• Clinical and Experimental Pediatrics
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• v.50 no.3
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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.

• Clinical and Experimental Pediatrics
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• v.57 no.10
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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.

• Clinics in Shoulder and Elbow
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• v.18 no.2
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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.

• Korean Journal of Agricultural Science
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• v.1 no.1
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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 Chest Surgery
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• v.43 no.2
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• pp.191-193
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• 2010

Unexplained hypotension during a stay in the ICU is not uncommon in patients who underwent major surgery such as open heart surgery. When the cardiac output of patients is low, the heart may be the origin of this problem. If the heart function is normal, then we have to consider adrenal insufficiency as a possible cause of this hypotension. Adrenal insufficiency is a rare condition in the general population, yet patients who are under a stressful condition might experience adrenal insufficiency more frequently. We report here on a case of a patient who was in an unstable postoperative state with adrenal insufficiency after surgery and the patient dramatically recovered after the replacement of hydrocortisone.

• Korean Journal of Veterinary Research
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• v.8 no.2
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• pp.110-116
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• 1968

The mature guinea pigs were grouped as indicated in the table 1. Radio-active iodine(I-131)in dose of 4.5mci, was administered to the experimental groups. The animals were killed for examination in 1, 7, 14, 28, 42, and 55 days after the administration the radio-active iodine. The thyroid and adrenal glands were observed histologically. The results obtained were as follows; 1. One day after the administration, thyroid epithelial cells were abnormally enlarged. After seven days, specimens taken from the middle of the thyroid showed that the follicles and epithelial cells were changing to fibrous tissue, however, some follicles still remained in the verge of the thyroid. Follicles were not observed after fourteen days. After twenty-eight days, the follicles had all changed to fibrous tissue, and had lost their function. 2. The size of the zonas gromerulosa of adrenal cortex epually, in both male and female, showed slight fluctuation in size with no tendency to be changed. 3. Among the zones of the adrenal glands, zona fasciculata showed marked changes. Zona fasciculata was atrophied in Process of time. In females, it was atrophied significantly(P<0.05) after fourteen days, and highly significant (P<0.01) in twenty-eight and fifty-six days after the administration of radioactive iodine. In males, it also decreased significantly(P<0.05) in seventy-eight days and highly significant(P<0.01) in forty-two and fifty-six days after the administration. 4. The size of the Zona reticularis of adrenal cortex in the females increased significantly (P<0.05) in twenty-eight days after the administration. In males, it showed slight fluctuation until twenty-eight days, but it increased significantly(P<0.05) in forty-two and fifty-six days after the administration. 5. The size of the adrenal medulla increased significantly(P<0.05) in twenty-eight and forty-two days in females. It was increased significantly(P<0.05) in fourth-two days and high significantly(P<0.01) in fifty-six days after the administration.

• Endocrinology and Metabolism
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• v.32 no.3
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• pp.353-359
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• 2017

Background: Cushing syndrome is characterized by glucose intolerance, cardiovascular disease, and an enhanced systemic inflammatory response caused by chronic exposure to excess cortisol. Eosinopenia is frequently observed in patients with adrenal Cushing syndrome, but the relationship between the eosinophil count in peripheral blood and indicators of glucose level in patients with adrenal Cushing syndrome has not been determined. Methods: A retrospective study was undertaken of the clinical and laboratory findings of 40 patients diagnosed with adrenal Cushing syndrome at Chungnam National University Hospital from January 2006 to December 2016. Clinical characteristics, complete blood cell counts with white blood cell differential, measures of their endocrine function, description of imaging studies, and pathologic findings were obtained from their medical records. Results: Eosinophil composition and count were restored by surgical treatment of all of the patients with adrenal Cushing disease. The eosinophil count was inversely correlated with serum and urine cortisol, glycated hemoglobin, and inflammatory markers in the patients with adrenal Cushing syndrome. Conclusion: Smaller eosinophil populations in patients with adrenal Cushing syndrome tend to be correlated with higher levels of blood sugar and glycated hemoglobin. This study suggests that peripheral blood eosinophil composition or count may be associated with serum glucose levels in patients with adrenal Cushing syndrome.

• Korean Journal of Agricultural Science
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• v.3 no.2
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• pp.198-206
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• 1976

In order to find the effects of testis function on adrenal gland, immature male rats were administered by 20 mg of testosterone propionate with 10 days interval for 50 days, and their adrenal weights and histological changes were compared with those of normal ones, and the results obtained were as follow: Adrenal weight was increased with the period of treatments, and especially the significant difference was recognized after 30 days. Of the zones in adrenal gland, the portion of zona fasciculata and reticularis increased significantly after 20 days and 30 days, respectively, while that of adrenal medulla was decreased significantly after 20 days. In histological changes, hypertrophy and vacuolization were observed in zona fasciculata and reticularis after 20 days, but no changes were recognized in zona glomerulosa and adrenal medulla.

• Journal of Hospice and Palliative Care
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• v.17 no.3
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• pp.113-121
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• 2014

The major symptoms of terminally ill cancer patients are fatigue, loss of energy, feeling of helplessness, poor appetite and pain as well as general weakness, which are very similar to symptoms of adrenal insufficiency. Adrenal insufficiency-induced symptoms widely vary from mild symptoms to life-threatening conditions and may be resulted from variable medical causes. For terminally ill cancer patients who are hospitalized for palliative care, opioid agents are prescribed to control moderate to severe pain. The use of acute or chronic opioid agents is believed to negatively affect adrenal gland function. In most studies of opioid effects (preclinical/clinical with animal subjects or and patients suffering non-malignant pain, adrenal insufficiency and hormonal abnormalities were observed as side effects. However, opioid-induced adrenal insufficiency has been rarely reported in studies with patients with malignant cancer pain. Relationship between the type, treatment period, dosage of opioid agents and hormonal abnormalities can be examined by measuring the functional level of the adrenal glands. We hope to improve patient's quality of life by indicating hormone substitution to treat symptoms of adrenal insufficiency.

• Development and Reproduction
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• v.25 no.4
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• pp.257-268
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• 2021

Phthalates and their metabolites are well-known endocrine disrupting chemicals. Di-(2-ethylhexyl) phthalate (DEHP) has been widely used in industry and the exposing possibility to adult is high. In this study, DEHP was treated (133 ㎍/L and 1,330 ㎍/L in drinking water) according to the OECD test guideline 443 to mature female mice and their adrenal gland were examined for histological characteristics and steroidogenic gene expression. The wet weight of the adrenal gland was increased in all administrated groups compared to control. The diameter of zona fasciculata (ZF) was increased by DEHP in both outer ZF and inner ZF but there was no difference in morphology of the cells and arrangements into zona between groups. In addition, the arrangement of extracellular matrix was not different between control and DEHP groups. CYP11B1 was mainly localized at ZF and the intensity was not different between groups. DAX1 was localized in zona glomerulosa (ZG) and ZF, and its expression levels were decreased by DEHP administration. Its level was lower in DEHP133 group than DEHP1330 group. On the other hand, CYP17A1 was localized in ZG of DEHP1330 group. These results suggest that chronic low-dose DEHP exposing may modify the microstructure and function of the adrenal cortical cortex.