Neurofibroma is a benign neurogenic tumor thatmost often occurs in the head and neck region. However, a solitary neurofibroma on the nasolabial fold is extremely rare, with only a few reported cases reported in the English literature. A 45-year-old woman with a nasolabial mass visited our department, and we performed an excisional biopsy using asublabial approach. The histopathology of the mass revealed it to be neurofibroma. We report a unique case of neurofibromain thenasolabial region with an associated literature review. To the best of our knowledge, no such case has previouslybeen reported in Korea.
Biopsy ; Female ; Head ; Humans ; Korea ; Middle Aged ; Nasolabial Fold ; Neck ; Neurofibroma*

In most cases, skull base osteomyelitis arises from infections of external auditory canal, middle ear or paranasal sinuses. On the other hand, atypical or central skull base osteomyelitis has no evidence of external otitis or other infection sources. It is often found located on clivus and involves lower cranial nerves and brainstem through the foramina of skull base. The overall rate of mortality reaches 10% and long-term neurologic sequelae are seen in additional 31% of cases regardless of aggressive treatment. We recently encountered a 68-year-old man with right facial pain and generalized headache, and we achieved good outcome with the recovery of vocal cord palsy and disappearance of headache by surgical debridement and long-term antibiotics. We report it with a review of literature.
Aged ; Anti-Bacterial Agents ; Brain Stem ; Cranial Fossa, Posterior ; Cranial Nerve Diseases* ; Cranial Nerves ; Debridement ; Ear Canal ; Ear, Middle ; Facial Pain ; Hand ; Headache ; Humans ; Mortality ; Osteomyelitis* ; Otitis Externa ; Paranasal Sinuses ; Skull Base* ; Vocal Cord Paralysis

There are relatively rare cases concerning about concurrent papillary thyroid cancer and thyroid tuberculosis with cervical tuberculous lymphadenitis in English literature so far. Cervical lymphadenitis (scrofula) is a common manifestation of extra-pulmonary invasion of the tuberculosis. A cervical tuberculous lymphadenitis could be confused with metastatic lymph node from the thyroid cancer. A 49-year-old woman with multiple right thyroid nodules of Bethesda category VI referred our department for surgery. We performed the right thyroid lobectomy with anterior compartment neck dissection. The histopathology revealed concurrent papillary thyroid carcinoma and thyroid tuberculosis with cervical tuberculous lymphadenitis. We report a unique case of concurrent papillary thyroid cancer and tuberculosis involving the thyroid gland and ipsilateral paratracheal lymph node with literature review. To our best knowledge, such case has not been reported earlier.
Carcinoma ; Carcinoma, Papillary ; Female ; Humans ; Lymph Nodes* ; Lymphadenitis ; Middle Aged ; Neck Dissection ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule ; Tuberculosis* ; Tuberculosis, Lymph Node

While ancient schwannoma (AS) from the cervical sympathetic chain is very rare. Preoperative Horner's syndrome resulting from cervical sympathetic chain schwannoma (CSCS) is extremely rare. A 58-year-old woman visited our clinic with a huge lateral neck mass that had been present for thirteen years. Ptosis and enophthalmos were observed on the left eye. After radiologic evaluation, we assessed the CSCS by performing surgical excision. Finally, pathologic examination revealed it to be AS. There has been no recurrence for 15 months after discharge, however Horner's syndrome has become more prominent. We report this unique case of ancient schwannoma with literature review.
Enophthalmos ; Eye ; Female ; Horner Syndrome ; Humans ; Middle Aged ; Neck ; Neurilemmoma ; Preoperative Period ; Recurrence ; Sympathetic Nervous System

Multinodular goiter (MNG) is one of the benign thyroid neoplasm and nodular hyperplasia is the most common pathologic type. MNG could be misdiagnosed as a malignancy because of its characteristic, which is its growing tendency. A-70-year-old female was referred to our clinic from endocrinology, with the huge and recently rapid growing thyroid mass. We performed the neck sonography, its guided fine needle aspiration cytology (FNAC), neck CT and MRI. She was presumed as the malignant thyroid neoplasm except papillary carcinoma. The right completion thyroidectomy and anterior compartment neck dissection had been done and the nodular hyperplasia was diagnosed finally. We learned a valuable lesson from this case in the following. Even if the malignancy is strongly suggested in the radiology and clinically, more careful consideration in determining the surgical method and its extent is mandatory.
Biopsy, Fine-Needle ; Carcinoma, Papillary ; Endocrinology ; Female ; Goiter ; Humans ; Hyperplasia ; Neck ; Neck Dissection ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

Multinodular goiter (MNG) is one of the benign thyroid neoplasm and nodular hyperplasia is the most common pathologic type. MNG could be misdiagnosed as a malignancy because of its characteristic, which is its growing tendency. A-70-year-old female was referred to our clinic from endocrinology, with the huge and recently rapid growing thyroid mass. We performed the neck sonography, its guided fine needle aspiration cytology (FNAC), neck CT and MRI. She was presumed as the malignant thyroid neoplasm except papillary carcinoma. The right completion thyroidectomy and anterior compartment neck dissection had been done and the nodular hyperplasia was diagnosed finally. We learned a valuable lesson from this case in the following. Even if the malignancy is strongly suggested in the radiology and clinically, more careful consideration in determining the surgical method and its extent is mandatory.
Biopsy, Fine-Needle ; Carcinoma, Papillary ; Endocrinology ; Female ; Goiter ; Humans ; Hyperplasia ; Neck ; Neck Dissection ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

PURPOSE: Topical anesthetic abuse resulting in sight-threatening keratitis may be seen as a masquerade syndrome in many cases because of ring infiltration of the cornea. The authors report two cases of keratopathy from topical anesthetic abuse that were originally suspected as infectious keratitis because of ring infiltration of the cornea METHODS: The medical records of two patients were retrospectively reviewed. The pathogenesis, diagnosis, and treatment of ring infiltrates were evaluated. RESULTS: The two patients presented a nonhealing epithelial defect, marked stromal edema, folds in Descemet's membrane, and typical stromal ring infiltrates of unknown etiology. The patients initially were treated empirically with antibacterial and antifungal agents in suspicion of infectious keratitis. These patients had sustained severe ocular pain, and chronically used topical anesthetics (0.5% proparacaine hydrochloride in one patient and 0.4% benoxinate hydrochloride in the other) for several weeks. All microbiology work-ups for the identification of infectious organisms including acanthamoeba were negative. After topical anesthetic was discontinued in two patients, amniotic membrane transplantation was performed on one patient. Corneas in two patients were re-epithelialized with mild scarring with topical antibiotic and steroid treatment.
Acanthamoeba ; Amnion ; Anesthetics ; Antifungal Agents ; Cicatrix ; Cornea ; Descemet Membrane ; Diagnosis ; Edema ; Humans ; Keratitis ; Medical Records ; Retrospective Studies

PURPOSE: The aim of this study is to determine the soluble Fas (sFas) levels in both sera and aqueous humor in patients with uveitis and compare them to the uveitis severity. METHODS: We measured the sFas levels in both sera and aqueous humor (AH) of patients (n=40) with uveitis and non-uveitis controls (n=27). The patients with uveitis comprised 24 Behcet's disease, 6 panuveitis, 5 anterior uveitis, 2 lens induced uveitis, 1 Vogt-Koyanagi-Harada-disease, 1 sarcoidosis, and 1 retinal vasculitis. The severity of uveitis was determined by the Hogan's grading method (0~4 grade) at the time of sampling. RESULTS:The concentration of aqueous sFas in uveitis patients was significantly higher than that in nonuveitis controls, while there was no difference in the serum concentration of sFas between the two groups. In the paired samples of serum and AH, obtained simultaneously, the aqueous sFas levels were higher than serum Fas levels in patients with uveitis, whereas the non-uveitis controls displayed significantly lower sFas levels in AH than in the serum. The sFas levels in AH or serum were not different between Behcet's uveitis and non-Behcet's uveitis. However, in patients with Behcet's uveitis, circulating sFas strongly correlated with aqueous sFas, which was not so in those with non-Behcet's uveitis. Patients (n=29) with more active (grade> or =2) uveitis had significantly higher levels of aqueous sFas than those (n=11) with less active (grade<2) uveitis. After treatment with steroid and/or immunosuppressive agents, aqueous sFas levels were decreased in parallel with a reduction in the number of inflammatory cells in the anterior chamber. CONCLUSIONS: The levels of sFas were elevated in patients with uveitis and correlated well with uveitis severity.
Anterior Chamber ; Aqueous Humor ; Humans ; Immunosuppressive Agents ; Panuveitis ; Retinal Vasculitis ; Sarcoidosis ; Uveitis* ; Uveitis, Anterior

PURPOSE: To evaluate 20% ethanol toxicity on the rabbit corneal epithelium, ethanol-treated rabbit corneas were examined with electron microscopy. METHODS: Rabbit corneas(24 eyes) were treated with 20% ethanol for 30 seconds, 1 minute, and 2 minutes by using LASEK(Laser Assisted Subepithelial Keratomileusis) instruments, and washed with sterile water. Zero time, 1, 3, 5 days after ethanol treatment, corneas were excised and examined with scanning and transmission electron microscopy. RESULTS: Widespread damage or disappearance of microvilli and local breaks of intercellular junction were observed. The changes were more severe in corneas with longer ethanol treament. In corneas with over 1 minute ethanol treatment, slough of superficial corneal epithelium was shown and increased with time. It was difficult to recognize microvilli or distinctive intercellular junction in corneas with 2 minute-treament. These pathologic changes persisted 5 days after ethanol-treatment. CONCLUSIONS: From these results, 30 seconds to 1 minute-ethanol treatment is recommended in corneal surgery to avoid severe, persisting damage of superficial corneal epithelium.
Cornea ; Epithelial Cells* ; Epithelium, Corneal ; Ethanol ; Intercellular Junctions ; Microscopy, Electron ; Microscopy, Electron, Transmission ; Microvilli ; Water

We evaluated the efficacy of polymerase chain reaction(PCR)in early diagnosis of herpes simplex keratitis(HSK)in rabbit model and compared the sensitivity and specificity of PCR in two kinds of primers. Only one eye of 8 rabbits was inoculated with HSV Type 1(F strain, ATCC VR-73)to induce HSK, and the other eye was used as control. Rabbit cornea was examined under slit lamp examination and PCR test of tear and corneal scraping specimens were performed at 1, 3, 5, 7, and 10th post-inoculation day. The sensitivity of PCR with POL primer was 100%in tear and corneal scraping specimens. The sensitivity of PCR with POL primer and LAT primer were 80%and 100%respectively. PCR test is very useful diagnotic tool for the early diagnosis of HSK in rabbit model. In addition, PCR test with corneal scraping specimens provided better yield compared with tears.
Cornea ; Early Diagnosis* ; Herpes Simplex* ; Keratitis, Herpetic* ; Polymerase Chain Reaction* ; Rabbits ; Sensitivity and Specificity