Dong Won Byun

Strong association of relatively low and extremely excessive iodine intakes with thyroid cancer in an iodine-replete area.

AbstractPurposenThe relationship between iodine intake and development of thyroid diseases shows a U-shaped curve with an increase of risk in both deficient and excessive iodine intakes. Our aim was to investigate the relationship between iodine intake and thyroid cancer in patients with thyroid nodules in an iodine-replete area.MethodsRetrospective analysis of 1170 patients with thyroid nodules was performed. Urinary iodine concentration (UIC) was measured by inductively-coupled plasma mass spectrometry. Predictive factors for thyroid cancer were evaluated using multivariate logistic regression models.ResultsnThe median UIC in all patients with thyroid nodules was 360xa0μg/L (range from 4 to 9631xa0μg/L). More than half of the patients (650/1170, 56xa0%) belonged to the category of excessive iodine intake (UICxa0≥xa0300xa0μg/L) according to WHO iodine recommendations. Patients with thyroid cancer were more likely to be distributed in UICxa0<xa0300xa0μg/L and in UICxa0≥xa02500xa0μg/L than those with benign thyroid nodules. Male gender (OR 1.528, pxa0=xa00.028) and UIC were independent predictors for thyroid cancer. The multivariate-adjusted OR (95xa0% CI) in the relatively low (UICxa0<xa0300xa0μg/L) and extremely excessive (UICxa0≥xa02500xa0μg/L) iodine intake groups for thyroid cancer were 1.519 (1.099–2.098) and 1.874 (1.094–3.208), respectively, compared to the other iodine intake group (300–2499xa0μg/L).ConclusionMale gender and UIC were independent predictors of thyroid cancer in patients with thyroid nodules. This study suggests that relatively low and extremely excessive iodine intakes are associated with thyroid cancer in an iodine-replete area.

Number of tumor foci as predictor of lateral lymph node metastasis in papillary thyroid carcinoma

The purpose of this study was to determine the clinicopathologic characteristics of patients with papillary thyroid carcinoma (PTC) by the number of tumor foci.

Expression of ezrin in vagina cells of postmenopausal rats after dietary administration of omega-3 Fatty Acid formula.

Objectives To see the effect of dietary administration of omega 3-fatty acid formula on the vaginal cells of postmenopausal rats. Methods Three-week-old female Wistar/ST rats were raised after one week of adjustment period. The rats were then divided into three groups, for three different kinds of diet; general diet, 1% omega-3 fatty acid diet, and 2% omega-3 fatty acid diet. After eight weeks of having assigned diet, after the oophorectomy, with the same diet previously they had Immunohistochemistry, Immunofluorescence, and Western Blot about ezrin, merlin were done. Results In immunohistochemistry, estrogen injection group revealed thicker and well differentiated features. In Immunofluorescence, Omega-3 fatty acid composition in diet did not effect expression of ezrin and merlin in rat vagina in estrogen injection group, their vaginal epithelium showed full layers (from basal to apical layer). In Western Blot analysis, Omega-3 fatty acid composition in diet did not affect expression of ezrin and merlin in rat vagina estrogen presented significant impact on expression of ezrin and merlin. Conclusion Although omega-3 fatty acid composition changed in diet, vaginal epithelial morphology unchanged. Estrogen did effect on vagina cell, but omega-3 fatty acid did not effect on ezrin and merlin in vagina.

Comparison of Monthly Ibandronate Versus Weekly Risedronate in Preference, Convenience, and Bone Turnover Markers in Korean Postmenopausal Osteoporotic Women

Patient preferences, convenience, and bone turnover markers were evaluated for the monthly ibandronate over the weekly risedronate regimen in Korean postmenopausal osteoporotic women. This was a 6-month, prospective, randomized, open-label, multicenter study with a two-period and two-sequence crossover treatment design. After a 30-day screening period, eligible participants with postmenopausal osteoporosis were randomized to receive either monthly oral ibandronate 150xa0mg for 3xa0months followed by weekly oral risedronate 35xa0mg for 12xa0weeks (sequence A) or the same regimen in reverse order (sequence B). Patient preference and convenience were evaluated by questionnaire. The changes in serum C-telopeptide after 3xa0months of treatment were analyzed. A total of 365 patients were enrolled in this study (sequence A 182, sequence B 183). Of patients expressing a preference (83.4%), 74.8% preferred the monthly ibandronate regimen over the weekly regimen (25.2%). More women stated that the monthly ibandronate regimen was more convenient (84.2%) than the weekly regimen (15.8%). There was no significant difference in the change in bone turnover marker between the two treatments. The two regimens were similarly tolerable. There were fewer adverse events in the monthly ibandronate group compared to the weekly risedronate group in terms of gastrointestinal side effects (nausea and abdominal distension). This study revealed a strong preference and convenience for monthly ibandronate over weekly risedronate in Korean postmenopausal osteoporotic women. There was no significant difference in change of bone turnover marker and safety profile between the two regimens.

Association of Triiodothyronine Levels with Future Development of Metabolic Syndrome in Euthyroid Middle-aged Subjects: A 6-Year Retrospective Longitudinal Study

BACKGROUNDnSeveral cross-sectional studies have reported that thyroid hormone levels are associated with cardiovascular risk markers and metabolic syndrome (MetS) even in euthyroid subjects. However, the prognostic role of serum thyroid hormone levels in the risk of incident MetS has not been elucidated.nnnAIMnWe aimed to investigate the associations of baseline serum thyroid hormone levels with the development of MetS in healthy subjects.nnnMETHODSnThis 6-year, cross-sectional, longitudinal and follow-up study was conducted in 12 037 euthyroid middle-aged subjects without MetS subjected to comprehensive health examinations. Subjects were grouped according to total triiodothyronine (T3) quartiles. The hazard ratio (HR) for the development of MetS according to T3 quartiles was estimated using Cox proportional hazards model.nnnRESULTSnDuring the 6-year period, 3544 incident cases of MetS (29%) were identified. The proportion of subjects with incident MetS increased across the T3 quartiles (P for trend <0.001). The HR and 95% confidence interval (CI) for the development of MetS were significantly higher in the highest T3 quartile compared with the lowest T3 quartile even after adjusting for confounding variables including gender, age and smoking (HR: 1.238, 95% CI: 1.128-1.358, Pu2009<u20090.001).nnnCONCLUSIONnIn euthyroid middle-aged subjects, serum T3 levels are associated with increased risk for future development of MetS.

Endoscopic comparison of alendronate alone and the enteric-coated alendronate with calcitriol combination in postmenopausal Korean females.

Background/Aims This study was performed to compare the mucosal findings after esophagogastroduodenoscopy in two groups before and after the use of alendronate only and following administration of the enteric-coated alendronate (5 mg) and calcitriol (0.5 µg) combined drug (Maxmarvil, Yuyu Co.). Methods The study population consisted of 33 postmenopausal healthy female volunteers, aged 50 to 70 years (mean age, 58 ± 5) without gastrointestinal symptoms and with normal baseline endoscopic findings. Esophagogastroduodenoscopy was performed at baseline and was repeated 2 weeks later after daily intake of Maxmarvil (n = 17 subjects) or alendronate only (n = 16 subjects). Mucosal injury scores were reported by an endoscopist after 2 weeks of treatment with each medication schedule. Results Esophageal mucosal injuries developed in two of 16 subjects in the alendronate only group and 0 of 17 in the Maxmarvil group. Gastric mucosal injuries developed in eight subjects in the alendronate group and four subjects in the Maxmarvil group; this difference was statistically significant. Conclusions The mucosal damage scores for the alendronate group (total score 24) were significantly higher than those for the Maxmarvil group (total score 9) in the esophagus and stomach. Therefore, this study suggested that enteric-coated Maxmarvil is less harmful to gastrointestinal mucosa than alendronate, and may improve the tolerability of osteoporosis medication in clinical practice.

Relationship between Decrease in Serum Sodium Level and Bone Mineral Density in Osteoporotic Fracture Patients

Background Recently, it has been suggested that decrease in serum sodium level is associated with osteoporosis. However, no study in Korea has reported the association of decrease in serum sodium level with osteoporosis. In this study, we investigated the relationship between the decrease in serum sodium level and severity of osteoporotic fracture in patients. Methods We enrolled 290 subjects who were admitted and operated at Soonchunhyang University Hospital due to major fractures. For the control group, we enrolled 1,027 subjects who visited a health promotion center. We carried a 1:1 matching with age and sex from the case group. Results In a total of 164 age- and sex-matched subjects, serum sodium level was significantly lower in the fracture group than in the non-fracture group (P=0.001). Serum sodium level was significantly lower in the severe osteoporosis group than that in the non-severe osteoporosis group (P=0.002). Old age and decrease in serum sodium level were independent risk factors of osteoporosis (odds ratio [OR]=1.088, P=0.008, confidence interval [CI]=[1.022-1.157]; OR= 0.840, P=0.037, CI=0.713-0.989). Conclusions Serum sodium level was significantly lower in the fracture group than that in the non-fracture group and in the severe osteoporosis group than that in the non-severe osteoporosis group. Based on our results, the decrease in serum sodium level could be an independent risk factor for osteoporosis.

Endometriosis in a postmenopausal woman on hormonal replacement therapy.

Endometriosis is a benign disease and an estrogen-dependent disease. Postmenopausal endometriosis is rare, because the absence of estrogenic hormone production. We report a case of endometriosis presenting in a postmenopausal woman with no history of endometriosis before hormone replacement therapy.

Compression Fracture in Postpartum Osteoporosis

Osteoporosis is mainly a problem in postmenopausal women. However, we had a case of postpartum compression fracture associated with osteoporosis. A 42-year-old multiparous woman had undergone tertiary cesarean section without complications 1 month before. She was breast-feeding her baby and had no other bone-related complication history. She did not exercise on a regular basis. She experienced back pain abruptly and was diagnosed with a recent compression fracture of T12, L1, and L3. We evaluated this rare case of postpartum osteoporosis and compression fracture.

Efficacy of a Once-Monthly Pill Containing Ibandronate and Cholecalciferol on the Levels of 25-Hydroxyvitamin D and Bone Markers in Postmenopausal Women with Osteoporosis

Background The present study evaluated the efficacy of a combination of ibandronate and cholecalciferol on the restoration of the levels of 25-hydroxyvitamin D (25[OH]D) and various bone markers in postmenopausal women with osteoporosis. Methods This was a randomized, double-blind, active-controlled, prospective 16-week clinical trial conducted in 20 different hospitals. A total of 201 postmenopausal women with osteoporosis were assigned randomly to one of two groups: the IBN group, which received a once-monthly pill containing 150 mg ibandronate (n=99), or the IBN+ group, which received a once-monthly pill containing 150 mg ibandronate and 24,000 IU cholecalciferol (n=102). Serum levels of 25(OH)D, parathyroid hormone (PTH), and various bone markers were assessed at baseline and at the end of a 16-week treatment period. Results After 16 weeks of treatment, the mean serum levels of 25(OH)D significantly increased from 21.0 to 25.3 ng/mL in the IBN+ group but significantly decreased from 20.6 to 17.4 ng/mL in the IBN group. Additionally, both groups exhibited significant increases in mean serum levels of PTH but significant decreases in serum levels of bone-specific alkaline phosphatase and C-telopeptide of type 1 collagen (CTX) at 16 weeks; no significant differences were observed between the groups. However, in subjects with a vitamin D deficiency, IBN+ treatment resulted in a significant decrease in serum CTX levels compared with IBN treatment. Conclusion The present findings demonstrate that a once-monthly pill containing ibandronate and cholecalciferol may be useful for the amelioration of vitamin D deficiency in patients with postmenopausal osteoporosis. Moreover, this treatment combination effectively decreased serum levels of resorption markers, especially in subjects with a vitamin D deficiency, over the 16-week treatment period.