PubMed Health⌕ Search

Biomedical subjects

D Dewailly

Publications and source records attributed to D Dewailly.

At least 109 records · Page 6Linked to original sources

Immunohistochemical detection of glycoprotein hormone alpha subunit in somatoprolactinic and pure somatotroph adenomas.

Glycoprotein hormone alpha subunit (alpha SU) is expressed in nearly all thyreotroph adenomas and most gonadotrophinomas, but is less well documented in plurisecreting adenomas. We therefore examined the immunohistochemical (IHC) expression of alpha SU in a generally accepted model of plurisecreting adenomas (somatoprolactinic type) by comparison to a series of pure monosecreting somatotroph tumors. Fifty patients (32 females, 18 males) aged 15 to 68 years with clinical and/or biological acromegaly requiring adenomectomy were studied. Forty-five had clinical acromegaly and 5 had isolated amenorrhea and/or galactorrhea syndromes. Forty-eight of the 49 patients who had baseline assessments of plasma GH had a mean concentration of 5 ng/ml or more (normal value < 5). Fifteen of the 46 patients who had baseline measurements of plasma PRL had a prolactinemia value greater than 20 ng/ml (normal value < 20) but below 100 ng/ml, except for one patient. All the adenomas studied were positive by GH immunohistochemistry; 21 were immunostained by an antiPRL antibody and formed the "somatoprolactinic" (GH-PRL) group. Five of these 21 patients were male. The 12 female patients younger than 50 years had amenorrhea or galactorrhea, and one male patient complained of impotence. Eleven patients (9 females, 2 males) in this GH-PRL group had hyperprolactinemia. Sixteen of these GH-PRL adenomas were immunolabeled by alpha SU antiserum. The remaining 29 adenomas, which were immunonegative with the PRL antibody and formed the "somatotroph adenoma" (GH) group, were more frequent in male patients (13/29; 45%) compared to GH-PRL group. Eight amenorrhea or galactorrhea syndromes occurred among the 14 women younger than 50 years, 3 of whom had hyperprolactinemia. Thirteen of these 29 adenomas (45%) were immunopositive with alpha SU antibody. Compared to the GH group, the GH-PRL group had a significant higher frequency of amenorrhea and/or galactorrhea syndromes among women under 50 years (100% vs 57%; p < 0.01), as well as hyperprolactinemia (55% vs 15%; p < 0.01) and positive alpha SU immunoreactivity (76% vs 45%; p < 0.05). The frequency of extrasellar macroadenomas was not different according to PRL or alpha SU immunoreactivity. Thus, in this series of somatoprolactinic adenomas, alpha SU immunopositivity was slightly more frequent than in a control group of pure somatotroph adenomas. Moreover, hyperprolactinemia was more frequent in patients with GH-PRL adenomas, although the size of the pure and mixed adenomas was not different. These results suggest that hyperprolactinemia and/or alpha SU immunopositivity are more often associated with mixed GH-PRL adenomas.

Acromegaly↗

[Postpartum thyroiditis. 31 cases].

Postpartum thyroiditis. 31 cases. Between 1977 and 1986, 29 women consulted in three internal medicine and endocrinology departments for clinical disorders which could be ascribed to 31 episodes of thyroiditis developed within 9 months of giving birth. Thyroiditis was diagnosed clinically on the basis of acute diffuse (11 cases) or nodular (7 cases) goitre formation, signs of dysthyroidism (16 cases) revealed by menstrual disturbances and/or galactorrhoea (11 cases). A thyrotoxic episode was observed in 9 patients; it was either without sequelae (5 cases) of followed by transient hypothyroidism (4 cases). In other patients transient hypothyroidism was observed in 11 cases and permanent hypothyroidism in 5 cases. Six patients showed no sign of dysthyroidism, and the diagnosis was made by immunological, cytological and/or histological examination of the thyroid gland. Circulating anti-thyroid antibodies were present in two-thirds of the patients. The results of radioisotope scanning varied according to the stage of the disease. In these patients, only the absence of goitre was predictive, in 4 out of 5 cases, of subsequent permanent hypothyroidism; in all other patients the prognosis was highly favourable, even without specific treatment.

Adult↗

[Polycystic ovary syndrome: recent genetic contributions].

Polycystic ovary syndrome is the most common endocrine disorder in women of reproductive age. It is characterized by hyperandrogenism, chronic anovulation and it is often associated with hyperinsulinemia, insulin resistance and dyslipidaemia. The pathophysiology of polycystic ovary syndrome seems to implicate primary defects in ovarian steroidogenesis, influenced by environment, insulin action and obesity. Polycystic ovary syndrome is probably both a multigenetic and environmental disease. Knowing the genes of polycystic ovary syndrome would be helpful to develop therapeutics and prevention. Genes of gonadotrophins, steroid hormone synthesis and insulin resistance seem not to be directly involved, except perhaps the CYP 11 a gene. On the other hand, identification of the signal transduction pathways involved in these genes may provide valuable information that can be applied to other clinical manifestations of polycystic ovary syndrome (follicular growth arrest, insulin resistance, obesity and endometrial cancer...).

Cholesterol Side-Chain Cleavage Enzyme↗

[The CRF test in psychiatry. Preliminary studies].

The HPA axis exploration in the endogenous depressions indicates an hyperactivity of this system. But the reason of this perturbation is not definite. The corticotropin-releasing factor (CRF) test has been described from research work carried out by Vale et al. In the endogenous depressions, this test enables us to specify physiopathological factors of the HPA axis dysfunction. Some research suggest an hypothalamic and limbic CRF hypersecretion in the endogenous depressions. But the results are not consistent principally because of the diversity of technical protocols. So the authors try to take stock of the CRF test specificity. They report the results obtained after 100 micrograms o-CRF intravenous administration in 7 voluntary normal men.

Adrenocorticotropic Hormone↗

[Plasma aldosterone and renin activity in hypopituitarism (author's transl)].

Plasma renin activity (P.R.A.) and plasma aldosterone were measured in twelve patients having hypopituitarism. Both mean values of this group were significantly lower than in normal subjects (P.R.A. recumbent: p less than 0.001, upright: p less than 0.001, plasma aldosterone: recumbent: p less than 0.02, upright: p less than 0.005). Hyporeninism is a controversed feature in hypopituitarism. Our preliminary data suggest that it is not directly correlated to ACTH or cortisol deficiency. Nevertheless it may explain the hypoaldosteronism prior reported in such patients.

Adrenal Cortex Hormones↗

[Inhibition of prolactin release by methysergide and bromocriptine in hyperprolactinemic subjects: comparative dynamic studies (author's transl)].

Reduction of hyperprolactinemia by Methysergide (4.4 mg p.o.) and Bromocriptine (2.5 ng p.o.) was studied in 20 patients (7 subjects with pituitary macroadenoma and 13 hyperprolactinemic patients with normal sella turcica). No difference was observed between the effects of the two drugs 4 hours after their administration, with and without respect of the aetiologies of hyperprolactinemia. However the serum prolactin levels were significantly lower 6 hours (n = 11 p = 0,01) and 12 hours (n = 10 p less than 0,01) after Bromocriptine than after methysergide. The difference observed between the two drugs seems to be inherent to their different half-lives.

Adenoma↗