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정철운(Chul Woon Chung) 한국의학교육학회 2004 Korean journal of medical education Vol.16 No.3
Purpose: As the importance of teaching professionalism has become more emphasized in medical education, Korean medical educators are trying to introduce and revise new learning materials concerning professionalism. The purpose of this study is to analyze the transition of curricula subjects related to medical professionalism in Korean medical schools. Methods: A search for the learning subjects was done by reviewing theKorean Medical Education Guidefrom 1998 to present. Subject titles relating to medical professionalism and the time allocation of these subjects in lectures and laboratories in the 41 Korean Medical Schools were identified. The annual increasing rate of related subjects, as well as some characteristic differences between medical schools were analyzed. Results: There were 28 subjects with content on medical professionalism in 1998/99. There was a rapid increase in the introduction of professionalism to the curriculum annually. Although private medical schools outnumber the public system, there was no significant difference between them in the number of established subjects. But schools with fewer students had more programs relating to professionalism. This may be seen as a reflection of the relatively newly established schools with fewer students being more ready to adopt curriculum reform than older, larger medical schools. Conclusion: The results show that there has been a rapid growth in the number of subjects relating to medical professionalism in the curriculua at Korean medical schools. This study focused mainly on analyzing the current subject constellation in the curricula. A further study on the specifics of curriculum content and its teaching method is required.
국내외 외과전공의 수련교육제도 비교 - 수련목표와 교육과정을 중심으로 -
정철운(Chul-Woon Chung),이경포(Kyung Po Lee) 한국의학교육학회 2002 Korean journal of medical education Vol.14 No.1
Purpose: The role of graduate medical education (GME) has become more important at the flood of knowledge and technical development. The korean board system in general surgery has a short history and has been developed mostly by the executive authorities rather than by autonomous civil organizations which is the case in america and europe. The aim and curriculum of our residency education is not yet well established, so that there requires the need to evaluate and analyze the training system of other well-established countries. Methods: The structures of residency education and their characteristics in U.S.A., England and Germany were reviewed from the literatures and internet sites in terms of aims and objects of learning during the training period. The korean system was compared to these characteristics. Results: Comparing the residency training programmes of U.S.A., Germany and England to our system there found some characteristic points as following that would be recommendable to be adopted for the renewal of our training programme. 1) Autonomous civil organizations endeavor for the regulations of educational goal, requirements and their accreditation. 2) The understanding of basic sciences that provide the fundamental principles of surgery was emphasized during the education. 3) Modern surgical techniques as a part of minimal invasive surgery can be easily acquired during the training course. 4) Participation in emergency medicine and intensive medicine was almost mandatory. 5) Interdisciplinary training and effective rotation schedule were highly recommended. All these characteristics could be actively integrated into our education, if we elaborate more well-established educational goal and curriculum for the residentship.
한상문(Sang Moon Han),김원우(Won Woo Kim),정철운(Chul Woon Chung),이경포(Kyung Po Lee),이경식(Kyung Sik Lee) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.72 No.6
Adult onset Still"s disease (AOSD) is a rare systemic inflammatory disorder of an unknown etiology, and its major clinical manifestations include high spiking fever, polyarthralgia, salmon-colored evanescent rash and neutrophilic leukocytosis. We describe here a 41 year old woman with AOSD who presented with non-remitting high fever, polyarthralgia, sore throat, skin rash, splenomegaly, thrombocytopenia, neutrophilic leukocytosis, hyperferritinemia and coagulopathy with disseminated intravascular coagulation (DIC). The patient had a history of laparoscopic cholecystectomy due to acalculous cholecystitis prior to admission. We suspected sepsis due to bile peritonitis after the previous laparoscopic cholecystectomy. Yet we could not detect infectious organisms on the cultures or serologic studies. Finally, we suspected AOSD-associated hemophagocytic syndrome (HS). So, intravenous immunoglobulin and pulse methylprednisolone treatment brought about transient improvement of the fever and the neutrophilic leukocytosis, but the disease progressed and the patient expired due to acute renal failure. HS is a fatal cause of AOSD. If a patient has DIC and sepsis and these fail to respond to conservative treatment, then AOSD should be added to the differential diagnosis of sepsis and DIC.
강성일(Sung Il Kang),김종우(Jong Woo Kim),김승기(Seung Ki Kim),정철운(Chul Woon Chung),권성원(Sung Won Kwon),안대호(Dae Ho Ahn),이경포(Kyong Po Lee),이경식(Kyong Sik Lee) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.74 No.6
Purpose: Endometriosis is the heterotropic occurrence of island of endometrial glands and stroma outside of uterus. It common occurs in pelvic cavity, but rarely at the ectopic area of extra-pelvic cavity. The aim of this study was to evaluate the clinical characteristics of extrapelvic endometriosis in order to help diagnosis and treatment. Methods: Between January 2001 and June 2007, 22 patients who underwent surgery and was diagnosed as ectopic endometriosis of extra-pelvic cavity at Bundang CHA hospital were retrospectively reviewed with medical records and a telephone interview. Results: All cases were women in their reproductive age, with a median age of 33 years (range 24~49 years). 17 of 22 cases were endometriosis in the scarring tissue of prior caesarean section wound on abdomen. 1 case in vaginal orifice on episiotomy wound of perineum, 1 case in femoral ring area and 3 cases in appendix. All patients except endometriosis of appendix, were presented with mass, pain and symptoms almost associated with menstruation. 18 of 22 cases were suspected of having extra-pelvic endometriosis due to their specific clinical features, 4 cases were suspected of hernia and acute appendicitis. All patients were treated with surgery. None has revisited to clinics due to recurrence. Conclusion: Women who have mass or lump in surgical scar and symptoms associated with menstruation period should be suspected of having endometriosis. Endometriosis of surgical scaring tissue should be treated by wide local excision to prevent local recurrence.
강성일(Sung Il Kang),강봉수(Bong Su Kang),안창욱(Chang Wook Ahn),고현석(Hyun Seok Ko),이성배(Sung Bae Lee),구혜영(Hye Young Koo),정철운(Chul Woon Chung) 한국간담췌외과학회 2008 한국간담췌외과학회지 Vol.12 No.3
A 57-year-old man with severe abdominal pain was admitted to our hospital. Chest PA and simple abdominal X-ray revealed no specific findings, but the abdominal-pelvis CT scan showed a 5cm sized multiloculated cystic tumor originating from the pancreatic head and a 3.2cm sized hepatic lesion that was suspected to be a metastic lesion. A radical operation was not able to be performed because of peritoneal metastasis and gastrocolonal infiltration. Only open lymph node biopsy was done and it revealed metastatic small cell carcinoma. Long-acting octreotide and gemcitabine was administered to the patient, but there was no therapeutic response. The tumor grew very rapidly to 26cm in size and the patient died 2 months later from his first hospital day. Necropsy was performed, and the pathologic finding of the resected mass was confirmed to be small cell carcinoma, the same as the result of the previous lymph node biopsy.