. We evaluate the changes of radial arterial diameter and procedural outcomes of repeated transradial procedure. MATERIALS AND METHOD: Of consecutive 1771 transradial coronary procedures, 117 patients received repeated transradial procedures through the same radial artery. Radial arterial diameter, vascular access time and procedural outcomes were evaluated in between the group of first-use and repeated-use of radial artery. RESULTS: Among 117 patients of second transradial coronary procedure in the repeated-use group, 47 patients (41.6%) underwent coronary intervention and 66 patients (58.4%) underwent coronary angiography. The right radial approach was used in 82.9% of the cases. There was no significant difference in radial artery mean diameter between pre-procedure and 1 day after procedure in patients with first-use and repeated-use group. There was no significant change of radial arterial diameter after first-use depending on the SAR (the ratio of sheath outer diameter to radial artery inner diameter). However, after repeated-use of radial artery, there was significant reduction of radial arterial diameter 1 day after procedure in the patients with SAR more than 0.9 (p<0.05). In repeated-use group, the mean radial arterial diameter was 2.63 +/- 0.35mm mm before the procedure and 2.51 +/- 0.29mm during follow-up (136 +/- 123 days) (p<0.05). There was no significant difference of the vascular access time between the first-use and repeated-use procedures (2.9+/-3.1 vs 3.3+/-3.6 minutes, p<0.05). The procedural success and vascular complication rate of repeated-use of radial artery were as similar to those of the first-use, but total occlusion of radial artery was higher in the repeated-use group (2.6% vs 0.7%, p<0.05). CONCLUSION: The diameter of radial artery after transradial procedures was significantly reduced during follow-up and the incidence of asymptomatic radial artery occlusion was more frequent after repeated-use. However, repeated-use of radial artery was feasible in most patients with high procedural success rate and low vascular complications.
Coronary Angiography ; Follow-Up Studies ; Humans ; Incidence ; Radial Artery*