Endocrinology and Metabolism

Dong Seop Choi (Choi DS)

36 Articles

Primary Hyperparathyroidism with Extensive Brown Tumors and Multiple Fractures in a 20-Year-Old Woman: Ju Hee Choi, Kyoung Jin Kim, Ye Jin Lee, Sun Hwa Kim, Sin Gon Kim, Kwang Yoon Jung, Dong Seop Choi, Nam Hoon Kim; Endocrinol Metab. 2015;30(4):614-619. Published online December 31, 2015; DOI: https://doi.org/10.3803/EnM.2015.30.4.614

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A brown tumor is a benign fibrotic, erosive bony lesion caused by localized, rapid osteoclastic turnover, resulting from hyperparathyroidism. Although brown tumors are one of the most pathognomonic signs of primary hyperparathyroidism, they are rarely seen in clinical practice. In this report, we present a case of 20-year-old woman with recurrent fractures and bone pain. Plain digital radiographs of the affected bones revealed multiple erosive bone tumors, which were finally diagnosed as brown tumors associated with primary hyperparathyroidism due to a parathyroid adenoma. This case shows that multiple, and clinically severe form of brown tumors can even occur in young patients.

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Brown tumor of the knee as the first presentation of primary hyperparathyroidism caused by parathyroid adenoma: A case report
Vaishnavi C Tapadia, Romana Riyaz, Abhigan Babu Shrestha, Javeed Akhtar Ankolvi
Radiology Case Reports.2023; 18(5): 1852. CrossRef
Brown tumors in nuclear medicine: a systematic review
Nicolas Jacquet-Francillon, Nathalie Prevot
Annals of Nuclear Medicine.2023; 37(5): 255. CrossRef
Misdiagnosis of brown tumour caused by primary hyperparathyroidism: a case report with literature review
Yanchun Zhong, Yuxi Huang, Jiaquan Luo, Yongjun Ye
BMC Endocrine Disorders.2022;[Epub] CrossRef
Gnathic Bones and Hyperparathyroidism: A Review on the Metabolic Bony Changes Affecting the Mandible and Maxilla in case of Hyperparathyroidism
Hazim Mahmoud Ibrahem
Advances in Medicine.2020; 2020: 1. CrossRef

Thyroid
A Rare Manifestation of Hypothyroid Myopathy: Hoffmann's Syndrome: Kang Won Lee, Sun Hwa Kim, Kyoung Jin Kim, Sang Hyun Kim, Hee Young Kim, Byung-Jo Kim, Sin Gon Kim, Dong Seop Choi; Endocrinol Metab. 2015;30(4):626-630. Published online December 31, 2015; DOI: https://doi.org/10.3803/EnM.2015.30.4.626

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Hypothyroid myopathy is observed frequently and the resolution of the clinical manifestations of myopathy following thyroid hormone replacement is well known. However, a specific subtype of hypothyroid myopathy, Hoffmann's syndrome, characterized by increased muscular mass (pseudohypertrophy), proximal muscle weakness, muscle stiffness and cramps, is rarely reported. Herein, we describe a 34-year-old male who presented with proximal muscle weakness and non-pitting edema of the lower extremities. He initially visited the neurology department where he was suspected of having polymyositis. Additional laboratory evaluation revealed profound autoimmune hypothyroidism and elevated muscle enzymes including creatine kinase. The patient was started on levothyroxine treatment and, subsequently, clinical symptoms and biochemical parameters resolved with the treatment. The present case highlights that hypothyroidism should be considered in the differential diagnosis of musculoskeletal symptoms even in the absence of overt manifestations of hypothyroidism. To our knowledge, this is the first case reported in Korea.

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Hoffmann’s syndrome in the differential work-up of myopathic complaints: a case report
Sabine Winter, Bianka Heiling, Niklas Eckardt, Christof Kloos, Hubertus Axer
Journal of Medical Case Reports.2023;[Epub] CrossRef
Hypothyroidism: A Peculiar Presentation
Rita V Nogueira, Rui Lima, Carina Parente, Pedro Liberal, Lucia Santos
Cureus.2023;[Epub] CrossRef
Hoffman's syndrome as the presenting manifestation of non-primary hypothyroidism in a case of Prader-Willi Syndrome
R. Ghosh, A. Ray, D. Roy, J. Benito-Leon
Neurología.2022; 37(9): 824. CrossRef
Hoffman's syndrome as the presenting manifestation of non-primary hypothyroidism in a case of Prader-Willi Syndrome
R. Ghosh, A. Ray, D. Roy, J. Benito-Leon
Neurología (English Edition).2022; 37(9): 824. CrossRef
Hoffmann’s syndrome necessitating forearm fasciotomy: a case report
Erling Aarsæther, Ragnar Joakimsen, Hanne Halvorsen, Trude Sildnes, Olav Sivertsen, Jan Due
Journal of Medical Case Reports.2020;[Epub] CrossRef
Hypothyroid myopathy: A peculiar clinical presentation of thyroid failure. Review of the literature
Alessandro Sindoni, Carmelo Rodolico, Maria Angela Pappalardo, Simona Portaro, Salvatore Benvenga
Reviews in Endocrine and Metabolic Disorders.2016; 17(4): 499. CrossRef

Thyroid
Anaplastic Thyroid Carcinoma Following Radioactive Iodine Therapy for Graves' Disease: Sun Hwa Kim, Hee Young Kim, Kwang Yoon Jung, Dong Seop Choi, Sin Gon Kim; Endocrinol Metab. 2013;28(1):61-64. Published online March 25, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.1.61

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Radioactive iodine (RAI) therapy has been used as a treatment option for Graves' disease, and it has been widely accepted to be safe. On the other hand, some evidence suggests that RAI therapy is possibly associated with a small increased risk of thyroid cancer. Herein, we report a rare case of anaplastic thyroid carcinoma (ATC) associated with Graves' disease, following RAI treatment. A 42-year-old woman had been diagnosed with Graves' disease and although she was treated with an antithyroid drug, she remained in a hyperthyroid state, which led to two RAI treatments. More than 10 years later, the patient revisited our clinic due to hoarseness, dysphagia, and dyspnea, which had lasted for 2 months. Neck computed tomography suggested thyroid carcinoma and a lymph node biopsy showed metastatic papillary carcinoma. The patient underwent total thyroidectomy and was finally diagnosed as having an ATC. It is not clear if the occurrence of ATC reported here was influenced by the RAI therapy or alternatively, it may only represent the delayed recognition of a rare change in the natural history of Graves' disease. Nevertheless, this report is worthwhile since it presents a very rare case of ATC that occurred eleven years after the RAI therapy for Graves' disease.

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Evaluation of ultrasonographical and cytological features of thyroid nodules in patients treated with radioactive iodine for hyperthyroidism
Muhammet C. Bilginer, Didem Ozdemir, Fatma N. C. Seyrek, Nilufer Yildirim, Aylin K. Yazgan, Mehmet Kilic, Reyhan Ersoy, Bekir Cakir
Diagnostic Cytopathology.2020; 48(1): 3. CrossRef
Papillary thyroid carcinoma in cervical lymph nodes with vanished thyroid gland after ablation of Graves’ disease by radioactive iodine
O Hamdy, S Raafat, GA Saleh, K Atallah, Mahmoud M Saleh, AM Shebl, MA Hegazy
The Annals of The Royal College of Surgeons of England.2019; 101(5): e122. CrossRef
Brief Review of Articles in 'Endocrinology and Metabolism' in 2013
Won-Young Lee
Endocrinology and Metabolism.2014; 29(3): 251. CrossRef

A Case of Multiple Osteoporotic Compression Fractures in Young Man with Budd-Chiari Syndrome.: Sun Hwa Kim, Tae Un Yang, Byeong Kwang Choi, Hye Jin Yoo, Ji A Seo, Kyung Mook Choi, Nan Hee Kim, Sin Gon Kim, Sei Hyun Baik, Dong Seop Choi, Hae Yoon Choi; Endocrinol Metab. 2012;27(4):334-339. Published online December 20, 2012; DOI: https://doi.org/10.3803/EnM.2012.27.4.334

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Abstract PDF: Osteoporosis in young men is extremely rare. In this report, we demonstrate a rare case of multiple vertebral fractures discovered in a young man with Budd-Chiari syndrome without prior history of trauma. A 29-year-old man was diagnosed as Budd-Chiari syndrome 12 years ago and underwent a mesocaval shunt to relieve the hepatic vein obstruction and was on warfarin therapy. He suffered from low back pain and it was not relieved by analgesics. A T-L spine X-ray revealed multiple compression fractures and the z-score at lumbar spine was -3.7 which is below the expected range for that age. The patient was treated with calcium, vitamin D and bisphosphonate, and showed clinical improvement. This case highlights the importance of the investigation for secondary osteoporosis in young adults with an underlying disease that alters bone metabolism.

Thyroid Dysfunction of North Korean Women Living in South Korea, Focusing on Subclinical Hypothyroidism.: Joo Hyung Kim, Sol Ah Park, Nam Hoon Kim, Jae Hee Ahn, Yoon Jung Kim, Myongjin Cho, Yoon Jung Lee, Hye Jin Yoo, Hee Young Kim, Ji A Seo, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi, Sin Gon Kim; Endocrinol Metab. 2012;27(3):200-207. Published online September 19, 2012; DOI: https://doi.org/10.3803/EnM.2012.27.3.200

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BACKGROUND
Thyroid function depends on ethnic and environmental factors. North Korean refugees have the same genetic background as South Koreans, but they have been exposed to different environments. This study examines the prevalence and pattern of thyroid disorders in North Korean women living in South Korea, focusing on subclinical hypothyroidism (SCH). METHODS: The intended sample was a total of 327 North Korean women residing in Seoul. Health questionnaires and medical examinations, including serum thyrotropin (thyroid stimulating hormone, TSH), free thyroxine, and thyroid autoantibodies, were conducted. RESULTS: The prevalence of SCH was 9.4%. In logistic regression analysis, smoking, menopause, length of stay in South Korea, body mass index, history of thyroid disease, and metabolic syndrome were not associated with the risk of SCH. Whereas, the positivity of autoantibodies were associated with a high risk for SCH (odds ratio [OR], 4.840; 95% confidence interval [CI], 1.80-13.017; P = 0.002), and age was associated with a low risk for SCH (OR, 0.94; 95% CI, 0.888-0.994; P = 0.031). The serum TSH levels also decreased with increasing age, and in particular, there was significant difference between 30-39 years, and over 60 years (2.33 +/- 1.51 microIU/mL vs. 1.54 +/- 0.73 microIU/mL, P = 0.028). CONCLUSION: In North Korean women, the positivity of autoantibodies was associated with a high risk for SCH. But interestingly, a younger age was associated with a high risk for SCH. Considering that they suffered from severe famine at the period of growth, and this led to malnutrition, their thyroid dysfunction might be associated with the peculiar environment that they experienced.

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Systematic review of evidence on public health in the Democratic People’s Republic of Korea
John J Park, Ah-Young Lim, Hyung-Soon Ahn, Andrew I Kim, Soyoung Choi, David HW Oh, Owen Lee-Park, Sharon Y Kim, Sun Jae Jung, Jesse B Bump, Rifat Atun, Hee Young Shin, Kee B Park
BMJ Global Health.2019; 4(2): e001133. CrossRef
Environmental Factors and Thyroid Dysfunction
Hyun-Kyung Chung
Endocrinology and Metabolism.2012; 27(3): 191. CrossRef

Hyperprolactinemia-Associated Breast Uptake of Radioiodine Following 131I Postablation Scan in Differentiated Thyroid Cancer.: Jae Hee Ahn, Sun Young Kim, Ye Ji Kim, Suk Young Lee, Jae Hyoung Lee, Seung Hun Kang, Ho Cheol Hong, Sae Jeong Yang, Hye Jin Yoo, Ji A Seo, Sin Gon Kim, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi, Hae Yoon Choi; Endocrinol Metab. 2011;26(4):345-347. Published online December 1, 2011; DOI: https://doi.org/10.3803/EnM.2011.26.4.345

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Scanning with whole-body 131I scintigraphy after surgery has been a valuable diagnostic modality in the surveillance of patients with differentiated thyroid cancer. Radioiodine uptake is rarely observed in non-lactating breast tissue, which mimics thyroid cancer metastasis. We now report a case of a 45-year-old female thyroid cancer patient who underwent radioiodine therapy, and in whom breast uptake of radioiodine was observed on a post-therapy whole body scan. Her serum prolactin level was elevated to 328 ng/mL at the time of the radioiodine uptake, and the hyperprolactinemia was induced by her antipsychotic medications. Six months after she discontinued that medication, her serum prolactin level was normalized to 12.6 ng/mL and breast uptake of iodine was no longer present in a follow-up whole body scan.

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Incidental Findings of Intense Radioiodine Uptake in Struma Ovarii and Bilateral Nonlactating Breasts Simultaneously on Postablation 131I SPECT/CT for Papillary Thyroid Cancer
Hye-kyung Shim, Mi Ra Kim
Nuclear Medicine and Molecular Imaging.2016; 50(4): 353. CrossRef

Successful Localization of Distant Metastasis in Parathyroid Carcinoma Using Intraoperative Parathyroid Hormone Assay.: Ho Cheol Hong, Sun Won Kim, Tae Hyung Kim, In Hye Cha, Jae Hee Ahn, Hye Jin Yoo, Hee Young Kim, Ji A Seo, Hyun Koo Kim, Sin Gon Kim, Nan Hee Kim, Kyung Mook Choi, Jae Bok Lee, Sei Hyun Baik, Dong Seop Choi; Endocrinol Metab. 2011;26(1):92-96. Published online March 1, 2011; DOI: https://doi.org/10.3803/EnM.2011.26.1.92

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Intra-operative parathyroid hormone (IOPTH) assay is a useful tool to confirm complete excision of all hyper-functioning parathyroid gland tissue. In this report, we describe a case with successful localization of distant metastasis in a patient with parathyroid carcinoma using the IOPTH assay. A 53-year-old man presented to our clinic with a serum calcium level of 11.8 mg/dL and an intact PTH level of 233.3 pg/mL. He had been treated for parathyroid carcinoma eleven years ago. Two suspected metastatic lesions were detected on the chest computed tomography. Due to the vastly different surgical field necessary to excise each lesion, we preferentially removed only one lesion and we monitored the other remaining suspected lesion without resection via IOPTH assay. Six months later, the patient's serum calcium and intact PTH levels remained within their normal ranges. To the best of our knowledge, this is the first case to effectively utilize IOPTH assay for the management of metastatic parathyroid carcinoma.

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The association of abdominal obesity, obesity and parathyroid hormone in Korean adults (aged≥50 years): The Korea National Health and Nutrition Survey, 2011
Kyu Su Lee, Yo Sang Yoon, Hyun Yoon
Journal of the Korea Academia-Industrial cooperation Society.2015; 16(6): 3882. CrossRef

Ectopic ACTH Syndrome with Bilateral Pheochromocytoma in Multiple Endocrine Neoplasia Type 2A.: Ji Mi Moon, Yoon Jung Kim, Young Jin Seo, Hye Yoon Choi, Joo Hyong Kim, Ju Ri Park, Yun Jeong Lee, Hee Young Kim, Sin Gon Kim, Dong Seop Choi; J Korean Endocr Soc. 2009;24(4):265-271. Published online December 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.4.265

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Multiple endocrine neoplasia type 2A (MEN 2A) is an autosomal dominant syndrome characterized by the presence of medullary thyroid carcinoma, pheochromocytoma, and hyperparathyroidism. MEN 2A arises due to a germline missense mutation of the RET proto-oncogene. Specific RET mutation analysis has revolutionized the diagnosis and therapy of this disorder, and early thyroidectomy may have lowered the morbidity and mortality associated with these diseases. Ectopic adrenocorticotropic hormone (ACTH) syndrome is characterized by hypercortisolism due to the hypersecretion of ACTH outside of the pituitary gland; the most common causes are malignancies, but rarely adrenal pheochromocytoma may be the cause.

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Pheochromocytoma With High Adrenocorticotropic Hormone Production Capacity Without Pigmentation and Cushingoid Symptoms: A Case Report With a Literature Review
Gen Mizutani, Masashi Isshiki, Eisuke Shimizu, Daigo Saito, Akira Shimada
Cureus.2024;[Epub] CrossRef
Ectopic ACTH- and/or CRH-Producing Pheochromocytomas
Patrick F Elliott, Thomas Berhane, Oskar Ragnarsson, Henrik Falhammar
The Journal of Clinical Endocrinology & Metabolism.2021; 106(2): 598. CrossRef
Severe Cushing Syndrome Due to an ACTH-Producing Pheochromocytoma: A Case Presentation and Review of the Literature
Jenan N Gabi, Maali M Milhem, Yara E Tovar, Emhemmid S Karem, Alaa Y Gabi, Rodhan A Khthir
Journal of the Endocrine Society.2018; 2(7): 621. CrossRef
Adrenocorticotropic hormone (ACTH)-producing pheochromocytoma presented as Cushing syndrome and complicated by invasive aspergillosis
Jae Ho Cho, Da Eun Jeong, Jae Young Lee, Jong Geol Jang, Jun Sung Moon, Mi Jin Kim, Ji Sung Yoon, Kyu Chang Won, Hyoung Woo Lee
Yeungnam University Journal of Medicine.2015; 32(2): 132. CrossRef

A Case of Recurrent Ectopic Parathyroid Adenoma Developed 22 Years after the Initial Parathyroidectomy.: Yoon Jung Kim, Ji A Seo, Ji Mi Moon, Young Jin Seo, Hae Yoon Choi, Hye Sook Kim, Sin Gon Kim, Kyeung mook Choi, Sei Hyun Baik, Dong Seop Choi, Nan Hee Kim; J Korean Endocr Soc. 2009;24(4):260-264. Published online December 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.4.260

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Abstract PDF: Persistent or recurrent primary hyperparathyroidism after initial parathyroid surgery occurs at rates of 1.5~10%. A single missed parathyroid adenoma accounts for the majority of persistent hyperparathyroidism, whereas metachronous parathyroid adenoma is a rare cause of recurrent hypercalcemia. We report a case of a 39-year-old female who presented with recurrent pancreatitis. She had symptoms of hyperparathyroidism such as hypercalcemia, hypophosphatemia, hypercalciuria, nephrocalcinosis, and osteoporosis. She had a 2-cm firm neck mass under the right submandibular area. She was diagnosed with primary hyperparathyroidism 22 years ago. At that time, the right upper and lower parathyroid glands were removed after exploration of all parathyroid glands, and a right upper parathyroid adenoma was diagnosed. Now, she had a second surgery to remove the right submandibular mass with intraoperative PTH monitoring, which was diagnosed as a parathyroid adenoma in an ectopic supernumerary parathyroid gland. Because of hungry bone syndrome, she received calcium carbonate replacement therapy and has no evidence of recurrence. Here, we report a recurrent parathyroid adenoma in the undescended, supernumerary parathyroid gland after a long interval from the initial surgery.

A Case of Fulminant Type 1 Diabetes Mellitus Complicated with Ischemic Ileitis.: Se Won Oh, Ju Ri Park, Yun Jeong Lee, Hee Yeong Kim, Ji A Seo, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi, Sin Gon Kim; J Korean Endocr Soc. 2009;24(2):116-120. Published online June 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.2.116

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Abstract PDF: Fulminant type 1 diabetes is characterized by diabetes with an abrupt onset, severe metabolic acidosis at diagnosis, a low HbA1c level and negativity for islet cell-related autoantibodies, and this illness has been classified as type 1B diabetes by the WHO. The prevalence of this disease is higher in Japan than any other country and recently, there have been an increasing number of such case reports in Korea. Genetic factors and environmental factors such as virus infection and an immune mechanism have been suggested as the mechanism of the pathophysiology, but this remains to be clarified.

Normal Repetitive Pregnancies and Tumor Regression Induced by Low-Dose Bromocriptine in a Patient with Macroprolactinoma.: Hye Jung Choi, Jin Yong Park, Woo Seok Choi, Jong Gyu Song, Hee Young Kim, Ji A Seo, Sin Gon Kim, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi; J Korean Endocr Soc. 2009;24(1):42-46. Published online March 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.1.42

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Abstract PDF: Prolactin-secreting adenomas are the most common pituitary tumors. Menstrual disturbances and infertility are the main complaints in women with prolactinoma. Dopaminergic agonists such as bromocriptine are well-established treatments for prolactinoma when pregnancy is desired. Pregnancy-related outcomes in macroprolactinoma are worse than those in microprolactinoma. In addition, symptomatic tumor expansion during pregnancy occurs in 30% of women with macroprolactinoma. Therefore, when women with macroprolactinoma are planning a pregnancy, serum prolactin level should be normalized and the tumor volume significantly reduced. On the other hand, a spontaneous regression of macroprolactinoma can occur after pregnancy. We report a case of macroprolactinoma showing significant tumor regression during repeated pregnancies and low dose bromocriptine treatment, with a literature review.

A Case of Graves' Disease with Pheochromocytoma.: Hye Sook Kim, Hyung Joon Joo, Yoon Seok Choi, Eun Sun Kim, Soo Yeon Park, Yun Jeong Lee, Hee Young Kim, Ji A Seo, Sin Gon Kim, Dong Seop Choi; J Korean Endocr Soc. 2007;22(6):465-469. Published online December 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.6.465

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Graves' disease is an autoimmune disorder in which thyrotropin-stimulating hormone receptor antibodies stimulate the thyroid gland. Stress hormones such as catecholamine are known to play important roles in the pathogenesis of Graves' disease. Pheochromocytoma with Graves' disease is extremely rare, and no case has been reported within the Republic of Korea. However, according to previous studies conducted abroad, pheochromocytoma influences the pathogenesis of Graves' disease by producing excessive cathecholamine. In the present report, we describe a 65-year-old female patient with paroxysmal hypertension and rapidly progressive body weight loss who was diagnosed as having Graves'disease with pheochromocytoma.

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Graves' Disease Accompanied by Pheochromocytoma: Report of a Case
Jin-Hwa Kim, Sang-Jun Lee, Ji-Hye Shin, Mi-Ra You, Jae-Sik Jung, Sang-Yong Kim, Hak-Yeon Bae
Journal of Korean Endocrine Society.2009; 24(2): 126. CrossRef

The Evaluation and Follow-up of Adrenal Incidentaloma.: Sin Gon Kim, Dong Seop Choi; J Korean Endocr Soc. 2007;22(4):257-259. Published online August 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.4.257

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No abstract available.

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Characterization of Incidentally Detected Adrenal Pheochromocytoma
Soon Jib Yoo, Woohyeon Kim
Endocrinology and Metabolism.2012; 27(2): 116. CrossRef

Two Cases of Acromegaly with Empty Sella Syndrome Treated by Long-Acting Release Octreotide.: Dong Jin Kim, Young Jin Seo, Nam Hoon Kim, Hye Soo Chung, Chai Ryoung Eun, Hye Jung Choi, Hye Sook Kim, Sae Jeong Yang, Juri Park, Hye Jin Yoo, Soo Yeon Park, Yun Jeong Lee, Ohk Hyun Ryu, Kye Won Lee, Hee Young Kim, Ji A Seo, Sin Gon Kim, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi; J Korean Endocr Soc. 2007;22(2):135-141. Published online April 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.2.135

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Abstract PDF: Two cases of typical acromegaly with empty sella syndrome presented to our institution. In the natural course of untreated pituitary adenoma, empty sella syndrome may result from necrosis by infarction or from hemorrhage of the pituitary gland. In our patients, the secretion of growth hormone continued in spite of the existence of empty sella syndrome. In one case, we confirmed the hypersecretion of growth hormone from sella by jugular vein sampling. Medical therapy with somatostatin analogue was attempted because there was no obvious mass in the sella. After 6~12 months of treatment with long-acting release octreotide, clinical features in our patients were improved, and the level of growth hormone and IGF-1 were also normalized.

Comparison of Target Organ Damages between Primary Aldosteronism and Essential Hypertension.: Juri Park, Dong Jin Kim, Sae Jeong Yang, Sook Hae Kim, Soo Yeon Park, Hye Jin Yoo, Yun Jeong Lee, Hee Young Kim, Ohk Hyun Ryu, Kye Won Lee, Ji A Seo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi; J Korean Endocr Soc. 2007;22(1):11-18. Published online February 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.1.11

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BACKGROUND
A number of recent clinical studies have reported marked target organ damages in patients with primary aldosteronism. The aim of this study was to compare the incidence of target organ damages in patients with primary aldosteronism (PA) and essential hypertension (EHT). METHODS: The clinical records of 41 PA patients, over a 20-year period, were retrospectively analyzed. The clinical characteristics and incidence of target organ damages of 33 of the patients in this group were compared with those of 66 patients with essential hypertension, directly matched for age, gender and mean blood pressure. 8 of the PA patients could not be matched with EHT patients for age, gender and mean blood pressure, so were excluded from the comparison. The patients with essential hypertension were sampled from patients who visited for the evaluation of hypertension. RESULTS: Ischemic heart diseases were found in 18.2 and 10.6% of patients with PA and EHT, respectively (P = 0.22). From echocardiograms, left ventricular hypertrophy was found in 93.3% and 61.4% of patients with PA and EHT, respectively (P = 0.017). The degrees of left ventricular hypertrophy were correlated with the levels of serum aldosterone, with an r value of 0.490 (P < 0.005). Cerebrovascular attack was found in 18.2% and 1.5% of patients with PA and EHT, respectively (P = 0.005). Hypertensive retinopathy was found in 50% and 33.3% of patients with PA and EHT (P = 0.255), and nephropathy was found in 42.4% and 25.8% of patients with PA and EHT, respectively (P = 0.074). CONCLUSION: Patients with primary aldosteronism had target organ damages more frequently than with those with essential hypertension, which was independent of blood pressure.

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Changes in the clinical manifestations of primary aldosteronism
Sun Hwa Kim, Jae Hee Ahn, Ho Cheol Hong, Hae Yoon Choi, Yoon Jung Kim, Nam Hoon Kim, Hye Jin Yoo, Hee Young Kim, Ji A Seo, Nan Hee Kim, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi
The Korean Journal of Internal Medicine.2014; 29(2): 217. CrossRef
Comparing the Prevalence of Primary Aldosteronism in Hypertensive Diabetic and Non-diabetic Patients
Yi Sun Jang, Koon Soon Kim, Hye Soo Kim
Journal of Korean Endocrine Society.2009; 24(4): 254. CrossRef
Aldosterone as a Cardiovascular Risk Factor
Soon Jib Yoo
Journal of Korean Endocrine Society.2007; 22(1): 8. CrossRef

A Case of Sheehan's Syndrome Presenting Central Diabetes Insipidus.: Dong Jin Kim, Nan Hee Kim, Ju Ri Park, Sae Jeong Yang, Hye Suk Kim, Hye Jin Yoo, Soo Yeon Park, Ohk Hyun Ryu, Kye Won Lee, Hee Young Kim, Ji A Seo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi; J Korean Endocr Soc. 2006;21(4):333-337. Published online August 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.4.333

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Abstract PDF: Sheehan's syndrome occurs as a result of ischemic pituitary necrosis due to severe postpartum hemorrhage. The manifestations of this clinical syndrome are most often caused by a deficiency in the hormones produced by the anterior pituitary gland, whereas the neurohypophysis is usually preserved but can be involved in severe cases that manifest as diabetes insipidus. This is a report of Sheehan's syndrome that manifested with diabetes insipidus as presenting symptom 2 month's after delivery. The patient suffered massive bleeding, so received a blood transfusion. A combined pituitary stimulation and water deprivation test revealed deficiencies of not only anterior pituitary hormones, such as growth hormone and prolactin, but also of anti-diuretic hormone. We report this case, with a review of the literature.

A Case of Primary Hyperparathyroidism Caused by Cystic Parathyroid Adenoma, Diagnosed during Intra-Operative PTH Monitoring.: Hye Jin Yoo, Nan Hee Kim, Soo Yeon Park, Dong Jin Kim, Sae Jeung Yang, Ju Ri Park, Hee Young Kim, Ji A Seo, Kye Won Lee, Sin Gon Kim, Kyung Mook Choi, Jae Bok Lee, Young Seok Lee, Sei Hyun Baik, Dong Seop Choi; J Korean Endocr Soc. 2005;20(3):278-282. Published online June 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.3.278

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Abstract PDF: Primary hyperparathyroidism is the most frequent cause of hypercalcemia, and its prevalence is increasing due to the routine examination of serum calcium levels. Primary hyperparathyroidims is most commonly caused by an adenoma or hyperplasia of the parathyroid gland. A cystic parathyroid adenoma is an extremely rare cause of primary hyperparathyroidism. In our case, a-79-year old female presented with lower back pain and constipation. Her serum calcium, phosphate and immunoreactive parathyroid homone levels were 15.6, 1.8mg/dL and 371.8pg/mL, respectively. Neck CT revealed a cystic mass and a contour bulging heterogeneous mass in the left inferior right thyroid gland, respectively. These mass lesions were removed, and the intra-operative parathyroid hormone levels monitored, to confirm the complete resection. After removing the left cystic mass to the inferior thyroid, the serum calcium and immunoreactive parathyroid hormone levels quickly returned to normal. We report a case of primary hyperparathyroidism, caused by a cystic parathyroid adenoma, with a brief review of the literature

A Case of Congenital Adrenal Hyperplasia due to 11beta-Hydroxylase Deficiency.: Ohk Hyun Ryu, Hye Jin Yoo, Soo Yeon Park, Soon Beom Kwon, Sang Soo Park, Hee Young Kim, Kye Won Lee, Ji A Seo, Jeong Heon Oh, Sin Gon Kim, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi; J Korean Endocr Soc. 2004;19(1):58-63. Published online February 1, 2004

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Abstract PDF: Congenital adrenal hyperplasia refers to a group of autosomal recessive disorders that is defective in the synthesis of cortisol. The enzymes most often affected are 21-hydroxylase and 11beta hydroxylase. The low levels of cortisol stimulate the pituitary gland to release ACTH. Chronic elevation of the ACTH level causes bilateral adrenal hyperplasia and a secondary increase in androgen formation. We examined a 19 year-old woman presented with clitoral hypertrophy and vaginal spotting. The subjects basal level of serum cortisol was low, but the serum levels of ACTH, 17a-hydroxyprogesterone, deoxy-corticosterone were elevated. The urinary excretions of 17-ketosteroids and 17-hydroxycorticosteroids were also increased. The karyotyping study and transrectal ultrasonography showed normal findings. The patient underwent clitoris reduction surgery and received hydrocortisone. To the best of our knowledge, this is the first case of 11beta-Hydroxylase deficiency in Korea.

A Case of Multiple Endocrine Neoplasia 2A with Germ Line Mutation of RET Gene.: Hee Young Kim, Ji Yeon Lee, Sung Bum Kim, Kye Won Lee, Ji A Seo, Jeong Heon Oh, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi, Nan Hee Kim; J Korean Endocr Soc. 2003;18(5):481-488. Published online October 1, 2003

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Abstract PDF: Multiple endocrine neoplasia 2A (MEN 2A) is an autosomal dominantly inherited disease, composed of medullary thyroid carcinoma, pheochromocytoma and hyperparathyroidism. The activation of germ-line mutations in the RET proto-oncogene are responsible for MEN 2. The analysis of the RET mutations has replaced the measurement of the calcitonin level in the diagnosis of the MEN carrier state. Specific RET codon mutations correlate with the MEN 2 syndromic variant, the age at onset of the medullary thyroid carcinoma (MTC) and the aggressiveness of the MTC. Herein, our experience of a 47-year-old woman, who had a bilateral pheochromocytoma and MTC, and MEN 2A confirmed by the detection of an RET proto-oncogene mutation at axon 10 on codon 618, is reported. Her sister was found to have the same mutant gene. After a total thyroidectomy and bilateral adrenalectomy, the calcitonin and catecholamine levels were normalized, and the patient discharged without problems. This case is reported, with a review of the literature.

Clinical Study of the Pheochromocytoma.: Dong Hyun Shin, Sin Gon Kim, Dong Rim Kim, Nan Hee Kim, Kyung Mook Choi, Saih Yun Baik, Dong Seop Choi, Sung Ock Suh; J Korean Endocr Soc. 2002;17(4):554-563. Published online August 1, 2002

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Abstract PDF: BACKGROUND
Pheochromocytoma may arise within the adrenal medulla, or in other locations where sympathetic ganglia or chromaffin tissues are known to exist. Approximately 0.1% of hypertensive patients have pheochromocytoma. Most of this hypertension can be cured by surgical removal of the tumor, but lethal complication can develop if proper treatment is not prepared. Therefore, accurate diagnosis and preoperative preparation is very important. The objective of this study was to evaluate the clinical characteristics of pheochromocytoma and the blood pressure change following tumor removal. METHOD: The medical records of 45 patients [29 cases of intra-adrenal, 16 cases of extra-adrenal (paraganglioma)] diagnosed with of pheochromocytoma at Korea University Medical Center between 1991 and 2001 were reviewed. RESULTS: Twenty of the cases were male and 25 were female. The mean age of these patients was 43 years old. Hypertension, headaches, palpitations and impaired glucose tolerance were observed more frequently in cases of intra-adrenal tumor than in those of extra-adrenal. In the extra-adrenal group, abdominal pain, hypertension and nausea were more frequently observed. A biochemical study showed that the sensitivity of the test for catecholamines and metabolites in 24 hours urine was over 80%. For the localization of tumors we used abdominal CT and MIBG. The sensitivities of the CT and MIBG for the tumor localization were 97 and 91%, respectively. Blood pressures during the operations were effectively controlled by preoperative treatment with phenoxybenzamine (non-competitive, non-selective -adrenoreceptor antagonists). CONCLUSION: Surgical treatment cured 23 of the 30 cases of hypertension with pheochromocytoma. We have to take careful approaches in the care of the patient who may have pheochromocytoma, due to the various clinical signs and symptoms.

A Case of Malignant Pleural Effusion with Pleural Metastasis in a Patient with Papillary Thyroid Carcinoma.: Ju Young Kim, Dae Won Park, Jin O Na, Byoung Yeon Hwang, Dong Lim Kim, Dong Hyun Shin, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi, Sung Jin Cho, Nan Hee Kim; J Korean Endocr Soc. 2002;17(2):269-274. Published online April 1, 2002

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Abstract PDF: Papillary thyroid carcinomas comprise approximately 80 percent of all thyroid cancers, but haves a good prognosis, with overall survival rates at 10 years of about 80 to 95 percent. They spreads through the lymphatic system, and the lung is the most frequent metastasis site. If distant metastasis is present, the overall survival rate is about 40 percent. Although malignant pleural effusion, with pleural metastasis is a rare complication in patients with papillary thyroid carcinoma, the development of malignant pleural effusion is an extremely adverse prognostic indicator. We recently experienced a case of malignant pleural effusion with papillary thyroid carcinoma. A 54-year-old woman was admitted to the hospital because of dyspnea. A chest X-ray showed massive pleural effusion in the right hemithorax. Previously total thyroidectomy, and iodine-131 therapy had been performed, but a local recurrence and pulmonary metastasis developed 5 years later, accompanied by malignant pleural effusion with pleural metastasis. We performed diagnostic thoracentesis, which confirmed a metastatic papillary thyroid carcinoma. This patient was a rare case of paplillary thyroid carcinoma, in which the disease was represented by a rapid deterioration with malignant pleural effusion. So we report this case with a review of the literature.

The Association between CRP and the Metabolic Syndrome in Korean Adults.: Sin Gon Kim, Dong Lim Kim, Dong Hyun Shin, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi; J Korean Endocr Soc. 2002;17(2):226-235. Published online April 1, 2002

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Abstract PDF: BACKGROUND
Metabolic syndrome (MS) is characterized by insulin resistance accompanied by one or more of the following: obesity, hypertension, impaired glucose tolerance, low HDL cholesterol levels, and/or hypertriglyceridemia. However, the precise underlying pathogenic mechanism of MS is not known. Several recent reports have suggested a positive association between components of MS and markers of the acute-phase response, including C-reactive protein (CRP). These results imply that MS is accompanied by an ongoing inflammatory process. The purpose of our study was to evaluate the association between circulating levels of C-reactive protein, a sensitive systemic marker of inflammation, with components of metabolic syndrome in Korean adults. METHODS: A total of 1,461 subjects aged between 20 and 81 years, who visited the Health Management Center at Korea university between November 2000 and February 2001 were studied. We investigated the correlation between CRP levels and components of MS. The components of MS were categorized, and age-sex adjusted mean values of CRP calculated for the categorized components. The BMI was categorized into 5 classes, and the CRP levels examined according to their BMI class. In addition, subjects with a different number of the MS components were grouped as follows: group 1 for 0 components, group 2 for 1 components, group 3 for 2 components and group 4 for > or = 3 components, and the CRP levels calculated for each group. RESULTS: There were significant positive correlations of CRP levels with age, BMI, TG, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBS), uric acid, insulin,and homeostasis model assessment IR (HOMAIR). A significant inverse correlation was observed between CRP levels and serum HDL. From the multivariate analysis, age and BMI were significantly correlated with CRP levels. The means of the CRP for the categorized components of MS were significantly higher in the BMI categories: > or =25 for female/27 for male, TG > or =200 mg/dL, fasting plasma glucose > or =126 mg/dL and blood pressure > or =140/90 mmHg, and the CRP levels by BMI class were: 1.19 (BMI <18.5), 1.54 (BMI 18.5~22.9), 1.59 (BMI 23.0~24.9), 1.77 (BMI 25.0~29.9) and 2.07 (BMI >30.0) mg/L. Furthermore, the increase in the CRP levels in relation to the numbers of MS were 1.46 (group 1), 1.70 (group 2), 1.95 (group 3) and 2.11 mg/L (group 4) with statistical significance. CONCLUSION: The above data showed associations between the CRP levels and the different components of MS. This might suggest that MS in Koreans could be accompanied by a systemic inflammation response

Usefullness of Urinary Free Cortisol Measurement in Diagnosis of Iatrogenic Cushing Syndrome.: Yong Hyun Kim, Sang Jin Kim, Dong Seop Choi; J Korean Endocr Soc. 2000;15(2):162-169. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Although insulin induced hypoglycemia test is a standard diagnostic method in assessment of hypothalamo-pituitary-adrenal axis, rapid ACTH stimulation test using 250microgram has been used as a first line diagnostic test especially in secondary adrenal insufficiency due to iatrogenic Cushing syndrome because it is easy and safe. However, it was suggested that a maximal cortisol response can be achieved with a much lower ACTH dose and 1microgram ACTH enhances the sensitivity without decreasing specificity of test. Also recently, there was a report that midnight to morning urine cortisol increment is more accurate, noninvasive method can be used for measurement of hypothalmo-pituitary-adrenal axis. In this study, we compared the 1microgram ACTH stimulation test with midnight to morning urinary free cortisol increment in secondary adrenal insufficiency due to iatrogenic Cushing syndrome to study the agreement of two test and accuracy of increment of urinary free cortisol in diagnosis of adrenal insufficiency. METHODS: Double voided urine sample were collected at midnight and 8 A.M. in 12 patients who have Cushing-like feature and history of taking glucocorticoids and in 12 normal controls. Urinary free cortisol was measured and cortisol increment was defined as the morning urine free cortisol minus the midnight urine free cortisol. The 1microgram ACTH stimulation test was performed in 12 iatrogenic Cushing syndrome patients at the same day and compard with the result of cortisol increment. RESULTS: Using the results of 12 controls, normal urine free cortisol increment was defined as greater than 165.5nmol/L(6.0microgram/dL). Subnormal cortisol response in 1microgram ACTH stimulation test was noted in 8 out of 12 patients group and urinary free cortisol increment was not observed in 7 out of 8 subnormal response group. Normal cortisol response in 1microgram ACTH stimulation test was noted in 4 out of 12 patients group and urinary free cortisol increment was observed in 3 out of 4 normal response group. So 83% of concordance rate between 1microgram ACTH stimulation test and urine free cortisol increment was recorded. CONCLUSION: Urinary free cortisol increment has high concordance rate with 1microgram ACTH stimulation test and simple, easy test in diagnosing secondary adrenal insufficiency due to iatrogenic Cushing syndrome. Further study including more patients will be helpful to know the adequacy and reliability of test in evaluation of hypothalamo-pituitary-adrenal axis.

A Case of Afrenocortical Carcinoma Associated with Multiple Paraganglioma.: Kyung Mook Choi, Jeong Heon Oh, Nan Hee Kim, Yong Hyun Kim, Ae Ree Kim, Chul Hwan Kim, Sang Jin Kim, Sei Hyun Baik, Dong Seop Choi; J Korean Endocr Soc. 1999;14(3):599-604. Published online January 1, 2001

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Abstract PDF: Simultaneous oceurrence of adrenocortical tumor and pheochromocytoma is extremely rare. Coexistence of adrenal tumor and pheochromocytoma was first reported by Cope in 1952 and some other cases were reported after that. But there was no report about coexistence of adrenocortical carcinoma and paragangliomas. Recently, we experienced a case of adrenocortical carcinoma associated with multiple paragangliomas. A 35-year-old woman was admitted to the hospital because of left upper abdominal pain. A palm-sized fum tender mass was palpated at left upper quadrant. Hormonal studies revealed pheochromocytomas feature. Fmergency operation was performed because of the possibility of intemal hemorrhage of the tumor. Operator found 10 cm sized mass in left adrenal area and also the other 5 small tumors adjacent to IVC. Pathologic report revealed that adrenal mass was adrenocortical carcinoma with hemorrhagic necrosis and tumors adjacent to IVC were paragangliomas. This patient was the first case of adrenocortical carcinoma with multiple paragangliomas in the world. So we report this case with a review of literature.

A Case of Bilateral Macronodular Adrenocortical Hyperplasia.: Yoon Sang Choi, Soo Mi Kim, Shin Gon Kim, Ie Byung Park, Sei Hyun Baik, Dong Seop Choi, Seung Woon Rha, Dong Hyun Shin; J Korean Endocr Soc. 1996;11(4):523-530. Published online November 7, 2019

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Abstract PDF: Cushing's syndrome associated with nodular adrenal glands will be divided into four main categories: adrenal adenoma, adrenal carcinoma, primary pigmented nodular adrenal dysplasia (PPNAD) and macronodular adrenal hyperplasia(MAH). The term macronodular adrenal hyperplasia is restricted to the presence of multiple nodules visible to the naked eye, ranging in size from 0.5 to 7.0 cm. We report a case of Cushings syndrome caused by bilateral macronodular adrenal hyperplasia (MAH). A 45-year-old man presented with Cushingoid features, hypertension and diabetes mellitus. Urine free cortisol was 449.9 mmol/day(27-276) and were not suppressed after administration of low-dose and high-dose dexamethasone. Plasma ACTH was very low(1.87 pmol/L(18)) and was not stimulated by administration of ovine CRH. In abdominal CT, both adrenal glands were markedly enlarged and nodular in appearance. Pituitary MRI showed no abnormal finding. Bilateral adrenalectomy was done. Histologic examination revealed multiple nodules and internodular hyperplasia. This case and other reports suggested that because of variable biochemical, radiologic and pathologic findings, macronodular adrenal hyperplasia represents a heterogeneous group of patients with varying degrees of adrenal autonomy.

Camprison of Diagnostic and Therapeutic scans in Patients with Differentiated Thyroid Cancer.: Yoon Sang Choi, Soo Mi Kim, Shin Gon Kim, Don Hyun Shin, Ie Byung Park, Sei Hyun Baik, Dong Seop Choi, Jae Myung Yu; J Korean Endocr Soc. 1996;11(4):431-437. Published online November 7, 2019

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Abstract PDF: Background
Whole body scan using 131-iodine is performed to detect local recurrence or metastasis after thyroidectorny in differenciated thyroid cancer patients. The sensitivity of this procedure is related to the dose of radiopharmaceutical administered. It was reported that 131I posttreatment whole body scan demonstrate foci of tracer uptake not previously observed in diagnostic scan in 10~30% of cases. Posttreatment scans were most likely to reveal new foci in young patients(<45) and patients who had previously received radioactive iodine therapy. Method: We observed the frequency of discordant posttreatment scans and analysed the clicnical significance in 33 differenciated thyroid cancer patients who were admitted for radioiodine ablation from June, 1995 to April, 1996. Results: In 7 cases(21.2%), post treatment scan demonstrated cme or more foci of uptake and revealed less sites of uptake than diagnostic scan in 3 cases(9.1%). In one case with elevated thyroglobulin level and negative diagnostic scan, post treatment scan revealed new uptake sites with thyroid bed and cervical 1ymph node. The sites of discordant uptake were cervical lymph nodes in 4 cases and rnediastinal lymph node in one case, lung in one case, thyroid bed and cervical lymph nodes in one case, 3 cases of 7 pts(43%), demonstrated ane or more foci of uptake in post treatment scan, had history of previous radioiodine treatent. Conclusion: Post treatment scan confirmed uptake into remnant and metaststic tissues identified on the corresponding low dose diagnostic scans. Scanning after high dose radioiodine treatment frequently demonstrated one or more foci of uptake, especially in patients with previous radioiodine treatment, which were not visualized on the diagnostic low dose scan. Treatment scan may be useful for detection of remnant tissue or metastatic lesion in patients with elevated thyroglobulin and negative diagnostic scan.

A Case of Isolated ACTH Deficiency.: Sang Jin Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi; J Korean Endocr Soc. 1995;10(4):445-450. Published online November 7, 2019

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Abstract PDF: solated ACTH deficiency is a very uncommon cause of hypoadrenocorticism, with less than 200 cases reported in the literatures. The clinical presentation can be similar to that of primary adrenal insufficiency, but there is a greater tendency for hypoglycemia and absence of hyperpigmentation. The diagnosis is established by demonstrating hypocortisolism with undetectable serum levels of ACTH, normal adrenal responsiveness to prolonged ACTH infusion, and an absent ACTH response to insulin-induced hypoglycemia. Other endocrine function is normal.We experienced a case of isolated ACTH deficiency in 34 years old female who was admitted due to fever and drowsy mentality.So we present this case with a review of literatures.

A Clinical Study of 11 Cases of Adrenal Ineidentaloma.: Jae Myung Yoo, Sang Jin Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi, Yong Hyun Kim, Eun Jong Lee; J Korean Endocr Soc. 1994;9(4):358-365. Published online November 6, 2019

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Abstract PDF: With the wide application of ultrasonography and CT scanning, the incidental finding of a radiologic abnormality, apparently adrenal origin, has presented a problem for clinical management. The prevalence of these clinically silent tumors has been reported as 0.6 to 1.3% of upper abdominal CT scans performed for other reasons.Once identified, an adrenal lesion must characterized as to its functional status and malignant potential. A thorough approach that initially excludes biochemical hypersecretion, then considers characteristics of anatomy and the functional nature of an adrenal mass, will allow a rational and cost-effective evaluation and management of these lesions.We present out experience of eleven adrenal incidentalomas with a review of literatures.

Changes in Bone Mineral Density in Patients with Sheehan's Syndrome.: Jae Myung Yoo, Sang Jin Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi, Eun Jong Lee, Yong Hyun Kim; J Korean Endocr Soc. 1994;9(1):10-17. Published online November 6, 2019

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Abstract PDF: Osteoporosis is a common clinical problem with high risk of fractures in old age, especially postmenopausal women.Secondary causes of osteoporosis can be identified in 20% of women and 40% of men with vertebral fractures. One of the causes of secondary osteoporosis is endocrine disease such as hypogonadism, ovarian agenesis, hyperadrenocorticism, hyperthyroidism, hyperparathyroidism and diabetes mellitus. Patients with Sheehan's syndrome have deficiency of multiple hormones which may cause bone loss.To determine changes in the bone mineral density in women with Sheehan's syndrome and to compare clinical and biochemical characteristics between the patients with osteoporosis and the patients without osteoporosis, we measured the bone mineral density(BMD) of the lumber spine and midradius by dual energy X-ray absortiometry(DEXA) and the serum levels of estrogen and osteocalcin in 11 patients of Sheehan's syndrome.The results were as follows;1) The BMDs of the lumbar spine were significantly decreased in patients with Sheehan's syndrome when compared with those of age-matched control.2) The prevalence of osteoporosis in patients with Sheehan's syndromes was 55%. Between the patients with osteoporosis and the patients without osteoporosis, there were no difference in the onset age of amenorrhea, the duration of amenorrhea, and the serum levels of osteocalcin and alkaline phosphatase.3) Serum estradiol levels were decreased uniformly in the patients with Sheehan's syndrome except three patients with estrogen replacement, but the concentration of estradiol was not correlated with the degree of the decrease in bone mass.In conclusion, the patients with Sheehan's syndrome have an increased prevalence of osteoporosis. But the effect of each anterior pituitary hormone deficiency on bone loss should be clarified in the futher prospective study.

4 unusual cases of pheochromocytoma.: Sai Hyun Baik, Kyung Mook Choi, Eun Jong Lee, Yong Hyun Kim, Sang Jin Kim, Jae Myung Yu, Dong Seop Choi; J Korean Endocr Soc. 1993;8(3):356-362. Published online January 1, 2001

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Abstract PDF: No abstract available.

A case of symptomatic rathke's cleft cyst.: Yong Hyun Kim, Eun Jong Lee, Sang Jin Kim, Jae Myung Yoo, Sei Hyun Baik, Dong Seop Choi; J Korean Endocr Soc. 1993;8(1):94-99. Published online January 1, 2001

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Abstract PDF: No abstract available.

A case of familial goiter due to organification defect in siblings.: Sang Jin Kim, Eun Jong Lee, Yong Hyun Kim, Goo Lee, Sai Hyun Paik, Jae Myung Yu, Dong Seop Choi, Jae Geol Choi; J Korean Endocr Soc. 1992;7(4):391-396. Published online January 1, 2001

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Abstract PDF: No abstract available.

A case of lingual thyroid with euthyroidism.: Sin Hyung Lee, Yong Hyun Kim, Eun Jong Lee, Sang Jin Kim, Jae Myung Yu, Sei Hyun Baik, Dong Seop Choi; J Korean Endocr Soc. 1992;7(3):300-304. Published online January 1, 2001

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Abstract PDF: No abstract available.

A case of acute supprative thyroiditis.: Sai Hyun Paik, Jin Goo Lee, Jae Myung You, Dong Seop Choi; J Korean Endocr Soc. 1991;6(2):187-190. Published online January 1, 2001

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Abstract PDF: No abstract available.

Tuberculous Addison's disease.: Hyun Joo Byun, Sai Hyun Paik, dong Seop Choi; J Korean Endocr Soc. 1991;6(1):100-103. Published online January 1, 2001

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Abstract PDF: No abstract available.

Viruses and autoimmune type I diabetes.: Dong Seop Choi; J Korean Endocr Soc. 1991;6(1):88-94. Published online January 1, 2001

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Abstract PDF: No abstract available.

Author index