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Biomedical subjects

M Gruner

Publications and source records attributed to M Gruner.

At least 37 records · Page 2Linked to original sources
PubMed1997

[A case of pulmonary mesenchymal hamartoma in a 9-year-old child].

This case of mesenchymatous hamartoma in a nine-year-old boy, was an incidental finding on a chest X ray. CT and MRI suggested the diagnosis showing a large (9 x 11 x 14 cm) mass developed in the right lower lung with sharp margins, without any sign of pulmonary or mediastinal compression. This lesion contained fatty areas on both CT and MRI. It showed no calcification. It enhanced slightly after IV contrast. On T2 WI, it appeared lobulated with low signal intensity septa. Presence of fatty tissues and lobulated margins were suggestive of the diagnosis of mesenchymatous hamartoma. A 1.2 kg mass was surgically removed. The tumor was attached to the right lower lobe by a small pedicle. Pathological examination disclosed fatty and connective tissues. This rare observation shows a good correlation between CT, MR, surgery and pathological examination.

Child↗
PubMed1997

[Treatment of ruptures of the posterior urethra in children? The value of the symphyseal approach].

Eight cases of rupture of the posterior urethra were observed in children and treated via a trans-symphyseal approach. Repair was easy in the cases seen rapidly (2 to 10 days), urethral suture was effective and the result was excellent. On the other hand, in cases seen later (6 cases), between 6 months and 5 years, marked fibrous callus had to be resected. Urethral repair was not always possible (only one failure out of 6 late cases). This approach preserves genital functions.

Adolescent↗
PubMed1997

[Value of percutaneous nephrostomy in the management of posterior urethral valves in newborn infants].

OBJECTIVES: This study evaluates the place of percutaneous nephrostomy (PCN) in neonates with posterior urethral valves (PUV). MATERIAL AND METHODS: 11 neonates with PUV, 10 of which were diagnosed antenatally, were treated. PCN drainage was performed in 9 cases, prior to endoscopic resection. Six PCN were bilateral and 3 were unilateral, for the following indications: renal failure in 5 cases, severe infection in 2 cases, evaluation of a dilated kidney in 2 cases. RESULTS: These PCN were left in place for an average of 18 days. Two cases of asymptomatic postoperative bacteriuria were observed. One nephrectomy and one cutaneous ureterostomy followed by reimplantation for megaureter were performed on the diverted kidneys. CONCLUSION: PCN has become the method of upper tract diversion in most cases of neonatal PUV. In addition to the classical indications (severe urinary tract infection, renal failure), it allows perfectly safe resection of valves in the case of upper tract dilatation and assessment of the kidneys.

Age Factors↗
PubMed1997

[The role of surgery in tuberculosis in children].

Despite increasingly rigorous preventive measures which have limited the number of cases in France, the number of children undergoing surgery for tuberculosis has remained unchanged. Over the last ten years we operated on 40 children in our pediatric unit. In 10 cases, surgery was indicated for diagnosis, in 19 cases surgery was required in an emergency situation during treatment and in 11 the operation was performed at the stage of sequellae. The type of surgery depended on the clinical situation. Thoracoscopy was used for surgical diagnosis and to empty caseous nodes in the lateral tracheal chain but was generally impossible at the sequellae stage.

Aspergillosis↗
PubMed1996

The value of split renal function in severe neonatal and infant pelviureteric obstruction managed by percutaneous nephrostomy.

A percutaneous nephrostomy (PCN) was inserted as part of the management in 17 newborns and infants with severe pelviureteric junction obstruction between 1981 and 1993. Nephrectomy was performed in eight cases and pyeloplasty in nine cases, successfully in six cases (mean follow-up: 7.7 years). PCN was useful for predicting that no non-functioning kidney on intravenous pyelography (IVP) in this series should have been preserved. Among the kidneys with a high excretion delay on IVP, PCN showed that only those that had a split creatinine clearance of more than 1 ml/min/1.73 m2, or theoretical clearance for age and weight of over 6%, should be preserved.

Creatinine↗
PubMed1996

[A case of intrapancreatic duodenal duplication communicating with the biliopancreatic channel].

Intestinal duplications are rare and are usually diagnosed in the first two years of infancy. They can occur at any level of the alimentary tract from the oral cavity to the anus. Duodenal duplication accounts for approximately 7% of all intestinal duplications. A previously healthy 4-year 6-month old boy was admitted with progressive increasing vomiting. Physical examination was normal, the serum amylase level was moderately increased. Upper gastrointestinal series showed an extrinsic compression defect of the proximal duodenum. Ultrasonography showed a 3 cm diameter cyst in the head of the pancreas. A duplication was suggested. Helical CT cholangiography showed a communication between duplication and the biliopancreatic common channel. The biliary tree was normal. Surgical resection of the intrapancreatic lesion was performed. Microscopic examination of the specimen revealed a duodenal duplication.

Child, Preschool↗
PubMed1996

Low concentrations of cis-linoleic acid induce cell damage in epithelial cells from bovine lenses.

As low as 5 micromol/l of cis-linoleic acid proves to be cytotoxic for bovine lens epithelial cells in culture. Albumin eliminates the linoleic acid cytotoxicity completely, presumably by binding the fatty acid. However, the damaging effect appears again when the molar ratio of linoleic acid to albumin exceeds 1:1. The assumption that the linoleic acid-caused cell damage would be mediated by peroxidation products could not be confirmed. The results obtained rather favor the idea that linoleic acid molecules themselves injure lens epithelial cells. Obviously, cell damage even occurs in the presence of albumin if one molecule of albumin binds more than one molecule of linoleic acid. Micromolar concentrations of linoleic acid produce reversible bleb formation as well as cell retraction within 30 min. In primary culture 10 micromol/l linoleic acid damage lens epithelial cells irreversibly within some hours. Trans-linoleic acid, linolenic acid and oleic acid are also harmful to lens cells but to a lesser degree, while saturated fatty acids are without any effect. Bleb formation as a leading early sign hints at the plasma membrane as the primary target for linoleic acid induced cytotoxicity.

Albumins↗
PubMed1995

[Unilateral inguinal hernia in infants: costs, risks and benefits of herniography? Results].

AIM: To assess the advantages of systématic herniography in cases of unilateral inguinal hernia in infants. METHOD: Decision analysis presented in the first part of this article was used. A preliminary retrospective study of 348 cases as well as a literature review were utilized to determine the probabilities required in order to create and run the decision aid algorithm. Gonadic benefit was used as the health indicator. RESULTS: For males, gonadic benefit procured by the herniography depends on the risk of strangulation in cases of groin hernia and on the frequency of testicular atrophy after inguinal hernioplasty. The evaluation of these two elements largely determines the choice of medical and surgical practices. For a 0.44% risk of post-operative testicular atrophy and a risk of strangulated hernia estimated at 20%, the cost-effectiveness ratio is FF, 199681 to save a testicle. One testicle is saved every 455 herniographies, with 24 possible post-examination complications. For female, herniography provides no gonadic benefit. DISCUSSION: Decision analysis permits the quantification of results, leading to improved clinical judgement and facilitating the evaluation of medical practice.

Atrophy↗
PubMed1995

Growth regulation by cell shape alteration and organization of the cytoskeleton.

The correlation between cellular growth and microfilament-dependent morphology was investigated. It was found that the proliferative growth of various nontransformed cell lines does not only depend on cell adhesion to a suitable substratum and cell flattening but also on intact microfilaments. Disintegration of microfilaments by cytochalasin D (CD) as well as lactrunculin (LAT)-A and LAT-B is correlated with a strong decline of the number of DNA-synthesizing cells during a period of 8 to 12 h after application of the drug. RNA and protein synthesis are reduced already after a preincubation time of 2 h. Although microinjected rhodamine-phalloin is colocalized with microfilaments there is no stabilizing effect against CD even at high phaloidin concentrations. Microinjection of DNAse I results in a strong alteration of the microfilament system. The disorganization of microfilaments was correlated with a moderate decrease of protein synthesis 2 h after microinjection, whereas RNA synthesis remained unchanged, if RNase-free DNase I was used. The number of DNA-synthesizing cells was somewhat diminished 24 h after microinjection. Furthermore, the microfilament system is disorganized by microinjection of gelsolin and gelsolin segment 1 + 2, respectively. The severing the microfilaments by gelsolin is correlated with a significant restriction of RNA and protein synthesis during a period of 2 to 4 h after injection, but the labeling index remaining unchanged. Therefore, we assume that inhibition of the G0-G1-S transition is only caused by a disintegration of microfilaments lasting longer than 4 h. The significance of microfilament organization for growth regulation is discussed.

Actin Cytoskeleton↗
PubMed1995

[Multilocular cyst of the kidney in a child. Value of MRI?].

We report one case of multilocular cyst of the kidney in one year and three months female infant who underwent echography, computed tomography and MRI before surgery. MR image accurately reflect the morphology of the tumor: the capsule is hypointense on T1-weighted images, the septa show moderate enhancement with intravenous contrast. Varied intensities from fluid in the visualised locules presumably represent different concentration of proteins. MR imaging features are highly suggestive but non pathognomonic of the disease. Positive diagnosis always require histology.

Female↗
PubMed1994

Amputation of penis after circumcision--penoplasty using expandable prosthesis.

A two-year-old boy was referred for correction of an amputation of penis following ritual circumcision. The reconstruction involved mobilization of the profound part of corpora cavernosa and coverage by a vascularised flap taken from the hypogastric area through the use of a sub-cutaneous expandable prosthesis. After two years, appearance of the neo-penis is satisfactory considering the initial lesions.

Amputation, Traumatic↗
PubMed1994

The risk of wound infection after inguinal incision in pediatric outpatient surgery.

To study the risk of wound infection in pediatric outpatients, two series of children operated on with an inguinal incision during a 5.2 year period in the same department, either in day-surgery or in standard hospitalization, are compared. It appears that the frequency of inguinal wound infection is lower for outpatients (1%; 18/1816) than for inpatients (4%; 17/427). This difference is due, on the one hand, to the way day-surgery hospitalization functions and, on the other hand, to the difference of population produced by the criteria for selection for admission in the Day-Surgery Unit.

Ambulatory Surgical Procedures↗
PubMed1994

Histiocytosis X revealed by complex anal fistula.

A very unusual clinical case of histiocytosis X in a young girl with no unusual medical history, is presented. The patient presented with chronic suppuration of the groin and complex anal fistulae and multiple recurrent abscesses, despite surgical treatment (abscess drainage, terminal colostomy). Intestinal and immunologic evaluation were normal. Only histology made the diagnosis. Chemotherapy (vinblastine) resulted in healing and the colostomy was closed.

Adolescent↗
PubMed1994

[The role of brachytherapy in the therapeutic strategy of vesico-prostatic rhabdomyosarcoma in children].

Because of its ballistic and physical characteristics, brachytherapy (BT) represents the optimal irradiation treatment in pediatric tumors, especially in prostate or bladder rhabdomyosarcoma. In a limited series of 15 children treated with BT (including three patients treated with salvage BT), 8 out of 9 patients surviving with NED benefited from conservative treatment among 12 patients treated with BT as first-line treatment. Sequelae were minimal consisting of one grade I cystitis and one asymptomatic vesical and ureteral reflux. BT allows administration of high doses to limited volumes sparing normal tissues. BT--whenever possible--represents the treatment of choice compared with external radiotherapy. Indications of BT depend on tumor accessibility and size (usually < or = 4 cm).

Adolescent↗
PubMed1993

Expandable prosthesis in right postpneumonectomy syndrome in childhood and adolescence.

Right pneumonectomy can lead to severe respiratory impairment due to stenosis of the left main bronchus. This syndrome is usually treated by inserting a fixed-volume prosthesis but, in children, expandable prostheses have the advantage of being adaptable to growth and permit progressive recentering of the mediastinum. We report 3 such cases, with the results of pulmonary function tests. The patients were aged 11, 17, and 22 years at the time of implantation and had undergone pneumonectomy during childhood for either bronchiectasis or complete pulmonary sequestration. All 3 patients are doing well, with a follow-up of 1 to 3 1/2 years. Pulmonary function tests have shown a substantial improvement in the obstructive syndrome in 2 patients whereas, in the third patient, in whom the contralateral lung was not perfectly healthy, the functional improvement was only moderate.

Adolescent↗
PubMed1993

[A rare cause of bone pain in children: primary hyperparathyroidism caused by adenoma].

BACKGROUND: Primary hyperparathyroidism is rare in children and adolescents. Bone changes may produce pain in the back or extremities, but this is rarely the first symptom of the disease. CASE REPORT: A 13 year-old girl suffered from pain in the back and lower extremities. Progressive bilateral genu valgum appeared. One year later, she became lame because of the deformity. ECG showed cardiac arrhythmia with atrial extra systoles. The serum calcium concentrations were 3.36 and 3.8 mmol/l, phosphate 0.76 mmol/l and alkaline phosphatases 6,612 U/I (N: 90-300). Urinary excretion of calcium was 17 and 26 mg/kg/day and the renal tubular reabsorption of phosphate was 77%. Radiological studies revealed resorption of subperiosteal bone, best seen along the margins of the phalanges, demineralization of the skull vault, bilateral coxa vara and zones of calcification on knee metaphyses. The serum concentration of parathyroid hormone (PTH) was 1,066 pg/ml (N: 10-55) and that of 1-25(OH)2D3 was 125 ng/ml (N: 20-80). Ultrasonography showed a heterogeneous mass, 23 x 15 mm, suggesting a parathyroid adenoma. This adenoma was independent of the left inferior parathyroid. It was removed and the biochemical findings gradually returned to normal. Bone demineralization also disappeared and the knee deformities were surgically corrected 9 months later. CONCLUSIONS: Bone changes may occasionally cause severe pain, indicating demineralization and hypercalcemia: hyperparathyroidism is one cause of such changes.

Adenoma↗