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Biomedical subjects

D Pellerin

Publications and source records attributed to D Pellerin.

At least 109 records · Page 6Linked to original sources
PubMed1983

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↗
PubMed1983

[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↗
PubMed1983

[Retrospective study of 56 congenital diaphragmatic hernias. Prognostic factors, therapeutic deductions].

Fifty-six neonates were treated for congenital diaphragmatic hernia (48 left and 8 right) in our intensive care unit from 1972 to 1980. Because of the high mortality, we studied the factors which could predict the outcome. Early onset of symptoms (before the 2nd hour of life) and low post-ductal shunt (PAO2/FiO2 less then 15) after the 3rd postoperative hour appear to be signs of poor prognosis. Our present attitude is early surgical procedure, controlled ventilation with a FiO2 1 with Pancuronium, prevention of pneumothorax and different use of pulmonary arterial vasodilatators.

Hernia, Diaphragmatic↗
PubMed1982

Management of compulsive shoplifting through covert sensitization.

A client with a shoplifting of 4 years' duration was treated by convert sensitization. To control for improvement attributable to demand characteristics alone, thought-stopping was utilized prior to the treatment period. Results indicated that the application of thought-stopping produced an increase in all dimensions (frequency, duration and intensity) of shoplifting urges which were brought under control and virtually eliminated by instituting covert sensitization. Follow-up assessments at 1, 2, 5 and 14 months showed maintenance of treatment gains. These findings are discussed from the viewpoint of a cognitively mediated model of compulsive shoplifting.

Adult↗
PubMed1982

[EEG recordings in prolonged hypercapnia during surgery of a cervico-mediastinal tumor in a 3-year-old child].

An EEG has been recorded during surgery for a cervico-mediastinal desmoid fibroma in a 3-year-old child. Soon after anesthetic induction a bronchospasm occurred, followed by major respiratory difficulties. During more than 3 h, hypercapnia reaching 15-24 kpa was noted without hypoxia. Meanwhile the EEG recording was inactive. The respiratory difficulties subsided only with the surgical liberation of the trachea. As the hypercapnia decreased, the EEG began to show "burst suppressive" activity. Progressively the tracing was more and more continuous with slow waves until complete recovery. The following day the EEG was quite normal. The mechanisms of these EEG features are discussed with regards to anesthetic drugs and to brain hypercapnic edema.

Acidosis, Respiratory↗
PubMed1982

[Continued evaluation of results of surgical management of female congenital adrenal hyperplasia. Report on 48 cases (author's transl)].

In a continued surgical and medical evaluation of the surgical management of female congenital adrenal hyperplasia, 48 girls were studied. Clitoroplasty (relocation and recession) was considered satisfactory in 22 out of 26 children of pubertal age. Vaginoplasty results were rated as excellent in 8 cases, and fair in 19 cases. Six patients indicated to have normal sexual intercourse. However a second surgical procedure will be necessary in 16 cases (30%) during or at the end of their puberty. These cases are among the more severely masculinized with a vaginal opening located at the upper part of the urethra. A prolonged follow-up is necessary in order to perform an adequate evaluation of these procedures, some of which have to be repeated at the age of adolescence.

Adolescent↗
PubMed1981

Quantitative analysis of anorectal pressures in Hirschsprung's disease.

Anorectal motility was investigated in 146 children with Hirschsprung's disease and 89 normal control subjects. Pressures were recorded in the rectum and anal canal at rest and during rectal distention. The rectoanal inhibitory reflex was absent in all but four patients. Intraluminal rectal pressure was higher than normal (16.5 vs. 14.6 cm H2O, P less than 0.03), with more frequent (41 per cent vs. 18 per cent, P less than 0.01) pressure waves. In the upper anal canal, there were more frequent (62 per cent vs. 18 per cent, P less than 0.001) spontaneous variations of pressure of lower frequency (9.5 vs. 12.8 cycles/min P less than 0.001) and greater amplitude (5.2 vs. 3.6 cm H2O, P less than 0.001) than normal. The rectoanal contractile reflex occurred in 47 per cent of the patients but in only 21 per cent of the control subjects (P less than 0.001). Aganglionosis was associated with the presence of a rectoanal inhibitory reflex in three patients. This study confirms the value of anorectal manometry in diagnosing Hirschsprung's disease in a large group of patients, and demonstrates other abnormalities that may be useful in cases in which histologic and manometric data are in conflict.

Adolescent↗
PubMed1981

[Acetylcholinesterase activity in suction rectal biopsies. An appraisal of its value in the diagnosis of Hirschsprung's disease (author's transl)].

Demonstration of an increase in Acetylcholinesterase activity within the terminal nerves of the aganglionic segment in Hirschsprung's disease can provide a useful additional criterion to the diagnosis of this disease. The value as well as the limitations of this histochemical investigation, when performed on superficial suction biopsies, is evaluated. 135 rectal biopsies taken from 123 children were studied. In 28 biopsies performed on children with Hirschsprung's disease, the correct diagnosis was established in 19 cases suggested in 5 and missed in 2. Conversely in 107 control specimens, the results of the histochemical method were correctly negative on 97 occasions and falsely positive on 2.

Acetylcholinesterase↗
PubMed1980

[Neonatal hernias of the dome of the diaphragm. Why a gloomy prognosis?].

The prognosis is neonatal hernias of the dome of the diaphragm remains extremely gloomy. Associated malformations, prematurity or dysmaturity, cannot explain it. The surgeon is now faced with conditions diagnosed in the labour room, which he previously never saw (and which therefore did not figure in his statistics). Those forms in which the lung gas exchange area is reduced are above all those in which there is a syndrome of persistence of foetal circulation. The association of drugs from the alphalytic group (tolazoline) and curarising agents (pancuronium) is often effective without having completely resolved the problem.

Hernia, Diaphragmatic↗
PubMed1980

[Primary intussuception of appendix (author's transl)].

A 2 years old female presents abdominal pain and rectal bleeding roentgenological and endoscopic investigations lead to the diagnosis of intussusception of the appendix. Surgically resected, the clinical course was uneventful and the patient promptly discharged. Primary intussusception of the appendix is a rare event (less than 200 cases recorded since 1858). The particularity of it, according the age of the patient, the clinical symptoms, and the endoscopic diagnosis are emphasized.

Appendix↗
PubMed1979

Serum gastrin levels in hypertrophic pyloric stenosis of infancy. Response to a gastrin secretion test.

The aim of this study was to look for a difference in fasting serum gastrin levels or in serum gastrin response to oral feeding between infants with hypertrophic pyloric stenosis and normal controls. Fasting serum gastrin levels were measured by radioimmunoassay in 10 patients with pyloric stenosis, before pyloromyotomy and 7 and 15 days after it, and in 11 controls. In addition, the serum gastrin responses to a casein hydrolysate meal were studied in both groups (in the patients, 7 days after operation). The fasting serum gastrin levels in the patients did not differ from those in the controls before operation, but they did so after it. The serum gastrin response to feeding in patients after pyloromyotomy was no greater than in controls.

Caseins↗