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Adrenal Mass

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3741. Newborn screening for congenital adrenal hyperplasia: additional steroid profile using liquid chromatography-tandem mass spectrometry. Full Text available with Trip Pro

Newborn screening for congenital adrenal hyperplasia: additional steroid profile using liquid chromatography-tandem mass spectrometry. Neonatal screening programs for congenital adrenal hyperplasia (21-CAH) using an immunoassay for 17alpha-hydroxyprogesterone (17-OHP) generate a high rate of positive results attributable to physiological reasons and to cross-reactions with steroids other than 17alpha-OHP, especially in preterm neonates and in critically ill newborns.To increase the specificity (...) of the screening process, we applied a liquid chromatography-tandem mass spectrometry method quantifying 17alpha-OHP, 11-deoxycortisol, 21-deoxycortisol, cortisol, and androstenedione. The steroids were eluted in aqueous solution containing d8-17alpha-OHP and d2-cortisol and quantified in multiple reaction mode.Detection limit was below 1 nmol/liter, and recovery ranged from 64% (androstenedione) to 83% (cortisol). Linearity was proven within a range of 5-100 nmol/liter (cortisol, 12.5-200 nmol/liter

2007 Journal of Clinical Endocrinology and Metabolism

3742. Steroid profiling by tandem mass spectrometry improves the positive predictive value of newborn screening for congenital adrenal hyperplasia. Full Text available with Trip Pro

Steroid profiling by tandem mass spectrometry improves the positive predictive value of newborn screening for congenital adrenal hyperplasia. Congenital adrenal hyperplasia (CAH) is primarily caused by 21-hydroxylase deficiency and leads to an accumulation of 17-hydroxyprogesterone and reduced cortisol levels. Newborn screening for CAH is traditionally based on measuring 17-hydroxyprogesterone by different immunoassays. Despite attempts to adjust cutoff levels for birth weight, gestational age (...) , and stress factors, the positive predictive value for CAH screening remains less than 1%. To improve this situation, we developed a method using liquid chromatography-tandem mass spectrometry to measure 17-hydroxyprogesterone, androstenedione, and cortisol simultaneously in blood spots. A total of 1222 leftover blood spots from six different screening programs using different immunoassays (fluorescent immunoassay and ELISA) were reanalyzed in a blinded fashion by liquid chromatography-tandem mass

2004 Journal of Clinical Endocrinology and Metabolism

3743. Imaging evaluation of the non-functioning indeterminate adrenal mass. (Abstract)

Imaging evaluation of the non-functioning indeterminate adrenal mass. With the increasing use of abdominal cross-sectional imaging in the investigation of patient symptoms and in cancer staging, incidental adrenal masses are frequently detected. The most common clinical question is whether these masses are benign or malignant. Benign adrenal masses such as myelolipomas, lipid-rich adenomas, adrenal cysts and adrenal haemorrhage have pathognomonic imaging findings. However, there remains (...) a significant overlap between the imaging appearances of some lipid-poor adenomas and malignant lesions, particularly metastases and small adrenal carcinomas. Our review looks at the recent advances in computed tomography, magnetic resonance imaging and positron emission tomography, which can be used to assist in the distinction between benign adenomas and malignant lesions of the adrenal gland.

2004 Trends in Endocrinology and Metabolism

3744. Hypertensive crisis in a patient undergoing percutaneous radiofrequency ablation of an adrenal mass under general anesthesia. Full Text available with Trip Pro

Hypertensive crisis in a patient undergoing percutaneous radiofrequency ablation of an adrenal mass under general anesthesia. Radiofrequency ablation (RFA) is an effective therapeutic intervention for a variety of neoplastic lesions. Many of these procedures are conducted with patients under general anesthesia. Although RFA is associated with infrequent complications, it is not without risk. Injury to adjacent normal structures is a major concern during RFA of cancerous lesions. Unintended (...) injury to normal adrenal tissue during RFA of adrenal tumors can lead to hypertensive crisis, a potentially catastrophic complication. Hemodynamic consequences of RFA of primary or metastatic adrenal masses have not been reported. We report a case of hypertensive crisis (249/140 mm Hg), tachycardia, and ventricular arrhythmia in an 82-yr-old woman undergoing RFA of renal cell carcinoma metastatic to the adrenal gland. Anesthesiologists should be aware of this potentially catastrophic complication

2004 Anesthesia and Analgesia

3745. Endoscopic Ultrasound in the Evaluation of Adrenal Masses Full Text available with Trip Pro

Endoscopic Ultrasound in the Evaluation of Adrenal Masses 21960932 2011 11 10 2018 11 13 1554-7914 4 8 2008 Aug Gastroenterology & hepatology Gastroenterol Hepatol (N Y) Endoscopic ultrasound in the evaluation of adrenal masses. 535-7 Eloubeidi Mohamad A MA Associate Professor of Medicine and Pathology Director, Endoscopic Ultrasound Program Division of Gastroenterology and Hepatology University of Alabama, Birmingham. eng Journal Article United States Gastroenterol Hepatol (N Y) 101262648 1554

2008 Gastroenterology & hepatology

3746. The indeterminate adrenal mass in patients with cancer Full Text available with Trip Pro

The indeterminate adrenal mass in patients with cancer With the increasing use of abdominal cross-sectional imaging, incidental adrenal masses are frequently detected. The commonest clinical question is whether these are benign adenomas or malignant primary or secondary masses. The nature of incidentally detected adrenal masses can be determined with a high degree of accuracy using computed tomography (CT) and magnetic resonance imaging (MRI) as benign adrenal masses such as myelolipomas, lipid (...) -rich adenomas, adrenal cysts and adrenal haemorrhage which have pathognomonic imaging findings. However, there remains a significant overlap between the imaging features of some lipid-poor adenomas and malignant lesions. We review the recent advances in CT, MRI and positron emission tomography (PET) which can be used to distinguish between benign adenomas and malignant lesions of the adrenal gland.

2007 Cancer Imaging

3747. Comparison of active renin concentration and plasma renin activity for the diagnosis of primary hyperaldosteronism in patients with an adrenal mass. (Abstract)

Comparison of active renin concentration and plasma renin activity for the diagnosis of primary hyperaldosteronism in patients with an adrenal mass. Plasma aldosterone concentration (PAC) to plasma renin activity (PRA) ratio is an established screening test for primary hyperaldosteronism. Due to the increased recognition of adrenal incidentalomas, reliable parameters are required. Determination of active renin concentration (ARC) in contrast to PRA offers advantages with regard to processing (...) and standardization. The present study compared PRA and ARC under random conditions to establish thresholds for the diagnosis of primary hyperaldosteronism.Fifty patients with various adrenal tumors, including ten patients with aldosterone-secreting adrenal adenomas, as well as ten hypertensive patients and 23 normotensive volunteers were studied. PAC and PRA were measured by radioimmunoassay. ARC was determined by an immunoluminometric assay.Receiver operating curve (ROC) analysis suggested a PAC to ARC ratio

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

3748. Management of the clinically inapparent adrenal mass ("incidentaloma"). (Abstract)

Management of the clinically inapparent adrenal mass ("incidentaloma"). The National Institutes of Health Consensus Development Program convened surgeons, endocrinologists, pathologists, biostatisticians, radiologists, oncologists, and other health care professionals, as well as members of the general public, to address the causes, prevalence, and natural history of clinically inapparent adrenal masses, or "incidentalomas"; the appropriate evaluation and treatment of such masses; and directions (...) for future research. Improvements in abdominal imaging techniques have increased detection of adrenal incidentalomas, and because the prevalence of these masses increases with age, appropriate management of adrenal tumors will be a growing challenge in our aging society. To address six predetermined questions, the 12-member nonfederal, nonadvocate state-of-the-science panel heard presentations from 21 experts in adrenal incidentalomas and consulted a systematic review of medical literature on the topic

2003 Annals of Internal Medicine

3749. Osteosarcoma invading adrenal gland: rare cause of adrenal mass. (Abstract)

Osteosarcoma invading adrenal gland: rare cause of adrenal mass. Adrenal gland metastasis from osteogenic sarcoma is extremely rare and is an atypical location for metastasis. Vascular hepatic exclusion techniques and the use of venovenous bypass with cardiac surgical techniques may be required to resect large adrenal masses that have invaded the inferior vena cava to achieve curative resection. The use of newer chemotherapeutic agents and aggressive surgical resection have prolonged

2005 Urology

3750. CT-scan, MRI and image-guided FNA cytology of incidental adrenal masses. (Abstract)

CT-scan, MRI and image-guided FNA cytology of incidental adrenal masses. The aim of this study was to compare the usefulness of computed tomography (CT)-scan, magnetic resonance imaging (MRI), and fine-needle aspiration (FNA) cytology in patients with incidentally discovered adrenal masses.Thirty-four consecutive patients (six men and 28 women, median age of 47 years, range 26-80) with non-functioning adrenal masses of 2 cm or more (median 3.5 cm, range 2-9) were studied. All patients underwent (...) CT-scan, MRI, and image-guided FNA cytology using spinal-type narrow-gauge needles prior to further procedures. Nineteen patients underwent adrenalectomy.Final pathology showed 13 benign adrenal lesions, four adrenocortical carcinomas, and two unsuspected adrenal metastases. Fifteen patients who did not have surgery were considered definitively as having benign adrenal lesions since the mass was unchanged on CT-scans performed during follow-up. The sensitivity, specificity, and positive

2003 European Journal of Surgical Oncology

3751. Functional molecular mass of rat hepatic lipase in liver, adrenal gland and ovary is different. Full Text available with Trip Pro

Functional molecular mass of rat hepatic lipase in liver, adrenal gland and ovary is different. Lipoprotein lipase (LPL) is functionally active only as a dimer. It is also generally assumed that the highly homologous hepatic lipase functions as a dimer, but no clear evidence has been presented. A hepatic lipase-like activity, also indicated as L-type lipase, is present in adrenal and ovary tissues. This enzyme is thought to originate from the liver and to be identical to hepatic lipase. We (...) determined the functional molecular mass of hepatic lipase in rat liver, adrenal gland and ovary by radiation inactivation, a method for determining the functional size of a protein without the need of prior purification. Samples were exposed to ionizing radiation at -135 degrees C. Hepatic lipase activity in liver homogenate showed a single exponential decay. The functional molecular mass was calculated to be 63 +/- 10 kDa. Hepatic lipase activity in adrenal homogenate was found to have a functional

1996 Biochemical Journal

3752. Adrenal mass with virilisation: importance of endocrine investigation. Full Text available with Trip Pro

Adrenal mass with virilisation: importance of endocrine investigation. 8870581 1996 11 26 2018 11 30 0959-8138 313 7061 1996 Oct 05 BMJ (Clinical research ed.) BMJ Adrenal mass with virilisation: importance of endocrine investigation. 872-3 Nasir J J Michael White Diabetes and Endocrinology Centre, Royal Hull Hospitals. Walton C C eng Case Reports Journal Article Research Support, Non-U.S. Gov't England BMJ 8900488 0959-8138 0 Androgens 0 Steroids AIM IM BMJ. 1997 Jan 18;314(7075):229-30 (...) 9022472 Adolescent Adrenal Cortex Neoplasms complications diagnosis Adrenalectomy Adrenocortical Adenoma complications diagnosis Androgens metabolism Diagnosis, Differential Endocrine System Diseases complications diagnosis Female Humans Steroids therapeutic use Virilism etiology 1996 10 5 1996 10 5 0 1 1996 10 5 0 0 ppublish 8870581 PMC2359047 Clin Radiol. 1986 Mar;37(2):155-60 3698500 Pediatrics. 1981 Aug;68(2):242-6 6267548 Urology. 1985 Jan;25(1):1-7 3966274 Urology. 1985 Nov;26(5):435-40 4060383

1996 BMJ : British Medical Journal

3753. A retroperitoneal bronchogenic cyst: a rare cause of a mass in the adrenal region Full Text available with Trip Pro

A retroperitoneal bronchogenic cyst: a rare cause of a mass in the adrenal region This report documents a bronchogenic cyst presenting as an adrenal tumour in a 51 year old man with persistent epigastric pain. The cyst is regarded as a developmental abnormality of the primitive foregut, which typically occurs in the chest. Subdiaphragmatic, and retroperitoneal locations in particular, are unusual. The differential diagnosis of a bronchogenic cyst in the retroperitoneum includes cystic teratoma

2001 Journal of Clinical Pathology

3754. The incidentally discovered adrenal mass. Full Text available with Trip Pro

The incidentally discovered adrenal mass. With the wider application of increasingly sensitive computed tomographic scans, more adrenal masses will be discovered incidentally. Because benign lesions of the adrenal are much commoner than malignant ones, an approach is needed to determine which incidentally discovered masses should be removed. The history and physical examination may guide the evaluation. Imaging studies and needle biopsies have limited value. If the history and physical findings (...) do not suggest a diagnosis, an approach using the size of the mass, results of any cyst puncture, and a biochemical assessment may determine which patients should have surgery. This approach is based on the relative prevalence of benign and malignant clinically silent adrenal tumors.

1984 Annals of Surgery

3755. Identification of steroids in rat adrenal glands by liquid chromatography-thermospray mass spectrometry. Full Text available with Trip Pro

Identification of steroids in rat adrenal glands by liquid chromatography-thermospray mass spectrometry. Liquid chromatography-thermospray mass spectrometry was applied to identify corticosterone, 11-deoxy-18-hydroxycorticosterone, 18-hydroxycorticosterone and aldosterone as the major corticosteroids in the intracellular and extracellular pools of rat adrenals.

1987 Biochemical Journal

3756. Characterization of adrenal masses using unenhanced CT: an analysis of the CT literature. (Abstract)

Characterization of adrenal masses using unenhanced CT: an analysis of the CT literature. Unenhanced CT scanning can reliably characterize incidentally detected adrenal masses when observers use density measurements of the adrenal gland. However, controversy exists as to the optimal density threshold required to differentiate benign from malignant lesions. This study attempts to establish a consensus by performing a pooled analysis of data found in the CT literature.Ten CT reports were analyzed (...) , from which individual adrenal lesion density measurements were obtained for 495 adrenal lesions (272 benign lesions and 223 malignant lesions). Threshold analysis generated a range of sensitivities and specificities for lesion characterization at different density thresholds.Sensitivity for characterizing a lesion as benign ranged from 47% at a threshold of 2 H to 88% at a threshold of 20 H. Similarly, specificity varied from 100% at a threshold of 2 H to 84% at a threshold of 20 H.The attempt

1998 AJR. American journal of roentgenology

3757. Management of clinically inapparent adrenal mass. (Abstract)

Management of clinically inapparent adrenal mass. 12945556 2003 08 29 2016 03 23 1530-440X 56 2002 Feb Evidence report/technology assessment (Summary) Evid Rep Technol Assess (Summ) Management of clinically inapparent adrenal mass. 1-5 Lau J J Balk E E Rothberg M M Ioannidis J P A JP DeVine D D Chew P P Kupelnick B B Miller K K eng Journal Article Meta-Analysis United States Evid Rep Technol Assess (Summ) 100890218 1530-440X IM Adrenal Gland Neoplasms diagnosis epidemiology physiopathology (...) therapy Adrenal Glands pathology Diagnosis, Differential Evidence-Based Medicine Humans Patient Care Management Prevalence 2003 8 30 5 0 2003 8 30 5 1 2003 8 30 5 0 ppublish 12945556 PMC4781357

2003 Evidence report/technology assessment (Summary)

3758. The diagnosis of congenital adrenal hyperplasia in the newborn by gas chromatography/mass spectrometry analysis of random urine specimens. Full Text available with Trip Pro

The diagnosis of congenital adrenal hyperplasia in the newborn by gas chromatography/mass spectrometry analysis of random urine specimens. Definitive neonatal diagnosis of congenital adrenal hyperplasia (CAH) is frequently complicated by normal 17-hydroxyprogesterone levels in 21-hydroxylase-deficient patients, residual maternal steroids, and other interfering substances in neonatal blood. In an effort to improve the diagnosis, we developed a gas chromatography/mass spectrometry method (...) -hydroxysteroid dehydrogenase deficiencies were used. The throughput for one bench-top gas chromatography/mass spectrometry instrument is 20 samples per day. Thus, this method affords an accurate, rapid, noninvasive means for the differential diagnosis of CAH in the newborn period without the need for invasive testing and ACTH stimulation.

2002 The Journal of clinical endocrinology and metabolism

3759. Comparison of hypothalamus-pituitary-adrenal axis suppression from superpotent topical steroids by standard endocrine function testing and gas chromatographic mass spectrometry. (Abstract)

Comparison of hypothalamus-pituitary-adrenal axis suppression from superpotent topical steroids by standard endocrine function testing and gas chromatographic mass spectrometry. We evaluated 38 males who had psoriasis vulgaris for evidence of hypothalamus-pituitary-adrenal axis suppression (HPAS) during treatment with superpotent topical glucocorticosteroids. All men were treated with 49 g per week of either Betamethasone Diproprionate in an optimized vehicle or Clobetasol Proprionate ointment (...) . Three methods used to assess HPAS were compared. Classic 8 a.m. plasma cortisol measurements, urinary-free cortisol, and 17-hydroxycorticosteroid determinations and gas chromatograph-mass spectrometry (GCMS) quantitation of urinary cortisol metabolites were compared. Values for all methods were obtained just prior to therapy and at days 4, 7, 14, and 21 during therapy and at day 28 after treatment was stopped for 7 d. Plasma cortisol measurements correlated well with other measures of HPAS. GCMS

1988 The Journal of investigative dermatology Controlled trial quality: uncertain

3760. Normal bone mineral density and lean body mass, but increased fat mass, in young adult patients with congenital adrenal hyperplasia. Full Text available with Trip Pro

Normal bone mineral density and lean body mass, but increased fat mass, in young adult patients with congenital adrenal hyperplasia. Patients with congenital adrenal hyperplasia attributable to 21-hydroxylase deficiency are treated with glucocorticoids. Glucocorticoid administration, even in substitution doses, may cause decreased bone mineral density (BMD) and obesity. The purpose of this study was to determine BMD, lean mass, and fat mass in young adult male (M, n = 15) and female (F, n = 15 (...) ) patients with 21-hydroxylase deficiency, who had been treated with currently recommended low doses of glucocorticoids. Measurements were performed with dual-x-ray absorptiometry. In addition, calcaneal ultrasound measurements were performed (broadband ultrasound attenuation and speed of sound). Results were compared with those in age- and sex-matched controls; to adjust for height, lean and fat mass were divided by (height)(2). M and F patients [M, 21.7 +/- 2.4; F, 20.6 +/- 2.9 yr old (mean +/- SD

2003 Journal of Clinical Endocrinology and Metabolism

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