Changes in Plasma Dehydroepiandrosterone-Sulfate ( DHEA-S ) Level & DHEA-S / cortisol Ratio by Age in Healthy Korean / 대한내분비학회지

BACKGROUND: DHEA-S is the most abundant steroid hormone in circulation, and primarily secreted from the adrenal cortex, but its physiological role is little known. One of the characteristic features of DHEA-S is progressive decrement of plasma DHEA-S level with advancing age, in contrast, plasma levels of other adrenal hormones are not chaging or littie decreasing. To grasp the trends of plasma DHEA-S level and DHEA-S/cortisol ratio by age in healthy Korean, we measured the plasma DHEA-S levels and DHEA-S/cortisol ratios in healthy Korean. METHODS: Healthy Korean (men: 99, women: 102, age range: 15-97 year old)were studied. Subjects were not taking drugs (such as glucocorticoid or androgenic medication) or cigarettes known to modify the plasma level of DHEA-S and cortisol, and had no evidence of hepatic, renal disease or hyperlipidemia as determined by serum lipid, bilirubin, SGOT, SGPT, BUN, creatinine. Data were analyzed by 10-year age group for men and women: i.e, 10-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80-89 and 90 year or more. Plasma DHEA-S levels were measured by using a commercially available RIA kit with 125I labeled-DHEA-SO4 (Coat-A Count DHEA-SO4), and for the measurement of plasma cortisol levels, commercial Gamma Coat TM[125I] Cortisol Radioimmunassay Kit was used. RESULTS:. 1) In both men and women, plasma DHEA-S level showed high interindividual variation within the same age group. 2) There were individual sex differences in plasma levels of DHEA-S, in all age groups, plasma DHEA-S levels were significantly higher values for men than for women. 3) Maximum plasma DHEA-S levels (men; 237+-3.35 ug/dL, women; 108+-17.5 ug/dL) were at third decade in both men and women. 4) Both men and women showed the continuous decline in plasma DHEA-S level with age. These age-related decline was more prominent in men than in women (men; y=-3.152 * +292.6, r2= 0.8459, P<0.05, women; y= -1.417 * +143.3, r2 = 0.7278, P< 0.05). 5) As an index of aging, there was no stastical difference between DHEA-S and DHEA-S/cortisol ratio. CONCLUSION: In healthy Korean, there were high interindividual variation of plasrna DHEA-S levels. In both men and women plasma DHEA-S level was peak at third decade, and from when it declined progressively with age. These results suggest that although the reliability of single plasma DHEA-S measurement are limited, the decline of DHEA-S with advancing age might be a specific marker of endocrinologic hormonal milieu (aging index). Also, concerning to individual adrenal secreting capacity, we measured DHEA-S/cortisol ratio. But we did not found that plasma DHEA-S/cortisol ratio is superior to the plasma DHEA-S level as an aging index.

A Case of Multiple Skeletal Tuberculosis with Spina Ventosa: A Case Report / 대한정형외과학회잡지

A case of multiple skeletal tuberculosis with spina ventosa proved by radiological and pathologicaI methods in 3 year old Korean male child is reported. It was treated with antituberculous chemotherapy (triple method of PAS, INAH, streptomycin). At follow up check within 2 years, we obtained good healing process without other complication.

A Case of Atraumatic Aseptic Necrosis of Both Talus: A Case Report / 대한정형외과학회잡지

We report one case of aseptic necrosis of both talus which has developed without any evidence of previous trauma. Aseptic necrosis of the talus is known to occur after any trauma which result in iterruption the blood supply to talus. Atraumatic aseptic necrosis of talus is extremely rarre condition. Some cases of atraumatic aseptic necrosis of talus were repoted by some authers, in whom Garcia described the first case in 1928. Most of the reported atraumatic aseptic necrosis were due to long term steroid therapy for unrelated medical problems and others were related to Alcoholism, Sepsis and Tuber culosis. ln this case we think for it may be caused or contributed by steroid therapy.