OBJECTIVE: The objective of this research is to survey the requirements of Oriental Medical Informatics, and to suggest a direction that Oriental Medical Informatics development may take. METHODS: Consumers and medical experts were randomly selected, and 14 uestions for consumers and 17 questions for medical experts were sent to respondents by mail and e-mail. RESULTS: Both consumers and medical experts were greatly concerned with the systemized dissemination of Oriental Medical Information, but they were not satisfied with it because of the perceived low quality of the information. Medical experts responded that they need standards and statistical evidences for Oriental Medicine. Consumers demanded good-quality information about diseases and health management. CONCLUSION: To carry out Oriental Medical Informatics, it is necessary to conduct a joint research between the sectors of Oriental Medicine and Information Technology, followed by the development of a standard information infrastructure. Oriental Medicine must also have standards in terms of medical data content, data format, and data communication, to ensure the reliability of the disseminated information on Oriental Medicine.
Surveys and Questionnaires ; Electronic Mail ; Joints ; Medical Informatics ; Medicine, East Asian Traditional* ; Postal Service

BACKGROUND: This study was aimed to investigate the current two years' clinical research coordinators (CRCs) employment and estimate total number of CRCs in Korea. METHODS: The participants were administrative officers or head CRCs in institutions designated by Korea Food & Drug Administration (KFDA). Data on the current status of CRCs' employment was collected with self-administered questionnaires or telephone interview. And total number of CRCs in Korea was estimated based on ratio between the number of the KFDA approved clinical trials and current number of CRCs. RESULTS: The number of CRCs was 1381 at 36 centers in 2009 and 1444 at 37 centers in 2010. About 79 percent of CRCs were employed by investigators. The estimated number of CRCs was from 1677 to 1763 at 135 centers in 2009 and from 1802 to 1890 at 142 centers in 2010 based on number of clinical trials approved by KFDA. Two third of regional clinical trial centers (RCTCs) had written employment policy, and 25 percent of RCTCs employed CRCs in a regular position. All RCTCs had educational programs for CRCs and supported CRCs for training outside. 75 percent of RCTCs provided ID card for CRCs belonging to investigators to access to hospital document. Half of RCTCs had CRC registration system in hospital-wide. CONCLUSION: The number of CRCs in Korea can be easily estimated with the number of KFDA approved clinical trials. Majority of RCTCs still employed CRCs in an irregular position, which should be switched to regular position to reduce the CRCs' unsatisfaction. It is also needed to develop centralized CRC management system for CRCs belonging to investigators.
Calcium Hydroxide ; Employment ; Head ; Humans ; Interviews as Topic ; Korea ; Surveys and Questionnaires ; Research Personnel ; Zinc Oxide

Anesthesia for a patient with a large mediastinal mass is a challenge for anesthesiologists, given the risk of airway collapse and hemodynamic compromise. Moreover, there are very few reports on the anesthetic management of non-intubated video-assisted thoracoscopic surgery (VATS). Thus, in the following case report, we provide an account of the successful anesthetic management and excisional biopsy of a large anterior mediastinal mass (measuring 13 × 10 cm) utilizing non-intubated VATS. The patient was kept awake, maintaining consciousness and spontaneous respiration throughout the procedure, in order to prevent devastating airway collapse and pain control and cough prevention were achieved by thoracic epidural analgesia and lidocaine nebulization.
Analgesia, Epidural ; Anesthesia ; Anesthesia, Epidural* ; Biopsy* ; Consciousness ; Cough ; Hemodynamics ; Humans ; Lidocaine ; Respiration ; Thoracic Surgery, Video-Assisted

BACKGROUND: Endotracheal intubation with direct laryngoscope requires movement of the head, neck, and cervical spine. Spine movement may be limited for anatomical reasons or because of cervical spine injury. The lightwand requires less neck flexion and head extension than the conventional laryngoscope. The purpose of this study was to compare the extension of cervical spine obtained with lightwand and Macintosh laryngoscope. METHODS: Twenty patients requiring general anesthesia with endotracheal intubation were studied. Patients were placed on the operating table and anesthesia was induced. Intubation were performed on two occasions: with lightwands and Macintosh #3 laryngoscopes. Cricoid pressure was not applied. To determine cervical spine extension, five radiographs were taken in each patient (before induction, during mask ventilation, during intubation with lightwand, during laryngoscopy with the Macintosh blade: in the best glottic view or during intubation). RESULTS: Of 20 cases, we excluded 2 cases due to the technical error. Significant reduction of radiographic cervical spine extension were found in the lightwand compared to Macintosh blade at all cervical level. Mean atlantooccipital extension angles were 6.2o and 11.7o for the lightwand and Macintosh, respectively. There were no significant differences between mask ventilation and intubation with lightwand. CONCLUSIONS: Lightwand may be better than the conventional intubation in patients whose cervical spine movement is limited or undesirable, especially in the patients in whom awake intubation is not available.
Anesthesia ; Anesthesia, General ; Head ; Humans ; Intubation ; Intubation, Intratracheal* ; Laryngoscopes* ; Laryngoscopy ; Masks ; Neck ; Operating Tables ; Spine* ; Ventilation

Background: Hemidiaphragmatic paralysis, a frequent complication of the brachial plexus block performed above the clavicle, is rarely associated with an infraclavicular approach. The costoclavicular brachial plexus block is emerging as a promising infraclavicular approach. However, it may increase the risk of hemidiaphragmatic paralysis because the proximity to the phrenic nerve is greater than in the classical infraclavicular approach. Methods: This retrospective analysis compared the incidence of hemidiaphragmatic paralysis in patients undergoing costoclavicular and supraclavicular brachial plexus blocks. Of 315 patients who underwent brachial plexus block performed by a single anesthesiologist, 118 underwent costoclavicular, and 197 underwent supraclavicular brachial plexus block. Propensity score matching selected 118 pairs of patients. The primary outcome was the incidence of hemidiaphragmatic paralysis, defined as a postoperative elevation of the hemidiaphragm > 20 mm. Factors affecting the incidence of hemidiaphragmatic paralysis were also evaluated. Results: Hemidiaphragmatic paralysis was observed in three patients (2.5%) who underwent costoclavicular and 47 (39.8%) who underwent supraclavicular brachial plexus blocks (P < 0.001; odds ratio, 0.04; 95% confidence interval, 0.01-0.13). Both the brachial plexus block approach and the injected volume of local anesthetic were significantly associated with hemidiaphragmatic paralysis. Conclusions The incidence of hemidiaphragmatic paralysis is significantly lower with costoclavicular than with supraclavicular brachial plexus block.

Background and Objectives: The canalith reposition procedure (CRP) is used for the treatment of benign paroxysmal positional vertigo (BPPV) where the accuracy of position may affect the therapeutic efficacy. We investigate the accuracy of head position in CRP and its influencing factors during the procedure by measuring the position using inertial sensors and three dimensional remodeling.Subjects and Method We included 28 patients who were diagnosed as BPPV. To evaluate the accuracy of the CRP, we used the inertial sensor on the patient’s goggle used for videonystagmography. We evaluated the accuracy of the treatment compared to the textual treatment used during CRP. We also evaluated patient factors that affected the accuracy of head position as well as analyzing the correlation between the error rate and the successful treatment rate. Results: While the average error rate was 12.6±5.8% for the PSCC group, it was 10.2±5.2% for the lateral semicircular canal (LSCC) group. For the posterior semicircular canal (PSCC) the group with body mass index (BMI), less than 25 patients had the lower error rate than the group with BMI greater than 25. There was no significant differences regarding the error rate according to BMI or age in the PSCC group. There is no significant differences regarding the error rate between those treated within 1 week and those over 1 week. For the LSCC delayed treatment group, there was no significant differences of error rate between the 1st and 2nd maneuver at each position. Conclusion For the Epley maneuver, the error rate of patients with high BMI is higher than those with low BMI. When the repeated barbeque maneuver was conducted, patients could have a more accurate position due to the learning effect. Care should be taken to ensure accurate CRP by considering various factors.

Rhabdomyosarcoma (RMS) of the breast is rare and there is scant information about the clinical behavior and treatment strategies. We report an adolescent female patient with metastatic RMS of the breast from the anus. An 18-year-old female patient was referred to our clinic due to palpable mass in the left breast. At age seven, she was diagnosed with acute lymphoblastic leukemia and treated with chemoradiation therapy. After 10 years of complete remission state, she presented with anal mass which was diagnosed as RMS and she received chemoradiation therapy. After 1 year of complete remission state, she noticed a palpable mass in her left breast. The breast mass was diagnosed as metastatic RMS based on core needle biopsy specimen. The RMS in breast was excised for the decreasing tumor burden despite of another metastatic lesion. Although rarely reported, metastasis of RMS should be considered as a cause of breast mass. Tissue biopsy is recommended when clinically suspected lesion is detected.
Adolescent ; Anal Canal ; Biopsy ; Biopsy, Large-Core Needle ; Breast ; Female ; Humans ; Neoplasm Metastasis ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Rhabdomyosarcoma ; Tumor Burden

This study aimed to compare the pharmacokinetic (PK) and safety profiles of 2 fenofibric acid formulations under fasting and fed conditions. The reference was a 135 mg capsule, while the test was a 110 mg enteric-coated tablet. This randomized, open-label, two-sequence, two-period crossover phase 1 clinical trial was conducted in healthy Korean men. Sixty participants were enrolled in each of the fasting and feeding groups. Blood samples were collected 72 hours after drug administration. PK parameters were calculated using a noncompartmental method with Phoenix WinNonlin ® . A total of 53 and 51 participants from the fasting and feeding groups, respectively, completed the study. The geometric mean ratio and 90% confidence intervals of the maximum concentration (C max ) and area under the concentration-time curve to the last measurable plasma concentration were 0.9195 (0.8795–0.9614) and 0.8630 (0.8472–0.8791) in the fasting study and 1.0926 (1.0102–1.1818) and 0.9998 (0.9675–1.0332) in the fed study, respectively. The time to reach C max of the enteric-coated tablet compared to that of the capsule was extended by 1 and 3 hours under fasting and fed conditions, respectively. In conclusion, enteric-coated tablets have a higher bioavailability than capsules. In addition, the enteric-coated tablet was smaller than the capsule, making it easier for patients to swallow.