SUNScholar - Browsing by Author "Heydenrych, J. J."

Browsing by Author "Heydenrych, J. J."

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The anatomy and movements of the pyloric sphincteric cylinder
(1982) Keet, A. D.; Heydenrych, J. J.
Disagreement about various aspects of the structure and function of the pylorus persists. Morbid anatomical, living anatomical, manometric and radiographic studies were done in an attempt to clarify some problems. It is shown that the pyloric ring (sphincteric ring) is not a separate anatomical structure, but that it constitutes the aboral end of the pyloric sphincteric cylinder, a muscular tube several centimeters in length. The ring does not function independently and conventional peristaltic waves do not proceed as far as the ring. Consequently the ring does not relax reciprocally with an oncoming peristaltic wave in the sense that a wave travels up to the ring, which relaxes upon its arrival. Each peristaltic wave stops on arrival at the oral end of the cylinder, simultaneously initiating a concentric or systolic contraction of the entire cylinder, including the ring. The cylinder, including the ring, is open at rest.
Application 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.
Binneaarse 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.
Carcinoma 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.
Caudal 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.
Early postoperative pancreatic endocrine function after segmental and pancreaticoduodenal allotransplantation in nonimmunosuppressed primates
(1987) Du Toit, D. F.; Heydenrych, J. J.; Smit, B.
In this study we evaluated the short-term hormonal effects of segmental and whole pancreatic allotransplantation on the glucose intolerance produced by hemipancreatectomy in the primate. In hemipancreatectomized animals without grafts the K-values were reduced to 0.6 ± 0.05, plasma insulin increased from 27.5 ± 2.5 to 63.5 ± 6.3 μU/ml, and glucagon levels declined from 252 ± 29.9 to 216.5 ± 33.0 pg/ml. Hemipancreatectomized segmental allograft recipients rendered K-values of 0.79 ± 0.05, plasma insulin increased from 19.98 ± 3.43 to 66.0 ± 17.03 μU/ml, and glucagon release declined from 395.6 ± 63.0 to 226.2 ± 37.6 pg/ml during IVGTT postoperatively. Hemipancreatectomized, pancreaticoduodenal allograft recipients rendered K-values of 0.82 ± 0.1, results not significantly different from hemipancreatectomized or segmental allograft recipients. Plasma insulin increased from 29.5 ± 4.0 to 186.0 ± 25.0 μU/ml, and glucagon release declined from 1,087.0 ± 31.6 to 656.0 ± 12.7 pg/ml. In summary, segmental pancreatic allotransplantation could not, in the short-term, restore the reduced K-values and hypoinsulinaemia in hemipancreatectomized primates to that of normal, unstressed controls. Although K-values of hemipancreatectomized recipients were not significantly improved, whole pancreas transplantation resulted in improved insulin release and hyperglucagonaemia during IVGTT when compared to segmental allograft recipients. The unexpected findings of hypoinsulinaemia and hyperglucagonaemia in both transplant groups may only reflect a function of the stressed state of the animals in the immediate postoperative phase.
Giant lower oesophageal ulcer in a Bushman baby : a case report
(Health & Medical Publishing Group, 1983) Heydenrych, J. J.; Keet, A. D.
The case of a giant, penetrating lower oesophageal ulcer in a 14-month-old Bushman baby is reported. This would probably be classified as a Barrett's ulcer. Histological examination showed that the ulcer developed in columnar epithelium and that there was normal stratified squamous oesophageal mucosa both proximally and distally to the ulcer, indicating that it had developed in an islet of ectopic gastric mucosa. The ulcer originally described by Barrett developed in a short oesophagus, into which gastric mucosa extended in a continuous sheet. Lower oesophageal ulcers should probably be divided into a primary type, of which the present case is an example, and a secondary type, in which there is direct extension of gastric mucosa into the oesophagus due to metaplasia of oesophageal mucosa secondary to reflux oesophagitis.
Haemoperitoneum 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.
Hemiplegia - 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.
Herpesvirus 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.
Midazolam premedication in paediatric anaesthesia
(Health & Medical Publishing Group, 1986) Payne, K. A.; Heydenrych, J. J.; Kruger, T. C.; Samuels, G.
To investigate the efficacy of midazolam (Dormicum; Roche) as a paediatric premedication, 150 children, aged 6 months - 5 years, were divided into three groups. All three groups spent time with the anaesthetist to allow rapport to be established. Group A received midazolam premedication, group B received oral trimeprazine, droperidol and methadone (TDM) and group C received no sedative medication. Midazolam gave the best behaviour patterns in the holding room. Behaviour at induction was the same in all three groups. The recovery times were similar in the midazolam and unsedated groups, but in the TDM group recovery was significantly delayed. Temperatures remained stable in the unsedated and midazolam groups, but decreased in the TDM group. It is concluded that midazolam is a satisfactory paediatric premedication agent.
Mycotic 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.
Organ allotransplantation since the advent of cyclosporin
(Health & Medical Publishing Group, 1985) Du Toit, D. F.; Heydenrych, J. J.; Laker, L.
Successful long-term organ transplantation has been made possible by the use of conventional immuno-suppression. In contrast with transplantation of other organs, transplantation of the kidney has become an accepted successful form of therapy, 80% of patients being fully rehabilitated. However, complications of therapy are frequent and severe and include bone necrosis, cataract formation, infections and stunted growth in children. The discovery of the immunosuppressive properties of cyclosporin A (CYA) by Borel in 1976 offered new hope to recipients of hepatic, cardiac, pancreatic and heart-lung transplants, since rejection frequently resulted in death. Although the use of CYA has led to significant accomplishments, subsequent studies have documented deleterious side-effects including nephrotoxicity, hepatotoxicity, hirsutism, gingival hyperplasia, tremors and tumours. Yet despite the side-effects, CYA has proved to be a promising immunosuppressive agent for use in human organ transplantation and is at present being evaluated in transplant centres throughout the world.
Pancreatic 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.
Primate endocrine function after pancreatico-duodenal-splenic allotransplantation
(1987) Du Toit, D. F.; Heydenrych, J. J.; Smit, B.; Louw, G.; Zuurmond, T.; Els, D.; Weideman, A.; Wolfe-Coote, S.; Du Toit, L.; Gonin, R.; Davids, H.
In this study the endocrine function following intraperitoneal hetero- and orthotopic pancreatico-duodenal-splenic allotransplantation (PDS) in hemipancreatectomized, non-immune-suppressed chacma baboons was assessed. Significantly reduced K-values and insulin release together with glucose intolerance during IVGTT were observed in hemipancreatectomized recipients (HPS) without grafts. Orthopic and heterotopic PDS transplantation improved the glucose intolerance of HPS recipients; orthotopically sited grafts rendering the best curves. Normal glucose tolerance was not achieved. Both orthotopic and heterotopic PDS transplantation rendered suboptimal insulin release during IVGTT; heterotopically draining grafts released signifcantly more insulin than orthotopic grafts. Hyperglucagonaemia during IVGTT was a constant feature in both groups, Heterotopic grafts releasing the most glucagon during stimulation. C-peptide release was significantly lower in orthotopic grafts compared to normal animals or heterotopically drained insulin. It is concluded that glucose tolerance was not directly related to insulin or glucagon release in this study as orthotopic grafts rendered near-normal IVGTT curves in the presence of hypoinsulinaemia, hyperglucagonaemia, and reduced C-peptide values. The hormonal response after PDS transplantation was variable and the advantages of portal vs systemic insulin drainage remain to be defined.
Solitary gumma in a neonate. A case report
(Health & Medical Publishing Group, 1988-11) Heydenrych, J. J.; McCormick, M. V.
An unusual case of congenital syphilis is reported. A week-old baby presented with abdominal distension, small-bowel obstruction, bilious vomiting and a large left upper quadrant mass. Histopathological examination of a specimen of the mass confirmed the clinical diagnosis of gumma formation. Primary resection with end-to-end anastomosis was carried out. The baby made an uneventful recovery.
Sonographic diagnosis of biliary ascariasis
(1982) Schulman, A.; Loxton, A. J.; Heydenrych, J. J.; Abdurahman, K. E.
In a prospective 6 month study, sonographic diagnosis of biliary ascariasis was made in 12 patients: In five, the diagnosis was confirmed by other means, mainly intravenous cholangiography. In three, such confirmation was not sought, but all had proven intestinal infestation. One possible and three definite false-positive diagnoses were made. There were no established false-negative diagnoses. The echogenic, nonshadowing images of the worms were seen in the main bile duct and/or gallbladder as single strips (on one occasion with its digestive tract seen as an anechoic 'inner tube'), as multiple strips giving a spaghettilike appearance, as coils, or as more amorphous fragments. Follow-up sonograms were obtained in six patients and showed expulsion of the worms by medical treatment.
Torsion of the spleen and associated 'prune belly syndrome' : a case report and review of the literature
(Health & Medical Publishing Group, 1978) Heydenrych, J. J.; Du Toit, D. F.
Splenic torsion as a complication of wandering spleen is rare. The authors report the clinical findings, diagnostic problems and treatment of a 1-year-old Coloured child (with classic 'prune belly syndrome') in whom the spleen had undergone torsion, thus simulating an intra-abdominal abscess. The postoperative course was uneventful.
An 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.
Unusual presentations of acute appendicitis in the neonate : a report of 2 cases
(Health & Medical Publishing Group, 1982) Heydenrych, J. J.; Du Toit, D. F.
Two neonates with acute appendicitis have been treated at the Paediatric Surgery Clinic, Tygerberg Hospital, during the past 6 months. One presented with red blood in the stool and had had persistent anorexia for 1 week. The second baby presented with a large tender swelling of the scrotum which was indistinguishable from a torsion of the testis or strangulation of an inguinal hernia. Both babies made an uneventful recovery.

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