Biomedical subjects
Publications and source records attributed to T Coste.
We report a patient with angio-immunoblastic lymphadenopathy (A.I.L.) with pulmonary localisation. The symptomatology of the A.I.L. was dominated by a polyclonal increase in gammaglobulins and a neuropathy 35 months before the generalized lymphadenopathy. We discuss this unusually long prodromal period and the nature of the neuropathy.
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A study was made of the daily elimination of fetal neutral sterols in 22 healthy subjects and the average proportions of the main sterols were established. These were cholesterol (9.5%), its main bacterial transformation products: coprostanol (65%) and coprostanone (less than 6%), cholestanol (less than 2%), delta7-cholestenol (less than 2%) and phytosterols (18%). Epicoprostanol, which indicates a secondary mean of bacterial degradation of cholesterol has been searched for systematically. In general, traces only are present but in one case it amounts to more than 8% of the neutral sterols. The bulk of neutral sterols eliminated daily is very variable for different subjects and also for a same subject, although the concentration of fecal sterols is relatively constant (6.37 +/- 0.36 mg of sterols/g of feces). For a given subject under controlled diet conditions, differences in fecal elimination of sterols can essentially be ascribed to irregularity of digestive transit.
The hypothalamo-pituitary gonadal function was evaluated in eleven chronically alcoholic menopausal women by measurement of basal serum oestradiol, FSH, LH and prolactin, followed by LHRH-TRH test and administration of clomiphene citrate. All patients had hepatic damage, fibrosteatosis or cirrhosis. Two subgroups have been isolated according to urinary and serum estrogen levels: seven patients with urinary estrogen output less than 14 microgram per 24 h and plasma oestradiol less than 40 pg per ml were considered as post menopausal women: basal values of FSH and LH and their response to LHRH did not differ from that observed in normal menopausal women; clomiphene citrate induced a significant suppression of FSH and LH blood levels. Four women with urinary estrogen output greater than 14 microgram per 24 h and plasma oestradiol greater than 40 pg per ml were considered in menopausal transition. Their basal and post LHRH-FSH blood levels were lower than in the control group. These results suggest a normal hypothalamo-pituitary-gonadal axis at least in the post menopausal alcoholic women.
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The isotopic dilution method, which permits the in vivo measurements of the rates of the processes involved in cholesterol turnover, has been applied to rats fed a commercial stock diet or a basal semipurified diet in which either the nature and proportions of the source of dietary fiber or the salt mixture were changed. The cholesterolemia was about 100 mg/100 g in rats fed agar-agar, cellulose, bran or the stock diet. Pectin addition (5%) lowered significantly the plasma concentration of cholesterol (70 mg/100 g). Changes in the source of dietary fiber or salt mixture have moderate effects on the absorption coefficient of dietary cholesterol (range 58.2%-82%). In comparison to agar-agar, cellulose at 2.3% in the diet significantly lowered this coefficient, but larger amounts of cellulose (6.8% or 12.3%), or pectin (5%) were without effect, while bran addition (10%) tended to slightly decrease cholesterol absorption. Hence, high levels of cellulose in the diet increased the absorption coefficient in comparison to a low cellulose diet. A decrease of this coefficient was also observed when the calcium content of the diet was increased. Cholesterol biosynthesis and fecal excretion were inversely correlated to the absorption coefficient of dietary cholesterol in rats fed all of the semipurified diets indicating, as previously shown, that the intestine was the major source of biosynthesized cholesterol diverted into the plasma. However, feeding a commercial stock diet greatly increased the cholesterogenesis and the fecal elimination of bile acids, suggesting a high hepatic cholesterogenesis.
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The authors report a case of major acanthocytosis which regressed spontaneously in a cirrhotic patient. The usual lipid abnormalities: considerable rise in free red cell cholesterol and lesser rise in phospholipid, regressed concommitantly to the disappearance of acanthocytes. No change in the main liver function tests was, however, observed. The etiological mechanisms of acanthocytosis in cirrhosis are probably multiple, and their interactions are compplex. The exchange of abnormal lipoproteins between the plasma and the red cell membrane is the last theory to be considered. On the other hand, no argument could explain the disappearance of the acanthocytosis, this phenomenon is considered up to now irreversible and a sign of the gravity of hepatic lesions.
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