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Biomedical subjects

J Duprey

Publications and source records attributed to J Duprey.

At least 37 records · Page 2Linked to original sources
PubMed1986

[Prognostic value of anti-TSH receptor antibodies in Basedow's disease treated with carbimazole].

In order to precise their prognostic value, the anti-TSH receptor antibodies (TRAK) have been measured in 70 cases of Graves' disease treated with carbimazole. Results (expressed in percentage of inhibition of labeled TSH binding) were grouped into 7 mean values: before treatment, from 15 days to 3 months, from 3 to 12 months, 2nd, 3rd, 4th and 5th years. For all cases together, a progressive decrease was observed: 40, 37, 29, 19, 14, 10, 7 p. 100. In 16 cases with good outcome, the mean values are significantly lower than those of 29 cases with bad outcome, respectively: 33 vs 46, 29 vs 43, 17 vs 30, 12 vs 27, 11 vs 22, 3 vs 15, 1 vs 11 p. 100. The TRAK titers at whatever t time are correlated to the clinical state at t + 2 years: about 30 p. 100 relapses if the TRAK titer is less than 10 p. 100; about 80 p. 100 relapses if it is 80 p. 100. So, the anti-TSH receptor antibodies have their place among the prognostic parameters of Graves' disease treated with carbimazole.

Antibodies↗
PubMed1985

[Malignant pheochromocytoma. A case].

A case of malignant phaeochromocytoma is reported. The primary tumour was removed in 1970. Metastases were diagnosed in 1979 and management of the condition included antihypertensive treatment with alphamethylparatyrosine, antitumoral chemotherapy and surgical reduction of secreting tissue. In these rare tumours malignancy can only be confirmed by metastases, i.e. presence of chromaffin cells in loci where they are not usually found. Histology is of little value. High levels of catecholamine precursors or their metabolites in the urine may be a sign of malignancy, but some asymptomatic tumours are only revealed by metastases. Computerized tomography and radioisotope scanning with I131 metaiodobenzylguanidine are the best available methods to locate the lesions. In view of the small number of cases and of the unpredictable course (sometimes spread over many years) of malignant phaeochromocytomas, the effectiveness of treatments with alphamethylparatyrosine, chemotherapy and radiotherapy is difficult to evaluate.

Adrenal Gland Neoplasms↗
PubMed1985

[Glucose intolerance and post-stimulatory hypoglycemia secondary to a probably congenital intrahepatic portacaval anastomosis].

Recurrent malaise in a 63 year old woman were found to be due to hypoglycaemic episodes. During a 5 hour oral glucose tolerance test, the "impaired glucose tolerance" type initial hyperglycaemic wave was followed by a post-stimulative hypoglycaemia. Serum C-peptide levels were normal during the test, but the insulin response which was initially normal became excessive, with a consequent decrease of the C-peptide/insulin ratio, similar to that usually observed in hepatic malfunction. An hepatic ultrasonography, a cavography and a selective superior mesenteric arteriography showed an intra-hepatic porto-caval anastomosis, probably congenital in origin. This vascular abnormality accounts for the blood glucose problems: the porto-caval shunt explains the early hyperglycaemia by defective liver uptake of glucose and secondary hyperinsulinism occurs because of the reduced hepatic degradation of the insulin secreted in normal quantity. The late hyperinsulinism then leads to secondary hypoglycaemia.

Blood Glucose↗
PubMed1984

[Congenital intrahepatic portacaval anastomosis: analysis of manifested glucose abnormalities].

The authors report a case of a high-flow intrahepatic portacaval shunt due to a congenital venous abnormality. Suspected by digestive echography, the abnormality was confirmed by angiography. A precise analysis of glycoregulation showed an "impaired glucose tolerance", followed by post-stimulative hypoglycemia with persistant hyperinsulinemia and lowering of the C peptide/insulin ratio. These abnormalities seem to be related to the shunt only. This observation appears as an experimental model permitting the appreciation of the disturbances in glucose metabolism related to an intrahepatic shunt without any hepatic cell disorder.

Blood Glucose↗
PubMed1981

[Location of an insulinoma by transhepatic phlebography with staged insulin assays (author's transl)].

Insulinoma was easily diagnosed in a 73-year-old woman who had organic hypoglycaemia associated with hyperinsulinism, but the tumour could not be located by echotomography and computerized tomography. The state of the patient's arteries precluded arteriography. Pancreatic phlebography was carried out by the portal transhepatic route and blood was collected at different levels for plasma insulin assays. A very high gradient at the pancreatic isthmus indicated the site of the tumour, which was found on surgery to be precisely there and could be enucleated. This technique cannot be used systematically to locate insulinomas, but it is unquestionably helpful when the tumour cannot be located by other methods or when these are contra-indicated.

Adenoma, Islet Cell↗
PubMed1980

[Morphology of adipose tissue. Study in 102 obese subjects in reference to some clinical and biological criteria (author's transl)].

In spite of the methodological reserves that the measure of adipocyte volume and the calculation of the number of adipocytes evoke, it appeared interesting to us to study these parameters in a group of 102 obese subjects in reference to some clinical and biological criteria. The following conclusions come out of this study. The greater the obesity, the greater the adipocyte volume. There is a positive correlation between the importance of obesity and cellularity of the adipose tissue. However, this correlation is no longer found for the most obese patients, in whom adipocyte hypertrophy intervenes but no longer the multiplication of the fat cells. The onset of obesity at adolescence pairs with a number of adipocytes higher than in the other chronological forms: obesity appearing at adolescence would be thus more frequently hyperplastic. This characteristic is not discovered in the cases of obesity appearing in infancy. No relation was found between the existence of impaired glucose tolerance and mean adipocyte diameter and/or the number of adipocytes. It has been the same for the cases of hyperlipidemia.

Adipose Tissue↗
PubMed1980

[Microangiopathy of the diabetic type, without carbohydrate intolerance (author's transl)].

Pathophysiology of diabetic microangiopathy is unclear, but hyperglycemia is admitted as an important factor. In three patients having microangiopathy with lesions very similar to those of diabetes (one nodular glomerulosclerosis, two retinopathies), glucose tolerance was found normal. Such cases, already reported, but rather rare, raise the question of the validity of tests currently used in the diagnosis of diabetes, of the importance of hyperglycemia compared to others factors (specially genetic) in the occurrence of microangiopathy, and of the specificity of these lesions.

Aged↗
PubMed1979

[Platelet functions in diabetes with angiopathy (author's transl)].

Platelet functions studied in 163 unselected diabetics compared with 163 controls had the following characteristics: hyperagregation induced by ADP (1.2 muM and 0.6 muM), delayed platelet disagregation (ADP: 0.6 muM), normal agregation in the presence of collagen and thrombin. Platelet hyperagregation induced by ADP was marked in both sexes in cases of retinopathy and in women after the age of 50. By contrast, no correlation was demonstrated between the degree of hyperagregation and age, weight, the duration of diabetes, blood glucose control, lipid profile, vascular complications other than retinopathy and the nature of treatment.

Adenosine Diphosphate↗
PubMed1979

[Mechanisms of spontaneous hypoglycaemia in the adult (author's transl)].

Hypoglycaemia increases hepatic glucose output; insulin release is suppressed and the secretion of counter regulatory hormones enhanced. Catecholamines and glucagon seem to play a major role. The brain energy content is initially preserved, but the neuronal activity exhibits a 40-60 % decrease. Neither cerebral blood flow, nor oxygen consumption are altered. In addition to glucose, other substrates are metabolized. Cerebral edema may occur. An insulin-storage defect seems to be the main abnormality in insulinoma beta cell function. The most accurate biological tests are the insulin/glucose ratio, stimulation tests and suppression tests such as fasting and insulin-induced hypoglycaemia. Ectopic release of ACTH, HCG, HLP, glucagon or gastrin, is observed in some malignant insulinomas. When inconclusive, classic localising procedures may be effected by selective venous-blood sampling. Hypoglycaemia of extra-pancreatic tumors results from glucose hyperconsumption and decreases in glucose hepatic output, lipolysis and ketogenesis, related to secretion of insulin-like peptides NSILAs or NSILAp. Rare cases of hypoglycaemia related to insulin auto-antibodies of unknown origin have been reported. Alcoholic hypoglycemia results from diminished hepatic glycogen content, alcohol dehydrogenase pathway blockade, reduction of gluconeogenesis defect in the alcohol catabolic catalase pathway and enhancement of peripheral glucose consumption.

Adenoma, Islet Cell↗
PubMed1979

[Does the insulin-secretion capacity of non-diabetic subjects possess a prognostic value? (author's transl)].

Twenty-two patients, whose initial oral glucose tolerance test (OGTT) was not diabetic, but who possibly had predisposition for diabetes, underwent iterative OGTT with plasma insulin determination and estimate of insulin-secretion capacity (plasma insulin area/blood glucose area ratio, and insulin-secretion coefficient). With a 30 months mean time interval between the two tests, a highly significant negative correlation was found between insulin-secretion capacity of the first test and blood glucose area of the last one. Glycemic curve of the OGTT was diabetic in 3 cases at the final test. Thus, it seems possible to select subjects most prone to future diabetes with simple parameters estimating insulin-secretion capacity during OGTT.

Adolescent↗
PubMed1979

[The provoked-hyperglycemia test. Follow-up after two years of 94 cases with doubtful results (author's transl)].

A retrospective study of 94 patients, who had had doubtful results in the oral provoked-hyperglycemia test, was made after an average period of 23 months. It was found that 26 patients were diabetic, 34 were normal and 34 were still doubtful. The factors which influence the evolution of these cases are the sex, a family history of diabetes (before 60 years of age), and the return to normal weight of obese patients.

Adolescent↗
PubMed1976

Relationship between plasma insulin, the size and number of adpocytes and habitual calory intake in a group of 186 obese women.

In a group of 186 obese women, no correlation was found between post-glucose load insulinemia, measured at 13:00 hrs, and the degree of overweight, nor between post-glucose insulinemia and mean adipocyte diameter. Significant correlations were found between post-glucose insulinemia and daily caloric intake, and between post-protein insulinemia and mean adipocyte diameter. Post-glucose and post-protein load insulinemia were interrelated.

Adipose Tissue↗