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Biomedical subjects

A J Rudolph

Publications and source records attributed to A J Rudolph.

At least 55 records · Page 3Linked to original sources
PubMed1977

Controlled trial of bicarbonate therapy in high-risk premature newborn infants.

Sixty-two high-risk acidemic premature newborn infants, given maintenance intravascular infusions of 10% glucose, were assigned to liberal or restricted sodium bicarbonate treatment groups. Those infants in the liberal group received 5 to 15 mEq bicarbonate/dl 10% glucose, depending on the degree of acidosis. Among infants given bicarbonate, correction of pH was not more rapid and mortality was not decreased. Instead, there was a small increase in the number of deaths, but the incidence of intraventricular hemorrhage was similar to that in infants not given bicarbonate.

Acidosis↗
PubMed1977

Assessment of gestational age by examination of the anterior vascular capsule of the lens.

The disappearance of the anterior vascular capsule of the lens (pupillary membrane was found to be useful in the preterm infant to estimate accurately gestational age between the twenty-seventh and the thirty-fourth weeks. Before the twenty-seventh week, the cornea was to opaque to allow good visualization of this vascular system. After the thirty-fourth week, these vessels had generally atrophied completely. One hundred infants between 27 and 34 weeks' gestational age as assessed by the Dubowitz scoring system were studied with the direct ophthalmoscope following dilatation of the pupil. Disappearance of the anterior vascular capsule was arbitrarily divided into four grades. The correlation between gestational age and the grade of anterior vascular capsule was found to be highly significant (p less than 0.001).

Atrophy↗
PubMed1977

Leprechaunism (Donohue's syndrome) in a low birth weight infant.

A 910 gm infant with leprechaunism, the smallest reported infant with this syndrome, was described. Marked discrepancies were noted between gestational age as assessed by physical examination, bone and dental roentgenographic studies, and renal histology. Radiographic and pathologic features of this syndrome were discussed. Failure to thrive characterized the course of this infant despite adequate caloric intake. The precarious nature of these infants and difficulties encountered in obtaining adequate studies to delineate the cause of this syndrome were emphasized.

Abnormalities, Multiple↗
PubMed1977

The foam stability test on gastric aspirate in the prediction of respiratory distress syndrome.

To evaluate the usefulness of the foam stability test (FST) on gastric aspirate for predicting respiratory distress syndrome (RDS) in premature infants, samples were collected at delivery or within 30 min from 194 infants less than or equal to 36 weeks gestation. Of 123 samples adequate for complete testing, 44 were positive at 1 : 2 dilution, 43 were positive only at dilutions less than 1 : 2 and 36 were negative at all dilutions. RDS was found in 2%, 21% and 25% of each group respectively. The FST on gastric aspirate at birth gives useful information only if positive at 1 : 2 when a very low incidence of RDS may be expected. However, a large proportion of infants with FST negative at 1 : 1 do not develop RDS, and hence the test is of limited value in screening for those with highest risk.

Amniotic Fluid↗
PubMed1977

Role of autonomic nervous system controlling surface tension in fetal rabbit lungs.

After the maternal abdomen was opened under methoxyflurane anesthesia, fetal rabbits of 27.5 days gestation were given injections through the intact uterine wall of saline, pilocarpine, isoxsuprine, muscarine, phenylephrine, atropine, phenoxybenzamine, or propranolo, alone or in appropriate combinations. Fetal rabbits were delivered by hysterotomy and killed without breathing 2.5 h later. Static pressure-volume curves with air showed improved retention on deflation in fetal rabbits that had injections of pilocarpine, or isoxsuprine, but not of muscarine or phenylephrine. The effect of pilocarpine on the pressure-volume curve was blocked by atropine, phenoxybenzamine, and propranolol, and the effect of isoxsuprine was blocked by propranolol but not phenoxybenzamine. The data suggest that pilocarpine produces secretion of surfactant into lung air spaces by exciting the sympathetic nervous system, a known function of pilocarpine, rather than the parasympathetic nervous system. This may result in stimulation of the same beta-adrenergic receptors affected by isoxsuprine which is also thought to stimulate surfactant secretion.

Animals↗
PubMed1977

Hyaline membrane disease and acidosis at birth in twins.

To test the hypothesis that the increased incidence of hyaline membrane disease in second-born twins is related to acidosis at birth, umbilical arterial [H+] was measured in 26 sets of premature twins. Although overall Twin B had a lower Apgar score than Twin A, there was no difference in their [H+]. If the delivery interval was prolonged over 8 minutes then Twin B infants were more acidemic and had lower Apgar scores. Infants with hyaline membrane disease had lower Apgar scores, but were not more acidemic than infants without respiratory distress. Our data suggest that acidosis at birth is not an important factor in the development of hyaline membrane disease.

Acidosis↗
PubMed1977

Postnatal head shrinkage in small infants.

The front-occipital circumference, frontooccipital and biparietal diameters, degree of suture overriding and weight were measured daily during the first week of life in 50 infants of birth weight under 2,000 gm. In a second similar group of 21 infants, fronto-occipital circumference, weight, and sodium balance were measured daily during the first week of life. Head volumes were estimated from the circumference and diameters of the head. The parameters of head size and derived volumes changed maximally and significantly in the direction of intracranial shrinkage around 3 days of age. The degree of shrinkage was significantly correlated (P less than .005) with the degree of weight and cumulative sodium losses, and decreasing gestational age. We postulate that postnatal head shrinkage results from shift of sodium and water outward from the intracranial cavity as a transient phenomenon during the first week of life. The significance of head shrinkage is discussed.

Cephalometry↗
PubMed1976

Fulminant neonatal sepsis and necrotizing enterocolitis associated with a "nonenteropathogenic" strain of Escherichia coli.

During 1973 a nonendemic mucoid strain of Escherichia coli entered the nursery of a hospital in Houston. This organism caused septicemia and was associated with a high incidence of necrotizing enterocolitis. The illness was fulminant and characterized by apnea, abdominal distension, and shock. Diarrhea was not a feature of the symptom complex. The epidemic organism was nontypable. Assays for invasiveness, enterotoxin production, and Kl antigen were negative. Surveillance revealed a colonization rate of 14%, an attack rate in colonized infants of 19.5%, and a mortality rate of 87.5%. These data suggest that in certain instances the specific bowel flora may increase the incidence and severity of NEC.

Disease Outbreaks↗
PubMed1976

Transient hypertrophic subaortic stenosis in infants of diabetic mothers.

Three newborn infants with congestive heart failure had hemodynamic, angiographic, and echocardiographic features of hypertrophic subaortic stenosis (hypertrophic obstructive cardiomyopathy). Treatment with digitalis and diuretic drugs was ineffective, but improvement occurred when these agents were withheld in one patient, and when treatment with propranolol was begun in two patients. Echocardiography was helpful in establishing the diagnosis in two patients and showed resolution of the condition during the first six months of life. Serial cardiac catheterizations confirmed resolution of the outflow obstruction in the third patient. Family studies revealed no evidence of familial cardiomyopathy, but the mothers of two infants had insulin-dependent diabetes mellitus and the mother of the third was presumed to be prediabetic.

Adult↗
PubMed1976

Reduced surface tension in lungs of fetal rabbits injected with pilocarpine.

After opening the maternal abdomen under methoxyflurane anesthesia, fetal rabbits 25.5-28.5 days gestation were given an intraperitoneal injection of pilocarpine (150 mg/kg) or saline through the intact uterine wall. They were delivered by hysterotomy and sacrificed without breathing 2.5 h later. Newborn rabbits 29.5 days gestation received an injection of pilocarpine or saline at birth and breathed 30-120 min. Other newborn rabbits 29.5 days gestation were alternately sacrificed at birth or after breathing 30 min. Static pressure-volume curves with air showed decreased recoil and improved air retention on deflation in fetal rabbits 25.5-27.5 days injected with pilocarpine. There was no change in the static pressure-volume curve of lungs filled with saline. The data suggest that pilocarpine reduced surface tension by producing secretion of surfactant into air spaces. No change in lung recoil occurred with pilocarpine at 28.5 days, or with pilocarpine or breathing at 29.5 days. This may mean that air spaces at 28.5-29.5 days contained optimal surfactant, so further secretion of surfactant stimulated by pilocarpine or breathing failed to reduce surface tension.

Animals↗
PubMed1976

The role of acidosis at birth in the development of hyaline membrane disease.

To test the hypothesis that intarpartum acidosis has a role in the etiology of hyaline membrane disease (HMD), blood was collected from the umbilical artery (UA) at birth from 110 premature infants and analyzed for hydrogen ion concentration ([H+]), PCO2, standard bicarbonate, and lactic acid. The infants were followed until a definite diagnosis was made of HMD (33 infants), type II respiratory distress syndrome (16 infants) or the absence of respiratory distress (61 infants). In general, infants with HMD were more premature and had lower Apgar scores than nondistressed infants; however, there were no significant differences between the two groups in any acid-base measurement. Only in those patients of 32 to 37 weeks' gestational age was it possible to detect a significant increase in UA [H+] in infants with HMD compared to those without respiratory distress. There was evidence that the reduced Apgar score of infants with HMD may be due to immaturity and abnormal pulmonary function secondary to lung disease. It is concluded that acidosis at birth is not a factor in the development of HMD except possibly in more mature infants.

Acidosis↗
PubMed1975

The use of indwelling radial artery catheters in neonates.

Indwelling radial artery catheterization was performed on 20 infants. In only one patient was it unsuccessful. Mean duration of indwelling catheterization was 44.1 hours. Advantages of this procedure include constant availability of arterial blood gas sampling and blood pressure monitoring. It is a relatively safe procedure offering a low incidence of clinical infection and serious vascular complications. Further experience will delineate its exact role in the care of the acutely ill neonate.

Blood↗