[Radiological case of the month. Pneumothymus in the neonate].
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Biomedical subjects
Publications and source records attributed to P Labrune.
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The authors report a case of extensive spinal epidural staphylococcal abscess responsible for spinal compression. All symptoms regressed after conservative management consisting of parenteral antibiotic therapy with Gentamycin and Vancomycin.
The authors report 2 cases of water intoxication. These clinical cases show the importance of neurological signs during the acute period. Hyponatremia is constant and responsible for the clinical signs. A rapid treatment is necessary.
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Results of 256 intraocular lens implants after extracapsular cataract extraction are analysed with a mean follow-up period of four years. Different models of intraocular lenses were used: mainly the Binkhorst 2 loops model, but also posterior chamber lenses, and a few anterior chamber lenses. Indications and special cases are discussed, according to the type of cataract: senile, traumatic, combined cataract and glaucoma. Peroperative (intraocular lens-endothelium contact, vitreous loss) and postoperative complications (non-fixation of the lens, corneal bullous dystrophy, cortical material remmants, uveitis, cystoid macular oedema, retinal detachment) are described.
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The prevention of retinal detachment by the argon laser photocoagulation of the peripheral degenerations of the retina was unsuccessful in 6 p. 100 of the cases. The proportion of failures is about the same as that of xenon photocoagulation. It is much more important than that of cryocoagulation. In the contrary the results are better in the management of macular holes without detachment.
A premature infant had three episodes of enterocolitis-like symptoms during the first three months of life. Brucella melitensis was isolated in a prolonged blood culture on day 85. The clinical manifestations disappeared under treatment and did not recur. A maternofetal transmission is suggested in this case. The importance of prolonged blood cultures when brucellosis is epidemiologically suspected is emphasized.
Gilbert syndrome (GS), characterized by mild, chronic and isolated unconjugated hyperbilirubinemia is due to a partial deficiency of bilirubin-UDP-glucuronosyltransferase (UGT1A1). Recently, the genetic basis of GS has been identified in caucasian populations : it is related to the insertion of a dinucleotide (TA) in the promoter region of the UGT1A1 gene. In Asian populations, GS is due to missense mutations (either homozygous or heterozygous) in the coding sequence. The aim of this study was to develop a simple and rapid method to detect both genetic polymorphisms and mutations. This technique was performed (1) to explore unrelated unconjugated hyperbilirubinemia; (2) to evaluate the frequency of GS in a population of 97 healthy caucasian volunteers: 17% of them were homozygous for the TA7/TA7 polymorphism; (3) to determine the incidence of this syndrome in a population of 105 neonates with unconjugated hyperbilirubinemia. The incidence of GS (15%) was not significantly higher than it was in the control group. A correlation between GS genotype and neonatal jaundice was not established; (4) to seek a relationship between GS and preeclampsia with or without Hellp syndrome. The incidence in the Hellp syndrome group (n = 19) was 26%, two fold higher than in preeclampsia group (n = 22) and control group (n = 50) with only 14% and 13% respectively, (5) to start a study regarding the toxicity of irinotecan treatment in a population of homozygous children for the UGT1A1 polymorphism.
A normal infant was born to a 25 year-old mother with phenylketonuria who had never been treated. The mother had been fed a phenylalanine restricted diet for 3 months before the beginning of the pregnancy. Dietary control was maintained throughout the whole gestation. The problems of dietary control in a mentally retarded woman are analysed.
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The authors report a case of congestive heart failure in an infant, related to a deep hypocalcemia. Hypocalcemia was due to rickets.