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42 "Sung Koo Kang"
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Case Reports
A Case of Mediastinal parathyroid adenoma localized by technetium-99m sestamibi scanning.
Bong Yun Cha, Kwang Woo Lee, Ho Young Son, Sung Koo Kang, Ki Ho Song, Sung Hee Lee, Won Hee Han, Hyung Sun Sohn
J Korean Endocr Soc. 1996;11(2):227-232.   Published online November 7, 2019
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  • 22 Download
AbstractAbstract PDF
We present a patient with primary hyperparathyroidism in whom preoperative Tc-99m sestarnibi scanning cleary demonstrated mediastinal parathyroid adenoma. After resectian of tumor through median sternotomy, he was restored to the normocalcemia. This case suggests that Tc-99m sestamibi scanning may be a useful method in the preoperative localization of mediastinal parathyroid adenoma.
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A Case of Pituitary Feedback Adenoma Caused by Primary Hypothyroidism.
Soon Jib Yoo, Sang A Chang, Yoo Bae Ahn, Hyun Sik Son, Kun Ho Yoon, Moo Il Kang, Bong Yun Cha, Kwang Woo Lee, Ho Young Son, Sung Koo Kang, Myung Hee Chung
J Korean Endocr Soc. 1996;11(2):199-206.   Published online November 7, 2019
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  • 29 Download
AbstractAbstract PDF
A 14-year-old girl presented with severe headache and grand mal seizure. A magnetic resonance imaging(MRI) of brain showed a pituitary mass(1.0X1.5X1.3cm) incidentally during seizure evaluation. On physical examination, nodular goiter was detected on her anterior neck. The hormone study showed markdly increased basal thyroid stimulating hormone(TSH) level compared to thyroid hormone level, hyperprolactinemia and decreased basal growth hormone level. TSH and prolactin showed exaggerated response to thyrotropin releasing hormone(TRH) and the growth hormone showed delayed and blunted response to insulin-induced hypoglycemia. With the results of thyroid autoantibody and thyroid scan, the diagnosis of Hashimoto's thyroiditis was possible. Thyroid hormone and anticonvulsant drug were started with close observation of clinical status under the impression of pituitary feedback adenoma caused by hypothyroidism. After 3 months replacement therapy of levothyroxine sodium, she achieved euthyroid state with disappearance of headache and nodular goiter. After continuous replacement therapy for 9 months more, the pituitary mass was successfully regressed on follow up MRI with normalization of basal prolactin level. Grand mal seizure was developed after withholding anticonvulsant drug even though continuous admmistration of thyroid hormone. Because of similarity among pituitary adenoma discovered incidentally, careful hormonal study and high index of suspicion should be maintained to achieve correct diagnosis in order to avoid unnecessary pituitary surgery in these patients.
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A Case of Thyroid Hemiagenesis with Papillary Adenocarcinoma.
Je Ho Han, Bong Yun Cha, Ho Young Son, Yoo Bae Ahn, Kwang Woo Lee, Sung Koo Kang, Se Jeong Oh, Jong Soon Na, Sang Ah Jang, Moo Il Kang
J Korean Endocr Soc. 1994;9(4):385-389.   Published online November 6, 2019
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AbstractAbstract PDF
Variation in the gross anatomy of the thyroid is relatively common. Although thyroid hemiagenesis is considered to be a rare congenital anomaly, its incidence is probably underestimated because the diagnosis is usually incidental.We present the case of a 26-year-old woman with right thyroid hemiagenesis associated with papillary adenocarcinoma. The diagnosis of hemiagenesis was established by isotope imaging, which showed hot nodule, thyroid ultrasonography and surgical exploration for proper management of a nodule in the left lobe of thyroid gland. As she was diagnosed to have papillary adenocarcinoma, total thyroidectomy was performed and at present she remains disease-free.
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Original Article
Expression of Epidermal Growth Factor Receptor mRNA by In Situ Hybridization in Normal and Abnormal Thyroid Tissue.
Hyun Sik Son, Kun Ho Yoon, Bong Yun Cha, Jong Min Lee, Kwang Woo Lee, Moo Il Kang, Ho Young Son, Sung Koo Kang, Se Jeong Oh, Jin Han Kang, An Hee Lee
J Korean Endocr Soc. 1994;9(4):337-343.   Published online November 6, 2019
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AbstractAbstract PDF
Growth factors are polypeptide molecules that regulate cell growth and function by binding with high affinity to specific receptor molecules in the plasma membrane and stimulating receptor mediated action of intracellular signal transduction pathway.Epidermal growth factor(EGF) and their receptors(EGFR) regulate normal cellular growth, proliferation, and differentiation of various cells in vivo and in tissue cultures. And also may contribute directly to oncogenesis.Overexpression of EGFR and autocrine stimulation of growth involving this receptor system has been identified in several types of human neoplasia. There is evidence that the EGF and receptor system is involved in the regulation of follicular cell growth in the thyroid gland especially with immunohistochemical technic. But there was a challenge about the validity of previously performed immunohistochemical studies.In the study we investigated the relationship between EGFR mRNA expression and tumorigenesis by rapid in situ hybridization method. Formalin-fixed, paraffin embedded tissue sections of 10 normal, 17 nodular hyperplasia, 6 follicular adenoma, and 15 papillary cancer were examined. The results were as follows:1) EGFR mRNA positivity were 20%(2/10) in normal thyroid, 70%(12/17) in nodular hyperplasia, and 100% in follicular adenoma and papillary cancer.2) There was a significantly increased EGFR mRNA expression in papillary cancer compare to normal and nodular hyperplasia(p<0.05). But no difference was found with papillary cancer and follicular adenoma.3) There was a significantly increased EGFR mRNA expression in follicular adenoma compare to normal (p<0.05). But no difference was found with follicular adenoma and nodular hyperplasia. These results suggest that an overexpression of EGFR mRNA may play an important role in the tumorigenesis of thyroid tissue.
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Case Reports
A Case of Pheochromocytoma Diagnosed as Preeclampsia during Prenancy.
Bong Yun Cha, Ho Young Son, Soon Jip Yoo, Ki Hyun Baik, Myung Hoon Kim, Moo Il Kang, E Jin Choi, Kwang Woo Lee, Sung Koo Kang, Uk Kim, Jong Man Won, Jin Young Yoo
J Korean Endocr Soc. 1994;10(3):295-299.   Published online November 6, 2019
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AbstractAbstract PDF
A case of a pregnant woman with an undiagnosed pheochromocytoma is presented. Gestational hypertension was developed at 33 weeks' gestation. Also she experienced intermittent chest discomfort, headache and irritability during those period. Normal vaginal delivery was successfully performed with close observation. Even though experiencing same symptoms for two years after delivery, she had been treated as neurosis. Uncatched pheochromocytoma was detected and the tumor was resected successfully. It seems to be that many cases of pheochromocytoma with pregnancy still go unrecognized because of close similarity between pheochromocytoma and toxemia. High index of suspicion should be maintained to achieve early diagnosis because antenatal diagnosis can lower the mortality in both mother and fetus.
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A Case of Primary Hyperparathyroidism Associated with Proximal Renal Tubular Acidosis and Postoperative Hungry Bone Syndrome.
Je Ho Han, Kun Ho Yoon, Bong Yun Cha, Ho Young Son, Kwang Woo Lee, Hae Ok Jung, Chang Sup Kim, Moo Il Kang, Chul Soo Cho, Ho Yun Kim, Sung Koo Kang
J Korean Endocr Soc. 1994;9(2):141-149.   Published online November 6, 2019
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  • 36 Download
AbstractAbstract PDF
Primary hyperparathyroidism is a generalezed disorder of calcium, phosphorus and bone metabolism due to an increased secretion of parathyroid hormone. Single parathyroid adenoma is the most common cause of primary hyperparathyroidism. Because parathyroid hormone has been proposed as an important inhibitor of renal bicarbonate reabsorption of proximal tubule, proximal renal tubular acidosis is not rare in primary hyperparaphyroidism. After parathyroid resection, significant hypocalcemia and hypophosphatemia requiring prolonged medical management may develop, termed hungery bone syndrome. We experienced a case of primary hyperparathyroidism associated with proximal renal tubular acidosis, and severe hungry bone syndrome after resection of the adenoma of parathyroid gland.
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Original Articles
Thyroid
Risk of Malignancy in Thyroid Incidentalomas Identified by Fluorodeoxyglucose-Positron Emission Tomography
A Reum Chun, Hye Min Jo, Seoung Ho Lee, Hong Woo Chun, Jung Mi Park, Kyu Jin Kim, Chan Hee Jung, Ji Oh Mok, Sung Koo Kang, Chul Hee Kim, Bo Yeon Kim
Endocrinol Metab. 2015;30(1):71-77.   Published online March 27, 2015
DOI: https://doi.org/10.3803/EnM.2015.30.1.71
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  • 28 Web of Science
  • 26 Crossref
AbstractAbstract PDFPubReader   
Background

Thyroid incidentalomas detected by 2-deoxy-2-18F-fluoro-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) have been reported in 1% to 4% of the population, with a risk of malignancy of 27.8% to 74%. We performed a retrospective review of FDG-avid thyroid incidentalomas in cancer screening subjects and patients with nonthyroid cancer. The risk of malignancy in thyroid incidentaloma and its association with the maximal standardized uptake value (SUVmax) in 18F-FDG PET/CT were evaluated to define the predictor variables in assessing risk of malignancy.

Methods

A total of 2,584 subjects underwent 18F-FDG PET/CT for metastatic evaluation or cancer screening from January 2005 to January 2010. Among them, 36 subjects with FDG-avid thyroid incidentalomas underwent further diagnostic evaluation (thyroid ultrasonography-guided fine needle aspiration cytology [FNAC] or surgical resection). We retrospectively reviewed the database of these subjects.

Results

Of the 2,584 subjects who underwent 18F-FDG PET/CT (319 for cancer screening and 2,265 for metastatic evaluation), 52 (2.0%) were identified as having FDG-avid thyroid incidentaloma and cytologic diagnosis was obtained by FNAC in 36 subjects. Of the subjects, 15 were proven to have malignant disease: 13 by FNAC and two by surgical resection. The positive predictive value of malignancy in FDG-avid thyroid incidentaloma was 41.7%. Median SUVmax was higher in malignancy than in benign lesions (4.7 [interquartile range (IQR), 3.4 to 6.0] vs. 2.8 [IQR, 2.6 to 4.0], P=0.001).

Conclusion

Thyroid incidentalomas found on 18F-FDG PET/CT have a high risk of malignancy, with a positive predictive value of 41.7%. FDG-avid thyroid incidentalomas with higher SUVmax tended to be malignant.

Citations

Citations to this article as recorded by  
  • Incidental 68Ga-DOTATATE uptake in thyroid nodules: Is guideline-directed management still appropriate?
    Kyla Wright, Jason C. Fisher, Gary D. Rothberger, Jason D. Prescott, John D. Allendorf, Kepal Patel, Insoo Suh
    Surgery.2024; 175(1): 228.     CrossRef
  • Prediction of Malignant Thyroid Nodules Using 18F-FDG PET/CT–Based Radiomics Features in Thyroid Incidentalomas
    Woo Seog Ko, Seong-Jang Kim
    Clinical Nuclear Medicine.2023; 48(6): 497.     CrossRef
  • KSNM60 in Nuclear Endocrinology: from the Beginning to the Future
    Chae Moon Hong, Young Jin Jeong, Hae Won Kim, Byeong-Cheol Ahn
    Nuclear Medicine and Molecular Imaging.2022; 56(1): 17.     CrossRef
  • The value of 99mTc-MIBI scan in the detection of malignancy potential of hypermetabolic thyroid incidentalomas of 18F-FDG PET/CT
    G. Tatar, G. Alçın, Ö. Erol Fenercioglu, E. Beyhan, H.Y. Barut, N. Ergül, T.F. Çermik
    Médecine Nucléaire.2022; 46(3): 139.     CrossRef
  • Diagnosis of thyroid nodules
    Erik K Alexander, Edmund S Cibas
    The Lancet Diabetes & Endocrinology.2022; 10(7): 533.     CrossRef
  • PET/CT Variants and Pitfalls in Head and Neck Cancers Including Thyroid Cancer
    Jasna Mihailovic, Ronan P. Killeen, John A. Duignan
    Seminars in Nuclear Medicine.2021; 51(5): 419.     CrossRef
  • Characteristics of malignant thyroid lesions on [18F] fluorodeoxyglucose (FDG)-Positron emission tomography (PET)/Computed tomography (CT)
    Hatem Nasr, Hussein Farghaly, Abdullah Alqarni, Seham Al-Salem, Mohamed Sayed
    European Journal of Radiology Open.2021; 8: 100373.     CrossRef
  • Focal Thyroid Incidentalomas on 18F-FDG PET/CT: A Systematic Review and Meta-Analysis on Prevalence, Risk of Malignancy and Inconclusive Fine Needle Aspiration
    J. F. de Leijer, M. J. H. Metman, A. van der Hoorn, A. H. Brouwers, S. Kruijff, B. M. van Hemel, T. P. Links, H. E. Westerlaan
    Frontiers in Endocrinology.2021;[Epub]     CrossRef
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    S.I. Rybakov
    INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine).2021; 17(4): 361.     CrossRef
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    Mark M. Cruz, Gregory S. Schmidt, Jeptha T. Johnson, Thanh D. Hoang, Mohamed K. M. Shakir
    Clinical Case Reports.2020; 8(11): 2302.     CrossRef
  • Clinical significance of thyroid incidentalomas detected on fluorodeoxyglucose positron emission tomography scan (PETomas): An Indian experience
    AVSAnil Kumar, Gaurav Datta, Harkirat Singh, ParthaBrata Mukherjee, Shashindran Vangal
    World Journal of Nuclear Medicine.2019; 18(3): 273.     CrossRef
  • Risk of Malignancy in FDG‐Avid Thyroid Incidentalomas on PET/CT: A Prospective Study
    Chadi Nimeh Abdel‐Halim, Tine Rosenberg, Kristine Bjørndal, Anders Rørbæk Madsen, John Jakobsen, Helle Døssing, Mette Bay, Anders Thomassen, Anne Lerberg Nielsen, Christian Godballe
    World Journal of Surgery.2019; 43(10): 2454.     CrossRef
  • Is TI-RADS classification and Score Modified Method of thyroid nodules can be effective for evaluation of Thyroid Incidentalomas on FDG PET-CT imaging
    Kara Pelin Ozcan, Koc Zehra Pinar, Balci Yüksel, Arpaci Rabia Bozdogan
    Open Journal of Thyroid Research.2019; 2(1): 005.     CrossRef
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    Filiz Eksi Haydardedeoglu, Gulay Simsek Bagir, Nese Torun, Emrah Kocer, Mehmet Reyhan, Melek Eda Ertorer
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    Medical Oncology.2017;[Epub]     CrossRef
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Adrenal gland
Clinical Characteristics and Metabolic Features of Patients with Adrenal Incidentalomas with or without Subclinical Cushing's Syndrome
Bo-Yeon Kim, A-Reum Chun, Kyu-Jin Kim, Chan-Hee Jung, Sung Koo Kang, Ji-Oh Mok, Chul-Hee Kim
Endocrinol Metab. 2014;29(4):457-463.   Published online December 29, 2014
DOI: https://doi.org/10.3803/EnM.2014.29.4.457
  • 4,141 View
  • 45 Download
  • 23 Web of Science
  • 20 Crossref
AbstractAbstract PDFPubReader   
Background

The aim of this study was to examine the clinical characteristics of adrenal incidentalomas discovered by computed tomography (CT) and to investigate metabolic features of subclinical Cushing's syndrome (SCS) in patients with adrenal incidentalomas in a tertiary hospital in Korea.

Methods

This retrospective study examined the clinical aspects of 268 patients with adrenal incidentalomas discovered by CT at Soonchunhyang University Bucheon Hospital. Clinical data and endocrine function of the patients as well as histological findings were obtained from medical records, while anatomic characteristics were analyzed by reviewing imaging studies. Hormonal tests for pheochromocytoma, Cushing's syndrome, and aldosterone-secreting adenoma were performed.

Results

Most (n=218, 81.3%) cases were nonfunctioning tumors. Of the 50 patients with functioning tumors (18.7%), 19 (7.1%) were diagnosed with SCS, nine (3.4%) with overt Cushing's syndrome, 12 (4.5%) with primary aldosteronism, and 10 (3.7%) with pheochromocytoma. Malignant tumors (both primary and metastatic) were rare (n=2, 0.7%). Body mass index, fasting glucose, hemoglobin A1c, and total cholesterol were significantly higher in patients with SCS in comparison with those with nonfunctioning tumors. The prevalence of type 2 diabetes mellitus and hypertension were significantly higher in patients with SCS compared with those with nonfunctioning tumors.

Conclusion

Functioning tumors, especially those with subclinical cortisol excess, are commonly found in patients with adrenal incidentalomas, although malignancy is rare. In addition, patients with SCS in adrenal incidentalomas have adverse metabolic and cardiovascular profiles.

Citations

Citations to this article as recorded by  
  • Management of Adrenal Cortical Adenomas: Assessment of Bone Status in Patients with (Non-Functioning) Adrenal Incidentalomas
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  • Adrenalectomy improves blood pressure control in nonfunctioning adrenal incidentalomas and glycemic and lipid control in patients with autonomous cortisol secretion
    Marta Araujo-Castro, César Mínguez Ojeda, María Noelia Sánchez Ramírez, Victoria Gómez Dos Santos, Eider Pascual-Corrrales, María Fernández-Argüeso
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    Archives of Endocrinology and Metabolism.2022;[Epub]     CrossRef
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    C. Bothou, F. Beuschlein, A. Spyroglou
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    Francesco Ferraù, Márta Korbonits
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    Won-Young Lee
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    Ji Yun Bae, Jihyun Lee, Yeji Han, Seog Ki Min, Min-Sun Cho, Yeon-Ah Sung
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    Ji Cheol Bae
    Endocrinology and Metabolism.2014; 29(4): 441.     CrossRef
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Case Report
A Case of Lymphocytic Infundibuloneurohypophysitis Along with Central Diabetes Insipidus, and this Improved with Conservative Care.
Ji Myoung Lee, Sang Mi Park, Byung Hee Hwang, Hyun Sook Choi, Seong Su Lee, Jee Young Kim, Sung Rae Kim, Kwang Woo Lee, Ho Young Son, Sung Koo Kang, Soon Jib Yoo
J Korean Endocr Soc. 2008;23(2):142-147.   Published online April 1, 2008
DOI: https://doi.org/10.3803/jkes.2008.23.2.142
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AbstractAbstract PDF
Idiopathic central diabetes insipidus is most likely to occur in young patients who have a clinical history of autoimmune disease. The presentation of clinical findings such as central diabetes insipidus and pituitary stalk thickening on sellar magnetic resonance imaging (MRI) in a young women would strongly suggest lymphocytic hypophysitis, which is a rare inflammatory process involving the pituitary stalk and the pituitary gland, yet this disease can sometimes regress.
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Original Article
The Effect of Oxidative Stress on the Proliferation and Differentiation of Human Bone Marrow Stromal Cell-Derived Osteoblasts.
Eun Sook Oh, Ki Hyun Baek, Won Young Lee, Ki Won Oh, Hye Soo Kim, Je Ho Han, Kwang Woo Lee, Ho Young Son, Sung Koo Kang, Moo Il Kang
J Korean Endocr Soc. 2006;21(3):222-232.   Published online June 1, 2006
DOI: https://doi.org/10.3803/jkes.2006.21.3.222
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  • 18 Download
  • 1 Crossref
AbstractAbstract PDF
BACKGROUND
The objectives of our study were to assess the effects of oxidative stress on the proliferation, differentiation and apoptosis of human bone marrow stromal cell (BMSC)-derived osteoblasts and to explore pathways by which osteoblast cell apoptosis was induced. METHODS: Mononuclear cells including BMSCs were cultured to osteoblastic lineage. Different doses of hydrogen peroxide (H2O2) were added to the culture media. The colony forming units-fibroblastic (CFU-Fs) were stained with crystal violet and alkaline phosphatase (ALP). The MTT assay was done to see the effect of H2O2 on cell viability. The effect of H2O2 on osteocalcin gene expression was determined by RT-PCR. The matrix calcification measurement was performed. FACS analysis was performed to determine the osteoblasts apoptosis. Caspase-3, -8 and 9 activity assay and cytochrome c release were measured. RESULTS: The size and number of ALP (+) CFU-Fs were also decreased by H2O2 treatment. When compared with the control group, H2O2 significantly decreased the total number of cells of each culture well during MTT assay. H2O2 significantly diminished expression of osteocalcin mRNA. N-acetylcystein (NAC) blocked the diminution of cell viability and the inhibition of osteocalcin mRNA expression by H2O2. H2O2 reduced matrix calcification. FACS analysis revealed H2O2 increased percentage of apoptotic cells. Addition of H2O2 resulted in the increase of caspase-9 and -3 activity but not caspase-8, and release of cytochrome c to the cytosol. CONCLUSION: These data suggest that, in primary human BMSCs, oxidative stress inhibits proliferation of stromal cells and inhibits the differentiation to osteoblastic lineage. In addition, oxidative stress induces apoptosis of human BMSC-derived osteoblasts and this may be mediated by mitochondrial pathway of apoptotic signal.

Citations

Citations to this article as recorded by  
  • Antioxidaitve and Differentiation Effects of Artemisia capillaris T. Extract on Hydrogen Peroxide-induced Oxidative Damage of MC3T3-E1 Osteoblast Cells
    Jee-Eun Seo, Eun-Sun Hwang, Gun-Hee Kim
    Journal of the Korean Society of Food Science and Nutrition.2011; 40(11): 1532.     CrossRef
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Case Reports
A Case of Early Gastric Cancer Coincidentally Developed in a Patient with Acromegaly.
Kyun Woo Park, So Young Lee, Hye Suk Son, Yi Sun Jang, Hye Soo Kim, Jong Min Lee, Bong Yun Cha, Kwang Woo Lee, Ho Young Son, Sung Koo Kang
J Korean Endocr Soc. 2006;21(2):165-169.   Published online April 1, 2006
DOI: https://doi.org/10.3803/jkes.2006.21.2.165
  • 1,661 View
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Acromegaly is associated with an increased risk for a variety of cancers such as colon cancer, prostate cancer and breast cancer. However, there have been few reports of gastric cancer developing in an acromegaly patient. A 66-year-old man suffered with diabetes mellitus and hypertension for 15 years, and he visited the endocrinology department due to dizziness. On physical examination, the biochemical studies and the sella MRI, he showed the typical features of acromegaly with pituitary microadenoma. During the cancer screening studies to find the cause of anemia, early gastric cancer was diagnosed by pathologic examination of the tissue biopsies. We described the summary of characteristics of the patient and reviewed literature.
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A Case of Atypical McCune-Albright Syndrome Associated with Hyperthyroidism.
Yi Sun Jang, Seok Hui Kang, Woong Ryoung Jung, Woo Tae Kim, Hye Soo Kim, Jong Min Lee, Sung Dae Moon, Bong Yun Cha, Kwang Woo Lee, Ho Young Son, Sung Koo Kang
J Korean Endocr Soc. 2006;21(2):158-164.   Published online April 1, 2006
DOI: https://doi.org/10.3803/jkes.2006.21.2.158
  • 2,021 View
  • 20 Download
AbstractAbstract PDF
McCune-Albright syndrome (MAS) is a sporadic disease that's characterized by polyostotic fibrous dysplasia, cafe-au-lait pigmentation of the skin, and multiple endocrinopathies, including sexual precocity, hyperthyroidism, acromegaly, and hypercortisolism. Recent evidence has shown that the clinical manifestations are caused by a postzygotic activating missense mutation in the gene coding for the alpha-subunit of Gs protein that stimulates c-AMP formation in the affected tissues. Substitution of the Arg(201) residue in Gsalpha with cysteine or histidine have been identified in many MAS patients and Arg(201) to Gly or Leu mutations have also been recently identified. We identified the Arg(201) to His mutation in the gene encoding Gsalpha in the thyroid tissue from a 36-year-old man who was suffering with polyostotic fibrous dysplasia and hyperthyroidism.
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A Case of Pituitary Macroadenoma Accompanied with CRH Deficiency.
Yoo Jung Nahm, Jin Soo Kim, Keun Jong Cho, Uk Hyun Kil, Sung Yong Woo, Sung Rae Kim, Soon Jib Yoo, Sung Koo Kang, Ho Young Son
J Korean Endocr Soc. 2006;21(2):153-157.   Published online April 1, 2006
DOI: https://doi.org/10.3803/jkes.2006.21.2.153
  • 1,671 View
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Pituitary tumor can be accompanied with various pituitary hormone abnormalities. Pituitary tumors can be divided into functioning or nonfunctioning tumors. A functioning pituitary tumor, via the oversecretion of pituitary hormones, causes diverse clinical features. A nonfunctioning pituitary tumor can be accompanied with pituitary dysfunction and this may be due to compression or destruction of normal pituitary tissue, suppression of the pituitary portal system or direct damage to the hypothalamus. Corticotropin-releasing hormone (CRH) deficiency, which is caused by defects in the synthesis or release of CRH, is a cause of secondary adrenocortical insufficiency. The clinical presentations are hypoglycemia, weight loss, anemia, weakness, nausea, vomiting and hyponatremia. Acquired CRH deficiency has also been suggested to occur based on a lack of adrenocorticotropic hormone (ACTH) response to insulin-induced hypoglycemia, but there is a normal ACTH response to exogenous CRH. We experienced a case of a woman with pituitary macroadenoma accompanied with CRH deficiency. We report here on this case with the review of the literature.
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Original Article
The Changes in the Serum RANKL and OPG levels after Bone Marrow Transplantation: Association with Bone Mineral Metabolism.
Hyun Jung Tae, Ki Hyun Baek, Eun Sook Oh, Ki Won Oh, Won Young Lee, Hye Soo Kim, Je Ho Han, Bong Yun Cha, Kwang Woo Lee, Ho Young Son, Sung Koo Kang, Choon Choo Kim, Moo Il Kang
J Korean Endocr Soc. 2005;20(1):40-51.   Published online February 1, 2005
DOI: https://doi.org/10.3803/jkes.2005.20.1.40
  • 1,641 View
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AbstractAbstract PDF
BACKGROUND
The loss of bone mass is usually detected after bone marrow transplantation(BMT), particularly during the early post-transplant period. We recently reported that enhanced bone resorption following BMT was related to both the steroid dose and increase in IL-6. It was also suggested damage of the marrow microenvironment due to myeloablation and changes in bone growth factors contribute to post-BMT bone loss. Recently, the interactions of OPG and RANKL have been reported to be crucial in osteoclastogenesis and therefore in bone homeostasis. There are few data on the changes in RANKL/OPG status during the post-BMT period. This study investigated the changes in the levels of RANKL and OPG during the post-BMT period, and also assessed whether the changes in these cytokine levels actually influenced bone turnover and post-BMT bone loss. METHODS: We prospectively investigated 110 patients undergoing allogenic BMT and analyzed 36 (32.4+/-1.3 years, 17 men and 19 women) where DEXA was performed before and 1 year after the BMT. The serum bone turnover marker levels were measured before and 1, 2, 3, 4 and 12 wks, 6 Ms, and 1 yr after the BMT. The serum sRANKL and OPG levels were measured in all patients before and 1, 3 and 12 wks after the BMT. RESULTS: The mean bone losses in the lumbar spine and total proximal femur, which were calculated as the percent change from the baseline to 1 yr, were 5.2(P<0.01) and 11.6%(P<0.01), respectively. The mean serum ICTP, a bone resorption marker, increased progressively until 3 and 6 months after the BMT, but decreased gradually thereafter, reaching the basal values after 1 year. The serum osteocalcin levels decreased progressively until 3 wks after the BMT, then increased transiently at 3 and 6 Ms, but returned to the basal level by 1 yr. The serum sRANKL and OPG levels had increased significantly by weeks 1 and 3 compared with the baseline(P<0.01), but decreased at 3 months. The sRANKL/OPG ratio increased progressively until 3 weeks, but then decreased to the basal values. During the observation period, the percent changes from the baseline in the serum RANKL levels and RANKL/OPG ratio showed positive correlations with the percent changes from the baseline serum ICTP levels. Patients with higher RANKL levels and RANKL/OPG ratio during the early post-BMT period lost more bone mass at the lumbar spine. CONCLUSION: In conclusion, dynamic changes in the sRANKL and OPG levels were observed during the immediate post-BMT period, which were related to a decrease in bone formation and loss of L-spine BMD during the year following the BMT. Taken together, these results suggest that increased sRANKL levels and sRANKL/OPG ratios could be involved in a negative balance in bone metabolism following BMT.
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Case Report
A Case of Cerebral Infarction in Young Woman with Graves' Disease and Atrial Fibrillation.
Young Yong An, Yi Sun Jang, Hyung Doo Kim, Ji Young Park, Hong Gun Bin, Hye Soo Kim, Jong Min Lee, Suk Young Kim, Kwang Woo Lee, Ho Young Son, Sung Koo Kang
J Korean Endocr Soc. 2004;19(5):528-534.   Published online October 1, 2004
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Thyrotoxicosis associated atrial fibrillation occurs in 9 to 22% of hyperthyroidism patients; its prevalence increases after the age 60 years. Atrial fibrillation is known to be major independent risk factor for a thromboembolic stroke. The characterization of patient subgroups with atrial fibrillation, with high or low rate risk factor of a stroke, would help clinicians decide the benefit or harm to patient of long term anticoagulation therapy. Thyrotoxicosis, old age, hypertension, diabetes, heart failure, history of stroke and thromboembolism are all high risk factors for a stroke in atrial fibrillation patients. Thus, anticoagulation therapy is recommended for stroke prevention in those groups with atrial fibrillation and thyrotoxicosis. Herein is reported a case of acute cerebral infarction, with thyrotoxic atrial fibrillation and congestive heart failure, in a young woman
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Endocrinol Metab : Endocrinology and Metabolism