의학교육에의 교육순환모델(Learning Cycle)의 적용과 쟁점

김보현,김상현,Kim, Bo-Hyun,Kim, Sang-Hyun 연세대학교 의과대학 2008 의학교육논단 Vol.10 No.2

Purpose: The 'learning cycle' proposed by Guilbert in 1981 has been accredited as an effective and useful model for curriculum design. Three components of learning cycle, learning objective, instructional method, and assessment are connected organically and form basic structure of curriculum. In this study, we intend to analyze how the learning cycle and its three components are applied to present medical curriculum and examine the points at issue of the learning cycle in medical education. Also, we try to identify the educational significance of the leaning cycle in medical education. Results: First, concerning the learning objective, it was identified that impractical and abstract expressions are major controversial points. Also, there is a need to make learning objectives covering entire medical curriculum. Second, because of various structural problems, it is hard to practice new and various instructional methods. Third, even though there is a growing need for medical curriculum to develop and utilize more various and detailed assessment and evaluation, it was revealed that only are standardized and traditional assessments mainly used. Conclusion: Synthetically, we have some suggestions as follows. First, it is necessary to specify and actualize the learning objectives. Also, instructional methods and assessments should be diversified. And finally, there is a need to build organic and delicate medical curriculum by applying the learning cycle to medical education more actively.

반월상연골 파열에 대한 관절경적 inside to out 봉합술의 결과

김보현,황인성,윤태봉,변재용,Kim, Bo-Hyun,Hwang, In-Sung,Yun, Tae-Bong,Byun, Jae-Yong 대한관절경학회 2004 대한관절경학회지 Vol.8 No.1

목적: 반월상 연골 파열에 대한 비흡수성 봉합사를 이용한 관절경적 inside to out봉합술후 임상적 치유와 환자의 만족도를 결과에 영향을 주는 인자에 따라 분석하였다. 대상 및 방법: 1999년 8월부터 2002년 6월까지 반월상 연골 파열에 대한 관절경적 Inside to out 봉합술을 비흡수성 봉합사를 이용하여 시행 후 12개월이상 추시가 가능하였던 95명 110례를 대상으로 하였다. 결과는 임상적 치유와 주관적 만족도로 평가 하였으며 이들 결과에 대한 나이, 수상 후 수술까지의 기간, 파열의 부위, 파열 길이, 파열의 종류, 관절 연골의 손상 정도, 동반된 전방 십자인대 수술이 미치는 영향을 분석하였다. 결과: 임상적 치유는 84례(76%)이었으며, 환자의 주관적 만족도는 98례(89%)이었다. 전방십자인대 파열을 동반한 경우에, 파열 길이가 2cm이하인 경우가 2cm이상인 경우보다. 관절 연골의 퇴행성 정도가 심하지 않은 경우가 심한 경우보다 임상적 치유율과 환자의 만족도가 유의하게 높았다. 내측 반월상 연골 파열의 경우에, 수상후 수술까지의 기간이 짧을수록, 파열의 종류가 종 파열인 경우 임상적 치유율이 높았다. 복잡 또는 퇴행성 파열의 경우 낮은 임상적 치유율에 비해 환자의 만족도는 높았다. 결론: 비흡수성 봉합사를 이용한 관절경적 반월상 연골 Inside to out 봉합술은 다양한 봉합이 가능하고 사용이 쉬운 술식이다. 반월상 연골의 봉합 여부 결정에 있어 환자의 연령은 절대적인 고려 대상이 아니며, 퇴행성 또는 복잡파열, 관절연골의 손상이 동반된 파열의 경우 환자선택과 수술에 신중을 기해야 할 것으로 사료 된다.증을 줄일수 있으며, PASTA 병변을 포함해서 후상방 파열과 동반되지 않은 견갑하건의 부분 파열은 매우 적합한 관절경하복원술의 적응증이 될 수 있다고 사료된다. Purpose: This study examined clinical cure and patients' satisfaction degrees by factors influencing surgical operation results, after arthroscopic inside to out repair as a nonabsorbable suture material, in case of meniscal rupture. Materials and Methods: Materials were 110 cases of 95 patients who could make paces for over 12 months from August 1999 to June 2002. Results were evaluated by clinical cure and subjective satisfaction degrees. This study, concerning those results, analyzed age, term from taking pictures to taking surgical operation, rupture section, rupture length, rupture types, lesion of articular-cartilage, and effects of anterior cruciate ligament operation accompanied. Results: 84 cases(76%) were clinically cured, 98 cases(89%) were subjectively satisfied. In case of accompanying anterior cruciate ligament rupture, and in case that rupture length was below 2 cm, rates of clinical cure and patients subjective satisfaction were significantly high. In case of complex or degenerative rupture, patients satisfaction rates were higher when comparing with clinical cure rates. Conclusion: Various sutures are possible as well as available in case of arthroscopic meniscal inside to out repair using nonabsorbable suture material. It can be concluded that patients age is not absolte consideration in determining the suture of meniscus. In cases of complex rupture, degenerative rupture, ruptures companied by joint-cartilage injuries, considerate consideratin need be paid to choose patients and operations.

신경 및 위장관 증세를 동반한 Erythropoietic Protoporphyria 환아 1예

김보현,박영년,정기섭,Kim, Bo Hyun,Park, Young Nyun,Chung, Ki Sup 대한소아소화기영양학회 2005 Pediatric gastroenterology, hepatology & nutrition Vol.8 No.2

본 저자들은 심한 간 부전과 함께 복통, 구토, 의식 변화, 사지 마비, 배뇨 장애 및 호흡부전을 동반한 EPP 예를 경험하였기에 보고하는 바이다. Erythropoietic protoporphyria is a genetic disorder due to a deficiency of ferrochelatase resulting in excessive accumulation and excretion of protoporphyrin. The predominant clinical feature is photosensitivity. Severe hepatic failure occurs in a small percentage of patients, and neurological symptoms are very rare. We report a case of erythropoietic protoporphyria associated with severe hepatic dysfunction and neurological symptoms. A 9-year-old girl presented with severe abdominal pain, nausea, weakness and pain of extremities, and urinary retention. Ultrasonogram and abdominal CT scanning revealed a diffuse infiltrated and enlarged liver. Liver biopsy showed deposition of dense dark brown pigment within the bile, hepatocytes and Kupffer cells. Plus, dense dark brown deposits gave a red birefringent under polarize light. Porphyrin studies demonstrated markedly elevated serum free erythrocyte protoporphyrin. This girl was diagnosed as erythropoietic protoporphyria with severe liver dysfunction and neurological symptoms.

플라즈마 산화방법을 이용한 질소가 첨가된 실리콘 산화막의 제조와 산화막 내의 질소가 박막트랜지스터의 특성에 미치는 영향

김보현,이승렬,안경민,강승모,양용호,안병태,Kim, Bo-Hyun,Lee, Seung-Ryul,Ahn, Kyung-Min,Kang, Seung-Mo,Yang, Yong-Ho,Ahn, Byung-Tae 한국재료학회 2009 한국재료학회지 Vol.19 No.1

Silicon dioxide as gate dielectrics was grown at $400^{\circ}C$ on a polycrystalline Si substrate by inductively coupled plasma oxidation using a mixture of $O_2$ and $N_2O$ to improve the performance of polycrystalline Si thin film transistors. In conventional high-temperature $N_2O$ annealing, nitrogen can be supplied to the $Si/SiO_2$ interface because a NO molecule can diffuse through the oxide. However, it was found that nitrogen cannot be supplied to the Si/$SiO_2$ interface by plasma oxidation as the $N_2O$ molecule is broken in the plasma and because a dense Si-N bond is formed at the $SiO_2$ surface, preventing further diffusion of nitrogen into the oxide. Nitrogen was added to the $Si/SiO_2$ interface by the plasma oxidation of mixtures of $O_2/N_2O$ gas, leading to an enhancement of the field effect mobility of polycrystalline Si TFTs due to the reduction in the number of trap densities at the interface and at the Si grain boundaries due to nitrogen passivation.

CO₂냉매용 제어밸브의 응답 특성

김보현,장지성,Kim, Bo Hyun,Jang, Ji Seong 유공압건설기계학회 2018 드라이브·컨트롤 Vol.15 No.4

Pilot operated control valve for $CO_2$ refrigerant is a valve that can perform various functions according to the user's intention by replacing pilot units, widely used for flow rate, pressure, and temperature control of refrigeration and air conditioning systems. In addition, $CO_2$ refrigerant, that requires high pressure and low critical temperature, can be installed and used in all positions of the refrigeration system, regardless of high or low pressure. In this paper, response characteristics are modeled and analyzed based on behavior of the main piston of the pilot-operated control valve. Although various factors influence operation of the main piston, this paper analyzes the effect of equilibrium pressure depending on valve installation position and application, and inlet and outlet orifice size of the load pressure feedback chamber to determine feedback characteristics of the main piston. As a result, it was possible to quantitatively analyze the effect of change in equilibrium and load pressure feedback chamber flow path size on the change in main piston dynamic and static characteristics.

간암 진료가이드라인의 현재와 전망

김보현,박중원,Bo Hyun Kim,Joong-Won Park 대한소화기암연구학회 2016 Journal of digestive cancer reports Vol.4 No.1

Hepatocellular carcinoma (HCC) is rather unique. Most of HCC patients have underlying chronic liver diseases with or without cirrhosis and the prognosis of HCC depends on the liver function, as well as the tumor extent. Non-invasive diagnosis of HCC can be made with certain risk factors and specific imaging findings (e.g. hypervascularity). Patients with HCC can receive surgical resection, radiotherapy, and systemic chemotherapy as other solid malignancies. HCC has more treatment options such as liver transplantation, transarterial chemoembolization (TACE) and radiofrequency ablation (RFA). A variety of practice guidelines for HCC has been published by many academic societies. Different healthcare systems and availability of resources also affect the practice guidelines; therefore, practice guidelines have similarities and dissimilarities. Herein, we review the current status of practice guidelines for HCC and future perspectives for the improvement of guidelines are also discussed.

버스 BIT 사례조사 및 이용상의 문제점 조사

김보현(Bo hyun Kim),김가영(Ga Young Kim),김가현(Ga Hyun Kim),이영훈(Young Hoon Lee),김현정(Hyeon jeong Kim) 한국디자인학회 2022 한국디자인학회 학술발표대회 논문집 Vol.2022 No.5

신 공정을 이용한 멤브레인형 체적탄성파 공진기의 제작 및 하부전극이 주파수 응답특성에 미치는 영향

김보현(Bo-Hyun Kim),김도영(Do-Young Kim),조동현(Dong-Hyun Cho),이진복(Jin-Bock Lee),박진석(Jin-Seok Park) 대한전기학회 2004 대한전기학회 학술대회 논문집 Vol.2004 No.7

가발생산 공정을 위한 IT 융합 기술 적용

김보현(Kim Bo Hyun),이평안(Lee Pyeong An),이학영(Lee Hak Young) 한국통신학회 2013 한국통신학회 학술대회논문집 Vol.2013 No.6

라카토스의 긍정적 발견법

김보현(Kim, Bo-hyun) 대한철학회 2011 哲學硏究 Vol.118 No.-

포퍼와 같은 반증주의자는 이론과 경험이 일치하지 않을 때 이론에 연연하여 어떻게든 그것을 정당화하려고 애쓰지 말고, 보다 포괄적인 새로운 이론을 찾아서 미련 없이 떠나라고 권고한다. 그러나 이러한 방법론적 권고에 대한 쿤의 비판은 과학의 역사상 이론과 경험의 불일치가 이론을 거부하는 이유가 된 적은 없었다는 것이었다. 쿤의 이 비판으로 비판적 합리주의자들은, 당장의 반증 자료를 근거로 이론을 포기하는 것보다는 잠재력을 최대한 발휘하여 스스로를 입증하도록 반증된 이론에 새로운 기회를 주는 것이 더 합리적임을 깨닫게 되었다. 라카토스의 과학적 연구프로그램의 탄생은 이러한 깨달음의 결과로 보인다. 그의 과학적 연구프로그램의 방법론에 따르면, 변칙사례에 직면하면 과학자는 이론을 포기하는 대신, 보호대를 수정함으로써 그 변칙사례가 이론을 확인하게 만들 새로운 기회를 주어야 한다. 자료와 이론이 서로 들어맞게 하려고 보호대를 수정하는 구체적인 방법이 긍정적 발견법인데, 그것에의 접근로는, 시인이 자신의 시를 위한 사상을 얻거나 악상이 작곡가의 머릿속에 떠오를 때 종종 그러하듯, 논리적 논의가 불가능할 정도로 사밀하고 신비적이지는 않다. 라카토스의 긍정적 발견법은 폴리아의 수학적 발견법에서 영감을 받은 만큼, 폴리아가 자신의 수학적 발견법을 논리적으로 다루었듯 나 역시 라카토스의 긍정적 발견법을 논리적으로 다룰 수 있다고 생각한다. 나는 이러한 믿음에서 긍정적 발견법의 개념을 이론의 잠재력 테스트에서 중요한 역할을 하는 방법론적 장치로 분석하고, 라카토스는 그 장치에 의해 반증주의의 순간적 합리성을 새로운 신중한 합리성으로 교체할 수 있었다고 주장한다. The falsificationist like Popper advises a scientist in the face of anomalous experiences to give up his theory and search for a better one instead of making every effort to justify it. Kuhn’s criticism on this methodological advice is, however, that no failure to make the facts fit the theory has ever been ground for theory rejection in history of science. The criticism led critical rationalists to become aware that it would be more reasonable to offer a falsified theory more new opportunities to realize its full potential for proving itself than to reject it on the basis of the current falsifying data. Lakatos’ scientific research programmes seem to come into being as a result of the above awareness. According to the methodology of scientific research programmes, faced with an anomaly the scientist should not so much give up his theory as provide it with a new chance to make the anomaly conform by modifying its protective belt. Concrete suggestions on how to alter the protective belt to make a data-theory fit are called positive heuristic, the way to which is not too private and mysterious to discuss rationally, as is often the case with the process in which the poet gets an idea for his poem or a musical motif comes into the mind of the composer. Since it is inspired by Polya’s mathematical heuristic, I believe I am allowed to treat the positive heuristic so much logically as Polya dealt with his mathematical heuristic in that way. With this belief I analyse the concept of positive heuristic as a methodological device playing an important role in testing potentiality of a theory, and argue that it enables Lakatos to substitute his new rationality in hindsight for the falsificationist instant rationality.