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*

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

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

According to Article 17 of the Korean Constitution, the privacy of no citizen shall be infringed. There have been considerable advances in the fields of computers and communications technology in the late 20th century. However, processing large amounts of personal information has caused many problems. In Korea, incidents of personal information leakage have been occurring frequently. To solve these problems, the Personal Information Protection Act was enacted in 2011. The most significant feature of this Act is that it applies not only to public institutions, but also to corporate bodies, organizations, and individuals who manage personal information. However, the Act does not allow the management of personal information for public purposes such as public health. Recently, the European Parliament has adopted a legislative resolution on the proposed European Union General Protection Regulation. This regulation allows the management of personal information for public health, reflecting the opinions of European public health experts. According to Article 81 of the proposed regulation, processing of personal data concerning health is permitted for the purposes of preventive or occupational medicine, medical diagnosis, the provision of care or treatment, or the management of health-care services. It is also permitted for reasons of public interest in the area of public health, such as protecting against serious cross-border threats to health or ensuring high standards of quality and safety for medicinal products or medical devices and reasons of public interest in areas such as social protection, in order to ensure the quality and cost-effectiveness of the health insurance system and the provision of health services. The proposed regulation is an example of the balance of privacy and public interest in the management of personal information. Although the management of personal information is allowed in the public interest without the consent of the subject of the information, all measures should be taken for privacy protection. It is time for Korea to take legislative steps for the management of personal health information for public health under conditions of strict privacy protection measures.
Computer Security ; Constitution and Bylaws ; Delivery of Health Care* ; Diagnosis ; European Union ; Health Services ; Humans ; Insurance, Health ; Jurisprudence* ; Korea ; Occupational Medicine ; Privacy ; Public Health ; Public Policy

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*

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

Unlike medical students, doctors-in-training (residents) are physicians who can legally provide medical treatment with a medical doctor's license obtained from Korea the Ministry of Health and Welfare, and thus they are liable for the care they provide. Therefore, residents need to be aware of the legal and risks they facing in medical practice and ensure that they have the ability to deal with such risks. Legal responsibilities of residents can be examined from three perspectives: the relationships between patients and doctors, the relationships between doctors and medical officials, and the Korean health and welfare system. With regard to the relationships between patients and doctors, the legal responsibilities of doctors-in-training span a diverse range of liability for explanation (informed consent), malpractice, medical records, prohibition on revealing medical secrets, emergency medical treatment, treatment for the opposite sex, and other basic responsibilities. They will be liable for any damage caused under Article 268 of the Criminal Code, which addresses the crime of professional negligence resulting in injury or in death, and Article 750 of the Civil Code, which addresses torts liability, and above and beyond them of legal liability in general. With regard to the relationships between doctors and medical officials, the legal responsibilities can be classified into two types of relationships. One is between a doctor and a senior doctor, and the other is between a doctor and a doctor from a different medical specialization. it there is miscommunication between two or more doctors, it could lead to poor outcomes for patients. Regarding the health and welfare system, the issuance of medical licenses and the duty of notification are the most important legal responsibilities. The system's treatment of residents require special caution as issuance of falsified medical licenses has caused serious social problems. Laws that state the various notification duties allow no exceptions even for the residents. Residints should therefore understand the basic notification duties involved in cases of accidental death, child abuse, and etc. and prepare for contingencies.
Child ; Child Abuse ; Crime ; Criminals ; Dietary Sucrose ; Dissent and Disputes ; Emergencies ; Humans ; Jurisprudence ; Korea ; Liability, Legal ; Licensure ; Malpractice ; Medical Records ; Social Problems ; Students, Medical

The ethics of medical research is an important area of physician ethics. Physicians are called to respect the life, health, and personality of human subjects. In contrast to other ethical fields, physician ethics, including the ethics of medical research, does not rely on the good faith of physicians alone; ethics and the law are intermingled. While respecting international norms related to medical ethics, individual countries have expanded legal interventions into medical research. The United States has regulated the research of human subjects receiving federal funding through the Common Rule. In Korea, legal interventions for human subjects protection have been applied to a limited extent in clinical trials under the Pharmaceutical Affairs Act and the Medical Devices Act in Korea. On January 29, 2004, the Bioethics and Safety Act was enacted, requiring embryo research institutes, gene banks, and gene therapy institutions to establish Institutional Review Boards. On February 1, 2012, the Bioethics and Safety act was completely revised, which was a significant turning point in medical ethics in Korea. Structural differences between the Common Rule of the United States and the Bioethics and Safety Act of Korea are as follows. First, the Bioethics and Safety Act shall be applied regardless of the presence or absence of government funding. Thus the Bioethics and safety act has a more comprehensive and compulsory effect than the Common Rule. Second, under the Bioethics and Safety Act, the Ministry of Health and Welfare has direct supervision over institutional review boards, rather than supervision of the research organization itself. This differs from the Common Rule, which regards the research organization as the counterpart to the government. Third, the Bioethics and Safety Act regulates the study of derivatives of human bodies, in addition to research on human subjects. The Bioethics and Safety Act has the following problems. First, it mandates that researchers, instead of IRBs, record and store data concerning medical research. Second, the Act does not provide a specific definition of "minimal risk". Third, as the Act does not allow the exemption of informed consent of children under the age of 18 even if specific prerequisites are met as in the case of adults, research involving children will atrophy significantly in Korea.
Academies and Institutes ; Adult ; Atrophy ; Bioethics ; Child ; Embryo Research ; Ethics Committees, Research ; Ethics, Medical ; Financial Management ; Genetic Therapy ; Human Body ; Humans ; Informed Consent ; Jurisprudence ; Korea ; Organization and Administration ; United States