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Biomedical subjects

A Grimfeld

Publications and source records attributed to A Grimfeld.

At least 73 records · Page 4Linked to original sources
PubMed1989

[Postoperative recurrence of esophago-tracheal fistula. Significance of peroperative catheterization of the fistula with tracheoscopy. Apropos of 10 cases].

Ten children with recurrent tracheo-oesophageal fistula have been treated over 13 years (1976-1988). Five patients were referred from other centers. The original pathology was oesophageal atresia in eight and two patients had a tracheo-oesophageal fistula alone. Barium swallow demonstrated the recurrent fistula in only five of eight cases. In fact, the key examination is tracheoscopy providing that catheterisation of the fistula. The position of the catheter is verified radiologically. The difficulties of surgery in recurrent fistula are linked to the problem of locating the level of the fistula peroperatively. Without catheterisation of the fistula, there were one failure out of three cases (one dead). By contrast, in the seven cases where the fistula was catheterised, a successful outcome was always obtained. The failure of surgery for recurrent tracheo-oesophageal fistula is not linked to a technical problem of closure of the fistulous tract but to failure to localize the fistula adequately.

Adolescent↗
PubMed1989

[Familial pulmonary hemorrhage and lupus syndrome with C4 deficiency].

A six year old girl developed severe pulmonary hemorrhage following appendectomy. Clinical findings and results of immunfluorescence studies of skin, lung and renal biopsy specimens were consistent with systemic lupus erythematosus (SLE). A sister also had hemoptyses and a lupus syndrome. Both girls, but none of the other siblings or parents, were shown to have a partial C4 deficiency. A review of the literature disclosed 13 pediatric cases of SLE with pulmonary hemorrhages. In none of these cases was congenital C4 deficiency reported (although C4 deficiency is known to induce autoimmune diseases, including lupus). Our two patients are therefore the first reported cases of SLE with pulmonary hemorrhage and a partial congenital C4 deficiency.

Biopsy↗
PubMed1988

Activation of alveolar macrophages from children with the acquired immunodeficiency syndrome-related complex.

The ability of alveolar macrophages (AM) to release hydrogen peroxide (H2O2), an indicator of AM function, was studied in five children with the acquired immunodeficiency syndrome (AIDS) related complex and, for comparison, in 11 children without disorders of the lung parenchyma. In the AIDS-related complex group, pulmonary manifestations were mild, and lung involvement was suspected by moderate clinical and/or radiological features. None had a past history of opportunistic infections; neither did any have lymphopenia. Cytologic study of the bronchoalveolar lavage (BAL) fluid revealed increased cellularity with increased percentage of lymphocytes. The study of H2O2 release was performed on unstimulated AM and on AM stimulated by phorbol myristate acetate (PMA). Under both experimental conditions, the amount of H2O2 accumulated in the medium was significantly increased in the group with AIDS-related complex (P less than 0.001). As no enhanced oxidative activity has been reported in AM from patients with full-blown AIDS, an increased ability of AM to release oxygen metabolites from children with AIDS-related complex may reflect an initial and temporary step in the course of the LAV/HTLV-III pulmonary disease. Determining AM activation might be a reliable method of assessing the evolution of lung disorder in AIDS.

AIDS-Related Complex↗
PubMed1988

Alveolar macrophage status in bronchopulmonary dysplasia.

The predominant inflammatory cell type within the alveolar structure in bronchopulmonary dysplasia (BPD) is the alveolar macrophage (AM). AM ability to release hydrogen peroxide, a way to evaluate the cell status, was studied in nine infants who developed clinical and radiological evidence of BPD, and was compared to those from infants without lung parenchymal disorders (n = 6). AM were collected by bronchoalveolar lavage which was done after the mechanical ventilation stage in the BPD group. The experiments were performed on unstimulated AM and on AM stimulated by phorbol myristate acetate. Results revealed that the amount of hydrogen peroxide accumulated in the culture medium was significantly enhanced in the BPD group, in both experimental conditions (p less than 0.01 and less than 0.001, respectively). Furthermore, improvement of patients treated with glucocorticoids was closely related to a reduction of the alveolitis with a decrease of AM ability to generate hydrogen peroxide. These data indicate that AM activation is a central component of alveolitis in BPD and that extracellular production of oxidants by stimulated AM may play a critical role in the pathogenesis of the disease.

Bronchopulmonary Dysplasia↗
PubMed1987

A controlled study of oxygen metabolite release by alveolar macrophages from children with interstitial lung disease.

The ability of alveolar macrophages (AM) to release O2 metabolites was studied in 8 children with interstitial lung disease (ILD), and in 11 children without lung parenchyma disorder. AM were collected by bronchoalveolar lavage. The experiments were performed on unstimulated AM and on AM stimulated by phorbol myristate acetate (PMA) or zymosan. Our results indicated that, with or without triggering agent, the amount of O2 metabolites release was a linear function pattern with time. The accumulation of superoxide anion (O2-) and hydrogen peroxide (H2O2) into the extracellular medium differed depending on the triggering agent used: with PMA, the amount of O2- released was threefold the amount of H2O2 detected in the medium, whereas with zymosan the O2- accumulation was tenfold higher than the amount of H2O2 measured. In patients with ILD, a significant increase in the amount of H2O2 release was observed for both unstimulated and stimulated AM (p less than 0.001). In this group, the measurement was repeated after a 2-month steroid treatment: prednisone had markedly improved the clinical, radiologic, and functional status of the patients, and this improvement was in good correlation with the decrease of O2 metabolite production. The amount of H2O2 release in each case was within the range of control values. Evaluation of O2 metabolite release by AM could be a useful parameter in the assessment of the activity of ILD.

Adolescent↗
PubMed1987

[Allergologic investigation of asthma in infants. Apropos of 153 cases of infants aged 5 to 36 months].

153 asthmatic children from 5 to 36 months (mean age: 26 months) were investigated. The aim of the study was twofold: 1) to determine the reliability and limits of an allergologic diagnosis before 36 months of age; 2) to compare the predictive value of skin-tests with other allergologic tests. Results were expressed according to a score involving 5 parameters derived from the allergologic investigation. Each parameter represented one point: atopic past history, increased level of total IgE antibodies related to the age, presence of blood specific IgE antibodies, blood hypereosinophilia. Infants were considered allergic if their score level was greater than or equal to 3. Concordance between this score level and each parameter was as follows: Positive skin-test 83%; Blood hypereosinophilia 82%; Presence of specific IgE antibodies 80%; Increased level of total IgE 78%; Familial history of atopy 54%. It is concluded that, in allergic infants, a significative link exists between positive skin-test plus the presence of specific IgE antibodies and an atopic disease. However, more children have to be enrolled in a multivariant analysis to assess definitively the predictive value to this score.

Asthma↗
PubMed1986

[Effect of amygdalectomy on asthmatic and allergic children. Study apropos of 55 cases].

The effects of tonsillectomy were investigated in 55 asthmatic and/or allergic children, by clinical and biologic, particularly immunoallergologic examinations before and 6 months and one year after operation. Tonsillectomy adversely affected clinical state of asthmatic and/or allergic children in less than 10% of cases, and then only to a moderate degree. In 40 to 60% the course of their illness was not affected by the operation and, a remarkable finding, in 40 to 45% of cases it was markedly improved. Biologic, and particularly immunoallergologic parameters studied were not significantly altered, but changes in immunoglobulins confirmed the immunocompetent role of the palatine tonsil.

Adolescent↗
PubMed1985

[Cholesterol pneumopathy in children. Apropos of 3 cases. Possible role of chronic Epstein-Barr virus infection].

Three cases of cholesterol interstitial pneumonia in patients 3, 9 and 10 years of age respectively are reported. All three were born in Island of Reunion. Two were sisters. All had failure to thrive, dyspnea on rest and clubbing. Respiratory symptoms had appeared early in infancy. Open pulmonary biopsy was diagnostic. Prognosis was poor the boy dying at 4 years of age and severe respiratory insufficiency at 9 or 10 years in the two girls. Current etiological investigations were non contributory. However a profile of chronic infection with Epstein Barr virus (EBV) was found in each case while serological profiles ruled out infection with a virus of the herpes group virus (cytomegalovirus, herpes simplex). The possible role of EBV as an etiological agent of cholesterol pneumonia is discussed and genetic or environmental factors as well.

Biopsy↗
PubMed1984

Lung function in children with hypersensitivity pneumonitis.

Pulmonary function tests were performed on 12 children with hypersensitivity pneumonitis (HP) aged from 4-15 years (10 with bird breeder's lung and 2 with farmer's lung). Lung volumes, lung mechanics (lung resistance, dynamic lung compliance (CLdyn], lung transfer factor for CO (TLCO), and blood gases were measured. Eleven children ceased to be exposed to the antigen, and the functional course was studied as a function of time after the cessation of exposure (CE). During the short term (less than 2 months after CE) initial hypoxemia was observed and CLdyn and TLCO were below normal. Two months after CE, blood gases were normal in most of the cases. A persistent hypoxemia appeared to be an unfavorable prognostic factor. CLdyn was normal by the eighth month after CE, while TLCO improved more slowly and remained significantly decreased in one case. In our series the children under 10 years had less functional abnormalities and normalized more rapidly than the older children. The one child without CE, had major functional abnormalities.

Adolescent↗
PubMed1984

[Pneumological aspects of bronchial foreign bodies in children. Experience with 100 cases].

100 cases of bronchial foreign body seen over a period of 4 years represent 1.2% of the admissions of a paediatric pneumology unit; 73% of the children were aged between 6 months and 3 years. The foreign body was vegetable in 61% of cases (a peanut in 44% of cases). The time between the inhalation and the endoscopic diagnosis was greater than 7 days in 70% of cases and greater than 30 days in 37% of cases. Removal of the foreign body was possible in all but one case. In particular, the authors studied the pneumological implications of a foreign body: the value of a quantitative bacteriological study of the bronchial secretions, which was significant in 43% of cases, and detection of the sequelae by prospective clinical and functional surveillance with a follow-up of 3 to 24 months. After 6 months, persistent radiological abnormalities were found in 40% of cases, perfusion disorders were found in 35% and ventilation disorders were found in 64%. A surgical operation was performed in 7 cases: one case of bronchotomy for extraction of the foreign body and 6 cases of parenchymal excision, including 2 total pneumonectomy for a destroyed lung. These were no death. The pathophysiology of the complications of functional disorders and of dilatation of the bronchi is discussed in the context of the experience gained from this series.

Bronchi↗