Recent Patient Health Monitoring Platforms Incorporating Internet of Things-Enabled Smart Devices / 대한배뇨장애요실금학회지

Synergistic integration of the Internet of Things (IoT), cloud computing, and big data technologies in healthcare have led to the notion of “smart health.” Smart health is an emerging concept that refers to the provision of healthcare services for prevention, diagnosis, treatment, and follow-up management at any time or any place by connecting information technologies and healthcare. As a significant breakthrough in smart healthcare development, IoT-enabled smart devices allow medical centers to carry out preventive care, diagnosis, and treatment more competently. This review focuses on recently developed patient health monitoring platforms based on IoT-enabled smart devices that can collect real-time patient data and transfer information for assessment by healthcare providers, including doctors, hospitals, and clinics, or for self-management. We aimed to summarize the available information about recently approved devices and state-of-the-art developments through a comprehensive, systematic literature review. In this review, we also discuss possible future directions for the integration of cloud computing and blockchain, which may offer unprecedented breakthroughs in on-demand medical services. The combination of IoT with real-time, remote patient monitoring empowers patients to assert more control over their care, thereby allowing them to actively monitor their particular health conditions.

Detecting Bladder Biomarkers for Closed-Loop Neuromodulation: A Technological Review / 대한배뇨장애요실금학회지

Neuromodulation was introduced for patients with poor outcomes from the existing traditional treatment approaches. It is well-established as an alternative, novel treatment option for voiding dysfunction. The current system of neuromodulation uses an open-loop system that only delivers continuous stimulation without considering the patient’s state changes. Though the conventional open-loop system has shown positive clinical results, it can cause problems such as decreased efficacy over time due to neural habituation, higher risk of tissue damage, and lower battery life. Therefore, there is a need for a closed-loop system to overcome the disadvantages of existing systems. The closed-loop neuromodulation includes a system to monitor and stimulate micturition reflex pathways from the lower urinary tract, as well as the central nervous system. In this paper, we reviewed the current technological status to measure biomarker for closed-loop neuromodulation systems for voiding dysfunction.

Recent Patient Health Monitoring Platforms Incorporating Internet of Things-Enabled Smart Devices / 대한배뇨장애요실금학회지

Due to a mistake in reference by the author submission in this article, an erroneous grant number had been published.

Use of Amplatz(R) canine duct occluder for closing a patent ductus arteriosus in a small-sized dog / 동물의과학연구지

A 2-year-old intact female pomeranian dog presented dyspnea, labored breathing, cough, exercise intolerance, machinery heart murmur, and precordial thrill. A left-to-right patent ductus arteriosus (PDA) was diagnosed based on two-dimensional echocardiography, thoracic radiography, electrocardiography, and blood work. An angiography was performed to accurately evaluate the size and shape of the duct. An interventional approach for transcatheterial occlusion of the PDA was achieved using an Amplatz(R) Canine Duct Occluder (ACDO), which is a commercially available ductal occluding device. Due to the limited size of the dog's femoral artery, a device smaller [125% of minimal ductal diameter (MDD); recommended size: 150~200% of MDD] than recommended was mounted. After placement of the ACDO, precordial thrill and continuous heart murmur disappeared, and the patient was discharged the next day after stabilization with O2 supply. Upon follow up examination, dyspnea, labored breathing, cough, exercise intolerance, and cardiomegaly were improved with no complications after the procedure. The ACDO was well maintained in position. This case represents successful clinical application of the Amplatz(R) Canine Duct Occluder to achieve closure of a PDA using a slightly smaller device than the recommended size.

Probiotic dietary supplementation in a dog with chronic kidney disease / 동물의과학연구지

A 7-year-old spayed female English Cocker Spaniel dog presented with polyuria (PU), polydipsia (PD), intermittent vomiting, and weight loss. Physical examination revealed pale, tacky mucous membranes and severe emaciation. Hematological and biochemical examinations revealed moderate normocytic normochromic non-regenerative anemia and moderate azotemia. Abdominal ultrasonography demonstrated bilaterally small lumpy-bumpy kidneys with hyperechoic parenchyma as well as loss of renal corticomedullary junction. Based on clinical history and examinations, the dog was diagnosed with chronic kidney disease (CKD). The dog was treated with supportive care including fluid therapy, phosphate-binding agent, and histamine H2-receptor antagonist. Darbepoetin Alfa was administered to control renal secondary non-regenerative anemia. Prescribed diet with low-protein and low-phosphorus was fed to alleviate CKD signs. Further, dietary probiotics were supplemented. This case demonstrates that oral probiotic supplementation helped reduce blood urea-nitrogen (BUN) levels. This case indicates that dietary probiotics can be a potential alternative therapeutic agent for management of renal failure.

Delusional Parasitosis as 'Folie a Deux'

Delusional parasitosis is characterized by the unshakeable belief of being infested with tiny (microscopic) insects. Patients spend much time trying to get rid of the bugs and suffer from these symptoms. Patients prefer to go to dermatologists because they have a strong conviction over the presence of a somatic disease and do not accept any psychiatric advice for their complaints. 'Folie a deux' or shared psychotic disorder (SPD) is a relatively rare syndrome, which has long attracted clinical attention. Delusional parasitosis is associated in 5-15% of SPD and can run within a family. We experienced delusional parasitosis as 'Folie a Deux' between a mother and her son and successfully treated them through early psychiatric intervention. We believe that attention should be drawn to DP with SPD.

Risperodone Induced Hyperprolactinemia and Its Clinical Complications / 대한정신약물학회지

OBJECT: Risperidone, unlike other atypical antipsychotics, is thought to elevate prolactin levels. This paper examines the relationship of risperidone-induced hyperprolactinemia and the sexual dysfunctions of the patients in the real clinical practice. METHODS: Forty nine patients (male 22, female 27) with 6 month-over risperidone medication were assigned and serum prolactin was assayed in serum by radioimmunometric assay. In the distinction of sex, six adverse events possibly associated with increased prolactin levels were determined by interviewing the patients (poor erection, ejaculatory dysfunction, galactorrhea, decreased libido, orgasmic dysfunction and obesity in male;amenorrhea, vaginal dryness, galactorrhea, decreased libido, orgasmic dysfunction and obesity in female). RESULTS: In 49 patients, thirty six patients (male 15;56%, female 21;95%) showed hyperprolactinemia and twenty two patients (male 13;48%, female 8;36%) had sexual side-effects. Both risperidone dosage per day and duration were not correlated with prolactin levels and adverse events. There was no significant direct correlation between serum prolactin levels and sexual adverse events. CONCLUSION: The risperidone-associated increase in serum prolactin levels was not significantly directly correlated with the emergence of possible prolactin-related adverse events in the real clinical practice. However, our results suggest that risperidone-induced hyperprolactinemia may play a role in sexual dysfunction of female patients.

Two-Year Naturalistic Outcome Study of Schizophrenics after Discharged from a University Hospital on a Regimen of Risperidone or Typical Antipsychotics / 신경정신의학

OBJECTIVES: To explore the naturalistic outcome of the schizophrenics, we evaluated key clinical outcome-drop-out rate and readmission rate among the 33 risperidone and 17 conventional antipsychotics(such as haloperidol, chlorpromazine, mesoridazine) treated patients who met DSM-IV diagnostic criteria for schizophrenia at psychiatric department of a university hospital. METHOD: Outcome data was extracted from the charts of 50-schizophrenic patients who were more than 2 years after initiation of treatment with risperidone and conventional anti-psychotics. RESULTS: During over the 2-year period, the drop-out rate of the conventional antipsychotics treated schizophrenics was significantly higher than that of risperidone treated patients. But no significant factors(such as age, education level, duration of illness) were found between these two differently treated groups. Among the risperidone treated patients, the percentage of readmission was 18.2% at 12 months and 45.5% at 24 months. CONCLUSIONS: Reduced drop-out and rehospitalization rate suggest that risperidone was better than conventional antipsychotics among schizophrenic patients in a university hospital. Our data may contribute essential functional outcome information to assist the clinician in long-term, comparative treatment evaluation in 'real' clinical practice.

Characteristic Eye Movement in Schizophrenic Patients: Accuracy and Adaptation Speed of Adaptive Gaze Control / 신경정신의학

OBJECTIVES: While most neurological models of schizophrenia have focused on cerebral functions, cerebellar abnormality, especially in cerebellar vermis has been repeatedly reported in schizophrenic patients from brain imaging and lesion studies. And cerebellar vermis has been implicated for adaptive control of saccadic eye movements, which has not been studied in schizophrenics to our knowledge. METHOD: We investigated saccadic adaptation using double-step paradigm in 5 patients with a DSM-IV diagnosis of schizophrenia and 5 age and sex-matched normal controls. Gaze and head movements were recorded with scleral search coil method in head-free condition. RESULTS: Time course of adaptation in schizophrenics was similar to that of normal control but it never reached to the complete level of adaptation seen in control, and accordingly gaze gain (gaze amplitude/target amplitude) was low even after 600 adaptive trials. Head contribution to gaze saccade was relatively low and time to peak head velocity was longer in schizophrenics. CONCLUSIONS: Our results suggested that schizophrenic patients used a different strategy of gaze control and some schizophrenics might have cerebellar abnormality. Variability across patients in adaptation parameters need to be further investigated in combination with cerebellar volumetry. This study was supported by "In-san Schizophrenia Research Grant" from the Research Institute of Korean Neuropsychiatric Association in 1997.