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Biomedical subjects

Y Revillon

Publications and source records attributed to Y Revillon.

At least 91 records · Page 5Linked to original sources
PubMed1989

[Home parenteral nutrition in children. Evaluation after 8 years' activity with 88 patients].

In cases where an anatomic or functional amputation of the small bowel dictates that parenteral nutrition needs to be prolonged, it is essential to offer the child the best possible quality of life. In this regard, being in his home environment is an important component. Over a 8 year-period (1980-1988), 88 children went home with cyclic parenteral nutrition. In 34, parental nutrition was eventually discontinued: 40 are still parenteral nutrition-dependent and 14 died. In most cases, the growth and quality of life were satisfactory. Complications consisted essentially of infections, with 1 septicemia for 692 days of home parenteral nutrition (HPN). In the light of these results, HPN appears to be the best option for prolonged parenteral nutrition-dependent children. However, it cannot be set up without the help of a suitable center able to follow the children and to ensure the logistic support necessary for this highly technical and demanding type of care.

Adolescent↗
PubMed1989

[Esophagoplasty in caustic esophageal stenosis in children].

Over a period of 30 years, 53 children suffering from caustic stenosis of the oesophagus were treated by oesophagoplasty. The left colon was most often used (49), though on occasions a Gavriliu gastric tube (3) or the right ileo-colon was used (1). Technical failure occurred in 7 cases with left esophagocoloplasty and this was treated with either a gastric tube (4) or right esophagocoloplasty (3). Oesophagectomy to prevent cancer was carried out on 20 occasions after the oesophagoplasty, on 23 occasions at the same time at the oesophagoplasty, and has yet to be carried out in 6 children. Early mortality was zero; 4 uncomplicated cervical fistulae occurred; 12 anastomotic stenoses were cured by dilatation and 5 required further surgery. Death occurred in 3 children as a late event: one at 2 months, due to difficulty with deglutition, one at 2 years, due to meningococcal septicemia, and one at 3 years due to obstruction from adhesions. Peptic reflux was seen in 3/9 Gavriliu plasties and in 6/45 coloplasties. Functional sequelae were absent in 29 cases and 12 cases suffered occasional episodes of obstruction. The best procedure appeared to be posterior mediastinal esophagocoloplasty combined with resection of the damaged oesophagus.

Burns, Chemical↗
PubMed1988

[Organ procurement in children. Surgical aspect].

Today, in every child in situation of organs donor, a multiple organ harvesting is performed which requires surgical techniques more precise, in order to improve the results. Heart, heart-lungs and liver transplantation represent in children, for volume reasons, situations where harvesting must be performed in a child matched for height with the recipient. Today a technique of unique harvesting took place of the initial techniques which required careful dissection of all organs, the preparation of organs being made secondarily, after refrigeration and harvesting. The first step is abdominal and sets up a device of abdominal spraying. The second step is the thoracic dissection, heart or cardio-pulmonary block harvesting being performed by the cardiac surgery team. Finally, the third step consists of the harvesting of the abdominal viscera. It is preceded by a precooling, begun during the period before thoracic dissection. It supposes a global cooling of the liver, kidneys, duodeno-pancreatic block and small bowel. Monoblock dissection then begins with the liberation of the liver and eventually of the duodeno-pancreatic block. After hepatectomy, both kidneys are harvested in monoblock. The intestine, itself, is harvested in last position. Progresses should occur, due to the improvement of the performances of the cooling solutions.

Abdomen↗
PubMed1988

[Intestinal transplantation in children].

A long period of experimental work has allowed to study successively hypothermic preservation of the small bowel, autotransplantation and finally allotransplantation. After this initial phase of experimental surgery, a certain number of intestinal transplantations in humans could be attempted as cyclosporine became available. Following a brief of report of 3 intestinal transplantations recently performed by the group of the hôpital des Enfants-Malades in Paris, indications for intestinal transplantation are provided. Subtotal resections of the small bowel in children or adolescents and extensive resections in neonates account for most of the indications. Despite significant progress, further advances in intestinal transplantation need to be made, because the small bowel poses unique problems in that it seems to represent a compendium of all the particularities and difficulties of other organ transplantations.

Animals↗
PubMed1985

[Partial disarterialization of the spleen and partial splenectomy in children].

Splenic hyperactivity can be reduced by partial vascular disconnection of the spleen or by partial splenectomy. The first method, which preserves only one superior polar artery and the whole venous system, was used in 6 patients, and the second method, which preserves a small portion of the spleen, usually fed by an inferior polar artery, was used in 11 patients. Ultrasonographic and scintigraphic measurements of the spleen, platelet counts, transfusion quotient and 51 Cr-labelled red cell survival were used to evaluate the effects of these two methods. No immediate post-operative complication was observed.

Arteries↗
PubMed1985

[Extensive resection of the small intestine in children].

Thirteen children aged 2 to 16 years have had a subtotal resection of small bowel, following a mid-gut volvulus in 10 cases. All children are still alive, and their growth was normal; 36 cumulative patient-years of parenteral nutrition and 11 years of constant rate enteral nutrition were performed. In 7 cases, where residual small bowel varied between 30 to 120 cm, termination of all artificial nutritional support was possible at a mean of 30 months after intestinal resection. On the other hand if resection was near total with less than 20 cm remaining, life long dependence on parenteral nutrition is unavoidable unless intestinal transplantation becomes feasible; with cyclic parental nutrition at home, their quality of life is near normal.

Adolescent↗
PubMed1984

[Hypersplenism in thalassemia major. Treatment by partial dearterialization of the spleen. Preliminary results apropos of 5 cases].

Partial dearterialization of the spleen is a surgical method aimed at reducing the volume of the spleen whilst preserving its defensive properties against bacterial infections. Four children with thalassaemia major and one with congenital dyserythropoiesis who developed hypersplenism in the course of their disease underwent the operation and were subsequently followed up for periods of 24 to 36 months. The effectiveness of the method was demonstrated by a smaller enlargement of the spleen, a lesser need for transfusions, a longer life of 51 Cr-labelled red cells and more numerous circulating platelets. Surgery was also effective in reducing post-transfusional iron overload, as shown by the decrease and stability of serum ferritin levels in all children subjected to iron chelation. No episode of infection or changes in serum IgM occurred during the follow-up period, and radioisotopic studies of the spleen showed that macrophage function was preserved in the remaining splenic tissue. One child inexplicably developed thrombosis of the splenic vein 1 year after surgery.

Arteries↗
PubMed1984

[Chronic septic granulomatosis. Disclosed by hepatic abscesses. Contribution of echography].

Skin infections and lymph node abscesses are the most common manifestations of chronic granulomatous disease (CGD) during the first year of life. Intra-hepatic abscesses occur later on. The case reported concerns a 4 month-old infant, in whom the disease presented initially with liver abscesses. Percutaneous needle aspiration of the liver under ultrasonographic control permitted the isolation of Staphylococcus aureus and allowed partial regression of the abscesses. Surgery was not required.

Granulomatous Disease, Chronic↗
PubMed1984

[Congenital tracheoesophageal fistulas in children].

Among 107 cases of congenital H-Type tracheoesophageal fistula without esophageal atresia collected, since 1955 to 1983 about 69 have been reported. The clinical aspect is significative when the digestive and respiratory symptoms are associated and very doubtful when only one is recovered. Often, the tape recording confirms the diagnosis, sometimes repeated examinations are necessary. The tracheoscopy with a rigid tube is probably more than the fibroscopy. The surgical correction is easy and induce the cure.

Child, Preschool↗
PubMed1984

[Autoimmune hemolytic anemia in children. Apropos of 14 cases].

Autoimmune hemolytic anemia is a rare disorder in childhood. The therapeutical difficulties encountered are described in a series of 14 patients aged 6 weeks to 10 years, 8 of them being under the age of 1 year at time of diagnosis. A remission was observed spontaneously in 1 patient and was obtained with steroids in 8 others. One patient died from acute irreversible hemolysis. Four patients were splenectomized because of an immediate or delayed resistance to steroids. After splenectomy, two patients died from infection, one was cured and the last patient is still in remission after one year. Steroid therapy is the primary treatment of autoimmune hemolytic anemia. The initial dose of 2 mg/kg/day has to be maintained until the remission (normal hemoglobin level and reticulocyte count) is achieved, then progressively decreased leading to alternate day therapy for several months. Resistance to steroid requires splenectomy, although it is an hazardous treatment in young children. The indication for immunosuppressive agents in childhood is difficult to define. It can be proposed in patients with steroid dependency in order to reduce the dose of steroid and/or to avoid long term steroid therapy.

Acute Disease↗
PubMed1984

[Pheochromocytoma in children disclosed by pseudomigrainous headache attacks].

The authors report the case of a 10 year old child presenting with a three year history of paroxysmal headaches resembling migraine, and with a positive family history of the condition. It was only after three years that the symptomatology changed to become very suggestive of pheochromocytoma. The case illustrates the difficulties of assessing headaches in childhood and the authors question whether catecholamines and their metabolites should be measured in addition to the classical investigations (retinoscopy, skull X-Ray, EEG, CAT) in children with recurrent, severe and unexplained headaches. The importance of taking the blood pressure during an attack, a simple procedure which may be performed by parents, is emphasised.

Adrenal Gland Neoplasms↗