This study was conducted to investigate the relationship of body fatness indicators and serum lipids (total cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein(LDL) cholesterol, triglycerides, myocardial infarction(MI) index) to find anthropometric indicators of body fat distribution that are strongly associated with serum lipids. 347 adult male workers of an industry in Kyungpook province were selected and data on the general characteristics were obtained using questionnaire from June 26 to June 29, 1991. Serum lipids were tested with 5 ml fasting blood and height, weight, circumferences of waist, hip and mid-thigh, five subcutaneous fat thickeness(biceps, triceps, supscapular, suprailiac, thigh) were mea sured using Ultrasound type A TATT. Waist circumference, waist/hip circumference ratio and subcutaneous fat thickness of suprailiac area are significantly increased with increasing age, but thigh circumference is significantly decreased (P< 0.05). These results suggest that central obesity is closely related to age and waist circumference may be the best indicator of body fatness or body fat distribution in men. In younger age group(below 40 year old), the result of canonical correlations analysis suggests that circumferences(0.501) was slightly closely related to serum lipids than subcutaneous fat thickness(0.493), however, in older age group (above 40 year old), subcutaneous fat thickness(0.528) were more strongly associated with serum lipids than circumferences(0.419). Weighted canonical analyses suggest that biceps and suprailiac areas in younger age group and sub scapular area in older age group are stronger indicators of serum lipids among .subcutaneous fatness measurements. Of the circumferences, waist is the most strongest indicator of serum lipids in both age groups. Therefore, it is recommended that circumference of waist and subcutaneous fat thickness of subscapular area should be measured to estimate the degree of central obesity for preventing cardiovascular disease in men.
Adipose Tissue* ; Adult ; Body Fat Distribution* ; Cardiovascular Diseases ; Cholesterol ; Fasting ; Gyeongsangbuk-do ; Hip ; Humans ; Lipoproteins ; Male ; Obesity, Abdominal ; Subcutaneous Fat ; Thigh ; Triglycerides ; Ultrasonography ; Waist Circumference ; Surveys and Questionnaires

We report on a case of torsion of an accessory spleen occurring in a 19-year-old female. She was admitted with a three-day history of left-upper quadrant pain that became slowly aggravated. On physical examination, left-side abdominal tenderness was observed, most markedly in the left upper quadrant, but no rebound tenderness was noted. Contrast-enhanced computed tomography (CT) scan showed a non-enhancing mass with a tubular vascular pedicle and normal enhancing spleen in the left upper abdomen. Doppler ultrasound showed no vascular flow within the hypoechoic mass in the left upper abdomen. Torsion of an accessory spleen was suspected, and emergent laparoscopic exploration was performed. Laparoscopic exploration showed a large rounded violet mass with a tw isted vascular pedicle, located anterior to the normal spleen. The mass was excised laparoscopically and then removed through a 2.5 cm extended incision of the left-sided trocar incision. Postoperative recovery was normal and she was discharged on the fifth postoperative day.
Abdomen ; Female ; Humans ; Physical Examination ; Spleen* ; Surgical Instruments ; Ultrasonography ; Viola ; Young Adult

We report on a case of torsion of an accessory spleen occurring in a 19-year-old female. She was admitted with a three-day history of left-upper quadrant pain that became slowly aggravated. On physical examination, left-side abdominal tenderness was observed, most markedly in the left upper quadrant, but no rebound tenderness was noted. Contrast-enhanced computed tomography (CT) scan showed a non-enhancing mass with a tubular vascular pedicle and normal enhancing spleen in the left upper abdomen. Doppler ultrasound showed no vascular flow within the hypoechoic mass in the left upper abdomen. Torsion of an accessory spleen was suspected, and emergent laparoscopic exploration was performed. Laparoscopic exploration showed a large rounded violet mass with a tw isted vascular pedicle, located anterior to the normal spleen. The mass was excised laparoscopically and then removed through a 2.5 cm extended incision of the left-sided trocar incision. Postoperative recovery was normal and she was discharged on the fifth postoperative day.
Abdomen ; Female ; Humans ; Physical Examination ; Spleen* ; Surgical Instruments ; Ultrasonography ; Viola ; Young Adult

Hepatoid thymic carcinoma is an extremely rare subtype of primary thymus tumor resembling “pure” hepatoid adenocarcinomas with hepatocyte paraffin 1 (Hep-Par-1) expression. A 53-year-old man presented with voice change and a neck mass. Multiple masses involving the thyroid, cervical and mediastinal lymph nodes, and lung were detected on computed tomography. Papillary thyroid carcinoma was confirmed by biopsy, and the patient underwent neoadjuvant chemoradiation therapy. However, the anterior mediastinal mass was enlarged after the treatment whereas the multiple masses in the thyroid and neck decreased in size. Microscopically, polygonal tumor cells formed solid sheets or trabeculae resembling hepatocytes and infiltrated remnant thymus. The tumor cells showed immunopositivity for cytokeratin 7, cytokeratin 19, and Hep-Par-1 and negativity for α-fetoprotein. Possibilities of germ cell tumor, squamous cell carcinoma, and metastasis of thyroid papillary carcinoma were excluded by immunohistochemistry. This report on the new subtype of thymic carcinoma is the third in English literature thus far.

Hepatoid thymic carcinoma is an extremely rare subtype of primary thymus tumor resembling “pure” hepatoid adenocarcinomas with hepatocyte paraffin 1 (Hep-Par-1) expression. A 53-year-old man presented with voice change and a neck mass. Multiple masses involving the thyroid, cervical and mediastinal lymph nodes, and lung were detected on computed tomography. Papillary thyroid carcinoma was confirmed by biopsy, and the patient underwent neoadjuvant chemoradiation therapy. However, the anterior mediastinal mass was enlarged after the treatment whereas the multiple masses in the thyroid and neck decreased in size. Microscopically, polygonal tumor cells formed solid sheets or trabeculae resembling hepatocytes and infiltrated remnant thymus. The tumor cells showed immunopositivity for cytokeratin 7, cytokeratin 19, and Hep-Par-1 and negativity for α-fetoprotein. Possibilities of germ cell tumor, squamous cell carcinoma, and metastasis of thyroid papillary carcinoma were excluded by immunohistochemistry. This report on the new subtype of thymic carcinoma is the third in English literature thus far.

The liver has a unique dual blood supply through the portal vein and the hepatic artery. There are several communications between these two vessels under various conditions such as in hepatic tumors, trauma and liver cirrhosis, vascular compromise, among others. When vascular compromise occurs, this dual blood supply system can cause changes in the volume of blood flow in individual vessels or even in the direction of blood flow. With rapid image acquisition and increased resolution available in multislice CT and MR imaging, hepatic perfusion disorders are now more frequently encountered than in the past. Familiarity with imaging findings of these perfusion disorders will be helpful in characterizing focal hepatic lesions and will also help to avoid false positive diagnoses.
Diagnosis ; Hepatic Artery ; Liver ; Liver Cirrhosis ; Magnetic Resonance Imaging* ; Perfusion* ; Portal Vein ; Recognition (Psychology)

To assess the extent of microfilaments in cholestatic liver diseases we examined the cytoplasmic microfilaments in intrahepatic and extrahepatic cholestasis in man by electron microscopy. Study subjects were two patients with drug-induced intrahepatic cholestasis, three patients with intrahepatic cholestasis due to viral hepatitis, four patients with extrahepatic cholestasis due to stones of the common bile duct and two patients with primary biliary cirrhosis. Two biopsied specimens from patients without clinical or histological evidence of liver disease served as noncholestatic controls. The microfilaments in hepatocytes and biliary ductular cells were significantly increased in cholestasis compared with those in non-cholestatic controls. Well developed bundles of microfilaments were noted around the pericanalicular ectoplasm and seemed to be parallel to plasma membrane of the hepatocytes in cholestasis. In cholestasis, there were increased bundles of microfilaments around the periluminal region, lateral cell wall, and nucleus of biliary ductular cells. Two patterns of microfilaments bundles (fine microfilamentous network and spindle-shaped dense or clusters of microfilaments) were associated with cholestasis. The clustered form of microfilaments also seemed to be clearly associated with intracytoplasmic vacuoles containing bile salts. In conclusion, the increase of microfilaments in hepatocytes and biliary ductular cells may be the consequence of various forms of cholestasis. Further studies are needed to clarify the functional significance of increased microfilaments in cholestasis.
Bile Canaliculi/*pathology/ultrastructure ; Biopsy ; Cholestasis, Intrahepatic/*pathology ; Hepatocytes/*pathology/ultrastructure ; Humans ; Microfilaments/*pathology/ultrastructure ; Microscopy, Electron

Sunitinib is a tyrosine-kinase inhibitor used to treat metastatic renal cell carcinoma and imatinib-resistant gastrointestinal stromal tumors. Hypothyroidism is a common side effect of sunitinib therapy. Nevertheless, overt thyrotoxicosis induced by destructive thyroiditis after sunitinib treatment is very rare. Here, we report a patient with overt thyrotoxicosis related to sunitinib therapy.
Carcinoma, Renal Cell ; Humans ; Hypothyroidism ; Indoles ; Pyrroles ; Thyrotoxicosis

Adult intussusception is a rare disease and it differs from childhood intussusception in its presentation, cause and treatment. Most of the cases have an underlying lesion within the intussusception that requires surgical resection. Making the diagnosis can be delayed because of the nonspecific and chronic symptoms, and many cases are diagnosed during performance of emergency laparotomy for treating the obstructive symptoms. A computed tomography (CT) scan is most useful for making the diagnosis of adult intussusception and is helpful in revealing the underlying lesion, although a barium enema can help to diagnose colonic intussusceptions. Surgical resection remains the recommended treatment for nearly all cases, but there is controversy about whether or not the intussusception should be initially reduced before resection. Gastrointestinal lipomas are rare benign tumors that can occur anywhere along the gut, and the small bowel is the second most common site for gastrointestinal lipomas after the colon. Intussusception of the ileum by a lipoma is very rare. We report here on a case of ileo-ileal intussusception that was caused by a lipoma of the ileum in a 35-year-old man who complained of abdominal pain of one week duration. The diagnosis of an ileo-ileal intussusception caused by a lipoma of the ileum was suspected preoperatively according to the typical CT findings, so we tried to initially reduce the intussusception during laparotomy. But manual reduction was impossible due to the edema of the lesion, and an ileum of some length had to be resected.
Abdominal Pain ; Adult ; Barium ; Colon ; Edema ; Emergencies ; Enema ; Humans ; Ileum ; Intussusception ; Laparotomy ; Lipoma ; Rare Diseases

BACKGROUND/AIMS: Hepatic nerve innervation plays important roles in hepatic metabolism and hemodynamic mechanisms. We compared the distribution patterns of hepatic nerves between normal livers and two liver diseases to elucidate the effects of liver disease on the distribution of hepatic nerves. METHODS: Tissue specimens were obtained by ultrasonography-guided needle biopsies from 10 normal controls, 74 patients with chronic hepatitis (CH), and 35 patients with liver cirrhosis (LC). The obtained specimens were immunohistochemically stained using antibodies for S-100 protein and alpha-smooth-muscle actin (alpha-SMA). The degree of the expression in liver tissues was quantified by manual counting of positively stained nerve fibers under light microscopy. The serum hyaluronic acid level was assayed in all subjects to evaluate hepatic fibrosis. Electron microscopy examinations were also performed. RESULTS: The hepatic nerve innervation was significantly lower in LC than in normal controls, as indicated by S-100 protein staining. alpha-SMA and hyaluronic acid levels were higher in LC and CH than in normal controls. Electron microscopy revealed that unmyelinated nerve fiber bundles in the intralobar connective tissue coursed in the vicinity of hepatic triads. CONCLUSIONS: These results suggest that hepatic nerve innervation can be decreased by hepatic inflammatory responses and/or fibrotic changes in LC patients. Further study is needed to clarify this observation.
Actins ; Antibodies ; Biopsy, Needle ; Connective Tissue ; Fibrosis ; Hemodynamics ; Hepatitis, Chronic ; Humans ; Hyaluronic Acid ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Metabolism ; Microscopy ; Microscopy, Electron ; Nerve Fibers* ; Nerve Fibers, Unmyelinated ; S100 Proteins