[Malignant multi-secretion insulinoma. A case].
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Female↗
Biomedical subjects
J F Henry
Publications and source records attributed to J F Henry.
[Osteomuscular serrato-costal free flap: application to mandibular reconstruction].
The serrato-costal free flap provides a large costal flap vascularized by a digitation of the serratus anterior muscle supplied by the dorsal thoracic artery. The flap is easy and rapid to raise with low morbidity. The repair obtained is functionally very satisfactory, but does not allow insertion of an implant. Six cases are reported. The indications of this technique of mandibular reconstruction are discussed.
Adult↗
[Current surgical aspect of primary hyperparathyroidism (100 years after F. D. Von Recklinghausen)].
The "Association Française de Chirurgie" asked to authors an update on primary hyperparathyroidism based on a retrospective multicentric study on 4883 patients operated on by 79 surgeons. Aim of this study was an update on clinical and biological aspects, localizing studies, and therapeutic aspects with their results. There were 3418 females (70%) and 1465 males (30%) mean age 53 years (9 to 91 years): 3702 solitary adenomas (75.8%), 720 multi-glandular lesions (14.7%) 92 multiple endocrine neoplasias (1.9%) and 86 carcinomas (1.8%). None lesions was found in 283 cases (5.8%). To day, diagnosis is most often made on fortuitous hypercalcemia. Localising studies showed sensibility less than 50%. Surgery was successful in 92.7%. Mortality occurred in 0.6% hypoparathyroidism in 3.8%, laryngeal palsy in 1.5% and hematomas in 0.45%. In conclusion this study shows the changes regarding the diagnosis, the uselessness of localizing studies before first cervicotomy, and the good results of surgery. Autotransplantation and cryopreservation allow reducing of hypoparathyroidism.
Adenoma↗
[Primary hyperparathyroidism. Results of a French multicenter study].
The "Association française de Chirurgie" asked to authors an update on primary hyperparathyroidism based on a retrospective multicentric study on 4883 patients operated on by 79 surgeons. Aim of this study was an update on clinic and biologic aspects, localizing studies, and therapeutic aspects with their results. There were 3418 females (70%) and 1465 males (30%) mean age 53 years (9 to 91 years): 3702 solitary adenomas (75.8%), 720 multiglandular lesions (14.7%) 92 multiple endocrine neoplasias (1.9%) and 86 carcinomas (1.8%). None lesion was found in 283 cases (5.8%). To day, diagnosis is most often made on fortuitous hypercalcemia. Localising studies showed sensibility less than 50%. Surgery was successful in 92.7%. Mortality occurred in 0.6%, hypoparathyroidism in 3.8%, laryngeal palsy in 1.5% and hematomas in 0.45%. In conclusion this study shows the changes regarding the diagnosis, the uselessness of localizing studies before first cervicotomy, and the good results of surgery. Autotransplantation and cryopreservation allow reducing of hypoparathyroidism.
Adolescent↗
[Permanent constriction of the jaw due to idiopathic bilateral hyperplasia of the coronoid process].
Bilateral hyperplasia of the coronoid processes of the mandible is not frequent and concerns most always males between the ages of 14 and 16. The restricted opening movement is caused by impingement of the process on the medial and anterior surfaces of the zygomatic arch. The diagnostic is made by a good radiography. The treatment is surgery by intraoral approach. The coronoid processes are removed on the two sides with postoperative physiotherapy. The results are good and permanent.
Adolescent↗
[Bilateral lymphoma of the adrenal glands. A rare cause of adrenal insufficiency].
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Adrenal Gland Neoplasms↗
Immunohistochemical study of thyroid peroxidase in normal, hyperplastic, and neoplastic human thyroid tissues.
An immunohistochemical study using two monoclonal antibodies (MoAb 30 and MoAb 47) against thyroid peroxidase (TPO) was performed on surgical specimens of human thyroid carcinoma (n = 65), adenoma (n = 70) and Graves' disease (n = 10). Normal adjacent thyroid tissue was used as positive control. Monoclonal antibody 30 reacted significantly with all adenoma and most carcinoma, whereas MoAb 47 reacted with 66 adenoma but only two carcinoma. Of the four adenomas that did not react with MoAb 47, three were of the fetal type. Both carcinoma reacting with MoAb 47 were of the well-differentiated follicular type. These findings further confirm the hypothesis that thyroid carcinoma is associated with changes in the quantity and antigenic properties of TPO. Although the alterations in antigenic behavior revealed by MoAb 47 are not 100% specific, they may allow more accurate diagnosis of malignancy in thyroid tumors.
Adenocarcinoma↗
Structurally intact (78-kDa) forms of maternal lactoferrin purified from urine of preterm infants fed human milk: identification of a trypsin-like proteolytic cleavage event in vivo that does not result in fragment dissociation.
Two forms of lactoferrin, an intact lactoferrin and a "nicked" but apparently intact (i.e., 78-kDa) form, have been isolated from the urine of preterm infants fed human milk. These two forms of lactoferrin, demonstrated to be entirely of maternal origin, were copurified using affinity columns of immobilized single-stranded DNA-agarose. The relative concentrations of the intact lactoferrin and the "nicked" lactoferrin were determined after denaturation and separation by reverse-phase HPLC. N-terminal sequence analyses showed that the intact 78-kDa form had lost two residues from its N terminus. The nicked 78-kDa form was composed of only two fragments; one fragment was identified as the N terminus of the N-lobe (residues 3-283). The other fragment started with Ser-284 and included the alpha-helical structures at the C terminus of the N-lobe, as well as the entire C-lobe. Although no disulfide bonds connect these two fragments, they were tightly associated in vivo and were not separated in vitro except under denaturing conditions. Limited in vitro digestion of human milk lactoferrin with trypsin produced a nicked, but stable (78-kDa), form of DNA-binding lactoferrin nearly indistinguishable from the isolated urinary lactoferrin, except for the absence of one additional arginine residue at the N terminus of the N-lobe. Residues involved in the stable molecular interaction between fragments were evaluated using data obtained from the high-resolution crystal structure of hololactoferrin. Two features, entirely within the N-lobe, account for the lack of fragment dissociation after cleavage at residue 283 in vivo: an extensive interface at the hinge region behind the iron-binding cleft and an "anchor" sequence traversing the remainder of the N-lobe at 90 degrees relative to the fragment interface. These results document the remarkably limited degradation of absorbed lactoferrin in vivo and suggest that iron-binding activity, receptor-binding properties, and postulated immune cell regulatory functions remain intact.
Amino Acid Sequence↗
Origin of intact lactoferrin and its DNA-binding fragments found in the urine of human milk-fed preterm infants. Evaluation by stable isotopic enrichment.
The origin of intact (78-kD) lactoferrin found in the urine of human milk-fed preterm infants was investigated using human milk containing proteins enriched with [13C]leucine and [15N2]lysine or [2H4]lysine. Mothers of infants selected for the study were infused i.v. with [13C] leucine and [15N2]lysine or [2H4]lysine to label milk proteins. The labeled milk was collected from each mother, pooled, fortified with a lyophilized human milk fraction, and fed to her preterm infant by continuous orogastric infusion for a period of 48 h. Urine was collected from each infant for 96 h. Intact lactoferrin (78 kD) and DNA-binding lactoferrin fragments (51 and 39 kD) were purified from the urine by affinity chromatography on columns of immobilized single-stranded DNA-agarose. The concentration and isotopic enrichment of the intact lactoferrin and DNA-binding fragments were determined separately after their isolation by high-performance reverse-phase (phenyl) chromatography. Mass spectral analyses indicated that the isotopic enrichment of the purified urinary lactoferrin was 87 to 100% of that in the labeled human milk lactoferrin. Similar results were obtained for the isolated DNA-binding lactoferrin fragments. The ratios of isotopically labeled leucine to lysine in the purified milk lactoferrins and urinary lactoferrins were similar for each mother/infant pair. Isotopically labeled lysine, added to the milk as free amino acid, was not incorporated into the purified urinary lactoferrin. These results demonstrate that undegraded (78-kD) lactoferrin of maternal origin is absorbed by the gut and excreted intact in the urine of preterm infants; nearly all of the urinary lactoferrin was of maternal origin. The possible immunoregulatory functions of the absorbed intact, maternal lactoferrin are discussed.
DNA-Binding Proteins↗
[Polycythemia secondary to primary hyperparathyroidism. Apropos of a case].
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Adult↗
[Idiopathic neuralgia of the glossopharyngeal nerve. Study of a series of 14 cases and review of the literature].
The authors report 14 cases of idiopathic glossopharyngeal neuralgias surgically treated and followed over a mean 3.5 year period. The series consisted of 7 females and 7 males, 66 years old on average. The pain was located on the left side in 13 out of the 14 cases. A trigeminal neuralgia was associated to the glossopharyngeal pain (on the same side) in 4 cases. The vertebral angiogram evidenced a megadolicho-artery in 6 cases and was considered normal in 8 cases. The surgical treatment was a percutaneous thermocoagulation of the Andersh ganglion in 3 case (the thermolesion could not be completed in one of these cases due to the onset of coronarian ischemia). A microsurgical vascular decompression was carried out 9 times, alone in 8 cases, associated with a radicotomy in one case. A mere radicotomy was performed in 2 other cases, because of no finding vascular compression. Total pain relief was achieved in the 2 cases of completed thermocoagulation and in all the 11 cases of direct approach. The thermocoagulations, as well as the radicotomies, of the IX and anterior rootlets of the X produced in each case permanent deficits in the IX and X territories, whilst the side-effects of the decompression procedure were only mild or transient. Therefore microsurgical vascular decompression is preferred by the authors everytime the age, general conditions and the patient's acceptance authorize it.
Adult↗
[Bone density after iatrogenic subclinical long-term thyrotoxicosis. Measurement by dual photon absorptiometry].
Thyrotoxicosis may be held responsible for osteoporosis. The question is whether a very slight subclinical hyperthyroidism, as is desirable in the post-operative treatment of differentiated thyroid carcinoma, can in the long run be detrimental to bone tissue. In a series of 37 patients, aged 50.9 +/- 11.1 years, presenting with the features of subclinical hyperthyroidism of 8.0 +/- 4.8 years duration, the authors have been unable to find any change in paraclinical parameters of bone and calcium-phosphate metabolism. Thirty-six of these 37 patients showed no abnormal decrease of vertebral bone density measured by dual photon absorptiometry.
Absorptiometry, Photon↗
Age-related effects of placebo and active treatment in patients beyond the age of 60 years: the need for a proper control group.
The age-related response to placebo and active antihypertensive treatment was evaluated in 742 elderly hypertensive patients who were followed in the double-blind placebo-controlled trial conducted by the European Working Party on High blood pressure in the Elderly (EWPHE). In the two treatment groups, the fall in systolic and diastolic blood pressures after 3 months was negatively correlated with age (P less than 0.02), indicating that the hypotensive effect of placebo and active treatment was more pronounced in older patients. Further comparison of the two treatment groups failed to demonstrate any statistical differences in the slopes of the hypotensive effect on age. These conclusions were not altered by cumulative adjustments for baseline blood pressure, pulse rate, serum creatinine and the presence of cardiovascular complications at entry. In conclusion, in the present study, a similar blood-pressure-lowering action which increased with age was observed on active and placebo treatment; thus, proof that an observed age-related hypotensive effect is caused by a particular drug requires comparison with a control group on placebo.
Aged↗
Structural homology of human, bovine, and porcine milk lactoferrins: evidence for shared antigenic determinants.
Although some degree of structural homology has been demonstrated among lactoferrins of different species, other reports suggest that these proteins are immunologically distinct. Human, bovine, and porcine lactoferrins were purified to homogeneity from colostral whey by affinity chromatography on immobilized single-stranded DNA. Evidence for shared antigenic determinants among human, bovine, and porcine lactoferrins was demonstrated by Ouchterlony immunodiffusion and immuno "dot" blots using whole antisera and purified Ig directed against each species of lactoferrin. There was no evidence that human transferrin was recognized by any of the lactoferrin-specific antisera evaluated. The degree of cross-reactivity between the lactoferrins and their trypsin digestion products was also evaluated after SDS-PAGE by immunoblotting. These data demonstrate that human, porcine, and bovine lactoferrins share common antigenic determinants and are likely to be more homologous in tertiary structures than suggested previously. Thus, investigations of human or bovine lactoferrin metabolism in infants that are based upon immunologic methods alone should be conducted cautiously in those cases where the presence of both human and bovine lactoferrin is suspected.
Animals↗
[Fibrous dysplasia of the jaw. Therapeutic approach apropos of 12 cases].
Twelve cases of maxillo-facial fibrous dysplasia are presented, with a brief review of the condition. Only the complete excision of the lesion allows full healing, but it is rarely feasible, even with immediate reconstruction. The surgical abstention and partial excision keep many indications, but require a regular follow-up.
Adolescent↗
Endosonography in the localization of parathyroid tumors: a preliminary study.
A preoperative transesophageal exploration of the parathyroids by endosonography was performed on 23 patients with primary hyperparathyroidism. The system used was a 7.5 MHz transducer mounted on the tip of an endoscope with an external diameter of 13 mm. The field of visualization was 360 degrees. A retrograde exploration was done moving up from the aortic arch to the upper esophageal sphincter. All patients underwent surgery afterward, and adenomas were found. In 12 cases the adenoma was visualized. All 12 adenomas were posteriorly located on the right side (four cases) and left side (eight cases) of the esophagus. Nine of these 12 tumors were on the posterior face of the thyroid lobes, with six tumors in the middle one third of the thyroid lobe and three in the lower one third of the thyroid lobe. The other three tumors were located below the lower pole of the thyroid lobes in the upper posterior mediastinum. Mean tumor weight was 1165 mg. Of the 11 tumors that could not be visualized, eight tumors were anteriorly located; three of these tumors were on the anterior and lateral surface of the lower pole of the thyroid, and five were in the thyrothymic tracts. The remaining three tumors were located on the back of the thyroid lobes; two of these tumors were at the upper esophageal sphincter, and one was on the side of the pharynx. Mean tumor size was 1334 mg. Localization of parathyroid tumors by endosonography appears possible but only if lesions are located posteriorly, close to the esophagus. Endosonography is not indicated before routine cervical exploration for primary or secondary hyperparathyroidism. As in other such studies, endosonography could be useful in cases of persistent or recurrent hyperparathyroidism.
Adenoma↗
[Obligatory parathyroid autotransplantation in thyroid surgery].
In a series of 301 bilateral thyroidectomies carried out over a 6 month period, immediate parathyroid autotransplantation was performed in 44 patients, i.e. 14.6%. Hypoparathyroidism was transient in 14 patients, i.e. 4.7% but was permanent in 4 patients, i.e. 1.3%. We attempted to determine the conditions justifying parathyroid autotransplantation during thyroidectomies. In our opinion parathyroid autotransplantation should be performed only to save a parathyroid gland accidentally removed or devascularized. It should not be used simply as a means of avoiding dissection no matter how long or tedious.
Humans↗
Reliability of clinical criteria for the diagnosis of dementia. A longitudinal multicenter study.
The reliability of the clinical diagnosis of dementia was estimated by comparing the diagnosis made at 1-year intervals on 55 consecutive subjects with suspected cognitive impairment seen at three different centers by neurologists and gerontologists. The diagnosis was based on history and clinical examination, the criteria of the Diagnostic and Statistical Manual of Mental Disorders (revised ed 3), the Modified Ischemic Score, and a computed tomographic scan. Fifty-two of 55 subjects were given the same diagnosis a year later indicating a reliability of 95%. The study shows that a diagnosis of dementia established by simple clinical criteria comparable to the NINCDS/ADRDA criteria affords sufficient reliability to allow the comparability of groups at different centers for purposes of research, including research on the evaluation of the efficacy of pharmacologic treatment.
Aged↗