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The Adrenal Gland by C. R. Kannan M.D. (auth.)

Posted On March 24, 2017 at 4:08 am by / Comments Off on The Adrenal Gland by C. R. Kannan M.D. (auth.)

By C. R. Kannan M.D. (auth.)

This quantity, The Adrenal Gland, is the second one within the medical Surveys in Endo­ crinology sequence. Like its predecessor at the pituitary gland, this paintings is written with one goal in mind-to view the significant, suitable adrenal literature via a clinician's eyes. The elaborate, and infrequently advanced, interrelationship among the medical and learn views of "adrenology" poses a problem. this is often, partly, as a result ordinarily held trust that the milieux of steroid hormone learn and medical drugs are parallel phenomena, no longer destined to satisfy. however the twain do meet, and sometimes with relative ease, while seen as dual aspects of an analogous gem. The view provided during this paintings is from the vantage aspect of the scientific endocrinologist who applies the learn literature to appreciate adre­ nal illnesses extra truly. Adrenal pathology is arguably the main attention-grabbing of all endocrinopathies. the photographs of sufferers struggling with adrenal ailments are of kaleidoscopic caliber: the child baby with ambiguous genitalia, in whom the first actual ritual of assigning intercourse turns into shrouded with uncertainty; the revitalized pa­ tient with hitherto undiagnosed Addison's affliction, who yet for the cognitive powers of the endocrinologist may have finally succumbed, undiagnosed; the virilized girl with adrenal tumor and its attendant onslaught at the physique and brain; the febrile sufferer with pheochromocytoma masquerading as fever of undetermined foundation for months.

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Chowers I, Feldman S, Davidson JM: Effects of intrahypothalamic crystalline steroids on acute ACTH secretion. Am] Physiol205:671, 1963. Bohus B, Strashmirov D: Localization and specificity of corticosteroid "feedback receptors" at the hypothalamo-hypophyseallevel; comparative effects of various steroids implanted in the median eminence or anterior pituitary of the rat. Neuroendocrinology 6:197, 1970. Stark E, Gyevai A, Acs Z, et al: The site of the blocking action of dexamethasone on ACTH secretion: In vivo and in vitro studies.

2 These words, spoken in front of a Society that had repeatedly shown no faith in his works, do indicate a sense of faltering in the beliefs that he had once held so strongly. " OnJune 29, 1860, he traveled to Brighton and committed suicide by throwing himself out of a window. Etiology The most common cause of primary adrenal failure is autoimmune disease of the adrenal cortex. Autoimmune adrenaIitis occupies the center of the stage in syndromes characterized by polyglandular endocrine failure.

If, on the other hand, the adrenals fail to respond to exogenous ACTH, the metyrapone test is not indicated, since lack of response to metyrapone can no longer be interpreted. The test is performed by measuring basal levels of urinary 17-0HCS, serum cortisol, and ACTH before and following the oral administration of 750 mg metyrapone every 4 hr for six doses. A failure to increase the 17-0HCS in the urine collection the day after metyrapone is indicative of either inadequate block, ACTH lack, or primary adrenal insufficiency.

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