Background: Regdanvimab has decreased the time to clinical recovery from coronavirus disease 2019 (COVID-19) and lowered the rate of oxygen therapy according to the results from phase 2/3 randomized controlled trial. More information is needed about the effects and safety of regdanvimab. Methods: We analyzed data for patients with high-risk mild or moderate COVID-19 being admitted to Busan Medical Center between December 1, 2020 and April 16, 2021. A propensity score (PS) matched analysis was conducted to compare patients treated with and without regdanvimab. The primary outcome was in-hospital death or disease aggravation which means the need for oxygen therapy (low- or high-flow oxygen therapy and mechanical ventilation) and secondary outcomes comprised the length of hospital stay and adverse reactions. Results: Among 1,617 selected patients, 970 (60.0%) were indicated for regdanvimab. Of these, 377 (38.9%) were administered with regdanvimab. Among a 1:1 PS-matched cohort of 377 patients each treated with and without regdanvimab, 19 (5%) and 81 (21.5%) reached the composite outcome of death, or disease aggravation, respectively (absolute risk difference, −16.4%; 95% confidence interval [CI], −21.1, −11.7; relative risk difference, 76.5%; P < 0.001).Regdanvimab significantly reduced the composite outcome of death, or disease aggravation in univariate (odds ratio [OR], 0.194; 95% CI, 0.112–0.320; P < 0.001) and multivariableadjusted analyses (OR, 0.169; 95% CI, 0.095–0.289; P < 0.001). The hospital stay was shorter for the group with than without regdanvimab. Some hematological adverse reactions were more frequent in the group without regdanvimab, but other adverse reactions did not significantly differ between the groups. Conclusion Regdanvimab was associated with a significantly lower risk of disease aggravation without increasing adverse reactions.

OBJECTIVE: Using immersive virtual environment technique, we aimed to preliminarily examine whether nicotine affects the interpersonal distance, as the size of personal space, in schizophrenic patients, which have extraordinarily high smoking rate. METHOD: Ten male schizophrenic patients who were at least moderate current smokers smoked a high (0.9 mg nicotine as an active drug) or low (0.1 mg nicotine as a placebo) nicotine-yielding cigarette after overnight-abstinence in randomized, double blind, cross-over design. Following the smoking session, subjects performed the 'self-introduction task' in virtual environment by introducing themselves consecutively to six different avatars, which varied in gender and facial/verbal expressions (neutral, angry, and happy). In the tasks, subjects were asked to step forward to each avatar until they felt most comfortable to greet the avatar first. The distance was measured by the head-tracking device, which was transmitting real-time data to the computer. Affective valence and arousal to each avatar were also rated by subjects following the tasks. RESULTS: The overall interpersonal distance of the drug group was significantly greater than that of placebo group (Z = -2.93, p = 0.022). The distances with emotionally neutral avatars (male/female) of the six were significantly different between the two groups (Z = -2.19, p = 0.028 ; Z = -2.09, p = 0.037). Within-group analysis revealed a significant difference among the distances with the six avatars in the placebo group (x2 = 17.03, df = 5, p = 0.004), but there was no significant within-group difference in the drug group (x2 = 6.11, df = 5, p = 0.295). CONCLUSION: These preliminary findings suggest that nicotine may increase the size of personal space of schizophrenic patients probably by enhancing the social stimuli perception through affecting the patients' cognitive function.
Female ; Male ; Humans

OBJECTIVES: Mobile healthcare applications are becoming a growing trend. Also, the prevalence of dementia in modern society is showing a steady growing trend. Among degenerative brain diseases that cause dementia, Alzheimer disease (AD) is the most common. The purpose of this study was to identify AD patients using magnetic resonance imaging in the mobile environment. METHODS: We propose an incremental classification for mobile healthcare systems. Our classification method is based on incremental learning for AD diagnosis and AD prediction using the cortical thickness data and hippocampus shape. We constructed a classifier based on principal component analysis and linear discriminant analysis. We performed initial learning and mobile subject classification. Initial learning is the group learning part in our server. Our smartphone agent implements the mobile classification and shows various results. RESULTS: With use of cortical thickness data analysis alone, the discrimination accuracy was 87.33% (sensitivity 96.49% and specificity 64.33%). When cortical thickness data and hippocampal shape were analyzed together, the achieved accuracy was 87.52% (sensitivity 96.79% and specificity 63.24%). CONCLUSIONS: In this paper, we presented a classification method based on online learning for AD diagnosis by employing both cortical thickness data and hippocampal shape analysis data. Our method was implemented on smartphone devices and discriminated AD patients for normal group.
Alzheimer Disease* ; Artificial Intelligence ; Brain Diseases ; Classification* ; Delivery of Health Care ; Dementia ; Diagnosis ; Discrimination (Psychology) ; Hippocampus ; Humans ; Learning* ; Magnetic Resonance Imaging ; Methods ; Mobile Health Units ; Prevalence ; Principal Component Analysis ; Sensitivity and Specificity ; Statistics as Topic

BACKGROUND: Cholesterol is a major component of specialized membrane microdomains known as lipid rafts or caveolae, which modulate the fluidity of biological membranes. Membrane cholesterol therefore plays an important role in cell signaling and vesicular transport. OBJECTIVE: In this study, we investigated the effects of cholesterol on matrix metalloproteinase-1 (MMP-1) expression in human dermal fibroblasts. METHODS: MMP-1 mRNA and protein expression were determined by RT-PCR and Western blotting, respectively. AP-1 DNA binding activity was detected by electrophoretic mobility shift assays. The amount of cholesterol was analyzed by cholesterol assay kit. RESULTS: We observed that MMP-1 mRNA and protein expression was dose-dependently decreased by cholesterol treatment. In contrast, cholesterol depletion by a cholesterol depletion agent, methyl-beta-cyclodextrin (M beta CD) in human dermal fibroblasts, increased MMP-1 mRNA and protein expression in a dose-dependent manner. Also, we investigated the regulatory mechanism of M beta CD-induced MMP-1 expression: cholesterol depletion by M beta CD, activated ERK1/2 and JNK, but not p38 MAPK cascade, and it also significantly increased c-Jun phosphorylation, c-Fos expression and activator protein-1 binding activity. Furthermore, the inhibition of ERK or JNK with specific chemical inhibitors prevented M beta CD-induced MMP-1 expression, which indicates that ERK and JNK play an important role in cholesterol depletion-mediated MMP-1 induction. In addition, M beta CD-induced phosphorylation of ERK and JNK and MMP-1 expression were suppressed by cholesterol repletion. CONCLUSION: Our results suggest that cholesterol regulates MMP-1 expression through the control of ERK and JNK activity in human dermal fibroblasts.
beta-Cyclodextrins ; Blotting, Western ; Caveolae ; Cholesterol ; DNA ; Electrophoretic Mobility Shift Assay ; Fibroblasts ; Humans ; Matrix Metalloproteinase 1 ; Membrane Microdomains ; Membranes ; p38 Mitogen-Activated Protein Kinases ; Phosphorylation ; RNA, Messenger ; Transcription Factor AP-1

OBJECTIVES: Impairment of social cognition affects the social functioning of patients with schizophrenia. For example, patients with schizophrenia have been shown to display abnormal eye contact during a one-on-one conversation. This study was designed to investigate the behavioral characteristics of patients with schizophrenia while talking with two people. METHODS: Twenty six patients with schizophrenia and 26 normal controls performed virtual reality conversation tasks, in which they talked with main and assistant avatars under positive or negative emotional conditions. While listening and speaking, the durations of eye gaze with the main and minor avatars were measured from the head orientations of the participants using a positional tracker. RESULTS: Compared with normal controls, the patient group showed a shorter duration of gaze towards the main avatar and a longer duration of gaze towards the assistant avatar. This pattern was more apparent in the negative situation. CONCLUSION: The results suggest a defect in social cognition, in which patients with schizophrenia fail to distribute their gaze appropriately during a conversation with more than one other person.
Cognition ; Eye ; Head ; Humans ; Orientation ; Schizophrenia

Chyle leakage (CL) due to lymphatic injuries is one of the rare complications that can develop after thyroidectomy. There are few studies on lymphatic embolization performed in case of CL after thyroid surgery. We report two cases of CL after thyroid surgery that were effectively treated by thoracic duct embolization. The patients had previously undergone total thyroidectomy with central compartment neck dissection with or without modified radical neck dissection. The amount of drainage from the operative site was ＞1000 mL per day in one patient and ＞500 mL per day in the other. In both cases, CL stopped after the thoracic duct embolization. Thoracic duct embolization seems to be an effective and important treatment option for CL after thyroid surgery.

OBJECTIVES: The relationship between substance dependence and poor decision making has received much attention in recent years. This study aimed to test the hypothesis that alcohol dependent subjects would demonstrate a more perseverative decision-making pattern, during ambiguous situations. METHODS: 15 alcohol dependent patients and 15 healthy normal controls performed a novel computerized decision-making task, which presented figures of coins. The subjects were instructed to guess whether the total number of coins was 'odd' or 'even'. Besides these two response, one could select a third alternative - 'pass' - in case the chances were assumed to be low. RESULTS: There was significant difference in performance between the two groups (F=4.339, p=0.008). The control group gained 15.4+/-14.4 points, whereas the alcohol dependent group lost 0.6+/-5.3 points. The normal control group demonstrated a tendency to make more pass responses as the trials were repeated. In contrast, the alcohol dependent group didn't make use of the alternative, but kept challenging between 'odd' and 'even', although they sensed that the chances were low. CONCLUSION: The alcohol dependent patients demonstrated a more rigid and perseverative response pattern and showed deficits in making use of compromise alternatives.
Alcoholism ; Decision Making ; Humans ; Numismatics ; Substance-Related Disorders

Diabetic ketoacidosis (DKA), a fatal acute diabetic complication, is characterized by severe metabolic decompensation and intravascular volume depletion. These conditions may result in hypercoagulability and prothrombic state. Pulmonary thromboembolism (PTE) could be presented as an uncommon and life-threatening complication of DKA. Reported herein is a case involving a 54-year-old male patient who was admitted with DKA due to chronic alcohol consumption and stopping the intake of oral antidiabetic drugs. After low-molecular-weight heparin and warfarin treatment because of PTE during the DKA treatment, the patient's condition improved over the week that he was discharged on insulin and warfarin.
Alcohol Drinking ; Anticoagulants ; Diabetes Complications ; Diabetic Ketoacidosis* ; Heparin, Low-Molecular-Weight ; Humans ; Hypoglycemic Agents ; Insulin ; Male ; Middle Aged ; Pulmonary Embolism* ; Thrombophilia ; Warfarin

OBJECTIVES: Anhedonia, defined as an inability to experience pleasure, has been considered to be a core feature of schizophrenia and depression. The purpose of the present study was to compare the specific characteristics of anhedonia in patients with the two illnesses by examining hedonic capacity during phased hedonic experience. METHODS: Hedonic rating tasks, using the film clips of physical and social hedonic stimuli and neutral stimuli, were performed by 29 patients with schizophrenia, 20 patients with depression, and 29 normal controls. Each task consisted of 'preview phase' with insufficient emotional information, and a subsequent 'theme phase' with sufficient emotional information. RESULTS: In normal controls, the mean hedonic score was increased in the theme phase compared with the preview phase, suggesting an appropriate augmentation of the hedonic response. In patients with schizophrenia, hedonic scores in the preview phase were comparable with those in normal controls, but showed deficient augmentation in the theme phase. In patients with depressive disorder, the range of increments in scores between the preview and theme phases was normal, but the scores themselves were lower in both phases than in the other two groups. CONCLUSION: The results indicate that patients with schizophrenia show a deficient augmentation of the hedonic response, whereas patients with depressive disorder have a pervasive lack of hedonic capacity.
Anhedonia ; Depression ; Depressive Disorder ; Humans ; Pleasure ; Schizophrenia

In Korea, cases of direct insertion of foreign bodies into the rectum are rare in the literature. Most cases of rectal insertion of foreign bodies are associated with sexual acts and psychiatric disorder such as schizophrenia. Objects inserted into the anus are usually blunt and shaped like the male genitalia. The removal method can be varied depending on the size and shape of the foreign object, its anatomical location, and the accompanying complications. In cases wherein attempts to remove the object fail or there are rectal perforation and peritonitis complications, immediate laparotomy may be required in order to prevent serious complications such as sepsis. Here, we report on a case of rectal perforation and peritonitis due to insertion of a foreign body in a middle-aged patient, with a literature review. He inserted a sharp pig backbone in his rectum and he only had depression. The patient underwent a Hartmann's operation as well as psychiatric counseling and treatment. Thus, after removal of foreign bodies, psychiatric counseling and treatment should be carried out in order to prevent similar accidents and to minimize the need for trauma medicine.
Anal Canal ; Counseling ; Depression* ; Foreign Bodies ; Genitalia, Male ; Humans ; Korea ; Laparotomy ; Male ; Peritonitis ; Rectum ; Schizophrenia ; Sepsis