The adrenocartical carcinoma is a rare tumor with an estimated incidence of 1 case per 1,700,000 population. Despite its rarity, a large number of investigators have studied this neoplasm for the following two reasons. The First is the occasional difficulty of differentiation between careinoma and adenoma at the time of initial surgery, even by histopathologic examination. The other is its unique feature of corticosteroidogenesis. Steroid metabolism of adrenocortieal carcinoma is characterized by its low efficiency of steroid production due to deficiency of steroidogenic enzyme. The deficieney of 11 B-hydroxylase has been indieated in case of adrenoeortical carcinoma by several investigators. In this study, the serum level of cortisol was within normal range, but the serum level of 11-deoxycortisol was 50 times higher than normal. After the removal of tumor, the serum level of ll-deoxycortisol was markedly decm. In conclusion, the results from the this case suggest that measurement of serum 11-deoxy- cortisol may be a useful tool in the diagnosis and follow-up of adrenocortical carcinoma.
Adenoma ; Adrenocortical Carcinoma* ; Cortodoxone ; Diagnosis ; Follow-Up Studies ; Humans ; Hydrocortisone ; Incidence ; Metabolism ; Reference Values ; Research Personnel

As a process to study the mechanism of steroid hormones at the molecular level,the activities of lactic dehydrogenase (L.D.) and malic dehydrogenase (M.D.),NAD-linked transhydrogenases, were measured in the testis and the prostate. Ahundred male rabbits were divided into ten group as follows: Group 1: Control Group 2: Estrogen (6,000 units) injected Group 3: Androgen (1,200 unite)injected Group 4: Progesterone (1,200 units) injected Group 5: Hydrocortisone(30 mg) injected Group 6: DOCA (6 mg) injected Group 7: Castration control Group8: Castration and estrogen (6, OOO units) injected Group 9: Castration and androgen (1,200 units) injected Group 10: Castration and progesterone (1,200units) injected Changes in the activities of lactic dehydrogenase and malic dehydrogenase in theorganic tissues by exogenous steroid hormones were carefullyobserved. The lactic dehydrogenase activities were measured by the method of Wroblewski and La Due, and malic dehydrogenase activities by the Bodansky's modification of Porter's method. The results are as follows: 1) The control valueof L.D. activities in the testicular tissue of normal rabbits proved to be 89,400units per ram. The L.D. activities showed an increase up to 110.4 per cent in theestrogen injected group, 179.3 per cent in the androgen injected group and 147.0 per cent in the progesterone injected group, while the administration of hydrocortisone and DOCA decreased the value down to 85.2 per cent and 81.5 per cent, respectively. 2) The control value of M.D. activities in the testicular tissue of the normal rabbits was 23,600 units per gram. The M.D. activities showed an increase upto 111.4 per cent in the estrogen injected group. 191.1 per cent in the androgen injected group, and 156.8 per cent in the progesterone injected group, while the administration of hydrocortisone and DOCA decreased the value down to 85.2 per cent and 81.5 per cent, respectively. 3) In the prostate tissues of non-castrated rabbits, the L.D. activities were estimated normally to be 48,100 units per gram. The administration of sex hormone resulted in raising the activities upto 101.8 per cent in the estrogen injected group, 196.9 per cent in the androgen injected group and 153.9 per cent in the progesterone injected group. But the administration of hydrocortisone and DOCA decreased the value down to 92.5 per cent and 97.1 per cent, respectively. 4) In the prostate tissue of non-castrated rabbits, the control value of M.D. activities proved to be 14,600 unite per gram. The M.D. activities showed an increase upto 117.8 per cent in the estrogen injected group, 206.8 per cent in the androgen injected group and, 176.7 per cent in the progesterone injected group, while the administration of hydrocortisone and DOCA decreased the value down to 81.9 per cent and 95.2 per cent, respectively. 5) The prostatic L.D. activities were decreased to half the normal two weeks after castration. The administration of sex hormones (i.e., estrogen, androgen and progesterone) acted inclusively upon elevating the level f activities. Androgen, in general, was the most effective to restore the activity to the level of pre-castrated state. 6) The prostatic M.D. activities were also decreased to half the normal two weeks after castration. The administration of sex hormones acted inclusively upon elevating the level ofthe activities. Androgen had a remarkable effect in elevating the M.D. activities, which showed twice the precastration level. In this study, it is concluded that L.D. and M.D. activities are present in the testis and the prostate. They are induced and activated by the administration of sex hormones, of which androgen has the most remarkable effect, and estrogen and progesteronehave less effect, while hydrocortisone and DOCA are ineffective in some cases orinhibitory in others.
Castration* ; Desoxycorticosterone Acetate ; Estrogens ; Gonadal Steroid Hormones ; Humans ; Hydrocortisone ; Malate Dehydrogenase* ; Male* ; Oxidoreductases ; Progesterone ; Prostate* ; Rabbits* ; Testis*

Congenital adrenal hyperplasia is inherited disorder of adrenal steroidogenesis. 21-hydroxylase deficiency is the most commone enzymatic defect and is divided into classic and late-onset or nonclassic forms. Both classic non-classic 21-hydrozylase deficiencies are inherited in a recessive manner as allelic variants. But it is rare that happened in twin infants. Chief complaints of affected twins in our case were ambiguous genitalia, hyperpigmentation and dehydrations. They were revealed into hyponatremia, hyperkalemia and increased amount of serum progesterone, 17-hydroxyprogesterone and urinary 17-ketosteroid excretion and were administered with DOCA, 9alpha-fluorohydrocortisone, hydrocortisone to control the electrolyte imbalance. And now, both of them are going to normal ratio of weight gain and body growth.
17-alpha-Hydroxyprogesterone ; Adrenal Hyperplasia, Congenital* ; Desoxycorticosterone Acetate ; Disorders of Sex Development ; Humans ; Hydrocortisone ; Hyperkalemia ; Hyperpigmentation ; Hyponatremia ; Infant ; Progesterone ; Steroid 21-Hydroxylase* ; Twins* ; Weight Gain

Congenital adrenal hyperplasia (CAH) caused by 21-hydroxylase deficiency is an autosomal recessive disease, which leads to cortisol and aldosterone deficiency and hyperandrogenism. Typical medical treatment includes oral glucocorticoid and mineralocorticoid administration to suppress adrenal androgens and to compensate for adrenal steroid deficiencies. Usually, they have been managed with hydrocortisone (cortisone) and fludrocortisone (florinef). However, some patients stopped taking medicine without the doctor's consent. Among these patients, four cases of CAH patients showing the presence of hyponatremia as an initial electrolyte disorder were found with adrenal adenoma discovered by abdominal computerized tomography scan. Hypersecretion of adrenocorticotrophic hormone may play a role in the development of adrenal tumor and chronic poor compliance to therapy appears to be associated with development of the tumor. Two cases were managed with adrenalectomy because of increasing adrenal tumor size and virilization. Whereas the other two cases did not increase in size and were observed without adrenalectomy. Therefore, it is important that patients with CAH maintain steroid medication to avoid the appearance of adrenal tumor.
Adenoma ; Adrenal Hyperplasia, Congenital* ; Adrenalectomy ; Adrenocorticotropic Hormone ; Aldosterone ; Androgens ; Compliance ; Fludrocortisone ; Follow-Up Studies* ; Humans ; Hydrocortisone ; Hyperandrogenism ; Hyponatremia* ; Steroid 21-Hydroxylase ; Virilism

We have prepared Triolone triacetate compound from 16-DPA. This is intermediate product for preparation of hydrocortisone by microbiological transformation. Analytical sample has proved in all respects with an authentic specimen
Pharmaceutical Preparations ; Pregnenediones

Female pseudohermaphroditism due to adrenogenital syndrome is a condition in which individuals with a 46XX karyotype, negative H-Y antigen, normal mullerian duct derivatives, and a lack of development of w lffian duct structures differentiate partially as phenotypic males. They usually manifest masculinization of the external genitalia as a result of excess endogenous androgens. Most female pseudohermaphrodities have one of the types of congenital virilizing adrenal hyperplasia. Adrenogenital syndrome is inborn errors transmitted by autosomal recessive genes and may be due to defects in any of the enzymic steps in the biosynthesis of cortisol. Most affected individuals have a failure of 21-hydroxylation which prevents the conversion of 17 alpha-hydroxyprogesterone to 11-deoxycortisol. Such a defect in 21-hydroxylase leads to excessive production of adrenal androgens causing virilization. The treatment is early endocrinologic support and surgical reconstruction. There are some considerations in surgical repairs including normal sized clitoris with adequate erogenous sensation, sufficiently wide vaginal introitus and normal aesthetic appearance of the external genitalia for her normalized life as a female. We have experienced four cases of female pseudohermaphroditism due to adrenogenital syndrome. In two cases, we performed clitoroplasty with nerve sparing technique, vulvoplasty with mons pubis augmentation, vaginoplasty with posterior perineal flap and urethral reconstruction. In the other cases, we performed clitoroplasty with nerve sparing technique, vulvoplasty and vaginoplasty There was no specific operative complication and the result of the correction was satisfactory.
17-alpha-Hydroxyprogesterone ; 46, XX Disorders of Sex Development* ; Adrenogenital Syndrome* ; Androgens ; Clitoris ; Cortodoxone ; Female* ; Genes, Recessive ; Genitalia ; H-Y Antigen ; Humans ; Hydrocortisone ; Hyperplasia ; Karyotype ; Male ; Sensation ; Steroid 21-Hydroxylase ; Virilism

Objective: To analyze the clinical and genetic characteristics of 33 children with congenital lipoid adrenal hyperplasia (CLAH) caused by StAR gene defects. Methods: The clinical, biochemical, genetic, and follow-up (until December 2021) data of 33 children diagnosed with CLAH from 2006 to 2021 were retrospectively analyzed in Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. Results: Of the 33 children with CLAH, 17 had a karyotype of 46, XX and 16 had a karyotype of 46, XY; 31 were female and 2 were male by social gender. Classic type and non-classic type were found in 30 and 3 children respectively. The age at diagnosis was 9.0 (3.0, 34.5) months. All the 30 cases with classic CLAH presented within the first year of life with skin hyperpigmentation (28 cases, 93%), vomiting and(or) diarrhea (19 cases, 63%), no increase in body weight (8 cases, 27%), elevated adrenocorticotropic hormone levels (21cases (70%)>275 pmol/L), decreased cortisol levels (47 (31,126) nmol/L), hyponatremia ((126±13) mmol/L), hyperkalemia ((5.7±1.1) mmol/L), and normal 17α-hydroxyprogesterone levels (30 cases, 100%). All these with classic CLAH exhibited female external genitalia. Three children with non-classic CLAH (including 2 cases of 46, XY and 1 case of 46, XX) also showed signs and symptoms of adrenal insufficiency, but 2 of them had an age of onset later than 1 year of age, including 1 case of 46, XY with male external genitalia and 1 case of 46, XX with female external genitalia. The other 46, XY patient with non-classic CLAH presented with adrenal insufficiency at 2 months of age, showing micropenis and hypospadias. In the 17 females with 46, XX, 4 older than 10 years of age showed spontaneous pubertal development. A total of 25 StAR gene pathogenic variants were identified in 33 patients, with p.Q258* (18/66, 27%), p.K236Tfs*47 (8/66, 12%) and p.Q77* (6/66, 9%) being the common variantion. Six novel variants were found, including c.358T>G, c.713_714del, c.125del, c.745-1G>A, c.179-2A>C, and exon 1 deletion. Conclusions: Patients with classic CLAH typically present with signs and symptoms of primary adrenal insufficiency in the early infancy period and female external genitalia. p.Q258*, p.K236Tfs*47 and p.Q77* are common variants in CLAH patients.
Adrenal Hyperplasia, Congenital/genetics* ; Adrenal Insufficiency ; Adrenocorticotropic Hormone ; Child, Preschool ; China ; Disorder of Sex Development, 46,XY ; Female ; Humans ; Hydrocortisone ; Hydroxyprogesterones ; Hyperplasia ; Infant ; Male ; Mutation ; Phosphoproteins/genetics* ; Retrospective Studies

17 -Hydroxylase deficiency is a rare form of congenital adrenal hyperplasia that is characterized by primary amenorrhea, absence of secondary sex characteristics, hypertension, and a hypokalemic alkalosis that has resulted resulting from increased production of deoxycorticosterone and corticosterone by the adrenal. The diagnosis of this enzyme deficiency can be recognized by the increasing serum concentrations of steroid precursors, DOC and corticosterone and the decreasing concentrations of cortisol, and adrenal androgens. We diagnosed this in a 19 year old female who presented with primary amenorrhea. We report this case with a review of the literatures.
Adrenal Hyperplasia, Congenital ; Alkalosis ; Amenorrhea* ; Androgens ; Corticosterone ; Desoxycorticosterone ; Diagnosis ; Female ; Humans ; Hydrocortisone ; Hypertension ; Sex Characteristics ; Young Adult

The present study was aimed at investigating whether the calcium current in the vascular smooth muscle (VSM) cells is altered in renal hypertension. Two-kidney, one clip (2K1C) and deoxycorticosterone acetate (DOCA)-salt hypertension were made in Sprague-Dawley rats. Rats without clipping the renal artery or implanting DOCA were used as control for 2K1C and DOCA-salt hypertension, respectively. Four weeks after clipping, systolic blood pressure was significantly higher in 2K1C rats than in control (192+/-24 and 119+/-4 mmHg, respectively, n=16 each). DOCA-salt rats also showed a higher blood pressure (180+/-15 mmHg, n=18) compared with control (121+/-6 mmHg, n=14). VSM cells were enzymatically and mechanically isolated from basilar arteries. Single relaxed VSM cells measured 5 ~ 10 mum in width and 70 ~ 150 mum in length were obtained. VSM cells could not be differentiated in size and shape between hypertensive and normotensive rats under light microscopy. High-threshold (L-type) calciumcurrents were recorded using whole-cell patch clamp technique. The amplitude of the current recorded from VSM cells was larger in 2K1C hypertension than in control. Neither the voltage-dependence of the calcium current nor the cell capacitance was significantly affected by 2K1C hypertension. By contrast, the amplitude of the calcium current was not altered in DOCA-salt hypertension. These results suggest that high-threshold calcium current of the VSM cells is altered in 2K1C hypertension, and that calcium channel may not be involved in calcium recruitment of VSM in DOCA-salt hypertension.
Animals ; Basilar Artery ; Blood Pressure ; Calcium Channels ; Calcium* ; Desoxycorticosterone ; Desoxycorticosterone Acetate ; Hypertension ; Hypertension, Renal* ; Microscopy ; Muscle, Smooth, Vascular* ; Rats ; Rats, Sprague-Dawley ; Renal Artery

The 11-hydroxylation of 16alpha,17alpha-epoxy-4-pregenene-3,20-dione as a useful intermediate for the preparation of hormones can be achieved by the mycelium of Absidia coerulea at higher conversion rate than using other strains. In this paper 16alpha,17alpha-epoxy-4-pregenene-3,20-dione mixed with a little water, beta-cyclodextrin, Tween-80 was introduced into the fermentation broth after ultrasonication to increase pseudo-water-solubility of the hydrophobic substrate. This pseudo-crystallo feed could avoid the toxicity of organic solvents and was more available for the microbial transformation. The multi layer feed-forward neural network was used to setup a model which indicated the relationship between medium and feed components and the conversion rate. Particle swarm optimization (PSO), which was a stochastic global optimization algorithm and of which the convergence speed was high, was applied to obtain the optimal concentration of the medium and feed components. At optimum conditions with the pseudo-crystallo feed, the conversion rate of 16alpha,17alpha-epoxy-4-pregenene-3,20-dione at an initial concentration of 10 g/L was 87.5% in shaking flasks. The conversion rate of the substrate was up to 86.6% at higher concentration of 20 g/L feed in a 3.7 L fermentor.
Absidia ; metabolism ; Fermentation ; Hydroxylation ; Pregnenediones ; metabolism