Objective: We aimed to identify the expectations and preferences for medication and medical decision-making in patients with major psychiatric disorders. Methods: A survey was conducted among patients with major psychiatric disorders who visited psychiatric outpatient clinics at 15 hospitals between 2016 and 2018 in Korea. The survey consisted of 12 questions about demographic variables and opinions on their expectations for medication, important medical decision-makers, and preferred drug type. The most preferred value in each category in the total population was identified, and differences in the preference ratio of each item among the disease groups were compared. Results: A total of 707 participants were surveyed. In the total population, patients reported high efficacy (44.01%±21.44%) as the main wish for medication, themselves (37.39%±22.57%) and a doctor (35.27%±22.88%) as the main decision makers, and tablet/capsule (36.16%±30.69%) as the preferred type of drug. In the depressive disorders group, the preference ratio of high efficacy was significantly lower, and the preference ratio of a small amount was significantly higher than that of the psychotic disorder and bipolar disorder groups. The preference ratio of a doctor as an important decision maker in the bipolar disorder group was higher compared to the other groups. Conclusion This study revealed the preference for medications and showed differences among patients with psychiatric disorders. Providing personalized medicine that considers a patient’s preference for the drug may contribute to the improvement of drug compliance and outcomes.

Objective: Attention-deficit/hyperactivity disorder (ADHD) is prevalent in adults, and psychiatric comorbidities are common in adults with ADHD. We aimed to examine the prevalence of adult ADHD with several common psychiatric conditions in a community sample in Korea and the association between adult ADHD and risk of psychiatric comorbidities. Methods: This study used a cross-sectional survey design. We provided supplementary and optional self-report questionnaires, including the Korean version of the World Health Organization Adult ADHD Self-Report Scale (ASRS) short screening scale, Patient Health Questionnaire-9 for screening for depression, Alcohol Use Disorders Identification Test alcohol consumption questions, and the Korean version of the Mood Disorders Questionnaire, to Korean adults who visited one of six centers of a large private healthcare company for the National General Health Examination. Results: A total of 17,799 subjects included in this study, and 430 (2.4%) were positive on the ASRS screen. ADHD was significantly associated with the 19−30-year-old age group (odds ratio [OR] = 3.938), lower income (OR = 1.298), depression (OR = 11.563), and bipolar disorder (OR = 3.162). Conclusion Adult ADHD was highly associated with depression and bipolar disorder, suggesting that clinicians should carefully evaluate and treat such psychiatric disorders in adults with ADHD symptoms.

Objectives: There has been increased use of medications in treating depressive disorders.Nowadays, patient value is an important part of prescribing medications. This study examines depressive patients’ perspectives on the side effects of medications. Methods: We administered questionnaires nationwide to 364 patients with depressive disorders. Intent or willingness to endure 21 side effects from the Antidepressant Side-Effect Checklist (ASEC) were examined and compared in patients who are less than mildly ill and who are more than moderately ill. Results: In the population, decreased appetite, yawning, increased body temperature, dry mouth, sweating, and constipation are regarded as generally endurable side effects. In contrast, dizziness, light-headedness, nausea or vomiting, headaches, disorientation, problems with urination, and difficulty sleeping are hard to endure. There were differences between patients who are less than mildly ill and those who are more than moderately ill regarding the willingness to endure drowsiness, decreased appetite, sexual dysfunction, palpitations, and weight gain. Conclusion This nationwide study revealed a general willingness in depressed patients to endure side effects. Sensitive and premeditative discussions of patient value with regard to medications might contribute to finding successful treatments.

OBJECTIVES: The aim of this study is to develop Treatment Guidelines for Alcohol Use Disorder-the Korean Addiction Treatment Guidelines-using the Adaptation method. METHODS AND PROCEDURES: As the Adaptation method of Guidelines, the ADAPTE Manual, which is developed by ADAPTE collaboration is applied. In Part 1 : preparatory work prior to the beginning of Adaptation is performed. In Part 2 : the core phase of the Adaptation in which we searched the guidelines and performed a systematic review of the literature. The two guidelines (of the AU and the UK) are selected by gone through the methodological quality and currency evaluation for guidelines. And, in order to choose the proper recommendations, the contents were evaluated with regard to the applicability and acceptability of guidelines to the domestic. Finally, in Part 3 : the adapted guideline is reviewed externally, with review and plan update. Therefore, in this way, the Korean Guidelines for Treatment of Alcohol Use Disorder, comprised of 55 recommendations, was developed. CONCLUSION: In this study, Korean Guidelines for Treatment of Alcohol Use Disorder were developed by application of the Adaptation method of ADAPTE. These are the first evidence-based Korean Guidelines for Treatment of Alcohol Use Disorder, which were modified and accepted in accordance with Korean circumstances within the range not damaging the validity of the treatment worth, and it is expected to contribute to improvement in quality and efficiency enhancement of Korean treatment of Alcohol Use Disorder.
Cooperative Behavior

Medullary thyroid carcinoma (MTC) is derived from the parafollicular or C-cells. As surgical resection is the only curative therapy for MTC, the early diagnosis is important for the patient's survival. F18-Fluorodeoxyglucose positron emission tomography-computed tomography (F-18 FDG PET CT) is a noninvasive imaging method which can be used to diagnose malignant thyroid tumors including recurrent or residual MTC. However, due to the limitations of this technique, it is difficult to differentiate benign from malignant thyroid tumors. We herein present a 47-year-old woman with ovarian cancer history who was found to have thyroid incidentaloma with metastatic cervical lymph node through F-18 FDG PET CT. Thyroid incidentaloma of the patient was examined by fine needle aspiration and the result of this diagnostic procedure showed suspicious MTC. The patient was subsequently diagnosed as having sporadic medullary thyroid carcinoma and metastatic cervical lymph node due to ovarian cancer.
Biopsy, Fine-Needle ; Early Diagnosis ; Electrons ; Female ; Humans ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Ovarian Neoplasms ; Positron-Emission Tomography ; Thyroid Gland ; Thyroid Neoplasms

Bilateral adrenal neoplasms are associated with metastatic cancer, pheochromocytoma and lymphoma. The coexistence of a unilateral functioning adrenocortical adenoma with contralateral pheochromocytoma is extremely rare. A 52-year-old woman complained of fatigue, headache, palpitation, and progressive weight gain. Hormonal assessment demonstrated high 24 hours urine epinephrine, norepinephrine, and free cortisol. A dexamethasone suppression test (overnight 1 mg, low dose 2 mg) showed insuppressible cortisol. Computerized tomographic scanning revealed a bilateral adrenal tumor. To preserve adrenal function, right adrenalectomy along with left adrenal tumorectomy was performed. Histological finding of the right adrenal tumor was pheochromocytoma and the left adrenal tumor was adrenocortical adenoma. This patient was the first case of a functional adrenocortical adenoma with contralateral cystic pheochromocytoma in Korea. We report the case with a review of the literature.
Adrenal Gland Neoplasms ; Adrenalectomy ; Adrenocortical Adenoma ; Cushing Syndrome ; Dexamethasone ; Epinephrine ; Fatigue ; Female ; Headache ; Humans ; Hydrocortisone ; Korea ; Lymphoma ; Middle Aged ; Norepinephrine ; Pheochromocytoma ; Weight Gain

The drug resistance of microorganisms isolated from laboratory animals never treated with antibiotics is being reported consistently, while the number of laboratory animals used in medicine, pharmacy, veterinary medicine, agriculture, nutrition, and environmental and health science has increased rapidly in Korea. Therefore, this study examined the development of antimicrobial resistance in bacteria isolated from laboratory animals bred in Korea. A total of 443 isolates (7 species) containing 5 Sphingomonas paucimobilis, 206 Escherichia coli, 60 Staphylococcus aureus, 15 Staphylococcus epidermidis, 77 Enterococcus faecalis, 27 Citrobacter freundii, 35 Acinetobacter baumannii were collected from the nose, intestine, bronchus and reproductive organs of ICR mice and SD rats. Of these species, Acinetobacter baumannii and Enterococcus faecalis showed significant antimicrobial resistance according to the minimum inhibition concentration (MIC) in E-test. In case of Acinetobacter baumannii, several isolates showed MIC values 16-128 microg/mL for cefazolin and cefoxitin, and higher resistance (128-512 microg/mL) to nitrofurantoin than that of standard type. Resistance to cefazolin, cefoxitin and nitrofurantoin was detected in 17.14, 20.00, and 8.57% of the Acinetobacter baumannii isolates, respectively. In addition, 44.1% of the Enterococcus faecalis isolates collected from the laboratory animals were resistant to oxacillin concentration of 16-32 microg/mL range, while MIC value of standard type was below oxacillin concentration of 6 microg/mL. These results suggest that in rodent species of laboratory animals, Acinetobacter baumannii are resistance to cefazolin, cefoxitin and nitrofurantoin, whereas those of Enterococcus faecalis were resistance to oxacillin.
Acinetobacter baumannii ; Agriculture ; Animals ; Animals, Laboratory ; Anti-Bacterial Agents ; Bacteria ; Bronchi ; Cefazolin ; Cefoxitin ; Citrobacter freundii ; Drug Resistance ; Drug Resistance, Microbial ; Enterococcus faecalis ; Escherichia coli ; Intestines ; Korea ; Mice ; Mice, Inbred ICR ; Nitrofurantoin ; Nose ; Oxacillin ; Pharmacy ; Rats ; Rodentia ; Sphingomonas ; Staphylococcus aureus ; Staphylococcus epidermidis ; Veterinary Medicine

This study was performed to examine the characteristics of protein of red crab (Chionoecetes japonicus) shell powder hydrolyzed by commercial proteases. Red crab shell was digested by commercial proteases, such as Protamex (P), Neutrase (N), Flavourzyme (F), Alcalase (A), Protease M (PM) and Protease A (PA). Protein yield analyzed by Biuret assay, absorbance at 280 nm and brix revealed that PA was the enzyme having the highest proteolytic activity. SDS PAGE showed that molecular weight of proteins produced by protease treatments was various and below 150 kDa. Combinational treatment of proteases (PA + P, PA + PM, PA + F, PA + A) was tried whether these increase protein hydrolysis from red crab shell powder compared to a PA single treatment. Soluble protein content was similar, but amino acid concentration by combinational treatments was higher than PA single treatment [PA + P 247.4 mg/g > PA + F (206.4 mg/g) > PA + A (133.4 mg/g) > PA + PM (59.1 mg/g) > PA (54.9 mg/g)]. Amino acid composition by combinational treatments was slightly different. Most abundant essential amino acids were phenylalanine, glycine, alanine, and leucine, whereas tyrosine and cystine were not detected.
Alanine ; Amino Acids, Essential ; Biuret ; Cystine ; Electrophoresis, Polyacrylamide Gel ; Endopeptidases ; Glycine ; Hydrolysis ; Leucine ; Metalloendopeptidases ; Molecular Weight ; Peptide Hydrolases ; Phenylalanine ; Proteins ; Subtilisins ; Tyrosine

Exercise training is highly correlated with the reduced glucose-stimulated insulin secretion (GSIS), although it enhanced insulin sensitivity, glucose uptake and glucose transporter expression to reduce severity of diabetic symptoms. This study investigated the impact of short-term swimming exercise on insulin regulation in the Goto-Kakizaki (GK) rat as a non-obese model of non-insulin-dependent diabetes mellitus. Wistar (W/S) and GK rats were trained 2 hours daily with the swimming exercise for 4 weeks, and then the changes in the metabolism of insulin and glucose were assessed. Body weight was markedly decreased in the exercised GK rats compare to their non-exercised counterpart, while W/S rats did not show any exercise-related changes. Glucose concentration was not changed by exercise, although impaired glucose tolerance was improved in GK rats 120 min after glucose injection. However, insulin concentration was decreased by swimming exercise as in the decrease of GSIS after running exercise. To identify the other cause for exercise-induced insulin down-regulation, the changes in the levels of key factors involved in insulin production (C-peptide) and clearance (insulin-degrading enzyme; IDE) were measured in W/S and GK rats. The C-peptide level was maintained while IDE expression increased markedly. Therefore, these results showed that insulin down-regulation induced by short-term swimming exercise likely attributes to enhanced insulin clearance via IDE over-expression than by altered insulin production.
Animals ; Body Weight ; C-Peptide ; Diabetes Mellitus, Type 2 ; Down-Regulation ; Glucose ; Glucose Transport Proteins, Facilitative ; Insulin ; Insulin Resistance ; Insulysin ; Rats ; Running ; Swimming

Immunoglobulin G4-related sclerosing disease is a novel clinicopathological disease entity known to involve various organs including the pancreas, bile ducts, gall bladder, retroperitoneum, kidney, salivary gland, lung and prostate. The most common organ involved is the pancreas and cases without pancreatic involvement are uncommon. Positive response to steroids is an important characteristic of this disease and this enables early diagnosis, which is required for good prognosis. We demonstrate a case of immunoglobulin G4-related tubulointerstitial nephritis in a 59-year-old male accompanied by sclerosing cholangitis and sialadenitis without any evidence of pancreatic infiltration. The patient was treated with prednisolone and was fully recovered in 6 months.
Bile Ducts ; Cholangitis ; Cholangitis, Sclerosing ; Early Diagnosis ; Humans ; Immunoglobulins ; Kidney ; Lung ; Male ; Middle Aged ; Nephritis, Interstitial ; Pancreas ; Prednisolone ; Prognosis ; Prostate ; Salivary Glands ; Sialadenitis ; Steroids ; Urinary Bladder