Search PubMed⌕ Search

Biomedical subjects

J H Louw

Publications and source records attributed to J H Louw.

At least 19 recordsLinked to original sources
PubMed1986

Twenty year experience with familial polyposis coli in Cape Town.

Forty-nine patients undergoing surgery for familial polyposis coli (FPC) over a twenty year period are presented. Forty-three patients underwent total colectomy with ileorectal anastomosis (TC + IRA) and five patients subsequently developed a rectal carcinoma. The incidence of rectal carcinoma following TC + IRA appears to increase with time. There were significant postoperative complications secondary to adhesive obstruction and desmoid tumour recurrence. Upper gastrointestinal pathology has been detected by endoscopy in only one of nine patients, but the importance of upper gastrointestinal pathology is now appreciated. The problem of screening a widely distributed and closely knit community has been considerable. TC + IRA remains the operation of choice for the majority of patients with FPC, but a total colectomy with ileal reservoir and ileo-anal anastomosis is appropriate in some cases.

Adolescent↗
PubMed1985

Axillofemoral bypass. A 2-decade experience reviewed.

A retrospective study of axillofemoral bypass performed at Groote Schuur Hospital over a period of 2 decades was undertaken to analyse the results and to re-examine current criteria for patient selection. During this period 109 patients underwent surgery. The primary indication was critical ischaemia (in 88% of cases). Operative mortality was 6,4%. Graft thrombosis and sepsis were identified as the major reasons for graft failure. Overall graft patency at 3 years was 43% and at 5 years 30%. Successful graft thrombectomy improved the overall cumulative patency rate at 5 years to 43%, and patient survival in the same period was 56%. Modern advances in the assessment of anaesthetic risk together with improved postoperative intensive care have allowed more patients who in the past would have been considered candidates for axillofemoral bypass to undergo direct aortic reconstruction. While the results of axillofemoral bypass are inferior to those of aortic grafts, the technique remains a valuable method of limb salvage for the poor-risk patient and a life-saving treatment for aortic graft sepsis.

Adult↗
PubMed1984

The mucosal pattern of the gall bladder ("areae cholecysticae").

During endoscopic retrograde cholangiopancreatography (ERCP) the mucosal fold pattern of the gall bladder can be seen if radiographs are made before the contrast medium has mixed with the bile. These appearances are demonstrated by studies both in vivo and in vitro.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1980

The long-term effects of vagotomy and drainage, parietal cell vagotomy and H2 receptor antagonists on duodenal ulcers and gastric function and structure.

This paper presents a comparative retrospective analysis of the effects of vagotomy and drainage, parietal cell vagotomy (PVC) and maintenance H2 receptor antagonist (H2RA) therapy on ulcer recurrence rates, clinical status, gastric acid secretion, serum gastrin responses and gastric structure in the elective treatment of duodenal ulcer. The results indicate that the operations offered greater protection against recurrent ulceration, and that H2RA therapy provides some protection against recurrence while the patient is on continued treatment but does not alter the natural history of the disease when treatment is stopped. The evidence to date suggests that neither PCV nor H2RA therapy has altered the conventional indications for surgical treatment in duodenal ulceration.

Drainage↗
PubMed1979

Liver tumours and the contraceptive pill: Controversies in aetiology, diagnosis and management.

Six female patients seen at Groote Schuur Hospital between 1973 and 1977, with the types of liver lesion that have been linked aetiologically with the contraceptive pill, are described. Four had focal nodular hyperplasia (1 with spontaneous rupture), and 1 patient had a hepatocellular carcinoma. The sixth patient had spontaneous rupture of the liver but no tumour was demonstrated. Based on this experience and a review of the literature, controversies in aetiology, diagnosis and managment are presented. A defined management policy is proposed for the benign lesions, a less aggressive approach being advocated for focal nodular hyperplasia than for hepatic adenoma.

Adenoma↗
PubMed1979

A brief history of the Medical Faculty, University of Cape Town.

Outstanding events in the history of the Medical School, University of Cape Town, include the establishment of a full faculty in 1920, the move of the teaching departments from the Gardens to Observatory in 1926/1928, the opening of the Groote Schuur Hospital in 1938, the signing of the joint agreement with the Cape Provincial Administration in 1951, and the tremendous growth and research activities since that time.

Curriculum↗
PubMed1979

Acid secretion in the bile duct-ligated pig.

Bile duct ligation is associated with severe gastric ulceration in the pig, but the pathogenesis is unknown. Gastric acid secretion was therefore studied before and after bile duct ligation in pigs with Heidenhain pouches. Basal pouch secretion and the response to submaximal pentagastrin stimulation incresed significantly 6--14 days after ligation of the common bile duct (P < 0,05). Bile duct ligation was not followed by gastric ulceration in the pigs in this study which had had, in effect, a 50--70% gastric resection in the course of fashioning the Heidenhain pouch. These observations suggest that oesophagogastric junction ulceration in pigs is associated with gastric acid hypersecretion.

Animals↗
PubMed1979

The diabetic foot.

Modern thought regarding the pathogenesis, clinical features and management of the 'diabetic foot' is reviewed. The interplay of the triad of ischaemia, neuropathy and infection is emphasized throughout. Management is directed at maintaining or providing a pain-free, working foot.

Aging↗
PubMed1979

A 10-year survey of large bowel carcinoma at Groote Schuur Hospital with particular reference to patients under 30 years of age.

In a 10-year survey of large bowel carcinoma at Groote Schuur Hospital 926 cases were studied retrospectively. A marked difference was seen in both the age of presentation and histological differentiation in two different racial groups. All patients who were 29 years of age or less at the time of presentation have been studied in detail. Predisposing factors, symptomatology, treatment, pathology and prognosis are discussed. It is apparent that large bowel carcinoma in the young has a very poor prognosis.

Adolescent↗
PubMed1979

A comparative randomized trial of heparin versus streptokinase in the treatment of acute proximal venous thrombosis: an interim report of a prospective trial.

A controlled, prospective study comparing streptokinase and heparin treatment has been completed in 51 patients presenting with acute proximal venous thrombosis of less than 8 days' clinical duration. Patients were studied by means of pre-treatment, post-treatment, 3- and 12-monthly phlebography and pulmonary perfusion scanning and were followed up at 3-monthly intervals. Of the 26 patients randomized to receive streptokinase, therapy was stopped in 3 because of complications. Phlebography 5 days after starting treatment showed 80--100 per cent lysis in 17 of the 23 patients who completed the course of streptokinase. Two patients later developed partial rethrombosis. One patient developed an asymptomatic pulmonary embolus during treatment. During follow-up (mean 19 months) only 1 of the 17 patients with 80--100 per cent lysis developed postphlebitic symptoms, 3 patients died of unrelated causes and 1 patient was lost to follow-up. In patients randomized to heparin therapy no significant lysis was achieved in any of the 25 patients and only 2 of these patients were found to have asymptomatic legs on follow-up. Two patients in this group died and autopsy confirmed massive pulmonary embolus during treatment. These data suggest that streptokinase is superior to heparin in the treatment of acute proximal venous thrombosis of less than 1 week's clinical duration especially if the thrombus is largely non-occlusive. It must be stressed that in order to avoid the bleeding complications of thrombolytic therapy, streptokinase must not be used within 10 days of major surgery, or even longer after vascular, neurosurgical or eye operations.

Adult↗
PubMed1978

Skin necrosis after warfarin therapy.

A rare but potentially lethal complication of coumarin and its congeners is skin necrosis. A case of skin necrosis due to warfarin is reported and the literature is reviewed. It is suggested that if necrosis develops, the coumarin therapy should be terminated, and the patient should immediately be heparinized. Heparin, which never causes necrosis, can be used freely if further anticoagulation therapy is required, and may well prevent necrosis due to the thrombotic process.

Adolescent↗
PubMed1978

Central papillary atrophy of the tongue and denture stomatitis.

A retrospective study of the epidemiologic data of 4,417 subjects has been undertaken to study the possibility of a link existing between glossal central papillary atrophy (median rhomboid glossitis) and denture stomatitis. Neither the association between glossal central papillary atrophy and denture stomatitis nor the association between glossal central papillary atrophy and denture use was statistically significant. However, the correlation between wearing removable dental prostheses and finding candidal mycelia in smears from these tongue lesions was statistically highly significant. Debilitation caused by general age changes would not appear to predispose to atrophy of the pappillae of the middle portion of the tongue-dorsum.

Atrophy↗