Metabolic Health, Obesity, and the Risk of Developing Open-Angle Glaucoma: Metabolically Healthy Obese Patients versus Metabolically Unhealthy but Normal Weight Patients

정윤혜,한경도,박혜영,이승훈,박찬기 대한당뇨병학회 2020 Diabetes and Metabolism Journal Vol.44 No.3

Background: This study sought to investigate the associations between metabolic health status, obesity, and incidence of primary open-angle glaucoma (POAG). Methods: In this nationwide, population-based, longitudinal prospective cohort study conducted using the Korean National Health Insurance System, we categorized all subjects based on presence and severity of metabolic syndrome and obesity. Insurance claims data were used to identify POAG development. Then, Cox regression was applied to calculate the hazard of developing POAG in people with various components of metabolic syndrome, obesity, or their combination. Results: Of the total 287,553 subjects, 4,970 (1.3%) developed POAG. High fasting glucose, blood pressure, and total cholesterol levels were all associated with increased risk of developing POAG. Regarding obesity level, people with body mass index (BMI) greater than 30 kg/m2 were more likely to develop POAG than those with normal BMI. Also, people with greater number of metabolic syndrome components showed a greater POAG incidence. People who are metabolically unhealthy and obese (adjusted hazard ratio [HR], 1.574; 95% confidence interval [CI], 1.449 to 1.711) and those who are metabolically unhealthy nonobese (MUNO: adjusted HR, 1.521; 95% CI, 1.405 to 1.645) but not those who are metabolically healthy obese (MHO: adjusted HR, 1.019; 95% CI, 0.907 to 1.144) had an increased hazard of developing POAG compared with metabolically healthy nonobese (MHNO) subjects. Conclusion: Metabolic health status and obesity were significantly associated with increased risk of POAG incidence. MUNO subjects but not MHO subjects showed a higher risk of POAG development than did MHNO subjects, suggesting that metabolic status is more important than obesity in POAG.

Dextran-based block copolymer for pH-responsive delievry of doxorubicin

정윤혜,정정욱,강대환,정영일 한국공업화학회 2013 한국공업화학회 연구논문 초록집 Vol.2013 No.-

Blepharoptosis Repair through the Small Orbital Septum Incision and Minimal Dissection Technique in Patients with Coexisting Dermatochalasis

정윤혜,나태윤 대한안과학회 2013 Korean Journal of Ophthalmology Vol.27 No.1

Purpose: To describe a modified surgical technique for blepharoptosis repair through a small orbital septum incision and minimal dissection, along with the results obtained in patients with coexisting dermatochalasis. Methods: A retrospective chart review included 33 patients (52 eyelids) with blepharoptosis coexisting with dermatochalasis, surgically corrected through a small orbital septum incision and minimal dissection after redundant upper lid skin excision, by placing a single fixation suture between the levator aponeurosis and the tarsal plate. Outcome measures included the pre- and postoperative marginal reflex distances (MRD1), eyelid contour, post-operative complications, and need for reoperation. Results: The pre- and postoperative MRD1 averaged 1.1 ± 0.8 mm and 2.8 ± 1.1 mm, respectively. Of the 33 patients, 9 patients (9 eyelids) underwent surgery on one eyelid for unilateral blepharoptosis and dermatochalasis (Group I), 5 patients (5 eyelids) underwent a simple skin excision blepharoplasty of the contralateral eyelid (Group II), and 19 patients (38 eyelids) underwent bilateral blepharoptosis and dermatochalasis repair (Group III). Of the 14 eyelids that underwent unilateral ptosis repair (Groups I and II), 12 eyelids (85.7%) showed less than a 1-mm difference from the contralateral eyelid. Of the 38 eyelids that underwent bilateral ptosis repair (Group III), 27 eyelids (71.1%), 5 eyelids (13.1%), and 6 eyelids (15.8%) had excellent, good, and poor outcomes, respectively. Overall, 44 eyelids (84.6%) out of a total of 52 eyelids had successful outcomes; the remaining 8 eyelids demonstrated unsatisfactory eyelid contour was corrected by an additional surgery. Conclusions: Blepharoptosis repair through a small orbital septum incision and minimal dissection can be considered an efficient technique in patients with ptosis and dermatochalasis.

라섹 후 각막내피세포의 변화

정윤혜,정성근 대한안과학회 2013 대한안과학회지 Vol.54 No.1

Purpose: In order to investigate the safety of laser-assisted subepithelial keratomileusis (LASEK), corneal endothelial cells before and after the LASEK procedure were evaluated. Methods: Thirty-six patients (72 eyes) who underwent LASEK between June 2010 and May 2011 were included in the present study. Parameters included corneal endothelial cell density (CD), coefficient of variation of the cell area (CV), and percentage of hexagonal cells (6A) which were all obtained by a specular microscope (Noncon ROBO sp 8000, Konan, Japan) before and 3, 6, and 12 months after LASEK. Results: Preoperative CD was 2952 ± 352 cells/mm2, and postoperative CD did not significantly change at 3, 6, and 12 months. Preoperative CV and 6A and postoperative CV and 6A at 12 months were not significantly different. Furthermore, correlation between change in corneal endothelial cell and degree of myopia correction was not statistically significant. Conclusions: LASEK appears to be a safe procedure for corneal endothelial cells over an extended period.

사례 분석을 통한 장수명주택의 용적률 인센티브 실효성 검토

정윤혜,강지연,김형근,박지영,Jung, Yoon-Hye,Kang, Ji-Yeon,Kim, Hyung-Geun,Park, Ji-Young 한국토지주택공사 토지주택연구원 2020 LHI journal of land, housing, and urban affairs Vol.11 No.2

The purpose of this study is to investigate the effect of floor area ratio incentive system for Long-life housing certification system by simulation of five recently built apartment complexes. Apartments that are certified as superior in Long-life housing can receive 10% of the floor are incentive in Seoul. However, the difference between base and permitted floor area ratio are in general residential area of class 2 and 3 is not more than 20%. limit of feasible allowance incentive is limited. Even if there is an unrealized permitted floor area ratio, there is no reason to apply the Long-life housing certification system preferentially. Because the items of the floor area ratio incentive provided by the District Unit Plan are various, it shows that the floor space ratio incentive for Long-life housing certification system has little effectiveness. To enhance the feasibility of incentives for the Long-life housing certification system, improvement in the urban planning level, including district unit planning, including the design criteria for apartments in Seoul, is needed.

Sildenafil Citrate 복용 후 발생한 하직근 비대 1예

정윤혜,이나영,임혜빈,Youn Hea Jung,MD,Na Young Lee,MD,PhD,Hye Bin Yim,MD,PhD 대한안과학회 2013 대한안과학회지 Vol.54 No.2

Purpose: Sildenafil citrate was developed to treat angina, but was found to also inhibit PDE in the corpus callosum and is now widely used to treat impotence. We report a case of enlargement of the inferior rectus muscle after sildenafil citrate ingestion. Case summary: A 58-year-old male presented with binocular diplopia which started 2 weeks prior. He had no underlying disease. The patient had taken sildenafil citrate on 3 different occasions 2 weeks prior, and 2 days after his first ingestion, his right conjunctiva was injected and binocular diplopia started. On the first visit, he showed 16 PD hypotropia of the right eye with limitation of motion at upgaze. The MRI scan showed enlargement and enhancement of the inferior rectus muscle, and 50 mg of prednisone was prescribed. The amount of hypotropia decreased to 8 PD 2 weeks later. Conclusions: Enlargement of extraocular muscle caused by sildenafil citrate ingestion has not been reported in Korea, and related mechanisms are yet to be researched. Additional case reports and research are necessary in the future.

공동주택 공동공간에서의 범죄예방을 위한 거주자참여 프로그램에 관한 연구

정윤혜,이유미,이윤재 대한건축학회지회연합회 2013 대한건축학회연합논문집 Vol.15 No.6

본 연구의 목적은 공동주택 내 범죄로부터 안전한 공동공간 유지관리를 위하여 겆자 참여 프로그램을 제시하는 것이다. 조사된 설문을 분석하기 위해 기술통계, 빈도분석, ANOVA, 상관분석 등 통계기법이 사용되었고 연구결과를 요악하면 다음과 같다. 1)거주자 참여 프로그램의 필요성 및 참여도를 살펴본 결과, S단지가 W단지보다 상대적으로 높은 필요성과 참여도를 보였다. 2) 거주자 참여 각 세부 프로그램에 대한 중요도 및 참여도를 분석한 결과, 두 단지 모두 3점 이상의 중요도와 참여도를 나타냈다. 3) 대부분 거주자가 교육 후 참여하는 프로그램보다 바로 참여 가능한 프로그램에 대한 선호도가 높은 것으로 나타났다. 4) 공동공간 내 적합한 거주자 참여 프로그램을 분석한 결과, 낙서 지우기 프로그램의 경우 놀이터에서 가장 필요한 공간으로 조사되었으며 공동동간의 순찰이 필요한 공간으로는 주차장, 놀이터가 조사되었다.

녹내장의 병인과 일상생활 속에서의 예방방법

정윤혜 대한의사협회 2017 대한의사협회지 Vol.60 No.12

Glaucoma is the leading cause of irreversible blindness worldwide. Increased intraocular pressure is the most important risk factor for glaucoma. Lifestyle patterns that can increase intraocular pressure include smoking, caffeine consumption, lifting heavy weights, certain yoga postures, playing wind instruments, using swimming goggles, and certain sleeping positions. Lifestyle patterns that may reduce intraocular pressure include aerobic exercise. Although only limited studies have investigated the relationship between these lifestyle patterns and glaucoma, smoking cessation and aerobic exercise are recommended. For other lifestyle patterns, including caffeine consumption, lifting heavy weights, certain yoga postures, wind instruments, swimming using goggles, and certain sleeping positions, there does not seem to be sufficient evidence to prohibit them, but they should be taken into account in patients with advanced glaucoma.

정신적 장애가 있는 노인을 위한 주거공간계획

정윤혜,이윤재 한국생태환경건축학회 2017 한국생태환경건축학회 논문집 Vol.17 No.6

Purpose: Recently, as Korea has become an aging society, numerous problems related to the elderly have occurred. In particular, issues related to the psychological wellness of the elderly are becoming more and more serious. In general, most of the elderly suffering from psychological disorders are hospitalized in facilities which due to their poor conditions has in fact been pointed out as a violation of their human rights. Therefore, based on the findings of previous research, this study aims to suggest design guidelines or basic design guidelines for residential space planning for the elderly with psychological disorders to support their living in residential spaces, rather than in facilities. Method: First, by referring to precedent studies and performing a review on the literature, the overall types and symptoms of the psychological disorders in the elderly were analyzed. Secondly, among the experimental research from Korea and abroad concerning wellness, the research in which positive effects on the wellness of the elderly suffering from psychological disorders were achieved were derived through a keyword search. Thirdly, design strategies for a residential space for the elderly with psychological disorders and specific plans for residential space planning were derived by grouping similar results among the foregoing experimental research with positive influences. Result: Based on the experimental research, seven design strategies were elicited for the residential space planning for the elderly with psychological disorders. The following is an overall summary of the specific guidelines depending on the design strategies: (i) for the elderly with psychological disorders, mental stability should be provide by controlling contact with others through the provision of separate personal provision of private space, and (ii) for the elderly with anxiety disorder, spaces should be planned to support the visual accessibility from rest of the family members. Furthermore, (iii) for the elderly with depression and anxiety disorder, orientation, locations and sizes of windows should be planned to allow the inflow of sunlight in the morning and (iv) natural or artificial 'natural' elements having positive effects on stress reduction should also be planned for the residential space. (iv) natural or artificial 'natural' elements should also be planned for the residential space to alleviate the stress level. Lastly (v) devices such as controlling TV channels, opening and closing of curtains should be installed to ensure that the elderly can control the spaces by themselves. Also a plan for reducing noises which may cause stress or sleep disturbance is also required.

한국의 정상 저신장아에서 다섯 번째 손가락 중간마디뼈의 원뿔 모양 골단과 짧은중간가락마디증의 임상적 의의

정윤혜,최은정,최임정,홍수영,유재호 대한소아내분비학회 2009 Annals of Pediatirc Endocrinology & Metabolism Vol.14 No.1

Purpose:The cone-shaped epiphyses mid-5 (CSE-5) and brachymesophalagia-5 (BMP-5) are common osseous anomalies. Those are thought to be normal variants. We evaluated the frequency of CSE-5 and BMP-5 and the influence of them on adult height in Korean children with normal short stature. Methods:We retrospectively reviewed medical records of 322 normal short stature children. Lengths of the fourth (MP-4) and fifth middle phalanx (MP-5) and widths of MP-5 of all children were measured. Two indicies for BMP-5 were used. Index 1 was based upon the ratio of the width to the length of the MP-5. Index 2 was based upon the ratio of the lengths of MP-5 to MP-4. CSE-5 was assessed by visual inspection only. We assessed several clinical parameters as follows; advanced skeletal maturation, z-scores of height, target height (THz) and predicted adult height (PAHz) according to CSE-5 and/or BMP-5. Results:Of the 322 children, 23.6% had BMP-5 (male 19.5%, female 27.4%), 23.6% had CSE-5 (male 13.0%, female 33.3%). The children with CSE-5 and/or BMP-5 were more advanced skeletal maturation than normal fifth finger (0.07±1.09 yrs vs -0.23±1.34 yrs, P=0.049), lower PAHz (-1.13±1.09 vs -0.71±1.28, P=0.008), lower PAHz- THz (-0.53±1.07 vs -0.14±1.30, P=0.013). In male subjects, the PAHz had weak correlation with index 1 (r=-0.26, P=0.001) and index 2 (r=0.27, P=0.001). Conclusion:This study suggests that BMP-5 and CSE-5 in Korean children with short stature are one contributable factor for adult height. 목 적:저신장을 보이는 소아 및 청소년들에서 관상골의 길이를 증가시키기 위해 필요한 연골내골화 과정에서 발생하는 변이 중 BMP-5와 CSE-5의 발생 빈도와 이러한 변이가 성인신장에 미치는 영향을 알아보고자 한다. 방 법:2007년 6월부터 2008년 6월까지 저신장을 주소로 메리놀병원, 동아대학교 의료원과 일신기독병원 외래를 방문한 6세 이상, 15세 미만의 소아 및 청소년 중에서 2007년 소아 및 청소년 표준성장도표에서 신장의 표준편차점수가 0 미만인 322명(남아 154명, 여아 168명)의 소아 및 청소년들을 대상으로, 이들의 의무기록을 후향적으로 분석하였다. 연구 대상에 포함된 환아들을 대상으로 BMP-5와 CSE-5가 어떤 빈도로 존재하는지 확인하고자 하였다. 정상적인 다섯 번째 손가락 중간마디뼈를 가지고 있는 저신장아들에 비해 골화에 이상을 동반하고 있는 소아 및 청소년에서 예측성인신장에 영향을 미치는 인자를 찾기 위해 분석을 시행하였다. 결 과:BMP-5가 동반된 경우는 전체 대상군에서 76명으로 23.6%였으며, 그 중 남아는 30명(19.5%), 여아는 46명(27.4%)으로 여아에서 많았으며, CSE-5가 동반된 경우도 전체 대상군에서 76명(23.6%)였으며, 남아에서 20명(13.0%), 여아에서 56명(33.3%)으로 여아에서 많았다. 다섯 번째 손가락 중간마디뼈가 정상인 군과 BMP-5나 CSE-5를 단독으로 가지고 있거나, 두가지의 이상을 함께 가지고 있는 비정상군을 비교하여 보았을 때 예측성인신장의 표준편차점수는 정상군에서 -0.71± 1.28, 비정상군에서 -1.13±1.09로 비정상군에서 유의하게 작았다. 다섯 번째 손가락 중간마디뼈가 정상인 군과 CSE-5만 있는 군, BMP-5만 있는 군 그리고 BMP-5와 CSE-5를 모두 가지고 있는 군으로 나누어 비교했을 때 예측성인신장 표준편차점수는 정상인 군에서 -0.71±1.28, CSE-5만 가지고 있는 군에서 -0.96±1.31, BMP-5만 가지고 있는 군에서 -1.15±0.65, BMP-5와 CSE- 5를 모두 가지고 있는 군에서는 -1.23±0.96로 다섯 번째 손가락 중간마디뼈의 이상이 심할수록 예측성인신장의 표준편차점수가 유의하게 작았다. 대상군 중에서 남아에서는 다섯 번째 손가락 중간마디뼈의 길이에 대한 너비의 비에 대해서 예측성인신장은 음의 상관관계를 보이고 있었으며, 네 번째 손가락 중간마디뼈의 길이와 다섯 번째 손가락 중간마디뼈의 길이의 비에 대해서는 양의 상관관계를 보이고 있었다. 그러므로 남아에서 BMP-5의 정도가 심할수록 예측성인신장과 음의 상관관계를 가지고 있었다. 여아에서는 BMP-5의 정도와 예측성인신장과의 상관관계는 없었다. 결 론:저신장을 보이는 한국 소아 및 청소년에서 BMP- 5와 CSE-5는 성인 신장에 영향을 주는 인자들 중에 하나로 생각되어지며, 이에 대한 추가 연구들이 필요할 것으로 생각된다.