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Biomedical subjects

B Guilhaume

Publications and source records attributed to B Guilhaume.

At least 37 records · Page 2Linked to original sources
PubMed1984

[Rapid beta 1-24-corticotropin test in the exploration of the corticotropic axis. 71 cases].

The reliability of the beta 1-24 corticotropin test, which is both cheap and safe, in the assessment of the hypothalamic-pituitary-adrenocortical function was re-evaluated by comparing its results with those of the metyrapone test in 71 subjects: 30 controls and 51 patients with suspected pituitary-adrenal dysfunction. Response to a 500 micrograms intramuscular injection of beta 1-24 corticotropin was evaluated by measuring the 60 min plasma cortisol levels; 4.5 g of metyrapone divided into 6 doses were then administered orally and response was evaluated by measuring plasma 11-desoxycortisol levels. A highly significant correlation (r = 0.79; p less than 0.001) was observed between plasma cortisol and plasma 11-desoxycortisol levels. The results were best interpreted by expressing the values obtained as plasma cortisol concentrations which, in normal subjects are at least 21 micrograms/100 ml. The rapid beta 1-24 corticotropin test was found to be very reliable (sensitivity 90%, specificity 100%) to detect adrenal insufficiency, irrespective of the organs affected on the hypothalamic-adrenocortical axis.

Adolescent↗
PubMed1984

[Paraneoplastic hypercorticism].

Paraneoplasic hypercorticism results from ectopic corticolipotropic secretion. Its incidence remains underestimated because of the latent clinical forms of Cushing's disease. In some cases the primary tumour (bronchopulmonary, thymic, pancreatic or other) presents late. The variability of hormonal secretion makes it difficult to interpret dynamic tests. Measurement of ACTH and LPH are useful diagnostic aids; more specific markers of ectopic secretion have recently been reported. When the primary tumour cannot be directly treated, the quality of survival may be improved by the use of synthetic anticortisol drugs.

Adrenocortical Hyperfunction↗
PubMed1982

[Results of surgical treatment of Basedow's disease].

Diffuse hyperthyroidism occurred in 88 patients (82 women and 6 men), aged 14 to 74 years, and was due to Graves disease in 65 cases and heteromultinodular goiter in 23 cases. After medical preparation, the surgical procedure was subtotal thyroidectomy for Graves disease and total unilateral with partial controlateral lobectomy for heteromultinodular goiter. The immediate postoperative course was uneventful except for two transient acute episodes of thyrotoxicosis. One to eight years after surgery, 53 patients are euthyroid, 34 are hypothyroid and one has recurrent hyperthyroidism. A TRH test was done in each of the 53 euthyroid patients. Three kinds of responses were demonstrated: a normal response in 22 cases, evidencing true euthyroidism; an excessive response in 24 cases, reflecting partial compensated hypothyroidism; an insufficient response in 7 cases.

Adolescent↗
PubMed1980

[Hyperandrogenism due to adrenal enzyme deficiency: possibility of pregnancy. Five cases (author's transl)].

Five women suffering from hyperandrogenism due to adrenal enzyme deficiency, with various clinical symptoms and discovered at a more or less early stage, had a total of 7 pregnancies. 21-hydroxylase was deficient in three, and 11-beta-hydroxylase in two women. The pregnancies occured 6 months to 10 years after corticosteroid treatment was started in four cases, and after it was discontinued in a case of partial deficiency in 11-beta-hydroxylase. Four women delivered on term, two of them normally and two by caesarean section. The fifth woman delivered prematurely on the 33rd week. Two pregnancies were interrupted either spontaneously or voluntarily. None of the newborn babies (three girls and two boys) showed any abnormality. With the exception of the premature girl, their weight was normal. The oldest of the girls had a normal puberty at the age of thirteen.

Adrenal Gland Diseases↗
PubMed1979

[Thyroid nodule secondary to subacute thyroiditis. 8 cases (author's transl)].

This description of 8 cases of thyroid nodules secondary to subacute thyroiditis serves to emphasise the relative prevalence of the circumscribed forms. These nodules, variable in size, firm and painful, developed after a period of cervical discomfort and pain. A contrast between a raised or normal blood hormone level and a very low uptake of I131 was found in five cases. It was all the more valuable when there was no iodine overload. Scintigraphy showed the nodule to be cold in 6 cases, isofixing in one and hot in one case. An essential diagnostic criterion is the rapidly favourable course: 4 nodules disappeared completely, 3 regressed in less than 6 months and one persisted, justifying excision with histopathological examination since localised thyroiditis of this type may be the presenting feature of a carcinoma.

Adult↗
PubMed1979

[Primary empty sella associated with peripheral endocrine deficiency: two cases (author's transl)].

The radiological finding of a large sella turcica in long standing peripheral endocrine insufficiency (adrenocortical in one case, thyroid in the other) and the persistence of plasma ACTH and TSH levels above normal despite hormone therapy was first attributed to the consequences of reactive hypersecretion of the corresponding stimulin. The results of scanner studies in one case, and of pathological examination in the other, revealed the presence of primary empty sella syndrom.

Addison Disease↗
PubMed1975

[Comparative action of carbamazepine and clofibrate in diabetes insipidus. Study of 7 cases].

A study was performed on the effects of carbamazepine and of clofibrate in 7 cases of diabetes insipidus of high origin. In 4 cases the action of the two substances used in association was studied. Carbamazepine, in a dose of 0.60 g/day was effective in all cases with negativisation of free water clearance in 5 out of 7. Clofibrate, in a dose of 1.50 g/day was effective in 4 cases out of 7 with negativation of free water clearance in 2. Both medications act by provoking the secretion of anti-diuretic hormone by the hypothalamic/posterior pituitary centres and are thus only active if a minimal secretion of ADH is still possible. There is no apparent potentialisation of the two substances, which both require a minimal possibility of ADH secretion to be active. There is no diminution in the ADH secretor effect, since both products remain active for as long as they are given, making it possible to observe in 3 out of 7 cases spontaneous cure of the diabetes insipidus, allowing suppression of the treatment.

Adolescent↗
PubMed1975

[Isolated premature breast development in young girls. Results of the LH-RH test].

Thirty-six cases of premature thelarche in girls 9 months to 7 years old have been studied. In most cases, breast development began before 3 years and came to regression. Onset after 3 years was less common and led usually to breast persistance. Height was lightly but significantly advanced. Plasma levels of estrone, estradiol (in 21 cases) and gonadotropins (FSH and LH, in 12 cases) were not significantly increased. However, LH-RH test (in 12 cases) suggested prolongation and/or increase of the physiologic gonadotropic hyperactivity of normal female infants.

Breast↗
PubMedDate not supplied

[Adrenal hyperandrogenism due to enzyme disturbance of late onset (author's transl)].

In the context of hyperandrogenism, the group of hyperandrogenism due to disturbances in hormon-synthesis of late onset is worthy of being considered separately, not by virtue of its prevalence but by the fact that its course may be one of isolate hirsutism (3 cases out of 11 in this study), or even sterility. The diagnosis may be of varying difficulty, because of the incomplete nature of the block. Eleven cases are reported, ten due to a partial deficit in 21 hydroxydation, and one due to a deficit in 11 hydroxydation. The presence of cortisone precursors is often more significant in stimulation tests. Estimation of blood testosterone levels may give somewhat high results in certain cases, but it must be emphasized that it may be diminished dexamethasone and the estimateion of delta 4 androstenedione is of value. In difficult cases, the diagnosis of a minor or incomplete disturbance is based upon a combination of biological, statistical and dynamic arguments. However this diagnosis is important since cortisone at low inhibitory doses are effective, in particular against menstrual disorders, sometimes making it possible to rapidly correct sterility.

Adolescent↗
PubMedDate not supplied

[Late diagnosis hyperandrogenism due to adrenal enzyme deficiency (author's transl)].

Six women aged from 17 to 30 years (mean: 21 years) were referred on account disorders which had begun at puberty and had been present for 3 to 15 years. The reasons for consulting were hirsutism in 5 cases and sterility in one. The patients' height (1.61 to 1.70 m; mean: 1.64 m) and weight (54 to 70 kg; mean: 59 kg) were normal. Three women menstruated regularly and 3 had anovular spaniomenorrhaea. Hirsutism with enlargement of the clitoris (Prader's stage I) was apparent in all six cases. Three patients had permanent, though moderate hypertension. The biochemical changes essential to the diagnosis were as follows: 1) in 2 women with 21-hydroxalyse deficiency there was a rise in cortisol precursors (plasma 17-OH progesterone and its urinary metabolite, pregnanetriol). In 4 women with 11-hydroxylase deficiency urinary 17-OH corticosteroids were increased; two had high desoxycorticol levels. A rise in plasma desoxycortisol/cortisol ration under tetracosactrin stimulation is of considerable diagnostic value; 2) plasma androgens (testosterone, delta 4 androstenedione) and their urinary metabolites (17-ketosteroids) were increased; 3) all abnormalities disappeared when the adrenal function was suppressed. Under dexamethasone treatment hirsutism became stabilized or even regressed, blood pressure values rapidly returned to normal, menstrual disorders disappeared and ovular cycles were established. Three women became pregnant and delivered on term.

Adolescent↗
PubMedDate not supplied

[Studies of the basal secretion and the response to TRH (thyrotropin-relapsing factor) of TSH (thyrotropin) and prolactin in Cushing's syndrome and Nelson's syndrome (author's transl)].

The present data relate the studies of TSH and Prolactin secretion in response to TRH (500 microgram, IV) in Cushing's syndrome. Twenty-five patients were explored before treatment (4 adrenal carcinoma, 5 adrenal adenoma, 2 Cushing's diseases with patent pituitary tumor, 14 Cushing's diseases without patent pituitary tumor). Thirteen of the twenty-five patients were studied after treatment of their hypercorticism. Identical studies were realized in 5 patients receiving oral corticotherapy. The results, compared with those obtained in normal subjects are: the TSH basal values are normal or low. The TSH response is lower in untreated Cushing's disease (p2a : 0,01) and normal or low in other cases. The Prolactin basal values are significantly higher in untreated adrenal carcinoma (p2a : 0,05) and in Nelson's syndrome (p2a : 0,01), normal or high in other cases. The prolactin response before treatment is significantly higher in male Cushing's diseases (p2a : 0,05), high or normal in other cases, and unchanged in Nelson's syndrome. Those abnormalities of basal values and/or responses of TSH and Prolactin do not seem sufficiently discriminant of the etiology of Cushing's syndrome especially tumoral causes, in particular pituitary causes. They seem connected to hypercorticism because of the treatment of the last one corrects them. But other factors must be concerned in the Nelson's syndrome case.

Adolescent↗