Objective: The diagnostic accuracy of novice residents in evaluating the scrotal pathology by point-of-care (POC) ultrasonography(US) was compared with that by the conventional US to determine the level of experience required toachieve competency. Methods: Three novice residents underwent a one-day training course on identifying scrotal pathologies using POC US.They performed POC US on patients with an acute scrotum to identify five pathological findings. The diagnosis was confirmedby conventional scrotal US. The sensitivity and specificity of POC US by novice residents were calculated, and thechanges in sensitivity and specificity over time were observed. Results: Sixty-two patients were included; the overall sensitivity and specificity were 76.7% (95% confidence interval [CI],61.3%-88.2%) and 78.9% (95% CI, 54.4%-93.9%), respectively. Decreased blood flow in the testicle showed very goodspecificity (100%; 95% CI, 93.8%-100.0%). The sensitivity and accuracy were variable at first 18 scans of each resident,but increased after 18 scans and were maintained over time. Conclusion Although the diagnostic accuracy of novice residents in evaluating the scrotal pathology using POC US wasvariable at first, the accuracy improved over time, especially after 18 scans of each resident. Nevertheless, larger, longtermresearch is needed to confirm the results of this study.

Awareness of intraoperative events in patients under general anesthesia is rare, but awareness during anesthesia is a serious complication that leads to anxiety and post-traumatic stress disorder. The Bispectral Index (BIS) has generally been accepted as a measurement of hypnosis under anesthesia. It is derived from a processed electroencephalogram and computer algorithm that assigns a numerical value based on the probability of consciousness. A 46-year-old, 65-kg male without underlying disease underwent elective surgery for ventral hernia. The patient in this case was administered an anesthetic that we frequently use and then average BIS value are 35. But he experienced awake during general anesthesia. We describe the first case of intraoperation awake under BIS 40 using desflurane.
Anesthesia ; Anesthesia, General ; Anxiety ; Consciousness ; Consciousness Monitors ; Electroencephalography ; Hernia, Ventral ; Humans ; Hypnosis ; Intraoperative Awareness ; Intraoperative Complications ; Isoflurane ; Male ; Mental Recall ; Stress Disorders, Post-Traumatic