• Title/Summary/Keyword: blindness

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Behcet`s Syndrome with Aortic Aneurysm: A Case Report (Bechet`s 병과 합병된 상부대동맥류: 치험 1례 보고)

  • Gang, Jeong-Ho;Lee, Jeong-Ho;Yu, Hoe-Seong
    • Journal of Chest Surgery
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    • v.10 no.1
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    • pp.98-105
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    • 1977
  • A 36 year old blindman, engineer was admitted with chief complaints of hemoptysis, recurrent sore throat, pyoderma in genital organ, uveitis and thrombophlebitis for 10 years. Above the chief complaints were remission or exacerbation during hospitalization. Physicalexamination showed that left radial, ulnar & brachial pulse was not palpable. No bruit or murmur was obtained over the mass. Neurologic examination revealed no significant finding.On admission, chest P-A showed hen egg sized round & oval compact hazy density on left upper lung field. Bronchogram revealed no pathological finding and Lt. tomogram showed well define large,ovoid mass density in the superior mediastinum. Fluoroscopy finding showed nonpulsatile on left upper lung field. Pre-op. aortography was not taken, under the impression of lung Ca. rule out .sortie aneurysm, exploratory operation was performed through the 2nd intercostal space, Lt. It was performed that the mass was ascending sortie aneurysm of saccular type. Direct aneurysmectomy with multiple figure of eight suture were done without any prosthetic graft. Post-op. control I.V.C graphy showed completely obstruction sign. Postopcontrol aortography revealed good surgical result. Final, histopathological answered non-specific sortie aneurysm, saccular type. Post-op. courses were uneventful except mild neurologic disturbance with subclavian steal syndrome and associated with both lower leg pitting edema due to inferior vena cava obstruction. After op, 3 month later, discharged to home, with big systemic problem. Behcet`s syndrome reviewed with related literatures. The coexistence of mouth and genital ulceration with hypopyon mentioned by hippocrates and described by various workers in the early part of this century was first defined as a syndrome by Behcet in 1937. In 1937 Behcet described a chronic relapsing triple symptom complex of oral ulceration, genital ulceration, and ocular inflammation. The place of the syndrome as part of a systemic disorder in now clearer, and the under lying pathology appears to be a vasculitis. The disease runs a- chronic course, blindness being the greatest disability and control nervous system involvement a cause of death. Thrombophlebitis is fairly frequent, france et al [1951] giving an incidence of 25% and Dowling [1961] 12%, superficial thrombophlebitis migrans and thrombosis of large veins, including venae cavae [Thomas, 1947: Boolukos 1960] are recorded. Little attention has been paid to arterial involvement. Mishima et al. [1961] described resection cf an aortic aneurysm in a 38 year old man with Behcet`s syndorme. Mounsey in a clinicopathological conference described a case [Brit, med. J., 1966] of ruptured aortic aneurysm in Bechcet`s syndrome treated by aorto-iliac graft. Also, Shikano and Oshima et al [1963] recorded two aneyrysm of smaller arteries. Unfrequently, aortic aneurysm was presumed to be secondary to osteomyelitis of the lumber spine, though the possible association between aortic aneurysm and Behcet`s syndrome was raised. A further case is reported here, in which ascending aortic aneurysm with Behcet`s Ds. appeared to form part of this generalized disease. This is a case report of surgical experience of Behcet`s Ds. with ascending aortic aneurysm which had nearly all the typical clinical features. Above mentioned and was reviewed with related literatures.

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Clinical Review of Toxic Alcohol Poisoning Cases in Korea (독성 알코올 중독 환자에 대한 고찰)

  • Rhee, Nu-Ga;Chung, Sung-Phil;Park, In-Cheol;Lee, Kyeong-Ryong;Kim, Hyun-Jin;Kim, Gun-Bea;Cho, Young-Soon;Kwon, In-Ho;Kim, Seung-Whan
    • Journal of The Korean Society of Clinical Toxicology
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    • v.10 no.1
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    • pp.15-21
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    • 2012
  • Purpose: Toxic alcohols are responsible for accidental and suicide motivated poisonings, resulting in death or permanent sequelae for the afflicted patients. Major therapeutic modalities in these cases include treatment with alcohol dehydrogenase inhibitors and extracorporeal elimination. There have been a number of case reports of toxic alcohol intoxication in Korea. The purpose of this study was to review the clinical characteristics of patients suffering toxic alcohol intoxication. Methods: We retrospectively reviewed the medical records of patients who presented with toxic alcohol intoxication at 8 emergency departments (ED) from Jun 2005 to Nov 2011. Patients who ingested methanol, isopropyl alcohol, ethylene glycol, and other alcohols except ethanol, were included in this study. The clinical characteristics of these patients were analyzed to include anion and osmolar gap, and estimated concentration of alcohol in the body. Results: During the study period, 21 patients were identified who had ingested toxic alcohol (methanol; 12 patients, ethylene glycol; 9 patients). At ED arrival, the mean anion gap was $18.7{\pm}6.9$ and the osmolar gap was elevated in 13 patients. Oral and IV ethanol were administrated to 11 patients in order to inhibit alcohol dehydrogenase. Extracorporeal elimination procedures such as hemodialysis were performed in 9 patients. There were no fatalities, but the one patient suffered permanent blindness. Conclusion: This study found that ethylene glycol and methanol were the substances ingested which produced toxic alcohol intoxication. The patients presented with high anion gap metabolic acidosis and were typically treated with oral ethanol and hemodialysis.

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CAVERNOUS SINUS THROMBOSIS : A CASE REPORT (해면 정맥동 혈전증(Cavernous Sinus Thrombosis) 치험례)

  • Chang, Hyun-Suk;Jang, Myung-Jin;Kim, Yong-Kwan;Kim, Kyoung-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.4
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    • pp.447-455
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    • 1995
  • Cavernous sinus thrombosis is one of the major complications of abscesses of the maxillofacial region. The initial symptoms of CST are usually pain in the eye and tenderness to pressure. this is associated with high fluctuating fever, chills, rapid pulse, and sweating. Venous obstruction subsequently causes edema of the eyelids, lacrimation, proptosis, chemosis and retinal hemorrhages. Blindness is sometimes an accompaniment of cavernous sinus thrombosis when the infection also involves the orbit. There is also cranial nerve involvement (oculomotor, troclear, abducence) and ophthalmoplegia, diminished or absent corneal reflex, ptosis, and dilation of the pupil occur. The terminal stages bring signs of advanced toxemia and meningitis. Infections of the face can cause a septic thrombosis of the cavernous sinus. Furunculosis and infected hair follicles in the nose are frequent causes. Extractions of maxillary anterior teeth in the presence of acute infection and especially curettage of the sockets under such circumstances can cause this condition. The infection is usually staphylococcal. The inflection may spread directly through the pterygoid plexus of veins and the pterygomaxillary space and then ascend into the sinus or it may spread directly from the pterygopalatine space to the orbit. This is possible because of the absence of valves in the angular, facial, and ophthalmic veins. The treatment is empirical antibiotic therapy followed by specific anbibiotic therapy based on blood or pus culture. The inflection usually involves one side, however, it may easily spread to the opposite side through the circulus sinus. Unless it is treated early, the prognosis is poor even in this doses. Occasionally the antibiotics will not adequately resolve the septic thrombus, and death ensues. the use of anticoagulants to prevent venous thrombosis has been recommended, but the efficacy of such therapy has not been substantiated. Surgical access through eye enucleation has been suggested. We report a case which demonstrates cavernous sinus thrombosis by the infection after the functional neck dissection and the intraoral reconstruction with auriculomastoid fascio-cutaneous island flap.

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Presentation of Retinoblastoma Patients in Malaysia

  • Subramaniam, Shridevi;Rahmat, Jamalia;Rahman, Norazah Abdul;Ramasamy, Sunder;Bhoo-Pathy, Nirmala;Pin, Goh Pik;Alagaratnam, Joseph
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7863-7867
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    • 2014
  • Background: Retinoblastoma is a rare type of cancer that usually develops in early childhood. If left untreated it can cause blindness and even death. The aim of this study is to determine sociodemographic and clinical features of retinoblastoma patients and also to determine the treatment pattern and outcome in Malaysia. Materials and Methods: Data for this study were retrieved from the Retinoblastoma Registry of the National Eye Database (NED) in Malaysia. Hospital Kuala Lumpur, Hospital Umum Kuching, Sarawak and Hospital Queen Elizabeth, Kota Kinabalu were the major source data providers for this study. Data collected in the registry cover demography, clinical presentation, modes of treatment, outcomes and complications. Results: The study group consisted of 119 patients (162 eyes) diagnosed with retinoblastoma between 2004 and 2012. There were 68 male (57.1%) and 51 (42.9%) female. The median age at presentation was 22 months. A majority of patients were Malays (54.6%), followed by Chinese (18, 5%), Indians (8.4%), and indigenous races (15.9%). Seventy six (63.8%) patients had unilateral involvement whereas 43 patients had bilateral disease (36.1%). It was found that most children presented with leukocoria (110 patients), followed by strabismus (19), and protopsis (12). Among the 76 with unilateral involvement (76 eyes), enucleation was performed for a majority (79%). More than half of these patients had extraocular extension. Of the 40 who received chemotherapy, 95% were given drugs systemically. Furthermore, in 43 patients with bilateral involvement (86 eyes), 35 (41%) eyes were enucleated and 17 (49%) showed extraocular extension. Seventy-two percent of these patients received systemic chemotherapy. The patients were followed up 1 year after diagnosis, whereby 66 were found to be alive and 4 dead. Sixteen patients defaulted treatment and were lost to follow-up, whereas follow-up data were not available in 33 patients. Conclusions: Patients with retinoblastoma in this middle-income Asian setting are presenting at late stages. As a result, a high proportion of patients warrant aggressive management such as enucleation. We also showed that a high number of patients default follow-up. Therefore, reduction in refusal or delay to initial treatment, and follow-up should be emphasized in order to improve the survival rates of retinoblastoma in this part of the world.

Effects of Abdominal Exercise Methods on Breathing Ability (복부 운동 방법에 따른 호흡기능 변화 비교)

  • Bae, Wonsik;Moon, Hyunju;Lee, Keoncheol
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.1
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    • pp.137-146
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    • 2020
  • Purpose : The enhancement of abdominal muscles increases the activation and contraction of respiratory muscles, including the diaphragm. Generally, diaphragm exercises are applied to increase the breathing ability of patients with respiratory disease. Previous studies have shown that breathing capacity can be increased through abdominal muscle strengthening exercises. However, studies on breathing ability are rare and it is doubtful whether these affect respiratory ability more than diaphragm exercises. Therefore, this study seeks to compare whether abdominal exercises can improve breathing ability and whether any increase is comparable to diaphragm exercises. Methods : After selecting subjects, the place of intervention was separated for blindness. The plank group was allowed to relax for 30 seconds after 30 seconds of planking; this was set at three and increased by one set each week. Subjects in the draw-in group were allowed to relax for 30 seconds after maintaining the draw-in contraction state for 30 seconds and this was done for 15 minutes. Subjects in the control group underwent abdominal dilation for five seconds of inspiration time and expired air for five seconds by exposing the lips; breathing was performed repeatedly for 15 minutes. Subjects in each group measured their respiration function three times before intervention, three weeks after the commencement of intervention and after intervention. Spirovit SP-1 was used to measure respiratory function. In each group, repeated ANOVA was used to compare the respiratory function over time and one-way ANOVA was used to compare the respiratory function between groups. The post hoc was conducted using the LSD method. Results : There was a significant increase in respiratory ability between the forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF), forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) according to the six-week period. However, there was no difference between each group. Conclusion : For patients with low respiratory muscle strength, plank exercises and abdominal draw-in are beneficial exercises for improving respiratory function. These are expected to be widely used in clinical practice for patients with weak respiratory muscles.

Study on effect of the herbs that invigorate and dispel blood stasis on Angiogenic inhibition (활혈거어약물(活血祛瘀藥物)이 항혈관신생(抗血管新生)에 미치는 영향(影響)에 관(關)한 연구(硏究))

  • Kim, Sung-Hoon;Shim, Bum-Sang;Choi, Seung-Hoon;Ahn, Kyoo-Seok
    • THE JOURNAL OF KOREAN ORIENTAL ONCOLOGY
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    • v.7 no.1
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    • pp.19-37
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    • 2001
  • Object When angiogenesis is excessive, Cancer, RA, Blindness, Psoriasis, Hemangioma, Diabetic retinopathy, Granulation, etc are induced. On the contrary, when it is insufficient, Stroke, Heart disease, Ulcer, Infertility, Scleroderma, artherosclerosis, delay of the wound recovery, etc occur. In recently, the methods which is control of abnormal angiogenesis are researching actively in relathion to anticancer research. This study is search for effective drugs which suppress this angiogenesis, in the ingredients of the herbs that invigorate and dispel blood stasis using to treat intravascular coagulation in the oriental herbal medicine. Methods We maked 80 % methanole extracts of Cnidii Rhizoma, Olibanum, Myrrha, Corydalidis Tuber, Curcumae Radix, Curcumae longe Rhizoma, Zedoariae Rhizoma, Salviae miltiorrhizae Radix, Polygoni cuspidati Rhizoama, Leonuri Herba, Persicae Semen, Carthami Flos, Trogopterorum Faeces, Achyranthis Bidentatae Radix, Manitis Squama, Eupolyphaga, Hirudo, Tabanus, Lycopi Herba, Artemisiae anomalae herba, Vaccariae Semen, Sappan Lignum, Gleditsiae Spina, Draconis Resina, Leonunari Semen, Selaginelliae Folium, Spatholobi Caulis, and these extracts were tested for MTT viabilaty test, BrdU incorporation, Tube foramtion assay on ECV304(immotalized human umbilical vein endothelial cell) at the concentration of $50{\mu}g/ml$, $100{\mu}g/ml$, $200{\mu}g/ml$, $400{\mu}g/ml$ Results All extracts except Draconis Resina have no cytotoxicity at the $100{\mu}g/ml$, and in BrdU incorporation test, proliferation rate were reduced below 60% at the concentaraion of $100{\mu}g/ml$ by Zedoariae Rhizoma, Sappan, Lignum Gleditsiae, Spina Draconis Resina Vaccariae Semen. Zedoariae Rhizoma Sappan Lignum Gleditsiae Spina Draconis Resina Vaccariae Semen Olibanum, Achyranthis Bidentatae Radix showed inhibition effects on tube formation of ECV304 at the concentration of $100{\mu}g/ml$. Conclusion At the concentration of $100{\mu}g/ml$ in which cytotoxicity is not found, Zedoariae Rhizoma, Sappan Lignum, Gleditsiae Spina, Vaccariae Semen showed the inhibition effect on proliferation and tubeformation of ECV304.

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The Influence of Unattended Distractors on the Identification of Targets (주의하지 않은 방해자극이 표적의 식별에 미치는 영향)

  • Park, ChangHo
    • Korean Journal of Cognitive Science
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    • v.24 no.4
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    • pp.365-391
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    • 2013
  • Negative repetition effect (NRE) refers to the phenomenon that the accuracy of report is impaired when a target was flanked by the same distractor than when by alternative distractor. To probe the nature of NRE, this study introduced attention window(s) indicating the positions where a target might be presented, and non-attention window(s) where a target could not be presented. Attention windows are supposed to help participants detect targets readily. Two among three positions are indicated by attention windows in Exp. 1, and a single large attention window encompassing central two positions among four positions was used in Exp. 2, and either large or small attention window was used depending on the number of target candidates in Exp. 3. In the result of three experiments, NREs were consistently observed when both positions of a target and a distractor were indicated by previous attention windows. However, NREs (including its tendency) and its opposite, PREs were observed when a distractor was presented in the non-attention position, depending on its distance from the target and the size of attention window. It seems that this pattern of repetition effects is hard to be explained by repetition blindness hypothesis (Kanwisher, 1991), positional uncertainty hypothesis (Keren & Boer, 1985), and inhibitory attention capture hypothesis (Kwak et al., 1993). Instead it was proposed that shifting of spatial attention should be considered accordingly with the structure of stimulus display. The promising role of this task was discussed in studying the relation of attention and perception.

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A Literature Study on the Korean Acupuncture for Eye diseases (국내침구서적의 안질환(眼疾患)치료에 관한 문헌 연구 - "치종지남(治腫指南)" "동의보감(東醫寶鑑)" "침구경험방(鍼灸經驗方)" "교감(校勘) 사암도인침법(舍岩道人鍼法)"의 비교연구 -)

  • Han, Chang-Hyun;Park, Sang-Young;Ahn, Sang-Young;Kwon, Oh-Min;Lee, Bong-Hyo;Ahn, Sang-Woo
    • Journal of Korean Medical classics
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    • v.22 no.3
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    • pp.79-95
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    • 2009
  • Background : Eye diseases refer to a wide range of disconveniences from conjunctivitis, pterygium, glaucoma to even blindness. Acupuncture has been widely used in Korea throughout the history and provides an efficient method in the treatment of them. Objectives : Establish a distinctive and efficient acupuncture method for the treatment of eye diseases based in literature research. Method : We reviewed four Korean medical literature, "Guide to Swollen Sore Treatment[治腫指南]", "Treasured Mirror of Eastern Medicine[東醫寶鑑]", "Experiential Prescriptions of Acupuncture and Moxibustion[鍼灸經驗方]", and "Essential Rhymes on Acupuncture and Moxibustion by Master Saam[舍岩鍼法]", and analyzed the therapeutic characteristics in the treatment of eye diseases. Result : 1. According to "Guide to Swollen Sore Treatment[治腫指南]", various methods were applied in the treatment of eye diseases. We can cite salt water washing method after needling, pricking bloodletting method using three-edged needle, surgery method using bent needle and lance needle, or sore treatment using sliced bean-curd and ground Aristolochiae Fructus among others. Acupuncture points like GV20[百會], BL1[睛明], EX-HN5[太陽], GB20[風池], GV24[神庭], GB1[瞳子髎], and GB15[臨泣] were mostly needled. 2. In "Treasured Mirror of Eastern Medicine[東醫寶鑑]", pricking bloodletting method were most frequently used in comparison to single acupuncture or moxibustion methods. Applied points were GV20[百會], BL1[睛明], LI4[合谷], EX-HN5[太陽], GB37[光明], BL18[肝兪], GB20[風池], BL2[攢竹], GB1[瞳子髎], and ST36[三里]. Also selections of adjacent points were considered important. 3. In respect to treatment methods "Experiential Prescriptions of Acupuncture and Moxibustion [鍼灸經驗方]" has some similarity to "Treasured Mirror of Eastern Medicine[東醫寶鑑]" as pricking bloodletting method were mostly used. Also focused on normal Qi flow through meridian. Points like BL18[肝兪], BL1[睛明], LU5[尺澤], EX-HN5[太陽], LI4[合谷] were used. 4. "Essential Rhymes on Acupuncture and Moxibustion by Master Saam[校勘舍岩道人鍼法]" considered visceral pattern identification method fundamental in the diagnosis and treatment of eye diseases. Specifically, Liver, Heart, Stomach, Lung, Kidney identification methods are presented. Combined both corresponding and connecting meridians supplementation and draining methods according to mother-child relation. Also Saam master's own experiential prescriptions are noted. Conclusions : After previous study on stroke, we could also find various efficient methods according to eye diseases, through literature research of korean medical classics. This study will concurrently result in establishing distinctive therapeutic method characteristic of Korea.

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Discussion on Preliminary Test for Male High School Students in Gwang-ju Area (광주지역 남자 고등학생들의 예비검사에 대한 고찰)

  • Ryu, Geun-Chang
    • Journal of Korean Ophthalmic Optics Society
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    • v.12 no.4
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    • pp.95-99
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    • 2007
  • This study performed apreliminary test with male high school students in Gwangju metropolitan city in order to determine visual function information of high school students. For the items in this preliminary test, there were inquiry, test for long distance unaided visual acuity, pinhole visual acuity test, colour vision test, cover test and stereo test. Most complaint related to eye was about blurred vision (28.4%) and over 90% of subjects had one or more, and among them, over 50% appealed two or more complaints. 76.1% of all subjects showed less than 0.7 in unaided distance visual acuity. In pinhole visual acuity test, 98% had an improved unaided pinhole visual acuity and most of them experienced an improvement and 2% had no change or dropped. The students with normal stereoscopic vision test were 85.6% and the students under normal range were 14.4%. In colour vision test, 7.9% of them were protanomaly and deuteranomaly and none of them had trichromasy and total color blindness. In cover test, it showed 30.2% of orthophoria, 8.2% of esophoria and 61.5% of exophoria, and none of them had strabismus.

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Modern Medicine and Phantom Pain (현대의학과 환상통 - 이응준의 『약혼』을 중심으로)

  • Ban, Jaeyu
    • Korean Medical Education Review
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    • v.13 no.1
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    • pp.25-34
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    • 2011
  • Modern medicine has early experienced the absence of mimesis and has been trying to replace the absence with objective grounds and experimental data. However, as medicine became science, the crisis of medicine spread more widely. Microscopic powers and violences are invisible, but individuals are powerless and vainly unable to resist. The anguish or introspection about the situation is sometimes described in stories such as An Engagement by Lee Eung Jun. An Engagement is mentioned in this article due to the writer's attitude, which shows his introspection and desire for harmony through the wounds of each trivial character. The writer is unceasingly talking about suffering people in his story and his seriousness enables readers to find his stronger sympathy over life and death than in any other medical stories. In fact, it is impossible for readers to comprehend the confusing propositions which the writer pours out, and even uncomfortable to read the story. Nevertheless, the propositions are always in contact with reality. Perhaps it is not the writer's confusing propositions that make us uncomfortable. It might be ourselves who are always alienated and starved. We can say that the characters' pains and wounds are phantom pains caused by the absence of mimesis. Since there is no affected area, their pains cannot be measured by only scientific medicine. However, the current medical profession regards objective research evidences as absolute truth and allows them to be the sole criterion. Although scientific skills such as DNA analysis and MRI scan can be the substitutes for doctors' judgment, so much of medicine is still interpersonal relationships. An Engagement. As a person promises to marry another, as all beings together in the world promise to subordinate to one another, every subject is consistently a valuable part of each other for the writer's eyes. He is aware that it is originally impossible to get engaged to the world, but he does not give up the possibility of genuine communication. In today's post-modernism society, where a large number of pathological views define the members and the world itself, endless questioning of existence and digging into pathology will be the only way to reduce the gap between individuals and their world. This article does not say that a literary work will lead the change of medical paradigm. It sprang from a desire for medical humanities to gain more interest of the medical field, where the encounter between literature and medicine is still unfamiliar, and to make medical education recognize the importance of humanities. Starting with this work, I believe that the humanities will help us to find the solution to the age of absence of mimesis and to the crisis of medicine.