Composite tumors containing pheochromocytoma and ganglioneuroma are very rare. We report a 70-year-old female with papillary thyroid carcinoma and a compound adrenal medullary tumor, composed of pheochromocytoma/ ganglioneuroma. She had complained of epigastric discomfort 2 months earlier. Chest computed tomography and pancreatic magnetic resonance imaging revealed an intrathoracic goiter and pancreatic cystic tumor. She underwent an explorative laparotomy, and a left adrenalectomy was done because of an adrenal mass, not the pancreatic mass. The pathological diagnosis was a compound adrenal medullary tumor, composed of pheochromocytoma and ganglioneuroma. Although there was no evidence of thyroid cancer on fine needle aspiration cytology, a total thyroidectomy was done because of the neck discomfort. The pathological diagnosis was a papillary thyroid carcinoma, and she underwent radioactive iodine therapy.
Adrenalectomy ; Aged ; Biopsy, Fine-Needle ; Brain Stem Neoplasms ; Carcinoma ; Female ; Ganglioneuroma ; Goiter, Substernal ; Humans ; Iodine ; Laparotomy ; Magnetic Resonance Imaging ; Neck ; Pancreatic Cyst ; Pheochromocytoma ; Thorax ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

One of the histopathologic hallmarks of early diabetic retinopathy is the loss of pericytes. Evidences suggest that the pericyte loss in vivo is mediated by apoptosis. However, the underlying cause of pericyte apoptosis is not fully understood. This study investigated the influence of methylglyoxal (MGO), a reactive -dicarbonyl compound of glucose metabolism, on apoptotic cell death in bovine retinal pericytes. Analysis of internucleosomal DNA fragmentation by ELISA showed that MGO (200 to 800 micrometer) induced apoptosis in a concentration-dependent manner. Intracellular reactive oxygen species were generated earlier and the antioxidant, N-acetyl cysteine, inhibited the MGO-induced apoptosis. NF-kB activation and increased caspase- 3 activity were detected. Apoptosis was also inhibited by the caspase-3 inhibitor, Z-DEVD-fmk, or the NF- kB inhibitor, pyrrolidine dithiocarbamate. These data suggest that elevated MGO levels observed in diabetes may cause apoptosis in bovine retinal pericytes through an oxidative stress mechanism and suggests that the nuclear activation of NF-kB are involved in the apoptotic process.
Acetylcysteine/pharmacology ; Animals ; *Apoptosis ; Caspases/metabolism ; Cattle ; Cell Death ; Cell Survival ; DNA Fragmentation ; Dose-Response Relationship, Drug ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Glucose/metabolism ; NF-kappa B/metabolism ; Nucleosomes/metabolism ; Oxidative Stress ; Pericytes/*drug effects ; Pyruvaldehyde/*pharmacology ; *Reactive Oxygen Species ; Retina/cytology/*drug effects

BACKGROUND: It is well known that non-alcoholic fatty liver disease is associated with type 2 diabetes mellitus, obesity, and dyslipidemia. Non-alcoholic fatty liver disease is frequently found in non-diabetic, normal weight adults, but the meaning of it is not fully investigated. We tested the hypothesis that there is association between non-alcoholic fatty liver disease with insulin resistance in non-diabetic, normal weight adults. METHODS: We examined 60 Korean adults above the age of 30 years, participating in medical check-up at the Chung-Ang University Hospital, from Sep 2003 to Jan 2004. Heapatitis B and C serologies were negative, and not the history of alcohol abuse. A standard interview, physical exam and biochemical study were conducted, and an experienced operator carried out ultrasound liver studies. We assessed the clinical characteristics of subjects and HOMA (Homeostasis Model Assessment), QUICKI (Quantitative Insulin Sensitivity Check Index) as an index of insulin resistance. RESULTS: We classified subjects into 2 groups: the controls (n=42), and those with non-alcoholic fatty liver disease (n=18). The frequency in the men was higher than that in the women (70 vs 30 %, p<0.05). Body mass index, waist circumference, hip circumference, waist/hip ratio, triglyceride, HDL-cholesterol, alanine transferase, and uric acid was significantly different between two groups (p<0.05). Insulin resistance (HOMA-IR) was significantly higher in subjects with non-alcoholic fatty liver disease (p<0.05). CONCLUSION: Non-alcoholic fatty liver disease is associated with insulin resistance in non- diabetic, normal weight adults.
Adult* ; Alanine ; Alcoholism ; Body Mass Index ; Diabetes Mellitus, Type 2 ; Dyslipidemias ; Fatty Liver* ; Female ; Hip ; Humans ; Insulin Resistance* ; Insulin* ; Liver ; Male ; Obesity ; Transferases ; Triglycerides ; Ultrasonography ; Uric Acid ; Waist Circumference

Chronic cough is defined as a cough that lasts for more than three weeks. In most patients, chronic cough is caused by four conditions: postnasal drip, asthma, chronic bronchitis, gastroesophageal reflux. Psychogenic chronic cough is not a frequent disorder. Furthermore, chronic vocal tic disorder is a very rare cause of chronic dry cough. A 22- year-old male suffered from chronic dry cough for last two years. His character showed obsessive- compulsive disorder. He has been shrugging both shoulders inadvertently since his childhood. Consequently, he was diagnosed as having chronic motor tic disorder. But after contracting respiratory tract infection, his motor tic disappeared and chronic dry cough was developed concomitantly. He had no history of smoking, chronic rhinitis, sinusitis, asthma, and gastroesophageal reflux. Physical examinations were normal. Chest X-ray, paranasal sinus view, metacholine bronchial provocation test, and esophago-gastroscopy were normal. Chronic cough was never relieved despite empirical treatment. Psychiatric consultation suggested chronic vocal tic disorder. The frequency of cough was diminished two days after administeration of valium and haloperidol and thereafter his complaint disappeared in one month. Here we report a very rare case of chronic motor tic disorder which was transformed into chronic vocal tic disorder presenting as a chronic cough. As far as we know, this is the first case of its kind in Korea.
Asthma ; Bronchial Provocation Tests ; Bronchitis, Chronic ; Cough ; Diazepam ; Gastroesophageal Reflux ; Haloperidol ; Humans ; Korea ; Male ; Physical Examination ; Prader-Willi Syndrome ; Respiratory Tract Infections ; Rhinitis ; Shoulder ; Sinusitis ; Smoke ; Smoking ; Thorax ; Tic Disorders ; Tics

BACKGROUND: It has been suggested that thyroid stimulation blocking antibody (TSBAb) is involved in the development of early hypothyroidism after radioiodine treatment in patient with Graves disease. However, previous studies have reported the effect of radioiodine treatment on overall changes of TSH receptor antibodies without detailed observation of changes in properties of TSH receptor antibodies. The aim of this study is to evaluate the effect of radioiodine treatment on thyroid stimulation antibody (TSAb) or on thyroid stimulation blocking antibody (TSBAb) activities and to see whether the appearance of TSBAb after radioiodine treatment is involved in the development of early hypothyroidism in patients with Graves disease. METHODS: The activities of TSAb, TSBAb were measured serially with human TSH receptor transfected Chinese hamster ovary (CHO) cells in 36 patients with Graves disease who received 131I treatment. In addition to the wild type TSH receptor-expressing cells, we used a chimeric receptor that 90-165 amino acid residues were substituted by those of rat LH/CG receptor (Mc2) for measurement of TSBAb without interference by the presence of TSAb and for evaluation of TSAb epitope spreading. We evaluated the association of early hypothyroidism after 131I treatment with changes of various immunologic parameters. RESULTS: In 14 (39%) of 36 patients, TSBAb activities were present in their sera before or after 131I treatment. Four of them had TSBAb activities before 131 treatment, and 12 newly acquired TSBAb activities after 131I treatment. The existence of TSBAb was not associated with the development of early hypothyroidism after 131I treatment but with low TSAb activities before 131 treatment, high thyroidal uptake of 131I given and with old age. The phenomena of epitope spreading measured by TSAb with Mc2 mutant clone before and after 131I treatment was not infrequent, but it had no clinical relevance. CONCLUSION: These results suggest that the existence of TSBAb may be not a major factor in the development of early hypothyroidism after radioiodine treatment in Graves disease. Other factors such as TSAb activities before radioiodine treatment, the efficiency of thyroidal uptake of 131I or old age are associated with the development of early hypothyroidism.
Animals ; Antibodies* ; Clone Cells ; Cricetinae ; Cricetulus ; Female ; Graves Disease* ; Humans ; Hypothyroidism ; Ovary ; Rats ; Receptors, Thyrotropin* ; Thyroid Gland ; Thyrotropin*

We investigated the optimal condition of thyroid stimulating antibody(TSAb) assay using Chinese hamster ovary cells transfected with cDNA of human TSH receptor(TSHr-CHO) stably expressing functional TSH receptors. The extracellular cAMP responses of TSHr-CHO cells to the stimulation of bTSH or Graves' IgG were observed in three different incubation media. Stimulation indices of extracellular cAMP were higher when sucrose containing NaCl-free isotonic Hank's balanced salt solution(HBSS)(media A)was used as incubation media than those of NaCl-free hypotonic HBSS(media B) or those of NaCl containing isotonic HBSS(media C). The incubation of TSHr-CHO cells in media B caused marked increase in the basal cAMP level without concomittant fold-increase in the stimulated cAMP level at various doses of bTSH and Graves' IgG. Decreasing the stimulation indices of extracellular cAMP, use of media B failed to detect TSAb activities in two TSAb-positive Graves' IgG tested. In case of media C, extracellular cAMP responses are poor at 0.001 and 0.1U/L of bTSH and at all doses of Graves' IgG tested(0.5, 1, 5g/L). The incubation of TSHr-CHO cells in media B caused significant increase in the number of trypan blue-stained, nonviable cells(5.7+-1.5, 7.6+-1.9 and 8.5+-1.6% at 1, 2 and 3h of incubation, respectively; p<0.01) comparing to those incubated in media A or media C(about 2-3% in both media). Those decrease in the viability of TSHr-CHO cells when incubated in hypotonic incubation media may explain the decrease in the stimulation index of extracellular cAMP with the use of media B in contrast to the case of FRTL-5 cells. TSAb assay of 87 consecutive fresh Graves' patients with TSHr-CHO cells using media A detected TSAb activities in 90%(78 patients) of them, and moreover TSAb activities showed significant positive correlation with the pre-treatment serum T_3 and free T_4 levels of those patients. We conclude that TSAb assay with TSHr-CHO cells is a sensitive and physiologically relevant assay system to measure TSAb activities merely through measurements of extracellular cAMP provided that the cells are incubated in NaCl-free isotonic incubation media.
Animals ; Asian Continental Ancestry Group ; Biological Assay ; Cricetinae ; Cricetulus ; DNA, Complementary ; Female ; Humans ; Humans ; Immunoglobulin G ; Immunoglobulins, Thyroid-Stimulating ; Ovary ; Receptors, Thyrotropin ; Sucrose ; Thyroid Gland ; Thyrotropin

No abstract available.
Thyroid Gland ; Thyroiditis

Morning glory syndrome is a rare congenital anomaly in optic disc, which is characterized by defect in optic disc due to optic nerve dysgenesis, abnormal retinal vessels, and chorioretinal pigment disturbance around optic disc. Retinal detachment in morning glory syndrome occurs in 26% to 38% of the cases, which is thought to be non-rhegmatogenous in nature and usually develops in posterior pole of the retina. Surgical treatment is indicated in cases with bullous and total retinal detachment in morning glory syndrome. The authors successfully reattached the detached retina in a 3 year old boy with morning glory syndrome using trans pars plana vitrectomy, scleral buckling, retinotomy, silicone oid injection, and endolaser photocoagulation. The authors followed up for 15 weeks after operation, and the vision of left eye was counting finger and the retina remained to be reattached.
Child, Preschool ; Fingers ; Humans ; Light Coagulation ; Male ; Optic Nerve ; Retina ; Retinal Detachment* ; Retinal Vessels ; Retinaldehyde* ; Scleral Buckling ; Silicones ; Vitrectomy

Morning glory syndrome is a rare congenital anomaly in optic disc, which is characterized by defect in optic disc due to optic nerve dysgenesis, abnormal retinal vessels, and chorioretinal pigment disturbance around optic disc. Retinal detachment in morning glory syndrome occurs in 26% to 38% of the cases, which is thought to be non-rhegmatogenous in nature and usually develops in posterior pole of the retina. Surgical treatment is indicated in cases with bullous and total retinal detachment in morning glory syndrome. The authors successfully reattached the detached retina in a 3 year old boy with morning glory syndrome using trans pars plana vitrectomy, scleral buckling, retinotomy, silicone oid injection, and endolaser photocoagulation. The authors followed up for 15 weeks after operation, and the vision of left eye was counting finger and the retina remained to be reattached.
Child, Preschool ; Fingers ; Humans ; Light Coagulation ; Male ; Optic Nerve ; Retina ; Retinal Detachment* ; Retinal Vessels ; Retinaldehyde* ; Scleral Buckling ; Silicones ; Vitrectomy

Since Purtscher's original discriptions similar clinical signs have been described following acute compressive neck or chest injuries, chest compression, val salva maneuvers, long bone fractures, acute pancreatitis and after childbirth. The appearance of Purtscher's retinopathy are believed to be due to ischemic episodes particularly in the end arterioles around the macula and disc. We experienced two cases of Purtscher's-like retinopathy in patients with systemic hypertension who had not any recent trauma history and reviewed the available literatures regarding this disease.
Arterioles ; Fractures, Bone ; Humans ; Hypertension* ; Neck ; Pancreatitis ; Parturition ; Thoracic Injuries ; Thorax