Browsing by Author "Klopper, J. F."
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- ItemBinneaarse radio-isotoop angiografie karotis-kaverneuse fistels(Health and Medical Publishing Group (HMPG), 1975) Van Heerden, P. D. R.; Rose Innes, A. P.; Klopper, J. F.The use of intravenous radio isotope angiography in 3 cases of unilateral carotid cavernous sinus fistula is described. The lesion gives a characteristic image pattern distinguishable from that of arteriovenous malformation in this region. An abnormal registration of intense radioactivity is seen in the early phases, accurately localised to the cavernous sinus, with a distinctive sigmoid shaped configuration. Rapid disappearance of this accumulation of isotope follows, accompanied by a paradoxical apparent increase in blood flow to the ipsilateral hemicranium. This is attributed to the massively arterialised venous drainage. This technique of demonstrating the cerebral circulation dynamically is considered a valuable diagnostic supplement to the static scintiscan and to conventional roentgen arteriography in this lesion.
- ItemChroniese miltabses : 'n gevalbespreking(Health & Medical Publishing Group, 1984) Tredoux, J. G.; Hough, F. S.; Adams, G.; Beyers, J. A.; Klopper, J. F.A 16-year-old girl had had a splenic abscess for approximately 20 months with minimal symptoms and signs. Progressive elevation of the left hemidiaphragm could be traced on chest radiographs from 20 months before admission, and was shown on ultrasonography, radionuclide scintigraphy and computed tomography to be secondary to massive splenomegaly. The presence of splenic abscesses was confirmed by laparotomy and she was cured by splenectomy. The nonspecific clinical presentation and potential high mortality of this condition are stressed, and the role of diagnostic aids is discussed. Ultrasonography is a good screening procedure in terms of cost and speed, but splenic scintigraphy is more sensitive. Computed tomography is the most sensitive and specific non-invasive procedure for the diagnosis of splenic abscesses.
- ItemDie effek van heparien-geinduseerde styging in vrye plasmatiroksien op die hartritme na miokardiale infarksie(Health and Medical Publishing Group (HMPG), 1985-12) Van Heerden, B. B.; Klopper, J. F.; Weich, H. F. H.; Van Heerden, P. D. R.It is well known that an acute myocardial infarction is accompanied by a rise in levels of plasma free fatty acids (FFA), which may lead to a subsequent increase in cardiac arrhythmias. Administration of heparin to patients after an acute myocardial infarction gives rise to an increase both in plasma FFA levels and plasma free thyroxine levels. If administered without a fatty meal the rise in FFA is not accompanied by an increase in arrhythmias. The effect of the heparin-induced rise in plasma free thyroxine on cardiac rhythm has never been investigated. The aim of the present study was to investigate a possible arrhythmic effect of a heparin induced increase in plasma free thyroxine in a group of patients with acute myocardial infarction. We were able to confirm a significant heparin-induced rise in plasma free thyroxine levels, as measured by the effective thyroxine ratio. Although a slightly significant increase in ventricular premature beats could be demonstrated after heparin administration when using the Wilcoxon rank sum test for statistical analysis (but not when the paired t-test was utilized), no significant correlation with free thyroxine levels could be found. Heparin administration to patients suffering from myocardial infarction seems to be safe in terms of a possible arrhythmic effect.
- ItemThe elimination of errors caused by prior technetium-99m scintigraphy on iodine-131 thyroid uptake measurements.(Health & Medical Publishing Group, 1987) Wasserman, H. J.; Muller, C.; Klopper, J. F.Coincidence summing of technetium-99m (99mTc) pulses may disturb iodine-131 (131I) thyroid uptake measurements if these are obtained after 99mTc thyroid scintigraphy performed on the same day. The magnitude of the error was assessed in 26 patients. It was found that when pre-dose measurements were subtracted, the 6-hour and 24-hour 131I uptakes could be falsely decreased by up to 137 percentage points using a lower discriminator level of 250 keV and by up to 35 percentage points with a discriminator level of 300 keV. When pre-dose measurements from 99mTc were ignored, there was a general increase in 131I uptake values at 6 hours. Increases of up to 22 and 9 percentage points occurred when 250 keV and 300 keV lower discriminator levels respectively were used. These errors may be eliminated by performing 131I uptake measurements through a 1 mm lead filter.
- ItemHepatobiliary scintigraphy in surgical patients(1984-10) Van Rensburg, L. C. J.; Klopper, J. F.; Ellmann, A.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.
- ItemMetastatiese verkalkinge soos aangetoon met tegnesium-99m-pirofosfaatbeenflikkergrafie : gevalbesprekinge(Health & Medical Publishing Group, 1982) Louw, N. W.; Klopper, J. F.; Van Heerden, P. D. R.Two cases of chronic renal failure showing very interesting technetium-99m-pyrophosphate bone scans are presented. In both cases striking uptake of activity was shown in the left ventricle of the heart, the mucosa of the stomach and in both lungs. This picture was attributed to metastatic calcification in these organs. Cases of metastatic calcification demonstrated with bone-seeking agents have been presented previously, but have mainly shown intense uptake of activity in the lungs and in a few cases, and to a lesser degree, in the stomach. However, we believe that our cases are unique in showing especially the left ventricle of the heart as well as the mucosa of the stomach with exceptional clarity.
- ItemMitral subannular left ventricular aneurysm : a case report(Health & Medical Publishing Group, 1987) Edelstein, C. L.; Blake, R. S.; Klopper, J. F.A mitral subannular left ventricular aneurysm in an Ovambo man is described. This condition should be suspected in patients of negroid descent presenting with mitral incompetence and a localised bulge on the left heart border on chest radiography. Mitral and aortic subannular aneurysms are discussed, including the diagnostic use of ECG gated cardiac blood pool imaging.
- ItemPreoperatiewe spesiale ondersoeke en intraoperatiewe arteriele suurstofspanning tydens eenlongnarkose(Health & Medical Publishing Group, 1990) Hattingh, P.; Coetzee, A.; McGregor, L.; Klopper, J. F.The value of preoperative lung function tests was examined in 11 patients as a method to predict changes in intraoperative PaO2 (dPaO2) during one-lung ventilation in pulmonary surgery. Ventilation (Kr-81m and Xe-133) and perfusion (Tc-99m microspheres) to the lung to be operated upon significantly predicted the intra-operative decrease in PaO2. The correlation between ventilation percentage to the diseased lung and dPaO2 was 0,87 (SEE = 9,99) and between perfusion and dPaO2 0,84 (SEE = 9,51).
- ItemA simple automated system for the routine production of (99m)Tc by methyl ethyl ketone extraction(HMPG, 1974-05) Klopper, J. F.; Van Heerden, P. D. R.; Muller, U. D.; Baard, W. P.A relatively simple, automated system for the rapid, efficient and safe routine production of 99Tc(m)O4 from 99Mo03 by the metyl ethyl ketone (MEK) extraction technique is described. The 4 phases of the extraction process (bubbling of air, phase separation, drawing off of 99Tc(m) in MEK, and evaporation to dryness) are controlled by an automatic timer, suction pressure pump and solenoid switches. The eluate was found to contain neither bacterial organisms or pyrogens nor significant levels of alumina and radioisotopic impurities. With this system it is possible to make use of locally produced 99Mo, even of low specific activity for the routine production of 99Tc(m) in any concentration required.
- ItemSystemic lupus erythematosus with coronary vasculitis and massive myocardial infarction : a case report(Health and Medical Publishing Group (HMPG), 1986-07) Przybojewski, J. Z.; Botha, D.; Klopper, J. F.A 32-year-old white woman presented with angina pectoris and an acute myocardial infarction (MI) complicated by congestive cardiac failure. Other symptoms and results of immunological investigation were highly suggestive of systemic lupus erythematosus (SLE). Thallium-201 scintigraphy confirmed an extensive MI, as initially suspected from an ECG. Cardiac catheterization delineated a poorly contracting left ventricle secondary to MI. Selective coronary angiography showed features suspicious of coronary arteritis involving the left anterior descendingand left circumflex coronary arteries. Right ventricular endomyocardial biopsy failed to show any 'small·vessel disease', vasculitis or myocarditis. We suggest that the acute MJ was caused by coronary arteritis due to SLE. Overview of the literature indicates that coronary arteritis is not as rare a complicatiqp of SLE as previously believed; however, acute MHs most unusual.
- ItemTwo simple inexpensive photographic methods for viewing ECG-gated radionuclide blood pool images(HMPG, 1979-04) Van Heerden, P. D. R.; Baard, W. P.; Klopper, J. F.; Reyneke, N. J.; Weich, H. F. H.; Blake, R. S.; Przybojewski, J. Z.Although the ECG-gated radionuclide blood pool scan (GBPS) has become an established method for studying regional myocardial wall motion, it is usually performed with the aid of an expensive computer system. A simple, inexpensive method was developed to view gated radionuclide blood images by a film loop and a photographic motion detection (PHOMOT) technique. These techniques were compared with left ventricular cine angiography in 15 patients. Segmental wall movement (78 segments) showed identical results in 92% of cases. In all patients the same diagnosis was arrived at by GBPS and cine angiography. The photographic techniques developed offer a simple screening procedure to reduce cardiac catheterization in patients with suspected abnormalities of left ventricular wall contraction.
- ItemVentilasiestudies van die long met kripton-81m(HMPG, 1981-08) Klopper, J. F.; Van Heerden, P. D. R.; Baard, W. P.During a 2-year study period it was found that krypton-81m was useful in routine clinical practice. During this period 1563 technetium-99m perfusion studies and 807 krypton-81m ventilation studies were performed. A distinct advantage of krypton-81m was the ease with which multiple views could be obtained. These views could be directly compared with those of preceding perfusion studies. However, interruptions in the regular supply of rubidium-81/krypton-81m generators affected 17.1% of perfusion studies and xenon-127 should be a suitable substitute for these periods.