[Diabetic coma disclosing legionellosis].
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Biomedical subjects
Publications and source records attributed to D Gautier.
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Over a period of 23 years, 3 members of a family of 5 presented with 7 parathyroid adenomas (4 in the first case, 2 in the second case, 1 in the third case). Excision of each adenoma, with systematic pre-operative assessment of the remaining parathyroid tissue, led to complete clinical and laboratory cure of each episode. The delay in the appearance of recurrence was between 3 and 9 years. After reviewing the literature, the authors stress the importance, in any case of hyperparathyroidism, of routinely investigating the serum calcium levels in members of the patient's family, especially if the patient is young and if he has had several episodes or a multiglandular involvement in the one episode. The authors discuss the literature concerning recurrent familial hyperparathyroidism with endocrine polyadenomatosis and the "hypercalcaemia - hypocalciuria" syndrome.
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75,375 males called to military service were screened to discover the incidence of hypertrophic pyloric stenosis. 49 men gave a history of previous surgery for this condition and were given a 45 g/m2 oral glucose tolerance test. Fourteen had impaired glucose tolerance. In no case was there a family history of diabetes mellitus.
Prolactin levels were measured in 84 patients aged 20 years with hypogonadism, both under baseline conditions and after stimulation with TRH. In those with impuberty from delayed puberty or gonadotropin insufficiency, baseline blood prolactin levels were normal but the response after stimulation was reduced in a significant manner. In patients with Klinefelter's syndrome, both baseline and reserve blood prolactin levels were increased. No correlation was observed between these abnormal levels and the usual clinical and biological disturbances found in this disorder (gynaecomastia, diabetes, hyperinsulinism, changes in 5-alpha-reduction). The significance of this hyperprolactinaemia remains obscure.
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An analysis of 100 cases detected at the age of 19 years during selection for National Service. A somatic, genetic, psychological and hormonal profile emerges from this homogeneous sample. A study of olfactory function and insulin secretion was made. Testosterone deficiency was moderate, DHT deficiency being much more marked and insensitive to stimulation, suggestive of a 5 alpha-reductase defect. Impairment of oestrogenic function of the testis was demonstrated.
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