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At least 1,063 records · Page 59Linked to original sources
PubMed1975

131I-19-iodocholesterol scintigraphy of the adrenal cortex.

131-I-19-iodocholesterol scintigraphy of the adrenal cortex has been carried out in 26 patients. In 4 patients with normal adrenocortical function the tracer was equally accumulated on the two sides. In 7 patients with untreated Cushing's syndrome, bilateral uptake was found in 4 patients with bilateral hyperplasia whereas unilateral visualization was obtained in three cases of cortisol producing adenomas. The side localization was confirmed at operation. Eight patients had been operated for Cushings syndrome prior to the scintigraphy. Remnant adrenocortical tissue with negligible or subnormal function (4 patients) could not be visualized. Normo- or hyperfunctioning remnant tissue was visualized in 3 patients. One patient had recurrent hypercorticism due to metastases from a previously removed adrenocortical carcinoma; a single pelvic accumulation was seen, whereas several metastases in the abdomen and thorax were not visualized. Four patients with aldosteronism were investigated. Three had primary aldosteronism due to an adrenocortical adenoma. In two of these, the site of the adrenal lesion was localized pre-operatively. In the third patient, equal bilateral accumulation of iodocholesterol was seen even after suppression with dexamethasone. At operation a small tumour was found. In 1 patient with indeterminate aldosteronism both glands were visualized and at a second examination the uptake was equally suppressed by dexamethasone.

Adrenal Cortex↗
PubMedDate not supplied

The nodular adrenal.

Nodules commonly occur in the human adrenal gland. They are best regarded as part of the ageing process, produced in response to adrenal vascular changes. Nodules exhibit a wide diversity of size and distribution and are seen not only in subjects with normal adrenal function but also in patients with hypercorticalism (Cushing's and Conn's syndromes). In these disorders, the nodules appear to be a consequence of the diseases, rather than being aetiological.

Adrenal Cortex↗
PubMed1996

[The hypophyseal-adrenal axis in chronic alcoholism].

In order to reveal the morphologic basis of clinically recognized pseudo Cushing syndrome in chronic alcoholism, we performed an analysis of histologic characteristics of hypothalamo-hypophyseal adrenal axis components. The experiment included Wistar rats which were given 15% ethanol solution in water for three months. By methods of classical histology, histochemistry and immunofluorescence adrenal and hypophyseal sections of experimental animals exposed to continual effects of alcohol and those from the control group were examined. ACTH (adrenocorticotropin) cells of the experimental group show expressed immunofluorescence as a proof of their high secretory granules present in numerous cytoplasmic endings which contribute to significantly increased number of these cells comparing to the control group. In the adrenal cortex of animals exposed to alcohol, in the zona fasciculata and zona reticularis, under the influence of hypophyseal corticotropin (ACTH) secretion, there is a statistically significant increase of the compact cells region, as synthetic active elements, in regard to vacuolized cells, as inactive elements, which has been established stereologically. Simultaneous hyperfunction of hypophyseal ACTH cells and ACTH dependent zones of the adrenal cortex in chronic alcoholism, proves that alcohol primarily acts at the level of hypothalamus and hypophysis, while adrenals react to hypersecretion of ACTH cells. The way alcohol affects neurotransmitters is the topic of the discussion, whereas stimulated synthesis of acetylcholine is pointed out.

Adrenal Cortex↗
PubMed2004

McCune-Albright syndrome associated with pituitary microadenoma: patient report.

McCune-Albright syndrome (MAS) is a rare disorder characterized by the classic triad of precocious puberty, polyostotic fibrous dysplasia and café-au-lait spots. Additional endocrine abnormalities may also be present, including hyperthyroidism, growth hormone excess and hyperprolactinemia. The most commonly encountered endocrine dysfunction is gonadal hyperfunction. Gonadotropin-independent precocious puberty is typically the initial manifestation of MAS in girls. Ovarian cysts may be detected on pelvic ultrasound. Our patient was also found to have pituitary microadenoma, evidenced by dynamic magnetic resonance imaging.

Adenoma↗
PubMed1990

Unusual cause for recurrent Cushing syndrome and its diagnosis by computed tomography and NP-59 radiocholesterol scanning.

Cushing syndrome can recur following an adrenalectomy. One of the primary causes is recurrence of adrenal carcinoma either locally or from metastases. Hyperplasia and hyperfunction of adrenal remnants may also occur if there is pituitary stimulation. We have a patient in whom recurrent Cushing syndrome developed from small nonmalignant deposits of adrenal tissue in the perirenal adipose tissue following adrenalectomy of a benign adenoma. These deposits were identifiable by computed tomography. A false-negative NP-59 iodocholesterol scan was instructive in pointing out some problems in the interpretation of this type of scan for adrenal tissue.

Adenoma↗
PubMed2001

Adrenal incidentaloma.

Because of the frequent use of computed tomography and other abdominal imaging modalities, clinicians more frequently see the incidentally discovered, clinically silent adrenal mass. Most adrenal incidentalomas should be evaluated for hormonal activity and assessed for their risk of malignancy. Adrenalectomy is indicated for hyperfunctioning tumors and for any potential primary malignant adrenal lesion. Nonfunctioning cortical adenomas < 4 to 5 cm in size should be followed clinically and radiographically. Laparoscopic adrenalectomy has been used increasingly as the preferred approach in patients who require surgical resection whereas open adrenalectomy is reserved for patients with large, malignant tumors. The indications for adrenalectomy in patients with nonfunctioning adrenal tumors should not be liberalized because of the laparoscopic approach.

Adrenal Gland Neoplasms↗
PubMed2004

Use of gadolinium contrast adrenal venography for the assessment of primary aldosteronism in a patient with iodine allergy.

Primary aldosteronism is a relatively common cause of secondary hypertension. It is often important to diagnose this disease accurately, since appropriate surgical therapy may result in cure of the disease. Assessment of the laterality of adrenal hyperfunction is possible using adrenal venous sampling of steroid hormones, but this procedure may not be feasible in patients with allergy to iodinated radiocontrast agents. In this paper, we report a patient with primary aldosteronism who was found to have bilateral adrenal tumors on CT. Because preoperative localization of the hyperfunctioning tumor was important, adrenal venous sampling and venography was performed by a highly-experienced radiologist using the MRI contrast agent gadolinium. After reviewing the data, the patient received a right adrenalectomy. This case report demonstrates that it was possible to perform adrenal venography using gadolinium in this patient, however the safety and efficacy should be re-assessed in individual cases.

Adrenal Gland Neoplasms↗
PubMed1986

Evaluation of canine hyperadrenocorticism, using computed tomography.

Abdominal computed tomography was performed in 9 dogs with hyperadrenocorticism and in 2 healthy dogs. Both adrenal glands were identified in all dogs. Computed tomography allowed accurate identification of the sites of adrenal gland dysfunction, when interpreted in combination with a biochemical diagnosis of canine hyperadrenocorticism. This accuracy permitted the retroperitoneal approach to be used for all adrenalectomies. Use of contrast medium (although not essential) was helpful in the computed tomographic identification of blood vessels, kidneys, and other abdominal organs.

Adrenal Cortex Neoplasms↗
PubMed1976

Adrenal medullary hyperplasia. A morphometric analysis in patients with familial medullary thyroid carcinoma.

The syndrome of familial medullary thyroid carcinoma (MTC), pheochromocytoma, and parathyroid hyperplasia is inherited as an autosomal dominant trait, and is characterized by development of bilateral and multicentric thyroidal and adrenal medullary tumors. One of the earliest manifestations of adrenal medullary hyperfunction in patients with this syndrome is an increased ratio of epinephrine to norepinephrine in urine. In order to define the morphologic correlates of these early catecholamine abnormalities in a large kindred with familial MTC, a morphometric analysis based on a point-counting system to asses adrenal medullary volume was undertaken. These studies clearly revealed adrenal medullary hyperplasia as reflected by a two- to three-fold increase in medullary volume and weight as compared to age- and sex-matched controls. The increase in total medullary mass resulted from diffuse and multifocal modular proliferations of adrenal medullary cells primarily within the head and body regions of the glands. These results support the hypothesis that the pheochromocytomas in patients with familial MTC may, in fact, represent extreme degrees of nodular hyperplasia of the medulla.

Adrenal Medulla↗
PubMed2001

[Licorice-induced pseudoaldosteronism in a patient with a non-functioning adrenal tumor].

A 72-year-old man was diagnosed with hypertension, hypokalemia, and left adrenal tumor at another hospital, and was referred to our hospital on suspicion of primary aldosteronism. Investigations revealed low plasma aldosterone concentration, and the left adrenal tumor proved to be nonfunctioning, not hyperfunctioning. "Licorice" had been prescribed for the treatment of recurrent cramps in his calf. After stopping the licorice, his condition changed to normokalemia strongly suggesting that his pseudoaldosteronism had been caused by the drug. We reviewed 140 reports on licorice-induced pseudoaldosteronism in Japan, and found a second patient who might have suffered a similar coincidental nonfunctioning adrenal tumor.

Adrenal Gland Neoplasms↗
PubMed2002

Quantitative assessment of CYP11B1 and CYP11B2 expression in aldosterone-producing adenomas.

BACKGROUND: The presence and pathophysiological role of CYP11B1 (11beta-hydroxylase) gene in the zona glomerulosa of human adrenal cortex is still controversial. METHODS: In order to specifically quantify CYP11B1, CYP11B2 (aldosterone synthase) and CYP17(17alpha-hydroxylase) mRNA levels, we developed a real-time RT-PCR assay and examined the expression in a series of adrenal tIssues, including six normal adrenals from patients adrenalectomized for renal cancer and twelve aldosterone-producing adenomas (APA) from patients with primary aldosteronism. RESULTS: CYP11B1 mRNA levels were clearly detected in normal adrenals, which comprised both zona glomerulosa and fasciculata/reticularis cells, but were also measured at a lower range (P<0.05) in APA. The levels of CYP11B2 mRNA were lower (P<0.005) in normal adrenals than in APA. CYP17 mRNAlevels were similar in normal adrenals and in APA. In patients with APA, CYP11B2 and CYP11B1 mRNA levels were not correlated either with basal aldosterone or with the change from basal aldosterone in response to posture or to dexamethasone. No correlation between CYP11B1 mRNA or CYP11B2 mRNA and the percentage of zona fasciculata-like cells was observed in APA. CONCLUSIONS: Real-time RT-PCR can be reliably used to quantify CYP11B1 and CYP11B2 mRNA levels in adrenal tIssues. Expression of CYP11B1 in hyperfunctioning zona glomerulosa suggests an additional formation of corticosterone via 11beta-hydroxylase, providing further substrate for aldosterone biosynthesis. CYP11B1 and CYP11B2 mRNA levels in APA are not related to the in vivo secretory activity of glomerulosa cells, where post-transcriptional factors might ultimately regulate aldosterone production.

Adenoma↗
PubMed1987

[Residual hypertension after removal of a pheochromocytoma (morphologic study of the kidneys)].

Renal parenchyma, and the juxtaglomerular apparatus in particular, was studied in 23 patients with verified diagnosis of pheochromocytoma. Intraoperative renal biopsy was performed in 21 cases, and kidneys obtained at nephrectomy or autopsy were examined in 2 cases. Twenty-one patients were examined following the removal of pheochromocytoma (2 patients died). Arterial BP returned to normal in 86.4%, and residual hypertension due to continuous hyperfunction of the juxtaglomerular apparatus in the presence of hypertensive angiosclerosis was recorded in 13.6%. Tubular epithelial atrophy of varying markedness, associated with renal ischemia, was detected in all cases. The pathogenetic contribution of the renin-angiotensin system to pre- and postoperative hypertension in pheochromocytoma patients is discussed.

Adolescent↗
PubMed1997

Imaging of adrenal masses.

Most adrenal masses are detected on CT scans, but only a minority has morphologic features that are characteristic of a specific histologic diagnosis. In patients with clinical or biochemical features of a hyperfunctioning adrenal syndrome, CT detection of a unilateral adrenal mass typically leads to surgical resection, although functional assessment of the mass with iodomethylnorcholesterol or MIBG scintigraphy sometimes is used to augment the CT findings. In patients with a nonhyperfunctioning adrenal mass, chemical shift MR and CT densitometry have begun to replace percutaneous adrenal biopsy or serial follow-up CT as methods to establish a specific diagnosis. In this article the authors review the clinical features and imaging findings of patients with known or suspected adrenal masses.

Adenoma↗
PubMed1995

[Sudden death from hypoglycemia].

The sudden death by hypoglycemia is an aspect of the forensic pathology frequently neglected. Authors initially described the pathogenesis of different hypoglycemia forms, distinguishing the primary ones due to hyperinsulinism and the secondary ones due to functional insufficiency of other organs (hypophysis, thyroid, adrenal gland, liver); after that Authors described three cases of sudden death induced hypoglycemia by hyperinsulinism: two were unweaned with nesidioblastosis and one adolescent. In any form of hypoglycemia the central nervous system damage is present with evident neuronal degenerative-necrotic phenomena, widespread edema with microhemorrhage, swollen and dissociation of myelin sheath, glial cells hyperplasia. Death caused by primary hypoglycemia is histopathologically different from the secondary one because of the maintenance of hepatic glycogen content in the former, that increase in striated muscles, including the heart, in spite of the constant secretion of catecholamine from the adrenal medulla. Glycogen is depleted in secondary hypoglycemia. In the primary form, behind the adrenal medulla hyperfunction, the increased functional activity of the adrenal cortex is moderate, contrasting with the seriousness of the syndrome, due prevalently to inhibit the gluconeogenesis response conditioned by the persistence of stored glycogen in the liver, heart and striated muscles. The rare anoxic processes coming with resynthesis of hepatic glycogen have to be considered in the differential diagnosis. The primary hypoglycemic death, especially in unweaned, is frequently promoted by other processes inducing hypoxia (fetal asphyxia outcome, pneumonia, etc.) or worsening the hypoglycemia (hypothyroidism, etc.). The secondary hypoglycemias are characterized by the normality of exocrine pancreas and by organic alterations that cause glycogen depletion from the liver.

Adolescent↗
PubMed2000

[Nuclear medicine for general radiologists: endocrinological examinations].

We reviewed nuclear endocrinological examinations of the thyroid, parathyroid, and adrenal glands that are clinically performed in Japan as well as somatostatin receptor imaging, which is widely used in Europe, the United States, and other countries. 123I thyroid scintigraphy is especially useful in detecting ectopic goiters and differentiating between Basedow's disease and subacute thyroiditis or Plummer's disease, all of which exhibit thyrotoxicosis. 201Tl is useful to detect foci metastasized from well differentiated thyroid cancer and to differentiate malignant from benign tumors. 67Ga-citrate is an agent used for patients suspected of having malignant lymphoma or undifferentiated carcinoma of the thyroid. Radioiodinated MIBG is a specific agent for medullary thyroid carcinoma. 99mTc-MIBI is a good agent for locating hyperfunctioning parathyroid tissues. 131I-adosterol is useful to locate the lesions of primary aldosteronism, Cushing's syndrome, adrenogenital syndrome, and select adenomas among incidental tumors. Radioiodinated MIBG scintigraphy has high diagnostic accuracy in locating pheochromocytomas and neuroblastomas. 111In-labeled octreotide is useful in locating, hormone-producing gastrointestinal and pancreatic tumors including carcinoids, gastrinomas, and insulinomas. Radiolabeled somatostatin receptor analogs are used not only to locate but also to treat malignant somatostatin receptor-positive tumors. We hope that Octreoscan will be available in Japan in the near future.

Endocrine Glands↗
PubMed2000

Correlation between age at neutering and age at onset of hyperadrenocorticism in ferrets.

OBJECTIVE: To determine prevalence of hyperadrenocorticism in ferrets in The Netherlands and evaluate age, sex, and age at neutering in affected ferrets. DESIGN: Prevalence survey and retrospective study. ANIMALS: 50 ferrets with hyperadrenocorticism and 1,267 ferrets without hyperadrenocorticism. PROCEDURE: A questionnaire was sent to 1,400 members of a ferret-owners organization in The Netherlands; 492 (35%) owners returned the questionnaire, providing usable data on 1,274 ferrets. Seven of these ferrets developed hyperadrenocorticism during the survey period; medical records for these ferrets and 43 ferrets with confirmed hyperadrenocorticism were reviewed. Hyperadrenocorticism was confirmed by histologic examination of an excised adrenal gland (92% of ferrets) or clinical improvement after excision. RESULTS: Prevalence of hyperadrenocorticism in the survey population was 0.55%. Sex was not associated with prevalence of disease. Median time interval between neutering and diagnosis of hyperadrenocorticism was 3.5 years. A significant linear correlation between age at neutering and age at time of diagnosis was detected. CONCLUSIONS AND CLINICAL RELEVANCE: Age at neutering may be associated with age at development of hyperadrenocorticism in ferrets.

Adrenocortical Hyperfunction↗
PubMedDate not supplied

Review: recent developments in adrenal surgery.

The improvements of biochemical methods and imaging techniques in the diagnosis of adrenal disorders have changed the surgical management with regard to indication for operation, surgical approach to the adrenals and the extent of resection. This study reviews recent developments in surgical strategy of adrenal disorders based on surgical treatment of 246 patients from 1975 to 1993 at the Medical School of Hannover. Today extraperitoneal incisions are used with increasing frequency in small benign tumours to minimize the surgical trauma. The indication for operation of adrenal incidentalomas should be considered in all patients with hyperfunctional lesions and suspected malignancy. Bilateral total adrenalectomy is attended with the need for life-long adrenocortical supplementation resulting in an impaired quality of life. In this respect MEN 2 patients with bilateral adrenomedullary disease benefit from unilateral or bilateral subtotal resections with preservation of adrenocortical function. In conclusion, adrenal surgery today aims at the reduction of surgical trauma, early diagnosis and treatment of adrenal malignancies, and the preservation of adrenocortical function.

Adrenal Gland Diseases↗
PubMed2000

Cushing's syndrome: historical aspects.

A brief overview of the most important steps leading to our present knowledge of hypercorticism is given. The adrenals were described in 1563 and the pituitary had been known since Antiquity. Until Addison's description of adrenal insufficiency in 1855 virtually nothing was known of their function. Cushing in 1912 described his famous patient with hypercorticism but assumed it to be a polyglandular disorder. For almost 40 years the etiology was disputed, though Bauer early had postulated that hypercorticism ultimately reflected adrenal hyperfunction, either primarily or secondarily. Though Krause, Schloffer, Cushing, Hirsch and others early in the 20th century had introduced pituitary surgery, it was not until 1933 that the first patient with Cushing's disease had neurosurgery performed. This therapy did not gain wide acceptance until Gidot & Thibaut and Hardy pioneered transsphenoidal surgery. Adrenal surgery was for many years the treatment of hypercorticism but prior to the availability of glucocorticosteroids substitution an extremely perilous undertaking.

Adrenal Glands↗