단안 상사근마비에서의 안구회선

나경선,이세엽,이영춘,Kyung Sun Na,Se Youp Lee,Young Chun Lee 대한안과학회 2007 대한안과학회지 Vol.48 No.10

Purpose: We evaluated the concordance of laterality of the paretic eye and the torsional eye in unilateral superior oblique palsy showing an inferior oblique overaction. Methods: Thirty-nine patients diagnosed as having a unilateral superior oblique palsy were evaluated for visual acuity, refractive manifestation, ocular movement, prism cover test, and fundus photograph. Of these patients, 32 derived from congenital causes and 7 acquired the condition from trauma. An ocular movement exam was performed to check an inferior oblique overaction, and a fundus photograph was used to measure the ocular torsional amount. Inferior oblique myectomy or recession was performed along with horizontal strabismus surgery. Results: Objective extorsion was presented in paretic eyes of 29 patients (74.4%) and nonparetic eyes of 10 patients (25.6%). The congenital superior oblique palsy patients were divided into two groups by the concordance of laterality of paretic eyes and torsional eyes. In the concordance group of 22 patients, the torsional amount was decreased from +17.69to +7.98and inferior oblique overaction from +2.27to +0.25after an inferior oblique muscle weakening procedure. In the discordance group of 10 patients, torsional amount was decreased from +16.97to +8.73and inferior oblique overaction from +2.50to +0.21postoperatively. In acquired oblique palsy patients, all patients showed the concordance of laterality, and the torsional amount was decreased from +16.76to +8.80and inferior oblique overaction from +2.5to +0.21after inferior oblique weakening procedure. Conclusions: We found that the paretic eye and the torsional eye may not coincide in congenital superior oblique palsy but always coincide in acquired oblique palsy after trauma. After an inferior oblique muscle weakening procedure, ocular torsional amount of paretic or sound eye is decreased in every case.

반복적인 눈꺼풀올림근 절제술 후 발생한 역 벨현상

나경선,신소정,양석우,Kyung Sun Na,M,D,So Jung Shin,M,D,Suk-Woo Yang,M,D 대한안과학회 2008 대한안과학회지 Vol.49 No.2

`Purpose: We report a complication involving a transient inversion of Bell's phenomenon observed following extensive levator resection performed to treat aponeurotic ptosis. Case summary: A 22 year old female patient complained of ptosis of both eyelid. The levator function of both lid was good, and a normal corneal protection mechanism was observed. The patient underwent levator resection and several reoperation because of asymmetrical lid height and entropion. Inversion of Bell's phenomenon was observed in the postoperative period. Eye with Bell's phenomenon reverted to normal within 1 month after final operation, and there were no corneal erosion. Lubricating eyedrop was used frequently during the postoperative period. Conclusions: It is important to consider that abnormal cases of Bell's phenomenon sometimes manifest after repetitive and extensive levator resection and to keep a close watch on the cornea while providing it with ample lubrication.`

눈물샘에 발생한 점막표피양암 1예

나경선,이나영,양석우,Kyung Sun Na,Na Young Lee,Suk Woo Yang 대한안과학회 2006 대한안과학회지 Vol.47 No.11

Purpose: We have experienced a mucoepidermoid carcinoma of the lacrimal gland. Methods: 39-year-old male patient complaint of proptosis and upper eyelid swelling of the left eye for 4 months. Orbit radiographs showed a 2 cm sized inhomogenous density mass in upper lateral aspect of the left orbit. Excisional biopsy was performed. Results: Histopathologically, the mass was proved as an intermediate grade mucoepidermoid carcinoma of the lacrimal gland. Postoperative radiopraphs showed no metastasis. Additional operation was performed to eliminate the remnant tumor near the lacrimal gland. The patient underwent a concurrent chemoradiotherapy and no recurrence or metastasis was found. Conclusions: We report a mucoepidermoid carcinoma which occurs rarely in lacrimal gland.

영수보사(迎隨補瀉)와 원방보사(圓方補瀉) 수기법(手技法)의 정량적(定量的) 연구(硏究)

나창수,박찬규,장경선,소철호,Na, Chang-Su,Park, Chan-Kyu,Jang, Kyung-Sun,So, Cheal-Ho 대한침구의학회 2000 대한침구의학회지 Vol.17 No.1

Previously two papers dealing with YoungSu(against the meridian course and following the course of the meridian) Acupuncture were published by our group. Here we are reporting the further analysis of YoungSu and WonBang(by twisting and rotating the needle) acupuncture methods. It is very important to understand objectively the Qi variation induced by the reinforcing-reducing manipulation method in the acupuncture therapy. We decided the medical treatment by utilizing the PyongChi Method (a kind of method to figure out the way of treatment by observing the unbalanced state of five phases). The Qi variation in the meridian treated by YoungSu and WonBang, the recovery of five phases deviation were measured by choosing single acupoint instead of complex acupoints. By using Youngsu and WonBang, we increased or decreased the Qi of the phase which caused the unbalanced state. We observed whether the Qi of the treated meridian can be increased and if the state of unbalance can be recovered. To achieve the effect of reinforcing-reducing, we needed a correct choice of treating method and a selection of a proper meridian in advance. This study was carried out by adding another way of acupuncture from the previous paper. We discovered that the effects of reinforcing-reducing by each manipulation method could be superposed each other when two counteracting Youngsu and WonBang methods were treated at the left and the right side of human body which was correspondent with our previous paper. We found that the Qi variation of the treated meridian, which was induced by Youngsu and WonBang, was linearly proportional to the reduction of five phase deviations. The slope of Qi variation was almost similar (y = -0.413x - 0.138) as that of previous paper (y = -0.266x - 0.038, Y = -0.446x - 0.079). It is assumed that the addition of other basic methods on the top of reinforcing-reducing manipulation method would magnify the effect of acupuncture.

모혈(募穴)의 탄력(彈力) 상태(狀態) 측정(測定)에 의한 허실(虛實) 진단(診斷) 연구(硏究)

나창수,윤여충,박현철,이동규,최찬헌,장경선,소철호,Na, Chang-Su,Yoon, Yeo-Choong,Park, Hyun-Cheal,Lee, Dong-Kyu,Choi, Chan-Hern,Jang, Kyung-Sun,So, Cheal-Ho 대한침구의학회 2000 대한침구의학회지 Vol.17 No.1

The meridian system is the most essential and basic connecting structure that maintains the vital activities of viscera and bowels by connecting them with each part of body's surface. Doctors can understand the healthy condition, and the region and deficiency-excessiveness of disease by observing the condition of Qi flowing. Deficiency and excessiveness could be differentiated by various symptoms expressed in meridian system. Especially there could be several clues like pain, heat-cold, protuberance-depression, change of color and shine in the line of channel leads to the judgment of deficiency-excessiveness The diagnosis of deficiency and excessiveness can be generalized by quantification of elastic status in skin surface along the meridian system. By comparing data from measurement of elastic condition with those from traditional deficiency and excessiveness, it could be utilized for the development of oriental medicine. All biological activities in the human body are based on meridian system according to the oriental medicine. Also the meridian system is viewed as basic and essential structure connecting internal viscera and each part of body. The areas of expressed channel phenomena are muscle to bone, muscle to muscle and bone to bone. These areas are called depression where meridian system is present and any changing state on those points can be measured. It could be difficult in diagnosing the reaction of meridian system because doctor can depend on his own judgment. Therefore, it is necessary to quantify and indexate channel reactions. To quantify the channel reactions, specially manufactured instrument was used to quantify the protuberance and depression to differentiate the deficiency and excessiveness. The results follow as below; 1. The elastic index measurement by the equipment proved a pattern of agreement showing the values that ranged within standard deviation 0.05kgf/cm throughout the experiment except few cases' measurement in CV-17. 2. To evaluate the state of deficiency & excessiveness of elastic index measurements in frontal point, elastic index measurements in the front paint were compared to the elastic index measured surrounding the point within 2.5 cm. Such result of indexing procedure was closely matched to the concept of palpitation. 3. If the elastic index values in the surrounding front point closely located to the elastic index values in the front point, the judgement on the state of deficiency and excessiveness was delayed. Otherwise, it was judged as deficiency or excessiveness. 4. Out of total 12 cases of comparing the elastic index values to the elastic index values in the surrounding front point, Three to nine front points were judged as either in the state of deficiency or excessiveness. 5. Among the nine front points judged as either in the state of deficiency or excessiveness, Four cases were matched to the electric index measured by EAV that evaluating the internal organs by five different phases. If more clinical cases are accumulated, it is expected to systematically theorize and improve the concept of deficiency and excessiveness in the internal organs using the front point.

전층각막이식술후 발생한 백내장

나경선,정성근,Kyung Sun Na,M,D,Sung Kun Chung,M,D 대한안과학회 2007 대한안과학회지 Vol.48 No.12

Purpose: To evaluate the risk factors for cataract formation and cataract extraction after penetrating keratoplasty to determine whether a combined surgery should be performed. Methods: Variables from 189 phakic eyes that underwent penetrating keratoplasty from April 1992 to November 2004 were analyzed for the possibility of cataract extraction after penetrating keratoplasty according to sex, age, diagnosis, accompanied glaucoma, preoperative vision and steroid use. The mean interval between penetrating keratoplasty and cataract extraction was also studied. Results: Cataract extraction was performed in 27 eyes (14.3%) and the mean interval between keratoplasty and cataract extraction was 24.5 months. Age was determined to be the most important independent risk factor for cataract extraction (p=0.0009) associated glaucoma also shown to be a risk factor (p=0.0011). Sex and corneal disease before keratoplasty were not shown to be risk factors. In the mean interval cataract extraction following penetrating keratoplasty, no statistically significant difference was found according to age, sex and diagnosis. Posterior subcapsular cataract was predominant (55.6%) and the mean visual acuity improved from 0.10 to 0.42. Conclusions: The likelihood of cataract formation and cataract extraction subsequent to penetrating keratoplasty increased with age and associated glaucoma. The results from this study can help surgeons to determine whether combined surgery should be performed and help them to counsel patients on the risk of cataract formation.

전방깊이에 따른 백내장수술 전후의 각막내피세포수의 변화

김성일,나경선,권형구,이현수,김만수,Sung Il Kim,Kyung Sun Na,Hyung Gu Kwon,Hyun Soo Lee,Man Soo Kim 대한안과학회 2010 대한안과학회지 Vol.51 No.12

Purpose: To evaluate the effects of preoperative and postoperative parameters, particularly anterior chamber depth, on corneal endothelial cell loss during cataract surgery. Methods: Eighty-two eyes of 82 patients who underwent cataract surgery by the same surgeon using the same technique were selected for the present study. Various preoperative and postoperative parameters including age, anterior chamber depth, duration and power of phacoemulsification, preoperative endothelial cell density, coefficient of variation, hexagonality, and grade of nucleosclerosis were evaluated. Endothelial cell densities were recorded preoperatively and at two months postoperatively using a noncontact specular microscope. Results: After two months, the mean central endothelial cell loss in all eyes was 8.77%. Among the pre- and post-operative parameters, patient’ age, anterior chamber depth, duration, power, and energy of phacoemulsification and grade of nucleosclerosis showed significant correlation with endothelial cell loss. Stepwise multiple linear regression analysis identified age, nucleosclerosis, anterior chamber depth, and phacoemulsification time as independent predictors for endothelial cell loss. Conclusions: The risk of endothelial cell loss increased with increases in patient’ age, nucleosclerosis, and phacoemulsification time. However, eyes with a deep anterior chamber showed a significantly lower risk of endothelial cell loss. J Korean Ophthalmol Soc 2010;51(12):1568-1572

백내장 수술 중 투명각막절개창 크기를 이용한 각막난시교정

전소희,나경선,김만수.Sohee Jeon. MD. Kyung Sun Na. MD. Man Soo Kim. MD. PhD 대한안과학회 2010 대한안과학회지 Vol.51 No.4

Purpose: To evaluate the effect of clear corneal incisional size on astigmatism during cataract surgery. Methods: Randomized prospective study of 78 patients (108 eyes) who had received cataract surgery for a corneal astigmatism over against-the-rule (ATR) 1.0 Diopter (D) was performed. The eyes were checked by corneal topography and autorefractor preoperatively and one week, one month, two months, and six months postoperative. Group 1 included patients who received an inserted foldable intraocular lens (IOL) through a 2.8 mm incision, and Group 2 included patients who underwent IOL implantation through a corneal incision enlarged to 4 mm. Results: Postoperative visual acuity showed a better visual acuity in Group 2 at both one week postoperatively (0.598±0.352 vs., 0.713±0.345, for Groups 1 and 2, respectively, p=0.046) and one month postoperatively (0.604±0.237 vs., 0.791±0.242, respectively, p=.043). There were no statistically significant differences between the groups after two and six months (p=.135, .087). Postoperative astigmatism measured by corneal topopgraphy showed 1.62±0.44D and, 0.94±0.30D for groups 1 and 2 respectively, (P=.045) at 2 months, and 1.73±0.45 D and, 0.92±0.34 D (P=.042) at six months. These results showed a statistically significant amount of residual astigmatism in Group 2. Autorefractor measurements showed similar results. There were no complications, such as wound leakage, resulting from the increased incision size. Conclusions: Widening of the incision during cataract surgery can reduce corneal astigmatism without significant complications. J Korean Ophthalmol Soc 2010;51(4):510-515

펨토초레이저를 이용한 각막이식술과 일반적인 전층각막이식술의 임상결과 비교

정경인,최진아,나경선,정소향,차흥원,김응권,주천기,Kyoung In Jung,Jin A Choi,Kyung Sun Na,So Hyang Chung,Hungwon Tchah,Eung Kweon Kim,Choun-Ki Joo 대한안과학회 2010 대한안과학회지 Vol.51 No.8

Purpose: To compare the outcomes of IntraLase femtosecond laser-enabled keratoplasty (IEK) versus conventional penetrating keratoplasty (C-PKP). Methods: This retrospective study included 18 eyes of 17 patients who underwent C-PKP and 26 eyes of 25 patients who underwent IEK. Postoperative clinical results were compared between two groups. Results: The mean logMAR best spectacle-corrected visual acuity (BSCVA) was 0.70, 0.58, and 0.61 in the IEK group, and 1.06, 1.01, and 0.90 in the C-PKP group at postoperative 2, 4, and 6 months respectively. The difference between the two groups was statistically significant at 2 and 4 months postoperatively (p=0.033, 0.011). The mean refractive cylinder was 4.08 diopters (D), 4.01D, and 4.44D in the IEK group, while 5.75D, 5.75D, and 5.21D in the C-PKP group for each month, and the difference between the groups was statistically significant at 2 and 4 months postoperatively (p=0.037, 0.027). The complication rate showed no significant differences up to 6 months of follow-up between the two groups. Conclusions: The IEK showed better results in BSCVA and refractive astigmatism in the early postoperative period, in comparison with the C-PKP, and can be considered as a valuable method in penetrating keratoplasty. J Korean Ophthalmol Soc 2010;51(8):1054-1063

각막굴절교정학 렌즈의 근시 진행 억제 효과 및 안정성

양순원(Soonwon Yang),나경선(Kyung-Sun Na),김현승(Hyun Seung Kim) 대한검안학회 2015 Annals of optometry and contact lens Vol.14 No.2

Orthokeratology have been effective and safe alternative method as temporary, predictable, and reversible correction of myopia. The improvement of uncorrected visual acuity is attained by flattening of the central corneal curvature using a reverse-geometry lens. With the development of a gas-permeable lens material, application of lenses during sleep became possible. Changes in uncorrected visual acuity, refractive error and corneal curvature have been firmly established for orthokeratology by many investigators. The effect of stabilization of myopia acceleration by orthokeratology lens is unclear. Recently, the effect of stabilization of myopia acceleration by orthokeratology lens is reported by clinical trials. The mechanism by which orthokeratology lenses prevent myopia is not clear, however, possible hypothesis is reported including induction of peripheral myopic defocus, or spherical aberration to reduce accomodation. Further longer-term studies are needed to determine whether there continue to be accrual of the effect of orthokeratology lens wear on myopia progression and to clarify the factors in myopic development, such as genetics and environment, in the progression of myopia in children.