Endocrinology and Metabolism

Bong Soo Cha (Cha BS)

47 Articles

A Case of Latent Autoimmune Diabetes in Adults Developed after Surgical Cure of Growth Hormone Secreting Pituitary Tumor.: Wonjin Kim, Jung Ho Kim, Youngsook Kim, Ji Hye Huh, Su Jin Lee, Mi Sung Park, Eun Yeong Choe, Jeong Kyung Park, Myung Won Lee, Jae Won Hong, Byung Wan Lee, Eun Seok Kang, Bong Soo Cha, Eun Jig Lee, Hyun Chul Lee; Endocrinol Metab. 2012;27(4):318-322. Published online December 20, 2012; DOI: https://doi.org/10.3803/EnM.2012.27.4.318

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Abstract PDF: Acromegaly is generally caused by a benign growth hormone (GH)-secreting pituitary adenoma. It is characterized by a wide range of complications; cardiovascular, respiratory, bone and joint, and metabolic complications. Among them, impaired glucose tolerance and diabetes mellitus, due to GH-induced insulin resistance, has been reported in approximately 16-46% and 19-56%. They are usually improved following the treatment of acromegaly, surgical or medical therapy. We report a first case of 36-year-old man who was paradoxically diagnosed with GAD antibody positive latent autoimmune diabetes in adults (LADA) after the surgical cure of acromegaly.

Effect of 17-beta Estradiol on Adipocyte Lipin-1 Expression in OLETF Rat.: Eun Seok Kang, In Sook Kim, Seok Jin Ko, Chul Hoon Kim, Sung Wan Chun, Chul Woo Ahn, Bong Soo Cha, Hyun Chul Lee; Endocrinol Metab. 2010;25(3):199-205. Published online September 1, 2010; DOI: https://doi.org/10.3803/EnM.2010.25.3.199

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BACKGROUND
17 beta-estradiol is known to play an important role in glucose homeostasis. Lipin-1 is a nuclear protein that is essential in adipocyte differentiation and it is considered to play a role in ectopic fat deposition and the redistribution of fat. The aim of this study was to evaluate the effect of 17 beta-estradiol on the lipin-1 expression in the adipocytes of OLETF rats, which is an animal model of diabetes. METHODS: The OLETF rats were divided into 3 groups, 1) the sham-operation group (SHAM) 2) the castrated group (CAST) and 2) the castrated and estradiol treatment group (EST), and all the rats were at 6 weeks of age. LETO rats were used as a control group (LETO). 0.1 mg of estradiol valerate was injected subcutaneously every 4 weeks in the rats of the EST group. The visceral and subcutaneous tissues were isolated to evaluate the lipin-1 protein expression. The lipin-1 expression was measured in human visceral and subcutaneous preadipocytes. RESULTS: Less body weight gain was observed in the EST group compared with that of the SHAM group. In addition, improvement in the glucose tolerance was observed in the EST group. The lipin-1 expression in visceral fat was decreased in the SHAM and CAST groups, but it was but recovered in the EST group. The lipin-1 expression in the subcutaneous fat was decreased in the SHAM, CAST, and EST groups. CONCLUSION: Long term estradiol treatment in OLETF rats reduces the body weight gain and improves the glucose tolerance. Estradiol enhances the lipin-1 protein expression in the visceral adipocytes, but not in the subcutaneous adipocytes.

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Effect of 17-beta Estradiol on Adipocyte Lipin-1 Expression in OLETF Rat
Seong-Kyu Lee
Endocrinology and Metabolism.2010; 25(3): 177. CrossRef

A Case of Insulin Autoimmune Syndrome in a Patient with Partial Hypopituitarism.: Obin Kwon, Eun Young Park, Jin Young Yoon, Kwang Joon Kim, Yong ho Lee, Jae Won Hong, Eun Jig Lee, Sung Kil Lim, Hyun Chul Lee, Bong Soo Cha; J Korean Endocr Soc. 2009;24(4):281-286. Published online December 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.4.281

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Abstract PDF: Insulin autoimmune syndrome is one of the rare causes of hypoglycemia, and characterized by hyperinsulinemic hypoglycemia associated with high titer of antibodies to endogenous insulin. We report a case of insulin autoimmune syndrome in a 57-year-old woman, presenting with mental changes due to hypoglycemia. She had no history of diabetes or insulin administration. The serum C-peptide level was 4.69 ng/mL and the insulin concentration was 229.55 microU/mL, when fasting plasma glucose level was 32 mg/dL. The insulin-to-glucose ratio was 7.17, while there was no radiologic evidence of insulinoma. The insulin antibody level was over 100 microU/mL, resulting in the diagnosis of insulin autoimmune syndrome. Hormonal studies revealed partial hypopituitarism and a lack of glucagon-response to hypoglycemia. Hypoglycemia disappeared with replacement of prednisolone with levothyroxine therapy. Under secretion of growth hormone and of adrenocorticotropic hormone due to hypopituitarism were associated with insufficient counterregulation to hypoglycemia. One should keep in mind that insulin autoimmune syndrome or hypopituitarism is one cause of hypoglycemia in patients with no history of diabetes, and corticosteroid can be an effective treatment for both diseases.

Retraction: Expression of RET in Thyroid Diseases of a Korean Population.: Si Hoon Lee, Soon Won Hong, Woo Chul Moon, Myoung Ryur Oh, Jin Kyung Lee, Bong Soo Cha, Chul Woo Ahn, Kyung Rae Kim, Sung Kil Lim, Hyun Chul Lee; J Korean Endocr Soc. 2008;23(1):70. Published online February 1, 2008

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Retraction: Contributing Factors to Different Natural Courses of Posttansplantation Diabetes Mellitus in Renal Allograft Recipients.: Kyu Yeon Hur, Myoung Soo Kim, Jae Hyun Nam, Eun Seok Kang, Hyun Joo Lee, So Hun Kim, Bong Soo Cha, Chul Woo Ahn, Soon Il Kim, Yu Seun Kim, Hyun Chul Lee; J Korean Endocr Soc. 2007;22(6):479. Published online December 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.6.479

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A Case of Turner's Syndrome with Transient Hypopituitarism.: Ji Sun Nam, Min Ho Cho, Jung Min Roh, Hai Jin Kim, Ji Eun Yoon, Han Young Jung, Jong Suk Park, Eun Seok Kang, Chul Woo Ahn, Bong Soo Cha, Eun Jig Lee, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee; J Korean Endocr Soc. 2007;22(4):266-271. Published online August 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.4.266

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Abstract PDF: Turner's syndrome is characterized by short stature and gonadal dysgenesis, and it is often associated with various systemic manifestations, such as cardiovascular, renal, thyroidal, gastrointestinal, and musculoskeletal disorders. Though very rare, it can also be accompanied by hypopituitarism. It is important to give a meticulous medical attention to short females with gonadal dysgenesis so that neither disease is neglected or gets delayed diagnosis. In this case, Turner's syndrome and hypopituitarism were diagnosed almost simultaneously, but hypopiuitarism was transient, and the normal pituitary function was recovered spontaneously without any treatment. Initial sella MRI showed mild congenital hypoplastic hypopituitarism, and combined pituitary function test was compatible with hypopituitarism, but after 5 years, though growth hormone deficiency was still present, otherwise normal pituitary function was noted without any change in MRI. Herein, we are reporting a case of Turner's syndrome with transient idiopathic hypopituitarism with the review of literature.

Effect of Fenofibrate and Exercise on Metabolic Syndrome and Hepatic Steatosis.: Bong Soo Cha, Jae Hyuk Lee; J Korean Endocr Soc. 2007;22(3):188-191. Published online June 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.3.188

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Minireview: A Need for an Adequate Diet Program for Postmenopausal Women with Obesity in the Republic of Korea
So Hee Park, Bo Dam Kim, Jae Hong Sang, Hae-Hyeog Lee, Tae-Hee Kim
Journal of Menopausal Medicine.2023; 29(2): 45. CrossRef

A Case of Autoimmune Hypoglycemia due to Insulin Antibody in Patient with End Stage Renal Disease.: Ji Ye Jung, Eun Seok Kang, Beom Seok Kim, Sung Wan Chun, Yumie Rhee, Chul Woo Ahn, Bong Soo Cha, Eun Jig Lee, Sung Kil Lim, Hyun Chul Lee; J Korean Endocr Soc. 2006;21(6):536-541. Published online December 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.6.536

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Abstract PDF: Fasting hypoglycemia results from several mechanisms. Autoimmune hypoglycemia is one of the rare causes of hypoglycemia, and characterized by hyperinsulinemia, fasting hypoglycemia and the presence of autoantibodies to insulin or insulin receptor. We report here on a 64-year-old male patient with autoimmune hypoglycemia with end stage renal disease. He had no history of diabetes or insulin use. He had experienced several severe hypoglycemic events. The serum C-peptide level was 7.48 ng/mL and the insulin concentration was 115.4 micro U/mL when the fasting plasma glucose level was 88 mg/dL. The insulin to glucose ratio was 5.42, which suggested the presence of insulinoma. Yet the radiologic studies, including magnetic resonance cholangiopancreatography, endoscopic ultrasonography and selective calcium stimulated venous sampling revealed no evidence of insulinoma. The insulin autoantibody level was 62 micro U/mL. Therefore, we could diagnosis the autoimmune hypoglycemia. The hypoglycemia was treated with prednisolone and the patient recovered from this. His insulin level decreased to 21.11 micro U/mL and the insulin autoantibody level decreased to 34 micro U/mL. Hypoglycemia in the hemodialysis patients is not uncommon. One should bear in mind autoimmune hypoglycemia as one of the causes of hypoglycemia in patients with no history of diabetes.

Contributing Factors to Different Natural Courses of Posttansplantation Diabetes Mellitus in Renal Allograft Recipients.: Kyu Yeon Hur, Myoung Soo Kim, Jae Hyun Nam, Eun Seok Kang, Hyun Joo Lee, So Hun Kim, Bong Soo Cha, Chul Woo Ahn, Soon Il Kim, Yu Seun Kim, Hyun Chul Lee; J Korean Endocr Soc. 2006;21(5):373-381. Published online October 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.5.373

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BACKGROUND
New onset diabetes is a major complication after kidney transplantation. However, the natural course of posttransplantation diabetes mellitus (PTDM) remains unclear. The aim of this study was to demonstrate the detailed natural courses of PTDM according to the onset and persistency of hyperglycemia, and to investigate risk factors for development of different courses of PTDM in renal allograft recipients. METHODS: A total of 77 renal allograft recipients without previously known diabetes were enrolled and performed a serial 75 g oral glucose tolerance test at 0, 1, and 7 years after kidney transplantation. Patients were classified according to the onset and persistency of PTDM: early PTMD (E-PTDM), late PTDM (L-PTDM), persistent PTDM (P-PTDM), transient PTMD (T-PTDM), and non-PTDN (N-PTDM). RESULTS: The incidence of each group was as follows: E-PTDM, 39%; L-PTDM, 11.7%; P-PTDM, 23.4% T-PTDM, 15.6%; N-PTDM, 49.3%. Tacrolimus and female gender were associated with the development of E-PTDM. Among E-PTDM, age at transplantation was a high risk factor for the development of P-PTDM. Higher BMI at year1 was associated with the development of L-PTDM. CONCLUSION: Different risk factors were associated with various natural courses of PTDM. Since old age and female gender are not modifiable risk factors, it may be important to modify immunosuppressive therapy regimens for the prevention of E-PTDM and control of body weight for L-PTDM.

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Efficacy and Safety of Gemigliptin in Post-Transplant Patients With Type 2 Diabetes Mellitus
Jaehyun Bae, Youjin Kim, Yongin Cho, Minyoung Lee, Ji-Yeon Lee, Yong-ho Lee, Byung-Wan Lee, Bong-Soo Cha, Dong Jin Joo, Kyu Ha Huh, Myoung Soo Kim, Yu Seun Kim, Eun Seok Kang
Transplantation Proceedings.2019; 51(10): 3444. CrossRef
Post-transplantation Diabetes Mellitus
Kun-Ho Yoon
Journal of Korean Endocrine Society.2006; 21(5): 370. CrossRef

The Relationship between the Leptin Concentration and the Small Dense Low Density Lipoprotein Cholesterol Concentration in Korean Type 2 Diabetic Patients.: Wan Sub Shim, Hae Jin Kim, Eun Seok Kang, Yu Mie Rhee, Chul Woo Ahn, Sung Kil Lim, Hyun Chul Lee, Bong Soo Cha; J Korean Endocr Soc. 2006;21(4):319-327. Published online August 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.4.319

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BACKGROUND
Leptin has been suggested as a possible cause of atherosclerotic disease. The small dense low-density lipoprotein cholesterol (LDL-C) has also been regarded as a new surrogate marker in atherosclerotic disease. The aim of this study was to evaluate the relationship between the leptin concentration and the small dense LDL-C concentration in Korean type 2 diabetic patients. METHODS: One hundred-ninety one type 2 diabetic patients, who did not use any medication that could affect the concentration of lipid such as statin, fibrate, thiazolidinediones and corticosteroid, were enrolled in this study. We analyzed the relationship between leptin, the small dense LDL-C and the other metabolic parameters. RESULTS: The small dense LDL-C concentrations were higher in the group with the highest tertile of the leptin value, both in males and females than those patients in the group with the lowest tertile of the leptin value. The small dense LDL-C concentrations were also higher in the group with the highest tertile of leptin divided by the BMI value both in males and females than those patients in the group with the lowest tertile of the leptin value. The leptin concentration was positively correlated with the small dense LDL-C, total cholesterol, triglyceride, LDL-C, insulin and HOMAIR values after adjusting for age, gender and BMI. CONCLUSION: The association between leptin and small dense LDL-C could be a factor that explains the association between leptin and cardiovascular disease.

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Relationships among Serum Adiponectin, Leptin and Vitamin D Concentrations and the Metabolic Syndrome in Farmers
Seo-Eun Yeon, Hee-Ryoung Son, Jung-Sook Choi, Eun-Kyung Kim
Korean Journal of Community Nutrition.2014; 19(1): 12. CrossRef
The Effect of Visceral Fat Area and Adipocytokines on Acute Myocardial Infarction: A Case-Control Study in Adult Korean Population
Kang-Kon Lee, Young-Sung Suh, Keun-Sang Yum
The Korean Journal of Obesity.2012; 21(1): 57. CrossRef

A Case of Patient with Opioid-Induced Adrenocortical Insufficiency and Hypogonadism.: Hai Jin Kim, Chul Sik Kim, Jong Suk Park, Jina Park, Eun Seok Kang, Chul Woo Ahn, Bong Soo Cha, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee; J Korean Endocr Soc. 2006;21(3):257-260. Published online June 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.3.257

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Abstract PDF: Opioids are known to decrease plasma cortisol and testosterone level in human and other mammals. Nowadays, opioid use is exponentially increasing, but little is known about its side effects. With the help of progressive human science, we can habit longer life and as result, are becoming more avid for healthy life. In this respect, analgesics play important role in maintaining good and healthy quality of life. For this reason, it is important to fully understand its side effects and handle it with special precaution. We are reporting a 22-year-old male who had been taken opioid analgesic for more than six years to relieve chronic, intractable headache. Then, his hormone test revealed hypogonadotropic hypogonadism combined with hypoadrenocorticotropic hypoadrenalism but showed no definite clinical features except for sexual frigidity. After two years of oxycodon discontinuation, we reevaluated that his hormone test, and all other laboratory tests returned to the normal range.

A Case of Multiple Endocrine Neoplasia Type 1 with Papillary Thyroid Carcinoma.: Hai Jin Kim, Chul Sik Kim, Hyun Chul Je, Jina Park, Jong Suk Park, Jee Hyun Kong, Eun Seok Kang, Chul Woo Ahn, Bong Soo Cha, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Hang Suk Jang, Soon Won Hong; J Korean Endocr Soc. 2006;21(1):79-84. Published online February 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.1.79

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This is the first report of papillary thyroid carcinoma combined with multiple endocrine neoplasia type 1 (MEN 1). It is an hereditary syndrome characterized by neoplastic disorders such as pituitary adenoma, parathyroid adenoma or hyperplasia and pancreatic neuroendocrine tumor, such as gastrinoma just like in our case. But sometimes pheochromocytoma, mucosal ganglioneuromas, lipoma, forgut carcinoid and thyroid disease could be accompany the disease, but coincidental papillary thyroid carcinoma was never reported before in Korea. Herein we represent a 39-year-old woman who manifested typical features of MEN 1 with coincidental papillary thyroid carcinoma. Despite with definite family history of MEN 1, her genetic analysis of DNA had not found any germline mutation in MEN 1 gene. Unidentified culprit gene unable further genetic study of finding LOH (loss of heterogeneity) in 11q13, the possible explanation of papillary thyroid carcinoma as a new component of MEN 1. As we have experienced a case of MEN 1 combined with papillary thyroid carcinoma, we report it with the review of literature.

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A Case of Multiple Endocrine Neoplasia Type I with Atypical Clinical Course
Yun Sun Choi, Youn Sun Bai, Bon Jeong Ku, Young Suk Jo, Young Kun Kim, Heung Kyu Ro, Minho Shong
Journal of Korean Endocrine Society.2008; 23(4): 266. CrossRef

A Case of Acromegaly Caused by Double Pituitary Adenomas.: Hai Jin Kim, Chul Sik Kim, Jong Suk Park, Jina Park, Jee Hyun Kong, Ji Sun Nam, Chul Woo Ahn, Bong Soo Cha, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Soon Won Hong; J Korean Endocr Soc. 2006;21(1):53-57. Published online February 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.1.53

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Abstract PDF: Acromegaly is a clinical syndrome, which is caused by an excess of growth hormone (GH), most commonly secreted from a pituitary solitary adenoma. However, our patient had bilateral GH-secreting pituitary tumors, the incidence of which has been reported in only 1.3 to 1.69% of all acromegalic patients. A 59-year-old female, with no family history of pituitary adenomas, demonstrated an increased level of serum insulin-like growth factor-1 (IGF-1), and GH not suppressed after 75 g oral glucose loading. On a preoperative MRI, only one pituitary tumor, measuring 1.1 x 0.7 cm, could be observed using sellar MRI. After surgical resection of the tumor, her headache and myalgia were sustained, and the IGF-1 level was still in a high titer. Therefore, a follow-up sellar MRI was taken, and a 0.6 x 0.7 cm sized newly growing pituitary tumor was found on the other side. With a retrospective review of radiological examinations, the patient was found to have bilateral tumors. The 0.3 cm sized tumor on the left was too small to be detected on the preoperative MRI. As the patient preferred medical treatment after surgery, she was treated with sandostatin analogues. Acromegaly with bilateral GH-secreting pituitary tumors, is a very rare disease, with no previous case having been reported in Korea. Herein, we report the case with a review of the literature.

The Effect of Hormone Replacement Therapy on Carotid Intima-Media Thickness in Healthy Postmenopausal Women.: Jang Yel Shin, Bong Soo Cha, Choon Hee Chung, Won Heum Shim, Hyun Chul Lee; J Korean Endocr Soc. 2006;21(1):14-21. Published online February 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.1.14

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Abstract PDF: BACKGROUND
Cardiovascular disease is the leading cause of death in postmenopausal women. The use of hormone replacement therapy (HRT) preventing for cardiovascular disease in postmenopausal women remains controversial. We investigated the effect of HRT on carotid intima-media thickness (IMT) according to the HRT duration in healthy postmenopausal women. METHODS: One hundred and twenty postmenopausal women (mean age: 55.4 +/- 3.3 years) were classified into never users, short-term, and long-term users according to the HRT duration. Carotid IMT was measured, and the clinical and biochemical cardiovascular risk factors were examined. RESULTS: The mean IMT was significantly thinner in the long-term users than that in the never users (0.62 +/- 0.11 vs. 0.71 +/- 0.14 mm, P < 0.01). Also, the maximal IMT was significantly thinner in the short-term and the long-term users. However, there is no significant difference in the mean and maximal IMTs between the estrogen alone and estrogen plus progestins used group. The period exposed to menopause was significantly shorter in the long-term users than that in the never users (1.8 +/- 2.3 vs. 4.3 +/- 3.3 years, P < 0.001). CONCLUSION: Our findings suggest that if HRT is initiated during early postmenopausal period before the onset of atherosclerosis, HRT may have a beneficial effect on the prevention of carotid atherosclerosis.

A Case of Acromegaly with Gall Bladder Cancer.: Ji Sun Nam, Chul Sik Kim, Jee Hyun Kong, Hai Jin Kim, Jin A Park, Jong Suk Park, Chul Woo Ahn, Se Joon Lee, Bong Soo Cha, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee; J Korean Endocr Soc. 2005;20(4):401-406. Published online August 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.4.401

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Abstract PDF: Acromegaly is a systemic endocrine disorder due to an excessive release of growth hormone, which increases the serum levels of insulin-like growth factor-1(IGF-1). Elevated levels of these hormones are assumed to increase the incidence of malignant tumors in patients with acromegaly, due to by stimulating the growth and maturation of cells. In particular, IGF-1 is considered to be closely related with the development of colon polyps and colon cancers. Studies suggest that various malignant tumors, including thyroid cancer, brain tumor and renal cell carcinomas, are also more common in patients with acromegaly. Here, a case of gall bladder cancer in a patient with acromegaly, and the possible relationships between these two disorders, is reported.

A Case of Multiple Endocrine Neoplasia Type 1 with Mutation in MENIN Gene.: Se Eun Park, Eun Seok Kang, Hyun Joo Lee, So Hun Kim, Mi Young Do, Shin Ae Kang, Seung Jin Han, Hyeong Jin Kim, Chul Woo Ahn, Bong Soo Cha, Sung Kil Lim, Kyung Rae Kim, Il Jin Kim, Hyun Chul Lee; J Korean Endocr Soc. 2005;20(1):71-77. Published online February 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.1.71

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Multiple endocrine neoplasia type 1(MEN 1) is an autosomal dominantly inherited syndrome, characterized by the combined occurrence of tumors of the parathyroid glands, endocrine pancreas, and anterior pituitary gland. The MENIN gene, which is a kind of tumor suppressor gene, is located at the chromosomal locus 11q13. It consists of one untranslated exon and nine exons encoding the menin protein. We report a case of a 22-yearss-old woman with MEN type 1, who was proven to have a mutation in the MENIN gene. The patient was admitted because of repeated hypoglycemia. The fasting plasma glucose level was 32mg/dL. Seventy two hours fasting test showed an the insulin/glucose ratio as 0.33. Endoscopic ultrasonography detected multiple masses on the pancreas. The arterial -stimulated venous sampling(ASVS) with calcium showed sudden step up of insulin at the head and tail portions of the pancreas. The sellar MRI showed a pituitary mass that produced prolactin. Instead of a pathologic diagnosis from operational specimen, the genetic analysis revealed a mutation in the MENIN 1 gene(exon 2, 200~201insAGCCC).

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Genetic and Epigenetic Analysis in Korean Patients with Multiple Endocrine Neoplasia Type 1
Yoon Jung Chung, Sena Hwang, Jong Ju Jeong, Sun Yong Song, Se Hoon Kim, Yumie Rhee
Endocrinology and Metabolism.2014; 29(3): 270. CrossRef
A Case of Familial Multiple Endocrine Neoplasia Type 1 with a Novel Mutation in theMEN1Gene
Min Jung Kim, Eun Hee Kim, Mi-Seon Shin, Joo Hui Kim, Hee Kyung Na, Seong Joon Park, Sang Ah Lee, Eun Hee Koh, Woo Je Lee, Ki Ho Song, Joong-Yeol Park, Ki-Up Lee, Gu-Hwan Kim, Han-Wook Yoo, Min-Seon Kim
Endocrinology and Metabolism.2011; 26(2): 171. CrossRef
Somatic Mutational Analysis of MEN1 and Phenotypic Correlation in Sporadic Parathyroid Tumors
Young Su Chae, Hee Jin Kim, Sun Wook Kim, Myung-Chul Chang
Journal of the Korean Surgical Society.2009; 76(1): 15. CrossRef
Multiple Endocrine Neoplasia Type 1 with Multiple Leiomyomas Linked to a Novel Mutation in the MEN1 Gene
Heekyoung Choi, Sehyun Kim, Jae-Hoon Moon, Yoon Hee Lee, Yumie Rhee, Eun Seok Kang, Chul Woo Ahn, Bong Soo Cha, Eun Jig Lee, Kyung Rae Kim, Hyun Chul Lee, Seon Yong Jeong, Hyun Ju Kim, Sung-Kil Lim
Yonsei Medical Journal.2008; 49(4): 655. CrossRef
A Case of Familial Multiple Endocrine Neoplasia Type 1 with MEN1 Gene Mutation
Young Eun Jo, Yong-Jun Choi, Yun Kyung Kim, Sang Mi Ahn, Sun Hye Jung, Hae Jin Kim, Dae Jung Kim, Kwan Woo Lee, Ji-Hee Hong, Seon-Yong Jeong, Hyon J Kim, Yoon-Sok Chung
Journal of Korean Endocrine Society.2007; 22(1): 68. CrossRef
A Case of Familial Multiple Endocrine Neoplasia with MEN1 Gene Mutation
Hye-Young Sung, Yeon-Joo Chun, Hyeug Lee, Bum Jun Kwon, Kun Woo Park, Jung Min Lee, Sung Dae Moon, Sang Ah Chang, Je-Ho Han
Journal of Korean Endocrine Society.2006; 21(6): 560. CrossRef

Adiponectin Gene Polymorphism and Carotid Artery Intima-Media thickness in Type 2 Diabetes.: Eun Seok Kang, So Young Park, So Hun Kim, Hyun Joo Lee, Kyu Yeon Hur, Seung Jin Han, Se Eun Park, Hyeong Jin Kim, Chul Woo Ahn, Bong Soo Cha, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee; J Korean Endocr Soc. 2005;20(1):29-39. Published online February 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.1.29

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Abstract PDF: BACKGROUND
The aim of this study was to examine the association between the common polymorphisms of the adiponectin gene(ACDC) and the intima-media thickness(IMT) of the common carotid arteries in type 2 diabetic patients. METHODS: The B mode ultrasound examination of carotid artery was performed on 133 type 2 diabetic patients. The carotid IMT was calculated using the Intimascope computer program. The SNP45 and SNP276 of the ACDC were examined. RESULTS: There was no significant difference in the carotid IMT among the SNP45 genotypes(0.66+/-0.18mm for TT, 0.71+/-0.12mm for TG and 0.64+/-0.15mm for GG, P=NS). Subjects carrying the SNP276 GG genotype had a markedly lower serum adiponectin concentration than those carrying the TT genotype(3.35+/-2.00microgram/mL vs. 4.98+/-2.24microgram/mL, P=0.029) The carotid IMT was significantly higher in patients with the SNP276 GG genotype than those with the TT genotype (0.70+/-0.17mm vs. 0.59+/-0.13mm, P=0.032). Patients with the +45GG/+276GG genotype combination showed significantly higher mean carotid IMT than the other genotype combinations(0.78+/-0.09mm vs. 0.71+/-0.15mm, P=0.013) CONCLUSIONS: These results suggest that the adiponectin gene, SNP276 is associated with the carotid IMT in type 2 diabetic patients. Further studies are will be needed to confirm these genotypephenotype associations.

A Case of Silent Corticotroph-cell Adenoma with Elevated Serum ACTH.: Jeong Geun Moon, So Young Park, Byoung Chul Cho, Jung Min Lee, Si Hoon Lee, Yoo Mee Kim, Yu Mie Rhee, Bong Soo Cha, Hyun Chul Lee, Sung Kil Lim; J Korean Endocr Soc. 2004;19(5):535-541. Published online October 1, 2004

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Abstract PDF: A 48 year-old man was referred to our Department with a headache, and also presented with an elevated serum ACTH level, but without an elevated serum cortisol. Although there was no clinical evidence of Cushing's syndrome, a brain CT and MRI showed a 4x4.5 cm sized pituitary mass, which was successfully removed by a transsphenoidal approach (TSA). A histopathological examination revealed the mass to have an ACTH positive reaction. Therefore, through hormonal and pathological evaluation, a silent corticotroph-cell adenoma (SCCA), with an elevated serum ACTH level, was diagnosed. Although reports on SCCA have been recently increased, this case is reported because these kinds of tumor are still rare, and those SCCA with an elevated serum ACTH even more so

A Case of Follicular Thyroid Carcinoma Developed in Pendred Syndrome.: So Hun Kim, Ji Young Jung, Sung Jae Shin, So Young Park, Si Hoon Lee, Yoo Mee Kim, Yu Mie Rhee, Soon Won Hong, Bong Soo Cha, Chul Woo Ahn, Kyung Rae Kim, Sung Kil Lim, Hyun Chul Lee; J Korean Endocr Soc. 2004;19(4):411-418. Published online August 1, 2004

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Abstract PDF: Pendred syndrome is an autosomal recessive genetic disorder, which is characterized by sensorineural hearing loss, goiter and a positive perchlorate discharge test. It is caused by mutations of the PDS gene, and its clinical characteristics vary widely. The thyroid function in most cases is normal, or shows only mild hypothyroidism. In Pendred syndrome, there is an organification defect that leads to defective thyroid hormone synthesis, followed by chronic TSH stimulation. Herein is reported a case of a follicular thyroid carcinoma associated with Pendred syndrome. To our knowledge, this is the first case reported in Korea. The patient presented with a huge anterior neck mass, sensorineural hearing loss and a positive perchlorate discharge test. Fine needle aspiration cytology suggested malignancy of the thyroid, and a total thyroidectomy, with central compartment node dissection, was performed. The pathology from the thyroid mass showed a poorly differentiated follicular thyroid carcinoma

A Case of Hepatomegaly due to Diabetic Glycogenosis Reversed by Glycemic Control.: Jina Park, Dae Hoon Song, Jong Suk Park, Joo Young Nam, Chul Sik Kim, Dol Mi Kim, Chul Woo Ahn, Bong Soo Cha, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Hae Ryoung Kim, Chan Il Park; J Korean Endocr Soc. 2004;19(2):223-228. Published online April 1, 2004

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Abstract PDF: Diabetes mellitus is well known to be associated with various structural and functional liver abnormalities. If diabetic patients are accompanied by hepatomegaly or abnormal findings from a liver function test, the most common pathological findings are steatosis and glycogenosis. The steatosis is characterized by deposition of macrovesicular fat droplets in the hepatocytes, which is common in obese, type 2 diabetes mellitus. If macrovesicular steatosis is combined with mixed inflammatory infiltrate, without evidence of alcoholic hepatitis, the case could be diagnosed as nonalcoholic steatohepatitis (NASH). NASH has the possibility of progressing to cirrhosis. Secondary glycogenosis is common in uncontrolled type 1 diabetes mellitus, and is completely reversible. A 22-year-old male, with uncontrolled type 1 diabetes mellitus, was admitted with anorexia, nausea and right upper quadrant pain. Hepatomegaly and elevated aminotransferases were noted. He was diagnosed as diabetic glycogenosis using computed tomogram and liver biopsy. The hepato megaly and liver function test abnormalities were markedly improved with glycemic control

A Case of Thyroid Papillary Cancer Associated with Familial Adenomatous Polyposis.: Sung Jae Shin, Hyun Joo Lee, So Hun Kim, Wan Sub Shim, Sihoon Lee, Yoo Mee Kim, Yumie Rhee, Tae Il Kim, Bong Soo Cha, Hyun Chul Lee, Sung Kil Lim; J Korean Endocr Soc. 2004;19(2):209-216. Published online April 1, 2004

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Abstract PDF: Familial adenomatous polyposis (FAP) is an autosomal dominant syndrome, typically characterized by multiple colorectal adenomas and increased incidence of colorectal carcinomas if left untreated. It is caused by germline mutations of the adenomatous polyposis coli (APC) gene, which has been mapped on chromosome 5q21, and is accompanied by various benign and malignant extracolonic manifestations. The prevalence of thyroid tumors developing in patients with FAP is about 1~2%, are associated with FAP and have certain characteristics; mean age of tumor diagnosis at less than 30 years of age, the pathology is the papillary histiotype in more than 90% of cases, including a so-called cribriform- morular pattern, and multifocality is a frequent feature. In a genetic analysis, thyroid cancer in FAP usually has a mutation in the 5-portion of exon 15 between 778 and 1309, on chromosome 5q21. Also, the ret/PTC (especially ret/PTC1 and ret/PTC3) and p53 genes are thought probably to be associated with thyroid cancer in FAP patients. A case of familial adenomatous polyposis, accompanied by thyroid papillary cancer, was experienced in a 29 year-old female. She had hundreds of adenomas throughout the entire colon and congenital hypertrophy of the retinal pigment epithelium (CHRPE). The pathological finding of thyroid cancer was revealed as a mixture of cribriform, trabecular and papillary patterns. In a genetic analysis, she and her brother had a germline mutation of the APC gene at codon 1309. In Korea, there has been no previous case of cribriform-morular pattern and familial genetic analysis in FAP associated with thyroid cancer. Therefore, this case is reported, with a review of the literature

A Case of Hypercalcemia Associated with Hepatic Tuberculosis.: So Young Park, Eun Seok Kang, So Hun Kim, Mi Young Do, Kyu Yeon Hur, Bong Soo Cha, Sung Kil Lim, Hyun Chul Lee, Sang Hoon Ahn, Young Myoung Moon, Young Nyun Park; J Korean Endocr Soc. 2004;19(1):64-68. Published online February 1, 2004

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Abstract PDF: In this report, a 70-year-old female patient was detected with laboratory findings of hypercalcemia. The most common causes of hypercalcemia are primary hyperparathyroidism and malignant disease. Her laboratory tests did not show any evidence for neither primary hyperparathyroidism nor malignant diseases. Thus, granulomatous disease was suspected as the cause of the hypercalcemia. Liver MRI (magnetic resonance image) was performed on the subject, which suggested the presence of hepatic tuberculosis and sarcoidosis. Because the chest x-ray did not show a definite tuberculous lesion, we performed a laparoscopic liver biopsy for a final diagnosis. Findings from the biopsy specimen showed typical tuberculosis. After treatment with tuberculosis medication, hypercalcemia of the subject was resolved. Hypercalcemia is a well recognized as a possible complication of active pulmonary tuberculosis. But one should consider hepatic tuberculosis without pulmonary tuberculosis as a cause of hypercalcemia.

A Case of Riedel's Thyroiditis in a Patient with a History of Subacute Thyroiditis.: Chul Sik Kim, Sung Ju Lee, Jong Suk Park, Joo Young Nam, Dol Mi Kim, Chul Woo Ahn, Bong Soo Cha, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee; J Korean Endocr Soc. 2003;18(4):414-419. Published online August 1, 2003

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Abstract PDF: Riedel's thyroiditis is a rare form of chronic thyroiditis, characterized by a fibroinflammatory process which partially destroys the thyroid, often involving surrounding tissues. The relationship of Riedel's thyroiditis to other forms of thyroiditis is not clear. A case of Riedel's thyroiditis in a 51-year-old female patient, admitted with a previous diagnosis of subacute thyroiditis, is reported. She was first diagnosed with subacute thyroiditis based on clinical manifestation and radiologic and laboratory results. She was treated with glucocorticoid for 8 weeks. The follow-up lasted for 12 months. However, three years later she underwent a thyroidectomy operation due to an enlargement of the thyroid nodule and suspicion of malignancy. Histopathologic examination confirmed that she had Riedel's Thyroiditis. Until now, few case of Riedel's thyroiditis in patients with a history of subacute thyroiditis have been reported in the literature. Although the etiology of Riedel's thyroiditis is unknown, it may develop in the course of subacute thyroiditis.

A Case of Adrenal Cortical Carcinoma with Liver Metastasis.: Hyun Joo Lee, Myung Soo Kim, Hyo Kyoung Park, Dae Jung Kim, Yu Mie Rhee, Chul Woo Ahn, Jae Hyun Nam, Bong Soo Cha, Young Duk Song, Sang Won Han, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 2003;18(2):232-238. Published online April 1, 2003

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Abstract PDF: An adrenal cortical carcinoma is a rare malignancy associated with poor prognosis. On diagnosis, most patients present with large tumor masses, which are often detected at an advanced stage. The most effective treatment is a complete resection, which is the only curative treatment for adrenal cortical carcinomas. The most important prognostic factor is a successful resection of the primary tumor, as long as it is low-grade and has not spread to distant sites. However, with advanced adrenal cortical carcinomas, with distant metastasis, there is no strict effective treatment program, and the prognosis is poor. The case of a 50-year-old female patient, presenting with an adrenal cortical carcinoma and Cushing's syndrome, who had a long-term survival of 78 months, is reported. The mass was completely resected on diagnosis, but 16 months later liver metastasis was discovered. She had received chemotherapy, with cisplatin, etoposide and bleomycin, for the liver metastasis for a period of 15 months, but with no response, furthermore, the size had increased after 10 months. Afterward, she received her 10th session of intrahepatic artery cisplatin chemotherapy and her 3rd hepatic artery embolization. Although the patient had a large degree of liver metastasis, this was tolerated. The tumor mass is presently not aggravated, and she still survives after 78 months.

Association between Serum Leptin Concentration and Bone Mineral Density in Healthy Korean Women.: Yumie Rhee, Dae Jung Kim, Se Hwa Kim, Chul Woo Ahn, Bong Soo Cha, Kyung Rae Kim, Hyun Chul Lee, Sung Kil Lim; J Korean Endocr Soc. 2003;18(2):177-183. Published online April 1, 2003

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Abstract PDF: BACKGROUND
Leptin is known to affect bone metabolism both centrally and peripherally. This study was performed to investigate the relationship between leptin and bone mineral density(BMD) in healthy premenopausal and postmenopausal Korean women. METHODS: 140 women were recruited for a routine health check-up. Anthro-pometric and biochemical data were checked as usual. BMDs were measured by dual x-ray absorptiometry of the spine and femur in 67 premenopausal women and 73 postmenopausal women, in addition to their serum leptin levels. RESULTS: Serum leptin level showed no correlation with BMD in premenopausal women, but there was a positive correlation betwen serum leptin and spinal BMD in postmenopausal women(r=0.468, p<0.001). After the correcting for age, body mass index, and duration of menopause, the serum leptin level and BMD still showed a positive correlation(r=0.217, p=0.088) although weak. The women in the lowest quartile of serum leptin level showed significantly lower lumbar and femoral neck BMD. CONCLUSION: Leptin level seems to have a weak relationship with BMD showing different features in premenopausal and postmenopausal women.

Expression of RET in Thyroid Diseases of a Korean Population.: Si Hoon Lee, Soon Won Hong, Woo Chul Moon, Myoung Ryur Oh, Jin Kyung Lee, Bong Soo Cha, Chul Woo Ahn, Kyung Rae Kim, Sung Kil Lim, Hyun Chul Lee; J Korean Endocr Soc. 2003;18(2):140-152. Published online April 1, 2003

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Abstract PDF: BACKGROUND
Activation of the RET proto-oncogene, located on the long arms of chromosome 10, contributes to the development of thyroid cancers in two different ways. Somatic rearrangements of RET with variable genes of activation are frequently found in papillary thyroid carcinomas. And Ggerm-line point mutations are responsible for the development of medullary thyroid carcinoma and the multiple endocrine neoplasia type 2(MEN2). There are several conflicting reports on the influences of RET expression and RET/PTC rearrangements on the clinical outcome of thyroid cancer. Therefore, we performed an examination of RET expression and RET/PTC-1, -2, -3 rearrangements in papillary thyroid carcinomas and other thyroid diseases. METHODS: Twenty-six papillary thyroid carcinomas(PTCs), three follicular thyroid carcinomas (FTCs), one anaplastic thyroid carcinoma(ATC), five follicular adenomas(FAs), nineteen hyperplasias, and two normal thyroid tissues were included in this study. RT-PCR and immunohistochemistry analysis were done to identify RET gene, RET/PTC rearrangements, and ret RET protein expression. RESULTS: By RT-PCR, 89.4% of PTCs, 100% of FTCs, and 62.1% of hyperplasias expressed the RET gene, but no RET was observed in ATCs, FAs, and normal thyroid tissues. RET/PTC-1, -2,-3 rearrangements were not detected in any specimens. Immunohistochemical results revealed that 76.9% of PTCs, 50% of FAs, 52.3% of hyperplasias, and 20.6% of normal thyroid tissues expressed the RET ret protein, but FTCs and ATCs did not. Most PTCs showed strong cytoplasmic positivity in RET ret immunostaining, but the positive non- PTCs expressed weak and membranous staining. Overall, the two methods for detecting RET gene, RT-PCR and immunohistochemistry showed similar results. CONCLUSION: The RET gene was highly expressed in PTCs. In contrast to the previous reports of that theRET gene expression of RET gene is being limited to PTCs, RET was also expressed in hyperplasias, Fas, and normal thyroid tissues. However, the pattern and the degree of expression of the RET ret protein in non- PTCs were are different from those in PTCs.

A Case of AVP Dependent Bilateral Macronodular Adrenal Hyperplasia.: Hyun Jin Kim, Se Hwa Kim, Yu Mie Rhee, Sung Eun Kim, Chul Woo Ahn, Bong Soo Cha, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh, Sung Kil Lim; J Korean Endocr Soc. 2002;17(4):603-609. Published online August 1, 2002

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Abstract PDF: Adrenocorticotropin (ACTH) independent bilateral macronodular adrenal hyperplasia (AIMAH) is a rare form of Cushing's syndrome, in which unique endocrinological, clinical and histopathological features have been described. In AIMAH, cortisol secretion is autonomous and independent of ACTH, thus plasma ACTH levels are persistently suppressed. Various etiological mechanisms have been proposed to explain the development of AIMAH, the development of aberrant adrenal sensitivity to gastric inhibitory polypeptide (GIP), vasopressin, beta-adrenergic receptor agonists or the presence of circulating adrenal stimulating immunoglobulins have been suggested. We report on a 46-year-old female who had Cushing's syndrome, due to AIMAH, with a positive response to vasopressin.

A Case of Bilateral Macronodular Adrenal Hyperplasia with Cushing's Syndrome Treated by Unilateral Adrenalectomy.: Si Hoon Lee, Kwang Eun Lee, Eun Seok Kang, Sang Su Chung, Dae Jung Kim, Yun Mi Jin, Bong Soo Cha, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 2002;17(4):596-602. Published online August 1, 2002

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Abstract PDF: In order to differentiate the causes of Cushing's syndrome; whether it is pituitary or adrenal-dependent, a high dose dexamethasone suppression test is usually performed but this does not always correlated with the imaging diagnosis. We report a case of bilateral macronodular adrenal hyperplasia, which was thought to be independent to adrenocorticotrophin (ACTH) stimulation. At first we thought it was pituitary-dependent Cushing's syndrome, due to its suppression by high dose dexamethasone. However, we found no abnormal findings on the brain sella magnetic resonance image (MRI). A significant finding, however, we found bilateral adrenal masses on the abdominal computed tomography (CT). We performed percutaneous selective adrenal venous sampling (PSAVS), and confirmed hypercortisolism of the left adrenal mass only. Therefore, we decided to remove the left adrenal gland to preserve the residual function of the right adrenal gland. After the left adrenalectomy, the patient became normotensive, and their buffalo hump disappeared, and her 24 hour urinary free cortisol level returned to normal.

A Case of Klinefelter's Syndrome with Rathke's Cleft Cyst.: Hyun Joo Lee, Hyo Kyoung Park, Dae Jung Kim, Yu Mie Rhee, Chul Woo Ahn, Sang Soo Jung, Jae Hyun Nam, Bong Soo Cha, Young Duk Song, Sung Kil Lim, Kyung Rae Kim, Yong Koo Park, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 2002;17(4):564-571. Published online August 1, 2002

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Abstract PDF: Klinefelter's syndrome is one of the most common forms of primary hypogonadism presenting with gynecomastia, azospermia and increased follicle-stimulating hormone. It is well known that this syndrome has an increased incidence of neoplasia, especially breast cancer and extragonadal germ cell tumors. However, it is rarely associated with an intracranial tumor of maldevelopmental origin, especially in the suprasellar area. We report, for the first time, a case of Klinefelter's syndrome, with a Rathke's cleft cyst is the patient was a 32-year-old male who was known to have an incidentaloma form brain computed tomography, which was clinically diagnosed as a suprasellar tumor. After operating, the suprasellar mass was confirmed as a Rathke's cleft cyst, and his hormonal abnormality, an elevated level of follicle-stimulating hormone, was not normalized. Therefore, we performed chromosomal analysis, and diagnosed Klinefelter's syndrome with the XXY karyotype.

Effects of Tibolone and Active Vitamin D Combined Treatment on Bone Mineral Density in Korean Postmenopausal Women.: Se Hwa Kim, Yu Mie Rhee, Soo Kyung Kim, Dae Jung Kim, Hyeung Jin Kim, Chul Woo Ahn, Bong Soo Cha, Young Duk Song, Kyung Rae Kim, Hyun Chul Lee, Gap Bum Huh, Sung Kil Lim; J Korean Endocr Soc. 2002;17(4):535-543. Published online August 1, 2002

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Abstract PDF: BACKGROUND
Tibolone is a novel synthetic compound with tissue-specific effects in bone, breast tissue and the endometrium. Tibolone, and active vitamin D, effectively prevent bone loss, and the maintain skeletal integrity of postmenopausal women. The aim of the present study was to examine the effect of tibolone, and active vitamin D (1-hydroxyvitamin D3), therapies given alone, or in combination, against bone loss in postmenopausal women. METHODS: One hundred and three postmenopausal women were treated with tibolone (n=40), alphacalcidol (n=27) or both drugs (n=36) for 12 months. All subjects took supplemental calcium carbonate (500 mg daily). The bone mineral densities (BMD) of the lumbar spine and proximal femur were measured by dual-energy x-ray absorptiometry (DXA) at the baseline and after 12 months. RESULTS: Tibolone therapy produced significant increase of 4.1 and 1.8% in the BMD at the lumbar spine (p<0.001) and femoral neck (p=0.009), respectively. The combination of tibolone and active vitamin D increased the BMD by 8.0 and 4.4% (p<0.001) at the spine and femoral neck, respectively. The differences in the change of BMD from the baseline at the lumbar spine was significant (p=0.038) in the combination treatment group compared that in the tibolone alone group. CONCLUSION: Tibolone alone, and in combination with active vitamin D, effectively increased the BMD at all skeletal sites in postmenopausal women. Combination treatment for osteoporosis is emerging as a promising modality in Korean postmenopausal women.

Neonatal Tetany Caused by Hyperparathyroidism Undetected During Pregnancy.: Wan Sub Shim, Hee Baek Park, Bong Soo Cha, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 2002;17(2):257-262. Published online April 1, 2002

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Abstract PDF: Primary hyperparathyroidism is rarely encountered during pregnancy but its prompt diagnosis and treatment if encountered during pregnancy is important because it can carry considerable morbidity not only for the mother but also for the fetus. It tends to remain undiagnosed because 50~80% of the patients are asymptomatic. Even if they do demonstrate symptoms, those are often nonspecific. The other reason for non-diagnosis is masking of hypercalcemia due to the change of calcium homeostasis during pregnancy. Neonatal tetany can be a clue for the presence and diagnosis maternal hyperparathyroidism. The asymptomatic patient who is diagnosed postpartum when her newborn is symptomatic should undergo elective parathyroidectomy to avoid future complication. We experienced a woman with undiagnosed primary hyperparathyroidism during pregnancy whose two children suffered neonatal tetany. We report this case along with a review of literature on primary hyperparathyroidism in pregnancy and calcium homeostasis during pregnancy.

A Case of Panhypopituitarism Due to Craniopharyngioma with Slipped Capitalis Femoral Epiphysis.: Jun Hee Lee, Kyung Rae Kim, Hi Yan Park, Jin Yang Ju, Young Duk Chae, Soo Jee Yoon, Ki Joong Kim, Woo Il Park, Bong Soo Cha, Young Duk Song, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 2002;17(1):104-109. Published online February 1, 2002

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Abstract PDF: Craniopharyngioma accounts for 3% to 5% of intracranial tumors and is the second most common neoplasm in the sellar region. Panhypopituitarism associated with craniopharyngioma has been reported in 7% of all patients with craniopharyngioma. Slipped capital femoral epiphysis is the condition in which the femoral head slips downward and backward on the femoral neck at the epiphyseal plate due to growth disturbance of capital physis, the actual cause of which is unknown. It is a disease of adolescence, during which many physiologic hormonal changes occur. The clinical association between slipped capital femoral epiphysis and endocrine disease is well known. There have been four cases of slipped capital femoral epiphysis associated with endocrine disorders in Korea. This is the first Korean case report of slipped capital femoral epiphysis combined with craniopharyngioma caused by hypopituitarism

A Case of Insulinoma Combined with Pheochromocytoma.: Si Hoon Lee, Young Hoon Youn, Sung Kil Lim, Bong Soo Cha, Hyun Chul Lee, Tae Woong Noh, Kap Bum Huh; J Korean Endocr Soc. 2000;15(4-5):640-647. Published online January 1, 2001

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Abstract PDF: Multiple endocrine neoplasia (MEN) is a combination of endocrine tumor associations and consists of 3 types: 1, 2A and 2B. Herein, we report a case of insulinoma which is combined with pheochromocytoma discovered at the left adrenal gland which was treated by surgical resection. We think there is a possibility of a new type of multiple endocrine neoplasia (MEN).

Serum Immunoreactive-Leptin Concentrations and its Relation to Adiposity and Other biochemical Parameters in Korean Males.: Sung Kil Lim, Bong Soo Cha, Young Duk Song, Hyun Chul Lee, Kap Bum Huh, Eun Sook Kim, Sang Kyu Na, Jae Ho Shin, Kyung Rae Kim, Soo Yeon Nam; J Korean Endocr Soc. 1998;13(2):216-223. Published online January 1, 2001

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Abstract PDF: 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.

A Case of Carney Complex.: Sung Kil Lim, Bong Soo Cha, Young Duk Song, Hyun Chul Lee, Kap Bum Huh, Kyung Rae Kim, Young Joon Won, Suk Ho Kwon, Ru Tha Lee, Bo Young Chung, Kwang Kil Lee; J Korean Endocr Soc. 1997;12(4):633-641. Published online January 1, 2001

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Abstract PDF: Carney Complex is an autosomal dominant syndrome characterized by multiple neoplasias, including myxomas at various sites and endocrine tumors, spotty pigmentations and schwannomas. The criteria for diagnosis of the complex is the presence of two or more of the following conditions: 1) cardiac myxoma, 2) cutaneous myxoma, 3) mammary myxoma, 4) spotty mucocutaneous pigmentation, 5) primary pigmented nodular adrenal cortical disease (Cushing's syndrome), 6) testicular tumors (sexual precocity), 7) pituitary adenoma secreting growth hormone (acromegaly or gigantism). It is thought that the genetic defects which are responsible for Carney complex maps to the short arm of chromosome 2 (2p16). There are about 200 patients with Carney complex reported in the world. We encounted a patient who had a cardiac myxoma with a family history of cardiac myxoma, acromegaly, lentigosis, testicular mass with calcification and left adrenal nodule. This patient met the criteria for the diagnosis of the complex. Therefore, we think this patient represents clinical presentation of the Carney complex and we report this case with reviews of the literatures.

The Benificial Effects of Growth Hormone Therapy with Diet Restriction in Obese Adults.: Sung Kil Lim, Bong Soo Cha, Young Duk Song, Hyun Chul Lee, Kap Bum Huh, Eun Sook Kim, Jae Ho Shin, Kyung Rae Kim, Soo Yeon Nam; J Korean Endocr Soc. 1997;12(4):571-583. Published online January 1, 2001

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Abstract PDF: 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.

A Study About Correlation Between Urinary Androgen Metabolites and Bone Mineral Density in Psstmenopausal Women.: Kyoung Rae Kim, Ji Hyun Lee, Sung Kil Lim, Young Jun Won, Seok Ho Kwon, Bong Soo Cha, Young Duk Song, Hyun Chul Lee, Kap Bum Huh, Su Youn Nam, Bong Chul Jung; J Korean Endocr Soc. 1997;12(3):450-461. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Positive correlations between bone mass and androgen levels have been observed in premenopausal and postmenopausal women as well as in men. Androgen production was decreased in women with osteoporosis compared to that in age-matched controls. We hypothesized that androgen metabolism might be also deranged in osteoporosis. To clarify our hypothesis, we investigated the relationship between urinary metabolites of androgen and bone mineral density (BMD) in Korean postmenopausal osteoporotics. METHODS: We examined the anthropometry and bone turnover marker in 67 postmenopausal women. BMD was measured by dual energy X-ray absorptiometry (DEXA). Serurn levels of estrone, estradiol, free testosterone were measured by radioirnmunoassay and serum level of sex hormone binding globulin (SHBG) was measured by two site immunoradiometric assay. The urinary metabolites of androgen were determined by gas chromatography-mass spectrometry (GC-MS) at Korean Institute of Science and Technology Doping Control Center. RESULTS: 1. Spinal BMD had a positive correlation with height (r 0.3049, p<0.05), weight (r=0.4114, p<0.001) and body mass index (BMI, r=0.2638, p<0,05). 2. Spinal and femoral neck BMD had no correlation with serum levels of estrone, estradiol and ten major urinary metabolites of androgen, but serum free testosterone had positive correlation with spinal BMD (r=0.3622, p<0.01) and SHBG had negative correlation with femoral neck BMD (r=-0.2625, p< (0.05). 3. Serum free testosterone in osteoporotics was lower than non-osteoporotics with spinal BMD (p<0.05) and SHBG in patients with osteopenia was higher than non-osteopenic subjects with femoral neck BMD (p <0.05). 4. In multiple stepwise regression analysis, weight and serum free testosterone were statistically significant for spinal BMD (R =0.3072). As for femoral neck BMD, weight was the independent determinant (R 0.1307). 5. Serum level of osteo#ealcin and urinary deoxypyridinoline/creatinine had a positive correlation with urinary 11-ketoandrosterone (p<0.05). SHBG was positive correlation with osteocalcin (r=0.3190, p<0.05). 6. Serum free testosterone (r=-0.2740, p<0.05) decreased with aging. CONCLUSION: Our data suggest that androgen metabolism is not deranged in osteoporotics, but serum free testosterone is important than estrogen on postmenopausal osteoporosis after 5-10 years menopause.

Clinical Features of Pityitary Hyperplasia.: Kyoung Rae Kim, Sung Kil Lim, Young Jun Won, Seok Ho Kwon, Bong Soo Cha, Young Duk Song, Hyun Chul Lee, Kap Bum Huh, Bo Young Choung, Su Yeun Nam, Sun Ho Kim, Tse Sung Kim, Jae Hwa Um; J Korean Endocr Soc. 1997;12(2):155-164. Published online January 1, 2001

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Abstract PDF: BACKGROUND
S: Pituitary hyperplasia can mimic pituitary adenoma. In MRI, enlarged pituitary gland is enhanced homogenously with upward convexity of the superior margin of the gland .The best definition of hyperplasia in the pituitary hyperplasia seems to be a multiplication of one or more cell types. But definition, etiology and clinical courses of this disease are not clear, METHOD: We reviewed clinical symptoms, MRI, and pathologic findindings in 6 patients with pituitary hyperplasia. RESULT: 1. Major clinical symptoms were headache (100%), visual field defect (84%), polyuria/polydipsia (64%), and irregular mensturation (32%). Other symptoms were amenorrhea (16%) and galactorrhea (16%). 2. Three of five cases showed abnormal responses to combined pituitary function test, 3. MRI findings were pituitary hyperplasia (4), macroadenoma (l), and microadenoma (1). 4. In two operated cases, there was no adenoma. One case showed hyperplasia of lactotroph cells, the other was hyperplasia of gonadotroph cells confirmed by the examination of immunocytochemistry. CONCLUSION: Pituitary hyperplasia should be considered in patients with enlarged pituitary gland without focal mass lesion.

Estrogen Receptor Gene Polymorphism, Urinary Estrogen Metabolites and Bone Mineral Density in Korean Postmenopausal Women.: Ji Hyun Lee, Sung Kil Lim, Young Jun Won, Seok Ho Kwon, Bong Soo Cha, Young Duk Song, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 1996;11(4):468-478. Published online November 7, 2019

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Abstract PDF: Background
Estrogen status is important for maintaining the homeostasis of bone. Estrogen has direct effects on bone cells, through binding to the high-affinity estrogen receptor. Several recent studies suggest that there might be genetically determined variations in biosynthesis and function of estrogen receptor in postmenopausal osteoporosis. Also the main cause of postmenopausal osteoporosis is decreased level of serum estrogen, whereas there had been some suggestion that the remaining estrogen have some effect on bone metabolism after menopause. We investigated the relationship between estrogen receptor gene PvulI polymorphism and bone mineral density(BMD), and the relationship between 18 urinary metabolites of estrogen and BMD in Korean postmeno- pausal osteoporosis. Methods: We examined the PvuII polymorphism of the estrogen receptor gene in 5' upstream region and the first intron by restrietion frapnent length polymorphism analysis in 62 postmeno- pausal wornen, BMD was measured by DEXA. The urinary estrogen metabolites were determined by GC/MS(Gas Chromatography-Mass Spectrometry) at Korean Institute of Science and Techno- logy Doping Control Center. Results: BMD of the spine and the femoral neck correlated with body weight, height, body mass index as we expected. There was no polymorphism of PvuII restriction site on 5 upstream region of estrogen receptor gene. Whereas the prevalen~ee of the PP, Pp, pp genotype in the first intron of estrogen receptor was 12.9%, 45.2%, 41.9%, respectively. But, there was no correlation between PvuII genotype and the spinel and femoral neck BMD. 2(OH)E2 among 18 urinary metabolites of estrogen, showed a negative correlation with the spinal and femoral neck BMD(r =-0.2551, p<0.05, and r =-0.3341, p<0.01, respectively), and the ratio of 16a(OH)E2/2(OH)E1> revealed a positive correlation with the spinal BMD(r =0.3057, p<0.05). In stepwise multiple regression analysis, body weight, 2(OH)E2, 16a(OH)E1, 2(Meo)E1 were independent predictors of the spinal bone density, and body weight and 2(OH)E2 were independent predictors of the femoral neck bone density. Conclusion: These results suggested that restrietion fragment length polymorphism analysis of the estrogen receptor gene with PvuII restriction enzyme was not helpful for early detection of patients at risk of developing osteoporosis. However, the ratio of 16-hydroxylation to 2-hydroxylation of estrogen metabolism was reduced in postmenopausal women and high catecholestrogen formation might be a greater risk factor for osteoporosis.

A Case of Giant Adrenal Adenoma Presenting Primary Aldosteronism.: Ji Hyun Lee, Bong Soo Cha, Moon Suk Nam, Young Duk Song, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh, Hyung Chan Suh, Young Hwa Choi, Jae Min Park, Jung Soo Park, Soon Won Hong, Dong Hwan Shin; J Korean Endocr Soc. 1996;11(3):348-354. Published online November 7, 2019

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Abstract PDF: Primary aldosteronism is a syndrome chracterized by hypokalemic alkalosis and hypertension. Small sized adrenal cortical adenomas have been the major cause of this syndrome in most of the patients. However, if the adrenal mass is larger than 6cm in diameter and with irregular consistency, malignancy is more favored. We experienced a patient who had a giant adrenal adenoma with primary aldosteronism. A 24-year-old female presented with hypertension, hypokalemia, low plasma renin, and high plasrna aldosterone levels, was found to have a 6×5.5×5 cm sized left adrenal tumor by MRI. Her clinical laboratory feature did not revealed any evidence of Cushing's syndrome or pheochromocytoma. Preoperatively adrenal carcinoma presenting pure adrenal aldosteronism was suspected due to large size and heterogenous signal character of the adrenal mass in radiologic study. At operation well encapsulated, round giant adrenal tumor weighing 65gm(4.5×4×4 cm) was removed. There was no evidence of metastasis with return of adrenal function to normal after surgery. Benign adrenal adenoma was confirmed by the gross morphology and the histologic features.

Clinical and Sellar MR Findings in Central Diabets Inspidus.: Bong Soo Cha, Young Duk Song, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh, Su Youn Nam, Eun Jig Lee, Sei Chang Oh, Byung Hee Lee, Dong Ik Kim; J Korean Endocr Soc. 1996;11(3):285-292. Published online November 7, 2019

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Abstract PDF: Background
s: Diabetes insipidus(DI) is a clinical syndrome characterized by excretion of copious volumes of dilute urine combined with persistent intake of abnormally large quantities of fluid. Central DI, caused by lack of antidiuretic hormone(ADH), most often results from lesions in the hypothalamic-neurohypophyseal axis. Magnetic resonance(MR) imaging is particularly useful in documenting the presence of a structural lesion, as opposed to assigning a diagnosis of idiopathic DI for which only symptomatic therapy is prescribed. Recently, several reports have described a specific MR finding in central DI, that is absence of normal posterior pituitary bright spot(PPBS). Methods: We retrospectivesly studied the clinical and MR findings in 25 patients with central DI, diagnosed by warter deprivation test. Results: 1) The subjects included 17 males and 8 females, between the ages of 2 and 58 years. 2) 24-hour urine volumes were 2,340~13,750 mL, and mean urine osmolarity was 147.7±65.8 mOsm/kg. The 23 subjects diagnosed complete central DI by warter deprivation test. 3) We found that the most common cause of cntral DI was infiltrative lesions of hypothalmic-neurohypophyseal axis(60%). Germ cell tumor was the single leading cause in present study, accounting for 36% of cases. The other causes were found, including pituitary apoplexy, meningitis, and trauma. Idiopathic central DI accounted for 20% of all cases. 4) Growth hormone deficiency was the most common accompanying anterior pituitary deficit, and panhypopituitarism was found in 7 cases, Hyperprolactinernia was seen in 6 cases. 5) In all patients, PPBS on Tl weighted MR images were not observed. A thickened pituitary stalk was seen in 15 cases(9 patients with germ cell tumor, 3 patients with histiocytosis X, 1 patient with tuberculosis, 2 patients with unknown origin). Conclusion: In our results, the most common causes of central DI was suprasellar infiltrative lesions. MR is currently the imaging methods of choice in the evaulation of dysfunction of the hypothalamic-neurohypophyseal system in patients with central DI. A specific MR finding, that is loss of normal PPBS allows a confirmative diagnosis of central DI.

Reduction of Central Dopamine Release in Hyperprolactinemia.: Bong Soo Cha, Young Duk Song, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh, Su Youn Nam, Eun Jig Lee, Bong Chul Chung, Jung Han Kim, Sei Chang Oh; J Korean Endocr Soc. 1996;11(3):277-284. Published online November 7, 2019

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Abstract PDF: Background
Prolactin(PRL) secretion is tonically inhibited by doparnine that originates from the hypothalamic tuberoinfundibular tract and reaches the lactotroph via the hypophyseal portal vessel. Hyperprolactinemia associated with oligomenorrhea-amenorrhea, galactorrhea and/or infertility is mainly due to PRL-secreting pituitary adenoma(PA). The diagnosis of idiopathic hyperprolac- tinemia(IHP) is made, when hyperprolactinemia is sustained and all causes of hyperprolactinemia are excluded without radiological abnormality. It is not known, whether IHP and PA are two distinct entities or two subsequent phases of the same disease. The etiology of both disorders remains unresolved. We investigated that PRL hypersecretion in patients with IHP and PA may be the result of a defect in the central nervous system(CNS)-dopamine release, and that there may be some differences in pathogenesis of both diseases. Methods: We measured 24 hour-urinary dopamine, norepinephrine, epinephrine, and serum and 24 hour-urinary VMA(vanillyl rnandelic acid), HVA(homovanilic acid), DOPAC(3,4-dihydroxy phenylaceticacid), MHPG(3-methoxy 4-hydroxy phenylglycol) in 10 normal controls, 9 patients with IHP, and 17 patients with PA in the early follicular phase. Results: Urinary HVA and DOPAC concentrations, the major metabolites of CNS dopaminergic activity, were signficantly lower in both patients with IHP and PA compared with those in normal controls(p 0.05), whereas they were not different in both disease groups. Dopamine, norepine-phrine, epinephrine, MHPG concentrations were similar to those of the normal controls. Although VMA concentrations of both disease groups were significantly higher than those of normal controls, all of them were within normal range. Conelusion: Although our data are unable to establish the precise biochemical defect responsible for central dopamine deficiency in pathogensis of IHP and PA, we can support the presence of a pathological reduction of brain dopamine activity in IHP and PA.

A Case of Adult Fanconi Syndrome with Hypophosphatemic Osteomalacia.: Ji Hyun Lee, Young Sup Byun, Bong Soo Cha, Moon Suk Nam, Young Duk Song, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh, Jin Kim, Jong In Yook; J Korean Endocr Soc. 1996;11(1):93-101. Published online November 7, 2019

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Abstract PDF: The Fanconi syndrome is characterized by generalized disturbance of tubular function. It leads to excessive losses of amino acids, glucose, phosphate, bicarbonate, and other organic and inorganic substrates handled by the proximal tubules. The metabolic consequences are acidosis, hypophosphatemia, hypocalemia, dehydration, rickets, osteomalacia, osteoporosis, and growth retardation. This syndrome may either be congenital or acquired, primary or secondary. Acquired Fanconi syndrome may result from multiple myeloma, Wilsons disease, primary amyloidosis, light chain nephropathy, and heavy metal poisoning such as lead, mercury, and cadmium. A 33-year-old female presented with multiple bone pain, and progressive proximal muscle weakness for 15 months. The blood urea nitrogen, creatinine, calcium, phosphate, and uric acid were 12.1 mg/dL, 1.5 mg/dL, 8.4 mg/dL, 1.8 mg/dL, and 1.7 mg/dL, respectively. The urine volume, protein, calcium, phosphate, and creatinine clearance were 2,330 ml, 343.7 mg, 146 mg, 424 mg, and 44.6 ml/min, respectively in 24 hour collection urine study. The tubular reabsorption rate of phosphate was decreased. In arterial blood gas analysis study, pH was 7.348, bicarbonate was 17.6 mmol/L, which means metabolic acidosis. In chest X-ray, fracture was seen in eighth and ninth left ribs. The whole body bone scan revealed hot uptake at both first and second ribs, right third rib, both eighth and ninth ribs, left sacroiliac joint and right hip joint. Bone densitometry showed moderate osteopenia in spine and femur neck. After NE4Cl loading, the urine pH was decreased below 5.0 at two and third hour, which means proximal renal tubular acidosis. Amino acid such as, hydroxyproline, threonine, serine, asparagine, glutamine excreted much more than normal in 24 hour urine. Bone biopsy showed the presence of increased osteoid volume and osteoid seam width and marked decreased mineral appositional rate as evidence for osteomalacia. The patients symptoms, including bone pain and proximal muscle weakness, were relieved after supplement of calcitonin, Vitamin D and calcium carbonate. We report a case of Fanconi syndrome with hypophosphatemic osteomalacia with brief review of literature.

Clinical and Endocrinologic Differences between Prolactinoma and Pseudoprolactinoma Proven by Immunohistochemical Study.: Jae Wha Jo, Eun Jig Lee, Moon Suk Nam, Su Youn Nam, Young Duk Song, Hyun Chul Lee, Kap Bum Huh, Tae Seung Kim, Sun Ho Kim, Kyung Rae Kim, Bong Soo Cha, Ji Hyun Lee, Sung Kil Lim; J Korean Endocr Soc. 1995;10(4):362-369. Published online November 7, 2019

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Abstract PDF: Hyperprolactinemia is the most common hypothalamo-pituitary disorder encountered in clinical endocrinology. Excluding the drug-induced hyperprolactinemia, the most common cause of this disorder is a pituitary tumor. Prolactinoma is mainly made up of prolactin-secreting cells but pseudoprolactinoma is tumor that does not secrete prolactin itself. The pseudoprolactinoma interrupts the flow of prolactin inhibiting factor, dopamine, from the hypothalamus through the pituitary stalk to the normal pituitary. The differentiation prolactinoma from pseudoprolactinoma is vitally important since true prolactinomas are most commonly responded well in terms of tumor shrinkage to medical treatment using dopamine agonist therapy, whereas pseudoprolactinomas do not. Thus surgical treatment is clearly indicated as first-line treatment if we know that a lesion is a pseudoprolactinoma. We compared prolactinoma with pseudoprolactinoma in clinical and endocrinologic characteristics of 48 cases after immunohistochemical diagnosis. We could not find any differential point of both tumors in clinical and radiological characteristics although some differences were exist. But we had found the relationship between the mean level of pretreatment serum prolactin and the presence of positive immunohistochemical stain for prolactin. The pretreatment serum prolactin level was significantly higher in patients with tumors showing many prolactin immunohistochemical staining cells than in those with none(p<0.05). When the pretreatment serum prolactin exceeded 100ng/ml, the tumors contain 94% of prolactin positive cells in stain. So, if the pretreatment serum prolactin exceeds 100ng/ml, we primarily suspect prolactinoma and medical treatment should be considered. If the pretreatment level below 100ng/ml, we suspect pseudoprolactinoma and surgical treatment should be considered.

A Case of Giant Cell Granuloma of The Pituitary Gland.: Eun Jig Lee, Young Duk Song, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh, Tae Seung Kim, Sun Ho Kim, Bong Soo Cha, Dong Hun Choi, Jeong Il Jeong; J Korean Endocr Soc. 1994;10(3):284-288. Published online November 6, 2019

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Abstract PDF: Granulomatous disease of the pituitary gland are uncommon disorders which are rarely diagnosed in patients presenting for hypophysectomy. The majority of reported cases come from neuropsy material and include infectious and systemic disease such as tuberculosis, sarcoidosis, syphilis and fungal infections. We experienced giant cell granuloma of the pituitary gland in a 47 years-old woman. The patient suffered from headache, polyuria and polydipsia. MR images of brain demonstrated a hyposignaled mass. The fibrous tissues were removed by transsphenoidal approach. The clinical and histopathological features of this rare entity are reviewed.

A Case of Idiopathic Juvenile Osteoporosis.: Moon Suk Nam, Young Duk Song, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh, Young Joon Weon, Bong Soo Cha, Ji Hyun Lee, Jung Ho Lee; J Korean Endocr Soc. 1994;10(3):278-283. Published online November 6, 2019

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Abstract PDF: Idiopathic juvenile osteoporosis is a rare disease of heterogenous etiology and occurs on children between the age of 8 and 15. Manifestations include bone pain, fractures in minimal trauma, reduced bone density at areas of new bone growth, and loss of height. It is important to exclude other causes of osteoporosis.We experienced a case of a 14 year old boy with idiopathic juvenile osteoporosis. He had suffered from pain in the back and difficulty on walking for two months. Radiologic finding of the thoracolumbar area of the spine showed generalized severe osteoporosis and multiple vertebral collapse. We could not find the causes of osteoporosis in biochemical study, bone marrow study, skin biopsy and hormonal study. He was treated with alphacalcidol and CaCO_3. After 4 month of initial management, his subjective symtoms were improved and we did not find any signs of progression of disease. On bone mineral density measured after 26 month, we observed markedly increased bone mineral density.We report our experience of follow up of this case and review with the disease reported in the literature.

Complication and Prognosis of Craniopharyngioma According to the Age of Onset.: Eun Jig Lee, Moon Suk Nam, Young Duk Song, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh, Kyung Rae Kim, Kun Hoon Song, Bong Soo Cha, Ji Hyun Lee; J Korean Endocr Soc. 1994;10(3):262-272. Published online November 6, 2019

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Abstract PDF: Craniopharyngioma is the most common tumor involving the hypothalamo-pituitary area in childhood and adolescence. Recently, we carried out collective review of 70 patients with craniopharyngioma treated from January 1980 to December 1994 in order to inverstigate the endocrine outcome and survival according to the age of onset.The following results were obtained:1) The male to female ratio was 1:1. Age at diagnosis ranged from 2 to 64 years(mean age: 23) with the greatest frequency in the 2nd decade of life(28.6%). Of the 70 cases, the first group, 27 cases were under the age of 15, and the other group, 43 cases were over 15 year-old.2) The most common symptom at diagnosis in both groups was headache. In the adult group, symptoms related to hypogonadism(amenorrhea, decreased libido, galactorrhea etc.) were not uncommon. The lag of time between onset of symptom and hospital visit ranged from 3 days to 156 months(mean: 20 months).3) The main site of tumor was suprasellar region in both groups. The most common CT finding in both groups was calcification in sella turcica.4) In pre-operative combined pituitary function test, the most common, abnormal responses were shown in growth hormone and thyroid stimulating hormone in both groups. In addition, prolactin frequently showed abnormal response in the adult group.In post-operative combined pituitary function test, more hormones tended to reveal abnormal response in the group treated with surgery plus radiation therapy.5) The operation by subtotal removal followed by radiation therapy was the most commonly used method in treatment of both groups. After treatment, panhypopituitarism was occurred more frequently in the group treated with RT after surgery than those treated with surgery alone, but the difference was not statistically significant(p=0.136 in childhood, 0.436 in adults). Except the cases with panhypopituitarism, the most commonly encountered endocrine abnormalities were growth retardation in the children group, and hypogonadism in adult. The recurrence was clinically observed in 11 cases. The recurrence rate were 11.1% in children, and 18.6% in adult respectively. The mean time from the initial treatment to recurrence was 23 months. There was no significant difference in recurrence rate between the group treated with RT after subtotal removal and the group treated with total removal(p=0.475).The overall five-year survival rate after treatment was 82.8%. According to the treatment modalities, the patients undergone RT after subtotal removal survived much longer than those treated with other modalities such as subtotal removal only or total removal, but the differences in survival were not statistically significant(Log rank test, p=0.0539).

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