- A Case of Primary Hyperparathyroidism Associated with Gall-bladder Stone and Chronic Cholecystitis.
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Jin Hyung Lee, Pil Moon Jung, Chong Whan Kim, Myeong Sang Shin, Hong Jun Park, Soo Min Nam, Mi Young Lee, Jang Hyun Koh, Mee Yoen Cho, Jang Yel Shin, Choon Hee Chung, Young Goo Shin
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J Korean Endocr Soc. 2007;22(6):470-474. Published online December 1, 2007
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DOI: https://doi.org/10.3803/jkes.2007.22.6.470
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- Primary hyperparathyroidism is caused mainly by a parathyroid adenoma or hyperplasia, and is characterized by hypercalcemia and hypophosphatemia induced by an increased level of parathyroid hormone (PTH). Patients with primary hyperparathyroidism are usually asymptomatic and the disease is most often detected incidentally. However, patients can present with symptoms of renal stones, peptic ulcer disease, muscle weakness, depression, constipation, and pancreatitis. In addition, it has been reported that choletithiasis can be combined with primary hyperparathyroidism. We report a case of a 49-year-old man with primary hyperparathyroidism accompanied with chronic cholecystitis caused by a gallbladder (GB) stone. The chief complaint was nausea, poor oral intake, abdominal pain, and weight loss. Abdominal sonography was performed and chronic cholecystitis with a GB stone was diagnosed. The serum calcium level was 18.5 mg/dL and the intact parathyroid hormone level was 1,777 pg/mL. A parathyroid mass was detected by neck-computed tomography, neck ultrasonography and a (99m)Tc-Tetrofosmin parathyroid scan. The parathyroid mass was removed and the mass was confirmed as a parathyroid adenoma. Cholecystectomy was performed and the diagnosis of chronic cholecystitis was confirmed. After the surgical procedure, the symptoms improved and the calcium level was normalized.
- A Case of Graves' Disease with Ulcerative Colitis.
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Pil Moon Jung, Mi Young Lee, Jang Hyun Koh, Jang Yeol Shin, Young Goo Shin, Mi Yeion Jo, Choon Hee Chung
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J Korean Endocr Soc. 2007;22(2):149-152. Published online April 1, 2007
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DOI: https://doi.org/10.3803/jkes.2007.22.2.149
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- A Case of Drug Induced Nephrogenic Diabetes Insipidus and Hyperprolactinemia in Schizophrenia Simultaneously.
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Ho Yoel Ryu, Mi Young Lee, Yeon Lee, Jang Hyun Koh, Mi Jin Kim, Young Goo Shin, Choon Hee Chung
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J Korean Endocr Soc. 2005;20(4):407-412. Published online August 1, 2005
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DOI: https://doi.org/10.3803/jkes.2005.20.4.407
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- In schizophrenia, when treatment using antipsychotics fails, lithium, which is known as an antimanic drug, can also be administered. It is reported that 12~20% of patients taking lithium develop nephrogenic diabetes lactotrophs. Hyperprolactinemia is induced by typical antipsychotics, as they block the dopamine-2 receptors of latotrophs in the pituitary gland. Therefore, atypical antipsychotics for decreasing the side effect, such as hyperprolactinemia, can be used. However, hyperprolactinemia can be induced by risperidone, one of the atypical antipsychotics. Here, a case of drug induced nephrogenic diabetes insipidus and simultaneous hyperprolactinemia, which occurred in a patient with schizophrenia, is reported.
- A Case of Pseudopseudohypoparathyroidism with Partial Empty Sella.
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Jang Hyun Koh, Yeon Lee, Joung Wook Choi, Tae Won Hong, Mi Jin Kim, Young Goo Shin, Choon Hee Chung
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J Korean Endocr Soc. 2004;19(4):433-438. Published online August 1, 2004
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- Pseudohypoparathyroidism (PHP) is a rare endocrine syndrome, which is characterized by Albright's hereditary osteodystrophy (AHO). Pseudopseudohypoparathyroidism (PPHP) presents with AHO features, but does not show clinical symptoms or the same laboratory finding as hypoparathyroidism. A 54 aged woman visited our department with lower abdominal pain. She had a history of a total hysterectomy due to persistent uterine bleeding 30 years previously. She showed abnormal physical findings, including a round face, short stature and brachydactyly. Her hormonal data were within normal limits, as follows: PTH 40.72 pg/mL, calcium 8.6 mg/dL, phosphorus 4.0 mg/dL and 24 hour urine cAMP 3.2 nmol/mg. On a pituitary challenge test, the basal levels and response rates of FSH and LH were low, and a sella CT scan showed partially empty sella. Herein is reported a case of PPHP, with partial empty sella, with a review of the literature
- A Case of 46 XX Male Syndrome.
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Jae Myoung Lee, Myung Sook Shim, Young Uck Kim, Young Goo Shin, Choon Hee Chung
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J Korean Endocr Soc. 2001;16(1):148-152. Published online February 1, 2001
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- The 46, XX male syndrome is rare disease that is characterized by a phenotypic male who has a 46, XX female karyotype. Since the first report by de la Chapelle and associates in 1964, several cases have been reported, but it is still a rare entity. Recently we examined a 20-year-old XX male who had the symptoms of gynecomastia, an infantile appearance of the external genitalia, scanty pubic hair, no Adams apple, and no axillary hair. We presently describe a patient with the 46, XX male syndrome who showed a 46, XX karyotype on chromosomal study and review the literatures.
- The Clinical Utility of HBME - 1 Immunostaining in the Diagnosis of Follicular Carcinoma of Thyroid.
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Young Goo Shin, Kyi Bum Lee, Yoon Sok Chung, Hyeon Man Kim
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J Korean Endocr Soc. 2000;15(4-5):513-521. Published online January 1, 2001
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- BACKGROUND
Currently, in follicular lesion of aspirates of thyroid, pathologic evaluation of surgical specimen is the only diagnostic method whether the patient had follicular thyroid malignancy or not. The aim of this study is the evaluation of the clinical utility of HBME-1 immunostaining in the diagnosis of follicular thyroid malignancy in surgical specimen, and to establish the diagnostic guideline of HBME-1 immunostaining. METHODS: From 1994 to Sep. 1999, the 72 paraffin embedded tissue, which was already diagnosed as thyroid follicular carcinoma or adenoma through the pathologic evaluation of surgical specimen, were studied. Among 72 specimens, the 29 follicular carcinoma were included, and the others were follicular adenoma. The specimens were stained with HBME-1 monoclonal antibody by standard avidin-biotin peroxidase complex methods. One limited pathologist had read the findings of the immunostaining with a basis such as percent of tumor area. These percentage were divided to 4 grade as follows: 1) Grade 0: negative stained, 2) Grade 1: stained area < 30%, 3) Grade 2: 30 < or = stained area < 60%, and 4) Grade 3: stained area > or = 60%. After we had set a basis of follicular carcinoma as more than Grade 2, defined the clinical utility of HBME-1 immunostaining. The clinical utility was based that the concordance rate between pathologic diagnosis and the findings of immunostaining was more than 80% in both groups. RESULTS: 1) There was significant difference between two groups in intensity of cellular staining (p=0.04, x2). But, there might not be helpful to rule out follicular carcinoma of thyroid from adenoma in fine-needle aspirates. 2) In both groups, the percent of stained area of tumor was very diverse from 0% to 100%, and was statistically significant different (p=0.007). 3) Because the only 5 cases of normal tissue in both groups were stained weakly, the HBME-1 immunostaining was like to specific reaction with tumor tissue in both groups. 4) When we had set a basis of follicular thyroid carcinoma as more than Grade 2 (> or = 30%), the concordance rate between pathologic diagnosis and the findings of immuno- staining was 69.7% in follicular adenoma, 65.5% in follicular carcinoma, respectively. CONCLUSION: The HBME-1 immunostaining may not be help to differentiate follicular carcinoma from adenoma.
- A Case of Multiple Endocrine Neoplasia Neoplasia Type IIa Complicated by Acute Myocardial Infarction.
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Eung Ho Karl, Mi Duck Lee, Young Uck Kim, Young Goo Shin, Jung Han Yoon, Seong Joon Kang, Choon Hee Chung
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J Korean Endocr Soc. 1999;14(1):189-196. Published online January 1, 2001
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- MEN IIa is the rare disorder consisted of thyroid medullary carcinoma, pheochromocytoma, and hyperparathyroidism. We experienced the case in which 42 year-old male patient with thyroid medullary carcinoma and pheochromocytoma complicated by acute myocardial infarction. During the process of conventional treatment of acute myocardial infarction, paroxysmal hypertension occurred for several times. We sought for the cause of paroxysmal hypertension, and found pheochromocytoma by the radiologic imaging study and the biochemical study and we found the 4X4 cm sized neck mass by palpation. After stabilizing his blood pressure by the use of phenoxybenzamine, we removed the pheochromocytoma in right adrenal gland and the medullary thyroid cancer, by right adrenalectomy and total thyroidectomy respectively. Thereafter, his subjective symptoms and objective signs were improved. We report the case with review of literatures.
- A Case of X-linked Agammaglobulinemia with Delayed Growth.
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Mi Jin Kim, Ho Young Kim, Mi Deok Lee, Hong Seung Kim, Young Goo Shin, Choon Hee Chung, Kye Chul Shin
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J Korean Endocr Soc. 1999;14(1):153-159. Published online January 1, 2001
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- In 1980, the clinical syndrome of X-linked agammaglobulinemia and isolated growth hormone defieiency (XLA/IGHD) was first described by Fleisher. We report here 25-year old man with isolated growth hormone deficiency and X-linked agammaglobulinemia. His height was below the third percentile. He had recurrent sinopulmonary infection, lacked circulating B lympocytes and had deficient growth hormone.
- Antibody-dependent Cell-mediated Cytotoxitity as a Prognostic Indicator in the Medical Treatment of Graves' Disease.
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Kwan Woo Lee, Young Goo Shin, Hye Rim Ro, Sung Kyu Lee, Yun Suk Chung, Hyun Man Kim, Yoon Jung Kim, Eun Kyung Hong, Bong Nam Chae
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J Korean Endocr Soc. 1998;13(4):554-562. Published online January 1, 2001
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- BACKGROUND
The several forms of treatment of Graves disease-thyroidectomy, antithyroid drugs and radioiodide therapy-are in wide use now. But which therapy is best is a matter of debate. Some authors reported that in patients who underwent thyroidectomy, higher titers of serum antimicrosomal antibody were associated with 1) higher formation rates of germinal centers, 2) more lymphocyte infiltration in the thyroid tissue, 3) higher incidence of hypothyroidism, and 4) lower incidence of recurrence. We were interested in the relationship of thyroid autoantibody titers, ADCC(antibody-dependent cell-mediated cytotoxicity) activity and the clinical response to antithyroid medication. METHODS: We measured ADCC activities from patients in Graves disease(n-48), Hashimoto thyroiditis(n=17) and normal control(n=9). The patients of Graves disease were followed up for more than 1 year, and they were grouped into A(n=17, well responsed group to antithyroid medication) and B(n=31, poorly responsed group). We examined ADCC activities of patients' sera by chromium release assay. RESULTS: 1) Mean age of patients with Graves disease was 34.4210.4 years and 15 patients were male(31%). 2) Results of thyroid function tests of the Graves' patients were T 585.9 +/- 255.3 ng/dL, T4 21.3 +/- 12.2 mg/dL, TSH 0.11 +/- 0.06mIU/mL. Concentrations of antimicrosomal antibody, antithyroglobulin antibody and thyrotropin binding inhibitory immunoglobulin were 1279.1 +/- 1486.7 IU/mL, 488.1 +/- 751.1 IU/mL, and 38.5 +/- 33.4U/L respectively. 3) There was no significant difference between levels of thyroid hormones or concentrations of thyroid autoantibodies and ADCC activities in graves patients. 4) The ADCC activity of the Graves patient group(24.49%) was significantly higher than that of the normal control group(3.76%), and significantly lower than that of the Hashimotos thyroiditis group(36.34%). 5) There was no significant difference in ADCC activity between group A(18.24 +/- 13.44%) and B(27.91 +20.02%). CONCLUSION: From this results, we suggested that ADCC activity seems to be no value as a prognostic factor in predicting the response to antithyroid drugs in Graves disease patients. But, further studies, larger number of patients and long-term follow up, are needed.
- Three Cases of Primary Hypothyroidism with Down Syndrome in Adult.
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Kwan Woo Lee, Young Goo Shin, Sung Keun Lee, Sung Kyu Lee, Yun Suk Chung, Hyun Man Kim
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J Korean Endocr Soc. 1998;13(3):453-458. Published online January 1, 2001
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- Down syndrome is perhaps the most common genetic condition associated with mental retardation. In cytogenetic examination, trisomy 21 is in 95% of Down syndrome, and the others are mosaicism, translocation or deletion. There are many associated diseases with Down syndrome such as, thyroid function abnormality, congenital heart disease, intestinal blockage, and so on. Hypothyroidism appeared in 15% before adolescent in Down syndrome patients. In Korea, there were several reports of Down syndrome with hypothyroidism in childhood but not in adulthood. And we had three cases of hypothyroidism with Down syndrome in adulthood. Cytogenetic examination revealed trisomy 21 in the 2 cases and 1 case of mosaicism. Antithyroid antibody was positive in one case. None of these cases was admitted due to symptoms of hypothyroidism. It is very difficult to make the diagnosis of hypothyroidism in Down syndrome because of similarity in symptoms between Down syndrome and hypothyroidism. Thus, periodic thyroid function test should be made in Down syndrome, and this could be a part of improving quality of life in Down syndrome.
- Clinical Characteristics in Korean Patients with Insulin Receptor Antibody Positive Acanthosis Nigricans.
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Hong Seung Kim, Choon Hee Chung, Young Goo Shin, Mi Duk Lee, Young Joon Won
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J Korean Endocr Soc. 1998;13(3):410-416. Published online January 1, 2001
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- BACKGROUND
Insulin resistance syndrome shows extreme insulin resistance and is associated with acanthosis nigricans. We can differentiate it into type A insulin resistance that has insulin receptor defect, and type B insulin resistance due to insulin receptor autoantibody. Type B insulin resistance was firstly described by Kahn in 1976. It was often found in adult female and showed autoimmune characteristics. As clinical characteristics, there are hyperglycemia, hypoglycemia, hyperinsulinemia, extreme insulin resistance and acanthosis nigricans. METHODS: We investigated 17 insulin receptor autoantibody positive cases and 8 cases of normal control who had visited Wonju Christian Hospital from October 1994 to December 1995. Among insulin receptor autoantibody positive subject, male was 4 cases and female 13 cases. Their mean age was 42.2. We compared patients who had insulin receptor antibody positive acanthosis nigricans(IRA) with normal controls. IRA patients were 6 cases(35.3%) of nomal glucose tolerance, 11 cases(64.7%) of abnormal glucose tolerance including overt diabetes mellitus. RESULTS: The 11 cases(64.7%) among IRA patrents were obese and 13 cases(76.5%) had hyperininsulinemia. In IRA patients, mean serum insulin concentration during oral glucose tolerance test was 202.1mU/mL and it was greater than 46.3 of normal controls. Insulin sensitivity in 1.79mg/L * mM * xmU * min normal controls was higher than 0.74mg/L * mM * min of IRA patients. CONCLUSION: IRA patients showed abnormal glucose tolerance including overt diabetes millitus, severe insulin resistance, hyperinsulinemia and obesity.
- A Case of Surgically Treated Insulinoma in Pregnancy.
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Kwan Woo Lee, Euy Young Soh, Young Goo Shin, Sung Keun Lee, So Yun Park, Sung Kyu Lee, Yun Suk Chung, Hyun Man Kim, Kyung Joo Hwang, Yun Mi JIn
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J Korean Endocr Soc. 1998;13(2):288-294. Published online January 1, 2001
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- Insuliin secreting tumor is 70% prevalent disease in female and predoadnant in forth and sixth deeade. The incidence of insulinoma is one case per 250,000 patient-years. Insulinoma in pregnancy was extremely rare, and the prevalence was not reported. The diagnosis of an insulinoma is depend on demonstration of hypoglycemia with high insulin and C-peptide levels. Immunoreactive insulin/plasma glucose ratio0.3 in particular support the diagnosis of an insulinoma. Fetal complication would be developed because of hypoglycemia. In approximately half of the cases reported, surgical exploration was done during pregrancy, the remainder were treated after delivery. Insulinoma poses serious diagnostic and therapeutic problems when she is pregnant. We experienced a case of insulinoma in pregnancy that represented Whipples triad and was treated by surgical intervention.
- Two Cases of Cushing's Disease Due to Large Pituitary ACTH Secreting Tumor.
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Hong Seung Kim, Choon Hee Chung, Mee Yeon Cho, Young Goo Shin, Il Hoe Kim, Seok Woo Yang, Jang Young Kim
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J Korean Endocr Soc. 1998;13(1):83-93. Published online January 1, 2001
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- Cushing's syndrome that is caused by an adenoma of the corticotrape cells of the anterior pituitay or, rarely, by couticotrope hyperplasia is refered to as Cushing's disease. Cushings disease is usually characterized by chronic, moderate hypersecretion of ACTH and other POMC derived peptide. Most patients have ACTH-secreting anterior pituitary corticotrope microadenomas, but a small minority have a pituitary macroadenoma. We recently experenced two cases of Cushings disease due to pituitary macroadenoma. and report this cases with review of literatures.
- A Case of Thymic Carcinoid Tumor Associated with Ectopic ACTH Syndrome.
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Kwan Woo Lee, Young Goo Shin, Sung Keun Lee, Sung Kyu Lee, Yun Suk Chung, Hyun Man Kim, Yo Han Cho, Kwang Hyun Ko, Jung Sun Kim, Chul Shim
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J Korean Endocr Soc. 1997;12(4):647-654. Published online January 1, 2001
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- The syndrome of ectopic production of ACTH by non-pituitary neoplasm occurs with various types of tumors. ACTH-producing thymic carcinoid tumor is rare and has not been reported in Korea. We have experienced a 36-year-old male patient with ACTH-producing thymic carcinoid tumor, presenting symptoms of generalized weakness and weight gain. Clinical presentation, radiologic and hormonal evaluation, and pathologic examination were compatible with ACTH-producing thymic carcinoid tumor. The immunohistochemical staining of the thymic carcinoid tumor showed positivity for ACTH. Primary and metastatic tumor and both adrenal glands were resected. Radiation therapy and chemotherapy were performed. The prognosis of this patient is thought to be poor.
- Four Cases of Newly Developing Goiter During Lithium Carbonate Therapy.
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Kwan Woo Lee, Young Goo Shin, Sung Keun Lee, Sung Kyu Lee, Yun Suk Chung, Hyun Man Kim
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J Korean Endocr Soc. 1997;12(4):621-626. Published online January 1, 2001
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- Since 1949, lithium has been widely used for treatment of manic depressive disorder. It has also been used for agranulocytosis after anticaneer chemotherapy and partially for hyperthyroidism. But it is well known that the long term administration of this drug is associated wih various antithyroid effects such as hypothyroidism, simple goiter, nodules and even thyrotoxicosis. Although the exact mechanism for leading hypothyroidism or goiter is still unknown, the incidence of lithium-induced hypothyroidism is 1-37% during lithium atment. We had an experience of newly developing goiter with or without hypothyroidism during lithium treatment in 4 MDP patients. Among our patients, the duration of lithium administration was from 0.7 months to 11 years, and the development of thyroid abnormality was impossible to predict. They were treated with thyroxine while lithium was discontinued causing favorable outcome. We suggest that routine thyroid function test include thyroid autoimmune antibody screening in patients planning to undergo lithium treatment.
- A Case of Piouitary Hyperplasia with Retardation due to Primary Hypothyroidism.
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Hong Seung Kim, Choon Hee Chung, Young Goo Shin, Bong Ki Lee
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J Korean Endocr Soc. 1997;12(4):589-595. Published online January 1, 2001
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- Primary hypothyroidism can result in reactive enlargement of the pituitary gland which is indistinguishable from primary pituitary lesions in clinical presentation and on magnetic resonance imaging. A 17-year-old girl came to the hospital due to short stature, general weakness and galac-torrhea. The magnetic resonance imaging (MRI) study showed pitutary enlargement. The hormone study showed hyperprolactinemia, decreased basal growth hormone level and primary hypothyroi-dism. By thyroid replacement therapy only, mass was successfully regressed on follow up MRI after 4 months, and growth acceleration could be achieved.
- A Case of Calcitonin Secreting Pheochromocytoma.
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Joo Won Byun, Young Goo Shin, Choon Hee Chung, Young Jun Won, Yoon Jong Choi, Eui Ryun Park, Mi Duck Lee, Chang Ho Song, Mi Youn Cho, Sung Jun Kang
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J Korean Endocr Soc. 1996;11(3):343-347. Published online November 7, 2019
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- Pheochromocytoma is a catecholamine producing turnor and raise with less than 0.1% of hypertensive patients. It is developed, most commonly, in sporadic pheochromocytoma or multiple endocrine neoplasia type 2. Therefore, when hypercalcitoninemia is found in a patient with pheochromocytoma, the possibility of multiple endocrine neoplasia type 2 or the ectopic secretion of calcitonin must be considered. Recently we experienced a 45 year old male patient with sporadic pheochrornocytoma. He also had hypercalcitoninemia and normocalcemia. After the removal of pheochromocytoma, serum calcitnnin level returned to normal. Secretion of calcitonin was confirmed by immunohisto- chemical stain.
- A Case of Autoimmune Hypoglycemia Due to Insulin Receptor Antibody Associated with Empty Sella Syndrome.
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Hong Seung Kim, Young Jun Won, Hyung Jun Lee, Yoon Jong Choi, Do Sik Yoon, Young Goo Shin, Choon Hee Chung
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J Korean Endocr Soc. 1996;11(1):119-123. Published online November 7, 2019
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- A Case of Turner Syndrome Associated with Autoimmune Thyroiditis and Empty Sella.
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Hong Seung Kim, Joo Won Byun, Do Sik Yoon, Byung Gi Seo, Young Goo Shin, Choon Hee Chung
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J Korean Endocr Soc. 1996;11(1):114-118. Published online November 7, 2019
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- A Case of Thyrotoxic Hypokalemic Periodic Paralysis Presenting as Cardiac Arrest.
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Chang Ho Song, Choon Hee Chung, Young Joon Weon, Mi Deok Lee, Seong Jin Park, Young Goo Shin, Won Sik Lee
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J Korean Endocr Soc. 1995;10(4):424-427. Published online November 7, 2019
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- Periodic paralysis associated with thyrotoxicosis is characterized by intermittent flaccid paralysis of the skeletal muscle. The paralysis usually involve the skeletal muscle of the limbs, especially lower extrimities. In general, sensory function is intact. Involvement of respiratory, ocular or bulbar muscles is very rare, but bulbar and respiratoy invelvement may prove fatal. It is very rare a case that has severe clinical manifestation such as cardiac arrest. We report a case of thyrotoxic hypokalemic periodic paralysis presenting as cardiac arrest.
- A Case of Thyrotoxic Hypokalemic Periodic Paralysis Presenting as Cardiac Arrest.
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Chang Ho Song, Choon Hee Chung, Young Goo Shin, Young Joon Weon, Mi Deok Lee, Seong Jin Park
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J Korean Endocr Soc. 1994;10(2):175-178. Published online November 6, 2019
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- No abstract available.
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