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Biomedical subjects

R J Sharp

Publications and source records attributed to R J Sharp.

53 records · Page 3Linked to original sources
PubMed1987

Neonatal genital reconstruction.

It is evident from studies of boys who suffered a surgical catastrophe at a young age and were then assigned a female sex role that cultural and environmental influence are a potent determinant of a child's gender identity. It is imperative that parents have their child's sex assignment firmly fixed in their minds as early as possible. Early surgical correction of a child with ambiguous genitalia to conform to the sex of assignment will serve greatly to reinforce appropriate behavior in the parent. Such surgical intervention for diagnostic and reconstructive purposes is both desirable and safe in the first weeks of life.

Disorders of Sex Development↗
PubMed1987

Care of infants with esophageal atresia, tracheoesophageal fistula, and associated anomalies.

One hundred consecutive patients with esophageal atresia or tracheoesophageal fistula, or both, were treated at The Children's Mercy Hospital during the past 14 years. Each patient was evaluated and a plan for therapy was formulated depending on the type and urgency of concomitant disease. Healthy patients were treated by primary repair. Those with respiratory disease were treated before repair by gastrostomy, upper pouch suction, and antibiotics. In the small premature infant and the patient with major associated anomalies, repair of the esophageal atresia and tracheoesophageal fistula was postponed by gastrostomy, upper pouch suction, and parenteral nutrition while the concomitant disease was treated. Fifteen patients with life-threatening associated anomalies required operation before esophageal repair and 13 of them survived. During the initial hospitalization two deaths related to esophageal atresia occurred, whereas three prerepair and two late (2 1/2 and 3 months) postrepair deaths related to associated anomalies occurred. Thus, 93 of the 100 patients left the hospital alive. The increased survival is due not only to improved care of esophageal atresia and tracheoesophageal fistula, but also to a more aggressive approach to the treatment of the serious associated anomalies.

Abnormalities, Multiple↗
PubMed1986

Isolation and preliminary taxonomic studies of Thermus strains isolated from Yellowstone National Park, USA.

Forty-eight strains of Thermus isolated from hot springs in Yellowstone National Park, Wyoming, USA, and eight reference strains were subjected to a numerical taxonomic analysis using Gower's coefficient (SG) with single and average linkage clustering. Two major groups were distinguished, which could be differentiated by colony morphology, ability to reduce nitrate and proteolytic activity. Cluster 1 contained Thermus aquaticus YT-1, the type strain of the species, and cluster 2 contained authentic strains of 'T. flavus' and 'T. thermophilus'. T. ruber was recovered as a single member cluster. The mol % G + C of DNA from representative strains from each cluster was 64.4 to 66.8 for cluster 1, 62.2 to 67.1 for cluster 2 and 62.5 for T. ruber.

Base Composition↗
PubMed1986

The isolation and characterization of bacteriophages infecting obligately thermophilic strains of Bacillus.

Twenty-four thermophilic bacteriophages have been isolated from diverse sources such as compost, soil, silage and rotting straw. Although considerable individual host specificity was observed, the phages were able to infect most of the major taxonomic groups of Bacillus thermophiles. The phages varied considerably in morphology and size; the phage heads were either cylindrical or polyhedral with tails varying in length between 15 and 500 nm. Most of the phages were stable at 50 degrees C for 4-5 h but at 70 degrees C the plaque-forming units decreased by between 10(2)- and 10(7)-fold in 2 h. The DNA of morphologically similar phages was examined by restriction enzyme analysis, and some differences in the DNA fragment patterns were found. Efficiency of plating data indicated that 'B. caldotenax' has a restriction and modification system. These phages may be valuable for the study of the genetics of thermophilic bacilli: transduction of 'B. caldotenax' and 'B. caldovelox' by phage JS017 has been observed.

Bacteriophages↗
PubMed1985

Incidence of Plasmids in Thermus spp. Isolated in Yellowstone National Park.

Forty-eight strains of Thermus spp. were isolated from thermal sites in Yellowstone National Park, Wyo., and 62.5% showed evidence of plasmid DNA. Attempts to assign function to the plasmid DNA were unsuccessful, and the presence of plasmid DNA could not be correlated with antibiotic or heavy metal resistance. A number of these cryptic plasmids are now being investigated for their potential as vectors for molecular cloning in Thermus spp.

Journal Article↗
PubMed1984

The Thal fundoplication for gastroesophageal reflux.

The technique of anterior fundoplication for gastroesophageal reflux originally described by Alan Thal has been used in our institution in 605 patients. The description of the technique is the purpose of this paper. A brief description of the results in these 605 patients are also presented.

Esophagus↗
PubMed1984

Ureteropelvic junction obstruction in the newborn.

Ureteropelvic junction (UPJ) obstruction is a common cause of hydronephrosis in infants. Newborns with severe obstruction often have marked improvement following correction; therefore early diagnosis and operation is important. From 1973 to 1983, 21 patients were operated on for UPJ obstruction diagnosed under 6 weeks of age. Six patients (29%) had antenatal ultrasonographic diagnosis. The remaining patients were diagnosed by IVP or radionuclide scan for palpable renal enlargment or for associated anomalies. Seventeen had unilateral and four had bilateral obstruction. Twenty-three pyeloplasties, one primary nephrectomy, and one cutaneous pyelostomy with subsequent nephrectomy were done. All pyeloplasties were dismembered, with tailoring of the renal pelvis. Postoperative renal function was followed with radionuclide scan or IVP. Postoperative complications included a single urinary tract infection in three patients and two bowel obstructions. One early postoperative death occurred in an infant with bilateral obstruction who developed congestive heart failure secondary to severe uncontrollable hypertension. There were two other unrelated late deaths. Documented functional improvement with minimal complications follow unilateral or simultaneous bilateral pyeloplasty in newborns with UPJ obstruction.

Female↗
PubMed1983

Diagnosis and treatment of right Bochdalek hernia associated with group B streptococcal pneumonia and sepsis in the neonate.

Neonatal sepsis due to group B beta-hemolytic Streptococcus (GBS) is reported to occur in about 1 out of 330 live births. Right-sided Bochdalek hernia (RBH) occurs in about 1 of 20,000 live births. The combination of group B streptococcal sepsis and delayed appearance of a right Bochdalek hernia is an infrequently reported phenomenon--18 patients have been previously reported in the English literature. We add four patients from our own experience to these previous reports. Since approximately 10% to 15% of the newborn population are exposed to group B Streptococcus we suspect that the inadequate diaphragmatic motion on the side of the Bochdalek hernia predisposes the child to development of septicemia and/or pneumonitis. Once the etiology has been established and appropriate antibiotic therapy instituted, progressive improvement in the patient's course should be seen. This is in contrast to a very significant mortality rate in many of the patients having early onset GBS. Any child, therefore, surviving early onset GBS only to deteriorate again, should be suspected of having an associated right Bochdalek hernia, and diagnostic steps should be taken to evaluate the integrity of the right diaphragm.

Female↗
PubMed1980

Phenotypic and genotypic characterization of some thermophilic species of Bacillus.

Some thermophilic species of Bacillus were characterized using biochemical tests, antibiotic sensitivity, bacteriocin and bacteriophage sensitivity, esterase patterns, DNA hybridization and % G+C content. The three caldo-active strains of bacilli isolated by Heinen (1971) were compared with strains of B. stearothermophilus. Eight of the strains examined showed characteristics which enabled them to be placed in the three main taxonomic groups suggested by Walker & Wolf (1971). Two strains showed characteristics of both groups 1 and 3. Examination of genotype data showed taxonomic groupings which differed from those based on phenotypic characterization.

Anti-Bacterial Agents↗
PubMedDate not supplied

A polyphasic taxonomic study of thermophilic bacilli from a wide geographical area.

Two hundred and thirty-four thermophilic Bacillus strains isolated from geographically widespread locations were examined by phenotypic characterisation followed by numerical analysis. The strains were distributed between eighteen cluster-groups which were subsequently evaluated in DNA base composition and DNA sequence homology studies. The inclusion of type and reference strains unambiguously identified strains related to B. licheniformis, B. pallidus, B. smithii, B. stearothermophilus, B. thermocloacae and B. thermoglucosidasius. Other reference strains included in distinctive groups were 'B. caldotenax', together with 'B. caldovelox' and 'B. caldolyticus', B. kaustophilus and 'B. thermodenitrificans'. An emended description of B. kaustophilus is provided. It is proposed that 'B. caldotenax' and 'B. thermodenitrificans' should be accepted as validly described species. Members of other clusters that appeared to have distinctive characteristics, including beta-glucanase production and the ability to degrade tyrosine, may provide the nuclei of further novel species.

Bacillus↗
PubMedDate not supplied

The training implications of day-case surgery.

The marked increase in the use of day surgery has major implications for the provision of surgical training. It is essential that day surgery units be used effectively for surgical training. We identify current constraints on such training and suggest methods for improvement.

Ambulatory Surgical Procedures↗