Laparoscopic adrenalectomy for phaeochromocytoma: endocrinological and surgical aspects of a new therapeutic approach.

Objectives: To evaluate the results of laparoscopic resection of phaeochromocytoma with a focus on pre- and intra-operative endocrinological and pharmacological aspects.

Design: Retrospective study based on review of case notes and intraoperative anaesthetic records.

Patients: Eight patients (four men, four women) aged 13 to 70 (median: 45) years with symptomatic phaeochromocytoma (two patients with MEN IIa syndrome) diagnosed 6-36 months before adrenalectomy in four patients and just before operation in the four remaining patients.

Influence of age on the clinical presentation of prolactinomas in male patients.

Objective: Secreting pituitary adenomas are usually not considered a disease of older people. However, in male patients, prolactin-secreting pituitary tumours occur at a similar frequency throughout the entire life span, giving the opportunity to study in this gender the influence of age on the clinical presentation and response to treatment of these tumours.

Methods: We conducted a retrospective study including 9 male patients aged >/=60 (range 60-73) years and 10 aged View Article and Find Full Text PDF

Heart failure induced by pheochromocytoma: laparoscopic treatment and intraoperative changes of several new cardiovascular hormones.

Since 1992, adrenalectomy for pheochromocytoma has been recognized as a safe and efficient technique when performed by a laparoscopic approach. Most of the cases of pheochromocytomas treated as such and published in the literature were not associated with malignant hypertension and acute heart failure. We report the case of a 23-year-old woman who presented with this clinical picture and show that laparoscopic adrenalectomy may be as safe and efficient as conventional adrenalectomy when performed in this situation.

Angiosarcoma of the thyroid and concurrent hyperthyroidism.

We describe the exceptional association of an angiosarcoma of the thyroid and hyperthyroidism in a 74-year-old woman who presented with a toxic multinodular goiter of recent growth. This association reported in two other cases may not be fortuitous but due a vascular effect of the angiosarcoma contributing to the development of thyrotoxicosis. This case also illustrates the diagnostic difficulties and the poor prognosis of this tumor.

Changes in blood pressure and in vasoactive and volume regulatory hormones during semistarvation in obese subjects.

The mechanisms underlying the reduction in blood pressure that occurs with a severe energy-restricted diet were evaluated in 12 obese subjects during 8 days on a very-low-calorie diet (1.67 MJ/d) with a constant intake of 17 mmol sodium per day. The relationship between changes in blood pressure, sodium balance, plasma volume, renin-aldosterone and sympathetic nervous system activities, plasma C-terminus and N-terminus of the atrial natriuretic factor (ANF) prohormone, brain natriuretic peptide (BNP), and endothelin-1 (ET-1) concentrations was investigated.

Late development of resistance to bromocriptine in a patient with macroprolactinoma.

We report the case of a man with an invasive macroprolactinoma who developed resistance to bromocriptine to which he had previously responded satisfactorily for 5 years. Subsequently, hyperprolactinemia was controlled equally well with 600 microg quinagolide daily and later with 4.5 mg cabergoline weekly.

Tamoxifen for retroperitoneal fibrosis.

Retroperitoneal fibrosis, either idiopathic or associated with aortic inflammatory aneurysm, is a chronic fibrotic disease that causes progressive obstruction of ureters and vessels around the lower abdominal aorta. Treatment is often difficult (surgery) or hazardous (steroids). We report a case of a woman with retroperitoneal fibrosis associated with aortic inflammatory aneurysm, who was successfully treated with oral tamoxifen.

Additional hypotensive effect of endothelin-1 receptor antagonism in hypertensive dogs under angiotensin-converting enzyme inhibition.

Background: Endothelin-1 (ET-1) may play a role in hypertension. ET-1 receptor antagonism by bosentan lowers blood pressure in hypertension. We evaluated whether the effect of bosentan is still observed under ACE inhibitors (ACEI).

Sex-related difference in the growth of prolactinomas: a clinical and proliferation marker study.

Prolactinomas in women commonly present as small intrasellar tumors, but are usually much larger in men. This discrepancy has generally been attributed to differences in the delay before diagnosis. However, studies comparing clinical and pathological correlates of growth of these tumors in both sexes are lacking.

Neuroarthropathy of the shoulder of unexpected origin.

The authors describe the case of a 65-year-old woman who developed a sudden and painless palsy of right shoulder one month after a benign fall. Radiographs showed severe articular destruction. Neurologic examination revealed only a mild sensory loss of the right upper extremity.

Expression of E-cadherin adhesion molecule in vocal cord carcinomas.

E-cadherin is a 120 kDa transmembrane protein that plays a major role in the maintenance of cell-cell adhesion in epithelial tissues. In the present study its expression was examined immunohistochemically for the first time using paraffin-embedded archival tissues of 38 vocal cord carcinomas. Ten cases of vocal cord polyps were used as positive controls.

Effects of the dopamine agonist cabergoline in patients with prolactinoma intolerant or resistant to bromocriptine.

Cabergoline is a new long-acting crgoline derivative used to treat hyperprolactinaemia. Its effect was assessed in 10 patients (eight women and two men) with prolactinoma who were intolerant (group I: N = 7) or resistant (group II: N = 3) to bromocriptine. In group I, no side effect was observed on cabergoline therapy; two patients became pregnant and normoprolactinaemia was achieved in the live others.

Role of endogenous endothelin-1 in experimental renal hypertension in dogs.

Background: Endothelin-1, a vasoconstrictive peptide released by endothelium, may be involved in the pathophysiology of hypertension. The goal of the present study was to evaluate the role of endogenous endothelin-1 in renal hypertension in dogs. The model of hypertension consisted of silk tissue wrapping of the left kidney, which produced hypertension associated with perinephritis after 6 to 8 weeks.

Proximal femur density in type 1 and 2 diabetic patients.

This study reports on the proximal femur mineral content in 36 Type 1 and 60 Type 2 diabetic patients. Bone mass measurements were performed in the neck, Ward's triangle and in the trochanteric area of the femur, using dual-photon absorptiometry with 153Gd. Bone mineral density (BMD) was significantly decreased in Type 1 diabetic men and women as well in Type 2 men, when compared with a non diabetic matched population.

Cardiovascular and endocrine effects of endothelin-1 at pathophysiological and pharmacological plasma concentrations in conscious dogs.

Background: Increased plasma concentrations of endothelin-1, a potent vasoconstrictor produced by the endothelium, have been reported in various pathological conditions. This study was conducted to evaluate effects of endothelin-1 at pathophysiological and pharmacological plasma concentrations.

Methods And Results: Endothelin-1 was infused at increasing doses (2.

Atrial natriuretic factor, cardiac volumes and filling pressures during exercise in congestive heart failure.

To study the mechanism of atrial natriuretic factor (ANF) release in heart failure, we measured plasma ANF concentrations, cardiac volumes and filling pressures at rest and during three graded exercise levels (E1, E2, E3) in six male patients with congestive heart failure (CHF) and compared them with 13 normal male subjects. At rest, ANF concentrations were sixfold higher in patients with CHF than in normal subjects (at rest: 53 +/- 12 vs 8 +/- 1 pmol.l-1; P less than 0.