We have evaluated the post-embolization findings of hepatic tumors(15 cases of hepatoma, and 5 cases ofmetastatic tumors)using Ivalon particles in conjunction with the pre-embolization status of CT. Serial CTexaminations were done every 3 week intervals after embolization procedure. Findings were as follows: 1. Inhepatoma, tumor volume was decreased in 7 cases at 3 week after procedure. Among which 5 cases revealed tumorvolume decrease of 0 to 25 percent. 2. Most important findings of post embolized hepatic tumors was decreasedtumoral density and attenuation of tumor wall enhancement. 3. Intratumoral air was developed within 3 week afterembolization and appeared as mottled or linear branching patterns in the center or periphery of the tumor. 4. Itseems to be important to observe the change of intratumoral density and measurement of tumoral volume to determinethe reembolizatin procedure.
Carcinoma, Hepatocellular ; Tumor Burden

PURPOSE: To describe the use of botulinum toxin injection of the lacrimal gland for palliative treatment of epiphora secondary to nasolacrimal duct obstruction. METHODS: A prospective non-comparative interventional case series study was designed to include 13 patients with nasolacrimal duct obstruction. Under topical anesthesia botulinum toxin A (1-4unit) was injected into the palpebral lobe of the lacrimal gland via a transconjunctival approach. Patients underwent a Schirmer test and a subjective evaluation of their epiphora symptoms was performed at 0 (baseline), 1, 4 and 12 weeks after injection. RESULTS: Subjective epiphora scores improved in 10 out of the 13 patients (76.9%). Schirmer test results showed objective reduction in tearing from baseline but did not strongly correlate with the subjective epiphora scores. Transient ptosis were experienced by two patients. CONCLUSIONS: Botulinum A toxin injection for palliative treatment of epiphora secondary to nasolacrimal duct obstruction is a simple, effective and safe treatment.
Anesthesia ; Botulinum Toxins* ; Botulinum Toxins, Type A ; Humans ; Lacrimal Apparatus ; Lacrimal Apparatus Diseases* ; Nasolacrimal Duct* ; Palliative Care* ; Prospective Studies

We use the concept of the “doctor’s role” as a guideline for developing medical education programs for medical students, residents, and doctors. Therefore, we should regularly reflect on the times and social needs to develop a clear sense of that role. The objective of the present study was to understand the knowledge structure related to doctor’s job competencies in Korea. We analyzed research trends related to doctor’s job competencies in Korea Citation Index journals using text network analysis through an integrative approach focusing on identifying social issues. We finally selected 1,354 research papers related to doctor’s job competencies from 2011 to 2020, and we analyzed 2,627 words through data pre-processing with the NetMiner ver. 4.2 program (Cyram Inc., Seongnam, Korea). We conducted keyword centrality analysis, topic modeling, frequency analysis, and linear regression analysis using NetMiner ver. 4.2 (Cyram Inc.) and IBM SPSS ver. 23.0 (IBM Corp., Armonk, NY, USA). As a result of the study, words such as “family,” “revision,” and “rejection” appeared frequently. In topic modeling, we extracted five potential topics: “topic 1: Life and death in medical situations,” “topic 2: Medical practice under the Medical Act,” “topic 3: Medical malpractice and litigation,” “topic 4: Medical professionalism,” and “topic 5: Competency development education for medical students.” Although there were no statistically significant changes in the research trends for each topic over time, it is nonetheless known that social changes could affect the demand for doctor’s job competencies.

We use the concept of the “doctor’s role” as a guideline for developing medical education programs for medical students, residents, and doctors. Therefore, we should regularly reflect on the times and social needs to develop a clear sense of that role. The objective of the present study was to understand the knowledge structure related to doctors’ job competencies in Korea. We analyzed research trends related to doctors’ job competencies in Korea Citation Index journals using text network analysis through an integrative approach focusing on identifying social issues. We finally selected 1,354 research papers related to doctors’ job competencies from 2011 to 2020, and we analyzed 2,627 words through data pre-processing with the NetMiner ver. 4.2 program (Cyram Inc., Seongnam, Korea). We conducted keyword centrality analysis, topic modeling, frequency analysis, and linear regression analysis using NetMiner ver. 4.2 (Cyram Inc.) and IBM SPSS ver. 23.0 (IBM Corp., Armonk, NY, USA). As a result of the study, words such as “family,” “revision,” and “rejection” appeared frequently. In topic modeling, we extracted five potential topics: “topic 1: Life and death in medical situations,” “topic 2: Medical practice under the Medical Act,” “topic 3: Medical malpractice and litigation,” “topic 4: Medical professionalism,” and “topic 5: Competency development education for medical students.” Although there were no statistically significant changes in the research trends for each topic over time, it is nonetheless known that social changes could affect the demand for doctors’ job competencies.

Although ‘assessment for learning’ rather than ‘assessment of learning’ has been emphasized recently, student learning before examinations is still unclear. The purpose of this study was to investigate pre-assessment learning activities (PALA) and to find mechanism factors (MF) that influence those activities. Moreover, we compared the PALA and MF of written exams with those of the clinical performance examination/objective structured clinical examination (CPX/OSCE) in third-year (N=121) and fourth-year (N=108) medical students. Through literature review and discussion, questionnaires with a 5-point Likert scale were developed to measure PALA and MF. PALA had the constructs of cognitive and meta-cognitive activities, and MF had sub-components of personal, interpersonal, and environmental factors. Cronbach's α coefficient was used to calculate survey reliability, while the Pearson correlation coefficient and multiple regression analysis were used to investigate the influence of MF on PALA. A paired t-test was applied to compare the PALA and MF of written exams with those of CPX/OSCE in third and fourth year students. The Pearson correlation coefficients between PALA and MF were 0.479 for written exams and 0.508 for CPX/OSCE. MF explained 24.1% of the PALA in written exams and 25.9% of PALA in CPX/OSCE. Both PALA and MF showed significant differences between written exams and CPX/OSCE in third-year students, whereas those in fourth-year students showed no differences. Educators need to consider MFs that influence the PALA to encourage 'assessment for learning'.
Education, Medical, Undergraduate ; Educational Measurement ; Humans ; Learning ; Students, Medical

A systematic educational program evaluation system for continuous quality improvement in undergraduate medical education is essential. Monitoring and evaluation (M&E) are two distinct but complementary processes referred to in an evaluation system that emphasizes formative purpose. Monitoring involves regular data collection for tracking process and results, while evaluation requires periodic judgment for improvement. We have recently completed implementing an educational evaluation using the M&E concept in a medical school. The evaluation system consists of two loops, one at the lesson/course level and the other at the phase/graduation level. We conducted evaluation activities in four stages: planning, monitoring, evaluation, and improvement. In the planning phase, we clarified the purpose of evaluation, formulated a plan to engage stakeholders, determined evaluation criteria and indicators, and developed an evaluation plan. Next, during the monitoring phase, we developed evaluation instruments and methods and then collected data. In the evaluation phase, we analyzed results and evaluated the criteria of the two loops. Finally, we reviewed the evaluation results with stakeholders to make improvements. We have recognized several problems including excessive burden, lack of expertise, insufficient consideration of stakeholders’ evaluation questions, and inefficient data collection. We need to share the value of evaluation and build a system gradually.

We investigated the work-life balance of clinical professors in charge of patient care, research, and education at medical schools and the demand for work-life balance support according to position (professor, associate professor, or assistant professor). In total, 163 clinical professors completed the consent form and participated in the study. They filled out an online survey consisting of questions about essential characteristics, a work-life balance test, stress, burnout, work-life satisfaction, and work-life balance support needs. We analyzed the results by analysis of variance and cross-tabulation using IBM SPSS ver. 23.0. Differences were found in work-life balance, stress, burnout, and satisfaction with life and work by position. The requirements for support for work-life balance also varied by professional status. Professors had a higher balance between life and work than associate professors or assistant professors. The specific requirements for work-life balance support were also slightly different for each position. Overall, there was a high demand for work process simplification and efficiency for work support, flexible working hours and sabbatical years for family and leisure, and career management consulting and training support for growth. Assistant professors and associate professors had a lower level of work-life balance than professors, as well as higher levels of stress and burnout. Professors' job satisfaction was also higher than that of the other groups. Based on the results of this study, we hope that a healthy work environment can be established through work-life balance support suitable for clinical professors’ positions.

Pusan National University School of Medicine (PNUSOM) began analyzing the cohort of pre-medical students admitted in 2015 and has been conducting purposeful analyses for the past 3 years. The aim of this paper is to introduce the process of cohort establishment, cohort composition, and the utilization of cohort analysis results. PNUSOM did not initially form a cohort with a purpose or through a systematic process, but was able to collect longitudinal data on students through the establishment of a Medical Education Information System and an organization that supports medical education. Cohort construction at our university is different in terms of a clear orientation toward research questions, flexibility in cohort composition, and subsequent guideline supplementation. We investigated the relevance of admission factors, performance improvements, satisfaction with the educational environment, and promotion and failure rate in undergraduate students, as well as performance levels and career paths in graduates. The results were presented to the Admissions Committee, Curriculum Committee, Learning Outcomes Committee, and Student Guidance Committee to be used as a basis for innovations and improvements in education. Since cohort studies require long-term efforts, it is necessary to ensure the efficiency of data collection for graduate cohorts, as well as the validity and ethics of the study.

The purpose of this study is to investigate domestic and international research trends in studies of medical students' characteristics by using the scoping review methods. This study adopted the scoping review to assess papers on the characteristics of medical students. The procedure of research was carried out according to the five steps of the scoping review. The full texts of 100 papers are obtained and are read closely, after which suitable 88 papers are extracted by us for this research. The review is mapped by the year of the study, source, location, author, research design, research subject, objective, and key results. The frequency is analyzed by using Microsoft Excel and SPSS. We found 70 papers (79.5%) on a single medical school, 15 (17.0%) on multiple medical schools, and three (3.4%) on mixed schools, including medical and nonmedical schools. Sixty-nine (79.5%) were cross-sectional studies and 18 (20.5%) were longitudinal studies. Eighty-two papers (93.2%) adopted questionnaire surveys. We summarized research trends of studies on medical students in Korea and overseas by topic, and mapped them into physical health, mental health, psychological characteristics, cognitive characteristics, social characteristics, and career. This study provides insights into the future directions of research for the characteristics of medical students.
Cross-Sectional Studies ; Humans ; Korea ; Longitudinal Studies ; Mental Health ; Research Design ; Research Subjects ; Schools, Medical ; Sociological Factors ; Students, Medical

Purpose: Today's students have distinctive generational characteristics and increased psychopathology and generational tension. The authors investigated the negative experiences of Late Millennial students in medical school to draw implications for student support. Methods: The authors explored medical students’ negative experiences using the critical incident technique. The authors conducted semi-structured in-depth interviews with 13 medical students, between February and May 2016. The authors focused on occurrences that significantly influenced medical students’ school lives negatively from the students’ perspective. All interviews were recorded and transcribed. The authors classified incidents into frames of reference for the use of faculty development for student support. Results: The authors extracted 22 themes from a total 334 codes and classified them into eight subcategories. Finally, four categories emerged from frames of reference. Students manipulate relationships and colluding for better specialty choice. They experience uncontrolled rifts in interpersonal relationships between peers including lawsuits, sexual assaults, and social network service conflicts. Today’s students feel resentment towards dependent hierarchical relationships with seniors. They struggle with gender discrimination but perpetuate outdated gender role toward the opposite gender. Conclusion Faculty members should understand today’s students’ level of career stress and desire for work life balance. They should motivate students’ professional identity, promote assertiveness against unfair authorities, and focus on mental health, teamwork, and relationship building. All generations need to understand other generations and develop appropriate leadership and gender sensitivity.