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Biomedical subjects

S Beasley

Publications and source records attributed to S Beasley.

11 recordsLinked to original sources
PubMed2001

The potential for improvement in outcome of children with intussusception in the South Island.

AIMS: To review the experience in the South Island to predict the extent to which the outcome in intussusception might be expected to improve by the introduction of management guidelines and access to a regional specialist paediatric surgical service. METHODS: Children with intussusception treated in the South Island during an eleven year period until 1998 were identified from hospital coding systems, the Southern RegionalHealth Authority and from departmental audit programmes. Details of management and outcome were analysed. RESULTS: Data proved difficult to obtain. There were 83 children identified with intussusception confirmed on enema or at surgery; 76 had an enema that was successful in 44. Delayed repeat enema and gas enema techniques were not used as frequently as might be expected. The operative rate was higher than that reported by other centres. CONCLUSIONS: Current data, coding and audit systems have significant short comings, which limit availability of reliable outcome data. Increased awareness of the expanded indications for enema reduction, use of air (rather than barium) and delayed repeat enemas, and access to specialist paediatric surgical involvement appears to increase the nonoperative rate. Implementation of guidelines for the management of intussusception might be expected to reduce by more than half the number of children undergoing surgery for this condition in the South Island.

Barium Sulfate↗
PubMed2001

The effect of neck flexion on oesophageal tension in the pig and its relevance to repaired oesophageal atresia.

The indications for postoperative ventilation and paralysis with neck flexion after repair of oesophageal atresia (OA) have been controversial, mainly because of a paucity of information on oesophageal compliance and the influence of posture on anastomotic tension. This study using a pig model demonstrates that 78.8% of oesophageal lengthening occurs between full flexion and the neutral position, contributing to an increase in oesophageal length of about 9%. Compliance of the oesophagus is a linear function of the natural log of the tension applied. These data imply that any postural change (e.g., head and neck flexion) that allows the oesophagus to shorten may produce an exponential reduction in the tension and suggest that the manoeuvre may be appropriate in long-gap OA where there is considerable tension across the oesophageal anastomosis.

Animals↗
PubMed2001

Structure of Thermotoga maritima stationary phase survival protein SurE: a novel acid phosphatase.

BACKGROUND: The rpoS, nlpD, pcm, and surE genes are among many whose expression is induced during the stationary phase of bacterial growth. rpoS codes for the stationary-phase RNA polymerase sigma subunit, and nlpD codes for a lipoprotein. The pcm gene product repairs damaged proteins by converting the atypical isoaspartyl residues back to L-aspartyls. The physiological and biochemical functions of surE are unknown, but its importance in stress is supported by the duplication of the surE gene in E. coli subjected to high-temperature growth. The pcm and surE genes are highly conserved in bacteria, archaea, and plants. RESULTS: The structure of SurE from Thermotoga maritima was determined at 2.0 A. The SurE monomer is composed of two domains; a conserved N-terminal domain, a Rossman fold, and a C-terminal oligomerization domain, a new fold. Monomers form a dimer that assembles into a tetramer. Biochemical analysis suggests that SurE is an acid phosphatase, with an optimum pH of 5.5-6.2. The active site was identified in the N-terminal domain through analysis of conserved residues. Structure-based site-directed point mutations abolished phosphatase activity. T. maritima SurE intra- and intersubunit salt bridges were identified that may explain the SurE thermostability. CONCLUSIONS: The structure of SurE provided information about the protein's fold, oligomeric state, and active site. The protein possessed magnesium-dependent acid phosphatase activity, but the physiologically relevant substrate(s) remains to be identified. The importance of three of the assigned active site residues in catalysis was confirmed by site-directed mutagenesis.

Amino Acid Sequence↗
PubMed2000

Oesophageal atresia in twins.

The twin incidence is higher in infants with oesophageal atresia (OA) than in the general population. The purpose of this study was to review the twin OA information from five institutions and evaluate possible links between the development of OA and the twinning process. Data were compared, combined, and analysed. There was a total of 1,215 infants with OA, of whom 50 were from a twin pregnancy and 1 from a triplet pregnancy. Two sets of twins were concordant for OA. Mean birth weights and gestational ages were lower in the twin infants (P < 0.0005) and survival was lower in twins (65%, P < 0.005) than singletons. The anatomical variant of pure OA without fistula was seen in proportionally fewer twins (4%) than in singletons (7%). Multiple anomalies were present in 40% of twins compared with 33% of singletons, although this did not reach statistical significance. OA in our multicentre population was more common in twins. Several possible mechanisms are put forward to explain the apparent link between twinning and OA. Further analysis of this aspect of OA may aid in understanding the aetiology of this congenital anomaly.

Esophageal Atresia↗
PubMed2000

Clarification of the process of separation of the cloaca into rectum and urogenital sinus in the rat embryo.

BACKGROUND/PURPOSE: The normal process of division of the cloaca into a rectum and urogenital tract is still not fully understood. The main controversies relate to how the urorectal septum (URS) divides the cloaca and whether the URS fuses with the cloacal membrane. This study used a 3-dimensional reconstruction technique, combined with histologic correlation, to observe the developmental and septational processes of the cloaca of the normal rat embryo from gestational days 11 to 16. METHODS: Normal rat embryos from gestational days 11 to 16 were sectioned serially both transversely and sagittally and stained with H&E. 3-dimensional reconstructions were performed on embryos younger than day 13.5. The relevant structures were examined in a temporo-spatial sequence. RESULTS: The tailgut started to regress by apoptosis on day 12 in a cranio-caudal direction. The URS, first evident in day-12.5 embryos, extended and fused with the cloacal membrane on day 15 of gestation, completing the separation of the cloaca into rectum and bladder. Regression of the tailgut and ventral protrusion of the urogenital sinus markedly changed the configuration of the cloaca. The cloacal membrane did not break down until after it had fused with the URS. CONCLUSIONS: These findings clarify the relative contributions made by active septation of the cloaca by the URS and configurational changes of the cloaca to produce a rectum and bladder. The URS fuses with the cloacal membrane before the anal and urogenital membranes break down.

Animals↗
PubMed1999

Limitations of percutaneous endoscopic gastrostomy in facilitating enteral nutrition in children: review of the shortcomings of a new technique.

Percutaneous endoscopic gastrostomy (PEG) insertion became the preferred technique for facilitating enteral nutrition in children unable to take adequate caloric intake orally once its advantages over the standard Stamm gastrostomy became apparent. It has taken longer for some of its limitations and shortcomings to be recognized. Problems encountered during PEG insertion include: inability to enter the stomach with the trocar, oesophageal laceration, colonic perforation, gastro-colo-cutaneous fistula, peritonitis, subcutaneous emphysema, external migration of inner flange, wound infection, peristomal excoriation, symptomatic gastro-oesophageal reflux requiring later fundoplication, intestinal obstruction and haemorrhage. Many of these complications can be avoided by attention to technique.

Child↗
PubMed1987

Congenital prepubic sinus: possible variant of dorsal urethral duplication (Stephens type 2).

We report on 3 patients with a midline sinus extending from the skin overlying the pubis to the anterior wall of the bladder. Two sinuses were lined by transitional epithelium. The sinuses were surrounded by bundles of smooth muscle and lacked any inflammatory reaction, which suggests a developmental origin. Possible etiological causes for this unusual congenital anomaly are discussed. We conclude that these sinuses may represent a variant of epispadiac duplication of the urethra.

Abdominal Muscles↗