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Biomedical subjects

H M Heshmati

Publications and source records attributed to H M Heshmati.

At least 55 records · Page 3Linked to original sources
PubMed1986

[Serum thyroglobulin is elevated in patients with heterogeneous goiter during radioiodide scintigraphy, but normal in those with homogeneous goiter].

Serum thyroglobulin (Tg) levels were determined in 98 biologically euthyroid patients with a diffuse or nodular goiter, and compared to values observed in 33 control subjects. Based on the results of clinical examination and thyroid scanning with radioiodine, patients were divided into 3 groups: group 1 with homogeneous diffuse goiters, group 2 with heterogeneous diffuse goiters without palpable nodules, and group 3 with solitary hypofunctioning nodules. The control group had a mean Tg of 37 +/- 15 micrograms/l. Group 1 (n = 32) had a mean Tg of 46 +/- 28 micrograms/l; six (19%) had an elevated Tg level (level greater than 74 micrograms/l). Group 2 (n = 30) had a mean Tg of 133 +/- 134 micrograms/l; fourteen (47%) had an elevated Tg level. Group 3 (n = 36) had a mean Tg of 188 +/- 191 micrograms/l; twenty (56%) had an elevated Tg level. The comparison of Tg between patient groups, and between patients groups and the control group, showed a significantly higher value in the groups of hypofunctioning nodules and heterogeneous diffuse goiters. It is concluded that the elevated serum Tg level in patients with a diffuse or nodular simple goiter is commonly associated with heterogeneity of the thyroid scan.

Adolescent↗
PubMed1986

[Isolated secretion of testosterone by an adrenocortical tumor in a menopausal woman].

A case of adrenal tumor with isolated secretion of testosterone in a menopaused woman is reported. All other androgens (Déhydro-épi-androstérone, Sulfate de Déhydro-épi-androstérone, Delta 4 androstène-dione) were normal as well as other adrenal hormones. This tumor produced a mild hirsutism. A treatment with Cyproterone Acetate, then with Dexamethasone did not produce a significant change. A complete review of literature points out the rarity of this observation, since only twelve similar cases have been previously reported.

Adenoma↗
PubMed1986

[Primary hypothalamic tumors (excluding craniopharyngioma). Endocrine and post-radiotherapy development study. Apropos of 17 cases].

The authors underline a number of features of primary hypothalamic tumours (except craniopharyngioma) based on a study of 17 cases: The vital prognosis is satisfactory; only one death was observed with an average follow-up period of 80 months (range 1 to 17 years). This raises the question of the necessity for systematic biopsy to confirm the tumour histology (although when performed in conditions of stereotaxis there are no serious risks). The site of the tumour makes surgery difficult and complete ablation impossible. As many hypothalamic tumours, including the pilocytic astrocytoma which is the commonest type, are sensitive to radiotherapy, this would seem to be the treatment of choice. Total regression is observed in the majority of cases. From the endocrine point of view, the mediocre prognosis is aggravated by high energy radiotherapy. However, with the present therapeutic methods, it is relatively easy to compensate complete or dissociated deficits. There is an endocrine syndrome suggestive of hypothalamic tumour which consists of anterior pituitary deficiency, diabetes insipidus and moderate hyperprolactinaemia (20 to 100 ng/ml). Close medical surveillance is essential, both of the local (visual field and frontal CT scanning) and endocrine effects. Hormonal deficits may occur as a late complication up to 5 years after radiotherapy. The problems inherent to hypothalamic tumours: neurogenic hypernatraemia which is luckily uncommon, with an unexplained weight gain occurring during substitute therapy for adrenal insufficiency with physiological doses of hydrocortisone. Finally, the overall prognosis is good with a minimum of complications due to radiotherapy, excepting endocrine deficiency, providing a dose of 60 grays in 6 weeks at 2 grays per session is not exceeded.

Adolescent↗
PubMed1985

Serum thyroglobulin levels in hypofunctioning nodules before and after surgery.

Serum thyroglobulin (Tg) level was determined in 34 biologically euthyroid patients having benign hypofunctioning nodule, before and after surgery. Based on the results of thyroid scanning with radioiodine, 2 groups of patients were considered. Group 1 (n = 18) had solitary hypofunctioning nodule with an otherwise normal thyroid gland and group 2 (n = 16) had hypofunctioning nodule inside an enlarged and/or heterogeneous thyroid. Results were compared to a group of 30 control subjects. Mean Tg level was significantly elevated in both groups 1 and 2 before surgery. No significant difference was found between group 1 and group 2. After surgical removal of the hypofunctioning nodule (follicular adenoma), mean Tg level was normalized in group 1 and decreased but still remained elevated in group 2. It is concluded that the observed elevated serum Tg level is due to the presence of hypofunctioning nodule and/or heterogeneous thyroid tissue. Thus, Tg determination may be useful in the follow-up of operated hypofunctioning nodules in order to detect abnormality in the remaining thyroid tissue.

Adenoma↗
PubMed1985

Testicular response to human chorionic gonadotrophin in chronic hyperprolactinaemia.

In order to evaluate the effect of hyperprolactinaemia on gonadal function in men, testicular stimulation by human chorionic gonadotrophin (hCG) (5000 IU/day, 3 consecutive days) was performed on 6 men with chronic hyperprolactinaemia and 6 control subjects. The following parameters were measured before and during the 4 consecutive days following the injections of hCG: the concentration in plasma of testosterone (T), oestradiol-17 beta (E2), dihydrotestosterone (DHT) and the urinary excretion of testosterone glucuronide (TG) and 5 alpha-androstane-3 alpha, 17 beta-diol glucuronide (3 alpha-Diol G). The rises in T, E2, DHT and the ratios of T/DHT and TG/3 alpha-Diol G were similar in both groups, but the rises in TG and 3 alpha-Diol G were lower in the hyperprolactinaemic group after hCG. There was no correlation between the response of T and the increment of E2 in either group. It is suggested that in men with chronic hyperprolactinaemia: 1) there is diminished testicular response to hCG; this could be due to chronic gonadotrophin deficiency or to a direct effect of hyperprolactinaemia on the testes, 2) there is no modulation of T synthesis through inhibition of aromatase activity and E2 secretion and 3) the 5 alpha-reduction of T is not deficient.

Adenoma↗
PubMed1985

[Results of bromocriptine treatment of giant or invasive prolactin adenomas. Apropos of 20 cases].

The therapeutic results of twenty patients with giant expansive prolactinomas were studied under bromocriptine as treatment of first intent (Group I, n = 10) or of second intent after surgery with or without radiotherapy (Group II, n = 10). Patients in Group I (PRL: 350-17 000 ng/ml) were given bromocriptine alone (10 to 20 mg/day) for a period of 21 days to 22 months. The visual fields and acuity returned to normal in 8 days to 3 months in 4 out of 7 patients and significantly improved in 2 out of 7 patients. A reduction in tumour size was demonstrated on CT scanning in 7 out of 10 patients mainly in the suprasellar region (6/9) with appearances of a partially empty sella in 4 cases. Normalisation of the PRL (7 out of 10 cases) was accompanied by a correction of one or more other hypophyseal deficits in 3 patients. Bromocriptine was continued in 5 out of 10 cases with a good result after 12 to 22 months follow-up. Five patients were referred secondarily for surgery for spontaneous rhinorrhea in 1 patient or because Bromocriptine was only partially effective in 4 patients; a postoperative visual improvement with reduced serum prolactin levels was observed in these 4 cases. In Group II (PRL: 200-11 600 ng/ml after surgery), bromocriptine therapy (5 to 30 mg/day for 1.5 to 72 months) was associated with normalisation or a significant improvement in visual symptoms in 6 out of 9 cases and a reduction in tumour size in 8 out of 10 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma↗
PubMed1984

[Mucigenous cysts of the pituitary gland. 3 cases].

Three cases of mucous cysts, or Rathke's cyst, of the pituitary gland are reported. The clinical and biological features were comparable to those of a non-secreting adenoma. Although extremely rare, these cysts must be recognized since their particular and, in theory, specific characteristics (wall made up of a ciliated epithelium with mucus cells and cavity filled with a mucoid substance) distinguish them from other intra or suprasellar pathological formations, especially craniopharyngiomas. The 62 cases reported in the literature suggest that they have a favourable prognosis.

Adenoma↗
PubMed1984

[The blood-testis barrier].

The blood-testis barrier in man is mainly due to the tight junctions of Sertoli cells. It creates favorable conditions for the spermatogenesis and sperm survival in the testicular fluid. It prevents the occurrence of autoimmunity after puberty. The alteration of the blood-testis barrier allows the production of antisperm antibodies and may lead to infertility.

Antibody Formation↗
PubMed1983

[A rare cause of amenorrhea: stenosis of the aqueduct of Sylvius. Apropos of 3 cases. Cure by ventriculo-atrial shunt].

Chronic hydrocephalus by aqueductal stenosis may result in endocrine dysfunction. Primary or secondary amenorrhea may be the only symptom. Endocrine function tests are usually normal, except for low estrogen levels, pointing to isolated functional hypothalamic amenorrhea. Roentgenologic investigations ensure diagnosis in all cases: skull films show enlargement and/or flattening of the sella turcica and digitate impressions; computed tomography shows dilatation of lateral and third ventricles. This rare cause of amenorrhea must be kept in mind as it can be easily diagnosed and successfully treated by atrioventricular shunt.

Adolescent↗
PubMed1983

[Inhibin: its origin, nature and role].

Inhibin is a protein secreted by the Sertoli cells in men and by the granulosa cells in women. It inhibits the synthesis and release of the follicle-stimulating hormone in the pituitary gland and reduces the hypothalamic LH - releasing hormone content. It also inhibits the multiplication of spermatogonias in male gonads and the production of progesterone by the ovaries. Inhibin determinations in biological fluids may help to understand the pathophysiology of puberty, ovulation, menopause and various types of infertility.

Female↗
PubMed1983

[Hypertensive forms of congenital adrenal hyperplasia].

The authors describe the principal clinical and biological features of congenital adrenal hyperplasia with hypertension with respect to their own experience and a review of the literature: a beta-11-hydroxylase deficiency is well-known, an alpha-17-hydroxylase deficiency is exceptionally rare. Several clinical and biological advances are discussed in the light of recent studies.

Adolescent↗
PubMed1983

[Treatment of hypertensive forms of congenital adrenal hyperplasia].

The treatment of congenital adrenal hyperplasia (hypertensive forms) is based, as in the other forms of congenital adrenal hyperplasia, on corticosteroid therapy. The choice of drug, dosage, precocity, clinical and biological surveillance, are analysed in turn. The results on pubertal development, adult size, gonad development in the 11-betahydroxylase deficit type, are considered in the light of recent studies. The treatment of the 17-alpha-hydroxylase type is also based on the inhibition of glucocorticoid secretion. Results are satisfactory in the few cases published.

Adolescent↗
PubMed1983

[Nonfunctional or nonsecreting hypophyseal adenomas. Review of clinical, biological, neuroradiological, developmental and immunohistochemical characteristics. Apropos of 40 cases].

The authors report 40 cases of functionless pituitary adenomas, investigated by the same protocol and treated in the same way, between 1976 and 1982. The clinical, biological, neuroradiological features, clinical course and anatomopathological findings of this very uniform series are described. A complete immuno-histochemical study was undertaken. These findings suggest that the diagnosis of a true functionless pituitary adenoma should be based on the following criteria: --clinical and biological: absence of hormonal hypersecretion; --histological: absence or very few signs of secretory activity (little ergastoplasma, few mitochondria and Golgi apparatus); --immuno-histochemical: absence of reactivity to immunofluorescence and immuno-peroxydase methods.

Adenoma↗