[Hepatic mesenchymal hamartoma in children. Immunohistochemical, ultrastructural and flow cytometric case study]. / L'hamartome mésenchymateux du foie de l'enfant. Etude immunohistochimique, ultrastructurale et en cytométrie en flux d'un cas.

Mesenchymal hamartoma is a rare liver lesion. This lesion was found in a 7-month-old girl with high serum alphafaetoprotein serum levels and was composed of loose connective tissue containing a certain number of epithelial cells of biliary or hepatic origin. Immunohistochemical studies showed that cytokeratins 7 and 19 were localized in bile duct epithelium. The ultrastructural study showed that the hamartoma was composed of well differentiated ductal structures surrounded by a myxoid mesenchyma with cysts formed either from degenerative mesenchymal areas or from dilated ducts. Flow cytometric analysis of nuclei from frozen tissue revealed that the lesion was DNA aneuploid, with a DNA index of 1.28.

[Practical role of ultrasonography and clinical examination for the diagnosis of acute appendicitis. Prospective study]. / Rôle pratique de l'échotomographie et de l'examen clinique dans le diagnostic de l'appendicite aiguë. Etude prospective.

The aim of this 100-patient prospective study was to compare three types of investigations in the diagnosis of acute appendicitis: initial clinical examination, initial appendicular ultrasound examination, and final results of repeated clinical examinations carried out within the first 48 hours. Final results included initial evaluation, obvious clinical results and definitive results from patients under 48 hour observation for uncertain diagnosis. Clinical initial or appendicular ultrasound examinations were poorly contributive to diagnosis (overall accuracy: 76 percent). On the contrary, repeated clinical examinations yielded a 100 percent sensitivity, a 94 percent specificity, a 94 percent positive predictive value, a 97 percent negative predictive value and a 97 p. 100 overall accuracy. No morbidity was noted in observing patients for 48 hours. Unwarranted appendectomies were carried out in 3 percent of cases. Ultrasonography of the appendix seems useful for the differential diagnosis of acute appendicitis.

[10 years' experience with intermittent catheterization in neurogenic bladder in children and adolescents: study of 165 cases]. / Dix ans d'expérience avec le cathétérisme intermittent dans les vessies neurologiques de l'enfant et de l'adolescent: étude de 165 dossiers.

Intermittent clean catheterization has been proposed in 1975 for the treatment of neurogenic bladder in children and teen-agers. We report results in 165 patients with neurogenic bladder (111 girls, 54 boys) from 1976 to 1986; 9 patients were lost for follow-up. Myelomeningocele was the cause of the neurogenic bladder in 132 cases. The effects on continence, upper-tract and urinary infection are studied. These data show that such a method is simple, harmless and effective for the protection of the upper urinary tract and for the control of urinary incontinence.

[Treatment of hydronephrosis caused by obstruction of the pyeloureteral junction diagnosed before birth]. / Traitement de l'hydronéphrose par obstacle à la jonction pyélo-urétérale diagnostiquée avant la naissance.

From 1981 to 1987, the authors observed 69 patients with ureteropelvic junction obstruction diagnosed by antenatal ultrasound, representing a total of 77 pathological renal units. Seventy renal units were treated by ureteropelvic resection, one renal unit returned to normal without treatment. There were 3 primary nephrectomies and 3 secondary nephrectomies for non-improvement after percutaneous nephrostomy. An early antenatal surgical management of ureteropelvic obstruction after antenatal ultrasound diagnosis does not seem to give better results than when diagnosis is made at a later stage. The interest of the antenatal diagnosis is not as important as for other uropathies such as urecterocele, mega-ureter or posterior urethral valves.

[Paraganglioma of the carotid body. Apropos of a case in a 14-year-old child]. / Paragangliome du corpuscule carotidien. A propos d'un cas chez un enfant de 14 ans.

Carotid body tumors are encountered infrequently. We report a case of a fourteen year old boy presenting an inflammatory biologic syndrome with a right neck mass. The diagnosis was first an Hodgkin disease but the surgical approach and histological examination of the neck mass conclude to a benign carotid body tumor. A subadventitial excision allowed a complete recovery with one year follow up. The diagnosis of these tumors is essentially made by arteriography. They are benign in most of the cases but sometimes need for a vascular reconstructive surgery in very extended forms.

[The Jaubert de Beaujeu technic in the treatment of hiatal hernia in newborn infants and children. Results apropos of 810 patients surgically treated from 1960 to 1986]. / La technique de Jaubert de Beaujeu pour le traitement des hernies hiatales du nourrisson et de l'enfant. Résultats à propos de 810 malades opérés de 1960 à 1986.

810 patients have been operated from 1960 to 1986 for gastroesophageal reflux. The surgical management has always been the same by an abdominal approach: dissection and repositioning of lower esophagus, closure of the columns, fixation of the esophagus to the columns, fixation of the gastric tuberosity to the esophagus and making an anterior valve. 59% of the patients have less than one year and 14.5% have been operated for respiratory syndromes. Mortality was 1.2% and 7% of patients developed post-operative complications. Because geographic diversity of the patients only one year results have been studied. 56 patients have been lost for follow up. 90.4% of patients have a clinical and radiological good result.

[Peritoneo-parietal fistula as a result of early amniocentesis. Apropos of a case. Review of the literature]. / Fistule péritonéo-pariétale au décours d'une amniocentèse précoce. A propos d'un cas. Revue de la littérature.

The authors report one case of omentum fistula after an earlier amniocentesis. It is an uneventful complication which has not yet been described. Based on the study of the literature, they describe the different fetal's trauma which have been encountered.

[Results of intermittent catheterization in neurogenic bladder in children and adolescents. 165 cases from 1976 to 1986]. / Résultats du cathétérisme intermittent dans les vessies neurologiques de l'enfant et de l'adolescent. 165 cas de 1976 à 1986.

Intermittent clean catheterization (CIC) has been proposed in 1975 for treatment of neurogenic bladder in children and tean-agers. We report herein the results of our experience from 1976 to 1986 with this method in a large number of patients with bladder dysfunction. 165 patients were included in this study (111 girls and 54 boys). 9 patients were lost for follow-up. Myelomeningocele was the cause of the neurogenic bladder in 132 cases. The effects on continence, upper tracts, and urinary tract infection are studied. Incontinence was managed by CIC in all 156 patients, with CIC alone (40 patients) or in association with oxybutynin (21 patients), enterocystoplasty, (20 patients), one method of increasing peripheral resistances (i.e. urethral lengthening, (8 patients), abdominal transposition of the urethra) (2 patients]. 40 very young children remain incontinent, 84 became continent; there were four technical failures, and an other method was used in 28 patients. Status of the upper urinary tracts was determined by IVP and cystography in 156 patients. IVP was normal in 123 cases (there was no change in 95%), and abnormal in 33 cases (there was improvement in 28 cases or no change in 3 cases). These data confirm those found in our previous study: this technique appears simple, harmless and effective for protection of the upper urinary tract and for control of urinary incontinence.