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    Aggregation and phosphorylation of α-synuclein with proteinase K-resistance in focal α-synucleinopathy predominantly localized to the cardiac sympathetic nervous system.
    Neuropathol Appl Neurobiol 2017 Jun 21. Epub 2017 Jun 21.
    Department of Pathology, The Jikei University School of Medicine, Tokyo, 105-8461, Japan.
    Aggregates of α-synuclein, a major component of Lewy bodies (LBs) and Lewy neurites (LNs), are distributed throughout the nervous system, including the central nervous system (CNS), sympathetic ganglia, enteric nervous system (ENS), cardiac and pelvic plexuses, submandibular gland, adrenal medulla and skin, in incidental Lewy body disease (ILBD), Parkinson's disease (PD), dementia with Lewy bodies (DLB), and pure autonomic failure (PAF) [1-3]. Here we report focal α-synucleinopathy predominantly localized to the cardiac sympathetic nervous system (SNS). Aggregation and phosphorylation of α-synuclein with proteinase K (PK)-resistance developed predominantly in the cytoplasm and proximal axon of the postganglionic sympathetic neuron (PGSN). Read More

    Angioedema: Perioperative management.
    SAGE Open Med Case Rep 2017 8;5:2050313X17713912. Epub 2017 Jun 8.
    Department of Anesthesiology and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
    Objective: To describe the perioperative management of a patient with acquired angioedema (AAE).

    Methods: A 66-year-old Caucasian male presented from an outside hospital with a history of acquired angioedema and gastrointestinal stromal tumor-related intractable urticaria and mastocytosis. He was admitted for urgent laparoscopic partial gastrectomy, secondary to gastric outlet obstruction symptomatology. Read More

    A case of recurrent, multifocal anastomosing haemangiomas.
    BMJ Case Rep 2017 Jun 18;2017. Epub 2017 Jun 18.
    Division of Abdominal Imaging, St. Michael's Hospital, Toronto, Ontario, Canada.
    Anastomosing haemangiomas are relatively rare lesions, with a renal predilection, and which, given their imaging and pathologic appearance, mimic aggressive malignancies such as angiosarcoma. The imaging characteristics of this case are informative when evaluating a vascular lesion of the adrenal gland. Read More

    Epigenetics of pheochromocytoma and paraganglioma.
    Mol Cell Endocrinol 2017 Jun 16. Epub 2017 Jun 16.
    Experimental Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
    Pheochromocytomas and paragangliomas (PPGLs) are neuroendocrine tumors arising in the medullae of the adrenal glands or in paraganglia. The knowledge of the tumor biology of these lesions has increased dramatically during the past two decades and more than a dozen recurrently mutated genes have been identified. Different clusters have been described that share epigenetic signatures. Read More

    Case 243: Extramedullary Hematopoiesis in an Adrenal Myelolipoma.
    Radiology 2017 Jul;284(1):292-296
    From the Departments of Radiology (J.T., E.M.G.) and Histopathology (S.M., H.E.), Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, England.
    History A 30-year-old man presented to the emergency department with epigastric pain. He was vomiting and in distress, and he had a history of thalassemia. Physical examination findings were unremarkable. Read More

    Intervention of the Nuss Procedure on the Mental Health of Pectus Excavatum Patients.
    Ann Thorac Cardiovasc Surg 2017 Jun 16. Epub 2017 Jun 16.
    Department of Thoracic Surgery, the Army General Hospital of PLA, Beijing, China.
    Pectus excavatum (PE) is the most common congenital chest wall deformity, but little is known about the influence of the Nuss surgical procedure on mental health of patients with PE. In this study, we aimed to evaluate the influence of the PE Nuss surgical procedure on mental health in Chinese patients and identify the predictors of psychological status for PE. Patients with PE (n = 266) underwent a standard surgical procedure by the same surgeon and did the Symptom Checklist 90 (SCL-90) and the Self-rating Depression Scale (SDS) questionnaires before and 1 year after surgery. Read More

    A Case of Retroperitoneal Paraganglioma.
    J UOEH 2017 ;39(2):161-166
    Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health.
    We report a surgical case of retroperitoneal paraganglioma. A paraganglioma is a catecholamine-producing tumor originating in the chromaffin cells of the sympathetic ganglion. It is a kind of pheochromocytoma which occurs on the outside of the adrenal gland. Read More

    Adrenal-derived stress hormones modulate ozone-induced lung injury and inflammation.
    Toxicol Appl Pharmacol 2017 Jun 13;329:249-258. Epub 2017 Jun 13.
    Environmental Public Health Division, National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, NC, United States. Electronic address:
    Ozone-induced systemic effects are modulated through activation of the neuro-hormonal stress response pathway. Adrenal demedullation (DEMED) or bilateral total adrenalectomy (ADREX) inhibits systemic and pulmonary effects of acute ozone exposure. To understand the influence of adrenal-derived stress hormones in mediating ozone-induced lung injury/inflammation, we assessed global gene expression (mRNA sequencing) and selected proteins in lung tissues from male Wistar-Kyoto rats that underwent DEMED, ADREX, or sham surgery (SHAM) prior to their exposure to air or ozone (1ppm), 4h/day for 1 or 2days. Read More

    Comparison of the frequency of use of a pupil expansion device with and without an intracameral phenylephrine and ketorolac injection 1%/0.3% at the time of routine cataract surgery.
    Clin Ophthalmol 2017 1;11:1039-1043. Epub 2017 Jun 1.
    Bucci Laser Vision Institute, Wilkes-Barre, PA, USA.
    Purpose: The objective of this study is to evaluate whether a phenylephrine and ketorolac injection 1%/0.3% (phenyl/keto injection) (Omidria(®)) prior to capsulotomy decreases the need for the Malyugin Ring(®) to manage small pupils.

    Setting: Bucci Laser Vision Institute, Wilkes-Barre, PA, USA. Read More

    Tranexamic acid plus diluted-epinephrine versus tranexamic acid alone for blood loss in total joint arthroplasty: A meta-analysis.
    Medicine (Baltimore) 2017 Jun;96(24):e7095
    aDepartment of Traumatology, Linyi People's Hospital bDepartment of Surgery; Feixian people's Hospital, Linyi, Shandong, China.
    Background: We conducted the present meta-analysis to assess the efficacy and safety of tranexamic acid (TXA) plus diluted-epinephrine (DEP) for patients with total joint arthroplasty (TJA, including total knee arthroplasty (TKA) and total hip arthroplasty (THA)).

    Methods: Electronic databases (PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Chinese Wanfang databases, and Google databases) were systematically searched up to December 2016. Only randomized controlled trials (RCTs) were included. Read More

    AN INDIVIDUALIZED APPROACH TO THE EVALUATION OF CUSHING SYNDROME.
    Endocr Pract 2017 Jun;23(6):726-737
    Cushing syndrome (CS) is caused by chronic exposure to excess glucocorticoids. Early recognition and treatment of hypercortisolemia can lead to decreased morbidity and mortality. The diagnosis of CS and thereafter, establishing the cause can often be difficult, especially in patients with mild and cyclic hypercortisolism. Read More

    Adrenal tumour bigger than 5 cm - what could it be? An analysis of 139 cases.
    Endokrynol Pol 2017 Jun 12. Epub 2017 Jun 12.
    Department of Surgery Clinic of Oncology Memorial M. Sklodowska-Curie Cancer Institute, Warsaw, Poland.
    Introduction: There is an increasing number of adrenal being tumours discovered incidentally during imaging examinations performed for many different indications. Radiological findings suggesting adrenal pathology may be caused by true adrenal tumours or by other retroperitoneal masses. Generally, the larger the tumour, the higher the possibility of adrenal cancer. Read More

    Severe hyperandrogenemia in postmenopausal woman as a presentation of ovarian hyperthecosis. Case report and mini review of the literature.
    Gynecol Endocrinol 2017 Jun 11:1-4. Epub 2017 Jun 11.
    a Department of Gynecological Endocrinology , Poznan University of Medical Sciences , Poznan , Poland.
    Ovarian hyperthecosis (OH) is characterized by the presence of abundant luteinized theca cells in ovaries that secret androgen. It typically presents as severe hyperandrogenism and/or virilization in postmenopausal woman. Here we describe a 66-year old woman with presentation of severe hirsutism, alopecia, clitoromegaly and laboratory finding of significantly elevated serum total testosterone concentration and hyperinsulinemia. Read More

    Comparison of Articaine and Lidocaine for Buccal Infiltration After Inferior Alveolar Nerve Block For Intraoperative Pain Control During Impacted Mandibular Third Molar Surgery.
    Anesth Prog 2017 ;64(2):80-84
    Piracicaba Dental School, University of Campinas.
    In order to compare the efficacy of lidocaine and articaine for pain control during third molar surgery, 160 patients presenting bilateral asymptomatic impacted mandibular third molars were selected. They received 1.8 mL of 2% lidocaine with epinephrine 1:100,000 during inferior alveolar nerve block. Read More

    Influence of opioids on immune function in patients with cancer pain: from bench to bedside.
    Br J Pharmacol 2017 Jun 8. Epub 2017 Jun 8.
    John van Geest Cancer Research Centre, Nottingham Trent University, Nottingham, UK.
    In patients with cancer, opioids are principally used for the management of acute surgical and chronic cancer-related pain. However, opioids have many non-analgesic effects, including direct and indirect effects on cancer cells and on anti-tumour immunity (natural killer (NK) cells, macrophages and T-cells). Direct effects on immune cells are manifested via opioid and non-opioid Toll-like receptors, whereas indirect effects are manifested via the sympathetic nervous system and hypothalamic-pituitary-adrenal axis. Read More

    Plasma Resuscitation Improved Survival in a Cecal Ligation and Puncture Rat Model of Sepsis.
    Shock 2017 Jun 6. Epub 2017 Jun 6.
    *Center for Translational Injury Research, University of Texas Health Science Center, Houston, TX †Department of Surgery, McGovern Medical School, University of Texas Health Science Center, Houston, TX ‡Capital Region Blood Bank, Rigshospitalet, Copenhagen, Denmark §Department of Pathology & Laboratory Medicine, University of California San Francisco, San Francisco, CA ||Blood Systems Research Institute, San Francisco, CA ¶Department of Surgery, Oregon Health & Science University, Portland, OR.
    Background: The paradigm shift from crystalloid to plasma resuscitation of traumatic hemorrhagic shock has improved patient outcomes due in part to plasma-mediated reversal of catecholamine and inflammation-induced endothelial injury, decreasing vascular permeability and attenuating organ injury. Since sepsis induces a similar endothelial injury as seen in hemorrhage, we hypothesized that plasma resuscitation would increase 48-hour survival in a rat sepsis model.

    Methods: Adult male Sprague-Dawley rats (375-425 g) were subjected to 35% cecal ligation and puncture (CLP) (t = 0 h). Read More

    The usefulness of laparoscopic adrenalectomy in the treatment of adrenal neoplasms - a single-centre experience.
    Endokrynol Pol 2017 Jun 6. Epub 2017 Jun 6.
    Department of General and Endocrine Surgery, Medical University of Warsaw.
    Introduction: Adrenal neoplasms comprise about 10% of all tumours affecting this organ and constitute a significant, at first diagnostic and subsequently therapeutic, problem, especially since a relatively high proportion of neoplastic lesions are asymptomatic. The number of diagnosed metastases to adrenal glands is increasing. Surgical treatment involves both open surgery as well as laparoscopy. Read More

    Incidentaloma: from general practice to specific endocrine frame.
    J Pak Med Assoc 2017 Jun;67(6):917-922
    Department of Endocrinology, Iuliu Hatieganu University of Medicine and Pharmacy & Clinical County Hospital, Cluj-Napoca, Romania.
    Incidentaloma, a modern concept connected to technology progress, represents an accidentally discovered tumour, usually used for hypophysis and adrenals, and rarely for thyroid, parathyroids, and ovaries. This is a narrative review based on PubMed research, between 2012 and 2016 focusing on general and endocrine approach and current controversies. Main dilemma is the terminology itself: randomly imagery finding is enough or non-functioning profile and low-growth rate (not requiring surgery) should be mandatory? The controversies refers to best time framing of re-scanning pituitary and adrenal incidentaloma and setting of clear criteria for subclinical Cushing's syndrome. Read More

    Central precocious puberty secondary to adrenocortical adenoma in a female child: case report and review of the literature.
    J Pediatr Adolesc Gynecol 2017 May 31. Epub 2017 May 31.
    Professor, Department of Pediatric Surgery, Celal Bayar University, School of Medicine, Manisa, TURKEY.
    Background: Pediatric adrenocortical tumors are rare but significant causes of virilization and peripheral precocious puberty (PPP).

    Case: A 4-year-old girl presented with development of breast, pubic hair, and facial acne. Her bone age was advanced, and gonadotropins did not elevate in gonadotropin-releasing hormone (GnRH) test. Read More

    Outcomes after adrenalectomy for unilateral primary aldosteronism: an international consensus on outcome measures and analysis of remission rates in an international cohort.
    Lancet Diabetes Endocrinol 2017 May 30. Epub 2017 May 30.
    Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilian University of Munich, Munich, Germany. Electronic address:
    Background: Although unilateral primary aldosteronism is the most common surgically correctable cause of hypertension, no standard criteria exist to classify surgical outcomes. We aimed to create consensus criteria for clinical and biochemical outcomes and follow-up of adrenalectomy for unilateral primary aldosteronism and apply these criteria to an international cohort to analyse the frequency of remission and identify preoperative determinants of successful outcome.

    Methods: The Primary Aldosteronism Surgical Outcome (PASO) study was an international project to develop consensus criteria for outcomes and follow-up of adrenalectomy for unilateral primary aldosteronism. Read More

    Acute onset of paraganglioma of filum terminale: A case report and surgical treatment.
    Int J Surg Case Rep 2017 19;36:126-129. Epub 2017 May 19.
    "Di Venere" City Hospital, Unit of Neurosurgery, Bari, Italy. Electronic address:
    Introduction: Paragangliomas of filum terminale are rare benign tumors, arising from the adrenal medulla or extra-adrenal paraganglia. These lesions usually present with chronic back pain and radiculopathy and only two cases of acute neurological deficit have been reported in literature.

    Presentation Of Case: A case with an acute paraplegia and cauda equina syndrome due to an hemorrhagic paraganglioma of the filum terminale is described. Read More

    Safety of Nebulized Epinephrine in Smoke Inhalation Injury.
    J Burn Care Res 2017 May 16. Epub 2017 May 16.
    From the *Department of Surgery, University of Texas Medical Branch Galveston, TX; and †Shriners Hospitals for Children, Galveston, TX.
    This pilot study was conducted to profile safety of nebulized racemic epinephrine when used as a therapy for smoke inhalation injury in severely burned children. We enrolled 16 patients who were 7 to 19 years of age ([mean ± SD], 12 ± 4 years) with burns covering more than 30% of the TBSA (55 ± 17%) and smoke inhalation injury, as diagnosed by bronchoscopy at burn center admission. Patients were randomized to receive either standard of care (n = 8), which consisted of nebulized acetylcysteine, nebulized heparin, and nebulized albuterol, or to receive standard of care plus nebulized epinephrine (n = 8). Read More

    Pheochromocytomatosis associated with a novel TMEM127 mutation.
    Endocrinol Diabetes Metab Case Rep 2017 25;2017. Epub 2017 May 25.
    Section of Endocrine Surgery, UCLA David Geffen School of Medicine, Los Angeles, USA.
    Pheochromocytomatosis, a very rare form of pheochromocytoma recurrence, refers to new, multiple, and often small pheochromocytomas growing in and around the surgical resection bed of a previous adrenalectomy for a solitary pheochromocytoma. We here report a case of pheochromocytomatosis in a 70-year-old female. At age 64 years, she was diagnosed with a 6-cm right pheochromocytoma. Read More

    SDHB mutation carriers with malignant pheochromocytoma respond better to CVD.
    Endocr Relat Cancer 2017 May 31. Epub 2017 May 31.
    D Cohen, Dept of Medicine; Renal and Hypertension Division, University of Pennsylvania Perelman School of Medicine, Philadelphia, United States.
    Pheochromocytomas and paragangliomas (PCC/PGL) are tumors in the adrenal medulla and extra adrenal sites, respectively. About a quarter are metastatic, often with a long latency period. Some PCC/PGL are defined as clinically aggressive given extensive local invasion into adjacent normal tissue. Read More

    Preoperative flap-site injection with ropivacaine and epinephrine in BABA robotic and endoscopic thyroidectomy safely reduces postoperative pain: A CONSORT-compliant double-blinded randomized controlled study (PAIN-BREKOR trial).
    Medicine (Baltimore) 2017 Jun;96(22):e6896
    aDepartment of Surgery, Seoul National University Bundang Hospital, Gyeonggi-do bDepartment of Surgery, Seoul National University Hospital and College of Medicine cCancer Research Institute, Seoul National University College of Medicine, Seoul dThyroid and Endocrine Surgery Section, Department of Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea.
    Background: Clinical trials on bilateral axillo-breast approach (BABA) thyroidectomy show that levobupivacaine and ropivacaine significantly reduce postoperative pain, but they focused on BABA robotic thyroidectomy only and did not identify specific sites of significant pain relief. Our objective was to assess the pain reduction at various sites and safety of ropivacaine-epinephrine flap injection in BABA thyroidectomy.

    Methods: This prospective double-blinded randomized controlled trial was conducted in compliance with the revised CONSORT statement (ClinicalTrials. Read More

    Peripancreatic paraganglioma mimics pancreatic/gastrointestinal neuroendocrine tumor on fine needle aspiration: report of two cases and review of the literature.
    Diagn Cytopathol 2017 May 30. Epub 2017 May 30.
    Department of Pathology, New York University Langone Medical Center, New York, New York.
    Cytologic diagnosis of extra-adrenal paraganglioma presenting as a peripancreatic mass is challenging with a high error rate due to its rarity. We report two cases of peripancreatic masses identified by radiology. Endoscopic ultrasound-guided fine needle aspiration (FNA) of the masses showed a moderately cellular tumor composed of small to medium sized neoplastic cells with round to oval nuclei, arranged singly and in loose clusters. Read More

    Conditional loss of hepatocellular Hedgehog signaling in female mice leads to the persistence of hepatic steroidogenesis, androgenization and infertility.
    Arch Toxicol 2017 May 30. Epub 2017 May 30.
    Rudolf-Schönheimer-Institute of Biochemistry, Faculty of Medicine, Leipzig University, Johannisallee 30, 04103, Leipzig, Germany.
    The Hedgehog signaling pathway is known to be involved in embryogenesis, tissue remodeling, and carcinogenesis. Because of its involvement in carcinogenesis, it seems an interesting target for cancer therapy. Indeed, Sonidegib, an approved inhibitor of the Hedgehog receptor Smoothened (Smo), is highly active against diverse carcinomas, but its use is also reported to be associated with several systemic side effects. Read More

    Complete Responses to Mitotane in Metastatic Adrenocortical Carcinoma-A New Look at an Old Drug.
    Oncologist 2017 May 30. Epub 2017 May 30.
    Department of Medicine, Center for Molecular Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
    Purpose: Based largely on reports that predate modern reporting standards, mitotane has been considered a systemic treatment option for both hormone control and antitumor control of metastatic adrenocortical cancer (ACC), although the therapeutic window is narrow.

    Methods: We searched electronic medical records to identify patients with metastatic ACC treated and prescribed single agent mitotane at Memorial Sloan Kettering Cancer Center from March 15, 1989-September 18, 2015. Reference radiologists reviewed all imaging and determined efficacy according to Response Evaluation Criteria in Solid Tumors 1. Read More

    Outcome of Judet's quadricepsplasty for knee contractures and the effect of local infiltration of epinephrine on reducing blood loss.
    Chin J Traumatol 2017 Jun 10;20(3):147-150. Epub 2017 May 10.
    Section of Orthopedics, Department of Surgery, Aga Khan University Hospital, Karachi 74800, Pakistan.
    Objective: To evaluate the effectiveness of Judet's quadricepsplasty for treatment of knee contractures and to identify the effect of local infiltration of epinephrine on blood loss associated with this procedure.

    Methods: A retrospective cohort study was conducted in which all cases of knee contractures managed with Judet's quadricepsplasty from 1st January 2009 to 31st December 2013 were included and were divided into two groups. The epinephrine group included patients who were infiltrated with diluted epinephrine (1:400,000) along with xylocaine, around the operative field 15 min prior to the incision time, while the control group did not receive any infiltration. Read More

    Minimally invasive resection of adrenal masses in infants and children: results of a European multi-center survey.
    Surg Endosc 2017 May 26. Epub 2017 May 26.
    Pediatric Surgery Unit, Women's and Children's Health Department, University of Padova, Padova, Italy.
    Background: Minimal access adrenal surgery (MAAS) for adrenal pathologies is the standard for many pediatric surgical centers. However, the literature offers few reports and minimal evidence from small case series. The aim of this study was to evaluate the outcomes of pediatric MAAS through a multi-center data analysis. Read More

    Testicular tumors of adrenogenital syndrome: From physiopathology to therapy.
    Presse Med 2017 May 23. Epub 2017 May 23.
    Ibn El Jazzar teaching hospital, Les Aghlabides surgical division, urology department, 3100 Kairouan, Tunisia.
    Testicular tumor of adrenogenital syndrome is a rare and benign anomaly usually presenting as bilateral testicular masses. It is the most important cause of infertility in adult male congenital adrenal hyperplasia. Distinction between testicular tumors of adrenogenital syndrome and Leydig cell tumors can be problematic; it is based on clinical, histopathologic, immunohistochemical and endocrine features. Read More

    Percutaneous CT-guided radiofrequency ablation for patients with extrahepatic oligometastases of hepatocellular carcinoma: long-term results.
    Int J Hyperthermia 2017 May 2:1-9. Epub 2017 May 2.
    a State Key Laboratory of Oncology in South China , Collaborative Innovation Center for Cancer Medicine , Guangzhou , PR China.
    Background: The aim of this study was to evaluate the therapeutic outcome of percutaneous computed tomography (CT)-guided radiofrequency ablation (RFA) for extrahepatic oligometastases of hepatocellular carcinoma (HCC).

    Methods: Institutional review board approval was obtained for this retrospective study, and all patients provided written informed consent. Between April 2004 and December 2015, 116 oligometastases (diameter, 5-50 mm; 20. Read More

    Open adrenalectomy in the era of laparoscopic surgery: a review.
    Updates Surg 2017 May 24. Epub 2017 May 24.
    Dipartimento di Scienze Mediche e Chirurgiche, Chirurgia Generale-Minni, Alma Mater Studiorum-Università di Bologna, Policlinico S.Orsola-Malpighi, Via Massarenti n.9, 40138, Bologna, Italy.
    Open adrenalectomy still plays an important role in adrenal surgery. A review of the current literature has been carried out to discuss the main indication to open adrenalectomy with regards to the main adrenal pathologies. The authors underlined the role of open adrenalectomy on the basis of personal experience and a literature review. Read More

    Comparison of the efficacy and safety of 2% lidocaine HCl with different epinephrine concentration for local anesthesia in participants undergoing surgical extraction of impacted mandibular third molars: A multicenter, randomized, double-blind, crossover, phase IV trial.
    Medicine (Baltimore) 2017 May;96(21):e6753
    aDepartment of Dental Anesthesiology bDepartment of Dental Anesthesiology and Dental Research Institute, Seoul National University School of Dentistry cDepartment of Oral & Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul dDepartment of Dental Anesthesiology, Dankook University College of Dentistry, Dankook University, Cheonan-si, Chungnam eDepartment of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University and Institute of Translational Dental Sciences, Pusan National University fDepartment of Dental Anesthesia and Pain Medicine, School of Dentistry, Pusan National University and Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Gyeongnam gCollege of Dentistry, Wonkwang University, Iksan city, Jeonbuk hDepartment of Oral and Maxillofacial Surgery, Dankook University College of Dentistry, Dankook University, Cheonan-si, Chungnam iDepartment of Oral & Maxillofacial Surgery, Kyung Hee University Dental Hospital Kyung Hee University School of Dentistry, Seoul jR&D Center, Huons Co. Ltd., College of Pharmacy, Hanyang University, Ansan-si, Kyeonggi-do, Republic of Korea.
    Background: The most commonly impacted tooth is the third molar. An impacted third molar can ultimately cause acute pain, infection, tumors, cysts, caries, periodontal disease, and loss of adjacent teeth. Local anesthesia is employed for removing the third molar. Read More

    Transcatheter aortic valve implantation in patients on corticosteroid therapy.
    Heart Vessels 2017 May 23. Epub 2017 May 23.
    Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu, Tokyo, 183-0003, Japan.
    Transcatheter aortic valve implantation (TAVI) is recommended for patients who are inoperable or at high risk for surgical aortic valve replacement (SAVR). Corticosteroid therapy is considered to be a risk factor for SAVR, but there is a paucity of information about TAVI in patients taking corticosteroids. The aim of this study is to elucidate the outcome of TAVI in patients on chronic corticosteroid therapy, compared with SAVR. Read More

    Surgery in late melanoma adrenal metastasis.
    BMJ Case Rep 2017 May 22;2017. Epub 2017 May 22.
    Department of General and Digestive Surgery, Hospital Universitario de la Princesa, Madrid, Spain.
    Metastatic melanoma to adrenal gland are very infrequent, being generally associated with additional evidence of systemic disease and, consequently, with short-term survival. However, the prognosis and the therapeutic management vary depending on some important oncological features. Long-term survival rates have been described after complete resection of metastatic disease. Read More

    Restoring normal anatomy in female patients with atypical genitalia.
    Semin Perinatol 2017 May 20. Epub 2017 May 20.
    UCSF Benioff Children's Hospital, 1825 Fourth St, 5th Floor, San Francisco, CA 94143. Electronic address:
    Female patients with congenital adrenal hyperplasia (CAH) have varying degrees of atypical genitalia secondary to prenatal and postnatal androgen exposure. Surgical treatment is focused on restoring normal genitalia anatomy by bringing the vagina to the normal position on the perineum, separating the distal vagina from the urethra, forming a normal introitus and preserving sexual function of the clitoris by accepting moderate degrees of hypertrophy as normal and strategically reducing clitoral size only in the most severely virilized patients. There remains a need for continued monitoring of patients as they go through puberty with the possibility of additional surgery for vaginal stenosis. Read More

    Epidural Dexamethasone Influences Postoperative Analgesia after Major Abdominal Surgery.
    Pain Physician 2017 May;20(4):261-269
    Yeungnam University School of Medicine and College of Medicine, Korea.
    Background: Epidurally administered dexamethasone might reduce postoperative pain. However, the effect of epidural administration of dexamethasone on postoperative epidural analgesia in major abdominal surgery has been doubtful.

    Objectives: To investigate the effects and optimal dose of epidural dexamethasone on pain after major abdominal surgery. Read More

    [Cardiac pseudotumor revealing Behçet's disease].
    Pan Afr Med J 2017 15;26:151. Epub 2017 Mar 15.
    Service de Chirurgie Cardiaque, Hôpital Militaire d'Instruction Mohamed V, Faculté de Médecine et de Pharmacie, Université Mohamed V, Rabat, Maroc.
    Intracardiac thrombosis is a rare complication of Behçet's disease (BD), which may manifest as intracardiac tumor. In half of cases, its detection precedes the diagnosis of MB. High mortality rates may be related to post-surgical complications and/or pulmonary arteries involvement. Read More

    Management of Incidental Pancreatic Cysts: A White Paper of the ACR Incidental Findings Committee.
    J Am Coll Radiol 2017 May 12. Epub 2017 May 12.
    Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts.
    The ACR Incidental Findings Committee (IFC) presents recommendations for managing pancreatic cysts that are incidentally detected on CT or MRI. These recommendations represent an update from the pancreatic component of the JACR 2010 white paper on managing incidental findings in the adrenal glands, kidneys, liver, and pancreas. The Pancreas Subcommittee-which included abdominal radiologists, a gastroenterologist, and a pancreatic surgeon-developed this algorithm. Read More

    Takotsubo cardiomyopathy after intravenous epinephrine administration following cardiac arrest provoked by pneumoperitoneum - a case report.
    Pol Merkur Lekarski 2017 Apr;42(250):165-169
    Józef Struś Hospital, Poznań, Poland: Department of General and Colorectal Surgery.
    In stress-induced takotsubo cardiomyopathy (TC) high levels of catecholamines, including epinephrine, may be detected in blood. On the other hand, administration of exogenous epinephrine may occasionally result in TC.

    A Case Report: The authors describe a case of a 58-year-old, otherwise healthy female, with TC which occurred after intravenous injection of 1 mg of epinephrine against cardiac arrest provoked by pneumoperitoneum performed before planned laparoscopic cholecystectomy. Read More

    Abiraterone acetate and prednisone in chemotherapy-naïve prostate cancer patients: rationale, evidence and clinical utility.
    Ther Adv Med Oncol 2017 May 22;9(5):319-333. Epub 2017 Mar 22.
    UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
    Abiraterone acetate 1000 mg/day, combined with prednisone 5 mg PO twice daily, is indicated for the treatment of metastatic castration-resistant prostate cancer (mCRPC). Abiraterone acetate is the oral prodrug of abiraterone, a specific CYP17 inhibitor that blocks androgen biosynthesis within the adrenal glands, testes and tumor microenvironment. In a phase III trial of men with asymptomatic or minimally symptomatic, chemotherapy-naïve mCRPC, treatment with oral abiraterone acetate plus prednisone led to a statistically significant improvement in the co-primary endpoints of overall survival and radiographic progression-free survival when compared with placebo plus prednisone. Read More

    Perioperative hypothalamic pituitary adrenal function in patients with silent corticotroph adenomas.
    Pituitary 2017 May 20. Epub 2017 May 20.
    Division of Clinical and Molecular Endocrinology, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, OH, 44106, USA.
    Background: Silent corticotroph adenomas (SCAs) are characterized by strong ACTH immunostaining without clinical manifestations of hypercortisolism. Patients with SCAs often present with mechanical symptoms related to tumor growth. This study investigates the hypothalamic pituitary adrenal axis (HPA) characteristics after adenomectomy in patients with SCAs. Read More

    Three-Quarters Adrenalectomy for Infantile-Onset Cushing Syndrome due to Bilateral Adrenal Hyperplasia in McCune-Albright Syndrome.
    Horm Res Paediatr 2017 May 19. Epub 2017 May 19.
    Department of Pediatrics, Oita University Faculty of Medicine, Oita, Japan.
    Background: Bilateral adrenalectomy is performed in cases with infantile-onset Cushing syndrome due to bilateral adrenal hyperplasia in McCune-Albright syndrome (MAS) because severe Cushing syndrome with heart failure and liver dysfunction can have a lethal outcome. This procedure can completely ameliorate hypercortisolism, although lifetime steroid replacement therapy and steps to prevent adrenal crisis are necessary. Recently, the efficacy of unilateral adrenalectomy has been reported in adult cases of bilateral macronodular adrenal hyperplasia, but there is no consensus regarding the appropriate surgical treatment for bilateral adrenal hyperplasia in MAS. Read More

    Stigma Associated with Classical Congenital Adrenal Hyperplasia in Women's Sexual Lives.
    Arch Sex Behav 2017 May 18. Epub 2017 May 18.
    Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
    The risk of intersex-related stigma often serves as social indication for "corrective" genital surgery, but has not been comprehensively documented. In preparation for the development of an intersex-specific stigma assessment tool, this qualitative project aimed to explore stigma in girls and women with classical congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. As part of a comprehensive follow-up project, 62 adult women with classical CAH (age range 18-51 years) took part in an open-ended retrospective interview focusing on the impact of CAH and its treatment on various aspects of girls' and women's lives. Read More

    Effects of β-Adrenoceptor and Catechol-O-Methyl-Transferase (COMT) Polymorphism on Postoperative Outcome in Cardiac Surgery Patients.
    Med Sci Monit Basic Res 2017 May 19;23:223-233. Epub 2017 May 19.
    Department of Cardiac Surgery, Heart Center Leipzig University of Leipzig, Leipzig, Germany.
    BACKGROUND There is a long-standing debate about the role of beta-adrenoceptor polymorphisms in the cardiovascular system. We wanted to elucidate whether β1-adrenoceptor-polymorphisms affects the postoperative catecholamine consumption and the length of intermediate care unit stay in patients undergoing cardiac surgery, and whether this might be enhanced or attenuated by catechol-O-methyl-transferase (COMT) polymorphism. MATERIAL AND METHODS We included 116 patients (63±1. Read More

    Single-stage laparoscopic adrenalectomy for pheochromocytoma and enucleation of a pancreatic neuroendocrine tumor in Von Hippel-Lindau disease: A case report.
    Mol Clin Oncol 2017 May 6;6(5):799-801. Epub 2017 Apr 6.
    Department of Surgery, IRCCS - Azienda Ospedaliera Universitaria San Martino-IST, University of Genoa, Ι-16132 Genoa, Italy.
    Von Hippel-Lindau (VHL) disease is an inherited syndrome with autosomal-dominant transmission, characterized by central nervous system and retinal hemangioblastomas, visceral cysts and tumors. Optimal surgical treatment, including its timing, remains a controversial topic. The present study reports the case of a 67-year-old female patient with adrenal and pancreatic manifestations of VHL. Read More

    Total Laparoscopic Management for Stage IV Colorectal Cancer Requiring Multivisceral Resection.
    Ann Surg Oncol 2017 May 16. Epub 2017 May 16.
    Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
    Background: Surgical resection of all sites of disease, in combination with effective systemic chemotherapy, offers the only potential chance for cure for patients with stage IV colorectal cancer (CRC). Coordinated multistage resection using a minimally invasive approach may provide optimal oncologic outcome while potentially offering the benefit of decreased morbidity.

    Patient: A 66-year-old women presented with transverse colon cancer and synchronous metastasis (CRLM) in segment IV involving the middle hepatic vein and main left portal pedicle, as well as the left adrenal gland. Read More

    Adrenal ganglioneuroma: The Padua Endocrine Surgery Unit experience.
    Int J Surg 2017 May;41 Suppl 1:S103-S108
    Endocrine Surgery Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Via Giustiniani 2, 35128 Padova, Italy. Electronic address:
    Background: Adrenal ganglioneuroma (AGN) is a rare tumor that originates from the gangliar cells of the sympathetic nervous system. It represents less than 5% of all adrenal masses. AGN occurs as a large mass, with benign behavior and no relevant symptoms and hormonal secretion, but it is often misdiagnosed because the preoperative radiological diagnosis is generally challenging. Read More

    Psychological adjustment in parents of children born with atypical genitalia one year after their child undergoes genitoplasty.
    J Urol 2017 May 11. Epub 2017 May 11.
    Children's Hospital of Michigan, Detroit, MI; Cook Children's Medical Center, Fort Worth, TX.
    Purpose: The current study examined the psychological adjustment of parents of children born with moderate to severe genital atypia 12 months after their child underwent genitoplasty.

    Materials And Methods: Parents were recruited longitudinally from a multi-center collaboration of 10 pediatric hospitals with specialty care for children with a Disorder/Difference of Sex Development and/or Congenital Adrenal Hyperplasia. Parents completed measures of depressive and anxious symptoms, illness uncertainty, quality of life, post-traumatic stress, and decisional regret. Read More

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