DOCSLIB.ORG

May 14, 1960 CARDIOVASCULAR EFFECTS of NICOTINE and OF

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
May 14, 1960 CARDIOVASCULAR EFFECTS of NICOTINE and OF N0. 4724 May 14, 1960 NATURE 525 but the particles continually shifted about, as could are collected by interstitial macrophages and fibrosi;; be explained by the repeated death of dust-laden is marked in regions where this occurs. The time phagocytes with release of their bm·den, which was sequence of clinical events and of lung content of then incorporated by new cells. fibres exceeding 26fL in length supports the argument. After a single administration of dust, phagocyte Papers on dust-sampling included the description of cmmts in saline washed into and out of rat lungs an ingenious centrifugal device called the 'conicyclo', demonstrated that the number of cells was related which collects only particles between upper and lower to the quantity of dust eliminated. The half-life of limits of falling speed. It has been engineered as a this phase of elimination by phagocytosis to the practical sampling tool for coal mines and is being bronchial epithelium was about 17 hr. The propor­ tried out underground. tion of dust eliminated in this way depended on The relationship between the acceptance curve of a the nature of the dust, but the time-constant did not ; sampling instrument designed to control dust condi­ it did not appear to matter whether the dust was given tions relevant to the incidence of pneumoconiosis, by inhalation or by intratracheal injection. and the actual deposition-particle-size curve of the Another series of experiments confirmed the human respiratory tract was given more emphasis destructive action of silica dusts on macrophages and by the engineers than om· crude and incomplete once again led to the suggestion that the damage knowledge of the latter can possibly justify. inflicted on the cells is the first step in tho chain of Argmnents in favom· of selecting finer particles causation of silicosis. The effect is believed not to than the 50 per cent at 5fL diameter and unit density, be cytotoxic, but to comprise an activation either of a which at present forms the basis of British selective serum complement absorbed on the outside of the cells sampling practice, are therefore poorly based. The or of an enzyme, possibly a non-specific esterase, opposite view was also put forward, that all dust within the cells. should be sa.mpled, irrespective of particle size ; Examination of lung residues from 50 asbestosis b esides being physically impossible this would encow-­ cases was reported, with t-he conclusion that a fibre­ age the collection of large quantities of coarse dust genic agent was liberated when asbestos bodies break which has no conceivable bearing on pneumoconiosis up. The deposition of an asbestos fibre in lung tissue because, when inhaled, it would not penetrate beyond is followed by its becoming enclosed in a protein the bronchi, and larger bronchioles. sheath which passes through a sequence of changes The papers and discussions will be published by and finally segments, after 10-15 years, with fracture Pergamon Press in due com·se. of tho contained fibre. The fragments of the sheath C. ~- DAVIES CARDIOVASCULAR EFFECTS OF NICOTINE AND OF SMOKING URING March 28-25 a symposium on the as 10-90 mgm. a day (Larsen, Richmond, Virginia.). D Cardiovascular Effects of Nicotine and of It is obvious that the taking of snuff and the chewing Smoking was held by the New York Academy of of tobacco offer rnuch loss ri<;k of producing canc·er Sciences. The papers presented covered more than tho of tho lung. cardiovascular effects and included other interesting The metabolism of nicotine i~ not yet fully known, observations. For example, nicotine is found not and further work is badly needed. Nicotine is found only in the tobacco plant, but it also occurs widely in the urine excreted unchanged, together with in the plant kingdom. It is produced in the root r elated substances (McKennis, Richmond, Virginia). system of the tobacco plant, and the growth of the Oxidation of the p:ynolidine ring appears to be a roots is very closely related to the rate of nicotine major step. The laetan1 (- )-cotinine which arist•s production, from which R . F. Dawson (Columbia) from the metabolism of (-)-nicotine is oxidized, and and his colleagues conclude that tho same reaction in the dog there is hydroxylation and methylation. step limits both processes. Nicotine arises from the It seems possible that the metabolism of nicotine precursors nicotinic acid and ornithine. From the changes with advancing years, some processes root it is transported primarily to the leaves, where deelining in rate or ceasing altogether. If the it accumulates during the active life of tho plant. It t.oleration of nicotine depends on a. high rate of is believed to be a terminal product with no appreci­ breakdown, the observation that some older peop!P. able physiological activity for the plant. Such a stop smoking who smoked mueh when young may conclusion seems to an animal physiologist to be depend on such a decline. highly unlikely. Nicotine has been known to cause poisoning in Nicotine is absorbed not only by those who smoke those using it. as an insectieide. Travell (Cornell) has hut also by those who take snuff and those who chew shown t-hat its absorption through tho skin is great!~' tobacco. The figures given for the amount of nicotine affected by the pH of the solution. At a pH of 5 ·0 absorbed when smoking one cigarette vary according or less it is very little abgorbed, but at an alkaline to the degree to which smoke is inhaled. They range pH it is readily absorbed. This holds true for the from estimates as low as 0·3 mgm. to others as high m embrane of the stomach and of the bladder. as 1·8 mgm. Since the intravenous injection cf Nicotine excreted in the urine may bo absorbed frorn 0·7 mgm. nicotine (base) produces unpleasant symp­ the bladder into the blood if the urine is alkaline, toms, the higher figures must be regarded with doubt. and may produce toxic effects. The spe\:ld of absorp­ Nicotine taken in the form of snuff has been tion depends on the concentration of free base. On !'stimated to amount to 20-60 mgm. a day, and that the cardiovascular system, nicotine has long been absorbed as a result of chewing has been estimated believed to owe its action to s1 imulation of the © 1960 Nature Publishing Group 526 NATURE Mav 14, 1960 VOL 186 J autonomic ganglia. Langley applied nicotine to Ringer's solution, nicotine no longer causes vasocon­ ganglia in order to determine the effect of stimulating striction. When the skin of such an ear is extracted, no the cell<> present in the ganglia. Recently, attention noradrenaline is found present in it. Some individuals has been directed to various peripheral effects of suffer from a disease called thrombo-angiitis obliterans nicotine at sites where ganglia are not present. Thus, which when active causes such a restriction of tho nicotine has a two-fold effect in the isolated heart. circulation through the fingers that the tissues become It causes first inhibition of contractions, and second dry and bloodless, and the finger tips may become acceleration and augmentation. The inhibition is gangrenous. The disease may be quiescent for long excluded in the presence of atropine, but the accelera­ periods ; but if the patient begins to smoke, the tion is unaffected. In the heart there is a store of symptoms get worse and the disease becomes active. noradrenaline which can be extracted from the heart. It seems likely that tho effect of smoking is explained Hitherto the existence of this store has been neglected by nicotine releasing noradrenaline from the neigh­ by physiologists. It is now evident that the accelera­ bourhood of the small vessels. tion of the heart caused by nicotine is due to the The exact site of storage of noradrenaline in tho release of some of the noradrenaline from the store. heart and in or near the vessels is unknown. There This follows from the observation that when there is is a possibility that it is held in tissue known aR no store of noradrenaline, nicotine loses its acceler­ chromaffin tissue. These are cells which stain brown ating action (Burn and Rand, Oxford). Treatment with potassimn dichromate ; they form the greater of the animal with reserpine causes a disappearance part of the cells of the adrenal medulla. Such cells of the store at the end of a few hours. The rise in have long been known to occur among the fibres of heart-rate which follows smoking is thus probably the sympathetic system, and side by side with the explained by an action of nicotine on the heart sympathetic ganglion cells. They originate in the itself releasing noradrenaline from storage sites in neural crest like the sympathomimetic ganglion cells the heart. and were called by Kohn "paraganglia" in 190:~. In 1940 it was shown by Grace Roth and her Evidence is beginning to accumulate that the dis­ colleagues that when a person smoked a cigarette in tribution of chromaffin cells is much wider. Busacchi a warm room there was a large fall in skin tempera­ in 1912 described a "paraganglion cardiacum" lying ture. This fall was believed to result from a con­ arotmd the origins of the coronary arteries. AdamB­ Btriction of tho skin vessels caused by a stream of Ray and Nordenstam (1956) have described such impulses passing down the vasoconstrictor nerves. cells in human skin, and Leach believes that they However, observations have recently been made in may be present in the skin of the rabbit ear, in the the isolated ear of the rabbit, which contains no skin of the eat's tail and in the nictitating membram1 ganglia.
Load more

Recommended publications
  • Hospital Medical School.)
    THE CONTROL OF THE SUPRARENAL GLANDS BY THE SPLANCHNIC NERVES'. BY T. R. ELLIOTT, M.D. (From the Research Laboratories of University College, Hospital Medical School.) THERE is no clear knowledge2 at present with regard to the share taken by the suprarenal glands in resisting various processes that are harmful to the body. For the last two years I have tried to gain some light on this question by analysing the state of exhaustion to which the human suprarenals are reduced in the different conditions leading to death in Hospital cases. Attention was paid chiefly to the loss of the normal load of cortical " lipoid " substance and of the adrenalin in the medulla, the gross total of the latter being measured quantitatively by physio- logical assay. Unfortunately the conditions of fatal disease in man were found to be too complex to permit of simple atialysis. Broadly summarising the results, it appeared that the glands suffered rapid eyhaustion in cases of any microbic fever, of repeated simple hawmorrhage, and of surgical shock: but to distinguish clearly the value and nature of each of these factors was impossible. I therefore tried to reproduce each separately on experimental animals, in which the relationship of the nervous system to the glands could at the same time be studied. Method. Cats were used in all the experiments. The lipoid in the cortex of the cat3 is never so abundant as in the human gland: changes in its distribution were observed histologically, but they did not seem to follow any special cause, and they will be referred to only incidentally in this paper.
    [Show full text]
  • Case Reports
    CASE REPORTS NONCHROMAFFIN PARAGANGLIOMA OF THE JUGULAR FORAMEN Jos~ G. ALBERNAZ,M.D.,* A:N'D PAUL C. BucY, M.D. Chicago Memorial Hospital and Department of Neurology and Neurological Surgery, University of Illinois, College of Medicine, Chicago, Illinois (Received for publication April 7, 1953) This paper deals with a carotid-body-like tumor found in the jugular foramen, similar to the tumors recently described by Lattes 12 as nouchromaffin paraganglio- mas. Kohn, 1~ in 1900, classified the carotid body as a paraganglion, in the belief that it was of sympathetic origin and part of the chromaffin system. Small masses of similar paraganglionic tissue have since been described in the following locations: 1) At the level of the middle ear. As early as 1840, Valentin 26 described a gangliolum tympanicum, associated with the tympanic branch of the 9th cranial nerve. Later, in 1879, Krause H showed that this structure resembles the carotid body and this has been confirmed recently by the studies of Guild s and Lattes and WaltnerY In addi- tion to the paraganglion tympanicum, Guild s described what he called the glomus jugularis "in the adventitia of the dome of the jugular bulb, immediately below the bony floor of the middle ear." ~) At the aortic-pulmonary region. Paraganglia related to the major vessels at the base of the heart were mentioned in 190~ by Biedl and Wiesel. 2 In the middle thirties, Palme, 2~ Seto, 24 Muratori ~9 and Nonidez 2~ described these structures in detail. From their contributions, well summarized by Boyd, 4 we learn that these "aortic bodies" are similar to the carotid bodies and that they can be found in four different locations: a) above the ductus arteriosus; b) on the trunk of the pulmonary artery, near the origin of the left coronary artery; c) near the root of the innominate artery; d) on the left part of the aortic arch.
    [Show full text]
  • A Xenograft and Cell Line Model of SDH-Deficient Pheochromocytoma Derived from Sdhb+/− Rats
    27 6 Endocrine-Related J F Powers et al. Rat model for Sdhb-mutated 27:6 337–354 Cancer paraganglioma RESEARCH A xenograft and cell line model of SDH-deficient pheochromocytoma derived from Sdhb+/− rats James F Powers1, Brent Cochran2, James D Baleja2, Hadley D Sikes3, Andrew D Pattison4, Xue Zhang2, Inna Lomakin1, Annette Shepard-Barry1, Karel Pacak5, Sun Jin Moon3, Troy F Langford3, Kassi Taylor Stein3, Richard W Tothill4,6, Yingbin Ouyang7 and Arthur S Tischler1 1Department of Pathology and Laboratory Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts, USA 2Department of Developmental, Molecular and Chemical Biology, Tufts University School of Medicine, Boston, Massachusetts, USA 3Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA 4Department of Clinical Pathology, University of Melbourne, Melbourne, Victoria, Australia 5Section on Medical Neuroendocrinology, Eunice Kennedy Shriver Division National Institute of Child Health and Human Development, Bethesda, Maryland, USA 6Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia 7Cyagen US Inc, Santa Clara, California, USA Correspondence should be addressed to J F Powers: [email protected] Abstract Tumors caused by loss-of-function mutations in genes encoding TCA cycle enzymes Key Words have been recently discovered and are now of great interest. Mutations in succinate f succinate dehydrogenase B dehydrogenase (SDH) subunits cause pheochromocytoma/paraganglioma (PCPG) and f paraganglioma syndromically associated tumors, which differ phenotypically and clinically from more f pheochromocytoma common SDH-intact tumors of the same types. Consequences of SDH deficiency include f cluster 1 rewired metabolism, pseudohypoxic signaling and altered redox balance. PCPG with f xenograft SDHB mutations are particularly aggressive, and development of treatments has been f cell culture hampered by lack of valid experimental models.
    [Show full text]
  • Opmaak 1 15/06/12 08:52 Pagina 124
    arain-_Opmaak 1 15/06/12 08:52 Pagina 124 JBR–BTR, 2012, 95: 124-125. PARAGANGLIOMA OF THE CAVERNOUS SINUS A. Arain, J. Vandevenne, B. Depeuter, J. Smits, F. Weyns, Y. Palmers 1 Key-word: Paraganglioma Background : A 15-year-old girl presented in a Dutch hospital with right-sided trigeminal neuralgia. MR-imaging showed a mass lesion in the right cavernous sinus. Differential diagnosis in this hospital was a meningioma or a schwannoma. The patient was referred to the neurosurgery department of our hospital, and resection of the lesion was planned. At surgery, the lesion pre - sented as a subdural bulge surrounded by swollen venous structures. The incision of the dura resulted in profuse hemorrhage of arterial origin, and hemostasis was obtained with difficulty. The tumor showed a fibrillar structure and a strong arterial vascularization which was not con - cordant with schwannoma. No further exploration of the lesion was performed, and no biopsy was obtained. To clarify the unexpected surgical findings and to reach a diagnosis without biopsy , pre-operative MR-images were reviewed. Digital subtraction angio graphy (DSA) was performed postoperatively. The lesion did not take up FDG on PET scan. Laboratory results showed increased catecholamines in the urine. AB CD E 1A 1B Fig. 1C 1D 1. Department of Medical Imaging, Campus Sint-Jan, Ziekenhuis Oost-Limburg, Genk, Belgium. 1E 2 arain-_Opmaak 1 15/06/12 08:52 Pagina 125 PARAGANGLIOMA OF THE CAVERNOUS SINUS — ARAIN et al 125 Work-up ly show a hyperintense signal on T2-weighted MR- images and a distinct contrast enhancement on T1- MRI of the brain (Fig.
    [Show full text]
  • Fernando De Castro and the Discovery of the Arterial Chemoreceptors
    REVIEW ARTICLE published: 12 May 2014 doi: 10.3389/fnana.2014.00025 Fernando de Castro and the discovery of the arterial chemoreceptors Constancio Gonzalez 1,2 *, Silvia V. Conde 1,2 ,Teresa Gallego-Martín 1,2 , Elena Olea 1,2 , Elvira Gonzalez-Obeso 1,2 , Maria Ramirez 1,2 , SaraYubero 1,2 , MariaT.Agapito 1,2 , Angela Gomez-Niño 1,2 , Ana Obeso 1,2 , Ricardo Rigual 1,2 and Asunción Rocher 1,2 1 Departamento de Bioquímica y Biología Molecular y Fisiología, Instituto de Biología y Genética Molecular, Consejo Superior de Investigaciones Científicas, Universidad de Valladolid, Valladolid, España 2 CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Facultad de Medicina, Universidad de Valladolid, Valladolid, España Edited by: When de Castro entered the carotid body (CB) field, the organ was considered to be a Fernando de Castro, Hospital Nacional small autonomic ganglion, a gland, a glomus or glomerulus, or a paraganglion. In his 1928 de Parapléjicos – Servicio de Salud de Castilla-La Mancha, Spain paper, de Castro concluded: “In sum, the Glomus caroticum is innervated by centripetal fibers, whose trophic centers are located in the sensory ganglia of the glossopharyngeal, Reviewed by: José A. Armengol, University Pablo de and not by centrifugal [efferent] or secretomotor fibers as is the case for glands; these are Olavide, Spain precisely the facts which lead to suppose that the Glomus caroticum is a sensory organ.” Ping Liu, University of Connecticut A few pages down, de Castro wrote: “The Glomus represents an organ with multiple
    [Show full text]
  • Chapter 13. Secondary Hypertension
    Hypertension Research (2014) 37, 349–361 & 2014 The Japanese Society of Hypertension All rights reserved 0916-9636/14 www.nature.com/hr GUIDELINES (JSH 2014) Chapter 13. Secondary hypertension Hypertension Research (2014) 37, 349–361; doi:10.1038/hr.2014.16 OVERVIEW AND SCREENING approximately 5–10% of hypertensive patients,984,985 and it is the most Hypertension related to a specific etiology is termed secondary frequent in endocrine hypertension. In addition, frequent etiological hypertension, markedly differing from essential hypertension, of factors for secondary hypertension include renal parenchymal hyper- which the etiology cannot be identified, in the condition and tension and renovascular hypertension. A study reported that sleep therapeutic strategies. Secondary hypertension is often resistant hyper- apnea syndrome was the most frequent factor for secondary hyper- tension, for which a target blood pressure is difficult to achieve by tension.517 The number of patients with secondary hypertension standard treatment. However, blood pressure can be effectively may further increase with the widespread diagnosis of sleep apnea reduced by identifying its etiology and treating the condition. There- syndrome. fore, it is important to suspect secondary hypertension and reach an Generally, the presence of severe or resistant hypertension, juvenile appropriate diagnosis. hypertension and the rapid onset of hypertension suggest the possi- Frequent etiological factors for secondary hypertension include bility of secondary hypertension. In such hypertensive patients, a close renal parenchymal hypertension, primary aldosteronism (PA), reno- inquiry on medical history, medical examination and adequate vascular hypertension and sleep apnea syndrome. Renal parenchymal examinations must be performed, considering the possibility of hypertension is caused by glomerular diseases, such as chronic secondary hypertension.
    [Show full text]
  • Paragangliomas of the Head and Neck: a Pictorial Essay
    Paragangliomas of the Head and Neck: A Pictorial Essay Jerry C. Lee, MD, Ajay Malhotra, MD, Henry Wang, MD, PhD, Per-Lennart Westesson, MD, PhD, DDS Division of Diagnostic and Interventional Neuroradiology Department of Imaging Sciences University of Rochester Medical Center Rochester, New York Presentation material is for education purposes only. All rights reserved. ©2007 URMC Radiology Page 1 of 25 Purpose Learn the common locations of paragangliomas of the head and neck and where they originate. Learn the common imaging findings of paragangliomas utilizing CT, MRI, and angiography. Presentation material is for education purposes only. All rights reserved. ©2007 URMC Radiology Page 2 of 25 J. Lee, MD et al Introduction Paragangliomas of the head and neck originate most commonly from the paraganglia within the carotid body, vagal nerve, middle ear, and jugular foramen. Also called glomus tumors, they arise from paraganglion cells of neuroectodermal origin frequently located near nerves and vessels. The function of most paraganglia in the head and neck is obscure; one exception is the carotid body, which is a chemoreceptor. Paragangliomas account for 0.6% of all neoplasms in the head and neck region, and about 80% of all paraganglioms are either carotid body tumors or glomus jugulare tumors. The classic manifestation of a carotid body tumor is a nontender, enlarging lateral neck mass which is mobile, pulsatile, and associated with a bruit. The jugulare and tympanicum tumors commonly cause pulsatile tinnitus and hearing loss and may cause cranial nerve compression. Vagal paraganglioms are the least common and present as a painless neck mass which may result in dysphagia and hoarseness.
    [Show full text]
  • Continuing Medical Education Article Anaesthesia for Phaeochromocytoma
    526 Continuing Medical Education Article Anaesthesia for John Pullerits ~D eacr'c, Sigmund Ein MD FRCSC, J. Wi~liamson Belle MD r~cvc phaeochromocytoma Phaeochromocytomas are functionally active cate- Type II-b (characterized by medullary carcinoma of the eholamine-seereting tumours of chromaffin tissue. These thyroid, Marf~oid appearance, mucosal adenomas and tumours are usually found in the adrenal medullae but phaeochromoeytoma). They can also be found as part of may occur anywhere where chromaffln tissue exists. von Hippel-Lindau syndrome which includes multiple Chromaffin tissue occurs in association with the celiac, phaeochromocytomas in association with haemangioblas- mesenteric, renal, adrenal, hypogastric, testicular and lomas of the retinae, cerebellum and other arcas of the paravertehral sympathetic nervous plexuses. Although central nervous system) most phaeochromocytomas are found in the adrenal Although most phaeochromocytoma8 are unilateral, medulla (in 90 per cent of cases), they can occur anywhere about nine per cent occur bilaterally. Bilateral tumours in the body where paraganglion ceils of the sympathetic also tend to be familial. Phaeochromocytomas may occur nervous system are found. Multiple and extra-adrenal at any age, but occur with the greatest frequency in the tumours are far more common in children (35 per cent) fourth and fifth decades of life. Ten per cent of these than in adults (eight per cent).t Although about 90 per tumours are found in children. In adults, the sex distribu- cent are benign and surgically curable, they are of special tion of the patient population shows a slightly higher interest because of the profound physiological effects female preponderance (55-60 per cent).
    [Show full text]
  • The Human Embryonic Heart in the Ninth Week
    THE HUMAN EMBRYONIC HEART IN THE NINTH WEEK RICHARD H. LICATA Department of Aqiatoniy, Univeisily of Michigan Medical School, Ann ArboT SIXTEEN I'IQURES Although observations on the developing heart go back to the time of Aristotle, it was not until late in the 19th century that the work of His (1885, 1886) and Born (1888, 1889) resulted in an understanding of heart development that was of sdlicient accuracy to be still of basic value by present standards. One of the crucial factors in their work was the development of adequate methods of reconstruction. Although His was the first to attempt sucli reconstructions, his efforts met with limited success and he had to resort to freehand modelling of embryonic hearts. These models, reproduced commercially by Ziegler, are fairly accurate, though they lack the detail of models made by the wax-plate method. In 1883 Born began to employ the wax-plate reconstruction method as a means of studying heart development. This technique was improved by Kastschenko (1886) and Strasser (1887). Later, the continued efforts of Born and Strasser brought this technique to a high degree of accuracy. A description of their methods was published in detail by Born in 1889. Tandler ('12, '13) greatly furthered knowledge of heart development by coordinating the results of earlier workers and supplementing them with extensive contributions of his own. Mall's work ('12) on the structure of the ventricles, and his observations on the development of the conduction sys- This paper represents x condensation of one section of a dissertation siili- rnitted in partial fulfillment of the requirements for the dqree of Doctor of Philosophy in the University of Michigan.
    [Show full text]
  • VU Research Portal
    VU Research Portal SDHB-linked Paraganglioma Rijken, J.A. 2020 document version Publisher's PDF, also known as Version of record Link to publication in VU Research Portal citation for published version (APA) Rijken, J. A. (2020). SDHB-linked Paraganglioma. General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights. • Users may download and print one copy of any publication from the public portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal ? Take down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. E-mail address: [email protected] Download date: 08. Oct. 2021 SDHB-linked Paraganglioma COLOPHON SDHB-linked Paraganglioma Cover drawing: Johannes Rijken Cover layout: Rachel van Esschoten, DivingDuck Design, (www.divingduckdesign.nl) Lay-out inside: Rachel van Esschoten, DivingDuck Design Printed by: Ipskamp Printing, Enschede (www.ipskampprinting.nl) Anatomical drawings: Bourgery, Paris 1831-1844, Library University of Heidelberg. ISBN: 978-94-028-1905-2 The publication of this thesis was financially supported by: ALK, Allergy Therapeutics, DOS Medical BV, Rhino Horn Benelux BV, Specsavers International Healthcare BV. VRIJE UNIVERSITEIT SDHB-linked PARAGANGLIOMA ACADEMISCH PROEFSCHRIFT ter verkrijging van de graad Doctor aan de Vrije Universiteit Amsterdam, op gezag van de rector magnificus prof.dr.
    [Show full text]
  • Extra-Adrenal Paraganglioma: an Uncommon Cause of Secondary Hypertension in a Young Subject
    Case Report September-December, 2011/Vol 31/Issue 3 Extra-adrenal Paraganglioma: An Uncommon Cause of Secondary Hypertension in a Young Subject Kota SK1, Kota SK2, Jammula S3, Panda S4 1Dr. Sunil Kumar Kota, DNB Resident, Department of Endocrinology, Medwin Hospital, Hyderabad-500001, Andhra Pradesh, India. 2 Dr. Siva Krishna Kota Department of Anaesthesia, Central Security Hospital, RIYADH, Saudi Arabia. 3Dr. Sruti Jammula Department of Pharmaceutics, Roland Institute of Pharmaceutical Sciences, BERHAMPUR, Orissa, India. 4Dr.Sandip Panda Department of Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pundicherry, India. Address for correspondence: Dr. Sunil Kumar Kota, E-mail: [email protected] Abstract A 8 year boy was admitted with features of tuberculous meningitis. He was detected to have hypertension. Further investigations revealed an extra-adrenal paraganglioma. Tuberculous meningitis and paraganglioma could be chance associations. Paraganglioma is a rare and potentially lethal cause of secondary hypertension, very uncommon at this age. If left untreated it leads to complications arising from unrelenting hypertension. We report a case report on this very rare disease of paraganglioma presenting in an unexpected way. Key words: Paraganglioma, Tuberculous meningitis, Secondary hypertension Introduction hemoglobin 13.8 g%, total leukocyte count 13,400 /mm3 The paraganglion system is formed by numerous with polymorphs 75% and lymphocytes 23%. His blood collections of neuroepithelial cells1. Paraganglioma are sugar, renal function tests, liver function tests, and serum tumors of paraganglia. The most common site is adrenal electrolytes were within normal limits. Cerebrospinal medulla, where it is known as pheochromocytomas. fl uid analysis revealed lymphocytic pleocytosis in the Those located outside the adrenal gland as extra-adrenal cerebrospinal fl uid with protein content of 134 mg% paragangliomas (EAPs).
    [Show full text]
  • Torsades De Pointes: a Rare Complication of an Extra-Adrenal Pheochromocytoma
    1263 Hypertens Res Vol.30 (2007) No.12 p.1263-1266 Case Report Torsades de Pointes: A Rare Complication of an Extra-Adrenal Pheochromocytoma Heiko METHE1), Martin HINTERSEER1), Ute WILBERT-LAMPEN1), Britt M. BECKMANN1), Gerhard STEINBECK1), and Stefan KÄÄB1) Pheochromocytoma is an infrequent secondary cause of arterial hypertension, often associated with parox- ysmal headache, sweating, weight loss, and palpitations. Cardiovascular complications of pheochromocy- toma include sudden death, heart failure due to toxic cardiomyopathy, and hypertensive encephalopathy. Here we report the case of a female with an acquired long-QT-syndrome as a rare complication of an extra- adrenal pheochromocytoma. Diagnosis was made after sotalol-induced Torsades de Pointes. (Hypertens Res 2007; 30: 1263–1266) Key Words: pheochromocytoma, long-QT-syndrome, Torsades de Pointes There was no family history of sudden death. Serum electro- Introduction lytes were as follows: sodium 139 mmol/L, potassium 5.1 mmol/L, calcium 2.7 mmol/L, anorganic phosphorus 4.1 mg/ Pheochromocytoma is a rare cause of sustained hypertension dL, magnesium 1.97 mg/dL. Fasting blood glucose was ele- or hypertensive crisis and many cardiac complications have vated to 124 mg/dL. Renal, liver and thyroid tests were all been reported with this neuroendocrine tumor. Development normal. of long-QT-syndrome (LQTS) due to myocardial hypertro- Her baseline ECG showed sinus rhythm and deep T-wave phy in this patient group is an occasional but potentially life- inversion in V2–4. Most remarkably it showed a QTc interval threatening complication increasing the risk for arrhythmias. of 480 ms (Fig. 1A). Sotalol-treatment was discontinued immediately but during intensive care unit monitoring, a Tor- Case Report sades de Pointes tachycardia was recorded (Fig.
    [Show full text]