ABSTRACT
Purpose@#The practical examination portion of the National Dental Licensing Examination (NDLE) is slated to be administered in the latter half of 2021 in the form of a clinical performance examination that comprehensively evaluates the patient-dentist interaction using standardized patients (SPs). The SPs should be equipped with the basic qualities and capacity as evaluators for a fair and reliable administration of the test. @*Materials and Methods@#In this study, we analyzed the existing training materials for SPs who participated in domestic and overseas practical tests for the development of training materials for SPs through seminars and surveys of 11 dentistry schools and colleges.Result: First, SPs should be selected according to the basic quality criteria and capacity, which they must possess, and the preliminary basic training about the details which they must have knowledge of and be provided through videorecorded cases before the implementation of the preliminary field training. Second, the roles of SPs and the calibration process of the evaluation result forms are needed when conducting the preliminary field training for SPs. After watching video-recorded scenario cases, the SPs participate in discussions about the watched videos before proceeding to calibration practices of evaluation result forms. Third, because the Type A questionnaire of the practical examination of the NDLE is dependent on the SPs’ capacity and training, the fairness of the practical test is largely dependent on the SPs. Therefore, practicing the roles as evaluators and evaluation training should be provided using practical test items that can improve the reliability of the test and show a high level of reproducibility about the same case. @*Conclusion@#The findings of this study will be utilized for the development of training materials for SPs, so they can participate in the administration of a fair and reliable practical examination of the NDLE.
ABSTRACT
Purpose@#The practical examination portion of the National Dental Licensing Examination (NDLE) is slated to be administered in the latter half of 2021 in the form of a clinical performance examination that comprehensively evaluates the patient-dentist interaction using standardized patients (SPs). The SPs should be equipped with the basic qualities and capacity as evaluators for a fair and reliable administration of the test. @*Materials and Methods@#In this study, we analyzed the existing training materials for SPs who participated in domestic and overseas practical tests for the development of training materials for SPs through seminars and surveys of 11 dentistry schools and colleges.Result: First, SPs should be selected according to the basic quality criteria and capacity, which they must possess, and the preliminary basic training about the details which they must have knowledge of and be provided through videorecorded cases before the implementation of the preliminary field training. Second, the roles of SPs and the calibration process of the evaluation result forms are needed when conducting the preliminary field training for SPs. After watching video-recorded scenario cases, the SPs participate in discussions about the watched videos before proceeding to calibration practices of evaluation result forms. Third, because the Type A questionnaire of the practical examination of the NDLE is dependent on the SPs’ capacity and training, the fairness of the practical test is largely dependent on the SPs. Therefore, practicing the roles as evaluators and evaluation training should be provided using practical test items that can improve the reliability of the test and show a high level of reproducibility about the same case. @*Conclusion@#The findings of this study will be utilized for the development of training materials for SPs, so they can participate in the administration of a fair and reliable practical examination of the NDLE.
ABSTRACT
BACKGROUND: Programmed cell death ligand 1 (PD-L1) plays a major role in the immune responses of a variety of cancers. Recently, several studies revealed that PD-L1 is differently expressed in some cases of non-melanoma skin cancer. The expression of PD-L1 in cutaneous squamous cell carcinoma has not yet been described in Korea. OBJECTIVE: To investigate the expression of PD-L1 in cutaneous squamous cell carcinoma and its association with variable clinicopathological factors. METHODS: We performed immunohistochemical staining of 52 cutaneous cell carcinoma cases, including 28 high-risk cases and 24 low-risk cases. Cases were selected from patients who had visited the department of dermatology of our hospital from 2001 to 2017. The expression patterns were assessed using the H-score. Cases demonstrating at least 1+ of PD-L1 in more than 1% of tumor cells were considered positive. RESULTS: PD-L1 expression of tumor cells was 19.2% (10/52) for all cases, 0.0% (0/24) for the low-risk group, and 35.7% (10/28) for the high-risk group. PD-L1 positive cutaneous squamous cell carcinoma cases showed a significantly higher proportion of large tumors and tumors with deep invasion and a higher lymphatic metastasis rate when compared to PD-L1 negative cutaneous squamous cell carcinoma cases. CONCLUSION: Our study shows that cutaneous squamous cell carcinoma exhibits PD-L1 expression in 19.2% of cases. PD-L1 positive tumors are associated with high-risk cases of cutaneous squamous cell carcinoma, which may help guide the choice of therapeutic strategy.
Subject(s)
Humans , Carcinoma, Squamous Cell , Cell Death , Dermatology , Epithelial Cells , Korea , Lymphatic Metastasis , Neoplasm Metastasis , Skin NeoplasmsABSTRACT
We report a rare case of a double cystic duct in a 55-year-old woman. The patient complained of upper abdominal pain and jaundice. The patient was diagnosed with distal common bile duct (CBD) cancer by endoscopic retrograde cholangiopancreatography (ERCP). ERCP was unable to reveal the presence of a double cystic duct. However, magnetic resonance imaging (MRI) and a percutaneous transhepatic biliary drainage (PTBD) were performed as images for obstructive jaundice before surgery showed two ducts that looked like cystic ducts-one duct branched from the common bile duct and the other duct branched from the right hepatic duct. A pancreatoduodenectomy was performed to remove the distal CBD cancer and the presence of a double cystic duct was confirmed with the naked eye. This case suggests that the imaging studies, such as preoperative ERCP and MRI or intraoperative cholangiography are required to avoid complications during hepatobiliary surgery.
Subject(s)
Female , Humans , Middle Aged , Abdominal Pain , Cholangiography , Cholangiopancreatography, Endoscopic Retrograde , Common Bile Duct , Cystic Duct , Drainage , Eye , Hepatic Duct, Common , Jaundice , Jaundice, Obstructive , Magnetic Resonance Imaging , Pancreaticoduodenectomy , Urinary BladderABSTRACT
Gallstone is a common disease with a prevalence of about 10%, but biliary ileus is a rare entity with a frequency of about 1% for all the symptomatic patients. We are reporting on a case of perforated terminal ileum that was due to gallstone, and this was without any associated intestinal obstruction or bilioenteric fistula. A 76 year old man presented with a history of jaundice and dark colored urine for a 3-month duration with no clinical features of intestinal obstruction. There was no past history of biliary tract disease. The abdominal radiograph demonstrated no biliary stones or classical findings of gallstone ileus, but there was a suspicion of cholangiocarcinoma. Laparotomy was performed. A perforation of terminal ileum was identified in the mesenteric border of the terminal ileum and adjacent to ileocecal valve, and it was wrapped by omentum. A small 1.5 cm sized stone was impacted in the mesentery at the site of the perforation. The perforation site was closed. Cholecystectomy and proximal common bile duct resection with Roux-en-Y choledochojejunostomy was then performed.
Subject(s)
Aged , Humans , Biliary Tract Diseases , Cholangiocarcinoma , Cholecystectomy , Choledochostomy , Common Bile Duct , Fistula , Gallstones , Ileocecal Valve , Ileum , Ileus , Intestinal Obstruction , Jaundice , Laparotomy , Mesentery , Omentum , PrevalenceABSTRACT
In this study, we developed MobileNurseTM; a prototype of mobile nursing information system using PDA. MobileNurseTM is designed to communicate with hospital information system(HIS) via mobile support station(MSS) which interchanges and stores clinical data. MobileNurseTM consists of 3 components. The first component is medical order checking module. It enables nurses to retrieve patients' information such as physicians' orders and test results at anywhere or anytime. The second component is nursing recording module which helps nurses to record the results of their practices at bedside. On the autosynchronization of MSS and PDA, the data in PDA and MSS can be interchanged and updated respectively. The last component is nursing unit care planing module. It is helpful for retrieving the nursing care plans of patients that are expected to be done, such as patients' discharge, consultation, or transfer. With use of PDA in clinical environment, nurses can spend more time on caring for patients by reducing time-consuming, redundant paperwork. It is promising that this 'point-of-care system enables nurses to improve the quality of nursing care.