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Biomedical subjects

L Perlemuter

Publications and source records attributed to L Perlemuter.

At least 55 records · Page 3Linked to original sources
PubMed1982

[Results of surgical treatment of Basedow's disease].

Diffuse hyperthyroidism occurred in 88 patients (82 women and 6 men), aged 14 to 74 years, and was due to Graves disease in 65 cases and heteromultinodular goiter in 23 cases. After medical preparation, the surgical procedure was subtotal thyroidectomy for Graves disease and total unilateral with partial controlateral lobectomy for heteromultinodular goiter. The immediate postoperative course was uneventful except for two transient acute episodes of thyrotoxicosis. One to eight years after surgery, 53 patients are euthyroid, 34 are hypothyroid and one has recurrent hyperthyroidism. A TRH test was done in each of the 53 euthyroid patients. Three kinds of responses were demonstrated: a normal response in 22 cases, evidencing true euthyroidism; an excessive response in 24 cases, reflecting partial compensated hypothyroidism; an insufficient response in 7 cases.

Adolescent↗
PubMed1980

[Value of high dosage propranolol and per-operative hypothermia in thyroidectomy when conventional preparatory treatment is unsuitable (author's transl)].

Five hyperthyroid patients could be prepared for surgery wit propranolol alone in daily doses of 240 to 400 mg. The drug administered for 3 to 5 days before, and 5 to 15 days after the operation. Following premedication with levopromazine, almost total thyroidectomy was performed under neuroleptanalgesia and moderate hypothermia. The immediate results were satisfactory and free from acute thyrotoxic crisis. On follow-up, 2 to 18 months after surgery 4 patients had clinically and biologically normal thyroid function, and one patient showed evidence of hypothyroidism. For the common forms of the disease the authors use the conventional preparatory treatment. However, they favour a short course of propranolol in high doses either when non-thyroid emergency operations require preliminary treatment of the patient's hyperthyroidism, or when the conventional treatment is ineffective or contra-indicated on account of haematological complications.

Adult↗
PubMed1980

[Hyperandrogenism due to adrenal enzyme deficiency: possibility of pregnancy. Five cases (author's transl)].

Five women suffering from hyperandrogenism due to adrenal enzyme deficiency, with various clinical symptoms and discovered at a more or less early stage, had a total of 7 pregnancies. 21-hydroxylase was deficient in three, and 11-beta-hydroxylase in two women. The pregnancies occured 6 months to 10 years after corticosteroid treatment was started in four cases, and after it was discontinued in a case of partial deficiency in 11-beta-hydroxylase. Four women delivered on term, two of them normally and two by caesarean section. The fifth woman delivered prematurely on the 33rd week. Two pregnancies were interrupted either spontaneously or voluntarily. None of the newborn babies (three girls and two boys) showed any abnormality. With the exception of the premature girl, their weight was normal. The oldest of the girls had a normal puberty at the age of thirteen.

Adrenal Gland Diseases↗
PubMed1979

[Thyroid nodule secondary to subacute thyroiditis. 8 cases (author's transl)].

This description of 8 cases of thyroid nodules secondary to subacute thyroiditis serves to emphasise the relative prevalence of the circumscribed forms. These nodules, variable in size, firm and painful, developed after a period of cervical discomfort and pain. A contrast between a raised or normal blood hormone level and a very low uptake of I131 was found in five cases. It was all the more valuable when there was no iodine overload. Scintigraphy showed the nodule to be cold in 6 cases, isofixing in one and hot in one case. An essential diagnostic criterion is the rapidly favourable course: 4 nodules disappeared completely, 3 regressed in less than 6 months and one persisted, justifying excision with histopathological examination since localised thyroiditis of this type may be the presenting feature of a carcinoma.

Adult↗
PubMed1979

[Primary empty sella associated with peripheral endocrine deficiency: two cases (author's transl)].

The radiological finding of a large sella turcica in long standing peripheral endocrine insufficiency (adrenocortical in one case, thyroid in the other) and the persistence of plasma ACTH and TSH levels above normal despite hormone therapy was first attributed to the consequences of reactive hypersecretion of the corresponding stimulin. The results of scanner studies in one case, and of pathological examination in the other, revealed the presence of primary empty sella syndrom.

Addison Disease↗
PubMed1979

[Thyroid hemiagenesis (single thyroid lobe). 8 cases (author's transl)].

Thyroid agenesis would appear to be a rare abnormality (50 cases, including 8 personal). In fact, it is a simple anatomical curiosity which may be found in the presence of any type of thyroid condition (simple goitre: 4 cases, thyrotoxicosis: 2 cases, cold nodule: 2 cases, as far as our own patients were concerned). Our 8 patients were all women, hemiagenesis being more commonly discovered in the female sex. In 2 patients the right lobe was absent, and the left in the other 6. In general, the abnormality affects the left lobe three times more commonly than the right. The differential diagnosis essentially lies with autonomic thyroid nodules, which are much more common, and isotope scanning provides the answer.

Adenoma↗
PubMed1979

[Foot lesions in non-insulin-dependent diabetes. A report on 25 cases (author's transl)].

Diabetic lesions in 25 patients with maturity-onset non-insulin-dependent diabetes, but with neuropathy and even other complications in spite of previous treatment, were studied. Distribution according to the duration of the diabetes and the age of the patients was comparable to that seen in insulin-dependent diabetes. The most frequent lesions are osteoporosis of the metaphysial line, interphalangeal arthrosis, and hallux valgus. A total of 7 perforating plantar ulcers were noted, and the physiopathology was similar to that described in insulin-dependent diabetes. Lowered insulin levels and the neuropathy which this produres are the major etiological factors, but foot deformities such as talipes equinus and/or flat-feet play a determining role. Treatment consists of insulin administration and avoidance of plantar pressure at the site of the lesions.

Adult↗
PubMed1976

[Results of long term use of a low dose estroprogestatif in diabetics and "high risk" women].

The authors study the long term effects (3 to 30 months) on carbohydrate metabolism of an oral contraceptive containing lowdoses of ethinyloestradiol (0.03 mg) and 0.15 mg of dnorgestrel. The study was carried out in 19 women with diabetes and/or high risk - 5 were on insulin, 6 had asymptomatic, latent or potential diabetes and 8 were obeses. In the insulin dependent group, no changes were seen in blood glucose levels. Insulin doses were the same before and during treatment. In the asymptomatic diabetes group, no modification in carbohydrate metabolism occured. Glucose tolerance tests which were abnormal before treatment became normal under treatment. This finding is discussed. In the obese group, carbohydrate tolerance remained normal during treatment. The low dose of ethinyloestradiol in this "pill" is probably responsible for the absence of diabetogenic side-effects. It would thus appear possible to use such an oral contraceptive in diabetics (overt or asymptomatic) when necessary. However the customary regular surveillance is required.

Blood Glucose↗
PubMed1975

[Assay of serum creatine phosphokinase in primary hypothyroidism. Comparison with other thyroid gland function tests in 32 cases. Value of isoenzyme studies].

Serum-creatine phosphokinase levels were measured in 32 cases of primary hypothyroidism in adults and compared with the results of other thyroid function test. C.P.K. elevation appeared to be almost completely uniform (31 out of 32 cases) and marked, reaching six times the normal value. This elevation is more marked in 18 myxoedematous patients than in 14 with those with hypothyroidism of mixed aetiology. Close correlation does not seem to exist between the elevation of C.P.K. and the lowering of serum thyroxine. The elevation of C.P.K. above the upper limits of normal seemed more constant than lengthening of the achilles reflex time, a rise in serum cholesterol, or a rise in other enzymes of muscular origin, such as the glutampopyruvic and glutamo-oxalocetic transaminases, lactodehydrogenase and hydroxybutyric dehydrogenase. In 8 cases of hypothyroidism, the isoenzymic study of serum C.P.K. by electrophoresis on cellulose acetate confirmed that the molecular structure was of the muscle type MM. The advantage of such a study shows that a structure MB found in the case of myocardial infarction in a patient with hypothyroidism deserves to be stressed.

Adolescent↗
PubMed1975

[Comparative action of carbamazepine and clofibrate in diabetes insipidus. Study of 7 cases].

A study was performed on the effects of carbamazepine and of clofibrate in 7 cases of diabetes insipidus of high origin. In 4 cases the action of the two substances used in association was studied. Carbamazepine, in a dose of 0.60 g/day was effective in all cases with negativisation of free water clearance in 5 out of 7. Clofibrate, in a dose of 1.50 g/day was effective in 4 cases out of 7 with negativation of free water clearance in 2. Both medications act by provoking the secretion of anti-diuretic hormone by the hypothalamic/posterior pituitary centres and are thus only active if a minimal secretion of ADH is still possible. There is no apparent potentialisation of the two substances, which both require a minimal possibility of ADH secretion to be active. There is no diminution in the ADH secretor effect, since both products remain active for as long as they are given, making it possible to observe in 3 out of 7 cases spontaneous cure of the diabetes insipidus, allowing suppression of the treatment.

Adolescent↗
PubMed1975

[Disorders of intra-cardiac conduction and hypothyroidism in adults. A systematic study of 42 cases].

The rate of occurrence of disturbances of intracardiac conduction in association with adult hypothyroidism is not well known. On the basis of routine study of the electrocardiograms of 42 non-treated patients, disturbances of conduction were found in almost one third. Left anterior hemiblock (6/42) and first degree atrioventricular block (5/42) are the commonest. Bifascicular involvement is rare. Neither a trifascicular lesion nor complete AV dissociation were seen. There was no evident effect of hormone therapy on conduction disturbances. Their prognosis is good but they should perhaps be taken into consideration when the indications for beta-blockers are weighed.

Adolescent↗