[Endoscopic treatment of bronchial cancer].

Endobronchial treatment plays a growing role in the treatment of bronchial carcinoma and other tracheobronchial tumours. Most patients are treated for the palliation of dyspnea or hemoptysis caused by a tumour located in a major airway. Different modalities are available for palliation including the neodymium YAG laser, endobronchial stents, cryotherapy and brachytherapy.

Adverse effect of hyperinflation on parasternal intercostals.

The force-generating ability of the parasternal intercostals is maintained during acute hyperinflation in the dog (Jiang et al. Am. Rev.

[The role of ultrasonography in abdominal pain in children in the emergency room].

Our retrospective study aims at defining the influence of ultrasonography on the management of acute abdominal pain in a pediatric population. This technique appears to be essential in the diagnosis of intussusception and thus, should be recommended in all cases of acute abdominal pain in the population at risk for this disorder. On the other hand, ultrasonography only plays a minor role in the management of the other diseases we observed, especially in acute appendicitis.

[Eruptive fever of rare cause: familial hemophagocytic lymphohistiocytosis].

Background: Clinical onset of familial lymphohistiocytosis is non-specific so that the diagnosis of this rare and severe disease is difficult.

Case Report: An 8 week-old girl was admitted suffering from fever and rash. She had hepatosplenomegaly.

Nonossifying fibromyxoid tumor of soft tissue.

A firm, painless tumor of the temporal region was excised in a 3-year-old girl. The diagnosis of nonossifying fibromyxoid tumor was established on pathologic examination, which showed that most of the cells formed cords and tubulelike structures in a myxoid background. Bone and osteoid were lacking.

Haematological disturbances during long-term valproate therapy.

A 14-year-old boy with mental retardation presented with severe thrombocytopenia, macrocytic anaemia and allergic dermatitis. He had been treated with valproate for seizures since the age of 2 years. Clinical examination showed severe purpura, mucous bleeding and extensive dermatitis.

A multicentre study of fluconazole versus oral polyenes in the prevention of fungal infection in children with hematological or oncological malignancies. Multicentre Study Group.

A randomized, comparative study was conducted in 502 patients in 23 centres world-wide to assess the efficacy and safety of fluconazole versus nystatin and amphotericin B for prevention of fungal infection in a severely immunocompromised pediatric population. Patients scheduled within 48 hours to undergo chemotherapy or radiotherapy for hematological or oncological malignancies were randomly allocated to receive 3 mg/kg oral fluconazole once daily, 50,000 U/kg oral nystatin four times daily or 25 mg/kg oral amphotericin B four times daily. Prophylaxis began with the initiation of chemotherapy or radiotherapy and continued throughout a patient's hospital stay or period of neutropenia as necessary.

Cervical epidural analgesia for a cancer child at home.

A cervical epidural catheter was placed in a 32-month-old girl suffering from painful bone metastases of a relapsing neuroblastoma in the left forearm. This therapeutic approach was chosen because oral morphine had failed to provide analgesia while producing intolerable side effects. The epidural injection of a mixture of morphine and bupivacaine provided complete analgesia with no side effects.

Two cases of congenital dyserythropoietic anaemia type I associated with unusual skeletal abnormalities of the limbs.

This report describes the cases of two young female patients with congenital dyserythropoietic anaemia (CDA) type I who presented similar hand and foot skeletal abnormalities: lack of distal phalanges and nails, and syndactyly. Up to now, some morphological malformations have been described in association with CDA type I but there is no report of skeletal defects. These two cases are suggestive of a possible association between this hereditary anaemia and specific skeletal abnormalities of the distal extremities.

Severe idiopathic congenital aplastic anemia: role of hematopoietic growth factors.

A baby boy with constitutional aplastic anemia refractory to treatment with hematopoietic growth factors underwent BMT from an unrelated HLA-compatible donor. The BM failed to engraft but the combination of a conditioning regimen, immunosuppression and hematopoietic growth factors resulted in a recovery of the patient's own BM and a good outcome.

Intrinsic PEEP in patients with chronic obstructive pulmonary disease. Role of expiratory muscles.

Many patients with severe chronic obstructive pulmonary disease (COPD) contract the transversus abdominis (TA) muscle during expiration. The mechanical correlates of this contraction, however, are uncertain. In the present study, we have measured airflow, esophageal (Pes), and gastric (Pga) pressures, the anteroposterior (AP) diameter of the abdomen, and the electromyogram of the TA during resting breathing in 25 seated patients with severe COPD (FEV1 = 28 +/- 8% of predicted).

Respiratory dysfunction in congestive heart failure: correction after heart transplantation.

Severe chronic congestive heart failure (CCHF) is known to induce a restrictive ventilatory defect, with a small decrease in lung transfer factor for carbon monoxide (TLCO). The aim of the present work was to assess the reversibility of this dysfunction. We studied a group of 47 patients with CCHF, before and one year after heart transplantation.

Hemihypertrophy, bilateral Wilms' tumor, and clear-cell adenocarcinoma of the uterine cervix in a young girl.

We report the case of a young girl who had hemihypertrophy and developed Wilms' tumor in both kidneys and clear-cell adenocarcinoma of the uterine cervix with no maternal history of stilbestrol ingestion during pregnancy. Karyotype on the second Wilms' tumor showed monosomy 22. The link between hemihypertrophy and Wilms' tumor is well known, but their association with clear-cell carcinoma of the cervix has not been previously described.

Plasma infusion as treatment for 33 children with haemolytic uraemic syndrome: a good therapy?

Between May 87 and December 91, 33 children aged from 2 months to 13 9/12 years were admitted for haemolytic uraemic syndrome (HUS). Treatment consisted of daily fresh-frozen plasma infusion (20 ml/kg/day) during 14 days. On admission, 20 patients (61%) had an oligoanuria: 18 underwent a peritoneal dialysis and 2 an haemodialysis with a median duration of dialysis of 14 days.

Bone marrow transplantation in sickle cell disease: the Belgian experience.

Twenty eight patients underwent bone marrow transplantation (BMT) for sickle cell anemia in Belgium. The patients were originating from Central Africa, were young and symptomatic. Engraftment occurred in all patients and was sustained in 25.

Tumour-like presentation of pulmonary sarcoidosis.

We report a case of pulmonary sarcoidosis, which initially presented as a left apical infiltrate. The later course mimicked a pulmonary neoplasm, with left upper lobe atelectasis secondary to bronchial stenosis, resulting from both endobronchial sarcoidosis and extrinsic compression by enlarged lymph nodes. Extrinsic pressure from sarcoid nodes on the left main pulmonary artery and recurrent laryngeal nerve, also caused a reduction in pulmonary parenchymal perfusion and left vocal cord paresis.

Second bone marrow transplantation in eight children.

Between 1985 and 1989, eight children underwent two successive bone marrow transplantations. The initial disease was chronic myelomonocytic leukemia in three patients, chronic myelocytic leukemia in two, acute M7 nonlymphoblastic leukemia in one, sickle cell anemia in one, and thalassemia major in one. The preparation in view of the second grafting included high-dose chemotherapy in all patients, associated with antithymocytic globulin transfusion and total nodal irradiation in three patients.

Preoperative chemotherapy of cellular congenital mesoblastic nephroma in a 5-month-old infant.

Cellular (or atypical) congenital mesoblastic nephroma (CMN) is a potentially aggressive form of the benign classical congenital mesoblastic nephroma. We report here a case of cellular CMN in a 5-month-old boy treated preoperatively with chemotherapy with an excellent response allowing a complete surgical resection.

Rib cage shape and motion in microgravity.

We studied the effect of microgravity (0 Gz) on the anteroposterior diameters of the upper (URC-AP) and lower (LRC-AP) rib cage, the transverse diameter of the lower rib cage (LRC-TR), and the xiphipubic distance and on the electromyographic (EMG) activity of the scalene and parasternal intercostal muscles in five normal subjects breathing quietly in the seated posture. Gastric pressure was also recorded in four subjects. At 0 Gz, end-expiratory LRC-AP and xiphipubic distance increased but LRC-TR invariably decreased, as did end-expiratory gastric pressure.

Abdominal muscle use during breathing in patients with chronic airflow obstruction.

To assess the pattern of abdominal muscle contraction in stable patients with chronic obstructive pulmonary disease (COPD), we studied electromyograms of the rectus abdominis, external oblique, and transversus abdominis muscles in 40 patients with variable degrees of chronic airflow obstruction (FEV1 between 17 and 82% of predicted); 12 control subjects with normal pulmonary function tests were studied for comparison. The subjects were studied during resting breathing in the supine posture, and the electromyograms were recorded with concentric needle electrodes implanted with the aid of a high-resolution ultrasound. The rectus abdominis and external oblique were silent in virtually all patients.

Kidney transplantation in patients with Wilms' tumor.

We report our experience of renal transplantation in three patients treated for Wilms' tumor (with lung metastasis in two of them), and review 26 previously reported cases in order to define the current indications of transplantation in this setting. Our patients, aged 5-12 years, were transplanted 13-95 months after completion of Wilms' tumor treatment. All three are alive and tumor-free, two with a functioning graft 20 and 97 months after transplantation.