Endocrinology and Metabolism

Yo Han Park (Park YH)

15 Articles

A Case of Sunitinib-Induced Destructive Thyroiditis.: Bu Kyung Kim, Young Sik Choi, Yo Han Park; Endocrinol Metab. 2012;27(1):68-71. Published online March 1, 2012; DOI: https://doi.org/10.3803/EnM.2012.27.1.68

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Abstract PDF: Sunitinib is a multi-targeted tyrosine-kinase inhibitor used for gastrointestinal stromal tumors and renal cell carcinoma (RCC). Several recent studies have reported sunitinib-induced hypothyroidism and thyroid dysfunction; however, the underlying mechanisms are not clear. Here, we report a patient with metastatic RCC, who developed destructive thyroidtis due to sunitinib treatment. The course followed in this case may be useful in understanding the clinical course of sunitinib-induced thyroiditis.

A Case of Follicular Thyroid Carcinoma Associated with Hemiagenesis of Thyroid Gland.: Bu Kyung Kim, Hyun Joo Jung, Ye Na Kim, Young Sik Choi, Yo Han Park, Hee Kyoung Chang, Jeong Hoon Kim; J Korean Endocr Soc. 2010;25(1):46-49. Published online March 1, 2010; DOI: https://doi.org/10.3803/jkes.2010.25.1.46

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Thyroid hemiagenesis is a rare congenital anomaly, in which one thyroid lobe fails to develop. Thyroid hemiagenesis is associated with thyroid diseases such as Graves' disease, Hashimoto's thyroiditis, colloidal goiter and thyroid follicular and papillary cancer. A 53-year-old female patient was diagnosed with a thyroid nodule on health examination. A 99mTc pertechnetate thyroid scan showed absent uptake in the left lobe and cold nodule on the right lobe of thyroid gland. By ultrasonography, we found hemiagenesis in the left thyroid gland and an irregular shaped thyroid nodule on the right lobe of thyroid gland. We performed ultrasonography guided fine needle aspiration and cytologic analysis showed indeterminate nature. Thyroidectomy was performed and finally diagnosed follicular carcinoma of thyroid gland. The authors report this case with a literature review.

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A Case of Thyroid Hemiagenesis with Concurrent Papillary Thyroid Carcinoma
Ye-Mo Nam, June Sik Park, Kyung Jin Na, Dongbin Ahn
Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2011; 54(8): 557. CrossRef

A Case of Idiopathic Myelofibrosis Associated with Acromegaly Patient.: Jun Young Song, Pyoung Rak Choi, Hong Jun You, Seong Hoon Shin, Yu Ri Kim, Young Sik Choi, Yo Han Park, Mi Hyang Kim, Bong Kwon Chun, Young Duk Joh; J Korean Endocr Soc. 2006;21(4):328-332. Published online August 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.4.328

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Abstract PDF: Acromegaly is a chronic condition resulting from the excessive secretion of growth hormone and insulin like growth factor 1, generally from pituitary adenoma. Although there have been several reports suggesting the possible association of hematologic malignancies with acromegaly, myelofibrosis with acromegaly is very rare. Here we report 54-year-old male patient with myelofibrosis accompanied with acromegaly. We treated this patient with low dose thalidomide (50 mg/day) and prednisone (30 mg/day). We reported this case with literature review.

A Case of Pituitary Mucormycosis in Diabetic Patient with Acromegaly and Gastric Cancer.: Pyoung Rak Choi, Hong Jun Yu, Seung Wu Yang, Gyu Jong Kim, Hark Rim, Yu Ri Kim, Young Sik Choi, Yo Han Park, Bong Kwon Chun; J Korean Endocr Soc. 2006;21(3):245-250. Published online June 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.3.245

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Rhino-orbito-cerebral mucormycosis (ROCM) is an uncommon, acute, and aggressive fungal infection occurring in several immunocompromised states including poorly controlled diabetes. ROCM causes a very high residual morbidity and mortality due to the angioinvasion property of the fungus. Acromegaly is a chronic condition resulting from the excessive secretion of growth hormone, generally from pituitary adenoma. Although it has been demonstrated that acromegalic patients have an increased risk of neoplasm, gastric cancer with acromegaly is very rare. We experienced a case of pituitary mucormycosis in the diabetic patient with acromegaly and gastric cancer. The patient was treated successfully with subtotal gastrectomy for early gastric cancer, transsphenoidal surgery for pituitary adenoma, and a systemic application of amphotericin B for the mucormycosis.

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Optimization of ethanol extraction and further purification of isoflavones from soybean sprout cotyledon
Seung Yong Cho, Yu Nam Lee, Hyun Jin Park
Food Chemistry.2009; 117(2): 312. CrossRef

A Case of Type 1 von Hippel-Lindau (VHL) Disease associated with VHL Germline Mutation.: Jeong Hoon Seo, Jae Hong Yang, Pyoung Lak Choi, Yu Lee Kim, Young Sik Choi, Yo Han Park, Ji Ho Ko, Hio Chung Kang, IL Jin Kim, Jae Gahb Park; J Korean Endocr Soc. 2006;21(3):239-244. Published online June 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.3.239

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Von Hippel-Lindau (VHL) disease is an autosomal dominant neoplasia syndrome that result from a germline mutation in the VHL gene. Germline mutation in the VHL gene lead to the development of hemangioblastomas of the central nervous system and retina, cysts and clear cell carcinoma of the kidney, cyst adenomas of other organs, and pheochromocytoma. VHL is a tumor suppressor gene on the short arm of chromosome 3. VHL disease has been classified into two main clinical subtypes depending on the presence (type 2) or absence (type 1) of pheochromocytoma. Type 2 has been subdivided into three categories depending on the presence (type 2B) or absence (type 2A) of renal cell carcinoma, with type 2C being a rare subtype in which pheochromocytoma is the sole manifestation of VHL disease. Recently we experienced a family with VHL type 1 who carry C to T (Q73X) transition in codon 217 nonsense germline mutation in exon 1 of VHL gene. The authors report this case with literature review.

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Germline mutation of Glu70Lys is highly frequent in Korean patients with von Hippel–Lindau (VHL) disease
Sena Hwang, Cheol Ryong Ku, Ji In Lee, Kyu Yeon Hur, Myung-Shik Lee, Chul-Ho Lee, Kyo Yeon Koo, Jin-Sung Lee, Yumie Rhee
Journal of Human Genetics.2014; 59(9): 488. CrossRef

Meanings of Expression of Vascular Endothelial Growth Factor in Thyroid Tumors.: Su Kyoung Kwon, Young Sik Choi, Yo Han Park, Hee Kyung Jang; J Korean Endocr Soc. 2005;20(2):134-141. Published online April 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.2.134

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BACKGROUND
Angiogenesis is essential for tumor growth and metastasis. Vascular endothelial growth factor(VEGF), also known as vascular permeability factor(VPF), is an angiogenic factor that plays important roles in tumor growth. Angiogenesis studies on VEGF deal with various types of malignant tumors, but little is known about the role or significance of VEGF in human thyroid neoplasms. Therefore, this study was performed to determine whether the VEGF expression in different histological types of thyroid tumors is altered and to see if there was a relationship between the expression of VEGF and either metastasis or the invasiveness of thyroid carcinomas. METHODS: Forty-two cases that underwent thyroidectomy at Kosin Medical Center, between March, 1999 and February, 2000, were included in this study. Of the 42 cases, 27 were malignant(26 papillary carcinoma, 1 Hurthle cell carcinoma) and 15 were benign lesions. The expression of VEGF was determined by immunohistochemistry using paraffin embedded thyroid tissue blocks, and was quantified as negative(absent), +(1~24%), ++(25~49%), +++(50~74%) and ++++(> or =75%), according to the extent of positive cells. RESULTS: VEGF was stained with red-brown colored granules in the cytoplasm of the thyroid tumor epithelium and was expressed in 27 of the 42 cases(+1, ++8, +++5, ++++13). Most malignant tumors(24 of 27 cases) were stained with VEGF, but only 3 of the 15 benign tumors cases were stained(P<0.001). When the VEGF expression was divided into ++ or below and +++ or above groups, the expression of VEGF was much more extensive in the malignant than benign tumors(P<0.001). Of the 27 malignant tumors cases, lymph node metastasis and/or invasion was noted in 13. VEGF expression was more extensive in malignant tumors with lymph node metastasis and/or invasion than in those without(P<0.001). CONCLUSION: In this study, the rate and extent of VEGF expression were greater in the malignant than the benign thyroid tumors, and also the extent of VEGF expression was the extent of VEGF greater in the malignant tumors with lymph node metastasis and/or invasion than those without

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Expression of vascular endothelial growth factor in oral squamous cell carcinoma
Seok-Kon Kim, Seung-Goo Park, Kyung-Wook Kim
Journal of the Korean Association of Oral and Maxillofacial Surgeons.2015; 41(1): 11. CrossRef

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 Relationship between Graves' Disease and Serum Immunoglobulin-E.: Hyun Young Kim, Ki Ryong Park, Seoung Hoon Kim, Jee Yeon Kim, Soo Keun Song, Young Sik Choi, Yo Han Park; J Korean Endocr Soc. 2002;17(5):640-648. Published online October 1, 2002

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Abstract PDF: BACKGROUND
It is widely believed that Graves' disease is an autoimmune disorder characterized by the presence of the circulating TSH receptor antibody (TRAb). The majority of the activity of TRAb is of the immunoglobulin G (IgG) class. However, other immunoglobulin such as immunoglobulin E (IgE), may play a role in the activity. IgE accumulation has been reported to occur in the thyroid gland and ocular muscles of subjects with Graves' disease. Furthermore, it has been noted that recurrence of Graves' disease can be induced by an allergy to pollen. Because an allergy to pollen is commonly associated with IgE, IgE might play a role in the induction of Graves' disease. Therefore, investigated whether IgE was elevated in Graves' disease, and evaluated the potential relationship between the levels of TRAb and IgE Graves' disease. METHODS: Forty-six patients with Graves' disease, and 6 with chronic thyroiditis, diagnosed at the Kosin Medical Center between April, 2000 and July, 2000 were included in this study. Thirty-five persons without thyroid disease or a history of allergic rhinitis were used as normal controls. The level of TRAb was measured using thyrotropin binding inhibitory immunoglobulin (TBII). Serum total IgE was measured using an enzymeimmunoassay method. Test for thyroid function, TBII and total IgE were performed in all cases, and the results statistically analyzed. RESULTS: TBII, as IgG, and the serum IgE level were higher in the patients with Graves' disease, and the levels of the latter were 598.1+/-1112.9U/mL, 98.5+/-79.7U/mL and controls 161.7+/-194.4U/mL in the Graves' patients, those with thyroiditis and the controls, respectively (p<0.05). The prevalence of allergic rhinitis in Graves' disease was 10.9%. The serum IgE level in Graves' disease with, and without, allergic rhinitis were 903.1+/-1152.2U/mL and 560.8+/-1117.0U/mL, respectively, although there was no significancant difference between the two groups. According to the clinical stage, the serum TBII level was higher in the untreated Graves', and relapsed patients 49.9+/-23.9% and 21.1+/-3.1%, respectively, than in the treated group, 7.4+/-18.6% (p<0.05). The serum IgE level was higher in the untreated Graves' and relapsed patients 758.6+/-1250.2U/mL and 1198.5+/-1952.1U/mL, respectively, than in the treated group 233.8+/-432.7U/mL, although this was not significant. According to the duration of treatment, the serum TBII levels were higher in the untreated Graves' patients, and those treated for less than 1 year, than in those treated for more than 1 year, with values of 49.9+/-23.9, 24.8+/-3.8 and 2.22+/-1.97%, respectively (p<0.05). The serum IgE level was higher in the untreated Graves' disease (758.6+/-1250.2U/mL) than in the groups treated for less than 12 months (158.3+/-91.5U/mL) and more than 12 months (252.7+/-483.4U/mL), but the differences were not significant. CONCLUSIONS: The concentration of IgE was high in Graves' patients, and although not statistically significant, the serum IgE level in Graves' patients with allergic rhinitis was higher than those without. With regard to the clinical stage of Graves' disease, the change in the IgE level tended to follow that of the TBII. Further study will be required to define the possible role of IgE in the pathogenesis in Graves' disease.

Molecular Diagnosis of Recurrent Thyroid Cancer by Reverse Transcription-Polymerase Chain Reaction of Thyroglobulin Messenger Ribonucleic Acid in Peripheral Blood.: Sung Il Kwon, Ki Ryong Park, Hyun Young Kim, Chae Hee Shin, Young Chan Lim, Young Sik Choi, Yo Han Park, Kang Dae Lee, Hee Kyung Chang, Jae Hwa Lee, Ha Yong Yum; J Korean Endocr Soc. 2002;17(4):501-513. Published online August 1, 2002

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Abstract PDF: BACKGROUND
Differentiated thyroid cancer is the most common endocrine malignancy. Despite advances in the treatment of thyroid cancer, disease recurrence and metastasis may occur in as many as 20% of patients, and so continues to pose major problems in its clinical management. Serum thyroglobulin (Tg) measurements, by immunoassay, are used to detect residual or recurrent thyroid cancer following thyroid ablation. However, the usefulness of immunoassay is limited by both the requirement for thyroid hormone withdrawal, to attain optimal test sensitivity, and interference by the antithyroglobulin antibody (Anti-Tg Ab). Recent studies have reported the clinical usefulness of reverse transcription-polymerase chain reaction (RT-PCR) detection of Tg mRNA in the peripheral blood of patients with differentiated thyroid carcinomas. We performed this study to evaluate the usefulness RT-PCR of Tg mRNA in peripheral blood of patients with thyroid carcinoma following a total thyroidectomy and radioiodine ablation therapy. METHODS: Forty cases that underwent a total thyroidectomy and radioiodine ablation therapy were included in this study. Of the 40 patients, 35 were papillary carcinomas and 5 were follicular carcinomas. Ten normal control subjects were also studied. Tg mRNA was extracted. Then RT-PCR, and nested RT-PCR, were run with specific Tg primers. Concurrently, DNA sequencing of the isolates was carried out to prove the isolates were identical to the nucleotide sequence of the Tg. RESULTS: The Tg was detected in 4 of 19 patients, with either a residual thyroid bed, or metastasis, on a 131I whole body scan and in 1 of 21 patients with a negative radioiodine scan. Surprisingly, the Tg mRNA was detected in all the patients and normal controls. CONCLUSION: From our results we can not recommend Tg mRNA, detected by RT-PCR in peripheral blood, as a tumor marker superior to that of the Tg serum level. We consider an intensive re-evaluation of the method is required before considering its clinical applications.

Expression of the MAGE-1, -2, -3, -4, -5, and -10 Genes in Thyroid Cancers.: Young Sik Choi, Hark Rim, Yo Han Park, Kang Dae Lee, Jae Hwa Lee, Hee Kyoung Chang; J Korean Endocr Soc. 2001;16(4-5):467-480. Published online October 1, 2001

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Abstract PDF: BACKGROUND
MAGE(melanoma antigen gene) has been named as cancer/testis specific antigens since its expression is only detected in the testis or cancer cells. Because of its relatively specific expression in cancer cells, it has been considered as a marker for the early diagnosis of several cancers, or as an appropriate target for a specific immunotherapy mediated by cytotoxic T lymphocytes. Therefore, there have been many reports concerning the expression of MAGE genes in various types of malignant tumors, although only a few reports in human thyroid neoplasms. The purpose of this study was to determine whether the MAGE-1, -2, -3, -4, -5, and -10 genes expressed in different histological types of thyroid tumors and to elucidate the clinical usefulness of MAGE genes on the diagnosis of thyroid tumors. METHODS: Thirty-eight patients who had undergone thyroidectomy at Kosin Medical Center between January and August, 1999 were included in the study. Of the 38 patients enrolled, 26 exhibited papillary carcinoma, 3 papillary carcinoma with lymph node metastasis, 1 follicular carcinoma, 1 medullary carcinoma, 5 nodular hyperplasia, 1 adenomatous goiter, and 1 follicular carcinoma. In the twelve normal control thyroid tissues, total cellular mRNA was extracted from 31 cancer tissues and 7 benign tissues, RT-PCR was run in 35 cycles, with specific primers of the subtypes of MAGE genes. With probes confirmed by DNA sequencing, the isolates were reevaluated by Southern blot hybridization. RESULTS: In the 26 papillary carcinomas, MAGE-1,-2,-3,-4,-5 and -10 genes were expressed in 88.5%, 92.3%, 3.8%, 26.9%, 26.9%, and 0% by RT-PCR respectively. In the three papillary carcinomas with regional lymph node metastasis, MAGE-1, -2 and -5 genes expressed in two of the three, and MAGE-4 in one of the three cases. In the one medullary carcinoma, the MAGE-1,-2,-4, and MAGE-5 genes were expressed, and in the one case of follicular carcinoma, only the MAGE-2 gene was expressed. In contrast, none of the 7 benign tumors and 12 normal control tissues expressed any of these MAGE genes. The sensitivity of MAGE-1,-2,-3,-4,-5 and -10 genes in thyroid tumors was 83.8%, 90.3%, 3%, 29.0%, 32.3%, and 0%, respectively and the specificity was 100%. CONCLUSION: These results demonstrate that MAGE genes were expressed in the malignant thyroid tumors but not in the benign tumors and normal tissues. Among the MAGE gene families, MAGE-1 and -2 genes were more sensitive than MAGE-3, 4,-5 and -10 genes. However, in order to demonstrate if the MAGE genes could be used for the diagnosis of follicular carcinoma and distant metastasis in thyroid tumors, further study is required.

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 .

A Case of Thyrotoxicosis During Lithium Therapy.: Young Sik Choi, Yo Han Park, Joon Chul Pyun, Dal Soo Park, Chul Hee Lee, Hyo KYun Chung, Hyun Joo Kim, Soo Yeol Ahn, Jin Sook Jun, Yong Chang Oh; J Korean Endocr Soc. 1998;13(4):629-633. Published online January 1, 2001

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Abstract PDF: Lithium has been established as a drug useful for the treatment of manic depressive disorder. It is now well recognized that long-term administration of this drug is associated with various antithyroid effects such as goiter, and subclinical and overt hypothyroidism. However, it has been associated less commonly with thyrotoxicosis. Recently we experienced a case of thyroitoxicosis during lithium therapy. A 24-year-old man treated with lithium carbonate 900 mg-1,200 mg/day for manic-depressive illness for four weeks. He then complained of nervousness, palpitation, tremor, heat intolerance, and sweating. Neck pain was not noted. At that time the results of thyroid function test were consistent with hyperthyroidism: T3 568.8 ng/dL, TSH 0.01 mU/mL, FT4 6.0 ng/dL, but 24 hr radioiodine uptake was 0.3%. We suspected this case as lithium induced thyrotoxicosis and discontinued lithium administration. After discontinuation of lithium thyrotoxic symptoms were subsided. One month later, thyroid hormon levels became normalized: T 100.2 ng/dL, TSH 0.06 mU/mL, FT4 0.97 ng/dL and 24hr radioiodine uptake was 16%. We report this case with review of literatures.

A Case of Adrenocortical Adenoma Associated with Incidental Pheochromocytoma.: Sung Jun Hong, Young Sik Choi, Yo Han Park, Byung Cheol Yoon, Young Hwan Bae, Seon Ja Park, Ja Young Koo; J Korean Endocr Soc. 1996;11(4):531-537. Published online November 7, 2019

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Abstract PDF: The coexistence of adrenal cortical tumor and pheochromocytoma was extremely rare. A total of 25 reported cases showing evidence of hyperfuction of the adrenal cortex and pheochromocytoma were noted in the literature. Of those twenty cases were coexistence of pheochromocytoma and adrenocortical hyperplasia and only five cases were coincident pheochromocytoma and adreno-cortical adenoma. Recently, we experienced a case of adrenocortical adenoma associated with incidental pheochrmocytoma. A 55-year-old woman complained of progressive weight gain and epigastric discomfort. Hormonal and radiologic studies revealed Cushings syndrome with a left adrenal tumor. Adrenalectomy was performed and the gland actually had two nodules on its surface, one pheochromocytoma and the other cortical adenoma. This patient was the first case of pheochromocytoma with adrenocortical adenoma in Korea. We report the case with a review of literature.

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.

A Case of Follicular Carcinoma Associated with Hashimoto's Thyroiditis Arising in a Thyroglossal Duct Remnant.: Jin Choi, Jun Cheol Lee, Sun Mi Park, Tae Joon Cha, Hark Rim, Young Sik Choi, Yo Han Park, Hee Kyung Chang; J Korean Endocr Soc. 1996;11(3):336-342. Published online November 7, 2019

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Abstract PDF: Thyroglossal duct remnants are common congenital abnormalities of the thyroid development but malignant tumors arising in the thyroglossal duct remnants are rare, occuring in less than 1%. In the literature, about 160 cases of malignancy in the thyroglossal duct remnant have been reported. Among the various types of carcinoma being found from the thyroglossal duct remnants, most are papillary carcinoma(79.8%) and Mixed follicular-papillary carcinoma(9.5%). Others are squamous cell carcinoma(7.6%), follicular carcinoma(1.2%), and anaplastic carcinoma(0.6%). Hashimotos thyroiditis is a common autoimmune disease of the thyroid gland. Malignant tumors of the thyroid gland with Hashimotos thyroiditis are rare disorder except malignant lymphoma whose association with Hashimotos thyroiditis is well known. Malignant tumors associated with Hashimotos thyroiditis arising in a thyroglossal duct remnant are extremely rare. Recently the authors experienced a case of follicular carcinoma associated with Hashimotos thyroiditis arising in a thyroglossal duct remnant, which was removed by local excision and reported with literature review.

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