Search PubMed⌕ Search

Biomedical subjects

F Grisoli

Publications and source records attributed to F Grisoli.

At least 127 records · Page 7Linked to original sources
PubMed1990

Enlarged adenomectomy for enclosed prolactinomas: a preliminary study of 26 cases.

Preliminary results obtained from 26 cases of prolactinomas less than 20 mm in diameter after treatment by enlarged adenomectomy are described. The operation consisted in removal of the adenoma, a layer of normal pituitary at the outer edge of the tumour and the pituitary capsule in contact with the sellar meninges. 24 women and 2 men were involved whose prolactin levels (PRL) were less than 200 ng/ml. All presented abnormal PRL responses to Thyrotropin releasing hormone (TRH) and Metoclopramide (MCP) tests and an absence of a nocturnal rise in the sleep cycle study. Postoperatively, three patients developed transitory diabetes insipidus and five transitory adrenal insufficiency. Gonadotropin reserve was always found normal. All 24 women resumed normal menstrual cycles and two became pregnant within one year. From a serological viewpoint, after surgery 100% of patients were found to be normal for levels of prolactin but only 85% turned to normal dynamic tests. The results of this small series of enlarged adenomectomies seem better than those obtained using selective adenomectomy, but must be confirmed with time.

Adolescent↗
PubMed1990

Microsurgical anatomy of the cisternal course of the perforating branches of the posterior communicating artery.

Both the perforating branches--especially the extracerebral segments--and the arachnoidal anatomy at the level of the posterior communicating artery were studied in 60 human brains previously fixed in formalin. The close relationships between this artery and the oculomotor nerve are described, and it is noted that each of them is enclosed in its own arachnoidal compartment, which in the case of the posterior communicating artery is to be distinguished from the interpeduncular cistern. The latter cistern was found to contain only the terminal segments of the posterior communicating artery. The hypothalamic branches were within the inner wall of the arachnoidal cistern surrounding the posterior communicating artery. The variations in diameter of this artery are explained by its embryological development and are not related to the number and the diameter of the perforators. The posterior communicating artery was absent at times. The surgical implications of such a variable anatomical arrangement are discussed in the light of the literature.

Brain↗
PubMed1990

Different pathways of secretion for glycosylated and nonglycosylated human prolactin.

Human prolactinoma cells in culture secrete the monomeric nonglycosylated form of human PRL (NG-hPRL) and its glycosylated variant (G-hPRL). We have performed pulse-chase experiments to investigate the individual patterns of release of these two molecular variants. The cells were pulse labeled for 10 min with [35S]methionine and then chased for increasing periods of time up to 24 h. The secretion of newly synthesized G- and NG-hPRL was followed by immunoprecipitation of the chase medium and sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis. Both forms were rapidly released (10 min of chase), but presented with different rates of secretion. Half-maximal release of G-hPRL occurred with 60-min chase, while 110 min were necessary for NG-hPRL. More than 50% of initially labeled G-hPRL was released in the medium vs. only 20% for NG-hPRL. Incubation of the cells with 8-chloroadénosine-cAMP during a 2-h chase period resulted in a 3.6-fold increase in the release of newly synthesized NG-hPRL and had only a slight effect on newly synthesized G-hPRL release (1.7-fold increase). The intracellular transit of labeled G- and NG-hPRL was investigated in cells treated by the ionophore monensin. The secretions of both newly synthesized forms were inhibited to the same extent, probably via an arrest of the transit at the level of the median Golgi, as judged by the delay of acquisition to endoglycosidase-H resistance for G-hPRL in monensin-treated cells. In contrast, Western blot analysis of the same medium-showed that monensin abolished the secretion of G-hPRL and had little effect on NG-hPRL. Our results on the different rates of secretion of G- and NG-hPRL indicate a sorting of the two forms into different compartments in the secretory pathway, with G-hPRL being secreted at a higher rate than NG-hPRL, possibly via a different intracellular route. The differential effects of 8Cl-cAMP and monensin further suggest that G-hPRL may be constitutively secreted after synthesis, while NG-hPRL secretion may involve a storage step.

8-Bromo Cyclic Adenosine Monophosphate↗
PubMed1990

Perforating branches of the basilar bifurcation.

The perforating branches of the upper basilar artery and of the first (P1) segment of the posterior cerebral artery were studied in 50 fixed brains obtained from human cadavers. No vertical branches arose from the basilar bifurcation. The upper basilar artery gave rise to horizontal branches, which were studied with reference to their angle of origin. Perforating arteries arising from P1 segments were found in all specimens. Rare branches were found to come from the inferior and anterior surfaces of P1 segments. The anatomical patterns of these branches are discussed in the light of previous reports. Preoperative knowledge of some anatomical aspects (the position of the basilar apex, the angle between the right P1 and left P1 segments, and relationships to the dorsum sellae and the mammillary bodies) can help in the selection of a neurosurgical approach and may improve the operative results in the surgical treatment of basilar apex aneurysms.

Basilar Artery↗
PubMed1990

Primary intracerebral plasma cell granuloma: a light, immunocytochemical, and ultrastructural study of one case.

A case of primary intracerebral plasma cell granuloma without meningeal attachment is presented. Histologically, the lesion showed two different patterns. At the center, it displayed the features of a benign fibrous histiocytoma. At the periphery, a mixture of polyclonal plasma cells, lymphocytes, and "epithelial-like" cells was observed. Electron microscopy and immunocytochemistry confirmed the histiocytic nature of the "epithelial-like cells." The differential diagnosis and histogenesis of such a lesion are discussed.

Brain Diseases↗
PubMed1990

[Micro-anatomy of collateral perforating branches of the middle cerebral artery].

The lenticulostriate arteries are the subject of a microanatomical study on 50 formalin fixed human brains. A single trunk arising from the middle cerebral artery is rarely found. In fact the branches are numerous and they are found to ramify before penetrating the anterior perforated substance. The length of the sphenoidal segment is variable and this aspect is discussed in the light of the literature data. The origin of the perforating branches is spread from the internal carotid artery to the bifurcation branches of the middle cerebral artery (M2 segment). On the other hand lenticulostriate arteries arising from the cortical branches of the middle cerebral artery are often found. These anatomical patterns are of essentially surgical interest. No branches must be damaged during the opening of the Sylvian fissure or during the dissection of an aneurysm in this region.

Cadaver↗
PubMed1989

Abnormal dopamine sensitivity in some human prolactinomas.

In most of human prolactin (PRL)-secreting adenomas, dopamine and dopamine agonists normally suppress the excessive PRL secretion. Nevertheless, a subpopulation of such patients presents a relative insensitivity to the ergot derivative bromocriptine. Six patients with a macroadenoma (n = 5) or microadenoma (n = 1) were considered resistant to bromocriptine which, at a daily dose of 15-60 mg, did not normalize high plasma PRL levels. Culture studies of these adenoma cells showed that: (1) 10(-8) M bromocriptine produced a 32 +/- 16% inhibition of PRL release versus 65 +/- 12% obtained in the same conditions with normal human pituitary cells; (2) sulpiride (10(-6) M) reversed the inhibitory effects of bromocriptine, and (3) the bacterial endotoxins, cholera toxin (10(-11) M) and pertussis toxin (250 ng/ml), respectively, produced a 45-500% increase and a total abolition of bromocriptine-induced PRL inhibition. These observations and recent data of the literature allow to discuss the possibility of receptor or postreceptor defects in such tumors.

Bromocriptine↗
PubMed1989

Anterior discectomy without fusion for treatment of cervical lateral soft disc extrusion: a follow-up of 120 cases.

One hundred and twenty patients with soft lateral disc herniation underwent surgery by anterior microsurgical discectomy and routine ablation of the posterior longitudinal ligament between 1976 and 1986. The study excluded patients with hard discs and soft disc extrusion with medullary symptoms. In our series 76.6% of patients were men. In 64% of the patients no causative factor was found. All of the patients presented with cervicobrachialgia; 53% also had a motor deficit. In 91.7% a single disc was involved. The last 40 cases were evaluated by computed tomography alone. In 51.5% an extruded disc was found. No permanent postoperative complication was encountered. All patients returned to their previous activities. Fifty patients underwent follow-up radiological evaluation at 1 and 5 years after the intervention and vertebral fusion was observed in 70% of these.

Adult↗
PubMed1989

[Modification of the relative plasma concentrations of methyl and methylene groups in cancer: a study using proton NMR spectroscopy].

Fossel et al. have recently proposed the proton NMR examination of plasmatic lipoproteins--and more precisely the determination of an index obtained from the averaged linewidth of the CH2 and CH3 resonances--as a possible tool for detection of cancer. Many evaluations conducted on an international basis have demonstrated that initial expectations were not met and that the test lacked sensitivity, specificity, and predictive value to be accepted as a screening and diagnostic tool. In our evaluation we have collected plasma from healthy subjects, from patients with various kinds of cancer at different stages of evolution and therapy, and from patients suffering from a variety of pathologies, including benign tumors. In accordance with Chmurny et al., we observed that the linewidth index (LWI) is precise and reproducible when care is taken in the handling and storage of samples and in the fasting of subjects. After finding no predictive value to the test, we have reanalyzed the spectra and studied the variations of the ratio defined by the methylene signal area over the methyl signal area. This ratio is significantly increased in cancer. Furthermore, it offers a better separation of statistical populations permitting a more precise discrimination between cancer, other pathologies and controls. We have also found that malignant tumors arising from mesenchyma (sarcoma, leukemia, lymphoma) induce less important variations in the CH2/CH3 ratio than adenocarcinoma or glioma, when such differences cannot be documented using the LWI. These observations are particularly interesting since they might bring new information on the metabolic modifications of the LWI and the CH2/CH3 ratio might reflect the embryologic origin of the tumors and raise the issue of the heterogeneity of cancer disease.

Humans↗
PubMed1989

[Autotransfusion by peroperative recuperation in neurosurgery. Preliminary study apropos of 40 cases].

Preliminary results of autotransfusion by peroperatory recuperation and washing of red blood cells in neurosurgery using the Cell Saver IV Haemonetics are reported. The goals of the study were the confirmation of the feasibility and innocuousness of the technique, and the evaluation of its role in the economy of homologous blood derivatives. Our series includes 40 patients with benign cerebral or spinal lesions selected on the basis of a significant hemorrhagic risk. The activation of peroperatory recuperation is rapid and can be undertaken in extreme emergencies. It represents, even in elective surgery, a safety factor for the patient and the surgical team. The washing and the means of retransfusion by gravity eliminates all the inconveniences of preceding generations of these systems, particularly systemic residual anticoagulation, overload of free hemoglobin, blood coagulation problems and air embolism. In our study the number of unites recuperated is significant by reason of the selection modality of patients according to hemorrhagic risk. For its part, autotransfusion represented 68.71% of transfused red blood cells and 44.27% of the entirely of blood derivatives used. The risk of infectious disease transmission was reduced for all these patients, it was annulled for 45% of them. In our study, autotransfusion by recuperation and washing of red blood cells in neurosurgery improves the safety of patients and allows for an important reduction in the use of homologous blood derivatives. This final result is even more effective through association, given the same patient, of several autotransfusion techniques.

Adult↗
PubMed1988

In vitro corticotropin-releasing hormone (CRH) stimulation of adrenocorticotropin release from corticotroph adenoma cells: effect of prolonged exposure to CRH and its interaction with cortisol.

To examine if down-regulation of CRH-induced ACTH release occurs in corticotroph adenoma cells as well as CRH-glucocorticoid interactions in these cells, we established primary cultures of pituitary adenoma cells obtained by transphenoidal surgery from five patients with Cushing's disease. To prevent binding of glucocorticoids by serum proteins, we used a serum-free medium containing insulin, transferrin, selenium, and epidermal growth factor. The latter was found to be essential for both basal and CRH-stimulated ACTH secretion. CRH acutely stimulated, in a dose-dependent manner, ACTH release by all adenomas studied, with an IC50 of 0.5 X 10(-9) mol/L. Prolonged exposure (10 days) to a half-maximal stimulatory concentration of CRH led to continuous stimulation of ACTH secretion. A 4-day incubation with cortisol induced a dose-dependent decrease in both basal and long term CRH-stimulated ACTH release, with no difference in the IC50 (1 X 10(-8) mol/L). These data suggest that long term exposure to CRH does not desensitize corticotroph adenoma cells. Thus, it is unlikely that long-acting analogs of CRH will be useful in the treatment of Cushing's disease. ACTH secretion from corticotroph adenomas is restrained by glucocorticoids; the sensitivity of these cells to the negative effect of glucocorticoids is not modified by long term stimulation with CRH.

Adenoma↗
PubMed1988

Characterization of corticotropin-releasing hormone receptors on human pituitary corticotroph adenomas and their correlation with endogenous glucocorticoids.

Specific receptors for CRH were identified in five freshly excised pituitary adenomas causing Cushing's disease. Their kinetic properties and mean affinity constant [1.45 +/- 0.38 (+/- SE) nmol/L] were comparable to the characteristics of rat and monkey anterior pituitary CRH receptors. No correlation was found between the immediate preoperative plasma and urinary cortisol levels and the number of pituitary adenoma CRH receptors, which ranged from 6-96 fmol/mg protein, unlike in rats, in which corticosterone modulates the number of anterior pituitary CRH receptors. The lack of correlation between the concentration of CRH receptors and plasma cortisol levels may reflect the inability of glucocorticoids to down-regulate CRH receptors in these tumors. Thus, corticotroph adenomas are resistant not only to the feedback actions of glucocorticoids on proopiomelanocortin synthesis and secretion but also to their actions on CRH receptors.

Adenoma↗
PubMed1988

Perioperative lumbar injection of Ringer's lactate solution in chronic subdural hematomas: a series of 100 cases.

A series of 100 patients underwent surgical treatment for chronic subdural hematomas between 1979 and 1987. The procedure consisted of craniectomy with a 30-mm trephine, irrigation and drainage of the hematoma, laceration of the outer and inner membranes, and lumbar intrathecal injection of Ringer's lactate solution for immediate cerebral reexpansion (average injection, 130 ml). This technique gave the following results: 2% mortality, 2% moderate morbidity, and 96% recovery. The recovery of the patients was rapid, and good outcome was achieved in Grade 3 and Grade 4 cases (Markwalder's classification).

Adult↗
PubMed1988

[Extra-medullary intradural melanotic tumor: apropos of a case of dorsal pigmented neurinoma. Review of the literature].

The authors report a case of pigmented thoracic neuroma (T3) discovered in a 40 year old woman on a routine chest x-ray. This hourglass-shaped extra-dural tumour was investigated by computed tomography, nuclear magnetic resonance imaging and iopamiron myelography. Treatment consisted of complete resection by T2-T3 laminectomy and left T3 foraminotomy. Light and electron microscopy revealed melanin secretion by the Schwann cells. A review of the literature confirms the findings observed in our case in terms of the slow clinical course, the benign nature and the excellent prognosis following complete resection, without the need for any radiotherapy or chemotherapy. The various histogenetic theories of extramedullary intra-dural melanotic tumours are reviewed. The difficulties of the differential diagnosis are discussed.

Adult↗
PubMed1987

MR imaging of epidermoid cysts.

After a short review of literature, MRI assessments of four cases of epidermoid cysts (EC) are reported. EC, (characterized in computed tomography by hypo or iso-density areas non-enhanced by contrast), are characterized in MRI by: 1) an important variability of signal intensity between the different cases, and sometimes between the different parts of the same cyst, 2) the absence of edema in surrounding parenchyma, in spite of important mass effect, 3) well defined limits, permitting certainty of the extra-cerebral nature of this tumor, 4) the presence of calcifications easily perceptible in MRI. It is proposed that the variability of signal intensity of EC is caused by different relaxation time values corresponding to different concentrations of keratin, cholesterol and water content.

Brain Diseases↗