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1.
The Korean Journal of Internal Medicine ; : 347-355, 2018.
Article in English | WPRIM | ID: wpr-713537

ABSTRACT

BACKGROUND/AIMS: Non-alcoholic fatty liver disease is associated with insulin resistance. Compound K (CK) is the final metabolite of panaxadiol ginsenosides that have been shown to exert antidiabetic effects. However, the molecular mechanism of the antidiabetic effects in the liver have not been elucidated; further, whether CK has beneficial effects in hepatosteatosis remains unclear. Therefore, we evaluated the effect of CK on hepatosteatosis as well as its mechanism in high-fat diet (HFD)-fed type 2 diabetic Otsuka Long-Evans Tokushima Fatty (OLETF) rats. METHODS: Twenty-four-week-old male OLETF rats were assigned to four groups: control (saline), CK 10 mg/kg, CK 25 mg/kg, or metformin 300 mg/kg (positive control); all treatments were administered orally for 12 weeks. RESULTS: Fasting glucose levels of the CK25 group were significantly lower than those of the control group during the 12 weeks. The results of the oral glucose tolerance test showed that both the glucose concentration after glucose loading and the fasting insulin levels of the CK25 group were significantly lower than those of the control. Hepatosteatosis was significantly improved by CK25. CK25 and metformin significantly increased the phosphorylation of hepatic adenosine monophosphate-activated protein kinase (AMPK). CK25 significantly inhibited the expression of sterol regulatory element-binding protein-1c and fatty acid synthase, while upregulating that of peroxisome proliferator-activated receptor-α and carnitine palmitoyltransferase-1. CONCLUSIONS: CK improved glucose intolerance and hepatosteatosis in HFD-fed OLETF rats through AMPK activation, which has dual mode of action that involves decreasing the synthesis of fatty acids and increasing fatty acid oxidation.


Subject(s)
Animals , Humans , Male , Rats , Adenosine , AMP-Activated Protein Kinases , Carnitine , Diabetes Mellitus, Type 2 , Diet, High-Fat , Fasting , Fatty Acids , Ginsenosides , Glucose Intolerance , Glucose Tolerance Test , Glucose , Insulin , Insulin Resistance , Liver , Metformin , Non-alcoholic Fatty Liver Disease , Peroxisomes , Phosphorylation , Protein Kinases , Rats, Inbred OLETF
2.
Korean Journal of Bone Metabolism ; : 59-65, 2012.
Article in Korean | WPRIM | ID: wpr-130866

ABSTRACT

Parathyroid carcinoma is very rare in patients with primary hyperparathyroidism, only accounts for 1% to 2% of all cases. It is characterized by higher incidence of renal dysfunction, metabolic bone disease and gastrointestinal symptoms. Although the clinical manifestations of hyperparathyroidism are more severe in patients with parathyroid carcinoma when compared to those with those with parathyroid adenoma, it is difficult to differentiate carcinoma from adenoma without pathologic confirmation. To our knowledge, there have only been a few cases of hyperparathyroidism due to parathyroid carcinomas reported to date. Here, we report a case of 63-year-old woman developing osteoporosis, hypercalcemia and hypophosphatemia due to a parathyroid tumor and was diagnosed with parathyroid carcinoma postoperatively.


Subject(s)
Female , Humans , Middle Aged , Adenoma , Bone Diseases, Metabolic , Hypercalcemia , Hyperparathyroidism , Hyperparathyroidism, Primary , Hypophosphatemia , Incidence , Osteoporosis , Parathyroid Neoplasms
3.
Korean Journal of Bone Metabolism ; : 59-65, 2012.
Article in Korean | WPRIM | ID: wpr-130863

ABSTRACT

Parathyroid carcinoma is very rare in patients with primary hyperparathyroidism, only accounts for 1% to 2% of all cases. It is characterized by higher incidence of renal dysfunction, metabolic bone disease and gastrointestinal symptoms. Although the clinical manifestations of hyperparathyroidism are more severe in patients with parathyroid carcinoma when compared to those with those with parathyroid adenoma, it is difficult to differentiate carcinoma from adenoma without pathologic confirmation. To our knowledge, there have only been a few cases of hyperparathyroidism due to parathyroid carcinomas reported to date. Here, we report a case of 63-year-old woman developing osteoporosis, hypercalcemia and hypophosphatemia due to a parathyroid tumor and was diagnosed with parathyroid carcinoma postoperatively.


Subject(s)
Female , Humans , Middle Aged , Adenoma , Bone Diseases, Metabolic , Hypercalcemia , Hyperparathyroidism , Hyperparathyroidism, Primary , Hypophosphatemia , Incidence , Osteoporosis , Parathyroid Neoplasms
4.
Diabetes & Metabolism Journal ; : 80-85, 2011.
Article in English | WPRIM | ID: wpr-196220

ABSTRACT

BACKGROUND: Type B insulin resistance syndrome is a manifestation of autoantibodies to the insulin receptor that results in severe hyperglycemia and acanthosis nigricans. However, the mechanisms by which these autoantibodies induce hypoglycemia are largely unknown. In this paper, we report the case of patient with type B insulin resistance syndrome who presented with frequent severe fasting hypoglycemia and acanthosis nigricans. METHODS: To evaluate the mechanism of hypoglycemia, we measured the inhibition of insulin binding to erythrocytes and IM9 lymphocytes in a sample of the patient's dialyzed serum before and after immunosuppressive therapy. RESULTS: In the patient's pre-treatment serum IgG, the binding of 125I-insulin to erythrocytes was markedly inhibited in a dose-dependent manner until the cold insulin level reached 10-9 mol/L. We also observed dose-dependent inhibition of insulin binding to IM9 lymphocytes, which reached approximately 82% inhibition and persisted even when diluted 1:20. After treatment with glucocorticoids, insulin-erythrocyte binding activity returned to between 70% and 80% of normal, while the inhibition of insulin-lymphocyte binding was reduced by 17%. CONCLUSION: We treated a patient with type B insulin resistance syndrome showing recurrent fasting hypoglycemia with steroids and azathioprine. We characterized the patient's insulin receptor antibodies by measuring the inhibition of insulin binding.


Subject(s)
Humans , Acanthosis Nigricans , Antibodies , Autoantibodies , Azathioprine , Cold Temperature , Erythrocytes , Glucocorticoids , Hyperglycemia , Hypoglycemia , Immunoglobulin G , Insulin , Insulin Resistance , Lymphocytes , Receptor, Insulin , Steroids
5.
Journal of the Korean Society of Emergency Medicine ; : 570-574, 2011.
Article in Korean | WPRIM | ID: wpr-76025

ABSTRACT

Thyrotoxic periodic paralysis (TPP) occurs in 2% of the asian patients with hyperthyroidism and is characterized by bilateral flaccid paralysis of the extremity, especially lower limbs. It is well-known that hypokalemia is usually accompanied by TPP. However, hypophosphatemia is usually mild and well neglected. Although paralysis is generally recovered without treatment, in some cases, patients with TPP may die due to cardiopulmonary complications, such as cardiac arrhythmia. Therefore, proper and rapid replacement of potassium is essential. But it should be acknowledged that replacement may cause a rebound. TPP is often unrecognized and over-treated in the emergency room due to its non-specific symptoms. This is why clinicians must be familiar with this disease and its diagnostic clues such as Echocardiography change and clinical features. This is a case report of a 29-year-old male presenting with TPP accompanied by hypokalemia, hypophosphatemia and second degree atrioventricular block, who showed rebound hyperkalemia and hyperphosphatemia after rapid replacement of electrolytes. EKG changed to the normal sinus rhythm in the end after the correction of the electrolytes.


Subject(s)
Adult , Humans , Male , Arrhythmias, Cardiac , Asian People , Atrioventricular Block , Echocardiography , Electrocardiography , Electrolytes , Emergencies , Extremities , Hyperkalemia , Hyperphosphatemia , Hyperthyroidism , Hypokalemia , Hypophosphatemia , Lower Extremity , Paralysis , Potassium
6.
Journal of Korean Medical Science ; : 953-956, 2010.
Article in English | WPRIM | ID: wpr-203335

ABSTRACT

Gastrinoma is the most frequent functional pancreaticoduodenal endocrine tumor in patients with multiple endocrine neoplasia type 1 (MEN 1). Primary hepatic gastrinomas in MEN 1 are very rare, with no previous reports published in the literature. We reported the case of a 39 yr old female patient with a history of repeated peptic ulcers and a hypoglycemia episode. Abdominal CT indicated a well-defined liver mass and a pancreatic head mass. Somatostatin-receptor scintigraphy with [111In] DTPA octeotride demonstrated a strong uptake of the radiotracer in the left lateral segment at the site of the hepatic mass. After operation, immunohistochemical staining was consistent with pancreatic insulinoma and primary hepatic gastrinoma. As the liver is a common site of metastases from gastrinoma, primary liver gastrinoma has not yet been reported with MEN 1. We diagnosed this patient using immunohistochemical studies and treated this patient by hepatic segmentectomy.

7.
Korean Journal of Nephrology ; : 358-363, 2007.
Article in Korean | WPRIM | ID: wpr-162643

ABSTRACT

IgA nephropathy is recognized worldwide as one of the most common form of primary glomerulonephritis. Clinical manifestations vary, ranging from microscopic hematuria to nephrotic syndrome. Most cases of IgA nephropathy are idiopathic. A variety of additional disorders have been associated with IgA nephropathy, some of which shed light on possible pathogenetic mechanism. Association with psoriasis has been debated for a long time. Secondary renal amyloidosis in psoriatic arthropathy and drug-induced renal lesions secondary to methotrexate or cyclosporine are accepted accompaniments of psoriasis. We report 3 cases of IgA nephropathy which was diagnosed by renal biopsy in a patient with psoriasis.


Subject(s)
Humans , Amyloidosis , Arthritis, Psoriatic , Biopsy , Cyclosporine , Glomerulonephritis , Glomerulonephritis, IGA , Hematuria , Immunoglobulin A , Methotrexate , Nephrotic Syndrome , Psoriasis
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