No abstract available.
Growth Hormone*

BACKGROUND: Insulin resistance syndrome shows extreme insulin resistance and is associated with acanthosis nigricans. We can differentiate it into type A insulin resistance that has insulin receptor defect, and type B insulin resistance due to insulin receptor autoantibody. Type B insulin resistance was firstly described by Kahn in 1976. It was often found in adult female and showed autoimmune characteristics. As clinical characteristics, there are hyperglycemia, hypoglycemia, hyperinsulinemia, extreme insulin resistance and acanthosis nigricans. METHODS: We investigated 17 insulin receptor autoantibody positive cases and 8 cases of normal control who had visited Wonju Christian Hospital from October 1994 to December 1995. Among insulin receptor autoantibody positive subject, male was 4 cases and female 13 cases. Their mean age was 42.2. We compared patients who had insulin receptor antibody positive acanthosis nigricans(IRA) with normal controls. IRA patients were 6 cases(35.3%) of nomal glucose tolerance, 11 cases(64.7%) of abnormal glucose tolerance including overt diabetes mellitus. RESULTS: The 11 cases(64.7%) among IRA patrents were obese and 13 cases(76.5%) had hyperininsulinemia. In IRA patients, mean serum insulin concentration during oral glucose tolerance test was 202.1mU/mL and it was greater than 46.3 of normal controls. Insulin sensitivity in 1.79mg/L * mM * xmU * min normal controls was higher than 0.74mg/L * mM * min of IRA patients. CONCLUSION: IRA patients showed abnormal glucose tolerance including overt diabetes millitus, severe insulin resistance, hyperinsulinemia and obesity.
Acanthosis Nigricans* ; Adult ; Diabetes Mellitus ; Female ; Gangwon-do ; Glucose ; Glucose Tolerance Test ; Humans ; Hyperglycemia ; Hyperinsulinism ; Hypoglycemia ; Insulin Resistance ; Insulin* ; Male ; Obesity ; Receptor, Insulin*

No abstract available.
Diagnosis* ; Growth Hormone* ; Humans*

The polyglandular autoimmune(PGA) syndrome designate as the dysfimction of endocrine and nonendocrine systems involving two or more organs on the basis of an autoimmune mechanism. There are 3 types of PGA syndrome and their etiology or pathogenesis is still not complete by understood. Type I PGA is present in the patients who have at least two of the triad of Addison's disease, hypopacathyroidism, and chronic mucocutaneous candidiasis. Type II PGA is present in the those who have Addisons disease with autoimmune thyroid disease and/or insulin dependent diabetes mellitus, but who do not have hypoparathyroidism or candidiasis. Type III PGA is present in the one who have autoimmune thyroid disease, without Addisons disease, but with another autoimmune disease report a case of autoimmune polyglandular syndrome type II in a seventy-three years old female patient who had primary adrenal insufficiency, primary hypothyroidism, and empty sella, pulmonary tuberculosis.
Addison Disease ; Autoimmune Diseases ; Candidiasis ; Candidiasis, Chronic Mucocutaneous ; Diabetes Mellitus ; Female ; Humans ; Hypoparathyroidism ; Hypothyroidism ; Insulin ; Polyendocrinopathies, Autoimmune ; Thyroid Diseases ; Tuberculosis, Pulmonary

No abstract available.

No abstract available.
Leydig Cell Tumor*

The adrenocartical carcinoma is a rare tumor with an estimated incidence of 1 case per 1,700,000 population. Despite its rarity, a large number of investigators have studied this neoplasm for the following two reasons. The First is the occasional difficulty of differentiation between careinoma and adenoma at the time of initial surgery, even by histopathologic examination. The other is its unique feature of corticosteroidogenesis. Steroid metabolism of adrenocortieal carcinoma is characterized by its low efficiency of steroid production due to deficiency of steroidogenic enzyme. The deficieney of 11 B-hydroxylase has been indieated in case of adrenoeortical carcinoma by several investigators. In this study, the serum level of cortisol was within normal range, but the serum level of 11-deoxycortisol was 50 times higher than normal. After the removal of tumor, the serum level of ll-deoxycortisol was markedly decm. In conclusion, the results from the this case suggest that measurement of serum 11-deoxy- cortisol may be a useful tool in the diagnosis and follow-up of adrenocortical carcinoma.
Adenoma ; Adrenocortical Carcinoma* ; Cortodoxone ; Diagnosis ; Follow-Up Studies ; Humans ; Hydrocortisone ; Incidence ; Metabolism ; Reference Values ; Research Personnel

No abstract available.
Hypertension, Renovascular*

The occurrence of the small intestinal adenocarcinoma is infrequent and the primary adenocarcinoma of the jejunum is rare. The survival of adenocarcinoma of the small bowel does not improve over the past three decades. Although symptoms appeared to be of long duration, most patients were diagnosed with advanced disease. All reports agree that these tumors are difficult to achieve good examination of the small bowel by both clinician and radiologist, so it cause a significant delay in diagnosis. The survival of these tumors appear to correlate with stage at presentation, and therefore early and aggressive diagnostic intervention seems to improve the outlook. We report a case of primary jejunal adenocarcinoma assoeiated with iron deficiency anemia with literatures review.
Adenocarcinoma* ; Anemia, Iron-Deficiency ; Diagnosis ; Humans ; Jejunum

BACKGROUND: Lack of sunlight exposure is the primary reason for the worldwide epidemic of vitamin D deficiency. Although recommended sunlight exposure guidelines exist, there is no evidence regarding whether current guidelines are optimal for increasing vitamin D levels among individuals with vitamin D deficiency.METHODS: Sixty Korean adults aged 20–49 years with serum 25-hydroxyvitamin D (25[OH]D) levels of < 20 ng/mL were randomly assigned to three groups: sunlight exposure (n = 20), vitamin D supplementation groups (n = 20), and daily living (n = 20) for 1 month. The sunlight exposure group had sunlight exposure on 20% to 30% of their body surface areas for 30–60 minutes per day, 3 times a week during the summer season. Vitamin D supplementation was prescribed with 800 IU/day of vitamin D. The serum levels of 25(OH)D were measured at baseline and at 1-month follow-up examinations.RESULTS: The largest change in serum 25(OH)D was observed among the vitamin D supplementation group (+3.5 ng/mL, P < 0.001). The sunlight exposure group showed a slight increase in serum 25(OH)D level, but the absolute increase was less than one-third that of the vitamin D supplementation group (+0.9 ng/mL, P = 0.043). Only two participants in the sunlight exposure reached serum concentrations of 25(OH)D ≥ 20 ng/mL at follow-up. The daily living group showed no difference in vitamin D levels (−0.7 ng/mL, P = 0.516).CONCLUSION: Sunlight exposure was not sufficient to overcome vitamin D insufficiency or deficiency in the current study subjects. Effectiveness of current sunlight exposure guidelines among various populations should be reassessed in larger clinical studies.TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0002671
Adult ; Body Surface Area ; Follow-Up Studies ; Humans ; Information Services ; Seasons ; Solar System ; Sunlight ; Vitamin D Deficiency ; Vitamin D ; Vitamins