Liver disease in pregnancy

The diseases which affect the liver in pregnancy can be subdivided into those which occur simultaneously with gestation and those which occur in the context of and exclusively during pregnancy. This review deals with the latter group and describes the histopathological features of acute fatty liver of pregnancy and liver disease in toxaemia of pregnancy, hyperemesis gravidarum and intrahepatic cholestasis of pregnancy.     

Participation of adrenal hormones in the genesis of arterial hypertension of hypothalamic origin

Continuous electrical stimulation for many hours of hypothalamic negative emotiogenic centers (the ventromedial nuclei) evoked persistent arterial hypertension with a characteristic phasic dynamics of adrenal secretory activity in waking, immobilized rabbits. Bilateral extirpation of the adrenals lowered the original level of the mean arterial pressure and inhibited the development of persistent arterial hypertension. Stimulation of the above-mentioned hypothalamic structures for many hours in adrenalectomized rabbits, in conjunction with administration of hydrocortisone and adrenalin, evoked persistent arterial hypertension again. After administration of hydrocortisone and adrenalin separately to adrenalectomized rabbits, stimulation of the ventromedial hypothalamic nuclei for many hours resulted in only a transient rise of blood pressure. It is concluded that an essential role in the formation of persistent arterial hypertension in rabbits during continuous stimulation of the hypothalamic negative emotiogenic centers for many hours is played by activation of adrenal cortical and medullary hormones.Department of Normal Physiology and Interclinical Hormonal Laboratory, I. M. Sechenov First Moscow Medical Institute. (Presented by Academician of the Academy of Medical Sciences of the USSR N. A. Fedorov.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 81, No. 4, pp. 399–402, April, 1976.     

Syndromes associated with abnormalities in the adrenal cortex

Recognizing that adrenal pathology is a component of many genetic syndromes is important for clinical management and genetic counselling. These syndromes may be divided into those which cause excessive adrenal growth including tumours, and those which cause hypoplasia or destruction of the adrenal glands. Syndromes associated with hyperplasia and tumour development include Beckwith-Wiedemann, Li-Fraumeni, Carney complex, McCune-Albright, multiple endocrine neoplasia type 1, hereditary nonpolyposis colorectal carcinoma, familial adenomatous polyposis, primary bilateral macronodular adrenal hyperplasia, and congenital adrenal hyperplasia. Syndromes associated with adrenal dysgenesis or atrophy include X-linked adrenal hypoplasia, IMAGe syndrome, MIRAGE syndrome, familial glucocorticoid deficiency, X-linked adrenoleucodystrophy, Allgrove syndrome, Wolman syndrome, autoimmune polyendocrine syndrome and steroid resistant nephrotic syndrome. The clinical, genetic, and histopathological features of each disease will be discussed.     

Lipid peroxidation in the adrenal cortex in exhausting stress

Laboratory of Biochemistry of the Endocrine Glands, Institute of Biochemistry, Academy of Sciences of the Belorussian SSR, Grodno. (Presented by Academician of the Academy of Medical Sciences of the USSR Yu. A. Pankov.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 109, No. 5, pp. 430–432, May, 1990.     

Primary aldosteronism by carcinoma of the adrenal cortex

Summary A 58-year-old white woman with hypertension and severe hypokalemia was found to have a carcinoma of the left adrenal gland. Plasma renin activity was constantly under the normal limit, while plasma aldosterone levels were pathologically elevated. Plasma cortisol (8:00 a.m.) and excretion rates of urinary free cortisol were within the normal range. After an adrenalectomy, relapsing excessive aldosterone secretion was successfully treated with opDDD (Lysodrene). Ten months after the diagnosis was established, the patient died from a bleeding liver metastasis.Abbreviations DOC Desoxycorticosterone - PA Plasma aldosterone - PC Plasma cortisol - PRA Plasma renin activity - UfC Urinary free cortisol     

Effect of pioglitazone treatment on the adrenal androgen response to corticotrophin in obese patients with polycystic ovary syndrome

BACKGROUND: To investigate the effect of pioglitazone on adrenal steroidogenesis in polycystic ovary syndrome (PCOS), we studied 11 obese (two with BMI >25 kg/m(2); nine with BMI >27 kg/m(2)) PCOS women before and after 6 months of treatment at a dose of 45 mg/day. METHODS: During the early follicular phase, ultrasonography and hormonal assays were performed. On separate days, all women underwent an oral glucose tolerance test (OGTT), a euglycaemic hyperinsulinaemic clamp and an adrenocorticotrophin hormone (ACTH) test. The same protocol was repeated after therapy. RESULTS: Pioglitazone treatment significantly reduced the insulin response to OGTT and improved the insulin sensitivity indices (P < 0.01 and P = 0.03 respectively). A significant decrease was found in LH (P < 0.05) and androstenedione (P < 0.01) levels after therapy, whereas the other hormonal parameters improved but not significantly. Pioglitazone administration reduced the response of 17alpha-hydroxyprogesterone (17OHP) and androstenedione to ACTH (P < 0.01 and P < 0.02 respectively), most likely through an inhibition of cytochrome P450. The same treatment was able to rebalance the relative activity of 17,20-lyase, as documented by an increase in the androstenedione:17OHP ratio (P < 0.05) after ACTH stimulation. CONCLUSIONS: Our data support the contention that insulin enhances ACTH-stimulated steroidogenesis, while inducing a relative impairment of 17,20-lyase activity. Whether the beneficial effects of pioglitazone on this imbalance could be related to the ameliorated glyco-insulinaemic metabolism or to a direct effect on the adrenal glands remains to be determined.     

Functional and structural changes in the adrenal cortex of rabbits with chronic prostatitis

Investigation of the state of the adrenal cortex of rabbits during inhibition of the internal secretory activity of the testes caused by chronic inflammation of the prostate gland revealed progressive hyperplasia of the zona reticularis of the adrenal cortex, whereas the zona glomerulosa showed no marked pathological changes and the zona fasciculata showed hypoplasia. Consequently, a normal or increased excretion of androgens observed in the experimental males, despite a reduction in the synthesis of testosterone in the testes, is maintained by increased activity of the zona reticularis of the adrenal cortex.Laboratory of Physiology and Pathomorphology, Khar'kov Scientific-Research Institute of Endocrinology and Hormone Chemistry. (Presented by Academician of the Academy of Medical Sciences of the USSR L. T. Malaya.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 83, No. 3, pp. 276–277, March, 1977.     

Update on tumours of the adrenal cortex,phaeochromocytoma and extra‐adrenal paraganglioma

McNicol A M
(2011) Histopathology  58, 155–168
Update on tumours of the adrenal cortex, phaeochromocytoma and extra‐adrenal paraganglioma This review covers aspects of adrenal cortical tumours, phaeochromocytoma and extra‐adrenal paragangliomas. Relevant clinical and epidemiological information is included. It is now known that about 30% of paragangliomas occur in a familial setting and these new aspects of the genetic background are presented. The main diagnostic problem in both groups of tumours is the recognition of malignant potential. The uses and limitations of multifactorial histological assessment in diagnosis and prognosis are discussed. Finally, data on the molecular changes associated with tumorigenesis and tumour progression are highlighted, and how this information may contribute in future to diagnosis and prognosis.     

Morphological analysis of the adrenal cortex after bilateral subdiaphragmatic vagotomy

In Wistar rats 7 and 45 days after bilateral subdiaphragmatic vagotomy the zona fasciculata and zona reticularis of the adrenal cortex were enlarged and the content of unsaturated phospholipids in their cells was increased. In the medulla the venous sinusoids were greatly dilated. Administration of glucose to the vagotomized animals caused further accumulation of unsaturated phospholipids in the cells of the zona fasciculata but there was no change in the width of the zones. These facts indicate that after vagotomy precursors of steroid hormones accumulate; this is interpreted as a morphological sign of depression of functional activity of the zona fasciculata and zona reticularis of the adrenal cortex.Department of Histology and Embryology, N. I. Pirogov Second Moscow Medical Institute. (Presented by Academician of the Academy of Medical Sciences of the USSR Yu. M. Lopukhin.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 82, No. 9, pp. 1128–1130, September, 1976.     

An ELISA method for the detection of autoantibodies to adrenal cortex

An enzyme-linked immunosorbent assay (ELISA) is described for autoantibodies to adrenal cortex. Microsomes were prepared from fresh human adrenal glands, and microtitre ELISA plates were incubated at 4 degrees C overnight with 25 micrograms antigen/ml, the optimal concentration for the system. Optimal dilution of patient's serum was 1/500. Peroxidase-labelled anti-human IgG and IgM sera were used in separate tests and o-phenylenediamine and H2O2 served as substrate. Intra-assay variance of optical density units was 4.5%, and inter-assay variance was negligible when antigen preparations from 2 different adrenal glands were compared. All sera positive or negative at first test gave the same qualitative result in a second. Non-organ-specific binding of sera containing mitochondrial or ribosomal antibodies was eliminated by a blocking ELISA system where the antigen-coated plates were incubated with test sera, and in a second step, peroxidase-labelled IgG from an adrenal antibody-positive control serum was added. In this test, optimal antigen concentration for coating of plates was 6.25 micrograms/ml and optimal serum dilution 1/50. The ELISA proved more sensitive and reproducible than indirect immunofluorescence. Adrenal antibodies detected by ELISA were usually of IgG class alone and only 1 of the 30 positives also contained IgM specificity. 30 out of 38 sera (79%) from patients with 'idiopathic' Addison's disease were positive whereas immunofluorescence revealed only 23 (61%) at first testing and another 4 positives when sera were tested on different adrenal glands. The ELISA described is useful for both scientific work and clinical diagnosis of autoimmune adrenalitis.     

Mechanisms of the primary response of the adrenal cortex to pain stress in dogs

A sharp decrease in the glucocorticoid content accompanied by an increase in the free cholesterol and a decrease in the content of esterified cholesterol were observed in the adrenal cortex of dogs 10–15 sec after nociceptive stimulation. The blood concentrations of the hormones were increased, mainly due to the proteinbound hydrocortisone fraction. The next phase of the response (30–60 sec after stimulation) was marked by activation of synthetic processes, leading to considerable accumulation of hormones in the gland. The blood glucocorticoid level was doubled, the original ratio of hydrocortisone to corticosterone was restored, and the transcortin depot was replenished. The role of the adrenal and transcortin deports of glucocorticoids in the feedback mechanism during stress is discussed.Department of Pathological Physiology, Rostov Medical Institute. (Presented by Academician of the Academy of Medical Sciences of the USSR V. K. Kulagin.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 88, No. 7, pp. 18–20, July, 1979.     

肾小球旁器细胞瘤的临床病理观察

目的 研究肾小球旁器细胞瘤的病因、临床病理及超微结构特点。方法 对5例患者的临床症状、肿瘤的大体和镜下特征、免疫组化及超微结构进行观察与分析。结果 多数患者术前都有高血压等临床症状;肿瘤大体包膜完整,光镜下可见腺管样及乳头样结构,部分区域有血管外皮瘤样图像;免疫组化部分细胞呈actin阳性反应;电镜下瘤细胞胞质内可见菱形或圆形的结晶颗粒。结论 肾小球旁器细胞瘤的诊断应结合临床、组织病理及电镜,其中电镜观察到结晶颗粒是诊断最可靠的依据。     

Functional State of Adrenocortical System in Rats with Manifest Alloxan-Induced Diabetes Mellitus

In the adrenals of male rats with manifest form of alloxan-induced diabetes mellitus (blood glucose >20 mmol/liter), the content of progesterone was higher by 1.6 times, deoxycorticosterone by 2.5 times, corticosterone by 3.3 times, and 11-dehydrocorticosterone by 1.8 times than in the adrenals of control animals. Increased concentration of corticosterone and 11-dehydrocorticosterone were also found in the serum of rats with alloxan diabetes, but the difference between the experimental and control groups by these parameters was less pronounced compared to parameters in the adrenal glands. Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Suppl. 1, pp. 23–25, 2008     

Morphometry of the juxtaglomerular apparatus of the allografted human kidney

A karyometric study was made of the juxtaglomerular apparatus of 17 allografted human kidneys at different times after transplantation. Kidneys of persons dying from head injuries or acute heart failure were used as the control. In the early periods (up to 2 months) there was a significant increase in volume of the nuclei of the epithelioid-modified cells of the afferent arteriole and of Goormaghtigh's cells. A tendency also was observed for the volume of the cell nuclei of the macula densa to increase. At the late stages the juxtaglomerular apparatus still remained in allografted kidneys with a slightly damaged parenchyma. If sclerosis and atrophy of the parenchyma of the graft was marked, the juxtaglomerular apparatus was reduced.Group for Cytology and Tissue Culture, Laboratory of Pathomorphology, Institute of Transplantation of Organs and Tissues, Ministry of Health of the USSR, Moscow. (Presented by Academician of the Academy of Medical Sciences of the USSR A. P. Avtsyn.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 81, No. 1, pp. 87–88, January, 1976.     

Dynamics of morphological indices of the juxtaglomerular complex of the kidney in rats with experimental renovascular hypertension

Experiments on 188 sexually mature albino rats showed a regular pattern of topographical distribution of the juxtaglomerular complex (JGC) in the different zones of the renal cortex. Renovascular hypertension was shown to intensify granularity of the JGC as early as the third day of the experiment. This was confirmed by an increase in the granularity index and also in the classes of the JGC. The cytomorphometric indices of the macula densa were increased after the second week of the experiment, changes before that time being not significant.Department of Human Anatomy, Ivano-Frankovsk Medical Institute. Electronic Laboratory, Scientific-Research Center, N. I. Pirogov Second Moscow Medical Institute. (Presented by Academician of the Academy of Medical Sciences of the USSR V. V. Kupriyanov.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 88, No. 8, pp. 220–223, August, 1979