각막굴절교정학 콘택트렌즈와 연관된 진균 각막염 1예

이자균,이지은,이종수.Ja Kyun Lee. M.D.. Ji Eun Lee. M.D.. Jong Soo Lee. M.D. 대한안과학회 2007 대한안과학회지 Vol.48 No.10

Purpose: To present a case report of fungal keratitis related to prolonged overnight use of orthokeratology contact lenses. Methods: A 13 year-old girl presented with a corneal ulcer in her left eye refractory to antibacterial medication. She had a history of wearing orthokeratology contact lenses overnight for seven months. Results: The organism Aspergillus was isolated by corneal scraping, the contact lens itself, and from the storage case. The patient was treated with topical fluconazole and Natamycin pimaricin in addition to oral itraconazole, resulting in a resolution of the ocular lesion. Conclusions: The risk of fungal infection as a potential complication of the use of overnight orthkeratology contact lenses should be considered when using these lenses.

항생제 사용에 관한 정량적 분석

이자균,조경희,반태환,박진영 한국병원약사회 1999 병원약사회지 Vol.16 No.3

The emergence of antibiotic-resistant microorganisms is a worldwide problem and its clinical aspects are diverse among countries or clinics. Thus, for obtaining consistent data which could be used as a guide for proper usage of antimicrobial agents, we carried out present studies analyzing the total amount of antimicrobial usage, the proportions of the preventive usage and the therapeutic one, and the antimicrobial susceptibility of clinical isolates from Kangbuk Samsung Hospital. The amount of antimicrobial usage was investigated on the basis of "Individual Drug Day(IDD)" theory in 1,574 patients who had left the hospital in May, 1998. The antimicrobial susceptibility test was performed in the 1,885 isolates obtained for six months from blood samples or microorganism specimens. The usage rates for the individual antimicrobial agents were 43.0%(5579/12970 days) for cephalosporines, 38.3%(4968/12979 days) for aminoglycosides, 12.7%(1643/12979 days) for penicillins (including β-lactam inhibitor complexes), 3.9%(507/12979 days) for quinolones, 0.96%(125/12979 days) for glycopeptides, 0.86% (112/12979 days) for monobactams, and 0.11% (15/12979 days) for carbaphenems, respectively. The total usage amount of antimicrobial agents administered by injection was determined as IDDs/1000 inpatients/day. The results showed that the usage day for the individual antimicrobial agents for 1,000 inpatients a day was 266, which means that the average rate of the patients under antimicrobial treatment by injection a day was 26%. In the susceptibility tests, MRSA was isolated from both blood culture tests and general microorganisms tests at high frequencies, 62% and 70%, respectively. The data furthermore suggests that more attention needs th be paid to vancomycin-resistant S. aureus (VRSA). Of 1007 cases receiving antimicrobial treatment by injection, the usage was for the purpose of prevention in 406 cases (40.3%) and 599 cases (59.5%), including the empiric antimicrobial treatment, were therapeutic treatment. We speculate that the guideline for antimicrobial usage needed to be revised, with a management in order, on the basis of our investigations for decreasing the antimicrobial resistant incidence rates and managing the DRG in advance.

약사의 중재활동을 통한 최적의 CDSS 구축

이자균,함정연,서지연,조경희,홍성연,서희남,정옥진,김정숙,이은재,신연경,김지현 한국의료QA학회 2009 가을학술대회 Vol.2009 No.2

당뇨황반부종이 동반된 백내장환자에서 수정체 유화술-후테논당하 스테로이드 주사 병합수술의 효과

이자균,이지은 부산대학교 병원 암연구소 2008 부산대병원학술지 Vol.- No.23

Purpose : To evaluate safety and effect of posterior subtenon triamcinolon injection combined with phacoemulsification in diabetic macular edema with catarct. Methods : The subjects were 11 eyes of 8 patients who had cataract with diabetic macular edema. Posterior subtenon injection of triamcinolone acetonide 40mg in combination with phacoemulsification was administered. Best corrected visual acuity (BeVA), macular thickness measured by optical coherence tomography, and intraocular pressure were assessed 1, 3, 6 months after the procedure. Results : Significant decreases in the mean central macular thickness and improvements in the mean visual acuity after operation were observed. The mean intraocular pressure in operation group was not significantly increased compare to baseline intraocular pressure. Conclusions : Posterior subtenon triamcinolon acetonide injection combined with phacoemulsification has effectiveness in reducing diabetic macular edema and needs for secondary procedures.

고안압증에서 안압과 연령, 혈압 및 비만지수와의 상관관계

이자균,한영상,이종수,김윤경 대한안과학회 2009 대한안과학회지 Vol.50 No.7

Purpose: To evaluate the relationship between intraocular pressure (IOP) and age, blood pressure and obesity index inocular hypertensive patients. Methods: A total of 2684 ocular hypertensive patients underwent automated multi-phasic testing, including fundus photography, blood pressure and assessment of obesity. The subjects were divided into six age groups by decades ranging from 20~29 years to over 70 years of age. The relationships between factors were examined using multiple regression analysis. Results: The mean participant age was 48.0±11.0 years, and 1,777 (66.3%) participants were male and 907 (33.7%) were female. The mean intraocular pressure (IOP) was 22.04±2.2 mmHg and was significantly higher in males than in females (p=0.023). The IOP was associated with mean blood pressure, gender and obesity index. After adjustment for mean blood pressure and obesity index, the relationship between IOP and age showed a significantly negative tendency (p<0.001). The relationship between IOP and obesity index adjusted for age and mean blood pressure had a significantly positive tendency (p<0.001), regardless of gender. The relationship between IOP and mean blood pressure adjusted for age and obesity index showed a significantly positive tendency (p=0.00014). Conclusions: IOP was associated with the mean blood pressure and obesity index. Regardless of gender, IOP decreased with age but increased with hypertension. It is necessary to check IOP regularly, especially in ocular hypertensive patients with systemic hypertension. 목적: 고안압증 환자에서 안압과 연령, 혈압 및 비만도의 상관관계를 알아보았다. 대상과 방법: 고안압증 환자 2,684명을 대상으로 혈압과 비만도를 측정하였다. 대상군을 20대에서 70까지 연령군으로 나누고, 안압과 성별, 혈압, 비만도와의 관계를 분석하였다. 결과: 평균연령은 48.0±11.0세로 평균안압은 22.04±2.2 mmHg였고, 평균안압, 혈압은 남성에서 여성 보다 유의하게 높았고(p=0.023, p=0.032), 비만도는 여성에서 유의하게 높았으나(p=0.002) 연령에 따른 차이는 없었다. 평균혈압 및 비만도로 보정한 연령과 안압과의 관계는 성별에 관계없이 유의하게 반비례하였다(p<0.001). 연령, 평균혈압으로 보정한 비만도와 안압과의 관계(p=0.001) 및 연령과 비만도로 보정한 혈압과 안압과의 관계는 성별에 관계없이 유의하게 비례하였다(p<0.001). 결론: 고안압증에서 안압은 혈압, 비만도와 연관성이 있었고, 성별에 상관없이 연령이 증가할수록 안압은 감소하였으나 평균혈압이 높을 때는 안압은 증가하므로 고혈압이 있는 고안압증의 경우 정기적인 안압의 경과 관찰이 필요하다고 생각된다.

현재 작고한 전통 예술인들 면담 자료

이자균 한국역사민속학회 2006 역사민속학 Vol.- No.22

건강지수와 안압과의 상관관계

이자균,이종수,김윤경,Ja Kyun Lee,Jong Soo Lee,Yoon Kyung Kim 대한안과학회 2009 대한안과학회지 Vol.50 No.1

Purpose: This study analyzed the relationship between intraocular pressure (IOP) and health parameters, including waist circumference, in healthy Koreans. Methods: A total of 6169 healthy participants underwent automated multi-phasic tests including tonometry, automated perimetry, and fundus photography. Parameters of these patients including height, weight, degree of obesity, body fat percentage, waist circumference, body mass index, and body muscle rate, were recorded. The subjects were divided into six age groups by decades ranging from 20∼29 years to over 70 years. Multiple regression analysis was used to examine the relationship between IOP and the parameters mentioned above. Results: The mean age of the participants was 47.87 years, and 3015 (51.1%) of the participants were men. The mean IOP was 13.58±3.1 mmHg, and was significantly higher in men than in women (p<0.05). The prevalence of ocular hypertension was 2.0% in men and 2.2% in women. IOP was associated with gender, age, height, weight, degree of obesity, body fat percentage, waist circumference, and body mass index (p<0.05). The relation between IOP and age showed a significantly negative tendency (p<0.05). Height, weight, degree of obesity, body fat percentage, waist circumference, and body mass index had a significantly positive relation with IOP (p<0.05). There was no significant relation between IOP and body muscle percentage (p>0.05). Conclusions: Because increased IOP is associated with several health parameters that can be modified by diet and exercise such as weight, body fat percentage, body mass index, and waist circumference, it is recommended that these be reduced.

유성기음반의 명인명창 열전(2)

이자균 한국고음반연구회 1994 한국음반학 Vol.- No.4

가시아메바각막염의 복합 치료약제에 의한 각막독성 2예

이자균,이종수 대한안과학회 2015 대한안과학회지 Vol.56 No.2

목적: 콘택트렌즈 사용의 합병증으로 생긴 가시아메바각막염의 치료에 복합적으로 사용되는 점안 약제에 의한 각막 독성 2예를 경험하였기에 보고하고자 한다. 증례요약: 각막굴절교정용 콘택트렌즈를 착용하는 12세 학생과 미용 콘택트렌즈를 사용하던 14세 학생이 안동통, 충혈과 시력저하로 본원에 내원하여 세극등검사, 공초점현미경, 배양검사에서 가시아메바각막염으로 진단받았다. 치료 약제로 polyhexamethylene biguanide(PHMB)와 chlorhexidine 점안 약제를 복합으로 사용하던 중, 각막상피층의 결손과 미란이 발생하였다. 사용하던 chlorhexidine을 사용중단하고 PHMB만을 사용하면서 각막상피층의 회복과 더불어 가시아메바각막염의 증상 호전을 얻었기에 이를 보고한다. 결론: 가시아메바각막염의 치료에서 PHMB와 chlorhexidine을 중복으로 사용하는 경우 각막 독성의 위험성이 나타날 수 있기에 임상적으로 각별한 주의가 요구된다. Purpose: To present a case of corneal toxicity caused by therapeutic duplication during treatment of acanthamoeba keratitis as a complication of contact lens use. Case summary: A 12-year-old girl with a history of wearing orthokeratology contact lenses and a 14-year-old girl with a history of wearing cosmetic contact lenses presented with ocular pain, injection, and decreased visual acuity. They were diagnosed as having acanthamoeba keratitis based on slit lamp examination, confocal microscopy and culture. After the patients were treated with polyhexamethylene biguanide (PHMB) and chlorhexidine, corneal epithelial defect and erosion occurred. Use of chlorhexidine was stopped, and PHMB was used to treat patients and recovery of the corneal epithelium with improvement in symptoms of acanthamoeba keratitis was found. Conclusions: Using PHMB and chlorhexidine together in treating acanthamoeba keratitis increases the risk of corneal toxicity.Therefore, these drugs should be avoided in combination.

망막진탕과 합병된 삼출망막박리로 인한 지연된 시력저하 1예

이자균,박성후,이지은,엄부섭 대한안과학회 2008 대한안과학회지 Vol.49 No.9

Purpose: To report a case of retinal contusion with the complication of exudative retinal detachment causing delayed visual disturbance. Case summary: A 28-year-old man presented with visual disturbance of the left eye. Three days prior, a soccer ball hit him on his left eye, and he visited a local clinic. His visual acuity was 0.9. Fundus examination revealed a lesion of the macula, which was diagnosedas retinal contusion. Two days later, visual acuity decreased to 0.3 and he was referred to us. At presentation, his visual acuity was 0.125. A gray to white lesion around the superotemporal vascular arcade, and exudative retinal detachment involving the fovea associated with the lesion were found. Subretinal fluid collection was confirmed with optical coherence tomography (OCT). Fluorescein angiography showed diffuse leakage over the contusion, and fluorescein was pooled in the detached area. At 15 days, subretinal fluid was resolved on OCT and vision was improved to 0.8. Conclusions: We suggest that leakage from the contusion caused delayed exudative retinal detachment and decrease of visual acuity. Visual acuity improved with resolution of the subretinal fluid. Though the visual acuity was good in spite of a severe retinal contusion on the perifoveal area, the possibility of exudative retinal detachment and delayed visual disturbance shoud be considered. J Korean Ophthalmol Soc 2008;49(9):1539-1542