[Hormonal influences in testicular tumors].
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Biomedical subjects
Publications and source records attributed to L Moreau.
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An immuno-enzymatic assay of serum ferritin was performed in subjects over 70 years of age. Wide variations in serum ferritin levels were demonstrated in the non-anemic group (17-510 ng/ml). This makes interpretation of results very difficult. In anemic patients a negative correlation was found between serum ferritin levels and TIBC (Total Iron Binding Capacity). When TIBC is under 42 mumol/l or above 63 mumol/l the two values are so closely correlated that serum ferritin assay does not provide any additional information for the diagnosis of anemia. On the contrary when TIBC is between 42 and 63 mumol/l serum ferritin can allow an estimation of tissue iron storage particularly in absolute iron deficiencies.
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A 32-month-old female with a unique interstitial deletion of 13q is presented, including cytogenetic and gene marker studies. The deleted 13 in the patient is a result of malsegregation of a maternal insertional translocation involving chromosomes 7 and 13, 46,XX,ins(7;13)(q22;q32q34). The demonstration of two esterase D alleles in this patient excludes band 13q33 as the site of the ESD locus, previously assigned to the distal long arm of chromosome 13. The BUdR dye studies reveal that the replicative pattern for 13q31 and 13q21 is not altered by deletion of 13q33 and permit precise delineation of the breakpoints of the rearrangement.
The authors report 4 personal cases, and analyse 18 cases of anterior pituitary insufficiency in the elderly found in the world literature. The initial symptoms are not specific and are difficult to interpret. They are frequently attributed to physiological ageing. In the absence of early diagnois, the patient may become comatose, this coma is often irreversible in spite of hormone treatment. In 60% of cases, the cause of the pituitary failure was not found. In the onset of the latter, the role of ageing on pituitary function, the responsibility of circulatory failure between the hypothalamus and the pituitary and, finally, the existence of auto-immune mechanisms are then discussed.
The authors report two cases of polycystic liver andkidney in two women. They were unusual in that the liver first gave risr to symptoms and the renal lesions were completely latent. Both hepatic and renal lesions were well tolerated in spite of hepatomegally. They emphasize the interest of laparoscopy and biopsy of the liver under direct vision, and selective aortography, in the diagnosis. They discuss the basic differences between polycystic liver and kidney in adults, from that in children ornewborn, and caroli's disease. Finally, they emphasize the usually poor prognosis dominated by progressive renal failure which should guide treatment. The latter depends on periodic supervision of the patient for the disease usually evolves slowly. Treatment should therefore be conservative. Tn some cases, however, renal transplantaton should be considered before irreversible renal failure in young subjects, at an age when it is still possible. On the other hand, the liver lesions do not require any radical treatment, unless there is intercurrent infection or pressure on neighbouringorgans.
The authors report the case of a young woman with acute miliary appearance of the lung with asphyxia, from which she rapidly recovered. No cause was demonstrated; this illustrates the difficulty in diagnosis of this disease. Contact with a bird, led the authors to consider exogenous, allergic granulomatosis, but immunological examinations did not confirm this. Apart from tuberculosis, almost 50 different pathogenic organisms may cause acute respiratory failure associated with a miliary or reticulo-nodular appearance of the lung. The main methods of diagnosis are discussed in relation to the most commonly observed causes in France.
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