PURPOSE: The peripapillary retinal nerve fiber layer thickness (RNFL) was measured in normal children using optical coherence tomography (OCT), and the effect of various factors on the RNFL thickness was examined. METHODS: From April 2006 to January 2007, the RNFL thickness of 74 normal children (148 eyes) between the ages of 4 and 17 years old was measured by OCT, and the effect of factors such as age, gender, refractive error, C/D ratios, cooperation, and laterality on the peripapillary RNFL thickness was analyzed. RESULTS: The mean age of the patients was 10.2 years (4~17 years), and the mean peripapillary RNFL thickness was 106.3+/-12.8 micrometer. As to the thickness of the different peripapillary locations, the superior side was thickest (135.3+/-20.6 micrometer), followed in order by the inferior side (130.9+/-23.0 micrometer), the temporal side (86.3+/-18.9 micrometer), and the nasal side (71.9+/-20.8 micrometer). The refractive error was correlated positively with RNFL thickness (r=0.277, p=0.001), and age correlated negatively with RNFL thickness (r=-0.194, p=0.018). CONCLUSIONS: RNFL thickness in normal children increases as the refractive error becomes hyperopic and decreases with age. The data about RNFL thickness of normal children obtained in this study may provide useful information for an early diagnosis of pediatric neuroophthalmologic disease and for monitoring its progression.
Child ; Early Diagnosis ; Humans ; Negotiating ; Nerve Fibers ; Refractive Errors ; Retinaldehyde ; Tomography, Optical Coherence

BACKGROUND: There have been no studies of airway management strategies for difficult intubation and cannot intubate, cannot ventilate (CICV) situations in Korea. This study was intended to survey devices or methods that Korean anesthesiologists and intensivists prefer in difficult intubation and CICV situations. METHODS: A face-to-face questionnaire that consisted of a doctor's preference, experience and comfort level for alternative airway management devices was presented to anesthesiologists and intensivists at study meetings and conferences from October 2014 to December 2014. RESULTS: We received 218 completed questionnaires. In regards to difficult intubation, the order of preferred alternative airway devices was a videolaryngoscope (51.8%), an optical stylet (22.9%), an intubating laryngeal mask airway (11.5%), and a fiber-optic bronchoscope (10.6%). One hundred forty-two (65.1%) respondents had encountered CICV situations, and most of the cases were identified during elective surgery. In CICV situations, the order of preferred methods of infraglottic airway management was cricothyroidotomy (CT) by intravenous (IV) catheter (57.3%), tracheostomy by a surgeon (18.8%), wire-guided CT (18.8%), CT using a bougie (2.8%), and open surgery CT using a scalpel (2.3%). Ninety-eight (45%) of the 218 respondents were familiar with the American Society of Anesthesiologists' difficult airway algorithm or Difficult Airway Society algorithm, and only 43 (19.7%) had participated in airway workshops within the past five years. CONCLUSION: The videolaryngoscope was the most preferred device for difficult airways. In CICV situations, the method of CT via an IV catheter was the most frequently used, followed by wire-guided CT method and tracheostomy by the attending surgeon.
Airway Management ; Bronchoscopes ; Catheters ; Congresses as Topic ; Education ; Intubation* ; Intubation, Intratracheal ; Korea* ; Laryngeal Masks ; Methods ; Surveys and Questionnaires ; Tracheostomy

BACKGROUND: Several kinds of stents have shown their safety and efficacy to treat acute or subacute closure after balloon angioplasty as well as to reduce restenosis rate. However, one of the limitations of stents is difficult to deploy especially in tortuos vessels, lesions at a bend, and distal to previously deployed stents. The Micro stent II, which was one of the most recently developed stents, ia a rapid-exchage balloon expandable stainless steel stent with a zigzag design connected with a continuous single weld in each 3mm segments. It scores over excellent trackability and optimum radio-opacity. Therefore, it is easy to operate and feasible in tortuous, distal lesions and variety of lesion lengths. We report our experiences with Micro-II stent implanatation in the first 76 patients at Tonsei cardiovascular center to assess its safety and efficacy in patients with complex coronary anatomy and clinical results in the first months. METHODS: Between January 1996 and July 1996, eighty-six Micro-II stent were implanted in the coronary arteries of 76 patients(male 65.8%, age 59+/-10 year). Forty-five patients had unstable angina, the others had stable angina(17pts), acute myocardial infarction(14pts). RESULTS: 1) Indication of stenting was de novo 51(59.3%), suboptimal result 25(29.1%), restenosis 1(1.2%) and 9(10.4%) of lesions were stented in bail out situation. 2) Single stent were implanted in 76(88.4%)lesions, overlapping stent in 10(11.6%)lesions. Among overlapping stents, the second stent with Micro-II stent and with another kind of stent were 4.6%, 7.0%, respectively. 3) Procedure related complication including a subacute closure was occurred in 1(1.2%) patient who had distal dissection and 45% residual stenosis. In 12(14%) lesions, preistent dissection has been noticed after stent impantation. 4) Angiographic success(defined as a residual stenosis of <30% without major dissection) was achieved in 82 of 86 attempts(95.3%). The procedual success rate(defined as a residual stenosis of <30% without occurrence of major clinical events within 4 weeks after procesure) was 96.1%(73/76 patients). Angiographic success and procedural success rate in calcified lesion were 100% and 100%, respectively. Angiographic success and procedural success rate in more than 45` angulated lesion were 97% and 100%, respectively. 5) The mean minimal luminal diameter of the target lesions was increased from 0.42+/-0.40mm before stent implantation to 2.93+/-0.50mm(p<0.001). The percentage of diameter stenosis was reduced from 86.49+/-13.04% to 1.40+/-7.11%(p<0.001) after stent implantation. CONCLUSION: Coronary stenting with AVE Micro-II stent can be safety performed and is particularly beneficial in tortuous and calcified arteries. There was a high tendency for peristent dissection which need to special consideration to avoid. Follow-up data is needed to assess mid and term patency. Coronary artery disease . AVE Micro-II stent . Immediate results.
Angina, Unstable ; Angioplasty, Balloon ; Arteries ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Vessels ; Follow-Up Studies ; Humans ; Phenobarbital ; Stainless Steel ; Stents*

PURPOSE: This study was designed to evaluate the prognostic significance of Magnetic resonance angiography(MRA) in patients with cerebral infarction. MATERIALS AND METHODS: Magnetic Resonance imaging(MRI) and 2 dimensional or 3 dimensional Time-of-Flight MR were performed subsequently in 83 patients with cerebral infarction proven by brain CT and clinical manifestations, using GE Signa Advantage 1.5T. We classified the size of infarction on MRI as Extent I((2cm), Extent 11(2-6cm), Extent ill( > 6cm) and classified the intracranial vascular occlusion according to visualizations of intracranial vascular branches on MRA as Grade 0, Grade I, Grade II, Grade III. And we evaluated clinical outcomes of these patients according to Rankin's disability scale, compared with MRI and MRA. RESULTS: In 72 cases(86.8%), the larger the size of infarction on MRI, the more severe vascular occlusion on MRA, the worse the clinical outcomes were noted(p < 0.01). However, in 7 cases(8.4%) who showed huge cerebral infarction on MRI with low grade intracranial vascular occlusion on MRA, the clinical outcomes were improved. In 4 cases(4.8%) who noted small sized cerebral infarction on MRI with high grade vascular occlusion on MRA, the clinical outcomes were worsened. CONCLUSION: MRA provides additional useful information to that provided by MRI in predicting the prognosis of patients with cerebral infarction.
Angiography* ; Brain ; Cerebral Infarction* ; Humans ; Infarction ; Magnetic Resonance Imaging ; Prognosis

Acute gastric anisakiasis is occurred when men intake a raw or inadequate cooked anisakis infected fish. The clinical symptoms are severe cramping abdominal pain, nausea, vomiting, and epigastric fulling sensation. It is well known that the whale is final host and man is opportunistic host. Recently, we experienced three cases of acute gastric anisakiasis. We think that acute gastric anisakiasis is probably rather undetected than rare disease. So through immediate gastrofiberscopy of patients with severe cramping epigstric pain occuring after ingestion of raw fish,we can find more cases of the anisakis larvae. In is adequate to abstract of larvae by biopsy forceps through gastrofiberscopy.
Abdominal Pain ; Anisakiasis ; Anisakis* ; Biopsy ; Eating ; Humans ; Larva ; Male ; Muscle Cramp ; Nausea ; Rare Diseases ; Sensation ; Surgical Instruments ; Vomiting ; Whales

BACKGROUND: It is known that HLA molecule can restrict specific IgE responses, but few studies have documented the association between HLA and sensitization to house dust mite(HDM). OBJECTIVE: To evaluate whether a specific HLA type can be a risk or protective factor for the development of HDM sensitivity. METHOD: Total 146 subjects were genotyped for HLA-DRB1 using PCR-SSP technique and HDM sensitivity, determined by skin prick test using two mite allergens, D. pteronyssinus (Dp) and D. farinae (Df). Subjects were grouped according to Dp or Df sensitivity and linkage analysis between HDM sensitivity and HLA-DRB1 genotype was performed. RESULTS: The data revealed higher allele frequencies of DRB1*07 in Dp or Df sensitive groups compared to insensitive groups (11.6% vs. 2.6% in Dp, 11.5% vs. 3.3% in Df group, p<0.05), but the other allele frequencies showed no difference. CONCLUSION: There was a significant association between HLA-DRB1*07 genotype and HDM sensitization. These results indicate that antigen presentation by HLA class II molecule restricts the development of specific IgE response to HDM.
Allergens ; Antigen Presentation ; Dust* ; Gene Frequency ; Genotype* ; HLA-DRB1 Chains* ; Immunoglobulin E ; Mites ; Pyroglyphidae* ; Skin

PURPOSE: Climacturia is involuntary loss of urine during orgasm. The mechanism of climacturia in men who undergo radical prostatectomy (RP) is not fully understood, while deficiency in bladder neck coaptation during orgasm may be the cause. We evaluated the prevalence and risk factors of climacturia after RP. MATERIALS AND METHODS: We retrospectively reviewed the medical records of prostate cancer patients who underwent RP from 2002 to 2013 and was able to have a vaginal intercourse postoperatively. RP was conducted using open or robot-assisted approach. We analysed the symptoms of climacturia, relationship between climacturia and several clinical factors. Also, we tried to find factors to predict the presence of climacturia. RESULTS: Total of 123 patients were analyzed in this study. The median age of the men was 65 year and postoperative follow-up period for the interview was 37 months. Of the total 123 patients, 29 (23.6%) complained of the climacturia. In climacturia group, robot-assisted RP (p=0.018), nerve-sparing (p=0.046) and penile rehabilitation (p=0.012) were significantly less frequent, and more pad were comsumed (p=0.001) compared to non-climacturia group. On multivariable analysis, post-prostatectomy incontinence (PPI) (OR 6.49, p=0.004) and penile rehabilitation (OR 0.22, p=0.036) were significant factors to predict the presence of climacturia. CONCLUSIONS: Climacturia occurs in more than 20% patients who were potent enough after RP in our study. PPI and penile rehabilitation were positive and negative factor to predict an occurrence of climacturia, respectively. Therefore, in addition to PPI and erectile dysfunction, patients must be informed of this complication before undergoing RP.
Erectile Dysfunction ; Follow-Up Studies ; Humans ; Male ; Medical Records ; Neck ; Orgasm ; Prevalence ; Prostatectomy* ; Prostatic Neoplasms ; Rehabilitation ; Retrospective Studies ; Risk Factors ; Urinary Bladder ; Urinary Incontinence

The pathophysiology, clinical presentation and prognosis of left ventricular obstruction present an important cardiological problem. Various anatomical and functional abnormality can cause this phenomenon. Rarely, left ventricular outflow obstruction can result after mitral valve surgery. We experienced a case of left ventricular outflow obdtruction 13 years after mitral valve replavement. The diagnosis was made using two-dimensinal Doppler echocardiography and confirmed by cardiac catheterization. The pressure gradient across the left ventricular outflow obstruction was 96mmHg. A second mitral valve replacement was performed. Because severe fibrosis, pannis around the prosthetic mitral valve and a subaortic web were detected during the operation, the subaortic web was removes.
Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Echocardiography, Doppler ; Fibrosis ; Mitral Valve* ; Prognosis ; Ventricular Outflow Obstruction*

Congenital bronchoesophageal fistula is a rare clinical entity in adults. This anomaly may cause various symptoms such as respiratory infections, coughing bouts when eating or drinking, and even hemoptysis. The fistula can cause symptoms in childhood but may not appear until adulthood. We recently experienced a case of congenital bronchoesophageal fistula associated with esophageal diverticulum in an adult. A 63-year-old woman was admitted to our hospital due to chest discomfort, sore throat and coughing bouts when eating. An empyema with lung abscess had occurred eight years previously. Results of the physical examination were unremarkable. A Barium swallowing revealed a medium-sized diverticulum at the right anterior aspect of the esophagus, which had developed a fistulous connection with the right lower lobe bronchus. The patient was treated by fistulectomy and lobectomy of the right lower lobe. The postoperative course was smooth and uneventful.
Bronchial Diseases/congenital* ; Bronchial Diseases/complications* ; Case Report ; Diverticulum, Esophageal/complications* ; Esophageal Diseases/congenital* ; Esophageal Diseases/complications* ; Female ; Fistula ; Human ; Middle Age

PURPOSE: The aim of this research was to establish the effect and variation in differing convergence angle and length of abutment on the retention of full veneer casted gold crown. MATERIALS AND METHODS: Two different length,5 mm and 10 mm in height with convergence angles of 5, 10, 15 and 25 degrees crowns were fabricated. Cementation was done using cements; zinc phosphate cement (Fleck's zinc phosphate cement), resin-modified glass ionomer cement (Vitremer) and resin cement (Panavia 21). These were tested for tensile force at the point of separation by using Instron Universal Testing Machine. Statistical analysis was done by SAS 6.04 package. RESULTS: In all cements the mean retention decreased with significant difference on increase of convergence angle (P<.05). Increase in every 5 degree-convergence angel the retention rate decreased with resin-modified glass ionomer cement of 15.9% and resin cement of 14.8%. With zinc phosphate cement, there was largest decreasing rate of mean retention of 25.5% between convergence angles from 5 degree to 10 degree. When the crown length increased from 5 mm to 10 mm, the retention increased with the significant difference in the same convergence angle and in all types of cement used (P<.05). CONCLUSION: The retention was strongly dependent on geometric factors of abutment. Much care is required in choosing cements for an optimal retention in abutments with different convergence angles and crown lengths.
Acrylic Resins ; Cementation ; Collodion ; Crowns ; Dental Cements ; Glass Ionomer Cements ; Phenothiazines ; Phosphates ; Resin Cements ; Retention (Psychology) ; Silicon Dioxide ; Zinc ; Zinc Compounds ; Zinc Phosphate Cement