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Biomedical subjects

A Lacombe

Publications and source records attributed to A Lacombe.

At least 19 recordsLinked to original sources
PubMed2001

Thermal diffuse x-ray scattering in a model columnar liquid crystal.

The fluctuation correlation functions and the density-density correlation functions for a realistic model of a columnar liquid crystal in its helically ordered phase are derived. The influence of positional and orientational molecular fluctuations on the thermal diffuse x-ray scattering is studied within a three-dimensional model of columns inscribed on a triangular lattice. Resulting from quasi-long-range ordering, very anisotropic long-tail scattered intensities are predicted, giving a nonuniversal signature for the helically ordered columnar liquid crystal phase. Scattered intensities both near the Bragg maxima at the inverse lattice vectors and at the Bragg condition due to periodic orientational ordering are treated. The percolation of the long-range behavior for a screw variable composed of two quantities having only quasi-long-range behavior is predicted.

Anisotropy↗
PubMed1999

[Urinary lithotripsy in children. Multicenter study of the Pediatric Urology Study Group].

The authors present the results of a survey conducted among French paediatric urologists belonging to the Groupe d'Etudes en Urologie Pédiatrique (GEUP) (Paediatric Urology Study Group). This study, based on 122 cases observed in 13 centres, is not exhaustive, but is nevertheless statistically significant. The preoperative assessment confirms the usual findings of urinary stones in children: pyelonephritis, haematuria and abdominal pain, the usual presenting complaint, concomitant malformative uropathy (10% of cases) and a predominance of calcium stones. More than 200 stones were treated, larger than 10 millimeters in diameter in one-third of cases. Renal stones, mainly caliceal (more than 50%), included 11 staghorn calculi. This study also included 22 ureteric stones, mainly in the pelvic ureter, and 2 bladder stones. Lithotripsy was ultrasound-guided in 2/3 of cases and required general anaesthesia in about 3/4 of cases. Ureteric catheterization was required in 19 infants preoperatively, but in only 2 infants (stein strasse) postoperatively. One or two lithotripsy sessions were sufficient in most cases, but 4 sessions were necessary in 5 patients, to the same kidney in 1 case. The mean hospital stay was 2 to 3 days, but the procedure was performed on an outpatient basis in 15 cases. The immediate postoperative course was uneventful and asymptomatic. This survey revealed about 10% of complete failures, corresponding to solitary caliceal stones in 2/3 of cases; 29 partial failures were essentially due to lower caliceal stones and staghorn calculi; 84 successes (stone-free), mainly pelvic or simple caliceal stones. Scintigraphy did not reveal any immediate postoperative impairment of renal function. This study reported a success rate of about 70%, regardless of the type of apparatus used. Assessment of the results of ESWL requires sufficient follow-up both concerning the outcome of fragmented stones and evaluation of possible functional repercussions. This survey defines the main indications: although ESWL can be applied to most stones, some stones constitute poor indications (cystine stones, stenotic malformative uropathy) or dubious indications: small lower caliceal stones, densely calcified staghorn calculi in older children. This study confirmed the efficacy and low morbidity of ESWL in children. A prospective study needs to be conducted according to a rigorous protocol in order to refine the technique and indications while reducing the possible long-term risks.

Abdominal Pain↗
PubMed1998

[Bladder paraganglioma (pheochromocytoma): a rare tumor in children. Apropos of a case].

The authors report the first case of bladder paraganglioma in a child admitted to their department successfully treated by partial cystectomy. The diagnosis was established histologically, after failure of clinical diagnosis. Retrospectively' the authors think that preoperative diagnosis should have been possible and emphasize the importance of a thorough clinical examination.

Child↗
PubMed1995

[Ethical problems raised by the current French practice of therapeutic abortions. Part I: prospective study for 24 months at the University Hospital of Tours (76 cases)].

OBJECTIVE: Determine the circumstances and conditions concerning ethical problems raised by medical abortions treated in a University hospital. METHODS: Prospective study for 2 years (1 Sept 1991--31 Aug 1993) conducted with a consulting Committee for the antenatal diagnosis and fetal medicine at the University Hospital at Tours. Each discussion of the medical file for proposed medical abortions, the conditions leading to the decision and the ethical recommendations formulated were registered as well as the outcome of the pregnancy and for the infant. RESULTS: There were 76 cases raising ethical problems. They were divided into 3 categories of recommendations: medical abortion (55 cases), abstention with acceptation of possible fetal death in utero (11 cases), conservation of the pregnancy (10 cases). CONCLUSION: A practical attitude could usually be decided after discussion between parents and physicians. A few cases of disagreement were observed which led to uncertainty [correction of incertainty] and diverging opinions concerning the diagnosis and prognosis for the fetal pathology.

Abortion, Therapeutic↗
PubMed1993

[Embryofetopathy of the newborn infant of a phenylketonuric mother. A diagnosis not to be missed].

Children with phenylketonuria (PKU) detected in the neonatal period and who have received the appropriate diet develop normally whatever their sex. However, female PKU patients who, before becoming pregnant, do not take the precaution to follow a diet bringing phenylalanine to "normal levels" (2 to 5 mg in 100 ml of blood) give birth to children presenting with severe embryofoetal damage (e.g. intrauterine growth retardation, microcephaly, mental retardation, various malformations) directly due to their hyperphenylalaninaemia (20 mg or more in 100 ml of blood under a free diet). It is important to know these facts, since the benefits of systematic neonatal PKU detection may be cancelled by this late complication. The therapeutic approach in such cases is a follows: 1. Young women with known PKU must be informed of this risk and how it can be avoided by a preconception therapeutic diet. This means that they must permanently reside in the same geographical area, receive an adequate information at the end of puberty, use and effective contraception method and program their pregnancies preceded by a return to low phenylalanine diet. 2. Doctors must remember that because PKU detection has not become systematic until 1978, PKU girls of child-bearing are remain undetected, that they are not always mentally debilitated and can normally five birth to children with embryofoetal damage. In case of e.g. unexplained intrauterine growth retardation or microcephaly, it is necessary to perform a Guthrie test on the woman, since a prenatal diagnosis may lead to therapeutic abortion, and a postnatal diagnosis to a genetic counselling which will avoid recurrences.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Early detection of visual disorders by pediatricians].

A group of pediatricians from Northern France whose aim was to develop research projects in ambulatory pediatrics, elaborated a method of rapid assessment of visual acuity that can be applied by the pediatrician in the consulting room. This test was included in the routine examination of children between the age of 2 1/2 and 4, the age of 3 years being the most appropriate. The method is simple, reliable, reproducible and cheap since it is part of the pediatrician's consultation. Visual defects can be detected at an early stage and children can be treated when they still have a maximum chance of being cured. Thus it appears a useful test in terms of prevention of disease and public health.

Child, Preschool↗
PubMed1990

Ureterovesical reimplantation after failure of endoscopic treatment of reflux by submucosal injection of polytef paste.

In a homogeneous series of 100 children (174 ureteric units) treated endoscopically (sting) for vesicorenal reflux, 33 children (42 ureters) presented with recurrent reflux after 2 months, 1 child had ureteral dilatation. 12 children (18 ureters) underwent a secondary Cohen's antireflux plasty without particular problems. In light of these cases, we consider that the submucosal injection of polytef paste modifies neither the process nor the immediate postoperative course of antireflux plasty. Histological study of the lower end of the ureters did not show an inflammatory reaction, except the presence inside the polytef paste of multiple macrophages, the long-term result of which is still unknown.

Child, Preschool↗
PubMed1989

[Ureterovesical reimplantation after failure of endoscopic treatment of reflux by Teflon injection. Apropos of 4 cases].

In a homogeneous series of 54 children (94 ureteric units) treated endoscopically for vesicorenal reflux, 19 patients (24 ureters) presented with recurrent reflux after 3 months. Four of them (6 ureteric units) underwent a secondary Cohen's antireflux plasty. In the light of these 4 cases, the authors consider that the submucosal injection of Teflon paste does not modify the immediate postoperative course of anti-reflux plasty. This constitutes another element in the discussion of the justification of this type of treatment.

Child↗
PubMed1988

[Lacerations of the perineum in children].

24 cases of disruption of the perineum from 8 Centres of Pediatric Surgery in France, were studied. The patients were aged between 4 months and 13 years, with an average age of 6.7 years, and 70% were boys. The cause of the injury was crushing in 13 cases. The associated were complex. Fractures of the pelvis (18) and associated multiple fractures (13), as were as profuse pelvi-peritoneal haemorrhages arising from fractures (3) or lower limb amputations (3) determined the care of associated soft-tissue injuries. Disruptions of the skin were almost constant and displayed a high rate of sepsis. There were noted lesions of the ureter (9), the vagina (5), the anus and rectum (17), the ano rectal sphincter (10) and the penis (1). The care of each of these lesions followed the usual practices of Reparative Surgery specific to each organ, but was also adapted to each case. In effect, disruptions of the perineum take place in a context of serious polytrauma, where the hierarchy of urgency determines the choice of therapeutic attitudes.

Adolescent↗
PubMed1988

[The procurement of organs of children. General aspects].

Improved results of organs transplantation have resulted in an increased request for organs. All brain-dead children do not undergo organ harvesting for 3 main reasons. First, the definition of brain death, which should remain strict, is not accepted by everyone, in spite of the laws on this topics. Then, organizing organs harvesting requires specific hospital structures, a co-ordinator and motivated medical staff. Finally, parent's authorization is mandatory before organs harvesting in children. Parents still often refuse. An improvement might be reached by informing the general public, a maintained trust in the medical profession and the quality of the talk with the parents when the child dies. All energies should tend to develop the collective consciousness in order to improve this new aspect of medicine.

Attitude of Health Personnel↗
PubMed1986

Ambient temperature and ketone body plasma concentration in fasting geese.

The effect on ketonemia of alternate exposure to ambient temperatures (Ta) of 25 and 5 degrees C was investigated in fasting geese. Three experimental birds were compared to three controls continuously exposed to 25 degrees C Ta while fasting. During the first 9 days of fasting, when both groups were exposed to 25 degrees C, plasma concentration of beta-hydroxybutyrate (beta-OHB) increased similarly in both, from 0.10 +/- 0.02 to 6.62 +/- 0.71 mmol X L-1. It later plateaued at 8-9 mmol X L-1 in the control birds. When the experimental birds were exposed to 5 degrees C Ta between the 9th and 15th day of the fast, it increased further during the first 24 h but thereafter decreased of 57%, from 8.62 +/- 1.56 to 3.73 +/- 1.24 mmol X L-1. This decrease was reversed within the 6 days of return to 25 degrees C Ta. In both groups, plasma acetoacetate (AcAc) concentration remained very low during the fast: 51 +/- 1 mumol X L-1. This reversible cold-induced effect on ketonemia may be used for investigating the possible role of ketone bodies in protein sparing during fasting.

3-Hydroxybutyric Acid↗
PubMed1985

Emergency embolization in posttraumatic hemobilia in a child.

The authors report a case of hemobilia in a ten-year-old boy after abdominal trauma. An intrahepatic false aneurysm was successfully embolized during the diagnostic angiogram. This is, to their knowledge, the first pediatric case successfully embolized with posttraumatic hemobilia.

Abdominal Injuries↗
PubMed1983

[Laparoschisis and atresia of the small intestine. Treatment strategy. Apropos of a personal case].

A case of gastroschisis and double small bowel atresia is reported. Primary surgical treatment consisted in jejunostomy located at 28 cm from the ligament of Treits, reinstatement of excluded bowel loops encased in a thick matrix of fibrinous material, and abdominal wall closure. Seven weeks later, the lower part of small bowel was anastomosed to the medium part. Because of uneven bowel caliber, an ileostomy was associated to parenteral nutrition using permanent instillation of secretions recovered from ileostomy was associated to parenteral nutrition. At 4 1/2 month, small bowel continuity was restored with jejunal modeling. Authors stress the necessity to preserve as far as possible, intestinal segments in such a case and emphasize the advantage of the digestive instillation method in order to recover the function excluded intestinal segments.

Abdominal Muscles↗
PubMed1980

[Mycotic aneurysm of bronchial artery. Apropos of a case in an infant].

The authors report the case of a 15 day old neonate presenting a beta hemolitic streptococic (group A) infection, followed by cardio-respiratory failure and radiological opacification of the left superior lobe associated with ventilatory troubles at the left lung base. Massive hemoptysis made an angiographic study mandatory with the diagnosis of a mediastinal vascular tumor placed besides the left descending aorta with compression of the left bronchovasculary pedicule. Tumor ressection was not possible during surgical exploration and a left superior lobectomy was performed. Histological examination showed pulmonary infarctus. The child died a few weeks later. Autopsy revealed mycotic arterial aneurysm of the superior bronchic artery, a very rare lesion considering its localisation and the age of the patient.

Aneurysm, Infected↗