• Title/Summary/Keyword: Endocrine disease

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The long-term prognostic impact of sentinel lymph node biopsy in patients with primary cutaneous melanoma: a prospective study with 10-year follow-up

  • Portinari, Mattia;Baldini, Gabriele;Guidoboni, Massimo;Borghi, Alessandro;Panareo, Stefano;Bonazza, Simona;Dionigi, Gianlorenzo;Carcoforo, Paolo
    • Annals of Surgical Treatment and Research
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    • v.95 no.5
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    • pp.286-296
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    • 2018
  • Purpose: Sentinel lymph node (SLN) biopsy (SLNB) is widely accepted for staging of melanoma patients. It has been shown that clinico-pathological features such as Breslow thickness, ulceration, age, and sex are better predictors of relapse and survival than SLN status alone. The aims of this study were to evaluate the long-term (10-year) prognostic impact of SLNB and to determine predictive factors associated with SLN metastasis, relapse, and melanoma specific mortality (MSM). Methods: This was a prospective observational study on 289 consecutive patients with primary cutaneous melanoma who underwent SLNB from January 2000 to December 2007, and followed until January 2014, at an Italian academic hospital. Results: SLN was positive in 64 patients (22.1%). The median follow-up was 116 months (79-147 months). Tenyear disease-free survival and melanoma specific survival were poor in patients with positive SLN (58.7% and 66.4%, respectively). Only the increasing Breslow thickness resulted independently associated to an increased risk of SLN metastasis. Cox regression analysis showed that a Breslow thickness >2 mm was an independent predictor of relapse, and male sex and Breslow thickness >2 mm was a predictor of MSM. At 10 years, SLN metastasis was not significantly associated to either relapse or MSM. Conclusion: After the fifth year of follow-up, SLN metastasis is not an independent predictive factor of relapse or mortality which are mainly influenced by the characteristics of the primary tumor and of the patient. Patients with a Breslow thickness >2 mm regardless of the SLN status should be considered at high risk for 10-year relapse and mortality.

Effect of Oral Administration of Houttuynia Cordata Extract on Benign Prostatic Hyperplasia (전립선비대증의 어성초추출물에 의한 경구투여 효과)

  • Song, Won-Yeong;Choi, Jeong-Hwa
    • Journal of Life Science
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    • v.29 no.6
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    • pp.705-711
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    • 2019
  • Benign prostatic hyperplasia (BPH) is the most common urogenital disorder in men, benign tumor and is a typical disease deteriorating the quality of old men's lives, and its prevalence increases with age. Though the molecular pathogenesis of BPH has not yet been clearly revealed, it is known that the variation and aging of the endocrine including sex hormone may cause BPH. Especially the hypertrophy of the prostate cell by the formation of the excessive dihydrotestosterone (DHT) is estimated to cause BPH. If testosterone exists excessively in blood, a lot of DHT is produced in prostate by $5{\alpha}-reductase$. Thus, in this study we tried to analyze haematological change and histopathological change by using the model rat with BPH caused by hypodermic injection of testosterone to prove the effect of Houttuynia cordata extracts on BPH. Rats were divided into four experimental groups: no treatment group (N), the testosterone injection and D.W treatment group (DO), the testosterone injection and Houttuynia cordata treatment group (HO) and testosterone injection and finasteride treatment group (FO). Prostate weight, volume and weight ratio in the HO and FO groups were significantly lower than the DO group. Testosterone and DHT levels in the HO group were significantly lower than the DO group. The HO and FO groups showed trophic symptoms and were lined by flattened epithelial cells, thus, the stromal proliferation is relatively low as compared to the DO group. These results suggest that Houttuynia cordata may control benign prostatic hyperplasia.

The Parathyroid Gland: An Overall Review of the Hidden Organ for Radiologists (부갑상선: 부갑상선 영상에 익숙하지 않은 영상의학과 의사들을 위한 전반적인 검토)

  • Suho Kim;Jung Hee Shin;Soo Yeon Hahn;Haejung Kim;Myoung Kyoung Kim
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.327-344
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    • 2024
  • Parathyroid glands are small endocrine glands that regulate calcium metabolism by producing parathyroid hormone (PTH). These are located at the back of the thyroid gland. Typically, four glands comprise the parathyroid glands, although their numbers may vary among individuals. Parathyroid diseases are related to parathyroid gland dysfunction and can be caused by problems with the parathyroid gland itself or abnormal serum calcium levels arising from renal disease. In recent years, as comprehensive health checkups have become more common, abnormal serum calcium levels are often found incidentally in blood tests, after which several additional tests, including a PTH test, ultrasonography (US), technetium-99m sestamibi parathyroid scan, single-photon-emission CT (SPECT)/CT, four-dimensional CT (4D-CT), and PET/CT, are performed for further evaluation. However, the parathyroid gland remains an organ less familiar to radiologists. Therefore, the normal anatomy, pathophysiology, imaging, and clinical findings of the parathyroid gland and its associated diseases are discussed here.

A Study on the Incidence of Thyroid Cancer in Gender Ultrasound (초음파검사에서 성별에 따른 갑상샘 암의 빈도에 관한 연구)

  • Kwak, Eun-Suk;Lim, Cheong-Hwan;Yang, Oh-Nam
    • Journal of radiological science and technology
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    • v.38 no.2
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    • pp.145-153
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    • 2015
  • Thyroid nodules are an endocrine disease often found in clinical practice, and patients with thyroid nodules found by chance have rapidly increased alongside development of thyroid ultrasound techniques for health examination purposes. This study analyzes the subjects' general characteristics, thyroid ultrasounds, and fine needle aspiration cytology in order to find out the relationship between male and female thyroid nodules and thyroid cancer frequency. An ultrasound examination of the thyroid was performed for 32,973 individuals who visited the K Hospital of Health Examination. Subjects have no history of thyroid disease and are 20 years old or over. Data of general characteristics, diabetes) was collected by a written survey completed by the subject, and the ultrasound of the thyroid(thyroid nodules existence, size, number) and FNAC was used to find out the malignancy rate. Frequency of patients with thyroid nodule was 4,611(26.1%) in men and 5,341(34.9%) in women between 32,973 individuals. Women's prevalence rate is significantly higher than men, and the prevalence rate significantly increased with age in men and women(p < 0.05). The prevalence of multiple nodules was significantly higher in women(43.5%) than in men(35.6%), and significantly increased with age in men and women(p < 0.05). The fine needle aspiration cytology was performed in 692(men 342, women 350) subjects who showed signs of malignancy through ultrasound. Prevalence of malignancy of the nodules was higher in men(33.3%) than in women(29.4%) although it is not statistically significant. It is known that thyroid nodule prevalence in women is much higher than in men. But this study shows the men's prevalence rate was not too low compared with women, and the men showed a rather higher malignancy rate in nodules than women. It is considered that the role of thyroid ultrasound is both important in men and women.

Effects of Dansambohyultang on the Gastrointestinal Mucosa of Rats Stressed by Heating, Immobilization and Starvation (단삼보혈탕(丹蔘補血湯)이 Stress로 유발(誘發)된 백단삼보혈탕(白丹蔘補血湯)이 Stress로 유발(誘發)된 백서(白鼠) 위장관(胃腸管)의 조직손상(組織損傷)에 미치는 영향(影響))

  • Ryu, Bong-Ha;Park, Dong-Won;Ryu, Ki-Won;Kong, Hyun-Sig
    • The Journal of Internal Korean Medicine
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    • v.21 no.1
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    • pp.74-86
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    • 2000
  • Objectives : This is the experimental paper to study the curative and preventive effects of Dansambohyultang, Methods : Oriental herb medicine for gastro-intestinal disease caused by stress, on the rats put under the stress through starvation, heating and immoblization, the author used four different group; the normal group, which was not put under stress and well fed, and the control group, to which the drug was not administered and put under the stress through starvation, heating and immoblization, the Sample I, to which the drug was administered before they were put under stress, the Sample lI, to which the drug was administered after they were put under stress. Results : When a Masson's trichrome stain method was applied to the control group, a small size of ulcer was found in the fundus and the pylorus, and atrophy was observed in the neck region of mucous membrane. When the drug was administered to the Sample I and the Sample II, the former recovered from the ulcer and atrophy to almost normal and showed better results than the latter. When a Masson's trichrome stain method was applied to the control group, atrophy of mucous membrane was found all over the intestines. When the drug was administered to the Sample I and the Sample ll, the curative and recovered effects was seen in both, but the former showed better results than the latter. After application of Mayer's hematoxylin stain method, the observation of numerical changes of goblet cells in the small intestines showed the most significant decrease in the control group. In the Sample I, the number of the cells in the duodenum, the jejunum and the ileum returned to an almost normal level. In the Sample II, a slight increase was observed only in the ileum. After application of Mayer's hematoxylin stain method, the observation of numerical changes of goblet cell in the large intestines showed a significant decreased in the control group. Both the Sample I and the Sample II showed an increase in the number of goblet cells in comparison with the control group. When a serotonin-immunoreaction test was applied, the control group showed a general decrease in the number of gastro-entero-endocrine cells, The Sample I showed the effect in all over gastro.intestinal tract as compared with control group and the Sample II showed the effect in all over gastro-intestinal tract except the duodenum and the former showed better results than the latter. Conclusion : According to the above results, the regions which are most sensitive to stress were observed to the ileum and the colon. It was concluded that Dansambohyultang has a remedical value particularly on the abnormalities caused by stress in all over gastro-intestinal tract and it was found to be more effective in the Sample I than in the Sample ll. Judging from the fact that the Sample I showed better results than the Sample ll, Dansambohyultang can be said to have a preventive effect more than a curative effect on gastro-intestinal tract disease.

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A Clinical Study on Nodular Thyroid Disease (결절성 갑상선 질환에 대한 임상적 고찰)

  • Lee Gyu-Joon;Park Soon-Tae;Ha Woo-Song;Kwon Soo-In;Choi Sang-Kyeon;Hong Soon-Chan;Lee Young-Joon;Lee Young-Jae
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.2
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    • pp.244-252
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    • 1998
  • The thyroid nodules are the most common endocrine disease requiring surgical management. We perfomed a clinical study of 298 cases with thyroid nodules, who were admitted to and operated at the Department of Surgery, College of Medicine, Gyeong sang National University from January 1987 to April 1997 and the results were summarized as follows: 1) Patients were composed of 214 cases(71.8%) of benign nodule and 84 cases(28.2%) of malignant nodule. Benign and malignant nodules were prevalent in fifth decade. 2) The sex distribution showed a preponderance of females with ratio of 5.88:1 in benign nodule and 11:1 in malignant nodule. 3) The nodules were located in the right lobe(134 cases, 44.9%), the left lobe(121 cases, 40.6%), both lobes(34 cases, 11.4%), and isthmus(8 cases, 2.7%). The possibility of malignancy was higher in the solid rather than cystic lesions. 4) Radioactive iodine scintiscans were perfomed in 273 cases and revealed cold nodules in 237 cases(86.8%), 58 of these cases(24.4%) were malignant. 5) According to the histopathologic classification, benign nodules included follicular adenomas 136 cases(63.5%), adenomatous goiters 67 cases(31.3%), Hurthle cell adenomas 4 cases(1.9%), cysts 3 cases(1.4%) and thyroiditis 4 cases(1.4%). In malignant nodules, papillary carcinomas 72 cases(85.7%), follicular carcinoma 8 cases(9.5%), undifferentiated carcinoma 2 cases(2.4%), medullary carcinoma 1 case(1.2%) and malignant lymphoma 1 case(1.2%). 6) The most commonly performed operative procedure was a lobectomy with isthmusectomy(85.5%) for bengn nodules and a total thyroidectomy(51.2%) for malignant nodules. 7) The rate of complications was higher in the cases with malignant nodules(20.2%) than in the benign cases(0.5%). The recurrence rate was 8.3%(7 cases).

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Evaluation of the Congenital Hypothyroidism for Newborn Screening Program in Korea: A 14-year Retrospective Cohort Study (한국인 선천성 갑상선기능저하증에 대한 신생아선별검사의 14년간의 후향적 연구; 발생빈도와 유효성)

  • Yoon, Hye-Ran;Ahn, Sunhyun;Lee, Hyangja
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.19 no.1
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    • pp.1-11
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    • 2019
  • Purpose: Congenital hypothyroidism (CH) is the most common congenital endocrine disorder. The purpose of the present study was to determine the incidence of CH in South Korea during the period from January 1991 to March 2004. Methods: Central data from each city branch of SCL (Seoul Clinical Reference Laboratories) in Yongin, South Korea, was gathered and collectively analyzed. Newborn screening (NBS) for CH was based on measuring the levels of neonatal thyroid stimulating hormone (TSH) and free T4 (a cut-off of 20 mIU/L and less than 0.8 ng/dL, respectively). Results: During the study period, 671,805 live births were screened for CH based on TSH and free T4 ELISA assays. A total of 159 newborns were deemed positive for CH out of 671,805, with a corresponding incidence of 1 in 4,225. When a cut-off of 20 mIU/L was used in TSH assays, the associated sensitivity, specificity, and positive predictive values (PPV) were 100.0%, 99.7%, and 10.8%, respectively. When a cut-off of 0.8 ng/dL in free T4 assays was used, the associated sensitivity, specificity, and PPV were 100.0%, 98.5%, and 3.9%, respectively. Conclusion: CH incidence in South Korea as evidenced by the results of NBS was compared with its incidence and comparable to the other countries prior to 2004.

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Molecular and Phenotypic Characteristics of Patients with Pseudohypoparathyroidism: Single Center's Experience (가성부갑상선기능저하증 환자의 분자유전학적 및 임상적 특징: 단일기관의 경험)

  • Kim, Min-ji;Yoon, Ju Young;Yoo, Sukdong;Lee, Jun;Cheon, Chong Kun
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.21 no.1
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    • pp.7-14
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    • 2021
  • Purpose: Pseudohypoparathyroidism (PHP) is caused by genetic and epigenetic alteration in the GNAS locus, and characterized by the resistance to multiple hormones and the Albright's hereditary osteodystrophy (AHO) phenotype. This study investigated the phenotypic characteristics and molecular features of PHP. Methods: Eight patients who diagnosed as PHP were enrolled at Pusan National University Children's hospital and clinical features, biochemical and genetic findings were retrospectively reviewed. Results: Of a total of 8 patients, 5 were diagnosed with PHP1a, and 3 were diagnosed with PHP1b. Patients with PHP1a had three different mutations in the GNAS gene, and patients with PHPIb had imprinting defect in differentially methylated regions (DMRs) of the GNAS locus. Two novel GNAS variants were identified in patients with PHP1a, including c.313-2A>T and c.1094G>A. All patients with PHP1a displayed AHO features; short stature (80%), brachydactyly (80%), a round face (80%), obesity (40%), heterotopic ossification (60%), and intellectual disability (60%), whereas only one patient (33.3%) with PHP1b showed AHO feature such as a round face. When phenotypic features between PHP1a and PHP1b patients were compared, patients with PHP1b showed a tendency of higher current height standard deviation scores (SDS) compared to patients with PHP1a, (-3.2±2.1 vs.-1.1±0.8; P=0.06) Conclusions: This study summarizes the phenotypic and genetic features of the PHP patients. Although we found considerable clinical overlap between PHP1a and PHP1b, further long-term follow-up is needed to evaluate the growth and development of children with PHP, as well as the effects of end-organ resistances to endocrine hormones.

The Effects of $1{\alpha}-(OH)D_3$ and Pamidronate on Steroid Induced Osteoporosis (SIO) in Children with Nephrotic Syndrome (NS) (신증후군 환아에서 스테로이드에 의한 골다공증 치료에 $1{\alpha}-(OH)D_3$와 Pamidronate의 효과)

  • Kim Sung-Do;Jhon Hye-One;Cho Byoung-Soo
    • Childhood Kidney Diseases
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    • v.6 no.2
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    • pp.209-217
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    • 2002
  • Purpose : Corticosteroid has been used as the mainstay therapy of childhood NS. But SIO is one of the serious complications of long-term steroid therapy, especially in growing children. Recently calcium, calcitonin, PTH, vitamin D and bisphosphonate has been used to treat or prevent SIO in adult, which is rare in children with NS. We studied the effect of $1{\alpha}-(OH)D_3$ and Pamidronate on SIO using dual energy X-ray absorptiometry (DEXA). Patients and methods : We studied thirty patients who admitted in the Dept. of Pediatrics of Kyung Hee Medical Hospital with NS. All patients was received longterm steroid therapy. There was no history of bone, liver, or endocrine disease. The samples, serum protein, albumin, BUN, creatinine, calcium, phosphorus, and BMD were obtained before and the six months after the dose of $1{\alpha}-(OH)D_3$ and Pamidronate, respectively Results : The mean age was $6.9{\pm}3.3\;and\;6.5{\pm}2.5$ years old. The mean duration of steroid therapy was $28.8{\pm}1.8\;and\;27.6{\pm}1.0$ months. The changes of serum protein, albumin, BUN, creatinine, calcium and phosphorus level between pre-treatment and post-treatment did not show statistical significance in both $1{\alpha}-(OH)D_3$ and Pamidronate treatment group. However, BMD was increased in both from $0.472{\pm}0.12\;and\;0.457{\pm}0.10\;g/cm^2\;to\;0.533{\pm}0.12$ and $0.529{\pm}0.09\;g/cm^2$ after treatment. (P<0.05) Conclusion : Both $1{\alpha}-(OH)D_3$ and Pamidronate appears to be effective in treating and preventing SIO in children with nephrotic syndrome requiring long-term steroid therapy.

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A study on Hospital based Home Health Care Service and the Level of Client Satisfaction (일 대학 병원의 가정간호시범사업 서비스 내용 및 만족도에 대한 조사연구)

  • Kim Chung Nam;Kwan Young Sook;Koh Hyo Jung;Kim Myung Ae;Park Chung Ja;Shin Yeong Hee;Lee Byung Sook;Lee Kyung Hee;Seo Hanng Suk
    • Journal of Korean Public Health Nursing
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    • v.14 no.2
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    • pp.246-259
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    • 2000
  • The purpose of this study was to assess the provided home health care services and to evaluate the patient's satisfaction level of received home health care services. Well trained two home health care nurses interviewed with 138 respondents who received home health care by Keimyung University Hospital from January 1st to August 31st 1999. The results were summarized as follows : 1) Among 138 respondents, $55.8\%$ were mail and $44.2\%$ were female and $70.3\%$ of them were over sixty years old. Respondents main family care givers were spouse$(53.6\%)$, daughters and sons$(36.2\%)$ and parents$(7.2\%)$. 2) $60.2\%$ of cancer patients received home health care services, $23.3\%$ of cerebral­cardiovascular patients, $7.5\%$ of endocrine disorder patients, $2.3\%$ of those who have indwelling foley catheter patients, $1.5\%$ of those who have respiratory problems and others$(5.2\%)$. 3) $88.1\%$ of respondents were satisfied with the number of home visits they received. $50.5\%$ of respondents' were received 1 to 3 times of home visits by home health care nurse per month. $48.6\%$ of respondents answered they were introduced by attending doctors or nurses to home health care services. $55.8\%$ of respondents answered registration to home health care services was simple and easy. $97.4\%$ of respondents answered home health care payment system was adequate. $64.9\%$ of respondents answered the cost of home health care per visit was adequate and comfortable. 4) Health education, counselling, physical assessment was provided to most of the patients. Those who suffered with cerebral-cardiovascular disease was needed hands on direct care most of all. The least home health care service provided was medication. 5) The satisfaction measurement tool was composed with 13 items and 3 score scale. The mean score of satisfaction on provided home health care services was 2.67 out of 3. Among 13 items. 'home health care service was kind enough' was highest(2.84). 'nurse use precise word to understand and communicate'. 'nurse gave home visiting notice ahead of time and kept the home visiting promise on time' was 2.83. 'whenever I need home health care nurse I can give a call and meet the nurse' was lowest 2.41. Special Home Health care programs such as comprehensive hospice care programs for elders over sixty years old should be organized. Adequate and standardized home health care payment system should be developed as soon as possible. In korean family situation. when family members are getting sick and stay at home. family members were taking care of the patients. special program such as counselling family members are needed.

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