Search

The article in the journal "Cytopathology" discusses a challenging case of small-cell melanoma with isolated adrenal metastasis. A 53-year-old man presented with right hypochondrium pain, weight loss, and loss of appetite. The diagnosis was confirmed through immunocytochemistry, highlighting the deceptive cytomorphologic features of small-cell melanoma. The patient received palliative radiotherapy and chemotherapy but unfortunately succumbed to the disease, showcasing the aggressive nature of small-cell melanoma metastases. [Extracted from the article]

Calcineurin inhibitors (CnIs) are effective immunosuppressants with decades of accumulated experience in treating immune disorders and, most notably, solid organ transplantation. While CnIs have significantly increased graft survival and transformed the patient standard of care, their use has been overshadowed by a number of undesired side effects. For instance, CnI‐associated nephrotoxicity has been reported since early studies and remains a major therapeutic concern. The occurrence of several ion imbalances alongside hypertension was also noted early on, indicating the involvement of the renin–angiotensin–aldosterone system (RAAS) in CnI‐mediated toxicity. However, the literature in this field is crowded with conflicting reports from clinical trials as well as studies using animal and invitro models. With this review, we aim to provide a structured and updated overview of the physiological and pathophysiological evidence supporting the involvement of the classical RAAS in CnI‐associated toxicity. [ABSTRACT FROM AUTHOR]

Aging progresses through the interaction of metabolic processes, including changes in the immune and endocrine systems. Glucocorticoids (GCs), which are regulated by the hypothalamic–pituitary–adrenal (HPA) axis, play an important role in regulating metabolism and immune responses. However, the age‐related changes in the secretion mechanisms of GCs remain elusive. Here, we found that corticosterone (CORT) secretion follows a circadian rhythm in young mice, whereas it oversecreted throughout the day in aged mice >18 months old, resulting in the disappearance of diurnal variation. Furthermore, senescent cells progressively accumulated in the zF of the adrenal gland as mice aged beyond 18 months. This accumulation was accompanied by an increase in the number of Ad4BP/SF1 (SF1), a key transcription factor, strongly expressing cells (SF1‐high positive: HP). Removal of senescent cells with senolytics, dasatinib, and quercetin resulted in the reduction of the number of SF1‐HP cells and recovery of CORT diurnal oscillation in 24‐month‐old mice. Similarly, administration of a neutralizing antibody against IL1β, which was found to be strongly expressed in the adrenocortical cells of the zF, resulted in a marked decrease in SF1‐HP cells and restoration of the CORT circadian rhythm. Our findings suggest that the disappearance of CORT diurnal oscillation is a characteristic of aging individuals and is caused by the secretion of IL1β, one of the SASPs, from senescent cells that accumulate in the zF of the adrenal cortex. These findings provide a novel insight into aging. Age‐related hypersecretory GCs could be a potential therapeutic target for aging‐related diseases. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to demonstrate the establishment of adrenal sparing in intrauterine growth restricted (IUGR) human fetuses. IUGR fetuses are a subgroup of small for gestational age (SGA) fetuses that are unable to reach their own growth potential because of chronic hypoxia and undernutrition. We hypothesized that in IUGR fetuses the adrenal gland is relatively larger and secretion of noradrenaline (NA), adrenaline (A), and cortisol is increased. Study Design: This is a prospective observational study including 65 singleton pregnancies (42 IUGR and 23 controls). Using two‐dimensional ultrasound, we measured fetal adrenal diameters and adrenal/abdominal circumference (AD/AC) ratio between 25 and 37 weeks. We considered only one measurement per fetus. In 21 pregnancies we also measured NA, A, and cortisol levels in arterial and venous fetal cord blood collected at the time of delivery. Results: The AD/AC ratio was significantly higher in IUGR fetuses than in controls. Cord NA and A levels were significantly higher in IUGR fetuses than in controls. An increase in cortisol secretion in IUGR fetuses was observed but the difference was not statistically significant. Conclusions: Adrenal sparing correlates with a relative increase in adrenal measurements and function. Synopsis: The adrenal gland of intrauterine growth‐restricted fetuses is relatively larger compared with controls and its function is enhanced. [ABSTRACT FROM AUTHOR]

Canine adrenal gland volume can be predicted based on body weight and computed tomography (CT) measurements using a validated algorithm. Use of this algorithm to detect adrenal pathology, including hyperplasia, hypoplasia and neoplasia, in clinical cases has not been described. The objective of this study was to illustrate application of the algorithm by estimating subject‐specific adrenal gland volume in a historical cohort of dogs with known adrenal disease. Forty‐six dogs that underwent CT and subsequent adrenalectomy were included. Clinical records and CT images from dogs that underwent adrenalectomy and histologic examination of the excised adrenal gland(s) were reviewed. Normal adrenal gland volumes for each dog were estimated using the algorithm, and compared with measured volumes of the affected glands. Linear measurement of the largest lesion diameter was also recorded. Fifty‐eight adrenal glands were removed from 46 dogs, with pathology confirmed in all glands. Pathology included 28 adenomas, 13 carcinomas, 11 pheochromocytomas and 6 other benign pathologies. The volume of all removed adrenal glands was measured to be larger than the expected normal volume estimated by the algorithm, ranging from 1.1 to 212.9 times larger than estimated. Adrenal glands with malignant and benign pathology showed variable volumes with overlapping ranges recorded. Assessment of the dimensions of any focal lesion against a cut‐off of 20 mm failed to discriminate malignancy. This study illustrates and supports the application of a validated volumetric algorithm for estimation of subject‐specific adrenal gland volume to identify the presence of pathology and as a tool to assist clinical decision‐making. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Patients presenting with abdominal pain and retroperitoneal mass in radiographic images may be in the early stages of primary adrenal mantle cell lymphoma, which requires histological studies for a definite diagnosis. This report presents a 37‐year‐old woman complaining of ambiguous abdominal pain, with imaging findings revealing a retroperitoneal abdominal mass on the left side of the aorta, and a possible diagnosis of non‐functional retroperitoneal paraganglioma. Total laparoscopic excision was performed. Surprisingly, histological examinations revealed features in favor of mantle cell lymphoma. [ABSTRACT FROM AUTHOR]

The global challenge of male infertility is escalating, notably due to the decreased testosterone (T) synthesis in testicular Leydig cells under stress, underscoring the critical need for a more profound understanding of its regulatory mechanisms. CREBZF, a novel basic region‐leucine zipper transcription factor, regulates testosterone synthesis in mouse Leydig cells in vitro; however, further validation through in vivo experiments is essential. Our study utilized Cyp17a1‐Cre to knock out CREBZF in androgen‐synthesis cells and explored the physiological roles of CREBZF in fertility, steroid hormone synthesis, and behaviors in adult male mice. Conditional knockout (cKO) CREBZF did not affect fertility and serum testosterone level in male mice. Primary Leydig cells isolated from CREBZF‐cKO mice showed impaired testosterone secretion and decreased mRNA levels of Star, Cyp17a1, and Hsd3b1. Loss of CREBZF resulted in thickening of the adrenal cortex, especially X‐zone, with elevated serum corticosterone and dehydroepiandrosterone levels and decreased serum dehydroepiandrosterone sulfate levels. Immunohistochemical staining revealed increased expression of StAR, Cyp11a1, and 17β‐Hsd3 in the adrenal cortex of CREBZF‐cKO mice, while the expression of AR was significantly reduced. Along with the histological changes and abnormal steroid levels in the adrenal gland, CREBZF‐cKO mice showed higher anxiety‐like behavior and impaired memory in the elevated plus maze and Barnes maze, respectively. In summary, CREBZF is dispensable for fertility, and CREBZF deficiency in Leydig cells promotes adrenal function in adult male mice. These results shed light on the requirement of CREBZF for fertility, adrenal steroid synthesis, and stress response in adult male mice, and contribute to understanding the crosstalk between testes and adrenal glands. [ABSTRACT FROM AUTHOR]

The present study aimed to unravel the possible adverse effects of methomyl on the developing adrenal gland of rat fetuses and pups. Additionally, this study explored the potential improving effects of propolis against these possible hazards induced by methomyl exposure. To achieve that, pregnant rats were divided into four groups: control group, received 1 mL distilled water, propolis group, received 1 mL propolis at a dose of 300 mg/kg, methomyl group, received 1 mL methomyl at a dose of 2 mg/kg, and combined group, received 1 mL methomyl followed by 1 mL propolis, an hour later at the same previous doses. The results revealed that methomyl exposure, during pregnancy and lactation, induced many histological and ultrastructural changes, caused DNA damage and downregulated the expression of steroidogenic acute regulatory (StAR) and CYP11B2 genes in the adrenal glands of both rat fetuses and pups. Interestingly, propolis supplementation demonstrated a remarkable ability to mitigate these deleterious effects and restored the histology and ultrastructure architecture of the adrenal glands of both fetuses and pups, as well as decreased DNA damage and upregulated the expression of StAR and CYP11B2 genes in the adrenal gland of rat fetuses and pups. In conclusion, our study highlights the potential hazardous impact of methomyl exposure during pregnancy and lactation on the development of the adrenal gland in rat fetuses and pups, moreover, the study presents a new approach to alleviate these effects through propolis administration which could be used as a dietary supplement to mitigate the adverse effects of methomyl exposure. Research Highlight: The methomyl and/or propolis were either orally administered to pregnant rats from 6th to 15th day of pregnancy or to lactating mothers from Day 1 to 14 postnatal. Methomyl altered the histological and ultrastructure of the adrenal glands of rat fetuses and pups. In addition, methomyl decreased the mRNA expression of steroidogenic acute regulatory and CYP11b2 genes and increased DNA damage. On the contrary, propolis ameliorated most of these effects. [ABSTRACT FROM AUTHOR]

The adrenal glands play a key role in maintaining the physiological balance of birds and helping them to survive environmental changes. The objective of the present work was to give a detailed investigation of the histological, ultrastructural, and immunohistochemical findings of the adrenal gland in Japanese quail during the prehatching phase. The current study was performed on 45 healthy Japanese quail embryos at different prehatching periods. Our results showed the primordium of the quail's adrenocortical tissue appeared at 3 days of incubation as a thickening of the splanchnic mesoderm. The prospective chromaffin cells appeared at 5 days as clusters of cells migrated from the neural crest cells along the dorsal aorta toward the interrenal tissue. TH immunoreactivity was observed in the neural crest cells during their migration toward the adrenal primordium. Furthermore, these TH immunopositive cells were intermingled with the developing interrenal cell cords that developed from the coelomic epithelium. NSE immunostaining was detected within the cytoplasm of interrenal cells, chromaffin cells, and ganglion cells. Sox10 is expressed in chromaffin and ganglion cells with different staining intensities. On the 13th day of prehatching, both interrenal and chromaffin cells were β‐catenin immunonegative, but on the 17th day, both cells were immunopositively. Our findings show that during prenatal life, the adrenal gland undergoes significant morphological changes. Together, the present data suggest that studying the prenatal development of the adrenal gland in birds is important for advancing our understanding of this critical organ and its functions. Research Highlights: The present study aimed to give a detailed study of the histological, ultrastructural, and immunohistochemical investigations of the adrenal gland in Japanese quail during the prehatching period.The interrenal primordium was observed on the third embryonic day, on the fifth ED the primordium of the chromaffin tissue appeared as row of migrating neural crest cell.At the ultrastructural level, the interrenal cells take steroid‐secreting cells characters, they have varying amounts of lipid droplets and abundant mitochondria at 15th ED contained moderate number of lysosomes and mitochondria. [ABSTRACT FROM AUTHOR]

Introduction: Spontaneous preterm birth prior to 32 weeks' gestation accounts for 1% of all deliveries and is associated with high rates of morbidity and mortality. A total of 70% are associated with chorioamnionitis which increases the incidence of morbidity, but for which there is no noninvasive antenatal test. Fetal adrenal glands produce cortisol and dehydroepiandosterone‐sulphate which upregulate prior to spontaneous preterm birth. Ultrasound suggests that adrenal volumes may increase prior to preterm birth, but studies are limited. This study aimed to: (i) demonstrate reproducibility of magnetic resonance imaging (MRI) derived adrenal volumetry; (ii) derive normal ranges of total adrenal volumes, and adrenal: body volume for normal; (iii) compare with those who have spontaneous very preterm birth; and (iv) correlate with histopathological chorioamnionitis. Material and methods: Patients at high risk of preterm birth prior to 32 weeks were prospectively recruited, and included if they did deliver prior to 32 weeks; a control group who delivered an uncomplicated pregnancy at term was also recruited. T2 weighted images of the entire uterus were obtained, and a deformable slice‐to‐volume method was used to reconstruct the fetal abdomen. Adrenal and body volumes were obtained via manual segmentation, and adrenal: body volume ratios generated. Normal ranges were created using control data. Differences between groups were investigated accounting for the effect of gestation by use of regression analysis. Placental histopathology was reviewed for pregnancies delivering preterm. Results: A total of 56 controls and 26 cases were included in the analysis. Volumetry was consistent between observers. Adrenal volumes were not higher in the case group (p = 0.2); adrenal: body volume ratios were higher (p = 0.011), persisting in the presence of chorioamnionitis (p = 0.017). A cluster of three pairs of adrenal glands below the fifth centile were noted among the cases all of whom had a protracted period at risk of preterm birth prior to MRI. Conclusions: Adrenal: body volume ratios are significantly larger in fetuses who go on to deliver preterm than those delivering at term. Adrenal volumes were not significantly larger, we hypothesize that this could be due to an adrenal atrophy in fetuses with fulminating chorioamnionitis. A straightforward relationship of adrenal size being increased prior to preterm birth should not be assumed. [ABSTRACT FROM AUTHOR]

Aims: Anastomosing haemangioma is a rare benign vascular neoplasm that may histologically mimic angiosarcoma. We report the largest single institution series of anastomosing haemangioma in the adrenal gland with emphasis on clinical and radiological features. Methods and results: Our laboratory information system was searched for a 25‐year period (1999–2023), yielding seven cases confirmed as anastomosing haemangioma of the adrenal gland after pathological re‐review. Clinical, radiological and pathological information was obtained from medical charts and submitting pathologists. Of a total of seven patients, four (57.1%) were men and three women, ranging in age from 37 to 75 years (mean = 61). Six of seven patients underwent adrenalectomies and one had radical nephrectomy. Tumours ranged from 0.7 to 6.4 cm (mean = 2.1 cm) and five of seven (71%) were grossly well‐circumscribed. Five of seven lesions were found incidentally at imaging for other indications. All tumours were unifocal except one, which presented with multifocal disease with a concurrent adjacent retroperitoneal anastomosing haemangioma. Three of five tumours imaged with contrast enhancement were almost completely hyperenhancing with a small central non‐enhancing portion, features overlapping with pheochromocytoma. One of seven tumours involved the peri‐adrenal adipose tissue with a focally infiltrative pattern. There were no recurrences or metastases in six patients with available follow‐up data (median = 95 months). Conclusions: Benign anastomosing haemangiomas of the adrenal gland tend to occur in older patients, may mimic pheochromocytoma on imaging and must be distinguished from angiosarcoma pathologically. Better awareness of this entity by pathologists, radiologists and surgeons is crucial to appropriate work‐up, diagnosis and management. [ABSTRACT FROM AUTHOR]

Background: A prediction tool was developed and internally validated to aid the diagnosis of Cushing's syndrome in dogs attending UK primary‐care practices. External validation is an important part of model validation to assess model performance when used in different populations. Objectives: To assess the original prediction model's transportability, applicability, and diagnostic performance in a secondary‐care practice in the Netherlands. Animals: Two hundred thirty client‐owned dogs. Methods: Retrospective observational study. Medical records of dogs under investigation of Cushing's syndrome between 2011 and 2020 were reviewed. Dogs diagnosed with Cushing's syndrome by the attending internists and fulfilling ALIVE criteria were defined as cases, others as non‐cases. All dogs were scored using the aforementioned prediction tool. Dog characteristics and predictor‐outcome effects in development and validation data sets were compared to assess model transportability. Calibration and discrimination were examined to assess model performance. Results: Eighty of 230 dogs were defined as cases. Significant differences in dog characteristics were found between UK primary‐care and Dutch secondary‐care populations. Not all predictors from the original model were confirmed to be significant predictors in the validation sample. The model systematically overestimated the probability of having Cushing's syndrome (a = −1.10, P <.001). Calibration slope was 1.35 and discrimination proved excellent (area under the receiver operating curve = 0.83). Conclusions and Clinical Importance: The prediction model had moderate transportability, excellent discriminatory ability, and overall overestimated probability of having Cushing's syndrome. This study confirms its utility, though emphasizes that ongoing validation efforts of disease prediction tools are a worthwhile effort. [ABSTRACT FROM AUTHOR]

The adrenal glands are paired abdominal endocrine organs vital to the bird's health. The present research aimed to provide a comprehensive examination of the histological, ultrastructural, and immunohistochemical investigations of the adrenal gland in Japanese quail during the post hatching period. The current study was performed on 21 healthy Japanese quail chicks at different post hatching periods. Our results showed the adrenal gland is surrounded by a connective tissue capsule, which consists of dense collagen fibers containing large blood vessels, chromaffin cells, autonomic ganglia, fibroblasts, and migrating Schwann cells. The zonation of the adrenal gland is composed of a subcapsular layer, a peripheral zone, and a central zone, which gets more pronounced with age. At the ultrastructural level, the interrenal cells take the steroid‐secreting cells characters; they have varying amounts of lipid droplets and abundant mitochondria. Adrenal medullary chromaffin cells showed positive immunoreactivity to the NSE. With increasing age, the chromaffin tissue's Sox10 immunoreactivity increased. β‐catenin is expressed within the plasmalemma and the cytoplasm of the interrenal and chromaffin cells and its reactivity increased with age, especially in the chromaffin cells. Our results indicate the adrenal gland undergoes significant morphological changes during the postnatal life. Overall, the postnatal period is an important time for the development and maturation of the adrenal glands. [ABSTRACT FROM AUTHOR]

Primary adrenal insufficiency is a life‐threatening disorder, which requires lifelong hormone replacement therapy. Transplantation of xenogeneic adrenal cells is a potential alternative approach for the treatment of adrenal insufficiency. For a successful outcome of this replacement therapy, transplanted cells should provide adequate hormone secretion and respond to adrenal physiological stimuli. Here, we describe the generation and characterization of primary porcine adrenal spheroids capable of replacing the function of adrenal glands in vivo. Cells within the spheroids morphologically resembled adult adrenocortical cells and synthesized and secreted adrenal steroid hormones in a regulated manner. Moreover, the embedding of the spheroids in alginate led to the formation of cellular elongations of steroidogenic cells migrating centripetally towards the inner part of the slab, similar to zona Fasciculata cells in the intact organ. Finally, transplantation of adrenal spheroids in adrenalectomized SCID mice reversed the adrenal insufficiency phenotype, which significantly improved animals' survival. Overall, such adrenal models could be employed for disease modeling and drug testing, and represent the first step toward potential clinical trials in the future. [ABSTRACT FROM AUTHOR]

Background: In a previous study, telmisartan suppressed aldosterone secretion in healthy cats but not in cats with primary hyperaldosteronism (PHA). Hypotheses: Telmisartan suppresses aldosterone secretion in middle‐aged healthy cat and cats with diseases that may result in secondary hyperaldosteronism, but not in those with PHA. Animals: Thirty‐eight cats: 5 with PHA; 16 with chronic kidney disease (CKD), subclassified as hypertensive (CKD‐H) or non‐hypertensive (CKD‐NH); 9 with hyperthyroidism (HTH); 2 with idiopathic systemic arterial hypertension (ISH); and 6 healthy middle‐aged cats. Methods: Prospective, cross‐sectional study. Serum aldosterone concentration, potassium concentration, and systolic blood pressure were measured before and 1 and 1.5 hours after PO administration of 2 mg/kg of telmisartan. The aldosterone variation rate (AVR) was calculated for each cat. Results: No significant difference in the minimum AVR was observed among groups (median [quartile 1 (Q1); quartile 3 (Q3)]: 25 [0; 30]; 5 [−27; −75]; 10 [−6; −95]; 53 [19; 86]; 29 [5; 78]) for PHA, CKD, HTH, ISH, and healthy cats, respectively (P =.05). Basal serum aldosterone concentration (pmol/L) was significantly higher in PHA cats (median [Q1; Q3]: 2914 [2789; 4600]) than in CKD‐H cats (median [Q1; Q3]: 239 [189; 577], corrected P value =.003) and CKD‐NH cats (median [Q1; Q3]: 353 [136; 1371], corrected P value =.004). Conclusions and Clinical Importance: The oral telmisartan suppression test using a single dose of 2 mg/kg telmisartan did not discriminate cats with PHA from healthy middle‐aged cats or cats with diseases that may result in secondary hyperaldosteronism. [ABSTRACT FROM AUTHOR]

Background: Radiotherapy (RT) is an effective treatment for dogs presented with neurologic signs caused by pituitary tumors. However, its impact on the outcome of concurrent pituitary‐dependent hypercortisolism (PDH) is controversial. Objectives: Determine whether dogs with PDH have longer survival after pituitary RT compared with dogs with nonhormonally active pituitary masses and to evaluate whether clinical, imaging, and RT variables affect survival. Animals: Ninety‐four dogs divided into 2 groups: PDH and non‐PDH, based on the presence of hypercortisolism. Forty‐seven dogs were allocated to the PDH group and 47 to the non‐PDH group. Methods: Retrospective cohort study in which clinical records of dogs undergoing RT for pituitary macroadenomas between 2008 and 2018 at 5 referral centers were retrospectively evaluated. Results: Survival was not statistically different between PDH and non‐PDH groups (median survival time [MST], 590 days; 95% confidence interval [CI], 0‐830 days and 738 days; 95% CI, 373‐1103 days, respectively; P =.4). A definitive RT protocol was statistically associated with longer survival compared with a palliative protocol (MST 605 vs 262 days, P =.05). The only factor statistically associated with survival from multivariate Cox proportional hazard analysis was total radiation dose (Gy) delivered (P <.01). Conclusions and Clinical Importance: No statistical difference in survival was identified between the PDH and non‐PDH groups, and longer survival was associated with higher Gy delivered. [ABSTRACT FROM AUTHOR]

A wide range has been reported for the ultrasonographic measurements of the normal adrenal gland in rabbits. Therefore, having sufficient information about the normal measurements of the adrenal gland and their relationship with indicators such as weight, sex and the diameter of the internal abdominal aorta will be of great help in diagnosing diseases of the adrenal gland. In the present study, 21 healthy adult intact rabbits were selected. The abdominal cavity of the animals was examined using ultrasound; adrenal gland parameters such as length, width, height, circumference and area on the right and left sides were measured in both sagittal and transverse planes. Additionally, the diameter of the abdominal aorta in the sagittal plane was imaged. After statistical analysis, the parameters of the adrenal glands on the right and left showed a positive significant correlation with the weight and the diameter of the abdominal aorta, although no significant correlation was found between these parameters and sex. The ratio of adrenal gland parameters to abdominal aortic diameter was calculated and the statistical analysis of the values showed that, except for the ratio of left adrenal area to aortic diameter, the other ratio of adrenal gland parameters to abdominal aortic diameter was not significantly related to weight. Therefore, these ratios can be used as suitable indicators for assessing the change in size of the adrenal gland of rabbits of different sizes. Knowing the relationship between normal adrenal measurements and the indices such as weight, sex and diameter of the abdominal aorta can help clinicians and researchers evaluate the changes in the size of the adrenal gland. [ABSTRACT FROM AUTHOR]

We present a patient referred for investigation of adrenal insufficiency, confirmed due to disseminated paracoccidioidomycosis (PCM), with abdominal and central nervous system (CNS) involvement. Establishing the pathogenesis and immunological processes involved in chronic or latent infections by PCM has been challenging. Medical doctors caring for patients with immunodeficiencies should learn about these fungal infections to properly guide travel planning and have this possibility in the diagnostic arsenal when the patient returns from endemic areas. After 13 months of treatment, the patient showed good clinical evolution, and we repeated imaging exams, showing partial improvement of the preview lesions. Diagnosis and treatment can prevent catastrophic events. [ABSTRACT FROM AUTHOR]

Introduction: Approximately 1% of the UK population is prescribed oral corticosteroids at any one time. It is not known how many of these patients present for major surgery. We aimed to establish the prevalence, characteristics and outcomes of patients taking oral corticosteroids., Methods: We identified patients aged > 18 y undergoing major surgery between 1 April 2010 and 31 March 2020 from Hospital Episode Statistics with linked Clinical Practice Research Datalink data and the Office for National Statistics Mortality register in England. Prescribing data were used to define three sets of patients: 'low-dose' - taking ≤ 7.5 mg oral prednisolone equivalents per day for at least 28/91 days before surgery; 'high-dose' - taking > 7.5 mg oral prednisolone equivalents per day for at least 28/ 91 days before surgery; and a 'no-steroids' group. We used ≤ 7.5 mg of prednisolone equivalents per day as our threshold, as this would likely exclude almost all patients who were taking corticosteroids as replacement for absolute adrenal/pituitary deficiency., Results: We identified 1,999,326 adult patients for inclusion in the dataset: 1,929,291 (96.5%) in the no-steroids; 63,353 (3.2%) in the low-dose group; and 6682 (0.3%) in the high-dose group. Median (IQR [range]) duration of hospital stay increased with increasing dose of corticosteroid (no-steroid 3 (0-14 [0-14,739]); low-dose 5 (1-26 [1-8079]); and high-dose 7 (2-28 [0-6956]) days). Mortality after the index surgery was 1.5%, 3.8% and 8.9% at 30 days and 5.5%, 11.6% and 39.9% at 1 year for no-steroids, low-dose and high-dose groups, respectively., Conclusion: Around 1 in 29 patients undergoing major surgery are taking oral corticosteroids for > 28 days in the 3 months before major surgery. Their outcomes are poor and warrant highlighting within care pathways to aid risk prediction and mitigation., (© 2025 The Author(s). Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists.)

Background: Clinical findings of glucocorticoid‐deficient hypoadrenocorticism (GDH) can overlap with other diseases, presenting a diagnostic challenge. Objectives: Describe clinicopathologic and ultrasonographic features of dogs with GDH and those suspected of having GDH that had the disease ruled out. Animals: Six hundred twenty‐three dogs. Methods: Records from dogs with suspected GDH between 2003 and 2018 were reviewed. Dogs with hyperkalemia or hyponatremia were excluded. Dogs were categorized as controls when the resting serum cortisol or post‐ACTH cortisol concentration were > 2 μg/dL. Clinicopathologic and ultrasonographic features were compared between groups. The optimal cut‐point, area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were calculated for individual features used to detect GDH. Results: Dogs were categorized as GDH (n = 29) or controls (n = 594). Lymphocyte count (>1750 cells/L; sensitivity, 96.6%; 95% confidence interval [CI], 82.8%‐99.8%; specificity, 60.3%; 95% CI, 56.3%‐64.1%; AUC, 0.828; 95% CI, 0.762‐0.894) and albumin/globulin ratio (<1.081; sensitivity, 86.2%; 95% CI, 69.4%‐94.5%; specificity, 78.8%; 95% CI, 75.3%‐81.9%; AUC, 0.886; 95% CI, 0.827‐0.944) had the highest discriminatory power between groups. Left adrenal gland width <0.39 cm was 80% (95% CI, 58.4%‐91.9%) sensitive and 82.4% (95% CI, 74.2‐88.4) specific for GDH. Serum cobalamin concentrations and ultrasonographic abnormalities of the GI tract were not different between groups. Conclusion and Clinical Importance: No single variable could be used to confidently rule out GDH and obviate the need for cortisol testing in dogs with a clinical presentation consistent with GDH. [ABSTRACT FROM AUTHOR]

Molybdenum is an essential dietary trace element required for several critical enzyme systems. High intake is associated with toxicity in ruminants and animal studies. The proposed therapeutic use of molybdenum‐based drugs poses a potential risk for accumulation through chronic administration of therapeutic doses of this element. The current experiment was designed to study the effect of daily dosing of a molybdenum compound, bis‐choline tetrathiomolybdate (TTM), in Sprague Dawley rats using laser ablation inductively coupled plasma time‐of‐flight mass spectrometry (LA‐ICP‐ToF‐MS) and two dosing levels of TTM for up to 3 months. To investigate if molybdenum accumulation was associated with tissue toxicity, histopathology, haematology and clinical biochemistry markers of toxicity were incorporated into the study design. There were no behavioural signs of toxicity to the rats, and no clinical or anatomic pathology was associated with treatment. The current data did show a progressive accumulation of molybdenum within the adrenal gland, kidneys, liver, spleen, brain and testes. Although this was not associated with tissue toxicity within the 3‐month study design, greater exposure over a longer period of time has the potential for producing adverse pathophysiological cellular function. Tissue toxicity, as a result of local excessive accumulation of molybdenum over time, has clear implications for the therapeutic use of molybdenum in humans and demands sensitive monitoring of tissue molybdenum levels to avoid toxicity. The current study highlights the shortcomings of conventional biomonitoring approaches to detect molybdenum accumulation with the goal of avoiding molybdenum‐associated toxicity. Following daily oral dosing of rats with bis‐choline tetrathiomolybdate, molybdenum for 3 months, accumulation was observed in the adrenal gland, kidneys, liver, spleen, brain and testes using laser ablation inductively coupled plasma time‐of‐flight mass spectrometry. Although this accumulation was not associated with adverse histopathology over the period of study, pigment accumulation, corresponding to the presence of molybdenum, was observed in phagocytic cells in all of the affected organs. Because this therapeutic is used in human medicine, it is considered prudent that levels of molybdenum are monitored to avoid potential toxicity following long‐term dosing. [ABSTRACT FROM AUTHOR]

A large number of previous reports described an effect of the pituitary hormone prolactin (PRL) on steroid hormone production by the adrenal cortex. However, those studies remained anecdotal and were never converted into a conceptual and mechanistic framework, let alone being translated into clinical care. In the light of our recently published landmark study where we described PRL signalling as a pivotal regulator of the sexually dimorphic adrenal phenotype in mouse and of adrenal androgen production in humans, we present here the overarching hypothesis that PRL signalling increases the activity of Steroidogenic Factor‐1 (SF‐1/NR5A1), a transcription factor that has an essential role in adrenal gland development and function, to regulate adrenal cortex growth and hormonal production in physiological and pathological conditions. PRL can then be considered as a bona fide adrenocorticotropic hormone synergizing with ACTH in the endocrine control of adrenal cortex function. [ABSTRACT FROM AUTHOR]

A 9‐year‐old male neutered Cockerpoo dog was presented with pyrexia and was diagnosed with sterile idiopathic panniculitis. During initial investigations, advanced imaging revealed a suspected left‐sided cervical paraganglioma and bilateral adrenal masses. The dog underwent immunosuppression and achieved remission of the sterile idiopathic panniculitis. Bilateral adrenalectomy and paraganglioma excision were then performed. Histopathology identified bilateral adrenocortical carcinoma and cervical neuroendocrine carcinoma. Three months later, the dog was diagnosed with primary hyperparathyroidism. Despite left total thyroidectomy and parathyroidectomy, mild hypercalcaemia persisted for several months. Eight months later the dog became persistently hypokalaemic refractory to potassium supplementation, with metabolic alkalosis and systemic hypertension. The dog was euthanised 5 months later due to clinical deterioration. On postmortem examination, right parathyroid hyperplasia and metastatic neuroendocrine carcinoma involving liver, jejunum, pancreas and tracheobronchial lymph node were identified. This is the first report describing the concurrent presence of these types of endocrine neoplasms in a dog. [ABSTRACT FROM AUTHOR]

Background and Objective: Information on the incidence of adrenal trauma and its association with other injuries is limited. Our objective was to study the incidence of adrenal haemorrhage, its association with other injuries, clinical parameters, and long‐term outcomes. Patients and Measurements: All patients treated for severe abdominal trauma (Level 1) at Karolinska University Hospital, Solna, between January 1, 2013 and December 31, 2018 were included. Patients with a radiological picture of adrenal haematoma were selected. The injury severity score (ISS) was analysed in the entire cohort. Data were collected from the electronic medical files. Results: In total, 1.7% (n = 29/1743) was affected by adrenal trauma. Right adrenal trauma (n = 20/29;69%) was more common than left (n = 6/29;21%, p < 0.01), and 10% were bilateral (n = 3/29). There was no difference in volume in right versus left adrenal trauma [(median 13 (interquartile range (IQR) (7–15) versus 8 (5–13)] ml, p = 0.30). ISS was 23.4 (17–43) in adrenal haematoma patients, higher compared with other trauma patients 16 (8–27) (n = 1714)(p < 0.001). Rib fractures, pneumothorax, and liver lacerations were the three most common findings in association with adrenal trauma. The underlying cause in 48% of the cases was falling from height (≥3 m). Biochemical data demonstrated normal sodium and potassium levels while the lowest haemoglobin level was 72 g/l. At follow‐up, 4 (2–6) years after the trauma, except for three patients who died as in‐patients, all other persons were still living. None seemed to have adrenal insufficiency. Conclusions: Adrenal trauma is rare and does not seem to be associated with clinical features of adrenal insufficiency, even if the bleeding is bilateral. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to assess adrenal gland volume by using magnetic resonance imaging (MRI) and to study its role as an indirect marker of impaired glucose metabolism and hypothalamic–pituitary–adrenal (HPA) axis activation in a population‐based cohort. Methods: Asymptomatic participants were enrolled in a nested case–control study and underwent a 3‐T MRI, including T1w‐VIBE‐Dixon sequences. For the assessment of adrenal gland volume, adrenal glands were manually segmented in a blinded fashion. Impaired glucose metabolism was determined using fasting glucose and oral glucose tolerance test. Cardiometabolic risk factors were also obtained. Inter‐ and intrareader reliability as well as univariate and multivariate associations were derived. Results: Among 375 subjects included in the analysis (58.5% male, 56.1 ± 9.1 years), 25.3% participants had prediabetes and 13.6% had type 2 diabetes (T2DM). Total adrenal gland volume was 11.2 ± 4.2 ml and differed significantly between impaired glucose metabolism and healthy controls with largest total adrenal gland volume in T2DM (healthy controls: 10.0 ± 3.9 ml, prediabetes: 12.5 ± 3.8 ml, T2DM: 13.9 ± 4.6 ml; p < 0.001). In the multivariate analysis, association of T2DM and increased adrenal gland volume was independent of age, sex, hypertension, triglycerides and body mass index (BMI), but was attenuated in subjects with prediabetes after adjustment for BMI. Conclusions: T2DM is significantly associated with increased adrenal gland volume by MRI in an asymptomatic cohort, independent of age, sex, dyslipidaemia, hypertension and BMI. Adrenal gland volume may represent an indirect marker of impaired glucose metabolism and HPA axis dysfunction. [ABSTRACT FROM AUTHOR]

BACKGROUND: With the development of new technologies and the changing patient profiles, cytopathology departments receive increasing numbers of adrenal gland cytology specimens. In this study, the authors analyzed archival adrenal gland cytology cases and attempted to implement a diagnostic reporting system. DESIGN: Retrospective electronic medical record search was performed for adrenal gland cytology specimens in seven tertiary care centers. The cytology diagnoses were grouped in 7 categories: nondiagnostic, nonneoplastic, benign adrenal cortical elements (BACE), primary neoplasm of noncortical origin (NONC), atypia of undetermined significance (AUS), suspicious for malignancy (SM), and malignant (MAL). If available, histopathology results of concurrent and/or follow‐up biopsies and/or resections were documented. RESULTS: A total of 473 adrenal gland cytology cases were included. BACE cases comprised 21.8%, whereas MAL cases were 57.5% of all cases. For BACE and MAL categories, there were 100% and 98.9% correlation, respectively, in the cases with histopathology follow‐up. Six of 10 NONC cases had histopathology diagnoses and there were 3 pheochromocytomas and 3 schwannomas. Twenty‐one AUS cases had histology follow‐up and 10 (47.6%) of them were malignant. Six cases of SM had histopathology follow‐up, and all of them were malignant on the follow‐up. CONCLUSIONS: The authors propose a 7‐tier diagnostic scheme for adrenal gland cytology. The risk of malignancy was 98.9% in MAL cases (87/88) in the cohort. The only case with discordance was reported as "adrenal cortical adenoma with marked atypia"' on resection. There was no difference between endoscopic ultrasound‐guided and percutaneous methods. Further studies are needed to validate and make this approach universal.; Using a 7‐tier diagnostic scheme, the authors were able to accurately stratify the risk of malignancies for the indeterminant diagnostic categories. The primary neoplasm of noncortical origin category made it possible to isolate pheochromocytoma and its differential diagnoses from the other indeterminant cytologic diagnoses. [ABSTRACT FROM AUTHOR]

A 35‐year‐old female Atlantic bottlenose dolphin (Tursiops truncatus) presented with lethargy, dysorexia, obesity and locomotor difficulties. An abnormal deposition of fat and superficial skin lesions was observed. Laboratory findings showed lymphopenia and eosinopenia associated with hypercholesterolemia. Endocrinological assessment revealed chronically increased serum cortisol values associated with increased plasma adrenocorticotrophic hormone (ACTH) concentration. ACTH‐dependent hyperadrenocorticism, also known as Cushing's syndrome, was strongly suspected. The bottlenose dolphin was treated with ketoconazole (2.3 mg/kg every 12 hours) and prednisone (0.03 mg/kg every 48 hours), which resulted in an improvement in clinical signs, except for obesity. Long‐term treatment with ketoconazole and prednisolone did not cause any adverse effects. However, the authors recommend avoiding concurrent hormonal treatment with altrenogest as it might cause a relapse of hyperadrenocorticism or drug–drug interaction with ketoconazole. Endocrinopathies are rare in cetaceans but this case highlights the importance of considering hyperadrenocorticism as a differential diagnosis in dolphins with obesity and skin lesions. [ABSTRACT FROM AUTHOR]

Adrenal disease is a common problem in dogs and MRI is increasingly being used as an adjunctive diagnostic test. To date, the MRI features of normal canine adrenal glands have only been reported using 1.5‐Tesla (T) MRI. The aims of this prospective, methods‐comparison, exploratory study were to evaluate the effects of pulse sequence on the appearance of normal canine adrenal glands using 3 Tesla MRI. Six research beagle dogs were sampled and the following pulse sequences were acquired for each: (1) T2‐weighted images using two‐dimensional (2D) turbo spin‐echo (TSE), single‐shot spin‐echo (SSTSE), and three‐dimensional (3D) TSE, (2) T1‐weighted images using 2D TSE, 3D TSE, and 3D turbo field echo sequences, (3) post‐contrast T1‐weighted images, and (4) chemical shift imaging. The signal‐to‐noise ratio and contrast‐to‐noise ratio were measured for each dog and each pulse sequence. The signal intensity, clarity of the contour, distinction of the corticomedullary junction, degrees of motion, partial volume, and chemical shift artifact, and homogeneity of the contrast enhancement were evaluated qualitatively. In all sequences, except for chemical shift imaging, the adrenal glands were visualized in both planes with successful control of motion artifacts by manual ventilation. The adrenal contour was considered to be most clearly visualized with 2D TSE. Adrenal images were acquired within the shortest time using SSTSE although the contour was less clearly visualized than with TSE. Findings from this study in normal dogs can serve as background for further 3.0‐T MRI studies of dogs with adrenal disease. [ABSTRACT FROM AUTHOR]

This research was aimed to present the histological and ultrastructure properties of the adrenal gland in the Persian squirrel. Two male and female animals were included in the study. The adrenal gland was bean‐shaped and located on the cranial pole of kidney. The enveloping capsule was dense connective tissue that reacted positively with Periodic‐Acid Schiff (PAS) and Masson trichrome stainings. The parenchyma of the gland consisted of two‐part, namely cortex and medulla; the cortex had three layers: zona glomerulosa (ZG), zona fasciculata (ZF), and zona reticularis (ZR). The cells of the ZG were mainly spherical and ovoid with circular arrangement and few lipid droplets in TEM micrographs. The cells of the ZF were columnar and spherical that were arranged in cord‐like rows. Transmission electron microscopy (TEM) indicated conspicuous lipid droplets and mitochondria in this zone. The cells of the ZR were arranged in a tangled networks and were almost similar to those in the ZF. TEM images showed fewer lipid vesicles in the ZR compared to the ZF and ZG. Chromaffin cells were located in the medulla of the adrenal gland in two layers. TEM images showed that some of them were smaller and contained fewer secretory granules; other cells were larger and contained more electron‐dense secretory granules. Immunofluorescence staining showed that steroidogenic factor 1 (SF1) expressed from cortex to the corticomedullary junction (CMJ) and tyrosine hydroxylase (TH) expressed in the medulla. In conclusion, the results indicated both similarities and differences between the adrenal gland of the Persian squirrel and other animals such as mammals and rodents. [ABSTRACT FROM AUTHOR]

Various cells within the adrenal microenvironment are important in maintaining the body homeostasis. However, our understanding of adrenal disease pathogenesis is limited by an incomplete molecular characterization of the cell types responsible for the organ's multiple homeostatic functions. We report a cellular landscape of the human adrenal gland using single‐cell RNA sequencing. We reveal characteristic features of cell types within the human adrenal microenvironment and found immune activation of nonimmune cells in the adrenal endothelial cells. We also reveal that abundant immune cells occupied a lot of space in adrenal gland. Additionally, Sex‐related diversity in the adrenocortical cells and different gene expression profiles between the left and right adrenal gland are also observed at single‐cell resolution. Together, at single‐cell resolution, the transcriptomic map presents a comprehensive view of the human adrenal gland, which serves as a fundamental baseline description of this organ and paves a way for the further studies of adrenal diseases. [ABSTRACT FROM AUTHOR]

The adrenal gland is a vital endocrine gland that secretes many important hormones in everyday bird life. The adrenal gland of the Japanese quail is grossly located ventromedially the corresponding kidney and has a creamy to yellow color. The quail gland is surrounded by a capsule and contains some ganglionic cells, and the capsule is characterized by the presence of chromaffin cells. The adrenal gland is subdivided into three concentric zones: subcapsular, peripheral, and central. The parenchyma consists of interrenal tissue, chromaffin islets, and blood sinusoids. The interrenal cells contain lipid droplets, are arranged in cords, and rest on the basement membrane. Chromaffin cells are categorized as two types: epinephrine (E) and norepinephrine (NE) cells. These cells contain the granules, and are characterized by the presence of lipid droplets. In this study, the interrenal tissue was found to have a higher proportion of chromaffin cells in quail as compared with other birds, which is attributed to the fact that the Japanese quail is a migratory bird. Therefore, the present investigation aims to provide a detailed study on the adrenal gland in the Japanese quail to help physiologists understand the gland's function and the pathologist to determine the implications for the differential diagnosis of adrenal gland tumors. Highlights: The adrenal gland is subdivided into three concentric zones: subcapsular, peripheral, and central.The interrenal cells contain lipid droplets, are arranged in cords.Chromaffin cells are categorized as two types: epinephrine (E) and norepinephrine (NE) cells. These cells contain the granules, and are characterized by the presence of lipid droplets.The interrenal tissue was found to have a higher proportion of chromaffin cells in quail because it is a migratory bird. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify specific unusual prenatal ultrasound (US) patterns of the adrenal gland and to propose a systematic approach for diagnosis. Six fetuses with unusual aspects of one or both adrenal glands, detected during routine prenatal US screening, were evaluated. Prenatal and postnatal management are described. A checklist of US features was created to perform a detailed analysis of adrenal lesions and guide prenatal management; this includes the time of appearance, location, growth, vascularization, structure, and presence of findings suggestive of malignancy. [ABSTRACT FROM AUTHOR]

Objective: To elucidate the mechanism of hypertensive crisis during energy device ablation of the adrenal gland. Methods: Electrocoagulation on the adrenal glands of six pigs was carried out with the same energy device (VIO300D) using four methods: (i) monopolar coagulation; (ii) monopolar soft coagulation using IO‐advanced ball‐type electrodes; (iii) bipolar soft coagulation by pinching; and (iv) bipolar soft coagulation by non‐pinching (surface contact) using Bipolar forceps Premium. After electrocoagulation for 5 s, blood pressure and pulse changes were monitored, and adrenal hormones were measured from a central vein. The adrenal glands were removed, and the degree of tissue damage was scored histologically. Results: Hypertensive crisis occurred with electrocoagulation of the adrenal gland by the monopolar coagulation, monopolar soft coagulation and bipolar soft coagulation pinching methods. Blood pressure did not change with the bipolar soft coagulation non‐pinching method. Pathologically, tissue damage to the adrenal medulla was associated with elevated blood pressure and adrenaline and noradrenaline release. Conclusions: Hypertensive crisis caused by energy device ablation to the adrenal gland is caused by the release of catecholamines due to heat damage to the adrenal medulla rather than the type of energy device. Proper use of an energy device that does not cause thermal degeneration of the medulla is required to prevent hypertensive crisis. [ABSTRACT FROM AUTHOR]

Copyright of Equine Veterinary Journal is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In psychological patients like our case, somatically expressed symptoms which can imply another psychological syndrome should be dealt with cautiously. [ABSTRACT FROM AUTHOR]

Context: The success rate of cannulation of the right adrenal vein is limited. The aldosterone gradient within the same adrenal vein branch is specific for aldosterone‐producing adenoma. Objective: This study was performed to investigate whether the absolute aldosterone gradient within the left adrenal vein (left‐AV absolute aldosterone gradient) indicates unilateral excess aldosterone. Design and setting: A retrospective cross‐sectional study in a single referral centre. Patients and methods: In total, 123 consecutive patients with primary aldosteronism who had successful adrenal vein sampling (AVS) data were examined. The left‐AV absolute aldosterone gradient was considered significant when a gradient of >4:1 in the aldosterone‐to‐cortisol ratio between the common trunk vein and central vein was found. Main outcome measure: The prevalence of the unilateral subtype in patients with a significant left‐AV absolute aldosterone gradient. Results: The prevalence of the unilateral subtype was higher in patients with than without a significant left‐AV absolute aldosterone gradient (88.2% [15/17] vs 21.7% [23/106], P <.001). Of 60 patients with spontaneous hypokalemia, left unilateral disease on computed tomography, or both, a significant left‐AV absolute aldosterone gradient was present only in patients with the unilateral subtype on AVS (42.9% [15/35]), but not in those with the bilateral subtype (0.0% [0/25]). These data were validated in an external cohort. Conclusion: The presence of a significant left‐AV absolute aldosterone gradient can be used to diagnose the left unilateral subtype of primary aldosteronism on AVS in patients with spontaneous hypokalemia, left unilateral disease on computed tomography or both. [ABSTRACT FROM AUTHOR]

Summary: A 7‐year‐old grey horse that had a history of inappetence, weight loss, weakness, dyspnoea, coughing and intermittent colic was examined post‐mortem. A melanoma, confirmed histologically, was found in the right adrenal gland and had eroded into the posterior vena cava. Thoracic metastases were also identified. The skin, including the legs, trunk and perineum was normal with no evidence of melanomas. This was considered to be a primary, malignant melanoma, a novel finding in the adrenal gland of the horse. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the sonographic ultrasound (US) appearances of adrenal gland schwannomas.Materials and Methods: This was a retrospective analysis of 15 cases of schwannomas involving the adrenal gland. The following US features were assessed: size, border, echogenicity, homogeneity, intralesional cystic necrosis, presence of septa, intralesional calcification, posterior acoustic enhancement and blood supply.Results: Of the 15 tumors, seven (46.7%) were located on the left side, and the remaining eight (53.3%) on the right side. The most frequent US appearance of adrenal schwannoma was a single, well-defined and isoechoic mass. The internal echotexture was homogeneous in 2 cases, and heterogeneous in 13 cases, with intralesional cystic areas (n = 11), septa (n = 10) or calcifications (n = 6). Posterior acoustic enhancement was seen in 12 of the 15 cases (80%). On color Doppler US, 86.7% (13/15) of the lesions did not show any vascularity.Conclusions: Adrenal schwannomas usually present on US as well-defined isoechoic masses often with posterior acoustic enhancement, cystic necrosis with septa and poor blood supply. These appearances should suggest the diagnosis of adrenal schwannomas. Nevertheless, additional information from laboratory tests and CT or MR imaging may be required to avoid unnecessary surgery. [ABSTRACT FROM AUTHOR]

Background and Aim: The aim of this study was to assess the efficacy of a new microwave ablation (MWA) system, the Emprint Ablation System, for the ablation of unresectable large liver tumors (≥ 30 mm). Methods: Twenty‐one hepatic tumors (mean diameter, 34.7 mm) from 21 patients who underwent percutaneous MWA were included in this cross‐sectional study. A volume analyzer based on computed tomography imaging was used for all patients within the month before and month after the procedure to evaluate the shape and volume of ablation zones. In addition, computed tomography imaging was performed again 3 months after the procedure to evaluate the presence of residual tumors and local recurrence. Results: Mean ablation time was 11.3 min, and mean overall procedure time was 33.4 min. An ablated adrenal gland‐induced Takotsubo (stress) cardiomyopathy occurred immediately after MWA as a major complication in one patient. Roundness index A, B, and C presented a mean value of 0.94, 0.94, and 1.01, respectively (all values near 1 is a perfect sphere), indicating that a spherical ablation zone was achieved. The mean ablation volume was larger than the volume of tumors (24.5 vs 41.7 cm3). Residual tumors were confirmed in only 4.8% of tumors after a single ablation session. There was no local recurrence. Conclusions: In our experience, the new MWA system provides an effective treatment option for unresectable large liver tumors. However, to ablate the liver tumors safely, it is necessary to consider the surrounding organs, such as the adrenal glands. [ABSTRACT FROM AUTHOR]

Abstract: Irisin, a novel peptide, was initially been shown to be expressed explicitly in the muscle tissues. We studied the presence of irisin immunoreactivity in porcupine adrenal glands and kidneys. Immunocytochemistry showed that irisin was localised both in the adrenal cortex and adrenal medulla. In organs, irisin immunoreactivity was found in the tubular and collecting system of the nephron. The functional role of irisin in the adrenal gland and kidney has not been precisely yet. However, irisin might have a paracrine and autocrine function as do other locally produced peptides. [ABSTRACT FROM AUTHOR]

Summary: This study was designed to investigate the HPA‐axis impairment in the streptozotocin (STZ)‐diabetic gerbils (Gerbillus gerbillus). Twenty‐six male gerbils (body weight ~27 g) were divided into 3 groups: vehicle control (n = 10), 2 days of diabetes (n = 09) and 30 days of diabetes (n = 07). The latter 2 groups received an intraperitoneal injection of STZ (150 mg/kg of body weight). At 2 and 30 days of diabetes, streptozotocin‐diabetic gerbils underwent a retro‐orbital puncture for assessment of biochemical and hormonal parameters. Subsequently the animals were decapitated and the adrenal glands were removed, weighed and processed for light microscopy and stereology. Nondiabetic control gerbils that had been injected with citrate buffer were examined as a comparison. At 2 days of diabetes, STZ gerbils exhibited symptoms that are characteristic of human diabetes type 1. The adrenal gland showed significant increase in weight, associated with a larger cortex layer, hypertrophy of the fasciculate cells and a significant decrease in the nucleocytoplasmic index. These changes were associated with higher plasma ACTH and cortisol concentrations compared to nondiabetic controls. At 30 days postdiabetes, ACTH levels remained elevated, whereas cortisol levels decreased compared to the early stage of diabetes. Histological analysis revealed the existence of a band of connective tissue (collagen) that separates the cortical and medullary zones and is not present in humans or laboratory rodents, which represents a striking change seen throughout the disease. STZ‐induced diabetes mellitus in Gerbillus gerbillus resulted in hyperactivation of the HPA axis in the early stages of diabetes mellitus which did not persist into the final stages of the disease, suggesting a possible reduction in adrenocortical sensitivity over time. [ABSTRACT FROM AUTHOR]

The insulin family of growth factors (insulin, IGF1, and IGF2) are critical in sex determination, adrenal differentiation, and testicular function. Notably, the IGF system has been reported to mediate the proliferation of steroidogenic cells. However, the precise role and contribution of the membrane receptors mediating those effects, namely, insulin receptor (INSR) and type-I insulin-like growth factor receptor (IGF1R), have not, to our knowledge, been investigated. We show here that specific deletion of both Insr and Igf1r in steroidogenic cells in mice leads to severe alterations of adrenocortical and testicular development. Double-mutant mice display drastic size reduction of both adrenocortex and testes, with impaired corticosterone, testosterone, and sperm production. Detailed developmental analysis of the testes revealed that fetal Leydig cell (LC) function is normal, but there is a failure of adult LC maturation and steroidogenic function associated with accumulation of progenitor LCs (PLCs). Cell-lineage tracing revealed PLC enrichment is secondary to Insr and Igf1r deletion in differentiated adult LCs, suggesting a feedback mechanism between cells at different steps of differentiation. Taken together, these data reveal the cell-autonomous and nonautonomous roles of the IGF system for proper development and maintenance of steroidogenic lineages. [ABSTRACT FROM AUTHOR]

New Findings: What is the central question of this study? Whether anaphylaxis affects sympathetic outflows to the brown adipose tissue (BAT) and adrenal gland and whether anaphylaxis affects some brain areas in association with sympathetic regulation. What is the main finding and its importance? Sympathoexcitatory responses to anaphylaxis occurred regionally in the kidney and adrenal gland, but not in the thermogenesis‐related BAT. Further, anaphylactic hypotension also caused increase in c‐fos immunoreactivity in the hypothalamic and medullary areas. Moreover, catecholaminergic neurons of the brainstem cause adrenal sympathoexcitation in a baroreceptor‐independent manner. Abstract: We previously reported that sympathetic nerve activity (SNA) to the kidney and the hindlimb increases during anaphylactic hypotension in anaesthetized rats. Based on this evidence, we examined effects of anaphylactic hypotension on SNA to the brown adipose tissue (BAT), and the adrenal gland and kidney in anaesthetized rats. We demonstrated that adrenal and renal SNA, but not BAT‐SNA, were stimulated. In addition, the effects of anaphylaxis on neural activities of the hypothalamic and medullary nuclei, which are candidates for relaying efferent SNA to the peripheral organs, were investigated via immunohistochemical staining of c‐fos. Anaphylaxis increased c‐fos expression in the neurons of the paraventricular nucleus (PVN) of the hypothalamus and in those of the nucleus tractus solitarii (NTS) and rostral ventrolateral medulla (RVLM) of the medulla oblongata; c‐fos was expressed in γ‐aminobutyric acid (GABA)‐ergic neurons of the NTS and in the catecholaminergic neurons of the RVLM. In addition, c‐fos expression in the rostral NTS and mid NTS during anaphylaxis was reduced by sinoaortic baroreceptor denervation; however, increased c‐fos expression in the caudal NTS and RVLM or adrenal sympathoexcitation were not affected by sinoaortic baroreceptor denervation. These results indicated that anaphylactic hypotension activates the hypothalamic PVN and the medullary NTS and RVLM independently of the baroreflex pathway. Further, it stimulated efferent SNA to the adrenal gland and kidney to restore blood pressure. [ABSTRACT FROM AUTHOR]

Contents: The objective of this study was to determine the activity of steroid‐ and eicosanoid‐metabolizing enzymes in horses with varying BCSs. The BCSs of twenty non‐pregnant, anoestrous mares were determined prior to euthanasia, and tissue samples were collected from the liver, kidney, adrenal gland, ovary and endometrium. Cytochrome P450 1A (CYP1A), 2C (CYP2C), 3A (CYP3A) and uridine 5′‐diphospho‐glucuronosyltransferase (UGT) activities were determined using luminogenic substrates. The MIXED procedure of SAS was used to test the effect of BCS on enzyme activity and differences between tissues. Activity of CYP1A in adrenals was increased (p ≤ .05) in BCS 5 versus BCSs 4 and 6. Activity of CYP1A in the liver was increased (p = .05) in BCS 4 versus BCSs 5 and 6. Activity of CYP1A was 100‐fold greater (p < .0001) in the liver than in the adrenal, ovary and kidney. Activity of CYP2C was 100‐fold greater (p < .0001) in the liver than in the adrenal, ovary and endometrium. Activity of CYP3A was only detectable in the liver. Activity of UGT in the kidney was decreased (p = .02) in BCS 4 versus BCSs 5 and 6. Activity of UGT was threefold greater (p < .0001) in the liver than in the kidney, whereas activity of UGT was ninefold greater (p < .0001) in the kidney than in the ovary and endometrium. In general, BCS did not alter the activity of steroid‐ and eicosanoid‐metabolizing enzymes in horses. However, tissue differences in these enzymes indicated abundant hepatic metabolism in horses, which is similar to other livestock species. [ABSTRACT FROM AUTHOR]

Therefore, it would be expected that a manipulation that attenuates this response (bilateral cervical vagotomy) would attenuate greater splanchnic nerve activity, since the greater splanchnic nerves contain adrenal sympathetic preganglionic fibres. Keywords: adrenal gland; autonomic nervous system; spleen; sympathetic activity; vagal afferents EN adrenal gland autonomic nervous system spleen sympathetic activity vagal afferents 5187 5188 2 12/19/22 20221215 NES 221215 Immune cells detect antigens and drive inflammatory responses that eliminate pathogens and protect the body, while exacerbated inflammation can cause tissue damage. [Extracted from the article]

Key Clinical Message: We present a 27‐year‐old woman with an adrenal oncocytoma. This is a very rare entity. We provide a review of the clinical, biochemical and pathological features of cases reported in the literature. [ABSTRACT FROM AUTHOR]

The adrenal gland is an endocrine organ that plays essential roles in stress responses. This organ consists of two types of tissues, adrenomedulla and adrenocortex, deriving from different embryonic origins. Whereas it is well accepted that the adrenomedulla derives from neural crest cells, the origin of the adrenocortex remains elusive. In addition, the adrenocortex and gonads, two major steroid hormone-producing tissues, have been thought to share the same origin, although the experimental evidence is lacking. In this study, to identify the origin of adrenocortex and to compare it to that of gonads, we scrutinized the medial portion of the coelomic epithelium ( CE) after the lateral plate mesoderm has split into two CE components with a concomitant opening of the coelomic cavity in between them. We found that early medial CE consists of a two-cell layer-thick band of epithelial-like cells, the outer and inner CEs. The outer CE faces the coelomic cavity, whereas the inner CE is juxtaposed to nascent blood vessels. Combining direct cell labeling with early molecular markers, we found that outer CE was the origin of the gonad but not the adrenocortex. The adrenocortex, instead, appears to derive from inner CE. Thus, the adrenocortical and gonadal progenitors are already segregated from each other when the coelomic cavity has opened. This study provides a new basis for understanding how the adrenal gland forms and how steroid hormone-producing tissues arise during development. [ABSTRACT FROM AUTHOR]

Environmental pollutants may act as endocrine disruptors in animals. Organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) enter the food chain and may accumulate in the fatty animal tissues, including adrenals. To our knowledge, no previous study has investigated their presence in the human normal adrenal (NA) cortex and aldosterone-producing adenomas (APA). Surgical fragments of APA from 11 patients and NA from 8 kidney donors were analyzed for 16 PCBs congeners and 10 OCPs. A Matrix Solid-Phase Dispersion (MSPD) method for simultaneous determination of the target compounds in cortex homogenates was developed. A gas-chromatography triple quadrupole mass spectrometry (Triple Quad GC-MS) system was used for the analysis. Data were analyzed using Random Forest and Wilcoxon's rank-sum test. OCPs and PCBs were found in specimens from both types. A subset of pollutants characterized APA more than NA. Higher concentrations (μg g−1) in APA were observed for α-, β-, and γ- Hexachlorocyclohexane (HCH) (1.48 ± 3.32 vs. 0.17 ± 0.19, P = 0.028; 2.81 ± 2.10 vs. 0.96 ± 0.98, P = 0.011; 2.16 ± 4.85 vs. 0.17 ± 0.26, P = 0.004, respectively), as well as for Hexachlorobenzene (HCB) and for PCBs 28, 52 and 101 (3.41 ± 3.11 vs. 0.97 ± 1.06, P = 0.021; 2.34 ± 4.68 vs. 0.25 ± 0.22, P = 0.039; 0.58 ± 1.19 vs. 0.06 ± 0.02, P = 0.002; 0.26 ± 0.43 vs. 0.05 ± 0.00, P = 0.001, respectively). Environmental organochlorine pollutants were shown to be present in the human normal and abnormal adrenal cortex, deserving future investigation on their possible role as adrenal endocrine disruptors in human disease. Copyright © 2017 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The study of vascular modulation has received a great deal of attention in recent years as knowledge has increased around the role of angiogenesis within disease contexts such as cancer. Despite rapidly expanding insights into the molecular processes involved and the concomitant generation of a number of anticancer vascular modulating chemotherapeutics, techniques used in the measurement of structural vascular change have advanced more modestly, particularly with regard to the preclinical quantification of off-target vascular regression within systemic, notably endocrine, blood vessels. Such changes translate into a number of major clinical side effects and there remains a need for improved preclinical screening and analysis. Here we present the generation of a novel structural biomarker, which can be incorporated into a number of contemporary image analysis platforms and used to compare tumour versus systemic host tissue vascularity. By contrasting the measurements obtained, the preclinical efficacy of vascular modulating chemotherapies can be evaluated in light of the predicted therapeutic window. Copyright © 2017 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Prolactin is a pleiotropic peptide hormone produced by the lactotrophs in the anterior pituitary. Its rate of secretion is primarily regulated by a negative-feedback mechanism where prolactin stimulates the activity of the tuberoinfundibular dopaminergic (TIDA) neurones, increasing their release of dopamine, which accesses the pituitary via the median eminence to suppress further prolactin secretion. In addition to its well established role in lactation, circulating prolactin is secreted in response to stress, although the mechanism by which this is achieved or its cellular targets remains unknown. In the present study, we show that 15 minutes of restraint stress causes an approximately seven-fold increase in circulating prolactin concentration in male mice. Monitoring prolactin receptor activation, using immunohistochemistry to determine the level and distribution of tyrosine phosphorylated signal transducer and activator of transcription 5 (pSTAT5), we show that this stress-induced increase in prolactin interacts with both central and peripheral targets. Restraint stress for 15 minutes significantly increased pSTAT5 staining in the arcuate nucleus, median eminence and the zona fasciculata of the adrenal cortex. In each case, this response was prevented by pretreating the animals with bromocriptine to block prolactin secretion from the pituitary. Interestingly, in contrast to many cells in the arcuate nucleus, stress reduced pSTAT5 staining of the TIDA neurones (identified by dual-labelling for tyrosine hydroxylase). This suggests that there is reduced prolactin signalling in these cells and thus potentially a decline in their inhibitory influence on prolactin secretion. These results provide evidence that prolactin secreted in response to acute stress is sufficient to activate prolactin receptors in selected target tissues known to be involved in the physiological adaptation to stress. [ABSTRACT FROM AUTHOR]