Objectives: The purpose of this study is to analyze educational effect of ultrasound examination training with ultrasonic phantom in the department of Korean Medicine Obstetrics and Gynecology. Methods: All 4th grade students in 2021 and 2022 of school of Korean Medicine, Dong-Shin University must be trained in the department of Korean Medicine Obstetrics and Gynecology according to ultrasound examination training guideline including Objective Structured Clinical Examination (OSCE). After completing ultrasound examination training, we distributed questionnaires to them about a confidence before OSCE and after OSCE, difficulty in using ultrasound, ultrasound reading, difficulty with probe manipulation and computer operation, ultrasound understanding, clinical usefulness. And then, we analyzed the related factors including descriptive statistics, frequency analysis, student's t-test and paired t-test by SPSS 12.0. Results: Confidence in using ultrasound showed differences among students by gender and year, but it was not statistically significant. The difficulty of ultrasound use and ultrasound reading was at a moderate level, and the gender difference was not significant, and the difference between the practical students by year was statistically significant. The difficulty of the operation of the ultrasonic probe was at a normal level, and the difference between the students in practice by gender and year was not statistically significant. Although they answered that they had a very good understanding of the use of ultrasound, there was a gender difference and it was statistically significant, and practical students by year was not statistically significant. They answered that the effect on clinical use was very sufficient, but it was not statistically significant. The appropriateness of the practice time was evaluated at a moderate level. Conclusions: The use and educational effect of ultrasound examination using ultrasonic phantom in the department of Korean Medicine Obstetrics and Gynecology clinical practice education was very effective.
Yamada, Ana Lucia M.;Pinheiro, Marcelo;Marsiglia, Marilia F.;Hagen, Stefano Carlo F.;Baccarin, Raquel Yvonne A.;da Silva, Luis Claudio L.C.
Journal of Veterinary Science
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제21권3호
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pp.21.1-21.14
/
2020
Background: Physical exercise is known to cause significant joint changes. Thus, monitoring joint behavior of athletic horses is essential in early disorders recognition, allowing the proper management. Objectives: The aims of this study were to determine the morphological patterns, physical examination characteristics and ultrasound findings of show jumping horses in training and to establish a score-based examination model for physical and ultrasound follow-ups of metacarpophalangeal joint changes in these animals. Methods: A total of 52 metacarpophalangeal joints from 26 horses who were initially in the taming stage were evaluated, and the horses' athletic progression was monitored. The horses were evaluated by a physical examination and by B-mode and Doppler-mode ultrasound examinations, starting at time zero (T0), which occurred concomitantly with the beginning of training, and every 3 months thereafter for a follow-up period of 18 months. Results: The standardized examination model revealed an increase in the maximum joint flexion angles and higher scores on the physical and ultrasound examinations after scoring was performed by predefined assessment tools, especially between 3 and 6 months of evaluation, which was immediately after the horses started more intense training. The lameness score and the ultrasound examination score were slightly higher at the end of the study. Conclusions: The observed results were probably caused by the implementation of a training regimen and joint adaptation to physical conditioning. The joints most likely undergo a pre-osteoarthritic period due to work overload, which can manifest in a consistent or adaptive manner, as observed during this study. Thus, continuous monitoring of young athlete horses by physical and ultrasound examinations that can be scored is essential.
Background: The objective structured clinical examination (OSCE) is used in the colleges of Korean Medicine, but few studies have validated the OSCE evaluation criteria or post-education questionnaires. Diagnostic ultrasound is used in Korean medicine treatment including acupuncture, acupotomy, and pharmacopuncture to increase the safety and efficacy of treatment. We aimed to develop and validate a OSCE checklist and questionnaire for diagnostic musculoskeletal ultrasound training. Methods: A OSCE checklist and rubric for diagnostic ultrasound training, and questionnaire was developed using literature research. Eight expert panelists verified each draft item in a single-round survey. Items with a content validity ratio (CVR) < 0.75 were excluded or modified to reflect the experts' opinions. Results: The OSCE checklist and rubric for diagnostic ultrasound training focusing on volar wrist and carpal tunnel syndrome included: 15 items revised according to CVR and expert opinions, the pre-examination procedure, structures to be identified by ultrasound, scans with 2 diagnostic criteria for carpal tunnel syndrome, an explanation of the exam results, and the post exam procedure. The questionnaire consisted of 15 items, including the overall evaluation of training, the effect of the OSCE, and the perception of the ultrasound. All 6 self-evaluation items were not revised, as they had a CVR of ≥ 0.75. Conclusion: An ultrasound OSCE for scanning the volar wrist and diagnosing carpal tunnel syndrome was developed using 15 validated tasks, 15 survey questions about ultrasound training, and 6 questions for self-evaluation. These results may be used in the future for education in diagnostic ultrasound.
This study examined the hygiene management of ultrasound probes by examining the cleaning tools for hygiene management of ultrasound probes, the presence or absence of wearing glove as a personal protective equipment, and the awareness of ultrasound probe hygiene. Parts 154 questionnaire about people working in the ultrasound room were surveyed and analyzed. The single gel removal tool of the ultrasound probe was most frequently used with a 48.7% cotton towel, and for double gel removal tools, the first gel removal tool was 42.4% cotton towel and the second gel removal tool was used with 57.6% wet tissue. Antimicrobial wipes were the most commonly used drug and instrument used in ultrasound hygiene management at 58.4%. According to the survey of the presence or absence of wearing glove during ultrasound examination, 46.8% were found to be unworn. When examining the intracavity ultrasound, 30.9% of those who do not wear glove and 61.0% of hygiene awareness of ultrasound probes are 'normal'. According to age, ultrasound probe gel removal tool was not significant difference(p>0.05). According to the working organization and the working department, it was significant difference to wearing gloves during ultrasound examination(p<0.05). Therefore, in order to properly sanitize the ultrasound probe, it is considered that a guideline for hygiene management of the ultrasound probe that fits the situation in Korea is necessary, and it is considered that thorough hygiene management training for inspector is necessary for efficient hygiene management of the ultrasound probe.
Objectives: The purpose of this study is to analyze csatisfaction with clinica1 training in the department of Korean Medicine Obstetrics and Gynecology and the related factors. Methods: All the students on the graduating class of school of Korean Medicine, Dong-Shin University must be trained for 1 year in the department of Korean Medicine Obstetrics and Gynecology according to clinical training guideline including Objective Structured Clinical Examination (OSCE). After completing clinical training, we distributed questionaries to them about a reflex of the object of study, usefulness, difficulty, satisfaction and preference. And then, we analyzed the related factors including descriptive statistics, frequency analysis and correlation analysis by SPSS 12.0. Results: In general, a reflex of the aim of study (7.31±1.59), satisfaction with contents (7.44±1.58), and difficulty (6.13±1.34) were evaluated restectively. There is no statistically significant difference with sex. There is a statistically significant positive correlation between a reflex of the aim of study and satisfaction with contents. The primary preferences of clinical practice were Clinic Training, Ward Training, PBL (Problem Based Learning), OSCE. In OSCE, a reflex of the aim of study (7.04±1.83) and usefulness (7.02±1.97) were highly evaluated. There is no statistically significant difference with sex. The primary preferences for clinical OSCE practice were breast examination, genital examination, ultrasound scan, and pap smear. Facilities and equipment (6.84±2.01), contents of clinical training (7.29±1.83), the handout (7.20±1.98) and time scheduling (7.29±1.90) were evaluated respectively in general composition of clinical training. Conclusions: Clinical training program in the department of Korean Medicine Obstetrics and Gynecology can be highly estimated from the viewpoint of satisfaction with clinical training and the related factors.
Objective: To evaluate the diagnostic performance of IOTA simple rules in predicting malignant adnexal tumors by non-expert examiners. Materials and Methods: Five obstetric/gynecologic residents, who had never performed gynecologic ultrasound examination by themselves before, were trained for IOTA simple rules by an experienced examiner. One trained resident performed ultrasound examinations including IOTA simple rules on 100 women, who were scheduled for surgery due to ovarian masses, within 24 hours of surgery. The gold standard diagnosis was based on pathological or operative findings. The five-trained residents performed IOTA simple rules on 30 patients for evaluation of inter-observer variability. Results: A total of 100 patients underwent ultrasound examination for the IOTA simple rules. Of them, IOTA simple rules could be applied in 94 (94%) masses including 71 (71.0%) benign masses and 29 (29.0%) malignant masses. The diagnostic performance of IOTA simple rules showed sensitivity of 89.3% (95%CI, 77.8%; 100.7%), specificity 83.3% (95%CI, 74.3%; 92.3%). Inter-observer variability was analyzed using Cohen's kappa coefficient. Kappa indices of the four pairs of raters are 0.713-0.884 (0.722, 0.827, 0.713, and 0.884). Conclusions: IOTA simple rules have high diagnostic performance in discriminating adnexal masses even when are applied by non-expert sonographers, though a training course may be required. Nevertheless, they should be further tested by a greater number of general practitioners before widely use.
Clement Chun Ho Wu;Samuel Jun Ming Lim;Damien Meng Yew Tan
Clinical Endoscopy
/
제57권4호
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pp.434-445
/
2024
Pancreatic cystic lesions (PCLs) have increased in prevalence due to the increased usage and advancements in cross-sectional abdominal imaging. Current diagnostic techniques cannot distinguish between PCLs requiring surgery, close surveillance, or expectant management. This has increased the morbidity and healthcare costs from inappropriately aggressive and conservative management strategies. Endoscopic ultrasound (EUS) needle-based confocal laser endomicroscopy (nCLE) allows for microscopic examination and delineation of the surface epithelium of PCLs. Landmark studies have identified characteristics distinguishing various types of PCLs, confirmed the high diagnostic yield of EUS-nCLE (especially for PCLs with an equivocal diagnosis), and shown that EUS-nCLE helps to change management and reduce healthcare costs. Refining procedure technique and reducing procedure length have improved the safety of EUS-nCLE. The utilization of artificial intelligence and its combination with other EUS-based advanced diagnostic techniques would further improve the results of EUS-based PCL diagnosis. A structured training program and device improvements to allow more complete mapping of the pancreas cyst epithelium will be crucial for the widespread adoption of this promising technology.
Background: Breast cancer in developing countries is on the rise. There are currently no guidelines to screen women at risk in India. Since mammography in the western world is a well-accepted screening tool to prevent late presentation of breast cancer and improve mortality, it is intuitive to adopt mammography as a screening tool of choice. However, it is expensive and fraught with logistical issues in developing countries like India. Materials and Methods: Our breast cancer screening camp was done at a local district hospital in India after approval from the director and administrators. After initial training of local health care workers, a one-day camp was held. Clinical breast examination, mammograms, as well as diagnostic evaluation with ultrasound and fine needle aspiration biopsy were utilized. Results: Out of total 68 women screened only 2 women with previous history of breast cancer were diagnosed with breast cancer recurrence. None of the women in other groups were diagnosed with breast cancer despite suspicious lesions either on clinical exam, mammogram or ultrasound. Most suspicious lesions were fibroadenomas. The average cost of screening women who underwent mammography, ultrasound and fine needle aspiration was $30 dollars, whereas it was $16 in women who had simple clinical breast examination. Conclusions: Local camps act as catalysts for women to seek medical attention or discuss with local health care workers concerns of discovering new lumps or developing breast symptoms. Our camp did diagnose recurrence of breast cancer in two previously treated breast cancer patients, who were promptly referred to a regional cancer hospital. Further studies are needed in countries like India to identify the best screening tool to decrease the presentation of breast cancer in advanced stages and to reduce mortality.
Zorlu, Ferruh;Divrik, Rauf Taner;Eser, Sultan;Yorukoglu, Kutsal
Asian Pacific Journal of Cancer Prevention
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제15권21호
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pp.9125-9130
/
2014
Background: This study aimed to determine the incidence of prostate cancer in Turkey in a population-based sample, and to determine clinical and pathological characteristics of the cases. Materials and Methods: All newly diagnosed prostate cancer patients were included in this national, multi-centered, prospective and non-interventional epidemiological registry study conducted in 12 cities representing the 12 regions of Turkey from July 2008 to June 2009. The population-based sample comprised 4,150 patients with a recent prostate cancer diagnosis. Results: Age-adjusted prostate cancer incidence rate was 35 cases per 100,000 in Turkey. At the time of diagnosis, median age was 68, median PSA level was 10.0 ng/mL. Digital rectal examination was abnormal in 36.2% of 3,218 tested cases. Most patients had urologic complaints. The main diagnostic method was transrectal ultrasound guided biopsy (87.8%). Gleason score was ${\leq}6$ in 49.1%, 7 in 27.8% and >7 in 20.6% of the cases. There was a statistically significant positive correlation between serum PSA level and Gleason score (p=0.000). The majority of patients (54.4%) had clinical stage T1c. Conclusions: This is the first population-based national data of incidence with the histopathological characteristics of prostate cancer in Turkey. Prostate cancer remains an important public health concern in Turkey with continual increase in the incidence and significant burden on healthcare resources.
License system of radiologic technologists has been started since 1965 in Korea. This study is to explore directions on radiotechnologists' license system classified by subspecialty. For this purpose, the authors surveyed on radiotechnologists' license system classified by subspecialty, with the subject related to radiotechnologic societies. Additionally, data on qualification and license system associated with medical and health care field were collected. The results are as follows. 1. The main body for subspecialty system for radiologic technologists should be the Korea Radiologic Technologists Association and the Association should maintain a close cooperation with radiotechnologic societies. 2. A radiologic technologist should be a basic role once they pass the license examination. In addition, they can get a special qualification by subspecialty in radiologic technology. 3. Radiotechnologists' license system classified by subspecialty will be keep priorities in order and done systematically. Execution order is as follows ; This study proposes that radiotechnologists responsible for ultrasonography, computed tomography(CT), magnetic resonance imaging(MRI) and security management be started for the first stage. For the second stage, radiotechnologists for mammography, angio-cardiography, digital imaging, maxillo-facial and dental radiography, nuclear medicine, radio-therapeutic field should be in force. 4. Professional education course(basic and intensive) and clinical training program have to be made for the eligibility of radiotechnologists' license system classified by subspecialty. 5. Eligibility system of radiotechnologists' license system classified by subspecialty(non-government or government) has to be made. Further more, inquiry commission to investigate eligibility for radiotechnologists' license system should be established.
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