1.Student self-assessment on education in cardiology: Analysis using questionnaire.
Toshinori UTSUNOMIYA ; Toshifumi MOROOKA ; Keiko KIDO ; Toshihiro OGAWA ; Yoshihiko OHTSUBO ; Toshihiro RYU ; Kazuyo YOSHIDA ; Shinsuke TSUJI ; Takashi TOKUSHIMA ; Shuzo MATSUO
Medical Education 1998;29(2):79-85
We analyzed the student self-assessment on education in cardiology using a questionnaire.
Subjects: Ninety-six 5th-year students at Saga Medical School who have completed the lectures and bedside teaching were evaluated.
Methods: A questionnaire survey of 14 topics in cardiology was performed at the finish of 3 weeks of bedside teachings. Self-assessment was categorized into 4 grades; 1) completely understood (3 points), 2) almost completely understood (2 points), 3) could be understood (1 point), and 4) could not be understood (0 point). Self-assessment scores were calculated for each topic in cardiology.
Results: Questionnaires were returned by 88 students (91.7%). Self-assessment scores were high for myocardial infarction, angina pectoris, and electrocardiogram reading. Scores were low for primary care, vascular diseases, and pericardial disease. Self-assessment scores did not significantly correlate with the length of lectures but did correlate with the number of admitted patients (r= 0.93) and scores on achievement tests (r= 0.43) in each topic.
Conclusions: Because students observed many patients with myocardial infarction and angina pectoris during bedside teaching, the self-assessment scores were high. Bedside teaching is important for medical students to understand topics in cardiology.
2.Association Between the Cool Temperature-dependent Suppression of Colonic Peristalsis and Transient Receptor Potential Melastatin 8 Activation in Both a Randomized Clinical Trial and an Animal Model
Satoshi SUGINO ; Ken INOUE ; Reo KOBAYASHI ; Ryohei HIROSE ; Toshifumi DOI ; Akihito HARUSATO ; Osamu DOHI ; Naohisa YOSHIDA ; Kazuhiko UCHIYAMA ; Takeshi ISHIKAWA ; Tomohisa TAKAGI ; Hiroaki YASUDA ; Hideyuki KONISHI ; Yasuko HIRAI ; Katsura MIZUSHIMA ; Yuji NAITO ; Toshifumi TSUJI ; Takashi OKUDA ; Keizo KAGAWA ; Makoto TOMINAGA ; Yoshito ITOH
Journal of Neurogastroenterology and Motility 2022;28(4):693-705
Background/Aims:
Several studies have assessed the effect of cool temperature on colonic peristalsis. Transient receptor potential melastatin 8 (TRPM8) is a temperature-sensitive ion channel activated by mild cooling expressed in the colon. We examined the antispasmodic effect of cool temperature on colonic peristalsis in a prospective, randomized, single-blind trial and based on the video imaging and intraluminal pressure of the proximal colon in rats and TRPM8-deficient mice.
Methods:
In the clinical trial, we randomly assigned a total of 94 patients scheduled to undergo colonoscopy to 2 groups: the mildly cool water (n = 47) and control (n = 47) groups. We used 20 mL of 15°C water for the mildly cool water. The primary outcome was the proportion of subjects with improved peristalsis after treatment. In the rodent proximal colon, we evaluated the intraluminal pressure and performed video imaging of the rodent proximal colon with cool water administration into the colonic lumen. Clinical trial registry website (Trial No. UMIN-CTR; UMIN000030725).
Results:
In the randomized controlled trial, after treatment, the proportion of subjects with no peristalsis with cool water was significantly higher than that in the placebo group (44.7% vs 23.4%; P < 0.05). In the rodent colon model, cool temperature water was associated with a significant decrease in colonic peristalsis through its suppression of the ratio of peak frequency (P < 0.05). Cool temperaturetreated TRPM8-deficient mice did not show a reduction in colonic peristalsis compared with wild-type mice.
Conclusion
For the first time, this study demonstrates that cool temperature-dependent suppression of colonic peristalsis may be associated with TRPM8 activation.
3.Treatment options for solitary hepatocellular carcinoma ≤5 cm: surgery vs. ablation: a multicenter retrospective study
Kazuya KARIYAMA ; Kazuhiro NOUSO ; Atsushi HIRAOKA ; Hidenori TOYODA ; Toshifumi TADA ; Kunihiko TSUJI ; Toru ISHIKAWA ; Takeshi HATANAKA ; Ei ITOBAYASHI ; Koichi TAKAGUCHI ; Akemi TSUTSUI ; Atsushi NAGANUMA ; Satoshi YASUDA ; Satoru KAKIZAKI ; Akiko WAKUTA ; Shohei SHIOTA ; Masatoshi KUDO ; Takashi KUMADA
Journal of Liver Cancer 2024;24(1):71-80
Background:
/Aim: The aim of this study was to compare the therapeutic efficacy of ablation and surgery in solitary hepatocellular carcinoma (HCC) measuring ≤5 cm with a large HCC cohort database.
Methods:
The study included consecutive 2,067 patients with solitary HCC who were treated with either ablation (n=1,248) or surgery (n=819). Th e patients were divided into three groups based on the tumor size and compared the outcomes of the two therapies using propensity score matching.
Results:
No significant difference in recurrence-free survival (RFS) or overall survival (OS) was found between surgery and ablation groups for tumors measuring ≤2 cm or >2 cm but ≤3 cm. For tumors measuring >3 cm but ≤5 cm, RFS was significantly better with surgery than with ablation (3.6 and 2.0 years, respectively, P=0.0297). However, no significant difference in OS was found between surgery and ablation in this group (6.7 and 6.0 years, respectively, P=0.668).
Conclusion
The study suggests that surgery and ablation can be equally used as a treatment for solitary HCC no more than 3 cm in diameter. For HCCs measuring 3-5 cm, the OS was not different between therapies; thus, ablation and less invasive therapy can be considered a treatment option; however, special caution should be taken to prevent recurrence.