Therapeutic effect of subconjunctival injection of bevacizumab in the treatment of corneal neovascularization

You, In-Cheon,Kang, In-Seong,Lee, Seung-Hyun,Yoon, Kyung-Chul Blackwell Publishing Ltd 2009 Acta ophthalmologica Vol.87 No.6

<P>Abstract.</P><P>Purpose: </P><P>To investigate the efficacy of subconjunctival injection of bevacizumab in the treatment of patients with corneal neovascularization.</P><P>Methods: </P><P>Twenty-nine eyes of 29 patients with corneal neovascularization were treated with subconjunctival injection [1.25 mg/0.05 ml (seven eyes), 2.5 mg/0.1 ml (15 eyes) and 5.0 mg/0.2 ml (seven eyes)] of bevacizumab. Best-corrected visual acuity, intraocular pressure and area of corneal neovascularization were measured before injection and at 1 week, 1 month and 3 months after treatment.</P><P>Results: </P><P>At 1 week, the mean neovascularized corneal area decreased significantly to 85.5 ± 18.0% (<I>p</I> =<I> </I>0.01) in the eyes treated with 2.5 mg bevacizumab and to 73.1 ± 23.4% (<I>p</I> =<I> </I>0.02) in the eyes treated with 5.0 mg bevacizumab. At 3 months, the mean neovascularized corneal area was 93.6 ± 10.6% (<I>p</I> =<I> </I>0.10 compared to baseline; <I>p</I> <<I> </I>0.01 compared to 1 week) in the eyes treated with 2.5 mg bevacizumab and 83.3 ± 25.8% (<I>p</I> =<I> </I>0.03 compared to baseline; <I>p</I> =<I> </I>0.02 compared to 1 week) in the eyes treated with 5.0 mg bevacizumab. However, there were no significant changes in the areas of the eyes injected with 1.25 mg bevacizumab.</P><P>Conclusion: </P><P>Subconjunctival injection of bevacizumab can partially reduce corneal neovascularization in the short term, and the efficacy of this treatment correlates with the injection dose.</P>

배양 양성 감염각막염의 임상양상 및 항생제감수성 변화: 10년간의 국내 다기관 연구

유인천(In-Cheon You),이상범(Sang-Bumm Lee),서경률(Kyoung Yul Seo),김미금(Mee Kum Kim),윤경철(Kyung-Chul Yoon),고재웅(Jae Wong Koh),이지은(Ji Eun Lee),김성재(Seong-Jae Kim),KOAIDS 대한안과학회 2021 대한안과학회지 Vol.62 No.4

목적: 최근 10년간 감염각막염 중 배양검사상 균주가 확인된 환자에 대하여 여러 임상양상에 대해 알아보고자 한다. 대상과 방법: 2008년 1월부터 2017년 12월까지 전국 8개 병원에서 균주가 확인된 감염각막염 956명의 의무기록을 후향적으로 분석하여, 선행요인, 원인균, 치료 방법, 예후 등을 분석하였다. 결과: 감염각막염의 가장 흔한 선행요인은 안외상(33.2%)이었다. 초기시력은 안전수지 이하가 449안(47.0%)이었다. 각막궤양은 중심부에서 흔하였고, 크기는 4 mm² 이하가 가장 많았다. 전방축농이 동반된 경우는 295안(30.9%)이었다. 배양된 균주는 총 1,039균으로 그람음성균 443균주(42.6%)가 가장 많았다. 가장 흔한 균은 그람음성균은 녹농균, 그람양성균은 피부포도알균, 진균은 푸사륨이었다. 수술 치료는 201안(21.0%)에서 양막이식술 66안, 안구내용제거술 44안 순이었다. 최종시력은 0.2보다 좋은 시력이 422안(44.1%)이었다. 그람양성균은 목시플록사신과 반코마이신에, 그람음성균은 레보플록사신과 세프타지딤에 높은 감수성을 보였지만 일부 장알균과 슈도모나스 등에서 저항성을 보였다. 결론: 국내 감염각막염은 안외상으로 흔히 발생하였고 그람음성균이 가장 많았다. 대표적인 원인균은 피부포도알균, 녹농균, 푸사륨이었다. 입원 후 약물 및 수술적 치료로 시력이 호전된 경우가 많았지만 일부 저항성을 보이는 세균과 진균에 대해서는 주의가 필요하다. 세균에서 불량한 임상결과에 이르는 위험인자는 초기시력 0.02 미만, 전방축농, 65세 이상 나이, 각막중심부 궤양이었고 진균은 70세 이상 나이였다. Purpose: To analyze the clinical manifestations of culture-proven infective keratitis patients over a recent 10-year period. Methods: We retrospectively reviewed the medical records of 956 cases of infective keratitis between January 2008 and December 2017 at eight tertiary hospitals. The study was performed to analyze the risk factors, causative microbial organisms, therapeutic outcomes, and prognosis. Results: The most common risk factor of keratitis was trauma (33.2%). Initial visual acuity (V/A) was finger count or less in 449 eyes (47.0%). The common location of keratitis was central, and the size was 4 mm2 or less. Hypopyon was observed in 295 eyes (30.9%). Of the 1,039 cultured isolates, 443 (42.6%) grew Gram-negative bacteria with the most common being Pseudomonas aeruginosa. The most prevalent Gram-positive bacteria was Staphylococcus epidermidis, and fungi was Fusarium species. Surgical treatments were performed in 201 eyes (21.0%), followed by amniotic membrane transplantation (66 eyes) and evisceration (44 eyes). Final V/A was 20/100 or more in 422 eyes (44.1%). Gram-positive organisms were highly susceptible to moxifloxacin and vancomycin, and Gram-negative organisms were highly susceptible to levofloxacin and ceftazidime. An increase in resistance to these antibiotics was detected for Enterococcus and Pseudomonas. Conclusions: In South Korea, infective keratitis occurs frequently in eyes with trauma. Staphylococcus epidermidis, Pseudomonas aeruginosa, and Fusarium species are commonly identified etiologies of microbial keratitis. The appropriate administered medical and surgical treatments of suspected infectious keratitis can lead to visual improvement with particular care taken to minimize infection related to resistant bacteria and fungal microbes as needed. An initial V/A of 0.02 or less, the presence of hypopyon, age of 65 years or more, and a central lesion were associated with poor clinical outcome of bacterial keratitis. Age of 70 years or more was a significant risk factor for poor clinical outcome of fungal keratitis.

스토리텔링 기법을 활용한 멸종위기의 바나나 정보 콘텐츠 개발

나인영(In Young Na),류시천(Si Cheon You) 한국스마트미디어학회 2018 스마트미디어저널 Vol.7 No.3

바나나는 유엔식량농업기구가 지정한 세계에서 여덟 번째로 중요한 작물이며, 주요 식량인 밀, 쌀, 옥수수 다음으로 지구상에서 생산량이 네 번째로 많다. 맛뿐만 아니라 영양분도 풍부하며 미래의 주요 식량자원으로도 주목받는 과일이다. 하지만 바나나는 인류의 이기심에서 비롯된 비정상적인 재배방법 때문에 오늘날 멸종위기에 처해 있다. 본 연구의 목적은 교과과정을 통해 농업혁명에 대한 배경 지식이 있는 중·고등학생들에게 바나나 멸종에 관한 정보를 쉽고 흥미롭게 전달할 수 있는 디지털 정보 콘텐츠를 개발하는 것이다. 바나나가 멸종위기에 처하게 된 원인과 과정을 스토리텔링 기법을 활용 하여 선형적 구조로 보여줌으로써 사용자들이 흥미를 갖도록 하였다. 또한 여러 단계로 구성된 스토리와 각각의 스토리를 뒷받침하는 정보 그래픽의 관계를 상하로 움직이는 병렬구조를 활용하여 시각화시킴으로써 본 콘텐츠와 사용자 사이의 자연스러운 상호작용이 일어나도록 하였다. 본 연구를 통해 멸종위기 종에 대한 인류의 관심이 증대되기를 기대한다. Banana is the eighth most important crop in the world designated by the United Nations Food and Agriculture Organization (FAO). In terms of production, it is the fourth most harvested crop following wheat, rice, and corn, considered to be a promising food source for mankind as it is not only scrumptious but also rich in nutrients. However, abnormal cultivation methods that mankind has invented to breed bananas is currently pushing them to the state of extinction. The aim of this study is to develop information-rich digital contents that can easily and intriguingly convey information about steadily but certainly increasing risk of banana extinction. The end-users are middle and high school students who are assumed to be aware of the agricultural revolution through their school curriculum. The linear storytelling method was meant to encourage the end-users to be interested in the causes and processes in which banana has become endangered. For generating a natural interaction between the content and the end-users, a parallel, upper-lower structure was used, in which the relationship between the stories comprising several stages and the information graphic supporting each story is represented. This paper can support an information campaign about the endangered species.

건성안 환자의 눈물에서 인터페론유도 T 세포 화학주성인자의 농도와 눈물표면인자와의 상관관계

김황균,유인천,윤경철,Hwang Gyun Kim,M,D,In Cheon You,M,D,Kyung Chul Yoon,M,D,Ph,D 대한안과학회 2008 대한안과학회지 Vol.49 No.10

Purpose: This study was performed to evaluate the level of I-TAC in tears of patients with dry eye syndrome and its correlation with the tear surface parameters. Methods: I-TAC levels were measured by enzyme-linked immunosorbent assay (ELISA) in tear samples collected from 33 dry eye patients (16 patients with Sjögren syndrome and 17 patients with non-Sjögren syndrome) and 15 control subjects. The correlations between I-TAC levels and tear surface parameters including tear film break-up time (BUT), basal tear secretion, tear clearance rate (TCR), corneal sensation, keratoepitheliopathy and conjunctival goblet cell density were analyzed. Results: The mean levels of I-TAC were 717±377 pg/ml in patients with dry eye and 444±119 pg/ml in control subjects (P=0.003). The mean levels in Sjögren syndrome patients (1261±324 pg/ml) were significantly higher than those of non-Sjögren syndrome patients (614±131 pg/ml, P=0.003). I-TAC levels correlated significantly with basal tear secretion (P=0.006), TCR (P=0.007), keratoepitheliopathy (P=0.022) and goblet cell density (P<0.001), but did not correlate with BUT (P=0.110) and corneal sensation (P=0.090). Conclusions: The level of I-TAC is elevated in tears of patients with dry eye syndrome including Sjögren syndrome. The level correlates with disease severity and tear surface parameters. J Korean Ophthalmol Soc 2008;49(10):1565-1571

알터나리아 각막염의 임상양상과 예후

유인천,강인성,윤경철,In Cheon You,M,D,In Seong Kang,M,D,Kyung Chul Yoon,M,D,Ph,D 대한안과학회 2007 대한안과학회지 Vol.48 No.4

Purpose: To investigate the risk factor, clinical manifestations, treatment results, and prognosis in Alternaria keratitis. Methods: Thirteen eyes of 13 patients who were diagnosed as Alternaria species by corneal smear and culture were included. The past history, visual acuity, location and size of ulceration, hypopyon, treatment results, and prognosis were analyzed retrospectively. Results: Nine (69.2%) were women, and 4 were men. The mean age was 65.23±8.70 years. Eleven eyes (84.6%) had previous history of corneal traumas by soil or plant material. In 7 eyes (53.8%), the lesions were located at the corneal center. The average size of ulceration was 13.90±21.80 mm2. Four eyes (30.8%) had hypopyon. The initial visual acuity was less than 0.1 in 10 eyes (76.9%). The final visual acuity improved more than 2 lines in 10 eyes (76.9%) and more than 1 line in 12 eyes (92.3%), and did not change in 1 eye (7.7%). The treatment success was achieved in 12 eyes (92.3%). Conclusions: Early diagnosis and specific antifungal treatments of Alternaria keratitis can lead to a good prognosis.

울릉도 너도밤나무림의 군집구조와 하층식생의 분포특성

천광일 ( Kwang Il Cheon ),정성철 ( Sung Cheol Jung ),이창우 ( Chang Woo Lee ),변준기 ( Jun Gi Byeon ),주성현 ( Sung Hyun Joo ),유주한 ( Ju Han You ),이슬기 ( Seul Gi Lee ),최철현 ( Cheol Hyun Choi ),박인환 ( In Hwan Park ) 한국환경복원기술학회 2012 한국환경복원기술학회지 Vol.15 No.4

This study was intended for Fagus engleriana stand in Is. Ulleung where the disturbance of vegetation has been caused by the exploitation and the increase of tourists. For the effective conservation and management on this issue, this study was conducted provide basic data. The sixteen study sites (20×20m) were installed in the dominant Fagus engleriana stand and the base environment and vegetation were investigated. The Fagus engleriana stand was classified into two groups, The Fagus engleriana stand was classified into two groups, community A is Fagus engleriana-Sorbus amurensis and community B is Fagus engleriana-Acer pictum subsp. Mono by cluster analysis and community A were nothing signigicant by indicator species analysis. Community B were Eight species (Tsuga sieboldii, Camellia japonica, Dystaenia takesimana ect.) significant by indicator species analysis. The diameter class of 16cm to 25cm was 53.7% in population structure of Fagus engleriana, which was the highest and showed inverse J-distribution. Species diversity index (H`) of investigated woody layer group ranged from 0.99 to 2.05 and that of under layer group ranged from 1.75∼2.59. According to Non-metric Multidimensional Scaling (NMS) analysis, the woody layer was divided into community A developed in the region having relatively high sand content at high altitudes and community B formed at the place having relatively high clay content at low altitudes. Then this classification was significant through Multi-Response Permutation Procedures (MRPP) analysis. The distribution of understory vegetation through Detrended Correspondence Analysis (DCA) was induced by the silt content and cover degree of vegetation layer.

패실로마이세스 각막염: 국내 증례 보고 및 해외 문헌 고찰

정새롬(Sae Rom Chung),유인천(In Cheon You),조남천(Nam Chun Cho),안민(Min Ahn) 대한안과학회 2016 대한안과학회지 Vol.57 No.3

목적: 패실로마이세스 각막염으로 확진된 본원 및 국내 사례를 종합하여 알아보고, 이를 외국에서 보고된 증례와 비교해 보고자 하였다. 대상과 방법: 본원 안과를 방문하여 패실로마이세스가 검출된 환자 3예와 국내에 보고된 증례를 종합하여 각막염 발생의 위험인자, 초기 임상양상, 수술적 처치 여부, 치료 후 시력에 대해 알아보고, 이를 외국에서 발표된 패실로마이세스 각막염 환자의 논문들을 정리하여 비교하였다. 결과: 국내 사례 중 자연적으로 발생한 1예의 여성을 제외하고 모두 남성이었으며 외상, 수술과 같은 위험인자가 있었다. 5예 모두 초기시력이 손가락세기 이하였으며 각막의 중심부위에 깊게 침범된 소견을 보였다. 전방 내 및 각막기질 내 보리코나졸 주사 등의 약물치료 외에도 안구내용제거술, 각막이식술을 시행 받았으며 1예는 안구위축 상태가 되는 등 시력이 불량한 경우가 많았다. 외국사례들도 과거 안수술, 외상, 콘택트렌즈 착용과 같은 위험인자가 존재하는 경우가 많았으며, 약물치료에 호전되지 않아 각막이식술과 같은 수술적 처치가 필요한 경우가 많았고, 최종 시력이 낮다는 점에서 국내와 비슷한 임상양상을 보였다. 결론: 패실로마이세스 각막염은 국내외에서 모두 직접적인 위험인자를 갖는 경우가 많고, 심한 임상 경과를 보이며 기존의 약물치료에 잘 호전되지 않고, 수술적 처치가 필요한 경우가 많았다. 패실로마이세스 각막염이 의심되는 경우에는 처음부터 전방내주사, 안내주사와 같은 적극적인 치료가 필요하다. Purpose: To analyze the Paecilomyces keratitis cases in Korea and compare cases from foreign literature. Methods: The records of 3 patients diagnosed with Paecilomyces keratitis at our hospital and other reported cases in Korea were evaluated to examine the predisposing factors, clinical aspects, antifungal therapy, therapeutic surgery, and visual outcome and compared with previously reported foreign cases. Results: In Korea, 1 patient was female, 4 patients were male and had predisposing factors including prior corneal trauma or surgery, except 1 spontaneous occurrence. All 5 eyes of 5 patients had poor initial visual acuity, less than finger count, and deep corneal infiltration. The patients were treated with multiple topical and systemic antifungal treatments such as intracameral or intrastromal voriconazole injections and required evisceration and penetrating keratoplasty. However, the final outcomes were unsatisfactory. Previously reported cases from foreign literature also had predisposing factors such as corneal surgery, trauma, and soft contact lens use. They were resistant to antifungal therapy and eventually led to surgeries such as penetrating keratoplasty and the final outcomes were poor. Conclusions: Frequently, Paecilomyces keratitis has direct risk factors and is resistant to many topical and systemic antifungal agents. In the majority of cases, therapeutic surgery was required and the final visual outcomes were poor. When Paecilomyces keratitis is suspected, we suggest aggressive therapy including intracameral and intravitreal injections of voriconazole in the initial treatment.

Prevalence, Risk Factors and Cutoff Values for Bronchial Hyperresponsiveness to Provocholine in 7-Year-Old Children

Jung, Sungsu,Suh, Dong In,Lee, So-Yeon,Yoon, Jisun,Cho, Hyun-Ju,Kim, Young-Ho,Yang, Song-I,Kwon, Ji-Won,Jang, Gwang Cheon,Sun, Yong Han,Woo, Sung-Il,Youn, You-Sook,Park, Kang Seo,Cho, Hwa Jin,Kook, My The Korean Academy of Asthma, Allergy and Clinical 2018 Allergy, Asthma & Immunology Research Vol.10 No.5

<P><B>Background</B></P><P>A US Food and Drug Administration (FDA)-approved drug methacholine chloride (Provocholine<SUP>®</SUP>) was recently introduced to Korea where it is now widely used in clinical practice. We aimed to evaluate the prevalence, risk factors and cutoff value of bronchial hyperresponsiveness (BHR) to Provocholine in 7-year-old children.</P><P><B>Methods</B></P><P>Six hundred and thirty-three children from the Panel Study on Korean Children who visited 16 regional hospitals were evaluated. Skin prick tests, spirometry and bronchial provocation tests for Provocholine as well as a detailed history and physical examinations were performed. The bronchial provocation test was reliably performed on 559 of these children.</P><P><B>Results</B></P><P>The prevalence of ever-diagnosed asthma via medical records was 7.7%, and that of current asthma (wheezy episode in the last 12 months + diagnosed asthma by physicians) was 3.2%. The prevalence of BHR to Provocholine was 17.2% and 25.8%, respectively, for a PC20 < 8 and < 16 mg/mL. The risk factors for BHR (PC20 < 16 mg/mL) were atopic dermatitis diagnosis and current dog ownership, whereas those for current asthma were allergy rhinitis diagnosis, a history of bronchiolitis before the age of 3, recent use of analgesics/antipyretics and maternal history of asthma. The BHR prevalence trend showed an increase along with the increased immunoglobulin E (IgE) quartile. The cutoff value of PC20 for the diagnosis of current asthma in children at age 7 was 5.8 mg/mL (sensitivity: 47.1%, specificity: 87.4%).</P><P><B>Conclusions</B></P><P>BHR to Provocholine (PC20 < 8 mg/mL) was observed in 17.2% of 7-year-olds children from the general population and the cutoff value of PC20 for the diagnosis of current asthma was 5.8 mg/mL in this age group. The risk factors for BHR and current asthma showed discrepancies suggesting different underlying mechanisms. Bronchial provocation testing with Provocholine will be a useful clinical tool in the future.</P>

감염성 각막궤양에 의한 절박천공에서 구조 전층각막이식술의 효과

정인영,유인천,박영걸,윤경철,In-Young Jeong,In-Cheon You,Yeoung-Geol Park,PhD,Kyung Chul Yoon 대한안과학회 2007 대한안과학회지 Vol.48 No.7

Purpose: To investigate the effect of tectonic penetrating keratoplasty for the treatment of impending perforations caused by infectious corneal ulcers. Methods: We analyzed preoperative and postoperative visual acuity, lesion location and size, graft size, postoperative outcome, and complications in 19 patients (19 eyes) with impending perforations due to infectious corneal ulcers. All patients underwent tectonic penetrating keratoplasty and had a minimum follow-up period of 6 months. Results: In our study, eight eyes (42.1%) had herpes simplex keratitis, 6 eyes (31.6%) had bacterial keratitis, and 5 eyes (26.3%) had fungal keratitis. Twelve eyes had a lesion located in the central cornea, while 7 eyes had a lesion located in the paracentral cornea. Visual acuity improved in 13 eyes (68.4%) and anatomical success was achieved in 16 eyes (84.2%). Three eyes (15.8%) developed a graft melting secondary to rejection. Complications included bullous keratopathy (3 eyes, 15.8%), graft infection (3 eyes, 15.8%), neovascularization (2 eyes, 10.5%), and secondary glaucoma (1 eye, 5.3%). Conclusions: Tectonic penetrating keratoplasty maintains ocular integrity and effectively treats impending perforations caused by infectious corneal ulcers.

스테노트로포모나스 말토필리아 각막염의 임상양상과 예후

유인천,이승현,박영걸,윤경철,In Cheon You,M,D,Seung Hyun Lee,M,D,Yeoung Geol Park,M,D,Ph,D,Kyung Chul Yoon,M,D,Ph,D 대한안과학회 2007 대한안과학회지 Vol.48 No.7

Purpose: To investigate the risk factor, clinical manifestations, treatment results, and prognoses in Stenotrophomonas maltophilia keratitis. Methods: Ten eyes of 10 patients who were diagnosed with, Stenotrophomonas maltophilia by corneal smear and culture were included in this study. Each patient`s past history, visual acuity, location and size of ulceration, hypopyon, treatment results and prognosis were analyzed retrospectively. Results: Seven pateints (70.0%) were men, and 3 were women. The mean age was 62.9±11.3 years. Only 2 eyes (20.0%) had previous histories of corneal traumas. Polymicrobial infections, including 3 cases infected with Pseudomonas species and 2 cases infected with Fusarium species, were detected in 7 eyes (70.0%). The lesions were located at the corneal center in 6 eyes, and hypopyon was observed in 9 eyes. The average size of ulceration was 28.5±19.6 mm2. Seven eyes (70.0%) underwent surgical treatment. The initial visual acuity was less than 0.02 in 9 eyes (90.0%). The final visual acuity improved in 3 eyes (30.0%) and was less than hand movement in 7 eyes (70.0%). Conclusions: Stenotrophomonas maltophilia keratitis occurs in patients with a compromised ocular surface, is often polymicrobial, and is associated with poor prognoses.