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Comparative effect of insulin and explanted adrenal medullary tissue and rat adrenal medulla in situ.

The adrenal medulla and explanted medullary cells in the anterior chamber of the eye were examined 3 h after the administration of insulin to rats. No alterations were seen in the explanted cells. In the adrenal medulla, light and electron microscopy indicated depletion of adrenaline cells; noradrenaline cells were not affected. Levels of catecholamines were three times higher in the explanted tissue after insulin treatment; in the medulla in situ they declined by 70%. These results confirm that insulin has no direct releasing effect on chromaffin cells.

Adrenal Medulla↗

Mediastinal foregut cyst containing an intramural adrenal cortical rest: a case report and review of supradiaphragmatic adrenal rests.

We present a case of a baby girl with a congenital cystic mediastinal mass which was excised at 20 months of age and was found to be a developmental foregut cyst of the gastroenteric type. Within the cyst wall was an adrenal cortical rest. Adrenal cortical rests arising above the diaphragm are exceedingly rare and previous cases are reviewed.

Adrenal Cortex↗

[Adrenal regeneration hypertension--effects of vascular connective tissue protein and plasma corticosterone on hypertension in rats with adrenal regeneration hypertension].

In young rats consuming 1% NaCl drinking solution, unilateral nephrectomy and bilateral adrenal enucleation caused a hypertension. Plasma corticosterone concentration in hypertensive rats was not significantly higher than that of normotensive control rats in early hypertensive or chronic hypertensive stage. At the end of experiment, each rat received an intravenous injection of 0.4 microCi/g of 3H-lysine and was sacrificed 2 hours after the injection. Incorporation of 3H-lysine into collagen or elastin of the mesenteric artery and heart in hypertensive rats was greater than that of normotensive rats. Administration of phenoxybenzamine hydrochloride lower the blood pressure of hypertensive rats and reduced the incorporation of 3H-lysine into collagen and elastin of the mesenteric artery and heart. From these findings, increased protein synthesis of collagen and elastin in hypertensive rats appears to play an important role for the maintenance of adrenal regeneration hypertension.

Adrenal Glands↗

Adrenal masses: the investigation and management of adrenal incidentalomas.

Most general surgeons will face at sometime in their career an 'incidentaloma' of the adrenal gland. How should a surgeon approach an incidentaloma found during routine investigation for other unrelated disease processes? This paper discusses the investigation and management of adrenal incidentalomas and includes guidelines for the non-specialist.

Adrenal Gland Neoplasms↗

[Acute adrenal insufficiency caused by bilateral adrenal hemorrhage as first manifestation of antiphospholipid syndrome. Report of a case and review].

Although adrenal hemorrhage is an unusual feature of antiphospholipid syndrome (APS), it can be its first clinical manifestation. The pathogenetic substratum is the thrombosis of the adrenal veins leading to hemorrhagic infarction. Recurrences are frequent in patients with APS-related thrombosis, thus long-term anticoagulation is advocated by most authors.

Acute Disease↗

Studies on cyclic nucleotides in the adrenal gland. IX. Effects of ACTH on cyclic AMP and steroid production by the zona fasciculata-reticularis of the adrenal cortex.

Effects of ACTH and calcium on cyclic AMP and steroid production by the zona fasciculata-reticularis (the decapsulated fraction) from the rat adrenal cortex have been studied. Increasing concentrations of extracellular calcium enhanced the action of ACTH on cyclic AMP and steroid production. These effects of ACTH with calcium were prevented by lanthanum, but not by tetracaine or verapamil, suggesting that ACTH stimulation may be mediated by calcium through a process not involving the tetracaine- or verapamil-vulnerable step(s) of the calcium current. High concentrations of external calcium itself increased cyclic AMP accumulation without any increase in steroidogenesis. A calcium ionophore, X537A was stimulatory for steroidogenesis but inhibitory with respect to cyclic AMP accumulation. Considered together with the findings of AMP increase, these results suggest that ACTH primarily increases intracellular calcium mobilization thus stimulating directly the steroidogenesis, which is independent of the cyclic AMP system. Relatively high concentrations of ACTH activate the adenylate cyclase, which depends on extracellular calcium to increase cyclic AMP levels and stimulation of steroidogenesis by the decapsulated fractions of the adrenal cortex.

Adrenal Cortex↗

[The effect of age-related changes on the hypophyseo-adrenal and sympathetico-adrenal systems in patients with cancer of the digestive tract and lungs].

An analysis of the activity of pituitary-adrenal and sympathetic-adrenal systems in patients with cancer of the digestive canal and lungs with consideration of age, sex and stage of the disease indicates that not age but the development of the tumour process is the leading factor in disorders of the neuroendocrine homeostasis. Therapeutic measures are discussed.

Adolescent↗

Morphometric analyses of adrenal gland growth in fetal and neonatal sheep. I. The adrenal cortex.

This, the first linear morphometric analysis of the epigenesis of the fetal mammalian adrenal cortex, has shown that in the fetal sheep during the latter two thirds of gestation and in the newborn lamb, there are two periods of rapid growth separated by a period of much reduced growth. The fetal ages studies were 53 days (0.36 gestation), a period when the fetal adrenal cortex is actively steroidogenic; 100 days (0.68 gestation), a period of adrenocortical quiescence; 130 days (0.88 gestation), the period of increasing responsiveness to ACTH and cortisol production; 144 days (0.98 gestation), the period of maximal adrenocortical steroidogenesis; and 2 days postpartum, when cortisol production is normally maintained. The first adrenocortical growth period extends to mid-gestation, then growth slows to 0.85 gestation when the second growth period begins. The changes between the first growth period (0.36 gestation) and the period of quiescence (0.68 gestation) are characterised by the attainment of normal adrenocortical zonation and the separation of the medulla. The rate of adrenocortical cell division slows and the zona fasciculata cells become smaller in size. The volume density of the adrenocortical blood sinusoids decreases significantly. The onset of the second growth phase is associated with the previously reported increased levels of fetal plasma ACTH at 0.85 gestation and is expressed initially as a hypertrophic response. Cellular hypertrophy increases from 0.88 gestation to 0.98 gestation and then declines over the birth period. The rate of adrenocortical cell division increases from 0.88 gestation and maintains a maximal rate from 0.98 gestation to 2 days postpartum. These interactions of cellular hypertrophy and hyperplasia, which result in adrenocortical growth, may be explained as a response to fetal ACTH, which has the ability to stimulate the production of peptide growth and differentiation factors, e.g. IGF-II, and cortisol, which then control adrenocortical development in an autocrine and paracrine fashion.

3-Hydroxysteroid Dehydrogenases↗

The innervation of the adrenal gland. I. The source of pre- and postganglionic nerve fibres to the rat adrenal gland.

The sympathetic innervation of the rat adrenal medulla was studied using the fluorescent tracer Fast Blue. Labelled preganglionic cell bodies were located in the intermediolateral horn of the spinal cord at segments T1 and L1; the greatest number was found in T9. The ILp nucleus contained 95%, the ILf nucleus 4%, and the IC nucleus 1% of the total number of labelled preganglionic cells. Labelled postganglionic cell bodies were found in the sympathetic ganglia at levels T4 and T12; the maximum number were located in ganglia at T9 and T10. In addition, labelled cells were found in the suprarenal ganglion. No labelled cells were found in the ganglia of the coeliac plexus. The number of labelled preganglionic cells in the spinal cord accounted for 88.6%, the labelled cells in the sympathetic chain for 8.7% and those in the suprarenal ganglia for 2.7% of the total number of labelled cells found. The detailed distribution within the gland of postganglionic axons has yet to be determined, but it is thought that some are destined for the adrenal cortex.

Adrenal Glands↗

[Functional relations between the adrenal cortex, thyroid gland and pineal body. I. Reactions of the adrenal cortex following interference with the thyroid regulatory cycle].

Histologic-cytological and morphometrical changes were investigated in the adrenal cortex of male Wistar-rats in experimental hypo- and hyperthyroid situation. Under hypothyroid metabolism's situation (methylthiouracil-application or thyroidectomy) a regressive transformation was found: It is a decrease of secretion of the fascicular zone. The glomerular zone was activated. After long-time application of high dosis of thyroxin, the histological findings show some criteria of an increasing function and also of a beginning exhaustion, too. It is evident, that the duration of the hyperthyroid situation is important. Thyroxin is an unspecific stressor. The long-time application of high thyroxin dosis induced a regressive transformation and atrophic changes in the adrenal cortex. The nuclei of the fascicular and the glomerular zone were diminuated significantly.

Adrenal Cortex↗

Failure to visualize adrenal glands in a patient with bilateral adrenal hyperplasia.

A patient with clinical and biochemical evidence of Cushing's disease and severe hyperlipidemia underwent an adrenal imaging procedure with NP-59 (6 beta-[131I]iodomethyl-19-norcholesterol), without visualization of either gland. Correction of the hyperlipidemia followed by repeated adrenal imaging resulted in bilateral visualization. A pituitary tumor was removed at surgery, confirming the diagnosis of Cushing's disease.

Adosterol↗

Purification of tropomyosin from bovine adrenal medulla and its inhibitory effect on the actin severing activity of adseverin (adrenal medulla 74 kDa actin severing protein).

Tropomyosin was purified from a gelation product produced in the crude extract of bovine adrenal medulla using several column chromatographies mixed with a boiling treatment. Purified tropomyosin was a mixture of major isoforms with low molecular weights and minor isoforms of high molecular weights. Purified tropomyosin showed a dose-dependent protective effect on actin filaments against the severing activity of adseverin derived from adrenal medulla, suggesting its important role in the regulation of cell shape and structure in vivo.

Actin Cytoskeleton↗

Inhibition of adrenal medullary catecholamine secretion by enflurane: II. Investigations in isolated bovine adrenals--site and mechanism of action.

To determine the site and mechanism of action underlying the inhibition of adrenal medullary catecholamine release by enflurane, the authors measured the effects of enflurane on catecholamine secretion evoked by various secretagogues in isolated bovine adrenals perfused with Locke's solution. Catecholamine concentrations in the perfusate were measured spectrofluorometrically. Enflurane caused concentration-dependent inhibition of catecholamine release in response to activation of the nicotinic receptors in the chromaffin cells with acetylcholine or dimethylphenylpiperazinium (DMPP). An enflurane concentration of 0.88 mM caused 50 per cent inhibition of the DMPP-induced secretion. The inhibition induced by enflurane was shown to be noncompetitive. The catecholamine release evoked by activation of the muscarinic receptors with pilocarpine was only slightly decreased by 3.74 mM enflurane. At this concentration the release in response to KCl, 56 mM, was partially inhibited, whereas the output in response to tyramine (from glands perfused with calcium-free Locke's solution) was unaffected. It is concluded that the site of action of enflurane is the cell membrane. At concentrations above 1 mM, enflurane may impair calcium ion influx, but at lower concentrations it probably interacts with hydrophobic regions of the nicotinic receptor.

Acetylcholine↗

[Adrenal mass and adrenal insufficiency].

Primary adrenal insufficiency is a non frequent disease, that is declared in young adults and in the most of the cases is produced from an autoimmune mechanism or a tuberculous disease. The incidence of these forms in the different geographic areas is dependent of degree of irradication of the tuberculosis. We report the case of a patient with latent chronic adrenal insufficiency of tuberculous origin who was affected for an addisonian crisis during an intercurrent infectious disease, which permitted the diagnosis of the addisonian crisis, and Mal of Pott was moreover detected. Evolution with corticosteroid and specific treatment was very favorable.

Addison Disease↗

Massive adrenal haemorrhage complicating adrenal neoplasm.

Two patients presented to hospital with clinical features of acute retroperitoneal haemorrhage. In each case, laparotomy revealed massive adrenal haemorrhage, and histological evidence of underlying neoplasia was eventually found.

Adrenal Cortex Neoplasms↗

Regulation of adrenal glucocorticoid synthesis by interleukin-10: a preponderance of IL-10 receptor in the adrenal zona fasciculata.

Several lines of evidence indicate that cytokines can affect adrenal function. To date most of these cytokines have been shown to be pro-inflammatory, such as interleukin (IL)-1, tumor necrosis factor (TNFalpha), and IL-6. However, we have previously shown that IL-10-/- (IL-10 knockout) mice have higher serum corticosterone levels than IL-10+/+ (wild type) mice following acute immune and physiologic stress, implying that IL-10, an anti-inflammatory cytokine, regulates glucocorticoid synthesis in a negative manner. Here, we show that IL-10 knockout mice produce more corticosterone under basal conditions as well (shown by ELISA). We further support this contention by showing that in Y-1 adrenocortical cells IL-10 inhibits steroid production (StAR) (measured by the production of the corticosterone precursor, progesterone), the expression of steroidogenic acute regulatory protein (semi-quantitative RT-PCR), as well as the activity of the proximal steroidogenic enzymes P450scc and/or 3beta-hydroxysteroid dehydrogenase (3beta-HSD) (measured by progesterone production in 22(R)-hydroxycholesterol-treated cells). Interestingly, all of the above-mentioned effects of IL-10 occur through its inhibition of ACTH effects, but not by IL-10 alone. Furthermore, immunocytochemistry data shows that the region of the adrenal gland responsible for the vast majority of corticosterone synthesis, the zona fasciculata, predominantly expresses the IL-10 receptor 1 (IL-10R1), with little expression in the zona glomerulosa and reticularis. These data demonstrate that IL-10 could play an important role in the regulation of glucocorticoid biosynthesis and in maintenance of homeostasis and immunity during periods of stress.

3-Hydroxysteroid Dehydrogenases↗

Hyposecretion of adrenal androgens and the relation of serum adrenal steroids, serotonin and insulin-like growth factor-1 to clinical features in women with fibromyalgia.

Neuroendocrine deficiencies have been implicated in fibromyalgia (FM). In the present study, adrenal androgen metabolites and their relationship with health status in FM were investigated. For comparison, serum levels of other implicated neuroendocrine mediators were correlated with health status. Fifty-seven consecutive women with FM completed the Fibromyalgia Impact Questionnaire (FIQ). Fasting blood samples were taken for measurement of dehydroepiandrosterone sulphate (DHEAS), free testosterone (T), cortisol, serotonin and insulin-like growth factor-1. Normal value for DHEAS and T were obtained from 114 controls. DHEAS levels were decreased significantly in pre- and postmenopausal patients (P<0.0001 and P<0.0005, respectively). T levels were decreased significantly in premenopausal and insignificantly in postmenopausal patients (P<0.0001 and P=0.06, respectively). The following correlations between neurohormonal levels and FIQ scores were found: DHEAS (after adjustment for age) vs. pain (P<0.001) and T (after adjustment for age) versus physical functioning (P=0.002). None of the other neurohormonal levels correlated significantly with any of the FIQ scores. IGF-1 levels were lower in the obese patients as compared to those who were non-obese (P=0.03). The BMI correlated positively with pain (P<0. 001) and inversely with DHEAS levels (P=0.006). After further adjustment for BMI, the correlation between age adjusted DHEAS and pain was no longer significant. Hyposecretion of adrenal androgens was documented in FM. This was more pronounced in obese patients. Low serum androgen levels correlated with poor health status in FM. Longitudinal studies are needed to elucidate whether these are cause and/or effect relationships.

Adolescent↗

Studies on auditory thresholds in normal man and in patients with adrenal cortical insufficiency: the role of adrenal cortical steroids.

Auditory thresholds for sinusoidal tones were determined in eight patients with adrenal cortical insufficiency (four with Addison's disease and four with panhypopituitarism) and compared to those in normal volunteers. In adrenal cortical insufficiency (ACI) the auditory detection sensitivity is significantly more acute than that of normal subjects over most of the frequency range, but especially in the region of greatest hearing sensitivity of normal subjects, 1,000 to 2,000 cycles per second (cps). Treatment of the patients with deoxycorticosterone acetate decreased serum potassium concentration and produced gains in body weight but did not alter auditory detection thresholds. Treatment with prednisolone or with maintenance doses of carbohydrateactive steroids returned the auditory detection threshold to normal in every patient tested.The mechanism by which carbohydrate-active steroids affect the sensitivity of the nervous system to sound is not known. However, since the senses of taste, smell, and hearing are all affected in similar fashion by their removal and replacement, there appears to be a generalized increase in sensitivity to all sensory stimuli in patients with ACI not receiving steroids. These hormones may play a significant role in maintaining the level of responsiveness of the sensory system to incoming stimuli.

Addison Disease↗