Generation of small bowel mucosa

Following massive bowel resection, the characteristic features of a 'short bowel' syndrome develop. Some patients respond to medical treatment but may succumb later to the effects of deficient absorption. Some surgical procedures devised for delaying transit through the bowel, are mentioned.The patient lacks absorptive surface of the bowel. Experiments performed on mongrel dogs to produce generation of mucosa and the results obtained, are described. Further experiments were carried out to show that this generated mucosa has absorptive capacity

Progress in paediatric gastro-enterology

Some of the greatest advances in paediatric surgery have been in the field of paediatric gastro-enterology. Progress in some of these conditions is discussed

Binding of Mycobacterium tuberculosis to complement receptor type 3 expressed in mammalian cells : dependence on serum opsonins

Nonopsonic invasion of mononuclear phagocytes by Mycobacterium tuberculosis (M. tb.) is likely important in the establishment of a primary infection in the lung. M. tb. binds to a variety of phagocyte receptors, of which the mannose receptor and the complement receptor type 3 (CR3) may support nonopsonic binding. CR3, a β₂ integrin, is a target for diverse intracellular pathogens, but its role in nonopsonic binding remains uncertain. We have examined the binding of M. tb. to human CR3 heterologously expressed in Chinese hamster ovary (CHO) cells, thereby circumventing the problems of competing receptors and endogenously synthesised complement, which are inherent in studies with mononuclear phagocytes. The surface expression and functional activity of CR3 were confirmed by rosetting with beads coupled to anti-CR3 monoclonal antibodies (MAbs) and with C3bi-coated microspheres, respectively. We found thatM. tb. binds 4-7-fold more avidly to CR3- expressing CHO cells than to wild-type cells, and importantly, that this binding is very similar in the presence of fresh or heat-inactivated human or bovine sera, or no serum. The binding of M. tb. to the transfected CHO cells is CR3-specific, as it is inhibited by anti-CDllb and anti-CD18 MAbs; interestingly, binding is not inhibited by a MAb (2LPM19c) specific for the C3bi-binding site on CDI lb. Electron micrographs of infected CR3-expressing CHO cells reveal the presence of intracellular bacteria enclosed in well-defined, membrane-bound vacuoles. We conclude that the binding of M. tb. to CR3 is nonopsonic and that the organism likely expresses a ligand that directly binds to CR3

Pyogenic abdominal wall and psoas abscesses in children

No Abstract

Sarcoma Botryoides of the vagina

No Abstrac

Poly-N-Acetylglucosamine Expression by Wild-Type Yersinia pestis Is Maximal at Mammalian, Not Flea, Temperatures

Numerous bacteria, including Yersinia pestis, express the poly-N-acetylglucosamine (PNAG) surface carbohydrate, a major component of biofilms often associated with a specific appearance of colonies on Congo red agar. Biofilm formation and PNAG synthesis by Y. pestis have been reported to be maximal at 21 to 28°C or “flea temperatures,” facilitating the regurgitation of Y. pestis into a mammalian host during feeding, but production is diminished at 37°C and thus presumed to be decreased during mammalian infection. Most studies of PNAG expression and biofilm formation by Y. pestis have used a low-virulence derivative of strain KIM, designated KIM6+, that lacks the pCD1 virulence plasmid, and an isogenic mutant without the pigmentation locus, which contains the hemin storage genes that encode PNAG biosynthetic proteins. Using confocal microscopy, fluorescence-activated cell sorter analysis and growth on Congo red agar, we confirmed prior findings regarding PNAG production with the KIM6+ strain. However, we found that fully virulent wild-type (WT) strains KIM and CO92 had maximal PNAG expression at 37°C, with lower PNAG production at 28°C both in broth medium and on Congo red agar plates. Notably, the typical dark colony morphology appearing on Congo red agar was maintained at 28°C, indicating that this phenotype is not associated with PNAG expression in WT Y. pestis. Extracts of WT sylvatic Y. pestis strains from the Russian Federation confirmed the maximal expression of PNAG at 37°C. PNAG production by WT Y. pestis is maximal at mammalian and not insect vector temperatures, suggesting that this factor may have a role during mammalian infection

A Genetical study of Hirschsprung's disease

No Abstract

Paediatric surgery in the RSA - practice and training

A survey of the current practice 'of general paediatric surgery in South Africa and Namibia was conducted by tneans of a postal questionnaire. One hundred and eighty-one replies were obtained (52%).Analysis showed that although surgeons are located predominantly in the major cities, 18% practised in the larger towns or rural areas. Although paediatric surgery represents a small volume of their work, most surgeons do attend to the surgical needs of children. The majority of surgeons have received some paediatric surgical training but this was considered inadequate by nearly half of all surgeons and by 60% of those who qualified in the last 10 years.Current postgraduate training at most of our universities involves a 3 - 6-month rotation, but from our survey this is considered insufficient in practice and there appears to have been some deterioration in paediatric surgical training in recent years. Steps needed to maintain paediatric surgical standards are discussed

Childhood near-drowning - a 12-year retrospective review

The epidemiological findings in 107 patients admitted to Red Cross War Memorial Children's Hospital, Cape Town, between 1976 and 1987 with a diagnosis of near-drowning are reported. Of these patients, 77% were less than. 5 years of age (ratio of boys to girls 2,1: 1) and 46% of accidents occurred In swimming pools, 18% in buckets and only 9% in the sea. The high percentage of bucket near-drownings is unique in published medical reports; this appears prevalent in socially disadvantaged communities. Seventy-six per cent of the children were normal on discharge from hospital, 12% died and 6% had neurological damage. In 6% the final outcome was not known. These results are in keeping with other hospital-based studies. Preventive strategies' are discussed and the need for further research highlighted