[Hypophyseal blockage by a gonadorelin analogue, D-Trp6-LHRH retard, to improve induction of ovulation].
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Biomedical subjects
Publications and source records attributed to M Harter.
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Two purely subdiaphragmatic intrasellar meningiomias are described. The rarity of this unusual intrasellar tumor is stressed, and the differential diagnosis of intrasellar meningioma versus pituitary adenoma is discussed. The good results of the rhinoseptal route for surgery are emphasized.
The fetal prognosis in pregnancy in a diabetic woman depends mainly on the blood sugar equilibrium of the mother that can be obtained, since the normal range lessens the chances of fetal abnormalities. This has been demonstrated in this series, since a system that uses the continuous automatic administration of insulin has been used. Six diabetic women were treated with continuous subcutaneous perfusion of insulin in the second half of pregnancy. The quality of the maternal blood sugar equilibrium has been proved by the normal values of glycosylated haemoglobin and the values of venous blood sugar which were always within the mean of the normal range. The tolerance of the technique is excellent (83 days in mean without a single complication). In 4 out of the 6 cases the baby was born at the 38th week of pregnancy and studies show that there was no increase in weight and a very low level of neonatal hypoglycaemia. It seems desirable to use this kind of insulin therapy which should help to contribute to a better fetal prognosis in diabetic pregnancies.
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A case of diabetic lipemia is reported in a 27 year-old man admitted for acute pancreatitis. Initial investigations revealed gross hyperlipoproteinemia and ketoacidosis. Hyperlipoproteinemia was progressively corrected up to normalization in four weeks under insulin-therapy; the metabolic control of diabetes was obtained in parellel. This feature is caracteristic of "diabetic lipemia". The following sequence could be suggested: onset of diabetes, occurence of diabetic lipemia and then acute pancreatitis.
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Residual beta cell function was evaluated through circadian determination of C-peptide immunoreactivity (CPR) in eighty insulin-dependent diabetics. Evaluation of beta cell activity through circadian CPR determination was in good agreement with the results obtained by glucagon test which is considered a potent stimulus of C-peptide release. The prevalence of residual beta cell function in our population was 35%. Residual beta cell function was associated with a shorter duration of diabetes, a lower dose of insulin therapy and less chronic complications. On the other hand, serum growth hormone circadian variations were more spread in diabetics without beta cell function. That is consistent with diabetes instability which has been reported more commonly insulin-dependent diabetics without beta cell function.