OBJECTIVE: Patients are becoming more active in communicating with doctors, forming e-communities, and participating in decision-making process of their treatment plans. However, only a few studies have examined how digitalized healthcare affects patients' and doctors' attitudes towards medical care services and deliverance structure, and the problems that might stem from these changes. In this study, we 1) explored the current changes in patients' healthcare utilization patterns and delivery structures, 2) examined the emerging behaviours and awareness of the participants, and 3) proposed how to prepare for such changes. METHODS: Face-to-face interviews and a group discussion with both Korean and US experts on consumer health informatics were conducted. Interview guidelines were developed based on reviews of recent studies on consumer health informatics. RESULTS: While the American scholars had larger expectations about the scope of the changes in the health care system induced by the digitalization of healthcare, compared to the Korean scholars, the interviewees and group discussion participants from both countries all agreed on the changes in medical environment and the increasing importance of medical information. The changes induced by the digitalization of healthcare were categorized as follows: (1) in the structure and location of healthcare service delivery, (2) in the doctor-patient communication methods, and (3) in the role of patients and increasing emphasis in empowerment. CONCLUSION: We expect that digitalized healthcare will continue to affect the doctor-patient relationship and change the deliverance structure. In order to better prepare for the fundamental paradigm shift in the healthcare system and increase the benefits to society of these changes, continuous and concerted policy efforts to protect the privacy and security of private information, alleviate the digital divide, and secure the quality of digitalized clinical knowledge will be required.
Delivery of Health Care ; Humans ; Informatics ; Power (Psychology) ; Privacy

OBJECTIVES: It has been shown that early intervention is crucial for favorable outcome in patients with schizophrenia. However, development of biomarkers for predicting prognosis of psychotic disorder still requires more research. In this study, we aimed to investigate whether baseline mismatch negativity (MMN) predict prognosis in patients with first episode psychosis (FEP). METHODS: Twenty-four patients with FEP and matched healthy controls (HCs) were examined with MMN at baseline, and their clinical status were re-assessed after 1 year. Repeated-measures analysis of variance was performed to compare baseline MMN between the two groups. Multiple regression analysis was used to identify factors predicting prognosis in FEP patients during the follow-up period. RESULTS: MMN amplitudes at baseline were significantly reduced in patients with FEP compared to healthy controls. In the multiple regression analysis, baseline MMN amplitude significantly predicted later improvement of performances on digit span and delayed recall of California Verbal Learning Test. However, baseline MMN did not predicted improvement of clinical symptoms. CONCLUSION: These results indicate that MMN may be a possible predictor of improvement in cognitive functioning in patients with FEP. Future study with larger sample and longer follow-up period would be needed to confirm the findings of the current study.
Biomarkers ; California ; Cognition ; Early Intervention (Education) ; Follow-Up Studies* ; Humans ; Polytetrafluoroethylene ; Prognosis* ; Psychotic Disorders* ; Schizophrenia ; Verbal Learning

This study aimed to evaluate the masticatory performance of Korean children and adolescents and to investigate related factors. Early loss of primary molars, degree of occlusion of first molars, occlusal relationship of first molars, and presence of anterior crossbite were considered. From March 2020 to July 2021, 56 children and adolescents between the ages of 6 and 12 were included. The mixing ability index (MAI) was calculated to evaluate the masticatory efficiency of children and adolescents. The subjects were classified into three groups according to the number of early lost primary molars; normal dentition, 1 - 2 teeth lost, more than 3 teeth lost. The number of participants are 23, 18, and 15, respectively. There was no difference in the MAI values between the normal dentition group and the group has 1 - 2 teeth lost. However, when 3 or more primary molars were lost, the MAI value decreased and a significant difference was observed. This study is the first study to evaluate the masticatory performance of children and adolescents in Korea, and it will be helpful to pediatric dentists who evaluate the masticatory performance of children and adolescents and strive to improve the masticatory efficiency of children and adolescents in clinical practice.

In schizophrenia, while antipsychotic medications are the primary treatment, auditory hallucinations may sometimes persist despite pharmacotherapy, and negative symptoms and cognitive impairments often show a limited response to these medications. Transcranial magnetic stimulation (TMS) has emerged as a promising adjunctive treatment, capable of modulating neuronal activity in targeted brain regions. Low-frequency repetitive TMS (rTMS) directed at the left temporoparietal cortex has demonstrated efficacy in reducing auditory hallucinations. In addressing negative symptoms, high-frequency rTMS applied to the dorsolateral prefrontal cortex has shown some effectiveness, though outcomes can vary. Innovative techniques, including theta burst stimulation and personalized approaches utilizing neuroimaging, are currently under investigation to further enhance the therapeutic potential of TMS. This review examines the application of TMS in the treatment of schizophrenia, emphasizing the necessity of ongoing research to refine and optimize its efficacy across diverse symptom domains.

In schizophrenia, while antipsychotic medications are the primary treatment, auditory hallucinations may sometimes persist despite pharmacotherapy, and negative symptoms and cognitive impairments often show a limited response to these medications. Transcranial magnetic stimulation (TMS) has emerged as a promising adjunctive treatment, capable of modulating neuronal activity in targeted brain regions. Low-frequency repetitive TMS (rTMS) directed at the left temporoparietal cortex has demonstrated efficacy in reducing auditory hallucinations. In addressing negative symptoms, high-frequency rTMS applied to the dorsolateral prefrontal cortex has shown some effectiveness, though outcomes can vary. Innovative techniques, including theta burst stimulation and personalized approaches utilizing neuroimaging, are currently under investigation to further enhance the therapeutic potential of TMS. This review examines the application of TMS in the treatment of schizophrenia, emphasizing the necessity of ongoing research to refine and optimize its efficacy across diverse symptom domains.

In schizophrenia, while antipsychotic medications are the primary treatment, auditory hallucinations may sometimes persist despite pharmacotherapy, and negative symptoms and cognitive impairments often show a limited response to these medications. Transcranial magnetic stimulation (TMS) has emerged as a promising adjunctive treatment, capable of modulating neuronal activity in targeted brain regions. Low-frequency repetitive TMS (rTMS) directed at the left temporoparietal cortex has demonstrated efficacy in reducing auditory hallucinations. In addressing negative symptoms, high-frequency rTMS applied to the dorsolateral prefrontal cortex has shown some effectiveness, though outcomes can vary. Innovative techniques, including theta burst stimulation and personalized approaches utilizing neuroimaging, are currently under investigation to further enhance the therapeutic potential of TMS. This review examines the application of TMS in the treatment of schizophrenia, emphasizing the necessity of ongoing research to refine and optimize its efficacy across diverse symptom domains.

In schizophrenia, while antipsychotic medications are the primary treatment, auditory hallucinations may sometimes persist despite pharmacotherapy, and negative symptoms and cognitive impairments often show a limited response to these medications. Transcranial magnetic stimulation (TMS) has emerged as a promising adjunctive treatment, capable of modulating neuronal activity in targeted brain regions. Low-frequency repetitive TMS (rTMS) directed at the left temporoparietal cortex has demonstrated efficacy in reducing auditory hallucinations. In addressing negative symptoms, high-frequency rTMS applied to the dorsolateral prefrontal cortex has shown some effectiveness, though outcomes can vary. Innovative techniques, including theta burst stimulation and personalized approaches utilizing neuroimaging, are currently under investigation to further enhance the therapeutic potential of TMS. This review examines the application of TMS in the treatment of schizophrenia, emphasizing the necessity of ongoing research to refine and optimize its efficacy across diverse symptom domains.

BACKGROUND: Compared to the general population, patients with end-stage renal disease have more gastrointestinal symptoms and a higher prevalence of peptic ulcer. Risk factors for peptic ulcer disease in patients with end-stage renal disease, however, remain poorly defined. This study aims to better identify those risk factors. METHODS: We analyzed 577 patients with end-stage renal disease from 2004 to 2016. We excluded patients with life-threatening conditions. All patients underwent upper endoscopy. We analyzed patient medical records, medication history, and endoscopic findings. Independent sample t test, chi-square test, Fisher’s exact test, and multiple logistic regression analysis were used in statistical analyses. RESULTS: Of the 577 patients with end-stage renal disease, 174 had peptic ulcer disease (gastric or duodenal ulcer). Patients on hemodialysis had a higher prevalence of peptic ulcer disease than those on peritoneal dialysis. Patients with peptic ulcer disease had lower serum albumin level and higher blood urea nitrogen level than those without peptic ulcer disease. Positive scores on two or more nutritional indices (albumin, serum cholesterol, uric acid, and creatinine levels) were associated with peptic ulcer disease in end-stage renal disease. CONCLUSION: Hemodialysis, hypoalbuminemia, and multiple malnutrition indices were associated with the prevalence of peptic ulcer disease in patients with end-stage renal disease receiving dialysis.
Blood Urea Nitrogen ; Cholesterol ; Creatinine ; Dialysis ; Endoscopy ; Humans ; Hypoalbuminemia ; Kidney Failure, Chronic ; Logistic Models ; Malnutrition ; Medical Records ; Nutrition Assessment ; Peptic Ulcer ; Peritoneal Dialysis ; Prevalence ; Renal Dialysis ; Risk Factors ; Serum Albumin ; Uric Acid

Purpose: Although chylous ascites is a frequent complication of radical gastrectomy for gastric cancer, proper diagnostic criteria and optimal treatment strategies have not been established. This study aimed to identify the clinical features of chylous ascites and evaluate the treatment outcomes. Materials and Methods: We retrospectively analyzed the data of patients who underwent radical gastrectomy between 2013 and 2019. Diagnosis was made when milky fluid or elevated triglyceride levels (≥100 mg/dL) appeared in the drains without a preceding infection. The clinical features, risk factors, and treatment outcomes were assessed according to the initial treatment modalities for fasting and non-fasting groups. Results: Among the 7,388 patients who underwent radical gastrectomy for gastric cancer, 156 (2.1%) experienced chylous ascites. The median length of hospital stay was longer in patients with chylous ascites than in those without (median [interquartile range]: 8.0 [6.0–12.0] vs. 6.0 [5.0–8.0], P<0.001). Low body mass index (adjusted odds ratio [aOR]=0.9; P<0.001), advanced gastric cancer (aOR=1.51, P=0.024), open surgery (reference: laparoscopic surgery; aOR=1.87, P=0.003), and extent of surgical resection (reference: subtotal gastrectomy, total gastrectomy, aOR=1.5, P=0.029; proximal gastrectomy, aOR=2.93, P=0.002) were associated with the occurrence of chylous ascites. The fasting group (n=12) was hospitalized for a longer period than the non-fasting group (n=144) (15.0 [12.5–19.5] vs. 8.0 [6.0–10.0], P<0.001). There was no difference in grade III complication rate (16.7% vs. 4.2%, P=0.117) or readmission rate (16.7% vs. 11.1%, P=0.632) between the groups. Conclusions A fat-controlled diet and medication without fasting provided adequate initial treatment for chylous ascites after radical gastrectomy for gastric cancer.