나팔꽃증후군에서 감각사시 교정 후 발생한 항상전증후군

채우정(Woo Jung Chae),조순영(Soon Young Cho) 대한검안학회 2020 Annals of optometry and contact lens Vol.19 No.4

Purpose: We report a case of antielevation syndrome caused by sensory strabismus surgery for the treatment of exotropia and hypertropia in morning glory syndrome. Case summary: A 4-year-old girl visited our hospital due to outward deviation of her left eye since birth. She showed 60 prism diopters (PD) exotropia and 20 PD hypertropia of her left eye by the Krimsky test. During fundus examination, we found funnel-shaped excavation of the posterior fundus. She was diagnosed to have sensory exotropia and hypertropia associated with morning glory syndrome. The patient received lateral rectus muscle recession (9.0 mm), medial rectus muscle resection (7.0 mm) and inferior oblique anteriorization 1.0 mm posterior to the inferior rectus muscle lateral border on her left eye. One week after surgery, the patient showed orthotropia at near fixation and far fixation in the primary position, and 2 months after surgery, the patient showed 6 PD exotropia and 2 PD hypertropia at near fixation and 10 PD exotropia at far fixation of her left eye in the primary position. However, antielevation syndrome was noticed and attributed to the use of unilateral inferior oblique transposition for the correction of hypertropia. Conclusions: The exptropia and hypertropia in morning glory syndrome was effectively treated with lateral rectus muscle recession, medial rectus muscle resection and inferior oblique muscle transposition. This case cautions meticulous care is needed to prevent antielevation syndrome when performing unilateral inferior oblique transposition.

장기간 스테로이드 사용 환자에게서 발생한 내인안내염의 임상양상과 예후

채우정(Woo Jung Chae),이승우(Seung Woo Lee) 대한안과학회 2021 대한안과학회지 Vol.62 No.10

목적: 장기간 스테로이드 복용 환자에서 발생한 내인안내염 환자들을 후향적으로 분석하여 임상양상과 치료 예후를 분석하고자 하였다. 대상과 방법: 2004년 3월부터 2019년 12월까지 장기간 스테로이드를 복용한 환자 중 내인안내염으로 진단받고 치료를 받은 17명 20안의 의무기록을 후향적으로 분석하였다. 결과: 환자의 평균 연령은 70.0세였으며, 남성은 58.8%였다. 17명 중 3명(17.6%)은 양안에 발생하였다. 장기간 스테로이드를 사용한 기저질환에는 관절염 6명(35.3%), 신장질환 5명(29.4%), 폐질환 5명(29.4%), 피부질환 1명(5.9%) 순이었다. 가장 흔한 원인 균은 그람양성균 12안(60.0%)이었다. 전신적 항생제와 유리체내 항생제 혹은 항진균제주입술은 모든 환자들에게 시행하였으며, 11안(55.0%)에서 유리체절제술을 추가로 시행하였다. 20안의 평균 최대교정시력은 치료 전 1.83 ± 0.79였으며, 치료 후 0.70 ± 0.98로 호전되었다(p<0.001). 초진 시력, 원인 균주, 패혈증 및 유리체절제술과 최종 시력과의 상관관계를 보았을 때, 패혈증이 있는 경우 최종 시력예후가 좋지 않았다. 결론: 장기간 스테로이드 사용으로 내인안내염이 발생할 수 있으며 가장 흔한 원인균은 그람양성균이었다. 패혈증이 동반된 경우 그렇지 않은 군보다 시력예후는 좋지 않았다. Purpose: To investigate the clinical characteristics and treatment outcomes of endogenous endophthalmitis (EE) in patients with a history of long-term oral corticosteroid (LTOC) use. Methods: This study was a retrospective review of the medical records of 17 patients (20 eyes) who were diagnosed and treated for EE from LTOC use from March 2004 to December 2019. Results: The mean age of the patients was 70.0 years, and 58.8% were men. Bilateral involvement was observed in three patients (17.6%). Predisposing medical conditions for steroid use were arthritis (6, 35.3%), renal disease (5, 29.4%), lung disease (5, 29.4%), and dermatologic disease (1, 5.9%). The most common causative agents were Gram-positive organisms (60.0%). All patients were treated with systemic antibiotics and vitreous tapping with intravitreal antibiotics or antifungal injection. Pars plana vitrectomy with intravitreal injection of antibiotics was performed in 11 eyes (55.0%). The initial best-corrected visual acuity (BCVA) of 20 eyes was 1.83 ± 0.79 and final BCVA was 0.70 ± 0.98 (p < 0.001). We analyzed the correlation between final visual acuity and initial visual acuity, causative organisms, sepsis, and vitrectomy. The results indicated a poor visual acuity prognosis for the patient group with sepsis. Conclusions: Our study revealed that LTOCs can induce EE. Gram-positive bacteria were the most common causative organisms of EE from LTOC use. The patient group with sepsis showed a worse visual acuity prognosis than the other groups. J Korean Ophthalmol Soc 2021;62(10):1381-1387

의료봉사에 대한 노인과 한의대생의 만족도 및 노인의 의료복지서비스에 대한 인식 조사

안재학 ( Jae Hak Ahn ),채우정 ( Woo Jung Chae ),조수경 ( Su Kyung Cho ),조충식 ( Chung Sik Cho ) 대전대학교 한의학연구소 2015 혜화의학회지 Vol.24 No.1

Objectives: The purpose of this study is to examine senior citizens`` perception of medical welfare service in Daejeon, and to investigate the level of Korean Medicine University students`` satisfaction about medical services that they have done. Methods: We visited Daejeon city hall and Dae jeon Seo-gu community health center, and interviewed them. After that we select two population and did two different surveys. First, to investigate the current state of medical services and medical welfare in Daejeon, we select neglected class senior citizens who were serviced at social welfare center. Second, we select Daejeon Korean Medicine University student to investigate the level of satisfaction about medical services and pre-education. In first population, we random select 25 of 34 senior citizen who visits mere social welfare center. In second population, we random select 78 of 115 Korean Medicine University student who belongs to medical welfare club. Results: We found some advantages and problems in medical services. A lot of senior citizen who were serviced at social welfare center showed high level of satisfaction about medical service. But there were few citizens who knows about health & medical welfare. And most Korean Medicine University student who services medical service to neglected class senior citizens showed high level of satisfaction. Conclusion: We concluded that medical welfare for senior citizen needs more publicizing. Because result of our survey, many senior citizens showed not only low level of recognition in medical welfare service, also showed low utilization rate in public health center. And most Korean Medicine University students were satisfied with themselves about medical service that they have done, it seemed medical service gives beneficial influence to not only senior citizen but also Korean Medicine University student.

외래 간호인력 업무활동 수행도와 중요도 분석 : 종합병원·종합전문요양기관 중심으로

황혜영,박정혜,김지수,전인숙,김문실,배경옥,서미숙,양우정,정문영,채지선,홍지연 대한간호행정학회 2007 간호행정학회지 Vol.13 No.1

Purpose: This study focused on analysing the performance and the perception of importance about workload of ambulatory nurses and nurse-aides for quality of nursing. Method: The subjects of this study were 126 ambulatory nurses and 117 nurse-aides in 6 secondary and 4 tertiary hospitals. The method of data collection was used the questionnaire. Result: As a result, First, nurses' activities that the performance score is above 3.0 are reception, guidance, reservation, confirm, checking medical record, operating report, explanation of disease, explanation of examination discuss with medical part, discuss with supporting part, solving patient problem environment management, and paper work. And the other side, those of nurse-aides are reception, guidance, reservation, preparation for clinic, assistant for clinic, preparation for examination, material transfer & receipt, confirm, checking medical record, and arrangement. Second, nurses-aids perceive above 3.0 performance score activities to be important for themselves. Finally, nurses perceive three categories of patient education/counselling, patient advocacy and quality improvement to be more important and higher performance when compared with nurse-aides. Conclusions: Ambulatory nurse's important nursing activities are therapeutic care, Patient education/counselling, patient advocacy, communication, personal management, quality improvement.