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Adrenal Mass

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3501. Oncocytic adrenocortical carcinoma. (PubMed)

Oncocytic adrenocortical carcinoma. Oncocytic adrenocortical carcinoma is rare. To our knowledge, only 6 cases have been previously reported. We describe an additional case of oncocytic adrenocortical carcinoma. A 54-year-old man presented with a right subcostal mass. Computed tomography demonstrated a massive tumor in the right abdomen. Because renal or adrenal cancer was suspected, right adrenalectomy and nephrectomy were performed. Histologic examination revealed an oncocytic adrenocortical (...) carcinoma. Five months postoperatively, multiple metastases had developed and were treated with surgical resection, chemotherapy, vascular embolization, and radiotherapy. At last follow-up, the patient was alive with pulmonary and adrenal metastases and undergoing treatment with mitotane.

2004 Urology

3502. 18F-fluorodeoxyglucose positron emission tomography as a diagnostic tool for malignancy of adrenocortical tumours? Preliminary results in 13 consecutive patients. (PubMed)

18F-fluorodeoxyglucose positron emission tomography as a diagnostic tool for malignancy of adrenocortical tumours? Preliminary results in 13 consecutive patients. This study is a preliminary report on 18F-fluorodeoxyglucose (18F-FDG) uptake for the characterization of hypersecretory or non-hypersecretory adrenocortical masses in patients without known neoplastic disease, thereby minimizing the presence of adrenal metastases, and without phaeochromocytoma, in comparison with computed tomography (...) (CT) scanning and with iodocholesterol scintigraphy.Thirteen consecutive patients with an adrenal mass scheduled to have surgery, underwent hormonal exploration, a CT scan for tumour size measurement and an 18F-FDG positron emission tomography scan. Eleven of these patients also had unenhanced density measurement at CT scan and iodocholesterol scintigraphy.CT-scanned adrenal masses ranged in size from 2.2 to 10 cm; attenuation value was <10 Hounsfield units (HUs) in two cases and >10 HU in nine

2004 European Journal of Endocrinology

3503. Glucocorticoid-dependent stimulation of adiposity and appetite by a ghrelin mimetic in the rat. (PubMed)

treatment. The increased body weight observed in ADX rats following GHS treatment was not due to increased fat mass or increased weight of other organs measured. Food intake was increased for up to 7 h following a single injection of GHRP-6 in both the adrenal-intact (P<0.01) and corticosterone-replacement groups (P<0.05). This stimulating effect on food intake was not observed at any time point in the ADX rats without corticosterone replacement.These data suggest that GHS-induced body weight gain (...) is glucocorticoid-independent. However, basal levels of glucocorticoids are permissive for the GHS-induced increase in food intake whilst activation of the hypothalamo-pituitary-adrenal axis appears to contribute to the GHS-induced accumulation of fat mass.

2004 European Journal of Endocrinology

3504. Plasma chromogranin A in incidental non-functioning, benign, solid adrenocortical tumors. (PubMed)

of these tumors.Plasma CgA of 80 patients with non-functioning, benign adrenocortical adenomas was compared with that of 137 tumor-free subjects. In 15 patients, the masses were surgically removed and CgA was measured 2 months later. The other 65 patients with adrenocortical adenomas underwent clinical and radiological follow-up (range 24-36 months).CgA was evaluated by immunoradiometric assay in peripheral blood and by immunohistochemistry in adrenal tissue specimens.An increase in plasma CgA (P<0.001) was observed (...) Plasma chromogranin A in incidental non-functioning, benign, solid adrenocortical tumors. To evaluate whether adenomas arising from the adrenal cortex, a tissue of epithelial origin, are associated with high chromogranin A (CgA) levels and whether such tumors may express and release this protein. In addition, to investigate whether high CgA levels imply a neuroendocrine differentiation of the adrenocortical adenomas and, therefore, represent a humoral marker of malignant transformation

2004 European Journal of Endocrinology

3505. Multiple endocrine neoplasia 2A syndrome presenting as peripartum cardiomyopathy due to catecholamine excess. (PubMed)

, milrinone, captopril and diuretics, her condition improved rapidly and a repeat echocardiogram showed that the left ventricular function had normalized. Diagnosis of pheochromocytoma was made by urine and plasma catecholamine measurements. Magnetic resonance imaging revealed a 3.7 cm left adrenal mass. Increased uptake activity was seen in the same region by an (131)I-metaiodobenzylguanidine (MIBG) scan. The patient underwent successful surgical resection of the pheochromocytoma. Subsequent DNA analysis

2004 European Journal of Endocrinology

3506. A meiotic recombination in a new isolated familial somatotropinoma kindred. (PubMed)

A meiotic recombination in a new isolated familial somatotropinoma kindred. We report here the genetic findings of a new isolated familial somatotropinoma (IFS) kindred in which the mother (subject I:2) and one daughter (subject II:2) are affected; their ages at diagnosis were 25 and 14 years respectively. Additionally, patient I:2 developed virilization due to an androgen-secreting adrenocortical mass, presenting clinical and molecular features of sporadic adrenal carcinoma. To genotype

2004 European Journal of Endocrinology

3507. Hormone-Balancing Effect of Pre-Gelatinized Organic Maca (Lepidium peruvianum Chacon): (III) Clinical responses of early-postmenopausal women to Maca in double blind, randomized, Placebo-controlled, crossover configuration, outpatient study. (Full text)

, four months outpatient crossover configuration Trial. After fulfilling the criteria of being early-postmenopausal: blood Estrogen (E2<40 pg/ml) and Follicle Stimulating Hormone (FSH>30 IU/ml) at admission, they were randomly allocated to Placebo (P) and Maca-GO (M) treatments (2 groups of 11 participants each). Two 500 mg vegetable hard gel capsules with Maca-GO or Placebo powder were self-administered twice daily with meals (total 2 g/day). At admission and follow-up monthly intervals, body mass (...) index (BMI), blood pressure, levels of gonadal, pituitary, thyroid and adrenal hormones, lipids and key minerals were measured. Bone markers were determined after four months M and P use in 12 participants. Menopausal symptoms were assessed according to Greene's Score (GMS) and Kupperman's Index (KMI). Data were analyzed using multivariate technique on blocs of monthly. Results and canonical variate technique was applied to GMS and KMI matrices. Two months application of Maca-GO stimulated (P<0.05

2006 International journal of biomedical science : IJBS Controlled trial quality: uncertain

3508. Evidence of increased visceral obesity and reduced physical fitness in healthy insulin-resistant first-degree relatives of type 2 diabetic patients. (PubMed)

to their insulin resistance.We measured fat distribution in 20 FDR and 14 age-, gender- and body mass index (BMI)-matched controls employing dual energy X-ray absorbtiometry (DEXA)- and computed tomography (CT)-scanning. Insulin-stimulated glucose uptake (ISGU) was determined by a hyperinsulinemic clamp and maximal aerobic work capacity (VO2 max) by a bicycle ergometer test. Baseline lipolysis was measured using [3H]palmitate. The activity level of the hypothalamic-pituitary-adrenal axis was assessed as the 24 (...) h urinary (u)-cortisol/creatinine ratio.All subjects had a normal oral glucose tolerance test (OGTT), but FDR were insulin resistant (ISGU: 6.64+/-0.48 vs 9.12+/-0.98 mg/kg ffm/min, P=0.01). Despite similar BMI (25.2+/-0.5 vs 24.8+/-0.7 kg/m2, P=0.61) and overall fat mass (26.4+/-1.6 vs 24.2+/-2.1%, P=0.41) in FDR vs controls, the amount of visceral adipose tissue was substantially increased (65.9+/-10.0 vs 40.1+/-11.3 cm2, P<0.05) and VO2 max was reduced (52.2+/-3.1 vs 63.3+/-3.9 ml/kg ffm/min

2004 European journal of endocrinology / European Federation of Endocrine Societies Controlled trial quality: uncertain

3509. Safety of inhaled corticosteroids delivered by plastic and metal spacers. (Full text)

Safety of inhaled corticosteroids delivered by plastic and metal spacers. Because of its non-electrostatic properties the metal Nebuchamber (NC) valved holding chamber (VHC) delivers a greater mass of aerosol to the mouth than the polypropylene Aerochamber (AC) VHC. Delivery of more aerosol to the lungs may also increase systemic absorption of inhaled corticosteroids (ICS) and hypothalamo-pituitary-adrenal (HPA) suppression.Thirty children (mean 4.3 (SD 0.3) years) received 200 micro g

2003 Archives of disease in childhood Controlled trial quality: uncertain

3510. [Robot-assisted laparoscopic surgery. Preliminary results at our Center]. (PubMed)

[Robot-assisted laparoscopic surgery. Preliminary results at our Center]. The aim of our study was to evaluate the advantages and disadvantages of robot-assisted laparoscopic surgery, in terms of operative times, complications and length of hospital stay, using the Da Vinci Robotic Surgical System (Intuitive Surgical, Inc.). Twenty-five patients underwent robotic procedures. The indications were gastro-oesophageal reflux disease in 13 cases, achalasia in 2, cholelithiasis in 2, adrenal adenoma (...) in Cushing syndrome in 6, pheochromocytoma in 2, and incidentaloma in 1. Robotic surgery was compared with the traditional laparoscopic approach. From January to September 2002 13 Nissen-Rossetti fundoplications, 2 Heller myotomies with Dor fundoplication, 2 cholecystectomies and 9 adrenalectomies (6 left adrenalectomies, 3 right adrenalectomies) were performed. There were no significant differences in age, preoperative body mass index (mean 28; range: 18-32) or sex between patients treated by robotic

2003 Chirurgia italiana Controlled trial quality: uncertain

3511. Neutrophil count in small-for-gestational age children: contrasting effects of metformin and growth hormone therapy. (Full text)

and reduced adiponectin levels. Metformin therapy in SGA-PP girls attenuates the hyperinsulinemia, the adrenal androgen excess, and the proinflammatory state. In contrast, GH therapy in SGA-SS children promotes height gain but may induce hyperinsulinemia. Both groups are associated with increased risk markers for future cardiovascular disease. Therefore, we studied markers of inflammation in both SGA subpopulations at baseline and after their respectively corrective therapies. SGA-PP girls (n = 33; mean (...) age, 8 yr; body mass index, 18.5 kg/m(2)) were randomized to remain untreated or to receive metformin (425 mg/d) for 6 months. SGA-SS children (n = 29; mean age, 7 yr; body mass index, 14.7 kg/m(2)) were randomly assigned to remain untreated or to receive GH (60 mug/kg/d). In SGA-PP girls, the mean neutrophil count (4.0 x 1000/mm(3)) was more than 2 sd above the mean reference level (2.8 x 1000/mm(3), P < 0.001); this remained stable over 6 months in untreated girls but dropped in metformin

2005 The Journal of clinical endocrinology and metabolism Controlled trial quality: uncertain

3512. Effects of testosterone replacement in androgen-deficient women with hypopituitarism: a randomized, double-blind, placebo-controlled study. (Full text)

Effects of testosterone replacement in androgen-deficient women with hypopituitarism: a randomized, double-blind, placebo-controlled study. Hypopituitarism in women is characterized by profound androgen deficiency due to a loss of adrenal and/or ovarian function. The effects of testosterone replacement in this population have not been reported.The objective of the study was to determine whether physiologic testosterone replacement improves bone density, body composition, and/or neurobehavioral (...) function in women with severe androgen deficiency secondary to hypopituitarism.This was a 12-month randomized, placebo-controlled study.The study was conducted at a general clinical research center.Fifty-one women of reproductive age with androgen deficiency due to hypopituitarism participated.Physiologic testosterone administration using a patch that delivers 300 microg daily or placebo was administered.Bone density, fat-free mass, and fat mass were measured by dual x-ray absorptiometry. Thigh muscle

2006 The Journal of clinical endocrinology and metabolism Controlled trial quality: predicted high

3513. Safety, tolerability, and exposure of ciclesonide nasal spray in healthy and asymptomatic subjects with seasonal allergic rhinitis. (PubMed)

and its active metabolite, desisobutyryl-ciclesonide, were measured using high-performance liquid chromatography assay with tandem mass spectrometric detection, with lower limits of quantification of 25 and 10 pg/mL, respectively. Adrenal function was monitored by diurnal serum free and 24-hour urine cortisol concentrations. Despite the use of a sensitive assay and a high ciclesonide dose (800 microg/d), serum levels of ciclesonide and desisobutyryl-ciclesonide were below the lower limits

2006 Journal of clinical pharmacology Controlled trial quality: uncertain

3514. Robot-assisted vs laparoscopic adrenalectomy: a prospective randomized controlled trial. (PubMed)

Robot-assisted vs laparoscopic adrenalectomy: a prospective randomized controlled trial. The aim of this study was to assess the benefits and disadvantages of robot-assisted laparoscopic surgery for disorders of the adrenal gland in terms of feasibility, safety, and length of hospitalization.Twenty consecutive patients with benign lesions of adrenal gland were randomized into two groups: Patients in the laparoscopic group underwent traditional laparoscopic adrenalectomy (LAP), whereas those (...) in the robotic group underwent robot-assisted adrenalectomy (ROBOT) using the da Vinci robotic system.There was no significant difference between the groups in terms of age, sex, body mass index, and size or locations of lesions. Operative times were significant longer in the ROBOT group (total operative time, 169.2 min [range, 136-215] vs 115.3 min (range, 95-155) p < 0.001. Skin-to-skin time was 107 m (range, 77-154) vs 82.1 min (range, 55-120) (p < 0.001). There were no conversions to open surgery

2004 Surgical endoscopy Controlled trial quality: uncertain

3515. Effects of dehydroepiandrosterone and alprazolam on hypothalamic-pituitary responses to exercise. (Full text)

Effects of dehydroepiandrosterone and alprazolam on hypothalamic-pituitary responses to exercise. The hypothalamic-pituitary-adrenal axis (HPA) is restrained by activation of gamma-amino-butyric acid receptors. Alprazolam (APZ) and dehydroepiandrosterone (DHEA) are purported to be gamma-amino-butyric acid agonists and antagonists, respectively.Our objective was to examine the effects of APZ and DHEA alone and in combination on HPA axis activity.This was a double-blind, crossover, placebo (...) -controlled study.The study setting was the general community.Subjects consisted of 15 men (age, 20-45 yr) with a body mass index of 20-25 kg/m2.DHEA (100 mg/d) or placebo was given for 4 wk, followed by a 2-wk washout; participants ingested 0.5 mg APZ or placebo 10 and 2 h before high-intensity exercise.We measured basal and exercise-induced ACTH, arginine vasopressin (AVP), cortisol, DHEA, and GH responses. It was hypothesized that DHEA would enhance and APZ would blunt exercise-induced ACTH

2005 The Journal of clinical endocrinology and metabolism Controlled trial quality: uncertain

3516. Efficacy of a long-acting growth hormone (GH) preparation in patients with adult GH deficiency. (Full text)

Efficacy of a long-acting growth hormone (GH) preparation in patients with adult GH deficiency. Treatment of adult GH deficiency (AGHD) with daily injections of GH results in decreased adipose mass, increased lean body mass (LBM), increased bone mineral density, and improved quality of life.This study seeks to determine whether a depot preparation of GH given every 14 d would lead to comparable decreases in trunk adipose tissue as daily GH.This open-label, randomized study compares subjects (...) absorptiometry.The percentage of the trunk region that is fat increased by 0.4 in the no treatment group, but decreased by 3.2 (P = 0.001 vs. untreated) in the GH depot group and by 2.5 (P < 0.004 vs. untreated) in the daily GH group. Visceral adipose tissue area decreased by 9.1% in the GH depot group and by 6.8% in the daily GH group. LBM and high-density lipoprotein increased in both treatment groups. Side effect profiles were similar. Three subjects receiving GH experienced serious episodes of adrenal

2005 The Journal of clinical endocrinology and metabolism Controlled trial quality: uncertain

3517. Prospective, randomized comparison of transperitoneal versus retroperitoneal laparoscopic adrenalectomy. (PubMed)

patient age greater than 80 years, body mass index greater than 40, bilateral adrenalectomy and significant prior abdominal surgery in the quadrant of interest. Mean followup was 5.96 years in the 2 groups.The groups were matched in regard to patient age (p = 0.84), body mass index (p = 0.43), American Society of Anesthesiologists class (p = 0.81) and laterality (p = 0.12). Median adrenal mass size was 2.7 cm (range 1 to 9) in the TLA group and 2.6 cm (range 0.5 to 6) in the RLA group (p = 0.83). TLA (...) Prospective, randomized comparison of transperitoneal versus retroperitoneal laparoscopic adrenalectomy. We report a prospective, randomized comparison of transperitoneal laparoscopic adrenalectomy (TLA) vs retroperitoneal laparoscopic adrenalectomy (RLA) for adrenal lesions with long-term followup.Between December 1997 and November 1999, 57 consecutive eligible patients with surgical adrenal disease were prospectively randomized to undergo TLA (25) or RLA (32). Study exclusion criteria were

2005 The Journal of urology Controlled trial quality: uncertain

3518. Multiple gastrointestinal stromal tumors and bilateral pheochromocytoma in neurofibromatosis (Full text)

and dizziness that lasted for years, a left adrenal mass was detected by CT. Laparotomy revealed a pheochromocytoma of the left adrenal gland while an ileoterminal GIST was found incidentally intraoperatively. After six months contralateral PCC and multiple recurrent GIST were resected again. After four years the patient is doing well without any signs of further recurrent tumors. Discussion includes review of the literature.

2007 World journal of gastroenterology : WJG

3519. Pheochromocytomas and secreting paragangliomas (Full text)

Pheochromocytomas and secreting paragangliomas Catecholamine-producing tumors may arise in the adrenal medulla (pheochromocytomas) or in extraadrenal chromaffin cells (secreting paragangliomas). Their prevalence is about 0.1% in patients with hypertension and 4% in patients with a fortuitously discovered adrenal mass. An increase in the production of catecholamines causes symptoms (mainly headaches, palpitations and excess sweating) and signs (mainly hypertension, weight loss and diabetes

2006 Orphanet journal of rare diseases

3520. Malakoplakia of the colon associated with colonic adenocarcinoma diagnosed in colonic biopsies (Full text)

Malakoplakia of the colon associated with colonic adenocarcinoma diagnosed in colonic biopsies Malakoplakia, typically involving the urinary tract, is an uncommon form of chronic inflammation caused by chronic infections and characterized by accumulation of macrophages. It has also been found in many other sites such as the gastrointestinal tract, pancreas, liver, lymph nodes, skin, respiratory tract, adrenal gland, vagina and brain. We present a case of a 64-year-old man referred to our (...) hospital with cachexia and radiologic evidence of metastatic tumor of the liver. Colonoscopy revealed a large malignant - appearing polypoid mass of the ascending colon and multiple distinct polyps throughout the rest of the colon. Biopsies of the ascending colon mass confirmed the diagnosis of adenocarcinoma. Histological examination of two of the other polyps revealed malakoplakia which was characterized by aggregates of granular histiocytes with Michaelis - Gutmann bodies and histochemically

2007 World journal of gastroenterology : WJG

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