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Biomedical subjects

M Jan

Publications and source records attributed to M Jan.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Hypophyseal surgical treatment of Cushing's disease in the child].

Cushing's disease in children is rare and not familar to pediatricians. We report here 7 cases concerning children between 8 and 16 years of age, treated by pituitary surgery with 1 to 9 year follow-up. A remission of hypercorticism was obtained in all cases. However, a pituitary deficiency requiring replacement opotherapy and/or a recurrence was observed in 5 out of 7 patients. From our experience and the review of literature (around 130 cases), Cushing's disease is more serious in children than in adult. We suggest therapeutic management with transsphenoidal surgery as the treatment of choice. Given the frequency of recurrence (13 à 54%) often late (9-12 years), we stress the need of regular and extended postoperative follow-up.

Adolescent↗
PubMed1998

Radiation-induced optic neuropathy 4 years after radiation: report of a case followed up with MRI.

We report a case of radiation-induced optic neuropathy in a 32-year-old man with Cushing's disease and a recurrent tumour of the left cavernous sinus. The patient experienced rapid, painless loss of vision 4 years after treatment without recurrence of tumour or other visual disorder. MRI showed enlargement and contrast enhancement of the optic chiasm. A year later the patient was almost blind and MRI showed atrophy and persistent contrast enhancement of the chiasm.

Adenoma↗
PubMed1998

Primary spinal melanoma: case report.

We report a case of primary melanoma of the thoracic spinal cord revealed by progressive bilateral lower extremity weakness associated with sensory loss and urinary dysfunction. The preoperative MRI revealed an intramedullary tumour from T7 to T9. Treatment was by complete surgical excision without radiotherapy. Histopathology and immuno-histochemical studies confirmed the diagnosis. The postoperative course was satisfactory with no sign of recurrence after 28 months of postsurgical follow-up. Primary spinal melanomas are rare intramedullary tumours that can be cured by appropriate surgical treatment.

Humans↗
PubMed1998

Microanatomy of the hypophyseal fossa boundaries.

OBJECT: The authors studied the heads of 17 adult cadavers and one fetus to clarify the anatomy of the sellar region, particularly the lateral boundaries of the hypophyseal fossa. METHODS: Vascular injections and microdissection or histological techniques were used in this study. The roof of the cavernous sinuses and diaphragma sellae were part of a single horizontal dural layer that joined the two anterior petroclinoid folds. Laterally, the direction of this layer changed; it became the lateral wall of the cavernous sinus and joined the dura mater of the middle cerebral fossa. On the midline, this layer ballooned toward the sella through the diaphragmatic foramina, created a dural bag containing the hypophysis, and attached to the inferior aspect of the diaphragma sellae. As a consequence, no straight sagittal dural wall existed between the pituitary gland and cavernous sinus; the lateral border of the hypophyseal fossa was part of this anteroposterior and superoinferior convex bag. The authors stress the importance of the venous elements of the region and discuss the structure of the cavernous and coronary sinuses. CONCLUSIONS: Invasion of the cavernous sinus makes surgery more risky and difficult and may necessitate modification of the surgical treatment plan. The preoperative diagnosis of cavernous sinus invasion is thus of great interest, but the possibility of normal lateral expansions of the pituitary gland must be kept in mind. A lateral expansion of this gland into the cavernous sinus was encountered in 29% of the specimens, and an adenoma that developed in such an expansion could easily mimic cavernous sinus invasion.

Adult↗
PubMed1998

[MRI diagnosis of sinus cavernous invasion by pituitary adenomas].

PURPOSE: To evaluate the preoperative MRI criteria of a sinus cavernous invasion by a pituitary adenoma. MATERIAL AND METHODS: Study of 102 cavernous sinuses among 51 patients who had had a surgical cure of pituitary adenoma. Thirteen patients had a surgical invasion of the cavernous sinus. RESULTS: A certain number of signs eliminated cavernous sinus invasion. The best means consisted in not crossing the intercarotid line (Sensitivity-Se = 100%, Specificity-Sp = 85% and Negative Predictive Value-NPV = 100%). The others means implied: not going past twelve o'clock on the internal carotid artery-ICA (NPV = 97.1%), symmetrical size of the cavernous sinus (NPV = 92.5%), non-convexity of the lateral wall (NPV = 90.2%), visualization of at least two venous groups of the laterosellar space (NPV = 90.2%) and finally, non-displacement of the ICA (NPV = 89.2%). The best criteria for diagnosis were passing by the intra and supracavernous ICA lateral tangent (Se = 84.6%, Sp = 95%) and the percentage of ICA encasement by the adenoma exceeding 25% (Se = 92.3%, Sp = 85%). CONCLUSION: Except the total encasement of the intracavernous ICA, the cavernous sinus can be invaded when the lateral tangent of the supra and the intracavernous ICA is crossed, and also when the percentage of ICA encasement exceeds 25%.

Adenoma↗
PubMed1998

[Surgical approaches to the corpus callosum].

There are no dedicated approaches to the corps callosum itself. The different approaches, subcallosal, supracallosal and posterior to the splenium are usually used to reach neighboring structures such as third ventricle or pericallosal arteries. MRI is the best guideline to reach a specific position in the corps callosum and must imperatively contribute to the choice of the type of approach. During the procedure, it is necessary to take great care to protect the vessels, arteries and veins especially, to avoid ischemic damage which is the main complication of these approaches.

Cerebrovascular Circulation↗
PubMed1998

[Clinical assessment of dysarthria: presentation and validation of a method].

We adapted in French the Frenchay Dysarthria Assessment (FDA) developed by P. Enderby in 1983. This tool quantitatively evaluates the organs involved in speech and provides a measurement of intelligibility. Productions of normal subjects were analyzed. Reproductibility of data (correlation and interobserver concordance) was high in 18 dysarthric patients. A study performed in 100 dysarthric patients corresponding to 4 types of dysarthria (spastic, ataxic, hypokinetic and mixte) showed that dysarthria resulted from a global impairment of organs implied in speech, rather than one specific organ. The reduction in the intelligibility score was related to organ impairment.

Aged↗
PubMed1997

Experimental antitumour activity of S 16020-2 in a panel of human tumours.

The antitumour activity of S 16020-2, a new topoisomerase II inhibitor, was evaluated in comparison with doxorubicin against 13 human tumours, including colon (HT-29, Colo320DM), breast (MCF7, MDAMB-231), ovary (SK-OV-3, A2780, NIH:OVCAR-3), non-small cell lung (NCI-H460, A549, Calu-6, NCI-H125) and small-cell lung (NCI-H69, SCLC6) cancers. S 16020-2 was administered weekly intravenous within a dose range of 20-90 mg/kg for 3 weeks. Antitumour responses were obtained in all the tumour types tested except in the two colon cancers. S 16020-2 produced significant growth delays in nine tumour models and induced regressions of all A549 lung tumours. The antitumour activity of S 16020-2 was superior to that of doxorubicin against the NCI-H460, A549, NCI-H69, SCLC6 and NIH:OVCAR-3 xenografts. These results demonstrate the broad spectrum of antitumour activity of S 16020-2 in a large panel of in vivo experimental models and confirm its interest as a potential agent in the treatment of malignant disease.

Animals↗
PubMed1997

Antitumor activity of S 16020-2 in two orthotopic models of lung cancer.

S 16020-2, a new olivacine derivative selected on the basis of its cytotoxicity in vitro and antitumor activity in vivo, was evaluated against the human A549 and the murine Lewis lung tumor models implanted s.c. and i.v. Against Lewis lung carcinoma implanted s.c., S 16020-2 was found to be curative, with an activity and therapeutic index (Ti = 4) similar to that of cyclophosphamide. S 16020-2 administered weekly demonstrated a high therapeutic efficacy against A549 non-small cell lung carcinoma implanted s.c. in nude mice and induced tumor regression at 80 mg/kg. When A549 tumor cells were injected i.v. in SCID mice, experimental metastases rapidly developed and the progressive invasion of the lung tissue by tumor preceded the death of animals. In this model, S 16020-2 administered at 40 mg/kg i.v. following an early (days 8, 18 and 28) or delayed (days 20, 30 and 40) treatment schedule prolonged the survival of tumor-bearing mice with T/C values of 150 and 145%, respectively. Against the i.v. Lewis lung carcinoma, S 16020-2 was also highly active since when administered at 60 mg/kg on days 5, 9 and 13 it totally inhibited tumor growth and cured up to 89% of mice. When administered on days 11, 15 and 19 to animals with established tumors, S 16020-2 was still active but not curative. In the presented studies, S 16020-2 antitumor activity was superior to that of adriamycin and comparable or superior to cyclophosphamide (used as reference compounds). Our results demonstrate the efficacy of S 16020-2 against these highly aggressive and chemoresistant tumor models.

Animals↗
PubMed1997

Eriochrome Black T, structurally related to suramin, inhibits angiogenesis and tumor growth in vivo.

The polyanionic species suramin is a potential anti-cancer agent of narrow therapeutic index. Among other pharmacological characteristics, suramin is an inhibitor of angiogenesis. We have targeted its angiostatic properties as part of a program to discover less toxic analogs. From screening a series of commercially available compounds, structurally related to suramin and containing a sulfonic acid substituted naphthylamine moiety, we discovered a new lead, Eriochrome Black T (EBT). EBT is a novel inhibitor of angiogenesis, more potent and less toxic than suramin in the chick chorioallantoic membrane assay. EBT was more active than suramin in inhibiting endothelial cell proliferation in primary culture and in inhibiting proliferation of three tumor cell lines, A431, L1210 and M5076 (IC50 10-100 microM). Cell cycle studies on the A431 line showed that both EBT and suramin caused an accumulation of cells in the S phase, EBT being 10-fold more potent. We suggest that this cell cycle perturbation is linked to inhibition of topoisomerase II catalytic activity. EBT was found to be a moderate but significant inhibitor of matrix metalloproteinases (10 microM range), more efficient than suramin. In a s.c. M5076 sarcoma model in mice, EBT had similar efficacy to suramin both by the i.p. or s.c. route and was moreover better tolerated. Combined pharmacological results show that EBT compared favorably with suramin in all assays, and that in ovo and in vivo, EBT is an analog of suramin with diminished toxicity.

Animals↗
PubMed1996

In vivo antitumor activity of S 16020-2, a new olivacine derivative.

The antitumor activity of S 16020-2, a new olivacine derivative, was investigated in vivo and compared with that of Adriamycin and elliptinium acetate in a panel of murine (P388 leukemia, M5076 sarcoma, Lewis lung carcinoma, and B16 melanoma) and human (NCI-H460 non-small-cell lung and MCF7 breast carcinomas) tumor models. S 16020-2 given i.v. was active against P388 leukemia implanted i.p., s.c., or intracerebrally. The therapeutic effect of an intermittent schedule (administration on days 1, 5, 9) was superior to that of single-dose treatment, allowing the i.v. administration of high total doses of S 16020-2 and resulting in the cure of 60% of mice in the i.p. P388 model. In this model, S 16020-2 was more active than elliptinium acetate and showed a better therapeutic index than Adriamycin: > or = 8 versus 2. A good therapeutic effect of S 16020-2 was also observed in three P388 leukemia sublines displaying the classic multidrug-resistance phenotype, namely, P388/VCR, P388/VCR-20, and P388/MDRC.04, the latter being totally insensitive to vincristine and Adriamycin. However, S 16020-2 was not active against the P388/ADR leukemia, a model highly resistant to adriamycin in vivo. S 16020-2 was both more active than Adriamycin and curative in the M5076 sarcoma and Lewis lung carcinoma implanted s.c. In the B16 melanoma implanted i.p. or s.c., S 16020-2 was less active than Adriamycin. Against the NCI-H460 human tumor xenograft, S 16020-2 demonstrated activity superior to that of Adriamycin (T/C = 20% versus 43% on day 21). Against the MCF7 breast cancer xenograft, S 16020-2 was active, but less so than Adriamycin (T/C = 23% versus 9% on day 21), whereas elliptinium acetate was marginally active (T/C = 49% on day 24). The hematological toxicity of S 16020-2 given to B6D2F1 mice at pharmacological dose appeared to be less severe than that of Adriamycin, particularly in bone-marrow stem cells. These results demonstrate that S 16020-2 is a highly active antitumor drug in various experimental tumor models and is markedly more efficient than elliptinium acetate. Because of its pharmacological profile, which is globally different from that of Adriamycin, S 16020-2 is considered an interesting candidate for clinical trials.

Adenocarcinoma↗
PubMed1996

[Fetal growth in premature infants in Haute-Normandie].

BACKGROUND: Fetal growth standards of preterm infants are different from one study to another, especially for extremely preterm babies. POPULATION AND METHODS: Between 1976 and 1990, a cross-sectional study of the resulting intrauterine growth of premature newborns from Haute-Normandie (France) was conducted by collecting data of the compulsory health certificate set up in the first week after birth. In spite of exclusions, curves for obstetrical terms ranging from 28 to 36 weeks of gestational age were settled. Equivalents of 8,042 birth weights, 7,792 statures, 8,041 head circumferences and 6,737 ponderal index were used. RESULTS: Comparing our results with those published in the literature, we observed short differences for mean or middle values: from less than 170 to more than 180 g for weight, from less than 1 to more than 2.6 cm for stature and from less than 1 to more than 1.9 cm for head circumference. CONCLUSION: The selected normal lower threshold for each parameter and the varieties of fetal growth inadequacy are under discussion.

Birth Weight↗
PubMed1996

[Primary intramedullary melanoma. Apropos of a case].

Primary melanoma is a rare spinal tumour first reported by Hirschberg in 1906. Since then, only 34 cases have been reported. When present here a new case of primary intramedullary thoracic melanoma developed in a 64-year old male patient. MRI showed a paramagnetic signal with reactive cysts. Macroscopy and histology confirmed the diagnosis. Spinal cord melanoma is presumed to be primary when no other melanoma is found outside the CNS. The tumour is often located in the middle or lower thoracic cord, may be intra- or extra-medullary and leptomeningeal or extradural. It frequently progresses slowly. MRI is the essential examination as it demonstrates a lesion with paramagnetic properties. Its image is not specific and may correspond to other pigmented tumours (meningeal melanocytoma, melanotic schwannoma), to a lipoma or to a vascular or tumoral haemorrhagic lesion. Treatment is uncertain, but surgery is frequently associated with radiation. Postoperative follow-up aims at detecting a local regrowth of the tumour or leptomeningeal dissemination which affects the prognosis.

Diagnosis, Differential↗
PubMed1995

Massive osteolysis of the cervical spine. A case report.

STUDY DESIGN: This study described the course of a case of massive osteolysis (Gorham's disease) of the cervical spine and discussed the literature data. OBJECTIVES: To describe a case of massive osteolysis of the cervical spine with fatal outcome and to discuss the classification of the disease among osteolysis and its therapeutic modalities. SUMMARY OF BACKGROUND DATA: Massive osteolysis is a rare condition (fewer than 100 cases reported in the literature) of unknown etiology, which may involve any bone in the body, with a propensity for the shoulder and pelvic girdle. Few cases of cervical spine involvement were reported. METHODS: The case of a 32-year-old man with fatal progressive massive osteolysis of the cervical spine despite multiple attempts to achieve surgical stabilization was reported. RESULTS: Massive osteolysis was characterized by complete destruction of all or part of a bone by angiomatous tissue and may have represented a local disturbance of osteoclastic activity. No successful therapy was proposed, and the prognosis of spine involvement was very poor. CONCLUSIONS: Massive osteolysis is a rare condition with no successful therapy. The hypothesis of involvement of circulating preosteoclasts in the osteolytic process may suggest treatment attempts with diphosphonates because of the futility of standard bone grafting techniques in spine involvement.

Adult↗
PubMed1995

Radiation-induced meningioma.

We report a case of radiation-induced meningioma that appeared 12 years after the discovery and treatment of a posterior fossa medulloblastoma. The features of the case that support the diagnosis of radiation-induced meningioma are discussed.

Adolescent↗
PubMed1994

Fronto-orbital sphenoidal fibrous dysplasia.

We report the clinical, radiological, and histological features of an 8-year-old boy with an unusual presentation of fronto-orbital sphenoidal fibrous dysplasia. The various forms of fibrous dysplasia are outlined and the differential diagnosis discussed. An approach to surgical management is proposed.

Bone Transplantation↗