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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Tumors of the female genital tract may be associated with a variety of unusual clinical manifestations. Uncommon endocrine and paraendocrine syndromes include production of human chorionic gonadotropin by tumors other than those of germ cell origin, hyperthyroidism associated with struma ovarii and gestational trophoblastic disease, the carcinoid syndrome, the Zollinger-Ellison syndrome, hypercalcemia, Cushing's syndrome, hypoglycemia, hypertension related to renin or aldosterone production, hyperprolactinemia, inappropriate secretion of antidiuretic hormone, and virilization associated with Nelson's syndrome and placental site trophoblastic tumor. Paraneoplastic syndromes associated with gynecological tumors include disorders of the nervous system, connective tissue, and skin, as well as hematologic abnormalities and the nephrotic syndrome. Heritable and other congenital syndromes associated with these tumors are the Peutz-Jeghers syndrome, the nevoid basal-cell carcinoma syndrome, Ollier's disease and Maffucci's syndrome, hereditary leiomyomatosis, ataxia-telangiectasia, von Hippel-Lindau's disease, thyroid abnormalities associated with Sertoli-Leydig cell tumors, and Carney's complex. Other syndromes associated with tumors of the female genital tract include Meigs' syndrome, hyperamylasemia, uveal melanocytic lesions, and pyrexia.
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PMID:Clinical syndromes associated with tumors of the female genital tract. 175 57

The pathogenesis of hypertension associated with Cushing's syndrome is incompletely understood. We have studied basal and saline-stimulated levels of plasma atrial natriuretic hormone in 10 subjects with active Cushing's syndrome (8 F: 2 M), aged 43 +/- 4 years (mean +/- SEM). Ten age- and sex-matched normal control subjects were also studied. Subjects fasted from 22.00 h, rose at 07.45 h, and remained ambulant until 09.45 h when blood was taken for plasma ANH, plasma renin activity and serum aldosterone. Subjects then rested supine until 10.00 h when blood was again taken, and blood pressure recorded. Then, while subjects remained supine, 21 of 0.9% NaCl were infused between 10.00 and 14.00 h. Blood was taken hourly. Basal plasma ANH was 8.0 +/- 0.9 pmol/l in Cushing's subjects and 6.9 +/- 2.5 pmol/l in controls. Levels increased in response to saline in both groups, and became significantly higher in the group of patients with Cushing's syndrome (14.00 h level 21.3 +/- 3.9 vs 10.4 +/- 1.9 pmol/l; p less than 0.05). Serum aldosterone and plasma renin activity were not different between groups. Mean blood pressure was higher in patients (114 +/- 4 vs 91 +/- 7 mmHg; p less than 0.05). Urinary sodium excretion was not different between groups before saline, but during the four hours of saline was higher in Cushing's subjects (133 +/- 12 vs 67 +/- 11 mmols; N = 6; p less than 0.05). Our results suggest that during salt loading the exaggerated natriuresis seen in the Cushing's group may have been caused by ANH.
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PMID:Basal and saline-stimulated plasma atrial natriuretic hormone in Cushing's syndrome. 182 38

Atrial natriuretic peptide has been considered to be a major regulator in the body's water and salt homeostasis. Antagonizing those mechanisms leading to volume retention and overload (renin, angiotensin, aldosterone), ANP has been suggested to play a critical role in the pathology of certain diseases like renal failure, congestive heart failure or hypertension. In this regard, we measured ANP plasma concentration in normal healthy dogs and dogs with renal failure, congestive heart failure and Cushing syndrome. ANP levels were slightly decreased in dogs with Cushing disease (n = 9; 5.5 +/- 2 fmol/ml), increased in renal failure (n = 7; 16.2 +/- 5.8 fmol/ml, p less than 0.05) and markedly augmented in dogs with congestive heart failure (n = 14; 52.9 +/- 29.75 fmol/ml, p less than 0.01) as compared to healthy dogs (n = 6; 8.3 +/- 3.5 fmol/ml). Furthermore, characterization of the measured immunoreactivity (IR-ANP) revealed, that up to 50% of the IR-ANP in dogs with congestive heart failure corresponds to the ANP precursor molecule, not found in healthy subjects. This fact might present one possible explanation for the attenuated response to ANP in congestive heart failure. In addition, this finding may also serve a diagnostical purpose.
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PMID:[Diagnostic possibilities of ANP blood measurements in dogs]. 182 66

A 55-year-old woman with bilateral multiple adenomas showed hypertension, muscle weakness, hypokalemia, moon-like face and truncal obesity. Increased serum and urinary levels of aldosterone were observed. Serum cortisol level did not show a normal circadian rhythm. Microscopic examination of the resected tumors showed two types of adenoma cells; one (golden yellow tumor) was a large clear cell with foamy cytoplasm which possibly secreted aldosterone and the other (dark brown tumor) was an acidophilic cell with lipofuscin which might have produced cortisol. This is a very rare case of primary aldosteronism with Cushing's syndrome due to multiple bilateral adrenal adenomas.
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PMID:Primary aldosteronism with cortisol overproduction from bilateral multiple adrenal adenomas. 186 73

The recent advances in the diagnosis of adrenal diseases owe much to the rapid progress in radiological and endocrinological areas. The former is ascribed to the progress of medical electronics. The latter has been realized by the development, improvement and spread of the measurement of a very small amount of hormones or hormone-like substances in blood, urine or tissues, supported by the improvement of measurement instruments as well as the immunoassay or chemical assay techniques. This paper reviews approaches to diagnosis of adrenal diseases causing hypertension and asymptomatic, incidentally discovered adrenal tumors. Incidentally discovered adrenal tumors have increased owing to the spread of medical electronic instruments such as abdominal ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI). Discrimination of malignancy is an important clinical concern. More than 90% of the tumors reported in the Japanese were larger than 3 cm in diameter. The diagnosis of primary aldosteronism has been made by the measurement of plasma renin and aldosterone, CT and 131I-cholesterol scintigraphy. However the differential diagnosis of adrenal adenoma from bilateral adrenal hyperplasia has remained as a problem. There were a few patients in whom adrenal adenomas appeared after 2-3 years' follow-up period. In Cushing's syndrome, tumors are found with ease by US, CT and MRI. The diagnosis of pheochromocytoma is made mainly by urinary catecholamines and metabolites including metanephrine, normetanephrine and VMA. US, CT and MRI are very useful. Diagnosis and discovery of metastasis will be more reliably made when 131I-MIBG comes to the clinical stage.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Diagnosis of adrenal diseases focusing on morphological and endocrinological viewpoints]. 194 68

The blood pressure shows circadian variation in normal subjects with higher diurnal than nocturnal values: the difference between day and night time blood pressure is about 10-20 mmHg for systolic and for diastolic blood pressure. These variations are mainly related to physical and/or psychosensorial stress: the physician is himself a cause of increased blood pressure (the "white coat" effect). The degree of the nocturnal decrease in blood pressure which is maximal 2 and 3 o'clock is related to the quality and depth of sleep. The nocturnal decrease is followed by an increase in blood pressure when the person wakes up (early morning peak). Diagnostic signs: a physiological inversion of the circadian rhythm may be observed in people who sleep during the daytime and work at night. There would seem to be less of a nocturnal fall in black persons in the United States. Some pathological conditions can inverse or at least disturb the ciacadian variation: apart from hypertension, this has been reported in autonomic nervous system disease, in diabetics with autonomic neuropathy in some elderly patients, in Cushing's syndrome, after cardiac transplantation, etc... In hypertensives, the lack of nocturnal decrease of the blood pressure or an inversion in circadian rhythm should be looked for in severe and secondary hypertension such as associated with pheochromocytoma, or in renal dialysis patients. In toxaemia of pregnancy, this abnormality may herald an eclamptic crisis. Prognostic signs: in normotensives (especially in black persons) and hypertensives, inversion of the circadian rhythm is associated with more severe left ventricular hypertrophy and a higher morbidity.
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PMID:[Nyctohemeral changes of blood pressure. Diagnostic and prognostic value]. 195 78

A 42-year-old female was admitted to our hospital with a chief complaint of hypertension. Endocrinologically, the plasma cortisol level was increased, but its diurnal rhythm had disappeared and the plasma cortisol level was not suppressed by dexamethasone loading at 2 mg or 8 mg. The plasma ACTH level was low. Computerized tomographic scan, echography and adrenocortical scintigraphy showed an adrenocortical tumor on the right adrenal gland. Physical examination did not reveal typical Cushingoid symptoms such as moon face, central obesity and violaceous striae. Thus we diagnosed this case as non-Cushingoid Cushing's syndrome and performed right adrenalectomy. Histological examination showed adreno-cortical adenoma without malignancy.
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PMID:[A case of non-Cushingoid Cushing's syndrome]. 196 57

A 7 months-old child affected of West syndrome presented a cardiac hypertrophy with subaortic obstruction induced by adrenocorticotropic hormone treatment. The administration of this hormone may induce a Cushing syndrome; at high doses has chronotropic and inotropic positive effects and may produce arterial hypertension and cardiac hypertrophy. We pointed out the importance of the echocardiography-Doppler in the diagnosis and follow-up of the cardiac hypertrophy with subaortic obstruction as well as the reversibility of the cardiac involvement when the drug is suppressed.
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PMID:[Cardiac hypertrophy associated with subaortic obstruction induced by adrenocorticotropic hormone treatment]. 196 92

We examined the clinical data for 230 depressed inpatients who had completed a dexamethasone suppression test (DST) to determine whether those with an elevated post-DST serum cortisol level exhibited any of the classic physiological stigmata of Cushing's syndrome. Hypertension was significantly more frequent among DST nonsuppressors (21.2%) than among normal suppressors (11.3%). Percent blood lymphocyte count was significantly lower among nonsuppressors. Confounders such as gender, age, body weight, and use of antihypertensives did not account for the findings. Implications for morbidity and mortality rates among patients with affective disorder are discussed.
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PMID:Association between post-dexamethasone cortisol level and blood pressure in depressed inpatients. 198 49

A retrospective analysis was carried out on 121 patients with primary adrenal tumors operated on at 2 Vancouver hospitals between the years 1970 and 1990. The purpose of the study was to identify discriminating factors between the various diagnoses in order to minimize both the time and the cost of the investigative process. There were 57 cortical adenomas, 35 pheochromocytomas, 15 carcinomas, 8 cases of cortical hyperplasia, and 6 miscellaneous tumors. The mean time from the onset of symptoms to diagnosis of those patients presenting with an identifiable syndrome was 48.3 months. Those with a hypertensive syndrome presented significantly later than those with Cushing's syndrome (57.7 months versus 22.8 months, p less than 0.01). There was a significant delay in diagnosis in those patients with hypertension on the basis of an aldosteronoma as compared with those with hypertension secondary to a pheochromocytoma (75.4 months versus 36.1 months, p = 0.02). Cortical carcinomas were significantly larger than benign cortical tumors (12.7 cm versus 5.5 cm). No malignant neoplasm measured less than 5 cm in diameter. Diagnostic sensitivity for intravenous pyelogram (IVP) was 59%, for ultrasound 71%, for venography 50%, for meta-iodobenzylguanidine (MIGB) (pheochromocytoma only) 80%, and for angiography 70%. However, for those patients with adrenal carcinomas, angiography was positive in 100% of cases. Computed tomography (CT) was the most sensitive localizing investigation with a sensitivity of 98%. While other localizing techniques were less sensitive than CT, they may still play a useful role in selected situations. Factors causing delay in diagnosis and the role of the various imaging modalities are discussed.
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PMID:Efficient management of adrenal tumors. 203 41


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