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Biomedical subjects

L David

Publications and source records attributed to L David.

At least 163 records · Page 9Linked to original sources
PubMed1989

[Familial infantile nephrotic syndrome with ocular abnormalities].

Two siblings born from consanguineous parents experienced infantile nephrotic syndrome with ocular and neurological abnormalities and a micropenis in the boy; both patients died before age 1. The opportunity to perform successively a renal biopsy and a two-step binephrectomy permitted a good histological follow-up. The lesions were characterized by mesangial involvement, followed by an extensive extracapillary proliferation and tubular dilatations with a high mitotic activity of the epithelium with anisocaryosis; the main features consisted in major ultrastructural changes of the glomerular basement membrane which were more significant and different from those previously described in the diffuse mesangial sclerosis. These 2 cases may either constitute a new entity or an extreme form of diffuse mesangial sclerosis, supported by recessive autosomal inheritance.

Basement Membrane↗
PubMed1988

Similar chemotactic factor for monocytes predominates in different animal models of uveitis.

Anterior uveitis or iritis occurs in a variety of systemic diseases including sarcoid, Behcet's, and spondyloarthritis. Iritis is, therefore, presumed to result from a variety of pathogenetic mechanisms. We hypothesized that unique chemotactic factors should be associated with different etiologies for inflammation. We have tested this hypothesis using rabbit models of anterior uveitis. We have found that aqueous humor generally contained chemotactic activity for monocytes 24 h after an intravitreal injection of endotoxin, killed mycobacteria, or human serum albumin (in a rabbit previously immunized against human serum albumin). Anterior chamber paracentesis resulted in aqueous humor with a high protein content. However, in contrast to the other models of inflammation, paracentesis did not result in a cellular infiltrate in the anterior chamber, and aqueous humor after paracentesis was not chemotactic. For either immunologically mediated inflammation or for inflammation resulting from injection of a killed bacterial product, chemotactic activity could be digested by papain or trypsin and tended to coelute with albumin on either gel filtration or ion-exchange chromatography. These observations suggest that a similar chemotactic factor for monocytes appears to be associated with ocular inflammation that follows either an immune response or injection of a killed bacterial product.

Animals↗
PubMed1988

Undescended testis: comparison of two protocols of treatment with human chorionic gonadotropin. Effect on testicular descent and hormonal response.

A randomized study of two protocols of human chorionic gonadotropin (hCG) treatment was performed in 183 prepubertal boys between 7 months and 12 years of age: protocol I, in which the boys were given 7 injections of 1,500 IU every other day, and protocol II consisting of 4 injections of 100 IU/kg at 4- to 5-day intervals. In both protocols, by the end of the test, testosterone had risen significantly to values within the normal adult male range. However, the amplitude of the rise was slightly but significantly lower using protocol II (4.08 +/- 2.07 ng/ml) than protocol I (5.16 +/- 2.73 ng/ml). It would thus appear that repetition of the hCG injection at intervals of less than 4 days is unnecessary, and that a total stimulation period of 2-3 weeks is sufficient. Although not correlated with testosterone levels, the success rates for treatment were similar in both protocols and comparable to rates reported in the literature.

Adolescent↗
PubMed1988

[Neurologic manifestations of arterial hypertension in children].

Neurological complications of arterial hypertension are analyzed in 31 children (mean age = 9 years). All patients presented a renal or renovascular disease (acute nephritis + hypoplastic dysplasia , transplantation = 58%) for which malignant hypertension was the first symptom in 16%. The mean +/- SD initial blood pressure was 189 +/- 33/113 +/- 25 mm Hg and was preceded by previous symptoms in 1 patient out of 6. Neurological abnormalities consisted in seizures (48%), acute intracranial hypertension (39%), cranial palsy (23%), coma (19%), hemiplegia/paresia (16%), retinal changes (6%) or aphasia (6%). The EEG was abnormal in 50% of the patients, sometimes showing permanent paroxysmal activity. Neuroradiologic investigations revealed hemorrhagic and/or ischemic lesions in 1/5 patients. On follow-up, hypertension disappeared in 41% of the children; a decrease in renal function was noted in 56% of the patients at the last examination; neurological sequellae were present in 40% (EEG anomalies +/- epilepsy, motor deficit, retinal changes, psychomotor delay, cranial palsy) and 1 patient died. The morbidity of malignant hypertension stresses the importance of early diagnosis and treatment (calcium channel blockers) when its prevention is not possible.

Adolescent↗
PubMed1988

[Benign vulvovaginal tumefactions in children. General review illustrated by a series of 57 personal cases].

There are numerous etiologies of benign vulvo-vaginal tumefactions in children. However, the etiological diagnosis can usually be based on clinical data after careful examination. Para-urethral cysts are the main cause of labial and vestibular tumefactions; they are generally cured by simple puncture. Solid vaginal tumors are uncommon, but they always require surgical resection in order to exclude the exceptional and severe malignant tumours. Neonatal hydrocolpos is frequent in our experience and must always be treated surgically; associated malformations are frequent and must be systematically searched for. Ectopic prolapsed ureterocele and circular prolapse of the urethral mucosa are easily recognizable and need surgical treatment.

Adolescent↗
PubMed1988

[Treatment of hypertensive attacks in children with nicardipine].

A prospective study of the hypotensive effects of nicardipine has been performed during 65 administrations of the drug in 6 children with malignant hypertension. We conclude that this calcium channel blocker is useful to treat hypertensive emergency in children owing to its tolerance and its efficacy (mean arterial blood pressure was lowered by 28 to 38% after 90 min). In addition, it ensures the maintenance of cerebral, renal and myocardial blood flow. A posology of 1 mg/kg/dose, 3 or 4 times/day (oral route) seems to be sufficient, as its effects last 6 to 10 h. Nevertheless the control of acute arterial hypertension must always be associated with the introduction or adjustment of long-term antihypertensive therapy.

Acute Disease↗
PubMed1988

[Epidemiological study and cost evaluation of measles in Lyons hospitals over a 5-year period].

The study of 414 measles cases, admitted in several childrens' hospitals in the Lyons area, underlines the important cost of this disease. Moreover, the occurrence of complications (in 56% of children hospitalized with measles), some of which as severe as encephalitis (n = 9) and/or death (n = 4), shows that an improvement of preventive measures is indispensable. Vaccination appears to be the most effective way, but the actual immunization level remains insufficient in France. This situation could be optimized either by intensifying the sensibilization fields or by rendering vaccination compulsory before entrance to school and collectivities.

Adolescent↗
PubMed1987

Chemotactic activity of lens proteins and the pathogenesis of phacolytic glaucoma.

Leakage of lens proteins from a hypermature cataract can result in a characteristic glaucoma that is associated with the invasion of the anterior chamber by monocytes. We hypothesized that the lens proteins themselves might account for the monocyte response. A sonicated lens induced concentration-dependent migration of monocytes in a Boyden chamber assay system. Checkerboard analysis indicated that the movement was directed rather than merely random. Relative to a control chemoattractant, N-formyl-methionyl-leucyl-phenylalanine, the lens induced monocyte migration more potently than neutrophil migration. The ability to induce migration was markedly reduced by incubating the lens with either trypsin or papain. Chemotactic activity was readily demonstrable in lenses from young donors without cataracts. Separation of lens proteins by gel filtration with high-performance liquid chromatography indicated that the chemotactic activity was most consistently associated with the gamma crystallin fraction. The chemotactic activity of lens proteins may contribute to the pathogenesis of phacolytic glaucoma or the uveitis resulting from retained cortical material after cataract extraction.

Aging↗
PubMed1987

Retinal pigment epithelial cells secrete substances that are chemotactic for monocytes.

Monocyte/macrophages play a prominent role in several forms of retinal pathology including proliferative vitreoretinopathy, senile macular degeneration, and retinal wound healing. In each of these entities, the retinal pigment epithelium (RPE) is characteristically involved as well. Since RPE cells are known to secrete chemoattractants for astrocytes, we considered the possibility that they might secrete chemotactic factors for monocytes in addition. We have found in in vitro assays that a 5% concentration of medium from 6 different well-established RPE culture lines each consistently induced monocyte migration greater than that elicited by either buffer or unconditioned medium. "Checkerboard" analysis indicated that RPE culture supernatants induced optimal migration with a stimulus gradient (chemotaxis as opposed to chemokinesis alone). Chemotactic activity could be detected in eluates from ion exchange high performance liquid chromatography or gel filtration columns. Several peaks of activity suggested that more than one factor may be responsible for the ability to induce cell migration. The chemotactic activity was largely heat stable. The chemotactic factor induced only minimal migration of polymorphonuclear leukocytes. The secretion of chemotactic factors for monocytes could contribute significantly to the pathogenesis of several retinal diseases.

Cell Line↗
PubMed1987

[Scriver type autosomal hypophosphatemic rachitis: a family case].

A familial observation of hypophosphatemic rickets with unusual inheritance and evolution, different from that of X linked hypophosphatemia, is reported. The mode of inheritance was autosomal dominant, a father and his son being affected. Severe early signs of rickets and delayed growth were present in both cases. Plasma 1,25 dihydroxyvitamin D and PTH levels were normal. There was no hypercalciuria. Complete cure of rickets and catch-up growth were obtained with the only treatment of vitamin D (40,000 U/day) in the father and of 1 alpha hydroxyvitamin D (1 microgram/day) in the son. This observation is quite similar to the 'autosomal hypophosphatemic bone disease' described by Scriver et al. It illustrates the heterogeneity of familial hypophosphatemia which presently includes 4 different physiopathological entities.

Genes, Dominant↗
PubMed1987

[A migrating ear of barley: a curious story of an intrabronchial foreign body].

A case of migrating inhaled ear of barley in a 2 1/2 year old boy is reported with: 1) mild initial symptoms at the time of inhalation followed by a symptomless interval of 8 days; 2) at day 9 fever and dyspnea, right paracardiac infiltrate with pleural reaction on X-rays, normal bronchoscopy; 3) at day 11 extensive right pneumothorax; 4) at day 20, right axillary inflammatory lesion; 5) at day 28 expulsion of an ear of barley from this lesion, followed by complete recovery.

Axilla↗
PubMed1987

[The role of immunosuppressive agents in the treatment of nephrosis in children].

Good clinical results are well known with the use of immunosuppressive therapy in children with idiopathic nephrotic syndrome; more recently, biological data have enhanced immunological anomalies, concerning mainly T helper lymphocytes. The need for steroids may decrease when relapsing nephrotic syndrome is associated with steroid intoxication and is absent when corticoresistance occurs. In these cases, the use of immunosuppressive agents is justified, but limited by side effects and toxicity. In patients treated with alkylating agents and now cyclosporine, good responses are often seen in frequently relapsing children whereas the course of steroid-resistant nephrotic syndrome is not significantly modified. However, the definite appreciation of such therapeutic results has to be further precised by both histological data and multicentric studies concerning new protocols.

Adrenal Cortex Hormones↗
PubMed1987

[Value of blood creatinine in children].

Non-standardized values of serum creatinine are studied in 205 children aged 3 months to 12 years. Data are collected from paediatric patients hospitalised for mild illness without previous renal impairment; these values are quite comparable to those related in the literature based or standardised methods. The normal age-dependent serum creatinine values (mean +/- 2 SD) are shown in a graphic curve, which confirms that serum creatinine increases with age and that it is a faithful parameter to estimate the glomerular filtration rate in children.

Aging↗
PubMed1987

[Severe, refractory neonatal inflammatory syndrome as the manifestation of a systemic multivisceral and meningeal syndrome].

A neonate presented with an inflammatory syndrome with multisystemic manifestations. There was no remission until age 6 years, despite anti-inflammatory treatments. Neonatal onset and neuromeningeal manifestations identified a peculiar rare inflammatory syndrome, whose relationship with juvenile rheumatoid arthritis is discussed. In the case reported, renal, abdominal, deep lymphatic and cranial involvements were present: these have not been previously reported.

Follow-Up Studies↗
PubMed1987

[Statural growth of Moghrabin children living in France].

In order to compare the statural growth of French and Maghrebian children living in France, the authors measured the height of 1,243 children aged between one month and 16 years. The study showed no significant difference at any age between the two ethnic groups. It is therefore possible, in daily medical practice, to use the same age charts for French and maghrebian children living in France.

Adolescent↗