No Abstract Available.
Endothelium, Corneal* ; Lidocaine*

PURPOSE: Vaginal erosion is known complication of synthetic sling material, Most series report a relatively low erosion rate, ranging from 0 to 11%. but few report on management of only vaginal erosion after TVT procedure have been described. We estimated the incidence of vaginal erosion associated with the use of TVT and investigated clinical outcomes. MATERIALS AND METHODS: Between 1999~2002, 296 cases (mean age: 48.8 yrs; range: 31~67 yrs) of TVT performed by 2 university were retrospectively reviewed. Post-operative vaginal erosion as well as their management and surgcial outcomes were investigated. We performed only TVT on 173 patients with grade 1, 2 cystocele, and TVT combined cystocele repair on 123 patients with cystocele grade 3, 4. RESULTS: 11 women (3.72%) required secondary interventions due to vaginal erosion. The interval between insertion and removal varied from 1 to 14 months (mean 6.24), 6 patients developed before postoperative three months. Among 11 patients, 7 patients had TVT combined cystocele repair (one vertical incision), and the others had TVT only. A transvaginal approach was used for vaginal flap over TVT in 2 patients (secondary vaginal erosion developed after 2 months) and a vaginal flap in 1 patient (secondary vaginal erosion developed after 7 months), and TVT removal in 8 patients. Before and after secondary intervention, all patients were totally dry (mean FU period: 12.5 months). CONCLUSION: We suggest that vaginal erosion after TVT procedure should be treated with complete removal of the tape.
Cystocele ; Female ; Humans ; Incidence ; Polypropylenes ; Postoperative Complications ; Retrospective Studies ; Suburethral Slings* ; Urinary Incontinence ; Vagina

PURPOSE: To assess the clinical efficacy of monocanalicular lacrimal silicone intubation in the pediatric patients with lacrimal duct obstruction. METHODS: The medical records of 14 children with 14 eyes who underwent this procedure were reviewed retrospectively. RESULTS: Monoka(r) silicone tube was used in 3 eyes and Ritleng Self-threading Monoka(r) tube, in 11 eyes. Postoperatively, epiphora was resolved in all cases between one week and 7 months. Early postoperative extrusion of silicone tube occurred in 3 eyes(21.4%). Corneal erosion in 1 eye(7.1%), and granuloma formation in another eye(7.1%) were noticed but disappeared after removal of tubes. Removal of silicone tube was easily performed postoperatively between 3 and 7 months(mean, 4.6 months) in the clinic without sedation in all cases. CONCLUSIONS: Monocanalicular lacrimal intubation using especially Ritleng Self-threading Monoka(r) silicone tube is an easy technique for intubation and removal, and an effective method for the treatment of pediatric lacrimal duct obstruction.
Child ; Granuloma ; Humans ; Intubation* ; Lacrimal Apparatus Diseases ; Lacrimal Duct Obstruction* ; Medical Records ; Retrospective Studies ; Silicones*

The purpose of this study was to evaluate the susceptibility of various intraocular lenses(IOLs) of different optic material to Nd:YAG laser in vitro. Four models of IOLs manufactured by different companies were selected and ten IOLs for each model were used for this study. Two models had lathe-cut polymethylmethacrylate(PMMA) optic, one silicone compound optic, and one acrylate/methacrylate copolymer optic. Q-switched Nd: YAG laser(7901 Nd-YAG laser, Coherent, Palo Alto, CA, USA) was used. The He-Ne aiming beam was focused on the posterior surface of optic, 2mm apart from the center of optic, and sixteen shots were applied to each optic with energy levels ranging from 0.3 to 2.0mJ with increment of 0.1 or 0.2mJ in a circular pattern. The spots were examined under phase contrast microscope and scanning electron microscope. The averages(+/-SD) of energy threshold at which damage was detected were 0.49+/-0.12mJ in silicone compound optic, 0.67+/-0.19mJ in acrylate/methacrylate copolyer optic, and 0.72+/-0.11mJ and 0.89+/-0.09mJ in lathe-cut PMMA optics. All interclass differences were statistically significant except the difference between lathe-cut PMMA optic with lower damage threshold and acrylate/methacrylate copolymer optic(Mann-Whitney test, p<.05). In conclusion, silicone compound and acrylate/methacrylate copolymer optics are more susceptible to Nd:YAG laser than PMMA optic in vitro and this suggests that in patients with high risk of developing severe posterior capsular opacification after cataract surgery, implantation of IOLs with PMMA optic is preferable and early Nd:YAG laser posterior capsulotomy with low energy is recommended in cases of implantation of foldable IOLs.
Cataract ; Humans ; Lasers, Solid-State* ; Lenses, Intraocular* ; Polymethyl Methacrylate ; Posterior Capsulotomy ; Silicones

OBJECTIVES: The daily activities and performance of the working population can be threatened by sleep disturbances, including insomnia. This study evaluated the sleep patterns, sleep problems, daytime sleepiness, and lost productivity time (LPT) resulting from sleep quality and sleep duration issues among workers. METHODS: The Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and the Health and Work Performance Questionnaire (HPQ) were completed by 653 workers in an urban area. Statistical analyses were performed using independent t-tests. RESULTS: The average sleep duration among the subjects was 6 h 37 min. While 19.6% of the subjects complained of poor sleep quality, 53.4% were affected during the day by insomnia. The estimated annual cost of LPT due to presenteeism (Won13,892,545 vs. Won11,840,140 ; p=0.033) and the total annual cost of LPT (Won14,040,968 vs. Won11,961,302 ; p=0.032) were higher in poor sleepers than in good sleepers. Furthermore, workers with a shorter sleep duration had a higher annual LPT due to presenteeism (747.83 vs. 648.57 h ; p=0.046) and a higher total annual LPT (754.48 vs. 657.99 h ; p=0.049) than workers with a longer sleep duration. CONCLUSION: Sleep deprivation among workers caused 1 h 51 min LPT per week. This suggests that sleep disturbance affects workers' performance in an organization, as well as in terms of individual health.
Efficiency ; Korea ; Occupational Health ; Surveys and Questionnaires ; Sleep Deprivation ; Sleep Initiation and Maintenance Disorders

OBJECTIVES: The daily activities and performance of the working population can be threatened by sleep disturbances, including insomnia. This study evaluated the sleep patterns, sleep problems, daytime sleepiness, and lost productivity time (LPT) resulting from sleep quality and sleep duration issues among workers. METHODS: The Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and the Health and Work Performance Questionnaire (HPQ) were completed by 653 workers in an urban area. Statistical analyses were performed using independent t-tests. RESULTS: The average sleep duration among the subjects was 6 h 37 min. While 19.6% of the subjects complained of poor sleep quality, 53.4% were affected during the day by insomnia. The estimated annual cost of LPT due to presenteeism (Won13,892,545 vs. Won11,840,140 ; p=0.033) and the total annual cost of LPT (Won14,040,968 vs. Won11,961,302 ; p=0.032) were higher in poor sleepers than in good sleepers. Furthermore, workers with a shorter sleep duration had a higher annual LPT due to presenteeism (747.83 vs. 648.57 h ; p=0.046) and a higher total annual LPT (754.48 vs. 657.99 h ; p=0.049) than workers with a longer sleep duration. CONCLUSION: Sleep deprivation among workers caused 1 h 51 min LPT per week. This suggests that sleep disturbance affects workers' performance in an organization, as well as in terms of individual health.
Efficiency ; Korea ; Occupational Health ; Surveys and Questionnaires ; Sleep Deprivation ; Sleep Initiation and Maintenance Disorders

OBJECTIVES: This randomized, multicenter, open-label, parallel clinical trial was carried to compare the therapeutic efficacy and the proportion of successful switch between 'direct switching method' and 'start-tapering switching method' when switching an antipsychotic to olanzapine. METHODS: This study included both inpatients and outpatients who fulfilled the criteria for schizophrenia as defined in the ICD-10 from 13 hospitals, and were in need to be appropriate for switching antipsychotics. Subjects were randomly assigned to one of the two switching methods. For 'direct switching method' group, previous antipsychotics were abruptly discontinued and 10mg of olanzapine was administered, whereas for 'start-tapering switching method' group, initially 10mg of olanzapine was administered and previous antipsychotics was gradually tapered for 2 weeks. Olanzapine was used for 6 weeks and the dose was adjusted within the range of 5-20mg. The therapeutic efficacy was measured with PANSS, BPRS, and CGI-Severity. A successful switching was defined as the completion of the 6 week trial without either worsening of the symptom(i.e. CGI-S score becomes worse twice consecutively) or the exacerbation of extrapyramidal symptoms(i.e. Simpson-Angus Scale scores becomes worse). RESULTS: 103 schizophrenic patients were participated in this study. There were no differences in baseline characteristics such as the demographic variables, the severity of symptoms, the history of previous antipsychotics treatments, the dosage of olanzapine used and the compliance between two groups. The proportion of successful switch was 71.1% for "direct switching method" and 82.2% for "start-tapering switching method", and there was no significant difference between the two switching methods. Also response rates to olanzapine based on total PANSS total scores were not different between the two groups(26.9% vs. 31.1%). At the time of completion of the trial, the scores of PANSS total, PANSS subscales, CGI-S and BPRS have significantly decreased after switching to olanzapine. But the changes of all scales measuring therapeutic efficacy in both endpoint and weekly analyses were not significantly different between the two switching methods. CONCLUSION: Although this study trial has many limitations and problems as an open clinical trial, the results may suggest that there were no significant differences between the two switching methods in the therapeutic efficacy. It was also found that the additional therapeutic benefits could be obtained by switching their antipsychotics to olanzapine.
Antipsychotic Agents ; Compliance ; Humans ; Inpatients ; International Classification of Diseases ; Outpatients ; Schizophrenia ; Weights and Measures