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Biomedical subjects

C Proye

Publications and source records attributed to C Proye.

At least 163 records · Page 9Linked to original sources
PubMedDate not supplied

[Alpha-methyl-paratyrosine in the treatment of malignant pheochromocytoma].

Alpha-methyl-paratyrosine (Demser) is a specific inhibitor of tyrosine hydroxylation to dopa. It is administered orally and may be given in combination with symptomatic treatments to reduce the hypersecretion of catecholamines. We report two cases of malignant phaeochromocytoma in which this drug was used. A pharmacological study of the compound is presented, and the literature on its long-term use in the treatment of malignant phaeochromocytoma is reviewed. In our second patient, who received alpha-methyl-paratyrosine for 9 months, a study of changes in differential catecholamine excretion showed that the urinary catecholamines were redistributed, with an increase in the dopamine/norepinephrine ratio. An HPLC study of urinary excretion of catecholamines demonstrated that their levels cannot be significantly increased by excretion of alpha-methyl-paratyrosine or its metabolites.

Adrenal Gland Neoplasms↗
PubMedDate not supplied

[Surgery of insulinoma].

Pre-operative imaging of insulinomas should always be considered, but, if diagnosis is certain, negative imaging studies should never preclude laparotomy. A pre-operative medical trial with Diazoxide is mandatory to check its efficiency and thus allow better therapy at the end of a fruitless exploration, avoiding unnecessary blind pancreatic resection. And even sometimes, its efficiency may lead to discard surgery in a frail elderly patient or in the special patient with multiple tumors and the MEN I syndrome. State-of-the-art surgical exploration requires careful intra-operative monitoring of blood glucose--possibly with biostator--allowing control of completeness of the procedure. Intra-operative localization of the inciting tumor requires full pancreatic mobilization, careful palpation, intra-operative echography and sometimes insulin staged portal sampling with quick intra-operative assay. Insulinomas are very rarely ectopic, but they are multiple in 10% of cases, three out of four such cases in a MEN I setting. Any type of pancreatic resection can be used for tumour removal, but the more conservative one, i.e, enucleation should be elicited, especially in the head. Ultrasonic dissection is a useful tool. Left pancreatic resection should aim to spare the spleen. Completeness of tumor removal is assessed by the hyperglycemic rebound--sometimes delayed till 40 minutes--, a dramatic plasma insulin decrease and possibly change in biostator output. Blind pancreatic resection should be given up. Surgery of liver metastases is of anecdotal interest. Chemotherapy and SMS-analogs can provide long-term palliation.(ABSTRACT TRUNCATED AT 250 WORDS)

Diagnostic Imaging↗
PubMedDate not supplied

[Reoperative parathyroid surgery. 350 cervicotomies. 11 reoperations. Remarks].

One or more repeat operations were necessary to obtain full recovery in 11 out of 350 patients receiving surgery for hyperparathyroidism. Analysis of factors, sometimes multiple, leading to failure showed: poor surgical technique (3 cases), typical (2 cases) or rare (3 cases) ectopias, a supernumerary gland (2 cases), or lack of recognition of hyperplasia of the total parathyroid system (3 cases). Indications for and tactical modalities of reoperation are discussed, and emphasis placed on the unreliability of techniques employed pre-operatively to locate the diseased gland, the very rare need for sternotomy (1 case), and the remarkable possibilities of parathyroid autografts (4 cases). (4 cases).

Female↗
PubMedDate not supplied

[Parathyroid risk in thyroid surgery. Reality and prevention. 502 bilateral thyroidectomies].

Prospective study of parathyroid risk in a bulk of 502 consecutive bilateral thyroidectomies. Early post-operative hypocalcemia has been documented in 8,8% of the patients, but persisted in only 1,6% one year later. Late parathyroid risk of total thyroidectomy is 3,3% but increases twofold if neck dissection is simultaneously performed. Methods of this study probably misdiagnose a number of mild hypoparathyroidism. Lack of early hyperphosphoremia seems to be an optimizing criteria for aftermath. In Grave's disease, early post-operative hypocalcemia is more common (6,9%) but often subsides (definitive risk: 0,4%). This acceptable morbidity is compared to the data of literature. To prevent post-operative hypoparathyroidism a painstaking dissection of parathyroid blood supply seems more promising and effective than routine autotransplantation of the glands.

Graves Disease↗