Seongnam, South Korea
Seongnam, South Korea

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Hwang Y.H.,Konyang University | Hwang Y.H.,Armed Forces Capital Hospital | Kim Y.Y.,Korea University
Clinical and Experimental Ophthalmology | Year: 2012

Background: To evaluate the correlation between optic nerve head parameters and retinal nerve fiber layer thickness measured by Cirrus HD spectral-domain optical coherence tomography (Cirrus HD-OCT; Carl Zeiss Meditec) in healthy myopic eyes. Design: Cross-sectional study. Participants: One hundred and sixty-one right eyes from 161 healthy young myopic subjects. Methods: Optic nerve head parameters and retinal nerve fiber layer thickness were measured with the Cirrus HD-OCT. The distance between optic disc margin and scan circle (disc margin-to-scan distance) was measured on the Cirrus HD-OCT en-face optic nerve head image with aid of National Institutes of Health ImageJ image-analysis software (developed by Wayne Rasbands, National Institutes of Health, Bethesda, MD). Main Outcome Measures: The correlations among optic nerve head parameters, retinal nerve fibre layer thickness and the disc margin-to-scan distance were evaluated with and without adjustment of the magnification effect. Results: Without correction of the magnification effect, the thicker average retinal nerve fiber layer was correlated with greater rim area and lower degree of myopia (P<0.001). When the magnification effect was corrected, thicker average retinal nerve fibre layer was associated with greater disc area and greater rim area in univariate and multivariate analyses (P≤0.028); however, degrees of myopia and the disc margin-to-scan distance were not significantly associated with average RNFL thickness (P≥0.104). Conclusions: Thicker average retinal nerve fibre layer thickness was associated with greater rim and disc areas. Disc margin-to-scan distance was not significantly correlated with average retinal nerve fibre layer thickness in healthy myopic eyes. © 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.


Ahn S.J.,Seoul National University | Ahn S.J.,Armed Forces Capital Hospital | Woo S.J.,Seoul National University | Park K.H.,Seoul National University
Investigative Ophthalmology and Visual Science | Year: 2014

Purpose: To investigate retinal and choroidal changes using spectral-domain optical coherence tomography (SD-OCT) and to evaluate visual outcome in patients with severe hypertension.Methods: In 42 eyes with hypertensive retinopathy from 21 patients with severe hypertension (systolic blood pressure [SBP] ≥ 180 mm Hg or diastolic blood pressure [DBP] ≥ 110 mm Hg), SD-OCT was performed on the day blood pressure (BP) was measured. Best-corrected visual acuity (BCVA), fundus features, and SD-OCT morphologic findings were evaluated and OCT features were compared between baseline and final visits. Associations between clinical findings, OCT image features, and Keith-Wagener-Barker (KWB) hypertensive retinopathy grades and baseline and final BCVA were examined.Results: Optical coherence tomography findings included macular edema (central macular thickness > 300 μm), irregularly reflective regions, retinal nerve fiber layer thickening, subretinal fluid (SRF), intraretinal fluid, and intraretinal hyperreflective dots. All abnormalities rapidly resolved with BP control except for the hyperreflective dots. Central macular thickness, subfoveal choroidal thickness (SCT), and SRF height significantly decreased following BP control. Subretinal fluid height was significantly correlated with baseline BCVA, final BCVA, and SCT. Based on fundoscopic and OCT features, eyes were classified as showing mild to moderate retinopathy, malignant retinopathy without SRF, and malignant retinopathy with SRF. Unlike KWB grades (P = 0.077), the OCT-based retinopathy grades were significantly correlated to final BCVA, as shown by linear regression analyses (P = 0.025).Conclusions: Severe hypertension resulted in exudative retinal and choroidal changes, characterized by SRF accumulation and increased SCT. Our grading system may represent retinopathy severity and predict visual outcome better than the KWB grading system in patients with severe hypertension. © 2014 The Association for Research in Vision and Ophthalmology, Inc.


Chung D.R.,Sungkyunkwan University | Huh K.,Armed Forces Capital Hospital
Expert Review of Anti-Infective Therapy | Year: 2015

Postinfluenza bacterial pneumonia is a leading cause of influenza-associated death, and Staphylococcus aureus and Streptococcus pneumoniae have been important pathogens that have caused pneumonia since the influenza pandemic in 1919. Emergence of novel influenza A (H1N1) pdm09 and the concomitant global spread of community-associated methicillin-resistant S. aureus (CA-MRSA) have led to increasing prevalence of CA-MRSA pneumonia following influenza infection. Such an epidemiologic change poses a therapeutic challenge due to a high risk of inappropriate empiric antimicrobial therapy and poor clinical outcomes. Early diagnosis and initiation of appropriate antimicrobial therapy for post-influenza bacterial pneumonia have become even more important in the era of CA-MRSA. Therefore, novel molecular diagnostic techniques should be applied to more readily diagnose MRSA pneumonia. © 2015 Informa UK, Ltd.


Hwang Y.H.,Armed Forces Capital Hospital | Yoo C.,Korea University | Kim Y.Y.,Korea University
Journal of Glaucoma | Year: 2012

Purpose: To investigate the correlation between myopic optic disc tilt and the characteristics of peripapillary retinal nerve fiber layer (RNFL) thickness measured by Cirrus HD spectral-domain optical coherence tomography (Cirrus HD OCT; Carl Zeiss Meditec, Dublin, CA). Methods: A total of 255 eyes of 255 healthy young male participants with various degrees of refractive errors (mean spherical equivalent, -3.17±2.40 D; range, -11.00 to 0.00 D) underwent ophthalmic examinations, including refractive error, axial length, and optic disc area measurement. The degree of horizontal/vertical optic disc tilt was evaluated by cross-sectional images obtained by the Cirrus HD OCT. The average, superior, nasal, inferior, and temporal quadrant thickness and superior/inferior peak locations of the peripapillary RNFL were also measured with the Cirrus HD OCT. Results: On the univariate analysis, eyes with more temporally tilted optic discs (horizontal tilt) had higher myopia, greater axial length, a thinner average, superior, nasal, and inferior RNFL, thicker temporal RNFL, and more temporally positioned superior/inferior peak locations (all P values <0.001). The degree of inferior optic disc tilt (vertical tilt) was associated with high myopia and a more temporally positioned inferior peak location (all P values <0.05). On multivariate analysis, eyes with more temporally tilted optic discs had a thicker temporal RNFL and more temporally positioned superior/inferior peak locations. Conclusions: The characteristics of the peripapillary RNFL thickness were associated with the degree of myopic optic disc tilt, especially in the temporal area. The degree of myopic optic disc tilt should be considered when interpreting the RNFL thickness measured by the Cirrus HD OCT. © 2012 by Lippincott Williams & Wilkins.


Hwang Y.H.,Armed Forces Capital Hospital | Yoo C.,Korea University | Kim Y.Y.,Korea University
Journal of Glaucoma | Year: 2012

PURPOSE: The purpose of the study was to investigate the effects of myopic optic disc tilt and rotation on peripapillary retinal nerve fiber layer (RNFL) thickness characteristics measured by Cirrus HD spectral-domain optical coherence tomography (Cirrus HD OCT). METHODS: A total of 93 right eyes from 93 healthy young male individuals with myopia underwent ophthalmic examinations, including refractive error, axial length, and optic disc area measurements. The superior/inferior peak locations, RNFL thickness, and horizontal/vertical optic disc tilt were evaluated using the Cirrus HD OCT. The optic disc rotation was assessed by the angle between the long axis of the optic disc and the vertical meridian. The patients were divided into the tilted group and the non-tilted group; the tilted group was further divided into the rotated group and the nonrotated group. RESULTS: The eyes in the tilted group (n=47) had a greater axial length and thicker temporal RNFL and more temporally positioned superior/inferior peak locations than the non-tilted group (n=46) (all P <0.05). Among the eyes in the tilted group, the eyes in the rotated group (n=23) had a thicker temporal RNFL and a more temporally positioned superior peak location than the eyes in the nonrotated group (n=24) (all P <0.05). CONCLUSIONS: The eyes with a myopic temporal optic disc tilt and counterclockwise rotation had a thicker temporal RNFL and more temporally positioned superior peak location. The characteristics of the RNFL thickness in eyes with myopic optic disc tilt and rotation should be considered when interpreting the RNFL thickness measured by the Cirrus HD OCT. Copyright © 2012 by Lippincott Williams & Wilkins.


Hwang Y.H.,Armed Forces Capital Hospital | Lee J.Y.,Korea University | Kim Y.Y.,Korea University
British Journal of Ophthalmology | Year: 2011

Background/aims: To evaluate the effect of head tilt on retinal nerve fibre layer (RNFL) and macular thickness measured by the Cirrus HD spectral-domain optical coherence tomography (Cirrus HD OCT). Methods: A total of 30 right eyes from 30 healthy young subjects underwent RNFL and macular thickness measurements with the Cirrus HD OCT. The measurements were performed at a baseline head position and at right and left head tilt positions. The differences in RNFL and macular thickness between the baseline head position and the positions with head tilt were analysed. Results: The right and left head tilt induced counter-clockwise (mean 8.27°) and clockwise (mean 8.47°) rotation of the optic disc. The right head tilt caused superior-temporal RNFL thickening, inferior-temporal RNFL thinning, superior outer macular thickening and inferior outer macular thinning (all p values <0.05). The left head tilt induced superior-temporal RNFL thinning, inferior-temporal RNFL thickening, superior outer macular thinning, nasal outer macular thickening and inferior outer macular thickening (all p values <0.05). Conclusions: RNFL and macular thickness measured with the Cirrus HD OCT was affected by head tilt. Artefacts caused by head tilt should be considered in the analysis of the Cirrus HD OCT measurements.


Yoo J.J.,Armed Forces Capital Hospital | Cho N.H.,Ajou University | Lim S.H.,Ajou University | Kim H.A.,Hallym University
Arthritis and Rheumatology | Year: 2014

Objective To evaluate the relationships between fat mass, muscle mass, fat:muscle mass ratio, metabolic syndrome, and musculoskeletal pain in community residents.Results Total fat mass and fat:muscle mass ratio were significantly and positively associated with musculoskeletal pain among female subjects only. Compared to the lowest quartile of fat:muscle mass ratio, the odds ratios for widespread pain among subjects in other quartiles were significantly increased after adjustment for confounders. Widespread pain was more prevalent among subjects with metabolic syndrome whether their BMI was high or normal, especially among female subjects.Conclusion Increased fat mass and fat:muscle mass ratio were significantly associated with musculoskeletal pain among women. Widespread pain was significantly associated with a high fat:muscle mass ratio after adjustment for confounders. Understanding the relationship between fat mass and pain may provide insights into preventative measures and therapeutic strategies for musculoskeletal pain.Methods In the Korean Health and Genome Study, 1,530 participants (mean ± SD age 60.8 ± 8.60 years) completed pain questionnaires and underwent dual x-ray absorptiometry to calculate body composition. Pain was categorized according to the number of pain regions, such that widespread pain, defined as pain above the waist, below the waist, on both sides of the body, and in the axial region, represented the most severe pain. Metabolic syndrome was defined using the International Diabetes Federation 2005 recommendations, and the association between metabolic syndrome and pain was evaluated by dividing the population into 4 groups, according to the presence/absence of metabolic syndrome and of high body mass index (BMI). © 2014 by the American College of Rheumatology.


Cho Y.,Armed Forces Capital Hospital
Clinics in orthopedic surgery | Year: 2011

The purpose of this study is to evaluate the disease-free survival (DFS) and overall survival (OS) of patients with stage IIB osteosarcoma at a single institution for 20 years and to compare the results according to the chemotherapy protocols. From Jan 1988 to Nov 2008, 167 patients with osteosarcoma were treated at our hospital and among them, 117 patients (67 males and 50 females) with stage IIB osteosarcoma were evaluable. Their mean age was 22.6 years (range, 8 months to 71 years). Seventy-eight cases underwent the modified T10 (M-T10) protocol (group 1), 23 cases underwent the T20 protocol (group 2) and 16 cases underwent the T12 protocol (group 3). The DFS and OS were calculated and compared according to the chemotherapy protocols. At a mean follow-up of 78.9 months, 63 patients were continuously disease-free (63/117), 6 patients were alive after having metastatic lesions, 7 patients died of other cause and 41 patients died of their disease. The 5- and 10-year OS rates were 60.2% and 44.8%, respectively and the 5- and 10-year DFS rates were 53.5% and 41.4%, respectively. There was no significant difference of the OS and DFS between the chemotherapy protocols (p = 0.692, p = 0.113). At present, we achieved success rates close to the internationally accepted DFS and OS. We were able to achieve the higher survival rates using the M-T10 protocol over the 20 years. However, there was no significant difference of results between the chemotherapy protocols. We think the M-T10 protocol will achieve more favorable results in the near future.


Lee J.S.,Armed Forces Capital Hospital | Seo H.S.,Armed Forces Capital Hospital | Hong T.H.,Catholic University of Korea
World Journal of Gastroenterology | Year: 2014

AIM: To investigate the quality of YouTube videos on gallstone disease and to assess viewer response according to quality. METHODS: A YouTube search was performed on September 18, 2013, using the keywords "gallbladder disease", "gallstone disease", and "gallstone treatment". Three researchers assessed the source, length, number of views, number of likes, and days since upload. The upload source was categorised as physician or hospital (PH), medical website or TV channel, commercial website (CW), or civilian. A usefulness score was devised to assess video quality and to categorise the videos into "very useful", "useful", "slightly useful", or "not useful". Videos with misleading content were categorised as "misleading". RESULTS: One hundred and thirty-one videos were analysed. Seventy-four videos (56.5%) were misleading, 36 (27.5%) were slightly useful, 15 (11.5%) were useful, three (2.3%) were very useful, and three (2.3%) were not useful. The number of mean likes (1.3 ± 1.5 vs 17.2 ± 38.0, P = 0.007) and number of views (756.3 ± 701.0 vs 8910.7 ± 17094.7, P = 0.001) were both significantly lower in the very useful group compared with the misleading group. All three very useful videos were PH videos. Among the 74 misleading videos, 64 (86.5%) were uploaded by a CW. There was no correlation between usefulness and the number of views, the number of likes, or the length. The "gallstone flush" was the method advocated most frequently by misleading videos (25.7%). CONCLUSION: More than half of the YouTube videos on gallstone disease are misleading. Credible videos uploaded by medical professionals and filtering by the staff of YouTube appear to be necessary. © 2014 Baishideng Publishing Group Co., Limited. All rights reserved.


Kim K.-E.,Armed Forces Capital Hospital
Journal of the Neurological Sciences | Year: 2014

A brachial plexus lesion is not common in hereditary neuropathy with liability to pressure palsy (HNPP). We report the clinical and electrodiagnostic features of young soldiers with HNPP presenting with brachial plexopathy. By reviewing 2 year medical records from Korean military hospitals, we identified soldiers with brachial plexus lesions. Among them, patients diagnosed with HNPP were determined and clinical and electrophysiological findings were compared between HNPP and non-HNPP patients with a brachial plexus lesion. Thirteen patients (6.8%) were diagnosed with HNPP among 189 patients with a brachial plexus lesion. Push-ups, as either a punishment or an exercise, was the most frequent preceding event in HNPP patients (76.9%), whereas it was rare in non-HNPP patients. The distal motor latency of the median nerve showed the highest sensitivity (90.9%) and specificity (100%) for HNPP in patients with a brachial plexus lesion. In conclusion, HNPP should be suspected in patients with brachial plexopathy if brachial plexopathy develops after push-ups or if the distal motor latency of median nerves is prolonged. © 2014.

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