Spontaneous lactation in virgin Sprague-Dawley rats.
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In this paper the pathophysiology and clinical symptoms of the most frequent hormonal and metabolic disorders are discussed with regard to their importance for the anaesthesiologist. Special recommendations for various anaesthesiological procedures are given. The disorders in particular discussed are diabetes mellitus, disorders of the thyroid and the adrenal cortex and phaeochromocytoma.
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With today's imaging technology, relatively invasive procedures can be performed in the radiology department without significant complication. Biopsies, in particular, are frequently performed using computed tomography (CT) or ultrasound (US) guidance. In this article, both the indications and methods for imaging-guided percutaneous biopsy of the kidney and adrenal gland are reviewed. Citing the experience of several authors, the accuracy and complications of such procedures are also discussed.
The etiology of abdominal masses in the left upper quadrant may be confusing because of the anatomic relationships of the organs involved. In three representative cases presented, computed tomography (CT) clearly defined masses as being nonurologic in origin, although conventional radiologic diagnostic techniques originally yielded results that suggested a renal or adrenal origin. In two other cases, masses thought to originate from the spleen or retroperitoneum were shown by CT to be renal tumors. In a sixth case, a large mass thought to be of renal origin but not evaluated by CT was found at surgery to be a pancreatic cyst. Abdominal CT is more sensitive than other imaging modalities in clarifying organ relationships and the origin of masses in the left upper quadrant.
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Angiotomography invariably imrpves the quality of the images obtained in vascular radiology, with respect to both vascular anatomy and pathology. Its contribution is obviously essential when, for technical reasons, arterial opacification is only mediocre (extended angiocardiopneumography). In the arteriolar study of deep seated or voluminous organs, its eliminates superimpositions, makes tri-dimensional study possible and provides a means of studying fine arterioles, useful in diagnosis and difficult to demonstrate using conventional techniques. Its principle limitations are technological in character. Accepting precise and clearly defined rules in its indications and realisation, appropriate equipment, and a constant effort in the analysis and reading of its results, it is reasonable to hope that angiotomography will quickly add a new dimension to vascular studies.
The prevalence of thyroid nodules is increased in patients with Cushing's disease, but the possibility of an association between thyroid and adrenal nodules in other patient groups has not been formally tested. We have evaluated the co-existence of thyroid and adrenal nodules in retrospective and prospective autopsy studies. Retrospective (83 autopsies) and prospective (29 autopsies) blinded studies of thyroid and adrenal gland histopathology were performed by two experienced histopathologists in unselected autopsies. The presence of nodules, defined as areas of tissue having discrete edges within the gland parenchyma seen as a step difference between the cells or architecture adjacent to the nodule, was determined for each gland. No association was found between the presence of adrenal and thyroid nodules in either the retrospective or prospective studies (p>0.2 for both). In the retrospective study, 23% of specimens had thyroid nodules and 28% adrenal nodules. In the prospective study, 24% of specimens had thyroid nodules and 7% adrenal nodules. The proportion of patients with adrenal nodules in the prospective study was significantly less than that in the retrospective study. In conclusion, thyroid and adrenal nodules are frequent autopsy findings in the general population but we have found no evidence of a relationship between the occurrence of nodules in these glands.
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The rational selection of imaging modalities for the diagnosis of renal and adrenal masses in children is discussed with a view toward obtaining an accurate assessment of pathologic changes with the least amount of stress and expense to the patient. The integration of the results of these tests in specific clinical settings is also described.
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Imaging plays a vital role in the evaluation of adrenal pathology. The most widely used modalities are computed tomography and magnetic resonance imaging. Alone or in conjunction with appropriate clinical and biochemical data, imaging can provide specific diagnoses that preclude the need for tissue sampling. This article reviews imaging features of normal and diseased adrenals, from both benign and malignant causes.