China
Africa
Explore chapters and articles related to this topic
Endocrinology and metabolism
Published in Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan, Essential Notes for Medical and Surgical Finals, 2021
Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan
The adrenal gland consists of the cortex and medulla. Within the cortex there are three zones: zona glomerulosa: produces mineralocorticoids – mainly aldosterone. Renin (from kidney) stimulates conversion of angiotensinogen (from liver) to angiotensin I, which is converted to angio tensin II in the lung by ACE. Angiotensin II stimulates aldosterone productionzona fasciculata: produces glucocorticoids – mainly cortisol. CRF/AVP stimulate ACTH production by the pituitary which stimulates cortisol productionzona reticularis: produces sex steroids The medulla secretes catecholamines (adrenaline, noradrenaline) in response to various stimuli, e.g. stress, fear.
Adrenalectomy
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Mikael Petrosyan, Timothy D. Kane
The adrenal cortex may be divided into three zones: The zona glomerulosa is the outermost zone of the cortex, responsible for the synthesis of aldosterone.The zona fasciculata is the largest zone of the cortex and the site of cortisol production.The zona reticularis is the innermost and smallest zone. Cells here produce adrenal androgens, dihydroepiandrosterone, and androstenedione.
Hormones of the Adrenal Gland
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
The adrenal cortex consists of three distinct zones of cells: (i) the zona glomerulosa, the outermost layer, which is the site of aldosterone, principal mineralocorticoid and corticosterone synthesis; (ii) the zona fasciculata, the wider middle layer and (iii) the zona reticularis, the innermost layer, which functions as a unit synthesizing cortisol and some corticosterone, and the androgen dehydroepiandrosterone (DHEA) sulphate.
Enlargement of the human adrenal zona fasciculata and chronic psychiatric illness – an autopsy-based study
Published in Stress, 2020
Johannes Rødbro Busch, Sissel Banner Lundemose, Niels Lynnerup, Christina Jacobsen, Martin Balslev Jørgensen, Jytte Banner
Biochemical measurements show endocrine dynamics, but long-term dysregulation of the HPA-axis in chronic mental illness may also be investigated by looking at the regulatory or effector organs themselves. Animal studies correlate a stressful environment to an increased size of the adrenal zona fasciculata (ZF), where the majority of endogenous corticosteroids are produced (Ulrich-Lai et al., 2006). In humans, most research has been limited to radiological studies, with CT and MRI studies demonstrating an increased volume of the adrenal glands in patients with major depressive disorder (Kahl et al., 2015; Nemeroff et al., 1992; Rubin, Phillips, Sadow, & McCracken, 1995; Rubin, Phillips, McCracken, & Sadow, 1996), while others have found no difference (Amsterdam, Marinelli, Arger, & Winokur, 1987; Ludescher et al., 2008). In one study, Szigethy, Conwell, Forbes, Cox, and Caine (1994) investigated adrenal glands removed at autopsies of suicide victims and matched controls, and found an increased weight and an association between larger gland weight and increased thickness of the cortex. This finding is contrasted by Stein, McCrank, Schaefer, & Goyer (1993) who, in a prospective sample of 118 various forensic autopsy cases, found that adrenal gland weight in individuals where the manner of death was ruled suicide was no different than in individuals who died from natural causes or by accident.
Virilising ovarian tumour in a postmenopausal woman after bilateral oophorectomy
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2020
Ankia Coetzee, Jocelynn Ann Hellig, Candice Sher-Lockitz, Annelize Barnard, Viju Thomas, Magda Conradie
Histopathology remains the gold standard for the diagnosis of steroid cell tumours NOS. Characteristically these tumours are benign, well circumscribed and non-calcified with a lobulated appearance. The tumours are also typically solid with a yellow or orange section surface because of intracytoplasmic lipids. On microscopic examination, the tumour cells typically have a nested arrangement but can be organised into columns or cords resembling adrenal zona glomerulosa and zona fasciculata. Cytologically, cells are polygonal or round with distinctive cell borders, central nuclei and prominent nucleoli. The cytoplasm varies from eosinophilic to clear and vacuolated. The absence of cytoplasmic Reinke’s crystals helps differentiate this tumour from the Leydig cell neoplasm. Immunohistochemical staining helps to distinguish steroid cell tumours from other stromal cell tumours as shown in the index case (see Figures 1 and 2). Based on the limited data available, the recommended management of steroid cell tumour NOS is primarily surgical.
Insufficiency of the zona glomerulosa of the adrenal cortex and progressive kidney insufficiency following unilateral adrenalectomy – case report and discussion
Published in Blood Pressure, 2018
Joanna Kanarek-Kucner, Adrian Stefański, Rufus Barraclough, Tomasz Gorycki, Jacek Wolf, Krzysztof Narkiewicz, Michał Hoffmann
In our patient zona fasciculata function was checked before and after UA and additional examination did not reveal any abnormalities. On supplemental fludrocortisone the patient’s aldosterone was 5.3 ng/dl which is in normal range (2.52-39.2ng/dl), with strikingly high renin level 71.5 ulU/ml (despite the fludrocoritosone administration). Specimen for testing was sampled after 1 hour of upright position. Physical activity should stimulate renin and as a consequence aldosterone secretion. In this case we observed abnormal high renin level with poor aldosterone response. Obtained laboratory results suggest subclinical insufficiency of zona glomerulosa. Taking into consideration laboratory results and evident clinical symptoms such as hyperkaliemia, hyponatremia, metabolic acidosis together, proper function of zona fasciculata and no other hormonal causes of hyperkaliemia, insufficiency of the zona glomerulosa of the remaining adrenal gland with residual secretion is suspected. Moreover, in some studies aldosterone level lower than 3.5ng/dl was considered as undetectable [6]. Directly after UA hyperkaliemia coexisted with deterioration in renal function, but further observation did not reveal any relation between creatinine levels (or eGFR) and potassium levels. Moreover in the 12 months follow up any attempt to stop fludrocortisone administration ended up with hyperkaliemia and hyponatremia. It seems unlikely that postoperative hyperkalemia is due only (and directly) to a reduction in renal function.