[Catecholamines in the cardiovascular expression of pheochromocytoma. II--Study of free urinary catecholamines in 14 pheochromocytomas. Classification of pheochromocytomas according to type of secretion].

Studies were conducted in 14 patients with pheochromocytoma over a 3-year period. Circumstances of detection of these tumors varied greatly and were sometimes misleading, hypertension being an inconstant finding in the clinical history and was not always the predominant feature. Biologic exploration involved assay of excretion of free urinary noradrenaline (NA), adrenaline (AD) and dopamine (DA) using a HPLC technique as well as assay of total methoxy derivatives and urinary vanilmandelic acid.

[Sensitivity of bone to parathyroid hormone in type I pseudohypoparathyroidism. 6 cases].

The sensitivity of bone to parathormone in pseudoparathyroidism is not well known. Six patients with Type I pseudohypoparathyroidism (4 with Albright's osteodystrophy) had increased alkaline phosphatase levels (5 patients) and radiological signs of periosteal resorption in the hand in one case. All patients had histological signs of increased surfaces of resorption and periosteocytic lacunae, increased osteoid surfaces and relative osteoid volume with no change of the index of osteoid thickness.

[Bone involvement in hypothyroidism in adults. Apropos of 20 patients].

Although bone changes in hyperthyroidism are well known, they have been much less studied in hypothyroidism and we set out to establish whether they did occur in the latter condition. We present the results of a prospective study of 20 adult patients, with acquired primary hypothyroidism. No changes in urinary or blood calcium or phosphorus metabolism were observed and serum parathormone, 25-hydro, 125-dihydro and 24-25-dihydroxycholecalciferol concentrations were normal.

[Catecholamines in the cardiovascular expression of pheochromocytomas. I. Physiological role of noradrenaline, adrenaline and dopamine].

The very diverse clinical expressions of pheochromocytoma are dependent upon type of catecholamine secreted and excreted by the tumor. The role of each of the three amines (adrenaline, noradrenaline, dopamine) is reviewed in relation to physiologic regulation of blood pressure: adrenaline and noradrenaline are pressor hormones and act on almost all blood pressure factors. They possess chronotropic and positive inotropic effects by their action on cardiac beta 1 adrenoceptors, a peripheral vasoconstricting action by interaction with vascular alpha 1 receptors and a direct effect on renin production and tubular resorption of sodium.

[X-ray computed tomography in pheochromocytoma. Apropos of 20 cases].

Study of 20 pheochromocytomas in 19 patients confirmed the remarkable sensitivity of computed tomography (100%) for the detection of their adrenal and juxtarenal localizations. However, ultrasonography was as effective as the CT scan in these same patients, and even detected latent tumors in several cases. Certain pheochromocytomas in this series presented unusual appearances, particularly two large tumors which were manifest as abdominal masses and a malignant form which provoked a total infarct of the homolateral kidney.

Treatment of human hyperprolactinaemia with a new dopamine agonist: CU 32085 (mesulergin).

CU 38085 (mesulergin) was given at doses ranging from 0.5 to 5 mg/day to 37 patients with pathological hyperprolactinaemia of varying aetiology. The effectiveness of this drug on the suppression of hyperprolactinaemia and on the recovery of gonadal functions was equivalent to that of bromocriptine previously given to a different group of 83 hyperprolactinaemic patients.

[Bone effects of hypothyroidism in adults. Apropos of 20 cases].

In contrast to the complications of hyperthyroidism, the bone lesions associated with hypothyroidism have not been extensively studied. A prospective study was conducted in 20 adults with protothyroid acquired hypothyroidism did not reveal any abnormalities in the parameters of phospho-calcium metabolism or the concentrations of PTH and the metabolites of vitamin D. The histomorphometric study of bone revealed hyperosteoidosis reflected by a considerable increase in the index of thickness of the osteoid, essentially affecting the relative osteoid volume.

[Posttraumatic neurogenic hyponatremia with late onset].

Ten months following a severe head injury, a 26-year-old man developed a syndrome of inappropriate secretion of antidiuretic hormone (ADH) with a grand mal seizure occurring after an increased intake of non alcoholic beverages. The water loading test was negative but the sorbitol infusion test was positive. In the basal state, plasma concentration of ADH was inappropriate to plasma osmolality.

[Thyroid function in the nephrotic syndrome].

Serum Total Thyroxine (T4), Triiodothyronine (T3), Free Thyroxine (FT4), Free Triiodothyronine (FT3) Reverse Triiodothyronine and T3 Resin Uptake (T3RU) as well as basal and post stimulating TSH were measured in twenty clinically euthyroid patients with the nephrotic syndrome. In comparison with control values, our patients showed (1) significantly lowered mean serum TBG levels (p less than 0,05) (2) unmodified mean serum T3, FT3 and rT3 values (3) significantly lowered mean serum T4 and FT4 levels (p less than 0,001 and p = 0,027 respectively) (4) significantly higher mean basal TSH, and increased TSH response to TRH. We found a significant correlation between proteinemia and T4 or FT4 (p less than 0,001; p less than 0,01 respectively).

[Craniopharyngioma in the same family].

Within 2 years, two sisters, aged 23 and 33, were operated on for a craniopharyngioma. With regard to this exceptional feature, relation between neuroectodermal affections and craniopharyngiomas is discussed, and genetic determination of the occurrence of those tumors is evoked.

[Basal C peptide levels in response to intravenous tolbutamide in the detection of incorrect insulin therapy (or prolonged misuse)].

Fifty nine insulin dependant diabetics were hospitalised for a trial withdrawal of insulin: 17 patients rapidly showed signs of lack of insulin, 18 did not develop cetoacidosis but could not be stabilised on diet and oral hypoglycemic agents, 24 were stabilised without insulin. A statistical study (multifactorial analysis of correlations, plotting of ROC graphs) validated the classification of these diabetics into 3 groups. It also showed that in patients with hypoglycemia, the values of C-protein, and after intravenous injection of tolbutamide, were good predictive factors for insulin-dependance: all patients with basal C-protein less than 1,9 ng/ml could not be stabilised without insulin; when the basal C-protein greater than or equal to 1,9 ng/ml and the amplitude of response at the 5th min was greater than or equal to 0,4 ng/ml, the diabetes could be stabilised by diet and oral hypoglycemic agents in 90 p.

[Hypothyroidism and the Gougerot-Sjögren syndrome].

The signs of Sjögren's syndrome were systematically researched in 36 patients with hypothyroidism (myxoedema with atrophic thyroiditis in 32 cases, Hashimoto's thyroiditis in 4). In a quarter of these patients were noted separately submaxillary glands and/or parotids enlarged, buccal and/or lacrymal sicca syndromes, and antisalivaryy ducts antibodies. The histologic analysis of minor salivar glands revealed foci of lymphocytes and plasmocytes (grades 3 and 4 of Chisholm's classification) in 6 subjects.