We recently encountered a rare autopsy case of neurofibromatosis type I(von Reckli- nghausen disease) associated with both Moyamoya disease and pheochromocytoma. A 36-year-old male died of subarachnoid and intracerebral hemorrhage, who had history of three times of head surgery due to head trauma since the age of 16, and abdominal surgery for inflammed granulation tissue with central abscess. On examination, he had numerous cafe au lait spots, and multiple sessile and pedunculated greysh yellow nodules varying in size on the skin of the whole body, histopathologically being proven neurofibromas. At the base of the brain, abnormal complex vascular networks were recognized around the circle of Willis. Microscopically, some of blood vessels showed eccentric intimal fibrous thickening and tortuous internal elastic lamina, a finding which is consistent with Moyamoya vessels. Also, a pheochromocytoma on right adrenal gland was incidentally found. To the best of our knowledge, this unique combination has never been reported in Korea.
Abscess ; Adrenal Glands ; Adult ; Autopsy ; Blood Vessels ; Brain ; Cafe-au-Lait Spots ; Cerebral Hemorrhage ; Circle of Willis ; Craniocerebral Trauma ; Granulation Tissue ; Head ; Humans ; Korea ; Male ; Moyamoya Disease* ; Neurofibroma ; Neurofibromatoses* ; Neurofibromatosis 1* ; Pheochromocytoma* ; Skin ; Subarachnoid Hemorrhage

Giant cell myocarditis is a rare rapidly fatal disease of unknown cause, often occuring in young to middle-aged adults. Most presented with congestive heart failure, ventricular arrhythmia, heart block or sudden cardiac death. The histologic hallmarks of giant cell myocarditis include a polymorphous inflammatory response with numerous multinucleated giant cells and myocyte necrosis. Response to immunosuppresive therapy is poor and cardiac transplantation is considered to be the treatment of choice. We experienced 4 cases of giant cell myocarditis, all of which were autopsied and underwent postmortem pathologic examination. Grossly, the heart was enlarged, measuring up to 510 gm, with thickend septal and ventricular wall. Microscopically, 3 cases showed diffuse active myocarditis with extensive myocyte necrosis, while 1 case showed exuberant fibrosis. Many multinucleated giant cells were present throughout the lesion. Immunohistochemical stain supports the view that the giant cells have a histiocytic origin. Neither microorganisms nor foreign material were found on PAS and AFB stains. Because giant cell myocarditis is on occasion associated wth immunologic disorders, autopsy should be carefully performed to define the correlation between the two.
Adult ; Arrhythmias, Cardiac ; Autopsy ; Coloring Agents ; Death, Sudden ; Death, Sudden, Cardiac ; Fibrosis ; Giant Cells* ; Heart ; Heart Block ; Heart Failure ; Heart Transplantation ; Humans ; Muscle Cells ; Myocarditis* ; Necrosis

Papillon-Lefevre syndrome (PLS) is an extremely rare autosomal recessive disorder characterized by palmoplantar keratoderma and periodontitis and occuring with an estimated incidence of 1-4 cases per million. Patients with PLS are highly susceptible to infection. The etiology of an infective susceptibility is unknown; however, an association with defects in neurophil dysfunction, insufficient lymphocyte response to pathogens, defects in monocyte functions and impairment of NK cell cytotoxic function has been suggested. To our knowledge, this is the first case report of atypical maxillary sinusitis accompanied by PLS, and we represent the case with a review of the related literatures.
Humans ; Incidence ; Keratoderma, Palmoplantar ; Killer Cells, Natural ; Lymphocytes ; Maxillary Sinus ; Maxillary Sinusitis ; Monocytes ; Papillon-Lefevre Disease ; Periodontitis

BACKGROUND: The aim of this study was to examine the expression of CD10 and CD15 in tumor cells, stromal cells and infiltrating inflammatory cells during colorectal carcinoma (CRC) development and to investigate their expression levels between the tumor center and invasive front and compare them to clinicopathological parameters in invasive CRC. METHODS: We performed immunohistochemical staining for CD10, CD15, and E-cadherin in 42 cases of CRC, 49 of tubular adenoma, 15 of hyperplastic polyp, and 17 of non-neoplastic colon. RESULTS: CD10 was expressed in tumor cells (tCD10), stromal cells (sCD10) and infiltrating inflammatory cells (iCD10), and CD15 was expressed in tumor cells (tCD15) and infiltrating inflammatory cells (iCD15). Their expressions were progressively increased during CRC development and the iCD10 expression level was significantly correlated with the iCD15 expression level in invasive CRC. Invasive front revealed a higher expression level of iCD10 and iCD15 than the tumor center. Moreover, the iCD15 expression level of invasive front was significantly correlated with the degree of tumor budding and tCD15 in whole tissue sections was closely associated with tumor depth. CONCLUSIONS: The present study suggests that the expression of CD10 and CD15 is associated with the development and progression of CRC.
Adenoma ; Antigens, CD15 ; Cadherins ; Colorectal Neoplasms ; Neprilysin ; Polyps ; Stromal Cells

Many surgical methods for the reconstruction of orbital floor fractures have been reported, and theseinclude transorbital, transantral and transnasal endoscopic approaches, among others. The choice of surgical approach and materials for the reduction of orbital blowout fractures depends on the surgeon's experience and preference. For the cases of large orbital floor fractures, reduction has beenperformed most frequently through the transantral approach, and the herniated orbital tissue generally has been supported by asilastic block, silastic tube or urethral balloon catheter. However, the transantral approach has significant drawbacks that includethe requirement of removal surgery, displacement of materials, and inflammation of the maxillary sinus. To overcome these negative effects, the authors used fibrin glue tosecure the reduction through the transantral approach in two cases of patients with orbital floor fractures.
Catheters ; Fibrin Tissue Adhesive* ; Humans ; Inflammation ; Maxillary Sinus ; Orbit* ; Orbital Fractures

In 2009, the novel swine H1N1 influenza (SI) virus infection had been pandemic and in some patients it led to death. But autopsy findings with pathologic features have been rarely known in the deceased with the SI infection. Herein we presented the findings in three deceased cases with the infection of SI virus, compared with those of other literatures. In all cases, postmortem examination with legal autopsy was done due to sudden unexpected death. SI virus infection was confirmed by detection of SI viral RNA performed on Korea center for Disease Control and Prevention. The autopsy findings with pathologic features of our cases were similar to those of the cases on other reports and those of previous pandemic influenza virus infection on literatures. And these findings may be helpful for understanding the biology of SI virus, and for diagnosis, treatment, and prevention of the SI infection.
Autopsy ; Biology ; Centers for Disease Control and Prevention (U.S.) ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; Korea ; Orthomyxoviridae ; Pandemics ; RNA, Viral ; Swine ; Viruses

Ocular symptoms related to orbital fracture occur immediately after the fracture in most cases. However, authors experienced a delayed onset diplopia occurred 16 months after orbital floor fracture. A 19-year-old man, who had right orbital floor fracture 16 months ago, presented with diplopia of upward gaze. At the time of the fracture, no surgery was performed because the fracture was minimal and there were no particular symptoms. Physical examinations revealed a minor ocular motility restriction of upward gaze, but orbital floor showed no definite interval change on computed tomography. Severe adhesion between the orbital fat tissue and orbital floor was noted intraoperatively and the adhesion was dissected. After the operation, the patient showed remarkable improvement in diplopia and restriction of the ocular motility.
Diplopia ; Floors and Floorcoverings ; Humans ; Orbit ; Orbital Fractures ; Physical Examination ; Young Adult

Purpose: The 2020 Dietary Reference Intakes for Koreans (KDRIs) serves as a foundation for daily nutrient and energy recommendations aiming to enhance public health and prevent chronic diseases. They act as guidelines for maintaining proper nutrition and overall health.Using KDRIs is crucial for promoting healthier lifestyles and making informed dietary choices. Thus, this study explores the influence of a nutrition education program, based on the 2020 KDRIs, on the nutrition knowledge and dietary habits of undergraduates in Gyeongsangnam-do and Gyeonggi-do. Methods: The nutrition education program, designed with diverse instructional materials, was executed across a wide range of universities. The education group (n = 75) engaged in the program for a 6-week instructional period, while the control group (n = 53) underwent the survey without participating in the education program. Nutrition Quotient (NQ) and knowledge assessments were administered to both groups immediately before and after the instructional period. Results: Within the education group, the nutrition education program positively impacted responses to NQ practice items, including knowledge of nutrition, daily intake, and portion sizes (p < 0.05). In contrast, there were no significant differences between the before and after responses of the control group for most survey items. Post-program evaluations showed significantly higher self-assessment scores and increased satisfaction levels (p < 0.05), with the satisfaction rate for the education program using the 2020 KDRIs reaching 99.2%. Conclusion This study has demonstrated the positive impact of an effective nutrition education program. However, there is a need for the continuous development and implementation of nutrition education programs to sustain these outcomes and further enhance the nutritional education experience.

BACKGROUND AND OBJECTIVES: It takes considerable time and effort to make decisions about management and follow up for the thyroid cancer. Also there are risks of incorrectness or confusion on the part of thyroid specialists. We developed a thyroid cancer calculator that does automatic thyroid cancer staging, prognosis predicting and suggesting follow-up strategies in order to reduce the burden of thyroid specialists who have to memorize a lot of guidelines and statistics, and to give consistency to the treatment plan. MATERIALS AND METHOD: An automatic thyroid cancer calculator was developed by using a computer program called 'Qt 5.2 version', based on patient demographics, diagnosis, treatment, and follow-up status. This partly cited the history of prior thyroid cancer or other cancer registration, and focused on the specification of differentiated thyroid cancer. RESULTS: The program consisted of survival, recurrence and, dynamic re-stratification with follow-up. The patient registration form consisted of identification number, name and operation date, and patients needed to enter their thyroid cancer status, including clinical and pathologic information after registration. The entered information could be easily accessed in a few seconds. The program helped to update patient's current status, promptly collect data for clinical studies of thyroid cancers and provide better patient care. This program was simple, convenient and time-saving for users as it specifically contained important thyroid cancer items. CONCLUSION: Although this program is still in its primitive stage, the Kosin thyroid calculator reduces the workload of thyroid specialists and prevents the loss of clinical data. Furthermore, it could be a useful tool for the management and research of thyroid cancer.
Demography ; Diagnosis ; Follow-Up Studies* ; Humans ; Neoplasm Staging ; Patient Care ; Prognosis* ; Recurrence ; Specialization ; Thyroid Gland ; Thyroid Neoplasms*

Cerebral cavernous angioma is a rare form of vascular malformations which is histologically composed of closely-packed, thin-walled blood vessels without neural tissue intervened. One of the most common symptoms is seizure, which is usually well-controlled by medication or surgery and known to be rarely intractable or fatal. Because sudden, unexpected death in epilepsy patients reveals generally its unclear death mechanism and negative autopsy finding in forensic pathology practice, particular attention should be paid. We recently experienced an autopsy case of 32-year-old woman who had suffered from epilepsy and showed cerebral cavernous angioma on autopsy. We report this case with literature review.
Adult ; Autopsy ; Blood Vessels ; Caves ; Central Nervous System ; Epilepsy ; Female ; Forensic Pathology ; Hemangioma ; Hemangioma, Cavernous ; Humans ; Seizures ; Vascular Malformations