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MEL-80으로 라섹수술 시 라식 모드 절삭과 PRK 모드 절삭의 임상적 유용성 비교
김영돈,이담호,경학수,Youngdon Kim,Damho Lee,Haksu Kyung 대한안과학회 2014 대한안과학회지 Vol.55 No.11
Purpose: We compared laser assisted in situ keratomileusis (LASIK) mode and photorefractive keratectomy (PRK) mode ablation methods in laser subepithelial keratomileusis (LASEK) surgery using the MEL-80 excimer laser.Methods: All patients were followed up for a minimum of 1 year. The PRK mode group consisted of 46 eyes of 23 patients and the LASIK mode group consisted of 97 eyes of 56 patients. The central corneal thickness (CCT), ablation thickness, manifest refractive error and uncorrected visual acuity were compared preoperatively, 1 month and 1 year postoperatively. Spherical equivalent (SE) of cycloplegic refraction at postoperative 1 month and the uncorrected visual acuity (UCVA) ratios of 1.0 or better at postoperative 1 year were compared between the two groups to evaluate clinical efficacy. Results: The SE of refractive error, CCT and target corneal ablation thickness of the two groups were not significantly different preoperatively. The PRK mode group obtained an actual ablation mean thickness of 82.8% of the target and the LASIK mode group obtained an actual ablation mean thickness of 94.1% of the target at postoperative 1 month. In each group, a statistically significant difference was observed between the actual corneal ablation thickness and target corneal ablation thickness. In the PRK mode group, the mean SE of postoperative 1 month cycloplegic refraction was +0.24 ± 0.47 D and in the LASIK mode group, +0.87 ± 0.54 D, indicating a statistically significant difference between the two groups. One year postoperatively, the UCVA ratios of 1.0 or better were 83% in the PRK mode group and 96% in the LASIK mode group, showing a statistically significant difference between the two groups. However, SE of manifest refractive error and CCT in the two groups were not statistically different at postoperative 1 year. Conclusions: The LASIK mode ablation method showed better results than the PRK mode ablation method in postoperative UCVA prognosis after LASEK surgery using the MEL-80 excimer laser. J Korean Ophthalmol Soc 2014;55(11):1625-1630
The Contributory Factors of CSF Shunt Failure
김영돈,황성규,황정현,성주경,함인석,박연묵,김승래,Kim, Young Don,Hwang, Sung Kyoo,Hwang, Jeong Hyun,Sung, Joo Kyung,Hamm, In Suk,Park, Yeun Mook,Kim, Seung Lae The Korean Neurosurgical Society 2001 Journal of Korean neurosurgical society Vol.30 No.1
목 적 : 뇌실 복강간 단락술 부전의 기여인자를 조사 및 분석하여 뇌실 복강간 단락술의 합병증 및 재수술의 가능성을 줄이는 데에 목적이 있다. 대상 및 방법 : 1995년 1월부터 1998년 12월까지 본원에서 뇌실 복강간 단락술을 시행 받은 237명의 수두증 환자를 후향적 방법으로 고찰하여 뇌실 복강간 단락 부전의 기여인자 및 단락기 생존율을 통계학적으로 분석하였다. 결 과 : 수두증의 원인은 종양, 출혈, 감염, 선천성 기형, 정상 뇌압 수두증, 외상 등이었다. 68명의 환자에서 109회의 재수술이 이루어졌다. 재수술의 이유는 폐색, 근위부 카세타의 위치이상, 감염 등이었다. 단락기 생존율은 1년, 2년, 3년에 각각 77.1%, 75.4%, 74.1%이었다. 10세 이하의 환자에서 재수술의 빈도가 통계학적으로 의의 있게 높았다. 그리고 수두증의 원인에 따라서 통계학적으로 의의 있게 재수술의 빈도 차이가 있었다. 결 론 : 대부분의 뇌실 복강간 단락 부전은 술후 1년내에 발생하였다. 환자의 나이 및 수두증의 원인이 뇌실 복 강간 단락 부전의 주요 기여인자였다. To investigate contributory factors of CSF shunt failure, 237 patients, who underwent shunt placement from January 1995 to December 1998 at our hospital, were reviewed retrospectively. The causes of the hydrocephalus were tumor, hemorrhage, infection, congenital anomaly, normal pressure hydrocephalus, trauma and others. One hundred nine revisions of CSF shunting were done during follow up periods. The causes of shunt revisions were mechanical obstruction, malposition, infection and others. The contributory factors of CSF shunt failure and shunt survival rate were analyzed using SPSS. The shunt survival rate at 1, 2 and 3 years after procedure was 77.1%, 75.4%, 74.1% respectively. In the young age group below 10 years old, postinfectous hydrocephalus was the most common high risk factor for shunt revision. In conclusion, the most shunt failures developed in the first year after surgery and the age and causes of the hydrocephalus were major determinant factors of shunt revision.
알츠하이머 치매 환자에서의 인지영역별 기능과 병식과의 연관성
김영돈(Youngdon Kim),김상하(Sang Ha Kim),명우재(Woojae Myung),최준배(Junbae Choi),윤혜연(Hyeyeon Yoon),강효신(Hyo Shin Kang),나덕렬(Duk L. Na),김성윤(Seong Yoon Kim),이재홍(Jae-Hong Lee),한설희(Seol-Heui Han),최성혜(Seong Hye Choi),김 대한노인정신의학회 2014 노인정신의학 Vol.18 No.2
Objective:The aim of this study was to investigate the association between cognitive subdomains and insight into one’s cognitive impairment in patients with Alzheimer disease (AD). Methods:We recruited 1,722 patients with AD from the Clinical Research of Dementia of South Korea study and designed a cross-sectional study. Each patient’s cognitive subdomain was assessed by using the Seoul Neuropsychological Screening Battery-Dementia version. Severity of dementia was evaluated by Korean version of Mini-Mental Status Examination (K-MMSE) and Clinical Dementia Rating Sum of Boxes (CDR-SB). Insight into one’s cognitive impairment was categorized as ‘with insight’ and ‘without insight’ through interview with patient’s caregivers. Results:Among the 1,722 patients with AD, 1,475 patients were included in the ‘with insight’ group and the remaining 247 patients were included in the ‘without insight’ group. Subjects in the ‘without insight’ group had lower K-MMSE and CDR-SB scores than those in the ‘with insight’ group. After controlling for demographic data and dementia severity, higher scores on both attention function (odds ratio=1.12, 95% confidence interval : 1.03-1.21) and frontal-executive function (odds ratio=1.03, 95% confidence interval : 1.01-1.05) significantly predicted the membership to ‘with insight’ group. Conclusion:In patients with AD, attention and frontal-executive function were associated with insight into one’s cognitive impairment.
소아 뇌전증 환자에서 항경련제 치료 후 재발의 위험인자
김소리나(Sorina Kim),이주연(Ju Yeon Lee),오민수(Min Su Oh),김윤주(Yoon Joo Kim),최재홍(Jae Hong Choi),강현식(Hyun Sik Kang),한경희(Kyoung Hee Han),김영돈(Young Don Kim),강기수(Ki Soo Kang),김승효(Seung Hyo Kim) 대한소아신경학회 2016 대한소아신경학회지 Vol.24 No.3
목적: 제주도에 거주하는 뇌전증 진단을 받은 소아 환자들을 대상으로 항경련제 치료 종결 후 발작의 재발에 영향을 미치는 예측 인자를 살펴보고자 하였다. 방법: 2001년 3월부터 2013년 5월까지 첫 발작으로 제주대학교 병원을 방문한 환자들을 연구 대상으로 하였다. 뇌자기공명영상이 정상이면서 마지막 경련으로부터 2년 이상 경과하고 치료 종결시 뇌파가 정상인 환아들을 최종 연구 대상으로 하였다. 그리고 최소 관찰 기간 1년 이상인 경우로 제한하였다. 결과: 재발은 전체 68명 중 23명에서 발생하여 치료 종결 후 1년 완치 비율은 66.2%였다. 치료 종결 후 재발 환자들의 평균 재발 간격은 6.9±7.1개월이었다. 누적으로 계산시 항경련제 중단 도중 4명, 3개월 이내 16.2% (11/68), 6개월 이내 19.1% (13/68), 1년 이내 86.9% (20/23), 19개월 1명, 22개월 1명, 24개월 1명으로 대부분의 재발은 1년 이내에 발생하였고 모든 환자는 2년 이내에 재발하였다. 재발에 영향을 미치는 인자에 대한 단변량 분석에서 10세 이상에서 첫 발작 발생(P=0.007), 후기 관해(P=0.020), 2년 이상 항경련제 치료(P=0.018), 복합열성발작(P=0.001)이 통계학적으로 의미있게 재발군에서 높은 빈도로 나타났다. 뇌전증 가족력(P=0.068)은 경계선상의 통계학적인 의미를 보였다. 다변량 분석 결과, 복합열성발작(P=0.009, odds ratio= 24.2, 95% CI 2.23-262.28), 10세 이상 첫 발작 발생(P=0.002, odds ratio=16.7, 95% CI 2.76-101.31), 후기 관해(P=0.047, odds ratio=4.4, 95% CI 1.02-18.93)에서 뇌전증 환자의 치료 종결 후 재발에 영향을 미치는 인자로 확인되었다. 결론: 복합열성발작, 10세 이상 첫 발작 발생, 항경련제 치료 후 12개월 이내 경련 조절 실패에 해당하는 변수가 뇌전증 환자의 치료 종결 후 재발에 영향을 미치는 독립 인자로 확인되었다. Purpose: We evaluated the risk factors for relapse of unprovoked seizures after drug withdrawal in epileptic children in Jeju Island, South Korea. Methods: A population-based retrospective study was performed in 632 children whose first unprovoked seizure occurred between March 2001 and May 2013. The study included children experiencing a seizure free-state during a minimum of 2- year treatment period with anti-epileptic drugs (AEDs) with at least 1-year follow-up after AED withdrawal at the Pediatric Department at the Jeju National University Hospital. Results: Sixty-eight children including 36 boys and 32 girls, met the above-mentioned inclusion criteria, and subsequent seizure relapse occurred in 23 patients (33.8%). The mean age at the first unprovoked seizure was 79.1±45.9 months and the mean number of unprovoked seizures was 7.1±4.9. Partial and generalized seizures were observed in 19 and 49 patients, respectively. Several variables such as the age at onset of the first seizure, late remission, duration of AED treatment longer than 2 years, and complex febrile seizures before the first unprovoked seizure affected the risk for relapse. Multivariate analysis identified complex febrile seizure, age at the first seizure onset being more than 10 years, and late remission as significant predictors of relapse. Conclusion: We identified three independent risk factors for relapse following an unprovoked seizure in epileptic children after AED withdrawal : complex febrile seizure, age at the first seizure onset being more than 10 years, and late remission.
기존 업무시설의 에너지 성능 관리를 위한 운영실태 조사 항목 도출
김혜기(Hye-Gi Kim),김지영(Ji-Young Kim),김영돈(Young-Don Kim),김선숙(Sun-Sook Kim) 한국생활환경학회 2020 한국생활환경학회지 Vol.27 No.1
As demand for energy improvement of existing buildings increases, the importance of building information to evaluate energy performance is increasing. It is necessary to collect and analyze energy performance related data since the operation or occupancy characteristics of existing buildings have a great impact on energy use. To manage the energy performance of existing buildings, the purpose of this paper is to survey and analyze the energy use characteristics of public office buildings in Korea, including operational conditions. Sampling was conducted and survey items were estabilshed based on the domestic and international survey cases. Next, we showed the importance and necessity of systematic investigation through correlation analysis between survey items and single regression analysis on energy consumption.