ヒロシマ ダイガク シガクブ リンショウ ジッシュウ シサツ ホウコク

We made a field trip to Hiroshima University Hospital to observe its clinical training practices on February 22, 2013. Distinctive features of the clinical training system were as follows. 1) Training schedule. Learning objectives and clinical cases required are established in each specialty clinics. Students can make training schedules in each specialty clinic for themselves in accordance with the progress of required cases of their own. They can move from a clinic to other clinic in a day in order to follow their cases. 2) The small group system and the tutor system for the group. Students are assigned to a group consisting of 3 to 4 persons. They get a clinical training together and share clinical experiences with each other. They hold the group meeting every other Wednesday. The tutor checks the progress on their cases and discusses about next training objectives with each person. 3) The stepwise training and evaluation system. The clinical training are given in 3 terms. Learning objectives in each term are established in stepwise setting. Students are evaluated for their levels of attainment at the end of each term. 4) Morning meeting and mini-lecture. Students attend morning meeting and a mini-lecture before the clinical training everyday. 5) Clinical clerkship. Clinical clerkship has been performed with support of patients. Patients in the hospital are informed for the clinical clerkship. Participants provide written informed consent prior to entry into the system. However, the number of patients for clinical clerkship were not enough. These features are informative and helpful for us to improve our clinical training system. And recruitment of patients who kindly support the clinical clerkship may be the biggest problem to solve in both universities

ガク カンセツショウ カンジャ ニオケル MR ガゾウ ショケン ト リンショウ ショケン ノ ヒカク ケントウ

Two hundred eighteen (28.4%) of 768 patients with temporomandibular disorders (TMD), who visited the Clinic for Temporomandibular Disorders, Tokushima University Medical and Dental Hospital during the period of January 2006 through December 2007, were examined using magnetic resonance (MR) imaging. The present study assessed clinico-statistically the correlation between MR images and the clinical findings of 157 patients with complete registered data in our TMD reporting system. The following findings were obtained: 1. MR imaging showed anterior disk displacement in 125 joints (67.9%), rotational disk displacement in 45 joints (24.5%), and sideways disk displacement in 13 joints (7.1%). 2. Joint effusion (JE) was found in 42.7% of 157 patients; 48.0% in females and 23.5% in males. In addition, anterior or rotational disk displacement was observed in 97% of patients with JE. Furthermore, condyle bone change was significantly higher in joints with than without JE. 3. The appearance of JE was significantly higher on the symptomatic side than the asymptomatic side, but tenderness of the temporomandibular joint (TMJ) area or the value of the visual analog scale (VAS) regarding pain and problems in daily life was not related to the presence of JE

ニホン シカ ダイガク リンショウ ジッシュウ シサツ ホウコク

We made a field trip to Nippon Dental University Hospital to observe its clinical training practices on February 16, 2011. Distinctive features of the clinical training system were as follows. 1) Clinical training is given to fifth-year students. Students in the sixth-year are intent on their studies. 2) There is a one-month overlap in the training periods between these two groups, as patients are handed over from the fifth- to the fourth-year students. This handover is a student-led event. 3) After this period, pre-clinical training is given to the fifth-year students for three months, and then clinical training begins. 4) Patients are requested to evaluate and give feedback to the students treating them. Each student should receive five or more evaluations. 5) A mentor system was introduced in 2005. According to our findings and the results of the“ World Café” held on the same day with trainee dentists and fifth-year students, we identified the following means of improving our clinical training system. First, students under clinical training are now permitted to participate in case-report conferences of trainee dentists, as of 2011. This program was introduced based on the concept of top-down processing to help students form perceptions about cases and treatment. Second, the necessity of a faculty-development program focused on clinical training is recognized, to standardize and improve the guidance given to students by advising doctors. Third, the mentor system and the“ World Café” need more attention as elements of clinical training to support students and motivate improvement

スパイラル CT オ モチイタ ガクカンセツ ノ サンジゲン ヒョウカホウ

Three-dimensional (3-D) image reconstructed from Computed Tomography (CT) data is an ef>cient method to evaluate temporomandibular joint (TMJ) morphologically. Even the 3-D image reconstructed from spiral CT data has some distortion, typically along to the table feed direction, very few studies were reported about accuracy of reconstructed 3-D image size. The purpose of this research was to evaluate the distortion on 3-D image reconstructed with spiral CT (Somatom Plas4, Siemens Co, Germany) quantitatively. We used three imaging targets, eight ceramic balls placed at corners of cubic frame, a calibration cube that has the CT value nearly equal to cortex bone of human dried mandibular head. We evaluated relation between a threshold level of CT image processing and reconstructed 3-D image size with a custom-made computer program. CT data of ceramic balls clari>ed changes of the reconstructed image, -0.215mm for table feed direction and less than ±0.006mm for the other directions. The calibration cube was used for the arrangement of optimal scanning condition (reconstruction mode, collimation, reconstitution interval) and evaluation of reconstructed image size. The distortion of the image was +0.207mm for table feed direction and less than +0.029mm for the other directions. Changes of dried skull TMJ image reconstructed with the optimal scanning condition were -1.463mm for lateral direction of the condylar head, -0.956mm for back and forth direction and -0.580mm for table feed direction. Results of this research suggested that the level of the 3-D image distortion was mostly affected with the scanning condition. And the size of 3-D image was susceptible to the threshold level of CT image processing. Consequently, we think that the standardization of scanning condition should be concerned for the quantitative evaluation of 3-D TMJ image using CT data

Effects of Team-Based Learning on Fixed Prosthodontic Education in a Japanese School of Dentistry

The aims of this study were to evaluate the quality of team-based learning (TBL) in prosthodontics education for fourth-year dental students at Tokushima University School of Dentistry and to compare this teaching method with traditional lecture-based delivery. Participants in the study were 36 students (22 males and 14 females) who attended the TBL-style fixed prosthodontics course. Ten 60-minute classes were held. The first three were traditional lecture-style classes and were followed by one class introducing the TBL style. The remaining six classes constituted the TBL-format fixed prosthodontics course. The effectiveness of TBL was evaluated through student questionnaires at the end of each class and the results of the term-end examination. The questionnaire revealed high student approval for TBL-style learning, and active group discussion among students during TBL was a key factor in these ratings. In the results of the term-end examination, there were significantly higher scores on the questions that covered TBL-taught material than those covering traditional lecture-taught topics. The results of this study suggest that TBL-style lecture was more effective than traditional-style lecture for teaching fixed prosthodontics and that TBL was a more efficient mode of delivering dental education than traditional lecture-based teaching

Reliability and validity of the patient disability-oriented diagnostic nomenclature system for prosthetic dentistry

Purpose: The Japan Prosthodontic Society (JPS) has proposed a new diagnostic nomenclature system (DNS), based on pathogenesis and etiology, to facilitate and improve prosthodontic treatment. This systemspecifies patient disability and the causative factor (i.e. ‘‘B (disability) caused by A (causative factor)’’). The purpose of this study was to examine the reliability and validity of this DNS. Study selection: The JPS Clinical Guideline Committee assessed mock patient charts and formulated disease names using the new DNS. Fifty validators, comprising prosthodontic specialists and dental residents, made diagnoses using the same patient charts. Reliability was evaluated as the consistency of the disease names among the validators, and validity was evaluated using the concordance rate of the disease names with the reference disease names. Results: Krippendorff’s α was 0.378 among all validators, 0.370 among prosthodontic specialists, and 0.401 among dental hospital residents. Krippendorff’s α for 10 validators (3 specialists and 7 residents) with higher concordance rates was 0.524. Two validators (1 specialist and 1 resident) with the highest concordance rates had a Krippendorff’s α of 0.648. Common disease names had higher concordance rates, while uncommon disease names showed lower concordance rates. These rates did not show correlation with clinical experience of the validator or time taken to devise the disease name. Conclusions: High reliability was not found among all validators; however, validators with higher concordance rates showed better reliability. Furthermore, common disease names had higher concordance rates. These findings indicate that the new DNS for prosthodontic dentistry exhibits clinically acceptable reliability and validity

Emerging concepts in biomarker discovery; The US-Japan workshop on immunological molecular markers in oncology

Supported by the Office of International Affairs, National Cancer Institute (NCI), the "US-Japan Workshop on Immunological Biomarkers in Oncology" was held in March 2009. The workshop was related to a task force launched by the International Society for the Biological Therapy of Cancer (iSBTc) and the United States Food and Drug Administration (FDA) to identify strategies for biomarker discovery and validation in the field of biotherapy. The effort will culminate on October 28th 2009 in the "iSBTc-FDA-NCI Workshop on Prognostic and Predictive Immunologic Biomarkers in Cancer", which will be held in Washington DC in association with the Annual Meeting. The purposes of the US-Japan workshop were a) to discuss novel approaches to enhance the discovery of predictive and/or prognostic markers in cancer immunotherapy; b) to define the state of the science in biomarker discovery and validation. The participation of Japanese and US scientists provided the opportunity to identify shared or discordant themes across the distinct immune genetic background and the diverse prevalence of disease between the two Nations