Proposed Master Plan for Reform of the National Infectious Disease Prevention and Management System in Korea

A Middle East respiratory syndrome (MERS) - coronavirus (CoV) cluster that attacked Korea in May 2015 revealed several weaknesses in Korea's health care system in the face of the crisis of an emerging infectious disease and its public health implications. This experience has shown that is necessary to prepare comprehensive countermeasures through the cooperation of civil and public agencies to prevent a second or even third MERS outbreak and to control future crises of infectious disease and public health. The MERS Policy Committee of the Korean Medical Association has thus proposed a master plan for reform of the national infectious disease prevention and management system to prepare a new framework for national infectious disease prevention and control. The specific targets of the master plan are improvement of the system of usage of medical services and of the medical culture among national health insurance subscribers, improvement of the emergency room management system to prevent the spread of infectious disease, the establishment of a support system to promote effective voluntary infectious disease prevention activities among medical institutions, the building of a public health crisis communication system in collaboration with medical organizations, the establishment of an independent Ministry of Health and capacity building of the Korea Centers for Disease Control (KCDC), the securing of an advanced research and development system in the field of prevention and control of infectious disease, and the capacity building of professional epidemiologists and personnel needed to prevent and control infectious disease. The five core strategies of the master plan have been planned by medical experts in this order of priority: the reform of the healthcare delivery system, the independence of the Ministry of Health and capacity building of the KCDC, fundraising for a public infection management fund, enforcement of medical organization infection control, and improvement of the emergency room management system.

Congenital Portal Vein Aneurysm: A case report / 한국간담췌외과학회지

Aneurysm of the portal venous system is extremely rare and its etiology is controversial. In the following study, a case congenital aneurysm of the portal vein is reported. A 47-year-old male had a one-year history of generalized weakness. During routine evaluation, an ultrasound examination showed a masslike dilatation of the portal vein near the porta hepatis and its distal portion was communicating with the normal-sized superior mesenteric vein. The diagnosis was confirmed by dynamic computed tomography and portal venography as portal vein aneurysm and an unusually tortuous portal vein. The patient had no history or clinical evidence of underlying liver disease, pancreatitis, or other disease states that would predispose development of an aneurysm. It was speculated that this portal vein aneurysm may have been congenital and that the associated tortuous portal vein may have been secondary to hemodynamic changes in the portal vein system.

A Study of the Factors Related to the Frequency of Postoperative Gomplications for Gastric Cancer

Prevention of fatal postoperative complications and improved management of patients with complications are important means for achieving increased survival in gastric cancer patients. A study of 390 patients undergoing gastrectomies at the Department of Surgery, Chonbuk National University Hospital, during 6 years from 1990 to 1995 was performed to examine factors related to a high rate of postoperative complications and to compare specific and non-specific complications. Postoperative complications developed in 185 (47.4%) out of the total 390 cases undergoing gastrectomies for gastric cancer; including 107 (27.4%) specific and 78 (20.0%) non-specific. Typical complications were 46 cases of diarrhea, 20 cases of intestinal obstruction including an adhesive and paralytic ileus, 16 cases of vomiting, 7 cases of anastomotic leakage, 7 cases of hemorrhage, 6 cases of anastomosis stenosis, 2 cases of duodenal stump leakage, 1 case of acute pancreatitis, 1 case of pancreatic fistula, 1 case of enterocutaneous fistula within the category of specific complications and 22 cases of elevated hepatic enzymes, 21 cases of pulmonary disease, 2 cases of abnormal EKG, 2 cases of sepsis, 2 cases of cerebral infarction, and 1 case of renal failure within the category of non-specific complications. Multivariate analysis identified combined resection, radical resection in stage IV in operative factors, blood(PRC) transfusion of over 4 units, elevation of sGOT and sGPT, age between 50 and 65, diabetic mellitus of coexistic diseases in non-operative factors as detrimental factors with an independent influence on the postoperative complications for gastric cancer. We believe that the postoperative complications for gastric cancer did not develope because of local and operative factors, but were significantly common when general and non-operative factors were combined with gastrectomy.