A case of multiple endocrine neoplasia type 1 with thymic carcinoid tumor

Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant tumor syndrome. Thymic carcinoid tumors in MEN1 are not common and their natural history is little known. But development of thymic carcinoid tumors is important because in 1993, they were identified as a frequent case of death. There has not been a report of case in Korea so far. We encountered a case of thymic carcinoid in MEN1. A 42 year old man was referred presenting with diabetes of 12 years duration. Abnormal findings in his blood chemistry were hypercalcemia and hyperprolactinemia. 99mTc-sestamibi scintigraphy showed parathyroid adenoma and hyperplasia. Sella MRI showed pituitary macroadenoma. Abnormal CT scan demonstrated multiple pancreas islet cell tumors, bilateral adrenal tumor and thymoma. Subtotal parathyroidectomy with thymectomy was perfomed and thymic carcinoid was confirmed. This is the first report of thymic carcinoid with MEN1 in Korea.ope

Locality-Aware Distributed Processing Architecture for Improving Throughput in MapReduce Clusters

학위논문 (석사)-- 서울대학교 대학원 : 전기·컴퓨터공학부, 2015. 8. 홍성수.대규모의 데이터를 처리하기 위한 클러스터의 플랫폼으로써 맵리듀스 프레임워크와 분산 파일 시스템 기반의 플랫폼이 많이 쓰이고 있다. 특별한 스토리지, 네트워크 시스템 없이 상용 하드웨어로 구축되는 맵리듀스 클러스터에서 네트워크 자원은 가장 스케일업이 어렵고, 희소한 자원이다. 그 때문에 멀티 테넌트 환경에서는 잡과 잡 사이의 네트워크 자원 경쟁을 줄여 클러스터 전체의 잡 처리량을 높이는 것이 중요하다. 네트워크 자원 경쟁이 발생하는 주된 요인은 입력 데이터의 지역성으로 인한 크로스랙 네트워크 트래픽 때문이며, 입력 데이터의 지역성을 높이고자 다양한 기법이 제안되어왔다. 이들은 지역성을 높이기 위한 데이터 분산 정책의 부재로 인해 단편적인 지역성 향상에 그친다는 한계가 있다. 따라서 본 학위 논문에서는 데이터 지역성 인지 기반 분산 처리 아키텍처를 제시한다. 파일 단위로 데이터의 지역성을 인지할 수 있는 분산 파일 시스템과 지역성 인지 기반의 잡 스케줄링 정책을 통해 잡 전체의 데이터 지역성을 높임으로써 완화된 네트워크 자원 경쟁을 통해 잡 처리량을 높인다. 실험 결과 제안된 시스템은 기존 시스템에 비해 맵리듀스 클러스터의 잡 처리량을 17% 이상 향상시킬 수 있었다. 대규모의 데이터를 처리하기 위한 클러스터의 플랫폼으로써 맵리듀스 프레임워크와 분산 파일 시스템 기반의 플랫폼이 많이 쓰이고 있다. 특별한 스토리지, 네트워크 시스템 없이 상용 하드웨어로 구축되는 맵리듀스 클러스터에서 네트워크 자원은 가장 스케일업이 어렵고, 희소한 자원이다. 그 때문에 멀티 테넌트 환경에서는 잡과 잡 사이의 네트워크 자원 경쟁을 줄여 클러스터 전체의 잡 처리량을 높이는 것이 중요하다. 네트워크 자원 경쟁이 발생하는 주된 요인은 입력 데이터의 지역성으로 인한 크로스랙 네트워크 트래픽 때문이며, 입력 데이터의 지역성을 높이고자 다양한 기법이 제안되어왔다. 이들은 지역성을 높이기 위한 데이터 분산 정책의 부재로 인해 단편적인 지역성 향상에 그친다는 한계가 있다. 따라서 본 학위 논문에서는 데이터 지역성 인지 기반 분산 처리 아키텍처를 제시한다. 파일 단위로 데이터의 지역성을 인지할 수 있는 분산 파일 시스템과 지역성 인지 기반의 잡 스케줄링 정책을 통해 잡 전체의 데이터 지역성을 높임으로써 완화된 네트워크 자원 경쟁을 통해 잡 처리량을 높인다. 실험 결과 제안된 시스템은 기존 시스템에 비해 맵리듀스 클러스터의 잡 처리량을 17% 이상 향상시킬 수 있었다.제 1 장 서론 1 제 2 장 배경 4 제 1 절 맵리듀스 클러스터 아키텍처 4 1. 네트워크 토폴로지 4 2. 소프트웨어 아키텍처 4 제 2 절 분산 파일 시스템 5 1. 소프트웨어 아키텍처 5 2. 파일 관리 6 3. 블락 쓰기 정책 6 제 3 절 맵리듀스 프레임워크 7 1. 맵리듀스 잡 7 2. 소프트웨어 아키텍처 8 3. 공정 스케줄러 9 제 3 장 관련 연구 11 제 1 절 데이터 지역성 11 제 2 절 맵 태스크의 데이터 지역성 관련 연구 11 제 3 절 리듀스 태스크의 데이터 지역성 관련 연구 12 제 4 장 문제 정의 14 제 1 절 기존 연구의 한계점 14 제 2 절 문제 정의와 해결책 개관 14 제 5 장 지역성 인지 분산 처리 아키텍처 16 제 1 절 고려해야할 사항들 16 제 2 절 파일 지역성 인지 분산 파일 시스템 17 제 3 절 지역성 인지 기반 잡 스케줄러 19 제 6 장 실험 및 검증 21 제 1 절 실험 환경 21 제 2 절 실험 응용 22 제 3 절 실험 결과 23 제 7 장 결론 25 참고문헌 26 Abstract 27Maste

Coronary Artery Calcification Quantified by Electron Beam Tomography as a Screening for Coronary Artery Disease in Asymptomatic Non-Insulin-Dependent Diabetes Mellitus

ope

All-Trans Retinoic Acid Has a Potential Therapeutic Role for Diabetic Nephropathy

PURPOSE: The aim of this study was to examine the effects of all-trans retinoic acid (ATRA) on diabetic nephropathy. MATERIALS AND METHODS: We measured amounts of urinary albumin excretion (UAE) after administrating ATRA to Otsuka Long-Evans Tokushima Fatty (OLETF) rats. In order to understand the mechanism of action for ATRA, we administrated ATRA to examine its inhibitory action on the production of transforming growth factor-β₁ (TGF-β₁), protein kinase C (PKC), and reactive oxidative stress (ROS) in cultured rat mesangial cells (RMCs). RESULTS: After 16 weeks of treatment, UAE was lower in the ATRA-treated OLETF rats than in the non-treated OLETF rats (0.07±0.03 mg/mgCr vs. 0.17±0.15 mg/mgCr, p<0.01). After incubation of RMCs in media containing 30 or 5 mM of glucose, treatment with ATRA showed time- and dose-dependent decreases in TGF-β₁ levels and ROS. Moreover, ATRA treatment showed a dose-dependent decrease in PKC expression. CONCLUSION: ATRA treatment suppressed UAE and TGF-β₁ synthesis, which was mediated by significant reductions in PKC activity and ROS production. Our results suggest that ATRA has a potential therapeutic role for diabetic nephropathy.ope

Metastatic lung cancer mimicking anaplastic thyroid cancer

Anaplastic thyroid cancer is the most aggressive form of cancer found in humans. Usually it is0aeasily diagnosed; however at times other diseases are mistaken for anaplastic thyroid cancer. We0apresent a case of primary lung adenocarcinoma presenting with features that appeared as anaplastic0athyroid cancer. The 43-year-old female patient was diagnosed with anaplastic thyroid cancer at a0alocal clinic just before presenting to our hospital. At the clinic she had a neck node excisional biopsy0aand was informed of the diagnosis of anaplastic cancer. On admission to our hospital, very large0abilateral thyroid masses, and lymphadenopathy involving multiple cervical lymph nodes was0aobserved; therefore, we started chemoradiotherapy. The patient showed dramatic improvement and0awe began to think of other potential etiologies. A FDG-PET study showed increased uptake at the0aleft lower lung area corresponding to a pneumonic consolidation; a TBLB was performed, and0areported as poorly differentiated adenocarcinoma. We referred the patient to the oncology department.0aThe patient died after two cycles of systemic chemotherapyope

Do Helper T Cell Subtypes in Lymphocytic Thyroiditis Play a Role in the Antitumor Effect?

BACKGROUND: Papillary thyroid carcinoma (PTC) is frequently accompanied by lymphocytic thyroiditis (LT). Some reports claim that Hashimoto's thyroiditis (the clinical form of LT) enhances the likelihood of PTC; however, others suggest that LT has antitumor activity. This study was aimed to find out the relationship between the patterns of helper T cell (Th) cytokines in thyroid tissue of PTC with or without LT and the clinicopathological manifestation of PTC. METHODS: Fresh surgical samples of PTC with (13 cases) or without (10 cases) LT were used. The prognostic parameters (tumor size, extra-thyroidal extension of PTC, and lymph node metastasis) were analyzed. The mRNA levels of two subtypes of Th cytokines, Th1 (tumor necrosis factor α [TNF-α], interferon γ [IFN-γ ], and interleukin [IL] 2) and Th2 (IL-4 and IL-10), were analyzed. Because most PTC cases were microcarcinomas and recent cases without clinical follow-up, negative or faint p27 immunoreactivity was used as a surrogate marker for lymph node metastasis. RESULTS: PTC with LT cases showed significantly higher expression of TNF-α (p = .043), IFN-γ (p < .010), IL-4 (p = .015) than those without LT cases. Although the data were not statistically significant, all analyzed cytokines (except for IL-4) were highly expressed in the cases with higher expression of p27 surrogate marker. CONCLUSIONS: These results indicate that mixed Th1 (TNF-α, IFN-γ , and IL-2) and Th2 (IL-10) immunity might play a role in the antitumor effect in terms of lymph node metastasis.ope

Reversible Pituitary Dysfunction in a Patient with Cushing’s Syndrome due to Adrenal Adenoma

A 45-year-old woman who complained of weight gain and irregular menstruation was diagnosed as having Cushing's syndrome due to a 3 cm sized left adrenal adenoma. She underwent left adrenalectomy, and she also underwent combined anterior pituitary tests before and 9 months after the surgery. The growth hormone and adrenocorticotropic hormone levels failed to respond to hypoglycemia before the surgery, but their responses recovered after the surgery. Cortisol and thyroid stimulating hormone failed to respond to hypoglycemia and thyrotropin releasing hormone (TRH) before the surgery, respectively, but these were improved after the surgery. Luteinizing hormone, follicle stimulating hormone, and prolactin adequately responded to gonadotropin-releasing hormone and TRH, respectively, before and after the surgery. However, the basal levels of these hormones were higher after adrenalectomy, suggesting that hypercortisolemia had a significant influence on all the pituitary hormones.ope

Normal-weight obesity is associated with increased risk of subclinical atherosclerosis

BACKGROUND: Subjects with normal body mass index (BMI) but elevated amounts of body fat (normal-weight obesity; NWO) show cardiometabolic dysregulation compared to subjects with normal BMI and normal amounts of body fat (normal-weight lean; NWL). In this study, we aimed to evaluate whether NWO individuals have higher rates of subclinical atherosclerosis compared to NWL subjects. METHODS: From a large-scale health checkup system, we identified 2078 normal weight (18.5 ≤ BMI 1 mm(2) within and/or adjacent to the vessel lumen and classified according to the presence/proportion of intraplaque calcification. RESULTS: NWO subjects (n = 283) demonstrated metabolic dysregulation compared to NWL individuals (n = 1795). After adjusting for age, sex, and smoking, NWO individuals showed higher PWV values than NWL individuals (1474.0 ± 275.4 vs. 1380.7 ± 234.3 cm/s, p = 0.006 by ANCOVA). Compared with NWL subjects, NWO subjects had a higher prevalence of soft plaques even after age, sex, and smoking adjustment (21.6% vs. 14.5%, p = 0.039 by ANCOVA). The PWV value and the log{(number of segments with plaque) + 1} showed a positive correlation with numerous parameters such as age, systolic blood pressure, visceral fat, fasting glucose level, serum triglyceride level, and C-reactive protein (CRP) in contrast to the negative correlation with high-density lipoprotein-cholesterol level. The visceral fat was an independent determinant of log{(number of segments with plaque) + 1} (ß = 0.027, SE = 0.011, p = 0.016) even after adjustment for other significant factors. Most importantly, NWO was an independent risk factor for the presence of soft plaques (odds ratio 1.460, 95 % confidence interval 1.027-2.074, p = 0.035) even after further adjustment for multiple factors associated with atherosclerosis (blood pressure, blood glucose, lipid level, CRP, medication, smoking status, physical activity). CONCLUSIONS: NWO individuals carry a higher incidence of subclinical atherosclerosis compared with NWL individuals, regardless of other clinical risk factors for atherosclerosis.ope

The Effect of Treatment Modalities on Survival Rates of Patients with？Anaplastic Thyroid Carcinoma

Background : Anaplastic thyroid carcinoma represents 2% to 5% of all thyroid cancers and it is one of the most aggressive human cancers. Local extension at the time of diagnosis and distant metastases are almost always the rule. Its lethality is evidenced by a 5-year survival rate of 3.6% and a median survival time of 4 months. We retrospectively reviewed patients with this disease at 4 tertiary referral centers. Methods : From 1990 to 2003, 19 cases (9 men and 10 women, mean age: 65.1 ± 7.1 years) of anaplastic thyroid carcinoma were reviewed via the medical records. The overall survival rates according to the prognostic factors and the treatment modalities were analyzed. Results : The presenting symptoms included rapidly enlarged neck masses in 16 patients, shortness of breath in 3 patients, hoarseness in 4 patients, dysphagia in 2 patients and chest wall pain in 1 patient. The mean diameter of tumor was 7.2 cm. Local extension was seen in all of the cases that had undergone surgery. Distant metastases (lung 6, bone 2, abdominal carcinomatosis 2, brain 1 and mediastinum 1) were seen in 9 patients. Surgical treatment was performed in 10 patients. Radiotherapy was performed in 9 patients and chemotherapy was done in 5 patients; radiotherapy was performed alone in 2 patients, combination chemo-radiotherapy was performed in 3 patients, postoperative radiotherapy was performed in 2 patients and postoperative combination chemo-radiotherapy was performed in 2 patients. 4 patients were treated cons ervatively after the confirmative diagnosis. The overall median survival time was 123 days (range: 23~621 days); the median survival time was 129 days in the treatment group (n=15), and 27 days in the no treatment group (n=4), and significantly higher survival rates were observed for the treated patients (p=0.02). According to the treatment modalities, patients who underwent surgical treatment and postoperative radiotherapy and/or chemotherapy were observed to have significantly higher survival rates than patients in the radiotherapy and/or chemotherapy group (p=0.03), and also than those patients in the surgical treatment only group (p=0.04). Conclusion : We found that aggressive surgical treatment and postoperative radiotherapy and/or chemotherapy improved the survival rates of patients with anaplastic thyroid carcinoma even though local invasion and distant metastases was generally observed to occur.ope

The association of insulin resistance and carotid atherosclerosis with thigh and calf circumference in patients with type 2 diabetes

BACKGROUND: The relationship between body composition parameters such as thigh and calf circumference and insulin resistance or atherosclerosis in type 2 diabetes is poorly understood. The aim of this study was to investigate the relationship between insulin resistance, atherosclerosis, and thigh and calf circumference in patients with type 2 diabetes. METHODS: A total of 4,427 subjects with type 2 diabetes were enrolled in this study. Insulin sensitivity was assessed according the rate constant for plasma glucose disappearance (Kitt) determined via the short insulin tolerance test. Biochemical and anthropometric profiles were measured according to a standardized protocol. Visceral fat thickness and carotid intima media thickness (IMT) were measured by ultrasonography. RESULTS: Insulin sensitivity index (Kitt) was significantly correlated with weight adjusted thigh and calf circumference. Thigh circumference was inversely associated with IMT in men and women and calf circumference was negatively correlated with IMT in women. Multiple stepwise regression analysis revealed that thigh circumference was independently correlated with insulin sensitivity index (Kitt) and IMT. Furthermore, in multivariate logistic regression analysis, thigh circumference was an independent determinant factor for carotid atherosclerosis in patients with type 2 diabetes even after adjusting for other cardiovascular risk factors. CONCLUSIONS: Thigh and calf circumference were correlated with insulin resistance and carotid atherosclerosis, and thigh circumference was independently associated with insulin resistance and carotid atherosclerosis in patients with type 2 diabetes.ope