펜타캠을 이용한 섬유주 절제술 전후의 각막 고위수차와 전방계측치의 변화 관찰

김병선,김병재,정인영,서성욱,유지명,김성재,Byoung Seon Kim,MD,Byung Jae Kim,MD,In Young Chung,MD,PhD,Seong Wook Seo,MD,PhD,Ji Myong Yoo,MD,PhD,Seong Jae Kim,MD,PhD 대한안과학회 2014 대한안과학회지 Vol.55 No.5

Purpose: To evaluate changes in corneal keratometry, high-order aberrations (HOAs), and anterior chamber parameters after trabeculectomy using Pentacam<sup>® (Oculus Inc., Dutenhofen, Germany). Methods: Forty eyes of 40 patients who underwent limbal-based trabeculectomy or fornix-based trabeculectomy between July 2011 and May 2012 were retrospectively reviewed. Intraocular pressure (IOP), corneal keratometry, central corneal thickness, anterior chamber depth, anterior chamber volume, and HOAs were measured using Pentacam<sup>® preoperatively and at 3 months postoperatively. Results: The mean age of patients who underwent trabeculectomy was 58.26 ± 16.28 years. IOP showed significant decrease after surgery in both groups compared to preoperative values (<em>p</em> < 0.05). There were no significant differences in corneal keratometry, anterior chamber depth, anterior chamber volume, central corneal thickness, total root mean square (RMS), trefoil, and coma after surgery (<em>p</em> > 0.05). Conclusions: Postoperative corneal keratometry and anterior chamber parameters did not change significantly compared to preoperative values in glaucoma patients after performing trabeculectomy. Most HOAs that affected quality of vision were not changed in the limbal-based trabeculectomy or fornix-based trabeculectomy. J Korean Ophthalmol Soc 2014;55(5):662-668

당뇨황반부종에서 베바시주맙 단일주입과 저용량 베바시주맙-트리암시놀론 혼합주입 단기효과 비교

김병선,정인영,박종문,한용섭,Byoung Seon Kim,In Young Chung,Jong Moon Park,Yong Seop Han 대한안과학회 2014 대한안과학회지 Vol.55 No.8

Purpose: To report the effects and intraocular pressure results of intravitreal bevacizumab alone injection compared with intravitreal low-dose bevacizumab combined with low-dose triamcinolone injection in patients with diabetic macular edema. Methods: In total, 40 eyes of 40 patients diagnosed with diabetic macular edema were evaluated. Of these, 20 eyes of 20 patients were injected with intravitreal bevacizumab (1.25 mg/0.05 mL) and 20 eyes of 20 patients were injected with low-dose bevacizumab (0.625 mg/0.025 mL) combined with low-dose triamcinolone (1 mg/0.025 mL). The best corrected visual acuity (BCVA), central macular thickness, and intraocular pressure of treated eyes were measured before injection and at 1 month, 2 months, and 3 months after injection. Results: In both the intravitreal bevacizumab and the low-dose bevacizumab combined with low-dose triamcinolone groups, BCVA increased significantly at 1 month, 2 months, and 3 months after injection (<em>p </em>< 0.05). In addition, in both groups, neither intraocular pressure (IOP) nor central macular thickness increased significantly at 1 month, 2 months, or 3 months after injection (<em>p</em> > 0.05). The BCVA, IOP, and central macular thickness (CMT) at 1 month, 2 months, and 3 months after injection showed no significant differences between the intravitreal bevacizumab group and the low-dose bevacizumab combined with low-dose triamcinolone group (<em>p</em> > 0.05). Conclusions: The BCVA of both groups increased significantly, and the CMT of both groups decreased significantly in patients with diabetic macular edema. The injection of low-dose intravitreal bevacizumab combined with low-dose intravitreal triamcinolone may be useful for the treatment of diabetic macular edema. J Korean Ophthalmol Soc 2014;55(8):1155-1161

건강한 소아에서 발생한 급성망막괴사 1예

김병선(Byoung Seon Kim),김지혜(Ji Hye Kim),한용섭(Yong Seop Han),정인영(In Young Chung),박종문(Jong Moon Park) 대한안과학회 2016 대한안과학회지 Vol.57 No.1

Purpose: To describe a case of acute retinal necrosis (ARN) in childhood. Case summary: A 6-year-old child visited our clinic complaining of conjunctival injection and decreased visual acuity in the left eye. Slit-lamp examination showed conjunctival injection, inflammatory cells (4+) in the anterior chamber, and keratic precipitates. Fundus examination showed disc swelling. The patient was treated with 30 mg of oral prednisolone and 1% prednisolone acetate with the suspicion of uveitis. After 2 days, retinal examination showed a peripheral multifocal yellowish patch and retinal hemorrhage. Herpes simplex virus-2 was detected using polymerase chain reaction (PCR) analysis of the aqueous humor, which was obtained by anterior chamber paracentesis. In the present case, ARN in childhood was successfully treated with intravenous acyclovir. Conclusions: We report a case of ARN in childhood diagnosed using PCR. Intravenous acyclovir may be an effective therapy in children with ARN. Ophthalmologists should promptly perform PCR analysis in patients diagnosed with ARN.

서부 경남 지역 감염안내염의 원인균과 임상양상

김병선(Byoung Seon Kim),홍채민(Chae Min Hong),최영제(Young Je Choi),최유진(Yu-Jin Choi),조용운(Yong Wun Cho),유웅선(Woong-Sun Yoo),김성재(Seong-Jae Kim),정인영(In Young Chung) 대한안과학회 2020 대한안과학회지 Vol.61 No.12

목적: 서부 경남 지역 3차 의료기관에서 진단한 감염안내염 환자들의 원인균, 임상양상 및 시력예후를 알아보고자 하였다. 대상과 방법: 2010년 1월부터 2019년 6월까지 경상대학교병원에서 감염안내염으로 진단된 93명(98안)을 대상으로 후향적으로 의무기록을 분석하였으며 모든 환자에서 전방과 유리체 검체의 배양검사를 시행하였고 배양된 균의 종류, 치료 방법, 시력예후 등을 분석하였다. 결과: 대상 환자 98안에서 균이 배양된 경우는 67안(68.4%)이었으며 가장 흔한 감염안내염의 원인은 백내장수술 후 발생한 안내염이었고. 가장 흔한 원인균은 그람양성균인 Staphylococcus epidermidis (16.3%)이었다. 최종 최대교정시력을 1.0 logMAR을 기준으로분석한 결과 초진 최대교정시력이 안전수지 이상인 경우, 유리체절제술을 시행한 경우가 통계적으로 의미있는 예후를 보였다(p<0.001, p=0.021). 결론: 감염안내염 중 외인안내염은 백내장수술 후 많은 발생 빈도를 보이며 그람양성균인 Staphylococcus epidermidis가 가장 흔하며 좋은 시력예후를 보여주었다. 내인안내염은 간농양이 가장 흔한 감염병소이고 그람음성균인 Klebsiella pneumoniae가 흔하고 나쁜 시력예후를 보여주었다. Purpose: To investigate the bacterial culture, clinical characteristics, and prognosis associated with infectious endophthalmitis in western Gyeongsangnam-do. Methods: This study was a retrospective review of the medical records of 98 eyes that presented with infectious endophthalmitis from 2010 to 2019. All patients were analyzed for the type of causative bacteria, treatment method, and the visual prognosis. Results: The bacterial cultures (n = 98 eyes) revealed bacterial growth in 67 eyes (68.4%). The most commonly isolated causative microorganism was Gram-positive Staphylococcus epidermidis (14.3%). As a result of analyzing the best corrected visual acuity (VA) based on 1.0 (logMAR), baseline VA was worse than counting fingers, and whether pars plana vitrectomy was undertaken showed a difference in the final visual acuity (p < 0.001, p = 0.021). Conclusions: Exogenous endophthalmitis occurs frequently after cataract surgery, and S. epidermidis is the most common causative agent, but a good visual prognosis resulted. Liver abscess was a common extraocular source of endogenous endophthalmitis and Klebsiella pneumonia was the most common causative agent for a poor visual prognosis.

방사상각막신경염의 임상양상을 보인 세라티아 마르세센스 각막염 1예

김영준,김병선,유웅선,정인영,서성욱,유지명,김성재,Young Jun Kim,Byoung Seon Kim,Woong Sun Yoo,In Young Chung,Seong Wook Seo,Ji Myong Yoo,Seong Jae Kim 대한안과학회 2014 대한안과학회지 Vol.55 No.9

Purpose: To report a case of Serratia marcescens keratitis presenting as radial keratoneuritis. Case summary: A 15-year-old female who wore cosmetic and orthokeratology contact lenses but performed inadequate lens care visited our clinic with severe pain and visual disturbance in her left eye. On slit lamp examination, central corneal epithelial defect and stromal infiltration with radial keratoneuritis were observed. Based on clinical findings and past history, Acanthamoeba keratitis was highly suspected. The patient was treated with topical chlorhexidine 0.02% (Sigma-Aldrich Co., MO, USA) and moxifloxacin 0.5% (Vigamox<sup><font size=`2`>Ⓡ</font>, Alcon, TX, USA) per hour with 200 mg of oral itraconazol (Sporaone<sup><font size=`2`>Ⓡ</font>, LG, Seoul, Korea) once a day. Symptoms and corneal lesions did not improve after three days. After Serratia marsenscens was isolated from her contact lenses and solution, topical chlorhexidine 0.02% was discontinued, and intravenous ceftazidime (Tazime<sup><font size=`2`>Ⓡ</font>, Hanmi, Seoul, Korea) and fortified ceftazidime (50 mg/mL) eye drop was added. The corneal lesion dramatically improved, and after six months of follow-up, best-corrected visual acuity was 20/20 in the affected eye. Conclusions: Radial keratoneuritis can present not only in Acanthamoeba keratitis, but also in Serratia marsenscens keratitis. Confirmation of the isolated organism is useful when treating radial keratoneuritis. J Korean Ophthalmol Soc 2014;55(9):1380-1383

Antiphospholipid Syndrome of Bilateral Nonarteritic Anterior Ischemic Optic Neuropathy Patient Deteriorating Over Time

조용운(Yong Wun Cho),김병선(Byoung Seon Kim),유웅선(Woong-Sun Yoo),서성욱(Seong-Wook Seo),정인영(In Young Chung) 대한안과학회 2021 Korean Journal of Ophthalmology Vol.35 No.2

강의실 자동화를 위한 유비쿼터스 환경에서의 서비스 제어 구조

오영선(Oh Young-Seon),김병선(Kim Byoung-Sun),이현태(Lee Hyeun-Tae) 한국콘텐츠학회 2004 한국콘텐츠학회 종합학술대회 논문집 Vol.2 No.2

본 논문은 유비쿼터스 컴퓨팅 환경에서의 강의실 자동화를 살현하기 위한 서비스 제어 구조와 사용자 인터페이스를 설계한다. 서비스 제어를 위하여 UPnP 프로토콜을 기반으로한 서비스 제어구조를 제안하고 강의실에서의 서비스 시나리오를 설계하고 이를 위한 사용자 인터페이스를 설계하였다. 제안한 유비쿼터스 환경에서의 미래의 강의실 환경은 상황인지 컴퓨팅 능력을 이용하여 이용자에게 적응적인 사용자 인터페이스를 제어하고 사용자의 동작 이벤트를 인지하여 지능적인 강의 콘텐츠의 제작을 가능하게 함을 보여준다. In this paper, we propose a service control framework and user interface in a class automation of ubiquitous computing environment. We propose UPnP-based service control architecture and introduce an example service scenarios for automatic classroom. We present context-aware design approaches to argument user interface. We also present intelligent content authoring that facilitates producing e-learning content using activity context.

IEEE 802.15.4 기반 WBAN의 공존 문제 완화 기법

최종현 ( Jong-hyeon Choi ),김병선 ( Byoung-seon Kim ),조진성 ( Jin-sung Cho ) 한국인터넷정보학회 2015 인터넷정보학회논문지 Vol.16 No.3

인체를 중심으로 동작하는 WBAN(Wireless Body Area Network)은 의료 및 비의료 서비스를 동시에 제공하는 것을 목적으로 하며, 저전력, 다양한 전송률과 높은 데이터 신뢰성을 요구하는 근거리 통신 기술이다. 이러한 요구사항을 만족시킬 수 있는 통신기술 표준 중 IEEE 802.15.4는 WBAN 운영에 높은 호환성을 제공할 수 있어 이를 통한 다양한 연구가 진행되고 있다. 한편, IEEE 802.15.4 기반 다수의 WBAN이 밀집될 경우 발생하는 신호 간섭과 충돌은 데이터의 신뢰성을 저하시키는 주요한 원인되고 있으며, IEEE 802.15.4 표준은 다수의 네트워크가 공존하는 상황을 고려하여 설계되지 않았기 때문에 이에 대한 개선이 필요하다. 이를 해결하기 위해 본 논문에서는 사전 실험을 통해 IEEE 802.15.4 기반의 WBAN 간 공존 상황에서 발생할 수 있는 문제점들을 파악하였고, 실험 결과를 바탕으로 다수의 WBAN이 공존하는 상황에서의 신뢰성 저하를 완화하기 위한 기법을 제안한다. 제안하는 기법의 동작은 크게 두 단계로 구분될 수 있으며, 첫 번째 단계에서는 슈퍼 프레임의 CFP 구간에서의 데이터 전송 방법을 개선하여 WBAN 간 충돌을 회피하며, 두 번째 단계에서는 채널 접근 방식을 전환함으로써 충돌을 완화한다. 제안하는 기법은 표준 기반의 WBAN과 비교 실험을 수행하여 성능을 검증하였다. WBAN(Wireless Body Area Network) operating around the human body aims at medical and non-medical service at the same time. and it is the short-range communication technology requiring low-power, various data rate and high reliability. Various studies is performing for IEEE 802.15.4, because IEEE 802.15.4 can provide high compatibility for operate WBAN among communication standard satisfiable these requirements. Meanwhile, in the case of coexisting many IEEE 802.15.4-based WBAN, signal interference and collision are the main cause that is decreasing data reliability. but IEEE 802.15.4 Standard does not consider about coexistence of many networks. so it needs improvement. In this paper, To solve about this problem, identify coexistence problem of IEEE 802.15.4-based WBAN by preliminary experiments. and propose a scheme to mitigate the reliability decrease at multiple coexistence WBAN. The proposed scheme can be classified in two steps. The first step is avoidance to collision on the CFP through improving data transmission. The second step is mitigation collision through converting channel access method. Proposed scheme is verified the performance by performing comparison experiment with Standard-based WBAN.

삼출성 황반변성에서 이중 망막색소상피파열 및 출혈성 망막박리 후 발생한 급성폐쇄각발작

최유진(Yu-Jin Choi),최영제(Young Je Choi),조용운(Yong Wun Cho),김병선(Byoung Seon Kim),유웅선(Woong-Sun Yoo),정인영(In Young Chung) 대한안과학회 2021 대한안과학회지 Vol.62 No.4

목적: 거대망막색소상피박리가 동반된 삼출성 황반변성에서 유리체강내 주사 후 이중 망막색소상피파열이 발생하였고 출혈성 망막박리와 급성폐쇄각발작을 치료하였기에 이를 보고하고자 한다. 증례요약: 66세 여자가 1달 전부터 시작된 좌안의 시력저하를 주소로 내원하였다. 빛간섭단층촬영과 인도시아닌그린혈관조영술에서 거대망막색소상피박리를 동반한 삼출성 황반변성으로 진단하고 유리체강내 애플리버셉트주입술을 1차 시행하였다. 주사 2주 후 망막색소상피파열이 발생, 이후 2차 주사 4주 후 망막색소상피파열의 범위가 황반부를 포함하여 확대되었다. 3차 주입술 3개월 후 대량의 황반하출혈이 발생하여 4차 주사 시행, 3일 후 안압 60 mmHg 상승과 전방각 폐쇄, 수정체 후면에 접촉되는 출혈성 장액망막박리가 발생하였다. 공막절개술을 이용한 망막하출혈과 망막하액의 배액을 시행하였고, 이후 안압하강과 망막박리의 감소 소견이 보여 경과 관찰 중이다. 결론: 삼출성 황반변성에서 유리체강내 주사 후 이중 망막색소상피파열로 진행되는 경우는 매우 드물다. 이중 망막색소상피파열에서 출혈성 망막박리로 발생한 급성폐쇄각발작으로 안압상승을 경험하고 이를 치료하였기에 보고하고자 한다. Purpose: To report a case of acute angle-closure attack resulting from hemorrhagic retinal detachment after a double retinal pigment epithelium (RPE) tear in exudative age-related macular degeneration (AMD) with large pigment epithelial detachment (PED). Case summary: A 66-year-old female visited with a complaint of poor vision in left eye, which began 1 month prior. She was diagnosed with exudative AMD with a large PED using optical coherence tomography and indocyanine green angiography. Intravitreal aflibercept injection was performed. The RPE tear occurred at 2 weeks after the intravitreal anti-vascular endothelial growth factor injection for AMD, after which the range of the RPE tear expanded and included the macular area at 4 weeks after the second injection. At 3 months after the third injection, massive submacular hemorrhage occurred; aflibercept injection was repeated. At 3 days after the fourth injection, the patient’s intraocular pressure (IOP) was 60 mmHg, and massive hemorrhagic serous retinal detachment and anterior movement of the lens with total angle closure were observed. Therefore, we performed a sclerotomy; a large amount of dark blood and subretinal fluid was drained. The IOP decreased, and the retinal detachment improved somewhat. The patient was kept under observation for careful monitoring of her condition. Conclusions: It is very rare to experience a double RPE rupture after intravitreal anti-vascular endothelial growth factor injection in AMD. We report on our experience and treatment of acute angle-closure attack. The IOP increased due to hemorrhagic retinal detachment after a double RPE tear over the treatment course.

골반장기 탈출증과 동반된 자궁내번증

선진규 ( Jin Gyu Sun ),문종필 ( Jong Pil Moon ),전준공 ( Jun Kong Cheon ),구진영 ( Jin Young Gu ),김병선 ( Byoung Seon Kim ),배유영 ( You Young Bae ),기광수 ( Kwang Soo Kee ) 대한산부인과학회 2011 Obstetrics & Gynecology Science Vol.54 No.2

Non-puerperal uterine inversion is a rare clinical problem with only 150 cases reported. It usually results from a tumor implanted on fundus of the uterus. Uterine inversion associated with pelvic organ prolapse (POP) is extremely rare with only 1 case reported. A 74-year-old multiparous menopausal women was admitted to our hospital with the following condition: purulent vaginal discharge, voiding difficulty, lower abdominal discomfort, vaginal bleeding, protruding vaginal mass and POP. She was diagnosed as a POP with uterine inversion. After a posterior hysterotomy, vaginal hysterectomy, bilateral salpingoophorectomy and colpocleisis was performed and the pathological examination revealed a pyometra. We report a rare case of uterine inversion associated with POP and pyometra with a brief review of literature.