• Title/Summary/Keyword: Medical consultation

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

  • Song, Jihyeo;Lee, Koeun;Song, Je Seon;Lee, Jaeho;Choi, Hyung-Jun
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.14 no.2
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    • pp.88-91
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    • 2018
  • Incontinentia pigmenti(IP), or Block-Sulzberger syndrome is a rare X-linked dominant genodermatosis that affects almost in female infant and is usually lethal for males in utero. IP is characterized by four cutaneous stages and is frequently associated with dental, ocular, central nervous system and structural anomalies. Dental problems are congenital missing of teeth, delayed eruption, abnormal crown shape. We reported a case of 5 year-old female with IP. She had congenital missing of multiple primary and permanent teeth, accessory cusp and cone-shaped crowns. Systemically, she had a problem of retina and hyperpigmented macules on her trunk and extremities as typical character of IP. As the syndrome involves many different medical problems and needs comprehensive consideration. Dental care should be performed in a multidisciplinary consultation system.

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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    • v.15 no.1
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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.

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

  • Hong, Sunggyu;Kwak, Hui-Yong;Kim, Jong-Woo;Chung, Sun-Yong
    • Journal of Oriental Neuropsychiatry
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    • v.31 no.4
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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
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.1
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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.

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

  • Lee, Hyun-Jung;Lee, Yoon-Jung;Yi, Kyung-Ok;Kim, Wha-Young
    • Journal of the Korean Society of Food Culture
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    • v.24 no.5
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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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    • v.29 no.4
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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.

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

  • Yeonjin Jung;Jee In Kang
    • Anxiety and mood
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    • v.19 no.2
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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
    • The Journal of Korean Medicine
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    • v.44 no.4
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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.

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

  • Honggu Kang;Huigyu Yang;Moonseong Kim;Hyunseung Choo
    • Journal of Internet Computing and Services
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    • v.25 no.3
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    • pp.19-25
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    • 2024
  • The worldwide aging population trend is causing an increase in the incidence of major retinal diseases that can lead to blindness, including glaucoma, cataract, and macular degeneration. In the field of ophthalmology, there is a focused interest in diagnosing diseases that are difficult to prevent in order to reduce the rate of blindness. This study proposes a deep learning approach to accurately diagnose ocular diseases in fundus photographs using less data than traditional methods. For this, Convolutional Neural Network (CNN) models capable of effective learning with limited data were selected to classify Conventional Fundus Images (CFI) from various ocular disease patients. The chosen CNN models demonstrated exceptional performance, achieving high Accuracy, Precision, Recall, and F1-score values. This approach reduces manual analysis by ophthalmologists, shortens consultation times, and provides consistent diagnostic results, making it an efficient and accurate diagnostic tool in the medical field.

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

  • Kim, Mee-Ran;Song, In-Ok;Yeon, Hye-Jeong;Choi, Bum-Chae;Paik, Eun-Chan;Koong, Mi-Kyoung;Song, Il-Pyo;Lee, Jin-Woo;Kang, Inn-Soo
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.2
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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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