• Title/Summary/Keyword: endocrine therapy

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Metabolic Signaling by Adipose Tissue Hormones in Obesity (비만에서 adipose tissue 호르몬에 의한 metabolic signaling)

  • Younghoon Jang
    • Journal of Life Science
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    • v.33 no.3
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    • pp.287-294
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    • 2023
  • Healthy adipose tissue is critical for preventing obesity by maintaining metabolic homeostasis. Adipose tissue plays an important role in energy homeostasis through glucose and lipid metabolism. Depending on nutritional status, adipose tissue expands to store lipids or can be consumed by lipolysis. The role of adipose tissue as an endocrine organ is emerging, and many studies have reported that there are various adipose tissue hormones that communicate with other organs and tissues through metabolic signaling. For example, leptin, a representative peptide hormone secreted from adipose tissues (adipokine), circulates and targets the central nervous system of the brain for appetite regression. Furthermore, adipocytes secrete inflammatory cytokines to target immune cells in adipose tissues. Not surprisingly, adipocytes can secrete fatty acid-derived hormones (lipokine) that bind to their specific receptors for paracrine and endocrine action. To understand organ crosstalk by adipose tissue hor- mones, specific metabolic signaling in adipocytes and other communicating cells should be defined. The dysfunction of metabolic signaling in adipocytes occurs in unhealthy adipose tissue in overweight and obese conditions. Therapy targeting novel adipose metabolic signaling could potentially lead to the development of an effective anti-obesity drug. This review summarizes the latest updates on adipose tissue hormone and metabolic signaling in terms of obesity and metabolic diseases.

The Analysis on Clinical Characteristics of Out-Patients of Oriental Thyroid Clinic (한방병원 갑상선 클리닉 내원 환자들의 임상적 특성 분석)

  • Byun, Sang-Hyuk;Kim, Soon-Il;Kang, Ki-Hoon;Lee, Byung-Cheol;Ahn, Young-Min;Doo, Ho-Kyung;Ahn, Se-Young
    • The Journal of Internal Korean Medicine
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    • v.26 no.1
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    • pp.213-220
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    • 2005
  • Objective : Thyroid diseases are one of the most common endocrine disorders. However, the first chosen-treatments including anti-thyroidal and hormone-supplement therapy in western medicines, sometimes have failed to improve abnormal thyroid hormone secretions and clinical symptoms. Therefore, there has been a growing expectation for Oriental Medicine to take the role of alternative therapy. However, there has been little analysis of clinical characteristics. In this study, clinical characteristics of thyroidal disease patients who visited Kyung-Hee oriental hospital from January to July 2004 were analyzed. Methods : A total 86 patients diagnosed as hyperthyroidism, hypothyroidism or thyroid nodule were selected. Clinical history, including sex, age, symptoms, disease duration and methods of previous therapy and thyroidal test, such as thyroid function test (TFT), thyroid scan and other thyroid examinations. Results : In distribution of onset age and sex, the patients who have visited oriental hospital with thyroidal diseases showed similar characteristics with typical patients. In clinical symptom, the most frequent clinical sign was fatigue in both hyperthyroidism and hypothyroidism, which differs from the classical characteristics of those diseases. Most patients complained the unresolved symptoms, some of which are attributable to abnormal thyroid hormone secretions, in spite of western therapy with anti-thyroidal and hormone supplement agents. Conclusions : In oriental therapy, it will be necessary to consider the unique clinical features of thyroidal diseases different from classical patterns, and this study suggests that oriental therapy is a good alternative method for patients whose first treatment with western agents failed. Furthermore, more public information to these patients about oriental medicine would be helpful to increase cure rates, and give various choices to patients with thyroid diseases.

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Guidelines for Dental clinicians in case of medically compromised Patients: Case reports of medically compromised patients taking oral Bisphosphonate (전신질환자 구강외과 소수술시의 주의사항 -골다공증약 복용환자 수술 포함-)

  • Kim, Sun-Jong;Kim, Myung-Rae
    • The Journal of the Korean dental association
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    • v.48 no.7
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    • pp.538-546
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    • 2010
  • Dental surgical procedures are potentially stress-inducing to not only patients but clinicians especially in case of medically compromised patients. The body response to dental stress involves the cardiovascular, respiratory and the endocrine system. To minimize the stress to the medically compromised patients, the stress reduction protocols should be established. The protocols include (1) Recognize the patient's degree of medical risk (2) Medical consultation before dental therapy (3) Schedule the patient's appointment in the morning (4) Monitor and record preoperative, perioperative and postoperative vital signs (5) Intra-venous sedation during surgical procedures (6) Adequate pain control during therapy (7) Short length of appointment time (8) Contact the patients on the same day. Two cases of Bisphosphonate-related osteonecrosis of the jaws were analyzed. There were 2 women, and the mean age was 70 years (range, 64~74 years). both are medically compromised, with steroids. Both patients were taking an oral bisphosphonate for several years. BRONJ is defined as an area of exposed bone of more than 8 weeks - duration in a patient taking a bisphosphonate for bone disease. Bisphosphonates have been widely prescribed over the last decade for a range of bone diseases, mainly intravenously for bone cancers and orally for osteoporosis. Although it is still controversial as to precisely how the bisphosphonates work, generally it is accepted that they prevent osteoclast action, with consequent cessation of osteoblast activity, so that the bone turnover is markedly reduced or ceased. The aim of this study is to informed the clinicians how to prepare and recognize in case of the BRONJ with medically compromised patients.

Final height of Korean patients with early treated congenital hypothyroidism

  • Lee, Jiyun;Lee, Jeongho;Lee, Dong Hwan
    • Clinical and Experimental Pediatrics
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    • v.61 no.7
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    • pp.221-225
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    • 2018
  • Purpose: Congenital hypothyroidism (CH) is the most common endocrine disorder in children. Thyroid hormone deprivation results not only in mental retardation but also growth retardation. This study investigates the final height (FH) in Korean patients with CH detected by newborn screening and examines factors that may affect the FH. Methods: The medical records of Korean CH patients (n=45) were reviewed. The FH was examined and target height (TH) was calculated based on mid-parental height. The FH z score (FHZ) and TH z score (THZ) were computed using the 2007 Korean National Growth Chart. The FHZ and THZ were compared with a Student t test. The impact of the etiology of CH (athyreosis, dyshormonogenesis, ectopic thyoid, hypoplastic thyroid), initial serum thyroid stimulating hormone (TSH) level, initial free thyroxine (T4) level, and time of therapy initiation based on FH was assessed. Results: The mean FHZ was $0.10{\pm}1.01$ for male patients and $-0.11{\pm}1.09$ for female patients. There were no significant differences between FHZ and THZ for both female (P=0.356) and male patients (P=0.237). No significant relationship was found between FH and the etiology of CH, initial TSH level, initial free T4 level, and the time of therapy initiation. Conclusion: Early intervention and satisfactory management do not appear to impede growth in Korean patients with CH. Thus, early detection and proper management of patients with CH detected by newborn screening program are necessary.

Ratio of fat to energy intake independently associated with the duration of diabetes and total cholesterol levels in type 2 diabetes

  • Yim, Jung-Eun;Kim, Young-Seol;Cho, Mi-Ran;Choue, Ryo-Won
    • Nutrition Research and Practice
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    • v.5 no.2
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    • pp.157-162
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    • 2011
  • The importance of dietary intake in the treatment of type 2 diabetes was emphasized. This study was performed to investigate the dietary intakes of Korean type 2 diabetes patients according to the treatment and duration of diabetes and to examine the relationships between their diet and serum lipid profiles. The subjects were 111 type 2 diabetic patients who were treated by medical nutrition therapy only, oral hypoglycemic agents (OHA), or insulin with medical nutrition therapy. Dietary intake was assessed by a registered dietitian using semi-quantitative food frequency questionnaires Comparisons according to treatment type were made using covariance analyses. General linear models identified the independent effects of the different treatments after covarying for age, duration of diabetes, and 2-way interactions. There were no significant differences in age and BMI but was in duration of diabetes according to treatment type in these subjects. Carbohydrate to energy ratio was higher in the OHA group (P < 0.05), whereas the fat to energy ratio was higher in the insulin group for males (P < 0.05). Carbohydrate ($R^2$ = 0.24, P = 0.005) and fat ($R^2$ = 0.26, P = 0.02) to energy ratios were independently associated with the duration of diabetes after covarying for age, sex, treatment, and 2-way interactions. The levels of triglyceride (TG; $R^2$ = 0.32, P = 0.02) and total cholesterol (TC) were associated independently with energy intake and the carbohydrate ($R^2$ = 0.15, P = 0.02) and fat ($R^2$ = 0.15, P = 0.01) to energy ratios, respectively. The concern that the independent association of dietary intake with either duration of diabetes or dietary factors affects blood lipid levels could suggest that specific dietary recommendations may work better for identifiable groups of diabetes patients.

Regional nodal irradiation in pT1-2N1 breast cancer patients treated with breast-conserving surgery and whole breast irradiation

  • Park, Shin-Hyung;Kim, Jae-Chul
    • Radiation Oncology Journal
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    • v.38 no.1
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    • pp.44-51
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    • 2020
  • Purpose: To evaluate the necessity of regional nodal irradiation (RNI) for pT1-2N1 breast cancer patients treated with breast-conserving surgery and radiotherapy, we compared clinical outcomes of patients treated with and without RNI. Materials and Methods: We retrospectively analyzed the data of 214 pT1-2N1 breast cancer patients treated with breast-conserving surgery and whole breast irradiation from 2007-2016. There were 142 (66.4%), 51 (23.85%), and 21 (9.8%) patients with one, two, and three positive lymph nodes, respectively. Thirty-six patients (16.8%) underwent RNI. Adjuvant chemotherapy, endocrine therapy, and anti-HER2 therapy were given to 91.6%, 79.0%, and 15.0% patients, respectively. The most common chemotherapy regimen was anthracycline + cyclophosphamide, followed by taxane (76.5%). The median follow-up was 64 months (range, 6 to 147 months). Patients were propensity matched 1:2 into RNI and no-RNI groups. Results: Two patients experienced locoregional recurrences simultaneously with distant metastases, ten patients developed distant metastases, and one patient died. Before matching, the 5-year actuarial locoregional control (LRC), distant metastasis-free survival (DMFS), and overall survival (OS) rates in the RNI and no-RNI groups were 100.0% and 99.4% (p = 0.629), 94.1% and 96.0% (p = 0.676), and 100.0% and 99.4% (p = 0.658), respectively. After matching, the 5-year LRC, DMFS, and OS were 98.3% and 100.0% (p = 0.455), 96.6% and 93.9% (p = 0.557), and 100.0% and 100.0% (p > 0.999) in the RNI and no-RNI groups, respectively. No clinicopathologic or treatment-related factors were significantly associated with LRC, DMFS, or OS. Conclusion: Adding RNI did not show superior LRC, DMFS, or OS in pT1-2N1 breast cancer patients.

Oriental and Western Medical Study on the cause and treatment of Obesity (비만의 원인과 치료에 대한 동서의학적 고찰)

  • Lee, Sang-Bong;Keum, Dong-Ho;Lee, Myeong-Jong
    • The Journal of Dong Guk Oriental Medicine
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    • v.5
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    • pp.33-52
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    • 1996
  • The purpose of this study was to investigate efficient treatment in obesity. In order to help clinical application in obesity treatment, this study was performed to investigate the cause and treatment in obesity. The main finding of this study were as follows. 1. In the cause of oriental medicine in obesity, that were moisture(濕), phlegm(痰), gore(瘀), the productive heat(積熱), overeating, supemutrition, underaction, heredity and habitude, psychologic factor(stress) etc. 2. In the western medicine, the cause of obesity were genetic cause, endocrine disorder, hypothalamic extraodinary and secondary effect of drug. But simple obesity is the greater part. Also there were psychologicai and environmental causes. 3. Ear acupuncture of wide application were Naebunbi, Sinmun, Taejang, $ij{\check{o}}m$, $Pyej{\check{o}}m$, $Bij{\check{o}}m$ etc. 4. Body acupuncture of application were $Naej{\check{o}}ng$, $Sangg{\check{o}}h{\check{o}}$, Pungnyung, Kokchi, $Sam{\check{o}}mgyo$, $Umn{\check{o}}ngch{\check{o}}n$ etc. 5. In oriental medical treatment of obesity, Bangpungtongs ngsan(防風通聖散), Daesihotang(大柴胡湯), Seungkitang(承氣湯), Bangkihwangkitang(防己黃?湯), Richulsaryeungtang(二朮四笭湯), Taeksatang(澤瀉湯), Opieum(五皮飮), Gongyundan(控涎丹) etc were wide applicated. 6. The western medical treatment in obesity encourage the dietary cure, exercise cure and behavior adjustment than medical therapy or operation. In treatment of obesity, the dietary cure and herb-drug therapy, ear acupuncture and body acupuncture are effective. But weight maintenance after treating is more important. After all the continuous dietary cure, behavior adjusting cure and exercise cure are necessary.

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Effects of Methadone Maintenance Therapy on Thyroid Function of Adult Men

  • Bozchelou, Shahrzad;Delirrad, Mohammad
    • Toxicological Research
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    • v.35 no.1
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    • pp.9-12
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    • 2019
  • One of the major challenges in methadone maintenance therapy (MMT) for drug dependence is the physiological side effects on endocrine hormones. Because of the key role of the thyroid gland in the normal functioning of the human body and brain, this study examined the effect of MMT on thyroid function. Thyroid hormones (T3, T4, and thyroid-stimulating hormone (TSH)) were evaluated in normal and user treated with MMT who were referred to the Province Clinical & Pathology Center of Urmia, Iran. The study was conducted for three months using the Case Series method. A total of 270 samples were collected, 215 were from individuals who were not treated, whereas 55 were from men treated with methadone. Average levels of T3 and T4 in non-treated sample of men are $1.34{\pm}0.02ng/mL$ and $90.96{\pm}1.38ng/mL$ while the corresponding values for patients treated with methadone are $1.39{\pm}0.04ng/mL$ for T3 and $94.57{\pm}2.72ng/mL$ for T4. Mean TSH levels of the non-treated group and the methadone consuming group were $1.75{\pm}0.08{\mu}IU/mL$ and $3.17{\pm}0.45{\mu}IU/mL$, respectively. These results indicate that although men treated with methadone had higher levels of T3, T4, and TSH than normal individuals, only the difference in TSH level was significant. The importance of this difference among individuals on methadone maintenance programs should be investigated in larger samples over long periods of time. Additionally, the effects of methadone treatment on women should be examined.

Current Status of the Diagnosis and Management of Pancreatic Neuroendocrine Tumors in Japan

  • Tetsuhide Ito;Masami Miki;Keijiro Ueda;Lingaku Lee;Ken Kawabe;Hisato Igarashi;Nao Fujimori;Kazuhiko Nakamura;Kohei Yasunaga;Robert T. Jensen;Takao Ohtsuka;Yoshihiro Ogawa
    • Journal of Digestive Cancer Research
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    • v.4 no.2
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    • pp.51-57
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    • 2016
  • The epidemiology of pancreatic neuroendocrine neoplasms (PNENs) in Asia has been clarified through epidemiological studies, including one conducted in Japan, and subsequently another in South Korea. As endoscopic ultrasonography (EUS) has become more widely accessible, endoscopic ultrasound-fine needle aspiration (EUS-FNA) has been performed in pancreatic tumors for which the clinical course was only monitored previously. This has enabled accurate diagnosis of pancreatic tumors based on the 2010 WHO classification; as a result, the number of patients with an accurate diagnosis has increased. Although surgery has been the standard therapy for PNENs, new treatment options have become available in Japan for the treatment of advanced or inoperable PNENs; of particular note is the recent introduction of molecular target drugs (such as everolimus and sunitinib) and streptozocin. Treatment for progressive PNENs needs to be selected for each patient with consideration of the performance status, degree of tumor differentiation, tumor mass, and proliferation rate. Somatostatin receptor (SSTR)-2 is expressed in many patients with neuroendocrine tumor. Somatostatin receptor scintigraphy (SRS), which can visualize SSTR-2 expression, has been approved in Japan. The SRS will be a useful diagnostic tool for locating neuroendocrine neoplasms, detecting distant metastasis, and evaluating therapy outcomes. In this manuscript, we review the latest diagnostic methods and treatments for PNENs.

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Electron Microscopic Ultrastructural Changes of Leiomyoma after Treatment with D-Trp6-Luteinizing Hormone Releasing Hormone (자궁근종시 LHRH agonist (D-Trp6-LHRH) 치료에 따른 근종세포내 미세구조의 변화)

  • Park, K.H.;Shin, M.C.;Lee, B.Y.;Lee, B.S.;Song, C.H.
    • Clinical and Experimental Reproductive Medicine
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    • v.18 no.2
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    • pp.189-196
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    • 1991
  • Long-term administration of luteinizing hormone-releasing hormone(LHRH) agonists, through a process of pituitary desensitization and down-regulation of receptors, inhibits the secretion of gonadotropin and sex-steroids and induces a reversible suppression of gonadal activity. This approach can be used as an effective endocrine therapy for some hormone-dependent tumors. We have used D-Trp6-LHRH, a long acting LHRH agonist, for the treatment of eleven patients with uterine leiomyomas, thereafter myomectomy was performed in seven cases and observed the ultrastructural changes of leiomyoma with an electron microscope. The use of LHRH agonist may be effective in reducing the size of a myoma considerably by primarily inducing medical hypophysectomy and would allow easier surgical removal. Electron microscopic findings of myoma cells after the use of LHRH agonist included the following: loss of cristae and swelling nuclear chromatin, perinuclear vacuolation in cytoplasm. Bone mineral density was slightly decreased, however, the difference was not statistically significant.

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