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Biomedical subjects

R Reif

Publications and source records attributed to R Reif.

At least 19 recordsLinked to original sources

[Immunomodulation of recurrent urinary tract infections with Urvakol vaccine].

The authors present the results of the URVAKOL vaccine use in clinical practice. The vaccine was administered in the treatment of recurrent cystitis, persistent lower urinary tract infection, chronic pyelonephritis and prostatovesiculitis. The clinical efficacy of the vaccine was assessed by detection of bacteria and leukocytes in the urine, subjective complaints, skin tests and the assessment of selected specific and nonspecific immunity parameters in the urine and saliva. Significantly positive clinical and laboratory responses were observed in patients with uncomplicated cystitis. In the group of persistent urinary tract infections excellent responses were detected in one half of the patients. The remainder half stated disappearance of subjective complaints, but with persistence of pyuria or bacteriuria. Similar results of "improvement" were observed in 10 patients with chronic pyelonephritis. There were no changes of the clinical state observed in patients with chronic prostatitis. (Tab. 5, Fig. 2, Ref. 7.)

Adult↗

[Surgical treatment of hydronephrosis].

The objective of the study was to find the most suitable method of surgery of primary hydronephrosis and congestive horseshoe kidney, based on the authors own experience. The result was the finding that plastic resection operations according to Anderson-Hynes and flap operations in long stenoses and horseshoe kidneys meet the demands which are the prerequisite of favourable therapeutic results.

Adult↗

Chorioamnionitis caused by gram-negative bacteria as an etiologic factor in preterm birth.

The role and microbiological causes of infection and inflammation of the chorioamnion were studied in 85 patients with spontaneous preterm deliveries (< 37 weeks) and in 85 control patients with full term deliveries. Microorganisms were isolated from the freshly separated chorioamnion in 55% of preterm and 26% of term deliveries (p < 0.001). Isolation rates of gram-negative enteric bacteria were significantly higher in preterm deliveries than in term deliveries (p < 0.001), whereas differences in the isolation of other bacterial species were not significant. Histological chorioamnionitis was noted in 49% of preterm and 14% of term deliveries (p < 0.001), and was strongly associated with a positive chorioamniotic culture in both groups (p < 0.001). Histological chorioamnionitis was noted in 94%, 54%, and 4% of membranes with gram-negative rods, other microbial species and negative cultures, respectively (p < 0.001). Preterm deliveries were also associated with significantly higher rates of bacterial vaginosis (38% vs. 14%) and isolation of vaginal pathogens (85% vs. 65%). In the case of the majority (88%) of chorioamniotic isolates the same species was isolated in the vagina. The findings suggest that gram-negative enteric rods are important placental pathogens responsible for sub-clinical chorioamnionitis and possibly preterm birth. The findings support the concept that microorganisms ascending from the lower genital tract produce local inflammation, which may result in preterm labour and delivery.

Amnion↗

Neurotoxicity after spinal anaesthesia induced by serial intrathecal injections of magnesium sulphate. An experimental study in a rat model.

We have previously demonstrated in a rat model that the lumbar intrathecal injection of 0.02 ml 6.3% magnesium sulphate, a concentration iso-osmolar with rat plasma, produces a state of spinal anaesthesia and general sedation which reversed completely after 6 h, without evidence of neurotoxicity, immediately or during the week thereafter. Using the same model and five groups of six animals in each, we administered the same volume and concentration of magnesium sulphate and compared its clinical effects with those of 0.02 ml 12.6% magnesium sulphate, 0.02 ml 2% lignocaine and 0.02 ml 0.9% sodium chloride solution, given as a series of 15 injections on alternate days for a period of 1 month. The animals were then killed and their spinal cords and meninges examined histologically. No significant differences were noted in the times of onset, durations of sensory and motor blockade and the times to full recovery throughout the entire period of 1 month's observation in the animals receiving intrathecal 6.3% magnesium sulphate. In the group receiving 12.6% magnesium sulphate, the time of onset of sensory and motor blockade was shorter and the duration of both parameters was significantly longer than in the former group. Full clinical recovery and resumption of normal eating and drinking took place in both groups throughout the entire series of 15 successive intrathecal injections. Identical, mild, uniform histopathological changes in the spinal cord were seen in all the five groups, including the group in which only the intrathecal catheter was implanted. The complete recovery and benign consequences of repeated intrathecal injections of iso-osmolar magnesium sulphate in a rat model indicate a lack of neurotoxicity and provide an impetus for further trials in larger animal species, before initial clinical trials of this substance, given intrathecally, in humans.

Anesthesia, Spinal↗

Gastric Mucosal Changes following Gastroplasty: A Comparative Study Between Vertical Banded Gastroplasty and Silastic Ring Vertical Gastroplasty.

BACKGROUND: Long-term changes of gastric mucosa following surgery for morbid obesity have never been studied, to the best of our knowledge. As 31 patients in our series presented with various gastrointestinal complaints following surgery, we used this opportunity to study mucosal changes. METHODS: Thirty-seven gastroscopies were performed on 31 patients, 20 patients following Vertical Banded Gastroplasty (VBG) and 11 patients following Silastic Ring Vertical Gastroplasty (SRVG) with various gastrointestinal complaints. Macroscopic appearance of the gastric mucosa was examined and biopsies taken from the proximal gastric pouch, the transitional zone and distal stomach. RESULTS: In most patients, macroscopic appearance of the proximal and distal pouches was normal. Pathological findings were mainly located in the transitional zone and were found mainly in the VBG group. CONCLUSIONS: This study indicates that damage to the gastric mucosa is related to the surgical technique, and mainly to the strip of mesh used in the VBG patients. Since hyperplasia and metaplasia were among the microscopic findings, a question is raised about the possibility of malignant transformation. We suggest that routine post-operative gastroscopies be considered, especially following VBG.

Journal Article↗

A comparison of various methods for cooling the kidney.

Various methods for achieving preoperative renal hypothermia were tested and evaluated. A kidney immersed in an oil bath solution at 4 degrees C resulted in the highest rate of contact hyperthermia at a determined safe temperature of cooling medium. The acquired basic temperature curve served as a model for the comparison of other methods tested. The results showed that perfusion hypothermia is most rapid but this method is limited by the number and state of the renal arteries and displays all the risks associated with cannulation of arteries. Covering the kidney with crushed ice led to a sufficiently rapid decrease in temperature but lack of regulation carries the danger of renal damage caused by excessive temperature reduction. The disadvantages of these methods were eliminated using a device developed and tested by the authors.

Humans↗

Kidney temperature measurement. Thermistors for temperature measurement.

During a study of the protective effects of cold on kidney cells under conditions of interrupted blood circulation, it was found that attention must be paid to the temperature of kidney tissue in order to prevent cell damage caused by an excessively reduced temperature. The authors correspondingly developed an instrument for the measurement of kidney tissue temperature where thermal sensors located in a needle are able to measure deep temperature in live tissue under conditions of external hypothermia. Thermal sensors were also placed in a hypothermal coil for contact measurement of surface temperature of a cooled kidney and in a duct for supply of cooling medium into a coil. Construction of these devices is described and basic the characteristics of the thermistor and thermocouple sensors for temperature measurement are presented. After evaluation of advantages of the tested sensors, indications regarding their application are given.

Body Temperature↗

A revised instrument for the regulated external cooling of the kidney.

The authors describe the instrument they have developed for the regulated external cooling of the kidney. This consists of a cooling thermostat fitted with a circulating pump, coils of their own construction for the surface cooling of the kidney and equipped with sensors for the measurement of kidney surface temperature, tube connectors, and a sensor for the measurement of the cooling medium temperature. A cooling liquid is supplied by means of a circulating pump from a thermostat through elastic tubes into the flow channels of the cooling coils. The temperature of the coolant is recorded by means of a thermistor sensor built into the system of tubes while the temperature of the kidney surface itself is monitored by a sensor installed in a coil. This permits the regulation of both the rate and depth of temperature reduction in order to prevent possible damage to the kidney caused by excessive temperature reduction. The efficiency and safety of this instrument were verified both experimentally and clinically.

Body Temperature↗

A revised coil for the external cooling of the kidney.

The authors describe a coil they have developed for contact peroperative hypothermia of the kidney. This new type of coil eliminates the disadvantages of existing cooling coils, namely slow thermal transfer from kidney to cooling agent due to imperfect contact between the coil and the concave surface of the kidney, use of an inadequately conductive material and thermal losses from the outer surface of the coil. Special features of the coil described here include its construction to match the contours of the kidney, isolation of external shell to reduce thermal losses and continuous monitoring of renal tissue to reduce the danger of overcooling.

Body Temperature↗

Protection of kidney cell against ischaemic damage by decreased kidney temperature.

At normal body temperature, kidney cells are highly sensitive to hypoxia. However, a bloodless operative field is advantageous in some interventions on the kidney. Kidney cells can be protected against the damage that might occur once blood flow has been interrupted pharmacologically or physically by reducing their temperature. The authors compare several methods for achieving renal hypothermia, including a method based on a device they developed themselves to eliminate defects found in existing equipment. The thermal curve obtained when the kidney is immersed in an oil bath cooled to 5 degrees C served as a model for other methods. Using the revised coil developed by the authors, renal hypothermia was achieved safely and efficiently. A combination of pharmacological and physiological methods is preferrable however in order to potentiate the effect of decreased temperature. This method was tested experimentally and then successfully applied in clinical practice.

Body Temperature↗

Priapism: a urological emergency.

The authors describe their experience obtained in the treatment of 25 patients with priapism. The results are analysed on the basis of recent physiological concepts and immediate surgery is recommended. Priapism is a urological emergency and requires urgent treatment. The method commonly used at their clinic is described.

Adolescent↗

Miliary Crohn's disease: early or different?

We describe what we take to be the eighth case of miliary Crohn's disease since 1967 with a view to the possibility that miliary Crohn's disease is a disease different from Crohn's disease, and not just an early stage. Miliary Crohn's disease might be a different disease because (a) miliary tubercles are seen so rarely on the serosal surface of the bowel, (b) the 100% chance of finding crowded, typical granulomas in the bowel wall, and (c) the anatomic distribution of the lesion.

Adolescent↗

[Gallbladder polyps].

There is a relatively high incidence of asymptomatic gallbladder polyps in the general population (1.5-9.5%). We present a 61-year-old woman who had a 22 x 37 mm polyp of the gallbladder.

Female↗

[Desmoid tumors].

Desmoid tumors in various anatomic sites were treated in 4 females and 3 males, ranging in age from 16-50 years, during a 6-year period. In 5 the tumor was completely excised with free margins. In the other 2 excision was incomplete and the tumor recurred within a few months. Desmoid tumors have a marked tendency to local recurrence, and therefore should be widely excised. There is no evidence that adjuvant therapy has a place in the management of these tumors.

Adolescent↗

Intraosseous neurilemmoma of skull--single case report.

Intraosseous neurilemmoma is a rare benign tumour of the bone with characteristic radiological and histological features. The most common places of this tumor are mandible, sacrum and vertebral bodies. A case of a not previously reported location of this tumor in the vault of the skull is presented.

Biopsy↗

[Presystolic increasing maximal flow velocity in the intracranial vessels in 3 children with heart failure].

The doppler-sonographic examination of flow velocities in intracerebral arteries is of central importance in the diagnostic evaluation of potential neurologic complications in intensive care patients. Furthermore pulsed Doppler-sonography can assess the hemodynamic consequences of several congenital heart defects (e.g. the ductus arteriosus Botalli). Characteristics of the normal flow profile in the intracranial arteries are the systolic and diastolic forward flow caused by the "Windkessel" function of the aorta. Well known pathologic flow profiles (systolically and diastolically increased flow velocities, diastolically decreased flow velocities and diastolic retrograde flow) occur in neurologic and cardiovascular diseases. We have investigated three children after cardiac surgery, who showed a presystolic increase in the flow velocities, which is clearly different from the flow profiles mentioned above. In our opinion, this abnormal flow pattern is due to a decreased ventricular output in combination with an elevated central venous pressure in these patients.

Aortic Valve Stenosis↗