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Biomedical subjects

S Cywes

Publications and source records attributed to S Cywes.

At least 109 records · Page 6Linked to original sources
PubMed1983

The use of radionuclides in the investigation of conjoined twins.

Three sets of thoraco-omphalopagous conjoined twins were investigated. The clinical findings indicated a complex shared heart in two sets, and separate cardiovascular systems in the other. These assessments were confirmed by dynamic imaging after bolus injection of Tc-99m(Sn)colloid or Tc-99m millimicrospheres. Static images were then used to establish the configurations of the shared livers. The results of these studies were in keeping with the angiographic and autopsy findings in the two sets with complex cardiac anomalies and with the surgical findings during successful separation of the third set.

Heart Defects, Congenital↗
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

Tracheal agenesis.

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Abnormalities, Multiple↗
PubMed1982

Jan Hendrik Louw.

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General Surgery↗
PubMed1981

Suppurative mesenteric lymphadenitis in children. Case reports.

Suppurative mesenteric lymphadenitis is so rarely encountered and its symptoms and findings so nonspecific tht it has not yet been diagnosed preoperatively. It seems to occur mainly in children between the ages of 3 and 13 years and presents in a manner suggestive of acute appendicitis. A palpable mass may further support this diagnosis (peri-appendiceal abscess) or encourage the consideration of other diagnoses such as lymphoma or inflammatory bowel disease. Even at laparotomy the diagnosis may not be immediately obvious. The organism is usually a haemolytic streptococcus, but a variety of other organisms have also been isolated. In the second case reported here, a pure growth of Staphylococcus aureus was obtained. Treatment consists of operative drainage with incidental appendicectomy followed by a course of the appropriate antibiotic. The postoperative course is usually uneventful and recovery rapid. The aetiology and mechanisms still have to be explained.

Abdominal Muscles↗
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

The physically handicapped child--is active management justified?

Deformities can either be congenital in origin or acquired after an accident or particularly after extensive surgery for malignant disease. Many congenital anomalies, especially if associated with Down syndrome, or when major residual handicaps are anticipated, raise the ethical question of whether or not to treat them initially. The effect of major handicaps on the child, family and society are discussed. Certain congenital anomalies can now be prevented by amniocentesis and termination of pregnancy in the high-risk group, and some of the acquired deformities can also be prevented to a certain extent. Lastly, some aspects of the legal situation are mentioned.

Congenital Abnormalities↗
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↗