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Biomedical subjects

C J Uys

Publications and source records attributed to C J Uys.

At least 37 records · Page 2Linked to original sources

Morphological changes in 49 chacma baboons after cardiac allografts.

The morhpological changes in 49 chacma baboons after cardiac transplantation were studied by light and electron microscopy. Non-immunosuppressed grafts were tolerated for an average of 10 days and immunosuppressed grafts for 18 days. Serial biopsy specimens of non-immunosuppressed grafts showed a progression in severity of rejection changes. Electron microscopy mirrored the light microscopic changes. Rejection changes in the baboon appear similar to those encountered in human and canine allografts. Heterotopic transplants showed more severe grades of rejection than would be compatible with life in orthotopic transplants.

Animals↗

The pathology of human cardiac transplantation: an assessment after 11 years' experience at Groote Schuur Hospital.

Over a period of 11 years, commencing in December 1967, 31 cardiac transplants, 10 orthotopic and 21 heterotopic, were performed at Groote Schuur Hospital. Two patients with orthotopic transplants have a long survival, 1 for 7 1/2 and 1 for 9 1/2 years, and 1 with a heterotopic transplant for 4 years. Eighteen patients have died, and autopsy was performed from 13 to 623 days postoperatively. Rejection of the donor heart was found in 61,1% and was the cause of death in 44,4% of cases. Infection, attributable to immunosuppression, was a common finding and consisted of extensive pneumonia, usually due to Klebsiella aerogenes and Pseudomonas aeruginosa (38,8%), herpesvirus infection (38,8%), cytomegalic virus infection (37,5%), aspergillosis and other opportunistic infections. A combination of cardiac rejection and infection accounted for most of the deaths. The cardinal microscopic features of acute rejection were interstitial lymphocytic infiltration and myocytolysis, while chronic rejection was typified by obliterative myo-intimal proliferation of coronary arteries, with concurrent lipid deposition in the major coronary arteries. These lesions resembled atherosclerosis and caused graft failure due to myocardial ischaemia. Ultrastructurally, severe myofibre damage was reflected in extensive loss of cytoplasmic myofilaments. The advantages of heterotopic over orthotopic transplantation are discussed.

Adult↗

Fatal veno-occlusive disease of the liver after chemotherapy, whole-body irradiation and bone marrow transplantation for refractory acute leukaemia.

Rapid onset of liver failure with fatal outcome occurred in a young woman after successful bone marrow transplantation undertaken for refractory acute leukaemia. Centrilobular necrosis was demonstrated at autopsy and was attributed to prior cytotoxic chemotherapy, possibly potentiated by the total-body irradiation that was used in preparation for the transplant. This association between liver damage and prolonged drug therapy, coupled with the short median survival currently achieved within these chemotherapy regimens, has initiated an evaluation of bone marrow transplantation in patients with leukaemia during the first complete remission, rather than at a later stage when cumulative drug toxicity to the liver may have taken place.

Adolescent↗

Cutaneous leishmaniasis in Southern Africa. A case report.

The microscopical findings in a case of cutaneous leishmaniasis from South West Africa are presented in order to highlight the pathology of this disease and facilitate its recognition, should unsuspected cases occur in the Republic of South Africa. In addition, the ultrastructural findings confirm the presence of typical Leishmania which occur in the cytoplasm of macrophages where they are undergoing destruction. This adds a further dimension to the characterization of this disease in southern Africa.

Female↗

Q fever endocarditis: a report of 2 cases.

Two patients with Q fever endocarditis are described. Both patients demonstrated some of the characteristic features of Q fever endocarditis, i.e. the long course of the disease before diagnosis, persistently negative blood cultures, resistance to conventional antibiotic therapy and a dramatic response to tetracycline therapy. Complications included arteriovenous thrombo-embolism and hepatic enlargement, and 1 patient developed an immune complex form of glomerulonephritis. The possibility of Q fever endocarditis should be considered in all patients with infective endocarditis in whom blood cultures are negative and who fail to respond to conventional antibiotic therapy.

Adult↗

Evaluation of endomyocardial biopsy in the diagnosis of cardiac rejection. A study using bioptome samples of formalin-fixed tissue.

The reliability of endomyocardial bioptome samples in detecting cardiac rejection was assessed in 26 formalin-fixed previously transplanted hearts. Thirteen human donor hearts (mean postoperative survival 128 days) and 13 baboon donor hearts (mean survival 16.5 days) were studied. Twenty samples were taken under direct vision from the endomyocardium of each heart with an Olympus bioptome catheter. A total of 397 tissue samples was examined "blindly" histologically (177 human and 220 baboon). The bioptome samples were assigned a histological rejection score and then compared with the score accorded multiple tissue sections from the same heart. Sample scores agreed with tissue section scores as follows: humans 86% (samples showed more severe alterations in 5% and less severe in 9%) and baboons 57% (samples more severe in 40% and less severe in 3%). Only 2 false-negative samples were encountered among 285 tissue samples from hearts showing rejection. Changes of rejection were equally distributed between the left and right ventricles. Endomyocardial sampling proved an accurate means of detecting the presence of rejection. In the baboon hearts the endomyocardium tended to show more severe changes than the rest of the myocardium.

Animals↗

Carcinoma of the breast with metaplasia to chondrosarcoma: a light and electron microscopic study.

Two carcinomas of the breast containing large areas of sarcomatous tissue were studied by light and electron microscopy. In one of these, the sarcomatous element was frankly cartilaginous and in the other, predominantly myxoid but with small cartilaginous-looking foci. By light microscopy, a highly suggestive metaplastic transition could be traced from cells within the epithelial nests to those within the sarcomatous lobules. Ultrastructurally, cells in the former region showed epithelial characteristics and those in the latter region, mesenchymal and/or cartilaginous features. The carcinomatous cells contained desmosomes and formed intercellular spaces lined by microvilli; a few cells showed prominent profiles of rough endoplasmic reticulum. In the first case, the cells in the immediate vicinity of the epithelial nests and those in the fully developed cartilaginous regions showed a progressive dilatation of their endoplasmic reticulum to form large sac-like structures filled with a finely granular and floccular material. The intercellular matrix was electron lucent and contained scattered dense particles, fibrillo-granular material and collagen fibres. Condensation of this material at some distance from the cell resulted in the formation of lacunae. In the second case, the cells in the myxoid areas also showed prominent dilatation of endoplasmic reticulum.

Breast Neoplasms↗

Completed pregnancy following vascularized heterotopic autotransplantation of the Fallopian tube in the ewe.

Transplantation of the Fallopian tube is a technically feasible operation. Previous authors have reported pregnancies following turbo-ovarian transplants, but there appears to be no record of gestation following transplantation of the isolated oviduct. This communication illustrates the method that we have used to perform Fallopian tube transplants in the ewe and documents our first full-term pregnancy following this operation. It provides further evidence of the technical feasibility of Fallopian tube transplants.

Animals↗

Massive deposition of mineral oil after prolonged ingestion.

A patient in whom prolonged mineral oil (liquid paraffin) ingestion caused the deposition of this material in the small intestine, abdominal lymph nodes, the liver, spleen and lungs, is described. The results of chemical and histochemical identification of the isolated material are presented. A description of the gross and microscopic pathology is followed by a brief consideration of some aspects of the subject of mineral oil ingestion. Prolonged unrestricted ingestion of mineral oil is dangerous and may cause structural and functional abnormalities which lead to severe malnutrition and death.

Humans↗

The autopsy findings in a case of heterotopic cardiac transplantation with left ventricular bypass for ischaemic heart failure.

The autopsy findings in a White man aged 59 years are presented; he underwent heterotopic cardiac transplantation with left ventricular bypass for irreversible left ventricular failure caused by severe ischaemic heart disease. Microscopically, the donor heart showed mild signs of chronic rejection with negligible loss of functional myocardium, and no complications attributable to the surgical technique. Severe, generalised atherosclerosis had resulted in fibrous replacement of the recipient left ventricular myocardium and intra-operative atheromatous embolisation to the brain, the latter being the main contributory factor in the patient's death. Other significant findings were bilateral femoral vein thrombosis with recurrent pulmonary infarction, Aspergillus granulomata of the right lung, cytomegalovirus infection of lungs and oesophagus, Herpes simplex infection of the tongue and oesophagus, and duodenal ulceration with haemorrhage.

Arteriosclerosis↗

Renal transplantation in the unimmunosuppressed pig: an abnormal response.

A series of 82 kidney allografts and autografts in unimmunosuppressed pigs surviving for longer than 5 days has been compared with a previously reported series of 24 unimmunosuppressed pig kidney allografts. In the previous series 40 per cent survived for longer than 20 days. In the present series only 2 per cent of 55 transplants performed in cross-bred pigs obtained from different farms survived for longer than 20 days. The major causes of death were unrelated to rejection, prinicipally gastric ulcer bleeding. In the further 16 transplants between different pure-bred animals (thereby ensuring genetic disparity) the ulcer incidence was lowered by a gastro-enterostomy, and 12 per cent survived for longer than 20 days. Histological assessment of rejection in the latter group revealed 20 per cent with minimal rejection, was considered insufficient to account for the death of the animals. Based on the evaluation of 95 unimmunosuppressed pig kidney allografts in both series, it is concluded that a wide and unpredictable range of survival time occurs. Therefore the pig kidney allograft model is an unsatisfactory model in which to study immunosuppressive régimes. Also the unimmunosuppressed pig appears to show less evidence of kidney allograft rejection than the dog, irrespective of genetic disparity. It is tentatively suggested that this might be a lesser manifestation of the unexplained phenomenon of minimal rejection of liver allografts noted in unimmunosuppressed pigs.

Animals↗