Yoon-Ho Alex Lee

A new surgical treatment of keloid : Keloid core excision

Keloids and hypertrophic scars result from excessive collagen deposition, the cause of which is not yet known. Unlike hypertrophic scars, keloids frequently persist at the site of injury, often recur after excision and always overgrow the boundaries of the original wound. There have been many trials to control keloids, but most of them have been unsuccessful. The authors propose a new surgical technique to treat keloids and name it keloid core extirpation. They excise the inner fibrous core from the keloid and cover the defect with a keloid rind flap, which is arterialized by the subcapsular vascular plexus. The authors treated 24 keloids of the ear, trunk, face, and genitalia with keloid core excision. Four cases of partial rind flap congestion or necrosis occurred. Those patients who healed primarily after surgery showed no evidence of keloid recurrence as long as they were followed. The authors have found the keloid core extirpation technique to be excellent in preventing keloid recurrence, with no adjuvant therapy after surgery.

Inferences from Litigated Cases

Priest and Klein argued in 1984 that, because of selection effects, the percentage of litigated cases won by plaintiffs will not vary with the legal standard. Many researchers thereafter concluded that one could not make valid inferences about the character of the law from the percentage of cases plaintiffs won, nor could one measure legal change by observing changes in that percentage. This article argues that, even taking selection effects into account, one may be able to make valid inferences from the percentage of plaintiff trial victories, because selection effects are partial. Therefore, although selection mutes changes in the plaintiff trial win rate, it does not make the win rate completely invariant to legal change. This article shows that inferences from litigated cases may be possible under the standard screening and signaling models of settlement, as well as under Priest and Klein’s original divergent-expectations model.

Reconstruction of defects after excision of facial skin cancer using a venous free flap.

After extensive excision of skin cancer on the face, or when skin cancer is located on the 3-dimensional structures of the face, reconstruction with a local flap can be impossible, or clinicians are reluctant to reconstruct defects with a skin graft because of postoperative contraction, hyperpigmentation, or other complication. Instead, an arterialized venous free flap can be used as an alternative method of reconstruction to prevent distortion and recurrence. Eight patients underwent surgery with an arterialized venous-free flap. We evaluated the cosmetic results using ordinary scale methods on the basis of 4 categories (color, contour, texture, and distortion of surrounding structures) and recurrence and metastases of skin cancer physically. The follow-up period ranged between 24 and 48 months, with an average of 33 months. All of the soft-tissue defects made by excising the tumor were reconstructed with good outcomes, except for 1 case. Regarding the cosmetic evaluation, the color was fair, the contour and texture were good, absence of distortion of surrounding structures was excellent, and the overall results in most all cases were good. There were no recurrences or metastases during the follow-up period. The arterialized venous free flap is an alternative plan among several reconstruction methods when skin cancer on the face is extensively excised.

Updating Priest and Klein

In their 1984 article, “The Selection of Disputes for Litigation,” Priest and Klein famously hypothesized a “tendency toward 50 percent plaintiff victories” among litigated cases. Nevertheless, many scholars doubt the validity of their conclusions, because the model they relied upon does not meet modern standards of rigor. This article updates the Priest-Klein model by considering three modifications. First, we raise a novel critique of the Priest-Klein model — that it is non-Bayesian — and show that most of the results of Priest and Klein (1984) pertaining to limits nevertheless remain valid under a modified model in which parties use Bayes’ rule to refine their estimates of the plaintiff’s probability of prevailing. Second, we show that even when an incentive-compatible mechanism is imposed, many of the results remain valid for symmetric Nash equilibria. Finally, we show how the Priest-Klein model can be modified to analyze asymmetric information, show that most results are false under this modification, and compare the modified Priest-Klein model to standard asymmetric information models.

Maybe there Is No Bias in the Selection of Disputes for Litigation

New York “closing statement�? data provide unique insight into settlement and selection. The distributions of settlements and adjudicated damages are remarkably similar, and the average settlement is very close to the average judgment. One interpretation is that selection effects may be small or non-existent. Because existing litigation models all predict selection bias, we develop a simple, no-selection-bias model that is consistent with the data. Nevertheless, we show that the data can also be explained by generalized versions of screening, signaling, and Priest-Klein models.

Litigation and Selection with Correlated Two-Sided Incomplete Information

This article explores the selection of disputes for litigation in a setting with two-sided incomplete information and correlated signals. The models analyzed here suggest that Priest and Klein’s conclusion that close cases are more likely to go to trial than extreme cases remains largely valid when their model is interpreted as involving correlated, two-sided incomplete information and is updated (i) to incorporate take-it-or-leave-it offers or the Chatterjee-Samuelson mechanism, (ii) to take into account the credibility of the plaintiff’s threat to go to trial, and (iii) to allow parties to make sophisticated, Bayesian inferences based on knowledge of the distribution of disputes. On the other hand, Priest and Klein’s prediction that the plaintiff will win fifty percent of litigated cases is sensitive to bargaining and parameter assumptions.

The Efficiency Criterion for Securities Regulation: Investor Welfare or Total Surplus?

Recent regulatory debates among legislators and legal scholars have centered on whether independent agencies should be subjected to a more rigorous cost-benefit analysis requirement than their current mandates, or alternatively, whether they should be required to conduct cost-benefit analyses that conform to the Office of Management and Budget’s guidance under Circular A-4, as many executive agencies already do. This Article closely examines the way in which one particular agency — the Securities and Exchange Commission (“SEC�?) — conducts its economic analysis in rulemaking. The SEC’s economic analysis, conducted pursuant to a statutory mandate to consider the effects on “efficiency, competition, and capital formation,�? is essentially an investor welfare analysis: it considers how the rule would benefit investors and then considers the out-of-pocket compliance costs that regulated entities would incur. Circular A-4, by contrast, recommends a total surplus approach: a rule’s benefits and costs are considered from the perspective of all stakeholders in the affected sectors, without making any value judgment as to which parties are more deserving of surpluses. The current debates therefore raise an urgent policy question for the SEC with regard to the proper criterion of efficiency for its rules: whether it should continue to consider the costs and benefits of its rules from the perspective of investors only, or whether it should instead consider them from the perspective of total surplus. This Article raises four points in considering this question. First, because the two approaches provide conflicting standards as to the efficiency determination, arguments to impose additional burdens on the economic analysis for SEC rules are unlikely to be constructive unless parties can first agree upon the relevant efficiency criterion for securities regulation. The efficiency-criterion question must therefore be considered prior to the procedural question. Second, because Circular A-4 considers a broader spectrum of costs and benefits, those concerned exclusively with investors’ economic welfare should have reasons to object to, rather than support, its application to SEC rules. Third, despite such reasons, there is nevertheless a case for preferring Circular A-4’s approach because, if used properly, it offers several important benefits from a broader policy perspective. Finally, because the SEC has broad rulemaking authority and is not in fact constrained by an obligation to justify all of its rules on efficiency grounds, if the SEC seeks to protect investors’ economic interests at the expense of other stakeholders, it should be both more transparent and aggressive in adopting such rules for non-efficiency purposes that would qualify as “compelling public needs.�?

To Empower, Prohibit, or Delegate?: Regulatory Strategies for the Consumer Credit Market

Much has been written about the state of U.S. consumer credit market. In this Article, we provide an overview of the scholarship in this area and an interim diagnosis of the market failure. We identify the chief problem as various epistemic failures on the consumers’ part, which lead to poor competitive dynamics and are perpetuated in turn as a result of insufficient competition. From an economic perspective, the government has several avenues of enhancing consumer welfare. Based on a cost-effectiveness framework – which asks how decision-making powers should be allocated among the consumer, the government, and other parties – we highlight empowerment, prohibition, and delegation as three regulatory approaches the government has in addressing these failures. We argue that the current regulation, consisting largely of variations of empowerment and prohibition, neglects the dynamic aspect of the consumer credit market. Given the market’s constantly evolving nature, we believe a well-structured delegation is a potentially powerful approach to enhancing consumer welfare. The provisions of the recently enacted Dodd-Frank Act are generally a step in the right direction. While the Act does not go far enough in certain directions, we argue that it does grant wide discretion to the Bureau of Consumer Financial Protection to pursue more creative avenues, including possibly those along the lines of delegation, as we suggest.

The Harm in Social Stigma: An Educational Rat-Race Game

I consider a variation of Michael Spences job market signaling game with a continuum of actors and discrete levels of education. I analyze the harm in social stigma by examining the effect of introducing a negative shock to the utility levels of the least educated members of society, compared to a world without stigma. When a stigma attaches to the bottom group, every individual - educated or not - in society suffers a welfare loss due to either lowered wages or higher signaling costs. This reduction in social welfare is due to the externality arising from the rat-race aspect of education. Significantly, in many instances the welfare loss from social stigma is not simply redistributed across all individuals but is magnified at equilibrium. Finally, I modify the model to consider the harm in social prestige and conclude that societys intangible reward for the social elite, too, may bring about overall welfare loss.