Browsing by Author "Laker, L."

Now showing 1 - 12 of 12
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    Bleeding from varicose veins -still potentially fatal. A case report
    (Health & Medical Publishing Group, 1985-02) Du Toit, D. F.; Knott-Craig, C.; Laker, L.
    A 57-year-old woman was admitted to hospital with spontaneous profuse haemorrhage from a small acute varicose ulcer of the left leg. She was in shock, semicomatose and anaemic because of blood loss. The haemorrhage was easily controlled by elevating the leg, applying compression bandages and administering a blood transfusion. The patient made an uneventful recovery.
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    Deep-vein thrombosis in pregnancy : a case report
    (Health & Medical Publishing Group, 1985) Du Toit, D. F.; McCormich, M.; Laker, L.
    The incidence of thrombo-embolic complications in pregnancy varies between 2 and 5 per 1 000 deliveries. Deep-vein thrombosis (DVT) is classically associated with pulmonary embolism and chronic venous insufficiency, which are leading causes of maternal morbidity and mortality. An accurate diagnosis of iliofemoral or calf vein thrombosis should be confirmed by either Doppler ultrasonography, impedance plethysmography or ascending phlebography. Full-dose continuous intravenous heparin for 5-10 days is the established method of therapy for acute DVT and pulmonary embolism occurring during pregnancy or in the puerperium. Thereafter, long-term treatment with self-administered subcutaneous injections of heparin in low doses is feasible and effective. During pregnancy. coumarin administration results in embryopathy as it readily crosses the placenta; it should be avoided until after delivery. In view of its safety and effectiveness, low-dosage intravenous heparin or heparin by subcutaneous injection seems to be the anticoagulant of choice for the expectant mother.
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    The effect of corticosteroid therapy on lysosomal enzymes and protein and lipid metabolism in rabbit lung after administration of Freund's adjuvant
    (Health & Medical Publishing Group, 1982) Engelbrecht, F. M.; Blom, M.; Laker, L.; Badenhorst, E.
    The effect of corticosteroid therapy on the bronchoalveolar cell response, the changes in activity of some lysosomal enzymes and the protein and lipid biosynthesis rates in lung tissue of normal rabbits and of rabbits after induction of an acute inflammation by the intravenous injection of complete Freund's adjuvant (CFA) 0.2 mlkg body weight was investigated. Three intramuscular injections of methylprednisolone acetate (Depo-Medrol) 1.2 mg/kg over a period of 8 days reduced the mean total bronchoalveolar free cell yields significantly. The percentages of lymphocytes and granulocytes were decreased. The increase in the macrophage percentage was associated with a significant increase in the acid phosphatase activity of the broncho-alveolar cells. The β-glucuronidase activity, on the other hand, was lowered in alveolar cells and even significantly suppressed in lung tissue. Protein and lipid biosynthesis was significantly retarded in lung tissue 8 days after the start of therapy. Administration of a single dose of CFA 0.2 ml/kg evoked an acute lung inflammation and a significant increase in total alveolar free cell yields. The macrophage percentage was reduced and the lymphocyte numbers doubled, whereas the granulocyte percentage increased more than sevenfold. The change in the percentage distribution of granulocytes may be associated with the marked increase in β-glucuronidase activity of the cells as well as of the lung tissue. In the inflammatory phase, protein biosynthesis was significantly increased but lipid synthesis was not affected. Corticosteroid therapy in animals treated with adjuvant reversed all the effects of CFA. It has very pronounced anti-inflammatory action and a catabolic effect on protein and lipid metabolism.
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    Extracranial internal carotid artery aneurysm : a case report
    (Health & Medical Publishing Group, 1984) Du Toit, D. F.; Van Zyl, J. A.; Laker, L.; Groenewald, J. H.
    A patient with an asymptomatic, right-sided internal carotid artery aneurysm is reported. The entity was accurately located and diagnosed pre-operatively by utilizing a duplex ultrasonographic scanner. Treatment comprised aneurysmectomy and restoration of arterial continuity by autogenous venous grafting. The patient recovered without the occurrence of any sequelae.
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    Gangrene of the hand and forearm after inadvertent intra-arterial injection of pyrazole : a case report
    (Health & Medical Publishing Group, 1985) Du Toit, D. F.; Sunshine, M.; Knott-Craig, C.; Laker, L.
    A case of gangrene of the hand following inadvertent intra-arterial injection of a pyrazole derivative (Tomanol) is presented. Gangrene of the hand and superficial sloughing of the distal arm necessitated a forearm amputation. Because of the serious sequelae, precautions must be taken to avoid inadvertent intra-arterial injections and due consideration must be given to the anatomical variations of the brachial artery and its branches in the cubital fossa.
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    Hepatic abscess in a patient with polycystic liver disease : a case report
    (Health and Medical Publishing Group (HMPG), 1985-04) Du Toit, D. F.; Van Schalkwyk, P.; Laker, L.
    A patient with a liver abscess and underlying polycystic renal and liver disease is described. The liver abscess was diagnosed on the clinical findings and accurately localized by ultrasonography. Tube drainage and antibiotic administration resulted in a rapid recovery. The polycystic liver disease, which was previously undiagnosed and asymptomatic, was an unexpected finding at laparotomy.
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    Hydatid cyst of the pancreatic tail : a case report
    (Health & Medical Publishing Group, 1984) Du Toit, D. F.; Loxton, A. J.; Laker, L.; Dreyer, J. F.
    A case of calcified hydatid cyst of the pancreatic tail is presented. The ultrasonographic and computed tomographic features of the lesion suggested the presence of a cystadenoma or a calcified hydatid cyst. Computed tomography proved the most useful investigation and accurately localized the lesion. A distal pancreatectomy and splenectomy were performed because on the basis of the results of pre-operative investigations and macroscopic operative findings, carcinoma of the pancreatic tail could not be ruled out with certainty. The patient made an uneventful recovery.
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    Intrahepatic gallstones : a case report
    (Health & Medical Publishing Group, 1985) Du Toit, D. F.; Retief, A.; Laker, L.
    A Coloured woman was admitted to hospital with a 3-day history of acute right upper abdominal pain, nausea and vomiting. Acute cholecystitis was confirmed by biliary imaging using technetium-99m. An acutely inflamed gallbladder and two pigment stones in the common bile duct were removed. There were numerous retained gallstones in biliary radicles of the right hepatic duct; attempts to dislodge these by saline flushing failed. An extended choledochotomy with further exploration of the intrahepatic radicles also failed to remove the incarcerated stones. Biliary enteric drainage was achieved by choledochoduodenostomy and short-term postoperative progress was uneventful.
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    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.
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    Recurrent pancreatitis after partial ileal bypass for hyperlipidaemia : a case report
    (Health & Medical Publishing Group, 1985) Du Toit, D. F.; Knott-Craig, C.; Laker, L.
    The case of a 28-year-old man with alcohol-induced bouts of recurrent acute pancreatitis after a partial ileal bypass performed for hyperlipidaemia is presented. Serial computed tomography proved valuable for assessing the resolution of the pancreatic mass. Peripheral parenteral hyperalimentation for 6 weeks had a beneficial effect on the course of the pancreatitis and proved to be useful for nutritional support.
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    Syphilitic aortitis : a case report
    (Health & Medical Publishing Group, 1985) Du Toit, D. F.; McCormich, M.; Laker, L.
    A case of syphilitic aortitis with total occlusion of the infrarenal aorta without aneurysmal dilatation is presented. Incapacitatin g c laudication of both legs together with pain at rest necessitated an aortobifemoral bypass operation, which resulted in complete relief of symptoms. Histological examination of the aorta showed atherosclerosis together with characteristic perivascular lymphocytic infiltration of the aortic vasa vasorum.
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    Takayasu's disease : a report of 3 cases
    (Health & Medical Publishing Group, 1985) Du Toit, D. F.; Warren, B.; McCormich, M.; Laker, L.
    Three patients with Takayasu's disease are described. In 2 cases aortography demonstrated an occlusion of the great vessels at the origin of the arch of the aorta. In 1 patient there was concomitant aneurysmal dilatation of the brachiocephalic trunk. Common and internal carotid artery stenosis occurred in 1 patient and was associated with hemiplegia and blindness. All 3 patients had constitutional symptoms and signs of the disease as well as markedly elevated erythrocyte sedimentation rates; 2 patients had moderate clinical responses to steroid administration in the short term and 1 developed bilateral calf vein thrombosis, which responded satisfactorily to conservative management.