Pub Date : 2009-06-01DOI: 10.3803/JKES.2009.24.2.144
K. Lee, Chul Woo Yang, D. Lim, H. Kwon, Mi-Ja Kang, Eun Sook Kim, K. Yoon, H. Son, B. Cha
Post-obstructive diuresis after treatment for neurogenic bladder-induced obstructive kidney disease is a common symptom. As polyuria may develop in many other conditions as well, the present case is about a patient with a chief complaint of polyuria accompanied by nocturia, that was initially diagnosed as hydronephrosis due to the presence of neurogenic bladder and bladder dysfunction. The result of the water deprivation test, which was conducted for persistent diluted polyuria, yielded a final diagnosis of central diabetes insipidus, notwithstanding the strong impression of post-obstructive diuresis initially made because of a sudden increase in urine output after an indwelling catheter was inserted for bladder decompression. In post-obstructive diuresis, polyuria actually does compensate for disturbed homeostasis through water and electrolyte diuresis and it does not require specific management. However, in central diabetes insipidus, which resembles manifestations of dilute polyuria, the urine and plasma osmolarity need to be under the strict control of anti-diuretic hormone. In the case of persistent dilute polyuria occurring after obstructive uropathy, underlying diseases such as diabetes insipidus should be taken into consideration. (J Korean Endocr Soc 24:144~147, 2009) ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ
{"title":"Central Diabetes Insipidus Surmised as from Post-obstructive Diuresis after Decompression Treatment for Neurogenic Bladder","authors":"K. Lee, Chul Woo Yang, D. Lim, H. Kwon, Mi-Ja Kang, Eun Sook Kim, K. Yoon, H. Son, B. Cha","doi":"10.3803/JKES.2009.24.2.144","DOIUrl":"https://doi.org/10.3803/JKES.2009.24.2.144","url":null,"abstract":"Post-obstructive diuresis after treatment for neurogenic bladder-induced obstructive kidney disease is a common symptom. As polyuria may develop in many other conditions as well, the present case is about a patient with a chief complaint of polyuria accompanied by nocturia, that was initially diagnosed as hydronephrosis due to the presence of neurogenic bladder and bladder dysfunction. The result of the water deprivation test, which was conducted for persistent diluted polyuria, yielded a final diagnosis of central diabetes insipidus, notwithstanding the strong impression of post-obstructive diuresis initially made because of a sudden increase in urine output after an indwelling catheter was inserted for bladder decompression. In post-obstructive diuresis, polyuria actually does compensate for disturbed homeostasis through water and electrolyte diuresis and it does not require specific management. However, in central diabetes insipidus, which resembles manifestations of dilute polyuria, the urine and plasma osmolarity need to be under the strict control of anti-diuretic hormone. In the case of persistent dilute polyuria occurring after obstructive uropathy, underlying diseases such as diabetes insipidus should be taken into consideration. (J Korean Endocr Soc 24:144~147, 2009) ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116337735","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 : 2009-03-01DOI: 10.3803/JKES.2009.24.1.47
M. Cho, I. Shin, A. Jin, Jong-Bin Park, H. Noh, Hun Soo Kim, H. Y. Kim, B. Park, C. Cho, J. Jeong
A 52-year-old female was admitted to the hospital with abdominal pain. Her electrocardiogram revealed ST depressions in leads II, III, aVF and V2-5. The echocardiography showed transient cardiomyopathy with akinesia of the basal and mid portions of the left ventricle and hyperkinesia of the apex. There was no evidence of any vascular lesion on the emergency coronary angiography. She was diagnosed with pheochromocytoma by abdominal computed tomography and the post-operative pathologic examinations. These findings led us to a diagnosis of inverted Takotsubo cardiomyopathy related with pheochromocytoma. The recognition of such a rare cardiac manifestation should be considered in the diagnosis of pheochromocytoma, and especially in the circumstances of acute heart failure. (J Korean Endocr Soc 24:47~53, 2009)
{"title":"A Case of Pheochromocytoma That Presented as Inverted Takotsubo Cardiomyopathy","authors":"M. Cho, I. Shin, A. Jin, Jong-Bin Park, H. Noh, Hun Soo Kim, H. Y. Kim, B. Park, C. Cho, J. Jeong","doi":"10.3803/JKES.2009.24.1.47","DOIUrl":"https://doi.org/10.3803/JKES.2009.24.1.47","url":null,"abstract":"A 52-year-old female was admitted to the hospital with abdominal pain. Her electrocardiogram revealed ST depressions in leads II, III, aVF and V2-5. The echocardiography showed transient cardiomyopathy with akinesia of the basal and mid portions of the left ventricle and hyperkinesia of the apex. There was no evidence of any vascular lesion on the emergency coronary angiography. She was diagnosed with pheochromocytoma by abdominal computed tomography and the post-operative pathologic examinations. These findings led us to a diagnosis of inverted Takotsubo cardiomyopathy related with pheochromocytoma. The recognition of such a rare cardiac manifestation should be considered in the diagnosis of pheochromocytoma, and especially in the circumstances of acute heart failure. (J Korean Endocr Soc 24:47~53, 2009)","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126064926","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 : 2009-03-01DOI: 10.3803/JKES.2009.24.1.38
H. Choi, H. Y. Ahn, Jae Seok Lee, Hyosang Kim, J. Lim, Tae Hyuk Kim, Min Joo Kim, Yenna Lee, Do-Jun Park, B. Cho
Acute suppurative thyroiditis (AST) is a rare disease of the thyroid gland that results from anatomical abnormalities, such as pyriform sinus fistula. However, in some case reports, patients with AST did not have anatomical abnormalities, including a report in which children with acute leukemia developed AST after chemotherapy. We report a case of AST in an adult with a hematologic disorder treated with chemotherapy. Although he was initially treated with parenteral antibiotics, surgical intervention was performed due to progressive worsening of AST. He recovered after surgical intervention and had no anatomical abnormality. (J Korean Endocr Soc 24:38~41, 2009) ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ
{"title":"A Case of Acute Suppurative Thyroiditis in a Patient with Leukemia Who was Treated with Chemotherapy","authors":"H. Choi, H. Y. Ahn, Jae Seok Lee, Hyosang Kim, J. Lim, Tae Hyuk Kim, Min Joo Kim, Yenna Lee, Do-Jun Park, B. Cho","doi":"10.3803/JKES.2009.24.1.38","DOIUrl":"https://doi.org/10.3803/JKES.2009.24.1.38","url":null,"abstract":"Acute suppurative thyroiditis (AST) is a rare disease of the thyroid gland that results from anatomical abnormalities, such as pyriform sinus fistula. However, in some case reports, patients with AST did not have anatomical abnormalities, including a report in which children with acute leukemia developed AST after chemotherapy. We report a case of AST in an adult with a hematologic disorder treated with chemotherapy. Although he was initially treated with parenteral antibiotics, surgical intervention was performed due to progressive worsening of AST. He recovered after surgical intervention and had no anatomical abnormality. (J Korean Endocr Soc 24:38~41, 2009) ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132121314","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 : 2009-03-01DOI: 10.3803/JKES.2009.24.1.1
D. Kim
세계적으로 당뇨병의 유병률과 발병률이 증가하면서 당 뇨병 치료와 만성합병증의 예방 및 치료에 드는 비용의 증 가와 합병증으로 인한 경제적 손실이 엄청나기 때문에 당뇨 병의 1차 예방 및 2차 예방에 많은 관심을 쏟게 되었다[1,2]. 당뇨병 만성합병증을 예방하기 위한 2차 예방을 목적으로 진행한 연구 중에서 가장 유명한 것은 90년대 후반에 발표 된 제1형 당뇨병 환자를 대상으로 연구한 ‘당뇨병 조절 및 합병증 치료(DCCT)’ 및 제2형 당뇨병 신환을 추적한 ‘United Kingdom Prospective Diabetes Study (UKPDS)’가 있다. 이 두 연구는 적극적인 인슐린 치료를 통한 적극적 혈당 조 절이 당뇨병의 만성합병증 특히 미세혈관합병증의 진행을 예방할 수 있음을 보여주었다. 이러한 대단위 연구결과로 인 해 당뇨병 환자에게 엄격한 혈당조절이 중요하다는 사실은 인정되었지만, 급성 질환이나 입원환자에게서 발견되는 고 혈당에 대한 관심은 상대적으로 적은 편이었다[3]. 미국에서 발표된 최근의 보고에 의하면 약 420만 당뇨병 환자가 매년 입원치료를 받고, 약 150만 명의 입원환자가 의미 있는 고혈당으로 진단된다고 한다. 그러므로 미국의 경 우에 매년 약 600만 명의 입원 환자가 고혈당으로 진단되는 것이다[3]. 아직 이 분야에 대한 우리나라 자료가 적어서 인 용할 수 있는 수치는 없지만 질병이 서구화되고 있는 현실 을 감안하면 상당수의 입원환자가 고혈당을 나타낼 것으로 생각된다[4]. 고혈당의 정도는 급성심근경색증 환자[5~9], 뇌 졸중 환자[10] 및 관상동맥 우회로술(CABG)[11]과 같은 수 술을 받은 환자의 사망률(mortality)이나 이환율(morbidity) 을 예측하는 중요한 인자로 알려져 있다. 그러므로 고혈당이 발견되면 본래의 질병이나 진단명에 관계없이 입원 당시부 터 고혈당을 적극적으로 조절하는 것이 중요하다. 즉 당뇨병 환자뿐만이 아니라 당뇨병이 아닌 다른 질환으로 입원한 환 자도 고혈당이 발견되면 적극적인 인슐린 치료로 엄격한 혈 당조절이 필요하다는 것이다[4]. 이런 개념을 더욱 더 적극 적으로 응용하여 van den Berghe 등은 기계호흡이 필요하여 외과계[12] 및 내과계 집중치료실[13](surgical and medical ICU)에서 치료 받는 환자를 대상으로 하여 포도당-인슐린용 액 정맥주사로 혈당조절을 엄격하게 한 환자군이 수술 후의 사망률, 이환율 등이 감소한 결과를 발표하여 집중치료실에 서 고혈당 치료가 중요함을 밝혔다[12,13]. 본 종설에서는 급성 질환에서 발견되는 고혈당이 중요한 이유를 알아보고, 최근까지 발표된 급성심근경색증에서 사망률 및 이환율과 고혈당 치료의 관련성, 그리고 집중치료실에서 적극적 인슐 린 치료에 관한 연구결과를 검토하고자 한다.
随着世界范围内糖尿病的发病率和发病率的增加，糖尿病治疗和慢性并发症的预防及治疗费用的增加和并发症造成的经济损失非常大，因此对糖尿病的第一次预防和第二次预防给予了很大的关注[1,2]。在以预防糖尿病慢性并发症为目的进行的第二次预防研究中，最有名的是90年代后期发表的以1型糖尿病患者为对象进行的“糖尿病调节及并发症治疗(DCCT)”和追踪2型糖尿病肾病的“United Kingdom Prospective Diabetes Study (UKPDS)”。这两项研究表明，通过积极的胰岛素治疗，积极的血糖调节可以预防糖尿病的慢性并发症，特别是微血管并发症的发展。这样大的研究结果虽然承认了对糖尿病患者严格的血糖调节很重要，但是对急性疾病或住院患者发现的高血糖关心相对较少[3]。根据美国最近发表的报告，约有420万糖尿病患者每年接受住院治疗，约150万名住院患者被诊断为有意义的高血糖。因此，美国每年约有600万住院患者被诊断为高血糖[3]。我国有关这一领域的资料尚少，没有可应用的数据，但考虑到疾病西方化的现实，估计相当多的住院患者会出现高血糖[4]。高血糖的程度是预测急性心肌梗塞患者[5~9]、中风患者[10]及冠状动脉迂回手术(CABG)[11]等手术患者死亡率(mortality)或转移性(morbidity)的重要因素。因此，如果发现高血糖，不论原有的疾病或诊断名称，从住院当时开始积极调节高血糖非常重要。也就是说，不仅是糖尿病患者，就连因非糖尿病的其他疾病住院的患者，如果发现高血糖，也需要积极进行胰岛素治疗，进行严格的血液检查[4]。van den Berghe等人更积极地应用了这一概念，针对需要机械呼吸，在外科[12]及内科集中治疗室[13](surgical and medical ICU)接受治疗的患者，采用葡萄糖-胰岛素用液静脉注射严格调节血糖的患者群，手术后死亡率;发表二环路等减少的结果，表明高血糖治疗在集中治疗室的重要性[12,13]。本种说中了解了在急性疾病中发现高血糖的重要原因，在最近发表的急性心肌梗塞中死亡率及转移率与高血糖治疗的关联性，以及在集中治疗室积极研究舒林治疗的研究结果。
{"title":"The Significance of Intensive Insulin Treatment in Acutely Ill Patients","authors":"D. Kim","doi":"10.3803/JKES.2009.24.1.1","DOIUrl":"https://doi.org/10.3803/JKES.2009.24.1.1","url":null,"abstract":"세계적으로 당뇨병의 유병률과 발병률이 증가하면서 당 뇨병 치료와 만성합병증의 예방 및 치료에 드는 비용의 증 가와 합병증으로 인한 경제적 손실이 엄청나기 때문에 당뇨 병의 1차 예방 및 2차 예방에 많은 관심을 쏟게 되었다[1,2]. 당뇨병 만성합병증을 예방하기 위한 2차 예방을 목적으로 진행한 연구 중에서 가장 유명한 것은 90년대 후반에 발표 된 제1형 당뇨병 환자를 대상으로 연구한 ‘당뇨병 조절 및 합병증 치료(DCCT)’ 및 제2형 당뇨병 신환을 추적한 ‘United Kingdom Prospective Diabetes Study (UKPDS)’가 있다. 이 두 연구는 적극적인 인슐린 치료를 통한 적극적 혈당 조 절이 당뇨병의 만성합병증 특히 미세혈관합병증의 진행을 예방할 수 있음을 보여주었다. 이러한 대단위 연구결과로 인 해 당뇨병 환자에게 엄격한 혈당조절이 중요하다는 사실은 인정되었지만, 급성 질환이나 입원환자에게서 발견되는 고 혈당에 대한 관심은 상대적으로 적은 편이었다[3]. 미국에서 발표된 최근의 보고에 의하면 약 420만 당뇨병 환자가 매년 입원치료를 받고, 약 150만 명의 입원환자가 의미 있는 고혈당으로 진단된다고 한다. 그러므로 미국의 경 우에 매년 약 600만 명의 입원 환자가 고혈당으로 진단되는 것이다[3]. 아직 이 분야에 대한 우리나라 자료가 적어서 인 용할 수 있는 수치는 없지만 질병이 서구화되고 있는 현실 을 감안하면 상당수의 입원환자가 고혈당을 나타낼 것으로 생각된다[4]. 고혈당의 정도는 급성심근경색증 환자[5~9], 뇌 졸중 환자[10] 및 관상동맥 우회로술(CABG)[11]과 같은 수 술을 받은 환자의 사망률(mortality)이나 이환율(morbidity) 을 예측하는 중요한 인자로 알려져 있다. 그러므로 고혈당이 발견되면 본래의 질병이나 진단명에 관계없이 입원 당시부 터 고혈당을 적극적으로 조절하는 것이 중요하다. 즉 당뇨병 환자뿐만이 아니라 당뇨병이 아닌 다른 질환으로 입원한 환 자도 고혈당이 발견되면 적극적인 인슐린 치료로 엄격한 혈 당조절이 필요하다는 것이다[4]. 이런 개념을 더욱 더 적극 적으로 응용하여 van den Berghe 등은 기계호흡이 필요하여 외과계[12] 및 내과계 집중치료실[13](surgical and medical ICU)에서 치료 받는 환자를 대상으로 하여 포도당-인슐린용 액 정맥주사로 혈당조절을 엄격하게 한 환자군이 수술 후의 사망률, 이환율 등이 감소한 결과를 발표하여 집중치료실에 서 고혈당 치료가 중요함을 밝혔다[12,13]. 본 종설에서는 급성 질환에서 발견되는 고혈당이 중요한 이유를 알아보고, 최근까지 발표된 급성심근경색증에서 사망률 및 이환율과 고혈당 치료의 관련성, 그리고 집중치료실에서 적극적 인슐 린 치료에 관한 연구결과를 검토하고자 한다.","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121603343","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 : 2009-03-01DOI: 10.3803/JKES.2009.24.1.54
H. Shin, Y. Oh, H. W. Jang, Ji In Lee, S. Kim, Y. Min, Myung-Shik Lee, Moon-Kyu Lee, K. Kim, J. Chung
Hyalinizing trabecular tumor is a rare benign thyroid tumor first described by Carney et al. in 1987. The tumor is characterized by an encapsulated nodule, trabecular arrangement of polygonal, oval, elongated cells, and hyalinized stroma. It is easily confused with papillary thyroid carcinoma or medullary thyroid carcinoma on surgical and cytologic specimens. A 45-year-old man presented with an incidentally detected left thyroid mass. Fine needle aspiration was performed and papillary thyroid carcinoma was suspected. However, the surgical specimen revealed a hyalinizing trabecular adenoma. We present this hyalinizing trabecular adenoma case to share our experience with physicians and specialists. (J Korean Endocr Soc 24:54~57, 2009)
{"title":"A Case of Hyalinizing Trabecular Adenoma of the Thyroid Gland","authors":"H. Shin, Y. Oh, H. W. Jang, Ji In Lee, S. Kim, Y. Min, Myung-Shik Lee, Moon-Kyu Lee, K. Kim, J. Chung","doi":"10.3803/JKES.2009.24.1.54","DOIUrl":"https://doi.org/10.3803/JKES.2009.24.1.54","url":null,"abstract":"Hyalinizing trabecular tumor is a rare benign thyroid tumor first described by Carney et al. in 1987. The tumor is characterized by an encapsulated nodule, trabecular arrangement of polygonal, oval, elongated cells, and hyalinized stroma. It is easily confused with papillary thyroid carcinoma or medullary thyroid carcinoma on surgical and cytologic specimens. A 45-year-old man presented with an incidentally detected left thyroid mass. Fine needle aspiration was performed and papillary thyroid carcinoma was suspected. However, the surgical specimen revealed a hyalinizing trabecular adenoma. We present this hyalinizing trabecular adenoma case to share our experience with physicians and specialists. (J Korean Endocr Soc 24:54~57, 2009)","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134104671","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 : 2009-03-01DOI: 10.3803/JKES.2009.24.1.42
Hye Jung Choi, Jin Yong Park, W. S. Choi, J. Song, Hee Young Kim, J. Seo, S. Kim, N. Kim, K. Choi, S. Baik, D. Choi
Prolactin-secreting adenomas are the most common pituitary tumors. Menstrual disturbances and infertility are the main complaints in women with prolactinoma. Dopaminergic agonists such as bromocriptine are well-established treatments for prolactinoma when pregnancy is desired. Pregnancy-related outcomes in macroprolactinoma are worse than those in microprolactinoma. In addition, symptomatic tumor expansion during pregnancy occurs in 30% of women with macroprolactinoma. Therefore, when women with macroprolactinoma are planning a pregnancy, serum prolactin level should be normalized and the tumor volume significantly reduced. On the other hand, a spontaneous regression of macroprolactinoma can occur after pregnancy. We report a case of macroprolactinoma showing significant tumor regression during repeated pregnancies and low dose bromocriptine treatment, with a literature review. (J Korean Endocr Soc 24:42~46,
{"title":"Normal Repetitive Pregnancies and Tumor Regression Induced by Low-Dose Bromocriptine in a Patient with Macroprolactinoma.","authors":"Hye Jung Choi, Jin Yong Park, W. S. Choi, J. Song, Hee Young Kim, J. Seo, S. Kim, N. Kim, K. Choi, S. Baik, D. Choi","doi":"10.3803/JKES.2009.24.1.42","DOIUrl":"https://doi.org/10.3803/JKES.2009.24.1.42","url":null,"abstract":"Prolactin-secreting adenomas are the most common pituitary tumors. Menstrual disturbances and infertility are the main complaints in women with prolactinoma. Dopaminergic agonists such as bromocriptine are well-established treatments for prolactinoma when pregnancy is desired. Pregnancy-related outcomes in macroprolactinoma are worse than those in microprolactinoma. In addition, symptomatic tumor expansion during pregnancy occurs in 30% of women with macroprolactinoma. Therefore, when women with macroprolactinoma are planning a pregnancy, serum prolactin level should be normalized and the tumor volume significantly reduced. On the other hand, a spontaneous regression of macroprolactinoma can occur after pregnancy. We report a case of macroprolactinoma showing significant tumor regression during repeated pregnancies and low dose bromocriptine treatment, with a literature review. (J Korean Endocr Soc 24:42~46,","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115027914","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 : 2009-03-01DOI: 10.3803/JKES.2009.24.1.58
Yongcheol Kim, B. Park, T. Yu, A. Jin, H. Noh, Chung-Yong Yang, H. Y. Kim, C. Cho
Adrenoleukodystrophy (ALD) is a rare inherited metabolic disease associated with the accumulation of very long chain fatty acids (VLCFA) in the central and peripheral nervous systems and adrenal glands, and leads to leukoencephaly myeloneuropathy, adrenal insufficiency, and hypogonadism. Frequent phenotypes, which account for 80% of cases, are infantile ALD and adrenomyeloneuropathy. Adult-onset ALD is rare (1~3%). The diagnosis of X-linked ALD is based on clinical findings and abnormal plasma concentrations of VLCFA. Here, we report a rare case of adult-onset ALD, which might involve a brain vascular operation as an aggravating factor, combined with moyamoya disease, in a 35-yea r-old male who presented with adrenal insufficiency, abnormal brain imaging, and elevated VLCFA levels. (J Korean Endocr Soc 24:58~62, 2009)
{"title":"A Case of Adult-Onset Adrenoleukodystrophy Combined with Moyamoya Disease","authors":"Yongcheol Kim, B. Park, T. Yu, A. Jin, H. Noh, Chung-Yong Yang, H. Y. Kim, C. Cho","doi":"10.3803/JKES.2009.24.1.58","DOIUrl":"https://doi.org/10.3803/JKES.2009.24.1.58","url":null,"abstract":"Adrenoleukodystrophy (ALD) is a rare inherited metabolic disease associated with the accumulation of very long chain fatty acids (VLCFA) in the central and peripheral nervous systems and adrenal glands, and leads to leukoencephaly myeloneuropathy, adrenal insufficiency, and hypogonadism. Frequent phenotypes, which account for 80% of cases, are infantile ALD and adrenomyeloneuropathy. Adult-onset ALD is rare (1~3%). The diagnosis of X-linked ALD is based on clinical findings and abnormal plasma concentrations of VLCFA. Here, we report a rare case of adult-onset ALD, which might involve a brain vascular operation as an aggravating factor, combined with moyamoya disease, in a 35-yea r-old male who presented with adrenal insufficiency, abnormal brain imaging, and elevated VLCFA levels. (J Korean Endocr Soc 24:58~62, 2009)","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125800322","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 : 2009-03-01DOI: 10.3803/JKES.2009.24.1.33
Jin-Woo Lee, Eui Kyung Hwang, Tae-Ho Kim, Hyung-Young Yoon, Jae-Ho Jung, Y. Choi, S. Yong, Jaehong Ahn, S. Y. Kim, Ho Sung Kim, Yoon-Sok Chung
Septo-optic dysplasia (SOD) is a rare congenital malformation syndrome that is manifested by a triad of optic nerve hypoplasia, midline brain abnormalities and hypopituitarism. It is known to be associated with homeobox gene HESX1 mutation in some familial cases. We experienced a case of SOD in a 23 year-old male who presented with short stature and delayed puberty. The basal serum levels of testosterone and IGF-1 were low and the prolactin level was high. The combined pituitary stimulation study revealed decreased growth hormone responses. Brain MRI revealed complete agenesis of the corpus callosum, hypoplasia of the anterior pituitary gland and herniation of the third ventricle into the pituitary fossa. On the neurologic and ophthalmologic examinations, there was no definite abnormality except mild optic atrophy on the optical coherence tomography. Genetic analysis using polymerase chain reaction with direct sequencing revealed no HESX1 mutation. (J Korean Endocr Soc 24:33~37, 2009)
{"title":"A Case of Septo-optic Dysplasia Associated with Anterior Pituitary Hormone Abnormalities","authors":"Jin-Woo Lee, Eui Kyung Hwang, Tae-Ho Kim, Hyung-Young Yoon, Jae-Ho Jung, Y. Choi, S. Yong, Jaehong Ahn, S. Y. Kim, Ho Sung Kim, Yoon-Sok Chung","doi":"10.3803/JKES.2009.24.1.33","DOIUrl":"https://doi.org/10.3803/JKES.2009.24.1.33","url":null,"abstract":"Septo-optic dysplasia (SOD) is a rare congenital malformation syndrome that is manifested by a triad of optic nerve hypoplasia, midline brain abnormalities and hypopituitarism. It is known to be associated with homeobox gene HESX1 mutation in some familial cases. We experienced a case of SOD in a 23 year-old male who presented with short stature and delayed puberty. The basal serum levels of testosterone and IGF-1 were low and the prolactin level was high. The combined pituitary stimulation study revealed decreased growth hormone responses. Brain MRI revealed complete agenesis of the corpus callosum, hypoplasia of the anterior pituitary gland and herniation of the third ventricle into the pituitary fossa. On the neurologic and ophthalmologic examinations, there was no definite abnormality except mild optic atrophy on the optical coherence tomography. Genetic analysis using polymerase chain reaction with direct sequencing revealed no HESX1 mutation. (J Korean Endocr Soc 24:33~37, 2009)","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114660155","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 : 2009-03-01DOI: 10.3803/JKES.2009.24.1.7
Chulwoo Lee, Kyu-suck Choi, Seok Won Jeong, H. Kim, Y. Seo
1996년 테오 콜본이 저술한 「도둑맞은 미래(Our Stolen Future)」가 출간되면서 내분비계장애물질(일명 환경호르몬) 이 세계적으로 센세이셔날한 반향을 불러온 바 있다[1]. 그 후 선진국들을 중심으로 내분비계 장애 독성에 대한 메카니 즘을 경쟁적으로 연구하였으며, 동시에 위해성 평가를 위한 노력도 기울여 왔다. 그러나 아직까지 내분비계장애물질의 독성작용과 환경 또는 식품중 위해성은 명확히 밝혀져 있지 않다. 내분비계장애물질에 대해서는 아직도 상당 부분이 규 명되고 있지 않기 때문에 많은 국민들은 막연한 불안감을 떨쳐버리지 못하고 있다. 따라서 인간 및 생태계를 위협하고 있는 내분비계장애물질들을 가려내고 이를 관리하기 위해서 는 과학적이고 효과적인 시험기술과 방법들이 우선적으로 확립되어야 하고, 이를 토대로 환경 중 실태조사, 용량-반응 평가, 노출량 산정 및 위해도 산출 등 일련의 위해성 평가과 정이 이루어져야 할 것이다. 즉, 내분비계장애물질의 원인규 명과 이을 예방하고 저감하기 위해서는 지금보다 몇 단계 진일보한 기술과 평가방법을 이용한 연구가 추진되어야 할 필요가 있다.
{"title":"An Overview and Future Perspective on Endocrine Disruptors","authors":"Chulwoo Lee, Kyu-suck Choi, Seok Won Jeong, H. Kim, Y. Seo","doi":"10.3803/JKES.2009.24.1.7","DOIUrl":"https://doi.org/10.3803/JKES.2009.24.1.7","url":null,"abstract":"1996년 테오 콜본이 저술한 「도둑맞은 미래(Our Stolen Future)」가 출간되면서 내분비계장애물질(일명 환경호르몬) 이 세계적으로 센세이셔날한 반향을 불러온 바 있다[1]. 그 후 선진국들을 중심으로 내분비계 장애 독성에 대한 메카니 즘을 경쟁적으로 연구하였으며, 동시에 위해성 평가를 위한 노력도 기울여 왔다. 그러나 아직까지 내분비계장애물질의 독성작용과 환경 또는 식품중 위해성은 명확히 밝혀져 있지 않다. 내분비계장애물질에 대해서는 아직도 상당 부분이 규 명되고 있지 않기 때문에 많은 국민들은 막연한 불안감을 떨쳐버리지 못하고 있다. 따라서 인간 및 생태계를 위협하고 있는 내분비계장애물질들을 가려내고 이를 관리하기 위해서 는 과학적이고 효과적인 시험기술과 방법들이 우선적으로 확립되어야 하고, 이를 토대로 환경 중 실태조사, 용량-반응 평가, 노출량 산정 및 위해도 산출 등 일련의 위해성 평가과 정이 이루어져야 할 것이다. 즉, 내분비계장애물질의 원인규 명과 이을 예방하고 저감하기 위해서는 지금보다 몇 단계 진일보한 기술과 평가방법을 이용한 연구가 추진되어야 할 필요가 있다.","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124475580","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 : 2009-03-01DOI: 10.3803/JKES.2009.24.1.17
Y. Jo, I. Lee, Woo-Jung Hong, I. Song, M. Shong, Je Ryoung Kim
Background: miRNAs can be diagnostic markers and therapeutic targets in cancers, but few studies have been conducted in thyroid cancer. We investigated the expression levels of miRNA 146a/b, 221, and 222 which are important miRNAs in papillary thyroid cancers (PTCa), and verified their impact on clinicopathological factors. Methods: We measured the expression of pre-miRNAs 146a/b, 221, and 222 in NPA cells treated with 10% fetal bovine serum (FBS) or in HEK293T cells transfected with RET/PTC3 or BRAF V600E expression vectors. We also investigated the relationship between miRNA expression levels in thyroid cancer tissue specimens and clinicopathological parameters. Results: Growth stimulation with 10% FBS induced miRNA expressions in NPA cells, and transfection of RET/PTC3 and BRAF V600E also increased the expression of these miRNAs in HEK293T cells. Most (25 cases; 50%) of PTCa showed increased expression of miRNA-146a/b and 30 cases (60%) had elevated expression of miRNA-221 and miRNA-222 compared to normal thyroid samples from the contralateral lobe. However, increased miRNA expression did not correlate with clinicopathological factors. Conclusion: Expression of miRNA 146a/b, 221, and 222 was increased by BRAF
{"title":"Expression of miRNA 146a/b, 221 and 222 in Thyroid Cancer.","authors":"Y. Jo, I. Lee, Woo-Jung Hong, I. Song, M. Shong, Je Ryoung Kim","doi":"10.3803/JKES.2009.24.1.17","DOIUrl":"https://doi.org/10.3803/JKES.2009.24.1.17","url":null,"abstract":"Background: miRNAs can be diagnostic markers and therapeutic targets in cancers, but few studies have been conducted in thyroid cancer. We investigated the expression levels of miRNA 146a/b, 221, and 222 which are important miRNAs in papillary thyroid cancers (PTCa), and verified their impact on clinicopathological factors. Methods: We measured the expression of pre-miRNAs 146a/b, 221, and 222 in NPA cells treated with 10% fetal bovine serum (FBS) or in HEK293T cells transfected with RET/PTC3 or BRAF V600E expression vectors. We also investigated the relationship between miRNA expression levels in thyroid cancer tissue specimens and clinicopathological parameters. Results: Growth stimulation with 10% FBS induced miRNA expressions in NPA cells, and transfection of RET/PTC3 and BRAF V600E also increased the expression of these miRNAs in HEK293T cells. Most (25 cases; 50%) of PTCa showed increased expression of miRNA-146a/b and 30 cases (60%) had elevated expression of miRNA-221 and miRNA-222 compared to normal thyroid samples from the contralateral lobe. However, increased miRNA expression did not correlate with clinicopathological factors. Conclusion: Expression of miRNA 146a/b, 221, and 222 was increased by BRAF","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126688110","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：