• 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.

• Journal of Life Science
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• v.17 no.8 s.88
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• pp.1068-1074
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• 2007

Parvalbumin occurs in various types of cells in the retina. We previously reported parvalbumin distribution in the inner nuclear layer of bat retina. In the present study, we identified the parvalbumin-immunoreactive neurons in the ganglion cell layer of the retina of a bat, Rhinolophus ferrumequinum, and investigated the distribution pattern of the labeled neurons. Parvalbumin immunoreactivity was found in numerous cell bodies in the ganglion cell layer. Quantitative analysis showed that these cells had medium to large-sized somas. The soma diameter of the parvalbumin-immunoreactive cells in the ganglion cell layer ranged from 12.35 to 19.12 ${\mu}m$ (n=166). As the fibers in the nerve fiber layer were also stained, the majority of parvalbumin-immunoreactive cells in the ganglion cell layer should be medium to large-sized retinal ganglion cells. The mean nearest neighbor distance of the parvalbumin-immunoreactive cells in the ganglion cell layer of the bat retina ranged from 59.57 to 62.45 ${\mu}m$ and the average regularity index was 2.95 ${\pm}$ 0.3 (n=4). The present results demonstrate that parvalbu-min is expressed in medium to large-sized retinal ganglion cells in bat retina, and they have a well-or-ganized distributional pattern with regular mosaics. These results should be important as they are applicable to a better understanding of the unsolved issue of a bat vision. This data will help to provide fundamental knowledge for the better understanding of the unique behavioral aspects of bat flight maneuverability.

• Tuberculosis and Respiratory Diseases
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• v.43 no.2
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• pp.236-242
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• 1996

Intracranial tuberculoma results from hematogenous spread of pulmonary, intestinal or urogenital tuberculosis. However, it might be caused by pulmonary tuberculosis, mainly. Clinically, symptoms of intracranial tuberculoma are headache and seizure, its symptoms are simillar to intracranial tumor. A 25-year-old-unmarried shopgirl was visited to this hospital because of headache, dizziness and visual disturbance for couple weeks in Sep. 1995. She had been treated with anti-tuberculosis agents of miliary tuberculosis during past nine months period. Brain MRI revealed intracranial tuberculoma and brain edema but not involved optic nerve. Ophthalmic examination revealed severe papilledema and splinter hemorrhage with bitemporal hemianopsis and central scotoma. This finding was strongly suggested of optic disc tuberculoma. Her symptoms became much better following repeated retrobulbar steroid injection with continuous anti-tuberculosis agents. We report a interesting case with intracranial tuberculoma and optic disc tuberculoma associated by miliary tuberculosis during anti-tuberculous treatment.

• Journal of Korean Neurosurgical Society
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• v.66 no.1
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• pp.72-81
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• 2023

Objective : Ischemia and hemorrhage of pituitary adenomas (PA) caused important clinical syndrome. However, the differences on clinical characteristics and surgical outcomes between these two kinds apoplexy were less reported. Methods : A retrospective analysis was made of patients with pituitary apoplexy between January 2013 and June 2018. Baseline and clinical characteristics before surgery were reviewed. All patients underwent transsphenoidal surgery and were followed up at least 1 year. Results : Total 67 cases (5.8%) among 1147 pituitary tumor patients were enrolled, which consisted of 28 (~2.4%) ischemic PA and 39 (~3.4%) hemorrhagic PA. There were more male patients in the ischemic group compared with hemorrhagic group (78.6% vs 53.8%, p=0.043). However, the mean age, tumor size and functional tumor ratio were significant higher in the hemorrhagic group. Headache was more common in ischemic PA (82.1%) than that of hemorrhagic PA (51.3%, p=0.011). Magnetic resonance imaging findings found that mucosal thickening and enhancement of the sphenoid sinus was observed in 15 ischemic PA patients (n=27, 55.6%), but none in patients with hemorrhagic PA (n=38, p<0.0001). It was worth noting that the rate of pre-surgical hypopituitarism in ischemic PA patients were seemed higher than that in hemorrhagic PA patients, but not significant. The two groups got a total tumor resection rate at 94.1% and 92.9%, independently. No significant difference on the operative time, blood loss in operation and complications in perioperative period was observed in two groups. After operation, cranial nerve symptoms recovered to normal at 81.8% of ischemic PA patients and 82.6% of hemorrhagic PA patients. Importantly, the incidence of postoperative hypopituitarism partially decreased in both groups, among which the rate of hypothyroidism in ischemic PA patients significantly decreased from 46.4% to 18.5% (p=0.044). Conclusion : Patients with ischemic PA presented different clinical characteristics to the hemorrhagic ones. Transsphenoidal surgery should be considered for the patients with neuro-ophthalmic deficits and might benefit for pituitary function recovery of the apoplectic adenoma patients, especially pituitary thyroid axis in ischemic PA patients.