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이정헌(Jeong Hyun Lee),최상봉(Sang Bong Choi),최진(Jin Choi) 대한안과학회 2016 대한안과학회지 Vol.57 No.12
목적: 에탐부톨 복용 환자에서 시행한 정기적인 안과 검사 및 환자 정보를 바탕으로 안과적 이상소견의 발생 여부 및 에탐부톨 시신경병증의 위험 요인을 알아보고자 하였다. 대상과 방법: 2010년 10월부터 2015년 6월까지 인제대학교 상계백병원 내과에서 결핵으로 진단 받아 에탐부톨 복용을 시작하면서 안과로 의뢰된 환자들의 의무기록을 후향적으로 분석하였다. 시력 저하는 없는 군(A군), 시력 저하가 있으나 에탐부톨 시신경병증으로 진단 받지 않은 군(B군), 시력저하가 있으면서 에탐부톨 시신경병증으로 진단 받은 군(C군)으로 나누었고 이들의 사구체여과율, 에탐부톨 하루 복용량, 에탐부톨 사용 기간, 최대교정시력 및 이시하라 색각검사의 변화, 빛간섭단층촬영에서 시신경유두주위 망막신경섬유층의 두께, 시야검사의 평균편차를 분석하였다. 결과: 전체 182명의 환자들 중 A군, B군, C군에 각각 158명(86.8%), 12명(6.6%), 12명(6.6%)이 포함되었다. 다중 회귀분석 결과 나이(p<0.001)가 에탐부톨 시신경병증의 위험 요인이었으며 기준치(cut off value)는 59.5세였다. 에탐부톨 복용 전후로 B군에서는 시력이 유의한 차이(p<0.001)를 보였고 C군에서는 시력(p<0.001)과 색각(p<0.001) 모두에서 유의한 차이가 있었다. B군과 C군을 비교하였을 때 시신경유두주위 망막신경섬유층의 두께는 유의한 차이가 없었지만 시야검사의 평균편차는 유의한 차이(p=0.010)가 있었다. 결론: 고령의 환자에서 에탐부톨 투여 시 각별한 주의를 요하며 색각 검사와 시야검사를 통해서 단순 시력저하 환자와 감별할 수 있다. Purpose: In the present study, regular ophthalmic examinations performed in patients taking ethambutol were analyzed and the risk factors for ethambutol optic neuropathy were investigated. Methods: We retrospectively collected the data of patients diagnosed with tuberculosis at Inje University Sanggye Paik Hospital and referred to the Department of Ophthalmology between October, 2010 and June, 2015. The patients were divided into three groups: group A (patients without visual loss), group B (patients with visual loss who were not diagnosed with ethambutol optic neuropathy), and group C (patients with visual loss who were diagnosed with ethambutol optic neuropathy). We evaluated each patient’s glomerular filtration rate, ethambutol daily dosage, duration of ethambutol prescription, change in best corrected visual acuity, Ishihara color test over time, and peripapillary retinal nerve fiber layer thickness based on optical coherence tomography and mean deviation of perimetry. Results: Group A consisted of 158 patients (86.8%), group B of 12 patients (6.6%), and group C of 12 patients (6.6%). Age was a risk factor for ethambutol optic neuropathy according to logistic regression analysis (p < 0.001) with a cut-off value of 59.5. In group B, visual acuity showed significant difference (p < 0.001) and in group C, visual acuity (p < 0.001) and color vision (p < 0.001) showed significant differences before and after taking ethambutol. When comparing groups B and C, average and temporal thickness of peripapillary retinal nerve fiber layer were not significantly different but mean deviation of perimetry was significantly different (p = 0.010). Conclusions: Elderly patients should be more cautious when taking ethambutol, and color vision test and perimetry are useful diagnostic tools to differentiate patients with ethambutol optic neuropathy from patients with simple visual loss.
세포진 검사상 ASCUS/LSIL이 나온 환자의 치료에 있어서 HPV DNA 검사의 임상적 유용성
이정례 ( Jeong Rye Lee ),송은섭 ( Song Eun Seop ),이정헌 ( Heong Hun Lee ),김세련 ( Se Ryun Kim ),박지현 ( Jee Hyun Park ),황성욱 ( Sung Ook Hwang ),고승권 ( Seung Kwon Koh ),임문환 ( Moon Whan Im ),이병익 ( Byoung Ick Lee ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.2
목적 : PCR을 이용한 HPV DNA 검사법이 비정상 세포진 (ASCUS/LSIL)이 나온 환자에서 고위험 병변을 알아내기 위한 보조적인 수단으로서 임상적인 효용성이 있는지 알아보고자 하였다. 연구 방법 : 1996년 9월 1일부터 2000년 5월 31일까지 인하대병원 산부인과에 내원하여 자궁경부 세포진 검사를 받은 여성 중에서 비정상 세포진 (ASCUS/LSIL)의 결과를 보여 HPV DNA 검사와 질확대경하 조직 생검을 시행 받은 61명을 대상으로 Objective : This study was performed to evaluate the clinical efficacy of high risk HPV DNA test using PCR for the detection of high-grade CIN or invasive cancer from patients with ASCUS or LSIL on Papanicolaou smear. Methods : Sixty one patients with a P
하루 4회 인슐린 투여로 과혈당을 조절한 모성 당뇨환자의 임상 분석
이호 ( Ho Lee ),김소영 ( So Young Kim ),이진교 ( Jin Kyo Lee ),이은택 ( Eun Taek Lee ),장진호 ( Jin Ho Jang ),이정헌 ( Jeong Hun Lee ),박지현 ( Jee Hyun Park ),황성욱 ( Sung Ook Hwang ),송은섭 ( Eun Seop Song ),고승권 ( Seung Kwo 대한산부인과학회 2005 Obstetrics & Gynecology Science Vol.48 No.2
목적: 모성 당뇨환자에서 인슐린의 투여량을 직접 결정하고 혈당치를 측정해가면서 하루 4회 인슐린 투여를 하였을 때 하루 1-3회 인슐린 투여와 비교하여 산모와 태아에 더 나은 효과가 있는지 알아보고자 한다. 연구 방법: 1998년 8월부터 2004년 4월까지 인하대학교 의과대학 산부인과를 방문한 임신한 진성 당뇨환자와 임신성 당뇨환자 29명을 대상으로 중간형 인슐린과 인슐린 lispro를 하루 4회 투여한 14예를 연구 대상군으로, 하루 1-3회 인슐린 Objective: To determine whether administrating insulin four times daily, compared to 1-3 times daily, improves maternal and perinatal outcomes of diabetes. Methods: From August 1998 to April 2004, the 14 pregnant diabetic women were treated with four time
임문환(Moon Whan Im),이정례(Jeong Rye Lee),박지현(Jee Hyun Park),이우영(Woo Young Lee),황태율(Tae Yul Hwang),김우철(U Chul Kim),이정헌(Jeong Hun Lee),이병익(Byong Ick Lee) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.12
N/A Reduced amniotic fluid volume generally leads to a poor perinatal outcome, especially when it is observed in the second trimester. The recent obstetric literatures have been reporting on various applications of amnioinfusion in the diagnostic, prophylactic and therapeutic management of oligohydroamnios. We experienced two cases of amnioinfusion, which were used to diagnose or to manage the midtrimester oligohydroamnios and we report them with a brief review.
탐침법으로 실패한 선천성 비루관 협착환자에서 이차적 수술방법에 따른 수술효과 비교
이충현,이정헌,양재욱.Chung-Hyun Lee. M.D.. Jeong-Heon Lee. M.D.. Jae-Wook Yang. M.D. 대한안과학회 2005 대한안과학회지 Vol.46 No.5
Purpose: Evaluate the surgical results and clinical value of monocanalicular stenting (Monaka?)(FCI Ophthalmics, Marshfield Hills, MA, U.S.A) and balloon catheter dacryoplasty (DCP) using PTCA balloon (Stormer?) for congenital nasolacrimal duct (NLD) obstruction in children. Methods: The authors performed monocanalicular stenting (Monaka?) and balloon catheter (Stormer?) DCP as a secondary treatment of 25 children (27 lacrimal systems) over 12 months of age who had undergone ineffective probing treatment. The patients were followed up over 3 months and the postoperative outcome was assessed by fluorescein dye test. Results: Nine of eleven children (nine of eleven lacrimal systems, 81.8%) and seven of nine children (seven of nine lacrimal systems, 77.7%) showed objective and subjective improvement, respectively. Conclusions: Monocanalicular stenting and balloon dacryoplasty are excellent secondary treatments for congenital nasolacrimal duct obstruction after initial probing and irrigation surgery have been failed. Balloon dacryoplasty is a new procedure in improve the life-quality and reduce the complications rather than monocanalicular stenting.
이동현 ( Dong Hyun Lee ),조동휴 ( Dong Hyu Cho ),이정헌 ( Jeong Heon Lee ),김영란 ( Young Ran Kim ) 대한산부인과학회 2012 Obstetrics & Gynecology Science Vol.55 No.6
Mycobacterium infection manifesting pyometra in postmenopausal women is a extremely rare disease that hardly responds to the usual treatment of pus drainage and antibiotics therapy. We present a case of a postmenopausal woman with pyometra caused by endometrial tuberculosis. Almost all of the pus could be drained through the stenotic cervical canal, with difficultly. The result of Pipelle endometrial biopsy was negative. However, her symptoms continued and fluid gradually re-accumulated in the uterine cavity, despite successful pus drainage and sufficient antibiotics use. Therefore, the endometrial tissue was obtained by fractional curettage after cervical dilatation to identify the accurate cause of pyometra. A pathologic examination and polymerase chain reaction confirmed the diagnosis of endometrial tuberculosis. After completion of antituberculous medication, she was doing well without further development of pyometra. In a case of postmenopausal pyometra, endometrial sampling should be performed to rule out endometrial tuberculosis.
덱사메타손 삽입물의 수정체 내로의 주입 후 수술적 처치
황제형(Jae Hyung Hwang),이정헌(Jeong Hyun Lee),김재석(Jae Suk Kim) 대한안과학회 2016 대한안과학회지 Vol.57 No.4
목적: 덱사메타손 삽입물의 수정체 내 주입 후 발생한 백내장 2예의 수술적 처치를 보고하고자 한다. 증례요약: (증례 1) 73세 남자 환자가 개인의원에서 우안 망막분지정맥폐쇄로 덱사메타손 삽입물 주사 중 수정체 내로 주입되어 본원으로 의뢰되었다. 경과관찰 중 후낭혼탁이 진행되어 수정체 내 주사 후 10일째 수정체유화술과 인공수정체삽입술을 시행하였고 덱사메타손 삽입물을 유리체강으로 위치시키려 했으나 삽입물이 부스러져 삽입물을 제거하고 덱사메타손 삽입물 유리체강내 주입술을 다시 시행하였다. (증례 2) 69세 여자 환자가 본원에서 좌안 망막분지정맥폐쇄로 덱사메타손 삽입물 주사 중 수정체 내로 주입되었다. 주사 후 1일째 수정체유화술과 인공수정체삽입술을 시행하였고 덱사메타손 삽입물을 유리체강으로 밀어 넣었다. 결론: 수정체 내 덱사메타손 삽입물이 주입되어 발생한 백내장의 제거 시 수정체유화술로 제거하는 데 무리가 없었으며, 수정체 내 삽입된 삽입물을 유리체강내로 밀어 넣는 경우 주사 후 약 10일 뒤에는 삽입물이 부스러져 유리체강내로 재위치시킬 수 없었고 주사 후 1일 뒤에는 삽입물의 경도가 유지되고 있어 후낭 파열부의 확장 없이 유리체강내로 재위치시킬 수 있었다. Purpose: To report two cases of phacoemulsification and intraocular lens implantation after inadvertent intralenticular injection of a dexamethasone implant. Case summary: (Case 1) A 73-year-old male was referred to our hospital after an accidental intralenticular injection of a dexamethasone implant in a local clinic for treatment of branch retinal vein occlusion in his right eye. During the follow-up period, posterior capsular opacity progressed and phacoemulsification and intraocular lens implantation were performed 10 days later. During the surgery, the dexamethasone implant shattered and could not be repositioned into the vitreous cavity. The remnants of that implant were removed and a second dexamethasone implant was successfully injected into the vitreous cavity. (Case 2) A 69-year-old female was being treated for branch retinal vein occlusion in her left eye in our hospital. A dexamethasone implant was accidentally injected into her lens, thus phacoemulsification and intraocular lens implantation were performed the following day. During the procedure, we were able to successfully reposition the dexamethasone implant into the vitreous cavity. Conclusions: Cataract formation after intralenticular injection of a dexamethasone implant can be easily managed with phacoemulsification. However, the dexamethasone implant shattered 10 days after the injection and could not be repositioned. The implant kept its hardness for at least one day and we were able to reposition it into the vitreous cavity without extending the rupture site of the posterior capsule.
질식분만 후 발생한 복강내 혈관손상의 경피적 혈관색전술 성공
이동현 ( Dong Hyeon Lee ),박인해 ( In Hae Park ),전용선 ( Yong Sun Jeon ),이정헌 ( Jeong Hun Lee ),변성수 ( Sung Soo Byun ),박지현 ( Jee Hyun Park ),송은섭 ( Eun Seop Song ),고승권 ( Seung Kwon Koh ),임문환 ( Moon Whan Im ),이병익 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.8
Even though arterial embolization was introduced as a treatment tool for postpartum hemorrhage, it is not performed frequently. As authors applied arterial embolization successfully to the patient who contracted retroperitoneal hematoma after delivery, we
골쇄보가 Streptomycin으로 손상된 생쥐의 배양 섬유모세포에 미치는 영향
박상면 ( Sang Myeon Park ),이종화 ( Joung Hwa Lee ),이강창 ( Kang Chang Lee ),양현웅 ( Hyun Woong Yang ),이병찬 ( Byung Chan Lee ),이정헌 ( Jung Hun Lee ),정종길 ( Jong Gil Jeong ),서부일 ( Bu Il Seo ),강영성 ( Young Seung Kang 대한본초학회 2003 大韓本草學會誌 Vol.18 No.1
N/A Objectives : To examine the cytotoxicity of streptomycin(STR) on cultured mouse fibroblasts, cytotoxocity-induced by STR was measured by MTT assay. Methods : Fibroblasts were cultured in the media containing various concentrations of STR for 72 hours. In addition, cytoprotective effect of Drynariase Rhizoma(DR) on STR-induced cytotoxicity in fibroblasts was examined when fibroblasts were preincubated with various concentrations of DR for 2 hours before treatment of 5 ㎍/ml STR for 72 hours. Results : STR decreased remarkably cell viability in a dependentmanner in these cultures, and also DR increased cell viability and amount of DNA synthesis damaged by STR. Conclusions : From the above results, it is suggested that STR has toxic effect in cultured mouse fibroblasts, and also DR was effective in the protection of STR-induced cytotoxicity in these cultures.