• Korean Journal of Biological Psychiatry
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• v.4 no.2
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• pp.272-278
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• 1997

Many investigators are trying to elucidate the pathogenesis of psychiatric disorders on the basis of neuroendocrine responses to stimulation or perturbation. Dexamethasone(DEX) suppression has been the most widely utilized as the prototypical challenge test. Dexamethasone suppression test(DST) has proven to be valuable in diagnosing the depressive spectrum disorder. Reported specificity of diagnosis of depression is relatively high, but sensitivity is limited. Some researchers used the combination of dexamethasone and corticotropin releasing hormone(CRH) in order to improve the sensitivity. They reported that combined DEX/CRH test is more sensitive than DST alone. In this study the authors modified the DEX/CRH test, i.e., we administered the insulin instead of CRH. Total subjects were 28(7 normal controls, 10 manic patients, 11 schizophrenic patients). Subjects were taken DEX(1.5mg p.o.) at 11 p.m., insulin 16 hours later(0.1 unit/kg i.v.). Five blood samples for the determination of cortisol and ACTH were serially drawn at 15 minute interval. The results are as followings : 1) The cortisol and ACTH levels of manic subjects increased following insulin administration. Manic subjects showed higher levels of cortisol and ACTH than schizophrenic and normal control subjects. The cortisol and ACTH levels of schizophrenic and normal control subjects did not show gross changes. 2) The sensitivity of the test was lower than that of reported DEX/CRH test.

• Korean Journal of Veterinary Research
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• v.36 no.3
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• pp.731-741
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• 1996

ELISA kit for cortisol was developed and then evaluated. Polyclonal antihydrocortisone-3-(o-carboxymethyl)oxime BSA rabbit serum was used to coat the 96-well microplates. The minimum detection limit of the kit was 250pg of cortisol per milliliter. The within-run variation and the day to day variation of the ELISA system were 2.0 and 5.9 at maximum, respectively. The kit was used to determine whether salivary cortisol concentration could replace blood cortisol concentration in dexamathasone suppression test of dogs. Changes of cortisol concentration were measured in serum or saliva after intravenous administration of 0.01mg of dexamethasone per kilogram of body weight. Blood alone, saliva alone or both were collected at 0, 30, 60, 120, 240, and 360 minutes after injection of dexamethasone. The change in blood cortisol concentration was found to be suitable in dexamathasone suppression test of dogs, but the change in salivary cortisol concentration was not. The kit was also used to determine whether salivary cortisol concentration could be a stress index as well as blood cortisol concentration in dogs. Two types of trial were performed to estimate the stress either by blood or salivary cortisol concentration. The first trial was stress experiment by intravenous injection of 0.2IU of PZI-insulin per kilogram body weight. Either blood alone or saliva alone was collected at 0, 30, 60, and 90 minutes after insulin administration. Both blood and salivary cortisol concentration were found to be suitable index in estimating stress from hypoglycemia by injection of insulin. The second trial was stress experiment by electrical irritation. The dogs were irritated with anti-bark device for 10 seconds. Blood was collected before and at 2 and 5 minutes after electrical irritation. Saliva was collected before and at 3 and 6 minutes after electrical irritation. The blood cortisol concentration, but not the salivary cortisol concentration was found to be suitable index in estimating stress from electrical irritation. Cushing syndrome in a dog was also successfully diagnosed with this kit.

• Journal of Yeungnam Medical Science
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• v.11 no.1
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• pp.63-71
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• 1994

The purpose of this study was to evaluate the effect of stroke on hypothalamic-pituitary axis using dexamethasone suppression test. The effects were evaluated according to age, sex, type, size, and lesion site of stroke. These tests were performed in 62 patients with stroke(cerebral infarction, 42 cases : intracerebral hemorrage, 20 cases) and 21 disabled controlled patients without intracranial diseases at Yeungnam University Hospital from June 1992 to June 1993. The results summarized as follows. 1. Cerebral infarction showed significantly higher frequency of DST non-suppression in stroke patients than control(p<0.05). 2. Patients with left hemisphere stroke showed more frequent abnormal neuroendocrine test results(p<0.01) 3. Patients with large infarction revealed strongly non-suppressed DST results(p<0.01). 4. Sinificantly higher basal cortisol level in patients with cerebral infarction was noted(p<0.01). 5. There are no statistical significance between DST results and sex, age, motor impairment, type of cerebral infarction.

• Journal of Veterinary Clinics
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• v.38 no.1
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• pp.41-44
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• 2021

Pituitary pars intermedia dysfunction (PPID), often referred to as equine Cushing's disease, is a common endocrine disorder often diagnosed in older horses. A 13-year-old 460 kg Warmblood gelding showed clinical signs suggestive of PPID, including hypertrichosis, fat redistribution, polyuria and polydipsia (PU/PD), and weight loss. Physical examination, complete blood cell count, and serum chemistry results were normal. However, dexamethasone suppression and plasma adrenocorticotropic hormone (ACTH) level tests confirmed PPID. Three months after the confirmed diagnosis, the horse was referred again with symptoms of laminitis. Radiography and venography were performed to evaluate the laminitis severity level. However, the foot condition continued to worsen, and the horse was eventually euthanized. The purpose of this case report is to describe clinical signs and diagnosis of PPID with laminitis.

• Journal of Veterinary Clinics
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• v.20 no.2
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• pp.233-236
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• 2003

A 10 year old, intact female Yorkshire terrier was referred to the Veterinary Teaching Hospital of Konkuk University. Upon admission, the patient had severe necrotic skin disease on face and abdominal wall, and also showed polyuria, polydipsia (PUPD), and polyphagia. A tentatative diagnosis of hyperadrenocorticism was made on the basis of history takings, physical examination, and results of CBC and serum biochemistry. Hyperadrencorticism was confirmed by ACTH stimulation test and pituitary-dependent hyperadrenocorticism (PDH) was diagnosed according to the results of high dose dexamethasone suppression test (HDDST). After initiating mitotane therapy, severe skin problem and clinical signs including PUPD were improved. And we determined whether or not mitotane therapy well controlled serum cortisol level with ACTH stimulation test. This case was presented to show that the patient misdiagnosed and treated for more than 1 year as other dermatologic problem in 3 local animal clinics was treated and managed sucessfully with mitotane administration.

• Korean Journal of Biological Psychiatry
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• v.8 no.1
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• pp.20-36
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• 2001

The debate about whether depressive disorders should be divided into categories or arrayed along a continuum has gone for decade, without resolution. In our review, there is more evidence consistent with the spectrum concept than there is with the idea that depressive disorders constitute discrete clusters marked by relatively discontinuous boundaries. First, "depression spectrum", "is there a common genetic factors in bipolar and unipolar affective disorder", "threshold model of depression" and "bipolar spectrum disorder" are reviewed. And, a new subtype of depression is so called SeCA depression that is a stressor-precipitated, cortisol-induced, serotonin-related, anxiety/aggression-driven depression. SeCA depression is discussed. But, there is with the idea that depressive disorders constitute discrete subtypes marked by relatively discontinuous boundaries. This subtypes of depressive disorder were reviewed from a variety of theoretical frames of reference. The following issues are discussed ; Dexamethasone suppression test(DST), TRH stimulation test, MHPG, Temperament Character Inventory(TCI), and heart rate variability(HRV).

• Journal of Veterinary Clinics
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• v.23 no.2
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• pp.202-206
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• 2006

A 7-year-old, spayed female, Yorkshire terrier dog with polyuria/polydipsia (PU/PD), interdigital edema, pruritus and abdominal enlargement was referred to the Veterinary Medical Teaching Hospital of the present university. Pituitary-dependent hyperadrenocortisim (PDH) was diagnosed by clinical signs, physical examination, laboratory examination (complete blood count, serum chemistry, urinalysis, ACTH stimulation test and high dose dexamethasone suppression test) and diagnostic imaging (radiography, ultrasonography and computed tomography). Clinical signs were improved after trilostane treatment, and maintenance therapy with trilostane still continued after successful induction therapy. Trilostane can be used as an alternative to mitotane therapy in hyperadrenocortisim in dogs.

• Journal of Medicine and Life Science
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• v.18 no.1
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• pp.16-19
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• 2021

Cushing's disease (CD) is a rare illness characterized by chronic hypercortisolism secondary to the overproduction of adrenocorticotropic hormone by a pituitary adenoma, which is associated with a high risk of developing serious complications, such as diabetes mellitus, cardiovascular disease, and emotional disorders. Endoscopic transsphenoidal surgery is performed for the treatment of CD, and was initially preferred over other types of treatments. However, the recurrence after pituitary surgery for CD is a common problem after an initial successful surgery. In microadenomas, the remission rates were higher than those of macroadenoma. This patient had a giant tumor that was greater than 4 cm in length on sella magnetic resonance imaging, and panhypopituitarism was detected using a combined pituitary stimulation test. After transsphenoidal surgery, the patient required temporary hormone replacement for a short period of time. After 1 year, he showed a normal cortisol response on the overnight dexamethasone suppression test and low morning cortisol levels. Therefore, we indicated that the patient was cured of giant macroadenoma with panhypopituitarism before surgery, and thus, reported this case.

• Biomolecules & Therapeutics
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• v.16 no.3
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• pp.255-260
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• 2008

The purpose of this study was to evaluate the bioequivalence of the test (Daewoo Hydrocortisone 10 mg, Daewoo Pharm. Co., Busan, Korea) and reference (Jenapharm Hydrocortisone 10 mg, JayTech Biogen, Seoul, Korea) hydrocortisone tablets. Twenty-four healthy male Korean volunteers were divided into two groups with a randomized $2{\times}2$ cross-over design. In order to suppress the endogenous cortisol secretion, a single oral dose of Dexamethasone (4 mg) was administered 10 hr prior to hydrocortisone administration. Blood samples were withdrawn for 10 hr at the predetermined intervals after a single oral dose of hydrocortisone (20 mg). The serum concentration of hydrocortisone was analyzed by HPLC/UV using a column switching method after liquid-liquid extraction process. The pharmacokinetic parameters ($AUC_{0{\sim}10hr}$, $C_{max}$, and $T_{max}$) of the test and reference hydrocortisone tablets were determined while the secretion of endogenous cortisol was being suppressed. The pharmacokinetic parameters of the test tablet were not statistically different from those of the reference tablet at ex value was 0.05. The 90% confidence intervals for the average ratio (test/reference) of $AUC_{0{\sim}10hr}$ and $C_{max}$ were within the Korea Food and Drug Administration acceptance range of 0.80-1.25 ($0.89{\sim}0.99$ and $0.86{\sim}0.99$ for $AUC_{0{\sim}10hr}$ and $C_{max}$, respectively). Therefore it was concluded that the test tablet, Daewoo Hydrocortisone tablet was bioequivalent to the reference tablet, Jenapharm Hydrocortisone tablet.

• Journal of Veterinary Clinics
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• v.22 no.4
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• pp.420-423
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• 2005

A 2-year-old 16-kg, intact female lindo was presented with weight loss and poor hair coat. Abnormal serum biochemical values included mild hypokalemia (3.9 mmol/L, reference range 4.37 to 5.35 mmol/L) and mild hyperglycemia (124 mg/dl, reference range 65 to 118 mg/dl). in the complete blood count and diagnostic imaging examination, abnormal changes wer not seen. The analysis of urine sample obtained from cystocentesis revealed glucosuria (> 100 mg/dl) and mild proteinuria. Repeated analysis after admission showed persistent glucosuria and hypokalemia. But blood glucose values did not exceed the renal threshold fur glucose reabsorption. To differentiate cause of the glucosuria, the glucose tolerance test and the low-dosage dexamethasone suppression test were indicated. Results of both tests were normal. In addition, the serum total thyroxine $(T_4)$ value was within normal range. The arterial blood gas analysis showed no remarkable changes. The fractional reabsorption rates of amino acids and phosphorus were calculated above $97\%$. Based on these findings, the dog was diagnosed as renal glucosuria due to proximal renal tubular dysfunction. But this persistent renal glucosuria with hypokalemia may be the initial sign of Fanconi's syndrome or proximal renal tubular acidosis.