- Cyclic Pamidronate Infusion in Primary Osteoporotic Women.
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Bong Nam Chae, Eun Gyoung Hong, Seone Kyu Lee, Yoon Sok Chung, Kwan Wook Lee, Hyeon Man Kim
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J Korean Endocr Soc. 2001;16(2):221-230. Published online April 1, 2001
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- BACKGROUND
Bisphosphonates are now well established as successful antiresorptive agents for the prevention and treatment of osteoporosis. We investigated the effect of cyclic intravenous treatment with an aminobisphosphonate, pamidronate in cases of primary osteoporosis. METHODS: Eighteen patients with primary osteoporosis (bone mineral density BMD t-score < -2.5) received four courses of pamidronate (30 mg with 500 mL normal saline over 2 hours every 3 months). The serum biochemical parameters and bone turnover markers were measured before each treatment. The bone pain score, medication score, and the side effects were also monitored. BMD and simple spine X-ray were performed before and 1 year after of treatment. RESULTS: BMD at the lumbar spine (L2-4) significantly increased from 0.798+/-0.110 g/cm2 to 0.860+/-0.107 g/cm2 after 1 year of treatment with pamidronate: by +8.3+/-9.4% of baseline. BMDs at the femoral neck, Ward s triangle and the trochanter also increased, but not significantly. Serum total alkaline phosphatase (p<0.05) and urine deoxypyridinoline/creatinine (p=0.069) decreased with treatment. Other bone turnover markers were unchanged. The bone pain score decreased significantly. None of the patients experienced a new fracture during treatment. The frequency of the side effects following the first infusion was 61.1% (a transient fever and myalgia with flu-like symptoms in 10 patients and mild phlebitis in 1 patient). However, only two patients complained of flu-like symptoms after second infusion, and no patient complained following the third infusion. CONCLUSION: Cyclic intravenous treatment of pamidronate every three months was effective in increasing BMD and in the decreasing bone turnover rate, and was relatively well tolerated in primary osteoporotic women.
- One Family of Familial Combined hyperlipidemia Associated with Various Metabolic Abnormalities.
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Kwan Woo Lee, Sung Kyu Lee, Yun Suk Chung, Hyun Man Kim, Yoon Jung Kim, Eun Kyung Hong, Bong Nam Chae, Ji Won Park
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J Korean Endocr Soc. 1999;14(2):418-424. Published online January 1, 2001
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- Familial combined hyperlipidemia is one af the manogenic disorders frequently found in humans and is seen in 0.5~2% of the general populatian, accounting for at least 10% of persons with pemature atlmmcletusis. The distinguishing feature of familial combined hyperlipidemia, in camparison with other single-gene abnarmalities of lipoprotein metabolism, is that not all affected members have the same plasma lipid phenotype; some individuals have an elevation of cholesterol concentration alane(type IIa lipoprotein pattern), while some athers have an elevation of triglyceride concentration alone(type IV pattem), and still others have elevations of both values(type IIb pattem). In any one persan, the lipid phenotype can change as a result of dietary or drug treatment. Familial combined hyperlipidemia should be suspected in those subjects with moderate hypertriglyceridemia and/or moderate hypercholestaolemia (lipoprotein types IIa, Ilb, IV), especially when premature coronary heart disease is evident in the family histary. Low plasma HDL-cholesterol, obesity, insulin resistance and hyperuricemia are often . Family members affected by familial combined hyperlipidemia should be identified and be treated, since tbe condition is associated with premature caronary heart diasease. We have found one family of familial combined hyperlipidemia with one member(case 1) associated with insulin resistance, hyperuricemia and gout, and another member(case 2) associated with diabetes mellitus and infertiTity.
- A Case of Acromegaly First Diagnosed in Pregnancy.
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Jinny Suh, Hyun Kyung Cho, Yoon Jung Kim, Eun Gyoung Hong, Bong Nam Chae, Seong Kyu Lee, Yoon Sok Chung, Kwan Woo Lee, Kyung Joo Hwang, Hyeon Man Kim
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J Korean Endocr Soc. 1999;14(1):148-152. Published online January 1, 2001
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- Pregnancy in acromegaly is very rare. Amenorrhea and infertility are common manifestations in acromegaly. The pregnancy may be influenced by acromegaly in many ways and pregnancy itself may influence the course of a pituitary tumor. We report of a case of pregnancy in a woman who was diagnosed with acromegaly during the course of pregnancy. Her pregnancy was uneventful and she delivered a healthy baby at 38 weeks by cesarean section. No treatment was undertaken during the pregnancy and transsphenoidal surgery was performed after the delivery.
- Plasma Leptin, Insulin Resistance, and Obesity Index of Type 2 Diabetics and Normal Subjects among Koreans.
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Seong Kyu Lee, Hye Lim Noh, Yoon Jung Oh, Yoon Jung Kim, Eun Gyoung Hong, Bong Nam Chae, Yoon Sok Chung, Kwan Woo Lee, Hyeon Man Kim
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J Korean Endocr Soc. 1999;14(1):122-133. Published online January 1, 2001
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- BACKGROUND
Leptin has been reported to be correlated with the amount of adipose tissue in humans. The plasma leptin concentrations were not different between diabetics and non-diabetics in Mexican-Americans; however, the leptin might stimulate or diminish insulin secretion and induce insulin resistance. Then, it can be postulated that leptin may one of the key factors in the development of insulin resistance. Therefore we were to note any differences in FPL (fasting plasma leptin levels) between diabetics and normal subjects, and to investigate variables such as PBF (percentage body fat), BMI (body mass index), FPI (fasting plasma insulin) to determine their effects on the variation of FPL. We also were to investigate whether FPL influenced the GUR (glucose utilization rate). METHODS: The subjects were 116 type 2 diabetics and 45 normal subjects in Korean. PBF, BMI, WHR (waist hip ratio) were measured. Fasting plasma insulin and leptin levels were measured by radioimmunoassay. Euglycemic and/or hyperglycemic clamp tests were performed in 19 diabetics and 16 normal subjects. RESULTS: 1. There was no difference in FPL between diabetics and normal subjects. 2. A significant difference was found in FPL between female and male subjects. 3. Gender and body composition such as PBF, BMI contributed plasma leptin levels. 4. FPL was associated with GUR (Insulin resiatance) only in male subjects. 5. During 2h clamp tests, the acute increments of insulin or glucose did not change the leptin levels. CONCLUSION: These data suggested that there was no difference in FPL between diabetics and normal subjects, whereas gender, body composition such as PBF, BMI contributed leptin levels.
- A Case of Methimazole Induced Agranulocytosis Complicated with Deep Neck Abscess.
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Kwan Woo Lee, Sung Kyu Lee, Yun Suk Chung, Hyun Man Kim, Yoon Jung Kim, Eun Kyung Hong, Bong Nam Chae, Jin Ho Lee, Chang Young Ha, Joon Sung Park
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J Korean Endocr Soc. 1998;13(4):617-621. Published online January 1, 2001
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- The thiourea derivatives, propylthiouracil and methimazole are in widespread use for the treatment of hyperthyroidism. The untoward side effects of these drugs are not infrequent and agranulocytosis is the most serious side effect them. We observed one case of methimazole induced agranulocytosis complicated by deep neck abscess. A 54-year-old woman was admitted because of fever, chilling and sore throat for 1 week. The symptom was developed after receiving methimazole 30mg daily day due to hyperthyroidism during last 3 months. Physical examination revealed hyperemic, enlarged tonsils and tender swelling of the right lower neck The peripheral blood total leukoeyte count was 1,500/mm' (absolute neutrophil count, ANC 9) and a peripheral blood smear revealed few neutrophil. The patient was administered G-CSF 2 mg/kg daily, and on the fifth day of hospitalization, fever subsided and ANC increased to 3,431. On the 11th day, fever developed again and the tenderness and swelling in both lower neck area were aggrevated. Computed tomography of the neck was performed, and revealed a large deep neck abscess. After pus aspiration and antibiotics therapy, the neck abscess was disappeared.
- Antibody-dependent Cell-mediated Cytotoxitity as a Prognostic Indicator in the Medical Treatment of Graves' Disease.
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Kwan Woo Lee, Young Goo Shin, Hye Rim Ro, Sung Kyu Lee, Yun Suk Chung, Hyun Man Kim, Yoon Jung Kim, Eun Kyung Hong, Bong Nam Chae
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J Korean Endocr Soc. 1998;13(4):554-562. Published online January 1, 2001
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- BACKGROUND
The several forms of treatment of Graves disease-thyroidectomy, antithyroid drugs and radioiodide therapy-are in wide use now. But which therapy is best is a matter of debate. Some authors reported that in patients who underwent thyroidectomy, higher titers of serum antimicrosomal antibody were associated with 1) higher formation rates of germinal centers, 2) more lymphocyte infiltration in the thyroid tissue, 3) higher incidence of hypothyroidism, and 4) lower incidence of recurrence. We were interested in the relationship of thyroid autoantibody titers, ADCC(antibody-dependent cell-mediated cytotoxicity) activity and the clinical response to antithyroid medication. METHODS: We measured ADCC activities from patients in Graves disease(n-48), Hashimoto thyroiditis(n=17) and normal control(n=9). The patients of Graves disease were followed up for more than 1 year, and they were grouped into A(n=17, well responsed group to antithyroid medication) and B(n=31, poorly responsed group). We examined ADCC activities of patients' sera by chromium release assay. RESULTS: 1) Mean age of patients with Graves disease was 34.4210.4 years and 15 patients were male(31%). 2) Results of thyroid function tests of the Graves' patients were T 585.9 +/- 255.3 ng/dL, T4 21.3 +/- 12.2 mg/dL, TSH 0.11 +/- 0.06mIU/mL. Concentrations of antimicrosomal antibody, antithyroglobulin antibody and thyrotropin binding inhibitory immunoglobulin were 1279.1 +/- 1486.7 IU/mL, 488.1 +/- 751.1 IU/mL, and 38.5 +/- 33.4U/L respectively. 3) There was no significant difference between levels of thyroid hormones or concentrations of thyroid autoantibodies and ADCC activities in graves patients. 4) The ADCC activity of the Graves patient group(24.49%) was significantly higher than that of the normal control group(3.76%), and significantly lower than that of the Hashimotos thyroiditis group(36.34%). 5) There was no significant difference in ADCC activity between group A(18.24 +/- 13.44%) and B(27.91 +20.02%). CONCLUSION: From this results, we suggested that ADCC activity seems to be no value as a prognostic factor in predicting the response to antithyroid drugs in Graves disease patients. But, further studies, larger number of patients and long-term follow up, are needed.
- Impaired Glucose Tolerance Associated with Klinefalter Syndrome.
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Kwan Woo Lee, Choong Keun Cha, Chul Uhm, Oh Young Kwon, Sung Kyu Lee, Yun Suk Chung, Hyun Man Kim, Yoon Jung Kim, Eun Kyung Hong, Bong Nam Chae
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J Korean Endocr Soc. 1998;13(3):495-500. Published online January 1, 2001
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- Klinefelter syndrome is one of the most common forms of primary hypogonadism and infertility in males. It is a clinical syndrome consisting of gynecomastia, azoospermia, and increased urinary excretion of follicle-stimulating hormone. Fequency of diabetes mellitus, emphysema, asthma, breast cancer increase in Klinefelter syndrome. We report a 16-year-old male patient with impaired glucose tolerance in association with Klinefelter syndrome, which was confirmed by chromosome analysis. The mechanism of impaired glucose tolerance in this patient was peripheral insulin resistance which clarified by euglycemic hyperinsulinemic clamp test.
- A Case with Multifocal Langerhans Cell Granulomatosis Involving the Thyroid Gland.
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Kwan Woo Lee, Chul Kwon Chung, Sung Chul Hwang, Hyun Hee Yim, So Yun Park, Sung Kyu Lee, Yun Suk Chung, Hyun Man Kim, Yoon Jung Kim, Eun Kyung Hong, Bong Nam Chae
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J Korean Endocr Soc. 1998;13(3):466-472. Published online January 1, 2001
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- Langerhans cell granulomatosis(LCG), previously termed 'Histiocytosis-X', is one of the rare disease. LCG is characterized by proliferation of Langerhans cells in a unifocal or multifocal pattern. And LCG may be manifested in a variety of way, ranging from a spontaneously regressing solitary lesion to a multisystem life-threatening disorder. This disease usually involves the bone, lung, skin and lymph node. The most common endocrinologic abnormalities in LCG are diabetes insipidus and growth hormone deficiency. LCG involving the thyroid gland is extremely rare and only a small numbers of cases have been reported worldwide. A 41-year-old diabetic female visited the hospital due to the neck swelling for 3 months and she also complained of polyuria, polydipsia and easy fatigue. LCG involving multiple organs included thyroid gland was diagnosed by high-resolution CT of lung, by characteristic histological findings of the thyroid lesion and by the immunohistochemical staining for S-100 protein and OKT 6(CD la). She is followed at OPD without any medication.
- Two Cases with Squamous Cell Carcinoma of the Thyroid Gland.
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Kwan Woo Lee, So Yun Park, Sung Kyu Lee, Yun Suk Chung, Hyun Man Kim, Yun Mi JIn, Yoon Jung Kim, Eun Kyung Hong, Bong Nam Chae, Ho Young Lim
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J Korean Endocr Soc. 1998;13(3):446-452. Published online January 1, 2001
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- Primary squamous cell carcinoma of the thyroid is rare, presenting much less than one percent of all primary thyroid malignancies. Most cases have been reported in elderly patients with a history of goiter. It is necessary to differentiate between primary squamous cell carcinoma and secondary involvement from other sites. Secondary involvement of the thyroid may be more amenable to palliation or cure. The treatment of choice in primary squamous cell carcinoma is radical surgery in resectable cases, but the squamous cell carcinoma behaves aggressively and carries a uniformly poor prognosis regardless of the treatment. We had an experience of a primary squamous cell carcinoma of the thyroid in two elderly patients. These patients presented a typical feature of a primary squamous cell carcinoma of the thyroid, which has been rarely reported in Korea.
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