Hong, Minha;Lee, Seung-Yup;Lee, Young Sik;Kim, Bongseog;Joung, Yoo Sook;Yoo, Hanik K;Kim, Eui-Jung;Lee, Soyoung Irene;Park, Su-Bin;Bhang, Soo-Young;Han, Doughyun;Bahn, Geon Ho
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.30
no.3
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pp.121-126
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2019
Objectives: Awareness of attention-deficit/hyperactivity disorder (ADHD) in adults has significantly increased; however, clinical data specific to the Korean population are insufficient. Clinical experience of ADHD may differ based on whether psychiatrists have received pediatric psychiatry-specific training. In order to prepare a practice parameter for adult ADHD patients in Korea, we examined questionnaire data to observe how pediatric psychiatry training could affect clinical practice for adults with ADHD. Methods: A questionnaire about the diagnosis and treatment process was distributed to both general psychiatrists (GPsy) and child and adolescent psychiatrists (CAP) at the summer and winter workshop meetings of Korean Academy of Child and Adolescent Psychiatry. Results: In total, 142 psychiatrists participated in the survey (86 GPsy, 56 CAP). GPsy and CAP preferred pharmacotherapy (GPsy 82.40%, CAP 64.30%) as the primary treatment option and answered that the clinical psychiatric interview is the most necessary step in diagnostic assessment (GPsy 22.16%, CAP 19.00%). The GPsy responded with an optimal and average treatment duration that was shorter than that reported by CAP. Conclusion: Identification of the initial presenting symptom as the correct diagnosis and the optimal duration of pharmacotherapy differed between GPsy and CAP in practice, whereas concepts in diagnosis and treatment of ADHD in adults were similar for both groups. These results suggest the urgent need for the Continuing Medical Education program for psychiatrists treating adults with ADHD.
Kim, Hee Young;Park, Jeongbin;Keum, Yujeong;Yeo, Inkeum;Eom, Dongmyung;Song, Jichung
Journal of Korean Medical classics
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v.34
no.2
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pp.85-94
/
2021
Objectives : Pulse diagnosis is one of the main diagnostic methods of Korean Medicine that understands the patient's condition and illness by reading changes in the patient's pulse, which is described in terms of pulse condition While they are described in detail in medical texts, it is difficult to grasp their true nature, as the written descriptions fail to do justice to the experience of pulse taking it tries to convey. As a way to approach pulse condition the effect of the body's tension on the radial vein was measured using an ultrasonic device, after which the measured changes and how they could be reflected in pulse condition were studied. In other words, changes in the radial vein following induced tension were analyzed. Methods : 1) The thickness of the subject's radial vein was measured using a linear probe of an ultrasonic device[LOGIQ 5 Basic, GE, USA]. 2) Fatigue level was increased through artificial stimulation using the Gripmeter[ks-301, Lavisen, Korea]. 3) Thickness of the radial vein post tension induction was measured. 4) The results were analyzed with the Tukey test or paired t-test as post hoc tests. Results : Thickness of the radial vein of the subject pre- and post- Gripmeter stimulation decreased with significance. Conclusions : Constriction of the radial vein that happened after tension induction could be linked to the Tight Pulse[緊脈] that is related to patterns of contraction and pulling.
This study aims to investigate the problem recognition and clue capture processes of the observation stage in a geological field trip using abductive inquiry. To this end, eight outdoor geological programs were developed in the order of diagnostic evaluation, outdoor geological fieldwork, and review. Six middle-school students participated in these programs The geological field trip was conducted twice, followed by data provision, observation, rule generation, hypothesis generation, and final hypothesis presentation. Outdoor geological fieldwork recordings and student activity sheets were collected and analyzed qualitatively. From these data, three aspects of student observations emerged during the geological fieldwork: The characteristics of each pattern were subdivided into the geological importance of the clues, attention, type of clues, observation characteristics (attention factor), clue utilization, and clue deletion. Here, by combining these results, we propose educational applications that correspond to each aspect.
We find out the clusters with high toxoplasmosis risk to discuss the geographical pattern in Gyodong-myeon and Samsan-myeon of Ganghwa-gun, Cheorwon-gun, and Goseong-gun, Korea. Seroepidemiological data of toxoplasmosis surveyed using rapid diagnostic tests for the residents in the areas in 2019 were analyzed to detect clusters of the infection. The cluster was investigated using the SaTScan program which is based on Kulldorff's scan statistic. The clusters were found with P-values in each region analyzed in the program, and the risk and patient incidence of specific areas can be examined by the values such as relative risk and log likelihood ratio. Jiseok-ri and Insa-ri were found to be a cluster in Gyodong-myeon and Seokmo-ri was the cluster in Samsan-myeon. Yangji-ri and Igil-ri were found to be a cluster in Cheorwon-gun and Madal-ri and Baebong-ri were the cluster in Goseong-gun. This findings can be used to monitor and prevent toxoplasmosis infections occurring in vulnerable areas.
Purpose: This study aimed to investigate the computed tomography and magnetic resonance imaging features of giant cell tumors in the temporomandibular joint region to facilitate accurate diagnoses. Materials and Methods: From October 2007 to June 2020, 6 patients (2 men and 4 women) at Yonsei University Dental Hospital had histopathologically proven giant cell tumors in the temporomandibular joint. Their computed tomography and magnetic resonance imaging findings were reviewed retrospectively, and the cases were classified into 3 types based on the tumor center and growth pattern observed on the radiologic findings. Results: The age of the 6 patients ranged from 25 to 53 years. Trismus was found in 5 of the 6 cases. One case recurred. The mean size of the tumors, defined based on their greatest diameter, was 32 mm (range, 15-41 mm). The characteristic features of all cases were a heterogeneously-enhancing tumorous mass with a lobulated margin on computed tomographic images and internal multiplicity of signal intensity on T2-weighted magnetic resonance images. According to the site of origin, 3 tumors were bone-centered, 2 were soft tissue-centered, and 1 was peri-articular. Conclusion: Computed tomography and magnetic resonance imaging yielded a tripartite classification of giant cell tumors of the temporomandibular joint according to their location on imaging. This study could help clinicians in the differential diagnosis of giant cell tumors and assist in proper treatment planning for tumorous diseases of the temporomandibular joint.
Kim, Ji-Hoon;Kong, Tae Hoon;Choi, Hong-Shik;Byeon, Hyung Kwon
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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v.31
no.2
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pp.61-65
/
2020
Background and Objectives The overall incidence of laryngeal tuberculosis (LT) has generally decreased over the recent years, yet there is still a discrete population of patients newly diagnosed with the disease. This study is aimed to examine the patients with LT over the recent 10 years and to investigate the changes in clinical pattern with respect to the past period. Materials and Method A retrospective review has been performed on 20 patients who have been initially diagnosed with LT between 2005 and 2015. Results The age of the patients ranged from 25 years to 95 years with an average age of 45.6 years. Seventeen patients (85%) showed hoarseness, which was the most common clinical symptom. Most affected lesion was the true vocal cord. Laryngoscopic examination showed various clinical manifestations: polypoid 30%, granulomatous 25%, nonspecific 25%, ulcerative 20%. A variety of methods were used for diagnostic confirmation of LT [acid-fast bacilli (AFB) smear 45%, AFB culture 40%, polymerase chain reaction 30%, surgical pathology 45%]. Coexisting pulmonary tuberculosis (PT) was detected in 10 patients (50%). Relative to the patients with inactive PT or normal lung status, those with active PT showed higher incidence of laryngeal lesions located in areas other than true vocal cord (p=0.050). Conclusion Based on the analytic results from this study, laryngologists should recognize the changes in the recent clinical patterns of LT and always be ready for clinical suspicion of this disease on such atypical laryngeal findings which can often mimic laryngeal malignancies to provide the pertinent treatment.
Jung, Bo Young;Lee, Eun Ja;Bae, Jong Myon;Choi, Young Jae;Lee, Eun Kyoung;Kim, Dae Bong
Investigative Magnetic Resonance Imaging
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v.25
no.1
/
pp.23-34
/
2021
Purpose: Differentiating between glioblastoma and solitary metastasis is very important for the planning of further workup and treatment. We assessed the ability of various morphological parameters using conventional MRI and diffusion-based techniques to distinguish between glioblastomas and solitary metastases in tumoral and peritumoral regions. Materials and Methods: We included 38 patients with solitary brain tumors (21 glioblastomas, 17 solitary metastases). To find out if there were differences in the morphologic parameters of enhancing tumors, we analyzed their shape, margins, and enhancement patterns on postcontrast T1-weighted images. During analyses of peritumoral regions, we assessed the extent of peritumoral non-enhancing lesion on T2- and postcontrast T1-weighted images. We also aimed to detect peritumoral neoplastic cell infiltration by visual assessment of T2-weighted and diffusion-based images, including DWI, ADC maps, and exponential DWI, and evaluated which sequence depicted peritumoral neoplastic cell infiltration most clearly. Results: The shapes, margins, and enhancement patterns of tumors all significantly differentiated glioblastomas from metastases. Glioblastomas had an irregular shape, ill-defined margins, and a heterogeneous enhancement pattern; on the other hand, metastases had an ovoid or round shape, well-defined margins, and homogeneous enhancement. Metastases had significantly more extensive peritumoral T2 high signal intensity than glioblastomas had. In visual assessment of peritumoral neoplastic cell infiltration using T2-weighted and diffusion-based images, all sequences differed significantly between the two groups. Exponential DWI had the highest sensitivity for the diagnosis of both glioblastoma (100%) and metastasis (70.6%). A combination of exponential DWI and ADC maps was optimal for the depiction of peritumoral neoplastic cell infiltration in glioblastoma. Conclusion: In the differentiation of glioblastoma from solitary metastatic lesions, visual morphologic assessment of tumoral and peritumoral regions using conventional MRI and diffusion-based techniques can also offer diagnostic information.
Objectives : Evidence supporting the cold-heat symptom and sasang constitution type, which are diagnostic items of traditional Korean medicine, is needed to manage sleep disturbances, which is a typical symptom of mibyeong (subhealth). This study examined the association between each cold-heat symptom and sleep disturbances according to each sasang constitution type. Methods : This research was a cross-sectional study of 5,793 subjects from the Korean Medicine Data Center (KDC) community cohort survey. The association between each cold-heat symptom and sleep disturbances was analyzed by logistic regression analysis adjusted for several demographic variables. Subgroup analysis was then performed for each type of sasang constitution. Results : The soeum and soyang types were 1.53 and 1.26 times more likely to have sleep disturbances than the taeum type. Sleep disturbances were associated with 'coldness of the abdomen', 'watery mouth' in the cold domain items, and 'body feverishness', 'flushed face and eye', 'thirst', and 'scanty dark urine' in the heat domain items. The soeum and soyang types were 1.55 and 1.39 times more likely to sleep less than five hours per night than the taeeum type. In addition, the associations of those showed a different pattern for each sasang constitution type. Conclusions : Sleep disturbances are associated with specific cold-heat symptoms, and the associated cold-heat symptoms differ according to the sasang constitution type. These results may help traditional medicine specialists select customized interventions for patients with sleep disturbances.
Purpose - The purpose of this study is to explore the possibility of predicting the degree of smartphone overdependence based on mobile phone usage patterns. Design/methodology/approach - In this study, a survey conducted by Korea Internet and Security Agency(KISA) called "problematic smartphone use survey" was analyzed. The survey consists of 180 questions, and data were collected from 29,712 participants. Based on the data on the smartphone usage pattern obtained through the questionnaire, the smartphone addiction level was predicted using machine learning techniques. k-NN, gradient boosting, XGBoost, CatBoost, AdaBoost and random forest algorithms were employed. Findings - First, while various factors together influence the smartphone overdependence level, the results show that all machine learning techniques perform well to predict the smartphone overdependence level. Especially, we focus on the features which can be obtained from the smartphone log data (without psychological factors). It means that our results can be a basis for diagnostic programs to detect problematic smartphone use. Second, the results show that information on users' age, marriage and smartphone usage patterns can be used as predictors to determine whether users are addicted to smartphones. Other demographic characteristics such as sex or region did not appear to significantly affect smartphone overdependence levels. Research implications or Originality - While there are some studies that predict smartphone overdependence level using machine learning techniques, but the studies only present algorithm performance based on survey data. In this study, based on the information gain measure, questions that have more influence on the smartphone overdependence level are presented, and the performance of algorithms according to the questions is compared. Through the results of this study, it is shown that smartphone overdependence level can be predicted with less information if questions about smartphone use are given appropriately.
Kim, Eun-Ji;Hwang, Eun-Jung;Yoo, Yeong-Min;Kim, Kyung-Hoon
The Korean Journal of Pain
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v.35
no.4
/
pp.361-382
/
2022
The third opium war may have already started, not only due to illicit opioid trafficking from the Golden Crescent and Golden Triangle on the international front but also through indiscriminate opioid prescription and opioid diversion at home. Opioid use disorder (OUD), among unintentional injuries, has become one of the top 4 causes of death in the United States (U.S.). An OUD is defined as a problematic pattern of opioid use resulting in clinically significant impairment or distress, consisting of 2 or more of 11 problems within 1 year, as described by the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition. Observation of aberrant behaviors of OUD is also helpful for overworked clinicians. For the prevention of OUD, the Opioid Risk Tool and the Current Opioid Misuse Measure are appropriate screening tests before and during opioid administration, respectively. Treatment of OUD consists of 3 opioid-based U.S. Food and Drug Administration-approved medications, including methadone, buprenorphine, and naltrexone, and non-opioid-based symptomatic medications for reducing opioid withdrawal syndromes, such as α2 agonists, β-blockers, antidiarrheals, antiemetics, non-steroidal anti-inflammatory drugs, and benzodiazepines. There are at least 6 recommendable guidelines and essential terms related to OUD. Opioid stewardship programs are now critical to promoting appropriate use of opioid medications, improving patient outcomes, and reducing misuse of opioids, influenced by the successful implementation of antimicrobial stewardship programs. Despite the lack of previous motivation, now is the critical time for trying to reduce the risk of OUD.
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