Dispute cases related to pain management in Korea: analysis of Korea Medical Dispute Mediation and Arbitration Agency data

Background@#Various developments in imaging techniques, interventional procedures, and medications for pain management have beneficial consequences. However, the nature of pain management often results in physicians becoming involved in medico-legal disputes with patients who purposely or accidentally bring litigation. @*Methods@#Data on medical disputes cases related to pain management were collected and analyzed through the Korea Medical Dispute Mediation and Arbitration Agency from 2012 to 2016. @*Results@#In total, we identified 210 public-disclosed cases; of these, we identified 36 cases related to pain management. The department of orthopedics (n = 9, 25%) was the most related to these pain management cases. Pain management was most commonly offered for pain in the lumbar region (n = 13, 37%), lower extremities (n = 12, 34%), and for infection (n = 7, 19%). The time spent resolving disputes ranged from 8.0 to 17.5 months and the final settlement amount ranged from 1,800,000 to 15,000,000 Korean won. Causal relationships and medical malpractice were the most common controversial subjects of legal debate. @*Conclusions@#Various characteristics of medical disputes related to pain management in Korea were identified. Information regarding medical disputes in pain management should be available to help prevent further disputes and litigation, which is also useful to both patients and pain physicians. Guidelines and recommendations for pain management are needed, especially those focused on medico-legal cases.

Aspergillus terreus JF27 Promotes the Growth of Tomato Plants and Induces Resistance against Pseudomonas syringae pv. tomato

Certain beneficial microorganisms isolated from rhizosphere soil promote plant growth and induce resistance to a wide variety of plant pathogens. We obtained 49 fungal isolates from the rhizosphere soil of paprika plants, and selected 18 of these isolates that did not inhibit tomato seed germination for further investigation. Based on a seed germination assay, we selected four isolates for further plant tests. Treatment of seeds with isolate JF27 promoted plant growth in pot tests, and suppressed bacterial speck disease caused by Pseudomonas syringae pathovar (pv.) tomato DC3000. Furthermore, expression of the pathogenesis-related 1 (PR1) gene was higher in the leaves of tomato plants grown from seeds treated with JF27; expression remained at a consistently higher level than in the control plants for 12 h after pathogen infection. The phylogenetic analysis of a partial internal transcribed spacer sequence and the β-tubulin gene identified isolate JF27 as Aspergillus terreus. Taken together, these results suggest that A. terreus JF27 has potential as a growth promoter and could be used to control bacterial speck disease by inducing resistance in tomato plants.

Control Efficacy of Streptomyces sp. A501 against Ginseng Damping-off and Its Antifungal Substance

Ginseng damping-off, caused by the fungal pathogens Rhizoctonia solani and Pythium sp., is a critical disease in ginseng seedling. In a continuing effort to find microorganisms with the potential of acting as a biocontrol agent against Rhizoctonia damping-off, we found that a Streptomyces sp. A501 showed significant antifungal activity against Rhizoctonia solani. In field experiment to test the efficacy of Streptomyces sp. A501 in controlling ginseng damping-off, the incidence of damping-off disease was meaningfully reduced when ginseng seeds were soaked in the culture broth of Streptomyces sp. A501 before sowing. To perform characterization of the antifungal compound, we isolated it from the culture broth of strain A501 through Diaion HP-20 and silica gel column chromatographies and preparative high-performance liquid chromatography. The structure of the antifungal compound was assigned as fungichromin by spectroscopic methods, mainly nuclear magnetic resonance and electrospray ionization-mass analysis.