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Biomedical subjects

M Panuel

Publications and source records attributed to M Panuel.

At least 73 records · Page 4Linked to original sources
PubMed1994

[Pulmonary tuberculosis in infants. Apropos of 6 cases].

BACKGROUND: The present increased incidence of tuberculosis in children can be explained by contacts with infected adults and/or late BCG vaccination. PATIENTS: Six infants, 3 to 18 months-old (mean: 8 months), were admitted from November 1990 to May 1992 for various reasons; only two were admitted with a diagnosis of tuberculosis based on tuberculin test and only one was given a BCG vaccine. The disease produced a broad range of symptoms. Diagnosis was based on tuberculin test and radiographic examination showing lymph node enlargement of mediastinum and segmental consolidation lesions. Mycobacterium tuberculosis was found in two cases. The patients were given isoniazid, rifampin, ethambutol and/or pyrazinamide; corticosteroids were added in five patients. Each patient received four or three drugs for 2-4 months and two drugs (isoniazid plus rifampin) beyond, for a mean total duration of 13 months (range: 9-17 months). Repeated CT scan of thorax was performed to evaluate the efficacy of treatment. Tuberculosis was diagnosed in 11 subjects in contact with these children. CONCLUSION: Tuberculosis in children is not rare, and BCG vaccination of neonates should be seriously considered.

BCG Vaccine↗
PubMed1993

Physeal and epiphyseal extent of primary malignant bone tumors in childhood. Correlation of preoperative MRI and the pathologic examination.

Twenty-two patients with metaphyseal primary malignant bone tumors (17 osteosarcomas, 5 Ewing's tumors) occurring before closure of the growth plate were examined with plain radiographs and MRI in order to determine the physeal or epiphyseal extent of the tumor. Results were correlated with the pathologic examination. Transphyseal spread was pathologically proven in 13 cases (59%): 12 cases of osteosarcoma and 1 case of Ewing's tumor (70% and 20%, respectively). There was no significant relation between epiphyseal invasion, age of patient, length of tumor or, in the cases of osteosarcoma, response to chemotherapy. Plain radiographs showed epiphyseal involvement in 4 cases and there were 10 false negatives. MRI revealed epiphyseal involvement in all cases; there were no false positives or false negatives. T1-weighted images in coronal or sagittal planes appeared to be sufficient. These findings are very useful in planning surgical limb salvage procedures and stress the ineffectiveness of the "barrier effect" of the growth plate against tumor spread.

Adolescent↗
PubMed1993

[Aneurysmal cyst of the bones in children].

The authors have analysed a series of aneurysmal bone cysts (A.B.C.) in children and adolescents which were reviewed at an average follow-up of 4 years 2 months (6 months-15 years). The average age at diagnosis was 8 years (3-19 years). Pathological fractures were the main reason for consultation, probably due to the predominance of central lesions. If conventional radiology remains indispensable to diagnosis, magnetic resonance imaging is nevertheless the most important examination in determining the extent of the affection. The diagnosis remains anatomopathological, even if this may be difficult due to associated lesions (A.B.C. illness and A.B.C. symptoms). In long bones lesions, we observed recurrence after curettage in 3 out of 7 cases. For this reason the recommend simple resection or reconstructive resection rather than curettage whenever possible. 5 lesions in contact with growth plate were observed. In such cases we recommend its conservation by careful curettage, especially in young children. We feel that subsequent recurrence is easier to treat than an epiphysiodesis bridge. The surgical techniques employed to conserve the plate are described along with methods of bone reconstruction after surgery.

Age Factors↗
PubMed1993

[Unusual intrathoracic tumor in children: lipoma].

BACKGROUND: Intrathoracic lipomas are rare, often asymptomatic and, in this case, discovered by chance on X-ray. CASE REPORT: A 3 year-old girl was admitted because chest X-rays prescribed for a persistent cough showed a mass in the right axillary area. The CT scan showed a mass with density of -80 Hounsfield units, characteristic of adipose tissue. There was a slight rib change in contact with the mass, but radionuclide bone scan showed no area of increased uptake. A chest X-ray performed 3 years earlier had shown such a mass, but it was not recognized at that time. Surgery demonstrated that the mass was extrapleural in location and adhering to the rib which was partly excised. Histologic examination showed the presence of mature adipocytes, but no malignant cells. CONCLUSION: The fatty component of an intrathoracic tumor is easily recognized with CT scan. Erosion of bone in contact with it has been reported.

Age Factors↗
PubMed1992

Splenic hemangioma--report of three pediatric cases with pathologic correlation.

Splenic hemangioma is a very rare neoplasm in children. We report three cases of splenic hemangioma, two of solitary hemangioma and one of hemangiomatosis. Two patients had hematologic disorders related to hemangioma. Imaging findings of this entity are presented and discussed with emphasis on pathologic correlation.

Child, Preschool↗
PubMed1992

Value of MRI and MIBG-I123 scintigraphy in the diagnosis of spinal bone marrow involvement in neuroblastoma in children.

The results of MRI and MIBG scintigraphy performed on the spine of 14 children with neuroblastoma are reported. In 6 cases of diffuse spinal bone marrow tumor infiltration, diagnosis is easier with MIBG scintigraphy than with MRI. In 5 cases, MRI detected hyposignal of the vertebral body without any spinal abnormality on MIBG scintigraphy. A discussion of the reasons for negative MIBG scintigraphy is presented and in these 5 cases, it is suggested that a lateral view of MIBG scintigraphy and HMDP-Tc99m scintigraphy may be performed, even vertebral body biopsy in order to assess bone marrow tumoral infiltration.

3-Iodobenzylguanidine↗
PubMed1992

[Rhabdoid tumor of the neck].

Three pediatric cases of malignant rhabdoid tumor of the neck are described. Clinical data and imaging findings (US, CT and MRI) are stressed. The mass was well defined, containing punctate calcifications in two cases and encasing the vessels in two other cases. Two patients were treated with a chemotherapy regimen according to MMT 89 SIOP protocol, one had chemotherapy and radiotherapy. Two children died of progressive disease; the remaining child who had complete surgical removal of the tumor is on remission 17 months after diagnosis.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

[Evaluation of diagnostic efficacy and clinical tolerability of ioversol in "whole body" computed tomography in children. A non comparative phase III trial].

An open-label noncomparative clinical study was conducted to evaluate the efficacy and tolerance of ioversol (Optiray 300), a new low-osmolality non ionic contrast medium, in body contrast-enhanced CT scanning in infants and children. Fourty pediatric patients who required contrast-enhanced CT scanning for evaluation of chest, abdominal or pelvic masses participated in the study. The vascular enhancement was judged to be excellent or good in 72.5% of the cases and the CT scans were judged to be diagnostic in 95% of the cases. Ioversol was well tolerated in the study with only two mild adverse reactions (nausea and vomiting, and metallic taste).

Adolescent↗
PubMed1992

[Ewing's tumor: current knowledge and ignorance].

The diagnosis of Ewing's malignant tumor in the young still raises major problems, either from a clinical point of view because of its rarity, its pluri-potentiality and various symptoms, or on imaging because of its numerous pitfalls. Accordingly the disease is often misdiagnosed as osteomyelitis. Only a high quality biopsy can determine histological diagnosis of undifferentiated small round cell tumor. The chromosomic study shows a specific (11;22)(q24;q12) translocation, and immunocytochemistry and molecular biology show the tumor's neuroectodermal origin. For 20 years, therapy tended toward first line tumor chemoreduction, followed, when appropriate, by complete resection and orthopedic reconstruction of the bone. Radiotherapy, which is responsible for long-term sequelae is now increasingly restricted to inaccessible or incompletely excised tumors. More intensive chemotherapy is being examined in patients with poor prognosis factors such as a negative response to induction chemotherapy, a significant mass or metastases. As a result of new strategies, disease-free survival rate is now between 60-70%. The management of this disease is highly multidisciplinary and patients will now be included in multicentric controlled therapeutic trials. Long term follow-up has to be carried out following completion of treatment.

Adolescent↗
PubMed1992

[Drash syndrome].

The authors report one case of Drash syndrome: association of Wilms' tumor, nephropathy and genital abnormalities. The definition, prognosis and origin of this triad are discussed.

Cadaver↗
PubMed1992

[Hydatid cyst of the kidney in the child].

Three pediatric cases of hydatic cyst of the kidney are reported. This is a very rare condition in children. Usually, the presentation is a cystic space-occupying lesion of the kidney. Several diagnostic methods are available but it is stressed that ultrasonography may be sufficient. Surgical treatment is still necessary.

Child↗
PubMed1992

[Duodenal atresia with bifid termination of the common bile duct].

A new case of duodenal atresia with gas below the obstruction is reported. This apparently contradictory feature is due to a bifid termination of the common bile duct in the duodenum, air by-passing the atretic area. The anomaly was proven by operative cholangiography.

Cholestasis, Extrahepatic↗
PubMed1991

Esophageal atresia, tracheomalacia and arterial compression: role of aortopexy.

Between 1985 and 1990, we treated 46 cases of esophageal atresia in the pediatric surgery department in Marseille. In 17 of these patients atresia was associated with tracheomalacia. The most common respiratory manifestations were acute apneic attacks, cyanotic spells and recurring pneumopathy. The underlying cause was arterial compression of the airways by the innominate artery in 6 cases, the aortic arch in 2 cases, and a common origin of the innominate and left carotid arteries in 2 cases. Eleven patients underwent surgery to relieve arterial compression: suspension of the aorta from the under surface of the sternum (10 cases) and reimplantation of the innominate artery (1 case). Results in terms of tracheal caliber and symptomatic relief were excellent in 10 cases including 1 case requiring redo, and poor in 1 case. For diagnosis, our experience shows the importance of endoscopy, nuclear magnetic resonance and recognition of gastroesophageal reflux which is often associated (9/11). The role of tracheomalacia is discussed. On the basis of our results and those previously reported, aortopexy appears to be an effective surgical technique in patients with esophageal atresia presenting respiratory complications due to arterial compression.

Airway Obstruction↗
PubMed1990

MRI of disc space infection in infants and children. Report of 12 cases.

The MR aspects of spondylodiscitis in pediatric patients were studied with a 0.5-Tesla supraconductive magnet: 12 patients were divided in two groups; acute disease (9) and period of sequelae (3). The first group was divided into two subgroups according to the age and the clinical findings: infants (2) and children (7). In infants, MR gave good visualization of the destruction of vertebrae and discs. Presuppurative abscesses appeared as light signals, their extent and position relative to the cord being clearly visualized in frontal and sagittal planes in T1-weighted images. In older children, there were a low vertebral signal and disappearance of the disc-vertebra borders on T1-weighted images and a high vertebral signal with a decreased and flattened disc signal on T2-weighted images. Frontal and sagittal planes were used. During the first month of antibiotic therapy, the follow-up scans showed no changes, and even disclosed a spread of the abnormal signal in the vertebral body. At the stage of sequelae, on T1 the spinal signal was normal with a decreased disc width and on T2 the disc signal was low while the vertebrae appeared normal.

Acute Disease↗
PubMed1990

Primary sacral bone tumours in children (report of 16 cases with a short literature review).

16 cases of primary sacral bone tumours in children are reported. These include 13 patients with Ewing's sarcoma and 3 with very rare primary sacral bone tumours in childhood--chordoma, haemangiopericytoma and osteoblastoma. All sacral bone tumours, with the exception of Ewing's sarcoma are very rare in childhood. The possibility of a sacral tumour should be considered in a child with radiculopathy. CT and MR make the diagnosis of primary sacral bone tumours much easier with the added possibility of recognition of the true nature of the lesion in many instances. Reports of primary sacral bone tumours in children are scarce. Most of the patients are incorporated in adult series which do not specify the age of the child and the site of the tumour. The purpose of this paper is to describe 16 children with primary sacral bone tumours.

Child↗
PubMed1988

The Mayer-Rokitansky syndrome. Report of 5 cases.

Five cases of uterus didelphys, unilateral imperforate vagina and ipsilateral renal agenesis are reported with a follow-up from 1 to 5 years. Diagnosis included typical revelation at puberty (2 cases) but also in the first months of life (2 cases). One case was only diagnosed at the age of 6 years, and the presence of an ectopic ureter was noted in the imperforate vagina. The authors point out the necessity of precise evaluation and careful management in order to maintain an intact reproductory tract. Simple excision of the septum is recommended which can most of the time be done by the vaginal approach.

Adolescent↗