말기녹내장으로 처음 진단받은 환자의 진단 경로 및 임상양상 분석 : 단일 3차 의료기관 경험

장준혁(Joon Hyuck Jang),이경화(Kyung Wha Lee),백성욱(Sung Uk Baek) 대한안과학회 2021 대한안과학회지 Vol.62 No.11

목적: 건강검진의 확대에도 불구하고 첫 진단 시 말기녹내장으로 진단을 받는 환자들이 적지 않다. 이들의 진단 경로 및 임상양상을 분석하여 연관 인자를 알아보고자 하였다. 대상과 방법: 2016년부터 2018년도까지 3차 의료기관에서 녹내장으로 처음 진단 받은 환자 중에서 연속된 초기 시야검사에서 mean deviation (MD) 값이 -12 dB 이하이며, 상응하는 구조 손상이 확인된 자를 대상으로 하였다. 전체 대상군을 각각 ‘단안, 양안말기녹내장’, ‘고안압, 정상안압녹내장’ 그리고 인공수정체안, 수정체안 으로 양안성, 치료 전 안압, 그리고 백내장수술 여부에 따라 분류, 비교 분석하였다. 결과: 전체 대상 환자는 73명으로 평균 나이 69.3세, 평균 MD값은 -19.6 dB이었다. 양안 말기녹내장군은 우연히 안과검진을 통해 진단된 경우가 가장 많고(52.2%), 중심 섬 양상의 시야결손이 가장 많았으나(54.2%), 단안군은 녹내장 연관증상으로 진단된 경우가 가장 많고(46.9%), 상하측 양상의 결손이 가장 많았다(42.8%). 고안압녹내장군에서 녹내장연관증상을 주소로 내원한 경우가 68.2%, 정상안압녹내장군에서 22.8%였으며, 중심 섬 양상의 시야결손은 고안압녹내장군에서 43.6%, 정상안압녹내장군에서 29.4%였다. 결론: 본 연구는 말기녹내장의 진단 경로 및 임상양상을 분석한 연구로서, 양안 말기녹내장군에서 안과검진으로 우연히 진단된 경우가 많았다. 세부분석에서 양안 말기녹내장, 고안압녹내장, 인공수정체안에서 중심 섬 양상의 시야결손의 비율이 높았다. 추후 사회경제적 요소 및 다기관 자료를 통한 보완 분석이 필요하다. Purpose: As routine health examinations become more common, many patients first diagnosed with glaucoma have advanced glaucoma. We analyzed the routes to diagnosis and the characteristics of patients initially diagnosed with advanced glaucoma. Methods: We retrospectively retrieved the medical records of patients first diagnosed with advanced glaucoma in our tertiary care center. The inclusion criteria were a mean deviation (MD) less than -12 dB on the visual field test, accompanied by structural damage. All patients were classified in terms of unilateral/bilateral disease, the intraocular pressure before medication, and lens status. We divided patients into those with monocular or binocular advanced glaucoma, high- or normal-pressure glaucoma, and those who were pseudophakic or phakic. Results: We included 73 patients of mean age 69.3 years. The visual field test MD was -19.6 dB. In those with binocular advanced glaucoma, incidental ophthalmic examination was the most common means of diagnosis (52.2%). Central-island visual field defects were the most common defects (54.2%). In those with monocular advanced glaucoma, glaucoma-associated symptoms most commonly triggered diagnosis (46.9%). Both superior and inferiorvisual field defects were the most common defects (42.8%). Glaucoma-associated symptoms were present in 68.2 and 22.8% of patients with high- and normal-pressure glaucoma, respectively. Central-island visual field defects were present in 43.6 and 29.4% of those with high- and normal-pressure glaucoma, respectively. Conclusions: We analyzed the routes to diagnosis and the clinical characteristics of patients with advanced glaucoma. In those with binocular disease, glaucoma was most commonly diagnosed on incidental ophthalmic examination. Central-island visual field defects were the most common defects in patients with binocular and high-pressure glaucoma, and the pseudophakic group. A multi-center longitudinal study on risk factors for delayed glaucoma diagnosis is needed.

앞허혈시신경병증 환자에서 뇌자기공명영상으로 확인한 측두동맥염

장준혁(Joon Hyuck Jang),김은수(Eun Su Kim),이주연(Joo Yeon Lee) 대한안과학회 2021 대한안과학회지 Vol.62 No.3

목적: 동맥염성 앞허혈시신경병증에서 측두동맥 조직검사 대신 뇌자기공명영상으로 측두동맥염을 진단하고 치료한 증례를 보고하고자 한다. 증례요약: 83세 여자 환자가 2주 전부터 발생한 우안 시력저하, 4개월 전부터 시작된 후두부 통증과 저작장애를 주소로 내원하였다. 초진 시 최대교정시력 우안 0.1로 시력저하와 상대구심동공운동장애를 보였다. 시야검사에서 하측수평시야결손과 안저검사에서 상측 시신경유두의 창백과 부종 그리고 면화반이 있었다. 혈액검사상 적혈구침강속도, C반응단백, 류마티스인자 상승 및 형광항핵항체(fluorescent antinuclear antibody) 양성이었다. 표재성 측두동맥의 혈관강을 확인할 수 있는 고해상도 뇌자기공명영상에서 측두동맥의 혈관강폐쇄로 혈관내 신호소실이 나타나지 않아서 측두동맥염에 의한 앞허혈시신경병증 의심하에 고용량 스테로이드 정주치료후 1주일 뒤 우안 시력 0.9, 중심시야 호전을 보였다. 경구 스테로이드 감량 및 azathioprine 병용 후 11개월째 우안 시력 0.9, 호전된 중심시야가 악화 없이 잘 유지되었다. 결론: 앞허혈시신경병증이 의심되는 환자에서 뇌자기공명영상으로 측두동맥 내경의 이상을 확인하여 측두동맥염으로 진단하고, 스테로이드와 면역억제제 치료를 통하여 시력과 시야장애가 호전되었다. Purpose: To report a case of arteritic anterior ischemic optic neuropathy diagnosed with brain magnetic resonance imaging (MRI) for temporal arteritis instead of temporal artery biopsy. Case summary: An eighty-three years old female visited our clinic for right blurred vision for 2 weeks ago with occipital headache for 4 months and mastication problems. Initial best corrected visual acuity was 0.1 in right eye. She had right inferior altitudinal visual field defect and superior pale optic disc swelling with few cotton wool spots were checked. In serologic tests, erythrocyte sedimentation rate, C reactive peptide, and rheumatoid factor were increased, and fluorescent antinuclear antibody was positive. We performed high resolution brain MRI which could find superficial temporal artery’s luminal signal. In MRI image, we could find loss of intraluminal signal intensity void with total luminal obstruction. We assumed as arteritic anterior ischemic optic neuropathy and high dose intravenous steroid was done. Visual acuity of right eye was 0.9 and central scotoma was improved 1 week after intravenous steroid. We changed to oral steroid with tapering and added oral azathioprine. After 11 months of oral steroid use, her visual acuity was 0.9 in right eye and inferior altitudinal visual field defect was much improved. Conclusions: A patient suspected anterior ischemic optic neuropathy was diagnosed by brain MRI with abnormalities in superficial temporal artery. Visual acuity and visual field defect were improved by steroid and immunosuppressive treatment for arteritic anterior ischemic optic neuropathy.

Scleral Lens Applications Focused on Korean Patients with Various Corneal Disorders

Ko Eun Lee(Ko Eun Lee),Su Young Moon(Su Young Moon),Sanghyu Nam(Sanghyu Nam),Joon Hyuck Jang(Joon Hyuck Jang),Jae Yong Kim(Jae Yong Kim),Hungwon Tchah(Hungwon Tchah),Hun Lee(Hun Lee) 대한안과학회 2023 Korean Journal of Ophthalmology Vol.37 No.2

Purpose: We aimed to report on the clinical outcomes of scleral lens applications in Korean patients with various corneal disorders. Methods: This retrospective review was conducted for 62 eyes of 47 patients who had been fitted with scleral lenses for variouscorneal disorders. The patients were referred for inadequate spectacle-corrected visual acuity and rigid gas permeable(RGP) or soft contact lens intolerance. Uncorrected visual acuity, habitually corrected visual acuity, best lens-corrected visualacuity, topographic indices, keratometry indices, and lens parameters were evaluated. Results: Twenty-six eyes of 19 patients with keratoconus were enrolled. Other conditions included corneal scar (13 eyes of12 patients), phlyctenules (three eyes), laceration (four eyes), chemical burn (one eye), keratitis (one eye), Peters’ anomaly (oneeye), fibrous dysplasia (one eye), ocular graft-versus-host disease (two eyes of one patient), irregular astigmatism (18 eyes of12 patients), and corneal transplant status (five eyes of four patients). The mean topographic values of the eyes include flatkeratometric value (43.0 ± 6.1 diopters [D]), steep keratometric value (48.0 ± 7.4 D), and astigmatism (4.9 ± 3.6 D). Of the eyesfitted with scleral lenses, best lens-corrected visual acuity (0.10 ± 0.22 logarithm of the minimum angle of resolution [logMAR])was significantly better than the habitually corrected visual acuity (0.59 ± 0.62 logMAR, p < 0.001). Conclusions: Scleral contact lenses are a good alternative for patients with corneal abnormalities and those who are intolerableto RGP contact lenses, resulting in both successful visual outcomes and patient satisfaction, especially concerning keratoconus,corneal scar, and corneal transplant status.

인공신경망을 활용한 기업실적예측 모델

이준혁 ( Joon-hyuck Lee ),김갑조 ( Gab-jo Kim ),박상성 ( Sang-sung Park ),장동식 ( Dong-sick Jang ) 한국정보처리학회 2014 한국정보처리학회 학술대회논문집 Vol.21 No.1

최근 기업의 기술력이 기업의 경영성과에 미치는 영향이 증가함에 따라 기업이 보유한 기술적 정보가 경영성과예측에 있어 필수적 요소로 대두되었다. 본 연구에서는 기업의 기술적 정보를 담고 있는 특허정보 및 특허지표를 활용하여 기업의 경영성과를 정량적으로 예측하는 모델을 제안한다. 또 미국 정보통신기업의 재무정보와 특허정보를 활용하여 제안된 예측모델을 구축하고 그 성능을 검증 및 평가하였다. 본 연구에서 제안한 기업실적예측 모델의 구축을 위해 인간의 두뇌가 학습하는 과정을 모방한 인공신경망알고리즘을 활용하였다.

홀로그램 압축으로 인한 열화 보정을 위한 네트워크 설계

송준범(Joon-Boum Song),장준혁(Jun-Hyuck jang),황윤석(Yun-Seok Hwang),조인제(In-Je Cho),서영호(Young-Ho Seo) 한국방송·미디어공학회 2020 한국방송공학회 학술발표대회 논문집 Vol.2020 No.11

LED Irradiation Decreases CoCb-induced Apoptosis In Human SH-SY5Y Neuroblastoma Cells : Signaling Mechanisms and Therapeutic Opportu

Jae Hyuck Yang,Youn Young Jang,Kwon Jung,Mi Kyeong Ko,Mi Sun Jang,Eun Byul Kook,Chae Kwang Lim,Won Bong Lim,Jin Soo Park,Ok Joon Kim,Hong Ran Choi 대한구강악안면병리학회 2005 대한구강악안면병리학회지 Vol.29 No.5

The purpose 01' pl'esent study was to examine the molecular events in apoptosis by CoCl2, mimicking hypoxic cond ition and recovering effects by LED ir l'adiation on Human SH-SY5Y neuroblastoma cells The SOUl'ce 0 1' light for ir l'adiation was a continuous-wave LED emitting at a wavelenl양h of 590 nm, and manufactured that ene rgy density was 5 mW!cm2 on sample surface, After ir l'adiation, cell viabi lity was measured with BrdU , cell morphol ogy was examined with Diff- Quik staining, cell signaling was monitored with various apoptosis-related molecules using RNase Pl'otection Assay(RPA) , W11en treated with CoC12, apoptotic induction was found in the SH-SY5Y cells in a concentration-dependent and time-dependent manner , Diff-Quik s taining was revealed that DNA fragmentation re presented apoptosis was examined in CoC12-tl'eated group, Moreover, RPA assay of SH-SY5Y cclls lIs ing val'iolls apoptosis-related molecllles showed that the apoptotic cell population was mcreased J-loweve. there was sorne signifïcant change in LED irradiatied cells aftel' treatement of CoC12 The main mechanism for Lhese a poptosis appearecl to be mito c hondriεt - m ecliated pathway, such as cytochrome- c‘ caspase-9, caspase-3, pro-apototic protein ßax, anti-apototic protein Bcl-2, and death receptor• mediated pathway, such as Fas, cas pase- 8, a ncl TNFRl These results demonstrate that CoCI2 induce apoptosis in SH-SY5Y via different dual apop tosis pathway through death receptor pathway as well as mitochondria- dependent pathway and LED irradiation can recl llces the CoCl2-induced apoptosis by blocking their internal signaling pathway

Poster Presentation : Antiviral Effect of Entecavir for Lamivudine-Resistant Chronic Hepatitis B: Comparison of Lamivudine-Entecavir Group vs. Lamivudine-Adefovir-Entecavir Group (초)

Hyung Joon Myung,Sook Hyang Jeong,Jin Wook Kim,Heui Seob Kim,Je Hyuck Jang 대한간학회 2009 Clinical and Molecular Hepatology(대한간학회지) Vol.15 No.4(S)

Case Report : Sorafenib-Induced Interstitial Pneumonitis in a Patient with Hepatocellular Carcinoma

( Hyung Joon Myung ),( Sook Hyang Jeong ),( Jin Wook Kim ),( Hee Sup Kim ),( Je Hyuck Jang ),( Ho Il Yoon ),( Jae Sung Kim ) The Editorial Office of Gut and Liver 2010 Gut and Liver Vol.4 No.4

Sorafenib is an oral multikinase inhibitor that has shown a survival benefit in patients with advanced hepatocellular carcinoma, and is considered to be generally safe. We treated a patient with interstitial lung disease that was associated with sorafenib therapy for the treatment of advanced hepatocellular carcinoma. A 74-year-old man with hepatitis-C-virus-related hepatocellular carcinoma was treated with sorafenib. After 8 days of sorafenib administration, he received radiation therapy for an intrahepatic tumor located in segment eight. On the 24th day of sorafenib treatment, the patient developed acute interstitial pneumonitis that rapidly improved after the discontinuation of sorafenib and treatment with high-dose steroids. This case alerts physicians to the possibility of sorafenib-induced interstitial lung disease. (Gut Liver 2010;4:543-546)

특허와 제약기업의 실적 간 상관관계에 관한 연구

이준혁(Joon-Hyuck Lee),김갑조(Gab-Jo Kim),박상성(Sang-Sung Park),장동식(Dong-Sik Jang) 한국콘텐츠학회 2013 한국콘텐츠학회 종합학술대회 논문집 Vol.2013 No.5

NPC 구조의 위상천이 풀-브릿지 컨버터를 적용한 전기자동차 충전기용 30kW급 파워모듈 개발

박찬혁(Chan-Hyuck Park),장푸름(Pooreum Jang),양형규(Hyoung-Kyu Yang),황대연(Dae Yeon Hwang),노용수(Yong-Su Noh),박준성(Joon Sung Park) 전력전자학회 2024 전력전자학술대회 논문집 Vol.2024 No.7