• 제목/요약/키워드: Ocular fatigue

검색결과 28건 처리시간 0.023초

Safety and Pitfalls of Blepharoptosis Surgery in Elderly People

  • Yuji Shirakawa;Kazuhisa Uemura;Shinji Kumegawa;Kazuki Ueno;Hiroki Iwanishi;Shizuya Saika;Shinichi Asamura
    • Archives of Plastic Surgery
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    • 제50권5호
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    • pp.446-451
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    • 2023
  • Background Elderly patients often have complications of blepharoptosis surgery that can result in the appearance or exacerbation of superficial punctate keratopathy (SPK). However, postoperative changes to SPK status have not been previously reported. We used subjective assessment of symptoms and measurement of SPK scale classification to investigate the safety and efficacy of blepharoptosis surgery in elderly patients. Methods Included in this prospective study were 22 patients (44 eyes) with bilateral blepharoptosis that underwent surgery. Patients comprised 8 males and 14 females with a mean (±standard deviation) age of 75.7 ± 8.2 years (range: 61-89). Blepharoptosis surgery consisted of transcutaneous levator advancement and blepharoplasty including resection of soft tissue (skin, subcutaneous tissue, and the orbicularis oculi muscle). Margin reflex distance-1 (MRD-1) measurement, a questionnaire survey of symptoms and SPK scale classification, was administered preoperatively and 3 months postoperatively for evaluation. Results The median MRD-1 was 1 mm preoperatively and 2.5 mm postoperatively, representing a significant postoperative improvement. SPK area and density scores were found to increase when the MRD-1 increase was more than 2.5 mm with surgery. All 10 items on the questionnaire tended have increased scores after surgery, and significant differences were observed in 7 items (poor visibility, ocular fatigue, heavy eyelid, foreign body sensation, difficulty in focusing, headaches, and stiff shoulders). Conclusion Blepharoptosis surgery was found to be a safe and effective way to maintain the increase in MRD-1 within 2.0 mm. Despite the benefits, surgeons must nonetheless be aware that blepharoptosis surgery is a delicate procedure in elderly people.

Management of asymptomatic to mild COVID-19 patients with Cheongpebaedok-tang on the telemedical basis: A retrospective observational case series

  • Sung-Woo Kang;Kwan-Il Kim;Mideok Song;Jinhwan Roh;Namhun Cho;Heung Ko;Sung-Se Son;Minjeong Jeong;Jun-Yong Choi;Ojin Kwon;Seojung Ha;Hee-Jae Jung;Beom-Joon Lee
    • 대한한의학회지
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    • 제44권4호
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    • pp.41-58
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    • 2023
  • Objectives: This retrospective observational study aimed to investigate the efficacy and safety of Cheongpebaedok-tang, a traditional Korean herbal medicine, provided via telemedicine to patients with asymptomatic to mild COVID-19 in Korea. Methods: From February to April 2020, a retrospective analysis investigated COVID-19 patients treated via Korean telemedicine. The study involved asymptomatic to mild cases receiving Cheongpebaedok-tang more than three times, along with continuous Korean medicine care in convalescence. Diagnoses and treatment adhered to the telemedicine guidelines of the Association of Korean Medicine, with varied Cheongpebaedok-tang prescriptions based on symptom severity. Symptom evaluation involved a detailed assessment using a 15-item tool at initial and final sessions. Results: The study included 27 patients, with a mean age of 48.7 ± 2.3 years (mean ± standard error). Patients began self-administering oral Cheongpebaedok-tang for an average of 19.4 ± 1.8 days after the date of COVID-19 diagnosis confirmation and continued the medication for 15.8 ± 1.2 days. The reported side effects of the Cheongpebaedok-tang included palpitations (11.1%), insomnia (7.4%), dizziness (3.7%), and diarrhea (3.7%). All side effects disappeared after adjusting the prescription according to standard treatment guidelines. The occurrence of all COVID-19-related adverse symptoms, except fatigue and myalgia, decreased. Fatigue was the most common chronic symptom persisting after 6 months (51.9%), followed by ocular symptoms (37.0%) and sore throat (22.2%). Conclusions: This study implies Cheongpebaedok-tang may offer a potentially safe, symptom-alleviating approach for managing mild COVID-19 cases via telemedicine, although further comprehensive research is warranted.

텔레비젼(TV)생산업체 근로자들의 영상단말기(VDT)작업이 시력과 안증상에 미치는 영향 (The Effect of VDT Work on Vision and Eye Symptoms among Workers in a TV Manufacturing Plant)

  • 우극현;최광서;정영연;한구웅;박정한;이종협
    • Journal of Preventive Medicine and Public Health
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    • 제25권3호
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    • pp.247-268
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    • 1992
  • 영상단말기 (VDT)작업이 시력과 안증상에 미치는 영향을 알아보기 위해 1991년 7월에서 10월 사이에 구미시의 1개 TV생산업체에 종사하는 근로자들 가운데 채용 당시 안과적으로 문제가 없었고, 나안시력이 1.0 이상인 40세 미만 남자 338명을 대상으로 일일 평균 화면작업시간이 4시간 미만인 근로자(I군, 60명)와 4시간 이상인 근로자(II군, 204명)를 폭로군으로 하고 유사한 작업환경에서 근무하는 비화면작업자(74명)를 비폭로군으로 나누어 연령, 작업경력, 교대근무형태, 확대경 사용유무, 1일 평균 TV시청 시간 및 수면시간과 그리고 안자각증상에 대한 설문조사를 실시한 후, 안과적검사를 시행하였다. 조사시 원거리시력 (양안의 평균시력)이 채용시에 비해 0.15 이상 저하된 비율은 II군이 20.6%로 비화면작업군의 14.9 %, I군의 15.0 % 보다 다소 높았으나 통계적으로 유의한 차는 아니었다. 연령, 작업경력, 확대경 사용유무, 교대근무형태 등에 따라 층화하여 원거리시력 저하율을 비교해 본 결과 세 군간에 통계적으로 유의한 차가 없었다. 근거리시력 저하율도 비화면작업군이 28.4 %, I군이 18.3 %, II군이 27.5 %로 통계적으로 유의한 차이가 없었으며, 연령 등 4가지 독립변수를 층화하여 비교해 보아도 유의한 차이가 없었다. 안자각증상 호소율은 안피로를 포함한 7가지 항목에서 눈물이 나는 것을 제외한 모든 항목에서 비화면작업군에 비해 I군이, I군 보다는 II군이 통계적으로 유의하게 높았다(P<0.01). 화면작업자 264명 가운데 조명이 나쁜 장소에서 일하는 근로자들의 원거리시력 저하율과 안자각증상 호소율이 조명이 좋은 작업장에서 일하는 근로자보다 더 높았다(P<0.05). 7가지 안자각증상을 각 증상 마다 늘 느끼는 경우는 2, 가끔 느끼면 1, 느끼지 않으면 0으로 점수화하여 개인별 총 안증상 점수를 구해 세 군간에 원거리시력 차이 유무별로 비교해 본 결과, 시력차 유무에 따른 평균 안자각증상 점수의 차는 없었으나 시력차 유무에 관계없이 II군의 평균 안자각증상 점수가 6.13 으로 I군(3.53) 또는 비화면작업군(3.30) 보다 훨씬 더 높았다(P<0.01). 안자각증상 점수와 유의한 상관관계를 보인 독립변수들은 화면작업시간, 확대경 사용유무, 교대근무형태 등이었고, 채용시와 조사시 원거리시력 차이, 원거리시력과 근거리시력 차이, 누액분비기능, 안압, 굴절력 등과 유의한 상관관계를 보인 독립 변수는 하나도 없었다. 안자각증상 점수를 종속변수로 하는 중선형 회귀분석 결과에서는 화면작업시간이 길수록, 단부제나 2교대 근무자보다 3교대 근무자에서 유의한 선형관계를 나타내었다(P<0.01). 본 조사에서는 1일 장시간 VDT작업으로 시력이 저하되는 것은 관찰할 수 없었고 안자각증상은 유발되는 것으로 나타났다. 안자각증상의 예방을 위해 VDT 작업장의 조명을 적절하게 유지하고 장시간 연속해서 작업하지 않도록 작업관리를 해야 할 것이다.

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VDT 작업 전·후 시기능 변화 (The Investigation of the Changes of Visual Problems in VDT Workers)

  • 강명진;최오목
    • 한국안광학회지
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    • 제7권2호
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    • pp.33-39
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    • 2002
  • 18세에서 30세 중반 사이의 남자 35명 여자 21명 총 56명을 대상으로 2시간 동안 VDT 작업을 하도록 한 후, 안구 및 전신 증상 등을 조사하고 순목 횟수, 눈물층파괴시간(BUT), 안검열의 높이, 시력, 타각적 굴절력, 조절력 등을 측정하였다. 안구증상에서는 눈의 피로를 느끼는 사람이 34%로 가장 많았고 시기능증상에서는 물체가 흐려 보이는 증상이 83%, 전신증상에서는 어깨가 아픈 사람이 38%로 가장 높게 나타났다. VDT 작업 중의 순목 횟수가 8/min로 휴식 때의 22/min에 비해 많이 감소했다. VDT 작업 직후의 눈물층파괴시간도 약 7초로 작업 전의 약 12초보다 현저히 감소되었다. 안검열의 높이는 작업 전 7.69mm보다 작업 중에는 9.04mm로 증가하였다. 평균 나안시력은 VDT 작업 전에 0.63에서 작업 후에는 0.57로 약 9.5% 감소하는 경향을 보였고, 타각적 굴절이상은 0.28D 정도 근시화 경향이 보였다. VDT 작업 후 조절력은 1.49D 정도 감소하였는데 주로 조절근점 굴절력의 감소가 원인인 것으로 보인다. 폭주근점 굴절력도 0.87D 감소하였다.

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광범위한 안와파열골절에서 Titanium Mesh Plate와 Porous Polyethylene (Medpor®) 동시 사용의 유용성 (Treatment of Blow-out Fractures Using Both Titanium Mesh Plate and Porous Polyethylene (Medpor®))

  • 구자혜;원창훈;동은상;윤을식
    • 대한두개안면성형외과학회지
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    • 제11권2호
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    • pp.85-90
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    • 2010
  • Purpose: The goals of a blow-out fracture reconstruction are to restore the osseous continuity, provide support for the orbital contents and prevent functional and anatomic defects. Over the past several years, a range of autogenous and synthetic implants have been used extensively in orbital reconstructions. None of these implants have any absolute indications or contraindications in certain clinical settings. However, in extensive blow-out fractures, it is difficult to restore support of the orbital contents, which can cause more complications, such as enophthalmos. This study examined the clinical outcomes of extensive or comminuted blow-out fractures that were reconstructed by the simultaneous use of a titanium mesh plate and $Medpor^{(R)}$. Methods: Eighty six patients with extensive orbital fractures, who were admitted between March 1999 and February 2007, were reviewed retrospectively. The patients' chart and CT were inspected for review. Twenty three patients were operated on with both a titanium mesh plate (Matrix MIDFACE pre-formed orbital plate, Synthes, USA) and $Medpor^{(R)}$ (Porex, GA, USA). The patients underwent pre-operative CT scans to evaluate the fracture site and measure the area of the fracture. A transconjunctival approach was used, and titanium mesh plates were inserted subperiosteally with screw fixation. $Medpor^{(R)}$ was inserted above the titanium mesh plate. The patients were evaluated post-operatively for enophthalmos, diplopia, sensory disturbances and eyeball movement for a period of at least 6 months. Results: No implant-related complications were encountered during the follow-up period. Enophthalmos occurred in 1 patient, 1 patient had permanent sensory disturbance, and 3 patients complained of ocular pain and fatigue, which recovered without treatment. Although there were no significance differences between groups, the use of 2 implants had fewer complications. Therefore, it can be an alternative method for treating blow out fractures. Conclusion: The use of both a titanium mesh plate and $Medpor^{(R)}$ simultaneously may be a safe and acceptable technique in the reconstruction of extensive blow-out fractures.

중증 근무력증 환자의 임상적 고찰 (A Clinical Study of Management In Myasthenia Gravis)

  • 김훈;이두연;조범구;홍승록;선우일남
    • Journal of Chest Surgery
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    • 제20권1호
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    • pp.112-127
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    • 1987
  • Myasthenia gravis is a neuromuscular transmission function disorder characterized by fatigue and weakness of voluntary muscles. This muscular weakness is intensified by activity and stress, and improved by the use of anticholinesterase compounds. It was initially described by Erb in 1879 and later named myasthenia gravis by Jolly in 1895. Although the pathogenesis is Known to be an autoimmune related reduction in the number of available acetylcholine receptors at neuromuscular junctions, the role of thymus in myasthenia gravis is still unclear and under investigation. Thymectomy in the management of myasthenia gravis has become increasingly important since Dr. Blalock observed in 1939 that some patients with thymic tumors and myasthenia gravis improved following thymectomy. A clinical study of 102 cases of myasthenia gravis was performed at Yonsei University College of Medicine. Seoul, Korea from Jan. 1976 to Jun. 1986. In order to determine which factors are of prognostic significance, attention is focused upon pre-operative patient evaluation, problems in operative and post-operative care, and long-term follow-up observations. The results were as follows: 1. The sex distribution was 67 females and 35 males, the mean age of onset was 28.95*1.69 years, and the maximal incidence occurred between 21 and 40 years of age [56 cases: 54.9%]. 2. Clinical manifestations of ocular symptoms were seen to 70 patients [68.6%] extremities weakness in 33 [32.3%], bulbar weakness in 29 [28.4%], and dyspnea in 13 [12.7%]. 3. Study cases more than two thirds were classified as mild types [MG 1 and MG 11A] and 6 cases as grave [MG 1V] based on the modified Osserman`s classification system, 4. Thymectomy was performed in 19 cases which presented in severe myasthenia symptoms and showed no improvement with cholinergic drugs. Histologic examination of the excised thymus glands revealed no abnormalities in 4 cases, thymic hyperplasia in 5, benign thymoma in 5, and malignant thymoma in 5. 5. Immediate post-operative complications included 2 cases of pneumothorax which were treated by tube thoracostomies, there was no operative mortality. 6. The response to cholinergic drugs in 36 cases younger than 20 years old and in 27 cases older than 40 years was relatively poor, while that in 35 cases between the ages of 21 and 40 years old was good. 7. Thirty of 39 cases in groups IIB, III & IV improved markedly with medical or surgical management while only 16 of 59 cases in the mild groups [I and IIA] improved, almost all surgical cases improved in all categories. 8. There were 5 deaths. occurring between 7 months and 3 years 3 months of treatment of myasthenia gravis. The causes of death were myasthenic crisis in 2 cases, respiratory failure due to candidiasis & radiation pneumonitis in one case, cerebral hemorrhage due to high blood pressure in two case.

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안경테 종류에 따른 유발프리즘 (Induced Prism by the Categories of Spectacle Frames)

  • 박우정;김수운;황해영;유동식;손정식
    • 한국안광학회지
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    • 제17권3호
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    • pp.311-319
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    • 2012
  • 목적: 안경의 조제가공에 있어서 동공중심과 교정렌즈의 광학중심이 일치하지 않으면 안경이 프리즘을 발생시켜 사위가 유발되고 유발된 사위는 안정피로를 일으키는 요인으로 작용한다. 동공의 중심과 교정렌즈 광학중심의 불일치로 인해 발생하는 유발프리즘에 대해 알아보고자 하였다. 방법: 본 연구는 총 103명을 대상으로 착용 안경렌즈의 광학중심과 동공중심의 일치 여부를 수평방향과 수직방향으로 나누어 조사하였고, 그리고 그 결과들을 안경의 구조에 따라 4개의 그룹으로 분류하였다. 프리즘유발에 안경테의 효과를 보기 위해 프리즘의 총량을 비교하였고, 측정된 프리즘 값들은 독일의 RAL-RG 915 규약과 비교하였다. 결과: 수평방향의 경우 10.7%의 실험 대상자에서는 유발프리즘을 관찰할 수 없었고, 73.8%의 실험 대상자들은 유발프리즘에 의해 영향을 받았으나 그 범위는 허용 수준 내에 있었다. 하지만 15.5%의 실험 대상자들은 허용 범위를 초과하여 프리즘에 의해 영향을 받는 것으로 나타났다. 수직방향의 경우, 23.3%의 실험 대상자들은 안경의 초기 착용시 프리즘에 의한 영향이 없었고, 54.4%의 실험 대상자들은 허용 범위 내의 극히 적은 프리즘에 영향을 받았으며, 22.3%의 실험대상자들은 허용 범위를 초과하는 프리즘 영향을 받는 것으로 나타났다. 이러한 결과는 안경조정(fitting)이 가능한 요소가 적은 그룹 A와 B에서 그룹 C와 D에 비해 보다 많은 수평, 수직 방향의 유발프리즘이 발생한 것을 보여준다. 결론: 안경 착용자의 굴절이상도가 높을수록 안경테 전조정(pre-fitting)을 통하여 동공중심과 렌즈의 광학중심점을 일치시킴으로서 수평, 수직방향 유발프리즘을 최소화시켜 안정피로를 줄일 수 있을 것이다. 따라서 시지각력을 향상시키기 위해 단안PD와 단안Oh의 정확한 설계와 적절한 안경테 조정을 통해 정확한 안경의 조제가공이 필요하다고 사료된다.

중증근무력증(重症筋無力症)에 대(對) 임상적(臨床的) 연구(硏究) (The clinical study of Myasthenia Gravis)

  • 채병윤
    • 대한한의학회지
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    • 제17권1호
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    • pp.190-211
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    • 1996
  • Generally the Myasthenia Gravis is classified into two of hereditary factor and acquement. Aquired Myasthenia Gravis was Quite well known to be caused by the autoimmune mechanism. Not in accurateness, on the hereditary, acetylcholine receptor antibody was to be analyzed very high in their parents and brothers. Also Myasthenia Gravis is a chronic disease characterized by voluntary muscle weakness and fatigue. above all, ocular Myasthenia Gravis is characterized clinically by blepharoptosis and external ophthalmoplegia and to be showed abut 90% cases and so oriental medicine can not but deal with myasthenia gravis at blepharoptosis. Accordinglv 20 out patients with Myasthenia Gravis were clinical study and observation as to the sex, age, progress state of MG, blood type, history, main symptom, liking for warm and cool food and tepidity, state of pulse, treatment of acupuncture and administration of oriental medicine etc. The results were as follows. 1. There was investigaed on the frequency of attack for sex, age, oculus dexter, oculus sinister, oculus uterque. Among the 20 patients, the number of female were 60% with 12 cases and male were 40% with 8 cases, therefore it was the rate of 6 : 4. the patients under 10 ages and 40 ages were 20% with 4 cases, 10 ages and 50 ages were 15% with 3 cases, 20, 30, 60 ages were 10% with 2 cases. And then oculus uterque was 90% with 18 cases, oculus sinister was 10% with 2 cases and oculus dexter were none of them. 2. Stage I were 50% with 10 patients, stage $II_A$ were 30% with 6 patients and stage $II_B$ were 20% with 4 patients, on the clinical stage and too class I were 20% with 4, class II were 45% with 9, class III were 35% with 7, in the functional activity the patients with chest heavy were 15% with 3 and hyperthyroidism were 10% with 2. 3. Hospital which patients had used to before came to this hospital were 10 university hospital and 6 local clinic. 4. The duration of disease was from 3 months to 30 years, the patients suffering between 3 months and within 1 year were 25% with 5 cases, 1-2 years were 30% with 6 cases, therefore within 2 years were 55%. 4-5 years were 15%, over 7 years were appeared less than 10%. 5. In the main symptom, all of patients were appeared to be heavy in opening their eyes the patients with blephroptosis were 70% with 14 cases on the oculus uterque, oculus sinisterf and oculus dexter, there were 20% with 4 eases each other in the oculogyation incomplete. visual failing, ophthalmoxerosis, strabismus etc and indigetion, frequency of urine(feel hurt), mild stools(or diarrea), oversensitiveness etc. but in addition, all of the other were 10%. 6. In the distribution of blood type, 0 types were 45% with 9 cases, A types were 25% with 5 cases, B and AB types were 15% each other. 7. For the rates of patients of liking for warm and cool food or tepidity, patients of liking for warm food possess 45% with 9 cases, and cool food possess 35% with 7 and tepidity possess 20% with 4, and then most of patients liking for warm food were females and cool food were much more males than females. 8. Hyunsae(弦細) were 40% with 8 cases, Buhurl(浮滑) were 20% with 4 cases, Hyunsak(弦數) were 15% with 3 cases, and in addition, the others were 10%, among 7 types of pulses. 9. The patients with less than 1 week were 40% with 8 cases, and there were female most of them and over 4 weeks were 20% and 1-2weeks were 15%, in the duration acupuncture treatment. 10. 15 kinds of prescriptions were administrated with oriental medicine from 1 week to 20weeks 1_2 weeks were 25.71% with 9 cases, 3 weeks were 17.14% with 6 cases and 6 weeks were 11.42% with 4 cases and also Gamibaetaugunbitang(加味培土健脾湯) were 28.57% with 10 cases, Gamijeounyongtang(加味正容湯) were 14.28% with 5 cases, Gamibojoongyigitung (加味補中益氣湯), Gamiyinsamyangyoungtung (加味人蔘養榮湯) were 8.57% with 3 cases each other and also Gamisamgitung (加味蔘?湯), Gamisamuloajatung(加味四物五子湯) Gamigoudungum (加味鉤藤飮), etc were applied.

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