• 제목/요약/키워드: Hypothalamic dysfunction

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A Neonatal Case of Septo-Optic Dysplasia with Schizencephaly (분열뇌증을 동반한 중격 시신경 형성장애 신생아 1례)

  • Lee, Won-Hee;Kim, Eun-Young;Park, Sang-Kee
    • Neonatal Medicine
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    • v.16 no.1
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    • pp.81-84
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    • 2009
  • Septo-optic dysplasia is a rare congenital disorder characterized by the absence of the septum pallucidum, hypoplasia of the optic chiasma and nerves, and various types of hypothalamic-pituitary dysfunction. Schizencephaly is an abnormal cleft in the brain, lined with gray matter which may communicate with the ventricular system. Septo-optic dysplasia with schizencephaly is associated with endocrinologic disorders, visual impairment, mental retardation, and seizures. We report a case of septo-optic dysplasia with schizencephaly which was diagnosed in the early neonatal period.

A regulatory effect of Cervi Cornu Parvum aqua-acupuncture on serum estradiol level after ovariectomy (녹용약침(鹿茸藥鍼)이 난소절제(卵巢切除) 흰쥐의 혈청(血淸) estradiol 함량(含量)에 미치는영향(影響))

  • Kwak Dong-Uk;Yang Chae-Ha
    • Journal of Acupuncture Research
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    • v.15 no.2
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    • pp.29-41
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    • 1998
  • The effect of Cervi Cornu Parvum aqua-acupuncture on serum levels of sex hormone was investigated in ovariectomized rats. Water extract of Cervi Cornu Parvum was daily injected for 30 days at points in rats corresponding to bilateral Taixi (Ki. 3) points of human and non-point at root of tail after ovariectomy, respectively. Serum levels of estradiol, testosterone, progesterone, LH and FSH were measured at 2 and 4 weeks after aqua-acupuncture treatment, respectively. Compared with ovariectomized rats, significant increase of estradiol and progesterone and significant decrease of FSH and LH were elicited at 2 and 4 weeks after aqua-acupuncture treatment. Aqua-acupuncture treatment at non-point did not produce any remarkable effect. These findings suggest aqua-acupuncture may restore dysfunction of hypothalamic-pituitary-ovarian axis, associated with a significant increase of serum estradiol level in ovariectomized rats.

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Growth Hormone Therapy in Adults with Prader-Willi Syndrome

  • Cho, Sung Yoon
    • Journal of mucopolysaccharidosis and rare diseases
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    • v.1 no.2
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    • pp.49-53
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    • 2015
  • Prader-Willi syndrome (PWS) is a complex multisystem genetic disorder characterized by hypothalamic-pituitary dysfunction. Many features of PWS indicate a deficiency in growth hormone (GH) production, and these findings provide a rationale for GH therapy in PWS. It is possible that rhGH therapy could have beneficial effects in adults with PWS, similar to those in adults with GH deficiency (GHD) of non-syndromic cause. However, there is a paucity of data on the use of GH in adults with PWS. Here, the previous studies about efficacy and safety of rhGH therapy in PWS adults are summarized. Briefly, rhGH therapy in PWS adults may improve body composition, leading to increased lean body mass and decreased fat mass, as well as decreased subcutaneous and visceral adiposity without overall changes in body mass index. There may be at least transient deterioration in glucose homoeostasis in some PWS patients on rhGH therapy, which requires further study. In addition, clinical care guidelines for rhGH therapy in adults with PWS were suggested.

The Clinical Study on the Case of Patient with Amenorrhea after Obesity Treatment (비만치료(肥滿治療) 후(後) 발생(發生)한 무월경(無月經) 환자에 대한 임상적 고찰)

  • Song, Mi-Seon;Lim, Eun-Mee
    • Herbal Formula Science
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    • v.14 no.1
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    • pp.192-200
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    • 2006
  • Women with moderate weight loss have secondary or primary amenorrhea. The amenorrhea. which is usually reversible with weight gain, decreased exercise. or both, is due to hypothalamic dysfunction. But 30% of amenorrheic women with weight gain is irreversible. Recently we experienced one case of secondary amenorrhea with severe weight loss, as oriental medicine treatment secondary amenorrhea is cured, so report a medical treatment course and result.

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Diencephalic syndrome: a frequently neglected cause of failure to thrive in infants

  • Kim, Ahlee;Moon, Jin Soo;Yang, Hye Ran;Chang, Ju Young;Ko, Jae Sung;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • v.58 no.1
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    • pp.28-32
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    • 2015
  • Purpose: Diencephalic syndrome is an uncommon cause of failure to thrive in early childhood that is associated with central nervous system neoplasms in the hypothalamic-optic chiasmatic region. It is characterized by complex signs and symptoms related to hypothalamic dysfunction; such nonspecific clinical features may delay diagnosis of the brain tumor. In this study, we analyzed a series of cases in order to define characteristic features of diencephalic syndrome. Methods: We performed a retrospective study of 8 patients with diencephalic syndrome (age, 5-38 months). All cases had presented to Seoul National University Children's Hospital between 1995 and 2013, with the chief complaint of poor weight gain. Results: Diencephalic syndrome with central nervous system (CNS) neoplasm was identified in 8 patients. The mean age at which symptoms were noted was $18{\pm}10.5$ months, and diagnosis after symptom onset was made at the mean age of $11{\pm}9.7$ months. The mean z score was $-3.15{\pm}1.14$ for weight, $-0.12{\pm}1.05$ for height, $1.01{\pm}1.58$ for head circumference, and $-1.76{\pm}1.97$ for weight-for-height. Clinical features included failure to thrive (n=8), hydrocephalus (n=5), recurrent vomiting (n=5), strabismus (n=2), developmental delay (n=2), hyperactivity (n=1), nystagmus (n=1), and diarrhea (n=1). On follow-up evaluation, 3 patients showed improvement and remained in stable remission, 2 patients were still receiving chemotherapy, and 3 patients were discharged for palliative care. Conclusion: Diencephalic syndrome is a rare cause of failure to thrive, and diagnosis is frequently delayed. Thus, it is important to consider the possibility of a CNS neoplasm as a cause of failure to thrive and to ensure early diagnosis.

Alteration of Thyroid Function in Indian HER 2-Negative Breast Cancer Patients Undergoing Chemotherapy

  • Ashif Khan, Mohd;Bhurani, Dinesh;Agarwal, Nidhi B
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7701-7705
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    • 2015
  • Background: Thyroid hormones (TH) are regulated by the hypothalamic-pituitary axis, which plays an important role in cell growth, differentiation, development and other aspects of metabolism. It is believed that an active hypothalamic-pituitary axis increases the susceptibility of thyroid dysfunction during systemic chemotherapy. In order to investigate the relation between thyroid function and chemotherapy the present study was designed to investigate TH in breast cancer patients receiving at least three cycles of chemotherapy. The levels of TH were measured at the baseline and before each cycle of chemotherapy. Materials and Methods: Blood samples for estimation of TH levels were collected from 80 (pre-menopausal-40; post-menopausal-40) breast cancer patients just before they were undergoing - $1^{st}$, $2^{nd}$, $3^{rd}$ and $4^{th}$ cycle of chemotherapy. The serum was separated and $T_3$, $T_4$ and TSH levels were determined by chemiluminescence method. Results: $T_3$ and $T_4$ were found significantly decreased and TSH was found significantly increased after $1^{st}$ (p<0.001), $2^{nd}$ (p<0.0001) and $3^{rd}$ cycle of chemotherapy (p<0.0001). The variation of $T_3$ levels (decreased) and TSH levels (increased) was found more in post-menopausal (p<0.0001) women then in pre-menopausal women after $3^{rd}$ cycle of chemotherapy as compared to baseline (p<0.001). Conclusions: TH were remarkably altered after each cycle of chemotherapy leading to decline in thyroid function of breast cancer patients. Further, the results also indicated that post-menopausal women were more prone towards decline in thyroid function then pre-menopausal women. The present study proposes the monitoring of TH after each cycle of chemotherapy in breast cancer patients.

Tetramethylpyrazine reverses anxiety-like behaviors in a rat model of post-traumatic stress disorder

  • Lee, Bombi;Shim, Insop;Lee, Hyejung;Hahm, Dae-Hyun
    • The Korean Journal of Physiology and Pharmacology
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    • v.22 no.5
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    • pp.525-538
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    • 2018
  • Post-traumatic stress disorder (PTSD) is a trauma-induced psychiatric disorder characterized by impaired fear extermination, hyperarousal, and anxiety that may involve the release of monoamines in the fear circuit. The reported pharmacological properties of tetramethylpyrazine (TMP) include anti-cancer, anti-diabetic, anti-atherosclerotic, and neuropsychiatric activities. However, the anxiolytic-like effects of TMP and its mechanism of action in PTSD are unclear. This study measured several anxiety-related behavioral responses to examine the effects of TMP on symptoms of anxiety in rats after single prolonged stress (SPS) exposure by reversing the serotonin (5-HT) and hypothalamic-pituitary-adrenal (HPA) axis dysfunction. Rats were given TMP (10, 20, or 40 mg/kg, i.p.) for 14 days after SPS exposure. Administration of TMP significantly reduced grooming behavior, increased the time spent and number of visits to the open arm in the elevated plus maze test, and significantly increased the number of central zone crossings in the open field test. TMP administration significantly reduced the freezing response to contextual fear conditioning and significantly restored the neurochemical abnormalities and the SPS-induced decrease in 5-HT tissue levels in the prefrontal cortex and hippocampus. The increased 5-HT concentration during TMP treatment might be partially attribute to the tryptophan and 5-hydroxyindoleacetic acid mRNA level expression in the hippocampus of rats with PTSD. These findings support a role for reducing the altered serotonergic transmission in rats with PTSD. TMP simultaneously attenuated the HPA axis dysfunction. Therefore, TMP may be useful for developing an agent for treating psychiatric disorders, such those observed in patients with PTSD.

Nonalcoholic Fatty Liver Disease Progressing to Cirrhosis in an Obese Boy with Hypopituitarism (청소년기에 간경화증으로 진행된 비알콜성 지방간질환 1예)

  • Park, Ji-Yong;Ko, Jae-Sung;Seo, Jeong-Kee;Lee, Ran;Shin, Choong-Ho;Kang, Gyeong-Hoon;Kim, Woo-Sun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.2
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    • pp.204-209
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    • 2008
  • Non-alcoholic fatty liver disease (NAFLD) is typically associated with obesity and insulin resistance. Non-alcoholic steatohepatitis (NASH) is a more serious form of NAFLD. Although fibrosis is common in pediatric NASH, cirrhosis has been rarely reported. Patients with hypothalamic or pituitary dysfunction are at risk for obesity and insulin resistance with subsequent development of NAFLD. We report a case of NAFLD progressing to cirrhosis in an obese 16 year-old boy with hypopituitarism.

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Endocrine problems in children with Prader-Willi syndrome: special review on associated genetic aspects and early growth hormone treatment

  • Jin, Dong-Kyu
    • Clinical and Experimental Pediatrics
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    • v.55 no.7
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    • pp.224-231
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    • 2012
  • Prader-Willi syndrome (PWS) is a complex multisystem genetic disorder characterized by hypothalamic-pituitary dysfunction. The main clinical features include neonatal hypotonia, distinctive facial features, overall developmental delay, and poor growth in infancy, followed by overeating with severe obesity, short stature, and hypogonadism later in development. This paper reviews recent updates regarding the genetic aspects of this disorder. Three mechanisms (paternal deletion, maternal disomy, and deficient imprinting) are recognized. Maternal disomy can arise because of 4 possible mechanisms: trisomy rescue (TR), gamete complementation (GC), monosomy rescue (MR), and postfertilization mitotic nondisjunction (Mit). Recently, TR/GC caused by nondisjunction at maternal meiosis 1 has been identified increasingly, as a result of advanced maternal childbearing age in Korea. We verified that the d3 allele increases the responsiveness of the growth hormone (GH) receptor to endogenous GH. This paper also provides an overview of endocrine dysfunctions in children with PWS, including GH deficiency, obesity, sexual development, hypothyroidism, and adrenal insufficiency, as well as the effects of GH treatment. GH treatment coupled with a strictly controlled diet during early childhood may help to reduce obesity, improve neurodevelopment, and increase muscle mass. A more active approach to correct these hormone deficiencies would benefit patients with PWS.

Misuse of testosterone replacement therapy in men in infertile couples and its influence on infertility treatment

  • Song, Seung-Hun;Sung, Suye;Her, Young Sun;Oh, Mihee;Shin, Dong Hyuk;Lee, Jinil;Baek, Jeongwon;Lee, Woo Sik;Kim, Dong Suk
    • Clinical and Experimental Reproductive Medicine
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    • v.46 no.4
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    • pp.173-177
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    • 2019
  • Objective: We investigated the clinical characteristics of men with testosterone replacement therapy (TRT)-induced hypogonadism and its effect on assisted reproductive technology (ART) in infertile couples. Methods: This study examined the records of 20 consecutive male patients diagnosed with azoospermia or severe oligozoospermia (< 5 × 106/mL) who visited a single infertility center from January 2008 to July 2018. All patients were treated at a primary clinic for erectile dysfunction or androgen deficiency symptoms combined with low serum testosterone. All men received a phosphodiesterase 5 inhibitor and TRT with testosterone undecanoate (Nebido®) or testosterone enanthate (Jenasteron®). Patients older than 50 years or with a chronic medical disease such as diabetes were excluded. Results: The mean age of patients was 37 years and the mean duration of infertility was 16.3 ± 11.6 months. At the initial presentation, eight patients had azoospermia, nine had cryptozoospermia, and three had severe oligozoospermia. Serum follicle-stimulating hormone levels were below 1.0 mIU/mL in most patients. Three ongoing ART programs with female factor infertility were cancelled due to male spermatogenic dysfunction; two of these men had normal semen parameters in the previous cycle. After withholding TRT, serum hormone levels and sperm concentrations returned to normal range after a median duration of 8 months. Conclusion: TRT with high-dose testosterone can cause spermatogenic dysfunction due to suppression of the hypothalamic-pituitary-testicular axis, with adverse effects on infertility treatment programs. TRT is therefore contraindicated for infertile couples attempting to conceive, and the patient's desire for fertility must be considered before initiation of TRT in a hypogonadal man.