안구길이, 수정체전낭-망막길이, 굴절상태 및 각막굴절력간의 상호관계

최시환,박주희,박우찬 충남대학교 의과대학 지역사회의학연구소 1992 충남의대잡지 Vol.19 No.2

Axial length is major determinant of ocular refractive power. The purpose of this study was to establish the interrelationship among axial length, anterior lens capsule to retina length(ACRL), refractive states, and corneal refractive power. We measured above four variables of 364 normal adult eyes. The results were as follows: 1. The mean axial length and ACRL of all 364 eyes were 24.93(±1.25mm) and 21.59(±1.20mm) respectively. 2. The mean axial length and ACRL of 63 eyes within ±1 diopter were 23.64(±0.82mm) and 20.34(±0.79mm) respectively. 3. Refractive states, axial length, and ACRL were closely associated. The coefficient of correlation between refractive states and axial length is r=-0.7542(p<0.001), the one between refractive states and ACRL is r=-0.7526(p<0.001). 4. The coefficient of correlation between corneal refractive power and axial length is r=-0.3589(p<0.001), the one between corneal refractive power and ACRL is r=-0.3727(p<0.001). 5. Axial length/ACRL ratio of 63 eyes within ±1 diopter is 1.16(±0.02).

초자체 출혈에 있어서 조직형 플라스미노젠 활성제의 효능

최시환 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.1

Tissue plasminogen activator(tPA) is a fibrin-specific fibrinolytic agent that has recently been shown to be effective in accelerating the clearance of hyphema. Intravitreal injection of tPA can promote repid lysis of experimental intravitreal fibrin clots. The purpose of this study was to investigate the efficacy of intravitreal tPA injection for the treatment of vitreous hemorrhage in the phakic non-vitrectomized rabbit eyes. Vitreous hemorrhages were produced by intravitreal injections of 0.55ml of autologous whole blood in twenty-five rabbit eyes with intact vitreous. The injection of 25 or 100 microgram of tPA in fifteen eyes resulted in the clearance of vitreous hemorrhage in 99±19 or 34±6.5 days respectively. This was significantly faster than control eyes in which the clearance was not seen until 131±17 days later. No tractional retinal datachment was observed.

응급의료센터의 단기입원치료실 활용경험

최승필,박승현,정시경,박규남,김영민,김세경,이운정,이환 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.2

Overcrowding of emergency department is a serious and growing problem at St. Mary's Hospital. This has motivated the development of short-stay unit(SSU) as an alternative ward to routine hospital admission and ED discharge. In our hospital a SSU begun to admit patients in January 6, 1997. The SSU received 247 patients from the ED during the eight month interval(January 6, 1997 to August 31, 1997). To examine the utilization of the SSU in ED, we retrospectively analyzed 247 patients admitted in SSU from the ED, and compared the average hours per patient with acute gastroenteritis spent in the ED during the 2-month intervals before(July-August 1996) and after(July-August 1997) the establishment of the SSU. The following results were obtained; 1. The total patients consist of EM 92(37.2%), GS 48(19.4%), IM 24(9.7%), PS 21(8.5%), OS 20(8.1%), OBGY 14(5.7%) and others 28(11.3%) 2. The results of EM patients admitted in SSU from ED 1) Sex ratio of male to female was 1:1.1 and the mean age was 37.3±16years 2) In diagnosis, acute gastroenteritis was 29 cases(31.5%), multiple contusion 14 cases(15.2%), drug intoxication 12 cases(13%), limb laceration 6 cases(6.5%), tendon rupture of hand 6 cases(6.5%), and others 19 cases(20.6). 3) Mean length of stay in ED was 9.18 hours. 4) Among 92 patients to the SSU, 79 patients(85.9%) were discharged, 11 patients(11.9%) formally admitted to hospital and 2 patients(2.2%) transferred to otherhospital. The mean hospital stay time of the patients admitted to SSU was 2.6 days. 3. There was a significant reduction in the average stay time spent in the ED by treat-and-releasing patients with acute gastroenteritis after the establishment of the SSU(from 14.65±9.6 to 7.52±5.4 hr/patient, p<0.001). Conclusively, the establishment of the SSU can shorten the average stay time that treat-and-releasing patients spend in the ED, and reduce the number of admitted patients waiting in the ED.

인공수정체안의 생체 측정

최시환,이성복 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1

In case of exchange of intraocular lenses(IOL) in pseudophakia, errors can happen in measuring axial length because of existing IOL. Therefore, we examined the accuracy of axial length measurement in pseudophakia by measuring axial lengths of pre- and post-operation. Eighty nine eyes of 77 patients were divided into four groups in the order of description (AMO SI3ONB, Staar AQ2003V, Pharmacia 720A, and HOYA UY-60SA) : Group 1 and 2 for silicone lenses, and 3 and 4 for PMMA lenses. We compared pre- and post-operative axial lengths with Ocuscan (Alcon, U.S.A.). The postoperative axial lengths were measured by phakic, aphakic, and pseudophakic mode. In pseudophakic mode, the velocity in IOL part was set at the rate of 980 and 1532 m/sec for Group 1 and 2, and 1532 and 2718 m/sec for Group 3 and 4. The preoperative average axial lengths of four groups were 23.34, 22.92, 22.88 and 23.73 mm, respectively. The postoperative average axial lengths of Group 1 and 2 were 23.20 and 23.07 mm at the rate of 980 m/sec in pseudophakic mode, and for Group 3 and 4, the lengths were 22.88 and 23.81 mm at the rate of 2718 m/sec in pseudophakic mode, and they were very close to the preoperative values. We can get the closest values to preoperative axial length by setting the velocity in pseudophakic mode at the rate of 980 m/sec for silicone lens and 2718 m/sec for PMMA lens.

토안에서 금판 삽입술의 효과

최시환,박영규,박우찬 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.1

Lagophthalmos can result in serious keratopathy because of corneal exposure and inadequate lacrimation. Four patients underwent gold plate insertion to rehabilitate paralysis of the eyelid caused by facial nerve palsy. Gold plate insertion resulted in exellent eyelid closure, protection, and cosmesis. There were no infections or extrusions. Lagophthalmos and exposure keratitis were resolved or were significantly improved in these patients. In selected patients this technique reestablishes a voluntary blink and provides corneal protection without the limitation of tarsorrhaphy. Gold plate insertion has become the procedure of choice for eyelid rehabilitation.

LASIK후 측정방법에 따른 각막곡률값의 비교

최시환,이수나 충남대학교 의학연구소 2001 충남의대잡지 Vol.28 No.2

The purpose of this study is to compare the corneal power(K) measured by different types of method in the patients who underwent LASIK. The corneal power was measured in 70 eyes(36 patients) by three different methods; autorefractokeratometer, manual keratometer, topography before LASIK, and postoperative corneal power was measured by five different methods; calculation meathod, hard contact lens method, autorefractokeratometer, manual keratometer, topography. Preoperative corneal power was 43.75±1.03D on the average, and no difference was found among three different types of method. Postoperative corneal power showed different results from each method. The results as follows; C-K(cornea1 power of calculation method); 38.64±2.25D, H-K(cornea1 power of hard contact lens method); 39.29±1.66D, A-K(corneal power of autorefractokeratometer); 39.53±1.61D, M-K(cornea1 power of manual kertatometer); 39.85±1.54D, T-K(cornea1 power of topography); 40.36±1.26D. C-K was lower than A-K(p=0.02), M-K(p=0.00) and T-K(p=0.00) statistically after LASIK. H-K and A-K were lower than T-K statistically (p=0.00, p=0.02) after LASIK. In conclusion, postoperative corneal power measured by five types of method were different statistically.

단안 안검봉합에 의한 병아리 안구크기의 변화

최시환,김세윤,서병로,민병무 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.2

In an attempt to elucidate the eyeball enlargement by eyelid suture, two-day old white Leghorn chickens (n=20) were lightly anesthetized with ether and monocular upper and lower eyelids were sutured together with 6-0 black silk. The other eye was used as control group. Refractive error, corneal curvature, or axial length by ultrasonography were assessed before the study, and 3 weeks and 6 weeks after lid suture. Dimensional changes, intraocular pressure, and weight of enucleated eyeball were measured at 6 weeks. The results of the study were as follows: 1. The eyelid sutured group developed significant axial elongation (11.00±0.36mm vs 10.69±0.24mm, mean±SD, by ultrasonography; 12.57±0.66mm vs 12.02±0.41mm by micrometer), equatorial length (15.48±0.45mm vs 15.32±0.48mm), and weight (1.51± 0.12g vs 1.39±0.09g) in comparison with control group. 2. Corneal sag and diameter, intraocular pressure, and refractive error were not significantly different between both groups. Our results support the hypothesis that form-vision deprivation induces the enlargement of eyeball, especially the posterior segment of the eyeball.

각막형태검사법을 이용한 각막양상과 눈의 굴절력과의 관계

최시환,민병무,김용백,김창식,안승일 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

We evaluated the topography of 200 normal cornea of Korean. The mean age was 37 years and mean refractive astigmatism was 0.82±0.69D. The corneal patterns were classified by Dr. Bogan such as round, oval, symmetric bow tie, asymmetric bow tie, and irregular pattern. Its incidence was 14.0%, 11.0%, 16.0%, 30.0% and 29.0%, respectively. There was no statistically significant difference in the distribution of topographic pattern in male and female and among age groups. The symmetric bow tie type had the greatest spherical equivalent and astigmatism and there was no statistically significant difference in those two values between round and oval group. Two bow-tie groups were not also statistically significantly different from each other in spherical equivalent and astigmatism. However, two bow tie groups were significantly different from round and oval group. So, it was possible to divide corneal topographic pattern into three groups such as round and oval, two bow tie, and irregualr group. We could understand normal corneal status related to corneal pattern and refractive power through this qualitative system for classifying corneal topography.

Paraquat Poisoning에서의 hemoperfusion치료 경험

김시환,최재성,윤경우,김영조,최수봉,김종설 대한신장학회 1986 대한신장학회잡지 Vol.5 No.1

반복적인 경련을 동반한 아이소니아지드(Isoniazid) 중독환자의 치험 1례

이환,오동렬,정시경,김영민,이운정,김세경,이원재,최경호 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.2

Isoniazid(Isonicotinic acid hydrazide) is an antimicrobial drug used since 1952 as a first line agent for the prophylaxis and treatment of tuberculosis. Isoniazid is well known for problems in population having a high prevalence of isoniazid use for prophylaxis or treatment of tuberculosis. But intentional or accidental isoniazid overdose is uncommon. The ingestion of toxic amounts of isoniazid causes recurrent seizures, profound metabolic acidosis, coma and even death. In adults, toxicity can occur with the acute ingestion of as little as 1.5g of isoniazid. Doses larger than 30mg per kg often produce seizures. When ingested in amounts of 80-150mg per kg or more, isoniazid can be rapid fatal. 40-year-old woman having previous pulmonary tuberculosis ingested 7gram of isoniazid(140mg/kg) to attempt suicide approximately 30 minutes prior to visit to our emergency medical center. She had recurrent generalized tonicclonic seizures and metabolic acidosis. We report one patient treated with pyridoxine, which was equivalent to the amount of isoniazid ingested and administered as a intravenous dose and oral dose