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Biomedical subjects

M Panuel

Publications and source records attributed to M Panuel.

At least 55 records · Page 3Linked to original sources
PubMed1999

[Is ultrasonographic evaluation the the length of the kidney possible in children? Apropos of a prospective study in Madagascar children less than 1 year of age].

Renal US was prospectively performed in 124 madagascan children less than 1 year of age. Patients were examined in the prone position and maximum kidney length was measured in the longitudinal plane. These measurements and the height and weight of our patient population were compared to published tables. Kidney length and height and weight of our patient population were inferior to the previously published reference data and the growth curve of kidneys steeper than normative standards (p < 0.001). Because of the important variability in US measurement of kidney length it is not possible to definitely conclude that length and growth curve of kidneys in madagascan children are statistically different from those of the published normative standards.

Age Factors↗
PubMed1999

[Abdominal cystic lymphangiomas in children. Clinical, diagnostic and therapeutic aspects: apropos of 21 cases].

Twenty-one abdominal cystic lymphangiomas were observed in paediatric patients during a 15-year period, in 11 boys and 10 girls. Diagnosis was prenatal in 2 cases; the mean age of the other 19 children was 4.7 years (range: 3 months-8 years). Tumours were intraperitoneal in 16 cases and retroperitoneal in 5 cases. Symptoms were variable: abdominal pain in 15 cases, palpable tumour in 6 cases (excluding the two cases of prenatal diagnosis). Complications included obstruction in 7 cases (including 3 by volvulus), infection in 6 cases, and intracystic haemorrhage in 3 cases. Abdominal ultrasonography correctly established the diagnosis in all children. Surgical treatment included 20 complete resections and one incomplete resection, including 6 with bowel resections. With a follow-up ranging from 6 months to 10 years, one recurrence occurred and was successfully reoperated. Intraabdominal cystic lymphangioma in childhood is a rare tumour with a variable presentation. An accurate diagnosis can be established by abdominal ultrasound. Complete resection should be performed whenever possible.

Abdominal Neoplasms↗
PubMed1999

[Exceptions to the rule concerning conservative treatment of polycystic renal dysplasia in children].

The authors report three cases of antenatally diagnosed polycystic renal dysplasia (PRD) associated with homolateral anomalies of the ureter and vas deferens requiring surgical exploration. The antenatal and postnatal diagnosis of polycystic renal dysplasia is based on ultrasound. It is recommended to look for associated vesicoureteric reflux by retrograde cystography. Conservative management is advised due to the natural involution of PRD. The authors emphasize the need for a more detailed ultrasound analysis of the lower genitourinary tract during the antenatal and postnatal period in order to identify an abnormal ureteric orifice, constituting the cause of the dysplasia. As dysplasia is predominant and the only anomaly detected on the antenatal examination, the associated lower tract anomalies will probably only be identified at birth. A better understanding and neonatal detection of associated lower urinary tract malformations probably justify a review of the current, systematic conservative approach, in a certain number of cases.

Abnormalities, Multiple↗
PubMed1998

[Recurrent osteitis and Coxiella burnetii: the relation to chronic recurrent multifocal osteomyelitis].

UNLABELLED: Chronic recurrent multifocal osteomyelitis (CRMO) is a disorder of suspected--but unproved-infectious etiology. OBSERVATION: A girl presented with a typical CRMO involving successively the left fibula, radius, humerus and the right carpus. A Coxiella burnetii infection was indicated during the first attack. Two recurrences occurred in spite of suitable antibiotic treatment and with negative infectious investigation. Two months after stopping antibiotic treatment, a new recurrence associated with antibodies increase and positive bone culture occurred. CONCLUSION: Coxiella burnetii can initiate a CRMO. The mechanism involved is probably a delayed hypersensitivity. CRMO would therefore be the first type of reactive osteitis.

Anti-Bacterial Agents↗
PubMed1998

Aneurysmal bone cyst in children: analysis of twenty-seven patients.

The authors have analyzed a retrospective series of 27 aneurysmal bone cysts (ABCs) in children and adolescents. The average age at diagnosis was 10 years (range: 3 years 7 months to 16 years), with a mean follow-up of 5 years (range: 1 month to 13 years 9 months). Pathologic fractures (8 cases) and pain (8 cases) were the main reasons for consultation. Of five spinal ABC patients, four presented with neurologic involvement. Although conventional radiology is useful for diagnosing ABCs, magnetic resonance imaging (MRI) is nevertheless the most important technique for checking the extent of the lesions. However, the diagnosis still must be based on the pathologic laboratory findings, even though this is sometimes difficult because of associated lesions. In lesions of the long bones, recurrence was observed after curettage in 5 of 12 cases. For this reason, simple resection or resection with reconstruction is recommended rather than curettage whenever possible. When an ABC is in contact with the growth plate in young children, blunt curettage should be performed to preserve the child's growth potential. Subsequent recurrence usually is easier to treat than an epiphysiodesis bridge and its consequences. The surgical procedures used to preserve the growth plate are described, along with methods of bone construction after surgery.

Adolescent↗
PubMed1997

Imaging of vascularized fibular grafts in large bone reconstruction in skeletally immature patients.

OBJECTIVE: To describe the imaging findings of vascularized fibular grafts (VFG) in large bone reconstruction in children and teenagers. DESIGN AND PATIENTS: Fifteen patients aged from 4 to 19 years underwent VFG for bone reconstruction for primary tumors involving bone in 13 cases and for chronic osteomyelitis in 2 cases. Lesions were located in the femur (6 cases), the tibia (6 cases), the humerus, the distal fibula and the ilium. Radiographic follow-up was performed in all patients, radionuclide studies in 12 patients and MRI in 8. RESULTS: Plain films showed a lamellated periosteal reaction on the VFG within 3 weeks following the procedure in all cases. Fusion of VFG and host bone occurred during the first 3 months. Radionuclide uptake of the VFG was seen in all cases but one. MRI showed cortical thickening and conservation of the high signal intensity of fatty marrow on T1-weighted sequences, and periosteal enhancement on dynamic post-contrast studies in all but one of the patients. CONCLUSION: Radionuclide studies and MRI show the periosteal enhancement and assess the viability of the VFG satisfactorily. However, we feel that plain films may be sufficient to ascertain this viability.

Adolescent↗
PubMed1996

Acute fracture of the distal tibial physis: role of gradient-echo MR imaging versus plain film examination.

OBJECTIVE: Recent reports indicate that, compared with MR imaging, plain film radiography often underestimates the extent of injury in children with physeal fracture-separation. Such underestimation may have significant therapeutic and prognostic outcomes. We performed this study to assess the benefit of MR imaging compared with plain film radiography in the diagnosis and immediate treatment of acute fractures of the distal tibial physis. SUBJECTS AND METHODS: Twenty-nine patients with acute fractures, including 15 Salter-Harris II, four Salter-Harris III, four Salter-Harris IV, and six triplane fractures, were prospectively examined by MR imaging with gradient-echo sequences. The MR images were compared with plain film radiographs. All cases were reviewed in a blind fashion by two experienced radiologists to determine the Salter-Harris classification on the basis of first plain film radiographs and then MR images. Two experienced pediatric surgeons were asked to propose treatment on the basis of first plain film radiographs and then MR images. Both the radiologists and the surgeons were asked to rate the two techniques in terms of degree of confidence and overall diagnostic effectiveness. RESULTS: Only 1 or 29 fractures (3%) was misclassified by plain film radiography. MR imaging never caused the treatment plan to be modified. However, the position of fracture fragments in Salter-Harris IV and triplane fractures was always better appreciated on MR images, facilitating more accurate surgical treatment. Except for those in the misclassified fracture, all other fracture lines were seen on both plain film radiographs and MR images but were more easily seen on MR images. CONCLUSION: Gradient-echo MR imaging allowed easier assessment of fracture lines than did plain film radiography, but the latter technique remains the primary means of evaluating epiphyseal injuries. For acute fractures of the lower extremity of the tibia, gradient-echo MR imaging should be limited to complex fractures and to cases in which the classification of a fracture on the basis of plain film evaluation is uncertain.

Acute Disease↗
PubMed1996

[Advanced-stage ankylosing spondylitis in a subject in the 8th century].

Paleopathological study of an adult male skeleton, coming from a Hungarian archeological site from the 8th century, revealed lesions of the spine (ankylosing vertebral syndesmophytosis, costo-vertebral ankylosis, discal calcifications), of the sacro-iliacs (bilateral ankylosis) and several extraspinal changes (abnormalities of symphysis pubis, enthesopathies). Radiological and CT investigations confirmed the diagnosis of advanced stage ankylosing spondylitis.

Adult↗
PubMed1995

[Thoracic standard radiology and x-ray computed tomography in mediastino-pulmonary tuberculosis in infants].

Primary mediastino pulmonary tuberculosis in infancy is increasing in France. Bacteriological diagnosis is difficult. The aim of the study is to assess the value of chest radiograph and CTscan for diagnosis of tuberculosis. We studied 15 infants, 3 month old to 18 month old, between November 1990 and June 1992. On plain film, lymphadenopathies were present in 13 cases and parenchymal disease in 10 cases, parenchymal nodular densities in 6 cases and pleural effusion in one case, displacement of the trachea in 6 cases. We found CTscan to be useful in delineating the lymphadenopathies and parenchymal changes. In 2 cases lymphadenopathies and in 2 cases alveolar condensation were discovered on CTscan as plain film was normal. In all cases lymphadenopathies were present in CTscan, often in right side and in all cases, lymphadenopathies were hypodense with peripheral enhancement. In conclusion, the association of right paratracheal nodes with displacement of trachea and alveolar consolidation is common in tuberculosis in infants. These findings when seen on chest radiographs must lead to perform a CTscan and suggest the diagnosis.

Bronchial Diseases↗
PubMed1995

[Acetabular anteversion in congenital luxation of the hip].

MATERIAL AND METHOD: Acetabular anteversion angle (AAA) and orientation angle of the iliac bone (AOOI) determined by use of a CT scan were studied in CDH. 55 children with CDH were selected on hip arthrography for this study. Subluxated hips were excluded (i.e. opposite hip of a unilateral CDH is normal). 10 boys and 45 girls with a mean of age of 2 years 1 month (extremes from 1 to 4 years 3 months) were studied. CT scan was performed before any orthopaedic treatment in 3 cases of bilateral luxation and 14 cases of unilateral. In the other cases, time between the end of orthopaedic treatment and CT scan varied between 4 and 18 months. A group of 23 normal children, 10 boys and 13 girls, (mean age of 2 years 10 months) served as reference group. On the selected CT slide we measured AAA, AOOI, IAA and IAP (anterior acetabular index and posterior acetabular index as proposed by Guggenheim). RESULTS: We noted that the orientation of the iliac bone was variable in the two groups. This orientation angle could have higher or lower values. AAA: in bilateral luxation, this angle was higher (16 degrees +/- 5 degrees) than in reference group (13 degrees +/- 4 degrees), p < 0.005. In unilateral luxation there was no statistical difference (14 degrees +/- 4 degrees) with reference group, between normal and pathological side and when CT scan was performed before or after orthopaedic reduction. AOOI: there was no significant difference between bilateral, unilateral or reference group. Correlation analysis showed that AAA and AOOI moved in the same direction. IAA: in bilateral luxation this index was higher (p < 0.001); in unilateral luxation only right luxation showed an higher index (p = 0.002). IAP: no significant difference between the different groups. DISCUSSION: This study shows that there is any typical CT scan aspects of morphologic abnormality in CDH. The lesions of the anterior or posterior acetabular wedge are variable. The orientation of the iliac bone is also variable; we concluded that acetabular anteversion must be analysed depending on the morphologic aspects of the anterior and posterior extremities of the acetabulum and iliac bone orientation.

Acetabulum↗