• Journal of Korean Medical classics
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• v.31 no.2
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• pp.1-16
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• 2018

Objective : The college of Korean medicine uses a variety of Korean medical classics. Thus, in order to overcome the natural difference of the details of their curriculum, this paper aims to study the usage of Flipped Learning as a way of standardizing the curriculum that teach Korean medical classics. Method : One effective teaching and learning methodology, which is called for by the changing educational paradigm, is Flipped Learning. To introduce this learning method, which is actively applied to different curriculum, the paper revises the goal of learning objectives and introduces a teaching model of Flipped Learning in order to suggest the standardization of Korean medical educations through the re-design of the curriculum for Korean medical classics. Result : The professors of the Korean medical classics must work together to use the revised learning objectives and teaching model and create a set of lectures to serve as a basis of educational standardization. Conclusion : The standardization of the education of Korean medical classics through the Flipped Learning method could pre-emptively deal with the Korean medical doctor's capacity model that is in development now.

• Journal of Preventive Medicine and Public Health
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• v.27 no.1 s.45
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• pp.135-144
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• 1994

The purpose of this study compares determinants of eldery medical cost inflation with those of other age groups by analysing aggregated data with a deterministic model. The deterministic model of per capita medical cost inflation consists of increases in price, intensity of services, and medical utilization. We used a time series data($1985{\sim}1991$) from National Medical Insurance and analyzed by age groups. In total population, the average increase rates of inpatient and outpatient medical costs were respectively 9.5% and 8.8% during 6 years and the major cause of inflation was the increase in service intensity in both of inpatient and outpatient cases. But in the population of 65 years old and over, the average increase rates of inpatient and outpatient medical costs were respectively 13.8% and 14.8% and the major cause of inflation was the increase in per-capita medical utilization in both of inpatient and outpatient cases. Also, the increase in service intensity of 65 years old and over was the highest of other age groups. This pattern was similar during study periods. We concluded that the level of medical cost-inflation and the determinants in eldery was the highest-especially in per capita medical utilization, therfore, the inflation of medical costs in eldery will be higher than other age groups for the furture in Korea.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7905-7909
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• 2015

Several studies reported there was a polymorphism (rs531564 C > G) in miR-124 gene. To investigate the MiR-124 rs531564 polymorphism and cancer risk. We conducted a literature search of the Medline, Embase and Wangfang Medicine databases to identify all relevant studies for this meta-analysis. We determined that the miR-124 rs531564 polymorphism was significantly associated with decreased risks of cancers in the allelic model (G vs C, OR=0.71, 95% CI=0.53-0.94, P=0.02), homozygote model (GG vs CC, OR=0.42, 95% CI=0.26-0.66, P=0.0002), dominant model (GG/GC vs CC, OR=0.71, 95% CI=0.51-0.98, P=0.04) and recessive model (GG vs GC/CC, OR=0.43, 95% CI=0.27-0.69, P=0.0004). In an analysis stratified by cervical cancer group, significant associations were observed in the allelic model (G vs C, OR=0.46, 95% CI=0.32-0.66, P<0.0001), and dominant model (GG/GC vs CC, OR=0.45, 95% CI=0.3-0.66, P<0.0001). Subgroup analysis also revealed a decreased risk for esophageal squamous cell carcinoma in the homozygote model (GG vs CC, OR=0.45, 95% CI=0.27-0.75, P=0.002) and recessive model (GG vs GC/CC, OR=0.46, 95% CI=0.28-0.75, P=0.002). This meta-analysis suggests that the miR-124 rs531564 C > G polymorphism is an important risk factor for cancers among the Chinese population.

• Korean Medical Education Review
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• v.17 no.1
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• pp.39-48
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• 2015

The purpose of this study was to propose a theoretical model for an integrated medical humanities curriculum based on a STEAM (science, technology, engineering, arts, and mathematics) education framework and to provide a guideline for curriculum integration. Three dimensions of integrated curriculum development are competencies, core contents, and elements of integration. Competencies imply the purpose of the medical humanities of a medical school and the exit outcomes of the curriculum. Core contents imply the goals and objectives of the curriculum. We compared the goals and themes of the medical humanities with core attributes of professionalism. Four elements of integration were proposed: units (cases, problem activities, core contents, disciplines/subjects), types (multidisciplinary, interdisciplinary, transdisciplinary), contexts of integration (life cycle of patients, scope of society), and stages of student development (from student to doctor). It is expected that this theoretical model for an integrated medical humanities curriculum can be used as a guideline for curriculum development and an evaluation criterion for instructional designers and subject matter experts.

• Health Policy and Management
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• v.24 no.1
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• pp.35-46
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• 2014

Background: This paper describes the relationship and effect of health examination on personal medical cost by identifying the difference of the cost for medical care in physician visit between the population without and with health examination. Methods: After classifying into three cohorts in which, independent variables were designed according to the Andersen's behavioral model, the association of personal medical cost for medical care and prescription drugs which is dependent variable was analyzed by t-test and Mann-Whitney test for description and gamma regression model for inference. Results: In personal average medical cost, the population with health examination paid significantly more than without health examination, 11.6% more in cohort 2008, 26.6% more in cohort 2009, and 48.0% more in combined cohort. The odds ratio on medical expenditure of outpatients with health examination was 1.067, 1.126, 1.398 significantly in cohort 2008, 2009, and combined cohort respectively, comparing to the group without health examination. In independent variables, that is female, the elderly, never married, non-working, non-metropolitan, the higher family income, the smaller family size, people with disability, the people with chronic disease, and people with health examination have significantly being paid more tendency showing positive association with medical cost. Conclusion: This result showed that medical expenditure in physician visit has been increased after taking a health examination. Therefore reasonable limitation of getting preventive medical service is suggested to avoid medical shopping around and reduce being repeated health examination by unifying control to find out easily the clinical results from various medical facilities.

• Journal of Microbiology and Biotechnology
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• v.30 no.7
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• pp.996-1004
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• 2020

Various genetically engineered microorganisms have been developed for the removal of heavy metal contaminants. Metal biosorption by whole-cell biosorbents can be enhanced by overproduction of metal-binding proteins/peptides in the cytoplasm or on the cell surface. However, few studies have compared the biosorption capacity of whole cells expressing intracellular or surface-displayed metal-adsorbing proteins. In this study, several constructs were prepared for expressing intracellular and surface-displayed Ochrobactrum tritici 5bvl1 ChrB in Escherichia coli BL21(DE3) cells. E. coli cells expressing surface-displayed ChrB removed more Cr(VI) from aqueous solutions than cells with cytoplasmic ChrB under the same conditions. However, intracellular ChrB was less susceptible to variation in extracellular conditions (pH and ionic strength), and more effectively removed Cr(VI) from industrial wastewater than the surface-displayed ChrB at low pH (<3). An adsorption-desorption experiment demonstrated that compared with intracellular accumulation, cell-surface adsorption is reversible, which allows easy desorption of the adsorbed metal ions and regeneration of the bioadsorbent. In addition, an intrinsic ChrB protein fluorescence assay suggested that pH and salinity may influence the Cr(VI) adsorption capacity of ChrB-expressing E. coli cells by modulating the ChrB protein conformation. Although the characteristics of ChrB may not be universal for all metal-binding proteins, our study provides new insights into different engineering strategies for whole-cell biosorbents for removing heavy metals from industrial effluents.

• Korean Medical Education Review
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• v.22 no.3
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• pp.173-188
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• 2020

Medical humanities education (MHE) is as essential as basic medical sciences and clinical medicine education. Despite the importance of MHE, MHE curriculum development (CD) has proven to be challenging. This critical review examines the MHE CD at one medical school. The critical review methodology was developed based on Kern's six step CD model to systematically examine the CD of "Doctoring and Medical Humanities (DMH)" at the Yonsei University College of Medicine. Five review questions were developed related to (1) necessity, (2) direction and purpose, (3) design, (4) operation, and (5) evaluation of CD based on Kern's model. The review showed that the process of DMH CD mapped to components of Kern's model. The DMH curriculum content selected was closely related to medical practice and aimed to combine the acquisition of understanding and skills by designing a student-participatory curriculum based on clinical cases. Assessment methods that emphasized students' reflections were actively introduced in the evaluation section. Since the regular committee for DMH continued the work of the special ad hoc committees for DMH CD, the CD was effectively completed. However, the planning and evaluation functions and responsibilities of the DMH committee need to be strengthened. Despite the apparent limitations, the fact that students showed a high satisfaction rate and preferred small group discussions based on clinical cases has significant implications in the instructional design of MHE, where changes in self-awareness and attitude are more important than the acquisition of information. It is necessary to systematically review and study students' reflection results produced by the changed assessment methods and to develop assessment indicators for MHE that reflect the achievements of the MHE competencies of students.

• The Korean Journal of Emergency Medical Services
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• v.18 no.1
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• pp.7-15
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• 2014

Purpose: The purpose of the study is to evaluate the distance and location of the rescuer to patient for the effective chest compressions qualities. Methods: The subjects were 42 students who earned the basic lifesaving technique and had informed consents to participate in the study from May 1 to 20 in 2013. The position of the rescuers included model-0(reference point), model-1(10 cm distance), model-2(20 cm distance), and model-kn(kneeling up). Results: The mean depth of compression was $50.6{\pm}6.6mm$ in Model-0, $48.7{\pm}8.2mm$ in Model-1, $44.2{\pm}10.4mm$ in Model-2, and $51.8{\pm}6.0mm$ in Model-kn. There were statistically significant differences between each Model(p<.001). Conclusion: The closer distance between rescuer and patient could provide more effective chest compressions. Kneeling on the bed stance provided the deeper chest compression consistently than the stool stance.

• Korean Journal of Radiology
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• v.23 no.8
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• pp.811-820
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• 2022

Objective: To develop a model incorporating radiomic features and clinical factors to accurately predict acute ischemic stroke (AIS) outcomes. Materials and Methods: Data from 522 AIS patients (382 male [73.2%]; mean age ± standard deviation, 58.9 ± 11.5 years) were randomly divided into the training (n = 311) and validation cohorts (n = 211). According to the modified Rankin Scale (mRS) at 6 months after hospital discharge, prognosis was dichotomized into good (mRS ≤ 2) and poor (mRS > 2); 1310 radiomics features were extracted from diffusion-weighted imaging and apparent diffusion coefficient maps. The minimum redundancy maximum relevance algorithm and the least absolute shrinkage and selection operator logistic regression method were implemented to select the features and establish a radiomics model. Univariable and multivariable logistic regression analyses were performed to identify the clinical factors and construct a clinical model. Ultimately, a multivariable logistic regression analysis incorporating independent clinical factors and radiomics score was implemented to establish the final combined prediction model using a backward step-down selection procedure, and a clinical-radiomics nomogram was developed. The models were evaluated using calibration, receiver operating characteristic (ROC), and decision curve analyses. Results: Age, sex, stroke history, diabetes, baseline mRS, baseline National Institutes of Health Stroke Scale score, and radiomics score were independent predictors of AIS outcomes. The area under the ROC curve of the clinical-radiomics model was 0.868 (95% confidence interval, 0.825-0.910) in the training cohort and 0.890 (0.844-0.936) in the validation cohort, which was significantly larger than that of the clinical or radiomics models. The clinical radiomics nomogram was well calibrated (p > 0.05). The decision curve analysis indicated its clinical usefulness. Conclusion: The clinical-radiomics model outperformed individual clinical or radiomics models and achieved satisfactory performance in predicting AIS outcomes.

• Health Policy and Management
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• v.29 no.1
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• pp.11-18
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• 2019

The purpose of this research is to introduce the best practice of the Japanese national dementia strategy and explore implications to the Korean national dementia strategy. Interview was conducted among professions those who is in charge of Kumamoto dementia care practice in Kumamoto province, upon review of related literature and public documents. The Kumamoto model is implemented by the department of neuropsychiatry in public university hospitals, which can offer dementia-specialized medical services. Medical centers for dementia in public university hospitals play a leading role for managing practice and training local dementia centers specialist, coordinating medical services among medical institutions and community welfare facilities. In reference to the Kumamoto model, the Korean national dementia strategy can find implications in the direction of current system, specifically its approaches toward policy governance.