Telemedica is working on auscultation education to build a better relationship of trust between medical professionals and patients.

November 21, 2023

Regular Maintenance Notification on November 29th from 6PM ~ 7PM (JST), a regular system maintenance will be performed. Please note that you may not be able to use this system during the maintenance period.

October 18, 2023

Regular Maintenance Notification on October 25th from 6PM ~ 7PM (JST), a regular system maintenance will be performed. Please note that you may not be able to use this system during the maintenance period.

September 21, 2023

Regular Maintenance Notification on September 27th from 6PM ~ 7PM (JST), a regular system maintenance will be performed. Please note that you may not be able to use this system during the maintenance period.

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  • iPax

    PR|iPax, PBL Application Examples

    Function for pulse while taking auscultation will be activated. Using two Kikuzo to examine auscultation and palpation. Connect a stereo L/R converter to the device, and connect Kikuzo to each of the L/R. The pulse wave is output from the L side. You can feel the pulse on the silicon surface by increasing the volume of the L side.





    Click on the chest illustration. You will listen to the sound of the site.

     

    Please use Kikuzo-speaker or earphones to listen to the sounds.

    Auscultation time 1 minutes. Press REFRESH when the sound stops.

     

    (C) 2023 Telemedica Inc.

    In order to prove that it is the original sound, special signals are incorporated into this sounds.

    iPax, PBL Application Examples

     

    The iPax chest and back illustrations can be changed, allowing for a more realistic case scenario setting by changing the picture or illustration to match your PBL scenario.
    HR and RR can be selected from the iPax database.

     

    iPax information page here

  • iPax

    PR|Evaluation of iPax

    Function for pulse while taking auscultation will be activated. Using two Kikuzo to examine auscultation and palpation. Connect a stereo L/R converter to the device, and connect Kikuzo to each of the L/R. The pulse wave is output from the L side. You can feel the pulse on the silicon surface by increasing the volume of the L side.





    Click on the chest illustration. You will listen to the sound of the site.

     

    Evaluation of iPax at a hands-on session of the Japan Society of Early Mobilization

     

    In a hands-on session of the Japan Society of Early Mobilization (June 24, 2023), iPax was used.  Mr. Tomoya Kuroda, who served as a lecturer, gave us his impressions of iPax, so we will introduce it below.

     

    The lecture was very well received. Thank you very much.

     

    We asked the participants to actually listen to the sound and confirm the difference between normal and abnormal sounds and the difference in sound depending on the part.Due to the sound equipment at the venue, we had a problem with not being able to make loud noises, but since it was a seminar with a small number of people, we were able to finish without any major problems.

     

    (C) 2023 Telemedica Inc.

    In order to prove that it is the original sound, special signals are incorporated into this sounds.

     

    Q: How did you feel about the iPax you used this time from the instructor's point of view? Please tell us about the advantages and disadvantages compared to conventional teaching materials and simulators.

     

    A: With iPax, you can hear the sound of the part where you move the stethoscope on the screen, so it was very realistic and popular. It was difficult to hear the breath sounds in the part where I wanted to hear the sound (middle precordial lobe), and it was sometimes difficult whether it was our clumsiness or a problem with the system.

    Comment from Telemedica:

    In iPax, vesicular sounds are set near the middle precordial lobe. This sound is difficult to hear because it has a lower pitch and volume than tracheal breath sounds and bronchial breath sounds. When outputting the iPax auscultation sound played on a computer to the venue, the sound will be louder if it is output to speakers that support deep bass through an amplifier. Or use Kikuzo to share auscultatory sounds without the need for a large sound system.

     

    Q: What was iPax like from the participants’ point of view? Please tell us about the advantages and disadvantages of the comparison with conventional teaching materials.

     

    A: The participants expressed their surprise at this as a new product. It seems that it was interesting to use it from an educational point of view.

    Comment from Telemedica : Thank you. At other academic societies, when we exhibited iPax as a company, we received similar opinions. Please see below.

  • iPax

    PR|Auscultation Education Systems for newborns

    Function for pulse while taking auscultation will be activated. Using two Kikuzo to examine auscultation and palpation. Connect a stereo L/R converter to the device, and connect Kikuzo to each of the L/R. The pulse wave is output from the L side. You can feel the pulse on the silicon surface by increasing the volume of the L side.





    Click on the chest illustration. You will listen to the sound of the site.


    【PR】Building Education Systems for learning auscultation for newborns 
    ~Contributing to amelioration in the quality of neonatal care by improving the skills of perinatal caregivers~ 

     

    National Center for Child Health and Development (located in Okura, Setagaya-ku, Tokyo, President Takashi Igarashi) and Telemedica Inc. (located in Aoba-ku, Yokohama-shi, Kanagawa, CEO Kiyoshi Fujiki) conducted joint research and developed an educational system for learning auscultation of neonates.  Click here for press release
     

     

    (C) 2023 Telemedica Inc.

    In order to prove that it is the original sound, special signals are incorporated into this sounds.

    Neonatal Case 1: Heart murmur due to right ventricular outflow tract stenosis

     

    In this case,  you can listen to the heart sounds and bowel sounds.

     

    Tetralogy of fallot

     

    36 weeks 5 days in gestation and birth weight is 2374g. This is a newborn baby with Noonan syndrome and tetralogy of Fallot. 

    3 days after birth. Heart rate at 156bpm. 

    The split of sound II is so slight that it isn’t recognizable until you lower the sound speed. 

    An ejection murmur is heard during systole. 

    A murmur heard from the right ventricular outflow tract obstruction (subpulmonary arterial valve and an obstruction over 7mm). 

    A faint alarm sound of the ECG monitor can be heard in the background.

     

    Heart Illustration of Tetralogy of Fallot

     

     

    Heart sound spectrum

     2RSB

     

     

    Supervisor

    Shoichiro Amari, M.D.

    Division of Neonatology

    Center for Maternal-Fetal, Neonatal and Reproductive Medicine

    National Center for Child Health and Development

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An example of the "case list" of the sound source

\ More than 700 cases in total /

Heart sounds (iPax case)

heart-icon

・Normal heart sounds
・S2 respiratory split
・S2 aberrant division
・S3 Gallop
・S4 Gallop
・Sumation Gallop
・Aortic valve stenosis
・Aortic regurgitation
・Mitral valve stenosis
・Mitral regurgitation

Lung sounds (iPax case)

lung sound icon

・Normal lung sounds
・Fine Crackles
・Course Crackles
・Weezes
・Lonkai
・Weezes + Ronkai
・Course Crackles + Ronkai
・Course Cluckles + Squawk + Ronkai
・Cavity breathing
・Decreased bronchial breath sounds

Other auscultation sounds

other sound icon

・ Korotkoff sound (including pulse palpation function)
・ Guru sound (including metallic sound)
・Dialysis shunt sound

Case Study

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・ Heart failure
(mitral regurgitation)
・ Heart failure
(mitral regurgitation + tricuspid regurgitation + atrial fibrillation)
・Cases of chest pain
・Cases with abnormal electrocardiogram
・Rheumatoid arthritis case of MTX lung
・ Interstitial pneumonia associated with rheumatoid arthritis COPD comorbid case
・Cases of idiopathic lung disease without honeycomb lung
・A case of high MDA-5 antibody-positive dermatomyositis
・Newborn cases

\ If you want a case that is not on the list or an original case, Telemedica will create and provide the sound source /

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Message from the Supervisors

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Gao Jie Jinghe profile icon Dr. Tsunekazu Takashina (MD.PhD, FACC, FAHA)

The more you use a Kikuzo speaker, the more you acquire auscultation skills.

The cardiology patient simulator "K" was developed in 1993. In 1997, its educational effectiveness of this study was reported in CARDIOLOGY. Even today, most of the university medical schools and medical colleges in Japan as well as many foreign countries have been using this simulator for their educational activities.

The advancement in diagnostic instruments using high technology has been remarkable in the last few decades. However, there is a tendency for many clinicians to become too dependent on these highly sophisticated instruments and to forget the importance of bedside clinical skills.

I believe that we have an excellent inborn sensor to recognize "organ language" and are able to detect minor changes of physical findings, such as heart sounds or murmurs of heart diseases. The Kikuzo speaker is used as an exciting teaching tool, whenever and wherever the self-learning of auscultation is needed. Please start with normal heart sounds and advance to each case at your own pace. So, you will be able to recognize various abnormal sounds and murmurs. The "Kikuzo" will be a great auscultation aide for you.

Takeshi Saratani profile icon Dr. Takeshi Saraya Department of Respiratory Medicine,
Kyorin University School of Medicine

Auscultation is an important skill for clinical practice.

Physicians can use the stethoscope whenever they want, which is an indispensable tool for discovering the etiologies and/or patients’ disease status even after the timing of modern technologies were applied. Furthermore, auscultation itself can give preferable emotional effects with the confidence for patients. Physicians should image the lung sounds for individual respiratory diseases just before performing auscultation. Learning of auscultation skills for discriminating respiratory diseases needs consideration for specific lung sounds in accordance with the anatomic location.

In this regard, the “kikuzo and its website” will provide an important and useful lung sounds for physicians, which can clearly and reproducibly learn the representative and/or essential lung sounds in general practice.

Zhiming profile icon Dr. Chiaki Hidai MD, PhD,
Professor of Nihon University School of Medicine

Auscultation is not done with the ears, but between the ears.

I remember 35 years ago when I first realized, “I have finally grasped the art of auscultation!” As a new intern I was assigned to the cardiology ward where one of my tasks was to listen to the chest sounds of a patient with five different cardiac conditions: mitral valve stenosis, mitral valve regurgitation, aortic valve stenosis, aortic valve regurgitation, and tricuspid valve regurgitation. But all I heard was a whirring sound and had no idea what it was. From that day on, every morning when I went to the ward, I spent dozens of minutes auscultating her chest. One day, about 10 days later, I suddenly heard several distinct sounds. I was able to differentiate the sound of mitral stenosis from that of aortic regurgitation. Auscultation is not something that can be understood by attempting it once. Listening carefully over and over again is what turns a noise into meaningful sounds. It is said that auscultation is not done with the ears, but between the ears. I encourage everyone to train what lies between the ears by listening carefully again and again.