• Title/Summary/Keyword: Adrenal hemorrhage

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A Case of Traumatic Bilateral Adrenal Hemorrhage Mimicking Bilateral Adrenal Adenomas

  • Lee, Min-Jung;Kim, Gi-Ae;Jang, Jung-Eun;Choi, Hyo-In;Lee, Seo-Hyun;Koh, Gwang-Beom;Kim, Ga-Hee;Kim, Min-Seon
    • Journal of Yeungnam Medical Science
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    • v.29 no.1
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    • pp.35-37
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    • 2012
  • Adrenal hemorrhages caused by blunt abdominal trauma have been frequently reported, and most of the lesions are unilateral. In contrast, bilateral hemorrhage of the adrenal glands after trauma rarely occurs in subjects with predisposing conditions such as coagulopathy, thromboembolism, and sepsis. Furthermore, bilateral hemorrhage of the adrenal glands is potentially fatal by inducing acute adrenal insufficiency. Here,a case of a 40-year-old man who developed traumatic bilateral adrenal hemorrhage after a car accident, without any predisposing condition, is reported. The spontaneous shrinkage of the bilateral lesions revealed in the follow-up abdominal computed tomography (CT) scansupported the aforementioned diagnosis. Fortunately, the patient had no clinical or biochemical evidence suggesting acute adrenal insufficiency. To these authors' knowledge, this is the first South Korean report of traumatic bilateral adrenal hemorrhage in a subject with no predisposing factors.

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Adrenal Hemorrhage in a Neonate (신생아의 부신 출혈)

  • Cho, Kyung-Ah;Yoo, Soo-Young
    • Advances in pediatric surgery
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    • v.1 no.2
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    • pp.204-208
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    • 1995
  • Neonatal adrenal hemorrhage is frequently associated with birth trauma or perinatal hypoxia. Hemorrhagic necrosis of the adrenal glands is often found at autopsy and many small lesions are usually asymptomatic. A palpable abdominal mass and jaundice are the usual presenting signs. Ultrasound is very useful in the diagnosis of this lesion; however, if the mass has mixed echoic pattern, magnetic resonance imaging (MRl) is helpful for the differential diagnosis from neuroblastoma. We present the case of a female newborn who was found to have a abdominal mass on physical examination. The patient showed anemia and hyperbilirubinemia. An ultrasonogram disclosed a $3.8{\times}3.0$ cm suprarenal mass with mixed echoic pattern. The mass was initially suspected to be neuroblastoma. An abdominal computed tomogram was not able to differentiate the mass. Magnetic resonance imaging revealed markedly increased signal intensity on T1 and T2-weighted sequences. This finding was consistent with adrenal hemorrhage. Serial sonogram demonstrated the mass that resolved completely by 12 weeks of age.

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Pathological Studies on Experimental Poisoning of Organic Phosphate Insecticide (유기인제 중독에 관한 병리학적 연구)

  • Lee, Cha Soo;Lim, Chang Hyeong
    • Korean Journal of Veterinary Research
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    • v.15 no.1
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    • pp.39-45
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    • 1975
  • The authors believe that farm livestok will be greatly affected by the marked increasing use of organic phosphate. This study was carried out to observe the clinical signs and histopathological changes of mouse, guinea pig, hamster and rabbit that were orally administered with diazinon used usually as agricultural insecticide, and cholinesterase (ChE) activity was histochemically examined in the liver, heart, kidney, adrenal gland, duodenum and salivary gland of these experimental animals administered with diazinon. The results obtained were as follows: 1. Clinical signs such as dullness, severe salivation, ataxia, dyspnea, irregular slight convulsion and inappetance and as the histopathological changes cloudy swelling, congestion and hemorrhage of parenchymal organs, catarrh or local necrsois of the gastrointestinal tract, congestion or hemorrhage of the other organs were observed. Especially, hemorrhage of adrenal glands (rabbit, guinea pig) and pulmonary congestion and hemorrhage were necessarily constant. 2. In the histochemical study, ChE activity appeared intensely in the liver, heart, medulla of adrenal glands and salivary glands (submaxillary and parotid) of control animals, but ChE activity was negative or markedly decreased in experimental animals administered with diazinon. There was no marked difference between the control and experimental animals in ChE activity of the kidney. 3. Histochemical observation of ChE activity was helpful to explain the clinical signs and histopathological changes and was regarded as a diagnostic method for organic phosphate poisoning.

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Effect of Hemorrhage on mRNA Expressions of Renin, Angiotensinogen and $AT_1$ Receptors in Rat Central and Peripheral Tissues

  • Lee, Mi-Kyung;Jo, Hak-Ryul;Kim, Kyung-Soon;Yang, Eun-Kyoung;Lee, Won-Jung
    • The Korean Journal of Physiology and Pharmacology
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    • v.1 no.2
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    • pp.151-159
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    • 1997
  • In an attempt to investigate whether hemorrhage affects the gene expression of the renin-angioteusin system (RAS) components in the brain and peripheral angiotensin-generating tissues, changes in mRNA levels of the RAS components in response to hemorrhage were measured in conscious unrestrained rats. Wistar rats were bled at a rate of 3 ml/kg/min for 5 min, and then decapitated 7 h after hemorrhage. Levels of mRNA for renin, angiotensinogen and angiotensin $II-AT_1$ receptor subtypes ($AT_{1A}$ and $AT_{1B}$) were determined with the methods of northern blot and reverse transcriptase-polymerase chain reaction (RT-PCR). Hemorrhage produced a profound hypotension with tachycardia, but blood pressure and heart rate recovered close to the basal level at 7 h. Plasma and renal renin levels were significantly increased at 7 h. Hemorrhage induced rapid upregulation of gene expression of both $AT_{1A}$ and $AT_{1B}$ receptor subtypes in the brainstem and hypothalamus, downregulation of them in the adrenal gland and liver. However, renin mRNA level increased in the brainstem, decreased in the liver, but was not changed in the hypothalamus, kidney and adrenals after hemorrhage. Angiotensinogen mRNA level was not significantly changed in any of the tissue except a slight increase in the liver. The kidney and liver did not show any significant change in gene expression of the RAS components. These results suggest that gene expression of the RAS in central and peripheral tissues are, at least in part, under independent control and the local RAS in each organ plays specific physiologic role.

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An Extra-adrenal Pheochromocytoma Presenting with Spontaneous Intracerebral Hematoma

  • Park, Seong-Keun;Lee, Jung-Kil;Kim, Jae-Hyoo;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • v.38 no.1
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    • pp.61-64
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    • 2005
  • We report a 18-year-old man, who has been taking antihypertensive medication for 1month in a local clinic, presented with a sudden onset headache followed by left blindness. He experienced palpitation and chest discomfort during physical exertion since 2years before admission, but unfortunately has been ignored. Brain CT showed intracerebral hemorrhage in the left temporoparietal area, but cerebral angiogram and magnetic resonance image revealed no vascular anomaly. He was managed conservatively, and headache and visual loss were improved over time. Subsequently, on the evaluation of hypertension, he was diagnosed as having extra-adrenal pheochromocytoma on left paraaortic area from the results of endocrinological evaluations, abdominal CT scan, and $^{131}I$-MIBG scintigraphy.

Recurrent Post-Traumatic Adrenal Bleeding after Transcatheter Arterial Embolization: A Case Report (외상성 부신 손상에 대한 경카테터 동맥 색전술 후 재발성 출혈: 증례 보고)

  • Hyojoo Kim;Sang Hyun Seo;Hyun Seok Jung
    • Journal of the Korean Society of Radiology
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    • v.84 no.6
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    • pp.1408-1413
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    • 2023
  • Adrenal gland trauma is uncommon and is diagnosed at an increasing frequency using CT scans. However, owing to the rarity of this injury and its diverse clinical presentations and prognoses, there is no consensus on its management. In this case report, a 73-year-old male patient experienced recurrent bleeding in the right adrenal gland due to an in-car traffic accident, which was treated with repeated transcatheter arterial embolization.

A Histopathological Observation on the Mammary Gland of Lactating Rat Injected with Dexamethasone (Dexamethasone을 투여(投與)한 Rat 유선조직(乳腺組織)의 병리조직학적(病理組織學的) 관찰(觀察))

  • Ryu, Si-Yun;Lee, Cha-Soo
    • Korean Journal of Veterinary Research
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    • v.23 no.1
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    • pp.57-67
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    • 1983
  • The present study was carried out to observe the histopathological changes in the mammary gland of lactating rats and rabbits injected with dexamethasone. White rats were intramuscularly injected with 0.25mg, 0.5mg or 1.0mg of dexamethasone sodium phosphate (containing $9{\alpha}$-fluoro-$16{\alpha}$-methylprednisolone, 5.0mg/ml) daily for 3 to 10 days on the 3rd day after parturition and white rabbits were intramammary infused with 4mg or 20mg of dexamethasone daily for 4 days on 7th day after parturition. The histopathological changes of the mammary glands, ovaries and adrenal glands of rats and rabbits were observed with light microscope. In the mammary glands of rats, the microscopic findings encountered were decrease of the milk in the alveolar lumina, necrosis and desquamation of epithelial cells, atrophy of alveoli, proliferation of fibroblasts and thickness of alveolar walls, destruction of alveoli, presence of fat droplets within the glandular epithelial cells, infiltration of mononuclear cells and proliferation of adipose tissue, which were relative to the dose and duration of injection. Especially, in the cases of the administration of large doses or long duration, there were severe fibrosis and focal necrosis of glandular tissue. In the mammary glands of rabbits, the morphological changes were similar to those findings in the rats. The milk in the alveolar lumina was decreased gradually according to the dose and duration of injection, while milk fat concentration regarded to increase. In the histological findings of ovaries, necrosis of granulosa cellos, vacuolization and necrosis of luteal cells, atrophy and necrotic foci in the corpora lutes were observed. In the adrenal glands, hyperemia, hemorrhage, vacuolization of adrenal cortical cells, necrotic foci and atrophy of adrenal cortex were observed.

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Experimental study on the changes of serum free fatty acid and blood sugar during hemorrhagic shock (출혈성(出血性) Shock 에 출현(出現)되는 유리지방산(遊離脂肪酸) 및 혈당량(血糖量)의 변동(變動)에 관(關)하여)

  • Kim, Hyong-Se
    • The Korean Journal of Pharmacology
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    • v.2 no.1 s.2
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    • pp.99-109
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    • 1966
  • It has been known that the pronounced hypotension resulting from hemorrhage gives rise to compensatory stimulation of the adrenosympathetic system, which leads to an increase of liberation of catecholamines from sympathetic nervous system and adrenal medulla. It is obvious, therefore, that numerous physiological and biochemical changes during the hemorrhagic hypotention might be mediated through the increased liberation of catecholamines. Although an extensive studies have been reported on changes of protein and carbohydrate metabolism in hemorrhagic shock a few studies on the changes of lipid metabolism have been reported. Levenson(1961) observed a marked increase of serum lipids content during hemorrhagic shock and also noticed a marked elevation of serum free fatty acids. He suggested that these effects were due to mobilization and accelerated metabolic breakdown of lipids which might be resulted by sympathetic stimulation as a cause. To elucidate the mechanism of this, author studied the change of serum free fatty acids and blood sugar with relation to catecholamines during experimentally induced hemorrhagic shock in dog. Healthy male mongrel dogs weighing approximately 15kg were used. Under the general anesthesia with pentobarbital, rapid hemorrhage was produced from the femoral artery maintaining blood pressure level of 40 mmHg measured by the manometer connected with the opposite femoral artery throughout the experiment. Serum free fatty acids(FFA) and blood sugar were measured by the methods of Dole(1956) and Folin-wu,(1920) respectively. Tissue catecholamine was measured by Shore and Olin method(1958) using Aminco-Bowman spectrophotofluorometer.

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Pathological observation on the piglets experimentally infected with Aujeszky′s disease virus isolated in Korea (국내 분리 오제스키병 바이러스 접종자돈의 병리학적 관찰)

  • Park, Nam-Yong;Chung, Chi-Young;Kim, JIn-Ho;Yoon, Jin-Gyu;Park, Young-Seok
    • Korean Journal of Veterinary Pathology
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    • v.2 no.2
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    • pp.117-125
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    • 1998
  • Pathological studies were performed on the five piglets experimentally infected with Aujeszky's disease virus(pseudorabies), NYJ isolate, isolated from the naturally infected pigs in Korea: two piglets were inoculated intramuscularly, two piglets intranasally, and one piglet subcutaneously at the dose of 1$m\ell$ per animal with the 105.5 $TCID_50$/0.1ml titer. Clinical signs included dyspnea, high fever(>$41^{\circ}C$), anorexia, vomiting, diarrhea or constipation, ataxia, circling movement, posterior paralysis, intermittent convulsion, and coma followed by death although some variations by age and inoculated routes were observed. Gross features included multiple necrotic foci in the liver, congestion and hemorrhage in the lymph nodes and spleen, petechial hemorrhage in the kidney, hemorrhagic pneumonia, marked meningeal congestion, severe sub meningeal hemorrhage in the spinal cord, excessive cerebrospinal fluid retention, and muscular necrosis at the inoculated area. Microscopically, non suppurative meningoencephalitis with gliosis and perivascular cuffing in CNS, ganglioneuritis, necrohemorrhagic splenitis, necrotic hepatitis, tonsillitis and rhinitis, hemorrhagic or interstitial pneumonia, and non-suppurative myositis in the injected area were observed. Eosinophilic intranuclear inclusion bodies were found in a variety of tissues the including the liver, kidney, adrenal gland, spleen, lymph nodes, tonsil, and lung. Ultrastructurally, virus particles were confirmed in nucleus and cytoplasms of pneumocytes around the necrotic areas.

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Etiological Studies on the Acute Fatal Disease of Angora Rabbits : The So-Called Rabbit Viral Sudden Death (앙고라 토끼의 급성폐사성질병(急性斃死性疾病)의 병인학적(病因學的) 연구(硏究) : 소위(所謂) 토끼의 바이러스성(性) 급사병(急死病))

  • Lee, Cha-soo;Park, Cheong-kyu
    • Korean Journal of Veterinary Research
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    • v.27 no.2
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    • pp.277-290
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    • 1987
  • This paper dealt with etiological studies on the acute fatal disease of Angora rabbits occurring as a group in Korea. The disease was confirmed as an acute infectious disease caused by virus. The results obtained were summarized as follows: The disease produced a high morbidity in the rearing Angora rabbits and a high mortality in the infected rabbits, and was acute. The infected rabbits died soon without premonitory signs after inappetence. The body temperature of the affected rabbits rose to $40^{\circ}C$ and nearly all deaths occurred within 48 hours after inoculation. In many cases a bloody foam was visible from the nostrils after death. According to the progress of the disease the nervous signs, such as ataxia, paralysis of the legs, and torticollis could be recognized in the some cases. Rabbits that had recovered from the disease were severe emaciation, and bristly and sparse hairs. In macroscopical findings, there were hemorrhage and edema of the lung, hemorrhage or hyperemia of the tracheal and broncheal mucosae, appearance of blood-tinged effusion in the respiratory tract. The principal lesions were found in the liver. Usually the lobular necrosis of the liver cells was progressed, and focal necrosis and hemorrhagic spots of various sizes were often observed in the liver. Liver was as a whole pale. In chronic cases, however, there was a slight liver cirrhosis with the atrophy of the parenchymal cells. The other lesions encountered grossly consisted of swelling and petechiae of the kidney, hyperemia and hemorrhage of the spleen, catarrh of the small intestine, and hyperemia of the brain. The urinary bladder contained a lot of turbid urine or bloody urine and urinary cast, and was distended with the urine. In microscopical findings, the most striking lesions occurred in the liver and may be classified as viral hepatitis. The hepatic lesions were initially characterized by progression from periportal to peripheral necrosis of the lobules with the infiltration of mononuclear cells. Focal necrosis of various sizes, hemorrhage and hyperemia were often observed in the hepatic lobules. In chronic cases, there were intensive infiltration of lymphocytes, proliferation of fibroblasts, appearance of plasmal cells, and atrophy of parenchymal cells in the hepatic tissue. Perivascular lymphocytic infiltration and meningitis were seen in the brain and spinal cord. In the kidney, there were acute glomerulonephritis, hemorrhage, necrosis of the uriniferous tubules, and retention of eosinophilic substance within the renal tubules. Proliferation of fibroblasts and infiltration of mono-nuclear cells were found in the interstitial stroma of the kidney in chronic case. There were also hemorrhage and edema in the lung, hyperemia and hemorrhage in the trachea and bronchus, perivascular lymphocytic infiltration and focal myocardial necrosis in the heart, hyperemia and hemorrhage in the spleen, vacuolization and desquamation of mucous epithelia in the urinary bladder, catarrhal inflammation of the small intestine, hemorrhage in the adrenal cortex and hyperemia in the other organs. In the electron microscopical findings of the hepatic tissue, crystals of viral particles appeared in the cytoplasm of the hepatocytes and the sinusoidal endothelial cells, and the viral particles, were small in size and polygonal. The authors suppose the virus may belong to picornaviridae family of RNA viruses. Also immature virus-like particles, dilated rough endoplasmic reticulum and destruction of nuclear membrane were seen in the hepatocytes. From these results, it is concluded that the sudden death is an acute viral disease characterized by hepatitis and the affected rabbits may be died of viremia.

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