A safe and effective way to control weight in patients with affective disorders is needed, and phentermine is a possible candidate. We performed a PubMed search of articles pertaining to phentermine, sibutramine, and affective disorders. We compared the studies of phentermine with those of sibutramine. The search yielded a small number of reports. Reports concerning phentermine and affective disorders reported that i) its potency in the central nervous system may be comparatively low, and ii) it may induce depression in some patients. We were unable to find more studies on the subject; thus, it is unclear presently whether phentermine use is safe in affective disorder patients. Reports regarding the association of sibutramine and affective disorders were slightly more abundant. A recent study that suggested that sibutramine may have deleterious effects in patients with a psychiatric history may provide a clue for future phentermine research. Three explanations are possible concerning the association between phentermine and affective disorders: i) phentermine, like sibutramine, may have a depression-inducing effect that affects a specific subgroup of patients, ii) phentermine may have a dose-dependent depression-inducing effect, or iii) phentermine may simply not be associated with depression. Large-scale studies with affective disorder patients focusing on these questions are needed to clarify this matter before investigation of its efficacy may be carried out and it can be used in patients with affective disorders.
Anti-Obesity Agents ; Central Nervous System ; Cyclobutanes ; Depression ; Humans ; Mood Disorders ; Obesity ; Phentermine

OBJECTIVES: This study was performed to evaluate the sleep patterns in a population of Korean labor workers and to assess the activity of the autonomic nervous system in relation to sleep habits. METHODS: A sampler of 1238 daytime workers (male 911, female 327) completed questionnaires on sleep habits and their short term heart rate variability(HRV) was also examined. We used the SA-2000 (medi-core) instrument for 5 minutes for each participant in the morning and performed basic physical examinations including height, weight, and blood pressure. RESULTS: Bed time and wake up time were negatively correlated with age, while the frequencies of waking up through the night and in the early morning showed positive correlation with age. We found that bed time and wake up time during weekdays, sleep latency during weekdays, frequency of waking up through the night, and the degree of sleepiness all varied significantly according to the average nightly amount of sleep within the last week. There was a positive correlation between wake up time at weekdays with mean heart rate. However, the other variables of sleep habits and pattern did not show significant correlation with HRV. CONCLUSION: Among Korean daytime workers, sleep phases become advanced with aging. In spite of the aging processes, general sleep health seems to be maintained among the healthy worker group. However, short-term HRV was not useful parameter to measure the alternation of autonomic nervous system resulting from the difference of sleep habits and pattern.
Aging ; Autonomic Nervous System ; Blood Pressure ; Female ; Heart Rate* ; Heart* ; Humans ; Korea* ; Physical Examination ; Questionnaires

Background: Because persistent fever often occurs in adrenal insufficiency, it might be confused with infectious diseases. This study aimed to identify clinical characteristics and risk factors of patients with adrenal insufficiency and fever. Methods: All adult patients (n = 150) admitted to a tertiary care hospital in South Korea and diagnosed with adrenal insufficiency between 1 March 2018, and 30 June 2019, were recruited. Patients were excluded if they had: 1) proven structural problems in the adrenal or pituitary gland; 2) a history of chemotherapy within 6 months prior to the diagnosis of adrenal insufficiency; and 3) other medical conditions that may cause fever. Results: Among the included patients, 45 (30.0%) had fever at the time of the diagnosis of adrenal insufficiency. The mean C-reactive protein level was higher (11.25 ± 8.54 vs. 4.36 ± 7.13 mg/dL) in patients with fever than in those without fever. A higher proportion of patients with fever changed antibiotics (33.3% vs. 1.0%). On multivariate logistic regression analysis, female sex (odds ratio [OR], 0.32) lowered the risk of adrenal insufficiency with fever, while a history of surgery within 6 months (OR, 4.35), general weakness (OR, 7.21), and cough (OR, 17.29) were significantly associated with that. Conclusion The possibility of adrenal insufficiency should be considered in patients with fever of unknown origin, especially those with risk factors.

Background: Because persistent fever often occurs in adrenal insufficiency, it might be confused with infectious diseases. This study aimed to identify clinical characteristics and risk factors of patients with adrenal insufficiency and fever. Methods: All adult patients (n = 150) admitted to a tertiary care hospital in South Korea and diagnosed with adrenal insufficiency between 1 March 2018, and 30 June 2019, were recruited. Patients were excluded if they had: 1) proven structural problems in the adrenal or pituitary gland; 2) a history of chemotherapy within 6 months prior to the diagnosis of adrenal insufficiency; and 3) other medical conditions that may cause fever. Results: Among the included patients, 45 (30.0%) had fever at the time of the diagnosis of adrenal insufficiency. The mean C-reactive protein level was higher (11.25 ± 8.54 vs. 4.36 ± 7.13 mg/dL) in patients with fever than in those without fever. A higher proportion of patients with fever changed antibiotics (33.3% vs. 1.0%). On multivariate logistic regression analysis, female sex (odds ratio [OR], 0.32) lowered the risk of adrenal insufficiency with fever, while a history of surgery within 6 months (OR, 4.35), general weakness (OR, 7.21), and cough (OR, 17.29) were significantly associated with that. Conclusion The possibility of adrenal insufficiency should be considered in patients with fever of unknown origin, especially those with risk factors.

A live attenuated zoster vaccine (ZOSTAVAX(TM), Merck & Co., Inc.) was approved by the Korea Ministry of Food and Drug Safety in 2009. However, the immunogenicity and safety of the vaccine has not been assessed in Korean population. This is multi-center, open-label, single-arm study performed with 180 healthy Korean adults > or =50 yr of age. The geometric mean titer (GMT) and geometric mean fold rise (GMFR) of varicella zoster virus (VZV) antibodies were measured by glycoprotein enzyme-linked immunosorbent assay (gpELISA) at 4 weeks post-vaccination. Subjects were followed for exposure to varicella or herpes zoster (HZ), the development of any varicella/varicella-like or HZ/HZ-like rashes, and any other clinical adverse experiences (AEs) for 42 days post-vaccination. For the 166 subjects included in the per-protocol population, the GMT at Day 1 was 66.9. At 4 weeks post-vaccination, the GMT for this population was 185.4, with a GMFR of 2.8 (95% CI, 2.5-3.1). Of the 180 subjects vaccinated, 62.8% experienced > or =1 AE, with 53.3% of subjects reporting injection-site AEs. The most frequently reported injection-site AEs were erythema (45.0%) with the majority being mild in intensity. Overall, 44 (24.4%) subjects experienced > or =1 systemic AE, 10 (5.5%) subjects experienced a systemic vaccine-related AE, and 3 (1.7%) subjects experienced > or =1 serious AE not related to vaccine. No subjects reported a VZV-like rash. There was no subject of death and no subject discontinued due to an adverse event. A single dose of zoster vaccine induced VZV-specific gpELISA antibody response and was generally well-tolerated in healthy Korean adults > or =50 yr of age (registry at www.clinicaltrial.gov No. NCT01556451).
Aged ; Antibodies, Viral/blood ; Enzyme-Linked Immunosorbent Assay ; Erythema/etiology ; Female ; Herpes Zoster/*prevention & control ; Herpes Zoster Vaccine/adverse effects/*immunology ; Herpesvirus 3, Human/immunology ; Humans ; Male ; Middle Aged

No abstract available.
Basal Ganglia* ; Dystonia* ; Humans

Varicella-zoster virus (VZV) is a member of the herpesviridae, which shares the characteristics of latent infection and reactivation. VZV causes two distinct clinical entities; varicella (chickenpox) and herpes zoster (shingles). Varicella pneumonia is the most common complication of adult varicella, especially in patients who are immunocompromised. We present two cases of VZV pneumonia occuring in patients with systemic lupus erythematosus (SLE) who were being treated with cytotoxic drugs and steroid. Both patients were treated with acyclovir and responses were good.
Acyclovir ; Adult ; Chickenpox ; Herpes Zoster ; Herpesviridae ; Herpesvirus 3, Human ; Humans ; Lupus Erythematosus, Systemic* ; Pneumonia*

BACKGROUND: The purpose of this study was to determine the efficacy of infection-control interventions to decrease the incidence of catheter-associated bloodstream infections (CA-BSI) and to examine the sustainability of its effect during and after the intervention in Korea. MATERIALS AND METHODS: We conducted a prospective multi-strategy intervention in intensive care units (ICUs) at 3 university hospitals in Korea. The intervention consisted of education and on-site training for medical personnel involved in catheter care, active surveillance, and reinforcement of current intervention in each unit. After the intervention of 3 months, we identified CA-BSI cases of each hospital using the electronic database for 6 months. RESULTS: During the intervention, the number of CA-BSI decreased significantly compared to pre-interventional period (8.7 vs. 2.3 per 1,000 catheter days; rate ratio 0.28; 95% CI, 0.13-0.61). After the intervention, CA-BSI rate increased slightly, but was still significantly lower than that of pre-interventional period (4.3 per 1,000 catheter days; rate ratio, 0.49; 95% CI, 0.31-0.78). Reduction of gram-negative bacterial infections was noted during and after the intervention. CONCLUSIONS: A multi-strategy approach to reduce CA-BSI could be implemented in diverse settings of medical and surgical units in Korea and decreased CA-BSI rates during the intervention.
Catheters ; Electronics ; Electrons ; Gram-Negative Bacterial Infections ; Hospitals, University ; Incidence ; Intensive Care Units ; Korea ; Prospective Studies ; Reinforcement (Psychology)

Vancomycin treatment failure in methicillin-resistant Staphylococcus aureus (MRSA) bacteremia patients has increased over the past decade. We experienced a case of repeated MRSA bacteremia resulting in left-side endocarditis in 38-year-old male with a huge complicated arteriovenous malformation in the left thigh. After vancomycin treatment failure, the patient was successfully treated with the administration of linezolid, leg amputation, and mitral valve replacement.
Acetamides ; Adult ; Amputation ; Arteriovenous Malformations ; Bacteremia ; Endocarditis ; Extremities ; Humans ; Leg ; Linezolid ; Male ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Mitral Valve ; Oxazolidinones ; Thigh ; Treatment Failure ; Vancomycin

Varicella-zoster virus (VZV) is a member of the herpesviridae, which shares the characteristics of latent infection and reactivation. VZV causes two distinct clinical entities; varicella (chickenpox) and herpes zoster (shingles). Varicella pneumonia is the most common complication of adult varicella, especially in patients who are immunocompromised. We present two cases of VZV pneumonia occuring in patients with systemic lupus erythematosus (SLE) who were being treated with cytotoxic drugs and steroid. Both patients were treated with acyclovir and responses were good.
Acyclovir ; Adult ; Chickenpox ; Herpes Zoster ; Herpesviridae ; Herpesvirus 3, Human ; Humans ; Lupus Erythematosus, Systemic* ; Pneumonia*