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PubMed1979

[Corticosteroid osteoporosis (author's transl)].

Otseoporosis is a common and sometimes severe complication of all prolonged corticosteroid therapy. After reviewing the clinical, radiological, histological and biological features, the authors discuss the various physiopathogenic mechanisms: anti-anabolic effect of corticosteroids and decreased bone formation, and hyperparathyroidism secondary to the calcium deficiency induced by corticosteroids (fall in intestinal calcium absorption). Treatment should be preventive, based upon great car in the prescription of corticosteroids (absolute indication, minimal effective dose, alternate administration in certain cases) and upon improved calcium balance (calcium, vitamin D or its derivatives).

Adrenal Cortex Hormones↗
PubMedDate not supplied

Ultrastructural pathology of the adrenal gland in Cushing's syndrome.

Authors studied the ultrastructural pathology of Cushing's syndrome. Some specific features correlated with the pathological aspects of the adrenals could be found. In the hyperplastic adrenal cortex the cytoplasm contains a rich smooth endoplasmic reticulum and numerous mitochondria. Increased lipid-pigment complexes were also found. The clear cell adenomas showed large lipid vacuoles. In the compact cell adenomas the mitochondria are of variable size and the smooth endoplasmic reticulum is well developed; the pigment bodies are frequent. The nuclei and especially the nucleoli are increased in size. In the adrenal carcinoma the nuclear and nucleolar alterations are still more evident. A marked pleomorphism of mitochondria was noticed. The behaviour of the steroidogenic activity in both tumoral and hyperplastic adrenal glands can be assessed using the ultrastructural picture of the agranular endoplasmic reticulum and of the mitochondria as functional parameters.

Adrenal Cortex↗
PubMed1984

[Cushing's disease caused by adrenocortical nodular hyperplasia--diagnosis and surgical treatment].

Six cases of Cushing's disease, in which perplex diagnostic problem was encountered, were reported. In the endocrinological examination two cases were not suppressed by a high dose of dexamethasone (8 mg), and the other four cases showed complicated clinical findings due to adrenocortical nodular hyperplasia. Among those four cases with adrenocortical nodular hyperplasia two of them were of functionally autonomic and showed different attitude in responding endocrine assay. When the serum cortisol is not suppressed by a high dose of dexamethasone, differential diagnosis from other causes, such as Cushing's syndrome due to adrenocortical macronodular hyperplasia, becomes quite important for surgical treatment. Usually plasma ACTH in the case of Cushing's disease is slightly increased over the normal range and, on the other hand, it is lower than normal value in the case of Cushing's syndrome due to autonomic adrenocortical nodular hyperplasia because of negative feed back phenomenon. However, in some cases of Cushing's disease plasma ACTH is within normal range or even lower than normal level, and, furthermore, it is not extremely unusual to find a case of adrenocortical macronodular hyperplasia with slightly increased plasma ACTH level over normal range. Those cases offer particularly complex problem in making diagnosis and therapeutic indication. According to our clinical experiences with those six cases, selective venous sampling is found quite useful in differentiating Cushing's disease from other causes and ACTH value in selective venous sampling from inferior petrosal vein is remarkably increased in the cases due to pituitary ACTH secreting adenoma. Cushing's disease with adrenocortical nodular hyperplasia reduces the ACTH value in the sampling to the lower normal range as the adrenocortical nodular hyperplasia progresses.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma↗
PubMed1984

[Inhalative steriod treatment in bronchial asthma].

In the light of substantial recent advances in knowledge regarding the use of inhaled corticosteroids, general recommendations for such treatment are reviewed. The therapeutic effect is dose-related. High dose treatment has been shown to be effective in improving asthma control and reducing oral steroid requirement, while adverse side effects are usually of little consequence. The use of metered dose inhalers using correct technique and at a convenient time is a basic prerequisite in securing maximum effect. The development of new drugs with a better separation of local and systemic effects is improving therapeutic potential.

Adrenal Cortex Hormones↗