• The Journal of Internal Korean Medicine
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• v.41 no.5
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• pp.745-753
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• 2020

Background: A number of studies have identified the effect of Korean medicine treatment for oculomotor nerve palsy, but few have reported treatment of subarachnoid hemorrhage. This paper reports two cases of oculomotor nerve palsy with ptosis and limitation of eye movement after subarachnoid hemorrhage whose conditions were improved by Korean medicine treatment. Methods: Two patients with ptosis and limitation of eye movement after subarachnoid hemorrhage were treated with Korean medicine, including acupuncture, electroacupuncture, herbal medicine, cupping, moxibustion, and pharmacoacupuncture. Clinical symptoms were measured as the distance of the interpalpebral fissure and eyeball movement (adduction, abduction). Results: After treatment, their clinical symptoms showed improvement. Conclusion: Korean medicine treatment, including pharmacoacupuncture and electroacupuncture, could be adopted as a treatment method for oculomotor nerve palsy after subarachnoid hemorrhage.

• Archives of Plastic Surgery
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• v.32 no.2
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• pp.219-226
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• 2005

Muller's muscle-levator aponeurosis advancement procedure was performed to correct mild to moderate congenital blepharoptosis with moderate to good levator function and to correct severe aquired blepharoptosis with poor levator function. Through the blepharoplasty incision, the upper half of the tarsal plate was exposed and the orbital septum was opened to show the levator aponeurosis. The Muller's muscle was dissected from the superior margin of the tarsal plate and from the posteriorly located conjunctiva with sharp scissors. The Muller's muscle and levator aponeurosis were advanced on the anterior surface of the tarsal plate as a composite flap and fixed approximately 3 to 4 mm inferior to the upper edge of the tarsal plate with three horizontal 6-0 nylon mattress sutures. The amount of advancement of the composite flap was controlled by the location of the upper eyelid margin 2 mm below the upper limbus in primary gaze after the first suture in the middle portion of the flap. The excess flap was trimmed off with scissors, but trimming was usually not necessary in cases of mild to moderate ptosis. Nine cases underwent this Muller's muscle-levator aponeurosis advancement procedure from September 2003 to September 2004. Five cases were congenital blepharoptosis with 2-4 mm ptosis and more than 5 mm of levator function, but three of the four acquired ptosis cases had more than 4 mm ptosis with poor levator function. The age of the patients ranged from 7 to 81 years. In operative results, all patients except one traumatic case were within 1 mm of the desired eyelid height in primary gaze. This procedure can provide not only tightening of the Muller's muscle but also advancement and firm fixation of the levator aponeurosis to the tarsal plate, yielding predictable results.

• Archives of Plastic Surgery
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• v.38 no.1
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• pp.63-68
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• 2011

Purpose: Mastectomy is one of the operative procedures of female to male transsexuals. It is aimed to excise all of breast tissues and to reconstruct male chest wall, areola, and nipple. Breast sizes are varied by developmental status and their hormonal therapy. There are several approaches for mastectomy. This study is aimed to suggest appropriate mastectomy methods according to breast size in the female to male transgenders. Methods: We retrospectively analysed 46 patients of female to male transgenders. Breast size was categorized by their inner wear size. In A cup size, mastectomy was done with periareolar approach. In C cup size, inframammary fold approach subcutaneous mastectomy was performed. In B cup size, periareolar approach was used for grade A or B ptosis patient, and inframammary fold approach was choosen for the patient with grade C ptosis. Results: Subcutaneous mastectomy was done through semicircular periareolar approach for 26 patients. There were 2 cases of major complications that should be corrected by hematoma evacuation. Circumareolar approach was used for 5 patients, and a case of nipple-areolar complex necrosis was observed. Two cases of another complications which were irregularity of breast and wound disruption could be corrected. Inframammary fold approach was selected for 15 patients. There was a case of wound disruption, so revision surgery whould be done. Four cases of breast irregularity was corrected spontaneously, and 2 cases of partial necrosis of nipple-areolar complex were corrected with secondary healing. Patient satisfaction score for periareolar, cicumareolar, and inframmammary fold approach were 4.5, 4.2 and 4.1, respectively. Some major and minor complications were observed, but satisfactory results could be secured. Conclusion: Semicircular periareolar incision looked adequate for A cup size patient, circumareolar incision was suitable for B cup size with grade A or B ptosis. In B cup size with grade C ptosis patient and C cup patients, inframammary fold incision looked suitable for optimal results.

• Journal of Acupuncture Research
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• v.27 no.4
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• pp.233-238
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• 2010

Objectives : This study is designed to find out the improvement of eyelid ptosis and eyeball movement trouble caused by idiopathic oculomotor nerve palsy after diagnosing the patient to Ghan-shil (肝實), Bee, Shin-hur(脾腎虛) and treating the patient with acupuncture and herb medicine. Methods & Results : The changes in clinical symptoms of eyelid ptosis and eyeball movement trouble were described as the patient was treated with acupuncture therapy and herb medicine, Shae-ghan-san gagam(洗肝散加減) and Yukmi-jihwang-tang gagam(六味地黃湯加減). Conclusions : The patient was treated by acupuncture, herb medicine on idiopathic oculomotor nerve palsy for 6 weeks and showed good effect.

• Clinical and Experimental Pediatrics
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• v.59 no.sup1
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• pp.32-36
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• 2016

Joubert syndrome (JS) is characterized by the "molar tooth sign" (MTS) with cerebellar vermis agenesis, episodic hyperpnea, abnormal eye movements, and hypotonia. Ocular and oculomotor abnormalities have been observed; however, Horner syndrome (HS) has not been documented in children with JS. We present the case of a 2-month-old boy having ocular abnormalities with bilateral nystagmus, left-dominant bilateral ptosis, and unilateral miosis and enophthalmos of the left eye, which were compatible with HS. Brain magnetic resonance imaging (MRI) revealed the presence of the MTS. Neck MRI showed no definite lesion or mass around the cervical sympathetic chain. His global development was delayed. He underwent ophthalmologic surgery, and showed some improvement in his ptosis. To the best of our knowledge, the association of HS with JS has not yet been described. We suggest that early neuroimaging should be considered for neonates or young infants with diverse eye abnormalities to evaluate the underlying etiology.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.527-530
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• 2011

Purpose: Liver transplantation is a groundbreaking section in the field of surgery. Nowadays over 90% of success rate is accomplished and life expectancy of the patients has been elongated. Patients are now seeking for surgical procedures including cosmetic plastic surgery. But these patients take immunosuppressive medication and steroids, which can increase the risk of wound infection, and delay wound healing. By reviewing the case of a 21-year-old liver transplant recipient who underwent mastopexy due to breast ptosis, we discussed about the matters we should consider when performing surgery in liver transplantation recipients. Methods: The patient was a 21-year-old female who received liver transplantation from her father. She was exposed to massive amount of steroids and immunosuppressants, which led to breast ptosis. The vertical and short horizontal incision mastopexy using a medial-based pedicle was done, 29 months after the liver transplantation. Results: On postoperative day 1, she was discharged. On day 10, sutures were removed and taping was applied. There was no sign of wound infection, wound dehiscence, hematoma or bleeding. The patient was followed up at 3, 6 and 9 months after the operation. Mild recurrence of the glandular ptosis was observed but revision was not required. Conclusion: We were able to successfully operate without any complications in the liver transplant recipient. With special attention and consideration, cosmetic plastic surgery can be safely performed in organ transplantation recipients.

• Archives of Plastic Surgery
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• v.47 no.5
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• pp.487-487
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• 2020

• Journal of Chest Surgery
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• v.13 no.3
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• pp.301-305
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• 1980

Myasthenia gravis is a disorder that affects neuromuscular transmission in a way that is still poorly understood. some think that myasthenia gravis results from a reduction of available acetylcholine receptors in neuromuscular junctions, consequent to some form of autoimmune injury. Surgical interest in this disease was first aroused in 1939 when Blalock observed that some patients with thymic tumors and myasthenia gravis improved following thymectomy. This report represents two cases of myasthenia gravis. The 14-year-old girl was admitted to Korea Universtiy Hospital with chief complaintment of bilateral ptosis, diplopia, swallowing difficulty, and mastication difficulty, which were relieved by administration of edrophonium (Tensilon) chloride, given intravenously. Myasthenica gravis was confirmed and thymectomy was given. After thymectomy, symptoms were relieved but the administration of neostigmine was contijued to be needed till following 3 months. After that period, she was free from this symptoms without anticholinesterase drugs. Second case is 57 year old male who has the symptoms of diplopia, bilatreal ptosis, walking disturbance, and speech difficulty. He had thymectomy too but in thymic tissue, malignant thymoma was included. He has subjective improvement only, with no major reduction of medication requirements after thymectomy.

• Journal of Chest Surgery
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• v.13 no.4
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• pp.490-494
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• 1980

Myasthenia gravis is a neuromuscular disorder manifested by fatigability and weakness of voluntary muscles. The basic defect in the myasthenia is reduction of available acetylcholine receptors at neuromuscuiar junctions by an autoimmune attack. Removal of the thymus gland now play an Important role in the management of this disease. We have two experiences of thymectomy for myasthenic patients. The 31-year-old housewife(J.H) was admitted to the Taegu Presbyterian Medical Center because of bilateral ptosis, mastication and swallowing difficulties. The presence of thymoma was strongly suggested by roentgenographic studies. A 99.8 gm thymoma was removed completely by total thymectomy. On the 2nd postoperative day respiratory failure developed. Tracheostomy was performed and ventilatory assist was given for 3 days. The patient was completely recovered with antichollestrase drug only. C.N. was 17-year-old girl who has the symptoms of bilateral ptosis and diplopia for 3 years. Tensilon test was positive and antichollnestrase was given for several months, but the patient showed no improvement. After thymectomy she was free from myasthenic symptoms with out anticholinestrase drug.

• Journal of Haehwa Medicine
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• v.23 no.2
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• pp.45-52
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• 2015

Object : This study is designed to confirm the effect of Traditional korean Medicine on oculomotor nerve palsy patient. Method : We treated with acupuncture therapy, electro-acupuncture therapy, herbal therapy, physical therapy, moxibustion therapy. And we evaluated a patient's eyelid ptosis, eyelid levator function, eyeball movement, eyeball pain. Result : After Traditional korean Medical treatment, ptosis and pain caused by ophthalmoplegia were improved. Conclusion : This study shows Traditional korean Medicine has a good effect on oculomotor nerve palsy.