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Biomedical subjects

B Fremond

Publications and source records attributed to B Fremond.

34 records · Page 2Linked to original sources
PubMed1990

[Millard's flap for sequelae of high anorectal malformations. Apropos of 6 cases].

Mucosal prolapse is a frequent sequela after surgical treatment of the high type of anorectal malformation whatever was the technic used for the pull-through operation. The authors report six cases treated with the spiral flap described by Millard. The initial procedures had been a Romualdi-Rehbein pull through in three cases with secondary revision of anoplasty and a Stephan's operation in the three other cases. Before Millard's plasty, all the patients were continent and two of them had an associated stricture. The anatomical result was good in all the cases with reconstruction of a cutaneous anal funnel and no stricture. Improvement of continence was noted in two cases, uncertain in two. Incontinence remained unchanged in two other cases. The advantages of the Millard's plasty are analysed. The prevention of mucosal prolapse is possible in the initial pull through operation using the same plasty or whatever plasty which provides a cutaneous anal canal.

Anal Canal↗
PubMed1989

[Accidental ingestion of caustics in children. Apropos of 100 cases].

One hundred children (67 boys, 33 girls) underwent early fiberoptic endoscopy (without general anesthesia in 96 cases) for caustic ingestion between January 1985 and June 1988. The intended use of the product was household (83) industrial (4) farm (6) or medicinal (7). Caustic burns were classified as grade 1 (mucosal hyperaemia), grade 2 (ulceration) and grade 3 (necrosis). Endoscopy was negative in 52, grade 1 in 41 who had evidence of esophagitis and/or gastritis, grade 2 and/or grade 3 in 7 cases, 4 of whom had ingested farm products. Eighty-seven children were discharged after examination, 6 were hospitalized for 24 hours. Outcome was favorable for the 5 cases with grade 2 lesions after total parenteral nutrition for an average period of 79 days. The 2 cases with grade 3 injuries went on to develop an esophageal stricture requiring endoscopic dilation and an antral stricture which was treated by antrectomy. Authors emphasize the severity of lesions secondary to the ingestion of dairy pipeline cleaners, the advantages of fiberoptic endoscopy and the role of parenteral nutrition.

Accidents, Home↗
PubMed1989

[The multiseptate gallbladder. A rare malformation of the biliary tract].

Multi-septate gallbladder is a very rare anomaly. In this 13-years-old girl with a complaint of nausea, vomiting and abdominal pain, sonographic examination and oral cholecystogram demonstrated a normal size gallbladder with many thin septa. The longitudinal section of the removed gallbladder revealed multiple inter-communicating lobules divided by many thin septa. She has been free of the previous complaints after surgery. Only two pediatric cases have been reported previously. Our case illustrates the main features of this entity.

Adolescent↗
PubMed1989

[Congenital diaphragmatic hernia with a late disclosure].

Two further cases of congenital diaphragmatic hernia with delayed presentation are reported: a 6-month-old male presented a posterolateral diaphragmatic hernia with small bowel in left hemithorax masquerading as pleural effusion; an 11-year-old boy with Down's syndrome presented a retrocostoxyphoid hernia revealed by vague faintness. The authors emphasize the deceptive clinical aspect, the different means for diagnosis, the risk of wrong diagnosis and pleural drain, the usual good outcome of these late-onset diaphragmatic herniation.

Child↗
PubMed1988

[Esophageal duplication with pleural effusion in antenatal diagnosis].

The authors report the case of a patient in whom an antenatal ultrasound showed a mediastinal tumor then a pleural effusion. At birth, the baby was intubated for adequate ventilation and pleural effusion was drained. Ultrasound, oesophagogram, CT scan permitted the diagnosis of tubular oesophageal duplication which was confirmed by surgery and pathologic examination. Review of the literature did not find such antenatal finding. The role of oral contraception during the first weeks of pregnancy is discussed.

Esophagus↗
PubMed1988

[Primary obstructive megaureter in infants: medical or surgical treatment? Apropos of 24 cases].

The authors analyse 24 cases of primary obstructive megaureter diagnosed before the age of 3 months. 18 were discovered by antenatal echography between 28 and 39 weeks, whereas 6 were detected by the occurrence of early urinary tract infection. Initial investigations included echography, intravenous urography and micturating cystouretrogram. Primary megaureter was bilateral in 14 cases, unilateral in 12. According to the urographic classification of Beurton, there were 12 ureters stage III, 12 stage II, 10 stage I. 15 patients were operated, 4 of them during the first months (2 reimplantations, 2 urinary diversions). 12 were submitted to later reimplantation at the mean age of 15 months, one had a non functioning kidney removed. 9 were non operated and treated conservatively by antibacterials and regular supervision. Results analysis evaluated according to radiological stage and treatment showed that in more cases, surgery should be differed initially. Complete clinical and radiological resolution is possible even in severe obstructions. Antibacterial treatment beginning at birth favorises regression of dilated ureter. Thus reimplantation should be deferred undercover of regular biological and radiological survey. The age of 12 to 18 months is the most technically favorable time to ureteric reimplantation.

Female↗
PubMed1988

[The treatment of drooling in handicapped children. Observations apropos of 12 operated cases].

The authors report their experience about the surgical treatment of drooling in handicapped children. They operated on twelve patients suffering from cerebral palsy, ranging from eleven to nineteen years of age. The procedure included the posterior rerouting of parotid ducts to the anterior pillars as in the Wilkie's operation but with tubularization of the mucosal flaps. The excision of the distal part of the submandibular duct on both sides was performed in a second operation, one to five years later in four patients, but in the initial operation for the last six cases. A successful control of drooling was reached in ten patients. But the two parts of the procedure are necessary to get a good result. The only first part is always insufficient as in the other two cases. There were few complications: one salivary cyst after rerouting of a parotid duct which required marsupialization, another one with spontaneous regression. Only one patient is complaining of feeling an excessive dryness of his mouth and lips. Other methods of treatment: physiotherapy and different kinds of surgical procedures are recalled. However, this series is too short to permit a valid conclusion and to define the place of the procedure in the treatment of drooling.

Adolescent↗
PubMed1988

[Stenosis of the common bile duct on a common biliopancreatic duct].

A 16 month-old girl presented with congenital common bile duct stenosis revealed by vague faintness. Percutaneous transhepatic cholangiography and surgical biliary opacification showed an abnormal junction of the pancreatico biliary ductal systems with an abnormally long common channel. These anatomic findings seem to be similar to those seen in congenital choledocal cysts and biliary tract dilatation.

Bile Ducts↗
PubMed1987

[A case of exostosis of the base of the acetabulum in a child with multiple exostoses].

The authors report a case of an exostosis of the base of the acetabulum seen at the age of four months in a routine radiograph of the pelvis in a child suffering from osteochondromatosis. The growth in size of this exostosis led to subluxation of the hip at the age of three years. Surgical removal resulted in reduction of the subluxation and restoration of joint stability three years after operation. An intra-acetabular site for an exostosis has rarely been described.

Acetabulum↗
PubMed1986

Obstructive uropathies diagnosed in utero. The postnatal outcome--a study of 43 cases.

The ultrasonic antenatal diagnosis of obstructive uropathies is now common. This study of 43 cases in which the mean follow-up is more than 2 years already allows us to show the importance of early diagnosis. The importance of a thorough postnatal examination is emphasised as well as the importance of preventing urinary tract infection. Although relief of the obstruction in the neonatal period in many cases allows an excellent recovery due to the exceptional qualities of the urinary tract at this age, there remain serious uropathies associated with significant renal dysplasia, for which ultrasonic diagnosis in utero is still insufficient. The results obtained allow us to be optimistic regarding the prognosis for many of these children.

Female↗
PubMed1986

Ultrasonographic anatomy and diagnosis of fetal uropathies affecting the upper urinary tract. II. Nonobstructive uropathies.

The authors describe the ultrasonographic anatomy and semiology of allowing detection of the main types of fetal non-obstructive uropathies. The results of the author's personal experience in this domain are compared to data from the literature. Differential features of the uropathies are given and the limitations and practical significance of prenatal and postnatal ultrasonography are discussed.

Female↗
PubMed1986

[Ectopic insertions of single ureters in children. Apropos of 9 cases].

The authors present 9 cases of ectopic implantation of a single ureter in children. Ureteric ectopia is part of a congenital anomaly of the whole of the urinary tract, which explains the incidence of renal ectopia and associated dysplastic lesions of the renal parenchyma. The authors stress the importance of ultrasonography and, more recently, the CT scan for the localisation of the kidney homolateral to the ureteral ectopia. An analysis of the treatment and the results demonstrates the contrast between the unilateral forms which are easily treated and which have a good prognosis and the bilateral forms which are more difficult to treat and have a less favourable prognosis.

Abnormalities, Multiple↗
PubMed1985

Ultrasonographic anatomy and diagnosis of fetal uropathies affecting the upper urinary tract. I. Obstructive uropathies.

The authors describe the ultrasonographic anatomy and semiology of allowing detection of the main types of fetal uropathies. The results of the author's personal experience in this domain are compared to data from the literature. Differential features of the uropathies are given and the limitations and practical significance of prenatal and postnatal ultrasonography are discussed.

Diagnosis, Differential↗
PubMedDate not supplied

Intratumoral consumption of indium-111-labeled platelets in a child with splenic hemangioma and thrombocytopenia.

The authors report Kasabach-Merritt syndrome (KMS) in a patient with thrombocytopenia and splenic hemangioma. A 13-month-old boy with a history of anemia, thrombocytopenia, and abdominal mass was admitted to the hospital. The scintigraphic studies showed that a large mass contiguous to the spleen was responsible for the platelet uptake. After partial splenectomy, the platelet count returned to normal. This report of KMS in a child with splenic hemangioma suggests that the scintigraphic studies are mandatory to confirm diagnosis. Indium-111-labeled platelets are useful in identifying hemangiomatous sequestration of platelets in patients with thrombocytopenia.

Anemia↗
PubMedDate not supplied

Correction of bilirubin conjugation in the Gunn rat using hepatocytes immobilized in alginate gel beads as an extracorporeal bioartificial liver.

A new extracorporeal bioartificial liver using alginate-entrapped hepatocytes was developed and evaluated for its ability to correct the lack of bilirubin conjugation in the Gunn rat. Hepatocytes were harvested from Sprague-Dawley rats by the two-step collagenase perfusion method and then immobilized in Ca(++)-alginate beads. The ability of immobilized hepatocytes to conjugate bilirubin was investigated in vitro by comparison with hepatocyte monolayer cultures. The bioartificial liver consisted of a cylindric bioreactor containing either alginate beads with hepatocytes (test group) or alginate beads alone (control group). Gunn rats were connected to this bioreactor via an extracorporeal circulation and bile fractions were collected at hourly intervals. Both bilirubin monoconjugates and bilirubin diconjugates were measured in the bile by high pressure liquid chromatography. Hepatocyte viability in alginate beads was determined prior to and at the end of each experiment and found to be unchanged (75%). In the test group, the concentration of bilirubin conjugates increase rapidly, attaining median values of 72.26 microM and 92.59 microM for mono and diconjugated bilirubin respectively, during a 3 h period of extracorporeal circulation. In the control group, the levels of either conjugate did not exceed 0.87 microM throughout the experiments. Statistical analysis showed a significant difference between the two groups (p < 0.0023). These results suggest that the bioartificial liver used in this study represents an effective method for the temporary correction of the Gunn rat's genetic defect. Such a system might be of therapeutic interest in acute liver failure.

Alginates↗