Electron microscopic radioautographic study on mitochondrial RNA synthesis in adrenal cortical and medullary cells of aging mice

In order to study the aging changes of intramito-chondrial RNA synthesis of mouse adrenal cells, 10 groups of developing and aging mice, each consisting of 3 individuals, total 30, from fetal day 19 to postna-tal newborn at day 1, 3, 9, 14, adult at month 1, 2, 6 and senescent animals at month 12 (year 1) and 24 (year 2) were injected with 3H-uridine, an RNA pre-cursor, sacrificed 1 hr later and the adrenal tissues were fixed and processed for electron microscopic radioautography. On electron microscopic radio-autograms obtained from each animal, the number of mitochondria per cell, the number of labeled mito-chondria with 3H-uridine showing RNA synthesis per cell and the mitochondrial labeling index in each adreno-cortical cells, in 3 zones, as well as in each adreno-medullary cells, 2 types of cells in the medulla, the adrenalin cells and the noradrenalin cells, were calculated and the results in respective aging groups were compared with each others. The results demon-strated that the number of mitochondria in adreno-cortical cells in 3 zones, the zona glomerulosa, fasciculata and reticularis of respective mice at vari-ous ages increased from fetal day 19 to postnatal month 1 reaching the plateau from month 1 to 24 due to development and aging of animals, respectively, while the number of labeled mitochondria per cell and the labeling index of intramitochondrial RNA synthesis incorporating 3H-uridine increased from fetal day 19 to postnatal month 2, reaching the maxima and decreased slightly from month 6 to month 24. On the other hand, the number of mito-chondria per cell in the medulla increased from fetal day 19 to postnatal month 1 reaching the plateau from month 1 to 24, while the number of labeled mi-tochondria per cell and the labeling index of in-tramitochondrial RNA synthesis increased from fetal day 19 to postnatal day 14, reaching the maxima and decreased from month 1 to 24. From the results, it was demonstrated that the activity of intramitochno-drial RNA synthesis in both the cortical and me-dullary cells in developing and aging mice adrenals changed due to aging of individual animals.

Adrenomedullary Function in Cohort of Brazilian Pediatric Patients with Classic Congenital Adrenal Hyperplasia

Congenital Adrenal Hyperplasia is a group of autosomal recessive disorders resulting from deficiency of enzymes essential for the synthesis of cortisol.Disease of the adrenal cortex,but there may be involvement adrenomedullary.Cortisol and epinephrine are directly related to the individual’s stress response.Lower values of epinephrine in children with congenital adrenal hyperplasia could be related to increased clinical complications and hospitalizations rate.We evaluated the serum values of metanephrines and normetanephrines in children and adolescents with classic congenital adrenal hyperplasia and primary hypothyroidism and possible correlations with disease and hospitalizations.Cross-sectional study involved 29 patients(10 simple virilizing and 19 salt-wasting),and control group of 28 patients with primary hypothyroidism(10 overt and 18 subclinical).There were no differences in age(p=0.24)and metanephrine(p=0.34)or normetanephrine values(p=0.85)between groups.Hospitalization rate was higher in the cases than in the controls(51 x 12).We conclude the serum values of metanephrine and normetanephrine in patients with congenital adrenal hyperplasia were within the normal values of reference,with no significant difference of group with primary hypothiroidism.The number of hospitalizations in the case was high in relation to the control,mainly in salt-wasting.

Histological Study on the Adrenal Gland of Zebra

In order to explore the histological structure of zebra and to protect en- dangered species diversity, it is especially important to study the zebra adrenal his- tological structure. 2 zebra adrenals were studied by means of histological methods. The adrenal gland tissues were dissected into serial paraffin sections at the thick- ness of 3 μm. After HE and Masson staining, they were observed and photographed by the light microscope and Image-Pro Plus 6.0. The results show that zebra adrenal capsule is covered with thick connective tissue, which is about 230 μm. A large number of nerves and blood vessels are distributed in the capsule. The area of cortex is about 5 times larger than medullae. Zona glomerulosa is thin, about 300？m. The cells were arranged as column and ball. Zona fasciculata with the thickness of 1 750 μm is 6 times as thick as zona glomerulosa. The cells were ar- ranged in cord. Zona reticular with the thickness of 250 wm was closely adjacent to medulla and formed a jagged boundary. The medulla with the area of 4 mm2 was deeply dyed. It was concluded that some sympathetic ganglion cells were found in the medulla arranged in groups and surrounded with zona reticular cells but lots of the cells were found in zona reticular. Some connective tissue with chromaffin cells was found in the medulla center vein. The purpose of the present study provides reliable evidences for further study on morphology, physiology and pathology of the zebra.

Adrenal myelolipoma within myxoid cortical adenoma associated with Conn's syndrome

The coexistence of myelolipoma within adrenal cortical adenoma is extremely rare,for both tumors present usually as separate entities.There are only 16 such cases reported worldwide.To the best of our knowledge,the case we reported here is the first one of myxoid adrenal cortical adenoma associated with myelolipoma reported.A 32-year-old Chinese woman with 4-year history of hypertension was presented in our study.Computed tomography(CT)of the abdomen showed a large heterogene- ously-enhancing mass(4.5 cm in diameter)in the left suprarenal region.Clinical history and laboratory results suggest a metabolic disorder as Conn's syndrome.The patient underwent a left adrenalectomy,and a histopathological study confirmed the mass to be a myxoid adrenal cortical adenoma containing myelolipoma.The patient was postoperatively well and discharged uneventfully.In the present case report,we also discuss the etiology of simultaneous myelolipoma and adrenal adenoma associated with Conn's syndrome,and the methods of the diagnosis and differential diagnosis.

Detection of a unicentric type of Castleman-like mass at the site of adrenal grand: A case report and review of literature

We present a case of adrenal CD in a 26-year-old female.The patient was referred to our hospital because of left flank pain for 1 wk.A computed tomography scan revealed a 4 cm×3 cm well-defined mass,considered as a paraganglioma.A preoperative diagnosis of left adrenal neoplasm and urinary tract infection was made.The patient underwent anti-inflammatory therapy followed by an open operation to remove the mass in the left adrenal.Through analysis of the morphological pattern and immunohistochemical markers,a diagnosis of CD was made.During the 12-mo follow-up,there was no evidence of metastasis or recurrence.This case reminds clinicians that CD should be considered in the evaluation of an adrenal mass.Surgery is suggested for its therapeutic management.

Role of endoscopic ultrasound fine-needle aspiration evaluating adrenal gland enlargement or mass

AIM： To report the clinical impact of adrenal endoscop-ic ultrasound fine-needle aspiration （EUS-FNA） in the evaluation of patients with adrenal gland enlargement or mass.METHODS： In a retrospective single-center case-series, patients undergoing EUS-FNA of either adrenal gland from 1997-2011 in our tertiary care center were included. Medical records were reviewed and results of EUS, cytology, adrenal size change on follow-up imag-ing ≥ 6 mo after EUS and any repeat EUS or surgery were abstracted. A lesion was considered benign if： （1） EUS-FNA cytology was benign and the lesion remained 〈 1 cm from its original size on follow-up computed tomography （CT）, magnetic resonance imaging or repeat EUS ≥ 6 mo after EUS-FNA; or （2） subsequent adrenalectomy and surgical pathology was benign. RESULTS： Ninety-four patients had left （n = 90） and/or right （n = 5） adrenal EUS-FNA without adverse events. EUS indications included： cancer staging or suspected recurrence （n = 31）, pancreatic （n = 20）, medi-astinal （n = 10）, adrenal （n = 7）, lung （n = 7） mass or other indication （n = 19）. Diagnoses after adrenal EUS-FNA included metastatic lung （n = 10）, esophageal （n= 5）, colon （n = 2）, or other cancer （n = 8）; benign primary adrenal mass or benign tissue （n = 60）; or was non-diagnostic （n = 9）. Available follow-up confrmed a benign lesion in 5/9 non-diagnostic aspirates and 32/60 benign aspirates. Four of the 60 benign aspirates were later confrmed as malignant by repeat biopsy, follow-up CT, or adrenalectomy. Adrenal EUS-FNA diagnosed metastatic cancer in 24, and ruled out metastasis in 10 patients. For the diagnosis of malignancy, EUS-FNA of either adrenal had sensitivity, specifcity, positive predic-tive value and negative predictive value of 86%, 97%, 96% and 89%, respectively.CONCLUSION： Adrenal gland EUS-FNA is safe, mini-mally invasive and a sensitive technique with signifcant impact in the management of adrenal gland mass or enlargement.

原发性肾上腺血管肉瘤临床病理分析并文献复习

本文报道了1例原发性肾上腺血管肉瘤(PAA)患者。女性,年龄52岁。体检B超发现左肾上极占位就诊。镜下见肾上腺结构破坏,代之大小不一的相互沟通的血管网浸润性生长,内皮细胞异型明显,核大、深染,核分裂可见。免疫表型:PAA瘤细胞表达Vim、CD34、CD31、ERG及F8,不表达CD117、HHV8、S-100、SMA和D2-40,Ki67增殖指数约20%。该疾病罕见,确诊需结合组织学形态及免疫组化标记,早期诊断,早期完整肿瘤切除,可改善预后。

Neural plasticity occurs in the adrenal medulla of asthmatic rats

Background Airway symptoms in asthma are related to decrease of epinephrine secretion, which may be ascribed to elevated nerve growth factor （NGF） in the organism. The aim of this study was to monitor the neuroendocrine alteration in the adrenal medulla of asthmatic rats. Methods Sixteen rats were randomly divided into two groups （n=-8）, control group and asthma group, and the asthmatic rats were sensitized and challenged with ovalbumin （OVA）. The levels of NGF, epinephrine and norepinephrine in serum were detected by enzyme linked immunosorbent assay （ELISA）, the NGF expression in adrenal medulla was detected by immunohistochemistry, and the changes in the ultrastructure of the adrenal medulla was observed by electron microscopy. Results The NGF expression was increased in asthmatic rats compared with control rats. Compared with control rats, the results indicated that the epinephrine level was decreased in asthmatic rats, but no significant difference was found in norepinephrine levels. We found more ganglion cells in the adrenal medulla of asthmatic rats than in control rats, with NGF immunostaining mainly located in these ganglion cells. Electron microscopic images showed the density of chromaffin granula decreased and there was shrunken nucleolemma in the adrenal medullary cells of asthmatic rats. Conclusion The innervation of the adrenal medulla is changed in asthmatic rats, and it may contribute to the epinephrine decrease in asthma.

罕见肾上腺神经纤维瘤1例并文献复习

目的探讨肾上腺神经纤维瘤(adrenal neurofibroma,ANF)的临床特征,提高对其的认识及诊治技术。方法分析我院收治的1例病理证实为ANF患者的临床资料、诊治过程及随访结果,并结合已发表的国内外相关文献进行复习总结。结果本例患者术前相关肾上腺激素水平检查均正常,增强CT发现右侧肾上腺占位性病变,考虑良性肿瘤性病变。行后腹腔镜手术完整切除肾上腺肿物及少部分右肾上腺。术后病理示:灰黄灰红组织一块,大小6.5 cm×5.5 cm×4.0 cm;可见包膜,切面呈多结节状,灰白实性质软,局部结节质硬,可见少许肾上腺组织;光镜所见梭形细胞肿瘤及神经纤维末梢,间质黏液样变,未见异常核分裂及细胞异型性;结合免疫组化,符合ANF。术后1个月复查,肾上腺相关激素水平均正常,无复发和转移。结论ANF为良性肿瘤,临床症状、体征缺乏特异性,术前实验室和影像检查并不能确诊,诊断依赖组织病理学检查。腹腔镜完整切除肿瘤是治疗的关键,腹膜后途径具有更大优势,大多数预后良好,但需密切观察及随访。

INTRACEREBRAL CO-GRAFTING OF SCHW ANN'S CELLS AND FETAL ADRENAL MEDULLA IN THE TREATMENT OF PARKINSON'S DISEASE

Intracerebral co-grafting of Schwann's cells and human fetal adrenal medullary tissue was performed in 10 patients with Parkinson's disease. One to six months after grafting, symptoms were improved significantly for 1 to 3 grade. Among them, 2 patients resumed nearly normal daily activities. Long-term follow-up showed that the symptoms were not improved satisfactorily in some patients. It is considered that careful selection of patients, administration of amantadine, and co-grafting of Schwann's cells which prompts the survival of chromaffin cells are essential to better results.

MSCT、3.0T MRI用于肾上腺肿瘤鉴别中的价值分析

目的分析MSCT和3.0T MRI在肾上腺肿瘤鉴别中的应用价值。方法回顾分析笔者医院2018年11月-2020年4月肾上腺肿瘤患者资料,共46例。均行MSCT和3.0T MRI扫描,行手术治疗,经病理组织检查确诊。以病理检查结果为准,分析两种诊断方法对不同病理类型(嗜铬细胞瘤、功能性肾上腺腺瘤、转移瘤、肾上腺皮质癌)的诊断准确率;对比两种诊断方法对瘤体良恶性鉴别的准确率;对比两种诊断方法在良性和恶性瘤体定位准确率;对比两种方法获取图像的清晰度;观察各种病理类型的瘤体在CT下的表现以及在3.0T MRI下的表现。结果3.0T MRI诊断嗜铬细胞瘤、功能性肾上腺腺瘤、转移瘤、肾上腺皮质癌准确率以及病理类型诊断准确率分别为83.33%、80.00%、77.78%、100.00%、82.61%,MSCT为66.67%、60.00%、44.44%、50.00%、58.70%,前者更高,P<0.05。3.0T MRI鉴别瘤体性质准确率(95.65%)高于MSCT(67.39%),P<0.05。MSCT对瘤体定位准确率(93.48%)高于3.0TMRI(67.39%),P<0.05。3.0T MRI图像清晰率(91.30%)高于MSCT(76.09%),P<0.05。结论两种诊断方法均能提供肾上腺肿瘤形态、大小、密度等信息,在病理类型和定性上3.0MRI更具有优势,在定位上MSCT更具优势,可结合二者提高诊断准确率。

大鼠肾上腺髓质增生模型的建立

目的 :建立大鼠肾上腺髓质增生 (AMH)模型。方法 :A、B、C组 (实验组 )分别皮下注射 0 .1%利血平 1.0ml (kg·d) ,2 5 %苯甲酸钠咖啡因 1.0ml (kg·d) ,0 .1%利血平和 2 5 %苯甲酸钠咖啡因各 [0 .5ml (kg·d) ],D组 (对照组 )皮下注射 0 .9%生理盐水 [1.0ml (kg·d) ],观察大鼠第 6周血压 ,2 4h尿中 3 甲氧 4 羟基苦杏仁酸 (VMA)的含量。肾上腺的病理变化。结果 :实验组与对照组比较 ,血压均无显著性差异 (P均 >0 .0 5 )。 2 4h尿中VMA含量有显著性差异 (P <0 .0 1,P <0 .0 5 ,P <0 .0 5 )。髓质百分数有显著性差异 (P <0 .0 1,P <0 .0 5 ,P <0 .0 1)。结论 :用利血平。

肾上腺髓质素在心血管系统的分布及在心血管功能调节中的作用

目的：观察肾上腺髓质素（ａｄｒｅｎｏｍｅｄｕｌｉｎ，ＡｄＭ）在大鼠心血管系统的分布及缩血管活性肽对血管平滑肌细胞中肾上腺髓质素表达的影响。方法与结果：应用免疫组织化学方法（ＡＢＣ法）证实，在大鼠的外周组织，尤其是主动脉和心肌等心血管组织以及培养的血管内皮细胞、血管平滑肌细胞和心肌细胞，均含有丰富的免疫活性的肾上腺髓质素。应用半定量反转录－聚合酶链式反应（ＲＴ－ＰＣＲ）分析方法证实，缩血管活性肽－内皮素（ＥＴ－１）和血管紧张素Ⅱ（ＡＧＴ）可明显地降低培养的血管平滑肌细胞中肾上腺髓质素ｍＲＮＡ水平，这一作用可选择性地分别被ＥＴ－１的特异性受体阻断剂ＢＱ１２３和ＡＧＴ的特异性受体阻断剂Ｄｕｐ７５３所抑制，提示ＥＴ－１／ＡＧＴ可抑制肾上腺髓质素的表达。应用［３Ｈ］－ＴｄＲ掺入和细胞计数发现，肾上腺髓质素可抑制培养的自发性高血压大鼠（ＳＨＲ）血管平滑肌细胞的ＤＮＡ合成和细胞增殖。结论：心血管系统含有丰富的肾上腺髓质素，其表达受ＥＴ－１和ＡＧＴ的调控，它可能作为一种增殖抑制因子而抑制ＳＨＲ血管平滑肌细胞ＤＮＡ合成和细胞增殖。

肾上腺节细胞神经瘤的临床和病理研究

为探讨肾上腺节细胞神经瘤的病因发病、病理、临床症状及诊断治疗 ,回顾性分析 4例肾上腺节细胞神经瘤患者的临床资料 ;结果显示患者术后生存良好 ,随访 4～ 2 8月 ,肿瘤无复发和转移。我们的体会是 :肾上腺节细胞神经瘤是罕见的良性肿瘤 ,多无明显的临床症状、体征 ,B超、CT常可提示肾上腺区实性肿物 ,确诊需在病理检查时发现有神经节细胞异常增生 ;手术治疗是其主要的治疗方法 ,本病预后良好。

肾素－血管紧张素系统──应激激素反应系统

各种急性与慢性应激时，循环血中及脑、心血管、肾腺等组织中血管紧张素Ⅱ（ＡⅡ）显著增多；人剧烈运动后血浆ＡⅡ与皮质醇一样均剧烈增加，在慢性应激性高血压动物循环及组织中，ＡⅡ含量持续地增高。还发现高浓度ＡⅡ对肾上腺糖皮质激素的分泌有直接的刺激作用，而组织ＡⅡ增多又受肾上腺素能β受体的激发。根据近年来的系列工作，并结合文献，我们认为ＡⅡ是一种重要的应激激素；肾素－血管紧张素系统是一个应激激素反应系统；它与经典的应激激素反应系统，下丘脑－垂体－肾上腺皮质系统及交感－肾上腺髓质系统也存在着密切的关系。

肾上腺成熟畸胎瘤的临床诊治(附2例报告)

探讨肾上腺畸胎瘤的病理、临床表现、诊断、治疗方法及预后。总结2例肾上腺成熟畸胎瘤的诊治经验,并结合国内外文献对肾上腺成熟畸胎瘤的临床诊断与治疗进行探讨。经完整手术切除,2例患者治愈,随访2年未见局部或远处复发征象。畸胎瘤是较为罕见的生殖细胞来源肿瘤,多发生于睾丸或卵巢,其他部位(如肾上腺区)罕见,有潜在恶变可能。诊断主要依靠影像学检查,发现后应尽早手术完整切除,再结合术后病检结果决定是否行辅助化疗。需终身定期随访,预后目前尚难估计。

肾上腺肿瘤的影像学表现与病理对照分析

目的 :探讨肾上腺肿瘤影像学表现的病理基础及在诊断中的价值。方法 :总结 71例肾上腺肿瘤患者的临床资料 ,对照分析肾上腺肿瘤的影像学表现与病理类型间的关系。结果 :手术治疗 6 3例 ,术后病理 :嗜铬细胞瘤 2 0例 ,皮质腺瘤 2 7例 ,皮质腺癌 5例 ,髓性脂肪瘤 4例 ,囊肿 5例 ,节细胞神经纤维瘤 2例。转移癌 3例经临床随访证实。嗜铬细胞瘤、皮质腺瘤、髓性脂肪瘤和囊肿的B超、CT及MRI的影像学改变各有其特点。结论 :综合分析多种检查的影像学特点对判定肾上腺肿瘤的病理类型有一定的帮助。

脂多糖刺激人血管内皮细胞分泌内皮素和肾上腺髓质素及其机制研究

目的 :研究脂多糖 (LPS)刺激人血管内皮细胞 (HVEC)分泌内皮素 - 1(ET - 1)与肾上腺髓质素 (Adm)的机制。方法 :在培养的HVEC上 ,用放射免疫法测定不同浓度LPS刺激HVEC分泌的ET - 1与Adm ,以及不同的细胞信号转导阻断剂对其分泌的影响。结果 :LPS呈时间和浓度依赖性地增加HVEC分泌ET - 1和Adm ,ET - 1/Adm比值与对照组比较无明显差异 (P >0 0 5 )。在LPS刺激基础上 ,细胞外信号调节激酶 (ERKs)抑制剂PD0 980 59和P38蛋白激酶抑制剂SB2 0 2 190 可明显降低LPS刺激HVEC分泌ET - 1(P <0 0 1) ,仅SB2 0 2 190 显著降低Adm的分泌 (P <0 0 5 ) ,其余PKC抑制剂H7,钙调素 (CaM)抑制剂W7,Ca2 + 阻断剂nicardipine,钙调神经磷酸酶 (CaN)抑制剂环孢霉素 (CsA)对LPS刺激HVEC分泌ET - 1和Adm均无明显影响 (P >0 0 5 )。结论 :LPS刺激HVEC分泌ET - 1可能与ERKs和P38两条途径有关 ,LPS刺激HVEC分泌Adm只与P38信号通路有关 ,两者均不取决于PKC、Ca2 + 、CaM、CaN依赖的信号通路。

肾上腺少见肿瘤的CT表现及其病理基础

目的 探讨肾上腺少见肿瘤的CT表现特征与病理的相关性 ,以提高诊断水平。资料与方法 对 18例经手术病理证实的少见肾上腺肿瘤进行回顾性分析 ,包括肾上腺节细胞神经瘤 5例 ,髓性脂肪瘤 4例 ,淋巴瘤 3例 ,囊肿、神经鞘瘤各 2例以及神经节母细胞瘤、畸胎瘤各 1例。在CT图像上 ,观察病变的位置、大小、形态、密度、内部结构及其与周围结构的关系。结果 肾上腺节细胞神经瘤CT表现为均匀软组织密度肿块 ,1例有点状钙化。髓性脂肪瘤为以脂肪密度为主的肿块。淋巴瘤为软组织密度肿块。良性神经鞘瘤为软组织肿块 ,有囊变及钙化 ;恶性神经鞘瘤也为软组织肿块 ,内见坏死区 ,伴淋巴结转移。囊肿呈水样密度 ,壁薄光整 ,1例有囊壁钙化。神经节母细胞瘤为密度不均匀软组织肿块 ,内见坏死灶 ,伴周围淋巴结肿大。畸胎瘤为含钙化、脂肪及软组织成分的肿块。结论 CT可揭示肾上腺少见肿瘤的病理基础 ,它们存在一定的影像表现特点 ,CT是临床上最常用的影像学检查方法。

肾上腺皮质腺瘤、腺癌48例临床病理分析

目的 探讨肾上腺皮质腺瘤 (ACA)、皮质腺癌 (ACC)的临床病理特征和诊断要点。方法 对 4 6例ACA、2例ACC的临床病理学资料进行分析 ,18例ACA、2例ACC做免疫组化检测。结果 ACA 4 6例 ,其中功能性ACA 34例 ,无功能性ACA 12例。腺瘤为有包膜的孤立性肿块 ,平均重量 9 12g ,包膜外肾上腺组织受压萎缩 ;肿瘤由透明细胞和致密细胞不同比例构成 ,瘤细胞形态较一致 ,核分裂罕见 ,可见散在巨形细胞 ,核不规则深染或怪异核。免疫组化 :18例ACA中 5例PCNA(+) ,见于致密嗜酸性细胞占肿瘤 6 0 %以上者 ,p5 3均 (- )。 2例ACC重量均 >10 0g,肿瘤与周围组织粘连 ,瘤细胞嗜酸性 ,高度异型 ,核分裂 >5个 5 0HPF ,瘤细胞浸润包膜及周围组织 ;PCNA( ) ,p5 3(+)。结论 功能性ACA的组织结构和细胞特征在预测内分泌综合征时不完全可靠 ,需要结合临床内分泌检测 ;ACA仅靠形态学难以判断良恶性 ,需随访 ;伴有肾上腺生殖器综合征者、PCNA阳性者应重点随访。肿瘤的大小、重量、核分裂象及PCNA、p5 3检测对肾上腺皮质肿瘤的良恶性鉴别有重要的参考价值 ;但包膜。