• 제목/요약/키워드: Medical consultation

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색소실조증 환자의 치과적 특성 : 증례보고 (DENTAL CHARACTERISTICS OF A PATIENT WITH INCONTINENTIA PIGMENTI : A CASE REPORT)

  • 송지혜;이고은;송제선;이제호;최형준
    • 대한장애인치과학회지
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    • 제14권2호
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    • pp.88-91
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    • 2018
  • 본 증례는 유전적 피부질환의 하나로 피부의 착색과 망막의 이상 그리고 다수의 유치 및 영구치 결손과 치아의 형태 이상을 나타내는 색소실조증 환자에 대한 보고이다. 현재 환자는 큰 불편감 없이 유치를 유지하고 있으며 향후 영구치열기까지 정기적인 관찰과 관리가 필요하며, 영구치열 완성 후 영구적인 보철적 수복이 필요할 것으로 사료된다.

Eating control and eating behavior modification to reduce abdominal obesity: a 12-month randomized controlled trial

  • Kim, Soo Kyoung;Rocha, Norma Patricia Rodriguez;Kim, Hyekyeong
    • Nutrition Research and Practice
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    • 제15권1호
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    • pp.38-53
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    • 2021
  • BACKGROUND/OBJECTIVES: Abdominal obesity is associated with metabolic disorders, and, in recent years, its prevalence in Korea has continuously increased. The change of lifestyle, particularly diet, is critical for the reduction of abdominal obesity. This study evaluated the effectiveness of an intervention focused on dietary self-efficacy and behaviors on the improvement of abdominal obesity. SUBJECTS/METHODS: Abdominally obese adults with additional cardiovascular risk factors were recruited through 16 medical facilities in South Korea from the year 2013 to 2014. The participants were randomly divided into 2 groups: an intensive intervention group (IG) that received a multi-component intervention to reduce abdominal obesity, by mainly focusing on dietary attitude and dietary behavior change, and a minimal information intervention group (MG) that received a brief explanation of health status and a simple recommendation for a lifestyle change. The interventions were provided for 6 mon, and health examinations were conducted at baseline, 3-, 6-, and 12-mon follow-ups. A path analysis was conducted to identify the process governing the changes in abdominal obesity. RESULTS: The IG showed an improvement in self-efficacy for eating control and diet quality at 6-mon follow-up. Abdominal obesity improved in both groups. Waist circumference was observed to be decreased through the path of "improved self-efficacy for eating control in food availability-eating restriction-improved dietary quality" in IG. Most changes in follow-ups were not significantly different between two groups. CONCLUSIONS: The intensive program targeting the modification of dietary behavior influenced management of abdominal obesity, and the effect occurred through a step-by-step process of change in attitude and behavior. Generally, improvements were also seen in the MG, which supports the necessity of regular health check-ups and brief consultation. The results can be used for further development and implementation of more successful interventions.

상담 장면에서의 명리의 활용에 대한 국내 연구 동향 분석 (National Research Trends Regarding Use of the Four Pillars of Destiny in the Counseling Realm)

  • 홍성규;곽희용;김종우;정선용
    • 동의신경정신과학회지
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    • 제31권4호
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    • pp.289-299
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    • 2020
  • Objectives: The aim of this study is to investigate current research trends of Four Pillars of Destiny and verify its values and potential in the counselling scene, as the Four Pillars of Destiny's territory has been expanding to counselling, medical and psychiatric realm nowadays. Methods: The studies were searched from psychotherapy to general consultation, directly or indirectly related to counseling and Four Pillars of Destiny. Twenty-one published research studies were selected for analysis. The studies were categorized into 7 groups, meta-analysis, comparison with other personality tests, user's trend analysis, utilization in job counseling, disease prediction study, utilization in treatment counseling, and use in Korean medicine. Results: The selected studies attempted to expand Four Pillars of Destiny's usage through combination with other fields such as artificial intelligence, Korean medicine, and personality test. Furthermore by analyzing Four Pillars of Destiny itself to extract its key elements in counseling, such as therapeutic counseling factors and occupational counseling factors. Conclusions: At present, there are no standard use of Four Pillars of Destiny in counseling scene, for no large-scale research has been conducted or completed on this subject. This current status quo leads this paper to end up just understanding the counseling factors and possibilities of Four Pillars of Destiny rather than its psychological theory and clinical effect. However, this research trend analysis will be helpful in preparing future studies investigating Four Pillars of Destiny's counseling effect, application in the counseling scene and its psychological theory. Also, further studies, including confirmation of the theory through the operational definition, prospective research, control study, statistical technique are required in order to evaluate Four Pillars of Destiny's psychological theory and its effects to verify its use in clinical scenes.

Transitional care for high-risk elderly patients pre/post discharge by collaboration between general hospital and community pharmacy: a pilot study

  • Park, Mi Seon;Lee, Ji Hee;Lee, Heung Bum;Kim, Ju Sin;Choi, Eun Joo
    • 한국임상약학회지
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    • 제32권1호
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    • pp.27-36
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    • 2022
  • Background: Medication-related problems (MRPs) frequently occur during the discharge period. Elderly patients, particularly, are at high risk for these problems due to polypharmacy and the use of potentially inappropriate medications. The purpose of this study was to build and implement collaboration between general hospital and community pharmacies to address MRPs among high-risk elderly patients before/after discharge. Methods: This retrospective study was conducted between June and December of 2020. The inclusion criteria were patients with aged ≥65 years; residents of Jeonju; discharged from Jeonbuk National University hospital; either on medication of exceeding 10 medications (or high-risk medications) after hospitalization through the emergency room, or having severe illness. Patients received medication reconciliation and counselling by hospital pharmacists before discharge and home-visit pharmaceutical care as follow-up by community pharmacists after discharge. Results: Twenty-two patients agreed to home-visit pharmaceutical services. Fifteen and 11 patients completed the first and second home-visit pharmaceutical care service, respectively. Forty-two MRPs were identified in 15 patients. The types of high-frequency MRPs were incorrect administration of drug, adverse drug reactions, medication non-compliance, drug-drug interactions, lifestyle modifications, and expired medication disposal. After consultation with the pharmacist, 34 out of 42 MRPs were resolved. Conclusions: Transitional care for high-risk elderly patients before and after discharge was successfully built and implemented through a collaboration between general hospital and community pharmacies. This study suggests that home-visit pharmaceutical services may have positive effects on the safe use of drugs during the transition period; however, additional research is needed to expand on these findings.

여대생 대상 체중조절 프로그램의 영양 교육 효과 평가 (Effectiveness of Nutrition Education in a Weight Control Program for Female College Students)

  • 이현정;이윤정;이경옥;김화영
    • 한국식생활문화학회지
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    • 제24권5호
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    • pp.570-580
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    • 2009
  • The purpose of this study was to evaluate the multilateral weight control program provided by the university health care center for female college students. The program was 8weeks long and composed of nutrition consultation, exercise, and behavior modification. Nutrition education focused on a low calorie and balanced diet, increasing the intake of protein and micronutrients and reducing carbohydrate and fat consumption. Evaluations were made upon completion of an 8-week program and upon follow-up at 6 months after the end of program. A total of 92 women completed the 8-week program, while 20 completed the follow-up survey. Upon completion of the 8-week program, significant decreases in body weight, BMI, body fat (kg), and %body fat were observed, and muscle mass was also reduced. The total energy and carbohydrates intake were also significantly decreased in subjects with weight loss, while the percentage of subjects whose consumption of protein, calcium, iron, vitamin $B_1$, $B_6$, and niacin did not meet the EAR, were decreased. The blood values of glucose, total cholesterol and HDL-cholesterol were decreased. The follow-up survey revealed that the subjects continued to lose weight after completion of the program. In addition, a Mini nutrition assessment revealed that diet quality improved, especially with respect to reductions in the consumption frequency of fried, greasy and salty food. In conclusion, the multilateral weight control program with diet education for female college students was effective for long lasting weight control and improved dietary behavior. Nutrition education for weight reduction should focus on balanced nutrition as well as lowering the total caloric intake.

The association between adverse childhood experiences and self-harm among South Korean children and adolescents: a cross-sectional study

  • Scott Seung W. Choi;Jeong-Kyu Sakong;Hyo Ju Woo;Sang-Kyu Lee;Boung Chul Lee;Hyung-Jun Yoon;Jong-Chul Yang;Min Sohn
    • Child Health Nursing Research
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    • 제29권4호
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    • pp.271-279
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    • 2023
  • Purpose: Adolescent self-harm is a public health problem. Research suggests a link between adverse childhood experiences (ACEs) and self-destructive behaviors. Few studies, however, have examined the effects of ACEs on self-harm among Asian adolescents. This study explored the association between lifetime ACEs and a history of self-harm among Korean children and adolescents in elementary, middle, and high schools. Methods: A cross-sectional, retrospective medical record review was conducted on a dataset of a national psychiatrist advisory service for school counselors who participated in the Wee Doctor Service from January 1 to December 31, 2020. The data were analyzed using multiple logistic regression to predict self-harm. Results: Student cases (n=171) were referred to psychiatrists by school counselors for remote consultation. Multiple logistic regression analyses revealed that the odds of self-harm were higher among high school students (adjusted odds ratio [aOR]=4.97; 95% confidence interval [CI]=1.94-12.76), those with two or more ACEs (aOR=3.27; 95% CI=1.43-7.47), and those with depression (aOR=3.06; 95% CI=1.32-7.10). Conclusion: The study's findings provide compelling evidence that exposure to ACEs can increase vulnerability to self-harm among Korean students. Students with a history of ACEs and depression, as well as high school students, require increased attention during counseling. School counselors can benefit from incorporating screening assessment tools that include questions related to ACEs and depression. Establishing a systematic referral system to connect students with experts can enhance the likelihood of identifying self-harm tendencies and offering the essential support to prevent self-harm.

고형장기이식 환자의 정신건강: 이식의 시기별 이슈 (Mental Health Issues in Solid-Organ Transplant Recipients; Pre-, Peri-, and Post-Transplant Phases)

  • 정연진;강지인
    • 대한불안의학회지
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    • 제19권2호
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    • pp.37-47
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    • 2023
  • This review article explores the psychological characteristics, comorbid mental disorders, and psychosocial assessments throughout the solid organ transplant journey, spanning the pre-transplant, peri-transplant, and post-transplant phases for transplant recipients. The psychological burden and anxiety in the pre-transplant phase are high for organ failure patients with complex physical difficulties who are deciding to undergo transplantation and are on the waiting list. The pre-transplant psychosocial evaluation covers various aspects, including the patient's readiness, awareness of, and commitment to transplant treatment, medical compliance, psychopathological conditions such as cognitive function and personality disorders, lifestyle factors, including substance abuse, as well as various psychosocial factors like social support. During the peri-transplant phase, mental health problems such as postoperative delirium should be carefully recognized and addressed. After transplantation, it is essential to assist patients in coping with the various stressful experiences they encounter, manage psychiatric symptoms such as depression, anxiety, and insomnia, and improve treatment adherence and quality of life during long-term care for the transplanted organ. Managing psychiatric problems in post-transplant patients requires a deep understanding of immunosuppressant medications and a keen awareness of associated risks, including adverse effects and potential drug interactions. This comprehensive review emphasizes the significance of proactive mental health care and psychosocial evaluation, highlighting the necessity of a multidisciplinary approach to enhance the quality of life and overall success of transplant patients throughout all phases of transplantation.

Fetal safety of medicinal herbs and food ingredients during pregnancy: Recommendations from traditional Korean medicine based on expert opinions

  • Hyeong Joon Jun;Dong Il Kim;Jeong-Eun Yoo;Seung-Jeong Yang;Deok-Sang Hwang;Hyeong Jun Kim;Yoon Jae Lee;Dong Chul Kim;Sanghun Lee
    • 대한한의학회지
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    • 제44권4호
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    • pp.121-135
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    • 2023
  • Objectives: This study aimed to establish and provide reliable information for general public, based on expert consensus, on the risks of misuse of medicinal herbs for food and pure food ingredients for the fetus during pregnancy. Methods: A panelist of seven traditional Korean medicine (TKM) gynecologists responded to a questionnaire summarizing the fetal safety literature for twenty-five medicinal herbs for food and pure food ingredients derived from medicated diet (藥膳, Yaksun) recipes during three online Delphi rounds anonymously. Results: Ginkgonis Semen (Ginkgo nut), Illici Veri Fructus (Star anise), lavender, bitter gourd, and parsley were agreed at the level 1 of "Do not consume". These five ingredients were recognized as having significant risks both in the literature evidence and in expert opinion. Rosemary, Citri Unshius Pericarpium, Discoreae Rhizoma, lemongrass, Schisandrae Fructus, Cassiae Semen, Foeniculi Fructus, Mori Fructus, Cinnamomi Cortex, and Astragali Radix were agreed at the level 2 of "consultation with TKM practitioner is required". Conclusion: Based on the consensus of a seven-member expert panel of TKM gynecologists, consumption of Ginkgonis Semen (Ginkgo nut), Illici Veri Fructus (Star anise), lavender, bitter gourd, and parsley should be avoided by pregnant women. For Rosemary, Citri Unshius Pericarpium, Discoreae Rhizoma, lemongrass, Schisandrae Fructus, Cassiae Semen, Foeniculi Fructus, Mori Fructus, Cinnamomi Cortex, and Astragali Radix, the level 2 advisory may be recommended to use with caution and to consult a TKM practitioner for advice on consumption, dose, and duration.

데이터 효율적 이미지 분류를 통한 안질환 진단 (Data Efficient Image Classification for Retinal Disease Diagnosis)

  • 강홍구;양희규;김문성;추현승
    • 인터넷정보학회논문지
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    • 제25권3호
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    • pp.19-25
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    • 2024
  • 전 세계적인 인구 고령화 현상으로, 녹내장, 백내장, 황반변성과 같은 실명을 초래할 수 있는 주요 안질환의 발병률이 상승하고 있다. 이에 안과 분야에서는 실명률을 줄이기 위해 예방이 어려운 질환의 진단에 관심이 집중되고 있다. 본 연구는 기존보다 적은 양의 데이터를 활용하여 안저 사진 내의 안질환을 정확하게 진단하는 딥러닝 방안을 제안한다. 이를 위해 적은 데이터로도 효과적인 학습이 가능한 Convolutional Neural Network (CNN) 모델을 선정하여 다양한 안질환 환자의 Conventional Fundus Image (CFI)를 분류 한다. 선정된 CNN 모델들은 Accuracy, Precision, Recall, F1-score에서 우수한 성능을 기록함으로써 CFI 내 안질환의 정확한 분류에 탁월한 성능을 보였다. 이러한 접근법은 안과 전문의들의 수작업 분석을 줄이고, 진료 시간을 단축하며, 리소스가 제한된 환경에서도 일관성 있는 진단 결과를 제공함으로써 의료 현장에 효율적이고 정확한 진단의 보조 도구로 기여할 수 있다.

난소기능평가를 위한 Gonadotropin Releasing Hormone Agonist Stimulation Test (GAST)의 효용성에 관한 연구 (GnRH Agonist Stimulation Test (GAST) for Prediction of Ovarian Response in Controlled Ovarian Stimulation (COH))

  • 김미란;송인옥;연혜정;최범채;백은찬;궁미경;손일표;이진우;강인수
    • Clinical and Experimental Reproductive Medicine
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    • 제26권2호
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    • pp.163-170
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    • 1999
  • Objectives: The aims of this study are 1) to determine if GAST is a better indicator in predicting ovarian response to COH compared with patient's age or basal FSH level and 2) to evaluate its role in detecting abnormal ovarian response. Design: Prospective study in 118 patients undergoing IVF-ET using GnRH-a short protocol during May-September 1995. Materials and Methods: After blood sampling for basal FSH and estradiol $(E_2)$ on cycle day two, 0.5ml (0.525mg) GnRH agonist ($Suprefact^{(r)}$, Hoechst) was injected subcutaneously. Serum $E_2$ was measured 24 hours later. Initial $E_2$ difference $({\Delta}E_2)$ was defined as the change in $E_2$ on day 3 over the baseline day 2 value. Sixteen patients with ovarian cyst or single ovary or incorrect blood collection time were excluded from the analysis. The patients were divided into three groups by ${\Delta}E_2$; group A (n=30):${\Delta}E_2$<40 pg/ml, group B (n=52): 40 pg/ml${\leq}{\Delta}E_2$<100 pg/ml, group C (n=20): ${\Delta}E_2{\leq}100$ pg/ml. COH was done by GnRH agonist/HMG/hCG and IVF-ET was followed. Ratio of $E_2$ on day of hCG injection over the number of ampules of gonadotropins used ($E_2hCGday$/Amp) was regarded as ovarian responsiveness. Poor ovarian response and overstimulation were defined as $E_2$ hCGday less than 600 pg/ml and greater than 5000 pg/ml, respectively. Results: Mean age $({\pm}SEM)$ in group A, B and C were $33.7{\pm}0.8^*,\;31.5{\pm}0.6\;and\;30.6{\pm}0.5^*$, respectively ($^*$: p<0.05). Mean basal FSH level of group $A(11.1{\pm}1.1mlU/ml)$ was significantly higher than those of $B(7.4{\pm}0.2mIU/ml)$ and C $(6.8{\pm}0.4mIU/ml)$ (p<0.001). Mean $E_2hCGday$ of group A was significantly lower than those of group B or C, i.e., $1402.1{\pm}187.7pg/ml,\;3153.2{\pm}240.0pg/ml,\;4078.8{\pm}306.4pg/ml$ respectively (p<0.0001). The number of ampules of gonadotropins used in group A was significantly greater than those in group B or C: $38.6{\pm}2.3,\;24.2{\pm}1.1\;and\;18.5{\pm}1.0$ (p<0.0001). The number of oocytes retrieved in group A was significantly smaller than those in group B or C: $6.4{\pm}1.1,\;15.5{\pm}1.1\;and\;18.6{\pm}1.6$, respectively (p<0.0001). By stepwise multiple regression, only ${\Delta}E_2$ showed a significant correlation (r=0.68, p<0.0001) with $E_2HCGday$/Amp, while age or basal FSH level were not significant. Likewise, only ${\Delta}E_2$ correlated significantly with the number of oocytes retrieved (r=0.57, p<0.001). All four patients whose COH was canceled due to poor ovarian response belonged to group A only (Fisher's exact test, p<0.01). Whereas none of 30 patients in group A (0%) had overstimulation, 14 patients among 72 patients (19.4%) in group B and C had overstimulation (Fisher's exact test, p<0.01). Conclusions: These data suggest that initial $E_2$ difference after GAST may be a better prognostic indicator of ovarian response to COH than age or basal FSH level. Since initial $E_2$ difference demonstrates significant association with abnormal ovarian response such as poor ovarian response necessitating cycle cancellation or overstimulation, GAST may be helpful in monitoring and consultation of patients during COH in IVF-ET cycle.

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