Search PubMed⌕ Search

Biomedical subjects

C Atlan-Gepner

Publications and source records attributed to C Atlan-Gepner.

23 records · Page 2Linked to original sources

[Corticotropic adenoma in slow adrenal insufficiency].

This case report deals with an insulin-dependent diabetic patient suffering peripheral adrenal insufficiency who, after 12 years of substitutive treatment exhibited resistance to mineralo- and gluco-corticoids with relapse of melanodermia and plasma ACTH levels higher than 1500 pg/ml despite increasing doses. A corticotrop macroadenoma was diagnosed by MR imaging and functional tests and confirmed by surgical excision followed by disappearance of resistance. Pre-operative functional investigation show autonomisation of the adenoma but with some partial persisting regulation. This case report draws attention to this rare either complication or association which can occur in peripheral adrenal insufficiency.

Addison Disease↗

Dietary protection against diabetes in NOD mice: lack of a major change in the immune system.

Pregestimil, a hypoallergenic infant formula in which casein hydrolysate replaces protein, protects NOD mice against diabetes, a T-cell-mediated autoimmune disease. Female and cyclosphosphamide (Cy)-treated male NOD mice were used to assess whether a modification of cellular immune mechanisms occurred when animals were fed Pregestimil from weaning to 110 days of life. Insulitis, sialitis and thyroiditis were observed, and the splenic T-cell proliferative response was measured. The ability of splenic T-cells of NOD mice in the Pregestimil group to transfer diabetes adoptively to young irradiated male NOD mice was also assessed. Pregestimil protected female NOD mice against spontaneous diabetes and male NOD mice against acute Cy-induced diabetes. Addition of bovine serum albumin (10%) to the diet did not alter the preventive effect. The Pregestimil diet also lessened insulitis severity in Cy-treated males, though not in females. Sialitis and thyroiditis, observed mainly in females, were not modified by the diets. The TCR-mediated proliferative response of splenocytes tended to increase specifically in Pregestimil-fed and Cy-treated males. Sensitivity to IL-2 was improved. In females, the TCR-mediated proliferative response and the ability of T cells to transfer diabetes adoptively were unchanged. It is concluded that the protective effect of Pregestimil against diabetes in NOD mice cannot be explained by major changes in peripheral immune response.

Aging↗

[Outlook for the future in the treatment of diabetic retinopathy].

With regard to diabetic retinopathy, in addition to the demonstration by the DCCT study that prevention is achieved by good metabolic control, our present knowledge on physiopathology leads us to imagine three types of possible therapeutic approach; inhibition of glucotoxicity, improvement of capillary flow, blockade of angiogenesis. 1) Inhibition of glucotoxicity Aldose reductase inhibitors can prevent cataract in diabetic or galactosemic rats. The effect of these drugs on retinopathy, evaluated in some clinical trials, remains controversial, suggesting a minor role. Aminoguanidine is an inhibitor of formation of advanced glycosylation end-products (AGE). This compound has been tested on a model of experimental retinopathy in rats. Parallel to the AGE decrease in retina, formation of microaneurysms and loss of endothelial cells in capillaries were delayed. Clinical tolerance allows human application and randomised trials will give further information on this potentially efficient drug. 2) Improvement of capillary flow This objective can be obtained by drugs inhibiting platelet aggregation or improving erythrocyte or leucocyte deformability. Clinical trials using such compounds were not very conclusive. 3) Blockade of angiogenesis Proliferation of new vessels is a rather severe stage of diabetic retinopathy. Angiogenesis is due to factors locally produced (as FGF, TGF and u-PA produced by anoxic tissues), systemic (IGF-1) or released by inflammatory reaction (IL1, TNF alpha and beta). One imagines usage of drugs which inhibit these factors and prevent angiogenesis. At the present time, two approaches have been used in proliferative retinopathy worsening despite panphotocoagulation; analogues of somatostatin and interferon alpha. The promissing results of these pilot studies have to be confirmed.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[Bone density after iatrogenic subclinical long-term thyrotoxicosis. Measurement by dual photon absorptiometry].

Thyrotoxicosis may be held responsible for osteoporosis. The question is whether a very slight subclinical hyperthyroidism, as is desirable in the post-operative treatment of differentiated thyroid carcinoma, can in the long run be detrimental to bone tissue. In a series of 37 patients, aged 50.9 +/- 11.1 years, presenting with the features of subclinical hyperthyroidism of 8.0 +/- 4.8 years duration, the authors have been unable to find any change in paraclinical parameters of bone and calcium-phosphate metabolism. Thirty-six of these 37 patients showed no abnormal decrease of vertebral bone density measured by dual photon absorptiometry.

Absorptiometry, Photon↗