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Biomedical subjects

J Cabiol

Publications and source records attributed to J Cabiol.

4 recordsLinked to original sources
PubMed2001

[Cushing's disease in the 90's: a review].

Since 1932 when Cushing's disease has been described, several important advances have been made in diagnosis and management. However several points remain obscure and there is no general agreement among authors. An accurate biological diagnosis is one of the difficulties found when we face a patient with hypercortisolism. In addition, corticotropin dependent syndrome should be distinguished from the independent one, as well as identifying the source of ACTH hypersecretion. The main problem in Cushing's disease is to localise the secreting adenoma and at the moment there is not any diagnostic method with absolute sensibility and specificity. Magnetic Resonance Imaging shows a sensibility of 77% and 87% especificity; inferior petrosal sinus sampling may help in localising the side, where the adenoma lies, although an appropriate technique is mandatory. New developing techniques, such as intraoperative doppler and assessment of ACTH levels in the peripituitary veins may help us in localising the source of ACTH hypersecretion. Sometimes the adenoma cannot be identified and a surgical exploration of the pituitary is required. If an adenoma is found, a 89% probility of curation has been reported; on the contrary, incomplete tumor removal, no tumor found at surgery, or the presence of the so-called corticotrop hyperplasia where followed of bad results and may explain the failed surgery. Then, hypofisectomy, hemi-hypofisectomy, radiotherapy, photon knife or gamma knife, may be of help in the control of this condition. We reviewed the recent literature and analysed the diagnostic strategies and teatments currently available for this illness. In addition we propose an algohritm for diagnosis and treatment and analyze our results in a consecutive series of 38 patients.

Adrenocorticotropic Hormone↗
PubMed1999

Dysembryoplastic neuroepithelial tumor.

Dysembryoplastic neuroepithelial tumors (DNTs) were first described in 1988. A DNT is a cortical tumor that produces enlargement of a gyrus, forming a megagyrus that exceeds the normal thickness of the cortex. This tumor is generally seen in young patients with a long-standing history of drug-resistant and disabling seizures mostly of the complex partial type. No neurological deficits are found between the interictal periods in the majority of the reported cases. A general agreement exists over the clinical and radiological manifestations of a DNT as well as the benign biological behavior. Two pathological variants of DNT have been recognized: the single form, composed only of the so-called specific glioneuronal element, and the complex form that additionally shows glial nodules and foci of cortical dysplasia. Nevertheless, and despite the benign biological course, nuclear atypias, cellular monstruosities, foci of necrosis and mitosis can also be found. Surgical eradication of the tumor will usuallly have a good prognosis, without recurrences and with a positive control to seizure-free clinical outcome. Controversy continues to exist over a hamartomatous or a neoplastic origin of this lesion. The DNT has been placed among the neuronal and mixed neuronal-glial neoplasms in the revised World Health Organization (WHO) brain tumor classification, a category that includes the gangliogliomas and the central neurocytomas. Ultrastructural studies and immunostaining techniques may suggest that these three lesions represent different spectrums of the same condition. This paper reviews the most recent publications to offer a better understanding of DNTs and their implications in diagnosis and management.

Journal Article↗
PubMed1998

Orbitozygomatic craniotomy. Technical note.

The orbitozygomatic approach provides wide, multidirectional access to the anterior and middle cranial fossae, as well as to the upper third of the posterior fossa and clivus. The authors describe technical details of the surgical approach as it has evolved over 3.5 years of experience in 83 consecutive cases. This modified technique eliminates the need for bone reconstruction of the orbital walls to prevent enophthalmos and minimizes the risk of injury to the frontal branch of the facial nerve. At a follow-up evaluation after a period averaging 14 months, all patients were pleased with the cosmetic results of this approach.

Brain Neoplasms↗