[Regarding Authorized Qualifications in Sonography].

Today, I will talk about the profession "Ultrasound Technologist." The written examination to gain this license includes clinical questions (35 questions including those using photographs; 70 minutes to answer) and basic questions related to ultrasound for medical use (35 questions including those requiring calculation; 70 minutes to answer). The answer to each question is selected from 5 alternatives. The questions used in the examination are not officially disclosed. The minimum score needed to pass the examination is 60 points for both the test with clinical questions and that with basic questions. My practice to prepare for the basic questions related to ultrasound for medical use involved attempting to answer a collection of questions while understanding physical phenomena by watching animations on the related Internet homepage. I wrote down how to approach the questions (including those requiring calculation), together with comments and answers to each of them. Basic questions about ultrasound for medical use differ little from year to year because there are few questions reflecting highlights or specific topics prevailing in a given year. So, to prepare for basic questions, I think it is important to become familiar with the trends of questions and how to answer them through repeating mock tests many times. Preparing for clinical questions is very difficult. Although many collections of clinical questions are available at bookstores, I have the impression that most of the questions in these collections have already been used in past examinations, and there is now a tendency for more precise clinical questions targeting specific areas to be adopted for the examination. The questions adopted in the past are becoming outdated, while the techniques of ultrasonography are continuing to advance. So, clinical questions are being increasingly adopted that cover recent topics in this field. In any event, knowledge covering extensive areas is needed to prepare for the clinical questions. For those who desire to attain the license "ultrasound technologist" despite insufficient clinical experience, the only possible approach may be to read through collections of questions and reference books.

Small peripheral lung carcinomas with five-year post-surgical follow-up: assessment by semi-automated volumetric measurement of tumour size, CT value and growth rate on TSCT.

OBJECTIVES: To retrospectively assess the utility of semi-automated measurements by stratification of CT values of tumour size, CT value and doubling time (DT) using thin-section computed tomography (CT) images. The post-surgical outcomes of favourable and problematic tumours (more advanced p stage than IA, post-surgical recurrence or mortality from lung cancer) were compared using the measured values. The computed DTs were compared with manually measured values. METHODS: The study subjects comprised 85 patients (aged 33-80 years, 48 women, 37 men), followed-up for more than 5 years postoperatively, with 89 lung lesions, including 17 atypical adenomatous hyperplasias and 72 lung cancers. DTs were determined in 45 lesions. RESULTS: For problematic lesions, whole tumour diameter and density were >18 mm and >-400 HU, respectively. The respective values for the tumour core (with CT values of -350 to 150 HU) were >15 mm and >-70 HU. Analysis of tumour core DTs showed interval tumour progression even if little progress was seen by standard tumour volume DT (TVDT). CONCLUSION: Software-based volumetric measurements by stratification of CT values provide valuable information on tumour core and help estimate tumour aggressiveness and interval tumour progression better than standard manually measured 2D-VDTs.

[A case of bronchial arterial aneurysm associated with recurrent massive hemoptysis].

A 69-year-old man was admitted to our hospital because of massive hemoptysis. Bronchial arteriography showed no abnormal findings. Bronchoscopic findings revealed a small, reddish elevated lesion on the posterior surface of the left upper lobe bronchus. Since the patient developed massive hemoptysis four times in a month, he underwent ligation and transection of the left bronchial artery, and bronchoplasty. Histopathologically, the resected tissue showed a bronchial arterial aneurysm without any inflammatory changes. We concluded that the aneurysm had developed in a malformed vessel.

Trend of neonatal group B streptococcal infection during the last 15 years.

BACKGROUND: The survey was designed to determine the trend of group B streptococcal (GBS) infection during the last 15 years, as well as update the reality of this disease. METHODS: Questionnaires were administered every 5 years towards neonatal intensive care unit-equipped hospitals. The first survey was made from 1983 to 1987, the second one from 1988 to 1992 and the third one from 1993 to 1997. The 15-year questionnaire survey included a total of 831 patients. The changes in number of patients, the ages at onset, the diagnosis, the serotypes of causative agents, the presence or absence of complicated delivery and the prognosis were analyzed. RESULTS: It seems that the increasing trend of the number of patients has stopped in the period from 1993 to 1997 (third survey). The most common causative subtype was type III GBS, regardless of early onset type or late onset type. As to perinatal abnormality, approximately 40% of the early onset cases were free from risk factors. Concerning the prognosis, 22.6% of early onset cases and 38.7% of late onset cases died or had sequelae. CONCLUSIONS: The number of GBS-infected cases has stopped increasing, but it is still necessary to carry out screenings of pregnant women for the purpose of decreasing the onset of the disease.