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Biomedical subjects

A Pont

Publications and source records attributed to A Pont.

34 records · Page 2Linked to original sources
PubMed1982

Ketoconazole blocks testosterone synthesis.

Ketoconazole, a new oral drug used to treat systemic and superficial mycoses, inhibits sterol synthesis in fungi. The development of gynecomastia in two patients prompted us to investigate the effect of the drug on testosterone production. After a 200-, 400-, or 600-mg dose, volunteer male testosterone serum concentrations fell markedly, but returned toward baseline eight to 24 hours later as ketoconazole serum concentrations waned. A marked but transient drop in testosterone levels occurred in patients receiving long-term therapy, and continuous testosterone depression was noted in one. A block of synthesis was demonstrated in vitro. Ketoconazole at concentrations achievable in serum with currently used doses blocked basal and gonadotropin-stimulated testosterone production by rat Leydig cells. The diminution of testosterone synthesis could be significant as further therapeutic trials may use larger doses or more than once-daily administration. The paucity of reports of endocrinologic toxicity may relate to the "escape" from the block demonstrated in vivo.

Adult↗
PubMed1981

Heterotopic ossification in the hand of a patient with spinal cord injury.

Heterotopic ossification (HO), reported to occur in 20% to 40% of spinal cord injured patients, has been described in the hips, knees, shoulders and elbows, but not in the hands or around the phalangeal joints. This report is believed to be the first of HO of the hand after spinal cord injury. Nine weeks after injury, a diving accident, a 27-year-old man having C6 quadriplegia, motor complete, sensory incomplete, developed acute swelling and loss of range of motion in both hands. Serum alkaline phosphatase showed no significant rise. Bone scan demonstrated increased uptake in many joints of the left hand with x-rays remaining normal. Repeat films three weeks later demonstrated calcific densities adjacent to the midshaft of the proximal phalanx of the left finger. Twice daily range of motion of the hand resulted in improved range of motion. the etiology of HO in spinal cord injured patients remains unknown, and we have no explanation of its occurrence in the hands of this patient.

Adult↗
PubMed1980

Multiple endocrine neoplasia syndromes.

The multiple endocrine neoplasia (MEN) syndromes consist of three distinct disease entities. They have in common adenomatous, carcinomatous or hyperplastic involvement of a variety of endocrine glands, and an autosomal dominant inheritance. MEN I includes hyperparathyroidism, islet cell and pituitary tumors. The components of MEN IIa are hyperparathyroidism, medullary thyroid carcinoma and pheochromocytoma. MEN IIb includes multiple neuromas, medullary thyroid carcinoma and pheochromocytoma. Effective tests are available for the early detection of components of the syndromes in potentially affected patients. Screening can lead to therapeutic intervention before clinical sequelae ensue.

Adenoma, Islet Cell↗
PubMed1979

Recurrence after a surgically induced remission.

In December 1976, an 18-year-old woman had symptoms typical of Cushing's syndrome. Laboratory evaluations and roentgenograms documented pituitary-dependent Cushing's disease in a patient with a pituitary microadenoma. In May 1977, she underwent transsphenoidal pituitary exploration. A 2-mm pituitary microadenoma was removed. The patient improved, and laboratory evaluation documented remission of the disease. In June 1978, she again complained of symptoms compatible with Cushing's disease. Laboratory evaluation confirmed a pituitary-dependent hypercortisonism. This case report marks the first recurrence of Cushing's disease in a patient previously cured by transsphenoidal resection of a pituitary tumor.

Adenoma↗
PubMed1979

Prolactin-secreting tumors in men: surgical cure.

Two men presented with decreasing libido and impotence. Endocrine evaluation showed that they both had low levels of serum testosterone and a prolactin-secreting adenoma. Transsphenoidal removal of their tumors resulted in normalization of serum prolactin and testosterone concentrations and normalization of sexual function. These patients represent the first two nonacromegalic men with prolactin-secreting tumors and hypogonadism in whom surgical resection of their tumors resulted in a complete clinical and biochemical remission. We discuss the effects of elevated prolactin on male sexual function.

Adenoma↗
PubMed1979

Diabetes mellitus and neuropathy following Vacor ingestion in man.

Two patients ingested Vacor, a rodenticide containing the active ingredient N-3 pyridylmethyl-N'-p-nitrophenyl urea. Both patients developed ketosis-prone diabetes mellitus and severe autonomic neuropathy. Niacinamide therapy given nine hours after Vacor ingestion in one patient and 14 hours after ingestion in the other was not successful in preventing these sequelae. Physicians need to be aware of the toxicity of Vacor, and the potential therapeutic benefit of early niacinamide therapy.

Adult↗
PubMed1977

Familial hemochromatosis. Physiologic studies in the precirrhotic stage of the disease.

We studied 12 members of a family with precirrhotic hemochromatosis to define the physiologic abnormalities in the asymptomatic phase of the disease. Six of 12 had increased iron stores; the mode of inheritance was consistent with an autosomal dominant trait. Serum ferritin levels were no more predictive of tissue iron levels than measurements of serum iron, transferrin saturation or chelatable iron excretion. In three affected family members intestinal iron content was normal. Liver proline hydroxylase activity and urinary hydroxyproline excretion did not correlate with tissue iron content, suggesting that, in addition to the possible role of tissue iron, hepatic fibrosis may involve other factors. "Borderline diabetes mellitus" was present in three affected family members, but extensive studies revealed that pituitary dysfunction is uncommon in early hemochromatosis. Increased levels of liver iron proved to be the most reliable marker for the disease.

Adolescent↗