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수정체제거와 유리체절제 동시 시술 때 인공수정체 삽입 시기에 따른 수술 결과 비교
조호균,박종화,Ho Kyun Cho,Jong Hwa Park 대한안과학회 2007 대한안과학회지 Vol.48 No.3
Purpose: To compare the surgical results according to the IOL implantation time in patients who were performed simultaneous lens extraction, vitrectomy and silicone oil endotamponade. Methods: We reviewed the medical records of 60 eyes in 57 patients with vitreoretinal diseseases. The group I included 32 eyes those were performed simultaneous lens extraction, vitrectomy and silicone oil endotamponade as the first surgery, and sequential IOL implantation at the time of silicone oil removal as the second surgery. The group II included 28 eyes those were performed simultaneous lens extraction, vitrectomy, silicone oil endotamponade and IOL implantation as the first surgery, and sequential oil removal as the second surgery. The cases were evaluated 6 months after silicone oil removal. Anatomical and functional success rate, difference of postoperative predictive refraction, postoperative complication occurrence rate were compared between two groups. Results: The anatomical successes were achieved in 93.8% (30/32 eyes) and 92.9% (26/28 eyes) in the group I and II respectively. The functional successes were achieved in 71.9% (23/32 eyes) and 78.6% (22/28 eyes) in the group I and II respectively. The differences between preoperative predicted target refraction and postoperative final refraction were 0.68D and 0.92D in the group I and II respectively. The incidence of postoperative anterior chamber reaction and secondary glaucoma were significantly high after second surgery in the group I. Conclusions: We recommend a simultaneous implantation of IOL at the combined surgery of lens extraction and vitrectomy with silicone oil endotamponade to reduce postoperative complications.
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당뇨망막병증 환자에서 cakcuyn dobesilate복용이 망막전위도에 미치는 영향
조호균,김정환,심재기 중앙대학교 의과대학 의과학연구소 1997 中央醫大誌 Vol.22 No.2
당뇨망막병증 환자에서 calcium dobesilate 복용이 망막전위도에 미치는 영향을 알아 보기 위하여, 혈당 조절이 잘 되고 있는 중정도 이하의 배경당뇨망막병증을 가진 비인슐린 의존형 당뇨병 환자 60 명을 대상으로 약물 투여 전후의 전위도 변동과 혈중 당화혈생소량이나 망막 광응고 치료 유무에 따라 약물이 망막전위도에 미치는 영향을 알아 보았다. 대상자들을 무작위로 두 군으로 나누어 약물 투여군은 calcium dobesilate 1g을 1일 2회 6 개월간 복용하도록 하였으며, 비투여군은 경과 관찰만을 하였다. 대상자들은 모두 검사 시작시점과 6 개월 후에 망막전위도를 측정하여 시간차에 따른 b파, b/a비, 율동양 파의 변동량에 대한 두 군 간의 유의성을 알아 보았고, 혈중 당화혈색소량이나 망막 광응고 치료 유무에 따른 시간차 변동량에 대한 두 군 간의 유의성을 student t-test로 검정하였다. 약물 투여군이나 비투여군에서 b파나 b/a비는 유의한 변동이 없었지만, 율동양 파는 비투여군에서 유의하게 감소되었다. 혈중 당화혈색소량이 6.5mg% 이상인 경우에 율동양 파가 비투여군에서 유의하게 감소하였다. 혈중 당화혈색소량이 6mg 이하인 경우에는 율동양 파가 약물 투여군에서는 증가된 반면 비투여군에서는 감소하였다. 망막 광응고 치료를 받았던 경우에는 율동양 파가 약물 투여군에서는 증가된 반면에 비투여군에서는 감소하였다. 결론적으로 당뇨망막병증에서 calcium dobesilate 복용은 망막전위도 율동양 파 감소를 유의하게 억제하였으며, 또한 약물 투여가 율동양 파의 변동에 미치는 영향은 혈중 당화혈색소가 정상이거나 이전에 망막 광응고 치료를 받았던 경우에 더욱 현저하였다. This study was undertaken to evaluate the effects of calcium dobesilate on the electroretinographic changes in 26 non-insulin dependent diabetic patients with mild to moderate disbetic retinopathy. The subjects were assigned randomly to receive oral calcium dobesilate 1g twice a day for 6 months. All patients were checked for the effects of blood glycosylated hemoglobin(HbA1c) and retinal photocoagulation electroretinographically before treatment and six months in both groups. The b-wave amplitudes and b/a ratio on the electroretinography were not changed in both groups, but decreased significantly in the non-treated group. In cases of blood HbA1c level over 6.5 mg% the oscillatory potentials were decreased significantly in the untreated group. In the eyes taken retinal photocoagulation treatment, oscillatory potentials was increased significantly in the calcium dobesilate treated group. It is, from the above results, suggested that the administration of calcium dobesilate to the patients with diabetic retinopathy may prevent the reduction of oscillatory potential. And the effects is more prominent in patients with the HbA1c blood level over 6.5 mg% or having previous retinal photocoagulation.
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조호균,하상우 중앙대학교 의과대학 의과학연구소 2001 中央醫大誌 Vol.26 No.3
The present study was performed to determine the appropriate intravitreal dose of Cefepime in the rabbit. Fifteen nonpigmented rabbits were divided into 3 groups.The first group,200㎍ of Cefepime in 0.1ml of distilled water was injected into five rabbits'vitreous cavities of right eyes, while same amount of balanced salt solution was injected into those of left eyes. The second group, the same method was used but 400㎍ of Cefepime was injected. The third group,1000㎍ of Cefepime was injected while using the same method as the first and the second. For the injection, 30 gauge syringe was guided to the center of the vitreous through the pars plana without conjunctival incision. To prevent ocular pressure increase from the intravitreal injection anterior chamber paracentesis was done. To observe the change of the retina, electron microscopic examination was done after 1,3, and 7 days respectively. There were no significant changes in the control and 200㎍ of Cefepime injection groups. On the other hand, in the 400㎍ Cefepime and 1,000㎍ Cefepime injection groups, ganglion cell deneneration, axonal deneneration, vacuole formation, retinal pigment epithelial deneneration were shown concentration dependently. These changes emerged in the inner retina first and progressed to the outer retina as the time went on. According to the result of the rabbit experiment, the proper concentration of intravitreal Cefepime dose is inferred as 600㎍ for human vitreous cavity.
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초자체내 유로키나제(Urokinase)투여로 인한 가토 망막 미세구조의 변화
조호균,구본술 중앙대학교 의과대학 의과학연구소 1984 中央醫大誌 Vol.9 No.2
The toxic effects on rabbit retina following intravitreally injected urokinase at different concentrations were studied with electron microscope. Saline was injected to the one eye of each animal as control. 1,000IU of urokinase produced mild swelling of the mitochondria in the inner retinal layer which appeared reversible within one week period. Following the injection of 3,000IU of urokinase, there were marked changes on first day; degeneration and vacuolization of the axon, degeneration of the synaptic vesicles and inner nuclear layer cells and fragmentation of the outer segment of the photoreceptor cells. The retinal pigment epithelium demonstrated many phagosomes and phagolysosomes. More advanced changes were progressed at one week after injection. With the increased dose of urokinase, more marked cellular changes took place in the inner and outer retinal layers. No evidence of regeneration was observed two weeks after the injection of 3,000IU of urokinase which indicates long lasting toxic effect of the urokinase onto the retina in large doses. Thus, the large dose of clinical application as the intravitreal injection over 3,000IU is much warned and further study on the long term follow up for the observation of the late complication is also suggested.
KCI
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