Sunitinib is a multi-targeted tyrosine-kinase inhibitor used for gastrointestinal stromal tumors and renal cell carcinoma (RCC). Several recent studies have reported sunitinib-induced hypothyroidism and thyroid dysfunction; however, the underlying mechanisms are not clear. Here, we report a patient with metastatic RCC, who developed destructive thyroidtis due to sunitinib treatment. The course followed in this case may be useful in understanding the clinical course of sunitinib-induced thyroiditis.
Carcinoma, Renal Cell ; Gastrointestinal Stromal Tumors ; Humans ; Hypothyroidism ; Indoles ; Pyrroles ; Thyroid Gland ; Thyroiditis

Anisakiasis refers to the infestation of humans by species of marine nematode larvae belonging to the subfamily Anisakiae. An acute abdominal symptom may occur after ingestion of raw marine fish containing nematode larvae of the genus Anisakis. Migration of the parasite into the wall of gtomach, small intestine or, less commomly, the colon elicits a striking eosinophilic granulomatous tissue response. A 39 year old man was visited St. Vincent Hospital because of abdominal distension and tenderness. The plain abdominal X-ray showed ileus pattern suggesting intestinal obstruction. Hence we presented a case of intestinal Anisakiasis combined with intstinal obstruction.
Adult ; Anisakiasis* ; Anisakis ; Colon ; Eating ; Eosinophils ; Humans ; Ileus ; Intestinal Obstruction ; Intestine, Small ; Larva ; Parasites ; Strikes, Employee

Kallmann's syndrome is characterized by hypogonadotrophic hypogonadism resulting from insufficient release of GnRH and associated with anosmia or hyposmia, which has been related to agenesis of olfactory bulbs. We experienced a case of 17 year-old Kallmann's syndrome woman and a case of successful pregnancy of 29 year-old Kallmann's syndrome woman with hMG and hCG treatment and present two cases with a review of literatures.
Adolescent ; Adult ; Female ; Gonadotropin-Releasing Hormone ; Humans ; Hypogonadism ; Kallmann Syndrome* ; Olfaction Disorders ; Olfactory Bulb ; Pregnancy*

PURPOSE: B1 field of birdcage RF (radiofrequency) coil that is used most for brain imaging in magnetic resonance imaging (MRI) decreases toward endring from the coil center. We investigated how much RF B1 homogeneity effect the endcap shield brings form the coil center as it towards to endcap region. MATERIALS AND METHODS: We compared RF B1 field distribution by each finite difference time domain (FDTD) simulations for lowpass, highpass and hybrid birdcage RF coils. We selected the highpass birdcage RF coil that was the highest RF B1 field condition as simulation result, and studied how much RF B1 homogeneity effect was occurred when endcap shield was applied to endring area. RESULTS: B1 field of the highpass birdcage RF coil was higher than other birdcage RF coil types as simulation result. However, the RF B1 homogeneity was lower than other coil types. RF B1 field of highpass birdcage RF coil with endcap shield is similar with RF B1 field of hybrid birdcage RF coil and the overall RF B1 homogeneity in sagittal direction was better. CONCLUSION: In this paper, proposed method can apply improving RF B1 homogeneity of RF coil in clinical examination.
Magnetic Resonance Imaging* ; Neuroimaging

BACKGROUND AND OBJECTIVES: Follicular tumors can present a difficult diagnostic challenge for cytological evaluation and ultrasound findings. Therefore, new methods which could help distinguish follicular adenoma from follicular carcinoma simply and accurately are greatly desired. This study investigated the usefulness of immnunohistochemical expression of CXC chemokine receptor 4 (CXCR4) and galectin-3 as marker of differentiated thyroid carcinomas. MATERIALS AND METHODS: Expression of CXCR4 and galectin-3 were examined immunohistochemically in the 60 paraffin embedded tissues which were already diagnosed as follicular adenoma (n=20), follicullar carcinoma (n=20), and papillary carcinoma (n=20) of thyroid. RESULTS: Galatin-3 was expressed significantly high in follicular carcinoma than follicular adenoma (p=0.022). CXCR4 was also expressed significantly high in follicular carcinoma than follicular adenoma (p=0.027). The sensitivity of CXCR4 and galectin-3 was 70% and 80% and specificity, 65% and 60% for differential diagnosis of follicular tumors. CONCLUSION: An immunohistochemical panel, including galatin-3 and CXCR4, could be useful in the differential diagnosis between follicular adenoma from follicular carcinoma.
Adenoma ; Carcinoma, Papillary ; Diagnosis, Differential ; Galectin 3 ; Paraffin ; Receptors, CXCR ; Receptors, CXCR4 ; Sensitivity and Specificity ; Thyroid Gland

The autoimmune polyglandular syndromes (APS) are groups of syndromes comprising a combination of endocrine and nonendocrine autoimmune diseases. Among of those four types of APS, the main characteristics of the 3 APS are autoimmune thyroid diseases associated to other autoimmune diseases, excluding Addison's disease. Type 3 APS are also subdivided into 3A, 3B, 3C, and 3D. Recently, we experience a case of APS manifesting 3A, 3C, and 3D subtype. A 28-year-old woman developed type I diabetes. According to her medical history, she had Graves' disease, vitiligo, auimmune hemolytic anemia and systemic lupus erythematosus (SLE). The antoantibodies associated with Graves' disease, SLE, and type I diabetes showed positive findings. We report this case with literatures review.
Addison Disease ; Adult ; Anemia, Hemolytic ; Autoimmune Diseases ; Female ; Graves Disease ; Humans ; Lupus Erythematosus, Systemic ; Thyroid Diseases ; Vitiligo

Interferon-induced thyroiditis (IIT) is a major clinical problem for patients receiving interferon-alpha (IFN-alpha) therapy. But, destructive thyroiditis followed by Graves' disease associated with IFN-alpha therapy is very rarely reported. Herein, we report a rare case of pegylated IFN-alpha (pegIFN-alpha) induced destructive thyroiditis followed by Graves' disease in a patient with HCV infection. A 31-yr-old woman suffered from chronic active hepatitis C and was treated with pegIFN-alpha and ribavirin for 12 months. Results of a thyroid function test and autoantibody levels were normal before IFN-alpha therapy was initiated. Destructive thyrotoxicosis appeared seven months after the initiation of IFN-alpha therapy, followed by Graves' thyrotoxicosis two months after the cessation of therapy. The diagnoses of destructive thyroiditis and Graves' disease were confirmed by the presence of TSH receptor antibodies in addition to Tc-99m scintigraphy findings. The patient's antithyroglobulin antibody titer increased gradually during IFN-alpha therapy and remained weakly positive after IFN-alpha therapy was discontinued.
Adult ; Antiviral Agents/*adverse effects/therapeutic use ; Female ; Graves Disease/*chemically induced ; Hepatitis C, Chronic/*drug therapy ; Humans ; Interferon-alpha/*adverse effects/therapeutic use ; Methimazole/therapeutic use ; Propranolol/therapeutic use ; Thyroiditis/*chemically induced

OBJECTIVES: The aim of this retrospective study was whether serum Tg predicts malignancy in follicular or Hurthle-cell neoplasms on fine needle aspiration. METHODS: A chart review of 111 patients (90 females, 21 males; mean age 46.8 +/- 11.9 years) with follicular or Hurthle-cell neoplasms on fine needle aspiration, who were surgically treated between Sep. 2001 and Sep. 2011, was performed. Predictive factors for malignancy were identified by the chi-squared test and multivariate logistic regression. RESULTS: There were no differences between 41 malignant and 70 benign lesions in serum Tg or any of the normalized indexes. Receiver-operator characteristic analysis revealed no cut-off value. Lesions with serum Tg levels greater than 500 g/L had no significant difference. And also there were no independent predictors of malignancy by multivariate logistic regression. CONCLUSIONS: In this study, the author found that serum Tg has poor accuracy for predicting malignancy in follicular or Hurthle cell neoplasms on fine needle aspiration.
Biopsy, Fine-Needle ; Diagnosis* ; Female ; Humans ; Logistic Models ; Male ; Retrospective Studies ; Thyroglobulin* ; Thyroid Gland* ; Thyroid Neoplasms

Many cases of RET proto-oncogene mutations of hereditary medullary thyroid carcinoma (MTC) have been reported in Korea. However, MTC with V804M RET proto-oncogene germline mutations have not been reported in Korea. A 33-yr-old man was diagnosed with a 0.7-cm sized thyroid nodule. Laboratory testing revealed serum calcitonin was elevated. The patient underwent total thyroidectomy with central compartment neck dissection for the thyroid tumor. RET gene analysis was performed in both the index patient and his family. There were no V804M RET mutation and abnormal laboratory findings within his family except the index patient. Therefore, this patient was a de novo V804M RET germline mutation.
Adult ; Calcitonin/blood ; Germ-Line Mutation ; Humans ; Male ; Pedigree ; Proto-Oncogene Proteins c-ret/*genetics ; Sequence Analysis, DNA ; Thyroid Neoplasms/*diagnosis/genetics/ultrasonography ; Thyroidectomy

Osteochondroma is a common bone tumor but a rare tumor in the rib. It is often asymptomatic and observed incidentally. This is a case report of a 49-year-old woman with an osteochondroma mimicking a mediastinal mass in hereditary multiple exostoses. The chest X-ray and computed tomography (CT) scans revealed the bony density feature of the mass. Surgical excision confirmed that the lesion was an osteochondroma.
Exostoses, Multiple Hereditary ; Female ; Humans ; Middle Aged ; Osteochondroma ; Ribs ; Thorax