ABSTRACT
Cases of coexisting Cushing's disease and unilateral adrenal tumor are rare, and there are conflicting reports in the literature regarding both the pathophysiology and the incidence. We have reported the case of a patient with a biochemically inactive incidental adrenal mass in whom pituitary-dependent Cushing's syndrome developed during follow-up. Authors of past reports have suggested that transitional change is responsible for the adrenal disease. A complete review of the literature has shown that cases of coexisting pituitary Cushing's disease and unilateral adrenal tumor, although rare, are more common than was previously believed. After studying a case in which the adrenal mass was present before disease developed, we suggest that the coexistence may be incidental in some cases.
Subject(s)
Adenoma/diagnosis , Adrenal Gland Neoplasms/diagnosis , Cushing Syndrome/diagnosis , 17-Hydroxycorticosteroids/urine , Adenoma/complications , Adenoma/epidemiology , Adrenal Gland Neoplasms/complications , Adrenal Gland Neoplasms/epidemiology , Adult , Comorbidity , Cushing Syndrome/complications , Cushing Syndrome/epidemiology , Dehydroepiandrosterone/blood , Dexamethasone , Female , Humans , Hydrocortisone/blood , Hydrocortisone/urine , Male , Middle Aged , Prevalence , Tomography, X-Ray ComputedABSTRACT
To investigate whether adenosine receptor blockade alters the response to serial coronary occlusions in the rabbit heart, we measured changes in segment length with ultrasonic dimension gauges placed in the field of a coronary branch. The coronary branch was subjected to four 5-minute occlusions, each separated by 10 minutes of reperfusion. In control hearts, the percentage of segment shortening fell from 15.7% to 9.3% after release of the first occlusion with no further deterioration after each of the subsequent three occlusions. In hearts in which adenosine receptors were blocked with PD 115,199, a potent blocker of both A1 and A2 receptors, segment shortening again recovered to about two thirds of the preischemic value during the reperfusion period after the first occlusion. Each subsequent occlusion, however, resulted in a further deterioration of function to the extent that shortening was less than 20% of the preischemic value during reperfusion after the fourth occlusion. Therefore the first occlusion of a series of four occlusions, while mildly stunning the heart, also preconditions the myocardium against further stunning by subsequent occlusions. Because that protection was when adenosine receptors were blocked, adenosine must play an important role in the mediation of this protective effect.
Subject(s)
Adenosine/physiology , Myocardial Contraction/drug effects , Myocardial Ischemia/physiopathology , Purinergic Antagonists , Purines/pharmacology , Sulfonamides/pharmacology , Animals , Female , Hemodynamics/drug effects , Male , RabbitsABSTRACT
14C stearic acid was incubated in organ culture of rabbit lens for 6, 12 and 20 hours. Stearic acid did penetrate the lens and was incorporated into triacyl-glycerides and phospholipids. It also served as a carbon source for cholesterol synthesis. Individual fatty acids were isolated and radioactivity measurements were made. Incorporation of label was found in C12:0, C14:0 and C16:0 fatty acids, indicating de novo synthesis in the lens; incorporation was found in C16:1 and C18:1, indicating delta 9 desaturase activity, and incorporation was found in the fatty acids of 20 carbons or longer, indicating the presence of a fatty acid elongation system in the lens.
