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Biomedical subjects

L C van Rensburg

Publications and source records attributed to L C van Rensburg.

At least 19 recordsLinked to original sources
PubMed1991

Neurotensin, vaso-active intestinal polypeptide and gastrin levels in plasma and portal venous blood in experimental mesenteric ischaemia.

The effect of mesenteric ischaemia on the levels of neurotensin, vaso-active intestinal polypeptide and gastrin in portal venous blood and in the peripheral circulation was studied in two groups of 7 and 6 baboons (Papio ursinus). In peripheral blood a decreasing trend in levels of neurotensin was observed, while vaso-active intestinal polypeptide and gastrin levels were unchanged. There was a similar trend in neurotensin levels in portal venous blood, together with an increasing trend in levels of vaso-active intestinal polypeptide. Gastrin levels were unchanged. Further investigation of these apparent trends in a large number of animals is warranted.

Animals↗
PubMed1991

Ceftriaxone (Rocephin) in abdominal trauma.

A prospective study was undertaken to evaluate the use of ceftriaxone in patients with abdominal trauma admitted to our hospital over a period of 6 months. Because of the large trauma load and an unacceptable waiting period before surgery combined with the fact that many patients on 6-hourly antibiotic regimes often did not receive their second and third doses, it was decided to use ceftriaxone because of its long half-life with maintenance of fluid and tissue concentrations for 24-48 hours. Because ceftriaxone is not reliably effective against anaerobic organisms such as Bacteroides fragilis, it was decided to add metronidazole as a combined initial dose. Two hundred ninety patients were entered in this trial, of which there were 259 stab wounds (89.3%), 20 missile injuries (6.9%), and 11 blunt injuries (3.8%). It was found that the mean delay between injury and initial dosage of ceftriaxone was 9.1 hours, with a range of 1-126 hours, and the mean delay between antibiotic therapy and operation 6.3 hours, with a range of 0-39 hours. The organs most frequently injured were the small bowel, the large bowel, the stomach, and the liver. Wound infection developed in only 4 patients (1.4%); intra-abdominal sepsis did not occur; and 35 patients (12%) developed respiratory infections. There were no deaths. We conclude that ceftriaxone, because of its 24-hour dosage was not only convenient but also adequate to prevent intra-abdominal sepsis and there was no difference in cost between this product and our previous protocol of 6-hourly antibiotic regime.

Abdominal Injuries↗
PubMed1991

Splenic regeneration and phagocytic function after partial splenectomy in baboons.

Total splenectomy, especially in children, results in diminished ability to combat infection by capsulated bacteria. It is, however, uncertain how much splenic tissue is needed to maintain this ability. In this experimental study on baboons, in situ remnants after partial splenectomy were examined to evaluate regeneration and phagocytic function after injection of dual-labelled liposomes into their splenic arterial supply. The results showed that resection of as much as two-thirds of the spleen in baboons allowed sufficient regeneration to support adequate macrophage phagocytic function.

Animals↗
PubMed1989

Phaeochromocytoma in pregnancy. A report of 3 cases.

The coincidence of phaeochromocytoma and pregnancy is rare and potentially lethal. Three cases are reported; in 2 the fetus had died before the patient presented. With early diagnosis and appropriate treatment there should be no maternal mortality, and the fetal mortality rate should be reduced to less than 20%.

Adrenal Gland Neoplasms↗
PubMed1986

Alcohol levels in trauma victims.

A group of 142 patients injured in motor vehicle accidents or assaults was investigated to ascertain patterns of alcohol usage and blood alcohol levels; 77% were positive for blood alcohol (range 0.01-0.492 g/dl; mean 0.212 g/dl). A correlation between alcohol levels and injury severity was found. In assaults, multiple injuries were associated with high alcohol levels because of less effective self-defence. Injured young pedestrians as well as injured occupants of motor vehicles showed alarmingly high alcohol levels. The increasing load placed on trauma services and the resultant burden to the taxpayer necessitates an urgent programme of public education designed to alter attitudes towards alcohol consumption.

Accidents, Traffic↗
PubMed1986

Possible radiation injury at Koeberg Nuclear Power Station. Organization of medical care.

Any injured patient from Koeberg Nuclear Power Station will be treated in the conventional manner as an acute surgical emergency; this has priority over decontamination. The ideal situation is decontamination at Koeberg before ambulance transferral to the Tygerberg Radiation Casualty Facility, but if this is not possible or complete, decontamination can be accomplished by a trained team in the unit. Teamwork is the essence at the place of injury, during transfer, in the decontamination area, in the operating theatre and during the postoperative phase. No surgical management is appropriate or complete without the very necessary guidance and advice from a physicist and the Advisory Group for Radiation Casualties.

Accidents↗
PubMed1986

Budd-Chiari syndrome. A report of 3 cases.

Three patients with the Budd-Chiari syndrome are presented. This is a rare condition characterized by hepatomegaly, progressive and refractory ascites, distension of the abdominal wall veins, abdominal pain and leg oedema. These features are attributed to congestion of the liver and portal hypertension. The condition has been notoriously difficult to treat medically. Surgical measures are directed towards relieving the liver congestion and lowering pressure in the portal system by portal-systemic shunting operations. In some cases refractory ascites may be treated by peritoneovenous shunting with a Le Veen shunt. In a select group of patients orthotopic liver transplantation has proved to be worth while.

Adolescent↗
PubMed1986

Eosinophilic granuloma of the stomach.

Two patients with eosinophilic granuloma of the stomach are discussed. The first patient had extensive and time-consuming investigations before the diagnosis was confirmed after surgery, while the second patient's presentation corresponded so closely to the first that a correct preoperative diagnosis was entertained with a minimum of investigations and delay. The barium-meal examinations in both patients were very typical of the condition, but the endoscopy findings and biopsy histology reports were noncontributory. Neither of the patients had a history of allergy or eosinophilia. The lesions were localized to the distal part of the stomach and the resected specimens were microscopically typical of eosinophilic granuloma of the stomach.

Adolescent↗
PubMed1985

Bolus obstruction of the intestine. Case reports.

Two cases of intestinal obstruction caused by peaches are reported. In the first case steamed dried peaches were eaten by a 56-year-old woman who had undergone a Billroth I gastrectomy 18 years previously, while in the second case canned peach halves were swallowed whole by a 75-year-old edentulous man. The cases both typify the usual clinical setting of bolus obstruction, certain aspects of which are discussed. The responsibility of the attending practitioner to advise his high-risk patients with regard to their diets is emphasized.

Aged↗
PubMed1984

Hepatobiliary scintigraphy in surgical patients.

Hepatobiliary scintigraphy as an investigative procedure has a definite role in the investigation of the surgical patient with various biliary problems. As it outlines the functional anatomy of the biliary tract, it has been employed for some time in the diagnosis of acute cholecystitis. In addition, it has a place in the investigation of patients with chronic cholecystitis, common bile duct obstruction and biliary leaks and in evaluating the integrity of biliary bypass procedures.

Adult↗
PubMed1984

The management of acute cholecystitis in the elderly.

This paper assesses the value of hepatobiliary scanning and surgical treatment of acute cholecystitis in patients above the age of 60 years over a 3 year period (1980-1982). During this period 382 cholecystectomies for biliary disease were performed in 257 women and 125 men with mean ages of 55 X 6 and 61 X 1 years respectively. Of the 382, 208 were older than 60, with a female to male ratio of 1 . 3:1. Acute cholecystitis occurred in 74 of the 208 patients; they were subjected to early cholecystectomy. Biliary tract imaging using 99 m technetium-labelled diisopropyl-IDA (DISIDA) proved valuable in confirming the diagnosis of acute cholecystitis. Of 85 patients over 60 years who underwent hepatobiliary scanning with a presumptive diagnosis of acute cholecystitis, 74 had positive scans and acute cholecystitis was confirmed at subsequent operation in these cases. There were two false positive and nine negative scans showing that biliary scintigraphy proved to be a rapid non-invasive and sensitive method of diagnosing acute cholecystitis. The advent of hepatobiliary scanning has strengthened our surgical strategy in the management of acute cholecystitis in the elderly and allows early elective surgery with an acceptable morbidity and in this series no mortality.

Acute Disease↗
PubMed1983

Oesophago-antrostomy with and without pyloroplasty - radiological and manometric findings in the chacma baboon.

Oesophago-antrostomy with and without pyloroplasty, and with preservation of Latarjet's anterior nerve with an intact pylorus, was studied in chacma baboons. Radiological and manometric studies showed that pyloroplasty is unnecessary after oesophago-antrostomy with an incidental vagotomy and that pyloroplasty in fact interferes with the muscular rhythm of the pyloric sphincteric cylinder.

Animals↗