Surgical anesthesia in a patient with a pheochromocytoma crisis supported by ECMO: a case report.

Pheochromocytoma is rare in clinical practice, with patients typically presenting with headache, high blood pressure and sweating. Patients who develop a pheochromocytoma crisis are particularly rare. This report describes the case of a patient in a pheochromocytoma crisis who presented with severe cardiogenic shock, acute respiratory failure, and acute coronary syndrome.

Unexpected pheochromocytoma leading to cardiac arrest during the perioperative period: a case report and literature review.

Background: Pheochromocytomas (PCCs) are rare neuroendocrine catecholamine (CA)-secreting tumours that originate from chromaffin tissue and can produce and store CAs. Unexpected PCCs pose a serious threat to the perioperative safety of patients and a considerable challenge to anaesthesiologists because of the risks of fatal hypertensive crises and other stresses.

Case Presentation: A 37-year-old woman who was scheduled for tonsillectomy and palatopharyngoplasty under general anaesthesia experienced a malignant cardiovascular event after induction, which was characterized mainly by a sharp increase in heart rate and blood pressure, ultimately leading to cardiac arrest and the occurrence of secondary long QT syndrome.

A rare case of sclerosing angiomatoid nodular transformation of spleen: A case report.

Introduction And Importance: Sclerosing angiomatoid nodular transformation of the spleen is a rare benign vascular lesion arising from red pulp of spleen with unknown etiopathogenesis. It is a non-neoplastic condition that affects the spleen only; not described in other sites except one case reported in adrenal gland. Epidemiologically it has slight female predilection.

EVIDENCE FOR ADRENAL DYSFUNCTION CONTRIBUTING TO PERACUTE MORTALITY SYNDROME IN RED PANDA ().

Red pandas () are endangered with extinction due to deforestation and habitat fragmentation. Reported causes of unexpected death in managed red pandas include kidney, liver, gastrointestinal, and cardiac disease. A previously undetailed syndrome, red panda peracute mortality syndrome, may be emerging, as red pandas have died unexpectedly, with no clear cause of death identified at necropsy.

DO HEALTHY COQUEREL'S SIFAKAS IN CAPTIVITY HAVE UNUSUALLY LOW CIRCULATING CORTISOL?

Cortisol, and other glucocorticoids, are routinely used as markers of physiological stress in wildlife. Typically, stress activates the hypothalamic-pituitary-adrenal (HPA) axis, with adrenocorticotropic hormone (ACTH) signaling the adrenal glands to release cortisol. Nevertheless, recent anecdotes in captive Coquerel's sifakas (), strepsirrhine primates that are difficult to maintain under human care, may challenge the assumption that physiological stress universally increases circulating cortisol.

Ultrasonographic adrenal gland changes in dogs with Cushing's syndrome with a low-dose dexamethasone suppression test result consistent with partial suppression or escape pattern.

Background: Cushing's syndrome (CS) in dogs is mainly caused by pituitary-dependent (PDH) or adrenal-dependent (ADH) hypercortisolism. Result of the low-dose-dexamethasone suppression test (LDDST) with partial suppression (PSP) or escape pattern (EP) are indicative of PDH. No data concerning the ultrasonographic characteristics of the adrenal glands from dogs with these patterns exists.

Challenging granulomatous differential diagnosis of CNS lesions in a 75-year-old patient with indolent lymphoma.

We report here on a patient with concomitant indolent lymphoma who showed a rapid progressive deterioration of his general condition and emerging neurological symptoms. The combination of severe B symptoms with hypermetabolic involvement of the adrenal glands and multiple central nervous system (CNS) lesions initially suggested a malignant disease. However, when the patient presented to us with biopsy results from one of the CNS lesions, the biopsy revealed granulomatous inflammation but no evidence of malignancy.

Lipopolysaccharide differentially alters systemic and brain glucocorticoid levels in neonatal and adult mice.

Glucocorticoids (GCs) are secreted by the adrenal glands and increase in response to stressors (e.g., infection).

Effects of the Combination of Epimedium brevicornum Maxim, Ligustrum lucidum Ait and Dexamethasone on asthmatic rats by endogenous glucocorticoid pathway.

Ethnopharmacological Relevance: The theory of traditional Chinese medicine (TCM) believes that kidney deficiency is the fundamental cause of chronic refractory asthma, accompanied by pathological changes such as airway remodeling and a reduction of endogenous glucocorticoid (GC) synthesis. The combination of Epimedium brevicornum Maxim (EB) and Ligustrum lucidum Ait (LL) is frequently used in TCM for kidney tonifying and the alleviation of asthma symptoms. This approach is based on Pei-Ben formula, a renowned treatment for asthma developed by the distinguished Shanghai Practitioner, Professor Huiguang Xu, over 30 years of clinical experience.

Concomitant, Acquired Cavo-Azygos Shunt and Spleno-Gastroepiploic Bypass After Multiple Venous Obstruction in a Dog.

A 13-year-old intact female Shih Tzu presented with anorexia, panting and pain of unknown origin. Physical examination was normal except for a systolic murmur (grade 3/6). Abdominal radiographs revealed an ill-defined area of increased opacity in the mid-abdomen.

Chaihu-Shugan-San Ameliorated Osteoporosis of Mice with Depressive Behavior Caused by Chronic Unpredictable Mild Stress via Repressing Neuroinflammation and HPA Activity.

Objective: Depression and osteoporosis are usually concurrent health problems. This study aimed to explore the development of osteoporosis in depressive mice model and investigate the beneficial effects of the classical herbal formula Chaihu-Shugan-San (CHSG) on the brain and bone.

Methods: CHSG powder was prepared by spray-drying following extraction with water.

Diaphragmatic pheochromocytoma: Two case reports and a review of the literature.

Rationale: Pheochromocytomas typically arise in the adrenal medulla, whereas ectopic pheochromocytomas/paragangliomas commonly occur near the abdominal aorta, bladder, mediastinum, and head. Diaphragmatic pheochromocytomas are exceedingly rare, and there is limited surgical experience with their treatment.

Patient Concerns: In Case A, the subject is a 45-year-old male, while in Case B, the subject is a 59-year-old female.

Metabonomics and Transcriptomics Analyses Reveal the Underlying HPA-Axis-Related Mechanisms of Lethality in Exposed to Underwater Noise Pollution.

The problem of marine noise pollution has a long history. Strong noise (>120 dB re 1 µPa) will affects the growth, development, physiological responses, and behaviors of fish, and also can induce the stress response, posing a mortal threat. Although many studies have reported that underwater noise may affect the survival of fish by disturbing their nervous system and endocrine system, the underlying causes of death due to noise stimulation remain unknown.

Graph theory analysis of a human body metabolic network: A systematic and organ-specific study.

Purposes: Positron emission tomography (PET) imaging is widely used to detect focal lesions or diseases and to study metabolic abnormalities between organs. However, analyzing organ correlations alone does not fully capture the characteristics of the metabolic network. Our work proposes a graph-based analysis method for quantifying the topological properties of the network, both globally and at the nodal level, to detect systemic or single-organ metabolic abnormalities caused by diseases such as lung cancer.

Diagnosis of Primary Aldosteronism without Discontinuation of Interfering Antihypertensive Medications.

Purpose Of Review: One of the challenges in the diagnosis and management of primary aldosteronism (PA), the most common type of secondary hypertension with curative potential, is the modification of antihypertensive medications. We seek to explore whether these medications can be continued during the diagnostic process of PA to minimize the duration and risks associated with medication adjustments.

Recent Findings: We searched PubMed for eligible original literature between 1990 and 2024 using the following keywords: (screening) AND (primary aldosteronism); (confirmatory) AND (primary aldosteronism); (adrenal vein sampling) AND primary aldosteronism).

Intimal sarcoma of the aortic valve and ascending aorta: a case report.

Background: Intimal sarcomas are rare tumors that typically affect the major vessels, such as the pulmonary artery and aorta, and are associated with a particularly poor prognosis. Intimal sarcomas found in the aorta are most commonly located in the abdominal section between the celiac artery and the iliac bifurcation. The descending aorta is involved in 30% of cases, while involvement of the ascending aorta is rare.

Cardiovascular risk improvement after laparoscopic adrenalectomy in patients with cortisol-secreting adrenal adenoma, a retrospective cohort study.

Background: Cushing syndrome increases morbidity and mortality, which is mainly caused by cardiovascular disorders. This study reports the cardiovascular risk outcomes at 3, 6, and 12 months after unilateral laparoscopic adrenalectomy in cortisol-secreting adrenal tumor and to identify the preoperative parameters predicting the resolution of cardiovascular risk factors after surgery.

Methods: All clinical data of patients with unilateral cortisol-secreting adrenal tumors who underwent laparoscopic adrenalectomy in King Chulalongkorn Memorial Hospital between 2001-2022 were retrospectively reviewed.

Benefits of transitioning from transperitoneal laparoscopic to retroperitoneoscopic adrenalectomy-a single center experience.

Background: Since 2017, switching from laparoscopic transabdominal adrenalectomy (LTA), posterior retroperitoneoscopic adrenalectomy (RPA) is used as standard procedure in this institution. Aim of this retrospective study was to compare both techniques regarding operative time, length of stay and safety of the procedures.

Methods: All patients operated in our institution for adrenal tumors were prospectively documented in the EUROCRINE-database and retrospectively analyzed.

Glucocorticoid replacement therapy after retroperitoneal laparoscopic unilateral adrenal adenoma resection in patients with non-cortisol secreting tumors: a retrospective cohort study.

Background: Adrenal Cushing's syndrome is caused by an adrenal tumor that produces hypercortisolism and requires glucocorticoid supplementation following resection of the tumour to prevent adrenal insufficiency. Few studies have examined whether glucocorticoid replacement (GR) therapy is required after retroperitoneal laparoscopic unilateral adrenal adenoma resection in patients with non-cortisol secreting tumors, or whether there is any correlation between preoperative biochemical indicators and postoperative cortisol function. This study sought to investigate which patients with non-cortisol secreting tumors required GR therapy after undergoing retroperitoneal laparoscopic resection of unilateral adrenal cortical adenoma.

Case Report: A rare case of antenatally diagnosed mature adrenal teratoma in an infant: insights and literature review.

Teratomas are germ cell tumors that arise from the derivatives of the three germ cell layers. They are categorized into subtypes by the extent of maturation, with mature teratomas being the most common subtype. While they can arise in various extragonadal regions, including the retroperitoneum, their occurrence in the retroperitoneal space is extremely rare.

CD226 adipose tissue macrophages arise from MDP-derived monocytes and regulate lipid metabolism.

Macrophages are innate immune cells present in all tissues, in which they participate in immune responses and maintenance of tissue homeostasis. They develop either from embryonic precursors or from circulating monocytes, and their functions are in part dictated by their origin. We previously observed robust monocyte recruitment and contribution to the macrophage pool in brown adipose tissue.

Atomoxetine-Induced Pheochromocytoma and Paraganglioma Crisis Managed With Veno-Arterial Extracorporeal Membrane Oxygenation.

Pheochromocytoma and paragangliomas (PPGLs) crises can be triggered by various factors, including norepinephrine reuptake inhibitors used to treat attention deficit hyperactivity disorder (ADHD), which worsen symptoms in patients with PPGLs. Therefore, attention should be paid to the potential for serious adverse reactions in patients with PPGLs taking ADHD medications. A 21-year-old man presented to the emergency department with acute onset of severe respiratory and circulatory failure after initiating atomoxetine treatment.

Arterial supply to the adrenal gland in the common marmoset ().

The common marmoset (Callithrix jacchus) has attracted much attention as a nonhuman primate animal model for stress-related experiments. The adrenal gland plays a key role in stress responses and has abundant vasculature, through which the hypothalamic-pituitary axis hormonally controls its activity. Understanding the arterial supply pattern to the gland is fundamental to understanding its function and performing experiments.

Pheochromocytoma-induced cardiogenic shock requiring ECMO: cardiovascular recovery prior to surgical resection.

An otherwise healthy woman in her 30s presented with cardiogenic shock and acute pulmonary oedema (APO), subsequently requiring extracorporeal membrane oxygenation (ECMO). A CT scan revealed an adrenal mass that prompted the differential diagnosis of a pheochromocytoma crisis that was later further suggested by raised plasma metanephrines. In the absence of clear guidelines due to the clinical rarity, a decision was made to delay adrenalectomy and stabilise the patient from a cardiac perspective with the view to operate after improvement of cardiac function with adequate alpha and beta blockade.