TSH secreting pituitary adenoma is a very rare disease, but it should be carefully suspected in patients with the lack of inhibition of TSH levels in the presence of increased thyroid hormones. The clinical manifestations are similar to those of hyperthyroidism, so TSH secreting pituitary adenoma can be easily misdiagnosed as hyperthyroidism resulting in inappropriate treatment. Surgery is the treatment of choice and the long-acting somatostatin analogs are effective in reducing TSH secretion with consequent restoration of the euthyroid state in the majority. Recently, development of neuroradiological techniques and better recognition of TSH-secreting adenomas increase the rate of diagnosis as microadenoma and improve surgical cure rate in patients with TSH secreting pituitary adenoma.
Adenoma ; Humans ; Hyperthyroidism ; Pituitary Neoplasms ; Rare Diseases ; Somatostatin ; Thyroid Hormones

No abstract available.
Insulin Resistance* ; Insulin*

BACKGROUND: The blood level of alanine aminotransferase (ALT) is associated with increased coronary heart disease (CHD) risk. However, its use as an independent factor for CHD risk prediction remains unclear in Asian populations. The purpose of this study was to examine the association between serum ALT levels and CHD risk in Koreans. METHODS: This was a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey (V-1, 2010 and V-2, 2011). The ALT levels of 3,215 individuals were analyzed. The Framingham Risk Score (FRS) modified by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) was used to compute the 10-year CHD risk prediction. RESULTS: Positive correlations were established between log-transformed ALT concentration and FRS (r=0.433, P<0.001). After adjusting for body mass index, low-density lipoprotein cholesterol, the amount of alcohol intake, and gamma-glutamyl transferase, the odds ratio (95% confidence interval) for intermediate or greater risk of 10- year CHD prediction (10-year risk ≥10%) for the lowest quartile of participants was 2.242 (1.405–3.577) for the second quartile, 2.879 (1.772–4.679) for the third quartile, and 3.041 (1.789–5.170) for the highest quartile. CONCLUSION: In Koreans, a higher serum ALT concentration was significantly correlated with 10-year CHD risk prediction according to NCEP ATP III guidelines.
Adenosine Triphosphate ; Adult ; Alanine Transaminase ; Alanine ; Asian Continental Ancestry Group ; Body Mass Index ; Cholesterol ; Coronary Disease ; Cross-Sectional Studies ; Education ; Humans ; Korea ; Lipoproteins ; Nutrition Surveys ; Odds Ratio ; Risk Factors ; Transferases

Secondary hypertension can account for 15% of hypertension cases. The causes of secondary hypertension mostly come from renal diseases, such as renal parenchymal or renovascular disease, and endocrine diseases. The importance of diagnosing secondary hypertension lies in the fact that it may convert an incurable disease into a potentially curable disease. Even if the underlying disease may not be curable, being able to offer disease specific treatments may often make blood pressure control much easier. The causes of endocrine hypertension include primary aldosteronism, pheochromocytoma, Cushing's syndrome, acromegaly, hyper- or hypothyroidism, hyperparathyroidism and other mineralocorticoid hypertension (e.g. apparent mineralocorticoid excess syndrome, Liddle's syndrome). Primary aldosteronsim, pheochromocytoma, and Cushing's syndrome are among the common causes of endocrine hypertension. The first step in evaluating a patient with suspected endocrine-related hypertension is to exclude other secondary causes, particularly renal disorders. An accurate diagnosis of endocrine hypertension provides the clinician a unique treatment opportunity. This topic review will summarize rare causes of endocrine hypertension except primary aldosteronism and pheochromocytoma.
Acromegaly ; Blood Pressure ; Cushing Syndrome ; Endocrine System Diseases ; Humans ; Hyperaldosteronism ; Hyperparathyroidism ; Hypertension ; Hypothyroidism ; Mineralocorticoid Excess Syndrome, Apparent ; Mineralocorticoids ; Pheochromocytoma ; Resin Cements

Early recognition and appropriate management of diabetic peripheral polyneuropathy (DPNP) is important. We evaluated the necessity of simple, non-invasive tests for DPNP detection in clinical practice. We enrolled 136 randomly-chosen patients with type 2 diabetes mellitus and examined them with the 10-g Semmes-Weinstein monofilament examination, the 128-Hz tuning-fork, ankle-reflex, and pinprick tests; the Total Symptom Score and the 15-item self-administered questionnaire of the Michigan Neuropathy Screening Instrument. Among 136 patients, 48 had subjective neuropathic symptoms and 88 did not. The abnormal-response rates varied depending on the methods used according to the presence of subjective neuropathic symptoms (18.8% vs. 5.7%, P < 0.05; 58.3% vs. 28.4%, P < 0.005; 81.3% vs. 54.5%, P < 0.005; 12.5% vs. 5.7%, P=0.195; 41.7% vs. 2.3%, P < 0.001; and 77.1% vs. 9.1%, P < 0.001; respectively). The largest abnormal response was derived by combining all methods. Moreover, these tests should be implemented more extensively in diabetic patients without neuropathic symptoms to detect DPNP early.
Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Diabetic Neuropathies ; Diagnosis ; Humans ; Mass Screening ; Michigan ; Neurologic Examination ; Peripheral Nervous System Diseases* ; Polyneuropathies ; Surveys and Questionnaires

No abstract available.
Diabetes Mellitus, Type 2* ; Humans ; Peripheral Nervous System Diseases*

The anti-obesity activities of Rapha diet(R) preparation containing silkworm pupa peptide, Garcinia cambogia, white bean extract, mango extract, raspberry extract, cocoa extract, and green tea extract were investigated in mice with dietary obesity. Male C57BL/6 mice were fed a high-fat diet (HFD) containing 3% Rapha diet(R) preparation for 8 weeks, and blood and tissue parameters of obesity were analyzed. The HFD markedly enhanced body weight gain by increasing the weights of epididymal, perirenal, and mesenteric adipose tissues. The increased body weight gain induced by HFD was significantly reduced by feeding Rapha diet(R) preparation, in which decreases in the weight of abdominal adipose tissue and the size of abdominal adipocytes were confirmed by microscopic examination. Long-term feeding of HFD increased blood triglycerides and cholesterol levels, leading to hepatic lipid accumulation. However, Rapha diet(R) preparation not only reversed the blood lipid levels, but also attenuated hepatic steatosis. The results indicate that Rapha diet(R) preparation could improve HFD-induced obesity by reducing both lipid accumulation and the size of adipocytes.
Abdominal Fat ; Adipocytes ; Animals ; Body Weight ; Bombyx ; Cacao ; Cholesterol ; Diet, High-Fat ; European Continental Ancestry Group ; Garcinia cambogia ; Humans ; Male ; Mangifera ; Mice ; Obesity ; Pupa ; Tea ; Triglycerides ; Weights and Measures

The anti-inflammatory effects of an ethanol extract of Angelica gigas (EAG) were investigated in vitro and in vivo using croton oil-induced inflammation models. Croton oil (20 microgram/mL) up-regulated mRNA expression of cyclooxygenase (COX)-I and COX-II in the macrophage cell line, RAW 264.7, resulting in the release of high concentrations of prostaglandin E2 (PGE2). EAG (1~10 microgram/mL) markedly suppressed croton oil-induced COX-II mRNA expression and PGE2 production. Application of croton oil (5% in acetone) to mouse ears caused severe local erythema, edema and vascular leakage, which were significantly attenuated by oral pre-treatment with EAG (50~500 mg/kg). Croton oil dramatically increased blood levels of interleukin (IL)-6 and PGE2 without affecting tumor-necrosis factor (TNF)-alpha and nitric oxide (NO) levels. EAG pre-treatment remarkably lowered IL-6 and PGE2, but did not alter TNF-alpha or NO concentrations. These results indicate that EAG attenuates inflammatory responses in part by blocking the COX-PGE2 pathway. Therefore, EAG could be a promising candidate for the treatment of inflammatory diseases.
Angelica/*immunology ; Animals ; Cell Line ; Cyclooxygenase 1/genetics/*immunology ; Cyclooxygenase 2/genetics/*immunology ; Dinoprostone/genetics/immunology ; Inflammation/drug therapy/enzymology/*immunology ; Interleukin-6/blood ; Macrophages ; Male ; Mice ; Mice, Inbred ICR ; Nitric Oxide/blood ; Phytotherapy/*methods ; Plant Extracts/*pharmacology/therapeutic use ; Plant Roots/immunology ; RNA, Messenger/chemistry/genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Tumor Necrosis Factor-alpha/blood

The effects of polarized-light therapy (PLT) on high-cholesterol diet (HCD)-induced hypercholesterolemia and atherosclerosis were investigated in comparison with that of lovastatin in rabbits. Hypercholesterolemia was induced by feeding male New Zealand white rabbits with 1% cholesterol in diet for 2 weeks and maintained with 0.5% cholesterol for 6 weeks, followed by normal diet for 2 weeks for recovery. Lovastatin (0.002% in diet) or daily 5-min or 20-min PLT on the outside surface of ears was started 2 weeks after induction of hypercholesterolemia. Hypercholesterolemic rabbits exhibited great increases in serum cholesterol and low-density lipoproteins (LDL) levels, and finally severe atheromatous plaques formation covering 57.5% of the arterial walls. Lovastatin markedly reduced both the cholesterol and LDL, but the reducing effect (47.5%) on atheroma formation was relatively low. By comparison, 5-min PLT preferentially decreased LDL, rather than cholesterol, and thereby potentially reduced the atheroma area to 42.2%. Notably, 20-min PLT was superior to lovastatin in reducing both the cholesterol and LDL levels as well as the atheromatous plaque formation (26.4%). In contrast to the increases in blood alanine transaminase and aspartate transaminase following lovastatin treatment, PLT did not cause hepatotoxicity. In addition, PLT decreased platelets and hematocrit level. The results indicate that PLT attenuates atherosclerosis not only by lowering blood cholesterol and LDL levels, but also by improving blood flow without adverse effects. Therefore, it is suggested that PLT could be a safe alternative therapy for the improvement of hypercholesterolemia and atherosclerosis.
Alanine Transaminase ; Aspartate Aminotransferases ; Atherosclerosis ; Blood Platelets ; Cholesterol ; Diet ; Ear ; Hematocrit ; Humans ; Hypercholesterolemia ; Lipoproteins, LDL ; Lovastatin ; Male ; Plaque, Atherosclerotic ; Rabbits

According to a high anti-osteoporotic efficacy of Sigma Anti-bonding Molecule Calcium Carbonate (SAC), repeated-dose toxicities of SAC were investigated to assess its feasibility as drug or functional food ingredient. Male ICR mice were given drinking water containing 0.006, 0.02 or 0.06% SAC for 4 weeks. SAC feeding decreased the body weights and feed and water consumptions of mice in a dose-dependent manner, especially, leading to severe emaciation and 70% death in 3 weeks in the high-dose (0.06%) group. Not only kidney and heart weights, but also the levels of blood urea nitrogen, creatinine, aspartate transaminase, and creatine phospokinase significantly increased after SAC administration, indicative of nephrotoxicity and cardiotoxicity. Such renal and cardiac toxicities were also confirmed by microscopic findings, exhibiting renal crystals and cardiac fibrosis, which may be due to the insoluble crystal formation and calcium overload, respectively. In conclusion, it is suggested that no observed adverse effect level of SAC is lower than 0.006% in mice, and that a long-term intake may cause serious adverse effects on renal and cardiac functions.
Animals ; Aspartate Aminotransferases ; Blood Urea Nitrogen ; Body Weight ; Calcium ; Calcium Carbonate ; Creatine ; Creatinine ; Drinking Water ; Emaciation ; Fibrosis ; Functional Food ; Heart ; Humans ; Kidney ; Male ; Mice ; Mice, Inbred ICR ; No-Observed-Adverse-Effect Level ; Weights and Measures