Usefulness of a PC-Based Digitalized Recording System for Cystoscopy in Medical Education / 한국의학교육

PURPOSE: Multimedia can be used to understand the basic anatomy and pathological features of the bladder, providing more intuitive knowledge than traditional education methods. Cystoscopy is one of the most fundamental and important diagnostic procedures for detecting pathology in the bladder. Thus, we developed a PC-based digitalized recording device and electronic document to create an electronic medical record to perform cystoscopy and used them for medical education. METHODS: To share them with an educatee, cystoscopic images from a camera unit were shown on the monitor of a personal computer, which was installed with an interface device with an S-VHS input. With these cystoscopic images, the operator could provide some information on important structures in the bladder, such as bilateral ureteral orifices, the verumontanum and the trigone to the educatee. Also, simple questionnaires were given to medical students to evaluate the effectiveness and value of this system. RESULTS: Cystoscopic images could be transferred to the monitor with considerable ease and quality through the personal computer. This system was effective and valuable in teaching the normal anatomy and pathology of the bladder. Also, based on the results of the questionnaire, we concluded that this system provides high-quality images that are sufficient to relay medical information and is superior to traditional methods with regard to educational effectiveness and increasing one's understanding of medical diseases. CONCLUSION: The PC-based recording system for cystoscopy substitutes for commercial recording devices for medical purposes, and provides sufficient medical information to medical students to allow them to understand the normal anatomy and pathological structure of the bladder.

The Comparison between Transperineal and Transrectal Ultrasound-Guided Prostate Needle Biopsy

PURPOSE: Prostate biopsy is a conventional method for the detection of prostate cancer in men with suspicious findings. However, there is no universal agreement on which method is the better approach to the prostate, with regard to cancer detection rate and complication rate. In this prospective randomized study, we compared cancer detection rates and complication rates between transperineal (TP) and transrectal (TR) prostate biopsy. MATERIALS AND METHODS: Between March 2006 and December 2007, we analyzed 200 Korean men. One hundred patients underwent randomized TP prostate biopsy and 100 patients underwent TR prostate biopsy. All biopsies were extended 12-core biopsies. With both approaches, 12 biopsy specimens were obtained systematically from the peripheral and transitional zones, including the apex, base, and transitional zone. The patient's subjective pain scale was measured by use of visual analogue scales. Immediately after the biopsy, the pain score was independently recorded by the patients. One week later, various complications were measured by answer note. RESULTS: The overall cancer detection rate was 22% (22 of 100 patients) with TR prostate biopsy and 29% (29 of 100 patients) with TP prostate biopsy. Considering the prostate cancer detection rate, there were no significant differences between the groups for prostate-specific antigen (PSA), age, body mass index (BMI), and prostate volume. Apart from the cancer detection rate and complication rate, the pain scale, in each different approach, was statistically meaningful. CONCLUSIONS: There were no significant differences in the cancer detection rate or complication rate between TP and TR prostate needle biopsy. However, with regard to pain relief and complication rates, TR prostate needle biopsy is preferable.