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Dumont M, Sann L, Gazarian A. Bilateral hand transplantation: Supporting the patient's choice. J Plast Reconstr Aesthet Surg 2017; 70:147-151. [DOI: 10.1016/j.bjps.2016.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Revised: 10/18/2016] [Accepted: 11/18/2016] [Indexed: 11/16/2022]
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Mouriquand PDE, Gorduza DB, Gay CL, Meyer-Bahlburg HFL, Baker L, Baskin LS, Bouvattier C, Braga LH, Caldamone AC, Duranteau L, El Ghoneimi A, Hensle TW, Hoebeke P, Kaefer M, Kalfa N, Kolon TF, Manzoni G, Mure PY, Nordenskjöld A, Pippi Salle JL, Poppas DP, Ransley PG, Rink RC, Rodrigo R, Sann L, Schober J, Sibai H, Wisniewski A, Wolffenbuttel KP, Lee P. Surgery in disorders of sex development (DSD) with a gender issue: If (why), when, and how? J Pediatr Urol 2016; 12:139-49. [PMID: 27132944 DOI: 10.1016/j.jpurol.2016.04.001] [Citation(s) in RCA: 126] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 03/25/2016] [Accepted: 04/04/2016] [Indexed: 01/25/2023]
Abstract
Ten years after the consensus meeting on disorders of sex development (DSD), genital surgery continues to raise questions and criticisms concerning its indications, its technical aspects, timing and evaluation. This standpoint details each distinct situation and its possible management in 5 main groups of DSD patients with atypical genitalia: the 46,XX DSD group (congenital adrenal hyperplasia); the heterogeneous 46,XY DSD group (gonadal dysgenesis, disorders of steroidogenesis, target tissues impairments …); gonosomic mosaicisms (45,X/46,XY patients); ovo-testicular DSD; and "non-hormonal/non chromosomal" DSD. Questions are summarized for each DSD group with the support of literature and the feed-back of several world experts. Given the complexity and heterogeneity of presentation there is no consensus regarding the indications, the timing, the procedure nor the evaluation of outcome of DSD surgery. There are, however, some issues on which most experts would agree: 1) The need for identifying centres of expertise with a multidisciplinary approach; 2) A conservative management of the gonads in complete androgen insensitivity syndrome at least until puberty although some studies expressed concerns about the heightened tumour risk in this group; 3) To avoid vaginal dilatation in children after surgical reconstruction; 4) To keep asymptomatic mullerian remnants during childhood; 5) To remove confirmed streak gonads when Y material is present; 6) It is likely that 46,XY cloacal exstrophy, aphallia and severe micropenis would do best raised as male although this is based on limited outcome data. There is general acknowledgement among experts that timing, the choice of the individual and irreversibility of surgical procedures are sources of concerns. There is, however, little evidence provided regarding the impact of non-treated DSD during childhood for the individual development, the parents, society and the risk of stigmatization. The low level of evidence should lead to design collaborative prospective studies involving all parties and using consensual protocols of evaluation.
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Gambrelle J, Till M, Lukusa B, Beby F, Mory N, Sann L, Kodjikian L, Grange JD, Putet G. Ocular Anomalies Associated with Interstitial Deletion of Chromosome 2q31: Case Report and Review. Ophthalmic Genet 2009; 28:105-9. [PMID: 17558854 DOI: 10.1080/13816810701351305] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We describe a newborn girl with multiple malformations associated with an interstitial deletion of chromosome 2q (q24q32). Clinical findings included growth retardation, microcephaly, facial malformations, common atrioventricular canal, digital anomalies of both hands and feet, and ovarian hypoplasia. Bilateral ocular anomalies included down-slanting palpebral fissures, blepharophimosis, microphthalmia, uveal coloboma, and corneal opacity. Chromosomal segment 2q31 may play a major role in the development of the eye and its adnexa.
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Slottosch I, Sann L, Wittwer T, Strauch JT, Wippermann J, Wahlers T. EuroSCORE is of predictive value to estimate prospective complication-related costs in cardiac surgery. Thorac Cardiovasc Surg 2009. [DOI: 10.1055/s-0029-1191618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sann L, Bourgeois J, Stephant A, Putet G. [Outcome of 249 premature infants, less than 29 weeks gestational age]. Arch Pediatr 2001; 8:250-8. [PMID: 11270248 DOI: 10.1016/s0929-693x(00)00191-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
UNLABELLED The aim of this paper was to report the vital and neurological outcome of 249 preterm infants of less than 29 weeks born between 1990 and 1996, and included in a prospective study until two years of age. RESULTS The initial mortality rate was 19%. This was related to gestational age and severe transfontanellar ultrasonographically (TFU) detected abnormalities. The rate of follow-up at two years of age was 98%. Neurological sequelae amounted to 12.8%, including four cases of deafness. The possibility of survival without neurological sequelae increased from 52% at 24-25 weeks to 72% at 26-28 weeks of gestational age (p < 0.005). The presence of sequelae was significantly related to severe cranial ultrasonographically-detected abnormalities, to parental social level, and to early neonatal anemia. Normal TFU and/or isolated periventricular hyperechogenicity could not exclude the presence of neurological sequelae which, however, appeared to be less severe than at the onset. CONCLUSION Gestational age, severe TFU abnormalities and neonatal anemia play a major role in the rate of mortality and in the neurological sequelae in preterm infants, and can influence the decisions concerning the treatment of this pediatric population.
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Sann L. Mechanism of hyperammonemia. J Pediatr 1998; 133:168-9. [PMID: 9672538 DOI: 10.1016/s0022-3476(98)70206-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Sann L, David M. -A new role for the pediatrician: the prevention of social violence-. Arch Pediatr 1998; 5:307-17. [PMID: 10328001 DOI: 10.1016/s0929-693x(97)89375-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Social violence is a kind of violence which is applied by one individual to another. It is a stake in the field of public health because of an increasing number of children with such behaviors. In addition to environmental factors, the occurrence of abnormal social behavior before 9 years of age seems to precede social violence for the subsequent 20 years of life. One must therefore identify an inadequate attitude towards the parents and/or the teachers, or a poor child's self-esteem and self-respect. These phenomena are based on parental authority, on the ethical development of the child, on his verbalization capacity, on his socialization and his affective development. It is therefore important to stimulate ethical capacities and feelings in the child not only to provide autonomy but also to allow reflexive distinction of language, behavior and judgment, which enable him to understand, consider and respect other individuals.
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Gladstone M, Lasne Y, Sann L, Putet G. Non-linear patterns of growth in very low birth weight infants. Am J Hum Biol 1998; 10:637-646. [DOI: 10.1002/(sici)1520-6300(1998)10:5<637::aid-ajhb10>3.0.co;2-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/1995] [Accepted: 07/26/1997] [Indexed: 11/08/2022] Open
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Sann L, Lasne Y, Gladstone M, Putet G. Modèle non linéaire de croissance des prématurés. Arch Pediatr 1997. [DOI: 10.1016/s0929-693x(97)88221-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Morlet T, Lapillonne A, Ferber C, Duclaux R, Sann L, Putet G, Salle B, Collet L. Spontaneous otoacoustic emissions in preterm neonates: prevalence and gender effects. Hear Res 1995; 90:44-54. [PMID: 8975004 DOI: 10.1016/0378-5955(95)00144-4] [Citation(s) in RCA: 58] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A number of lines of evidence indicate that the human cochlea is fully functional as a mature sound transducer by 6 months of age. However, information about the development of the active cochlear mechanisms and notably the development of outer hair cell (OHC) activity is yet incomplete. Recording and analysis of otoacoustic emissions (OAEs), probably generated by the OHCs of the organ of Corti, have led to a better understanding, in humans, of how sounds are analysed in the cochlea by means of active mechanisms. Evoked OAEs (EOAEs) and spontaneous OAEs (SOAEs), when they can be recorded in full-term and preterm neonates, show different characteristics from those in adults, suggesting that maturation of the peripheral auditory system is incomplete at birth. To learn more about this maturation, using the best-established facts concerning SOAEs in adults, such as their greater prevalence in females and also in right ears, SOAEs were studied in more detail in 81 preterm neonates, from 30 to 40 weeks of conceptional age, all presenting bilateral EOAEs according to objective criteria. The first finding of this study was that SOAEs existed and could be recorded as of 30 weeks of conceptional age in humans. Some SOAE characteristics in preterm neonates, such as prevalence, peak number and acoustic frequencies, showed similarity with full-term neonates. Comparison of other criteria between the two populations, such as greater SOAE prevalence in right ears and higher SOAE peak number in females, suggested that these developmental factors emerge around term in humans. Comparison of SOAE characteristics between male and female preterms suggested that male preterms were less advanced in peripheral auditory development than were female preterms.
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Guillaumont M, Sann L, Leclercq M, Dostalova L, Vignal B, Frederich A. Changes in hepatic vitamin K1 levels after prophylactic administration to the newborn. J Pediatr Gastroenterol Nutr 1993; 16:10-4. [PMID: 8433228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
We undertook a study of hepatic concentrations of vitamin K (vitamin K1 or phylloquinone, vitamin K1-epoxide, and menaquinones) in 18 infants, ages 1-8 days, with or without vitamin K1 supplementation. The infants who had no supplementation had a total hepatic storage ranging between 0.1 and 0.9 micrograms. Also, hepatic storage of phylloquinone was poor (< 1 microgram) when compared with daily requirements. Moreover, we did not detect any menaquinone in the livers of these infants in our study. The prophylaxis applied to the other infants was very efficient. Hepatic vitamin K1 concentrations, obtained < 24 h after administration, were very high (62.8-93.5 micrograms/g). Vitamin K1-epoxide concentrations were high, which proved the efficiency of the vitamin K cycle. In contrast, the decrease in vitamin K1 concentrations was also very rapid, since the median value after 48 h was 8.4 micrograms/g and only 2.9 micrograms/g 5 days after administration. However, hepatic total storage after 5 days in one infant with vitamin K1 supplementation was much higher (112 micrograms) than in infants who had not received supplementation. In conclusion, hepatic phylloquinone storage at birth was poor (< 1 microgram). The newborn infant might be in a situation of potential deficiency. After prophylactic oral administration of phylloquinone, uptake by the liver was quite satisfactory, but concentrations dropped quickly. However, phylloquinone hepatic storage remained elevated (112 micrograms) after 5 days.
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Pracros JP, Sann L, Genin G, Tran-Minh VA, Morin de Finfe CH, Foray P, Louis D. Ultrasound diagnosis of midgut volvulus: the "whirlpool" sign. Pediatr Radiol 1992; 22:18-20. [PMID: 1594304 DOI: 10.1007/bf02011603] [Citation(s) in RCA: 137] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The authors present their US findings in 24 patients with proved complicated midgut malrotation: volvulus in 18 and occlusive Ladd's bands in 6. All the 24 patients have had US examination prior to surgery. Contrast examinations were performed in only 9 patients, always after US and before surgery. The sonographic "whirlpool" pattern of the superior mesenteric vein and mesentery around the superior mesenteric artery was detected in 15 of the 18 patients with midgut volvulus, and was best seen using Doppler color. Embryological signification of midgut malrotation is discussed.
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Sann L. Effect of dietary phosphorus in preterm infants. J Pediatr 1990; 117:1006. [PMID: 2246679 DOI: 10.1016/s0022-3476(05)80162-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Abstract
Neonatal hypoglycemia is particularly dangerous for the brain when it is symptomatic or/and recurrent. In order to avoid symptomatic hypoglycemia a compensatory production of ketone bodies is required since they are actively taken up by the neonatal brain. Recurrent hypoglycemia can be avoided by stimulation of neonatal gluconeogenesis which is limited by glucose infusion and/or insulin secretion. Lipid administration induces a hyperglycemic response which is explained by a stimulation of gluconeogenesis. It also results in ketogenesis which provides the compensatory factors of hypoglycemia and which seems to be linked to gluconeogenesis. We therefore suggest that the best way to prevent neonatal hypoglycemia is achieved by supplementing the neonate with lipids and especially medium chain triglycerides.
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Sann L, Guillaumont M, Leclercq M. Vitamin K deficiency in breast-fed infants. J Pediatr 1989; 115:1025-6. [PMID: 2585220 DOI: 10.1016/s0022-3476(89)80771-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Sann L, Leclercq M, Guillaumont M, Bethenod M. [Does the newborn infant need vitamin K supplementation?]. ARCHIVES FRANCAISES DE PEDIATRIE 1988; 45:775-7. [PMID: 3071283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Ajacques JC, Campo-Paysaa A, Sempe M, Sann L, David M, Bey-Omar F. [Facial clefts and endocrine deficiencies]. ACTUALITES ODONTO-STOMATOLOGIQUES 1988:429-46. [PMID: 3252718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Abstract
Growth of arm muscle, fat and water areas were evaluated longitudinally in a prospective study in 81 infants from birth to the age of 12 months. The percentage of arm fat area v the cross sectional upper arm area increased at the age of 15 days with a peak peak at the age of 6 months while arm muscle area increased progressively throughout the year. As arm water area represented only 1% of cross sectional upper arm area, calculations of arm fat and muscle areas can be carried out from measurements of mid arm circumference and tricipital skinfold at 15 seconds. Percentiles are presented for the upper arm fat and muscle areas, which can be used as index for the infants' nutritional state.
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Sann L, Mousson B, Rousson M, Maire I, Bethenod M. Prevention of neonatal hypoglycaemia by oral lipid supplementation in low birth weight infants. Eur J Pediatr 1988; 147:158-61. [PMID: 3259179 DOI: 10.1007/bf00442214] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The effect of oral lipid supplementation (2.9 g/day containing 67% medium chain triglycerides) on the prevention of neonatal hypoglycaemia was evaluated in 28 low birth weight infants (mean +/- 1 SD for gestational age: 36 +/- 1.2 weeks and birth weight: 1778 +/- 230 g) and compared to a control group of 23 infants with similar gestational age, birth weight and sex. The incidence of hypoglycaemic patients with plasma glucose less than 1.72 mmol/l was 8/23 (35%) in the control group versus 2/28 (7%) in the supplemented group: chi 2 = 6.72; P less than 0.01. Determinations of plasma beta-hydroxybutyrate concentrations in 11 infants of the supplemented group did not show values higher than 1.2 mmol/l. This prospective study shows that supplementation with lipids can prevent the occurrence of hypoglycaemia in low birth weight infants.
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Guillaumont MJ, Durr FM, Combet JM, Gueho AG, Fournier BM, Sann L, Leclercq MA, Frederich AH. Vitamin K1 diffusion across the placental barrier in the gravid female rat. DEVELOPMENTAL PHARMACOLOGY AND THERAPEUTICS 1988; 11:57-64. [PMID: 3383722 DOI: 10.1159/000457665] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The hemorrhagic disease of the newborn can be prevented by administration of vitamin K1. The modes of utilization of the vitamin need to be studied in the mother and child. An experimental pharmacokinetic study was conducted, using the gravid female rat. Results showed rapid intestinal absorption of phylloquinone. The fetus plasma concentration rose from 8.6 micrograms/l at time 0 to 0 to 44.3 micrograms/l at 8 h. Such an increase is an evidence of phylloquinone diffusion across the placenta. The phenomenon requires a high gradient. On the other hand, maximum plasma concentrations are not reached until the 8th hour.
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Excler JL, Lasne Y, Sann L, Picard J. Assessment of proportional growth of very low birth weight infants fed banked human milk. Early Hum Dev 1987; 15:279-93. [PMID: 3678120 DOI: 10.1016/0378-3782(87)90051-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Twenty appropriate (mean +/- S.D., gestational age (AGA): 29.9 +/- 1.5 weeks) and 15 small (GA: 34.6 +/- 2.4 weeks) for gestational age (SGA) very low birth weight infants fed banked mature human milk were studied until term for anthropometric parameters: midarm (MAC), chest (CC), head (HC) circumferences, triceps (TSKF) and subscapular (SSKF) skinfold thickness recorded at 15 and 60 s, dynamic skinfold (delta % SKF), muscle (AMA) and fat (AFA) areas, weight and length. In AGA infants, all the parameters at term were significantly lower in extrauterine (EUL) that in intrauterine life (IUL). At term the relative proportion of AFA to total arm area was increased in EUL compared to IUL both in AGA (25.87 +/- 3.8 vs. 23.26 +/- 1.27% respectively, P less than 0.01) and in SGA infants (21.89 +/- 4.63 vs. 18.81 +/- 3.9 respectively, P less than 0.05). SGA infants showed a similar growth in EUL compared to IUL, and a significantly lower AMA and AFA than in AGA infants in EUL. Although HC was in both infants below the 10th centile at term, the ratio weight/HC2 suggests a relative preservation of head growth in EUL compared to IUL (AGA: 20.72 less than 0.87 vs. 22.65 +/- 1.46 respectively, P less than 0.001; SGA; 20.82 +/- 1.16 vs. 21.62 +/- 1.86 respectively, NS). Delta %SKF were negatively correlated with post-conceptional age suggesting a loss of extracellular water in AGA (delta %TSKF: r = -0.287, P less than 0.02) and in SGA infants (delta %TSKF: r = -0.301, P less than 0.02; delta %SSKF: r = -0.316, P less than 0.02). An intrauterine model of discrimination between AGA and SGA infants does not apply to EUL. An equation was established in SGA infants with the best discriminant parameters giving a predictive post-conceptional age: post-conceptual age (PCA) (weeks) = 0.276 HC (cm) + 0.723 CC (cm) - 0.122 MAC (cm) + 0.5 TSKF (mm) + 10.173, (r = 0.867, P less than 0.001) allowing a clear discrimination between AGA and SGA infants. These results suggest that infants show quite different growth patterns between IUL and EUL both for AGA and SGA infants.
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Fournier B, Sann L, Guillaumont M, Leclercq M. Variations of phylloquinone concentration in human milk at various stages of lactation and in cow's milk at various seasons. Am J Clin Nutr 1987; 45:551-8. [PMID: 3825982 DOI: 10.1093/ajcn/45.3.551] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
An improved high-performance liquid chromatographic method was used to measure phylloquinone concentrations in human and cow's milk. Concentrations in human milk obtained serially from 10 mothers 3, 8, and 21 days after delivery were found to increase during the course of lactation. No correlation was found between phylloquinone concentration and lipids but a significant negative correlation was observed between phylloquinone and cholesterol concentrations. Determinations in cow's milk showed increased levels during the summer months. Also, levels in cow's milk were significantly higher than in human milk. Notwithstanding marked individual variations in human milk, phylloquinone concentrations in cow's milk always proved higher than in human milk. Results prompt the necessity of protecting breast-fed infants by applying relevant prophylactics measures.
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