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A Case of Multiple Paraganglioma Presenting as Recurrent Tumor Nermerous Times (수차례 재발한 다발성 부신경절종 1예)

  • Lee, Seok-Hee;Sun, Min-Jin;Choi, Mi-Suk;Lee, Dong-Wook
    • Korean Journal of Head & Neck Oncology
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    • v.27 no.1
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    • pp.80-83
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    • 2011
  • Paraganglioma is a relatively rare, generally benign and slow growing tumor arising from widely distributed paraganglionic tissue thought to originate from the neural crest. In the head and neck region, paraganglionic tissue is distributed in the superior and inferior paraganglia such as the carotid body, the vagal body, and the jugulotympanic region. Approximately 10% of patients with paraganglioma have a family history of such tumors. Multiple lesions can be found in 26% of patients with family history. It is important to distinguish between paraganglioma and atypical carcinoid tumor and medullary thyroid cancer. This can be done with histopathologic evaluation and immunohistochemical markers. Complete excision is recommended for the treatment of this tumor. Paraganglioma is particularly aggressive and rapid recurrence of paraganglioma is common after local resection. We present a case of malignant paraganglioma in the neck which recurred 2 months after local resection. We suppose that radiation therpay could be the last option for the treatment in this clinical setting.

Lorenzo's Oil Treatment in X-linked Adrenoleukodystrophy (X 염색체 연관 부신백질이영양증에서 Lorenzo Oil의 투여효과)

  • Kim, Hyo Jung;Kim, Eun Young;Woo, Young Jong;Kook, Hoon
    • Clinical and Experimental Pediatrics
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    • v.48 no.11
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    • pp.1232-1238
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    • 2005
  • Purpose : Though more than 15 years have passed after introduction of Lorenzo's oil therapy in X-linked adrenoleukodystrophy(ALD), its efficacy is still fully not known. In patients who already have neurologic symptoms, most reports indicate that the neurologic disability continues to increase. We evaluated its efficacy in X-linked ALD patients. Methods : Four patients who were treated with Lorenzo's oil for at least 12 months were enrolled from 1996 to 2003. During treatment, changes of neurologic symptoms, brain magnetic resonance imaging(MRI) findings, and serum saturated very long-chain fatty acid(C26:0) were assessed. Results : Two patients with childhood cerebral ALD had progression of neurologic symptoms and MRI lesions during treatment. One asymptomatic patient developed childhood cerebral ALD after six year treatment of Lorenzo's oil. One "Addison only" patient remained neurologically intact after three years. During Lorenzo's oil therapy, serum C26:0 levels which had increased at diagnosis decreased in all four patients. Conclusion : Treatment with Lorenzo's oil did not prevent disease progression in childhood cerebral ALD patients who were already symptomatic. Long term follow up will be needed in asymptomatic ALD including "Addison only" to reveal the efficacy of Lorenzo's oil.

Effect of Inhaled Fluticasone Propionate on Hypothalamic-Pituitary-Adrenal Axis in Bronchial Asthma Patient (기관지 천식환자에서 Fluticasone Propionate 흡입제가 Hypothalamic-Pituitary-Adrenal Axis에 미치는 영향)

  • Hwang, Jun-Kyu;Lee, Ho-Meong;No, Yang-Won;Park, Gye-Young;Park, Chong-Wung;Park, Jae-Kyung;Jeong, Seong-Hwan;Nam, Gui-Hyun;Kim, Hong-Kyu;Park, Hye-Young;Kang, Moon-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.1
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    • pp.25-34
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    • 2001
  • Background : Inhaled glucocorticoids are the medical treatment of choice in asthma patients. Fluticasone propionate is one of the most effective inhaled corticosteroids and has been reported to have minimal effect on the hypothalamic-pituitary-adrenal axis at the recommended dose. However, reports of long-term trials characterizing their systemic safety with chronic use are rare. This study was designed to evaluate the long-term safety of inhaled fluticasone propionate to the hypothalamic-pituitary-adrenal axis. Method : This study was conducted on 21 patients to evaluate the adrenal response to rapid ACTH stimulation test after 6 months of treatment with fluticasone propionate from $200\;{\mu}g$ to $750\;{\mu}g$ daily. The serum cortisol levels was measured to assess its effect on the hypothalamic-pituitary-adrenal axis just prior to the injection, at 30 minutes and 60 minutes after an intramuscular injection of synthetic ACTH. Result : The mean dose of inhaled fluticasone propionate was $355\;{\mu}g$ per day(SD=$174\;{\mu}g$, range=$200\;{\mu}g$ to $750\;{\mu}g$). The mean serum cortisol levels of the patients was $11.0\;{\mu}g/d{\ell}$(SD=$6.4\;{\mu}g/d{\ell}$) prior to the injection, $20.0\;{\mu}g/d{\ell}$ (SD=$7.7\;{\mu}g/d{\ell}$) after 30 minutes, and $23.0\;{\mu}g/d{\ell}$(SD=$6.3\;{\mu}g/d{\ell}$) after 60 minutes. Sixteen patients of the 21 patients had a normal response(> $18\;{\mu}g/d{\ell}$), and 5 out of the 21 patients had serum cortisol levels below the normal range after the rapid ACTH stimulation test. Conclusion: Adrenal suppression occurred in 5 out of 21 patients with 6 months treatment with inhaled fluticasone propionate.

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Effect of Induced molting on the Relative Weights and Hormone Levels of Thyroid, Ovary, and Adrenal Glands in Spent Laying Hens (산란노계에서 강제환우가 갑상선, 난소, 부신 및 호르몬 수준에 미치는 영향)

  • M. Akram;rahman, Zia-ur;C.S. Na;Kim, S.H.;K.S. Ryu
    • Korean Journal of Poultry Science
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    • v.29 no.4
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    • pp.243-247
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    • 2002
  • A study was conducted to investigate the effect of induced molting on the relative weight and hormone levels of thyroid, ovary, and adrenal glands in spent laying hens. Three hundred sixty 77-wk-old, Babcock White hens were divided into 36 experimental units of 10 hens each and induced to molt for seven weeks. A diet containing 16% CP and 2,800 kcal ME/kg was fed ad libitum from 84 to 126 weeks of age. Thirty-six birds were randomly selected for blood collection and slaughtered at Pre-molt, 5% egg Production, Peak, and end Phase of the egg Production. Weights of the thyroid, ovary, adrenal glands, and plasma T3, T4, cortisol, and estradiol contents were measured at each stage. Weight of the thyroid reached its highest level at 5% e99 Production stage. The ovary weight was greatly reduced during molting, but started to increase after induced molting until the end of the egg Production Phase (P<0.05). Plasma T3,T4 and cortisol were found to be the highest at the start of the Post-molt Production stage, but reached their minimum at the end Phase of e99 Production. Plasma estradiol was the lowest at the 5% egg Production stage. The Present study demonstrated that molting is a complex Process that require the involvement of endocrine glands to trigger their specific hormones, which play a key role in molt induction.

Forskolin-Induced Potentiation of Catecholamine Secretion Evoked By Ach, DMPP, McN-A-343 and Excess $K^+$ From the Rat Adrenal Gland (Forskolin의 흰쥐적출관류부신으로 부터 Ach, Excess $K^+$, DMPP, McN-A-343에 의한 Catecholamine 분비효과의 증강작용)

  • Lim, Dong-Yoon;Kim, Won-Shik;Choi, Cheol-Hee
    • The Korean Journal of Pharmacology
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    • v.27 no.2
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    • pp.167-181
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    • 1991
  • The present study was an attempt to investigate the effect of forskolin on secretion of catecholamines (CA) evoked by Ach, excess $K^+$, DMPP, McN-A-343 and caffeine from the isolated perfused rat adrenal glands and to elucidate its mechanism of action. The perfusion with forskolin (1.0 uM) for 1 min into the adrenal vein enhanced markedly the secreation of CA evoked by Ach (50 ug), excess $K^+$ (56 mM) DMPP (100 uM) and by caffeine (0.3 mM) but did not that by McN-A-343. Forskolin alone did not potentiate the CA secretion. Moreover, forskolin augmented the CA release evoked by the above same stimulation even in the absence of extracellular calcium. The 1 min perfusion of 300 uM-dibutyryl cyclic AMP (DBcAMP), which is known to increase cyclic AMP levels, led to enhancement of Ca secretion evoked by Ach, excess $K^+$ and DMPP but did not that by McN-A-343 and caffeine. DBcAMP by itself also did not augment the CA secretion. In the calcium-free medium DBcAMP significantly enhanced the CA secretion by the same stimulation, except for the case of McN-A-343. These experimental results suggest that forskolin activates adenylate cyclase, resulting the elevation of cyclic AMP which may potentiate cholinergic nicotinic receptor-mediated and also depolarization-dependent CA secretion and that it may alter the intracellular calcium homeostasis in the rat adrenal glands.

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Ultrastructural Studies on the Adrenal Medulla of The Developmental Rats (연령에 따른 흰쥐 부신 수질의 전자현미경적 관찰)

  • Park, Joo-Hee;Lee, Jae-Hyun;Ku, Sae-Kwang;Lee, Hyeung-Sik
    • Applied Microscopy
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    • v.28 no.2
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    • pp.215-224
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    • 1998
  • To investigate ultrastructural changes on the adrenal glands of the developmental rats, tissues were collected at 20 days of gestation, at birth, 7 days, 15 days and 30 days after birth and studied by electron microscope. In the medulla of adrenal gland of the rat, two types of granules were observed at ultrastructural level. The one were adrenaline $(123\sim200nm)$ and the others were noradrenaline ($177\sim279nm$ of long axis, $124\sim194$ of short axis). Adrenaline granules were characterized by presence of round or spherical with low or moderate electron density. The granules showed a wide lucent or clean halo between the contents and the limiting membrane. On the other hand noradrenaline granules were characterized by the presence of irregular shape with high electron density. This granules showed a wide lucent between the contents and limiting membrane. These two types of granules were co-existed in one cell in the late gestation and at birth, but after that two types of cells were clearly observed. The different sizes and numbers of granules were observed with ages.

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Sporothrix schenckii Infection in a Dog with Concurrent Hyperadrenocorticism and Diabetes Mellitus (부신겉질기능항진증과 당뇨 병발 개에서 Sporothrix schenckii 감염 증례)

  • Song, Jaeyong;Lee, Bareun;Kim, Hyun-Min;Kang, Jooyeon;Cho, Hyunkee;Choi, Ul-Soo;Hwang, Cheol-Yong;Choi, Jung Hoon;Chung, Jin-Young
    • Journal of Veterinary Clinics
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    • v.32 no.6
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    • pp.511-513
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    • 2015
  • A 12-year-old spayed Pomeranian was presented with a purulent, erythematous mass. The dog also suffered from concurrent hyperadrenocorticism and diabetes mellitus. Sporothrix schenckii was isolated through the fungal culture of the mass. Surgical ablation of the mass was performed for the removal of continuous inflammation and fungal infection of deep origin. After histological examination of the mass, severe multifocal pyogranulomatous dermatitis and panniculitis were diagnosed. This is the first confirmed case of pyogranulomatous dermatitis and panniculitis due to Sporothrix schenckii infection in a dog with concurrent hyperadrenocorticism and diabetes mellitus. In addition this is the first case report of sporotrichosis in South Korea.