副腎의 電算化 斷層撮影

서상일,전정동,전우기,유필문,한창열 인제대학교 1983 仁濟醫學 Vol.4 No.4

저자들은 CT를 이용하여 정상 봉신의 크기 모양 및 위치를 분석하여 한국인의 부신의 정상 범위를 정하였으며 CT는 재래의 방법보다도 쉽게 부신을 발견할 수 있었고 부신질환의 진단에 중요한 역할을 할 것으로 사료된다. Computed tomography is an excellent screening test far adrenal glands. Abdominal CT scans of 94 randomized patients without evidence of adrenal disease were reviewed to determine the location, size, and shape of both side normal adrenal glands. Results are as follow: 1.Adrenal glands are shorten in 85 patients. (90.4%) 2.Most of the right adrenal glands were linear in shape. (71%) 3.and most of the left adrenal glands were inverted V or Y, or triangular in shape. (79%) 4.Right adrenal glands. Mean length of 2.2cm, Width of 2.35cm, and Thickness of 0.59cm Left adrenal glands, Mean length of 2.5cm, Width of 2.09cm, and Thickness of 0.69cm. 5.Thickness of limbs was always less than 5mm.

Untreated Congenital Adrenal Hyperplasia with 17-α Hydroxylase/17,20-Lyase Deficiency Presenting as Massive Adrenocortical Tumor

이수진,송지은,황세나,이지연,박혜선,한승희,이유미 대한내분비학회 2015 Endocrinology and metabolism Vol.30 No.3

Congenital adrenal hyperplasia (CAH) with 17α-hydroxylase/17,20-lyase deficiency is usually characterized by primary amenorrhea, characterized by hypertension and primary amenorrhea, sexual infantilism in women, and pseudohermaphroditism in men. hypertension, and sexual infantilism in women and pseudohermaphroditism in men. In rare cases, a huge adrenal gland tumor can present as a clinical manifestation in untreated CAH. Adrenal cortical adenoma is an even more rare phenotype in CAH with 17α-hydroxylase/17,20-lyase deficiency. A 36-year-old female presented with hypertension and abdominal pain caused by a huge adrenal mass. Due to mass size and symptoms, left adrenalectomy was performed. After adrenalectomy, blood pressure remained high. Based on hormonal and genetic evaluation, the patient was diagnosed as CAH with 17α-hydroxylase/17,20-lyase deficiency. The possibility of a tumorous change in the adrenal gland due to untreated CAH should be considered. It is important that untreated CAH not be misdiagnosed as primary adrenal tumor as these conditions require different treatments. Adequate suppression of adrenocorticotropic hormone (ACTH) in CAH is also important to treat and to prevent the tumorous changes in the adrenal gland. Herein, we report a case of untreated CAH with 17α-hydroxylase/17,20-lyase deficiency presenting with large adrenal cortical adenoma and discuss the progression of adrenal gland hyperplasia due to inappropriate suppression of ACTH secretion.

Phenylethanolamine N-methyltransferase: 부신, 뇌간, 시상하부 효소의 조절

전양숙,서유헌,Chun, Yang-Sook,Suh, Yoo-Hun 대한약리학회 1996 대한약리학잡지 Vol.32 No.2

To determine the regulatory mechanism of phenylethanolamine N-methyltransferase (PNMT) in the adrenal gland and in central nervous system, we observed the change of enzyme activity and mRNA level of PNMT in the adrenal gland, the brain stem, and hypothalamus of rats, which were injected with two neuroleptic agents(reserpine and haloperidol ). Reserpine depleting catecholamines in presynaptic vesicle increased PNMT activities in the adrenal gland and the brain stem to 150% of the control in time-dependent manner, but not in the hypothalamus. Haloperidol blocking dopamine receptor decreased PNMT activities in the adrenal gland and the hypothalamus, but not in the brain stem. Thus, the results indicate that catecholamines inhibit synthesis of epinephrine in the brain stem and the adrenal gland, and that dopamine stimulates synthesis of epinephrine in the hypothalamus and the adrenal gland. In addition, since the change of mRNA levels were nearly in accordance with the change of activities, the transcriptional regulation of PNMT is considered the mechanism of the regulation of epinephrine neuron.

Expression of Preadipocyte Factor-1 (Pref-1) and Vitamin D3 Up-regulated Protein 1 (VDUP1) Genes in Rat Adrenal Gland following Chronic Immobilization Stress

이유경(You Kyung Lee),박진운(Jin Woon Park),송수성(Su Sung Song),양영(Young Yang),이건수(Keon Su Lee),이영호(Young Ho Lee) 대한해부학회 2004 Anatomy & Cell Biology Vol.37 No.5

Pref-1은 뇌하수체, 부신, 이자, 고환 등 신경내분비 기관에서 발현된다. VDUP1은 산화 스트레스 매개체로서 조기에 반응하는 새로운 유전자로 알려져 있다. 본 연구에서는 만성 부동스트레스 후 부신에서 스트레스에 반응에 Pref-1과 VDUP1이 관여하는지 규명하고자 하루에 2시간씩 7일간 부동스트레스를 가한 후 흰쥐 부신에서 Pref-1과 VDUP1에 대한 in situ hybridization을 시행하였다. Pref-1 유전자는 스트레스 후 부신 속질에서 발현이 증가되었으나, 부신 겉질의 사구층에서는 발현이 감소하였다. VDUP1 유전자는 스트레스 후 부신 겉질의 사구층 및 부신 속질 모두 발현이 증가되었다. 본 결과는 Pref-1과 VDUP1이 부신에서 부동 스트레스에 반응하는 새로운 유전자임을 보여준다. Preadipocyte factor-1 (Pref-1) is expressed in the neuroendocrine organs such as the pituitary gland, the adrenal gland, the pancreas, the testis, etc. Vitamin D3 up-regulated protein 1 (VDUP1) gene is known to be a novel member of early response genes as an oxidative stress mediator. The aim of the present study was to investigate whether Pref-1 and VDUP1 is involved in stress response in the adrenal gland following chronic immobilization stress. In situ hybridization for Pref-1 and VDUP1 genes (Pref-1 and VDUP1) was performed in the rat adrenal glands following immobilization stress, 2 hr once daily for 7 days. In situ hybridization analysis revealed that Pref-1 expression was upregulated in rat adrenal medulla following chronic immobilization stress. However, Pref-1 was down-regulated in the zona glomerulosa of the adrenal cortex following chronic immobilization stress. VDUP1 expression was up-regulated in the zona glomerulosa and the adrenal medulla following chronic immobilization stress. These results show that Pref-1 and VDUP1 may be novel genes responding to chronic immobilization stress in adrenal gland.

동측 부신에 발생한 부신외피 선종과 크롬친화 세포종 - 1예 보고 (증례)

김진수 외 중앙대학교 의과대학 의학연구소 2007 中央醫大誌 Vol.32 No.3

Pheochromocytoma and concomitant adrenal cortical adenoma in the same gland is a rare case. The case of a 37-year-old woman with pheochromocytoma and concomitant adrenal cortical adenoma in the same gland is presented. She has no symptoms associated with adrenal gland. Elevated norepinephrine and metanephrine are noted. Two masses in left gland on computed tomography are detected. A left adrenalnectomy is performed. One part of the tumor grows in a trabecular pattern and consists of cell which has lipid rich cytoplasm and small, hyperchromatic nucleus, which is showing positive stain for vimentin and negative stain for chromogranin A in immunohistochemical study. Theses histologic results are regarded as typical adrenal cortical adenoma. The other part consisted of cells with fine granular, basophilic cytoplasm, round nucleus and prominent nucleoli, showing fascicular pattern. These tumor cells are positive stain for Chrmogranin A, NSE, synaptophysin, resulting in the diagnosis of the pheochromocytoma.

부신에서 발생한 단독성 섬유성 종양: 1예 보고

팽미혜,김도연,강병철,백승연 대한영상의학회 2002 대한영상의학회지 Vol.47 No.4

단독성 섬유성 종양은 폐의 흉막에서 주로 발생하는 간엽 기원의 매우 드문 질환으로, 최근에는 신체의 다양한 부위에서도 발생하는 것으로 보고되고 있다. 특히 부신에 생긴 경우는 세계적으로 2예가 보고되었으며, 국내에서는 보고된 바가 없다. 저자들은 우연히 CT에서 발견된 좌측 부신의 단독성 섬유성 종양 1예를 경험하였기에 이를 문헌고찰과 함께 보고하고자 한다. Solitary fibrous tumor is a rare mesenchymal tumor, usually involving the pleura. Its occurrence in various organs of the body has recently been described; in particular, two cases of solitary fibrous tumor of the adrenal gland have been reported worldwide, but no case has been reported in Korea. We describe a case of solitary fibrous tumor occurring in the left adrenal gland and discovered incidentally at CT.

부신 기형종 1예

김지영,조윤주,이강우,임동미,박근용,김병준 대한내분비학회 2011 Endocrinology and metabolism Vol.26 No.3

Teratoma is a congenital tumor containing tissues derived from all germ layers. Teratoma in the region of the adrenal gland is a very uncommon retroperitoneal tumor. Only 7 cases of adrenal teratoma have been reported worldwide, but in Korea, no similar cases have been reported until now. This case report describes an adrenal teratoma in a 38-year-old healthy woman who was incidentally diagnosed with a left adrenal mass on abdominal ultrasonography during a medical inspection. Computed tomographic scans revealed a 9-cm heterogeneous circumscribed round mass, containing primarily fat tissue, and a solid calcification component in the left adrenal gland. Adrenal hormonal assessment results and biochemical markers for gonadal neoplasia were negative. Result of serum laboratory tests were normal. The patient underwent laparoscopic adrenalectomy. Histologic analysis confirmed the diagnosis of a mature teratoma; the obtained specimen measured 5 × 7 × 7.5 cm and weighed 267 g. The surface of the mass was smooth,and sebaceous tissue and hair with hard material were observed on the incisional surface. The patient was discharged on postoperative day 4, without complications. In this case report, we describe the incidental finding of a teratoma occurring in the adrenal gland region in a healthy woman; the teratoma was laparoscopically excised.

Adrenal Tuberculosis Mimicking a Malignant Tumor with Primary Adrenal Insufficiency

Woo Seok Kim,Jin Hyung Lee 순천향대학교 순천향의학연구소 2017 Journal of Soonchunhyang Medical Science Vol.23 No.1

Adrenal tuberculosis is a relatively infrequent cause of primary adrenocortical insufficiency in developed countries. Isolated adrenal tuberculosis, especially with enlargement of adrenal glands, can cause diagnostic problems and requires differentiation from primary or secondary neoplasms. A 40-year-old woman presented to Soonchunhyang University Gumi Hospital with altered consciousness. She showed biochemical evidence of adrenal insufficiency without signs of tuberculosis. Abdominal computed tomography (CT) scan showed a calcified mass 3.3×2.3 cm in size and peripheral enhancement of the left adrenal gland. A laparoscopic adrenalectomy was performed for a diagnosis of left adrenal malignant tumor. The diagnosis of adrenal tuberculosis was confirmed by a final histological examination.

Studies on Secretion of Catecholamines evoked by Panaxadiol in the Isolated Rabbit Adrenal Gland

임동윤,박규백,김규형,최철희,배재웅,김무원,Lim, Dong-Yoon,Park, Kyu-Baik,Kim, Kyu-Hyeong,Choi, Cheol-Hee,Bae, Jae-Woong,Kim, Moo-Won The Korean Society of Pharmacology 1988 대한약리학잡지 Vol.24 No.1

본 연구에서 한국산 인삼의 활성성분의 하나인 Panaxadiol(PD)에 대한 가토적출부신에서 카테콜아민(CA)의 분비작용과 작용기전을 파악하고자 실험을 시행하여 다음과 같은 결과를 얻었다. $PD(400{\mu}g)$을 가토적출부신에 투여하였을 때 카테콜아민의 분비를 의의있게 증가시켰다. PD의 이러한 CA 분비작용은 atropine 처치로 현저히 억제되었다. Physostigmine 전처치시 PD 뿐만 아니라 Ach의 CA 분비작용은 뚜렷이 증가되었다. 그러나 chlorisondamine 전처치로 PD나 Ach의 분비 효과는 억제되었다. 또한 $PD(400{\mu}g/30\;min)$을 주입한 후에 Ach의 CA 분비 효과는 오히려 강화되었다. PD나 Ach의 작용은 adenosine 전처러시 현저히 증강되었다. EGTA(5mM)와 함께 Ca-free Krebs액으로 30분 주입한 경우에 Ach의 분비작용은 거의 전적으로 차단되었으며, PD의 작용도 약화되었다. 이상의 실험결과로 보아, PD는 가토적출부신에서 $Ca^{++}$ 의존적으로 CA분비를 증가시키며, 이러한 작용은 cholinergi muscarinic 및 nicotinic receptor의 흥분작용에 기인하며, chromaffincell 대한 일부 직접작용도 개재되어 나타나는 것으로 사료된다. The effect of Panaxadiol(PD), which is an active component of Korean Ginseng Saponins, on the secretion of catecholamines (CA) from the rabbit adrenal gland and its mode of action were investigated in the present study. $PD(400{\mu}g)$ increased significantly the secretion of CA from the isolated perfused rabbit adrenal gland. PD-induced secretion of CA was reduced markedly by treatment of atropine, CA secretion induced by Ach or PD was potentiated significantly by physostigmine-treatment. Chlorisondamine did inhibit CA secretion of PD or Ach. Perfusion of $PD(400{\mu}g)$ for 30 min enhanced the secretory activity of CA by Ach. Ouabain weakened the secretory response induced by PD but rather enhanced the response by Ach. Adenosine-treatment resulted in marked enhancement of CA secretion by PD or Ach, Pefusion with $Ca^{2+}-free$ Krebs containing EGTA (5 mM) for about 30 min totally blocked secretory effect induced by Ach and also weakened that by PD. From the above experimental results, it is suggested that PD causes secretion of catecholamines from the rabbit adrenal gland by a calcium-dependent exocytotic mechanism. The secretory effect of PD is due to the stimulation of cholinergic muscarinic and nicotinic receptors present in the adrenal gland and partly to a direct action on the chromaffin cell itself.

파낙사디올의 가토적출부신의 카테콜아민 분비작용에 관한 연구

임동윤(Dong Yoon Lim),박규백(Kyu Baik Park),김규형(Kyu Hyeong Kim),최철희(Cheol Hee Choi),배재웅(Jae Woong Bae),김무원(Moo Won Kim) 대한약리학회 1988 대한약리학잡지 Vol.24 No.1

본 연구에서 한국산 인삼의 활성성분의 하나인 Panaxadiol(PD)에 대한 가토적출부신에서 카테콜아민(CA)의 분비작용과 작용기전을 파악하고자 실험을 시행하여 다음과 같은 결과를 얻었다.PD(400μg)을 가토적출부신에 투여하였을 때 카테콜아민의 분비를 의의있게 증가시켰다. PD의 이러한 CA 분비작용은 atropine 처치로 현저히 억제되었다. Physostigmine 전처치시 PD 뿐만 아니라 Ach의 CA 분비작용은 뚜렷이 증가되었다. 그러나 chlorisondamine 전처치로 PD나 Ach의 분비 효과는 억제되었다. 또한 PD(400μg/30 min)을 주입한 후에 Ach의 CA 분비 효과는 오히려 강화되었다. PD나 Ach의 작용은 adenosine 전처러시 현저히 증강되었다. EGTA(5mM)와 함께 Ca-free Krebs액으로 30분 주입한 경우에 Ach의 분비작용은 거의 전적으로 차단되었으며, PD의 작용도 약화되었다. 이상의 실험결과로 보아, PD는 가토적출부신에서 Ca⁺⁺ 의존적으로 CA분비를 증가시키며, 이러한 작용은 cholinergi muscarinic 및 nicotinic receptor의 흥분작용에 기인하며, chromaffincell 대한 일부 직접작용도 개재되어 나타나는 것으로 사료된다. The effect of Panaxadiol(PD), which is an active component of Korean Ginseng Saponins, on the secretion of catecholamines (CA) from the rabbit adrenal gland and its mode of action were investigated in the present study. PD(400μg) increased significantly the secretion of CA from the isolated perfused rabbit adrenal gland. PD-induced secretion of CA was reduced markedly by treatment of atropine, CA secretion induced by Ach or PD was potentiated significantly by physostigmine-treatment. Chlorisondamine did inhibit CA secretion of PD or Ach. Perfusion of PD(400μg) for 30 min enhanced the secretory activity of CA by Ach. Ouabain weakened the secretory response induced by PD but rather enhanced the response by Ach. Adenosine-treatment resulted in marked enhancement of CA secretion by PD or Ach, Pefusion with Ca²⁺-free Krebs containing EGTA (5 mM) for about 30 min totally blocked secretory effect induced by Ach and also weakened that by PD. From the above experimental results, it is suggested that PD causes secretion of catecholamines from the rabbit adrenal gland by a calcium-dependent exocytotic mechanism. The secretory effect of PD is due to the stimulation of cholinergic muscarinic and nicotinic receptors present in the adrenal gland and partly to a direct action on the chromaffin cell itself.