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Biomedical subjects

R Roulier

Publications and source records attributed to R Roulier.

42 records · Page 3Linked to original sources

[The endocrine status in anorexia nervosa (author's transl)].

Alterations in the secretion of iodothyronines, cortisol, testosterone and growth hormone have previously been described in anorexia nervosa. We have studied prolactin and gonadotropins secretion in 23 cases of anorexia nervosa. Prolactin secretion was normal. Modifications in gonadotropins release were observed. However they could not be always related to weight loss since amenorrhea could either precede weight loss or still be present after return of the weight to normal. In all cases, FSH release after LHRH stimulation was normal. No increase in LH levels was observed after LHRH injection when the weight was 70% below the ideal weight. With increasing weight, LH release progressively recovered and normal LHRH-induced LH release was obtained when the weight was above 90% of the ideal weight. At normal weight, the ratio of LH/FSH was normal in patients menstruating less than 3 months after the test, while the ratio was low in non-menstruating females. In conclusion, when the weight was insufficient basal levels of FSH and LH and responses after LHRH stimulation corresponded to a prepuberal stage. An increase in the LH/FSH ratio and a normal LH/FSH ratio preceeded the recovery of menstruations. In about 1/3 of the cases, such an evolution was not observed without any satisfactory explanation. Other factors than weight may be involved, especially when the amenorrhea persists after weight recovery.

Anorexia Nervosa↗

[Intracytoplasmic injection and embryo quality: comparison with conventional in vitro fertilization].

We report here the results of a study comparing the quality of the embryos obtained after conventional IVF and after ICSI (respectively 872 and 459 embryos for 184 and 108 cycles). In the ICSI group, the female age was lower than in the IVF group, the oestradiol level on the day of hCG injection was higher, so that the number of retrieved oocytes and the number of mature oocytes. The policy of transfer being the same in the two groups, the mean number of transferred embryos was identical. The percentage of embryos without anucleate fragments, the percentage of embryos without irregularities, the percentage of 1, 2, 3, 4 or 5-cell embryos and the distribution of embryos in the 5 embryo scores were similar. In both IVF and ICSI groups, the transfer score (sum of the embryo scores of each transferred embryo) was higher for the patients who achieved pregnancy.

Adult↗

[Gonadotropins before and after LHRH in male infertility (259 cases) (author's transl)].

In primary hypogonadism (n=73) FSH basal levels and responses are elevated. LH basal levels and/or responses are elevated in 68 cases. In idiophatic oligospermia FSH and/or response are elevated in 28% cases, normal in 68% cases, decreased in 4% cases. LH and/or LH response are elevated in 44% cases normal in 53% cases and decreased in 4% cases. High significant correlation is found between FSH basal levels and FSH response, and between FSH and LH response.

Drug Evaluation↗

[Estimation of FSH and LH before and after stimulation with LH-RH in male sterility and hypogonadism].

Plasma levels of FSH and LH, in 232 subjects examined for sterility or hypogonadism, have been assessed vefore and after stimulation by LH RH (100 microng IV). In excretory azoospermia, the basal levels as well as the response to LH RH of FSH as well as LH are normal. In early testicular damage (constitutional or acquired); basal FSH levels are elevated (91% of the cases) as well as the FSH response to LH RH (78%); basal LH levels are either normal (66% of the cases) or elevated (34%). An augmentation of the LH response has been found in 92% of the cases. In hypogonadotrophic hypogonadism (n = 12) 3 types of responses have been noticed : absence of response of FSH and of LH (7 cases); normal FSH response, no LH response (2 cases); exaggerated FSH and LH response (2 cases). In idiopahtic oligospermia (n = 84); basal FSH levels are elevated in 24 cases but normal in the rest. There is a highly significant correlation between basal FSH and its response to LH RH injection (r = 0.73, t = 9,67 p less than 0,001); basal LH levels are normal, except in 5 cases where a definite increase has been noted. The response of LH is exaggerated in 36 cases which includes the 5 showing enhanced basal LH levels. There is a highly significant correlation between FSH response and LH response (r = 0,55; t = 5,94; p less than 0,001). Exploration of patients with varicocoele intact or operated show no difference from those suffering from idiopathic oligospermia. From a practical point of view, the LH RH test enables : a distinction between excretory azoospermia and secretory azoospermia with normal testicular volume, without recourse to testicular biopsy; affirmation, in 36% of cases with idiopathic oligospermia of the early damage to spermatogenesis, thus contra-indicating any treatment involving testicular stimulation. From the physico-pathological point of view : the early damage to spermatogenesis is characterized by an elevation in basal FSH and its response to LH RH injection. The significance of the augmented Lh response, which often accompanies an augmentation in FSH response but incertain cases is isolated, is discussed.

Adult↗

[Prostatic utricle, a rare but potentially curable cause of male sterility].

This case report describes a patient presenting a cyst of the prostatic utricule that was detected during assessment for sterility and removed surgically. A review of the pertinent literature is proposed. Azoospermia or severe oligospermia associated with a low ejaculation volume are the main manifestations. Transrectal ultrasonography is the diagnostic examination of choice. In most cases incision of the mouth of the utricule promptly abolishes sterility and enables fertilization.

Adult↗