Within the past few years, information regarding osteocyte function as been emerging and expanding significantly. No longer is the osteocyte considered a passive cell acting simply as a 'placeholder' within mineralized bone. Osteocytes are derived from osteoblast progenitors and in the adult skeleton compose 90-95% of all bone cells. Therefore, the function of these cells in the adult and aging skeleton has become the focus of recent investigation. These cells are proving to be multifunctional, ranging from mechanotransduction, to regulation of mineral homeostasis, to control of bone remodeling. The osteocyte as a source and reservoir of signaling factors important in health and maintenance of the adult skeleton is addressed in this review.
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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
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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
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BACKGROUND Although so many experimental trials have been done to improve the redifferentiation and responsiveness of radioiodide therapy, they have not yet yielded any satisfactory results. As statins inhibit both farnesylation and geranylgeranylation, they have been reported to have an antineoplastic and redifferentiation effect in experimental and clinical studies. In this study, we investigated the relationship between statins and the alteration of the NIS expression and, TPC-1 cell apotosis to evaluate the possibility of using statins as adjuvant therapeutic agents for papillary thyroid cancer. METHODS: We used the TPC-1 cell lines for our experiments. Cell viabilities were measured by CCK-8. The degrees of apoptosis and, the expressions of NIS mRNA and NIS protein were measured by flow cytometry, semi quantitative RT-PCR and Western blot assay. RESULTS: Increased levels of NIS mRNA and NIS protein were observed under therapeutic blood concentrations (concentrations of simvastatin: 20, 50, 80 nM, concentrations of atorvastatin: 50, 80,110 nM), but the dose-response relationship was only manifested within simvastatin. The TPC-1 cells showed a concentration dependent decrease of viability and an increase of apoptosis not under therapeutic blood concentrations, but under excessively high concentrations (after treatment with 10-50 microM of atorvastatin and with 1-10 microM of simvastatin). CONCLUSION: The results of this study show that effective therapeutic blood concentrations of simvastatin and atorvastatin can give a favorable effect on the NIS expression under effective therapeutic blood concentrations. Therefore, we demonstrated the possibility that simvastatin and atorvastatin might have an important role as adjuvant therapeutic agents to improve the responsiveness of radioiodide therapy for papillary thyroid cancer. Further studies are needed to clarify this issue.
BACKGROUND 17 beta-estradiol is known to play an important role in glucose homeostasis. Lipin-1 is a nuclear protein that is essential in adipocyte differentiation and it is considered to play a role in ectopic fat deposition and the redistribution of fat. The aim of this study was to evaluate the effect of 17 beta-estradiol on the lipin-1 expression in the adipocytes of OLETF rats, which is an animal model of diabetes. METHODS: The OLETF rats were divided into 3 groups, 1) the sham-operation group (SHAM) 2) the castrated group (CAST) and 2) the castrated and estradiol treatment group (EST), and all the rats were at 6 weeks of age. LETO rats were used as a control group (LETO). 0.1 mg of estradiol valerate was injected subcutaneously every 4 weeks in the rats of the EST group. The visceral and subcutaneous tissues were isolated to evaluate the lipin-1 protein expression. The lipin-1 expression was measured in human visceral and subcutaneous preadipocytes. RESULTS: Less body weight gain was observed in the EST group compared with that of the SHAM group. In addition, improvement in the glucose tolerance was observed in the EST group. The lipin-1 expression in visceral fat was decreased in the SHAM and CAST groups, but it was but recovered in the EST group. The lipin-1 expression in the subcutaneous fat was decreased in the SHAM, CAST, and EST groups. CONCLUSION: Long term estradiol treatment in OLETF rats reduces the body weight gain and improves the glucose tolerance. Estradiol enhances the lipin-1 protein expression in the visceral adipocytes, but not in the subcutaneous adipocytes.
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Effect of 17-beta Estradiol on Adipocyte Lipin-1 Expression in OLETF Rat Seong-Kyu Lee Endocrinology and Metabolism.2010; 25(3): 177. CrossRef
BACKGROUND The aim of this study was to investigate the favorable factors for gonadotropin-releasing hormone (GnRH) agonist treatment with regard to the growth velocity and the predicted adult height (PAH) in central precocious puberty (CPP) girls. METHODS: We reviewed the clinical and auxological parameters in 46 CPP girls who were treated with GnRH agonist at the pediatric endocrinology clinic of Korea University Hospital from January 2001 to August 2007. We divided the two groups according to the growth velocity of 5 cm/yr and we assessed the related factors associated with growth velocity. We also assessed the changes in PAH for two years. RESULTS: The pretreatment chronological age and bone age were significantly younger in the high growth velocity group (> 5 cm/yr) compared to that of the low growth velocity group (7.8 +/- 0.9 year vs. 8.4 +/- 0.5 year, 9.4 +/- 1.2 year vs. 10.1 +/- 0.9 year, respectively) (P < 0.05). The PAH after treatment was significantly greater in the high growth velocity group (> 5 cm/yr)(P < 0.05). Growth velocity during treatment had negative correlation with the pretreatment chronological age and positive correlation with the PAH after one and two years of treatment (r = -0.45, P < 0.05 and r = 0.51, P < 0.01). PAH had positive correlation with the treatment duration (r = 0.31, P < 0.05). CONCLUSION: In our study, the growth velocity during GnRH agonist treatment was negatively related to age at the initiation of treatment. Therefore, earlier treatment is important to improve the outcomes and to maintain appropriate growth velocity in CPP girls.
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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.
Hypoglycemia in diabetic patients is usually caused by excessive exogenous insulin or the administration of an insulin secretagogue relative to the prevailing glucose concentration. Thus, the clinical manifestations of hypoglycemia are usually not observed in diabetic patients after either insulin or an oral hypoglycemic agent is discontinued. In contrast, diabetic ketoacidosis results from relative or absolute insulin deficiency. Although about 40% of diabetic patients who inject human insulin have insulin antibodies, these antibodies seldom significantly affect the glycemic control. It has not been reported in the literature that insulin antibody in the setting of human insulin therapy is associated with diabetic ketoacidosis and subsequent hypoglycemia. We describe here a rare case of spontaneous hypoglycemia due to insulin antibody after the improvement of diabetic ketoacidosis in a patient with type 2 diabetes mellitus and who had been treated with human insulin.
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Pseudohypoparathyroidism is a rare disease that is characterized by target cell resistance to the effects of parathyroid hormone and this disease is classified into various types depending on the phenotypic and biochemical findings. The patients with pseudohypoparathyroidism present with the clinical and biochemical features of hypoparathyroidism, but they have an increased serum level of parathyroid hormone. We experienced a case of pseudohypoparathyroidism in a 24 years old woman who had Graves' disease at that time. She had hypocalcemia, hyperphosphatemia, an elevated serum parathyroid hormone level and a normal urinary basal cyclic AMP(adenosine monophosphate) level. She also had a normal phenotypic appearance. Therefore, she was classified as suffering with pseudohypoparathyroidism type II. The clinical and laboratory abnormalities were improved by calcium supplementation in addition to vitamin D. To the best of our knowledge, this is the first case of pseudohypoparathyroidism combined with Graves' disease in Korea.
One of the rare diseases for differential diagnosis of subacute thyroiditis is metastases within the thyroid gland. We report here on a 72-year-old-woman with painful goiter and signs of hyperthyroidism. Her serum concentration of thyroid hormone was in the upper limit of normal, and the uptake of radioactive iodine by the thyroid was completely depressed. Although subacute thyroiditis was suspected, an additional work up that included a chest CT scan was done for the combined cough and chronic weakness. The result was lung cancer with metastatic involvement of the thyroid and multiple lymph nodes. She refused further anti-cancer therapy and died 5 months after the diagnosis. For the differential diagnosis of such a rare case, careful examination is important even in patients with the typical symptoms and laboratory findings of subacute thyroiditis.
New onset diabetes and diabetic ketoacidosis have been reported with administering atypical antipsychotics. Whereas clozapine and olanzapine are associated with a relatively high incidence of new onset diabetes and diabetic ketoacidosis, there are few case reports that have has been documented implicating quetiapine as the contributor to causing diabetes and diabetic ketoacidosis. I report here on a case of diabetic ketoacidosis that developed in a patient who was associated with quetiapine therapy. A 32-year-old woman with schizophrenia was transferred to the emergency room with diabetic ketoacidosis and vaginal bleeding. Seventeen months before this episode, she was hospitalized in an inpatient psychiatric institution and treated with quetiapine 1200mg, haloperidol 3mg, diazepam 5mg and benztropine 3mg with normal blood glucose levels. She had no personal and familial history of diabetes mellitus. She had no risk factors for diabetes mellitus and she also had no precipitating factor for diabetic ketoacidosis except for taking the atypical antipsychotic quetiapine. I believe that this case is the first case report of quetiapine associated diabetic ketoacidosis in Korea. Considering the unpredictability of hyperglycemia associated with quetiapine, monitoring the blood glucose should be part of the routine care when administering quetiapine.
Pheochromocytoma is derived from the chromaffin cells and patients with pheochromocytoma present with several signs and symptoms by producing, storing and secreting catecholamine. Spontaneous rupture or necrosis of pheochromocytoma is extremely rare, but it can be lethal because of the dramatic change in the circulation such as an acute abdominal emergency or shock. Spontaneous remission of the clinical symptoms due to necrosis of the pheochromocytoma is rare. We describe such a case that presented with cardiogenic shock due to extensive necrosis of the pheochromocytoma and this was followed by spontaneous remission of the clinical symptoms without removal of the pheochromocytoma.
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Pheochromocytoma-induced cardiogenic shock successfully treated by extracorporeal circulation Min Young Lee, Sang Bae Lee, Hyun Seo Cha, Ji Hong You, Eui Young Choi, Jong Suk Park Yeungnam University Journal of Medicine.2017; 34(2): 285. CrossRef