스테로이드 노출 수정체 상피세포에서 중합효소연쇄반응 방법을 통한 유전자의 발현 변화

유웅선,서진석,조용운,하영술,정인영,서성욱,김성재 대한안과학회 2020 대한안과학회지 Vol.61 No.5

Purpose: We investigated the expression levels of 84 genes in dexamethasone-exposed human lens epithelial cells using polymerase chain reaction (PCR) array analysis. Methods: The viability and motility of lens epithelial cells were examined after treatment with dexamethasone at 0.01, 0.1, and 1 mg/mL; Western blot was used to evaluate the expression levels of fibronectin, α-smooth muscle actin (α-SMA), and E-cadherin. After 24, 48, and 72 hours of dexamethasone treatment at 0.1 mg/mL, the expression levels of 84 growth factors were analyzed using PCR array. Results: Cell viability did not change significantly at dexamethasone levels of 0.01 or 0.1 mg/mL, but decreased markedly at 1 mg/mL; motility increased in a concentration-dependent manner at 0.01 and 0.1 mg/mL. Western blot showed that fibronectin levels increased significantly at all dexamethasone concentrations tested; the α-SMA level increased only at 0.01 mg/mL, and E-cadherin levels decreased significantly at all tested concentrations. PCR showed that the levels of FGF1, FGF2, IL-11, regulators of apoptosis (GDNF, IL-1β, and NRG2), and regulators of cell differentiation (BMP5, FGF1, FGF2, and FGF5) decreased more than twofold, whereas the levels of FGF9 and FGF19 increased more than twofold. Conclusions: PCR performed after exposure of lens epithelial cells to dexamethasone may identify the genes involved in the development of steroid-induced cataracts. 목적: 수정체 상피세포에 덱사메타손을 처리한 후 polymerase chain reaction (PCR) array을 이용하여 84개 유전자들의 발현 변화를 조사하였다. 대상과 방법: 수정체 상피세포에 0.01, 0.1, 1 mg/mL 농도의 덱사메타손을 처리한 후 세포생존율과 이동성 변화를 조사하였으며, fibronectin, α-smooth muscle actin (α-SMA), E-cadherin 발현 확인을 위한 Western blot를 시행하였다. 그리고 0.1 mg/mL 농도의 덱사메타손을 24, 48, 72시간 처리한 후 84개 성장 인자의 발현 변화를 PCR array로 조사하였다. 결과: 덱사메타손 0.01과 0.1 mg/mL 농도에서 세포생존율의 의미있는 변화는 관찰되지 않았으며, 1 mg/mL 농도에서는 현저한 세포독성을 나타내었다. 세포 이동성은 덱사메타손 0.01과 0.1 mg/mL 농도에서 농도 의존적으로 증가하였다. Western blot에서 fibronectin은 덱사메타손의 모든 농도, α-SMA는 0.01 mg/mL에서 의미 있게 증가하였으며, E-cadherin은 모든 농도에서 의미 있는 감소를 나타내었다. PCR array에서 FGF1, FGF2, IL-11 등과 세포자멸사에 관여하는 인자인 GDNF, IL-1β, NRG2, 그리고 세포 분화와 관련된 BMP5, FGF1, FGF2, FGF5는 2배 이상 감소하였고, FGF9, FGF19은 2배 이상 증가하였다. 발달 조절 인자인 BDNF, NGF, DKK1, NRG1, NRG2, LIF, INHBA는 2배 이상 감소하였고 CSPG5, FIGF, NODAL은 2배 이상 증가하였다. 결론: 수정체 상피세포에서 덱사메타손 노출시킨 후 실시한 PCR array을 통해 스테로이드 유발 백내장에 관여하는 후보 물질을 발굴하는 데에 도움을 줄 수 있을 것으로 생각된다.

유리체절제술과 백내장병합수술 시 동시 시행한 후낭절개술 후 앞방 깊이와 굴절력 변화

유웅선,서진석,정지성,신민호,김성재,정인영 대한안과학회 2019 대한안과학회지 Vol.60 No.10

목적: 유리체절제술과 백내장병합수술 시 유리체절단침을 이용하여 후낭절개술을 동시에 시행한 경우 수술 후 앞방 깊이 및 굴절력변화를 확인하고자 하였다. 대상과 방법: 유리체절제술과 백내장병합수술 및 유리체절단침을 이용한 후낭절개술을 받은 20명 20안을 대상으로 하였다. 술 전후의 앞방의 깊이는 샤임플러그 사진기(Pentacam®, OCULUS Optikger te GmbH, Wetzlar, Germany)를 이용하여 측정했으며, 술 후 굴절력은 자동각막굴절측정기를 이용하여 예측한 굴절력과 차이를 비교하였다. 결과: 수술 전 앞방 깊이는 2.58 ± 0.248 mm였으며, 수술 후 1개월째 3.65 ± 0.475 mm로 유의하게 깊어졌으며(p<0.001), 수술 후 3개월째 3.70 ± 0.452 mm로 1개월째와 유의한 차이를 보이지 않았다(p=0.213). 술 전 예측 굴절력은 -0.60 ± 0.809D였고, 수술 후 1개월째 -1.45 ± 1.252D로 술 전 예측 굴절력에 비해 의미 있는 근시성 이동이 관찰되었으며, 이는 3개월째 -1.48 ± 1.235D로 술 후 1개월에 비해 유의한 변화를 보이지는 않았다. 안압상승이나 인공수정체 관련 합병증은 관찰되지 않았다. 결론: 유리체절제술과 백내장병합수술 시 유리체절단침을 이용한 후낭절개술은 술 후 3개월까지 수정체 낭 수축 등으로 인한 인공수정체의 앞방 이동을 방지할 수 있는 유용한 방법이 될 수 있으나 근시화되는 점을 고려하여 인공수정체 도수 계산을 해야할 것으로 생각된다. Purpose: To evaluate the changes in anterior chamber depth (ACD) and refractive error after combined phacovitrectomy with posterior capsulotomy using a vitrectomy probe. Methods: In 20 eyes of 20 patients who underwent combined phacovitrectomy with posterior capsulotomy using a vitrectomy probe, the ACD was measured with Scheimpflug imaging (Pentacam®, OCULUS Optikgeräte GmbH, Wetzlar, Germany) preoperatively and postoperatively. We compared the preoperative desired refraction and postoperative refraction using an autokeratorefractometor. Results: The preoperative ACD was 2.58 ± 0.248 mm; the ACD significantly increased in 1 month postoperatively to 3.65 ± 0.475 mm (p < 0.001), and it was maintained as 3.70 ± 0.452 mm (p = 0.213) at 3 months postoperatively. The preoperative target spherical equivalent was -0.60 ± 0.809 diopters (D). Myopic shifting was noticed at 1 month postoperatively as -1.45 ± 1.252 D, and it changed between 1 month and 3 months postoperatively (-1.48 ± 1.235 D at 3 months postoperatively was not statistically significant). There was no increased intraocular pressure or intraocular lens-related complication. Conclusions: Phacovitrectomy with posterior capsulotomy using a vitrectomy probe might be a useful way to stabilize the axial position of an intraocular lens without constriction of the capsular bag. However, using this procedure, the surgeon must consider the possibility of myopic shifting in the postoperative refractive error.

징병신체검사에서 의뢰된 성인 약시 환자의 무늬시유발전위의 양상

유웅선,박연정,유지명,Woong Sun Yoo,MD,Yeon Jung Park,MD,Ji Myong Yoo,MD,PhD 대한안과학회 2010 대한안과학회지 Vol.51 No.10

Purpose: To evaluate the pattern VEP in adult amblyopic patients seen in consultation for ophthalmic evaluation as a past of physical examinations for conscription. Methods: We retrospectively analyzed, 67 men, 20-year-old or older, who had pattern VEP done for the diagnosis of amblyopia from January 2004 to May 2009. P100 latency and P100 amplitude were analyzed. Results: Thirteen patients were non-amblyopic, and 54 patients had amblyopia. Binocular amblyopia and monocular amblyopia were found in 23 and 31 patients, respectively. In the binocular amblyopic patients, four patients were hyperopic, seven patients were myopic, and 12 patients were astigmatic amblyopia. In the monocular amblyopic patients, 15 patients were anisometropic, 12 patients were strabismic, and four patients had organic amblyopia. The value of P100 latency and P100 amplitude were statistically significantly different between non-amblyopic and amblyopic eyes, with check size of 32×32. However, the types of amblyopia among the patients were not different at a statistically significant level. Visual acuity and P100 amplitude were significantly positively correlated. Conclusions: VEP might be a useful tool for diagnosis of adult amblyopia, especially using a 32×32 check size. This tool may impart the ability to decide relationship between amblyopia and visual acuity by analyzing P100 latency and amplitude values. J Korean Ophthalmol Soc 2010;51(10):1392-1397

백내장수술 후 발생한 비전형적 임상양상의 스트렙토코커스 디스갈락티아 안내염 2예

유웅선,강현지,정지성,신민호,정인영 대한안과학회 2019 대한안과학회지 Vol.60 No.3

Purpose: To report two cases of postoperative endophthalmitis caused by Streptococcus dysgalactiae subspecies equisimilis (SDSE), which appeared as hyperacute presentation and panophthalmitis. Case summary: A 68-year-old male was treated with cataract surgery and was evaluated the next day (less than 24 hours after surgery) because of acute loss of vision. There was severe inflammation and the visual acuity was light perception. The patient underwent pars plana vitrectomy (PPV) with intravitreal antibiotic injection. The vitreous culture revealed SDSE. After PPV, regression of inflammation was observed, although the corneal edema had progressed. The cornea evolved to decompensate due to bullous keratopathy and visual acuity of the eye decreased to no light perception after 3 months. A 87-year-old male who underwent phacoemulsification and intraocular lens implantation 2 days previously was hospitalized due to severe ocular pain and visual loss. There was severe inflammation, and the visual acuity was no light perception. The patient received only intravitreal injections of antibiotics due to severe corneal necrosis. The aqueous humor revealed SDSE. Four days after intravitreal injection, erythema and swelling of the eyelid of the affected eye was observed, and diagnosed as panophthalmitis. After treatment with intravenous antibiotics, cellulitis of the eyelid was resolved. The eye progressed as phthisis after 3 months without recurrence. Conclusions: Postoperative SDSE endophthalmitis showed aggressive and hyperacute presentation, resulting in blindness despite prompt treatment. SDSE is an emerging organism and should be considered a potential cause of postoperative endophthalmitis. 목적: 백내장수술 후 Streptococcus dysgalactiae subspecies equisimilis (SDSE)에 의한 안내염으로 초급성 발현과 전안구염의 비전형적 증상을 보인 2예를 보고하고자 한다. 증례요약: 68세 환자가 백내장수술 후 24시간 이내에 발생한 시력저하로 내원하였으며, 시력은 광각 상태였으며 안구 내 심한 염증 소견으로 유리체절제술과 유리체내 항생제 주사를 시행하였다. SDSE가 동정되었으며 수술 후 염증은 호전되었으나 각막부종은 지속되었고 술 후 3개월째 수포각막병증과 안구위축으로 진행하였다. 87세 환자가 2일 전 백내장수술 후 시력저하와 안구통증으로 내원하였다. 내원 시 시력은 광각무 상태로 안구 내 심한 염증 소견과 각막궤사로 유리체내 항생제 주사만 시행하였다. SDSE가 동정되었고 술 후 4일째 전안구염 소견이 관찰되어 항생제 정맥주사 후 호전되었으나 술 후 3개월째 안구위축으로 진행하였다. 결론: 수술 후 발생한 SDSE 안내염은 초급성의 양상을 보이며 즉각적인 치료에도 호전되지 않아 실명으로 진행되기도 한다. SDSE는 최근 발견이 증가되는 추세로 수술 후 발생한 안내염에서 원인균으로 반드시 고려해야 할 것이다.

산소로 유도된 망막증 모델에서 트리암시놀론이 망막 혈관 관련 인자에 미치는 영향

유웅선,서성욱,박종문,유지명,정인영,Woong Sun Yoo,Seong Wook Seo,Jong Moon Park,Ji Myong Yoo,In Young Chung 대한안과학회 2012 대한안과학회지 Vol.53 No.12

Purpose: The present study investigated the effects of triamcinolone acetonide (TA) on retinal vessel-related factors and retinal vascular leakage in the retina of oxygen-induced retinopathy (OIR) rats. Methods: Sprague-Dawley rats used for OIR were exposed to hyperoxia from postnatal day 2 to day 14, then returned to normoxia from day 15 to day 30 and compared with control rats. On postnatal day 16, 2 μl of TA (4 mg/kg) was injected into the vitreous of the right eye in control and OIR rats. The Evans blue method was used for evaluating vascular leakage and RT-PCR was performed for confirmation of mRNA expression. Results: In OIR rats exposed to hyperoxia, retinal vascular permeability increased when returned to normoxia. After intravitreal injection of TA, vascular permeability was decreased in OIR rats, but no changes were found in control rats. In OIR rats, mRNAs of HIF-1α, VEGF, SDF-1 and ICAM-1 were more expressed and down-regulated after intravitreal injection of TA. Occludin mRNA level was decreased in the hypoxic condition and up-regulated after TA treatment. Conclusions: The present study suggests the ability of TA to inhibit retinal vascular leakage in OIR rats and a possibility that TA controls expression of the HIF-1, VEGF, SDF-1, ICAM-1 and Occludin, which may protect retinal vascular destruction from hypoxic conditions; further studies are necessary to confirm changes in protein levels.

Successful Treatment of Infectious Scleritis by Pseudomonas aeruginosa with Autologous Perichondrium Graft of Conchal Cartilage

유웅선,김성재,김새론,김병재,안성기,서성욱,유지명 연세대학교의과대학 2015 Yonsei medical journal Vol.56 No.6

Infectious scleritis by Pseudomonas aeruginosa is a well-known vision-threatening disease. In particular, scleral trauma followingpterygium surgery may increase the risk of sclera inflammation. Surgical debridement and repair is necessary in patients who donot respond to medical treatments, such as topical and intravenous antibiotics. We reports herein the effectiveness of an autologousperichondrium conchal cartilage graft for infectious scleritis caused by Pseudomonas aeruginosa. This procedure was performedon four eyes of four patients with infectious scleritis who had previously undergone pterygium surgery at GyeongsangNational University Hospital (GNUH), Jinju, Korea from December 2011 to May 2012. Pseudomonas aeruginosa was identified incultures of necrotic scleral lesion before surgery. The conchal cartilage perichondrium graft was transplanted, and a conjunctivalflap was created on the scleral lesion. The autologous perichondrium conchal cartilage graft was successful and visual outcomewas stable in all patients, with no reports of graft failure or infection recurrence. In conclusion, autologous perichondrium conchalcartilage graft may be effective in surgical management of Pseudomonal infectious scleritis when non-surgical medical treatmentis ineffective. Further studies in larger, diverse populations are warranted to establish the effectiveness of the procedure.

원발성 종격동 정상피종

유웅선 ( Woong Sun Yu ),김안명 ( An Myung Kim ),정은택 ( Eun Taik Jeong ),최순호 ( Soon Ho Choi ),최찬 ( Chan Choi ) 대한결핵 및 호흡기학회 1990 Tuberculosis and Respiratory Diseases Vol.37 No.3

이리 및 인접 지역에서 발생한 쭈쭈가무시병 40 예에 대한 임상적 고찰

유웅선(Woong Sun Yu),노인환(In Whan Ro),허종(Jeong Huh),김경중(Kyeong Joong Kim),안태규(Tae Gyoo Ahn),이용구(Yong Goo Lee) 대한내과학회 1989 대한내과학회지 Vol.37 No.4

N/A We reviewed 20cases of tsutsugamushi disease who were admitted to WonKwang University Hospital from October to November 1988 and the following clinical results were obtained: 1) Seasonally, the 40cases mainly occurred from Odctober to November. 2) Most of the cases resided in rural areas or were associated with farm work and the age distribution was mainly in the forties. fifties, and sixties. The number of female cases was twice that of male cases. 3) On physical examination, rash, lymphadenopathy and eschar were observed in 38 cases (95%), 28cases (70%) and 17cases (42.5%) respectively. 4) On laboratory findings, leukocytosis (15%) and leukopenia (10%) were observed but anemia was not observed. The degree of elevation of AST and ALT was 2 or 3 times the normal values and elevation of LDH was observed in all cases. 5) On EKG, sinus tachycardia was observed in 6cases (15%). On simple chest X-ray, abnormal X-ray findings (20%) were observed. 6) One case was positive to Weil-Felix reaction. Indirect immunofluorescent antibody test was performed in 26cases of which 3cases (84.6%) were positive. Thirteen cases were positive to indirect immunofluorescent antibody test among 14cases with eschar. 7) Thirty-nine cases were treated with T-C and doxycycline and one case was treated with chloramphenicol. Thirty-eight cases recovered, one case died 3 days after early discharge and the clinical course of one case was not known after early discharge.

다발성 근염으로 오진된 클레부딘에 의한 근병증 1예

최정란 · 강규근 · 박소현 · 송지영 · 유웅선 · 한승완 · 서재원 · 양수현 · 박원형 조선대학교 의학연구소 2012 The Medical Journal of Chosun University Vol.37 No.3

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The Effect of 0.02% Mitomycin C Injection into the Hair Follicle with Radiofrequency Ablation in Trichiasis Patients

김규남,유웅선,김성재,한용섭,정인영,박종문,유지명,서성욱 대한안과학회 2014 Korean Journal of Ophthalmology Vol.28 No.1

Purpose: To investigate the inhibitory effect of 0.02% mitomycin C on eyelash regrowth when injected to theeyelash hair follicle immediately after radiofrequency ablation. Methods: We prospectively included 21 trichiasis patients from June 2011 to October 2012. Twenty eyes of 14patients were treated with 0.02% mitomycin C to the hair follicle immediately after radiofrequency ablation ingroup 1, while radiofrequency ablation only was conducted in ten eyes of seven patients in group 2. Recurrencesand complications were evaluated until six months after treatment. Results: One hundred sixteen eyelashes of 20 eyes in group 1 underwent treatment, and 19 (16.4%) eyelashesrecurred. Eighty-four eyelashes of ten eyes in group 2 underwent treatment, and 51 (60.7%) eyelashes recurred. No patients developed any complications related to mitomycin C. Conclusions: Application of 0.02% mitomycin C in conjunction with radiofrequency ablation may help to improvethe success rate of radiofrequency ablation treatment in trichiasis patients.