방수유출장치삽입술을 이용하여 여과포로 인한 감각이상을 치료한 1예

강규동,김연덕,AmanShahB,AbdulMajid,곽지현,JohnSalmon,임혜빈,Kui Dong Kang,MSc,Yeon Deok Kim,Aman Shah B,Abdul Majid,BSc,MB ChB,Jee Hyun Kwag,D,Phil&#,John Salmon&#,Hye Bin Yim 대한안과학회 2010 대한안과학회지 Vol.51 No.5

Purpose: To report a case of bleb dysesthesia successfully treated after Baerveldt tube implantation. Case summary: A 37-year-old woman presented with a history of persistent foreign body sensation and pain in the left eye. The patient was referred to our hospital and was diagnosed as having had plateau iris syndrome. Having shown no improvement with conservative management, she eventually received trabeculectomy in the left eye six months prior to her current presentation. Under the impression of bleb dysesthesia, she received artificial tears and a bandage contact lens. These, however, failed to alleviate her symptoms. She then had a compression suture of the bleb and bleb revision. These were performed sequentially but neither was effective. Finally, a Baerveldt tube implantation was performed successfully, and, three months later, bleb revision was performed using a donor sclera, which resulted in no further complaint of ocular discomfort. Conclusions: Bleb dysesthesia, although not a common postoperative complication, can occur after trabeculectomy and can be successfully treated with Baerveldt tube implantation. Patients should receive appropriate counseling and advice on bleb dysesthesia prior to undergoing trabeculectomy. J Korean Ophthalmol Soc 2010;51(5):790-793

광간섭단층촬영에 내장된 시신경섬유층두께 지표와 새로 계산된 지표의 녹내장 진단 정확도 비교

강규동,박찬기.Kui Dong Kang M.D.. Chan Kee Park M.D. 대한안과학회 2006 대한안과학회지 Vol.47 No.2

Purpose: To find the optimal parameter of retinal nerve fiber layer (RNFL) analysis using optical coherence tomography (OCT) and to compare the diagnostic precision between the new discriminant formula and the preprogrammed indicator (95%, 99% cut off value of normal RNFL thickness) in the diagnosis of glaucoma. Methods: The study comprised 499 eyes of 284 patients. Routine ophthalmic examinations, fundus examination, visual field test, OCT optic nerve head analysis and OCT RNFL analysis were performed. Results were analyzed and classified into normal, suspected glaucoma, and glaucoma groups. Results: There were 237 glaucomatous eyes and all parameters of the OCT RNFL analysis showed statistically significant differences between the glaucoma and non-glaucoma groups. The average RNFL thickness was most significantly correlated with the visual field indexes and was the most useful parameter in the detection of glaucoma. Using age, horizontal integrated rim area (HIRA) and average thickness, the accuracy, sensitivity and specificity of the new discriminant formula were 76.2%, 73.1% and 73.1% respectively. Conclusions: Average thickness was the most useful parameter in the detection of glaucoma. The next most useful parameter was inferior average thickness, and both were more precise than the preprogrammed indicator. The new discriminant formula is useful in the diagnosis and follow-up of the glaucoma patients.

소아에서 빛간섭단층촬영을 통하여 얻어진 지표를 이용한 녹내장의 판별

강규동,Aman Shah B. Abdul Majid,김연덕,곽지현,임혜빈 대한안과학회 2009 대한안과학회지 Vol.50 No.6

Purpose: To find the optimal parameter of retinal nerve fiber layer (RNFL) analysis in optical coherence tomography (OCT) for diagnosing glaucoma in children. Methods: The study was comprised of 127 eyes of 84 patients (aged 6 to 18 years) who visited our institute between March 2006 and February 2008. Subjects were classified into normal, glaucoma suspect and glaucoma groups, and each eye was scanned using Stratus 3.0 OCT. Routine ophthalmic examinations including fundus examination, visual field test and OCT RNFL analysis were performed. Results: There were 55 normal eyes, 27 glaucoma suspect eyes and 45 glaucomatous eyes. The average RNFL thickness was the most useful parameter to differentiate between the glaucoma and non-glaucoma groups. The next most useful parameter was inferior average thickness, followed by superior RNFL thickness. The sensitivity and specificity of the new discriminant of the formula used were 78%, and 68.6%, respectively. Conclusions: In OCT analysis, the average RNFL thickness is the most useful parameter in the diagnosis of glaucoma in children. The new discriminant of the formula is useful in the diagnosis of pediatric glaucoma patients. 목적: 소아에 있어서 빛간섭단층촬영을 통하여 얻어진 지표중에서 어떠한 지표가 녹내장 진단에 있어 유용한지 알아보고자 한다. 대상과 방법: 2006년 3월부터 2008년 2월까지 본원 안과에 내원한 6세에서 18세 사이의 소아 84명 127안을 대상으로 하였으며 모든 환자에게 안과학적 검사와 빛간섭단층촬영을 이용한 망막신경섬유층두께 분석을 시행하였다. 대상을 정상, 녹내장의증, 녹내장군으로 구분하여 결과를 후향적으로 조사하였다. 결과: 정상안은 55안, 녹내장의증안은 27안, 녹내장안은 45안으로 분류되었고 녹내장과 가장 높은 상관관계 및 민감도를 보이는 지표 는 평균 망막신경섬유층두께였고 하측, 상측 망막신경섬유층두께 순이었다. 상측, 하측, 평균 망막신경섬유층두께를 조합한 판별식의 판별력은 각각을 이용한 판별력보다 높았고 민감도는 78%, 특이도는 68.6%였다. 결론: 빛간섭단층촬영을 통하여 얻어진 지표 중에서 평균 망막신경섬유층두께, 하측 망막신경섬유층두께 순으로 녹내장 진단에 유용 하였고 높은 민감도와 특이도로 가지는 새로운 판별식을 이용하여 녹내장 진단하는 것이 유용하다.

마우스 안구건조증 모델에서 포도껍질 추출물인 안토시아닌 올리고머의 효과에 관한 연구

강규동,정재균,Ramsha Afzal,양현필,황형빈 한국식품영양과학회 2019 한국식품영양과학회지 Vol.48 No.4

This study was conducted to investigate the effects of anthocyanin oligomers on dry eye disease through animal experiments. To accomplish this, 80 eyes of 40 mice were used, and dry eyes were induced by administration of 0.02% benzalkonium chloride (BAC). Anthocyanin oligomers of two doses (10 mg/kg and 50 mg/kg) were administered once a day for 2 weeks, while the control group received 0.1% cyclosporine A (CA) eye drops twice a day. Under a slit lamp microscope, the degree of corneal erosion (NEI grading system), tear break up time (TBUT) and phenol red test were observed. Moreover, histopathologic analysis of the lacrimal gland and corneal tissue was also performed. In the anthocyanin oligomer group (50 mg/kg), NEI score was significantly lower than that of the BAC treated group, while the TBUT and the wet length of phenol red thread were significantly higher than in the BAC group (P<0.01). Analysis of corneal tissue by hematoxylin and eosin (H&E) staining showed that keratinization and thickening of the cornea epithelial layer was not more prominent than those of eyes treated with anthocyanin oligomer (50 mg/kg) and CA eye drops. Overall, our results demonstrated that this natural compound has potential positive effects on the clinical index of dry eyes in the murine dry eye model. 본 연구에서는 안토시아닌 올리고머(50 mg/kg)가 염화벤잘코늄으로 유발된 안구건조증에서 다양한 안구건조증 지표의 개선에 효과가 있음을 보여주었다. 본 연구에서 염화벤잘코늄을 안구에 점안하였을 때 안구표면에 다양한 반응이 나타났다. 염화벤잘코늄이 각막상피세포에 직접적인 손상을 주어서 각막상피세포의 편평상피화생(squamous metaplasia)이 나타났고 다양한 염증세포의 각막침윤이 관찰되었다. 이상의 결과로 보아 염화벤잘코늄을 이용한 안구건조증 유발 모델에서 안토시아닌 올리고머는 염화벤잘코늄의 점안 이후에 나타나는 다양한 염증성 사이토카인의 증가 및 이로 인한 세포 사멸을 억제함으로써 각막표면상피세포의 편평상피화생을 막아 안구건조증에 나타나는 다양한 변화를 개선시키는 것으로 추정해볼 수 있다. 이러한 안구건조증에서 안토시아닌 올리고머의 효과는 항염 작용과 더불어 안토시아닌이 본래 가지고 있는 강력한 항산화 작용에 의한 것으로 생각된다. 특히 본 연구에 사용된 안토시아닌은 단량체가 아닌 중합체로써 기존의 단량체보다 생리활성이 높을 것으로 생각되는데, 향후 추가적인 연구를 통하여 중합체의 우수한 생리활성이 추가로 규명된다면 다양한 안과영역에서 관심을 받을 것으로 생각된다. 안구건조증은 치료가 쉽지 않고 환자의 삶의 질까지 영향을 미치는 질환이다. 치료가 잘 되지 않는 이유 중에 하루에도 수차례씩 치료 약제를 점안하여야 하므로 환자의 순응도가 떨어지는 점이 있는데 경구 약제가 이러한 점을 보완해줄 수 있을 것이라 생각된다. 향후 좀 더 장기적인 연구, 염증 관련 단백질 분석 등과 점안제와 동시에 복용했을 경우의 효과 등에 대한 추가적인 연구가 필요할 것으로 생각된다.

구간의 최고속도 설정 및 적용사례

김용석,강규동,Kim, Yong-Seok,Kang, Kyu-Dong 대한교통학회 2011 교통 기술과 정책 Vol.8 No.3

일차 쇼그렌증후군 환자에서 안구표면염색점수와 침샘 신티그래피

박선경,강규동,김현승,황형빈 대한안과학회 2020 대한안과학회지 Vol.61 No.8

목적: 눈마름 임상증상을 보이는 일차 쇼그렌증후군(Sjögren’s Syndrome) 환자에서 안구표면염색점수와 정량화한 침샘 신티그래피지표 간의 상관관계 및 진단적 가치에 대해 분석하고자 한다. 대상과 방법: 2017년 7월부터 2019년 4월까지 류마티스내과에서 의뢰된 눈마름 임상증상을 보이는 쇼그렌 및 비쇼그렌증후군의 성인 51명의 의무기록을 후향적으로 검토하였으며, 일차 쇼그렌증후군과 비쇼그렌증후군 간에 안구표면염색점수와 침샘 신티그래피 각 지표의 차이가 있는지에 대한 비교에는 각각 Mann Whitney U-test 및 student t-test를 사용하였고, 안구표면염색점수와 침샘 신티그래피 지표 간의 상관분석은 Spearman correlation을 사용하였다. 결과: 안구표면염색점수(p=0.021), 귀밑샘의 excretion fraction (p=0.022), 턱밑샘의 excretion fraction (p=0.045)은 일차 쇼그렌증후군과 비쇼그렌증후군 두 군 간에 통계적으로 유의한 차이가 있었으며, 턱밑샘의 uptake ratio (rho=-0.369, p=0.008), 턱밑샘의 excretion fraction (rho=-0.359, p=0.010)은 안구표면염색점수와 통계적으로 유의한 음의 상관관계를 보였다. 결론: 안구표면염색점수는 일차 쇼그렌증후군에서 건성안의 정도를 평가하는 데에 있어서 표준진단법이며, 일차 쇼그렌증후군 환자가 초기에 눈마름 증상을 호소하지 않아도 침샘 신티그래피상에서 기능저하가 관찰될 때 반드시 안구표면병변의 유무를 확인해야 할 것이다. Purpose: To analyze the correlation between the ocular surface staining score and indices of salivary gland scintigraphy in patients with primary Sjögren's syndrome and dry eye symptoms, and to evaluate the diagnostic value of these indices. Methods: The patients were 51 adults with primary Sjögren's syndrome or non-Sjögren's syndrome plus dry eye symptoms, who were referred to our ophthalmology clinic for evaluation of the degree of dry eye at the Department of Rheumatology, from July 2017 to April 2019. The Mann-Whitney U test and student’s t-test were used for analyzing the ocular surface staining score and quantitative indices of salivary gland scintigraphy, respectively, in the primary Sjögren's syndrome and non-Sjögren's syndrome patients. Spearman correlation was used to analyze the correlations of ocular surface staining score with salivary scintigraphy indices. Results: The ocular surface staining score (p = 0.021), parotid gland excretion fraction (p = 0.022), and submandibular gland excretion fraction (p = 0.045) were significantly different between the primary Sjögren's syndrome and non-Sjögren's syndrome patients. The submandibular gland uptake ratio (r = -0.369, p = 0.008) and submandibular excretion fraction (r = -0.359, p = 0.010) were significantly negatively correlated with ocular surface staining scores. Conclusions: The ocular surface staining score was identified as the gold standard for evaluating the degree of dry eye in primary Sjögren's syndrome patients. If salivary gland dysfunction is identified by salivary gland scintigraphy, ocular surface staining should be performed to confirm the presence of ocular surface lesions, regardless of the presence of dry eye symptoms.

사고예측모형을 활용한 회전교차로 안전성 향상에 관한 연구 - 전라북도를 중심으로 -

김칠현,권용석,강규동 한국도로학회 2016 한국도로학회논문집 Vol.18 No.4

PURPOSES: There are many recently constructed roundabouts in Jeollabuk-do province. This study analyzed how roundabouts reduce the risk of accidents and improve safety in the province. METHODS: This study analyzed safety improvement at roundabouts by using an accident prediction model that uses an Empirical Bayes method based on negative binomial distribution. RESULTS : The results of our analysis model showed that the total number of accidents decreased from 130 to 51. Roundabouts also decreased casualties; the number of casualties decreased from 7 to 0 and the seriously wounded from 87 to 16. The effectiveness of accident reduction as analyzed by the accident prediction model with the Empirical Bayes method was 60%. CONCLUSIONS : The construction of roundabouts can bring about a reduction in the number of accidents and casualties, and make intersections safer.

쇼그렌 및 비쇼그렌증후군 환자에서 안구표면염색점수와 혈중 비타민 D 농도의 상관관계 비교

공예슬(Yeseul Gong),강규동(Kui Dong Kang),김현승(Hyun Seung Kim),황형빈(Hyung Bin Hwang) 대한검안학회 2021 Annals of optometry and contact lens Vol.20 No.1

Purpose: To analyze the correlation between the ocular surface staining score (OSS) and serum vitamin D level for patients of Sjögren s syndrome (group A) and non-Sjögren s syndrome (group B) with dry eye symptoms. Methods: In this observational cross-sectional study, The Schirmer I test, OSS, tear film break-up time and serum vitamin D level were measured in 65 eyes of 65 adults complaining of dry eye. Among 65 people, 35 people in group A and 30 people in group B. The Student’s t-test was used for analyzing the ocular surface staining respectively, in group A and group B patients. Pearson’s correlation was used to analyze the correlations of OSS with serum vitamin D level. Results: The serum vitamin D level (rho = -0.245, p = 0.049) was negatively correlated with OSSs. Especially, the serum vitamin D level (rho = -0.440, p = 0.008) was significantly negatively correlated with OSSs in Sjögren s syndrome patients even more than total patient group. Conclusions: This suggests that the OSS is highly related to immunological factors such as vitamin D in dry eyes due to an underlying immunological disease. Finding the exact relationship between the inducer of dry eye and the degree of dry eye and clarifying the correlation seems to play an important role in the direction of treatment for dry eye.

백내장 수술 안내 영상물 제작을 통한 고객 만족도 향상

문정일,박주완,최윤주,김연덕,강규동,송민혜,이경민,이상규,이미연,박지선,황현주 한국의료QA학회 2005 가을학술대회 Vol.2005 No.2

치료 경험이 없는 당뇨황반부종에서 유리체내 덱사메타손삽입물-베바시주맙 병합요법과 베바시주맙 단독 요법의 단기 치료 결과 비교

이여진(Yeo Jin Lee),강규동(Kui Dong Kang) 대한안과학회 2020 대한안과학회지 Vol.61 No.12

목적: 치료 경험이 없는 당뇨황반부종에서 유리체강내 베바시주맙과 덱사메타손삽입물(Ozurdex??) 병합주사요법과 베바시주맙 단독주사요법에 대한 치료 효과를 비교하였다. 대상과 방법: 당뇨황반부종이 있는 환자 41명 41안의 의무기록을 후향적으로 분석하였으며 이 중 20안은 베바시주맙 단독요법을 시행받았고 21안은 덱사메타손삽입물과 베바시주맙 병합요법을 시행 받았다. 시술 전과 시술 후 1, 3, 6개월의 최대교정시력, 중심황반두께, 안압, 재치료 빈도를 비교 분석하였다. 결과: 병합요법군에서는 주사 후 3개월, 6개월째 최대교정시력이 유의하게 상승되었다. 단독요법군에서는 3개월까지는 유의한 값을 보이지 않았으나 6개월째에는 치료 전과 비교하여 유의한 시력호전이 관찰되었다. 중심황반두께는 3개월까지는 병합요법군이 단독요법군보다 유의하게 감소하였다. 병합요법군에서 1개월째 중심황반두께는 264.39 ± 54.95 μm였고 단독요법군에서는 349.00 ± 112.18 μm로 유의한 차이가 있었다(p=0.011). 병합요법군에서 3개월째의 중심황반두께 역시 단독요법군과 비교하였을 때 유의한 차이가 있었으나(p<0.001), 6개월에는 두 군 간 차이가 없었다. 6개월간 평균 재주사 횟수는 병합요법군이 0.45회, 단독요법군이 1.15회였다. 병합요법군에서 6개월간 두 단계 이상 진행된 피질혼탁과 후낭혼탁성 백내장 발생은 7%, 15%였다. 결론: 당뇨황반부종에서 베바시주맙과 덱사메타손삽입물의 병합요법은 베바시주맙 단독요법과 비교하여 첫 3개월 동안 중심황반두께의 감소 효과가 있었고 재주사의 빈도를 감소시켰다. Purpose: To compare the visual and anatomical outcomes of intravitreal bevacizumab combined with the dexamethasone intravitreal implant (Ozurdex??) and bevacizumab monotherapy in eyes with treatment-naive diabetic macular edema. Methods: We retrospectively reviewed 41 eyes of 41 patients with diabetic macular edema who underwent either intravitreal bevacizumab (1.25 mg) (21 eyes, intravitreal bevacizumab [IVB] group) injection alone or simultaneous injection of bevacizumab (1.25 mg) and dexamethasone implant (0.7 mg) (20 eyes, intravitreal dexamethasone [IVD] group). Best-corrected visual acuity (BCVA), central macular thickness (CMT), intraocular pressure, and retreatment percentages were accessed 1, 3, and 6 months after injection. Results: At 3 and 6 months, the IVD group showed a significant improvement in BCVA compared to the baseline. Only a slight improvement in BCVA was observed in the IVB group during the initial 3 months; however, significant improvement was evident at 6 months compared with the baseline. During the first 3 months, the IVD group showed significant improvement in CMT compared with the IVB group; at 1 month after the initial injection, the CMT was 264.39 ± 54.95 μm for the IVD group versus 349.00 ± 112.18 μm for the IVB group (p = 0.011). At 3 months, the CMT in the IVD group had improved significantly compared with that of the IVB group (p < 0.001). The average number of additional intravitreal injections during the 6-month follow-up was 0.45 and 1.15 for the IVD and IVB groups, respectively. In the IVD group, cortical (7%) and posterior subcapsular (15%) cataracts developed by two grades or more during follow-up in phakic eyes. Conclusions: In patients with diabetic macular edema, simultaneous therapy combining a dexamethasone implant plus bevacizumab showed significant improvement in CMT during the initial 3 months and the combined treatment group had fewer additional intravitreal injections.