• Clinical and Experimental Pediatrics
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• 제57권10호
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• pp.425-433
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• 2014

Adrenal and thyroid hormones are essential for the regulation of intrauterine homeostasis, and for the timely differentiation and maturation of fetal organs. These hormones play complex roles during fetal life, and are believed to underlie the cellular communication that coordinates maternal-fetal interactions. They serve to modulate the functional adaptation for extrauterine life during the perinatal period. The pathophysiology of systemic vasopressor-resistant hypotension is associated with low levels of circulating cortisol, a result of immaturity of hypothalamic-pituitary-adrenal axis in preterm infants under stress. Over the past few decades, studies in preterm infants have shown abnormal clinical findings that suggest adrenal or thyroid dysfunction, yet the criteria used to diagnose adrenal insufficiency in preterm infants continue to be arbitrary. In addition, although hypothyroidism is frequently observed in extremely low gestational age infants, the benefits of thyroid hormone replacement therapy remain controversial. Screening methods for congenital hypothyroidism or congenital adrenal hyperplasia in the preterm neonate are inconclusive. Thus, further understanding of fetal and perinatal adrenal and thyroid function will provide an insight into the management of adrenal and thyroid function in the preterm infant.

• Clinical and Experimental Pediatrics
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• 제50권3호
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• pp.236-240
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• 2007

Majority of sick full term newborns have adequate adrenal cortical function in response to stress. Acutely ill neonates with a basal cortisol level less than $15{\mu}g/dL$ (414 nmol/L) suggest adrenal insufficiency and require function testing of adrenal function. In premature infant, immaturity of hypothalamic-pituitary adrenal axis (HPA axis), may limit the ability to increase cortisol production in response to stress. The response to low dose ACTH and CRH appears to be useful as an additional test of adrenal function. CRH stimulation has been used increasingly in neonates. The ACTH and CRH stimulated cortisol response of more than $17{\mu}g/dL$ (469 nmol/L) indicates a normal response.

• Journal of Genetic Medicine
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• 제14권1호
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• pp.27-30
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• 2017

Adrenal hypoplasia congenita (AHC) is a rare cause of adrenal insufficiency during neonatal period. Mutations in the gene coding for DAX1 cause X-linked adrenal hypoplasia. Most affected patients are shown to have salt wasting and hyperpigmentation on the skin during the neonatal period and require intensive medical care. In addition, it is usually associated with hypogonadotropic hypogonadism in adolescence. The DAX1 gene is expressed in the adrenal cortex, pituitary gland, hypothalamus, testis, and ovary. We report on a patient with genetically confirmed AHC whose initial clinical presentations were consistent with congenital adrenal hyperplasia. A point mutation in the DAX1 gene identified in this report resulted in a truncated DAX1 protein. Our patient was diagnosed with AHC.

• 농업과학연구
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• 제1권1호
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• pp.47-58
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• 1974

This study was made to investigate whether there would be any direct relationship between testis and adrenal gland. After the iadministration of testosterone propionate to the hypophysectomized male rats, weight of adrenal glands, each zona rates in adrenal gland and histological changes measured from the 1st day to 56th day of the experimental period. The results obtained were as follows; 1. For the weight changes of thyriod gland, it showed a similar changes between the hypophysectomized and the testosterone propionate treated-hypophysectomized group. However, the weight of adrenal glands for the treatment groups were decreased as the time passed as compared to the control group, and the difference were highly significance at the 7th day and there on. 2. For the zona rates in adrenal gland the changes were similar between the hypophysectomized and the testosterone propionate treated-hypophysectomized group. Zona fasciculata and reticularis were decreased rapidly as time passed as compared to the control group, and the difference were significant at the 7th day and highly significant at the 14th day and there on. Adrenal medulla tended to increase, showing a significance with P<0.05 at 7th day, and P<0.01 at 14th day and there on. Zona glomerulosa showed no differences among the groups. 3. Histological changes for the testosterone propionate treated-hypophysectomized group were similar to the hypophysectomized group. Of adrenal gland, zona fasciculata and reticular is were degenerated and lost their function as time passed after treatment, and zona glomerulosa and adrenal medulla were observed not bo changed. 4. Since there were re no differences in weight changes of adrenal glands, the zonarates in adrenal gland and histological changes between the hypophysectomized and testosterone propionate treated-hypophysectomized group, it would appear that there were no direct relationship between the testis and the adrenal gland, but the involvement of hypophysis might be necessary for the control mechanism.

• Journal of mucopolysaccharidosis and rare diseases
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• 제3권1호
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• pp.28-32
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• 2017

Lipoid congenital adrenal hyperplasia (LCAH) is the severe form of congenital adrenal hyperplasia and is characterized by adrenal insufficiency with hyperpigmentation and female external genitalia irrespective of genetic sex. The steroidogenic acute regulatory protein (StAR) is required for the transport of cholesterol into the mitochondria for steroidogenesis, and defects in the StAR gene account for the majority of LCAH cases. In this report, we present a two-day-old hyperpigmented infant with phenotypical female genitalia. With consideration of the clinical and laboratory findings, the infant was suspected of having adrenal insufficiency due to LCAH and treated with glucocorticoid, mineralocorticoid, and sodium chloride. Karyotyping revealed 46, XY. Upon pelvis ultrasonography, adrenal hyperplasia with abdominal masses (thought to be the testicles) was reported. Molecular analysis with targeted exome sequencing revealed the homozygote mutation of c.772C>T ($p.Q258^*$) in exon 7 of the StAR gene. The early detection and treatment of adrenal insufficiency in infants with hyperpigmentation can prevent clinically apparent adrenal crises. During follow-up, the patient had a good clinical condition and maintained normal electrolyte and adrenocorticotropic hormone levels with medication.

• Toxicological Research
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• 제6권1호
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• pp.89-97
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• 1990

Neural regulation of phenylethanolamine N-meth-yltransferase (PNMT) was studied with reserpine as a neuronal agent in rat adrenal medulla. The enzyme activity assay and northern blot analysis were performed to determine whether the induction of PNMT activity after reserpine treatment was associated with elevation of mRNA coding for PNMT. The i.p. administration of reserpine (2.5 mg/kg) on alternate days fot 4 injections to rats brought about 30% increase of adrenal medullary PNMT activity and approximately 60% stimulation of the PNMT mRNA level in rat adrenal gland. A dose of 10 mg/kg of reserpine was chosen to perform optimum induction of PNMT activity in the rat adrenal gland based on the results of dose response curve of reserpine. Time course reserpine (10 mg/kg) effects on the rat adrenal medullary PNMT were as follows: 1. Peripheral PNMT activity reached maximum level after 7 days of drug treatment on alternate days. 2. Trans-synaptic stimulation by reserpine increased pretranslational activity of rat adrenal PNMT, but not translational activity. 3. Immunotitration of PNMT molecule after reserpine treatment indicated that reserpine produced an enzyme with greater antibody affinity than endogenous molecule in the rat adrenal gland.

• BMB Reports
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• 제31권2호
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• pp.156-160
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• 1998

In this study, we cultured bovine capillary endothelial cells from adrenal cortex and compared these cells with capillary endothelial cells obtained from bovine adrenal medulla on morphological and cytokinetic properties. We demonstrated that bFGF and gelatin matrix were required for the growth of adrenal cortex-derived capillary endothelial cells over middle passage, but not for the growth of adrenal medulla-derived capillary endothelial cells. Also, we showed that the growth of adrenal cortex-derived capillary endothelial cells must be stimulated by bFGF and the gelatin matrix for the measurement of in vitro angiostatin activity. These data indicate that adrenal cortex-derived capillary endothelial cells over middle passage are more suitable than adrenal medulla-derived capillary endothelial cells for in vitro angiogenesis assay.

• Journal of Yeungnam Medical Science
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• 제36권3호
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• pp.265-268
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• 2019

Adrenal cystic lymphangiomas are extremely rare entities that are often identified incidentally, with less than 60 cases reported to date. We found a protruding ovoid mass consisting of a multiloculated cystic lesion within right adrenal gland in the cadaver of a 75-year-old Korean man. The epithelial cells lining the adrenal cyst were diffusely positive for cluster of differentiation 31 and podoplanin, and negative for pan-cytokeratin. The histopathological diagnosis confirmed a cystic lymphangioma arising from the adrenal gland. Post-mortem findings of the present case are discussed based on the clinicopathological features of adrenal cystic lymphangiomas.

• Nuclear Medicine and Molecular Imaging
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• 제42권sup1호
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• pp.130-133
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• 2008

Adrenal tumors are increasingly detected by widespread use of anatomical imaging such as a, MRI, etc. For these adrenal tumors, differentiation between malignancy and benignancy is very important. In diagnostic assessment of adrenal tumor, $^{18}F-FDG$ PET and PET-CT have been reported to have high diagnostic performance, especially, very excellent performance in evaluation of adrenal metastasis in the oncologic patient. In cases of adrenal incidentalomas, $^{18}F-FDG$ PET or PET-CT is helpful if a or chemical-shift MRI is inconclusive. $^{18}F-FDG$ PET and PET-CT may be applied to the patients with MIBG-negative pheochromocytomas. In summary, $^{18}F-FDG$ PET and PET-CT are expected to be effective diagnostic tools in the management of adrenal tumor.

• Clinics in Shoulder and Elbow
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• 제18권2호
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• pp.80-85
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• 2015

Background: This study measured the rate of adrenal insufficiency among rotator cuff tear patients, and determined the roles of steroid treatment and herbal medicine as specific risk factors of adrenal insufficiency. Methods: We prospectively evaluated the 53 patients who agreed to participate in the study and underwent arthroscopic rotator cuff repair due to a chronic full-thickness tear from March 2012 to September 2013. The diagnosis of adrenal insufficieny was made by rapid adrenocortical hormone test before the operation. We collected information regarding their history of steroid and herbal medicine treatment within the last 12 months. Results: The rate of adrenal insufficiency among the rotator cuff tear patients in our study was 18.9% (10 of 53 patients). Steroid treatment (p=0.034), frequency of local steroid injection (p=0.008), and herbal medicine treatment (p=0.02) showed significant association with the risk of adrenal insufficiency. Conclusions: In this study, careful taking of a patient's medical history, such as the use of steroids and herbal medicine, is important when investigating adrenal function before surgery.