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Biomedical subjects

A Goutelle

Publications and source records attributed to A Goutelle.

At least 37 records · Page 2Linked to original sources

[Lumbosciatica caused by spondylolisthesis. Results of the surgical treatment by facetolaminectomy and interbody arthrodesis by the posterior approach in a series of 66 cases].

66 patients with spondylolisthesis were reviewed after surgical procedure with a follow-up period of more than a year postoperatively. The indication for the operation was disabling sciatica in all patients. 4 patients had undergone prior excision of the herniated disc. All the patients underwent a removal of the loose posterior element as suggested by the Gill procedure and intervertebral body fusion using a posterior surgical approach. The surgical procedures with only one regressive neurological complication are described. The results are considered from a clinical and anatomo-radiological point of view. In this series 86.5 percent of 66 patients became sciatica-free. 62 percent of the total series rated the end result as excellent or good. 92.4 percent of the patients demonstrated bony fusion between the two grafted vertebrae. The benefits of posterior laminectomy with interbody fusion are also attractive for spondylolisthesis with sciatica.

Adolescent↗

Human pituitary gonadotropic adenoma; histological, immunocytochemical, and ultrastructural and hormonal studies in eight cases.

Among 230 surgically removed pituitary adenomas, eight tumours showing immunostaining gonadotropic cells and elevated intratumours gonadotropin concentrations have been detected (frequency: 3.5 per cent.). By light microscopy the tumours were composed of agranular cells and generally PAS negative cytoplasm. The immunofluorescence technique revealed the presence of immunoreactive FSH (beta-subunit) alone in two cases, of both FSH and LH in six cases with immunoreactive beta endorphin in two of them. By electron microscopy, the cells contained an often dilated moderately or well developed rough endoplasmic reticulum, secretory granules measuring 150 nm to 200 nm which varied in electron density, and numerous microtubules. Basal plasma FSH and LH levels were simultaneously elevated in two cases; FSH levels alone were elevated in two cases; in three cases, both FSH and LH plasma values were normal. FSH and LH intratumour concentrations were simultaneously elevated in five cases; FSH alone was elevated in two cases. In all cases, the concentrations of the other hormones were negligible, except in two cases where beta endorphin concentration was elevated. The comparison of the immunocytochemical findings, the hormonal plasma levels and intratumour concentrations showed a good relationship between the immunoreactivity of the tumour and the intratumour RIA. The gonadotropic adenoma is uncommon but not rare. Its diagnosis is possible if immunocytochemical techniques are applied.

Adenoma↗

[Surgical treatment of pituitary adenomas. An analysis of 188 cases (author's transl)].

The authors report on a series of 188 patients operated upon for pituitary tumour. Since 12 operations were performed because of local recurrence, the total number of operations was 200 : 27 by the intracranial route and 173 by the naso-sphenoidal route. Four deaths (17%) followed surgery by the former route and three (1.8%) by the latter route. During the decade under review surgical indications have decreased for large tumours belatedly diagnosed and increased for micro-adenomas giving rise to endocrine symptoms only, notably prolactin-secreting adenomas. Improved knowledge of histopathology has resulted in the classification being altered : the conventional division into eosinophilic and chromophobe adenomas has been abandoned to be replaced by cellular types corresponding to the various hormone-producing and functional adenomas. Also a new type has appeared : oncocytoma. Secreting adenomas generally have a better prognosis than non-secreting adenomas, would it be only because they are smaller. Technical advances in operations almost exclusively performed nowadays by the naso-sphenoidal route have improved the results with regard to sight. Sight is now improved in 70.5% of the cases and completely restored in 32.4%.

Adenoma↗