Pub Date : 2010-03-01DOI: 10.3803/JKES.2010.25.1.37
S. Kim, Do-Hee Kim
Background: Somatostatin analogues have been used as the first-line medical therapy for active acromegaly that is not completely cured, or which recurs after surgery. The aim of this study was to compare the effects of octreotide long-acting repeatable (LAR) and lanreotide Autogel. Such a comparison has not been reported in Korea. Methods: Twenty-seven patients who had previously undergone surgery for acromegaly from December 2003 to March 2005 were included. We retrospectively investigated eight patients who underwent operation only and 19 patients who additionally received medical treatment after surgery (octreotide LAR, n = 5; lanreotide Autogel, n = 5). Growth hormone (GH) and insulin-like growth factor-I (IGF-I) levels were measured. Results: The mean pre-operative and post-operative levels of GH were lower in patients who underwent surgery only than in those who received adjuvant therapy, but IGF-I levels were not significantly different. In the 19 patients receiving medical treatment after unsuccessful surgery, the mean baseline GH levels were 24.2 g/L for octreotide LAR and 22.8 g/L for lanreotide Autogel (P = 0.711), and the mean GH levels 36 months post-treatment were 4.1 g/L and 2.5 g/L, respectively (P = 0.794). GH g/L represented 30% of octreotide LAR patients and 33.3% of lanreotide Autogel patients (P = 0.91). Patients with normal IGF-I levels represented 54.5% and 66.7%, respectively (P = 0.71). Conclusion: No significant difference in therapeutic effect of octreotide LAR and lanreotide Autogel was evident in 19 Korean acromegalic patients who were not completely cured by surgery and radiation therapy.
背景:生长抑素类似物已被用作未完全治愈或术后复发的活动性肢端肥大症的一线药物治疗。本研究的目的是比较奥曲肽长效可重复(LAR)和奥曲肽的疗效。这样的对比在国内还没有报道过。方法:回顾性分析2003年12月至2005年3月间行肢端肥大症手术治疗的患者27例。我们回顾性调查了8例仅接受手术的患者和19例术后额外接受药物治疗的患者(奥曲肽LAR, n = 5;lanreotide autol, n = 5)。测定生长激素(GH)和胰岛素样生长因子- i (IGF-I)水平。结果:仅接受手术的患者术前和术后平均GH水平低于接受辅助治疗的患者，但IGF-I水平无显著差异。手术失败后接受内科治疗的19例患者，奥曲肽LAR组和lanreotide autol组的平均基线GH水平分别为24.2 g/L和22.8 g/L (P = 0.711)，治疗后36个月的平均GH水平分别为4.1 g/L和2.5 g/L (P = 0.794)。GH g/L占奥曲肽LAR患者的30%，占奥曲肽autol患者的33.3% (P = 0.91)。IGF-I水平正常的患者分别占54.5%和66.7% (P = 0.71)。结论:奥曲肽LAR与lanreotide autol治疗19例韩国肢端肥大症患者手术及放疗未完全治愈的疗效无明显差异。
{"title":"Comparison of the Efficacy of Octreotide Long-acting Repeatable and Lanreotide Autogel in Acromegalic Patients","authors":"S. Kim, Do-Hee Kim","doi":"10.3803/JKES.2010.25.1.37","DOIUrl":"https://doi.org/10.3803/JKES.2010.25.1.37","url":null,"abstract":"Background: Somatostatin analogues have been used as the first-line medical therapy for active acromegaly that is not completely cured, or which recurs after surgery. The aim of this study was to compare the effects of octreotide long-acting repeatable (LAR) and lanreotide Autogel. Such a comparison has not been reported in Korea. Methods: Twenty-seven patients who had previously undergone surgery for acromegaly from December 2003 to March 2005 were included. We retrospectively investigated eight patients who underwent operation only and 19 patients who additionally received medical treatment after surgery (octreotide LAR, n = 5; lanreotide Autogel, n = 5). Growth hormone (GH) and insulin-like growth factor-I (IGF-I) levels were measured. Results: The mean pre-operative and post-operative levels of GH were lower in patients who underwent surgery only than in those who received adjuvant therapy, but IGF-I levels were not significantly different. In the 19 patients receiving medical treatment after unsuccessful surgery, the mean baseline GH levels were 24.2 g/L for octreotide LAR and 22.8 g/L for lanreotide Autogel (P = 0.711), and the mean GH levels 36 months post-treatment were 4.1 g/L and 2.5 g/L, respectively (P = 0.794). GH g/L represented 30% of octreotide LAR patients and 33.3% of lanreotide Autogel patients (P = 0.91). Patients with normal IGF-I levels represented 54.5% and 66.7%, respectively (P = 0.71). Conclusion: No significant difference in therapeutic effect of octreotide LAR and lanreotide Autogel was evident in 19 Korean acromegalic patients who were not completely cured by surgery and radiation therapy.","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122994146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-03-01DOI: 10.3803/JKES.2010.25.1.72
K. J. Kim, Hyun-Min Kim, Obin Kwon, Eun Young Park, Yong‐ho Lee, J. Hong, J. Wi, Eun Jig Lee
Pituitary hyperplasia associated with untreated primary hypothyroidism in children is a rare condition. There are only a few reports on this condition in children, and especially when pituitary hyperplasia is accompanied with Hashimoto thyroiditis and growth arrest. Here, we describe an unusual association of pituitary hyperplasia with hypothyroidism and growth retardation, and this was all caused by Hashimoto thyroiditis. Hormonal testing showed a low thyroxine level and a high thyroid stimulating hormone level, elevated anti-thyroglobulin, low growth hormone levels and prepubertal levels of gonadotropins. A large intrasellar mass expanding beyond the sella turcica was detected on magnetic resonance imaging (MRI). Homogeneous contrast enhancement of mass highly suggested that it was a pituitary hyperplasia rather than a pituitary tumor. Therapy with L-thyroxine resulted in rapid improvement of the clinical signs, including renewed growth, normalization of the hormone levels and resolution of the pituitary hyperplasia on MRI within 90 days. In children, prolonged unrecognized primary hypothyroidism might be accompanied by growth deficiency and pubertal disharmony. Physicians must be aware of pituitary hyperplasia in these cases. (J Korean Endocr Soc 25:72~77, 2010)
{"title":"Secondary Pituitary Hyperplasia Induced by Hashimoto's Thyroiditis Related Hypothyroidism: A Case Report","authors":"K. J. Kim, Hyun-Min Kim, Obin Kwon, Eun Young Park, Yong‐ho Lee, J. Hong, J. Wi, Eun Jig Lee","doi":"10.3803/JKES.2010.25.1.72","DOIUrl":"https://doi.org/10.3803/JKES.2010.25.1.72","url":null,"abstract":"Pituitary hyperplasia associated with untreated primary hypothyroidism in children is a rare condition. There are only a few reports on this condition in children, and especially when pituitary hyperplasia is accompanied with Hashimoto thyroiditis and growth arrest. Here, we describe an unusual association of pituitary hyperplasia with hypothyroidism and growth retardation, and this was all caused by Hashimoto thyroiditis. Hormonal testing showed a low thyroxine level and a high thyroid stimulating hormone level, elevated anti-thyroglobulin, low growth hormone levels and prepubertal levels of gonadotropins. A large intrasellar mass expanding beyond the sella turcica was detected on magnetic resonance imaging (MRI). Homogeneous contrast enhancement of mass highly suggested that it was a pituitary hyperplasia rather than a pituitary tumor. Therapy with L-thyroxine resulted in rapid improvement of the clinical signs, including renewed growth, normalization of the hormone levels and resolution of the pituitary hyperplasia on MRI within 90 days. In children, prolonged unrecognized primary hypothyroidism might be accompanied by growth deficiency and pubertal disharmony. Physicians must be aware of pituitary hyperplasia in these cases. (J Korean Endocr Soc 25:72~77, 2010)","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116849261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-03-01DOI: 10.3803/JKES.2010.25.1.46
Bukyung Kim, Hyun-Joo Jung, Yesel Kim, Y. Choi, Yohan Park, H. Chang, Jeong Hoon Kim
Thyroid hemiagenesis is a rare congenital anomaly, in which one thyroid lobe fails to develop. Thyroid hemiagenesis is associated with thyroid diseases such as Graves' disease, Hashimoto's thyroiditis, colloidal goiter and thyroid follicular and papillary cancer. A 53-year-old female patient was diagnosed with a thyroid nodule on health examination. A 99mTc pertechnetate thyroid scan showed absent uptake in the left lobe and cold nodule on the right lobe of thyroid gland. By ultrasonography, we found hemiagenesis in the left thyroid gland and an irregular shaped thyroid nodule on the right lobe of thyroid gland. We performed ultrasonography guided fine needle aspiration and cytologic analysis showed indeterminate nature. Thyroidectomy was performed and finally diagnosed follicular carcinoma of thyroid gland. The authors report this case with a
{"title":"A Case of Follicular Thyroid Carcinoma Associated with Hemiagenesis of Thyroid Gland","authors":"Bukyung Kim, Hyun-Joo Jung, Yesel Kim, Y. Choi, Yohan Park, H. Chang, Jeong Hoon Kim","doi":"10.3803/JKES.2010.25.1.46","DOIUrl":"https://doi.org/10.3803/JKES.2010.25.1.46","url":null,"abstract":"Thyroid hemiagenesis is a rare congenital anomaly, in which one thyroid lobe fails to develop. Thyroid hemiagenesis is associated with thyroid diseases such as Graves' disease, Hashimoto's thyroiditis, colloidal goiter and thyroid follicular and papillary cancer. A 53-year-old female patient was diagnosed with a thyroid nodule on health examination. A 99mTc pertechnetate thyroid scan showed absent uptake in the left lobe and cold nodule on the right lobe of thyroid gland. By ultrasonography, we found hemiagenesis in the left thyroid gland and an irregular shaped thyroid nodule on the right lobe of thyroid gland. We performed ultrasonography guided fine needle aspiration and cytologic analysis showed indeterminate nature. Thyroidectomy was performed and finally diagnosed follicular carcinoma of thyroid gland. The authors report this case with a","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124703728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-03-01DOI: 10.3803/JKES.2010.25.1.68
J. Roh, J. Yoo, Yoonbum Lee, H. An, H. Choi, K. T. Jung, J. Park, Kwan Sik Lee, K. Kim
Combination treatment with pegylated interferon and ribavirin has been established as a standard therapy for chronic hepatitis C. Although interferon therapy is relatively safe, an important side effect is the induction of autoantibodies and autoimmune disease, especially autoimmune thyroid disease. Interferon associated autoimmune thyroid disease can consist of autoimmune hypothyroidism, Graves’ disease, and destructive thyroiditis. Thyroid disease may lead to dose reduction or discontinuation of therapy. To the best of our knowledge, there are no case reports of pegylated interferon induced autoimmune hypothyroidism in Korea. We report here a case of a 26-year-old woman who developed hypothyroidism during antiviral therapy for chronic hepatitis C with pegylated interferon. (J Korean Endocr Soc 25:68~71, 2010)
{"title":"Autoimmune Thyroiditis during Antiviral Therapy with Peginterferon","authors":"J. Roh, J. Yoo, Yoonbum Lee, H. An, H. Choi, K. T. Jung, J. Park, Kwan Sik Lee, K. Kim","doi":"10.3803/JKES.2010.25.1.68","DOIUrl":"https://doi.org/10.3803/JKES.2010.25.1.68","url":null,"abstract":"Combination treatment with pegylated interferon and ribavirin has been established as a standard therapy for chronic hepatitis C. Although interferon therapy is relatively safe, an important side effect is the induction of autoantibodies and autoimmune disease, especially autoimmune thyroid disease. Interferon associated autoimmune thyroid disease can consist of autoimmune hypothyroidism, Graves’ disease, and destructive thyroiditis. Thyroid disease may lead to dose reduction or discontinuation of therapy. To the best of our knowledge, there are no case reports of pegylated interferon induced autoimmune hypothyroidism in Korea. We report here a case of a 26-year-old woman who developed hypothyroidism during antiviral therapy for chronic hepatitis C with pegylated interferon. (J Korean Endocr Soc 25:68~71, 2010)","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129607395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-03-01DOI: 10.3803/JKES.2010.25.1.56
Sei-Hyun Kim, Joo Il Kim, Y. Park, I. Won, Kwen-Chul Shin, Y. Jo, Sihoon Lee, Y. Kim, Kiyoung Lee, I. Park
A 33-year-old woman visited our hospital because of oligomenorrhea. Acromegaly was diagnosed based on elevated insulin like growth factor-I (IGF-I) and paradoxical growth hormone (GH) rise in oral glucose tolerance test. Pituitary macroadenoma was detected on magnetic resonance imaging (MRI). The pituitary tumor was removed. Still, diabetes insipidus developed. We prescribed desmopressin and bromocriptine. Two months post-surgery, IGF-I was decreased and a combined pituitary function test was normal, except for the follicle stimulating hormone response. Residual tumor was detected on MRI. The bromocriptine dose was increased and treatment with the long-acting somatostatin analogue octreotide long acting release (LAR) was begun. After the fifth round of octreotide LAR, IGF-I was normalized. After the seventh round of octreotide LAR, the patient became pregnant. Bromocriptine and octreotide LAR were stopped, and desmopressin was continued. Successful delivery occurred at week 38 of pregnancy. The patient was discharged without any complications. Acromegaly is a disease caused by chronic GH hypersecretion, generally related to a somatotroph adenoma. Amenorrhea and menstrual irregularities are common in acromegaly. Pregnancy rarely occurs because chronic anovulation usually exists. When gonadotroph axis was preserved, the possibility of pregnancy in a woman of child-bearing age with acromegaly should be considered. (J Korean Endocr Soc
一名33岁妇女因少经血来我院就诊。根据口服葡萄糖耐量试验中胰岛素样生长因子- i (IGF-I)升高和矛盾生长激素(GH)升高诊断肢端肥大症。应用磁共振成像(MRI)检测垂体大腺瘤。切除垂体瘤。尽管如此，尿崩症还是发生了。我们开了去氨加压素和溴隐亭。术后2个月，除促卵泡激素反应外，igf - 1下降，垂体综合功能检查正常。MRI检查残余肿瘤。增加溴隐亭剂量，开始使用长效生长抑素类似物奥曲肽长效释放剂(LAR)治疗。第5轮奥曲肽LAR治疗后，igf - 1恢复正常。经第七轮奥曲肽LAR治疗后，患者怀孕。停用溴隐亭和奥曲肽LAR，继续使用去氨加压素。妊娠第38周成功分娩。病人出院，无任何并发症。肢端肥大症是一种由慢性生长激素分泌过多引起的疾病，通常与生长滋长性腺瘤有关。闭经和月经不规律在肢端肥大症中很常见。妊娠很少发生，因为通常存在慢性无排卵。当促性腺激素轴保存完好时，应考虑育龄肢端肥大症妇女妊娠的可能性。(韩国博士
{"title":"Acromegaly with Diabetes Insipidus after Pituitary Tumor Removal: Successful Pregnancy and Delivery","authors":"Sei-Hyun Kim, Joo Il Kim, Y. Park, I. Won, Kwen-Chul Shin, Y. Jo, Sihoon Lee, Y. Kim, Kiyoung Lee, I. Park","doi":"10.3803/JKES.2010.25.1.56","DOIUrl":"https://doi.org/10.3803/JKES.2010.25.1.56","url":null,"abstract":"A 33-year-old woman visited our hospital because of oligomenorrhea. Acromegaly was diagnosed based on elevated insulin like growth factor-I (IGF-I) and paradoxical growth hormone (GH) rise in oral glucose tolerance test. Pituitary macroadenoma was detected on magnetic resonance imaging (MRI). The pituitary tumor was removed. Still, diabetes insipidus developed. We prescribed desmopressin and bromocriptine. Two months post-surgery, IGF-I was decreased and a combined pituitary function test was normal, except for the follicle stimulating hormone response. Residual tumor was detected on MRI. The bromocriptine dose was increased and treatment with the long-acting somatostatin analogue octreotide long acting release (LAR) was begun. After the fifth round of octreotide LAR, IGF-I was normalized. After the seventh round of octreotide LAR, the patient became pregnant. Bromocriptine and octreotide LAR were stopped, and desmopressin was continued. Successful delivery occurred at week 38 of pregnancy. The patient was discharged without any complications. Acromegaly is a disease caused by chronic GH hypersecretion, generally related to a somatotroph adenoma. Amenorrhea and menstrual irregularities are common in acromegaly. Pregnancy rarely occurs because chronic anovulation usually exists. When gonadotroph axis was preserved, the possibility of pregnancy in a woman of child-bearing age with acromegaly should be considered. (J Korean Endocr Soc","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130266948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-03-01DOI: 10.3803/JKES.2010.25.1.9
J. Ha, Sooho Lee
현대사회에서는 비만, 당뇨병, 고지혈증 및 심혈관계 질 환 등으로 나타나는 복합적 원인으로 대사 장애가 급격히 증가하고 있다. 그 중에서도 특히 에너지 항상성의 불균형은 근육, 간, 그리고 지방 세포의 기능 이상을 초래하고, 그로 인해 대사성 질환이 발생된다[1]. 에너지 대사 조절의 이상 은 인슐린 저항성에 기인하며, 이는 대사 장애의 다양한 병 리생리학적인 요인으로 작용할 것으로 생각되지만, 이에 대 한 자세한 조절 메커니즘은 밝혀져 있지 않은 상황이다[2]. 최근 연구 결과들은 AMPK (AMP-activated protein kinase) 를 중심으로 생체 내의 에너지 인식 및 항상성 조절이 이루 어지며, 당과 지방의 대사에 있어서 중요한 역할을 한다는 사실을 밝히고 있으며, 이러한 에너지 센서의 이상은 대사성 질환을 비롯한 심혈관계 질환, 암 발생과도 연관성이 높은 것으로 나타나고 있다[3]. 세포 내의 에너지 항상성 유지에 센서 역할을 하는 효소 인 AMPK는 대사성 스트레스나 운동에 의해 세포 내의 에 너지가 감소하는 경우, 즉 ATP가 고갈되어 AMP/ATP 비율 이 증가하는 경우에서 활성화되어 ATP를 소비하는 과정(예 를 들어, 지방산 합성과 콜레스테롤 합성)을 억제하고 ATP 를 생산하는 과정(예를 들어, 지방산 산화와 해당과정)을 촉 진한다[4](Fig. 1). AMPK의 활성화에 대한 효과는 에너지 대사 조절과 밀접하게 연관되어 있는 표적장기(간, 근육, 지 방, 췌장)에 관여되어 있다[5]. 간에서 AMPK가 활성화가 되면 지방산과 콜레스테롤의 합성을 억제하고 지방산의 산 화를 촉진한다. 골격근에서 AMPK가 활성화되면 지방산의 산화와 당 흡수를 촉진하며 지방세포에서는 지방분해와 지 방생성을 억제한다. 또한 췌장 β세포에서 AMPK의 활성화 는 인슐린 분비를 촉진시킨다. 이러한 AMPK의 역할과 관 생체 에너지 대사 조절에서 AMPK의 역할
在现代社会，由于肥胖、糖尿病、高脂血症及心血管疾病等综合性原因，代谢障碍正在急剧增加。其中特别是能量恒常性的不均衡会导致肌肉、肝和脂肪细胞功能异常，从而引发代谢性疾病[1]。能量代谢调节的异常是由胰岛素抵抗引起的，被认为是代谢障碍的多种病理生理学因素，但对此的详细调节机制尚不清楚[2]。最近研究结果是ampk (amp - activated protein kinase)为中心内的能源认识及持久性调整成活体,党和地方在台词中起重要作用的事实表明,这种能源传感器的理想代谢性疾病在内的心血管疾病、癌症发生过度表现的相关性较高,[3]。维持细胞内能量外部传感器作用的酶的ampk代谢性压力或被运动细胞内你减少的情况,即atp枯竭amp / atp比率增长的情形中,atp激活消费的过程(例如,抑制脂肪酸和胆固醇合成),生产atp的过程(例如,湿润脂肪酸氧化及相关过程[4](Fig)。1). AMPK活性化的效果与能量代谢调节密切相关的目标脏器(肝，肌肉，脂房，胰腺)有关[5]。如果AMPK在肝脏中活性化，就会抑制脂肪酸和胆固醇的合成，促进脂肪酸的酸化。在骨骼肌中，AMPK被活性化，会促进脂肪酸的氧化和糖的吸收，在脂肪细胞中抑制脂肪分解和脂放生性。另外，在胰腺β细胞中，AMPK的活性化会促进胰岛素的分泌。AMPK在调节器官生物能量代谢中的作用
{"title":"Role of AMPK in the Regulation of Cellular Energy Metabolism","authors":"J. Ha, Sooho Lee","doi":"10.3803/JKES.2010.25.1.9","DOIUrl":"https://doi.org/10.3803/JKES.2010.25.1.9","url":null,"abstract":"현대사회에서는 비만, 당뇨병, 고지혈증 및 심혈관계 질 환 등으로 나타나는 복합적 원인으로 대사 장애가 급격히 증가하고 있다. 그 중에서도 특히 에너지 항상성의 불균형은 근육, 간, 그리고 지방 세포의 기능 이상을 초래하고, 그로 인해 대사성 질환이 발생된다[1]. 에너지 대사 조절의 이상 은 인슐린 저항성에 기인하며, 이는 대사 장애의 다양한 병 리생리학적인 요인으로 작용할 것으로 생각되지만, 이에 대 한 자세한 조절 메커니즘은 밝혀져 있지 않은 상황이다[2]. 최근 연구 결과들은 AMPK (AMP-activated protein kinase) 를 중심으로 생체 내의 에너지 인식 및 항상성 조절이 이루 어지며, 당과 지방의 대사에 있어서 중요한 역할을 한다는 사실을 밝히고 있으며, 이러한 에너지 센서의 이상은 대사성 질환을 비롯한 심혈관계 질환, 암 발생과도 연관성이 높은 것으로 나타나고 있다[3]. 세포 내의 에너지 항상성 유지에 센서 역할을 하는 효소 인 AMPK는 대사성 스트레스나 운동에 의해 세포 내의 에 너지가 감소하는 경우, 즉 ATP가 고갈되어 AMP/ATP 비율 이 증가하는 경우에서 활성화되어 ATP를 소비하는 과정(예 를 들어, 지방산 합성과 콜레스테롤 합성)을 억제하고 ATP 를 생산하는 과정(예를 들어, 지방산 산화와 해당과정)을 촉 진한다[4](Fig. 1). AMPK의 활성화에 대한 효과는 에너지 대사 조절과 밀접하게 연관되어 있는 표적장기(간, 근육, 지 방, 췌장)에 관여되어 있다[5]. 간에서 AMPK가 활성화가 되면 지방산과 콜레스테롤의 합성을 억제하고 지방산의 산 화를 촉진한다. 골격근에서 AMPK가 활성화되면 지방산의 산화와 당 흡수를 촉진하며 지방세포에서는 지방분해와 지 방생성을 억제한다. 또한 췌장 β세포에서 AMPK의 활성화 는 인슐린 분비를 촉진시킨다. 이러한 AMPK의 역할과 관 생체 에너지 대사 조절에서 AMPK의 역할","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125347892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-03-01DOI: 10.3803/JKES.2010.25.1.18
J. G. Kim
최근 당뇨병 신약들이 많이 출시가 되고 있고 또 여러 제 약사, 벤처 기업들에서 당뇨병과 관련된 새로운 약들을 개발 하고 있는 것으로 추측된다. 그러나 이러한 것은 회사의 기 밀에 속한 부분이 많아서 접근하기 힘들고, 또 자세한 내용 은 공개된 지면에 다루기 어려운 점이 있을 것으로 판단된 다. 따라서 아래 언급된 내용들은 제약사들의 기밀과 관련이 없는 것으로 인터넷(http://www.clinicaltrials.gov/)과 논문 검색을 통해 정보를 파악한 것임을 밝혀둔다. 현재 새로이 출시되거나 2상, 3상 시험 중에 있는 당뇨병 관련 약제들은 대다수가 DPPIV-억제제와 GLP-1 유사체들로서 이들 약제 는 이미 약리작용이 잘 알려져 있어 소개에서 제외하였다. 아래 언급한 몇 가지 약제는 인크레틴과는 기전이 전혀 다 른 것으로 향후 출시가 될 가능성이 있어 간단히 살펴보고 자 한다.
{"title":"Recent Developments of Anti-diabetic Agents Undergoing 2 and 3 Phase Clinical Trials","authors":"J. G. Kim","doi":"10.3803/JKES.2010.25.1.18","DOIUrl":"https://doi.org/10.3803/JKES.2010.25.1.18","url":null,"abstract":"최근 당뇨병 신약들이 많이 출시가 되고 있고 또 여러 제 약사, 벤처 기업들에서 당뇨병과 관련된 새로운 약들을 개발 하고 있는 것으로 추측된다. 그러나 이러한 것은 회사의 기 밀에 속한 부분이 많아서 접근하기 힘들고, 또 자세한 내용 은 공개된 지면에 다루기 어려운 점이 있을 것으로 판단된 다. 따라서 아래 언급된 내용들은 제약사들의 기밀과 관련이 없는 것으로 인터넷(http://www.clinicaltrials.gov/)과 논문 검색을 통해 정보를 파악한 것임을 밝혀둔다. 현재 새로이 출시되거나 2상, 3상 시험 중에 있는 당뇨병 관련 약제들은 대다수가 DPPIV-억제제와 GLP-1 유사체들로서 이들 약제 는 이미 약리작용이 잘 알려져 있어 소개에서 제외하였다. 아래 언급한 몇 가지 약제는 인크레틴과는 기전이 전혀 다 른 것으로 향후 출시가 될 가능성이 있어 간단히 살펴보고 자 한다.","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121045774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-03-01DOI: 10.3803/JKES.2010.25.1.1
T. Martin, N. Sims
In the adult human skeleton, approximately 5 to 10% of the existing bone is replaced every year by bone remodelling. The remodelling process, which continues throughout adult life, provides for the calcium homeostatic system and is essential for resorptive removal of old bone, the removal and repair of micro-damage, and for the adaptation to mechanical stress[1,2]. The cellular sequence is initiated with signals that lead to osteoclast development and bone resorption (Fig. 1). How those signals are initiated is uncertain. In the case of micro-damage, this is proposed to lead to apoptosis of osteocytes that transmit signals to surface cells to promote production of receptor activator of NFκB ligand (RANKL) and hence osteoclast production[3]. Remodelling is essential for the maintenance of skeletal material and structural strength, with bone being continuously resorbed and reformed at about 1~2 million microscopic remodelling foci per adult skeleton. This sequence of events is initiated asynchronously throughout the skeleton, at sites that are geographically and chronologically separated from each other. Both bone resorption and bone formation occur at the same place in these “basic multicellular units” (BMUs), so that there is no change in the shape of the bone[4]. Within each of these BMUs, focal resorption is carried out by haemopoietically-derived osteoclasts and takes about 3 weeks per site, whereas the refilling of lost bone by osteoblasts, derived from bone marrow stromal cells and circulating precursors, takes about 3~4 months. In addition to remodelling, bone modelling on its periosteal surface is characterised by bone formation without prior bone resorption. This process, so vigorous during growth, establishes the adult size and shape of bone. At the completion of linear growth with closure of the epiphyses, periosteal apposition continues but markedly less so[5]. Tight regulation of these processes is essential for the achievement and maintenance of skeletal strength. Modelling and remodelling during growth achieves peak bone strength, and continued remodelling during adulthood maintains the mechanical integrity of the skeleton. Circulating hormones contribute, but the key influences are locally generated cytokines that are the signals mediating information transfer among osteoblasts, osteoclasts, immune cells and constituents of the bone matrix. How Cells Communicate in the Bone Remodelling Process
{"title":"How Cells Communicate in the Bone Remodelling Process.","authors":"T. Martin, N. Sims","doi":"10.3803/JKES.2010.25.1.1","DOIUrl":"https://doi.org/10.3803/JKES.2010.25.1.1","url":null,"abstract":"In the adult human skeleton, approximately 5 to 10% of the existing bone is replaced every year by bone remodelling. The remodelling process, which continues throughout adult life, provides for the calcium homeostatic system and is essential for resorptive removal of old bone, the removal and repair of micro-damage, and for the adaptation to mechanical stress[1,2]. The cellular sequence is initiated with signals that lead to osteoclast development and bone resorption (Fig. 1). How those signals are initiated is uncertain. In the case of micro-damage, this is proposed to lead to apoptosis of osteocytes that transmit signals to surface cells to promote production of receptor activator of NFκB ligand (RANKL) and hence osteoclast production[3]. Remodelling is essential for the maintenance of skeletal material and structural strength, with bone being continuously resorbed and reformed at about 1~2 million microscopic remodelling foci per adult skeleton. This sequence of events is initiated asynchronously throughout the skeleton, at sites that are geographically and chronologically separated from each other. Both bone resorption and bone formation occur at the same place in these “basic multicellular units” (BMUs), so that there is no change in the shape of the bone[4]. Within each of these BMUs, focal resorption is carried out by haemopoietically-derived osteoclasts and takes about 3 weeks per site, whereas the refilling of lost bone by osteoblasts, derived from bone marrow stromal cells and circulating precursors, takes about 3~4 months. In addition to remodelling, bone modelling on its periosteal surface is characterised by bone formation without prior bone resorption. This process, so vigorous during growth, establishes the adult size and shape of bone. At the completion of linear growth with closure of the epiphyses, periosteal apposition continues but markedly less so[5]. Tight regulation of these processes is essential for the achievement and maintenance of skeletal strength. Modelling and remodelling during growth achieves peak bone strength, and continued remodelling during adulthood maintains the mechanical integrity of the skeleton. Circulating hormones contribute, but the key influences are locally generated cytokines that are the signals mediating information transfer among osteoblasts, osteoclasts, immune cells and constituents of the bone matrix. How Cells Communicate in the Bone Remodelling Process","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128378521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-03-01DOI: 10.3803/JKES.2010.25.1.61
Yoon-Shick Yom, M. Lee, Hyunjung Lim, J. Park, Sung-Tae Kim, Yu Mi Lee, D. Yang, Youn-Zoo Cho, M. Park, K. Lee, Keun-Young Park, Dong-Mee Lim, Byung-Joon Kim
Primary hyperparathyroidism is usually caused by a parathyroid adenoma, occasionally by primary parathyroid hyperplasia and rarely by parathyroid carcinoma. Coincidental occurrence of thyroid carcinoma in parathyroid adenoma is not uncommon, but synchronous parathyroid and thyroid carcinoma is extremely rare. Here, we describe a case of synchronous parathyroid carcinoma and papillary thyroid carcinoma. A 68-year-old female with no history of neck irradiation presented with hyperparathyroidism by parathyroid mass that was observed during the treatment of bronchiolitis obliterans organizing pneumonia. During the preoperative evaluation thyroid nodules were also observed. Therefore, she underwent surgery at Konyang University Hospital and was diagnosed with coexisting parathyroid and papillary thyroid carcinoma. (J Korean
{"title":"A Case of Coexistence of Parathyroid and Papillary Thyroid Carcinoma","authors":"Yoon-Shick Yom, M. Lee, Hyunjung Lim, J. Park, Sung-Tae Kim, Yu Mi Lee, D. Yang, Youn-Zoo Cho, M. Park, K. Lee, Keun-Young Park, Dong-Mee Lim, Byung-Joon Kim","doi":"10.3803/JKES.2010.25.1.61","DOIUrl":"https://doi.org/10.3803/JKES.2010.25.1.61","url":null,"abstract":"Primary hyperparathyroidism is usually caused by a parathyroid adenoma, occasionally by primary parathyroid hyperplasia and rarely by parathyroid carcinoma. Coincidental occurrence of thyroid carcinoma in parathyroid adenoma is not uncommon, but synchronous parathyroid and thyroid carcinoma is extremely rare. Here, we describe a case of synchronous parathyroid carcinoma and papillary thyroid carcinoma. A 68-year-old female with no history of neck irradiation presented with hyperparathyroidism by parathyroid mass that was observed during the treatment of bronchiolitis obliterans organizing pneumonia. During the preoperative evaluation thyroid nodules were also observed. Therefore, she underwent surgery at Konyang University Hospital and was diagnosed with coexisting parathyroid and papillary thyroid carcinoma. (J Korean","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124471525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-03-01DOI: 10.3803/JKES.2010.25.1.28
Won Gu Kim, D. Han, Hyun-jeung Choi, Eui Young Kim, Tae Yong Kim, Y. Shong, W. Kim
Background: Induction of re-differentiation is necessary for the proper treatment of patients with recurrent or metastatic differentiated thyroid cancer (DTC) because cancer cells show de-differentiation in about 30% of these patients. In this study, we evaluated the expression of thyroid specific genes after treatment with various agents to induce re-differentiation in the follicular thyroid cancer cell line FTC-133. Methods: FTC-133 cells were treated with U0126, LY294002, trichostatin A, retinoic acid (RA), 5'-azacytidine and α-lipoic acid (ALA). We evaluated mRNA expression of thyroid specific genes, thyroglobulin (Tg), sodium iodine symporter (NIS), PAX-8 and TTF-1 by reverse transcriptase polymerase chain reaction (PCR). Quantified expression of Tg mRNA was also evaluated by real-time PCR. Results: The expression of Tg mRNA increased after 48 h of treatment with 0.1 uM RA and the expression of Tg mRNA and TTF-1 mRNA increased after 48-72 h of treatment with ALA (10~100 uM). There was no change in thyroid specific gene expression by the other agents. Increased expression of Tg mRNA was confirmed by real-time PCR (1.3 times by 10 uM ALA and 3.6 times by 100 uM ALA). There was no basal NIS mRNA expression in FTC-133 cells and none of the tested agents induced expression of NIS mRNA. There was no change in phosphorylation of AMPK1-α after ALA treatment of FTC-133 cells. Conclusion: ALA increases mRNA expression of Tg and TTF-1 of FTC-133 thyroid cancer cells and these effects are not mediated by activation of AMP kinase. The finding that ALA could be a potential re-differentiation inducing agent in thyroid cancer cells is novel. Further studies are needed to elucidate the mechanism of induction of re-differentiation. Furthermore, the effect of ALA on NIS expression and on iodine uptake should be evaluated using diverse thyroid cancer cell lines. (J Korean Endocr Soc 25:28~36, 2010)
背景:诱导再分化对于复发或转移分化型甲状腺癌(DTC)患者的适当治疗是必要的，因为约30%的患者癌细胞表现为去分化。在这项研究中，我们评估了甲状腺特异性基因在不同药物诱导滤泡性甲状腺癌细胞FTC-133再分化后的表达。方法:用U0126、LY294002、曲古霉素A、维甲酸(RA)、5′-氮胞苷和α-硫辛酸(ALA)处理FTC-133细胞。采用逆转录聚合酶链式反应(PCR)检测甲状腺特异性基因、甲状腺球蛋白(Tg)、碘同调钠(NIS)、PAX-8和TTF-1的mRNA表达。实时荧光定量PCR法测定Tg mRNA的表达。结果:0.1 uM RA作用48 h后Tg mRNA表达升高，ALA作用48 ~ 72 h (10~100 uM)后Tg mRNA和TTF-1 mRNA表达升高。其他药物对甲状腺特异性基因表达没有影响。实时荧光定量PCR证实Tg mRNA表达增加(10 μ m ALA 1.3倍，100 μ m ALA 3.6倍)。在FTC-133细胞中未见NIS mRNA的基础表达，所试药物均未诱导NIS mRNA的表达。ALA处理FTC-133细胞后，AMPK1-α的磷酸化没有变化。结论:ALA增加FTC-133甲状腺癌细胞Tg和TTF-1 mRNA的表达，这种作用不是通过激活AMP激酶介导的。ALA可能是一种潜在的甲状腺癌细胞再分化诱导剂的发现是新的。诱导再分化的机制有待进一步研究。此外，ALA对NIS表达和碘摄取的影响应该在不同的甲状腺癌细胞系中进行评估。(韩国医师学报25:28~ 36,2010)
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