The ovarian hyperstimulation syndrome in in-vitro fertilization: a Belgian multicentric study. II. Multiple discriminant analysis for risk prediction.

The considerable overlap of distributions of values for different parameters between control and ovarian hyperstimulation syndrome (OHSS) populations makes any single variable inefficient for risk prediction. Combinations of variables were studied in a discriminant function in order to increase predictivity and decrease the false negative rate. Such analyses were performed on two groups of in-vitro fertilization (IVF) patients: all OHSS cases (n = 128) (group A) and only severe OHSS cases (n = 92) (group B). Progressive introduction and automated stepwise selection of variables were applied to both groups. The best prediction (78.5%) was obtained in group A under post-oocyte retrieval conditions using log oestradiol, slope of log oestradiol increment, human menopausal gonadotrophin (HMG) dosage, number of oocytes retrieved and ratio of luteinizing hormone/follicle stimulating hormone (LH/FSH), in the formula. The corresponding false negative rate was 18.1%. However, effective prevention of OHSS implies the ability to withhold human chorionic gonadotrophin injection. Therefore a formula for pre-oocyte retrieval conditions was established yielding a prediction rate of 76.1% with a false negative rate of 18.1%. To be validated, such formulae have to be applied to another population of IVF cases used as a 'testing-set'.

[Pleurisy in ovarian hyperstimulation syndrome]. / les pleurésies d'hyperstimulation ovarienne.

The syndrome of ovarian hyperstimulation is an exceptional aetiology of pleural effusion. It should be thought of any young women who are under treatment to induce ovulation. The effusions are exudates and not transudates as occurs in Demons-Meigs syndrome. The regression of effusions is usual.

[Fatal pulmonary hypertension in Sharp syndrome (M.C.T.D.) with pulmonary fibrosis]. / Hypertension pulmonaire fatale dans un syndrome de Sharp (M.C.T.D.) avec fibrose pulmonaire.

We have followed a case of Mixed Connective Tissue Disease (M.C.T.D.) during 5 years. A progressive pulmonary hypertension inducing cor pulmonary failure terminated in a fatal issue. The prognosis of M.C.T.D. previously considered good is sometimes more severe in spite of immunosuppressive therapy.

Bronchial cancer and hypereosinophilia.

A 73 yr old man with a marked eosinophilia, associated with generalized bronchial carcinoma was observed. Ten months earlier his blood count was normal. The mechanism of the eosinophilia is discussed.

[Apical pulmonary fibrosis and rheumatoid polyarthritis]. / Fibrose pulmonaire apicale et polyarthrite rhumatoïde.

The authors report a case of apical pulmonary fibrosis associated with rheumatoid arthritis. The pulmonary lesions were clearly different from the classical features of pleuro-pulmonary disease in rheumatoid arthritis. They were identical to those described in ankylosing spondylitis. A review of the literature reveals recent report on ten similar cases. The authors discuss a possible relationship with bronchiolitis obliterans.

[Adrenergic receptors of the bronchoalveolar system in the obstructive syndrome]. / Les récepteurs adrénergiques du réseau broncho-alvéolaire dans le syndrome obstructif.

Alpha and beta adrenergic receptors of the lower airways play a role in obstructive airway diseases. These receptors intervene not only in the contraction of the smooth bronchial muscle, but also in mucus secretion, mucociliary clearance and vascular permeability. The pathology of the receptors responsible for perturbations corresponding to these different functions is involved in the pathogenesis of obstructive airway diseases.

[Pleural effusion and Toxocara canis]. / Epanchement pleural et Toxocara canis.

Toxocariasis is an infrequent disease which particularly affects children. Toxocara canis is an uncommon parasite of man, who is not the normal host for the nematode. Without doubt Toxocara will be recognised more and more thanks to specific serological tests, in particular the ELISA-ESA test. The authors observed the association of a pleural reaction and a generalised hypereosinophilia (blood, pleural fluid and broncho-alveolar lavage). They noted a complete regression on Mebendazole.

[Value and limitations of ultrasonic diagnosis in pneumology]. / Intérêt et limites de l'échographie en pneumologie.

For a number of valid reasons, echotomography has the reputation of being of little interest in respiratory medicine. Its indications are certainly infrequent in everyday practice. However, if chest physicians lose interest in the technique, the paradoxal situation may arise where echotomography in respiratory medicine would be under-estimated and under-used. It would be a pity, since the technique is non-invasive and perfectly harmless. The authors review and illustrate the various indications of the method, emphasizing its interest and its limitations.

[A new iatrogenic pathology: pneumothorax after acupuncture]. / Nouvelle pathologie iatrogène: pneumothorax après acupuncture.

Since 1974 a few cases of pneumothorax after acupuncture have been reported. We report a new case of complete pneumothorax after insertion of needles in the chest wall.

[Dosage of prolactin in normal and pathological subjects (author's transl)]. / Dosage de la prolactine dans les conditions normales et pathologiques

Homologous radioimmunoassay of human prolactin was performed and used to investigate the secretion of this pituitary hormone under normal and pathological conditions. The following data were developed in this paper: --During the menstrual cycle, prolactin levels are more elevated during ovulatory and luteal phases than during follicular phase; --During pregnancy, prolactin levels progressively increase to reach their maximum at the end of gestation; --During lactation, prolactin levels increase for the two days following delivery, then progressively decrease; --Bromocryptine oral administration drastically reduces prolactin levels within the 24 hours as it inhibits the prolactin release normally induced by suckling. Assays of prolactin is useful to define the role of this hormone in the genesis of the galactorrhea. Bromocryptine as L Dopa reduce the hyperprolactinemia either functional or tumoral in origin. TRH provokes prolactin release which is more pronounced in females than in males. Pituitary prolactin reserve may be appreciated in several pathological conditions. It appears to be of first interest to assess the residual function of the pituitary gland after surgical removal of adenoma. Depuis 1971, la prolactine humaine peut être dosée dans les milieux biologiques par méthode radio-immunologique (G. BRYANT et coll., 1971; M. L'HERMITTE et coll., 1972; H. FRIESEN et coll., 1972; SINHA et coll., 1973). En 1974 nous avons proposé une méthode de dosage radio-immunologique homologue (A. REUTER et coll., 1976). Grâce à celle-ci nous avons exploré la sécrétion de cette hormone hypophysaire dans certaines conditions normales et pathologiques.

[Release of neurophysins during suckling in the lactating woman]. / Libération des neurophysines lors de la têtée chez la femme allaitante

Using radioimmunoassay for total immunoreactive blood neurophysins (I.R.Neur.) we demonstrate a significant increase 30' after the onset of suckling in 26 normal carefully studied lactating women. On the first day postpartum a constant increase is only observed in 12 patients whilst a significant increase is clearly shown for all patients from the 2nd to the 6th day. These variations are similar to those observed for prolactin blood levels; there is however no relation between basal, suckling stimulated, or ergocryptin inhibited prolactin blood level on the one hand and I.R.Neur. blood level on the other hand.