No abstract available.
Lipoma*

BACKGROUND: Demands for complicated and long-term administration clinical trials have been increased since investigators actively involved in early stage clinical trials including first-in-human (FIH) trials. Research wards in our clinical trial center were mainly used for phase 1 trials. In order to perform several clinical trials simultaneously during a short period with a minimum number of rooms, beds, and equipment, staffs have to spend a lot of time for efficient operation of limited numbers of facilities. In this study, automated bed-allocation system was developed for efficient scheduling of the research ward based on clinical trial condition and status like experts. METHODS: The system was developed based on clinical trial design, schedule, and the information on research bed and availability stored and updated in database (DB). Automatic assignment system was designed to find an optimal schedule according to the given information using expert rules and algorithms. The optimal solution can be visualized on Gantt chart using C# and Chart FX API. RESULTS: The system was developed to demonstrate the schedule on color chart. It turned out to be well-designed to find an optimal schedule for bed allocation. The system also allows automatic updating of the schedule and information in the DB. CONCLUSION: Automated bed-allocation system developed in this study could save time and improve the efficiency for using space and equipment in clinical trial center. The system can be also applied to similar works or tasks in other fields.
Appointments and Schedules ; Expert Systems ; Humans ; Research Personnel

PURPOSE: Electrical injuries may cause many psychiatric complications such as depression, acute stress disorder, post-traumatic stress disorder (PTSD), etc. The purpose is to search the incidence of psychiatric complications in electrical injury and to compare its associated risk factors with other burn and trauma. METHODS: We reviewed the medical records of 709 electrically injured patients who were admitted to Hanil General Hospital from 2002 to 2007. Psychiatric complications were defined as depression, acute stress disorder and PTSD according to DSM-IV. We sorted the medical records into demographics, hospitalization, electrical voltage, injured type, extent or site of burn and type of amputation. RESULTS: Total incidence of psychiatric complications was 27.5% (Depression; 15.8%, acute stress disorder or PTSD; 17.6%). High voltage injured patients had psychiatric complications 2.38 times higher than low voltage. Incidence of psychiatric complications were 1.83 times in 6~10% of BSA, 2.01 times in 11~20% and 2.41 times in 21~30% higher than in 0~5% of BSA. If the site of burn included face, psychiatric complications occurred 1.96 times more than other sites. Patients with history of minor and major amputation showed 2.39 and 7.70 times incidence of psychiatric complications, respectively. CONCLUSION: The risk factors of psychiatric complications were high voltage electrical injury, facial burn, extent of burn and history of amputation. If the patients have risk factors, earlier psychiatric consultation may help to manage the psychiatric complications of electrical injury.
Amputation ; Burns ; Demography ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Facial Injuries ; Hospitalization ; Hospitals, General ; Humans ; Incidence ; Medical Records ; Risk Factors ; Stress Disorders, Post-Traumatic ; Stress Disorders, Traumatic, Acute

PURPOSE: Complications and mortality rate of burn injuries are recently decreasing owing to development of systematic and special burn therapy. Whereas we are suffering from the lack of the medical manpower in burn center. In the future we might need more medical assistants to compensate these shortages. In this study we tried to search the path through these difficulties by considering the practical application of medical assistants. METHODS: We compared Korea's current situation of burn treatment with other countries in various references. Also we studied and compared recent situation of medical assistants in Korea and U.S.A. We took special considerations for Korean emergency medical technician, physical therapist and occupational therapist. RESULTS: Our study showed that we are practically using emergency medical technician, physical therapist and occupational therapist as medical assistants in various fields including burn centers. Emergency medical technician, physical therapist and occupational therapist as medical assistants can be excellent medical substitutes for shortage of manpower in our burn centers. Compared with U.S.A's current situation we are quite lacking of certain certified programs for such medical assistants. Burn therapists can be promoted from medical assistants through certain certified educational programs. CONCLUSION: We think that emergency medical technician, physical therapist and occupational therapist, who have certification concerning certain medical experience, should undergo certified educational program for burn therapy and should be used as a actual burn therapists to overcome the shortage of manpower in our burn centers.
Burn Units ; Burns ; Certification ; Emergency Medical Technicians ; Humans ; Korea ; Physical Therapists ; Stress, Psychological

Purpose: This clinical study sought to evaluate the possible clinical effectiveness and practicality of URINO, an innovative, incisionless, and disposable intravaginal device, designed for patients suffering from stress urinary incontinence. Methods: A prospective, multicenter, single-arm clinical trial was carried out, involving women diagnosed with stress urinary incontinence who used a self-inserted, disposable intravaginal pessary device. Comparisons were made between the results of the 20-minute pad-weight gain (PWG) test at baseline and visit 3, where the device was applied. After 1 week of device usage, compliance, satisfaction, the sensation of a foreign body, and adverse events were assessed. Results: Out of 45 participants, 39 completed the trial and expressed satisfaction within the modified intention-to-treat group. The average 20-minute PWG of participants was 17.2±33.6 g at baseline and significantly dropped to 5.3±16.2 g at visit 3 with device application. A total of 87.2% of participants exhibited a reduction ratio of PWG by 50% or more, surpassing the clinical trial success benchmark of 76%. The mean compliance was recorded as 76.6%±26.6%, the average visual analogue scale score for patient satisfaction was 6.4±2.6, and the sensation of a foreign body, measured on a 5-point Likert scale, was 3.1±1.2 after 1 week of device use. No serious adverse events were reported; there was 1 instance of microscopic hematuria and 2 cases of pyuria, all of which recovered. Conclusions The investigated device demonstrated significant clinical effectiveness and safety for patients with stress urinary incontinence. It was easy to use, showing favorable patient compliance. We propose that these disposable intravaginal pessaries could potentially be an alternative treatment for patients with stress urinary incontinence who are seeking nonsurgical options or are unable to undergo surgery.Trial Registration: The study was registered as a clinical trial (KCT0008369).

OBJECTIVES: Although prognosis for pancreatic cancer is generally poor, it is well known that the survival rate for resected pancreatic cancer is much higher than that for more conservative treatment. The importance of early detection is emphasized for resection of pancreatic cancer. Measurement of serum CA 19-9 has shown satisfactory sensitivity and predictive value in symptomatic patients, but there was no available data in healthy asymptomatic subjects. Thus, we aimed to determine the clinical usefulness of CA19-9 for screening of pancreatic cancer in asymptomatic subjects. METHODS: 11,974 asymptomatic persons visiting Samsung Health Promotion Center from December 1994 to July 1996 participated in this study. All subjects underwent ultrasonography and CA19-9 as initial screening tests. We analyzed sensitivity, specificity, and predictive values in detecting pancreatic cancer of CA 19-9 using statistical methods. RESULTS: Mass screening of 11,974 asymptomatic persons resulted in the detection of only 2 cases of pancreatic cancer. 179 subjects had CA 19-9 values above the cutoff of 37u/ml, including the 2 cases diagnosed with pancreatic cancer. The prevalence of pancreatic cancer over the age of 30 in Korea is 14.8 per 100,000 population. Therefore, sensitivity is 100% and specificity is 98.5%. However, positive predictive value of CA19-9 for detection of pancreatic cancer is only 0.98% in asymptomatic population. CONCLUSION: Mass screening of pancreatic cancer using CA 19-9 in asymptomatic subjects is ineffective due to low predictive value, despite high sensitivity and specificity.
Health Promotion ; Humans ; Korea ; Mass Screening* ; Pancreatic Neoplasms* ; Prevalence ; Prognosis ; Sensitivity and Specificity ; Survival Rate ; Ultrasonography

Purpose: Although metformin and sildenafil can protect various organs against ischemia/reperfusion (I/R) injuries, their effects and mechanisms of action in bladder I/R injuries remain unknown. This study investigated the effects and mechanisms of action of metformin and sildenafil against bladder I/R insults in rats. Methods: One hundred male Sprague-Dawley rats were randomly divided into 5 groups, each of which contained 20 rats: a sham-operated group, a bladder I/R group, and bladder I/R groups treated with metformin, sildenafil, or both agents. Ischemia was induced by clamping the bilateral common iliac arteries with atraumatic vascular clamps for 2 hours, followed by reperfusion for 7 days. During this period, rats were injected once daily with 4-mg/kg metformin and/or 1-mg/kg sildenafil. Results: I/R injuries induced increased malondialdehyde levels and myeloperoxidase activity and decreased superoxide dismutase activity. These changes were attenuated by treatment with metformin and/or sildenafil. The I/R group had significantly higher Jun N-terminal kinase, p38 mitogen-activated protein kinase (MAPK), Bax, caspase-3, and nuclear factor-kappa B (NF-κB) levels, and lower extracellular signal-regulated kinase, and Bcl-2 levels in the bladder than the sham-operated group; these changes were significantly ameliorated by metformin and/or sildenafil treatment. No differences in the levels of these markers were observed between rats coadministered metformin and sildenafil and those treated with either agent alone. Conclusions Metformin and sildenafil protected the rat bladder against I/R injuries. This effect may have been due to the inhibition of reactive oxygen species production through MAPK, Bax, and Bcl-2 activation, and the restoration of inflammation through NF-κB inhibition. However, the combination of metformin and sildenafil was not more effective than either agent alone.