Plasma and tumor levels of somatostatin (SRIF) and somatostatin immunochemistry in medullary thyroid carcinoma: apparently discrepant preliminary results.
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Biomedical subjects
Publications and source records attributed to C Houdent.
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Seven cases of hypothyroidism developed within 6 months of delivery are reported. Radioimmunoassays regularly showed very low thyroxin levels and high thyroid-stimulating hormone levels, thus confirming that the thyroid deficiency was of peripheral origin. A significant rise in antimicrosomal or antithyroglobulin antibodies was noted in 5 cases. One patient had HLA-B8 and 4 had HLA-DR3, which was not significantly different from the prevalence in the regional population. In contrast with the transient post-partum hypothyroidism reported mainly in Japan, the condition proved to be permanent in 6 patients followed up for more than two years. The increased frequency of HLA-DR3 and 5 recently described in thyroiditis with transient post-partum thyrotoxicosis was not found in our series. It would appear that pregnancy, which is a period of immune incompetence, may disclose a latent lymphocytic thyroiditis.
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Fifteen women with idiopathic hirsutism (N = 11) or hirsutism with androgen excess (N = 4) were treated by Cyproterone acetate orally (50 mg from the 5 th to the 25 th day of the menstrual cycle) and Ethinyl Estradiol (day 15-25). Hirsutism was improved in 86% of cases with progressive improvement at 3, 6, 12 months. At 12 months, the clinical score for hirsutism was 56% of the original score. Disturbance of menstrual cycles was more frequent than reported with Hammerstein's pattern of treatment. Clinical and biological tolerance was good. delta 4 androstenedione decreased significantly at 6 months (respectively 2,26 ng/ml - 1,25 ng/ml). There was no significant decrease of plasma testosterone. Result of B 1-24 corticotropin test remained normal after 12 months of treatment.
Basal plasma cortisol levels and adrenal responses to stimulation by endogenous and exogenous ACTH were compared between a group of controls and a group of patients with corticotrophic insufficiency. In addition, the adrenal response to the administration of exogenous ACTH was compared in each of these groups in relation to the timing of the test. There was a clear parallel between respective adrenal responses to exogenous ACTH and endogenous ACTH. Adrenal stimulation by exogenous ACTH may be used to investigate the residual secretion of endogenous ACTH and in the diagnosis or corticotrophic insufficiency, when a lesion interrupting functional hypothalamo-pituitary connections has been excluded. In the opposing case, use of a short test with metopirone is essential in order to confirm corticotrophic insufficiency. This test is better tolerated than the classical test and is not subject to sources of error due to urine collections.
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A case of cerebrotendinous xanthomatosis without hyperlipidaemia but with tendinous scanthomatosis, subtle neurological disorders and endocrine cataract is reported. Accumulation of cholestanol, a cholesterol derivative, was detected by mass fragmentography. The plasma cholestanol : cholesterol ratio was 30 times higher than normally. Treatment with chenodesoxycholic acid during 26 months brought about neurological improvement, stabilization of the cataract and xanthomatosis and return to normal of plasma cholestanol levels.
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The sella turcica was investigated systematically by radiotomography in 19 patients with either idiopathic hirsutism (6 cases) or hirsutism associated with hypomenorrhea (13 cases), without hyperandrogenism. Morphological abnormalities of the sella were noted in 9 cases, but these radiological abnormalities were also observed in 5 out of 19 women without hirsutism studied at the same time, and these images should therefore be interpreted very prudently. Only two patients had associated sella anomalies and raised LH levels, which could suggest, but not confirm the presence of an LH micro-adenoma.
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