scholarly journals Modern possibilities of the urine steroid profile testing applying for the adrenocortical cancer diagnosis

2020 ◽  
Vol 14 (1) ◽  
pp. 4-13
Author(s):  
Ilya E. Shcherbakov ◽  
Roman A. Chernikov ◽  
Vladimir F. Rusakov ◽  
Elysey A. Fedorov ◽  
Uriy N. Fedotov ◽  
...  
Keyword(s):  
Cancer Diagnosis ◽  
Diagnostic Method ◽  
Diagnostic Methods ◽  
Gas Chromatography Mass Spectrometry ◽  
Adrenal Tumors ◽  
Adrenocortical Cancer ◽  
X Ray ◽  
Adrenal Neoplasms ◽  
Steroid Profile ◽  
Urine Steroid

BACKGROUND: X-ray diagnostics methods are important in detection of adrenal neoplasms malignant nature. The sensitivity and specificity of these methods are high enough. However the hormonal tests are also necessary to make an accurate clinical diagnosis with the high diagnostic efficiency of modern X-ray methods for adrenal tumors diagnosing. The urine steroid profile violations are detected with the adrenal glands various pathologies (primary hyperaldosteronism, hypercorticism, congenital hyperplasia of the adrenal cortex and adrenocortical cancer). Urine steroid profile tests in patients with diagnosed adrenal neoplasms are intended primarily to confirm or refute the adrenocortical cancer risk. At the same time in the medical community to date there are a number of disagreements accumulated regarding the accuracy and significance of the urine steroid profile tests. AIMS: The study aims to determine the urine steroid profile determination accuracy limits for the adrenocortical cancer diagnosis. MATERIALS AND METHODS: In total 62 samples were tested for urine steroid profile by gas chromatography-mass spectrometry. 58 patients had morphologically confirmed adrenal neoplasms. The study was blind prospective. To increase the study accuracy the 30 patients with adrenocortical adenomas (n = 17) and adrenocortical cancer (n = 13) were selected out of 58 tested persons. The sensitivity, specificity and accuracy of the urine steroid profile were determined in order to assess information content of such method for the adrenocortical carcinoma diagnosis. RESULTS: The possibilities of the urine steroid profile determining for the adrenocortical cancer diagnosis are estimated. The method sensitivity was 46.2%, specificity and accuracy were 70.6% and 60% respectively. The most reliable of adrenocortical cancer markers were tetrahydro-11-deoxycortisol and dehydroepiandrosterone (38.5% of cases) increasing concentrations. CONCLUSIONS: The present study demonstrates relatively low diagnostic efficacy of the urine steroid profile as a primary diagnostic method for adrenocortical cancer determining. This is especially evident in comparison with X-ray diagnostic methods. The technique interpretation is complex and accessible only to specialists with extremely high qualifications. Such fact complicates the distribution and widespread use in clinical practice of this testing method. At the same time the urine steroid profile determination in the future (after additional study) may be apply as an auxiliary diagnostic method which in some cases determines the treatment tactics for patients undergoing adrenocortical cancer adrenalectomy treatment.KEYWORDS: dPheochromocytoma; intraoperative hemodynamic instability; laparoscopic adrenalectomy; Endovascular embolization of preoperative; сase report.

scholarly journals DIAGNOSTICS AND TREATMENT OF PATIENTS WITH SUBCLINICAL FORMS OF HORMONAL-ACTIVE ADRENAL TUMORS

2020 ◽  
Vol 23 (2) ◽  
pp. 181-186
Author(s):  
P. N. Romashchenko ◽  
N. A. Maistrenko ◽  
S. G. Bliumina ◽  
A. M. Ivanov
Keyword(s):  
Liquid Chromatography ◽  
Blood Plasma ◽  
Dehydroepiandrosterone Sulfate ◽  
Diagnostic Methods ◽  
Adrenal Tumors ◽  
Laboratory Diagnostics ◽  
Adrenocortical Cancer ◽  
Catecholamine Metabolites ◽  
In Blood Plasma

The increased incidence of accidental revealing adrenal tumors in radiation studies requires further improvement of laboratory diagnostic methods for the timely detection of their latent hormonal activity and malignancy potential, as well as the determination of strategic therapeutic approaches. The aim of the work was to evaluate the capabilities of modern laboratory diagnostics in verification of latent forms of hormone-active adrenal tumors to determine further treatment tactics. The study included 207 (14.9%) of 1390 patients in whom the hormones precursors of steroidogenesis and catecholamine metabolites were studied in blood plasma by liquid chromatography, as well as tumor markers. These patients were divided into a group of subclinical forms of hormone-active NP tumors (n = 173) and a group of truly hormone-inactive formations (n=34). It has been established that pre-aldosteroma is characterized with an increase of corticosterone (8.1±3.4 ng/ml), 11-deoxycorticosterone (12.3±3.0 ng/ml), 18-hydroxycorticosterone (5.4±1,4 ng/ml) in blood. For pre-corticosteroma: increased cortisol (119.2±16.1 ng/ml), 11-deoxycortisol (11.5±1.9 ng/ml), 11-deoxycorticosterone (12.8±2.1 ng/ml), the ratio of cortisol/cortisone (9.1±1.6 ng/ml) in blood. The presence of «silent» pheochromocytoma was confirmed by an increase of blood free methanephrine (105.0±27.1 ng/ml) and normetanephrine (196.0±43.6 ng/ml), as well as chromogranin A (223.3±15.3 pg/ml). The latent forms of adrenocortical cancer were characterized by an increase in blood dehydroepiandrosterone sulfate (45.2±3.9 μmol/L), cancer embryo antigen (9.8±1.2 ng/ml), vascular endothelial growth factor (1122.0±24.5 ng/ml), IL-6 (95.4±1.8 pg/ml), 11-deoxycortisol (21.8±4.5 ng/ml), 11-deoxycorticosterone (4.2±3.2 ng/ml). All 173 patients with hormone-active NP tumors, as well as 30 (88.2%) with large (6.5±2.0 cm) hormone-inactive formations with the presence of compression syndrome, underwent adrenalectomy. Determination of the precursors of steroidogenesis and catecholamine metabolites in blood plasma by liquid chromatography can reliably identify the functional activity of adrenal tumors and determine their malignant potential, as well as substantiate indications for timely surgical treatment.

scholarly journals DIAGNOSTIC TACTICS FOR TRAUMATIC INJURIES OF THE SPLEEN

2020 ◽  
pp. 155-159
Author(s):  
M. M. Belous
Keyword(s):  
Minimally Invasive ◽  
Information Content ◽  
Diagnostic Method ◽  
Diagnostic Methods ◽  
Traumatic Injuries ◽  
X Ray ◽  
Non Invasive ◽  
Examination Methods ◽  
Minimally Invasive Methods

Summary. Purpose. Having based on the determination of the degree of effectiveness and information content of the diagnostic methods for traumatic injuries of the spleen, to analyze the results of the instrumental diagnostic methods to create an algorithm for diagnostic and treatment tactics. Materials and methods: 355 victims were hospitalized with traumatic injuries of the spleen. Of these, physical and laboratory diagnostic methods were used in 100 % of cases, laparoscopy — 245 patients (69 %), laparocentesis — 21 (6 %), laparotomy —- 75 (21 %), ultrasound — 199 (56 %), x-ray — 67 (19 %), CT — 7 (2 %). Research results and discussion.The most informative diagnostic method is laparotomy. Of minimally invasive methods — laparoscopy, and of non-invasive methods — ultrasound. Conclusions. For successful recognition of spleen damage, it is necessary to use complex examination methods, depending on the indication developed for them, that significantly reduces the duration of the diagnostic phase.

Urine steroid profile as a new promising tool for the evaluation of adrenal tumors. Literature review

Endocrine ◽  
2020 ◽  
Author(s):  
Marta Araujo-Castro ◽  
Pablo Valderrábano ◽  
Héctor F. Escobar-Morreale ◽  
Felicia A. Hanzu ◽  
Gregori Casals
Keyword(s):  
Literature Review ◽  
Adrenal Tumors ◽  
Promising Tool ◽  
Steroid Profile ◽  
Urine Steroid

scholarly journals SUN-073 Urine Steroid Profile of Girls with Premature Adrenarche

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Grit Sommer ◽  
Marco Janner ◽  
Michael Groessl ◽  
Christa E Flueck
Keyword(s):  
Multiple Testing ◽  
Polycystic Ovary ◽  
Adverse Outcomes ◽  
Gas Chromatography Mass Spectrometry ◽  
Premature Adrenarche ◽  
Steroid Profile ◽  
Health And Disease ◽  
Urinary Steroid ◽  
Urine Steroid

Abstract Background: Adrenarche describes the development of the human adrenal cortex when the zona reticularis increases the synthesis of C19 steroids (DHEA/-S). Girls with premature adrenarche have a higher risk to develop adverse outcomes including polycystic ovary syndrome and metabolic syndrome later in life. The role of novel biosynthetic pathways of androgen production in health and disease remains largely unsolved. Objective: This study aimed to compare the urinary steroid metabolome between girls with premature adrenarche and healthy girls with focus on metabolites originating of novel, alternate androgen pathways. Methods: In 23 girls with premature adrenarche (median age 7 years) and 22 healthy, age-matched girls, we measured 39 steroid metabolites comprising progesterones, corticosterones, aldosterone, androgens, estrogens and glucocorticoids in the urine collected over 24 h by gas chromatography mass spectrometry. We compared metabolites and metabolite ratios between both groups of girls using Mann-Whitney tests with Bonferroni correction to account for multiple testing. Results: Girls with premature adrenarche were heavier than healthy girls (median weight 26.2 kg vs. 21.5 kg, p=0.003) and had a higher BMI SDS (0.8 vs -0.3, p=0.013). Gestational age and birth weight was similar between groups. Overall androgen excretion was different between groups, in particular amounts of androsterone, etiocholanolone, androstanediol, dehydroepiandrosterone, androstenediol, androstenetriol and pregnenetriol were higher in girls with premature adrenarche than in healthy girls (p<0.05). Some of these metabolites originate from alternate androgen pathways, e.g. androsterone. We found no differences in progesterones, corticosterones, aldosterone, estrogens and glucocorticoids, except for 20β-dihydrocortisone, which was higher in girls with premature adrenarche. Activities of 17βHSD and of 17,20-lyase via the Δ4pathway were higher in girls with premature adrenarche than in healthy girls. Conclusions: Girls with premature adrenarche produce more androgens than healthy girls of similar age. The urinary steroid signature of adrenarche includes metabolites of alternate pathways. Androstanediol seems a marker of adrenarche. Future studies should assess whether the steroid signature of adrenarche is just appearing earlier in girls with premature adrenarche or earlier and different compared to adrenarche at normal timing.

scholarly journals PRACTICAL ASPECTS OF LAPAROSCOPIC ADRENALECTOMY IN CHILDREN WITH BENIGN ADRENAL TUMORS

2019 ◽  
Vol 23 (5) ◽  
pp. 248-253
Author(s):  
I. V. Poddubny ◽  
Raisa S. Oganesyan ◽  
K. N. Tolstov ◽  
M. A. Kareva
Keyword(s):  
Laparoscopic Adrenalectomy ◽  
Adrenal Tumors ◽  
Malignant Neoplasms ◽  
Main Stage ◽  
Adrenocortical Cancer ◽  
Domestic Literature ◽  
Adrenal Neoplasms ◽  
Average Size ◽  
Literature Material ◽  
Preoperative Examination

Introduction. Despite of almost 30-year world experience in mini-invasive adrenalectomy in non-oncologic pediatric patients, this issue remains not fully understood and systematized in the domestic literature. Material and methods. Our work is based on 67 laparoscopic adrenalectomies performed in 65 patients, aged from 3 months to 17 years, with predominantly benign neoplasms. Despite of a thorough preoperative examination of each patient, we met malignant neoplasms in 7 cases: 4 - adrenocortical cancer and 3 - neuroblastomas (further they were treated by oncologists). Location of the neoplasms was as follows: right-sided - 31, left-sided - 26, bilateral - 8 (6 patients out of them had bilateral simultaneous removal). Average size of the removed formations was 4.65 ± 1.29 cm (maximum 12 cm). Results and discussion. The vast majority of detected adrenal neoplasms are removed. Exceptions may be neoplasms less than 4 cm in diameter with the native density less than 10 HU by computed tomography; however, they should be actively monitored by specialists. If a malignant process is suspected, patients should be examined more thoroughly and should be treated in specialized hospitals. Nowadays, a minimally invasive and safe surgical treatment of neoplasms in the adrenal glands depends on the experience and trainings of surgeons and anesthesiologists, as well as on the equipment in the operating room. A key to the successful treatment of patients with benign adrenal neoplasms is a specific attention to curative peculiarities in such patients as well as an adequate sequence of actions during laparoscopic adrenalectomy in its main stage, namely, ligation of the central adrenal vein.

scholarly journals Chemical Recycling of WEEE Plastics—Production of High Purity Monocyclic Aromatic Chemicals

Processes ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 530
Author(s):  
Tobias Rieger ◽  
Jessen C. Oey ◽  
Volodymyr Palchyk ◽  
Alexander Hofmann ◽  
Matthias Franke ◽  
...  
Keyword(s):  
High Purity ◽  
Fractional Distillation ◽  
Gas Chromatography Mass Spectrometry ◽  
Thermochemical Conversion ◽  
Chemical Recycling ◽  
Pyrolysis Oil ◽  
X Ray ◽  
Benzene Toluene ◽  
Halogen Content ◽  
Methyl Styrene

More than 200 kg real waste electrical and electronic equipment (WEEE) shredder residues from a German dismantling plant were treated at 650 °C in a demonstration scale thermochemical conversion plant. The focus within this work was the generation, purification, and analysis of pyrolysis oil. Subsequent filtration and fractional distillation were combined to yield basic chemicals in high purity. By means of fractional distillation, pure monocyclic aromatic fractions containing benzene, toluene, ethylbenzene, and xylene (BTEX aromatics) as well as styrene and α-methyl styrene were isolated for chemical recycling. Mass balances were determined, and gas chromatography–mass spectrometry (GC-MS) as well as energy dispersive X-ray fluorescence (EDXRF) measurements provided data on the purity and halogen content of each fraction. This work shows that thermochemical conversion and the subsequent refining by fractional distillation is capable of recycling WEEE shredder residues, producing pure BTEX and other monocyclic aromatic fractions. A significant decrease of halogen content (up to 99%) was achieved with the applied methods.

scholarly journals Bacterial cellulose films with ZnO nanoparticles and propolis extracts: Synergistic antimicrobial effect

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Alexandra Mocanu ◽  
Gabriela Isopencu ◽  
Cristina Busuioc ◽  
Oana-Maria Popa ◽  
Paul Dietrich ◽  
...  
Keyword(s):  
Synergistic Effect ◽  
Bacterial Cellulose ◽  
Food Packaging ◽  
Antimicrobial Effect ◽  
Gas Chromatography Mass Spectrometry ◽  
Trolox Equivalent Antioxidant Capacity ◽  
Zno Nps ◽  
X Ray ◽  
Cellulose Films ◽  
Trolox Equivalent

AbstractThis study aimed to obtain possible materials for future antimicrobial food packaging applications based on biodegradable bacterial cellulose (BC). BC is a fermentation product obtained by Gluconacetobacter xylinum using food or agricultural wastes as substrate. In this work we investigated the synergistic effect of zinc oxide nanoparticles (ZnO NPs) and propolis extracts deposited on BC. ZnO NPs were generated in the presence of ultrasounds directly on the surface of BC films. The BC-ZnO composites were further impregnated with ethanolic propolis extracts (EEP) with different concentrations.The composition of raw propolis and EEP were previously determined by gas-chromatography mass-spectrometry (GC-MS), while the antioxidant activity was evaluated by TEAC (Trolox equivalent antioxidant capacity). The analysis methods performed on BC-ZnO composites such as scanning electron microscopy (SEM), thermo-gravimetrically analysis (TGA), and energy-dispersive X-ray spectroscopy (EDX) proved that ZnO NPs were formed and embedded in the whole structure of BC films. The BC-ZnO-propolis films were characterized by SEM and X-ray photon spectroscopy (XPS) in order to investigate the surface modifications. The antimicrobial synergistic effect of the BC-ZnO-propolis films were evaluated against Escherichia coli, Bacillus subtilis, and Candida albicans. The experimental results revealed that BC-ZnO had no influence on Gram-negative and eukaryotic cells.

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