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Biomedical subjects

J Bertrand

Publications and source records attributed to J Bertrand.

At least 145 records · Page 8Linked to original sources

Approach to the mechanism of androgen overproduction in a case of Krukenbery tumor responsible for virilization during pregnancy.

Virilization may occur during pregnancy as the result of an ovarian Krukenberg tumor. mechanism of the androgen overproduction in this exceptional condition is still poorly understood. A new case is reported in which only in the postpartum clinical, endocrine, and endoscopic studies led to the diagnosis of an ovarian Krukenberg tumor secondary to a gastric carcinoma. In the mother, basal hormonal studies were done 1 and 4 weeks after delivery, then after gastric and ovarian surgery. Three months after delivery, ovarian steroid response to hCG (priming dose, 5000 IU; then 1500 IU every other day for 12 days) and a study of progesterone (P) metabolism at a steady state after a constant infusion of [3H]P and cold P (92 micrograms/min leads to blood production rate (BPR) of 152 mg/day designed to reproduce the BPR of P usually seen in pregnancy) were successively performed. Hormones were measured by specific RIAs after chromatographical purification. Basal hormonal levels were normal in the child. In the mother, on the 5th day postpartum, mean hormone levels (in nanograms per dl) were: testosterone (T), 4181; androstenedione (delta 4), 8876; 17 alpha-hydroxyprogesterone (17-OHP), 9746; P 1075; estrone (E1), 195; and estradiol (E2), 151. One month later, levels were normal for the follicular phase; T, 40; delta 4, 146; P, 52; E2, 9; and E2, 4.5. At both times, dehydroepiandrosterone was normal (703-750). Hormone levels increased progressively during hCG stimulation but their time course was different between hormones. At the end of the test, T. 144; delta 4, 746;' 17-OHP, 789; P, 723; E1, 37; and E2, 20. The MCR of P was decreased, 1450 liters/day (normal, 2020). Conversion ratios between products and precursor during constant infusion were normal. From these data, obtained in four different conditions (postpartum period, hCG stimulation, progesterone infusion, and after oophorectomy), the following can be concluded: adrenal production of dehydroepiandrosterone was normal; the ovarian overproduction of androgens likely resulted from the excessive reductive metabolism of both placental and ovarian P along the delta 4 steroid biosynthetic pathway by an hypertrophic stromal compartment; and HCG stimulation seems to be the necessary stimulus for this condition. The enhancement by T on its own peripheral production is also discussed.

Androgens↗

[Dupuytren's contracture and palmar erythema in alcoholic cirrhosis].

Three comparable groups were studied : 100 patients with alcoholic cirrhosis, 100 alcoholics without cirrhosis, and 100 subjects without either alcoholism or cirrhosis. Dupuytren's contracture was noted in 43% of cases in group I, 34% in group 2, and in 14% of group 3. There was no parallel between the frequency of Dupuytren's contracture and the severity of the liver involvement. Palmar erythema was noted in 34% of cases of group 1, 23% of cases of group 2, 12% of cases of group 3. Dupuytren's contracture has a genetic background, but its clinical expression is facilitated by metabolic causes, the most frequent being chronic alcoholism. Palmar erythema appears to be a sign of severe liver disease.

Adult↗

Detection of Na+ and K+ in the rat adrenal cortex with the electron microprobe.

1. In order to demonstrate whether modification of aldosterone secretion is mediated by parallel changes of K+ in the adrenal zona glomerulosa, the total (intracellular+extracellular) Na+ and K+ content of the rat adrenal cortex was determined with the electron microprobe. 2. Groups of rats were submitted to one of the following dietary regimens: standard, low Na+, high K+ or high Na+. 3. Distribution of Na+ and K+ across the zona glomerulosa and zona fasciculata was compared. Standards of known electrolyte concentration were also analysed. 4. The [Na+] was found to be greater in the zona glomerulosa than in the zona fasciculata but K+ was distributed evenly in both zones. This was independent of dietary regimen. 5. Aldosterone production, assessed by plasma aldosterone concentrations, could not be correlated with zona glomerulosa K+ content.

Adrenal Cortex↗

[Comparison of plasma testosterone (T), androstenedione (A) and dhea variations after métopirone in 10 normal and 12 hirsute women (author's transl)].

Plasma testosterone; androstenedione and DHA were measured by radio-immunoassay before (J1) under (J2) and 24-hour after (J3) oral metyrapone (4,5 g) in 10 normal and 12 hirsute women. Although individual values were dispersed, hirsute women, as a group, had significantly higher values at each time for each steroid. Hirsute women with normal basal T had normal T and A values for J1, J2, J3; while these with elevated basal T had elevated T and A value for all samples. Plasma DHEA was elevated in the two groups, before, under and after métopirone.

Administration, Oral↗

[Surgical treatment of loss of substance of the lower lip].

Repair of loss of substance of the lower lip has been the object of numerous studies. Each author has used his own ingenuity to describe a new type of flap aimed at restoring a particular form of loss of substance. The techniques suggested here are capable of solving a majority of problems on the basis of simple and original solutions. These flaps make it possible to resolve the problems posed by most cases of loss of substance of the lower lip. The choice of these plastic procedures permits restoration which is at one and the same time functional and anesthetic.

Dermatologic Surgical Procedures↗

[Effects of clomiphene and estrogens on circulating gonadotropins, testosterone, androstenedione, in old menopausal women (author's transl)].

The threshold of sensitivity of the gonadostat has been tested in 20 old menopausal women by clomiphene (50 or 200 mg/day for 5 days) and/or low doses of ethinyl oestradiol (EE2) (10 or 20 microgram/day). Clomiphene did not increase nor decreased serum levels of LH-FSH and testosterone (T) but increased significantly androstenedione (A) levels. Even at the lower dosage used, EE2 decreased drastically the levels of LH but less completely that of FSH. Clomiphene breaks off partially the oestrogen's blockade on FSH but not on LH. No modification was observed for T and A even after 30 days of estrogen therapy. This data shows the peculiar sensitivity of the gonadostat in advanced menopaused women. It also suggests that the gonadostat exhibits a low threshold of sensitivity analogous to that observed in late prepubertal period. Moreover, the different behaviour of LH and FSH in response to the negative feedback of oestrogens supports that an ovarian factor, distinct from estrogens and missing during menopause plays a role in the regulation of FSH.

Clomiphene↗