BACKGROUND: We evaluated the effects of neurofeedback as an augmentation treatment on depressive symptoms and functional recovery in patients with treatment-resistant depression (TRD). METHODS: We included 24 adult patients with TRD and 12 healthy adults. 24 TRD patients were assigned to the neurofeedback augmentation group (n = 12) and the medication-only (treatment as usual [TAU]) group (n = 12). The neurofeedback augmentation group underwent combined therapy comprising medication and 12–24 sessions of neurofeedback training for 12 weeks. To assess the serum levels of brain-derived neurotrophic factor (BDNF) in both groups, pre- and post-treatment blood samples were obtained. Patients were evaluated using the Hamilton Depression Rating Scale (HAM-D), Beck Depression Inventory (BDI), Clinical Global Impression-Severity (CGI-S), 5-level version of European Quality of Life Questionnaire 5-Dimensional Classification (EQ-5D-5L), and Sheehan Disability Scale (SDS) at baseline, and at the 1-, 4-, and 12-week. RESULTS: From baseline to week 12, neurofeedback training reduced mean scores on HAM-D, BDI-II, CGI-S, and SDS, and increased mean EQ-5D-5L tariff score. In the neurofeedback augmentation group, the response and remission rates were 58.3% and 50.0%, respectively, at week 12. Changes in HAM-D, EQ-5D-5L tariff score, and SDS were significantly larger in the neurofeedback group than in the medication-only (TAU) group. No significant difference in BDNF level was found pre- vs. post-treatment in any of the groups. CONCLUSION: Despite the small sample size, these results suggest that neurofeedback treatment may be effective as an augmentation treatment, not only for depressive symptoms, but also for functional recovery, in patients with TRD. TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0004183 ClinicalTrials.gov Identifier: NCT04078438
Adult ; Brain-Derived Neurotrophic Factor ; Classification ; Depression ; Depressive Disorder, Major ; Humans ; Information Services ; Neurofeedback ; Pilot Projects ; Quality of Life ; Sample Size

This study has focused on genetical patterns of rotavirus positives on diarrhea patients in Incheon. Fecal specimens collected from January 2002 to December 2004 from patients with diarrhea in seven localities in Incheon were screened for group A rotavirus by RT-PCR. To survey the prevalence of group A rotavirus infection and distribution of P (VP4) and G (VP7) genotypes of rotaviruses in Incheon, we performed the nested RT-PCR using rotavirus ELISA positive samples. Among a total of 4,865 samples investigated, 1,100 samples (22.6%) were positive. The predominant genotypes of 293 RT-PCR positive samples were confirmed as G4P[6] (101 samples, 34.5%) followed by G2P[4] (73 samples, 24.9%), G1P[8] (38 samples, 13.0%), G3P[8] (28 samples, 9.6%), G3P[10] (14 samples, 4.8%), G4P[8] (6 samples, 2.0%) and G9P[8] (6 samples, 2.0%). Mixed types and untypable types were 3.8% and 5.1%, respectively. The most prevalent types in 2002, 2003 and 2004 were G4P[6] (71 samples, 40.3%), G4P[6] (22 samples, 40.7%) and G2P[4] (15 samples, 22.2%) respectively. This is the first nationwide genoepidemiological study for determining the prevailing of genotypes of rotaviruses in Incheon. The genetic analysis for investigating sequence variations among group A rotavirus strains in this study would provide the useful information to establish the preventing strategy of human rotaviruses and of developing vaccines which will be used in Korea.
Diarrhea ; Enzyme-Linked Immunosorbent Assay ; Gastroenteritis* ; Genotype ; Humans ; Incheon* ; Korea ; Prevalence* ; Rotavirus Infections ; Rotavirus* ; Vaccines

We aimed to compare fentanyl, remifentanil and dexmedetomidine with respect to hemodynamic stability, postoperative pain control and achievement of sedation at the postanesthetic care unit (PACU). In this randomized double-blind study, 90 consecutive total laparoscopic hysterectomy patients scheduled for elective surgery were randomly assigned to receive fentanyl (1.0 µg/kg) over 1 minute followed by a 0.4 µg/kg/hr infusion (FK group, n = 30), or remifentanil (1.0 µg/kg) over 1 minute followed by a 0.08 µg/kg/min infusion (RK group, n = 30), or dexmedetomidine (1 µg/kg) over 10 minutes followed by a 0.5 µg/kg/hr infusion (DK group, n = 30) initiating at the end of main procedures of the operation to the time in the PACU. A single dose of intravenous ketorolac (30 mg) was given to all patients at the end of surgery. We respectively evaluated the pain VAS scores, the modified OAA/S scores, the BIS, the vital signs and the perioperative side effects to compare the efficacy of fentanyl, remifentanil and dexmedetomidine. Compared with other groups, the modified OAA/S scores were significantly lower in DK group at 0, 5 and 10 minutes after arrival at the PACU (P < 0.05), whereas the pain VAS and BIS were not significantly different from other groups. The blood pressure and heart rate in the DK group were significantly lower than those of other groups at the PACU (P < 0.05). DK group, at sedative doses, had the better postoperative hemodynamic stability than RK group or FK group and demonstrated a similar effect of pain control as RK group and FK group with patient awareness during sedation in the PACU. (World Health Organization registry, KCT0001524).
Blood Pressure ; Dexmedetomidine* ; Double-Blind Method ; Fentanyl* ; Heart Rate ; Hemodynamics* ; Humans ; Hysterectomy ; Ketorolac ; Pain, Postoperative* ; Vital Signs

Transurethral resection has been the gold standard in the operative management of benign prostatic hyperplasia and bladder tumor; however, it is associated with several complications that may cause patient discomfort. We evaluated the usefulness of continuous infusion of dexmedetomidine on emergence agitation, hemodynamic status, and recovery profiles in patients undergoing elective surgery by a randomized clinical trial. Sixty patients aged 30 to 80 yr who were scheduled for elective transurethral resection under general anesthesia were included in this study. Participants were randomly assigned to two groups (control group, group C; dexmedetomidine group, group D). A total of 60 male patients were enrolled in this study and randomly assigned to group C (n=30) or group D (n=30). The quality of emergence in group D was marked by a significantly lower incidence of emergence agitation than in group C (P=0.015). Patients in group D therefore felt less discomfort induced by the indwelling Foley catheter than those in group C (P=0.022). No statistically significant differences were found between the two groups with respect to side effects including bradycardia (P=0.085), hypotension (P=0.640), and postoperative nausea and vomiting (P=0.389). Our study showed that intraoperative dexmedetomidine infusion effectively reduced the incidence and intensity of emergence agitation and catheter-induced bladder discomfort without delaying recovery time and discharge time, thus providing smooth emergence during the recovery period in patients undergoing transurethral resection (Clinical Trial Registry No. KT0001683).
Adult ; Aged ; Aged, 80 and over ; Blood Pressure ; Bradycardia/etiology ; Dexmedetomidine/adverse effects/*therapeutic use ; Hemodynamics ; Humans ; Hypnotics and Sedatives/adverse effects/*therapeutic use ; Hypotension/etiology ; Male ; Middle Aged ; Nausea/etiology ; Prostatic Hyperplasia/*surgery ; Psychomotor Agitation/*drug therapy ; *Transurethral Resection of Prostate ; Vomiting/etiology

Noroviruses (NoVs) cause major epidemic gastroenteritis in humans. To obtain the molecular epidemiological information on gastroenteritis sporadic cases in Incheon city, Korea, we analyzed the nucleotide sequences of NoV strains detected during 2005~2007. We performed one step RT-PCR amplifying the open reading frame (ORF) 2 (capsid region) followed by semi-nested PCR from the stool samples from acute gastroenteritis patients from 2005 to 2007. Amplicons of the capsid region of norovirus strains were sequenced and analyzed using MegAlign in DNAstar software. Faecal samples were collected from 6,618 acute gastroenteritis patients during the study period. The incidence of NoV infection was about 10.7% (n=708) among patients with acute gastroenteritis and genotypes of the 320 positive samples were determined by sequence analysis. Sequence comparison of NoV strains revealed that 16 genotypes of GII NoV strains were circulated in Incheon city, from 2005 to 2007. Among norovirus strains, the most prevalent genotype GII/4 was most common 69.7% (223 strains), followed by GII/3 17.2% (55 strains), GII/12 4.4% (14 strains), GII/1 2.2% (7 strains), GII/5 1.6% (5 strains), GII/15 1.3% (4 strains) and 0.6% (2 strains) each of GII/9 and GII/16. The GII-3 strains were most frequently detected in Incheon, 2005. From the phylogenetic analysis of NoV strains, we detected 16 genotypes of GII NoV strains during 2005~2007 in Incheon. Our results suggest that various genotypes of human NoV strains in sporadic case of AGE were circulated in Incheon, Korea.
Base Sequence ; Capsid ; Gastroenteritis ; Genotype ; Humans ; Incidence ; Korea ; Norovirus ; Open Reading Frames ; Polymerase Chain Reaction ; Sequence Analysis