CO₂레이저 시술을 위한 신체부위에 따른 적절한 EMLA^(?) 도포 시간에 대한 고찰

이동초,오경재 원광대학교 대학원 2008 論文集 Vol.41 No.-

Background : Topical anesthetics are commonly used to decrease the pain associated with laser or minor surgical procedure. EMLA^?(Euteric Mixture of Local Anesthetics) is the most commonly used topical anesthetic agent prior to procedures. Application duration of 1 hour was usually recommendedfor adequate anesthesia for procedures involving intact skin. Objective : To determine the optimal application duration of EMLA^(?) for adequate cutaneous anesthesia for CO₂ laser procedure according to each part of the body, gender. Methods : Twenty volunteers (14 men, 6 women) between the ages of 22-29 years were participated in study. They had many nevi on their faces, hand dorsum, arm, leg; abdomen and back. The face was divided into four regions including forehead, zygomatic region, cheek and chin. Four skin lesions in every region of each part were selected as experimental regions. Equal amount of EMLA^(?) cream were applied to the total 36 test sites under an impermeable plastic occlusion dressing. One by one each region was stimulated by CO₂ laser every 45, 60, 75, 90, 105 and 120 minutes. Volunteers rated the level of pain experienced during laser treatment on a five-point pam scale (grade 0-4). We defined the shortest time when they become numbed (grade 0) or they had a sense with no pain (grade 1) as optimal anesthetic duration. Result : When stimulated by CO₂ laser, optimal application duration of EMLA^(?) was 56.63, 86.25, 71.25, 73.5, 60, 48.75 minutes for lesion on the face, hand dorsum, arm, leg, abdomen and back. And there's no difference according to sex. Conclusion : For the treatment of CO₂ laser, application duration of EMLA^(?) is approximately 50 minutes for lesion on the back, 60 minutes for lesion on the face, abdomen, 70 minutes for lesion on the arm, leg, 90 minutes for the lesion on the hand dorsum.

맥락막 혈관종으로 유발된 장액성 망막발리의 광응고술 치료경험 1례

이동초(Dong Cho Lee),장무환(Moo Hwan Chang) 대한안과학회 1998 대한안과학회지 Vol.39 No.10

부비동 -안와 -두개강의 침윤성 국균증 1예

이동초(Dong Cho Lee),이종훈(Jong Hoon Lee),최웅산(Woong San Choi) 대한안과학회 1999 대한안과학회지 Vol.40 No.6

당뇨병 유발 백서의 조기 망막 변화에 대한 전자현미경적 연구

이동초(Dong Cho Lee),장무환(Moo Hwan Chang),최웅산(Woong San Choi) 대한안과학회 1999 대한안과학회지 Vol.40 No.7

원자 폭탄 피해자의 후손에서 발생한 색소성 건피증과 각막 편평상피세포암 1예

이동초(Dong Cho Lee), 최웅산(Woong San Choi), 안정현(Jung Hyun Ahn) 대한검안학회 2007 검안 및 콘택트렌즈 학회지 Vol.6 No.1

Purpose: To report a case of corneal squamous cell carcinoma and Xeroderma pigmentosum in the offspring of atomic bomb survivor. Methods: A 45-year old male diagnosed with Xeroderma Pigmentosum at the age of 15 years presented with decreased visual acuity of his left eye. His brother also had Xeroderma Pigmentosum. His father was atomic bomb survivor in Hiroshima. Multiple squamous cell carcinoma affected right eye which was developed on his face starting from the age of 15 years, and were treated by local excision and exentration at other hospital. On his first visit to our hospital, his left visual acuity was 0.3. The left eye revealed 3×6 mm sized, whitish mass on temporal cornea, and corneal opacity on nasal cornea with pterygium-like growth. The excision of the pterygium-like lesion and corneal mass was done. Amniotic membrane was sutured with 10-0 nylon to cover the bare sclera fully. Results: The pathologic result was consistent with the diagnosis of squamous cell carcinoma in situ. During the one year follow-up, neither recurrence nor any postoperative complication. We found postoperative best corrected visual acuity improved from 0.3 to 0.6 after one year.

1시간이상 떨어진 다발성 망막열공에 의한 망막박리 환자에서 기체망막유착술을 시행한 3예

조우형, 이동초, 장무환Woo-Hyung Cho M.D. Dong-Cho Lee M.D. Moo-Hwan Chang M.D. 대한안과학회 2005 대한안과학회지 Vol.46 No.12

Purpose: To determine the effects of performing pneumoretinopexy in patients without the conventional indication of pneumoretinopexy but with rhegmatogenous retinal detachment by multiple retinal tears separated over 1 hour in distance. Methods: Three patients with rhegmatogenous retinal detachment by multiple retinal tears separated over 1 hour in distance from November 2003 to December 2003 were the subject of this study. Treatment records of the patients were examined retrospectively. In one case, when performing pneumoretinopexy, 0.5 cc of vitreous was aspirated followed by an injection of 0.8 cc SF6 gas. In the other two cases, after injecting 0.5 cc of SF6 gas, one retinal tear was adhered in the proper position. Then, sequential retinal adhesion was attempted by changing the position. Results: In all three cases, anatomical retinal adhesion was maintained, and visual acuity functionality was improved. Conclusions: Both sequential retinal adhesion by changing the position and performing pneumoretinopexy after vitreous aspiration are successful method of retinal adhesion. Therefore, pneumoretinopexy can be used as an effective medical treatment in patients with rhegmatogenous retinal detachment by multiple retinal tears separated over 1 hour in distance.

MELAS 증후군 환자에서 발견된 시신경병증 1예

이명원, 안정현, 경성은, 이동초Myung Won Lee M.D. Jung Hyun Ahn M.D. Sung Eun Kyung M.D. Dong Cho Lee M.D. 대한안과학회 2007 대한안과학회지 Vol.48 No.9

Purpose: The purpose of this case report is to describe accompanying ocular findings, especially optic neuropathy, in a patient with MELAS syndrome. Methods: A 10-year-old male patient who had lactic acidosis and neurological symptoms (loss of consciousness, vomiting, epilepsy, decreased vision, and constricted visual field), underwent a brain magnetic resonance imaging (MRI) scan and a molecular genetic analysis. Results: A diagnosis of cerebral infarction due to occlusion in the right posterior cerebral artery was made and confirmed by MRI scan. The diagnosis of MELAS syndrome was confirmed by performing molecular genetic analysis demonstrating the transformation of the mitochondrial tRNAleu(UUR) gene (MTTL1) A to G(3243). According to the ocular examinations, the patient??s left eye showed decreased vision, hemianopsia, relative afferent pupillary defects, mild swelling of optic nerve, and decreased amplitude on visual evoked potential exam. Conclusions: We encountered a case of MELAS syndrome involving optic neuropathy, which can (although rarely) occur with this syndrome. Therefore, in patients with an optic neuropathy of uncertain etiology, clinicians should consider performing comprehensive ocular exams and molecular genetic exams to rule out the possibility of genetic diseases.

무한성 외배엽 이형성증 환자의 안과적 소견

이명원,이동초,장무환.Myung Won Lee. M.D.. Dong Cho Lee. M.D.. Moo Hwan Chang. M.D. 대한안과학회 2007 대한안과학회지 Vol.48 No.7

Purpose: This clinical report describes the characteristics and ophthalmic treatment of a patient with anhidrotic ectodermal dysplasia showing bilateral upper eyelid entropion, conjunctival mass and dry eye syndrome. Methods: A 12-year-old boy presented to our clinic complaining of a white mass on the lower tarsal conjunctiva, foreign body sensation, and an itching in his right eye of one-year duration. He had developmental defects in his hair, teeth, nails and sweat glands. He had dry skin, a flat upper-lip, heat intolerance, a saddle-backed nose, and hypohidrosis. Ophthalmic examination showed blepharitis, a conjunctival mass, and bilateral upper eyelid entropion. Results: Upper eyelid entropion surgery was performed. An excisional biopsy of the conjunctival mass showed nonspecific acute and chronic inflammation. Conclusions: We concluded that the conjunctival mass developed as a result of chronic inflammation caused by chronic conjunctivitis and dry eye syndrome. Regular lid-hygiene with swab and lubrication is useful to minimize recurrent ocular inflammation in anhidrotic ectodermal dysplasia.

미세각막절삭기를 이용한 라식 수술 시 각막절편 두께에 영향을 미치는 수술 전 인자

조우형,이동초,장무환,Woo Hyung Cho,Dong Cho Lee,Moo Hwan Chang 대한안과학회 2006 대한안과학회지 Vol.47 No.4

Purpose: To identify factors that may be related to variations in corneal flap thickness in LASIK using the Moria M2 microkeratome. Methods: The charts of patients having LASIK based on steep keratometry nomogram using Moria M2 microkeratome (head : 110 ?m) and excimer laser (VISX STAR S2, USA) in our department of ophthalmology from March, 2003, to May 2005, were reviewed retrospectively. A total of 195 eyes were enrolled in the investigation. We analyzed relationship between corneal flap thickness and preoperative factors including central corneal thickness, steep keratometer, corneal diameter, suction ring using multiple regression analysis. Results: Mean corneal flap thickness was 119.37±21.21 ?m. There was a statistically significant positive correlation between flap thickness and central corneal thickness (p<0.05). No correlation was found between flap thickness and other preoperative factors including steep keratometer, corneal diameter and suction ring. Conclusions: Mean corneal flap thickness using the Moria M2 110 ?m head was 119.37±21.21 ?m, little thicker than our expectation. When surgery is performed based on steep keratometry nomogram using Moria M2 microkeratome, if intraoperative factors are excluded, there is a trend toward thicker flap thickness with thicker central corneal thickness, whereas steep keratometer, corneal diameter or suction ring have no influence on flap thickness.

표피박리성 수장족저 각피증 1예

원태혁,이동초,오경재 원광대학교 대학원 2008 論文集 Vol.40 No.-

The palmoplantar keratoses comprise a heterogenous group of disorders of keratinization, which can be subdivided into hereditary and acquired forms. Epidermolytic palmoplantar keratoderma (EPPK) is an autosomal dominant disease which presents as abnormal thickening of the palms and soles with epidermolytic hyperkeratosis pathologically. We report a 18-month-old female baby showing the clinical and histologic features of EPPK without family history. She has been treated intermittently with topical urea and oral isotretinoin for 2 years, but the lesions remain unchanged.