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Venoarterial extracorporeal membrane oxygenation for refractory cardiogenic shock induced by adrenal lesions:a case report and review of the literature

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World Journal of Emergency Medicine 2023年第4期14卷 325-328页

作者： Liping Zhou Xiaoye Mo Guoqing Huang Ping Wu Changshou She Shanshan Hu Ben Liu Zhen Zhao Ning Yang Department of Emergency Medicine Xiangya HospitalCentral South UniversityChangsha 410008China

The adrenal gland secretes a variety of hormones that regulate physiological functions,and adrenal lesions can lead to insidious or sudden onset diseases that are easily misdiagnosed.Recently,several young patients with unknown sudden and refractory cardiogenic shock or cardiac arrest(CA)were successfully treated in our emergency department by the application of venoarterial extracorporeal membrane oxygenation(VA-ECMO).These life-threatening conditions were finally determined to be caused by adrenal lesions,which highlight the bridging role of VA-ECMO.[1]

关键词： adrenal lesions arterial

Anti-inflammatory mechanism of electroacupuncture involves the modulation of multiple systems,levels and targets and is not limited to“driving the vagus-adrenal axis”

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Journal of Integrative Medicine 2023年第4期21卷 320-323页

作者： Arthur Yin Fan American TCM Association ViennaVA 22182USA McLean Center for Complementary and Alternative Medicine PLCViennaVA 22182USA

In October 2021,an international collaborative study on the use of electroacupuncture(EA)to treat inflammation was published in the journal Nature by Dr.Qiufu Ma’s team.Based on the results of EA on inflammation in the mouse model of lipopolysaccharide inflammatory storm,the study showed that the distal effect of acupuncture can be achieved by“driving the vagus-adrenal axis(through the adrenal medulla,by releasing catecholamines).”PROKR2Cre-marked sensory neurons,which innervate the deep hindlimb fascia but not the abdominal fascia,are crucial for driving this axis.The study suggests the existence of specificity distribution of acupoints,that different EA stimulation intensities or different needle penetration depths have different therapeutic effects,that photosensitive stimulation may be a substitute for needle acupuncture,and that massage,stretching and body movements may also activate PROKR2Cremarkable dorsal root ganglion sensory neurons and elicit anti-inflammatory effects.However,results of some other studies are contrary to the conclusions of Ma’s team.For examples:low-intensity EA at GB30 point significantly reduced the inflammation in the rat model of persistent inflammation,which is more relevant to the real daily acupuncture practice,and this effect was partly related to the adrenal cortex and associated with the stimulation of corticosterone and adrenocorticotropic hormone;manual acupuncture(similar to the low-intensity EA)at KI3,Zhichuan point(an extra point),etc.was effective in a severe COVID-19 patient with sepsis;stimulating ST25 with low-intensity EA or manual acupuncture was effective against gastrointestinal inflammations;the above mentioned points are not in an area enriched with PROKR2Cre-marked sensory nerve endings.Evidence shows that the mechanism of EA against inflammation includes modulating multi-systems,multi-levels and multi-targets,which does not limit to“driving the vagus-adrenal axis.”

关键词： Electric acupuncture Acupuncture Anti-inflammation Mechanism adrenal Autonomic nerves

Acute adrenal insufficiency caused by antiphospholipid syndrome

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World Journal of Emergency Medicine 2023年第5期14卷 402-404页

作者： Yunfei Feng Weibin Zhou Daiqiong Fang Department of Endocrinology the First Affi liated HospitalZhejiang University School of MedicineHangzhou 310003China

Antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE) are frequently discussed together and considered two closely related diseases.APS involves multiple organ systems,but APS-related endocrine manifestations are rare.^([1])Among them,adrenal insufficiency (AI) is the first endocrine manifestation of APS.The prompt diagnosis of AI is critical,as this disorder has high morbidity and mortality if left untreated.Here,we report a rare case of acute AI caused by APS secondary to SLE.CASEIn August 2022,a 39-year-old woman without a significant family history of medical diseases presented to our emergency department (ED) for low back pain,nausea,anorexia,fatigue,hypoglycemia,and hypotension.One month prior,she had fatigue,loss of appetite,low back pain,cough with sputum.

关键词： insufficiency adrenal diagnosis

Overview of adrenals Tumors in Dakar Hospitals

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Open Journal of Internal Medicine 2024年第2期14卷 141-150页

作者： Nafy Ndiaye Yakham Mohamed Leye Mouhamadou Moustapha Ndong Ngoné Diaba Diack Amadou Fall Cisse Abdoulaye Leye Baidy Sy Kane Alpha Omar Touré Cherif Mohamed Dial Pape Saloum Diop Internalmedeccine and Endocrinology Department Teaching Hospital of Pikine Dakar Senegal General Surgery Department Aristide Le Dantec Teaching Hospital of Dakar Dakar Senegal Anatomo-Pathology Department General Hospital of Grand Yoff Dakar Dakar Senegal General Surgery Department General Hospital of Grand Yoff Dakar Dakar Senegal

Introduction: adrenal tumours (AT) are commonly encountered in clinical practice. For any patient presenting an adrenal mass, there are two crucial points to consider: is the adrenal mass malignant and is it hormonally active? The objective of our study was to evaluate the epidemiological, diagnostic, therapeutic, and evolutionary aspects of AT in a developing country. Methodology: We conducted a retrospective study spanning 17 years (from January 2005 to October 2022) in four Dakar hospital services. We included all patient medical records with explored AT. Results: AT was diagnosed in 35 patients who had a mean age of 36.62 years (range: 12-79), and a female predominance (26 women to 9 men). Among these patients, 17.2 % had incidental AT. Hypertension was the commonest presenting symptom in 27 patients (77%), which was associated with Mnards triad in 14 patients (40%). Abdominal pain was reported by 20 patients (57%), and 14 presented with an abdominal mass. Among the patients, 29 had functional AT: 22 with pheochromocytoma, 5 with primary hyperaldosteronism, and 2 with hypercortisolism. Imaging evaluations revealed that 33 patients had unilateral AT and one had bilateral AT. Tumour sizes varied, 5 patients had tumours 10 cm. Two patients presented with metastases. The therapeutic approach involved adrenalectomy in 32 patients. Perioperative complications were observed in five patients, including haemorrhage (two patients), hypotension (two cases), and hypertensive crisis (one case). One patient with bilateral pheochromocytoma developed acute adrenal insufficiency postoperatively, followed by abdominal herniation. Histopathological examination confirmed pheochromocytoma in 21 patients, Conns adenoma in 5, adrenocortical carcinoma in 3, cortisol adenoma in 2, and adrenal cyst in 1 patient. Non-functional AT included adrenocortical carcinoma (three patients), adrenal cyst (one patient), and pheochromocytoma (two patients). After a one-year follow-up, 29 patients with benign tumours had favourable outcomes, while

关键词： Tumour adrenal Pheochromocytoma Conn Adrenocortical Carcinoma Dakar

Concurrent laparoscopic management of giant adrenal myelolipoma and contralateral renal cell carcinoma

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Asian Journal of Urology 2022年第1期9卷 97-98页

作者： Tarun Jindal Pravin Pawar Neeraj Subedi Department of Uro-oncology Tata Medical CentreKolkataIndia

Dear editor,Myelolipomas are uncommon,benign tumors of the adrenal gland that can occasionally attain a large size.These tumors,very rarely,can occur along with renal cell carcinoma[1].We describe the first case of a giant right sided adrenal myelolipoma co-existent with a contralateral renal cell carcinoma,both of which could be operated laparoscopically in the same sitting.

关键词： adrenal renal laparoscopic

adrenal metastasis from endometrial cancer: A case report

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World Journal of Clinical Cases 2019年第14期7卷 1844-1849页

作者： Gianfranco Da Dalt Alberto Friziero Andrea Grego Simone Serafini Ambrogio Fassina Stella Blandamura Cosimo Sperti Department of Surgery Oncology and Gastroenterology3rd Surgical ClinicUniversity of Padua Department of Medicine Surgical Pathology and CytopathologyUniversity of Padua

BACKGROUND Metastases to adrenal glands originate principally from lung, breast, or gastrointestinal cancers, followed by malignant melanoma and thyroid neoplasms. We present an unusual case of uterine cancer metastasizing to the adrenal glands with a review of the English literature on the management of this rare disease. CASE SUMMARY A 53-year-old Caucasian woman with a history of endometrial cancer (grade 2;International Federation of Gynecology and Obstetrics III A) was hospitalized in November 2017 for a left adrenal mass found on a follow-up computed tomography scan 3 years after her gynecological surgery. Laboratory test results were normal. A laparoscopic left adrenalectomy was performed. The postoperative course was uneventful, and no chemotherapy was administered. The pathological report confirmed an adrenal endometrioid metastasis. At 36 mo of follow-up, the patient is alive and well, with no evidence of recurrent disease. A literature review identified only 11 previously-published cases of adrenal metastases from uterine cancer. CONCLUSION adrenal metastasis from uterine cancer is very rare. Laparoscopic adrenalectomy may be an effective treatment in selected cases of localized adrenal metastasis.

关键词： adrenal gland adrenal neoplasms Uterine cancer Laparoscopy Laparoscopic surgery Case report

Maternal betaine suppresses adrenal expression of cholesterol trafficking genes and decreases plasma corticosterone concentration in offspring pullets

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Journal of Animal Science and Biotechnology 2020年第1期11卷 241-250页

作者： Halima Abobaker Yun Hu Nagmeldin A.Omer Zhen Hou Abdulrahman A.Idriss Ruqian Zhao MOE Joint International Research Laboratory of Animal Health&Food Safety Nanjing Agricultural UniversityNanjing 210095People’s Republic of China Key Laboratory of Animal Physiology&Biochemistry Nanjing Agricultural UniversityNanjing 210095People’s Republic of China College of Allied Medical Sciences University of Nyala155 NyalaSudan.

Background:Laying hens supplemented with betaine demonstrate activated adrenal steroidogenesis and deposit higher corticosterone(CORT)in the egg yolk.Here we further investigate the effect of maternal betaine on the plasma CORT concentration and adrenal expression of steroidogenic genes in offspring pullets.Results:Maternal betaine significantly reduced(Padrenal expression of vimentin that is involved in trafficking cholesterol to the mitochondria for utilization in offspring pullets.Concurrently,voltage-dependent anion channel 1 and steroidogenic acute regulatory protein,the two mitochondrial proteins involved in cholesterol influx,were both down-regulated at m RNA and protein levels.However,enzymes responsible for steroid syntheses,such as cytochrome P450 family 11 subfamily A member 1 and cytochrome P450 family 21 subfamily A member 2,were significantly(Padrenal gland of pullets derived from betaine-supplemented hens.Furthermore,expression of transcription factors,such as steroidogenic factor-1,sterol regulatory element-binding protein 1 and c AMP response element-binding protein,was significantly(P<0.05)enhanced,together with their downstream target genes,such as 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase,LDL receptor and sterol regulatory element-binding protein cleavage-activating protein.The promoter regions of most steroidogenic genes were significantly(P<0.05)hypomethylated,although methyl transfer enzymes,such as AHCYL,GNMT1 and BHMT were up-regulated.Conclusions:These results indicate that the reduced plasma CORT in betaine-supplemented offspring pullets is linked to suppressed cholesterol trafficking into the mitochondria,despite the activation of cholesterol and corticosteroid synthetic genes associated with promoter hypomethylation.

关键词： adrenal gland Chicken Cholesterol Corticosterone Maternal betaine Steroidogenesis

Metabolism of adrenal androgen and its impacts on prostate cancer after castration

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Chinese Medical Journal 2008年第4期121卷 369-374页

作者： HU Ming-qiu NA Yan-qun Department of Urology Peking University First Hospital Beijing 100034 China

With the extensive utilization of PSA, digital rectum examination and transrectal ultrasound for screening in the aging population, the diagnosis of prostate cancer in China has markedly increased during the past years, particularly in developed regions. It was reported that the prevalence of prostate cancer in Shanghai city from 1973 to 1975 was 1.6/100 000 persons and rose to 7.7/100 000 persons by 2000.

关键词： adrenal androgen prostate cancer

Inhibitory Effects of 20α-Hydroxyprogesterone on Steroid Hydroxylation Reactions of Guinea Pig adrenal Microsomes

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Science China Chemistry 1993年第4期36卷 411-419页

作者：黄德盈 Shiro Kominami Shigeki Takemori Department of Chemistry South Central Institute for National Minorities Wuhan 430074 PRC Faculty of Integrated Arts and Sciences Hiroshima University

Using guinea pig andrenal microsomes, we studied the inhibitory effects of 20α-hydroxyprogesterone on steroid hydroxylation reactions catalyzed by cytochromes P-450. When 17α-hydroxyprogesterone was used as a substrate, 20α-hydroxyprogesterone functioned as a competitive inhibitor on the C17—C20 bond cleavage reaction of P-45017α lyase. The inhibition constant, Ki was 1.37 μmol/L. 20α-hydroxyprogesterone also competitively inhibited the convertion of 17α-bydroxyprogesterone to 11-deoxycortisol by the action of P-450c21. The value of Ki was 1.73μmol/L. When progesterone was used as a substrate, 20α-hydroxyprogesterone inhibited neither the 21-hydroxylation of P-450c21. the C17—C20 bond cleavage, nor 17α-hydroxylation of P-45017α lyase. Based on the seresults, we can deduce that the production of androstenedione from progesterone by the action of P-45017α lyase proceeds through a successive monooxygenase reaction.

关键词： cytochrome P-450c21 cytochrome P-450(17α lyase ) 20α-hydroxyprogesterone adrenal microsome steroidogenesis.