A Survey of Medical Students' Social Participation and Direction in Medical Education / 의학교육논단

In the ever-changing medical environment, the social participation of medical doctors is becoming more necessary. Currently, there is not enough participation or action by doctors within our society due to reasons such as a lack of educational curriculum in this area. This study aimed to investigate medical students' opinions and attitudes about social participation and action. A total of 438 medical students were surveyed about their attitudes toward doctors' relations with the public, social participation, social action, and medical education for social participation or action. Regarding doctors' relations with the public, participants responded that the government (73.5%) and the media (82.0%) were causing social distrust of doctors, and more than 70% of the respondents answered that doctors were passive when it comes to social participation. When asked about social participation and social action, 76.7% of the students surveyed had experienced social participation, and 28.3% had experienced taking social action. A total of 73.4% of the students answered that medical education needs to be changed, and it is necessary to introduce subjects such as sociology and law to improve social participation and action. The results are significant in that they show medical students' thoughts on social participation and social action as doctors in the Fourth Industrial Revolution. We believe that a change of medical curriculum to promote active and collaborative social participation by doctors is necessary.

Clinical Significance of Ultrasound Biomicroscopy in Early Stage of Traumatic Hyphema

PURPOSE: To evaluate the clinical significance of angle-opening distance 500 (AOD500) using ultrasound biomicroscopy (UBM) in the early stage of traumatic hyphema. METHODS: The participants of this study were 46 hospitalized traumatic hyphema patients. We measured the quantity of initial blood clotting using a slit-lamp and the range of angle recession, AOD500 using UBM and then reviewed the relationship between the two. RESULTS: The difference of AOD500 in the traumatic and the non-traumatic eye measured by UBM at admission increased significantly in the wider recessed angle group (p=0.008), but did not increase at a statistically significantly level in the larger initial blood clot grade group (> or =Grade 2). CONCLUSIONS: These results suggest that the measurement of the angle-opening distance of both eyes using UBM will aid in evaluating the range of angle recession in patients in the early stage of traumatic hyphema.

Comparison of Silicone Oil Removal Using 23-Gauge and 20-Gauge System for Pars Plana Vitrectomy

PURPOSE: The purpose of this study was to compare the clinical results of silicone oil removal using a 23-gauge transconjunctival sutureless pars plana vitrectomy (TSVS) and the 20-gauge pars plana vitrectomy (PPV) system and to evaluate the clinical value of 23-guage PPV system in silicone oil removal. METHODS: Eight eyes of 8 patients who received removal of silicone oil using the 23-gauge TSVS and 6 eyes of 6 patients using the 20-gauge PPV system were included in this study. The total operation time, silicone oil removal time, intraoperative and postoperative advantages, shortcomings, and complications were compared. RESULTS: The operation time and silicone oil removal time were 44.6+/-14.1 minutes, 42.7+/-10.5 minutes and 2.0+/-0.9 min/cc, 1.4+/-0.6 min/cc when silicone oil removal was performed using 23-gauge TSVS and 20-gauge PPV system, respectively. They were not significantly different (p=0.80, 0.22). Attention for the complete removal of the oil is necessary because of the intraocular trocar length when the 23-gauge TSVS is used. There were no complications except transient hypotonies (2 eyes), transient hypertonies (2 eyes) in the 23-gauge system and transient hypertonies (2 eyes) in the 20-gauge system. CONCLUSIONS: The operation time for silicone oil removal using the 23-gauge TSVS was not different than that of the 20-gauge PPV system and can be performed safely without any particular complications. Care and precautionary measures are needed in order to remove silicone oil completely.

Changes of Anterior Chamber Depth and Angle After Cataract Surgery Measured by Anterior Segment OCT

PURPOSE: To report the change of anterior chamber parameters according to cataract severity after cataract surgery and to determine its relationship to the severity of cataract by using anterior segment optical coherence tomography. METHODS: We measured the anterior chamber parameters in 19 eyes of 14 patients before, 1 week after, and 1 month after cataract surgery by slit lamp-adapted optical coherence tomography (SL-OCT). The measured parameters were as follows : the anterior chamber depth (ACD), the angle-opening distance 250 micrometer from the scleral spur (AOD250), the angle-opening distance 500 micrometer from the scleral spur (AOD500), and the trabecular-iris angle (TIA). We analyzed the relationship between the severity of cataract and the change of the anterior chamber parameters. RESULTS: The ACD, AOD250, AOD500, and TIA increased significantly at postoperative 1 week (P=0.000, 0.002, 0.005, 0.022) and 1 month (P=0.000, 0.004, 0.001, 0.002). The preoperative parameters were negatively correlated with the differences between the postoperative 1 week and preoperative parameters (gamma=-0.834, -0.591, -0.421, -0.826) and between postoperative 1 month and preoperative parameters (gamma=-0.659, -0.700, -0.770, -0.821). The change of parameters at postoperative 1 week (by N P=0.959, 0.916, 0.824, 1.000, by C P=0.454, 0.665, 0.578, 0.578) and 1 month (by N P=0.858, 0.973, 0.959, 0.959, by C P=0.999, 0.207, 0.950, 0.981) were not significantly different according to the severity of cataract (N, C). CONCLUSIONS: Our results showed that cataract surgery significantly deepened the anterior chamber and widened its angle. The shallower and narrower the preoperative anterior chamber depth and angle were, respectively, the greater the postoperative changes of anterior chamber depth and angle were.