A CT scan study of the sella turcica and its contents was conducted in patients with Sheehan's syndrome with a search for correlation between the radiological data and the degree of endocrine insufficiency on one hand, and the time course of the disease on the other. Fifty-four patients with Sheehan's syndrome were included: 32 with complete anterior hypopituitarism, 22 with at least one spared pituitary function. Subgroups of equal size were obtained with a cut-off of 9 years evolution. The CT scan appearance of the pituitary was never normal in Sheehan's syndrome. The sella turcica was totally empty in 39 patients. A pituitary remnant was visible in 15 patients, more frequently in those with incomplete hypopituitarism (p less than 0.005) and those with short evolution (p less than 0.025). The size of this pituitary residue never exceeded one third of the normal pituitary gland. The pituitary stalk was always visualized. On the other hand, the size of the fossa was significantly (p less than 0.001) smaller in the patients, as compared to a 12-female control group, matched for age and number of pregnancies. Among the patients there was no difference when considering the disease duration nor the degree of hypopituitarism. An empty or partially empty sella of normal or reduced size is a constant feature of Sheehan's syndrome. The presence of a pituitary remnant is inversely correlated to the duration and extension of the disease. Arachnoid herniation alone does not induce a dilatation of the fossa.

The echo patterns of diffuse thyroid lesions in children are not yet well known. We present here the ultrasound findings of 32 children aged 5 to 15 years with a newly diagnosed diffuse thyroid disease. 23 patients had thyromegaly by palpation, 9 had hypothyroidism but no goiter. Of the 23 goitrous patients 9 were hypo-, 3 hyper-and 11 euthyroid. The 9 with hypothyroidism had all autoimmune thyroiditis as judged by antithyroid antibodies, and confirmed cytologically in 5. They had all 9 a hypoechogenic patchy, partly nodular thyroid by ultrasound.2 of the 3 with Graves disease had initially a similar pattern than in thyroiditis, the 3rd showed hypoechogenity later. Of the 11 euthyroid patients 8 had antithyroid antibodies and the ultrasound suggested thyroiditis in 5 of them, 3 were judged normal (2 and 1 became later hypothyroid). Of the 3 patients with euthyroid goiter but without antithyroid antibodies the ultrasound finding was normal in 1, showed multicystic thyroid in 1 and suggested thyroiditis in 1 who later had antithyroid antibodies. Of the 9 hypothyroid patients without thyromegaly one had an unusually small hit otherwise normal thyroid by ultrasound. The others had an echopoor thyroid, but the patchy and nodular pattern was often less marked than in goitrous hypothyroidism. We conclude that autoimmune thyroiditis gives a typical ultrasound pattern, and ultrasonography gives useful information especially of euthyroid goiter and nongoitrous hypothyroidism. PERICARDIAL EFFUSION IN CONGENITAL HYPOTHYROID/ ; A 1NFANTS:AN AETIOLOGICAL CORRELATION. Gianfili~po -" ...~e h children positive at the newborn screen'ing program for congenital hypothyroidism were studied. Confirmlng diagnosis was made in 8/10 infants,while 2/10 were false positive. Moreover we have considered in the study a patient clinically diagnosed at 19 months (he did not undergo the screening prograrn),in which was demonstrated an ectopic g1and.A complete thyroid function evaluation (FT3,FT4,T3,T4,TBG,TRH test),scintlgraphy (TC99),echocardiography (B-mode)were carried out in all the babies (scintigraphy was not performed in the 2 false positive children). Pericardial effusion was demonstrated in 4/9 patients (44%); complete resolution occurred after a variable period of L-T4 therapy (15 days to 5 months).None of the patients showed clinical symptoms nor electrocardiographrc signs of cardiac failure. Data collected in Zaire suggested that severe iodine deficiency resulted in neonatal hypothyroidism and its longterm consequence, endemic cretinism. In order to further evaluate this possibility, we initiated neonatal thyroid screening in an endemic goiter area in Algeria (area A) with a high prevalence of goiter (51.3 %) and cretinism (1.1 %) and a low dietary supply of iodine (I)(Mean urinary I : 16.2 uglg creatinine) and in a non goitrous area (B) with no cretinism and a normal iodine supply (urinary 1:73.9 ug/g creat.). Serum TSH levels in 3135 newborn infants of area A were shifted towards high values as compared to the results obtained in a...

No abstract

The clinical and biochemical features of myxoedematous and neurological cretinism were studied in an endemic goitre area in Algeria (goitre prevalence 51.3%; endemic cretinism 1.1%; mean urinary iodine level 127.6 nmol/l). When comparing the data collected in six different villages of the area, significant negative correlations were found between the decrease in urinary iodide and iodide/thiocyanate ratio (I/SCN) and the increase in prevalences of visible goitres, endemic cretinism and transient neonatal hypothyroidism. The cretins were divided on clinical signs into two groups: myxoedematous (MC) and neurological (NC) cretinism. Differences were noted in the neurological signs and the type of deafness encountered in both types. Although some overlap did exist, proximal spasticity and rigidity were characteristic of NC. The hormonal profiles of the two groups, including TRH tests, were clearly different. The two groups were similar with regard to the percentage of palpable thyroids, the absence of antimicrosomal and anti-thyroglobulin antibodies, seropositive viral antibodies and thiocyanate concentrations in serum and urine. Thus it is unlikely that these factors have any significant aetiological role in NC. The data collected in the general population in this area and those obtained in the mothers of the myxoedematous and neurological cretins support the hypothesis that the neurological signs are the result of hypothyroxinaemia in the mothers and the fetus at different periods of pregnancy. They could be aggravated by neonatal hypothyroidism, which may be transient in NC and permanent in MC.

Concentrations of natural (40K,210Pb, uranium, and thorium series) and artificial radioelements (137Cs,90Sr,239+240Pu) were determined in seawater and sediment samples collected from stations along the Algerian coast. Seawater was collected from the surface to a maximum depth of 2000 m; the sediment cores were sampled from a depth of around 1500 m. This work was carried out in August 2001, in the framework of the Regional African project /7/004 (RAF), by the accomplishment of an oceanographic campaign organized by the International Atomic Energy Agency (IAEA) in collaboration with Commissariat à l'Energie Atomique (COMENA) and L'Institut des Sciences de la Mer et de L'Amenagement du Littoral (ISMAL), on board of the research vessel of M.S. Benyahia of ISMAL. In addition to the record of the conductivity (mS) and temperature (°C) data at each station, seawater samples were treated and preconcentrated on board, those of sediment cores were divided into different layers in order to undergo analyses in the laboratory of radiological impact studies of Algiers. Concentration results were obtained for137Cs and90Sr in mBq/L and239+240Pu inμBq/L in seawater, and also for natural and artificial radionuclides in Bq/kg dry weight in the layers of the sediment cores. The different profiles of137Cs,239+240Pu,90Sr, and210Pb concentrations against depth were presented to show artificial radioactivity distribution in the water column and sediment core. Concentrations of137Cs in the sediment core were also used to identify the137Cs peak in the area of interest.