Endocrinology and Metabolism

Jae Myung Yoo (Yoo JM)

17 Articles

Impact of Serum Adiponectin Concentration on Progression of Carotid Atherosclerosis in Patients with Type 2 Diabetes Mellitus.: Chul Sik Kim, Ju Ri Park, Sung Hoon Yu, Jun Goo Kang, Ohk Hyun Ryu, Seong Jin Lee, Eun Gyung Hong, Doo Man Kim, Jae Myung Yoo, Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo; Endocrinol Metab. 2012;27(1):31-38. Published online March 1, 2012; DOI: https://doi.org/10.3803/EnM.2012.27.1.31

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Abstract PDF: BACKGROUND
Increased cardiovascular events, which is the leading cause of death in type 2 diabetic patients, are mainly caused by accelerated atherosclerosis. Adiponectin has been suggested as a risk factor for cardiovascular diseases in cross-sectional studies. However, little is known about the impact of adiponectin on the progression of carotid atherosclerosis in type 2 diabetic patients. This study was conducted to evaluate the impact of early adiponectin levels on the progression of carotid atherosclerosis. METHODS: From March 2009, 150 patients with type 2 diabetes were consecutively enrolled in our affiliated outpatient clinic. Anthropometric and biochemical data, including adiponectin levels, were measured in each participant. We measured the carotid intima-media thickness (CIMT) at baseline and at 1-year follow-up (n = 111). Then, we prospectively studied the relationship between the serum adiponectin levels and the progression of CIMT for 1 year. RESULTS: Adiponectin levels negatively correlated with CIMT (r = -0.219, P = 0.015). Moreover, mean progression of CIMT was 0.016 +/- 0.040 mm. However, there was no correlation between adiponectin levels and the progression of CIMT within 1-year follow-up period (r = -0.156, P = 0.080). Age (beta = 0.556, P = 0.004), LDL cholesterol (beta = 0.276, P = 0.042), and A1C (beta = 0.309, P = 0.038) were found to be independent risk factors for CIMT. However, A1C (beta = 0.311, P = 0.042) was found to be the only independent risk factor for the progression of CIMT. CONCLUSION: In our study, adiponectin levels were negatively associated with CIMT. However, it did not affect the progression of CIMT at 1-year follow-up. Overall glycemic control is the most important factor in the progression of CIMT in patients with type 2 diabetes.

A Case of Unilateral Exophthalmos Caused by a Dural Arteriovenous Malformation in Thyroid-Associated Ophthalmopathy.: Sun Ryoung Choi, Seong Jin Lee, Hae Ri Lee, Jun Goo Kang, Ohk Hyun Ryu, Chul Sik Kim, Byung Wan Lee, Eun Gyung Hong, Hyeon Kyu Kim, Doo Man Kim, Jae Myung Yoo, Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo; J Korean Endocr Soc. 2008;23(1):51-55. Published online February 1, 2008; DOI: https://doi.org/10.3803/jkes.2008.23.1.51

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Abstract PDF

Thyroid-associated ophthalmopathy is associated with thyroid dysfunction, particularly Graves' disease, and is manifested as eye signs, including proptosis. In cases of unilateral exophthalmos with thyroid-associated ophthalmopathy, other causes such as orbital neoplasm, carotid-cavernous fistula, cavernous sinus thrombosis, and dural arteriovenous malformation (AVM) should be excluded. Dural AVM, an abnormal dural arteriovenous connection, is a rare neurovascular entity that mimics thyroid-associated ophthalmopathy. When eye involvement is unilateral or asymmetric, dural AVM can be considered in the differential diagnosis of thyroid-associated ophthalmopathy. A twenty-six year-old woman presented with unilateral exophthalmos in Graves' disease. By orbital magnetic resonance imaging and cerebral angiography, thyroid-associated ophthalmopathy and dural AVM were diagnosed. The unilateral exophthalmos improved after coil embolization of the dural AVM. In summary, we report the first case of a dural AVM with Graves' disease and thyroid-associated ophthalmopathy.

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Proptosis as a Primary Symptom of Brain Arteriovenous Malformation
Jong Eun Lee, Jin Sook Yoon, Keun Young Park
Ophthalmic Plastic & Reconstructive Surgery.2020; 36(2): e53. CrossRef
Ophthalmopathy Induced by Bilateral Carotid Cavernous Fistula in a Patient with Graves' Disease
Jong Kun Ha, Ji Hye Suk, A Ra Jo, Chan Woo Jung, Bong Jae Kim, Seong Oh Park, Sang Su Kim, Mi Kyung Kim
Endocrinology and Metabolism.2011; 26(4): 335. CrossRef

The Clinical Significance of Retinoic Acid Receptor beta Expressions in Primary and Recurred Metastatic Lymph Node Papillary Thyroid Carcinomas.: Jae Pil Han, Seong Jin Lee, Kyung Chan Choi, Young Euy Park, Hae Ri Lee, Jun Goo Kang, Ohk Hyun Ryu, Chul Sik Kim, Byung Wan Lee, Eun Gyung Hong, Hyeon Kyu Kim, Doo Man Kim, Jae Myung Yoo, Sung Hee Ihm, Hyung Joon Yoo, Moon Gi Choi; J Korean Endocr Soc. 2007;22(6):419-427. Published online December 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.6.419

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Abstract PDF: BACKGROUND
The present study was designed to investigate the correlations of retinoic acid receptor beta(RARbeta) expression for primary and recurred metastatic lymph node (LN) papillary thyroid carcinoma (PTC) tissues and the correlations of RARbeta expression with the uptake of I(131) as detected on a whole body scan (WBS). METHODS: Primary and metastatic LN PTC tissues were examined by immunohistochemical methods. Staining positivity was calculated, and staining intensity was graded as negative (0), weak (1+), moderate (2+) and strong (3+). Nuclear staining intensity (NSI) of cells from tissues was also examined. RESULTS: Seventeen patients who had regional cervical LN metastasis without distant metastasis were included in the study, and 13 patients had the abnormal uptake of I(131) as detected on a WBS. In primary PTC tissues, RARbeta staining positivity and intensity of carcinoma cells were significantly higher than those of normal cells but NSI was significantly higher in normal cells than carcinoma cells. Between primary and metastatic LN PTC tissues, RARbeta staining intensity was correlated after controlling for age. Primary PTC tissues from 14 (82.4%) out of 17 patients were concordant between NSI and the uptake of I(131) as detected on a WBS. NSI predicted the I(131) uptake as detected on a WBS with 81.3% positive predicted value (PPV) and 100% negative predicted value. Metastatic LN PTC tissues from 13 (76.5%) out of 17 patients were concordant between NSI and the uptake of I(131) as detected on a WBS. NSI predicted the uptake of I(131) as detected on a WBS with 76.5% PPV. When the results of NSI taken either as positive or negative were correlated with those of the uptake of I(131) as detected on a WBS in primary and metastatic LN PTC tissues, the correlation was not significant after controlling for age. CONCLUSION: Our results demonstrate that nuclear RARbeta expression may be decreased in PTC tissues than normal thyroid tissues, and RARbeta expression in primary PTC tissues as well as in recurred metastatic LN PTC tissues may predict the uptake of I(131) as detected on a WBS.

A Novel Mutation of the Vasopressin-Neurophysin II Gene in a Familial Neurohypophyseal Diabetes Insipidus.: Mi Jung Kim, Byung Wan Lee, In Kyung Jeong, Jun Goo Kang, Seong Jin Lee, Eun Gyung Hong, Hyeon Kyu Kim, Doo Man Kim, Jae Myung Yoo, Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo; J Korean Endocr Soc. 2007;22(2):118-124. Published online April 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.2.118

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Abstract PDF: Autosomal dominant familial neurohypophyseal diabetes insipidus (adFNDI) is a rare form of central diabetes insipidus (DI), and this malady is clinically characterized by polydipsia and polyuria, and it is caused by mutation in the vasopressin-neurophysin II. We identified a Korean family that suffered with adFNDI and we found a novel mutation in the NP II molecule. The index subject's DI symptoms dated to childhood, and his familial history was consistent with autosomal transmission. The diagnosis of central DI was done by performing a water deprivation test and a vasopressin challenge test. For molecular analysis, the genomic DNA was extracted and the AVP-NP II gene was amplified by polymerase chain reaction from four clinically-affected members and seven clinically-nonaffected members. Genetic analysis of AVP-NP II revealed new a heterozygous missense mutation in exon 2 of the AVP-NP II gene (+1692C > A) and this amino acid substitution (Cys105Stop) was predicted to have occurred in four clinically-affected subjects. In summary, in the present study we have described a novel mutation of the AVP-NPII gene in a Korean family suffering with adFNDI.

A Case of Hashimoto's Thyroiditis with Transient T3-Thyrotoxicosis Induced by Hydatidiform Mole.: Ji Youn Yoo, Hong Ju Moon, Cheol Young Park, Seong Jin Lee, In Kyung Jeong, Eun Gyung Hong, Gi Weon Oh, Hyeon Kyu Kim, Doo Men Kim, Jae Myung Yoo, Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo, Sung Woo Park, Soo Kee Min; J Korean Endocr Soc. 2005;20(3):294-298. Published online June 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.3.294

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Abstract PDF

Human chorionic gonadotropin(HCG) is a member of the glycoproteins family synthesized by the placenta, which consists of 2 noncovalently joined subunits(alpha(alpha) and beta(beta)). The alpha- and beta-subunits have a structural homology with the alpha- and beta-subunits of TSH and LH. The thyrotropic action of HCG results from its structural similarity to TSH, so beta-HCG can bind to the TSH receptor in the thyroid gland. A high level of HCG accompanied by an increased thyroid hormone level, can be observed in gestational trophoblastic disease (GTD), such as a hydatidiform mole or a choriocarcinoma, but the clinical symptoms of hyperthyroidism are rarely observed. We experienced a case of Hashimoto's thyroiditis, where the patient was diagnosed with T3-thyrotoxicosis, which had initially been induced by excess beta-HCG due to an H-mole; after evacuation of the H-mole, the condition was diagnosed as hypothyroidism. It has been speculated that a patient with Hashimoto's thyroiditis could have hyperthyroidism, induced by beta-HCG, due to an H-mole

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Transient T3 toxicosis associated with Hashimoto’s disease
Sarah Jaroudi, Meredith Gavin, Kathryn Boylan, Alan N. Peiris
Baylor University Medical Center Proceedings.2019; 32(1): 80. CrossRef

A Case of Apical Hypertrohic Cardiomyopathy Associated with Pheochromocytoma.: Joon Ho Moon, Sung Woo Park, Sung Hee Ihm, Cheol Young Park, Ki Won Oh, Cheol Soo Choi, Seong Jin Lee, In Kyung Jung, Eun Gyung Hong, Hyeon Kyu Kim, Doo Man Kim, Jae Myung Yoo, Moon Gi Choi, Hyung Joon Yoo, So Young Ku, Soo Kee Min; J Korean Endocr Soc. 2004;19(5):522-527. Published online October 1, 2004

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Abstract PDF: Pheochromocytomas often present with cardiovascular manifestations, such as arrhythmia, angina pectoris and acute myocardial infarction and so on. Both dilated and nonobstructive hypertrophic cardiomyopathies are also rare complications of pheochromocytomas. In hypertrophic cardiomyopathy, an apical variant form constitutes about 25% of cases in Japan, but only 1 to 2% of those in non-Japanese populations, including Korea. The cause of apical hypertrophic cardiomyopathy (AHC) remains unknown. Recently, some cases of AHC associated with pheochromocytomas have been reported, with catecholamine thought to be an important cause. AHC associated with a pheochromocytoma has never been previously reported in Korea. Herein is reported our experience of a case of apical hypertrophic cardiomyopathy associated a pheochromocytoma with a review of the literature

A Case of Adrenocortical Oncocytoma.: Seong Jin Lee, Ho Gwon Lee, Cheol young Park, In Kyung Jeong, Eun Gyung Hong, Gi Weon Oh, Hyeon Kyu Kim, Doo Man Kim, Jae Myung Yoo, Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo, Sung Woo Park; J Korean Endocr Soc. 2004;19(1):82-89. Published online February 1, 2004

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Abstract PDF: Oncocytomas are neoplasms, histologically are composed of epithelial cells, with abundant, acidophilic and granular cytoplasm. Electron microscopic studies of oncocytomas have shown that the cytoplasm of oncocytes is packed with mitochondria. The adrenal gland is a very rare anatomical site for oncocytomas, and to the best of our knowledge, only thirty-six cases of adrenal oncocytomas have been described. Herein, a case of a large adrenal mass in a forty-year-old man, which was incidentally detected by abdominal ultrasonography, is presented. This patient demonstrated no clinical manifestation associated with adrenal hyperfunction. Hormonal studies showed no abnormal findings, except for a mild elevation of the 24-hour urinary VMA level. Abdominal computed tomography with enhancement revealed a large, well-defined left adrenal mass, measuring 5.0x.2 x.0cm. The patient underwent a left adrenalectomy, and a light microscopic examination confirmed an adrenocortical oncocytoma, with characteristic oncocytes and polygonal, abundant, eosinophilic and granular cytoplasm. The tumor cells were positive for cytokeratin and vimentin as well as S-100, but negative for chromogranin on immunohistochemical staining. An electron microscopic examination demonstrated closely packed mitochondria, containing intramitochondrial inclusions. After surgery, there was no evidence of a recurrent or distant metastatic disease at the 5 month follow-up. In summary, an extremely rare case of a man with an adrenocortical oncocytoma is reported, which was confirmed by histological examinations, including electron microscopy.

The Effect of T3 on Thyroid Hormone Receptor Dynamics in Thyroid Hormone Response Element of Chicken Lysozyme Silencer.: Seong Jin Lee, Cheol Young Park, In Kyung Jeong, Eun Gyung Hong, Cheol Soo Choi, Hyeon Kyu Kim, Doo Man Kim, Jae Myung Yoo, Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo, Sung Woo Park, P Reed Larsen; J Korean Endocr Soc. 2003;18(4):379-391. Published online August 1, 2003

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Abstract PDF: BACKGROUND
The regulation of gene transcription can be controlled by both positive (enhancer) and negative (silencer) regulatory sequences. Several enhancer and silencer elements have been described in the 5' region of the chicken lysozyme gene. The silencer located at -2.4 kb upstream of the chicken lysozyme gene is composed of two separate modules (F1 and F2) that can function as silencers by themselves, but also show synergistic repression after multimerization. The F1 module is bound by a protein termed NeP1 and F2 module, a F2 thyroid hormone response element (F2-TRE), and can be bound by the thyroid hormone receptor (TR). F2-TRE has an inverted palindromic structure, with high affinity to TR. Although many current reported results have tried to explain the regulatory mechanism of chicken lysozyme gene expression due to the thyroid hormone, there have been few studies that clarify the TR dynamics in the F2-TRE of the chicken lysozyme gene, either with or without exposure of the thyroid hormone. Here, the changes in the TR binding patterns in the F2-TRE of the chicken lysozyme gene are described, both before and after T3 stimulation over time. METHODS: Using the stably transfected rat pituitary somatotroph tumor cell line, GC8 cells, with the F2-TRE inserted 5' to the thymidine kinase (TK) promoter, together with a mouse TRalpha- expressing plasmid, a chromatin immunoprecipitation (ChIP) technique was employed to reveal the TR-TRE interaction before and after T3 stimulation. Following the cross-linking and sonication of the cells, the immunoprecipitation was performed overnight, at 4 degrees C, with TRalpha1, TRbeta1 and TRbeta2 antibodies, respectively. The binding patterns and amounts of TRalpha1, TRbeta1 and TRbeta2 to the F2-TRE, before and after 12 hours of 100 nM T3 stimulation, were analyzed using conventional and quantitative real-time polymerase chain reactions (RQ-PCR). The ChIP technique was used to give a basal value for 20 minutes and 1, 2, 4, 6, 8 and 12 hours after the 100 nM T3 stimulation, and RQ-PCR was then performed. Western blot with TRalpha1, TRbeta1 and TRbeta2 antibodies were also performed. RESULTS: After 12 hours of 100 nM T3 stimulation of the GC8 cells, the TRalpha1 and TRbeta2 binding to the F2-TRE increased, but the TR 1 binding to the F2-TRE decreased, by conventional PCR. Although all the TR isoforms were bound to the F2-TRE by RQ-PCR, the TR 1 binding to the F2-TRE, after 12 hours of 100 nM T3 stimulation, was significantly increased (1.01-->2.73, delta=+170.3%, p<0.05), but the change in the amount of TRbeta2 binding was not significant (2.53-->2.98, delta=+17.8%). The TRbeta1 binding was significantly decreased compared with that of the basal level (4.59-->2.06, delta=-55.1%, p<0.05). The total TR bindings to the F2-TRE had a tendency to decrease after 12 hours of 100 nM T3 stimulation (8.13-->7.77, delta=-4.4%). The binding patterns and amounts of TRalpha1, TRbeta1 and TRbeta2, both before and after the 100 nM T3 stimulation, were also identified over time. While the TRbeta1 bindings to the F2-TRE after 1 hour of 100 nM T3 stimulation were acutely reduced, those of the TRalpha1 at 20 minutes and 6 hours were increased. The TRbeta2 bindings showed a maximal increase at 20 minutes. The directions of the TR binding patterns, between the before and after 2 hours of 100 nM T3 stimulation, were identical to those for between 4 and 6 hours of T3 stimulation. There was no significant difference in the TR bindings to the F2-TRE in relation to the amounts (1.5 vs. 4.5 microliter) of TR antibodies used during the ChIP assays. The Western blots showed no significant change of the levels of each TR isoform proteins, either before or after 12 hours of exposure to 100 nM T3. CONCLUSION: These results show the dynamic binding patterns of the TR isoforms to the F2-TRE of the chicken lysozyme gene, both before and after T3 stimulation, over time. Further investigation, however, will be needed to clarify the mechanisms of our observations. The ChIP technique may then be used to reveal the dynamic models of the cofactors, as well as TR isoforms, in the TR-regulated transcription machinery.

Thyroid Hormone Receptor Dynamics in Thyroid Hormone Response Elements of the Human Type 1 Iodothyronine Deiodinase Gene.: Seong Jin Lee, Cheol young Park, In Kyung Jeong, Eun Gyung Hong, Cheol Soo Choi, Hyeon Kyu Kim, Doo Man Kim, Jae Myung Yoo, Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo, Sung Woo Park, P Reed Larsen; J Korean Endocr Soc. 2003;18(3):283-295. Published online June 1, 2003

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Abstract PDF: BACKGROUND
Type 1 iodothyronine deiodinase (D1), the product of the hdio1 gene, is involved in thyroid hormone activation by the deiodination of thyroxine (T4) to form 3, 5, 3'-triiodothyronine (T3). Recent studies have identified two thyroid hormone response elements (TREs) in the 5 flanking region of the hdio1 gene. TRE1, proximal to TRE in the hdio1 gene, consists of a direct repeat of thyroid hormone receptor (TR) binding octamers with 10 bp separating the two TR binding sites. The upstream TRE, TRE2, is a classical direct repeat of retinoid X receptor (RXR)/TR binding half-sites with a 4-bp separation. There are few studies clarifying the TR dynamics in the TRE of a specific gene with or without the exposure of activated thyroid hormone. We evaluated TR binding patterns in the proximal and distal TREs of the hdio1 gene before and after T3 stimulation. METHODS: We employed chromatin immunoprecipitation (ChIP) technique to investigate the TR-TRE interaction before and after T3 stimulation in human hepatocellular carcinoma HepG2 cell line.Following cross-linking and sonication of the cells, immunoprecipitation was performed overnight at 4degrees C with TR 1, TR 1 and TR 2 antibodies. We analyzed the binding patterns and amounts of TR 1, TR 1 and TR 2 to TRE1 and TRE2 before and after 12 hours stimulation with 100 nM T3 by using conventional and quantitative real-time polymerase chain reactions (RQ-PCR). Reverse transcriptional PCR (RT-PCR) and Western blot with TR 1, TR 1 and TR 2 antibodies were performed to measure the levels of hdio1 mRNA and TR 1, TR 1 and TR 2 proteins before and after 12 hours exposure to 100 nM T3. RESULTS: In TRE1, TR 1 binding was significantly decreased after 12 hours stimulation with 100nM T3 (3.74-->1.97, delta=-47.3%, p<0.05), but TR 1 and TR 2 bindings were not detected by conventional PCR and RQ-PCR. Although all TR isoforms were bound to TRE2, the binding patterns were quite different. While TRalpha1 and TR 1 bindings to TRE2 after 12 hours stimulation with 100 nM T3 were significantly decreased (10.41-->3.01, delta=-71.1%, p<0.05; 12.56 --> 2.93, delta=-76.7%, p<0.05, respectively), TR 2 binding was increased but not significantly (9.17 --> 9.84, delta=+7.3%). Total TR bindings in TRE2 were significantly decreased after 12 hours stimulation with 100 nM T3 (32.14 --> 15.78, delta=-50.9%, p<0.05). The TR bindings to TRE1 and TRE2 were not significantly different by the amounts of TR antibodies used during ChIP assays. The levels of hdio1 mRNA were significantly increased, 2.03 times, after 12 hours exposure to 100nM T3 (p<0.001). Western blot showed no significant change of the level of each TR isoform protein before and after 12 hours exposure to 100 nM T3. CONCLUSION: Our results demonstrate the dynamics of TR 1 at proximal TRE (TRE1) and the switching phenomenon of TR isoforms at distal TRE (TRE2) of the hdio1 gene after T3 stimulation. Further investigation, however, is needed to clarify the mechanisms of these observations.

Lymphocytic Hypophysitis associated with Pregnancy.: Seong Jin Lee, Hyang Lim Lee, In Kyung Chung, Eun Gyung Hong, Cheol Soo Choi, Hyeon Kyu Kim, Doo Man Kim, Jae Myung Yoo, Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo, Sung Woo Park; J Korean Endocr Soc. 2002;17(5):705-712. Published online October 1, 2002

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Abstract PDF: Lymphocytic hypophysitis is a rare inflammatory disease of the pituitary gland that is often recognized as a cause of hypopituitarism and may be due to the autoimmune pituitary destruction that usually occurs in women in the peripartum period. We report a rare case of lymphocytic hypophysitis in a 26 year-old woman presenting with nausea and headaches for 2 months after an artificial abortion of her second pregnancy. Magnetic resonance imaging, with enhancement, showed an expanding 1.0x1.0 cm sized sellar mass. The patient underwent transsphenoidal surgery with a preoperative diagnosis of pituitary macroadenoma. A histological examination revealed diffuse lymphocytes and plasma cells infiltration which are characteristic of lymphocytic hypophysitis. Here, we present the first reported case of a pregnant woman with lymphocytic hypophysitis with a review of the literature on this increasingly recognized condition.

A Case of Postpregnancy Spinal Osteoporosis.: Ji Young Seo, Hyeon Kyu Kim, Cheol Soo Choi, Doo Man Kim, Sung Hee Lim, Jae Myung Yoo, Moon Gi Choi, Huung Joon Yoo, Sung Woo Park, Jin Young Lee; J Korean Endocr Soc. 2001;16(2):265-270. Published online April 1, 2001

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Abstract PDF: Osteoporosis is a common disease of the elderly and occurs especially in the postmenopausal women. Rarely, it occurs during a pregnancy or shortly thereafter and is accompanied by a substantial bone loss, resulting in fractures. The clinical significance of pregnancy-associated osteoporosis has been noted since the 1950s. Although its etiology is still unknown, it has recently been proposed that PTHrP may be an important causative factor in pregnancy-associated osteoporosis. There are three types of the pregnancy-associated osteoporosis, (1) a transient osteoporosis of the hip pregnancy, (2) a postpregnancy spinal osteoporosis and (3) a lactation-associated osteoporosis. Postpregnancy spinal osteoporosis typically occurs within three months after a first delivery and usually involving the axial skeleton accompanied by back pain, bone loss and a fracture. We present a case of postpregnancy spinal osteoporosis that developed three months after a first delivery. Our patient also showed multiple compression fractures in her lumbar spine and biochemical evidence of increased bone resorption.

The Clinical Characteristics of Hyperthyroidism Combined with Ocular Myasthenia Gravis: Report of Six cases.: Ji Young Seo, Doo Man Kim, Hyeon Kyu Kim, Cheol Soo Choi, Sung Hee Ihm, Jae Myung Yoo, Moon Gi Choi, Hyung Jun Yoo, Sung Woo Park, Hyeung Cheul Kim, Hong Ki Song, Deuk Hwan Kim; J Korean Endocr Soc. 2000;15(4-5):606-613. Published online January 1, 2001

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Abstract PDF: Myasthenia gravis is an autoimmune disease characterized by impaired neuromuscular transmission due to circulating antiacetylcholine receptor autoantibodies. The relation between myasthenia gravis and thyroid disease remains unclarified. The association is thought to be uncommon and approximately 0.2% of myasthenia gravis has been reported in patients with autoimmune thyroid disease. Clinical expression of myasthenia gravis varies, ranging from a mild localized disease such as ocular myasthenia gravis (OMG) to a severe generalized disease. A higher frequency of thyroid antibodies has been observed in OMG compared to generalized myasthenia gravis, but the exact mechanisms of this increased association between OMG and thyroid autoimmunity has not been confirmed. The "see-saw" relationship between hyperthyroidism and myasthenia gravis is presented by some authors, while others reported that the optimal maintenance of euthyroid status was essential in treatment. Today many authors agree to the latter and we think that the adequate control of hyperthyroidism is more important. We have experienced six cases of hyperthyroidism combined with OMG and it was somewhat difficult to diagnose myasthenia gravis when the patient have Graves' ophthalmopathy.

A Case of Multiple Extraadrenal Pheochromocytoma Iocalized by 131 I-MIBG Scan.: Sung Hee Ihm, Jae Myung Yoo, Moon Gi Choi, Hyung Joon Yoo, Seok Boo Yoon, Jin Bong Kim, Doo Man Kim, Jin Seon Cho, Sang Kon Lee, Sung Woo Park; J Korean Endocr Soc. 1995;10(4):439-444. Published online November 7, 2019

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Abstract PDF: Peroperative localization of pheochromocytoma is the very crucial step for the successful removal of tumors. Computed tomography(CT) and magnetic resonance(MR) imaging have been commonly used for tumor localization, but in some cases of pheochromocytoma, such as extraadrenal location or distant metastasis of malignant tumor, their localization is somewhat difficult. Recently ^131 I-metaiodobenzylguanidine(MIBG) scintigraphy has been developed and increasingly used for the localization of pheochromocytoma and reported to be more sensitive and specific than CT or MR imaging in the cases of extraadrenal tumor location.We report a case of multiple extraadrenal pheochromocytoma in which ^131 I-MIBG scintigraphy clearly localized two intraabdominal and one bladder tumors, after failure of localization with conventional CT and MR imaging.

A Case of Non - Islet Cell Tumor Hypoglycemia.: Moon Hee Lee, Seung Sik Kang, Jin Lee, Sung Hee Ihm, Jae Myung Yoo, Moon Gi Choi, Hyung Joon Yoo, Sung Woo Park; J Korean Endocr Soc. 1995;10(1):65-69. Published online November 6, 2019

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Abstract PDF: The association between non-islet cell tumors and fasting hypoglycemia has been recognized since 1929. The humoral mediator of this non-islet cell tumor hypoglycemia(NICTH) is now known as IGF-II. Hypoglycemia develops commonly in the course of hepatocellular carcinoma(HCC), mostly late in the course and usually mild to moderate in severity. Rarely, severe hypoglycemia occurs early in the course of HCC, suggesting NICTH. We report a case of HCC in which hypoglycemic coma due to NICTH was the presenting symptom.A 52-year-old man developed mental confusion and seizures in the early morning. At emergency room, he was found to have severe hypoglycemia. Circulating levels of insulin, C-peptide, insulinlike growth factor-I(IGF-I) and growth hormone were reduced during hypoglycemia. Diagnostic work-up revealed that he had unresectable HCC. During admission, infusion of more than 400g of dextrose per day in addition to meals was required to prevent hypoglycemia. Because the chemotherapy was refused, he was transferred to a local hospital to receive infusions of dextrose.

A Clinical Study of 11 Cases of Adrenal Ineidentaloma.: Jae Myung Yoo, Sang Jin Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi, Yong Hyun Kim, Eun Jong Lee; J Korean Endocr Soc. 1994;9(4):358-365. Published online November 6, 2019

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Abstract PDF: With the wide application of ultrasonography and CT scanning, the incidental finding of a radiologic abnormality, apparently adrenal origin, has presented a problem for clinical management. The prevalence of these clinically silent tumors has been reported as 0.6 to 1.3% of upper abdominal CT scans performed for other reasons.Once identified, an adrenal lesion must characterized as to its functional status and malignant potential. A thorough approach that initially excludes biochemical hypersecretion, then considers characteristics of anatomy and the functional nature of an adrenal mass, will allow a rational and cost-effective evaluation and management of these lesions.We present out experience of eleven adrenal incidentalomas with a review of literatures.

Changes in Bone Mineral Density in Patients with Sheehan's Syndrome.: Jae Myung Yoo, Sang Jin Kim, Kyung Mook Choi, Sei Hyun Baik, Dong Seop Choi, Eun Jong Lee, Yong Hyun Kim; J Korean Endocr Soc. 1994;9(1):10-17. Published online November 6, 2019

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Abstract PDF: Osteoporosis is a common clinical problem with high risk of fractures in old age, especially postmenopausal women.Secondary causes of osteoporosis can be identified in 20% of women and 40% of men with vertebral fractures. One of the causes of secondary osteoporosis is endocrine disease such as hypogonadism, ovarian agenesis, hyperadrenocorticism, hyperthyroidism, hyperparathyroidism and diabetes mellitus. Patients with Sheehan's syndrome have deficiency of multiple hormones which may cause bone loss.To determine changes in the bone mineral density in women with Sheehan's syndrome and to compare clinical and biochemical characteristics between the patients with osteoporosis and the patients without osteoporosis, we measured the bone mineral density(BMD) of the lumber spine and midradius by dual energy X-ray absortiometry(DEXA) and the serum levels of estrogen and osteocalcin in 11 patients of Sheehan's syndrome.The results were as follows;1) The BMDs of the lumbar spine were significantly decreased in patients with Sheehan's syndrome when compared with those of age-matched control.2) The prevalence of osteoporosis in patients with Sheehan's syndromes was 55%. Between the patients with osteoporosis and the patients without osteoporosis, there were no difference in the onset age of amenorrhea, the duration of amenorrhea, and the serum levels of osteocalcin and alkaline phosphatase.3) Serum estradiol levels were decreased uniformly in the patients with Sheehan's syndrome except three patients with estrogen replacement, but the concentration of estradiol was not correlated with the degree of the decrease in bone mass.In conclusion, the patients with Sheehan's syndrome have an increased prevalence of osteoporosis. But the effect of each anterior pituitary hormone deficiency on bone loss should be clarified in the futher prospective study.

A case of symptomatic rathke's cleft cyst.: Yong Hyun Kim, Eun Jong Lee, Sang Jin Kim, Jae Myung Yoo, Sei Hyun Baik, Dong Seop Choi; J Korean Endocr Soc. 1993;8(1):94-99. Published online January 1, 2001

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Abstract PDF: No abstract available.

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