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ESROC-KES Joint Symposium
from 105年會論文摘要集
by Endo 電子書上傳區
S5-1 Liang-Yu Lin, M.D., Ph.D.
Personal Information
Nationality: Taiwan, R.O.C.
Position: Attending physician
Department: Division of Endocrinology and Metabolism, Department of Medicine
Organization: Taipei Veterans General Hospital
Email: linly@vghtpe.gov.tw
Educational background & professional experience (in sequence of the latest year)
2008- Division of Endocrinology and Metabolism/ Taipei Veterans General Hospital Attending physician 2015- Faculty of medicine/National Yang-Ming University Assistant Professor 2003-2007 Division of Endocrinology and Metabolism/ Taipei Veterans General Hospital Fellow
Research Interests
1. Diabetes vasculopathy 2. Dyslipidemia 3. General endocrine disorder
Publications (5 important publications – latest sequence)
1.Chang LH, Hwu CM, Chu CH, Won JG, Kwok CF, Lin HD, Chen HS, Lin YC, *Lin LY: The Ankle
Brachial Index Exhibits Better Association of Cardiovascular Prognosis than Non-High-Density
Lipoprotein Cholesterol in Type 2 Diabetes. Am J Med Sci 2016 (accepted). 2.Chang LH, Chu CH, Lin HD, Kwok CF, Won JG, Chen HS, *Lin LY: The ankle brachial index is associated with prognosis in patients with diabetic kidney disease. Diabetes Res Clin Pract 2015;108:316-322. 3.Lin LY, Huang CC, Chen JS, Wu TC, Leu HB, Huang PH, Chang TT, Lin SJ, *Chen JW. Effects of pitavastatin versus atorvastatin on the peripheral endothelial progenitor cells and vascular endothelial growth factor in high-risk patients: A pilot prospective, double-blinded, randomized study. Cardiovasc Diabetol 2014;13(1):111. 4.Huang CJ, Chen PJ, Chang JW, Huang DF, Chang SL, Chen SA, Jap TS, *Lin LY: Amiodaroneinduced Thyroid Dysfunction in Taiwan: a retrospective cohort study. Int J Clin Pharm 2014;36(2):405-11. 5.Liu PY, #Lin LY, Lin HJ, Hsia CH, Hung YR, Yeh HI, Wu TC, Chen JY, *Chien KL, *Chen JW:
Pitavastatin and Atorvastatin Double-Blind Randomized ComPArative Study among HiGh-Risk
Patients, Including ThOse with Type 2 Diabetes Mellitus, in Taiwan (PAPAGO-T Study). PLoS One. 2013 Oct 1;8(10):e76298.
S5-1 Drug-Induced Thyroid Dysfunctions
藥物引起的甲狀腺功能異常
LIANG-YU LIN 林亮羽
Division of Endocrinology and Metabolism, Taipei Veterans General Hospital 臺北榮民總醫院 內分泌新陳代謝科
“Iatrogenic” means any adverse condition in a patient resulting from treatment by a physician, nurse, allied health professional. Iatrogenic disorders are an important cause of morbidity, mortality, and admission to hospital in the worldwide. Normal thyroid secretion depends on thyroid-stimulating hormone (TSH), which is inhibits by thyroid hormones and stimulated by endogenous thyrotropinreleasing hormone (TRH). Similar to many other organs, the thyroid gland may be affected by various drugs, often used for the treatment of non-thyroid disorders. Drug may affect thyroid function via different mechanisms, including thyroid hormone production, storage, transport and metabolism offering numerous targets for drug interventions. Usually, the effect of pharmacotherapy is observed more frequently and is stronger in case of the presence of the concomitant disorder of thyroid gland. The drugs which may cause thyrotoxicosis include interferon, molecular-targeted agents, amiodarone and so on. Those which cause hypothyroidism included immune checkpoint therapy, lithium, and iodine etc. which inhibit thyroid hormone synthesis and secretion, and dopamine etc. which block TSH secretion. An understanding of the proposed mechanisms of these drug interactions and their evaluation and differential diagnosis is helpful in the interpretation of the findings associated thyroid disorders and in establishing the correct treatment. Therefore, it is important to review the present state of knowledge on the influence of various drugs on the hypothalamic-pituitary-thyroid axis and concern the diagnosis and treatment of drug induced thyroid dysfunctions.
S5-2 Prof. Yoon-Sok Chung, M.D., Ph.D.
Personal Information
Nationality: South Korea
Position: President of the Korean Society of Osteoporosis (KSO)
Department: Endocrinology and Metabolism
Organization: Ajou University School of Medicine
Email: yschung@ajou.ac.kr
Educational background & professional experience (in sequence of the latest year)
2001 ~ 2002 Loma Linda University, California, USA Visiting Professor 1994 ~ 1997 Yonsei University, Seoul, Korea Ph.D. 1982 ~ 1988 Yonsei University, Seoul, Korea M.D.
Research Interests
1. Osteoporosis 2. Bone Metabolism 3. Osteoblast
Publications (5 important publications – latest sequence)
1.Quantification of Visceral Fat Using Dual-Energy X-Ray Absorptiometry and Its Reliability
According to the Amount of Visceral Fat in Korean Adults. J Clin Densito 18(2):192-197, 2015 (Corresponding author) 2.Insulin is inversely associated with bone mass, especially in the insulin-resistant population. The
Korea and US National Health and Nutrition Examination Surveys. J Clin Endocrinol Metab 99:1433-1441, 2014 (Corresponding author) 3.The prevalence of osteoporosis in Korean adults aged 50 years or older and the higher diagnosis rates in women who were beneficiaries of a national screening program: The Korea National
Health and Nutrition Examination Survey 2008-2009. J Bone Miner Res. 27:1879-1886, 2012 (Corresponding author) 4.The importance of morphometric radiographic vertebral assessment for the detection of patients who need pharmacological treatment of osteoporosis among postmenopausal diabetic Korean women.
Osteoporos Int. 23:2099-2105, 2012 (Corresponding author) 5.Poncirin prevents bone loss in glucocorticoid-induced osteoporosis in vivo and in vitro. J Bone
Miner Metab. 30:509-516, 2012 (Corresponding author)
S5-2 Type 2 Diabetes Mellitus and Osteoporosis
YOON-SOK CHUNG
Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, South Korea
Fragility fracture rate is increased in type 2 diabetic patients despite of higher bone mineral density (BMD) than non-diabetic control subjects. Vertebral fractures are usually asymptomatic; therefore, radiologic evaluation might be considered for diabetic patients. Fracture Risk Assessment Tool (FRAX) has been used for prediction of 10-year probability of major osteoporotic fractures.
Bone quality may more contribute to the increased risk of osteoporotic fractures in patients with type 2 diabetes than bone mass. Hip geometry, cortical porosity, and trabecular bone score (TBS) have been studied as bone quality parameters by imaging in type 2 diabetes mellitus (T2DM).
We performed the study comparing TBS, BMD, and FRAX score in the association of vertebral fractures in T2DM Korean postmenopausal women. TBS and FRAX as well as BMD may be good supplementary tools to predict osteoporotic fractures.
S5-3 Prof. Won Bae Kim, M.D., Ph.D.
Personal Information
Nationality: Republic of Korea
Position: Director, Division of Endocrinology & Metabolism
Department: Department of Internal Medicine
Organization: Asan Medical Center
Email: kimwb@amc.seoul.kr
Educational background & professional experience (in sequence of the latest year)
1987 Seoul National University, College of Medicine 2008 Asan Medical Center, Dept. of Internal Med & Ulsan Univ college of Medicine Professor 2015 Korean Thyroid Association Chief of directors
Research Interests
1. Cancer biology : cancer cell metabolism & mechanism of invasion & metastasis 2. Translational research : Thyroid cancer 3. Clinical research : Thyroid cancer & Hyperthyroidism
Publications (5 important publications – latest sequence)
1. Features Predictive of Distant Metastasis in Papillary Thyroid Microcarcinomas. Thyroid. 2016 2. Alpha lipoic acid inhibits proliferation and epithelial mesenchymal transition of thyroid cancer cells.
Mol Cell Endocrinol. 419:113-23, 2016 3. Usefulness of NRAS codon 61 mutation analysis and core needle biopsy for the diagnosis of thyroid nodules previously diagnosed as atypia of undetermined significance. Endocrine. 2015 Nov 7. 4. Recent changes in the clinical outcome of papillary thyroid carcinoma with cervical lymph node metastasis. J Clin Endocrinol Metab. 100:3470-3477, 2015 5. Sub-Classification of Lateral Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma by
Pathologic Criteria. PLoS One. 2015 Jul 17;10(7):e0133625.
WON BAE KIM
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
The naturally occurring short-chain fatty acid, α-lipoic acid (ALA) is a powerful antioxidant which is clinically used for treatment of diabetic neuropathy. Recent studies suggested the possibility of ALA as a potential anti-cancer agent, because it could activate adenosine monophosphate activated protein kinase (AMPK) and inhibit transforming growth factor-β (TGFβ) pathway. In this study, we evaluate the effects of ALA on thyroid cancer cell proliferation, migration and invasion. We performed in vitro cell proliferation analysis using BCPAP, HTH-83, CAL-62 and FTC-133 cells. ALA suppressed thyroid cancer cell proliferation through activation of AMPK and subsequent downregulation of mammalian target of rapamycin (mTOR)-S6 signaling pathway. Low-dose ALA, which had minimal effects on cell proliferation, also decreased cell migration and invasion of BCPAP, CAL62 and HTH-83 cells. ALA inhibited epithelial mesenchymal transition (EMT) evidently by increase of E-cadherin and decreases of activated β-catenin, vimentin, snail, and twist in these cells. ALA suppressed TGFβ production and inhibited induction of p-Smad2 and twist by TGFβ1 or TGFβ2. These findings indicate that ALA reduces cancer cell migration and invasion through suppression of TGFβ production and inhibition of TGFβ signaling pathways in thyroid cancer cells. ALA also significantly suppressed tumor growth in mouse xenograft model using BCPAP and FTC-133 cells. This is the first study to show anti-cancer effect of ALA on thyroid cancer cells. ALA could be a potential therapeutic agent for treatment of advanced thyroid cancer, possibly as an adjuvant therapy with other systemic therapeutic agents.
S5-4 Yen Hsiang Chang, M.D.
Personal Information
Nationality: TAIWAN
Position:Attending physician
Department: Nuclear Medicine
Organization: Kaohsiung Chang Gung Memorial Hospital
Email: changyh@cgmh.org.tw
Educational background & professional experience (in sequence of the latest year)
2000-2008 National Taiwan University Bachelor of Medicine 2009-2013 Department of Nuclear Medicine, Kaohsiung Chang Gung memorial hospital Resident 2014 Dec- Department of Nuclear Medicine, Kaohsiung Chang Gung memorial hospital Attending Physician
Research Interests 1. Nuclear Medicine 2. Thyroid Cancer
Publications (5 important publications – latest sequence)
1.Y-H Chang, C-C Hsu, P-W Wang, Y-C Huang: Left ventricular dyssynchrony occurs frequently in patients with coronary artery disease. Ann Nucl Med Mol Imaging. 2013 Dec; 26:140-148. 2.Y-H Chang, P-W Wang: “T-shaped” sign: a false-positive I-131 uptake in the stenum mimicking thyroid cancer metastasis. Ann Nucl Med Mol Imaging. 2013 Sep; 26: 113-115.
S5-4 Impact of 18F-FDG PET/CT on the Clinical Outcome and Management of Differentiated Thyroid Cancer Patients with Positive 131I Whole Body Scan and Elevated Thyroglobulin
YEN-HSIANG CHANG 張雁翔
Department of Nuclear Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan, R.O.C. 高雄長庚醫院 核子醫學科
Background: 18F-fluoro-deoxyglucose positron emission tomography and computed tomography (18F-FDG PET/CT) has a role in the surveillance of patients with differentiated thyroid cancer (DTC), especially those with thyroglobulin (Tg)-positive and a negative radioiodine whole body scan (131I WBS). Its usefulness in DTC patients with positive 131I WBS had seldom been discussed. The aim of this study was to evaluate the impact of 18F-FDG PET/CT on the management and clinical outcome of DTC patients with positive 131I WBS and elevated Tg.
Methods: From 2005 to 2013, a total of twenty-seven patients with DTC were retrospectively evaluated. All of the patients had undergone total or near-total thyroidectomy followed by radioiodine ablation. During the follow-up, the patients with positive 131I WBS and a concurrent detectable stimulated-Tg underwent an 18F-FDG PET/CT study within one year. Patients with any other form of malignancy were not included in this study. The 18F-FDG PET/CT findings were analyzed, with disease progression as a primary endpoint.
Results: Among the 27 patients, twenty (74%) patients had positive 18F-FDG PET/CT findings. The sensitivity, specificity, and diagnostic accuracy of 18F-FDG PET/CT for detecting recurrent/ residual lesions were 86.3%, 80%, and 85%, respectively. In 12 (44%) patients, 18F-FDG PET/CT provided additional information than 131I WBS and conventional imaging; 8 (30%) of them resulted in a change of clinical management.
Twelve (44%) patients experienced disease progression after 18F-FDG PET/CT during followup. The maximal standard uptake value (SUVmax) of the lesion with strongest 18F-FDG uptake was significantly higher in patients with progression than those without progression. Patients with lesion SUVmax over 4.5 were suggestive for disease progression with sensitivity of 90% and specificity of 87.5%. Of the 7 (26%) patients with negative 18F-FDG PET/CT result, 6 patients achieved undetectable Tg at the end of follow-up.
Conclusion: In DTC patients with positive 131I WBS and an elevated Tg, 18F-FDG PET/CT plays a complementary role to conventional follow-up methods. Lesion SUVmax provides prognostic information in identifying DTC patients with disease progression, while a negative 18F-FDG PET/CT result suggests a favorable prognosis.
