Purpose: We report a diagnosis of Moyamoya disease based on brain magnetic resonance imaging (MRI) and brain magnetic resonance angiography (MRA) performed in a child diagnosed with morning glory syndrome.Case summary: A 6-year-old boy visited the hospital with a chief complaint of exodeviation of his left eye that started at 1 year of age. The corrected visual acuity was 20/30 in the right eye and 20/400 in the left. The Krimsky test showed exotropia of 35 prism diopters (PD) for near vision and 30 PD for distance. Fundus photography showed an enlarged optic disc with funnel-shaped excavation in the left eye. With a diagnosis of morning glory syndrome accompanied by exotropia, the patient underwent brain MRI and brain MRA. The patient had no neurological symptoms such as headache and muscle weakness. Moyamoya disease was diagnosed, as brain MRI and MRA showed tiny tortuous vessels forming collateral vessels from the lenticulostriatal arteries, left posterior cerebral artery, and left middle meningeal artery, which originated from the external carotid artery. Conclusions Moyamoya disease can occur in children with morning glory disease. Brain MRI and MRA can help to diagnose Moyamoya disease. Caution is needed because transient ischemic attack, cerebral infarction, and cerebral hemorrhage may occur in patients with Moyamoya disease.

This study aimed to investigate structural differences in the retinal and choroidal blood vessels before and after patch occlusion treatment in patients with amblyopia using optical coherence tomography angiography (OCTA) and to determine whether these differences are related to clinical improvement in patients. A total of 26 eyes of 17 patients with monocular or binocular amblyopia who underwent patch occlusion treatment for at least 1 month were retrospectively enrolled. The width of the foveal avascular zone, retinal blood vessel density, choroidal thickness, and choroidal vascularity index (CVI) measured by OCTA were compared before and after the treatment; the correlation with change in best-corrected visual acuity (BCVA) was analyzed for the data showing statistically significant differences. The mean BCVA of amblyopic eyes before and after patch occlusion treatment was 0.41 ± 0.23 and 0.25 ± 0.16 in logarithm of the minimum angle of resolution units, respectively. A decrease of about 2% in CVI was observed after the treatment (p = 0.011). The correlation between the changes in CVI and the changes in BCVA were insignificant (Rs = 0.086, p = 0.718). The results indicated that a decrease in CVI was observed after the patch occlusion treatment, but the relationship between CVI and BCVA could not be established. Patch occlusion treatment in amblyopia appears to affect the changes in the choroidal vessels and stroma.

The Korean Intermittent Exotropia Multicenter Study (KIEMS), which was initiated by the Korean Association of Pediatric Ophthalmology and Strabismus, is a collaborative multicenter study on intermittent exotropia in Korea. The KIEMS was designed to provide comprehensive information, including subjective and objective findings of intermittent exotropia in a large study population. A total of 65 strabismus specialists in 53 institutions contributed to this study, which, to date, is one of the largest clinical studies on intermittent exotropia. In this article, we provide a detailed methodology of the KIEMS to help future investigations that may use the KIEMS data.

The Korean Intermittent Exotropia Multicenter Study (KIEMS), which was initiated by the Korean Association of Pediatric Ophthalmology and Strabismus, is a collaborative multicenter study on intermittent exotropia in Korea. The KIEMS was designed to provide comprehensive information, including subjective and objective findings of intermittent exotropia in a large study population. A total of 65 strabismus specialists in 53 institutions contributed to this study, which, to date, is one of the largest clinical studies on intermittent exotropia. In this article, we provide a detailed methodology of the KIEMS to help future investigations that may use the KIEMS data.

Purpose: To distinguish the dominant eye in patients with intermittent exotropia by comparing the width of the foveal avascular zone (FAZ), the vascular density (VD), and the choroidal thickness (CT) in both eyes. Methods: A total of 34 subjects with intermittent exotropia were enrolled. Optical coherence tomography angiography (OCTA) was performed after discrimination of the dominant eye using a prism cover test (PCT). FAZ widths in the superficial capillary plexus (referred to here as superficial FAZ or SFAZ) and in the deep capillary plexus (deep FAZ or DFAZ); VDs of the 1-mm fovea and 3-mm parafovea, specifically the superficial capillary plexus density (SCPD); and CT measured by OCTA were compared between both eyes using a one-sample t-test. These abovementioned parameters were compared between dominant and non-dominant eyes through Pearson’s correlation analysis. Results: The widths of SFAZ and DFAZ, the 1-mm fovea and 3-mm parafovea SCPDs, and CT of dominant eye showed positive correlations with respect to the non-dominant eye. Although there was no statistically significant difference in SFAZ and DFAZ widths, the 3-mm parafovea SCPD, or CT between eyes, the 1-mm fovea SCPD in the non-dominant eye showed a statistically significant higher density than that of the dominant eye (p = 0.039). Conclusions Our results suggest that the higher 1-mm fovea SCPD in the non-dominant eye is due to the secondary development of capillaries around the FAZ of the non-dominant eye after the retina of both eyes had developed to some extent.

The goal of this study is to present efficient measures to improve the quality of medical education through using a developed and applied continuous quality improvement (CQI) model suitable for medical education.To achieve this purpose, we developed a theoretical CQI model through a review of the literature according to the design-based research method. Through repetitive productive cyclical processes and professional reviews, we finally deduced an appropriate CQI model for medical education. The most important results of this study are as follows: First, the CQI model for medical education is defined as a quality management system with a cyclical course of planning, implementation, evaluation, and improvement of medical education.Second, the CQI model for medical education is composed of quality management activities of educational design, work, and evaluation. In addition, each activity has the implementation strategies of planning, doing, checking, and improving based on the PDCA model (Plan-Do-Check-Act model). Third, the CQI model for medical school education is composed of committees related to medical education doing improvement activities, as well as planning, implementing and evaluating it with CQI. As a result, we can improve teaching by using the CQI model for medical education. It is more meaningful because this gives us organized and practical measures of quality management and improvement in medical education as well as in the educational process.

Purpose: To distinguish the dominant eye in patients with intermittent exotropia by comparing the width of the foveal avascular zone (FAZ), the vascular density (VD), and the choroidal thickness (CT) in both eyes. Methods: A total of 34 subjects with intermittent exotropia were enrolled. Optical coherence tomography angiography (OCTA) was performed after discrimination of the dominant eye using a prism cover test (PCT). FAZ widths in the superficial capillary plexus (referred to here as superficial FAZ or SFAZ) and in the deep capillary plexus (deep FAZ or DFAZ); VDs of the 1-mm fovea and 3-mm parafovea, specifically the superficial capillary plexus density (SCPD); and CT measured by OCTA were compared between both eyes using a one-sample t-test. These abovementioned parameters were compared between dominant and non-dominant eyes through Pearson’s correlation analysis. Results: The widths of SFAZ and DFAZ, the 1-mm fovea and 3-mm parafovea SCPDs, and CT of dominant eye showed positive correlations with respect to the non-dominant eye. Although there was no statistically significant difference in SFAZ and DFAZ widths, the 3-mm parafovea SCPD, or CT between eyes, the 1-mm fovea SCPD in the non-dominant eye showed a statistically significant higher density than that of the dominant eye (p = 0.039). Conclusions Our results suggest that the higher 1-mm fovea SCPD in the non-dominant eye is due to the secondary development of capillaries around the FAZ of the non-dominant eye after the retina of both eyes had developed to some extent.

The mission of an organization defines the fundamental reason for the organization's existence and serves as a compass that leads and guides the organization. This study aimed to develop a system regarding mission and vision in accordance with the value system of organizations. The Delphi questionnaires were formulated in such a way to reflect an open survey for the first survey and then a structured survey in the second survey. The validity of the Delphi survey results was analyzed using the content validity ratio (CVR).Missions include the reason for the existence of an organization and its management purpose. A vision is a blueprint that outlines the future roles and goals of an organization beyond its current position. Then, a strategy is seen as a method to achieve the mission and vision. Values are consistent principles and tenet. This study found through the web sites of all 40 medical schools that 9 schools (22.5%) had both missions and visions, 10 schools (25.0%) had only one of them, and 21 schools (52.5%) had none of them. this study recommends the inclusion of various stakeholder, the selection of a mission system, modification or improvements after re-analyzing the relationship, the use of the Delphi method, proofreading of the draft by Korean language experts, the suitability and notify about the mission development to medical school members.
Humans ; Methods ; Religious Missions ; Schools, Medical

The mission of an organization defines the fundamental reason for the organization's existence and serves as a compass that leads and guides the organization. This study aimed to develop a system regarding mission and vision in accordance with the value system of organizations. The Delphi questionnaires were formulated in such a way to reflect an open survey for the first survey and then a structured survey in the second survey. The validity of the Delphi survey results was analyzed using the content validity ratio (CVR).Missions include the reason for the existence of an organization and its management purpose. A vision is a blueprint that outlines the future roles and goals of an organization beyond its current position. Then, a strategy is seen as a method to achieve the mission and vision. Values are consistent principles and tenet. This study found through the web sites of all 40 medical schools that 9 schools (22.5%) had both missions and visions, 10 schools (25.0%) had only one of them, and 21 schools (52.5%) had none of them. this study recommends the inclusion of various stakeholder, the selection of a mission system, modification or improvements after re-analyzing the relationship, the use of the Delphi method, proofreading of the draft by Korean language experts, the suitability and notify about the mission development to medical school members.

The mission of an organization defines the fundamental reason for the organization's existence and serves as a compass that leads and guides the organization. This study aimed to develop a system regarding mission and vision in accordance with the value system of organizations. The Delphi questionnaires were formulated in such a way to reflect an open survey for the first survey and then a structured survey in the second survey. The validity of the Delphi survey results was analyzed using the content validity ratio (CVR).Missions include the reason for the existence of an organization and its management purpose. A vision is a blueprint that outlines the future roles and goals of an organization beyond its current position. Then, a strategy is seen as a method to achieve the mission and vision. Values are consistent principles and tenet. This study found through the web sites of all 40 medical schools that 9 schools (22.5%) had both missions and visions, 10 schools (25.0%) had only one of them, and 21 schools (52.5%) had none of them. this study recommends the inclusion of various stakeholder, the selection of a mission system, modification or improvements after re-analyzing the relationship, the use of the Delphi method, proofreading of the draft by Korean language experts, the suitability and notify about the mission development to medical school members.