Background: Despite the critical importance of sleep medicine within neurology, notable gaps in education and clinical practice persist among neurologists. This study aims to explore the extent of involvement and the challenges faced by Korean neurologists in sleep medicine, focusing on awareness of polysomnography training program, the operation of sleep study facilities, and educational exposure. Methods: An online survey collected responses from 233 neurologists, focusing on their demographics, knowledge of and involvement in sleep medicine, operation of sleep study facilities, and participation in residency training. Results: The findings indicated that 84.9% of neurologists were aware of polysomnography training program, primarily through professional societies. Nonetheless, 15.1% reported unfamiliarity with these initiatives, with 72.7% of this subgroup expressing interest in sleep medicine yet lacking access to information. In terms of clinical practice, 74 neurologists operated sleep study facilities, with 63% intending to expand. Key operational challenges included staff management, maintaining patient volumes, and inadequate institutional support. Among respondents from teaching hospitals, only 36 out of 114 reported active resident involvement in sleep study interpretations, predominantly hindered by excessive workloads and insufficient staffing. Conclusions A significant number of neurologists have an interest in sleep medicine; however, substantial challenges impede effective education and clinical practice. These results underscore the need for improved educational resources and institutional support to enhance the growth and effectiveness of sleep medicine practices among neurologists.

Purpose: To examine the factors impacting cone contrast sensitivity in Koreans aged > 60 years who are scheduled for cataract surgery and do not have congenital color vision deficiencies. Methods: The ColorDx Cone contrast test HD® (CCT-HD; Konan Medical, Inc., CA, USA) was administered to 33 Korean individuals (33 eyes) to evaluate CCT scores before and after cataract surgery, as well as changes in CCT scores according to the degree of progression by cataract type. Correlations between CCT scores and age, best corrected visual acuity (BCVA), regional retinal thickness, and length of the photoreceptor outer segment (PROS) at the fovea were analyzed in pseudophakic eyes. Results: Average scores for short-, medium-, and long-wavelength cone contrast sensitivity tests (S-CCT, M-CCT, and L-CCT, respectively) improved after surgery (p = 0.010, p = 0.001, and p = 0.028, respectively). Comparing CCT score changes before and after surgery by cataract progression, higher cataract grades were associated with greater CCT score changes, though the differences were not statistically significant (p > 0.05). In pseudophakic eyes, S-CCT scores negatively correlated with age (p = 0.017). No significant correlations were found between S-CCT, M-CCT, and L-CCT scores and BCVA, whereas S-CCT, M-CCT, and L-CCT scores positively correlated with PROS at the fovea (p < 0.001). Conclusions Cone contrast sensitivity in individuals aged > 60 years is influenced by age and cataract status and may serve as a valuable indicator of visual function in clinical research.

Background: Despite the critical importance of sleep medicine within neurology, notable gaps in education and clinical practice persist among neurologists. This study aims to explore the extent of involvement and the challenges faced by Korean neurologists in sleep medicine, focusing on awareness of polysomnography training program, the operation of sleep study facilities, and educational exposure. Methods: An online survey collected responses from 233 neurologists, focusing on their demographics, knowledge of and involvement in sleep medicine, operation of sleep study facilities, and participation in residency training. Results: The findings indicated that 84.9% of neurologists were aware of polysomnography training program, primarily through professional societies. Nonetheless, 15.1% reported unfamiliarity with these initiatives, with 72.7% of this subgroup expressing interest in sleep medicine yet lacking access to information. In terms of clinical practice, 74 neurologists operated sleep study facilities, with 63% intending to expand. Key operational challenges included staff management, maintaining patient volumes, and inadequate institutional support. Among respondents from teaching hospitals, only 36 out of 114 reported active resident involvement in sleep study interpretations, predominantly hindered by excessive workloads and insufficient staffing. Conclusions A significant number of neurologists have an interest in sleep medicine; however, substantial challenges impede effective education and clinical practice. These results underscore the need for improved educational resources and institutional support to enhance the growth and effectiveness of sleep medicine practices among neurologists.

Purpose: To examine the factors impacting cone contrast sensitivity in Koreans aged > 60 years who are scheduled for cataract surgery and do not have congenital color vision deficiencies. Methods: The ColorDx Cone contrast test HD® (CCT-HD; Konan Medical, Inc., CA, USA) was administered to 33 Korean individuals (33 eyes) to evaluate CCT scores before and after cataract surgery, as well as changes in CCT scores according to the degree of progression by cataract type. Correlations between CCT scores and age, best corrected visual acuity (BCVA), regional retinal thickness, and length of the photoreceptor outer segment (PROS) at the fovea were analyzed in pseudophakic eyes. Results: Average scores for short-, medium-, and long-wavelength cone contrast sensitivity tests (S-CCT, M-CCT, and L-CCT, respectively) improved after surgery (p = 0.010, p = 0.001, and p = 0.028, respectively). Comparing CCT score changes before and after surgery by cataract progression, higher cataract grades were associated with greater CCT score changes, though the differences were not statistically significant (p > 0.05). In pseudophakic eyes, S-CCT scores negatively correlated with age (p = 0.017). No significant correlations were found between S-CCT, M-CCT, and L-CCT scores and BCVA, whereas S-CCT, M-CCT, and L-CCT scores positively correlated with PROS at the fovea (p < 0.001). Conclusions Cone contrast sensitivity in individuals aged > 60 years is influenced by age and cataract status and may serve as a valuable indicator of visual function in clinical research.

Background: Despite the critical importance of sleep medicine within neurology, notable gaps in education and clinical practice persist among neurologists. This study aims to explore the extent of involvement and the challenges faced by Korean neurologists in sleep medicine, focusing on awareness of polysomnography training program, the operation of sleep study facilities, and educational exposure. Methods: An online survey collected responses from 233 neurologists, focusing on their demographics, knowledge of and involvement in sleep medicine, operation of sleep study facilities, and participation in residency training. Results: The findings indicated that 84.9% of neurologists were aware of polysomnography training program, primarily through professional societies. Nonetheless, 15.1% reported unfamiliarity with these initiatives, with 72.7% of this subgroup expressing interest in sleep medicine yet lacking access to information. In terms of clinical practice, 74 neurologists operated sleep study facilities, with 63% intending to expand. Key operational challenges included staff management, maintaining patient volumes, and inadequate institutional support. Among respondents from teaching hospitals, only 36 out of 114 reported active resident involvement in sleep study interpretations, predominantly hindered by excessive workloads and insufficient staffing. Conclusions A significant number of neurologists have an interest in sleep medicine; however, substantial challenges impede effective education and clinical practice. These results underscore the need for improved educational resources and institutional support to enhance the growth and effectiveness of sleep medicine practices among neurologists.

Purpose: To examine the factors impacting cone contrast sensitivity in Koreans aged > 60 years who are scheduled for cataract surgery and do not have congenital color vision deficiencies. Methods: The ColorDx Cone contrast test HD® (CCT-HD; Konan Medical, Inc., CA, USA) was administered to 33 Korean individuals (33 eyes) to evaluate CCT scores before and after cataract surgery, as well as changes in CCT scores according to the degree of progression by cataract type. Correlations between CCT scores and age, best corrected visual acuity (BCVA), regional retinal thickness, and length of the photoreceptor outer segment (PROS) at the fovea were analyzed in pseudophakic eyes. Results: Average scores for short-, medium-, and long-wavelength cone contrast sensitivity tests (S-CCT, M-CCT, and L-CCT, respectively) improved after surgery (p = 0.010, p = 0.001, and p = 0.028, respectively). Comparing CCT score changes before and after surgery by cataract progression, higher cataract grades were associated with greater CCT score changes, though the differences were not statistically significant (p > 0.05). In pseudophakic eyes, S-CCT scores negatively correlated with age (p = 0.017). No significant correlations were found between S-CCT, M-CCT, and L-CCT scores and BCVA, whereas S-CCT, M-CCT, and L-CCT scores positively correlated with PROS at the fovea (p < 0.001). Conclusions Cone contrast sensitivity in individuals aged > 60 years is influenced by age and cataract status and may serve as a valuable indicator of visual function in clinical research.

Heart rate variability (HRV) is a well-established marker of autonomic nervous system function and resistant starch (RS) is known to modulate gut microbiota and promote short-chain fatty acid production. This study aimed to investigate whether RS consumption improves HRV by modulating autonomic function in individuals with metabolic syndrome risks. Methods: This randomized controlled trial included 30 women with metabolic syndrome, recruited from a university hospital. Participants were randomly assigned to either the high-resistant starch (HRS) group or the low-resistant starch (LRS) group. The intervention lasted for 8 weeks. The primary analysis of this study focused on participants in the lower 50% of baseline total power (TP), assessing the differential effects of HRS intake on autonomic function in this subgroup. Statistical analyses, including the Wilcoxon rank-sum test, were performed to compare differences between groups. Results: In the subgroup with baseline TP in the lower 50%, the HRS group showed an increase in TP (median ΔTP: 435 ms², interquartile range [IQR]: 964 ms²), while the LRS group showed a decrease (-30.9 ms², IQR: 146 ms²). The between-group difference in TP change was statistically significant (P=0.03). Similarly, low frequency (LF) power increased significantly in the HRS group compared to the LRS group (P=0.03). Although high frequency and very low frequency also showed greater improvement in the HRS group, these changes did not reach statistical significance. Conclusion: RS intake was associated with significant improvements in TP and LF in individuals with lower baseline HRV, suggesting its potential role in autonomic nervous system modulation.

Objectives: Clinical nutrition treatment is the central part of diabetes management, such as prevention, treatment, and self-management of diabetes, and personalized clinical nutrition treatment, which enables improvement in patients with type 2 diabetes mellitus (T2DM). Our study aimed to contribute to the improvement of appropriate nutrition management in personalized treatment for obese and non-obese diabetes patients. Methods: T2DM patients were recruited as participants, and 36 final participants were assigned to the lean diabetes mellitus group (LDM; body mass index [BMI] < 25 kg/m2) and the obese diabetes mellitus group (ODM; BMI ≥ 25 kg/m2). We assessed the dietary intakes, body composition, dietary habits, the Korean version of obesity-related quality of life, and biochemical indices. Results: According to the phenotype’s comparison, the ODM group had a high prevalence of T2DM complications and hypertension, had a dietary habit of less than 10 minutes of mealtime duration and preferred fast food intake, and had a low obesity-related quality of life. However, the LDM group had a high choice of Korean dishes at the time of eating out and a high intake of vitamin C, and iodine because of the intake of vegetables and seaweeds. Conclusion We observed differences in diet, nutrient intake, and clinical characteristics according to the phenotype of T2DM patients. In particular, obese diabetes patients have an increased risk of cardiovascular diseases, bad dietary habits, and low obesity-related quality of life. Therefore, personalized nutrition treatment is needed in consideration of the risk of cardiovascular disease and dietary habits for patients in the ODM group, as well as determining the energy requirements of Korean patients with T2DM.

Background: Although there is general agreement on performing concomitant ablation of atrial fibrillation (AF) during left-sided heart valve surgery in low-risk patients due to its proven long-term clinical benefits, its role in reoperative cases remains debated because of perceived high risks. Methods: This study included 338 consecutive patients with AF who underwent redo surgery for left-sided valve disease between 2000 and 2015 at 2 tertiary referral centers.Among them, 143 patients underwent concomitant surgical ablation for AF (ablation group), while 195 did not (no-ablation group). To evaluate comparative long-term clinical outcomes between the 2 groups, inverse probability of treatment weighting was applied. Results: Early mortality rates were 3.5% (4/143) in the ablation group and 9.2% (18/195) in the no-ablation group (p=0.064). At 5 years, the cumulative incidence of AF recurrence was 12.3%±0.1% in the ablation group and 85.2%±0.1% in the no-ablation group (p<0.001). During follow-up (median, 103 months), the ablation group demonstrated significantly lower risks of death (adjusted hazard ratio [aHR], 0.495; 95% confidence interval [CI], 0.312–0.784; p=0.003) and thromboembolic events (aHR, 0.212; 95% CI, 0.058–0.771;p=0.019) compared with the no-ablation group. Conclusions Concomitant AF ablation during redo valve surgery was associated with improved rhythm outcomes, survival, and freedom from thromboembolic events, supporting its consideration as a reasonable option even in this high-risk group.