• 제목/요약/키워드: Visual Disturbance

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A Case of Penetrating Facial Wound by a Grinder (분쇄기에 의한 얼굴 관통창 1 례)

  • Kang, Jin-ah;Kim, Kang Ho;Paik, Jin Hui;Hong, Dae Young;Kim, Ji Hye;Lee, Kyoung Mi;Kim, Jun Sig;Han, Seung Baik
    • Journal of Trauma and Injury
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    • v.19 no.1
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    • pp.89-92
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    • 2006
  • Penetrating facial wounds are uncommon and are usually life threatening because of the possibility of brain damage. There are three possible pathways for penetrating the cranium through the orbit: via the orbital roof, via the superior orbital fissure, or between the optic canal and lateral wall of the orbit. Brain injuries resulting from the penetrating wounds show extensive parenchymal damage, hemorrhage, and brain edema. Transorbital penetrating wounds can lead to diverse lesions of the optical apparatus, including the eye globe, the optical nerve, and the chiasm. Moreover, intracerebral structures may be hurt, and bleeding and infection may occur. Early diagnosis and prompt debridement are the fundamental factors affecting the outcome of a penetrating facial wound. An 87-year-old man was admitted to the emergency department with a grinder impacted into the medial aspect of the right eye. On presentation, the man was fully conscious with a Glasgow Coma Scale score of 15 and complained of a visual disturbance of the right eye. Computed tomography demonstrated a right orbital medial and inferior wall fracture, a frontal bone fracture, and a contusional hemorrhage in frontal lobe of the brain. A craniotomy with hematoma removal and repair of the orbital floor was done. He showed no neurological deficits except right visual loss. This appears to be the first report of a man with a penetrating facial wound caused by a grinder, who presented with a potentially disastrous craniocerebral injury that did not lead to any serious neurological seguelae.

Feasibility of Endoscopic Endonasal Approach for Recurrent Pituitary Adenomas after Microscopic Trans-Sphenoidal Approach

  • Hwang, Joo Min;Kim, Yong Hwy;Kim, Jin Wook;Kim, Dong Gyu;Jung, Hee-Won;Chung, Young Seob
    • Journal of Korean Neurosurgical Society
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    • v.54 no.4
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    • pp.317-322
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    • 2013
  • Objective : The surgical approach for recurrent pituitary adenoma after trans-sphenoidal approach (TSA) is challenging. We report the outcomes of the endoscopic TSA for recurrent pituitary adenoma after microscopic TSA. Methods : From February 2010 to February 2013, endoscopic TSA was performed for removal of 30 recurrent pituitary adenomas after microscopic TSA. Twenty-seven (90%) patients had a clinically non-functioning pituitary adenoma. Twenty-four (80%) patients suffered from a visual disturbance related to tumor growth. The clinical features and surgical outcomes were retrospectively analyzed for the ophthalmological, endocrinological, and oncological aspects. Results : The mean tumor volume was 11.7 $cm^3$, and gross total resection was achieved in 50% of patients. The volumetric analysis based on the postoperative MR showed that the mean extent of resection rates were 90%. Vision was improved in 19 (79%) of 24 patients with visual symptoms, and endocrinological cure was achieved in all of three functioning pituitary adenomas; however, the post-operative follow-up endocrinological examination revealed a new endocrinological deficit in one patient. Two patients required antibiotics management for post-operative meningitis. Conclusion : The endoscopic TSA can be an effective treatment option for recurrent pituitary adenoma after microscopic TSA with acceptable outcome.

Surgical Treatment of Orbital Tumors at a Single Institution

  • Park, Hyun-Joon;Yang, Seung-Ho;Kim, Il-Sup;Sung, Jae-Hoon;Son, Byung-Chul;Lee, Sang-Won
    • Journal of Korean Neurosurgical Society
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    • v.44 no.3
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    • pp.146-150
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    • 2008
  • Objective : The authors reviewed the experience of 19 patients with orbital tumors and summarize the clinical features, surgical treatment and outcomes. Methods : The authors searched the database for all patients who underwent surgery for the treatment of orbital tumors at a single institution between 1999 and 2007. Data from clinical notes, surgical reports, and radiological findings were obtained for the analysis. Results : Orbital tumors constituted a heterogenous array of histopathology. The presenting symptoms were exophthalmos (52.6%), visual disturbance (26.3%) and pain (21.1%). The surgical approaches used were transcranial in 17 patients. Tumors located in the intraconal or perioptic space were surgically excised using a frontoorbital approach (8 cases). while pterional (3 cases). orbital (2 cases) and combined approaches (6 cases) were used for tumors in other sites. Total resection of tumors was achieved in 12 of 19 patients. In 4 patients with glioma and lymphoma only diagnostic biopsy was done. Three patients experienced visual deterioration postoperatively. Two patients had temporary diplopia, and one patient had temporary ptosis. Conclusion : Surgical treatment could be the mainstay of therapy for the majority of symptomatic orbital tumors. Many orbital tumors can be treated safely via a transcranial approach. Frontoorbital approach allows the surgeon to reach both the intraorbital and intracranial structures. Knowledge of the microanatomy of the orbit and meticulous surgical skills are necessary to overcome the pitfalls of intraorbital surgery.

Psychotic Symptoms of Hashimoto's Encephalopathy: A Diagnostic Challenge

  • Savarimuthu, Monisha K;Tsheringla, Sherab;Mammen, Priya
    • 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.

A Literature Study of Ophthalmotolaryngologic Diseases from the Viewpoint of Onbyeong; On the Basis of Imjeungjinamuian (溫病學에서의 眼耳鼻咽喉科 疾患에 대한 文獻考察;臨證指南醫案을 중심으로)

  • Cho, Jae-Hun;Chae, Byung-Yoon;Kim, Yoon-Bum
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.15 no.1
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    • pp.198-218
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    • 2002
  • On the basis of Imjeungjinamuian(臨證指南醫案), authors investigated the pathogenesis and treatment of ophthalmotolaryngobgic diseases from the viewpoint of Onbyeong(溫病). 1. The symptoms and diseases investigated according to department were as follows;. 1) Ophthalmology : blepharitis, blepharedema, lacrimal hypersecretion, hyperemia, ophthalmalgla, photopsia, visual disturbance, mydriasis 2) Otology : full-feeling, otorrhea, otalgla, mastoiditis, tinnitus, hearing disturbance, vertigo 3) Rhinology : rhinorrhea, nasal obstruction, sinusitis, epistaxis 4) Laryngology : sore throat, hoarseness 5) The Others : headache, cough, asthma 2. The pathogenesis and treatment of ophthalmotolaryngologic diseases were as follows. 1) When the pathogenesis of hyperemia, otorrhea, otalgia, mastoiditis, hearing disturhance. epistaxis, sore throat, headache and cough are wind-stagnanc(風鬱), wind-warm(風溫), wind-fire(風火), wind-dryness(風燥), dryness-heat(燥熱), the treatment of pungent-cool-evaporating(辛凉解表) with Dajosan(茶調散), Mori Folium(桑葉), Lonicerae Flos(金銀花), Forsythiae Fructus(連翹), Viticis Fructus(蔓荊子), Prunellae Spica(夏枯草), Arctii Fructus(牛蒡子), etc can be applied. 2) When the pathogenesis of hoarseness, cough and asthma are cold(寒), cold with endogenous heat(寒包熱, 外冷內熱), water retention(水邪), fluid retention(伏飮), impairment of YangKi by overexertion(勞傷陽氣), the treatment of pungent-warm-evaporating(辛溫解表) with Mahaenggamseoktang(麻杏甘石湯), Socheongryongtang(小靑龍湯), Jeongryeokdaejosapyetang(정력대조사폐탕), Gyejitang(桂枝湯), Armeniacae Amarum Semen(杏仁), etc can be applied. 3) When the pathogenesis of photopsia, otorrhea, otalgia, rhinorrhea, sinusitis, epistaxis, sore throat, hoarseness, headache and cough are stagnancy-induced heat(鬱熱), wind-dryness(風燥), wind-heat(風熱), summer heat(暑熱), summer wind(暑風), insidious summer heat(伏暑), autumn heat(秋暑), autumn wind(秋風), autumn dryness(秋燥), dryness-heat(燥熱), heat in Ki system(氣分熱), insidious warm(溫伏), brain discharge by fire in Ki system(氣火 腦熱), heat in stomach(胃熱), endogenous fire by deficiency of Yin(陰虛內火), deficiency of Yin in stomach(胃陰虛), the treatment of Ki-cooling(淸氣) with Bangpungtongseongsan(防風通聖散), Ikweonsan(益元散), Gyejibaekhotang(桂枝白虎湯), Geumgwemaekmundongtang(금궤맥문동탕), Gyeongokgo(瓊玉膏), Sojae Semen Praeparatum(두시), Scutellariae Radix(黃芩), Phyllostachys Folium(竹葉), Adenophorae Radix(沙參), Mori Cortex(桑白皮), Fritillariae Cirrhosae Bulbus(貝母), etc can be applied. 4) When the pathogenesis of blepharitis, hyperemia, ophthalmalgia, full-feeling, otorrhea, otalgia, tinnitus, hearing disturbance, sinusitis, hoarseness, headache and cough are fire in liver(肝火), fire in gallbladder(膽火), ministerial fire in Soyang system(少陽相火), wind-stagnancy(風鬱), stagnancy-induced fire(鬱火), brain discharge by phlegm-fire(痰火 腦熱), the treatment of mediation(和解) with Gardeniae Fructus(梔子), Moutan Cortex(牧丹皮), Saigae Tataricae Cornu(羚羊角), Artemisiae Annuae Herba(靑蒿), Cyperi Rhizoma(香附子), Poria(적복령), etc can be applied. 5) When the pathogenesis of blepharedema and cough are dampness in both spleen and lung(脾肺濕) damp-heat(濕熱), damp-phlegm(濕痰), the treatment of dampness-resolving(化濕) with Poria(백복령), Coicis Semen(薏苡仁), Tetrapanacis Medulla(通草), Armeniacae Amarum Semen(杏仁), Talcum(滑石), etc can be applied. 6) When the pathogenesis of vertigo and cough are deficiency of Yong(營虛), heat in Yong, system(營熱), the treatment of Yong-cooling(淸營) with Rehmanniae Radix(生地黃), Liriopis Tuber(麥門冬), Biotae Semen(柏子仁), Lilii Bulbus(百合), Phyllostachys Folium(竹葉), etc can be applied. 7) When the pathogenesis of epistaxis are heat in blood system of heart(心血熱), reversed flow of fire(火上逆), overexertion(努力), the treatment of blood-cooling(凉血) with Rhinoceri Cornu(犀角), Rehmanniae Radix(生地黃), Moutan Cortex(牧丹皮), Salviae Miltiorrhizae Radix(丹參), Scrophulariae Radix(玄蔘), etc can be applied. 8) When the pathogenesis of nasal obstruction is pathogen-stagnancy(邪鬱), the treatment of resuscitation(開竅) with Sosang(少商, LU11) acupuncture can be applied. When the pathogenesis of hoarseness is evil Ki(穢濁), the treatment of resuscitation(開竅) with Arctii Fructus(牛蒡子), Lasiosphaera Seu Calvatia(馬勃), Curcumae Radix(鬱金), etc can be applied. When the pathogenesis of headache is stasis of both Ki and blood(氣血瘀痺), the treatment of resuscitation(開竅) with Cnidii Rhizoma(川芎), Asari Herba Cum Radice(細辛), Scorpio(全蝎), moxibustion(灸), etc can be applied. 9) When the pathogenesis of lacrimal hypersecretion, visual disturbance, mydriasis, tinnitus, hearing disturbance, sinusitis, epistaxis, hoarseness and cough are deficiency of Yin(陰虛), deficiency of kidney(腎虛), deficiency of both liver and kidney(肝腎虛), deficiency of both heart and kidney(心腎虛), brain discharge by deficiency of Yin(陰虛 腦熱), exuberance of Yang in liver(肝陽上亢), overexertion(勞損), the treatment of Yin-replenishing(滋陰) with Yukmijihwanghwan(六味地黃丸), Hojamhwan(虎潛丸), Jeobutang(猪膚湯), Lycii Fructus(枸杞子), Polygoni Multiflori Radix(何首烏), Rehmanniae Radix(生地黃), Schizandrae Fructus(五味子), Liriopis Tuber(麥門冬), Asini Gelatinum(阿膠), etc can be applied. 10) When the pathogenesis of ophthalmalgia, mydriasis, vertigo and headache are deficiency of Yin in liver(肝陰虛), exuberance of Yang in liver(肝陽上亢), endogenous wind(內風), excess in upper and deficiency in lower part(上實下虛), the treatment of Yin-replenishing(滋陰) and endogenous wind-calming(熄風) with Rehmanniae Radix Preparat(熟地黃), Lycii Fructus(枸杞子), Polygoni Multiflori Radix(何首烏), Paeoniae Radix Alba(白芍藥), Ostreae Concha(牡蠣), Saigae Tataricae Cornu(羚羊角), Chrysanthemi Flos(菊花), etc be applied. 11) When the pathogenesis of mydriasis, sinusitis, hoarseness, headache, cough and asthma are exhaustion of vital essence(精氣無收藏), brain discharge(腦髓不固), floating Yang(陽虛浮), exsanguination(失血), deficiency of both Yin and Yang(陰陽不足), overexertion(勞損), deficiency of Yang in kidney(腎陽虛), the treatment of Yang-restoring and exhaustion-arresting(回陽固脫) with Yangyeongtang(養營湯), Cheonjinhwan(天眞丸), Bokmaektang(복맥탕), Geonjungtang(建中湯), Dogihwan(都氣丸), Singihwan(腎氣丸), Jinmutang(眞武湯), Ostreae Concha(牡蠣), Nelumbinis Semen(蓮子肉), etc can be applied. 12) When the pathogenesis of lacrimal hypersecretion, vertigo and headache are deficiency of stomach and endogenous wind(胃虛內風), endogenous wind with phlegm(內風挾痰), liver check of stomach(肝木橫擾), the treatment of concomitant-treating of both liver and stomach(肝胃同治) with Paeoniae Radix Alba(白芍藥), Uncariae Ramulus Et Uncus(釣鉤藤), Gastrodiae Rhizoma(天麻), Astragali Radix(황기), Pinelliae Rhizoma(半夏), etc can be applied. When the pathogenesis of asthma is failure of kidney to promote inspiration(腎不納氣), the treatment of kidney-tonifing and inspiration-promoting(補腎納氣) with Singihwan(腎氣丸), Psoraleae Fructus(補骨脂), Juglandis Semen(胡桃), Aquilariae Resinatum Lignum(沈香), etc can be applied. When the pathogenesis of asthma is deficiency of Ki(氣虛), the treatment of Ki-reinforcing(補氣) with Sagunjatang(四君子湯), Insamgeonjungtang(人參建中湯), etc can be applied.

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Clinical Analysis of Pituitary Apoplexy (뇌하수체졸중의 임상적 고찰)

  • Kim, Jung Tae;Park, Bong Jin;Sung, Jung Nam;Kim, Young Joon;Cho, Maeng Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.6
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    • pp.724-728
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    • 2001
  • Objectives : Pituitary apoplexy is a well-described clinical syndrome resulting from pituitary hemorrhage, hemorrhagic infarction, or infarction, almost invariably occurring in the presence of an adenoma. We analyzed pituitary apoplexy with an emphasis on clinical presentation, pathology and predisposing factors. Methods : We reviewed 35 histologically proven pituitary adenomas, operated from January 1995 to August 1999, to select 8 cases which showed clinical or operative findings compatible with pituitary apoplexy. These patients were analyzed in terms of symptom and sign, hormonal status, and predisposing factors, pathologic findings. Results : Among 35 surgically treated tumors of the pituitary gland, 8 cases(23%) were diagnosed as pituitary apoplexy. The pathologic findings revealed hemorrhage(7 cases) and infarction(1 case) of pituitary adenomas. One case had predisposing factor of appendectomy. The most common presenting symptom and sign were sudden severe headache and visual disturbance. Conclusion : We treated pituitary apoplexy surgically and obtained good outcomes. Pituitary apoplexy due to massive infarction of the pituitary gland is very rare condition but surgical treatment by trans-spheniodal surgery showed a good result.

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Development of Intelligent Rain Sensing Algorithm for Vision-based Smart Wiper System (비전 기반 스마트 와이퍼 시스템을 위한 지능형 레인 센싱 알고리즘 개발)

  • Lee, Kyung-Chang;Kim, Man-Ho;Lee, Seok
    • Journal of Institute of Control, Robotics and Systems
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    • v.10 no.7
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    • pp.649-657
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    • 2004
  • A windshield wiper system plays a key part in assurance of driver's safety at rainfall. However, because quantity of rain and snow vary irregularly according to time and velocity of automotive, a driver changes speed and operation period of a wiper from time to time in order to secure enough visual field in the traditional windshield wiper system. Because a manual operation of wiper distracts driver's sensitivity and causes inadvertent driving, this is becoming direct cause of traffic accident. Therefore, this paper presents the basic architecture of vision-based smart wiper system and the rain sensing algorithm that regulate speed and interval of wiper automatically according to quantity of rain or snow. Also, this paper introduces the fuzzy wiper control algorithm based on human's expertise, and evaluates performance of suggested algorithm in the simulator model. Especially the vision sensor can measure wider area relatively than the optical rain sensor, hence, this grasps rainfall state more exactly in case disturbance occurs.

Clinical Observation on 1 Case of The Wallenberg's syndrome Caused by The Pons Infarction (뇌교경색에 따른 Wallenberg 증후군 치험 1례에 관한 고찰)

  • Seo, Sang-ho;Kim, Sung-hwan;Hong, Sang-hoon;Youn, Hyoun-min
    • Journal of Acupuncture Research
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    • v.20 no.5
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    • pp.244-251
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    • 2003
  • Objective: The main symptoms of the Wallenberg's syndrome are ataxia of gait, clumsiness of ipsilateral limbs, nausea and vomiting, vertigo, visual disturbance such as difficulty in focusing blurred vision diplopia, numbness, dysphagia, hoarseness, hiccup, nystagmus, Homer's syndrome. The purpose of this paper is to report the patient with the Wallenberg's syndrome who was improved by oriental medical treatment. Methods: In terms of exuberance of Yang(vital function) of the liver and stagnation of the liver Ki(energy), we let the patient take Chunghunhwadam-Tang, Hwangryeonhaedok-Tang and Dangkwihwalhyeol-Tang, at the same time, treated with acupuncture, Sa-Am and Dong-Si acupuncture therapy twice a day. Results: We could know that symptoms of the Wallenberg's Syndrome were improved after observing left sensory paralysis was almost recovered, hiccup was completely healed and vertigo was reduced to 1/10. Conclusions: We confirmed that oriental drugs and acupuncture by differentiation of syndromes make the patient with the Wallenberg's Syndrome reduce and improve symptoms he has.

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A Study on the Retina shaped Optical Path Shift Using the Prism

  • Kwon Yun Jung;Nam Sang Yep;Lee Sung Chang
    • Proceedings of the IEEK Conference
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    • 2004.08c
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    • pp.699-702
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    • 2004
  • This paper discusses about the mechanism of catching an image through an optical manipulation of each organizations in the eye, more specifically, mechanism of catching an image on a retina through a Camera and a Crystal Lens. In the retina, the macula roles as a fovea contrails and it leads the image which is about 3 mm to be shaped on there. However, even the macula may not properly function, our eyes still can catch the image by shifting the optical path to around of the macula, even if the sensitivity of the image is generally lower than the image on the macula. This paper proposes a method of shifting the shaped image on the retina by refracting the optical path through a prism located on the rear of a screen which consists of a 0.7' TFT LCD. Applying this method that throwing an image around on the macula, central visual disturbance patients among retinitis pimentos patients can expect to recover such a mechanism to catch an image.

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Case reports: Effect of Korean Medicine Including Pharmacopuncture on Chemotherapy Induced Peripheral Neuropathy (항암제 유발 말초신경병증 한의 치험 2례)

  • Hong, Sang Hoon;Jung, Yu-jin
    • Journal of Korean Traditional Oncology
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    • v.24 no.2
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    • pp.23-31
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    • 2019
  • Objective : Peripheral neuropathy refers to the symptoms caused by damage to peripheral fibers, inflammation and degeneration. This study reports the effects of moxibustion, electric moxibustion, and pharmacopuncture including GeonChil(Rhus verniciflua stokes, 乾漆)and Whalhyul(活血) pharmacopuncture on patients with peripheral neuropathy induced by anti-cancer drugs and chemotherapy. Method : We administered moxibustion, electric moxibustion, GeonChil and Whalhyul pharmacopuncture to two patients who showed peripheral neuropathy induced by anti-cancer drugs and chemotherapy. The symtoms were evaluated using Visual Analog Scale (VAS) and chemotherapy induced peripheral neuropathy assessment tool (CIPNAT). Results : Following observations were made after treatments. Case 1 : After nine procedures, the score of VAS was decreased. Feeling of cold and numbness were improved, and as rotation movement of ankle was also possible, gait disturbance were improved. Case 2 : After, seven procedures symptoms of both shoulder pain were improved, and the symptoms of peripheral neuropathy were eliminated. Conclusion : We found the possibility of symptom improvement after moxibustion, electric moxibustion, and pharmacopuncture treatment on peripheral neuropathy caused by anti-cancer drugs. Clinical studies of pilot study and control settings will need to be carried out later.