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Biomedical subjects

D F du Toit

Publications and source records attributed to D F du Toit.

At least 19 recordsLinked to original sources
PubMed2006

Surgical treatment of comminuted, displaced fractures of the greater tuberosity of the proximal humerus: a new technique of double-row suture-anchor fixation and long-term results.

Conventional techniques of internal fixation of displaced fractures of the greater tuberosity may be insufficient in presence of comminution. A new surgical technique of internal fixation using a double-row of suture-anchors is described. Long-term results of this technique are evaluated in 21 patients with an isolated, displaced and comminuted greater tuberosity fracture at an average of 3.5 years (range 1-5 years) after surgery. The average age of the patients in the study was 51 years (range 17-93 years). Twenty fractures healed without post-operative displacement. The result was rated as excellent in 8, good in 10, satisfactory in 2 and unsatisfactory in 1 patient. Post-operative bicipital impingement in two patients and reaction to fixation material in one patient resulted in persistent, severe pain in the rehabilitation period, necessitating additional surgery.

Adolescent↗
PubMed2005

Morphology of the human internal vertebral venous plexus: a cadaver study after latex injection in the 21-25-week fetus.

The morphology of the anterior and posterior internal vertebral venous plexus (IVVP) in human fetuses between 21-25 weeks of gestational age is described. The results are compared to the findings of a previous morphological study of the IVVP in the aged. The morphological pattern of the anterior IVVP in the fetus is very similar with the anterior IVVP in the aged human. In contrast, the posterior IVVP in the fetus lacks the prominent transverse bridging veins that are present in the aged lower thoracic and the lumbar posterior IVVP. The background of these morphological differences is unclear. Maybe the thoracolumbar part of the posterior IVVP is subject to "developmental delay," or the observed differences in the aged may result from functional and age-related factors that trigger this part of the vertebral venous system during (erect) life. The observed age related morphological differences of the posterior IVVP support the concept of the venous origin of the spontaneous spinal epidural hematoma (SSEH).

Adult↗
PubMed2004

Heimlich manoeuvre: adjunctive emergency procedure to relieve choking and asphyxia.

Choking on aspirated food or a foreign body (i.e. meat, mushroom, coin, chewing gum and a balloon) is a common cause of laryngeal obstruction, particularly in those persons who are intoxicated by alcohol or who have bulbar palsy (degeneration of motor neurons in the brain stem nuclei of the glossopharyngeal and vagal nerve). The rima glottis in the larynx is an important site where aspirated food or material becomes lodged, thereby causing laryngeal obstruction (choking). Because the lungs still contain air, intentional compression thrusts to the abdomen (Heimlich manoeuvre) will theoretically expel air from the lungs and dislodge the entrapped food or other material. The manoeuvre can also be used to expel aspirated water from the airways in cases of near drowning. The manoeuvre has been found to be successful as an emergency adjunct measure in removing food blocking the airway.

Airway Obstruction↗
PubMed2004

Salivary glands: applied anatomy and clinical correlates.

The major salivary glands include the paired parotid, submandibular and sublingual glands. Salivary glands act as accessory digestive glands and produce a secretion referred to as saliva. Saliva has lubricating, cleansing, digestive and antimicrobial properties. The parotid is the largest salivary gland and saliva is secreted into the mouth via the parotid duct (Stensen's duct). The submandibular gland lies inferior to the body of the mandible and is susceptible to sialolithiases. Drainage is via the duct of the submandibular gland (Wharton's duct) into the floor of the mouth on either side of the lingual frenulum. The sublingual glands are situated under the mucosa in the floor of the mouth, on the sides of the tongue. These glands are in relationship to important nerves in the surrounding tissue. Disease processes such as chronic intraparenchymal sialolithiasis and neoplastic changes frequently mandate surgical removal of the underlying salivary gland. Detailed, applied knowledge of anatomy on a regional basis is required to avoid inadvertent nerve damage during surgery and resulting litigation.

Humans↗
PubMed2003

Endovascular management of traumatic cervicothoracic arteriovenous fistula.

BACKGROUND: This study evaluated a single-centre experience with endovascular repair of traumatic arteriovenous fistula in the cervicothoracic region. METHODS: Endovascular repair of 27 traumatic cervicothoracic arteriovenous fistulas was attempted between August 1998 and December 2001. Patients with active bleeding or end-organ ischaemia were excluded. Follow-up was accomplished with clinical, duplex Doppler and arteriographic evaluation after 1 month and then every 3 months. RESULTS: Twelve patients with a major vessel injury were treated by stent-graft placement. Vessels involved were the subclavian (eight), common carotid (three) and internal carotid (one) arteries. Subclavian artery side branches were embolized in three of the eight patients. Four patients developed early type 4 endoleaks but all resolved. Treatment with stent-grafts was ultimately successful in all 12 patients. Three patients were lost to follow-up. During mean follow-up of 21 (range 3-36) months, one of the remaining patients developed a graft stenosis. Fifteen patients with minor vessel injuries were treated with arterial embolization. Vessels embolized were subclavian artery branches (four), external carotid artery and branches (seven) and vertebral arteries (four). Successful embolization was accomplished in ten of 15 patients. CONCLUSION: Endovascular therapy is a promising alternative to surgery for selected patients with cervicothoracic arteriovenous fistula.

Adolescent↗
PubMed2003

Relevance of the pharyngotympanic tube.

The auditory (Eustachian) tube connects the middle ear with the nasopharynx. This conduit permits equalisation of pressure between the middle ear and the throat. Balanced pressure allows the eardrum to vibrate freely as sound waves strike it. The auditory tube is also a potential anatomical route whereby opportunistic pathogens may migrate from the nose and throat to the middle ear. Eustachian tube (ET) function is disturbed in children with cleft palate, thereby rendering them susceptible to chronic otitis media with effusion (OME) and temporary conductive deafness. ET obstruction follows in these patients, and is thought to be related to the inability of the tensor veli palatini (TVP) to function properly. This anatomical overview reviews the clinical importance of the ET in the normal population and children with cleft palate.

Cleft Palate↗
PubMed2003

The tongue: structure and function relevant to disease and oral health.

The tongue (L. lingua; G. glossa) functions as a digestive organ by facilitating the movement of food during mastication and assisting swallowing. Other important functions include speech and taste. The tongue consists of striated muscle and occupies the floor of the mouth. The dorsal mucosal surface consists of stratified squamous epithelium, with numerous papillae and taste buds. The tongue, a voluntary muscular structure, is attached by a fold, called the frenulum, to the floor of the mouth. Typically, between 8 and 12 circumvallate papillae are arranged in an inverted V-shape towards the base of the tongue. This anatomical review focuses on structure, function relationships and diseases affecting the tongue. From a primary oral health care perspective, this overview will facilitate the process of differential diagnosis in persons presenting with vesiculo-bullous, ulcerative, atrophic and cystic disorders of the tongue. Suspicious lesions should be biopsied to rule out carcinoma.

Humans↗
PubMed2001

Endovascular repair of occluded subclavian arteries following penetrating trauma.

PURPOSE: To describe the endovascular repair of 2 subclavian arteries occluded due to penetrating trauma. CASE REPORTS: Two male patients were admitted with zone-I neck stab wounds. Both were hemodynamically stable and had absent pulses in the ipsilateral upper limb with decreased Doppler pressures. There were no signs of critical ischemia or active bleeding. On arteriography, complete occlusion of the second segment of the left subclavian arteries in both patients was demonstrated. Stent-graft repair and embolectomy under local anesthesia were successfully performed. No procedure-related complications occurred, and both patients were discharged after 2 days. At 1-year follow-up, stent-graft patency was demonstrated in both patients. CONCLUSIONS: Endovascular repair is a feasible and safe option in the management of occluded subclavian arteries due to penetrating trauma. This may represent another indication for stent-grafting in the expanding role of this technique.

Adult↗
PubMed2000

Anatomical importance of infrarenal aortic branches in conventional and endovascular surgery: a review.

Minimally invasive or catheter-directed, endoluminal stent-graft treatment of abdominal aortic aneurysms (AAA) is a novel and important advance in the armamentarium of the vascular surgeon and interventional therapist. Provided adequate training is available, infrastructure is optimal, and patient selection correct, successful exclusion of AAA can safely and effectively be achieved with low morbidity and mortality by this lesser invasive technique. An important Achilles heel of endovascular repair (EVR) of AAA is back bleeding or endoleak formation due to incomplete sealing or bridging of aortic branches ostia by endoluminal stents. Significant, recurrent, and persistent retroleaks, a topic of clinical interest, are related to either incompletely sealed-off inferior mesenteric and/or lumbar arteries. The optimal method to diagnose and manage these endoleaks is currently in a state of evolution. In the process of stent-graft treatment of AAA, other important aortic branches are also bridged that may potentially present with the sequelae of peripheral ischemia. This review re-emphasizes the anatomical and clinical importance of abdominal aortic branches relevant to conventional aortic surgery and EVR of AAA.

Adrenal Glands↗
PubMed2000

Endovascular treatment of penetrating thoracic outlet arterial injuries.

OBJECTIVES: to establish the feasibility of stent-graft treatment of penetrating thoracic outlet arterial injuries. DESIGN: prospective study. MATERIALS AND METHODS: forty-one patients with penetrating injuries to the carotid, subclavian and proximal axillary arteries admitted between August 1998 and May 1999 were studied. Patients requiring urgent surgical exploration for active bleeding (n=26) were excluded. Remaining patients underwent arteriography to assess suitability for stent-graft placement. After successful stent-graft treatment clinical and sonographic follow-up were done at 1 month and thereafter 3-monthly. RESULTS: of the 15 patients considered, 10 patients qualified for stent-graft treatment (seven male, three female, mean age 27 years). The vessels involved were subclavian artery (seven), carotid artery (two) and axillary artery (one). Seven had arteriovenous fistulae and three, pseudoaneurysms. Stent-graft treatment was successful in all 10 patients with no procedure-related complications. On mean follow-up of 7 months no complications were encountered. CONCLUSION: endovascular treatment shows promise as a treatment modality for thoracic outlet arterial injuries. Long-term follow-up is required for comparison to the results of standard surgical repair.

Adolescent↗
PubMed2000

An immunocytochemical profile of the endocrine pancreas using an occlusive duct ligation model.

CONTEXT: Ligation of the pancreatic duct, distally to its confluence into the bile duct has been shown to induce endocrine tissue regeneration. The surplus endocrine tissue formed is presumed to be able to replace pathologically and/or experimentally compromised tissue. OBJECTIVE: This is a quantitative study on the histology of duct ligated pancreas employing immunocytochemistry and computerised morphometry. INTERVENTIONS: Pancreatic duct ligation was performed on 25 groups of six normal Sprague-Dawley rats. Experimental animals were sacrificed at 12-hour intervals from day one to ten post-duct ligation and every 24 hours thereafter to day 14, the pancreas removed, fixed and processed. Six consecutive 3-6 micron serial sections were cut on a rotary hand microtome, floated onto 3-aminopropyl-trimethoxysilan coated slides and alternatively immunocytochemically stained for insulin, glucagon, pancreatic polypeptide and somatostatin. RESULTS: Pancreas transformation between days 1/2 and 3 1/2 was characterised by acinar deletion and the appearance of immunoreactive cells for the primary endocrine hormones. Transdifferentiation of existing endocrine tissue saw islet insulin core cells replaced by pancreatic polypeptide- and somatostatin positive cells, glucagon deletion and random appearance of all endocrine cell types within the inter-islet interstitium by day 3 1/2. Days 4 to 14 were characterised by cellular migration and islet reconstruction. CONCLUSIONS: To date our laboratory has investigated transplantation of foetal tissue beneath the renal capsule in syngeneic, isogeneic and allogeneic normal and diabetic rats. As pancreatic duct ligation induces the development of surplus endocrine tissue our next step would be to investigate the use of ligated pancreas as a replacement for foetal tissue.

Animals↗
PubMed1998

Development, differentiation, and regeneration potential of the Vervet monkey endocrine pancreas.

Using immunolabelling techniques, characterization of the Vervet monkey pancreas included a study of both its development and its structure and normal functioning in the adult. We found that PP and somatostatin occurred during development before glucagon. Insulin and all four pancreatic peptides occurred in one of the primordial buds prior to fusion. These finding call into question the suggested contribution of only PP cells by the ventral bud and non-PP cells by the dorsal bud. Co-localization of glucagon and PP was observed extensively with their relative expressions occurring in what appeared to be an organised non-random manner. Cells expressing both glucagon and PP persisted in the adult, together with many other combinations, suggesting an interesting plasticity of endocrine cell differentiation in the adult. Cellophane wrapping of the head of the Vervet monkey pancreas was shown to result in a noticeable increase in duct cell proliferation and endocrine cell volume but no increased replication of endocrine cells. Cells, immunoreactive for pancreatic peptides, were observed to bud from the ducts, suggesting a regeneration of endocrine cell tissue by neogenesis, although it is uncertain whether the duct epithelium contains the only stem cell source of new endocrine tissue. Hopefully, further investigations will elucidate a mechanism by which endocrine cell regenerative capacity can be stimulated in diabetics to overcome their absolute or relative deficiencies of insulin production.

Animals↗
PubMed1998

Induction of cell proliferation and differentiation in the pancreas of the adult Vervet monkey (Cercopithecus aethiops): preliminary results.

Cellophane wrapping of the adult Syrian golden hamster pancreas has been found to result in ductular cell proliferation leading to islet regeneration. Injection of cytosol from a cellophane-wrapped pancreas into normal or diabetic hamsters evoked a similar response. In view of the therapeutic potential of the active substance in this cytosol, it was decided to investigate whether a similar response could be achieved in a primate. In normal adult Vervet monkey (Cercopithecus aethiops) pancreas, proliferation is seen only rarely in islet cells and occasionally in duct and acinar cells. Immunohistochemical investigation of normal Vervet monkey pancreas (n = 4) and 14 days (n = 2) and 56 days (n = 1) after cellophane wrapping of the Vervet monkey pancreas revealed a slight increase in proliferation of islet and acinar cells and a larger increase in proliferation of duct cells and in total endocrine cell volume. The results suggest that there is a latent developmental capability in the adult primate pancreas.

Animals↗