• Journal of Korean Neurosurgical Society
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• v.37 no.4
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• pp.275-281
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• 2005

Objective: The prolactinoma is the most common pituitary tumor and sometimes shows severe invasiveness to the adjacent cavernous sinus, especially in the male patient. The dopamine agonist can be used as an alternative treatment modality to surgery. But, the transsphenoidal or transcranial approach for tumor removal has been more preferred treatment option of neurosurgeons in invasive prolactinoma. Especially rapid decompression of mass effect and resolution of the neurologic deficit is demanded. The prospective study is done in order to identify the therapeutic efficacy of bromocriptine as an initial treatment option for the invasive prolactionomas. Methods: Twenty patients with invasive prolactinoma were studied. Preoperative neurological and endocrinological evaluations were done, and size and invasiveness of the tumor was estimated on MRI. Bromocriptine was administrated by increasing dose planning reaching maximum dose at 1 month of treatment, with close neurological and endocrinological monitoring. At 3months after treatment, MRI was taken and decision was made whether to continue bromocriptine or to have surgical intervention. Results: Thirteen patients showed excellent result with only bromocriptine treatment. These patients showed not only marked reduction of tumor volume and prolactin level, but also, improving clinical symptoms and other hormonal deficits. 13patients who had visual field defect and decreased visual acuity had all improved visual symptoms. But, the remaining 4patients required surgical treatment due to insufficient reduction of tumor size inspite of normalized prolactin level within 3months. Remaining 2patients had $20{\sim}30%$ of tumor size reduction, but prolactin level was not normalized. One patient required radiation therapy. Conclusion: Bromociptine can be used as initial treatment for the invasive prolactinomas with careful monitoring of the neurological and endocrinological status. It should be carefully followed up for tumor size reduction within 3 months after initiation of treatment.

• Journal of Korean Ophthalmic Optics Society
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• v.11 no.4
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• pp.317-322
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• 2006

For this study we made up a question investigation to analyze a grade of satisfaction and a side effect about the prescription actual condition of contact lens of person with astigmatism among the person who has a error of refraction. The whole patient of refractive error was 46 person, there were 11 person who only wear spectacles by correction of visual acuity among person to a question investigation and 35 person who only wear contact lens. Under investigation 35 person who only wear contact lens, there were 25 person who experience the problem which occurs because of contact lens wearing for a long time. The most patient who made up a question investigation very choose remainder item except for item of very satisfaction. The their reason that could not satisfaction was non corrected astigmatism, wrong prescription, wrong Base curve, out of life span etc.

• Journal of Genetic Medicine
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• v.15 no.1
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• pp.13-16
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• 2018

X-linked juvenile retinoschisis (XLRS) is characterized by the progressive loss of visual acuity and vitreous hemorrhage. XLRS is caused by a mutation of retinoschisin 1 (RS1) gene at Xp22.13. In the current report, a 2-year-old Korean patient with XLRS was described. The germline deletion of exon 1 was identified in the RS1 gene. Considering X-linked inheritance pattern, validation of a carrier state of a patient's mother is important for the genetic counseling of other family members and for the future reproductive plan. To confirm the carrier state of his mother, the multiplex ligation-dependent probe amplification analysis was done using peripheral leukocytes and found the heterozygous deletion of exon 1 in his mother.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.30 no.1
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• pp.42-44
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• 2019

Hashimoto's encephalopathy (HE) is a rare and underdiagnosed neuropsychiatric illness. We present the case of a 17-year-old girl who was admitted to a tertiary-care psychiatric center with acute onset psychosis and fever. Her psychotic symptoms were characterized by persecutory and referential delusions, as well as tactile and visual hallucinations. Her acute behavioral disturbance warranted admission and treatment in a psychiatric setting (risperidone tablets, 3 mg/day). She had experienced an episode of fever with a unilateral visual acuity defect approximately 3 years before admission, which was resolved with treatment. Focused clinical examination revealed an enlarged thyroid, and baseline blood investigations, including thyroid function test results were normal. Abnormal laboratory investigations revealed elevated anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) levels (anti-TPO of 480 IU/mL; anti-TG of 287 IU/mL). Results of other investigations for infection, including cerebrospinal fluid examination, electroencephalography, and brain magnetic resonance imaging were normal. She was diagnosed with HE and was treated with intravenous corticosteroids (methylprednisolone up to 1 g/day; tapered and discontinued after a month). The patient achieved complete remission of psychotic symptoms and normalization of the anti-thyroid antibody titers. Currently, at the seventh month of follow-up, the patient is doing well. This case highlights the fact that in the absence of well-defined clinical diagnostic criteria, a high index of suspicion is required for early diagnosis of HE. Psychiatrists need to explore for organic etiologies when dealing with acute psychiatric symptoms in a younger age group.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.289-293
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• 2001

Objectives : The optimal treatment of craniopharyngioma is controversial. Despite recent advances in microsurgical management, complete surgical removal of craniopharyngioma remains very difficult. Radiation added to surgery is effective, but radiation therapy resulted in untoward side effect in young patient. Gamma knife radiosurgery offers the theoretical advantage of a reduced radiation dose to surrounding structures during the treatment of residual or recurrent craniopharyngioma compared with fractionated radiotheraphy. We described retrospective analysis of tumor size and clinical symptoms of patients after gamma knife radiosurgery in residual or recurrent craniopharyngioma were performed. Material and Methods : From September 1990 to January 2000, 18 patients of craniopharyngioma were treated by gamma knife radiosurgery. All patient had undergone surgery, but residual or recurrent tumor was found and all of them treated postoperative gamma knife radiosurgery. The mean age was 19(from 6 to 66) and male to female ratio was 10 to 8 and 8 patients were below 15 years old. In young age group(below age 15), the average volume of the tumor was $2904.8mm^3$ and mean maximal gamma knife dose was 34.9Gy. In old age group(older than 15), the average volume of the tumor was $2590.4mm^3$ and mean maximal gamma knife dose was 45.2Gy. The size of the tumor was average $2730.1mm^3$($88-12000mm^3$), mean average radiation dose was 40.7Gy and the mean prescription dose was 17.6 Gy(4-35Gy) delivered to a median prescription 50.7% isodose. Results : The follow up was from 1 year to 9 years(mean 59.1 months) after gamma knife radiosurgery. The tumor was controlled in 13(72.2%) patients. The tumor decreased in 9 patients and not changed in 4 patients. The tumor size increased in 4(22.2%) patients during follow up period. In two cases the tumor size increased because of its cystic portion was increased, but their solid portion of the tumor was not changed. In another two patients, the solid portion of the tumor was increased. So, one patient underwent reoperation and the other patient underwent operation and repeated gamma knife radiosurgery. The tumor recurred in one case(5.6%) that is a outside of irradiated site. The presenting symptoms were improved in 4 patients(improved visual acuity in 1, controlled increased intracranial presure sign in 3 patients). In one case, visual acuity decreased after gamma knife radiosurgery. The endocrine symptoms were not influenced by gamma knife radiosurgery. Conclusion : Craniopharyngioma can be treated successfully by gamma knife radiosurgery. Causes of the tumor regrowth are inadequate dose planning because of postoperatively poor margination of the tumor, close approximation of optic nerve and residual tumors outside the target lesion. Recurrence can develop 4 years after gamma knife radiosurgery. Volume is important, but the accurate targeting is more important to prevent tumor recurrence. If the tumor definition is not clear during planning gamma knife surgery, long-term image follow up is required.

• Journal of Korean Ophthalmic Optics Society
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• v.21 no.3
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• pp.275-280
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• 2016

Purpose: This study is intended to look into the difference in surgery effects through the analysis of risk factors on how the common adult diseases among Korean adults diseases (glaucoma, hypertension and diabetes) are affecting cataract. Methods: Cataract surgery patients' daily records at hospitals in Jeonnam were used as analysis data. Factors - which can affect the results of medical treatment before and after an operation - were classified into the input, process and outcome of medical treatment. The medical treatment and patient characteristics were reflected as the input of medical treatment, and clinical results, functional status and general status as the process of medical treatment. Results: There was a close relationship between adult diseases of glaucoma, diabetes and hypertension, and cataract. Visual acuity of adult diseases patients was 10% lower than of non-adult diseases patients. And for post-surgery it was around 16% difference in refractive error and visual acuity between two groups. Conclusions: According to a study result, the cataract has been confirmed that there is a close relationship of Adult disease patients's glaucoma, diabetes and hypertension. Depending on the type about these adult diseases, before and after cataract surgery, vision and refractive power was found to indicate a significant difference when compared with conventional low normal adult control.

• Journal of Korean Ophthalmic Optics Society
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• v.11 no.4
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• pp.329-335
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• 2006

The aim of this study was to evaluate the relation between Asthenopia of near lateral phoria and fusional reserve and also to provide fundamental clinical data. A total of 97 subjects, aged between 17 and 35 years old, who had no strabismus, an eye trouble or whole body disease, were examined nacked visual acuity, corrected visual acuity, corrected diopter, phoria, fusional reserve tests from October of 2005 to July of 2006. We excluded 8 subjects for the following reasons: if they had an amblyopia affecting binocular vision or inaccurate data. After these exclusions, 87 subjects remained. The results were as follow. According to interview results was that in near works, exophoria and esophoria with asthenopia was 59.6%, 64.7%, and 52.6% respectively. The subjects who have exophoria of $0-6{\Delta}$ in the range of normal state was 19.1%. The subjects who have exophoria of $7{\Delta}$ over in the range of abnormal state was 80.9%. The fusional reserve was in inverse proportion to phoria. The fusional reserve was twice over of phoria were 30.3%, and twice under were 69.7%. The asthenopia complain persons were 33.9% with the twice over fusional reserve of phoria. The asthenopia no complain persons were 66.1% with the twice under fusional reserve of phoria. In conclusion, our research has shown conclusively that there is a link between asthenopia of lateral phoria and fusional reserve and we also find that fusional reserve must be examined when we prescribe for a patient who has phoria.

• Journal of Korean Ophthalmic Optics Society
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• v.4 no.1
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• pp.73-76
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• 1999

Screening of strabismus was followed in 1306 healthy elementary school students from 8 to 13 years old. The cover-uncover test with M1N GLASSES was used to screen strabismus for all of students and then we examined abnormal students by the prism cover test. Finally 16 students were strabismus. So the cover-uncover test with MIN GLASSES was a good method to screen strabismus because of easy and simple testing. The number of strabismus was 16 patients who consisted in from 10 to 13 years old, and girls(2.4%) was 3 times more than boys(0.9%). The type of 16 strabismus was only heterophoria which consisted in 8 patients of exophoria, 7 patients of esophoria and 1 patient of hyperphoria. So the rate of exophoria and esophoria was almost same. 3 patients was ametropic amblyopia by testing visual acuity, and all of patients were normal color vision by color testing.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.4
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• pp.131-140
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• 2019

Purpose : The purpose of this study was to investigate the interrelationship between eye movement and auditory function through the effects of eye lateralization on transient evoked otoacoustic emissions of auditory function. Methods : 25 subjects with complete set of ears were used in this study, which composed of 12 males and 13 females with pure tone threshold of below 25 dB without otolaryngology were evaluated. Each of the patient has a visual acuity of greater than 1.0 after correction, and has no problems with eye disease, eye movement, and human parallel system. In a dark silent room, the subjects sat on a chair with their heads fixed on a headrest. The tests were performed by asking the patients to look at a fixed red light dot on a light bar in front of them. This light was directed to the front, right and left sides of the subject at an angle of 40 ° In the presence of the stimulus sound in the ipsilateral ear, the transient evoked otoacoustic emissions of the ipsilateral ear was measured at the straight, right and left fixation. In order to evaluate the transient evoked otoacoustic emissions through the efferent auditory pathway, the transient evoked otoacoustic emission values of the contralateral ear were measured at the straight, right and left fixation. These measurements were taken at frequencies of 1 kHz, 1.4 kHz, 2.0 kHz, 2.8 kHz and 4 kHz, respectively. Results : Transient evoked otoacoustic emissions caused by lateral movement of the eye showed significant changes at 1.4 KHz and 2 KHz of the afferent pathway of the ipsilateral ear. Also, significant changes were observed at 1.4 KHz and 4 KHz of the efferent pathway of the contralateral ear. Conclusion : These results indicated that there is a close relationship between eye movement and auditory cochlea. In the future, further studies considering more diverse subjects and age groups will be needed.

• Journal of Korean Ophthalmic Optics Society
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• v.14 no.1
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• pp.133-138
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• 2009

Purpose: This study was designed to investigate the changes of vision and ocular functions induced by increase of blood alcohol level. Methods: Blood alcohol level, vision, refractive errors, near point convergence, heterophoria, and relative convergence were measured at 1 h, 4 h, and 24 h after acute alcohol ingestion of 0.7 g per kg body weight. Results: At 1 h after alcohol ingestion, myopization and ocular functions which measured near point convergence, positive and negative convergences, and degree of heterophoria remarkedly worked a changes accompanied with the maximum value of blood alcohol level. But at 24 h after that, all of ocular functions were recovered to degree of 90~99% compared with non-alcoholic normal conditions. Conclusions: As the increase of blood alcohol level is able to induce the significant changes of visual acuity and ocular functions, opticians have to understand thoroughly the patient's conditions by alcohol ingestion before refractive test and ocular examinations.