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Biomedical subjects

D Bourdelat

Publications and source records attributed to D Bourdelat.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Ano-rectal sphincter myectomy in children. Indications and results].

Ano-rectal myectomy, described by B. Duhamel in 1965, is the logical therapy of rectoanal achalasia; an experience of 117 cases is reported. Clinical examination and radiological investigations have been made prior to surgery. This surgical procedure is simple, without complication. Three kinds of rectoanal achalasia are described: achalasia with structural change of the internal sphincter (fibrosis, sclerosis); achalasia with a functional sphincteric disorder (with normal histology); achalasia with intrinsic innervation abnormality. Excellent results have been observed in the two first groups but more variable successful results in the third group which concerns short segments of Hirschsprung's disease.

Adolescent↗
PubMed1990

[Ureterocele: diagnosis and treatment at birth].

Antenatal ultrasound diagnosis of ureterocele remains difficult. Two cases are presented. The presumption of the diagnosis was realized at 25 weeks of amenorrhea in one case; in the other case, the diagnosis was sure at 38 weeks. A vesical exploration was performed after visualization of a dilatation of the upper pole of the kidney associated with an ureteral distension. An ectopic ureterocele was display in one case and an orthotopic ureterocele in the other case. These findings were confirmed during the radiologic examination after the birth. An hemi-nephroureterectomy was realized for an ectopic ureterocele in the first case, and an enucleation for an orthotopic bilateral ureterocele in the second case. doses of 1 and 100 micrograms+100 g BW, T3 was without effect of inhibited 45Ca uptake. In ventricles and atria, the stimulatory effect of T3 on 45Ca uptake was very rapid [within 2 min, at which time it was at or near maximum (50-90% above control] and then declined gradually and was not seen after 10-20 min. Of the several calcium blockers employees, verapamil (organic) and cadmium (inorganic) were found to be the most effective. Verapamil and cadmium produced a rapid, transient, and dose-related inhibition of 45Ca uptake in the tissues examined (except fat tissue where, under the experimental conditions employed, 45Ca uptake was undetected). Verapamil, given iv (200 micrograms/100 g BW) or ip (1 mg+100 g BW), reduced tissue 45Ca uptake by 50-90% within 2 or 10 min, respectively, and then its inhibitory effect diminished rapidly and was not seen after 20-30 min.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1990

[Morphological differentiation of the anorectal sphincter in the human embryo and fetus].

In order to obtain a better understanding of the anorectal continence in the newborn child, the development of the anorectal sphincter was studied in 25 embryos (3 to 60 mm CR), sectioned in the sagittal, transversal and frontal planes. A macroscopic study was also performed in 20 human embryos, completed by a light microscopic study and by a morphometric analysis of the smooth and striated components of the sphincter. The anorectal sphincter is composed of three parts: the external sphincter, which appears in the early embryos as a condensation of mesenchymal tissue around the anorectum. It receives smooth longitudinal fibers later; the m. puborectalis appears before 10 weeks and forms a sling around the anorectum; the internal sphincter, which is only well differentiated at 10 weeks and grows after the rupture of the anal membrane. This study emphasizes the importance of the anorectum in the development of its own sphincter.

Anal Canal↗
PubMed1989

The arterial blood supply of the human fetal diaphragm.

To gain a better understanding of the development of the human diaphragm, a study of the arterial supply was made in 20 fetuses. The Micropaque injection was injected either by an ascending route in the thoracic aorta or by a descending route in the left internal carotid below the ductus arteriosus. Two studies using diaphanization have displayed the diaphragmatic anastomoses. The phrenic and the intercostal a. seemed the most important to explain the diaphragm organogenesis.

Arteries↗
PubMed1989

[Fracture of the femoral diaphysis in children. Treatment using flexible internal nailing and changes in this technic].

Flexible Medullary Nailing, described by Métaizeau and Prevot of Nancy Children's Hospital is an excellent method in the treatment of the femoral shaft in children. Some modifications are described in 14 cases. The biomechanical concept is preserved; two flexible rods are introduced under the trochanter major, in a metaphyseal area, in lateral decubitus. The review of the cases showed that with growth, there was good remodeling, without sepsis and delayed union.

Adolescent↗
PubMed1988

A study in organogenesis: the arterial supply of the anorectal region in the human embryo and fetus. Anatomic and embryologic bases of anorectal malformations.

The development of the anorectal region is based on differentiation of the terminal portion of the hindgut. The origin of anorectal malformations is still unknown but seems to occur very early in the embryologic period. To gain a better understanding of their development, a study of the arterial supply of the anorectal region was made in 26 embryos and 50 fetuses.

Anal Canal↗
PubMed1987

[Arterial and neural pedicles of the anorectal region in the human embryo and fetus. Inductor role in normal and pathological development].

To gain a better understanding of the development of ano-rectal malformations, a study of the arterial supply of the ano-rectal region was made in 26 human embryos and fetuses. The development of the ano-rectum was studied in 20 embryos, varying in length from 3 mm to 40 mm (Crown-Rump: 22-60 days), and 6 using Born's method reconstruction; 10 fetuses aged from 3 to 7-8 months were used for a topographic study of the ano-rectal region. 40 fetuses, the majority frozen after expulsion were injected immediately. The fetuses obtained were of ages corresponding to 12-39 weeks of amenorrhea. A staged histologic study after selective micropaque injections of the inferior mesenteric artery was carried out to demonstrate the arterial parietal distribution in the ano-rectum. Smith silver impregnation method, emphasizes the connections between the rectal arteries and extrinsic and intrinsic nerves. The subdivision of the cloaca is constituted by the folding of the ano-rectal and uro-genital parts and by the thickening of the dorsal cloacal epithelium, explained perhaps by the precocious development of arterial supply. The superior rectal artery is predominant and supplies the whole of the anorectum, eventually penetrating the wall of the anal canal. The well-developed median sacral artery is surrounded by a nervous tissue which reaches the M. Levator Ani. The sympathetic nerve fibers follow the arteries until the submucous layer. The development of the intramural plexus of the rectum is independent of the arterial supply.(ABSTRACT TRUNCATED AT 250 WORDS)

Anal Canal↗
PubMed1986

[Strangulated ureterocele and prolapsed urethral mucosa in a little girl. Diagnostic difficulties].

The author reports a case of a 2 year-old girl, with prolapse of the urethra treated since birth, twice by electro-coagulations. The persistence of the symptoms required further urological examinations (Urography, Ultrasonography), which revealed an ureterocele, prolapsed into the urethra with total duplication of the urinary tract. The operation consisted of a nephro-ureterectomy of the upper tract, with resection and suture of the exteriorized part of the ureterocele in the urethra.

Child, Preschool↗
PubMed1986

[Complications of the ritual circumcision].

Over the last 8 years, 23 cases of complications following ritual circumcision in home surroundings have been admitted for treatment. Patients were seen either as emergencies for immediate complications, sometimes serious, requiring recovery surgery or at a later stage for sequelae of variable severity.

Child↗
PubMed1985

[Teratoma strictly of the buttocks in a 13-year-old girl].

A 13-year old girl was admitted to our hospital because of an ulcerated gluteal tumor. This tumor was present since birth. A diagnostic procedure was performed. This tumor was strictly limited to the gluteal region, without pelvic extension, but with sacral malformation. Total surgical excision was completed. Pathology report revealed a histologically benign teratoma. The origin of the tumor is discussed.

Adolescent↗
PubMed1985

[Traumatic rupture of the aortic isthmus in a child, revealed by paraplegia].

After a severe polytraumatism, a 14 year-old boy presents paraplegia without vertebral lesion. Angiocardiography showed rupture of aortic isthmus. Surgical treatment resulted in successful outcome. The authors insist on the rarity of traumatic rupture of aorta in children and or the particularity of the diagnosis revealed by paraplegia.

Adolescent↗
PubMed1985

A new method of ventilation with a mixture of helium and oxygen in the management of congenital diaphragmatic hernia. A preliminary study.

To prevent the severe prognosis of pulmonary hypoplasia in congenital diaphragmatic hernia, the authors developed a new method of ventilation, using a modulated mixture of helium and oxygen. Associated with a leptanalgesia (Chlorpromazine-Morphine), the authors observed with this method two good results. Efficiency of this technique has been confirmed by X-rays and successive pulmonary scintigraphies (Xenon 133).

Female↗
PubMed1985

[Acute osteomyelitis in a child with homozygous sickle cell anemia. Difficulty in early diagnosis].

Febrile painful edema of a limb segment in Black children should suggest a bone complication (infarct or osteomyelitis) of a homozygous sickle cell anemia. The possibility of an early diagnosis can be improved by scintigraphy since the appearance of radiologic signs is delayed in relation to functional symptomatology onset. The risk of an infectious graft, particularly from Salmonella in children under 2 years, on a bone infarct makes it essential to combine routine antibiotic therapy with the orthopedic treatment, to provide resolution of the very often quite impressive lesions.

Acute Disease↗
PubMed1984

[Coralliform lithiasis in children. Apropos of 20 case reports].

The authors recall the characteristics of infantile staghorn calculus, in relation to twenty personal cases. The complaint is more frequently encountered in boys than in girls. A frequent etiology is proteus urinary infection. The morphology of the staghorn and the state of the parenchyma are determining factors in the treatment. A sinusoid morphology and thickness of the renal parenchyma are operative indications. The bivalving operation is exceptional. Results are generally satisfactory (80% of cases), and recurrences are rare.

Adolescent↗
PubMed1983

Surgical treatment of malignant esophagotracheal fistulas.

Malignant esophagotracheal fistulas represent the fatal evolution of esophageal cancer. Since October 1974, 18 patients were seen who had confirmed esophagotracheal fistula, and in half of these patients, the fistula was the revealing symptom. Upper gastrointestinal studies (using hydrosoluble dye) and bronchoscopic examination confirmed the diagnosis, which was already strongly suspected in 16 of the patients due to the specific nature of the cough triggered by swallowing. The average age of the patients was 57 years, (range, 32 to 78 years). In 12 patients, the nutritional repercussions were moderate, and in only 6 patients, were the bronchopulmonary consequences serious. Therapeutically, we adopted a palliative surgical attitude since the physical and psychological condition of these patients was considered fatal the month after discovery of the fistula. In addition, the results of intubation were uncertain and transitory. Our surgical methods evolved in three stages: first, we performed bipolar exclusion of the esophagus coupled with gastrostomy (four patients), second, we performed retrosternal coloplasty (five patients), and third retrosternal gastroplasty with drainage of the inferior portion of the esophagus by Roux-Y jejunal anastomosis (six patients). The latter technique was inspired from that described by Kirschner in 1920. It is moderately aggressive and has the advantage of dealing with several objectives: exclusion of the fistula, reestablishment of normal alimentation, drainage of the inferior portion of the esophagus, and permitting postoperative radiotherapy. In our series, when only the patients who underwent coloplasty or gastroplasty were considered, 3 of 11 died, and the longest postoperative survival times were 16 and 23 months. Regarding gastroplasty alone, our results were in agreement with those in the literature. In the 19 patients who underwent gastroplasty, the operative mortality was 31.5 percent and the average length of survival was 9 months. Six patients survived from 8 to 26 months. Therefore, this "last resort" surgery seems legitimate in light of the fact that the results are sometimes superior to those of radical curative surgery for extirpative esophageal cancer.

Adult↗
PubMed1983

[Therapeutic approach to bilateral hepatoblastoma].

The treatment of a case of bilateral hepatoblastoma by continuous infusion of adriamycin in the hepatic artery accompanied by ligature of the right hepatic artery enabled the authors to carry out six weeks later an extensive right lobe hepatectomy. Unfortunately the patient died seven weeks after the partial hepatectomy from complication of surgery. Thus it was possible to demonstrate the effectiveness of the intra arterial chemotherapy. No residual tumor could be found at autopsy. As in the case with the adult, arterial ligature combined with carefully targeted chemotherapy would seem to be potentially important therapeutic option in the treatment of malignant liver tumors in children.

Age Factors↗