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.

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.

지방자치단체 공유잡종재산관리의 문제점과 합리적 개선방향

김보현,남창우 ( Bo Hyun Kim,Chung Woo Nam ) 한국지방자치학회 1998 한국지방자치학회보 Vol.10 No.3

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.

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.

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.

한·일 고대 사리장엄 비교연구

김보현(Bo Hyun Kim) 중앙승가대학교 불교학연구원 2015 불교와 사회 Vol.7 No.-

이 논문은 백제의 사리장엄을 연구하기 위한 목적으로 작성되었다. 이를 위해 본문에서는 능산리사지, 왕흥사지, 미륵사지에서 있었던 최근의 고고학적 연구성과들을 충분하게 반영코자 하였으며, 일본 飛鳥․白鳳期의 자료와 백제 사리장엄을 다양하게 비교 분석하는 내용을 담아내고자 하였다. 釋尊의 다비를 전하는 ‘舍利八分’을 始原으로 하는 사리신앙은 佛敎東漸과 함께 전래되어 각각의 문화적 전통 및 지역성과 융합하면서 장엄양식을 발전시켜 나갔다. 하지만 사리안치를 위해 중첩식 사리용기를 마련하고 탑을 세워 공양을 올리는 등의 기본 형식만은 변함없이 유지되었다. 이것은 『열반경』과 같은 경전의 내용을 의식하고 지키려는 뜻이 있었기 때문으로 파악하였으며, 백제와 일본의 경우에서도 이 같은 내용은 예외 없이 확인된다. 사리가 직접적으로 안치되는 사리용기와 사리를 장엄하기 위해 갖추어지는 사리공양품들은 모두 사리장엄구의 범주에 속하며, 여러 발굴조사를 통해서도 이들은 대체로 동일한 공간 내에 안치되고 있음이 확인된다. 이로 인하여 사리용기와 사리공양품은 유사한 특성을 지니는 것으로 간주되기 쉬우나, 조사결과 이들은 그 성격과 의미를 각기 달리하고 있다는 사실을 확인할 수 있었다. 사리용기는 매납 방법이나 재질의 이용 등에서 경전의 내용을 충실히 따르고 있는 것으로 파악된다. 그 중에서도 중국·백제·일본의 경우에는 한역본 경전의 영향이 크게 작용하였다. 반면 사리공양품의 경우에는 각 지역의 지역성에 영향을 받으면서 구성품들을 변화시키고 있는데, 일부 유물들에서는 완성품 자체보다는 그 재료의 구비를 목적으로 공양품을 조성한 흔적이 확인되기도 한다. 사리공양품의 매납과 고분 부장품과의 영향 관계를 감안할 때, 백제의 경우 追善 대상이나 발원자의 유품 등이 사용되었다는 점에서 그 유사성을 찾을 수 있었다. 또한 일본은 武具·馬具類 등과 같이 고분 부장품과 직접 관련이 있는 장엄구 이외에도, 사리공양품 매납에 미친 고분 부장풍습의 영향을 각 시대별로 살펴볼 수 있었다 This paper aims to research on Sarira decorations of Korea anicient Baekje Dynasty. The paper included recent archaeological researches around Nungsanri, Wanghungsa and Miruksa temple site and investigated Japanese Sariras of Asuka and Hakuho period to compare those periods with Korea Baekje dynasty. Sarira belief developed the style of the decorative arts by combining various traditional and cultural backgrounds. However, the basic structures, including several layers of caskets and stupas to keep Sariras, were maintained. Sarira decoration in general includes the casket that contains Sarira and all other decorations related to Sarira. The paper researched that these decorations were usually found from same place but have different meanings and characteristics. The casket follows the Buddhist scripture in terms of materials and the method it was buried. China, Japan and Baekjae especially followed the scripture translated and edited in Korea. On the other hand, other decorations vary in their components depending on local characteristics. The decorations in Baekjae included the relics of the person who had the Sarira while the decorations in Japan were influenced by their traditional funeral cultures.

공공요트학교 시설의 서비스품질에 대한 중요도-성취도 분석

김보현(Kim, Bo-hyun),진대근(Jin, Dae-geun),조송현(Cho, Song-hyun) 한국사회체육학회 2021 한국사회체육학회지 Vol.- No.83

Purpose: The purpose of this study is to analyze the importance and achievement of service quality of customers using public yacht school facilities. Method: In order to achieve this goal, the study extracted 350 samples from customers who had the experience of using public yacht school facilities and used a total of 320 pieces for data, excluding 30 parts judged to be unsatisfactory. IBM SPSS Win Ver. 25.0 Statistical Package Program was used to analyze the collected data. Exploratory factor analysis and Cronbach"s α values were used to test the validity and reliability of the questionnaire. To derive the results, the following conclusions were drawn from the use of descriptive analysis, frequency analysis, paired sample t-test, and importance-performance analysis techniques. The significant level of hypothesis verification was set-up as α=.05. Results: The results of this study are as follows. Quadrant Ⅰ included 5 attributes including ‘The Instructor"s method of systematic guidance’, ‘Responsible and sincere instructors’ and ‘The Instructor"s excellent leadership skills’. Quadrant II included 8 attributes including ‘education to suit performance’, and ‘specialized education’, ‘website and consultation’. Quadrant III included 9 attributes including ‘Various programs’, ‘Providing places for social gatherings’, and ‘Providing places for cultural events and education’. Quadrant IV included 9 attributes including ‘Program reservation’, ‘consideration for peer activities’ and ‘sponsored for community development events’. Conclusion: It is necessary to draw up an improvement plan that satisfies the perceived achievement of the customers by making the highest priority investment in the intensive improvement oriented area. It is the place where the customers who use the service quality of the public yacht school facilities are important but have low achievement.

『자기록』, 삶과 죽음에 대한 반성적 글쓰기

김보현(Kim Bo Hyun) 서강대학교 인문과학연구소 2016 서강인문논총 Vol.0 No.46

<자기록>은 죽음을 대하는 삶의 기록이라고 할 수 있다. <자기록>은 대부분 모친과 남편의 죽음에 대해 서술하고 있다. <자기록>은 모친과 남편의 죽음이 마땅하지 않은 이유를 기술함으로써, 이를 통해 자신의 죽음이 마땅하지 않음을 확인한다. <자기록>에 기술된 조씨가 만나는 일상은 유교적 이념에 근거를 두고 있는데 비해, 조씨가 만나는 죽음은 현실적인 문제를 담고 있다. 이러한 이념적 근거와 현실적인 문제는 <자기록>을 통해 서로 충돌 혹은 대화하면서, 조씨로 하여금 일상을 회복하도록 만든다. 화자는 <자기록>에서 죽음에 대해 반복적으로 기술함으로써, 죽어서는 안 되는 죽음을 되새긴다. 이는 죽어서는 안 되는 화자의 죽음과 동일시되는 죽음을 다시 말하는 것이다. 즉, 두 사람의 죽음을 되새기고 애도함으로써, 화자 자신이 죽을 수 없는 이유를 찾아내고, 일상으로 되돌아갈 수 있는 힘을 얻는 것이다. 따라서 <자기록>은 일상에 대한 기술이 아니라, 일상의 회복을 위한 기술이라고 할 수 있다. 살아있으므로 살아가는 것이 당연한데, 실제 세계는 살아있어도 죽는 것이 마땅한 세계이다. 화자는 이러한 모순을 글쓰기를 통해 확인하고 극복하고자 한다. 자신이 욕망하는 현실이 기존의 세계와는 대항적임을 확인하고, 규범을 대체함으로써 충돌하는 두 세계를 통합할 수 있는 새로운 가치 체계를 구축한다. Jagirok is a record of a life confronting death. The most part of Jagirok is described of the deaths of the narrator"s mother and her husband. Lady Cho, the narrator confirms that her own death is improper for her by describing why their deaths are improper for them. The deaths which she encounters contain practical problems, whereas her dailiness is based on the Confucian ideals. Those ideological basis and realistic problems, which conflicting or conversing with each other in Jagirok help her restore her dailiness. By describing deaths in Jagirok repeatedly she reminds herself of deaths which should not happen. It suggests again the deaths identified with her death which she does not want. In other words, as remembering and mourning their deaths, she finds out the reasons she ought not to die and obtains vigor to return to her everyday life. Therefore Jagirok is not a description on one"s daily life, but a description for restoration to dailiness. It is natural for you to live since you are alive, but the real world she lives in forces her into dying even though she is alive. The narrator tries to realize and overcome that contradiction with writing. She recognizes that the world she desires is against the world where she belongs and constructs a new value system which can integrate the two worlds by substituting the norms.