Suprarenals

T. Addison, On the Constitutional andEocalEffects ofiDisease ofithe Suprarenal Capsules Samuel Highley, London, 1855, p. 2. 

Neben-hoden, m. Anat.) epididymis, -kem, m. Biol.) paranucleus, -kette,/. side chain, subordinate chain, -klasse, f. subsidiary class, -kosten, f.pl. extra costs, extras, -leiter, m. Elec.) branch conductor, -leitung, /. bypass branch line, -linie, /. secondary line branch line, -luft, /. admixed air secondary air, supplementary air. -niere, /. suprarenal capsule. 

Nebennieren-. suprarenal, adrenal, -rinde, /. suprarenal (or adrenal) cortex. 

Bacq ZM, Fischer P (1957) The action of various drugs on the suprarenal response of the rat to total-body x-irradiation. Radiat Res 7 365-372... 

Hypersensitivity to these agents depressed sodium or potassium serum levels marked kidney and liver disease or dysfunction suprarenal gland failure hyperchloremic acidosis adrenocortical insufficiency severe pulmonary obstruction with inability to increase alveolar ventilation since acidosis may be increased (dichlorphenamide) cirrhosis (acetazolamide, methazolamide) long-term use in chronic noncongestive angle-closure glaucoma. 

Another example is the tissues that are particularly rich in vitamin C, for example, the cortex of the suprarenal gland or the lens here, vitamin C fulfills both antioxidative functions and metabolic ones as it helps in the formation of collagen structures. Approximately 40% of the body s ascorbate is stored in skeletal muscle because this tissue is relatively abundant and its cellular concentration is tenfold higher than the plasma level. Similarly, the intracellular ascorbate concentration in the brain (3 mM) greatly exceeds the level in the extracellular fluid (200-400 zM). The majority of ascorbate is stored in the astroglial cells that are capable of reducing great quantities of DHAA to ascorbate, which then becomes available for release back into the extracellular fluid. 

During the 1930 s, several seientists isolated eortisone among other adrenoeortieal hormones from the suprarenal glands of cattle. Kendall et al. [12-14] isolated 8 steroidal hormones (cortisone being Kendall s compound E), while Wintersteiner et al. [15,16] isolated 4 compounds (Wintersteiner s compound F was cortisone). Reichstein [17] isolated 31 substances, with his compound Fa being cortisone. Kuizenga and Cartland [ 18] isolated 5 substances, and Wettstein et al. [ 19] isolated 18 hormones. 

Berberine inhibits oxidative decarboxylation of yeast pyruvic acid (310) the same dose has, however, no effect upon aerobic glycolysis, Warburg s respiratory enzymes, indophenol oxidase, etc. Berberine and tetrahydroberberine have an inhibitory effect on oxidation of (+ )-alanine in rat kidney homogenates (498). Berberine and palmatine show a specific inhibitory effect upon cholinesterase in rabbit spleen and on pseudocholinesterase in horse serum (499). Berberine inhibits cellular respiration in ascitic tumors and even in tissue cultures (500-502). The specific toxic effect of berberine on the respiration of cells of ascitic tumors in mice was described (310). The glycolysis was not found to be affected, but the uptake of oxygen was smaller. Fluorescence was used in order to demonstrate berberine in cellular granules. Hirsch (503) assumed that respiration is inhibited by the effect of berberine on the yellow respiratory enzymes. Since the tumorous tissue contains a smaller number of yellow respiratory enzymes than normal tissue it is more readily affected by berberine. Subcutaneous injections of berberine, palmatine, or tetrahydropalmatine significantly reduce the content of ascorbic acid in the suprarenals, which is not affected by hypophysectomy (504). 

The endovascular procedure is most frequently used to treat infrarenal AAAs that are a leading cause of death in the older population, As our population ages, we will encounter AAAs more frequently than ever before. An aneurysm is defined by a size greater than 5 cm or 2.5 times the normal diameter of the native artery. Most aneurysms begin below the renal arteries and end close to the iliac bifurcation. More complicated AAAs exist involving the suprarenal aorta and visceral vessels and extending into the iliac arteries. The prevalence of AAAs is 3% to 10% for patients older than 50 years (I). They occur more frequently in men and reach a peak incidence close to the age of 80 years. AAA rupture is associated with an 80% to 90% mortality rate and therefore the focus of AAA treatment is on intervening before the aneurysm ruptures elective repair has mortality rate of less than 5%. 

The visceral vessels are evaluated for patency because the required coverage of the inferior mesenteric artery mandates that blood supply to the viscera be adequate from other sources (celiac and superior mesenteric arteries). With experience, some of these contraindications can be overcome with suprarenal attachment devices, additional cuffs, and limbs, but for the nascent EVAR physician the contraindications should be acknowledged and adherence to the fundamental principles of endovascular device implantation will permit good outcomes. 

In humans, the kidneys are located in the posterior part of the abdomen. There is one on each side of the spine the right kidney sits just below the liver, the left below the diaphragm and adjacent to the spleen. Above each kidney is an adrenal gland (also called the suprarenal gland). The asymmetry within the abdominal cavity caused by the liver results in the right kidney being slightly lower than the left one. 

The discovery in 1895 of the hypertensive effect of adrenaline (epinephrine) was initiated by Dr Oliver, a physician in practice, who conducted a series of experiments on his young son into whom he injected an extract of bovine suprarenal. The effect was confirmed in animals and led eventually to the isolation and synthesis of adrenaline in the early 1900s. Many related compounds were examined and, in 1910, Barger and Dale invented the word sympathomimetic and also pointed out that noradrenaline (norepinephrine) mimicked the action of the S5rmpathetic nervous system more closely than did adrenaline. 

In 1855, Dr Thomas Addison, assisted in his observations by three colleagues, published his famous monograph On the constitutional effects of disease on the suprarenal capsules (Addison s disease). It was not until the late 1920s that the vital importance of the adrenal cortex was appreciated and the distinction between the hormones secreted by the cortex and medulla. 

Fig. 3.8 Diagram showing the metabolic exchange of lipids between intestine, fatty tissue, musculature and liver (FFA = free fatty acids, LL = lipoprotein lipase, C2 = apoprotein, SG = suprarenal gland)...

Distally, the suprarenal veins and Retzius veins provide a pathway into the inferior vena cava via the renal vein. The Retzius veins act as anastomoses between the portal vein branches in the intestinal and mesenteric regions and the branches of the inferior vena cava. (57)... 

McMunn, C. A. (1884). On myohaematin, an intrinsic muscle-pigment of vertebrates and invertebrates, on histohaematin, and on the spectrum of the suprarenal bodies. The Journal of Physiology, 5, XXIV. 

References include investigations of adrenal medulla and cortex, as well adrenal (interrenal, suprarenal) tissue of non-mammalian vertebrates. Studies using cells of the adrenal medulla are indicated by an asterisk. 

Addison, T. On the constitutional and local effects of disease of the suprarenal capsules. S. Highley London, 1855. 

Mason, H. L., Myers, C. S., Kendall, E. C. The chemistry of crystalline substances isolated from the suprarenal gland. J. Biol. Chem. 1936,114, 613-631. 

The effects of thyrocalcitonin in reducing the serum levels of calcium and phosphate, and in increasing the output of phosphate in the urine, have not at present been shown to be significantly influenced by any hormone other than parathormone. Milhaud ef al. (M8) found that neither the thyrocalcitonin content of the thyroid gland nor the hypo-calcemic activity brought about by administration of thyrocalcitonin was significantly altered by hypophysectomy. The presence or absence of the thyroid gland, and therefore of thyroid hormone, does not appear to influence the sensitivity of an animal to thyrocalcitonin administration, while the interrelationship, if any, to suprarenal cortical activity does not appear to have been studied as yet. 

Fazekas IG. 1939. Experimental suprarenal hypertrophy induced by ammonia. Endokrinologie 21 315-337. 

The major mechanisms involve the HPA axis. The hypothalamus, pituitary, and adrenals that form the HPA axis also collectively form the neuroendocrine control system. The hypothalamus and pituitary gland, adjacent to each other and connected by nerve fibers, are part of the evolutionary old brain —a group of anatomic regions also present in lower animals. The adrenal glands (suprarenal glands) are far away from the brain at the top of each kidney. 

Hypoxanthine— mne—C,H.N,0—136—occurs iu the spleen, muscul tissue, thymus, suprarenal capsules and brain of mammals in the liver in acute veLlow atrophy and in the blood anmother liquor of the preparation of creatine (<. v.). 

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