안구 철 침착증으로 발생한 백내장 및 지연성 이차성 녹내장 1예

한겨레(Gyu Le Han),공민귀(Min Gui Kong),한종철(Jong Chul Han),기창원(Chang Won Kee) 대한안과학회 2015 대한안과학회지 Vol.56 No.11

목적: 저자들은 철 이물에 의한 백내장 제거 후 10년 뒤 지연성 녹내장이 발생한 안구 철 침착증의 드문 증례를 경험하였기에 이를 보고하고자 한다. 증례요약: 47세 환자가 3년 전 좌안을 철 조각에 수상한 뒤 본원에서 수정체 철 침착증으로 백내장 수술을 시행 받았다. 백내장 수술 10년 뒤 좌안의 안압 상승이 발생하였으며 철 침착증에 의한 이차성 녹내장으로 진단되었다. 섬유주 절제술을 시행 받았으며, 절제된 섬유주에서 철 성분은 관찰되지 않았으나 섬유 조직의 퇴행성 변화가 관찰되었다. 결론: 외상성 수정체 철 침착증이 있는 환자에서 이를 치료한 후에도 지연성 이차성 녹내장이 발생할 수 있다. Purpose: We report a rare case of ocular siderosis with delayed-onset secondary glaucoma occurring 10 years after cataract and iron foreign body removal. Case summary: A 47-year-old male who suffered an ocular injury with an iron material to his left eye 3 years prior to his initial visit was treated in our clinic for a cataract with siderosis lentis. Ten years after he underwent cataract surgery he developed secon-dary open-angle glaucoma. Trabecular block taken during trabeculectomy showed no iron material, however, a fibrosclerotic change was observed. Conclusions: In patients with a history of traumatic siderosis lentis, a potential risk of siderosis remains for a long period.

데스메막 각막내피이식술 후의 1년 임상결과

한겨레(Gyu Le Han, MD),현주(Joo Hyun, MD),임동희(Dong Hui Lim, MD),정의상(Eui Sang Chung, MD, PhD),정태영(Tae Young Chung, MD, PhD) 대한안과학회 2015 대한안과학회지 Vol.56 No.10

목적: 저자들은 국내 최초로 데스메막 각막내피이식술 후의 1년 임상결과를 보고하고자 한다. 대상과 방법: 2012년 1월부터 2013년 12월까지 본원에서 데스메막 각막내피이식술을 시행 받은 9명, 10안을 대상으로 하였으며, 12개월 이상 추적관찰 후 의무기록을 분석하였다. 결과: 각막부종이 감소한 8안을 분석 시 술 전 최대 교정시력은 평균 1.64 ± 0.21 (logMAR)이었으며 술 후 1개월에 0.35 ± 0.22로 통계적으로 유의한 향상을 보여주었다(p=0.012, Wilcoxon signed ranks test). 술 후 3개월, 6개월, 12개월에 측정한 최대 교정시력은 0.25 ± 0.23, 0.20 ± 0.17, 0.16 ± 0.17 logMAR로 호전되는 양상을 보였다. 내피세포 수는 술 후 1개월에 1,996 ± 528/mm2로 측정되었고 3개월, 6개월, 12개월에 1,564 ± 174/mm2, 1,463 ± 541/mm2, 1,205 ± 358/mm2로 감소하는 양상을 보였으나 통계적으로 유의하지 않았다. 술 전과 술 후 3개월째 각막 전면 난시값은 평균 3.32 ± 2.36 diopter, 2.57 ± 1.44 diopter로 유의한 차이를 보이지 않았다. 10안 중 2안에서 일차 각막절편 생착실패를 보였으며, 1안에서 재수술을 시행하였다. 1안에서 각막절편의 완전 분리가 발생하였다. 결론: 데스메막 각막내피이식술 후 장기 경과 관찰 결과 빠른 시력 호전을 보이고 12개월 이상 이를 유지하였다. 데스메막 각막내피이식술은 각막내피세포 질환의 치료에 있어 유용한 술기가 될 것으로 보인다. Purpose: To evaluate the 1-year results of Descemet's membrane endothelial keratoplasty (DMEK) in Korea. Methods: The medical records of 9 patients (10 eyes) with endothelial disease who underwent DMEK from January 2012 to December 2013, and were followed up for more than 12 months were reviewed retrospectively. Results: In 8 eyes with successful results after surgery, best corrective visual acuity (BCVA) was significantly improved from 1.64 ± 0.21 (log MAR, mean) to 0.35 ± 0.22 at 1 month and was maintained at 12 months (p = 0.012, Wilcoxon signed ranks test). BCVA at postoperative 3, 6 and 12 months were gradually increased (0.25 ± 0.23, 0.20 ± 0.17 and 0.16 ± 0.17 log MAR). Endothelial cell counts were 1,996 ± 528/mm2, 1,564 ± 174/mm2 and 1,463 ± 541/mm2, 1,205 ± 358/mm2 at 1, 3, 6, and 12 months after surgery, tended to decrease but showed no statistical significance. There was no statistical difference in astigmatism before and 3 months after the operation (3.32 ± 2.36 diopter and 2.57± 1.44 diopter). Primary graft failure occurred in 2 eyes and 1 received reoperation. Total detachment was found in 1 eye. Conclusions: The 1-year results of DMEK showed fast visual recovery which was maintained for 12 months. DMEK may be a very efficient option for the surgical management of corneal endothelial disease.

Comparison of Clinical Outcomes among Conventional Scleral Fixation, Retropupillary Iris-claw Intraocular Lens Implantation, and Intrascleral Fixation

Min-Ji Kim(Min-Ji Kim),Gyu Le Han(Gyu Le Han),Tae-Young Chung(Tae-Young Chung),Dong Hui Lim(Dong Hui Lim) 대한안과학회 2022 Korean Journal of Ophthalmology Vol.36 No.5

Purpose: To compare the efficacy and safety of conventional scleral fixation (C-SF), retropupillary iris-claw intraocular lens (RP-IOL) implantation, and intrascleral fixation (ISF). Methods: This retrospective observational study included 58 patients (58 eyes) who underwent C-SF (23 eyes), RP-IOL (23 eyes), and ISF (12 eyes) by a single surgeon at Samsung Medical Center from October 2017 to July 2020 and were followed up for at least 6 months. This study analyzed various clinical outcomes before surgery, and 1 day, 1 week, 1 month, 3 months, and 6 months after surgery. Results: Six months after surgery, best-corrected visual acuity in logarithm of minimum angle of resolution was 0.08 ± 0.10, 0.08 ± 0.16, and 0.03 ± 0.04 in C-SF group, RP-IOL group, and ISF group, respectively, and there was a significant improvement in each group compared to preoperative best-corrected visual acuity. All groups showed a significant increase in astigmatism postoperatively, but no between-group differences were observed. The prediction error was -0.15 ± 0.77, 0.56 ± 0.62, and 0.44 ± 1.00 diopters in the three groups, respectively, indicating RP-IOL group and ISF group for hyperopic shift. The three groups did not differ in terms of absolute prediction error. Six months after surgery, the corneal endothelial cell counts were 2,073 ± 691, 2,014 ± 692, and 1,712 ± 891 cells/mm2, respectively, which were lower than before surgery. IOL dislocation occurred in five eyes only in RP-IOL group, two of which underwent two reoperations, and reenclavation was performed smoothly without complications in all cases. Conclusions: Although the frequency of IOL dislocation in RP-IOL group was higher than that in the other groups, it can be reenclavated relatively easily. As a method of secondary IOL fixation, both RP-IOL implantation and ISF were as effective as conventional scleral fixation.

α-Lipoic Acid Prevents Neointimal Hyperplasia Via Induction of p38 Mitogen-Activated Protein Kinase/Nur77-Mediated Apoptosis of Vascular Smooth Muscle Cells and Accelerates Postinjury Reendothelialization

Kim, Han-Jong,Kim, Joon-Young,Lee, Sun Joo,Kim, Hye-Jin,Oh, Chang Joo,Choi, Young-Keun,Lee, Hyo-Jeong,Do, Ji-Yeon,Kim, Sun-Yee,Kwon, Taeg-Kyu,Choi, Hueng-Sik,Lee, Mi-Ock,Park, In-Sun,Park, Keun-Gyu,Le Ovid Technologies Wolters Kluwer -American Heart A 2010 Arteriosclerosis, thrombosis, and vascular biology Vol.30 No.11

Living donor liver transplantation for patients with alcoholic liver disease

Yo-Han Park,Shin Hwang,Chul-Soo Ahn,Ki-Hun Kim,Deok-Bog Moon,Tae-Yong Ha,Gi-Won Song,Dong-Hwan Jung,Gil-Chun Park,Jung-Man Namgoong,Hyung-Woo Park,Chun-Soo Park,Sung-Hwa Kang,Bo-Hyeon Jung,Sung-Gyu Le 한국간담췌외과학회 2013 한국간담췌외과학회지 Vol.17 No.1

Backgrounds/Aims: Since most transplantation studies for alcoholic liver disease (ALD) were performed on deceased donor liver transplantation, little was known following living donor liver transplantation (LDLT). Methods: The clinical outcome of 18 ALD patients who underwent LDLT from Febraury 1997 to December 2004 in a large-volume liver transplantation center was assessed retrospectively. Results: The model for end-stage liver disease score was 23±11, and mean pretransplant abstinence period was 16±13 months, with 14 (77.8%) patients being abstinent for at least 6 months. Graft types were right lobe grafts in 11, left lobe grafts in 2 and dual grafts in 5. Graft to recipient body weight ratio was 0.94±0.16. The relapse rates in patients who did and did not maintain 6 months of abstinence were 7.1% and 50%, respectively (p=0.097). Younger recipient age was a significant risk factor for alcohol relapse (p=0.027). Five recipients with antibody to hepatitis B surface antigen (HBsAg) received core antibody-positive liver graft, but two of them showed positive HBsAg seroconversion. Overall 5-year patient survival rate following LDLT was 87.8%, with a 5-year relapse rate of 16.7%. Conclusions: Pretransplant abstinence for 6 months appears to be benefical for preventing posttransplant relapse. Life-long prophylactic measure should be followed after use of anti-HBc-positive liver grafts regardless of hepatitis B viral marker status of the recipient.

HPLC-UV method for the quantitative determination of sesquiterpenes in nardostachys rhizomes

Vu Ngoc Han Le,Thi Phuong Duyen Vu,Seol Gyu Park,Kyung Tae Kim,Jong Seong Kang 한국분석과학회 2016 학술대회논문집 Vol.2016 No.11

브라운 맥린증후군의 2예

이동영(Dongyoung Lee),한겨레(Gyu Le Han),임동희(Dong Hui Lim),정태영(Tae Young Chung) 대한안과학회 2021 대한안과학회지 Vol.62 No.8

목적: 백내장수술 후 무수정체안에서 나타나는 브라운 맥린증후군의 증례를 경험하여 이를 보고하고자 한다. 증례요약: (증례 1) 4년 전 좌안 백내장수술을 받고 무수정체 상태인 54세 말판증후군 여성이 안과 검사 중 우연히 좌안의 주변부 각막부종이 발견되었다. 각막 중심부는 정상이나 주변부가 전체적으로 융기되어 있었고, 환자도 이물감, 통증, 눈물 흘림 등의 증상을 호소했다. 경면현미경검사상 각막내피세포 수나 형태는 특이 소견이 없었다. 항생제, 자가혈청 안약, 5% NaCl 안약을 사용하였고, 각막부종이 호전되어 추적 관찰 중이다. (증례 2) 11년 전 양안 백내장수술 후 좌안은 무수정체 상태로 지내던 61세 여자 환자가 황반원공에 대한 수술 후 2개월째에 좌안 각막 주변부의 미란과 부종이 확인되었다. 경면현미경검사상 각막내피세포 수나 형태는 특이 소견이 없었다. 5% NaCl, 인공눈물 점안하며 경과를 보았고, 각막 중앙부 침범 없이 주변 각막부종도 악화되지 않아 추적 관찰 중이다. 결론: 브라운 맥린증후군은 드문 질환이지만, 백내장수술 후 무수정체 상태의 환자에서 수년 내 각막 주변부로 부종이 나타난다면 그 가능성을 고려해봐야 한다. Purpose: To report two rare cases of Brown McLean syndrome after cataract surgery in a patient with aphakia. Case summary: (Case 1) A 54-year-old woman with Marfan’s syndrome who had aphakia and peripheral corneal edema after left eye cataract surgery 4 years ago. The patient had an elevated lesion in the peripheral cornea without involving the central cornea, and had symptoms of pain, irritation and tearing. Specular microscopy showed normal endothelial cell density and morphology in the edematous cornea. The peripheral corneal edema improved after use of antibiotics, autoserum eyedrops and 5% NaCl eyedrops. (Case 2) A 61-year-old woman with aphakia in her left eye after bilateral cataract surgery 11 years ago, underwent surgery for a macular hole in both eyes. The patient developed peripheral corneal erosions and edema in the left eye 2 months after the surgery. Specular microscopy showed normal endothelial cell density and morphology. The peripheral corneal edema was static over the years while using 5% NaCl eyedrops and artificial tears, and did not progress to involve the central cornea. Conclusions: Brown McLean syndrome is a rare disease but the possibility should be considered if a patient with aphakia after cataract surgery has peripheral corneal edema for several years.

New Water-soluble Alkynylating Agent for Cell Surface Protein: Sulfosuccinimidyl 4-Pentynoate

Lim, Choon Woo,Le, Hoa Thi,Han, Ji Hye,Kim, Dong-Hwan,Jang, Jae Gyu,Kim, Tae Woo Korean Chemical Society 2013 Bulletin of the Korean Chemical Society Vol.34 No.6

New Water-soluble Alkynylating Agent for Cell Surface Protein: Sulfosuccinimidyl 4-Pentynoate

임춘우,Hoa Thi Le,Ji Hye Han,김동환,Jae Gyu Jang,김태우 대한화학회 2013 Bulletin of the Korean Chemical Society Vol.34 No.6

펨토초레이저 상피투과 활모양각막절개 시 절개부 개방이 난시교정에 미치는 영향

정준교(Joon Kyo Chung),한겨레(Gyu Le Han),노훈(Hoon Noh),임동희(Dong Hui Lim),정태영(Tae-Young Chung) 대한안과학회 2021 대한안과학회지 Vol.62 No.12

목적: 각막난시교정을 위한 펨토초레이저 상피투과 활모양각막절개 시 절개부를 그대로 유지하는 방법에 비해 절개부를 개방하는 방법에서의 난시교정 효과를 살펴보고자 하였다. 대상과 방법: 2016년 4월부터 2018년 12월까지 삼성서울병원 안과에서 펨토초레이저 백내장수술을 받을 환자를 대상으로 후향적으로 조사하였다. 절개부 개방군, 절개부 유지군에 대해 수술 전후로 각막난시의 크기 비교 및 벡터분석을 시행하였다. 결과: 절개부 개방군과 절개부 유지군에서 target induced astigmatism (TIA)가 각각 1.28 ± 0.55, 1.26 ± 0.29디옵터, surgically induced astigmatism (SIA)가 각각 0.80 ± 0.52, 0.53 ± 0.32디옵터, correction index (CI)가 각각 0.63 ± 0.28, 0.43 ± 0.26으로, 절개부 유지군보다 절개부 개방군에서 난시교정 효과가 더 큰 것으로 나타났다(p=0.048, p=0.025). TIA가 1.2디옵터 미만인 하위집단에서는 두 군의 SIA 및 CI가 유의한 차이가 없었으나, TIA가 1.2디옵터 이상인 하위집단에서는 SIA가 절개부 개방군, 유지군에서 각각 1.09 ± 0.59, 0.54 ± 0.37디옵터, CI는 0.60 ± 0.28, 0.36 ± 0.23으로 절개부 개방군에서 난시교정 효과가 큰 것으로 나타났다(p=0.022, p=0.047). 결론: 펨토초레이저 상피투과 활모양각막절개 시 절개부를 개방하는 방식이 절개부를 유지하는 방식보다 더 큰 난시교정 효과를 보였다. Purpose: The purpose of this study was to compare corneal astigmatism correction between “wound open” and “wound intact” methods during femtosecond laser-assisted transepithelial arcuate keratotomy. Methods: From April 2016 to December 2018, a retrospective survey was conducted on patients undergoing femtosecond laser cataract surgery at the Ophthalmology Department of Samsung Medical Center. Size comparison and vector analysis of corneal astigmatism before and after surgery were performed in the wound open and wound intact groups. Results: In the wound open and wound intact groups, the target-induced astigmatism (TIA) was 1.28 ± 0.55; and 1.26 ± 0.29 diopters, the surgically induced astigmatism (SIA) was 0.80 ± 0.52; and 0.53 ± 0.32 diopters, and the correction index (CI) was 0.63 ± 0.28; and 0.43 ± 0.26, respectively. The astigmatism correction was superior in the wound open group (p = 0.048, p = 0.025). In a subgroup with TIA < 1.2 diopters, there were no significant differences in SIA or CI between the two groups; however, in the subgroup with a TIA > 1.2 diopters, the SIA was 1.09 ± 0.59; and 0.54 ± 0.37 diopters and the CI was 0.60 ± 0.28; and 0.36 ± 0.23 in the wound open and wound intact groups, respectively (p = 0.022, p = 0.047). Thus, astigmatism correction was superior in the wound open group. Conclusions: The wound open method during femtosecond laser-assisted transepithelial arcuate keratotomy was superior for astigmatism correction compared to the wound intact method.