ABSTRACT
Background/Aims@#Probe-based confocal laser endomicroscopy (pCLE) requires the administration of intravenous (IV) fluorescein. This study aimed to determine the optimal dose of IV fluorescein for both upper and lower gastrointestinal (GI) tract pCLE. @*Methods@#Patients 20 to 79 years old with gastric high-grade dysplasia (HGD) or colorectal neoplasms (CRNs) were enrolled in the study. The dose de-escalation method was employed with five levels. The primary endpoint of the study was the determination of the optimal dose of IV fluorescein for pCLE of the GI tract. The reduced dose was determined based on off-line reviews by three endoscopists. An insufficient dose of fluorescein was defined as the dose of fluorescein with which the pCLE images were not deemed to be visible. If all three endoscopists determined that the tissue structure was visible, the doses were de-escalated. @*Results@#A total of 12 patients with gastric HGD and 12 patients with CRNs were enrolled in the study. Doses were de-escalated to 0.5 mg/kg of fluorescein for both non-neoplastic duodenal and colorectal mucosa. All gastric HGD or CRNs were visible with pCLE with IV fluorescein at 0.5 mg/kg. @*Conclusions@#In the present study, pCLE with IV fluorescein 0.5 mg/kg was adequate to visualize the magnified structure of both the upper and lower GI tract.
ABSTRACT
Background/Aims@#Probe-based confocal laser endomicroscopy (pCLE) requires the administration of intravenous (IV) fluorescein. This study aimed to determine the optimal dose of IV fluorescein for both upper and lower gastrointestinal (GI) tract pCLE. @*Methods@#Patients 20 to 79 years old with gastric high-grade dysplasia (HGD) or colorectal neoplasms (CRNs) were enrolled in the study. The dose de-escalation method was employed with five levels. The primary endpoint of the study was the determination of the optimal dose of IV fluorescein for pCLE of the GI tract. The reduced dose was determined based on off-line reviews by three endoscopists. An insufficient dose of fluorescein was defined as the dose of fluorescein with which the pCLE images were not deemed to be visible. If all three endoscopists determined that the tissue structure was visible, the doses were de-escalated. @*Results@#A total of 12 patients with gastric HGD and 12 patients with CRNs were enrolled in the study. Doses were de-escalated to 0.5 mg/kg of fluorescein for both non-neoplastic duodenal and colorectal mucosa. All gastric HGD or CRNs were visible with pCLE with IV fluorescein at 0.5 mg/kg. @*Conclusions@#In the present study, pCLE with IV fluorescein 0.5 mg/kg was adequate to visualize the magnified structure of both the upper and lower GI tract.
ABSTRACT
BACKGROUND/AIMS: Upper gastrointestinal symptoms are more frequent and severe in female than in male outpatients in Japan. This study compared the upper gastrointestinal symptoms between healthy male and female young adult volunteers using a questionnaire. METHODS: In total, 581 third-grade medical students at Saga Medical School aged 22 to 30 years underwent upper gastrointestinal endoscopy and completed a questionnaire (frequency scale for symptoms of gastroesophageal reflux disease) from 2007 to 2013. Of these 581 students, 298 who were negative for Helicobacter pylori infection and had no particular lesions on endoscopic examination were enrolled in the present evaluation. A symptom was defined as positive when the subject evaluated the frequency of the symptom as sometimes, often, or always. RESULTS: The subjects comprised of 163 males (average age, 23.7 years) and 135 females (average age, 23.1 years). Upper gastrointestinal symptoms were more frequent in the females (75 of 135, 55.6%) than males (69 of 163, 42.3%; P < 0.05), with a high score for 4 symptoms (bloated stomach, heavy feeling in the stomach after meals, subconscious rubbing of the chest with the hand, and feeling of fullness while eating meals). Of the 144 subjects (69 males and 75 females) who complained of these symptoms, the females complained of dysmotility symptoms more often than did the males, but this was not true for reflux symptoms. CONCLUSIONS: This study suggests that females develop upper gastrointestinal symptoms more frequently than do males among the young healthy Japanese population.
Subject(s)
Female , Humans , Male , Young Adult , Asian People , Dyspepsia , Eating , Endoscopy , Endoscopy, Gastrointestinal , Esophagitis , Gastroesophageal Reflux , Gastrointestinal Motility , Hand , Helicobacter pylori , Japan , Meals , Outpatients , Schools, Medical , Stomach , Students, Medical , Thorax , Unconscious, Psychology , VolunteersABSTRACT
Departments of general medicine in medical schools have a mission to innovate in clinical education. However, the kind of work departments should do to promote a newly developed method of clinical education is unclear. In our medical school, the department of general medicine was organized in 1997. In that year, the first task of this department was to strengthen a program of physical-diagnosis skills. Since 1999, this program has developed further and been reorganized. The basic clinical skills course has been organized to include communication, physical diagnosis, basic laboratory examination, and basic surgical skills. In this course students do not rotate through clinics in groups but learn together via a systematic program with simulators. The department of general medicine played a central role in establishing this course. This course led to the introduction of clinical clerkships at our medical school.
ABSTRACT
To clarify the experience in clinical practice of students at Osaka University Medical School, a questionnaire survey was performed according to the International Classification of Primary Care. More than half of the students had observed only 6 of the 23 reasons for seeking primary care such as headache and hypertension but had not experienced 17 of the 23 reasons, such as cough and abdominal pain. Most students had observed malignancy and chronic diseases, but more than half had only knowledge of 54 of 105 diseases such as appendicitis. In conclusion, medical students' experiences in clinical practice are not well balanced.
ABSTRACT
Approximately 80 % of medical students start medical training in a specific department at their medical school hospital after graduation and do not experience medical practices in other departments. Therefore, a questionnaire survey of conditions in and opinions about the present postgraduate clinical training was conducted among trainees at Osaka University Hospital. Questionnaires were returned by 136 of the 156 trainees (87.2 %). Their average income was ¥255, 000 per month. Approximately 85 % of trainees had less than 1 day's vacation each month. Forty percent of trainees were not satisfied with the present postgraduate clinical training course, because 75 % felt that their training life was too busy and did not allow them to observe a variety of diseases. These results suggest that the postgraduate medical training program in university hospitals should be changed to include various disciplines in several departments in cooperation with other hospitals and clinics for outpatients. To raise the quality of postgraduate medical training, an education system for trainees must be established and duties unrelated to medical examinations and treatment must be reduced.
ABSTRACT
We have reviewed the Recommendations on Undergraduate Medical Education published by the General Medical Council (GMC) of the United Kingdom in 1993, and have visited the University of Leicester to see how they have revised their medical course to take account of the GMC's recommendations. The aim of the GMC's recommendations is to promote a culture of self directed learning which will be of value to the future medical practitioners in their postgraduate careers. To achieve this the GMC recommends a reduction in the burden of factual information delivered to the student while promoting learning through curiosity and the exploration of knowledge. The students are given an integrated view of clinical and basic scientific disciplines. The University of Leicester has reorganised its medical teaching around modules relating to body function rather than the traditional disciplines, with contributions being made by clinicians and basic scientists in the same module. The new course places great emphasis on carefully guided and structured self directed study and a reduced number of lectures. Clinical skills are introduced early in the curriculum, while a deeper understanding of selected scientific disciplines are achieved by a series of special study modules where the students undertake supervised scientific research.