Endocrinology and Metabolism

Kap Bum Huh (Huh KB)

82 Articles

Clinical Study
Relationships between Thigh and Waist Circumference, Hemoglobin Glycation Index, and Carotid Plaque in Patients with Type 2 Diabetes: Myung Ki Yoon, Jun Goo Kang, Seong Jin Lee, Sung-Hee Ihm, Kap Bum Huh, Chul Sik Kim; Endocrinol Metab. 2020;35(2):319-328. Published online June 24, 2020; DOI: https://doi.org/10.3803/EnM.2020.35.2.319

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Background
This study investigated the relationships of thigh and waist circumference with the hemoglobin glycation index (HGI) and carotid atherosclerosis in patients with type 2 diabetes.
Methods
This observational study included 3,075 Korean patients with type 2 diabetes, in whom anthropometric measurements and carotid ultrasonography were conducted. HGI was defined as the measured hemoglobin A1c (HbA1c) level minus the predicted HbA1c level, which was calculated using the linear relationship between HbA1c and fasting plasma glucose levels. Carotid atherosclerosis was defined as a clearly isolated focal plaque or focal wall thickening >50% of the surrounding intima-media thickness.
Results
The frequency of a positive HGI decreased with increasing thigh circumference in men and increased with increasing waist circumference in women after adjusting for potential confounding variables. Thigh and waist circumference had a combined augmentative effect on the likelihood of positive HGI, which was dramatically higher in patients in higher waist-to-thigh ratio quartiles (adjusted odds ratios for the highest compared to the lowest quartile: 1.595 in men and 1.570 in women). Additionally, the larger the thigh circumference, the lower the risk of carotid atherosclerosis, although in women, this relationship lacked significance after adjustment for potential confounders.
Conclusion
HGI was associated with thigh circumference in men and waist circumference in women. In addition, the combination of low thigh circumference and high waist circumference was strongly associated with a higher HGI in Korean patients with type 2 diabetes. In particular, thigh circumference was associated with carotid atherosclerosis in men. However, further longitudinal studies are warranted.

Citations

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Association between hemoglobin glycation index and subclinical myocardial injury in the general population free from cardiovascular disease
Zhenwei Wang, Yihai Liu, Jing Xie, Nai-Feng Liu
Nutrition, Metabolism and Cardiovascular Diseases.2022; 32(2): 469. CrossRef
Association of Hemoglobin Glycation Index With Contrast-Induced Acute Kidney Injury in Patients Undergoing Coronary Angiography: A Retrospective Study
Zhezhe Chen, Duanbin Li, Maoning Lin, Hangpan Jiang, Tian Xu, Yu Shan, Guosheng Fu, Min Wang, Wenbin Zhang
Frontiers in Physiology.2022;[Epub] CrossRef
Associations of continuous glucose monitoring-assessed glucose variability with intima-media thickness and ultrasonic tissue characteristics of the carotid arteries: a cross-sectional analysis in patients with type 2 diabetes
Naohiro Taya, Naoto Katakami, Tomoya Mita, Yosuke Okada, Satomi Wakasugi, Hidenori Yoshii, Toshihiko Shiraiwa, Akihito Otsuka, Yutaka Umayahara, Kayoko Ryomoto, Masahiro Hatazaki, Tetsuyuki Yasuda, Tsunehiko Yamamoto, Masahiko Gosho, Iichiro Shimomura, Hi
Cardiovascular Diabetology.2021;[Epub] CrossRef

Relationship with Serum Adiponectin Concentrations and Obesity in Korean Children.: Hyoun Ah Kim, Hyoung Suk Lee, Chul Sik Kim, Chul Woo Ahn, Yoon Sok Chung, Kwan Woo Lee, Kap Bum Huh, Dae Jung Kim; J Korean Endocr Soc. 2003;18(5):473-480. Published online October 1, 2003

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Abstract PDF: BACKGROUND
Adiponectin is an adipocytokine that is highly specific to adipose tissue. In contrast to other adipocytokine, the adiponectin levels are decreased in obesity and/or type 2 diabetes. There are few studies regarding the correlation between the adiponectin concentration and obesity in children. Thus, whether the serum adiponectin concentrations are associated with adiposity in children was investigated. METHODS: One hundred and sixty four subjects were selected from the participants in an ongoing study on the relationship between birth weight and insulin resistance in children. The current weights, heights, body fat percentages, waist circumferences, blood pressures, lipid profiles and insulin resistance, by the HOMA method, were measured in all the subjects. The serum adiponectin concentrations were determined by a validated sandwich ELISA, using a human adiponectin-specific antibody. RESULTS: The serum adiponectin concentration was negatively correlated with the body mass index, waist circumference, systolic blood pressure, insulin resistance by HOMA and serum triglycerides, and positively correlated with the serum HDL cholesterol level. The serum adiponectin concentrations in the boys were significantly lower than in the girls. In a multiple regression analysis, the serum adiponectin concentration was strongly associated with waist circumference and gender. CONCLUSION: It is concluded that there was an inverse relationship between the serum adiponectin concentration and abdominal adiposity in children. However, further studies on independent gender differences on adiponectin are needed.

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.

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.

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 Thyroid Storm Due to Thyrotoxicosis Factitia.: Kee Sup Song, Seung Hyun Cho, Byoung Eun Park, Soo Jee Yoon, kyung Wook Kim, Su Youn Nam, Young Duk Song, Sung Kil Lim, kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 2001;16(2):260-264. Published online April 1, 2001

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Abstract PDF: Thyrotoxicosis factitia, a syndrome that results from a surreptitious ingestion of excess thyroid hormone, has generally been diagnosed in young or middle-aged women who have psychopathological disturbances. An 18-year-old female was admitted to the hospital 24 hours after taking an overdose of more than 50 tablets of synthyroid (levothyroxine, 5mg). She had taken 6 to 9 tablets of synthyroid daily for 6 months for the purpose of weight reduction even though she was not overweight. Because of her stuporous mental state and an acute respiratory failure, she was intubated and treated in the intensive care unit. After careful history taking and after her plasma thyroid hormone levels were determined, we diagnosed a thyroid storm that was caused by a thyrotoxicosis factitia. The laboratory results were, T3 430.0 ng/dL, free T4 70.0 ng/dL, TSH 0.05 IU/mL. Her symptoms improved after treatment by steroids and propranolol. She was discharged 8days after admission. Cases of thyrotoxicosis factitia have been reported very infrequently and, there has been no reports of a thyroid storm due to thyrotoxicosis factitia in Korea. We now report a case of a thyroid storm that resulted from thyrotoxicosis factitia that was caused by the ingestion of a massive dose of thyroid hormone that was takan daily for 6 months. We also present a brief review of the relevant literature.

Effect of weight loss on cerebrospinal Fluid and Plasma Concentrations of NPY, alpha -MSH and leptin in Obese Women.: Su Youn Nam, Kyung Wook Kim, Jun Hee Lee, Soo Jee Lee, Kyung Rae Kim, Young Duck Song, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 2001;16(2):199-209. Published online April 1, 2001

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Abstract PDF: BACKGROUND
Although leptin and its principal mediators, neuropeptide Y (NPY) and -melanocyte stimulating hormone (MSH) are postulated to play a pivotal role in the energy balance in experimental animals, the physiologic roles of leptin and its molecular targets are not fully identified in cases of human obesity. METHODS: The subjects consisted of 16 obese women (mean BMI 35.6 kg/m2) before and after weight loss that was induced by a 2 week-very low caloric diet (800 kcal/day) and 14 normal weight women (who had a mean BMI of 20.4 kg/m2). We evaluated the plasma and cerebrospinal fluid (CSF) leptin, NPY and alpha -MSH levels and their relationship in normal weight and obese women. Additionally, changes of these peptides during a negative energy balance (800 kcal/day) were assessed in causes of human obesity. RESULTS: Obese subjects exhibited a 6.3-fold higher plasma leptin level (21.9+/-1.2 vs 3.5+/-0.4 ng/mL, p<0.05) and a 2.8-fold higher CSF leptin level (0.29+/-0.02 vs 0.10+/-0.01 ng/mL, p<0.05) compared to control subjects. The CSF/plasma leptin ratio in normal weight subjects was 2.3-fold higher than that in obese subjects. After a weight loss in obese subjects, the plasma leptin level decreased by 40% and the CSF level decreased by 51%. The CSF/plasma leptin ratio was slightly lower than the baseline level. There was a positive linear correlation between CSF and plasma leptin level at the baseline in obese subjects (r= 0.74, p<0.05) and a positive logarithmic correlation in normal weight subjects and in obese subjects after a weight loss (r= 0.66, p<0.05). The BMI negatively correlated with the CSF/plasma leptin ratio (r=-0.86, p<0.05) in any subjects. Neither the baseline plasma levels nor the baseline CSF levels of NPY were different between the normal weight subjects and obese subjects. After a weight loss the CSF NPY level decreased significantly compared to the baseline values in obese subjects. The alpha -MSH levels in plasma and CSF did not differ significantly from controls in obese subjects at the baseline or after a weight loss. The baseline CSF leptin level neither correlated with the baseline CSF NPY level nor the baseline CSF alpha -MSH level. CONCLUSION: These results demonstrated that the efficiency of leptin delivery to the CNS is reduced in human obesity and that the CNS leptin uptake involves the combination of saturable and unsaturable mechanisms. A marked reduction in the CSF leptin levels compared to the plasma level after a weight loss in obese subjects can be a potent stimulus for the body to regain weight. In contrast to the results that were observed in experimental animals, the CSF NPY and alpha -MSH did not differ from the controls in human obesity and there was no significant correlation between the CSF leptin and CSF of these neuropeptides. This could have resulted from leptin resistance in cases of human obesity although the mechanisms for this resistance remain to be determined.

A Case of Primary Amenorrhea due to 17 -Hydroxylase Deficiency.: Hong Seub Rim, Seon Hwa Lee, Jung Min Hong, Jae Hyun Nam, Hee Back Park, Chul Woo An, Do Min Ki, Sung Kil Lim, Young Duk Song, Hyun Chul Lee, Kap Bum Huh, Inn Soo Kang; J Korean Endocr Soc. 2001;16(1):130-133. Published online February 1, 2001

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Abstract PDF: 17 -Hydroxylase deficiency is a rare form of congenital adrenal hyperplasia that is characterized by primary amenorrhea, absence of secondary sex characteristics, hypertension, and a hypokalemic alkalosis that has resulted resulting from increased production of deoxycorticosterone and corticosterone by the adrenal. The diagnosis of this enzyme deficiency can be recognized by the increasing serum concentrations of steroid precursors, DOC and corticosterone and the decreasing concentrations of cortisol, and adrenal androgens. We diagnosed this in a 19 year old female who presented with primary amenorrhea. We report this case with a review of the literatures.

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).

A Case of Adult Fanconi's Syndrome with Glomerular Podocyte Foot Process Effacement and osteomalacia Induced by k Light Chain Disease.: Jae Hyun Nam, Gyu Hyun Choi, Ki Hyun Park, Chul Woo Ahn, Young Duk Song, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 2000;15(4-5):627-633. Published online January 1, 2001

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Abstract PDF: The Fanconi's syndrome is characterized by generalized disturbance of proximal tubular function. It leads to excessive losses of amino acids, glucose, phosphate, bicarbonate, and other substrates handled by the proximal tubules. The metabolic consequences are acidosis, hypophosphatemia, hypocalcemia, osteomalacia, osteoporosis, and growth retardation. Adult Fanconi's syndrome is mostly secondary form caused by multiple myeloma, primary amyloidosis, light chain nephropathy, and heavy metal poisoning. We experienced 50-year-old woman with kappa light chain disease whose chief complaints were weakness of both lower extremities and multiple bone pain. This patient had renal glycosuria, hypercalciuria, normal anion gap type metabolic acidosis, osteomalacia and normal distal tubule acidification. Her bone marrow biopsy showed inappropriate proliferation of plasma cell. The patient underwent percutaneous renal biopsy in which was exceptionally observed focal effacement of podocyte foot process. So we report a case of osteomalacia caused by adult Fanconi's syndrome and foot process effacement by kappa -light chain disease.

Two Cases of Malignant Lymphoma Involving Bilateral Adrenal Glands as Huge Masses.: Seung Hyeok Han, Jin Seok Kim, Myung Soo Kim, Hye Won Chung, Jae Ho Jung, Young Suck Goo, Chul Woo Ahn, Jae Hyun Nam, Sang Soo Jung, Young Duk Song, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh, Jee Sook Hahn; J Korean Endocr Soc. 2000;15(1):121-127. Published online January 1, 2001

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Abstract PDF: Adrenal gland is a common site of metastatic tumors such as breast cancer, lung cancer, and colon cancer. When adrenal mass is found incidentally, adenoma is the most common among single adrenal masses. But in the case of bilateral adrenal masses, infection, bilateral metastases and hemorrhage are common. Secondary involvement of the adrenal gland is found in 25% of autopsy cases of non-Hodgkin's lymphoma. However, adrenal insufficiency is rare because it becomes apparent only when approximately 90% of adrenal cortex is destructed. We exprienced two cases of malignant lymphoma which involved the adrenal glands bilaterally. One case in which adrenal insufficiency was suspicious, was accompanied by hypovolemic shock and sepsis at the initial presentation. He died of sepsis combined with DIC even though hydrocortisone, intravenous saline infusion, and antibiotics therapy were started immediately. The other one was found incidentally, in which adrenal infiltraion was confirmed by CT scan. Hormonal level was normal and adrenal masses disappeared after chemotherapy.

Mutations in Thyroid Hormone Receptor-beta Associated with Patients with Generalized Resistance and Pituitary Resistance to Thyroid Hormone.: Yong Seok Yun, Sung Kkwan Hong, Chul Woo Ahn, Jae Hyun Nam, Seok Won Park, Bong Su Cha, Young Duk Song, Eun Jig Lee, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 2000;15(1):113-120. Published online January 1, 2001

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Abstract PDF: We report a point mutation in the TRbeta gene in korean patients with generalized resistance and pituitary resistance to thyroid hormone. One mutation at TRbeta (P453S) were detected in patient with pituitary resistance to thyroid, which showed different phenotype, generalized resistance to thyroid hormone, in her mothers. But, the other (C31Y), did not show clear relations with the disease. Therefore, further study of molecular and cellular basis will be warranted to explain the clear mechanism of the resistance to thyroid hormone.

A Case of Propylthiouracil Induced Anti: Neutrophil Cytoplasmic Antibody (ANCA) Positive Vasculitis.: Yumie Rhee, Sang Su Chung, Su Youn Nam, Young Duk Song, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 1999;14(4):757-763. Published online January 1, 2001

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Abstract PDF: A 40-year-old woman just had started to take propylthiouracil for Graves disease, However, the treatment had to be interrupted because she developed skin rash, arthritis, chest pain, fever and proteinuria after 2 months. The serologic study revealed antineutrophil cytoplasmic antibody(ANCA) positivity, especially showing perinuclear pattern. The anti-myeloperoxidase titer was high. The hematoxylin & eosin stain of the specimen obtained from kidney was compatible with pauci-immune glomerulonephritis with crescent formation. There were no immune complex deposits under electron microscope. Such findings suggested propylthiouracil-induced vasculitis. Vasculitis is a rare side effect of propylthiouracil. Recently more cases of vasculitis associated with anti-thyroid drug with ANCA positivity are being reported up to about 36 cases worldwide. There are possibilities of underdiagnosis of this side effect, meaning more cautions on the patients under anti-thyroid drug treatment. We present a case with review of related literature.

Two Cases of Extensive Pituitary Calcification.: Chul Woo Ahn, Shin Myung Kang, Do Young Kim, Jang Yel Shin, Seok Won Park, Jae Hyun Nam, Young Duk Song, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 1999;14(4):739-744. Published online January 1, 2001

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Abstract PDF: Although calcification of such endocrine gland as adrenal or pineal gland is common, extensive calcification of the pituitary gland is unusual. Calcification is a well recognized but uncommon feature of prolactin-secreting, growth hormone-secreting and non-functioning pituitary tumours. The calcification varies in extent, but rarely exceeds a tiny amount histologically or radiologically. Recently, we had the opportunity to investigate two patients with radiologically demonstrated "pituitary stone" (severely calcified pituitary adenoma). The first Patient, a 51 year-old female, initially presented with general weakness, dizziness, visual disturbance, and loss of hair for 2 months. She was suspected to have a pituitary lesion. Decreased secretion of GH, TSH, LH, and FSH was demonstrated by dynamic tests. On CT scan, she was found to have multilobulated calcified sella mass. She was successfully managed by medical treatment. The second patient, a 65 year-old male, presented with general weakness, nausea, vomiting and polyuria for 2 months. Combined pituitary stimulation test showed subnormal response of GH and prolactine. Radiologic studies revealed pituitary stone which was managed with medical treatment of hormone replacement. We suggest that calcific changes in the pituitary adenoma might be common and occur to the extent of pituitary stone formation with the possible alteration of hormonal secretion.

Polymorphisms of the Interleukin - 6 Gene and Bone Mineral Density at Postmenopause in Korean Women.: Soo Young Yoon, Sung Kil Lim, Song Zae Li, Young Duk Song, Hyun Chul Lee, Kyung Rae Kim, Kap Bum Huh; J Korean Endocr Soc. 1999;14(4):698-705. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Interleukin-6 (IL-6) is one of the candidate cytokines to play an important role in bone loss followed by estrogen deficiency. Recently, the IL-6 VNTR (various number tandem repeats) genotype was reported to be associated with bone mineral density, raising the possibility that genotyping at this site might be of value in identifying women who are at risk for postmenopausal osteoporosis. To evaluate whether allelic variants in the gene encoding the polymorphism of VNTR located at the 3 flank of the IL-6 gene in Koreans were also the same as those of Caucasian, we analyzed the distribution pattern of the polymerase chain reaction product of the IL-6 gene. METHODS: The IL-6 VNTR were examined in 134 postmenopausal Korean women. Bone mineral densities were measured by DEXA (dual energy X-ray absorptiometry, Lunar Radiation, Madison, WI). RESULTS: The IL-6 VNTR polymorphism of Koreans was different from that of Caucasian, and four genotypes (KaKb, KbKb, KbKc and KbKd) were identified. The genotypes KaKb and KbKd were found only in one individual each and most Koreans had KbKb or KbKc genotypes. The overall prevalences of KbKb and KbKc genotypes were 76.9% Rlld 21.6%, respectively, and the distribution patterns of the genotypes were not different among normal, osteopenic and osteoporotic groups. The values of bone mineral density at the lumbar spine and femoral neck were not different between the frequent genotypes of KbKb and KbKc. Furthermore, the levels of alkaline phosphatase, osteocalcin and urinary deoxypyridinoline/creatinine were also not different between the two genotypes. CONCLUSION: There are ethnic differences in IL-6 VNTR polymorphism, and IL-6 VNTR polymorphism may not be associated with postmenopausal osteoporosis in Korean women. Our data suggest that the analysis of IL-6 VNTR polymorphism may not be helpful in detecting patients at risk of developing osteoporosis.

The Effect of Body Fat Disribution on Glucose, Lipid Metabolism and Grewth Hormone Secretion in Obesity.: Ae Jung Huh, Byeong Kee Choi, Dae Ho Chung, Kyung Wook Kim, Su Youn Nam, Kyung Rae Kim, Young Duk Song, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 1999;14(3):541-552. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Body fat distribution, rather than the level of obesity per se, appears to be a strong predictor of abnormalities in metabolic complication. Visceral fat accumulation is significantly correlated with glucose intolerance and constitutes as an independent risk factor for the diabetes mellitus. METHODS: We investigated the impact of body fat distribution on the glucose, lipid metabolism and growth hormone secretion in obese subjects with varying glucose tolerance and lean controls matched with sex and age. 69 obese Koreans (34 men, 35 women; 43.8 yrs) and 21 lean Koreans (10 men, 11 women; 40.8 yrs) were recruited. Anthropometric measurement and impedence for measurement of total body fat, and computed tomography for visceral and subcutaneous fat area at umbilicus level were performed. All subjects underwent a standard oral glucose tolerance test and GH stimulation test by L-dopa. RESULTS: The results are summarized as follows. 1. Obese patients had greater ideal body weight (%, IBW) and lean body mass (LBM) than lean controls. But no significant differences were found in IBW and LBM between 3 obese groups. 2. The 25 obese NIDDM had the highest FFA-AUC during OGTI and the lowest GH-AUC to L-Dopa stimulation test. The insulin-AUC during OGTT was the highest in 24 obese subjects with normal glucose tolerance. 3. All male groups have VSR of more than 0.4, which has been designated visceral fat obesity. In contrast all female groups have VSR of lesser than 0.4 but obese DM subjects have the highest VSR. Visceral fat area per body weight ratio(VWR) showed increasing tendency in obese, IGT, and DM group. 4. Waist circumference and VWR showed strong correlation with metabolic parameters among anthropometric parameters. They were positively correlated with FFA-AUC during OGTT and negatively correlated with GH-AUC to L-dopa stimulation. CONCLUSION: Visceral fat accumulation are associated with insulin resistance, dyslipidemia and impairment of growth hormone secretion via increase of free fatty acid. The simple waist circumference may provide a more practical indicator that correlated with aMominal fat distribution and metabolic complications associated with obesity.

The Growth Hormone (GH) - Binding Protein in Obesity with Varying Glucose Tolerance: Relationship to Body fat Distribution Sex Hormones, Insulin and GH-Insulin-Like Growth Factor (IGF)-1 Axis.: Su Youn Nam, Kyung Wook Kim, Sang Won Ji, Se Jung Yoon, Kyung Rae Kim, Young Duk Song, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 1999;14(3):531-540. Published online January 1, 2001

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Abstract PDF: BACKGROUND
As GHBP is believed to be derived from proteolytic cleavage of the extracellular domain of the GH receptor and may be regarded as an intrinsic part of the GH-IGF-1 axis, an effect of body composition on circulating GHBP levels may be expected. We investigated GHBP variations in obesity with varying glucose tolerance and its relationship to body fat distribution, sex hormones, insulin secretion, and the GH-IGF-1 axis. METHODS: Bioelectrical impedence for measurement of total body fat and computed tomography for visceral fat and subcutaneous fat at umbilicus level were performed in 69 obese Koreans and 21 lean Koreans. Insulin secretion in response to an oral glucose tolerance test (OGTT) and a GH stimulation test by L-dopa, growth hormone-binding protein (GHBP), insulin-like growth factor (IGF)-1 and sex hormones (estrone, estradiol, total and free testosterone) were measured. RESULTS: Obese type 2 DM group had the highest GHBP levels and the most visceral fat amount. GHBP levels were most strongly correlated with the ratio of visceral fat area to body weight (VWR) above other parameters (r=0.725, p<0.001). Insulin- and free fatty acid-area under the curve (AUC) during OGTT and IGF-1 level were also positively correlated with GHBP levels (r=0.474, p<0.005; r=0.572, p<0.005; r=0.453, p<0.005). GH-AUC to L-dopa stimulation test was negatively correlated with GHBP levels (r=0.432, p<0.005). The GHBP level was slightly higher in females than in male in the same glucose tolerance category. In males, total and free testosterone levels were negatively correlated with GHBP levels (r=-0.516, p<0.001;r=-0.653, p<0.001). Stepwise multiple linear regression analysis showed that VWR, FFA-and insulin-AUC significantly contributed to the variability of GHBP (r=0.58). CONCLUSION: We demonstrated that 1) visceral fat amount was mainly determined GHBP levels in obese subjects with varying glucose tolerance; 2) hyperglycemia per se did not influence GHBP level, whereas insulin and FFA could play a role in regulation of GHBP level. 3) The constant concentration of IGF-1 despite GH hyposecretion suggests that increased GHBP level retlect GHBP hypersensitivity in order to compensate for decreased GH secretion in obesity; 5) the lower level of GHBP in males might be explained at least in part by a suppressive effect of androgen.

SR (Slow-Replase) Lanreotide Treatment in Acromegalic Patients.: Jae Hyun Nam, Sung Kil Lim, Sun Ho Kim, Chul Woo Ahn, Song Chul Lee, Young Duk Song, Kyung Rae Kim, Hyun Chul Lee, Ki Hyun Park, Kap Bum Huh; J Korean Endocr Soc. 1999;14(3):472-482. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Several clinical studies reported the efficacy of the long-acting SRIH analog, octreotide (Octreotide, Sandoz) in the treattnent of acromegaly. Recently, another SRIH analog (BIM 23014, Ipsen Biotech) was shown to decrease plasma GH levels in acromegalic patients. The recent availability of a long-acting formulation of BIM 23014 [slow release (SR) lanreotide] could avoid repeated sc injections or continuous sc infusions. The objective of this study was to determine the tolerability and effectiveness of the slow release (SR) somatostatin analog, SR lanreotide in active acromegaly. METHOD: Between March 1998 and May 1998, 10 patients were recruited in the prospective study carried out at Yonsei University. The effects of 6 weeks of SR lanreotide, given every 14 days at a dosage of 30 mg, im, were analyzed. All the patients completed the 6-week period of therapy. RESULTS: SR lanreotide injection produced 45% suppression of area under the curve of GH levels from the basal value on oral glucose tolerance test(OGTT). GH values on OGTT were normalized (< 2ng/mL) in 30% of patients after 6 weeks, whereas insulin-like growth factor I (IGF-I) levels were normalized in 50% of patients. No correlation was found between pretreatment GH levels and GH response to SR lanreotide or between changes in GH and IGF-I during therapy, The significant differences in response to SR lanreotide were shown between the patients with residual mass and no visible mass. During treatment, there was the significant reduction in the percentage of patients complaining of joint pain, hyperhydrosis, and paresthesias. Changes in soft tissue swelling were documented by a significant decrease in the diameter of fingers. Mild diarrhea and fatigue were the most frequent side-effects (20 30%) when SR lanreotide therapy was started. However, these side effects decreased progressively. Significant changes were noted in carbohydrate tolerance. CONCLUSIONS: These data indicate that SR lanreotide at a dose of 30 mg, im, every 14 days is an effective treatment in most unselected acromegalic patients, especially in patients with no visible mass. Tolerability to SR lanreotide therapy is high. The use of a new sustained release formulation of somatostatin analog is clearly advantageous in improving patient compliance with medical treatment for acromegaly.

A Case of Osteosarcoma induced Oncogenic Osteomalacia Detected by MRI.: Sung Kil Lim, Young Duk Song, Hyun Chul Lee, Kap Bum Huh, Ki Hyun Park, Kyung Rae Kim, Soon Won Hong, Jae Hyun Nam, Jong In Yook, Byung Joo Choi, Mi Kyung Kim, Kyu Ho Shin; J Korean Endocr Soc. 1999;14(2):401-409. Published online January 1, 2001

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Abstract PDF: Oncogenic osteomalacia is a syndrome characterized by phosphaturia, hypophosphatemia, decreased 1,25-dihydroxyvitamin D level and specific signs and symptoms of osteomalacia. It is associated with the presence of neoplasm originated from mesenchyme. Until now, less than 100 cases of oncogenic osteomalacia have been reported. The pathophysiology of oncogenic osteomalacia has not been fully understood, but it has been suggested that a certain substance released by tumor may inhibit not only la-hydroxylase activity and reduce 1,25-dihydroxyvitamin D level in part, but directly inhibit reabsorption of phosphate. And then, reduced phosphaturia, hypophosphatemia and eventually osteomalacia develop. We report a case of osteosarcoma induced oncogenic osteomalacia detected by MRI in 59 year old woman.

The Repreducitve History and Other Potential Risk Factors as The Determinants of Bone Mineral Density at Postmenopause.: Min Kyung Song, Young Jun Won, Suk Won Park, Young Duk Song, Sung Kil Lim, Jae Jun Oh, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 1999;14(1):91-101. Published online January 1, 2001

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Abstract PDF: BACKGROUND
The purpose of this study was to determine the associations of the potential risk factors including reproductive history and lifestyle factors with bone mineral density at postmenopause. METHODS: The bone mineral density of the lumbar spine and proximal femur were measured by dual energy X-ray absorptiometry (DEXA), and physical and anthropometric data were obtained in 187 healthy postmenopausal women aged 45 to 73. Informations about risk factors were assessed by questionairres including medicosurgical and family history, reproductive history and lifestyle factors (dietary calcium intake, past use of oral contraceptives, consumption of alcohol and caffeine, smoking habits and exercise pattern). RESULTS: 1) Each prevalence of osteopenia and osteoporosis was 43.9% and 16.6% in postmenopausal women. 2) In simple correlation analysis between each risk factor and bone mineral density, factors associated with higher level in body mineral density (BMD) were body mass index (BMI)(p<0.01) and reproductive periods (p<0.05) in lumar spine and femur neck, and exerecise strength in femur neck (p<0.05). On the other hand, more aging and longer postmnopausal periods, lower BMD in lumbar spine and femur (p<0.01) and later menarche, lower BMD in lumbar spine (p<0.01) and femur neck (p<0.05) and higher frequencies of parity were influenced on lower BMD in lumbar spine and femur wards (p<0.01) and femur neck (p<0.05). But the other factors had no relation to BMD. 3) There was no significant difference in BMD according to the amount of diet calcium intake, gravity, lactation, the past use of oral contraceptives, the family history of osteoporosis, smoking habits and intake of caffeine and alcohol. 4) No reproductive history and other risk factors were significantly associated with BMD after the influences of age, postmenopausal periods and BMI were adjusted in multiple regression analysis. CONCLUSION: These results show there are no consistent effects on bone mineral density, after adjusting for age and BMI, of reproductive history and any other risk factors in postmenopausal women.

Anabolic Effects of Recombinant Human Parathyroid Hormone (1-84) on Bone Histomorphometry in Overiectomized Rats.: Young Jun Won, Du Hong Park, Jae Hyun Nam, Jong In Yook, Jin Kim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh, Sung Kil Lim; J Korean Endocr Soc. 1999;14(1):81-90. Published online January 1, 2001

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Abstract PDF: To evaluate the anabolic effects of human recombinant parathyroid hormone [hrPTH(1-84)], we examined effect of low-dose and high-dose of [hrPTH(1-84)] and estradiol on bone histomorphometry in ovariectomized rats. Sixty Sprague-Dawley female rats aged 8~10 weeks were used. Eight weeks after ovariectomy, or sham operation, rats were given daily sc injection of hrPTH (1-84), 30 pg/kg (OVX+L group), 150 pg/kg (OVX+H group), 17-estradiol (30 pg/kg, OVX+E group) or vehicle (OVX+V group) for 4 weeks. After double tetracycline labeling, all rats were killed at day 84. We completed the histomorphometric analysis of distal femoral metaphyseal cancellous bone for trabecular bone volume (TBV), mean trabecular plate thickness (MTPT), mean trabecular plate density (MTPD), mean trabecular plate separation (MTPS), mean osteoid seam width (OSW) and appositional rate (AR). The histomorphometric parameters (TBV, MTPT, OSW and AR) of trabecular bone mass in (OVX+E) group were higher than those in (OVX+V) group. The TBV of trabecular bone in PTH treated groups were higher than that in sham operated, (OVX+V) and (OVX+E) group. The histomorphometric parameters (TBV, MTPD, OSW and AR) of trabecular bone mass in (OVX+H) group showed a tendency to be higher than those in (OVX+L) group, but statistically not significant. In conclusion, Low dose (30 mg/kg) hrPTH (1-84) also shows a sufficient anabolic effect on trabecular bone.

Growth Hormone Therapy with Diet Restriction in Obese Patients with Type 2 Diabetes Mellitus.: Su Youn Nam, Kyung Rae Kim, Young Duk Song, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 1999;14(1):27-39. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Insulin resistance in obesity constitutes an independent risk factor for the development of type 2 diabetes mellitus (DM). Insulin resistance in obese DM can be improved by a decrease in visceral fat and an increase in skeletal muscle which may influence insulin sensitivity via its capacity to uptake glucose load. Diet restriction as a treatment for obesity causes protein catabolism which results in a decrease in muscle mass. Growth hormone (GH) therapy accelerates a lipolysis and promotes protein conservation. We evaluated the effects of GH therapy with diet restriction on lipolysis and anabolism, which can change body composition, insulin resistance and lipid metabolism in obese DM. METHODS: Eighteen newly-diagnosed obese type 2 DM patients (42-56 yrs) were treated with recombinant human GH (GH; 0.06 unit/kg ideal body weight#/day, 3 times/wk) and with diet restriction (25 kcal/kg ideal body weight/day) for 12 weeks. They underwent anthropometric measurement, bioelectrical impedence for total body fat and lean body mass, as well as computed tomography for visceral and subcutaneous fat at the umbilicus level and the muscle area at the mid-thigh level. All subjects underwent a standard oral glucose tolerance test (OGTT) and GH response to L-dopa stimulation. The glucose disposal rate was measured during an euglycemic hyperinsulinemic clamp study. RESULTS: 1. The fraction of body weight lost as fat was significantly greater and the visceral fat area was decreased more in the GH-treated group than in the control group. There was a significant loss of lean body mass and muscle area in the control group, whereas there was an increase in lean body mass and muscle area in GH-treated group. 2. The glucose disposal rate was significantly increased only in the GH-treated group and it was negatively correlated with the ratio of the visceral fat area/muscle area. The serum glucose levels, insulin-area under the curve (AUC) and free fatty acid (FFA)-AUC during OGTT and HbAlc were significantly decreased after GH treatment. The decrease in FFA-AUC was positively correlated with the decrease in the visceral fat area. 3. Total cholesterol and triglyceride were decreased in both groups. LDL-cholesterol was decreased in only the GH-treated group. 4. The GH response to L-dopa stimulatian was blunted in aU subjects and after treatment, the GH response was increased. The insulin-like growth factor-I level was inereased 1.6-fold after the GH treatment. CONCLUSION: This study suggested that in obese DM fed a hypocaloric diet, GH treatment exerted a decrease in visceral fat and an increase in muscle mass via accelerated lipolytic and anabolic effects which could result in the improvement of insulin resistance, glucose metabolism and dyslipidemia.

Structure and Function Analysis of alpha-MSH Analogues.: Sung Kil Lim, Song Chul Lee, Won Tae Lee, Jung Hoon Lee, Soo Yeon Nam, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 1999;14(1):18-26. Published online January 1, 2001

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Abstract PDF: No abstract available.

Insulin Resistance Syndrome in Koreans.: Hyun Chul Lee, Kap Bum Huh, Seok Won Park, Jong Ho Lee; J Korean Endocr Soc. 1999;14(1):1-13. Published online January 1, 2001

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Abstract PDF: No abstract available.

Aldosterone-Producing Adenoma Diagnosed by Selective Adrenal Venous Catheterization.: Sung Kil Lim, Young Duk Song, Hyun Chul Lee, Kap Bum Huh, Min Kyung Song, Hyun Soo Kim, Kyung Rae Kim, Seok Won Park, Yoo Mi Lee, Yong Suk Yoon, Suk Ho Kwon, Jae Hyun Nam, Sul Hye Han, Do Yeon Lee; J Korean Endocr Soc. 1998;13(4):652-658. Published online January 1, 2001

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Abstract PDF: Primary aldosteronism, not a common cause of high blood pressure, is a syndrome which results from excessively secreted aldosterone from adrenal gland and it accounts for 0.05-2.2% of unselected hypertension. In this case the lesion was not visualized on routine abdominal computed tomographic scan due to its small size. Therefore the selective adrenal venous catherterization & venous sampling was done. As there is some difficulty of sampling from Rt. adrenal vein, the method of measuring aldosterone vs. cortisol ratio of Lt. adrenal vein and inferior vena cava was used to localize the aldosterone-producing adenoma. Clinical symptoms normalized and laboratory data returned to normal range after the surgical adrenalectomy.

2 Cases of Peripheral Nerve Tumors of Anterior Neck Simulating Thyroid Nodule.: Sung Kil Lim, Young Duk Song, Hyun Chul Lee, Kap Bum Huh, Kyung Rae Kim, Soo Yeon Nam, Byung Ki Choi, Sang Soo Chung, Kyung Wook Kim, So Rae Choi; J Korean Endocr Soc. 1998;13(4):640-645. Published online January 1, 2001

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Abstract PDF: Peripheral nerve tumors are mostly benign and can arise on any nerve trunk or twig. Although peripheral nerve tumors can occur anywhere in the body, including the spinal roots and cauda equina, many cases are subcutaneous in location and present as a soft swelling, sometimes with a purplish discoloration of skin. There are two major catagories, schwannoma(neurilemmoma), and neurofibroma. Schwannomas are usually solitary and grow in the nerve sheath, rendering them relatively easy to dissect free. In contrast, neurofibromas tend to be multiple, grow in the endoneural substance, which renders them difficult to dissect, may undergo malignant changes, and are the hallmark of von Recklinghausens neurofibromatosis. Masses in the anterior part of neck may be initially thought to be thyroid nodule and then other cervical masses should be considered. The diagnosis rests on clinical suspicion and diagnostic support may be obtained by CT scan, magnetic resonance imaging(MRI) and substraction angiography in the literature. After imaging, fine needle aspiration for cytology may be helpful. If they are resected unrecognized and/or without regard to their nerve origin, major and permanent nerve defects can unnecessarily occur. We experienced 2 cases of peripheral nerve tumors of anterior neck simulating a thyroid nodule.

Effects of B3-adrenergic Receptor Gene Mutation on the Body Fat Distribution and Weight Loss in Obese Subjects.: Sung Kil Lim, Young Duk Song, Hyun Chul Lee, Kap Bum Huh, Kyung Rae Kim, Seok Won Park, Seok Joo Kwon, Eun Young Cho, Jong Ho Lee; J Korean Endocr Soc. 1998;13(4):590-600. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Recently, missense mutation of the B3-adrenergic receptor gene has been shown to be associated with early onset of type 2 diabetes, abdominal obesity and an increased capacity to gain weight. This study was performed to investigate the effects of Trp64Arg mutation in the B3-adrenergic receptor gene on body fat distribution and weight loss in obese subjects. METHODS: Determination of the B3-adrenergic receptor gene mutation with restriction enzyme digestion method, anthropometry, various biochemical studies, including oral glucose tolerance test were performed in 99 obese and 35 control subjects. Body fat distributions were also evaluated by computerized tomography before and after weight-reduction program. RESULTS: I) There were no differences in the frequencies of Trp64Arg mutation in the B3-adrenergic receptor gene between obese and control subjects (15.2 vs 12.9 %). 2) The obese subjects with Trp64Arg mutation had higher waist to hip circumference ratio(WHR) (0.93 +/- 0.05 vs 0.87 +/- 0.04, p<0.001), visceral fat area (115.0 +/- 25.9 vs 86.4 +/- 41.4 cm, p=0.01), but decreased plasma free fatty acid (618.0 +/- 163.1 vs 817.5 +/- 248.2 pEq/L, p=0.001), and triglyceride level (118.7 +/- 36.2 vs 158.4 +/- 105.8 mg/dL, p=0.015) than those without mutation. 3) The obese subjects with Trp64Arg mutation had smaller decreases in weight (-3.4 vs -5.1 kg, p<0.001), body fat content (-2.1 vs -3.8 %, p<0.001), WHR (-0.01 vs -0.03, p=0.025), and abdominal fat masses (total, subcutaneous, and visceral fat) after weight-reduction program than those without mutation. CONCLUSION: Trp64Arg mutation in the B3-adrenergic receptor gene might be one of genetic loci contributing to central obesity and a predictor of difficulty in losing weight in obese subjects.

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 Turner's Syndrome with Hypothyroidism and Pericardial Effusion.: Sung Kil Lim, Young Duk Song, Hyun Chul Lee, Kap Bum Huh, Jin Seok Kim, Yong Suk Yoon, Suk Ho Kwon, Jae Hyun Nam; J Korean Endocr Soc. 1997;12(4):661-666. Published online January 1, 2001

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Abstract PDF: Clinical manifestations of hypothyroidism are very various and these degree are related to the severity and duration of the disease. Pericardial effusions, one of the manifestations of hypothy-roidism, were relatively common in the past. However, recently they may not be so frequent representative of hypothyroid subjects. The higher frequency of Hashimotos thyroiditis in Turners syndrome, especially those with an X-isochromosome, compared with the general population is well known. The pathophysiological process of autoimmunity is thought to be linked with the presence of an abnormal X-chromosome. Recently we experienced a case of X-isochromosome Turners syndrome with hypothyroidism and pericardial effusion and report it with reviews of the literatures.

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.

A Case of Central Diabetes Insipidus Caused by Metastatin Malignant Lymphoma.: Sung Kil Lim, Young Duk Song, Hyun Chul Lee, Kap Bum Huh, Hyun Soo Kim, Kyung Rae Kim, Yoo Mi Lee, Yong Suk Yoon, Suk Ho Kwon, Jae Hyun Nam, Sang Hak Lee; J Korean Endocr Soc. 1997;12(4):596-601. Published online January 1, 2001

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Abstract PDF: The causes of central diabetes insipidus (CDI) are numerous; some primary cases are idiopathic while most secondary cases are surgically induced or the result of tumor. The frequency of metastatic tumor as a cause of DI is 6% to 20% of cases, Variety of malignancies including breast, lung, colon, prostate cancer, and leukemia/lymphoma have been reported to metastasize to the pituitary, although most patients are asymptomatic. Clinical manifestations of pituitary metastases include anterior pituitary failure, visual disturbance, and extraocular muscle weakness. DI is the most common clinical manifestation of hypothalamic-pituitary axis (HPA) metastases. Anatomical basis far this clinical picture is that most metastases occur in the posterior lobe. We report on a 35-year-old male patient with meningeal involvement of malignant lymphoma that was thought to be associated with DI. Confirmation of primary malignancy was made by biopsy at site of cervical lymph node and tonsil, Pituitary involvement was suspected on brain MRI, and satisfactory symptornatic relief was obtained with vasopressin. Because of the progres-sion of underlying lymphorna that has shown no response to combined anticancer chemotherapy, the patient expired on 60th hospital day.

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 use of Urinary Androgen Metabolites in Hyperprolactinemia.: Kyoung Rae Kim, Sung Kil Lim, Young Duk Song, Hyun Chul Lee, Kap Bum Huh, Eun Sook Kim, Su Youn Nam, Eun Jig Lee, Bong Chul Jung, Byeong Kee Choi, Jae Ho Shin; J Korean Endocr Soc. 1997;12(3):443-449. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Hyperprolactinemia has been linked with hyperandrogenism and hirsutism in some women. High plasma Dihydroandrosterone and DHA-S levels were reported in patients with hyperprolactinemia and a dissociation of adrenal androgen and cortisol secretion occurs in normal subjects. The mechanism has not been elucidated, but it has been suggested that pituitary factors other than ACTH modulate adrenal androgen synthesis, One candidate hormone is prolactin. Adrenal tissue has been found to possess prolactin receptors and prolactin has been shown to act synergistically with ACTH and lowers the activity of the enzyme 5a-reductase or 3B-hydroxysteroid dehydrogenase (3B-HSD). The aim of this study was to investigate the secretion of adrenal androgen metabolites in patients with idiopathic hyperprolactinemia and prolactinoma and to deterrnine the relationship with prolactin and androgens. METHODS: We measured 24 hour-urinary DHEA, androstenedione, androsterone, pregnenolone, tetrahydrocorticoid and cortisol in 16 normal controls and 5 patients with idiopathic hyperprolac-tinemia (HP) and 12 patients with prolactonoma in the early follicular phase. RESULTS: Urinary DHEA, AD (androsteredione), and androsterone, the metabolites of adrenal androgen, were significantly higher in both patients with idiopathic HP and prolactinoma compared with those in normal controls (p<0.05), whereas they were not different in both disease groups. Urinary pregnenolone levels, early metabolite of adrenal steroid synthesis, were lower in patients. In contrast, urinary tetrahydorcortisol and cortisol were higher in patients compared to controls. There was no difference in DHEA:androsterone ratio between patients and controls. And there were no correlation between prolactin levels and the levels of androgenic metabolites or clinical symptoms. CONCLUSION: Prolactin has a tropic effct on the secretion of androgens and steroids by the adrenal cortex. But prolactin levels were not correlated with androgen levels or clinical symptoms (amenorrhea), and it might have little effect on lowering the activity of 3B-HSD.

Primary empty sella syndrome.: Kyoung Rae Kim, Sung Kil Lim, Young Duk Song, Hyun Chul Lee, Kap Bum Huh, Eun Sook Kim, In Jai Kim, Yoon Jae Moon, Sang Kyu Na, Su Youn Nam, Eun Jig Lee; J Korean Endocr Soc. 1997;12(3):386-392. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Primary empty sella syndrome (PES) is thought to arise from an incompetent diaphragma allowing progressive herniation of arachnoid membrane with secondary compression and atrophy of the pituitary gland. As a consequence of the improvement and widespread use of neuroradiological techniques, such as computerized tomography (CT) and magnetic resonance imaging (MRI), empty sella is more frequently disclosed. The aim of this study is to assess the associated clinical characteristics and endocrinologic disturbance in empty sella syndrome. METHODS: From January 1986 to June 1996, 171 patients with empty sella syndrome have undergone analysis for clinical characteristics and associated disease. RESULT: In our study, PES was diagnosed in 131 of the 171 patients (77%). Primary empty sella syndrome was frequent in middle aged women (female:male 115:16, mean age: 50.6+12.6 years). The common clinical features were headache (80.2%), obesity (72.5%), and hypertension (27.5%). Most of patients with PES have normal pituitary function (75%). The frequent pituitary dysfunction was hyperprolactinemia in PES (21%). Partial and total emptiness of sella on sella CT or MRI were in 111 (84.7%) patients, and in 20 (15.4%) patients, respectively. The most common associated disease with empty sella syndrome was pituitary adenoma. CONCLUSION: PES should be considered as a possible cause in obese middle aged women with unexplained headache. The combined pituitary function test should be considered for evaluation of pituitary dysfunction when clinically suspected.

Two Cases of Hyperparathyroidism Presenting as Acute Pancreatitis.: Sung Kil Lim, Young Jun Won, Young Duk Song, Hyun Chul Lee, Kap Bum Huh, Bai Jin Lee, Jun Myoung Kim, Yoo Bock Lee; J Korean Endocr Soc. 1997;12(2):321-327. Published online January 1, 2001

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Abstract PDF: The relationship between hypercalcemic crisis and pancreatitis, first described in patients with hyperparathyroidism, still remains controversial. Acute pancreatitis may complicate the clinical course of hyperparathyroidism, particularly when the degree of hypercalcemia is severe. The incidence of hyperparathyroidism presenting as acute pancreatitis appears to be steadily decreasing, possibly reflecting the earlier diagnosis of asymptomatic hyperparaparathyroidism due to widespread application of screening methods. Here, we report two patients with primary hyperparathyroidism manifesting clinically as acute pancreatitis. One patient died of progessive pancreatitis and uncontrolled sepsis. The other patient was fullly recovered by emergent parathyroidectomy followed by medical management of hypercalcemia.

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.

A Case of Down's Syndrome with Graves' Disease.: Kap Bum Huh, Kyoung Ah Kim, Jae Hoon Chung, Yeun Sun Kim, Kyu Jeung Ahn, Eun Mi Koh, Young Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim, Hyun Kyun Ki; J Korean Endocr Soc. 1997;12(1):61-67. Published online January 1, 2001

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Abstract PDF: Down's syndrome (trisomy 21) has been frequently associated with thyroid disease, mainly subclinical hypothyroidism (12.5-32.5%). The occurrence of Downs syndrome in conjunction with hyperthyroidism is rare (0.6-2.5%). The mechanism that Down's syndrome was frequently associated with autoimmune thyroid disease is not clear, but T cell maturation defects and overexpression of chromosome 21 products in Down's syndrome have been suggested. A 19-year-old female was transferred because of generalized weakness. She was born to a 42-year-old mother, She had been suffered from heat intolerance, weight loss, palpitation, dyspnea on exertion and neck swelling and had intermittently taken some medication since her age 9. She had mental retardation (IQ 41) and underdeveloprnent. Exophthalmos, upward-outward slant of palpabral fissures, epicanthal folds, lowset ears, and large, protruding, fissured tongue were identified. Short fifth middle phalanges, clinodactyly and small-sized interventricular septal defect were also detected. Thyroid gland was diffusely enlarged four times the normal size, firm in consistency and had a bruit. Serum T concentration was 7.8ug/dL, T2 306ng/dL, and TSH 0.01ulU/mL. She was positive for thyroid autoantibodies (antimicosomal antibody 1,867 IU/mL, antithyroglobulin antibody 106 IU/mL, and TBII 79.6%). Twenty-four hours radioactive iodine uptake was 64%. Chromosomal analysis with T cell culture stimulated by phytohemagglutinin revealed 47XX, 21 trisomy. Pituitary hormones except TSH were fully stimulated by combined pituitary stimulation. She was finally diagnosed as Down's syndrome with Graves' disease and controlled with use of methimazole.

The Effects of Growth Hormone Tretment on Body Composition and Glucose Metabolism in Adult Hypophysectomized Rats.: Kwan Woo Lee, Hyun Chul Lee, Kap Bum Huh, Yoon Sok Chung, Deok Bae Park, Yup Kang, Hyeon Man Kim, Seoung Oh Yang; J Korean Endocr Soc. 1997;12(1):53-60. Published online January 1, 2001

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Abstract PDF: BACKGROUND
It is well known that growth hormone (GH) stimulates animal growth, but studies on metabolic effects of growth hormone have recently been increasing. The purpose of this study was to clarify the effects of growth hormone treatment on body composition and glucose metabolism in hypophysectomized growth hormone-deficient rats. METHODS: The 20-week-old rnale Sprague-Dawley rats were hypophysectomized and replaced with cortisol and thyroxine for 8 weeks, then administered with recombinant human growth hormone for 2 weeks. Group 1 consisted of intact controls (n 15), while group 2 consisted of hypophysectomized controls (n 12), and group three consisted of those with GH treatment (n 13). The body weights, body composition, blood glucose levels, plasma insulin-like growth factor-I (IGF-I) levels, euglycemic hyperinsulinemic clamp test, and glycogen synthase activities in gastrocnemius muscle were measured before and after growth hormone treatment. RESULTS: Plasma IGF-I levels in GH-treated group increased to intact control group levels after 2 weeks of GH treatment. There were significant changes in body composition after the treatment (fat mass significantly decreased and lean body mass significantly increased). There were no changes in glucose metabolism in peripheral tissue after 2 weeks of GH treatment. CONCLUSION: Human GH treatment (4 IU/kg/day) in adult hypophysectomized GH-deficient rats changed the body composition, but did not alter the glucose metabolism in peripheral tissue.

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.

A Case of Anterior Cervical Lipoma Mimicking Diffuse Goiter.: Eun Jig Lee, Moon Suk Nam, Su Youn Nam, Young Duk Song, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh, Kyung Rae Kim, Jun Sik Na, Yee Hyun Nam, Jeon Hong Kang, Jung Ki Seo; J Korean Endocr Soc. 1995;10(4):418-423. Published online November 7, 2019

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Abstract PDF: Lipoma is a benign fatty tumor that can arise in any location of the body where fat is present. It is found most commonly in the upper half of the body, particularly the head and neck, shoulders, and back. A mass in the antero-inferior part of the neck may be initially thought to be thyroid masses and then other cervical masses should be considered. Ultrasongraphic examination of benign lipoma demonstrates solid and echogenic mass and may differentiate nonthyroid from thyroid masses. Although the location of tumors, its consistency, and its motion with deglutition, seperation from the thyroid on sonographic examination, all pointed to nonthyroidal origin, did not rule out a possible mass that isolated from the lobes of the thyroid. Fine needle aspiration and biopsy can provide clear answer.We herein report a case of anterior cervical mass in a 48-yr-old male patient presenting a non-tender, slightly hard and nodular mass slowly growing for several years and moved with swallowing, and diagnosed his case as benign lipoma using thyroid scan and ultrasonography. When we encounter patients with anterior neck mass, we should consider benign lipoma mimicking diffuse goiter.

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.

Immunohistochemical Study of c - Myc, c - Fos and c - Jun Oncoprotein Expression in the Human Pheochromocytoma.: Jae Wha Jo, Eun Jig Lee, Moon Suk Nam, Kyung Rae Kim, Su Youn Nam, Young Duk Song, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh, Yong Hye Lee, Tae Seung Kim, Kwan Woo Lee; J Korean Endocr Soc. 1995;10(1):26-34. Published online November 6, 2019

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Abstract PDF: A large number of studies for genes involved in oncogenesis have been done during last decade. Over 20 oncogenes have been isolated characterized, and the oncogene expressions in human tumors have been examined. The proto-oncogenes of c-Myc, c-Fos and c-Jun, which modulate the transcription factors, have overexpressed in a variety of human cancers. Immunohistochemical method was used in this study to examine c-Myc, c-Fos and c-Jun oncoprotein expression in 31 patients with human pheochromocytoma 28(90.0%) were benign and 3(10.0%) malignant. C-Myc oncoprotein immunoreactivity was found in 24 cases(77.4%), c-Fos in 29(93.5%), and c-Jun in 25(80.6%). Twenty-one(67.7%) showed positive immunoreactivity for all these oncoproteins, six(19.4%) for 2 oncoproteins, 3 for one oncoprotein. Only 1 case showed negative immunoreactivity for all 3 oncoproteins. The oncoprotein immunoreactivity did not correlate with the amount of 24 hour urinary catecholamine excretion. Although the number of malignant pheochromocytomsa was not so many, most of them showed that the immunoreactivity for oncoprotein was more than 30 percent of tumor cells.The expression of c-Myc, c-Fos and c-Jun oncoprotein were frequently found in human pheochromocytoma. These results suggest that the oncoprotein expression may play an important role in tumorogenesis and proliferation of human pheochromocytoma.

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).

The Effect of Tumor Necrosis Factor - α on Extra Thyroidal Conversion of T4 to T3 in Slices and Extracts of Porcine Liver and Kidney.: Jae Wha Jo, Moon Suk Nam, Su Youn Nam, Young Duk Song, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh, Kyung Rae Kim, Eun Jig Lee; J Korean Endocr Soc. 1994;10(3):242-248. Published online November 6, 2019

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Abstract PDF: Abnormal thyroid function is seen in a wide variety of patients with acute and chronic nonthyroidal-illness, consisting of reduction in both thyroid function and peripheral T_4 to T_3 conversion including decreased serum thyroxin(T_4), decreased triiodothyronine and normal or slightly increased serum TSH. Recently increasing awareness of the role tumor necrosis factor-alpha(TNF-alpha) in systemic illness led us to consider a possible contribution of TNF-alpha to thyroid dysfunction in this setting. So we hypothesized that TNF-alpha might affect peripheral conversion of T_4 to T_3. We, therefore, explored the effects of TNF-alpha in slices and extracts of porcine liver and kidney. Thyroxine(T_4, 5ug/ml) was incubated in 0.15M phosphate buffer(PH 7.4) with slices(approximately 0.3 g-equivalent of tissue) and extracts(approximately 0.23 g-equivalent of tissue) of porcine liver and kidney with various concentrations(0-500pg/ml) of recombinant human TNF-alpha for 2 hours at 37 degree, and the T_3 generated during incubation was measured by radioimmunoassay of an ethanol extracts of the extracts and the homogenates of the slices. The slices produced more T_3 than extracts and the kidney was more active than the liver. TNF-alpha inhibited T_4 to T_3 conversion in dose-dependent manner in slices and extracts of porcine liver and kidney. Our data suggest that TNF-alpha have inhibitory effect of T_4 to T_3 conversion in liver and kidney(J Kor Soc Endocrinol 10: 242-248, 1995).

The Effect of Tumor Necrosis Factor - α on the Thyroglobulin Synthesis and TSH Action in Cultured Porcine Thyroid Cells.: Jae Wha Jo, Eun Jig Lee, Moon Suk Nam, Su Youn Nam, Young Duk Song, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh, Kyung Rae Kim; J Korean Endocr Soc. 1994;10(3):220-228. Published online November 6, 2019

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Abstract PDF: Abnormal thyroid function is seen in a wide variety of patients with acute and chronic nonthyroidal-illness, consisting of reduction in both thyroid function and peripheral T_4 to T_3 conversion including decreased serum thyroxin(T_4), decreased triiodothyronine and normal or slightly increased serum TSH. Recently increasing awareness of the role of tumor necrosis factor-alpha(TNF-alpha) in systemic illness led us to consider a possible contribution of TNF-alpha to thyroid dysfunction in this setting. So we hypothesized that TNF-alpha might affect the function of the thyroid gland. We, therefore, explored the effects of TNF-alpha on the cultured porcine thyroid cells in TSH-stimulated and TSH-nonstimulated conditions. Primarily cultured porcine thyroid cells were incubated with various concentrations(-500pg/ml) of recombinant buman TNF-alpha and bTSH(1mu/ml), with measurement of secreted thyroglobulin(Tg) and cyclic AMP(c-AMP) as the end points of stimulation, and produced intracellular Tg by pulse-labelling. TNF-alpha significantly inhibited TSH-stimulated intracellular Tg synthesis and extracellar Tg secretion at 200 and 500pg/ml concentration. TNF-alpha didn't affect c-AMP production at any concentration tested. So we conclude that increased in serum TNF-alpha may be responsible for reduced thyroid function in patients with acute and chronic nonthyroidal-illness.

A Case of Primary Hyperparathyroidism Associated with Hypercalcemic Crisis and Systemic Calcinosis.: Young Duk Song, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh, Bong Sou Park; J Korean Endocr Soc. 1994;10(2):148-152. Published online November 6, 2019

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Abstract PDF: Recent reports have fueled on interest in the prevalance and significance of metastatic calcium deposition in patients with chronic hyperparathyroidism. Nephrocarcinosis and cutaneous cacifications have been recognized in patients with chronic renal failure, but the hypercalcemic crisis and systemic calcinosis are extremely rare in patients with primary hyperparathyroidism. We experienced a patient with primary hyperparathyroidism, presented with hypercalcemic crisis and metastatic calcification in the lungs, stomach, liver, and disappeared by successful parathyroidectomy.

10 Years Prospective Study for the Surgical Total Removal of Pituitary Tumor; Preliminary Report - 2, 5 Years Follow Up.: Eun Jig Lee, Sung Kil Lim, Kap Bum Huh, Sun Ho Kim, Dong Ik Kim, Byung Hee Lee, Ju Heon Yoon, Su Yeon Choi, Joong Uhn Choi, Sang Seop Chung, Kyu Chang Lee; J Korean Endocr Soc. 1994;10(2):85-94. Published online November 6, 2019

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Abstract PDF: The goal of the pituitary tumor surgery is restoration of the normal endocrine function and releaving the pressure effects of the tumor mass on the adjacent neural structures. The authors had proceeded with the 10 years prospective follow-up study for the endocrine function and recurrence of pituitary tumor in the patients who received the complete total resection of tumor mass by the means of total capsulectomy.The authors will discuss the preliminary result of 2.5 years follow-up of this study.

Signal Transduction Related Oncogenes in Human Adrenal Cortical Tumor; Gsα Giα, CREB.: Eun Jig Lee, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh, Sung Kil Lim, eun Kyung Jung, Hyung Chun Park, Woo Hee Jung, Dong Whan Shin, Hyun Suk Lee, Yung Dae Yoon; J Korean Endocr Soc. 1994;9(4):350-357. Published online November 6, 2019

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Abstract PDF: Functioning adrenal cortical tumors are originated form a distinct zone(zonna glomerulosa, zonna fasciculata or zonna reticularis) or the transitonal zone of adrenal gland. Each zone of the gland is regulated by their specific hormons or cytokines, and their signal transduction systems are different. The oncogenes of many endocrine tumors were mutated proteins involved in signal transduction, however gip is the only reported oncogene in adrenal cortical tumors. Therefore we decided to reevaluate whether gsp might be detected as an oncogene in several different functioning adrenal tumors, and we also tested whether CREB protein is a tentative oncogene or not. In our study, gsp was not detected in 13 patients, however gip was not also detected unexpectedly. There were no mutations in the phosporylation site of CREB("P" box) in adrenal cushing syndrome. We concluded that gip was not a oncogene detected frequently in adrenal cortical tumor, and CREB protein was not considered as a tentative oncogen, because there might be no amplification of the signals due to its extreme distal component of PKA or PKC system.

The Effect of Methimazole on the Thyroglobulin Synthesis in Cultured Porcine Thyroid Cells.: Eun Jig Lee, Hyun Chul Lee, Kap Bum Huh, Kyung Rae Kim, Sung Kil Lim, Kyung Mi Lee; J Korean Endocr Soc. 1994;9(4):332-336. Published online November 6, 2019

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Abstract PDF: The thioureylene drugs, propylthiouracil and methylmercaptoimidazol(MMI), exert their antithyroid effect primarily through inhibition of thyroid peroxidase-catalyzed iodination of thyroglobulin. Recently the interest about the effect to the thyroglobulin synthesis of these drugs have been increasing. So we studied the MMI effect to the thyroglobulin synthesis in cultured porcine thyroid cells. Porcine thyroid cells were isolated by sequential trypsinization in the presence of EGTA, seeded at high density(1X10^6 cells/cm^2) and cultured. One week later, MMI was added in different concentrations(0, 0.2, 1, 5mM) with TSH only or with 4H(b-TSH, Insulin, Transferrin, Hydrocortisone) or without hormone. Medias were collected after 24 hours and compared the amount of thyroglobulin secreted. And also pulse-labeling were performed with S^35 cysteine/methionine(1-2uCi/well) for 30, 60, 90min at the same conditions.There was no significant change in the amount of the secreted thyroglobulin by MMI, and there was no significant change in the pulse-labeled interacellular thyroglobulin by MMI. And also there was no significant change in the secretion of TSH-stimulated thyroglobulin by MMI. So we conclude that MMI has no effect on the thyroglobulin synthesis in cultured porcine thyroid cells and also MMI has no effect on the TSH-stimulated thyroglobulin synthesis in cultured porcine thyroid cell.

The Effect of Iodine on the thyroglobulin Synthesis in Cultured Porcine Thyroid Cells.: Eun Jig Lee, Hyun Chul Lee, Kap Bum Huh, Kyung Rae Kim, Sung Kil Lim, Kyung Mi Lee; J Korean Endocr Soc. 1994;9(4):318-324. Published online November 6, 2019

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Abstract PDF: The amount of thyroglobulin synthesized from thyroid cells and stored in colloid space in very important in thyroid hormone synthesis. The thyroglobulin synthesis is mainly regulated by TSH secreted from the pituitary gland. But recently there were some reports about the possibility that iodine regulated the thyroid protein synthesis. So our studied were conducted to determined whether iodine could have inhibitory effect on thyroglobulin synthesis and methimazole could abolish the inhibitory effect of idoine.Porcine thyroid cells were isolated by sequential trypsinization in the presence of EGTA, seeded at high density(1X10^6 cells/cm^2) and cultured. One week later, Nal was added in different concentrations(10^-7, 10^-6, 10^-5, 10^-4M). 24hour medias were collected and checked the amount of thyroglobulin secreted. And also pulse-labeling were performed with[^35S] cysteine/methionine(1-2 uCi/well) for 1 hour at the same conditions. We used 3mM methimazole and 10^-4M NaI to observe the blocking effect of methimazol in iodine.The extracellular thyroglobulin secretion was significantly decreased by iodine in dose dependent manner(82.4%, 80.7%, 76.8% and 73.1% of control). And also intracellular thyroglobulin synthesis was significantly decreased by iodide in dose dependent manner(100.5%, 83.4%, 82.3% and 79.4% of control). The inhibitory effect of iodide was abolished by methimazole(74.7% to 101.3% of control). These data indicate that high iodide inhibit the thyroglobulin synthesis and secretion from the thyroid cells, and furthermore autoregulation by iodide may include thyroglobulin synthesis. And also this effect is dependent on the generation of an organic form of iodine because methimazole abolish the inhibitory effect of iodide.

Seasonal Variation in Serum 25-Hydroxyvitamin D in The Elderly in Korean.: Eun Jig Lee, Kyung Rae Kim, Young Duk Song, Hyun Chul Lee, Kap Bum Huh, Choon Hee Chung, Sung Kil Lim, Yoon Sok Chung; J Korean Endocr Soc. 1994;9(2):121-127. Published online November 6, 2019

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Abstract PDF: The seasonal variations in the parameters of calcium metabolism including 25-hydroxyvitamin D were analyzed in 19 free-living elderly subjects (mean age:68.7±6.7 yr) in Seoul. Mean serum total calcium concentration was 9.0±0.3 mg/dl in March and had risen to 9.3±0.3mg/dl in the following September(p<0.001). Despite their comparable calcium intake. Serum phosphorus and alkaline phosphatase concentrations did not show any seasonal variations, whereas serum PTH concentrations were significantly lower in September than in March(20.1±8.6 vs. 32.5±8.4 pg/ml, p<0.001). Seasonal changes in serum 25-hydroxyvitamin D concentrations were also found between the value(17.3±6.9 ng/ml) in March and that (28.5±7.4 ng/ml) in September(p<0.001). There was a significant correlation between seasonal increase in 25-hydroxyvitamin D and seasonal reduction in serum PTH/Cr(r=-0.5394, p<0.05). This study suggests that the winter minimum of serum 25-hydroxyvitamin D concentration and the elevated PTH may be a contributing risk factor for the development of osteopenia especially in the elderly individuals. When exposure to sunlight is reduced, as in the case of nursing home population, an additional exogenous form of the vitamin D may be advisable.

In Situ Hybridization Analysis of Human Growth Hormone and Prolactin Secreting Pitultary Adenomas.: Jae Wha Jo, Eun Jig Lee, Moon Suk Nam, Kyung Rae Kim, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh, Tae Seung Kim, Sun Ho Kim, Joong Uhn Choi, Kyu Chang Lee, Hyun Joo Jung, Sang Seop Chung; J Korean Endocr Soc. 1994;9(2):82-92. Published online November 6, 2019

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Abstract PDF: A non-isotopic in situ hybridization method with biotin-labelled oligonucleotide probes was used to examine growth hormone(GH) and prolactin(PRL) gene expression in 32 patients with pituitary adenomas; 13 were prolactinomas, 8 GH secreting adenomas, and 11 mixed GH and PRL secreting adenomas.Positive immunostaining for GH was found in all patients with GH secreting adenomas, and mixed GH and PRL secreting adenomas. Positive immunostaining for PRL was found in all patients with prolactinomas and 9(81.8%) of 11 mixed GH and PRL secreting adenomas, 5(62.5%) of 8 GH secreting adenomas. Immunohistochemistry revealed that 13 were lactotrope adenomas, 5 somatotrope adenomas, and 14 GH and PRL cell adenomas.In situ hybridization revealed that GH mRNA expression was found in all the patients with somatotrope adenomas and GH and PRL cell adenomas, and 6(46.1%) of 13 lactotrope adenomas. PRL mRNA expression was 100% in lactotrope and GH and PRL cell adenomas, and 4(80.0%) of 5 somatotrope adenomas.The patients with a clinical diagnosis of acromegaly had detectable PRL mRNA in their neoplasm and it is suggested that the PRL cells in the adenomas did not result from dedifferentiation, but from the neoplastic stimulus for some mixed tumors probably occurred in cells previously committed to produce PRL and GH. In lactotrope adenomas, the PRL cells of the patients without expression of GH mRNA may be arised from cells programmed to secrete PRL or precussor PRL cells rather than from mixed GH-PRL cells. The finding that some patients produced mRNA detectable by in situ hybridization, but no hormone detectable by immunohistochemistry within tumor was suggested of a silent adenoma.These observations indicated that in situ hybridization studies may improve the classification of pituitary adenomas and may provide a precise knowledge of the biology of these neoplasms.

Clinical usefulness of urinary growth hormone measurements in adults.: Yoon Sok Chung, Hyun Chul Lee, Kap Bum Huh, Duk Hi Kim, Myung Hee Lee; J Korean Endocr Soc. 1993;8(4):398-403. Published online January 1, 2001

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Abstract PDF: No abstract available.

Causes and endocrinological characteristics of pituitary insufficiency in koreans.: Mee Hee Oh, Hyeon Man Kim, Uk Kyun Hong, Eun Jik Lee, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 1993;8(4):390-397. Published online January 1, 2001

1,030 View
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Abstract PDF: No abstract available.

The effects of different hormone conditions on the structure of the thyroglobulin from cultured pig thyroid cells.: Kyung Rae Kim, Eun Jig Lee, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 1993;8(3):310-317. Published online January 1, 2001

943 View
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Abstract PDF: No abstract available.

Thyroglobulin synthesis in cultured porcine thyroid cells.: Kyung Rae Kim, Eun Jig Lee, Kyoung Mi Lee, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 1993;8(3):303-309. Published online January 1, 2001

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Abstract PDF: No abstract available.

Antibody-dependent cell-mediated cytotoxicity against FRTL-5 cells in korean postpartum thyroiditis.: Hyun Chul Lee, Kwan Woo Lee, Kyung Rae Kim, Eun Jig Lee, Kwang Jin Ahn, Jai Hee Jung, Yun Sok Chung, Mi Rin Kim, Hyeon Man Kim, Sung Kil Lim, Kap Bum Huh; J Korean Endocr Soc. 1993;8(3):296-302. Published online January 1, 2001

916 View
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Abstract PDF: No abstract available.

Growth hormone response to L-dopa and pyridostigmine in women with polycystic ovary syndrome.: Kyeong Mi Lee, Eun Jig Lee, Kyung Rae Kim, Byung Seok Lee, Ki Hyun Park, Hee Dong Bae, Yoon Sok Chung, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 1993;8(3):265-272. Published online January 1, 2001

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Abstract PDF: No abstract available.

The effect of ipriflavone on postmenopausal osteoporosis.: Young Joon Weon, Yoon Sok Chung, Ki Young Hong, Yoo Kyoung Park, Hee Son Kim, Jong Ho Lee, Eun Jig Lee, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 1993;8(3):259-264. Published online January 1, 2001

1,135 View
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Abstract PDF: No abstract available.

The effect of body fat on bone density in pre-and postmenopausal women.: Young Duk Song, Sung Kil Lim, Yoon Sok Chung, Seog Won Park, Choon Hee Chung, Kwang Jin Ahn, Eun Jig Lee, Hyun Chul Lee, Kap Bum Huh, Mi Sook Choi, In Kyung Paik, Jong Ho Lee; J Korean Endocr Soc. 1993;8(3):251-258. Published online January 1, 2001

1,028 View
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Abstract PDF: No abstract available.

A case of cushing's syndrome due to bilateral macronodular adrenocortical hyperplasia associated with empty sella syndrome.: Jin Ahn Kim, Kyung Mi Lee, Yoon Sok Chung, Eun Tack Shin, Uk Hee Won, Eun Jig Lee, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh, Ki Whang Kim, Hee De Lee, Woo Hee Jung; J Korean Endocr Soc. 1993;8(2):203-210. Published online January 1, 2001

1,090 View
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Abstract PDF: No abstract available.

The correlation between body composition and bone mineral density in pre-and postmenopausal women.: Moon Suk Nam, Eun Jig Lee, Kyung Rae Kim, Kyung Mi Lee, Yoon Sok Chung, Sung Kil Lim, Hyun Chul Lee, Byung Suk Lee, Ki Hyun Park, Kap Bum Huh; J Korean Endocr Soc. 1993;8(2):180-186. Published online January 1, 2001

1,022 View
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Abstract PDF: No abstract available.

Comparision of bone mineral density in acromegalic pateints according to the gonadal status.: Seog Won Park, Young Soo Kim, Woon Sok Chung, Kyung Mi Lee, Eun Jig Lee, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 1993;8(2):149-156. Published online January 1, 2001

985 View
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Abstract PDF: No abstract available.

alpha-subunit secretion of pituitary adenomas.: Kyeong Mi Lee, Eun Jig Lee, Kyung Rae Kim, Yoon Sok Chung, Byoung Kwon Lee, Seg Won Park, Sung Kil Lim, Hyun Chul Lee, Doe Heum Yoon, Young Soo Kim, Kap Bum Huh; J Korean Endocr Soc. 1993;8(2):127-133. Published online January 1, 2001

1,126 View
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Abstract PDF: No abstract available.

A case of pituitary metastasis from periampullary carcinoma.: Eun Tack Shin, Eun Jig Lee, Kyung Rae Kim, Kyung Mi Lee, Hee Dong Bae, Kwan Sik Lee, Yoon Sok Chung, Kwang Jin Ahn, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 1993;8(1):88-93. Published online January 1, 2001

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Abstract PDF: No abstract available.

Gonadotropin-releasing hormone(GnRH) therapy in male patients with hypothalamic hypogonadism.: Seog Won Park, Yoon Sok Chung, Choon Hee Chung, Sung Eun Kim, Eun Jig Lee, Hyun Chul Lee, Kap Bum Huh, Hyung Ki Choi, Moo Sang Lee, Ki Hyun Park; J Korean Endocr Soc. 1993;8(1):27-34. Published online January 1, 2001

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Abstract PDF: No abstract available.

Empty sella syndrome associated with diabetes insipidus: report of two cases.: Jae Hee Chung, Eun Jig Lee, Yoon Seog Chung, Eui Suk Whang, Kwang Jin Ahn, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 1992;7(1):66-70. Published online January 1, 2001

1,029 View
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Abstract PDF: No abstract available.

Pituitary oncocytoma.: Eun Jig Lee, Kyung Rai Kim, Hyun Chul Lee, Kwang Jin Ahn, Yoon Sok Chung, Sung Kil Lim, Kap Bum Huh, Woo Ick Yang, Woo Hee Chung, Tae Seung Kim, Do Heum Yoon, Sang Seop Chung; J Korean Endocr Soc. 1992;7(1):16-23. Published online January 1, 2001

1,008 View
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Abstract PDF: No abstract available.

Clinical review of pheochromocytoma.: Shin Kee Ahn, Kwang Jin Ahn, Eun Jig Lee, Yoon Sok Chung, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh, Cheong Soo Park, Jin Moo Lee; J Korean Endocr Soc. 1991;6(3):245-253. Published online January 1, 2001

1,147 View
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Abstract PDF: No abstract available.

Clinical aspexts on craniopharyngioma.: Jae Hee Chung, Hyun Chul Lee, Nae Choon Yoo, Yoon Sok Chung, Seong Kil Lim, Kyung Rae Kim, Kap Bum Huh; J Korean Endocr Soc. 1991;6(2):163-169. Published online January 1, 2001

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Abstract PDF: No abstract available.

A case adult onset hypophosphatemic osteomalacia.: Hyun Chul Lee, Young Duk Song, Kwang Jin Ahn, Mi Rim Kim, Kwan Woo Lee, Seong Kil Lim, Kyung Rae Kim, Kap Bum Huh, Chang dong Han, Je Geun Chi; J Korean Endocr Soc. 1991;6(1):75-81. Published online January 1, 2001

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Abstract PDF: No abstract available.

Effect of elcatonin on patients with osteoporosis.: Nam Jyun Kim, Hwan Mo Lee, Kap Bum Huh, Hyun Chul Lee; J Korean Endocr Soc. 1991;6(1):51-57. Published online January 1, 2001

1,094 View
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Abstract PDF: No abstract available.

Author index