Biomedical subjects

B Guilhaume

Publications and source records attributed to B Guilhaume.

39 records · Page 3Linked to original sources

PubMedDate not supplied

[Cushing's disease. Current data on its course and treatment].

Recent developments in the treatment of Cushing's disease, particularly the trans-sphenoidal microadenomectomy, have prompted a survey of the pathophysiological theories of ACTH hypersecretion in this condition. The results of the trans-sphenoidal approach are reported and the post-surgical evolution (success failure or recurrence) are discussed. It is emphasized that a long fellow up is essential to assess the efficacy of this therapeutic approach.

Adenoma↗

PubMedDate not supplied

[Long term results of the surgical treatment of acromegaly. Longitudinal study of a series of 68 patients (author's transl)].

In order to evaluate treatment of acromegaly, a 5-year study was undertaken on 68 acromegalics, selected from a series of 155 cases, treated by surgery alone (31 cases) or by combined surgery and radiotherapy (37 cases). Immediate return to normal of STH levels in the post-operatoire period is rare (7%) and the clinical improvement observed in most instances seems to be explained by the relative fall in STH that is usually found. Blood volume appears to be the best metabolic parameter of STH levels. Rapid return to normal of STH levels in the post-operative period is a good pronostic sign, but the authors emphasize that STH secretion can vary in the same patient after surgery alone or after combined surgery and radiotherapy. The pituitary insufficiency observed in 35% of cases is more frequent after limited surgical excision followed by radiotherapy or after wide excision alone. In 70% of cases, patients with pituitary insufficiency retain raised STH levels.

Acromegaly↗

PubMedDate not supplied

[Magnetic resonance imaging in Cushing disease. Prediction of surgical results].

OBJECTIVES: The purpose of the study is to determine if pituitary Magnetic Resonance Imaging (MRI) can predict the outcome of transsphenoidal surgery in patients with Cushing's disease. METHODS: Fifty four patients were divided in three groups according to MRI findings: those with a well circumscribed focal lesion clearly separated from the cavernous sinus (group 1, n = 24), those with adenomas in close contact with the cavernous sinus (group 2, n = 18), and those with no identified lesion (group 3, n = 12). RESULTS: The adenoma is found on the predicted side in 97,6% of the cases with positive MRI. A histologically proven adenoma is found in 96, 100 and 33% of the cases in groups 1, 2 and 3, with successful outcome in 91, 94 and 58% of the patients respectively. In group 2, surgery failed in a patient in whom tumoral tissue surrounded the internal carotid artery, but succeeded in two other cases in whom a MRI involvement of the cavernous sinus was suspected. CONCLUSION: We confirm the excellent localization value of MRI. Failure due to cavernous sinus involvement can be predicted only when MRI shows that the adenomatous tissue surrounds the carotid artery. In cases of negative MRI, the outcome is less favorable.

Adenoma↗