성인에서 발생하는 급성 내사시의 임상적 특징

조한주,라상훈,Han-Joo Cho,Sang-Hoon Rah 대한안과학회 2005 대한안과학회지 Vol.46 No.11

Purpose: To identify the characteristics of adult patients who develop acute concomitant esotropia during adulthood. Methods: Using a retrospective noncomparative method, this study evaluated the medical charts of 10 adults who were diagnosed with acute onset esotropia between January 2003 and May 2005. All patients presented the symptoms of estotropia when they were older than age 18. All patients in the study group had no previous ocular history, no cause of interruption of fusion, no history of systemic disease or head trauma, and no abnormal findings on neurologic examination. Results: The average follow-up period was 10.8 months (range, 5~17 months). The mean age was 44.7 years (range, 18~62 years). The average refractive error was -1.43 diopter (range, -5.50~+0.50 diopter). An operation was performed in one case. The prism diopter decreased according to follow-up in other patients. Conclusions: There are characteristics of acute onset esotropia of adulthood that differentiate it from existing esotropia. Almost all patients were myopic, showed nearly the same prism diopter between near and far vision, and deviation improved with follow-up.

가토 각막 알칼리 화상에서 전방내의 아스코르빈산 농도와 합병증 발생과의 관계

조한주,이종혁.Han-Joo Cho. M.D.. Jong-Hyeok Lee. M.D. 대한안과학회 2005 대한안과학회지 Vol.46 No.12

Purpose: To study the relationship between the concentration of ascorbic acid in the anterior chamber and the complications of an experimental alkali burn in rabbit corneas. Methods: Standardized corneal alkali wounds were induced in both eyes of 33 albino rabbits by applying a 5.5 mm-sized round filter paper, soaked in 1N NaOH for 20 seconds. Then, the control group (22 eyes) was given Tears Natural IIⓡ (Alcon), treated group A (22 eyes) was given ascorbic acid (10%) for 2 hours, and treated group B (22 eyes) was given ascorbic acid (10%) for 6 hours. The concentrations of ascorbic acid in the anterior chamber were measured using a microplate assay immediately post-injury, and at 5 days, 15 days, and 30 days post-injury. During the experiment, clinical observation was performed to detect complications such as corneal ulcer or perforation. Results: The incidence of ulceration was significantly lower between control group and treated groups A and B (p<0.05). The incidence of perforation was significantly lower in treated group A compared to the control group B (p<0.05). In addition, a higher concentration of ascorbic acid in the anterior chamber and a lower severity of corneal injury was significant (ρ=-0.302, P<0.05). Conclusions: Higher concentrations of ascorbic acid in the anterior chamber were associated with fewer complications in experimental alkali burns in rabbit corneas.

복합운영 프로젝트 사업관리 위험 요인에 관한 실증적 연구

박준호 ( Joon-ho Park ),조한주 ( Cho Han Joo ),박진호 ( Jin-ho Park ) 한국정보처리학회 2017 한국정보처리학회 학술대회논문집 Vol.24 No.1

IT 사업은 개발 사업, 운영 사업, 유지보수 사업, 인프라 구축 사업으로 구분한다. IT 사업은 각 사업 특성에 맞는 개발 방법론과 사업관리 방법론을 사용한다. 하지만 최근 IT 사업은 운영 사업, 유지보수 사업, 개발 사업을 포함한 사업을 발주하고 있다. 이러한 사업 발주로 인하여 수행에 많은 문제가 생기고 있다. 이러한 사업을 복합운영 프로젝로 정의하고, 위험리스크를 도출하고 이러한 사항을 해결하기 위한 방안을 연구한다.

아토피 환자에서 발생한 망막박리의 임상적 양상

최성찬(Seong Chan Choi),조한주(Han Joo Cho),이동원(Dong Won Lee),조성원(Sung Won Cho),김철구(Chul Gu Kim),김종우(Jong Woo Kim),김형석(Hyoung Seok Kim) 대한안과학회 2016 대한안과학회지 Vol.57 No.8

목적: 아토피 환자에서 발생한 망막박리를 대상으로 임상적 특징 및 수술 결과에 대해 알아보고자 하였다. 대상과 방법: 2009년부터 2015년까지 아토피 환자에서 발생한 망막박리로 본원에서 치료 받은 37명을 대상으로 의무기록을 후향적으로 조사하였다. 초기시력, 과거력, 망막박리의 종류, 망막열공의 개수와 종류, 시행한 수술 종류, 망막박리의 재발 유무, 백내장 동반유무 등을 조사하였다. 백내장 유무와의 연관성을 알아보기 위해 초진시 백내장이 없는 환자군을 A, 백내장이 있는 환자군을 B, 이전 백내장 수술력이 있는 환자군을 C로 구분하여 각 군 간의 차이를 조사하였다. 결과: 대상 환자 37명 중 남자가 29명, 여자가 8명이었으며, 양안 망막박리는 10명(27.0%)이었다. 망막열공의 위치는 이측을 포함한 경우가 47안 중 42안(89.4%)이었으며, 비측에만 열공이 생긴 경우는 5안(10.6%)이었다. 백내장 여부로 구분한 세 군 간에 성비, 평균 나이, 수술 전후 교정시력, 안축장 길이, 열공의 위치는 유의한 차이가 없었다. 1차 수술 후 12명, 총 14안(37.8%)에서 망막박리가 재발하였고, 양안 망막박리로 진단 받은 환자 10명 중 5명에서 재발하였다. 재발한 14안 중 12안이 본원에서 재수술을 받았고, 그중 3안에서 다시 재발하여 추가수술을 시행 받았다. 결론: 아토피 피부염에서 동반된 망막박리는 양안에 동시에 발병한 경우가 많으며, 망막열공이 이측에 있을 확률이 높다. 백내장이 동반되어 있거나 이전 백내장 수술을 받은 환자의 경우, 백내장이 없는 환자에 비해 유의하게 망막박리의 재발이 많았다(p=0.024). Purpose: To evaluate the clinical characteristics and surgical outcomes of retinal detachment associated with atopic dermatitis. Methods: A retrospective investigation of clinical notes of 37 patients with retinal detachment associated with atopic dermatitis was conducted from January 2009 to December 2015. Initial visual acuity, medical history, type of retinal detachment, number of tears, types of treatment, success rate of treatment, and presence of cataract were investigated. To evaluate the relationship with cataract, the patients were classified into three groups according to lens status: group A (eyes with clear lens), group B (eyes with cataract), and group C (pseudophakic eyes). Results: Of the 37 patients, 29 were male and 8 were female; 10 patients had bilateral retinal detachment (27.0%). The retinal breaks were often located temporally (89.4%), with only 5 cases (10.6%) involving nasal-side retinal breaks. No significant differences were noted in the ratio of males to females, age distribution, visual acuity before and after treatments, axial length, and location of retina breaks among the three groups. After primary surgery, retinal detachment recurred in 12 patients (14 eyes), 5 of whom were initially diagnosed with bilateral retinal detachment. In addition, 12 of 14 eyes underwent a second operation, in which detachment recurred in 3 eyes. Conclusions: Incidence of bilateral retinal detachment was high in patients with atopic dermatitis, and the retinal breaks were often found on the temporal side. Retinal re-detachment was statistically high in patients with cataract or pseudophakic eyes compared to patients with clear lens (p = 0.024).

백내장수술 후 발생한 스테노트로포모나스말토필리아 안내염: 임상양상, 항생제 감수성과 예후

김재민(Jae Min Kim),조한주(Han Joo Cho),김형석(Hyung Suk Kim),한정일(Jung Il Han),이동원(Dong Won Lee),김철구(Chul Gu Kim),김종우(Jong Woo Kim) 대한안과학회 2017 대한안과학회지 Vol.58 No.6

Purpose: To describe the clinical manifestations, treatment results, and antibiotic susceptibility in 6 cases of Stenotrophomonas maltophilia endophthalmitis. Methods: We retrospectively reviewed 6 eyes of 6 patients who were diagnosed with Stenotrophomonas maltophilia endophthalmitis. Specifically, we considered each patient s age, sex, past history, visual acuity, hypopyon, treatment, and prognosis. Results: For our study, we considered patients treated during the period of January 2008 to December 2015. Stenotrophomonas maltophilia (6 eyes) was the second most common gram-negative bacteria cause of total bacterial endophthalmitis while Pseudomonas aeruginosa (14 eyes) was the most common gram-negative bacteria cause during the same period. Visual disturbance was the dominant symptom being found in all 6 patients. Other symptoms include ocular pain and hypopyon. The initial visual acuity was light perception (1 patient), hand motion (3 patients), finger count (1 patient), and 0.02 (1 patient). Excluding the 1 patient with light perception, the mean initial visual acuity was logMAR 1.72 (Snellen equivalent; 20/1,049). Overall, 5 patients underwent vitrectomy and intravitreal antibiotics injection, while, the remaining other patient was treated with intravitreal antibiotics injection, followed by vitrectomy. All 6 patients showed sensitivity to Ceftazidime and Levofloxacin and 2 patients showed sensitivity to Trimethoprim/Sulfamethoxazole. Conclusions: Stenotrophomonas maltophilia endophthalmitis was the second most common gram negative organism to cause endophthalmitis after cataract surgery. All 6 of the tested isolates were found to be sensitive to ceftazidime and levofloxacin. Urgent treatment outcomes were similar to previous reports. J Korean Ophthalmol Soc 2017;58(6):663-669 목적: 백내장수술 후 발생한 Stenotrophomonas maltophilia 안내염의 임상 경과와 항생제 감수성, 그리고 치료 결과에 대해서 보고하 고자 한다. 대상과 방법: 2008년 1월과 2015년 12월 사이에 본원으로 안내염으로 의뢰되어 치료받은 환자 중 세균배양검사에서 Stenotrophomonas maltophilia 안내염이 확진된 환자 6명의 의무기록을 후향적으로 분석하였다. 결과: Stenotrophomonas maltophilia는 연구 기간 동안 확진된 그람 음성균 관련 안내염 중(총 23안)에서 Pseudomonas aeruginosa (14안) 다음으로 두 번째로 흔한 원인균(6안)이었다. 대상안들의 초진 시력은 light perception부터 0.02까지였다(평균 logMAR 1.72 [snellen equivalent; 20/1,049]). 초기 치료로서 모든 환자에서 vancomycin과 ceftazidime을 병합한 intravitreal antibiotics injections가 시행되었는데 5명에서는 일차적으로 유리체 절제술이 병행되었고, 1명에서는 일차적 항생제 주입 후 유리체 절제술이 추후에 추가적으로 시행되었다. 항생제 감수성 검사에서는 대상안 6안 모두 Ceftazidime과 Levofloxacin에 감수성을 보였고 Trimethoprim/Sulfamethoxazole 에는 2안에서 감수성을 보였다. 치료 후 6명의 대상안 중 5안에서 0.1 이상의 최종시력을 보였으며, 치료 후 초진시력에 비해 나쁜 시력을 보인 환자는 없었다. 결론: Stenotrophomonas maltophilia 그람 음성균 관련 안내염의 두 번째로 흔한 원인 균주였으며, 대상안 모두 ceftazidime과 Levofloxacin에 감수성을 보였다. 즉각적인 치료는 기존에 보고되었던 안내염의 치료 결과와 유사하였다.

백내장 수술 후 발생한 안내염으로 의뢰된 113 사례 분석 및 시력예후와 관련된 인자

최성찬(Seong Chan Choi),조한주(Han Joo Cho),김형석(Hyoung Seok Kim),한정일(Jung Il Han),이동원(Dong Won Lee),조성원(Sung Won Cho),이태곤(Tae Gon Lee),김철구(Chul Gu Kim),김종우(Jong Woo Kim) 대한안과학회 2016 대한안과학회지 Vol.57 No.3

목적: 백내장 수술 후 발생한 감염성 안내염으로 본원에 의뢰되어 치료 받은 환자들을 분석하여 최종 시력과 연관된 인자들을 분석하고자 하였다. 대상과 방법: 2008년부터 2013년까지 백내장 수술 후 발생한 안내염으로 본원에 의뢰된 환자 113명의 의무기록을 후향적으로 조사하였다. 초진시력, 술 후 안내염 발생 시기, 전방축농 유무, 의뢰되어 시행한 치료의 종류, 균 동정 유무 및 종류 등이 최종시력에 미치는 영향을 조사하였다. 결과: 환자 총 113명 중 초진시력이 안전수동 이하인 환자는 75명(66.3%)이었으며, 치료 후 최종시력이 0.5 이상 회복된 환자는 73명(64.6%)이었다. 초진시력이 안전수동 이상인 경우에 시력예후가 더 좋았으며(p=0.001), 그람 음성균에 의한 감염인 경우(p=0.007) 또는 백내장 수술 후 2일 이내에 발생한 안내염인 경우(p=0.043) 최종시력이 유의하게 나빴다. 초진시력이 안전수동 이상인 환자에서 초기 치료로 유리체절제술과 안구 내 항생제주입술은 최종시력에 유의한 차이가 없었다. 결론: 초진시력, 동정된 균의 종류와 백내장 수술 후 안내염 발생까지의 기간이 치료 후 좋은 시력예후와 연관이 있었다. 조기 유리체 절제술과 안구 내 항생제주입술의 치료 효과는 분명치 않았으나, 향후 추가적인 연구가 필요할 것으로 보인다. Purpose: To evaluate factors affecting final visual acuity by analyzing patients referred with infectious endophthalmitis after cataract surgery. Methods: A retrospective investigation of clinical notes of 113 patients referred with endophthalmitis following cataract surgery was conducted from January 2008 to December 2013. To evaluate factors affecting final visual acuity, initial visual acuity, onset of endophthalmitis after the cataract surgery, types of treatment, presence of hypopyon and culture results were investigated. Results: Of the 113 patients, visual acuities at presentation were hand motions or less in 75 patients (66.3%) and final visual acuities after treatments were 0.5 or better in 73 patients (64.6%). Cases with initial visual acuity of hand motions or better achieved favorable outcomes whereas cases with gram-negative infection or endophthalmitis occurring within 2 days postoperatively showed poor prognosis. Statistically, vitrectomy versus intraocular antibiotic injection as primary means of treatment showed no differences in final visual acuity in patients with initial visual acuity of hand motion or better. Conclusions: Visual acuities at presentation, type of cultured organism and onset of endophthalmitis after cataract surgery are significantly related to visual prognosis. Advantages of initial vitrectomy versus intraocular antibiotic injections were unclear and further investigations are necessary to clarify these issues.

내경계막절편술 및 삽입술을 이용한 황반원공수술의 장기 임상결과

박상민(Sang Min Park),김종우(Jong Woo Kim),김철구(Chul Gu Kim),이동원(Dong Won Lee),유수진(Su Jin Yoo),조한주(Han Joo Cho),김재휘(Jae Hui Kim) 대한안과학회 2021 대한안과학회지 Vol.62 No.3

목적: 특발성 황반원공에서 내경계막절편술 또는 내경계막삽입술의 장기간 결과를 분석하고, 두 수술 기법 사이의 결과를 서로 비교하고자 한다. 대상과 방법: 특발성 황반원공으로 내경계막절편술(절편술군, 9안) 혹은 내경계막삽입술(삽입술군, 8안)을 시행받은 17안을 대상으로 의무기록을 분석하였다. 각 군에서 술 전 시력을 최종추적 관찰 시의 시력과 서로 비교하였다. 추가적으로 양 군 사이에 외경계막 및 타원체구역 회복 빈도와 최종추적 관찰 시의 시력을 서로 비교하였다. 결과: 술 후 평균 추적 관찰 기간은 25.1 ± 13.7개월이었으며, 모든 안에서 황반원공이 폐쇄되었다. 전체 17안의 logarithm of minimal angle of resolution 시력은 술 전 평균 0.88 ± 0.23에서 최종추적 관찰 시 0.42 ± 0.23으로 유의하게 호전되었다(p<0.001). 절편술군(0.92 ± 0.25에서 0.37 ± 0.29, p=0.007)과 삽입술군(0.83 ± 0.19에서 0.48 ± 0.15, p=0.018) 모두에서 시력은 유의하게 호전되었다. 양 군 사이에 최종추적 관찰 시 시력에는 유의한 차이가 없었다(p=0.075). 외경계막 및 타원체구역의 회복 빈도는 절편술군에서 77.8% (7안)로 삽입술군의 12.5% (1안)에 비해 유의하게 높았다. 결론: 내경계막절편술과 삽입술은 황반원공 치료에 효과적인 방법으로 생각된다. 술 후 망막외층의 회복은 절편술군에서 더 나은 결과를 보였다. 두 수술 방법의 장기 시력결과에 대해서는 향후 보다 많은 안을 대상으로 한 연구가 필요할 것이다. Purpose: To evaluate the long-term outcomes of inverted internal limiting membrane (ILM) flap and ILM insertion in idiopathic macular hole (MH) and to compare the outcomes between the two techniques. Methods: We retrospectively reviewed the medical records of 17 eyes that underwent an inverted ILM flap procedure (flap group, n = 9) or ILM insertion procedure (insertion group, n = 8) for idiopathic MH. Within each group, best-corrected visual acuity (BCVA) before surgery was compared with that at the final follow-up. The BCVA at the final follow-up was compared between the two groups. In addition, the incidence of restoration of the external limiting membrane (ELM) and ellipsoid zone was evaluated. Results: The mean follow-up period was 25.1 ± 13.7 months after surgery. All MHs were closed after the surgery. In all 17 eyes, the logarithm of minimal angle of resolution BCVA had improved significantly from a mean value of 0.88 ± 0.23 before surgery to 0.42 ± 0.23 at the final follow-up (p < 0.001). The BCVA was significantly improved in both the flap group (from 0.92 ± 0.25 to 0.37 ± 0.29, p = 0.007) and the insertion group (from 0.83 ± 0.19 to 0.48 ± 0.15, p = 0.018). There was no significant difference in BCVA at the final follow-up between the two groups (p = 0.075). The incidence of restoration of the ELM and ellipsoid zone was significantly higher in the flap group (seven eyes, 77.8%) than in the insertion group (one eye, 12.5%). Conclusions: Both inverted ILM flap and ILM insertion are effective in MH treatment. The restoration of retinal outer layers was better in the flap group. Further studies with a larger study population are needed to evaluate the long-term visual outcomes of the two methods.

패널식 토론을 활용한 역사과 학습지도 모형 개발 연구

조한주 이화여자대학교 교육대학원 2004 이화교육논총 Vol.14 No.-

This study presents a panel-debate model of history education that stimulates students' interest in history, improves their ability to perceive history and critically develops their ability for self-study. This study verifies that the suggested panel-debate model can be practied very easily and we can achieve the education objective very effectively using the model in history classes. Results of tests and questionnaires strongly wupport this argument. The empirical framework for measuring the effect of discussions on students' performance is designed as follows. The 366 students of 11 classes (3rd graders) of J middles school in Seoul region are studied. They are divided into two groups: one experimental class used panel discussions when each chapter of history text was finished and summarized. Panel debate is organized with two groups that adopt contrasting views on the same issus for example, one proup represents advocates of the open-door policy of the Chosun dynasty in the 19th century with the other representing the closed-door policy and the two groups debate with each other on the pros and cons of their respective policies. Three topics of Chapter 4 of the textbook of Korean History are tested in this study to estimate the effect of the debated model on student performance (enhancement in historical thinking). The validity and reasonability of all the problems are evaluatied by questionnaires answered bjy history teachers in the Seoul metorpolitan region. The basic results are summarized as follows. First, student ability in historical thinking clearly impjroved through the introduction of debate into classrooms. Second, discussion leads students to have stronger motivation for studies than before and to regard historical knowledge as useful and applicable. Third, students participating in panel debate class records better performance than before and than those who do not. Fourth, self-studying ability is clearly increased. This is mainly due to excellent motivation for learning and thorough reviews on various aspects of historical fact. Fifth, in a questionnaire, history teachers evaluated the panel-debate model as being practiced easily in classrooms to improve student scholatic achievement, historical thinking and self-studying ability. Therefore, we can conclude that the debate model is highly manageable and develops historical and high-level thinking to enhance the ability for self-study.