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

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

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

No abstract available.
Jurisprudence

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

Korea has achieved a remarkable expansion in health coverage at modest costs relative to other Organization for Economic Cooperation and Development (OECD) countries. Hospitals are more accessible and equipped with more advanced medical technologies than in most other OECD countries. OECD Reviews of Health Care Quality seek to support the development of better policies to improve the quality of healthcare. In 2012, a report on Korea presented best practices and offered recommendations for improvement in the Korean health system. Korea's health care system needs to shift its focus from simply supporting an ever-continuing expansion of acute care services to quality of healthcare. First, Korea needs to strengthen the focus of governance to the quality of healthcare by establishing HIRA as an institutional champion for quality. Second, Korea must strengthen primary healthcare because in Korea it is woefully underdeveloped today. Third, Korea must use financing to drive improvements in quality of care. In reality, HIRA has used its power over healthcare providers to force them to accept financial constraints; it has not supported quality of all healthcare sectors. Without structural changes allowing for independent judgment on the quality at HIRA, NECA is more suitable for ensuring quality for all healthcare sectors. As suggested by the OECD report, Korea must strengthen primary healthcare by restoring patients' trust in health professionals. In using financing to drive improvements in quality of healthcare, Pay for Performance may be helpful, but that must be driven on a voluntary basis and with a great financial incentive.
Adenosine-5'-(N-ethylcarboxamide) ; Delivery of Health Care ; Health Care Sector ; Health Occupations ; Health Personnel ; Humans ; Judgment ; Korea ; Motivation ; Practice Guidelines as Topic ; Primary Health Care ; Quality of Health Care ; Reimbursement, Incentive

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