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Adrenal Tissue (adrenal + tissue)
Selected AbstractsAntiphospholipid syndrome and endocrine damage: why bilateral adrenal thrombosis?EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 4 2003Kaspar Berneis Abstract: We describe a rare case of bilateral hemorrhagic infarction of the adrenal glands diagnosed in the context of positive antiphospholipid antibodies (aPL). The patient presented atypical clinical symptoms of adrenal insufficiency. Laboratory investigation showed complete adrenal failure and increased aPL, both manifestations persisted 1 yr after the initial event. MR imaging at baseline was compatible with bilateral hemorrhagic infarction and showed almost complete loss of viable adrenal tissue 1 yr later. Although no direct causal effect can be proved, the sequence of events and the exclusion of other common causes of bilateral adrenal hemorrhage (e.g. tuberculosis, severe coagulation disorder) support an association between aPL and adrenal hemorrhagic infarction. A unique link between particular anatomical characteristics of the adrenal fascicular zone and a novel, previously described, explanation model of aPL-thrombosis is hypothesized. It is based on the properties of late endosomes, which are important organelles participating in cholesterol trafficking and protein sorting within cells and express epitopes recognized by aPL. It would be interesting to investigate adrenal tissue for presence of late endosomes and their aPL relevant epitopes for proof of this tempting hypothesis. Focal accumulation of aPL and isolated, simultaneous, bilateral adrenal infarctions could thus be explained. [source] Osteopontin stimulates invasion of NCI-h295 cells but is not associated with survival in adrenocortical carcinoma,THE JOURNAL OF PATHOLOGY, Issue 2 2009Dirk Weismann Abstract Gene array studies indicated that osteopontin (OPN) mRNA is highly expressed in adrenocortical carcinomas (ACCs). OPN enhances invasiveness, proliferation, and metastasis formation, and is associated with poor survival in some malignant diseases. Integrin ,v,3 has been shown to mediate OPN effects on invasion. In this study, we demonstrated OPN and integrin ,v,3 expression in normal adrenal glands and benign adenomas, with staining seen exclusively in adrenocortical cells as well as even stronger staining in ACC. Western blot analysis confirmed overexpression of OPN in ACC (p < 0.01). With Matrigel invasion assays, we have shown that OPN greatly stimulates the invasiveness of NCI-h295 cells (>six-fold increase, p < 0.001). Transfection with integrin ,v,3 further increased invasiveness after OPN stimulation (p < 0.001). This increase was reversed by the addition of an anti-integrin ,3 antibody, indicating a functional relationship of OPN and integrin ,v,3 in ACC. With tissue arrays, we confirmed high OPN expression in 147 ACC samples. However, no association with survival was seen in Kaplan-Meier analysis including 111 patients with primary tumours graded for OPN staining and follow-up data available. In conclusion, our in vitro data indicate that OPN and integrin ,v,3 may act as a functional complex facilitating the invasiveness of adrenocortical tumours. This relationship remains of relevance to our understanding of carcinogenesis, but further studies are needed to address the physiological and pathological function of OPN in adrenal tissue. Copyright © 2009 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. [source] Expression of Agouti-related Protein (Agrp) and its mRNA in the Hypothalamus and the Adrenal Gland of the Duck (Anas platyrhynchos)ANATOMIA, HISTOLOGIA, EMBRYOLOGIA, Issue 2005N. Mirabella Introduction:, Agouti-related protein (AGRP) is a neuropeptide involved in the control of body weight. Morphological and pharmacological studies have shown that AGRP is implicated in the central control of feeding behaviour acting as an endogenous antagonist of the alpha-melanocyte stimulating hormone (,-MSH), a potent satiety-inducing factor, at the melanocortin 3 (MC3)- and four (MC4)-receptors. Aim:, The aim of the present study was to investigate the expression of AGRP and its mRNA in the hypothalamus and adrenal gland of the duck and, in particular, to establish which type of adrenal tissue is involved in the AGRP synthesis. Methods:, Immunohistochemistry, western blotting, reverse transcriptase (RT)-polimerase chain reaction (PCR). Results and Discussion:, AGRP-immunoreactivity was observed in neurons and nerve fibres in a restricted area of the hypothalamus. AGRP-ir neurons were located in the nucleus infundibularis and distributed ventromedially to the third ventricle in the hypothalamic tuberal region. These neurons were round or, with a lesser extent, elongated in shape. AGRP-ir fibres were seen to project to the median eminence (ME) and anterior periventricular hypothalamus. The AGRP ir-fibres in the ME were distributed in the external layer in close vicinity to the capillaries of the hypothalamo-hypophysial portal system. In the avian adrenal gland, AGRP immunoreactivity was observed in the medullary tissue. A partial sequence of AGRP cDNA was identified using RT-PCR cloning and sequencing. This sequence was highly homologous to the corresponding fragment of the chicken AGRP gene. The western blotting analysis of adrenal gland and hypothalamus tissue extracts showed a well-defined single band with an electrophoretic mobility consistent with the molecular weight of the avian AGRP protein. These results demonstrate that AGRP is expressed in the hypothalamus and adrenal glands of the duck and suggest an involvement of this peptide in the regulation of the melanocortin system in birds. [source] Reoperative adrenal surgery: lessons learntANZ JOURNAL OF SURGERY, Issue 5 2009Charles T. Tan With the widespread use of abdominal imaging, the detection and therefore incidence of adrenal tumours is increasing. The laparoscopic approach to primary surgical resection of adrenal tumours has now become the standard of care. There is scarce published literature regarding the management and outcomes of recurrent adrenal tumours. The aim of the present study was therefore to review the authors' experience with reoperative adrenal surgery. A retrospective review of reoperative adrenalectomy cases identified from the prospectively maintained University of Sydney Endocrine Surgical Unit Database from January 1988 to July 2007 was carried out. There were nine (3.5%) reoperative adrenalectomies in six patients. Two were cases of adrenocortical carcinoma, two involved cases of familial phaeochromocytomas and two cases were due to sporadic phaeochromocytomas. Reoperative adrenal surgery is an uncommon event. During the index surgery for adrenal tumours, all adrenal tissue should be removed and knowledge of the vagaries of adrenal anatomy is essential. Reoperative adrenal surgery is a safe procedure and may confer survival benefit or symptom relief. Lifelong follow up is essential for all patients who have had surgery for functional and malignant adrenal tumours. [source] Retroperitoneoscopic partial adrenalectomy for small adrenal tumours (,1 cm): the Ruijin clinical experience in 88 patientsBJU INTERNATIONAL, Issue 6 2010Xiao-jing Wang Study Type , Therapy (case series) Level of Evidence 4 OBJECTIVE To present our experience of retroperitoneoscopic partial adrenalectomy (RPA) for small adrenal tumours, as with modern imaging methods small adrenal lesions are being diagnosed more commonly, and retroperitoneoscopic adrenal surgery for small adrenal tumours (,1 cm) can be challenging. PATIENTS AND METHODS We retrospectively reviewed the records of 389 consecutive retroperitoneoscopic adrenalectomies from September 2005 to December 2008, 88 of which were small adrenal tumours and treated by RPA. Ultrasonography and computed tomography (CT) were used in all patients before RPA, and magnetic resonance imaging or positron emission tomography/CT in some patients. We used RPA for adrenal tumours and total adrenalectomy for adrenal cancer. During the surgery, the internal part of the adrenal gland close to the retroperitoneum was freed first, and the whole adrenal tissue was dissected completely. The preoperative imaging was important in these procedures. RESULTS There were no deaths; conversions to open surgery were necessary in four patients (4.5%), the reasons being a missing target in two, massive haemorrhage caused by central adrenal vein injury in one, and severe adhesion in one. The mean (range) size of the adrenal tumours was 0.7 (0.5,1.0) cm, including 69 aldosterone-producing adenomas, 11 nonfunctional adrenal adenomas, three Cushing syndrome, two phaeochromocytomas, two myelolipomas and one melanoma. The operative duration in the initial 38 cases was significantly longer than that in the subsequent 50 (P < 0.01). However, there was no significant correlation between estimated blood loss and the number of procedures. Tumour size did not correlate with estimated blood loss and operative duration. There was no significant correlation between body mass index and operative duration. CONCLUSION RPA is a safe, effective and minimally invasive therapeutic option for patients with small adrenal tumours. With improved operative technique the RPA has been completed in more quickly. Freeing the internal part of the adrenal gland close to the retroperitoneum first, and exploring the whole adrenal tissue during surgery are the key points of RPA. The location of the small adrenal tumour can be different from that shown on imaging before surgery, and the abnormality of the adrenal gland should be considered. [source] The cytochrome P450 aromatase lacking exon 5 is associated with a phenotype of nonclassic aromatase deficiency and is also present in normal human steroidogenic tissuesCLINICAL ENDOCRINOLOGY, Issue 5 2007Carolina M. Pepe Summary Objective, The previously described c655G>A mutation of the human cytochrome P450 aromatase gene (P450aro, CYP19) results in aberrant splicing due to disruption of a donor splice site. To explain the phenotype of partial aromatase deficiency observed in a female patient described with this mutation, molecular consequences of the c655G>A mutation were investigated. Design To investigate whether the c655G>A mutation causes an aberrant spliced mRNA lacking exon 5 (,Ex5), P450aro RNA was analysed from the patient's lymphocytes by reverse transcription polymerase chain reaction (RT-PCR) and by splicing assays performed in Y1 cells transfected with a P450aro ,Ex5 expression vector. Aromatase activity of the c655G>A mutant was predicted by three dimensional (3D) protein modelling studies and analysed in transiently transfected Y1 cells. Exon 5 might be predicted as a poorly defined exon suggesting a susceptibility to both splicing mutations and physiological alternative splicing events. Therefore, expression of the ,Ex5 mRNA was also assessed as a possibly naturally occurring alternative splicing transcript in normal human steroidogenic tissues. Patients An aromatase deficient girl was born with ambiguous genitalia. Elevated serum LH, FSH and androgens, as well as cystic ovaries, were found during prepuberty. At the age of 8·4 years, spontaneous breast development and a 194·6 pmol/l serum oestradiol level was observed. Results The ,Ex5 mRNA was found in lymphocytes of the P450aro deficient girl and her father, who was a carrier of the mutation. Mutant minigene expression resulted in complete exon 5 skipping. As expected from 3D protein modelling, ,Ex5 cDNA expression in Y1 cells resulted in loss of P450aro activity. In addition, the ,Ex5 mRNA was present in placenta, prepubertal testis and adrenal tissues. Conclusions Alternative splicing of exon 5 of the CYP19 gene occurs in the wild type (WT) as well as in the c655G>A mutant. We speculate that for the WT it might function as a regulatory mechanism for aromatization, whereas for the mutant a relative prevalence of the shorter over the full-length protein might explain the phenotype of partial aromatase deficiency. [source] | ||||||||||