PURPOSE: To report a case of laser photocoagulation treatment for the patient of Coats' disease accompanying a retinal macrocyst. CASE SUMMARY: A three-year-old boy visited the hospital whose chief complaint was visual acuity decrease of his left eye. Fundus examination showed macular scar, foveal hard exudates and inferior retinal cystic lesion in his left eye. Two months later, examination under anesthesia (EUA) and fluorescein angiography (FAG) was performed. The results revealed inferior retinal macrocyst, nasal avascular retina and telangiectasia around the retinal macrocyst. Laser photocoagulation was performed around the retinal macrocyst and at the nasal avascular retina. One year after the laser photocoagulation, retinal macrocyst did not further progress and the retina was stabilized. CONCLUSIONS: Laser photocoagulation was done around the retinal macrocyst and at the nasal avascular retina of the Coats' disease accompanying a retinal macrocyst and the lesions did not further progress and the retina was stabilized.
Anesthesia ; Cicatrix ; Exudates and Transudates ; Eye ; Fluorescein Angiography ; Humans ; Light Coagulation ; Retina ; Retinaldehyde ; Telangiectasis ; Visual Acuity

Dumbbell-shaped spinal extradural cavernous hemangioma is rare. The differential diagnosis of dumbbell-shaped spinal tumors based on magnetic resonance imaging includes schwannoma and lymphoma. Here, we report a dumbbell-shaped spinal extradural cavernous hemangioma with intrathoracic growth on T2-3 in a 64-year-old man complaining of right side infrascapular area back pain with no neurologic deficit. The cavernous hemangioma was resected through combined video-assisted thoracoscopy and laminectomy without a fusion procedure. The patient had tolerable operative wound pain with no neurologic deficit after surgery. Based on magnetic resonance imaging findings and a review of the literature, we discuss cavernous hemangioma among the differential diagnosis of paravertebral dumbbell-shaped spinal tumors and the importance of complete resection.
Back Pain ; Diagnosis, Differential ; Hemangioma ; Hemangioma, Cavernous* ; Humans ; Laminectomy ; Lymphoma ; Magnetic Resonance Imaging ; Middle Aged ; Neurilemmoma ; Neurologic Manifestations ; Spine ; Thoracoscopy ; Wounds and Injuries

Depigmented halos surrounding cutaneous lesions have been the common description of many diseases, including benign melanocytic nevus, acquired blue nevi, malignant melanoma and neurofibromatosis. To the best of our knowledge, a halo around seborrheic keratosis has not been reported in the Korean dermatologic literature, and only two cases have been described abroad. Though vitiligo is known to be frequently associated with this halo phenomenon, the exact etiopathogenesis of vitiligo and the halo phenomenon is still unknown. Herein, we report on a case of halo seborrheic keratosis in a patient with vitiligo.
Humans ; Keratosis, Seborrheic ; Melanoma ; Neurofibromatoses ; Nevus, Blue ; Nevus, Pigmented ; Vitiligo

No abstract available.
Cerebral Infarction ; Stroke* ; Thrombocythemia, Essential*

Extradural spinal meningiomas are uncommon, and their pathophysiology is not entirely understood. Here, we present the case of a 49-year-old woman with low back and left leg pain of 5 years duration. Magnetic resonance imaging revealed a mass, 1.8-cm in size, with rim enhancement in the spinal canal at the T12 level and extending into the left T12-L1 foramen. In the surgical field, the mass presented with the characteristics of an extra-intradural spinal meningioma. The patient underwent a T12 total laminectomy. A linear durotomy was performed at the midline, and the intradural portion was removed. The extradural portion was not separable from the adjacent dura and the left T12 root, and it was removed by dural excision. Pathological examination confirmed the diagnosis of psammomatous meningioma. We also conducted a literature review of similar cases. Based on our experience with this case, we believe that it is important to clearly distinguish extradural meningiomas from other types of tumors as misdiagnosis can change the operative plan. The long term prognosis of extradural meningiomas is not clear but total excision is thought to be essential.
Diagnosis ; Diagnostic Errors ; Female ; Humans ; Laminectomy ; Leg ; Magnetic Resonance Imaging ; Meningioma* ; Middle Aged ; Prognosis ; Spinal Canal

BACKGROUND AND OBJECTIVES: Fibroblasts interact with eosinophils and play a key role in the pathogenesis of airway diseases. The aims of this study were to investigate whether Th1 or Th2 type cytokines can induce mRNA and protein expression of eotaxin and RANTES in human nasal fibroblast (HNF) and to verify the correlation between the stimulation of different cytokines and chemokines in HNF. Materials and Methods: Cultured HNF were stimulated by IL-13, TNF-alpha, IFN-gamma, IL-13 with TNF-alpha, IL-13 with IFN-gamma, TNF-alpha with IFN-gamma for 6, 24 and 48 hours. In addition, HNF were stimulated by different concentration of IL-13 (0.2, 2, 20, 200 ng/ml). MRNA expression of eotaxin and RANTES were revealed by RT-PCR and protein of eotaxin and RANTES were revealed by ELISA. RESULTS: TNF-alpha and IFN-gammar induced mRNA and protein expression of RANTES in HNF and they synergistically induced protein expression of RANTES. RANTES expression increased in a time dependent manner. IL-13 induced mRNA and protein expression of eotaxin in HNF and it synergistically reacted with TNF-alpha or IFN-gamma. The effects of IL-13 on mRNA and protein expression of eotaxin increased in a concentration dependent manner. CONCLUSION: Th1 or Th2 type cytokines induce mRNA and protein expression of eotaxin and RANTES in human nasal fibroblasts. TNF-alpha or IFN-gamma induce more RANTES than eotaxin but IL-13 induces more eotaxin than RANTES. There may be some synergic effects of cytokines for mRNA and protein expression of chemokines.
Chemokine CCL5* ; Chemokines ; Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Fibroblasts* ; Humans* ; Interleukin-13 ; RNA, Messenger* ; Tumor Necrosis Factor-alpha

Purpose: To report a rare case of optic perineuritis as the presenting sign of sarcoidosis. Case summary: A 57-year-old man presented with decreased visual acuity and pain with extraocular movement in his left eye starting 2 weeks earlier. He had a history of asymptomatic optic perineuritis in that eye 18 months previously, which had improved after 1 month on oral prednisolone. His best corrected visual acuity had decreased to 20/50 and he also had relative afferent pupillary defect and color vision defects in the left eye. Slit lamp examination results were normal. There were no inflammatory reactions in the anterior chamber or vitreous. Fundoscopy showed optic disc edema. Orbital magnetic resonance imaging showed diffuse enhancement surrounding the left optic nerve. The serum levels of eosinophil cationic protein and angiotensin- converting enzyme were markedly increased. A chest radiograph showed bilateral hilar lymph node enlargement. A biopsy via endobronchial ultrasound-guided transbronchial needle aspiration revealed multifocal non-caseating granulomas. Acid fast bacilli stain showed no evidence of tuberculosis. Based on these findings, he was diagnosed with sarcoidosis. After treatment with high-dose intravenous methylprednisolone and subsequent tapering with oral prednisolone for 6 months, the visual acuity improved. Conclusions Optic perineuritis can be the initial sign of sarcoidosis. Therefore, sarcoidosis should be considered in the differential diagnosis of optic perineuritis.

Purpose: To report a rare case of optic perineuritis as the presenting sign of sarcoidosis. Case summary: A 57-year-old man presented with decreased visual acuity and pain with extraocular movement in his left eye starting 2 weeks earlier. He had a history of asymptomatic optic perineuritis in that eye 18 months previously, which had improved after 1 month on oral prednisolone. His best corrected visual acuity had decreased to 20/50 and he also had relative afferent pupillary defect and color vision defects in the left eye. Slit lamp examination results were normal. There were no inflammatory reactions in the anterior chamber or vitreous. Fundoscopy showed optic disc edema. Orbital magnetic resonance imaging showed diffuse enhancement surrounding the left optic nerve. The serum levels of eosinophil cationic protein and angiotensin- converting enzyme were markedly increased. A chest radiograph showed bilateral hilar lymph node enlargement. A biopsy via endobronchial ultrasound-guided transbronchial needle aspiration revealed multifocal non-caseating granulomas. Acid fast bacilli stain showed no evidence of tuberculosis. Based on these findings, he was diagnosed with sarcoidosis. After treatment with high-dose intravenous methylprednisolone and subsequent tapering with oral prednisolone for 6 months, the visual acuity improved. Conclusions Optic perineuritis can be the initial sign of sarcoidosis. Therefore, sarcoidosis should be considered in the differential diagnosis of optic perineuritis.

Purpose: The balloon-stent technique (BST) has certain strengths as an assisted technique for the treatment of complex aneurysms. After Atlas release, the BST can be executed without an exchange maneuver of the balloon to the stent-delivery catheter. The purpose of this article is to share our experience with the BST using the Scepter-Atlas combination. Materials and Methods: Device inspection led us to a simple method to avoid failure in loading Atlas to the Scepter. From March 2018 to December 2019, 57 unruptured distal internal carotid artery (dICA) aneurysms were treated with coil embolization; among which, 25 aneurysms in 23 patients were treated with BST. Clinical and angiographic data were retrospectively collected and reviewed. Results: The technical success rate of the Scepter-Atlas combination increased from 50% to 100% after careful inspection. BST angiographic results were comparable to the stent-assisted coil (SAC) group treated during the immediately post-embolization same period (modified Raymond-Roy classification [MRRC] 1 & 2 84% in BST, 96.3% in SAC) and during short-term follow-up (MRRC 1 & 2 95.8% in BST, 88.4% in SAC). A small number of patients showed periprocedural complications, but none had clinical consequences. Conclusion BST using the Scepter-Atlas combination can provide an effective and safe method for the treatment of dICA aneurysms. Scepters can be used as delivery catheters for Atlas.

Purpose: The balloon-stent technique (BST) has certain strengths as an assisted technique for the treatment of complex aneurysms. After Atlas release, the BST can be executed without an exchange maneuver of the balloon to the stent-delivery catheter. The purpose of this article is to share our experience with the BST using the Scepter-Atlas combination. Materials and Methods: Device inspection led us to a simple method to avoid failure in loading Atlas to the Scepter. From March 2018 to December 2019, 57 unruptured distal internal carotid artery (dICA) aneurysms were treated with coil embolization; among which, 25 aneurysms in 23 patients were treated with BST. Clinical and angiographic data were retrospectively collected and reviewed. Results: The technical success rate of the Scepter-Atlas combination increased from 50% to 100% after careful inspection. BST angiographic results were comparable to the stent-assisted coil (SAC) group treated during the immediately post-embolization same period (modified Raymond-Roy classification [MRRC] 1 & 2 84% in BST, 96.3% in SAC) and during short-term follow-up (MRRC 1 & 2 95.8% in BST, 88.4% in SAC). A small number of patients showed periprocedural complications, but none had clinical consequences. Conclusion BST using the Scepter-Atlas combination can provide an effective and safe method for the treatment of dICA aneurysms. Scepters can be used as delivery catheters for Atlas.