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Adrenal Mass

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3721. Hypertension and hypothalamo-pituitary-adrenal axis hyperactivity affect frontal lobe integrity. Full Text available with Trip Pro

Hypertension and hypothalamo-pituitary-adrenal axis hyperactivity affect frontal lobe integrity. Chronically elevated cortisol levels have been associated with elevated blood pressure, brain atrophy, and cognitive impairments. In this cross-sectional exploratory study, we assessed whether hypertension was related to hypothalamo-pituitary-adrenal axis hyperactivity and whether this may in part explain prefrontal brain atrophy and cognitive impairments in this population. We studied 27 patients (...) with hypertension and 27 normotensive control subjects. Glucocorticoid feedback was assessed using the combined dexamethasone-CRH test. All participants completed a neuropsychological battery and received brain magnetic resonance imaging for volumetric measurement of frontal and medial temporal lobe regions. Hypertension was significantly associated with impaired glucocorticoid feedback control after statistically controlling for age, gender, and body mass index (P = 0.01). Hypertensive patients also showed

2005 Journal of Clinical Endocrinology and Metabolism

3722. Adrenal hyperandrogenism is induced by fetal androgen excess in a rhesus monkey model of polycystic ovary syndrome. Full Text available with Trip Pro

of similar age, body weight, and body mass index were studied during d 2-6 of two menstrual cycles or anovulatory 30-d periods.Predexamethasone adrenal steroid levels were assessed in the first cycle (cycle 1). In a subsequent cycle (cycle 2), occurring one to three cycles after cycle 1, adrenal steroids were determined 14.5-16.0 h after an i.m. injection of 0.5 mg/kg dexamethasone (postdexamethasone levels) and after an i.v. injection of 50 microg ACTH-(1-39).Both before and after dexamethasone, serum (...) Adrenal hyperandrogenism is induced by fetal androgen excess in a rhesus monkey model of polycystic ovary syndrome. Adrenal androgen excess is found in approximately 25-60% of women with polycystic ovary syndrome (PCOS), but the mechanisms underlying PCOS-related adrenal androgen excess are unclear.The objective of this study was to determine whether adrenal androgen excess is manifest in a nonhuman primate model for PCOS.Six prenatally androgenized (PA) and six control female rhesus monkeys

2005 Journal of Clinical Endocrinology and Metabolism

3723. Irregular and frequent cortisol secretory episodes with preserved diurnal rhythmicity in primary adrenal Cushing's syndrome. Full Text available with Trip Pro

Irregular and frequent cortisol secretory episodes with preserved diurnal rhythmicity in primary adrenal Cushing's syndrome. To evaluate the pathophysiology of altered cortisol secretion in patients with primary adrenal hypercortisolism, cortisol secretion was investigated in 12 patients, seven with a unilateral adenoma and five with ACTH-independent macronodular adrenal hyperplasia compared with age- and gender-matched controls and with patients with pituitary-dependent hypercortisolism (...) . Pulsatile secretion was increased 2-fold (P = 0.04), attributable to increased event frequency (P = 0.002). All patients showed a significant diurnal rhythm with a delay in phase shift of 3 h (P = 0.01). Approximate entropy ratio, a feedback-sensitive measure, was increased compared with controls (P = 0.00003) but similar to that of pituitary-dependent hypercortisolism (P = 0.77), denoting loss of autoregulation. Cortisol burst-mass tended to be smaller in patients with ACTH-independent macronodular

2005 Journal of Clinical Endocrinology and Metabolism

3724. Cardiovascular risk factors and ultrasound evaluation of intima-media thickness at common carotids, carotid bulbs, and femoral and abdominal aorta arteries in patients with classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Full Text available with Trip Pro

Cardiovascular risk factors and ultrasound evaluation of intima-media thickness at common carotids, carotid bulbs, and femoral and abdominal aorta arteries in patients with classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency. In congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency, a tendency for obesity, high insulin, and high 24-h blood pressure levels has been reported in children and adolescents. Increased intima-media thickness (IMT) is considered (...) a measure of subclinical atherosclerosis and a predictor of myocardial infarction and stroke.The objective of the study was to evaluate glucose metabolism, lipid profile, IMT of the abdominal aorta, right and left common carotids, carotid bulbs, and common femoral arteries in adult CAH patients.Nineteen (10 females, nine males; 28 +/- 3.5 yr) patients (12 salt wasting and seven simple virilizing) and 19 (10 females, nine males) healthy subjects matched for anthropometric parameters (age, sex, body mass

2007 Journal of Clinical Endocrinology and Metabolism

3725. Hypothalamic-pituitary-adrenal axis dysregulation and memory impairments in type 2 diabetes. Full Text available with Trip Pro

Hypothalamic-pituitary-adrenal axis dysregulation and memory impairments in type 2 diabetes. There is evidence of both hypothalamic-pituitary-adrenocortical (HPA) axis and cognitive dysfunction in type 2 diabetes mellitus (T2DM). However, the exact nature and the associations between these abnormalities remain unclear.The aim of the study was to characterize the nature of the HPA dysregulation in T2DM and ascertain whether impaired cognition in T2DM could be attributed to these abnormalities.A (...) , and 30 age-, gender-, and education-matched controls.Basal cortisol levels, cortisol levels during the DEX/CRH test, and performance on neuropsychological tests were measured.Individuals with T2DM had elevated basal plasma cortisol levels, higher levels after DEX suppression, and a larger response to CRH (all P mass index

2007 Journal of Clinical Endocrinology and Metabolism

3726. Altered 24-hour blood pressure profiles in children and adolescents with classical congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Full Text available with Trip Pro

Altered 24-hour blood pressure profiles in children and adolescents with classical congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Children and adolescents with classical congenital adrenal hyperplasia have been shown to be at risk for obesity associated with higher insulin and leptin levels. Because these factors are also known to cause hypertension, the aim of this study was to analyze 24-h blood pressure profiles and their relation to different clinical and laboratory (...) parameters.Fifty-five subjects, aged between 5.3 and 19.0 yr, were enrolled in a prospective, cross-sectional study. All patients had genetically proven 21-hydroxylase deficiency and underwent ambulatory 24-h blood pressure monitoring during a period off school/work. RESULTS (MEDIAN, RANGE): The median body mass index of the cohort was significantly elevated [1.09 sd score (SDS), -2.45 to 3.77]. Daytime and nighttime systolic blood pressures were also significantly elevated (0.67 SDS, -1.5-4.1; 0.63 SDS, -0.91

2006 Journal of Clinical Endocrinology and Metabolism

3727. Metabolic profile and body composition in adult women with congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Full Text available with Trip Pro

Metabolic profile and body composition in adult women with congenital adrenal hyperplasia due to 21-hydroxylase deficiency. The chronic, often supraphysiological glucocorticoid doses used in congenital adrenal hyperplasia (CAH) might increase morbidity in cardiovascular disease and diabetes.Our aim was to assess risk factors for cardiovascular disease and diabetes in CAH women. SUBJECTS, METHODS, AND DESIGN: We compared 61 women, 18-63 yr, with CAH due to 21-hydroxylase deficiency with 61 age (...) - and sex- matched controls. Twenty-seven were younger than 30 yr, and 34 were 30 yr or older. Anthropometry, fat and lean mass measured by dual-energy x-ray absorptiometry, serum lipids, insulin, and adrenocortical steroids were studied.Body composition and cardiovascular risk factors were the main outcome measures.Younger patients and controls had similar waist to hip ratio, lean and fat mass, and insulin. Older patients had higher waist to hip ratio, lean mass, and insulin than controls. Fat mass

2007 Journal of Clinical Endocrinology and Metabolism

3728. Lack of Association of the 11beta-hydroxysteroid dehydrogenase type 1 gene 83,557insA and hexose-6-phosphate dehydrogenase gene R453Q polymorphisms with body composition, adrenal androgen production, blood pressure, glucose metabolism, and dementia. Full Text available with Trip Pro

reductase deficiency (CRD) when at least three alleles are affected.The aim was to study the separate and combined effects of these polymorphisms on body composition, adrenal androgen production, blood pressure, glucose metabolism, and the incidence of dementia in the healthy elderly population.The Rotterdam study (n = 6105) and the Frail Old Men study (n = 347) are population-based cohort studies in the elderly.Genotype distributions and influences of (combined) genotypes on body mass index, adrenal (...) Lack of Association of the 11beta-hydroxysteroid dehydrogenase type 1 gene 83,557insA and hexose-6-phosphate dehydrogenase gene R453Q polymorphisms with body composition, adrenal androgen production, blood pressure, glucose metabolism, and dementia. Recently, it was proposed that a combination of the 83,557insA polymorphism in the 11beta-hydroxysteroid dehydrogenase type 1 (HSD11B1) gene and the R453Q polymorphism in the hexose-6-phosphate dehydrogenase (H6PD) gene interacts to cause cortisone

2007 Journal of Clinical Endocrinology and Metabolism

3729. Adrenal sensitivity to adrenocorticotropin 1-24 is reduced in patients with autoimmune polyglandular syndrome. Full Text available with Trip Pro

Adrenal sensitivity to adrenocorticotropin 1-24 is reduced in patients with autoimmune polyglandular syndrome. Autoimmune polyglandular syndromes are fairly common diseases that are classified into four constellations based on the clinical clustering of the various component diseases. In types 1, 2, and 4, primary adrenal insufficiency due to an autoimmune process is usually present, but its diagnosis is often delayed because it is difficult to detect in a subclinical phase. It is widely (...) accepted that the classical dose of 250 microg ACTH(1-24) is supramaximal, whereas 0.06 microg has been shown to be one of the lowest ACTH doses that is able to stimulate adrenal secretion in normal young subjects. The aim of this study was to clarify the sensitivity and maximal secretory response of the adrenal gland to ACTH in a group of patients with at least two autoimmune diseases, without clinical signs and symptoms of overt or subclinical hypocortisolism. Cortisol (F), aldosterone

2004 Journal of Clinical Endocrinology and Metabolism

3730. Overrepresentation of the N363S variant of the glucocorticoid receptor gene in patients with bilateral adrenal incidentalomas. Full Text available with Trip Pro

Overrepresentation of the N363S variant of the glucocorticoid receptor gene in patients with bilateral adrenal incidentalomas. Some variants of the glucocorticoid receptor (GR) gene have been found to alter glucocorticoid sensitivity and have been associated with altered metabolic profiles.The objective of the study was to examine whether N363S and ER22/23K variants of the GR gene may be associated with the development of adrenal incidentalomas and whether these variants may contribute (...) to metabolic abnormalities frequently present in these patients.The study included 99 patients with unilateral and 44 patients with bilateral adrenal incidentalomas, 102 population-matched control subjects, and 100 patients with type 2 diabetes mellitus.Metabolic and hormonal parameters and GR gene variants were determined.When compared with control subjects, the carrier frequency for the N363S variant was markedly and significantly higher in patients with bilateral (7.8 vs. 20.5%, P < 0.05

2006 Journal of Clinical Endocrinology and Metabolism

3731. Acetylcholine-induced relaxation and hyperpolarization in small bovine adrenal cortical arteries: role of cytochrome P450 metabolites. Full Text available with Trip Pro

of 56 +/- 4 and 90 +/- 5%, respectively. The arachidonic acid-induced relaxation was blocked by SKF 525A. Using high-pressure liquid chromatography and gas chromatography/mass spectrometry analysis, EETs were identified in small adrenal arteries. These results demonstrate that acetylcholine is a potent vasodilator of small adrenal cortical arteries. The acetylcholine-induced relaxation is largely mediated by an endothelium-dependent hyperpolarization mechanism, presumably through cytochrome P450 (...) Acetylcholine-induced relaxation and hyperpolarization in small bovine adrenal cortical arteries: role of cytochrome P450 metabolites. The present study characterizes the vascular responses of isolated small bovine adrenal cortical arteries to acetylcholine, an endogenous neurotransmitter in the adrenal gland. Acetylcholine (10(-10) to 10(-6) m) elicited a concentration-dependent relaxation, with a maximal relaxation of 96 +/- 1% and EC50 of 4.2 nm. The relaxation was abolished by endothelial

2004 Endocrinology

3732. Clinical utility of noncontrast computed tomography attenuation value (hounsfield units) to differentiate adrenal adenomas/hyperplasias from nonadenomas: Cleveland Clinic experience. Full Text available with Trip Pro

Hounsfield units (HU) in characterizing whether an adrenal mass is adenoma or nonadenoma. The mean (+/- SD) HU value for the adrenocortical adenoma/hyperplasia group was 16.2 +/- 13.6 and significantly lower (P < 0.0001) than primary adrenocortical cancers (36.9 +/- 4.1), metastases (39.2 +/- 15.2), and pheochromocytomas (38.6 +/- 8.2). The sensitivity and specificity for 10- and 20-HU cutoff values to differentiate adenomas/hyperplasias from nonadenomas were 40.5 and 100% and 58.2 and 96.9 (...) %, respectively. The size of the adrenal tumor had less value with only 40.7 and 81.3% sensitivity and 94.7 and 61.4% specificity for 2- and 4-cm cutoff values. A combination of less than or equal to 4-cm adrenal mass size and noncontrast computed tomography HU less than or equal to 20 had 42.1% sensitivity and 100% specificity. Our study, the largest with surgical histopathology as the gold standard for diagnosis, supports a noncontrast computed tomography attenuation value of 10 HU as a safe cutoff value

2005 Journal of Clinical Endocrinology and Metabolism

3733. Hypothalamic-pituitary-adrenal axis function and the cellular immune response in former preterm children. Full Text available with Trip Pro

Hypothalamic-pituitary-adrenal axis function and the cellular immune response in former preterm children. Animal data suggest that adverse early experiences may affect endocrine and immune functioning in later life.Our objective was to assess the impact of preterm delivery on hypothalamus-pituitary-adrenal axis functioning, heart rate responses, and immune function.Former preterm children [aged 8-14 yr (n = 18)], sex and age-matched full-term born control children (n = 18), data on birth weight (...) , gestational age, birth weight for gestational age (in sd units), actual body weight, height, and body mass index were assessed.Subjects were exposed to a standardized laboratory stressor ("Trier Social Stress Test for Children"). Cortisol in saliva was determined in 10-min intervals before and after the stress test; heart rates were obtained continuously during the stress test. Additional assessment of saliva cortisol was performed: 1) on 3 consecutive days after awakening and at +10, +20, and +30 min

2007 Journal of Clinical Endocrinology and Metabolism

3734. Patients with classic congenital adrenal hyperplasia have decreased epinephrine reserve and defective glycemic control during prolonged moderate-intensity exercise. Full Text available with Trip Pro

Patients with classic congenital adrenal hyperplasia have decreased epinephrine reserve and defective glycemic control during prolonged moderate-intensity exercise. Patients with classic congenital adrenal hyperplasia (CAH) have adrenomedullary dysplasia and hypofunction, and their lack of adrenomedullary reserve has been associated with a defective glucose response to brief high-intensity exercise.Our objective was to assess hormonal, metabolic, and cardiovascular response to prolonged (...) moderate-intensity exercise comparable to brisk walking in adolescents with classic CAH.We compared six adolescents with classic CAH (16-20 yr old) with seven age-, sex-, and body mass index group-matched controls (16-23 yr old) using a 90-min standardized ergometer test. Metabolic, hormonal, and cardiovascular parameters were studied during exercise and recovery.Glucose did not change throughout exercise and recovery for controls, whereas CAH patients showed a steady decline in glucose during exercise

2007 Journal of Clinical Endocrinology and Metabolism

3735. Prenatal diagnosis of fetal bilateral adrenal carcinoma. Full Text available with Trip Pro

Prenatal diagnosis of fetal bilateral adrenal carcinoma. Fetal malignancies that are capable of metastasizing to other fetal organs and the placenta are exceedingly rare. Fetal tumors are suspected on ultrasonography in the presence of structures of abnormal shape or size that are occasionally associated with polyhydramnios and hydrops. Most of the large abdominal masses detected antenatally are renal in origin, although adrenal tumors should also be kept in mind in their differential diagnosis (...) . We report a case of a large-for-gestational-age fetus with abdominal distention secondary to bilateral adrenal carcinoma, polyhydramnios and placental enlargement. Postmortem histological findings included nesidioblastosis, (i.e. hyperplasia of the cells of the islets of Langerhans) and adrenocortical cytomegaly, suggestive of a form of Beckwith-Wiedemann syndrome.(c) 2005 ISUOG

2005 Ultrasound in Obstetrics and Gynecology

3736. Hypothalamic-pituitary-adrenal axis function in ankylosing spondylitis. Full Text available with Trip Pro

Hypothalamic-pituitary-adrenal axis function in ankylosing spondylitis. To assess basal function and responsiveness of the hypothalamic-pituitary-adrenal (HPA) axis in patients with ankylosing spondylitis during dynamic testing.Insulin induced hypoglycaemia (IIH) (Actrapid HM 0.1 IU/kg, as intravenous bolus) was induced in 17 patients and 11 healthy controls matched for age, sex, and body mass index. Concentrations of glucose, adrenocorticotrophic hormone (ACTH), cortisol, insulin

2004 Annals of the Rheumatic Diseases

3737. An evidence-based, multidisciplinary approach to the clinical considerations, management, and surveillance of adrenal lesions in familial adenomatous polyposis: report of three cases. (Abstract)

An evidence-based, multidisciplinary approach to the clinical considerations, management, and surveillance of adrenal lesions in familial adenomatous polyposis: report of three cases. Adrenal masses are commonly discovered incidentally in patients with familial adenomatous polyposis, and adrenal malignancies have been rarely reported. Individuals with familial adenomatous polyposis frequently undergo abdominal CT-scan examinations for surveillance or symptoms. Adrenal lesions often are detected (...) unexpectedly and are thus becoming a common clinical problem in this population. Adrenal lesions encompass a heterogeneous spectrum of pathologic entities, including primary adrenocortical and medullary tumors, benign or malignant lesions, hormonally active or inactive lesions, metastases, and infections. When an adrenal mass is detected, the clinician needs to address two crucial questions: 1) is the mass malignant? and 2) is it hormonally active? This article presents three new cases of incidental

2006 Diseases of the Colon & Rectum

3738. 34-year-old woman with hypotension, respiratory failure, fever, and an abdominal mass. Full Text available with Trip Pro

34-year-old woman with hypotension, respiratory failure, fever, and an abdominal mass. 8342266 1993 08 31 2018 11 13 0093-0415 158 5 1993 May The Western journal of medicine West. J. Med. 34-year-old woman with hypotension, respiratory failure, fever, and an abdominal mass. 499-505 Lee P C PC Department of Medicine, Stanford University Medical Center, CA 94305. Gocke C D CD Harris E D ED Jr Pillsbury H E HE Bergin C J CJ Vosti K L KL Melmon K L KL Clinkingbeard C C eng Case Reports Clinical (...) Conference Journal Article United States West J Med 0410504 0093-0415 AIM IM Adrenal Gland Neoplasms diagnosis Adult Diagnosis, Differential Female Humans Pheochromocytoma diagnosis 1993 5 1 2001 3 28 10 1 1993 5 1 0 0 ppublish 8342266 PMC1022132 N Engl J Med. 1979 Sep 27;301(13):682-6 481462 Am J Surg Pathol. 1980 Apr;4(2):121-6 6103678 N Engl J Med. 1984 Nov 15;311(20):1298-303 6149463 Hum Pathol. 1985 Jun;16(6):580-9 3997135 Radiology. 1987 Oct;165(1):89-93 3628794 N Engl J Med. 1988 Jul 21;319(3):136

1993 Western Journal of Medicine

3739. Diagnosis of abdominal masses with percutaneous biopsy guided by ultrasound. Full Text available with Trip Pro

in a spring loaded firing device (Biopty gun) that was advanced under simultaneous ultrasound scanning, permitting precise localisation of the target organ.Results of histological examination of tissue specimens.Biopsy failed in four patients. Adequate histological specimens were obtained in 104 patients with masses in the liver (31), pancreas (37), kidney (10), and adrenal glands (six) and in 20 undiagnosed abdominal and retroperitoneal masses. Follow up was until death or confirmation of the diagnosis (...) Diagnosis of abdominal masses with percutaneous biopsy guided by ultrasound. To assess the accuracy and safety of percutaneous biopsy of abdominal masses guided by ultrasound.Prospective study.Combined gastroenterology service, Scarborough Hospital.108 Consecutive patients identified as having a discrete mass on diagnostic ultrasound examination of the abdomen.A sample of tissue was obtained with an aseptic technique under local anaesthesia: an 18 steel wire gauge needle (Tru-Cut) was mounted

1990 BMJ : British Medical Journal

3740. A 36-year-old woman with a pulsatile mass of the left tympanic membrane. Full Text available with Trip Pro

A 36-year-old woman with a pulsatile mass of the left tympanic membrane. 2161587 1990 07 11 2018 11 13 0093-0415 152 4 1990 Apr The Western journal of medicine West. J. Med. A 36-year-old woman with a pulsatile mass of the left tympanic membrane. 439-40 Reiser J J University of Arizona Health Sciences Center, Tucson. Danielson K S KS Levy J M JM Zonis R D RD Christensen F K FK eng Case Reports Journal Article United States West J Med 0410504 0093-0415 AIM IM Adult Female Glomus Jugulare Tumor (...) diagnostic imaging therapy Humans Paraganglioma, Extra-Adrenal diagnostic imaging Prognosis Tomography, X-Ray Computed 1990 4 1 1990 4 1 0 1 1990 4 1 0 0 ppublish 2161587 PMC1002389 Postgrad Med. 1982 Aug;72(2):213-4 6285322 Head Neck Surg. 1987 May-Jun;9(5):306-11 3040625 Radiology. 1987 Jun;163(3):801-6 3033738 Clin Radiol. 1986 Jul;37(4):359-64 3015479

1990 Western Journal of Medicine

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