• 대한두경부종양학회지
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• 제17권1호
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• pp.63-65
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• 2001

Pituitary apoplexy resulting from hemorrhage or necrosis of a pituitary tumor with subsequent compression of the optic nerves and cavernous sinuses is a life-threatening condition. The diagnosis is made clinically by the sudden onset of headache, meningismus, visual impairment, and ocular abnormalities, Modern surgical techniques seem to have reduced morbidity. Nevertheless, it is evident that not every patient requires surgical decompression after pituitary apoplexy because of spontaneous resolution after hormonal replacement therapy. We report an 84-year-old man who had pituitary apoplexy presenting with headache, ptosis and eyelid swelling. A good result has been achieved with immediate replacement of steroid.

• 한국발생생물학회지:발생과생식
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• 제14권2호
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• pp.91-97
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• 2010

FOXL2는 winged-helix/forkhead(FH) 도메인 전사인자로서 FOXL2 유전자에 돌연변이가 발생할 경우 blepharophimosis-ptosis-epicanthus inversus syndrome이라 불리는 BPES 질병이 유발되게 된다. BPES는 상염색체 우성인 유전적 질환이다. BPES type I의 환자는 조기난소부전증(POF)과 안검하수 증상이 함께 나타나는 반면, BPES type II의 경우 안검하수 및 소안검 등 안면기형만이 유발된다. FOXL2 단백질이 결여된 난소에서 granulosa 세포의 분화가 멈추는 것으로 보아 FOXL2가 정상적인 난소의 folliculogenesis에 필수적인 역할을 하고 있음을 시사한다. 이전의 연구 결과에서, 본 연구진은 FOXL2와 상호작용하는 단백질에 대한 스크리닝을 통해 스테로이드 합성효소인 CYP19 전사활성에 영향을 미치는 steroidogenic factor-1(SF-1)을 동정하였다. 이번 연구를 통해 FOXL2가 CYP19의 전사를 향상시키고, SF-1에 의한 CYP19의 전사를 더욱 촉진시킨다는 것을 증명하였다. 이와 반대로, BPES 타입 I과 II에서 발견된 FOXL2의 돌연변이형들은 SF-1에 의해 증가된 CYP19의 전사활성을 향상시키는 능력이 감소함을 보여주었다. 본 실험을 통해 FOXL2 돌연변이에 의해 유발되어지는 BPES 질환의 병리생리학적인 이해에 대해 도움을 줄 수 있는 FOXL2의 야생형과 돌연변이형 사이의 서로 다른 기능적인 차이점을 규명하였다.

• Archives of Plastic Surgery
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• 제33권2호
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• pp.149-154
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• 2006

The levator and $M{\ddot{u}}ller^{\prime}s$ muscle balanced tucking was performed to correction myogenic or aponeurotic blepharoptosis. Through the blepharoplasty incision, the upper half of tarsal plate was exposed and the orbital was opened to show the levator aponeurosis. the $M{\ddot{u}}ller^{\prime}s$ muscle dissected from the upper border of the tarsal plate and from the posteriorly located conjunctiva with sharp scissors. $M{\ddot{u}}ller^{\prime}s$ muscle was advanced about 3 mm to 8 mm on anterior surface of the tarsal plate and fixed approximately upper one third of the tarsal plate with three horizontal 6-0 Nylon mattress sutures. The amount of tucking of $M{\ddot{u}}ller^{\prime}s$ muscle was controlled by the location of the upper eyelid margin 2 mm below the upper limbus in primary gaze after first temporary fixations suture in the maximum superior point of the limbus. The amount of advancement of levator aponeurosis was controlled by the location of the upper eyelid margin 1 mm below the upper limbus in primary gaze after first temporary fixations suture in the maximum superior point of the limbus. And then levator aponeurosis was fixed with three horizontal 6-0 Nylon mattress on beside the point that was tucked $M{\ddot{u}}ller^{\prime}s$ muscle. We have been thirty cases with levator and $M{\ddot{u}}ller^{\prime}s$ muscle balanced tucking from January 2004 to Jun 2005. 3 cases were traumatic blepharoptosis with 3-5 mm ptosis and poor levator function. 27 cases were myogenic or aponeurotic blepharoptosis with 2-5 mm ptosis with and more than 4 mm of levator function. the age of the patients ranged from 6 to 78 years. The levator aponeurosis and $M{\ddot{u}}ller^{\prime}s$ muscle tucking procedure can reduce the amount of the levator and $M{\ddot{u}}ller^{\prime}s$ muscle resection, and improve discomfort when the patients open eyes.

• Archives of Plastic Surgery
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• 제40권5호
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• pp.603-609
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• 2013

Background Although the conventional direct brow lift operation provides a simple means of managing lateral brow ptosis, the scars produced have been unacceptable. However, using the modifications proposed here, scarring showed remarkable improvement. This article reviews our experiences with the presented technique, mainly with respect to postoperative scarring. Methods Measured amounts of supra-eyebrow skin and subcutaneous fat were excised en bloc in the conventional manner under 'hyper-hydrated' local infiltration anesthesia. The lower flap and the edge of the upper flap were undermined above the muscular plane, and the orbicularis oculi muscle was directly suture-plicated and suspended upward to the distal frontalis muscle. Skin closure was performed in a basic plastic surgical manner. Results From April 2007 to April 2012, a consecutive series of 60 patients underwent surgery using the above method. The average width of the excised skin was 8 mm (range, 5-15 mm) at the apex of the eyebrow. Preoperative complaints were resolved without occurrence of significant complications. The surgical scars showed remarkable improvement and were negligible in the majority of the cases. Conclusions The direct brow lift operation combined with plication/suspension of the superior and lateral portion of the orbicularis oculi muscle provides a simple, safe, and predictable means of correcting lateral brow ptosis. The scars were acceptable to all of the patients. For proper management of the frontalis tone, upper blepharoplasty and/or repair of eyelid levator function must be considered in addition to brow lift procedures.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권6호
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• pp.563-566
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• 2010

Retrobulbar abscess is a rare, but severe complication of paranasal sinusitis. The clinical presentations are eyelid swelling, erythema, proptosis, conjunctival chemosis, restricted ocular movement, and decreased visual acuity. Diagnostic methods available for evaluating retrobulbar abscess include sinus X-ray, ultrasonography, computed tomography (CT), and bacterial culture. For the treatment of retrobulbar abscess, immediate surgical drainage and systemic antibiotic therapy are needed. Proper diagnosis and treatments are necessary for preventing visual loss, cavernous sinus thrombosis, subdural abscess, and other lifethreatening complications. A patient, a 30-year-old man, was admitted to our hospital because of progressive eyelid swelling, erythema, ptosis and decreased visual acuity on the right eye after endodontic treatment. The sinusitis occurred secondary to the infection from an upper molar tooth. The spread of the infection led to the orbit via ethmoidal sinus and posterior orbital wall. Immediate surgical intervention was performed and systemic antibiotics was administrated. The symptoms and signs are improved after treatments, so we present our case with a brief review of the literature.

• Archives of Plastic Surgery
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• 제36권2호
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• pp.211-220
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• 2009

Purpose: Even in a small levator resection for blepharoptosis, 10 ~ 13 mm of $M{\ddot{u}}ller^{\prime}s$ muscle and levator aponeurosis is resected. To solve the problem, $M{\ddot{u}}ller^{\prime}s$ muscle was detached from the superior tarsal border and conjunctiva, and the muscle with overlying levator aponeurosis was advanced on the upper tarsus as a composite flap. The purpose of this study was to evaluate the effectiveness of the $M{\ddot{u}}ller^{\prime}s$ muscle - levator aponeurosis complex advancement technique for the correction of blepharoptosis. Methods: Between 2003 and 2008, 107 patients(183 eyes) underwent the advancement procedure of the $M{\ddot{u}}ller^{\prime}s$ muscle - levator aponeurosis composite flap for blepharoptosis. The advanced composite flap was fixed 3 mm below the superior tarsal border and 2 ~ 3 mm of distal flap stump was left after trimming up to 5 mm. The results of the operations were evaluated. Results: The mean age of the patients was 35.2 years and 83 patients(145 eyes) were followed up for a mean of 16.7 months. 128 eyes (88.3%) showed a normal level of upper eyelid margin (MRD1 4.1 ~ 5.0 mm) or less than 1 mm ptosis (MRD1 3.1 ~ 4.0 mm). 10 eyes(6.9%) showed 1 ~ 2 mm ptosis (MRD1 2.1 ~ 3.0 mm). 7 eyes(4.8%) showed more than 2 mm ptosis which required secondary correction. About 80% of the 183 eyes needed no trimming of the flap stump with 5 ~ 6 mm of composite flap advancement and 20% had about 3 mm of the flap stump trimmed with 8 ~ 9 mm of composite flap advancement(shortening of the levator complex). Conclusion: $M{\ddot{u}}ller^{\prime}s$ muscle - levator aponeurosis complex advancement technique offers several advantages: There is no, or minimal, sacrifice of the normally functioning $M{\ddot{u}}ller^{\prime}s$ muscle; it is more physiological; it is reproducible and it is predictable - with gratifying results for blepharoptosis.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.659-666
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• 2010

Purpose: Blepharoplasty plays a vital role in facial rejuvenation. Aging eyelids are the result of relaxation of lid structures as the skin, the orbicularis muscle, and mainly the septum, with subsequent protrusion or pseudoherniation of intraorbital fat contents. Traditional blepharoplasty has often involved the excision of excessive lax skin and muscle and removal of fat, leaving the eyelid unnatural and even causing the brow ptosis. The authors propose the septal approach through which the amount of skin excision can be decreased and solid fixation can be achieved in the upper blepharoplasty. Methods: From November 2007 to February 2010, total of 15 patients underwent upper blepharoplasty with septal approach. In 9 patients, orbital septum anchored into the orbital periosteum only. But in 6 patients, the attenuated septum was strengthened through shortening and fixing into orbital periosteum with non-absorbable suture. Results: Pleasing results were obtained from most of the patients. But one patient who had septum anchoring procedure complained of slight undercorrection, therefore secondary operation with septum shortening procedure was followed. Conclusion: We found that the method using orbital septum fixation into orbital periosteum has several advantages: less amount of skin excision, less recurrence rate, and more natural appearance. And the results were reliable and satisfactory.

• Clinical and Experimental Pediatrics
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• 제59권sup1호
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• pp.10-13
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• 2016

Chromosome 11q13 deletion syndrome has been previously reported as either otodental syndrome or oculo-oto-dental syndrome. The otodental syndrome is characterized by dental abnormalities and high-frequency sensorineural hearing loss, and by ocular coloboma in some cases. The underlying genetic defect causing otodental syndrome is a hemizygous microdeletion involving the FGF3 gene on chromosome 11q13.3. Recently, a new form of severe deafness, microtia (small ear) and small teeth, without the appearance of eye abnormalities, was also reported. In this report, we describe a 1-year-old girl presenting with ptosis of the left upper eyelid, right auricular deformity, high-arched palate, delayed dentition, simian line on the right hand, microcephaly, and developmental delay. In this patient, we identified a deletion in the chromosome 11q13.2-q13.3 (2.75 Mb) region by using an array-comparative genomic hybridization analysis. The deletion in chromosome 11q13 results in a syndrome characterized by variable clinical manifestations. Some of these manifestations involve craniofacial dysmorphology and require a functional workup for hearing, ophthalmic examinations, and long-term dental care.

• 대한약침학회지
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• 제12권1호
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• pp.91-97
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• 2009

Objective : Oculomotor nerve palsy is a disorder which causes eyeball movement trouble, diplopia, dizziness and eyelid ptosis. It is caused by aneurysm, mass, trauma, infection and so on. But sometimes we can't establish the cause. We observed 3 cases of idiopathic oculomotor nerve palsy patient treated with hominis placenta pharmacopuncture. Method & Result : We treated three idiopathic oculomotor nerve palsy patients with hominis placenta pharmacopuncture and electroacupuncture. As the result, symptoms of three patients were improved remarkably. Conclusion : In this cases, the hominis placenta pharmacopuncture is effective on idiopathic oculomotor nerve palsy. We need further study about idiopathic oculomotor nerve palsy and hominis placenta pharmacopuncture.

• Journal of Acupuncture Research
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• 제21권6호
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• pp.281-289
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• 2004

Objective : Blepharoptosis is drooping of eyelid which causes impairment of visual field by covering partially or completely, and it is classified into congenital ptosis and acquired one. In western medicine, idiopathic blepharoptosis is usually treated by tarsectomy. Contrary to that concept, we consider eyelid is assigned to Yookryoon(肉輪) among Ohryoon(五輪) which matches to spleen. In oriental medicine, it can be treated by promoting spleen and kidney. Here I report two cases of idiopathic blepharoptosis improved by conservative acupuncture therapy and herb medicine. Methods : The changes in clinical symptoms of general body weakness, anorexia, dizziness, dry eye, etc, in degree of eyelid drooping and in individual expression were described as they were treated with acupuncture therapy, herb medicine, Bojoong-ikgi-tang(補中益氣湯) and some physical therapy including Negative, I.C.T, S.S.P and Carbon. Results : Symptoms(ex) general body weakness, anorexia, dizziness, dry eye, etc) at admission improved and disappeared gradually with acupuncture therapy and herb medicine. The patients could discharge with favorable recovery. Conclusions : In oriental medicine, blepharoptosis is mainly treated by promoting Qihyul(氣血) and enhancing flow of that. If the patient has deficiency of Suhnchun-poomboo(先天稟褓賦) and Mungmoon-hwa(命門火), he is treated by promoting Shin-yang(腎陽). If he is weak in Bee-qi(脾氣), he needs to be treated by strengthening Bee-yang(脾陽) where patient with lack of Ganhyul(肝血) is supposed to be treated by promoting Hyul(血). These following two cases were managed by acupuncture, herb medicine and physical therapy on idiopathic blepharoptosis.