실명한 녹내장안에서 통증 조절을 위해 시행한 녹내장 수술의 경과

강은민,이윤하,서상진,김찬윤,성공제,홍사민,Eun Min Kang,Yun Ha Lee,Sang Jin Seo,Chan Yun Kim,Gong Je Seong,Samin Hong 대한안과학회 2014 대한안과학회지 Vol.55 No.10

Purpose: To investigate the clinical outcome of glaucoma surgery performed in patients with painful blind glaucomatous eyes. Methods: A single-center, retrospective, interventional case series was performed by reviewing the medical records of 74 glaucoma patients (74 eyes) who underwent Ahmed glaucoma valve (AGV) implantation or trabeculectomy for painful blind eyes from October 2004 to January 2014. Blindness was defined as visual acuity less than hand motion at the time of surgery. Preoperative and postoperative intraocular pressure (IOP), number of anti-glaucoma medications, and presence of pain were compared in the patients grouped according to the type of glaucoma surgery. The glaucoma type, history of previous glaucoma surgery and postoperative failure/complications were also evaluated. Results: AGV implantation was performed in 42 eyes (56.8%) of 42 patients, and trabeculectomy was performed in 32 eyes (43.2%) of 32 patients. The average IOP decreased from 41.73 ± 11.77 mm Hg before surgery to 14.29 ± 9.34 mm Hg at five years after the surgery (<EM>p </EM>< 0.001, paired t-test). The IOP was not significantly different between the groups at any follow-up time point (<EM>p</EM> = 0.949, linear mixed model). Overall, three patients (4.1%) still experienced eye pain after surgery, IOP greater than 30 mm Hg was observed in eight eyes (10.8%), and additional surgery was required in 11 eyes (14.9%). Evisceration was required in only two eyes (2.7%). Sympathetic ophthalmia was not found in any patient during the follow-up period. Conclusions: Glaucoma surgery including AGV implantation/trabeculectomy was effective and safe even for painful blind eyes. The procedure may be considered as an alternative to enucleation as an initial surgical option for painful blind glaucomatous eyes. J Korean Ophthalmol Soc 2014;55(10):1511-1519

허혈시신경병증 및 시신경교종과 유사한 소견을 보인 시신경염

강은민,권계윤,최문정,김찬윤,성공제,홍사민,Eun Min Kang,Kye Yoon Kwon,Moon Jung Choi,Chan Yun Kim,Gong Je Seong,Samin Hong 대한안과학회 2014 대한안과학회지 Vol.55 No.11

Purpose: To report a case of optic neuritis difficult to differentiate from ischemic optic neuropathy and optic nerve glioma. Case summary: A 63-year-old male visited our clinic because of a sudden painless decrease in visual acuity in his right eye. He had a relative afferent pupillary defect and inferior altitudinal scotoma with disc pallor in his right eye. Ischemic optic neuropathy was suspected based on these clinical observations. However, a focal enhancing lesion was found in the intracranial portion of the right optic nerve on gadolinium-enhanced T1-weighted MRI. The radiologist’s report revealed right intracranial optic glioma. Optic neurectomy was planned in accordance with the suspicion for optic glioma. However, a systemic mega-dose methylprednisolone therapy which is relatively less invasive was performed first based on the decision that optic neuritis should be distinguished from optic nerve glioma. The patient was hospitalized and 1 gram of methylprednisolone was injected intravenously daily for 3 days. The patient's visual acuity in the right eye improved from 0.1 before treatment to 0.3 after treatment. MRI scans at 8 months after steroid treatment showed disappearance of the previously enhanced lesion suspicious for optic glioma with developed atrophic change. The patient was finally diagnosed with optic neuritis based on these results. Conclusions: Careful differential diagnoses and therapeutic approaches to possible diseases are necessary because optic neuritis can manifest as a variety of clinical entities and imaging findings.J Korean Ophthalmol Soc 2014;55(11):1721-1725

혈액학적 이상과 동반된 급성 구후시신경염

박시윤,강은민,이윤하,김찬윤,성공제,홍사민,Si Yoon Park,Eun Min Kang,Yun Ha Lee,Chan Yun Kim,Gong Je Seong,Samin Hong 대한안과학회 2014 대한안과학회지 Vol.55 No.10

Purpose: We present a case of a patient with optic neuritis who had underlying suspicious idiopathic thrombocytopenic purpura.Case summary: A 35-year-old female with no other systemic disease visited our clinic due to acutely decreased visual acuity in her left eye 10 days in duration. Relative afferent pupillary defect was observed, but without definite papilledema. Based on brain magnetic resonance imaging (MRI), optic neuritis was suspected. Laboratory tests showed increased red blood cells, hemoglobin and, hematocrit levels and decreased platelets. Peripheral blood smear test showed decreased platelets, relative lymphocytosis and atypical lymphocytes. Specific antibodies for autoimmune disease were not present. High-dose steroid pulse therapy (methyl prednisolone 1.0 g/d, 3 days) was started. One month after treatment her visual acuity and platelet count recovered and her visual field defect improved. J Korean Ophthalmol Soc 2014;55(10):1567-1572

강우정보를 이용한 산사태 예보 기준우량

강원석 ( Won Seok Kang ),마호섭 ( Ho Seop Ma ),강은민 ( Eun Min Kang ) 한국임학회 2014 산림과학 공동학술대회 논문집 Vol.2014 No.-

우리나라에서 강우가 주요인이 되어 발생한 산사태의 강우유형을 일강우량형, 최대시우량형, 연량형, 누적강우량형(Ⅰ)(Ⅱ)(Ⅱ) 총 6가지로 나타내었다. 산사태 예보 기준우량 설정을 위해서 다양한 강우사례를 통해 일강우량, 최대시우량 유형들도 있지만 누적강우량형과 같이 기존의 산림청 예 보 기준우량인 시우량, 일강우량, 연속강우량으로 예측할 수 없는 유형들도 있고 연속시우량과 같이최근 들어 발생하는 유형들도 있다. 이러한 유형들을 커버하기 위해 기존의 연속강우량을 대신해 누적강우량과 연속시우량 기준을 추가적으로 제시할 필요성이 있다고 생각된다. 경상남도는 일강우량41.9%(경보), 58.1%(주의보 및 무예보), 최대시우량 55.6%(경보), 44.4%(주의보 및 무예보), 연속강우량66.2%(경보), 33.8%(주의보 및 무예보)의 예측도를 보였다. 경상남도는 일강우량은 98mm이상에서 산사태 경보 기준우량으로 분석되었고, 최대시우량의 경우 28mm이상을 산사태 경보로 분석되었다. 연속시우량은 70mm이상에서 산사태 경보로 분석되었고 3일 누적강우량은 128mm이상에서 산사태 경보로 분석되었다. 7일 누적강우량은 211mm이상에서 산사태 경보 기준우량으로 분석되었고 10일 누적강우량은244mm이상에서 산사태 경보로 분석되었다. 14일 누적강우량은 275mm이상에서 산사태 경보 기준우량으로 분석되었고 20일 누적강우량은 349mm이상에서 산사태 경보 기준우량으로 분석되었다. 6 rainfall types including daily rainfall, maximum hourly rainfall, continuous hourly rainfall, and accumulated rainfall (I), (II) and (III) are classified as the main cause of landslides. There are a variety of rainfall types such as daily rainfall and maximum hourly rainfall. However, there are unpredictable accumulated rainfall types such as hourly rainfall and daily rainfall that are current weather forecast systems of Korea Forest Service and there is continuous hourly rainfall, a newly appeared types. Therefore, to comprehensively cover these, accumulated rainfall and continuous hourly rainfall should be additionally presented instead of current continuous rainfall. The prediction of Gyeongsangnam-do is 41.9%(evacuation), 58.1%(landslide warning and non landslide evacuation) in daily rainfall, 55.6%(evacuation), 44.4%(landslide warning and non landslide evacuation) in maximum hourly rainfall and 66.2%(evacuation), 33.8%(landslide warning and non landslide evacuation) in continuous rainfall. In Gyeongsangnam-do the result shows that more than 98mm of daily rainfall was analyzed as to standard rainfall of landslide evacuation, while it was more than 28mm in case of maximum hourly rainfall. More than 70mm of continuous rainfall was analyzed as to standard rainfall of landslide evacuation, while 3-day accumulated rainfall for that was more than 128mm. More than 211mm of 7-day accumulated rainfall was analyzed as to standard rainfall of landslide evacuation, while 10-day accumulated for that was more than 244mm. More than 275mm of 14-day accumulated rainfall was analyzed as to standard rainfall of landslide evacuation, while 20-day accumulated for that was more than 349mm of rainfall.

임상에 따른 계류수의 수질변화에 관한 연구

마호섭 ( Ho Seop Ma ),강원석 ( Won Seok Kang ),강은민 ( Eun Min Kang ) 한국임학회 2011 한국산림과학회지 Vol.100 No.2

본 연구는 밤나무림, 소나무림 개벌조림지로 이용되고 있는 산지소유역에서 임상별 계류수질의 차이와 변화를 분석하고, 이를 먹는물 수질기준과의 비교를 통하여 얻은 결과를 요약하면 다음과 같다. 세 임분의 계류수 pH는 소나무임분(pH 7.18) >밤나무임분(pH 6.90) >개벌조림지(pH 6.82) 순으로 나타났다. 전기전도도는 개벌조림지 >밤나무임분 >소나무임분의 순으로 높게 나타났다. 양이온은 세 조사구의 계류수 모두 Ca2+, Na+, Mg2+, K+, NH4+의 순으로 높게 나타났다. 음이온은 밤나무임분과 소나무임분 계류수에서는 SO4(2-), Cl-, NO3-의 순으로 높게 나타났으나, 개벌조림지 계류수에서는 SO4(2-), NO3-, Cl-의 순으로 높게 나타나 차이를 보이고 있다. 세 조사구의 계류수 간에 차이를 살펴보기 위하여 각 임분별 수질의 변화에 대한 다중검정을 실시한 결과 12개 항목 중에서 pH, EC, NO3-, Ca2+, Mg2+, Na+, Cl-, TNU, Color 9개 항목들은 임분 간에 유의성이 인정되므로 각 임분별 수질의 차이가 나타났다. 특히, 개벌조림지는 식재목 성장을 위한 비료의 시용으로 인하여 밤나무림과 소나무림에 비해 오염지표라 할 수 있는 EC, NO3-, SO4(2-), Cl-, 탁도, 색도 등이 높은 것으로 보아 임지 이용에 따라 수질에 영향이 있는 것으로 나타났다. 각 임분별 계류수의 pH, NH4+, Cl-, SO4(2-), NO3-는 먹는물 기준이하를 나타내어 수질이 비교적 양호한 편으로 나타났으나, 탁도와 색도의 수치는 모든 임분에서 먹는물 기준을 초과하는 것으로 나타났다. 따라서 도시주변 산림지역은 토사유출로 인하여 탁수화 및 밤나무 재배지는 시비 등으로 수질오염이 예상되므로 계류수를 식수화하기 위해서는 간이수질정화시설과 같은 적절한 대비책이 마련되어야 할 것으로 사료된다. This study was carried out to clarify the change characteristics of stream water quality by type of forest from June to August, 2009 in three stands (Castanea crenata, Pinus densiflora and Plantation Land) of Samgye-ri Naedong-myeon Jinju-si Gyeongsangnam-do. The pH of stream water in three stands was highest in Pinus densiflora (pH 7.18) followed by Castanea crenata (pH 6.90) and Plantation land (pH 6.90) while the electrical conductivity of stream water was highest in Plantation land followed by Castanea crenata stand and Pinus densiflora stand was the lowest. Cations contents of stream water in three stands were high in order of Ca2+, Na+, Mg2+, K+ and NH4+. But anions of stream water in Castanea crenata stand and Pinus densiflora stand were high in order of SO4(2-), Cl- and NO3- while those of stream water in Plantation land were high in order of SO4(2-), NO3-. and Cλ-. The stream water in three stands was significant at pH, EC, NO3-, Ca2+, Mg2+, Na+, Cl-, TNU and Color by duncan test. These results indicate that quality of stream water have a difference among three stands. The level of pH, NH4+, Cl-, SO4(2-) and NO3- of stream water in three stands were within the domestic use standard for drinking water. but turbidity and color of stream water were more than that of domestic use standard for drinking water. Therefore, non-point sources like urban forest watersheds which are soil erosion and fertilizer application lands should be taken to the appropriate mitigation measures if they are to be used as source of drinking water.

산림환경인자가 계류수의 탁수화에 미치는 영향

마호섭 ( Ho Seop Ma ),강원석 ( Won Seok Kang ),강은민 ( Eun Min Kang ) 한국산림과학회 2012 한국산림과학회지 Vol.101 No.4

This study was carried out to clarify the influences of forest environmental factors on turbidity of Stream water on three stands (Castanea crenata Pinus densiflora and Plantation Land) of small watershed in Samgye-ri Naedong-myeon Jinju-si Gyeongsangnam-do. The relationship between turbidity and forest environmental factors was a positive correlation at 1% level with chromaticity suspended solid sediment runoff erosion slope rainfall intensity preceding dry days watershed area and stream length and at 5% level with accumulative rainfall. The important factors that affected turbidity in small watershed showed in order of preceding dry days rainfall intensity stream length chromaticity and suspended solid. In the stepwise regression between turbidity and forest environmental factors the estimation equation is as follow; Y=-28.125+0.047x (suspended solid) +0.058x (chromaticity)+1.518x(rainfall intensity)+0.264x(stream length)+1.837x (preceding dry days). The results indicates that dangerous areas of landslide and soil runoff by land use could be applied to the mitigation measures such as afforestation erosion check dam and revetment for erosion control and water quality management in small watershed.

산지소유역에 있어서 강우특성에 따른 임분별 탁도 변화

마호섭 ( Ho Seop Ma ),강원석 ( Won Seok Kang ),강은민 ( Eun Min Kang ) 한국임학회 2012 한국산림과학회지 Vol.101 No.3

산지소유역의 밤나무림, 소나무림 및 개벌조림지를 대상으로 강우특성에 따른 임분별 탁도 변화 특성을 분 석한 결과를 요약하면 다음과 같다. 동일한 강우의 발생 시 임분별 탁도 발생은 개벌조림지 >밤나무림 >소나무림 순으로 나타나 임분별 차이를 알 수 있었다. 탁도와 강우강도와의 상관분석에서 밤나무림 91%, 소나무림 80%, 개벌 조림지는 71%로서 세 임분 모두 높은 설명력을 보였다. 반면 탁도와 강우지속시간과의 상관분석에서 밤나무림, 소 나무림 및 개벌조림지 모두 0~1%의 낮은 설명력을 보였다. 탁도와 선행무강우일수와 분석에서 밤나무림, 소나무림 및 개벌조림지 모두 30% 범위의 낮은 설명력을 보였고, 탁도와 누적강우량과의 분석에서도 밤나무림, 소나무림 및 개벌조림지에서 세 임분 모두 6~22%의 낮은 설명력을 보였다. 따라서 산림의 개발과 이용으로 집중호우 시 산사태 등 산지재해로 인해 발생된 토사는 산지계류에 유입되어 하류 하천의 수질에 많은 영향을 미칠 수 있으므로 산림지 역의 중·하류에서는 사방댐 등을 설치하여 계류수의 탁수화와 수질오염을 방지할 필요성이 있다. This study was carried out to clarify the turbidity change on three stands (Castanea crenata, Pinus densiflora and Plantation Land) by rainfall characteristics in small watershed. The change of turbidity showed in order of plantation land, Castanea stand and Pinus stand. The linear equations models between turbidity and rainfall intensity were able to account for 91% in Castanea stand, 80% in Pinus stand and 71% in plantation land. The linear equations models between turbidity and duration of rainfall were able to account for about 0-1% in three stands. The linear equations models between turbidity and preceding dry days were able to account for about 30% in three stands. The linear equations models between turbidity and accumulative rainfall were able to account for about 6-22% in three stands. The results indicates that soil runoff by land use and development of forest area could be applied to the mitigation measures such as afforestation and erosion check dam for erosion control and water quality management in small watershed.