[Effect of thyroid function on ketogenesis (author's transl)]. / Influence de l'état thyroïdien sur la cétogénèse.

Thyroid hormone effects have been studied in both rats and human. In rats ketone body levels are increased by thyroid hormone excess at the initial phase of starvation. Glucose levels are also increased at the initial and late phase of starvation. Ketone bodies production of isolated liver cells from thyroidectomized fed rats (14 +/- 0,2 muMol/g/h) are decreased when compared with cells from thyroidectomized fed rats treated with triiodothyronine 63 +/- 3 muMol/g/h). These changes are related to a direct effect of T3. Ketone bodies levels are increased in Grave's diseases. The increase is significantly correlated to thyroid hormone levels.

[Surgical treatment of Graves' disease (author's transl)]. / Traitement chirugical de la maladie de Basedow.

135 patients with goiter treated for Graves' disease have been followed during 10 years (12) 5 to 1 years (64) 1 to 5 years (59) after surgical treatment. The incidence of hypothyroidism increases with the delay (23 % after 1 year, 32,6 % after 5 years, 37,8 % after 10 years). The incidence of relapses is similar (7,4 % after 1 year, 15,5 % after 5 years, 22,2 % after 10 years). There is no predictive value of clinical and biological data. Only the limits of thyroidectomy and the pathological findings can inform on the post operative evolution : relapses are more frequent after subtotal bilateral thyroidectomy, hypothyroidism is more frequent after one total lobectomy + subtotal lobectomy on the other side and in the case of large lymphocytic infiltration.

[Thyrotropic reserve in Sheehan's syndrome. Study in 36 patients (author's transl)]. / La réserve thyréotrope au cours syndrome de Sheehan. Etude chez 36 malades.

Thyrotropic involvement is considered to be constant in Sheehan's syndrome. In this study, plasma thyroid stimulating hormone (TSH) levels were similar to those of normal women (respectively: 1.01 +/- 0.54 ng/ml and 0.54 +/- 0.27 ng/ml). The pituitary response to the administration of TRH was nul in 63.8% of cases. In one patient, thyrotrophic function was normal. Twelve patients had a minimal or moderate reserve of TRH. By order of prevalence, thyrotrophic involvement succeeds that of the somatotrophic and lactotrophic axes. There is no correlation with involvement of other axes which would make it possible to define a sequential course of pituitary lesions. These results are discussed in the light of the existing literature. The TRH test does not offer certain evidence of hypothalamic involvement.