[Bronchiolitis in infants. Respiratory functional exploration in the acute phase]. / Bronchiolites du nourrisson. Exploration fonctionnelle respiratoire en phase aiguë.

Respiratory function tests were performed in infants hospitalized for bronchiolitis immediately after the acute stage, in order to appreciate the function of the respiratory muscles. A study of the ventilatory mechanics, of the transdiaphragmatic pressure, of the ventilatory rate and of the blood gases was performed. Results were compared with those obtained in 10 "healthy" infants. They showed: a decrease in the dynamic compliance (DYN.C) (p less than 0.001) and an increase in the total pulmonary resistances (TPR) (p less than 0.05) providing evidence for the intensity of bronchial and bronchiolar obstruction; an increase in the abdominal and intrathoracic pressures difference (Pdi) (p less than 0.01) which may reach 3 times the normal value and which is proportional to the decrease in DYN.C. (r = 0.74; p less than 0.001), providing evidence for the intensification of the inspiratory diaphragmatic effort and of its adjustment to the degree of obstruction; a reverse of the abdominal pressure curve with respect to that in normal subjects, with an increased pressure level, providing evidence for abdominal distension and increased pressure during all the expiration, suggesting the active participation of the abdominal muscle to expiration; a change in the ventilatory rate, characterized by a high respiratory frequency, a decreased tidal volume, a shortened inspiratory time and a normal inspiratory time/total time ratio. this rate is opposed to that observed in older children with bronchial obstruction. It might optimize the respiratory muscles output, as at this age, they have not yet reached all their contractile capacity.

[Oral occlusion pressure in scoliosis and neuromuscular syndromes]. / Pression d'occlusion buccale au cours des scolioses et des syndromes neuro-musculaires.

Oral occlusion pressure, a neuro-muscular index of the activity of the respiratory centers, was measured in 2 groups of children: one of 43 "healthy" children, in order to establish a predictive equation according to age (Y = 1.23 + 8.30 X A-1) and another of children presenting with respiratory failure, either due to an impairment of the thoracic cavity (10 dorsal scoliosis) or to an impairment of the respiratory muscles (29 children with muscular dystrophy or spinal muscular atrophy). The occlusion pressure increases with the degree of the ventilation deficiency in children with scoliosis. It remains paradoxically normal in children with neuro-muscular disease, irrespective of the ventilation deficiency. In the latter, the respiratory centers activity being considered as normal, this situation would indicate their muscular incapacity to correctly express this activity. It would show a severe muscular deficiency with a high risk of occurrence of respiratory distress accidents.

[Alveolar microlithiasis in children. Contribution of bronchoalveolar lavage]. / Microlithiase alvéolaire de l'enfant. Apport du lavage broncho-alvéolaire.

This case of pulmonary alveolar microlithiasis emphasizes the rarity of the disease and its exceptional diagnosis in infants which relies on the pulmonary pathologic study. Besides allowing for diagnosis, the study of the alveolar brushing fluid permitted to describe for the first time pictures of post-necrotic cellular calcification which is probably responsible for the disease.

[Idiopathic pulmonary hemosiderosis and celiac disease in a child. Case report]. / Hémosidérose pulmonaire idiopathique et maladie coeliaque chez l'enfant. Une observation.

An enteropathy with almost total atrophy of the villi was discovered in a 13-year old girl with idiopathic pulmonary haemosiderosis. Coeliac disease was strongly suspected but could not be proven. This case draws attention to the possible association of an idiopathic pulmonary haemosiderosis with a coeliac disease.

[Unilateral small lung with translucent cystic appearance. Congenital or acquired origin? 2 case reports]. / Petit poumon unilatéral avec images claires d'aspect kystique. Origine congénitale ou acquise? Deux observations.

The distinction between congenital or acquired lung disease is often a difficult problem. This is illustrated by case reports on two boys aged 10 and 12. The clinical, pulmonary function and radiological details were very similar in the two cases, suggesting pulmonary hypoplasia. However, the histology seen in the second case, a type of bronchiolitis obliterans and follicular bronchiectasis were among several arguments in favour of acquired pulmonary disease of infective origin. The recorded literature as well as this observation show that certain respiratory viral infections may lead to bronchial and above all bronchiolar damage which can be severe and progressive.