Non-functional Pituitary Adenoma Detected on 18F-fluorodeoxyglucose Positron Emission Tomography (18F-FDG-PET) in a Patient with Mucosa-associated Lymphoid Tissue Lymphoma

Magnetic resonance imaging (MRI) is the modality of choice for the detection and characterization of a pituitary adenoma. Uptake of 18F-fluorodeoxyglucose (FDG) by intrasellar tumors, including pituitary adenomas, has been reported in several previous studies. We report a case where a pituitary adenoma was detected on FDG-positron emission tomography(PET), but the tumor was not detected with the use of sellar MRI. A 31-year-old woman was referred to the clinic due to a focal increase of FDG uptake at the pituitary fossa seen on whole body FDG-PET. The patient was receiving chemotherapy due to a recurred B-cell lymphoma of the mucosa-associated lymphoid tissue type. Subsequently, sellar MRI was performed, and images showed a small non-enhancing heterogenous cystic lesion in the midline of the pituitary gland, radiologically suggestive of a Rathke`s cleft cyst. However, sellar MRI failed to identify a lesion consistent with a pituitary tumor that corresponded to the site of increased FDG uptake detected by the use of PET, despite the inclusion of a dynamic contrast enhanced sequence. Despite the negative findings of the MRI examination, basal and stimulated levels of the GnRH free α-subunit were profoundly increased. Therefore, we suspected the presence of a non-functional pituitary tumor in addition to a Rathke`s cleft cyst, rather than pituitary involvement of a lymphoma, based on the hormone levels and PET scan findings.ope

Expression and role of estrogen receptor α and β in medullary thyroid carcinoma: Different roles in cancer growth and apoptosis

Medullary thyroid carcinoma (MTC) originates from parafollicular C cells. Estrogen receptor beta(ERbeta) expressionwas detected in normal parafollicular C cells and MTC tumor tissue, but ERalpha expression in MTC tumors still remains undetermined. The appearance and loss of ERalpha or ERbeta expression has been known to play a role in the development and progression of many human cancers. We performed immunohistochemical studies of ERalpha, ERbeta, and Ki67, a mitotic index, in 11 human MTC tissue samples. ERalpha was detected in 10 cases (91%), and ERbeta expression was observed in 8 cases (72.7%). A majority (8/10) of ERalpha-positive tumors showing ERbeta Ki67 expression was detected in three cases (27.3%). Neither clinical parameters nor tumor node metastasis (TNM) tumor staging was correlated with the positivity for ERs or Ki67. To investigate the biological role of each ER, we used ER-negative MTC TT cells and adenoviral vectors carrying ERalpha (Ad-ERalpha), ERbeta (Ad-ERbeta), estrogen response element (ERE)-Luc (Ad-ERE-Luc), and activator protein 1 (AP1)-Luc (Ad-AP1-Luc). Estrogen stimulated and anti-estrogen, ICI 182 780, suppressed ERE reporter activity in TT cells expressing ERalpha or ERbeta, suggesting that both ERs use the same classical ERE-mediated pathway. Ad-ERalpha infection stimulated TT cell growth; in contrast, Ad-ERbeta infection suppressed their growth. Apoptosis was detected in Ad-ERbeta-infected TT cells. Estrogen and anti-estrogen suppressed AP1 activity in Ad-ERalpha-infected cells, whereas upon Ad-ERbeta infection estrogen further stimulated AP1 activity which in turn is suppressed by anti-estrogen, suggesting that each ER acts differently through a non-ERE-mediated pathway. Our results suggest that ERalpha and ERbeta may play different roles in MTC tumor growth and progression.ope

Comparision of the funtional independence measure and the modified barthel index in the spinal cord injured

의학과/석사[한글] 재활의학에서는 Barthel Index와 같은 표준화된 척도를 사용하여 장애가 있는 환자가 일상생활의 기본적인 기능들을 얼마나 독립적으로 수행하는지에 대한 평가를 하였는데, 최근에는 Uniform Data System far Medical Rehabilitation에 포함되어 있는 Functional Independence Measure가 맡은 관심의 대상이 되어 사용되고 있다. 이 연구의 목적은 척수손상후에 나타나는 장애를 Functional Independence Measure와 Modified Barthel Index로 검사하여 두 기능평가 결과간의 상관관계 및 각 항목에서의 변화양상을 관찰하는 것이다. 이에 연구자는 수상후 3개월이 경과하지 않은 척수손상 환자 32명을 대상으로 입원시, 퇴원시 및 추적관찰시에 기능평가를 실시하여 다음과 같은 결과를 얻었다. 1. 두 기능평가 방법의 자기관리 (self-care) 영역에서는 대소변관리, 목욕하기, 하의입기 항목이 음식먹기와 단장하기 항목보다 낮은 점수를 보였으며, 각 항목의 입원시와 퇴원시의 점수는 의의있는 차이가 있었다(p<0.01). 2. 두 기능평가 방법의 가동성 (mobility) 영역에서는 계단오르기 항목이 다른 항목들에 비해 낮은 점수를 보였으며, 각 항목의 입원시와 퇴원시의 점수는 의의있는 차이가 있었다 (p<0.01). 3. Functional Independence Measure의 의사소통과 사회적 인지 영역에서는 사회적 인지 영역이 의사소퉁 영역보다 다소 낮은 점수를 보였으나 의의있는 차이가 없었고, 각 항목의 입원시와 퇴원시의 점수도 의의있는 차이가 없었다. 4. Functional Independence Measure와 Modified Barthel Index는 검사한 모든 시점, 모든 영역에서 높은 상관관계를 보였다 (p＜O.01). 5. Functional Independence Measure와 Modified Barthel Index는 모두 근력점수 (motor score)와 높은 상관관계를 보였다. 이상의 결과로 보아 Functional Independence Measure가 Modified Banhel Index와 마찬가지로 척수손상 환자의 상태에 대한 적합한 평가지표로 임상적 변화를 잘 반영하는 것을 알 수 있었다. [영문] In rehabilitation medicine, the assessment of level of independence in basic functions of daily living for the disabled persons has been accomplished using a standardized scale, such as the Barthel Index. Recently, the functional Independence Measure has attained wide attention and used as a part of the Uniform Data System for Medical Rehabilitation. The purpose of this study was to investigate the relationship between Functional Independence Measure and Modified Barthel Index and progress of each items of these scales during rehabilitative treatment in the spinal cord iniury patients. The functional levels of 32 spinal coed injury patients were evaluated by two scales at admission, discharge, and fellow-up, and 7hen the fellowing results were obtained; 1) In self-care subscores, the scores of bowel and bladder continence, bathing, and lower-body dressing were lower than those of eating and grooming, and there was significant difference between admission and discharge scores. 2) In mobility subscores, the score of stair climbing was lower than that of the other items and there was significant difference between admission and discharge scores. 3) In communication and social cognition subscores on Functional Independence Measure, social cognition subscore was little lower than communication subscore, and there was no significant difference between admission and discharge scores. 4) Functional Independence Measure and Modified Barthel Index were showed excellent correlations at all points in time, and at all subscores that were studed. 5) Both Functional Independence Measure and Modified Barthel Index were showed good correlations with motor scores. In conclusion, the Functional Independence Measure is well reflecting the clinical changes of the spinal cord injured and can be substitute the Modified Barthel Index.restrictio

Focusing on the Soft Power of Japan and France

학위논문 (석사)-- 서울대학교 대학원 : 국제학과(국제협력전공), 2012. 2. 이근.A Study on the Formation of Country Brand: Focusing on the Soft Power of Japan and France (국가 브랜드 형성에 관한 연구: 일본과 프랑스의 소프트 파워를 중심으로) 국문초록 FutureBrand-BBC 국가 브랜드 지수(CBI)와 Anholt-GfK Roper 국가 브랜드 지수(NBI)는 국가 이미지가 형상화된 국가 브랜드를 측정할 때 세계적으로 가장 널리 쓰이는 지표이다. 우호적인 국가 브랜드를 가지고 있는 국가는 자국이 원하는 바를 보다 용이하게 얻을 수 있다. 즉, 긍정적인 국가 브랜드를 가지고 있는 국가는 소프트 파워를 행사할 수 있는 것이다. 본 논문에서는 국가 브랜드 형성에 영향을 미치는 요인들을 찾고자 한다. 이를 위해 국가의 전반적인 생활수준(well-being)을 보여주는 척도로서 OECD의 더 나은 삶 지수(Your Better Life Index)를 사용하였다. CBI와 NBI에서 상위 10위권에 든 대부분의 국가들은 OECD 더 나은 삶 지수에서도 높은 점수를 받았다. 하지만 그 중 일본과 프랑스는 CBI와 NBI에서 모두 상위 10위권에 들었음에도 불구하고, OECD의 더 나은 삶 지수가 상대적으로 크게 낮았다. 프랑스와 일본의 전반적인 생활수준이 낮음에도 불구하고 이들이 우호적인 국가브랜드를 형성할 수 있었던 요인들을 찾고자, 이 논문에서는 조셉 나이(Joseph Nye)의 소프트 파워 이론을 응용하였다. 본 논문은 소프트 파워, 공공 외교, 문화 외교에 관한 이론적 논의를 토대로 공적개발원조(ODA)와 문화 외교라는 두 가지의 독립변수를 선택하였다. 이에 따라 본 논문은 일본, 프랑스, 덴마크와 아일랜드의 공적개발원조 및 문화 외교의 경향을 분석하고자 한다. 덴마크와 아일랜드는 일본과 프랑스와는 대조적으로, 전반적인 생활수준이 높음에도 불구하고 CBI와 NBI에서 모두 상위 10위권 안에 들지 못하였다. 이에 덴마크와 아일랜드를 일본과 프랑스의 대조군으로 삼고자 한다. 이러한 비교 분석을 통해, 본 논문은 다음과 같은 결론에 이른다. 공적개발원조의 총액과 문화외교는 국가 브랜드 형성에 영향을 미친다. 하지만 이 두 요인들은 국가 브랜드에 영향을 미치는 다수의 요인들 중 일부일 뿐이다. 이 점을 간과한 채, 무조건 공적개발원조 규모만을 늘리거나 세계에 자국의 문화를 널리 알리려고만 한다면 우호적인 국가 브랜드 형성에 실패할 수 있다. 따라서 국가 브랜드 형성에 영향을 미치는 다양한 요인들에 대한 지속적 연구가 향후 이루어져야 할 것이다.A Study on the Formation of Country Brand: Focusing on the Soft Power of Japan and France Abstract The FutureBrand-BBC Country Brand Index(CBI) and the Anholt-GfK Roper Nation Brands Index(NBI) were designed to measure country brands, which are reflections of the image of countries. A country with a better country brand can obtain its desired outcomes more easily. In other world, a country with a fine country brand can wield its soft power. The thesis traces the variables affecting country brands. To examine the correlation between country brands and countries well-being, the OECD Your Better Life Index was used in this paper. Most of the top 10 countries of the country brands indexes got high scores for their well-being. However, well-beings of Japan and France were quite low even though they ranked in the top 10 in both CBI and NBI. To identify the factors that made France and Japan have fine country brands despite their low degrees of well-being, a theory of soft power by Joseph Nye was applied in the paper. Through literature review on soft power, public diplomacy, and cultural diplomacy, two independent variables have been selected in this paper: the total volume of official development assistance(ODA) and cultural diplomacy. Accordingly, the thesis explores the ODA trends and cultural diplomacy of four countries: Japan, France, Denmark and Ireland. Contrary to Japan and France, Demark and Ireland were not ranked in the top 10 in any of the country brands indexes regardless of their high scores for well-being. The analysis leads to a conclusion that both total amounts of ODA and cultural diplomacy affects country brands. However, these two variables are just a few of the many factors affecting country brands or country image. Without considering other factors, merely increasing the volume of ODA budget or trying to spread out their cultures across the globe might not be the way to develop country brands. Hence, further researches to identify various other factors affecting country brands or country image must be made.Maste

The association between insulin resistance and Framingham risk score among type 2 diabetes

Background and purpose: Insulin resistance has been known to be associated with the risk of cardiovascular diseases. However, the relationship with Framingham risk score among type 2 diabetes has not been well known. We investigated the relationship between insulin resistance (IR) and the Framingham risk score(FRS) among type 2 diabetes in Korea. Methods: We estimated the 5-year risk of ischemic heart disease(IHD) based on Framingham equation among 1,941 diabetes patients(1,294 men and 647 women), who visited Huh"s clinic, enrolled from January 2003 to June 2006. IR, which was measured by insulin tolerance test (ITT), was divided into five groups(Q1 to Q5). High risk of IHD was defined as upper 10 percentile of FRS. Multivariate regression and logistic regression models were used to see independent association of higher quintiles of IR level, compared with lowest quintile(Q1) for the risk of IHD. Results: Mean (±standard deviation) 5-year FRS of study subjects were 8.40%(±6.89) for men and 5.92%(±5.23) for women. There were significant correlation between IR, body mass index, HbA1C, fasting glucose, triglyceride, LDL-cholesterol, C-peptide and FRS in both men and women. After adjusting for triglyceride, LDL-cholesterol, C-peptide, multivariate regression model analysis showed that IR was independently associated with the FRS. A positive association between IR and high risk of IHD was observed in men: highest versus lowest quintile of IR (odds ratio 5.45 in men and 4.71 in women). Conclusion: Increased IR level was independently associated with risk of IHD measured by FRS among type 2 diabetes in Korea.ope

Serum parathyroid hormone is associated with carotid intima-media thickness in postmenopausal women.

OBJECTIVES: To test whether parathyroid hormone (PTH) might be related to the development of atherosclerosis in postmenopausal women, we measured serum levels of PTH, the carotid intima-media thickness (IMT), and other clinical and biochemical parameters. METHODS: One hundred and seven postmenopausal women were recruited for this study. The serum level of PTH was measured by immunoradiometric assay, and carotid IMT was measured with high resolution B-mode ultrasonography. RESULTS: On the basis of bivariate correlation analyses or unpaired t-tests, the body mass index (BMI), waist circumference, estimated glomerular filtration rate, and 25-hydroxyvitamin D were not associated with carotid IMT. In contrast, age (r = 0.414, p < 0.001), serum level of PTH (r = 0.304, p = 0.001), hypertension (p < 0.001), and hypercholesterolaemia (p = 0.004) were related to carotid IMT. On the basis of multiple regression analysis, the serum level of PTH (beta = 0.198, p = 0.029), as well as age (beta = 0.309, p = 0.001) and hypertension (beta = 0.262, p = 0.006), were independent predictors of carotid IMT. CONCLUSIONS: Our results have demonstrated that serum PTH is an independent determinant of carotid IMT in postmenopausal women. This result suggests that serum PTH, even in the reference range, might be associated with the development of atherosclerosis or cardiovascular diseases in postmenopausal women. Further study is necessary in males and premenopausal women to fully elucidate the clinical significance of this finding.ope

The adaptation and relationship of FGF-23 to changes in mineral metabolism in Graves' disease

OBJECTIVE: The aim of this study was to observe the changes in bone and mineral metabolism and to confirm the regulation of fibroblast growth factor-23 (FGF-23) in untreated Graves' disease. PATIENTS AND MEASUREMENTS: The study comprised 39 patients, with or without Graves' disease. The Graves' disease group was made up of 21 newly diagnosed patients, enrolled before starting treatment. Their disease was determined by biochemical and radiological means. The control group was composed of 18 people who were proven to be euthyroid without any diseases affecting bone and mineral metabolism. FGF-23, calcium, phosphate, PTH, 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D [1,25(OH)2D] levels and bone turnover markers were compared between these groups. RESULTS: Serum calcium and phosphate, plasma FGF-23 and free T4 were significantly higher in the Graves' disease group than in the healthy control group (P < 0.05). The bone turnover markers serum osteocalcin and C-terminal cross-linked telopeptide of type 1 collagen (s-CTx) were also significantly elevated in the Graves' disease group, and had a positive correlation with free T4 levels. However, there was no significant decrease in PTH and 1,25(OH)2D in the Graves' disease group. Plasma levels of FGF-23 exhibited a positive correlation with serum phosphate levels and with free T4 levels (P < 0.05). CONCLUSIONS: These findings suggest that FGF-23 is physiologically related to serum phosphate homeostasis, as indicated indirectly by the changes in bone and mineral metabolism, in untreated Graves' disease.ope