1.The Situation of Trainees and Problems of Postgraduate Clinical Training: Results of a Survey of Trainees at Osaka University Hospital.
Akinori KASAHARA ; Nobuyuki TAENAKA ; Takashi SHIMAZU ; Toshiaki NISHIDA ; Koji YAMAMOTO ; Atsushi HIRAIDE ; Ikuto YOSHIYA ; Kunihiko YOSHIKAWA ; Morito MONDEN
Medical Education 1999;30(6):457-463
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.
2.Diagnosis of Myocardial Viability by Fluorodeoxyglucose Distribution at the Border Zone of a Low Uptake Region.
Eiji TOYOTA ; Teruki SONE ; Kunihiko YOSHIKAWA ; Hiroaki MIMURA ; Akihiro HAYASHIDA ; Nozomi WADA ; Kikuko OBASE ; Koichiro IMAI ; Ken SAITO ; Tomoko MAEHAMA ; Masao FUKUNAGA ; Kiyoshi YOSHIDA
Yonsei Medical Journal 2010;51(2):178-186
PURPOSE: In cardiac 2-[F-18]fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET) examination, interpretation of myocardial viability in the low uptake region (LUR) has been difficult without additional perfusion imaging. We evaluated distribution patterns of FDG at the border zone of the LUR in the cardiac FDG-PET and established a novel parameter for diagnosing myocardial viability and for discriminating the LUR of normal variants. MATERIALS AND METHODS: Cardiac FDG-PET was performed in patients with a myocardial ischemic event (n = 22) and in healthy volunteers (n = 22). Whether the myocardium was not a viable myocardium (not-VM) or an ischemic but viable myocardium (isch-VM) was defined by an echocardiogram under a low dose of dobutamine infusion as the gold standard. FDG images were displayed as gray scaled-bull's eye mappings. FDG-plot profiles for LUR (= true ischemic region in the patients or normal variant region in healthy subjects) were calculated. Maximal values of FDG change at the LUR border zone (a steepness index; S(max) scale/pixel) were compared among not-VM, isch-VM, and normal myocardium. RESULTS: S(max) was significantly higher for n-VM compared to those with isch-VM or normal myocardium (ANOVA). A cut-off value of 0.30 in Smax demonstrated 100% sensitivity and 83% specificity for diagnosing n-VM and isch-VM. S(max) less than 0.23 discriminated LUR in normal myocardium from the LUR in patients with both n-VM and isch-VM with a 94% sensitivity and a 93% specificity. CONCLUSION: S(max) of the LUR in cardiac FDG-PET is a simple and useful parameter to diagnose n-VM and isch-VM, as well as to discriminate thr LUR of normal variants.
Aged
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Aged, 80 and over
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Echocardiography
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Female
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Fluorodeoxyglucose F18/*metabolism
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Humans
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Male
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Middle Aged
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Myocardial Infarction/metabolism/pathology
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Myocardium/*metabolism/*pathology
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Positron-Emission Tomography
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Young Adult