A retrospective study of magnetic resonance-guided focused ultrasound ablation for uterine myoma in Taiwan

AbstractObjectiveTo report our experiences with 40 patients who were treated with magnetic resonance-guided focused ultrasound surgery (MRgFUS) for uterine fibroids and their 6-month follow-up status.Materials and MethodsA total of 40 patients with uterine fibroids underwent MRgFUS from January 2009 to November 2011. The Uterine Fibroid Symptoms and Quality of Life Questionnaire was used to determine the patients' Symptom Severity Scores (SSS) prior to and 6 months after treatment. The nonperfused volume (NPV) values and NPV ratio were obtained immediately at the end of the treatment and at 6 months follow-up.ResultsNo procedure-related complications were noted throughout the 6-month follow-up period among the 40 patients who underwent MRgFUS for uterine fibroids. The mean reduction in SSS in our patients after 6 months was 43.7%, and the mean reduction of fibroid volume was 31.7%. In addition, the mean reduction of NPV and mean NPV ratio was 52.7% and 33.3%, respectively.ConclusionThe results obtained from this study demonstrated that MRgFUS can be safely and effectively used to ablate uterine fibroids to produce a significant decrease in mean fibroid volume and improve SSS for up to 6 months after treatment

Carbon Dioxide Angiography in Lower Limbs: A Prospective Comparative Study With Selective Iodinated Contrast Angiography

This was a prospective comparison of the accuracy and image quality of carbon dioxide digital subtraction angiography (CO2 DSA) and iodinated contrast digital subtraction angiography (ICDSA) in evaluating lower extremity arteries and patient tolerance of the procedures. Selective DSA was performed in 14 Taiwanese patients who were diagnosed with peripheral artery occlusive disease (PAOD). Both contrast materials were administered through mechanical injectors. Post-processing of the image used pixel shifting. Images of vessels were divided into 22 anatomic segments and evaluated by two experienced radiologists. A four-point scale was used to classify diseased vessels. Two interpreters rated the CO2 DSA image against the ICDSA image on a three-point scale. Patient tolerance was assessed from verbal descriptions. Cohen's kappa was used to determine interobserver agreement and descriptive statistics were used to summarize patient experience. Interobserver agreement ranged from fair to excellent, with most being good or excellent. Three patients (21.4%) could not tolerate the whole procedure and nine patients (64.3%) reported discomfort during the CO2 DSA procedure. CO2 DSA image quality was better for the thigh than the distal runoff and pelvic regions. Our results showed that selective CO2 DSA cannot replace ICDSA as a routine diagnostic tool for PAOD because it does not give images of comparative quality

Students’ view upon graduation: a survey of medical education in Taiwan

Abstract Background Improving the quality of medical education is a key goal of government policy in Taiwan. The aim of this study was to reflect the responses of medical education from the perspective of graduating medical students in Taiwan. This is the first survey study of medical education in Taiwan. Methods Using the Medical School Graduation Questionnaire from the Association of American Medical Colleges (AAMC), we distributed 406 questionnaires to medical students of four medical schools in their last semester, and received 270 back (response rate, 66.5%). There were 11 medical schools in Taiwan. Most questions were assessed on a 5-point Likert scale. Results Students identified genetics, biochemistry, and ethics as the three most important premedical subjects preparing them for medical education and gross anatomy, physiology, and pharmacology as the three most helpful basic science subjects preparing them for clinical clerkships and electives. Most Taiwanese students were satisfied with their learning experience in internal medicine. Only 55.9% of students were confident that they had acquired the clinical skills required to become a resident, and 70.7% were satisfied with the quality of their medical education. Conclusion The study offers preliminary results on the views of graduating students on the medical education system in Taiwan. In particular, our government and medical educators need to continuously put more effort into building students’ confidence in their clinical skills.</p