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1.
Hum Reprod ; 27(4): 983-90, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22267833

RESUMO

BACKGROUND: Human toxicity of bisphenol A (BPA), a weak estrogenic environmental endocrine disrupting compound, widely used in plastics, baby bottles, cans and dental sealants, is under investigation. Fetal or perinatal exposure in rodents is associated with programmed adult reproductive diseases. Human epidemiological studies remain scarce, especially concerning testicular development. We have investigated the relationship between fetal exposure to BPA and cryptorchidism. METHODS: Using a radioimmunoassay performed after extraction, validated by high-performance liquid chromatography and mass spectrometry, active levels of unconjugated BPA (uBPA) in cord blood (CB) were measured in 152 boys born after 34 weeks gestation, with cryptorchid or descended testes. RESULTS: Active uBPA was detectable in all CB samples, with values in the control group (n = 106) of 0.14-4.76 ng/ml, median: 0.9 ng/ml; mean ± SD: 1.12 ng/ml ± 0.86 ng/ml, which did not differ from cryptorchid boys (n = 46, 1.26 ± 1.13 ng/ml, P = 0.38). uBPA in controls correlated with CB inhibin B (P < 0.01) and total testosterone (P < 0.05), and with maternal milk polychlorinated bisphenyl 138 (P < 0.03). uBPA did not correlate with clinical maternal or fetal parameters or with other steroid or polypeptide CB hormones assessed. CONCLUSIONS: The presence of uBPA in all CB samples suggests placental transfer and fetal exposure. Similar uBPA levels in the control and cryptorchid groups make the participation of fetal exposure to uBPA in the physiopathology of undescended testes unlikely. However, the observed nanomolar uBPA concentrations support assessment of epidemiological relationships between CB uBPA and other human diseases.


Assuntos
Compostos de Boro/sangue , Criptorquidismo/sangue , Disruptores Endócrinos/sangue , Exposição Ambiental/análise , Sangue Fetal/metabolismo , Fenilalanina/análogos & derivados , Compostos de Boro/toxicidade , Cromatografia Líquida de Alta Pressão , Disruptores Endócrinos/toxicidade , Feminino , Humanos , Recém-Nascido , Masculino , Espectrometria de Massas , Leite Humano/química , Fenilalanina/sangue , Fenilalanina/toxicidade , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Testosterona/sangue
2.
Int J Androl ; 35(6): 835-844, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22712465

RESUMO

The histological classification of testicular germ cell tumours (TGCTs) to seminoma or non-seminomatous germ cell tumours is at present the main criterion for the clinical outcome and selection of the treatment strategy. In view of the need to identify novel prognostic biomarkers for TGCTs, we investigated the expression of the matrix metalloproteinases MMP-2 and MMP-9 in testicular tumour tissues and cell lines of both seminoma and non-seminoma origin. Immunohistochemistry and zymography analysis of tumoural tissues showed significantly higher levels of MMP-2 and MMP-9 compared with normal testis with the active forms detected only in the tumour tissues. Three cell lines representative of the different tumour types, JKT-1 seminoma, NCCIT teratocarcinoma and NTERA2/D1 embryonal carcinoma were also evaluated for their expression of these MMPs using qPCR and zymography and for their invasive properties. The more invasive non-seminomatous teratocarcinoma and embryonal cells expressed considerably more MMP-2 and MMP-9 compared with seminoma cells exhibiting lower invasiveness. Furthermore, an inverse relation was observed between invasiveness and the expression of endogenous inhibitors TIMP-1 and TIMP-2. The MMP inhibitor Marimastat inhibited invasion in all cell lines, the highest inhibition was observed in the more invasive NTERA2/D1 and NCCIT cells, which presented the highest ratio of MMP-2 and MMP-9 vs. TIMP-1 and TIMP-2. These results highlight the importance of MMP-2 and MMP-9 in the invasiveness of testicular tumours and suggest that their levels, vs. those of TIMP-1 and TIMP-2, may represent potential biomarkers for testicular malignancy.


Assuntos
Metaloproteinase 2 da Matriz/metabolismo , Metaloproteinase 9 da Matriz/metabolismo , Invasividade Neoplásica , Neoplasias Embrionárias de Células Germinativas/patologia , Neoplasias Testiculares/patologia , Inibidor Tecidual de Metaloproteinase-1/metabolismo , Inibidor Tecidual de Metaloproteinase-2/metabolismo , Sequência de Bases , Linhagem Celular Tumoral , Primers do DNA , Humanos , Imuno-Histoquímica , Masculino , Neoplasias Embrionárias de Células Germinativas/enzimologia , Neoplasias Embrionárias de Células Germinativas/metabolismo , Reação em Cadeia da Polimerase , Neoplasias Testiculares/enzimologia , Neoplasias Testiculares/metabolismo
3.
Int J Androl ; 34(5 Pt 2): e499-510, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21831232

RESUMO

To assess the incidence and risk factors of cryptorchidism in Nice area. A 3-year prospective study was conducted at two maternity wards involving neonatal screening of boys born ≥34weeks of amenorrhoea. Methodology was strict with examination at birth, 3 and 12months by the same paediatrician. Two strictly matched controls were included for each case. Information on child and parents (medical history, pregnancy, lifestyle) was recorded using medical chart and self-administered questionnaires. A total of 102 of 6246 boys were born with cryptorchidism (prevalence 1.6%, 95 included). Half of them were still cryptorchid at three and 12months with, however, 10% of secondary re-ascent (recurrent cryptorchidism) at 12months, justifying long-term follow-up. Cryptorchidism at birth was associated with instrumental delivery, inguinal hernia and urogenital malformations, particularly micropenis and paternal history of cryptorchidism. Our results suggest that maternal exposure to anti-rust or phthalates could be a risk factor, whereas eating fruits daily seemed somewhat protective. Prevalence of cryptorchidism in our area is on the lower bracket compared with other countries, and is associated with both familial and environmental risk factors.


Assuntos
Criptorquidismo/epidemiologia , Estudos de Casos e Controles , Criptorquidismo/etiologia , Feminino , França/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Exposição Materna/efeitos adversos , Gravidez , Prevalência , Estudos Prospectivos , Fatores de Risco
4.
Int J Androl ; 33(6): 848-52, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20201982

RESUMO

Testicular germ cell cancers are the most common solid malignancies in young men, but their pathogenesis remains undetermined although some epidemiological data have implicated both environmental and genetic factors. Glial cell-derived neurotrophic factor (GDNF) is secreted by Sertoli cells, and promotes germ stem cell proliferation by activating RET, a tyrosine kinase receptor. Over-expression of GDNF in adult transgenic mice induces the development of testicular tumours that mimic human seminoma, the most frequent testicular germ cell tumour. Activating mutations of RET were previously reported in several types of cancer, including thyroid, pituitary, adrenal and melanoma cancer. Both mouse experimental model and clinical studies suggested that mutations or selective polymorphisms of RET might be associated with human seminoma. To verify this hypothesis, we conducted this study in a French University Hospital and carried out an association study using tissue samples from 66 paraffin-embedded seminoma tumours. The most frequently mutated exons of the RET proto-oncogene were sequenced to identify mutations or selective polymorphisms. No somatic mutations were identified. The polymorphic variants frequencies did not differ from those in a control Caucasian population. Human classical seminoma that occurs in young men does not appear to be linked with mutations or relevant polymorphisms of RET.


Assuntos
Neoplasias Embrionárias de Células Germinativas/genética , Proteínas Proto-Oncogênicas c-ret/genética , Seminoma/genética , Animais , Fator Neurotrófico Derivado de Linhagem de Célula Glial/genética , Humanos , Masculino , Camundongos , Proto-Oncogene Mas , Neoplasias Testiculares/genética
5.
Ann Endocrinol (Paris) ; 70(4): 246-51, 2009 Sep.
Artigo em Francês | MEDLINE | ID: mdl-19200942

RESUMO

Turner's syndrome is characterized by an ovarian failure, which occurs in most cases before puberty and leads to infertility. In vitro fertilization with oocyte donation has dramatically transformed the prognosis of infertility of these women. However, in the same time, it has become obvious that pregnancies in Turner's syndrome are at very high risk of possible sudden death because of a specific risk for cardiovascular complications involving aortic root dissection. We report the case of a serious cardiac failure occurred during a twin pregnancy obtained by oocyte donation in a 39-year-old patient with Turner's syndrome. Pregnancy outcome was hopefully favourable thanks to a foetal extraction at 27 weeks of amenorrhoea. If the most reported cases of maternal deaths in patients with Turner's syndrome are associated with an aortic root dissection, our observation is characterized by a full normal cardiologic assessment before the pregnancy and by the absence of aortic root dilatation during pregnancy. This case also illustrates the very high risk of pregnancy in women with Turner's syndrome and the importance of a multidisciplinary care by professionals informed and been used to this obstetric practice.


Assuntos
Gravidez de Alto Risco/fisiologia , Síndrome de Turner/complicações , Alanina Transaminase/sangue , Dissecção Aórtica/epidemiologia , Aspartato Aminotransferases/sangue , Glicemia/metabolismo , Colesterol/sangue , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Feminino , Morte Fetal , Hormônios/sangue , Humanos , Doação de Oócitos , Gravidez , Complicações na Gravidez/epidemiologia , Gravidez de Alto Risco/sangue
6.
Ann Endocrinol (Paris) ; 70(4): 218-24, 2009 Sep.
Artigo em Francês | MEDLINE | ID: mdl-19481731

RESUMO

BACKGROUND: Iodine deficiency (ID) is still common in Western Europe and its prevention remains a challenge, particularly during pregnancy. METHODS: We studied 330 pregnant women in the third trimester of pregnancy for ioduria (UIE) and thyroid tests (TSH, fT4). We collected information on personal history of thyroid disease and treatment with thyroid hormones or iodinated pregnancy tablets. RESULTS AND DISCUSSION: Median UIE was 64 microg/l, reflecting inadequate iodine intake in our population. According to the UIE threshold used for diagnosis (100 to 150 microg/l), ID was present in 74.3% to 85.8% of women; 5.4% had excessive iodine intake, including one taking iodine fortified tablets. Only 8.8% had adequate intake, suggesting that current strategies to eradicate ID are inefficient in our country. Among the 22 women taking iodine supplements, only three had adequate UIE and four had UIE below the detection level, which could suggest either poor compliance or insufficient supplementation. Median fT4 was 12.3pmol/l (8-20.1) and TSH 1.93mUI/l (0.24-6.57). We used different thresholds proposed in the literature to diagnose: hypothyroxinemia: 41.2% were less than 12pmol/l, 10% less than 10.3pmol/l and 1.8% less than 9pmol/l (lower limit of our reference range); subclinical hypothyroidism: 26.3% had TSH greater than 2.5 or 3.9% greater than 4mUI/L, 1.2 to 13% had combined low fT4 (<9pmol/l or <12pmol/) and higher TSH (>2.5mUI/l). There was no correlation between UIE and thyroid tests, nor maternal predicting factors for ID. CONCLUSION: ID is common in our population. The wide range of hypothyroxinemia and subclinical hypothyroidism prevalence should also trigger reflection of diagnostic thresholds and therapeutic intervention.


Assuntos
Iodo/deficiência , Segundo Trimestre da Gravidez/fisiologia , Terceiro Trimestre da Gravidez/fisiologia , Glândula Tireoide/fisiologia , Adulto , Feminino , Humanos , Hipotireoidismo/epidemiologia , Iodo/sangue , Iodo/urina , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/fisiopatologia , Testes de Função Tireóidea , Tireotropina/sangue , Tiroxina/sangue
7.
Hum Reprod ; 23(12): 2858-66, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-18689851

RESUMO

BACKGROUND: One of the most well-documented cytokines suspected as a hazard to male fertility is tumor necrosis factor-alpha (TNFalpha). Genetic factors such as single-nucleotide polymorphisms (SNPs) in the TNF gene cluster impact TNFalpha levels. Our objective was to establish the potential involvement of -308 TNF SNP in male infertility risk. METHODS: In 684 infertile male patients undergoing an intracytoplasmic sperm injection procedure, we used allele-specific polymerase chain reaction (PCR) and PCR-RFLP to investigate the distribution of the guanine (G)-to-adenosine (A) substitution at position -308 in the promoter region of the TNFalpha gene. RESULTS: An increased frequency of the -308 TNFalpha A allele was found in patients with low sperm count of testicular origin [P = 0.002; odds ratio (OR) = 2.93] or with normal production count but altered sperm motility (P = 0.003; OR = 2.32), compared with a patient group with normal sperm count and quality (morphology and motility). In patients with low sperm count exhibiting TNFalpha A allele, compared with those with G allele, an alteration in hormonal balance was observed with increased inhibin B levels and subsequent reduced FSH plasma levels, leading to an FSH/inhibin B ratio roughly half as high (from 0.07 +/- 0.01 in TNFA versus 0.13 +/- 0.02 in TNFG allele groups, P < 0.0001). CONCLUSION: As the -308 TNFalpha A allele has been associated with an increased expression/production of TNFalpha, the potential use of therapies based on inhibition of TNFalpha activities could represent possible therapeutic opportunities for patients with low sperm count (i.e. primary testicular dysfunction) or with altered sperm motility.


Assuntos
Infertilidade Masculina/genética , Polimorfismo de Nucleotídeo Único , Fator de Necrose Tumoral alfa/genética , Adulto , Astenozoospermia/genética , Hormônio Foliculoestimulante/sangue , Humanos , Inibinas/sangue , Hormônio Luteinizante/sangue , Masculino , Pessoa de Meia-Idade , Oligospermia/genética , Globulina de Ligação a Hormônio Sexual/análise , Injeções de Esperma Intracitoplásmicas , Motilidade dos Espermatozoides , Testosterona/sangue
8.
Gynecol Obstet Fertil ; 36(9): 891-7, 2008 Sep.
Artigo em Francês | MEDLINE | ID: mdl-18706846

RESUMO

Turner's Syndrome (TS) is characterized by an ovarian failure which occurs in most cases before puberty and leads to infertility. In less than 10% of women with TS, puberty may occur and spontaneous pregnancies are possible with a high risk of fetal loss, chromosomal and congenital abnormalities. Fertile women with TS should therefore be counselled with regard to these increased risks and be offered prenatal diagnosis testing. For all the other women with TS, in vitro fertilization with oocyte donation (OD) has dramatically transformed the prognosis of infertility. However, in the same time, it has become obvious that pregnancies in TS either spontaneous or obtained after oocyte donation are at very high risk of possible sudden death. Miscarriages are very frequent probably linked to uterine abnormalities. The most specific risks lie in cardiovascular complications involving aortic root dissection, severe hypertension (HTA) or ventricular insufficiency. In fact pregnancies in TS women cumulate the risk of congenital heart defects and HTA associated to TS, the risk of preeclampsia associated to oocyte donation and the increased cardiac work necessary for pregnancy. It is therefore absolutely necessary for all women with TS to undergo a full cardiological assessment before seeking to become pregnant including echocardiography, thoracic magnetic resonance imaging (MRI) to verify aortic root, cardiac valves and left ventricular function, hypertension monitoring and treatment. Single embryo transfer must definitively be considered. Cardiovascular surveillance during pregnancy has to be enhanced especially at the third trimester and during the peripartum period, most women requiring caesarean section for delivery because of cephalopelvic disproportion and/or aortic root dilatation risk.


Assuntos
Infertilidade Feminina/etiologia , Infertilidade Feminina/terapia , Complicações na Gravidez/epidemiologia , Insuficiência Ovariana Primária/etiologia , Síndrome de Turner/complicações , Aborto Espontâneo , Adulto , Ecocardiografia/métodos , Transferência Embrionária , Endométrio/fisiopatologia , Feminino , Humanos , Doação de Oócitos , Cuidado Pós-Natal/normas , Cuidado Pré-Concepcional/normas , Gravidez , Resultado da Gravidez , Cuidado Pré-Natal/normas , Diagnóstico Pré-Natal , Medição de Risco , Fatores de Risco , Síndrome de Turner/fisiopatologia
9.
Gynecol Obstet Fertil ; 36(10): 969-77, 2008 Oct.
Artigo em Francês | MEDLINE | ID: mdl-18805035

RESUMO

Human epidemiological studies and experimental animal data strongly suggest that xenobiotics with estrogenic activity may participate in to the increasing incidence of breast cancer, the most frequent cancer all around the world. Several reports have since 15 years reported positive correlations between blood or peritumoral adipose tissue levels of persistent organic compounds including organochloride pesticides and breast cancer risk. Moreover, fetal or perinatal exposition to low doses of such endocrine disruptors induce premalignant or malignant transformation of adult mammary gland in rodents. However, this environmental endocrine disrupter hypothesis still needs to be demonstrated. Further human studies are needed which will consider the exposition window, the association of several xenoestrogens, the molecular mechanisms involved and the possible individual genetic susceptibility in order to identify pertinent biomarkers and to define acceptable environmental concentration levels for agricultural or industrial chemical new products to be used.


Assuntos
Neoplasias da Mama/induzido quimicamente , Neoplasias da Mama/epidemiologia , Mama/efeitos dos fármacos , Carcinógenos Ambientais/toxicidade , Disruptores Endócrinos/toxicidade , Mama/metabolismo , Exposição Ambiental , Feminino , Humanos , Resíduos de Praguicidas/toxicidade , Fatores de Risco
10.
Gynecol Obstet Fertil ; 36(9): 840-7, 2008 Sep.
Artigo em Francês | MEDLINE | ID: mdl-18707911

RESUMO

OBJECTIVE: Numerous maternal lipophilic compounds are eliminated into milk during lactation, their concentrations reflecting fetal in utero exposure. Some of them are endocrine disruptors. Their role in the occurrence of genital malformation, dysfunction or cancer has been suggested. We wanted to study the exposure of our population and its potential association with cryptorchidism, as few clinical studies are available. PATIENTS AND METHODS: Over three years, we screened for cryptorchidism all boys born alive at or above 34 weeks of gestational age, in two maternity wards (CHU Nice, CHG Grasse). Cryptorchid boys were matched with two controls. Nursing mothers provided a colostrum sample that was screened for 15 compounds known for their antiandrogenic and/or anti estrogenic properties, including dichloro-diphenyl-trichloro-ethylene (DDE), polychlorinated biphenyls (PCBs), dibutylphthalate (DBP) (& metabolite monobutylphthalate-mBP) and hexachlorobenzene (HCB). RESULTS: Out of 6246 boys, 102 were cryptorchid (1.6%). All available colostrums (56 for cryptorchid and 69 for controls) were contaminated. Median concentrations of DDE, PCBs, HCB and phthalates were higher though not significantly in cryptorchid versus controls. Cryptorchid boys were more likely to be classified in the most contaminated groups for DDE and SigmaPCBs, with a trend for mBP. Odds ratio (OR) for cryptorchidism was increased for the highest score of SigmaPCB, with a trend only for DDE versus the lowest score of those components. Our results are similar to those of a Scandinavian study with comparable design. DISCUSSION AND CONCLUSIONS: Our results show the universal contamination of milk with endocrine disruptors in our area, and support the association between congenital cryptorchidism and fetal exposure to PCBs and possibly DDE, alone or in association with other chemicals.


Assuntos
Colostro/química , Criptorquidismo/induzido quimicamente , Exposição Materna/efeitos adversos , Leite Humano/química , Praguicidas/toxicidade , Adulto , Estudos de Casos e Controles , Criptorquidismo/epidemiologia , Diclorodifenil Dicloroetileno/análise , Diclorodifenil Dicloroetileno/toxicidade , Poluição Ambiental , Feminino , Humanos , Recém-Nascido , Masculino , Praguicidas/análise , Bifenilos Policlorados/análise , Bifenilos Policlorados/toxicidade
11.
Ann Endocrinol (Paris) ; 69(5): 453-8, 2008 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-18620332

RESUMO

Testicular adrenal rest tumours are frequently associated with congenital adrenal hyperplasia (CAH). These ACTH-dependent tumours cannot be easily distinguished histologically from Leydig-cell tumours. We report the case of a 30-year-old man who was explored for infertility, azoospermia and unilateral testicular tumour. High levels of 17-OH progesterone and ACTH, low cortisol and undetectable gonadotropins levels, associated to bilateral adrenal hyperplasia, led to the diagnosis of CAH by 21-OH deficiency with a composite heterozygoty. The testicular tumour was first considered as adrenal rest. However, histological analysis of this unilateral painful tumour showed a steroid-hormone-secreting cell proliferation with atypical and frequent mitosis. To discriminate between a benign adrenal rest tumour and a possible malignant leydigioma, tumoral expression of specific gene products was analyzed by RT-PCR. No 11-beta-hydroxylase nor ACTH receptor mRNAs could be found in the tumour, which did not behave like usual adrenal rest cells. For this unilateral testicular tumour, the lack of adrenal-specific markers associated with a high rate of mitosis and pleiomorphism supported a leydigian origin with malignant potential. However, lack of tumoral LH-R mRNA expression and a tumour-free 3-year follow-up led us to retain the diagnosis of adrenal rest tumour with loss of adrenal gene expression and progressive autonomous behaviour.


Assuntos
Hiperplasia Suprarrenal Congênita/complicações , Hiperplasia Suprarrenal Congênita/diagnóstico , Tumor de Resto Suprarrenal/diagnóstico , Tumor de Células de Leydig/diagnóstico , Neoplasias Testiculares/complicações , Neoplasias Testiculares/diagnóstico , Corticosteroides/sangue , Corticosteroides/genética , Hiperplasia Suprarrenal Congênita/cirurgia , Tumor de Resto Suprarrenal/patologia , Tumor de Resto Suprarrenal/cirurgia , Adulto , Anti-Inflamatórios/uso terapêutico , Azoospermia/etiologia , Biomarcadores Tumorais , Dexametasona/uso terapêutico , Diagnóstico Diferencial , Hormônios Esteroides Gonadais/sangue , Hormônios Esteroides Gonadais/genética , Gonadotropinas/sangue , Humanos , Infertilidade Masculina/etiologia , Tumor de Células de Leydig/patologia , Tumor de Células de Leydig/cirurgia , Masculino , RNA Mensageiro/biossíntese , RNA Mensageiro/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Neoplasias Testiculares/cirurgia , Testículo/patologia
12.
Gynecol Obstet Fertil ; 35(1): 49-54, 2007 Jan.
Artigo em Francês | MEDLINE | ID: mdl-17196426

RESUMO

Struma ovarii, a rare form of ovarian tumor, represents less than 3% of ovarian teratomas. The peak frequency occurs during the fifth decade of life. Diagnosis is usually a surprise of pelvic ultrasound or histological analysis. Surgery is the main mode of treatment and prognosis is excellent. Struma ovarii can be associated with thyroid biology abnormalities, or exceptionally become malignant, and thus managed as a thyroid cancer.


Assuntos
Neoplasias Ovarianas/diagnóstico , Estruma Ovariano/diagnóstico , Fatores Etários , Diagnóstico Diferencial , Feminino , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/cirurgia , Prognóstico , Estruma Ovariano/epidemiologia , Estruma Ovariano/cirurgia
13.
Ann Endocrinol (Paris) ; 68(2-3): 191-5, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17559792

RESUMO

Adrenal gland involvement could account for 6% of active tuberculosis. The diagnosis of this extrapulmonary form of tuberculosis is difficult, especially when presenting as unilateral adrenal tumor. This report describes an unusual case of adrenal tuberculosis presenting as a tumor occurring shortly after surgical removal of an adrenal pheochromocytoma located in the opposite gland, in a 63-year-old woman with a previous history of breast cancer. At initial presentation, the patient suffered from symptomatic paroxysmal hypertension. A pheochromocytoma in the left adrenal was diagnosed and resected. One year later, while physical examination and biological parameters were unremarkable, an enhanced adrenal computed tomography (CT) scan showed a right adrenal mass mimicking the CT features of the resected pheochromocytoma. A peripheral tissular rim delineating a central hypodensity characterized this tumor. Magnetic resonance imaging (MRI) showed the same findings on gadolinium-enhanced T1-weighted slices, while the mass was not seen on T2-weighted images. No tumoral signal loss was observed on out of phase images when using the in phase-out of phase T1-weighted sequence. Because of the tumoral evolution and the uncertainty of the nature of that lesion, the patient underwent a second adrenalectomy. Definitive diagnosis was provided by culture of tissue sample, which resulted in the identification of Mycobacterium tuberculosis. In an era of tuberculosis resurgence, this unusual case underscores the necessity of keeping in mind adrenal tuberculosis as a possible differential diagnosis in adrenal tumors of uncertainty nature. It stresses the importance of culture of biopsy tumor, whenever feasible, to avoid unnecessary operations. In the near future, interferon-gamma assay could be a valuable means to recognize extrapulmonary forms of tuberculosis.


Assuntos
Doenças das Glândulas Suprarrenais/complicações , Doenças das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/complicações , Neoplasias das Glândulas Suprarrenais/diagnóstico , Feocromocitoma/complicações , Feocromocitoma/diagnóstico , Tuberculose/complicações , Tuberculose/diagnóstico , Doenças das Glândulas Suprarrenais/tratamento farmacológico , Neoplasias das Glândulas Suprarrenais/cirurgia , Antagonistas Adrenérgicos alfa/administração & dosagem , Antagonistas Adrenérgicos alfa/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Antineoplásicos Hormonais/efeitos adversos , Antituberculosos/uso terapêutico , Neoplasias da Mama/patologia , Diagnóstico Diferencial , Feminino , Fludrocortisona/uso terapêutico , Humanos , Hidrocortisona/uso terapêutico , Interferon gama/metabolismo , Labetalol/administração & dosagem , Labetalol/uso terapêutico , Laparoscopia , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Feocromocitoma/cirurgia , Tamoxifeno/efeitos adversos , Tomografia Computadorizada por Raios X , Tuberculose/tratamento farmacológico
14.
Ann Endocrinol (Paris) ; 68(1): 51-4, 2007 Feb.
Artigo em Francês | MEDLINE | ID: mdl-17313936

RESUMO

Struma ovarii is an ovarian teratoma mainly composed of thyroid tissue, which can become malignant with possible peritoneal dissemination or even distant metastases. Therapeutic management follows protocols used for thyroid cancer. We report the first use of (18)F-fluorodeoxyglucose positron emission tomography (PET) in the follow-up of malignant struma ovarii with persistently elevated serum thyroglobulin level and negative diagnostic iodine 131 whole body scan after thyroidectomy and four courses of 131 iodine. Hilar and mediastinal lymph node uptake was detected but histological verification concluded that there was a false-positive localization corresponding to sarcoidosis lesions without malignant aspect.


Assuntos
Neoplasias Ovarianas/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Sarcoidose/diagnóstico por imagem , Adulto , Reações Falso-Positivas , Feminino , Fluordesoxiglucose F18 , Humanos , Compostos Radiofarmacêuticos , Glândula Tireoide/patologia
15.
J Mol Endocrinol ; 35(1): 191-9, 2005 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16087732

RESUMO

It is now well established that estrogens participate in the control of normal spermatogenesis and endogenous or environmental estrogens are involved in pathological germ cell proliferation including testicular germ cell tumors. Studying a human testicular seminoma cell line, JKT-1, we show here that 17beta-estradiol (10(-12) to 10(-6) M) induced in vitro a significant dose-dependent decrease of cell growth. This antiproliferative effect was maximum after 4 days of exposure at a physiologically intratesticular concentration of 10(-9) M, close to the K(d) of ER, and reversed by ICI 182780, an ER antagonist, suggesting an ER-mediated pathway. By RT-PCR and Western blot we were able to confirm that JKT-1, like tumoral seminoma cells and normal human testicular basal germ cells, expresses estrogen receptor beta (ERbeta), including ERbeta1 and ERbeta2, a dominant negative variant, but not ERalpha. Using immunofluorescence and confocal microscopy, ERbeta was observed as perinuclear intracytoplasmic spots in JKT-1 and tumoral seminoma cells without significant translocation of ERbeta into the nucleus, under 17beta-estradiol exposure. Double staining observed by confocal microscopy revealed that ERbeta colocalized in JKT-1 cells with cytochrome C, a mitochondrial marker. We report for the first time the expression of a functional aromatase complex in seminoma cells as assessed by RT-PCR, Western blot and enzymatic assay. Seminoma cells are able to respond to estrogens through a possible autocrine or paracrine loop. These preliminary results support estrogen-dependency of human testicular seminoma, the most frequent tumor of young men, and suggest potential pharmacological use. Whether this estrogen control, however, involves an ERbeta-mediated stimulation of cell apoptosis and/or an ERbeta-mediated inhibition of cell proliferation, remains to be further determined.


Assuntos
Aromatase/genética , Aromatase/metabolismo , Estradiol/farmacologia , Receptor beta de Estrogênio/genética , Receptor beta de Estrogênio/metabolismo , Seminoma/tratamento farmacológico , Seminoma/metabolismo , Neoplasias Testiculares/tratamento farmacológico , Neoplasias Testiculares/metabolismo , Sequência de Bases , Linhagem Celular Tumoral , Proliferação de Células , DNA de Neoplasias/genética , Relação Dose-Resposta a Droga , Estradiol/administração & dosagem , Estradiol/análogos & derivados , Moduladores de Receptor Estrogênico/farmacologia , Fulvestranto , Expressão Gênica , Humanos , Masculino , Seminoma/patologia , Neoplasias Testiculares/patologia
16.
Gynecol Obstet Fertil ; 33(9): 610-4, 2005 Sep.
Artigo em Francês | MEDLINE | ID: mdl-16126441

RESUMO

Intensive use of radiochemotherapy has greatly improved the prognosis associated with cancer in young women patients. However, improvement of the vital prognosis is frequently associated with impairment of fertility and premature ovarian failure. Cryopreservation of ovarian tissues has been developed but effective secondary use of cryopreserved tissue by means of autograft or through in vitro follicular maturation need yet to be clarified even though first success seemed to be recently obtained. Infant ovaries have been considered to be less sensitive than adult ovaries, which has suggested that hypophysal blockage could protect adult ovaries against fertility impairment before and during radiochemotherapy. Non-randomized studies using LHRH agonists support such a hypothesis. However what we know about physiopathology of follicular destruction involving exaggerated apoptosis and several animal models do not fit with these results. By consequence randomized studies need to be performed to verify the benefit, which one could expect from such a systematic clinical use.


Assuntos
Antineoplásicos/efeitos adversos , Infertilidade Feminina/prevenção & controle , Neoplasias/tratamento farmacológico , Neoplasias/radioterapia , Insuficiência Ovariana Primária/prevenção & controle , Radioterapia/efeitos adversos , Criopreservação , Feminino , Humanos , Infertilidade Feminina/etiologia , Ovário/transplante , Insuficiência Ovariana Primária/etiologia , Prognóstico , Fatores de Risco , Transplante Autólogo
17.
Gynecol Obstet Fertil ; 33(6): 389-94, 2005 Jun.
Artigo em Francês | MEDLINE | ID: mdl-15927506

RESUMO

OBJECTIVES: To evaluate and compare the outcome of pregnancies in women with type 1 diabetes treated with continuous subcutaneous insulin pump or multiple insulin injections. PATIENTS AND METHODS: Thirty-three patients treated with pump, 23 with multiple injections. Were mainly investigated: glycemic control (HbA1C), fetal outcome (congenital malformations, preterm delivery, perinatal mortality), rates of gestational hypertension and cesarean section. RESULTS: HbA1C (1st, 2nd and 3rd trimester) with pump was not significantly different from that obtained with multiple injections (respectively, 7.5 +/- 1.24 vs 7.6 +/- 1.4; 6.34 +/- 0.6 vs 6.6 +/- 0.8; 6.6 +/- 0.7 vs 6.4 +/- 0.7). Fetal prognosis was also similar. The occurrence of gestational hypertension was linked to diabetic complications [OR 5,7, IC95% 1.24-25, p = 0.0025]. The rate of cesarean section (70% in women treated with pump) was influenced by diabetes duration. In planned pregnancy, independently of therapeutic device, HbA1C during organogenesis was better (6.9% +/- 0.78 vs 8.51 +/- 1.3, p < 0.0001) with no perinatal death and no major congenital malformation. DISCUSSION AND CONCLUSION: Fetal prognosis is not overall significantly different with insulin pump compared with intensified conventional therapy. The initiation of insulin pump therapy should not be systematic. Instead, the benefits risks ratio must be assessed resulting in a tailored prescription according to individual needs. This therapeutic choice should be discussed before conception, as planned pregnancy is a main prognostic factor. Diabetes duration and complications remain key factors for the prognosis.


Assuntos
Diabetes Mellitus Tipo 1/tratamento farmacológico , Sistemas de Infusão de Insulina , Insulina/administração & dosagem , Resultado da Gravidez , Gravidez em Diabéticas/tratamento farmacológico , Adulto , Cesárea/estatística & dados numéricos , Anormalidades Congênitas/epidemiologia , Complicações do Diabetes/epidemiologia , Feminino , Hemoglobinas Glicadas/análise , Humanos , Hipertensão Induzida pela Gravidez/epidemiologia , Mortalidade Infantil , Recém-Nascido , Trabalho de Parto Prematuro/epidemiologia , Gravidez , Prognóstico
18.
Diabetes Metab ; 41(2): 107-15, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25454091

RESUMO

The prevalence of type 2 diabetes (T2D) has dramatically increased worldwide during the last few decades. While lifestyle factors, such as decreased physical activity and energy-dense diets, together with genetic predisposition, are well-known actors in the pathophysiology of T2D, there is accumulating evidence suggesting that the increased presence of endocrine-disrupting chemicals (EDCs) in the environment, such as bisphenol A, phthalates and persistent organic pollutants, may also explain an important part in the incidence of metabolic diseases (the metabolic syndrome, obesity and T2D). EDCs are found in everyday products (including plastic bottles, metal cans, toys, cosmetics and pesticides) and used in the manufacture of food. They interfere with the synthesis, secretion, transport, activity and elimination of natural hormones. Such interferences can block or mimic hormone actions and thus induce a wide range of adverse effects (developmental, reproductive, neurological, cardiovascular, metabolic and immune). In this review, both in vivo and in vitro experimental data and epidemiological evidence to support an association between EDC exposure and the induction of insulin resistance and/or disruption of pancreatic ß-cell function are summarized, while the epidemiological links with disorders of glucose homoeostasis are also discussed.


Assuntos
Diabetes Mellitus Tipo 2/induzido quimicamente , Disruptores Endócrinos/efeitos adversos , Exposição Ambiental/efeitos adversos , Poluentes Ambientais/efeitos adversos , Diabetes Mellitus Tipo 2/fisiopatologia , Humanos , Resistência à Insulina/fisiologia , Síndrome Metabólica/induzido quimicamente , Síndrome Metabólica/fisiopatologia
19.
FEBS Lett ; 308(2): 116-20, 1992 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-1499717

RESUMO

Rapid steroid effects, reported in several cell types, have pointed out the possibility of non-genomic mechanisms of action, presumably on cell surface receptors. Here we analyzed the effects of antibody-mediated aggregation of a novel type of progesterone receptor on the plasma membrane of human sperm cells. We report that aggregation of hormone-receptor complexes induces Ca2+ influx and a Ca(2+)-dependent exocytotic event in this system. These data suggest a possible mechanism for rapid steroid-induced events. Further research is warranted to examined if a similar mechanism is involved in rapid steroid effects in other cell types.


Assuntos
Progesterona/metabolismo , Receptores de Progesterona/metabolismo , Espermatozoides/metabolismo , Transporte Biológico , Cálcio/metabolismo , Cátions Bivalentes , Membrana Celular/metabolismo , Humanos , Imuno-Histoquímica , Masculino
20.
J Histochem Cytochem ; 48(6): 793-805, 2000 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10820153

RESUMO

Connexin43 (Cx43) is one of the most predominant gap junction proteins found in the testis. We used in situ hybridization and indirect immunofluorescence to study the distribution of Cx43 mRNA and protein in the rodent seminiferous epithelium. During mouse testis maturation, Cx43 mRNA and its corresponding protein were first detected in the adluminal compartment of the growing seminiferous tubules (early postnatal age: Day 12) to become progressively located in the basal compartment at later ages (Days 16, 19, 27). In seminiferous tubules of sexually mature animals, the intensity of the hybridization signal was stage-dependent, with a maximum at Stage VII compared with Stages V and IX of the spermatogenic cycle (p<0.05). The highest expression of Cx43 mRNA was observed in the supporting Sertoli cells and, to a lesser extent, in the most basally located and less mature germ cells (spermatogonia and spermatocytes). Consistent with these observations, in situ dye coupling was observed between Sertoli cells and basal germ cells. In a mutant mouse deficient for the retinoid X receptor beta, which exhibited abnormal spermatogenesis due to altered Sertoli cell function, Cx43 transcripts were markedly decreased in the seminiferous epithelium (p<0.01). The immunoreactive signal for Cx43 was significantly reduced in seminiferous tubules of the 3-month-old mutant mice (p<0.05) and undetectable in older animals. These data provide new information about the precise localization of Cx43 mRNA and protein in seminiferous tubules of immature and mature rodent testes. Moreover, they suggest that retinoids, through the RXRbeta receptors, could be involved in the control of Cx43 gene expression in Sertoli cells.


Assuntos
Conexina 43/genética , Regulação da Expressão Gênica no Desenvolvimento , Epitélio Seminífero/metabolismo , Animais , Conexina 43/biossíntese , Técnica Indireta de Fluorescência para Anticorpo , Corantes Fluorescentes , Hibridização in Situ Fluorescente/métodos , Indóis , Isoquinolinas , Masculino , Camundongos , Camundongos Knockout , RNA Mensageiro , Ratos , Ratos Long-Evans , Receptores do Ácido Retinoico/genética , Receptores do Ácido Retinoico/fisiologia , Receptores X de Retinoides , Rodaminas , Epitélio Seminífero/patologia , Espermatogênese/fisiologia , Testículo/metabolismo , Testículo/patologia , Fatores de Transcrição/genética , Fatores de Transcrição/fisiologia
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