No abstract available.
Acromegaly* ; Octreotide* ; Somatostatin*

Bilateral inferior petrosal sinus sampling(IPSS) is known to be useful for the differential diagnosis of ACTH-dependent Cushing's syndrome and for the preoperative localization of pituitary microadenomas.To evaluate the usefulness of IPSS, we performed the procedure in the 17 cases of ACTH-dependent Cushing's syndrome including 2 cases of macroadenomas, 6 of them with CRH stimulation test. A inferior petrosal sinus-to-peripheral ACTH ratio of 2:1 or greater(3:1 after CRH stimulation) indicates a pituitary source of ACTH hypersecretion, and a ratio of the ACTH level in one inferior petrosal sinus to the ACTH level in the other of 1:4 or greater lateralizes the microadenomas to that half of the pituitary gland.With these criteria, we diagnosed Cushing's disease in 15 of 17 cases of ACTH-dependent Cushing's syndrome, and localized the lesion in 8 of 13 cases of microadenoma.In conclusion, IPSS with CRH stimulation has high diagnostic accuracy in the differential diagnosis of ACTH-dependent Cushing's syndrome, but still has the limitations on the localization of microadenoma.
Adrenocorticotropic Hormone ; Clinical Study ; Cushing Syndrome ; Diagnosis, Differential ; Petrosal Sinus Sampling

BACKGROUND/AIMS: The aims of this study were to determine subgoups of functional dyspesia and to evaluate the short-term effect of cisapride in patients with functional dyspepsia in Korea. METHODS: 1025 patients, with a mean age of 42.6 years, with symptoms of functional dyspepsia, were recruited consecutively and upper gastrointestinal symptoms were investigated by interview in 41 hospitals in Korea. In an open, multicenter trial, 1025 patients received Smg of cisapride three times a day (TID) for at least .2 weeks for the treatment of symptoms of functional dyspepsia. When necessary, the dose of cisapride was increased to 10mg TID and the duration of therapy was extended to 4 weeks. RESULTS: The most frequently reported symptoms of functional dyspepsia were epigastric discomfort or fullness (85%), bloating (70%), belching (53%), early satiety (52%) and epigastric pain (46%) retrospectively. Subgroups of functional dyspepsia were as follows; dysmotility-like 73.5%, ulcer-like 39.7%, reflux-like 13.0%, and unspecified dyspepsia 14.0%. However, 33.2% of subjects with functional dyspepsia could be classified into more than one subgroup. Upper gastrointestinal symptoms were decreased to average 50.3% (range; 42.2 to 59.2%) after 2 weeks of cisapride treatment and to 25% (19.2 to 29.9%) after 4 weeks. cisapride therapy resulted in good or excellent improvement in 59.0% of the patients after two weeks, in 75% of patients after 4 weeks. Adverse events were occurred in 52 patients (5.8% of all patients), most commonly, loose stools or diarrhea (3.5%), abdominal pain (1.1%), and dizziness (0.3%). The majority of adverse events was mild and transient in nature and led to premature discontinuation of treatment in 4 patients. CONCLUSIONS: Although the majorities of patients with functional dyspepsia have dysmotility like symptoms in Korea, there is such overlap among the dyspepsia subgroups. Most patients responded well to a short therapeutic trial with cisapride without significant side effects.
Abdominal Pain ; Cisapride* ; Diarrhea ; Dizziness ; Dyspepsia* ; Eructation ; Humans ; Korea* ; Retrospective Studies