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Results for “Adrenocortical Hyperfunction”

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At least 1,099 records · Page 61Linked to original sources
PubMed1999

From open to laparoscopic adrenalectomy: a review of 16-year experience.

OBJECTIVE: To review the experience with adrenal surgery which was associated with significant morbidity and notable mortality in the past, although laparoscopic approach is beginning to be accepted as the procedure of choice. METHODS: The indications and results of adrenalectomy in 104 patients (36 men, 68 women) over the past 16 years were reviewed. Any potential improvement of surgical results over time was analyzed. RESULTS: Ninety-three patients (89%) had functional problems while malignancy was present in 11 patients (11%). Anterior approach was employed in 27 patients, posterior in 56, lateral in 10, and laparoscopic in 11. One patient required conversion from laparoscopic to anterior approach. No operative mortality was seen, but the morbidity occurred in 16.7%. Complication rate decreased significantly in this study period (1981-1990 versus 1991-1996, 22% versus 5%; P = 0.02). Laparoscopic adrenalectomy was successfully performed for 59% of the patients requiring adrenalectomy recently, compared to 68% of posterior adrenalectomy in the past. CONCLUSIONS: Adrenal surgery is a safe procedure, associated with acceptable morbidity, which has decreased over time. Laparoscopic adrenalectomy is becoming the preferred approach for the majority of patients requiring adrenalectomy.

Adolescent↗
PubMed2000

[Hyperplasia of chromaffin cells in adrenocortical hyperplasia and adenoma].

OBJECTIVE: To study whether there is chromaffin cells hyperplasia in adrenocortical hyperplasia and adenoma. METHODS: Chromaffin cells with chromogranin A were marked by immunohistochemistry method. RESULTS: In 52 cases of adrenocortical hyperplasia and adenoma 3 were associated with eochromocyte hyperplasia and 5 with micro-pheochromocytoma. Six of the 8 cases were characterized by hypercortiso (or aldostero)-hypercatecholamine clinically. CONCLUSIONS: Few cases of adrenocortical hyperplasia and adenoma may be associated with pheochromocytic hyperplasia and micro-pheochromocytoma, and may be characterized by symptoms of hypercortiso (or aldostero)-hypercatecholamine.

Adrenal Cortex↗
PubMed1975

[Clinical contribution to the surgery of adrenal glands].

The anatomopathological and clinical features of 131 cases subjected to adrenalectomy for metastasis of breast cancer, hypercortico-adrenalism and pheochromocytoma are described. The results of surgical management are analysed.

Adrenal Gland Diseases↗
PubMed1975

Hypercortisolism in childhood: shortcomings of conventional diagnostic criteria.

Two patients are described in whom hypercortisolism occurred prepubertally as a consequence of bilateral adrenocortical hyperplasia. In contrast with the manifestations of Cushing's syndrome in adults, these children presented with obesity and reduced stature and no other symptoms. Both patients excreted amounts of urinary 17-OHCS before and during a conventional suppression test with dexamethasone (0.5 mg every six hours) which were within the usual normal range. However, when urinary 17-OHCS excretion was expressed per gram of urinary creatinine or per square meter of surface area, and when the dose of dexamethasone was tailored to body mass (20mug/kg/day) the results were clearly abnormal, as were plasma corticoids and (in one patient) cortisol secretion rate. Resumption of linear growth occurred after bilateral adrenalectomy in both patients and was associated, in the one patient so studied, by a return of hypoglycemia-stimulated increases in plasma growth hormone levels from previously suppressed values to the normal range, and by a slight increase in the fasting plasma somatomedin concentration. The observations suggest that pediatric patients with hypercortisolism are likely to be overlooked when conventional criteria for laboratory diagnosis are used, but can be recognized by the simple diagnostic modifications used in these studies.

17-Hydroxycorticosteroids↗
PubMed1975

[Differential diagnosis of essential adiposity and Cushings syndrome].

On account of the increasing number of patients with essential obesity the delimitation of the Cushing-syndrome is of actual importance. Two observations of hypercortisolism in hyperplasia of the adrenal glands are reported on and the differential-diagnostically important parameters are demonstrated. According to our opinion anamnesis and clinical findings give the possibility of making a diagnosis already on a large scale. Analyses of the hormones and special X-ray examinations only serve for the preoperative ascertainment and localisation of the endocrine defective function. With the help of literary data causes and possibilities of treatment of Cushing's syndrome are entered.

17-Ketosteroids↗
PubMed2002

[Differential diagnosis and medical treatment in Cushing's disease].

Cushing's disease remains a difficult diagnosis in spite of new technical procedures such as pituitary MRI, selective bilateral petrosal or cavernous sampling, (111)In pentreotide scan and 18 Flurodeoxyglucose pituitary PET scan. In this article, we review biological diagnostic procedures of Cushing's disease and corticotroph adenomas. According to our experience and the literature, we summarize the approach in medical treatment of Cushing's disease.

ACTH Syndrome, Ectopic↗
PubMed1975

Effect of combination of stresses on myocardial metabolism.

The effect of hypoxia, exercise, and thermal stress on myocardial metabolism have been widely investigated, but little attention has been paid to studying the effects of a combination of these stress. The influence of hypoxia as modified by physical exertion (swimming) and cold stress was therefore studied. The parameters investigated included myocardial glycogen and noradrenaline, serum free fatty acid, adrenal ascorbic acid, and adrenal weight. It was observed that maximal stress was produced when hypoxia was combined with physical exertion. No suppression of cold-induced lipolysis by hypoxia was observed, in contrast to previously reported observations. Maximal depletion of cardiac blycogen and cardiac noradrenaline was noted in hypoxic exercise. Adrenal overactivity was not found to be related to any particular stress but was seen to be proportional to the severity of the stress applied.

Adrenal Glands↗
PubMed2001

[Open versus video-endoscopic approach in the treatment of hypercortisolism by bilateral adrenalectomy].

Progress in the technique of the hypophysectomy and in the imaging procedures reduced drastically the indications of bilateral adrenalectomy (BA) in the treatment of hypercortisolism (HC). Indeed BA is indicated in 10 to 30% after failure of pituitary surgery, when HC is related to ACTH ectopic secretion, and in HC related to autonomous adrenal secretion. The purpose of this work is to demonstrate the validity of the bilateral video endoscopic adrenalectomy (BVA) in regard to open surgery. During the last 20 years, 88 patients were operated on by open adrenalectomy (Group 1), either by transperitoneal approach, or bilateral posterior lombetomy. From 1994, 62 patients (Group 2), were operated by video endoscopy. Two death occurred in group 1. The frequency of the preoperative complications were identical in each group, but postoperative morbidity were lower in the group 2. The fall in the postoperative pain, the simplicity of the follow up, the rapid hospital discharge, the low rate of parietal complications were observed in BVA. We conclude that the postoperative follow up is better after BVA a specialized training and time of adaptation are imposed to the surgeon.

Adrenalectomy↗
PubMed2002

Cyproterone acetate-ethinyl estradiol treatment alters urinary 6-sulfatoxymelatonin excretion in hyperandrogenic women.

OBJECTIVES: To investigate melatonin production in hyperandrogenic women before and during treatment with cyproterone acetate and ethinyl estradiol (Diane 35). MATERIAL AND METHODS: We studied 10 women with late onset adrenal hyperplasia due to 21-hydroxylase deficiency (LOCAH) and 10 women with idiopathic hirsutism (IH). Patients were treated with Diane 35 for four months. Fasting blood samples for the determination of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone and dihydroepiandrosterone sulfate (DHEAS) and 24-hour urine collections for the determination of 6-sulfatoxymelatonin (aMT6s) excretion were obtained from all patients at baseline and after 4 months of treatment. Results were compared with those obtained in 15 control women. RESULTS: At baseline, women with LOCAH had significantly higher serum testosterone, 17-hydroxyprogesterone (17OHP) and ACTH stimulated 17OHP values than IH and control women. Their aMT6s values (51.0+/-20.5 mg/24h) were significantly higher than the values in IH (34.3+/-7.1) and control women (30.5+/-6.5) (p< 0.001). Diane 35 treatment significantly decreased serum LH, FSH and testosterone levels and aMT6s values in LOCAH patients (29.8+/-16.6 mg/24h) (p<0.0001) in LOCAH patients. CONCLUSIONS: These results indicate that hyperandrogenic women with LOCAH have increased melatonin production. The normalization of aMT6s and testosterone values during cyproterone acetate-ethinyl estradiol treatment, suggest that sex steroids either directly or through the suppression of gonadotropin, modulate melatonin secretion in these patients.

Adolescent↗