BACKGROUND: It is generally known that the principle treatment of obesity is life-style modification and behavior therapy for weight reduction. This study was carried out to investigate the effect of office-based education for weight control and behavior modification in overweight patients. METHODS: We selected 119 patients among the overweight or obese (BMI >or=23 kg/m2) patients who visited the Department of Family Medicine at Asan Medical Center. Life styles such as diet, exercise, smoking, and alcohol drinking were evaluated by self-questionnaire. Weight, height, body mass index, waist circumference, waist to hip ratio, and body fat were measured. The patients were divided randomly into two groups, the intervention (n=60) and the control (n=59) group. We educated the intervention group about the importance of weight reduction, life-style modification and provided specific guidelines. Two months later, we measured anthropometric variables and evaluated changes of behavior modification. RESULTS: After two months, 28 patients of the intervention group and 22 patients of the control group were followed up. At the follow-up time, the body weight and waist circumference decreased significantly in the intervention group compared with those of the control group. The exercise time increased significantly in the intervention group compared to the control group. The frequency of fatty meal ingestion decreased significantly in the intervention group. CONCLUSIONS: The office-based education for weight reduction in overweight or obese patients has contributed substantially in changing their life-style and reducing their waist circumference. As a result, we have found that patient education for behavior modification was essential part of comprehensive approach for weight control in overweight patients.
Adipose Tissue ; Alcohol Drinking ; Behavior Therapy* ; Body Height ; Body Weight ; Chungcheongnam-do ; Diet ; Eating ; Education ; Follow-Up Studies ; Humans ; Life Style ; Meals ; Obesity ; Overweight* ; Patient Education as Topic* ; Smoke ; Smoking ; Waist Circumference ; Waist-Hip Ratio ; Weight Loss

At present, health care industries throughout the world are struggling with the challenges to set up financial structures as cost-effective ways and means of satisfying customer needs for health care services. Many hospitals consign foodservice management to foodservice companies for the purpose of efficiency. The companies taking charge of hospital foodservice are also striving to gain an advantage over keen competitions. This study applied Quality Function Deployment (QFD) to one hospital (which will be shown as [A hospital] below) managed by a contract foodservice company for the purpose of strategy planning to provide sustainable competitive advantage. First of all, this study scanned internal and external environment of [A hospital] by means of a Quality Measurement Tool and a fieldwork study. With the result of environment scanning, this study elicited 20 strategies through SWOT analysis, which were categorized by 4 perspectives such as financial, customer, internal process, learning and growth perspectives. Finally, the priorities of 20 strategies were extracted from QFD methodology. According to the results obtained by applying QFD to [A hospital] 's foodservice, the strategies which [A hospital] foodservice was obliged to introduce and implement were : the specialization of Children's hospital foodservice, scientific foodservice management through the standardization of foodservice operations, the maintenance of sanitary quality through sanitary system, the remodeling of facilities, the introduction of new equipment, the prompt and accurate response to customer needs, the development of appropriate patient menus, the provision of competitively priced meals for patient selection, the development of a demand forecast model by considering the characteristics of a children's hospital, improvement of productivity and the reduction of labor costs through the employment of experienced employees based on their seniority.
Delivery of Health Care ; Efficiency ; Employment ; Health Care Sector ; Humans ; Learning ; Meals ; Patient Selection

We found an error in our published article.

PURPOSE: Foreign body aspiration in the tracheobronchial tree is a common medical emergency in children and represents an important cause of morbidity and mortality. This study was aimed to analyze the clinical spectrum of tracheobronchial foreign bodies in children and to evaluate the causes of late diagnoses. METHODS: A total of 108 patients with foreign body aspiration were recruited in the last 10 years, who had a flexible or rigid bronchoscopic examination. The age, sex, symptoms, causes of aspiration, radiologic findings, and clinical courses were investigated retrospectively. Patients were divided into 2 groups according to the elapsed time from aspiration to a definite diagnosis as early (< or =24 hours after aspiration) and late diagnoses (>24 hours after aspiration). The two groups were compared for clinical courses, radiologic findings, and the duration of admission of early- and late-diagnosed foreign body aspiration. RESULTS: Approximately 80% of the patients were less than 24 months of age and the most common symptoms were the sudden onset of a cough. Hyperinflation or obstructive emphysema (52.8%) and normal chest radiographs (19.4%) were the most frequent radiologic findings. Plain chest radiographies revealed visible foreign bodies in 7.4% of all patients with foreign body aspiration. Nuts were the most common foreign bodies aspirated. Sudden onset of a persistent cough and fever were predominant in the late-diagnosed group.(P<0.05) CONCLUSION: Our results suggest that clinical suspicion upon interviewing is enough to indicate bronchoscopy. The best way to reduce the number of accidents and deaths associated with foreign body aspiration is to promote public prevention polices.
Bronchoscopy ; Child ; Cough ; Delayed Diagnosis ; Diagnosis* ; Emergencies ; Emphysema ; Fever ; Foreign Bodies* ; Humans ; Mortality ; Nuts ; Radiography, Thoracic ; Retrospective Studies ; Thorax

No abstract available.

Congenital central hypoventilation syndrome (CCHS) is a life-threatening disorder with apnea and cyanosis during sleep requiring immediate endotracheal intubation during the first day of life. The PHOX2B gene has been identified as the major gene involved in CCHS. This is the first report of a Korean neonate with CCHS confirmed to have a PHOX2B mutation with expanded alleles containing 20 polyalanine repeats that is a relatively small number compared to previous cases. The patient required intermittent ventilator support during sleep only and did not suffer from any other disorders of the autonomic nerve system. He consistently needs ventilator support during sleep and remains alive. Analysis of PHOX2B gene is useful for diagnosis and appropriate therapeutic intervention of CCHS patients.
Alleles ; Asian Continental Ancestry Group/*genetics ; Genotype ; Homeodomain Proteins/*genetics ; Humans ; Hypoventilation/congenital/*genetics ; Infant, Newborn ; Male ; Mutation ; Peptides/genetics ; Republic of Korea ; Sequence Analysis, DNA ; Transcription Factors/*genetics ; Ventilators, Mechanical

Objective: To investigate clinical and psychological characteristics of young men referred for a psychiatric evaluation due to expected unsuitability for military service and identify their heterogeneous subgroups based on the profiles of MMPI-2 and TCI. Methods: We conducted a latent profile analysis of 348 men using MMPI-2 and TCI and then a comparative analysis of four latent classes in relation to sociodemographic, clinical, and IQ variables. Results: We identified four classes with distinct clinical and psychological features: Class 1 (nonclinical: n=68), Class 2 (internalized: n=129), Class 3 (externalized: n=60), Class 4 (confused: n=91). Class 1 showed no significant psychiatric symptoms and relatively adaptive temperament and characteristics. Class 2 showed relatively higher harm avoidance and introverted traits indicating vulnerability to internalizing disorder. Class 3 was related to higher novelty seeking, impulsivity, and bipolarity. Class 4 showed the most severe clinical symptoms including psychotic experiences with extremely unstable temperament and immature personality. In total, 50–70% participants reported clinically significant depression, anxiety, and suicidal idea. Participants showed lower processing speed index (M=85.9, SD=16.6) than the general population. Conclusion The results suggest that clinical conceptualization and therapeutic intervention considering distinctive features of young men with adaptive problems related to military service are needed.

OBJECTIVE: Idiopathic thrombocytopenic purpura (ITP) frequently occurs in young women. Consequently, clinicians often give medical treatment to pregnant women who are diagnosed with ITP. This study might help to make a clinical guidelines for obstetrical ITP patients and their infants. METHODS: We retrospectively investigated the medical charts of 19 cases of deliveries and 22 neonates which from mothers with the diagnosis of ITP during pregnancy from March 1998 to March 2007. RESULT: Corticosteroid treatment was administrated in 13 cases, high-dose immunoglobulin therapy in 3 cases, and concentrated platelet transfusion in 17 cases during their antenatal care. Ten (45%) vaginal deliveries and twelve (55%) cesarean sections were performed. There were no obstetrical complications associated with their ITP and only four infants with platelet counts below the 150,000/micronLiter were reported after birth. However there were not any signs and symptoms of neonatal complications resulting from their maternal ITP. CONCLUSION : Our results demonstrate that mothers with ITP can successfully deliver healthy infants in most case. Although maternal and fetal bleeding may occur, such a fatal complication is uncommon.
Blood Platelets ; Cesarean Section ; Diagnosis ; Female ; Hemorrhage ; Humans ; Immunization, Passive ; Infant ; Infant, Newborn ; Mothers ; Parturition ; Platelet Count ; Platelet Transfusion ; Pregnancy* ; Pregnant Women ; Purpura, Thrombocytopenic, Idiopathic* ; Retrospective Studies

Background: Over the last decade, extracorporeal membrane oxygenation (ECMO) use in critically ill children has increased and is associated with favorable outcomes. Our study aims to evaluate the current status of pediatric ECMO in Korea, with a specific focus on its volume and changes in survival rates based on diagnostic indications. Methods: This multicenter study retrospectively analyzed the indications and outcomes of pediatric ECMO over 10 years in patients at 14 hospitals in Korea from January 2012 to December 2021. Four diagnostic categories (neonatal respiratory, pediatric respiratory, postcardiotomy, and cardiac-medical) and trends were compared between periods 1 (2012–2016) and 2 (2017–2021). Results: Overall, 1065 ECMO runs were performed on 1032 patients, with the annual number of cases remaining unchanged over the 10 years. ECMO was most frequently used for post-cardiotomy (42.4%), cardiac-medical (31.8%), pediatric respiratory (17.5%), and neonatal respiratory (8.2%) cases. A 3.7% increase and 6.1% decrease in pediatric respiratory and post-cardiotomy cases, respectively, were noted between periods 1 and 2.Among the four groups, the cardiac-medical group had the highest survival rate (51.2%), followed by the pediatric respiratory (46.4%), post-cardiotomy (36.5%), and neonatal respiratory (29.4%) groups. A consistent improvement was noted in patient survival over the 10 years, with a significant increase between the two periods from 38.2% to 47.1% (P = 0.004). Improvement in survival was evident in post-cardiotomy cases (30–45%, P = 0.002).Significant associations with mortality were observed in neonates, patients requiring dialysis, and those treated with extracorporeal cardiopulmonary resuscitation (P < 0.001). In pediatric respiratory ECMO, immunocompromised patients also showed a significant correlation with mortality (P < 0.001). Conclusion Pediatric ECMO demonstrated a steady increase in overall survival in Korea;however, further efforts are needed since the outcomes remain suboptimal compared with global outcomes.

This practice parameter for non-pharmacological treatment for attention-deficit hyperactivity disorder(ADHD) review the domestic and international literature on the psychosocial treatment of children and adolescents with ADHD. This parameter include the parental training & education, cognitive behavior therapy(group or individual), social skill training, family therapy, play therapy(individual psychotherapy) and non-traditional therapy(art therapy, herbal therapy et al). Among them, there is some proven evidence only in parental training & education and cognitive behavior therapy. So, this parameter describes some details only in the field of parental training & education and cognitive behavior therapy. The efficacy or effectiveness, especially, cost-effectiveness of specific psychosocial treatment method for ADHD cannot be fairly assessed due to the scarcity of controlled clinical data. Based on the clinical expert consensus and limited evidence, we cautiously suggest the practice recommendations about the non-pharmacological psychosocial treatment for children and adolescents with ADHD.
Adolescent ; Child ; Cognitive Therapy ; Consensus ; Education ; Family Therapy ; Humans ; Parents ; Phytotherapy