• The Korean Journal of Nuclear Medicine
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• v.10 no.1
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• pp.15-20
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• 1976

8 cases of sheehan's syndrome, diagnosed clinically and with laboratony tests, ware tested for the TSH secretion after TRH ($200{\mu}g$) stimulation. 2 cases out of the 8 showed normal response in its TSH secretion, and was interpreted as an evidence for clinical complexity in pituitary insufficiency of the sheehan's syndrome.

• 대한핵의학회:학술대회논문집
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• 1979.05a
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• pp.6.1-6.1
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• 1979

• Korean Journal of Psychosomatic Medicine
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• v.5 no.1
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• pp.118-122
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• 1997

We experienced a case of 51-year-old female patient who showed symptoms of persecutory delusion, auditory hallucination and hallucinatory behavior, severe insomnia, psychomotor retardation and social withdrawal, along with some clinical signs of the deficiency of various hormones those gradually progressed after massive postpartum vaginal bleeding 13 years ago. She was admitted to a psychiatric ward under the impression of psychotic depression. However careful history taking and evaluation of clinical feature gave rise to the possibility of underlying medical condition. Laboratory work-up revealed panhypopituitarism, hypoglycemia and hyponatremia. After replacement of thyroid hormone and cortisol for 1 week, her clinical symptoms including psychiatric symptoms were improved. Taken together, these findings were compatible with the diagnosis of Sheehan's syndrome. On reporting this case, we would like to emphasize again the importance of differential diagnosis of medical problems causing psychiatric symptoms those are easily neglected in the clinical approach toward psychiatric patients.

• Clinical and Experimental Reproductive Medicine
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• v.11 no.2
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• pp.17-25
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• 1984

Hypothalamic-pituitary function in patients of 6 selected groups of amenorrhea was evaluated by performing premarin test. Selected amenorrheic patients were divided into 6 groups of Turner's syndrome(5), adrenogenital syndrome(3), Sheehan's syndrome(4), moderate hyperprolactinemia(3), severe hyperprolactinemia(9) and functional oligoamenorrhea(9) the diagnoses of which were performed according to modified our own protocol for management of amenorrheic patients. As control 20 normally cycling women in mid follicular phase determined by their symptothermal charts during last 6 months designed by WHO were compared. The premarin test which is one of the tests evaluating the hypothalamic-pituitary function by the principle of negative and positive feed back effect's of estrogen was performed by injecting 20 mg of premarin in volus intravenously. The levels of serum LH before, 24, 48, 72, 96 and 120 hours after injection of premarin were measured by double antibody technique radioimmunoassay the reagents of which were supplied by WHO. The results were as follows: 1. Both negative and positive feed back effects by exogenous estrogen were well preserved even in the patients of gonadal dysgenesis although the baseline levels were much higher than normal. 2. In the patients of Sheehan's syndrome one could observe the minimal response of feed back effect in the case with minimal pituitary function. 3, Androgens in adrenogenital syndrome and prolactin in hyperprolactinemia may suppress mainly the positive feed back effect rather than the negative one. The suppressive effect can be abolished by proper treatments which can eliminate those suppressive hormones. 4. This premarin test may be beneficial for predicting the result of clomiphene in ovulation induction.

• Journal of Korean Neurosurgical Society
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• v.45 no.2
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• pp.118-121
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• 2009

Pituitary apoplexy is a clinical syndrome caused by an acute ischemic or hemorrhagic vascular accident involving a pituitary adenoma or an adjacent pituitary gland. Pituitary apoplexy may be associated with a variety of neurological and endocrinological signs and symptoms. However, isolated third cranial nerve palsy with ptosis as the presenting sign of pituitary apoplexy is very rare. We describe two cases of pituitary apoplexy presenting as sudden-onset unilateral ptosis and diplopia. In one case, brain magnetic resonance imaging (MRI) revealed a mass in the pituitary fossa with signs of hemorrhage, upward displacement of the optic chiasm, erosion of the sellar floor and invasion of the right cavernous sinus. In the other case, MRI showed a large area of insufficient enhancement in the anterior pituitary consistent with pituitary infarction or Sheehan's syndrome. We performed neurosurgical decompression via a transsphenoidal approach. Both patients showed an uneventful recovery. Both cases of isolated third cranial nerve palsy with ptosis completely resolved during the early postoperative period. We suggest that pituitary apoplexy should be included in the differential diagnosis of patients presenting with isolated third cranial nerve palsy with ptosis and that prompt neurosurgical decompression should be considered for the preservation of third cranial nerve function.

• The Korean Journal of Nuclear Medicine
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• v.13 no.1_2
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• pp.31-36
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• 1979

The TRH stimulation test was known as a highly diagnostic method in hypothalamopituitary disorders. To evaluate the location and the extension of the lesion, we estimated TSH response to TRH test in 27 patients. Correlation between volume of sella and TSH response was also studied. The results obtained were as follows: 1. In Sheehan's syndrome, TSH response after TRH test were not observed in all of 12 patients. 2. All 2 acromegaly patients showed normal TSH response. 3. In 4 cases of chromophobe adenoma, 2 cases showed no TSH response. In 2 responded cases, one patient whose tumor mass extended to suprasella region was hypothyroid state. 4. In craniopharyingioma 3 cases, the tumor which extended to intrasella showed hypothyroid and no TSH response. 5. Correlation between volume of sella and TSH response were valuable in 2 cases, but no diagnostic significance. 6. In diabetes inspidus, TSH response were all absent. 7. In primary amenorrhea, TSH response observed in 1 case, which conformed with isolated FSH deficiency.

• Clinical and Experimental Reproductive Medicine
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• v.19 no.1
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• pp.49-56
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• 1992

Bone mineral density was measured to assess whether the patients with premonopausal hypogonadism, comprised of 19 patients with hypogonadotropic hypogonadism(HH), 55 with premature ovarian failure(POF), 23 with hyperprolactinemia(HPLN), and 8 with Sheehan's syndrome. All aged from 20 to 39, were associated with some decrease in regional bone mass compared with that of 63 normal-associated with some decrease in regional bone mass compared with that of 63 normal-cycling control women matched with age and sex. Measurement of bone mineral density was carried out using Dual photon absorptiometry at four sites; femur neck, ward's triangle, trochanter and spine(L2-L4). Bone mineral density at all four sites were significantly decreased in patients with HH(p<0.01), POF(p<0.01). In hyperprolactinemic patients, the decrease in bone mass was significant at femur neck and Ward's triangle(p<0.05). The patients with POF were noted to be associated with significant bone loss when their duration of amenorrhea exceeded one year. In this study, the degree of loss of bone mass and the affected sites seemed to be different depending on the various types of hypogonadism and POF was noted have caused the appearance of loss of bone mass earlier than other thpes of hypogondism we experienced.

• The Korean Journal of Nuclear Medicine
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• v.13 no.1_2
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• pp.37-43
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• 1979

This is an analysis of 39 patients studied at the Yonsei Medical Center from January, 1976 to March 1979. Of these35 patient were suspected of having hypothalamic insufficiency and subjected to the L-Dopa stimulation test to observe growth hormone sceretory function while four acromegaly patient received the glucose loading test and L-Dopa stimulation test. The results are as follows: 1. The basal level of GH in the various disease was as follows: a. The basal level was lower than the control level but was not statistically significant b. In diabetes the mean value tended to be higher than the control level but was not significant statistically c. In all four acromegaly patients the GH level was significantly higher than the control level 2. Of 13 patients with diabetes, nine had diabetic retinopathy, and of those nine, sir showed increased L-Dopa response. However, of the four non retinopathic DM patients, only one showed increased response to L-Dopa. 3. Two patients out of ten with Sheehan's syndrome responded to L-Dopa stimulation. 4. One Patient of eight with pituitary chromophobe adenoma responded to L-Dopa stimulation. 5. Four acromegaly patients revealed 3 acidophilic adenoma and one chromophobe adenoma histologically. Of patients receiving the L-Dopa stimulation test. Two showed a paradoxical response. Two patients who received the glucose loading test showed supressed response. 6. Of two craniopharyngioma patients, one showed increased GH response after L-Dopa stimulation. Increased response of GH after L-Dopa stimulation was seen in one of two craniopharyngioma patients and also in one of two patients with