The Fundus in Tuberculosis in Children

The authors presented the fundus findings of 25 cases with ocular lesions among 67 tuberculosis in children who were referred to our ophthalmic department from pediatric ward at Busan National University Hospital and Busan Christian Children's Hospital within a year from October 1971 to September 1972. These 67 cases were composed of 33 tuberculous meningitis, 8 hilar lymphadenopathy, 17 active pulmonary tuberculosis, 2 miliary tuberculosis and 7 tuberculous arthritis and spondylitis. The results were; 1. Of 67 tuberculosis in children 25 cases (37.3%) were shown ocular lesions, some of which were multiple. 2. 19 cases of 33 tuberculous meningitis were shown eye lesions of which cases combined with hilar lymphadenopathy or miliary tuberculosis had frequently ocular complications. 3. The common findings in fundi of tuberculosis in children were pale in optic disc and small tubercles in choroid. 4. A case of bilateral tuberculous endophthalmitis in a 3 year aged orphan was presented of which case was developed in the process of tuberculous meningitis and miliary tuberculosis.

Goldenhar's Syndrome

The authors presented a case of Goldenhar's Syndrome which was shown the following findings, such as epibulbar dermoid, bilateral colobomas of upper eye lids, pretragal blind fistulas, preauricular appendages, skin tags, lacrimal fistula, persistant pupillary membrane, myopia and alopecia atropicans with bulae.

A Case of von Hippel-Lindau's Disease

The authors presented a case of von Hippel-Lindau's disease. The patient was a 33-year-old man who visited to our hospital with visual disturbance on the right eye for a month and blind in the left eye for 10 years on the 4th May, 1973. On the eye examination, the left eye revealed ocular hypertension, deep chamber, and vitreous opacity which interfered with the visuality of the fundus. The right eye was normotensive and 0.1 incorrectable in visual acuity. The fundus revealed two angioma associated with large feeding vessels, scattered hemorrhages, and massive exudates along the engorged and tortuous vessels at the temporal retina. On general physical examination, no neurological signs were found, but multiple hard corn sized masses were palpated on the both sides of epididymal head. The masses were confirmed as epididymal cyst on microscopic examination. The x-ray findings were pulmonary tuberculosis far advanced on chest, an extrinsic pressure indentation in the floor of bladder on I.V.P., and abnormal intracranial vascularity, on right carotid angiogram. The blood chemistry showed an abnormal increase of amylase and lipase titers.

A Case of Alveolar Soft Part Sarcoma in the Orbit

Alveolar soft part asrcoma is a primary malignant neoplasm that very rarely occurs in the orbit and it's histogenesis is uncertain. Authors reported a case of alveolar soft part sarcoma occurred primarily in the orbit. The patient, 58 years old Korean male, was admitted to Busan National University Hospital on June 9, 1972 with the chief complaints of the protrusion of the orbital content and pain in the left eye which were gradually developed after receiving enucleation for treatment of the orbital tumor, lasted for 3 months, on Feb. 21, 1972 at local clinic. The patient family history was not contributory. His medical history revealed prior episodes of typhoid fever, liver disease, and a chronic ethanol intake. Physical examination revealed chronic ill appearence in general condition, absent breathing sound at the right lower quadrant of the chest and 3 finger palpable liver. On eye examination, the right eye had good vision and no structual abnormalities, whereas the left side showed anophthalmos, protrusion of the intraorbital content on which surface was rather soft and smooth. We found tortous and dilated superficial skin vessels on the zygomaticotemporal area at which a soft mass was palpated in small fist size. On X-ray studies, there were bony destructive lesion on superior and lateral orbital margin in the skull, atlectatic pattern on the right lower lobe and notching pattern on the right diaphragm in the chest, and other long bone series showed no specific abnormal findings. On liver scanning, mottled areas on the right lower lobe were noted. There were no abnormal findings in C.B.C., urinalysis, C.S.F., stool and blood chemistry. The further studies for the abnormal findings containing liver lesion and atlectatic lung pattern could not perform because of patient's incooperation. We tried the exenteration of left orbit under the general anesthesia on July 8, 1972 but biopsy only performed because the tumor seemed to be extended to pterygoid fossa through the destructed zygomatic bone and to adjacent orbital bone. Histopathological findings showed striking features of alveolar soft part sarcoma; The tumor cells were arrlinged in alveolated or organoid patterns with delicate fibrous band or endothelium lined spaces. The cells were characterized by large, round, oval, and polyhedral cells with rather abundant cytoplasm, which were acidophilic and occasionally contained fine granules and vacuoles in H-E stain. The nuclei were almost located in eccentric, and binucleated, hyperchromatic, anaplastic and occasional mitotic figures were evident.

The effects of adrenergic and adrenergic blocking agents on the phosphorylase activity of bovine extraocular muscles

The author investigated the effect of adrenergic and adrenergic blocking agents on the phosphorylase activity of bovine extraocular muscle in vitro and obtained the following results: 1. The phosphorylase a activity of bovine extraocular muscle was revealed 53.6% in vitro. 2. The phosphorylase a activity of bovine extraocular muscle was slightly enhanced by the adrenergic agents such as epinephrine, norepinephrine and isoproterenol. 3. The phosphorylase a activity of bovine extraocular muscle was not affected by the adrenergic areceptor blocking agent, phenoxybenzamine but slightly inhibited by the adrenergic beta-receptor blocking agent, propranolol. 4. The phosphorylase a activity of bovine extraocular muscle previously treated with the adrenergic agents was blocked by a sole administration of propranolol or combined administrations of propranolol and phenoxybenzamine but not blocked by phenoxybenzamine alene.

On the Ratio to the Physiologic Cupping and Optic Disc. and Optic Disc

A method of charting and scoring the optic disc and cupping from fundus color photographs is presented. The imase that the color slides were projected on the graphic sheet was traced and calculated C/D ratio as horizontal diameter and mensuration of division by measure. The result showed statiscal significancy in calculation of the C/D ratio as mensuration of division in cases which the cupping showed irregular form.

A Case of Pseudotumor

We present a case of pseudotumor. The patient was a 51 year old male, complaining of unilateral exophthalmos of the right eye for about 10 years. It was much aggravated during last a year. Past and family history were non-contributory. At the first examination on the 10th of May, 1971, the left eye was recorded normal. The right eye showed H.M./50cm. in vision, proptosis (18mm differenee in both eyes), limitation of ocular motility, exposure keratitis, and pallor disk in funduscopy. The skul X-ray showed a radiopaque density with enlarged orbital cavity but no evidence of bone estruction. The patient was admitted to our department on the 13th of May, 1971. on the seventh hospital day, a child fist sized firm tumor mass removed through anterior approach. The right eye had also enucleated. Groasly the mass had a gray color, partially discolorated and have alveolar structures. Microscopically lymphoid follicles were seperated by fibrous. occasionally hyalinized fibrous connective tissue. Also occasional hemorrhagic foci and infiltration of eosinophils were seen.

Normal Retinal Vascular Pattern: Arteriovenous Pairing and A/V ratio

All physicans regard the fundus as an important guide to prognosis in the systemic disease which permits the retinal changes, especially hypertension. There are fallacies in the ophthalmoscopic examination of as essing arteriolar calibre by the arteriovenous ratio. The selection of comparable vessels by ophthalmoscopy for the estimation of the arteriovenous ratioshould be fully appreciated, and no other reference base is available unless measurments are made on retinal photographs or by means of an ophthalmoscope fitted with a special graticule. Studies were made by a random selection of 30 normal persons (60 fundi) in 2nd decades. This series of fundus color photographs incorporated a field extending to 3-5 disc diameters from the disc margin. This paper is a series on the retinal vessels which was concerned with the arteriovenous comparable pairing and its ratio. The results were: 1. Total comparable pairs ware 142 pairs in the 60 fundi. 2. In the 60 fundi comparable pairs were found in 50, and in 118 out of 240 quadrants(48 percent). 3. Comparable pairs were found more frequently in the temporal half of fundi. 4. The mean A/V ratio was 0.703.

Normal Retinal Vascular Pattern: Arteriovenous Pairing and A/V ratio

All physicans regard the fundus as an important guide to prognosis in the systemic disease which permits the retinal changes, especially hypertension. There are fallacies in the ophthalmoscopic examination of as essing arteriolar calibre by the arteriovenous ratio. The selection of comparable vessels by ophthalmoscopy for the estimation of the arteriovenous ratioshould be fully appreciated, and no other reference base is available unless measurments are made on retinal photographs or by means of an ophthalmoscope fitted with a special graticule. Studies were made by a random selection of 30 normal persons (60 fundi) in 2nd decades. This series of fundus color photographs incorporated a field extending to 3-5 disc diameters from the disc margin. This paper is a series on the retinal vessels which was concerned with the arteriovenous comparable pairing and its ratio. The results were: 1. Total comparable pairs ware 142 pairs in the 60 fundi. 2. In the 60 fundi comparable pairs were found in 50, and in 118 out of 240 quadrants(48 percent). 3. Comparable pairs were found more frequently in the temporal half of fundi. 4. The mean A/V ratio was 0.703.

A Case of Intra-orbital Sparganosis

The orbitll sparganosis is an extremely rare disease which clinical signes were similar to orbital-cellulitia. Authors reported a case of sparganosis which a 59 years old Korean man complained swellina of lid, chemosis and dull ocular pain in the right eye for 5 months. On eye examination, the visual acuity was 0.5 in the right eye and 0.8 in the left which was incorrectable because of bilateral senile cataract. The left eye had no other anomalities. The right eye was markedly chemotic and restricted ocular motility in the 6 cardinal directions but no exophthalmos. There was a soft elevated and mobile nodule subconjunctivally on the upper portion of the globe and the other nodule was palpated along lower orbital margin. Roentgenologic findings showed diffuse increased radiopaque density but no bony changes in the orbit. Chest and skull x-ray were normal. In the laboratory findings, eosinophilia showed in CBC, hookworm, trichuris T., and T. orientalis in stool examination and positive skin test in Paragonimus westermani and Clonorchis sinensis. On the 3rd, Sep., 1971, we found 4 spargana on surgical exploration of which sizes were approximately 8.5, 9.5, 5.0, and 3.6 cm. in length. A sparganum in upper portion freely stirred sluggishIy in the subconjunctiva but the other 3 in the lower orbital portion were found in the seperated long cysts. The cystic tissue showed nonspecific chronic inflammatory reaction in pathological examination. The infected source was suggested to a history of having taken raw flesh of snake about 30 years ago. Orbital signs were much regressed 15 days later after operation.

A Case of Intra-orbital Sparganosis

The orbitll sparganosis is an extremely rare disease which clinical signes were similar to orbital-cellulitia. Authors reported a case of sparganosis which a 59 years old Korean man complained swellina of lid, chemosis and dull ocular pain in the right eye for 5 months. On eye examination, the visual acuity was 0.5 in the right eye and 0.8 in the left which was incorrectable because of bilateral senile cataract. The left eye had no other anomalities. The right eye was markedly chemotic and restricted ocular motility in the 6 cardinal directions but no exophthalmos. There was a soft elevated and mobile nodule subconjunctivally on the upper portion of the globe and the other nodule was palpated along lower orbital margin. Roentgenologic findings showed diffuse increased radiopaque density but no bony changes in the orbit. Chest and skull x-ray were normal. In the laboratory findings, eosinophilia showed in CBC, hookworm, trichuris T., and T. orientalis in stool examination and positive skin test in Paragonimus westermani and Clonorchis sinensis. On the 3rd, Sep., 1971, we found 4 spargana on surgical exploration of which sizes were approximately 8.5, 9.5, 5.0, and 3.6 cm. in length. A sparganum in upper portion freely stirred sluggishIy in the subconjunctiva but the other 3 in the lower orbital portion were found in the seperated long cysts. The cystic tissue showed nonspecific chronic inflammatory reaction in pathological examination. The infected source was suggested to a history of having taken raw flesh of snake about 30 years ago. Orbital signs were much regressed 15 days later after operation.

The Effects of Mg++, Ca++, Na+ and K+, on the ATPase Activity of Mitochondrial Fraction Isolated from Bovine Extraocular Muscle and Ciliary Process

The author investigated the effect of Mg++, Ca++, Na+ and K+ on the ATPase activity of mitochondrial fraction isolated from bovine extraocular muscles and ciliary processes and obtained the following results: 1. The mitochondrial fraction isolated from bovine extrocoular muscle and ciliary process appeared to possess the Na+ & K+ activated ATPase in the presence of Mg++, and on the contrary, in the absence of Mg++, the ATPase was not activated by K+, Na+ and Ca++. 2. The ATPase activity was enhanced with the increase of protein concentration in fractions from both, the bovine extraocular muscle and the ciliary process. 3. The ATPase in those fractions was potently activated under the condition of that the sample was modulated at 10 mM of K+ and 100 mM of Na+, respectively. 4. The K+- and Na+-activated ATPase in the presence of Mg++ was stimulated to enhance its activity by the addition of Ca++ up to 5 micro M, thoughby the higher concentration of Ca++ up to 10 micro M, its activity did not correspondingly increase.

Ocular injudes, analytical view of 340 cases

The authors analysed 340 cases of the ocular injuries among 7633 out and in-patients who visited to the clinic of P.N.U. hospital during 5 years, from Jan. 1964 to Dec. 1968. Followings were discussed. 1. We found that 4.6% of all cases attending our eyes clinic was victims of ocular injuries. 2. The sex incidence showed that 78.9% of such ocular injuries occured in male and 21.1% in female. 3. The incidence was prevalent in young adult 21-30 years of age, and their large number of cases were injured from blowing and industrial accidents, while in children under 10 years of age sharp-pointed toys were more frequent causes. 4. The subconjunctival hemorrhage was the most frequent disturbance of ocular injuries and then came traumatic cataract and corneal foreign bodies in that order. 5. The prognosis of ocular injuries was generally poor, especially, poor, especially in the perforating and penetrating wound of the whether the foreign body was retained or not.