찰스보넷증후군의 국내 유병률 및 임상특성

박영명,정진구 대한안과학회 2019 대한안과학회지 Vol.60 No.12

Purpose: To report the clinical characteristics and prevalence of Charles Bonnet syndrome (CBS) in patients with retinal diseases in the Republic of Korea. Methods: Patients with deterioration of visual acuity or visual field or episodes of complex visual hallucination (cVH) with retinal diseases between March 2019 and June 2019 at the retinal outpatient clinic of the Chonbuk National University Hospital were selected to answer standardized questions to determine whether they had symptoms of CBS. Results: The selected 303 patients from the total of 2,916 patients were comprised of 163 males (53.8%) and 140 females (46.2%). The mean age of the patients was 66.0 ± 15.1 years. six patients (2.4%) of 245 with no response to initial question in 301 with best-corrected visual acuity less than finger counting and two patients with experience of cVH were diagnosed with CBS. Most patients had seen a wide variety of hallucinations, including objects, people, and scenery, with negative emotions, for > 1 year. The hallucinations were experienced daily with the same frequency. Negative feelings such as fear and worry improved when they received appropriate patient education about the hallucinations. Conclusions: The prevalence of CBS in the Republic of Korea is higher than previously reported. We found that relatively young patients with visual impairment could experience cVH from CBS. CBS patients experienced negative emotions for long periods due to the hallucinations which decreased their quality of life. CBS should be considered during the differential diagnosis of cVH in patients with visual impairment due to ophthalmic diseases. We should also provide appropriate patient education to assist them in understanding more fully the clinical characteristics of CBS. 목적: 망막질환환자에서 찰스보넷증후군의 임상특성 및 국내 유병률을 보고하고자 한다. 대상과 방법: 2019년 3월부터 2019년 6월까지 전북대학교병원 망막분과 외래환자를 대상으로, 망막질환으로 시력 및 시야장애가 있거나 복합환시를 호소하는 환자를 선별하여 찰스보넷증후군의 확인을 위한 설문조사를 실시하였다. 결과: 연구 대상은 2,916명으로 이 중 선별 설문을 실시한 환자는 303명으로 남성이 163명(53.8%) 여성이 140명(46.2%)이었으며, 평균 연령은 66.0 ± 15.1세였다. 안전수지 이하의 시력을 보이는 환자 301명과 복합환시를 호소하는 환자 2명 중에서 선별 질문에 참여하지 않은 58명을 제외한 245명 중 6명(2.4%)을 찰스보넷증후군으로 진단하였다. 환시는 사물, 인물 그리고 풍경 등 다양하게 나타났으며 부정적인 감정이 동반되었고 경험 기간은 1년 이상이 대부분이었다. 매일 환시를 경험하였고 시간 경과에 따른 빈도 변화는 없었다. 환시에 대한 적절한 환자교육이 제공되었을 때 환자의 두려움, 걱정 등의 감정은 개선되었다. 결론: 국내 찰스보넷증후군의 유병률은 기존의 연구 결과에 비해 높았다. 비교적 젊은 연령의 환자에서도 시각장애가 있으면 찰스보넷증후군의 환시가 나타날 수 있다. 환시에 의해 환자는 장기간 부정적인 감정을 느끼게 되고 삶의 질이 저하될 수 있다. 그러므로 안질환으로 시각장애가 있는 환자에서 환시를 호소하는 경우 찰스보넷증후군을 감별 진단으로 생각할 수 있어야 하며, 적절한 환자교육을 통해 환자가 찰스보넷증후군의 임상양상을 충분히 이해하는 데 도움을 줄 수 있어야 할 것이다.

점안 인터페론 Alpha-2b로 재발을 억제한 재발 점액종성 각막변성 1예

박영명,안민,강완석,유인천 대한안과학회 2017 대한안과학회지 Vol.58 No.8

Purpose: To report a case of recurrent myxomatous corneal degeneration after pterygectomy. Case summary: A 65-year-old man with a history of abdominal keloid was referred to our hospital for assessment of a well-circumscribed, gelatinous, whitish corneal mass on the nasal corneal area of the left eye that appeared one month prior. The patient had undergone pterygectomy on his left eye 2 years ago. The patient experienced mild foreign body sensation. The other anterior segment and fundus examination of the left eye were both normal. We diagnosed the case as keloid and we performed excisional biopsy of the corneal mass. Histologic findings revealed proliferation of myxoid-appearing material in the anterior corneal stroma. On immunohistochemical examination, sections were stained positive for actin and calretinin, and negative for S-100. We diagnosed the tumor as myxomatous corneal degeneration. After six months, a recurrent mass was found on the previously excised site. Re-excisional biopsy and topical interferon α-2b treatment were then performed in response. After re-excision, there was no recurrence or complications during one year follow-up. Conclusions: Myxomatous corneal degeneration should be considered during differential diagnosis of an elevated, whitish, gelatinous lesion of the cornea with previous history of trauma or operation, such as pterygectomy. An interferon α-2b topical treatment is useful for recurrent corneal myomatous degeneration. 목적: 군날개 절제술 후 각막에 발생한 재발한 점액종성 각막변성 1예를 보고하고자 한다. 증례요약: 2년 전 좌안의 군날개 절제술을 받았으며, 복부에 켈로이드 소견을 보인 65세 남자 환자가 1개월 전 발생한 좌안 내측 각막의 종괴를 주소로 내원하였다. 좌안의 내측 각막에서 주위 조직과 경계가 뚜렷한 젤리 같은 백색의 종괴가 관찰되었고, 환자는 약간의 이물감을 호소하였다. 다른 전안부 검사 및 안저 검사는 정상이었다. 각막의 켈로이드로 의심하고 종괴에 대한 절제생검을 실시하였다. 병리조직학적 검사에서 각막 상부 기질에 점액질성 변성이 관찰되었고 면역염색검사상 S-100에 음성이고 Actin과 Calretinin에 양성 소견을 보여 각막 점액종성 각막변성으로 진단되었다. 6개월 뒤에 절제 부위의 각막 윤부에서 동일 성상을 가진 덩어리의 재발이 확인되었고 재절제한 후 Interferon α-2b 점안액을 추가 사용하여 치료하였으며 1년 경과까지 특별한 합병증이나 재발은 관찰되지 않았다. 결론: 군날개 수술과 같이 정상조직 손상 후에 발생한 각막의 젤리 같은 하얀 종괴에 대해서는 점액종성 각막변성을 감별진단으로 고려해야 하고 재발하는 경우에는 Interferon α-2b 점안도 도움이 될 수 있을 것으로 생각된다.

태권도선수의 추가적 야간운동을 통한 체중조절이 신체구성 및 체력에 미치는 영향

박영명,유연호,김한철,최경훈,이주희,박진호 한국스포츠리서치 2007 한국 스포츠 리서치 Vol.18 No.6

초정밀 동작 인지를 위한 100 GHz 단일 LTCC 패치 Antenna-in-Package (AiP)

박영명,오정석 한국정보통신설비학회 2020 한국정보통신설비학회 학술대회 Vol.2020 No.09

위내시경으로 확인된 Anisakis와 구충의 비교 관찰

박영명,이정규,최춘한,김원,정영기,서동룡,박두복 大韓消化器病學會 1989 大韓消化器病學會誌 Vol.21 No.3

공공체육시설의 장애인 편의시설 실태 및 개선방안

박영명,박기용,곽동주,김인수,김성진 한국스포츠리서치 2007 한국 스포츠 리서치 Vol.18 No.6

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.

다른 형태의 일회성운동이 태권도선수의 혈중 면역글로불린에 미치는 영향

박영명(Park Young-Myung),권영우(Kwon Yeung-Woo) 한국체육과학회 2009 한국체육과학회지 Vol.18 No.3

The purpose of this study was to investigate the effect of different exercise type on blood immunoglobulins concentration(IgA, IgG, IgM). Eleven Taekwondo players(age Z2.7±1.83, weight 71.5±7.42) participated in this study and performed 3 different type exerciselcycling at 80%HRmax and interval exercise by bicycle ergometer during 30 minutes, sparring of 5round). Venous blood samples were taken from an antecubital vein by venepuncture and were collected at pre-exercise, immediate post-exercise and recovery period(1day later). Acute exercise increased blood IgA concentration and returned near baseline level(p=.000) after recovery period. Blood IgG concentration increased significantly after immediate exercise and returned near baseline values after recovery period(p=.000), especially the recovery rate of sparing treatment was lower than that of other treatment(interval exercise, cycling at 80%HRmax, p=.016). Acute exercise increased blood IgM concentration(p=.002) and such exercise induced increase was higher in sparing treatment than that of interval exercise and cycling at 80%HRmax(p=.000). Increased blood IgM concentration returned to the baseline levels during recovery period in all treatment except sparing treatment which did not showed any significant decrease after acute exercise(p=.000). In conclusion immunoglobulins concentration increased significantly after acute exercise and returned near baseline level after recovery period. But sparing exercise partially showd enhanced exercise induced immunoglobulins increase and did not showed any decrease after recovery period. Further study is required to investigate the influences of other immune related parameter and plasma volume change.

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.

태권도 선수의 일회성 최대 운동이 혈중 면역글로불린 및 혈장량에 미치는 영향

박영명(Park Young-Myung) 한국체육과학회 2008 한국체육과학회지 Vol.17 No.3

The purpose of this study was to investigate the effects of acute maximal exercise on immunoglobulins(IgA, IgG, IgM) and plasma volume and how plasma volume change effect on this parameter. Seven Taekwondo player (age 22.3±1.77, weight 72.5±6.52) participated in this study and performed graded maximal exercise (Bruce protocol). Before exercising, immediately after the exercise blood samples were obtained and the levels of immunoglobulins and plasma volume were determined. Blood samples were collected before, after exercise from antecubital vain. No significant increase observed on IgA, IgG but IgM increased significantly immediately after graded maximal exercise. Plasma volume was found to have decreased significantly immediately after exercise. When IgA, IgG, IgM were adjusted for the significant % delta plasma volume, their concentrations did not change over the experimental period, suggesting that the changes in measured concentration of these parameters may be due to change in plasma volume. It is recommended, when sampling immune parameters in blood following an acute bout of exercise, that corrections for plasma volume change should be conducted. Plasma volume change should be taken into consideration when interpreting results regardless of exercise protocol and exercise mode performed. Further study need to elucidate the exact mechanism between acute exercise and immunoglobulin, plasma volume related to other immune parameter and different exercise intensity.