• Korean Medical Education Review
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• v.16 no.3
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• pp.126-131
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• 2014

The purpose of this study is to analyze the medical education system of Korea and to propose a method of curriculum redesign. Although there have been many attempts by medical educators to improve the quality of medical education, the results have not been fruitful. First, there exists a limitation to the dualistic curriculum design based on Flexnerianism, and thus, this model does not provide an integrated experience to medical students. Therefore, we propose a unidimensional model for curriculum redesign. Second, it is impossible to promote excellence in medical education without solving the structural problems of teaching and learning, such as the teaching competency of the faculty, large-scale lectures, and team teaching systems. A curricular strategy that emphasizes mutual interaction and teaching accountability is necessary to promote meaningful learning. Third, the current clinical training system, the circulation model, provides incomplete training as well as a lack of sequence and articulation experiences. This system needs to be redesigned in a way that allows only those students who have mastered both the knowledge and the application of medical education to advance to the next step. Fourth, norm-referenced assessments of a medical college distort the learning process and create unconstructive system energy. A criterion-referenced assessment that values cooperation, independent study, and intrinsic motivation is more important for the reliability and validity of the assessment. Medical students should not focus on formative and informative learning. Medical colleges should investigate the multifaceted potential of the students and provide transformative learning to grow students into change agents. For this to take place, curriculum redesign-not new methods of medical education-is required.

• Archives of Plastic Surgery
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• v.34 no.3
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• pp.330-335
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• 2007

Purpose: The purpose of this study is to evaluate the functional outcome and donor site morbidity of anterolateral thigh free flap(ALT) compared to Radial forearm free flap(RFFF) for the reconstruction of partial glossectomy defect. Methods: 5 ALT free flap (group I) were attempted for partial glossectomy patients. We compared patients undergone ALT flap with those(n=11) of similar size defect reconstructed with RFFF (Group II). Rating scales for articulation and swallowing function were applied and donor site morbidity have been evaluated. Results: The scales for speech function showed no difference between the two groups (average score; group I - 6.4, group II - 6.45). Swallowing function also showed no difference between the two groups(average score; Group I - 6.6, Group II - 6.27). ALT group had one patient with donor site morbidity(numbness). All of the RFFF patients(11/11) complained and suffered from hypertrophic scar, retraction, numbness or hyperpigmentation on forearm donor site. Based on our study, ALT free flap is comparable to that of RFFF in terms of functional assessment in tongue reconstruction. Conclusion: Considering the donor site morbidity, ALT flap is to be valuable to reconstruct partial glossectomy defect.

• Journal of Korean Orthopaedic Sports Medicine
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• v.12 no.1
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• pp.16-23
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• 2013

Multiple ligament knee injury is defined as rupture to at least two of the four major knee ligament structures. Three or four knee ligament injury results in knee dislocation as complete disruption of the integrity of the tibiofemoral articulation. In multiple ligament knee injury, vascular and neurologic assessment should be performed meticulously and systematically. Emergency surgery should be needed if arterial injury is suspected. Surgical treatment rather than conservative management should be done and early surgery might be better than delayed surgery. Reconstruction of ACL and PCL, repair or reconstruction of MCL, and reconstruction of posterolateral corner are recommended, although many debates have occurred. Multiple ligament knee injury requires more aggressive management than single ligament knee injury.

• Journal of the Korea Convergence Society
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• v.9 no.6
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• pp.125-132
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• 2018

This study was to investigate the speech sound production characteristics and evaluation aspects of preschool children through word test and connected speech test. For this, the authors conducted Assessment of Phonology and Articulation for Children(APAC) to 72 normal children(24 three-, four-, and five-year-olds each) and analyzed difference in percent of correct consonant(PCC) and intelligibility according to age and sex, correlation between PCC and intelligibility, and speech sound error patterns. PCC and intelligibility increased with age but there was no difference according to sex. The correlation was statistically significant in 5-year-old group. Speech sound error patterns were different in the two tests. This study showed that children's speech sound production varied according to language unit. Therefore, both types of tests should be done to grasp their speech sound production ability properly. This suggests that current standard to identify language impairment only by PCC of word level requires review and further studies.

• Archives of Plastic Surgery
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• v.44 no.3
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• pp.202-209
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• 2017

Background No consensus exists on the optimal treatment protocol for orofacial clefts or the optimal timing of cleft palate closure. This study investigated factors influencing speech outcomes after two-stage palate repair in adults with a non-syndromal complete unilateral cleft lip and palate (UCLP). Methods This was a retrospective analysis of adult patients with a UCLP who underwent two-stage palate closure and were treated at our tertiary cleft centre. Patients ${\geq}17$ years of age were invited for a final speech assessment. Their medical history was obtained from their medical files, and speech outcomes were assessed by a speech pathologist during the follow-up consultation. Results Forty-eight patients were included in the analysis, with a mean age of 21 years (standard deviation, 3.4 years). Their mean age at the time of hard and soft palate closure was 3 years and 8.0 months, respectively. In 40% of the patients, a pharyngoplasty was performed. On a 5-point intelligibility scale, 84.4% received a score of 1 or 2; meaning that their speech was intelligible. We observed a significant correlation between intelligibility scores and the incidence of articulation errors (P<0.001). In total, 36% showed mild to moderate hypernasality during the speech assessment, and 11%-17% of the patients exhibited increased nasalance scores, assessed through nasometry. Conclusions The present study describes long-term speech outcomes after two-stage palatoplasty with hard palate closure at a mean age of 3 years old. We observed moderate long-term intelligibility scores, a relatively high incidence of persistent hypernasality, and a high pharyngoplasty incidence.

• Korean Journal of Cleft Lip And Palate
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• v.12 no.1
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• pp.1-6
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• 2009

Oronasal fistula are a well-known complication of surgical treatment of cleft palate, occurring most frequently in the alveolus and hard palate. Previous reports have demonstrated that oronasal fistulas, particularly if greater than l cm in diameter, had an adverse effect on speech. The aim of this study was to demonstrate the relationship between the size of the fistula and the influence on velopharyngeal function. The site and size of the fistula were indicated on graph paper with calipers and measured in $mm^2$. Speech assessment was carried out using a Nasometer, VPI articulation differential test, spectrography. Patient whose fistulas affected their speech had significantly larger fistulas than those whose fistulas did not. The study shows that the larger the fistula, the greater the risk of hypernasality and nasal emission, but even small fistulas can cause speech problems. If obstruction of the nasal passage is eliminated in a patient with a previously asymptomatic fistula, it may result in a fistula becoming symptomatic, resulting in hypernasality and nasal emission. In conclusion, even small fistulas can influence speech production and should be considered before any treatment is planned. The study lends support to early closure of oronasal fistulas, particularly before pharyngeal flap surgery is contemplated.