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Biomedical subjects

C van Heyningen

Publications and source records attributed to C van Heyningen.

29 records · Page 2Linked to original sources

Thecal cell reaction associated with an ovarian leiomyoma and presenting with virilization.

A 56-year-old woman presented with marked hirsutism and virilization of gradual onset. Menstruation had ceased at 43 years. The serum testosterone was grossly elevated (49 nmol/l) with levels of estradiol well above the postmenopausal range (200 pmol/l). Both serum testosterone and estradiol levels showed a marked but transient increase during the administration of the GnRH analog, buserelin. This indicated that the release of these steroids was under gonadotropin control. Bilateral oophorectomy revealed a greatly enlarged left ovary, and histology demonstrated a leiomyoma of the ovary with marked thecal reaction, which was probably responsible for the elevated serum testosterone and virilization. Testosterone levels returned to normal after bilateral oophorectomy. Excessive thecal androgen production associated with non-epithelial ovarian tumors is extremely uncommon and the response to buserelin has not previously been reported.

Buserelin↗

Anti-smoking advice for young diabetic smokers: is it a waste of breath?

The effect of health counselling on the smoking habits of 60 diabetic patients (aged less than 40 years) was assessed. Measurement of breath carbon monoxide (CO) and urinary cotinine, a metabolite of nicotine, were used as objective markers of smoking. All patients wished to cease smoking and the impact of health counselling was reviewed in a 'Stop Smoking' clinic. In addition to routine advice on the health hazards of smoking, half the patients and their families also received further counselling during a home visit by a health visitor. After 6 months many of the 60 patients claimed to have reduced their cigarette consumption. However, the urinary cotinine concentrations did not confirm this. Only one patient actually stopped smoking and he had sustained a myocardial infarction during the study. There was a small but significant reduction of breath CO in the patients seen at home by the health visitor but the urinary cotinine concentrations were unchanged. This suggests that these patients abstained from smoking for only a few hours before attending the 'Stop Smoking' clinic.

Adult↗

Virilization due to ovarian hyperthecosis in a postmenopausal woman.

A 51-year-old woman presented with hirsutism and virilization of gradual onset. The serum gonadotropin concentrations were in the postmenopausal range, the serum testosterone concentration was markedly elevated (9.8 nmol/l) and the serum estradiol concentration (220 pmol/l) was elevated above the postmenopausal range. A selective venous catheterization study demonstrated raised serum testosterone and androstenedione levels in ovarian veins and suggested the presence of a left ovarian tumor. The raised peripheral estradiol level was shown to be due to ovarian hypersecretion. After bilateral oophorectomy the serum testosterone became normal. Ovarian histology revealed bilateral stromal hyperthecosis. Ovarian hyperthecosis is a rare but important cause of serum testosterone levels in the neoplastic range. This is the third case reported of postmenopausal virilization due to ovarian hyperthecosis and the first report of a selective venous catheterization study in such a patient.

Androstenedione↗

Diagnostic value of a modified assay of free triiodothyronine in serum.

The performance of a modified commercial (Diagnostic Products Corp.) assay for free triiodothyronine in serum was evaluated, and its diagnostic value was compared with two other methods for free triiodothyronine estimation in euthyroid subjects and in patients with thyroid dysfunction. No advantage was demonstrated for the modified assay as an index of thyroid status. In conditions involving thyroxin-binding globulin excess the modified assay produced misleading results more frequently than did the comparison methods.

Female↗

Glycosylated haemoglobin by affinity chromatography in diabetic and non-diabetic children.

We have made an evaluation of glycosylated haemoglobin measurements by affinity chromatography in a paediatric population. Age-related reference values for non-diabetic infants and children are reported. A poor correlation (r = 0.24) was found between glycosylated haemoglobin values in 26 insulin-dependent diabetic children and the paediatrician's independent assessment of clinical control.

Adolescent↗