노안교정을 위한 비수술요법

나경선 대한의사협회 2019 대한의사협회지 Vol.62 No.12

This study aimed to describe the basic optical properties for presbyopia correction, including eyeglasses and contact lenses. Conventional eyeglasses are the most established technology for presbyopia correction, and contact lenses have been recognized to have a huge potential in presbyopia correction. However, successful treatment using contact lenses is dependent on age-related factors, such as upper and lower eyelid movements, palpebral aperture, and decreased lacrimal secretion and tear stability. Monovision and multifocality are optical properties of the lens that form the basis of presbyopia correction. The monovision method is based on the principle of neuro-adaptation, wherein one eye automatically selects a clear image and suppresses an unclear image for processing in the brain when there is a difference in the clarity of the images obtained from both the eyes because of anisopia, which is characterized by unequal visual power between the two eyes. Simultaneous views of near and far objects cannot be achieved using eyeglasses, but these can be realized using contact lenses or intraocular lenses. Alternative views of near and far objects can be achieved using a variety of bifocal contact lenses, which function similar to bifocal eyeglasses. Traditional strategies for presbyopia correction, including the use of monovision, bi/tri/multifocal, and progressive eyeglasses and the use of contact lenses, are being challenged by novel strategies involving pharmacotherapy and electrostimulation. Although the immediate prospect of any newly developed innovation remains slim, improved lens profiles would lead to a better match between the lens and the needs of individuals with presbyopia.

측두악관절 잡음자의 수평면상 하악 편위 운동에 관한 연구

나경선,강동완,Na, Kyung-Seon,Kang, Dong-Wan 대한치과보철학회 1993 대한치과보철학회지 Vol.31 No.2

Although pantograph has been used to investigate whether the determinents of the mandibular movement were possible contributing factors of TMJ click, there was the problems to understand the role of tooth morphology upon the occurrence of click because of using appliance without tooth contacts. There Were advantages to evaluate the effects of tooth morphology upon the mandibular movements, because intraoral tracing device(Functiograph$^{(R)}$) had been obtained maintaining occlusal contact between the upper and lower natural teeth during mandibular movement. The purpose of this study was to record the mandibular eccentric movement quantitatively performed in 20 adult control subjects and 20 adult subjects with TMJ click and to investigate the effects of occlusion upon the occurrence of TMJ click. The obtained results were as follows : 1. The average ICP-P distance was $3.07{\pm}0.73mm$ in subjects with TMJ click, $2.14{\pm}0.85mm$ in control subjects. There was a statistical significance between subjects with TMJ click and control subjects(P<0.001). 2. The average ICP-P distance was $3.07{\pm}1.14mm$ in subjects with TMJ click, $2.61{\pm}0.96mm$ in control subjects. There was a statistical significance between subjects with TMJ click and control subjects(P<0.05). 3. The average distance of right and left lateral movement was not statistically significant between subjects with TMJ click and control subjects. 4. The average lateral displacement from midline during RCP was $0.75{\pm}0.54mm$ subjects with TMJ click, $0.16{\pm}0.17mm$ in control subjects. There was a statistical significance between subjects with TMJ click and control subjects(P<0.001). 5. The average lateral displacement from midline during protrusive movement was $0.88{\pm}0.54mm$ in subjects with TMJ click, $0.20{\pm}0.23mm$ in control subjects. There was a statistical significance between subjects with TMJ click and control subjects(P<0.001). 6. The average angle of right and left lateral movement was $144.2{\pm}20.20^{\circ}$ in subjects with TMJ click, $138.15{\pm}20.09^{\circ}$ in control subjects. There was a statistical significance between subjects with TMJ click and control subjects(P<0.05).

측두악관절 잡음자의 수평면상 하악 편위 운동에 관한 연구

나경선,강동완 朝鮮大學校 口腔生物學硏究所 1992 口腔生物學硏究 Vol.16 No.2

단안 상사근마비에서의 안구회선

나경선,이세엽,이영춘,Kyung Sun Na,Se Youp Lee,Young Chun Lee 대한안과학회 2007 대한안과학회지 Vol.48 No.10

Purpose: We evaluated the concordance of laterality of the paretic eye and the torsional eye in unilateral superior oblique palsy showing an inferior oblique overaction. Methods: Thirty-nine patients diagnosed as having a unilateral superior oblique palsy were evaluated for visual acuity, refractive manifestation, ocular movement, prism cover test, and fundus photograph. Of these patients, 32 derived from congenital causes and 7 acquired the condition from trauma. An ocular movement exam was performed to check an inferior oblique overaction, and a fundus photograph was used to measure the ocular torsional amount. Inferior oblique myectomy or recession was performed along with horizontal strabismus surgery. Results: Objective extorsion was presented in paretic eyes of 29 patients (74.4%) and nonparetic eyes of 10 patients (25.6%). The congenital superior oblique palsy patients were divided into two groups by the concordance of laterality of paretic eyes and torsional eyes. In the concordance group of 22 patients, the torsional amount was decreased from +17.69to +7.98and inferior oblique overaction from +2.27to +0.25after an inferior oblique muscle weakening procedure. In the discordance group of 10 patients, torsional amount was decreased from +16.97to +8.73and inferior oblique overaction from +2.50to +0.21postoperatively. In acquired oblique palsy patients, all patients showed the concordance of laterality, and the torsional amount was decreased from +16.76to +8.80and inferior oblique overaction from +2.5to +0.21after inferior oblique weakening procedure. Conclusions: We found that the paretic eye and the torsional eye may not coincide in congenital superior oblique palsy but always coincide in acquired oblique palsy after trauma. After an inferior oblique muscle weakening procedure, ocular torsional amount of paretic or sound eye is decreased in every case.

전층각막이식술후 발생한 백내장

나경선,정성근,Kyung Sun Na,M,D,Sung Kun Chung,M,D 대한안과학회 2007 대한안과학회지 Vol.48 No.12

Purpose: To evaluate the risk factors for cataract formation and cataract extraction after penetrating keratoplasty to determine whether a combined surgery should be performed. Methods: Variables from 189 phakic eyes that underwent penetrating keratoplasty from April 1992 to November 2004 were analyzed for the possibility of cataract extraction after penetrating keratoplasty according to sex, age, diagnosis, accompanied glaucoma, preoperative vision and steroid use. The mean interval between penetrating keratoplasty and cataract extraction was also studied. Results: Cataract extraction was performed in 27 eyes (14.3%) and the mean interval between keratoplasty and cataract extraction was 24.5 months. Age was determined to be the most important independent risk factor for cataract extraction (p=0.0009) associated glaucoma also shown to be a risk factor (p=0.0011). Sex and corneal disease before keratoplasty were not shown to be risk factors. In the mean interval cataract extraction following penetrating keratoplasty, no statistically significant difference was found according to age, sex and diagnosis. Posterior subcapsular cataract was predominant (55.6%) and the mean visual acuity improved from 0.10 to 0.42. Conclusions: The likelihood of cataract formation and cataract extraction subsequent to penetrating keratoplasty increased with age and associated glaucoma. The results from this study can help surgeons to determine whether combined surgery should be performed and help them to counsel patients on the risk of cataract formation.

반복적인 눈꺼풀올림근 절제술 후 발생한 역 벨현상

나경선,신소정,양석우,Kyung Sun Na,M,D,So Jung Shin,M,D,Suk-Woo Yang,M,D 대한안과학회 2008 대한안과학회지 Vol.49 No.2

`Purpose: We report a complication involving a transient inversion of Bell's phenomenon observed following extensive levator resection performed to treat aponeurotic ptosis. Case summary: A 22 year old female patient complained of ptosis of both eyelid. The levator function of both lid was good, and a normal corneal protection mechanism was observed. The patient underwent levator resection and several reoperation because of asymmetrical lid height and entropion. Inversion of Bell's phenomenon was observed in the postoperative period. Eye with Bell's phenomenon reverted to normal within 1 month after final operation, and there were no corneal erosion. Lubricating eyedrop was used frequently during the postoperative period. Conclusions: It is important to consider that abnormal cases of Bell's phenomenon sometimes manifest after repetitive and extensive levator resection and to keep a close watch on the cornea while providing it with ample lubrication.`

[연예인 데이트] 진한 향기속에 숨은 당돌함 - ‘보고 또 보고’의 김지수

나경선 샘터사 1998 월간 샘터 Vol.29 No.9

눈물샘에 발생한 점막표피양암 1예

나경선,이나영,양석우,Kyung Sun Na,Na Young Lee,Suk Woo Yang 대한안과학회 2006 대한안과학회지 Vol.47 No.11

Purpose: We have experienced a mucoepidermoid carcinoma of the lacrimal gland. Methods: 39-year-old male patient complaint of proptosis and upper eyelid swelling of the left eye for 4 months. Orbit radiographs showed a 2 cm sized inhomogenous density mass in upper lateral aspect of the left orbit. Excisional biopsy was performed. Results: Histopathologically, the mass was proved as an intermediate grade mucoepidermoid carcinoma of the lacrimal gland. Postoperative radiopraphs showed no metastasis. Additional operation was performed to eliminate the remnant tumor near the lacrimal gland. The patient underwent a concurrent chemoradiotherapy and no recurrence or metastasis was found. Conclusions: We report a mucoepidermoid carcinoma which occurs rarely in lacrimal gland.

난치성 전신성 홍반성 루푸스 환자에 대한 자가조혈모세포이식

나경선 ( Kyoung Sun Na ),최정혜 ( Jung Hae Choi ),유대현 ( Dae Hyun Yoo ),김신규 ( Think You Kim ),안명주 ( Myung Ju Ahn ),배상철 ( Sang Cheol Bae ) 대한류마티스학회 2003 대한류마티스학회지 Vol.10 No.2

Objective: To determine the safety and efficacy of immune ablation followed by autologous hematopoietic stem cell transplantation (HSCT) in refractory systemic lupus erythematosus (SLE). Methods: Three patients who had been refractory to steroid and one or more immunosuppressive drug were included. Peripheral blood stem cells were mobilized with cyclophosphamide (CTX, 3 g/m2), followed by granulocyte-colony stimulating factor (5μg/kg/day). T lymphocytes were depleted from the graft by selection of CD34 positive cells. Conditioning regimens composed of high dose CTX (total dose 200 mg/kg) and anti-thymocyte globulin (total dose 90 mg/kg) in 2 patients and BEAM (BCNU 300 mg/m2, etoposide 200 mg/m2, cytarabine 200 mg/m2, melphalan 200 mg/m2) in 1 patient. Stored stem cells were reinfused 48 hours after conditioning. Results: Among 3 patients, first patient had lupus nephritis, second patient had overlap syndrome combined with rheumatoid arthritis (rhupus) and the last patient had severe thromobocytopenia and intractable polyserositis. No life threatening complications were observed during the treatment. All patients demonstrated rapid and marked improvement in organ function and quality of life just after HSCT. Previous massive proteinuria in first patient was decreased to less than 500 mg/day with 6 months follow up. Rhupus patient satisfied American college of rheumatology 70% response criteria with 3 months follow up. But third patient improved polyserositis dramatically 1 month after HSCT and relapsed at 9 weeks. Conclusion: In refractory SLE patients, HSCT can be performed safely with marked improvement and sustained withdrawal of all immunosuppressive medication. A further randomized trial is needed to confirm the efficacy and durability of remission.

인류의 신장 혈관간세포에서 유착분자 발현과 Chemokine 발현에 미치는 Th1 Cytokine과 Th2 Cytokine의 상호 작용

나경선 ( Kyoung Sun Na ),강태영 ( Tae Young Kang ),이진숙 ( Jin Sook Lee ),박용욱 ( Yong Wook Park ),이혜순 ( Hye Soon Lee ),엄완식 ( Wan Sik Uhm ),김태환 ( Tae Hwan Kim ),전재범 ( Jae Bum Jun ),배상철 ( Sang Cheol Bae ),이춘용 ( 대한류마티스학회 2004 대한류마티스학회지 Vol.11 No.2

Purpose: Predominance of IFN-γ over Th2 cytokines is evident in proliferative lupus nephritis. Th2 cytokines such as IL-10, or IL-4 have been known to suppress Th1 cytokine driven pro-inflammatory responses. However a combination of cytokines can exert variable effects during the evolution of autoimmune diseases depending on the various factors, such as the stage of diseases or local versus systemic expression. To determine whether Th2 cytokines play a pro- or anti-inflammatory role in the local glomerular inflammation induced by IFN-γ, we studied the effect of IL-10 and IL-4 on the expression of chemokines and adhesion molecules in human mesangial cells stimulated with IFN-γ. Methods: Human mesangial cells were obtained from 3 patients undergoing nephrectomy. MCP-1, RANTES, ICAM-1, and CD40 expressions were examined in response to various cytokine stimulation; IFN-γ, IL-10, IL-4, IFN-γ+IL-10, IFN-γ+IL-4, and IFN-γ+IL-10+IL-4, respectively. Expression of MCP-1 mRNA was analyzed by RT-PCR and the levels of MCP-1 and RANTES in the culture supernatants were measured using an enzyme immunoassay. ICAM-1 and CD40 surface expressions were analyzed by flow cytometry. Results: IFN-γ increased basal mRNA expression of MCP-1, and IL-10 strongly enhanced the level of MCP-1 mRNA and protein expressions induced by IFN-γ. IL-4 did not affect significantly on the MCP-1 expression induced by IFN-γ. Although IFN-γ increased the concentration of RANTES, IL-10 and IL-4 did not affect IFN-γ induced RNTES expression. Increased expression of ICAM-1 and CD40 induced by IFN-γ were not down-regulated by IL-10 or IL-4. Conclusion: Taken together, IL-10 appears to augment local inflammatory reaction though the up-regulation of MCP-1 from mesangial cells in the presence of IFN-γ rather than inhibit inflammatory response in the pathogenesis of proliferative glomerulonephritis.