Search PubMed⌕ Search

Biomedical subjects

M Dechaux

Publications and source records attributed to M Dechaux.

53 records · Page 3Linked to original sources

[Diffuse arterial calcified elastopathy].

Diffuse arterial calcified elastopathy was observed in 6 pediatric patients presenting with severe renovascular hypertension. Renal ultrasonography showed a characteristic pattern, the dotted corticomedullary junction, related to the increased echogenicity of the interlobar and/or arcuate arteries. Superficial temporal artery biopsy demonstrated the presence and the extension of the calcifying process involving the elastic layers of the muscular arteries. This clinicopathological syndrome may be heterogeneous from an etiological point of view: etiologic investigations led to the diagnosis of pseudoxanthoma elasticum in 2 patients; no etiology could be found in the others.

Arteries↗

Inactive renin in infants and children: evidence for its physiological response to orthostasis in children.

The aim of this work was to investigate the presence of inactive renin (IR) in plasma of normal infants and children and nephrectomized children and to study the plasma IR response to stimulation of the renin-angiotensin system (orthostasis) in children. The study was performed in 10 normal infants (2 days to 1 yr old), 28 normal children (1-15 yr old), 8 nephrectomized children (8-14 yr old), and 7 normal adults (20-40 yr old). IR was calculated as the difference in renin activity in trypsin-treated (1500 micrograms/ml) plasma, e.g. total renin (TR), and in untreated plasma, e.g. active renin (AR). IR was not detectable in most infants in the supine position, but their AR values were high (8.8-30 ng/ml X h). Moreover, in some of these infants, trypsin appeared to degrade renin activity, since TR values were lower than AR values. IR was detectable in 3 infants and 27 children, but their AR values were in a lower range (0.3-10 ng/ml X h). Trypsin degradation of renin activity was not found in either children or adults. With increasing age (2 days to 40 yr), AR decreased while IR and the IR to TR ratio increased significantly (P less than 0.001). A significant (P less than 0.001) inverse relationship was found between the IR and AR values of subjects 2 days to 40 yr old. IR was detectable in all nephrectomized children and represented 25% of normal values, while AR was undetectable (less than 0.1 ng/ml X h). In children in the upright position, IR decreased and AR increased significantly (P less than 0.001) in a reciprocal manner. TR did not change. These data suggest 1) that trypsin degradation of renin activity and absence of trypsin-activated IR are specific to infants with high AR levels, and 2) that IR might be activated in vivo into AR, especially after changes in position in children. IR could be a prorenin playing a physiological role in children.

Adolescent↗

[Beta 2 microglobulin. Index of glomerular filtration in children].

121 assays for plasma Beta 2 microglobulin (B2M) levels were carried out with an immuno-enzymatic technique in 94 children whose ages ranged from 13 months to 18 years and whose renal functions showed various levels of renal impairment. In the 37 children with normal glomerular filtration rate, plasma B2M level was 1.58 +/- 0.48 mg/l (mean +/- 1 SD) and no significant differences were found according to sex, ages or heights. In the 29 children with glomerular filtration rate (GFR) ranging from 20 to 100 ml/min/1.73 m2, there was a significant correlation between B2M and the inulin clearance, plasma creatinine level and creatinine clearance (p less than 0.001). In 28 patients presenting with terminal renal failure, plasma B2M levels were significantly higher in children undergoing hemodialysis than in those under chronic peritoneal dialysis. These results indicate that B2M levels are as good an index of glomerular filtration rate as serum creatinine whereas its assay uses a long and difficult technique.

Adolescent↗

Nyctohemeral rhythm of plasma renin activity and plasma aldosterone in children.

Circadian rhythms of plasma renin activity (PRA) and plasma aldosterone (PA) were studied in eight healthy children, 7 to 15 years old. Blood samples were obtained at 7:00 AM, 10:00 AM, 1:00 PM, 4:00 PM, 5:00 PM, 8.00 PM, and midnight on day 1 and 4:00 AM and 7:00 AM on day 2. Children had normal activity during this test. Intra- and interindividual changes were noted in PRA in plasma taken in the upright position. Mean PRA values for samples taken in the upright position were maximal at 1:00 PM (7 ng/ml/hr) and minimal at 5:00 PM (4.1 ng/ml/hr). Mean PRA in the supine position was maximal at 4:00 AM on day 2 (5.6 ng/ml/hr), and its rise was statistically significant compared with the mean PRA at 7:00 AM on the same day (3.9 ng/ml/hr). Plasma aldosterone varied without any definite pattern. No correlation was found between PRA and PA and 24-hr urinary sodium excretion.

Adolescent↗

[Captopril in severe arterial hypertension of childhood (authors transl)].

Twenty patients with severe arterial hypertension were treated with Captopril (an inhibitor of angiotensin 1 converting enzyme). Decrease in blood pressure occurred early and was sometimes important. Significant changes in plasma renin activity, plasma aldosterone and converting enzyme activity were observed. There was a significant inverse correlation between the action of Captopril on blood pressure and the level of extra-cellular volumes. Eighteen patients received long-term treatment (m = 10.05 +/- 1.32 mo.). Side-effects consisted of positive antinuclear antibodies and a possible kidney failure in cases with stenosis of the renal artery.

Adolescent↗

Micro determination of plasma renin activity in normal infants and children of capillary and venous blood.

Plasma renin activity (PRA) has been measured by microassay on capillary and venous blood sampled simultaneously in 21 subjects; there is no significant difference between these two groups of PRA values. PRA values in normal infants, children and adults have been measured with this microassay and the results are similar to those previously published by authors using different radioimmunological assays.

Adult↗

[Plasma creatinine, and clearance and urinary excretion of creatinine in children].

The 24 hour clearance of endogenous creatinine was compared with that of inulin in 112 children aged between 15 months and 17 years. The children had a variety of kidney disorders with renal function than ranged from normal to terminal renal failure. When the inulin clearance was less than 10 ml/min/1.73 m2 it was on average 75% of the value of the creatinine clearance. Between 10 and 60 ml/min/1.73 m2 the relationship of the inulin clearance to that of creatinine was similar (77%) but above 60 ml/min/1.73 m2 the ratio of the inulin clearance to that of creatinine was 1.05 with a wide scatter. With increasing degrees of renal failure the plasma creatinine increased less in the children under 2 years old than in those over this age so it is poor index of glomerular function in infants. In renal failure the urinary excretion of creatinine in 24 hours was reduced. When the clearance was less than 10 ml/min/1.73 m2, the urinary creatinine excretion for children under the age of 2 was 58% of the normal for the age and for children over 2, it was 86% of the expected mean.

Adolescent↗

[Electrometric determination of urinary ammonia using a continuous-flow automatic method].

A critical study has been designed to evaluate the application of an electrometric method to the assay of ammonia in urine. The use of NH3-gaz permeable membrane electrode with a continuous flow system seems to have solved most of the problems evoked by former studies. The results obtained show that the method is reliable for the use in clinical routine. The simplification of the ammonia measurement procedure thus achieved will allow an important increase in the number of renal function tests that a clinical routine laboratory can handle in a hospital.

Ammonia↗

Zinc bone loss in chronic renal failure and chronic metabolic acidosis.

The effects of chronic metabolic acidosis (CMA) on zinc (Zn) bone content and urinary excretion were examined in the presence of normal or reduced renal function together with some aspects of calcium (Ca) metabolism. Four groups of rats were compared. All were fed a 30% protein and 9 mg Zn/100 g diet. Two were uremic (U): The first developed acidosis (UA), which was suppressed in the other (UNA) by NaHCO3 supplement. Two other groups had normal renal function: One was normal (CNA), and the other had NH4Cl in the drinking water and acidosis (CA). Femur total Zn and Ca content was markedly reduced by CMA and was not affected by uremia. Zn urinary excretion was increased by CMA and unaltered by uremia. Ca urinary excretion was markedly reduced in uremic rats, but was enhanced in both acidotic conditions. Urinary Ca and Zn showed a strong correlation in uremic and in control rats. Plasma parathormone and 1,25(OH)2D3 were unchanged by CMA. These data are in agreement with a direct primary effect of CMA on bone in releasing buffers. CMA induces bone resorption and a parallel decrease of mineral bone components, such as Ca and Zn, with little or no role of PTH, 1,25(OH)2D3 and of uremia itself.

Acidosis↗

[Clinical value of urinary biochemical parameters].

Twelve of the urine parameters, namely sodium, potassium, chloride, urea, creatinine, uric acid, calcium, phosphate, protein, microalbumin, amylase and glucose, routinely measured in a biochemistry laboratory were chosen to revalue their interest in clinical practice. For each parameter, urinary collection method, physiologic review and specific indications were set out. The clinical interest of chloride, urea, phosphate or uric acid measurement seem limited to specific pathological conditions. The measurement of urine amylase is out of interest.

Adolescent↗

[Parathyroidectomy in children with renal failure. Retrospective study of 17 cases].

Parathyroidectomy (PTX) is rarely needed in children with end-stage renal disease and the new forms of vitamin D decrease its frequency. We report 17 cases of patients (14 with dialysis and 3 with functional renal graft) suffering from renal insufficiency in the pediatric age group who required a PTX. The surgical indications and techniques (partial PTX, total PTX with or without graft) varied with time and circumstances. After partial PTX, 3/10 patients were reoperated on. After PTX + graft one patient needed a second graft and another a graft curettage. Whatever the method, we noted normalization of clinical and radiological signs and a decrease in biological signs. The growth rate improved in most children during puberty, but outside of this period, no effect was noted. There is a definite indication for a PTX in cases with tertiary hyperparathyroidism. The indication seems questionable in cases with secondary hyperparathyroidism which can now be effectively treated with 1 alpha-hydroxylated forms of vitamin D. When necessary, total PTX with or without graft should be performed.

Adolescent↗

Diffuse arterial calcified elastopathy--a new cause of renovascular hypertension in children.

Diffuse arterial calcified elastopathy was observed in 6 pediatric patients presenting with severe renovascular hypertension. Renal ultrasonography showed a characteristic pattern, the dotted corticomedullary junction, related to the increased echogenicity of the interlobar and/or arcuate arteries. Superficial temporal artery biopsy demonstrated the presence and the extension of the calcifying process involving the elastic layers of the muscular arteries. This clinicopathological syndrome may be heterogeneous from an etiological point of view: etiologic investigations led to the diagnosis of pseudoxanthoma elasticum in 2 patients; no etiologic cause could be found in the others.

Arterial Occlusive Diseases↗