Browsing by Author "Heydenrych, J. J."
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- ItemApplication of irradiation as an immunosuppressive agent(Health & Medical Publishing Group, 1987-04) Du Toit, D. F.; Heydenrych, J. J.ENGLISH ABSTRACT: The concept of using total lymphoid irradiation (TLI) for immunosuppression is based on the prolonged and profound immunosuppressive effects observed after TLI in the treatment of patients with Hodgkin's disease. Pre-operative TLI of allograft recipients has been shown to be immunosuppressive when used alone or together with chemical immunosuppression. Fractionated TLI and allogeneic bone marrow injections produce stable chimaerism without graft-versus-host disease in inbred mice, rats and mongrel dogs and transplantation tolerance of skin and cardiac grafts in rats. In the primate, TLI and bone marrow injection result in significant tolerance of liver and kidney allografts. In 1959 sublethal whole-body irradiation was used as an immunosuppressive agent for the first successful related-human renal allografts between non-identical twins. Despite the dangers of myelosuppression, recent clinical experience has shown TLI to be a useful immunosuppressant for organ transplantation, allowing decreased dosage of concomitant immunosuppressive drugs.
- ItemBinneaarse vogterapie in kinderchirurgie(Health and Medical Publishing Group (HMPG), 1975-03) Heydenrych, J. J.From 1956 to 1969 we adopted a generous approach pertaining to the quantity of parenteral fluid required for paediatric surgery. Since 1970 we have changed our policy, and we now give smaller quantities during surgery and postoperatively. This article presents the calculated parenteral fluid regimen as implemented for general paediatric surgery in the Tygerberg Hospital. Our reasons for this change are indicated.
- ItemCarcinoma of the breast in children : a case report and review of the literature(Health & Medical Publishing Group, 1980) Heydenrych, J. J.; Villet, W. T.; Von der Heyden, U.The case of a 10-yr-old girl with juvenile carcinoma of the breast is presented. The literature is reviewed and current thoughts relating to the treatment of breast carcinoma in children are discussed. The major controversy seems to revolve around the choice between radical and local excision in cases of juvenile or secretory breast cancer.
- ItemCaudal block for analgesia after paediatric inguinal surgery(Health & Medical Publishing Group, 1987) Payne, K.; Heydenrych, J. J.; Martins, M.; Samuels, G.Two hundred and eleven children aged 1 - 5 years were studied after undergoing herniorrhaphy or orchiopexy. In 111 cases a caudal block was used for postoperative analgesia. This was administered immediately after induction of anaesthesia, using bupivacaine 0,25% plain (0,7 ml/kg lean body mass), and was successful in 100 patients. A mean analgesic level (± SE) of T9,9 ± 0,47 was achieved (range L2-T6). In 5 cases no block occurred and in 6 the level was below T12. The other 100 children acted as controls. Behaviour patterns were more restful in the caudal block group on awakening and less opiate was required during the first 5 postoperative hours. No complications resulted.
- ItemHaemoperitoneum and associated torsion of the testicle in the newborn(Health & Medical Publishing Group, 1974) Heydenrych, J. J.A case of haemoperitoneum and concomitant torsion of the testes is reported - the first case in the English literature. The management of the case and the aetiological factors responsible for haemoperitoneum and torsion of the testes in the newborn are discussed. The role of vitamin K in the prevention of a possible subcapsular haematoma is discussed. At laparotomy approximately 80 ml of blood were aspirated from the peritoneal cavity. On the anterolateral aspect of the right lobe of the liver a 4 cm long tear (capsule and parenchyma) was discovered. Many abnormalities predispose towards torsion of the testis, the commonest of which is a horizontal position of the testes, but other factors which may contribute to the condition include a long mesorchium, broad flat chord and an unduly large tunica vaginalis. There are doubts whether torsion can occur in an anatomically normal testis. Although trauma is usually blamed for torsion of the testis, torsion can occur during sleep. Although haemoperitoneum in the newborn is always due to birth trauma, abnormalities in the blood clotting factors are important. There is a correlation between haemoperitoneum and breech extraction of the baby. In the case under discussion, trauma was probably produced by hyperextension, severe flexion or compression of the soft tissue structures against a hard bony prominence of the pelvic bones.
- ItemHemiplegia - an unusual complication of appendectomy. A case report(Health & Medical Publishing Group, 1987-6) McCormick, M. V.; Heydenrych, J. J.; Le Roux, J. L.A 12-year-old boy developed complete right hemiplegia and 7th cranial palsy 2 days after laparotomy for a perforated appendix. Full recovery took 2 months. Although it can be accepted that the hemiparesis was not caused by acute appendicitis it is postulated that this unusual association was due either to a septic embolus which lodged in the region of the internal capsule or to a minor cerebrovascular accident.
- ItemHerpesvirus hominis oesophagitis and oesophageal stricture(Health & Medical Publishing Group, 1980) Heydenrych, J. J.; Keet, A. D.; Mare, J. B.; Becker, W. B.The literature on herpetic involvement of the esophagus is reviewed and a case is described in which the presumptive clinical diagnosis of primary Herpesvirus hominis stomatitis and oesophagitis and subsequently esophageal strictures was made. The differential diagnosis of an esophageal lesion and its treatment are discussed.
- ItemMycotic aneurysm : a rare complication of acute osteomyelitis in a child : a case report(Health & Medical Publishing Group, 1985) Heydenrych, J. J.A case of mycotic aneurysm formation of the right iliac artery is described. This unusual complication developed as a result of acute osteitis of the left tibia which was initiated by a kick on the lower leg. One month after treatment for osteitis of the tibia, the patient was readmitted because of unequivocal evidence of ischaemia of the right leg and a large pulsatile mass in the right iliac fossa, confirming the clinical diagnosis of mycotic aneurysm. The aneurysm was excised but because the wall of the artery was extremely friable simultaneous revascularization was deferred for fear of uncontrollable haemorrhage from the anastomotic line.
- ItemPancreatic transplantation in a patient with severe insulin resistance : a case report(Health & Medical Publishing Group, 1988) Du Toit, D. F.; Heydenrych, J. J.; Coetzee, A. R.; Weight, M.A 22-year-old white woman with insulin-dependent diabetes mellitus of 20 years' duration and advanced secondary complications underwent pancreatic transplantation for severe insulin resistance and rapidly progressive nephropathy. Resistance to all forms and strengths of subcutaneously administered insulin had necessitated almost permanent hospitalisation for the previous 10 years. Short-term improvement of the endocrine and metabolic status was achieved by initial segmental and subsequent whole pancreatic transplantation.
- ItemAn unusual presentation of carcinoma of the colon in a child : a case report(Health & Medical Publishing Group, 1984) Heydenrych, J. J.; Warren, B.A patient with carcinoma of the large bowel who presented with a subphrenic abscess is reported. This case emphasizes two important facts relating to colonic cancer in childhood: (i) premalignant disease of the large bowel is no prerequisite for the development of colonic cancer; and (ii) in childhood this disease is characterized by a fulminating course and high mortality. In about 50% of cases the tumor is of the signet ring or mucin-producing type, which explains the grave prognosis.