[Adrenocortical hormone preparations].
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The authors report their experience of 34 benign and 17 malignant tumours of the adrenal cortex. Both occurred more frequently in women (79.4% of cortical adenomas and 70.6% of adrenocortical carcinomas). Moreover, females were significantly younger (average age: adenomas: females 44.9 years and males 54.4 years, adrenocortical carcinomas: females 34.1 years and males 58.3 years). Some tumours presented in the form of increased hormone production, while others were hormonally inactive and did not cause clinical signs until later. Pain was the first symptom in the cases of malignant adrenocortical tumours. Adenomas occurred as frequently twice in the left adrenal gland (24 versus 12), whereas carcinomas were more than twice are frequent on the right (10 versus 7). Ultrasonography and CT were appropriate and fully sufficient methods for the diagnosis of adrenal tumours. Arteriography was valuable in the differential diagnosis of large upper abdominal masses when the organ of origin could not be identified by CT and for determination of anatomic conditions and subsequent surgical tactics. For small tumours of the adrenal cortex, the classic lumbar approach through the bed of the resected eleventh rib is adequate. For larger tumours, extended lumbotomy, laparotomy or thoracotomy is necessary.
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Cholera toxin, through adenylate cyclase activation reproduced cyclic AMP-mediated effects of thyroid-stimulating hormone (TSH) in dog thyroid slices, i.e. protein iodination, [1-14C]glucose-oxidation and hormone secretion. Iodide and carbamylcholine decreased the cyclic AMP accumulation induced by cholera toxin as well as by TSH, which supports the hypothesis of an action of these agents beyond the steps of hormone-receptor and receptor-adenylate cyclase interaction. Cooling to 20 degrees C did not impair the TSH induced cyclic AMP accumulation in thyroid slices, but completely suppressed the cholera toxin effect. This observation has been extended to other hormones and target tissues, such as the parathyroid hormone (PTH) (kidney cortex), adrenocorticotropic hormone (ACTH) (adrenal cortex) and luteinizing hormone (LH) (ovary systems). As in thyroid, cooling dissociated the cholera toxin and hormonal effects on cyclic AMP accumulation. In homogenate, cooling decreased cyclic AMP generation in the presence of cholera toxin but at 20 degrees C and 16 degrees C a cholera toxin stimulation was still observed. These results bear strongly against the hypothesis that the glycoprotein hormones TSH and LH acetivate adenylate cyclase by a mechanism identical to cholera toxin.
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This paper describes the use of hormone analysis in the diagnosis of adrenal cortex dysfunction in the dog, cat and horse. Analytical problems concerning the determination of corticosteroid levels are discussed and the pathology of adrenal dysfunction is briefly presented. The paper focuses on the problems in establishing physiological norms for adrenal function based on the established assays. Own experiences and other reported data are referred to.
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