PubMed Health⌕ Search

Biomedical subjects

A E Groeneveld

Publications and source records attributed to A E Groeneveld.

7 recordsLinked to original sources
PubMed1999

[Fournier's gangrene].

Fournier's gangrene is a rapidly progressive, necrotizing fasciitis of the perineal, genital or perianal regions. Despite increasing knowledge about aetiology, diagnostic procedures and treatment, the gangrene is still a destructive and potentially lethal disease. In two patients, men aged 54 and 63 years, Fournier's gangrene was diagnosed. The first one died of septic shock 12 hours after admission. Surgical débridement had been performed immediately. He had a latent promyelocytic leukaemia. The second patient recovered fully after extensive surgical and antimicrobial therapy. Fournier's gangrene appears to be caused by the synergistic pathogenic action of various individually non-pathogenic commensal bacteria. Virtually all patients have an underlying systemic disorder, mainly chronic alcoholism or diabetes mellitus. Immunosupression is a predisposing factor. The gangrene requires an aggressive approach, treatment being based on the combination of haemodynamic stabilisation, antibiotic triple therapy and radical surgical débridement.

Aged↗
PubMed1996

Bladder cancer in various population groups in the greater Durban area of KwaZulu-Natal, South Africa.

OBJECTIVE: To study the incidence of different histological types of bladder cancer in various racial groups living within the same geographical region. PATIENTS AND METHODS: The study included 615 new patients with bladder cancer seen at three Provincial hospitals in Durban from January 1980 to January 1990. The patients were classified as Caucasian (white people of European descent). African (indigenous black people), Asian (people originating from the Indian subcontinent) or Coloured (people of mixed race). The bladder tumours were classified according to standard histopathological criteria as transitional cell carcinoma, adenocarcinoma or sarcoma. Mixed tumours consisted of both carcinomatous and sarcomatous or undifferentiated elements. RESULTS: Transitional cell carcinoma constituted 95% of the cancers in Caucasians, compared with only 30% in Africans, whereas squamous cell carcinoma occurred in 53% of the African patients, but in only 2% of the Caucasians. In Asian patients, 75% of the tumours were transitional cell and 18% were squamous cell carcinoma, whereas in Coloureds 82% were transitional cell and 9% squamous cell carcinoma. Undifferentiated carcinoma occurred in 8% of African and only 1% of Caucasian patients, whereas adenocarcinoma, mixed tumours and sarcoma occurred in 9% of African patients and only 2% of Caucasian patients. Ova of Schistosoma haematobium were seen in microscopic sections of the bladder tumour in 85% of the patients with squamous cell carcinoma, in 50% of those with undifferentiated tumours and adenocarcinoma, in 17% of those with mixed tumours or sarcoma, and in only 10% of the patients with transitional cell carcinoma. At presentation, African patients were a mean of > 20 years younger than Caucasians. In African patients with squamous cell carcinoma, 90% had stage T3 or T4 disease at presentation, whereas in Caucasian patients with transitional cell carcinoma 76% had stage T1 or T2 disease at presentation. From the study group, it appears that bladder cancer is about six times more common in Caucasians than in Africans. However, the value for Caucasian patients with bladder cancer probably underestimates the true value by about five times, so that bladder cancer in the greater Durban area may be as much as 30 times more common in Caucasians than in Africans. CONCLUSION: In African patients, endemic Schistosomiasis appears to be related to a high incidence of not only squamous cell carcinoma, but also undifferentiated tumours and adenocarcinoma of the bladder. The effective management of squamous cell carcinoma of the bladder in African patients will depend on the eradication of Schistosomiasis and the early detection of bladder cancer at a stage when it may still be cured by radical treatment.

Adenocarcinoma↗
PubMed1989

The role of ESWL in the treatment of large kidney stones.

With extracorporeal shock wave lithotripsy firmly established as the treatment of choice for the majority of kidney stones, the management of large stone burdens and staghorn stones remains a point of discussion(1,2,3,4). Although with increasing experience the original limitations(5,6) posed by the size and the number of kidney stones have gradually become less important, most centres still approach large stones with a combination of percutaneous ultrasound lithotripsy and ESWL. This article reports on a personal series of 96 kidneys with an average stone burden of 51 mm treated by ESWL alone or in combination with indwelling ureteral drainage tubes, so called double J stents. Of these 96 kidneys, twelve were treated in one session, 74 in two, nine in three and one in four sessions. At six to twelve weeks after their last treatment session 42 were stonefree, 30 contained residual fragments smaller than 3 mm and four contained fragments larger than 3 mm. Complications were hematuria, pain, fever, encrustration of stone on the double J stent, spontaneous knotting of the double J stent and subcapsular hematoma. No kidneys were lost in this series and no deaths occurred. The results are comparable to those of combined PCN and ESWL(1). A case is made for ESWL with internal drainage by double J stent as the only auxiliary measure in kidneys with large stone burdens(7,8).

Adult↗
PubMed1984

Experimental studies in pelviureteric obstruction and hydronephrosis.

The 'cellophane sclerosis' phenomenon was used to produce a slowly progressive pelviureteric obstruction in dogs. One group of the resulting hydronephrotic kidneys was treated by non dismembered pelvioplasty, the other by dismembered pelvioplasty. In order to establish some theoretical support for the prevailing clinical preference for the dismembered technique, postoperative results were compared in these groups. Criteria used were perfusion pressure profiles of the pelviureteric segment, still X-ray, fluoroscopy with videorecording, pathology and biochemistry. Scanning electron microscopy and video-densitometry were also introduced. Pressure profiles showed no significant difference after the two types of surgery. Still X-ray in the dismembered group shows a better anatomical result in the pelviureteric segment but suggests more extensive loss of renal parenchyma. X-ray videography in the non dismembered group shows irregular contours of the lumen with saccular pouches ('dogears'). In the dismembered group the pelviureteric segment can hardly be distinguished from that in the normal situation. Functionally however, no clear difference is observed between the two. Microscopy shows more fibrosis in the scar after dismembered operations. However, sufficient muscular tissue had regenerated for normal peristaltic waves to run across the scar in both groups. The epithelium had healed completely in both groups. Scanning electron microscopy shows 'thinning out' of the pelvic urothelium to only one layer in the hydronephrotic stage. Videodensitometry shows a resumption of coordinated peristaltic waves across the scar in both groups.

Animals↗
PubMed1978

An unusual scapular fracture.

This paper describes a fracture of the scapula, extending around the coracoid process and through the glenoid cavity. No humeral subluxation developed in this case. The diagnosis, complications and treatment of scapular fractures are discussed with reference to data from the literature.

Adult↗