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Biomedical subjects

R J Goris

Publications and source records attributed to R J Goris.

At least 19 recordsLinked to original sources
PubMed1992

Superoxide dismutase and catalase in an experimental model of multiple organ failure.

Multiple organ failure (MOF) can be induced by sterile intraperitoneal injection of zymosan in the rat. This results in a typical triphasic illness with maximal clinical signs at Days 2 and 12. In this model, superoxide production and lipid peroxidation closely correlate with the triphasic clinical illness. In the present experiment we studied the effect of albumin conjugated superoxide dismutase (SOD) and catalase (CAT) on lipid peroxidation and organ damage in the acute phase (Days 1 and 2). Lipid peroxidation in plasma was significantly decreased by SOD and CAT but clinical condition, mortality, and organ damage did not improve. We conclude that oxygen radical damage is not a key factor in the pathogenesis of the acute phase of multiple organ failure.

Animals↗
PubMed1992

Collagen synthetic capacity throughout the uninjured and anastomosed intestinal wall.

The capacity to synthesize collagen was measured throughout the intestinal tract of the rat, using an in vitro technique. In addition, the effect of anastomotic construction in either the ileum or the colon on collagen synthetic capacity at specific distant locations both 1 and 4 days after operation was investigated. Collagen synthetic capacity is relatively uniform throughout the large bowel. However, in the small bowel in which synthesis is lower than in the large bowel, synthesis is significantly higher in the most proximal and distal segments than in the intermediate tissue. Anastomotic construction in either part of the bowel strongly increases collagen synthetic capacity at the immediate wound site. The synthetic response is not restricted to the anastomotic site but appears to be more generalized and is, in the small bowel, to some extent specific for collagen since the collagen synthetic capacity is increased far more than the capacity to produce noncollagenous protein. Anastomotic construction in the colon has only minor, although sometimes significant, effects on collagen synthetic capacity in the ileum, and vice versa.

Anastomosis, Surgical↗
PubMed1992

Scoring systems for predicting outcome in acute hemorrhagic necrotizing pancreatitis.

Five scoring systems for predicting the severity and outcome of acute haemorrhagic necrotizing pancreatitis were retrospectively evaluated in 39 patients. The respective scores were Ranson, Imrie, APACHE II, multiple organ failure (MOF) and Sepsis Sensitivity Score (SSS). Twenty-two (56%) of the patients died. The survivors were significantly younger than the non-survivors, 68% of whom died within 3 weeks of admission to the intensive care unit. Stay in the unit was significantly longer in the former group. Sensitivity in prediction of death was best with APACHE II score greater than 9 (96%) and Ranson score greater than or equal to 3 (95%). Of the five scores, MOF greater than or equal to 4 gave the best equilibration between sensitivity (73%) and specificity (76%) and the strongest prediction of lethal outcome (80%). Although the independent factor age had low sensitivity (55%), it showed the highest values for specificity (88%) and prediction of death (86%). APACHE II scoring is concluded to be best for grading the severity of disease on admission to intensive care, while the MOF score is best for monitoring the degree of organ dysfunction and the intensity of supportive treatment.

Acute Disease↗
PubMed1992

Evaluation of infectious diabetic foot complications with indium-111-labeled human nonspecific immunoglobulin G.

Osteomyelitis of the foot is a well-known complication of diabetes mellitus. In this study, the validity of 111In-labeled human nonspecific immunoglobulin G (IgG) scintigraphy was studied in 16 diabetic patients with foot ulcers, gangrene or painful Charcot joints. In all patients, plain radiographs, conventional bone scan images and 111In-IgG images were recorded. The results were verified by histologic examination of surgical specimens in patients who did not respond to antibiotic treatment within 2-3 wk (10 lesions) or long-term clinical follow-up of at least 6-mo (16 lesions). On the bone scans, all seven osteomyelitic foci were detected. However, 19 additional foci not due to osteomyelitis were seen. The absence of true-negative bone scans in this study resulted in a specificity of 0%. On the plain radiographs, four of seven osteomyelitis foci were detected; for 111In-IgG scintigraphy, six of seven (sensitivity 57% and 86%, respectively). Plain radiographs correctly ruled out osteomyelitis in 15 of 19 lesions, 111In-IgG scintigraphy in 16 of 19 (specificity 79% and 84%, respectively). All imaging procedures gave false-positive results in penetrating ulcers over the calcaneus in two patients and in one patient with a Charcot joint, most likely due to recent fractures. A false-negative 111In-IgG study was observed in a patient with severe arterial angiopathy. Accurate estimation of probable osteomyelitis was not possible from the results of soft-tissue cultures, since in only 6 of 12 positive cultures, osteomyelitic foci could be proven. Indium-111-IgG scintigraphy can contribute to adequate evaluation of osteomyelitis in diabetic foot complications because it improves specificity when compared to bone scan and radiographic findings and improves sensitivity in comparison to plain radiographs.

Adult↗
PubMed1991

Does selective decontamination of the gastrointestinal tract prevent multiple organ failure? An experimental study.

Gut bacteria have been incriminated as causing or contributing to generalized sepsis with multiple organ failure in severely ill patients, and selective decontamination of the gastrointestinal tract of Enterobacteriaceae has been claimed to decrease septic complications in these patients. We studied the effects of selective decontamination of the gastrointestinal tract on survival and organ function in an experimental model of sepsis with multiple organ failure. Wistar rats were inoculated intraperitoneally with zymosan and randomized into control or treatment groups (trimethoprim or streptomycin sulfate). Selective decontamination effectively prevented bacterial translocation of Enterobacteriaceae. However, only early mortality was decreased, and only so in the streptomycin-treated rats. Selective decontamination did not result in a significantly better condition of the surviving animals on day 12.

Animals↗
PubMed1991

Bronchial suction by minitracheotomy as an effective measure against sputum retention.

Bronchial suction by means of a minitracheostomy is a new method for treatment of sputum retention and related pulmonary diseases. Through a small coniotomy, a specially designed cannula is inserted into the trachea, allowing frequent bronchial suction. The effectiveness of this method was prospectively analyzed in 74 consecutive patients and the results were compared with those reported in the literature. The operative procedure for insertion of the Minitracheotomy cannula caused nonlethal bleeding in three patients who were receiving anticoagulant medications. Thirty-eight of 43 patients treated on the intensive care ward were detubated and dismissed at an earlier stage than usual because of a minitracheostomy. The method failed in two comatose patients and in one patient with a laryngeal tumor. The method was effective in 18 patients who had serious pulmonary disease postoperatively. Thirteen patients at high risk for pulmonary infections, in whom the cannula had been prophylactically applied after extensive operations, did not have postoperative pulmonary complications. Over-all, the median period for bronchial suction was 4.0 days; decannulation followed on average 4.7 days later. No complications were caused by the presence of the cannula and the device was well tolerated by the patients.

Adolescent↗
PubMed1991

Timing of osteosynthesis of major fractures in patients with severe brain injury.

A retrospective study was performed to assess the effects on outcome of early osteosynthesis of major extremity fractures in patients with severe brain injury (GCS less than or equal to 7). In a consecutive series of 58 patients, early osteosynthesis was performed on the day of injury in 15 patients. (Group A). In 43 patients no major fractures were present or no early osteosynthesis was performed (Group B). The severity of brain injury as seen on CT scan was similar in both groups. Mortality was significantly lower in Group A, despite a significantly higher ISS. As to the functional end result of brain injury, an indication of a better outcome was present in Group A.

Adolescent↗
PubMed1990

[The clinical symptoms in post-traumatic dystrophy].

The clinical signs and symptoms in 441 patients with post-traumatic dystrophy were recorded. This form of dystrophy occurred three times as often in females as in males and twice as often in the arms as in the legs. In 5% of the patients the first symptom is a cold extremity; these patients run a greater risk of major sequelae. Exacerbation of the symptoms under influence of muscular exercise proved to be an important prognostic factor. A large proportion of the referred patients proved to have undergone a treatment aimed at elimination of the sympathetic nervous system, without success. Post-traumatic dystrophy can impede all structures and functions of the affected extremity and may result in major sequelae and disablement. The pseudoparalysis of the later phase may be mistaken for conversion.

Adolescent↗
PubMed1990

Mediators of multiple organ failure.

Multiple Organ Failure (MOF) has largely been attributed to bacterial sepsis, though conclusive evidence of an essential role for bacteria and/or their endotoxins is still lacking. On the other hand, MOF and the clinical syndrome of sepsis may be aseptically induced in germ-free animals. This paper reviews the evidence that excessive activation of endogenous humoral mediators and inflammatory cells may cause this highly lethal syndrome.

Complement Activation↗