No abstract

89 patients were operated on for pheochromocytoma. 61 patients (37 women and 24 men) were available for extended follow-up. The final survey, performed 79.1 +/- 66.9 months postoperatively, provided data on survival, blood pressure tumor recurrence, malignant metastatic lesions, cardiovascular complications and coexisting diseases. There were 4 deaths during the follow-up period, including 2 instances of malignant pheochromocytoma. Permanent normalization of blood pressure was achieved in 38 patients (62.3%). This hypotensive effect was noted in 79.2% of patients with preoperative paroxysmal hypertension and in 40.8% of those with sustained hypertension. Permanent or re-developing postoperative hypertension was noted in 23 (37.7%) patients. This includes 4 cases of malignant pheochromocytoma, 4 cases of recurrent benign pheochromocytoma and 15 cases of essential hypertension. Cardiovascular complications during follow-up were rare and concerned the patients with essential hypertension diagnosed postoperatively.

Diverse changes in plasma aldosterone and cortisol found in response to the postural test may indicate pathogenetic heterogeneity amongst patients with aldosterone producing adenomas and should be considered during diagnosis of primary aldosteronism.

The plasma aldosterone to renin activity ratio (A/PRA) ratios in patients with primary aldosteronism were associated with unsuppressed plasma renin activity (PRA). was assessed retrospectively in 103 patients with primary aldosteronism including 74 patients with surgiAlthough the mean values of the A/PRA ratio differed significantly between the groups, complete separation cally proven adrenal cortical adenoma (APA) and 29 patients with idiopathic adrenal cortical hyperplasia was not obtained. The serum potassium level at time of testing did not influence the diagnostic value of the (IHA). The results were compared with those obtained in 31 patients with essential hypertension (EH) and 45 A/PRA ratio, although an inverse correlation between serum potassium and the A/PRA ratio was found in the healthy normotensive controls. The upper limit of normal A/PRA ratio, as obtained in the controls was 17.8. patients with APA. This study supports the high sensitivity of the A/PRA ratio in diagnosis of primary aldosThis value was exceeded in 89% of patients with APA; postoperatively it decreased in 97% of the APA group, teronism, however, a single determination with a normal result may not be sufficient for exclusion of the disease. and returned to normal in 81%. In the IHA group the A/PRA was elevated in 70% of patients. The normal

Background In contrast to those for coronary restenosis, the data regarding the risk factors for renal restenosis are limited.Objective To evaluate potential humoral risk factors for restenosis after percutaneous transluminal renal angioplasty (PTRA).Methods We studied 27 patients aged 54 ± 10 years with atherosclerotic renal artery stenosis in a 1-year prospective follow-up. Restenosis (confirmed by angiography) occurred in eight patients 1-6 months after PTRA. We detected no Doppler ultrasound evidence of restenosis in 19 patients throughout 1 year. Blood studies were done before PTRA for all patients, at the time of diagnosis of restenosis and, for those without restenosis, after 1 year. including determinations of fibrinogen, lipids, platelets and leukocytes. ResultsThe mean level of fibrinogen in patients who experienced restenosis was higher than that in those who did not (450 ± 150 mg% versus 337 ± 57 mg%, P <0.0 1) and remained unchanged for both groups during follow-up. The other parameters did not differ between the groups before PTRA and did not change over time, with the exception of platelet count in patients who did not experience restenosis, which had decreased from 253 ±93 Gil to 200 ±63 Gil (P