PURPOSE: This study was conducted to identify the factors contributing to sleep disorders in patients on hemodialysis. Methods: A descriptive correlational study design was used. The participants were 135 patients on hemodialysis in hemodialysis clinics. Data were collected from March to May 2007 using structured questionnaires and hematologic sample. Stepwise multiple regression was used to identify factors influencing sleep disorders among the demographic-clinical factors, depression and fatigue. RESULTS: About 69% of the patients had a sleep disorders. There were significant differences in sleep disorders according to marital status, caregiver, religion, economic level, insurance, erythropoietin, somnifacient, and antihypertensive agents. But there were no differences according to age, gender, dialysis period, or antidepressants. Their sleep disorders had significant correlations with depression, and fatigue, and a significant negative correlation with Protein, Albumin, Phosphate and BUN. But there were no correlations with hematocrit, hemoglobin, creatinine, sodium, potassium, or calcium. Depression and fatigue were factors influencing sleep disorders. They accounted for 43.8% of the variance in sleep disorders in these patients. CONCLUSION: Findings provide an understanding of sleep disorders and the factors that are an influence in patients on hemodialysis. To promote sleep in these patients, nursing interventions to manage depression and fatigue are needed.
Antidepressive Agents ; Antihypertensive Agents ; Calcium ; Caregivers ; Creatinine ; Depression ; Dialysis ; Erythropoietin ; Fatigue ; Hematocrit ; Hemoglobins ; Humans ; Insurance ; Marital Status ; Potassium ; Surveys and Questionnaires ; Renal Dialysis ; Sleep Wake Disorders ; Sodium

No abstract available.
Gallbladder Neoplasms ; Gallbladder ; Liver Abscess ; Liver

Objectives: ：This study looked at the effects of chronic IPV on suicide ideation among married women in the country. Methods: ：This study used data from the five-year-old Korea Welfare Panel and analyzed using questions about verbal and physical violence, depression and suicide ideation that were investigated every year. Age, education, and economic levels, drinking, religion, chronic disease, satisfaction with family relationship, satisfaction with social relationship, were included as variables. Results: ：The five-year cumulative score of verbal violence had a statistically significant effect on the depres-sive symptom, and the relative risk was 1.180. The relative risk of five-year-old cumulative score of verbal violence in suicidal ideation was 1.276, and it was also significant even if they exclude the effects of depressive symptom.On the other hand, the five-year cumulative score of physical violence was found to have no significant impact on suicide ideation if they excluded the effects of depressive symptom. Conclusions ：Unlike previous studies, this study found that chronic verbal IPVs increase suicide ideation,even though they do not contain effects of depression. Such findings suggest that intervention in IPV in married women may help reduce the nation's suicide rate.

Objectives: ：This study looked at the effects of chronic IPV on suicide ideation among married women in the country. Methods: ：This study used data from the five-year-old Korea Welfare Panel and analyzed using questions about verbal and physical violence, depression and suicide ideation that were investigated every year. Age, education, and economic levels, drinking, religion, chronic disease, satisfaction with family relationship, satisfaction with social relationship, were included as variables. Results: ：The five-year cumulative score of verbal violence had a statistically significant effect on the depres-sive symptom, and the relative risk was 1.180. The relative risk of five-year-old cumulative score of verbal violence in suicidal ideation was 1.276, and it was also significant even if they exclude the effects of depressive symptom.On the other hand, the five-year cumulative score of physical violence was found to have no significant impact on suicide ideation if they excluded the effects of depressive symptom. Conclusions ：Unlike previous studies, this study found that chronic verbal IPVs increase suicide ideation,even though they do not contain effects of depression. Such findings suggest that intervention in IPV in married women may help reduce the nation's suicide rate.

Genomic analysis indicated that the genome of Drosophila melanogaster contains more than 80 cytochrome P450 genes. To date, the enzymatic activity of these P450s has not been extensively studied. Here, the biochemical properties of CYP6A8 were characterized. CYP6A8 was cloned into the pCW vector, and its recombinant enzyme was expressed in Escherichia coli and purified using Ni2+ -nitrilotriacetate affinity chromatography. Its expression level was approximately 130 nmol per liter of culture. Purified CYP6A8 exhibited a low-spin state in the absolute spectra of the ferric forms. Binding titration analysis indicated that lauric acid and capric acid produced type І spectral changes, with Kd values 28 ± 4 and 144 ± 20 μM, respectively. Ultra-performance liquid chromatography–mass spectrometry analysis showed that the oxidation reaction of lauric acid produced (ω-1)-hydroxylated lauric acid as a major product and ω-hydroxy-lauric acid as a minor product. Steady-state kinetic analysis of lauric acid hydroxylation yielded a kcat value of 0.038 ± 0.002 min –1 and a Km value of 10 ± 2 μM. In addition, capric acid hydroxylation of CYP6A8 yielded kinetic parameters with a kcat value of 0.135 ± 0.007 min –1 and a Km value of 21 ± 4 μM. Because of the importance of various lipids as carbon sources, the metabolic analysis of fatty acids using CYP6A8 in this study can provide an understanding of the biochemical roles of P450 enzymes in many insects, including Drosophila melanogaster.

No abstract available.
Child ; Humans ; Neural Tube Defects

Head and neck cutaneous metastasis of advanced gastric cancer is uncommon, and scalp metastasis is particularly rare. We present the case of a 60-year-old man who was diagnosed with cutaneous metastasis on the scalp originating from advanced gastric cancer. The patient was referred to the plastic surgery department for a scalp mass near the hairline. He had been diagnosed with advanced gastric cancer and undergone total gastrectomy and Roux esophagojejunostomy 3 years previously. The differential diagnosis for a single flesh-colored nodule on the scalp included benign tumors such as epidermal cyst or lipoma; therefore, the patient underwent excision and biopsy. In the operative field, the mass was found to be located in the frontalis muscle. The biopsy result showed that the mass was a metastatic lesion of advanced gastric cancer. Whole-body computed tomography revealed a gastric tumor with blood vessel infiltration, peritoneal carcinomatosis, liver metastasis, and multiple disseminated subcutaneous metastases. Although scalp metastasis originating from an internal organ is extremely rare, plastic surgeons should always consider a metastatic lesion in the differential diagnosis if a patient with a scalp lesion has a history of malignant cancer.

A 46-year-old female presented a mass on her right lower leg where she had a burn injury due to moxibustion 10 years ago. Physical examination revealed a 3 cm sized firm nodule with tenderness. Plain radiograph was performed and it revealed well-defined calcifications. According to the history of moxibustion burn injury and the result of plain radiograph, dystrophic calcinosis cutis caused by burn injury was suspected. The patient underwent excisional biopsy using pre-,intra-, and postoperative ultrasonography (USG). There was no sign of recurrence. Herein, we report a case of a 46-year-old healthy woman who presented with single hard nodule on the right lower leg. Our case is worthwhile in two respects. First, It is first case report of dystrophic calcinosis cutis due to moxibustion burn injury. In east asian culture, moxibustion is a commonly conducted procedure and it often induces burn injury. Second, USG was used pre-, intra-, and post-operatively to assess the shape, location, and depth of the calcinosis cutis and to determine the surgical margin.

Purpose: The aim of this study was to evaluate the diagnostic image quality of low dose abdominal digital radiography processed with a new post-processing technique. Materials and Methods: Abdominal radiographs from phantom pilot studies were post-processed by the novel and conventional post-processing methods of our institution; the proper dose for the subsequent patient study of 49 subjects was determined by comparing image quality of the two preceding studies. Two radiographs of each patient were taken using the conventional and derived dose protocols with the proposed post-processing method. The image details and quality were evaluated by two radiologists. Results: The radiation dose for the patient study was derived to be half of the conventional method. Overall half-dose image quality with the proposed method was significantly higher than that of the conventional method (p < 0.05) with moderate inter-rater agreement (κ = 0.60, 0.47). Conclusion By applying the new post-processing technique, half-dose abdominal digital radiography can demonstrate feasible image quality compared to the full-dose images.

Plasma exchange performed with the aid of acid-citrate-dextrose formula A (ACD-A) is generally regarded as safe. However, unfractionated heparin (UFH) can serve as an anticoagulant for patients experiencing serious side effects such as anaphylaxis. No guidelines have currently been defined for the stand-alone UFH dosing during plasma exchange. We describe here two patients who developed anaphylaxis to ACD-A during plasma exchange, and we successfully used UFH as a standalone anticoagulant. The first patient was a 55-year-old man who required plasma exchange before ABO-incompatible kidney transplantation. During plasma exchange, he developed an allergic reaction. Thereafter, UFH was used as a standalone anticoagulant during four sessions of plasma exchange; the UFH (5,000 units) was added to a 500 mL normal saline bag and the UFH:whole blood ratio was maintained at 1:28. The second patient was an 80-year-old woman with steroid pulse-resistant neuromyelitis optica. She developed an allergic reaction during the first session of plasma exchange. The patient subsequently underwent five successful sessions of plasma exchange using UFH as a standalone anticoagulant. These findings may be useful when establishing a protocol for UFH as a standalone anticoagulant during plasma exchange in patients who develop an allergic reaction to citrate.