Background: A novel antiviral agent, remdesivir (RDV), is a promising candidate treatment for coronavirus disease 2019 (COVID-19) in the absence of any proven therapy.Materials and Methods: This retrospective case series included 10 patients with a clinically and laboratory confirmed diagnosis of severe COVID-19 pneumonia who had received RDV for 5 days (n = 5) or 10 days (n = 5) in the Phase III clinical trial of RDV (GS-US-540-5773) conducted by Gilead Sciences. The clinical and laboratory data for these patients were extracted. Results: One patient in the 10-day group received RDV for only 5 days because of nausea and elevated liver transaminases. No patient had respiratory comorbidity. Seven patients had bilateral lesions and three had unilateral lesions on imaging. All patients had received other medications for COVID-19, including lopinavir/ritonavir and hydroxychloroquine, before administration of RDV. Five patients required supplemental oxygen and one required mechanical ventilation. All patients showed clinical and laboratory evidence of improvement.Half of the patients developed elevated liver transaminases and three had nausea. There were no adverse events exceeding grade 2. Conclusion Our experience indicates that RDV could be a therapeutic option for COVID-19.A well-designed randomized controlled clinical trial is now needed to confirm the efficacy of RDV in patients with COVID-19.

BACKGROUND: We compared the efficacies of vildagliptin (50 mg twice daily) relative to pioglitazone (15 mg once daily) as an add-on treatment to metformin for reducing glycosylated hemoglobin (HbA1c) levels in Korean patients with type 2 diabetes. METHODS: The present study was a multicenter, randomized, active-controlled investigation comparing the effects of vildagliptin and pioglitazone in Korean patients receiving a stable dose of metformin but exhibiting inadequate glycemic control. Each patient underwent a 16-week treatment period with either vildagliptin or pioglitazone as an add-on treatment to metformin. RESULTS: The mean changes in HbA1c levels from baseline were -0.94% in the vildagliptin group and -0.6% in the pioglitazone group and the difference between the treatments was below the non-inferiority margin of 0.3%. The mean changes in postprandial plasma glucose (PPG) levels were -60.2 mg/dL in the vildagliptin group and -38.2 mg/dL in the pioglitazone group and these values significantly differed (P=0.040). There were significant decreases in the levels of total, low density lipoprotein, high density lipoprotein (HDL), and non-HDL cholesterol in the vildagliptin group but increases in the pioglitazone group. The mean change in body weight was -0.07 kg in the vildagliptin group and 0.69 kg in the pioglitazone group, which were also significantly different (P=0.002). CONCLUSION: As an add-on to metformin, the efficacy of vildagliptin for the improvement of glycemic control is not inferior to that of pioglitazone in Korean patients with type 2 diabetes. In addition, add-on treatment with vildagliptin had beneficial effects on PPG levels, lipid profiles, and body weight compared to pioglitazone.
Blood Glucose ; Body Weight ; Cholesterol ; Hemoglobin A, Glycosylated ; Humans ; Lipoproteins ; Metformin* ; Thiazolidinediones

OBJECTIVES: The aim of this study is to evaluate difference of somatic symptoms of anxiety disorder and major depressive disorder and domainal association with suicidal idealization, plan, and attempts. METHODS: A total of 359 adults diagnosed with major depressive disorder and anxiety disorder of last one year participated. Participants interviewed with certain sections of Korean version of Composite International Diagnostic interview of CIDI. Sections of interests includes questionnaires regarding somatic symptoms and suicidal idea, plan and attempts of last one year. RESULTS: Chest pain shows more prevalence in major depressive disorder. Symptoms of Headache and loose stool are more prevalent in anxiety disorder. Difficulty in equilibrium and fainting spells are more common somatic complaints of co-diagnosis states of anxiety disorder and major depressive disorder. Comparing 3 domains of pain symptoms, gastrointestinal symptoms and pseudo-neurological symptoms, pain symptom domains, gastrointestinal symptoms domain shows significant statistic difference between diagnosis. Average somatic symptom numbers of each symptom domains increase through suicidal idealization, plan and attempt, accordingly. CONCLUSIONS: Our finding shows some of somatic symptoms are more prevalent at certain diagnosis. Since increasing numbers of somatic complaints of each symptom domains goes with the suicidal idealization to suicidal attempts, proper psychiatric evaluation and consultations are crucial for patients with numerous somatic complaints in non-psychiatric clinical settings.
Adult ; Anxiety Disorders* ; Anxiety* ; Chest Pain ; Depression ; Depressive Disorder, Major* ; Diagnosis ; Headache ; Humans ; Prevalence ; Referral and Consultation ; Suicide ; Syncope

OBJECTIVE: The aim of this study was to estimate the prevalence and correlates of mental disorders in Korean adults. METHODS: Door to door household surveys were conducted with community residents aged 18-74 years from July 19, 2011, to November 16, 2011 (n=6,022, response rate 78.7%). The sample was drawn from 12 catchment areas using a multistage cluster method. Each subject was assessed using the Korean version of the World Health Organization Composite International Diagnostic Interview (CIDI) based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). RESULTS: Lifetime and 12-month prevalence estimates were as follows: alcohol use disorders, 13.4% and 4.4%, respectively; nicotine use disorders, 7.2% and 4.0%, respectively; anxiety disorders, 8.7% and 6.8%, respectively; and mood disorders, 7.5% and 3.6%, respectively. The prevalence rates of all types of DSM-IV mental disorders were 27.6% and 16.0%, respectively. Being female; young; divorced, separated, or widowed; and in a low-income group were associated with mood and anxiety disorders after adjustment for various demographic variables, whereas being male and young were associated with alcohol use disorders. Higher income was not correlated with alcohol use disorder as it had been in the 2001 survey. CONCLUSION: The rate of depressive disorders has increased since 2001 (the first national survey), whereas that of anxiety disorders has been relatively stable. The prevalence of nicotine and alcohol use disorders has decreased, and the male-to-female ratio of those with this diagnosis has also decreased.
Adult* ; Anxiety Disorders ; Depressive Disorder ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders* ; Divorce ; Family Characteristics ; Female ; Humans ; Male ; Mental Disorders* ; Mood Disorders ; Nicotine ; Prevalence* ; Tobacco Use Disorder ; Widowhood ; World Health Organization

The July issue of Clinical Endoscopy deals with selected articles covering the state-of-the-art lectures delivered during the 50th seminar of the Korean Society of Gastrointestinal Endoscopy (KSGE) on March 30, 2014, highlighting educational contents pertaining to either diagnostic or therapeutic gastrointestinal (GI) endoscopy, which contain fundamental and essential points in GI endoscopy. KSGE is very proud of its seminar, which has been presented twice a year for the last 25 years, and hosted more than 3,500 participants at the current meeting. KSGE seminar is positioned as one of premier state-of-the-art seminars for endoscopy, covering topics for novice endoscopists and advanced experts, as well as diagnostic and therapeutic endoscopy. The 50th KSGE seminar consists of more than 20 sessions, including a single special lecture, concurrent sessions for GI endoscopy nurses, and sessions exploring new technologies. Nine articles were selected from these prestigious lectures, and invited for publication in this special issue. This introductory review, prepared by the editors of Clinical Endoscopy, highlights core contents divided into four sessions: upper GI tract, lower GI tract, pancreatobiliary system, and other specialized topic sessions, including live demonstrations and hands-on courses.
Endoscopy ; Endoscopy, Gastrointestinal* ; Lectures ; Lower Gastrointestinal Tract ; Publications ; Upper Gastrointestinal Tract

BACKGROUND/AIMS: Because of the similarities in the clinical presentations of Crohn's disease (CD) and intestinal tuberculosis (ITB), differential diagnosis is critical. Mesenteric adipose tissue hypertrophy and creeping fat are characteristic features of CD. The purpose of this study was to assess the usefulness of visceral fat for the differential diagnosis of CD and ITB. METHODS: We conducted a retrospective review of 50 patients with findings of CD or ITB between January 2005 and July 2008. Abdominal computed tomography (CT) was performed on all subjects during their first evaluation. The abdominal fat area was assessed using quantitative abdominal CT. RESULTS: The ratio of visceral fat to total fat (VF/TF) was significantly higher in male CD patients than in male ITB patients. The ratio of visceral fat to subcutaneous fat (VF/SF) was also higher in CD patients than in patients with ITB. For a VF/TF cut-off value of 0.46, the sensitivity and specificity for the diagnosis of CD were 42.1% and 93.3% respectively, with positive and negative predictive values of 88.9% and 56.0%, respectively. CONCLUSION: Measurement of the abdominal fat area using CT can be clinically useful for the differential diagnosis of CD and ITB.
Abdominal Fat ; Adipose Tissue ; Crohn Disease* ; Diagnosis ; Diagnosis, Differential* ; Humans ; Hypertrophy ; Intra-Abdominal Fat* ; Male ; Retrospective Studies ; Sensitivity and Specificity ; Subcutaneous Fat ; Tomography, X-Ray Computed ; Tuberculosis*

OBJECTIVES: The purpose of this study was to investigate the differences of the suicidal behavior, stress, internet gaming disorder-related symptoms and personality profiles between online game overusers and general users. METHODS: A total of 460 adult online game users (40 overusers, 420 general users) participated in this study and were asked to complete several self-report measures. Questionnaires included demographic information, suicidal behavior, stress, internet gaming disorder-related symptoms, and big five inventory-10. RESULTS: Compared to the general user group, the overuser group showed statistically significant higher suicide idea, suicidal plan, stress, internet game withdrawal symptoms, online game-related daily life problems and lower extraversion, conscientiousness. Online game overusers showed lower extraversion, decreased conscientiousness, and higher neuroticism compared to the psychiatrically undiagnosed group. CONCLUSION: The current results indicate the possibility that online game overuse may be related to suicidal behavior, stress, and the personality traits of extraversion, conscientiousness, and neuroticism.
Adult ; Extraversion (Psychology) ; Humans ; Internet* ; Surveys and Questionnaires ; Substance Withdrawal Syndrome ; Suicide

Rapid advances in the technology of gastrointestinal endoscopy as well as the evolution of science have made it necessary for us to continue update in either various endoscopic techniques or state of art lectures relevant to endoscopy. International Digestive Endoscopy Network (IDEN) 2013 was held in conjunction with Korea-Japan Joint Symposium on Gastrointestinal Endoscopy (KJSGE) during June 8 to 9, 2013 at Seoul, Korea. Two days of impressive scientific program dealt with a wide variety of basic concerns from upper gastrointestine (GI), lower GI, pancreaticobiliary endoscopy to advanced knowledge including endoscopic submucosal dissection forum. IDEN seems to be an excellent opportunity to exchange advanced information of the latest issues on endoscopy with experts from around the world. In this special issue of Clinical Endoscopy, we prepared state of art review articles from contributing authors and the current highlights will skillfully deal with very hot spots of each KJSGE, upper GI, lower GI, and pancreaticobiliary sessions by associated editors of Clinical Endoscopy.
Endoscopy ; Endoscopy, Gastrointestinal ; Joints ; Korea ; Lectures

This special May issue of Clinical Endoscopy discusses the tutorial contents dealing with either the diagnostic or therapeutic gastrointestinal (GI) endoscopy that contain very fundamental and essential points in this filed. The seminar of Korean Society of Gastrointestinal Endoscopy (KSGE) had positioned as one of prime educational seminars covering the very beginner to advanced experts of GI endoscopy. Besides of four rooms allocated for each lecture, two additional rooms were open for either live demonstration or hands-on course, covering totally 20 sessions including one special lecture. Among these prestigious lectures, 12 lectures were selected for the current review articles in this special issue of Clinical Endoscopy journal. Basic course for beginner to advanced tips to expert were all covered in this seminar. This introductory review prepared by four associated editors of Clinical Endoscopy contained core contents divided into four sessions-upper gut, lower gut, pancreaticobiliary, and specialized topic session part-to enhance understandings not covered by enlisted review articles in this issue.
Endoscopy ; Endoscopy, Gastrointestinal ; Lectures

Whether hydrogen and methane gas produced during lactulose breath test (LBT) are associated with symptoms of irritable bowel syndrome (IBS) is not determined. We aimed to investigate whether hydrogen and methane on LBT are associated with IBS symptoms. Sixty-eight IBS patients meeting the Rome III criteria for IBS, and 55 healthy controls, underwent LBT. The IBS subjects recorded their customary gastrointestinal symptoms on a questionnaire using visual analogue scales. LBT positivity was defined to be above 20 ppm rise of hydrogen or 10 ppm rise of methane within 90 min. Gas amounts produced during LBT were determined by calculating area under the curve of hydrogen and methane excretion. Symptom severity scores were not different between the LBT (+) IBS and LBT (-) IBS subjects and also between methane producers and non-methane producers. Gas amounts produced during LBT were not associated with IBS symptoms, except a weak correlation between total gas amounts and a few IBS symptoms such as bloating (r = 0.324, P = 0.039), flatulence (r = 0.314, P = 0.046) and abdominal pain (r = 0.364, P = 0.018) only in LBT (+) IBS. In conclusion, hydrogen and methane gas on LBT are not useful for predicting the customary symptoms and subtypes of IBS.
Abdominal Pain/etiology ; Adult ; Area Under Curve ; Breath Tests ; Female ; Flatulence/etiology ; Gases/analysis ; Humans ; Hydrogen/*analysis ; Irritable Bowel Syndrome/*diagnosis ; Lactulose/*metabolism ; Male ; Methane/*analysis ; Middle Aged ; ROC Curve ; Risk Factors