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Biomedical subjects

F Grisoli

Publications and source records attributed to F Grisoli.

At least 73 records · Page 4Linked to original sources
PubMed1998

Hidden chromosome abnormalities in a primary central nervous system lymphoma detected by multicolor spectral karyotyping.

Cytogenetic analysis provides important information for diagnosis and prognosis in some tumors. But karyotype analysis can be difficult in some cases, because metaphase chromosomes are contracted. New techniques, such as fluorescence in situ hybridization and, more recently, spectral karyotyping, or SKY, based on the hybridization of 24 fluorescently labeled chromosome painting probes, allow the detection and identification of complex chromosomal rearrangements. We report here a case of primary central nervous system lymphoma in which chromosomal rearrangements and marker chromosomes not identified by a routine cytogenetic technique were clarified by SKY. This shows the value of the SKY technique in the cytogenetic diagnosis of tumors.

Aged↗
PubMed1998

The hormonal response to stress is not modified by the dramatic decrease in prolactin plasma concentration during surgery for microprolactinoma.

OBJECTIVES: To determine the endocrine response to surgical stress in a homogeneous population of 36 women with microprolactinomas, particularly to evaluate the effect of the sharp decrease in plasma prolactin on stress induced hormonal secretion. In addition, the effects of exogenous opiates on prolactin secretion were studied. METHODS: The plasma kinetics of cortisol, prolactin, ACTH, GH, and beta-endorphin like immunoreactivity (beta-ELI) were analysed by including patients operated on with strict anaesthetic and surgical protocols, and by sampling blood every 10 minutes, starting at premedication up to 3 hours after induction. RESULTS AND CONCLUSIONS: (a) Surgical stress or opiate administration did not induce prolactin release in patients with microprolactinoma. (b) The dramatic decrease in prolactin concentrations have apparently no effect on the release of other hormones involved in stress. (c) The existence of an early GH peak, independently of any surgical procedure, strongly suggests that GH is released by surgical stress whereas beta-endorphin is secreted in response to pain. Thus GH may be a useful marker of surgical stress.

Adolescent↗
PubMed1998

Short-term endocrinological results after gamma knife surgery of pituitary adenomas.

We report our preliminary results after the radiosurgical treatment of 25 secreting pituitary adenomas with a mean follow-up of 20 months (range 6-36 months). Fifteen acromegalic patients showed a decrease of 65% in mean growth hormone (GH) levels after 6 months and of 77% after 12 months. Only 3 patients (20%) are considered to be in remission (mean GH and IGF1 level into the normal range). A decrease of prolactin (PRL) was noted in 46% and 64% at 6 and 12 months after radiosurgery in 4 patients with prolactinomas. There was no case of PRL normalizaion. At present 3/4 patients have individual PRL levels slightly above the normal range. A normalization of Urinary Free Cortisol (UFC) was noticed in 4/6 (66%) patients Cushing's disease within 6-12 months. Pituitary deficiency was noticed in this series in 4/25 patients (16%) who received subtotal or total pituitary irradiation for large postoperative remnants of secreting adenomas poorly defined on magnetic resonance imaging (MRI).

Acromegaly↗
PubMed1998

[Meningeal hemangiopericytomas. A retrospective reciew of 20 cases].

BACKGROUND AND PURPOSE: Meningeal hemangiopericytomas (MHP) account for 2% of meningeal tumours. Clinical features, radiology findings, therapy and outcome of 20 MHP operated in our department from 1965 through 1995 were analyzed to determine presurgical features for diagnosis, histologic diagnostic criteria and the role of adjuvant post-operative radiotherapy. METHODS: In conformity with the new WHO classification which differentiates MHP from meningiomas, 20 patients with tumors compatible with this definition were reviewed. RESULTS: The clinical features differed slightly from meningiomas. Only epidemiologic data were different. The CT and MRI scanning gave no preoperative distinction between MHP and meningiomas. Angiography played a predominant role in this distinction. The 20 patients were operated. Twelve received post-operative radiotherapy. The rate of local recurrency was 45%. Of these, 88% did not receive radiotherapy post-operatively. Two patients (10%) presented late recurrence and three patients (15%) one or more extra-neural metastases. Two patients received radiosurgical treatment. In one case with disseminated metastasis, chemotherapy was used without success. Three patients died during the follow up. CONCLUSION: Considering our review and the current literature, it seems that complete excision followed by adjuvant radiotherapy of more than 50 Gy significatively reduces the risk of recurrence (p < 0.0001). Radiosurgery is indicated for recurrent tumors measuring less than 30 mm in their greatest diameter.

Adolescent↗
PubMed1998

[A free meningioma of the cauda equina].

We report an unusual case of a cauda equina meningioma occurring in a young girl. This tumor was neurinoma-like. No meningeal attachment was identified in the neuroradiological study and during its microsurgical removal.

Adolescent↗
PubMed1998

Contribution of cytogenetics and FISH in the diagnosis of meningiomas. A study of 189 tumors.

The correlation between cytogenetic and histopathological findings were analysed in 189 meningiomas. The tumors were classified according to increasing degrees of anaplasia. We observed normal karyotype or only monosomy 22 in grade 1 (benign) tumors, while in grade 3 (anaplastic) only 1.5% of karyotypes were normal. Grade 2 (atypical) and 3 (anaplastic) tumors showed complex structural abnormalities. Loss of chromosome 14 were only found in grade 3. In cases with complex structural rearrangements, fluorescence in situ hybridization technique (FISH) has been realized and permitted a best identification of abnormalities. In our series, five patients recurred. They presented chromosomal abnormalities. These complex karyotypes in recurrent meningiomas might indicate aggressive tumor characteristics. Our results indicate histolopathological and cytogenetics correlations might represent a prognostic factor in meningiomas.

Adult↗
PubMed1997

Intraoperative autologous blood transfusion in intracranial surgery.

OBJECTIVE: The purpose of this study was to evaluate the benefits of intraoperative autotransfusion of autologous blood on the conservation of allogenic blood, including cost-effectiveness and the consequences for hemoglobin level and coagulation tests. METHODS: The Hoemonetics Cell Saver 4 autotransfusion system (Hoemonetics Corporation, MA) was used when the estimated blood loss was equal to or more than 500 ml. A total of 472 patients undergoing intracranial surgery were included in the study. RESULTS: Ninety patients (19%) received transfusions either with autologous blood or allogenic blood. Fifty-five patients (61%) received only autologous blood transfusions, 10 patients (11%) received both autologous and allogenic blood transfusions, and 25 patients (28%) received only allogenic blood transfusions. The amount of autologous blood transfused was 600 +/- 590 ml (range, 230-3000 ml). The amount of allogenic blood transfused was 3 +/- 3 units (range, 2-15 units). Autologous blood represented 68% of all blood products transfused. Mild abnormalities during coagulation tests occurred without clinical bleeding. CONCLUSION: Autologous blood transfusions were demonstrated to be safe in patients undergoing intracranial surgery and to be more cost-effective than allogenic blood transfusions. Intraoperative autologous blood transfusions may be used alone in more than half of the patients requiring transfusions during intracranial surgery and decrease the amount of allogenic blood used. Improvements in the monitoring for the need of performing this technique, as well as preoperative blood donations, would decrease the amount of allogenic blood transfused.

Adult↗
PubMed1997

[Left temporal meningioma disclosed by ipsilateral hemiplegia].

A 46 year-old woman presented with a weakness of the left side. MRI of the brain showed a left temporal meningioma, a left temporal lobe herniation and two high-signals in the right cerebral peduncle. The involvement of the pyramidal tract in the foot of the cerebral peduncle, in this case, results from temporal lobe hemiation. These findings are different from the mechanisms reported in other cases of ipsilateral hemiplegia. The ipsilateral hemiplegia syndrome was classically described by Ectors in relation to a meningioma of the foot of the third frontal circonvolution. Pathophysiological theories of ipsilateral hemiplegia are reviewed.

Brain Neoplasms↗
PubMed1996

The contribution of cytogenetics to the histogenesis of meningeal hemangiopericytoma.

Some controversy has existed regarding the nosology of meningeal hemangiopericytoma. In the WHO's classification of 1979 these tumours were included as a subgroup of meningiomas, but for some authors, they should not be classified as meningiomas. Cytogenetic studies on meningioma demonstrate monosomy or partial deletion of chromosome 22 in 60% of these tumors. There have been few cytogenetic studies about meningeal hemangiopericytoma. We present here the results of cytogenetic studies and fluorescence in situ hybridization in six cases of meningeal hemangiopericytoma. In these tumours we have never found monosomy 22, but all six cases were hyperdiploid. These cytogenetic data might provide additional evidence to differenciate the meningeal hemangiopericytoma from the meningioma.

Adolescent↗
PubMed1996

Pit-1 gene expression in human lactotroph and somatotroph pituitary adenomas is correlated to D2 receptor gene expression.

The expression of the pituitary-specific transcription factor Pit-1 gene was analyzed in a series of 30 human lactotroph and somatotroph pituitary tumors. Northern blot analysis failed to reveal any quantitative differences in Pit-1 gene expression between somatotroph and lactotroph tumors, and reverse transcription-PCR analysis showed similar patterns of Pit-1 isoforms expression in both populations of tumors. The expression of the D2 receptor gene was subsequently analyzed in the same adenomas. In the prolactinomas, which presented with a variable sensitivity to dopamine agonist treatment, the intensity of the D2 receptor transcripts (2.8 kilobases) was variable and was related to the sensitivity to the dopamine agonist treatment. Notably, the individual D2 receptor messenger ribonucleic acid (mRNA) levels were highly correlated to the Pit-1 mRNA levels measured in the same tumors (r = 0.90; P < 0.0001). In the GH-secreting tumors, a significant expression of the D2 receptor gene was evidenced by Northern blot in all mixed somato-lactotroph adenomas and in some of the pure somatotroph adenomas; again, a positive correlation was found between D2 mRNA and Pit-1 mRNA levels (r = 0.68; P < 0.01). These results suggest the existence of mechanisms responsible for a coordinate control of Pit-1 and D2 receptor genes that remain to be determined.

Adenoma↗
PubMed1996

Unusual chromosome abnormalities in primary central nervous system lymphoma.

Primary central nervous system (PCNS) lymphoma is a relatively rare disease. The Epstein-Barr virus (EBV) has often been implicated in the development of lymphomas. Few cytogenetic. studies on PCNS lymphomas have been reported. We describe here an unusual case of PCNS B cell lymphoma, centroblastic polymorphic type without coexistent immune deficiency. The cytogenetic study showed unusual abnormalities: t(l;9) (q25;p21); del (6) (q14 q25), trisomy 12 and in addition one clone with trisomy 7 and loss of chromosome X. We did not observe any chromosome 14 abnormality, which is more commonly reported in PCNS lymphomas.

Aged↗
PubMed1996

[Corticotropic adenoma in slow adrenal insufficiency].

This case report deals with an insulin-dependent diabetic patient suffering peripheral adrenal insufficiency who, after 12 years of substitutive treatment exhibited resistance to mineralo- and gluco-corticoids with relapse of melanodermia and plasma ACTH levels higher than 1500 pg/ml despite increasing doses. A corticotrop macroadenoma was diagnosed by MR imaging and functional tests and confirmed by surgical excision followed by disappearance of resistance. Pre-operative functional investigation show autonomisation of the adenoma but with some partial persisting regulation. This case report draws attention to this rare either complication or association which can occur in peripheral adrenal insufficiency.

Addison Disease↗
PubMed1996

[Cytomegalovirus encephalitis in an immunocompetent adult].

Cytomegalovirus encephalitis in immunologically normal patients is rarely reported in the literature. Only seven cases have been previously reported. CMV infection was diagnosed in a 24-year-old, immunologically normal female presenting a severe clinical picture due to encephalitis. Diagnosis was based on detection of CMV DNA in the CSF with the polymerase chain reaction. Administration of ganciclovir was followed by an immediate improvement.

Adult↗
PubMed1996

[Angiographically occult vascular malformations of the brain stem. Apropos of 25 cases].

Due to the current use of magnetic resonance imaging (MRI), angiographic occult vascular malformations (AOVM) located in the brain stem are frequently reported in the last ten years. The term AOVM is ambiguous and controvers. For, most of these lesions presented with MRI pattern of a cavernous angioma, but only few cases received pathological confirmation. In this location, the operative treatment while worthwhile could be hazardous indeed, so a conservative management is more commonly discussed first. However, the potential risk of rebleeding or poor clinical condition sometimes encourage a more aggressive decision. We report our experience in 25 patients (4 children and 21 adults) admitted between 1982 and 1994 with an AOVM located in the brain stem. In 17 patients, the cryptic vascular lesion was removed surgically. A cavernous angioma was strictly confirmed in only 8 cases. Conversely, 8 patients were managed conservatively. In the surgically treated group of patients, 10 improved their neurological deficit postoperatively, 2 patients remained unchanged, 3 patients worsened, and 2 patients died. The final outcome in 14 patients was evaluated after 51 months of mean follow-up (17 to 70 months). In 5 cases (35.7%) the result was excellent (no symptoms), 5 cases had a good result (normal activity with minimal residual disability), and 4 cases (28.5%) remained with severe permanent disability. In the non-surgically treated group of patients, the final outcome was evaluated after a mean follow-up period of 67 months (from 1 to 120 months). One patient experienced a rebleeding and remained severely disabled. Another patient had two bleeding episodes leaving only a minor facial numbness. Four patients were symptom-free, and the last case was lost for follow-up.

Adolescent↗
PubMed1996

[Acute Weston Hurst necrotizing hemorrhagic leukoencephalitis].

The clinical and pathological findings of a 43-year-old woman, diagnosed as having acute hemorrhagic leukoencephalitis at postmortem examination, are presented. The acute hemorrhagic leukoencephalitis affects mainly young adults and is the most fulminant from of demyelinating disease. It is frequently preceded by a respiratory infection. Diagnosis is facilitated by CT scanning and MRI, which reveal the massive lesion in the cerebral white matter. Many cases terminate fatally in 2 or 4 days, but in others survival is longer. The pathological findings are distinctive.

Acute Disease↗
PubMed1995

Do the suprasellar neurenteric cyst, the Rathke cleft cyst and the colloid cyst constitute a same entity?

Two cases of entirely suprasellar cysts are reported. Total surgical removal was performed in both cases. Pathological and immunohistochemical profiles were consistent with neurenteric cysts, Rathke's cleft cysts or colloid cysts and was also in keeping with an endodermal origin. It is now admitted that these three kinds of cysts share similar histological and immunohistological features. We propose an hypothesis of common embryological origin from endodermal remnants.

Adult↗
PubMed1995

A comparison of extradural and intraparenchymatous intracranial pressures in head injured patients.

The reliability of extradural pressure measurements for the measure of intracranial pressure (ICP) is still controversial. This study was undertaken to assess the limits of agreement between extradural and intraparenchymatous pressures using respectively the Plastimed extradural sensor and the Camino fiberoptic system. The study took place in a neurosurgical intensive care unit. Ten head injured patients were included in the study, leading to the comparison of 1032 pairs of hourly ICP values. Although the measures were significantly correlated, there was no agreement between the two methods of ICP monitoring. Extradural pressure was higher than intraparenchymatous pressure (bias 9 mmHg; 95% confidence interval of bias -9.8 to 27.8 mmHg). The lack of agreement between the two methods is probably due to the unreliability of extradural pressure for the measurement of ICP.

Adolescent↗