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Biomedical subjects

W Sonnabend

Publications and source records attributed to W Sonnabend.

8 recordsLinked to original sources
PubMed1979

[Effect of aerobic and anaerobic germs on the healing of decubitus ulcers].

Bacteriological examinations of decubitus ulcers were performed in 34 geriatric patients. A total of 179 wound swabs were analyzed for aerobic and anaerobic bacteria. The decubitus ulcers were divided into three groups according to wound healing: group A with progressive worsening, group B, stationary, and group C with healing within 10 weeks. The aerobic bacteria isolated from the three groups were significantly different (p less than 0.0001). In group A Pseudomonas aeruginosa was isolated in 88%, enterococci in 73% and Providentia in 34%, whereas in group B staphylococci were found in 69%, enterococci in 62% and E. coli in 32%. In group C staphylococci dominated with 91%, followed by enterococci (51%) and E. coli (25%). Anaerobic microorganisms were significantly (p less than 0.01) more frequent in decubitus ulcers with poor healing tendency (group A and B) than in healing ulcers (group C). These results suggest that bacterial growth on decubital ulcers significantly influences decubital ulcer healing. Furthermore, bacteriological examinations are of prognostic value and the results should be considered in treatment.

Aerobiosis↗
PubMed1978

[Transitory bacteremia in rectoscopy].

A prospective study was undertaken to determine the frequency of transient bacteremia on recto-sigmoidoscopy. Blood specimens were drawn for aerobic and anaerobic bacterial culture immediately before, and 1, 5, 10, 15, 20, 25 and 30 min after the beginning of recto-sigmoidoscopy. 19 blood cultures were supposed to be contaminated. In 3 patients (6%) a positive blood culture was found with the following types of organisms: enterococci, Escherichia coli and nonhemolytic streptococci. The need for antibiotic prophylaxis in patients with valvular heart diseases or prosthetic valves is discussed. In such cases the authors propose prophylaxis with 1 g streptomycin i.m. and 3 g ampicillin by mouth 30 min before recto-sigmoidoscopy.

Anti-Bacterial Agents↗
PubMed1978

[The enlarged diagnosis of the fatal penicillin accident. Immunehistologic demonstration of antigen-antibody complexes and of antibodies against the tubular basement membrane after administraiton of depot penicillin].

In a case of fatal penicillin allergy it proved possible at autopsy to demonstrate (by immunohistological examination of basal membranes of proximal renal tubuli) antigen-antibody complexes belonging to the penicillin (BPO) group and to an anti-penicilloyl antibody of the IgG type. In addition, complement C3 was detected. Antibodies against the basal membranes or renal tubuli were also demonstrated in material eluted from the kidney, although an inflammatory reaction ot the immunoligical changes had not yet been observed in light microscopy. It is undecided whether this discrepancy is due to the low dose of penicillin administered or the relatively short time lag between first injection and time of fatality. It is assumed that, pathogenetically, a reaction of the serum sickness type is probably involved. For etiological clarification the use of immunohistological methods in addition to serological procedures provides further indices for an antecedent sensitization to penicillin, because assay effectiveness does not decrease even after a lengthy postmortal time-lapse. On the other hand, tissues and serum for examination should be frozen at low temperatures immediately after autopsy.

Antigen-Antibody Complex↗
PubMed1977

[Clostridium infections with and without manifest gas gangrene. Report on 77 infections in 76 patients].

Systematic microbiological research and correlation of the histopathological findings obtained from random autopsies revealed 23 hitherto undetected clostridial infections including 11 cases of gas gangrene, 4 of septicemia, 3 of bacteremia, and 5 other clostridial infections. The knowledge gained from this study led to clinical diagnosis of several cases of gas gangrene which were confirmed bacteriologically and histologically. Of 8 hospital patients who were thus diagnosed in this surgical clinic, 7 recovered, including a case of gas gangrene of the abdominal wall. The problem in gas gangrene is timely clinical diagnosis. Little is known about gas edema illnesses which are not traumatically conditioned. Recognition of the local and general symptoms (local, violent, yet inappropriate pain in the wound, "unexplained" postoperative secondary bleeding, appearance of tachycardia wholly unrelated to the patient's temperature, sudden shock, rapid deterioration of patient's general condition, jaundice and rise in CPK) makes it possible to diagnose postoperative gas edema in time. 77 infections with isolation of clostridia, seen in 76 patients, are reported. On the basis of clinical and histopathological criteria they have been classified as follows: 22 cases with gas gangrene (clostridial myonecrosis), 16 cases with anaerobic cellulitis, 20 wound infections, 8 cases of septicemia, 5 of bacteriemia, 1 of tetanus, and 5 other clostridial infections.

Adolescent↗
PubMed1977

[A fatal food poisoning caused by bacillus cereus (author's transl)].

The autopsy of a 37 year old man who had died under extraordinary circumstances showed a bromatoxism by bacillus cereus. The verification of the bacillus was possible although the man had already died 2-3 days before; and that in spite of the existence of early beginning rottenness. With the help of morphological findings the pathogenetic effect of the toxins (exotoxin and enterotoxin) of bacillus cereus is discussed. Blood cultures of the heart alone are not sufficient to prove a causal connexion between infection and death. For this purpose bacteriological examination of the organs (liver, spleen, kidney, lungs and brain) is at the same time necessary. An aseptic method, which is described in detail, is the absolute condition for useful results. The forensic value of proof of the bacteriological examination is secured and improved by an additional verification of bacteria in histological specimen coloured by Gram.

Adult↗
PubMed1977

[Gas gangrene after abdominal surgery].

This is a report on nine cases of gas-gangrene which developped after abdominal surgery. In five patients the diagnosis was made at the bedside, three of these patients survived. Cardinal symptoms were rapid deterioration of the general condition, severe pain around the incision, tachycardia, and the appearance of jaundice along with a fall of the hemoglobin.

Abdomen↗
PubMed1975

Pattern of core and surface expression in liver tissue reflects state of specific immune response in hepatitis B.

A series of 67 liver biopsies (20 kidney transplant recipients and 47 outpatients with hepatitis) was investigated for the presence of hepatitis B antigen core (HBc) and surface (HBs) components by immunofluorescence and electron microscopy. The variable appearance of the core in liver cell nuclei and of the surface in the cytoplasm allowed the recognition of expression patterns which, together with histologic parameters, could be integrated into four reaction types of diagnostic and prognostic implications: Type I (Elimination Type). No components or only occasional expression of HBc; histologically, classic lobular hepatitis; clinically, acute, self-limited viral hepatitis. Type II (HBc Predominance, or Immunosuppression Type). Abundant core expression in each liver cell nucleus and moderate appearance of HBs; histologically, nonaggressive inflammation (nonspecific reactive or portal hepatitis); clinically, mild, chronic, persistent hepatitis in transplant patients. Type III (HBs Predominance, or Nonaggressive Type). Prominent HBs expression largely in the absence of HBc; histologically, nonaggressive inflammation (nonspecific reactive and portal hepatitis) or normal liver tissue, together with ground-glass hepatocytes in light microscopy, as a correlate of HBs-containing hepatocytes; clinically, hepatitis B antigen carrier, or chronic persistent hepatitis. Type IV (HBc+s Equivalence, or Aggressive Type). Spotty expression of both components, especially of core; histologically, periportal hepatitis; clinically, mainly corresponds to chronic aggressive hepatitis and to acute hepatitis with possible transition to chronicity. As a unifying concept for these types, it is suggested that immune responsiveness determines the reaction pattern, the key mechanism being immune elimination of affected cells. Between efficient elimination (type I) and effective immunosuppression (type II), a graded elimination insufficiency is found in chronic forms (types III and IV), explaining the persistence and probably also the aggressiveness of hepatitis B virus infection.

Acute Disease↗