PURPOSE: Objectives of this study were to identify factors influencing depression in patients with chronic renal failure according to patient characteristics and to provide basic data to develop nursing interventions for depression in these patients. METHODS: This descriptive correlative study was conducted using structured questionnaires with 114 patients diagnosed with chronic renal failure. Data were analyzed using t-tests, ANOVA, Pearson's correlation and multiple regression analysis with SPSS/WIN 18.0. RESULTS: 1) Level of depression was different according to the history of smoking (p<.001), past health history (p=.001), only drugs as therapy, peritoneal dialysis, hemodialysis (p=.028), and perceived health status (p<.001); 2) Significant correlations were found between depression, stress, value of life and social support; 3) multiple regression analysis showed that stress (beta=.24, t=3.41, p=.001), value of life (beta=-.46, t=-6.37, p<.001) and social support (beta=-.19, t=-2.79, p=.006) in that order contributed to depression and explained 56.4% of variance in depression. CONCLUSION: Findings from this study indicate that health professionals should provide proper management for depression for patients with chronic renal failure, as well as factors influencing depression, including stress, value of life and social support. There is also a need to implement stress management and self-help group programs for these patients.
Depression* ; Health Occupations ; Humans ; Kidney Failure, Chronic* ; Nursing ; Peritoneal Dialysis ; Surveys and Questionnaires ; Renal Dialysis ; Self-Help Groups ; Smoke ; Smoking ; Value of Life

Purpose: This study aimed to examine the differences in scores of the Attitude to Patient Safety Questionnaire (APSQ) by medical students before and after the outbreak of COVID-19. Methods: In total, 97 and 118 medical students completed patient safety courses at Yonsei University Wonju College of Medicine in 2019 and 2020, respectively. In 2019, the course was conducted using traditional learning in the classroom, whereas, in 2020, most of the classes were conducted using non-face-to-face learning methods. Results: In 2019 and 2020, 49 and 53 students responded to the APSQ. Only one item “Patients are not really aware of how safe their care is” had a lower score in 2020 than in 2019. Conclusion Although the total APSQ score did not differ between 2019 and 2020, the students in 2020 might have a poor understanding of the role of patients in medical errors.

Purpose: This study aimed to examine the differences in scores of the Attitude to Patient Safety Questionnaire (APSQ) by medical students before and after the outbreak of COVID-19. Methods: In total, 97 and 118 medical students completed patient safety courses at Yonsei University Wonju College of Medicine in 2019 and 2020, respectively. In 2019, the course was conducted using traditional learning in the classroom, whereas, in 2020, most of the classes were conducted using non-face-to-face learning methods. Results: In 2019 and 2020, 49 and 53 students responded to the APSQ. Only one item “Patients are not really aware of how safe their care is” had a lower score in 2020 than in 2019. Conclusion Although the total APSQ score did not differ between 2019 and 2020, the students in 2020 might have a poor understanding of the role of patients in medical errors.

Due to the complex structure and function of the kidneys, the mechanism of kidney disease is unclear. In particular, transcriptomics approaches at the bulk level are unable to differentiate primary autonomous responses, which lead to disease development, from secondary cell non-autonomous responses. Single-cell analysis techniques can overcome the limitations inherent in the measurement of heterogeneous cell populations and clarify the central issues in kidney biology and disease pathogenesis. Single-cell sequencing helps in identifying disease-related biomarkers and pathways, stratifying patients, and deciding on appropriate treatment methods. Here we review a variety of single-cell analysis techniques and single-cell transcriptomics studies performed in the field of nephrology. Moreover, we discuss the future prospects of single-cell analysis-based precision medicine in nephrology.

Due to the complex structure and function of the kidneys, the mechanism of kidney disease is unclear. In particular, transcriptomics approaches at the bulk level are unable to differentiate primary autonomous responses, which lead to disease development, from secondary cell non-autonomous responses. Single-cell analysis techniques can overcome the limitations inherent in the measurement of heterogeneous cell populations and clarify the central issues in kidney biology and disease pathogenesis. Single-cell sequencing helps in identifying disease-related biomarkers and pathways, stratifying patients, and deciding on appropriate treatment methods. Here we review a variety of single-cell analysis techniques and single-cell transcriptomics studies performed in the field of nephrology. Moreover, we discuss the future prospects of single-cell analysis-based precision medicine in nephrology.

Objectives: This study investigated the 24-hour ambulatory blood pressure monitoring (ABPM) and Holter parameters for evaluating their prognostic significance of cardiovascular events including stroke in population without atrial fibrillation (AF). Methods: Among 3,199 patients that underwent ABPM, 335 who also underwent Holter recordings were selected in a tertiary hospital. Seventeen patients who had been documented with AF on Holter monitoring or diagnosed with AF were excluded, and finally 318 patients were analyzed. The association between cardiovascular events and ABPM/Holter parameters was analyzed by a logistic regression model, and the risk factors were estimated by a Cox hazard model. Age, sex, and histories of cardiovascular disease were adjusted by a multivariable analysis, and the cut-off values were suggested by a Kaplan-Meyer analysis. Results: During the total follow-up (28.5±1.7 months), 13 (4.1%) stroke, 6 (1.9%) heart failure, and 12 (3.8%) acute coronary syndrome incidences were observed. In the univariate analysis of the ABPM parameters, an increment in the night systolic BP (hazard ratio=1.034, P=0.020) and night diastolic BP (hazard ratio=1.063, P=0.031) significantly elevated the risk of a stroke occurrence. According to the Kaplan-Meyer analysis, there was a significant difference in the stroke incidence between the groups divided by a cut-off value of the night systolic BP of 120 mmHg (P=0.014) and night diastolic BP of 75 mmHg (P=0.023). Conclusion In a population without AF, the nocturnal BP was a significant predictor of a stroke incidence. At this point, the cut-off value of mean 120/75 mmHg in 24 ABPM was advisable.

BACKGROUND: Arginine vasopressin (AVP) is widely used as a vasopressor agent. Some recent studies have suggested that AVP may exert an immunomodulatory effect. However, the mechanism about the anti-inflammatory effect of AVP is not well known. We investigated the effect of AVP on the ihibitor of kappa B (IkappaBalpha)/nuclear factor-kappa B (NF-kappaB) pathway in RAW 264.7 cells. METHODS: Cultured RAW 264.7 cells were pretreated with AVP and stimulated with lipopolysaccharide (LPS). To evaluate the effect of AVP on inflammatory cytokines, the concentration of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) were assessed by an enzyme-linked immunosorbent assay technique. The expression of IkappaBalpha and nuclear translocation of NF-kappaB p65 were measured by Western blotting, and IkappaB kinase (IKK) activity was analyzed by an in vitro immune complex kinase assay. To confirm the AVP effect on IkappaBalpha/NF-kappaB cascade and via V2 receptor, we added tolvaptan (V2 receptor antagonist) after AVP pretreatment. RESULTS: The increase of IL-6 and TNF-alpha in LPS-stimulated RAW 264.7 cells was suppressed by a treatment with AVP. Pretreatment of AVP inhibited increasing of IKK activity and IkappaBalpha degradation induced by LPS in RAW 264.7 cells. Furthermore, LPS induced and NF-kappaB transcription was inhibited by AVP pretreatment. The observed changes in IKK activity, IkappaBalpha degradation and NF-kappaB transcription by AVP was abolished by tolvaptan treatment. CONCLUSIONS: Our results suggest that AVP showed anti-inflammatory effect on LPS-induced IkappaBalpha/NF-kappaB cascade in mouse macrophages via V2 receptors.
Animals ; Antigen-Antibody Complex ; Arginine Vasopressin ; Blotting, Western ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; I-kappa B Kinase ; Interleukin-6 ; Macrophages ; Mice ; NF-kappa B ; Phosphotransferases ; Receptors, Vasopressin ; Tumor Necrosis Factor-alpha

Sciatic nerve can be injured by various mechanism such as compression, traction during surgery, and direct trauma. This case reports a sciatic neuropathy caused by compression due to hematoma occurring after intramuscular injection in the gluteus medius muscle far from the nerve. In order to avoid occurrence of sciatic neuropathy after buttock injection, the injection was made in the upper outer quadrant of the buttock, but sciatic neuropathy occurred. Sciatic neuropathy can be confused with lumbar radiculopathy, so differential diagnosis is important.

BACKGROUND/AIMS: Fibromyalgia (FM) is a common rheumatologic disease characterized by chronic widespread pain, along with various clinical manifestations including atypical autoimmune characteristics. Despite its high prevalence, there remain no approved laboratory tests to identify specific manifestations of FM, or to rule out FM from other rheumatic diseases. Anti-dense fine speckled 70 (anti-DFS70) antibodies were initially identified as a form of anti-nuclear antibodies in a patient with interstitial cystitis. Anti-DFS70 antibodies are found in ≤ 10% of healthy individuals, but have suggestive negative association with autoimmune diseases; however, the clinical significance of these autoantibodies in FM patients remains poorly understood. METHODS: We examined 39 patients with FM, along with 17 patients with systemic lupus erythematosus (SLE), and 19 healthy individuals (HI). Patients were compared based on physical measurements, disease duration, tender point counts, FM Impact Questionnaire (FIQ) scores, visual analog scale (VAS) for pain, somatic symptoms, and anti-DFS70 antibodies. RESULTS: Levels of anti-DFS70 antibodies were significantly higher in the FM and HI groups than in those with SLE. Both anti-DFS70 antibodies and VAS scores were positively correlated with FM. Within the FM group, patients with arthralgia had higher anti-DFS70 antibody values compared to those without arthralgia (p = 0.024); antibody levels were also higher in patients with sleep disturbances relative to those without sleep issues (p = 0.024). In contrast, there were no correlations between anti-DFS70 antibodies and age, body mass index, disease duration, tender point counts, FIQ, short-form health survey results, or other clinical manifestations. CONCLUSIONS Anti-DFS70 antibodies may represent a useful biomarker for differentiating between FM and other autoimmune diseases. The levels of anti-DFS70 antibodies were also significantly higher among patients with arthralgia and sleep disturbances. Further investigations are necessary to evaluate the relationships between anti-DFS70 antibodies and other cytokines as a predictive marker for pain.

Sciatic nerve can be injured by various mechanism such as compression, traction during surgery, and direct trauma. This case reports a sciatic neuropathy caused by compression due to hematoma occurring after intramuscular injection in the gluteus medius muscle far from the nerve. In order to avoid occurrence of sciatic neuropathy after buttock injection, the injection was made in the upper outer quadrant of the buttock, but sciatic neuropathy occurred. Sciatic neuropathy can be confused with lumbar radiculopathy, so differential diagnosis is important.