• The Korean Society of Law and Medicine
• /
• v.22 no.3
• /
• pp.3-30
• /
• 2021

Reasons for disqualification to restrict a medical person's license should be considered in functional and moral terms. In this sense, the grounds for disqualification of medical personnel should be expanded to include all crimes that have been declared to be "imprisonment without labor or greater punishment" by a court. Because a sentence of "imprisonment without labor or greater punishment" means that it is highly reprehensible and undermines the trust of the state as well as the trust in medical personnel. Therefore, the expansion of the scope of license restrictions for medical personnel cannot be regarded as a violation of "the Less Restrictive Alternative" rule. However, it is necessary to reflect the specificity of medical services in the license restrictions of medical personnel. This is because not all diseases can be treated with current medical services. In addition, unpredictable situations can occur at any time during medical practice. Consequently, the negligence that occurs during medical practice should be carefully examined from a functional perspective of the medical personnel. And it should be treated differently from ordinary crimes. To this end, an independent license review organization should be established to establish expertise in license management.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.24 no.3
• /
• pp.288-294
• /
• 2021

Purpose: Despite aggressive medical and nutritional management, patients with methylmalonic acidemia (MMA) often suffer from multi-organ damage. Early deceased donor liver transplantation (DDLT) has emerged as an intervention to prevent disease progression. We investigated the efficacy of living donor LT (LDLT) with a potential carrier of MMA and a small volume of graft in patients with MMA as an alternative to DDLT. Methods: Of five patients (three male, two female; median age 5.7 years; range, 1.3-13.7 years), four underwent carrier LDLT, while one underwent non-carrier auxiliary LDLT. All patients received pre- and post-LT continuous renal replacement therapy and were provided with minimal restriction diet according to serum MMA level after LT. MMA levels in the serum and urine, the incidence of metabolic crisis, and clinical findings before and after LT were compared. Results: The survival rate was 100% during 2.2 years of follow up period after LT. In all five cases, MMA titer in the serum after transplantation decreased with less restrictive diet. Metabolic crisis was not observed during the follow-up period. In addition, no patient showed progression of severe renal impairment requiring hemodialysis. Progression of delayed cognitive development was not observed. Social functioning with improved neuropsychiatric development was observed. Conclusion: This study showed that LDLT achieved improved quality of life with less restrictive diet, therefore it could be a feasible alternative option to DDLT for the treatment of patients with MMA, even with an auxiliary LT.

• Journal of Chest Surgery
• /
• v.42 no.1
• /
• pp.87-91
• /
• 2009

The surgical management of complete transposition of the great arteries, ventricular septal defect, and pulmonary stenosis still remain a significant challenge. The Rastelli (REV procedure) remains the most widely applied procedure for surgical repair of these lesions. Although the Rastelli procedure can be performed with good early results, the intermediate- and long-term results have been less than satisfactory because of deterioration of the hemodynamic performance of the LVOT or RVOT. We performed a modified Nikaidoh procedure as an alternative surgical procedure in a 19-month-old boy weighing 10.4 kg with this anomaly. Aortic translocation with biventricular outflow tract reconstruction resulted in a more "normal" anatomic repair and postoperative echocardiography showed straight, direct, and unobstructed ventricular outflow.