안구돌출을 주소로 진단된 신세포암의 눈물샘 전이 1예

최정한,박인기,서경훈,신재호,Jeong Han Choi,In Ki Park,Kyung Hoon Seo,Jae Ho Shin 대한안과학회 2012 대한안과학회지 Vol.53 No.12

Purpose: To report a very rare case of lacrimal gland metastasis of renal cell carcinoma presenting with proptosis. Case Summary: A 68-year-old man visited our clinic with a 3-month history of proptosis in the right eye. Corrected visual acuity was 0.8 in the right eye and 0.9 in the left eye and 11 mm proptosis of the right eye was observed. There were no specific findings except cataracts in both eyes. Orbital computed tomography (CT) demonstrated a solid lacrimal gland mass which was 24 × 36 × 29 mm in size and showed irregular enhancement. The CT scan also showed bone destruction around the orbital lateral wall and infiltration to the lateral rectus muscle. A metastatic tumor was suspected, thus a chest CT and abdominal CT were performed. The CT scan showed a large exophytic hypervascular mass with heterogeneous enhancement. The mass size was confirmed by the abdominal CT and malignant tumors were suspected. Regarding the left renal mass, a urology surgeon performed nephrectomy and adrenalectomy and regarding the lacrimal gland mass we performed an incisional biopsy via lid crease incision. Both masses were diagnosed as renal cell carcinoma based on the pathophysiologic findings. Conclusions: Lacrimal gland metastasis of renal cell carcinoma is very rare and extensive systemic evaluation for metastatic malignancy should be performed. In the present study, the authors report of a primary tumor found by chest CT a review of the literature.

연마 방법과 칫솔질이 아크릴릭 레진의 표면 거칠기에 미치는 영향

이주리,정철호,최정한,황재웅,이동환,Lee, Ju-Ri,Jeong, Cheol-Ho,Choi, Jung-Han,Hwang, Jae-Woong,Lee, Dong-Hwan 대한치과보철학회 2010 대한치과보철학회지 Vol.48 No.4

연구 목적: 본 연구는 연마 술식에 따른 polymethyl methacrylate (PMMA)의 표면 거칠기의 차이를 비교하고, 광중합 광택제가 PMMA의 표면 거칠기에 주는 영향과 이후 칫솔질에 의한 거칠기의 변화를 알아보는데 그 목적이 있다. 연구 재료 및 방법: 총 60개의 $10{\times}10{\times}5\;mm$ 크기의PMMA 시편을 만들었다. 중합 방법 (압력 하 중합과 대기압 하 중합)과 표면 연마 방법 (기계적 연마와 화학적 연마)에 따라 대조군을 포함하여 각 10개씩 총 6군으로 나누었다. 기계적 연마는 카바이드 덴처버로 표면 마무리 한 후, 러버 포인트와 퍼미스를 이용하여 하였으며, 화학적 연마는 표면 마무리 후 광중합 광택제 ($Plaquit^{(R)}$; Dreve-Dentamid GMBH)를 도포하여 실시 하였다. 연마가 완료된 후 비 접촉식 3차원적 표면 형상 분석장치인 Accura $2000^{(R)}$으로 표면거칠기를 측정하였으며, 그 3차원적 영상을 얻었다. 그 후 칫솔질에 의한 마모의 영향을 평가하기 위해 초음파 전동 칫솔을 이용하여 각 시편당 칫솔질을 행하고 다시 Accura $2000^{(R)}$에 의한 표면 분석을 시행하였으며, 거칠기의 정도는 Ra 값으로 표시하였다. 연마 후와 칫솔질 후의 표면 거칠기를 비교하기 위한 통계적 분석은 Mann-Whitney test와 t-test를 이용하여 95% 유의수준에서 실시하였다. 결과: 화학적 연마군은 기계적 연마군에 비해 통계적으로 유의한 작은 평균 표면 거칠기 값을 보였으며 (P = .0045), 일반 대기압 하에서 중합시킨 군에서 그 차이가 더 크게 나타났다 (P = .0138). 초음파 전동 칫솔에 의한 모의 칫솔질 후 표면 거칠기는 기계적 연마군을 제외한 모든 군에서 크게 증가하였으며, 칫솔질 후의 표면 거칠기는 각 군에서 통계적으로 유의한 차이를 보이지 않았다. 결론: 비록 칫솔질에 의한 마모의 영향으로 표면 거칠기가 증가하기는 하지만, 화학적 연마가 기계적 연마에 비해 우수한 표면 거칠기를 보인다고 할 수 있다. Purpose: This study evaluated the effect of polishing techniques on surface roughness of polymethyl methacrylate (PMMA), as well as the influence of light-cured surface glaze and subsequent brushing on surface roughness. Materials and methods: A total of 60 PMMA specimens ($10{\times}10{\times}5\;mm$) were made and then divided into 6 groups of 10 each according to the polymerization methods (under pressure or atmosphere) and the surface polishing methods (mechanical or chemical polishing) including 2 control groups. The mechanical polishing was performed with the carbide denture bur, rubber points and then pumice and lathe wheel. The chemical polishing was performed by applying a light-cured surface glaze ($Plaquit^{(R)}$; Dreve-Dentamid GmbH). Accura $2000^{(R)}$, a non-contact, non-destructive, optical 3-dimensional surface analysis system, was used to measure the surface roughness (Ra) and 3-dimensional images were acquired. The surface roughness was again measured after ultrasonic tooth brushing in order to evaluate the influence of brushing on the surface roughness. The statistical analysis was performed with Mann-Whitney test and t-test using a 95% level of confidence. Results: The chemically polished group showed a statistically lower mean surface roughness in comparison to the mechanically polished group (P = .0045) and the specimens polymerized under the atmospheric pressure presented a more significant difference (P = .0138). After brushing, all of the groups, except the mechanically polished group, presented rougher surfaces and showed no statistically significant differences between groups. Conclusion: Although the surface roughness increased after brushing, the chemical polishing technique presented an improved surface condition in comparison to the mechanical polishing technique.

PC기반 시야검사를 통한 효과적인 시선고정 유도방법 연구

이지형,이백희,박현지,최정한,유희천,강자헌,Ji Hyoung Lee,Baek Hee Lee,Hyun Ji Park,Jeong Han Choi,Hee Cheon You,Ja Heon Kang 대한안과학회 2013 대한안과학회지 Vol.54 No.9

Purpose: The present study explored novel methods in visual field tests that actively induce the gaze of the examinee to the fixation target in the center vision and compared their effectiveness. Methods: Four gaze induction methods (dot-on, dot-off, number-on, and number-off) were prepared by combining 2 types of fixation targets (dot and number) and 2 conditions of sound presence (on and off). The gaze induction methods were implemented to a PC-based visual field testing system and the 24-2 visual field testing protocol was administered to 14 participants without glaucoma. The performance of the gaze induction method was evaluated in terms of fixation error rate, target detection rate, and subjective satisfaction (7-point scale, 1 for least satisfied and 7 for most satisfied). Results: The fixation error rates of dot-on (5.7%) and number-on (6.4%) were relatively lower than the other methods; the target detection rates of the induction methods were very high (95-96%) without significant differences, and the subjective satisfaction levels of dot-on (5.7) and number-on (5.4) were significantly higher than the other methods. Conclusions: In the present study we determined number-on as the preferred effective gaze induction method compared to the conventional dot-off method when fixation error rates and subjective satisfaction were considered.

편측 정상안압녹내장의 반대편 눈과 정상인의 눈과의 시신경 유두 기울기와 비틀림 비교

주진호(Jin-Ho Joo),최정한(Jeong Han Choi),김태기(Tae Gi Kim),강자헌(Jaheon Kang) 대한안과학회 2017 대한안과학회지 Vol.58 No.8

목적: 편측 정상안압녹내장 환자에서 녹내장안과 반대편안 그리고 정상인의 시신경 유두 기울기와 비틀림을 비교하고, 망막신경섬유 층 두께와의 연관 관계를 확인하고자 하였다. 대상과 방법: 본원 안과를 내원한 환자 중 편측 정상안압녹내장으로 진단받은 환자 23명을 대상으로 녹내장안과 반대안의 시신경 유두 기울기와 비틀림을 측정하였다. 대조군으로 비슷한 연령대 및 성별의 정상인 23명 46안을 대상으로 시신경 유두 기울기와 비틀 림을 측정하여 정상안압 녹내장 환자의 녹내장안과 반대안과 비교분석 하였다. 또한 정상 안압 녹내장 환자 23명에서 빛간섭단층촬영 기를 이용해서 망막신경섬유층 두께를 측정하여 비교하였다. 결과: 시신경 유두 기울기와 비틀림의 평균 값은 녹내장안에서 1.17± 0.19/15.57 ± 8.16, 반대안에서 1.10 ± 0.10/8.26 ± 5.20로 기울기는 유의한 차이를 보이지 않았으나( p =0.109), 비틀림의 경우에는 의미 있는 차이를 보였다( p =0.001). 대조군 23명 46안의 평균 시신경 유두 기울기와 비틀림은 1.11 ± 0.08/3.28 ± 2.69로 편측 정상안압녹내장 환자의 반대안과 비교하여 기울기는 유의한 차이 를 보이지 않았으나( p =0.601), 비틀림의 경우에는 의미 있는 차이를 보였다( p <0.001). 망막신경섬유층 평균 두께는 녹내장안에서 71.91 μm, 반대안에서 115.83 μm로 정상안보다 각각 49.35 μm/9.70 μm 감소되어 있었고 두 그룹 간의 두께 감소는 유의한 차이를 보였다( p <0.01, p <0.01). 또한 비틀림 정도에 따라서 비틀림과 같은 방향의 망막신경섬유층 두께의 감소는 유의성이 있다는 것을 확인 할 수 있었다( p =0.024). 결론: 시신경 유두 비틀림은 편측 정상안압녹내장 환자의 반대안과 정상안을 비교하였을 때 유의한 차이를 보였고, 비틀림 정도와 망막신경섬유층 두께 감소는 유의한 상관관계를 보였다. 이는 편측 정상안압녹내장 환자의 반대안에서도 시신경 유두의 구조적 변화 로 녹내장이 진행할 수 있어 주의 깊은 관찰이 필요하다. Purpose: To determine the association between optic disc tilt and torsion of glaucomatous and fellow eyes of unilateral nor-mal-tension glaucoma (NTG) patients and normal. Methods: We measured optic disc tilt and torsion of 23 unilateral NTG patients and 23 normal controls by analyzing fundus pho-tography and compared 3 groups. We also measured retinal nerve fiber layer (RNFL) thickness through optical coherence to-mography in 23 unilateral NTG patients and compared the findings with those of normal eyes. Results: The mean values of optic disc tilt ratio and torsion degree in glaucomatous eyes were 1.17 ± 0.19˚ and 15.57 ± 8.16˚, re-spectively, while those in fellow eyes were 1.10 ± 0.10˚ and 8.26 ± 5.20˚. There was no significant difference in tilt ratio (p = 0.109), but there was a significant difference in torsion degree (p = 0.001). The mean values of optic disc tilt ratio and optic disc torsion in the controls were 1.11 ± 0.07˚ and 3.25 ± 2.69˚, respectively. Also, there was no significant difference in optic disc tilt ratio (p = 0.601), but a significant difference in optic disc torsion between fellow eyes and controls (p < 0.001). The RNFL thickness of the same torsion direction in unilateral NTG eyes was measured to be 49.35 ± 17.18 µm smaller than the normal value (mean RNFL thickness: 71.91 ± 16.92 µm). Reduced RNFL thickness of the same torsion direction between glaucomatous eyes and fellow eyes was significantly different (p < 0.001). In addition, it was confirmed that RNFL thickness was significantly decreased accord-ing to the degree of disc torsion (p = 0.024). Conclusions: The optic disc torsion showed a significant difference between glaucomatous and fellow eyes in unilateral NTG pa-tients and normal controls. Also, the RNFL thickness significantly decreased according to the degree of the optic disc torsion. Therefore, fellow eyes of unilateral NTG patients need to be carefully monitored for the progression of glaucoma.