Management and prognostic factors of pancreatic pseudocysts / 中华胰腺病杂志

Objective To investigate the characteristics and prognosis of acute and chronic pancreatic pseudocysts and to identify the predictive factors of interventional treatment of pancreatic pseudocysts. Methods From January 1995 to December 2004, 36 patients with pancreatic pseudocysts at Nippon Medical School were studied retrospectively. Group 1 included 9 patients with acute pancreatitis associated pseudocysts which resolved spontaneously. Group 2 included 9 patients with acute pancreatitis associated pseudocysts and symptoms persisted or with complications which requiring interventional treatment. Group 3 included 9 patients with chronic pancreatitis associated pseudocysts which resolved spontaneously. Group 4 included 9 patients with chronic pancreatitis associated pseudocysts with symptoms persisted or with complications which requiring interventional treatment. Results Among the 36 patients, there were 13 women and 23 men. The etiology of pancreatitis due to alcohol was 18(50.0%) cases, biliary tract disease 8(22.2%)cases, others 10(27.8%) cases. The average duration of follow up was (24. 2 ± 18.5) months. The majority of pseudocysts (32/36, 88.9%) were not communicated with the main pancreatic duct;the number and location of the 4 groups of pseudocysts were not significantly different;the biggest diameter of pancreatic pseudocysts in group 3 was the smallest, all below 4 cm, which was significantly less than those in other 3 groups (P < 0.05) ;the majority of volume of pancreatic pseudocysts in group 1 and 3 was not increased, while it was increased in group 2 and 4.

An Efficient Simulation-Based Training Method for Obtaining Clinical Skills in an Introduction to Clinical Medicine / 医学教育

At Nippon Medical School, a "Basic Clinical Training Course" is provided as an introduction to clinical medicine. Medical students undergo initial clinical skills training with simulators. We describe the technique of effective training to acquire clinical skills and the results of student evaluations and a questionnaire survey.1) The training consisted of 8 practicums, including internal examination, funduscopic examination, otoscopic examination, breast examination, auscultation (heart sounds and lung sounds), and collection of blood samples. Medical students moved in rotation once per time period (45 minutes) and performed practical training in each unit, which comprised 2 practicums.2) The training with the prescribed number of 50 students in 4 time periods was efficiently performed for 2 days and required 9 trainers per day. Student evaluations and a questionnaire survey revealed the interest and enthusiasm of medical students and showed they thought highly of the training.3) The training was efficiently performed and was thought to help reduce the teaching load of instructors. The educational effect of the training can be strengthened by increasing the convenience of the clinical simulation laboratory, by reinforcing the education of clinical skills and attitudes in clinical clerkship, and by evaluating these factors after the completion of the clinical clerkship.