The Experts below are selected from a list of 111 Experts worldwide ranked by ideXlab platform
F. Havlicek - One of the best experts on this subject based on the ideXlab platform.
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Corticomedullary Tumors of the Adrenal Glands: Report of Two Cases. Association of Corticomedullary Tumor with Spindle Cell Sarcoma
Pathology research and practice, 1996Co-Authors: Michal Michal, F. HavlicekAbstract:Summary We describe two cases of corticomedullary tumors of the adrenal gland. The patients suffered from Cushings Syndrome and paroxysmal hypertension. The corticomedullary tumors consisted of benign looking cortical adenoma cells growing on the background of the pheochromocytoma cells. We further present the ultrastructural and immunohistochemical features of these tumors. Focally a spindle cell sarcoma arising from the corticomedullary tumor was found in one case. The spindle cell sarcoma was immunohistochemically negative with antibodies to chromogranin, synaptophysin, cytokeratin and 5-100 protein. Ultrastructurally the sarcoma was composed of undifferentiated primitive cells poorly endowed with cytoplasmic organelles. Focal transitions of the pheochromocytoma into the spindle cell sarcoma were seen. It is hypothesized that the spindle cell sarcoma was arising from the pheochromocytoma component of the corticomedullary tumor.
Pedro Iglesias - One of the best experts on this subject based on the ideXlab platform.
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pharmacological therapy of Cushings Syndrome drugs and indications
Mini-reviews in Medicinal Chemistry, 2007Co-Authors: Juan J Diez, Pedro IglesiasAbstract:OBJECTIVE To review the main pharmacological properties and clinical applications of the drugs used in the medical therapy of Cushing's Syndrome. DATA SOURCES Search for articles were performed in the following dababases: MEDLINE, EMBASE, Cochrane Database of systematic Reviews and The Cochrane Central Register of Controlled Trials (CENTRAL). Search terms included Cushing's Syndrome and drug therapy. DATA SYNTHESIS Available data suggest that neuromodulatory compounds affect corticotropin (ACTH) or ACTH-releasing hormone (CRH) synthesis and release. They include serotonin antagonists, dopaminergic agonists, valproic acid, reserpine, somatostatin analogs and thiazolidinediones. These agents have been effective in a limited number of patients with ACTH-dependent Cushing's Syndrome. Inhibitors of steroidogenesis reduce cortisol production by blocking one (metyrapone, trilostane) or several (aminoglutethimide, ketoconazole, fluconazole, etomidate) enzymes involved in steroid biosynthesis. Mitotane is a steroidogenesis inhibitor with adrenolitic properties. Mifepriston'e blocks glucocorticoid receptor activation without modifying cortisol synthesis. CONCLUSION Agents that inhibit steroidogenesis are useful in all forms of Cushing's Syndrome and are effective in about 70% of patients. Main indications for drug therapy include preparation for surgery, persistence or recurrence after surgery, while awaiting for the effect of radiation therapy, occult ectopic ACTH Syndrome, severe hypercortisolism and malignancy related hypercortisolism.
Jolene Lowery - One of the best experts on this subject based on the ideXlab platform.
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pancreatic neuroendocrine tumor presenting as a Cushings Syndrome associated with hypertension
Journal of Hypertension, 2013Co-Authors: Chinedu Ivonye, Ebere Okeke, Rohan Mankikar, Jolene LoweryAbstract:A young female was evaluated in the emergency department (ED) for persistent headache and fatigue one week after being started on antihypertensive therapy with poor response. Her medications were Amlodipine 10 mg daily, Hydrochlorothiazide 25 mg daily, Atenolol 100 mg daily and Hydralazine 50 mg three times daily. Further evaluation revealed cushingoid appearance, her blood pressure was 171/100 mmHg despite compliance with multiple antihypertensive therapy. Her clinical manisfestation prompted the evaluation for secondary causes of hypertension with laboratory evidence of hypokalemia, hyperglycemia, hypercortisolism with high ACTH that did not respond to low and high dose dexamethasone suppression. A splice mutation in MEN 1gene was found with the eventual diagnosis of metastatic pancreatic neuroendocrine tumor. Her turbulent course unravels how complex medical problems continue to masquerade as general medical ailments.
Michal Michal - One of the best experts on this subject based on the ideXlab platform.
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Corticomedullary Tumors of the Adrenal Glands: Report of Two Cases. Association of Corticomedullary Tumor with Spindle Cell Sarcoma
Pathology research and practice, 1996Co-Authors: Michal Michal, F. HavlicekAbstract:Summary We describe two cases of corticomedullary tumors of the adrenal gland. The patients suffered from Cushings Syndrome and paroxysmal hypertension. The corticomedullary tumors consisted of benign looking cortical adenoma cells growing on the background of the pheochromocytoma cells. We further present the ultrastructural and immunohistochemical features of these tumors. Focally a spindle cell sarcoma arising from the corticomedullary tumor was found in one case. The spindle cell sarcoma was immunohistochemically negative with antibodies to chromogranin, synaptophysin, cytokeratin and 5-100 protein. Ultrastructurally the sarcoma was composed of undifferentiated primitive cells poorly endowed with cytoplasmic organelles. Focal transitions of the pheochromocytoma into the spindle cell sarcoma were seen. It is hypothesized that the spindle cell sarcoma was arising from the pheochromocytoma component of the corticomedullary tumor.
Juan J Diez - One of the best experts on this subject based on the ideXlab platform.
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pharmacological therapy of Cushings Syndrome drugs and indications
Mini-reviews in Medicinal Chemistry, 2007Co-Authors: Juan J Diez, Pedro IglesiasAbstract:OBJECTIVE To review the main pharmacological properties and clinical applications of the drugs used in the medical therapy of Cushing's Syndrome. DATA SOURCES Search for articles were performed in the following dababases: MEDLINE, EMBASE, Cochrane Database of systematic Reviews and The Cochrane Central Register of Controlled Trials (CENTRAL). Search terms included Cushing's Syndrome and drug therapy. DATA SYNTHESIS Available data suggest that neuromodulatory compounds affect corticotropin (ACTH) or ACTH-releasing hormone (CRH) synthesis and release. They include serotonin antagonists, dopaminergic agonists, valproic acid, reserpine, somatostatin analogs and thiazolidinediones. These agents have been effective in a limited number of patients with ACTH-dependent Cushing's Syndrome. Inhibitors of steroidogenesis reduce cortisol production by blocking one (metyrapone, trilostane) or several (aminoglutethimide, ketoconazole, fluconazole, etomidate) enzymes involved in steroid biosynthesis. Mitotane is a steroidogenesis inhibitor with adrenolitic properties. Mifepriston'e blocks glucocorticoid receptor activation without modifying cortisol synthesis. CONCLUSION Agents that inhibit steroidogenesis are useful in all forms of Cushing's Syndrome and are effective in about 70% of patients. Main indications for drug therapy include preparation for surgery, persistence or recurrence after surgery, while awaiting for the effect of radiation therapy, occult ectopic ACTH Syndrome, severe hypercortisolism and malignancy related hypercortisolism.
