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한은령,임기환.Eun Ryung Han. M.D.. Key Hwan Lim. M.D.. Ph.D. 대한안과학회 2008 대한안과학회지 Vol.49 No.8
Purpose: To evaluate the clinical features and natural course of sixth cranial nerve palsy. Methods: We reviewed the medical records of 50 patients who were diagnosed with sixth nerve palsy from January 2000 to December 2006 to analyze the age of onset, etiology, recovery, and natural course of this disease. Results: The mean age at onset was 43.2 years old. Vascular disease (n=17, 34.0%) was the most common cause of sixth cranial nerve palsy, followed by undetermined causes (n=14, 28.0%), trauma (n=10, 20.0%), and neoplasm (n=3, 6.0%). According to age group, vascular disease (n=7, 46.7%) was the most common cause in patients in their fifties and sixties, and trauma and undetermined causes (n=10, 76.9%) were the most common causes of this disease in patients in their twenties and thirties. Of the 40 patients who were followed up for more than 6 months, 28 (70.0%) showed improvement of paresis and 26 (65.0%) achieved complete recovery. The mean period to recovery was 3.7 months. No significant differences were observed in sex, age, laterality, and etiology between non-recovered and completely-recovered patients, but completely-recovered patients showed a significantly smaller initial angle of deviation than non-recovered patients. Conclusions: Vascular disease was the most common etiology of sixth nerve palsy. Sixty-five percent of patients showed spontaneous complete recovery, and completely-recovered patients showed a significantly smaller initial angle of deviation compared to that of non-recovered patients. J Korean Ophthalmol Soc 49(8):1323-1329, 2008
성인 단안 약시 환자에서의 문양시유발전위 검사의 진단적 기준
임선희,임기환,Sun Hee Lim,Key Hwan Lim 대한안과학회 2013 대한안과학회지 Vol.54 No.12
Purpose: To suggest a diagnostic criteria of pattern visual evoked potential (VEP) in adult monocular amblyopic patients in comparison to normal subjects.<br /> Methods: The medical records of patients’ military service certificates from January 2000 to December 2011 were reviewed. The parameters of pattern VEP were analyzed by comparing monocular amblyopic patients with normal controls.<br /> Results: This study included 47 monocular amblyopia and 39 normal control patients. All parameters of pattern VEP were statistically significantly different between monocular amblyopic eyes and normal eyes. The cut-off values for diagnosis of adult amblyopia using receiver operating characteristic (ROC) curve were 113.50 msec (P100 latency), 1.05 (ratio of P100 latency), 8.50 msec (interocular difference of P100 latency), and 5.25 μV (interocular difference of P100 amplitude). Cut-off value sensitivities were generally low: (51.1%, 70.2%, 53.2%, and 31.9%, respectively).<br /> Conclusions: The value of pattern VEP parameters had limitations due to low sensitivity and could be considered as ancillary diagnostic criteria when diagnosing amblyopia. <br /> J Korean Ophthalmol Soc 2013;54(12):1875-1881
이현주,임기환,Hyun-Joo Lee,M,D,Key-Hwan Lim,M,D 대한안과학회 2005 대한안과학회지 Vol.46 No.10
Purpose: To determine the range of cyclotorsion in the mass screening of patients by studying the spatial relationship between the optic disc and the fovea. Methods: We examined the horizontal and vertical distances from the center of the optic disc to the fovea using the fundus photographs of 249 subjects (498 eyes) without a past history of strabismus through mass screening and then calculated the optic disc-foveal angle. We studied the differences in all the measured parameters between the right and left eyes and between men and women. Results: The horizontal distance from the center of the optic disc to the fovea was 2.59±0.26 DD (disc diameter) in the right eye and 2.58±0.27 DD in the left eye. The mean horizontal distance was 2.59±0.26 DD. The vertical distance from the center of the optic disc to the fovea was 0.28±0.14 DD in the right eye and 0.30±0.13 DD in the left eye. The mean vertical distance was 0.29±0.14 DD. The calculated disc-foveal angle was 6.26±2.98 degrees in the right eye and 6.69±2.84 degrees in the left eye (mean, 6.50±2.92 degrees). There were no significant differences between the right and left eyes or between males and females. The 95% range of the location of the fovea was from 0.01 DD to 0.57 DD inferior to the optic disc center. Conclusions: We concluded that the clinical location of the fovea, as measured in the mass screening, extends from the center of the optic disc to the lower edge of the optic disc.
김현진,이현주,임기환,Hyun-Jin Kim,M,D,Hyun-Joo Lee,M,D,Key-Hwan Lim,M,D 대한안과학회 2008 대한안과학회지 Vol.49 No.5
Purpose: To investigate the clinical characteristics and disability rates of patients seeking expert consultation for legal reasons because of ophthalmologic symptoms. Methods: We analyzed the gender, age, reason for consultation, and result of consultation, among other factors, by retrospectively examining the medical files of 89 patients from January 1999 to December 2004. Results: Out of 89 patients, men constituted 76.4% and patients in their forties constituted 23.0%. The most common reason for consultation was a traffic accident (64.0%), followed by a medical lawsuit (11.2%). Forty-nine patients (55.1%) were diagnosed with a disability, while 30 patients (33.7%) were not. Diagnostic decisions for the other 10 patients (11.2%) were deferred. Optic atrophy was the most frequent cause for deteriorating visual acuity in patients, accounting for 19 cases, and diplopia caused by orbital wall fracture was also prevalent (9 patients). Among the resulting types of damage, brain damage was the most frequent, while the percentage of patients with an impairment in the visual system was approximately 29.0% among the patients diagnosed with a disability. Conclusions: Our results will be helpful in elucidating the clinical characteristics of patients referred to the ophthalmic clinic for consultation because of legal concerns.