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이병두,Rhee, Byoung Doo 연세대학교 의과대학 2016 의학교육논단 Vol.18 No.3
The Korea Association of Medical Colleges (KAMC) has been developing learning outcomes for basic medical education (BME) since 2012. This initiative is designed to help medical schools implement competency-based medical education. KAMC divided the BME competencies into three domains (clinical practice, scientific concepts and principles, and human beings and society) with learning outcomes for each domain. KAMC plans to revise the learning outcomes to reflect feedback from medical schools, changes in social health needs, and changes in the healthcare environment and healthcare system in the near future. KAMC also plans to specify learning outcomes that integrate the three domains.
유리지방산이 원형질막 Na+ , K+ - ATPase 에 미치는 효과에 대한 알부민의 역할
이병두(Byoung Doo Rhee),임성희(Sung Hee Ihm),장학철(Hak Chul Jang),박경수(Kyong Soo Park),김성연(Seong Yeon Kim),조보연(Bo Youn Cho),이홍규(Hong Kyu Lee),고창순(Chang Soon Koh),민헌기(Hun Ki Min) 대한내과학회 1988 대한내과학회지 Vol.35 No.1
N/A There is increasing evidence that free fatty acids (FFA) inhibit the activity of plasma membrane Na+, K+-ATPase in vitro and thereby could be a control agent of metabolism. However, in several recent studies, physiological conclusion were drawn from the effect of FFA in systems in which albumin was absent. To explore the role of albumin in modulating the effect of FFA on the activity of this enzyme, the activities plasma membrane Na+, K+-ATPase were measured in the presence of various concentrations of FFA and/or albumin. 1) The activities of Na+, K+-ATPase in the presence of 4% bovine serum albumin (BSA) were inhibited by oleic and linoleic acid at concentrations ranging from 0.05 to 2.0mM. 2) The inhibitory effects of oleic acid at each concentration on the activities of Na+, K+-ATPase were increased as the concentration of BSA was decreased from 4% to 0%. 3) The activities of Na+, K+-ATPase were not inhibited when the FFA to albumin molar ratio was less than 1.0 but were inhibited to less than 50% when the ratio exceeded 3.5. The above results shows that, in vitro, the activities of plasma membrane Na+, K+-ATPase are inhibited by unsaturated FFA and albumin has a protective role on this inhibition. This suggests that in vivo unsaturated FFA could be a regulator of cellular metabolism by inhibition of Na+, K+-ATPase under the pathologic condition in which the FFA to albumin molar ratio is increased markedly.
인제대학교 의과대학의 성과바탕교육과정 개발실례 및 결과 소개
이종태,이병두,노혜린,Lee, Jong-Tae,Rhee, Byoung Doo,Roh, Hye Rin 연세대학교 의과대학 2013 의학교육논단 Vol.15 No.1
This paper focuses on the outcome-based curriculum of Inje University College of Medicine to describe our curriculum development process and results. Starting in 2006, we have revised the curriculum based on the competency-based clinical presentation curriculum. We stated clearly the learning outcomes from the social needs and educational goal of our university. We defined 8 exit outcomes and specified phase outcomes, course outcomes, lesson outcomes, and outcome objectives. By 2012, we identified 128 clinical presentations and 149 basic scientific concepts. Various evaluation and assessment methods and teaching-learning strategies were assigned to each outcome. Problem-based learning, standardized patient practice, and learning portfolios are the main strategies of our curriculum. We have performed a progress test to assess the level of achievement of students' outcomes. We have also collected feedback from students and faculty members about the curriculum, including every lesson, course, and the overall curriculum. To maintain this change of the curriculum, we reorganized the curriculum committee, educational faculty and teams, and administrative support system. To fine tune this curriculum, we have held three 3-day workshops on curriculum development and weekly meetings. We believe this is just the beginning of developing the curriculum of Inje University. Further upgrades will be necessary to continue to improve medical education.
Graves 병 환자에서 갑상선 아전절제술 후 갑상선자극항체와 갑상선자극홀몬 결합억제 면역글로불린의 변화
송영기(Young Kee Shong),이병두(Byoung Doo Rhee),조보연(Bo Youn Cho),이홍규(Hong Kyu Lee),고창순(Chang Soon Koh),민헌기(Hun Ki Min),오승근(Seung Keun Oh) 대한내과학회 1989 대한내과학회지 Vol.37 No.1
N/A The authors measured changes in thyroid stimulating antibody (TSAb) and thyrotropin binding inhibitor immunoglobulin (TBII) in 15 patients with Graves' disease treated with subtotal thyroidectomy. Before surgery all 15 had detectable TBII actvities, and 11 had TSAb activities. During the 12 month postoperative follow-up, TBII disappeared in 7 out of 15, and TSAb disappeared in 6 out of 11. Twelve months after surgery, 10 patients with negative TSAb (including 4 patients whose TSAb activities were negative before surgery) remained in remission, Of 5 patients whose TSAb remained persistently positivie during the 12 month observation period, one remained in remission, two experienced relapse, and two became hypothyroid. In the persistently positive TSAb and TBII group, their activities did not change after surgery. There was no difference in clinical and laboratory findings save for the higher TSAb and TBII activity preoperatively between the persistently positive group and disappearing group. In summary, after subtotal thyroidectomy, TSAb and TBII disappeared in some of the patients. Disappearance of TSAb is associated with remission but persistence of TSAb has no prognostic implication. The production sites of thyrotropin reccptor antibody are thought to be intrathyroidal, but in some patients extrathyroidal production might contribute significantly, due to the pattern of postoperative changes in thyrotropin receptor antibody activities.
윤보영,최익선,김세진,박효진,주현정,이병두,이종태,Yoon, Bo Young,Choi, Ikseon,Kim, Sejin,Park, Hyojin,Ju, Hyunjung,Rhee, Byoung Doo,Lee, Jong-Tae 연세대학교 의과대학 2015 의학교육논단 Vol.17 No.3
Competency-based medical education (CBME) is an outcome-oriented curriculum model for medical education that organizes learning activities and assessment methods according to defined competencies as the learning outcomes of a given curriculum. CBME emerged to address the accountability of medical education in response to growing concerns about the patient safety in North America in the 1970s, and the number of medical schools adopting CBME has dramatically increased since 1990. In Korea, CBME has been under consideration as an alternative curriculum model to reform medical education since 2006. The purpose of this paper is three-fold: (1) to review the literature on CBME to identify the challenges and benefits reported in North America, (2) to summarize the process and experiences of planning and implementing CBME at Inje University College of Medicine, and finally (3) to provide recommendations for Korean medical schools to be better prepared for the successful adoption of CBME. In conclusion, one of the key factors for successful CBME implementation in Korea is how well an individual school can modify the current curriculum and rearrange the existing resources in a way that will enhance students' competencies while maximizing the strengths of the school's existing curriculum.
박경수(Kyong Soo Park),박도준(Do Joon Park),이병두(Byoung Doo Rhee),김성연(Seong Yeon Kim),이홍규(Hong Kyu Lee),고창순(Chang Soon Koh),민헌기(Hun Ki Min) 대한내과학회 1987 대한내과학회지 Vol.33 No.6
N/A To evaluate the in viva effect of hyperglycemia per se on plasma free fatty acid (FFA) levels, euglycemic and hyperglycemic clamp targeted at 80㎎/dl and 250㎎/dl respectively, were performed in 6 overnight fasted mongrel dogs while plasma insulin and glucagon levels were suppressed by somatostatin infusion. During somatostatin infusion, plasma FFA levels rose from 0.32±0.05mmol/l at basal state to 0.76±0.04mmol/l at the steady-state (60-120 min) in euglycemic clamp (p[t]<0.0001) and from 0.26±0.04mmol/l to 0.43±0.02mmol/l in hyperglycemic clamp (p[t]<0.0001). The steady-state plasma FFA levels in hyperglycemic clamp were significantly lower than those in euglycemic clamp (p[t]<0.0001). This findings suggest that hyperglycemia per se can significantly decrease plasma FFA levels and thus support that hyperglycemia per se may play a compensatory role in the circumstances of severe insulin deficiency.
정재훈(Jae Hoon Chung),박중열(Joong Yeol Park),박용수(Yong Soo Park),이문규(Moon Kyu Lee),이병두(Byoung Doo Rhee),이홍규(Hong Kyu Lee),고창순(Chang Soon Koh),민헌기(Hun Ki Min),조수헌(Soo Hun Cho),강문호(Moon Ho Kang) 대한내과학회 1989 대한내과학회지 Vol.36 No.3
N/A In order to evaluate the effectiveness of systemic hyperbaric oxygen (HBO) therapy on diabetic gangrene, we treated 11 patients with diabetic gangrene with HBO therapy and 7 without HBO therapy in 1988. Seventeen patients with diabetic gangrene were treated without HBO therapy in 1987. HBO was administered in 60-min sessions twice a day or in daily 75-min sessions (20±4 times) within a monoplace oxygen chamber pressurized at 2.5 atm. Clinical characteristics such as sex, age, diabetes duration, fasting blood glucose, HbA1c, severity of diabetic microangiopathy and macroangiopathy were comparable in the patients of 1987 and 1988. In 1988, 13 patients (72.2%) recovered or showed improvement, 2 patients (11.1%) showed no improvement, and 3 patients (16.7%) were amputated. By contraries, in 1987, 8 patients (47.0%) recovered or showed improvement, 8 patients (47.0%) were amputated, and the remaining patient (6.0%) expired. There was a significant difference in hospitalization period (days) between the groups (33.8±3.7 vs 60.1±7.1, p<0.05 by Wilcoxon rank sum test). However, the values of nerve conduction velocity, amplitude, and latency of electrophysiologic test performed before and after HBO therapy were not altered. We conclude that HBO therapy may be an effective modality for the treatment of diabetic gangrene.