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Biomedical subjects

H F Joubert

Publications and source records attributed to H F Joubert.

12 recordsLinked to original sources

Biochemical analysis of tunica vaginalis fluid in patients with or without idiopathic hydroceles.

OBJECTIVE: To establish the differences, if any, between the biochemical composition of idiopathic hydrocele fluid and the fluid normally present in the tunica vaginalis. PATIENTS AND METHODS: Aspiration and sclerotherapy of 37 idiopathic hydroceles from patients who presented to this urology clinic were performed. The biochemical content of the fluid was compared with that of the tunica vaginalis fluid from a small group of controls (n = 8), taken from patients undergoing orchidectomy for carcinoma of the prostate. RESULTS: Differences in several measurements were recorded; in particular, there were significantly higher concentrations of calcium, albumin, total protein and creatine-kinase in the hydrocele group. The levels of potassium, aspartate transaminase, alanine transaminase and alkaline phosphatase were significantly lower in the hydrocele group. CONCLUSION: Whether these differences have a role in the causation of an idiopathic hydrocele is, at this stage, speculative. A similar study on a larger scale would probably be more conclusive.

Albumins↗

Serum beta-2-microglobulin in the differential diagnosis of monoclonal gammopathies.

Serum beta-2-microglobulin (B2m) concentrations were determined in 43 southern African black patients with multiple myeloma (MM), in 130 black patients with monoclonal gammopathy of undetermined significance (MGUS) and in 70 control subjects. The results showed median values for serum B2m in patients with MM, MGUS and the control group to be 8.10 mg/l, 3.05 mg/l, and 2.35 mg/l, respectively; these values differed significantly from one another (P less than 0.01), even when patients with normal renal function (serum creatinine value less than 110 mumol/l) were considered separately. The median serum B2m concentration for IgG MM (22 cases) was 4.3 mg/l, for IgA MM (8 cases) 7.3 mg/l, and 24.2 mg/l for Bence Jones MM (12 cases). These differences were also significant (P = 0.001), but not in the restricted group of MM patients with normal renal function. In the 43 MM patients serum B2m concentrations had a significant positive correlation with serum creatinine (r = 0.706; P less than 0.005) and a significant negative correlation with haemoglobin values (r = -0.459; P = 0.006). In 28 MM patients with normal renal function, serum B2m values had a significant negative correlation with serum albumin (r = -0.602, P = 0.003). Sixty-five per cent of the 43 MM patients and 18.5% of the MGUS patients had raised serum B2m values (greater than 4.7 mg/l). An optimum cut-off value for serum B2m of 6.9 mg/l for differentiating MM from MGUS was determined using a classification rule. Despite lacking specificity, serum B2m measurement was useful in differentiating MM from MGUS, and was the best second choice variable in relation to serum albumin and haemoglobin in patients with normal renal function.

Creatinine↗

The effect of gamma-linolenic acid, an in vitro cytostatic substance contained in evening primrose oil, on primary liver cancer. A double-blind placebo controlled trial.

The cytostatic effects of essential fatty acid metabolic intermediates and of some prostaglandins and leukotrienes in vitro have been extensively documented. The essential fatty acids (EFAs) exhibit no side-effects when taken as a dietary supplement, even in large doses. Primary Liver Cancer (PLC) is a fatal disease in our area as it is always multifocal in nature. In vitro studies have shown a cytostatic effect of gamma-linolenic acid (GLA) on primary liver cancer cells. In a double-blind placebo controlled trial, using Evening Primrose Oil (as a source of GLA) as a dietary supplement in PLC patients, no statistically significant effect was observed on survival time or liver size. There was however a statistical significant beneficial effect on Gamma Glutamyl transferase values as a measure of liver function. No side-effects were observed. The large size of tumour and the low doses of GLA used in this trial probably explain the lack of significant effect on survival times.

Antineoplastic Agents↗

The rapid and sensitive diagnosis of tuberculous meningitis by the detection of tuberculostearic acid in cerebrospinal fluid using gas chromatography-mass spectrometry with selective ion monitoring.

Tuberculostearic acid (10-Methyloctadecanoic acid) is a lipid component of the mycobacterial cell wall and its presence in cerebrospinal fluid can serve as a diagnostic marker for tuberculous meningitis. Using gas chromatography-mass spectrometry with selective ion monitoring, tuberculostearic acid (TBSA) was detected in nine different mycobacterial reference strains. Analysis of derivatised cerebrospinal fluid specimens from 35 patients showed the presence of TBSA in 5/6 culture-positive samples and 0/19 negative control patients (diagnosed as bacterial or viral meningitis). In addition 4/10 clinically suspected cases of tuberculous meningitis showed the presence of TBSA in the absence of other confirmatory laboratory results. A routine method has been developed for the detection of TBSA, which allows the fast and sensitive diagnosis of tuberculous meningitis within 5 h of receiving the cerebrospinal fluid specimen, compared to the 3 to 8 weeks required to culture the bacteria.

Gas Chromatography-Mass Spectrometry↗

A comparison of health parameters in two different canine populations. Part II: Chemical pathology data.

Blood samples were collected on a random basis from 2 canine populations. A selection of serum enzymes, serum electrolytes, serum protein fractions and serum concentrations of iron, creatinine and urea were investigated in a population of kennelled dogs and a population of dogs from a rural township in a developing country. Significant differences between the 2 populations were found for 16 of the 26 constituents evaluated, although differences in variance and distribution made comparisons difficult for some of the tests. The dogs from the rural township had a low mean serum iron, a very low mean serum albumin and a very high mean serum gammaglobulin concentration compared to that of the kennelled dogs. It is postulated that these differences were caused by environmental factors of a biological, physical and social nature.

Animals↗

Neonatal maintenance solution--is neonatalyte safe?

Newborns in the neonatal unit at Ga-Rankuwa Hospital who required intravenous fluids were randomly allocated, after 24 hours of life, to receive either Neonatalyte (Sabax) or a control solution. Biochemical monitoring was performed every 12 hours for a period of 5 days. Neonatalyte does not cause hyperkalaemia or hypocalcaemia in the early neonatal period.

Calcium↗

The effect of a 1-deoxynojirimycin derivative on post-prandial blood glucose and insulin levels in healthy black and white volunteers.

BAY m1099 (a 1-deoxynojirimycin derivative) is a glucose analogue which is an alpha-glucosidase inhibitor. Its effects on post-prandial blood glucose and insulin levels was compared with a placebo in 12 healthy male volunteers (6 Blacks and 6 Whites). It produced a similar, significant depression of post-prandial blood glucose and insulin levels when the groups were assessed separately and when the data were pooled. Although blood insulin levels in Whites were higher than in Blacks, as previously reported, the difference was not statistically significant and did not appear to influence the response to the drug. BAY 1099 produced no objective or subjective untoward effects and appears to warrant further investigation as an adjuvant to dietary control of diabetes mellitus.

1-Deoxynojirimycin↗

The IgA immune system in epileptics on anticonvulsant therapy.

Disturbances in IgA have often been reported in white epileptics on anticonvulsant therapy. The clinical significance of these disorders is of interest as this aspect does not appear to have been sufficiently explored. In a previous study neither African nor Caucasian epileptics on treatment showed a deficiency of serum IgA. Since secretory IgA is the main defence factor in protecting mucosal surfaces, the object of the present study was simultaneously to determine serum and salivary IgA in suitable subjects and to monitor related clinical events. A similar elevation of salivary IgA level was found in Black and White epileptics on treatment. Clinical events were rare and were not related either to serum or secretory IgA concentrations. It is concluded that at present epileptics do not seem to require special immunological or clinical monitoring.

Epilepsy↗

IgA in epileptics receiving anticonvulsant therapy.

Epilepsy is a common disorder and requires long-term drug treatment. Epileptics on anticonvulsant therapy have often been reported to have a depressed immune system, especially an IgA deficiency. An association with clinical manifestations has not yet been clearly explored. So far investigations have been performed in Whites only. The objectives of this study were to assess if there is a racial difference in the immune response to anticonvulsants between Blacks and Whites and to establish the clinical significance of the IgA deficiency. Our results showed normal IgA values in Black and White epileptics on anticonvulsant therapy. This implies, at least at the present stage, that patients do not require immunological monitoring or protective measurements. Further studies including the determination of secretory IgA might help to explain the discrepancy between our findings and the literature and should provide deeper insight into the correlation between potential immune disturbances and clinical implications.

Adult↗