1.Development of a Program Evaluation Framework for Improving the Quality of Undergraduate Medical Education
Yulim KANG ; Hae Won KIM ; Jun Yong CHOI
Korean Medical Education Review 2025;27(1):60-81
The development and implementation of a systematic program evaluation framework is critical for improving the quality of the undergraduate medical education. At Yonsei University College of Medicine, we established the following five evaluation domains that encompass various aspects of educational experiences: (1) preclinical curriculum; (2) clinical curriculum; (3) educational environment, resources, and systems; (4) performance of students and graduates and program outcomes; and (5) implementation and outcomes of the curriculum. Specific evaluation indicators were designed within these domains and validated through the Delphi technique, which integrated expert opinions. In total, 98 indicators were identified across five domains. These indicators will function as a comprehensive tool for assessing medical education programs. The proposed evaluation framework addresses both shortand long-term educational changes, facilitating systematic monitoring, continuous quality improvement of curricula, and better outcomes for students. As this framework is grounded in the unique context of the institution, it is appropriate for a comprehensive evaluation of interactions at various educational stages. Furthermore, it may serve as a strategic foundation for identifying areas that require improvement, ensuring that the curriculum aligns with current medical education standards and practices. The framework’s structured approach and continuing evaluation processes may make it possible to obtain essential data for ongoing development, potentially contributing to a robust system for quality improvement in medical education. The findings of this study are expected to serve as a valuable reference for developing similar evaluation frameworks in other medical schools.
2.Development of a Program Evaluation Framework for Improving the Quality of Undergraduate Medical Education
Yulim KANG ; Hae Won KIM ; Jun Yong CHOI
Korean Medical Education Review 2025;27(1):60-81
The development and implementation of a systematic program evaluation framework is critical for improving the quality of the undergraduate medical education. At Yonsei University College of Medicine, we established the following five evaluation domains that encompass various aspects of educational experiences: (1) preclinical curriculum; (2) clinical curriculum; (3) educational environment, resources, and systems; (4) performance of students and graduates and program outcomes; and (5) implementation and outcomes of the curriculum. Specific evaluation indicators were designed within these domains and validated through the Delphi technique, which integrated expert opinions. In total, 98 indicators were identified across five domains. These indicators will function as a comprehensive tool for assessing medical education programs. The proposed evaluation framework addresses both shortand long-term educational changes, facilitating systematic monitoring, continuous quality improvement of curricula, and better outcomes for students. As this framework is grounded in the unique context of the institution, it is appropriate for a comprehensive evaluation of interactions at various educational stages. Furthermore, it may serve as a strategic foundation for identifying areas that require improvement, ensuring that the curriculum aligns with current medical education standards and practices. The framework’s structured approach and continuing evaluation processes may make it possible to obtain essential data for ongoing development, potentially contributing to a robust system for quality improvement in medical education. The findings of this study are expected to serve as a valuable reference for developing similar evaluation frameworks in other medical schools.
3.Primary Cholangiocarcinoma of the Liver Presenting as a Complicated Hepatic Cyst: A Diagnostic Challenge
Chang Won HA ; Sang Deok SHIN ; Myung Ji GOH ; Byeong Geun SONG ; Wonseok KANG ; Dong Hyun SINN ; Geum-Youn GWAK ; Yong-Han PAIK ; Moon Seok CHOI ; Joon Hyeok LEE
The Korean Journal of Gastroenterology 2025;85(1):83-88
Primary cholangiocarcinoma is a rare bile duct epithelial neoplasm that can present with atypical clinical manifestations, complicating its diagnosis. A 62-year-old male showed symptoms suggestive of a complicated hepatic cyst that was later identified as intrahepatic cholangiocarcinoma. The patient presented with abdominal discomfort without fever. Imaging revealed a large cystic lesion in the liver. Despite the initial treatment for a presumed abscess, a biopsy confirmed cholangiocarcinoma. This case highlights the diagnostic challenge of distinguishing between benign complicated hepatic cysts and malignancies, particularly when typical markers of infection are absent. Early biopsy and vigilant assessments are crucial in such presentations to avoid a delayed diagnosis and initiate appropriate treatment.
4.Miliary Tuberculosis Initially Presenting as an Isolated Hepatic Abscess
Chang Won HA ; Sang Deok SHIN ; Myung Ji GOH ; Byeong Geun SONG ; Wonseok KANG ; Dong Hyun SINN ; Geum-Youn GWAK ; Yong-Han PAIK ; Moon Seok CHOI ; Joon Hyeok LEE
The Korean Journal of Gastroenterology 2025;85(1):78-82
Hepatic tuberculosis, typically associated with miliary tuberculosis, can occasionally present as localized liver lesions. This case report describes a 77-year-old male presenting with persistent abdominal pain and fever, following an endoscopic retrograde cholangiopancreatography for bile duct sludge removal. Subsequent computed tomography revealed focal liver lesions. Despite initial treatment with antibiotics for a suspected inflammatory liver abscess, his condition did not improve. A liver biopsy was performed, revealing caseous granulomas, and the tuberculosis polymerase chain reaction result was positive. The patient was diagnosed with primary hepatic tuberculosis, which later disseminated. Oral anti-tuberculosis therapy was initiated and is currently being closely monitored. This case emphasizes the importance of considering hepatic tuberculosis in the differential diagnosis of liver lesions, particularly in cases involving cholestatic liver function tests, and persistent symptoms unresponsive to conventional antibiotics.
5.Clinical Application of Artificial Intelligence in Breast Ultrasound
John BAEK ; Jaeil KIM ; Hye Jung KIM ; Jung Hyun YOON ; Ho Yong PARK ; Jeeyeon LEE ; Byeongju KANG ; Iliya ZAKIRYAROV ; Askhat KULTAEV ; Bolat SAKTASHEV ; Won Hwa KIM
Journal of the Korean Society of Radiology 2025;86(2):216-226
Breast cancer is the most common cancer in women worldwide, and its early detection is critical for improving survival outcomes. As a diagnostic and screening tool, mammography can be less effective owing to the masking effect of fibroglandular tissue, but breast US has good sensitivity even in dense breasts. However, breast US is highly operator dependent, highlighting the need for artificial intelligence (AI)-driven solutions. Unlike other modalities, US is performed using a handheld device that produces a continuous real-time video stream, yielding 12000–48000 frames per examination. This can be significantly challenging for AI development and requires real-time AI inference capabilities. In this review, we classified AI solutions as computer-aided diagnosis and computer-aided detection to facilitate a functional understanding and review commercial software supported by clinical evidence.In addition, to bridge healthcare gaps and enhance patient outcomes in geographically under resourced areas, we propose a novel framework by reviewing the existing AI-based triage workflows including mobile ultrasound.
6.Incidence and mortality of upper tract urothelial carcinoma in Korea: A nationwide population-based study conducted from 2002 to 2020
Seongmin MOON ; Yun-Sok HA ; Mina KIM ; Hoseob KIM ; Won Tae KIM ; Yong-June KIM ; Seok-Joong YUN ; Sang-Cheol LEE ; Ho Won KANG
Investigative and Clinical Urology 2025;66(1):11-17
Purpose:
To describe the incidence and mortality of upper tract urothelial carcinoma (UTUC) from 2002–2020 using data from the Korean National Health Insurance Service, which contains data from the entire Korean population.
Materials and Methods:
Reimbursement records for 43,255 patients diagnosed with primary UTUC (according to the International Classification of Disease 10th revision code C65 and C66) between 2002–2020 were retrieved. The study period was split into four: period I (2002–2005), period II (2006–2010), period III (2011–2015), and period IV (2016–2020). Trends were quantified by calculating the annual percentage change (APC). Mortality data were obtained from the Statistics Korea.
Results:
From 2002–2020, the incidence of UTUC in Korea increased gradually from 9.34 to 11.40 per 100,000 person-years. Although there was a male predominance, the male to female ratio did not change significantly over time; however, age at the time of diagnosis, the comorbidity index, and the proportion of patients undergoing open/laparoscopic surgery increased significantly over time. There was a modest improvement in 5-year survival (both all cause- and cancer-specific) over the study period. Multivariate analysis identified age at diagnosis, sex, the comorbidity index, and open/laparoscopic surgery as being associated with survival.
Conclusions
Between 2002 and 2020, the incidence of UTUC in Korea showed a general upward trend; however, survival outcomes have improved. These representative datasets from the Korean population might provide crucial information that enables clinicians to better understand of the epidemiology of UTUC in Korea.
7.Primary Cholangiocarcinoma of the Liver Presenting as a Complicated Hepatic Cyst: A Diagnostic Challenge
Chang Won HA ; Sang Deok SHIN ; Myung Ji GOH ; Byeong Geun SONG ; Wonseok KANG ; Dong Hyun SINN ; Geum-Youn GWAK ; Yong-Han PAIK ; Moon Seok CHOI ; Joon Hyeok LEE
The Korean Journal of Gastroenterology 2025;85(1):83-88
Primary cholangiocarcinoma is a rare bile duct epithelial neoplasm that can present with atypical clinical manifestations, complicating its diagnosis. A 62-year-old male showed symptoms suggestive of a complicated hepatic cyst that was later identified as intrahepatic cholangiocarcinoma. The patient presented with abdominal discomfort without fever. Imaging revealed a large cystic lesion in the liver. Despite the initial treatment for a presumed abscess, a biopsy confirmed cholangiocarcinoma. This case highlights the diagnostic challenge of distinguishing between benign complicated hepatic cysts and malignancies, particularly when typical markers of infection are absent. Early biopsy and vigilant assessments are crucial in such presentations to avoid a delayed diagnosis and initiate appropriate treatment.
8.Miliary Tuberculosis Initially Presenting as an Isolated Hepatic Abscess
Chang Won HA ; Sang Deok SHIN ; Myung Ji GOH ; Byeong Geun SONG ; Wonseok KANG ; Dong Hyun SINN ; Geum-Youn GWAK ; Yong-Han PAIK ; Moon Seok CHOI ; Joon Hyeok LEE
The Korean Journal of Gastroenterology 2025;85(1):78-82
Hepatic tuberculosis, typically associated with miliary tuberculosis, can occasionally present as localized liver lesions. This case report describes a 77-year-old male presenting with persistent abdominal pain and fever, following an endoscopic retrograde cholangiopancreatography for bile duct sludge removal. Subsequent computed tomography revealed focal liver lesions. Despite initial treatment with antibiotics for a suspected inflammatory liver abscess, his condition did not improve. A liver biopsy was performed, revealing caseous granulomas, and the tuberculosis polymerase chain reaction result was positive. The patient was diagnosed with primary hepatic tuberculosis, which later disseminated. Oral anti-tuberculosis therapy was initiated and is currently being closely monitored. This case emphasizes the importance of considering hepatic tuberculosis in the differential diagnosis of liver lesions, particularly in cases involving cholestatic liver function tests, and persistent symptoms unresponsive to conventional antibiotics.
9.Clinical Application of Artificial Intelligence in Breast Ultrasound
John BAEK ; Jaeil KIM ; Hye Jung KIM ; Jung Hyun YOON ; Ho Yong PARK ; Jeeyeon LEE ; Byeongju KANG ; Iliya ZAKIRYAROV ; Askhat KULTAEV ; Bolat SAKTASHEV ; Won Hwa KIM
Journal of the Korean Society of Radiology 2025;86(2):216-226
Breast cancer is the most common cancer in women worldwide, and its early detection is critical for improving survival outcomes. As a diagnostic and screening tool, mammography can be less effective owing to the masking effect of fibroglandular tissue, but breast US has good sensitivity even in dense breasts. However, breast US is highly operator dependent, highlighting the need for artificial intelligence (AI)-driven solutions. Unlike other modalities, US is performed using a handheld device that produces a continuous real-time video stream, yielding 12000–48000 frames per examination. This can be significantly challenging for AI development and requires real-time AI inference capabilities. In this review, we classified AI solutions as computer-aided diagnosis and computer-aided detection to facilitate a functional understanding and review commercial software supported by clinical evidence.In addition, to bridge healthcare gaps and enhance patient outcomes in geographically under resourced areas, we propose a novel framework by reviewing the existing AI-based triage workflows including mobile ultrasound.
10.Primary Cholangiocarcinoma of the Liver Presenting as a Complicated Hepatic Cyst: A Diagnostic Challenge
Chang Won HA ; Sang Deok SHIN ; Myung Ji GOH ; Byeong Geun SONG ; Wonseok KANG ; Dong Hyun SINN ; Geum-Youn GWAK ; Yong-Han PAIK ; Moon Seok CHOI ; Joon Hyeok LEE
The Korean Journal of Gastroenterology 2025;85(1):83-88
Primary cholangiocarcinoma is a rare bile duct epithelial neoplasm that can present with atypical clinical manifestations, complicating its diagnosis. A 62-year-old male showed symptoms suggestive of a complicated hepatic cyst that was later identified as intrahepatic cholangiocarcinoma. The patient presented with abdominal discomfort without fever. Imaging revealed a large cystic lesion in the liver. Despite the initial treatment for a presumed abscess, a biopsy confirmed cholangiocarcinoma. This case highlights the diagnostic challenge of distinguishing between benign complicated hepatic cysts and malignancies, particularly when typical markers of infection are absent. Early biopsy and vigilant assessments are crucial in such presentations to avoid a delayed diagnosis and initiate appropriate treatment.

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