[Postero-lateral hernia of the left diaphragmatic coupola in the newborn. Recovery from refractory hypoxemia with nifedipine].
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Biomedical subjects
Publications and source records attributed to J Borde.
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Simian virus 40 (SV40) transformed V 11 F 1 clone 1 subclone 7 rat cells (subclone 7) do not synthesize normal-size large T antigen (M(r), 90,000); instead, they produce a 115,000 M(r) super T antigen (115K super T antigen). This super T antigen is SV40 virus coded, and its synthesis results from rearrangement and amplification of integrated viral DNA sequences in subclone 7 (May et al., Nucleic Acids Res. 9:4111-4128, 1981). In this study the functional activities of 115K super T antigen were compared with the functional activities of SV40 large T antigen. Transfection experiments were performed with (i) cosmid SVE 5 Kb and plasmid pSVsT, both containing the super T antigen gene and (ii) plasmids pSV1 and pSV40, both containing the large T antigen gene. Transfection of pSVsT DNA or SVE 5 Kb DNA into secondary cultures of rat kidney cells induced the formation of transformed cell foci with an efficiency that was about 50% of the efficiency of pSV1 DNA or pSV40 DNA. Concomitant with the transforming activity, two other activities were also retained by super T antigen, namely, the ability to enhance the level of host cellular protein p53 and the capacity to bind to p53. In contrast, pSVsT and SVE 5 Kb DNAs were markedly deficient in the capacity to support tsA58 DNA replication in CV1-P cells at a nonpermissive temperature (41 degrees C), as shown by cotransfection experiments. The yield of virus produced in these experiments was 400-fold less than the yield obtained in parallel experiments with pSV40 or pSV1. However, SVE 5 Kb and pSVsT have a functional SV40 replication origin, as shown by their efficient replication in COS 1 cells which provided functional large T antigen. Super T antigen also possesses a specific affinity for sequences of SV40 viral origin. Our results suggest that under certain conditions, evolutionary changes in T antigen take place and that these changes could be restricted to the phenotypic requirement of maintaining a structure that is able to induce cell transformation, to form a complex with p53, and to enhance the cellular level of p53. Therefore, there appears to be a close relationship among the activities of T antigen involved in transforming cells, in binding to p53, and in enhancing the p53 cellular level. Moreover, this set of activities appears to be separable from the replicative ability of T antigen, based on the observation that 115K super T antigen is markedly defective for initiating viral DNA synthesis.
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220 children with intussusception were treated at Rouen Children's Hospital between 1969 and 1981. The patients are separated in four groups according to the treatment: --primary operation without barium enema, --operation after failure of the barium enema, --surgical control after reduction by barium enema, --barium enema alone. This study shows that in the third group, the operation did not demonstrate neither any "lead-point", nor any intestinal damage requiring resection. A "lead-point" or an intestinal lesion have been found only in intussusceptions which had not been reduced by barium enema. Thus, one can conclude that a surgical control is useless when the barium enema is successful. The technique of the enema is described.
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During last 10 years, 33 children presenting with a severe constipation (19 of them with subobstruction episodes) have been treated with sphincteromyectomy at ages varying from 3 m. to 13 y. The aetiologic study of the constipation includes a barium enema, a manometric study (for the cases treated since 1975) and a histologic study of the muscular strip obtained during the sphincteromyectomy. The barium enema does not show any specific pattern of Hirschsprung's disease, on the other hand, the manometric study brings more constant arguments to distinguish the idiopathic constipation from the short-segment Hirschsprung's disease. The sphincteromyectomy is done by anal approach (28 times) or by posterior approach (6 times). One patient has had 2 sphincteromyectomies. 14 patients had a Hirschsprung's disease and we find among them 9 very good or good results. 5 failures needed a rectal resection by the Swenson's technique. 19 children had an idiopathic constipation. 2 have not been reviewed. Among the 17 others, we find 11 very good results. No postoperative complications have been observed particularly not any incontinence.
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Four cases of children with recurrent latero-cervical epithelial cystic tumours which where identified as exceptional derivatives of the 4th endobranchial pouch on the basis of their connections with the pharynx and in particular the piriform fossa. The opportunity is taken to review the characteristics of equally rare digestive, duplications and congenital diverticula at a cervical and buccopharyngeal level. This diagnosis was made initially in the first of these cases.
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The authors undertook a retrospective study of a series of 17 cases of idiopathic megaoesophagus seen over a period of 25 years in two paediatric surgery departments. Age distribution was regularly between 20 months and 15 years. No neonatal nor familial forms were seen. Symptoms were dominated by regurgitation and dysphagia. Weight loss was an almost constant feature. Heller's operation, via an abdominal approach with retro-oesophageal valve of the tuberosity fixed to both edges of the myotomy, was the operation proposed. In one case of recurrent megaoesophagus operated upon elsewhere a Thal operation gave a good result with a follow up of 8 years. Immediate clinical and radiological results were favourable in the great majority of cases : 16 cases out of 17. Long term results (follow up of more than 5 years in 8 patients) were also favourable. However one patient was sometimes troubled by regurgitations due to persistent achalasia and a grave failure occured in a patient who five years after a Heller operation developed a peptic stenosis of the lower oesophagus. No recurrence of megaoesophagus was seen. The authors emphasise the importance of the prevention of gastro-oesophageal reflux and the value of oesophagoscopy and of manometry in cases where the result of a Heller's operation is imperfect.
Since 10 years, 19 cases of gastroschisis have been observed in the surgical paediatric unit of Rouen. 12 children are alive and 7 died. It is possible to classify the lesions of the alimentary tract in four groups of increasing gravity. For the first two groups, survival is probable when the treatment is correct. The third group, including bowel resections and risk of short bowel is more difficult to treat. The last group, with necrosis of the main part of the bowel is uncurable. Surgical treatment of choice is immediate closure with small enlargement of the initial parietat defect. It was possible without complication in 8 cases (9 trials). Delayed closure is now employed when immediate closure is impossible. Post-operative treatment is marked by risks of infectious problems and chronic subocclusion. In this last occurence, reintervention must not be too much delayed. Parenteral feeding, with occasionnal continuous enteral feeding must be sufficient.
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