- The Effects of Combination Therapy of Cathepsin K Inhibitor and PTH on Change in Bone Mineral Density in an Animal Model of Osteoporosis.
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Seung Hun Lee, Jung Min Koh, Young Sun Lee, Beom Jun Kim, Je Yong Choi, Ghi Su Kim
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Endocrinol Metab. 2011;26(4):303-309. Published online December 1, 2011
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DOI: https://doi.org/10.3803/EnM.2011.26.4.303
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- BACKGROUND
We hypothesized that combination therapy of cathepsin K inhibitor (CTKi) and human parathyroid hormone (1-34) (teriparatide, PTH) would overcome the coupling phenomenon of bone resorption and formation and thus may rapidly increase bone mass. METHODS: We selected a dose of zoledronic acid (ZA) that had shown similar effects with CTKi on body bone mineral density (BMD) change during the preliminary experiment. Female mice were subjected to ovariectomized (OVX control) or a sham operation (SHAM group). The mice were treated with CTKi (CTKi group), ZA (ZA group), PTH (PTH group) or with a combination of PTH with ZA (ZA + PTH group) or CTKi (CTKi + PTH group) for 8 weeks. Total BMD was measured before the operation and at 4 and 8 weeks. RESULTS: In the preliminary results, 10 microg/kg of ZA showed similar BMD changes with CTKi. Compared with the OVX control, BMD in the SHAM, ZA, CTKi, PTH, ZA + PTH, and CTKi + PTH groups was significantly increased after treatment. BMD in the CTKi + PTH group, but not in the ZA + PTH group increased more significantly than in the PTH group at the end of treatment. Compared with the OVX control, changes in BMD in the SHAM, ZA, CTKi, PTH, ZA + PTH, and CTKi + PTH groups increased significantly after 8 weeks of treatment. The change in BMD in the CTKi + PTH group, but not in the ZA + PTH group was more significantly increased than the change in BMD in the PTH group. CONCLUSION: When combined with PTH, CTKi augmented the anabolic action of PTH. Therefore, combination therapy with CTKi and PTH might be a new therapeutic modality capable of overcoming the coupling phenomenon, thereby markedly and rapidly increasing bone mass.
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Citations
Citations to this article as recorded by  - The Effects of Combination Therapy of Cathepsin K Inhibitor and PTH on Change of Bone Mineral Density in Animal Model of Osteoporosis
Yumie Rhee
Endocrinology and Metabolism.2011; 26(4): 295. CrossRef
- Retraction: 2-Bromopropane as a New Etiology of Primary Ovarian Failure.
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Chul Hee Kim, Ghi Su Kim, Jung Min Ko, Eun Sug Sin, Hyo Jung Kim, Young Tak Kim, Kyoung Sik Cho, Ghil Suk Yoon
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J Korean Endocr Soc. 2008;23(1):66. Published online February 1, 2008
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- A Case of Hyperthyroidism Associated with Symptomatic Hypercalcemia.
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Ju Hyun Choi, Woo Je Lee, Yun Hee Chung, Hye Won Park, Dan Bi Lee, Jong Chul Won, Duk Jae Kim, Ghi Su Kim
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J Korean Endocr Soc. 2006;21(3):251-256. Published online June 1, 2006
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DOI: https://doi.org/10.3803/jkes.2006.21.3.251
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- Two of the common causes of hypercalcemia are malignancy and primary hyperparathyroidism. These disorders are easily diagnosed by the clinical manifestations and measurement of the serum intact parathyroid hormone (PTH) level. On the other hand, hyperthyroidism is an uncommon cause of hypercalcemia. The diagnosis of hypercalcemia associated with hyperthyroidism can only be made by excluding the common causes of hypercalcemia and by observing the improvement of the hypercalcemia and its associated symptoms with normalizing the thyroid function. Herein we reported our experience with a 67 year-old woman who presented with nausea and vomiting. She showed elevated serum calcium and phosphorus levels. Serum intact PTH level was 1.1 pg/mL (normal range; 10~65). The results of the thyroid function test were compatible with hyperthyroidism. After resolution of the thyrotoxicosis with combination treatment of methimazol and Lugol's solution, the patient's serum calcium and phosphorus levels were normalized and the symptoms were improved.
- Effects of alpha-Lipoic Acid on Bone Metabolism in Rats with Low Bone Mass.
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Jung Min Koh, Hee Sook Lee, Duk Jae Kim, Ghi Su Kim
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J Korean Endocr Soc. 2005;20(5):476-487. Published online October 1, 2005
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DOI: https://doi.org/10.3803/jkes.2005.20.5.476
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Growing evidence has shown a biochemical link between increased oxidative stress and reduced bone density. In our previous study, alpha-lipoic acid (alpha-LA), a thiol antioxidant, suppressed both osteoclastogenesis and bone resorption, and also prevented TNF-alpha-induced apoptosis of osteoblast lineages. The effects of alpha-LA were investigated on bone metabolism in rats with a low bone mass. METHODS: An ovariectomy (OVX) or Talc injection (inflammation-mediated osteopenia, IMO) was performed in 12 week old female Sprague-Dawley rats. Diets containing either 0.3%, 0.5% or 1.0% alpha-LA were administered to the OVX rats for 16 weeks, and to the IMO rats for 21 days. The bone mineral densities (BMD) of the anterior-posterior lumbar spine and total femur were measured using dual-energy X-ray absorptiometry (Hologic QDR 4500-A), with small animal software. The plasma bone specific alkaline phosphatase activity (BSAP) and urinary free deoxypyridinoline concentration (DPD) were determined using enzyme immunoassay methods. RESULTS: The body weights were significantly decreased in the OVX rats on the diets containing 0.3 and 0.5% alpha-LA than in the OVX control. No significant differences in the BMD at either site were noted between rats administered the diets with or without alpha-LA. However, the administration of various doses of alpha-LA noticeably decreased the level of urinary DPD in both the OVX and IMO rats. High doses of alpha-LA (0.5% and/or 1.0%) also decreased the levels of plasma BSAP in both models. CONCLUSION: Although no increase in BMD was demonstrated by the administration of alpha-LA, these results suggest that alpha-LA suppresses the rates of bone turnover in rats with a low bone mass
- Serum Leptin Levels in Relation to Quantitative Ultrasound Values of Calcaneus in Korean Postmenopausal Women in Chung-Up District.
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Sang Wook Kim, Jung Min Koh, Ha Young Kim, Duk Jae Kim, Ghi Su Kim
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J Korean Endocr Soc. 2002;17(1):79-86. Published online February 1, 2002
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Obese postmenopausal women usually have a tend to have greater bone mineral density than lean women. This has been attributed to either the mechanical effects of their excessive weight on bone tissue or to their high body fat content. A recent study demonstrated that leptin, the hormone produced in adipocytes, acts on bone metabolism. These findings have prompted speculations on the possible role of leptin in the protective effect of obesity on bone. METHEODS: We studied the relationship between serum leptin levels and quantitative ultrasound (QUS) values of calcaneus in 94 postmenopausal Korean women who were randomly selected from the population of the Chung-Up osteoporosis prevalence study. QUS values, broadband ultrasound attenuation and speed of sound; were measured at the calcaneus. RESULTS: Leptin values were strongly correlated with body mass index (r = 0.478, p< 0.001), confirming a positive relationship between leptin levels and fat mass. In contrast, no significant correlations were observed between serum leptin levels and calcaneal QUS values. CONCLUSION: Our results suggest that circulating plasma leptin does not have a significant influence on QUS values of calcaneus in Korean postmenopausal women.
- Effects of Glucocorticoid on Apoptosis of Human Bone Marrow Osteogenic Stromal Cells.
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Ha Young Kim, Duk Jae Kim, Si Yeol Lee, Jeong Soo Hong, Dong Kwan Kim, Ghi Su Kim
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J Korean Endocr Soc. 2002;17(1):23-31. Published online February 1, 2002
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Osteoporosis is one of the most serious side effects of long-term glucocorticoid therapy, but the mechanism of glucocorticoid-induced bone loss remains poorly defined. Glucocorticoid induces decreased bone formation and death of isolated segments of bone (osteonecrosis) suggesting that glucocorticoid excess may affect the birth or death rate of bone cells and thereby reduce their numbers. It has been known that reduction in bone formation is due to reduced proliferation in osteoblast precursor cells and reduced matrix synthesis in mature osteoblast. Here, we present evidence for dexamethasone-induced apoptosis on human bone marrow stromal cells (hBMSC). To understand the mechanism of glucocorticoid-induced osteoporosis, we investigated the effects of glucocorticoid on primary cultured hBMSC. METHEODS: Treatment with dexamethasone at the concentration of 10-9 M for 3~5 days significantly decreased cleavage tetrazolium salt WST-1 level/concentration by mitochondrial dehydrogenase in viable cells. Greater decrease was observed with higher concentration of dexamethasone (10-7 M, and 10-5 M). Apoptosis was measured by annexin V binding/propidium iodide using fluorescence-activated cell sorter (FACS) analysis and nuclear morphology stained with the fluorescence dye, Hoechst 33342. RESULTS: The level/concentration of apoptotic hBMSC (annexin V positive / PI negative) was increased with 10-9 M dexamethasone (1.2% to 5.3%) and further increased with 10-7 M, and 10-5 M concentration (11.7% and 12.5%, respectively). The same result was observed with Hoechst 33342 staining. CONCLUSION: These results indicate that glucocorticoid induces apoptosis on osteoblast precursor cell, hBMSC, and may contribute to decrease bone formation
- Association Between Peak Bone Mass and Genetic Polymorphisms of the Vitamin D Receptor, Estrogen Receptor, and Type I Collagen 1 Genes in Healthy Young Korean Women.
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Hong Kyu Kim, Sang Wook Kim, Eun Sook Kim, Ghi Su Kim
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J Korean Endocr Soc. 2001;16(1):97-114. Published online February 1, 2001
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Genetic suggest that strongest effect is observed in the premenopausal peak bone mass, which become less with age. However, the evaluation of candidate genes polymorphisms has been most frequently done in postmenopausal women and the results have been controversial. Therefore, we studied the possible association of the peak bone mass and candidate for osteoporosis genes polymorphism in premenopausal women. METHODS: The associations between BMD and polymorphisms of the vitamin D receptor (3'-end region by BsmI restriction enzyme and start codon by FokI restriction enzyme), estrogen receptor (by PvuII and XbaI restriction enzyme), and type I collagen 1 (Sp1 binding site by MscI and BalI restriction enzyme) genes were examined in 100 healthy young Korean women who had a peak bone mass (age 20-35 years). Bone mineral densities were measured by dual energy X-ray absorptiometry (DEXA). Dietary calcium intake was also measured using a food frequency questionnaire. RESULTS: The frequencies of the B allele of the vitamin D receptor gene BsmI polymorphism and the X allele in the estrogen receptor gene, XbaI polymorphisms were lower in Koreans than those in Caucasians. The allelic frequencies of the vitamin vitamin D receptor gene FokI polymorphism and the estrogen receptor gene PvuII polymorphism were similar to those of Caucasians. No significant association was found between BMD and the vitamin D receptor genotype according to BsmI or FokI polymorphisms. There was also no significant relation between the PvuII or XbaI polymorphisms of the estrogen receptor gene and BMD. The associations between BMD and cross-genotypes combining the vitamin D receptor gene (BsmI and FokI) and estrogen receptor gene (PvuII and XbaI) polymorphisms were also analyzed. Among the subjects who lacked the Bf haplotype of the vitamin D receptor gene, the BMD of the femoral neck area was significantly higher in subjects lacking Px haplotypes of the estrogen receptor gene than in those having Px haplotype (p < 0.05). When dietary calcium intake was taken into consideration, there were significant differences in BMD according to the cross-genotype in the group having a low calcium intake (< 500 mg/day). The subjects that lacked the Bf and Px haplotypes had a significantly higher BMD in the femoral neck (p < 0.01), Ward's triangle (p < 0.05), and in the trochanteric area (p < 0.05) than those who lacked Bf but a Px haplotype. We did not find a polymorphism in the Sp1 binding site of the type I collagen 1 gene in our subjects. CONCLUSION: These data suggest that a complex interaction of vitamin D and the estrogen receptor gene with the dietary calcium intake, rather than a polymorphism of a single gene, may influence peak bone mass in healthy young Korean women.
- 2-Bromopropane as a New Etiology of Primary Ovarian Failure.
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Chul Hee Kim, Ghi Su Kim, Jung Min Ko, Eun Sug Sin, Hyo Jung Kim, Young Tak Kim, Kyoung Sik Cho, Ghil Suk Yoon
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J Korean Endocr Soc. 1997;12(2):255-264. Published online January 1, 2001
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Primary ovarian failure is reportedly increasing in recent years. Environmental factors have been frequently implicated as responsible for this increase, However, only a few of the environmental factors have been proven to cause the ovarian failure in human. METHODS: In June 1995, 24 female laborers, who worked in a factory which used Solvent #5200 (with a main chemical component being 2-bromopropane), developed symptoms of amenorrhea or irregular menstruation. All subjects underwent laboratory tests including measurement of serum LH, FSH, and estradioL Magnetic resonance imaging and ultrasonography of the pelvis were performed in all subjects. Laparoscopic examination was performed in 6 out of 24 patients after obtaining informed consent and 4 of 6 underwent ovarian biopsy. RESULTS: One subject was excluded because she had undergone hysterectomy previously. Among the remaining 23 subjects, 14 and 9 complained of amenorrhea and irregular menstrual periods, respectively. When we defined primary ovarian failure as FSH>30mIU/mL, all of those 14 patients with amenorrhea could be classified as primary ovarian failure. On the other hand, those 9 patients with irregular menstruations had normal FSH levels. Pathologic examination of ovaries showed interstitial fibrosis, loss of primordial follicles, and development arrest of follicles in the group with amenorrhea, similar to what is found in those who received chemotherapy or were exposed to radiation. CONCLUSION: The female laborers who were exposed to the solvent with 2-bromopropane developed primary ovarian failure. This failure was associated with longer duration of exposure. To our knowledge, this is the first report in the world indicating 2-bromopropane as a possible agent for ovarian failure.
- The Role of Low-dose ACTH Stimulation Test in the Diagnosis of Adrenal Insufficiency.
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Chul Hee Kim, Ghi Su Kim, Hong Kyu Kim, Joong Yeol Park, Young Kee Shong, Ki Up Lee, Il Min Ahn, Sung Kwan Hong
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J Korean Endocr Soc. 1997;12(2):222-229. Published online January 1, 2001
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Rapid adrenocorticotropin (ACTH) stimulation test using 250ug of ACTH (1-24) has been used as a standard test in the initial assessment of adrenal function. However, it has recently been suggested that a rnaximal cortisol response can be achieved with a much lower ACTH dose, and reducing the dose might further enhance the sensitivity of the test in the detection of mild adrenal insufficiency. This study was performed to evaluate the role of low-dose (lug) ACTH stimulation test in the assessment of adrenal function and the diagnosis of subtle adrenal insufficiency. METHODS: Twenty-two subjects with suspected adrenal insufficiency due to long-term corticosteroid use were included in this study. The correlations between clinical features and the serum cortisol responses to low dose (lug) and high dose (250 ug) ACTH stimulation were evaluated. RESULTS: In high dose test, 10 (67%) out of 15 subjects with clinical features of adrenal insufficiency showed decreased serum cortisol response (peak cortisol level <18 ug/dL), but 5 (33%) subjects showed normal response (peak cortisol level > 18ug/dL). On the other hand, 14 (93%) subjects with clinical features of adrenal insufficiency showed decreased serum cortisol response in low dose test, while only one showed normal response. In 7 subjects without clinical features of adrenal insufficiency, 5 subject (71%) showed normal response, and 2 subjects (29%) showed decreased response in both low and high dose tests. CONCLUSION: These results suggest that the 1-ug low dose ACTH stimulation test might be more sensitive than conventional 250-ug test in the detection of mild adrenal insufficiency. Further studies are needed to determine the optimal dose of ACTH and the criteria for normal response to ACTH stimulation.
- Piruitray Thyrotropin-Secreting Tumors in Korean.
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Chul Hee Kim, Ghi Su Kim, Hong Kyu Kim, Joong Yeol Park, Young Kee Shong, Sang Bum Hong, Jung Min Ko, Chang Jin Kim
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J Korean Endocr Soc. 1997;12(2):165-175. Published online January 1, 2001
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Thyrotropin-secreting pituitary adenoma is an uncommon disease and about 150 cases has been reported in the world literature. In Korea, only seven cases were reported as yet. The authors recently experienced four cases of TSH secreting pituitary tumor and analyzed the clinical characteristics and treatment outcomes of TSH-secreting tumors in Korean. METHODS: We analyzed clinical records of the four cases who had been recently treated at Asan Medical Center and the Korean literature which deals with the previously reported seven cases of TSH-secreting pituitary tumor. RESULTS: The average age at diagnosis was 37 years (ranging from 11 to 55 years). Four were men and seven were women. After the detection of hyperthyroidism, TSH-secreting pituitary adenoma was diagnosed 3.6 years later on the average. Ten patients presented with hyperthyroidism, but one had primary hypothyroidism. Typical features of acromegaly were observed in two patients. Visual disturbance was present in three cases, and galactorrhea was present in one case. Serum TSH concentrations ranged from 1.5 to 42.5uIU/mL showing mildly elevated or unsup-pressed TSH levels despite of elevated serum thyroid hormone concentrations. Among six cases in whom a-subunit level was measured, five showed elevated a-subunit level and a-subunit/TSH molar ratio. Two of 11 cases had microadenoma and the remainder had macroadeno#ma. Immunohisto-cheical studies were done in eight cases and revealed that three were positive for TSH only and five patients were positive for multiple hormones. Eight patients underwent transsphenoidal pituitary surgery and seven (88%) of them were cured. External irradiation or octreotide was used as adjunctive treatment in three cases. After treatment, TSH levels decreased in all six patients studied, hyperthyroidism was eliminated in all eight patients studied and visual disturbance was improved in two patients. CONCLUSION: Clinical characteristics of TSH-secreting pituitary adenoma in Koreans were similar with world literature, but were more common in women, had less visual disturbance and better surgical results. Diagnosis was commonly delayed for several years. TSH-secreting pituitary adenoma may be diagnosed more frequently and earlier with widespread use of sensitive TSH assay and early and proper diagnosis would lead proper treatments with improved outcome.
- Clinical Features of Multiple Endocrine Neoplasia Type I in Koreans.
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Chul Hee Kim, Ghi Su Kim, Hong Kyu Kim, Joong Yeol Park, Young Kee Shong, Ki Up Lee
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J Korean Endocr Soc. 1996;11(2):163-174. Published online November 7, 2019
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Multiple endocrine neoplasia type I(MEN I) is a rare, eomplex, and potentially lethal disease. In Korean, only five anecdotal cases were reported as yet. The authors rescently experienced four cases of MEN I, and analysed the clinieal characteristics of MEN I in Koreans. Methods: The authors evaluated nine cases of MEN I, retrospectively. Four cases were analysed by clinical records in patients admitted to Asan Medical Center and five cases were reviewed by previously reported Korean literature from 1986 to 1995. Results: The average age was 39 years(ranged from 33 to 59 years). Eight of the nine patients had hyperparathyroidism documented by elevated serum calcium and PTH level with or without evidence of parathyroid mass. Initial presenting manifestations were symptomatic urinary stone, hypoglycernia due to insulinoma, hypogonadism, acromegaly, or peptic ulcer. Eight of nine patients had pancreatic islet cell tumors, and three of them were be malignant by radiologic and/or pathologic findings. The pancreatic tumors produced various hormones, such as gastrin, insulin, glucagon, or combination of them. Six of the nine cases had pituitary lesion. The most cornmon pituitary tumor was prolactinoma and the remaining was GH or GH and TSH producing tumor. In addition to the major components of MEN I, four had adrenocortical hyperplasia or adenoma and two had carcinoid tumor. There was only one familial case. Conclusion: The clinical charateristics of MEN I in Korean are mostly not different from the previous reports except older age at diagnosis, more comrnon adrenal involvement(44%) and gastrointestinal carcinoid tumor(22%). Although only one case was familial, more cases could be found if careful screening were done for the family members of the MBN I patients. In addition, screening and close follow up for endocrine pancreatic tumors are required for MEN I patients without detectable pancreatic lesion becau~se the malignant potential of pancreatic tumors has beeome an increasing concem for the prognosis of MEN I.
- Effects of Interleukin-6 on mRNA Expression of Alkaline Phosphatase, Osteopontin, Decorin and a1(1)-collagen in Human Bone Marrow Stromal Cells.
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Chul Hee Kim, Dong Kwan Kim, Seung Il Park, Kwang Hyun Sohn, Ghi Su Kim
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J Korean Endocr Soc. 1996;11(2):156-162. Published online November 7, 2019
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Inter1eukin-6(IL-6) is known to be produced by osteoblastic cells and to have impartant role in regulation of bone remodelling, Most previous studies indicated that IL-6 bas a major role in stimulating osteoclastic resorption by increasing recruitment and proliferation of preosteoclasts. But its autocrine effect on osteoblastic cells has not been well established yet. Therefore, we studied the effects of IL-6 on messenger RNA (mRNA) expression of proteins that are characteristic of osteoblastic cells in human bone marrow stromal (osteoprogenitor) cells (hRMSC). Methods: The expression of mRNAs for alkaline phosphatase, al(1)-collagen, osteopontin and decorin were studied by northern blot analysis after 3 7 days' treatrnent with IL-6 in the concenttation range of 101,000 U/ml. Results: The mRNA levels for any of the osteoblastic proteins studied did not change significantly by IL-6 treatment up to the concentration of 1,000 U/ml. Conclusion: These results suggest that IL-6 does not have a significant role in differentiatian or activities of human bone rnarrow stromal.
- Autoantigenic Role of Variant Thyroperoxidase.
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Young Kee Shong, Dae Hyuk Moon, Ghi Su Kim
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J Korean Endocr Soc. 1996;11(1):61-67. Published online November 7, 2019
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Thyroperoxidase(TPO) is one of the most important autoantigens in autoimmune thyroid disorders and autoantibody to TPO is found in almost every patients with various autoimmune thyroid diseases. Human TPO was already cloned and the completed nucleotide sequences are well known. In human thyroid tissues, several variants mRNA's of TPO are found in addition to the wild type. Especially the variants lacking exon 10(TPOΔexon10) and exon 16(TPOΔ exon16) are found in very large amount in both normal and Graves thyroid tissues. The significance of these variants TPO mRNAs are largely unknown. The authors tried to investigate the autoantigenic role of these variant TPO. Methods : To produce variant TPO cDNAs, oligonucleotide directed mutagenesis was performed using cDNA for wild type human TPO as template. The produced variants cDNAs were transfected into Cos-7 cells and variants TPO proteins were tested against patients sera showing high titers of anti-TPO antibody. Results: Seven of 12 Graves sera reacted with TPOΔexon 10 and 8 Graves sera with TPOΔ exonl6. Eight of 15 Hashimoto sera reacted TPOΔexon16 and 9 with TPOΔexon16. The reactivity with variants TPO was not related to clinical findings. Conclusion: These two variant TPOs, that is TPOexon10 and TPOΔexon16, could act as an autoantigen if they were translated in vivo, and could play a role in autoimmune thyroid disease. Their exact role in the pathogenesis of autoimmune thyroid disorders are to be clarified.
- A Korean Pedigree of Paget Bone Disease.
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Young Kee Shong, Joong Yeol Park, Ki Up Lee, Ghi Su Kim, Suhn Hee Kim, Jae Kun Cho, You Sook Cho, Hong Ja Kim, Myung Jin Shin
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J Korean Endocr Soc. 1995;10(4):451-455. Published online November 7, 2019
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- Paget bone disease(PBD) is usually focal, but can be wide spread disorder of the skeletal remodeling characterized by greatly increased osteoclast size and activity. It has extremely variable prevalence worldwide, being common in England and northern European countries and areas populated by their descendants, but strikingly uncommon in Asia, the middle east, Africa and Scandinavia. It's occurrence also shows familial clustering, some postulates autosomal dominant inheritance. Many studies have shown that paramyxoviruses may play a critical role in the etiology of this disorder. However, the precise etiology of PBD remains unknown.We describe a kindred with PBD in 3 successive generations. The propositus, a 55-year-old man, has panostotic PBD and giant cell reparative granuloma of pagets disease involving his head, mandible, abdomen and ileum, rare tumorous complication of Paget's disease. Bowed limbs were first noticed at age 25 years, and progressed for 20 years. Giant cell reparative granuloma began manifesting at age 45 years, and responded dramatically to high-dose dexamethasone therapy. His pretreatment biochemical finding were remarkable for elevated serum ALP, 765(normal 66-220 u/L) and osteocalcin, 154(normal 6.3-30.7 mg/ml), but normal serum calcium, phosphorous, 250HD and PTH. A nondecalcified iliac crest specimen demonstrated classic histopathologic 25OHD and PTH. A nondecalcified iliac crest specimen demonstrated classic histopathologic changes of PBD on light microscopy. His decreased father had a similar degree of bony deformities beginning at age 20 years, but had not been examined. His two asymptomatic daughters, 20 and 24-year-old, were both found to be affected with widespread PBD by bone scan, radiographic study, and their serum ALP levels, 939 and 435U/L, respectively. This is the first report of familial occurance of PBD and a case of giant cell reparative granuloma of Paget's disease in Korea, where PBD is very rare.
- A Case of Nesidioblastosis in Adult with Hyperinsulinemic Hypoglycemia.
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Young Kee Shong, Hong Kyu Kim, Young Joo Min, Joong Yeol Park, Sung Kwan Hong, Ki Up Lee, Duck Jong Han, Ho Jeong Lee, Ghi Su Kim, Gyung Yub Gong
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J Korean Endocr Soc. 1994;10(3):273-277. Published online November 6, 2019
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- Nesidioblastosis is a primarily childhood disease which is often associated with hyperinsulinemic hypoglycemia. It is very rarely found in adults. Only a few well documented cases are found in the world interature. The authors have recently experienced a case of nesidioblastosis in an adult. A 55-year-old man was admitted due to repeated episodes of reversible loss of consciousness. Hyperinsulinemic hypoglycemia was documented. Under the presumptive diagnosis of insulinoma, localization procedures were done but no definite tumor was found. Only suspicious gradient in insulin concentration was found around the head of pancreas by percutaneous transhepatic portal venous sampling. Exploratory laparotomy was performed and Whipple's operation was done. Seventy percent of proximal pancreas was removed. Histomorphometric study of the resected specimen revealed uneven graded hyperplasia of the islet cells with the most profuse hyperplasia in the head region and progressive decrease in the degree of hyperplasia to the body and tail. The patient remains euglycemia until 6 months after operation since immediate postoperative period and can tolerate 24 hour fasting without any medication.
- Clinical Significance of Thyrotropin Measurement as a Screening Test in Ambulatory Patients.
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Young Kee Shong, Hong Kyu Kim, Ghi Su Kim, Dae Hyuk Moon
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J Korean Endocr Soc. 1994;10(3):191-199. Published online November 6, 2019
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- The objective of this study is to determine the clinical significance of thyrotropin(TSH) measurement as a screening test in ambulatory patients. One hundred and nintynine patients with abnormal TSH levels detected at routine examinations were studied. The patients were examined and histories about the recent medications and nonthyroidal illness were taken. Additional thyroid tests were done including measuments of total T_3, free T_4, antithyroid autoantibodies, thyroid scan and radioiodine uptake. Of the total 199 patients, 107(54.7%) had thyroid diseases. 49 out of 101 patients with subnormal TSH had thyroid diseases, and the remainder had supressed TSH due to medications, associated nonthyroidal illness, and normal variations. 58 out of 99 patients with elevated TSH had thyroid diseases. Of those 47 patients whose TSH level was below 0.05 mIU/L, functional sensitivity of TSH assay in our laboratory, 37 had thyroid diseases. Of those 19 patients whose TSH level was above 7.0mIU/L, two times of upper normal limit, all had thyroid iseases.Simultaneous measurement of free T_4 disclosed 50(25.1%) out of total 199 patients with abnormal TSH levels had abnormal free T_4 values which is regarded as evidence of clinical thyroid dysfunction. In summary, a single measurement of TSH level alone seems to have high sensitivity but low specificity. Simultaneous measurement of free T_4 can reasonably compensate the low specificity of TSH measurement. In case of ambulatory patients without significant nonthyroidal illness, TSH values below functional sensitivity or above twice upper normal limit may predict thyroid disease and dysfunction with reasonable specificity.
- A Case of Primary Thyroid Lymphoma Involving Bone Marrow (Stage IVE) Assoeiated with Hashimoto's Thyroiditis.
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Young Kee Shong, Joong Yeol Park, Ghi Su Kim, Jae Kun Cho, Yun Ho Chu, Wan Sik Eom, Sang Hee Kim, Hyun Sook Chi, Gyung Yub Gong, Ki Up Lee
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J Korean Endocr Soc. 1994;9(4):390-394. Published online November 6, 2019
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- Primary lymphoma of the thyroid is a relatively rare malignant tumor of the thyroid. It is known to be frequently associated with Hashimoto's thyroiditis. In Korea, a few cases of primary lymphoma of the thyroid have been reported and most of these cases were in the stage I E or II E. Recently, we experienced a case of the primary thyroid lymphoma, stage IV E associated with Hashimoto's thyroiditis in a 70-year-old woman who presented with dysphagia and dyspnea due to rapidly enlarging neck mass.She was treated with combination chemotherapy(cyclophosphamide, adriamycin, vincristine and methylprednisolone) and local radiotherapy and achieved partial response with resolution of dysphagia and dyspnea.
- Cushing's Disease Due to ACTH Producing Pituitary Carcinoma.
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Young Kee Shong, Joong Yeol Park, Ghi Su Kim, Won Kyoung Cho, Jung Kyo Lee, Ghee Young Choe, Mun Ho Lee, Ki Up Lee
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J Korean Endocr Soc. 1994;9(2):136-140. Published online November 6, 2019
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- Primary carcinoma of the pituitary is only rarely reported. About half of the reported cases are nonfunctional. It is generally agreed that the presence of distant metastasis is required to clearly establish the diagnosis of pituitary carcinoma. We have experienced a case of ACTH-producing pituitary carcinoma causing Cushing's syndrome which could be diagnosed by histologic features only without evidence of distant metastasis. A 35-year-old female with Cushingoid appearance was diagnosed as Cushing's disease after biochemical and neuroradiological evaluation. Near total removal of the pituitary tumor was performed. By histopathologic examination, the tumor revealed evidences of histological malignancy such as prominent nuclear pleomorphism, frequent mitoses and extensive tumor necrosis. Pseudosarcomatous components were also noted. By immunohistochemical studies, the tumor cells expressed ACTH. However, there was no evidence of distant metastasis at the initial operation. She was diagnosed as having ACTH producing pituitary carcinoma by histologic feature only. One month later, she complained progressive nausea and vomiting, and follow-up brain MRI revealed regrowing pituitary mass. She was reoperated and near total tumor bulk was removed again followed by radiotherapy with 5580 rads. Four month after the second operation, she developed generalized tonic clonic seizure. Brain CT showed multiple enhancing nodules on left temporal and frontal lobes, and around falx cerebri. She refused further treatment and was managed only with anticonvalsants. About month after discharge she died at home.
- Sporadic Nonfamilial Hypophosphatemic Osteomalacia.
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Young Kee Shong, Joong Yeol Park, Ghi Su Kim, You Sook Cho, Goo Yeong Cho, Sang Wook Kim, Jung Sik Park, Ki Up Lee
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J Korean Endocr Soc. 1994;9(1):25-31. Published online November 6, 2019
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- Chronic hypophosphatemia caused by decreased intestinal absorption or increased renal clearance, may lead to rickets or osteomalacia independently of other predisposing abnormalities. The conditions commonly associated with increased renal clearance of phosphate are X-linked hypophosphatemic rickets, tumor associated rickets/osteomalacia, RTA and Fanconi syndrome. Recently we experienced 3 men with adult-onset, histologically proven osteomalacia associated with increased renal clearance of phosphate. None of them had a family history of bone disease, tumors or other tubular defects. All of these had remarkable biochemical and clinical improvement with medical treatment such as 1, 25-dihydroxyvitamin D and phosphate supplementation. Although we did not find tumors yet, we could not rule out the possibility of tumor-associated osteomalcia since it often takes several years to make a diagnosis because of small size, benign nature and unusual location of tumors. Thus, careful long-term follow up for tumor occurrence will be maintained in these patients with sporadic nonfamilial hypophosphatemic osteomalacia.
- A case of osteoporosis associated with pernicious anemia.
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Sang Wook Kim, Seung Won Choi, Jung Shin Lee, Joong Yeol Park, Ki Up Lee, Ghi Su Kim
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J Korean Endocr Soc. 1993;8(3):351-355. Published online January 1, 2001
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- No abstract available.
- A case of isolated ACTH deficiency.
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Seung Won Choi, Ki Up Lee, Dong Wan Seo, Ghi Su Kim, Munho Lee
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J Korean Endocr Soc. 1992;7(4):397-401. Published online January 1, 2001
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- No abstract available.
- Tuberculous abscess of the thyroid.
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Seon Mee Park, Young Kee Shong, Ki Up Lee, Ghi Su Kim, Munho Lee, Kun Choon Park
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J Korean Endocr Soc. 1992;7(2):149-152. Published online January 1, 2001
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- No abstract available.
- Autonomously functioning thyroid nodules.
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Young Kee Shong, Ki Up Lee, Ghi Su Kim, Munho Lee
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J Korean Endocr Soc. 1992;7(2):121-126. Published online January 1, 2001
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- No abstract available.
- Serum lipids and apolipoproteins in subclinical and overt hypothyro- idism and their changes with thyroxine therapy.
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Young Kee Shong, Jin Sook Ryu, Ki Up Lee, Ghi Su Kim, Munho Lee
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J Korean Endocr Soc. 1992;7(1):31-38. Published online January 1, 2001
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- No abstract available.
- A case of pituitary stone eith hypopituitarism combined with primary hypothyroidism.
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Hyoung Eun Im, Chi Yuel Kim, Young Bum Kim, Young Suk Chung, Min Hwa Chung, Ghi Su Kim, Suk Cho
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J Korean Endocr Soc. 1991;6(3):266-270. Published online January 1, 2001
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- No abstract available.
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