Background: Hearing level reference values based on the results of recent audiometry have not been established for the general population of South Korea. This study aimed to evaluate the mean hearing levels of each age group and to measure the annual progression of hearing loss. Methods: We used the database of the eighth and ninth Korea National Health and Nutrition Examination Survey from 2020 to 2022, and included participants with normal tympanic membranes and without occupational noise exposure. Mean hearing levels were calculated by averaging hearing levels at 0.5 kHz, 1 kHz, 2 kHz, and 4 kHz. Hearing loss was defined as a hearing level exceeding 25 dB in the better ear, and severity of hearing loss was classified as moderate, moderately severe, severe, and profound, following the World Health Organization classification. Results: Hearing levels and the proportions of patients with hearing loss increased with age. Hearing levels were 9.11 ± 6.28 dB, 13.33 ± 7.85 dB, 19.90 ± 10.30 dB, and 31.95 ± 13.37 dB in those in their 40s, 50s, 60s, and 70s, respectively, and the proportions of patients with hearing loss were 1.81%, 7.51%, 25.32%, and 63.94%, respectively. The annual increase in hearing level was 0.71 dB, and increases were greater at higher frequencies. Hearing loss was also worse in men. Conclusion The present study provides reference values for normal hearing levels by age group, and indirectly reveals the progression of age-related hearing loss. Based on the results, physicians will be able to provide appropriate advice regarding hearing levels and the need for monitoring in the elderly.

Cerebellar ataxia, neuropathy, and vestibular areflexia syndrome (CANVAS) is a neurodegenerative disorder caused by a biallelic expansion of pentanucleotide repeats in the RFC1 gene. Previous studies have reported up to 22% of patients with late-onset ataxia harbor this pathogenic repeat expansion. Despite its relatively high prevalence, CANVAS is often underdiagnosed because the disease is not well recognized and genetic testing is not performed in clinical practice. Here, we present a patient with characteristic clinical features, confirmed by genetic testing.

Background: Hearing level reference values based on the results of recent audiometry have not been established for the general population of South Korea. This study aimed to evaluate the mean hearing levels of each age group and to measure the annual progression of hearing loss. Methods: We used the database of the eighth and ninth Korea National Health and Nutrition Examination Survey from 2020 to 2022, and included participants with normal tympanic membranes and without occupational noise exposure. Mean hearing levels were calculated by averaging hearing levels at 0.5 kHz, 1 kHz, 2 kHz, and 4 kHz. Hearing loss was defined as a hearing level exceeding 25 dB in the better ear, and severity of hearing loss was classified as moderate, moderately severe, severe, and profound, following the World Health Organization classification. Results: Hearing levels and the proportions of patients with hearing loss increased with age. Hearing levels were 9.11 ± 6.28 dB, 13.33 ± 7.85 dB, 19.90 ± 10.30 dB, and 31.95 ± 13.37 dB in those in their 40s, 50s, 60s, and 70s, respectively, and the proportions of patients with hearing loss were 1.81%, 7.51%, 25.32%, and 63.94%, respectively. The annual increase in hearing level was 0.71 dB, and increases were greater at higher frequencies. Hearing loss was also worse in men. Conclusion The present study provides reference values for normal hearing levels by age group, and indirectly reveals the progression of age-related hearing loss. Based on the results, physicians will be able to provide appropriate advice regarding hearing levels and the need for monitoring in the elderly.

Background: Complete revascularization has demonstrated better outcomes in patients with acute myocardial infarction (AMI) and multivessel disease. However, in the case of left main (LM) culprit lesion AMI with multivessel disease, there is limited evidence to suggest that complete revascularization is better. Methods: We reviewed 16,831 patients in the Korea Acute Myocardial Infarction Registry who were treated from July 2016 to June 2020, and 399 patients were enrolled with LM culprit lesion AMI treated with percutaneous coronary intervention. We categorized the patients as those treated with complete revascularization (n=295) or incomplete revascularization (n=104). The study endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause death, myocardial infarction, ischemia-driven revascularization, stent thrombosis, and stroke. We performed propensity score matching (PSM) and analyzed the incidence of MACCE at 1 year. Results: After PSM, the two groups were well balanced. There was no significant difference between the two groups in MACCE at 1 year (12.1% vs. 15.2%; hazard ratio, 1.28; 95% confidence interval, 0.60–2.74; p=0.524) after PSM. The components of MACCE and major bleeding were also not significantly different. Conclusion There was no significant difference in clinical outcomes between the groups treated with complete or incomplete revascularization for LM culprit lesion AMI with multivessel disease.

Background and Objectives: Among various emerging catheter-based treatments for severe tricuspid regurgitation (TR), the spacer device can reduce the regurgitation orifice without manipulating the valve leaflet. However, its clinical application has been hampered by traumatic anchoring to the myocardium and the coaxial alignment of the balloon resulting in insufficient TR reduction. This study aimed to evaluate the early-stage safety, technical feasibility, and preliminary efficacy of the novel atraumatic vertical spacer in patients with isolated severe TR. Methods: All procedures were guided by fluoroscopy and transthoracic echocardiography.The maximum device placement time with an inflated balloon was 24 hours. Changes in the amount of TR, right ventricular function, and patient hemodynamics were measured during balloon deployment. Results: A total of 7 patients (median age 74), underwent successful device implantation without procedure-related complications. During balloon inflation (median 25 minutes), there were no symptoms or signs indicative of TR intolerance. TR was reduced by 1 grade or greater in all patients, with 2 patients exhibiting a reduction of 3 grades, from torrential TR to a moderate degree. Mild TR after balloon inflation was achieved in 3 patients with baseline severe TR. The TR reduction observed during initial balloon deployment was sustained during the subsequent balloon maintenance period. Conclusions The Pivot-balloon procedure was safe, technically feasible, and effective in reducing TR in patients with severe TR. No periprocedural complications or adverse cardiovascular events were reported during device placement with TR reduction observed in all patients. However, longer-term follow-up is needed to confirm safety and treatment effect.

Cerebellar ataxia, neuropathy, and vestibular areflexia syndrome (CANVAS) is a neurodegenerative disorder caused by a biallelic expansion of pentanucleotide repeats in the RFC1 gene. Previous studies have reported up to 22% of patients with late-onset ataxia harbor this pathogenic repeat expansion. Despite its relatively high prevalence, CANVAS is often underdiagnosed because the disease is not well recognized and genetic testing is not performed in clinical practice. Here, we present a patient with characteristic clinical features, confirmed by genetic testing.

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.

Purpose: To analyze prognostic factors for morphological and functional recovery after vitrectomy in patients with idiopathic epiretinal membrane (ERM). Methods: We conducted a retrospective analysis of patients with ERM who underwent vitrectomy. Postoperative outcomes were evaluated in terms of functional and morphological changes, assessing best-corrected visual acuity (BCVA) and central macular thickness (CMT) after 6 months. Logistic regression was used to identify factors influencing postoperative outcomes. Results: This study included 77 patients (35.1% men). Thirty-eight patients underwent combined vitrectomy and cataract surgery. Logistic regression revealed that better preoperative BCVA was associated with improved postoperative BCVA (p = 0.002). Among the 38 eyes that underwent combined surgery, longer preoperative axial length was linked to better visual outcomes in univariate analysis (p = 0.043), although the association was not statistically significant in multivariate analysis (p = 0.064). Younger age and thinner preoperative CMT were associated with better morphological outcomes (p = 0.034 and p = 0.001, respectively). Conclusions Preoperative BCVA, age, preoperative CMT, and axial length are predictive factors for functional and morphological outcomes after vitrectomy in patients with ERM. These findings may facilitate treatment planning and prognosis prediction before surgery.

Purpose: To analyze anterior, posterior, and total corneal refractive profiles and thickness using anterior segment (AS) sweptsource optical coherence tomography (SS-OCT) in Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) patients. Methods: This retrospective study compared 23 eyes from 14 patients with SJS/TEN with 23 eyes from 14 age- and sexmatched controls. AS SS-OCT measured corneal refractive profiles and pachymetry. Parameters included anterior, posterior, and total corneal power values, posterior to anterior curvature ratio, maximal corneal power, and thickness profiles. The SJS/TEN group was subdivided based on corneal opacity presence (subgroup A) or absence (subgroup B). Results: The SJS/TEN group showed significantly higher corneal astigmatism and maximal corneal power values for both anterior and posterior curvatures. Steep total corneal power and total corneal astigmatism were higher in the SJS/TEN group. The thinnest corneal thickness was lower, and its distance from the corneal vertex was greater in the SJS/TEN group. Subgroup analysis revealed that these differences were primarily attributed to the presence of corneal opacity. Additionally, automated keratometry of the anterior corneal surface showed significantly higher values, including steep, flat, and average keratometry and corneal astigmatism, in the SJS/TEN group. Conclusions AS SS-OCT shows significant alterations in both anterior and posterior corneal curvatures in patients with SJS/TEN. These findings emphasize the importance of considering posterior corneal curvature changes in pre-cataract surgery assessments and contact lens prescriptions for patients with SJS/TEN.

Ectopic thyroid is thyroid tissue found in places other than the anterolateral aspect of the second to fourth tracheal ring. Mediastinal ectopic thyroid is rare and only few cases have been reported. The authors experienced a case of 41-year-old female patient with an anterior neck mass. The patient had mild chest discomfort when breathing with no other symptoms. Imaging studies suggested tumor of thymic tissue origin and surgical excision was done. The mass was successfully removed and histopathologically determined to be thyroid tissue. We hereby report with a review of literature a case of ectopic thyroid found in the mediastinum, which was successfully removed by transcervical incision.