Biomedical subjects

Laurent Castillo

Publications and source records attributed to Laurent Castillo.

6 recordsLinked to original sources

PubMed2006

[Parathyroid carcinoma].

Parathyroid carcinoma is a rare disease accounting for 1 to 5% of parathyroid neoplasms. This malignant tumour must be suspected when a severe primary hyperparathyroidism occurs with high hypercalcemia and elevated parathormon levels. At this time, a cervical mass is often palpable. Both head and neck ultrasonography and 99mTc-sestamibi scintigraphy are the best preoperative imaging tests to suspect and localize the tumour. Surgical approach with simultaneous tumorectomy and hemithyroidectomy, completed by selective neck dissection (level VI) is the treatment of choice. An elective lateral neck dissection should be performed if necessary. Tumour control should be monitored by regular measurement of calcium and parathormon levels. Local recurrence or metastasis risk is 30 to 70% and the 5 year overall survival about 50 to 80%. In case of recurrence, aggressive surgical management should be applied and adjuvant radiation therapy may be discussed.

Humans↗

PubMed2006

Evaluation of calcium alginate nasal packing (Algostéril) versus Polyvinyl acetal (Merocel) for nasal packing after inferior turbinate resection.

Nasal packing is commonly used to control postoperative bleeding in patients undergoing endonasal surgical procedures. Bleeding and pain on packing removal are frequently reported. The principal objective of this study was to investigate the efficacy and safety of Algosteril to control post-operative nasal bleeding. The secondary objective was to assess nasal bleeding and pain on packing removal, and to evaluate the endoscopic appearance of nasal mucosa 9 days after the procedure. This open, multicenter, randomized, controlled study was conducted on 50 patients undergoing partial bilateral inferior turbinectomy, packed with Algosteril on one side versus Polyvinyl acetal tampon (Merocel) on the other side following a left/right randomization. Both nasal packs effectively prevented post-operative bleeding. However, bleeding on packing removal was statistically less frequent and less severe with Algosteril than with Polyvinyl acetal (p = 0.016). In addition, pain was statistically lower with Algosteril than with Polyvinyl acetal (p = 0.0001). A trend to a better healing of the wound on day 9 was observed with Algosteril, leading us to further investigations. Algosteril nasal packing is as effective as Polyvinyl acetal in preventing postoperative bleeding following partial inferior turbinate resection. Its removal, however, is less traumatic for the nasal mucosa and less painful for the patient, therefore improving patient's comfort.

Adult↗

PubMed2006

A comparison between functional and radical sinus surgery in an experimental model of maxillary sinusitis.

PURPOSE OF THE STUDY: To compare functional and radical surgery in a maxillary sinusitis' treatment during in vivo experiments in rabbits. METHODS: An experimental chronic maxillary sinusitis was induced in 21 New Zealand white rabbits by inducing mucosal trauma combined with an injection of Streptococcus pneumoniae, and a maxillary sinus ostium occlusion during 28 days. Functional surgery (FS) by reopening the natural ostium and radical surgery (RS) by reopening the natural ostium were performed in association with removal of the sinus mucosa. They were macroscopically and histologically evaluated 15 days, 1 month and 2 months after the surgery. RESULTS: FS had diminished chronic inflammatory criteria (lymphoid and plasma cells) faster that RS ([15 days (p = 0.016)]; [1 month (p = 0.03)]; [2 months (p = 0.03)]). Mucosa fibrosis was more important after RS ([15 days (p = 0.016)]; [1 month (p = 0.03)]; [2 months (p = 0.016)]). CONCLUSION: FS accelerates healing with less fibrosis that RS in pathological mucosa altered by a chronic inflammation.

Animals↗

PubMed2004

The value of polymerase chain reaction detection of Mycobacterium tuberculosis in granulomas isolated by laser capture microdissection.

AIMS: The aim of this study was to investigate the usefulness of polymerase chain reaction (PCR) detection of Mycobacterium tuberculosis in granulomas isolated by laser capture microdissection (LCM). METHODS: The PCR DNA amplification method was used to detect M. tuberculosis in granulomas microdissected from one section stained by haematoxylin and eosin (H&E) from a formalin-fixed paraffin-embedded specimen. The results were compared to those obtained from PCR performed from 10 whole paraffin sections of 5 micro m each, and with the histology, culture and the patient's clinical findings. RESULTS: Forty-nine formalin-fixed and paraffin-embedded samples from 49 patients with a histological suspicion of a mycobacterial infection were investigated. Using culture as the reference method, the sensitivity for the detection of M. tuberculosis was 92% and the specificity was 100% using PCR from microdissected granulomas and were similar to those obtained by using PCR from 10 whole sections. CONCLUSIONS: The PCR method of examination of microdissected granulomas from deparaffinised sections is a sensitive, specific and rapid method for the detection of M. tuberculosis in formalin-fixed and paraffin-embedded samples. The method is as sensitive as that using PCR on 10 whole tissue sections, thus making it suitable for small biopsies. However, although these methods reduce the delay in diagnosis, culture remains the gold standard for identification of mycobacteria in tissue. Culture also allows for the testing of antibiotic sensitivity of any isolated species, in this way determining appropriate treatment.

Animals↗

PubMed2003

Usefulness of frozen section in rhinocerebral mucormycosis diagnosis and management.

AIMS: Rhinocerebral mucormycosis (RCM) is a well-described fulminant fungal infection that presents acutely in patients with ketoacidosis and immunosuppression. Very early diagnosis, established with the demonstration of characterised hyphae in tissues, greatly improves the prognosis of RCM. In this regard, the specificity and the sensitivity of frozen section for the diagnosis and the surgical debridement of RCM were evaluated in this study. METHODS AND RESULTS: Frozen section was performed for the diagnosis (six of seven cases) and surgical treatment (three of seven cases) of RCM. In all cases, diagnosis was made by frozen section and confirmed by histological examination. Frozen section allowed radical surgical excision of infected tissue. In all cases, invasive, broad-based non-septated hyphae with branching at right angles were well demonstrated on toluidine blue staining. Cultures were positive for Rhizopus oryzae in three of seven cases. Outcome was favourable for five of seven patients and two patients died after the diagnosis. CONCLUSIONS: Frozen section is a specific and sensitive method to make both a quick initial diagnosis of RCM and to successfully eradicate the tissue infected by organisms belonging to the order Mucorales.

Adult↗

PubMed2003

[Value of PCR amplification from formalin-fixed paraffin-embedded tissues in the diagnosis of Mycobacterium tuberculosis infection].

Mycobacterium tuberculosis infection remains a major health problem throughout the world. In France, tuberculosis is endemic, particularly in the Paris area (Ile-de-France) and in the south (Provence Alpes côte d'Azur) where immigration is greater than in other countries in northern Europe. Culture is the gold standard for diagnosis of tuberculosis and is the only method enabling a study of strain sensitivity to treatment. Histology contributes to diagnosis in most cases by revealing typical necrotizing granulomatous lesions. The diagnosis is then confirmed by the detection of acid-fast bacilli with Ziehl-Neelsen staining. However, the Ziehl-Neelsen stain is not sensitive and does not allow identification of different species. The polymerase chain reaction (PCR) DNA amplification method has been used to detect M. tuberculosis in formalin-fixed paraffin-embedded tissues. The aim of the present study was to investigate the value of this method for the diagnosis of M. tuberculosis infection. The results obtained with PCR assay were compared to those obtained with histological and microbiological methods (direct examination and culture). Sixty-three specimens (mainly lymph node and lung specimens) exhibiting a positive culture for M. tuberculosis were analyzed. Tuberculosis granulomas were noted in 32/63 cases, tuberculoid granulomas in 18/63, pyoepitheloid granuloms in 10/63, and non-specific inflammation in 3/63. Ziehl-Neelsen staining was positive in 11/63 cases. PCR assay on tissue sections was positive for M. tuberculosis in 58/63 cases. Controls of the PCR method (granulomas due to other mycobacterial species, foreign body granulomas, sarcoidosis granulomas) were all negative. This study shows that PCR from deparaffinized sections, 1) greatly increases the sensitivity of diagnosis of tuberculosis, 2) enables the diagnosis of M. tuberculosis infection. However, although this method reduces the time to diagnosis, culture remains the gold standard for identification of the mycobacterium and for determining the sensitivity of the isolated strain to treatment.

Adult↗