Endocrinology and Metabolism

Hyun Sook Kim (Kim HS)

5 Articles

Association between Serum Thyroid Stimulating Hormone Level and Papillary Thyroid Microcarcinoma in Korean Euthyroid Patients.: Hyun Sook Kim, Seung Joon Lee, Jung Kyu Park, Chang Ho Jo, Ho Sang Shon, Eui Dal Jung; Endocrinol Metab. 2011;26(4):297-302. Published online December 1, 2011; DOI: https://doi.org/10.3803/EnM.2011.26.4.297

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BACKGROUND
Thyroid cancer is a common disease and its prevalence is increasing. Recent reports have shown that an elevated thyrotropin (thyroid stimulating hormone, TSH) level is associated with thyroid cancer risk. However, the association between TSH level and thyroid cancer risk is not yet known for euthyroid patients diagnosed with papillary thyroid microcarcinoma (PTMC). METHODS: Our study included 425 patients who underwent thyroid surgery and were diagnosed with PTMC between 2008 and 2009. Control group patients were diagnosed with benign nodules < or = 1 cm in size by US-guided fine needle aspiration. Nodules with one or more suspected malignant-ultrasonographic feature(s) were excluded from this study. Patients who were not euthyroid or who took thyroid medication were also excluded. RESULTS: The mean age of all patients was 48.5 +/- 11.0 years and 88.8% were women. The mean age of those with PTMC was significantly lower than that of the control group. The mean TSH level was 1.78 +/- 0.93 mIU/L, and the mean free T4 level was 15.96 +/- 2.32 pmol/L. There was no difference in TSH level between the PTMC and control groups (1.77 +/- 0.93 mIU/L vs. 1.79 +/- 0.91 mIU/L, P = 0.829). After adjusting for age, TSH level was not correlated with tumor size (r = 0.02, P = 0.678) in the PTMC group. Moreover, the TSH level did not differ between patients with stage I and stage III-IV carcinoma (stage I, 1.77 +/- 0.95 mIU/L; stage III-IV, 1.79 +/- 0.87 mIU/L; P = 0.856). CONCLUSION: TSH levels are not elevated in euthyroid PTMC patients. Thus, further evaluation is needed before serum TSH can be used as a tumor marker for small nodules < or = 1 cm in size in euthyroid patients.

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Evaluation of serum thyroid‐stimulating hormone as indicator for fine‐needle aspiration in patients with thyroid nodules
Ji Soo Choi, Chung Mo Nam, Eun‐Kyung Kim, Hee Jung Moon, Kyung Hwa Han, Jin Young Kwak
Head & Neck.2015; 37(4): 498. CrossRef

A Case of Pheochromocytoma Presenting as Syncope Due to Orthostatic Hypotension.: Ji Yeun Kim, Sung Woo Kim, Seung Jun Lee, Hyun Sook Kim, Eui Dal Jung, Yun Seop Kum; Endocrinol Metab. 2011;26(2):155-159. Published online June 1, 2011; DOI: https://doi.org/10.3803/EnM.2011.26.2.155

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Abstract PDF: Patients with pheochromocytoma manifest with headache, perspiration, and palpitation. Although most patients have either sustained or paroxysmal hypertension, some patients present with hypotension. However, severe orthostatic hypotension is relatively rare in patients with pheochromocytoma. We report here on a 72-year-old woman with pheochromocytoma and she presented with recurrent syncope due to hypotension and blood pressure fluctuation. Syncope due to hypotension is unusual in patients with pheochromocytoma and only a few such cases have been reported. The present case serves to illustrate an unexpected presentation of this tumor.

Free T4 is Negatively Correlated with Non-alcoholic Fatty Liver Disease in Euthyroid Women.: Eon Ju Jun, Hyun Sook Kim, Hyue Kyung Chung, Ji Hyun Lee, Sae Rom Kim, Eui Dal Jung; J Korean Endocr Soc. 2009;24(2):87-92. Published online June 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.2.87

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Abstract PDF: BACKGROUND
Thyroid hormones play an important role in the regulation of lipid and carbohydrate metabolism and the body mass index (BMI), which all affect non-alcoholic fatty liver disease (NAFLD). In a previous study, we demonstrated that free T4 was negatively associated with the BMI in euthyroid women. However, there is still uncertain as to whether the thyroid function within the normal range is associated with NAFLD and liver function abnormalities. We sought to evaluate the thyroid function (free T4, TSH) and its possible relationship with NAFLD in euthyroid women. METHODS: A total of 835 euthyroid, non heavy alcoholics women who visited the Daegu Catholic University University Medical Centre for primary health screening from January 1, 2006 to December 31, 2006 participated in this cross-sectional study. The women who were not euthyroid or heavy alcoholics (> 70 g/week in women according to the DSM-IV), there was no known history of diabetes mellitus, the fasting blood glucose was more than 5.55 mmol/L and those who had viral hepatitis were excluded. Hepatic ultrasonography scanning was performed in all the participants by a single experienced radiologist. The TSH, free T4, BP, fasting glucose, serum liver enzymes (AST, ALT, GGT, T-bilirubin), lipid profiles [total-cholesterol, triglyceride (TG), HDL-C, LDL-C] and NAFLD were evaluated. RESULTS: Euthyroid women with NAFLD had lower free T4 levels than did the euthyroid women without NAFLD. After adjustment for age and BMI, free T4 was negatively correlated with TG, but free T4 was positively correlated with the total serum bilirubin. Free T4 was not correlated with the serum AST, ALT and GGT. After adjustment for age, the BMI, the fasting glucose, the GGT and free T4, but not TSH, were significantly negatively correlated with NAFLD. CONCLUSION: We demonstrated a negative correlation between free T4 and NAFLD in euthyroid women. This finding suggests lower levels of free T4 is associated with NAFLD in euthyroid subjects.

Galectin-3 and Thyroid Peroxidase Expression in Thyroid Nodules.: Gyu Hwan Bae, Hyun Dae Yoon, Jong Yup Bae, Ho Sang Son, Eui Dal Jung, Sung Pyo Hong, Myung Hwan Kim, Sun Ah Lee, Hyun Sook Kim, Sun Young Ahn; J Korean Endocr Soc. 2007;22(2):105-111. Published online April 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.2.105

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BACKGROUND
The accurate diagnosis of a thyroid nodule is important in deciding a patient's treatment plan and for predicting the prognosis. The histopathological diagnosis of resected specimens are largely positively accomplished, but the consistency of the diagnosis is low when the specimen shows a small carcinomatous cytological feature or the nodule does not express papillary proliferation. Therefore, the need for supplementary diagnostic measures is increased. Herein, the expressions of galectin-3 and thyroid peroxidase (TPO) of resected specimens were investigated using immunohistochemical staining, and their potential for contributing to an accurate diagnosis studied. METHODS: The specimens included 195 resected thyroid nodules obtained from 179 patients having undergone thyroid surgery. Immunohistochemical staining for two useful antibodies, galectin-3 and TPO, were performed, and the expressions of these two antibodies investigated with regard to the histological diagnosis. RESULTS: The sensitivity, specificity, and positive and negative predictive values of galectin-3 and TPO for detecting papillary carcinomas were all 100%, but these values were low for other forms of carcinoma. CONCLUSION: Our data showed the diagnosis of thyroid nodules, using immunohistochemical staining for galectin-3 and TPO, was very useful for detecting thyroid papillary carcinoma, but insufficiently sensitive for follicular carcinoma. Immunohistochemical staining for TPO is also useful for distinguishing cases when a false positive result for galectin-3 is obtained.

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Immunohistochemical Expression of CXC Chemokine Receptor 4 and Galectin-3 in Follicular Tumors of Thyroid
Ji Eun Park, Bu Kyung Kim, Sangeon Gwoo, Yo-Han Park, Young Sik Choi, Young Ok Kim
Journal of Korean Thyroid Association.2012; 5(1): 45. CrossRef
The Significance of Immunohistochemical Staining in Thyroid Nodule: TPO and Galectin-3
G Gong
Journal of Korean Endocrine Society.2007; 22(2): 95. CrossRef

p-ANCA Positive Vasculitis after Propylthiouracil (PTU) Medication in a Patient with Graves' Disease.: Chan Kwon Park, Yun Hwa Jung, Ji Hyeon Ju, Hyun Sook Kim, Chong Hyeon Yoon, Young Il Seo, Ho Youn Kim, Sung Hwan Park; J Korean Endocr Soc. 2007;22(1):45-49. Published online February 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.1.45

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Abstract PDF: A 34-year old woman was admitted to our hospital complaining of fever and multiple palpable purpura. She presented with symmetrical, polymorphic, dark-violet and black colored, edematous, tender, necrotic ulcerations and palpable purpuric lesions on her upper and lower extremities and face, except for her trunk, after restarting PTU therapy for relapsing Graves' disease. Palpable purpura can have many causes, including infectious and autoimmune processes. A rare cause is drug-induced vasculitis, and this may result from the production of antineutrophil cytoplasmic antibodies (ANCAs) in response to a medication. The patient's PTU-induced vasculitis was diagnosed by skin biopsy, and biopsy displayed remarkable p-ANCA positivity. The skin lesions resolved immediately after discontinuation of the drug and steroid therapy. We report here on a case of PTU induced vasculitis in a woman with Graves' disease who presented with palpable purpuric lesions and myeloperoxidase ANCA positivity in the blood. We observed clinical resolution of her symptoms following withdrawal of the PTU.

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