This study examines the legality and appropriateness of keeping the multiple-choice question items of the Korean Medical Licensing Examination (KMLE) confidential. Through an analysis of cases from the United States, Canada, and Australia, where medical licensing exams are conducted using item banks and computer-based testing, we found that exam items are kept confidential to ensure fairness and prevent cheating. In Korea, the Korea Health Personnel Licensing Examination Institute (KHPLEI) has been disclosing KMLE questions despite concerns over exam integrity. Korean courts have consistently ruled that multiple-choice question items prepared by public institutions are non-public information under Article 9(1)(v) of the Korea Official Information Disclosure Act (KOIDA), which exempts disclosure if it significantly hinders the fairness of exams or research and development. The Constitutional Court of Korea has upheld this provision. Given the time and cost involved in developing high-quality items and the need to accurately assess examinees’ abilities, there are compelling reasons to keep KMLE items confidential. As a public institution responsible for selecting qualified medical practitioners, KHPLEI should establish its disclosure policy based on a balanced assessment of public interest, without influence from specific groups. We conclude that KMLE questions qualify as non-public information under KOIDA, and KHPLEI may choose to maintain their confidentiality to ensure exam fairness and efficiency.

This study examines the legality and appropriateness of keeping the multiple-choice question items of the Korean Medical Licensing Examination (KMLE) confidential. Through an analysis of cases from the United States, Canada, and Australia, where medical licensing exams are conducted using item banks and computer-based testing, we found that exam items are kept confidential to ensure fairness and prevent cheating. In Korea, the Korea Health Personnel Licensing Examination Institute (KHPLEI) has been disclosing KMLE questions despite concerns over exam integrity. Korean courts have consistently ruled that multiple-choice question items prepared by public institutions are non-public information under Article 9(1)(v) of the Korea Official Information Disclosure Act (KOIDA), which exempts disclosure if it significantly hinders the fairness of exams or research and development. The Constitutional Court of Korea has upheld this provision. Given the time and cost involved in developing high-quality items and the need to accurately assess examinees’ abilities, there are compelling reasons to keep KMLE items confidential. As a public institution responsible for selecting qualified medical practitioners, KHPLEI should establish its disclosure policy based on a balanced assessment of public interest, without influence from specific groups. We conclude that KMLE questions qualify as non-public information under KOIDA, and KHPLEI may choose to maintain their confidentiality to ensure exam fairness and efficiency.

This study examines the legality and appropriateness of keeping the multiple-choice question items of the Korean Medical Licensing Examination (KMLE) confidential. Through an analysis of cases from the United States, Canada, and Australia, where medical licensing exams are conducted using item banks and computer-based testing, we found that exam items are kept confidential to ensure fairness and prevent cheating. In Korea, the Korea Health Personnel Licensing Examination Institute (KHPLEI) has been disclosing KMLE questions despite concerns over exam integrity. Korean courts have consistently ruled that multiple-choice question items prepared by public institutions are non-public information under Article 9(1)(v) of the Korea Official Information Disclosure Act (KOIDA), which exempts disclosure if it significantly hinders the fairness of exams or research and development. The Constitutional Court of Korea has upheld this provision. Given the time and cost involved in developing high-quality items and the need to accurately assess examinees’ abilities, there are compelling reasons to keep KMLE items confidential. As a public institution responsible for selecting qualified medical practitioners, KHPLEI should establish its disclosure policy based on a balanced assessment of public interest, without influence from specific groups. We conclude that KMLE questions qualify as non-public information under KOIDA, and KHPLEI may choose to maintain their confidentiality to ensure exam fairness and efficiency.

OBJECTIVE: Nonstress test(NST) has become an important method of antepartum evaluation of fetal well-being. The fetal heart rate(FHR) testing is used frequently as a nonstress test(NST). However, NST highly depends on whom to interpret the result of FHR testing. Recently, for interpretation of FHR, objective decision methods using softwares have been introduced. In this study, we aim to analyse the correlation between each variable affecting FHR and fetal outcome using objective decision basis with principal component analysis and multiple regression analysis. MATERIALS AND METHODS: The clinical observation was made on 5,314 data from pregnant women who took a NST which had been collected from 1989 to 1997 at Hanyang University Hospital. For collection of data and values of each variable, we used our own FHR interpretation softwares, HYFM-I(DOS version, 1989) and HYFM-II(Window-version, 1998). Then, the principal component analysis is performed to find significant variable and multiple regression analysis using these variables. RESULTS: Each groups were divided and classified as followings ; 1 minute Apgar score-normal, 1 minute Apgar score-abnormal, 5 minute Apgar score-nomal, 5 minutes Apgar score-abnormal; there is significant difference between signal loss and 1 minute Apgar score only. And significant difference was shown between mean baseline FHR, FHR variability-amplitude, FHR variability-MMR, and fetal outcomes(body weight of newborn & Apgar score). The FHR variability-amplitude, FHR variability-MMR, and weight of baby were important values in predict of fetal well-being. CONCLUSIONS: In conclusion, there are close relation in each variable of FHRand fetal outcome. The result of this study would be useful background data in the development of objective and automated FHR analysis software, especially in the computerized FHR analysis system.
Apgar Score ; Female ; Fetal Heart* ; Heart Rate, Fetal* ; Humans ; Infant, Newborn* ; Pregnancy ; Pregnant Women ; Principal Component Analysis

BACKGROUND: Recently, an elevated serum homocysteine level has been reported to be associated with increased fracture risk and reduced bone mineral density (BMD). So far, little research has been done to evaluate such association in Korean population. Therefore, we investigated the association between serum homocysteine levels and BMD in Korean adults. METHODS: The subjects consisted of 2,750 adults who visited a health promotion center at a university hospital from January 2005 to March 2006. Self-administered questionnaires provided information about lifestyle and medical history. Fasting plasma samples were collected and BMD of the lumbar spine and femoral neck were obtained by dual energy X-ray absorptiometry. To adjust for menopausal state, the female subjects were divided into three groups according to age (< or =45 yrs, 46~55 yrs, 55 yrs <). Multiple linear regression analysis was used to evaluate the association between serum homocysteine levels and BMD in each gender and age group. RESULTS: The results adjusted for alcohol and smoking history showed significant association between serum homocysteine levels and BMD in women (Lumbar spine: beta=-0.006, P=0.015, Femoral neck: beta=-0.065, P=0.012) but not in men (Lumbar spine: beta=0.001, P=0.240, Femoral neck: beta=0.001, P=0.242). With analyses by three age groups, plasma homocysteine level was associated with both lumbar and femoral BMD in age 46~55 women (Lumbar spine: beta=-0.014, P=0.024, Femoral neck: beta= -0.007, P=0.019). CONCLUSION: Our study suggests that increased serum homocysteine level is an independent risk factor for low BMD among women, especially perimenopausal women. Further studies about the sexual differences and the mechanisms linking serum homocysteine level to BMD are needed.
Absorptiometry, Photon ; Adult ; Bone Density ; Fasting ; Female ; Femur Neck ; Health Promotion ; Homocysteine ; Humans ; Life Style ; Linear Models ; Male ; Osteoporosis ; Plasma ; Risk Factors ; Smoke ; Smoking ; Spine ; Surveys and Questionnaires

Norwegian scabies can be defined as a generalized, severe scabies infestation which usually affects immunocompromised patients. The diagnosis is commonly missed, and can lead to mismanagement. We describe a patient with Norwegian scabies affecting the whole body. The patient had suffered with pemphigus foliaceus for several years and had an immunosuppressed status due to long-term use of oral corticosteroids. He was admitted to our hospital. At first, we made a diagnosis of exfoliative dermatitis secondary to pemphigus foliaceus. However, no improvement of the condition was seen after an increased dosage of oral corticosteroids, azathioprine, and mycophenolate mofetil. We then identified adult scabietic mites, eggs and scybala upon microscopic examination of skin scales. He was treated with an application of gamma benzene hexachloride cream. We recommend that the diagnosis of scabies be considered in immunocompromised patients with thick skin scales and associated night pruritus.
Adrenal Cortex Hormones ; Adult ; Azathioprine ; Dermatitis, Exfoliative ; Diagnosis ; Eggs ; Humans ; Immunocompromised Host ; Lindane ; Mites ; Ovum ; Pemphigus* ; Pruritus ; Scabies* ; Skin ; Weights and Measures

Behcet's disease is a systemic inflammatory disorder of unknown etiology, characterized by recurrent oral aphthous ulcers, genital ulcers, uveitis, and skin lesions. Renal involvement is rare in patients with Behcet's disease particularly immunoglobulin A (IgA) nephropathy. Other autoimmune diseases have been associated with increased risk of malignancy, but not Behcet's disease. Some cases of Behcet's disease accompanied by bladder cancer, thyroid cancer, stomach cancer, or hematologic malignancies have been reported. However, to the best of our knowledge, co-occurrence of Behcet's diseases with thymic carcinoma has not yet been reported. We experienced a 49-year-old male patient who had been treated for Behcet disease and IgA nephropathy, who presented with a large mediastinal mass on chest x-ray. After thymectomy, he was diagnosed with thymic carcinoma with complete resection.
Autoimmune Diseases ; Behcet Syndrome ; Glomerulonephritis, IGA* ; Hematologic Neoplasms ; Humans ; Immunoglobulin A ; Male ; Middle Aged ; Skin ; Stomach Neoplasms ; Stomatitis, Aphthous ; Thorax ; Thymectomy ; Thymoma* ; Thyroid Neoplasms ; Ulcer ; Urinary Bladder Neoplasms ; Uveitis

Acute esophageal necrosis is a rare clinical entity characterized by the endoscopic finding of extensive black discoloration of the esophageal mucosa. Acute esophageal necrosis in a patient with diabetic ketoacidosis has rarely been reported. We report a case of acute esophageal necrosis in a patient with diabetic ketoacidosis. The patient had coffee ground emesis and, after an esophagogastroduodenoscopy with mucosal biopsy, acute esophageal necrosis was diagnosed. The patient was treated conservatively with an intravenous proton pump inhibitor and oral sucralfate without any complications.
Biopsy ; Coffee ; Diabetes Mellitus ; Diabetic Ketoacidosis ; Endoscopy, Digestive System ; Esophagus ; Humans ; Mucous Membrane ; Necrosis ; Proton Pumps ; Sucralfate ; Vomiting

Meckel-Gruber syndrome is a multiple malformation syndrome featuring occipital meningoencephalocele, multicystic dysplasia of kidney, cystic and fibrotic change of liver, polydactyly, and other characteristics inherited by the autosomal recessive trait. We exprienced a case of Meckel-Gruber syndrome in a newborn male diagnosed clinically and confirmed pathologically. Abnormalities of the fetus were found prenataly by ultrasonogram, and subsequently the baby was terminated by cesarean section delivery at 32 weeks of gestational age. We report this case with brief review of literature.
Cesarean Section ; Female ; Fetus ; Gestational Age ; Humans ; Infant, Newborn ; Kidney Diseases, Cystic ; Liver ; Male ; Polydactyly ; Pregnancy ; Ultrasonography

BACKGROUND: The family medicine residency program consists mainly of clinical rotations in other specialties and the family medicine-specific training. We conducted this study to investigate how family medicine residents evaluated their training program that include family-oriented medicine, clinical preventive medicine, behavioral science and research in primary care. METHODS: In 2009, third-year residents of 129 training hospitals in Korea were surveyed to investigate the current state and their expectation of the residency program. The contents of questionnaires included training periods, conferences, procedures, interview techniques, outpatient and inpatient consultations, and written thesis. RESULTS: Total 133 out of 142 residents (93.7%) responded that 3 years of training is ideal or pertinent. Residents responded that the types of conference that they need most are journal review (81%), staff lecture (73.2%), and clinical topic review (73.2%), in that order. Procedures and interview techniques that the residents want to learn most were gastroscopy (72.5%), abdominal ultrasonography (65.2%), and pain management (46.4%). Hospitals where family medicine residents do not see hospitalized patients or patients in the outpatient clinic were 7.9% and 6.5%, respectively, whereas hospitals that maintain continuous family medicine outpatient clinics were only 40.8%. Education in outpatient clinic and articlewriting seminars was done less frequently in the secondary hospitals than in the tertiary hospitals. CONCLUSION: Evaluation and quality improvement of family medicine training program as well as specialty rotations should be considered in order to foster better family physicians. The efforts have to be made to minimize the difference in quality of each family medicine residency program.
Ambulatory Care Facilities ; Behavioral Sciences ; Clinical Medicine ; Congresses as Topic ; Family Practice ; Gastroscopy ; Humans ; Inpatients ; Internship and Residency ; Korea ; Outpatients ; Pain Management ; Physicians, Family ; Preventive Medicine ; Quality Improvement ; Referral and Consultation