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광간섭단층촬영기로 구한 시신경 및 망막신경섬유층 측정치들에 영향을 미치는 요인
한정일,임한웅,송유미,엄기방,Jung-Il Han,M,D,Han-Woong Lim,M,D,Yoo-Mi Song,M,D,Ki Bang Uhm,M,D 대한안과학회 2007 대한안과학회지 Vol.48 No.8
Purpose: To determine the factors influence retinal nerve fiber layer (RNFL) and optic nerve head (ONH) parameters measured by Stratus optical coherence tomography (OCT). Methods: Topographic RNFL thickness and optic disc parameters of 129 healthy Korean subjects of aged 14 to 87 were measured using the fast retinal nerve fiber layer thickness and fast optic disk algorithms of Stratus OCT. One eye of each subject was randomly selected for statistical analysis. Using multiple linear regression, the effect of optic disc area, age, refractive error, and zone beta on each parameter was analyzed. Results: Large discs had large horizontal integrated rim width (HIRW), cup area, rim area, C/D area ratio, and vertical C/D ratio. The thickness of average, superior, inferior, and nasal quadrant RNFL increased significantly with an increase in optic disc area. Average and superior quadrant RNFL thickness, and HIRW decreased with age. Refractive error showed a correlation with the vertical integrated rim area, horizontal C/D ratio, and temporal quadrant RNFL thickness. Gender and zone beta had no statistically significant influence on ONH and RNFL parameters. Conclusions: This study shows that optic disc size affects most RNFL thickness and ONH parameters. Because of the relationships revealed in this study, optic disc area in addition to age should be considered when the Stratus OCT RNFL thickness and ONH parameters are interpreted.
한정일,조성원,이태곤,김종우,이재흥,Jung Il Han,M,D,Sung Won Cho,M,D,Ph,D,Tae Gon Lee,M,D,Jong Woo Kim,M,D,Ph,D,Jae Heung Lee,M,D,Ph,D 대한안과학회 2008 대한안과학회지 Vol.49 No.6
Purpose: The purpose of this study is to evaluate the clinical results of 23-gauge sutureless vitrectomy. Methods: We retrospectively analyzed 111 eyes that had undergone 23-gauge sutureless vitrectomy. The eyes underwent surgery from February 2006 to July 2006 and were examined for surgical outcome as well as intraoperative and postoperative complications. Results: The preoperative best corrected visual acuity (BCVA) was 1.43±0.12 and increased to 0.88±0.11 (P>0.01). Thirteen (11.7%) of 111 eyes developed intraoperative complications, and 21 (18.9%) of 111 eyes developed postoperative complications. Intraoperative complications included wound‐leaking (seven eyes), conjunctival suture (three eyes), and difficult insertion (two eyes). Postoperative complications included postoperative hypotony (seven eyes), vitreous hemorrhage (seven eyes), hyphema (five eyes), and infectious endophthalmitis (two eyes). Conclusions: Unlike 20-gauge vitrectomy, sutureless 23-gauge vitrectomy offers all the advantages of minimally invasive sutureless vitrectomy. J Korean Ophthalmol Soc 49(6):911-916, 2008
요추부 한 분절 유합술에서 생존 분석을 이용한 인접 분절 퇴행성 변화로 인한 재수술률 평가
김태형(Tae-Hyung Kim),김진혁(Jin-Hyok Kim),김성수(Sung-Soo Kim),임동주(Dong-Ju Lim),한정일(Jung-Il Han),김태완(Tai-Wan Kim),석세일(Se-Il Suk) 대한정형외과학회 2010 대한정형외과학회지 Vol.45 No.4
목적: 요추부의 한 분절 유합술 후에 발생된 인접 분절 퇴행성 변화에 시행된 재수술에 따른 생존율을 분석하고 그에 관여하는 요인을 알아보고자 하였다. 대상 및 방법: 1997년 3월부더 2006년 12월까지 본 척추센터에서 한 분절 유합술을 시행한 총 1,447예 중 추적 기능했던 1,206예를 대상으로 후향적으로 분석하여 인접 분절 퇴행성변회로 인한 재수술에 대한 생존분석을 시행하였다. 수술 시 나이, 성별, 진단명, 유합의 방법, 유합 부위, 골유합의 재료, 수술 집도의, 비만도(BMI), 흡연 여부 등에 따른 생존에 대한 단 인자 및 다중 인자분석을 시행하였다. 결과: 총 1,206예 중 인접 분절의 퇴행성 변화로 본원에서 재수술을 했던 경우는 27예였다(2.24%). 평균추시 기간은 39.0개월(6개월-12년 6개월)이었으며 수술 시 평균나이는 47.0세(13-85세)였다. 5년 생존율은 97.3%였으며, 10년 생존율은 89.4%였다. 수술 당시의 나이는 50세를 기준으로 나누어 분석한 결과 50세 미만의 재수술률이 유의하게 낮게 나타났으며(P=0.002), 다른 부위보다 제 4-5 요추 부위를 유합하였을 때 재수술률이 유의하게 높게 분석되었고(p=0.003), 과체중 및 비민인 경우(BMI 25 이상) 재수술률이 의미 있게 높았으며(p=0.040), 후외측 유합술만 시행한 경우보다 후방 요추체 유합술을 함께 시행한 군에서 재수술률이 의미 있게 낮게 분석되었다(p=0.021). 성별, 원인 질환, 골 유합의 재료, 수술 집도의, 흡연 여부에 따른 차이는 재수술률에 유의한 차이를 보이지 않았다(ps>0.05). 다중 인자 분석에서는 나이에 따른 요인만이 유의한 의미를 가졌다(p=0.048, Hazard ratio=2.50). 결론: 생존 분석 결과 요추부 한 분절 유합술에서 인접 분칠의 퇴행성변화로 인한 재수술 없이 생존하는 데에 가장 중요한 인자는 수술 당시의 나이임을 알 수 있었다. 50세 이상의 환자의 경우, 단 분절 유합술이라도 인접 분절 질환이 발생할 수 있음을 술 전에 인지시킬 필요가 있을 것으로 사료된다. Purpose: To analyze survival rates of patients after mono-segmental lumbar or lumbosacral fusion and to evaluate factors affecting the revision operation due to adjacent segmental degeneration. Materials and Methods: This study enrolled 1,206 patients who had mono-segmental lumbar or lumbosacral fusion between March 1997 and December 2006 at the Seoul Spine Institute. The survival rates for the revision operation due to adjacent segmental degeneration were analyzed retrospectively. The age at index operation, sex, etiologic diagnosis, fusion method, fusion level, substance of bone graft, operator, body mass index (BMI), and smoking were considered as risk factors for the revision operation. Results: There were 27 patients with a revision operation for adjacent segmental degeneration (2.24%). The average follow-up period was 39.0 months (6 months to 12 years 6 months) and the average age at operation was 47.0 years (13 to 85 years). The survival rate at 5 years was 97.3%, and at 10 years it was 89.4%. Patients less than 50 years old had a significantly lower revision operation rate than those aged 50 or more (p=0.002). When fusion between the 4th lumbar and the 5th lumbar spinal vertebrae was done, the revision operation rate was significantly higher than for other levels (p=0003). Obese patients with BMI≥25 had a significantly higher revision rate than did patients with BMI<25 (p=0.040). In a comparison of circumferential fusion versus other types of fusion, circumferential fusion had a lower revision rate and the difference was significant (p=0.021). Other factors such as diagnosis, sex, surgeon, substance used for the bone graft, and smoking were not significant for revision rate (ps>0.05). In multivariate analysis, age alone was a significant risk factor (p=0.048, Hazard ratio=2.50). Conclusion: The most important factor for survival without revision surgery for adjacent segmental degeneration following instrumented mono-segment lumbar or lumbosacral fusion is the age at index operation. Patients 50 year-old or older should be informed of the possibility of adjacent segmental disease after instrumented mono-segment lumbar or lumbosacral fusion.