The Short-term Efficacy of Subthreshold Micropulse Yellow (577-nm) Laser Photocoagulation for Diabetic Macular Edema

권윤형,이동규,권오웅 대한안과학회 2014 Korean Journal of Ophthalmology Vol.28 No.5

Purpose: This pilot study aimed to evaluate the efficacy and safety of subthreshold micropulse yellow (577-nm) laser photocoagulation (SMYLP) in the treatment of diabetic macular edema (DME). Methods: We reviewed 14 eyes of 12 patients with DME who underwent SMYLP with a 15% duty cycle at an energy level immediately below that of the test burn. The laser exposure time was 20 ms and the spot diameter was 100 μm. Laser pulses were administered in a confluent, repetitive manner with a 3 × 3 pattern mode. Results: The mean follow-up time was 7.9 ± 1.6 months. The baseline-corrected visual acuity was 0.51 ± 0.42 logarithm of the minimum angle of resolution (logMAR), which was improved to 0.40 ± 0.35 logMAR (p = 0.025) at the final follow-up. The central macular thickness at baseline was 385.0 ± 111.0 μm; this value changed to 327.0 ± 87.7 μm (p = 0.055) at the final follow-up. Conclusions: SMYLP showed short-term efficacy in the treatment of DME and did not result in retinal damage. However, prospective, comparative studies are needed to better evaluate the efficacy and safety of this treatment.

실험적으로 유발된 안검유착가토에서 안검의 조직유착 해리시 양막 이식의 효과에 대한 연구

권윤형,박정민,노미숙,안희배,Yoon Hyung Kwon,Jung Min Park,Mi Sook Rho,Hee Bae Ahn 대한안과학회 2006 대한안과학회지 Vol.47 No.8

Purpose: We investigated the usefulness of subsequent amniotic membrane transplantation following adhesiolysis in preventing readhesion and improving the results of surgery. Methods: Primary blepharoplasty was done on both eyelids of 8 albino rabbits. After 2 weeks, a new skin incision was made and adhesiolysis was done on both eyelids. The rabbits were categorized into two groups, one with adhesiolysis alone in left eyelids (control), and the other with adhesiolysis with AM graft in right eyelids (AM graft). In the AM graft group, the 15×4-mm sized amniotic membrane was designed and transplanted between tarsal plate, orbicularis muscle and subcutaneous tissue with 8-0 Vicryl suture (4 points). The skin was sutured with 6-0 nylon. The rabbits were sacrificed at 1, 2, 4 and 8 weeks after operation, at which time the change of lid shape, inflammation and fibrosis were evaluated. The degree of inflammatory cell infiltration was examined on H & E stain and Masson-trichrome stain was performed to evaluate the degree of fibrosis. Results: On eyelid examination directly after the operation, lid traction was detected in both groups, but after 1 week, the shape of the eyelids had recovered completely in both groups. At 8 weeks, the control group showed more irregular lid margin and surfaces than AM graft group. In microscpic findings at 2 weeks, the AM graft group showed more inflammatory cell infiltration than the control group. At 4 weeks, amniotic membranes were absorbed and inflammatory cell infiltration decreased in both groups, but the AM graft group showed more inflammation than the control group. At 8 weeks, the two groups had little inflammation but the AM graft group showed less fibrosis than the control group on Masson-trichrome stain. Conclusions: From these findings, we suggest that the use of amniotic membrane graft after adhesiolysis and blepharoplasty is an effective method for prevention of postoperative adhesion.

Predictive Findings of Visual Outcome in Spectral Domain Optical Coherence Tomography after Ranibizumab Treatment in Age-related Macular Degeneration

권윤형,이동규,김형은,권오웅 대한안과학회 2014 Korean Journal of Ophthalmology Vol.28 No.5

Purpose: To investigate which spectral domain optical coherence tomography (SD-OCT) findings predict visual outcome after anti-vascular endothelial growth factor (VEGF) treatment in neovascular age-related macular degeneration (NV-AMD). Methods: We reviewed the medical records of patients with treatment-naïve NV-AMD who underwent three or more consecutive anti-VEGF injections. The patients were divided into three groups according to their changes of visual acuity (VA); improved (group I), static (group S), or worsened (group W). We assessed the incidences and values of all available SD-OCT findings of these groups, compared these findings between the three groups and compared the initial values with the post-treatment values. Results: Better initial VA and longer external limiting membrane (ELM) length were associated with less change in VA after anti-VEGF treatment. The initial VA was mildly correlated with initial photoreceptor inner and outer segment junction (IS/OS) length and initial ELM length. The final VA was also mildly correlated with the final IS/ OS length and the final ELM length. VA was significantly changed after anti-VEGF treatment in groups W and I. With regard to incidence, disruption of the IS/OS (IS/OS-D), disruption of the ELM (ELM-D) and ELM length differed significantly between the three groups, particularly ELM-D. The incidences of IS/OS-D and ELM-D in group I were significantly lower than those in groups S and W, and those in group S were also lower than those in group W. The ELM length in group I was significantly longer than it was in groups S and W, and the ELM length in group S was longer than that for group W. However, these three findings did not change after the anti-VEGF treatment. Conclusions: Initial IS/OS-D, ELM length and particularly ELM-D can be useful predictors of the visual outcome after anti-VEGF treatment in NV-AMD patients.

소아 안와골절 환자의 임상양상

권윤형,박동원,정준영,안희배,Yoon Hyung Kwon,Dong Won Park,Jun Young Chung Hee Bae Ahn 대한안과학회 2006 대한안과학회지 Vol.47 No.1

Purpose: We sought to evaluate the clinical aspects associated with a preoperative and postoperative state in cases of blow-out fracture. Methods: We retrospectively assessed the cause, location, type, and ocular motility restriction in 25 eyes of 25 pediatric patients with blow-out fracture, which were repaired by orbital reconstruction between January 2001 and June 2004. Results: The mean age of patients was 14.96 years, the most common cause of fracture was assault (13 cases, 52%); there were 15 case (60%) of inferior wall fracture, 14 cases (45%) of comminuted type fracture, and 11 cases (35.4%) of trapdoor type fracture. The mean time to intervention was 14 days (range, 3 to 56 days). Ocular motility restriction improved most in the early postoperative period, and then decreased gradually. At last follow-up, the majority of patients had improved. Their diplopia improved almost completely, except in one patient who had late orbital reconstruction. Conclusions: Most cases of blow-out fracture were resolved with orbital reconstruction. Even when performed late, orbital reconstruction is helpful in improving the symptoms associated with blow-out fracture.

Results of Tuberculosis Contact Investigation in Congregate Settings in Korea, 2013

권윤형,김소정,김지은,김설이,송은미,이은정,최윤,김예진,임병옥,김다설,최덕선,김혜성,박지은,윤지은,박진아,정종락,김주경,강성희,홍서연,이승재,박수진,박선화,윤선혜,김윤선,최윤정,서윤정,서율아,박지선,성민희,신민장,손현진,이연경,고은영,권근용 질병관리본부 2014 Osong Public Health and Research Persptectives Vol.5 No.-

Objectives: This study aimed to check the status of the contact investigation in congregate settings to eradicate tuberculosis (TB) in the Republic of Korea. Methods: The “Integrated System for Disease and Public Health Management” is used for care and follow-up for patients and contacts of TB. We downloaded data for contact investigations conducted from January to December 2013. Results: A total of 1,200 contact investigations in congregate settings were carried out by 25 field investigators in 2013. We performed the status of contact investigation, TB, and LTBI rate by age, accept rate of LTBI treatment, and complete rate of LTBI treatment during 2013. A total of 1,547 index TB patients, 149,166 contacts, and 259 additional TB patients were found through the investigation. Kindergartens showed the highest LTBI rate, 19.8%, among educational facilities. The second highest was in elementary schools and the subtotal LTBI rate of educational facilities was 7.8%. Social welfare/correctional facilities and workplaces showed relatively high LTBI rates of 23.8% and 23.6%, respectively. By age, individuals >35 years showed the highest LTBI rate, followed by those aged 0-4 years, 30-34 years, and 5-9 years, with rates of 18.1%, 16.4%, and 15.4% respectively. When comparing the tuberculin skin test (TST) positive conversion ratio by facility, middle school and high school were relatively high compared to the others. The accept rate of LTBI treatment in the workplace was lowest at 63% and the complete rate in elementary schools was lowest at 76.5%. Conclusion: TB contact investigation is considered as a meaningful strategy for preventing TB outbreaks in congregate settings and decreasing the prevalence of TB in young people. Results of this study could be used to establish the LTBI management policy.

일부 도시지역 고등학교 1학년 학생들의 흡연실태와 관련요인

이석구,권윤형,이길희 대한가정의학회 2000 Korean Journal of Family Medicine Vol.21 No.8

일부 청소년들에서 흡연노출량에 따른 혈중 카드뮴 농도

장성실,권윤형,배진순,노영만,한진구 韓國學校保健學會 2001 韓國學校保健學會誌 Vol.14 No.2

Objectives: We surveyed the prevalence of smoking among the adolescent population and analysed the correlation of the two exposure biomarkers-concentration of blood cadmium and urinary cotinine-to the smoking status. Methods: Subjects were 193 middle and high school students in Chungnam province. Blood cadmium and urinary cotinine were compared by sex and smoking status. Smoking status were classified by either the concentration of urinary cotinine or subjective answering as a smoker in the questionnaire. Results: Smoking prevalence was 24.6%, 36.2% and 6.7% among all subjects, male and female subjects, respectively. Average smoking amount was 17.5 and 1.5 cigarettes per month among the male subjects and female subjects, respectively Mean concentration of urinary cotinine among the male subjects was 135.57 ㎍/ℓ, and that of female subjects was 116.59 ㎍/. Direct smokers showed higher concentration of urinary cotinine than those of indirect smokers, and subjects with higher urinary concentration showed higher prevalence of smoking, too. Mean concentration of blood cadmium was 0.0572 ㎍/㎗ among the male subjects, and 0.0693 ㎍/㎗ among the female subjects. Among the male subjects, both exposure biumarkers showed significant correlation to the smoking status, but among the female subjects urinary cotinine did not show significant correlation to the smoking status. Conclusion: Concentrations of these two biomarkers suggested that this population had significantly high evironmental tobacco smoking(ETS) and efficient stop-smoking programs to reduce ETS should be directed to this population. Key words : environmental tobacco smoking, urinary cotinine, blood cadmium

레이저 각막절삭 가공성형술을 이용한 노안 및 굴절교정수술 후 눈물막과 각막지각의 변화

허문정,권윤형,노세현.Mun Chong Hur. MD. Yoon Hyung Kwon. MD. Sae Heun Rho. MD. PhD 대한안과학회 2011 대한안과학회지 Vol.52 No.12

Purpose: To evaluate the changes in break-up time (BUT) and corneal sensitivity following LASIK surgery for refractive error correction with presbyopia in patients older than 45 years. Methods: The authors of the present study measured the BUT and corneal sensitivity of 92 eyes that received LASIK surgery for correcting refractive error with presbyopia. The eyes were divided into groups according to gender and preoperative refractive error before surgery and 1, 3, 6 and 12 months after LASIK. Results: The mean age of patients was 52.01 ± 5.51 years, and the male to female eye distribution was 31:61. The value of BUT before surgery and 1, 3, 6, and 12 months postoperative was 5.31 ± 2.03 sec, 4.47 ± 1.67 sec, 4.04 ± 1.58 sec, 4.53 ± 1.51 sec, and 4.87 ± 1.46 sec, respectively; corneal sensitivity was 56.35 ± 5.94 mm, 40.07 ± 14.21 mm, 46.42 ± 10.41 mm, 50.75 ± 8.04 mm, and 52.92 ± 7.51 mm, respectively. BUT was not significantly different relative to refractive error and was significantly shorter in the female group than the male group at 1 month postoperative. Corneal sensation of myopia at 12 months postoperative was statistically higher than at other time points; however, there was no difference between genders. BUT and corneal sensitivity at 12 months postoperative recovered to 91.6% and 93.9% of the preoperative value, respectively. Conclusions: BUT and corneal sensitivity after LASIK for presbyopia were decreased until 12 months postoperative and recovered slowly, but did not return to preoperative levels. J Korean Ophthalmol Soc 2011;52(12):1419-1426

유리체내 베바시주맙 주사술 후 발생한 HLA‐B27 양성 급성 전방 포도막염 1예

서장원,권윤형,Jang Won Seo,MD,Yoon Hyung Kwon,MD 대한안과학회 2013 대한안과학회지 Vol.54 No.12

Purpose: Intravitreal injection of bevacizumab (Avastin<SUP>®) can lead to several intraocular complications including endophthalmitis, hemorrhage and inflammation. We present one case of acute anterior uveitis with hypopyon in an HLA-B27(+) patient following intravitreal injection of bevacizumab.<br /> Case summary: A 40-year-old male with known central retinal vein occlusion presented with redness and decreased visual acuity in the left eye. Symptoms had developed 4 days earlier after the sixth intravitreal injection of bevacizumab in that eye. The patient had a marked anterior chamber reaction with hypopyon and posterior synechiae. Nine days after onset, similar symptoms in the left eye occurred in the uninjected right eye. Through examination and clinical manifestations, we diagnosed acute anterior uveitis associated with HLA-B27 positivity. The patient was treated with 1% prednisolone acetate, 0.5% moxifloxacin and 1% atropine in both eyes and all symptoms had resolved after 6 weeks.<br /> J Korean Ophthalmol Soc 2013;54(12):1945-1949

대전지역 일부 청소년의 식생활습관과 체격과의 관계

변화봉,권윤형,이태용 韓國學校保健學會 2001 韓國學校保健學會誌 Vol.14 No.2

This study investigates the effect of adolescent dining habits on their physical development. We selected 200 students from the three high schools in Taejon, and surveyed with a questionnaire and collected data concerning physique from school health records. The results obtained from this study were as follows: 1. A point of intersection of two development trends of male and female students' heights was between sixth grade of elementary school and first grade of middle school. Two development trends of weights didn't have a point of intersection and male students' development trend of weights was a little higher than that of female students. 2. There were significant differences in the weight and BMI of male students. The 'regular dining' group had heavier weight and higher BMI than the other group, and the 'Eating only favorite food' group had lower weight and BMI than the other group. In female, heights of 'three meals a day' group were higher than that of 'two meals a day' group and the more snacks per day, the higher students' height was. 3. The 'regular exercise' group had significantly heavier weight and higher BMI than the other group amount females. 4. 'Regular dining' and 'Eating habits' had a positive linear relationship with male students' weight and BMI. 'Number of times of snacking' has a positive linear relationships with female students' height and a negative linear relationship with female students' BMI. Since dining habits of adolescents have not only an effect on their development but also later adults' health, to develop good habits of health and dining is a critical issue.