Effect of nanospinel additions on the sintering of magnesia-zirconia ceramic composites.

Nanocrystalline magnesium aluminate (MA) spinel powder produced through a coprecipitation method and calcined at 900°C for 1 h was added to magnesia-zirconia composite in the range of 0-25 mass % and sintered at 1600°C for 2 h. Scanning electron microscope (SEM) and X-ray diffraction (XRD) techniques were used for studying the microstructure and the phase composition of the sintered composites. Bulk density, apparent porosity, volume shrinkage, and Young's modulus of the sintered composites were also investigated. The results revealed that the nanospinel addition up to 20 mass % increases the sintering ability and Young's modulus of the composite bodies. Microstructure showed that the presence of nanospinel and zirconia in the triple point between magnesia grains closed the gaps in the ceramic matrix and enhanced the compactness of the composites.

[Hemoptysis in a young man smoking cannabis]. / Inhalation de cannabis frelaté, responsable d'une hémoptysie.

The respiratory toxicity of cannabis is well known today. Along with the classic cannabis 'joint', there are other ways of consuming it, which should be known. Smoking cannabis that has been cut with micro-particles of silicon dioxide may cause hemoptysis. We will describe here the case of a young 16-year-old man who was in the hospital because of hemoptic expectoration. The etiologic investigation was negative, in particular a thoracic scan and a bronchial fiberscope. Questioning the patient afterwards allowed us to discover the inhalation of cannabis 2 h before the hemoptysis, cannabis mixed with micro-particles of silicon dioxide. Stopping inhalation stopped the symptoms. Pediatricians should be familiarized with such practices. Silicon dioxide particles cause ENT problems or bronchial ones (coughing, spitting, hemoptysis, wheezing). Over the long term, the risk of silicosis cannot be excluded, although a longer and more complete exposure is necessary.

[Transient myeloproliferative disorder in a neonate without Down syndrome]. / Syndrome myélo-prolifératif transitoire chez un nouveau-né indemne de toute pathologie constitutionnelle.

We report a new case of transient myeloproliferative disorder (TMD) in a non Down syndrome neonate. The cytogenetic and molecular studies within from the blood blast cells identified a trisomy 21 and a partial deletion in exon 2 of the transcription factor GATA1. Spontaneous regression of the TMD was achieved at the age of 1 month as the clonal and molecular abnormalities. A survey by periodic cytological examinations of peripheral blood cells and GATA1 mutation analysis was instituted since three years and has not detected up to date acute leukaemia.

[Quality of life of adolescents surviving childhood acute lymphoblastic leukemia]. / Vécu des adolescents guéris d'une leucémie aiguë lymphoblastique.

PURPOSE: To evaluate how adolescents and young adults cured of acute lymphoblastic leukemia (ALL) treated during childhood have integrated the disease, and possible death related to cancer. Particularly, we have focused on experiences related to diagnosis announcement, hospitalisation and treatments and consequences on their social, psychological and somatic behaviour. PATIENTS: Forty-one patients cured of ALL have been enrolled in the study and answered one interview with clinical psychologist or research nurse. RESULTS: Although 60% of the patients argued that they think rarely of their disease, 10% thought about it every day. Traumatic evidence was detectable in most of them. Physical pain was the most reported stress, mainly during hospitalisation (93%), as well as psychological suffering (83%). Afterwards, the mostly often-reported stress was psychological pain (61%). Sixty-six percent declared that they still experience psychological and health consequences at the time of the interview, in some cases reported as a handicap in their life. In 83% of the cases they considered themselves as cured, nevertheless fear of relapse persisted in 1/3. Ninety percent said they have a pleasant life, 56% did not like to talk about leukaemia and 70% thought they could have died. For 85%, disease has been the most important event of their life and 75% testify to repercussions of the disease on their family (family relationship changes, overprotection, siblings difficulties). CONCLUSION: Most of these patients declared to be 'as the others' and developed life projects, but overcoming the pain experience of the disease remained difficult. This study emphasized the need for long-term continuous information and reinforces the importance of addressing treatment psychological and physical pain mainly after the initial hospitalisation period.

Three-year follow-up of hydroxyurea treatment in severely ill children with sickle cell disease. The French Study Group on Sickle Cell Disease.

PURPOSE: To observe the safety and efficacy of hydroxyurea (HU), a drug that stimulates fetal hemoglobin (Hb F) production, in previously severely ill children with sickle cell disease. PATIENTS AND METHODS: HU was given in an uncontrolled study to 35 children with sickle cell disease, aged from 3 to 20 years, suffering from frequent painful crises. Mean duration of treatment was 32 months (range: 12-59 months). RESULTS: HU induced an increase in Hb F levels in all children out one; this increase was maximal after 9 months of treatment, was largely sustained thereafter, and was related to HU dose and inversely to patients' age. We also noted an apparent reduction in crisis, which occurred principally after 3 months of therapy and did not seem strictly correlated with the rise in Hb F level. No serious hematopoietic complication was observed. Growth curves and sexual development were not modified. CONCLUSION: Our data support the efficacy of HU in reducing painful events in children with sickle cell disease. Short- and middle-term tolerances are good. Thus, we think that HU can be given to children affected by frequent and severe painful crises. We recommend, however, very cautious use of this drug, because its long-term effects in children are still unknown.

[Macrophage activation syndrome and dysgammaglobulinemia. Role of the Epstein-Barr virus]. / Syndrome d'activation macrophagique et dysgammaglobulinémie. Rôle du virus d'Epstein-Barr.

The case of a five-year-old boy with macrophage activation syndrome and Epstein-Barr virus infection is reported. Several unusual features were found, including an early major increase in IgA levels, persistent oligoclonal gammapathy, and delayed development of anti-EA antibodies accompanied with an increase in anti-VCA antibodies. Despite the negative family history, an immune deficit and Purilo syndrome are discussed as possible diagnoses in this child.

[A rare cause of neonatal exudative enteropathy: congenital Langerhans cell histiocytosis (histiocytosis X)]. / Une cause rare d'entéropathie exsudative néonatale: l'histiocytose congénitale à cellules de Langerhans (histiocytose X).

A case of Langerhans cell histiocytosis is reported in a neonate. Intestinal involvement was especially diffuse and severe, presenting as a protein-losing enteropathy secondary to massive mucosal infiltration by histiocytic cells. The infant died at the age of 3 1/2 months despite therapy with corticosteroids and vinblastine then etoposide and interferon. Such an outcome confirmed the severity of forms with neonatal onset and digestive involvement.

[Isolated Candida albicans meningitis after treatment of B lymphoma]. / Méningite à Candida albicans isolée au décours du traitement d'un lymphome B.

A case of candida meningitis occurring in a child treated for a lymphoma is reported. Diagnosis was made with Candida albicans culture in the CSF. Blood cultures were negative. Cerebral CT scan was normal. No other localization was found. The child was successfully treated by amphotericin B (initially with 5-fluorocytosin). Fluconazole was continued orally later on. This case is noteworthy by the absence of other localization, the favourable evolution and its occurrence in childhood. The therapeutic attitude and prevention are discussed.

[Lead poisoning in children. Apropos of 129 cases]. / Saturnisme de l'enfant. A propos de 129 cas.

One hundred and twenty nine children with chronic lead poisoning were followed from August 1985 to July 1989. Old lead paint was recognized as the contaminant source at home. Pica of paint flakes was the main mode of intoxication. Children were classified according to the Center for Disease Control 1985 as follows: class IV (39 cases), class III (45 cases), class II (30 cases), class I (15 cases). Nineteen of those in class IV had blood lead levels above 700 micrograms/l and received BAL + EDTA followed by EDTA alone for a mean of 4.6 +/- 3.5 courses. With this treatment, blood lead level decreases were 50 +/- 17%. Nine of these class IV children had an evaluation at last 3 months after the last chelation course: 5 became class I or II, and 2 class III with a negative provocative test. The remaining 20 children in class IV were given a mean of 2.7 +/- 1.4 courses of EDTA. Blood lead levels decreased by 52 +/- 15%; 11 children were evaluable at least 3 months after the last chelation course: 4 became class I, and 7 class II. Thus overall 80% of class IV moved under treatment to class I or II. Among those 45 children in class II, 30 underwent a provocative test and 24 one to three courses of EDTA: 8 were further studied: 3 became class I and 5 class II. Combination of screening, medical treatment and sociocultural approach led to avoid acute effects of severe chronic childhood lead poisoning. The efficacy of such an approach in preventing chronic effects has still to be evaluated.