Education of History of Medicine for 80 Years: History and Current Status in Republic of Korea / 의사학

Medical history education enables the medical students to understand the humanistic aspects of medicine and also help to promote the professionalism of doctors. It makes them understand the disappearing or emerging diseases by recognizing the historical changes and trends to respond appropriately. Therefore, it is helpful to study and understand modern medicine.As of March 2023, 22 (55.0%) out of 40 medical schools in Republic of Korea have medical history course as an independent subject and two schools have integrated courses with medical ethics. Compared to 53.1% in 1995 and 56.2% in 2010, similar percentage of medical schools maintained the subject independently. However, the average credits of 18 schools in 2023(2.0) are higher than those of 1995(1.4) and 2010(1.2).The number of full-time professor who specialized in the history of medicine was 2 in 1995, 6 in 2010, and 11 in 2023. Generally, a full-time professor majoring medical history tend to have other duties besides the education and research of medical history, depending on the role of the department to which he or she belongs since they are assigned to the humanities education other than medical history education.Currently, the curriculums that have been recommended by Korea Association of Medical Colleges(KAMC), Korean Institute of Medical Education and Evaluation(KIMEE), and The Korean Society of Medical Education(KSMED), emphasize medical humanities but do not necessarily include the medical history. As a result, medical history courses have increased slightly, but the other humanities classes have increased significantly since 2000.The knowledge of medical history will help students become a doctor, and a doctor with professionalism adapting to the rapidly changing medical environment. Students will also be able to establish the ideas they must pursue in the present era when they come into contact with numerous historical situations. And if they share a sense of history, they will inspire a sense of unity as a profession and will be more active in solving social problems such as health equity.It is hoped that The Korean Society for the History of Medicine will step forward to set the purpose and goal of the medical history education, and organize the contents of the education. Classes should be prepared so that students are interested in them, and education should be focused on how the contents of education will be able to be used in medicine. To this end, it is necessary to establish the basic learning outcomes of history of medicine, and prepare learning materials based on these learning outcomes. It is also necessary to increase the competencies of educators for the history of medicine, such as performing workshops.With the dedication of the pioneers who devoted their energy to the education of medical history, it is expected that medical history will find out what to do in medical education to foster better doctors and provide better education.

Analysis of Role Modeling Experiences and Reflection Level of Fourth‐Year Medical Students at a Single Medical College: A Focus on the Clinical Clerkship / 의학교육논단

This study aimed to analyze the subjects, situations, and reflection levels related to role modeling experienced by medical students during their clinical clerkship and their own reflections. This study intends to suggest ways of improving how residents and clinical faculty should treat and teach medical students. Written interviews were conducted regarding senior medical students’ role modeling experiences during their clinical clerkships in 2018 and 2019. Content analysis was conducted for a total of 224 cases from 196 students. Content analysis revealed three types of role modeling content: subjects (faculty, residents, nurses, peer students), situations (clinical competence, personal qualities, teaching skills), and the level of reflection (critical reflection, reflection, thoughtful action, and habitual action) in each case. As role model subjects, faculty were found to be the paramount role model (n=142, 62.83%). Role modeling was the most frequently performed for clinical competence (n=103, 45.98%). Clinical competence was frequently shown in communication and empathic listening during rounds and outpatient relationships between the patient and doctor. Regarding the level of reflection for role modeling, the number of critical reflections was 86 (38.39%) and that of reflections was 80 (35.71%). In particular, negative role modeling showed a high level of critical reflection in relation to faculty (64.44%) and nurses (8.89%). In conclusion, role modeling of medical students participating in clinical clerkships occurs in situations that the role models are not aware of, with positive or negative effects on the formation of professional identity among medical students.

To Prepare the Best Remote Learning / 의학교육논단

no abstract available

The Concept of Remote Learning and How to Do It Well / 의학교육논단

no abstract available

The Best Teaching Method / 의학교육논단

No abstract available.

English Resources for Research Ethics Education / 의학교육논단

No abstract available.

Suksin Lee, the First Ph.D. and Full-Time Professor of Biochemistry in Korea

No abstract available.

How Can We Improve Premedical Education in Korea? / 의학교육논단

When a new educational system for college students in South Korea was established in 1946, the National Committee for Educational Planning adopted a 6-year curriculum of medical education, consisting of a 2-year premedical component and a 4-year medical component. For more than half a century, the premedical curriculum has received little attention. However, it is very important for premedical students to have a range of experiences that could be useful in their future medical careers. In 2005, another change was made to the system of medical education, in which medical schools without a 2-year premedical curriculum were established. This began to stimulate interest in premedical education, and more and more professors have become interested in premedical education as 6-year medical colleges have become more popular than before. Since 2015, the Education and Cultural Center of the Korean Association of Medical Colleges has annually hosted a workshop for redesigning premedical education; these workshops quickly fill up with registrants, reflecting the participants' lively interest in premedical education. The problems of premedical education are mostly due to students' and educators' attitudes. A more effective approach will be needed in the educational system of the future to train highly competent medical doctors. To judge whether an educational program is successful, its aims must be clearly articulated. For this reason, medical colleges must prepare premedical education curricula based on their educational aims. It is expected that the system of premedical education will be strengthened in the future due to the growing awareness of its importance.

Application of 'Writing for Healing' in Premedical Humanities Education / 한국의학교육

There has been a recent tendency to attach special importance to writing education. Books on 'writing to heal' are being written in or translated into Korean. According to these texts, writing is a valuable tool for internal healing, depending on the mode of application. Writing can have positive effects and give hope to an individual or group, but it can also be a source of frustration and despair. Based on the distinct effects of writing, we cannot overemphasize the significance of writing education. Writing is generally taught during a premedical course that targets students who will eventually practice medicine. Many reports have examined immorality in medical students and health care providers, which is a reason that writing education is important for medical systems. 'Writing for Healing' is open to freshmen at Yonsei University Wonju College of Medicine. The aim of this subject is to help students identify and acknowledge internal diseases to lead a healthier life and eventually become positive and responsible health care providers. However, in addition to the vague definition of what 'healing' is, the concept of 'writing for healing' has not been defined. This paper attempts to define the concept of 'writing for healing' and considers what influences it can have on a humanities curriculum in medical colleges.

Functional Expression of P2Y Receptors in WERI-Rb1 Retinoblastoma Cells

P2Y receptors are metabotropic G-protein-coupled receptors, which are involved in many important biologic functions in the central nervous system including retina. Subtypes of P2Y receptors in retinal tissue vary according to the species and the cell types. We examined the molecular and pharmacologic profiles of P2Y purinoceptors in retinoblastoma cell, which has not been identified yet. To achieve this goal, we used Ca2+ imaging technique and western blot analysis in WERI-Rb-1 cell, a human retinoblastoma cell line. ATP (10 microM) elicited strong but transient [Ca2+]i increase in a concentration-dependent manner from more than 80% of the WERI-Rb-1 cells (n=46). Orders of potency of P2Y agonists in evoking [Ca2+]i transients were 2MeS-ATP>ATP>>UTP=alphabeta-MeATP, which was compatible with the subclass of P2Y1 receptor. The [Ca2+]i transients evoked by applications of 2MeS-ATP and/or ATP were also profoundly suppressed in the presence of P2Y1 selective blocker (MRS 2179; 30 microM). P2Y1 receptor expression in WERI-Rb-1 cells was also identified by using western blot. Taken together, P2Y1 receptor is mainly expressed in a retinoblastoma cell, which elicits Ca2+ release from internal Ca2+ storage sites via the phospholipase C-mediated pathway. P2Y1 receptor activation in retinoblastoma cell could be a useful model to investigate the role of purinergic [Ca2+]i signaling in neural tissue as well as to find a novel therapeutic target to this lethal cancer.

Transforming growth factor-beta gene promoter polymorphism:its association with renal involvement in Henoch-Scholein Purpura in childhood / 소아과

Purpose: Several cytokines play important roles in the inflammatory process of Henoch-Scholein Purpura (HSP). It is likely that transforming growth factor-beta (TGF-beta) is involved in the pathogenesis of HSP. The purpose of this study is to investigate whether TGF-beta promoter polymorphism is associated with the renal involvement of childhood HSP. Methods: Thirty-four patients younger than 15 years, who had been diagnosed with HSP, as well as 27 controls, were examined. Patients and controls were genotyped for TGF-beta C-509T by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results: The T allelic frequencies in patients and controls showed no difference (45% vs. 48.8%). No allele or genotype differences between the group of HSP group and control group were observed. The frequencies of TGF-beta 509 genotypes TT, TC, and CC were no different between patients and controls (26% vs. 22%). The TT genotype of polymorphism of the TGF-beta C-509T gene had no relation to the susceptibility of children to HSP and renal involvement in HSP. Conclusion: TGF-beta T allele may not be related to the susceptibility of children to HSP. The TT genotype of polymorphism of the TGF-beta C 509T gene does not appear to have an influence on renal involvement in childhood HSP.

The Relationship Between Interleukin 1beta Gene Polymorphism and Renal Involvement in Henoch-Schonlein Purpura

PURPOSE: High interleukin-1 beta(IL-1beta) expression in the skin biopsy specimens of patients with Henoch-Schonlein Purpura(HSP) has been observed. We examined IL-1beta gene polymorphism in patients with HSP. The purpose of this study is to examine the relationship between IL-1beta gene polymorphism and renal involvement in HSP. METHODS: Patients from mideast Korea with HSP were studied. All patients had at least 6 months of follow up. Patients and ethnically matched controls were genotyped for IL-1beta gene polymorphism by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). RESULTS: Thirty-four patients(all younger than 15 years old) who had been diagnosed with HSP and 27 controls were examined. No allele or genotype differences between the HSP and control groups were observed. No significant association between the carriage of IL-1beta(-511) T allele and renal involvement(P=0.525, OR:1.417, CI:0.545-3.686) was found. CONCLUSION: In unselected patients with HSP, carriage of IL-1beta(-511) T allele does not appear to influence renal involvement.

Thiamine-responsive Megaloblastic Anemia Syndrome in a Mother and Five Daughters / 대한소아혈액종양학회지

Thiamine-responsive megaloblastic anemia (TRMA) syndrome is an early-onset autosomal recessive disorder characterized by megaloblastic anemia with ringed sideroblasts, diabetes mellitus and progressive sensorineural deafness, all of which respond in varying degrees to the administration of thiamine, in pharmacologic doses. TRMA syndrome has been reported in less than 30 families, but has never been reported in Korea. It has been demonstrated recently that TRMA is consistently associated with a defect in thiamine transport across cellular membranes and with impaired intracellular pyrophosphorylation. The TRMA syndrome gene, SCL19A2, locates on chromosome 1q23.2-23.3, and encodes a high-affinity thiamine transporter protein. We recently experienced 6 cases of thiamine-responsive megaloblastic anemia syndrome in a family, including a mother and five daughters. All the six cases revealed megaloblastic anemia refractory to vitamin B12 and folic acid therapy but responded to thiamine. We report the cases with a brief review of the literature.

F508 amino acid deletion mutation of CFTR gene in Korean lung cancer patients

Mutations of the transmembrane conductance regulator (CFTR) gene in cystic fibrosis lead to dysfunction of the lung, pancreas, and sweat glands, etc. To investigate the possibility of the relationship between lung cancer and the mutations of CFTR gene, we determined amino acid sequences using reverse transcription-polymerase chain reaction (RT-PCR) and DNA sequencing. In this study, the deletion mutation of 508th amino acid in one of nine lung caner patients was found confirming that CFTR gene mutation exists in a Korean lung cancer patient.

Mutation of Ha-ras Oncogene in Rat Salivary Gland Tumors Induced by DMBA / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The incidence of salivary gland tumor is approximately 2% among all head and neck tumors, of which malignant cases account for only about 5%. Much research has been performed in order to clarify the mechanism of oncogene activation, however salivary gland tumors remain understudied. We performed this study in order to characterize the ras gene in these tumors. MATERIALS AND METHODS: We treated white rats with 7, 12-dimethylbenz[a]anthracene (DMBA) and confirmed the occurrence of salivary gland tumors after ten to thirty weeks. Isolated genomic DNAs from tumor tissues were added to NIH 3T3 cells. In order to detect Ha-ras mutations, we performed a two-step PCR-RFLP and 7analyzed the mutated sequences. RESULTS: We induced salivary gland tumors by DMBA treatment in white rats. Isolated DNAs from the tumor tissues transformed the NIH 3T3 cells. Point mutations were observed in codons 12 and 61 of the Ha-ras oncogene. The total frequency of point mutations was 13.9% in DMBA-induced salivary gland tumors in rats. CONCLUSION: Our results demonstrate that a variety of cancers ras oncogene mutations were also found in salivary gland tumors. We confirmed that a point mutation of the Ha-ras oncogene in a DMBA-induced salivary gland tumor occurs at a frequency of 13.9%.

The new genotypic human calicivirus isolated in Seoul

A new type of human calicivirus (HuCV) showing the classic cup-shaped surface morphology was identified in the stool sample from a child with symptoms of acute gastroenteritis in Seoul, Korea (SK virus). Genomic RNA was extracted directly from the stool sample, and the nucleotide sequence of 3.2 kb of the 3' end of SK virus was determined from cDNA. This region spanned sequences from the RNA-dependent RNA polymerase (RDRP) region in the open reading frame 1 (ORF1) to the 3' poly A tail. The non-structural and capsid protein coding sequences were fused in a single ORF as observed in Manchester type (Genogroup III). However, ORF2 of Manchester virus was missing in SK virus. In RDRP region, SK virus showed amino acid and nucleotide identities of 74-75% and 68-69% respectively, with those of Manchester virus, while showed 34-46% and 55-60% identities respectively with those of other human caliciviruses. However, capsid protein of SK virus showed a partial (29-46%) amino acid identity with those of other caliciviruses including Manchester type. The closest resemblance in amino acid (97-99%) and nucleotide sequence (85-86%) identities were found in RDRP region with Vanderbijlpark and Pretoria isolates recently found in South Africa. These results suggest that SK virus together with Vanderbijlpark and Pretoria isolates belong to a new type different from Manchester virus.

The prediction of interferon-alpha therapeutic effect by sequence variation of the HCV hypervariable region 1

Interferon-alpha (IFN-alpha) has been used to treat hepatitis C virus (HCV)-induced hepatitis, but it has been effective in only about half of the treated patients, with recurrence appearing in the other half. As a consequence of the possible complications associated with IFN-alpha and the high cost of treatment, it has become extremely important to select the proper patients for IFN-alpha treatment. In our previous study, we found that the quasispecies in the hypervariable region (HVR) 1 of HCV were various and that a new quasispecies can appear in non-responders and/or lead to deterioration in the patients' condition. The preliminary data we obtained in the process of our previous research led us to believe that the quasispecies of HVR 1 has something to do with the effect of IFN-alpha. Thus, in this investigation, we tried to determine the predictive factors of IFN-alpha therapy. Thirty patients with HCV infection were treated with IFN-alpha. Among them, 15 patients recovered after six months IFN-alpha treatment, but the remaining 15 patients showed no response after six months IFN-alpha treatment. We cloned HVR 1 DNA by reverse transcription-polymerase chain reaction (RT-PCR) and examined the quasispecies of HVR 1. As the quasispecies of HVR 1 in non-responders varied more than in the complete remission group, we concluded that the sequence variation in HVR 1 of HCV can be used to predict the effect of IFN-alpha.

Inhibition of HBV replication by antisense oligodeoxyribonucleotides in HepG2 cells transfected with a cloned HBV DNA

The effect of antisense oligodeoxyribonucleotides(oligo[dN]s) on hepatitis B virus(HBV) replication in HepG2 cells harboring a cloned HBV genome was examined. Antisense oligo(dN)s directed at translational initiation sites of S, pre C and P genes of HBV were treated to the cells and the amount of HBsAg and HBV DNA content were measured 72 hours after the treatment. HBsAg expressions in HepG2 cells harboring the HBV genome were inhibited 68%, 53%, and 46% by the treatment with antisense oligo[dN] directed at S, pre C, and P gene loci, respectively, and HBV DNA content in the cells was also reduced by the treatment of each antisense oligo[dN]. The doubling times of the cultured cells treated with 25 micrograms, 50 micrograms, and 100 micrograms of antisense oligo[dN]/ml medium were 43.3, 62.1, and 93.0 hours, respectively, compared with 37.5 hours of the untreated control cells. Cellular DNA synthesis was inhibited by the treatment with 100 micrograms/ml of antisense oligo [dN], however, no significant effect was observed by the treatment with 50 micrograms or less of antisense oligo[dN]/ml. These results suggested that antisense oligo[dN]s specific to the translational initiation sites of S, pre C, and P genes of HBV may have therapeutic potential for the suppression of HBV propagation in chronic HBV infected patients.

Identification of mutagenic site of c-H-ras oncogene damaged by N-acetoxyacetylaminofluorene(AAAF)

A molecularly cloned human cellular H-ras (c-H-ras) oncogene(pbc N1 plasmid) was treated with N-acetoxyacetylaminofluorene (AAAF) in vitro and subcloned into E.coli. This was done to identify the mutational changes at specific codons of the gene. Guanine nucleotides were identified as the major AAAF binding site of the DNA adduct formed. Base changes in codons 12 and 61 were determined by the analysis of restriction fragment length polymorphism (RFLP) and site specific oligonucleotide hybridization. RFLP was observed due to the loss of the Hpall recognition site at codon 11 and 12 of AAAF-treated c-H-ras gene. Hybridization of AAAF treated c-H-ras with 32P-labeled oligonucleotide probes for the mutant alleles of codon 61 showed no substitutions at codon 61. From these results, it is assumed that AAAF treatment in vitro caused mutation at codon 12 but not at codon 61 of the c-H-ras oncogene and that codon 12 is the primary target of mutation by AAAF