No abstract available.
Folic Acid* ; Homocysteine* ; Methylenetetrahydrofolate Reductase (NADPH2)*

No abstract available.
Diabetes Mellitus*

No abstract available.

No abstract available.
Addison Disease*

solated ACTH deficiency is a very uncommon cause of hypoadrenocorticism, with less than 200 cases reported in the literatures. The clinical presentation can be similar to that of primary adrenal insufficiency, but there is a greater tendency for hypoglycemia and absence of hyperpigmentation. The diagnosis is established by demonstrating hypocortisolism with undetectable serum levels of ACTH, normal adrenal responsiveness to prolonged ACTH infusion, and an absent ACTH response to insulin-induced hypoglycemia. Other endocrine function is normal.We experienced a case of isolated ACTH deficiency in 34 years old female who was admitted due to fever and drowsy mentality.So we present this case with a review of literatures.
Addison Disease ; Adrenocorticotropic Hormone ; Diagnosis ; Female ; Fever ; Humans ; Hyperpigmentation ; Hypoglycemia

No abstract available.
Thyroid Gland* ; Thyroiditis*

OBJECTIVE: Thyroid nodule is frequent and occurs in about 5+ACU- of the general population. In contrast, thyroid cancer is much less frequent and occurs in about 5-10+ACU- of thyroid nodules. Distinguishing between benign and malignant lesions is an important task that is best accomplished by fine needle aspiration. Recently, Chiappetta et al. reported that the expression of the high mobility group (HMG) I(Y) proteins correlates with the malignant phenotype of human thyroid neoplasia, and suggested that the detection of the HMG I(Y) proteins might be a valid tool for an easy and sensitive discrimination assay between benign and malignant neoplastic thyroid disease. METHODS: We evaluated the expression of the HMG I(Y) mRNA in 39 frozen thyroid tissues from patients with thyroid nodule by semiquantitative RT-PCR. RESULTS: The expression of the HMG I(Y) mRNA was low in all of 10 normal thyroid tissues. In all of 3 adenomatous goiters, 6 follicular adenomas and 2 Hurthle cell adenomas, the HMG I(Y) mRNA expression level was low. In 11 of 13 papillary carcinomas and all of 5 follicular carcinomas, the HMG I(Y) mRNA expression level was high. CONCLUSION: These results indicate that there is a correlation between the expression of HMG I(Y) and the malignant phenotype of thyroid cancer, suggesting that these proteins may be useful as a marker in thyroid cancer.
Biopsy, Needle ; Comparative Study ; Diagnosis, Differential ; Female ; Gene Expression Regulation, Neoplastic ; High Mobility Group Proteins/analysis+ACo- ; Human ; Male ; Probability ; RNA, Messenger/analysis+ACo- ; Reverse Transcriptase Polymerase Chain Reaction ; Sensitivity and Specificity ; Thyroid Neoplasms/genetics+ACo- ; Thyroid Neoplasms/diagnosis+ACo- ; Thyroid Nodule/genetics+ACo- ; Thyroid Nodule/diagnosis+ACo- ; Tumor Markers, Biological/analysis+ACo-

Eruptive neonatal hemangiomatosis is an uncommon disorder, which is divided into two types according to the extent of involvement: Benign type with cutaneous hemangiomatosis only and diffuse type with widespread hemangiomas of skin and viscera. The organs commonly affected are the gastrointestinal tract, brain, liver and lung. The Diffuse type is often fatal. We herein report a case of eruptive neonatal hemangtomatosis with cutaneous and hepatic involvement. The size of the hepatic arteriovenous malformation was markedly decreased after 2 months' therapy with oral prednisolone.
Arteriovenous Malformations ; Brain ; Gastrointestinal Tract ; Hemangioma ; Liver ; Lung ; Prednisolone ; Skin ; Viscera

No abstract available.

BACKGROUND: Although insulin induced hypoglycemia test is a standard diagnostic method in assessment of hypothalamo-pituitary-adrenal axis, rapid ACTH stimulation test using 250microgram has been used as a first line diagnostic test especially in secondary adrenal insufficiency due to iatrogenic Cushing syndrome because it is easy and safe. However, it was suggested that a maximal cortisol response can be achieved with a much lower ACTH dose and 1microgram ACTH enhances the sensitivity without decreasing specificity of test. Also recently, there was a report that midnight to morning urine cortisol increment is more accurate, noninvasive method can be used for measurement of hypothalmo-pituitary-adrenal axis. In this study, we compared the 1microgram ACTH stimulation test with midnight to morning urinary free cortisol increment in secondary adrenal insufficiency due to iatrogenic Cushing syndrome to study the agreement of two test and accuracy of increment of urinary free cortisol in diagnosis of adrenal insufficiency. METHODS: Double voided urine sample were collected at midnight and 8 A.M. in 12 patients who have Cushing-like feature and history of taking glucocorticoids and in 12 normal controls. Urinary free cortisol was measured and cortisol increment was defined as the morning urine free cortisol minus the midnight urine free cortisol. The 1microgram ACTH stimulation test was performed in 12 iatrogenic Cushing syndrome patients at the same day and compard with the result of cortisol increment. RESULTS: Using the results of 12 controls, normal urine free cortisol increment was defined as greater than 165.5nmol/L(6.0microgram/dL). Subnormal cortisol response in 1microgram ACTH stimulation test was noted in 8 out of 12 patients group and urinary free cortisol increment was not observed in 7 out of 8 subnormal response group. Normal cortisol response in 1microgram ACTH stimulation test was noted in 4 out of 12 patients group and urinary free cortisol increment was observed in 3 out of 4 normal response group. So 83% of concordance rate between 1microgram ACTH stimulation test and urine free cortisol increment was recorded. CONCLUSION: Urinary free cortisol increment has high concordance rate with 1microgram ACTH stimulation test and simple, easy test in diagnosing secondary adrenal insufficiency due to iatrogenic Cushing syndrome. Further study including more patients will be helpful to know the adequacy and reliability of test in evaluation of hypothalamo-pituitary-adrenal axis.
Adrenal Insufficiency ; Adrenocorticotropic Hormone ; Axis, Cervical Vertebra ; Cushing Syndrome* ; Diagnosis* ; Diagnostic Tests, Routine ; Glucocorticoids ; Humans ; Hydrocortisone* ; Hypoglycemia ; Insulin ; Sensitivity and Specificity