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Biomedical subjects

F Brunelle

Publications and source records attributed to F Brunelle.

At least 127 records · Page 7Linked to original sources
PubMed1992

[Kasabach-Merritt syndrome in children].

Kasabach-Merritt syndrome is a combination of thrombocytopenia, intravascular coagulation, and a rapid increase in the size of an angioma. Anemia and disseminated intravascular coagulation may develop. This infrequent syndrome is severe and may be life-threatening. Pathophysiologic mechanisms underlying the condition are incompletely understood and, consequently, many different treatments are used, including systemic corticosteroids, compression, embolization, antifibrinolytic agents, platelet aggregation inhibitors, irradiation, and others. From findings in eight personal cases, the authors review clinical and biological features, pathophysiologic hypotheses and therapeutic strategies.

Aspirin↗
PubMed1991

Modified Blalock Taussig shunt anastomosis in a three month old child with pulmonary stenosis: embolization therapy.

A case of transcatheter occlusion of a modified Blalock-Taussig (BT) shunt with a detachable balloon is described. A three month old boy with pulmonary atresia with intact ventricular septum had a repair consisting in valvotomy and a modified BT. This palliative aorticopulmonary shunt created congestive heart failure. As an alternative to surgery, a detachable balloon was used to occlude the BT shunt.

Anastomosis, Surgical↗
PubMed1991

Height of normal pituitary gland as a function of age evaluated by magnetic resonance imaging in children.

MR anatomy of hypothalamo-hypophyseal axis is well established. However data about pituitary gland height (PGH) in children are sparse. A retrospective study was therefore performed in 60 children (30 boys and 30 girls) aged from 8 days to 21 years. All these children had MR for various neurological diseases. Patients with hypothalamo-hypophyseal disease and intracranial hypertension were excluded. The PGH was measured on a strict midline sagittal T1 weighted scan 3 to 7 mm thick. A positive linear correlation was found in children aged from 1 year to puberty followed by a plateau. In the first year of life a negative linear correlation was found. A positive linear correlation was found between PGH and statural height as well.

Adolescent↗
PubMed1991

Neuroradiological findings in Sturge-Weber syndrome (SWS) and isolated pial angiomatosis.

In 14 children with Sturge-Weber syndrome, cortical calcifications on CT scan was present in 12, localized brain atrophy in 10, enlargement of the choroid plexus in 7, and abnormal veins in 7. Cortical enhancement was present on 12 CTs performed shortly after an episode of severe seizures or hemiplegia but was absent or considerably less marked at a distance from the acute episodes. We suggest that cortical enhancement is related to seizure activity and/or blood-brain disturbances rather than to the extension of pial angioma.

Adolescent↗
PubMed1990

[Treatment using transluminal angioplasty of arterial stenosis of kidney transplants in children].

We report our experience with endoluminal angioplasty for the treatment of arterial stenosis involving transplanted kidneys in children. Four anatomic groups were individualized: stenosis of the iliac artery proximal to or at the level ot the anastomosis, single stenosis of the main renal artery, double stenosis of the main renal artery and/or a branch of the renal artery, and multiple arterial lesions. Angioplasty is performed under general anesthesia using balloon catheters appropriate for pediatric patients. Prevention of spasm and heparin therapy are essential. Results depended on the distal vascular bed. Good results were achieved in those patients with a dilatation distal to the stenosis and no multiple arterial lesions (type IV) that actually reflect vascular rejection. The overall success rate was estimated at 66% and the recurrence rate at 22%.

Adolescent↗
PubMed1990

[The contribution of pulsed Doppler in kidney transplantation].

In order to evaluate the value of pulsed-Doppler studies in renal transplantation, we analyzed 101 procedures in 89 transplant recipients. The resistivity indices was used to quantify results. In 45 children with no complications, pulsed-Doppler results were normal. No arterial signal was present in seven recipients. Thrombosis of the renal artery was confirmed upon arteriography and surgery in all these cases. Eight patients had stenosis of the renal artery that was demonstrated upon the pulsed-Doppler study and confirmed upon arteriography. Among 18 patients with acute tubular necrosis, 12 had normal pulsed-Doppler results, two had a diastolic flow decrease, and four had abolition of diastolic flow. Among five recipients with cellular rejection, four had a normal pulsed-Doppler study, one a diastolic flow decrease, and one abolition of diastolic flow. Among six recipients with vascular rejection, two exhibited flow reversal and three had abolition of diastolic flow. Pulsed-Doppler is a good tool for studying vascular complications involving renal transplants and helps differentiate vascular rejection from other complications.

Acute Kidney Injury↗
PubMed1990

[Evaluation of new markers of bone metabolism in renal osteodystrophy in children].

Serum intact parathormone (PTH 1.84) and osteocalcin levels were evaluated as early markers for secondary hyperparathyroidism in a group of pediatric patient treated with chronic hemodialysis. PTH 1.84 levels which were more closely related with alkaline phosphatase levels than PTH 53.84 levels, allowed to identify a group of children without biologic or roentgenographic evidence of hyperparathyroidism and with a normal residual hormone level. PTH 1.84 levels seem to be a reliable indicator of parathormone secretion than conventional assays and may be used as a routine test for monitoring children under chronic hemodialysis. Conversely, the plasma osteocalcin level measured by radioimmunoassay was increased in all studied patients regardless of parathyroid status and seemed to be of little value for monitoring renal osteodystrophia. Lumbar vertebral plate bone density studies disclosed abnormalities of bone mineralization in half the children with renal failure. Dialyzed or non dialyzed. Patients with decreased bone mineralization presented, in most of cases, a history of previous steroid treatment. A group of children with very severe renal failure had increased bone mineralization. The interpretation of this abnormality remains to be determined.

Bone and Bones↗
PubMed1990

[Radiologic aspects of pulmonary aspergillosis in chronic septic granulomatosis in children. Apropos of 17 cases].

The authors describe the radiological aspects of pulmonary aspergillosis in chronic granulomatous disease in children. The radiological anomalies reveal the aspergillosis in 35% of the cases. Association of alveolar opacities, chronic peripheral, sometimes bilateral, with localized pleural thickening must raise the diagnosis. CT scan allows an early diagnosis of parietal and mediastinal involvement and can show invisible lesions on standard chest film.

Adolescent↗
PubMed1989

Pancreatic venous samplings in infants and children with primary hyperinsulinism.

The authors present 19 cases of hyperinsulinism in children worked up with selective pancreatic venous samplings (PVS). Focal lesions were found in 7, diffuse secretion in 8 and normal insulin levels in 4. In three patients with focal hypersecretion less extensive surgery could be performed and confirmed the presence of focal lesions in two. These preliminary results are encouraging and PVS seems to be a valuable technic for detection of focal lesions in the pancreas of children with hyperinsulinism.

Adenoma, Islet Cell↗
PubMed1989

Radiological treatment of common bile duct lithiasis in infancy.

The authors report a series of 10 infants aged from 20 days to 11 months, presenting with CBD lithiasis, explored and cured by radiological procedure. US showed BD dilatation in 9 cases, sludge in the GB in 5 and in the CBD in 2. Histological findings of cholangitis were present in 4 infants. PTC was performed by GB puncture in 6 and BD puncture in 4. There was evidence of a filling defect in CBD but no anatomical anomaly. Blackish concretions were removed through a side-holes catheter or pushed in the duodenum by washing with saline. An external drainage was left a few days to allow control cholangiogram. Three infants underwent subsequent surgery but no residual lithiasis was found. No recurrence has occurred with a follow-up ranging from 10 months to 7 years. Mechanisms of this entity are discussed.

Diagnosis, Differential↗
PubMed1989

MRI study of lumbosacral lipoma in children.

The authors report 16 cases of lumbosacral lipoma in children studied by MRI. The exact position of the cord and its relationship to the lipoma were well demonstrated in all cases but one. There was as high incidence (25%) of syringomyelia in the terminal conus. Arnold Chiari malformation was never associated, which differentiates lumbosacral lipomas from myelomeningoceles. However, the nerve roots and their relationship to the lipoma were rarely visualized. Despite these drawbacks, MRI is the examination of choice if lumbosacral lipoma is suspected in children.

Adolescent↗
PubMed1989

MR imaging of the posterior hypophysis in children.

The posterior lobe of the pituitary gland was studied by MR imaging in 30 children without pituitary gland disease and compared with studies from a group of 13 children with central diabetes insipidus, including eight cases of primary diabetes insipidus and five cases of diabetes insipidus secondary to suprasellar tumors (four proved germinomas, one still unknown tumor). Two components in the sella turcica were identified in all 30 children without pituitary gland disease, and the posterior lobe was identified as a high-intensity structure on T1-weighted images. In all 13 patients with diabetes insipidus, the normal hyperintense signal of the posterior hypophysis was absent on T1-weighted images. Three patients with suprasellar tumors presented with a progressively enlarging pituitary stalk on follow-up. Our findings show that absence of the normal hyperintense signal of the posterior lobe is closely related to a loss of function of the neurohypophysis. Size or signal modification of the pituitary stalk should suggest the development of a suprasellar tumor.

Adolescent↗
PubMed1989

Cystic renal diseases in children.

Renal cysts are present in a wide variety of renal diseases, including those having a dysplastic nature and those of genetic origin. Genetic counseling requires clear differentiation between these types of cysts. This concept has made the classification of Potter useless because of the confusion it introduces between inherited diseases and developmental abnormalities. According to this classification, type I corresponds to autosomal recessive polycystic kidney disease (RPKD), type II to multicystic dysplasia, type III to autosomal dominant polycystic kidney disease (DPKD), and type IV to cystic dysplasia associated with urethral obstruction. The term "polycystic kidney disease" should be reserved for two hereditary cystic diseases, RPKD and DPKD, which are clearly distinct both by their modes of inheritance and by their pathologic characteristics. Both forms of polycystic disease may occur in children, but because the recessive form is much more prevalent, it is commonly called the "infantile form," whereas dominant polycystic disease is commonly known as the "adult form." The pediatric expression of these two forms and the problems of differential diagnosis will be examined.

Child↗