Biomedical subjects

P Delmas

Publications and source records attributed to P Delmas.

At least 91 records · Page 5Linked to original sources

PubMed1992

[Section of spermatic vessels (Fowler-Stephens procedure). A possible treatment for high undescended testis].

Although orchidopexy for an undescended testis is generally a satisfactory operation, high undescended testis is often a problem. Management of such testicles remains controversial and since 1984 the authors have used spermatic vessels division (Fowler Stephens procedure) in 29 cases with satisfactory results. Although the Fowler-Stephens procedure carries a certain risk of testicular atrophy, the results are equivalent to those achieved by the two stage orchidopexy if careful attention is paid to details of the procedure and selection of cases.

Arteries↗

PubMed1991

Epitope mapping of two monoclonal antibodies to the central portion of human osteonectin.

In this study preliminary characterization of two monoclonal antibodies against osteonectin was undertaken. One monoclonal originally raised against bovine bone osteonectin cross reacts with human bone and platelet osteonectin. The other monoclonal antibody has been reported to react with osteonectin derived from human bone and bovine bone but not to the same extent with that from platelets. Initial mapping of the antigenic determinants for both monoclonals was done by testing their ability to bind to the expressed forms of osteonectin in two overlapping SaOS-2 lambda gt11 osteonectin cDNA clones. One clone contains a 0.54 kb insert and is comprised of 50 nucleotides of 5' noncoding and a coding segment for a 17 amino acid signal peptide and 146 amino acids of the N-terminal region of the mature protein. The other clone has a 1.9 kb insert, and includes amino acid no. 18 to the C-terminus of the molecule (amino acid no. 286), a single termination codon, and 1115 nucleotides of 3' noncoding sequence. Both monoclonals recognized expressed osteonectin from the two lambda gt11 SaOS-2 cDNA clones. These results localize the epitope to a region between amino acids 18-146 of osteonectin.

Amino Acid Sequence↗

PubMed1990

Multicenter survey of endoscopic treatment of vesicoureteral reflux in children.

17 centers answered an inquiry on the endoscopic treatment of vesicoureteral reflux. 844 children were reviewed representing 1,290 ureters treated by endoscopic injection of Teflon. The first results in cases of primary or secondary reflux showed a success rate of 82.3%. All authors report low morbidity and excellent tolerance of this technique. In view of the long-term prognosis, these results should be reanalyzed, the median follow-up presently being 1 year. The next logical step should be the development of implant material with a higher biocompatibility but the identical physical properties as Teflon.

Belgium↗

PubMed1990

[Circumscribed spinal myositis ossificans of infections origin].

A case of paravertebral, non-traumatic myositis ossificans in a 4.5 year-old boy is reported. Infectious spondylitis and osteosarcoma were considered before the diagnosis was established on the basis of histological examinations of a biopsy performed during excision. A group G beta hemolytic streptococcus was isolated from the biopsy, suggesting an infectious etiology which has rarely been reported. The child appears to be completely cured one year after excision.

Child, Preschool↗

PubMed1990

[Chronic pain of the knee in children and adolescents: diagnosis and therapeutic management].

Chronic pain of the knee in children and adolescents may result from multiple etiologies, mainly related to the pathology of the extensor apparatus. The diagnosis is mostly based on a good interrogatory, a careful and systematic physical examination and standard X-rays. Complementary investigations such as arthrography, arthroscopy and CT scan are only needed in a limited number of cases. The pathology of the hip is part of the differential diagnosis.

Adolescent↗

PubMed1989

Corticosteroid-induced changes in the responsiveness of human osteoblast-like cells to parathyroid hormone.

We investigated the in vitro effect of corticosteroids on the responsiveness of human cells of osteoblast lineage to parathyroid hormone (PTH). Prior to corticosteroid treatment, the cells demonstrated only a small increase in cAMP production and no measurable change in transmembrane potential in response to PTH. Exposure of cells to dexamethasone resulted in a 5-fold increase in PTH-induced cAMP production and in measurable PTH-induced membrane depolarization in all cells studied. The effect of corticosteroids on cAMP production was specific for PTH (not seen with PGE1 or forskolin), occurred in a time- and dose-dependent fashion and in the absence of cell proliferation. Most of the cells were of osteoblast lineage as determined by the presence of alkaline phosphatase activity and BGP secretion. These findings further support the idea that corticosteroids increase the sensitivity of cells of osteoblast lineage to PTH, perhaps by transforming cells which initially have a low responsiveness to PTH to a state of high responsiveness.

Adolescent↗

PubMed1989

Antibiotic therapy of perforated appendicitis in children: a comparison of amoxycillin/clavulanate with a combination of benzylpenicillin, netilmicin and metronidazole.

This multicentre trial compared the clinical efficacy of amoxycillin/clavulanate used as a single-agent therapy with that of the three-agent combination usually prescribed in the post-operative period for appendicular peritonitis in children. Only bacteriologically documented peritoneal infections were included. Sixty-four patients were randomly distributed between two groups: Group A (29 cases) treated with amoxycillin/clavulanate, first administered iv (100 mg/kg/day) followed by conversion to the oral route (50 mg/kg/day) once the patient had been afebrile for 48 h; Group B (35 cases) first treated by the iv route with benzylpenicillin (100,000 IU/kg/day) plus netilmicin (5 mg/kg/day) plus metronidazole (30 mg/kg/day) followed by conversion to the oral route for metronidazole (30 mg/kg/day). In both groups, the total duration of parenteral and oral treatment was not less than five days. A total of 180 bacterial strains were recovered from peritoneal fluid samples obtained during surgery; 86% of these were sensitive to amoxycillin/clavulanate. Clinical efficacy, assessed on the basis of time until return to normal temperature and gut transit and duration of hospitalization, was identical in both groups, with follow-up monitoring on day 30 showing recovery in all cases. Cure was obtained without any problems of infection in 25/29 patients in group A and in 34/35 patients in group B (non-significant difference). Tolerance was excellent and identical in the two groups with the exception of three cases of thrombophlebitis which occurred in group B. The results of this study suggest that amoxycillin/clavulanate may be useful as single-agent therapy as a first-line curative treatment for appendicular peritonitis in children.

Amoxicillin↗

PubMed1989

[Surgical treatment of vesico-ureteral reflux using the Gil Vernet technic. Apropos of 30 cases in children].

The authors report their experience of the Gil Vernet procedure in the surgical management of primary vesico-ureteral reflux in children. 30 children were operated by this technique. Follow up studies range from 6 months to 30 months. All cases were successful. Therefore this technique was not performed routinely for all vesico-ureteral reflux and there is no grade IV reflux, no reflux secondary to neuropathic bladder in this study.

Adolescent↗

PubMed1988

A study in organogenesis: the arterial supply of the anorectal region in the human embryo and fetus. Anatomic and embryologic bases of anorectal malformations.

The development of the anorectal region is based on differentiation of the terminal portion of the hindgut. The origin of anorectal malformations is still unknown but seems to occur very early in the embryologic period. To gain a better understanding of their development, a study of the arterial supply of the anorectal region was made in 26 embryos and 50 fetuses.

Anal Canal↗

PubMed1988

[Ureteropelvic junction syndrome. Apropos of 59 cases diagnosed with fetal echography].

We reviewed 59 cases of ureteropelvic junction obstruction diagnosed in 55 fetuses by echographic examination during prenatal period between 1981 and 1987. Postnatal excretory urograms and voiding cysto urethrography were obtained in all patients. Quantitative renal scans with 99 m technetium labeled dimercaptosuccinic acid or 99 m technetium labeled diethylenetriamine penta acetic acid were used in 49 patients and demonstrated a renal impairment in 19 cases (38%). 8 neonates were not operated, 1 required unilateral nephrectomy and 50 were treated by the Anderson-Hynes surgical procedure. 46 (92%) among those 50 obtained a significant improvement of pelvi-caliceal dilatation or excretion; 4 (8%) only a stabilisation. Early recognition of congenital hydronephrosis is now very common. After birth renal scans provided better estimation of renal function than excretory urograms but for the graduation of the obstruction the data did not appear to be always reliable (10% of false negatives in this study). The real problem is to know within which period of time the neonates whose renal function is impaired need surgery. In our study that question cannot be given a definitive answer because of too few post operative renal scans. However, we think, just as literature data tend to prove, that those neonates required early surgery if normal renal function is to be obtained.

Female↗

PubMed1988

[Pyogenic sacroiliac arthritis in children. Apropos of 6 cases].

Pyogenic arthritis of the sacro-iliac joint is uncommon in children; 6 cases were observed over 4 years. The diagnosis may be difficult and should include specific examination of the sacro-iliac joint. Posterior pain with a febrile illness needs radiological examination and a skeletal scintigraphy, which has always been positive in our experience. All the patients had a very good functional recovery after antibiotherapy and rest (bed or plaster).

Adolescent↗

PubMed1988

[Crohn's enteritis and chronic tubulo-interstitial nephropathy in an adolescent].

We report for the first time a case of Crohn's enteritis associated with a chronic tubulo-interstitial nephritis in an adolescent. The illness started insidiously in an 11 year-old boy who had suffered from failure to thrive and protracted watery diarrhea. At presentation the patient had an inflammatory bowel disease located to the left colon but no renal dysfunction. Until the age of 15, the intestinal symptoms were stable but a progressive renal insufficiency developed. A percutaneous renal biopsy was then performed which showed a widespread chronic tubulo-interstitial nephritis. Following a 6 months corticosteroid treatment, renal dysfunction seemed to be stabilized. However, delayed growth and corticosteroid dependency led to total colectomy. Pathologic examination showed granulomatosis involvement of the entire colon and severe interstitial nephritis with neither linear nor granulous deposits along tubular basement membranes. After a 2 year-delay following the colectomy, renal function was stabilized and a catch up growth was achieved.

Child↗

PubMed1987

Intravenous disodium etidronate therapy in Paget's disease of bone and hypercalcemia of malignancy. Effects on biochemical parameters and bone histomorphometry.

Nineteen patients with Paget's disease and four patients with hypercalcemia of malignancy underwent hypocalcemic therapy with etidronate disodium (etidronate) administered intravenously. The dosage for patients with Paget's disease was 4.3 mg/kg/day, infused on each of seven consecutive days. Nine of the 19 patients also received oral etidronate 5 mg/kg/day for three months after administration of intravenous therapy. Etidronate administered orally sustained the decreases in urinary hydroxyproline produced by the infusions, whereas levels returned to pretreatment values in most patients receiving only the intravenously administered drug. Serum alkaline phosphatase levels were not reduced in the 10 patients receiving only intravenously administered etidronate, but they declined by approximately 50 percent in the nine patients who received the additional orally administered etidronate. Transiliac-crest bone biopsy specimens obtained three months after intravenous therapy revealed a regular lamellar structure, compared with the characteristic woven pattern of pagetic bone. In all four patients with hypercalcemia of malignancy, normocalcemia was achieved by the 10th day of treatment using a dosage of 4.3 mg/kg/day. Oral etidronate therapy was beneficial in maintaining normocalcemia.

Bone and Bones↗

PubMed1987

Serum bone gla-protein in multiple myeloma.

Serum bone gla-protein (SBGP), a marker of bone formation, was measured by radioimmunoassay in 57 patients with multiple myeloma (MM) and correlated with presenting features and disease activity. As a whole, patients with MM did not differ from normal controls or from patients with a monoclonal gammopathy of undetermined significance, but a significant percentage of abnormal values of SBGP was found in this MM population (18% of cases, P less than 0.005). At the time of diagnosis, SBGP was significantly lower in advanced disease (Stage III) than in less active disease (Stage I and II) with mean values of 4.4 +/- 2.7 ng/ml and 7.1 +/- 1.9 ng/ml, respectively (P less than 0.02). SBGP levels inversely correlated with the severity of the disease, the lowest values being observed in patients with extensive lytic bone lesions frequently associated with hypercalcemia (2.9 +/- 1.7 ng/ml). These data suggest the presence of a strong osteoblastic inhibition, at the body level, in the majority of patients (80%) with active osteoclastic MM (uncoupled process). However, a small subset of myeloma patients (20%) presented coupled MM, as defined by increased bone resorption (i.e., lytic bone lesions +/- hypercalcemia) and increased bone formation (i.e., increased SBGP values). Similar features of coupling-uncoupling were observed during disease progression. Finally, serial studies performed in 15 patients confirm these findings and the relation of SBGP levels to disease activity. Of major interest was the observation of a return of SBGP levels from low to normal values during remission induction, after successful completion of a plateau phase. According to these data, SBGP appears to be a new and promising marker for the clinical evaluation of MM.

Adult↗

PubMed1987

Skeletal distribution and biochemical parameters of Paget's disease.

Quantitative bone scans were performed with 99mTc-EHDP in 170 untreated pagetic patients (93 men, 77 women; mean age, 65.4 years). The distribution of 863 pagetic skeletal locations was analyzed. Bone scans demonstrated 8.3% more pagetic sites than roentgenograms. The extent of Paget's disease was evaluated in each patient by a scintigraphic skeletal index. This index correlated with serum alkaline phosphatase (SAP) and urinary hydroxyproline (HyPro) levels, and also with hypocalcemic acute response to calcitonin. The correlation of SAP with an index of activity (extent index adjusted by uptake ratios) was better than with the nonadjusted index. Only 30.6% of pagetic sites were responsible for clinical symptoms. No correlation was found between age and skeletal index of the disease.

Adult↗

PubMed1987

[Permanent constriction of the jaws due to progressive ossifying myositis].

A case is reported of progressive ossifying myositis (fibrodysplasia ossificans progressiva, Münchmeyer's disease) with onset at 16 years of age by a lesion of internal pterygoid with limitation of opening of mouth. Surgery to relieve ankylosis was followed by recurrence. Diagnosis was established only after the appearance of lesions in other regions (sternocleidomastoid, latissimus dorsi, lumbar muscles...). Clinical and paraclinical signs of this exceptionally rare disease are reviewed and diagnostic difficulties at onset of the disease discussed. Treatment of acute myositis episodes with diphosphonates delays passage to the ossification stage, allowing local surgery to be performed with less risk of relapse.

Adolescent↗

PubMed1986

[Nutritional management of neonates and infants with cystic fibrosis of the pancreas detected at birth].

From a systematic neonatal screening for cystic fibrosis in the Basse-Normandie area and to prevent disorders of the intestinal transit related to malabsorption, neonates then infants were given a semi-elemental hypercaloric diet, with supplements in nitrogen, MCT, minerals, vitamins and low in LCT. Diets were adjusted every month during a consultation using clinical and biological parameters. Results in the first 14 children showed that clinically as well as biologically, these children may remain within the normal range, avoiding the previously reported growth retardation and mineral or vitamin deficiencies. This procedure should allow an improvement in the quality of life and prognosis of such children, by maintaining adequate nutritional status.

Avitaminosis↗

PubMed1985

Anatomical basis of the surgical approach to the kidney in children.

The authors studied the different surgical approaches to the upper urinary tract in children. These approaches are the posterolateral lumbar, posterior and anterolateral lumbar routes. Special emphasis should be given to the anterolateral extraperitoneal approach. This approach in children gives excellent exposure of the kidney and causes minimum disruption of the normal anatomy, thereby yielding very satisfactory functional and cosmetic results.

Abdominal Muscles↗