Stellenbosch University - Scopus Tygerberg Hospital Publications

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Browsing Stellenbosch University - Scopus Tygerberg Hospital Publications by browse.metadata.type "Review"

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    A comparative analysis of embryo implantation potential in patients with severe teratozoospermia undergoing in-vitro fertilization with a high insemination concentration or intracytoplasmic sperm injection
    (1996) Oehninger S.; Kruger T.F.; Simon T.; Jones D.; Mayer J.; Lanzendorf S.; Toner J.P.; Muasher S.J.
    The objective of this study was to assess fertilization, implantation and pregnancy rates in infertile patients with severe teratozoospermia [P (poor prognosis) pattern sperm morphology assessed by strict criteria] treated by in-vitro fertilization (IVF) using a high insemination concentration (HIC), or by intracytoplasmic sperm injection (ICSI). This was a retrospective cohort study performed in an academic tertiary institution. The outcome of 115 consecutive ICSI cycles was compared to that of a similar number of cycles of IVF with HIC performed during a similar time frame and matched by woman's age and basal serum (cycle day 3) follicle stimulating hormone concentrations. The inclusion criteria were sperm morphology ≤4% normal forms (P pattern) and ≥1×106 total motile spermatozoa per ejaculate. The diploid fertilization rate in the HIC-IVF group was 86% and in the ICSI group 68% (P < 0.05). Importantly, an equal number of embryos was transferred to both groups of patients. The morphological quality of the embryos (proportion of transfers having superior morphology embryo scores) was significantly better in the ICSI group than in the patients receiving HIC-IVF. Although there was a clear trend for better implantation and pregnancy rates in the ICSI group, these differences were not statistically significant. We conclude that, although HIC-IVF resulted in a higher fertilization rate than ICSI in patients with severe teratozoospermia, ICSI produced a significantly higher proportion of morphologically superior embryos with a tendency towards a higher implantation potential. Therefore, teratozoospermic patients having adequate numbers of motile spermatozoa should be offered ICSI as an alternative to modified (HIC) IVF treatment.
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    A role for mitochondrial DNA in the pathogenesis of radiation-induced myelodysplasia and secondary leukemia
    (1993) Hatfill S.J.; La Cock C.J.R.; Laubscher R.; Downing T.G.; Kirby R.
    The onset of acute myeloid leukemia following ionizing radiation or alkylating agent exposure is antedated months to years by the development of 'preleukemia', or secondary myelodysplastic syndrome (sMDS). Mitochondrial abnormalities induced by chloramphenicol and clonal deletions of mitochondrial DNA (mt DNA) in the bone marrow create hematological defects similar to sMDS, and abnormal dimers of mt DNA are observed in acute leukemia. This suggests a role for mt DNA in the pathogenesis of sMDS and secondary leukemia. We outline disparate experimental evidence to support this concept and suggest a role for select protease inhibitors in the clinical management of this disorder.
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    Abruptio Placentae and Disseminated Intravascular Coagulopathy
    (2009) Hall D.R.
    Abruptio placentae is an important cause of vaginal bleeding in the latter half of pregnancy. The key factor in the pathophysiology is hemorrhage at the decidual-placental interface. Small episodes may escape clinical detection, but severe grades impact significantly on fetal and maternal morbidity and mortality, with the most frequent complications being fetal death, severe maternal shock, disseminated intravascular coagulopathy, and renal failure. Important risk factors for the development of abruptio placentae are previous abruption, hypertensive diseases, abdominal trauma, growth restriction, and smoking. The diagnosis is essentially made on the clinical picture that includes vaginal bleeding (usually dark blood), abdominal pain, and uterine contractions. The essence of management is restoration of circulating volume followed by delivery of the fetus and placenta, most often by cesarean section when the diagnosis is clear and the fetus alive and viable. Aggressive resuscitation and expeditious vaginal delivery are the goals when the fetus is dead. © 2009 Elsevier Inc. All rights reserved.
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    Acrosome reaction, acrosin levels, and sperm morphology in assisted reproduction
    (1996) Kruger T.F.; Menkveld R.
    Strict criteria are clinically helpful and can be used to counsel patients and to plan correct treatment in assisted reproduction to alleviate male-factor problems. It can be concluded that normal sperm morphology is needed for normal sperm function, especially sperm-zona pellucida binding, the acrosome reaction with release of (pro)acrosin, and sperm-oolemma fusion. The inclusion of an acrosome index, however, can be a more valuable addition to the evaluation of sperm morphology for the prediction of expected IVF rates, especially in patients with 4% or less morphologically normal spermatozoa.
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    Adjuvant pre- and postoperative radiation therapy, influence on negative prognostic factors - A review of the recent literature
    (2001) Smit B.J.
    The purpose of this article is to review the known and new prognostic factors in carcinoma of the uterine cervix with reference to pre- and postoperative radiotherapy. A literature search of the most recent articles was done and reviewed. Risk factors identified include tumor volume and stage, lymph node status, number of positive lymph nodes, depth of invasion, histology, vascular invasion, anaemia, vascular stromal invasion, radiosensitisers, tumour grade, tumour markers, HPV status, positive surgical margins, interval between surgery and radiotherapy, parametrial invasion, radiotherapeutic technique, upper versus lower node involvement and overall radiotherapeutic treatment time. Several possibly useful new insights have emerged. Of these, of immediate practical use is the observation that lower pelvic node involvement, or a single positive node, did not affect survival when postoperative radiotherapy was given. Paraaortic node involvement remains a serious matter, but postoperative irradiation of these nodes does seem useful to prevent recurrence in this region. Parametrial invasion plus more than two positive lymph nodes is a cut-off point with regard to prognosis. Postoperative radiotherapy for patients with the more common risk factors did succeed in securing an excellent local control. Overall treatment time for radiotherapy, as well as the interval between surgery and radiotherapy are important factors to ensure successful postoperative radiotherapy. Tumour size, differentiation and ploidy all correlated with treatment outcome. Among patients with pelvic lymph node metastases without parametrial extension, those who received postoperative chemotherapy or chemoradiation had significantly better recurrence-free survival (p = 0.017) and overall survival (p = 0.043) than those who received no adjuvant therapy. Specific survival rates for defined nodal status could be demonstrated. Strategies to improve survival in patients with many positive nodes are urgently needed. Three-dimensional (3D) and parallel-opposed techniques are equi-effective, but the 3D technique is far less damaging to the normal structures. A very promising finding is that elevated squamous cell carcinoma antigen (SCCA) at the time of diagnosis of stage IB-IIA cervical cancer indicated a three-times increase in risk of tumour recurrence, independent of tumour diameter, grade or the presence of lymph node metastases. High pre-treatment SCCA could therefore be used to select high-risk patients for adjuvant therapy. Preoperative radiochemotherapy led to a response in 100% of patients: 64% complete and 36% partial; of 24 patients operated on, 23/24 showed negative section margins. In early-stage patients, dose at point A was a significant prognostic factor. Postoperative radiotherapy after inappropriate surgery seemed to be effective in retrospective stage IA or IB disease.
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    Adolescents with cancer: How can we meet their specific needs in developing countries?
    (2008) Stefan D.C.
    Cancer occurring in adolescents (10 to 19 years) is more than twice as common as cancer in children but has received less attention in South Africa. In the process of becoming adults, adolescents undergo major physical, psychological, and social changes. They manifest specific behaviors and have special emotional needs. Malignant disease and its treatment have the potential to disrupt seriously the processes of adolescence, whereas the emotional instability and the risk-prone behavior characteristic to this age may jeopardize the success of the treatment. A further disruption in the management of these patients, in South Africa, is the need to refer children over the age of 13 to the adult medicine service. Research done worldwide on transferring of adolescents with cancer and other chronic diseases to adult health care underscores the need for a structured and individualized transition. Whilst, in some developed countries, adolescent cancer units already function for years, the extent of the problem has not yet been evaluated in most developing countries, where cancer registers do not even exist. A few simple measures might improve substantially the outcome of cancer in adolescents in the developing world. ©Freund Publishing House Ltd.
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    Allergic conditions of the eye
    (2010) Smit D.
    [No abstract available]
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    Alternative magnesium sulphate regimens for women with pre-eclampsia and eclampsia
    (2008) Duley L.; Matar H.E.; Almerie M.Q.; Hall D.R.
    [No abstract available]
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    An approach to the diagnosis and management of patchy, non-scarring hair loss
    (2007) Jordaan H.F.
    This article presents a clinical approach to patchy, non-scarring hair loss and includes conditions like alopecia areata, trichotillomania, dermatophyte infection of the scalp, syphilitic alopecia and traction folliculitis.
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    An update on bronchopulmonary dysplasia: Is there a relationship to the development of childhood asthma?
    (2003) Smith J.
    There appears to be some interesting commonalities between asthma and BPD. The prevalence of both conditions is on the rise, both conditions tend to cluster in families, and they share wheezing phenotypes, i.e., mild-moderate reversible airway obstruction and a similar degree of response to pharmacological provocation. Furthermore, significant overlap exists with regard to the presence of elevated concentrations of airway inflammatory mediators concurrent with reduced levels of anti-inflammatory activity, in serum and BAL fluid, as well as histological evidence for airway 'remodelling'. Both BPD and asthma are characterized by increased smooth muscle contraction, and in asthma, the smooth muscle may be involved in the primary development of the asthmatic phenotype. Since wheezing is a common finding among children with BPD, an interesting question is whether BPD is a phenotypic variant of asthma? © 2003 Elsevier Ltd. All rights reserved.
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    Anatomical and functional aspects of testicular descent and cryptorchidism
    (1997) Hutson J.M.; Hasthorpe S.; Heyns C.F.
    [No abstract available]
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    Antepartum haemorrhage of unknown origin after 24 weeks of pregnancy - How to approach it
    (2011) Lourens R.J.; Steyn D.W.
    [No abstract available]
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    Arterial oxygenation and one-lung anesthesia
    (2008) Levin A.I.; Coetzee J.F.; Coetzee A.
    PURPOSE OF REVIEW: In the presence of the obligatory shunt during one-lung ventilation, arterial oxygenation is determined by the magnitude of the shunt in addition to the oxygen content of the mixed venous blood coursing through that shunt. The present discussion aims to heighten awareness of factors determining arterial oxygenation during one-lung anesthesia, other than the magnitude of the shunt and dependent lung low-ventilation perfusion units. RECENT FINDINGS: A convenient way to increase mixed venous and thereby arterial oxygenation is to raise cardiac output. While this approach has achieved some success when increasing cardiac output from low levels, other studies have highlighted limitations of this approach when cardiac output attains very high levels. The effect of anesthesia techniques on the relationship between oxygen consumption and cardiac output could also explain unanswered questions regarding the pathophysiology of arterial oxygenation during one-lung anesthesia. SUMMARY: The effects of anesthesia techniques on oxygen consumption, cardiac output and therefore mixed venous oxygenation can significantly affect arterial oxygenation during one-lung anesthesia. While pursuing increases in cardiac output may, under limited circumstances, benefit arterial oxygenation during one-lung ventilation, this approach is not a panacea and does not obviate the necessity to optimize dependent lung volume. © 2008 Lippincott Williams & Wilkins, Inc.
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    Ascites revisited: The value of serum-ascites albumin gradient (SAAG)
    (2010) Wilken E.
    [No abstract available]
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    Assessing and managing blood loss
    (2010) Langenegger E.; Rout C.
    [No abstract available]
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    Atopic dermatitis - New perspectives in clinical assessment
    (1993) Cilliers J.
    [No abstract available]
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    Automated sperm morphology analysis: Quo vadis
    (1997) Coetzee K.; Kruger T.F.
    [No abstract available]
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    Avian influenza: What the family practitioner should know
    (2006) Senekal M.; Wasserman E.
    [No abstract available]
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    Biomarkers in Barrett's oesophagus
    (South African Gastroenterology Review, 2009) Marais M.
    [No abstract available]
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    Bladder cancer in Africa.
    (2008) Heyns C.F.; van der Merwe A.
    Accurate epidemiological data about the incidence and mortality of bladder cancer are unavailable for most African countries. Transitional cell carcinoma (TCC) of the bladder is probably less common in rural African regions than in industrialized countries, due to lower levels of exposure to carcinogenic chemicals. In areas with endemic schistosomiasis (bilharzia) caused by parasitic schistosomes (blood flukes), most bladder cancer cases are comprised of squamous cell carcinoma (SCC). However, with increased urbanization, industrialization, and cigarette smoking in many African countries, there is an increasing incidence of TCC relative to SCC of the bladder. SCC of the bladder presents in patients who are on average 10 to 20 years younger than those with TCC. In Egypt and other North African countries, SCC is more common in men (the male to female ratio ranges from 3:1 to 5:1), probably because boys and men performing agricultural work are more exposed to schistosomiasis-infested water. In some sub-Saharan countries, SCC of the bladder is equally common in men and women, probably due to equal schistosomiasis exposure of girls and boys, and because women obtain household water and perform most agricultural tasks. Although SCC of the bladder often presents at a locally advanced stage, the tumors are usually well differentiated, with a relatively low incidence of lymphatic and hematogenous metastases. Patients with localized SCC are ideal candidates for cystectomy and orthotopic neobladder construction, because they are relatively young and healthy, and there is no risk of urethral recurrence, unlike with TCC. Unfortunately, many patients in Africa still present with advanced and inoperable bladder cancer, and many do not have access to healthcare facilities that can provide a cure and a good quality of life by means of radical cystectomy and neobladder construction.