말초혈액단핵구와 화학적으로 손상된 각막세포의 혼합반응에 대한 시스테아민의 효과

이영복(Young Bok Lee, MD),현준영(Joon Young Hyon, MD, PhD),위원량(Won Ryang Wee, MD, PhD),정태영(Tae Young Chung, MD, PhD),정의상(Eui Sang Chung, MD, PhD),이가영(Ka Young Yi, MD, PhD),신영주(Young Joo Shin, MD, PhD) 대한안과학회 2015 대한안과학회지 Vol.56 No.10

목적: 말초혈액단핵구와 화학적으로 손상된 각막세포의 혼합반응에 대한 시스테아민의 효과를 알아보고자 하였다. 대상과 방법: 사람각막간질세포를 0.05 N NaOH로 60초간 처리하여 화학적으로 손상시킨 후 말초혈액단핵구자극 검사를 시행하였다. 혼합 말초혈액단핵구-각막세포반응은 이후 다양한 농도의 시스테아민(0-10 mM)으로 처리되었다. 세포 내 활성산소물질 형성 정도는 산화에 민감한 형광탐침자인 2′,7′-dichlorofluorescein diacetate (DCF-DA)를 사용하여 측정되었다. NaOH로 처리된 각막세포에 의해 촉진된 말초혈액단핵구의 증식 속도와 염증성 사이토카인 분비는 각각 bromodeoxyuridine 증식분석검사와 효소결합 면역흡수분석법으로 측정하였다. 결과: 말초혈액단핵구 증식은 시스테아민의 농도에 비례하여 억제되었다(p=0.019). DCF-DA 형광은 시스테아민 농도에 비례하여 감소하였다(p<0.001). 시스테아민의 농도에 비례하여 기질분해효소-9 (matrix metalloprotease-9, MMP-9), 인터류킨-6 (interleukin-6, IL-6), 형질전환성장인자-베타1 (transforming growth factor-beta 1, TGF-β1)은 억제되었고(p<0.05), 대식세포이동저해인자(macrophage migration inhibitory factor, MIF)는 증가하였다(p=0.008). 결론: 시스테아민이 활성산소물질의 억제를 통하여 화학적으로 손상된 각막세포에 의해 유발된 말초혈액단핵구의 증식과 염증 사이토카인의 분비를 억제하였다. 따라서 시스테아민이 화학적 각막손상 환자에서 치료제로 사용될 수 있을 것으로 기대된다. Purpose: To investigate the effect of cysteamine on mixed peripheral blood mononuclear cells (PBMCs)-chemically injured keratocytes reaction (mixed lymphocyte-keratocyte reaction; MLKR). Methods: PBMC stimulation assay was performed after keratocytes were chemically injured with 0.05 N NaOH for 60 seconds. MLKR was treated with various concentrations of cysteamine (0-10 mM). Intracellular reactive oxygen species (ROS) formation was measured using the oxidation-sensitive fluorescent probe, 2′7′-dichlorofluorescein diacetate (DCF-DA). Proliferation rate of PBMCs stimulated by NaOH-treated keratocytes and secretion profiles of matrix metalloprotease-9 (MMP-9), transforming growth factor-beta1 (TGF-β1), interleukin-6 (IL-6), and macrophage migration inhibitory factor (MIF) were determined using the bromodeoxyuridine proliferation assay and enzyme-linked immunosorbent assay, respectively. Results: Proliferation rate of PMBCs was suppressed by cysteamine in a dose-dependent manner (p = 0.019). Fluorescence of DCF-DA decreased depending on cysteamine concentration (p < 0.001). MMP-9, IL-6 and TGF-β1 levels were suppressed by cysteamine in a dose-dependent manner (p < 0.05), whereas MIF levels increased with cysteamine concentration of 0.5-10 mM (p = 0.008). Conclusions: These study results indicate that cysteamine induced the ROS-mediated inhibition of inflammatory cytokine release and proliferation of PBMCs stimulated by chemically injured keratocytes. Thus, cysteamine can be used in the treatment of chemical corneal burns.

이중샤임플러그 전안부분석기를 이용한 백내장 수술 시 인공수정체 도수 계산

이영복(Young Bok Lee),이가영(Ka Young Yi),배소현(So Hyun Bae),김하경(Ha Kyoung Kim),현준영(Joon Young Hyon),위원량(Won Ryang Wee),신영주(Young Joo Shin) 대한안과학회 2016 대한안과학회지 Vol.57 No.3

목적: 백내장 수술 환자에서 이중샤임플러그 전안부분석기(dual Scheimpflug analyzer, DSA; Galilei G2)로 측정한 생체계측값과 예측굴절력을 기존 방식과 비교하고 DSA의 simulated keratometry (simK)를 이용한 인공수정체 계산공식들의 예측오차를 알아보고자 하였다. 대상과 방법: 백내장 환자 총 39명을 대상으로 초음파계측기, 자동각막굴절계, 부분결합간섭계(IOL master??), DSA로 생체계측을 하였다. 수술 전 자동각막굴절계의 auto-keratometry (Auto-K), 부분결합간섭계의 mean K, DSA의 simK와 총각막굴절력(total corneal power, TCP)을 측정하고 4가지 각막굴절값을 이용하여 예상굴절력을 계산하였다. 또한 DSA의 simK를 Sanders-Retzlaff-Kraff (SRK)-II, SRK-T, Holladay II, Haigis, Hoffer-Q 공식에 대입하여 얻은 예상굴절력을 비교하였다. 수술 후 1, 3, 6개월에 측정한 구면렌즈대응치와 예상굴절력의 차이를 평균예측오차로, 그 절대값을 절대예측오차로 정의하여 그 값을 비교하였다. 결과: DSA의 TCP는 simK, mean K, Auto-K에 비해 유의하게 낮았다(p〈0.05). 수술 후 1개월에 평균예측오차는 simK, mean K와 Auto-K 사이에 차이가 없었고, TCP를 사용한 경우에는 다른 각막굴절력을 사용한 경우보다 평균예측오차가 컸다(p〈0.05). 수술 후 6개월에 simK와 TCP를 사용하여 계산된 평균예측오차는 유의한 차이를 보였다(p〈0.05). DSA의 simK를 5가지 인공수정체 계산공식에 대입하여 계산된 평균예측오차는 SRK-T 공식에서 가장 작았다. 결론: 정상각막을 가진 백내장 환자에서 인공수정체 도수 계산 시, DSA의 TCP보다 simK와 SRK-T 공식을 사용하는 것이 유용할 것으로 생각된다. Purpose: To investigate the accuracy of intraocular lens power calculations using simulated keratometry (simK) of dual Scheimpflug analyzer and 5 types of formulas in cataract patients. Methods: The keratometry (K), axial length (AXL) and anterior chamber depth (ACD) were measured using ultrasound biometry (USB) combined with auto-keratometry (Auto-K), parital coherence interferometry (PCI; IOL master??) and dual Scheimpflug analyzer (DSA; Galilei??) in 39 eyes of 39 patients. Predicted refraction was calculated using Auto-K, mean K of PCI, and simK and total corneal power (TCP) of DSA in the Sanders-Retzlaff-Kraff (SRK-T) formula. The SRK-II, SRK-T, Holladay II, Haigis, and Hoffer-Q formula were used to calculate predicted refraction with the simK of DSA and AXL of USB. Manifest refraction, mean numerical error (MNE) and mean absolute error were evaluated 1, 3 and 6 months after cataract surgery. Results: TCP of DSA was lower compared with other keratometric values (p 〈 0.05). The MNE was not different among Auto-K, mean K and simK. The MNE using TCP was larger compared with Auto-K, mean K and simK at 1 month after surgery (p 〈 0.05). There was a difference in MNE between simK and TCP of DSA at 6 months after surgery (p 〈 0.05). The MNE of SRK-T formula was the smallest in the intraocular lens (IOL) power calculation using the simK of DSA. Conclusions: We suggest using IOL power calculations with simK of DSA and SRK-T formula rather than TCP of DSA in cataract patients with normal corneas.

노인의치보철사업 참여 치과의사의 참여 만족도와 사업개선방안에 대한 연구

김미경(Mee-Kyung Kim),김미자(Mee-Za Kim),유승연(Seung-Youn You),이미숙(Mi-Sook Lee),이영복(Young-Bok Yi),최용근(Yong-Geun Choi) 대한치과의사협회 2007 대한치과의사협회지 Vol.45 No.10

Few reports regarding the effect of government paid denture project for low-income elders evaluated by the participating dentists are available despite the project was launched in 2002. Thus, this study investigated the effect of the project evaluated by the participating dentists and suggested public health policies for the better development of the project. Survey questionnaire regarding desire to continue participation, motivation of the participation, list of complaints, wish of the payment increase, and wish of the abutment crown increase were completed by 117 dentists in Seoul and Pusan. 78.6% them desired to continue the participation while 16.2% of them did not. When the motivation of participation was the service for the society, they tended to show the desire of continuing participation. Half of them were satisfied with the current payment(50.4%), while the other 47.9% did not. Complicated oral health status(48.7%), poor cooperation of patients(8.5%) and too frequent after cares low payment(6.8%) were complained. Payment increase compensating the addition of preprosthetic procedures for the complicated oral health status and the after cares was desired. Also, more thorough education regarding the denture project for the patients by the public health center is needed to alleviate the inconvenience of the participating dentists.

경·흉추 부위에서 극돌기 촉지를 이용한 척추 Level 판별의 정확도

이영복,한이경,박종택,김순열,윤경봉 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.37 No.4

Background : The C7-T1 interspinous space is commonly chosen for cervical epidural blockade, usually regarding the vertebral prominence as C7. But determining the vertebral prominence itself is confusing and unreliable because of individual variances. For this reason, we decided to look into the accuracy of estimating segmental level from palpating the surface anatomy. Methods : 1. When the neck was flexed in the sitting position, cervical spinous processes were palpated and the first and most prominent spinous processes were marked. 2. In the same position, the estimated location of the C7 vertebral spinous process was marked, counting cephalads from the lower end of scapular (known to be at the T7 level, customarily). 3. By using the radiologic imaging method, actual cervical vertebral levels were confirmed and the results were compared with the vertebral spinous processes palpated and marked by the above methods. Results : The first prominent spinous process was most commonly the C6 spinous process in both male and female subjects. The most prominent spinous processes palpated were C7 in males and C6 in females in the largest number of subjects. Estimates from the lower end of the scapular were correct in only 47.2% of cases. Conclusions : Because of considerable individual variances, estimates from the surface references can be incorrect in many circumstances, and radiologic imaging methods are suggested for the correct determination of the cervical vertebral levels. (Korean J Anesthesiol 1999; 37: 608∼612)