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Biomedical subjects

S Arlot

Publications and source records attributed to S Arlot.

31 records · Page 2Linked to original sources
PubMed1985

[Intrasellar carotid aneurysm simulating prolactin adenoma].

A 52-year-old woman with secondary amenorrhea presented with ophthalmoplegia, subarachnoidal bleeding. Pituitary function tests showed mild hyperprolactinemia and deficiencies of other functions of adenohypophysis. X-ray films of the skull showed enlarged sella turcica, and CT scan was interpreted as demonstrating pituitary tumour. Carotid arteriography led to diagnosis of intrasellar aneurysm of the right internal carotid, without any pituitary tumour. After embolisation of the aneurysm, followed, by a temporo-sylvian anastomosis, endocrine functions did not improve. The mechanism of hyperprolactinemia is discussed, probably due to pituitary ischemia. This case provides evidence of interest of further investigations before a transsphenoidal surgery in pituitary tumours, in particular if subarachnoidal bleeding occurs.

Adenoma↗
PubMed1985

[Insulinoma: critical study of methods of localization and strategy].

In patients with proven hyperinsulinism, localization of the underlying insulinoma may be difficult. The localization diagnosis may be performed preoperatively using different procedures, such as ultrasonography, computed tomography, selective arteriography of the pancreatic vessels and percutaneous transhepatic blood sampling in the portal venous system. At operation, insulinomas may be detected by inspection and bidigital palpation, pancreatico-sonography and rapid determination of insulin concentration after sampling of blood in pancreatic veins. By discussing the advantages and disadvantages of each localization procedure, the authors propose a strategy fort the detection of pancreatic insulinomas.

Adenoma, Islet Cell↗
PubMed1985

[Pathogenesis of diabetic neuropathies].

There are two types of diabetic neuropathy: on the one hand, mononeuritis and, on the other hand, the symmetric polyneuropathy with a glove and stocking distribution and autonomic polyneuropathy. Mononeuritis (or mononeuritis multiplex) seems to be the result of ischaemia due to intrinsic or extrinsic (altered coagulability) vascular disease. Polyneuropathy is probably due to metabolic factors related to chronic hyperglycaemia: abnormal nerve energy metabolism, impaired axonal transport, increased activity of the sorbitol pathway, non-enzymatic nerve protein glucosylation and abnormal myo-inositol metabolism. The respective roles of these different factors in the pathogenesis of polyneuropathy are discussed.

Animals↗
PubMed1985

[Primary empty sella turcica. Analysis of 14 cases and review of the literature].

14 patients (13 women, 1 man) presenting with primary empty sella had endocrinologic and radiological investigations. 8 women are obese, 5 multiparous. Initially, headaches have needed a radiological study of sella turcica in 8 cases (57%). Pneumoencephalography and/or CT scan have led to diagnosis; but in 3 cases, a suspected associated pituitary adenoma justified a surgical exploration. In one case, a GH-secreting microadenoma was found, in both other cases histologic studies revealed fibrous or normal pituitary. Endocrine findings were normal, regarding to gonadotrophs, corticotrophs and thyreotrophs. GH was blunted in four cases, below 5 ng/ml during insulin tolerance test. In 9 cases, GH rose to 19,51 +/- 10,03 ng/ml (mean +/- S.D.). In 13 patients, serum prolactin was normal: 7,1 +/- 3,9 ng/ml (normal values 2 -20 ng/ml), elevated in the last case: 112,5 ng/ml. One year later, two patients did not show any modification on clinical, radiological or endocrine data. Physiopathology of intrasellar arachnoidocele is discussed: intrasellar extension of subarachnoid space may be due to diaphragm insufficiency and disturbances of dynamics of cerebrospinal fluid, flattening the otherwise normal pituitary gland.

Adult↗
PubMed1984

[Blood glucose self-monitoring: visual or automated read-out? Comparative study of 6 methods of blood glucose determination by reactive strips].

Home blood glucose monitoring is becoming increasingly popular in diabetic patients. The purpose of this work was to determine the accuracy of this technique. We have compared plasma glucose obtained in the laboratory and two reagent strips (Dextrostix and Haemoglukotest 20-800). No differences were found among visually-read values and meter-read values using either Dextrometer, Glukometer, Hypocount or Glucochek. Thus, visually-read strips seem to be sufficient for clinical purposes with best results for HGT. The performances of different meters are similar. Nevertheless must patients favoured the use of a meter because of the apparent "objectivity" of the values. Furthermore, meters provide to patients a better involvement in the management of their disease.

Automation↗
PubMed1982

[Effect of cyproterone acetate on the 3 alpha-hydroxysteroid-dehydrogenase activity of cutaneous fibroblasts in culture].

In men, parallel variations in urinary 3 alpha 5 alpha androstane 17 beta diol with the amount of sex skin fibroblast DHT receptors rise the question of a relationship of 3 ketosteroid reductase activity and specific DHT binding. To test this hypothesis, we measured 3 alpha 5 alpha androstane 17 beta diol biosynthesis in cultured sex skin fibroblasts, in the presence of high amounts of cyproterone acetate which competes with DHT for its receptor: when 95% of DHT is displaced by cyproterone acetate, the 3 keto steroid reductase activity remains unchanged. These results suggest that the relationship of 3-keto-steroid reductase activity and androgen receptors is unlikely.

Animals↗
PubMedDate not supplied

[Male pseudohermaphroditism caused by partial insensitivity to androgens. Clinical and biochemical heterogeneity].

Male pseudohermaphroditism due to partial androgen insensitivity (PAI) may be suspected clinically in case of incomplete masculinization of external genitalia in spite of age related plasma androgen levels. In 25 children or adolescents in whom PAI was suspected, the 5 alpha-reductase activity of external genitalia fibroblasts, the number of androgen receptor sites (Bmax) and the affinity of receptors for dihydrotestosterone (Kd) were studied. Clinical expression of PAI is highly polymorphic (Prader's type I to type IV), when most children (18/25) were considered as males. In a single patient the very low 5 alpha-reductase activity permitted the diagnosis of 5 alpha-reductase deficiency. The number of receptor sites (fmoles/mg DNA) varied from 0 to 730. Mean Bmax of patients (282 +/- 187 fmoles/mg DNA) was statistically lower than that of normal subjects (642 +/- 220 fmoles/mg DNA), p less than 0.05. The 5 cases in whom receptor concentrations were normal may be related to a qualitative abnormality of the androgen receptor or to a "post-receptor" defect. On the contrary no significant differences in Kd values were found. Correlation between sexual ambiguity and the number of measured receptors was not possible. These results emphasize the clinical and biochemical heterogeneity of PAI. Nevertheless, the decrease in number of androgen receptor sites remains the major data for the biochemical diagnosis of PAI. Study of post-receptor "markers" (3 alpha-reductase activity, aromatase, collagen) might allow better analysis of cases with PAI in whom androgen receptor concentrations are normal.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗
PubMedDate not supplied

[Contraception in diabetic women].

The choice of a contraceptive method for diabetic women must take into account metabolic and vascular risks. Combined oestrogen-progestogen contraception is not contra-indicated in insulin-dependent diabetes but requires close supervision. Progestogens alone for nulliparous women and mechanical devices for multiparous women appear to be preferable. Oral contraceptives have a more limited use in insulin-independent overt or chemical diabetes. In such patients combined oestrogen-progestogen contraception is absolutely contra-indicated and progestogens should be given under strict metabolic monitoring. The potential risks incurred by these women already liable to vascular and metabolic complications make male contraception even more desirable.

Adult↗