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Biomedical subjects

J Samuel

Publications and source records attributed to J Samuel.

At least 91 records · Page 5Linked to original sources

Surgery for correction of bilateral choanal atresia.

A transnasal approach was employed in 28 neonates (26 blacks and 2 whites) with bilateral choanal atresia. In each patient the atresia was perforated microsurgically with the drill, followed by insertion of a Portex endotracheal tube for a period of three months. By this method a satisfactory nasal respiration was established immediately. Removal of the posterior part of the vomer is crucial to the successful result. During the follow-up, one death was recorded in a microcephalic neonate, unrelated to the operation and another four patients required repositioning of the tube under general anesthesia. We feel that the above technique is simple and definitive with negligible complications.

Female↗

Otogenic complications with an intact tympanic membrane.

A review of 21 cases of complications of acute otitis media with a hyperemic, dull, bulging but intact tympanic membrane is presented. All cases had a retroauricular swelling. In 10 cases, a subperiosteal abscess was found, 1 of them complicated with a posterior fossa abscess, 2 had meningitis, 3 had Bezhold's abscess, 2 had thrombosis of the lateral sinus, 1 had a cerebellar abscess, 1 had cerebellitis, and 2 presented with facial nerve palsy. Ninety percent of the patients were below the age of 13. An incomplete course of antibiotic treatment was found to have been given in seven cases (30%) prior to admission. Surgical therapy consisted of a cortical mastoidectomy and a wide myringotomy. Ventilating tubes were inserted in three patients. The mastoid radiography demonstrated cloudiness, and CT scan was performed in six patients with suspected intracranial complications. The present study stresses that an intact tympanic membrane with minimal changes may be regarded by the medical profession with a low index of suspicion and can lead to severe otogenic complications. The disease can be masked by an improper antibiotic therapy.

Abscess↗

Synthesis of 131I, 125I and 82Br labelled (E)-5-(2-halovinyl)-2'-deoxyuridines.

Radiohalogenated (E)-5-(2-iodovinyl)-2'-deoxyuridine (IVDU, 4) and (E)-5-(2-bromovinyl)-2'-deoxyuridine (BVDU, 5) were synthesized by reaction of (E)-5-(2-carboxyvinyl)-2'-deoxyuridine (1) with radiolabelled iodide or bromide in the presence of chloramine-T. A "no-carrier-added" synthesis of [131I]IVDU was completed within 30 min providing a radiochemical yield of 65%. Alternatively, radioactive iodine was incorporated into IVDU using a halogen isotope exchange reaction catalyzed by cuprous ion. [82Br]BVDU was also prepared by direct neutron activation of unlabelled BVDU.

Antiviral Agents↗

Asking only one question in the conservation experiment.

Rose and Blank have shown that 6-yr-old children do a great deal better in a conservation of number task if they are only asked to make a comparison after the transformation rather than both before and after seeing the quantity transformed. Our experiment shows that this important result applies as well to other materials (mass and volume) and to a wide age range (5-8 yr).

Child↗

Quantitative uptake studies of 131I-labeled (E)-5-(2-iodovinyl)-2'-deoxyuridine in herpes simplex virus-infected cells in vitro.

We have synthesized a 131I-radiolabeled antiviral compound (E)-5-(2-iodovinyl)-2'-deoxyuridine (IVdU) and shown that this agent was selectively trapped within rabbit kidney cells, infected in vitro by thymidine kinase-positive (TK+) herpes simplex virus (HSV). The uptake of 131I-labeled IVdU was specific, as it was not concentrated within either HSV (TK-) or mock-infected cells. In certain conditions, over 40% of the radiolabel was selectively trapped within HSV (TK+)-infected cells. This was a 20- to 30-fold increase over the uptake of 131I-labeled IVdU by HSV (TK-) or mock-infected cells. The uptake of 131I-labeled IVdU varied directly with (i) the dose of the virus used to infect the rabbit kidney cells; (ii) the concentration of radiolabeled IVdU added to the system; and (iii) the time of exposure of IVdU to infected cells. The ability of this agent to be trapped within HSV (TK+)-infected cells merits further evaluation in animal models as it has potential as a noninvasive, herpes-specific diagnostic test, in particular for HSV encephalitis.

Animals↗

Cardiac thrombosis and thromboembolism in chronic Chagas' heart disease.

A retrospective study of Chagas' heart disease was carried out by a review of 1,345 autopsy reports, with special reference to cardiac thrombus and thromboembolic phenomena. The incidence of cardiac thrombus was higher in cases of heart failure (36%) than in cases of sudden death (15%), higher in heavier hearts, and unrelated to age or sex. The left- and right-sided cardiac chambers were equally affected by thrombus. Endocarditis and blood stasis were considered important factors in the pathogenesis of cardiac thrombus. Thromboembolic phenomena were more common in the systemic circulation but caused relatively more deaths by pulmonary embolism. Fourteen percent of patients with thromboembolic phenomena died from them. Patients with multiple thromboembolic phenomena had a higher risk of death from embolism. Cardiac thrombosis or thromboembolic phenomena, or both, were present in 44% of the cases studied. Prophylactic measures should be taken for these important complications of Chagas' heart disease.

Arterial Occlusive Diseases↗

Sleep apnea following bilateral excision of carotid body tumors.

A patient is described who developed apnea, hypertention, and tachycardia following the excision of bilateral carotid body tumors. Hypertension and tachycardia resulted, most probably, from bilateral ablation of the carotid sinus and/or the nerve of Hering. These phenomena have been described in the literature. The pathogenesis of the apneic attacks may be related to the ablation of the peripheral sensory organs (both carotid bodies), interference with the function of the respiratory automatic control system, and impaired control of ventilation during non-REM sleep. Temporary unilateral paralysis of the hypoglossal nerve with partial airway obstruction possibly represented a mechanical trigger. The apneic attacks subsided but bouts of hypertention and tachycardia persist.

Adult↗

Use of middle ear ventilation tubes in recurrent acute otitis media.

A method of treatment of recurrent acute otitis media with polythene middle ear ventilation tubes in young children is presented. 56 ears in which infection had persisted for one to six months despite antibiotic therapy and multiple myringotomies were included in the study. The tubes were inserted under topical anaesthesia and cure within one week was obtained in 73 per cent of ears. In another 9 per cent the otorrhoea stopped within 3 weeks, but in 18 per cent reinsertion of the tube became necessary and in this latter group 11 per cent resolved in two weeks following adenoidectomy as well. In 7 per cent the problem remained unresolved. Therefore with this regimen a total of 93 per cent of recurrent infections settled. It is emphasized that the ventilation tube should remain 'in situ' for over 3 months.

Acute Disease↗

Spinal cord compression caused by a metastatic lesion from an aortic body tumour.

An aortic body tumour in a 7-year-old wire-haired fox terrier with hind limb ataxia is described. A metastatic lesion in the dorsal arch of the eighth thoracic vertebra caused compression of the spinal cord. Radiographic techniques are discussed that enabled the position and extent of the primary tumour and its metastasis to be defined and allowed a provisional diagnosis of chemodectoma.

Animals↗

Surface tonsillar microflora versus deep tonsillar microflora in recurrent acute tonsillitis.

One hundred patients suffering from recurrent acute tonsillitis were studied. One hundred tonsils were cultured. Surface bacteria were compared to deep bacteria. In 48 per cent of the cases a different pathogen was cultured from the interior of the tonsil as compared to the surface culture. This fact may explain recurrence of tonsillitis and makes the reliability of the conventional tonsillar culture questionable. Surgical extirpation of the tonsils seems to be the only treatment since deep bacteria remain unidentified and resist the antibiotic therapy that may affect only the surface microflora.

Acute Disease↗