급성 눈물주머니염에 합병된 안와연조직염 및 안와농양

박영명(Young Myoung Park),이태은(Tae Eun Lee),유인천(In Cheon You),조남천(Nam Chun Cho),안민(Min Ahn) 대한검안학회 2019 Annals of optometry and contact lens Vol.18 No.3

Purpose: To report a case of orbital cellulitis and orbital abscess secondary to acute dacryocystitis. Case summary: A 56-year-old man with eyelid swelling on the left eye hit by a car door was diagnosed with orbital cellulitis at a local clinic and was treated with oral antibiotics for days. However, the symptoms got worse and the patient was referred for assessment. The patient had severe eyelid and conjunctival swelling on the left eye with decreased visual acuity with proptosis. We obtained a contrast-enhanced computed tomography (CT) scan, which demonstrated dacryocystitis with orbital cellulitis, sinusitis of left maxillary and ethmoid sinus. Endoscopic endonasal dacryocystorhinostomy and functional endoscopic sinus surgery at the ear, nose, and throat department was done to treat the patient. The day after the operation, eyelid swelling and proptosis were better than the previous day. But the next day, symptoms got worse so we obtained a follow-up contrast-enhanced CT scan, which demonstrated increased soft tissue attenuation medially medial rectus muscle. These findings in the CT scan were thought of as orbital abscess, so surgical incision and drainage was done. After the operation, pain, eyelid and conjunctival swelling were decreased and the best-corrected visual acuity of the left eye was recovered to 1.2. Conclusions: In adults, orbital cellulitis is mostly caused by sinusitis, but we should consider that it could be caused by acute dacryocystitis.

양안 위눈꺼풀에 발생한 표피하 석회 결절

박영명(Young Myoung Park),정명자(Myoung Ja Chung),유인천(In Cheon You),조남천(Nam Chun Cho),안민(Min Ahn) 대한안과학회 2021 대한안과학회지 Vol.62 No.4

목적: 소아에서 발생한 양안 위눈꺼풀의 표피하 석회 결절 1예를 보고하고자 한다. 증례요약: 과거 외상의 기왕력이나 전신질환의 과거력이 없는 5세 여자 환자가 8개월 전부터 발생한 양안 상안검의 종괴를 주소로 내원하였다. 종괴는 통증 없이 서서히 크기가 커졌으며, 단단하고 황백색으로 돌출되어 있었다. 우안의 병소는 내안각 주변의 위눈꺼풀에 위치하였으며, 크기는 0.2 × 0.2 cm였다. 좌측의 병소는 우안에 비해 조금 더 내측에 위치하고 있었으며, 크기는 0.2 × 0.1cm였다. 소아황색육아종, 물사마귀로 의심하여 절제생검을 실시하였다. 병리검사상 병변은 다양한 크기의 칼슘 침착물을 포함하고 있었으며, 과증식되거나 과다각화증을 보이는 상피조직의 아래 혹은 과다각화증을 보이는 상피조직내에 위치하고 있었다. 표피하 석회 결절로 진단되었으며, 절제 후 재발 없이 잘 회복되었다. 결론: 눈꺼풀에서 발생한 통증이 없는 황백색의 융기성 병변에 대해서는 표피하 석회 결절을 감별진단으로 고려해야 한다. Purpose: To report a case of bilateral subepidermal calcified nodules of the upper eyelid in a child. Case summary: A 5-year-old girl with no history of trauma or systemic disease was referred for assessment of bilateral eyelid masses that had appeared 8 months prior. The masses grew slowly without pain, and were hard, elevated, and yellowish-white in color. The right eyelid mass was close to the medial canthus and measured 0.2 × 0.2 cm. The mass of the left upper eyelid was smaller (0.2 × 0.1 cm) and closer to the medial side. The clinical impression was juvenile xanthogranuloma and molluscum contagiosum. Excisional biopsy of the bilateral eyelid masses was performed. Histologic findings revealed that the lesions were composed of variable-sized multiple calcium deposits, lined by hyperplastic and hyperkeratotic epidermis or within the hyperkeratotic epidermis. The diagnosis was subepidermal calcified nodules (SCNs) for both of the bilateral eyelid masses. The patient made a complete recovery after the excision, without recurrence. Conclusions: SCNs should be considered during differential diagnosis of a painless, elevated, yellowish-white eyelid lesion.

진균각막염의 임상양상 및 예후 : 20년간의 변화 분석

조상일(Sang Il Cho),박영명(Young Myoung Park),안민(Min Ahn)조남천(Nam Chun Cho),유인천(In Cheon You) 대한안과학회 2021 대한안과학회지 Vol.62 No.7

목적: 최근 20년간 국내에서 발생된 진균각막염 환자의 임상양상, 원인균, 치료, 예후 등의 변화에 대해 알아보고자 하였다. 대상과 방법: 본원에서 각막염으로 진단받고 시행한 각막찰과 및 배양검사에서 진균이 검출된 177안의 의무기록을 후향적으로 조사하였다. 성별, 연령, 선행 요인, 원인균, 임상양상, 치료 방법, 예후 등을 분석하였다. 또한 배양과 KOH염색 여부에 따라 KOH양성그룹, 배양양성그룹, KOH-배양동시양성그룹으로 나누어 조사하였다. 불량한 임상결과와 관련 있는 위험인자를 로지스틱 회귀분석으로 조사하였다. 결과: 대상 환자의 평균연령은 67.4 ± 11.3세였고, 남자가 107명(60.5%)이었다. 진균각막염 발생의 위험인자는 안외상(57.6%), 특히 식물에 의한 외상(29.4%)이 많았다. 가장 흔한 사상진균은 푸사륨 49균주(31.6%)였고 효모균은 칸디다 17균주(11.0%)였다. 진균과 세균이 함께 배양된 41안 중 사상진균과 그람양성균이 29안(70.7%)으로 많았다. 치료 후 시력이 호전된 경우는 KOH양성그룹이 19명(79.2%), 악화된 경우는 배양양성그룹이 36명(40.4%)으로 흔하였다. 다변량분석에서 불량한 임상결과의 위험인자는 이전의 안질환(odds ratio [OR]: 3.744, p=0.010), 전방축농(OR: 2.941, p=0.030), 수술적 치료를 받은 경우(OR: 24.482, p<0.001)였다. 결론: 진균각막염은 KOH만 양성이면 임상양상이 양호하였고, 배양에서 균이 확인되면 심하였다. 진균이 의심되면 초기에 KOH염색과배양검사를 해야 하고, 불량한 임상결과의 위험인자가 있을 경우 조기에 최대한 약물치료를 시행해야 한다. Purpose: To describe the clinical manifestations, causative organisms, treatment, and prognostic factors of fungal keratitis based on analysis of patients over the past 20 years. Methods: A total of 177 patients (177 eyes) with fungal keratitis, who were diagnosed by smears and cultures, were reviewed retrospectively. Sex, age, predisposing factors, causative organisms, clinical manifestations, treatment, and prognosis were evaluated. The patients were divided into three groups: only potassium hydroxide (KOH)-positive, only culture-positive, and KOH- and culture-positive. Logistic regression was performed to identify the factors associated with a poor clinical outcome. Results: The mean age of the patients was 67.4 ± 11.3 years; 107 (60.5%) patients were men. The most common predisposing factor was ocular trauma (57.6%), especially by plants (29.4%). The most prevalent filamentous fungi were Fusarium species (31.6%, 49 isolates), and the most prevalent yeasts were Candida species (11.0%, 17 isolates). In cases of bacterial and fungal keratitis, filamentous fungus with Gram-positive bacterial infection (70.7%, 29/41) was the most common presentation. Visual improvement after treatment was common in the KOH-positive group (79.2%, 19/24), while visual deterioration after treatment was common in the culture-positive group (40.4%, 36/89). Previous ocular disease (odds ratio [OR]: 3.744, p = 0.010), hypopyon (OR: 2.941, p = 0.030), and surgical treatment (OR: 24.482, p < 0.001) were risk factors for a poor clinical outcome in the multivariate logistic regression model. Conclusions: Clinical prognosis was good in the KOH-positive only group, but poor in the culture-positive group. If fungal keratitis is suspected, diagnostic KOH staining and culture tests should be performed initially. Early intensive antifungal medical treatments are necessary for patients with risk factors for poor clinical outcomes.

유리체절제술 후 발생한 눈물막 및 안구표면장애에 대한 0.15% 히알루론산나트륨 점안액의 효과

최지호(Ji-Ho Choi),박영명(Young-Myoung Park),정진구(Jin-gu Jeong),조남천(Nam-Chun Cho),유인천(In-Cheon You) 대한검안학회 2021 Annals of optometry and contact lens Vol.20 No.1

Purpose: To confirm the effect of 0.15% sodium hyaluronate on tear film and ocular surface disorders after vitrectomy surgery. Methods: The control group 19 patients and the test group 20 patients who underwent vitrectomy were enrolled. The control group took only antibiotics and steroids eye drops after surgery for 1 month, and the test group used 0.15% sodium hyaluronate eye drops for 2 months additionally. Ocular surface disease index (OSDI), tear film break-up time, Schirmer test, corneoconjunctival staining and meibomian gland seretion test were evaluated before surgery (baseline), 1 day, 1 week, 1 month, and 2 months after surgery. Results: There was significant difference between the control and trial group at 1 week in Schirmer test (p = 0.038). In OSDI, the score significantly increased until 2 months after vitrectomy in the control group (p = 0.021). However, the test group recovered at 2 month after surgery. In control group, TBUT showed significant decrease at 1 month (p = 0.022) and Schirmer test showed significant decrease at 2 months (p = 0.048) compared to the baseline, but there was no difference in the test group. Corneoconjunctival staining showed early increase and then progressive decreasing tendency at postoperative period in both groups, but there was a significant decrease of corneal staining at 2 months (p = 0.007) compared to the baseline only in the test group. Conclusions: Tear film and ocular surface disorders that occurred after vitrectomy worsen after surgery and then mostly recover. Postoperative 0.15% sodium hyaluronate instillation can alleviate the dry eye symptoms and is thought to contribute to early improvement of clinical findings.

최근 3년간 (2005-2007년) 전북지역 육계의 주요 바이러스성 질병 발생추이 분석

박종범 ( Jong Beom Park ),차세연 ( Se Yeoun Cha ),박영명 ( Young Myoung Park ),조단단 ( Dan Dan Zhao ),송희종 ( Hee Jong Song ),장형관 ( Hyung Kwan Jang ) 한국가축위생학회 2008 韓國家畜衛生學會誌 Vol.31 No.1

Recently, the major viral diseases, Newcastle disease(ND), infectious bronchitis(IB), low pathogenic avian influenza(LPAI), avian pneumovirus infection(APV), Marek`s disease(MD) and infectious bursal disease(IBD), have led to huge economic losses in chicken industry of Korea. To evaluate prevalence of the major viral disease infections in broiler breeder and broiler farms, epidemiological survey has been conducted in Jeonbuk province from 2005 to 2007 by serological ELISA test for APV, PCR for MD, and RT-PCR for ND, IB, LPAI and IBD, respectively. A total of 424 cases was submitted to our labo-ratory for diagnosis of the major viral disease from broiler breeder and broiler farms in the above period. The diagnosed results were analysed for the detection rate of infections on basis of years, seasons and ages, respectively. This study was showed that the detec-tion rates of ND and APV were considerably high for every years regardless of seasons and ages in both broiler breeder and commercial broiler. In comparison with detection rates of ND and APV, IB and LPAI were lower but detected around 10% for every years. Especially, detection rate of IB was significantly high in commercial broiler than in broiler breeder. Therefore, to minimize economic losses for broiler breeder and broiler farms, it will need for effective countermeasures to decrease detection rate of the viral respira-tory diseases. Although the detection rates of MD and IBD were gradually decreased from 2005 to 2007 in both broiler breeder and commercial broiler, it will continually make an effort about disease control for increasing productivity in chicken industry.