The most common pancreatic cystic lesion is pancreatic pseudocyst which represents about 85%. Primary cystic neoplasms represent about 10 to 15% of the lesion. Pathologically cystic neoplasms can be classified into serous cystadenoma, mucinous cystadenoma and papillary cystic neoplasm by epithelial lining-cell, whereas pseudocyst is characterized by fibrotic capsules. Mucinous form is known to be premalignant or malignant and serous cystadenoma was known to be benign in the past, but recently 4 cases of malignant transformation have been reported. Serous cystadenoma is described under a variety of names, including microcystic adenoma and glycogen-rich cystadenoma but recently macroqystic variants have been reported. Serous cystadenoma is most commonly seen in middle aged women with symptoms of vague upper abdominal pain or palpable mass. It is sometimes associated with extra- pancreatic diseases such as gallstones, diabetes mellitus, hypertension, duodenal ulcers, sterility, obesity and thymic dysfunction, but coexisting papillary thyroid cancer have been reported in only 2 cases to our knowledge. The pathogenesis of associated diseases is unknown and appears to be due to function of age of the patients or incidental occurrence. Herein, we report a patient who had a pancreatic serous cystadenoma coexisting with papillary thyroid cancer. Since pancreatic serous cystadenoma can occur in association with papaillary thyroid cancer, examination of thyroid seems to be advisable when pancreatic serous cystadenoma is found.
Abdominal Pain ; Adenoma ; Capsules ; Cystadenoma ; Cystadenoma, Mucinous ; Cystadenoma, Serous* ; Diabetes Mellitus ; Duodenal Ulcer ; Female ; Gallstones ; Humans ; Hypertension ; Infertility ; Middle Aged ; Mucins ; Obesity ; Pancreatic Cyst ; Pancreatic Diseases ; Pancreatic Pseudocyst ; Thyroid Gland* ; Thyroid Neoplasms*

Ehlers-Danlos syndrome type IV (EDS IV) is a hereditary disorder of the connective tissue, characterized by easy bruising, thin skin with visible veins, and spontaneous rupture of the large arteries, uterus, or bowel. EDS IV is caused by mutations of the gene for type III procollagen (COL3A1), resulting in insufficient collagen production or a defect in the structure of collagen. EDS IV can have fatal complications such as the rupture of great vessels or organs, which can cause hemorrhaging and sudden unexpected death. Here, we report a case of a 43-year-old female who collapsed after a struggle with a neighbor. In this patient, the bifurcation of the bilateral common iliac artery ruptured, with no evidence of trauma, inflammation, or atherosclerosis. Genetic analysis of COL3A1 showed the presence of a c.2771G>A (p.Gly924Arg) mutation, which may be associated with EDS IV. The forensic pathologist should consider the possibility that the spontaneous visceral or arterial rupture was caused by EDS IV. Genetic analysis is not currently a routine procedure during autopsy. However, in this case, we suggest that the patient possibly had an underlying EDS IV condition, and we recommended family members of the deceased to seek genetic analysis and counseling.
Adult ; Aortic Rupture* ; Arteries ; Atherosclerosis ; Autopsy ; Collagen ; Collagen Type III ; Connective Tissue ; Counseling ; Ehlers-Danlos Syndrome* ; Female ; Humans ; Iliac Artery ; Inflammation ; Rupture ; Rupture, Spontaneous ; Skin ; Uterus ; Veins

Familial adenomatous polyposis (FAP) is an autosomal dominantly inherited colon cancer-predisposing disorder, characterized by the development of innumerable adenomas in the large intestine. Polyps are present in the upper gastrointestinal tract in almost all FAP patients and there is a peculiar predilection for adenomatous change in the duodenum. Colonic adenomas in FAP are commonly observed as polyps but nonpolypoid adenomas can also be seen in the upper gastrointestinal tract. Careful endoscopic examination is needed for detecting such nonpolypoid lesions. At present, the adenoma-carcinoma sequence is thought to exist also in the duodenum, and malignancy of the duodenum represents one of the most common causes of mortality among patients with FAP. Therefore, careful periodic follow-up of upper intestinal endoscopies are recommended in patients with this disease, in consideration to the possible development of duodenal nonpolypoid adenomatous lesions. A case involving an experience of antral and duodenal nonpolypoid adenomas in a patient with FAP is herein reported.
Adenoma* ; Adenomatous Polyposis Coli* ; Colon ; Duodenum ; Follow-Up Studies ; Humans ; Intestine, Large ; Mortality ; Polyps ; Pyloric Antrum ; Upper Gastrointestinal Tract

Peutz-Jeghers syndrome is a genetic disorder consisting of mucocutaneous pigmentation and gastrointestinal polyposis. Although the polyp may be found in a solitary fashion in this syndrome, such a case is exceedingly rare and would result in a case report even in other countries. A solitary Peutz-Jeghers polyp had not been reported domestically until now, and thereby, the authors here present a case of a clinical experience of Peutz-Jeghers syndrome with a solitary hamartomatous polyp in the duodenum.
Diagnosis* ; Duodenum* ; Hemorrhage* ; Peutz-Jeghers Syndrome ; Pigmentation ; Polyps*

Phlegmonous esophagitis is an uncommon disease characterized by purulent infection of the esophageal wall, sparing the mucosa. Bacterial infection of the eosphagus is usually presented as a superimposed infection upon a preexisting viral or fungal esophagitis and most victims are immunocompromised hosts. A case was experienced involving an acute phlegmonous esophagitis in an 21-year-old man who was immunologically normal and whose main symptoms were epigastric pain and fever for one day. Esophagographic examination revealed a large ulceration of the eosphagus with exudation, and submucosal lesions. Due to its rarity, this case is herein reported with a review of the corresponding literature.
Bacterial Infections ; Cellulitis* ; Esophagitis* ; Fever ; Humans ; Immunocompromised Host ; Mucous Membrane ; Ulcer ; Young Adult

Atrial fibrillation occurs in 10 to 25% of patients with thyrotoxicosis. Several recent studies have found a high frequency of cerebral thromboembolism in such patients. Thus anticoagulation has been recommended for patients with thyrotoxic atrial fibrillation to prevent embolic complications especially when associated with predictors of an increased risk of arterial thromboembolism in nonrheumatic atrial fibrillation such as recent congestive heart failure, history of hypertension, previous thromboembolism, left atrial enlargement, and global left ventricular dysfunction. Most reported cases of embolic events involving central nervous system in thyrotoxic atrial fibrillation affected cerebrum, and cerebellar embolic infarction from the heart was rarely seen. We herein report our experience of a case of cerebellar embolism in thyrotoxic atrial fibrillation.
Atrial Fibrillation* ; Central Nervous System ; Cerebrum ; Embolism ; Heart ; Heart Failure ; Hepatitis ; Humans ; Hypersensitivity ; Hypertension ; Infarction* ; Thromboembolism ; Thyrotoxicosis ; Ventricular Dysfunction, Left

Up to 1937, 357 cases of tongue tuberculosis had been reported. However, Since potent antituberculosis drugs had been introduced, the incidence of oral tuberculosis lesions has been dramatically decreased. This might be related to the marked vascularity of the tongue which enables a high concentration of the drug to be reached to the lesion. Both the primary and secondary types of tuberculosis can be revealed in the oral cavity. In the primary type, the causative organisms are directly inoculated in the oral mucosa of a person who has never been tuberculosis earlier and who has not acquired an immunity to the disease, In the secondary type, tuberculosis of the oral cavity is coexistent with pulmonary disease. We report a case of tongue tuberculosis with pulmonary tuberculosis, with a review of literature.
Humans ; Incidence ; Lung Diseases ; Mouth ; Mouth Mucosa ; Tongue* ; Tuberculosis* ; Tuberculosis, Oral ; Tuberculosis, Pulmonary*

OBJECTIVES: We report an outbreak of skin disorder in semiconductor packing workers. Through an evaluation of the degree of work-relatedness in this case, we aim to develop a method to overcome such health problems in the workplace. METHODS: A questionnaire investigating the job characteristics and skin symptoms was administered to 51 packing workers working in a semiconductor production factory and 49 questionnaires returned. The 16 subjects in the exposure group and 12 in the non-exposure group underwent doctor's examination and patch test. Two of 28 subjects were excluded in patch test. We investigated the work environment and carbon fiber level which was the potential causative agent. RESULTS: Forty-five (91.8%) of 49 packing workers complained of itching and stinging. Three of 14(21.4%) in the exposure group and 3 of 11 (27.3%) in the non-exposure group were positive at 48hr reading of patch test for carbon fiber and carbon fiber paper. None was positive at 96hr reading of patch test. Prominent carbon fibers were microscopically observed on the surface of the packing box and the fiber diameter, measured up to 6.0~7.5 micrometer, was likely to induce skin irritation to skin. To avoid worker's direct contact with to carbon fiber, carbon fiber paper box was substituted by a wax coated carbon fiber paper box was substituted for the original carbon fiber paper box, which caused and the workers' symptoms to of workers disappeared. CONCLUSION: The probably cause of this outbreak of skin disorder was mild irritant contact dermatitis for carbon fiber. To prevent outbreaks of such occupational skin disorder like this, workers should avoid direct contact with carbon fiber.
Bites and Stings ; Carbon* ; Dermatitis, Contact ; Disease Outbreaks ; Patch Tests ; Pruritus ; Questionnaires ; Semiconductors ; Skin*

OBJECTIVES: Subway drivers experience various types of work-related problems during their driving, and those experiences can act as risk factors for depressive symptoms. This study was conducted to investigate the association between work-related problems and subway driver's depressive symptoms. METHODS: We recruited all of the 961 current subway drivers of a subway company located in Seoul, South Korea and conducted a survey of their socio-demographic and vocational characteristics, hospital visits as an outpatient or inpatient, and work-related problem experiences during the last year. Work-related problems included an accident resulting in death or injury, a conflict with a customer, a sudden stop from an emergency bell, or a near accident. Depressive symptoms were measured with the Center for Epidemiologic Studies-Depression (CES-D) instrument. The survey was performed using a self-report questionnaire from April 16 to July 13, 2007. The data of 827 drivers (86.2%) were analyzed. RESULTS: Experience of a conflict with a passenger (p=0.011), a sudden stop from an emergency bell (p=0.001), or a near accident (p=0.001) increased the prevalence of depressive symptoms among subway drivers. A multiple logistic regression analysis revealed that a sudden stop from an emergency bell increased the risk of depressive symptoms significantly (OR=2.59, p=0.026). Near accidents were marginally associated with a higher risk for depressive symptoms (OR=1.62, p=0.062). CONCLUSION: The experience of a sudden stop from an emergency bell increased subway driver's depressive symptoms, and near accidents may increase the risk of depressive symptoms. Therefore, interventions for the drivers who had experienced these work-related problems are needed.
Depression ; Emergencies ; Humans ; Inpatients ; Logistic Models ; Outpatients ; Prevalence ; Railroads ; Republic of Korea ; Risk Factors ; Surveys and Questionnaires

Alkaline Phosphatase ; Calcium ; Cell Culture Techniques ; Cell Proliferation ; Dexamethasone ; Durapatite ; Glucocorticoids ; Humans ; Osteoblasts ; Osteogenesis ; Osteonecrosis ; Osteoporosis ; Periosteum ; Phenotype