Abordaje laparoscópico transperitoneal de feocromocitomas y paragangliomas / Transperitoneal laparsoscopic surgery for pheochromocytomas and paragangliomas

Los feocromocitomas adrenales y extra-adrenales o paragangliomas funcionantes constituyen una causa inusual de hipertensión arterial pasible de ser tratada mediante el tratamiento laparoscópico...El abordaje laparoscópico de feocromacitomas adrenales funcionantes constituye un método seguro y efectivo, siendo considerado actualmente el procedimiento de elección. Los avances de los métodos por imágenes de localización pre-operatoria y el continuo desarrollo quirúrgico laparoscópico permitirán, en un futuro no muy lejano, imponer el acceso laparascópico también como vía de elección en feocromocitomas extra-adrenales o paragangliomas. La alta incidencia de bilateralidad y compromiso extraadrenal justifica, a nuestro entender, la triple evaluación imagenológica (TAC-RMN-Centellografía MIBG) en todos los pacientes.

Effect of iloprost on adrenal medullary grafts in central nervous system transplantation and apoptosis

To investigate whether iloprost, a stable analog of prostacyclin, is useful for the preservation of neural grafts in transplantation surgery. This study was conducted at the Microsurgery Laboratory of the Department of Neurosurgery, Faculty of Medicine, Ankara University, Ankara, Turkey in 2003. The animals [rabbits] were divided into 3 groups. In group I, autografts taken from the adrenal medulla were stored in 0.9% sodium chloride [NaCl] solution for 45 minutes before transplantation. In group II, autografts taken from the adrenal medulla were stored in iloprost solution [50 ng/ml] for 45 minutes before transplantation. Graft transplantation was not performed in the third group. In group I, the grafts partially preserved their viability. In group II, the large adrenal medullary cells had evident euchromatin nuclei fused with neurons, and there was an increase in vascularization. Three weeks after transplantation surgery, it was determined that iloprost maintained the viability of the graft tissue and probably prevented apoptosis, and facilitated the integration of the graft tissue into the host brain

Effect of intrathecal transplantation of adrenal medullary tissue on the sciatic nerve regeneration following chronic constriction injury in the rat

It has been demonstrated that the adrenal medullary transplants into the spinal subarachnoid space can alleviate neuropathic pain behaviors. The aim of the present study was to test the possibility that histological changes of the sciatic nerve in a neuropathic model as well as sensory dysfunction are repaired by adrenal medullary transplantation. Left sciatic nerve was ligated in three groups of rats by 4 loose ligatures [CCI]. After one week of nerve constriction, rats of first group were implanted with adrenal medullary tissue [CCI + adrenal medulla] and rats of the second group with striated muscle at the level of L1-L2 [CCI + muscle]. The third group received only left ligature [CCI] and in the fourth group the sciatic nerve was exposed and then muscle and skin sutured [sham]. Behavioral assessment was evaluated before surgery and 2, 4, 7, 10, 14, 21, 28, 42, and 56 days after the onset of experiment. According to behavioral results, 4 rats in each group were anesthetized and then the distal part of sciatic nerve were isolated and prepared for histological quantitative investigation of nerve regeneration. The results showed that CCI was accompanied with hyperalgesia and morphological changes in the distal part of sciatic nerve. In animals with adrenal medullary transplantation, not only hyperalgesia was markedly reduced or even eliminated, but also the number of myelinated fibers in the distal segment of nerve increased to nearly normal. Our findings showed that the implantation of adrenal medullary tissue might have caused regeneration of ligated nerves as well as alleviation of pain behavior

Effects of adrenalectomy and adrenal enucleation on liquid gastric emptying in rats

The effects of adrenalectomy and adrenal enucleation on liquid gastric emptying were studied in male Wistar rats that were adrenalectomized, adrenal enucleated (AE) or sham operated (SH). The animals in the first group had free access to a 1 percent NaCl solution (ADS), while the animals in the second and third groups were divided into two subgroups, which ingested either tap water (AEW, SHW) or 1 percent NaCl solution (AES, SHS). The gastric emptying study was performed on the 16th post-operative day. Three test meals labeled with phenol red (6 mg/dl) were used (0.9 percent NaCl, 1.8 percent NaCl and 5 percent glucose). Percent gastric retention was determined 10 min after orogastric infusion of the NaCl test meals and 15 min after the glucose meal. Gastric retention of the ADS subgroup was significantly lower (P<0.01) (median = 19.8 percent vs 25.5 percent for SHW, vs 31.9 percent for SHS, vs 25.7 percent for AEW, and vs 27.1 percent for AES) for the 0.9 percent NaCl test meal and for the 1.8 percent NaCl test meal (33.5 percent for ADS vs 47.5 percent for AEW and 50.6 percent for AES). When 5 percent glucose was used as a test meal, gastric retention was similar for all subgroups. These results suggest that ablation of the adrenal cortex results in increased gastric emptying of an isosmolar NaCl meal

Changes in the TBARs content and superoxide dismutase, catalase and glutathione peroxidase activities in the lymphoid organs and skeletal muscles of adrenodemedullated rats

Thiobarbituric acid reactant substances (TBARs) content, and the activities of glucose-6-phosphate dehydrogenase (G6PDh), citrate synthase (CS), Cu/Zn- and Mn-superoxide dismutase (SOD), catalase, and glutathione peroxidase (GPX) were measured in the lymphoid organs (thymus, spleen, and mesenteric lymph nodes (MLN)) and skeletal muscles (gastrocnemius and soleus) of adrenodemedullated (ADM) rats. The results were compared with those obtained for sham-operated rats. TBARs content was reduced by adrenodemedullation in the lymphoid organs (MLN (28 percent), thymus (40 percent) and spleen (42 percent)) and gastrocnemius muscle (67 percent). G6PDh activity was enhanced in the MLN (69 percent) and reduced in the spleen (28 percent) and soleus muscle (75 percent). CS activity was reduced in all tissues (MLN (75 percent), spleen (71 percent), gastrocnemius (61 percent) and soleus (43 percent)), except in the thymus which displayed an increment of 56 percent. Cu/Zn-SOD activity was increased in the MLN (126 percent), thymus (223 percent), spleen (80 percent) and gastrocnemius muscle (360 percent) and was reduced in the soleus muscle (31 percent). Mn-SOD activity was decreased in the MLN (67 percent) and spleen (26 percent) and increased in the thymus (142 percent), whereas catalase activity was reduced in the MLN (76 percent), thymus (54 percent) and soleus muscle (47 percent). It is particularly noteworthy that in ADM rats the activity of glutathione peroxidase was not detectable by the method used. These data are consistent with the possibility that epinephrine might play a role in the oxidative stress of the lymphoid organs. Whether this fact represents an important mechanism for the establishment of impaired immune function during stress remains to be elucidated

Neuroblastoma intrarrenal: descripción de un caso / Intrarenal neuroblastoma: description of a case

El Neuroblastoma es un tumor de la médula suprarrenal típicamente infantil; después del retinoblastoma se le considera el tumor congénito más frecuente. En el 80 por ciento de los casos se manifiesta antes de los 5 años. El 50 por ciento de los neuroblastomas están localizados en la suprarrenal pero las localizaciones pueden ser múltiples, en el retroperitoneo, mediastino, vejiga, riñon (1-2); hígado, nervios, etc. La presencia del neuroblastoma en otros sitios, es comprensible considerando el desarrollo embriológico de las células componentes (3-4). En la literatura se describe la presencia de un Neuroblastoma en pacientes con Neurofibromatosis Múltiple (6-7) relacionandolo al desarrollo biológico del Neuroblastoma. Así también describen una Nefroblastomatosis (4) que suelen con frecuencia confundir histogenéticamente con un tumor de Wilms

Tratamiento médico y quirúrgico de la enfermedad de Parkinson: estudio a largo plazo / Medical and surgical treatment of Parkinson's disease. A long term study

Este trabajo estudia los efectos del tratamiento médico y quirúrgico sobre el curso natural de la enfermedad de Parkinson. Tres grupos de pacientes fueron estudiados: I. Pacientes tratados con levodopa/carbidopa y anticolinérgicos (n = 10). II. Pacientes tratados con talamotomía (n = 9). III. Pacientes con tratamiento médico más trasplante autólogo de médula adrenal al núcleo caudado (n = 8). Fueron evaluados antes de iniciar el tratamiento médico o de efectuar la cirugía, al mes, a los seis meses y al año. Fueron usadas las escalas clínicas: New York Parkinson's Disease Scale, Unified Parkinson's Disease Scale, Schwab and England y Hoehn and Yarth Scale. Se evaluó por separado temblor, rigidez, bradicinesia y deterioro mental. Se uso un análisis de varianza tipo Friedman. Grupo I. No hubo mejoría significativa y sí un deterioro mental significativo al año. Grupo II. Hubo mejoría significativa del temblor y la rigidez, sin embargo el deterioro mental al año determinó un empeoramiento de la escala global. Grupo III. No hubo mejoría significativa, pero el deterioro al año fue menos pronunciado que para los otros grupos