PURPOSE: To report a rare case of choroidal metastasis from renal cell carcinoma. CASE SUMMARY: A 61-year-old man visited our clinic with the chief complaint of decreased vision in the right eye. Three years earlier, he underwent right nephrectomy due to renal cell carcinoma. Best corrected visual acuity was 0.2 in the right eye and 1.0 in the left eye. Fundoscopic examination of the right eye revealed a yellowish, dome-shaped elevated choroidal mass with serous retinal detachment, measuring 5.0 x 4.0 disc diameter and located lateral to the macular area. Systemic evaluations showed multiple lung and brain metastases. A diagnosis of choroidal metastasis from renal cell carcinoma was made for the right eye, and the patient received local treatments with oral sorafenib therapy, composed of subtenon triamcinolone injection and intravitreal ranibizumab injection. Tumor progression continued, and visual acuity declined to hand motion. Enucleation was recommended, but the patient refused and is on a regular follow-up after transpupillary thermotherapy. CONCLUSIONS: Ocular manifestation may be the initial presenting sign of a recurrent tumor, and an extensive systemic evaluation for metastatic malignancy should be performed. The present example showed a rare case of choroidal metastasis from renal cell carcinoma.
Antibodies, Monoclonal, Humanized ; Brain ; Carcinoma, Renal Cell ; Choroid ; Eye ; Follow-Up Studies ; Hand ; Humans ; Lung ; Middle Aged ; Neoplasm Metastasis ; Nephrectomy ; Niacinamide ; Phenylurea Compounds ; Retinal Detachment ; Triamcinolone ; Vision, Ocular ; Visual Acuity ; Ranibizumab

Cytotoxic lesions of the corpus callosum (CLOCC) are secondary lesions on corpus callosum caused by cytokinopathy of callosal neurons and microglia. Fever, headache, and digestive disturbances are common symptoms. Reversible and hyperintense signals on fluid‐attenuated inversion recovery imaging, diffusion‐weighted imaging (DWI) and decreased apparent diffusion coefficient are typical features of magnetic resonance imaging. Herein, we report a rare case of CLOCC caused by COVID19 vaccination (BNT162b) and discharged without no neurologic symptoms due to prompt treatment.

Guillain-Barre syndrome (GBS) is an immune-mediated acute polyradiculoneuropathy and commonly occurs after a preceding infection or immunization sequalae. Following the severe acute respiratory syndrome-coronavirus-2 virus pandemic with co-introduction of massive vaccinations, several GBS cases associated with coronavirus disease 2019 (COVID-19) infection per se or after vaccination for COVID-19 were reported internationally. Herein, we report two cases of Korean GBS presenting with tetraplegia after two different COVID-19 vaccinations (42-year old man by AstraZeneca and 48-year woman by Pfizer vaccines) within four weeks after vaccination. The patients were diagnosed with clinical examination, serial electromyography, and compatible laboratory results and improved after comprehensive rehabilitative treatment and intravenous immunoglobulin therapy. Furthermore, we performed an electrodiagnostic follow-up study of each case to examine their unique characteristics.

Objective: This study was conducted to evaluate the effects of menopausal hormone therapy (MHT) on the progression of non-alcoholic fatty liver disease (NAFLD) in postmenopausal women. Materials and Methods: We included 515 women who received MHT for 12 months. Changes in NAFLD was evaluated by ultrasonography (progressiono progression) were compared before and after 12 months of MHT based on the route of estrogen administration (transdermal/oral). In addition, changes in NAFLD according to estrogen dose and type of progestogen were evaluated. Results: Baseline characteristics did not differ between patients who received transdermal (n=82) vs. oral (n=433) MHT. After 12 months of transdermal MHT, the prevalence of NAFLD decreased from 23.2% to 18.3% and the progression of NAFLD was observed in 3.7% patients, but this was not significantly different from those taking oral MHT. NAFLD progression was more common in women who had NAFLD at baseline and who received on oral MHT regimen compared to transdermal regimen (12.4% vs. 5.3%), however, differences were not statistically significant. In the oral MHT group, progression of NAFLD was significantly more common in standard-dose than low-dose (P=0.039). There was no significant difference in NAFLD progression according to the type of progestogen in patients using standard dose of estrogen. Conclusion Our findings suggest that the route of estrogen administration and oral dose of estrogen might affect progression of NAFLD in women with NAFLD at baseline.

Background: The present study was to compare the potential impact of remifentanil-based propofol-supplemented anesthesia regimen vs. conventional sevoflurane-sufentanil balanced anesthesia on postoperative recovery of consciousness indicated by c) values in patients undergoing cardiac surgery. Methods: Patients undergoing cardiac surgery were randomly allocated to get the remifentanil-based propofol-supplemented anesthesia employing target-controlled infusion (TCI) of remifentanil and propofol (Group-PR, n = 15) or a balanced-anesthesia employing sevoflurane-inhalation and TCI-sufentanil (Group-C, n = 19). In Group-PR, plasma concentration (Cp) of TCI-remifentanil was fixed at 20 ng/ml, and the effect-site concentration of TCI-propofol was adjusted within 0.8–2.0 μg/ml to maintain BIS value of 40–60. In Group-C, sevoflurane dosage was adjusted within 1–1.5 minimum alveolar concentration to maintain BIS of 40–60, and Cp of TCI-sufentanil was fixed at 0.4 ng/ml. The inter-group difference in the time for achieving postoperative BIS > 80 (T-BIS80) in the intensive care unit was determined as the primary outcome. The inter-group difference in the extubation time was determined as the secondary outcome. Results: T-BIS80, was shorter in Group-PR than Group-C (121.4 ± 64.9 min vs. 182.9 ± 85.1 min, respectively; the difference of means –61.5 min; 95% CI –115.7 to –7.4 min; effect size 0.812; P = 0.027). The extubation time was shorter in Group-PR than in Group-C (434.7 ± 131.3 min vs. 946.6 ± 393.3 min, respectively, P < 0.001). Conclusions Compared with the conventional sevoflurane-sufentanil balanced anesthesia, the remifentanil-based propofol-supplemented anesthesia showed significantly faster postoperative conscious recovery in patients undergoing cardiac surgery.

Background: A job-exposure matrix (JEM) is an important surrogate indicator to evaluate past exposure levels. Although a Korean asbestos JEM has been constructed previously, this JEM includes only a few industrial and occupational groups. This study aimed to reconstruct the JEM by integrating the latest organized data to improve its utility. Methods: We used recent Korean standard industry and occupation codes and extracted 36 articles from a systematic literature review to initiate the reconstruction of the previous Korean asbestos JEM. The resulting data consisted of 141 combinations of industrial and occupational groups. Data from the Netherlands's JEM were also reviewed and categorized into 70 industrial and 117 occupational groups by matching with the Korean data. We also utilized Germany's data, which consisted of 10 industrial and 14 occupational groups. Results: The reconstructed Korean asbestos JEM had 141 combinations of industries and occupations. The time periods are from the 1980s to the 2000s in 10-year intervals. Most of the data were distributed between the 1990s and the 2000s. Occupations with high exposure to asbestos included knitting and weaving machine operators, automobile mechanics or assemblers, ship mechanics or assemblers, mineral ore and stone products processing mechanics, and metal casting machine operators or mold makers. Conclusions The reconstructed Korean asbestos JEM has expanded the type and duration of the occupational groups of the previous JEM and can serve as an important reference tool for evaluating asbestos exposure and designing compensation and prevention policies in Korea.

Background: A job-exposure matrix (JEM) is an important surrogate indicator to evaluate past exposure levels. Although a Korean asbestos JEM has been constructed previously, this JEM includes only a few industrial and occupational groups. This study aimed to reconstruct the JEM by integrating the latest organized data to improve its utility. Methods: We used recent Korean standard industry and occupation codes and extracted 36 articles from a systematic literature review to initiate the reconstruction of the previous Korean asbestos JEM. The resulting data consisted of 141 combinations of industrial and occupational groups. Data from the Netherlands's JEM were also reviewed and categorized into 70 industrial and 117 occupational groups by matching with the Korean data. We also utilized Germany's data, which consisted of 10 industrial and 14 occupational groups. Results: The reconstructed Korean asbestos JEM had 141 combinations of industries and occupations. The time periods are from the 1980s to the 2000s in 10-year intervals. Most of the data were distributed between the 1990s and the 2000s. Occupations with high exposure to asbestos included knitting and weaving machine operators, automobile mechanics or assemblers, ship mechanics or assemblers, mineral ore and stone products processing mechanics, and metal casting machine operators or mold makers. Conclusions The reconstructed Korean asbestos JEM has expanded the type and duration of the occupational groups of the previous JEM and can serve as an important reference tool for evaluating asbestos exposure and designing compensation and prevention policies in Korea.

OBJECTIVES: Nicotine has various adverse effects including negative impacts associated with maternal exposure. In the current study, we examined nicotine-induced damage of hair cells and embryotoxicity during zebrafish development. METHODS: Zebrafish embryos were exposed to nicotine at several concentrations (5, 10, 20, and 40 μM) and embryotoxicity were evaluated at 72 hours, including hatching rate, mortality, teratogenicity rate, and heart rate. Hair cells within the supraorbital (SO1 and SO2), otic (O1), and occipital (OC1) neuromasts were identified at 120 hours. Apoptosis and mitochondrial damage of hair cells were analyzed using TUNEL (terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling) and DASPEI (2-[4-(dimethylamino)styryl]-N-ethylpyridinium iodide) assays, respectively, and changes of ultrastructure were observed by scanning electron microscopy. RESULTS: The control group without nicotine appeared normal with overall mortality and teratogenicity rate < 5%. The hatching rate and mortality rate was not significantly different according to nicotine concentration (n=400 each). The abnormal morphology rate (n=400) increased and heart rate (n=150) decreased with increasing nicotine concentration (P < 0.05). Nicotine-induced hair cell damage significantly increased as nicotine concentration increased. A significantly greater number of TUNEL-positive cells (P < 0.01) and markedly smaller DASPEI area (P < 0.01) were shown as nicotine concentration increased. CONCLUSION: The current results suggest that nicotine induces dose-dependent hair cell toxicity in embryos by promoting apoptosis and mitochondrial and structural damage.
Apoptosis ; Embryonic Structures ; Female ; Hair* ; Heart Rate ; In Situ Nick-End Labeling ; Maternal Exposure ; Microscopy, Electron, Scanning ; Mortality ; Nicotine* ; Tobacco ; Zebrafish*