Purpose: To develop and evaluate a large language model (LLM)-based learning tool, featuring virtual patients (VPs) and virtual assessors (VAs), and to assess its impact on medical students’ perceptions of history-taking education compared to conventional learning methods. Methods: A tool using the GPT-4 API was developed to provide seven clinical VP scenarios and a VA that delivered both immediate, reflective dialogue and comprehensive written feedback. First- and second-year medical students participated in a 6-day study. Pre- and post-participation surveys using a 5-point Likert scale assessed perceptions of the LLM tool versus conventional methods across usability, self-efficacy, and feedback quality domains. Results: Twenty-one students completed the study. The LLM-based tool demonstrated statistically significant improvements over conventional methods in all assessed domains. Students reported greater comfort during practice (mean 4.57 vs. 2.95, p=0.0002). Significant gains were seen in six of eight self-efficacy measures, including confidence in handling unfamiliar cases (4.00 vs. 2.90, p=0.0002). All nine feedback quality dimensions improved significantly, with feedback perceived as more specific (4.43 vs. 3.24, p=0.0005) and personalized (4.19 vs. 3.19, p=0.0001). Conclusion An LLM-based learning tool featuring VPs and VAs can significantly enhance medical students’ perceived learning experience in history-taking education. It offers a scalable, accessible, and cost-effective complementary training method. Future research should validate these subjective improvements with objective performance metrics.

OBJECTIVE: Cyanidin-3-glucoside (C3G), is a component of anthocyanin, have been considered to positively influence cognition and be beneficial for the prevention and treatment of dementia. We aimed to assess the safety and efficacy of cyanidin-3-glucoside-rich Oryza sativa L. (black rice) extract on cognitive function. METHODS: A 12-weeks double-blind randomized, placebo controlled trial assessed safety and cognitive outcomes in participants with subjective memory impairment (n=48) following consumption of 6 black rice extract capsules or a placebo. Cognitive function was assessed using the ADAS-cog and the CERAD-K. Subjective memory impairment also assessed. Safety was assessed by hematologic blood test, urine analysis, and participant reports of adverse events. RESULTS: There was significant improvement on subjective memory in intervention group. There was no statistically significant difference in objective cognitive outcomes following 12 weeks of consuming black rice extract. ADAS-cog scores, however, trended toward improvement in the intervention group compared to the placebo group. There was no adverse event. CONCLUSION: Although significant improvement in objective cognitive function was not proved, we found that C3G-rich Oryza sativa L. extract improves subjective memory in this study. Therefore the results may be informative of the possible effectiveness of the C3G-rich Oryza sativa L. on cognitive function.
Adult ; Anthocyanins ; Capsules ; Cognition ; Dementia ; Hematologic Tests ; Humans ; Memory ; Oryza

Normal aging and to a greater degree degenerative brain diseases such as Alzheimer's disease (AD), cause changes in the brain's structure and function. Degenerative changes in brain structure and decline in its function are associated with declines in cognitive ability. Early detection of AD is a key priority in dementia services and research. However, depending on the disease progression, neurodegenerative manifestations, such as cerebral atrophy, are detected late in course of AD. Functional changes in the brain may be an indirect indicator of trans-synaptic activity and they usually appear prior to structural changes in AD. Resting-state functional magnetic resonance imaging (RS-fMRI) has recently been highlighted as a new technique for interrogating intrinsic functional connectivity networks. Among the majority of RS-fMRI studies, the default mode network (DMN), salience network (SN), and central executive network (CEN) gained particular focus because alterations to their functional connectivity were observed in subjects who had AD, who had mild cognitive impairment (MCI), or who were at high risk for AD. Herein, we present a review of the current research on changes in functional connectivity, as measured by RS-fMRI. We focus on the DMN, SN, and CEN to describe RS-fMRI results from three groups: normal healthy aging, MCI and AD.
Aging ; Alzheimer Disease ; Atrophy ; Brain Diseases ; Brain* ; Dementia ; Disease Progression ; Magnetic Resonance Imaging* ; Mild Cognitive Impairment

OBJECTIVES: The purpose of this study was to find brain regions in which gray matter volume was reduced and to show the capability of voxel-based morphpmetry(VBM) analysis for lateralizing clinically significant brain regions in dementia of Alzheimer's type patients compared to healthy group. METHODS: MR T1-weighted images of the 20 dementia of Alzheimer's type patients were compared with those of the 20 normal controls. Images were transformed to standard MNI space. In order to observe gray matter volume change. Gray matter was smoothed with a Gaussian kernel. After these preprocessing, stati-stical analysis was performed using statistical parametric mapping software(SPM2). RESULTS: Gray matter volume was significantly reduced in the bilateral parahippocampal gyri, Lt. anterior cingulate gyrus, Lt. posterior cingulate gyrus, bilateral superior temporal gyri Lt. middle temporal gyrus, Lt. superior, bilateral middle, Rt. anterior frontal gyri and Rt. precuneus in dementia of Alzheimer's type patient group. CONCLUSIONS: These VBM results confirm previous findings of temporal lobe and limbic lobe atrophic cha-nges in dementia of Alzheimer's type, and suggest that these abnormalities may be confined to specific sites within that lobe, rather than showing a widespread distribution.
Alzheimer Disease ; Brain ; Cerebral Cortex ; Dementia ; Gyrus Cinguli ; Humans ; Temporal Lobe

Several studies have reported that either risperidone or olanzapine is effective and tolerable in the elderly patients with psychotic symptoms. However, there is a lack of clinical data of risperidone and olanzapine prescription for elderly patients in the Aisan population. We reviewed retrospectively the medical records of risperidone (n=112) and olanzapine (n=96) treated patients older than age 60 who were admitted to a university-affiliated hospital between October 2005 and August 2006. The mean daily dose of risperidone was 3.4+/-1.5 mg and olanzapine, 8.8+/-5.6 mg, respectively. The response rate on the CGI (much and very much improved) appeared to be 67.4% in the risperidone group and 70.8% in the olanzapine group, respectively. Adverse events were reported in 48.2% in the risperidone group and 46.9% in the olanzapine group, without serious adverse events, respectively. This study showed that either risperidone or olanzapine would be effective and tolerable in elderly patients with psychotic symptoms and that provides similar results to those reported from western countries.
Aged* ; Humans ; Inpatients* ; Medical Records ; Prescriptions* ; Psychotic Disorders ; Retrospective Studies ; Risperidone*

This study compared the effectiveness and tolerability of amisulpride and risperidone in patients with psychosis associated with dementia of the Alzheimer's type (DAT). This 8-week open label study randomized 72 patients with DAT associated psychosis either to amisulpride (n=36) and risperidone (n=36). The effectiveness of the treatments was assessed with the Korean version of Neuropsychiatry Inventory (K-NPI) psychosis subscale and total K-NPI and the Clinical Global Impression-Severity of Illness (CGI-S) scale. The Simpson-Angus Rating Scale, the Barnes Akathisia Rating Scale and the Abnormal Involuntary Movement Scale were used for the assessment of side effects. The K-NPI psychosis subscale, total K-NPI and CGI-S scores were significantly decreased over time in both treatment groups without any significant group difference and time by the group interaction effect. There were no serious adverse events in both groups. This study showed that either amisulpride or risperidone would be effective and tolerable for treating psychotic symptom associated with DAT. Adequately powered studies with a head-to-head comparison design will be mandatory to draw any definite conclusion.
Dementia* ; Dyskinesias ; Humans ; Neuropsychiatry ; Psychomotor Agitation ; Psychotic Disorders* ; Risperidone*

We surveyed the causes of blindness among the 6692 eye patients of 3 hospitals(Seoul, Chunan, Kumi) in 1984. Blindness is defined as visual acuity of 0.1(20/200) or less in better eye with best correction. The representation of the diagnosis of the ocular diseases is based on the examination of the ophthalmologists. The estimated number of blindness is 259(6.74%)in Seoul, 106(8.92%) in Chunan, 70(4.21%) in Kumi with total of 435(6.5%) among the 6692 eye patients. The leading causes of blindness for individual districts are cataract(28.19%), retinal and vitreous diseases(20.46%), trauma (15.06%), diseases of optic nerve(10.81%), corneal diseases(8.10%) in Seoul; cataract(35.81%), corneal diseases(18.87%), global diseases(13.21%), trauma(10.38%), retinal and vitreous diseases(6.60%) in Chunan; and cataract(34.29%), corneal diseases(14.21%), trauma (12.86%), global diseases(8.57%), retinal and vitreous diseases(8.50%) in Kumi. Rates of the blind eyes for the age groups are; 1.2%(under the age of 5), 4.1%(6~9), 10.3%(10~19), 30.8%(20~39), 23.5%(40~59), and 30.1%(above 60). Important causes of blindness in each age group are trauma(43.48%), optic nerve diseases(13.04%), and global diseases(13.04%) for below the age of 10, trauma(28.89%), retinal diseases(17.78%), and optic nerve diseases(13.33%) in 10~19 age group, corneal diseases(19.40%). cataract(18.66%), and retinal diseases(16.42%) in 20~39 age group, cataract(28.43%), retinal diseases(18.63%), and corneal diseases(10.78%) in 40~59 age group and cataract(59.54%), retinal diseases(9.92%), and glaucoma(8.40%) for above 60. There are no significant differences between male and female, right eyes and left eyes in the causes of the blind eyes, and also we make some comparisons with different statistics of domestic and foreign countries.
Blindness* ; Chungcheongnam-do ; Diagnosis ; Female ; Gyeongsangbuk-do ; Humans ; Male ; Optic Nerve ; Retinaldehyde ; Seoul ; Visual Acuity