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Biomedical subjects

H Rode

Publications and source records attributed to H Rode.

At least 109 records · Page 6Linked to original sources
PubMed1984

Prenatal perforation of the extraperitoneal part of the rectum, associated with a developmental defect of the pelvic floor.

Perforation of the extraperitoneal part of the rectum during foetal life is an exceptionally rare event. Two cases are reported where this has been associated with a para-rectal defect in the pelvic floor. It is postulated that in these instances, the rectal lesion is due to this abnormality. As a consequence of the perforation meconium extravasates into the buttock. This has a classic presentation which should be immediately recognised. Urgent rectal decompression, as an emergency measure before surgery, is required if further serious complications are to be prevented.

Extravasation of Diagnostic and Therapeutic Materi↗
PubMed1984

The walk-in anergic patient. How best to assess the risk of sepsis following elective surgery.

This prospective study evaluated host resistance in a surgical population who walked into the hospital for elective surgery. Patients were stratified into Hospital Reactive (HR, n = 19) if they reacted to two or more of five recall skin test antigens and Walk-in Anergic (WA, n = 26) if they did not react to the antigens. The WA patients were slightly older (74.4 +/- 1.8 years, +/- SEM versus 66.7 +/- 2.7 p less than 0.05). Diagnosis in the HR and WA group were: tumors 13/19 versus 21/26, diverticulitis 3/19 versus 0/19, and miscellaneous 3/19 versus 5/26. Twenty-five laboratory normal controls (LN) were also studied. There were no significant differences in the following parameters between the HR and WA groups: stage of disease; hemoglobin; circulating leukocyte count; polymorphonuclear cell counts; total lymphocyte counts (both groups lower than LN, p less than 0.05), monocyte counts (both higher than LN, p less than 0.05); per cent E-rosettes and lymphocyte blastogenesis to mitogens (phytohemagglutinin, concanavalin-A) and antigens (purified protein derivative and tetanus); phagocytosis of preopsonised Staphylococcus aureus 502A, at 5, 10, and 20 minutes; alpha, beta, and gamma globulins; C3, and total hemolytic complement (CH50) levels; C-reactive protein; and ANA and DNA levels. The HR group demonstrated an increase in the rate of killing of Staphylococcus 502A at 10, 20, 40, and 80 minutes compared to the LN group but the WA group did not show this augmentation (p less than 0.001). The serum albumins were: LN = 4.46, HR = 3.98, WA = 3.43 g/dl (p less than 0.05). Degree and duration of surgery was the same in the HR and WA groups. There were no major sepsis episodes (bacteremia or proven intracavitary abscess) in the HR patients versus 25% in the WA patients (p less than 0.05). There was one death (6%, pulmonary embolus) in the HR group and 8 (40%) in the WA group (p less than 0.05). Antibiotic prophylaxis was equal but the WA patients received therapeutic antibiotics more frequently (65% versus 11% p less than 0.05). Of all the host immunocompetence tests measured in this study, the delayed type hypersensitivity skin test response and the serum albumin were variables abnormal between the survivors and those who died.

Adult↗
PubMed1984

In vivo and in vitro humoral immunity in surgical patients.

In vivo and in vitro humoral immunity was studied in surgical patients. Laboratory controls (LC), delayed type hypersensitivity (DTH) skin test reactive (HR), and anergic (HA) patients were immunized with tetanus toxoid. Maximum in vivo antibody levels occurred 14 days after immunization. Eighty-six, 47, and 17% of LC, HR, and HA subjects, respectively, showed a positive response (X2(2) = 21.1 with Yates, p less than 0.0005). Peak in vitro antibody production in unstimulated lymphocyte cultures occurred at day 6 after immunization. Antibody responses in vitro were reduced in all surgical patients, worst in HA, and correlated quantitatively with in vivo antibody responses at day 14 (Spearman rank correlation = 0.794, p less than 0.001). Total IgG production in vitro was not decreased; 595, 1080, and 1538 ng IgG/culture were produced by LC, HR, and HA, respectively. These data demonstrate decreased in vivo and in vitro humoral immunity in all surgical patients, worst in those with decreased DTH responses. There is a kinetic and quantitative correlation between in vivo and in vitro responses, the latter being a biologic reflection of the integrity and magnitude of the in vivo process. Finally, failure to produce specific antibody is not due to failure of total IgG synthesis.

Antibodies, Bacterial↗
PubMed1982

The phreno-pyloric syndrome in symptomatic gastroesophageal reflux.

Pathologic gastroesophageal reflux encountered during the neonatal period can be associated with projectile vomiting often of bile stained gastric content. Between 1960 and 1979, symptomatic gastroesophageal reflux was diagnosed in 36 neonates. Duodenogastroesophageal reflux was present in 16 or 44.4% of this group. This abnormal phenomenon is classically encountered in our experience during the neonatal period. The in-series incompetence of the pyloric and lower esophageal sphincteric mechanisms gives rise to a variant of the so called phreno-pyloric syndrome. The seriousness of this association is emphasized in our series by the high incidence of complications encountered in the patients with this syndrome, i.e., gastroesophageal bleeding in 44% esophagitis with stricture of formation in 12.5%. Conservative management of the cases encountered with this syndrome was successful except in two cases where reflux esophagitis was complicated by severe stricture formation. It is postulated that the pathogenesis of this form of phreno-pyloric syndrome is most probably based upon a motility disturbance of the upper gastrointestinal tract, involving the hormone motilin.

Esophagogastric Junction↗
PubMed1982

D-(--)-tartrate dehydratase of Rhodopseudomonas sphaeroides: purification, characterization, and application to enzymatic determination of D-(--)-tartrate.

An isolate of Rhodopseudomonas sphaeroides was capable of growing phototrophically and chemotrophically (mu = 0.15 h(-1) for either condition) with d-(-)-tartrate as the carbon source. A d-(-)-tartrate dehydratase, (d-(-)-tartrate hydrolyase, EC 4.1.2.70) was induced in the presence of d-(-)-tartrate. The enzyme was purified 30-fold from cell extracts of R. sphaeroides to a specific activity of 7.5 U/mg of protein and was subsequently crystallized in the presence of 1 M KCl. The enzyme was homogeneous upon analytical electrophoresis in 5% polyacrylamide gels and by criteria of ultracentrifugation. The native enzyme had a molecular weight of 158,000 +/- 1,000 as determined by gel filtration and ultracentrifugation. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis yielded a single polypeptide chain with an estimated molecular weight of 39,500 +/- 500, indicating that d-(-)-tartrate dehydratase was a tetramer. The isoelectric point of the native enzyme was at pH 5.5. The enzyme catalyzed irreversibly the conversion of d-(-)-tartrate to oxaloacetate and water, and the turnover number was calculated to be 1,185. The reaction followed Michaelis-Menten kinetics, and a K(m) value of 1.8 x 10(-4) M was determined. d-(-)-Tartrate dehydratase required Mg(2+) for activity. The pH optimum was within a range from 6.2 to 7.2, and the activation energy of the reaction (Delta H(0)) was 63.2 kJ/mol. The enzyme was specific for d-(-)-tartrate; it did not react with l-(+)-tartrate, meso-tartrate, and other hydroxycarboxylic acids. d-(-)-Tartrate dehydratase was strongly inhibited by meso-tartrate (50% at 0.6 mM). l-(+)-Tartrate and a variety of hydroxycarboxylic acids caused 50% inhibition at concentrations of >30 mM.

Cations, Divalent↗
PubMed1982

Ferrous- or cobalt ion-dependent D-(-)-tartrate dehydratase of pseudomonads: purification and properties.

D-(-)-Tartrate dehydratases [D-(-)-tartrate hydro-lyase, EC 4.2.1...] were isolated from two Pseudomonas strains. The molecular weights of the native enzymes were determined to be 72,000 and 7 8,000, respectively, and each enzyme was composed of two subunits of identical size. The dehydratases had no requirements for thiol compounds, were insensitive to oxygen, and required Fe2+ (0.1 mM) or Co2+ (0.5 mM) ions for optimal activity.

Cobalt↗
PubMed1982

Biliary ascariasis in children.

In the Cape Town Children's Hospital ascariasis is the commonest cause for an acute abdominal emergency; over a thousand cases have been admitted with ascariasis to the paediatric surgical wards. There was a high incidence of biliary ascariasis (424 cases) and routine intravenous cholangiography should be performed in all children with abdominal pain where ascariasis is suspected. The normal host/parasite relationship is described and the frequent invasion of the ampulla of Vater by the worm is discussed. The typical worm biliary colic is described and the classical surgical findings reported. The radiographic, ultrasonic and duodenoscopic diagnoses of the disease are evaluated. The management of the patient is described. Ninety-five percent of them were uncomplicated cases, but in 20 or 5% of the patients complications arose, the most important of them being ascariasis cholangitis, pyogenic cholangitis, perforation of the bile duct, cholecystitis and pancreatitis. The diagnosis and surgical management of these complications are described in some detail.

Abdomen, Acute↗
PubMed1981

Hiatus hernia in infancy and childhood.

Regurgitation of stomach contents is common in babies. One of the causes is gastro-oesophageal reflux due to an incompetent lower oesophageal sphincter, which may or may not be associated with a sliding hiatus hernia. Persistence of this defect will result in a pathological entity leading to reflux oesophagitis. If this symptom complex is not recognized, early disabling complications will result. The purpose of this study is to draw attention to the symptomatology of gastro-oesophageal reflux and hiatus hernia in infancy and childhood so as to improve our understanding of this entity and consequently allow earlier diagnosis, appropriate treatment and prevention of complications.

Child↗
PubMed1981

The manometric evaluation of the rectosphincteric reflex in total colonic aganglionosis.

The manometric assessment of rectosphincteric function in 33 patients with histologically proven aganglionosis is reviewed. The age of the patient at first assessment and the presence of total colonic aganglionosis influenced the results obtained. Overall, a 67% accuracy rate was achieved at first assessment. This rate fell to 43% when the test was carried out during the first 7 days of life. Six cases had total colonic aganglionosis. In only a single patient of this group was the first test result positive for aganglionosis. Attention is drawn to this finding.

Humans↗
PubMed1981

Burn wound management.

In this chapter the local therapy for burns is discussed. Between 400 and 500 children with burns are treated every year at the Red Cross War Memorial Children's Hospital in Cape Town, but in only 10% of them do the burns affect over 20% of the body surface. These latter patients are treated in special rooms equipped for intensive therapy. Open and closed methods of treatment for burns used in addition to early excision are compared. The first aim is early skin cover for areas with skin loss preserving as much function as possible and achieving the best possible cosmetic result. Local therapy must be atraumatic to prevent extension of the skin lesion. Bacterial contamination must be prevented as far as possible by keeping the wound clean. Emergency treatment and the course of wound healing up to the third week after the injury using the appropriate dressings are described. Early excision until the fifth day after the accident should be used mainly for burns of the hand, deep second degree burns of up to 10% of the body surface, deep second degree burns over the joints and deep second degree burns of the neck. It must be admitted that the depth of the burn can only be definitely estimated between the seventh and tenth day after the accident. If no autografts are available homografts or grafts from animals are used. The age of the patient, associated injuries, associated diseases and the extent of the burn all play a role in determining the prognosis. Furthermore endogenous bacterial infections, absorption of local therapeutic agents and the state of the surrounding skin do also influence the healing process. Finally the various local therapeutic agents like sulphamylon, silver sulphadiazine and betadine are discussed. A 0.05% solution of silver nitrate is also active against gram-negative infections. Skin transplants are disinfected with a solution containing one third 0.25% acetic acid, one third 3% cent hydrogen peroxide and one third saline. Hydrogen peroxide must not be applied to burns that are healing spontaneously. A classification of burns to help to choose the appropriate local therapy is proposed.

Administration, Topical↗
PubMed1981

An experimental evaluation of the germicidal efficacy of three topical antimicrobial agents in burns.

The bacteriocidal effect of three substances is discussed: 10% povidone iodine ointment (Betadine, betaisodona), 11,2% mafenide acetate (Naplatan) and silver sulphadiazine (Flamazine, Silvadene, Silvertone). A modified Walker burn model using male Long-Evans rats was studied. The infections were produced with a solution of 3 times 10(8) Pseudomonas aeruginosa pyocin type H. organisms. The authors described the pharmacological properties of the three substances and report the following results. All three substances are able to penetrate third degree burns. It takes 4 hours for povidone iodone, 12 for mafenide acetate and 24 for silver sulphadiazine to penetrate the burn. Mafenide acetate and silver sulphadiazine were the most useful agents after 12 and 24 hours respectively. When the substances were applied for a second time 24 hours after the first application only mafenide acetate was highly effective. The effectiveness of povidone iodine and silver sulphadiazine decreased by half when compared with the first application. For practical purposes the following recommendations are made: For deep burns povidone iodine should be applied every 4--6 hours, mafenide acetate every 12--18 hours and silver sulphadiazine once every 24 hours in order to ensure an antibacterial effect.

Administration, Topical↗
PubMed1980

Congenital jejuno-ileal atresia and stenosis.

Eighty-four patients with congenital jejuno-ileal atresias and stenoses admitted over a 20-year period (1959-1978) are reviewed. The overall survival rate of 88% is a reflection of the improvement in diagnosis and supportive care and refinements in technique. Our current ideas on this subject are expressed and a detailed account of the presentation, diagnosis and management is given.

Humans↗