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Journal of Ayub Medical College,... 2021The adrenal gland is one of the major endocrine glands involved not only in different physiological functions, but also in response to stress This study was done to...
BACKGROUND
The adrenal gland is one of the major endocrine glands involved not only in different physiological functions, but also in response to stress This study was done to asses the effects of L-arginine and insulin on streptozotocin (STZ) induced adrenal gland damage in albino rats.
METHODS
This laboratory based experimental study on animals was undertaken in the Anatomy department of Basic Medical Sciences Institute (BMSI), Jinnah postgraduate Medical Center (JPMC), Karachi, from February to March 2018. Forty adult, healthy male albino rats were placed into 4 groups (10 each). Group A was taken as control. Group B was given STZ. Group C and D were given STZ as in group B with insulin and L-arginine respectively. Absolute and relative weight of adrenal glands was measured at the end of the study. Tissues from adrenal glands were processed and stained with Haematoxylin and Eosin for the morphometric study.
RESULTS
The absolute as well as relative adrenal weight of animals was significantly raised in group B in comparison to control, although showed a significant recovery in group C and D animals when insulin and L-arginine were added to STZ. Haematoxylin and Eosin (H&E) stained sections of adrenal cortex of STZ treated Group B showed reduced width of zona glomerulosa, with increased width of zona fasciculata and zona reticularis when compared to control. The width of these zones of adrenal cortex recovered to a significant extent when group C and D tissue sections were compared with STZ- treated group B tissue sections.
CONCLUSIONS
This study highlighted the protective effect of L-arginine on adrenal gland weight and histology in streptozotocin induced adrenal gland damage, which was comparable to insulin.
Topics: Adrenal Glands; Animals; Arginine; Insulin; Male; Protective Agents; Rats; Streptozocin
PubMed: 33774970
DOI: No ID Found -
Endocrinologia, Diabetes Y Nutricion Apr 2023Primary bilateral macronodular adrenal hyperplasia (PBMAH) accounts for <2% of cases of Cushing's syndrome. The majority of patients present with no obvious steroid... (Review)
Review
Primary bilateral macronodular adrenal hyperplasia (PBMAH) accounts for <2% of cases of Cushing's syndrome. The majority of patients present with no obvious steroid excess it means with autonomous cortisol secretion (ACS). The classic treatment for patients with overt Cushing's syndrome is bilateral adrenalectomy, but unilateral resection of the larger adrenal gland can result in clinical and/or biochemical remission in >90% of cases, especially in cases of ACS. In this article, a series of 32 cases with PBMAH is described. Most of the cases of PBMAH had ACS, except for one case with overt Cushing's syndrome. A study of aberrant receptors was performed in six patients, being negative in three cases, positive in the metoclopramide test in two cases and positive in the metoclopramide test and in the mixed meal test in another patient. The patient with overt Cushing's syndrome was treated with adrenostatic therapy achieving biochemical control, while two patients with ACS underwent unilateral adrenalectomy with resection of the largest adrenal gland, demonstrating hypercortisolism remission and improvement of cardiovascular risk factors after surgery. This article describes a series of 32 cases of PBMAH and offers a comprehensive review of PBMAH.
Topics: Humans; Cushing Syndrome; Hyperplasia; Metoclopramide; Hydrocortisone; Adrenal Glands
PubMed: 37116968
DOI: 10.1016/j.endien.2023.04.005 -
Anatomia, Histologia, Embryologia Nov 2022The canine adrenal glands receive blood from the celiac artery, cranial mesenteric artery, caudal phrenic artery, cranial abdominal artery, phrenicoabdominal trunk,...
The canine adrenal glands receive blood from the celiac artery, cranial mesenteric artery, caudal phrenic artery, cranial abdominal artery, phrenicoabdominal trunk, abdominal aorta, renal artery and lumbar artery. These are classified into three types: cranial, middle and caudal adrenal branches. It is also known that the adrenal vein flows into the phrenicoabdominal vein. However, individual differences in the branching pattern of adrenal vessels have not been systematically analysed. We evaluated adrenal vessels in dogs that underwent contrast-enhanced abdominal computed tomography (CT). There were 255 arteries travelling to the adrenal glands in 47 cases, with 1-6 arteries travelling per adrenal gland. The arteries included 67 caudal phrenic arteries, 62 aortic arteries, 60 cranial abdominal arteries, 39 renal arteries, 12 phrenicoabdominal trunks, 8 cranial mesenteric arteries, 6 celiac arteries and 1 lumbar artery. Most of the branches were from the aorta and caudal phrenic artery on the left side, and the cranial abdominal and caudal phrenic artery on the right side. A total of 110 adrenal veins were identified. Inflow into the phrenicoabdominal vein and into the right and left renal veins was observed, and we identified no inflow into other veins. This study demonstrated two points: laterality and individual differences in adrenal blood vessels. When evaluating adrenal blood vessels with abdominal contrast-enhanced CT, it is recommended to take images under general anaesthesia with breath-holding and observe them using multiplanar reconstruction.
Topics: Dogs; Animals; Renal Artery; Abdomen; Aorta, Abdominal; Renal Veins; Adrenal Glands
PubMed: 36047693
DOI: 10.1111/ahe.12858 -
Nature Aging Jul 2023
Topics: Female; Humans; Male; Adrenal Gland Neoplasms; Adrenal Glands; Aging; Sex Factors
PubMed: 37291221
DOI: 10.1038/s43587-023-00440-y -
The British Journal of Radiology Nov 2021Adrenal hemorrhage (AH) is a rare condition. It can be traumatic or non-traumatic. Most common causes are septicemia, coagulopathy or bleeding diathesis, and underlying... (Review)
Review
Adrenal hemorrhage (AH) is a rare condition. It can be traumatic or non-traumatic. Most common causes are septicemia, coagulopathy or bleeding diathesis, and underlying neoplasms. Other reported less common causes of AH are COVID-19 and neonatal stress. Clinical diagnosis of AH is challenging due to its non-specific presentation and occurrence in the setting of acute medical illness. Therefore, most cases are diagnosed incidentally on imaging. Having high clinical suspicion in the proper clinical setting for AH is crucial to avoid life-threatening adrenal insufficiency that occurs in 16-50% of patients with bilateral AH. We discuss the clinical situations that predispose to AH, review the imaging features on different imaging modalities, highlight a variety of clinical cases, imaging features that should be concerning for an underlying neoplasm, and outline the potential role of interventional radiology in management of AH.
Topics: Adrenal Gland Diseases; Adrenal Glands; Diagnostic Imaging; Hemorrhage; Humans
PubMed: 34464549
DOI: 10.1259/bjr.20210753 -
Journal of Feline Medicine and Surgery Apr 2020The objectives of this study were to describe the CT characteristics of the adrenal glands in healthy cats, to provide normal reference biometry for adrenal gland size...
OBJECTIVES
The objectives of this study were to describe the CT characteristics of the adrenal glands in healthy cats, to provide normal reference biometry for adrenal gland size and attenuation values, and to investigate the association with age, sex, laterality and body weight.
METHODS
Retrospective evaluation of 30 CT studies of healthy adult cats recruited from September 2013 to July 2015 was performed. Healthy cats >1 year of age were included based on the absence of clinical signs, unremarkable physical examination, normal results of the complete blood count, biochemical profile, feline immunodeficiency virus, feline leukaemia virus and species infection tests. The relationship between gland biometry (size and attenuation values) and the age, sex, laterality and body weight of cats were tested by two-way ANOVA. The intraclass correlation coefficient was assessed and mean, SD, range provided.
RESULTS
Twenty-seven cats were included. Bilobed, arrowhead and oval adrenal gland shape patterns were recognised, the first being most common. No statistically significant differences were observed between the biometric parameters (length, height and attenuation values) and age, sex, Regarding the width of the adrenal glands, there was a statistically significant effect of sex and laterality. he length (11.6 ± 2.1 mm) and height (6.1 ± 1.3 mm) were the most consistent biometrical parameters to describe adrenal glands.
CONCLUSIONS AND RELEVANCE
Adrenal gland shape, size and attenuation CT data of healthy feline patients are provided in this study, as well as normal reference intervals for morphometric characterisation based on adrenal length and height.
Topics: Adrenal Glands; Animals; Body Weight; Cats; Female; Male; Reference Values; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 30942657
DOI: 10.1177/1098612X19840090 -
The Journal of Surgical Research Sep 2022While adrenal venous sampling (AVS) differentiates between the unilateral and bilateral disease in patients with primary aldosteronism (PA), it is unknown if AVS can... (Review)
Review
INTRODUCTION
While adrenal venous sampling (AVS) differentiates between the unilateral and bilateral disease in patients with primary aldosteronism (PA), it is unknown if AVS can determine laterality of pheochromocytoma in patients with bilateral adrenal masses. This study analyzes adrenal vein (AV) epinephrine and norepinephrine levels in nonpheochromocytoma patients to determine the "normal" range.
MATERIALS AND METHODS
We reviewed patients who underwent AVS for PA between 2009 and 2019 at a single institution; pheochromocytoma was excluded. Aldosterone, cortisol, epinephrine, and norepinephrine levels were obtained from the inferior vena cava (IVC), left adrenal vein (LAV), and right adrenal vein (RAV). Successful AV cannulation was defined by an AV/IVC cortisol ratio of ≥3:1 or an AV epinephrine level ≥364 pg/mL. Plasma measurements (pg/mL) are median values with interquartile ranges; normal ranges for epinephrine and norepinephrine are 10-200 pg/mL and 80-520 pg/mL, respectively.
RESULTS
AVS was performed in 172 patients in 405 AVs (173 LAV and 232 RAV). Median epinephrine levels were IVC = 19 (14 and 34), LAV = 3811 (1870 and 6915), and RAV = 2897 (1500 and 5288). Median norepinephrine levels were IVC = 325 (186 and 479), LAV = 1450 (896 and 2050), and RAV = 786 (436 and 1582). There was a difference between LAV and RAV epinephrine levels (P = 0.024) and between LAV and RAV norepinephrine (P = 0.002) levels.
CONCLUSIONS
This extensive experience with AVS demonstrated a wide range of "normal" AV catecholamine levels in patients without pheochromocytoma, which suggests that the utility of AVS to determine disease laterality in patients with pheochromocytoma and bilateral adrenal nodules is likely to be limited.
Topics: Adrenal Gland Neoplasms; Adrenal Glands; Epinephrine; Humans; Hydrocortisone; Hyperaldosteronism; Norepinephrine; Pheochromocytoma; Retrospective Studies
PubMed: 35453052
DOI: 10.1016/j.jss.2022.03.016 -
European Journal of Obstetrics,... Sep 2019The objective of this study was to evaluate whether ultrasound measured fetal adrenal gland size can be a predictor of spontaneous term labor.
OBJECTIVE
The objective of this study was to evaluate whether ultrasound measured fetal adrenal gland size can be a predictor of spontaneous term labor.
STUDY DESIGN
This study was a diagnostic test accuracy study using a prospective cohort design evaluating the ability of 2-dimensional ultrasound measurement of fetal adrenal gland total length, total width, fetal zone length and fetal zone width in women in the third trimester to predict the primary outcome of spontaneous term labor. Secondary outcomes were vaginal delivery, length of labor, and maternal and neonatal morbidities.
RESULTS
Of 43 patients recruited, 3 were excluded. 11 (25.6%) presented in spontaneous labor and 29 (67.4%) underwent induction of labor. Patient demographics were similar for all included except for admission cervical exam and oxytocin use. A receiver operative curve was created to assess test predictability. Weighted width of fetal adrenal gland was the best predictor of spontaneous labor amongst variables measured with an area under the curve of 0.674, p = 0.93. w/W ≥ 0.41 had a sensitivity of 91.0%, specificity of 44.8%, positive predictive value of 38.5% and a negative predictive value of 92.3%. Maternal and neonatal morbidities were not different between the spontaneous labor group and the induction of labor group.
CONCLUSION
Ultrasound measured fetal w/W was moderately predictive of spontaneous labor.
Topics: Adrenal Glands; Adult; Female; Humans; Labor, Obstetric; Organ Size; Pregnancy; Pregnancy Trimester, Third; Prospective Studies; Term Birth; Ultrasonography, Prenatal
PubMed: 31377462
DOI: 10.1016/j.ejogrb.2019.07.031 -
Nature Aging Mar 2024Adrenal glands, vital for steroid secretion and the regulation of metabolism, stress responses and immune activation, experience age-related decline, impacting systemic...
Adrenal glands, vital for steroid secretion and the regulation of metabolism, stress responses and immune activation, experience age-related decline, impacting systemic health. However, the regulatory mechanisms underlying adrenal aging remain largely uninvestigated. Here we established a single-nucleus transcriptomic atlas of both young and aged primate suprarenal glands, identifying lipid metabolism and steroidogenic pathways as core processes impacted by aging. We found dysregulation in centripetal adrenocortical differentiation in aged adrenal tissues and cells in the zona reticularis region, responsible for producing dehydroepiandrosterone sulfate (DHEA-S), were highly susceptible to aging, reflected by senescence, exhaustion and disturbed hormone production. Remarkably, LDLR was downregulated in all cell types of the outer cortex, and its targeted inactivation in human adrenal cells compromised cholesterol uptake and secretion of dehydroepiandrosterone sulfate, as observed in aged primate adrenal glands. Our study provides crucial insights into endocrine physiology, holding therapeutic promise for addressing aging-related adrenal insufficiency and delaying systemic aging.
Topics: Animals; Humans; Aged; Dehydroepiandrosterone Sulfate; Adrenal Glands; Aging; Zona Reticularis; Primates
PubMed: 38503993
DOI: 10.1038/s43587-024-00588-1 -
RoFo : Fortschritte Auf Dem Gebiete Der... Jun 2021Primary aldosteronism (PA) is the most common detectable cause of secondary hypertension. The majority of patients have either an adrenal aldosterone-producing... (Review)
Review
BACKGROUND
Primary aldosteronism (PA) is the most common detectable cause of secondary hypertension. The majority of patients have either an adrenal aldosterone-producing adenoma (APA) or bilateral adrenal hyperplasia (BAH) demanding different therapeutic approaches. Screening tests and imaging cannot reliably distinguish between a unilateral or bilateral PA.
METHODS
This review article gives an overview concerning etiology, diagnostics, and therapeutic options of PA, and reviews the indication, the technique, and relevance of selective adrenal venous sampling (AVS) in the context of the current literature and the authors' experience.
RESULTS
AVS can verify or exclude a unilaterally dominated secretion with a high success rate. Patients with PA and a unilateral APA can be treated curatively by adrenalectomy.
CONCLUSIONS
AVS is an established diagnostic examination for differentiation of unilateral from bilateral adrenal disease in patients with PA.
KEY POINTS
· Selective adrenal venous sampling (AVS) is a safe, reliable, and minimally invasive method to detect a unilateral or bilateral adrenal adrenal gland disease.. · Verification of lateralization by AVS has direct therapeutic relevance for patients with primary aldosteronism (PA).. · AVS can be performed with low radiation exposure, without contrast medium, and with a high success rate when performed by an experienced interventional radiologist..
CITATION FORMAT
· Loberg C, Antoch G, Stegbauer J et al. Update: Selective adrenal venous sampling (AVS) - Indication, technique, and significance. Fortschr Röntgenstr 2021; 193: 658 - 666.
Topics: Adrenal Glands; Adrenalectomy; Aldosterone; Humans; Hyperaldosteronism; Retrospective Studies; Veins
PubMed: 33327032
DOI: 10.1055/a-1299-1878