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The Tohoku Journal of Experimental... Jan 2023Laparoscopic adrenalectomy is currently the standard treatment modality for unilateral aldosterone-producing adenoma (APA); however, a less-invasive treatment is needed...
Laparoscopic adrenalectomy is currently the standard treatment modality for unilateral aldosterone-producing adenoma (APA); however, a less-invasive treatment is needed for its treatment. A new bipolar ablation system that poses a lower risk of complications has been recently developed. This study aimed to evaluate the safety and performance of a novel bipolar radiofrequency ablation (RFA) system for the treatment of APAs. Ablations were performed in an ex vivo study using bovine adrenal glands [group A: n = 6, single-probe; group B: n = 6, two probes, interprobe distance (ID) = 12 mm; group C: n = 6, two probes, ID = 20 mm]. The in vivo study was conducted in groups A and B (n = 2 each) using porcine adrenal glands. For the ex vivo study, the mean vertical diameter (Dv) of the coagulative necrosis area and the mean transverse diameter (Dt) values were 11.99 mm and 10.96 mm for group A, 12.66 mm and 10.0 mm for group B, and 23.37 mm and 22.10 mm for group C, respectively. For the in vivo study, the mean Dv and Dt values were 12.23 mm and 9.03 mm for group A, and 16.38 mm and 9.52 mm for group B, respectively. No heat-induced damage to the adjacent organs was observed. To our best knowledge, this is the first study to evaluate the performance of the bipolar system in RFA of the adrenal gland. RFA using the new bipolar ablation system is safe and produces a sufficient coagulation area to treat APAs.
Topics: Animals; Cattle; Swine; Liver; Catheter Ablation; Necrosis; Adrenal Glands; Radiofrequency Ablation
PubMed: 36517016
DOI: 10.1620/tjem.2022.J110 -
BMC Medical Imaging Nov 2023The value of radiomics features from the adrenal gland and periadrenal fat CT images for predicting disease progression in patients with COVID-19 has not been studied...
BACKGROUND
The value of radiomics features from the adrenal gland and periadrenal fat CT images for predicting disease progression in patients with COVID-19 has not been studied extensively. We assess the value of radiomics features from the adrenal gland and periadrenal fat CT images in predicting COVID-19 disease exacerbation.
METHODS
A total of 1,245 patients (685 moderate and 560 severe patients) were enrolled in a retrospective study. We proposed a 3D V-net to segment adrenal glands in onset CT images automatically, and periadrenal fat was obtained using inflation operation around the adrenal gland. Next, we built a clinical model (CM), three radiomics models (adrenal gland model [AM], periadrenal fat model [PM], and fusion of adrenal gland and periadrenal fat model [FM]), and radiomics nomogram (RN) after radiomics features extracted.
RESULTS
The auto-segmentation framework yielded a dice value 0.79 in the training set. CM, AM, PM, FM, and RN obtained AUCs of 0.717, 0.716, 0.736, 0.760, and 0.833 in the validation set. FM and RN had better predictive efficacy than CM (P < 0.0001) in the training set. RN showed that there was no significant difference in the validation set (mean absolute error [MAE] = 0.04) and test set (MAE = 0.075) between predictive and actual results. Decision curve analysis showed that if the threshold probability was between 0.4 and 0.8 in the validation set or between 0.3 and 0.7 in the test set, it could gain more net benefits using RN than FM and CM.
CONCLUSIONS
Radiomics features extracted from the adrenal gland and periadrenal fat CT images are related to disease exacerbation in patients with COVID-19.
Topics: Humans; Retrospective Studies; COVID-19; Adrenal Glands; Disease Progression; Delivery of Health Care; Tomography, X-Ray Computed
PubMed: 37950171
DOI: 10.1186/s12880-023-01145-9 -
Frontiers in Endocrinology 2022The adrenal gland is a common organ involved in metastasis. This study aimed to compare adrenal metastases (AMs) and adrenal benign masses (ABMs) of patients with...
BACKGROUND AND OBJECTIVES
The adrenal gland is a common organ involved in metastasis. This study aimed to compare adrenal metastases (AMs) and adrenal benign masses (ABMs) of patients with extra-adrenal malignancies during the staging or follow-up.
METHODS
We retrospectively collected data from 120 patients with AMs and 87 patients with ABMs. The clinical characteristics, imaging features, pathology, and treatment regimes were analyzed.
RESULTS
The most common types of extra-adrenal malignancies in patients with ABMs included thyroid, kidney, and gynecological cancers. On the other hand, lung and kidney cancers and lymphoma were the most frequent primary cancers of AMs. The age and incidence of symptoms were significantly higher in patients with AM. Radiological analysis showed that AMs tended to have larger tumor sizes and higher attenuation values than ABMs on pre-contrast computed tomography (CT). The diagnostic accuracy of positron emission tomography-CT for AM was 94.1%. An adrenal biopsy had a diagnostic accuracy of 92.5%. A multivariate logistic regression model demonstrated that the origins of extra-adrenal malignancies, the enhancement pattern, and attenuation values in pre-contrast CT were independent predictors of AMs. The sensitivity and specificity of this predictive model of combination was 92.5% and 74.1%, respectively.
CONCLUSIONS
The differential diagnosis between AMs and ABMs is extremely important. The combination of origin of first malignancy, enhancement pattern and CT value in non-enhanced phase is a valuable model for predicting AMs.
Topics: Adrenal Gland Neoplasms; Adrenal Glands; Diagnosis, Differential; Humans; Neoplasms, Second Primary; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 36246921
DOI: 10.3389/fendo.2022.978730 -
BMC Infectious Diseases Dec 2022Nocardia cyriacigeorgica is one of the most common Nocardia species found in human infections, recently reclassified. Even though Nocardia may affect all organs by... (Review)
Review
BACKGROUND
Nocardia cyriacigeorgica is one of the most common Nocardia species found in human infections, recently reclassified. Even though Nocardia may affect all organs by hematogenous dissemination, bacteremia are uncommon. Among all possible dissemination sites, the involvement of the adrenal glands is particularly rare.
CASE PRESENTATION
We report here a rare case of Nocardia disseminated infection with notably bacteremia and adrenal gland abscess, in a 77-years-old immunocompetent man. Adrenal gland abscess diagnosis was made by imaging (computerized tomography, magnetic resonance and positron emission tomography scan). A complete regression of all lesions including the left adrenal gland was obtained after 6 months of antibiotics. A review of literature was also performed.
CONCLUSION
Nocardia bacteremia is a rare event but blood cultures may help to improve detection of Nocardia spp. in a non-invasive way. Adrenal abscess due to Nocardia spp. is very rare with only fourteen cases reported in the literature, but it is a true cause of adrenal masses. Our report suggests that clinician should be aware of this rare location and prioritize a non-invasive diagnosis strategy.
Topics: Male; Humans; Aged; Abscess; Nocardia Infections; Nocardia; Adrenal Glands; Bacteremia; Anti-Bacterial Agents
PubMed: 36581805
DOI: 10.1186/s12879-022-07839-9 -
The Ceylon Medical Journal Sep 2007Adrenal insufficiency can be due to disease of the adrenal gland itself (primary adrenal deficiency) or of the hypothalamic or pituitary regulation of the adrenal gland...
Adrenal insufficiency can be due to disease of the adrenal gland itself (primary adrenal deficiency) or of the hypothalamic or pituitary regulation of the adrenal gland (secondary adrenal insufficiency). This article discusses its causes, clinical features, diagnosis and treatment.
Topics: Adrenal Gland Diseases; Adrenal Glands; Adrenal Insufficiency; Glucocorticoids; Humans; Mineralocorticoids
PubMed: 18020029
DOI: 10.4038/cmj.v52i3.970 -
The Journal of Endocrinology Aug 2012Adrenarche is an endocrine developmental process whereby humans and select nonhuman primates increase adrenal output of a series of steroids, especially DHEA and DHEAS.... (Review)
Review
Adrenarche is an endocrine developmental process whereby humans and select nonhuman primates increase adrenal output of a series of steroids, especially DHEA and DHEAS. The timing of adrenarche varies among primates, but in humans serum levels of DHEAS are seen to increase at around 6 years of age. This phenomenon corresponds with the development and expansion of the zona reticularis of the adrenal gland. The physiological phenomena that trigger the onset of adrenarche are still unknown; however, the biochemical pathways leading to this event have been elucidated in detail. There are numerous reviews examining the process of adrenarche, most of which have focused on the changes within the adrenal as well as the phenotypic results of adrenarche. This article reviews the recent and past studies that show the breadth of changes in the circulating steroid metabolome that occur during the process of adrenarche.
Topics: Adrenal Glands; Adrenarche; Animals; Humans; Metabolome; Models, Biological; Primates; Steroids; Zona Reticularis
PubMed: 22715193
DOI: 10.1530/JOE-12-0183 -
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 -
Vitamins and Hormones 2024Mouse models have been widely used in the study of adrenal gland development and diseases. The X-zone is a unique structure of the mouse adrenal gland and... (Review)
Review
Mouse models have been widely used in the study of adrenal gland development and diseases. The X-zone is a unique structure of the mouse adrenal gland and lineage-tracing studies show that the X-zone is a remnant of the fetal adrenal cortex. Although the X-zone is considered analogous to the fetal zone in the human adrenal cortex, the functional significance of the X-zone has remained comparatively more obscure. The X-zone forms during the early postnatal stages of adrenal development and regresses later in a remarkable sexually dimorphic fashion. The formation and regression of the X-zone can be different in mice with different genetic backgrounds. Mouse models with gene mutations, hormone/chemical treatments, and/or gonadectomy can also display an aberrant development of the X-zone or alternatively a dysregulated X-zone regression. These models have shed light on the molecular mechanisms regulating the development and regression of these unique adrenocortical cells. This review paper briefly describes the development of the adrenal gland including the formation and regression processes of the X-zone. It also summarizes and lists mouse models that demonstrate different X-zone phenotypes.
Topics: Mice; Humans; Animals; Adrenal Glands; Adrenal Cortex; Adrenal Cortex Neoplasms
PubMed: 38408801
DOI: 10.1016/bs.vh.2023.05.003 -
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 -
Advances in Clinical and Experimental... May 2018Adrenal hemorrhage (AH) is a rare condition that can lead to acute adrenal insufficiency and may be fatal. The risk factors of AH include focal adrenal lesion, abdominal... (Review)
Review
BACKGROUND
Adrenal hemorrhage (AH) is a rare condition that can lead to acute adrenal insufficiency and may be fatal. The risk factors of AH include focal adrenal lesion, abdominal trauma and anticoagulation therapy. The clinical manifestation of AH varies widely; the symptoms may be related to adrenal insufficiency or may reflect multiple organ failure. However, in many cases, the course of AH is asymptomatic.
OBJECTIVES
The study is a retrospective analysis of 23 cases of AH, whose aim is to discuss the etiology and the management of selected patients, as well as a literature review.
MATERIAL AND METHODS
The paper presents a retrospective analysis of 23 patients with AH confirmed by radiological and/or pathological examination. Epidemiological data, the results of laboratory tests, and radiological and pathological examinations were included in the analysis.
RESULTS
The risk factors of AH were not established in 13 patients, 5 patients had experienced a trauma prior to AH diagnosis, 1 patient was diagnosed with sepsis, 2 patients had concomitant neoplastic disease, and in 2 patients, 2 risk factors were present. Among patients who required emergency admission, 5 patients were hospitalized due to acute abdominal pain, 1 patient due to sepsis and 1 patient due to symptoms of active endocrinopathy. In the remaining patients, diagnostic procedures were prompted by the detection of adrenal incidentaloma (AI). A total of 40% of patients underwent surgical treatment due to the magnitude of AH or clinical and laboratory evidence of overt endocrinopathy. In the remaining patients, conservative treatment and further observation was recommended. In 34.8% of these patients, follow-up examinations revealed a gradual regression.
CONCLUSIONS
It seems that there is a need to distinguish patients with AH who do not require surgical intervention. Follow-up radiological examination is necessary to reassess the lesion. The patients in whom shrinkage of the tumor can be observed are likely not to require surgical treatment.
Topics: Abdominal Injuries; Adrenal Gland Diseases; Adrenal Glands; Anticoagulants; Hemorrhage; Humans; Risk Factors
PubMed: 29616752
DOI: 10.17219/acem/68897