No abstract available.

PURPOSE: Small group discussions are useful tools in medical ethics education. We aimed to assess student satisfaction with specific components of a small group discussion and to evaluate student self-assessment of the objectives of education. METHODS: A structured questionnaire was developed after a literature review and a focus group interview. Components of the small group discussion were categorized by discussion case (self, other), individual activities (self-study, making materials, presentation experience), and group activities (preclass/in-class/postclass/plenary discussion, instructor's comments). The items for student self-assessment were: "To specify ethical issue in actual practice", "To get new knowledge", "To consider doctor's entity", "Empathy to others", "To get multidimensional viewpoint", "Viewpoint change", "To deliver my thought clearly", and "Ability to confront the medical ethics dilemma in the future". After the survey, an in-depth interview was performed to determine the reason behind the students' answers. RESULTS: A total of 121 students responded, for whom overall satisfaction and self-assessment were high. Students reported greater satisfaction with self-case, presentation experience, in-class discussion, and instructor's comments but less satisfaction with self-study before class and postclass discussion. Student self-assessment was highest in the ability to specify an ethical issue and lowest for viewpoint change and self-confidence. After multivariate analysis, higher student self-assessment was associated with greater satisfaction with the small group discussion. CONCLUSION: To improve the quality of medical ethics education, close investigation and monitoring of each component of the small group discussion and student achievement are essential, as is continuous feedback.
Achievement ; Ethics, Medical ; Focus Groups ; Humans ; Multivariate Analysis ; Self-Assessment ; Surveys and Questionnaires

PURPOSE: Small group discussions are useful tools in medical ethics education. We aimed to assess student satisfaction with specific components of a small group discussion and to evaluate student self-assessment of the objectives of education. METHODS: A structured questionnaire was developed after a literature review and a focus group interview. Components of the small group discussion were categorized by discussion case (self, other), individual activities (self-study, making materials, presentation experience), and group activities (preclass/in-class/postclass/plenary discussion, instructor's comments). The items for student self-assessment were: "To specify ethical issue in actual practice", "To get new knowledge", "To consider doctor's entity", "Empathy to others", "To get multidimensional viewpoint", "Viewpoint change", "To deliver my thought clearly", and "Ability to confront the medical ethics dilemma in the future". After the survey, an in-depth interview was performed to determine the reason behind the students' answers. RESULTS: A total of 121 students responded, for whom overall satisfaction and self-assessment were high. Students reported greater satisfaction with self-case, presentation experience, in-class discussion, and instructor's comments but less satisfaction with self-study before class and postclass discussion. Student self-assessment was highest in the ability to specify an ethical issue and lowest for viewpoint change and self-confidence. After multivariate analysis, higher student self-assessment was associated with greater satisfaction with the small group discussion. CONCLUSION: To improve the quality of medical ethics education, close investigation and monitoring of each component of the small group discussion and student achievement are essential, as is continuous feedback.
Achievement ; Ethics, Medical ; Focus Groups ; Humans ; Multivariate Analysis ; Self-Assessment ; Surveys and Questionnaires

The noninvasive vascular laboratory has become central to the evaluation of patients with peripheral arterial occlusive disease (PAOD) of the lower extremities. Most such patients have atherosclerosis as the cause of PAOD. Because noninvasive vascular laboratory techniques are widely available, relatively inexpensive, well-tolerated, and provide quantitative physiologic information, they are most commonly used as the first line objective modalities to confirm the diagnosis, establish the severity of ischemia, and estimate the anatomic level of involvement in patients that are suspected as having PAOD based on history and physical signs. This article focuses on the commonly used instruments, examination techniques, interpretive guidelines, and clinical application of each modality.
Arterial Occlusive Diseases ; Atherosclerosis ; Humans ; Ischemia ; Lower Extremity

Mobile C-arm fluoroscopic X-ray systems are used for various diagnostic imaging and minimally invasive endovascular procedures. One of the greatest advantages of a mobile C-arm is its ability to move around the patient. The purpose of this study was to address the optimal setting of the mobile C-arm and the operating table, as well as the proper position of the operator and assistants for each procedure. In addition, methods to minimize radiation exposure to the operator and medical staff are described. Both the optimal setting and the proper position were classified by 5 types. These include the setting for aortic and inferior vena caval procedures (type I); left lower extremity (LE) intervention with an up-and-over technique (type II); right LE intervention with up-and-over technique, or bilateral LE vascular intervention with antegrade access (type III); arteriovenous fistula/graft intervention (type IV); and central vein catheterization (type V).
Aorta ; Catheterization ; Catheters ; Diagnostic Imaging ; Endovascular Procedures ; Fluoroscopy ; Humans ; Lower Extremity ; Medical Staff ; Operating Rooms ; Operating Tables ; Radiation Exposure ; Veins

Cyanoacrylate glue is a non-thermal, non-tumescent agent used to treat saphenous reflux. It was introduced to overcome heat-related discomfort and complications. Multiple randomized controlled trials using this therapy have demonstrated excellent clinical outcomes at long-term follow-up. However, diffuse injection-site inflammation and systemic urticaria are worrisome complications. In preclinical studies, serial histopathological findings demonstrated acute inflammatory reaction, subacute vasculitis, chronic granulomatous foreign body reaction, fibrotic changes with partial vascular recanalization, and chronic foreign body-type inflammatory response. While the exact nature of this unique complication remains undefined, complex hypersensitivity and irritation reaction phenomena have been suggested based on reported clinical presentations. The incidence of this complication has been reported as ranging from 0.3%-25.4%. Typically, erythematous reactions can occur near treatment sites, with symptoms ranging from mild pruritus and/or erythema that resolves without treatment to recurrent severe inflammation and pruritus requiring nonsteroidal anti-inflammatory drugs, antihistamines, and/ or corticosteroids. Surgical excision has been rarely reported in patients with severe intractable inflammation or treatment-site infections. Although several anecdotal studies reported on using antihistaminics or corticosteroids, no effective strategies have been established to prevent this complication.

Peripheral artery disease (PAD) is a common vascular condition affecting over 200 million people worldwide. It is primarily characterized by stenosis or occlusion of peripheral arteries due to atherosclerosis. The infrainguinal segment is frequently involved in PAD, making revascularization decisions for infrainguinal arterial disease (IAD) complex. Multiple factors, including the patient’s condition and anatomical characteristics, must be carefully considered when determining the optimal treatment approach. Once these factors are evaluated, the first revascularization strategy is selected from among open, endovascular, or hybrid modalities, based on high-level evidence. Endovascular therapy is widely accepted as the standard treatment for simple IAD, with balloon angioplasty and stenting being the commonly used techniques.However, advancements in endovascular techniques have enabled the treatment of increasingly complex lesions. Additionally, drug-based technologies have enhanced the durability of treatment outcomes, including improvements in primary patency rates and freedom from target lesion revascularization. Similar to surgical endarterectomy, percutaneous atherectomy has been developed to remove atherosclerotic plaques and mitigate intimal calcification. The purpose of this paper is to present an algorithm for revascularization of IAD through a comprehensive review of studies comparing the outcomes of various treatment modalities.

Peripheral artery disease (PAD) is a common vascular condition affecting over 200 million people worldwide. It is primarily characterized by stenosis or occlusion of peripheral arteries due to atherosclerosis. The infrainguinal segment is frequently involved in PAD, making revascularization decisions for infrainguinal arterial disease (IAD) complex. Multiple factors, including the patient’s condition and anatomical characteristics, must be carefully considered when determining the optimal treatment approach. Once these factors are evaluated, the first revascularization strategy is selected from among open, endovascular, or hybrid modalities, based on high-level evidence. Endovascular therapy is widely accepted as the standard treatment for simple IAD, with balloon angioplasty and stenting being the commonly used techniques.However, advancements in endovascular techniques have enabled the treatment of increasingly complex lesions. Additionally, drug-based technologies have enhanced the durability of treatment outcomes, including improvements in primary patency rates and freedom from target lesion revascularization. Similar to surgical endarterectomy, percutaneous atherectomy has been developed to remove atherosclerotic plaques and mitigate intimal calcification. The purpose of this paper is to present an algorithm for revascularization of IAD through a comprehensive review of studies comparing the outcomes of various treatment modalities.

Peripheral artery disease (PAD) is a common vascular condition affecting over 200 million people worldwide. It is primarily characterized by stenosis or occlusion of peripheral arteries due to atherosclerosis. The infrainguinal segment is frequently involved in PAD, making revascularization decisions for infrainguinal arterial disease (IAD) complex. Multiple factors, including the patient’s condition and anatomical characteristics, must be carefully considered when determining the optimal treatment approach. Once these factors are evaluated, the first revascularization strategy is selected from among open, endovascular, or hybrid modalities, based on high-level evidence. Endovascular therapy is widely accepted as the standard treatment for simple IAD, with balloon angioplasty and stenting being the commonly used techniques.However, advancements in endovascular techniques have enabled the treatment of increasingly complex lesions. Additionally, drug-based technologies have enhanced the durability of treatment outcomes, including improvements in primary patency rates and freedom from target lesion revascularization. Similar to surgical endarterectomy, percutaneous atherectomy has been developed to remove atherosclerotic plaques and mitigate intimal calcification. The purpose of this paper is to present an algorithm for revascularization of IAD through a comprehensive review of studies comparing the outcomes of various treatment modalities.

Peripheral artery disease (PAD) is a common vascular condition affecting over 200 million people worldwide. It is primarily characterized by stenosis or occlusion of peripheral arteries due to atherosclerosis. The infrainguinal segment is frequently involved in PAD, making revascularization decisions for infrainguinal arterial disease (IAD) complex. Multiple factors, including the patient’s condition and anatomical characteristics, must be carefully considered when determining the optimal treatment approach. Once these factors are evaluated, the first revascularization strategy is selected from among open, endovascular, or hybrid modalities, based on high-level evidence. Endovascular therapy is widely accepted as the standard treatment for simple IAD, with balloon angioplasty and stenting being the commonly used techniques.However, advancements in endovascular techniques have enabled the treatment of increasingly complex lesions. Additionally, drug-based technologies have enhanced the durability of treatment outcomes, including improvements in primary patency rates and freedom from target lesion revascularization. Similar to surgical endarterectomy, percutaneous atherectomy has been developed to remove atherosclerotic plaques and mitigate intimal calcification. The purpose of this paper is to present an algorithm for revascularization of IAD through a comprehensive review of studies comparing the outcomes of various treatment modalities.