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Biomedical subjects

C Rudolph

Publications and source records attributed to C Rudolph.

At least 37 records · Page 2Linked to original sources
PubMed1991

Anuria following reduction of a giant omphalocoele in a neonate: an unusual complication.

Giant omphalocoele in the neonate is a challenging surgical emergency and requires individualized approaches to operative repair. Post-operative complications and associated congenital anomalies still continue to exert a high morbidity and mortality in spite of intensive and improved post-operative care. This case report describes an unusual mechanism which produced anuria in a neonate immediately after operative reduction of a giant omphalocoele. In retrospect, this complication was related to the unique anatomy of the neonate and the type of closure utilized.

Anuria↗
PubMed1990

[Electromyographic and manometric studies of the antrum and duodenal motility in rabbits under the influence of pentagastrin in a mechanical duodenal passage disorder].

The influence of a mechanical disturbance of the duodenum on the motility of the antrum and duodenum was investigated by means of the electromyography and the perfusion manometry. Thereby the effect of the pentagastrin stimulating the motility of the unstriated muscles of the gastro-intestinal tract was used for testing the function reserve of the antrum- and duodenal-muscles. After one and a half month of establishing the passage obstacle there occurs a complex disturbance of the electrical activity; the unstriated muscles does not react on a stimulating excitation.

Animals↗
PubMed1990

[The dynamics of the microbial count in experimentally-induced salmonellosis of calves].

Numerical developments of pathogens were followed up in intestinal matter, mucosa, and lymph nodes as well as in spleen and liver of calves which had been orally infected with Salmonella (S.) dublin or S. typhimurium. Massive flooding of the organism with Salmonellae and eventually fatal proliferation were found to be possible immediately after infection or after some days of pathogen-host equilibrium. Complete elimination of Salmonellae was found to be achievable even after infestation of spleen and liver. Intestinal lymph nodes, in addition to intestinal mucosa and intestinal matter, proved to be of decisive relevance to pathogenesis of the infection and to persistence of germs.

Animals↗
PubMed1990

Interhospital referral of high-risk newborns in a rural regional perinatal program.

In light of increased competition for patients among hospitals, a trend toward deregionalization for perinatal programs and expansion of level II hospital neonatal intensive care services has been noted. This study investigates the determinants of the decision to transport very low birthweight (VLBW) babies born live at primary care community hospitals to a regional tertiary NICU or to a level II hospital in a semirural regional perinatal program. Data were collected from medical records of mothers and their newborns at 18 level I hospitals (primary care only), three level II hospitals (intermediate care), and the one tertiary hospital in the region. The sample includes all newborns with birthweights between 500 g and 1750 g born in 1983 (299). Despite dramatic increases in the proportion of very low birthweight deliveries at the tertiary center in the past decade, one third of the VLBW babies continue to be delivered at community hospitals in the study region. Although 25% of all transports from level I are to level II hospitals rather than to the level III hospital, birthweight and need for assisted ventilation were statistically significant determinants of transport of newborns from level I to level III hospitals rather than to a level II hospital. While both level I and level II hospitals are likely to transport newborns who need assisted ventilation to the level III hospital, the odds of transport are significantly higher for newborns born at level I as opposed to level II hospitals. Nontransported babies who were born at very low birthweight (less than 1000 g) died within 24 hours. The nontransported babies who survived had birthweights of greater than 1000 g, and fewer required assisted ventilation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Effect of Ca2+ entry blockers on myosin light-chain kinase and protein kinase C.

Thirteen Ca2+ entry blockers were compared with respect to their inhibitory effects on the activity of smooth muscle myosin light-chain kinase and smooth muscle protein kinase C, and the Ca2+-induced contraction of basilar artery rings. Comparison of the IC50 values obtained for these compounds, suggests that with the exception of ferdiline inhibition of the enzymes does not contribute to vascular smooth muscle relaxation.

Animals↗
PubMed1988

Pharmacokinetics of fentanyl in neonatal humans and lambs: effects of age.

To determine whether the clearance of fentanyl in neonates varies with age, the authors determined the pharmacokinetics of fentanyl in 14 humans ages 1-71 days and 15 lambs ages 3-37 days. In humans, fentanyl, 54.1 +/- 2.3 (mean +/- SD) micrograms/kg, was administered as a 2-min iv infusion; in lambs, fentanyl, 50 micrograms/kg, was administered as an iv bolus. Ventilation was controlled to maintain end-tidal or arterial PCO2 normal, and potent inhaled anesthetics were not administered; in humans, additional anesthesia was provided with iv morphine. Arterial or venous samples were obtained for 12 h, and plasma concentrations of fentanyl were determined by radioimmunoassay. Plasma concentration versus time data were fitted to two- and three-compartment pharmacokinetic models, and clearance, volume of distribution at steady-state (Vdss), and elimination half-life were determined. Clearance increased with age in both humans and lambs. Two humans who had intraabdominal surgery had no clearance of fentanyl: plasma concentrations of fentanyl remained constant for approximately 10 h after an initial distribution phase. In lambs, but not in humans, Vdss increased with age; elimination half-life did not change with age in either lambs or humans. The authors conclude that at least two factors--postnatal age and the type of surgery--affect fentanyl clearance during the neonatal period. The effect of other factors, such as inhaled anesthetics, remains to be determined.

Aging↗
PubMed1988

[Balloon valvuloplasty in mitral stenosis. Hemodynamic results, influencing factors and comparison with surgical procedures].

Percutaneous transluminal valvuloplasty for mitral stenosis represents an alternative to surgical treatment. The reported increases in valve orifice area vary with values from 0.6 to 2.03 cm2 over a wide range. This study was undertaken to evaluate our own results and to determine if factors could be identified which may exert an influence on the outcome of the procedure. Additionally, to evaluate this new method of treatment, the pressure-flow relationship at rest and during exercise after valvuloplasty was compared with that observed after mitral valve commissurotomy or mitral valve replacement. In 25 patients with moderately-severe to severe mitral stenosis, mean age 56 +/- 11 years, mean valve orifice area 1.1 +/- 0.37 cm2, 52% with preexistent regurgitation, antegrade percutaneous, transvalvular valvuloplasty was carried out. Diagnostic catheterization was performed immediately prior to and after the procedure. Two concurrent groups of patients were analyzed for the purpose of comparison: 26 consecutive patients who underwent mitral valve commissurotomy with a comparable valve orifice area of 1.13 +/- 0.39 cm2 of whom 31% had a regurgitant component; and 37 consecutive patients who had valve replacement mostly with a Björk-Shiley prosthesis (M 29, 31, 33), mean age 52 +/- 8 years, comparable valve orifice area of 1.1 +/- 0.37 cm2 and a regurgitant component in 65%. Dilatation of the valve was carried out after transseptal catheterization with the use of an 8F Mullins sheath introducing a 7F balloon-tipped catheter (Critikon) via the left atrium, the left ventricle and into the descending aorta through which a 300 cm long 0.035" guidewire was advanced. By means of a retrieval catheter introduced via the femoral artery into the descending aorta, the guidewire was exteriorated via the femoral artery. After dilatation of the septum with a 9F dilatation catheter with a balloon of 8 mm diameter, a 10F or 12F dilatation catheter (Trefoil 3 X 12 mm or Bifoil 2 X 19 mm) (Schneider-Shiley) was advanced transseptally and the balloons positioned at the level of the mitral valve. The balloons were inflated with a pressure averaging 3.6 + 0.65 atmospheres (2-4.7 atm) and a mean duration of 27 +/- 8 s (16 to 45 s) on the average 3.9 +/- 1.6 times (1 to 9X) until disappearance or widening of the hour-glass waist of the balloon.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1987

Phosphorylation of the purified receptor for calcium channel blockers by cAMP kinase and protein kinase C.

The dihydropyridine receptor purified from rabbit skeletal muscle contains three proteins of 165, 55 and 32 kDa. cAMP kinase and protein kinase C phosphorylate the 165-kDa and the 55-kDa proteins. At identical concentrations of each protein kinase, cAMP kinase phosphorylates the 165-kDa protein faster than the 55-kDa protein. Protein kinase C phosphorylates preferentially the 55-kDa protein. cAMP kinase incorporates up to 1.6 mol phosphate/mol protein into the 165-kDa protein and 1 mol/mol into the 55-kDa protein upon prolonged incubation. At a physiological concentration of cAMP kinase 1 mol phosphate is incorporated/mol 165-kDa protein within 10 min, suggesting a physiological role of this phosphorylation. Protein kinase C incorporates up to 1 mol phosphate/mol into the 55-kDa protein and less than 1 mol/mol into the 165-kDa protein. Tryptic phosphopeptide analysis reveals that cAMP kinase phosphorylates two distinct peptides in the 165-kDa protein, whereas protein kinase C phosphorylates a single peptide in the 165-kDa protein. cAMP kinase and protein kinase C phosphorylate three and two peptides in the 55-kDa protein, respectively. Mixtures of the tryptic phosphopeptides derived from the 165-kDa and 55-kDa proteins elute according to the composite of the two elution profiles. These results suggest that the 165-kDa protein, which contains the binding sites for each class of calcium channel blockers and the basic calcium-conducting structure, is a specific substrate for cAMP kinase. The 55-kDa protein apparently contains sites preferentially phosphorylated by protein kinase C.

Animals↗
PubMed1986

Dysphagia lusorum in children.

The association of difficulty in swallowing and an aberrant right subclavian artery is termed dysphagia lusorum. Dysphagia lusorum has been reported not to occur in children. We describe four children who had difficulty swallowing and aberrant right subclavian arteries. Esophageal manometry showed high pulsatile pressure in the area of the aberrant right subclavian artery in each child (12 to 100 mm Hg). Three of the four children underwent surgical correction, and their symptoms resolved. Postoperatively, esophageal manometric findings were normal. We conclude that dysphagia lusorum occurs in children and esophageal manometry shows persistently increased intraesophageal pressure, causing a functional partial obstruction in symptomatic children with dysphagia lusorum.

Cardiac Catheterization↗
PubMed1986

Patterns of medical services utilization by infants discharged from a neonatal intensive care unit.

A decreasing neonatal mortality rate has increased the number of infants who survive their stay in a neonatal intensive care unit only to need continued medical care. Medical services utilization by families with high-risk infants has been widely studied, but research is sparse on high-risk infants who do not receive follow-up care through medical specialists' services or speciality clinics. After dividing medical services utilization into four patterns, ranging from use of only primary care to use of three kinds of medical services, the authors analyzed a set of predictors of utilization. The factors most likely to affect pattern of utilization significantly are related to health need and illness level. The infants with more serious medical conditions diagnosed at birth were found to use the most follow-up services. No effects of location of residence or social class were found, which suggests that families had no significant problems of access to medical care services for their infants in the defined region of the study.

Child Health Services↗