Purpose: To investigate the clinical characteristics, endocrinological function, and etiologies of patients with bilateral adrenal lesions.Methods: A retrospective study of 777 patients with bilateral adrenal lesions was conducted at the Chinese General Hospital of the People's Liberation Army between January 2013 and January 2018. Patient demographic features, hormonal pro les, imaging ndings, and histopathological ndings were reviewed from the database records.Results: Of the 777 patients with bilateral adrenal lesions, 495 were men, and the mean age at diagnosis was 52.0±13.0 years. A total of 511 (65.8%) cases were benign, followed by adrenal metastases (n=224, 28.8%), pheochromocytoma (n=26, 3.3%), adrenal lymphoma (n=9, 1.2%), and adrenal corticocarcinoma (ACC) (n=7, 0.9%). Hormonal evaluation revealed that 34.3% of bilateral adrenal lesions were functional. The primary etiologies of functional lesions were primary aldosteronism (16.6%, 129/777) , and PBMAH (8.8%, 68/777). Patients with lymphoma and metastases were signi cantly older than those with benign nonfunctional lesions (60.4±11.0 years vs. 54.5±10.4 years and 57.9±10.8 years vs. 54.5±10.4 years, respectively; P<0.001). Lesions in adrenal lymphoma, ACC, pheochromocytoma, metastases, CAH, tuberculosis, and Cushing's syndrome were signi cantly larger than benign nonfunctional lesions (all P<0.001).Conclusion: Benign adrenal lesions and metastases to the lungs are the most common causes of bilateral adrenal lesions, and primary aldosteronism and BMAH are the most prevalent functional lesions. In addition, our ndings suggest that patients with lymphoma or metastases are older and possess larger masses.
AIM: To characterize changes of corneal nerve morphology and tear indices in patients with neurotrophic keratitis (NK) treated with recombinant human nerve growth factor (rhNGF). METHODS: In a prospective observational study, six patients (nine eyes) were locally treated with rhNGF. Visual acuity, corneal fluorescein staining score, the heights of the tear river, lipid layer thickness (LLT), tear ferning (TF) test, conjunctival impression cytology (CIC) examination, the densities of cornea subbasal nerve fibers were determined before and after treatment. RESULTS: Compared with baseline, there was a significant difference in corneal fluorescence staining scores (P<0.01); all patient corneal epithelial defects recovered completely within 8wk, but there was no significant improvement in the height of the tear river (P=0.202). LLT was significantly increased when compared with baseline (P=0.042); however, the function of conjunctival goblet cells and mucin content did not significantly improve using the TF test and CIC examination (P=0.557, P=0.539). After 8wk of treatment, the average corneal subbasal nerve fiber density increased significantly (P<0.01), as did the number of corneal nerve fiber branches (P=0.001). CONCLUSION: RhNGF can increase the density of corneal subbasal nerve fibers, promote the healing of persistent corneal epithelial defects and corneal ulcers in patients with NK, also improving tear function partially.
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