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PubMed1977

Effects of various hormones and adrenalectomy on the levels of amylase in rat pancreas and parotid gland.

Dexamethasone, adrenocorticotropic hormone and thyroxine increased the amylase activities in both the pancreas and the parotid gland of infant rats. After adrenalectomy, the amylase activities of the pancreas and parotid gland were about half the control levels, suggesting that both glucocorticoid and thyroxine are involved in maintaining the amylase activities in these organs.

Adrenalectomy↗
PubMed1983

Influence of adrenalectomy on vitamin B6 status.

Adrenalectomy results in depletion of vitamin B6 stores. This depletion is rapid and significant in liver, as compared to brain. When the adrenalectomized rats are fed with excess vitamin B6 or injected with corticosterone, the normal vitamin levels are maintained. Thus, it is possible that adrenocortical hormones help in the retention of vitamin B6 in the body.

Adrenalectomy↗
PubMed1984

Acute changes in dopamine metabolism in the medio-basal hypothalamus following adrenalectomy.

During the first hour following adrenalectomy the alpha-MPT-induced disappearance of dopamine was increased in the arcuate nucleus compared to that in sham-operated rats. In a number of other brain regions of both adrenalectomized and sham-adrenalectomized rats only stress-induced changes were observed in catecholamine utilization. These data suggest that corticosterone selectively modulates dopamine utilization in the medio-basal hypothalamus.

Adrenalectomy↗
PubMed1981

Effect of adrenalectomy on sound-induced seizure susceptibility and intensity in genetically susceptible rats.

Neither seizures susceptibility nor intensity was altered by sham-operation or by adrenalectomy in adult rats that are genetically susceptible to sound-induced seizures. Thus, sound-induced seizures in genetically susceptible rats are analogous to those in genetically susceptible mice to the extent that removal of the adrenal glands does not alter established seizure characteristics in either species.

Acoustic Stimulation↗
PubMed1980

Adrenalectomy prevents hypoxic lung histamine accumulation.

The lung histamine concentration of rats exposed to chronic hypobaric hypoxia was higher than in normoxic sea-level control rats. This hypoxia-induced lung histamine increase was absent in adrenalectomized chronically hypoxic rats. Adrenalectomy, per se, did not influence lung histamine content. The results suggest that the lung histamine content of chronically hypoxic rats is under hormonal control. This control mechanism is not evident under normoxic conditions.

Adrenal Glands↗
PubMed1978

Sodium excretion after bilateral adrenalectomy in rats with experimental cirrhosis.

Bilateral adrenalectomy (ADX) or a sham procedure was performed in cirrhotic and control rats. After ADX, controls increased their sodium excretion with respect to the basal values but cirrhotics did not. When sodium-loaded, the ADX cirrhotic rats retained a significant amount of the load. These data do not support a primary role of aldosterone in the impaired sodium handling by cirrhotic rats.

Adrenalectomy↗
PubMed1991

Effects of hypophysectomy and adrenalectomy on naloxone-induced analgesia.

Experiment 1 demonstrated that pairings of the opiate antagonist, naloxone, with a heated floor came to induce analgesia, as indexed by the latencies with which rats licked their paws. This analgesia appears to be neurally mediated because it is unaffected by either hypophysectomy (experiment 2) or adrenalectomy (experiment 3). However, there was evidence for a pituitary involvement, as its removal potentiated the analgesic effect accruing from naloxone-stressor pairings.

Adrenalectomy↗
PubMed1994

Time course of the effects of adrenalectomy and corticosterone replacement on 5-HT1A receptors and 5-HT uptake sites in the hippocampus and dorsal raphe nucleus of the rat brain: an autoradiographic analysis.

Previous studies have shown that adrenalectomy (ADX) increases the binding of 3H-DPAT to 5-HT1A receptors in the hippocampus (HIP) and this effect is partially overcome by corticosterone (CORT) replacement. The present study investigated the time course of the effects of ADX with or without CORT replacement on serotonin (5-HT) pre- and postsynaptic systems in the HIP and dorsal raphe nucleus (DR) by quantitative autoradiography. In the HIP, ADX for 7, 10 or 14 days caused a significant increase in 3H-DPAT binding in the CA1 region (pyramidal layer), CA2,3 region (molecular and pyramidal layers) and in the dentate gyrus (molecular and granular layers) which returned to control levels when measurements were made 35 days post-ADX. A decrease in 3H-DPAT binding was observed 14 days after ADX in the DR but not in the median raphe nucleus (MR). Although replacement with CORT did not lead to a reversal in 3H-DPAT binding early time points, binding was restored to control levels 7-28 days after CORT replacement in all regions of the HIP. In the DR, CORT did not cause a reversal in 3H-DPAT binding at any of the time points examined. In contrast to the effects seen on the 5-HT1A receptor subtype, no significant change was noted on the binding of 3H-CN-IMI to uptake sites for 5-HT in the HIP or DR after ADX or CORT replacement. The results of this study indicate that long-term alterations in the HPA axis lead to changes in the 5-HT1A receptor system that are both region-specific and time-dependent.

8-Hydroxy-2-(di-n-propylamino)tetralin↗
PubMed1996

Effect of adrenalectomy on the initiation and expression of cocaine-induced sensitization.

The role of corticosterone in the initiation and expression phases of sensitization to cocaine was examined. To determine the effect of corticosterone on the initiation of sensitization, male Sprague-Dawley rats were given a sham adrenalectomy (ADX), or ADX surgery. Approximately 1 week later, rats were given a cocaine (15 mg/kg, i.p.) injection on day 1. On days 2-6, rats were given cocaine (30 mg/kg, i.p.), and the next day, a cocaine challenge (15 mg/kg) was administered (= early withdrawal). Four days later, 50% of the ADX rats were given corticosterone pellets and corticosterone in the evening drinking water to mimic the circadian variation in corticosterone levels. After 1 week, rats were given a final saline challenge followed by a cocaine challenge (15 mg/kg) the next day (= late withdrawal). Locomotor activity was monitored after cocaine treatment on day 1 and after challenge at early and late withdrawal. Sham controls demonstrated a sensitized locomotor response to the cocaine challenge at early withdrawal, with a slight increase in this behavioral sensitization at the late withdrawal time. In contrast, sensitization was not observed in ADX rats after early withdrawal from cocaine, but this attenuation was not permanent, since ADX animals demonstrated control levels of sensitization by the late withdrawal time 12 days later. Animals given corticosterone replacement 1 week prior to the late cocaine challenge also demonstrated a sensitized response similar to control levels. The effect of corticosterone on the expression of sensitization was examined by administering daily cocaine as before followed by surgery a few days later. The treatment groups were sham, ADX and ADX+corticosterone replacement as described. Fourteen days later, a saline injection was given followed by a cocaine challenge the next day. Behavioral sensitization to a cocaine challenge was found in all three treatment groups. These data suggest that adrenal hormones are necessary during the initiation phase of sensitization when observed after early withdrawal (1 day), but not when sensitization is examined at a later withdrawal time (12 days). In addition, corticosterone levels do not significantly affect the expression phase of behavioral sensitization to cocaine.

Adrenalectomy↗
PubMed1988

Effects of adrenalectomy and of adrenal hormones on the tissue distribution of 14 elements in the rat.

The effects of adrenalectomy (ADY) and of replacement therapy using a mineralocorticoid, deoxycorticosterone (DOC) and a glucocorticoid, dexamethasone (DEX) on the tissue distribution of elements in the rat, were studied under semichronic conditions. The elements Na, K, Ca, Mg, Fe, S, P, Rb, Sr, Mn, Cu, and Zn were determined in whole blood, plasma, brain, liver, kidney, heart, skeletal muscle, spleen, thymus, and bone. Additionally, Mo was determined in kidney and liver and Ba in bone. ADY modified concentrations of all elements tested. Small changes were observed for K, Mg, Ca, S, and P, whereas much larger changes were noted for Na, Rb, and Sr. Cu, Zn, and Fe were mainly modified in liver and kidney, organs involved in storage and/or elimination. The consequences of ADY were corrected fairly well by DEX for Mg, Mn, Ca, Cu, and Mo; by DOC for Na and K, and by the two corticoids for Zn, Fe, Sr, and Rb. This study revealed that corticoids, mainly glucocorticoids, play an important role in the plasma and tissue balance of elements. It is suggested that these results may have a pathological and clinical significance.

Adrenal Cortex Hormones↗
PubMed1988

Distribution of 14 elements in various rat tissues following hypophysectomy, thyroparathyroidectomy, adrenalectomy, and castration.

The tissue distribution of 14 elements was simultaneously determined in rats 28 d after hypophysectomy (HPY), thyroparathyroidectomy (TPTY), adrenalectomy (ADY), and castration (CTN). The elements Na, K, Ca, Mg, Fe, S, P, Rb, Sr, Mn, Cu, and Zn were investigated in whole blood, plasma, brain, liver, kidney, heart, skeletal muscle, and bone. Additionally Mo was determined in kidney and liver. The following results were obtained: 1) With regard to hormone deficiency: HPY induced the most noticeable variations on all the elements tested owing probably to the direct and indirect effects of adenohypophyseal hormones. ADY led to the expected modification of Na and K but also to a Sr accumulation and a Rb depletion. TPTY induced a sharp decrease in plasma and tissues Ca, an increase in plasma P, but did not disturb the two elements in bone. An increase of Rb in many tissues and of Fe in heart, kidney, and liver were also observed. CTN had little consequences except in bone whose Cu and Fe contents were increased; 2) With regard to element variations: K, Mg, and S underwent little change. Discriminations were revealed between elements such as K and Rb, Ca and Sr, Ca and Mg, and Cu and Zn. The changes of Rb and Sr were consistent with regulatory mechanisms. The accumulation of Fe and Cu in tissues such as liver after HPY, TPTY, and ADY, suggest that the hormonal deficiencies could worsen the hemochromatosis and Wilson's disease; 3) With regard to plasma and tissues: No correlation appeared in element levels between plasma and other tissues. Brain was the least affected and liver, kidney and bone the most.

Adrenalectomy↗
PubMed1990

The anticoordinate changes of pancreatic lipase and colipase activity to amylase activity induced by adrenalectomy in normal and diabetic rats.

The effect of adrenalectomy (Adx) on pancreatic lipase and colipase activities in normal, streptozotocin-induced diabetic, and obese Zucker rats was studied. It was found that Adx induced a rapid decrease in amylase activity, a rapid increase in lipase activity, and a slow increase in colipase activity in normal rats. Twenty days after Adx, the levels of amylase activity were 70% lower than control, whereas the activities of lipase and colipase were 55 and 25% higher than control, respectively. The replacement of hydrocortisone normalized the changes in the three enzyme activities. Injection of insulin partially corrected the amylase activity, but had no significant effect on the activities of lipase and colipase. In streptozotocin-induced diabetic rats and obese Zucker rats, amylase activity was decreased, and lipase and colipase activities increased, compared to normal rats. These changes of enzyme activity were further enhanced by Adx. It is concluded that Adx results in an anticoordinate change in pancreatic lipase, colipase, and amylase activities, suggesting that glucocorticoid also influences the synthesis of the pancreatic lipolytic enzymes.

Adrenal Glands↗
PubMed2000

Anesthesia for laparoscopic adrenalectomy (pheochromocytoma) in an anemic adult Jehovah's Witness.

PURPOSE: To report the anesthetic management of an anemic Jehovah's Witness patient presenting for laparoscopic adrenalectomy for pheochromocytoma. CLINICAL FEATURES: A 49-yr-old woman presented with hemodynamic instability progressing to cardiogenic shock and subsequent acute renal failure. Her course was complicated by anemia. An adrenal pheochromocytoma was diagnosed. Preoperatively, alpha- and beta-adrenergic blockade was instituted with phenoxybenzamine and metoprolol therapy and her anemia was treated with erythropoietin. She underwent laparoscopic resection of the adrenal tumour. A cell saver device was employed and attached to the laparoscopic suction-irrigation apparatus to provide salvage capability in the event of a major hemorrhage. The surgical intervention was uneventful and well tolerated. The patient was discharged home and well on follow-up. CONCLUSIONS: Cell salvage is the only mechanism currently acceptable to Jehovah's Witnesses which will allow for perioperative salvage and replacement of blood loss. Its use is encouraged in all situations in which surgical hemorrhage is anticipated.

Adrenal Gland Neoplasms↗
PubMedDate not supplied

Pheochromocytoma and sub-clinical Cushing's syndrome during pregnancy: diagnosis, medical pre-treatment and cure by laparoscopic unilateral adrenalectomy.

The coexistence of pheochromocytoma and primary adrenal Cushing's syndrome of the same adrenal gland has rarely been reported. We describe here the case of a female patient presenting with mild Cushing's stigmata, hypertension and diabetes mellitus in whom we diagnosed a pheochromocytoma of the left adrenal gland with coexisting non-ACTH-dependent cortisol hypersecretion. While hormonal work-up was still in progress, the patient became pregnant and wanted to carry her pregnancy to full-term. A laparoscopic adrenalectomy in the 17th week of gestation was decided upon and the patient accordingly prepared for surgery by pre-treatment with phenoxybenzamine. Successful surgery--the first ever reported laparoscopic resection of a pheochromocytoma in pregnancy--without perioperative complications was performed under general anesthesia, with the patient receiving peri- and post-operative hydrocortisone substitution. Pathohistological examination revealed a pheochromocytoma with positive immunostaining for interleukin-6 (IL-6) and negative immunostaining for ACTH, vasoactive intestinal polypeptide (VIP) and cytochrome P450, and with no signs of malignancy. A paracrine stimulation of the ipsilateral adrenal cortex by IL-6 produced by the pheochromocytoma, leading to cortical hyperplasia and subclinical Cushing's syndrome, is suggested by the positive immunostaining for IL-6 and the MRI findings. Post-operatively, secondary adrenal insufficiency ensued, necessitating continuing hydrocortisone replacement over 12 months. Hypertension resolved after surgery, and diabetes after the uncomplicated vaginal delivery at term.

Adrenal Gland Neoplasms↗
PubMed2000

Comparative analysis of plasma 17-hydroxyprogesterone and cortisol responses to ACTH in patients with various adrenal tumors before and after unilateral adrenalectomy.

Patients with non-hyperfunctioning adrenal adenomas often have an increased plasma 17-hydroxyprogesterone response to ACTH stimulation. The effects of adrenal surgery on this abnormality have rarely been investigated. One hundred and sixty-one patients with unilateral adrenal tumors (non-hyperfunctioning adenomas, 78; cortisol-producing adenomas, 8; aldosterone-producing adenomas, 37; adrenal cysts, 12; pheochromocytomas, 26) were studied. Patients before and after adrenal surgery as well as 60 healthy subjects underwent an ACTH stimulation test using 2 mg synthetic ACTH(1-24) (Cortrosyn Depot, Organon). Basal and ACTH-stimulated plasma 17-hydroxyprogesterone and cortisol concentrations are reported. Before adrenal surgery, the basal plasma 17-hydroxyprogesterone concentrations were normal in patients with all types of tumors. However, the ACTH-stimulated plasma 17-hydroxyprogesterone levels were abnormally increased in 53% and 31% of patients with non-hyperfunctioning adenomas and aldosterone-producing adenomas, respectively. In addition, a few patients with adrenal cysts and pheochromocytomas also showed an increased ACTH-stimulated 17-hydroxyprogesterone response. After unilateral adrenalectomy, this hormonal abnormality disappeared in most, although not all patients with adrenal tumors. In patients with non-hyperfunctioning adrenal tumors, ACTH-stimulated plasma 17-hydroxyprogesterone and cortisol concentrations significantly correlated with the size of the tumors. These results firmly indicate that the tumoral mass itself may be responsible for the increased plasma 17-hydroxyprogesterone and cortisol responses after ACTH stimulation in patients with non-hyperfunctioning and hyperfunctioning adrenal adenomas.

17-alpha-Hydroxyprogesterone↗
PubMed2006

Cushing's syndrome during pregnancy secondary to adrenal adenoma: metyrapone treatment and laparoscopic adrenalectomy.

Cushing's syndrome during pregnancy is a rare and difficult to diagnose disorder. We describe the case of a 30-yr-old woman presenting with symptoms and signs of mild hypercortisolism, in which ACTH-independent Cushing's syndrome was diagnosed. Urinary cortisol excretion was elevated and circadian rhythm of cortisol was absent. ACTH levels were low. In addition, plasma cortisol failed to suppress after a high dexamethasone dose. An abdominal computed tomography scan confirmed a left adrenal mass. While diagnosis work-up was still in progress, the patient became pregnant and wanted to carry her pregnancy to full-term. Hypercortisolism was successfully controlled with metyrapone, which was started at 8 weeks of gestation. At 16 weeks of gestation, a laparoscopic left adrenalectomy was performed. Pathologic examination of the gland showed a benign adrenocortical adenoma. The patient developed secondary adrenal insufficiency and was discharged on 20 mg hydrocortisone daily dose. At 30 weeks of gestation, the patient had a pre-term rupture of membranes and underwent spontaneous vaginal delivery. The newborn was a normal virilized male who weighed 1280 g. No apparent metyrapone-induced teratogenic effects were observed and there was no clinical or biochemical suppression of adrenocortical function. In conclusion, in adrenal Cushing's syndrome during pregnancy, medical treatment with metyrapone as soon as the diagnosis is made, in combination with laparoscopic surgery during the second trimester, are useful in preventing complications secondary to hypercortisolism and safe both for the mother and infant.

Adenoma↗
PubMed1987

Diagnosis of lung carcinoid with cutaneous hyperpigmentation eight years after bilateral adrenalectomy.

A 26-yr-old male was submitted to bilateral adrenalectomy in 1977 for Cushing's syndrome. Some months later he developed intense skin hyperpigmentation together with increased ACTH levels (149 to 4000 ng/l). The sellar region was always normal in X-ray studies. In April 1985, when the patient complained of chest pain, a chest x-ray showed a polycyclic mass in the upper left lobe of the lung. ACTH ranged from 20,000 to 100,000 ng/l, with no response to CRF or cyproheptadine administration. Urinary 5-OH-indolacetic acid was negative. Thoracotomy was performed in July 1985 with resection of two intrapulmonary masses. Histologic study demonstrated a carcinoid tumor, with positive neuron-specific enolase and ACTH immunochemical stain. ACTH concentration in tumoral tissue was 91 pg/g tissue. After surgery ACTH fell dramatically to 37 ng/l, and has remained at this level since then, associated with resolution of the skin hyperpigmentation.

Adrenalectomy↗
PubMed2004

Exacerbations of Graves' disease after unilateral adrenalectomy for Cushing's syndrome.

Cushing's syndrome is characterized by endogenously increased production of glucocorticoids. The activity of immune system is regulated mainly by two systems in the body. Glucocorticoids and NF-kappaB counteract the effects of each other on the immune system. It has been reported that immune response is exaggerated after the amelioration of Cushing's syndrome. We report a rare case of exacerbation of Graves' disease after unilateral adrenalectomy for Cusing's syndrome. A 50-yr-obese woman with hypertension, dyslipidemia, impaired glucose tolerance and insulin resistance wasadmitted to outpatients clinic of endocrinology. The results of evaluation of glucocorticoids metabolism and adrenal magnetic resonance imaging revealed the Cusing's syndrome. We also assessed thyroid function tests because of the diagnosis of goiter and thyroid hormone replacement in her medical history, and the presence of exophthalmia and tachycardia in examination. Althoug TSH level was detected at the lower border of normal range, free T4 and free T3 were in normal range and autoantibody of thyroidal peroxidase and thyroglobulin was higer than normal reference range. An operation was performed and a mass was removed from her left adrenal gland. The pathologic examination confirmed adrenal adenoma. She was re-admitted to the outpatient clinic 9 months after with complaints of palpitation, malaise and weight loss. Tests carried out to determine the thyroid function revealed Graves' disease. We prescribed propylthiouracil and beta-blocker treatment.

Adrenalectomy↗