[Abnormalities of insulin secretion in coronary patients. Apropos of 67 cases]. / Anomalies de la sécrétion d'insuline chez les coronariens. A propos de 67 observations.

The curve of blood insulin levels recorded during the oral provoked hypoglycaemia test (OPHG) was studied in 67 proven coronary patients. None of the curves obtained was normal. The abnormalities found in this way are of two types: either a hypoinsulinaemic response, with a high non-retarded peak (type 1) or a high retarded peak (type 2), or else a hypoinsulinaemic response, with a flat curve (type 3) or a very small late peak (type 4). The possible role of these abnormalities of insulin secretion in the pathogenesis of atheroma is discussed. The correlations between age, sex, obesity, hypertriglyceridaemia, and the OPHG curve are investigated. The preliminary results of a test in which insulin levels are monitored after intravenous provoked hypoglycaemia, followed by tolbutamide, are reported.

[Thyrotoxic periodic paralysis. Its nosographic situation]. / La paralysie périodique thyrotoxique. Sa place nosographique.

Thyrotoxic Periodic Paralysis is a well-defined syndrome from the standpoint of clinical, electromyographic, biochemical, microscopic and etiologic features. The syndrome is characterized by acute episodes of flaccid para or tetraplegia induced by excess exogenous or endogenous thyroid hormones. This syndrome is distinct from thyrotoxic myopathy and familial periodic paralysis. The rare occurrence of TPP compared to that of hyperthyroidism, is higher incidence in males and Asiatics and the role of high carbohydrate intake raise questions as to the predisposing factors which lead thyroid hormones to directly or indirectly modify muscle membrane permeability to electrolytes. Cure of hyperthyroidism consistently results in arresting the sequence of the paralytic attacks.

[Anomalies of corticotropin secretion in chromophobe adenomas]. / Anomalies de la sécrétion corticotrope dans les adénomes chromophobes

Corticotrophic secretion has been studied in several groups of subjects during metopirone test and arginine L-Dopa infusion. In animals, a net plasma ACTH increase is observed under while it is inconstant after arginine L-Dopa. In hypopituitarism, metopirone ACTH levels are low and unchanged during the tests. In chromophobe adenoma, basal ACTH levels are high, ACTH increase is normal during test and significantly higher than in controls after L-Dopa injection. Significance of these metopirone corticotrophic abnormalities is discussed.

[Apparent internal male pseudo-hermaphroditism. Gynecomastia. Negative gonad surgical research. Caryotype 46, XX. Presence of H-Y antigen (author's transl)]. / Pseudo-hermaphrodisme mâle interne apparent. Gynécomastie. Recherche chirurgicale des gonades négatives. Caryotype 46, XX. Présence d'antigène H-Y.

Boy 15. Aspect of delayed puberty with empty scrotum and gynecomastia. Caryotype 46, XX. Presence of H.Y. Antigen. Plasmatic testosterone 1 020 pg/ml. Normal plasmatic FSH and LH. Hypotrophic uterus and tubes. No gonad found. Small right epididymis. Complete virilization by testosterone.

[46 XX karyotype men (author's transl)]. / Les hommes à caryotype 46, XX.

85 cases of this syndrom have been published since the original case in 1964. The main clinical symptoms are those of Klinefelter's disease from which it differs by the caryotype only. Azoospermie is the rule. 3 mechanisms can be implicated: Mosaic 46 XX/47 XY with secondary loss of Y chromosome; Translocation of a part of Y chromosome upon an autosome or Y chromosome; Autosomal mutant gene acting upon the masculinizing site of X chromosome and inducing the primitive development of the testis as the short arm and proximal part of the long arm of Y chromosome normally do. These mechanisms perhaps are distinct origins of a syndrom which clinic alone cannot dissociate.

[Thyrotoxic periodic paralysis: case report (author's transl)]. / Un cas de paralysie périodique thyrotoxique.

Boy 19, french -- Attacks of hypokaliemic flaccid tetraplegia in 1972 -- 4 months later thyreotoxicosis -- Disappearance of neurologic symptoms and euthyroid condition after carbimazole. Relapse 5 years later of concomitant thyreotoxicosis, hypokaliemic tetraplegia attacks and lower limbs myalgias. Normal conventional and enzymatic light histology of quadriceps. Anomalies of membraneous system (T system and sarcoplasmic reticulum) on electron microscopy -- subtotal thyroidectomy -- hormonal and neurologic total recovery. Caucasoid erythrocyte and HLA groups.

[Incomplete testicular feminisation syndrome by testosterone insensitivity (author's transl)]. / Pseudo-hermaphrodisme mâle incomplet par insensibilité à la testostérone

Male pseudo-hermaphroditism by partial testosterone sensitivity, without steroido-genesis abnormality, without apparent 5 alpha reductase deficit - Empty complete scrotum and hypospadias surgically normalized. At 39, scrotal testis 32 X 15 mm right, 23 X 10 mm left. Infantile penis and prostata. Gynoid scapulo-pelvic proportions, adipo-muscular ratio and fat distribution. Bilateral gynecomastia. Caryotype 46 XY - 17 ks 26 mg. After intravenous 100 ng LH RH: plasma (pl) LH increased 105 to 285 ng/ml, pl testosterone 5 ng/ml unchanged, pl oestradiol 115 to 135 pg/ml. 48 h after intra muscular 300 mg testosterone propionate: pl testosterone increased, 13 to 39 ng/ml, androstenedione 1,5 to 3,04 ng/ml, dihydrotestosterone 0,85 to 1,45 ng/ml, OEstradiol 52 to 110 pg/ml. No effect of 29 g testosterone oenanthate in 2 years.

[Sexual differentiation of the adipose tissue-muscle ratio. Its metabolic impact]. / La différenciation sexuelle du rapport adipo-musculaire. Ses incidences métaboliques.

Muscle and fat development are regulated by opposite and also cooperating factors. Adipo-muscular ratio is the result of those forces. The need of a determined fat mass and of its corollary a determined muscle mass is an important physiologic parameter. Sexual differentiation is the main factor adipo-muscular ratio. Feminine fat is twice as big as masculine fat: it predominates in the lower body, masculine fat in the upper body. Brachio-femoral adipo-muscular ratio is, among others, a good index of fat sexual differentiation. Android obesity, predominating in both sexes in the upper body, is, with genetic predispositions, the main factor of non insulin dependent diabetes carbohydrate sensitive hyperlipoproteinemia, hyperuricemia, atherosclerosis. Easy determination on fat topography before the age of 30 is, particularly in women, the best tool for an efficacious prophylaxis of obesity's metabolic complications.