Sleep Disturbance in Hemodialysis Patients / 대한신장학회잡지

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.

A Case of a Primary Gastric Choriocarcinoma Diagnosed by Endoscopic Biopsy / 대한소화기내시경학회지

A case of primary choriocarcinoma in the stomach of a 60-year-old male is herein presented. The tumor was diagnosed as a choriocarcinoma by histologic examination and the immunohistochemical method of endoscopic biopsy of a specimen. Serum alpha- fetoprotein and beta-human chorionic gonadotropin were found to be significantly elevated. Multiple distant metastasis of the liver, intraabdominal lymph nodes and malignant ascites were also discovered. The high alpha-fetoprotein level in the serum might have been due to the coexistence of embryonal cell carcinoma or hepatoid adenocarcinoma or both in the stomach.

A seroepidemiological study on the efficiency of hepatitis B vaccination - An analysis of serologic markers in a rural area, korea - / 대한내과학회지

BACKGROUND: The objectives of this study are to determine the positive rate of HBV serologic markers and infection rate, and to evaluate the efficiency of hepatitis B vaccination. METHODS: Study subjects included 905 persons in 1988-1989 and 744 persons in 1993-1994 living in typical rural communities in Korea. Three serologic markers(HBsAg, anti-HBs, anti-HBc) were tested by radio-immunoassay(RIA). Supplemental informations were collected by self-administered questionnaire and interview on age, sex, history and frequency of vaccination. RESULTS: 1) Among non-vaccinees, HBsAg, anti-HBs, anti-HBc positive rates and infection rate in 1993-1994/1988-1989 were 5.4%/6.5%, 49.1%/45.9%, 48.3%/44.1% and 60.6%/54.5% respectively. The infection rate showed a trend of continuous increase as the age increased, while statistically significant increase was seen over age 20. 2) Overall vaccination rate was 18.1% in 1988-1989 and 37.9% in 1993-1994, showing statistically significant increase in vaccination rate. The rate in younger age groups were higher than in older groups in 1988-1989, but there was no difference by age groups in 1993-1994. Among vaccinees, anti-HBs only positive group occupied 42.7% in 1988-1989 and 41.3% in 1993-1994. HBs Ag negative and anti-HBc positive group occupied 26.2% in 1988-1989 and 36.73% in 1993-1994. CONCLUSION: 1) Among non-vaccinees, HBsAg positive rate was decreased, but the hepatitis B infection rate was not decreased. 2) The test for selection of eligible person of vaccination and education program for completion of vaccination schedule must be reevaluated to improve the efficiency of hepatitis B vaccination.