특발성 경화성외안근염 환자에서 발생한 눈꺼풀의 IgG4 연관경화병증 1예

윤제환,정지웅,지미정,Je Hwan Yoon,Jee Woong Jung,Mi Jung Chi 대한안과학회 2013 대한안과학회지 Vol.54 No.1

Purpose: To report a case of IgG4-related sclerosing disease involving the eyelid in an idiopathic sclerosing myositis patient. Case summary: A 51-year-old woman presented with swelling, redness, and tenderness of the left lower eyelid of 1 month duration had taken an immunosuppressant for idiopathic sclerosing myositis. Eye movements showed limitation all directions but there was no exophthalmos. A palpable mass was noted in the left lower eyelid. The left extraocular muscles were hypertrophied but the lacrimal gland was normal on orbital magnetic resonance imaging. IgG4-related sclerosing disease was confirmed by immunostained biopsy from the left lower eyelid, showing infiltration of IgG4-positive lymphoplasmacytic cells. The patient was given oral steroids and an immunosuppressant and the symptoms did not recur for at least 7 months. Conclusions: IgG4-related sclerosing disease involving ocular adnexa usually consists of bilateral lacrimal gland involvement. Additionally, the orbital soft tissue involvement without dacryoadenitis is rare. The authors of the present study report a case of IgG4-related sclerosing disease involving the left lower eyelid in an idiopathic sclerosing myositis patient and should be considered in the differential diagnosis of eyelid masses.

눈꺼풀처짐을 동반한 위눈꺼풀올림근에 국한된 외안근염 1예

윤제환,문현승,지미정,Je Hwan Yoon,Hyun Seung Moon,Mijung Chi 대한안과학회 2012 대한안과학회지 Vol.53 No.5

Purpose: To present a rare case of idiopathic orbital myositis involving levator palpebrae superioris. Case summary: A 27-year-old male presented with a 1-week history of redness, discomfort, swelling, and drooping of his left upper eyelid. A computed tomography scan showed isolated enlargement of the right superior rectus/levator muscle complex. On examination, there was a left blepharoptosis, although eye movements were normal. The authors treated the patient with 3rd-generation cephalosporin; however, after 3 days, the symptoms did not improve. Subsequently, the patient was diagnosed with idiopathic orbital myositis and treated with oral corticosteroids for 1 month; the symptoms gradually resolved. Conclusions: Idiopathic orbital myositis is a subtype of nonspecific orbital inflammation primarily involving the extraocular muscles. Although the exact cause of orbital myositis is unknown, an immune-mediated pathophysiologic mechanism appears to be one of the causes. Medial rectus myositis is the most common, and isolated levator muscle myositis is very rare. The authors of the present study reported a case of orbital myositis involving the levator palpebrae superioris which should be considered a differential diagnosis of blepharoptosis with eyelid swelling. J Korean Ophthalmol Soc 2012;53(5):707-711

안검에 발생한 호산구 증가증을 동반한 혈관림프증식증 1예

윤제환,지미정,Je Hwan Yoon,Mijung Chi 대한안과학회 2012 대한안과학회지 Vol.53 No.5

Purpose: The authors of the present study describe a rare case of angiolymphoid hyperplasia with eosinophilia (ALHE) of the eyelid. Case summary: A 63-year-old male who was diagnosed with ALHE based on biopsy of an inguinal mass presented with an eyelid mass of 1 month duration. A light brown, solitary, 1.0 × 0.5 cm-sized mass involved the right upper eyelid. There was no lymphadenopathy, but eosinophilia was present. An excisional biopsy of the mass was performed for diagnosis and management. Macroscopic examination of the excised mass revealed a well-defined, smooth, firm, yellowish-red colored lesion measuring 1.0 × 0.6 × 0.5 cm. Histopathology showed the proliferation of small blood vessels, many of which were lined by enlarged endothelial cells with uniform ovoid nuclei and intracytoplasmic vacuoles. The distinctive endothelial cells were described as having a cobblestone appearance. In addition, a perivascular and interstitial infiltrate composed primarily of lymphocytes and eosinophils was present. ALHE was finally confirmed with clinical and microscopic examination. Conclusions: The authors of the present study report a rare case of ALHE of the eyelid and suggest that a differential diagnosis should be considered. J Korean Ophthalmol Soc 2012;53(5):712-715

열공망막박리 환자의 수술 후 시야 및 망막신경섬유층 변화 비교

윤제환,남동흔,이대영,Je Hwan Yoon,Dong Heun Nam,Dae Young Lee 대한안과학회 2012 대한안과학회지 Vol.53 No.9

Purpose: To compare the visual field and retinal nerve fiber layer of scleral buckling (SB) and primary pars plana vitrectomy (PPV) for treatment of simple rhegmatogenous retinal detachment (RRD). Methods: We studied 20 eyes with RRD that were underwent successful surgical reattachment. Visual field test and retinal nerve fiber layer (RNFL) thickness measurements were performed in patients, and outcomes were compared not only between the operated eye and fellow eye, but also between SB and PPV 3 months postoperatively. Results: After the operation, PSD and MD were higher in the operated eye than in the fellow eye (p = 0.002, p < 0.001, respectively). RNFL thickness was lower in the operated eye than in the fellow eye (p < 0.001). No significant differences in BCVA were detected between SB and PPV. However, the respective differences between the operated eye and fellow eye regarding pattern standard deviation (4.0 ± 4.0, 0.7 ± 1.5), mean deviation (6.5 ± 4.6, 1.9 ± 1.9), and RNFL (8.2 ± 10.3 μm, 1.8 ± 2.7 μm) were significantly higher in PPV than in SB. Conclusions: Both visual field defect and retinal nerve fiber damage are significantly larger in PPV than in SB. J Korean Ophthalmol Soc 2012;53(9):1285-1290

세균각막염 원인균주의 항생제 감수성과 초기 항생제 선택의 적절성

윤제환,정지웅,문현승,문호석,신경환,김균형,Je Hwan Yoon,Jee Woong Jung,Hyun Seung Moon,Ho Seok Moon,Kyung Hwan Shyn,Kyun Hyung Kim 대한안과학회 2013 대한안과학회지 Vol.54 No.1

Purpose: The present study aims to determine the common pathogens involved in the etiology of bacterial keratitis and to analyze not only the antibiotic susceptibility of bacterial isolates from patients with bacterial keratitis but also the propriety of initial treatment. Methods: A retrospective study of 161 eyes in 161 patients with bacterial keratitis, who were diagnosed by cultures from 2000 to 2011, was performed. Causative bacteria and antibiotic susceptibility were evaluated in consecutive 6-year periods. Results: The most common bacteria was the pseudomonas species in the 2 time periods tested and cefazolin with tobramycin was the most commonly used antibiotic (125 cases, 77.6%) for initial treatment of bacterial keratitis. In vitro testing showed gram-negative susceptibility to tobramycin and ciprofloxacin was over 70%, gram-positive susceptibility to cephalothin and vancomycin was 100% and there was no significant difference between the 2 time periods tested. Eight cases had resistance to the initial treatment, but only 1 case showed treatment failure. Conclusions: Antibiotics used for initial treatment of bacterial keratitis were able to obtain a proper effect but several cases showed bacterial resistance to antibiotics. Thus, continued testing is essential to monitor for antibiotic resistance.

해군장병의 마이봄선기능장애가 건성안에 미치는 영향

윤제환 ( Je Hwan Yoon ) 국군의무사령부 2014 대한군진의학학술지 Vol.45 No.1

Objectives: We conducted a study to evaluate influence of meibomian gland dysfunction of ROK navy soldiers on symptoms and signs of dry eye syndrome. Methods: We selected the 50 male soldiers on service with dry eye syndrome who visited in the department of ophthalomology, korea naval 3rd fleet and the other 50 male soldiers who visited for routine physical exams from April, 2014 to July, 2014. We checked tearfilm break up time(TBUT), fluoescein staining, ocular surface disease index(OSDI) and meibomian gland dysfunction grade. Then we compared between patient group and comparison group and we performed correlation analysis for each group. Results: The OSDI and meibomian gland dysfunction grade were significantly higher(p<0.05) and TBUT was significantly shorter(p<0.05) in the patient group than the comparison group. The OSDI was correlated with TBUT and meibomian gland dysfunction grade in the patient group but it was not correlated with them in the comparison group. Conclusions: Meibomian gland dysfunction is associated with symptom and sign of dry eye syndrome and its severity is also related to severity of dry eye syndrome.

음주에 따른 음성 변화에 대한 고찰

김정현,윤제환,조형호,조연,조재식,Kim, Jung-Hyun,Yoon, Je-Hwan,Cho, Hyung-Ho,Cho, Yeon,Cho, Jae-Sik 대한후두음성언어의학회 2002 대한후두음성언어의학회지 Vol.13 No.1

Background and Objectives : It has been pointed out that alcohol intake in human beings induces changes in voice register and maximum phonation time. These changes supposedly result from injection of the vibratory vocal folds. The purpose of this study was to clarify the voice changes associated with alcohol intake and the changes of laryngeal mucosa. Materials and Methods : The subjects included 29 volunteers, including 20 men and 9 women ranging in age from 22 to 31 years. Alcohol intake was accomplished by oral administration of 23% soju 1 bottle (255cc). Serum alcohol concentration levels were evaluated hourly for 3 h after ingestion of alcohol. Seven measurements were performed at pre-alcohol intake and post-alcohol intake hourly : fundamental frequency, jitter, shimmer, noise to harmonic ratio as the acoustic analysis, maximal phonation time, mean flow rate, and subglottal pressure as the aerodynamic analysis. The changes of laryngeal mucosa were evaluated by flexible laryngoscope at each measurement. Results : By comparing the acoustic and aerodynamic data and laryngeal mucosa before and after alcohol intake, there were not remarkable changes (p>0.05). Conclusion : The voice and laryngeal mucosa have not remarkably changed according to alcohol concentration in this study. Furthermore studies on the voice change induced by multiple alcohol concentrations are required.

비강 및 부비동의 반전성 유두종에서 인유두종바이러스검출과 p53및 c-erbB-2의 발현

조재식(Jae Shik Cho),백준(Joon Baik),임상철(Sang Chul Lim),조연(Yeon Cho),윤제환(Je Hwan Yoon),서덕중(Duk Jung Seo),박창수(Chang Soo Park) 대한두경부종양학회 2001 대한두경부 종양학회지 Vol.17 No.2

Background: Inverted papilloma(IP) of the nasal cavity and paranasal sinuses is a benign neoplastic condition that can be associated with squamous cell carcinoma (SCC). Several studies have indicated an etiologic role for viruses in the development of inverted papilloma. And it is necessary to find out the significance of a biologic markers such as p53, c-erbB-2 to predict the malignant potential. The purposes of this study are to detect HPV in inverted papilloma of the nasal cavity and paranasal sinus, to examine role of HPV as an etiological agent, to examine the relationship between HPV subtype and malignant transformation of inverted papilloma, and to investigate the relation between expression rate of p53, c-erbB-2 and HPV in recurrent or malignant transformation cases. Material and Methods: Thirty two cases of inverted papilloma(IP) in the nasal cavity and paranasal sinuses were reviewed and classified into 3 groups; simple IP, IP with dysplasia group, IP with squamous cell carcinoma group. Paraffin embedded achival tissue was used in this study. The HPV was detected by in situ hybridzation (ISH) using HPV type 6/11, 16/18, 31/33/35 DNA probes. Expression of p53 and c-erbB-2 was examined by immunohistochemical staining. Results: 1) The HPV was detected in 6(19%) out of 32 cases. 2) The HPV 6/11 was dectected in 4 out of 21 cases of simple IP, HPV 16/18 in 1, HPV 31/33/35 in lout of 8 cases of IP with dysplasia respectively. 3) The positive expression of p53 was 13 cases out of 32 cases; 2 out of 21 cases of simple IP, all of 8 cases of IP with dysplasia and 3 cases of IP with squamous cell carcinoma 4) The positive expression of c-erbB-2 was in 24 out of 32 cases; 16 out of 21 cases of simple IP, 6 out of 8 cases of IP with dysplasia, 2 out of 3 cases of IP with squamous cell ca. 5) The recurrence of IP occurred in lout of 6 cases of positive for HPV, in 4 out of 26 cases negative for HPV. 6) The recurrence of IP occurred only in positive cases for p53. 7) The recurrence of IP occurred in 4(17%) out of 24 cases positive for c-erbB-2, in 1(13%) out of 8 cases negative for c-erbB-2. Conclusion: The p53 expression was associated with Inverted papillomas exhibiting evidence of malignant transformation. Also, there was a correlation between the p53 expression and recurrence.

진주종성 만성 중이염에 합병된 경뇌막외 농양과 횡정맥동혈전염

문태옥,민경민,윤제환,장인원 대한이비인후과학회 2001 대한이비인후과학회지 두경부외과학 Vol.44 No.1