• 제목/요약/키워드: Adrenal Function

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신생아에서의 부신기능 평가와 질환 (Evaluation of function and disorders of the adrenal gland in neonates)

  • 황일태
    • 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.

Adrenal and thyroid function in the fetus and preterm infant

  • Chung, Hye Rim
    • 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.

Adrenal Insufficiency in Patients with Rotator Cuff Tear: Prevalence, Risk Factors and Influence on Outcome

  • Kim, Jung-Han;Gwak, Heui-Chul
    • 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.

하수체척출(下垂體剔出) 숫흰쥐에 있어서 Testosterone Propionate의 투여(投與)가 부신(副腎)에 미치는 영향(影響) (Effects of Testosterone Propionate Administration on Adrenal Gland in Hypophysectomized Male Rats)

  • 김관영;이규승;정영채
    • 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.

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개심술 후 부신피질 결핍증에 의한 혈역학적 불안정 (Hemodynamic Instability due to Adrenal Insufficiency after Open Heart Surgery)

  • 김혜원;정철현
    • Journal of Chest Surgery
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    • 제43권2호
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    • pp.191-193
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    • 2010
  • 개심술과 같은 큰 수술을 받은 환자가 중환자실 치료 중 저혈압을 겪게 되는 경우는 드물지 않다. 환자의 심장 기능이상이 주요 원인이지만 부신피질 결핍에 의한 경우도 한 원인이 될 수 있다. 부신피질 호르몬 결핍증은 일반인에게는 매우 드물지만, 수술과 같은 스트레스 상황에 처한 환자들에게서는 종종 볼 수 있다. 본 증례는 개심술 후 발생한 부신피질 호르몬 결핍증을 치료한 경우로, 극심한 저혈압으로부터 hydrocortisone 투여 후 극적인 회복을 보여주는 예이다.

Guinea pig의 갑상선기능(甲狀腺機能)이 부신(副腎), 뇌하수체(腦下垂體) 및 생식선(生殖腺)에 미치는 영향(影響) I. Guinea pig의 갑상선(甲狀腺)이 부신(副腎)에 미치는 영향(影響) (Effects of the Thyroid Function on the Adrenal Gland, Hypophysis and Gonads in the Guinea Pigs. 1 Effects of the Thyroid Function on the Adrenal Gland in the Guinea Pigs)

  • 이강욱;이규승;정영채
    • 대한수의학회지
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    • 제8권2호
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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.

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The Eosinophil Count Tends to Be Negatively Associated with Levels of Serum Glucose in Patients with Adrenal Cushing Syndrome

  • Lee, Younghak;Yi, Hyon-Seung;Kim, Hae Ri;Joung, Kyong Hye;Kang, Yea Eun;Lee, Ju Hee;Kim, Koon Soon;Kim, Hyun Jin;Ku, Bon Jeong;Shong, Minho
    • Endocrinology and Metabolism
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    • 제32권3호
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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.

Testosterone Propionate의 투여(投與)가 어린 숫흰쥐의 부신(副腎)에 미치는 영향(影響) (Effect of Testosterone Propionate Administration on Adrenal Gland in Immature Male Rats)

  • 이규승
    • 농업과학연구
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    • 제3권2호
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    • pp.198-206
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    • 1976
  • 정소의 기능(機能)이 부신(副腎)에 미치는 영향(影響)을 구명(究明)코져 말성숙(末成熟) 숫흰쥐에 매(每) 10일간격(日間隔)으로 20 mg씩의 testosterone propionate를 투여(投與)한 후(後) 부신(副腎)의 중량(重量) 및 조직학적(組織學的) 변화(變化)를 50일간(日間) 조사하여 정상대조군(正常對照群)과 비교(比較) 검토(檢討)한바 다음과 같은 결론(結論)을 얻었다. 부신(副腎)의 중량(重量)은 처리기간(處理期間)이 경과(經過)할수록 증가(增加)되는 결과(結果)였는데 30일후(日後)부터 유의성(有意性)이 인정(認定)되었다. 부신(副腎)에서 각층(各層)이 차지하는 비율(比率)의 변화(變化)에 있어서, 색상대(索狀帶)는 20일후(日後), 망상대(網狀帶)는 30일후(日後)부터 유의(有意)하게 증가(增加)하였으며, 부신수질(副腎髓質)은 감소(減少)하는 경향(傾向)이었는데 20일후(日後)부터 유의성(有意性) 인정(認定)되었다. 부신(副腎)의 조직학적변화(組織學的變化)는 색상폐(索狀幣)와 망상대(網狀帶)에서는 20일후(日後)부터 세포(細胞)가 비대(肥大)하여지고 공포변성(空胞變性)이 인지(認知)되었으나 피질(皮質)의 구상대(球狀帶)와 부신수질(副腎髓質)에서는 특기(特記)할 만한 변화(變化)가 인지(認知)되지 않았다.

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마약성 진통제 사용과 부신기능부전 (Opioids Use and Adrenal Insufficiency)

  • 정지훈;최윤선;김정은;김이연
    • Journal of Hospice and Palliative Care
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    • 제17권3호
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    • pp.113-121
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    • 2014
  • 치료 불가능한 암환자들은 전신적 쇠약 이외에 피로와 에너지 상실, 무력감, 식욕부진 및 통증 등이 주요 증상으로 알려져 있으며, 이러한 증상들은 부신기능부전으로 인한 증상들과 매우 유사한 양상을 보인다. 부신기능부전으로 인한 증상들은 가벼운 증상부터 생명을 위협하는 증상까지 다양하게 나타날 수 있으며, 이러한 부신기능부전은 다양한 원인에 의해 나타난다. 완화의료병동에 입원 중인 말기암환자들 중 중등도 이상의 통증을 호소하는 환자들은 마약성 진통제를 사용하여 통증 조절을 받고 있는데, 이러한 마약성 진통제의 사용은 부신기능에 영향을 주는 것으로 알려져 있다. 동물 및 비암성 통증을 호소하는 환자 대상으로 여러 연구들이 시행되었으며 대부분의 연구에서 마약성 진통제로 인해 부신기능의 저하가 나타났음을 보여주었다. 그러나 아직 암환자를 대상으로 한 마약성 진통제로 인한 부신기능의 저하에 대한 연구 결과는 드물다. 마약성 진통제로 통증 조절을 받고 있는 완화의료병동에 입원한 말기암환자들의 부신기능을 측정함으로써 마약성 진통제의 종류, 사용기간 및 용량과 부신기능의 관계를 파악하고 이에 따른 대증치료 및 호르몬 보충 요법은 환자들의 예후 및 삶의 질 향상에 도움을 줄 수 있을 것으로 기대된다.

A Chronic-Low-Dose Exposing of DEHP with OECD TG 443 Altered the Histological Characteristics and Steroidogeic Gene Expression of Adrenal Gland in Female Mice

  • Lee, Bo Young;Jo, Jeong Bin;Choi, Donchan;Lee, Sung-Ho;Cheon, Yong-Pil
    • 한국발생생물학회지:발생과생식
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    • 제25권4호
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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.