Insulin is the most effective drug for reducing blood glucose in patients with diabetes commonly. But it has negative aspect for diabetic patients to change from oral hypoglycemic drug to insulin injection. Insulin injection makes patients feel reducing self-esteem and QOL (quality of life). So they complain depressive moods. Multiple insulin injection has an effect on patient's emotion more negatively than one or two injection of insulin. It is suggested that physicians much more concern about self-esteem and emotional aspect of patients when they prescript insulin
Anxiety ; Blood Glucose ; Depression ; Diabetes Mellitus ; Humans ; Insulin ; Quality of Life

No abstract available.
Thioctic Acid*

No abstract available.
Atherosclerosis* ; Oxidative Stress*

No abstract available.
Angiomyoma ; Ear

No abstract available.
Cushing Syndrome* ; Glucose* ; Humans ; Metabolism*

The polyglandular autoimmune syndrome is constellation of multiple endocrine insufficiencies often associated with diseases of nonendocrine organs occurring in individual patients and their families. In 1980, Neufeld classified this syndrome into three major types. Type II is characterized by adrenocortical insufficiency, autoimmune thyroiditis, and insulin-dependent diabetes mellitus. We experienced a case characterized by adrenocortical insufficiency, autoimmune thyroiditis, and ovarian failure and report with the review of the literature. A 38-year-old woman visited our clinic because of progressing brown colored pigmentation of skin and mucosa which is developed a year ago. Nine years ago prior to visit, amenorrhea was developed after right oophrectomy. Three years ago, she revealed feature of hyperthyroidism such as palpitation, loss of body weight (8kg/1-2years), heat intolerance, and sweating, so received antithyroid therapy for 14 months. Brown colored pigmentation of skin and mucosa, especially scar and gingiva, has been progressively aggravated during last year. She had no past or family history of other endocrine disease. Diffuse pigmentation of skin, loss of axillary and pubic hair, and diffuse enlargement of both thyroid glands were shown on physical examination. Blood cell count, serum chemistry and blood sugar test were all within normal range. Basal hormone levels were T3-uptake 29.7% (30~40), T3 153 ng/dL (85~185), T4 7.5ug/dL (5.5~11.5), TSH 2.4 IU (0.34~3.5), anti-TG antibody <100 U/mL (0~100), anti-microsome antibody <50 U/mL (0~100), TBII (thyrotropin binding inhibiting immunoglobulin) 2.2% ( (-15)~15), ACTH 989 pg/mL (0~37), cortisol 0.1 ug/dL (5~25), renin 7.1ng/mL/hr (1~2.5), aldosterone 81.0pg/mL (50~194), LH 115.2 mIU/mL (0.6~16.8), FSH 122 mIU/mL (1.6~19.0), and estradiol <10.0pg/mL (30~120). In ACTH stimulation test, levels of basal cortisol, 30 minutes, and 60 minutes were <0.1, <0.1, and <0.1 g/dL respectively. And, in glucagon stimulation test, levels of basal C-peptide, 5 minutes, 10 minutes, and 15 minutes were 0.9, 5,1, 6.3, and 5.5 ng/dL respectively. Thyroid scan showed diffuse enlargement of bilateral thyroid glands and pelvic ultrasonogram showed atrophy of left ovary. We administered corticosteroid, estrogen, and progesterone which were deficient to the patient, and has followed up the clinical course of the patient.
Adrenocorticotropic Hormone ; Adult ; Aldosterone ; Amenorrhea ; Atrophy ; Blood Cell Count ; Blood Glucose ; Body Weight ; C-Peptide ; Chemistry ; Cicatrix ; Diabetes Mellitus, Type 1 ; Endocrine System Diseases ; Estradiol ; Estrogens ; Female ; Gingiva ; Glucagon ; Hair ; Hot Temperature ; Humans ; Hydrocortisone ; Hyperthyroidism ; Mucous Membrane ; Ovary ; Physical Examination ; Pigmentation ; Progesterone ; Reference Values ; Renin ; Skin ; Sweat ; Sweating ; Thyroid Gland ; Thyroiditis, Autoimmune ; Ultrasonography

No abstract available.
Anemia, Pernicious* ; Osteoporosis*

Background: Multiple endocrine neoplasia type I(MEN I) is a rare, eomplex, and potentially lethal disease. In Korean, only five anecdotal cases were reported as yet. The authors rescently experienced four cases of MEN I, and analysed the clinieal characteristics of MEN I in Koreans. Methods: The authors evaluated nine cases of MEN I, retrospectively. Four cases were analysed by clinical records in patients admitted to Asan Medical Center and five cases were reviewed by previously reported Korean literature from 1986 to 1995. Results: The average age was 39 years(ranged from 33 to 59 years). Eight of the nine patients had hyperparathyroidism documented by elevated serum calcium and PTH level with or without evidence of parathyroid mass. Initial presenting manifestations were symptomatic urinary stone, hypoglycernia due to insulinoma, hypogonadism, acromegaly, or peptic ulcer. Eight of nine patients had pancreatic islet cell tumors, and three of them were be malignant by radiologic and/or pathologic findings. The pancreatic tumors produced various hormones, such as gastrin, insulin, glucagon, or combination of them. Six of the nine cases had pituitary lesion. The most cornmon pituitary tumor was prolactinoma and the remaining was GH or GH and TSH producing tumor. In addition to the major components of MEN I, four had adrenocortical hyperplasia or adenoma and two had carcinoid tumor. There was only one familial case. Conclusion: The clinical charateristics of MEN I in Korean are mostly not different from the previous reports except older age at diagnosis, more comrnon adrenal involvement(44%) and gastrointestinal carcinoid tumor(22%). Although only one case was familial, more cases could be found if careful screening were done for the family members of the MBN I patients. In addition, screening and close follow up for endocrine pancreatic tumors are required for MEN I patients without detectable pancreatic lesion becau~se the malignant potential of pancreatic tumors has beeome an increasing concem for the prognosis of MEN I.
Acromegaly ; Adenoma ; Asian Continental Ancestry Group ; Calcium ; Carcinoid Tumor ; Chungcheongnam-do ; Diagnosis ; Follow-Up Studies ; Gastrins ; Glucagon ; Humans ; Hyperparathyroidism ; Hyperplasia ; Hypogonadism ; Insulin ; Insulinoma ; Islets of Langerhans ; Mass Screening ; Multiple Endocrine Neoplasia Type 1 ; Multiple Endocrine Neoplasia ; Peptic Ulcer ; Pituitary Neoplasms ; Prognosis ; Prolactinoma ; Retrospective Studies ; Urinary Calculi

Amelanotic maliganat melanoma is a comparatively rare disease. It accounts for 1.8~8.1% of all malignant melanoma. It is sometime difficult to diagnose amelanotic malignant melanoma because there is no pigmentation, clinically. Polypoid melanoma is a variant of nodular melanoma, which in depth seldom reaches the reticular dermis. The main part of the tumor is located above the nearby epidermis, raised in the form resembling cauliflower. We report a rare case of amelanotic malignant melanoma with polypoid feature in a 78-year-old woman who presented a single bright red nodule on the left thigh.
Aged ; Brassica ; Dermis ; Epidermis ; Female ; Humans ; Melanoma ; Melanoma, Amelanotic ; Pigmentation ; Rare Diseases ; Thigh

BACKGROUND: Activated fibrinolysis during cardiopulmonary bypass(CPB) is one of the causes of post CPB coagulopathy. Antifibirinolytics such as tranexamic acid have been administered prophylactically before CPB to decrease postCPB bleeding. However, their routinely application has been challenged as regarding it's thrombotic complication. This study was performed to evaluate the effect of tranexamic acid administered before CPB by thromboelastography. METHODS: 50 open heart surgical patients were randomly selected and devided into two groups, control(N=25) and tranexamic acid group(N=25). In tranexamic acid group. 125mg of tranexamic acid were singly infused before vena caval and aortic cannulation. All of parameters of thromboelastography (TEG) and fibrin degradation products measured before and after CPB were compared between two groups. RESULTS: There were no significant differences in fibrinolytic indexes of TEGs between control group and tranexamic group afte CPB. And there were also no changes in fibrinolysis index between before and after CPB in both groups. The concentration of FDP did not changed after CPB in both groups. CONCLUSIONS: It may be considered that prophylactic administration of tranexamic acid before CPB to reduce post-CPB bleeding would not be recommended routinely.
Catheterization ; Fibrin Fibrinogen Degradation Products ; Fibrinolysis* ; Heart* ; Hemorrhage ; Humans ; Thoracic Surgery* ; Thrombelastography ; Tranexamic Acid*