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.

Marjolin’s ulcer is a rare but aggressive form of skin cancer that often presents significant surgical challenges due to the complex anatomy of the pelvis and the necessity for wide excision to avoid recurrence. This case report highlights the innovative use of a 3-dimensional (3D)–printed model for the precise planning and successful execution of a high partial sacrectomy in a 48-year-old male patient with quadriplegia. This patient, who had sustained a cervical spine injury in 1996, developed a sacral pressure sore that progressed into a Marjolin's ulcer. Utilizing high-resolution 3D computed tomography scans, we created a detailed 3D-printed model of the patient's sacrum, which facilitated a thorough understanding of the tumor's anatomy and its spatial relationships with critical structures. This approach significantly aided the surgical team in executing a challenging excision while minimizing risk to the adjacent organs. This case underscores the potential of 3D printing technology to enhance surgical planning and outcomes in complex oncological resections, particularly in anatomically challenging regions.

Background: It is well known that a large number of patients with diabetes also have dyslipidemia, which significantly increases the risk of cardiovascular disease (CVD). This study aimed to evaluate the efficacy and safety of combination drugs consisting of metformin and atorvastatin, widely used as therapeutic agents for diabetes and dyslipidemia. Methods: This randomized, double-blind, placebo-controlled, parallel-group and phase III multicenter study included adults with glycosylated hemoglobin (HbA1c) levels >7.0% and <10.0%, low-density lipoprotein cholesterol (LDL-C) >100 and <250 mg/dL. One hundred eighty-five eligible subjects were randomized to the combination group (metformin+atorvastatin), metformin group (metformin+atorvastatin placebo), and atorvastatin group (atorvastatin+metformin placebo). The primary efficacy endpoints were the percent changes in HbA1c and LDL-C levels from baseline at the end of the treatment. Results: After 16 weeks of treatment compared to baseline, HbA1c showed a significant difference of 0.94% compared to the atorvastatin group in the combination group (0.35% vs. −0.58%, respectively; P<0.0001), whereas the proportion of patients with increased HbA1c was also 62% and 15%, respectively, showing a significant difference (P<0.001). The combination group also showed a significant decrease in LDL-C levels compared to the metformin group (−55.20% vs. −7.69%, P<0.001) without previously unknown adverse drug events. Conclusion The addition of atorvastatin to metformin improved HbA1c and LDL-C levels to a significant extent compared to metformin or atorvastatin alone in diabetes and dyslipidemia patients. This study also suggested metformin’s preventive effect on the glucose-elevating potential of atorvastatin in patients with type 2 diabetes mellitus and dyslipidemia, insufficiently controlled with exercise and diet. Metformin and atorvastatin combination might be an effective treatment in reducing the CVD risk in patients with both diabetes and dyslipidemia because of its lowering effect on LDL-C and glucose.

Background: Left ventricular assist devices (LVADs) are widely employed as a therapeutic option for end-stage heart failure. We evaluated the outcomes associated with centrifugal-flow LVAD implantation, comparing 2 device models: the Heartmate 3 (HM3) and the Heartware Ventricular Assist Device (HVAD). Methods: Data were collected from patients who underwent LVAD implantation between June 1, 2015 and December 31, 2022. We analyzed overall survival, first rehospitalization, and early, late, and LVAD-related complications. Results: In total, 74 patients underwent LVAD implantation, with 42 receiving the HM3 and 32 the HVAD. A mild Interagency Registry for Mechanically Assisted Circulatory Support score was more common among HM3 than HVAD recipients (p=0.006), and patients receiving the HM3 exhibited lower rates of preoperative ventilator use (p=0.010) and extracorporeal membrane oxygenation (p=0.039). The overall early mortality rate was 5.4% (4 of 74 patients), with no significant difference between groups. Regarding early right ventricular (RV) failure, HM3 implantation was associated with a lower rate (13 of 42 [31.0%]) than HVAD implantation (18 of 32 [56.2%], p=0.051). The median rehospitalization-free period was longer for HM3 recipients (16.9 months) than HVAD recipients (5.3 months, p=0.013).Furthermore, HM3 recipients displayed a lower incidence of late hemorrhagic stroke (p=0.016). In the multivariable analysis, preoperative use of continuous renal replacement therapy (odds ratio, 22.31; p=0.002) was the only significant predictor of postoperative RV failure. Conclusion The LVAD models (HM3 and HVAD) demonstrated comparable overall survival rates. However, the HM3 was associated with a lower risk of late hemorrhagic stroke.