Sleep disturbance and restless legs syndrome (RLS) among uremic patients is known to be high, but data on the prevalence, clinical significance, and causative factors are limited. A semiquantitative sleep and RLS questionnaire was distributed to 62 chronic hemodialysis(HD) patients. 74.5N had sleep complaints and frequent awakening was the most frequent specific sleep complaints followed by daytime sleepiness. Presence of diabetes mellitus(DM), RLS, depres- sion, high CRP level, low intact parathyroid hormone level, low subjective global assessment score, and short HD duration were associated with more sleep complaints. 58.3N had RLS and presence of DM, low serum albumin level were also associated with more severe RLS. But Kt/V, protein catabolic rate, hematocrit, plasma bicarbonate level, use of erythropoietin and sleep medication were not associated with sleep complaints and RLS. Sleep problems and RLS are comrnon in HD patients and seem to be associated with malnutrition. Presence of DM, de- pression, and RLS are likely to contribute the high prevalence of sleep disturbance.
Erythropoietin ; Hematocrit ; Humans ; Malnutrition ; Parathyroid Hormone ; Plasma ; Prevalence ; Renal Dialysis* ; Restless Legs Syndrome ; Serum Albumin ; Surveys and Questionnaires

Pulmonary arteriovenous fistula is a congenital vascular malformation in lung resulting from abnormal capillary development and the exact etiology is not well known but it may occur with or without hereditary hemorrhagic telangiectasia. Hereditary hemorrhagic telangiectasia (L-IHT) or Rendu-Osler-Weber disease is an autosomal dominant vascular disorder which associates epistaxis, mucocutaneous and visceral telangicetases, and recurrent hemorrhage with chronic anemia and visceral shuntings. Recently we experienced a case of the pulmonary arteriovenous fistula in a 23 year old woman with a family history of this disease, which was confirmed by pulmonary angiography.
Anemia ; Angiography ; Arteriovenous Fistula* ; Capillaries ; Epistaxis ; Female ; Hemorrhage ; Humans ; Lung ; Telangiectasia, Hereditary Hemorrhagic ; Vascular Malformations ; Young Adult

Purpose: To describe current cataract surgery practice patterns and trends among Korean ophthalmologists. Methods: A survey was conducted among members of the Korean Society of Cataract and Refractive Surgery in October 2020. Of the 998 questionnaires, 262 (26.3%) were received for analysis. Data were analyzed using descriptive statistics and compared with those of previous surveys. Results: The largest percentage of respondents (39%) had <5 years of practical experience, and 40% had >11 years of practical experience. The average, median, and mode monthly volumes of cataract surgeries performed by the Korean Society of Cataract and Refractive Surgery members were 31, 20, and 10 cases, respectively. Topical anesthesia was administered by 85% of the respondents. For intraocular lens (IOL) calculations, 96% of the respondents used optical biometry. The proportion of surgeons providing femtosecond laser-assisted cataract surgery increased significantly from 5% in 2018 to 29% in 2020. This increase was accompanied by an increase in the multifocal IOLs. Those who implant multifocal IOL for >10% of their cases increased from 16% (2018) to 29% (2020). Topical nonsteroidal anti-inflammatory drugs were prescribed postoperatively by 76% of the respondents. Most respondents (70%) prescribed these anti-inflammatory drugs for 4 weeks. Conclusions This survey provided a comprehensive update on current cataract surgery practice in the Republic of Korea. The results highlighted the increasing use of premium IOLs, femtosecond laser-assisted cataract surgery, optical biometry, and topical anesthesia to better meet the patients’ needs.

Purpose: To describe current cataract surgery practice patterns and trends among Korean ophthalmologists. Methods: A survey was conducted among members of the Korean Society of Cataract and Refractive Surgery in October 2020. Of the 998 questionnaires, 262 (26.3%) were received for analysis. Data were analyzed using descriptive statistics and compared with those of previous surveys. Results: The largest percentage of respondents (39%) had <5 years of practical experience, and 40% had >11 years of practical experience. The average, median, and mode monthly volumes of cataract surgeries performed by the Korean Society of Cataract and Refractive Surgery members were 31, 20, and 10 cases, respectively. Topical anesthesia was administered by 85% of the respondents. For intraocular lens (IOL) calculations, 96% of the respondents used optical biometry. The proportion of surgeons providing femtosecond laser-assisted cataract surgery increased significantly from 5% in 2018 to 29% in 2020. This increase was accompanied by an increase in the multifocal IOLs. Those who implant multifocal IOL for >10% of their cases increased from 16% (2018) to 29% (2020). Topical nonsteroidal anti-inflammatory drugs were prescribed postoperatively by 76% of the respondents. Most respondents (70%) prescribed these anti-inflammatory drugs for 4 weeks. Conclusions This survey provided a comprehensive update on current cataract surgery practice in the Republic of Korea. The results highlighted the increasing use of premium IOLs, femtosecond laser-assisted cataract surgery, optical biometry, and topical anesthesia to better meet the patients’ needs.

Emphysematous pyelonephritis is an uncommon, but life-threatening necrotizing inflammation of renal parenchyme and perinephric tissue by gas-forming organisms. This disease is encountered mainly in patients with uncontrolled diabetes mellitus and/or urinary tract obstruction etc. Though the pathogenesis of this diseases is still poorly understood, radiographic demonstration of gas shadow in renal parenchyme and peri-nephric tissue establishes the diagnosis of emphysematous pyelonephritis. The identification of this finding has been believed to consider incision and drainage or nephrectomy in addition to medical treatment, because of high mortality rate of this disease in spite of vigorous medical management. We report two cases of emphysematous pyelonephritis complicated in 62-year-old female and 48- year-old male patients with diabetes mellitus. Nephrectomies were not performed because of bilateral emphysematous pyelonephritis in one patient and of refusal of nephrectomy by the other patient. But patients were recovered completely on medical management.
Diabetes Mellitus ; Diagnosis ; Disulfiram ; Drainage ; Female ; Humans ; Inflammation ; Male ; Middle Aged ; Mortality ; Nephrectomy ; Pyelonephritis* ; Urinary Tract

BACKGROUND/AIMS: Signaling pathways via integrin-linked kinase (ILK) and beta-catenin are important in the initiation and progression of various malignant diseases. ILK modulates the transcription of beta-catenin and is implicated in cell migration and invasiveness. Recently, premalignant colon polyps were found to express ILK and beta-catenin. Therefore, we investigated the expression of ILK and beta-catenin in colon polyps according to the gross morphology and pathologic type. METHODS: Based on morphology, colon polyps (62) were classified as being a pedunculated polyp (Ip, 16), sessile polyp (Is, 22), or laterally spreading tumor (LST, 24). The colon polyps were classified pathologically as tubular adenomas (TAs, 47) and hyperplastic polyps (HPs, 15). The expression levels of ILK and beta-catenin in colon polyps and normal colon (6) were evaluated with immunohistochemistry. RESULTS: In normal colon, ILK was not expressed, and beta-catenin stained in the cell membrane only. Based on the gross morphology of the colon polyps, no significant difference was seen in the expression of ILK and beta-catenin (p>0.05). The expression of both ILK and beta-catenin in TAs was greater than that in HPs (p<0.01): the greater the dysplasia in TAs, the more both ILK and beta-catenin were expressed (p<0.05). The grade of expression of ILK was correlated with that of beta-catenin in colon polyps (p<0.01). CONCLUSIONS: The expression of ILK and beta-catenin did not differ according to the morphology of colon polyps, but was expressed more in TAs than in HPs, especially in severe dysplasia.
Adenoma ; beta Catenin ; Cell Membrane ; Cell Movement ; Colon ; Immunohistochemistry ; Phosphotransferases ; Polyps ; Protein-Serine-Threonine Kinases ; Proteins

BACKGROUND/AIMS: Bone marrow-derived cells (BMDC) contribute to tissue maintenance under many kinds of pathologic conditions. We carried out a study to see how BMDC play a role in the treatment of experimental murine colitis. METHODS: We divided the animals into 3 groups and treated them with 50% ethanol (control group), 2,4,6-trinitrobenzene sulfinic acid colitis (TNBS group), and TNBS+bone marrow transplant (BMT group). To induce colitis, TNBS (5.0 mg/mouse) dissolved in 50% ethanol was injected into anus weekly for two weeks. Bone marrow transplantations were performed using bone marrow of male transgenic mouse (donor) with green fluoresence protein (GFP) into female wild type mouse (recipient) three weeks before TNBS instillation. All animals were sacrificed, and colons were extracted one week after the last TNBS instillation. We measured microscopic scores of mucosal injury and investigated the GFP expression for bone marrow engraftment. The immunostaining of vimentin and alpha-smooth muscle actin (alpha-SMA) for myofibroblasts was performed. RESULTS: The score of mucosal injury in the TNBS group was much more severe than those in control, and reduced significantly by BMT (p<0.05). GFP-positive cells were almost deposited in pericryptal niche of BMT group but not at all in both control and TNBS group. Most of myofibroblasts stained with both vimentin and SMA also infiltrated into pericryptal niche. But, the number of myofibroblasts stained with vimentin and SMA in both control and TNBS group was smaller than that in BMT group. CONCLUSIONS: BMDC deposited on pericryptal niche might have a significant role in repairing acute experimental murine colitis.
Actins/metabolism ; Acute Disease ; Animals ; *Bone Marrow Transplantation ; Colitis/chemically induced/pathology/*surgery ; Female ; Fibroblasts/cytology ; Intestinal Mucosa/cytology ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Transgenic ; Transplantation, Homologous ; Trinitrobenzenesulfonic Acid/*toxicity ; Vimentin/metabolism

PURPOSE: Vascular endothelial growth factor (VEGF) levels in malignant ascites have high diagnostic value for their discrimination from asictes of non-malignant origin. However, there have been no reports on the comparison of VEGF levels between malignant ascites of chemonaive and chemotreated patients. MATERIALS AND METHODS: VEGF levels were measured in 44 ascites patients (cirrhosis ascites, 10; chemonaive patients, 21; chemotreated patients, 13) and compared to the level of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9). The diagnostic parameters of sensitivity, specificity, and correlation among 3 markers were evaluated. RESULTS: VEGF levels in malignant ascites of chemonaive and chemotreated patients were significantly higher than those in cirrhotic ascites (p<0.05). VEGF levels in ascites of chemonaive patients were significantly higher than those in chemotreated patients (p<0.05). A cutoff value of 10.4pg/mL was calculated using receiver operating characteristic curves (ROCs) for VEGF in chemotreated and chemonaive patients, which gave sensitivities of 75.0% and 53.8% and specificities of 69.6% and 47.1%, respectively. Positive correlations were observed between VEGF and CEA (r=0.353, p<0.05) as well as between VEGF and CA19-9 (r=0.367, p<0.05) in ascites. CONCLUSION: VEGF levels could be a useful tumor marker for malignant ascites, but its value should carefully be interpreted because of lesser reliability in chemotreated ones.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Ascites/*drug therapy/*metabolism/pathology ; CA-19-9 Antigen/metabolism ; Carcinoembryonic Antigen/metabolism ; Child ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Tumor Markers, Biological/metabolism ; Vascular Endothelial Growth Factor A/*metabolism