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Context.—: New-generation antiseizure medications (ASMs) are increasingly prescribed, and therapeutic drug monitoring (TDM) has been proposed to improve clinical outcome. However, clinical TDM data on new-generation ASMs are scarce., Objective.—: To develop and validate a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for therapeutic drug monitoring (TDM) of 6 new-generation ASMs in serum and analyze the clinical TDM data from a large cohort of Korean patients with epilepsy., Design.—: Stable isotope-labeled internal standards were added to protein precipitations of serum. One microliter of sample was separated on an Agilent Poroshell EC-C18 column, and lacosamide, perampanel, gabapentin, pregabalin, vigabatrin, and rufinamide were simultaneously quantified by Agilent 6460 triple-quad mass spectrometer in multiple-reaction monitoring mode. Linearity, sensitivity, precision, accuracy, specificity, carryover, extraction recovery, and matrix effect were evaluated. TDM data of 458 samples from 363 Korean epilepsy patients were analyzed., Results.—: The method was linear with limit of detection less than 0.05 μg/mL in all analytes. Intraassay and interassay imprecisions were less than 5% coefficient of variation. Accuracy was within ±15% bias. Extraction recovery ranged from 85.9% to 98.8%. A total of 88% (403 of 458) were on polypharmacy, with 29% (118 of 403) using concomitant enzyme inducers. Only 38% (175 of 458) of the concentrations were therapeutic, with 53% (244 of 458) being subtherapeutic. Drug concentration and concentration-to-dose ratio were highly variable among individuals for all 6 ASMs., Conclusions.—: A simple and rapid LC-MS/MS method for TDM of 6 ASMs was developed and successfully applied to clinical practice. These large-scale TDM data could help establish an effective monitoring strategy for these drugs., Competing Interests: The authors have no relevant financial interest in the products or companies described in this article., (© 2025 College of American Pathologists.)

Background: Sleep technicians are at high risk of shift work sleep disorders. We therefore aimed to identify the optimal shift system for sleep technicians., Methods: We performed a nationwide survey of the work schedules, health and quality of life of sleep technicians using e-mail questionnaires including the Insomnia Severity Index (ISI), Epworth Sleep Scale (ESS), Functional Outcomes of Sleep Questionnaire-10 (FOSQ-10), Short Form-12 Health Survey (SF-12), and Hospital Anxiety and Depression Scale (HADS) in Korea. A multivariate general linear model was used to assess the effect of shift schedules on health and quality of life., Results: Fifty-four technicians from 30 sleep laboratories participated. Their work schedules were classified as fixed night (F) (n = 18), slow rotation alternating from a night-only to a day-only schedule with a 3-months to one-year interval (S) (n = 20), rapid rotation within a week (R) (n = 5), night once a week (D+) (n = 5) and day (D) (n = 6). The adjusted ISI and HADS-anxiety scores were higher in F, S, and R than D and D+. Among night shift-dominant schedules, a less favorable profile was observed for R followed by F, and S regarding the ISI, FOSQ-10, mental SF-12 and HADS-depression. The physical SF-12 was lower in the order of R, S and F. The HADS-anxiety score was higher in the order of F, R and S., Conclusions: The S system appears to have the least negative effect on health and quality of life among night shift-dominant systems. The development of consensus guidelines for scheduling shifts in sleep laboratories is urged., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Objectives: The objectives of this study were to investigate the relationship between a low libido and objective sleep parameters as well as mood disturbances in patients with obstructive sleep apnea syndrome (OSA)., Methods: We enrolled 436 untreated patients who were newly diagnosed with OSA (all male, mean age 42.8 years). Patients completed the Symptom checklist-90-Revised (SCL-90-R), Epworth Sleepiness Scale (ESS), Beck Depression Inventory-II (BDI), and Beck Anxiety Inventory (BAI). Patients were divided into low-libido and normal-libido groups according to their response to the statement "Loss of sexual interest or pleasure" on the SCL-90-R., Results: Approximately 23% of patients reported a low libido. Patients with a low libido were older (47.5 ± 9.0 vs. 41.4 ± 11.1 years; p < 0.001), had more nocturia (33.3% vs. 16.6%; p < 0.001), higher BDI (9.0 (5.0-14.0) vs. 5.0 (2.0-9.0); p < 0.001) and BAI score (11.0 (6.3-16.8) vs. 5.0 (2.0-10.0); p < 0.001). These patients had a lower non-REM sleep stage 3 (N3) % (0.1 (0-4.0) vs. 2.3 (0.1-7.9); p < 0.001). Multivariate analysis revealed that older age and higher BDI score were independent factors associated with a low libido., Conclusions: Men with untreated OSA suffered from a low libido. Older age and depressed mood were the most important factors of low libido in middle-aged men with OSA., (Copyright © 2018 Elsevier B.V. All rights reserved.)

There have been a number of studies about correlations between HLA genotypes in various ethnic groups and occurrence of various cutaneous adverse drug reactions, ranging in intensity from mild to severe, caused by antiepileptic drugs (AEDs). This is the first report analyzing the HLA genotypes of 9 Korean patients with skin rashes induced by various AEDs. The AEDs that induced skin rash were lamotrigine (n=3), carbamazepine (n=3), oxcarbazepine (n=1), phenobarbital (n=1), and phenytoin (n=1). None of the patients' HLA genotypes was either HLA-B*1502 or HLA-A*3101. Based on these series of cases, AED-induced skin rash can occur independently of HLA-B*1502 or HLA-A*3101 genotypes in the Korean patients.