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Biomedical subjects

R Severijnen

Publications and source records attributed to R Severijnen.

9 recordsLinked to original sources
PubMed2002

The origin of hydrogen sulfide in a newborn with sulfhaemoglobin induced cyanosis.

This report investigated the origin of H(2)S in a newborn boy with sulfhaemoglobin induced cyanosis, who died because of multiple organ failure. Frozen material was collected and studied after death. The results suggest that enzymes had been released from deteriorating organs into the blood and abdominal fluid, and that the reaction of one of these enzymes with sulfur containing amino acids might have resulted in increased H(2)S concentrations. It is hypothesised that this release of enzymes resulted from a haemolysin produced by an invasive haemolytic Escherichia coli that was found in the blood and organs of this patient.

Cyanosis↗
PubMed2000

Lactobacilli and acidosis in children with short small bowel.

BACKGROUND: In patients with a short small bowel, D-lactic acidemia and D-lactic aciduria are caused by intestinal lactobacilli. The purpose of this study was to obtain a detailed picture of the metabolic acidosis in young children with short small bowel. METHODS: Feces, blood, and urine of children with short small bowel and acidosis were studied microbiologically and/or biochemically. RESULTS: Previous findings were confirmed that more than 60% of the fecal flora of patients with small short bowel, who are not receiving antibiotics, consists of lactic acid-producing lactobacilli. In blood, D-lactic acid was the most prominent metabolite: the highest serum D-lactate (15.5 mmol/l) was observed in a sample taken immediately after the onset of hyperventilation. The highest D-lactate excretion was in urine collected some hours after the onset of hyperventilation, and amounted to 59 mol/mol creatinine. Acidosis in the patients with short small bowel was related to strongly increased serum D-lactate and anion gap and to strongly decreased serum bicarbonate and pH. CONCLUSION: In children with small short bowel and acidosis, the common intestinal flora of mainly lactobacilli abundantly produces D-lactic acid from easily fermentable carbohydrates. Thus, these bacteria directly cause shifts of bicarbonate, pH, and base excess and indirectly cause shifts of the anion gap, as well as hyperventilation. These kinetic parameters are strongly associated.

Acidosis↗
PubMed1995

D-lactic acidemia and aciduria in pediatric and adult patients with short bowel syndrome.

D-Lactate produced by abundant intestinal lactobacilli during acidotic episodes in short bowel (SB) patients is commonly regarded as a main factor in the pathogenesis of SB syndrome-associated (D-lactic) acidosis. Since we had observed that gram-positive bacteria, mainly lactobacilli, were abundant even in the absence of acidosis, we studied serum concentrations and urinary excretions of D- and L-lactate in young and adult SB patients, especially during nonacidotic periods. Serum L-lactate and urinary L-lactate excretion were similar in adults and children. Serum D-lactate and urinary D-lactate excretion were higher in SB children than in SB adults. Food consumption affects D-lactate production and alters D-lactic acidemia and aciduria. We conclude that D-lactate is frequently present in serum of SB patients even in the absence of acidosis. High serum concentrations and urinary excretions may reflect dietary factors in these patients.

Acidosis, Lactic↗
PubMed1993

[2 children with stridor and a thymus in the posterior mediastinum].

Two infants are described with an inspiratory and expiratory stridor with apnea. X-ray examination showed a mass in the posterior mediastinum. For this reason both infants underwent a diagnostic thoracotomy because detailed study didn't resolve the problem. An aberrant localized thymus was found in both infants. In both infants, however, the complaints persisted after the operation. Both infants needed a second operation to relieve the stridor, which appeared to be due to (primary and secondary) tracheomalacia. This article describes shortly the embryology of the abnormally located thymus. The possibilities to diagnose a posterior mediastinal mass without thoracotomy are also described. Using magnetic resonance imaging (MRI), the posterior located thymus can be diagnosed noninvasively in most cases. The aberrantly positioned thymus should be included in the differential diagnosis of a posterior mediastinal mass, otherwise invasive methods are needed to come to the good diagnosis.

Apnea↗
PubMed1991

Chronic relapsing pancreatitis in childhood.

As a result of our experience and a review of the literature, early investigation by endoscopic retrograde cholangiopancreaticography (ERCP) and surgical intervention is recommended in chronic relapsing pancreatitis in childhood.

Adolescent↗
PubMed1989

Total colonic aganglionosis: treatment and follow-up.

We reviewed the problems during diagnosis and therapy of 11 patients with total colonic aganglionosis. Better knowledge of the clinical picture and greater alertness for the occurrence of this disease has led to an earlier diagnosis. Definitive operative therapy is still controversial. After ileostomy, a crucial point seems to be the allowance of sufficient time for the small bowel to adapt its absorptive ability. Little seems to be gained by performing a difficult procedure, such as Martin's operation, which involves the risk of serious complications. Our experience confirms that a standard Hirschsprung's operation is, in general, satisfactory. At present (mean follow-up 6.7 years), all our patients show normal growth and development, have no serious peri-anal problems, and are (with one exception) continent for faeces.

Child↗
PubMed1989

Rectal prolapse in children.

Rectal prolapse in children is nowadays a rare anomaly. Potty training in young children is the common cause and the resulting prolapse can be treated conservatively. In children with refractory prolapse, sclerosing injections may be used. Operative treatment by posterior rectopexy is only indicated in the very few cases of long-standing prolapse.

Adolescent↗
PubMed1986

Totally implantable systems for intravenous drug delivery. Experiences in children with cancer.

A totally implanted system for central venous access--consisting of a subcutaneous injection port, connected to a silastic catheter positioned into the superior caval vein--has been utilised in 17 children with cancer treated by aggressive chemotherapy regimens. This preliminary study over a 1 1/2-year period suggests that such devices may represent an improvement over currently available techniques of prolonged venous access, and are suitable for children as well. The device has proved to be a reliable, safe, convenient and effective method for delivering drugs, antibiotics, blood products, nutritional and other intravenous fluids. In 3881 patient days no serious complications have occurred. The complications encountered must be considered as starting problems of this device in the paediatric age group. These problems have been solved. Continuous infusion therapy lasted up to 122 consecutive days without skin problems. The system has the advantage of simplicity of positioning, use and maintenance. It facilitates ambulatory anticancer treatment.

Adolescent↗