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홈 > 분야별

의약학 > 기타의약학 (20,803건)

Projected lifetime cancer risk from cone-beam computed tomography for orthodontic treatment
Projected lifetime cancer risk from cone-beam computed tomography for orthodontic treatment
Nayansi Jha;Yoon-Ji Kim;Youngjun Lee;Ju Young Lee;Won Jin Lee;Sang-Jin Sung
대한치과교정학회 / The Korean Journal of Orthodontics 제51권 제3호 / 2021 / 189-198 (10 pages)
의약학>기타의약학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 치의학
* 이 논문은 저작권자의 요청으로 무료로 제공됩니다.
초록보기
Objective: To estimate the projected cancer risk attributable to diagnostic cone-beam computed tomography (CBCT) performed under different exposure settings for orthodontic purposes in children and adults. Methods: We collected a list of CBCT machines and their specifications from 38 orthodontists. Organ doses were estimated using median and maximum exposure settings of 105 kVp/156.8 mAs and 130 kVp/200 mAs, respectively. The projected cancer risk attributable to CBCT procedures performed 1–3 times within 2 years was calculated for children (aged 5 and 10 years) and adult (aged 20, 30, and 40 years) male and female patients. Results: For maximum exposure settings, the mean lifetime fractional ratio (LFR) was 14.28% for children and 0.91% for adults; this indicated that the risk to children was 16 times the risk to adults. For median exposure settings, the mean LFR was 5.25% and 0.58% for children and adults, respectively. The risk of cancer decreased with increasing age. For both median and maximum exposure settings, females showed a higher risk of cancer than did males in all age groups. Cancer risk increased with an increase in the frequency of CBCT procedures within a given period. Conclusions: The projected dental CBCT-associated cancer risk spans over a wide range depending on the machine parameters and image acquisition settings. Children and female patients are at a higher risk of developing cancer associated with diagnostic CBCT. Therefore, the use of diagnostic CBCT should be justified, and protective measures should be taken to minimize the harmful biological effects of radiation.
IN MEMORIAM
IN MEMORIAM
Dong-Seok Nahm
대한치과교정학회 / The Korean Journal of Orthodontics 제51권 제3호 / 2021 / 1-1 (1 pages)
의약학>기타의약학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 치의학
* 이 논문은 저작권자의 요청으로 무료로 제공됩니다.
Midfacial soft tissue changes after maxillary expansion using micro-implant-supported maxillary skeletal expanders in young adults
Midfacial soft tissue changes after maxillary expansion using micro-implant-supported maxillary skeletal expanders in young adults
Hieu Nguyen;Jeong Won Shin;Hai-Van Giap;Ki Beom Kim;Hwa Sung Chae;Young Ho Kim;Hae Won Choi
대한치과교정학회 / The Korean Journal of Orthodontics 제51권 제3호 / 2021 / 145-156 (12 pages)
의약학>기타의약학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 치의학
* 이 논문은 저작권자의 요청으로 무료로 제공됩니다.
초록보기
soft tissue changes following maxillary expansion using micro-implantsupported maxillary skeletal expanders (MSEs) in young adults by cone-beam computerized tomography (CBCT) and to evaluate the correlations between hard and soft tissue changes after MSE usage. Methods: Twenty patients (mean age, 22.4 years; range, 17.6–27.1) with maxillary transverse deficiency treated with MSEs were selected. Mean expansion amount was 6.5 mm. CBCT images taken before and after expansion were superimposed to measure the changes in soft and hard tissue landmarks. Statistical analyses were performed using paired t-test and Pearson’s correlation analysis on the basis of the normality of data. Results: Average lateral movement of the cheek points was 1.35 mm (right) and 1.08 mm (left), and that of the alar curvature points was 1.03 mm (right) and 1.02 mm (left). Average forward displacement of the cheek points was 0.59 mm (right) and 0.44 mm (left), and that of the alar curvature points was 0.61 mm (right) and 0.77 mm (left) (p < 0.05). Anterior nasal spine (ANS), posterior nasal spine (PNS), and alveolar bone width showed significant increments (p < 0.05). Changes in the cheek and alar curvature points on both sides significantly correlated with hard tissue changes (p < 0.05). Conclusions: Maxillary expansion using MSEs resulted in significant lateral and forward movements of the soft tissues of cheek and alar curvature points on both sides in young adults and correlated with the maxillary suture opening at the ANS and PNS.
Evaluation of strategic uprighting of the mandibular molars using an orthodontic miniplate and a nickel-titanium reverse curve arch wire
Evaluation of strategic uprighting of the mandibular molars using an orthodontic miniplate and a nickel-titanium reverse curve arch wire
Jae-Hyun Park;HyeRan Choo;Jin-Young Choi;Kyu-Rhim Chung;Seong-Hun Kim
대한치과교정학회 / The Korean Journal of Orthodontics 제51권 제3호 / 2021 / 179-188 (10 pages)
의약학>기타의약학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 치의학
* 이 논문은 저작권자의 요청으로 무료로 제공됩니다.
초록보기
Objective: To evaluate the overall treatment effects in terms of the amount of uprighting with changes in the sagittal and vertical positions of mandibular molars after applying an orthodontic miniplate with a nickel-titanium (NiTi) reverse curve arch wire (biocreative reverse curve [BRC] system). Methods: A total of 30 female patients (mean age, 25.99 ± 8.96 years) were treated with the BRC system (mean BRC time, 10.3 ± 4.07 months). An I-shaped C-tube miniplate (Jin Biomed) was placed at the labial aspect for the alveolar bone of the mandibular incisors. A 0.017 × 0.025-inch NiTi reverse curve arch wire was engaged at the C-tube mini-plate anteriorly and the first and second premolars and molars posteriorly in the mandibular arch. Pre- and post-BRC lateral cephalograms were analyzed. A paired t-test was used to analyze the treatment effects of BRC. Results: The mandibular second molars were intrusively uprighted successfully by the BRC system. Distal uprighting with a controlled vertical dimension was noted on the first molars when they remained engaged in the BRC and the distal ends of the arch wire were laid on the second molars. The mandibular first and second premolars showed a slight extrusion. The changes in the mandibular incisors were unremarkable, while the mandibular molar angulation improved significantly. The lower occlusal plane rotated counterclockwise (MP-LOP: 1.13° ± 2.60°). Conclusions: The BRC system can provide very effective molar uprighting without compromising the position of the mandibular anterior teeth.
Nonsurgical maxillary expansion in a 60-year-old patient with gingival recession and crowding
Nonsurgical maxillary expansion in a 60-year-old patient with gingival recession and crowding
Harim Kim;Sun-Hyung Park;Jae Hyun Park;Kee-Joon Lee
대한치과교정학회 / The Korean Journal of Orthodontics 제51권 제3호 / 2021 / 217-227 (11 pages)
의약학>기타의약학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 치의학
* 이 논문은 저작권자의 요청으로 무료로 제공됩니다.
초록보기
Maxillary transverse deficiency often manifests as a posterior crossbite or edgeto- edge bite and anterior crowding. However, arbitrary arch expansion in mature patients has been considered to be challenging due to the possible periodontal adverse effects such as alveolar bone dehiscence and gingival recession. To overcome these limitations, nonsurgical maxillary expansion of the basal bone has been demonstrated in young adults. However, the age range for successful orthopedic expansion has remained a topic of debate, possibly due to the underlying individual variations in suture maturity. This case report illustrates nonsurgical, miniscrew-assisted rapid palatal expansion (MARPE) in a 60-yearold patient with maxillary transverse deficiency accompanied by anterior and posterior crossbites, crowding, and gingival recession. The use of MARPE allowed relief of crowding and correction of the crossbite without causing significant periodontal adverse effects.
READER’S FORUM
READER’S FORUM
Mihee Hong;Myung-Jin;Kim, Hye Jung;Shin, Heon Jae;Cho, Seung-Hak Baek
대한치과교정학회 / The Korean Journal of Orthodontics 제51권 제3호 / 2021 / 1-2 (2 pages)
의약학>기타의약학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 치의학
* 이 논문은 저작권자의 요청으로 무료로 제공됩니다.
Effect of extraction treatment on upper airway dimensions in patients with bimaxillary skeletal protrusion relative to their vertical skeletal pattern
Effect of extraction treatment on upper airway dimensions in patients with bimaxillary skeletal protrusion relative to their vertical skeletal pattern
Ha-Nul Cho;Hyun Joo Yoon;Jae Hyun Park;Young-Guk Park;Su-Jung Kim
대한치과교정학회 / The Korean Journal of Orthodontics 제51권 제3호 / 2021 / 166-178 (13 pages)
의약학>기타의약학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 치의학
* 이 논문은 저작권자의 요청으로 무료로 제공됩니다.
초록보기
Objective: To investigate dimensional changes in regional pharyngeal airway spaces after premolar extraction in bimaxillary skeletal protrusion (BSP) patients according to vertical skeletal pattern, and to further identify dentoskeletal risk factors to predict posttreatment pharyngeal changes. Methods: Fiftyfive adults showing BSP treated with microimplant anchorage after four premolar extractions were included in this retrospective study. The subjects were divided into two groups according to the mandibular plane steepness: hyperdivergent (Frankfort horizontal plane to mandibular plane [FH-MP] ≥ 30) and nonhyperdivergent groups (FH-MP < 30). The control group consisted of 20 untreated adults with skeletal Class I normodivergent pattern and favorable profile. Treatment changes in cephalometric variables were evaluated and compared. The association between posttreatment changes in the dentoskeletal and upper airway variables were analyzed using linear regression analysis. Results: The BSP patients showed no significant decrease in the pharyngeal dimensions to the lower level in comparison with controls, except for middle airway space (MAS, p < 0.01). The upper airway variable representing greater decrease in the hyperdivergent group than in the nonhyperdivergent group was the MAS (p < 0.01). Posttreatment changes in FH-MP had negative correlation with changes in MAS (β = –0.42, p < 0.01) and inferior airway space (β = –0.52, p < 0.01) as a result of multivariable regression analysis adjusted for sagittal skeletal relationship. Conclusions: Decreased pharyngeal dimensions after treatment in BSP patients showed no significant difference from the normal range of pharyngeal dimensions. However, the glossopharyngeal airway space may be susceptible to treatment when vertical dimension increased in hyperdivergent BSP patients.
Complications reported with the use of orthodontic miniscrews
Complications reported with the use of orthodontic miniscrews
Antonino Lo Giudice;Lorenzo Rustico;;Miriam Longo;Giacomo Oteri;Moschos A. Papadopoulos;Riccardo Nucera
대한치과교정학회 / The Korean Journal of Orthodontics 제51권 제3호 / 2021 / 199-216 (18 pages)
의약학>기타의약학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 치의학
* 이 논문은 저작권자의 요청으로 무료로 제공됩니다.
초록보기
Objective: The aim of this systematic review was to evaluate the complications and side effects associated with the clinical use of orthodontic miniscrews by systematically reviewing the best available evidence. Methods: A survey of articles published up to March 2020 investigating the complications associated with miniscrew insertion, in both the maxilla and mandible, was performed using 7 electronic databases. Clinical studies, case reports, and case series reporting complications associated with the use of orthodontic miniscrew implants were included. Two authors independently performed study selection, data extraction, and risk-of-bias assessment. Results: The database survey yielded 24 articles. The risk-of-bias assessment revealed low methodological quality for the included studies. The most frequent adverse event reported was root injury with an associated periradicular lesion, vitality loss, pink discoloration of the tooth, and transitory loss of pulp sensitivity. Chronic inflammation of the soft tissue surrounding the miniscrew with mucosal overgrowth was also reported. The other adverse events reported were lesion of the buccal mucosa at the insertion site, soft-tissue necrosis, and perforation of the floor of the nasal cavity and maxillary sinus. Adverse events were also reported after miniscrew removal and included secondary bleeding, miniscrew fracture, scars, and exostosis. Conclusions: These findings highlight the need for clinicians to preliminarily assess generic and specific insertion site complications and side effects.
The effect of different micro-osteoperforation depths on the rate of orthodontic tooth movement
The effect of different micro-osteoperforation depths on the rate of orthodontic tooth movement
Tugba Haliloglu Ozkan;Selim Arici
대한치과교정학회 / The Korean Journal of Orthodontics 제51권 제3호 / 2021 / 157-165 (9 pages)
의약학>기타의약학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 치의학
* 이 논문은 저작권자의 요청으로 무료로 제공됩니다.
초록보기
Objective: This study aimed to identify the clinical effectiveness of two different penetration depths of micro-osteoperforations (MOPs) on the rate of orthodontic tooth movement. Methods: Twenty-four patients requiring the removal of the upper first premolar teeth were selected and randomly divided into two groups. The control group participants did not undergo MOPs. Participants in the experimental group underwent three MOPs each at 4-mm (MOP-4) and 7-mm (MOP-7) depths, which were randomly and equally performed to either the left or right side distal to the canine. The retraction amount was measured on three-dimensional digital models on the 28th day of retraction. MOP-related pain was measured using a visual analog scale (VAS). Between-group statistical differences in the VAS scores were determined using an independent t-test and those in canine retraction were determined using analysis of variance and posthoc Tukey test. Results: No significant difference was found between the MOP- 4 (1.22 ± 0.29 mm/month) and MOP-7 (1.29 ± 0.31 mm/month) groups in terms of the canine retraction rate. Moreover, both the groups demonstrated a significantly higher canine movement than the control group (0.88 ± 0.19 mm/ month). MOPs did not significantly affect the mesialization of the posterior teeth (p > 0.05). Moreover, the pain scores in the MOP-4 and MOP-7 groups were similar and showed no statistically significant difference. Conclusions: Three MOPs with a depth of 4 mm can be performed as an effective method to increase the rate of tooth movement. However, three MOPs with depths of 4–7 mm does not additionally enhance tooth movement.
Antiphospholipid Syndrome of Bilateral Nonarteritic Anterior Ischemic Optic Neuropathy Patient Deteriorating Over Time
Antiphospholipid Syndrome of Bilateral Nonarteritic Anterior Ischemic Optic Neuropathy Patient Deteriorating Over Time
조용운(Yong Wun Cho);김병선(Byoung Seon Kim);유웅선(Woong-Sun Yoo);서성욱(Seong-Wook Seo);정인영(In Young Chung)
대한안과학회 / The Korean Journal of Ophthalmology 제35권 제2호 / 2021 / 168-170 (3 pages)
의약학>기타의약학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 안과학
Surgical Outcomes of Medial Rectus Recession and Lateral Rectus Resection for Large-angle Deviations of Acute Acquired Concomitant Esotropia
Surgical Outcomes of Medial Rectus Recession and Lateral Rectus Resection for Large-angle Deviations of Acute Acquired Concomitant Esotropia
Wonki Kang;Won Jae Kim
대한안과학회 / The Korean Journal of Ophthalmology 제35권 제2호 / 2021 / 101-106 (6 pages)
의약학>기타의약학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 안과학
초록보기
Purpose: This study aimed to evaluate the surgical outcomes of unilateral medial rectus recession and lateral rectus resection(R&R) for patients with large-angle deviations of acute acquired concomitant esotropia (AACE) without a neurologicaldisease. Further, we have also suggested the surgical dosage of R&R for large-angle deviations of AACE. Methods: This was a retrospective study of patients with AACE who underwent surgery and followed up after surgery for atleast 6 months between September 2016 and March 2020. Among them, patients with ocular deviations of ≥30 prism diopters(PD) who underwent unilateral R&R were included. Results: Seventeen patients with AACE were enrolled in this study (mean age, 23.5 years; four females). The mean amount ofdeviation was 40.00 PD at distance and near (range, 30–55 PD). Fifteen patients (88.2%) had myopia. The mean interval betweenthe initial visit and surgery was 7.7 months (range, 4–20 months). All included patients had resolved diplopia after thesurgery. Most patients with decreased stereoacuity displayed stereoacuity recovery after surgical treatment. At the final visit(mean follow-up period, 12.8 months), the mean angle of esodeviation was 0.82 PD (range, 6–0 PD) at distance and 0.47 PD(range, 4–0 PD) near. No patient displayed over-correction or adduction limitations in the operated eye. Conclusions: The unilateral R&R procedure presented favorable surgical outcomes for patients with large-angle deviations ofAACE. These results and proposed surgical dosage guidelines may be useful for surgeons in planning the surgical treatment oflarge-angle deviations of AACE.
외국의 약품비 지출 관리 정책 현황과 국내 시사점
외국의 약품비 지출 관리 정책 현황과 국내 시사점
박다혜(Dahye Park);이혜영(HyeYeong Lee);김동숙(Dong-Sook Kim)
대한약학회 / 약학회지 제65권 제2호 / 2021 / 121-131 (11 pages)
의약학>기타의약학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 약학
초록보기
The aging population and increasing demand have threatened the sustainability of the National Health Insurance (NHI) system. Although spending efficiency is crucial, few studies exist on the method of setting pharmaceutical expenditure budgets. As this study reviewed drug spending prediction and control measures, it attempted to derive implications from domestic policy. We conducted a report review of the Organisation for Economic Cooperation and Development (OECD). Further, we conducted interviews with seven experts in pharmaceutical policy-related academia and Health Insurance Review & Assessment Service (HIRA) practitioners. The results showed that 13 out of 22 countries regularly set public pharmaceutical spending budgets. Additionally, to control pharmaceutical expenditures, numerous foreign countries have implemented policies on pricing and reimbursements. The results of the interview on the domestic drug spending control policy highlighted the necessity of a demand-based policy targeting physicians and patients. Based on the review of foreign policies and the interview results, we suggest the necessity of projecting future expenditures and using the soft drug expenditure limit.
테논낭밑마취 후 발생한 결막의 화농육아종 1예
테논낭밑마취 후 발생한 결막의 화농육아종 1예
이승현(Seung Hyeun Lee);김경우(Kyoung Woo Kim);전연숙(Yeoun Sook Chun)
대한안과학회 / 대한안과학회지 제62권 제4호 / 2021 / 566-570 (5 pages)
의약학>기타의약학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 안과학
초록보기
목적: 백내장수술 중 시행한 하이측부 결막의 테논낭밑마취 후 발생한 결막 화농육아종 증례를 보고하고자 한다. 증례요약: 노년백내장, 당뇨망막병증 및 원발개방각녹내장으로 진단받고 티몰롤/타플루프로스트 복합제제 및 브리모니딘 안약 점안중이던 74세 남자 환자가 우안 하이측부 결막에 테논낭밑마취 후 백내장수술을 받았으며 수술 중 특이 사항은 없었다. 수술 후 통상적인 치료로 목시플록사신, 1% 프레드니솔론 아세테이트 및 0.1% 브롬페낙 나트륨 수화물을 1달간 점안하였다. 수술 1달 후 테논낭밑마취 시행 부위인 하이측 결막에서 자라나오는 분홍빛 타원형의 육아종성 종괴가 발생하였다. 이에 종괴의 절제 없이 덱사메타손 함유 항생제 안약을 투약하였으며 2주 후 종괴의 크기는 현저히 줄어들었고, 6주 후 종괴는 완전히 사라졌다. 결론: 테논낭밑마취 후 시행한 백내장수술 후 결막 화농육아종이 생길 수 있음을 환자에게 설명해야 하며, 화농육아종의 발생 가능성을 염두에 두고 경과 관찰 시 마취 부위 확인, 안약 점안의 순응도 등을 확인할 필요가 있다. 이 경우 스테로이드 약물만으로도 성공적인 치료가 가능하다.
비증식당뇨망막증과 증식당뇨망막증에서 범망막광응고술 후 형광안저조영술로 측정한 망막순환시간의 변화
비증식당뇨망막증과 증식당뇨망막증에서 범망막광응고술 후 형광안저조영술로 측정한 망막순환시간의 변화
심하은(Ha Eun Sim);이정현(Jeong Hyun Lee);박재용(Jae Yong Park);최진(Jin Choi);강민지(Min Ji Kang);황제형(Je Hyung Hwang);김재석(Jae Suk Kim)
대한안과학회 / 대한안과학회지 제62권 제4호 / 2021 / 507-515 (9 pages)
의약학>기타의약학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 안과학
초록보기
목적: 심한 비증식당뇨망막병증과 초기 증식당뇨망막병증 환자에게 범망막광응고술 시행 후 망막순환시간의 변화량을 통해 범망막광응고술의 망막혈류 순환 개선 효과가 당뇨망막병증 중증도별로 차이가 있는지 비교하고자 한다. 대상과 방법: 심한 비증식당뇨망막병증과 초기 증식당뇨망막병증 환자 중 범망막광응고술이 필요하다고 판단되는 환자들을 대상으로 범망막광응고술 시행 전후로 비디오 형광안저혈관조영술을 시행하여 동맥순환시간, 동정맥통과시간, 정맥충만시간의 변화를 당뇨망막병증의 중증도에 따른 환자군으로 나누어 비교 분석하였다. 결과: 총 33명 환자에 심한 비증식당뇨망막병증 환자 17명과 초기 증식당뇨망막병증 환자 16명이 포함되었다. 동맥순환시간과 동정맥통과시간은 심한 비증식당뇨망막병증 환자군(p=0.927, p=0.138)과 초기 증식당뇨망막병증 환자군(p=0.137, p=0.268)에서 범망막광응고술 전후로 유의한 차이가 없었다. 정맥충만시간은 심한 비증식당뇨망막병증 환자군(p=0.000)과 초기 증식당뇨망막병증 환자군(p=0.022) 모두 범망막광응고술 시행 후 유의하게 단축되었다. 하지만 정맥충만시간의 단축 정도는 심한 비증식당뇨망막병증 환자군과 초기 증식당뇨망병증 환자군 사이에 유의한 차이가 없었다(p=0.217). 결론: 정맥충만시간의 감소를 통해 심한 비증식당뇨망막병증 환자와 초기 증식당뇨망막병증 환자에게 범망막광응고술 시행 후 망막혈류 순환 개선 효과를 확인할 수 있었다. 따라서, 심한 비증식당뇨망막병증 환자와 초기 증식당뇨망막병증 환자에서 범망막광응고술 시행을 통해 얻을 수 있는 혈류 개선 효과가 비슷하다고 유추해볼 수 있다.
의약품 허가 규제 국제 협력에서의 허가참조제도
의약품 허가 규제 국제 협력에서의 허가참조제도
권진원(Jin-Won Kwon);송윤경(Yun-Kyoung Song);이승미(Seung-Mi Lee);박은혜(Eun-Hye Park);시아차린가린다(Siachalinga Linda);박희영(Hee Young Park);공수진(Su Jin Kong);이인향(Iyn-Hyang Lee)
대한약학회 / 약학회지 제65권 제2호 / 2021 / 141-149 (9 pages)
의약학>기타의약학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 약학
초록보기
This study sought to understand the current regulatory collaboration practices of reference country systems in selected countries. The study included eight countries, namely; Nigeria, South Africa, Malaysia, Vietnam, Singapore, Indonesia, Switzerland, Mexico, and two alliances;, namely European Union and ACCESS consortium. The latest data on the reference country systems in the selected countries were collected and analyzed. The reference regulatory authorities include (1) internationally recognized countries (e.g., Stringent Regulatory Authority, SRA), (2) internationally recognized collaborations (e.g. Pharmaceutical Inspection Co-operation Scheme), (3) internationally recognized programs (e.g., WHO Prequalification), and (4) mutual recognition between countries. The SRA is the most frequently mentioned reference in unilateral reference systems, which are not based on mutual recognition. A reference country system could affect regulatory processes in two ways; either by countries requiring market approval from a reference country as a condition for a new application or by reducing the period of review if an applicant submits an assessment report and relevant data reviewed by a reference country. The European Union Mutual Recognition has resulted into efficient work-flow among member states, and similar international alliances are emerging. Of these, the ACCESS consortium is seeking the possibility of a new collaboration not based on geographical region, in contrast to regional collaboration, which seems seclusive to worksharing among nonequivalent member states.
가속 각막 교차결합술과 라섹 병합 수술의 장기간 효용성과 안정성
가속 각막 교차결합술과 라섹 병합 수술의 장기간 효용성과 안정성
윤이상(Yi Sang Yoon);김국영(Kook Young Kim)
대한안과학회 / 대한안과학회지 제62권 제4호 / 2021 / 439-446 (8 pages)
의약학>기타의약학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 안과학
초록보기
목적: 가속 각막 콜라겐 교차결합술을 함께 시행한 라섹(아베드로라섹) 환자군과 라섹수술을 단독으로 시행한 환자들을 2년간 경과 관찰하여 효용성과 안정성을 비교 평가하였다. 대상과 방법: 후향적 연구로 아베드로라섹 19명 38안, 대조군인 라섹 17명 34안을 대상으로 2년간 추적 관찰하여 나안시력의 변화, 구면렌즈대응치의 변화, 각막곡률도의 변화, 술 후 각막 염증의 유무 등을 비교, 분석하였다. 결과: 수술 전 두 군 간의 구면렌즈대응치(p<0.05)와 중심각막두께(p<0.05)는 유의한 차이를 보였다. 아베드로라섹군과 라섹 환자군의 나안시력은 수술 후 2년간 통계적으로 유의한 차이는 없었다. 구면렌즈대응치와 각막곡률도의 변화에도 술 후 2년간의 경과 관찰에서 유의한 차이를 보이지 않았다. 2년째 구면렌즈대응치는 아베드로라섹군 92%에서 ±0.25디옵터, 라섹수술을 받은 환자 90.2%에서 ±0.5디옵터 이내에 있었으며 두 군 모두 높은 시력 예측도를 보였다. 아베드로라섹군과 라섹 환자군 간 시간의 영향을 보정한 상태에서 수술 방법 차이에 따른 수평각막곡률값(p=0.38)과 수직각막곡률값(p=0.56)은 유의한 차이가 없었다. 아베드로라섹 환자군 중 21%에서 주변부 각막 염증이 관찰되었으나 시력저하나 각막확장증은 관찰되지 않았다. 결론: 2년간의 장기 경과 관찰 기간 동안 아베드로라섹과 라섹을 시행한 두 환자군 간의 유의한 차이는 보이지 않았고, 두 시술 모두 안정성과 효용성이 있어 효과적인 근시교정수술 방법으로 생각된다.
Association with Corneal Remodeling Related Genes, ALDH3A1, LOX, and SPARC Genes Variations in Korean Keratoconus Patients
Association with Corneal Remodeling Related Genes, ALDH3A1, LOX, and SPARC Genes Variations in Korean Keratoconus Patients
Jee-Won Mok;Ha-Rim So;Min-Ji Ha;Kyung-Sun Na;Choun-Ki Joo
대한안과학회 / The Korean Journal of Ophthalmology 제35권 제2호 / 2021 / 120-129 (10 pages)
의약학>기타의약학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 안과학
초록보기
Purpose: To determine whether the cornea remodeling-related genes aldehyde dehydrogenase 3A1 (ALDH3A1), lysyl oxidase(LOX), and secreted protein acidic and rich in cysteine (SPARC) were potential susceptibility candidate genes for keratoconusin Korean patients, we investigated the associations of single nucleotide polymorphisms (SNPs) in these three genes in Koreanpatients with keratoconus. Methods: Genomic DNA was extracted from blood samples of unrelated patients with keratoconus and healthy control individuals. For screening of genetic variations, all exons from the entire coding regions of the ALDH3A1, LOX, and SPARC geneswere directly sequenced to determine the presence of mutations. Control individuals were selected from the general populationwithout keratoconus. Results: In this study, we detected nine SNPs in ALDH3A1, four SNPs in LOX, and 18 SNPs in SPARC. rs116992290, IVS3-62c>t,rs116962241, and rs2228100 in ALDH3A1 and rs2956540 and rs1800449 in LOX were significantly different between patientand control groups. In the SPARC gene, the distribution of the *G allele of EX10+225 T>G (p = 0.018; odds ratio, 1.869) wasstrongly associated with the risk of keratoconus in the Korean population. In haplotype analysis, C-G of rs2956540-rs2288393in LOX (p = 0.046) and C-C-G and G-G-G of rs60610024-rs2228100-rs57555435 (p = 0.021 and p < 0.001), G-A of IVS3-62 a>g- rs116962241 in ALDH3A1 (p = 0.048) predisposed significantly to keratoconus. After cross-validation consistency and permutationtests, two locus model was the best SNP variations interaction pattern. Conclusions: Our results suggested that genetic variations in ALDH3A1, LOX, and SPARC genes were associated with a predispositionfor keratoconus in Korean individuals. Moreover, variations in ALDH3A1and LOX may serve as strong biomarkers forkeratoconus.
휴대용 망막전위도의 임상적 유용성
휴대용 망막전위도의 임상적 유용성
김민진(Min Jin Kim);최경식(Kyung Seek Choi)
대한안과학회 / 대한안과학회지 제62권 제4호 / 2021 / 524-530 (7 pages)
의약학>기타의약학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 안과학
초록보기
목적: 휴대용 망막전위도측정기를 이용하여 망막전위도 측정 시 피부전극과 ERG-jet 전극을 사용할 때의 망막전위도 파형과 ERG-jet 전극을 이용하여 측정한 탁상용 전체시야망막전위도의 파형을 비교하여 차이를 알아보고자 하였다. 대상과 방법: 양안의 안과질환이 없는 성인 30명의 좌안을 대상으로 5개의 표준망막전위도 측정을 각각 휴대용 망막전위도측정기RETevalTM (LKC Technologies, Gaithersburg, MD, USA)를 이용하여 RETevalTM의 피부전극과 ERG-jet (Fabrinal SA, La Chaux-De-Fonds, Swiss) 전극으로 검사한 망막전위도를 서로 비교하였고, 이를 ERG-jet 전극을 이용한 탁상용 망막전위도검사(LKC Technologies, Gaithersburg, MD, USA)로 측정된 파형과 비교하였다. 결과: 피부전극을 이용하여 휴대용 망막전위도 측정기로 망막전위도를 측정하였을 때, 모든 파형은 탁상용 망막전위도의 파형과 통계적으로 유의한 차이를 보이며 작게 나타났다(모두 p<0.001). ERG-jet 전극을 이용하여 휴대용 망막전위도 측정기로 망막전위도를 측정하였을 때, 모든 파형은 ERG-jet 전극을 이용한 탁상용 망막전위도의 파형과 통계적으로 유의한 차이를 보이지 않았다(모두 p>0.1). 결론: 휴대용 망막전위도에 피부전극을 연결할 경우 탁상용 망막전위도검사보다 파형의 크기가 작아 결과를 해석하는 데에 유의해야 한다. 휴대용 망막전위도에 ERG-jet 전극을 이용하면 탁상용 망막전위도검사와 같은 진폭의 파형을 얻을 수 있다.
비강-안와-대뇌 방선균증
비강-안와-대뇌 방선균증
박형준(Hyung Jun Park);김선태(Seon Tae Kim);지미정(Mijung Chi)
대한안과학회 / 대한안과학회지 제62권 제4호 / 2021 / 545-551 (7 pages)
의약학>기타의약학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 안과학
초록보기
목적: 안와와 비강에서 시작되어 빠른 시간에 대뇌까지 침범한 방선균증 감염의 증례를 경험하였기에 이를 보고하고자 한다. 증례요약: 57세 남자 환자가 내원 7일 전 오른쪽 아래치아를 발치하였으며, 내원 4일 전부터 발생하여 점점 심해지는 눈꺼풀부종과 통증을 주소로 내원하였다. 내원 당시 우안의 최대교정시력은 광각, 안압은 37 mmHg였다. 눈꺼풀농양, 결막하출혈과 심한 결막부종이 관찰되었다. 안면부 전산화단층촬영상, 안와주변 및 상악동, 사골동에 연부조직 음영이 증가되고, 다발성 공기음영을 확인할 수 있었다. 모균증을 의심하여 응급으로 부비동내시경수술 및 가쪽 눈구석 절개술을 시행하였으며 정맥내 항진균제 치료를 시작하였다. 치료 2일째 뇌자기공명영상검사상 안와내 병변이 경막과 전두동을 침범한 소견을 보여 이비인후과, 신경외과와 협진수술을 시행하였다. 치료 8일째 세균배양검사 결과 방선균이 동정되어 정맥내 Ampicillin 치료를 시작하였으나 감염은 조절되지 않았고 지속적인 뇌내 출혈 및 뇌내 부종으로 환자는 치료 28일만에 사망하였다. 결론: 심한 눈꺼풀부종으로 내원한 환자들 중 발치 등의 과거력이 있는 경우 감별진단 중 하나로 드물지만 방선균 감염을 고려해야 하며 이에 대한 진단 및 치료가 늦어지는 경우 심각한 결과를 초래할 수 있음을 염두에 두어야 한다.
Transepithelial Laser versus Alcohol Assisted Photorefractive Keratectomy Safety and Efficacy: 1-Year Follow-up of a Contralateral Eye Study
Transepithelial Laser versus Alcohol Assisted Photorefractive Keratectomy Safety and Efficacy: 1-Year Follow-up of a Contralateral Eye Study
Hesham Mohamed Gharieb;Mo’mena Ahmad A Awad-Allah;Anas Adel Ahmed;Ihab Saad Othman
대한안과학회 / The Korean Journal of Ophthalmology 제35권 제2호 / 2021 / 142-152 (11 pages)
의약학>기타의약학 / KDC : 기술과학 > 의학 / KCI : 의약학 > 안과학
초록보기
Purpose: To compare single-step transepithelial photorefractive keratectomy (TPRK) to conventional alcohol assisted epithelialremoval then photorefractive keratectomy (AAPRK) regarding pain, epithelial healing, visual acuity, corneal haze measuredsubjectively and objectively, higher order aberrations changes, contrast sensitivity and vector analysis of astigmatic correctionwith one year follow-up. Methods: A prospective double-blind randomized study of 29 subjects (58 eyes) who underwent myopic aberration-freelaser correction by smart pulse technology using Schwind Amaris 1050 Hz with 1-year follow-up. Right eye was randomlytreated by AAPRK or TPRK. Postoperative assessment was performed on day 1 and 3, at 1st week, and 1st, 3rd, 6th, and 12thmonths. Patients were assessed for pain, epithelial healing, visual acuity, corneal haze, astigmatic correction, higher order aberrationsand contrast sensitivity. Results: Epithelial healing was complete by the 3rd day in 62.1% of AAPRK eyes and in 89.7% of TPRK eyes. First day postoperativepain was higher in TPRK group (p = 0.0134). The decimal uncorrected visual acuity at 12 months was 1.47 ± 0.39 and1.57 ± 0.38 in the AAPRK and TPRK groups respectively (p = 0.3719). Post-photorefractive keratectomy haze reached a finallevel of 0.04 ± 0.14 and 0.02 ± 0.1 in AAPRK and TPRK groups respectively (p = 0.5607). Contrast sensitivity was comparable inlow and high frequency cycles per degree. Vector analysis of astigmatic correction showed correction index at one year of 0.99and 1.05 for AAPRK and TPRK groups respectively. Conclusions: Alcohol assisted and transepithelial photorefractive keratectomy have comparable results regarding safety andefficacy.