These days, a less invasive surgery is stressed. One current thought is that the endovascular surgery itself is the less invasive and safer surgery for a cerebral aneurysm, and not the microsurgery. Is this true? We have evaluated the merits and demerits of each method. Our conclusion is as follows. Endovascular Surgery should be considered as an alternative, only for the specific patients. Microsurgery itself retains its position of the first treatment of choice for a cerebral aneurysm. "Less invasive" cannot be equated with "less dangerous". We will show the above reasons using slides and videotapes of several patients.
Humans ; Intracranial Aneurysm ; Microsurgery ; Videotape Recording

BACKGROUND/AIMS: Endoscopic ultrasonography (EUS) has been useful in evaluating submucosal lesions of the upper gastrointestinal tract as well as providing guidelines for therapeutic plans. Large proportions of submucosal tumors are diagnosed as stromal tumors. Most are benign, but a significant proportion of them could be malignant. There are a few reports concerning EUS findings as being predictive of malignancy. The aim of this study was to evaluate specific EUS features favoring malignancy in stromal tumors of the UGI tract. METHODS: From January, 1992 to June, 1997, thirty-three cases appeared involving stromal tumors (18 benign, 15 malignant (including 8 STUMP)), and were either surgically (27 cases) or endoscopically (6 cases) resected. Videotapes and photographs were reviewed and EUS features that favored the malignancy were analyzed.
Endosonography* ; Upper Gastrointestinal Tract* ; Videotape Recording

PURPOSE: Standardized patients participate in clinical performance examinations not only to simulate case scenarios but also to evaluate the performance of students using a checklist. The accuracy in checking off checklist items is one of the most important factors determining the reliability of this examination. The purposes of this study were to determine the SP' s overall accuracy in recording checklist items, and whether their accuracy was affected by certain characteristics of checklist items. METHODS: Three professors, who have been fully involved in scenario development and SP training, reviewed videotapes of the examination and evaluated the performance of the students using the same checklist. SP' s checklists were marked on this 'correct checklist'. The checklists and checklist guidelines of the items marked under the score of 50 out of 100 were analyzed. RESULTS: Results showed that the accuracy of the SP' s in recording checklist items was 86.9% and was affected by certain characteristics, such as complexity or ambiguity of checklists and checklist guidelines. CONCLUSION: In this study, the SP' s accuracy in recording checklist items was good to very good, and the result suggested that the accuracy could be improved by the elaboration of checklists and checklist guidelines.
Checklist* ; Educational Measurement ; Humans ; Observer Variation ; Videotape Recording

PURPOSE: To compare the evaluation results of faculties to those of Standardized Patients (SP) participating in a Clinical Performance Examination (CPX) administered at Ewha Womans University College of Medicine. METHODS: The CPX was taken by 77 fourth year medical students. Cases and checklist were developed by the medical school consortium in capital area. Six cases were used and 24 SPs participated and evaluated the students' performances. The whole session was recorded on videotapes so that 6 medical school faculties could analyze and evaluate the students' performances as well. The results were compared and analyzed by SPSS package. RESULTS: The agreement between the faculties and the SPs was relatively good (r=0.79), but not good enough. In every case, SPs gave higher marks than did the faculties. Clear disease entity cases like "hepatitis" and "anemia" showed better agreement than obscure clinical contexts such as "bad news delivery". Better agreement was seen in the items of physical exam category (r=0.91), but the agreement was very poor in the items of doctor-patient (Dr-Pt) relationship category (r=0.54). The construction of checklist and the character of each evaluation item should influence the differences. CONCLUSION: More detailed guidelines and clear/specific evaluating items are necessary to improve the agreement rate. In certain categories like physical exam and brief history taking, the SP' s evaluation can replace the faculties', but for complex contexts like Dr-Pt relationship.
Checklist ; Female ; Humans ; Schools, Medical ; Students, Medical ; Videotape Recording

BACKGROUND: Clinicians broadly accept the Global Deterioration Scale (GDS) as a staging measure for dementia. The aim of this study is to test the inter-rater reliability and concurrent validity of the Korean version of GDS. METHODS: Participants included 34 subjects without dementia and 41 patients with Alzheimer's disease, in addition to 37 patients with vascular dementia. A rater, using a semi-structured clinical interview, interviewed the participants and their informed collateral sources. To obtain the concurrent validity, all participants received the Korean Mini-Mental State Examination (K-MMSE), the Korean version of Syndrome Kurz Test (K-SKT) and a 15-items abbreviated Korean-Boston Naming Test (K-BNT) on the same day. We also tested the inter-rater reliability among the four raters using a videotape design. RESULTS: The agreements of the overall GDS ratings by the four raters were high (kappa, 0.93-1.0). GDS correlated significantly with K-MMSE, K-SKT, and the abbreviated K-BNT and Clinical Dementia Rating scale. CONCLUSION: The Korean version of GDS may be a reliable and valid tool to be used as a staging measure for Korean patients with Alzheimer's disease as well as vascular dementia.
Alzheimer Disease ; Dementia ; Dementia, Vascular ; Humans ; Videotape Recording

BACKGROUND: The importance of communication between patients and physicians has been proven in many previous studies. The authors analyzed the effect of interview skill education through videotapes which recorded students' interviews with real patients in the outpatient department of family medicine. METHODS: This study was conducted with all students who chose the elective course of family medicine and one randomly selected student every week from an 'infectious internal medicine' class at Dongguk University Ilsan Hospital during the period from December 2008 to March 2011. All students performed a preliminary examination of a new patient at the outpatient department of family medicine. All consultations were videotaped. Feedback to the student was given on the same day by viewing the videotape together. After feedback, all students performed another preliminary examination of one new patient at the department of family medicine the same week. Three family medicine residents scored all videotapes using 10-item interview skill checklists. Many parts of the checklists were modified using the Arizona Clinical Interview Rating Scales. RESULTS: Thirty-three students participated. Of 10 items, nine showed increased scores after feedback. There was a significant change in four items after feedback: 'type of question' (before 2.36 +/- 0.60, after 2.73 +/- 0.72), 'timeline' (before 2.82 +/- 0.68, after 3.18 +/- 0.73), 'positive verbal reinforcement' (before 2.24 +/- 0.56, after 2.61 +/- 0.90), and the total score (before 21.70 +/- 2.62, after 23.39 +/- 3.13) (P < 0.05). CONCLUSION: Giving feedback to medical school students on medical interview skills using videotapes of students' preliminary consultations with real patients in outpatient settings, was effective in improving the interview areas of 'type of question,' 'timeline,' 'positive verbal reinforcement,' and the total interview scores.
Arizona ; Checklist ; Humans ; Outpatients ; Referral and Consultation ; Schools, Medical ; Videotape Recording

BACKGROUND: The Clinical Dementia Rating (CDR) scale is broadly accepted by clinicians as a staging measure for dementia. The aim of this study was to test inter-rater reliability and concurrent validity of the Korean version of the CDR. METHODS: Participants included 34 persons without dementia and 41 patients with Alzheimer's disease, and 37 patients with vascular dementia. The participants and their informed collateral sources were interviewed by a rater using a semistructured clinical interview. To obtain concurrent validity, all the participants received K-MMSE, K-SKT (Syndrom Kurz Test), and a 15-items abbreviated K-BNT on the same day. We also tested inter-rater reliability among four raters using a videotape design. RESULTS: Agreements of the overall CDR ratings (kappa, 0.86-1.0) and Sum of Boxes of CDR (CDR-SB) (gamma, 0.89-1.0) by the four raters were high. Both global CDR and CDR-SB correlated significantly with K-MMSE, K-SKT and the abbreviated K-BNT. The Orientation and Memory box score correlated significantly with orientation and memory scores of K-MMSE. CONCLUSIONS: The Korean version of CDR appears to be a reliable and valid tool as a staging measure for Korean dementia patients.
Alzheimer Disease ; Dementia* ; Dementia, Vascular ; Humans ; Memory ; Videotape Recording

BACKGROUND: Current studies have focused mainly on the push-pull effect (PPE), the reduction of +Gz tolerance when hypergravity (>+1 Gz) preceded by hypogravity (<+1 Gz). However, the reduced G tolerance could be induced by any G-transition. The frequency and extent of maneuvers to cause G-transition effect (GTEM) have not been studied previously in fighter aircraft. METHODS: 26 HUD (head-up display) videotapes from F-16 aerial combat training missions were reviewed for the presence of GTEM. The frequency and magnitude of the +Gz profiles were analyzed. RESULTS: GTEMs were found in 34 (29.6%) of 115 engagements reviewed. PPEMs (maneuvers found to cause push-pull effect) and rPPEMs (maneuvers found to cause reversed PPE) were found in 7.8%, 11.3% respectively. Combined maneuver that rPPEM followed by PPEM consecutively was found in 10.4% of engagements. There was no difference the frequency of GTEMs between BFM and ACM engagements (28.8% vs. 30.9%). CONCLUSION: GTEMs including PPEMs and rPPEMs are present in aerial combat training missions of F-16 aircraft and represent a significant source for accidents. These findings support the necessity of continued research into the physiologic response to GTE.
Aircraft* ; Humans ; Hypergravity ; Hypogravity ; Missions and Missionaries* ; Videotape Recording

OBJECTIVE: The purpose of this study was to investigate the effects of video feedback training for the parents of autistic spectrum disorder children. METHOD: Ten Autistic spectrum disorder children and their mothers participated in this training. Twenty minutes play times were videotaped including free play time and chosen play time. After one session, watching videotape, the researcher analyzed the relation of the children and their mother and had a feedback training with the mother of child. RESULTS: The child's responses to the mother's start actions had significant differences (p<0.05). The language responses of children increased in the organized environment of chosen play. Language responses increased but negative actions and no responses reduced when mother encouraged child centered play rather than mother engaged in children's play directly. In log sector model, mother's responses according to the play type had meaningless difference (p0.05). But in division analysis mother's responses to child's start action had meaningful difference in pre/post treatment and play type. CONCLUSION: The effects of video feedback training of autistic spectrum disorder children's parents were positive. Through this investigation the interaction and the communication with autistic spectrum disorder children and their parents are influenced positively.
Child ; Humans ; Language Development* ; Mothers ; Parents* ; Videotape Recording

OBJECTIVE: The purpose of this study is to test interrater & intrarater reliability of FIM. METHOD: We trained 7 members in our rehabilitation team with educational FIM manual and videotape published at State University of New York. After training workshop and several practice of FIM, videotaped FIM of the 10 patients with stroke were evaluated twice at 30 days interval by 7 trained testers. With each FIM data interrater & intrarater correlations were analyzed. RESULTS: Both interrater & intrarater reliability of FIM was significantly high. And the results of intrarater reliability were more reliable than those of interrater reliability. Also motor FIM components were more reliable than cognition FIM components. CONCLUSION: With proper training of the testers, FIM could be used as a standard assessment tool in a rehabilitation unit to quantify patients' disability.
Activities of Daily Living* ; Cognition ; Education ; Humans ; Rehabilitation ; Stroke ; Videotape Recording