Journal of Korean Endocrine Society最新文献

{"title":"A Case of Pseudohypoparathyroidism without Albright's Hereditary Osteodystrophy in an Adult","authors":"Yoonbum Lee, J. Roh, J. Yoo, J. Han, J. Nam, M. Cho, J. Park, C. Ahn, K. Kim","doi":"10.3803/JKES.2009.24.2.132","DOIUrl":"https://doi.org/10.3803/JKES.2009.24.2.132","url":null,"abstract":"Pseudohypoparathyroidism is a rare disease caused by resistance to parathyroid hormone, and is associated with typical clinical typical symptoms such as tetany and seizures, hypocalcemia, hyperphosphatemia and increased parathyroid hormone levels. Pseudohypoparathyroidism is classified to Type Ia, Ib, Ic and II according to the clinical and biochemical manifestations. Type Ia and Ic have morphological characteristics called Albright's hereditary osteodystrophy. Type Ib differs from type II for the pathogenesis. Type Ib mayreceptors and type II maypathway, but the pathophysiology of type II is not clear yet. Administration of parathyroid hormone extract may help to distinguish between the two types. We report a case of a pseudohypoparathyroidism type Ib or II patient who had tetany, hypocalcemia and hyperphosphatemia with normal morphologic features.","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134131451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Six Cases of Congenital Adrenal Hyperplasia That Were Due to 17α-hydroxylase/17,20-lyase Deficiency","authors":"D. Shin, S. Yu, Y. Choi, Jung Gu Kim, S. W. Kim, C. Shin, K. Park, S. Kim","doi":"10.3803/JKES.2009.24.2.109","DOIUrl":"https://doi.org/10.3803/JKES.2009.24.2.109","url":null,"abstract":"α-hydroxylase/17,20-lyase deficiency is a rare phenotype of congenital adrenal hyperplasia (CAH), and this is characterized by hyporeninemic hypertension, primary amenorrhea and abnormality of the secondary sexual characteristics (pseudohermaphroditism in men). This typ e of CAH is usually misdiagnosed at first as mineralocorticoid induced hypertension with primary aldosteroni sm, but primary amenorrhea with deficient sex hormone is a clue for making the correct diagnosis. The authors experienced 6 cases of 17α -hydroxylase/17,20-lyase deficiency in patients who ranged from 15 to 42 years of age. 4 cases were diagnosed according to the investigation of their mineralocorticoid-induced hypertension and 2 cases their primary amenorrhea and sexual infantilism. All of them had hypokalemia, hyporeninemic hypertension and an atrophied uterus and ovaries. In the genotypic male (46 XY), the testicles were atrophied in the abdominal cavity. The levels of cortisol, estrogen and dehydroepiandroste rone sulfate (DHEAS) were low, but the levels of progesterone and 11-deoxycorticosterone were high. Therefore, the diagnosis of 17α-hydroxylase/17,20-lyase deficiency should be considered in female patients who present with both sexual infantilism and mineralocorticoid hypertension. We report on these cases with a brief review of the literature. (J Korean","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129769634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of Growth Regulatory Factors in Medullary Thyroid Carcinoma Cell Line","authors":"Y. Jo, M. Shong","doi":"10.3803/JKES.2009.24.2.84","DOIUrl":"https://doi.org/10.3803/JKES.2009.24.2.84","url":null,"abstract":"84 갑상선암의 임상 경과는 활동성이 미약한(indolent) 경우 에서부터 가장 공격적인 종양에 이르기까지 다양한 것으로 알려져 있다. 이러한 다양한 경과를 보이는 갑상선암의 치료 는 갑상선 유두암, 갑상선 여포암, 갑상선 수질암 및 역형성 암과 같은 조직학적 유형에 따라 여러 방법이 시행되고 있 는데, 어느 경우에 해당되든지 수술적 치료가 근간을 이루고 있다. 분화암의 경우 수술 후 T4 억제요법과 방사성 요오드 치료가 전신요법으로 사용되나, 방사성 요오드 치료에 저항 성을 갖는 분화 갑상선암, 수질암 및 역형성암 등은 현재로 선 수술 후 특별한 치료방법이 없는 실정이다[1]. 최근 5년 간 갑상선암의 분자생물학적 발생기전에 관련된 연구가 집 중적으로 이루어지고 표적치료제가 개발되어 1상부터 3상까 지 다양한 단계의 임상연구에 진입해 있지만 아직까지 임상 의에게 확신을 주는 치료제의 개발은 이루어지지 않은 실정 이다. 갑상선 수질암의 경우에도 신 등이 기술한 바와 같이 Sorafenib이나 Sunitinib과 같은 키나아제 억제제(kinase inhibitor)들이 임상연구에 진입해 있으나, 그 효과가 기대에 미치지 못 하고 있다[2]. 따라서, 본 연구에서와 같이 갑상선 수질암 세포주에 대한 여러 가지 약물의 성장 억제 효과를 검증하는 것은 매우 의미 있는 연구로 사료된다. 신 등[3]의 연구에서 dexamethasone, estradiol-17-beta, progesterone 및 somatostain과 같은 호르몬과 세포 내 cAMP를 증가시키는 것으로 알려진 forskolin을 사용하여 갑상선 수질암 세포주인 TT 세포주의 성장과 calcitonin 분 비의 변화양상을 확인하였는데, 호르몬에 의한 갑상선 수질 암 세포주의 성장 지연과 calcitonin 분비 억제는 이전의 연 구에서 다양한 작용기전을 통해 이루어질 것으로 제시된 바 있다. 또한, 신 등이 기술한 forskolin에 의한 RET/PTC 종 양유전자 억제기전도 TSH/cAMP 신호체계를 활성화하여 sodium/iodide symporter (NIS)의 발현을 증가시키고 이를 통 해 갑상선 유두암의 분화를 유도하는 것으로 알려져 있다[4]. Calcitonin receptor (CTR)은 네 개의 동형(isofrom)이 알 려져 있는데, calcitonin을 왕성하게 분비하는 TT 세포주의 경우 CTR2를 발현하는 것으로 보고되어 있다[5]. 또한, 신 등의 연구에서와 같이 dexamethasone을 처리할 경우 TT 세 포주의 성장을 억제할 뿐만 아니라, calcitonin의 발현이 감 소하고 반대로 CTR2의 발현이 증가하는 것으로 알려져 있 다. 이는 TT 세포주에 calcitonin과 CTR2의 자가분비 조절 기전이 존재하며 이러한 조절기전이 TT 세포주의 성장에 중요한 역할을 함을 시사한다. 또한, dexamethasone이 calcitonin의 발현을 억제함으로써 calcitonin과 CTR2의 자 가분비 조절기전에 영향을 미쳐 TT 세포주의 성장을 억제 하는 것으로 추측할 수 있다. 한편, dexamethasone을 사용 한 다른 연구에서는 흥미로운 관찰결과를 제시한 바 있는데, dexamethasone이 CA-77 (rat medullary thyroid cancer cell line) 세포주에서 분비되는 alpha-amidating activity를 50~70%까지 감소시킨다는 것이다. 반면, calcium과 같은 calcitonin secretogogue를 처리하면 CA-77 세포주에서 분 비되는 alpha-amidating enzyme activity가 증가하는 것으로 도 알려져 있다. 이러한 결과는 CA-77 세포주의 성장과 caltonin의 분비가 alpha-amidating activity에 연관되어 있으 며, dexamethasone과 같은 호르몬이 이러한 alpha-amidating activity에 영향을 미침으로서 CA-77 세포주의 성장을 억제 함을 시사한다[6]. 이러한 연구결과들은 종합해 볼 때, dexamethasone은 갑상선 수질암 세포주에서 calcitonin의 합성 및 분비와 관련된 다양한 단계에 작용함을 추측할 수 있다. Dexamethasone과 관련된 또 다른 연구에서도 갑상선 수 질암 세포의 성장에 호르몬이 중요한 역할을 수행함을 시사 하는 자료를 제시하고 있다. C-cell에서의 calcitonin 분비는 calcium signaling 이외에도 intracellular 3'5'-cyclic adenosine monophosphate (cAMP)에 의해 촉진된다. 흥미 갑상선 수질암 세포주 증식에 영향을 주는 물질 탐색","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130168125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous Pregnancy and Delivery in a Patient with Sheehan's Syndrome","authors":"Y. Choo, W. Yoo, Do Hee Kim, Hyun-Kyung Chung, Hee Jin Kim","doi":"10.3803/JKES.2009.24.2.121","DOIUrl":"https://doi.org/10.3803/JKES.2009.24.2.121","url":null,"abstract":"Sheehan's syndrome is postpartum hypopituitarism due to the necrosis of the pituitary gland. It is usually the result of severe hypotension or shock caused by massive hemorrhage during or after delivery. Patients with Sheehan's syndrome have varying degrees of anterior pituitary hormone deficiency. They are accompanied with amenorrhea and ovulation dysfunction, and so they rarely get pregnant naturally. Ovulation induction is necessary if these patients desire to become pregnant. However, spontaneous pregnancy may be possible in some patients who have a preserved gonadotrophin reserve. We experienced a case of 29-year-old woman who was diagnosed Sheehan's syndrome 20 months after delivery and we medicated her with prednisolone and thyroxine. She got pregnant spontaneously after 18 months of hormone replacement therapy although she had amenorrhea and irregular menstrual cycles. She successfully delivered a baby by cesarean section. Here we report on this case with a review of the relevant literature concerned with pregnancy and Sheehan's syndrome.","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114088395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Fulminant Type 1 Diabetes Mellitus Complicated with Ischemic Ileitis","authors":"S. Oh, Ju Ri Park, Y. Lee, Heejung Kim, J. Seo, N. Kim, K. Choi, S. Baik, D. Choi, S. Kim","doi":"10.3803/JKES.2009.24.2.116","DOIUrl":"https://doi.org/10.3803/JKES.2009.24.2.116","url":null,"abstract":"Fulminant type 1 diabetes is characterized by diabetes with an abrupt onset, severe metabolic acidosis at diagnosis, a low HbA1c level and negativity for islet cell-related autoantibodies, and this illness has been classified as type 1B diabetes by the WHO. The prevalence of this disease is higher in Japan than any other country and recently, there have been an increasing number of such case reports in Korea. Genetic factors and environmental factors such as virus infection and an immune mechanism have been suggested as the mechanism of the pathophysiology, but this remains to be clarified. We report here on a case of fulminant type 1 diabetes with ischemic ileitis in a 44 year-old male, and we include a review of the relevant literature. (J Korean Endocr Soc 24:116~120, 2009) ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":"104 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131211310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gly1057Asp Polymorphism of the Insulin Receptor Substrate-2 Genes May Not Have a Significant Impact on Insulin Resistance in Korean Women with Polycystic Ovary Syndrome","authors":"J. Oh, Jee-young Oh, Y. Sung, Hyejin Lee, H. Chung","doi":"10.3803/JKES.2009.24.2.100","DOIUrl":"https://doi.org/10.3803/JKES.2009.24.2.100","url":null,"abstract":"Background: Insulin resistance is a key factor in the pathogenesis of polycystic ovary syndrome (PCOS), and several candidate genes involved in insulin action such as insulin receptor or insulin recpetor substrate (IRS) have been investigated. In this study, we examined the genetic effects of the IRS-1 and IRS-2 genes on the metabolic and reproductive features in women with PCOS. Methods: 125 patients with PCOS and 344 regular cycling controls were enrolled. Analysis of the polymorphisms of Gly972Arg in the IRS-1 gene and Gly1057Asp in the IRS-2 gene was performed and oral glucose tolerance tests and hyperinsulinemic euglycemic clamp tests were done. Results: The genotype frequencies of the Gly972Arg polymorphism in the IRS-1 gene and the Gly1057Asp polymorphism in the IRS-2 gene were not significantly different between the women with PCOS and the controls. Gly972Arg polymorphism of the IRS-1 gene was extremely rare in both groups. PCOS women with the IRS-2 Asp1057Asp genotype showed significantly higher hirsutism scores, higher levels of free testosterone and higher post-load 60, 90, and 120 min plasma glucose levels compared to those women with the Gly1057Gly or Gly1057Asp genotype. In contrast, the control women with the Asp1057Asp genotype showed significantly lower post-load 60, 90, and 120 min plasma glucose levels compared with those women with the Gly1057Gly or Gly1057Asp genotype. Conclusion: Gly972Arg polymorphism of the IRS-1 gene was extremely rare in Korean women. Gly1057Asp polymorphism of the IRS-2 gene was associated with the phenotypic features of PCOS such as hirsutism, hyperandrogenemia and hyperglycemia, but it was not associated with the insulin sensitivity index. In conclusion, Gly1057Asp polymorphism of the IRS-2 gene may not have a significant impact on insulin resistance in Korean women with PCOS. (J Korean Endocr Soc 24:100~108, 2009) ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":"67 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120843034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Pseudopseudohypoparathyroidism with Normal Stature","authors":"S. Kim, Y. Doh, Hee Kyung Kim, S. Moon, J. Y. Lee, Jae-Han Jeon, Soo Won Kim, B. W. Kim, In-Kyu Lee, J. G. Kim","doi":"10.3803/JKES.2009.24.2.138","DOIUrl":"https://doi.org/10.3803/JKES.2009.24.2.138","url":null,"abstract":"Pseudopseudohypoparathyroidism (PPHP) is characterized by the phenotype of Albright hereditary osteodystrophy (AHO) alone without biochemical evidence of multihormone resistance, which is unlike pseudohypoparathyroidism. AHO is associated with characteristic developmental abnormalities that include a short stocky stature, a short neck, brachydactyly, a round face, central obesity, mental retardation and subcutaneous ossifications. AHO is an autosomal dominant disease that’s caused by heterozygous inactivating mutations in the Gsα gene (GNAS1). Melanocortin-4 receptor (MC4R) is a hypothalamic Gs-coupled receptor that is thought to mediate the central effect of leptin on satiety. MC4R mutations cause morbid obesity starting in infancy, as well as an elevated leptin level. A 62 year old man with a height of 171.5 cm, a round face, a short neck, central obesity and brachydactyly had normal ranges of serum calcium, phosphorus and PTH and a normal Ellsworth-Howard test. GNAS1 gene analysis revealed substitution of alanine to cysteine in the 165 codon of exon 6 and substitution of alanine to cysteine in the 231 codon of exon 9. Two known SNPs (Cyt-1042Thy, Gua-719Ade) in the MC4R were detected in the patient. We report here on a case of PPHP and the patient had normal stature. We propose that MC4R may have contributed to the obesity & normal","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":"65 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122902512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Insulin Resistance and Its Clinical Application","authors":"Ji Hoon Kim, Lee Young Lee, S. Lee","doi":"10.3803/JKES.2009.24.2.75","DOIUrl":"https://doi.org/10.3803/JKES.2009.24.2.75","url":null,"abstract":"인슐린은 1922년, Banting 등[1]에 의해 처음 발견된 이 래 당뇨병의 치료에 널리 이용되고 있으며, 생체 내 포도당 대사 및 생명 현상의 유지에 필수적인 펩타이드 호르몬이다. 인슐린은 근육과 지방 조직에서 포도당이 흡수되어 적절히 이용되게 하고, 간에서 당신생을 억제하여 혈중 포도당을 일 정하게 유지하는 작용을 한다. 인슐린은 이러한 전통적인 대 사작용 외에도 뇌, 췌장 베타세포, 심장, 혈관내피세포 등에 작용하는데 대사작용과 연계하여 생명 현상을 조절한다. 대표 적인 예로 인슐린은 혈관내피세포에서 phosphatidylinositol 3-kinase (PI3K)를 경유하는 세포 내 신호전달체계를 통하 여 nitric oxide (NO)를 생성함으로써 혈관확장 효과를 나타 내고, mitogen-activated protein kinase (MAPK)를 경유하 는 세포 내 신호전달체계를 통해 강력한 혈관 수축 물질인 endothelin-1 (ET-1)을 생성하여 혈관수축작용을 나타내는 데, 건강한 상태에서는 이 두 가지 신호전달체계가 적절히 균형을 이루고 있지만, 이 균형이 깨어지게 되면 각종 병적 인 상태가 나타나게 된다[2]. 인슐린 저항성이란 1936년, 더 많은 용량의 인슐린이 치료에 필요한 당뇨병 환자를 기술하 면서 처음 제안된 개념으로[3], 전통적으로 인슐린 감수성이 감소한 상태, 즉 인슐린 매개 포도당 흡수와 간에서의 당신 생을 억제하는 인슐린의 대사 작용에 대한 반응이 감소한 상태를 일컫는다. 인슐린 저항성은 제2형 당뇨병의 발생에 주된 역할을 할 뿐만 아니라 이와 관련된 고혈압, 비만, 관 상동맥질환, 이상지질혈증 등의 주요 보건 문제와 더불어 이 들 대사질환과 심장혈관질환들의 집합체로 정의되는 대사증 후군의 핵심적인 원인요소로 잘 알려져 있다[4]. 전 세계적 으로 비만한 인구의 폭발적인 증가는 제2형 당뇨병의 발생 률과 유병률, 그리고 이와 관련된 심혈관계 합병증의 급격한 증가로 이어지고 있다[5]. 따라서 인슐린 저항성을 인체와 실험 동물에서 정확하게 측정하여 인슐린 저항성의 유병률 과 병태생리학적인 기전, 치료 효과, 인슐린 저항성을 가진 환자의 임상 경과 등을 규명하고 이를 임상에 적용하는 것 은 매우 중요하기 때문에 인슐린 저항성을 정확히 측정하는 방법을 고안하는 것은 매우 중요하다. 본 지상강좌에서는 인 슐린 저항성의 측정을 위하여 개발된 각종 기법들에 대해서 설명하고, 이를 임상 연구와 환자의 진료에 적용하는데 도움 이 되고자 하였다.","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114269214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Therapeutic Strategies for Fat Induced Insulin Resistance","authors":"C. Choi","doi":"10.3803/JKES.2009.24.2.65","DOIUrl":"https://doi.org/10.3803/JKES.2009.24.2.65","url":null,"abstract":"제2형 당뇨병뿐만 아니라 대사증후군 발생의 핵심인자로 생각되고 있는 인슐린 저항성은 생리적 인슐린 농도에서 인 슐린의 작용(인슐린 감수성: Insulin sensitivity)이 저하된 대 사 상태로 정의할 수 있다. 많은 인슐린 작용 중 당질 및 지 질대사에 대한 작용이 감소된 상태가 대사성 질환의 발병과 깊은 연관성을 나타내어 이를 일반적으로 인슐린 저항성이 라 정의한다. 좀 더 구체적으로 인슐린은 근육으로 포도당섭 취를 촉진하거나 간에서 포도당생성을 억제함으로 혈당을 조절하는데 인슐린이 부족하지 않은 상태에서 이러한 인슐 린 작용이 감소된 상태를 의미한다[1~3]. 제2형 당뇨병은 고 혈당을 공통적 요소로 보이지만 많은 다양한 원인에 의한 질환군으로 인슐린 저항성은 제2형 당뇨병 환자의 대부분 에서 특징적이고 공통적으로 관찰되며[1~3], 제2형 당뇨병 환자의 당뇨병이 발병하지 않은 자식에서 이미 인슐린 저 항성을 보이는 경우가 있고[4], 전향적연구에서 인슐린 저 항성이 제2형 당뇨병 발생의 가장 강력한 예측인자이며[5], 인슐린 저항성을 호전시킴으로 당뇨병 발병을 예방할 수 있다는 연구결과[6]를 근거로 제2형 당뇨병의 대부분을 차 지하는 비만 및 고지방식이 관련 당뇨병에서는 일반적으로 인슐린 저항성이 선행하는 일차적인 원인으로 생각되고 있 다(Fig. 1).","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125139944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Graves' Disease Accompanied by Pheochromocytoma: Report of a Case","authors":"Jin Hwa Kim, Sang Jun Lee, J. Shin, M. You, Jae Sik Jung, Sang Yong Kim, H. Bae","doi":"10.3803/JKES.2009.24.2.126","DOIUrl":"https://doi.org/10.3803/JKES.2009.24.2.126","url":null,"abstract":"We present here a rare case of Graves' disease accompanied by pheochromocytoma, and the patient showed normal urine and serum levels of catecholamines and their metabolites. A 45-year-old woman was referred to our hospital for the evaluation of a right adrenal incidentaloma that was detected by chest computed tomography. She had been diagnosed with Graves' disease 1 month previously. She had no symptoms of pheochromocytoma such as hypertension or a history of hypertension attack. Two consecutive 24-hour urine samples were sent to the lab for measurement of the catecholamines, and both samples showed normal levels of metanephrine and vanillylmandelic acid (VMA). After right adrenalectomy was performed, the final pathological diagnosis was adrenal pheochromocytoma. This case suggests that the onset of Graves' disease may be associated with excess catecholamine secreted by a pheochromocytoma. In addition, although the conventional method for detecting pheochromocytoma is to identify an increase of the urine catecholamines, physicians should be aware of the possibility of false negativity on this test. (J Korean Endocr Soc","PeriodicalId":119859,"journal":{"name":"Journal of Korean Endocrine Society","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2009-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133186918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}