The lymphoepithelial cyst (LEC) rarely occurs in the thyroid gland. The LEC has been thought to be related to developmental rest, namely solid cell nest, which is derived from ultimobranchial body. We report a case of lymphoepithial cyst in a 34- year-old woman clinically diagnosed with Hashimoto's thyroiditis. The cyst was located in mid to lower portion of the left lobe. It was a single unilocular cyst, which for the most part was lined with squamous epithelium, and at certain foci with ciliated columnar epithelium. The cyst wall showed a dense lymphocytic infiltration, numerous lymphoid follicles with germinal centers and admixed thyroid follicles. This morphology is similar to the branchial cleft cyst, with the exception of the thyroid follicles in the cyst wall. Near the cyst were several solid epidermoid cell nests. Immunohistochemical stain of this cyst-lining epithelium and solid cell nests showed CEA positivity. In view of the similarity in histomorphology and CEA positivity to branchial cleft cyst of the lateral neck, the LEC of the thyroid could also have been of branchial origin. However, the admixed thyroid follicles in the cyst wall suggests that the LEC of the thyroid gland might have derived from another branchial cleft as a ultimobranchial body, because it has the potential for thyroid follicular differentiation.
Branchial Region* ; Branchioma ; Epithelium ; Female ; Germinal Center ; Humans ; Neck ; Thyroid Gland* ; Thyroiditis ; Ultimobranchial Body

No abstract available.
Brain* ; Child* ; Humans ; Seizures*

BACKGROUND: To determine the associations between serum osteocalcin level and insulin resistance, coronary atherosclerosis by using dual-source coronary computed tomography angiography. METHODS: A total of 98 subjects (24 men and 74 women) were selected for this retrospective cross-sectional study who voluntarily visited a health examination center for routine health check-up including the blood test for serum osteocalcin level and coronary computed tomography angiography. Multiple regression analysis was used to determine which variables were independently related to osteocalcin levels and coronary atherosclerosis. RESULTS: Stepwise multiple regression analysis adjusted for age, sex, menopausal status, body mass index, serum alkaline phosphatase, serum calcium and phosphate showed that osteocalcin negatively correlated with serum glucose (β=-0.145, P=0.001) and homeostasis model assessment of insulin resistance (HOMA-IR) index (β=-1.794, P=0.027) independently. The age, serum glucose, smoking status but not osteocalcin level were independent risk factors for coronary atherosclerosis by use of multiple logistic regression analysis after controlling for other variables. CONCLUSIONS: Serum osteocalcin level was inversely associated with fasting glucose level and insulin resistance measured by HOMA-IR, suggesting that osteocalcin is important for glucose metabolism. However, in this study, no significant difference was observed in the serum osteocalcin level according to the presence of coronary atherosclerotic plaques.
Alkaline Phosphatase ; Angiography ; Blood Glucose ; Body Mass Index ; Calcium ; Coronary Angiography ; Coronary Artery Disease* ; Cross-Sectional Studies ; Fasting ; Glucose ; Hematologic Tests ; Homeostasis ; Humans ; Insulin Resistance* ; Insulin* ; Logistic Models ; Male ; Metabolism ; Osteocalcin* ; Plaque, Atherosclerotic ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking

Metastatic carcinoma of the eyelid is extremely rare; Oltmans reported the first case in 1930. We experienced a case of metastatic adenocarcinoma of the left lower eyelid in a 51-year-old male patient. The lesion was clinically similar to chalazion. Histopathologic findings of biopsy revealed gastric adenocarcinoma.
Adenocarcinoma* ; Biopsy ; Chalazion ; Eyelids* ; Humans ; Male ; Middle Aged

BACKGROUND: Serum osteocalcin level has been widely used as a bone turnover marker in clinical setting. In this study, we analyzed the relationship between serum osteocalcin concentration and metabolic syndrome as a cardiovascular risk factor in adult women. METHODS: We retrospectively reviewed the medical records of 89 adult women (29 premenopausal, 60 postmenopausal) who voluntarily measured serum osteocalcin concentration and lumbar spine bone mineral density (BMD) for the purpose of screening. The definition of metabolic syndrome was used National Cholesterol Education Program's Adult Treatment Panel III criteria except waist circumference which was adopted the Korean standard. RESULTS: The serum osteocalcin concentration with metabolic syndrome was significantly lower than those without metabolic syndrome (15.4±8.0 ng/mL vs. 22.4±12.2 ng/mL; P=0.001). The osteocalcin level was significantly lower in the groups with more than 4 risk factors for metabolic syndrome (10.1±6.7 ng/mL) than the groups with more than 3 (18.0±7.6 ng/mL) or 2 (23.6±7.1 ng/mL) risk factors. As a result of logistic regression analysis using serum osteocalcin, age, menopausal status, lumbar spine BMD and body mass index as independent variables, the presence of metabolic syndrome was independently associated with the serum osteocalcin level (β=-0.151, P=0.018). CONCLUSIONS: The serum osteocalcin levels in adult women were significantly lower in the metabolic syndrome group, and also lower in the group with higher clustering of individual risk factors of metabolic syndrome.
Adult* ; Body Mass Index ; Bone Density ; Bone Remodeling ; Cholesterol ; Education ; Female ; Humans ; Logistic Models ; Mass Screening ; Medical Records ; Osteocalcin* ; Retrospective Studies ; Risk Factors ; Spine ; Waist Circumference

Central venous catheterization is a common diagnostic and therapeutic procedure in modern clinical practice. Pseudoaneurysms of the subclavian artery are rare and usually occur immediately after the causative event, whether the cause was trauma or a medical procedure. Here we report the rare case of a 71-year-old woman with delayed presentation of catheter-related subclavian pseudoaneurysm. The patient was treated for aspiration pneumonia with respiratory failure in another hospital. The patient's chest wall swelling began two weeks after the initial catheterization in the other hospital, probably because of slow leakage of blood from the injured subclavian artery caused by incomplete compression of the puncture site and uremic coagulopathy. She was successfully treated with ultrasound-guided thrombin and angiography-guided histoacryl injection without stent insertion or surgery. Her condition improved, and she was discharged to her home.
Aged ; Aneurysm, False* ; Catheterization ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters ; Enbucrilate ; Female ; Humans ; Pneumonia, Aspiration ; Punctures ; Respiratory Insufficiency ; Stents ; Subclavian Artery* ; Thoracic Wall ; Thrombin

Cerebral infarcts rarely occur following head injury. Carotid artery dissection is usually proposed mechanism in such cases. We experienced a case of middle cerebral artery (MCA) infarct occurred just after head trauma without evidence of vascular abnormality. A 59-year-old male was transported to the emergency room immediately after traffic accident. He had right zygomatic fracture without neck injury. Left hemiparesis was noticed, and brain CT revealed hyperdense MCA sign in the right side. His neurologic status deteriorated over 2 days, and brain MRI showed total right MCA infarct with midline shift. Cerebral angiography was unremarkable. Two months later he had improved so much, but left hemiparesis with right MCA infarction re-developed. We suggest head trauma immediately can induce cerebral infarct without neck vessel injury, and in differential diagnosis of focal neurologic deficit after trauma, cerebral infarct as well as hemorrhage or contusion must be considered.
Accidents, Traffic ; Brain ; Carotid Arteries ; Cerebral Angiography ; Contusions ; Craniocerebral Trauma* ; Diagnosis, Differential ; Emergency Service, Hospital ; Head* ; Hemorrhage ; Humans ; Infarction, Middle Cerebral Artery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Middle Cerebral Artery* ; Neck ; Neck Injuries ; Neurologic Manifestations ; Paresis ; Zygomatic Fractures

Subclavian vessels are well protected by muscles, fascia and sheaths, so vascular complications associated with clavicular fractures are rare. Pseudoaneurysms after clavicular fractures have been reported, and the occurrence or rupture of pseudoaneurysm has been reported rarely as a late complication. However, cases of pseudoaneurysm after rupture of the clavicular fracture following delayed osteosynthesis of the clavicular fracture have not been reported. A 58-year-old female that presented with a right clavicular shaft fracture obtained conservative treatment. Surgery was performed after 4 months because of non-union in the local medical center. After operation, rupture of the subclavian pseudoaneurysm occurred following osteosynthesis of the clavicular shaft fracture. We report this case here with a review of the literature.
Aneurysm ; Aneurysm, False* ; Clavicle ; Fascia ; Female ; Humans ; Middle Aged ; Muscles ; Rupture* ; Subclavian Artery*

Obesity is one of the well-known risk factors of breast cancer. We evaluated the relationship between serum adiponectin and resistin levels and breast cancer risk in 41 biopsy-proven breast cancer patients and 43 age- and body mass index-matched controls. The mean serum adiponectin level was lower in the breast cancer group than the control group (6.93+/-3.2 microgram/mL, vs. 7.60+/-3.5 microgram/mL), but this difference did not reach statistical significance (p=0.37). There was a statistically significant difference in serum resistin levels between the groups (breast cancer group 5.23+/-6.9 ng/mL vs. control 1.46+/-2.0 ng/mL; p<0.001). The risk of breast cancer was significantly increased in the highest tertile group for serum resistin level compared to the lowest tertile group (adjusted odds ratio 2.77 [95% CI 1.40-5.50]). The lymph node metastasis was significantly increased in the patients with less than the median adiponectin level (p=0.017). In the patients whose resistin level was higher than the median, the frequency of tumor with the highest histological grade was significantly increased (p=0.025). In conclusions, both the low serum adiponectin levels and high resistin levels are likely to be associated with increased breast cancer risk in Korean women.
Resistin/*blood ; Odds Ratio ; Middle Aged ; Insulin Resistance ; Humans ; Female ; Case-Control Studies ; Breast Neoplasms/*blood/etiology/pathology ; Adult ; Adiponectin/*blood

BACKGROUND: Molluscum contagiosum is a commom benign viral disease of the skin characterized by discrete, 2-5 mm, flesh colored, slightly umbilicated, dome-shaped papules with frequent grouping. But atypical presentation of site, number and size is recently not rare, it may give rise to difficulty in diagnosis. OBJECTIVE: The purpose of this study was to investigate the clinical and histopathological characteristics of various atypical molluscum contagiosa. METHODS: We reviewed medical records, clinical photographs, and histopathologic findings in biopsy specimens of 17 patients with molluscum contagiosa diagnosed at Korea Veterans Hospital from January 1990 to June 2001. The ratio of male to female patients was 3:1, and the mean age at diagnosis was 30 years(range: 3-67). RESULTS: 1. Most commonly involved sites were trunk(80%), extremities(30%), and perianal(12%). 2. The duration of the lesion is 15 days to 3 years. 3. The size of lesion is 2 mm to 50 mm. 4. The number of lesions is one to over a hundred. 5. The clinical features were multiple papules without umbilication(9 cases, 53%) and giant tumor(2 case), pyogenic granuloma-like lesion(2 cases), solitary papule with flat surface(2 cases). 6. The combined disease are atopic dermatitis(1 case), epidermal cyst(1 case), and liver cirrhosis(1 case), diabetes mellitus(1 cases). CONCLUSION: This study shows various atypical molluscum contagiosa in immunocompetent patients. Histopathological examination in atypical molluscum contagiosa is necessary for the proper diagnosis and treatment.
Biopsy ; Diagnosis ; Female ; Hospitals, Veterans ; Humans ; Korea ; Liver ; Male ; Medical Records ; Molluscum Contagiosum ; Skin ; Virus Diseases