A Case of Posterior Ischemic Optic Neuropathy and Abducens Nerve Palsy

PURPOSE: To report a case of a patient with posterior ischemic optic neuropathy and abducens nerve palsy who responded to steroid therapy. CASE SUMMARY: A 47-year-old man visited our clinic with decreasing visual acuity and abduction limitation in his right eye, which suddenly started 4 days earlier. The best corrected visual acuity (BCVA) was 20/250 in the right eye and 20/20 in the left eye. Fundus examination showed normal in both eyes, and relative afferent pupillary defect was positive in the right eye. The visual field test showed a right central scotoma with inferior altitudinal field defect. In addition, the brain magnetic resonance imaging (MRI) was done. Orbit MRI, fluorescein angiography (FAG), and carotid ultrasonography results were normal. Therefore, the patient was diagnosed with non-arteritic posterior ischemic optic neuropathy. The systemic steroid therapy was started and tapered over a period of 5 weeks. At one month after treatment, the BCVA was 20/20 and abduction limitation in the right eye improved.

Quantitative Analysis of Retinal Nerve Fiber Layer Thickness Profile in Myopic Eyes

PURPOSE: To investigate peripapillary retinal nerve fiber layer (RNFL) thickness profiles associated with myopia. METHODS: One hundred and twenty-seven normal eyes of 67 Korean adults were divided into three groups by spherical equivalent. All subjects were tested with fast RNFL scans of Stratus optical coherence tomography. The angular locations of superior and inferior maximal thickness points in relationship to a reference line drawn horizontally though the center of the scan circle were calculated from the raw data of scanned images (angle alpha, angle beta). Differences of angle alpha and angle beta were compared among the three groups. RESULTS: Angle alpha and angle beta were significantly different in three groups (ANOVA, p<0.001, respectively). Angle alpha and angle beta were also significantly different among the three groups for excluded eyes with tilted discs. CONCLUSIONS: The points of superior and inferior maximal peripapillary RNFL thickness were significantly different in three groups divided by spherical equivalent. As myopia becomes more severe, superior and inferior maximal peripapillary RNFL thickness points are located closer to the fovea.

Clinical Analysis of 29 Cases of Germ Cell Tumor in Children

Germ cell tumors(GCT) are not infrequently encounted tumor in pediartic age group. In order to study the clinical behaviors of the disease, we reviewed 29 cases of GCT diagnosed and treated at Kosin Medical Center in the period of 7 years form Jan. 1984 to Dec. 1991 and the results are summarized as follows: 1) The age distribution is the highest between 10 and 15 years(45%) and girls have 1.9 times higher frequency than that of boys. 2) The most frequent primary site of GCT was ovary(15). The next common primary site was testis(5), pineal body(4), sacrococcygeal region(2), retroperitoneum(1), soft palate(1), anterior mediastinum(1) in descending order of frequency. 3) In the pathological analysis of tumors, the most frequent type was mature teratoma(12). The next common type was endodermal sinus tumor(6), immature teratoma(5), dysgerminoma(3), mixed type(2), and choriocarcinoma(1)in descending order of frequency. 4) All the 5 cases of EST have elevated serum levels of alpha-fetoprotein. Two of the three dysgerminoma, one of the two mixed type tumors both of which have germinoma components, and one choriocarcinoma have elevated serum levels of beta-HCG above the age related physiological levels. 5) Among 17 cases of malignant GCT, 9 cases have metastatic areas such as regional lymph nodes, scrotum, pleura, retroperitoneum, omentum and lumbar spine. 6) All except on case of immature teratoma in the anterior mediastinum underwent surgery. Chemotherapy was given to 12 of 17 malignant GCT and radiotherapy was given to 4 of 17 malignant GCT. 7) Among the 4 expired cases within 12 months of follow up, three were originated from pineal body, which had been underwent simple V-P shunt or incomplete resection, and one case was metastatic immature teratoma of anterior mediastinum to the pleura which had not been undergone surgery. Finally, in review of literature and or cases, the survival of properly managed GCT except some of those difficult surgical access is relatively good. To continue the survival of children of GCT to be impoved, we should use all the treatment modalit properly with more positive outlook about the disease.

Acute appendicitis in children

No abstract available.