Endocrinology and Metabolism

Kwang Won Kim (Kim KW)

58 Articles

Sustained Maintenance of Normal Insulin-like Growth Factor-I during Pregnancy and Successful Delivery in an Acromegalic Patient with Octreotide-LAR(R) Treatment.: Soo Kyoung Kim, Jung Hwa Jung, Jae Hyeon Kim, Kyu Yeon Hur, Alice Hyun Tan, Hee Kyung Kim, Ji In Lee, Hye Soo Chung, Kwang Won Kim; Endocrinol Metab. 2010;25(3):213-216. Published online September 1, 2010; DOI: https://doi.org/10.3803/EnM.2010.25.3.213

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Abstract PDF: We report here on a 34-year-old Korean woman with active acromegaly and who received Octreotide-LAR(R) for 12 months following transsphenoidal pituitary surgery. During Octreotide-LAR(R) treatment, the clinical improvement was paralleled with the decrease of the growth hormone levels to 1.1 ng/mL and the insulin-like growth factor-I (IGF-I) levels to 345.5 ng/mL. Octreotide-LAR(R) was discontinued when the patient was found to be at the 12th week of pregnancy. During pregnancy, the patient experienced clinical well-being and she maintained her IGF-I levels within the normal range for her age-matched despite discontinuation of Octreotide-LAR(R) treatment at early gestation. She delivered a full-term healthy male infant. The serum IGF-I levels of the patient increased progressively increased after delivery. This report describes a successful pregnancy in an acromegalic woman who was exposed to Octreotide-LAR(R) during the early gestational period. She and who showed an unexpected pattern of persistently normal IGF-I levels through the pregnancy despite discontinuation of Octreotide-LAR(R) therapy.

Clinicopathological Characteristics and Prognostic Factors of Medullary Thyroid Carcinoma.: Hye Won Jang, Ji In Lee, Kyu Yeon Hur, Jae Hyeon Kim, Sun Wook Kim, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim, Jae Hoon Chung; Endocrinol Metab. 2010;25(3):183-191. Published online September 1, 2010; DOI: https://doi.org/10.3803/EnM.2010.25.3.183

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BACKGROUND
Studies on the clinicopathological characteristics and prognostic factors of medullary thyroid carcinoma (MTC) in Korea are very rare. METHODS: We enrolled 56 MTC patients who underwent surgery at Samsung Medical Center from 1995 to 2006. We analyzed their gender, age at diagnosis, the pathologic findings, the TNM stage, the association with multiple endocrine neoplasia (MEN), RET protooncogene mutation and the, serum basal calcitonin levels before and after the surgery. We investigated the overall survival and the prognostic factors. RESULTS: The mean age at diagnosis was 46 years and the male/female ratio was 1:2.7. Fine needle aspiration cytology detected 61% of the MTC. The mean tumor size was 2.6 cm (range: 0.2-9.0 cm). Fifty-two percent of patients had the TNM stage more than III at the time of diagnosis. Distant metastasis was found in 5.3% (3/56) of the patients, either at the time of diagnosis or during the follow-up period. Hereditary MTC comprised of 23% of the patients and the disease developed at a younger age (38 years vs. 48 years, respectively, P < 0.05) with more bilaterality. RET protooncogene mutations were found in 27% (9/33) of the patients and most of them were in codon 634. After the primary surgery, the serum basal calcitonin levels were persistently elevated over 13 ng/L in 49% of the patients. The overall 5-year survival rate was 95.5%. Tumor size and distant metastasis were the significant prognostic factors for survival by univariate analysis (P < 0.05). CONCLUSION: There were no significant differences in the clinicopathological characteristics of MTC and survival in Korea compared to those of the Western countries.

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Preoperative Clinical and Sonographic Predictors for Lateral Cervical Lymph Node Metastases in Sporadic Medullary Thyroid Carcinoma
Hye-Seon Oh, Hyemi Kwon, Eyun Song, Min Ji Jeon, Dong Eun Song, Tae Yong Kim, Jeong Hyun Lee, Suck Joon Hong, Won Bae Kim, Young Kee Shong, Jung Hwan Baek, Won Gu Kim
Thyroid.2018; 28(3): 362. CrossRef
The Relationship between Ultrasonographic Features and Clinical Characteristics of Medullary Thyroid Carcinoma
Min Joon Park, Young Sik Choi, Hee Sung Song, Beom Su Kim
Clinical Ultrasound.2018; 3(1): 8. CrossRef
Dynamic risk stratification for medullary thyroid cancer according to the response to initial therapy
Hyemi Kwon, Won Gu Kim, Min Ji Jeon, Dong Eun Song, Yu-Mi Lee, Tae-Yon Sung, Ki-Wook Chung, Jong Ho Yoon, Suck Joon Hong, Jung Hwan Baek, Jeong Hyun Lee, Tae Yong Kim, Won Bae Kim, Young Kee Shong
Endocrine.2016; 53(1): 174. CrossRef
Postoperative biochemical remission of serum calcitonin is the best predictive factor for recurrence‐free survival of medullary thyroid cancer: a large‐scale retrospective analysis over 30 years
Kyong Yeun Jung, Seok‐Mo Kim, Won Sang Yoo, Bup‐Woo Kim, Yong Sang Lee, Kyung Won Kim, Kyu Eun Lee, Jong Ju Jeong, Kee‐Hyun Nam, Se Hoon Lee, Jeong Hun Hah, Woong Youn Chung, Ka Hee Yi, Do Joon Park, Yeo‐Kyu Youn, Myung‐Whun Sung, Bo Youn Cho, Cheong Soo
Clinical Endocrinology.2016; 84(4): 587. CrossRef
Changing trends in the clinicopathological features and clinical outcomes of medullary thyroid carcinoma
Hyemi Kwon, Won Gu Kim, Tae‐Yon Sung, Min Ji Jeon, Dong Eun Song, Yu‐Mi Lee, Jong Ho Yoon, Ki‐Wook Chung, Suck Joon Hong, Jung Hwan Baek, Jeong Hyun Lee, Tae Yong Kim, Young Kee Shong, Won Bae Kim
Journal of Surgical Oncology.2016; 113(2): 152. CrossRef
Localization of medullary thyroid carcinoma after surgery using 11C-methionine PET/CT: comparison with 18F-FDG PET/CT
Hye Won Jang, Joon Young Choi, Ji In Lee, Hee Kyung Kim, Hyun Won Shin, Jung Hee Shin, Sun Wook Kim, Jae Hoon Chung
Endocrine Journal.2010; 57(12): 1045. CrossRef

Clinico-pathologic Characteristics of the Primary Thyroid Cancer in Patients with Breast Cancer.: Hyun Won Shin, Hye Won Jang, Ji Young Park, Jae Hoon Chung, Young Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim, Sun Wook Kim; J Korean Endocr Soc. 2009;24(4):240-246. Published online December 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.4.240

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BACKGROUND
Both thyroid and breast cancers occur more frequently in women than in men. Some suggest that estrogen plays a role in the tumorigenesis of both cancers. The aim of this study was to identify the prevalence and clinico-pathologic characteristics of primary thyroid cancer in patients with breast cancer. METHODS: We retrospectively obtained clinical and pathologic data for 112 patients diagnosed with both thyroid and breast cancer from a single center. Patients with thyroid cancer were grouped according to the chronological sequence of tumor diagnosis. When thyroid and breast cancers were diagnosed within 12 months of each other, they were considered to have been diagnosed simultaneously. Female patients who had only papillary thyroid cancer were used as a historic control. RESULTS: Between 1994 and 2008, 7,827 patients at our hospital were diagnosed with breast cancer and 6,571 patients with thyroid cancer. There were 112 patients who had both thyroid and breast cancer. All thyroid cancers (111/112) except one hurthle cell cancer were papillary thyroid cancers. Average tumor size of thyroid cancer cases diagnosed 1) after or 2) simultaneously with the diagnosis of breast cancer was significantly lower than that for 3) thyroid cancer cases found before breast cancer diagnosis or 4) historical controls with papillary thyroid cancer [sizes (in cm), respectively, were: 1) 0.9 +/- 0.6 2) 0.9 +/- 0.5 vs 3) 1.4 +/- 0.9 4) 1.4 +/- 1.1, P < 0.05]. No patients had distant metastases and there were no statistically significant differences in known risk factors for recurrence and survival of patients with thyroid cancer. CONCLUSION: Thyroid cancer is the most common second primary malignancy in patients with breast cancer and most of them are papillary thyroid cancers. There are no differences in risk factors for tumor recurrence and patient survival compared with those with conventional papillary thyroid cancer except for differences in tumor size. These difference in size may reflect an increase in medical surveillance in patients after they are diagnosed with breast cancer.

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Survival Outcomes in Thyroid Cancer Patients with Co-Occurring Breast Cancer: Evidence of Mortality Risk Attenuation
Matheus Wohlfahrt Baumgarten, Iuri Martin Goemann, Rafael Selbach Scheffel, Ana Luiza Maia
Clinical Breast Cancer.2024;[Epub] CrossRef
The prognosis and treatment of primary thyroid cancer occurred in breast cancer patients: comparison with ordinary thyroid cancer
Chang Min Park, Young Don Lee, Eun Mee Oh, Kwan-Il Kim, Heung Kyu Park, Kwang-Pil Ko, Yoo Seung Chung
Annals of Surgical Treatment and Research.2014; 86(4): 169. CrossRef
Thyroid Metastasis from Breast Carcinoma Accompanied by Papillary Thyroid Carcinoma
Song-I Yang, Kwang-Kuk Park, Jeong-Hoon Kim
Case Reports in Oncology.2014; 7(2): 528. CrossRef

Search for Materials that Influence Human Medullary Thyroid Carcinoma Cell Proliferation.: Hyun Won Shin, Hye Won Jang, Keun Sook Kim, Ji In Lee, Ji Young Park, Sun Wook Kim, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim, Jae Hoon Chung; J Korean Endocr Soc. 2009;24(2):93-99. Published online June 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.2.93

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BACKGROUND
Surgical excision is the only effective treatment of medullary thyroid carcinoma (MTC) and there is no certain treatment for recurrence or distant metastasis. Materials that influence MTC cell proliferation were recently reported. Presently, we evaluated the influence of dexamethasone, somatostatin, progesterone, estradiol-17-beta, forskolin and gastrin on MTC cell proliferation and calcitonin secretion. METHODS: Genomic DNA was extracted and sequenced from untreated thyroid TT cells and cells treated with 10-5~10-10 M dexamethasone, somatostatin, progesterone, estradiol-17-beta, forskolin or gastrin, and cultured for 1~6 days. Cell proliferation was assessed using a BrdU assay at days 1, 2, 3, and 6. Calcitonin in the culture medium from dexamethasone-treated TT cells was measured at days 1~3. RESULTS: Replacement of cysteine with tryptophan at codon 634 of exon 11 was evident in treated TT cells. There was no significant difference in cell proliferation at days 1~3 in cells treated with somatostatin, progesterone, estradiol-17-beta, gastrin and forskolin, while proliferation was inhibited in dexamethasone-treated cells in a concentration-dependent manner from 10-5~10-8 M with no inhibition evident at 10-10 M. Calcitonin levels in 10-5~10-8 M dexamethasone-treated cells were decreased. CONCLUSION: Dexamethasone is a potentially useful compound to suppress MTC cell proliferation. Further studies are necessary to explore this potential further prior to clinical use.

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Identification of Growth Regulatory Factors in Medullary Thyroid Carcinoma Cell Line
Young Suk Jo, Minho Shong
Journal of Korean Endocrine Society.2009; 24(2): 84. CrossRef

A Case of Hyalinizing Trabecular Adenoma of the Thyroid Gland.: Hyun Won Shin, Young Lyun Oh, Hye Won Jang, Ji In Lee, Sun Wook Kim, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim, Jae Hoon Chung; J Korean Endocr Soc. 2009;24(1):54-57. Published online March 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.1.54

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Hyalinizing trabecular tumor is a rare benign thyroid tumor first described by Carney et al. in 1987. The tumor is characterized by an encapsulated nodule, trabecular arrangement of polygonal, oval, elongated cells, and hyalinized stroma. It is easily confused with papillary thyroid carcinoma or medullary thyroid carcinoma on surgical and cytologic specimens. A 45-year-old man presented with an incidentally detected left thyroid mass. Fine needle aspiration was performed and papillary thyroid carcinoma was suspected. However, the surgical specimen revealed a hyalinizing trabecular adenoma. We present this hyalinizing trabecular adenoma case to share our experience with physicians and specialists.

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A Case of Multifocal Hyalinizing Trabecular Tumors of the Thyroid Gland
Suhwan Jeong, Hanaro Park
Journal of Clinical Otolaryngology Head and Neck Surgery.2021; 32(3): 308. CrossRef
A Case of Hyalinizing Trabecular Tumor of the Thyroid Gland
Kun Woo Kim, Sang Joon Lee, Phil-Sang Chung, Junghwan Moon
Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2012; 55(12): 795. CrossRef

Solitary Papillary Thyroid Microcarcinoma (0.3 cm in Diameter) Presenting Multiple Distant Metastases at the Time of Diagnosis.: Tae Hyun Kim, Jung Han Kim, Young Lyun Oh, You Cheol Hwang, Jung Hwa Jung, Hye Seung Jung, Mira Kang, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim, Jae Hoon Chung; J Korean Endocr Soc. 2007;22(4):287-291. Published online August 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.4.287

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Papillary thyroid microcarcinoma (PTMC) is defined as being 1 cm or less in diameter. Although the prognosis of PTMC is known to be more favorable than that of papillary thyroid carcinoma greater than 1 cm in diameter, pathologic factors suggesting aggressiveness, such as multifocality and lymph node invasion, have been reported to be highly prevalent in PTMC. However, the rate of distant metastasis in patients with PTMC is very low. Many investigators have reported that initial distant metastasis was detected only in patients with PTMC greater than 0.4 cm in diameter, however these cases have involved only one organ, usually the lung. We report here on an extremely unusual case of solitary PTMC (0.3 cm in diameter) presenting multiple distant metastases at the time of diagnosis.

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Clinico-pathologic Characteristics of the Primary Thyroid Cancer in Patients with Breast Cancer
Hyun Won Shin, Hye Won Jang, Ji Young Park, Jae Hoon Chung, Young-Ki Min, Myung-Shik Lee, Moon-Kyu Lee, Kwang-Won Kim, Sun Wook Kim
Journal of Korean Endocrine Society.2009; 24(4): 240. CrossRef

ras Mutation in Korean Papillary Thyroid Carcinomas.: Jung Hwa Jung, Keun Sook Kim, Tae Sik Jung, Young Lyun Oh, Hye Won Jang, Hye Seung Jung, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim, Jae Hoon Chung; J Korean Endocr Soc. 2007;22(3):203-209. Published online June 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.3.203

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Abstract PDF: BACKGROUND
RET/PTC rearrangement and mutations of BRAF and ras are well-known oncogenes involved in the pathogenesis of papillary thyroid carcinoma (PTC). The prevalence of RET/PTC rearrangement and BRAF mutations were 0~13% and 66~83% in Korean patients with PTC, respectively. We evaluated the prevalence of ras mutations in surgical specimens of PTC, and we compared them with the patients' clinical features. SUBJECTS AND METHODS: We included the surgical specimens of 49 PTCs and a few follicular thyroid carcinomas (FTCs) and follicular adenomas (FAs) as positive controls. Polymerase chain reaction, single strand conformation polymorphism and direct sequence analysis were consecutively performed to detect ras mutations. RESULTS: No mutations of the ras oncogenes were detected in 49 PTCs. However, heterozygous mutations of the ras oncogenes were found in a FTC and FA as positive controls, respectively. CONCLUSION: These findings suggested that ras mutation is not or rarely related to the tumorigenesis of PTCs in Koreans. Therefore, BRAF mutations and RET/PTC rearrangement, rather than ras mutation, might contribute the development of PTC in Koreans.

p53, p21 and bcl-2 Protein Expressions and the Clinical Significance in Papillary Thyroid Carcinoma.: Tae Sik Jung, Keun Sook Kim, Young Lyun Oh, Jung Hwa Jung, Eun Young Lee, Hye Seung Jung, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim, Jae Hoon Chung; J Korean Endocr Soc. 2007;22(2):98-104. Published online April 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.2.98

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BACKGROUND
There have been some investigations concerning the role of p53, p21 and bcl-2 protein expressions for the tumorigenesis of thyroid cancer. It had been debated that these protein expressions were associated with aggressive features of papillary thyroid carcinoma. We studied to evaluate the prevalence of these protein expressions and their clinical significances in papillary thyroid carcinoma. METHODS: We selected 49 patients with papillary thyroid carcinoma who had been operated on at Samsung Medical Center during the last 10 years. Immunohistochemical staining for p53, p21 and bcl-2 was done by the use of paraffin embedded tissues. We analyzed the results of immunohistochemical staining for p53, p21 and bcl-2 and the correlation with the patients' age, gender, tumor size, multifocality, tumor invasion to both lobes, extrathyroidal invasion, cervical lymph node invasion, distant metastasis and the clinical outcomes. RESULTS: Immunohistochemical staining for p53 was positive in 10 patients (20%), p21 was positive in 36 patients (73%) and bcl-2 was positive in 18 patients (37%). The p53 and bcl-2 expressions were not associated with the clinical parameters. Tumor multifocality and extrathyroidal invasion were significantly higher in the p21 positive group (both P < 0.05). CONCLUSION: This study showed that the p21 protein expression was associated with tumor multifocality and extrathyroidal invasion in the patients with papillary thyroid carcinoma. Immunohistochemical stains for p21 may be used as a parameter for tumor aggressiveness in papillary thyroid carcinoma.

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Clinicopathologic and Diagnostic Significance of p53 Protein Expression in Papillary Thyroid Carcinoma
Mi Kyung Shin, Jeong Won Kim
Asian Pacific Journal of Cancer Prevention.2014; 15(5): 2341. CrossRef

Analysis of the Pharmacokinetics of Recombinant Human TSH in Patients with Thyroid Papillary Carcinoma.: Tae Sik Jung, Hye Seung Jung, Jung Hwa Jung, Yun Jae Chung, Eun Young Oh, Young Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim, Jae Hoon Chung; J Korean Endocr Soc. 2006;21(3):204-212. Published online June 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.3.204

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BACKGROUND
Individual variations of the pharmacokinetics of recombinant human TSH (rhTSH) might influence the efficacy of the radioactive iodine (RAI) uptake. We studied to investigate the individual pharmacokinetics of rhTSH and the effect of the anthropometric parameters on the serum TSH levels in patients with thyroid papillary carcinoma. METHODS: We selected 16 patients with conventional rhTSH administration for the preparation of RAI administration between June 2004 and May 2005. We measured serum TSH levels at 24-hour (prior to second rhTSH injection), 48-hour (peak level, prior to RAI administration) and 96-hour (prior to scanning) after the first rhTSH injection. We analyzed the correlation of each TSH levels with age, height, weight, creatinine clearance, body mass index (BMI), and body surface area (BSA). RESULTS: Peak TSH levels were negatively correlated with weight, BMI, and BSA. Among them, weight was an independent parameter by multivariate analysis. Decrement of serum TSH levels from the peak to the level at 96-hour was negatively correlated with weight, BMI, and BSA. It was positively correlated with increment of serum TSH levels from the level at 24-hour to the peak level. Serum TSH level at 96-hour was lower than 25 mU/L in nine of 16 patients. CONCLUSION: Body weight was inversely correlated with peak TSH level after rhTSH administration. rhTSH-stimulated TSH levels might be exaggerated to unwanted levels, and very rapidly degraded in lower-weighted patients. We should make up for the rhTSH regimen considering the individual variations of its pharmacokinetics.

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Efficacy of Low-dose and High-dose Radioactive Iodine Ablation With rhTSH in Korean Patients With Differentiated Thyroid Carcinoma
Ji Young Joung, Ji Hun Choi, Yoon Young Cho, Na Kyung Kim, Seo Young Sohn, Sun Wook Kim, Jae Hoon Chung
American Journal of Clinical Oncology.2016; 39(4): 374. CrossRef

Analysis of Clinical Features of Korean Patients with Adrenocortical Carcinoma.: Chan Ho Yoon, Tae Sik Jung, Hye Seung Jung, Eun Yonug Lee, Sung Jin Bae, Ji Youn Kim, Jae Hoon Chung, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim; J Korean Endocr Soc. 2006;21(1):47-52. Published online February 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.1.47

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BACKGROUND
Adrenocortical carcinoma (ACC) is an extremely rare tumor. Its early detection is difficult and its prognosis is poor. METHOD: We retrospectively analyzed the medical records of 13 patients with ACC between 1995 and 2005 at Samsung Medical Center. Their clinical features and prognosis were evaluated. RESULTS: The average age of the patients with ACC was 40 years (2~75 years). Eight patients were men and five were women. On the first visit, eight of 13 patients (62%) complained abdominal pain, and abdominal mass was palpable in five of 13 patients (38%). Urinary concentration of 17-ketosteroid collected for 24 hours was increased in two of eight patients (25%). Three out of 13 patients were identified as having functioning adrenal tumors (1 Cushing's syndrome and 2 androgen-producing tumors), and the other 10 patients had hormonally inactive adrenal tumors. Ten patients had tumors in left adrenal gland, and three had in right adrenal gland. At the time of diagnosis, four patients were classified as having stage II, seven as stage III, and two as stage IV. Twelve patients underwent adrenalectomy. One of them received additional chemotherapy, and two patients were treated with external radiation therapy after surgery. The other one patient was treated only with chemotherapy due to the presence of liver metastasis. It was possible to continue the regular follow-up in eight of 13 patients. The median duration of follow-up was 39 months (7~114 months). Six of them are still alive (three have no evidence of disease, one had persistence of disease, and two had recurrence of disease during follow-up period). Two patients died of multiple metastases and lung metastasis, respectively. CONCLUSION: Radical surgery is the only curative approach and is recommended for all patients with resectable tumors, even though in those patients with recurrent disease. There is no consensus concerning adjuvant therapy.

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A Case Report of Bilateral Adrenocortical Carcinoma Complicated by Adrenal Insufficiency
Min Joo Kim, Jung Hee Kim, Tae Young Kim, Sang Wan Kim
Endocrinology and Metabolism.2011; 26(3): 243. CrossRef

Upper Airway Obstruction Caused by Intratracheal Ectopic Thyroid Tissue during Pregnancy.: Eun Young Lee, Byung Wan Lee, Jhingook Kim, Sung Jin Bae, Tae Sik Jung, Hye Seung Jung, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim, Jae Hoon Chung; J Korean Endocr Soc. 2005;20(4):413-420. Published online August 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.4.413

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Herein is report an extremely rare case of an intratracheal ectopic thyroid gland related with pregnancy. A 34-year-old woman, in gestational week 11, presented with stridor, progressive dyspnea and a choking sensation during her second pregnancy. Computed tomography of the neck and chest revealed a round intratracheal mass obstructing the airway. A bronchoscopic biopsy with LASER cauterization was performed, and the histological finding revealed normal thyroid tissue. The external thyroid of the patient was evaluated, but only found benign nodules in the thyroid gland. She underwent a segmental resection of the trachea, including the mass and the 1st tracheal cartilage. The histological findings revealed the intratracheal mass to be composed of benign thyroid tissue with nodular hyperplasia. After surgery, no pulmonary symptoms were evident. This case suggested the effect of pregnancy on thyroid tissue stimulatied due to a combination of an increasing human chorionic gonadotropin(hCG) level and relative iodine deficiency during pregnancy. This is the first report on the detection of intratracheal ectopic thyroid tissue during pregnancy in Korea.

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A case of mediastinal ectopic thyroid presenting with a paratracheal mass
Eun Roh, Eun Shil Hong, Hwa Young Ahn, So-Yeon Park, Ho Il Yoon, Kyong Soo Park, Young Joo Park
The Korean Journal of Internal Medicine.2013; 28(3): 361. CrossRef

Efficacy of Octreotide LAR in Acromegalic Patients.: Ji Youn Kim, Jae Hwan Jee, Chan Ho Yoon, Yun Jae Chung, Byung Wan Lee, Gun Yong Cho, Sang Young Kim, Jae Hoon Chung, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim; J Korean Endocr Soc. 2005;20(4):344-352. Published online August 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.4.344

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BACKGROUND
Octreotide(OC)-LAR is a long-acting preparation of octreotide which has been effectively used to suppress GH/IGF-1 hypersecretion in acromegalic patients. The clinical response, biochemical outcomes, and safety of OC-LAR were evaluated in 27 active acromegalic patients. METHOD: 27patients with an active disease status (according to the clinical picture, GH >5microgram/L and elevated age-matched IGF-1), and previously treated with bromocriptine after surgery, comprised the study population. OC-LAR was given(20mg, i.m., every 4 week for 3 injections, then the doses were titrated individually) and the acromegalic symptoms and adverse reactions recorded. The serum levels of GH and IGF-1 were evaluated every 12 week. The acromegalic symptoms including headache, fatigue and arthralgia, improved in all patients. RESULTS: Gastrointestinal side effects were transient and mild. The levels of GH significantly decreased, from 8.9+/-3.5 to 2.9+/-2.2 microgram/L at 12 weeks(P<0.001, vs. baseline), to 2.9+/-2.1microgram/L after 24 weeks(P<0.001) and to 2.5 +/-1.3microgram/L at 48 weeks(P<0.001). The levels of IGF-1 significantly decreased, from 753.7+/-213.6 to 429.7+/-253.4 microgram/L at 12 weeks(P<0.001, vs. at baseline), to 405.7+/-213.3microgram/L at 24 weeks(P <0.001) and to 348.9+/-144.7microgram/L at 48 weeks(P<0.001). The safelevel of GH is less than 2.5microgram/L and normal age-matched IGF-1 levels were achieved in 63 and 52% of the patients, respectively. CONCLUSION: Octreotide-LAR was well tolerated and effective as an adjuvant treatment in lowering the levels of GH and IGF-1 in active acromegalic patients.

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Letter: Comparison of the Efficacy of Octreotide Long-acting Repeatable and Lanreotide Autogel in Acromegalic Patients (J Korean Endocr Soc 25:37-45, 2010)
Yu-Bae Ahn
Endocrinology and Metabolism.2010; 25(2): 157. CrossRef
The Effect of Octreotide LAR on GH and TSH Co-Secreting Pituitary Adenoma
Nam Keong Kim, Yu Jin Hah, Ho Young Lee, Sang Jin Kim, Mi Kyung Kim, Keun Gyu Park, Ealmaan Kim, Hyukwon Chang, Hye Soon Kim
Endocrinology and Metabolism.2010; 25(4): 378. CrossRef
Comparison of the Efficacy of Octreotide Long-acting Repeatable and Lanreotide Autogel in Acromegalic Patients
Seul young Kim, Dohee Kim
Journal of Korean Endocrine Society.2010; 25(1): 37. CrossRef
Response: Comparison of the Efficacy of Octreotide Long-acting Repeatable and Lanreotide Autogel in Acromegalic Patients (J Korean Endocr Soc 25:37-45, 2010)
Seul Young Kim, Dohee Kim
Endocrinology and Metabolism.2010; 25(2): 159. CrossRef

Effects of USF-1, USF-2, PTEN and Thyroid Transcription Factors on the Function and Growth in FRTL-5 Cells.: Yun Jae Chung, eun Sook Kim, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim, Jae Hoon Chung; J Korean Endocr Soc. 2004;19(2):127-140. Published online April 1, 2004

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Abstract PDF: BACKGROUND
Upstream stimulatory factors (USFs) and PTEN are known to be tumor suppressants. USFs and PAX-8 were reported to be the functional competitors in sodium iodide symporter (NIS) gene expression. We investigated the effects of USF-1, USF-2, PTEN, and thyroid-specific transcription factors (TTF-1, PAX-8) on the function and growth of thyrocytes of FRTL 5 rat thyroid cells. METHODS: Complementary DNAs of the USF-1, USF-2, PTEN, TTF-1 (homeodomain), and PAX-8 were synthesized from RNA extracted from FRTL-5using an RT-PCR kit. Each of them was transiently transfected to the FRTL-5 cells using the lipofectamine after being cloned into the pcDNA3.1 vectors. Stable cell lines, which were transfected by USF-1, PTEN, TTF-1, and PAX-8, were also obtained from the FRTL-5 cells, respectively. Extracellular cAMP concentrations were measured after 24 hours of incubation with varying concentrations of bTSH (0.1~100 mIU/mL). After, [Methyl-3H] thymidine uptake or 5-bromo-2'-deoxyuridine (BrdU) assay was performed. RESULTS: USF-1 and USF-2 significantly increased cAMP levels and decreased thymidine uptake in both transiently and stably transfected cells (p<0.01). PTEN had a tendency to increase both the cAMP levels and BrdU uptake in stable cells, but had a tendency to decrease thymidine uptake in transiently transfected cells. TTF-1 significantly increased the cAMP levels and either thymidine or BrdU uptake in both transiently and stably transfected cells (p<0.05). PAX-8 significantly increased both the cAMP levels and BrdU assay in stable cells, but in transiently transfected cells, it significantly decreased cAMP concentrations (p<0.01). CONCLUSIONS: These results suggested that both the USF-1 and USF-2 play a role in suppressing the growth of thyrocytes but at the same time, they kept the ability to produce cAMP after TSH stimulation. They had opposing effects on TTF-1 and PAX-8 in terms of the proliferation of thyrocytes

The Change of Insulin Sensitivity and Insulin Secretion According to Glucose Metabolism Status in Patients with Cushing's Syndrome.: In Kyung Jeong, Sung Hoon Kim, Jae Hoon Chung, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Hyung Joon Yoo, Kyu Jeong Ahn, Jung Hynun Noh, Dong Jun Kim, Kwang Won Kim; J Korean Endocr Soc. 2003;18(4):392-403. Published online August 1, 2003

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Abstract PDF: BACKGROUND
Glucocorticoid plays an important role in the control of carbohydrate metabolism. Patients with Cushing's syndrome have been reported to have an increased incidence of carbohydrate intolerance due to peripheral insulin resistance and hyperinsulinemia, although the exact incidence and nature of this disorder have remained unclear. Few results have been published about insulin resistance and insulin secretion according to the level of glucose concentration, or about the reversibility of such defects in patients with Cushing's syndrome. METHODS: To assess the effect of glucocorticoid on the insulin sensitivity and insulin secretion in Cushing's syndrome, 15 patients with Cushing's syndrome were classified into 3 groups (normal glucose tolerance: NGT, impaired glucose tolerance: IGT, diabetes: DM) according to the degree of glucose tolerance based on the oral glucose tolerance test (OGTT). Insulin modified, frequentlysampled, intravenous glucose tolerance test (FSIGT) was performed before and after curative surgery on these patients and on 15 healthy control subjects. Data were evaluated by non-parametric statistical analysis. RESULTS: 1) Among the 15 patients with Cushing's syndrome, 3 (20%) were NGT, 4 (27%) IGT, and 8 (53%) DM, based on OGTT. Twenty-four hour urinary free cortisol (UFC) was significantly higher in the DM group. 2) Insulin sensitivity index (SI) of Cushing's syndrome was significantly lower than that of the control group (P=0.0024), but was not significantly different among the three Cushing's syndrome groups of NGT, IGT and DM. 3) Glucose mediated glucose disposal (SG) (Ed- confirm this abbreviation; it does not seem to match the definition) of Cushing's syndrome was not significantly different from that of the control group. 4) Insulin secretion (AIRg) of Cushing's syndrome tended to be high, but it was not significantly different from that of control. However, according to the level of glucose concentration there was significant difference in AlRg among the three Cushing's syndrome groups (P=0.0031); AIRg of DM was significantly lower than that of NGT. 5) After surgical treatment, parameters of insulin sensitivity and insulin secretion were normalized in 6 cured patients; 1 with NGT, 1 with IGT, and 4 with DM, preoperatively. Median SI of all 6 patients was significantly improved up to the normal range postoperatively (P=0.0022). Median AIRg of these 6 patients was balanced around that of normal control postoperatively (P=0.0286). CONCLUSION: Eighty percent of patients with Cushing's syndrome had abnormality of carbohydrate metabolism. Insulin sensitivity was significantly decreased in Cushing's syndrome. Insulin secretion was significantly higher only in the NGT and IGT groups of Cushing's syndrome. As the hypercortisolemia is exacerbated, insulin secretion is significantly decreased and causes DM, suggesting that glucocorticoid has a direct or indirect toxic effect on the pancreatic beta cell.

Analysis of Ret Proto-oncogene Mutation in Korean Patients with Medullary Thyroid Carcinomas.: Hyung Hoon Kim, Hyun Jin Kim, Yun Jae Chung, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim, Chang Seok Ki, Jong Won Kim, Jae Hoon Chung; J Korean Endocr Soc. 2003;18(4):360-370. Published online August 1, 2003

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Abstract PDF: BACKGROUND
Medullary thyroid carcinomas (MTC) have been reported as hereditary in about 25 ~30% of cases. The identification of germline mutation in RET proto-oncogene is important in the diagnosis of hereditary MTC, and occurs in three forms: MEN 2A, MEN 2B and familial MTC (FMTC). To evaluate the prevalence of the relationship of RET proto-oncogene mutation and genotype-phenotype was studied in Korean patients with MTC. METHODS: Genomic DNA was obtained from 29 patients, with MTC, who underwent a total thyroidectomy, between 1997 and 2003, at the Samsung Medical Center. There were 7 male and 22 female patients, with an average age of 39, ranging from 20 to 60 years. Exon 10, 11, 13, 14 and 16 of the RET proto-oncogene were amplified, with specific primers, using PCR. A sequencing analysis was performed on the PCR product using an automatic sequencing analyzer. RESULTS: Nine of the 29 patients (31%) were identified as having RET mutations. The average age of these 9 patients was 33 years, ranging from 20 to 51, with a female to male ratio of 2. Five patients had MEN 2A and one had FMTC, with the other 3 thought to have non-hereditary (sporadic) MTC. The 4 patients with MEN 2A had RET mutations on codon 634 of exon 11 (2 patients, C634R; 2 patients, C634Y) and the other patient on codon 618 of exon 10 (C618R). One patient with FMTC had a mutation on codon 634 (C634W). Three patients with sporadic MTC had RET mutations on codon 634 (2 patients, C634Y; 1 patient, C634S). However, no genotype- phenotype relationship could be found, due to the limited number of patients. CONCLUSION: Thirty-one percent (9/29) of the patients with MTC had RET proto-oncogene mutations. Three-quarters (9/12) of the Korean patients with MEN 2A, including another 7 patients reported in 3 papers in Korea, had RET mutations on codon 634 of exon 11 (4 patients, C634R; 4 patients, C634Y; 1 patient, C634W), but a quarter (3/12) had mutations on codon 618 of exon 10 (2 patients, C618R; 1 patient, C618S). Although no relations could be found between the genotypes and phenotypes, extensive prospective studies will be required to verify this.

Diffuse nesidioblastosis underwent reoperation after streptozotocin treatment.: Hyun Hoon Kim, In Kyung Jeong, Byung Wan Lee, Sang Yop Shin, Duck Shin Cho, Jong Wook Yun, Bum Jin Kim, Jae Hoon Chung, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Young Lyun O, Yeon Lim Suh, Mi Kyung Park, Kwang Won Kim; J Korean Endocr Soc. 2002;17(5):720-729. Published online October 1, 2002

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Abstract PDF: Nesidioblatosis is a term that describes small clusters of pancreatic islet cells budding off exocrine ducts, and is commonly reported in infants with intractable idiopathic hypoglucemia. The onset of nesidioblastosis in adults is an extremely rare entity associated with hypersecretion of insulin and the treatment of choice is pancreatic resection. Medical treatment, including somatostatin, propranolol, diazoxide, hydrochlorthiazide and streptozotocin have achieved limited success. We experienced a case of adult nesidioblastosis that underwent reoperation after the failure of medical treatment following an inappropriate first operation. A 54-year old man was admitted due to intermittent hypoglycemic symptoms, which had been relieved by carbohydrate ingestion. Hyperinsulinemic hypoglycemia was documented during a prolonged fast. Image studies found no localized lesion, so a distal pancreatectomy was performed. The pathological examination of the resected pancreas revealed irregularly sized islets and a scattering of small endocrine cell clusters throughout the acinar tissue and ductuloinsular complex. After a partial pancreatectomy the hypoglycemia had not disappeared. The patient did not want to undergo a reoperaton due to the post operative wound infection that occurred after the distal pancreatectomy. Therefore, diazoxide, somatostatin, propranolol, and streptozotocin was used as the alternative to an operation. However, the hypoglycemia persisted during and after the medical treatment. Finally, he underwent a near total pancreatectomy (85%), and the hypoglycemia disappeared. The extent of pancreatectomy is important in clinical outcome of patients with nesidioblastosis

Clinical and Ultrasonographic Characteristics of Malignant Thyroid Incidentalomas.: Hahn Wook Kang, Kwang Won Kim, Byung Wan Lee, Bo Hyun Kang, Hyung Hoon Kim, Bum Jin Kim, Jae Hoon Chung, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee; J Korean Endocr Soc. 2002;17(5):649-656. Published online October 1, 2002

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Abstract PDF: BACKGROUND
High-resolution ultrasonography has made the detection of asymptomatic small thyroid possible. Recent increases in the detection of incidentalomas have created a clinical dilemma on how to properly manage such incidental nodules. We investigated the prevalence, clinical and ultrasonographic characteristics, and optimal diagnostic approach toward incidentally detected benign and malignant thyroid nodules of less than 1.5 cm in size. METHODS: A retrospective review was undertaken on the 1,475 patients who had visited Samsung Medical Center, Seoul Korea between January 1999 and December 2000. The review consisted of a physical examination of the thyroid gland, thyroid function test, antithyroid antibodies, thyroid ultrasonography, fine-needle aspiration biopsy, pathology and TNM staging of the incidentally detected thyroid nodules of less than 1.5 cm in size. RESULTS: The prevalence of thyroid incidentalomas was 13.4% and the malignancy rate within them was 28.8%. There were no significant differences in age, sex, thyroid function test and size between the benign and malignant incidentalomas. Ultrasonographic characteristics showed meaningful diagnostic value for the detection of malignancy in incidentalomas. Most malignant incidentalomas were of a low stage. CONCLUSION: Occult thyroid cancers are fairly common finding. There are no clinical difference between benign and malignant thyroid nodules less than 1.5 cm ; however, ultrasonographic fingings can be used to decision of optimal management strategies.

A Case of Acromegaly with Diabetic Ketoacidosis and Hypertriglyceridemia-Induced Acute Pancreatitis .: Choon Young Lee, Moon Kyu Lee, Sun Young Lee, Sung No Hong, Hyung Hoon Kim, Bo Hyun Kang, Han Wook Kang, Byung Wan Lee, Yu Jeong Park, Yong Ki Min, Myung Shik Lee, Kwang Won Kim, Jong Hyun Kim; J Korean Endocr Soc. 2002;17(1):110-116. Published online February 1, 2002

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Abstract PDF: Secondary diabetes mellitus caused by increased growth hormone secretion (GH) has well been known. There is a close association between glucose intolerance and GH secretion, and increased GH level itself probably worsens the blood glucose control and lipid profile by increasing glycogenolysis and / or gluconeogenesis and by suppressing lipase activity. We report a case of acromegaly with diabetic ketoacidosis as and hypertriglyceridemia-induced acute pancreatitis. A 38 year old male, previously diagnosed to have acromegaly and diabetes, presented with nausea, vomiting, diffuse abdominal pain and altered mentality. There was no history of drug or alcohol consumption, blood gas analysis showed severe acidosis and urinanalysis for ketone was positive. His serum blood glucose, amylase and lipase levels were 494 mg/dL, 331 U/L, and 1288 U/L, respectively (reference values: 70~110 mg/dL, 13~100 U/L and 13~190 U/L, respectively). The patient was diagnosed as having diabetic ketoacidosis and acute pancreatitis. With the serum concentration of triglyceride being 1488 mg/dL and the absence of any obvious precipitating factors, we considered hypertriglyceridemia to be the cause of acute pancreatitis. He was treated with continuous intravenous insulin infusion, lipid lowering agent, and fluid replacement. After conservative management, general condition gradually improved and his serum amylase, lipase and triglyceride levels were all normalized. GH level was not suppressed under 2 ng/mL during oral glucose loading test, and basal GH and IGF levels were 231 ng/mL and 29.5 ng/mL, respectively. Sella MRI showed a 3.7 cm sized pituitary mass. On the 55th day of admission, transsphenoidal surgery was performed. In immunohistochemical staining, the pathologic tumor specimen was proved to be GH positive pituitary adenoma. This is the first case reported in the English literature of an acromegaly presenting with diabetic ketoacidosis and acute pancreatitis

A Case of Multiple Endocrine Neoplasia Type I Presenting with a Watery Diarrhea.: Won Hyeok Choe, Yu Jeong Park, Il Chol Hong, Se Hoon Park, Sung Chul Choi, Hyo Rak Lee, In Kyung Jeong, Jae Hoon chung, yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim, Won Seog Kim; J Korean Endocr Soc. 2001;16(2):231-237. Published online April 1, 2001

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Abstract PDF: MEN1 is characterized by the combined occurrence of tumors of the parathyroids, pancreatic islet cells and the anterior pituitary. Pancreatic islet cell tumors occur in 40% of MEN1 patients. Pancreatic polypeptidomas occur most commonly but they are asymptomatic. Gastrinomas are the second most common type. VIPomas are rare and there has been no report of a case in Korea so far. We encountered a case of pancreatic VIPoma in MEN Type I. A 49 year old man was referred from his local hospital presenting with a sudden onset of an explosive watery diarrhea of 3 months duration. Abnormal findings in his blood chemistry were hypercalcemia and hypokalemia. The 99mTc-sestamibi sintigraphy showed an increased uptake in right lower parathyroid gland. Abdominal CT demonstrated a mass of 6x4 cm in tail of the pancreas and multiple lesions in both hepatic lobes. Serum levels of VIP hormones were elevated. Subtotal parathyroidectomy and subtotal pancreatectomy were done. Postoperatively his symptoms were improved transiently, however the patient showed repetitive attacks of watery diarrhea. So in order to palliate his symptoms, an RF ablation of the metastatic liver masses was performed. After that therapy his clinical symptoms were reduced dramatically. Unfortunately, the patients condition worsened again. Despite of continuous octreotide therapy, interferon and two courses of combination chemotherapy, the hepatic metastases failed to regress and the patient died 10 months after the diagnosis of a metastatic VIPoma. This is the first report of pancreatic VIPoma in MEN type I in Korea.

2 Cases of Ectopic ACTH Syndrome due to Thymic Neuroendocrine Carcinoma Associated with Different Clinical Manifestations.: Yu Jeong Park, Moon Kyu Lee, Jong Ryeal Hahm, Jung Ho Do, Sang Taek Heo, Ju Sung Kim, Yong Ki Min, Myung Shik Lee, Kwang Won Kim, Joung Ho Han; J Korean Endocr Soc. 2001;16(1):115-122. Published online February 1, 2001

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Abstract PDF: Primary neuroendocrine carcinoma of the thymus (formerly known as thymic carcinoids) are unusual tumors that account for 5% of all anterior mediastinal neoplasms. Thymic neuroendocrine carcinomas exhibit a much more aggressive behavior than those originating from other foregut locations and are associated with the ectopic ACTH syndrome in 38% of cases. Patients having a thymic neuroendocrine carcinoma usually present with symptoms such as chest tightness, dyspnea, a palpable neck mass and sometimes a weight gain. We report on 2 patients with thymic neuroendocrine carcinoma who showed different clinical manifestations each other. One presented with a typical. Cushingoid appearance and the other had symptoms of fatigue and weight loss which is a common symptom of malignant tumors.

Comparison of Clinical Features and MRI Findings between Adamantinous and Papillary Craniopharyngioma.: Tae Wook Kang, Jong Ryeal Hahm, Sung Uk Kwon, Gun Young Cho, Ji Min Lee, Mun Hee Bae, In Kyung Chung, Tae Young Yang, Jae Hoon Chung, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Jong Hyun Kim, Yeun Lim Suh, Jae Wook Ryoo, Dong Kyu Na, Kwang Won Kim; J Korean Endocr Soc. 2000;15(2):170-178. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Craniopharyngioma is a suprasellar or intrasellar epithelial neoplasm that occurs in both children and adults. It accounts for 1.2 to 3 % of intracranial tumors with an incidence of 0.5 to 2 cases per one million populations each year. Recently, it has been postulated that it may have two pathogenetically separate subtypes, which are adamantinous and papillary craniopharyngioma, and that their clinical features may be different. However, there are some disagreements in this postulation. Therefore, we studied 22 consecutive patients with craniopharyngioma to evaluate the differences in clinical features and MRI findings between two subtypes. METHODS: We studied 22 patients with histologically proven craniopharyngioma after surgery at Samsung Medical center from 1995 to 1999. Thirteen patients were male, and nine patients were female. The average age was 30 years, with a range from 1 to 58 years. We divided 22 patients into two histopathologically separate subtypes; adamantinous and papillary subtypes. We compared the clinical features and MRI findings of two subtypes by reviewing medical records. RESULTS: Out of 22 patients with craniopharyngioma, 19 patients had an adamantinous subtype and 3 patients had a papillary subtype. The adamantinous subtype occurred frequently in the fifth decade and below twenty years, while the papillary subtype occurred predominantly in forth and fifth decades. The adamantinous subtype located in suprasellar or intrasellar portion as well as extrasellar portion, while the papillary subtype was restricted to the suprasellar location. The average tumor size of the adamantinous subtype was 3.7 cm, with a range from 1.4 to 6.0 cm, which was larger than that of the papillary subtype (average size 1.8 cm with a range from 1.5 to 2.3 cm, p< 0.05). The adamantinous subtype was predominantly cystic, while the papillary subtype was predominantly solid (p< 0.05). There were no significant differences in the preoperative clinical features and the postoperative complications between two subtypes. CONCLUSION: The adamantinous subtype had two peaks of occurrence in the fifth decade and below twenty years, while the papillary subtype occurred predominantly in forth and fifth decades. The adamantinous subtype was larger and had cystic portion, while the papillary subtype was smaller and had solid portion. The preoperative clinical features and the postoperative complications between two subtypes seemed not to be different.

Routine Measurement of Serum Calcitonin Concentration is Useful in Early Detection of Medullary Thyroid Carcinoma Among Patients with Nodular Thyroid Disease.: Jong Ryeal Hahm, Jae Hoon Chung, Eun Young Oh, In Kyung Chung, Tae Young Yang, Dong Jun Kim, Byung Ju Kim, Sung Hoon Kim, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim; J Korean Endocr Soc. 2000;15(1):70-84. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Serum calcitonin is a sensitive and specific marker for diagnosis of medullary thyroid carcinoma (MTC) and its determination leads to accurate preoperative diagnosis and gives chances of definite cure. However, since many non-MTC diseases are also associated with calcitonin elevation, its significance in patients with mild or moderately elevated basal serum calcitonin levels is not clear. Furthermore, the normal value of calcitonin using immunoradiometric assay (IRMA) kit has not so far been definitely ascertained. This study is aimed at assessing the clinical significance of routine measurement of serum basal calcitonin concentration in nodular thyroid disease patients and evaluating the pentagastrin stimulation test in case of mild or moderate elevation of basal calcitonin level. We also measured serum calcitonin value in 408 normal individuals. METHODS: The basal serum calcitonin concentrations using a commercial IRMA kit (Medgenix CT-U.S.-IRMA) were measured in 818 patients with nodular thyroid disease (average age 45 years with a range from 13 to 82 years; 125 males and 693 females) who visited thyroid clinics in Samsung Medical Center between June 1997 and December 1998. Serum concentrations of T3, T4, TSH and thyroid autoantibodies were measured and ultrasonography of thyroid and thyroid scan using 131I or 99mTc-pertechnetate were performed in all patients. We also studied 408 healthy subjects without any thyroid disease (average age 48 years with a range from 20 to 86 years; 224 females). RESULTS: The calcitonin value in normal subjects was found to range from 0 to 13 pg/mL, and it was shown that men had higher calcitonin level than women (p< 0.05). The rate of serum calcitonin elevation (> 10pg/mL) in nodular thyroid disease was 1.71% (14/818), and the incidence of MTC was 0.73% (6/818) in this study. MTC was found in all patients with basal serum calcitonin levels more than 100 pg/mL. Pentagastrin stimulation test was also required to diagnose MTC in patients with basal serum calcitonin levels between 30 and 100pg/mL. The calcitonin concentration stimulated by pentagastrin increased more than 400pg/mL or more than 3.8 times of basal concentration. It was possible to diagnose MTC with fine needle aspiration and cytology in only one case out of six patients with MTC. CONCLUSION: Fine needle aspiration and cytology in diagnosing MTC was not sensitive and not devoid of false positive results. We confirmed that serum calcitonin measurement was very useful means for the preoperative diagnosis of unsuspected MTC. Pentagastrin stimulation test may be a reliable means of evaluation in nodular thyroid disease patients with mild or moderate elevation of basal calcitonin level. We recommend routine measurement of serum calcitonin concentration in patients with nodular thyroid disease.

Cholesterol Lowering Effect of Cerivastatin in Korean Patients with Primary Hypercholesterolemia.: Sung Hoon Kim, Dong Jun Kim, Jong Rhulk Hahm, Byung Joon Kim, Jae Hoon Chung, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim; J Korean Endocr Soc. 1999;14(4):729-738. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Cerivastatin is a kind of statin, a synthetic HMG-CoA reductase inhibitor with high liver selectivity which lowers plasma cholesterol level by inhibiting endogenous cholesterol synthesis. This study evaluates the efficacy, safety, and tolerability of cerivastatin 0.1 mg and 0.3 mg in Korean patients with primary hypercholesterolemia. METHODS: A parallel group, randomized, placebo-controlled, double-blind study was conducted at Samsung Medical Center. The patients with primary hypercholesterolemia were placed on an American Heart Association Step 1 diet for whole study period. Single-blind placebo was administered for the final 4 weeks of period A, before randomization. Thirty two patients with low-density lipoprotein cholesterol (LDL-C) >160 mg/dL (if patients with a definite personal history of coronary heart disease (CHD) or with two or more cardiovascular risk factors, LDL-C >130 mg/dL) were randomized to 6 weeks treatment with one of the following regimens: cerivastatin 0.1 mg (n=11) or cerivastatin 0.3 mg (n=10) or placebo once daily at bedtime (n=11). RESULTS: Cerivastatin 0.1 mg and 0.3 mg treatment groups produced statistically significant (p<.05) changes at 6 weeks after treatment, compared to baseline and placebo in LDL-C (cerivastatin 0.1 mg 16.3%; cerivastatin 0.3 mg 35.2%; placebo 1.5%) and total cholesterol (cerivastatin 0.1 mg 10.3%; cerivastatin 0.3 mg 26.2%; placebo 1.3%). Cerivastatin 0.1 mg and 0.3 mg treatments were well tolerated and resulted in no significant increase in biochemical or clinical side effects compared to placebo. CONCLUSION: Cerivastatin at doses of 0.1 mg and 0.3 mg/day is a safe, well-tolerated, and highly effective HMG-CoA reductase inhibitor for the treatment of primary hypercholesterolemia.

Clinical and Hormonal Analysis of Five New Cases and Eight Previously Reported Cases of Isolated ACTCH Deficiency in Korea.: Eun Young Oh, Byoung Joon Kim, Yun Jae Chung, Dong Joon Kim, Jong Ryul Hahm, Jae Hoon Chung, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim; J Korean Endocr Soc. 1999;14(3):568-577. Published online January 1, 2001

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Abstract PDF: Isolated ACTH deficiency is an uncommon disorder, which is defined by low cortisol production with low or normal plasma ACTH levels and no other pituitary abnormalities. We report five new cases of this disorder, and summarize the clinical and hormonal features of 8 previously reported cases in Korea plus 5 new cases. 1) The clinical manifestations of isolated ACTH deficiency are variable, non-specific and similar to those seen in adrenocortical insufficiency of any cause, the age of patients ranged from 21 to 66 years old with an average age of 46 years, and the male to female ratio was 10:3. 2) Hyponatremia and hypoglycemia were commmon laboratory findings, so the presence of unexplained hyponatremia or hypoglycemia should always warrant consideration of the diagnosis of isolated ACTH deficiency. 3) 3 of 13 patients accompanied by empty sella suggesting selective destruction of pituitary ACTH producing cells. 4) ACTH response to exogenous CRH or vasopressin was not elicited in all tested cases, suggesting pituitary disorders. 5) Most patients showed dramatic response with oral predinisone. In conclusion, when there are unexplained general weakness, fatigue, weight loss, nausea, vomiting, hypoglycemia, or hyponatremia, isolated ACTH deficiency should be excluded. Immunologic and pathologic studies, and hormonal evolution with glucocorticoid treatment are needed to understand the pathogenesis of isolated ACTH deficiency.

A Case of Diabetes Mellitus Caused by Calcitonin and Somatostatin Secreting Pancreatic Islet Tumor.: Jae Hoon Chung, Kwang Won Kim, Byoung Joon Kim, Sung Hoon Kim, Kyung Ah Kim, Myung Sik Lee, Moon Gyu Lee, Yong Ki Min, Jong Ryol Ham, Dong Joon Kim, Hoe Jung Lee, Young Ryoon Oh; J Korean Endocr Soc. 1999;14(2):425-431. Published online January 1, 2001

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Abstract PDF: A case of 39-year-old diabetic patient with a calcitonin and somatostatin secreting pancreatic islet tumor is presented. He had suffered from chronic diarrhea and dyspepsia for 10 years and was diagnosed with diabetes 2 years ago. Abdominal CT revealed a huge abdominal mass which was considered as a neuroendocrine tumor after US-guided needle biopsy. A distal pancreatectomy and splenectomy were performed. Histologically, tumor cells, amanged in solid sheets, showed small nuclei without significant atypia and granular eosinophilic cytoplasm. Tumor cells showed strong immunoreacitivity for calcitonin and somatostatin. The serum clacitonin was markedly elevated (268.7 pmol/L, normal range; 0.9-7.6 pmol/L). After resection of the tumor, diarrhea and dyspepsia diappeared, and oral glucose tolerance test showed normal glucose tolerance with normalization of calcitonin.

Prevalence of Thyrotoxicosis and Hypothyroidism in the Subjects for Health Check-Up.: Jae Hoon Chung, Byoung Joon Kim, Yun Ho Choi, Myung Hee Shin, Sung Hoon Kim, Yong Ki Min, Myung Sik Lee, Moon Gyu Lee, Kwang Won Kim; J Korean Endocr Soc. 1999;14(2):301-313. Published online January 1, 2001

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Abstract PDF: BACKGROUND
The prevalence of ovat hyperthyroidism ar hypothyroidism has been estimated up to 5% in the general populatian. Subclinical hyperthyroidism and subclinical hypothyroidism have pevalences of approximately 1% and 6%, ectively. The prevalence of hypothyroidism may be associated with excessive intake of iodine in iodine sufficient areas. Therefore, we assumed the prevalence of thyroid dysfunction in Karea might be different from those af Western cauntries. However, thete have been no surveys to examine the prevalence of thyroid dysfunction in Karea. We performed the study to investigate the prevalence of thyrotoxicosis and hypothyroidism in Korean adults. METHODS: This study was performed in 15019 subjects (8275 men, 6744 women; between 17 and 87 years of age) visited in health promotion center of Samsung Medical Center for 12 months in 1996. Serum T3, T4, and TSH concentrations were measured with RIA or IRMA using commercial kits. History of thyroid dysfunction and current medication were obtained from medical records. The criteria for thyrotoxicosis were TSH level below than 0.30 mU/L and increased T3 or T4 levels (T3 > 3.1 nmol/L or T4 > 152 nmol/L). Patients who had TSH level above than 5.0 mU/L and T4 level below than 77 nmol/L met the criteria for hypothyroidism. RESULTS: The prevalence of thyrotoxicosis was 5.5/1000 population (men 3.6/1000, women 7.7/1000) with peak prevalence in fifth decade. The prevalence of previously undiagnosed thyrotoxicosis was 4.0/1000 (men 2.9/1000, women 5.3/1000). The prevalence of hypothyroidism was 2.8/1000 population (men 1.1/1000, women 4.9/1000) with peak prevalence in seventh decade. The prevalence of previously undiagnosed hypothyroidism was 1.6/1000 (men 0.6/1000, women 2.S/1000). The prevalence of subclinical thyrotoxicosis was 12.4/1000 population (men 11.8/1000, women 13.0/1000). The prevalence of subclinical hypothyroidism was 18.2/1000 population (men 11.2/1000, women 26.7/1000) which frequency was increased with age. CONCLUSION: Although the prevalence of thyrotoxicosis and hypothyroidism was not significantly different from those of other countries, it was lower than expected and female preponderance is not significant. The prevalence of subclinical thyrotoxicosis and subclinical hypothyroidism was lower than those of other countries. The prevalence of subclinical hypothyroidism was higher in women and old ages. (J Kor Soc Endecrinol 14:301~313, 1999)

Unolateral Aldosterone-producing Adenoma with a Contralateral Black Adenoma.: Eun Young Oh, Myung Shik Lee, Young Hee Lim, Soo Jung Kang, Jung Hak Chun, Byoung Joon Kim, Jae Hoon Chung, Yong Ki Min, Moon Kyu Lee, Kwang Won Kim, Jung Hyun Yang; J Korean Endocr Soc. 1999;14(1):177-182. Published online January 1, 2001

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Abstract PDF: Primary aldosteronism due to unilateral adenoma is a rare cause of surgically curable hypertension. Bilateral adrenal mass has occasionally been reported in this syndrome, and bilateral aldosterone-producing adenoma (APA), or bilateral adrenal nodular hyperplasia have been demonstrated in some cases. However, another possibility is the coexistence of a unilateral APA with a contralateral benign or metastatic nonfunctioning mass, because adrenal tumors are frequently found at autopsy or incidentally detected during abdominal morphological evaluation in patients without adrenal dysfunction. A 39 year-old woman presented with hyperaldosteronism, suppressed renin levels, and bilateral adrenal mass on adrenal CT scanning. Selective adrenal venous sampling was unsuccessful in demonstrating concentration gradient of aldosterone. Postoperative measurement of hormone content in the tumor extract revealed unilateral aldosteron-producing adenoma with contralateral nonfunctioning black adenoma, Determination of hormone content in the tumor extract could be useful for the discrimination of functioning and nonfunctioning endocrine tumors, particularly in case of multiple tumors.

ret/PTC-1, -2, and -3 Incogene Rearrangements of Papillary Thyroid Carcinomas in Korea and Its Relevance to Clinical Aggressiveness.: Jong Ryeal Hanhm, Jae Hoon Chung, Byung Joon Kim, Kyoung Ah Kim, Sung Hoon Kim, Dong Jun Kim, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim, Seok Jin Nam, Jung Hyun Yang, Howe Jung Ree; J Korean Endocr Soc. 1999;14(1):53-62. Published online January 1, 2001

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Abstract PDF: BACKGROUND
The prevalence of ret/PTC rearrangement in papillary thyroid carcinomas has been found to have wide variance in different populations. Recent studies, however, have been reporting no significant geographical difference between Asian and Western countries. In addition, there are some arguments about the correlation of ret/PTC expression with clinical aggressiveness. We have performed this study in order to examine the prevalence of ret/PTC-1, -2 and -3 rearrangements in korean papillary throid carcinomas and to ascertain its clinical relevance. METHODS: Fourteen thyroid tumors histologically confirmed to be papillary carcinomas were included in this study. To find rearrangements, we adopted RT-PCR and automated direct sequencing. Initial and follow-up clinical data were obtained form the patients medical records. The plasmid containing ret/PTC-2, and 3 was kindly provided by Dr. Ahn (Ulsan University, Seoul Choonang Hospital). RESULTS: We identified one tumors containing ret/PTC-1(1/14, 7.1%), and two containing ret/PTC-2 (2/14, 14.2%), and could not find ret/PTC-3 rearrangement in other patients (0/11). There was no significant correlation of ret/PTC with clinical aggressiveness. CONCLUSION: We found that the prevalence of ret/PTC rearrangement (3/14, 21.4%) in papillary thyroid carcinomas from Korea was similar to those recently reported in other nations. ret/PTC rearrangement may not affect biological behaviors of papillary thyroid carcinomas.

A Case of Acromegaly with Graves' Disease.: Jae Hoon Chung, Kwang Won Kim, Byoung Joon Kim, Sung Hoon Kim, Myung Sik Lee, Moon Gyu Lee, Yong Ki Min, Jong Hyun Kim, Eun Young Oh, Yun Jae Chung, Sang Soo Bae; J Korean Endocr Soc. 1998;13(3):432-438. Published online January 1, 2001

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Abstract PDF: Goiter is present in 25-50% of patients with acromegaly, which probably results from IGF- I stimulation of thyroid cell growth. These goiters are usually non-toxic but there have been well documented cases of co-existent hyperthyroidism and acromegaly. Graves disease with acromegaly has been rarely reported compared with the other type of hyperthyroidism due to increased tumoral secretion of TSH. We experienced a 44-year-old woman who presented with Graves disease and acromegaly. Basal serum GH and IGF-I concentrations were 10.8 pg/L and 571.82 ng/mL, respectively (reference value: (5 mg/L and 130-354 ng/mL, respectively). GH was not suppressed less than 2 pg/L during oral glucose loading test. GH was stimulated by TRH. Postcontrast sellar MRI demonstrated ovoid-shaped low signal intensity nodule measuring O.8 cm in diameter in left side of pituitary gland. Thyroid scan(131I) showed enlarged thyroid with increased radioiodine uptake (61.3%). Histologic examination showed acidophilic adenoma. GH and prolactin were positive on immunohistochemical staining. GH was suppressed less than 2.26 mg/L by oral glucose loading following operation. The patient has been followed with antithyroid drug(PTU) medication after operation(TSA).

A Case of Acromegaly Caused by Mixed Gangliocytoma-Adenoma of the Pituitary Gland.: Jae Hoon Chung, Kwang Won Kim, Byoung Joon Kim, Sung Hoon Kim, Myung Sik Lee, Moon Gyu Lee, Yong Ki Min, Yeon Rim Seo, Jong Hyun Kim, Sang Jong Park; J Korean Endocr Soc. 1998;13(3):423-431. Published online January 1, 2001

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Abstract PDF: The tumors containing ganglion cells are rare in the pituitary gland. These tumors are divided into two groups. The first group is the cases of mixed gangliocytoma-adenoma that contained both gangliocytoma and pituitary adenoma elements in the same tumor and the second group is those of gangliocytoma that contained only gangliocytoma element. Since the first description by Kiyono in 1926, 45 cases have been reported. The most common presentation of these tumors is acromegaly and the cases of Cushings disease and galactorrhea-amenorrhea also have been reported. In immunohistochemical study, hypothalamic-releasing hormones are stained in gangliocytoma cells and adenohypophyseal hormones are stained in adenoma cells. The releasing hormones stained in gangliocytoma element and the pituitary hormones stained in adenoma elements are usually closely related but unrelated cases also have been reported. We report a case of a 41 year-old lady with acromegaly which was diagnosed as mixed gangliocytoma-adenoma after surgical removal of the pituitary tumor.

A Case of Cushing's Disease due to Large Pituitary Adenoma Treated by Surgery in Combination with Radiotherapy.: Jae Hoon Chung, Kwang Won Kim, Myung Sik Lee, Moon Gyu Lee, Yong Ki Min, Jong Hyun Kim, Eun Young Oh, Yun Jae Chung, Jung Ho Park; J Korean Endocr Soc. 1998;13(3):417-422. Published online January 1, 2001

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Abstract PDF: Large pituitary adenomas causing Cushings disease are uncommon, and usually present with mild manifestations of Cushings syndrome. Large adenomas may have rapid growth and quickly reach a size large enough to become clinically apparent. These tumors are more frequently invasive than microadenomas, their widespread extensions make radical surgical removal difficult and the ultimate clinical course malignant. We report a case of 37 year-old women presenting amenorrhea, weight gain, and moon face. Sellar magnetic resonance imaging(MRI) demonstrated a large lobulating tumor measuring 3.5cm in diameter, arising from sella turcica, extending up to suprasellar area and invading the cavernous sinuses. Transfrontal adenectomy was performed to remove a mass, but residual mass was remained after surgery. Subsequent external brain radiotherapy(total dose 5400cGy) was performed. Histology revealed an adrenocorticotrophin(ACTH) secreting pituitary adenoma. After treatment, her menstration was started, body weight was reduced, and moon face was disappeared.

A Frequency of Hypothyroidism in a Population of Hypercholesterolemin Subjects.: Jae Hoon Chung, Kwang Won Kim, Byoung Joon Kim, Sung Hoon Kim, Kyung Ah Kim, Myung Sik Lee, Moon Gyu Lee, Yong Ki Min, Yun Ho Choi, Myung Hee Shin; J Korean Endocr Soc. 1998;13(3):351-358. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Hypothyroidism is a treatable cause of secondary hyperlipidemia. The lipid profile usually seen is an increased total and low density lipoprotein(LDL) cholesterol, and the plasma triglyceride may also be increased. Hypercholesterolemia associated with hypothyroidism is an important factor in the pathogenesis of coronary artery disease(CAD). And the hyperchole-sterolemia caused by hypothyroidism is potentially reversible by thyroid hormone replacement therapy. Hypothyroidism should be ruled out by routine laboratory screening as a treatable cause of secondary hyperlipidemia and increased CAD risk. We carried out this study aimed at evaluating the frequency of hypothyroidism and its relationship with serum cholesterol concentration in Koreans. METHODS: We investigated 15028(men 8273, women 6755) Korean subjects who visited our hospital center for health promotion during an one year period(from January 1, 1996, to December 31, 1996). Among them, we analyzed 6756 hypercholesterolemic subjects whose serum cholesterol levels were greater than 200 mg/dL. They performed thyroid function tests(total T, T4, and TSH) and lipid profiles(total cholesterol, triglyceride and HDL-cholesterol) were measured by enzyme assay. We defined hypothyroidism by serum thyrotropin values greater than 5 U/mL. RESULTS: The observed prevalence of hypothyroidism was 2.4%(163/6756). Among those with high TSH levels, 17(10.4%) had overt hypothyroidism with a low T4 (below 6 g/dL) level. As we analyzed the frequency of hypothyroidism according to cholesterol range by 20 mg/dL, the frequency was significantly increased in the group whose serum cholesterol levels were greater than 300 mg/dL, especially in women over 50 years of age. Analysis of lipid parameters showed that hypertriglyceridemia was frequent and hyperHDLaemia was observed in hypothyroidic populations. CONCLUSION: Screening for hypothyroidism by measurement of thyrotropin values is of particular importance in patients with hypercholesterolemia. And the frequency of hypothyroidism was more significantly increased in whose serum cholesterol levels were greater than 300 mg/dL, especially in the group of women over 50 years of age.

Comparison of Immunohistochemical and Clinical Characteristics in Pituitary Adenoma with Acromegaly.: Jae Hoon Chung, Eun Mi Koh, Kwang Won Kim, Byoung Joon Kim, Sung Hoon Kim, Kyung Ah Kim, Myung Sik Lee, Moon Gyu Lee, Yong Ki Min, Yeon Rim Seo, Dong Kyu Na, Jong Hyun Kim, Kyu Jeong Ahn, Jin Seok Kim; J Korean Endocr Soc. 1998;13(3):324-330. Published online January 1, 2001

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Abstract PDF: BACKGROUND
It assumed that plurihormonal pituitary adenomas in acromegaly, which were immunohistochemically stained with other pituitary hormones in addition to GH and prolactin, would be originated from poorly differentiated cells. Therefore, we speculated that they might have higher growth rates and worse prognosis than monohormonal adenomas. To verify this speculation, we analyzed the frequency of plurihormonal adenomas and compared the clinical parameters and radiological invasiveness between plurihormonal adenoma and GH-prolactin adenoma in acromegaly. METHODS: We studied 38 patients with acromegaly (22 males and 16 females, mean age 40.7 years) who were underwent surgical removal of pituitary adenomas by TSA from January 1995 to February 1998. We performed immunohistochemical staining in these tumors using avidinbiotin peroxidase complex method. An adenoma was considered as immunoreactive when above 50 percents of tumor cells were stained with anti-hormonal antibodies. Invasiveness of tumors were evaluated by preoperative MRI findings on the basis of Hardys classification. RESULTS: The frequencies of plurihormonal and GH-prolactin adenomas were 42% and 58%, respectively. Plurihormonal adenoma included an adenoma which was not stained with prolactin, but with GH and other hormones. Prolactin immunoreactivity was found in 97%(37/38) of the tumors. Immunoreactivities to FSH, ACTH, LH, and TSH were found in 37.8%, 13.1%, 2.6% and 2.7%, respectively. There were no significant differences in age, basal serum GH and IGF-1 concentrations between plurihormonal and GH-prolactin adenomas. There were also no significant differences in response to TRH & LH stimulation tests and somatostatin & bromocriptine suppression tests between two groups. There were no differences in radiological invasiveness between two groups (plurihormonal adenoma, grade I 2, grade II 3, grade III 7, grade IV 4; GH-prolactin adenoma, grade I 3, grade II 6, grade III 9, grade IV 4). CONCLUSION: Plurihormonal adenomas were 44% and immunoreactivity to prolactin was 97% in pituitary adenomas in acromegaly. There were no significant differences in clinical parameters and radiological invasiveness between plurihormonal and GH-prolactin adenomas in acromegaly.

Small Medullary Thyroid Cancer Dectected by Genetic Mutation Screening in Men IIa Family.: Jae Hoon Chung, Kwang Won Kim, Ji Eun Kim, Byoung Joon Kim, Sung Hoon Kim, Kyung Ah Kim, Myung Sik Lee, Moon Gyu Lee; J Korean Endocr Soc. 1998;13(2):230-239. Published online January 1, 2001

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Abstract PDF: Multiple endocrine neoplasia (MEN) Ila is an inherited disease characterized by the development of medullary thyroid carcinoma, pheochromocytoma and hyperparathyroidism. It has been shown to be associated with germ-line mutatians in the RET proto-oncogene. Presymptomatic screening of medullary thyroid carcinoma in MEN IIa families enables the early diagnosis of this tumor with its significant morbidity, We describe a 19-year-old woman fmm a MEN IIa family who was founded by DNA analysis to be a gene carrier of MEN IIa and then was diagnosed, using a pentagastrin stimulation test, as having presymptomatie medullary thyroid carcinoma She underwent thyroidectomy and histologic examination confirmed medullary thyroid carcinoma. It is cancluded that direct genetic analysis for mutations in the RET proto-oncogene should be the diagnstlc test of choice for identifying family members at risk for MEN IIa and thyroidectomy on the basis of genetic analysis is a rational course of action.

Heterogeneity of TSH Receptor Autoantibodies in Autoimmune Thyroid Disease.: Won Bae Kim, Bo Youn Cho, Kyoung Ah Kim, Jae Hoon Chung, Young Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim; J Korean Endocr Soc. 1997;12(2):176-193. Published online January 1, 2001

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Abstract PDF: BACKGROUND
It has been known that most of thyroid stimulating antibodies (TSAbs) may interact with epitopes near N-terminal, and thyroid stimulation blocking antibodies (TSBAbs) near C-terminal on the extracellular domain of TSH receptor. However, many authors have reported different results about epitopes reacting with TSH receptor autoantibody (TRAb). TSBAbs inhibit thyroid stimulation of TSH and TSAbs at the receptor level. However, it has been reported that there are some TSBAbs which bind to the other sites, not TSH receptor, or block post-reeeptor process. These findings raise the possibility that TRAbs may be heterogeneous according to the mechanism of action. In order to investigate the heterogeneity of TRAb, we undertook immuno-precipitation using synthetic peptides of TSH receptor and measured TRAb activities by FRTL-5 cells and chimeric CHO cells. METHODS: We studied 102 patients with autoimmune thyroid disease (Graves disease 32, Hashimotos thyroiditis 29, atrophic thyroiditis 41) and 35 healthy persons. Three synthetic peptide fragments of TSH receptor were used to perform immunoprecipitation with serum or IgG of patients and healthy persons, TSAb and TSBAb activities were measured by FRTL-5 cells and CHO cells transfected with wild-type and 2 mutant TSH receptor cDNA (Mc2, Mc1+2). Mc2 and Mcl+2 were rnade to substitute amino acid residues of 90-165, 8-165 of the TSH receptor with corresponding residues of LH/CG receptor, respectively. RESULTS: Two out of 10 IgGs extracted from Graves disease and 2 out of 9 IgGs from atrophic thyroiditis had specific bidings over 0.84% in immunoprecipitation with peptide I (amino acid residue 35-50). Four out of 18 IgGs from Graves disease, 9 out of 41 IgGs from atrophic thyroiditis, and 6 out of 14 IgGs from Hashimotos thyroiditis had specific bidings over 0.84% in immunoprecipitation with peptide II (amino acid residue 317-332). Only 2 out of 10 IgGs from Graves disease had specific bidings over 0.84% in immunoprecipitation with peptide III (amino acid residue 341-358). When 10 IgGs extracted from Graves disease were reacted with wild-type, Mc2, and Mcl+2 CHO cells, 7 IgGs in wild-type and 4 IgGs in Mc2 had positive for TSAb activities. In 10 IgGs from atrophic thyroiditis, 5 in wild-type, 5 in Mc2, and 3 in Mcl+2 CHO cells had positive for TSBAb activities. In Hashimoto's thyroiditis, only 1 with hyperthyroidism had positive for TSAb activity in wild-type and 1 with hypothyroidism had positive for TSBAb activities in both of wild-type and Mc2 CHO cells. Therefore, patients with Graves disease were divided into at least 3 groups according to the TSAb activities measured by wild-type, Mc2, Mcl+ 2 CHO cells and TBII activities. And patients with atrophic thyroiditis were divided into at least 4 groups according to the TBII activities, TSBAb activities by wild-type, Mc2, Mcl+2 CHO cells and FRTL-5 cells. CONCLUSION: From these results, epitopes of TSH receptor reacting with TSAb or TSBAb in autoimmune thyroid disease may be scattered in the TSH receptor, although epitopes of TSAb tend to be near N-terminal and those of TSBAb near C-terminal. Graves disease or atrophic thyroiditis were divided into 3 or 4 groups according to the TBII and TRAb activities. Therefore, TRAb detected in autoimmune thyroid disease may be heterogenous.

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.

Serum Lipoprotein (a) and Lipid Concentrations in Patients with Subelinical Hypothyroidism.: Kyoung Ah Kim, Jae Hoon Chung, Yeun Sun Kim, Kyu Jeung Ahn, Eun Mi Koh, Young Ki Min, Myung Shik Lee, Moon Kyu Lee, Jong Hun Lee, Kwang Won Kim; J Korean Endocr Soc. 1997;12(1):11-17. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Overt hypothyroidism is well-known cause of secondary hyperlipidemia and atherosclerosis. However, there have been dissenting reports of abnormalities in serum lipid concentrations in patients with subclinical hypothyroidism (SH). Recently, it has been reported that serum Lp (a) concentration, an independent risk factor of atherosclerosis, was increased in patients with SH. Therefore, we analyzed serum Lp (a) and other lipid concentrations to investigate whether they are increased in patients with SH and the correlation between serum Lp (a) and TSH concentrations. METHODS: We undertook this study in 53 patients with SH (TSH > 6 uiU/ml) and 197 age-and sex-matched healthy control subjects, They had no abnormalities in liver function, BUN, creatinine, fasting blood glucose, urinalysis, and past medical histories. Serum T3, T4, and TSH concentrations were measured by RIA using commercial kits. Serum concentrations of Lp (a), total cholesterol, triglyceride (TG), and HDL cholesterol (HDL-C) were measured by rate nephelometry and enzyme assay, respectively. RESULTS: There were no significant differences of serum Lp (a), total cholesterol, LDL cholesterol, TG, and HDL-C concentrations in 53 patients with SH and 197 control subjects (25.6+-3.8mg/dL vs. 25.4+-1.5mg/dL ; 204.0+-4.2mg/dL vs. 204.0+-2.4mg/dL ; 127.0+-3.9mg/dL vs. 125.0+-2.3 mg/dL ; 133.0+-8.5mg/dL vs. 130.0+-6.0mg/dL ; 50.0+-1.5mg/dL vs. 53.0+-0.9mg/dL). There was no correlation between Lp (a) and TSH concentrations in SH (r=0.12, p>0.05). CONCLUSION: Serum Lp (a) concentration as well as total cholesterol, LDL cholesterol, and TG was not increased in patients with SH. There was no correlation between serum Lp (a) and TSH levels in subclinical hypothyroidism.

A Case of Diabetes Insipidus with Langerhans Cell Histiocytosis in Adult.: Jae Hoon Chung, Kwang Won Kim, Kyu Jeung Ahn, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Eun Mi Koh, Choon Kwan Kim, Mann Pyo Jung; J Korean Endocr Soc. 1996;11(3):330-335. Published online November 7, 2019

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Abstract PDF: In Langerhans cell histiocytosis, diabetes insipidus is the most common endocrinologic complication. We experienced a case of Langerhans cell histiocytosis, involving pituitary stalk and lung. The patient was a 43 year old male with complaint of polyuria and polydipsia. The water deprivation test was carried out to confirm the diagnosis of diabetes insipidus. We found multiple small cysts and nodules in HRCT of lung, and diagnosed Langerhans cell histiocytosis by transbronchial lung biopsy, The patient was managed conservatively with DDAVP nasal spray. The polyuria,polydipsia was relieved completely. After that, we follow up and observe closely the patients lung and pituitary lesion.

Two cases of 111Indium Pentetreotide Scan for the Pre- and Post-Operative Evaluation of Localization and Metastasis in Medullary Thyroid Carcinoma.: Jae Hoon Chung, Kwang Won Kim, Kyu Jeung Ahn, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Kyoung Ah Kim, Yeun Sun Kim, Eun Mi Koh; J Korean Endocr Soc. 1996;11(1):85-92. Published online November 7, 2019

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Abstract PDF: Medullary carcinoma of the thyroid gland(MTC) constitutes approximatesly 3% to 10% of all malignant thyroid tumors. It appears in both familial and sporadic forms. Metastases are frequently present at diagnosis and are resistant to chemotherapy and radiotherapy. Surgical resection of the primary tumor and the metastases is the mainstay of treatment. Although MTC can be detected by elevated serum calcitonin, localization of residual or metastatic foci may be difficult. Many scintigraphic methods have been used for identification of the residual tumor or metastasis. However, most of them have either low sensitivity or low specificity. MTC frequently secretes somatostatin and may express somatostatin receptors. Recently, somatostatin-receptor imaging has been known to be useful for the detection of residual and recurrent medullary thyroid carcinoma. A 25 year-old woman who was dignosed as medullary carcinoma by biopsy of thyroid mass is presented. Thirteen years ago, she underwent left thyroidectomy due to thyroid cancer(MTC). Laboratory tests revealed an increase in the levels in serum CEA(CEA=557.6 ng/ml) and calcitonin(calcitonin= 720 pg/ml). The second patient, a 30 year-old female, complained of a palpable mass in the left anterior neck. Ten years ago, she underwent a right lobectomy of thyroid gland due to adenomatous goiter. Laboratory tests revealed an increase in the levels in serum CEA(CEA=617 ng/ml) and Calcitonin (Calcitonin=2,300 pg/ml). In both cases, pre- and postoperative In-111 pentetreotide scintigraphy were done and compared with "'I scintigraphy. In-111 pentetreotide scan may be useful for the localization of residual or metastatic medullary thyroid carcinoma. Further study is warranted to define the sensitivity and specificity of the technique.

Spontaneous Recovery from Hypothyroidism in Autommune Thyroiditis.: Bo Youn Cho, Jae Hoon Chung, Kwang Won Kim, Kyu Jeung Ahn, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee; J Korean Endocr Soc. 1996;11(1):30-40. Published online November 7, 2019

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Abstract PDF: Background
A lifelong thyroxine therapy is indicated in all patients who have hypothyroidism as a result of autoimmune thyroiditis. However, it has been reported that some hypothyroid patients with autoimmune thyroiditis have spontaneous remission with restriction of iodine intake instead of thyroxine therapy. The purpose of study was to investigate how many hypothyroid patients with autoimmune thyroiditis can recover from hypothyroidism with restriction of iodine intake instead of thyroxine therapy and which factors predict recovery from hypothyroidism. Methods: We studied 64 patients with autoimmune thyroiditis(goitrous autoimmune thyroiditis 56, atrophic autoimmune thyroiditis 8). Thyroxine therapy was discontinued in patients with goitrous autoimmune thyroiditis on the way(group 1, n=32) or from the beginning(group 2, n=24) and atrophic autoimmune thyroiditis on the way(group 3, n-8). All patients were asked to avoid iodine-rich foods and thyroid function was monitored every one to two months for up to 35 months. Serum T3, T4, TSH concentrations, antithyroglobulin and antimicrosomal antibodies were measured by radioimmunoassay(RIA). TSH binding inhibitor immunoglobulin(TBII) was measured in serum using radioreceptor assay. Two hundred micrograms of thyrotropin releasing hormone (TRH) were given as intravenous bolus and TSH levels were measured in blood samples taken at 0, 30, and 60 minutes. All values were expressed as mean+-SEM. Statistical analysis was done with paired or non-paired t-test, ANOVA, and the Chi-square test. Statistical significance was defined as p-value below 0.05. Results: Thirteen(40.6%) of 32 patients in group 1 remained euthyroid after 12-35 months of discontinuation of thyroxine therapy. The other 19(59.4%) patients in group 1 had recurrences of hypothyroidism within 3 months after discontinuation of thyroxine therapy. In 11(45.8%) out of 24 patients in group 2, serum TSH concentrations declined below 5 mU/L within 3 months without thyroxine therapy. The other 13(54.2%) patients in group 2 remained hypothyroid till 2-16 months and the thyroxine was given. In contrast, all 8 patients in group 3 had recurrences of hypothy- roidism within 3 months after stopping thyroxine therapy. When we compared the recovered patients of goitrous autoimmune thyroiditis with the non-recovered patients of goitrous autoimmune thyroiditis, regardless of thyroxine therapy from the beginning, age at onset of disease of the 24 recovered patients was significantly younger than the 32 non-recovered patients(30.1+2.0 years vs. 40.2+ 2.4 years; p=0.004). Concl#usion: These findings suggest that 42.9% of hypothyroid patients with goitrous autoim- mune thyroiditis remain or become spontaneously euthyroid with restriction of iodine intake instead of thyroxine therapy. Young age may be a predicting factor of recovery from hypothyroidism in goitrous autoimmune thyroiditis.

A case of multiple symmetric lipomatosis.: Seung Joon Oh, Jeong Taek Woo, Sung Woon Kim, Ihn Myung Yang, Jin Woo Kim, Young Seol Kim, Kwang Won Kim, Young Kil Choi; J Korean Endocr Soc. 1993;8(4):456-461. Published online January 1, 2001

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Abstract PDF: No abstract available.

Human IGF-I gene expression in normal and thyroid tumor tissues.: Sung Woon Kim, Hyun Ha Jang, Sang Mee Park, Deog Yoon Kim, Jeong Taek Woo, In Myung Yang, Jin Woo Kim, Young Seol Kim, Kwang Won Kim, Suck Hwan Koh, Sung Wha Hong, Young Kil Choi; J Korean Endocr Soc. 1993;8(4):414-421. Published online January 1, 2001

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Abstract PDF: No abstract available.

Effect of ipriflavone on the lumbodorsal pain in osteoporosis.: Jeong Taek Woo, Deok Yoon Kim, In Myung Yang, Sung Woon Kim, Jin Woo Kim, Young Seol Kim, Kwang Won Kim, Young Kil Choi; J Korean Endocr Soc. 1993;8(3):340-346. Published online January 1, 2001

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Abstract PDF: No abstract available.

Expression of type 1?collagen mRNA of osteoblast like(MC3T3-E1) celss to sodium fluoride.: Jeong Taek Woo, Sung Woon Kim, In Myung Yang, Jin Woo Kim, Young Seol Kim, Kwang Won Kim, Young Kil Choi, Kwang Sik Seo, Kyu Rhim Chung, Jeung Bin Hwang; J Korean Endocr Soc. 1993;8(3):334-339. Published online January 1, 2001

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Abstract PDF: No abstract available.

A clinical study of thyrotoxic periodic paralysis.: Sung Yi Kang, Sung Hoon Kim, Duk Yoon Kim, Jeong Taek Woo, In Myung Yang, Sung Woon Kim, Jin Woo Kim, Young Seol Kim, Kwang Won Kim, Young Kil Choi; J Korean Endocr Soc. 1993;8(1):19-26. Published online January 1, 2001

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Abstract PDF: No abstract available.

Thrombolytic effect of esterase on the cerebral thrombosis.: Deog Yoon Kim, Jeong Tack Woo, Jin Woo Kim, Young Seol Kim, Kwang Won Kim, Young Kil Choi; J Korean Endocr Soc. 1992;7(4):379-383. Published online January 1, 2001

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Abstract PDF: No abstract available.

Effect of cilostazol in diabetic patients with vascular complication .: Kyu Nam Lee, Jeong Tack Woo, Duck Yoon Kim, Sung Woon Kim, In Myung Yang, Jin Woo Kim, Young Seol Kim, Kwang Won Kim, Young Kil Choi; J Korean Endocr Soc. 1992;7(4):373-378. Published online January 1, 2001

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Abstract PDF: No abstract available.

Effects of human growth hormone treatment in healthy older female.: Jeong Tack Woo, Deog Yoon Kim, Sung Woon Kim, In Myung Yang, Jin Woo Kim, Young Seol Kim, Kwang Won Kim, Young Kil Choi, Jong Eun Park; J Korean Endocr Soc. 1992;7(4):352-357. Published online January 1, 2001

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Abstract PDF: No abstract available.

Review of clinical characteristics of primary hyperparathyroidism.: Hyung Keun Chung, Deog Yoon Kim, Jeong Taek Woo, Sang Woon Kim, In Myung Yang, Jin Woo Kim, Young Seol Kim, Kwang Won Kim, Young Kil Choi; J Korean Endocr Soc. 1992;7(3):234-242. Published online January 1, 2001

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Abstract PDF: No abstract available.

Expression of apolipoprotein C-II mRNA in cultured HepG2 cell.: Myung Jae Park, Dong Hee Seo, Kwang Sik Seo, Jeong Taek Woo, Jin Woo Kim, Young Seol Kim, Kwang Won Kim, Young Kil Choi; J Korean Endocr Soc. 1992;7(2):127-135. Published online January 1, 2001

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Abstract PDF: No abstract available.

Increase of bone mineral density after surgical treatment of primary hyperparathyroidism.: Hyun Duck Son, Jeong Taek Woo, Sung Woon Kim, Ihn Myung Yang, Jin Woo Kim, Young Seol Kim, Kwang Won Kim, Young Kil Choi; J Korean Endocr Soc. 1992;7(1):76-79. Published online January 1, 2001

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Abstract PDF: No abstract available.

A case of true precocious puberty successfully treated with LHRH analogue.: Hyun Suck Son, Jeong Taek Woo, Sung Woon Kim, Ihn Myung Yang, Jin Woo Kim, Young Seol Kim, Kwang Won Kim, Young Kil Choi; J Korean Endocr Soc. 1992;7(1):71-75. Published online January 1, 2001

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Abstract PDF: No abstract available.

Expression of c-erb A mRNA according to thyroid function status.: Young Sil Ju, Jeong Taek Woo, Sung Woon Kim, In Myung Yang, Jin Woo Kim, Young Seol Kim, Kwang Won Kim, Young Kil Choi, Sang Mi Park; J Korean Endocr Soc. 1992;7(1):24-30. Published online January 1, 2001

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Abstract PDF: No abstract available.

Role of hepatitis B infection in pathogenesis of autoimmune thyroid disease.: Hyung In Yang, Jeong Taek Woo, Seong Wun Kim, In Myung Yang, Jin Woo Kim, Young Seol Kim, Kwang Won Kim, Young Kil Choi; J Korean Endocr Soc. 1991;6(4):348-352. Published online January 1, 2001

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Abstract PDF: No abstract available.

Serum lipoprotein(a) as an independent risk factor for cerebral infarction in Korea.: Yi Sook Hwang, Jeong Tack Woo, Jin Woo Kim, Young Seol Kim, Kwang Won Kim, Young Kil Choi; J Korean Endocr Soc. 1991;6(3):232-237. Published online January 1, 2001

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Abstract PDF: No abstract available.

Effect of fluoride and vandate on the osteoblast MC3T3-E1 function.: Jung Taek Woo, Hyun Koo Yoon, Young Seol Kim, Sung Woon Kim, In Myung Yang, Jin Woo Kim, Kwang Won Kim, Young Kil Choi, Kwang Sik Seo; J Korean Endocr Soc. 1991;6(2):157-162. Published online January 1, 2001

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Abstract PDF: No abstract available.

A case of bilateral adrenal cortical hyperplasia.: Jung Hee Kim, Jin Woo Kim, Young Seol Kim, Kwang Won Kim, Young Kil Choi; J Korean Endocr Soc. 1991;6(1):97-99. Published online January 1, 2001

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Abstract PDF: No abstract available.

A clinical study on 79 cases of lymphocytic thyroiditis by fine needle aspiration.: Kyung Jin Kim, Jeong Taek Woo, Sung Woon Kim, In Myung Yang, Jin Woo Kim, Young Seol Kim, Kwang Won Kim, Young Kil Choi; J Korean Endocr Soc. 1991;6(1):38-44. Published online January 1, 2001

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Abstract PDF: No abstract available.

Author index