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Biomedical subjects

M De Juan

Publications and source records attributed to M De Juan.

10 recordsLinked to original sources
PubMed2001

[A new case of hepatic adenomatosis treated with orthotopic liver transplantation].

Hepatic adenomatosis is a rare disease with multiple hepatic adenomas (10 or more), not associated with an history of oral contraceptive use or anabolic steroids use or with glycogen storage disease. A new case is reported in a 23 year-old woman who consulted for an abdominal mass and who had more than 50 adenomas of the liver. The suspicion of malignant transformation by the elevation of the alpha-foetoprotein, and the diffuse affectation of the liver, with minimum free parenchyma, suggested to carry out an orthotopic liver transplantation. The definitive histological examination of the surgical specimen confirmed the existence of local areas of hepatocellular carcinoma.

Adenoma↗
PubMed1999

High incidence of allograft cirrhosis in hepatitis C virus genotype 1b infection following transplantation: relationship with rejection episodes.

The natural history of hepatitis C virus (HCV) infection following liver transplantation and predictors of disease severity remain controversial. The aims of the study were to assess in a homogeneous population of 81 cyclosporine-based HCV-infected liver transplant recipients mostly infected with genotype 1b and undergoing strict protocol annual biopsies: 1) the histological progression of posttransplantation HCV disease and, in particular, the incidence of HCV-related graft cirrhosis within the first 5 years after surgery; and 2) the relationship between progression to cirrhosis and i) rejection episodes and ii) first-year liver biopsy findings. We studied 81 consecutive HCV-RNA-positive patients (96% genotype 1b) undergoing liver transplantation between 1991 and 1996 with a minimum histological follow-up of 1 year. All patients received cyclosporine-based immunosuppression and underwent protocol yearly liver biopsies for the first 5 years. The mean histological follow-up was 32 months (range, 12-60 months). Biopsies were scored according to the histological activity index (HAI), with separate evaluation of grade (activity) and stage (fibrosis). Histological hepatitis, present in 97% of patients in the most recent biopsy, was moderate or severe in 64%. Twelve patients developed HCV-related cirrhosis at a median time of 24 months (range, 12-48 months), with an actuarial rate of HCV-cirrhosis of 3.7%, 8.5%, 16%, 28%, and 28% at 1, 2, 3, 4, and 5 years, respectively. Rejection was significantly more common among patients with cirrhosis versus those without (83% vs. 48%; P =.02), with an association between the incidence of cirrhosis and the number of rejection episodes: 5%, 15%, and 50% in patients without rejection, one and two episodes, respectively (P =.001). The degree of activity and fibrosis score in the first-year biopsy were higher in patients who developed cirrhosis than in those who did not (P =.008 and.18, respectively). In conclusion, HCV genotype 1b-infected liver recipients are at a high risk of developing graft cirrhosis in the first 4 to 5 years following transplantation, especially those with previous rejection episodes. First-year liver biopsies may help to sooner identify patients at the highest risk, improving further patient management.

Adult↗
PubMed1998

Reversible endocrine dysfunction and pituitary stalk enlargement.

We report 4 patients (3 of which were children) with diabetes insipidus and different degrees of hypopituitarism in whom a pituitary stalk enlargement was disclosed on imaging techniques, and in whom radiological and functional recovery was observed during follow-up. Pituitary substitution therapy with desmopressin, thyroxine, hydrocortisone, growth hormone and/or oral contraceptives was prescribed. During follow-up, regression of the stalk lesion was seen which was spontaneous in 2 cases, following a short course of corticosteroids in another and an empirical trial of tuberculostatic drugs in the fourth. A partial recovery of pituitary function was also observed. These cases illustrate that pituitary stalk enlargement and associated hypopituitarism may be reversible; however, this morphological and functional recovery has rarely been described in adults and has not been previously reported in children.

Adolescent↗
PubMed1998

Influence of age on laryngeal carcinoma.

The constant increase in human life expectancy has led to a higher proportion of oncologic patients of advanced age. The clinical characteristics of 272 patients with laryngeal carcinoma diagnosed when they were 70 or older are compared with those of a group of younger patients with the same kind of tumor. The advanced age group showed a higher proportion of women, less tobacco and alcohol use, a predominance of glottic location, and a higher previous morbidity. The T category was similar in both groups, but the advanced age group had a higher proportion of N0 tumors. The planning of treatment was similar in the two groups of patients, except for less use of both chemotherapy and partial larynx surgery in the advanced age group. Results in terms of local and regional control, distant metastasis, and 5-year adjusted survival were similar in both groups of patients. The results suggest that advanced age is not a determining factor when considering radical treatment in a patient with laryngeal carcinoma.

Adult↗
PubMed1997

[Results of salvage treatment of carcinoma of the larynx recurring after radiotherapy].

An analysis is made of salvage treatments and their results after unsuccessful radiotherapy in 113 carcinomas of the larynx. A group of 27 patients (24%) was excluded from salvage treatment. In the remaining 86 patients (76%), radical surgical salvage treatment was tried: total laryngectomy (74 cases) or partial surgery (12 cases). Four of the 12 patients treated with partial surgery suffered a second local relapse, which was rescued by new surgery. Treatment was successful in 72% of the laryngectomized patients and in all those treated with partial surgery. Survival correlated with local (T) and regional (N) extension of the initial tumor, its location, and simultaneous regional relapse. In contrast, survival did not correlate with the time interval between end of radiotherapy and relapse, or with local tumoral extension in the resection piece in surgically treated cases (rpT).

Carcinoma↗
PubMed1986

Perinatal hypoxic-ischaemic syndrome. Diagnostic and prognostic value of computed tomography.

Sixty-two full-term neonates with hypoxic-ischaemic encephalopathy were studied. Computed tomography (CT) was performed during the first week of life and the clinical and radiologic findings were correlated. In 57 cases (92%) CT was abnormal. Subarachnoid haemorrhage (SAH) was present in 53 cases, oedema in 23 cases and other lesions in 7 cases. Twenty-two cases had associated SAH and oedema. It was concluded that SAH and/or oedema has a good prognosis. When neurologic involvement is severe and CT shows signs of necrosis, the prognosis is less favourable.

Brain↗
PubMed1984

Spontaneous partial empty sella. A study of 41 cases.

53 cases of partial empty sella turcica have been studied, both clinically and radiologically. Excluding 12 with an incomplete endocrine study, 41 remain of which 31 cases (75.6%) were found to have an adenohypophyseal hyperfunction of the hyperplasia (primary hypothyroidism, etc.) or adenoma type (acromegaly, etc.); 4 (9.7%) had a clear neurological cause (head trauma, thrombosis in the venous sinus, hydrocephalus) and only 6 (14.6%) were of unknown, primary or idiopathic cause. The published cases of "primary" partial empty sella have been revised, proposing: the substitution of the term "primary" for "spontaneous", since as we have already pointed out, the majority of the "spontaneous" cases are attributable to pituitary hyperfunction and a few of them to neurological or neurosurgical processes. Finally, we should like to emphasize the importance of empty sella in the prognosis and treatment of those patients whose most exact diagnostic terminology would be, for example, hypothyroidism "with" partial empty sella turcica, or, as another example, prolactinoma "with" empty sella.

Adult↗
PubMed1979

Posterior fossa xanthogranuloma. Case report.

A large subdural xanthogranuloma was removed from the posterior fossa of a 53-year-old woman with symptoms of Hand-Schüller-Christian disease. Two additional masses with similar density on computerized tomography were found in the hypothalamus and in the choroid plexus of the right lateral ventricle.

Brain Diseases↗