Elevated A1C is associated with impaired early-phase insulin secretion rather than insulin resistance in Koreans at high risk for developing diabetes.

Kim, Tae Nyun,Park, Man Sik,Lee, Seong Keon,Yang, Sae Jeong,Lee, Kwan Woo,Nam, Moonsuk,Nam, Moon Suk,Park, Yong Soo,Woo, Jeong-Taek,Woo, Jeong Taek,Kim, Young Seol,Baik, Sei Hyun Macmillan Press 2012 Endocrine Vol.42 No.3

<P>The purpose of this study is to examine the association of A1C with beta-cell dysfunction, insulin resistance, and cardiovascular risk factors in Koreans with the relatively high risk for the future development of diabetes. This cross-sectional study recruited subjects from the pre-diabetic cohort of the Korea National Diabetes Program. Among study subjects (n = 616) aged 21-77 years with a history of hyperglycemia (fasting plasma glucose (FPG) 5.5 mmol/mL), analyses were conducted on 504 participants (296 women, 208 men) except for subjects with FPG 7.0 mmol/L or 120-min post-challenge plasma glucose 11.1 mmol/L or A1C 6.5 %. For insulin sensitivity and β-cell function classified by the categories of A1C levels, ?Ins(30-0)/?Glu(30-0) was lower in the highest quartile group than other groups. Although there was no significant difference in HOMA-IR according to the A1C categories, even lowest A1C group ( 5.3 %) already included many subjects with abnormal glucose tolerance. A1C showed a significant association with hsCRP, number of metabolic syndrome (MetS) components and ?Ins(30-0)/?Glu(30-0) after adjusting for age, gender, BMI, and medications whereas HOMA-IR was insignificantly associated with A1C. Stepwise regression analysis for A1C showed that A1C is independently and negatively associated with ?Ins(30-0)/?Glu(30-0), and positively associated with hsCRP. Our study showed that higher A1C was associated with impaired early-phase insulin secretion, MetS, and low grade inflammation in Koreans with the relatively high risk for the future development of diabetes.</P>

Association of urinary sodium/creatinine ratio with bone mineral density in postmenopausal women: KNHANES 2008-2011.

Kim, Sung-Woo,Jeon, Jae-Han,Choi, Yeon-Kyung,Lee, Won-Kee,Hwang, In-Ryang,Kim, Jung-Guk,Lee, In-Kyu,Park, Keun-Gyu Macmillan Press 2015 Endocrine Vol.49 No.3

<P>Accumulating evidence shows that high sodium chloride intake increases urinary calcium excretion and may be a risk factor for osteoporosis. However, the effect of oral sodium chloride intake on bone mineral density (BMD) and risk of osteoporosis has been inadequately researched. The aim of the present study was to determine whether urinary sodium excretion (reflecting oral sodium chloride intake) associates with BMD and prevalence of osteoporosis in postmenopausal women. This cross-sectional study involved a nationally representative sample consisting of 2,779 postmenopausal women who participated in the Korea National Health and Nutritional Examination Surveys in 2008-2011. The association of urinary sodium/creatinine ratio with BMD and other osteoporosis risk factors was assessed. In addition, the prevalence of osteoporosis was assessed in four groups with different urinary sodium/creatinine ratios. Participants with osteoporosis had significantly higher urinary sodium/creatinine ratios than the participants without osteoporosis. After adjusting for multiple confounding factors, urinary sodium/creatinine ratio correlated inversely with lumbar spine BMD (P?=?0.001). Similarly, when participants were divided into quartile groups according to urinary sodium/creatinine ratio, the average BMD dropped as the urinary sodium/creatinine ratio increased. Multiple logistic regression analysis revealed that compared to quartile 1, quartile 4 had a significantly increased prevalence of lumbar spine osteoporosis (odds ratios 1.346, P for trend?=?0.044). High urinary sodium excretion was significantly associated with low BMD and high prevalence of osteoporosis in lumbar spine. These results suggest that high sodium chloride intake decreases lumbar spine BMD and increases the risk of osteoporosis in postmenopausal women.</P>

Extract of Litsea japonica ameliorates blood-retinal barrier breakdown in db/db mice.

Kim, Junghyun,Kim, Chan-Sik,Lee, Ik Soo,Lee, Yun Mi,Sohn, Eunjin,Jo, Kyuhyung,Kim, Joo Hwan,Kim, Jin Sook Macmillan Press 2014 Endocrine Vol.46 No.3

<P>Loss of blood-retinal barrier (BRB) properties is an important feature in the pathology of diabetic retinopathy. Endothelium integrity is important for the normal vascular function. Litsea japonica (Thunb.) Jussieu is a Korean native plant that is consumed as a vegetable food. In this study, we evaluated the ability of an ethanol extract of L. japonica to prevent retinal vascular leakages in db/db mice, which is an animal model of type II diabetes. L. japonica extracts (LJE, 100 and 250 mg/kg) were administered once a day, orally, for 12 weeks. Vehicle-treated db/db mice exhibited hyperglycemia and retinal vascular leakage. LJE treatment blocked diabetes-induced BRB breakdown and decreased retinal VEGF expression in db/db mice. LJE also inhibited the degradation of occludin, which is an important tight junction protein. These findings support the potential therapeutic usefulness of L. japonica for retinal vascular permeability diseases.</P>

A case of fugitive acromegaly, initially presented as invasive prolactinoma.

Lim, Jung Soo,Ku, Cheol Ryong,Lee, Mi-Kyung,Kim, Tai Seung,Kim, Sun Ho,Lee, Eun Jig Macmillan Press 2010 Endocrine Vol.38 No.1

<P>Fugitive acromegaly is most commonly caused by pituitary acidophil stem cell adenomas, and is characterized by a relatively short clinical history, a large and locally invasive tumor, and relatively low hormonal activity. Here, we report an unusual case of fugitive acromegaly that initially presented as invasive prolactinoma. A 48-year-old man with a huge pituitary mass extending to the suprasellar area was referred to our hospital in December 2007. He had undergone transsphenoidal surgery in November 1999 because of a large invasive prolactinoma. The tumor had grown progressively, despite therapy with dopamine agonists. Subtle features of acromegaly were noted and serum IGF-1 levels were high (733 ng/ml). An oral glucose tolerance test revealed that basal and nadir levels of growth hormone (GH) were 1.56 and 1 ng/ml, respectively. As a therapeutic trial, long-acting octreotide (20 mg IM, monthly) was added, and the tumor size markedly reduced within 6 months on magnetic resonance imaging examination. Immunohistochemical staining of the tumor tissue obtained at the surgery in 1999 showed positive staining for GH and prolactin (PRL). Double immunofluorescence staining showed a mixed positivity for GH and PRL in the majority of tumor cells; however, the two hormones colocalized in a minority of tumor cells, indicating that the tumor was composed of three different cell types (GH, PRL, and GH/PRL). The diagnosis of fugitive acromegaly was initially overlooked in this patient because of normal serum GH levels and a lack of acromegalic features, although histological evidence for GH production was present. IGF-1 determinations would be helpful for the diagnosis of fugitive acromegaly.</P>

Intraoperative multiple-staged resection and tumor tissue identification using frozen sections provide the best result for the accurate localization and complete resection of tumors in Cushing's disease.

Lim, Jung Soo,Lee, Seung Ku,Kim, Se Hoon,Lee, Eun Jig,Kim, Sun Ho Macmillan Press 2011 Endocrine Vol.40 No.3

<P>The treatment of choice in Cushing's disease (CD) is surgical removal; however, most tumors are too small to be detected. The objective was to establish a method to achieve the complete removal of tumors on the basis of the results of high-resolution magnetic resonance imaging (MRI), inferior petrosal sinus sampling (IPSS), and a surgical resection technique using frozen biopsy. Eighteen patients who underwent transsphenoidal surgery from 2004 to 2010 were included. High-resolution MRI and IPSS, multiple-staged resection, and tumor tissue identification in frozen sections (surgical and histological identification, SHI) were performed. All patients achieved surgical remission, as confirmed by 24?h urinary free cortisol excretion tests. Visible microlesions were identified on the initial MRI in 11 patients (61%). The SHI findings agreed with the MRI findings in 10 of the 11 patients (90.9%) and with IPSS lateralization in 6 of the 11 patients (54.5%). In the 7 patients whose lesions were not visible on the initial MRI, only 1 (14.3%) showed an agreement between IPSS and SHI. In 3 of the 7 patients, the microlesions were identified by additional MRI. The rate of concordance with SHI was 77.8% for the overall MRI and 38.9% for IPSS. High-resolution MRI is better than IPSS for localizing corticotroph adenomas. In patients with lesions not visible on the initial MRI, additional MRI should be performed using a different protocol. Although high-resolution MRI is better for localizing tumors, SHI remains an important approach for removing the tumors completely.</P>

Dynamic prognostic value of the revised international prognostic scoring system following pretransplant hypomethylating treatment in myelodysplastic syndrome

Yahng, S-A,Jeon, Y-W,Yoon, J-H,Shin, S-H,Lee, S-E,Choi, Y-S,Kim, D-Y,Lee, J-H,Cho, B-S,Eom, K-S,Lee, S,Min, C-K,Kim, H-J,Lee, J-W,Lee, K-H,Min, W-S,Lee, J-H,Kim, Y-J MACMILLAN PRESS LTD 2017 BONE MARROW TRANSPLANTATION -BASINGSTOKE- Vol.52 No.4

<P>This study aimed to analyze the use of the revised International Prognostic Scoring System (IPSS-R) assessed after hypomethylating treatment (HMT) for patients with myelodysplastic syndrome (MDS) undergoing an allogeneic stem cell transplantation (SCT). Among 115 patients who received pre-SCT HMT, comparison analysis of the prognostic values between the IPSS-R at the time of HMT (IPSS-R@HMT) and at the time of SCT after HMT (IPSS-R@SCT) showed a significantly higher predictive power for overall survival (OS) of the latter. Alteration in IPSS-R risk occurred in 60%, while the patients with 'down-staged' IPSS-R@ SCT showed better OS compared with those with 'unchanged' or 'up-staged' risk. On multivariate analysis in all 201 patients, IPSS-R@ SCT, monosomal karyotype, treatment failure to pre-SCT treatment, and high hematopoietic cell transplantation-comorbidity index were independently associated with OS. Constructed using these factors, the MDS Transplantation Prognostic Scoring System (MTPSS) identified four risk groups with 4-year OS of 76.4% in low, 61.4% in intermediate-1 and 21.9% in intermediate-2 risk groups, whereas all in the high risk group died within 2 years after SCT (P<0.001). Our study emphasizes the need for further studies aiming to evaluate a transplantation prognostic model such as the MTPSS to make appropriate decisions for transplantation in MDS.</P>

Usefulness of thyroglobulin measurement in needle washouts of fine-needle aspiration biopsy for the diagnosis of cervical lymph node metastases from papillary thyroid cancer before thyroidectomy.

Kim, Dae-Weung,Jeon, Se Jeong,Kim, Chang Guhn Macmillan Press 2012 Endocrine Vol.42 No.2

<P>In evaluating cervical lymph node (LN) metastasis from papillary thyroid cancer (PTC), ultrasonography (US)-guided fine-needle aspiration biopsy (FNAB) is very important tool. There were limited number of studies about the diagnostic value of thyroglubion measurement in FNAB (FNAB-Tg) in non-thyroidectomized patients. Therefore, in this study, the authors evaluated the role of FNAB-Tg in diagnosing cervical LN metastases in patients with PTC before thyroidectomy. A total 91 suspicious LNs of 68 patients were undergone US-guided FNAB-Tg and cytology. Any FNAB-Tg concentration above 50 ng/ml considered as positive, irrespective of thyroid gland presence. Based on the final pathology, 49 LNs were positive, and the remaining 42 LNs were negative for metastasis. The sensitivity, specificity, and accuracy of FNAB-Tg in thyroidectomized patients were 80.0, 100.0, and 88.9%, respectively. The diagnostic performance of FNAB-Tg was not compromised by the presence of thyroid gland (sensitivity, specificity and accuracy = 95.0, 90.9 and 93.2%, respectively). FNAB-Tg is useful and simple method for the diagnosis of metastatic cervical LNs from PTC. The diagnostic performance of FNAB-Tg was not compromised by the presence of thyroid gland. Therefore, FNAB-Tg could be performed actively for the LN staging of PTC.</P>

Development and characterization of structured lipids containing capric and conjugated linoleic acids as functional dietary lipid molecules.

Vu, Phuong-Lan,Shin, Jung-Ah,Lee, Yun-Jeung,Nam, Ha-Young,Lee, Jeung-Hee,Akoh, Casimir C,Lee, Ki-Teak Scientific and Medical Division, Macmillan Press 2008 International journal of food sciences and nutriti Vol.59 No.2

<P>Recently, dietary oil with high diacylglycerol (DAG) contents, so called DAG-oil, was introduced in Japan and the USA. It was claimed that the oil mostly composed of DAG is metabolized differently from conventional triacylglycerol oil, reducing body weight and fat mass because DAG tends to be oxidized to provide energy rather than stored as fat in the body. Monoacylglcyerol and DAG could be prepared by lipase-catalyzed reactions including hydrolysis, esterification, and glycerolysis. In this study, modified lipid containing some DAG esterified with the health-beneficial medium-chain fatty acids and conjugated linoleic acid was produced by lipase-catalyzed reactions. Many health benefits of medium-chain fatty acids (C6:0-C12:0) and conjugated linoleic acid isomers have been reported, including anticarcinogenic and antiatherogenic activities, and being rapid energy sources for humans with little or no deposition as body fat. The produced lipid molecules in this study have potential applications as functional healthy dietary fats and oils.</P>

Change of skin color after application of topical anesthetic cream.

Kim, Hye-One,Kim, Byeong-Gyun,Shin, Jung-Won,Huh, Sun-Young,Youn, Sang-Woong,Huh, Chang-Hun,Park, Kyoung-Chan M. Dunitz and Macmillan Press 2009 The Journal of dermatological treatment Vol.20 No.6

A case of atopic dermatitis-associated lichen amyloidosis successfully treated with oral cyclosporine and narrow band UVB therapy in succession.

Kang, Min Ju,Kim, Hei Sung,Kim, Hyung Ok,Park, Young Min M. Dunitz and Macmillan Press 2009 The Journal of dermatological treatment Vol.20 No.6

<P>Lichen amyloidosis (LA) is a chronic, severely pruritic skin disease characterized by deposition of amyloid in the skin with no visceral involvement. Current treatments of LA are unsatisfactory, with high relapse rates, complications, and treatment failures. A 31-year-old woman with a history of refractory atopic dermatitis (AD) presented with pruritic, multiple, discrete papules on the extremities and back. Histopathologic examination confirmed the diagnosis of LA. A treatment regimen of oral cyclosporine and subsequent narrow band UVB (NBUVB) for a total of 8 months resulted in nearly complete regression. Although further studies are required to define the exact mechanism of action of this treatment regimen (oral cyclosporine + NBUVB), it seems to be an effective alternative in treating patients with LA and/or AD-associated LA.</P>