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Biomedical subjects

V Rohmer

Publications and source records attributed to V Rohmer.

At least 91 records · Page 5Linked to original sources
PubMed1988

[Primary lymphoma of the thyroid gland. Diagnostic and therapeutic discussion. Apropos of 4 cases].

Non Hodgkin lymphomas (NHL) of the thyroid are rather uncommon and account for about 7.7 p.100 of the tumours of the gland. They are remarkable by their usual occurrence in patients with Hashimoto's disease and by controversy about their therapy. The clinical features and the course of four additional cases occurring in four female patients (ages ranged from 61 to 73 years) are reported. The clinical picture was that of a quickly growing diffuse or multinodular goiter, squeezing surrounding neck structures. Antithyroid antibodies were present in 3 cases; microscopical examination showed cytologic features of lymphocytic thyroiditis. Two patients died within a few months, the follow-up is about two years for the others. Two main problems are discussed. First, NHL of the thyroid usually occurs in patients with Hashimoto's disease: how to confidently recognize lymphomas by fine needle biopsy in such cases? Second, which is the best treatment? The authors think that lymphomas of the thyroid have to be considered rather as lymphomas than thyroid tumours. Therefore the cure of the disease may need chemotherapy, in some cases associated with radiotherapy according to careful staging and grading in each case.

Aged↗
PubMed1987

Angiotensin I-converting enzyme in a suprasellar germinoma.

High levels of angiotensin I-converting enzyme (ACE) were found by both direct radioimmunoassay and enzyme activity evaluation in a patient's plasma that had suprasellar germinoma. ACE levels returned to normal values after surgery, suggesting the tumor was the cause of the elevated plasma ACE. ACE was found in the tumor, and ACE activity was measured in a tumor extract. With the use of specific antihuman ACE antibodies, ACE was localized by immunohistochemistry in the tumoral germinal cells. Because ACE was also found in testicular germinomas, it appears to be a possible marker for germ cell tumors.

Aged↗
PubMed1986

[Plasma noradrenaline in hyperthyroidism and hypothyroidism].

Plasma noradrenaline concentrations (NA) were measured in 11 hypothyroid patients, 24 hypothyroid patients and 30 normal subjects after 30 minutes of supine rest and after 5 minutes of standing. Observed noradrenaline levels, after rest as well as after standing, were significantly higher in hypothyroid patients (NA rest = 0.66 +/- 0.35 microgram/l, NA standing = 1.26 +/- 0.70 micrograms/l) and significantly lower in hyperthyroid patients (NA rest = 0.22 +/- 0.13 micrograms/l, NA standing = 0.37 +/- 0.20 microgram/l) than in normal subjects (NA rest = 0.32 +/- 0.13 microgram/l, NA standing = 0.55 +/- 0.20 microgram/l). The increase in noradrenaline with standing, when expressed in percent, was similar for the three groups studied (about 100%). These results suggest that a sympathetic nervous system adaptation occurs in hyperthyroidism and hypothyroidism as a compensatory phenomenon to the direct effect of thyroid hormones on the heart.

Adult↗
PubMed1986

Presence of renin, angiotensinogen, and converting enzyme in human pituitary lactotroph cells and prolactin adenomas.

Renin, angiotensinogen, and converting enzyme were detected in 10 normal human pituitary glands by immunohistochemical techniques. Renin was stained by polyclonal and monoclonal antibodies directed against human renin, and an antibody directed against the renin prosegment revealed the presence of prorenin. Immunoreactive angiotensinogen and angiotensin I-converting enzyme were found in the same cells as renin. Using serial sections and double immunohistochemical labeling with a PRL antiserum, all of the proteins of the renin-angiotensin system appeared to be localized within the lactotroph cells, and no component of the renin system was detected in any of the other pituitary cells. Renin, angiotensinogen, and angiotensin I-converting enzyme also were found in 6 PRL-secreting adenomas as well as in a mixed PRL/GH-secreting adenoma. The renin content of a PRL adenoma was about 1/100th that of a normal kidney. Renin activity could be blocked by an anticatalytic human renin antibody. No renin, angioten-sinogen, or angiotensin I-converting enzyme was found in 6 GH-secreting adenomas, 1 corticotroph adenoma, or 10 nonsecreting pituitary adenomas. The colocalization of proteins of the renin-angiotensin system suggests production of angiotensin II within the lactotroph cells and favors the hypothesis of a paracrine action of this peptide.

Adenoma↗
PubMed1986

[Non-tumor-related hirsutism in the adult woman: ovarian dystrophy or disorders of adrenal gland hormonogenesis?].

As Yen admits, polycystic ovarian disease (POD) probably has several causes, one of which involves an adrenal origin. In 20 out of a group of 45 hirsute women, the authors detected a biologic pattern suggesting ovarian dystrophy. Kinetic investigation of the adrenal function in these subjects during a synacthen retard test detected abnormal adrenal hormone production due to partial enzymatic block: in 3 cases of 21-hydroxylase, in 1 case of 11-hydroxylase and in 3 cases of 3 beta-hydroxydehydrogenase. The existence of the first two types of blockade is well established, but that of the third type remains subject to doubt. Systematic screening for disorders of this type during ovarian dystrophy would appear to be of clinical interest. The frequently empirical prescription of dexamethasone in dysovulation in POD cases may find its justification in this phenomenon; the same is also true for the use of bromocriptine in 3 beta-hydroxydehydrogenase.

Adrenal Gland Diseases↗
PubMed1984

[Assay of the free fraction of thyroxine. Its role in the study of thyroid function].

In a prospective study of 467 subjects with normal, increased or decreased thyroid function the results of free thyroxine (FT4) assays by 2 radioimmunological methods were compared with the free thyroxine index (FT1) and the T4/TBG ratio. It appeared from this study that FT4 assays were at least as good as the FT1 to confirm the diagnosis of euthyroidism and were distinctly superior to measurements of FT1, T4 adn T3 in patients with abnormal thyroid function. In view of the close correlation observed between clinical findings and the results of FT4 assays, a new strategy may be proposed to investigate thyroid function. However, further studies are required to evaluate the reliability of FT4 assays in some severe pathological conditions or in patients taking drugs interfering with thyroid hormone metabolism.

Humans↗
PubMed1984

[Fruste form of hyperthyroidism manifested by auricular arrhythmia. Importance of the assay of the free fraction of thyroxine (FT4) and the role of the TRH test].

The TRH test was used to detect hyperthyroidism in 87 patients aged from 38 to 85 years who presented with atrial arrhythmia with or without heart disease. The patients had no clinical evidence of thyrotoxicosis, and total thyroxine (T4), free thyroxine index (FTI) and triiodothyronine (T3) values were normal. Hyperthyroidism was diagnosed in the 18 patients (21%) with negative TRH test; 15 of them had high free thyroxine (FT4) levels. The most common causes of hyperthyroidism were "warm" nodules in 7 and iodine overload in 10. Adding an anti-thyroid treatment to the hitherto unsuccessful anti-arrhythmic treatment resulted in a return to sustained sinus rhythm in 50% of cases. FT4 levels became normal in all. This study indicates that all patients with atrial arrhythmia, with or without heart disease, should be investigated for occult hyperthyroidism. It also demonstrates the value of FT4 assays to detect the disease. The TRH test is only required as a second-line exploratory method in some patients, notably those with iodine overload.

Adult↗
PubMed1982

[Anti-tumorous effect of bromocriptine in prolactin-secreting adenomas. A case-report (author's transl)].

Bromocriptine inhibits prolactin release. An increasing number of observations, including the one reported in this paper, provide evidence that bromocriptine can also cause significant reduction in the size of prolactin-secreting adenomas. This effect can now be easily demonstrated by CT scanning. Bromocriptine can be used, not only after surgery has failed, but also in order to facilitate the surgical procedure, thereby increasing the surgical success rate. Some authors suggest that prolactin-secreting adenomas be treated with bromocriptine only. Several questions remain open, for instance, why the response to bromocriptine is unpredictable, and whether prolonged therapy with a dopaminergic drug whose effect is not restrained to hypophyseal cells will have adverse side-effects.

Adenoma↗
PubMed1982

[Cutaneous alternariosis revealing Cushing's disease. A case with ultrastructural study].

This case concerned a 67 old farmer who presented a vegetating and crusted tumor of the right knee. Histological examination revealed intracellular round structures PAS + within an inflammatory dermal granuloma, including epithelioid and giant cells. Alternaria could be isolated on cultures from biopsies of the tumor. Ultrastructural study specifies the morphological aspects of Alternaria within dermal granuloma; furthermore, large numerous myelinic bodies were present within the parasitic cells. The clinical aspect of the patient led to hormonal explorations and a Cushing's disease yet unrecognized was ascertained, that probably represented the "special terrain" which made the growth of Alternaria possible. The survey of the available literature revealed two cases of alternariosis and Cushing's syndrome, but in these two cases the diagnosis of the endocrinopathy was already established when the cutaneous infection developed. The lesion cleared within a month after electrocoagulation, local iodine compound and griseofulvine per os, with nonrelapse 12 months after.

Aged↗
PubMed1981

[Tumoral development of prolactin-secreting pituitary adenomas during pregnancy. Therapeutic approaches (author's transl)].

During pregnancy the volume of prolactin-secreting pituitary adenomas tends to increase dangerously for surrounding structures, especially the optic chiasma. When rapid growth occurs, at least three therapeutic approaches are possible: resection of the adenoma, temporization under monitoring and administration of bromocriptine. The latter treatment, which seems to be of particular value, was applied to a female patient and was followed by prompt regression of optic chiasma compression. However, as bromocriptine was given concurrently with chlormadinone acetate, this excellent result cannot be ascribed to bromocriptine alone.

Adenoma↗
PubMed1980

[Pituitary insufficiency and auto-immunity (author's transl)].

An indirect immunofluorescence study of the serum of 37 patients with anterior pituitary disease suggested that in a number of them an auto-immune process intervened in the pathogenesis of the condition. Seven sera reacted positively to human pituitary gland and 15 to rat pituitary gland. Auto-antibodies directed specifically against one or several types of pituitary cells seem to be more frequent in pituitary insufficiencies involving one or two hormones. These are more readily detectable when rat pituitary glands are used, and only by this technique can auto-antibodies directed against ACTH-secreting cells be detected.

Animals↗
PubMed1979

[Variations in urinary antidiuretic hormone levels related to sodium intake (author's transl)].

Eighteen healthy male subjects, were investigated under normal sodium intake and after 5 days of high and low sodium intake. Under normal sodium intake, the following mean values were observed -- plasma osmolality (Posm): 294 +/- 5 mOsm/kg -- plasma volume (Vp): 33.9 +/- 4,3 ml/kg -- urinary sodium output (UNa.V): 173 +/- 73 mEq/24 h -- urinary antidiuretic hormone (A.D.H.): 68.8 +/- 35.6 ng/24 h. Under low sodium intake these values decreased to -- Posm: 289 +/- 4 m Osm/kg -- Vp: 32.7 +/- 3.2 ml/kg -- UNa.V: 12 +/- 9 mEq/24 h -- A.D.H.: 40.9 +/- 16.3 ng/24 h. Under high sodium intake these values increased to -- Posm: 298 +/- 5 m Osm/kg -- Vp: 36.3 +/- 4.1 ml/kg -- UNa.V: 325 +/- 67 mEq/24 h -- A.D.H.: 118.2 +/- 45.5 NG/24 H. Highly significant correlations are found between Posm and A.D.H. and between the Posm or A.D.H. and UNa.V. Interest is focused on UNa.V since the correlation between A.D.H. and UNa.V (r = 0.78) is more significant than that between A.D.H. and Posm (r = 0.47). Overriding of Posm on Vp in the regulation of A.D.H. secretion is again demonstrated. Plasma renin activity decrease when A.D.H. increase.

Adult↗
PubMedDate not supplied

Predictive value of testing random urine sample to detect microalbuminuria in diabetic subjects during outpatient visit.

The predictive value of random urine sample during outpatient visit to predict persistent microalbuminuria was studied in 76 Type 1, insulin-dependent diabetic subjects, 61 Type 2, non-insulin-dependent diabetic subjects, and 72 Type 2, insulin-treated diabetic subjects. Seventy-six patients attended outpatient clinic during morning, and 133 during afternoon. Microalbuminuria was suspected if Urinary Albumin Excretion (UAE) exceeded 20 mg/l. All patients were hospitalized within 6 months following outpatient visit, and persistent microalbuminuria was assessed then if UAE was between 30 and 300 mg/24 h on 2-3 occasions in 3 urines samples. Of these 209 subjects eighty-three were also screened with Microbumintest (Ames-Bayer), a semi-quantitative method. Among the 209 subjects, 71 were positive both for microalbuminuria during outpatient visit and a persistent microalbuminuria during hospitalization: sensitivity 91.0%, specificity 83.2%, concordance 86.1%, and positive predictive value 76.3% (chi-squared test: 191; p less than 10(-4)). Data were not different for subjects examined on morning, or on afternoon. Among the 83 subjects also screened with Microbumintest, 22 displayed both a positive reaction and a persistent microalbuminuria: sensitivity 76%, specificity 81%, concordance 80%, and positive predictive value 69% (chi-squared test: 126; p less than 10(-4)). Both types of screening appeared equally effective during outpatient visit. Hence, a persistent microalbuminuria can be predicted during an outpatient visit in a diabetic clinic.

Adult↗