ABSTRACT
Although the papillary thyroid carcinoma generally follows an indolent course characterized by slow growth and abscence of distant metastasis, distant metastases to extrathyroid organ may occur in the lung, bone and brain in about 5% of patients. The lung metastases are usually diagnosed by plain X-ray, chest CT and 131I whole body scan. However, we present a case of papillary thyroid carcinoma with microscopic pulmonary metastasis that could not be detected by conventional method, such as chest X-ray, chest CT and 131I whole body scan. A 62-year-old female visited due to traumatic hemopneumothorax. In the pathology of resected tissues from lacerated lung parenchyme, metastatic papillary carcinoma was diagnosed without evidence of abnormality in radiologic examination and we diagnosed and treated an asymptomatic papillary thyroid carcinoma.
Subject(s)
Female , Humans , Middle Aged , Brain , Carcinoma, Papillary , Hemopneumothorax , Lung , Neoplasm Metastasis , Pathology , Thorax , Thyroid Gland , Thyroid Neoplasms , Tomography, X-Ray Computed , Whole Body ImagingABSTRACT
BACKGROUND: Leptin, the product of obese(ob) gene, is thought to be a lipostatic hormone that contributes to body weight regulation through modulating food intake and energy expenditure. Animals with leptin deficiency are obese and lose body weight when they are given leptin. However little is known about the physiologic actions of leptin in humans. Plasma leptin concentrations are shown to be elevated in obese humans. So far, the factors that regulate plasma leptin concentrations remain to be identified. This work is undertaken, therefore, to examine the basal leptin concentrations in lean and obese korean males, and relation between leptin concentrations, body fat and other biochemical pararneters. METHODS: We measured the height, weight, waist/ hip ratio, fasting blood glucose, insulin, total cholesterol, triglyceride, free fatty acid and leptin concentrations in 45 obese and 45 normalweight males without medical and surgical problems. RESULTS: Means of percent IBW were 136.3+/-10.3%(mean+/-SD) and 97.2+/-6.5% in obese and control group respectively. Pasting blood sugar, free fatty acid, total cholesterol concentrations were not different between obese and control group. But the insulin and triglyceride concentrations were higher in obese group than those in control group(p< 0.05). Also, the mean leptin concentrstion was higher in obese group than that in control group(5.8+/-3.5 vs 3.0+/-2.1). The leptin concentrations were not correlated with fasting blood sugar, free fatty acid, total cholesterol levels, triglyceride, insulin or age, but correlated with WHR(r2=0.203), BMI and percent IBW. CONCLUSIONS: These findings suggest that the leptin coneentrations are positively correlated with adiposity. The mean serum leptin concentrations in korean obese males were lower than those reported in other studies, probably because the subjects of this study were only males and had lower fat amount compared to other studies, and the change of body weight and calorie intake before study was not considered.
Subject(s)
Animals , Humans , Male , Adipose Tissue , Adiposity , Blood Glucose , Body Weight , Cholesterol , Eating , Energy Metabolism , Fasting , Hip , Insulin , Leptin , Obesity , Plasma , Pravastatin , TriglyceridesABSTRACT
Peripheral nerve tumors are mostly benign and can arise on any nerve trunk or twig. Although peripheral nerve tumors can occur anywhere in the body, including the spinal roots and cauda equina, many cases are subcutaneous in location and present as a soft swelling, sometimes with a purplish discoloration of skin. There are two major catagories, schwannoma(neurilemmoma), and neurofibroma. Schwannomas are usually solitary and grow in the nerve sheath, rendering them relatively easy to dissect free. In contrast, neurofibromas tend to be multiple, grow in the endoneural substance, which renders them difficult to dissect, may undergo malignant changes, and are the hallmark of von Recklinghausens neurofibromatosis. Masses in the anterior part of neck may be initially thought to be thyroid nodule and then other cervical masses should be considered. The diagnosis rests on clinical suspicion and diagnostic support may be obtained by CT scan, magnetic resonance imaging(MRI) and substraction angiography in the literature. After imaging, fine needle aspiration for cytology may be helpful. If they are resected unrecognized and/or without regard to their nerve origin, major and permanent nerve defects can unnecessarily occur. We experienced 2 cases of peripheral nerve tumors of anterior neck simulating a thyroid nodule.
Subject(s)
Angiography , Biopsy, Fine-Needle , Cauda Equina , Diagnosis , Neck , Neurilemmoma , Neurofibroma , Neurofibromatoses , Peripheral Nerves , Peripheral Nervous System Neoplasms , Skin , Spinal Nerve Roots , Thyroid Gland , Thyroid Nodule , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: Carolic restriction as a treatment for obesity causes catabolism of body protein stores and produces negative nitrogen balance. GH administration causes acceleration of lipolysis and promotion of nitrogen conservation. We evaluated the effects of GH treatment and caloric restriction on lipolysis, anabolic effects and body composition in obese subjects. METHODS: 24 obese (20% over IBW) subjects (22 women and 2 men; 22-46yr old) were fed a diet of 25kcal/kg IBW with 1.2g protein/kg IBW daily during treatment. The subjects were assigned at random to either treatment with recombinent human GH (n=12, 0.06U/kg IBW every other day) or placebo (n 12, vehicle injection) for 12 weeks. Body fat was assessed by impedence and abdominal fat, visceral fat area at the umbilicus level and muscle area of mid thigh level were measured using computed tomography. RESULTS: Fraction of body weight lost as fat lost was significantly greater in GH treatment than in placebo group (1.21+-0.48%/kg, vs 0.52+-0.28%/kg, p0.05). GH treatment caused significant decrease in visceral fat area (35.3% vs 28.5%, p<0.05). In placebo group, there were significant loss of muscle area (-4.8 +-2.6cm ) and lean body mass (-2.62 +-1.51kg) after treatment. In contrast, GH treatment group had more increase in muscle area (3.5+-2.3cm ) and lean body mass (1.13 +-1.04kg) and positive nitrogen balance (1.81+-4.06g/day). GH injections cuased a 1.6-fold increase in IGF-I, despite caloric restriction. GH responses to L-dopa stimulation were blunted in all subjects and GH responses were increased after treatment. Both group showed hyperinsulinemia during oral glucose tolerance test (OGTT), and after treatment, they had decreased in insulin secretion. However, GH treatmnent group had not significant decrease, because GH might induce insulin resistance. FFA response areas during OGTT markedly decreased after treatment in both group. In GH treatment group, more decrease of FFA responses might result from the antilipolytic effect by higher level of insulin or more decrease in amount of fat. CONCLUSION: This study has demonstrated that in obese subjects fed hypocaloric diet, GH accelerates body fat loss and exerts anabolic effects.
Subject(s)
Adult , Female , Humans , Male , Abdominal Fat , Acceleration , Adipose Tissue , Anabolic Agents , Body Composition , Body Weight , Caloric Restriction , Diet , Glucose Tolerance Test , Growth Hormone , Hyperinsulinism , Insulin , Insulin Resistance , Insulin-Like Growth Factor I , Intra-Abdominal Fat , Levodopa , Lipolysis , Metabolism , Nitrogen , Obesity , Thigh , UmbilicusABSTRACT
No abstract available.