We report a case of primary cutaneous cryptococcosis on Rt. forehead and perioral area of 57 year old woman with non-insulin dependent diabetes mellitus and Lt. cerebral infarction. She had large ulcers with yellowish purulent exudates on Rt. forehead and perioral area for 2months. A histopathological examination from the lesion showed numerous encapsulated, round spores and the organisms were identified as Cryptococcus neoformans in a series of fun-gal studies. The patient received a 5-week course of IV and oral fluconazole with resolution of her skin lesion. The patient is free of any lesion several months after completing therapy. This experience supports the use of fluconazole as initial and single therapy in primary cutaneous cryptococcosis.
Cerebral Infarction ; Cryptococcosis* ; Cryptococcus neoformans ; Diabetes Mellitus ; Exudates and Transudates ; Female ; Fluconazole* ; Forehead ; Humans ; Skin ; Spores ; Ulcer

Wilms' tumor is the most common urinary tract neoplasm and one of the most frequent solid abdominal malignant tumors of childhood, usually diagnosed between the ages of 2 and 5 years. Typically, it is manifested as an asymptomatic unilateral or upper abdominal mass. Abdimonal pain after some traumatic incident, fever, anemia, hematuria and hypertension are other patterns of presentation. In a considerable number of these patients, pulmonary metastases are present at the time of primary diagnosis. But, the initial presentation of acute pulmonary tumor emboli without surgical manipulation is very rare. We describe a sudden unexpected infantile death case diagnosed as pulmonary tumor embolism preexisting Wilms tumor. To our knowledge, this is the initial autopsy presentation of Wilms tumor with tumor embolism as sudden and unexpected death in Korea.
Anemia ; Autopsy ; Death, Sudden* ; Diagnosis ; Fever ; Hematuria ; Humans ; Hypertension ; Korea ; Neoplasm Metastasis ; Neoplastic Cells, Circulating* ; Urologic Neoplasms ; Wilms Tumor*

In recent years, the Korean Medical Association has undertaken the feat of establishing the Korean Standard Terminology of Medical Procedures with the dedicated help of 32 medical academic societies. However, because the project is being conducted by several different circles, it has yet to see a clear system of classification. This thesis, therefore, proposes the three principles of scientific properties, usefulness and ideology as the basis for classification system and has developed the Classification System of Medical Procedures in Korea upon their foundation. The methodology and organization of this thesis as follows. First, by adopting scientific classification system of Feinstein(1988), an analysis of the classification systems of the medical procedures in the United States, Japan, Taiwan, Who Was carried out to reveal the framework and the basic principles in each system. Second, the direction of classification system has been constructed by applying the normative principle of medical field in order to show the future direction of the medical field and realize its ideology. Third, a finalized framework for the classification system will be presented as based on the direction of classification system. Of the three basis principles mentioned above, the analysis on the principles of usefulness was left out of this thesis due to the difficulty of establishing specific standards of analysis. The results of the study are as follows. The overall structure of the thesis is aimed at showing the 'Prevention-Therapy-Rehabilitation' quality of comprehensive health care and consists of six chapters; I. Prevention and Health Promotion. II. Evaluation and Management . III. Diagnostic Procedures. IV. Endoscopy. V. Therapeutic Procedures. VI. Rehabilitation. Chapter three Diagnostic Procedures is divided into four parts; Functional Diagnosis, Visual Diagnosis, Pathological Diagnosis, Biopsy and Sampling. Chapter five Therapeutic Procedures is divided into Psychiatry, Non-Invasive Therapy, Invasive Therapy, Anaesthesia and Radiation Oncology. Of these sub-divisions, Functional Diagnosis, Biopsy and Sampling, Endoscopy and Invasive Therapy employs the anatomical system of classification. On the other hand, Visual Diagnosis, Pathological Diagnosis, Anesthesia and Diagnostic Radiology, namely those divisions in which there is little or no overlapping in services with other divisions, used the classification system of its own division. The classification system introduced in this thesis can be further supplemented through the use of the cluster analysis by incorporating the advice and assistance of other specialists.
Anesthesia ; Biopsy ; Classification* ; Comprehensive Health Care ; Diagnosis ; Endoscopy ; Hand ; Health Promotion ; Japan ; Korea* ; Radiation Oncology ; Rehabilitation ; Specialization ; Taiwan ; United States

Three years have passed since the Korea Medical Dispute Mediation and Arbitration Agency (KMDMAA) was established. In this time, its performance has fallen far short of expectations. Currently, both the KMDMAA and the Korea Consumer Agency (KCA) are responsible for alternative medical dispute resolution in Korea. In the most recent National Assembly administration inspection, Rep. Kim Jae Won of the Saenuri Party made the criticism that in 2013 the KMDMAA spent more than 13 times the budget of the KCA, but did not achieve significantly improved results. An analysis of the relevant law reveals that the KMDMAA has a much more advantageous legal and financial position than the KCA. Mediation takes the form of alternative dispute resolution in place of court adjudication. Mediation is a voluntary process and generally only succeeds when both parties agree. The mediator must be impartial and should aid parties in arriving at a mutually agreed-upon outcome. However, the KMDMAA has failed to build a trusting relationship with medical professionals, and has instead sought power to rule over them. The agency should be aware that power over medical personnel might deter mediation processes, which are based on the spontaneity and trust of both parties. The Department of Health and Human Services and the National Assembly also need to understand the essence of this problem and seek to remedy it.
Budgets ; Dissent and Disputes* ; Jurisprudence ; Korea ; Negotiating* ; United States Dept. of Health and Human Services

In the US, over-the-counter (OTC) drugs have long been available in non-pharmacy outlets, and in the UK, general sale list medicines can be supplied without the need for the supervision of a pharmacist. Recently, the Japanese government allowed medications for colds or fever and painkillers, which account for 95% of general pharmaceuticals, to be sold at retail stores through the amendment to the Pharmaceutical Affairs Act. Among the key trends of the global OTC market are major changes in product distribution. However, in Korea, the independent pharmacy model traditionally has been the method of OTC distribution for many years. 19 years have passed since the first civil petition for non-pharmacy distribution of selected OTC drugs. At last in 2012, Korea revised the Pharmaceutical Affairs Act, allowing selected non-prescription drugs to be distributed by non-pharmacy outlets. The revised Pharmaceutical Affairs Act restricted the number of selected OTC drugs to under 20. The new Act included the registrations of nonpharmacy outlets and the mandatory education of the sellers. We must discuss the criteria for placement of medicines on the GSL, the reclassification system based on the safety profile of the medicines, and the expansion of non-pharmacy outlets. In preparation for the aged society, we should implement health policies to lower the price of pharmaceuticals by adopting the market principle thus giving consumers a broader choice.
Aged ; Asian Continental Ancestry Group ; Cold Temperature ; Commerce ; Fever ; Health Policy ; Humans ; Korea ; Nonprescription Drugs ; Organization and Administration ; Pharmacists ; Pharmacy

Professional ethics can often encompass areas regulated by law. This is true of the Korean Medical Association (KMA) code of ethics. Therefore, doctors should consider their legal obligations when complying with medical ethics guidelines. A revision prepared by the KMA committee on medical ethics guidelines contains 5 types of amendments. First, some guidelines deal with areas that are not governed by current legislation. A second set of guidelines clarify the obligation to comply with current legislation by specifying “to the extent permitted by the law”. A third set of guidelines repeat the contents of current legislation almost verbatim. A fourth set of guidelines explain the content of the current legislation in lay language when a chance of misunderstanding is present. Fifth, some guidelines can be interpreted as being in conflict with current legislation. The statement that physicians must consider the content of relevant laws does not mean that they must accept those laws uncritically. At a minimum, doctors should avoid falling into legal difficulties because of legal ignorance. Furthermore, doctors must make efforts to revise relevant laws that are not acceptable from the point of view of medical ethics. If doctors continue this effort, they can maintain their professional dignity. The revision of the medical ethics guidelines is the beginning of this effort. If doctors understand the relationship between medical ethics guidelines and current legislation, it will be easier for doctors to comply with medical ethics guidelines in the clinical setting.
Accidental Falls ; Codes of Ethics ; Ethics, Medical* ; Ethics, Professional ; Jurisprudence*

Professional ethics can often encompass areas regulated by law. This is true of the Korean Medical Association (KMA) code of ethics. Therefore, doctors should consider their legal obligations when complying with medical ethics guidelines. A revision prepared by the KMA committee on medical ethics guidelines contains 5 types of amendments. First, some guidelines deal with areas that are not governed by current legislation. A second set of guidelines clarify the obligation to comply with current legislation by specifying “to the extent permitted by the law”. A third set of guidelines repeat the contents of current legislation almost verbatim. A fourth set of guidelines explain the content of the current legislation in lay language when a chance of misunderstanding is present. Fifth, some guidelines can be interpreted as being in conflict with current legislation. The statement that physicians must consider the content of relevant laws does not mean that they must accept those laws uncritically. At a minimum, doctors should avoid falling into legal difficulties because of legal ignorance. Furthermore, doctors must make efforts to revise relevant laws that are not acceptable from the point of view of medical ethics. If doctors continue this effort, they can maintain their professional dignity. The revision of the medical ethics guidelines is the beginning of this effort. If doctors understand the relationship between medical ethics guidelines and current legislation, it will be easier for doctors to comply with medical ethics guidelines in the clinical setting.
Accidental Falls ; Codes of Ethics ; Ethics, Medical* ; Ethics, Professional ; Jurisprudence*

According to the World Medical Association Declaration of Madrid on Professionally-led Regulation, physicians have been granted a high degree of professional autonomy, which is an essential component of high quality medical care. As a result, physicians have a continuing responsibility to be self-regulating. Historically, credible self-regulation has required maintaining professional competence, identifying problem physicians and conflicts of interest, and taking appropriate action. Recently, our society had two incidents that gave patients strong doubts about the professional expertise of physicians. The Korean Medical Association should consider the following in promoting its self-regulatory policies. First, if the structure of the self-regulation of lawyers is instructive, self-regulation completely independent from the government is unlikely to be realized. KMA or independent bodies should exercise primary authority and responsibility for self-regulation, and if this is not implemented well, it is reasonable that the Department of Health and Human Services should intervene. Second, the Ethics Committee of KMA should avoid political disputes between members and devote itself solely to establishing the core ethics of the medical profession. Third, KMA should inform its members that the ultimate beneficiaries of self-regulation are physicians and patients. KMA must determine the objectives it has in common with the Department of Health and Human Services and create a model of self-regulation.
Dissent and Disputes ; Ethics ; Ethics Committees ; Financing, Organized ; Humans ; Korea ; Lawyers ; Professional Autonomy ; Professional Competence ; Self-Control* ; United States Dept. of Health and Human Services

According to the World Medical Association Declaration of Madrid on Professionally-led Regulation, physicians have been granted a high degree of professional autonomy, which is an essential component of high quality medical care. As a result, physicians have a continuing responsibility to be self-regulating. Historically, credible self-regulation has required maintaining professional competence, identifying problem physicians and conflicts of interest, and taking appropriate action. Recently, our society had two incidents that gave patients strong doubts about the professional expertise of physicians. The Korean Medical Association should consider the following in promoting its self-regulatory policies. First, if the structure of the self-regulation of lawyers is instructive, self-regulation completely independent from the government is unlikely to be realized. KMA or independent bodies should exercise primary authority and responsibility for self-regulation, and if this is not implemented well, it is reasonable that the Department of Health and Human Services should intervene. Second, the Ethics Committee of KMA should avoid political disputes between members and devote itself solely to establishing the core ethics of the medical profession. Third, KMA should inform its members that the ultimate beneficiaries of self-regulation are physicians and patients. KMA must determine the objectives it has in common with the Department of Health and Human Services and create a model of self-regulation.
Dissent and Disputes ; Ethics ; Ethics Committees ; Financing, Organized ; Humans ; Korea ; Lawyers ; Professional Autonomy ; Professional Competence ; Self-Control* ; United States Dept. of Health and Human Services

No abstract available.
*Cost Control ; *Government Regulation ; Humans ; Medical Informatics ; Monitoring, Ambulatory ; Republic of Korea ; Societies, Medical/*trends