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: Medical interviewing skills are now recognized as the most important skill to be acquired for the purpose of accurate diagnosis and treatment. Among the several evaluation methods of interviewing skills, audiovisual method has the merit of allowing the fellow residents to have discussion about the interview and of receiving feedback from the teaching faculty by replaying the real interview. In addition, it allows the resident to evaluate his or her interviewing skills, The purpose of this study is to evaluate the reliability and the validity of family residents' self-interviewing skill evaluation protocol. METHODS: A modified arizona interview rating scale which is an interviewing skill evaluating protocol has been used after Korean version became available. Six interviews with outpatients were recorded and evaluated respectively by 10 residents. The results were compared with that of Golden Standard to assess its validity. Finally, 10 residents were divided into two groups and the results among the groups were compared to evaluate the reliability of the scale. RESULTS: The evaluation of interviewing skills conducted by the residents showed significant rate of correspondence with the Golden Standard(kappa=.22), and in the comparison of 17 evaluation items, there appeared significant correspondence in 7 items. The analysis of the rate of correspondence between the two group of residents revealed significant rate of correspondence (kappa=0.43). Lastly, the comparisons between the items showed significant rate of correspondence in ll items CONCLUSIONS: The residents' self interviewing skill evaluation protocol showed significant validity and reliability from which it may be concluded that the protocol can be used as an effective evaluating method.
Arizona ; Diagnosis ; Diagnostic Self Evaluation ; Humans ; Outpatients ; Reproducibility of Results*

OBJECTIVEInjuries are common and important problem in Tehran, capital of Iran. Although therapeutic centers are not essentially established following the constructional principles of developed countries, the present opportunities and equipments have to be used properly. We should recognize and reduce the deficits based on the global standards. This study deliberates the trauma resources and capacities in university hospitals of Tehran based on Arizona trauma center standards, which are suitable for the assessment of trauma centers.

METHODSForty-one university hospitals in Tehran were evaluated for their conformity with "Arizona trauma center standards" in 2008. A structured interview was arranged with the "Educational Supervisor" of all hospitals regarding their institutional organization, departments, clinical capabilities, clinical qualifications, facilities and resources, rehabilitation services, performance improvement, continuing education, prevention, research and additional requirements for pediatric trauma patients. Relative frequencies and percentages were calculated and Student's t test was used to compare the mean values.

RESULTSForty-one hospitals had the average of 77.7 (50.7%) standards from 153 Arizona trauma center standards and these standards were present in 97.5 out of 153 (63.7%) in 17 general hospitals. Based on the subgroups of the standards, 64.8% items of hospital resources and capabilities were considered as a subgroup with the maximum criteria, and 17.7% items of research section as another subgroup with the minimum standards.

CONCLUSIONSOn the basis of our findings, no hospital meet all the Arizona trauma center standards completely. The hospitals as trauma centers at different levels must be promoted to manage trauma patients desirably.

The aim of the present study was to retrospectively identify sexual dysfunction changes in the patients under mirtazapine-augmented serotonin reuptake inhibito (SSRI) treatment. The study comprised medical records of 20 outpatients, under mirtazapine-augmented SSRI treatment for their major depressive disorder, who had been selected among the patients that had developed sexual dysfunction to previous treatment as monotherapy, with SSRI for at least six weeks. These drugs were maintained and mirtazapine were added (15-45 mg/day). There was a significant difference in scores between baseline and week 4 or week 8 on the both Hamilton Depression Rating and Arizona Sexual Experience Scale. According to Clinical Global Impression-Improvement, 68.4% of the patients were responders. The use of low-dose mirtazapine as an add-on treatment to SSRIs appears to be an effective and well-tolerated augmenttaion for sexual dysfunction caused by SSRIs.
Arizona ; Depression ; Depressive Disorder, Major ; Humans ; Medical Records ; Mianserin ; Outpatients ; Retrospective Studies ; Serotonin

PURPOSE: Recently, the Recon Challenge at the 2009 ISMRM workshop on Data Sampling and Image Reconstruction at Sedona, Arizona was held to evaluate feasibility of highly accelerated acquisition of time resolved contrast enhanced MR angiography. This paper provides the step-by-step description of the winning results of k-t FOCUSS in this competition. MATERIALS AND METHODS: In previous works, we proved that k-t FOCUSS algorithm successfully solves the compressed sensing problem even for less sparse cardiac cine applications. Therefore, using k-t FOCUSS, very accurate time resolved contrast enhanced MR angiography can be reconstructed. Accelerated radial trajectory data were synthetized from X-ray cerebral angiography images and provided by the organizing committee, and radiologists double blindly evaluated each reconstruction result with respect to the ground-truth data. RESULTS: The reconstructed results at various acceleration factors demonstrate that each components of compressed sensing, such as sparsifying transform and incoherent sampling patterns, etc can have profound effects on the final reconstruction results. CONCLUSION: From reconstructed results, we see that the compressed sensing dynamic MR imaging algorithm, k-t FOCUSS enables high resolution time resolved contrast enhanced MR angiography.
Acceleration ; Angiography ; Arizona ; Cerebral Angiography ; Image Processing, Computer-Assisted ; Principal Component Analysis

PURPOSE: Recently, the Recon Challenge at the 2009 ISMRM workshop on Data Sampling and Image Reconstruction at Sedona, Arizona was held to evaluate feasibility of highly accelerated acquisition of time resolved contrast enhanced MR angiography. This paper provides the step-by-step description of the winning results of k-t FOCUSS in this competition. MATERIALS AND METHODS: In previous works, we proved that k-t FOCUSS algorithm successfully solves the compressed sensing problem even for less sparse cardiac cine applications. Therefore, using k-t FOCUSS, very accurate time resolved contrast enhanced MR angiography can be reconstructed. Accelerated radial trajectory data were synthetized from X-ray cerebral angiography images and provided by the organizing committee, and radiologists double blindly evaluated each reconstruction result with respect to the ground-truth data. RESULTS: The reconstructed results at various acceleration factors demonstrate that each components of compressed sensing, such as sparsifying transform and incoherent sampling patterns, etc can have profound effects on the final reconstruction results. CONCLUSION: From reconstructed results, we see that the compressed sensing dynamic MR imaging algorithm, k-t FOCUSS enables high resolution time resolved contrast enhanced MR angiography.
Acceleration ; Angiography ; Arizona ; Cerebral Angiography ; Image Processing, Computer-Assisted ; Principal Component Analysis

Some of the techniques for bone grafting for delayed union or nonunion of the long bone are used currently. In 1991, at arthroscopy workshop in Phoenix, Arizona, Lanny L. Johnson, M.D. reported a case of endoscopic bone grafting for the delayed union on the humerus. He suggested the possibilities of endoscopic bone grafting such as minimal incision, magnified visualization, accurate debridement, accurate graft placement, vascular preservation, outpatient surgery and reduced cost. The author performed endoscopic bone grafting and extra-articular adhesionlysis on the delayed union of femur with extra-articular ankylosis. The patient was a 28 year old housewife with blood type Rh(-). The duration after initial operation was more than 9 months. The result of the graft was satisfactory. In the future endoscopic bone grafting could be performed for nonunion, delayed union and congenital bone defect.
Ambulatory Surgical Procedures ; Ankylosis ; Arizona ; Arthroscopy ; Bone Transplantation ; Debridement ; Education ; Femur ; Humans ; Humerus ; Transplants

Coccidioidomycosis is a fungal infection caused by the soil fungus Coccidioides immitis, which is endemic to the south-western United States. Increasingly, cases are being recognized outside the endemic area, due to travelers who have visited the endemic area. Here, we report a case of pulmonary coccidioidomycosis in a Korean man who has traveled in Arizona, U.S.A. Cardinal clinical symptoms were fever, central lung mass with mediastinal lymphadenopathy on the chest X-ray which mimicked lung cancer, and a 14% eosinophilia in the peripheral blood. Coccidioidomycosis was diagnosed by serology and mediastinoscopic biopsy by identifying typical spherules. The symptoms disappeared spontaneously without specific treatment. Coccidioidomycosis must be considered in the differential diagnosis of pulmonary infiltrates with peripheral eosinophilia, especially if patient has lived in or visited endemic area.
Arizona ; Biopsy ; Coccidioides ; Coccidioidomycosis* ; Diagnosis, Differential ; Eosinophilia ; Fever ; Fungi ; Humans ; Lung Neoplasms* ; Lung* ; Lymphatic Diseases ; Soil ; Thorax ; United States

PURPOSE: This study aimed to compare differences on sexual satisfaction between non-smokers and smokers of Korean adult males. METHOD: The subjects of this study were 304 current smokers and 331 current non-smokers(stop smokers, never smokers) (58.0%). Because of the nature of the study, the participants were recruited through a home page advertisement of a brand newspaper company in Korea, and the survey was done through Internet system. The tool to measure participant's sexual satisfaction was adopted from the Arizona Sexual Experience Scale-Male. RESULT: Participant's age ranged from 20 to 49, mostly in their 30s-40s(96.1%). They were smoking average of 15 cigarettes per day. There were no significant difference on sexual satisfaction between current smokers and non- smokers(t=-.55, p>.05). However, there were significant difference on sexual satisfaction between ever smokers(n=481) and never smokers(n=154) (t=2.10, p<.05). There were significant differences an erectile and orgasm satisfaction according to number of cigarettes they smoked per day. 54.5% smokers who said that they have difficulty in keeping erectile state considered on smoking cessation within 30 days whereas 24.2% in those who said that keeping erectile state was easy. CONCLUSION: Informing about the high risk of sexual dysfunction with cigarette smoking should become a important part of smoking cessation education and for smoking adolescents.
Adolescent ; Adult* ; Arizona ; Education ; Humans ; Internet ; Korea ; Male* ; Newspapers ; Orgasm ; Periodicals ; Smoke* ; Smoking Cessation ; Smoking* ; Tobacco Products

Coccidioidomycosis is a fungal infection acquired by inhalation of the arthrospore of Coccidioides immitis, and endemic disease in specific geographic areas, such as south central California, south Arizona, Nevada, and New Mexico. Approximately 60 percent of infected people is asymptomatic and the remainders mostly exhibit respiratory complaints, from flu-like coughing to overt pneumonia. Usually the infection due to Coccidioides immitis is self-limited. Symptoms resolve within several weeks but radiographic abnormalities could be resolved more slowly. If the radiographic abnormalities persist more than 8 weeks, the term 'chronic pulmonary coccidioidomycosis'is designated. They take forms of nodules, cavities or progressive pneumonia. When manifested as nodule(s), lung malignancy is suspected as a possible diagnosis and histologic confirmation is needed. Here, we report a case of chronic pulmonary coccidioidomycosis manifested as solitary pulmonary nodule in a Korean woman who has traveled in Arizona, which is diagnosed fianlly by lobectomy and histologic examination.
Arizona ; California ; Coccidioides ; Coccidioidomycosis* ; Cough ; Diagnosis ; Endemic Diseases ; Female ; Humans ; Inhalation ; Lung ; Nevada ; New Mexico ; Pneumonia ; Solitary Pulmonary Nodule*