Purpose: : This study aimed to investigate the difference in compliance with the sepsis bundle and mortality rates according to the body temperature of patients with sepsis in general wards identified using a rapid response system (RRS). Methods: : A retrospective observational study of 1,083 patients with sepsis in general wards identified using the RRS from July 2018 to December 2022 was performed at a tertiary care hospital in South Korea. The patients were classified into hypothermia (＜36℃), normothermia (36-38℃), and hyperthermia (＞38℃) groups according to their body temperature at the time of RRS activation. Results: : A total of 1,083 sepsis patients were analyzed, comprising 17 cases of hypothermia, 624 cases of normothermia, and 442 cases of hyperthermia. There were statistically significant differences among the body temperature groups in the rate of compliance with the sepsis bundle within 1 h (hypothermia: 64.7% vs. normothermia: 49.5% vs. hyperthermia: 60.4%, p =.010), the rate of compliance with the overall sepsis bundle, including lactate re-measurement (64.7% vs. 49.5% vs. 60.4%, p =.001), and the rate of blood culture testing (94.1% vs. 85.9% vs. 92.8%, p =.002). The 28-day mortality rates in the hypothermia, normothermia, and hyperthermia groups were 29.4%, 32.4%, and 16.5%, respectively (p ＜.001). Conclusion : There were statistically significant differences in compliance with the sepsis bundle and mortality rates according to body temperature. Patients with sepsis and normothermia showed lower compliance with the sepsis bundle and higher mortality rates. Therefore, it is recommended to develop strategies for the early recognition of patients with sepsis and normothermia and to improve compliance with the sepsis bundle.

OBJECTIVES: The aim of this study was to examine the correlation between anxiety and premenstrual eating symptoms in premenstrual dysphoric disorder (PMDD). METHODS: A total of 49 women in the late luteal phase participated in this study. The psychiatric symptoms were assessed by Hamilton Rating Scale for Depression, State Trait Anxiety Inventory, and Menstrual Distress Questionnaire. Eating symptoms were assessed using the Dutch Eating Behavior Questionnaire and cocoa intake experiment. Estradiol, progesterone, and leptin were collected through venous blood. RESULTS: Participants with PMDD (n=25) showed a higher level of depression (p<0.001), trait anxiety (p=0.012), restrained eating symptoms (p=0.039), and leptin (p=0.015). Among PMDD patients in the luteal phase, trait anxiety showed correlation with emotional eating (p=0.023), alcohol (p=0.022), and unrestricted intake of cocoa (p=0.001). CONCLUSION: Our data suggest that PMDD subjects showed higher trait anxiety, depression, and difficulty in eating behavior control. Trait anxiety plays an important role in increased and uncontrolled eating symptoms during the premenstrual period and chronic course of PMDD.
Anxiety* ; Cacao ; Depression ; Eating* ; Estradiol ; Feeding Behavior* ; Female ; Humans ; Leptin ; Luteal Phase ; Premenstrual Syndrome ; Progesterone

OBJECTIVE: Social anxiety disorder (SAD) shows relatively delayed responses to pharmacotherapy when compared to other anxiety disorders. Therefore, more effective early therapeutic decisions can be made if the therapeutic response is predictable as early as possible. We studied whether the therapeutic response at 12 weeks is predictable based on the early improvement with escitalopram at 1 week. METHODS: The subjects were 28 outpatients diagnosed with SAD. The subjects took 10-20 mg/day of escitalopram. The results of the Liebowitz social anxiety scale (LSAS), Hamilton anxiety rating scale, and Montgomery-Asberg depression rating scale were evaluated at 0, 1, 4, 8, and 12 weeks of treatment. Early improvement was defined as a ≥10% reduction in the LSAS total at 1 week of treatment, and endpoint response was defined as a ≥35% reduction in the LSAS total score. The correlation between clinical characteristics and therapeutic responses was analyzed by simple linear regression. The correlation between early improvement responses and endpoint responses was analyzed by multivariate logistic regression analysis and receiver operating characteristic curves. RESULTS: When we adjusted the influence of a ≥35% reduction in the LSAS total endpoint score on a ≥10% reduction of the LSAS total score at 1 week of treatment for the patients' age, the early improvement group at 1 week of treatment was expected to show stronger endpoint responses compared to the group with no early improvement. CONCLUSION: The results suggest that a ≥10% reduction in the LSAS total score in a week can predict endpoint treatment response.
Anxiety Disorders* ; Anxiety* ; Citalopram* ; Depression ; Drug Therapy ; Humans ; Linear Models ; Logistic Models ; Outpatients ; Phobic Disorders ; ROC Curve

OBJECTIVE: Several lines of evidence suggest that brain-derived neurotrophic factor (BDNF) plays a role in the pathophysiology of anxiety. We analyzed the association of the BDNF gene polymorphism, G196A (val66met), in the coding region of exon XIIIA in chromosome 11p13, and generalized social anxiety disorder (GSAD). METHODS: Patients with GSAD (n=73) and age-matched control subjects (n=152) were tested for the BDNF (val66met) polymorphism. A clinical interview and a Mini-International Neuropsychiatric Interview were conducted by trained psychiatrists in order to diagnose GSAD. The symptomatic characteristics of the GSAD patients were assessed with the Hamilton Anxiety Rating Scale, the Beck Anxiety Inventory, the Retrospective Self Report of Inhibition, the Spielberger State-Trait Anxiety Inventory, and the Liebowitz Social Anxiety Scale. RESULTS: There were no significant differences in the frequencies of the genotypes (chi2=0.961, degree of freedom [df]=2, p=0.619), alleles (chi2=0.415, df=1, p=0.519), or allele (methionine) carriers (chi2=0.019, df=1, p=0.889) between the patients and controls. In addition, when we compared the severity of social anxiety symptom as determined by the clinical scales with the genotypes of the BDNF gene, we could not find any significant differences between the genotypes or allele carriers. CONCLUSION: These results do not support the hypothesis that the BDNF gene might be a candidate gene for susceptibility or severity of GSAD in the Korean population in this study.
Alleles ; Anxiety ; Anxiety Disorders ; Brain-Derived Neurotrophic Factor ; Clinical Coding ; Exons ; Freedom ; Genotype ; Humans ; Psychiatry ; Retrospective Studies ; Self Report ; Weights and Measures

OBJECTIVES: Many patients diagnosed with cancer suffer from various psychiatric symptoms such as depression, anxiety and insomnia as well as cancer itself. Patients with cancer are more vulnerable to possible adverse events of psychotropic medications. Although antidepressants are widely used among cancer patients, there is little information about tolerability of antidepressants. This study was conducted to compare tolerability of antidepressants in cancer patients referred for psychiatric consultation. METHODS: The participants were cancer patients who had been referred to psychiatrist for their psychiatric symptoms. We retrospectively analyzed the data of patients diagnosed with cancer from 9 general hospitals in Korea. The discontinuation rate for a 6 months period after treatment initiation for three antidepressants(Escitalopram, Mirtazapine, Paroxetine) were compared. RESULTS: Antidepressants were prescribed for 96.3% of subjects and Escitalopram 150(47.2%), Mirtazapine 92 (28.9%) and Paroxetine 76(23.9%) were prescribed frequently in order There were no significant differences in discontinuation rates among the three antidepressants during the 6 month period after initiation of pharmacotherapy. But there was a difference in discontinuation rates between inpatients versus outpatients(p<0.0001). CONCLUSIONS: In a naturalistic setting for the antidepressant treatment for cancer patients, it seems that there are no differences in discontinuation rates among these three antidepressants. It is therefore essential that such interactions are carefully considered when treating patients of antidepressants who already have cancer.
Antidepressive Agents ; Anxiety ; Citalopram ; Depression ; Hospitals, General ; Humans ; Inpatients ; Korea ; Mianserin ; Paroxetine ; Psychiatry ; Retrospective Studies ; Sleep Initiation and Maintenance Disorders

OBJECTIVE: With respect to the pharmacotherapy of social anxiety disorder (SAD), it has been suggested that treatment duration is an important factor that can significantly predict responses. The present study aimed to compare the treatment adherence of SAD patients who were taking either SSRIs or reversible inhibitors of MAO-A (moclobemide) by measuring treatment duration and all-cause discontinuation rates of pharmacotherapy in a natural clinical setting. METHODS: We retrospectively analysed the data of 172 patients diagnosed with SAD. Depending on their medication, we divided the patients into two groups, SSRI (n=54) or moclobemide (n=118). The expected number of all-cause discontinuation every 2 weeks after starting treatment was calculated by life table survival methods. A multi-variable Cox proportional hazard regression was used to analyze the potential influence of explanatory variables. RESULTS: Treatment duration was significantly longer in the SSRI group [46.41+/-56.96, median=12.0 (weeks)] than in the moclobemide group [25.53+/-34.74, median=12.0 (weeks), Z=2.352, p=0.019]. Overall, all-cause discontinuation rates were significantly lower with SSRIs (81%) than moclobemide (96%, chi2=4.532, p=0.033). CONCLUSION: The SSRI group had a longer treatment duration and lower all-cause discontinuation rate than moclobemide. Further, only the type of medication had a significant effect on all-cause discontinuation rates and therefore, we could predict better treatment adherence with the SSRIs in the treatment of SAD.
Anxiety ; Anxiety Disorders ; Humans ; Life Tables ; Moclobemide ; Monoamine Oxidase ; Retrospective Studies ; Serotonin Uptake Inhibitors

OBJECTIVES: This study was performed to analyze the factors that affect the decision to approve workers compensation claims for cerebrovascular and cardiovascular diseases and to analyze the worker characteristics. METHODS: Three hundred, sixty-nine cases were collected based on the workers compensation records of three Seoul and Incheon Regional centers of the Labor Welfare Corporation between 1998 and 1999. They contained the general characteristics, injury information and past medical histories. The x2-test and logistic regression were performed to investigate the factors affecting the approvals. Seventy-two survivors were surveyed by telephone for job stress. Job stress was surveyed in three parts: job demands, decision latitude and personal free time. RESULTS: Of the cases, 167 obtained approval from the Corporation; the others did not. Regardless of approval, 62% of all subjects had more than one of the cerebral and cardiovascular risk factors. Especially, 53.9% of subjects had hypertension. According to the logistic regression, the fatal cases had a higher approval rate (OR=26.4, CI=9.13-76.22). The cases with working condition change (OR=6.5, CI=3.45-12.07), accidents on worksite (OR=4.9, CI=2.39-10.07), female (OR=4.0, CI=1.21-13.3), accidents at night duty (OR=2.9, CI=.156-5.39), cases occurring on duty (OR=.25, CI=1.34-4.72) and cases without past disease history (OR=1.8, CI=1.02-3.36) also had higher approval rates. Telephone survey found that the approval rate increased with decreasing freedom of personal time schedule. However, the logistic regression revealed that job stress didnt affect the approvals. CONCLUSION: To prevent cerebrovascular and cardiovascular diseases, the most important aspect is to control hypertension which is the most common risk factor among the victims. Moreover, job stress and over working should be considered in the just approval of the workers compensation claims.
Appointments and Schedules ; Cardiovascular Diseases* ; Female ; Freedom ; Humans ; Hypertension ; Incheon ; Logistic Models ; Occupational Diseases* ; Risk Factors ; Seoul ; Survivors ; Telephone ; Workers' Compensation ; Workplace

BACKGROUND: A leukoreduction filter was recently developed in Korea to reduce various kinds of adverse transfusion reactions. The objective of this study was to propose a domestic evaluation system for leukoreduction filters and to apply this evaluation system to assess the newly developed leukoreduction filter. METHODS: We prepared packed red blood cells from 60 units of whole blood (400 mL) collected from 60 normal individuals and evaluated the efficacy of the newly developed filter (FINECELL, KOLON INDUSTRIES, Gumi, Korea) and a control filter (RCM1, Haemonetics, MA, USA). To verify the evaluation system, we assessed the filtration time, residual leukocyte count, RBC recovery, RBC hemolysis, hemoglobin concentration, and hematocrit using a control filter RCM1 and compared the results with those of an evaluation performed by the American Red Cross (ARC) in 2013. We then evaluated the efficacy of the test filter FINECELL using the methods established in this study and compared the results with those of the control filter RCM1. RESULTS: The results of the current study were similar to those of the ARC with the control filters. The test filters developed in Korea were not inferior to commonly used control filters regarding residual leukocyte count, RBC recovery, and RBC hemolysis at 35 days after filtration. All of the results in the evaluation satisfied the international standards. CONCLUSION: These results of this study showed that the efficacy of the newly developed domestic leukoreduction filter were satisfactory and will contribute to improvement of quality of blood components in Korea.
Erythrocytes ; Filtration ; Gyeongsangbuk-do ; Hematocrit ; Hemolysis ; Korea ; Leukocyte Count ; Methods* ; Red Cross ; Transfusion Reaction

OBJECTIVES: Occupational low back pain is a major cause of morbidity and the increases of medical and industrial costs. Efforts to control occupational low back pain have been largely unsuccessful, and further understanding of the risks including the psychological factors is needed. This retrospective study was designed to identify the effect of job stress on occupational low back pain among shipyard workers. METHODS: The study group consisted of 976 male workers who were working at a Korean shipyard. A structured self-reported questionnaire was used to assess the participants' physical work factors, job stress and general characteristics. Job stress was measured using Karasek's JCQ(Job Content Questionnaire). Occupational low back pain was identified according to the NIOSH symptom survey criteria. Physical work factors were assessed using the Quick Exposure Check. Since the work duration can affect the relationship of physical work factors and job stress to occupational low back pain, we analyzed this association by dividing workers into two groups by work duration: 1) all workers, and 2) less than 5 years. Cox's proportional hazard model was used to elucidate the relationship of job stress with occupational low back pain in these two groups. Data were analysed with SAS 8.1. RESULTS: In the all workers group, job demand, bending or twisting of the back, and carrying heavy materials were associated with an increased the risk of occupational low back pain. In the workers with less than 5 years work experience, people with high job demand were more likely to experience occupational low back pain than those with low job demand. CONCLUSIONS: These RESULTS suggest that job stress as well as physical work factors can raise the risk of occupational low back pain. Especially, in the workers with less than 5 years work duration, job stress played a more crucial effect on the occurrence of occupational low back pain than physical work factors did.
Humans ; Low Back Pain* ; Male ; Musculoskeletal Diseases ; National Institute for Occupational Safety and Health (U.S.) ; Proportional Hazards Models ; Psychology ; Questionnaires ; Retrospective Studies ; Survival Analysis*

BACKGROUND: This study was performed to investigate the prevalence of qnr genes in clinical isolates of Escherichia coli from Korea that produce extended-spectrum beta-lactamases (ESBLs). METHODS: During the period of May to June 2005, we collected clinical isolates of E. coli that were intermediate or resistant to ceftazidime and/or cefotaxime from 11 Korean hospitals. Antimicrobial susceptibility was determined by the disk diffusion and agar dilution methods. ESBL production was confirmed phenotypically by the double-disk synergy test. ESBL and qnr genes were searched for by PCR amplification, and the PCR products were then subjected to direct sequencing. RESULTS: Double-disk synergy tests were positive in 84.3% (118/140) of ceftazidime- and/or cefotaxime-nonsusceptible E. coli isolates. The most prevalent types of ESBL in E. coli isolates were CTX-M-14 (N=41) and CTX-M-15 (N=58). Other ESBLs were also identified, including CTX-M-3 (N=7), CTX-M-9 (N=8), CTX-M-12 (N=1), CTX-M-57 (N=1), SHV-2a (N=2), SHV-12 (N=17) and TEM-52 (N=4). The qnrA1 and qnrB4 genes were identified in 4 and 7 ESBL-producing isolates, respectively. CONCLUSIONS: CTX-M-type enzymes were the most common type of ESBL in E. coli isolates from Korea, and the qnr genes were not uncommon in ESBL-producing E. coli isolates. Dissemination of E. coli containing both ESBL and qnr genes could compromise the future usefulness of the expanded-spectrum antibiotics for the treatment of infections.
Disk Diffusion Antimicrobial Tests ; Escherichia coli/*enzymology/genetics/isolation & purification ; Escherichia coli Proteins/classification/*genetics ; Humans ; Inhibitory Concentration 50 ; Polymerase Chain Reaction ; beta-Lactamases/biosynthesis/genetics/*metabolism