• Title/Summary/Keyword: medullary

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Simultaneous Occurrence of Medullary and Papillary Thyroid Carcinoma with Lymph Node Metastasis: A Case Report (림프절 전이를 동반한 갑상선에 동시 발생한 수질암과 유두상 암종 1례)

  • Joo, Young-Hoon;Yun, Chang-Hyun;Sun, Dong-Il;Kim, Min-Sik
    • Korean Journal of Bronchoesophagology
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    • v.12 no.2
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    • pp.31-34
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    • 2006
  • Simultaneous occurrence of medullary and papillary thyroid carcinomas in the same gland is very rare. In fact. there are only 18 cases of simultaneous occurrence of medullary and papillary thyroid carcinomas in the literature. We report a case of simultaneous medullary and papillary carcinoma of thyroid gland. A 67-year-old woman was diagnosed with medullary carcinoma of right lobe of thyroid gland and papillary carcinoma of left lobe of thyroid gland by fine needle aspiration cytology. Total thyroidectomy, anterior neck dissection, bilateral modified radical neck dissection and tracheotomy was undertaken. The tumor metastasized to regional lymph node and extrathyroidal muscle invasion of left papillary carcinoma was also revealed by pathological report. This report describes a case of thyroid carcinoma that demonstrated both medullary carcinoma and papillary components in the thyroid with lymph node metastasis.

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RET Proto-Oncogene Mutation in Medullary Thyroid Carcinoma (갑상선 수질암 조직에서 RET 원암유전자의 돌연변이 양상)

  • Chung Woong-Youn;Song Hyeun-Jung;Cho Nam-Hoon;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.18 no.1
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    • pp.3-10
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    • 2002
  • Background: The molecular pathogenesis of hereditary medullary thyroid carcinoma is well known to be associated with germ-line mutation in the RET proto-oncogene and sporadic medullary thyroid carcinoma has been shown to carry somatic RET mutation especially in exon 13 and 16. The aim of this study is to evaluate the genetic background in the pathogenesis of the sporadic medullary thyroid carcinoma which shows extremely high incidence in Korea. Materials and Methods: Direct DNA sequencing for RET exon 13 and 16, as well as immunohistochemistrical assay for a monoclonal RET antibody were performed from 20 cases of archival tissues of medullary thyroid carcinoma. Results: Monoclonal RET antibody with C-terminal epitope showed comparatively stronger expression in tumor cells than in normal tissues and immunoreactive area in the tumor was $66.0{\pm}40.1%$. Direct sequencing of RET exon 13 revealed 4 cases of mis-sense mutations in Codon 778, Codon 767, and both in Codon 768 and 778. One case showed a silent mutation (ACG-ACT) in RET exon 16 (Codon 926). Conclusions: The strong RET immunoreactivity of medullary thyroid carcinoma may suggest that there could be a genetic alteration in oncoprotein level. RET proto-oncogene mutation may be involved in the evolutional process of medullary thyroid carcinoma in the aspect of molecular basis.

Medullary Infarction Presenting as Sudden Cardiac Arrest: Report of Two Cases and Review of the Literature (급성 심정지로 나타난 연수경색)

  • Lee, Eung-joon;Choo, Il-yeon;Ha, Sue Young;Kwon, Hyung-min
    • Journal of the Korean neurological association
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    • v.36 no.4
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    • pp.310-313
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    • 2018
  • The causes of sudden death after medullary infarction involve arrhythmia, central respiratory failure, and dysautonomia. Sudden cardiac arrest in a medullary infarction is uncommon. Most of these cases experienced sudden cardiopulmonary arrest within 2 weeks from stroke onset as the extent of lesion increased. Here, we report two cases of medullary infarction presenting as sudden cardiac arrest. These cases indicate that medullary infarction could be one of the causes of sudden cardiac arrest.

Postoperative Analysis of Prognostic Factors of Thymoma (흉선종의 술후 예후판정요인의 분석)

  • 박창권
    • Journal of Chest Surgery
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    • v.27 no.9
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    • pp.785-792
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    • 1994
  • In this study, the authors analyzed the prognostic value of four clinical variables[age and sex of patients, association with myasthenia gravis and clinical stage] and histological type in 30 consecutive patients with thymoma, histologically classified as cortical[10],medullary[5] and mixed[15]type according to Marino and Muller-Hermelink classification. There were significant differences between the histological types in the frequency of the different tumor stages and myasthenia gravis and prognosis.Most of the cortical thymomas were at stage III and all of the medullary and most of the mixed tumors at stage I or II.Myasthenia gravis occurred more commonly in patients with cortical[30%] and mixed thymoma[60%] than in patients with medullary thymoma[10%]. Follow-up was conducted in 30 patients,with follow-up range from 3 months to 120 months[mean,47.3months]. 5 year actuarial survival was 100% for medullary thymoma, 73% for mixed thymoma, and 47% for cortical thymoma.The overall survival curve shows that 87.6% of the patients are alive at 2 years and 72.8% at 5 years. And 7 patients was dead during follow-up periods.By Kaplan-Meier technique, we found that the patients who had myasthenia gravis had better prognosis[P<0.05]. Medullary thymoma is a comparatively rare, benign tumor, and usually not associated with myasthenia gravis. Cortical thymoma must be regarded as malignant. Mixed thymoma is intermediate in its behavior between medullary and cortical thymoma. But these tumors should be considered potentially malignant despite of presence as stage I of II disease. Also, the patients with stageI,II had good prognosis and the patients with total resection had good prognosis[P<0.05].

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The Clinical Analysis of Medullary Thyroid Carcinoma : 10 Cases (갑상선 수질암 10례의 임상적 분석)

  • Kim Sang-Hyun;No Ho-Sang;Moon Jun-Hwan;Kim Jung-Su;Hwang Dong-Jo;Seo Jeong-Min
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.2
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    • pp.222-225
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    • 1999
  • Background and Objectives: Medullary thyroid carcinoma(MTC) is a rare tumor derived from the parafollicular C cells of the thyroid gland accounting for 5-10% of all thyroid malignancies. In Korea, there has been a few case report of medullary thyroid carcinoma(MTC) but their clinical analysis were not exactly studied. So, we made clinical study of 10 patients diagnosed as medullary thyroid carcinoma. Materials and Methods: We reviewed clinical data of 10 patients who were diagnosed as medullary thyroid carcinoma(MTC) from April 1973 to August 1998 at National Medical Center. Results: The incidence of MTC was 2.3% of all thyroid cancer and their mean age were 44.2 years old. Preoperative thyroid scan showed cold nodule in all patients and thyroid function test(TFT) was within normal range. Of the 10 patents, only 4 patients had diagnosis of MTC in preoperative fine needle aspiration biopsy. All the patients underwent total thyroidectomy with central neck dissection. Two patients with cervical lymph node metastasis underwent total thyroidectomy, central neck dissection and modified neck dissection. Two patients (20%) showed recurrence at the site of neck, lung, mediastinum, bone and liver. Conclusion: Most MTC is sporadic form and have peak incidence in the fifth decade and female preponderance. Preoperative fine needle aspiration biopsy is considered to be a clinically useful diagnostic method, but its accuracy is not considered as much high as others. Total thyroidectomy with central neck dissection may be an useful surgical modality in treating medullary thyroid carcinoma.

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A CASE OF MEDULLARY THYROID CARCINOMA IN CHILD (소아 갑상선 수질암종 1례)

  • Jung, Kwang-Yoon;Park, Chan;Lee, Jae-Yong;Choi, Jong-Ouck;Yoo, Hong-Kyun
    • Korean Journal of Bronchoesophagology
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    • v.2 no.2
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    • pp.274-279
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    • 1996
  • Medullary thyroid carcinoma constitutes about 5-10% of all thyroid malignancies, but rare in children. It has frequent association with multiple endocrine neoplasia(MEN) and frequent familial occurrence. They are derived from parafollicular cells of thyroid glands and produce calcitonin. They are capable of local invasion, spread to regional lymph nodes, or distant metastases. Histopathologically, the lesions are characterized by sheets of non-follicular cells surrounded by deposits of hyaline amyloid. Aggressive surgical intervention is recommended due to the propensity of medullary thyroid carcinoma for local microvascular invasion, late recurrence and metastasis. A total thyroidectomy is generally recommended because of the high incidence of bilaterality. Recently, authors experienced a case of medullary carcinoma in child. We report this case with review of the literatures.

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A Case of Peripheral Facial Palsy in Ponto-medullary Junction Area Infarction (말초성 안면신경 마비로 발현된 교뇌-연수 인접 부위 뇌경색 1예)

  • Cho, Jeong-Seon;Kim, Doo-Eung;Kim, Jung-Mee;Han, Young-Su;Ha, Sang-Won;Park, Sang-Eun;Han, Jeong-Ho;Cho, Eun-Kyoung
    • Annals of Clinical Neurophysiology
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    • v.8 no.2
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    • pp.186-189
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    • 2006
  • A 69 year-old woman was admitted with sudden left facial weakness. She had no other neurologic deficit, except for left peripheral type facial palsy. She had a presumptive diagnosis of Bell's palsy. The blink test was indicative of left facial neuropathy due to left medullary lesion. Diffusion weighted (DWI) brain MRI demonstrated high signal signal lesion in left dorsolateral ponto-medullary junction. Apperant diffusion coefficient (ADC) brain MRI showed low signal lesion in the same area. We present an unusual case of ipsilateral peripheral facial palsy in dosolateral ponto-medullary infarction without other neurologic deficits.

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Effect of Capsaicin on the Excitatory Amino Acids Neurotranmitters in Medullary Dorsal Horn (Capsaicin이 연수후각의 흥분성 아미노산 전달물질에 미치는 영향)

  • Kwon, Soo-Kyung;Yoon, Soo-Han;Lee, Jong-Heun
    • Restorative Dentistry and Endodontics
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    • v.19 no.2
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    • pp.621-632
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    • 1994
  • This experiment was performed to study the effect of capsaicin on the excitatory amino acids (EAAs) neurotransmitter in medullary dorsal horn and to clarify the relationship between substance P and excitatory amino acids. Horizontal slice of rat medullary dorsal horn was prepared and perfused with modified Krebs-Ringer solution in brain slice chamber. Release of EAAs was induced by veratrine and capsaicin were added to perfusion solution to observe the changes in EAA release. Capsaicin and ruthenium red, capsaicin antagonist, were also systemically injected with 50mg/kg in first day and 100mg/kg in second day for 2 days. Medulla oblongata containing the medullary dorsal horn was isolated, homogenized and centrifused. Spernatant was freeze-dried and EAA was determined by HPLC. Release of glutamate and aspartate was significantly increased by veratrine or capsaicin, but veratrine evoked release of EAAs was blocked by capsaicin in vitro, and injected ruthenium red did not have effect on the contents of EMs in vivo. Systemically injected capsaicin evoked the slight decrease in content of glutamate and aspartate in medullary dorsal horn and this effect of capsaicin was unaffected by ruthenium red.

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Artificial Seed Production and Nursery Culture Conditions Using Regeneration of Isolated Utricles and Medullary Filaments of Codium fragile (Suringar) Hariot (청각, Codium fragile (Suringar) Hariot의 분리수사 재생에 의한 종묘생산과 가이식 조건)

  • Hwang, Eun-Kyoung;Baek, Jae-Min;Park, Chan-Sun
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.38 no.6
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    • pp.393-398
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    • 2005
  • Codium fragile is commercially farmed in Korea by natural blooming zygote attachment. Experiments found optimum conditions for artificial seed production and nursery culture of C. fragile by asexual reproduction. Isolated utricles and medullary filaments were regenerated to erect thalli using both indoor and outdoor culture experiments. Under the indoor culture conditions, irradiance was an important factor to control the development of erect thalli. Formation of erect thallus from the isolated medullary filaments in the indoor culture was induced after 30 days under $20^{\circ}C$ and $60{\mu}mol/m^2/sec$. The detachment of isolated utricles and medullary filaments from the substrates of seed strings was reduced by exposure to the air during 2 hrs before the indoor culture of seed strings. The maximum growth and development of erect thalli in the nursery culture was induced at a water depth of 0.5 m. Depending on the substrates of the seed strings the growth of erect thalli was not significantly different (p>0.05).

A Case Report of a Patient with Lateropulsion in Lateral Medullary Infarction Improved by Korean Medicine Treatment Including Scalp Acupuncture (가쪽쏠림보행을 동반한 외측 연수경색 환자의 두침요법을 병행한 한의치료: 증례보고)

  • Hyun, Jae-Cheol;Jeong, Su-Hyeon
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.4
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    • pp.193-201
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    • 2021
  • The aim of this study was to report the effect of Korean medicine treatment with scalp acupuncture of patient with lateropulsion, dizziness, headache caused by lateral medullary infarction. We treated the patient with scalp acupuncture, acupuncture, herbal medicine. Numeric rating scale (NRS), Korean version of berg balance scale (K-BBS), gait balance evaluation, dizziness handicap inventory (DHI), activities-specific balance confidence scale (ABC) and vestibular disorders activities of daily living scale (VADL) were used to evaluate symptoms. NRS of Lateropulsion, dizziness, headache were decreased. K-BBS score increased from 4 to 56, and in the gait balance evaluation, it returned to normal. DHI, VADL score were decreased and ABC score increased from 0 to 1,300. This case report shows that Korean medicine treatment with scalp acupuncture can be effective in lateral medullary infarction. However, further controlled studies are needed to confirm the effect of scalp acupuncture on such patients.