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*

OBJECTIVES: This study aimed to observe the decrease in tooth color after home and office bleaching due to consumption of juice, soda, and coffee over a period of one year. METHODS: We obtained written consent from 30 subjects, who were divided into two groups i.e., home bleaching and office bleaching groups. They were treated with opalessence® and Zoom2 whitening gel, and the color of their teeth was assessed using shade Eye-NCC over a one-year period. A self-describing questionnaire was used to determine the frequency of juice, soda, and coffee consumption. RESULTS: The changes in color were measured before and after 1 day, 1 month, 3 months, 6 months, and 12 months. Although the tooth color slightly changed after 12 months, the teeth were brighter than the original color. Consumption of juices, sodas, and coffee is thought to be associated with decrease in tooth color, although the change was not statistically significant. CONCLUSIONS: The ΔE* values showed that the tooth bleaching effect remained for 12 months. Consuming a normal amount of juice, sodas, and coffee does not significantly reduce tooth color after tooth bleaching.
Coffee ; Follow-Up Studies* ; Tooth Bleaching* ; Tooth*

PURPOSE: The Suprapubic Arc (SPARC) procedure has recently been introduced as a new surgical treatment option for stress urinary incontinence in women. We have reported our early results of SPARC procedures. MATERIALS AND METHODS: A total of 23 patients received SPARC procedures at our hospital between November 2002 and August 2003. All the patients were evaluated with history taking, physical examination, urodynamic study and cystography preoperatively. The procedure was carried out under IV propofol or spinal anesthesia. The enrolled patients were followed-up for more than 3 months postoperatively. The cure rate was evaluated and perioperative and postoperative complications were assessed. RESULTS: The mean age of the patients was 48.8 years (ranges from 32 to 67 years) and eight patients had past history of previous abdominal or pelvic surgery. The mean hospital stay was 1.9 days (ranges from 1 to 7 days). Mean follow-up period was 7.9 months (ranges from 3.7 to 14.0 months). Nineteen of the 23 patients (82.6%) were completely cured and 2 patients (8.7%) were much improved, hence the total success rate of the procedure was 91.3%. Bladder perforation during procedure occurred in 7 patients (30.4%) but conservative management sufficed. No serious complication was occurred. CONCLUSION: Our early results show that the SPARC procedure is a effective treatment option for the management of stress urinary incontinence. But we suggest that surgeons should be careful to avoid the bladder injury especially in their early period of experience.
Anesthesia, Spinal ; Female* ; Follow-Up Studies ; Humans ; Length of Stay ; Physical Examination ; Polypropylenes ; Postoperative Complications ; Propofol ; Urinary Bladder ; Urinary Incontinence* ; Urodynamics

A case of nutcracker syndrome which was initially diagnosed by magnetic resonance angiography (MRA) is reported. On preoperative MRA in an 18-year-old male patient with gross hematuria, left renal vein was obliterated at the level of superior mesenteric artery and there was no connection with inferior vena cava. The follow-up MRA after surgical correction with external prosthesis demonstrated entire course of left renal vein without evidence of obstruction which might suggest a possible usage of MRA for a non-invasive diagnosis of nutcracker syndrome.
Adolescent ; Angiography* ; Diagnosis* ; Follow-Up Studies* ; Hematuria ; Humans ; Magnetic Resonance Angiography ; Male ; Mesenteric Artery, Superior ; Prostheses and Implants ; Renal Veins ; Vena Cava, Inferior

A case of nutcracker syndrome which was initially diagnosed by magnetic resonance angiography (MRA) is reported. On preoperative MRA in an 18-year-old male patient with gross hematuria, left renal vein was obliterated at the level of superior mesenteric artery and there was no connection with inferior vena cava. The follow-up MRA after surgical correction with external prosthesis demonstrated entire course of left renal vein without evidence of obstruction which might suggest a possible usage of MRA for a non-invasive diagnosis of nutcracker syndrome.
Adolescent ; Angiography* ; Diagnosis* ; Follow-Up Studies* ; Hematuria ; Humans ; Magnetic Resonance Angiography ; Male ; Mesenteric Artery, Superior ; Prostheses and Implants ; Renal Veins ; Vena Cava, Inferior

OBJECTIVE: Osteoporosis results in increased fragility of the bone and thereby predisposes the patients to have a fracture with relatively little trauma. Osteoporosis is more common in women, however, its incidence in men is also increasing. Purpose of this article is to assess the clinical difference between male and female patient, and the effects of vertebroplasty or kyphoplasty. METHODS: Between January 2009 and December 2012, total 198 patients have undergone vertebroplasty or kyphoplasty for osteoporotic vertebral compression fractures and we selected 54 patients (27 male and 27 female) in this retrospective study. We investigated the difference of clinical characteristics between male and female osteoporotic vertebral compression fractures. RESULTS: There were no significant differences between the 2 groups in terms of distribution of body mass index, diabetes mellitus, hypertension, stroke, previous vertebroplasty or kyphoplasty. However, bone mineral density and vertebral compression fracture induced by trauma were significantly higher in male group. And preoperative visual analogue scale (VAS) is higher in male group. CONCLUSION: Osteoporotic vertebral compression fracture induced by trauma is more frequent in men. Higher VAS score before operation in men might reflect this difference in etiology. The VAS scores decreased after operation in both men and women, suggesting vertebroplasty or kyphoplasty is effective in osteoporotic compression fracture regardless of etiology.
Aged* ; Body Mass Index ; Bone Density ; Diabetes Mellitus ; Female* ; Fractures, Compression* ; Humans ; Hypertension ; Incidence ; Kyphoplasty ; Male* ; Multiple Endocrine Neoplasia Type 1 ; Osteoporosis ; Retrospective Studies ; Stroke ; Vertebroplasty

OBJECTIVE: Osteoporosis results in increased fragility of the bone and thereby predisposes the patients to have a fracture with relatively little trauma. Osteoporosis is more common in women, however, its incidence in men is also increasing. Purpose of this article is to assess the clinical difference between male and female patient, and the effects of vertebroplasty or kyphoplasty. METHODS: Between January 2009 and December 2012, total 198 patients have undergone vertebroplasty or kyphoplasty for osteoporotic vertebral compression fractures and we selected 54 patients (27 male and 27 female) in this retrospective study. We investigated the difference of clinical characteristics between male and female osteoporotic vertebral compression fractures. RESULTS: There were no significant differences between the 2 groups in terms of distribution of body mass index, diabetes mellitus, hypertension, stroke, previous vertebroplasty or kyphoplasty. However, bone mineral density and vertebral compression fracture induced by trauma were significantly higher in male group. And preoperative visual analogue scale (VAS) is higher in male group. CONCLUSION: Osteoporotic vertebral compression fracture induced by trauma is more frequent in men. Higher VAS score before operation in men might reflect this difference in etiology. The VAS scores decreased after operation in both men and women, suggesting vertebroplasty or kyphoplasty is effective in osteoporotic compression fracture regardless of etiology.
Aged* ; Body Mass Index ; Bone Density ; Diabetes Mellitus ; Female* ; Fractures, Compression* ; Humans ; Hypertension ; Incidence ; Kyphoplasty ; Male* ; Multiple Endocrine Neoplasia Type 1 ; Osteoporosis ; Retrospective Studies ; Stroke ; Vertebroplasty

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*