Endocrinology and Metabolism

Kyung Seung Oh (Oh KS)

3 Articles

A Case of Multiple Endocrine Neoplasia Associated with VIPoma.: Si Won Lee, Young Sik Choi, Yo Han Park, Kyung Seung Oh, Jung Woo Shin, Il Jin Kim, Shinya Uchino; J Korean Endocr Soc. 2005;20(1):64-70. Published online February 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.1.64

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Multiple endocrine neoplasia I(MEN I) is a genetic disorder that consists of neoplasia of neuroendocrine type in the parathyroid glands, in the islets of Langerhans in the pancreas, and in the anterior pituitary gland. Primary hyperparathyroidism is the most common feature and occurs in approximately 95% of MEN I patients. Pancreatic islet cell tumors occur in 40% of MEN I patients. Most of these tumors produce excessive amounts of hormones, such as gastrin, insulin, glucagon and vasoactive intestinal polypeptide(VIP). VIP-producing pancreatic tumors(VIPoma) associated with MEN I are rare and so far only one has been reported in Korea. Recently, we came across a case of MEN I, associated VIPoma presented persistent hypercalcemia after a parathyroidectomy. A 70 year old man had suffered from large amount of watery diarrhea, severe general weakness and paralysis of lower limbs for 3 months which suggests symptoms of hypercalcemia. Before the patient visited our hospital, he underwent subtotal parathyroidectomy due to hyperparathyroidism. Even though he was operation, there was no subsidization of the symptoms and abnormal findings of blood chemistry such as hypercalcemia, hypocalemia were remained unchanged. However, the parathyroid hormone level was still within normal limits. Abdominal computerized tomography scan demonstrated a mass of 2.5cm diameter in tail of the pancreas. As serum level of VIP hormone was also elevated, distal pancreatectomy was carried out to performed. There was improvement in the symptoms towards the normal condition and the level of biochemical parameters such as serum potassium, calcium and VIP, were also within the normal limits. In a direct sequence analysis, GAC-->CAT(Asp-->His) point mutation, at codon 383 of exon 9 of the MEN I gene was identified in both the patient and his son. The authors report a rare case of VIPoma associated with MEN I with review of literature on MEN I.

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Genetic and Epigenetic Analysis in Korean Patients with Multiple Endocrine Neoplasia Type 1
Yoon Jung Chung, Sena Hwang, Jong Ju Jeong, Sun Yong Song, Se Hoon Kim, Yumie Rhee
Endocrinology and Metabolism.2014; 29(3): 270. CrossRef
Somatic Mutational Analysis of MEN1 and Phenotypic Correlation in Sporadic Parathyroid Tumors
Young Su Chae, Hee Jin Kim, Sun Wook Kim, Myung-Chul Chang
Journal of the Korean Surgical Society.2009; 76(1): 15. CrossRef
Multiple Endocrine Neoplasia Type 1 with Multiple Leiomyomas Linked to a Novel Mutation in the MEN1 Gene
Heekyoung Choi, Sehyun Kim, Jae-Hoon Moon, Yoon Hee Lee, Yumie Rhee, Eun Seok Kang, Chul Woo Ahn, Bong Soo Cha, Eun Jig Lee, Kyung Rae Kim, Hyun Chul Lee, Seon Yong Jeong, Hyun Ju Kim, Sung-Kil Lim
Yonsei Medical Journal.2008; 49(4): 655. CrossRef

The Diahnostic Value of Ultrasound-Guided Fine Needle Aspiration Cytology in the Thyroid Indedentaloma.: Young Sik Choi, Kibum Kwon, Seong Man Kim, Yo Han Park, Kyung Seung Oh, Ji young Seo, Bong Kwon Chun, Hee Kyung Chang; J Korean Endocr Soc. 1999;14(1):71-80. Published online January 1, 2001

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Abstract PDF: BACKGROUND
The introductian of highly sensitive imaging techniques has made it possible to detect many nonpalpable nodules, or incidentaloma. Because these nodules are small sized or deep seated, the diagnostic approach is difficult with conventional methods but it is easy with ultrasound-guided fine needle aspiration (FNA). However, the role of ultrasound-guided FNA on the incidentalomas has been poorly evaluated, so we tried to assess the diagnostic value of high resolution ultrasound-guided FNA in the incidentalomas. METHODS: One hundred forty-nine patients who underwent high resolution ultrasound-guide FNA for nonpalpable nodules that was smaller than 1.5 cm in diameter at Kosin Medical Center from June, 1996 to April, 1998 were included in the study. Ultrasound-guided FNA was performed with a 22-guage needle attached to 10 mL syringe with 10 MHz linear transducer in a free hand fashion. The aspirated materials were smeared and stained with Papanicolaou stain. For those who underwent surgery histopathologic diagnoses were compared to cytological diagnoses. RESULTS: The mean age of the patients was 45 and most of them were middle aged. Male to female ratio was 1:11.4. Of 149 patients 16 were involutional change, 55 hyperplasia, 42 Hashimotos thyroiditis, 8 follicular neoplasm, 19 papillary carcinoma, 1 subacute thyroiditis, and 6 inadequate specimen. Of the 149 nodules, 123 cases were solid, 11 cystic, and 15 mixed. Malignant nodules were more frequent in the solid nodule, but there was no significant difference between each group. Ten of 93 cases (10.7%) measured less than 1 cm and nine of 56 cases (16.1%) between 1.0 cm to 1,5 cm were malignant nodules. The difference of incidence rate of malignant nodules between each group was not significant. The incidence of malignancy was 13.6% (12/88) in solitary nodule and 11.5% (7/61) in multiple nodules. The difference of incidence rate of malignant nodules between each group was not significant. Eighteen cases including 14 malignancies diagnosed by FNA underwent operation. Of those 13 were papillary carcinoma and 5 adenomatous goiter. Upon the correlation of ultrasound-guided FNA cytology with pathologic diagnosis, the sensitivity of ultrasound-guided FNA cytology in differentiating benign and malignant nodule was 92.3% and overall diagnostic accuracy was 80.0%. The obtainability of adequate cytologic specimen by ultrasound-guided FNA was 95.9%. No complication except pain was noted during this study. CONCLUSION: High resolution ultrasound-guided FNA cytology may be useful for the diagnosis of thyroid cancer in the thyroid incidentalomas and also useful for early detection of recurrence of thyroid cancer .

The Diagnostic Value of Ultrasound-Guided Fine Needle Aspiration Cytology in the Thyroid Nodules.: Yang Hun Koo, Sung Jun Hong, Hwi Choi, Hark Rim, Young Sik Choi, Yo Han Park, Kyung Seung Oh, Hee Kyung Chang; J Korean Endocr Soc. 1996;11(4):391-400. Published online November 7, 2019

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Abstract PDF: Background
Thyroid nodule is a common disease of thymid gland. The incidence of malignant nodule is about 3%, so most of thyroid nodules are benign. Because most thyroid nodule morbidity is related to cancerous lesions, early detection of malignant nodule is important. However, some of these nodules are srnall sized or deep seated which were not detected by physieal exarnination but by ultrasonography incidentally. In these cases the diagnostic approach is difficult with conventional methods but it is easy with ultrasound-guided fine needle aspiration (FNA). However, the role of ultrasound-guided FNA on the thyroid nodules has been poorly evaluated, so we tried to assess the diagnostic value of high resolution ultrasound-guided FNA in the thyroid nodules. Methods: We examined the medical records retrospectively of all patients who were engaged in high resolution ultrasonography(ATL Ultramark-9, 10 MHz linear transducer) due to thyroid nodules and/or other thyroid abnormalities from September, 1995 to March, 1996. Ultrasound- guided FNA was performed in 137 patients with palpable or nonpalpable(small sized or deep seated) nodules which were detected by high resolution ultrasonography. Results: The mean age of the patients was 45 and most of them were middle aged. Male to female ratio was 1:8.1. Malignant nodules were frequent in patients over 30 yus of age. Of 137 patients 43 were involutional change, 45 hyperplasia, 12 Hashimotos thyroiditis, 12 follicular neoplasm, ll papillary carcinoma, 1 Hurthle cell tumor, 1 medullary carcinoma, and 12 inadequate specimen. In 22 cases thyroid nodules were not detected by physical examinatian but by ultrasonography and in 31 cases additional thyroid nodules were detected by ultrasonography. In the nature of thyroid nodules, 99 cases were solid, 16 cystic, 22 mixed. Malignant nodule were more frequent in the solid nodule, but thete was no significant difference between each group. The size of masses was categorized into four groups. Thirty-one cases measured less than 1cm, 63 between 1cm and 1.9cm, 29 between 2cm to 2.9cm, and 14 over 3cm. The malignant nodule was not palpable in 3 cases and the smallest was 0.7cm in diameter. Most of malignant lesions were between 1cm and 2.9cm, but the difference of incidence rate of rnalignant nodules between each group was not significant. The incidence rate of malignancy was 8.8% in solitary nodule and 8.7% in multiple nodules. Twenty-three cases including 12 malignancies diagnosed by FNA underwent operation. Of those 13 were papillary earcinoma, 1 follicular carcinoma, 1 medullary carcinoma. Upon the correlation of ultrasound-guided FNA cytology with pathologic diagnosis, the sensitivity of ultrasound-guided FNA cytology in differentiating benign and malignant nodule was 80.0%, the specificity 100% and overall diagnostic accuracy was 86.1%. The obtainability of adequate cytologic specimen by ultrasound-guided FNA was 91%. No complication except pain was noted during this study. Conclusion: High resolution ultrasound-guided FNA cytology in the thyroid nodules may be useful in the diagnosis of thyroid cancer especially in the nodules which were small sized or deep seated and also useful in early detection of recurrence of thyroid cancer.

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