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G Weryha

Publications and source records attributed to G Weryha.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Thyroid metastases from cancer of the kidney. Two cases].

Non-thyroid cancers rarely metastases to the thyroid gland. Metastases can be divided into those with clinical expression and those identified at necropsy. Symptom producing thyroid metastases are usually due to a primary renal cell cancer. We report two cases of thyroid metastasis of a clear cell renal carcinoma. In the first case, an 82-year-old woman presented with an enlarged thyroid gland. This inaugural element led to the diagnosis of thyroid metastasis and identification of recurrent renal cell carcinoma which had been treated by radiotherapy 24 years earlier. After radiotherapy for a concomitant pulmonary metastasis, the patient is in good general health with no signs of recurrence. In the second case, increased thyroid volume led to signs of compression in a 71-year-old man. The pathology report after left lobular thyroidectomy suggested trabecular adenoma or metastasis of a clear-cell primary tumour. Abdominal CT-scan revealed a 3.5 cm tumour found to be a clear-cell renal carcinoma at nephrectomy. Another osteolytic metastasis to the femur was also observed three months after surgery. The patient is in good health 15 months after the initial diagnosis. The significance of thyroid metastasis of renal cell carcinoma would vary according to the different cases reported in the literature with survival ranging from 32 months to 3-7 years after surgical exeresis. Prognosis would thus not appear to be as poor as for thyroid metastasis from other primary tumours.

Aged↗
PubMed1995

[Hyperprolactinemic amenorrhea:treatment with cabergoline versus bromocriptine. Results of a national multicenter randomized double-blind study].

OBJECTIVES: Cabergoline is a new, long-acting D2 agonist, highly effective in suppressing prolactin and restoring gonadal function in hyperprolactinaemic amenorrhoea. This study compares its efficacity and safety with that of the reference compound, bromocriptine. METHODS: A prospective study involved 21 French Centres and 120 women, with hyperprolactinaemic amenorrhoea, randomized to either cabergoline (CAB 0.5-1 mg twice weekly) or bromocriptine (BRC 2.5-5 mg twice daily). Treatment is given under double-blind conditions for the first 8 weeks, and subsequently in open conditions in further 16 weeks with dose adjustments according to response. Patients were assessed for biochemical and clinical efficacy and drug safety (adverse symptoms and biology). RESULTS: Normoprolactinaemia was achieved in 56/60 (93.3%) taking CAB and 27/58 (48.2%) taking BRC (p < 0.0001). Ovulatory cycles or pregnancy were recorded in 71.6% and 48.2% of patients (p = 0.001). Prolactin suppression to below 50% of the baseline value was observed in 1.6% and 15.5% (p = 0.007). Adverse symptoms were recorded in 31/60 (51.6%) and 40/58 (69.2%) patients respectively in the double-blind period, and 53.3% versus 65.5% for the full course of the study. There were significantly fewer gastro-intestinal symptoms in the CAB group, 36.6% versus 84.5% (p < 0.0001). CONCLUSION: Cabergoline is a new prolactin-lowering drug, more effective and better tolerated with fewer gastrointestinal symptoms than the reference compound, bromocriptine.

Adolescent↗
PubMed1995

Paracrine regulation of bone remodeling.

Bone remodeling tightly couples resorption and formation in a cell unit called bone modeling unit (BMU). The activity of the BMU leads to a negative balance of bone mass in adults with physiological osteopenia. The regulation of the BMU is done at a local level by paracrine and autocrine factors such as cytokines and at an endocrine level by hormones. The hormonal level has been widely discussed in previous reviews and recent studies focus on the relations between hormonal triggers and cytokine-mediated responses to their stimulations. This review is dedicated to the means of coupling osteoblasts and osteoclasts and the recruitment of early cell precursors that originate in the hematopoietic bone marrow. Bone should be considered not only as an individual organ but as integrated in the bone-bone marrow organ.

Animals↗
PubMed1995

[Bilateral testicular ischemia in vasculitis. Differential diagnosis with torsion and the value of color Doppler ultrasonography].

The authors report a case of acute bilateral testicular pain simulating simultaneous bilateral torsion of the spermatic cord in a 22-year-old man. Duplex ultrasound revealed parenchymal ischaemia secondary to an early form of polyarteritis nodosa (PAN). Surgery, performed because of the doubtful differential diagnosis with torsion of the spermatic cord, excluded this hypothesis. The aetiological investigation, after excluding an infectious cause, consisted of revealing at least three diagnostic criteria necessary for the diagnosis of PAN among those defined by Godeau Guillevin or the American College of Rheumatology. The authors also discuss the value of duplex ultrasound in the follow-up of this disease.

Adult↗
PubMed1995

[Physiological role of PTHrP].

Parathyroid hormone related protein (PTHrP) is the aetiological factor for the syndrome of humoral hypercalcemia of malignancy. The PTHrP gene encodes three isoforms of respectively 139, 141 and 173 amino acids with N-terminal homology to parathormone (PTH). PTHrP, which has a wide tissue distribution, appears to be a polyhormone with different physiologic functions that depend on the particular fragment secreted. PTHrP may act in an autocrine, a paracrine or an endocrine fashion. There is evidence for a role in the growth and development of both embryonic and mature tissues, in cellular differentiation, in smooth muscle relaxation, lactation and calcium and magnesium transport. The best known PTHrP functions are those mediated by the N-terminal domain fixation on the classical PTH/PTHrP receptor. Nevertheless, several other functions are mediated by different fragments of PTHrP such as midregion fragments or carboxy-terminal forms. Each of these functional forms of PTHrP has one or several physiological function(s) which is (are) mediated by his own specific receptors and signal transduction pathways, some of which may be tissue specific.

Animals↗
PubMed1995

[Heart and thyroid].

Thyroid hormones may exert cardiovascular actions by direct effects on the myocardium, by interacting with the sympathetic nervous system and through alterations of the peripheral circulation. Then, thyroid hormones increase myocardial contractility and relaxation, sensitise the myocardium to sympathetic nervous system and decrease arterial resistance. Hyperthyroidism results in an enhanced myocardial contractility, an increased cardiac output and a fall in systemic vascular resistance. Nevertheless "high output" cardiac decompensation may occur. Thyrotoxicosis may trigger arrythmia and disease seems to be associated with an increase in the frequency of mitral valve prolapse. Even in mild or subclinical hyperthyroidism complication may occur. Sympathetic blocking agents are the treatment of choice in addition to aetiologic treatment. Hypothyroidism is associated with bradycardia, a decreased cardiac output, increased vascular resistance and perhaps a decreased sensitivity of the sympathoadrenal system. An increase in cholesterolemia leads to an additional risk for the development of atherosclerosis. Main cardiovascular complications of hypothyroidism are angina pectoris, diastolic hypertension, atrio-ventricular blocks or pericarditis. Mild hypothyroidism might also be correlated with an increase in adverse effects.

Cardiovascular Diseases↗
PubMed1994

Serum parathormone profile during surgical treatment of hyperfunctioning parathyroid adenoma: a multicompartmental model.

Patterns of intact parathyroid hormone (iPTH) elimination and subsequent recovery of parathyroid function were studied in seven patients undergoing surgical removal of solitary hyperfunctioning parathyroid adenoma. Using a sensitive two-site immunoradiometric assay, iPTH levels were measured pre, peri-, and postoperatively. Blood samples were taken at very early and at late stages, including 3, 6, 9, and 15 minutes and 48, 72, and 96 h after adenomectomy. A biexponential formula was calculated to fit the decreasing values of iPTH in all patients. The PTH half-life in the early phase was 1.4 +/- 1.1 minutes (95% confidence limits). The PTH half-life in the second phase was 64.45 +/- 32.19 minutes (95% confidence limits). A third phase is represented by a slow, linear increase in plasma iPTH values as a result of the recovery of healthy suppressed parathyroid glands. The extrapolation to baseline of the later phase shows that the recovery of normal parathyroid function begins as soon as 240 minutes after adenomectomy and is independent of the decrease in PTH of adenomatous origin. All individual results were consistent with this model. Five patients had iPTH values below 5 pg/ml, one had 15 pg/ml, and the last had 27 pg/ml 5 h after parathyroid adenomectomy. The recovery of the hormonal activity of the remaining glands occurred rapidly. By the postoperative hour 24 the mean serum iPTH concentration was 12.28 +/- 8.07 pg/ml. The intraoperative serum iPTH concentration offers a model to assess both recovery of hormonal secretion from functionally suppressed parathyroid glands and disappearance of parathyroid hormone.

Adenoma↗
PubMed1994

[Undifferentiated osteogenic carcinoma of the thyroid].

A case of osteogenic thyroid carcinoma in a 68 years old male patient is reported. The WHO histopathological classification of such exceptional tumor is reminded. A review of the literature and the treatment modalities are discussed. Several etiological hypotheses are discussed.

Aged↗
PubMed1994

[Rhinorrhea and otorrhea: rare complications of the medical treatment in invasive prolactinomas].

Cerebrospinal fluid rhinorrhea and otorrhea are rare complications of conservative and medical management of invasive macroprolactinomas. The slow shrinkage of the tumor during therapy is responsible for delayed rhinorrhea and otorrhea which carry the risk of meningitis. The operative procedure for closure of the fistulae is needed. We report the occurrence of CSF rhinorrhea in two patients with macroprolactinoma who were treated by bromocriptine. In one patient the fistulae is surgically treated and the treatment by bromocriptine is maintained. In the other patient the rhinorrhea is associated with otorrhea and the operation is not required because of the massive destruction of skull base. The CSF rhinorrhea and otorrhea stopped after diminution of bromocriptine doses.

Adult↗
PubMed1993

[Severe hyponatremia disclosing adenohypophyseal insufficiency with empty sella syndrome].

We report a case of extremely severe hyponatraemia which led to the discovery of anterior hypophysis insufficiency associated with empty sella turcica in a dysimmune context. This type of hyponatraemia is consecutive to corticotropic and thyreo-tropic hormones deficiency and to inappropriate secretion of arginine vasopressin. These endocrine abnormalities are of suprapituitary origin. They can be explained by a hypothalamo-hypophyseal dysregulation of little known mechanism, or by a lesion of the hypothalamus.

Aged↗
PubMed1993

[Value of ketoconazole in the treatment of Cushing disease].

Ketoconazole has been successfully used in short-term treatment of Cushing's syndrome. We treated 4 patients who had Cushing's disease with ketoconazole administered during 5 to 18 months. Two of them are still controlled after 15 months of treatment and 7 months after treatment was withdrawn. In the other two patients, treatment was ineffective primarily and after 5 months. Our data confirm the usefulness of ketoconazole in the treatment of Cushing's disease, but they also show that primary resistance and tachyphylaxis in long-term treatment may occur, as previously reported.

Adult↗
PubMed1993

Osteogenic anaplastic carcinoma of the thyroid.

An unusual osteogenic anaplastic carcinoma of the thyroid developed in a 68-year-old man and showed follicular and osteosarcomatous components. Seven months after surgery and 70 mCi 131I treatment, a local tumor recurrence was found and showed an intense uptake of 99mTc-MDP on the bone scan. After a second operation, pathologic and immunostaining analysis revealed no more thyroid carcinoma but only osteosarcomatous cells. Chemotherapy was ineffective and the patient died with diffuse pulmonary metastases 26 months after the diagnosis. The importance of osteogenic sarcomatous differentiation is proven by the bone scan. Osteosarcoma of the thyroid is a rare but well known tumor. Usually these tumors do not contain any cells originating from the thyroid epithelium and only comprise sarcomatous components. Ten cases of undifferentiated carcinoma of thyroid origin with osteogenic component have been reported. These tumors have been recently included in undifferentiated carcinomas in the second edition of the WHO classification. The evolution and pathologic findings favor the hypothesis of a transdifferentiation of the thyroid cell into osteogenic cells.

Aged↗