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눈물점 마개 사용 후 발생한 Staphylococcus epidermidis에 의한 눈물소관염 1예
석수지,이중호,서억수,이종임 동국대학교 의학연구소 2008 東國醫學 Vol.15 No.1
안구 건조증으로 5년 전 좌안의 아래 눈물점에 실리콘 눈물점 마개를 삽입한 53세 여자 환자로 1년 전부터 좌안에 지속적인 눈꼽낌과 눈물흘림을 주소로 내원하였다. 내원시 눈물점에서 비후성 조직 소견과 황색 분비물이 관찰되었다. 실리콘 눈물점 마개 삽입 후 발생한 눈물소관염 진단 하에 항생제 점안을 시행하였으나, 증상이 호전되지 않아 눈물소관절개술과 긁어냄술을 시행하여 눈물점 마개를 제거하였다. 눈물점 입구 분비물의 세균배양 검사에서 표피포도알균(Staphylococcus epidermidis)이 배양되었으며, 조직 검사에서 만성 활동성 염증소견이 나왔다. 눈물점 마개 사용 후 발생한 눈물소관염은 약물 치료가 쉽지 않으며 수술적 치료가 필요할 수 있으므로, 그 사용에 있어서 신중함과 제한적 선택 그리고 사용 후 주의 깊은 관찰을 요한다. A 53-year-o1d woman who had undergone implantation of a punctal plug 5 years ago presented with a pinkish mass over the left lower punctum and recurrent mucopurulent discharge lasted for a year. Under the diagnosis of lacrimal duct inflammation, curettage in the lacrimal duct and histologic examination were carried out. Staphylcoccus epidermidis was cultured but did not response to antibiotics eye drop. The lacrimal silicone plug was then removed from the lacrimal duct at the time of the lacrimal duct curettage and tissue biopsy revealed active chronic inflammation. Complications after the use of punctal plugs are relatively intractable should be surgcally treated. These punctal plugs have to be used with careful selection of indication and we should observe the patient carefully.
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헤르페스 각막염 후 발생한 각막 신생혈관에서 Bevacizumab 점안액 적용 1예
석수지,서억수,정보영,김호창 동국대학교 의학연구소 2009 東國醫學 Vol.16 No.1
각막 신생혈관은 각막의 염증성,허혈성 변성,외상성 질환 등에 의해 혈관형성인자와 혈관형성억제인자의 균형이 깨지면서 발생하며, VEGF가 각막의 신생혈관 형성에 중요한 역할을 한다. 64세 남자환자로 헤르페스 바이러스 감염 후 각막 염증이 지속되면서 각막의 전 영역에 신생혈관이 발생하였으며, 이로 인한각막혼탁으로 시력저하를 호소하였다. 신생혈관 억제를 위해 단기간동안 VEGF 억제제인 1.25% bevacizumab을 하루에 2회 점안 후 반복적으로 시력측정과 세극등검사를 시행하였다. 4개월 점안 후 각막 신생혈관이 억제되고 각막 혼탁이 호전되는 것을 확인하고 이를 보고하는 바이다. Corneal neovascularization occur as a result of disequilibrium between angiogenic and antiangiogenic stimuli, caused by inflammation, ischemia and truama. VEFG is a important factor of corneal neovascularization. 64 year-old man with herpetic keratitis presented with a complant of decreased vision. He also presented with ocular surface inflammation and corneal new vessels on the whole cornea. He received 1.25% topical bevacizumab twice daily that is directed against VGEF. Ophthalmic evaluation included visual acuity and slit-lamp examination. 4 months later, topically administered bevacizumab reduces corneal new vessles and corneal opacity
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석수지,김호창,정보영,서억수,정병욱 동국대학교 의학연구소 2009 東國醫學 Vol.15 No.2
결핵성 눈물샘염은 매우 드물게 발생하며 주로 혈액을 통해 감염되거나 결막 또는 부비동으로부터 직접 전파되어 발생할 수 있다. 진단은 특징적인 조직 병리 소견으로 확진하며 피부 결핵 반응 검사, 항산균 염색법, 세균 배양법등도 진단에 도움이 된다. 임상소견은 무통성 종괴로 나타날 수 있으며, 눈물샘에 흔히 발생하는 양성 혼합 종양과 감별하기 위해 절제 생검과 병리조직검사를 시행하여야 하며, 항결핵제 요법을 시행한다. 저자들은 64세 여자환자에서 특별한 안증상이나 피부증상 없이 발생한 좌측 안와 종괴를 절제 생검하여 결핵성 눈물샘염을 진단하고 항결핵제를 투여하여 완치를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Infection of the lacrimal gland by the M. tuberculosis is uncommon. It usually occur by hematogenous spread from some other systemic focus or directly from primary conjunctival tuberculosis or from the paranasal sinuses. The diagnosis is established through specific histopathologic finding, tuberculin skin test and the stain and culture of acid-fast bacilli. The presenting symptom is usually painless swelling of the eyelid, mimicking a benign mixed tumor of the lacrimal gland. Treatment with anti-tubercular drugs is mandatory in lacrimal gland tuberculosis. The authors experienced a case of primary tuberculosis of the lacrimal gland which occurred in a 64 year-old female whose showed painless swelling of eyelid and which was treated with excisional biopsy and anti-tuberculosis medication.
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점안제로 오인하여 사용한 순간접착제에 의한 안손상의 임상양상 및 예방법
석수지,이승우,서억수,김호창,Susie Soek,Seung Woo Lee,Euk Su Suh,Ho Chang Kim 대한안과학회 2010 대한안과학회지 Vol.51 No.10
Purpose: To investigate the clinical features and prevention of ocular injuries associated with the mistaken use of superglue as eyedrops. Methods: Medical records of 13 patients with ocular superglue injury who visited our hospital from January 1, 2002 to December 31, 2004 were analyzed. The clinical features of ocular superglue injury and causes of using superglue instead of eyedrops for each patient were analyzed. Results: The present study involved 15 eyes of 13 patients, including seven men (53.8%) and six women (46.2%), ranging from 6 to 72 years of age, with a mean age of 38.4 years. Ocular superglue injuries were corneal abrasion in all patients. The bonding of eyelids (eight cases, 61.5%) and eyelashes (two cases, 15.4%) were identified. Ocular injuries were treated conservatively and resolved without complications. The major cause of mistaken use of superglue was similarly packaged eye drops (11 cases, 84.6%). Other causes included poor eyesight (one case) and unsupervised children (one case). Conclusions: The availability of eyedrops in various ocular diseases has recently increased, and superglue is found in many households, wherefore incidence of ocular superglue injuries can increase. Therefore, modifying the design of superglue bottles and providing proper education for patients to prevent ocular superglue injury is important. J Korean Ophthalmol Soc 2010;51(10):1398-1402
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석수자,박수진,이재락 한국화학공학회 2007 화학공학의이론과응용 Vol.10 No.2
In this work, the epoxy resins (DGEBA) were cured by two cationic latent thermal catalysts, i.e., N-benzylpyrazinium hexafluoroantimonate (BPH) and benzyl-2,5-dimethyl-pyrazinium hexafluoroantimonate (BDPH) to investigate the effect of substituted methyl groups of BDPH on thermal and mechanical interfacial properties of the specimens. Cure behaviors of the epoxy resins using the two catalysts were determined by dynamic differential scanning calorimetry. The mechanical interfacial properties of the cured epoxy were also characterized by critical stress intensity factor ( KIC). As a result, the conversion and cure activation energy of the DGEBA/BDPH system were higher than those of DGEBA/BPH system. The KIC of DGEBA/BDPH system was also superior, as compared with DGEBA/BDPH system. These results were probably due to the effect of substituted methyl groups of BDPH, which was modified from BPH, resulting in increasing the crosslinking density and structural stability in the epoxy resins studied.
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