后腹腔镜肾上腺全部切除与部分切除治疗醛固酮瘤的疗效对比

目的:探讨后腹腔镜肾上腺全部切除与部分切除治疗醛固酮瘤的疗效。方法:收集我院收治的醛固酮瘤患者60例,随机分为部分切除组和全切除组,每组30例,分别给予肾上腺部分切除以及肾上腺全切除手术,手术结束后,对所有患者的住院时间、术中出血量、手术时间、血清钾、血清醛固酮水平以及患者的治疗效果进行检测并比较。结果:手术后,部分切除组和全切除组患者血清钾水平均升高(P0.05),醛固酮水平均降低(P0.05);与全切除组相比,部分切除组患者的术中出血量以及住院时间较短(P0.05),血清钾水平较高(P0.05),血清醛固酮水平较低(P0.05);两组患者的手术时间以及临床疗效无明显差异(P0.05)。结论:后腹腔镜肾上腺部分切除术较全切除术能够缩短醛固酮瘤患者住院时间,减少手术出血量,升高血清钾水平,降低醛固酮水平。但两种术式的手术时间以及临床疗效相当,对临床有指导意义。     

白暨豚肾上腺的研究

白鱀豚肾上腺重与体重的平均比值为0.25克/公斤,皮质体积与髓质体积的比值为6.59。白鱀豚肾上腺的组织结构与其它海豚相似,它有比较发达的球状带。讨论了白鱀豚肾上腺形态变化在年龄生长、授乳等生理过程和在自然环境、豢养环境生态适应上的意义。并报道了一例罕见的白鱀豚肾上腺先天性表皮样囊肿。       

Distribution and morphology of ghrelin immunostained cells in the adrenal gland of the African ostrich

Ghrelin is the endogenous ligand for the growth hormone secretagogue receptor. We investigated the distribution and morphological characteristics of ghrelin-immunopositive (ghrelin-ip) cells in the African ostrich adrenal gland. We found that the adrenal gland of the African ostrich consisted of three parts: capsule, inter-renal tissue and chromaffin cells. The inter-renal tissue and chromaffin cells interdigitated irregularly. The inter-renal tissue consisted of a peripheral zone and a central inner zone. The peripheral zone could be divided into an outer subcapsular zone and an inner zone. The subcapsular zone cells were arranged as a bow, while the inner area cells formed cords that were perpendicular to the capsule. The central inner zone exhibited irregular clumps and the cells were morphologically similar to chromaffin cells. Ghrelin-ip cells were located throughout the adrenal gland except the capsule. The majority of ghrelin-ip cells were found among the chromaffin cells. The number of ghrelin-ip cells in the inter-renal tissue decreased gradually from the central inner zone, to the inner zone to the subcapsular zone. The ghrelin-ip cells were oval or irregular in shape and exhibited cytoplasmic staining. Our findings suggest that ghrelin may play a role in regulating adrenal hormone secretion in the African ostrich.     

促肾上腺皮质激素引起大鼠肾上腺c-fos原癌基因表达的免疫组化研究

采用冰冻切片及免疫组化法观察了注射促肾上腺皮质激素(ACTH,75U/kg)、胰岛素及正常对照大鼠中肾上腺各部分c-fos原癌基因表达产物Fos蛋白的出现和分布特点。结果表明注射ACTH后90min,大鼠肾上腺皮质网状带出现Fos蛋白染色阳性细胞,阳性染色物集中于细胞核,肾上腺皮质束状带仅见少数Fos蛋白染色阳性细胞,肾上腺髓质则未见Fos蛋白染色阳性细胞。与注射ACTH相反,注射胰岛素引起肾上腺髓质出现Fos蛋白染色阳性细胞。注射生理盐水对照组动物肾上腺皮质和髓质均未见Fos蛋白染色阳性细胞。上述结果表明,注射ACTH或胰岛素可以引起大鼠肾上腺不同部位c-fos原癌基因表达。     

Adrenal responsiveness and social status in intact and ovariectomized Macaca fascicularis

Plasma cortisol (F) response to intravenous adrenocorticotropin (ACTH) infusion (following dexamethasone suppression) was examined in adult female Macaca fascicularis that had been living for 22 months in social groups consisting of four to six females and one male. A portion of these females were ovariectomized (n = 21), while the rest were reproductively intact (n = 23). The social behavior of all animals was monitored with a focal sampling procedure, and dominance ranks were determined on the basis of fight outcomes. Further, intact females were swabbed vaginally to determine onset of menstruation and were sampled for plasma progesterone (P) every three days during the luteal phase of their cycles. Among the results was that the plasma F response to ACTH infusion was greater in subordinate animals than in dominants (P < .02). Subordinates and dominants did not, however, differ in plasma F measured at baseline. It was found further that plasma F concentrations were greater in ovariectomized than in intact females at baseline and following ACTH injection (P < .01). Finally, there was an appreciable elevation in plasma F across all animals during the 15- and 30-minute post-ACTH injection measurements (P < .01). Subsequent analyses of data from intact females showed interrelationships among dominance rank, reproductive function (indicated by luteal phase plasma P concentrations), adrenal size, and adrenal response to ACTH infusion. These data indicated that subordinate females were at a reproductive disadvantage compared to dominants, a result that may have been mediated, in part, by the increased adrenal size and enhanced adrenal responsiveness of subordinate females.     

Inhibition of the rat adrenal ornithine decarboxylase activity by immobilization stress and/or dexamethasone

The effects of immobilization stress and/or dexamethasone (DEX) on the adrenal ornithine decarboxylase (ODC) activities of sham-operated and adrenal-medulloectomized (enucleated) male Sprague-Dawley rats were investigated. On day 11 after surgery, rats were injected with saline or DEX (1 mg/kg), 3 h before the time of sacrifice (0600 h or 1800 h). Four groups, from sham-operated and enucleated rats (ENU) treated with saline or DEX were subjected to immobilization stress for 1 h prior to sacrifice. Groups of rats from stress-sham-DEX, non stress-sham-DEX, stress-sham, non stress-sham, stress-ENU-DEX, non stress-ENU-DEX, stress-ENU, and non stress-ENU were sacrificed at 0600 h or 1800 h on day 11 after surgery. Adrenal glands were excised and later analyzed for ODC activities. Results indicated that DEX and/or immobilization stress inhibited ODC activities (p < 0.05) in normal and regenerating adrenal glands at 1800 h and ODC activity varies diurnally, the activity being greater at 1800 h than at 0600 hours (p < 0.001).     

Enhanced differentiation of sexually dimorphic organs in L-thyroxine treated Tfm mice

Summary In the present study we examined the effects of L-thyroxine on the differentiation of three sexually dimorphic organs in mice affected by the testicular feminization mutation (Tfm): the submaxillary salivary glands, the kidneys, and the adrenal glands. In the salivary gland we compared the effects of L-thyroxine and testosterone in normal and Tfm mice on the morphology of the intercalated tubules and on the NGF content of this gland. In the kidney we examined thyroid hormone effects on the sexually dimorphic proximal convoluted tubules. In the adrenal gland we studied the effects of the same hormone on the weight of the organ and on the structure and ultrastructure of the zona reticularis in untreated and L-thyroxine treated Tfm mice. The results show that the thyroid hormone enhances differentiation of the dimorphic structures in all these organs and increases the secretory activity of the salivary and adrenal glands. The stimulatory effects of L-thyroxine are more pronounced on the weight of the adrenal than of the salivary gland and of the kidney. Our results raise the question whether the enhanced differentiation elicited by L-thyroxine in the three sexually dimorphic organs of Tfm mutants is due to a direct hormonal effect, or whether it is fully, or in part, mediated through the hypothalamo-pituitary-thyroid axis.This investigation was supported by the Progetto Finalizzato Biologia della Riproduzione of the Italian National Council of Research (CNR)     

Ultrastructural changes in adrenaline- and SGC-cells after morphine coincide with alterations of adrenaline and dopamine levels

Summary The effects of morphine on chromaffin cell ultrastructure and catecholamine contents were studied using the adrenal glands from male mice (ICR strain). After 2 h adrenaline was increased 25% from 8.1 to 11.6 mol/g tissue, followed by a 50% decrease to 5.2 mol/g between 8–24 h and low values persisting at 72 h. Dopamine increased initially, reaching peak values of 0.5 mol/g between 8–24 h, but had returned towards control values of 0.29 mol/g by 72 h. Noradrenaline remained unchanged at 2.5 mol/gram. Naloxone prevented alterations in adrenaline and dopamine levels.Ultrastructural examination revealed several types of catecholamine-storing cells. Of these the adrenaline and small-granule chromaffin (SGC) cells were more affected by morphine than noradrenaline cells. While the initial elevation of adrenaline 2 h after morphine was not accompanied by significant ultrastructural changes, the decrease after 8 and 24 h was paralleled by a significant (p<0.001) loss of adrenaline granules. Signs of active membrane turnover included an increase in the number of vacuoles, and the appearance of numerous coated omega profiles and coated (77.7±0.6 nm) vesicles. Clusters of synaptic-like vesicles (59.8±8.2 nm), slightly larger than neuronal vesicles (45.4±6.4), increased in the SGC-cells. After 72 h, the chromaffin granules in adrenaline cells remained low in numbers and were heterogeneous in electron density. Many synapticlike vesicles were aligned along the SGC-cell membranes where only few chromaffin granules (109.3±20 nm) remained. Thus, continuous morphine exposure for 8–72 h increases the turnover of storage granules in adrenaline and SGC-cells with less effect on the noradrenaline cells which maintain catecholamine levels as indicated by biochemical analysis.     

The possible structural changes in the adrenal gland cortex after induction of hepatic ischemia–reperfusion injury in male albino rats: Light and electron microscopic study

The adrenal gland is an important endocrine gland in the body that secrets the adrenal hormones. One of the important clinical issues is the hepatic ischemia–reperfusion (IR) injury. Liver IR injury results in many distant organs dysfunctions such as lung, kidney, intestine, pancreas, and myocardium. The aim of the present study was to investigate the possible remote effects of hepatic IR on the structure of the adrenal cortex. Twenty healthy males, Sprague–Dawley albino rats aged 6–8 weeks were randomly divided into two groups (10 rats each): the sham control group (SC-group) and the ischemia–reperfusion group (IR-group). Sera were estimated for the following: aspartate transaminase (AST), alanine transaminase (ALT), lactic dehydrogenase (LDH), and corticosterone levels. Also oxidative markers such as malondialdehyde (MDA) and tumor necrosis factor-α (TNF-α), and the antioxidative enzyme, catalase were measured. Adrenal glands were processed for light and transmission electron microscopic study. The results showed a significant increase in serum liver enzymes (AST, ALT, and LDH), corticosterone, MDA, and TNF-α levels and a significant decrease in serum levels of catalase in IR-group compared with SC-group. Adrenal cortical tissue of IR-group showed the loss of normal appearance. Some cells of zona glomerulosa and most of the zona fasciculata cells appeared swollen and degenerated with highly vacuolated cytoplasm. Other cells were shrunken with deeply acidophilic cytoplasm and pyknotic nuclei. Degenerated mitochondria with disrupted cristae, lipid droplets were confluent and dilated smooth endoplasmic reticulum were seen. Few zona reticularis cells had the dark nucleus and cytoplasmic vacuolations. In the different zones, blood capillaries were markedly congested and some inflammatory cells infiltrations were observed. Liver IR affected the structure of the adrenal cortex.     

Catecholamine content of chromaffin granule ‘ghosts’ isolated from bovine adrenal glands

Studies on the mechanism of catecholamine transport into chromaffin granules is complicated by the release of endogenous catecholamines. To overcome this problem chromaffin granule ghosts have been prepared by many investigators by osmotic lysis of the granules which results in a loss of over 90% of the endogenous catecholamine. However, in the studies reported here, the resulting ghosts still contained 36 ± 3.9 nmol epinephrine/mg of protein if they were lysed by passage through a Sephadex G-50 column preequilibrated with hypoosmtic media. This residual catecholamine was foun the slowly diffuse out of the ghosts in a temperature-dependent process at a rate sufficient to interfere with kinetic analysis of catecholamine transport. Attempts to remove the endogenous catecholamine from the ghosts indicated that most of it could not be removed by further osmotic shock or freeze-thaw treatments, but that over 85% of it was released from the granules by incubating them at 30°C for 90 min or by dialysis with a 35 and 86% loss of rate of catecholamine transport into the ghosts, respectively. If the endogenous catecholamine was removed from chromaffin granule ghosts by preincubating them for 90 min at 30°C, these resulting ghosts transported catecholamine with a linear Lineweaver-Burk plot indicating a K_m of 12±2 μM. In addition, the resulting ghosts did not leak catecholamines over a 10 min period at 30°C, and the transport of catecholamines was blocked by reserpine and enhanced with increasing pH from 6.0 to 8.5.     

Receptor sites for atrial natriuretic factors in brain and associated structures: an overview

1. Recent data have clearly shown the existence of specific receptor binding sites for atrial natriuretic factors (ANF) or polypeptides in mammalian brain tissues. 2. Ligand selectivity pattern and coupling to cGMP production suggest that brain ANF sites are similar to high-affinity/low-capacity sites found in various peripheral tissues (kidney, adrenal gland, blood vessels). These brain ANF sites possibly are of the B-ANP subtype. 3. High densities of ANF binding sites are found especially in areas of the central nervous system associated with the control of various cardiovascular parameters (such as the subfornical organ and area postrema). However, high densities of sites are also present in other regions such as the hippocampus, cerebellum, and thalamus in the brain of certain mammalian species, suggesting that brain ANF could act as a neuromodulator of noncardiovascular functions. 4. The density of brain ANF binding sites is modified in certain animal models of cardiovascular disorders and during postnatal ontogeny, demonstrating the plasticity of these sites in the central nervous system (CNS). 5. Specific ANF binding sites are also found in various other CNS-associated tissues such as the eye, pituitary gland, and adrenal medulla. In these tissues ANF appears to act as a modulator of fluid production and hormone release. 6. Thus, ANF-like peptides and ANF receptor sites are present in brain and various peripheral tissues, demonstrating the existence of a family of brain/heart peptides.     

Purification and reconstitution of the 32Pi-ATP exchange activity of bovine chromaffin granule membrane

Ghosts derived from bovine chromaffin granules have a ³²P_i-ATP exchange activity which is associated with the H⁺ pump of that membrane. This activity was low when compared to bacteria, chloroplasts or submitochondrial particles, but had similar properties (K_m for ATP and P_i, ATP/Mg²⁺ ratio, pH profile, inhibition by dicyclohexylcarbodiimide and tributyltin) to the ATPase from above membranes. The ³²P_i-ATP exchange activity was solubilized by cholate/octylglucoside mixtures. The soluble extract was lipid depleted by ammonium sulfate fractionation and partially purified by sucrose gradient centrifugation. The purified preparation was reconstituted with phospholipids by freeze-thawing. The reconstituted vesicles had a ³²P_i-ATP exchange sensitive to dicyclohexylcarbodiimide and trybutyltin and an ATPase with a sensitivity to the inhibitors which varied with the reconstitution conditions. The α- and β-subunits of F₁-ATPase were major components of the preparation.     

Effects of selenium on chemical carcinogenesis

Chemical carcinogenesis can be characterized by a sequence of events leading to the development of tumors. Selenium (Se) inhibition of colon, liver, and lung carcinogens is demonstrated. Using the male Sprague Dawley rat model Se inhibited the colon tumor incidence in 1,2-dimethylhydrazine (DMH) treated rats and reduced the total number of colon tumors in methylazoxymethanol (MAM) treated rats. Selenium inhibited 2-acetylaminofluorene (AAF) and 3′-methyl-4-dimethylaminoazobenzene (3′-MeDAB) hepatocarcinogenesis. The hepatic tumor incidence induced by 3′-MeDAB was reduced by both inorganic Se (Na₂SeO₃) and by organic Se (Se-yeast) supplements. In vitro systems have been studied in an effort to decipher the inhibitory properties of Se on the multistage origin of tumors induced by chemical carcinogens. Current studies suggest that the protective effect of Se against AAF hepatocarcinogenesis may be correlated with a change in AAF metabolism. The mutagenicity of AAF and AAF metabolites inSalmonella typhimurium TA1538 is decreased by Se. Additionally, Se reduced N-t-OH−AAF induction of sister chromatid exchange (SCE) frequencies in whole blood cultures, and also reduced aryl hydrocarbon hydroxylase activity using benzo(a) pyrene as substrate. The comparative effects of antioxidants on DMH induction of colon tumors are presented in detail. Supplements of 4 ppm Se to the drinking water, 1.2% ascorbic acid (V _c ) to the diet or 0.5% butylated hydroxytoluene (BHT) to the diet of DMH-treated rats reduced the colon tumor incidence of DMH controls from 64 to 31% (Se), 38% (V _c ), and 43% (BHT). The colon tumor incidence in DMH-treated rats receiving a combination of Se+V _c increased to 83%, while the combination of Se+BHT decreased the colon tumor incidence to 55%. The growth and survival of rats provided long-term supplements of 4 ppm Se in the drinking water are compared with untreated controls.     

Comparative Studies on the Orcadian Rhythm of Corticosterone Lipid and Cholesterol Levels in Adrenals and Blood of Rats

The time-dependent relationship of corticosterone, lipids and cholesterol over a 48-hr period was studied in the adrenals and blood of rats. In addition an attempt was made to determine whether there was a reciprocal dependence among these compounds and also a correlation between corticosterone and cholesterol in the adrenals and blood.

Corticosterone and cholesterol exhibit a circadian rhythm in the adrenals and blood. The same is true for lipids in the serum. A reciprocal dependence between the compounds in the adrenals and blood could not be demonstrated. Only the time-dependent processes of the corticosterone content in the adrenals and plasma are well correlated with each other. High levels of these steroids in the adrenals are associated with high levels of these steroids in the plasma and vice versa.

An inverse correlation between corticosterone and cholesterol exists in the adrenals and in blood. Maximal levels of corticosterone correspond to minimal levels of cholesterol and vice versa.     

Comparative Studies on the Orcadian Rhythm of Corticosterone Lipid and Cholesterol Levels in Adrenals and Blood of Rats

The time-dependent relationship of corticosterone, lipids and cholesterol over a 48-hr period was studied in the adrenals and blood of rats. In addition an attempt was made to determine whether there was a reciprocal dependence among these compounds and also a correlation between corticosterone and cholesterol in the adrenals and blood.

Corticosterone and cholesterol exhibit a circadian rhythm in the adrenals and blood. The same is true for lipids in the serum. A reciprocal dependence between the compounds in the adrenals and blood could not be demonstrated. Only the time-dependent processes of the corticosterone content in the adrenals and plasma are well correlated with each other. High levels of these steroids in the adrenals are associated with high levels of these steroids in the plasma and vice versa.

An inverse correlation between corticosterone and cholesterol exists in the adrenals and in blood. Maximal levels of corticosterone correspond to minimal levels of cholesterol and vice versa.     

Splanchnic Nerve Transection Abolishes the Age-Dependent Increase of Neuropeptide Y-Like Immunoreactivity in Rat Adrenal Gland

Using an antiserum directed against porcine neuropeptide Y (NPY), a high concentration of NPY immunoreactivity (NPY-IR) was detected in rat adrenal gland. The level of NPY-IR in the adrenal gland was found to increase considerably with age. Biochemical characterization by reverse-phase HPLC indicated that this increase was due to accumulations of NPY and another molecular form of NPY-like immunoreactive peptide. Chronic denervation of the splanchnic nerve abolished this age-dependent increase of NPY-IR rat adrenal gland.     

腹膜后腹腔镜技术在泌尿外科的应用

目的:对比腹膜后腹腔镜手术起步阶段和相对成熟阶段的临床资料,总结手术经验,提高应用水平。方法:对2005年1月至2008年12月起步阶段腹膜后腹腔镜手术65例患者,及2016年1月至2016年12月相对成熟阶段腹膜后腹腔镜手术148例患者进行回顾性分析。结果:起步阶段:中转开放手术5例,术后发热及切口延迟愈合7例;相对成熟阶段:中转开放手术4例,术后发热及切口延迟愈合6例,无大血管破裂、腹腔内脏器损伤、死亡等并发症。在肾囊肿去顶减压手术及肾上腺手术中,成熟阶段患者的各项指标包括手术时间、出血量、中转开放手术比例、术后拔除引流管时间及住院时间均显著优于起步阶段,差异有统计学意义(P0.05)。结论:腹膜后腹腔镜技术适于治疗上尿路及肾上腺疾病,具有患者创伤小、安全、术后康复快等优点,早期起步阶段适合选择简单术式,随着手术技术的熟练可逐步开展复杂的手术。