• Title/Summary/Keyword: oculomotor

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Treatment of Severe Blepharoptosis after Blow Out Fracture (안와 파열골절 후 발생한 중증 안검하수의 치료)

  • Kim, Nam-Hun;Yang, Jeong-Yeol;Moon, Jae-Won;Kim, Gyu-Bo;Cheon, Ji-Seon
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.461-464
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    • 2010
  • Purpose: Blepharoptosis can result from either congenital or acquired causes. Blow out fracture or facial bone fracture including blow out fracture can be one of the causes. Authors experienced 3 cases of severe blepharoptosis after blow out fracture treated only with observation after reduction of associated fracture. Methods: Reconstruction of orbital wall was conducted on all cases diagnosed as blow out fracture using 3 dimensional computed tomography, and conservative treatment was done on accompanying severe blepharoptosis. Results: At the time of injury, all cases showed severe blepharoptosis requiring frontalis muscle transfer for correction. But blepharoptosis was recovered in an average of 18 weeks without any surgical procedure except reconstruction of orbital wall. Conclusion: Once Blepharoptosis occurred after blow out fracture, thorough evaluation must be done at first. If definitive cause of blepahroptisis cannot be found as authors' cases, injury of oculomotor nerve may result in blepharoptosis. So, as for blepharoptosis after blow out fracture, conservative treatment following reconstruction of fractured orbital wall can be one of good management.

The Analysis of Korean Medicine treatment for Ptosis (안검하수의 한의학적 치료에 대한 국내 임상 연구 경향)

  • Lee, Hyun-Bum;Hong, Hyeon-Jin;Lee, Chang-Won
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.32 no.3
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    • pp.136-150
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    • 2019
  • Objectives : The purpose of this study is to analyze and understand the trend of Korean medical treatment on ptosis. Methods : From the domestic databases KCI, KISS, OASIS, KTKP, 16 studies were selected using the keyword 'ptosis', published after 2000. Results : Selected 16 studies contain 19 cases in which mainly acupuncture and herbal medicine were practiced to treat ptosis. Treatment period varies from 12 to 134 days. When Korean medical treatment was started before 10 days from the onset, average of treatment period is about 28.6 days, but after 40 days, it increases three times longer. It takes 1.5 times longer to treat ptosis caused from central nerve than which from peripheral nerve. Conclusion : According to the results, Korean medicine can be effective treatment for ptosis which mostly depends on surgical treatment currently. tments of purpura and vasculitis up to date and some points that may have clinical significance.

Exercise rehabilitation for recurrent extraocular muscle movement limitation after pediatric blowout fracture surgery: a case report

  • Jeong Do Park;Syeo Young Wee;Se Young Kim
    • Archives of Craniofacial Surgery
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    • v.24 no.3
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    • pp.133-138
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    • 2023
  • White-eyed blowout fractures with extraocular muscle (EOM) entrapment necessitate emergency surgical intervention. However, even after surgery, diplopia or EOM motion limitations may persist due to the incomplete reduction of soft tissue herniation caused by inadequate dissection or unresolved muscle strangulation. In this report, we present a case of postoperative EOM movement limitation in a 5-year-old girl who experienced recurrent restriction in the upward gaze of her right eye 14 days after surgery. Instead of revision surgery, the patient was treated with targeted EOM exercises focusing on the inferior rectus muscle and inferior oblique muscle. The patient was instructed to slowly move her pupils from the central point to the upper and outer sides, then in a straight line from the central point to the lower and inner sides before returning to the center point. On the 28th postoperative day, 2 weeks after initiating the exercises, the patient's EOM motion fully recovered. This case highlights the effectiveness of EOM exercises as a non-surgical treatment approach for improving recurrent EOM movement limitations in the absence of soft tissue herniation following surgical management of blowout fractures in children.

Tracing study for the rabbit eye ball control nerve utilizing the PRV-Ba isolated in the Korea (한국분리산 PRV-Ba를 이용한 가토 안구지배신경의 추적 연구)

  • Park, Il-kwon;Kim, Moo-kang;Shin, Kwang-soon;Lee, Kyung-youl;Song, Chi-won;Lee, Kang-iee;Hyun, Byung-hwa;Chang, Kyu-tae;Jeong, Young-gil
    • Korean Journal of Veterinary Research
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    • v.40 no.3
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    • pp.463-470
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    • 2000
  • Until now peudorabies virus(PRV) has been used a neurotracer, because of it's properties of retrograde & anterograde transport. But it's anterograde transfort is not perfect, so we tested the applicability of the Bartha strain of PRV(PRV-Ba) isolated from South Korea as a neurotracer in the visual system. We performed immunohistochemical study of the rabbit brain after intravitreal injection of the PRV-Ba. After given survival time(24, 48, 72, 96, 120, 144hrs), the brain was removed and processed immunohistochemical stain for PRV-Ba. The strong PRV immunoreactivity(PRV-ir) were almost oberserved contralaterally in oculomotor neurons, fro example Edinger-Westphal nucleus, trigerminal nucleus of pons and peritrigerminal zone but locus of innervating sensitive neurons. The latter were weak positive and selective. PRV-Ba immunoreactive neurons were stained strongly in nucleus compared to cytoplasm. This study suggests that PRV-Ba isolated from South Korea is also a useful neurotracer in the motor innervated system like other PRV-strain.

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Intracavitary Radiation Therapy for Recurrent Cystic Brain Tumors with Holmium-166-Chico : A Pilot Study

  • Ha, Eun Jin;Gwak, Ho-Shin;Rhee, Chang Hun;Youn, Sang Min;Choi, Chang-Woon;Cheon, Gi Jeong
    • Journal of Korean Neurosurgical Society
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    • v.54 no.3
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    • pp.175-182
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    • 2013
  • Objective : Intracavitary injection of beta-emitting radiation source for control of cystic tumors has been tried with a benefit of localized internal radiation. The authors treated cystic brain tumor patients with Holmium-166-chitosan complex (Ho-166-chico), composed of a beta-emitting radionuclide Holmium-166 and biodegradable chit polymer, and evaluated the safety and effective measurement for response. Methods : Twenty-two patients with recurrent cystic brain tumor and/or located in a deep or eloquent area were enrolled in this pilot study. The cyst volume and wall thickness were determined on CT or MRI to assess radiological response. The activity of Ho-166-chico injected via Ommaya reservoir was prescribed to be 10-25 Gy to the cyst wall in a depth of 4 mm. Results : There was neither complications related to systemic absorption nor leakage of Ho-166-chico in all 22 patients. But, two cases of oculomotor paresis were observed in patients with recurrent craniopharyngioma. Radiological response was seen in 14 of 20 available follow-up images (70%). Seven patients of 'evident' radiological response experienced more than 25% decrease of both cyst volume and wall thickness. Another 7 patients with 'suggestive' response showed decrease of cyst volume without definitive change of the wall thickness or vice versa. All patients with benign tumors or low grade gliomas experienced symptomatic improvement. Conclusion : Ho-166-chico intracavitary radiation therapy for cystic tumor is a safe method of palliation without serious complications. The determination of both minimal effective dosage and time interval of repeated injection through phase 1 trial could improve the results in the future.

Wernicke's encephalopathy in a child with high dose thiamine therapy

  • Park, So Won;Yi, Yoon Young;Han, Jung Woo;Kim, Heung Dong;Lee, Joon Soo;Kang, Hoon-Chul
    • Clinical and Experimental Pediatrics
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    • v.57 no.11
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    • pp.496-499
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    • 2014
  • Wernicke's encephalopathy is an acute neurological disorder characterized by mental confusion, oculomotor dysfunction, and ataxia. It has been reported in individuals with alcohol dependence, hyperemesis gravidarum, and prolonged parenteral nutrition without vitamin supplementation. Here we present the case of a 13-year-old male patient with neuroblastoma and a history of poor oral intake and nausea for 3 months. After admission, he showed gait disturbances, nystagmus, and excessive dizziness; his mental state, however, indicated he was alert, which did not fit the classical triad of Wernicke's encephalopathy. A diagnosis of Wernicke's encephalopathy was made only after brain magnetic resonance imaging and serum thiamine level analyses were performed. The patient's symptoms remained after 5 days of treatment with 100-mg thiamine once daily; thus, we increased the dosage to 500 mg 3 times daily, 1,500 mg per day. His symptoms then improved after 20 days of replacement therapy. This case report describes a pediatric patient who was promptly diagnosed with Wernicke's encephalopathy, despite only 2 suspicious symptoms, and who completely recovered after high doses of thiamine were given intravenously.

A Case of Metastatic Hepatocellular Carcinoma of the Orbit (간세포암종의 안와 전이 1예)

  • Yang, Young-Joo;Bae, Seung-Hyeon;Jang, Il-Young;Jun, Mi-Jung;Jung, Ji-Won;An, Ji-Hyun;Shim, Ju-Hyun
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.152-155
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    • 2013
  • Orbital metastasis from hepatocellular carcinoma is very rare, with only 14 biopsy-proven cases from hepa tocellular carcinoma cases reported in English literature and three cases reported in Korea. Common symptoms of orbital metastasis are proptosis, visual loss, ocular pain and oculomotor dysfunction. For its precise diagnosis, we can perform fine needle aspiration biopsy, orbit CT or MRI, and ultrasonography. Radiotherapy is the mainstay in the treatment of orbital metastasis. In addition, chemotherapy, hormonal therapy and surgical intervention can play a role in the treatment of orbital metastasis according to the primary cancer and symptoms. However, the prognosis of orbital metastasis is poor. We report herein a rare case of a patient with orbital metastasis from hepatocellular carcinoma, which was treated with various modalities that included resection, and who had good clinical and radiological responses to radiation therapy and sorafenib (Nexavar, Bayer HealthCare).

Functional Relationship between the Vestibular Canals and the Extraocular Oblique Muscles (미노반규관(迷路半規管)과 외안사근(外眼斜筋)의 기능적(機能的) 관계(關係)에 관(關)하여)

  • Kim, Jeh-Hyub
    • The Korean Journal of Physiology
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    • v.6 no.2
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    • pp.49-56
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    • 1972
  • This experiment was designed to explore specific functional relationship between the vestibular canals and the extraocular oblique muscles by observing the isometric tension responeses of the muscles to the selected vestibular canal excitation. The vestibular excitation was simulated by either stimulation of the individual canal nerve or endolymphatic fluid displacement in each canal. Each canal nerve was subjected to square wave pulses with a monopolar wire electrode placed closely to the ampullary nerve endings for electrical stimulation, and a fine stainless cannula was introduced into the each canal toward the ampulla and a minute amount $(0.5{\sim}3.5\;microliter)$ of fluid was injected in or ejected out by means of a microsyringe connected to the cannula to produce ampullopetal or ampullofugal displacement of endolymphatic fluid. The superior oblique muscle was contracted by the excitation of homolateral canals and was relaxed by contralateral canals. On the contrary, the inferior oblique was contracted by the contralateral canals and was relaxed by the homolateral canals. Summation of excitatory and inhibitory canal effects from the bilateral vestibular system was demonstrable on the tension changes of the oblique muscles. Excitation of either dual or triple canals of the unilateral vestibular system also caused summation effect on the tension response of the oblique pair; thus multiple signals from the different ampullary receptors seems to be converged into the relevant ocular motor muclei. Since the superior and inferior obliques are known to receive their motor fibers from the contralateral trochlear nuclei and intermediate nuclei of the homolateral oculomotor complex respectively, the above experimental evidences indicate that the ocular motor nuclei for oblique muscles receive excitatory signals from the contralateral vestibular canals and inhibitory signals from the homolateral canals.

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The Study on an Using Effect of Head Mounted Display to the Body in Virtual Environments (가상환경에서의 HMD사용이 인체에 미치는 영향에 관한 연구)

  • 이창민;정진희
    • Journal of Korea Multimedia Society
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    • v.3 no.4
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    • pp.389-398
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    • 2000
  • The focus of this study is to investigate how personal display system - Head Mounted Display(HMD) and VDU-affect to the body in virtual environments. This prediction was tested by a comparing of playing 3D games while wearing a HMD and monitoring a VDU for an hour. As quantitative measuring and analyzing tools, SSQ, RSSQ, pre and post posture stability test and vision test are used. The results showed that SSQ and RSSQ total score (TS) are related with the results of pre and post posture stability test and SSQ and RSSQ TS of HMD is higher than TS of VDU by one point five times. Especially, TS of MRG3C, having large field of view, has a possibility by two times of simulator sickness (SS). And in order to investigate the degree of SS regarding to the simulator control condition, two conditions, subjective-passive and subjective-active environments were compared. However, there was no significant difference between two environments. The repetition of the same environment has no effect to reduce the SS. Disorientation and oculomotor scores of the SSQ and RSSQ are higher than that of another symptoms. In addition, RSSQ score of strain/confusion is higher than that of nausea. Therefore, we assume that personal fear could possibly increase the simulator sickness in virtual environments.

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Anterior Choroidal Artery Aneurysm Surgery : Ischemic Complications and Clinical Outcomes Revisited

  • Lee, Young-Sup;Park, Jaechan
    • Journal of Korean Neurosurgical Society
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    • v.54 no.2
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    • pp.86-92
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    • 2013
  • Objective : Surgical results for anterior choroidal artery (AChA) aneurysms have previously been reported as unsatisfactory due to inadvertent occlusion of the AChA, while the low incidence of AChA aneurysms hampers the accumulation of surgical experience. The authors reviewed their related surgical experience to document the ischemic complications and surgical outcomes. Methods : Identification of the AChA at its origin by rigorous visual scrutiny, careful microdissection, and meticulous clip placement to avoid the AChA origin are all crucial surgical maneuvers. A retrospective review of a surgical series of 62 consecutive cases of an AChA aneurysm between 2004 and 2012 was performed. Results : All patients, except for five (8.1%) with a small residual neck, showed complete aneurysm obliteration in postoperative angiographic evaluations. There was no incidence of procedure-related permanent AChA syndrome or oculomotor nerve palsy, while three (4.8%) patients suffered from transient AChA syndrome. The clinical outcomes [the 3-month modified Rankin Scale (mRS)] of the patients were related to their preoperative World Federation of Neurologic Surgeons (WFNS) grade. As regards the 3-month mRS, significant differences were found between patients with an unruptured aneurysm (WFNS grade 0; n=20), good-grade subarachnoid hemorrhage (WFNS grade 1-3; n=30), and poor-grade subarachnoid hemorrhage (WFNS grade 4-5; n=4). Conclusion : In surgical treatment of AChA aneurysms, a risk of AChA insufficiency can be minimized by taking every precaution to preserve the AChA patency and intraoperative monitoring. In addition, the surgical outcome is primarily determined by the preoperative clinical state.