Endocrinology and Metabolism

Volume 21(1); February 2006

Review Articles

Susceptible Genes of Autoimmune Thyroid Diseases.: Takashi Akamizu; J Korean Endocr Soc. 2006;21(1):1-10. Published online February 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.1.1

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Abstract PDF: No abstract available.

Regulation of Gene Expression in Oocyte Growth and Maturation.: Kyung Ah Lee; J Korean Endocr Soc. 2006;21(1):11-13. Published online February 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.1.11

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Abstract PDF: No abstract available.

Original Articles

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

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

Standardization of Isolation Procedure and Analysis of Variables on Successful Isolation of Islet from the Human Pancreas.: Song Cheol Kim, Duck Jong Han, Ik Hee Kim, Yoo Me We, Yang Hee Kim, Jin Hee Kim, Ji He Back, Dong Gyun Lim; J Korean Endocr Soc. 2006;21(1):22-31. Published online February 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.1.22

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Abstract PDF: BACKGROUND
Identifying the donor and isolation-related factors during the islet isolation would be greatly helpful to improve the result of human islet isolation for successful clinical islet transplantation. METHODS: Sixty-nine pancreata from cadaveric donors were isolated with standard protocol and analyzed to identify the donor factors and isolation variables for successful isolation. Islet isolations recovered > or = 100,000 Islet Equivalent (IEQ, n=53) were compared to islet mass less than 100,000 IEQ (n=16). RESULTS: The mean islet recovery was 216.0 x 10(3) +/- 173.7 x 10(3) (IEQ) before purification and 130.6 x 10(3) +/- 140.2 x 10(3) (IEQ) after purification. Mean purity was 54 +/- 31%. Mean age of donor was 31.2 +/- 13.2 year and mean cold ischemic time was 6.9 +/- 6.2 hour. Quality of isolated islets was acceptable in terms of bacterial culture, viability and secretory function in vitro and in vivo. In univariate analysis on successful isolation, status of pancreas was the only significant factor and sex, duration of collagenase expansion and digestion time were marginal factors. Stepwise multivariate logistic regression analysis showed donor sex, status of pancreas and digestion time were significant factors for the successful islet isolation. CONCLUSION: This study confirms some donor factors and variables in isolation process can influence the ability to obtain the successful isolation of human islet. Enough experiences and pertinent review of donor and isolation factors can make islet isolation successful, supporting the clinical islet transplantation without spending of cost.

Effect of High Concentration of Estradiol on Thyroid Specific Genes Expression and Cell Growth.: Dong Woo Kim, Hee Youn Park, Do Hee Kim, Hee Jin Kim, Hyun Kyung Chung; J Korean Endocr Soc. 2006;21(1):32-39. Published online February 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.1.32

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Abstract PDF: BACKGROUND
Since various thyroid diseases have dominant prevalence in women, it has been suggested that female sex hormone have important role on thyroid cell physiology. Interestingly, many thyroid disorders are newly diagnosed or changed their course around the period of high estrogen status, such as pregnancy. In this study, we questioned whether high concentration of estrogen could modulate thyroid cell function. METHODS: We treated normal rat thyroid FRTL-5 cell line with different time and concentration of estradiol. Using cell count, FACscan, and Northern blot analysis, we compared the changes of cell growth, cell cycle progression and thyroid specific genes expression. To evaluate the influence of thyroid stimulating hormone (TSH), all experiment was designed as two different sets, with (6H) or without TSH (5H). RESULTS: The concentration of 10-1000 nM estradiol had definite stimulatory function on thyroid cell growth in 5H condition as concentration dependent manner. FACscan revealed the increased cell growths were related to G1/S progression. The Pax-8, TTF-1 and NIS gene expressions were dramatically increased in 10-1000 nM of estradiol, too. With TSH (6H), however, we could not find any cell growth stimulating effects with 10-1000 nM of estradiol. CONCLUSION: High concentration of estradiol is one of important control factor for thyroid growth and thyroid specific genes expression, especially in 5H condition. It indicate that exposure to high concentration of female sex hormone, such as pregnancy, can be a direct stimulating factor to various thyroid function and related to autoimmune or nodular thyroid diseases around the period of pregnancy.

Growth Hormone Treatment in Prader-Willi Syndrome.: Ji Eun Park, Seung Won Lee, Kyoung Eun Song, Hyoung Suk Lee, Dae Jung Kim, Yoon Sok Chung, Kwan Woo Lee, Hyon Joo Kim; J Korean Endocr Soc. 2006;21(1):40-46. Published online February 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.1.40

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Abstract PDF

BACKGROUND
Prader-Willi syndrome (PWS) is a congenital disorder, which is clinically characterized by a short stature, muscular hypotonia, hypogonadism, mental retardation and hyperphagia, leading to early childhood obesity. Impaired growth hormone (GH) secretion, hypogonadism, and obesity are common in patients with PWS. The purpose of this study was to find the effects of growth hormone treatment in patients with PWS. METHODS: Six patients with PWS confirmed by a genetic study were recruited, and treated with growth hormone(Eutropin(R))(0.8-1 IU/kg/week) divided into five or seven day doses per week for six months. The heights and weights of the subjects were evaluated. GH status were evaluated using the serum insulin-like growth factor (IGF)-I level, the L-dopa test, and insulin-induced hypoglycemia tess. Glucose metabolism was evaluated using the random serum glucose and HbA1c levels. RESULTS: GH was found to be deficient in 2 out of 6 subjects by the insulin test, in 3 out of 6 by the IGF-I level, and in 5 out of in 5 by the L-dopa test. After six months of GH treatment, the height percentile was increased and weight percentile decreased. The serum glucose and HbA1c levels remained unchanged. CONCLUSION: Six months of GH treatment in patients with PWS improved the height and degree of obesity. This study has shown the beneficial effects of GH treatment for patients with PWS, and without significant side effects.

Citations

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Effects and adverse-effects of growth hormone therapy in children with Prader-Willi syndrome: A two year study
Su Jin Kim, Joong Bum Cho, Min Jung Kwak, Eun Kyung Kwon, Kyung Hoon Paik, Dong-Kyu Jin
Korean Journal of Pediatrics.2008; 51(7): 742. CrossRef
Phenotype-genotype correlations and the efficacy of growth hormone treatment in Korean children with Prader-Willi syndrome
Keun Wook Bae, Jung Min Ko, Han-Wook Yoo
Korean Journal of Pediatrics.2008; 51(3): 315. 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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Abstract PDF

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.

Citations

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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

Case Reports

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

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

A Case of Adrenocortical Adenoma Causing Subclinical Cushing's Syndrome Mistaken for Liddle's Syndrome.: Kyu Hong Kim, Kwang Hyun Kim, Ho Yoel Ryu, Soo Min Nam, Mi Young Lee, Jang Hyun Koh, Jang Yel Shin, Soon Hee Jung, Choon Hee Chung; J Korean Endocr Soc. 2006;21(1):58-62. Published online February 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.1.58

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Abstract PDF

Subclinical Cushing's syndrome is defined as an autonomous cortisol hyperproduction without specific clinical signs of cortisol excess, but detectable biochemically as derangements of the hypothalamic-pituitary-adrenal axis function. We report a case of a 33-year-old woman with subclinical Cushing's syndrome caused by left adrenocortical adenoma, mistaken for Liddle's syndrome. The patient complained of fatigue. Laboratory findings showed metabolic alkalosis, hypokalemia, high TTKG (transtubular K concentration gradient), low plasma renin activity, and low serum aldosterone level, that findings implied as Liddle's syndrome. So we performed further study. Hormonal and radiologic studies revealed subclinical Cushing's syndrome with a left adrenal mass. The adrenal mass was resected and pathologically diagnosed as adrenocortical adenoma. After the resection of the left adrenal mass, patient's hormonal levels showed normal range.

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Missed Ipsilateral Adrenal Adenoma With Recurrent Hypercortisolism After Prior Left Adrenalectomy
Jihoon Kim, Hae Kyung Kim, Choon Hee Chung
Journal of Korean Medical Science.2022;[Epub] CrossRef

A Case of Iodine-induced Thyrotoxicosis with Acromegaly.: Kwang Hyun Kim, Kyu Hong Kim, Ho Yoel Ryu, Su Min Nam, Mi Young Lee, Jang Hyun Koh, Jang Yeol Sin, Choon Hee Chung; J Korean Endocr Soc. 2006;21(1):63-67. Published online February 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.1.63

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Abstract PDF: Hyperthyroidism is seen in 3.5-26% of subjects with acromegaly. Hyperthyroidism can be developed by thyroid stimulating hormone (TSH) dependent mechanism in TSH-secreting adenomas with acromegaly or by TSH independent mechanism through the stimulation of thyroid cells by growth hormone (GH). So, confirming the cause of hyperthyroidism is important to treat that. We report a case of a 56-year-old man who had acromegaly with iodine-induced thyrotoxicosis. He took the sea tangle for 4 years because he had constipation. His face and hands indicated acromegaly. Thyroid function test showed that T3 and free T4 were increased and TSH was decreased. Ultrasonography of neck showed diffuse enlargement of thyroid gland and thyroid scan showed decreased uptake of thyroid gland. So we could confirm iodine-induced thyrotoxicosis due to excessive iodine intake. Serum GH and insulin-like growth factor (IGF)-1 were markedly increased and brain MRI showed heterogenous 1 cm sized pituitary mass in right side. Acromegaly was confirmed by brain MRI, pituitary stimulation test and increased level of GH, IGF-1. He stopped iodine intake. After 6 months, T3, free T4 and TSH were normalized and he is waiting for the surgical removal of pituitary adenoma.

A Case of Malignant Insulinoma Metastasized to Liver after Partial Pancreatectomy due to Insulinoma 10 Years before.: Yang Il Kang, Byung Hyuk Yang, Suk Chon, Seungjoon Oh, Jeong Taek Woo, Sung Woon Kim, Jin Woo Kim, Young Seol Kim, Ju Hie Lee, Kwanpyo Koh; J Korean Endocr Soc. 2006;21(1):68-73. Published online February 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.1.68

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Abstract PDF: Malignant insulinomas are very rare endocrine tumours with a variable clinical course. Here, a case of a malignant insulinoma, resected from the tail of the pancreas 10 years previously, which was found to have hepatic metastasis, is reported. A pancreatic mass, without evidence of metastasis, has been found using an abdominal CT scan and intra-operative ultrasonography 10 years previously. Recently, the patient has suffered from dizziness, sweating and an altered mentality. Hyperinsulinemia was diagnosed from the biochemical laboratory finding. An abdominal CT scan and intra-operative abdominal sonography showed multiple hepatic metastasis, without local recurrence in pancreas. Therefore, a partial hepatic segmentectomy was performed. Immunohistochemical staining of the postoperative specimen was strongly positive for insulin. The postoperative biochemical response was normalized, and the patient experienced no further hypoglycemic symptom.

A Case of Non-islet Cell Tumor Hypoglycemia.: Yun Tae Chae, Il Jun Hwang, Kyung Hee Ryu, Eun Hyang Ko, Jung Im Rue, Soo Kyung Kim, Seok Won Park, Yoo Ri Kim, Yong Wook Cho, Young Kil Choi, Sang Jong Lee; J Korean Endocr Soc. 2006;21(1):74-78. Published online February 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.1.74

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Abstract PDF

Mesenchymal tumors including hemangiopericytomas, hepatocellular tumors, adrenal carcinomas, and a variety of other large tumors have been reported to produce excessive amounts of insulin-like growth factor (IGF) type II precursor, which binds weakly to insulin receptors and strongly to IGF-I receptors, leading to insulin like actions. In addition to increased IGF-II production, IGF-II bioavailability is increased due to complex alterations in circulating binding proteins. The authors of this article diagnosed non-islet cell tumor hypoglycemia from an 81-year-old male patient suffering from repetitive fasting hypoglycemia while he has not received any treatment for pulmonary hemangiopericytoma diagnosed in the past. Moreover, this topic is getting reported as the authors have experienced a significant improvement of catamnesis by a treatment with glucocorticoid.

Citations

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A Case of Epithelioid Hemangioendothelioma of the Pelvic Retroperitoneum with Hypoglycemia
Ji Ryang Kim, Yun Kyung Jeun, Kee Tae Park, Yang Ho Kang, Seok Man Son, In Ju Kim, Yong Ki Kim, Kyung Un Choi, Kwang Jae Lee
Journal of Korean Endocrine Society.2007; 22(6): 440. CrossRef

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

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Abstract PDF

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

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

A Case of Papillary Thyroid Carcinoma Combined with Metastatic Renal Cell Carcinoma in the Thyroid.: Kang Il Cheon, Kyung Wook Lee, Ji Oh Mok, Yeo Ju Kim, Hyung Kyu Park, Chul Hee Kim, Sang Jin Kim, Dong Won Byun, Kyo Il Suh, Myung Hi Yoo, Hee Kyung Kim, Youn Woo Ko; J Korean Endocr Soc. 2006;21(1):85-89. Published online February 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.1.85

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Abstract PDF

Metastasis to the thyroid from distant cancer is rarely diagnosed clinically and renal cell carcinoma is the most common group of neoplasm to metastasize to the thyroid. Papillary thyroid carcinoma is known as the most frequent primary thyroid cancer. But coexistence with metastatic renal cell carcinoma to thyroid and papillary thyroid carcinoma is very rare. We are reporting this highly unusual case of metastatic renal cell carcinoma to thyroid, which harbored papillary thyroid cancer. To our knowledge, this is the first case reported in Korea. A 57-year-old woman presented with hoarseness and palpable anterior neck mass. She had a history of renal cell carcinoma of right kidney, which had been resected 10 years previously and had undergone lower anterior resection due to sigmoid colon cancer 2 months before. Fine needle aspiration cytology suggested follicular neoplasm, and total thyroidectomy was performed. The pathology from the thyroid nodules showed papillary thyroid cancer combined metastatic renal cell carcinoma.

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A Case of Metastatic Renal Cell Carcinoma to Thyroid Gland Mimicking as Anaplastic Thyroid Carcinoma
Sooyeon Jo, Hyung Gyun Na, Chang Hoon Bae, Yoon Seok Choi
Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2021; 64(10): 755. CrossRef

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