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Biomedical subjects

J P Massin

Publications and source records attributed to J P Massin.

At least 19 recordsLinked to original sources
PubMed1986

Multifactorial study of prognostic factors in differentiated thyroid carcinoma and a re-evaluation of the importance of age.

A multivariate analysis of prognostic factors has been carried out with 375 cases of differentiated thyroid cancer (DTC) treated in the same centre by total thyroidectomy and 131I therapy. The patients have been followed for 5 to 23 years. The isolated prognostic roles of age, sex, clinical stage and histology were confirmed, but these factors were found to be strongly interrelated. Multifactorial analysis was conducted following Cox's model. It demonstrated that the prevalent role of clinical staging (nodular versus lobar or massive form) is as important as the initial presence of metastases (P = 0.0001). Histological assessment of differentiation, age and sex were of lesser importance. Thus, the most significant prognostic variable is clinical stage. These data must be taken into account when formulating management protocols for DTC.

Adolescent↗
PubMed1984

Pulmonary metastases in differentiated thyroid carcinoma. Study of 58 cases with implications for the primary tumor treatment.

Fifty-eight cases of pulmonary metastases (PM) from 831 cases of differentiated thyroid carcinoma (DTC) were studied. PM were found in about 10% of follicular and 5% of papillary tumors. 131I uptake was found in 55% of the cases, irrespective of histology. Twenty-one patients were treated by 131I only and 12 were cured. Micronodular metastases, 92% papillary, with 86% positive 131I uptake and 77% 8-year survival rate, are the most favorable forms. In others the influence of PM size/age, uptake, delay of appearance, presence of cervical or mediastinal lymph nodes is discussed. Occurrence of late PM according to treatment of the primary tumor was 1.3% thyroidectomy + 131I; 3% thyroidectomy; 5% partial thyroidectomy + 131I; 11% partial thyroidectomy only. Thus prevention in DTC of severe PM (28% 8-year survival rate) can best be achieved by complete thyroidectomy + 131I ablation dose.

Adult↗
PubMed1984

Iodine-induced thyrotoxicosis: analysis of eighty-five consecutive cases.

Iodine-induced thyrotoxicosis was documented in eighty-five cases. Eighty per cent occur in apparently normal thyroid glands; 60% among them occur in males. Amiodarone accounted for 50% of iodine-induced thyrotoxicosis. Mean thyroid hormone levels at diagnosis were: FT1: 21.7 (normal mean: 7.5, arbitrary units); T3: 4.53 nmol 1(-1) (normal: 2.30 nmol 1(-1). Mean 131I- 24-h uptake was 3.5% (normal range in France 25-45%) and was activated by exogenous TSH (mean 27%). The spontaneous cure in nontreated cases was observed within an average 6 months. A phase of biological hypothyroidism (mean FT1: 3.7, T3: 1.23 nmol 1(-1), TSH: 9.6 microU ml-1 (normal TSH range: 1-7 microU ml-1] preceded the return to euthyroidism. Intrathyroid iodine content measured by X-ray fluorescence was high, then fell gradually. Thyroid tissue study showed a large quantity of intrathyroid iodine and the overiodination of thyroglobulin. Histological and electron microscopic studies are reported. Prednisone and in some cases propylthiouracile were found to be effective.

Adolescent↗
PubMed1982

[Absorption and metabolism of labelled vitamin D3 in elderly subjects].

This study involved three adult men and six elderly individuals (3 men and 3 women). Adult subjects served as the control group. All subjects were given one dose of 10 microCi of tritiated vitamin D3 (approximately 15 IU) per os. Blood samples were taken 5 min., 1 h, 2 h, 3 h, 4 h, 6 h, 8 h, 24 h, 48 h, 72 h, 96 h, 120 h, 144 h, 168 h and 192 h after administration of vitamin D3. The concentrations of tritiated vitamin D3 and 25-hydroxyvitamin D3, its principal metabolite, were measured in each sample after extraction and purification by high performance liquid chromatography (HPLC). In addition, two adult subjects and three elderly women subjects were given an identical dose of tritiated vitamin D3 approximately 10 days following the end of the initial experience. Blood samples were collected at the times indicated above and analyzed in identical fashion. The percentage of intestinal absorption of vitamin D3 and the amount of vitamin D3 metabolized to 25-hydroxyvitamin D3 were calculated as were the time constants for vitamin D3 and 25-hydroxyvitamin D3 disappearance curves. Review of these parameters confirmed that significant individual variations exist for intestinal absorption of vitamin D3. Study results did not furnish any evidence of a decrease in 25-hydroxylation of vitamin D3, nor any increase in the rate of disappearance of vitamin D3 or 25-hydroxyvitamin D3 which might explain the very low levels of 25-hydroxyvitamin D3, often found in aged persons.

Administration, Oral↗
PubMed1979

A single tracer method for background subtraction in 197HgCl2 renal uptake measurements.

The 197HgCl2 renal uptake was measured in 70 patients in order to study the degree of the background activity and to determine the best correction method. The deduction of background activity was made: a) From a concentric perirenal region of interest with no additional correction. b) Using a double tracer technique with colloid 99mTc, subtracting consecutively the liver and spleen activity and the residual background. Comparison of the results revealed: a) The correction of background activity significantly altered the uptake estimations, and thus must include both the liver and spleen activity, and the residual background. b) The choice of a median region of interest for the residual background evaluation led to a systematic error. c) The assessment of background activity, based upon a perirenal region of interest provided a sufficiently precise and reliable correction of the total background, while avoiding the inconveniences associated with the double tracer method.

Humans↗
PubMed1977

[Scintigraphic discordances between technetium 99m and iodine 131 in the study of thyroid nodules].

Eighty thyroid nodules found to be hyperfixating, isofixating or heterogeneous after an initial scintigraphy with Technetium 99m were studied comparatively using iodine 131. Differences in the apparent activity of the nodule and the extra-nodular parenchyma were found in one third of cases. A "cold nodule" appearance, not seen with techneitum was found in 8 cases at the time of the examination using iodine. Five of these patients underwent operation, the diagnosis being a carcinoma in one.

Adenocarcinoma↗
PubMed1976

[Hyperthyroidism induced by iodine in an apparently normal thyroid gland. A new iatrogenic disease].

Iodine-induced thyrotoxicosis was reported to occur in patients with previously altered thyroid gland. Evidence is presented here from 23 cases that iodine-induced thyrotoxicosis may also occur in patients with no prior thyroid desorder and is characterized by: a) an almost undetectable 131I uptake, wich can be activated by TSH; b) a spontaneous improvement within a few weeks or months after withdrawing the high intake of iodine; c) the absence of any detectable thyroid abnormality after recovery.

Diagnosis, Differential↗
PubMed1975

Iodine-induced thyrotoxicosis in apparently normal thyroid glands.

Although iodine-induced thyrotoxicosis was reported to occur in patients with obvious underlying thyroid disorders, it is not known to occur in patients with apparently normal thyroid glands. From ten such cases evidence is presented that thyrotoxicosis: a) appeared during treatments by iodide or organic-iodine-containing drugs, in the absence of any past history of thyroid disorder; b) was accompanied by almost undetectable radioidine uptake which nevertheless could be activated by TSH; c) subsided spontaneously within a few weeks or months after stopping the high intake of iodine; d) and left, after a period of hypothyroidism, an apparently normal thyroid gland which had resumed normal size, function, uptake, and suppressibility.

Adult↗
PubMed1973

Studies on mono- and diiodohistidine. II. Congenital goitrous hypothyroidism with thyroglobulin defect and iodohistidine-rich iodoalbumin production.

Butanol-insoluble iodinated compounds in the urine of patients with congenital goiters have been generally regarded as iodopeptides. Monoiodohistidine (MIH) and diiodohistidine (DIH) were identified from the urine of four patients with congenital goitrous hypothyroidism. From radioiodine studies, 40-70% of the urinary radioactivity was in the iodide-free fraction from which about 40% was identified as MIH and DIH by crystallizations to a constant specific activity. Iodotyrosines were simultaneously identified in the urine. However the presence of an iodotyrosine-deiodinase activity was demonstrated in the two removed goiters with a normal K(m) for MIT. In vivo iodotyrosine deiodination was normal for hypothyroid subjects. No thyroglobulin was identified in the thyroids from these patients. The major iodoprotein was iodoalbumin which, after in vivo labeling, contained 84-89% of the total soluble protein radioactivity. The thyroxine content of the goiter iodoalbumins and other iodoproteins was extremely low. Iodohistidines were identified in comparable proportions in the iodoalbumin and in the other iodoproteins isolated from each goiter. The average iodohistidine content of these proteins as crystallizable MIH and DIH was in the individual cases 15 and 4% of the in vivo incorporated radioiodine. DIH was identified in all iodoprotein fractions. The mean DIH/MIH ratios from the individual cases were 1.16 and 0.35. The corresponding DIT/MIT ratios were 3.19 and 1.45, respectively. The major consequence of this thyroglobulin defect is the iodination of inappropriate proteins (mainly albumin) resulting in low yields of thyroxine and high yields of iodohistidines. Iodohistidines from the goiter iodoproteins were not deiodinated and, at least for MIH, were quantitatively excreted in the urine of these patients. From the MIH iodoalbumin content and the MIH urinary excretion, goiter iodoalbumin turnover estimates were made and, although elevated, could not maintain a normal thyroxine secretion. The urinary excretion of iodohistidines easily demonstrated by column chromatography is offered as a test for detecting this variety of congenital goiter.

Adult↗