PubMed Health⌕ Search

Biomedical subjects

Y Révillon

Publications and source records attributed to Y Révillon.

At least 37 records · Page 2Linked to original sources

Pheochromocytoma in children: 15 cases.

Pheochromocytoma is an uncommon tumor in childhood; nevertheless, 20% of all pheochromocytomas are found in the pediatric population. Fifteen children have been treated in our institution from 1962 to 1990. One percent of patients referred over the same period for investigation of high blood pressure were found to have a pheochromocytoma. The majority of patients have hypertension. It varies in intensity and is paroxysmal in about half the patients. Many pediatric cases of unilateral, bilateral, extra-adrenal, familial, and recurrent pheochromocytomas have been reported. We reviewed our 28 years experience with this tumor and concentrated on the diagnosis, the preoperative and operative management, and the occurrence of the multiple endocrine neoplasia syndromes.

Adolescent↗

[Surgery of the esophagus under thoracoscopy. Study of feasibility].

An experimental study of thoracoscopic surgery on the esophagus was conducted in 11 animals. Complete dissection of the esophagus was carried out in the ten last cases. Other procedures performed included mode picking, truncal vagotomies, and myotomies. The thoracoscopic esophageal surgery might allow to decrease the morbidity of thoracotomy. Its interest, compared with other methods of dissection without thoracotomy, has to be evaluated.

Animals↗

[Prevention of vascular thromboses after renal transplantation using low molecular weight heparin].

Vascular thrombosis is one of the main causes of early transplant failure in pediatric patients. This paper reports the results of an open trial of the low molecular weight heparin (Enoxaparine) used to prevent renal graft thrombosis in pediatric recipients with risk factors including donor or recipient age under 5 years, multiple arteries supplying the transplant, and positive history for recurrent thrombosis. During 1989, 42 of 67 children given a renal transplant were prophylactically treated with Enoxaparin. Only one transplant was lost to thrombosis among treated patients (1.5%), versus 9 transplants among 73 (12%) children who received their kidney in 1988 without prophylactic Enoxaparin. Risk factors were comparable in both groups of recipients. Enoxaparine therapy was associated with an increased rate of bleeding (12/42) without severe consequences. In conclusion, Enoxaparin is effective in preventing renal graft thrombosis. Availability of this prophylactic therapy makes it possible to use transplants removed from the youngest donors considered as inadequate by some groups.

Age Factors↗

[A study of tolerance induced by liver transplantation on intestinal graft in the rat].

In some strain combinations of rats, orthotopic liver transplantation (OLT) permits long-term donor-specific survival of fully allogeneic kidney, heart or skin grafts. The difficulties encountered in the clinical situation to obtain tolerance of small-bowel transplantation (SBT), in spite of massive non-specific immunosuppression, led us to study possible liver-induced tolerance in SBT. Inbred DA (RTIa) and PVG (RT1c) rats were used respectively as donors and recipients and divided in two groups: group 1: SIT alone (n = 6); group 2: combined OLT/SBT (n = 6). SIT was performed 17 days after OLT. No immunosuppressive treatment was given to the recipients. Biopsies of small-bowel grafts were performed in both groups at various times after small bowel engraftment. All animals in group 1 showed evidence of acute rejection of the graft between days 6 and 9 post-graft. The histologic pattern of rejection associated lamina propria (LP) mononuclear cell infiltration, crypt lesions and villous atrophy at the end-point of rejection. In group 2, long-term survival (> 100 days) of small bowel grafts was achieved in five of the six animals in spite of strong mononuclear cell infiltration in the LP, which peaked two months after small bowel grafting but then disappeared partially. This striking mononuclear cell infiltrate contrasted with only minor epithelial damage. These data demonstrate that liver grafting can enhance the survival of a small-bowel graft from the same donor in a rat model. Histological findings show that an intense immunological reaction takes place within liver-induced tolerated small-bowel grafts.

Animals↗

[Diagnostic approach of pleural effusion in children. Report of 59 cases].

The retrospective analysis of 59 pediatric cases of pleural effusion showed that infectious agents account for 80% of cases. Thoracentesis proved to be the first-line diagnostic tool. Pleural biopsy was diagnostic in four tuberculous and two malignant pleural effusions. The literature data shows that pleural fluid total protein, lactate deshydrogenase, glucose, pH, white blood cell count and differential should be obtained in all patients. Because of the high incidence of infection, microbiologic studies are also indicated in children. These studies are of great value in distinguishing transudates from exsudates and in deciding on pleural drainage.

Adolescent↗

[Cryptorchism and surgery].

Many different anatomical situations are observed by pediatric surgeons during the surgical procedure for cryptorchidism at any age. The authors propose an easy anatomical classification: type I seems to be a small trouble of the process of migration and to be more a disturbed fixation. Type III results from a big disturbed wolfian duct process. Type II is intermediary. A series of 102 cryptorchidism operated upon at the Pediatric Surgical depart. Children's Hospital Paris, were studied according to this classification and collorated with histopathological study. The correlation is significative. The authors suggest that this protocol of surgical description could be agreed by a lot of Pediatric surgeons, whatever be the age of patient at operation, in the purpose to allow a longitudinal study from initial anatomical disorders to spermogram and at last to bring a response to the unanswered question: what, when and how, a cryptorchidism has to be cured.

Child↗

Idiopathic disorders of fecal continence in children.

A group of 176 patients aged 2 to 15 years was investigated for idiopathic disorders of bowel function other than Hirschsprung's disease. Anorectal motility, as well as colorectal transit of radiopaque markers, were investigated. Before the end of the first month of life, 70 of the patients were constipated. Resting pressure was more unstable (P less than 0.001) and higher than normal in the rectal ampulla and upper anal canal (P less than 0.01). Retardation of markers occurred in the proximal and/or distal large bowel of 61% of the patients. The existence of functional abnormalities was demonstrated in the majority of children with idiopathic disorders of fecal continence.

Adolescent↗

[The place of surgery in the treatment of neuroblastoma].

From 1957 to 1980, 170 neuroblastoma were surgically approached: 3 cervical, 11 thoracic, 147 abdominal, 5 pelvic. The surgical data gathered from this large series leads us to assess that there are great differences between lateral and median neuroblastoma. Lateral ones can be surgically removed without major risk. Median ones arising from sympathetic nerves which depend on the aorta or on the visceral arteries (coeliac or mesenteric) cannot be removed totally without life-threatening risk. These data do not agree with Evans and d'Angio staging. Indeed, stage I and II are only observed in neuroblastomas developed on the lateral nerves of the sympathetic chain and can be removed. Stage III tumors can also be removed surgically when arising from a lateral site, even if they cross the median line. On the contrary all median perivascular neuroblastomas are to be staged III: total removal is not possible and the surgical risk is too high when compared with efficiency of chemotherapy. A special type, the distal perivascular neuroblastoma, is pointed out (5 cases). It is very important to precise exactly the initial localization of neuroblastoma, whatever be their metastatic extension. The new technics of investigation (C.T., ultrasonography, but also plain film and front and lateral views of intravenous pyelogram) allow to define precisely the median or lateral site of the tumor and also to choose between a non-surgical (median) or a surgical (lateral) treatment. This distinction seems in correlation with the two different ways of pathway of the embryonic neuroblast cells.

Abdominal Neoplasms↗

[Gastroschisis: study of a series of 50 cases from 1960 to 1976 and therapeutic indications].

Fifty cases of gastroschisis were treated at the Hôpital des Enfants Malades from 1960 to 1976. Up to 1973, 90% of the babies died. From 1974-1976, 17 infants were treated and 10 (59%) were cured. The authors emphasise the importance of intravenous feeding, the prevention of infections and intensive respiratory care. Complete intestinal ileus for more than one month is associated with a bad prognosis. The use of drugs and further surgery in this situation in discussed.

Abdominal Muscles↗