Gadoxetic Acid (Gd-EOB-DTPA)-Enhanced MRI versus Gadobenate Dimeglumine (Gd-BOPTA)-Enhanced MRI for Preoperatively Detecting Hepatocellular Carcinoma: an Initial Experience

박율리,김성현,김승훈,전용환,이종미,김민주,최동일,이원재,김희정,구지현,임효근 대한영상의학회 2010 Korean Journal of Radiology Vol.11 No.4

Objective: This study was designed to compare the diagnostic performance of gadoxetic acid-enhanced magnetic resonance imaging (MRI) with gadobenate dimeglumine-enhanced MRI for preoperatively detecting hepatocellular carcinoma (HCC). Materials and Methods: Eighteen consecutive patients (17 men and one woman, age range: 31-73 years) with 22 HCCs underwent examinations with gadoxetic acid enhanced MRI and gadobenate dimeglumine-enhanced MRI on a 3.0-Tesla unit. The diagnosis of HCC was established after surgical resection and pathological conformation. Three observers independently reviewed each MR image in a random order on a tumor-by-tumor basis. The diagnostic accuracy of these techniques for the detection of HCC was assessed by performing an alternative free-response receiver operating characteristic (ROC) analysis. The sensitivity and positive predictive values were evaluated. Results: The average value of the area under the ROC curve (Az) for gadoxetic acid enhanced MRI (0.887) was not significantly different from the Az (0.899) for gadobenate dimeglumine-enhanced MRI (p > 0.05). The overall sensitivities of gadoxetic acid enhanced MRI and gadobenate dimeglumine-enhanced MRI were 80% and 83%, respectively, with no significant difference (p > 0.05). The differences of the positive predictive values for the two contrast agents for each observer were not statistically significant (p > 0.05). Conclusion: The diagnostic performance of gadoxetic acid-enhanced MRI and gadobenate dimeglumine-enhanced MRI for preoperatively detecting HCC is quite similar. Objective: This study was designed to compare the diagnostic performance of gadoxetic acid-enhanced magnetic resonance imaging (MRI) with gadobenate dimeglumine-enhanced MRI for preoperatively detecting hepatocellular carcinoma (HCC). Materials and Methods: Eighteen consecutive patients (17 men and one woman, age range: 31-73 years) with 22 HCCs underwent examinations with gadoxetic acid enhanced MRI and gadobenate dimeglumine-enhanced MRI on a 3.0-Tesla unit. The diagnosis of HCC was established after surgical resection and pathological conformation. Three observers independently reviewed each MR image in a random order on a tumor-by-tumor basis. The diagnostic accuracy of these techniques for the detection of HCC was assessed by performing an alternative free-response receiver operating characteristic (ROC) analysis. The sensitivity and positive predictive values were evaluated. Results: The average value of the area under the ROC curve (Az) for gadoxetic acid enhanced MRI (0.887) was not significantly different from the Az (0.899) for gadobenate dimeglumine-enhanced MRI (p > 0.05). The overall sensitivities of gadoxetic acid enhanced MRI and gadobenate dimeglumine-enhanced MRI were 80% and 83%, respectively, with no significant difference (p > 0.05). The differences of the positive predictive values for the two contrast agents for each observer were not statistically significant (p > 0.05). Conclusion: The diagnostic performance of gadoxetic acid-enhanced MRI and gadobenate dimeglumine-enhanced MRI for preoperatively detecting HCC is quite similar.

하직근 이상을 동반한 선천 한눈상전장애 1예

박율리,강남여 대한안과학회 2012 대한안과학회지 Vol.53 No.12

Purpose: To report a congenital monocular elevation deficiency (MED) associated with inferior rectus anomaly. Case summary: A 3-year-old, otherwise healthy boy presented with left hypotropia. He showed chin-up and left head turn with left pseudoptosis. On examination, there was a left hypertropia of 60 prism diopters (PD) and esotropia in primary position. Upgaze -4 limitation in abduction and -3 from primary position, poor Bell’s phenomenon, and normal vertical saccadic velocity until midline were observed. On orbital CT, thin and nasally displaced left inferior rectus showing enlargement at its posterior segments near the orbital apex was observed. Forced duction test at surgery revealed a strong positive restriction and thin, taut, fibrotic inferior rectus was inserted and displaced nasally. Conclusions: Left inferior rectus recession of 5.5 mm with 2.0 mm of temporal transposition improved elevation deficiency, but consecutive exotropia and hypotropia remained. Knapp procedure combined with left lateral rectus recession of 5.5 mm and left medial rectus resection of 4.5 mm, and right superior rectus recession of 9.5 mm were additionally performed. Pseudoptosis and chin elevation resolved but left hypotropia 10PD, and exotropia 6PD remained. Elevation restriction in primary position and abduction were improved but still persisted. This case indicated that MED may accompany congenital inferior rectus anomaly. If severe inferior rectus restriction is observed during the forced duction test, a structural anomaly of the inferior rectus causing motility defects of MED.

Effectiveness of Overnight Orthokeratology with a New Contact Lens Design in Moderate to High Myopia with Astigmatism

박율리,Hoon Kim,Jae Ku Kang,조경진 대한의학레이저학회 2021 MEDICAL LASERS Vol.10 No.4

Background and ObjectivesTo assess the effectiveness of overnight orthokeratology (OK) in myopia using a new contact lens design over a one-month wearing period.Materials and MethodsParticipants were required to have myopia between –3.00 and –7.50D and astigmatism ≤ 2.00 D to participate in the study. The participants underwent OK with the White OK lens® (Interojo, Pyungtek, Korea), which has a 6-curve lens design. Participants were assessed at weeks 1, 2, and 4 using slit-lamp bio-microscopy, and tested for refraction, uncorrected distance visual acuity, and corneal topography. Success was defined as achieving a Logarithm of the Minimum Angle of Resolution (logMAR) ≤ 0.1.ResultsA total of 46 eligible subjects with a mean age of 23.11 ± 7.89 years were recruited. Baseline logMAR was 1.18 ± 0.30 and a consistent decrease in logMAR was observed from week 1 to week 4. The success rate was 95.35% at week 4. The mean sphere significantly decreased from a mean pre-fitting value of –4.58 ± 1.28 D to a mean value of –0.65 ± 0.69 D at week 4 (p < 0.0001). Statistically significant corneal flattening was detected during keratometry at week 4.ConclusionOvernight OK with the White OK lens is effective for the correction of moderate and high myopia with astigmatism over a one-month wearing period.

접촉식과 광학적 방식에 의한 전방깊이 측정값의 비교

박율리,황형빈,정성근.Yuli Park. MD. Hyung Bin Hwang. MD. Sung Kun Chung. MD. PhD 대한안과학회 2013 대한안과학회지 Vol.54 No.8

Purpose: To assess the reproducibility and reliability of applanation A-scan ultrasonography (Pacscan 300A, Sonomed Inc., Chicago, IL, USA) and optical measurements with IOL Master<sup>® (Carl Zeiss Meditec, Germany), Pentacam<sup>® (Oculus, Wetzlar, Germany), and Orbscan II<sup>® (Orbtek Inc., Laredo, TX, USA) when measuring anterior chamber depth (ACD). Methods: In this study of 188 eyes of 94 patients, ACD estimation prior to cataract surgery was preformed by the applanation A-scan method and IOL Master<sup>®, Pentacam<sup>®, and Orbscan II<sup>® optical methods. Repeatability from each device was evaluated by coefficient of variation, standard deviation, and intraclass correlation coefficient. RM-ANOVA on Ranks was used to compare the differences in ACD among the devices. The Bland-Altman plot was performed to assess agreement in measurements between the devices. Results: The mean ACD according to the applanation A-scan method and IOL Master<sup>®, Pentacam<sup>®, and Orbscan II<sup>® optical methods were 2.89 ± 0.49 mm, 3.25 ± 0.45 mm, 3.21 ± 0.46 mm, and 3.19 ± 0.47 mm, respectively, and the differences were statistically significant (p < 0.01). The coefficient of variation for the 4 methods was 2.50% in the A-scan, 0.87% in the IOL Master<sup>®, 1.25% in the Pentacam<sup>®, and 1.04% with Orbscan II<sup>®, and reproducibility was higher with the optical principle devices. The correlation coefficient between A-scan and IOL Master<sup>® was 0.65, between IOL Master<sup>® and Pentacam<sup>® 0.91, between IOL Master<sup>® and Orbscan II<sup>® 0.90, between A-scan and Pentacam<sup>® 0.69, between A-scan and Orbscan II<sup>® 0.71, and between Pentacam<sup>® and Orbscan II<sup>® 0.93. Conclusions: Applanation A-scan provided lower measurements for ACD compared with IOL Master<sup>®, Pentacam<sup>® and Orbscan II<sup>®. There was good agreement between results obtained with the latter 3 methods, and reproducibility was high with optical measurements. The coefficient of variation was low for IOL Master<sup>®.

녹내장환자에서 백내장수술 후 안압하강에 영향을 미치는 전방각경 점수 및 술 전 인자

박율리,김영빈,조경진 대한안과학회 2019 대한안과학회지 Vol.60 No.5

Purpose: To evaluate a new gonioscopy score and preoperative factors as a potential predictor for intraocular pressure (IOP) reduction after phacoemulsification. Methods: This is a retrospective review of 182 eyes with glaucoma of either open or narrow angles that underwent phacoemulsification. Preoperative variables such as age, IOP, refractive errors, anterior chamber depth (ACD), axial length, and lens position were evaluated at 6 months after surgery. A preoperative gonioscopy score was created, summing the Shaffer gonioscopy grading in 4 quadrants. To determine variables associated with IOP change at 6 months, univariate and multivariate linear regression analysis was performed. Results: The mean age of the patients was 72.8 ± 9.5 years and the average preoperative IOP was 16.4 ± 3.7 mmHg with 1.2 glaucoma medications. The mean IOP reduction after phacoemulsification was 2.7 ± 2.2 mmHg at postoperative 6 months. Preoperative IOP (β = 0.55, p < 0.001), gonioscopy score (β = -0.29, p < 0.001), ACD (β = -0.67, p = 0.02), and IOP/ACD ratio (β = 0.58, p = 0.01) were associated with IOP reduction at 6 months. Conclusions: Preoperative predictors for IOP reduction after phacoemulsification were preoperative IOP, ACD, gonioscopy score, and IOP/ACD ratio in patients with glaucoma. The IOP/ACD ratio and gonioscopy score can be easy parameters to obtain and may help clinicians to estimate the IOP reduction after phacoemulsification. 목적: 녹내장환자에서 수정체유화술 후 안압에 영향을 주는 전방각경 점수를 포함한 술 전 인자에 대해 알아보고자 하였다. 대상과 방법: 녹내장환자 중 백내장수술을 받은 182안을 대상으로 후향적 의무기록 분석을 시행하였다. 나이, 안압, 안축장, 전방 깊이, 수정체 위치, 굴절력을 술 후 6개월째에 비교 분석하였다. 술 전 전방격경 점수는 4사분면의 Shaffer 전방각경 grading을 합하여 계산하였다. 단변량 및 다변량 회귀분석을 이용하여 위 인자들과 술 후 안압의 관계를 분석하였다. 결과: 환자들의 평균 나이는 72.8 ± 9.5세, 평균 술 전 안압은 16.4 ± 3.7 mmHg로 측정되었으며, 평균 1.2개의 안압하강제를 사용하고 있었다. 술 후 6개월째에 평균 2.7 ± 2.2 mmHg의 안압하강을 보였다. 다변량 분석상 술 전 안압(β=0.55, p<0.001). 전방 깊이(β=-0.67, p=0.02), 전방각경 점수(β=-0.29, p<0.001) 및 intraocular pressure/anterior chamber depth (IOP/ACD)비(β=0.58, p=0.01)가 통계적으로 유의하게 술 후 6개월의 안압하강과 연관성을 보였다. 결론: 녹내장환자에서 수정체유화술 후 안압하강과 관련된 술 전 인자는 술 전 안압, 전방 깊이, 전방각경 점수 그리고 IOP/ACD비였다. IOP/ACD비와 전방각경 점수는 백내장수술 후 안압하강을 예측하는 데에 도움이 될 것으로 생각된다.

2009 개정 중학교 1학년 과학 교과서에 반영된 과학의 본성 분석

박율리,우애자 이화여자대학교 교과교육연구소 2017 교과교육학연구 Vol.21 No.3

The purpose of this study is to analyze the nature of science reflected in the middle school first year science textbook for the 2009 revised curriculum. For the study, four kinds of textbooks were selected and each chapter was divided into five areas, i.e., introduction, main body, inquiry activities, reading materials, and evaluation to classify the analysis unit. The textbooks were analyzed using the four themes of the nature of science by Lee(2013) and the explicitness of the nature of science by Kim(2010). The results are as follows. First, the nature of science was analyzed under four themes: ‘I. nature of scientific knowledge’ was 54.3%, while ‘II. nature of scientific inquiry’, ‘III. nature of scientific thinking’, and ‘IV. nature of interaction among science, technology, and society’ were 27.1%, 8.8%, and 9.8%, respectively. And each theme was mainly found in the specific sub-themes. Analysis of the textbooks by five areas showed that themes I and III were higher in the evaluation, theme II was higher in inquiry activities, and theme IV was higher in the main body and the reading materials. Analysis by chapter showed that chapter 1 included the theme IV at the highest ratio and in the rest of the chapters the distribution of the four themes was similar. Analysis by publisher shows that the distributions of the four themes were similar across publishers. Second, the nature of science was implicitly presented in 99% of the total analysis units. Especially, only chapter 1 showed explicit descriptions of the nature of science. 본 연구에서는 2009 개정 중학교 1학년 과학 교과서에 반영된 4가지 과학의 본성의 분포와 과학의 본성에 대한 명시성을 분석하고자 하였다. 이를 위해 교과서 4종을 분석 대상으로 선정하였고, 교과서 단원을 단원 도입, 본문, 탐구 활동, 읽을거리, 평가 문항의 영역으로 구분하여 분석 단위를 선정하였다. Lee(2013)의 과학의 본성 개념 틀과 Kim(2010)의 과학의 본성의 명시성 기준을 사용하여 분석하였다. 본 연구의 결과는 다음과 같다. 첫째, 4종 교과서 전체에서 ‘I. 과학 지식의 본 성’이 54.3%를 차지하고 있었으며, ‘II. 과학적 탐구의 본성’, ‘III. 과학적 사고의 본성’과 ‘IV. 과학과 기술 및 사회의 관계적 본성’은 각각 27.1%, 8.8%와 9.8%로 나타났으며, 과학의 본성 각 범주별로 특정 하위 항목에 편중되어 나타났다. 분석 영역별 분석 결과, 범주 I과 범주 III은 평가 문항, 범주 II는 탐구 활동, 범주 IV는 본문과 읽을거리에서 높은 비율로 나타났다. 단원별 분석 결과, 1단원은 범주 IV를 가장 높은 비율로 포함하고 있으며, 나머지 단원에서는 4가지 과학의 본성의 범주의 분포가 비슷하게 나타났다. 출판사별 분석 결과, 출판사에 관계없이 4가지 범주의 분포는 비슷한 것으로 나타났다. 둘째, 과학의 본성의 명시성을 분석한 결과 전체 분석 단위의 99.0%가 암시적인 것으로 나타났다. 단원별 분석 결과, 과학의 본성에 관한 명시적 표현은 1단원에서만 나타나고 있었다.

두 종류의 다초점 비구면 인공수정체 삽입 후 임상 결과의 비교

박율리,황규연,주천기,Yu Li Park,MD,Gyu Yeon Hwang,MD,Choun Ki Joo,MD,PhD 대한안과학회 2013 대한안과학회지 Vol.54 No.8

Purpose: To evaluate the efficacy of the OptiVisTM Multifocal intraocular lens (IOL) and compare the clinical outcome between OptiVisTM and AcrySof<sup>® ReSTOR<sup>® D1. Methods: We reviewed 20 eyes of 11 patients implanted with OptiVisTM and 20 eyes of 10 patients implanted with AcrySof<sup>® ReSTOR<sup>® D1. The clinical outcomes of the 2 IOLs were evaluated 1 and 2 months postoperatively and consisted of distant, intermediate, and near visual acuity, depth of focus, contrast sensitivity, wavefront aberration, patient satisfaction, decentration and IOL tilt. Results: Intermediate vision was better in the OptiVisTM group. There were no statistical differences between the 2 groups with respect to distant vision, near vision and wavefront aberration, contrast sensitivity, decentration and IOL tilt. Depth of focus was deeper in the OptiVisTM group at the intermediate visual acuity zone. There were no statistically significant result differences between postoperative 1 and 2 months. Conclusions: The OptiVisTM multifocal IOL provided satisfactory visual acuity at distance, near, and intermediate with no apparent reduction in contrast sensitivity. The IOL can be effective for improving patient satisfaction after cataract surgery as well as correcting presbyopia.

개방각녹내장 환자에서 수정체유화술 시 안압하강에 영향을 미치는 인자 분석

박율리(Yuli Park),문정일(Jung Il Moon),조경진(Kyong Jin Cho) 대한안과학회 2018 대한안과학회지 Vol.59 No.10

목적: 원발개방각녹내장 환자에서 수정체 초음파유화술 시 안압하강에 영향을 미치는 인자에 대해 알아보고자 하였다. 대상과 방법: 원발개방각녹내장 환자 중 초음파유화술 시행 후 3년 이상 경과한 145안을 대상으로 후향적 의무기록 분석을 시행하였다. 나이, 안압, 안축장, 전방 깊이, 수정체 위치, 굴절력, 초음파유화술 시간, 누적소비에너지, 평형염액 사용량 등을 술 후 6, 12, 24, 36개월째 비교 분석하였다. 단변량 및 다변량 회귀분석을 이용하여 위 인자들과 술 후 안압의 관계를 분석하였다. 결과: 술 후 6, 12, 24, 36개월에 각각 평균 -1.9 ± 2.9, -1.6 ± 2.8, -1.4 ± 3.1, 그리고 -1.2 ± 2.7 mmHg의 통계적으로 유의한 안압하강을 보였다(p<0.01). 단변량 회귀분석상 술 전 안압이 높을수록(p<0.001), 술 전 수정체가 앞쪽으로 위치하였을수록(p<0.001), 초음파유화술 시간이 길수록(p<0.05), 누적소비에너지가 클수록(p<0.05) 술 후 안압하강이 더 컸다. 다변량 회귀분석상 술 전 안압(p<0.01), 수정체 위치(p=0.04), 그리고 초음파유화술 시간(p=0.04)이 술 후 3년까지 안압하강과 연관이 있었다. 결론: 원발개방각녹내장 환자에서 높은 술 전 안압은 초음파유화술 후 더 큰 안압하강 효과를 보였고, 술 전 안압과 나이를 보정하였을 때 초음파유화술 시간과 앞쪽으로의 수정체 위치가 안압하강과 연관성을 보였다. 이는 개방각녹내장 환자에서 수정체 초음파유화술과 녹내장 수술의 동시 수술 여부의 결정에 있어 도움이 될 것으로 생각된다. Purpose: To identify independent predictors of long-term postoperative intraocular pressure (IOP) reduction after phacoemulsification in patients with primary open-angle glaucoma (POAG). Methods: This was a retrospective review of 145 eyes with open-angle glaucoma (OAG) who were followed up for more than 3 years after uncomplicated phacoemulsification cataract surgeries. Demographic, clinical, biometric, and intraoperative variables such as IOP, refractive errors, anterior chamber depth, axial length, relative lens position (RLP), and phacoemulsification parameters such as phaco time, cumulative dissipated energy (CDE), and balanced salt solution volume were evaluated at 6, 12, 24, and 36 months after surgery. Univariate and multivariate linear regression were used to analyze the relationship between these variables and the postoperative IOP. Results: There was a statistically significant average postoperative IOP reduction at 6, 12, 24, and 36 months of -1.9 ± 2.9, -1.6 ± 2.8, -1.4 ± 3.1, and -1.2 ± 2.7 mmHg, respectively (p < 0.01). Higher preoperative IOP (p < 0.001), a more relative anterior lens position (p < 0.001), shorter phaco time (p < 0.05), and higher CDE (p < 0.05) were significantly associated with a greater postoperative decrease in IOP using univariate analyses. Using multivariate analyses, preoperative IOP (p < 0.01), lens position (p = 0.04), and phaco time (p = 0.04) were associated with greater postoperative IOP reduction at 3 years. Conclusions: Higher preoperative IOP was associated with a greater IOP-lowering effect after phacoemulsification in OAG patients. Phaco time and anterior RLP were independently associated with IOP reduction after adjusting for age and preoperative IOP. These findings have important implications when considering combined cataract extraction and filtration surgery for POAG patients.

해외저술 소개 : 임상 연구: 치료 ; 고주파열치료 후 국소암 진행(Local tumor progression) 예측 인자로서의 간세포암의 동맥기 조영증강 정도(초)

박율리 ( Y. Park ),김영선 ( Y. S. Kim ),임현철 ( H. Rhim ),임효근 ( H. K. Lim ),이원재 ( W. J. Lee ),( D. Choi ) 대한간암연구회 2010 대한간암학회지 Vol.10 No.-

스트레이라이트 및 빛번짐 정도를 이용한 한국인의 후낭 혼탁의 분석

최승용,박율리,김현승 대한안과학회 2015 대한안과학회지 Vol.56 No.7

목적: 스트레이라이트 및 빛번짐 정도를 이용하여 후낭 혼탁을 평가하고, 기존의 방법과 비교하여 후낭 혼탁 평가 방법으로서의 적합성을 확인하고자 한다. 대상과 방법: 초음파 유화술 후 후낭 혼탁이 생긴 36명을 대상으로 산동 전 최대교정시력, 스트레이라이트(C-quant, Oculus GmbH,Wetzlar, Germany) 및 빛번짐 정도(Binoptometer, Oculus GmbH, Wetzlar, Germany)를 측정하고, 산동 후 세극등현미경으로 촬영한후낭 혼탁 이미지를 Evaluation of Posterior Capsular Opacification (EPCO) 프로그램(EPCO software, University of Heidelberg,Heidelberg, Germany)으로 분석하였다. 레이저 후낭 절개술 전후로 같은 검사를 시행 후 치료 전후 수치를 비교하였다. 결과: 후낭 혼탁 치료 전후의 최대교정시력, EPCO 점수, 스트레이라이트가 모두 유의하게 호전되었다(p<0.05). 최대교정시력 0.63이상인 경도의 시력 저하를 보이는 후낭 혼탁의 경우 시력은 유의한 호전이 없었으나 스트레이라이트와 EPCO 점수는 유의한 호전을보였다(p<0.05). 빛번짐 정도는 유의한 호전이 없었으나 스트레이라이트와 유의한 상관관계가 관찰되었다(p=0.023, Rho=0.732). 결론: 스트레이라이트는 후낭 혼탁 평가에 적용 가능한 검사이며 빛번짐 정도는 유사한 시기능을 평가하는 스트레이라이트와의 상관관계가 있어 후낭 혼탁 평가에 보조적으로 사용 가능할 것으로 사료된다. Purpose: To evaluate posterior capsular opacity (PCO) using straylight and glare sensitivity meter and to compare availability of straylight and glare sensitivity with known methods for PCO evaluation. Methods: Thirty-six pseudophakic eyes with PCO were selected for this study. Best-corrected visual acuity (BCVA), straylight(C-quant, Oculus GmbH, Wetzlar, Germany) and glare sensitivity (Binoptometer, Oculus GmbH, Wetzlar, Germany) were measured before mydriasis. After mydriasis, PCO images were captured with a slit-lamp and analyzed using the Evaluation of Posterior Capsular Opacification (EPCO) program (EPCO software, University of Heidelberg, Heidelberg, Germany). The same measurements were taken after capsulotomy and compared with pre-capsulotomy data. Results: After capsulotomy, BCVA, EPCO score and straylight were improved with statistical significance (p < 0.05). Cases of PCO with mildly decreased visual acuity showed statistically significantly improved EPCO score and straylight (p < 0.05). Glare sensitivity did not show significant improvement but was statistically significantly correlated with straylight (p = 0.023, Rho =0.732). Conclusions: Straylight is an available measurement for evaluation of PCO. Glare sensitivity meter which correlates with straylight can be used as a supportive measurement.