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PubMedDate not supplied

Laparoscopic adrenalectomy: transperitoneal lateral approach. Cases study.

AIM OF THE STUDY: To compare the results of the laparoscopic adrenalectomy achieved with the traditional laparotomic one. MATERIAL AND METHOD: In the period 1997-September 2004 we treated 17 patients with adrenal pathology: eight patients underwent to an open anterior transperitoneal adrenalectomy and nine patients underwent a laparoscopic adrenalectomy with lateral transperitoneal approach. RESULTS: Among the immediate results a longer operative time was evident in the laparoscopic approach and a greater blood loss in the open approach; there were no conversions to a laparotomic procedure. In the postoperative period there were some bronchopneumonic infiltrates and some infections of the laparotomy in the open group; in the laparoscopic group there was a parietal haematomas that cleared up spontaneously, in correspondence of a trocar access. DISCUSSION: Both procedures allow to achieve the complete resolution of the adrenal pathology if it is confined within the gland and no more than 8 cm. in size. The morbidity in the mininvasive approach is surely much lower than the open technique. The advantages of a laparoscopic approach can be found in a minor surgical stress. The evident datum that results from the literature analysis of the results of the the laparoscopic adrenalectomies, is the very rapid resumption of the normal activities in the postoperative course. CONCLUSIONS: The laparoscopic adrenalectomy with lateral transperitoneal approach is a safe and efficacious procedure. Therefore, the AA can believe that the laparoscopic approach is at present the gold standard in the treatment of all benign adrenal pathologies with a no more than 8 cm. size.

Adenoma↗
PubMed1990

The role of adrenalectomy in Cushing's syndrome.

Forty-four patients with Cushing's syndrome were treated by adrenalectomy between 1975 and 1989. Twenty patients had adrenal adenomas: 13 with obvious Cushing's syndrome and 7 whose disease was subclinical, detected after evaluation of an incidentally discovered adrenal mass (es). Twelve patients underwent bilateral adrenalectomies for Cushing's disease after failed transsphenoidal explorations and pituitary irradiation. Six patients had primary adrenal hyperplasia, five as manifestations of Carney's complex. Two others underwent bilateral adrenalectomies for ectopic adrenocorticotropic hormone from carcinoid tumors. Four patients had adrenocortical carcinoma treated with transabdominal adrenalectomy. Three are alive from 8 years to 5 months. There was one postoperative death (2.3%) caused by coagulopathy and multiple organ failure and three (7%) minor postoperative complications. Follow-up showed good to excellent results in 95% of patients. It is concluded that adrenalectomy provides prompt relief from the severe morbidity of Cushing's syndrome regardless of the cause. It is the treatment of choice for adrenal adenomas, carcinomas, primary hyperplasia, and selected patients with Cushing's disease.

Adenoma↗
PubMed1975

The effects of adrenalectomy and hydrocortisone replacement on the thyriod of the adult male rat I. Morphometrical data and histochemistry of some oxidative enzymes.

Morphometrical and histochemical studies were performed to determine the effects of adrenalectomy and hydrocortisone replacement on the rat thyroid. It follows from the performed studies that morphometrical and histochemical changes in the rat thyroid induced by adrenalectomy or hydrocortisone replacement depend upon the duration of the experiment. From the 4th day of the experiment adrenalectomy results in an increase in the volume fraction of the epithelium of the thyroid vesicles with a concomitant decrease of the colloid fraction. As compared to sham operated animals on the 10th day of the experiment the increase in the height of the epithelial cells was seen. Hydrocortisone replacement partially prevents the thyroid changes induced by adrenalectomy, however, this hormone markedly increases the volume fraction of the thyroid stroma and the height of the epithelial cells. On the other hand, histochemical reactions for various oxido-reductases do not provide helpful information for evaluation of the secretory activity of the rat thyroid. It follows from our results that adrenalectomy enhances thyroid stimulation by TSH and enhances the secretory activity of this gland, effects partially prevented by hydrocortisone replacement.

Adrenal Glands↗
PubMed1988

The effects of adrenalectomy on the alpha-adrenergic regulation of cytosolic free calcium in hepatocytes.

We have previously published that bilateral adrenalectomy in the rat reduces the Ca2+-mediated alpha-adrenergic activation of hepatic glycogenolysis, while it increases the cellular calcium content of hepatocytes. In the experiments presented here, the concentration of cytosolic free calcium (Ca2+i) at rest and in response to epinephrine was measured in aequorin-loaded hepatocytes isolated from sham and adrenalectomized male rats. We found that in adrenalectomized rats the resting Ca2+i was elevated, the rise in Ca2+i evoked by epinephrine was reduced, and the rise in 45Ca efflux that follows such stimulation was depressed. Furthermore, the slope of the relationship between Ca2+i and calcium efflux was decreased 60% in adrenalectomized. Adrenalectomy did not change Ca2+ release from intracellular calcium pools in response to IP3 in saponin-permeabilized hepatocytes. The EC50 for inositol 1,4,5-triphosphate and the maximal Ca2+ released were similar in both sham and adrenalectomized animals. Finally, the liver calmodulin content determined by radioimmunoassay was not significantly different between sham and adrenalectomized rats. These results suggest that 1) adrenalectomy reduces calcium efflux from the hepatocyte, probably by an effect on the plasma membrane (Ca2+-Mg2+)-ATPase-dependent Ca2+ pump and thus alters cellular calcium homeostasis; 2) adrenalectomy decreases the rise in Ca2+i in response to epinephrine; 3) this decreased rise in Ca2+i is not due to defects in the intracellular Ca2+ storage and mobilization processes; and 4) the effects of adrenalectomy on cellular calcium metabolism and on alpha-adrenergic activation of glycogenolysis are not caused by a reduction in soluble calmodulin.

Adrenalectomy↗
PubMed1986

[Effect of adrenalectomy on the capacity of brown adipose tissue for thermogenesis and the development of obesity in the fa/fa Zucker rat].

This study was undertaken to examine whether adrenalectomy performed during the weaning period could correct some of the first metabolic abnormalities to develop in obese fa/fa rats: impaired thermogenesis in brown adipose tissue and hyperlipogenesis in interscapular brown and white (inguinal) adipose tissues. Pups were adrenalectomized or sham-operated at 23 days of age and studied at 30 days of age. Body weight, interscapular brown adipose tissue and inguinal white adipose tissue weight were decreased after adrenalectomy in Fa/fa and fa/fa pups. Adrenalectomy had no effect on the thermogenic capacity of brown adipose tissue (as assessed by GDP binding to mitochondria) which remained significantly lower in fa/fa than in Fa/fa rats. In both Fa/fa and fa/fa rats the lipogenic capacity of brown and white adipose tissues (as assessed by fatty acid synthetase activity) was dramatically reduced by adrenalectomy. However, in adrenalectomized rats, the fatty acid synthetase activity of brown and white adipose tissue remained 2 and 5-fold higher, respectively, in fa/fa than in Fa/fa rats. These results show that adrenalectomy at postweaning, did not affect specifically the rats bearing the fatty genotype but induced large alterations in both groups of rats. Adrenalectomized fa/fa animals remained obese as compared to the appropriate controls.

Adipose Tissue↗
PubMed1986

Adrenalectomy reduces but does not reverse obesity in ob/ob mice.

Bilateral adrenalectomy (ADX) of 4-month-old ob/ob mice led to reduced rates of body weight gain, a complete cessation of fat deposition and increased percentage carcass protein and ash during a 2-month observation period after surgery. However, ADX obese mice were still heavier and had more body fat and lower concentrations of carcass protein and ash than intact sex-matched littermate lean mice at the end of the experiment. When adrenalectomy was performed in younger obese mice before the syndrome was fully expressed (23 +/- 2 days of age), body weight gain was reduced by 40 per cent and fat deposition by 50 per cent during the next 3.5 months, but each was still greater than that of littermate lean mice. Despite the lower rate of weight gain after adrenalectomy, the skeletal and lean body growth of the early ADX obese mice equalled that of both obese and lean mice fed ad libitum. When the carcass composition of early ADX obese mice was compared with that of intact obese mice which were calorically restricted to the same rate of body weight gain, the ADX group had significantly less carcass fat (28 per cent) and more protein (50 per cent) and ash (20 per cent) than the dieted obese mice. In both experiments adrenalectomy led to reduced circulating immunoreactive insulin levels, although hyperinsulinemia persisted. The present results show that adrenalectomy is an effective tool for ameliorating the severity of many aspects of the ob/ob syndrome, particularly when compared with caloric restriction, but the procedure does not entirely reverse the deranged metabolism or abnormal carcass composition of these mice.

Adrenal Glands↗
PubMedDate not supplied

Adrenalectomy for advanced breast cancer: a reappraisal.

The introduction of strict criteria of treatment response for advanced breast cancer facilitates comparison of treatment modalities. Recent studies of pharmacological measures are usually recorded according to UICC criteria but this has not been the case with regard to adrenalectomy. An analysis of 41 patients undergoing adrenalectomy for advanced breast cancer was undertaken to assess response according to UICC criteria. There were no complete objective responses but 12.2% had Partial Remission and 12.2% Static Disease, the remainder showing disease progression. These figures are lower than in most reported series which have used less clearly defined criteria of response. The Partial Response and No Change groups were similar in terms of symptomatic improvement and survival but superior to the treatment failure group. Adrenalectomy was associated with significant morbidity (46.7%) and operative mortality (6.7%). Only 1 patient of 11 previously treated with tamoxifen had a subsequent response to adrenalectomy. The low response rate when assessed on UICC criteria and high morbidity when compared with alternative treatment suggest that adrenalectomy will be less widely used in the future.

Adrenalectomy↗
PubMed1995

[Experience in seven cases of laparoscopic adrenalectomy].

We have experienced 7 cases of laparoscopic adrenalectomy for adrenal tumors during the past two years since our department opened in July, 1992. In four cases, the tumors were clinically diagnosed preoperatively as primary aldosteronism and in the other three cases as endocrine-inactive tumors. Four tumors were found on the left adrenal and three on the right. Five tumors were successfully resected with laparoscopic surgery, but in the other two cases it was immediately followed by open surgery because of an uncontrollable hemorrhage. Laparoscopically unresected tumors existed, one on the right and the other on the left adrenal. The average operation time for laparoscopic adrenalectomy was twice as much as that of open adrenalectomy previously performed. However, the operation time has been recently shortened to be less than 200 minutes. Hemorrhage during the operation was rather less in laparoscopic surgeries if they were successfully done. Postoperative recovery was found to be much faster and the hospital stay was shortened by more than 10 days in patients operated with a laparoscope. These findings indicate that laparoscopic adrenalectomy is a minimally invasive operation that can increase the QOL's of the patient. Although we consider that this operation may propagate as a method for adrenalectomy in future, it must be performed with a careful backup system in the case of an emergency.

Adenoma↗
PubMed1996

[Laparoscopic adrenalectomy. Experiences with 50 patients].

Fifty patients with adrenal tumors (18 men and 32 women, average age 51.8 years) underwent laparoscopic adrenalectomy from February 1992 to October 1995. Clinical diagnosis included pheochromocytoma in 3 patients, primary aldosteronism (including 1 with a 11-OH-corticosterone-producing tumor) in 15, Cushing's syndrome (including 7 with pre-Cushing's syndrome) in 13, non-functioning tumors in 17, 1 metastatic adrenal carcinoma, and 1 adrenal tuberculosis. Transperitoneal laparoscopic adrenalectomy was performed by the method reported previously. Extraperitoneal laparoscopic adrenalectomy was performed with the patient under general anesthesia in the lateral position. A working space was created by inserting a balloon dissector through a small skin incision. A total of four trocars were inserted. Three of the 50 patients were switched to open surgery, including 1 with metastatic adrenal carcinoma and 1 with adrenal tuberculosis. Laparoscopic tumor removal was successful in the other 47 patients. The average operating time and blood loss were 209 min and 177 ml, respectively. Blood loss was greater in the patients with pheochromocytoma. In patients with Cushing's syndrome, postoperative recovery tended to take longer. Postoperative complications occurred in 40% of the patients in this group, but all complications were minor and successfully treated without any surgical procedures. In the 10 patients undergoing retroperitoneal laparoscopic adrenalectomy, operative courses were excellent, excluding 1 patient with adrenal tuberculosis. Although laparoscopic adrenalectomy is considered to be appropriate for patients with pheochromocytoma and Cushing's syndrome, it appears unsuitable for the removal of malignant and inflammatory lesions.

Adrenal Cortex Hormones↗
PubMed1997

Bilateral laparoscopic adrenalectomy for adrenocorticotropic dependent Cushing's syndrome.

PURPOSE: We report our experience with bilateral laparoscopic adrenalectomy for total adrenal ablation in patients with Cushing's syndrome. MATERIALS AND METHODS: Four women (mean age 63 years) with Cushing's syndrome secondary to nonlocalized ectopic adrenocorticotropic hormone production in 3 and pituitary microadenoma after failed transsphenoidal ablation in 1 underwent bilateral transabdominal laparoscopic adrenalectomy. Preoperatively risk was III or IV according to the American Society of Anesthesiologists classification. RESULTS: In all cases bilateral laparoscopic adrenalectomy was successfully performed. Operative time ranged from 375 to 475 minutes (mean 404) and mean blood loss was 162 cc. All patients resumed oral intake on postoperative day 1, mean number of postoperative parentral narcotic doses was 2.25 and mean postoperative hospital stay was 5.75 days (range 3 to 8). Complications included an abdominal wall hematoma. All patients resumed baseline activity by postoperative day 14. CONCLUSIONS: Our experience in 4 cases of Cushing's syndrome suggests that bilateral laparoscopic adrenalectomy is a safe and effective alternative to open adrenalectomy. Further experience with this technique will likely decrease operative time, and confirm the benefit of a decreased hospital stay and convalescence.

Adrenalectomy↗
PubMed1978

Incidence of pituitary tumors following adrenalectomy. A long-term follow-up study of patients treated for Cushing's disease.

The long-term follow-up of 21 patients who had undergone bilateral adrenalectomy for Cushing's disease has revealed eight definite and two suspected cases of pituitary tumors. The average time from adrenalectomy to the diagnosis of the pituitary tumor was 6 1/2 years, with a range of 1 1/2 to 12 years. The incidence of tumors in this study (38%) is higher than that reported by others and may reflect (1) that none of these patients received pituitary irradiation in addition to adrenalectomy, (2) the length of follow-up, and (3) the high index of suspicion and early diagnosis of pituitary tumors in recent years. These data raise the question of whether bilateral adrenalectomy alone is an acceptable form of therapy for Cushing's disease. For patients treated in this way, a life-long commitment should be made to undergo annual reexamination for the possible occurrence of a pituitary neoplasm.

Adenoma↗
PubMed2002

Results of laparoscopic adrenalectomy for suspected and unsuspected malignant adrenal neoplasms.

BACKGROUND: Laparoscopic resection for malignant adrenal tumors is controversial, because they are rare and limited data exist in the literature. HYPOTHESIS: Laparoscopic adrenalectomy for malignant adrenal tumors is safe and effective. PATIENTS AND METHODS: Twenty-three patients who had a laparoscopic approach for suspected and unsuspected malignant adrenal tumors were studied retrospectively. The adrenal mass was suspected to be metastatic if the patient had a history of previous extra-adrenal primary malignancy and/or positive fine-needle aspiration cytologic findings. A primary adrenal cancer was suspected if there were positive fine-needle aspiration cytologic findings and/or a malignant adrenal imaging phenotype. MAIN OUTCOME MEASURES: (1) Margins of tumor resection, (2) tumor recurrence (locoregional, port site, and distant), and (3) disease-free survival. RESULTS: Twenty-three patients (15 men and 8 women) had 24 laparoscopic procedures (20 adrenalectomies, 3 biopsies, and 1 diagnostic laparoscopy). Permanent histologic specimens in the 23 patients showed 5 adrenocortical cancers, 1 undifferentiated adrenal cancer, 13 adrenal metastases, 2 lymphomas, and 2 cases with no evidence of tumor. Clinically suspected adrenal metastases were true positive in 19 patients (83%). The sensitivity of fine-needle aspiration cytology was 57% (n = 7). Only 1 of 6 patients with primary adrenal cancer was suspected to have a malignant tumor preoperatively. The tumor resection margin was negative in all adrenalectomies. There were 3 locoregional recurrences (2 local and 1 lymph node metastasis) in the 6 patients with primary adrenal cancer, no port site recurrences, and 4 distant recurrences in 13 patients with metastatic adrenal tumors. The disease-free survival was 65% at a mean follow-up time of 3.3 years (range, 1-7 years). CONCLUSIONS: A laparoscopic approach in patients with suspected adrenal metastasis can be both diagnostic and therapeutic, and achieves complete tumor resection. In contrast, laparoscopic adrenalectomy for clinically unsuspected adrenocortical cancer is associated with a high recurrence rate. Furthermore, preoperative fine-needle aspiration cytology for the evaluation of suspected malignant adrenal tumors is unreliable.

Adrenal Gland Neoplasms↗
PubMed2004

Applicability of laparoscopic adrenalectomy in a prospective study in 150 consecutive patients.

HYPOTHESIS: Within a decade, laparascopic adrenalectomy has become the new "gold standard" for the surgical treatment of most adrenal lesions. Designed as a single-center project focused on patients with adrenal lesions, this study should provide an indication of the number of patients requiring surgery who can safely undergo laparoscopy, after consideration of such selection criteria as tumor size and benign or malignant lesion status at magnetic resonance imaging. Furthermore, the access-related complications were analyzed. DESIGN: According to a prospective protocol, 150 consecutive patients selected for adrenal surgery were assigned to transperitoneal endoscopic or open adrenalectomy. SETTING: University hospital section of endocrine surgery. RESULTS: One hundred two patients (68%) were selected for a laparoscopic approach that had to be converted to open surgery in 5 patients (5%). Two malignant cortisol-secreting lesions were operated on laparoscopically because of their small size and benign appearance at magnetic resonance imaging. During histological examination, 14 (29%) of 48 patients assigned to transperitoneal open adrenalectomy had lesions deemed malignant (16 [11%] of 150 patients). The laparoscopic group had significantly fewer complications (9%) than did the open group (21%; P =.04). CONCLUSIONS: By applying defined selection criteria for the treatment of adrenal lesions, transperitoneal endoscopic adrenalectomy can be a safe procedure and may be performed in at least two thirds of patients. The choice of endoscopic or open approach in larger tumors should depend on the results of preoperative imaging studies and the endocrine surgeon's experience in endoscopic adrenal surgery.

Adrenal Gland Neoplasms↗
PubMed2005

The safety and efficacy of laparoscopic adrenalectomy in children.

HYPOTHESIS: Laparoscopic adrenalectomy (LA) has become standard therapy for benign adrenal masses in adults. The utility of LA in children with adrenal masses is less well defined because of the infrequency and pathologic variability of pediatric adrenal masses, and body size and instrumentation considerations that exist in small children. Evaluation of a case series of children undergoing lateral, transperitoneal LA will reflect the safety and efficacy of this procedure in pediatric patients and identify preferred patient selection criteria. DESIGN: A combined case series including patients treated between March 1999 and November 2004. SETTING: Urban tertiary referral pediatric teaching hospitals. PATIENTS AND INTERVENTIONS: All children with pathologic adrenal masses undergoing LA were included. MAIN OUTCOME MEASURES: The primary study outcome measures included operative duration, conversions to open adrenalectomy, complications, length of hospital stay, and freedom from recurrence of the original pathologic adrenal mass. RESULTS: A total of 21 LAs (including a staged, bilateral LA) were performed in 20 patients (13 girls, 7 boys) with a mean age of 6.4 years (range, 14 months to 18 years). Nine patients (43%) had neuroblastic tumors. Operative duration averaged mean +/- SD 101 +/- 48 minutes, and there was a single conversion to open adrenalectomy in a patient with a left adrenal carcinoma and tumor thrombus extending into the renal vein. There were no perioperative complications, and no patients required blood transfusions. The postoperative hospital stay averaged 1.5 days (range, 1-4.5 days). At a mean +/- SD follow-up of 31 +/- 17 months, all patients remained clinically (radiologically and/or biochemically) free of their original adrenal disease. CONCLUSION: Laparoscopic adrenalectomy can be used to safely treat suspected benign and selected malignant adrenal masses in children.

Adolescent↗
PubMed1975

Bilateral adrenalectomy for metastatic breast carcinoma.

Ninety-five patients who underwent bilateral adrenalectomy for metastatic breast carcinoma are reviewed. An objective remission of tumor was observed in 66% of the patients over the age of 45 years with metastasis limited to soft tissue, osseous, or pulmonary system. In those patients below the age of 45, only 19% had remission irrespective of the sites of metastasis. Thirty-three patients were admitted with no "free interval," with objective remission occuring in 42%. This observation indicates that the "free interval" is not as striking a determinant in selecting adrenalectomy candidates as had been stressed by others. The serial treatment of adrenalectomy followed by chemotherapy after adrenalectomy failure or relapse was shown to objectively benefit 74% of 72 patients evaluated. Sulfokinase activity in breast cancer tissue was studied in 17 patients. The results were not as definitive as reported by others.

Adrenal Gland Neoplasms↗
PubMed1999

Laparoscopic adrenalectomy for cancer.

We will review the literature on the operative techniques and patient outcomes of laparoscopic adrenalectomy for cancer. Further, in our own study, an analysis of the preoperative assessment, operative, and hospital course, and postoperative follow-up was performed on all patients undergoing a laparoscopic adrenalectomy for cancer or metastasis from October 1996 through February 1998. Twelve laparoscopic resections were performed in 11 patients. There were six males and five females with an average age of 62 years (range, 40 to 79). The mean American Society of Anesthesiologists (ASA) score was 3.1 (range, 2 to 4). All of the tumors except one were due to metastatic cancer. The metastatic sources included renal cell cancer (four), lung cancer (two), colon cancer (two), adrenal cancer (one), and melanoma (one). Seven patients required a left adrenalectomy, three underwent a right adrenalectomy, and one was bilateral. The approach was transperitoneal in eight cases and retroperitoneal in four. The mean size of the tumors was 5.9 cm (range, 1.8 to 12 cm). Operative time averaged 181 minutes (range, 100 to 315 minutes), and blood loss was 138 cc (range, 20 to 1,300 cc). Average hospital stay was 2.3 days (range, < 1 to 6 days). One patient required conversion to an open approach due to local invasion of the tumor into the lateral wall of the vena cava, which was resected with the specimen. This procedure resulted in the largest blood loss of the series (1,300 cc). All specimens had negative surgical margins. There was one complication (9%), a laceration of the epigastric artery, which was controlled laparoscopically. At a mean follow-up of 8.3 months (range, 0.5 to 19 months), there have been no port site or local recurrences. One patient has developed a new hepatic nodule, which is being worked up for metastatic disease. Ten of the 11 patients (91%) are currently alive; one has died of expansive cerebral metastases from melanoma.

Adrenal Gland Neoplasms↗
PubMed1977

Medical and surgical adrenalectomy in patients with advanced breast carcinoma.

Twenty-four postmenopausal patients with metastatic breast carcinoma were placed on aminoglutethimide and dexamethasone as a form of reversible medical adrenalectomy. Six patients experienced adverse side-effects. Of the 18 remaining patients 50% had a definite subjective or objective response to therapy. Thirteen of these patients underwent subsequent surgical adrenalectomy after a maximum of 3 month's trial of the medical regimen. In every patient the response to therapy was identical with the two modalities of therapy. In those postmenopausal patients with metastatic breast cancer who are felt to have a hormone- dependent tumor by clinical and/or hormonal assay criteria, medical adrenalectomy may eventually be a feasible replacement for surgery in selected cases. As important, perhaps, is the potential value of this medical adrenalectomy as a reliable indicator of the subsequent response to endocrine ablative therapy.

Adrenal Glands↗
PubMed1994

Induction of glial fibrillary acidic protein immunoreactivity in the rat dentate gyrus after adrenalectomy: comparison with neurodegenerative changes using silver impregnation.

In the present study we performed a light microscopic anatomical comparison of adrenalectomy (ADX)-induced neurodegeneration using silver impregnation and reaction of astroglial cells using GFAP immunocytochemistry in the hippocampus of the rat. Three survival times following ADX were studied: 24 hours, 3 days, and 3 weeks. Twenty-four hours following ADX we found no degenerative changes or altered GFAP immunostaining. Three days after adrenalectomy, argyrophilic somata appeared in the granular cell layer of the dentate gyrus. Argyrophilic dendrites were seen in the molecular layer of the dentate gyrus and neuritic argyrophilia were seen in the mossy fiber layer. Induction of GFAP immunoreactivity occurred simultaneously with degeneration. Increased GFAP immunoreactivity could be observed 3 days after adrenalectomy in the molecular layer of the dentate gyrus, granular cell layer, sub and supragranular cell layer, and mossy fiber layer. Size and shape of astroglial cells were changed, and their processes in the molecular layer changed from unidirectional to randomly organized. Degeneration and astroglial reaction were more pronounced 3 weeks after adrenalectomy and both were prevented by adding corticosterone to the drinking solution. Animals that did not show degenerative changes showed no increased GFAP immunoreactivity, while both effects were confined to the dentate gyrus and mossy fiber zone. These results show that there is a close relationship between the induction of GFAP immunoreactivity in the hippocampus of the rat and neuronal degeneration in the dentate gyrus following ADX, both in time and space.

Adrenalectomy↗