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Biomedical subjects

O Cachin

Publications and source records attributed to O Cachin.

16 recordsLinked to original sources
PubMed1985

[Genital malformations and castration. Femininity, sexuality at adolescence].

A study group has been constituted at the Hôpital des Enfants-Malades in order to analyse the relational approach with adolescent girls with various disorders and malformations of the genital tract followed since childhood. This group has been using a methodology which has already been applied to psychological aspects of other somatic diseases. Endocrinologists, gynecologists and psychoanalysts have weekly discussions about clinical cases. Their discussions are tape-recorded. The transcriptions are analysed by the whole group in order to evaluate the objective and subjective data concerning patients, families and doctors. We intend to discuss problems which appear to be the most important in relation to these disorders. Whatever the somatic problem is, these girls' future is also determined by their psychic reality and also that of their families and doctors. This psychic reality integrates and modifies the objective data as well as their environment.

Adrenal Hyperplasia, Congenital↗
PubMed1984

Preservation of gonadal function in true hermaphroditism.

Twelve documented cases of true hermaphroditism have been studied since 1965; there was histological evidence of both ovarian and testicular tissue in all cases. The clinical, anatomical, and therapeutic procedures are reviewed with special emphasis on gonadal morphology, histology, and function. Seven patients were reared as females, 5 as males; 6 are now postpubertal and 3 are more than 30 years old. Five underwent bilateral castration; in seven cases, only the discordant gonadal tissue has been removed so that these patients may have endogenous gonadal secretion in keeping with their sex of rearing.

Adolescent↗
PubMed1983

Persistence of Müllerian ducts in male pseudohermaphroditism, and its relationship to cryptorchidism.

Twenty-two cases of male pseudohermaphroditism with persistence of Müllerian duct derivatives were reviewed. In 12 cases of mixed gonadal dysgenesis and five cases of dysgenetic male pseudohermaphroditism, testosterone-dependent steps of sex differentiation were also impaired, and testicular dysgenesis was prominent, even in the younger age group. The capacity of testes to inhibit the ipsilateral Müllerian duct was correlated with testicular descent: it is suggested that testicular dysgenesis explains both the functional and topographical testicular abnormalities observed in these male pseudohermaphrodites. Five other patients were cryptorchid but externally normally virilised, persistence of Müllerian derivatives representing their only abnormality of sex differentiation. Testicular structure was usually normal or showed changes attributable to long-standing cryptorchidism. It is suggested that in these patients, persistence of Müllerian derivatives is due to an inborn error of metabolism, affecting the binding of anti-Müllerian hormone to its receptor and that failure of testicular descent is caused by mechanical restraint by the abdominal Müllerian organs.

Cryptorchidism↗
PubMed1982

[Precocious puberty. Comment on the diagnostic conditions and etiological aspects].

The present review is based on the retrospective study of 124 children with precocious puberty, 92 girls and 32 boys. In girls, the analysis of the clinical initial presentation has shown that premature pubarche (n = 18), premature adrenarche (n = 2) or isolated menstruations (n = 3) must be ruled out, as these symptoms can remain isolated for more than a year. However, in most cases the presence of growth acceleration and vaginal estrogenisation was of major diagnostic value. Bone maturation, although generally accelerated, can be normal in recently developed puberty. Precocious puberty may proceed by steps, with complete disappearance of physical signs in the intervals. Organic causes were found in 31% of the girls, and 44% of the boys with some characteristic features as rapid progression, and elevated LH response to LRF stimulation. Main causes were glioma of the optic chiasma (n = 11), 3rd ventricule invasive tumors, hamartoma (n = 8). The latter should be looked for by a non invasive procedure as the CT scan. In girls, precocious puberty with very high circulating estrogen levels was observed as part of a McCune-Albright syndrome. As the effect of precocious puberty on the final adult height is variable, the evaluation of therapeutic results remains uncertain. Medroxyprogesterone as well cyproterone acetate have not been fully efficient in controlling bone maturation. More recently, and still controversial, the treatment with long acting LRF analogues might provide a more satisfactory statural prognosis.

Bone Development↗
PubMed1977

[Precocious puberty associated with Silver's syndrome].

Precocious puberty has been reported as an important feature of the Silver-Russell syndrome. The present case refers to a boy entered puberty at the chronological age of 11 years and the bone age of 6 years 6/12. Criteria for precocious puberty in this syndrome are discussed by comparison with previously published cases, and it is concluded that abnormalities in clinical pubertal development are quite unusual in this syndrome.

Bone Diseases, Developmental↗
PubMed1975

[Pure trisomy 9p 47,XX,+ del(9) (q11). Discovery of one cell 46,XX, del(9) (q11) in the father].

A case is reported of "pure" trisomy 9p: 47,XX,+del(9) (q11). The affected 6-year-old girl has moderate psychomotor retardation (IQ near 70), with speech retardation. She is mildly dysmorphic, with the characteristic features of trisomy 9p: a "worried look", a unilateral grin, slant of the palpebral fissures, a globulous nose, brachymesophalangia and the characteristic dermatoglyphic features. The parents karyotypes are normal, except for one cell from the father which had the karyotype 46,XY,del(9)(q11), the implications of which are discussed.

Child↗
PubMed1975

Aspects of communication between patients and doctors: an analysis of the discourse in medical interviews.

The transcripts of tape-recorded interviews of pediatric endocrinologists and patients with Turner's syndrome and their parents were reviewed in consultation with child psychoanalysts in order to evaluate certain aspects of communication between patients and doctors. The transcripts showed that the doctors often talked at cross purposes with the parents and their patients, evading emotional issues in favor of quasi-scientific explanations which the patients and parents did not understand. Parts of the discourse, at times unconscious, have been shown to be of great importance as means of communication. Reviewing the transcripts of the doctor-patients discourse is an excellent way of improving one's therapeutic communication with the patient. The same material can be used for teaching purposes.

Adolescent↗
PubMedDate not supplied

[Endocrine sequela of radiation treatment of extracranial head and neck tumors].

A study of the thyroid and hypothalamo-pituitary functions was undertaken in 14 children having been irradiated for tumors of the neck and head. The following anomalies were found: S.T.H. deficiency: 8 cases, A.C.T.H. deficiency: 2 cases, T.S.H. deficiency: 4 cases, primary thyroid insufficiency: 4 cases. Growth was severely impaired since the height of 10 out of 14 patients was less than or equal to 2 S.D. These results emphasize the frequency of endocrine lesions related to radiotherapy, as the lesions were essentially extracranial. They also show a repercussion on growth, which worsen the long-term prognosis of these diseases.

Adolescent↗