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Biomedical subjects

K B Huh

Publications and source records attributed to K B Huh.

At least 55 records · Page 3Linked to original sources
PubMed1994

Pulsatile gonadotrophin-releasing hormone therapy in patients with pituitary tumours treated by surgery and irradiation.

OBJECTIVE: Pulsatile administration of GnRH for induction of ovulation is effective for women with idiopathic hypogonadotrophic hypogonadism. We were interested to assess the pituitary-ovarian response to pulsatile GnRH infusion and the therapeutic effectiveness of restoring ovulation in a group of hypogonadotrophic women previously treated with surgery and irradiation to pituitary tumours. PATIENTS: The group of patients comprised 15 hypogonadotrophic women, aged 29-40 years (mean 32.4 years), who had undergone transsphenoidal adenomectomy or craniotomy and irradiation with a total of 4500-5400 cGy in 25 fractional doses divided over 5-6 weeks. The time interval from irradiation to study was 6.3 +/- 2.0 years (mean +/- SD). TREATMENT: A single bolus GnRH (100 micrograms) test and pulsatile infusion of GnRH were performed to assess the pituitary gonadotrophin reserve and induce ovulation. We tried to correlate the pituitary response with characteristics of intracranial lesions on computerized tomography findings. We undertook ovarian biopsy in one patient who failed to respond to gonadotrophin therapy and pulsatile infusion of GnRH. RESULTS: Twelve women (80%) showed evidence of ovulation in response to pulsatile GnRH treatment and five subsequently became pregnant. Four of 12 ovulators were previous non-ovulators to exogenous gonadotrophin therapy. There was no correlation between pituitary response and character of lesions based on computerized tomography findings. A patient who failed to respond to either gonadotrophin or pulsatile infusion of GnRH had premature ovarian failure on ovarian histology. CONCLUSIONS: The functional reserve capacity of pituitary gonadotrophs may remain less impaired by tumour encroachment, pituitary surgery or irradiation than had previously been thought. This holds promise for ovulation induction in hypogonadotrophic patients who had been treated with surgery and irradiation for pituitary tumours.

Adult↗
PubMed1994

Reduction in size of a thyrotropin-secreting pituitary adenoma treated with octreotide acetate (somatostatin analog).

We present a 55-year-old female with a thyrotropin (TSH)-secreting pituitary adenoma who had been treated with somatostatin analog octreotide acetate (SMS 201-995) for 4 months. Subcutaneous injection of 100 micrograms octreotide acetate twice daily resulted in significant reduction of the TSH, thyroid hormone, and tumor size. During the treatment, there was no evidence of any side effects. We may conclude that octreotide acetate administration is an effective treatment in patients with TSH-secreting pituitary adenoma for suppressing TSH hypersecretion and reducing the size of the tumor.

Adenoma↗
PubMed1994

Growth hormone replacement therapy in adults with growth hormone deficiency; thrice weekly low dose administration.

Recent reports on growth hormone (GH) therapy have shown that GH has various beneficial effects in GH deficient adults. In most of these studies, GH was administered daily. Because GH is still expensive and has to be delivered by subcutaneous injection, we studied the 6-month therapeutic effects of thrice weekly GH injection therapy and compared it with daily therapy. Twenty eight adult patients with GH deficiency were randomly assigned into group 1 (ten cases, thrice weekly injections of GH), group 2 (nine cases, daily injections), and group 3 (nine cases, placebo injections). Lean body mass, serum basal GH levels, and insulin-like growth factor 1 levels significantly increased after six months of GH therapy in both groups 1 and 2. According to computed tomography, the mean mid-thigh muscle mass significantly increased in group 1, while the visceral fat mass significantly decreased in group 2. GH levels significantly increased exercise rate-pressure product and hand grip strength only in group 1. These results suggest that thrice weekly injections of GH are as effective as daily injections in GH deficient adults.

Adult↗
PubMed1994

Evaluation of thyroid function after bilateral subtotal thyroidectomy for Graves' disease--a long term follow up of 100 patients.

One hundred patients who underwent bilateral subtotal thyroidectomy for Graves' disease between January 1980 and September 1984 have been evaluated. The observation period ranged from 5 to 9 years, the average being 6.2 years. Postoperative thyroid function was evaluated with T3, T4 and TSH and compared with their clinical manifestations. Eighty-two patients became euthyroid, 14 patients had recurrence and 4 patients developed hypothyroidism. The thyroid hormone level of euthyroid patients were in an unstable state up to 5 years after the operation. Sixteen variables which might influence the postoperative recurrence and hypothyroidism were analyzed but no statistically significant factors were determined, although recurrences were found frequently in patients over 30 years, the patients with lower infiltration of lymphocytes and absent of fibrosis of thyroid tissue. The results obtained in the present study suggest that mean 6.0 gm of remnant thyroid is suitable for maintaining euthyroidism postoperatively in a majority of patients. In addition, patients should be followed closely for many years and should undergo hormonal determination periodically because recurrence and hypothyroidism can occur at 5 years or more after the operation.

Adolescent↗
PubMed1994

Reduced growth hormone response to L-dopa and pyridostigmine in obesity.

The purpose of this study was to evaluate growth hormone (GH) secretion and clarify the factors influencing GH secretion in obesity. Nine obese subjects and eight controls were recruited. We compared the GH response to L-dopa with or without pyridostigmine pretreatment in obese and control subjects. Plasma glucose, insulin, insulin-like growth factor I (IGF-I) and free fatty acid (FFA) were also measured. Growth hormone responses and GH area under the response curve (AUC) to L-dopa were significantly lower in obese subjects than those in controls. Pyridostigmine significantly enhanced the GH response to L-dopa in both obese and control subjects. However, enhanced GH responses in obese subjects were attenuated biologically and lower than those in controls with L-dopa only. Plasma levels of insulin insulin and FFA were significantly higher in obese subjects than those in controls. Body mass index had a positive correlation with the levels of insulin and FFA. However, GH AUC had an inverse correlation with insulin and FFA in obese subjects and controls. Stepwise multiple regression analysis showed a highly significant effect of FFA on GH AUC, but no independent influence of other factors on GH AUC. The reduced GH secretion found in this study suggests an increase in somatostatinergic tone and a diminished release of GHRH from the hypothalamus in obesity. However, other factors including hyperinsulinemia and increased plasma FFA may play an important additional role in the secretory dysfunction of GH in obesity.

Adult↗
PubMed1993

Growth hormone response to L-dopa and pyridostigmine in women with polycystic ovarian syndrome.

OBJECTIVE: To evaluate the GH secretion and clarify the factors influencing the GH secretion in women with polycystic ovarian syndrome (PCOS). DESIGN: Comparison of the GH response to L-dopa with or without pyridostigmine (inhibitor of acetylcholinesterase) pretreatment and insulin response to oral glucose tolerance test in patients with PCOS and matched controls. SETTING: Outpatients and healthy volunteers studied at a clinical research unit of a university hospital. PATIENTS, PARTICIPANTS: Ten women with PCOS and 9 controls with regular cycles were recruited. INTERVENTIONS: After an overnight fast, each subject underwent a GH stimulation test with L-dopa with or without pyridostigmine pretreatment. Plasma insulin and glucose levels were measured after a 75-g glucose load. MAIN OUTCOME MEASURES: Plasma GH, insulin-like growth factor I (IGF-I), insulin, and nonesterified fatty acids. RESULTS: Growth hormone responses and GH area under the response curve (AUC) to L-dopa were significantly lower in PCOS than those in controls. Pyridostigmine enhanced the GH response to L-dopa significantly in PCOS. Insulin responses and insulin AUC to oral glucose load were significantly higher in PCOS than those in controls. Plasma IGF-I levels of PCOS were significantly higher than controls. Insulin AUC had a positive correlation with plasma IGF-I levels but an inverse correlation with GH AUC in PCOS and controls. CONCLUSION: Our result indicated that decreased GH secretion of PCOS may be associated with a high somatostatin activity and a high plasma IGF-I level.

Adolescent↗
PubMed1993

Peak bone mass and affecting factors in Korean women.

Maximizing peak bone mass is advocated as a way to prevent osteoporosis. To evaluate the peak bone mass and the affecting factors in Korean women, we analyzed bone stiffness in 116 middle school students, 118 high school students and 115 female college students by using the Achilles densitometer (Lunar Corporation). Peak bone stiffness of Korean women was relatively lower than that of white women (94% of white women) and a rapid rise of bone stiffness was observed in those subjects 3-4 years after menarche. In adolescent females without menstruation, the bone stiffness was lower than that of adolescent girls with menstruation. The factors affecting the peak bone mass was similar to the risk factors of post menopausal osteoporosis: menstruation status, calcium intake and physical activity. The amount of calcium intake in Korean girls at the critical age (3-4 years after menarche) was lower than the RDA (requirement of daily allowance) at this age. To improve any program aimed at maximizing peak bone mass, further intensive study will be required to evaluate some other common factors affecting peak bone mass in Korean.

Adolescent↗
PubMed1992

Immunogenetic and nutritional profile in insulin-using youth-onset diabetics in Korea.

There are few reports on the genetic, immunological and nutritional characteristics of insulin-using youth-onset diabetes mellitus, insulin-dependent diabetes mellitus (IDDM) and malnutrition-related diabetes mellitus (MRDM) in Korea. Among 1266 hospitalized Korean diabetics, 29 (2.3%) were IDDM and 84 (6.6%) were MRDM. A diabetes history of first-relatives (28.6%) was more frequently found in the MRDM group than in the IDDM (14.8) and non-insulin-dependent diabetes mellitus (NIDDM) (19.0%) groups. HLA-DR4 was more common among IDDM (54.2%) and MRDM (52.4%) patients than controls (26.3%), and HLA-DR3 was more common among only IDDM patients (29.2%) than controls (10.9%). Conventional islet-cell antibodies were detected in 8 of 15 IDDM patients tested (53.3%) and in 11 of 22 MRDM patients (50.0%). MRDM patients had higher serum basal (1.02 +/- 0.51 ng/ml) and peak (1.44 +/- 0.76 ng/ml) C-peptide concentrations than IDDM patients, but lower concentrations than NIDDM patients. Before the onset of diabetes, the calorie intake of 21 MRDM patients assessed was 63.1% of the daily requirement and the intake of carbohydrate, protein and fat was 71.7%, 55.9% and 39.8%, respectively. In summary, our data suggest that IDDM in Korea is associated with HLA-DR3 or HLA-DR4, indicating a risk for IDDM in Western societies; furthermore, MRDM has a history of undernutrition at the preonset period and is also associated with HLA-DR4. It might be also concluded that MRDM in Korea is another expression of IDDM caused by the shortage of some nutrients for the structural and/or functional maintenance of pancreatic beta-cells.

Adolescent↗
PubMed1992

Allotransplantation of rat islets into the cisterna magna of streptozotocin-induced diabetic rats.

Islets were isolated from the pancreata of Sprague-Dawley rats and transplanted into streptozotocin-induced diabetic outbred Wistar rats. The effect of transplantation of islets into the cisterna magna on the diabetic state of the recipients was compared with that of the conventional transplantation of islets into liver via the portal vein. After successful intraportal (IP) transplantation, rejection took place between days 7 and 15 in all diabetic recipients. All of the eleven rats surviving after stereotaxic implantation of islets into the cisterna magna returned to normoglycemia within 7 days after transplantation. Nine of the recipients with intra-cisterna magna (IM) islet allografts were still normoglycemic at 210 days after transplantation. The glucose disappearance rate of the IM transplant rats was slower than that of the IP transplant rats, and blood glucose returned to the normal basal level within 5 hr following glucose administration. Although the insulin levels were almost undetectable in cerebrospinal fluid before IM transplantation, the insulin levels were markedly increased after IM transplantation and twice as great in CSF than blood. Thus, these findings indicate that the cisterna magna can serve as an immunologically privileged site for implantation of allogeneic pancreatic islets, and islets in CSF can regulate and maintain normal glucose homeostasis via secretion of insulin across the blood-brain barrier.

Animals↗
PubMed1992

Computed tomographic correlation with pituitary function in Sheehan's syndrome.

Twenty six patients with Sheehan's syndrome were studied with high-resolution computed tomography (CT) and the sequential pituitary stimulation test in order to correlate the CT findings of the sella turcica with the pituitary reserve functions. CT revealed 21 completely empty sella (CES), 4 partially empty sella (PES) and 1 normal sella. Panhypopituitarism occurred in 1 of 4 patients with PES and 20 of 21 with CES. One patient showing normal sella had a normal preservation of prolactin (PRL), thyroid stimulating hormone (TSH), follicle stimulating hormone (FSH) and lutenizing hormone (LH). In all patients with PES and CES, growth hormone (GH) responses to hypoglycemia and PRL responses to thyrotropin releasing hormone (TRH) were blunted. Three (75.0%) with PES had normal basal cortisol levels, which were more frequent than two (9.6%) with CES; however, most of the PES (3 of 4) and CES (20 of 21) demonstrated blunted cortisol responses to hypoglycemia. Three (75.0%) with PES and only one (4.8%) with CES had normal thyroxine levels and TSH responses to TRH. None with PES showed decreased basal and stimulated levels of FSH and LH, whereas 15 of 21 with CES did. The pituitary functions of the patients having considerable amounts of pituitary remnants visualized by CT were relatively preserved for TSH, cortisol, FSH and LH. Considering the above results, changes in the amounts of pituitary remnants detected by CT might correlate with hormonal secretory capacity.

Adult↗
PubMed1991

Euglobulin fibrinolytic activity in NIDDM patients.

The euglobulin fibrinolytic activity was measured in 56 non-insulin-dependent diabetics and 118 age-matched healthy controls before and after venous occlusion for 5 min at 100 mmHg of the left antecubital vein. In the basal state, fibrinolytic activity was impaired in diabetics compared with controls (93.1 +/- 6.7 vs 101.6 +/- 0.9 BAU) (P less than 0.05) and plasma fibrinogen level was increased but this did not reach statistical significance (467.3 +/- 264.1 vs 359.2 +/- 200.2 mg/dl). In diabetics, stimulated fibrinolysis following venous occlusion was depressed compared with controls (110.6 +/- 3.9 vs 121.6 +/- 1.9 BAU) (P less than 0.05). No relation of fibrinolytic activity to age, duration of diabetes, obesity, serum triglyceride, HbA1c, or 24 h proteinuria was demonstrated. In the diabetic retinopathy group, the fibrinolytic activity was lower than in the non-retinopathy group. Diabetics with long-standing diabetes (10 years or more) who remained free from retinopathy had significantly increased fibrinolytic activity than the diabetics with short-standing diabetes (less than 10 years) who have developed retinopathy (P less than 0.05). These findings imply a poor fibrinolytic activity, not in all diabetics, but only in those with retinopathy, and this may play a role in the development of diabetic retinopathy.

Age Factors↗
PubMed1987

Epidemiological characteristics of ketoacidosis among Korean diabetic patients.

An epidemiological study on diabetic ketoacidosis (DKA) was done by analysis of 207 cases collected from the medical records of 6 major general hospitals in Seoul area during the period of 5 years between 1979 and 1984. There was female predominance in the occurrence of DKA (male/female ratio, 0.71) in spite of the male predominance in general prevalence of diabetes mellitus (1.80). This female predominance in DKA was most striking in the age group under 40. There was a significant seasonal variation in the occurrence of DKA. DKA occurred most frequently in colder season with the highest peak in December. In July and August, the hottest season in Korea, not even a single case of DKA was recorded in this series. No discernible precipitating factor was found in 39.3% of DKA cases and infections was present as a cause of DKA in 30% of cases. In 27.5%, DKA was the first clinical presentation of diabetes and in the remainders of cases, diabetes was known to be present for average of 6.4 years. Mortality of DKA was 13.2% in this series. As to the socioeconomic status, the education level, the style of living and the duration of diabetes, there were not ascertainable differences between the DKA cases and other diabetic cases. The prospective epidemiological study of diabetic population in Korea, especially in female group, would be necessary for elucidation of the characteristics of DKA in Koreans such as the female predominance and the seasonal difference of the occurrence.

Adolescent↗