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Urine Vanillylmandelic Acid

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81. Adrenal Glands (Follow-up)

, arrhythmias, headache, fatigue, visual blurring, sweating and heat intolerance, weight loss, abdominal pain, and polyuria and polydipsia. These symptoms should prompt biochemical testing to confirm excess catecholamine secretion characteristic of pheochromocytoma. Measurement of urinary catecholamines, epinephrine and norepinephrine, and their metabolites (ie, metanephrine, homovanillic acid, and vanillylmandelic acid) in a 24-hour urine collection is a sensitive (>90%) test for the diagnosis (...) , with lesser amounts of sulfates formed. About 75% of these degradation products are excreted in the urine, and the rest is excreted in the stool by means of the bile. Mineralocorticoids Aldosterone accounts for 90% of mineralocorticoid activity, with some activity contributed by deoxycorticosterone, corticosterone, and cortisol. The normal concentration of aldosterone in the blood ranges from 2 to 16 ng/dL supine and from 5 to 41 ng/dL upright, though the concentration exhibits diurnal variation

2014 eMedicine Pediatrics

82. Radiographic Evaluation of the Pediatric Urinary Tract (Diagnosis)

is suspected, perform the appropriate urine studies (homovanillic acid [HVA] and vanillylmandelic acid [VMA]). Cloaca Retrograde genitography and VCUG are helpful in outlining the level of confluence of the urethra, vagina, and colon when surgery is being planned. Baseline renal US is also necessary because renal agenesis, reflux, and megaureter are common associated findings. MRI of the pelvis is an important ancillary study in complex cloacal cases. Cystic kidney disease Multicystic dysplastic kidneys (...) . Dimercaptosuccinic acid scanning DMSA is bound in the cortex of the kidney after injection, revealing relative renal function. It is the criterion test for renal scarring. [ ] A bladder catheter is not required for DMSA scanning, because DMSA is not excreted into the urine. The "top-down" approach has suggested that the DMSA scan be used as the primary test in patients with UTI, in that it selects for patients with renal injury. [ ] Limitations of DMSA scanning include intermittent unavailability and the need

2014 eMedicine Pediatrics

83. Adrenal Carcinoma (Overview)

AC typically present with any of the following: Fever Weight loss Abdominal pain and tenderness Back pain Abdominal fullness Symptoms related to metastases See for more detail. Diagnosis Laboratory studies These include the following: Serum glucose Serum cortisol Serum adrenal androgen Urine adrenal hormone Urine vanillylmandelic acid (VMA) Urine homovanillic acid (HVA) levels Imaging studies Adrenal computed tomography (CT) scanning and magnetic resonance imaging (MRI) are the imaging studies (...) , TP57 , TP16 , H19 , retinoblastoma gene, APC gene, and various deoxyribonucleic acid (DNA) repair ̶ enzyme genes Inhibition of senescence and/or apoptosis: Mutations involving telomerase and/or BCL-2 genes Changes in adrenocortical tissue-specific factors: Mutations involving the genes for StaR, SF-1 (steroidogenic factor), and Dax-1 transcription factor Aberrant expression of receptors to normal adrenocorticotropic agents and ligands: Adrenocorticotropic hormone, angiotensin 2, catecholamines

2014 eMedicine Pediatrics

84. Adrenal Glands (Overview)

, arrhythmias, headache, fatigue, visual blurring, sweating and heat intolerance, weight loss, abdominal pain, and polyuria and polydipsia. These symptoms should prompt biochemical testing to confirm excess catecholamine secretion characteristic of pheochromocytoma. Measurement of urinary catecholamines, epinephrine and norepinephrine, and their metabolites (ie, metanephrine, homovanillic acid, and vanillylmandelic acid) in a 24-hour urine collection is a sensitive (>90%) test for the diagnosis (...) , with lesser amounts of sulfates formed. About 75% of these degradation products are excreted in the urine, and the rest is excreted in the stool by means of the bile. Mineralocorticoids Aldosterone accounts for 90% of mineralocorticoid activity, with some activity contributed by deoxycorticosterone, corticosterone, and cortisol. The normal concentration of aldosterone in the blood ranges from 2 to 16 ng/dL supine and from 5 to 41 ng/dL upright, though the concentration exhibits diurnal variation

2014 eMedicine Pediatrics

85. Adrenal Glands (Treatment)

, arrhythmias, headache, fatigue, visual blurring, sweating and heat intolerance, weight loss, abdominal pain, and polyuria and polydipsia. These symptoms should prompt biochemical testing to confirm excess catecholamine secretion characteristic of pheochromocytoma. Measurement of urinary catecholamines, epinephrine and norepinephrine, and their metabolites (ie, metanephrine, homovanillic acid, and vanillylmandelic acid) in a 24-hour urine collection is a sensitive (>90%) test for the diagnosis (...) , with lesser amounts of sulfates formed. About 75% of these degradation products are excreted in the urine, and the rest is excreted in the stool by means of the bile. Mineralocorticoids Aldosterone accounts for 90% of mineralocorticoid activity, with some activity contributed by deoxycorticosterone, corticosterone, and cortisol. The normal concentration of aldosterone in the blood ranges from 2 to 16 ng/dL supine and from 5 to 41 ng/dL upright, though the concentration exhibits diurnal variation

2014 eMedicine Pediatrics

86. Pediatrics, Anaphylaxis (Overview)

is secreted constitutively by the mast cells. The ratio of total tryptase to β-tryptase can help distinguish systemic mastocytosis from anaphylaxis. A ratio ≤10 implies anaphylaxis, whereas a ratio ≥20 is consistent with systemic mastocytosis. [ ] C1INH, VMA, RAST, and Cutaneous Antigen Testing Other tests that may be useful in distinguishing anaphylaxis from the differential diagnosis include C1 inhibitor functional assay (C1INH) ( ) and urine vanillylmandelic acid (VMA) and serum serotonin levels

2014 eMedicine Emergency Medicine

87. A Pilot Study on ALK Gene Mutations in Neuroblastoma

, and differentiation therapy. Criteria Inclusion Criteria: Diagnosed by clinical criteria(one of below) Proved or maybe as Neuroblastoma by : pathological section Bone meta with 24 hrs urine Vanillylmandelic acid(VMA)or Homovanillic acid(HVA) elevated CT or MRI found tumor around adrenal gland or Neuroblastic tumor Have tumor or blood samples to analyze ALK gene: will operation to remove tumor or biopsy, and will preserve tumor sample;or after operation and have tumor sample preserved;or after operation without (...) acid(mRNA) and protein expression levels of ALK will also be analyzed. The results will be correlated with the clinical characteristics and pathological findings of this NB cohort. technique Prospective cases: Cryopreservation of tumor samples Retrospective cases: Archived tumor Sequencing: point mutation array-based comparative genomic hybridization(aCGH) & MLPA(multiplex ligation-dependent probe amplification):analyze copy number alterations (CNAs) compare to clinical data expected results

2013 Clinical Trials

88. Evaluation of 18F-dopa and 123I-MIBG Uptake in the Patients With Neuroblastoma

Healthy Volunteers: No Sampling Method: Probability Sample Study Population Patients With Neuroblastoma Criteria Inclusion Criteria: (1) Diagnosed by clinical criteria(one of below) Proved as Neuroblastoma by a pathological section Bone meta with 24 hrs urine VMA(Vanillylmandelic acid )or HVA (Homovanillic acid) elevated CT or MRI found tumor around adrenal gland or Neuroblastic tumor (2) Age between 0-30 years old,Body weight over 2.5kg (3) Signed Inform Consent Form Exclusion Criteria: (1)AST (...) Last Update Posted : April 14, 2014 Sponsor: National Taiwan University Hospital Information provided by (Responsible Party): National Taiwan University Hospital Study Details Study Description Go to Brief Summary: Neuroblastic tumors are childhood neoplasms that possess amino acid decarboxylase (AADC) activity and Meta-iodobenzylguanidine(MIBG), they can theoretically be imaged by (18)F-fluorodihydroxyphenylalanine ((18)F-FDOPA) and (123)I-Meta-iodobenzylguanidine((123)I-MIBG) PET, they are new

2013 Clinical Trials

89. Discriminating Pheochromocytomas from Other Adrenal Lesions: The Dilemma of Elevated Catecholamines. Full Text available with Trip Pro

between 1997 and 2011 with elevation of urine or serum catecholamines. A database of clinicopathologic factors was created including preoperative urine and plasma metanephrines, normetanephrines, vanillylmandelic acid, and fractionated catecholamines, and tumor dimensions on imaging and pathology.A total of 70 patients underwent adrenalectomy because of presence of an adrenal mass and elevation of catecholamines or normetanephrines or metanephrines. Of these, 46 had pathologically confirmed (...) Discriminating Pheochromocytomas from Other Adrenal Lesions: The Dilemma of Elevated Catecholamines. Screening tests for pheochromocytoma involve measuring levels of catecholamines in the urine or plasma, which have significant false-positive rates. We reviewed patients with adrenal masses and elevated levels of catecholamines to determine the value of different preoperative tests in diagnosing pheochromocytomas.A retrospective chart review identified patients who underwent adrenalectomy

2013 Annals of Surgical Oncology

90. Multiple Retroperitoneal Paragangliomas Full Text available with Trip Pro

are tumours arising in extra-adrenal paraganglia either in the paravertebral space. We report a rare case of two discrete paragangliomas in the retroperitoneum of a young girl presenting with throbbing headache. Contrast Enhanced CT Abdomen showed the lesions as a large irregular heterogeneous and intensely enhancing mass lesions. Elevated levels of vanillylmandelic acid were found in the Urine. The lesions were removed by surgery and the histopathologic findings of both the lesions confirmed

2012 The Indian journal of surgery

91. A Prospective Study of Expectant Observation as Primary Therapy for Neuroblastoma in Young Infants: A Children's Oncology Group Study. Full Text available with Trip Pro

-week interval. Infants experiencing a 50% increase in the volume of the mass, urine catecholamine values, or an increase in the homovanillic acid to vanillylmandelic acid ratio greater than 2, were referred for surgical resection.Eighty-seven eligible patients were enrolled: 83 elected observation and 4 chose immediate surgery. Sixteen observational patients ultimately had surgery; 8 had International Neuroblastoma Staging System stage 1 neuroblastoma, 2 had higher staged neuroblastoma (2B and 4S (...) that expectant observation could be a safe alternative for infants younger than 6 months who have small adrenal masses.A prospective study of infants younger than 6 months with small adrenal masses and no evidence of spreading beyond the primary tumor was performed at participating Children's Oncology Group institutions. Parents could choose observation or immediate surgical resection. Serial abdominal sonograms and urinary vanillylmandelic acid and homovanillic acid measurements were performed during a 90

2012 Annals of Surgery

92. Prenatal intrarenal neuroblastoma mimicking a mesoblastic nephroma: a case report. (Abstract)

with elevated blood pressure and cardiac failure. Postnatal ultrasound confirmed a left intrarenal tumor with microcalcifications and perirenal adenopathy. An open total left nephrectomy by laparotomy was performed. The pathologic study reported that the mass was an intrarenal neuroblastoma with local and regional invasion. Immediate postoperative urine analysis revealed a high level of vanillylmandelic acid, and blood samples showed high levels of normetanephrine. The purpose of this report (...) is to demonstrate that prenatal intrarenal neuroblastoma can clinically and radiologically mimick a mesoblastic nephroma. High blood pressure, calcifications, and lymphadenopathy on ultrasound should raise the index of suspicion for a possible malignant process. Preoperative measurement of urinary vanillylmandelic acid (VMA) and metanephrines should be performed if the diagnosis is in doubt.Copyright © 2012 Elsevier Inc. All rights reserved.

2012 Journal of Pediatric Surgery

93. Human norepinephrine metabolism: Its evaluation by administration of tritiated norepinephrine Full Text available with Trip Pro

specific activities of norepinephrine and its major catabolites, vanillylmandelic acid, 3-methoxy-4-hydroxyphenylethyleneglycol, and normetanephrine, as well as the cumulative 24 hr isotope excretion were determined. The major endogenous norepinephrine catabolites were also quantitatively assayed. In order to verify the reliability of the isotope label, parallel studies were carried out in two patients to whom norepinephrine-(14)C was administered. Metabolic studies were repeated after (...) Human norepinephrine metabolism: Its evaluation by administration of tritiated norepinephrine It has become increasingly apparent that evaluation of human norepinephrine metabolism simply by assay of catecholamines in urine is inadequate for differentiation of many physiological or pathological states. In an attempt to examine norepinepherine metabolism in the human subject, tritium-labeled d,l-norepinephrine was administered to 11 normal adults and the definitive turnover rates and relative

1971 Journal of Clinical Investigation

94. Study of some biological indices of the state of the sympathoadrenaline system under the effect of polychlorocamphene. Full Text available with Trip Pro

Study of some biological indices of the state of the sympathoadrenaline system under the effect of polychlorocamphene. The effect of exposure to different amounts of polychlorocamphene (toxaphene) on the level of cathecholamines (noradrenalin and adrenalin), their precursors (DOPA and dophamine), and a metabolite (vanillylmandelic acid) in tissues (adrenals, brain, heart) and daily urine in white male rats has been studied. It was established that the single administration of 120 mg/kg

1979 Environmental health perspectives

95. Catecholamine turnover in normotensive and hypertensive man: effects of antiadrenergic drugs Full Text available with Trip Pro

Catecholamine turnover in normotensive and hypertensive man: effects of antiadrenergic drugs Intravenous administration of tritium-labeled 3,4-dihydroxyphenylalanine (dopa) to human subjects resulted in the labeling of endogenous catecholamines and vanillylmandelic acid (VMA). Determination of the changes in specific activity of these compounds with time in fractional collections of urine and in cardiac biopsies from patients undergoing corrective cardiac surgery permitted estimation

1968 Journal of Clinical Investigation

96. Pediatric Cancers - Neuroblastoma

. Diagnosis of neuroblastoma is then confirmed by biopsy of any identified mass. Alternatively, diagnosis can be established without biopsy or surgery of the primary tumor by finding characteristic cancer cells in a bone marrow aspirate or core biopsy plus elevated urinary catecholamine intermediates. These methods of diagnosis are not commonly done but can be useful in situations where biopsy and/or surgery is considered high risk because of patient or tumor characteristics. Urinary vanillylmandelic acid (...) (VMA), homovanillic acid (HVA), or both are elevated in ≥ 90% of patients. A 24-h urine collection can be used, but a spot urine test is usually sufficient. If the primary site of the neuroblastoma is adrenal, it must be differentiated from and other renal masses. It may also need to be differentiated from , hepatoblastoma, lymphoma, and tumors of genital origin. Staging of neuroblastoma The following should be done to evaluate for metastases: Bone marrow aspirates and core biopsies from multiple

2013 Merck Manual (19th Edition)

97. Pheochromocytoma

is hypertensive render the diagnosis extremely unlikely. Measurement of urinary norepinephrine and epinephrine is nearly as accurate. The principal urinary metabolic products of epinephrine and norepinephrine are the metanephrines, vanillylmandelic acid (VMA), and homovanillic acid (HVA). Healthy people excrete only very small amounts of these substances. Normal values for 24 h are as follows: Free epinephrine and norepinephrine < 100 μ g ( < 582 nmol) Total metanephrine < 1.3 mg ( < 7.1 μ mol) VMA < 10 mg (...) of Physiologic pH and Buffers SOCIAL MEDIA Add to Any Platform Loading , MD, University of Oxford; Fellow, Green-Templeton College Click here for Patient Education NOTE: This is the Professional Version. CONSUMERS: Topic Resources A pheochromocytoma is a catecholamine-secreting tumor of chromaffin cells typically located in the adrenals. It causes persistent or paroxysmal hypertension. Diagnosis is by measuring catecholamine products in blood or urine. Imaging tests, especially CT or MRI, help localize

2013 Merck Manual (19th Edition)

98. Diurnal variation of melatonin and cortisol is maintained in non-septic intensive care patients. (Abstract)

nmol/l, mean +/- SD) were higher than at midnight (415 +/- 172 nmol/l; P < 0.0001), and the decrease at midnight was significant also in the patients treated with benzodiazepines. Sympathetic activity was monitored with urine vanillylmandelic acid (VMA). The 12-h VMA excretions did not show a diurnal variation, but a significant positive relationship between the 12-h VMA and aMT6s excretions was observed. The severity of organ dysfunction did not correlate either with the aMT6s and VMA excretion (...) or corticosteroids. Twenty-five of the patients were sedated with benzodiazepines.None.The pattern of melatonin production was monitored by the determination of 6-sulphatoxymelatonin (aMT6s) in urine. The 12-h aMT6s excretions at nights (11.8 +/- 8.9 microg, mean +/- SD) were higher than in the daytime (6.8 +/- 7.5 microg; P < 0.0001), and benzodiazepine treatment did not abolish the diurnal periodicity of aMT6s excretion during the entire 3-day study period. Serum cortisol concentrations at noon (524 +/- 276

2009 Intensive Care Medicine

99. Mental and physical fatigue-related biochemical alterations. (Abstract)

, and blood, saliva, and urine samples were taken.After the fatigue-inducing mental and physical sessions, subjective scores of fatigue were increased. After the fatigue-inducing mental session, the vanillylmandelic acid level in urine was higher and plasma valine level was lower than after the relaxation session. In contrast, after the fatigue-inducing physical session, serum citric acid, triacylglycerol, free fatty acid, ketone bodies, total carnitine, acylcarnitine, uric acid, creatine kinase (...) , aspartate aminotransferase, lactate dehydrogenase, cortisol, dehydroepiandrosterone, dehydroepiandrosterone sulfate, plasma branched-chain amino acids, transforming growth factor-beta1 and -beta2, white blood cell and neutrophil counts, saliva cortisol and amylase, and urine vanillylmandelic acid levels were higher and serum free carnitine and plasma total amino acids and alanine levels were lower than those after the relaxation session.Some mental or physical fatigue-related biochemical changes were

2009 Nutrition (Burbank, Los Angeles County, Calif.) Controlled trial quality: uncertain

100. Effectiveness of screening for neuroblastoma at 6 months of age: a retrospective population-based cohort study. (Abstract)

Effectiveness of screening for neuroblastoma at 6 months of age: a retrospective population-based cohort study. In Japan, a nationwide programme between 1984 and 2003 screened all infants for urinary catecholamine metabolites as a marker for neuroblastoma. Before 1989, this was done by qualitative spot tests for vanillylmandelic acid in urine, and subsequently by quantitative assay with high-performance liquid chromatography (HPLC). However, the Japanese government stopped the mass-screening

2008 Lancet

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