Goo, Ae-Jin;Park, Jin-Park;Lee, Jong-Il;Jhin, Hye-Kyung;Kim, Yeni
Korean Journal of Biological Psychiatry
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v.19
no.4
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pp.205-210
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2012
Objectives The purpose of this study was to investigate clinical profile, efficacy, and safety of long-term treatment with selective serotonin reuptake inhibitors (SSRIs) in Korean autism spectrum disorders (ASDs) patients. Methods Effectiveness was assessed through a retrospective review of self-reported target symptom improvement at the last follow-up visit. Changes in illness severity and improvement were measured using the Clinical Global Impression-Severity (CGI-S) of illness and Clinical Global Impression-Improvement (CGI-I) Scales. Tolerability was assessed through a review of the reason for discontinuation of SSRI and documented adverse events. Results A total of 21 ASDs patients (aged 9 to 19 years) treated with SSRI during July 2010 to July 2011 in department of child and adolescent psychiatry of Seoul National Hospital were identified. The mean duration of SSRI treatment was 47.9 (standard deviation = 36.9) months (range 0.7-114.5), and the mean fluoxetine equivalent dosage of SSRIs was $27.1{\pm}10.8$ mg. Nineteen (90.5%) patients were using concomitant medication. We found that SSRIs were prescribed for symptoms of agitation, stereotyped behavior, aggression, depression, impulsivity and self-injury in ASDs. Ten patients (47.6%) reported improvement in their target symptom after SSRI treatment based on CGI-I scores (CGI-I ${\leq}$ 2). The side effects were reported in 5 patients (23.8%) ; vomiting (n = 2, 9.5%), excessive mood elevation (n = 1, 4.8%), insomnia (n = 1, 4.8%), somnolence (n = 1, 4.8%) and decreased appetite (n = 1, 4.8%). Self-injurious behavior was reported in one patient (4.8%). Conclusions The results of this study suggest that SSRIs may be used effectively in children and adolescents diagnosed with ASDs. However, safety issues need to be considered carefully when choosing SSRIs for treatment. Future controlled trials are needed to confirm these findings.
Korean Journal of Construction Engineering and Management
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v.21
no.6
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pp.103-112
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2020
In this study, based on actual project implementation cases, task management plans for construction management related green building certification were derived in major stages. Accordingly, the importance from details of construction management tasks for the operation and management process of the schematic design phase, design development phase, and construction document phase, focusing on G-SEED certification, was analyzed. In addition, major items were derived based on the weight of additional construction costs and acquisition scores through previous research cases on the analysis of construction costs for G-SEED certification, and the importance from details of construction management tasks on the major items of G-SEED certification was analyzed. As a result, the review and confirmation of the elements of reflection related to G-SEED in the schematic design phase, the adequacy of design documents and the connectivity of design phase in the design development phase were important. And the review and confirmation of the items directly related to the construction phase in the construction document phase were important.
Objective : To investigate the current international researches which identify the effect of stroke with hemiplegia after dual-task training Methods : We systematically examined journals published from 2007 to 2015, searching PubMed. Total 5 researches were selected for the analyses. Results : Selected studies were all in international journal and they used two group experimental design. In addition, all the paper got PEDro scores above 6. They conducted gait task for motor task, at the same time used various domain of cognitive task such as from sustain attention to working memory. The outcome measure tools used for evaluation by the standardized assessment tool and operational definition, further also included the assessment tool designed for the dual-task training such as a variety of tools make possible to assess various aspects of effect. Discussion : Dual-task training in this study was found to give a positive effect on the dual-task performance, as well as improving the motor and cognitive function in patients with stroke. However there were also limitation to the studies conducted so far. In order to apply the occupational therapy, this results can consider as the preliminary data which suggest supplement point and can be a evidence for effective treatment for stroke with hemiplegia.
Background: Gestational trophoblastic neoplasia (GTN) is a spectrum of disease with abnormal trophoblastic proliferation. Treatment is based on FIGO stage and WHO risk factor scores. Patients whose score is 12 or more are considered as at extremely high risk with a high likelihood of resistance to first line treatment. Optimal therapy is therefore controversial. Objective: This study was conducted in order to summarize the regimen used for extremely high risk or resistant GTN patients in our institution the in past 10 years. Materials and Methods: All the charts of GTN patients classified as extremely high risk, recurrent or resistant during 1 January 2002 to 31 December 2011 were reviewed. Criteria for diagnosis of GTN were also assessed to confirm the diagnosis. FIGO stage and WHO risk prognostic score were also re-calculated to ensure the accuracy of the information. Patient characteristics were reviewed in the aspects of age, weight, height, BMI, presenting symptoms, metastatic area, lesions, FIGO stage, WHO risk factor score, serum hCG level, treatment regimen, adjuvant treatments, side effects and response to treatment, including disease free survival. Results: Eight patients meeting the criteria of extremely high risk or resistant GTN were included in this review. Mean age was 33.6 years (SD=13.5, range 17-53). Of the total, 3 were stage III (37.5%) and 5 were stage IV (62.5%). Mean duration from previous pregnancies to GTN was 17.6 months (SD 9.9). Mean serum hCG level was 864,589 mIU/ml (SD 98,151). Presenting symptoms of the patients were various such as hemoptysis, abdominal pain, headache, heavy vaginal bleeding and stroke. The most commonly used first line chemotherapeutic regimen in our institution was the VAC regimen which was given to 4 of 8 patients in this study. The most common second line chemotherapy was EMACO. Adjuvant radiation was given to most of the patients who had brain metastasis. Most of the patients have to delay chemotherapy for 1-2 weeks due to grade 2-3 leukopenia and require G-CSF to rescue from neutropenia. Five form 8 patients were still survived. Mean of disease free survival was 20.4 months. Two patients died of the disease, while another one patient died from sepsis of pressure sore wound. None of surviving patients developed recurrence of disease after complete treatment. Conclusions: In extremely high risk GTN patients, main treatment is multi-agent chemotherapy. In our institution, we usually use VAC as a first line treatment of high risk GTN, but since resistance is quite common, this may not suitable for extremely high risk GTN patients. The most commonly used second line multi-agent chemotherapy in our institution is EMA-CO. Adjuvant brain radiation was administered to most of the patients with brain metastasis in our institution. The survival rate is comparable to previous reviews. Our treatment demonstrated differences from other institutions but the survival is comparable. The limitation of this review is the number of cases is small due to rarity of the disease. Further trials or multicenter analyses may be considered.
Background: Faced with highly prevalent and recalcitrant cancer-related fatigue (CRF), together with the absence of any official guidelines on management, numerous groups have been striving to seek and test alternative therapies including acupuncture and moxibustion. However, different patients have various feedbacks, and the many clinical trials have given rise to varied conclusions. In terms of the therapeutic effect of acupuncture and moxibustion, there exist vast inconsistencies. Objective: The aim of the study was to evaluate the auxiliary effectiveness of acupuncture and moxibustion in the treatment of CRF, and to provide more reliable evidence to guide clinical practice. Methods: Randomized controlled trials (RCTs) published before December 2012 were all aggregated, focusing on evaluation of acupuncture or moxibustion for CRF. The quality of the included studies was assessed basing on Cochrane handbook 5.1.0, and the available data were analyzed with RevMan software (version 5.2.0). Descriptive techniques were performed when no available data could be used. Results: A total of 7 studies involving 804 participants were eligible. With real acupuncture versus sham acupuncture, subjects receiving true acupuncture benefited more in the reduction of fatigue. With real acupuncture versus acupressure or sham acupressure, fatigue level appeared 36% improved in the acupuncture group, but 19% in the acupressure group and only 0.6% with sham acupressure. When real acupuncture plus enhanced routine care was compared with enhanced routine care, the combination group improved mean scores for general fatigue, together with physical and mental fatigue. With real acupuncture versus sham acupuncture or wait list controls, the real acupuncture group displayed significant advantages over the wait list controls at 2 weeks for fatigue improvement and better well-being effects at 6 weeks. When moxibustion plus routine care was compared with routine care alone, the meta-analyses demonstrated the combination had a relatively significant benefit in improving severe fatigue and QLQ-C30. Conclusion: Up to the search date, there exist few high quality RCTs to evaluate the effect of acupuncture and moxibustion, especially moxibustion in English. Yet acupuncture and moxibustion still appeared to be efficacious auxiliary therapeutic methods for CRF, in spite of several inherent defects of the included studies. Much more high-quality studies are urgently needed.
The purpose of this study is to evaluate the service attributes and consumer reactions of telemedicine apps in South Korea and visualize their differentiation by constructing positioning maps. We crawled 23,219 user reviews of 6 major telemedicine apps in Korea from the Google Play store. Topics were derived by BERTopic modeling, and sentiment scores for each topic were calculated through KoBERT sentiment analysis. As a result, five service characteristics in the application attribute category and three in the medical service category were derived. Based on this, a two-dimensional positioning map was constructed through principal component analysis. This study proposes an objective service evaluation method based on text mining, which has implications. In sum, this study combines empirical statistical methods and text mining techniques based on user review texts of telemedicine apps. It presents a system of service attribute elicitation, sentiment analysis, and product positioning. This can serve as an effective way to objectively diagnose the service quality and consumer responses of telemedicine applications.
Background: The purpose of this study was to compare and analyze the differences in charges and length of stay per case between spine specialty hospitals and non-specialty hospitals, and to identify the factors that influenced them. Methods: This study used claims data from the Health Insurance Review and Assessment Service, including inpatient visits from January 2021 to December 2022. The healthcare facility status data was used to identify the characteristics of study hospitals. Multilevel analysis was conducted to identify factors associated with the charges and Poisson regression analysis was conducted to analyze the length of stay between spine specialty hospitals and non-specialty hospitals. There were 32,015 cases of spine specialty hospitals and 17,555 cases of non-specialty hospitals. Results: For four of five common spinal surgeries, specialty hospitals shaped longer length of stay than those of non-specialty hospitals. Multilevel and Poisson regression analysis revealed that regardless of the type of surgery, higher age and higher Charlson comorbidity index scores were significantly associated with an increase in both the charges per case and length of stay (p<0.05). However, when hospitals were located in metropolitan areas, there was a significant decrease (p<0.05). Conclusion: This study found that specialty hospital had higher inpatient charges and loner length of stay contrary to the previous study results. Further studies will be needed to find which contribute to the differences.
Purpose The purpose of this study was to describe the clinical features and chest computed tomography (CT) findings of coronavirus disease 2019 (COVID-19) pneumonia. Materials and Methods An Institutional Review Board-approved retrospective review was performed for 51 laboratory-confirmed COVID-19 pneumonia patients. Patients were divided into two groups depending on their clinical status: mild and severe. Clinical characteristics and chest CT findings were compared between the two groups. Results Among the 51 patients (22 men, 29 women; mean age, 56.5 ± 16 years; range, 22-88 years), 37 (72.5%) were in the mild group and 14 (27.5%) were in the severe group. The patients in the severe group (68.7 ± 12.5 years) were older than the patients in the mild group (51.8 ± 14.9 years, p < 0.001). Premorbid conditions and decreased lymphocyte counts were more often observed in the severe group than in the mild group (71% vs. 41%, p = 0.049 and 86% vs. 32%, p = 0.001, respectively). On chest CT, most patients exhibited a mixed ground-glass opacification (GGO) with consolidation (76%) or a GGO (22%) pattern. The majority of lesions were predominantly bilateral in the lower lung with a posterior, peripheral distribution. The patients in the severe group had higher severity scores than those in the mild group. Conclusion Patients with laboratory-confirmed COVID-19 pneumonia have typical chest CT findings that provide important information regarding expected disease severity.
Considering the increase in health insurance benefits and the elderly population of the baby boomer generation, the amount consumed by health care in 2020 is expected to account for 20% of US GDP. As the healthcare industry develops, competition among the medical services of hospitals intensifies, and the need of hospitals to manage the quality of medical services increases. In addition, interest in online reviews of hospitals has increased as online reviews have become a tool to predict hospital quality. Consumers tend to refer to online reviews even when choosing healthcare service providers and after evaluating service quality online. This study aims to analyze the effect of sentiment score of healthcare service quality on hospital rating with Yelp hospital reviews. This study classifies large amount of text data collected online primarily into five service quality measurement indexes of SERVQUAL theory. The sentiment scores of reviews are then derived by SERVQUAL dimensions, and an econometric analysis is conducted to determine the sentiment score effects of the five service quality dimensions on hospital reviews. Results shed light on the means of managing online hospital reputation to benefit managers in the healthcare and medical industry.
The Journal of Churna Manual Medicine for Spine and Nerves
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v.2
no.2
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pp.105-116
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2007
Objectives : Physical activity is known as beneficial to mental health like decreasing depression and stress. In this study, we tried to find out the relationship between body composition, stress, depression, and self-esteem with physical activity level. Methods : International Physical Activity Questionnaire(IPAQ)-short form, SRRS(Social readjustment rating scale), SRI(Stress response index), and BDI(Beck's depression index), SES(Self-esteem scale) were given to peri-menopausal women aged 45-55 and BMI$\geq$23kg/m2. They were given written consent and this study is performed under the permission of institutional review board of Kyung Hee East-west Neo Medical Center. Results : The mean of physical activity of total subjects was 2406MET-min/week(n=42). The physical activity of overweight(23kg/m2$\leq$BMI<25kg/m2) and obese(BMI$\geq$25kg/m2) permimenopausal women was 1428MET-min/week and 2970MET-min/week(p<0.05) respectively. When three levels of physical activity pattern(inactive, minimally active, and HEPA(Health-enhancing physical activity) active) was analyzed, all of them were heavily relied on the activity intensities of walking. The scores of BDI, SRRS, and SRI were lower and that of SES were higher in HEPA active group, not showing statical significance. Anger(subscale of SRI) measures were lower and SES measures were higher in HEPA active group than others among overweight women(p<0.05). Conclusions : The level of physical activity of peri-menopausal women was on the average, but the vigorous activity is thought to be necessary. The HEPA active group showed lower depression, stress and higher self-esteem than minimally active and inactive group.
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