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Biomedical subjects

J A van Zyl

Publications and source records attributed to J A van Zyl.

At least 19 recordsLinked to original sources
PubMed2006

Oligozoospermia: recent prognosis and the outcome of 73 pregnancies in oligozoospermic couples.

The minimum value for each of the five main semen parameters, below which conception rarely occurred or did not occur at all, was calculated in a group of 1884 couples complaining of primary and secondary infertility: 304 conceptions including first as well as consecutive conceptions, occurred. The parameters evaluated were (minimum value calculated in this study between brackets) volume (1.0 ml), sperm count ml(-1) (2.0 million), total sperm count (4.0 million), motility (10%), forward progression (2.0 MacLeod units: scale 1-4) and normal sperm morphology (3%). The pregnancy rate in the group of 308 oligozoospermic men and the minimum value of semen parameters were the cornerstones in determining the prognosis for oligozoospermic patients. A sperm count of >2.0 million ml(-1) was considered relatively adequate for eventual conception judged by the 68 of 308 (22.1%) pregnancies that occurred among oligozoospermic men in this study, provided that the other five semen parameters showed values above the minimum value. In cases where the average sperm count was <2 million ml(-1), the chances for conception became rare, viz five of 308 (1.6%). The total number of pregnancies in the group classified as oligozoospermic was 73 (23.7%). With these pregnancies there was no increase in the rate of foetal wastage and congenital abnormalities. Abortion occurred in 15.09% and ectopic pregnancy in 0.9% among first and consecutive pregnancies. One infant among the 56% boys and 44% girls was born with congenital abnormalities. Most of these infants had a normal birth mass of >2500 g.

Abortion, Spontaneous↗
PubMed1995

Tumour excision plus continuous tamoxifen compared with modified radical mastectomy in patients over 70 years of age with operable breast cancer.

Between 1985 and 1991, we randomly assigned 77 women over the age of 70 years with stage I-3a breast cancer to undergo a modified radical mastectomy or tumour excision followed by tamoxifen. Median follow-up was 45 months. Patients treated by tumour excision and tamoxifen had a significantly better survival (P = 0.04). The disease-free survival of the tumour excision and tamoxifen group was close to significantly better (P = 0.10). Only two patients in the tamoxifen group required an axillary dissection on follow-up for progressive nodal enlargement. Two patients underwent a local mastectomy for locally recurrent disease. We conclude that tumour excision followed by continuous tamoxifen is an acceptable, safe alternative to a modified radical mastectomy in patients over 70 years of age.

Aged↗
PubMed1991

[The cost of treatment operable breast cancer].

The cost of primary treatment of operable breast cancer was investigated in 25 patients. As a result, appropriate cost-saving measures were instituted. In 1988 the total costs paid by the patients amounted to R40 690. The actual cost calculated according to the Scale of Benefits would have amounted to R175 035. The average subsidy per patient amounted to R5 373. If the minimum number of special investigations before treatment on the 258 new patients registered in 1988 had been performed an amount of R60 000 would have been saved. If the number of inpatient days could have been reduced R284 832 would have been saved. Doctor's fees, theatre fees and the cost of medicine are fixed. Long-term savings are possible only if breast cancer can be diagnosed early, if inpatient days are limited, and if all doctors and students are selective in their requests for special investigations.

Breast Neoplasms↗
PubMed1990

The evaluation of morphological characteristics of human spermatozoa according to stricter criteria.

The evaluation of the morphology of human spermatozoa varies widely between and sometimes even within laboratories. The purpose of this study was to determine whether the method that has been developed in our laboratory and which resulted in the use of stricter criteria for the evaluation of sperm morphology is a practical, reliable and repeatable method and to establish the within and between observer variations. The criteria used for a 'normal' spermatozoon are based on the appearance of spermatozoa found in the mucus of the upper endocervical canal. The results of the morphological evaluations of 26 samples by four observers were statistically analysed by various methods. The method of Barnett showed a high degree of relative accuracy between observers with error variances of between 2.89 and 19.67 as well as high Spearman rank correlation coefficients of between 0.8675 and 0.6537 (P less than 0.0003). The Spearman correlation coefficient for 15 duplicate evaluations by one observer was 0.9650 (P less than 0.0001) while the coefficients of variation for repeated evaluations of single samples were also within acceptable limits. Based on these results, the method described in this article allows comparable and reliable results between and within observers to be obtained. From this and other studies it can be concluded that the method also has a good prognostic value for the prediction of expected IVF fertilization, the hamster test and hemizona assay.

Cytodiagnosis↗
PubMed1989

Phyllode tumours of the breast. A review of 21 cases.

Twenty-one cases of phyllode tumours of the breast (9 malignant, 4 borderline and 8 benign) were reviewed. Three patients with malignant tumours developed metastases, and all died. Eight patients developed local recurrence, 6 in the malignant and borderline groups and 2 in the benign group. The classification into malignant, borderline and benign groups is a reliable guide for use when deciding on the extent of surgery. Malignant and borderline tumours require local mastectomy, while tumour excision suffices for benign disease. The customary pathological separation of malignant phyllode tumours from primary sarcoma of the breast is questioned.

Adult↗
PubMed1987

Sex and infertility. Part I. Prevalence of psychosexual problems and subjacent factors.

Data on 514 couples with psychogenic factors affecting their sex lives and fertility showed that the most prevalent problems were lack of sex education, consequences of premarital sex and the problem of infertility per se. These factors contributed to psychosexual problems of which the general prevalence was 42% (10.5% women, 13.2% men and 18.3% both husband and wife). The high prevalence of psychosexual problems emphasises the importance of the inclusion of extensive training in sex counselling in the curricula of medical students and the urgent need for sex counselling facilities at training hospitals.

Female↗
PubMed1987

Sex and infertility. Part II. Influence of psychogenic factors and psychosexual problems.

In a study of 514 couples ignorance about sex because of a complete lack of or inadequate sex education resulted in an unfavourable attitude towards sexual behaviour which adversely affected their fertility. Sexual activities which gave rise to feelings of guilt, fear or anguish had a dramatic effect on fertility; most important were premarital intercourse, criminal and therapeutic abortion, illegitimate children and prostitution. Psychosexual problems were found to have a direct influence on intercourse, as the results of post-coital tests showed. In 18.3% of cases severe psychosexual problems caused infertile couples to use lubricating substances to facilitate intercourse; this had a deleterious effect on penile penetration and on the migration of spermatozoa in the cervical mucus.

Female↗
PubMed1986

Sperm morphologic features as a prognostic factor in in vitro fertilization.

To determine whether there is a prognostic value in the percentage normal sperm morphologic features in a human in vitro fertilization (IVF) program, the authors conducted a prospective study in women with bilateral tubal damage. Based on the percentage of morphologically normal spermatozoa, the patients were divided into four groups: group I, normal morphologic features between 0% and 14%; group II, 15% to 30%; group III, 31% to 45%; and group IV, 46% to 60%. One hundred ninety successful laparoscopic cycles were evaluated. In group I, 104 oocytes were obtained, of which 37% fertilized, but no pregnancy resulted; in group II, 81% of 324 oocytes were fertilized, with a pregnancy rate per embryo transfer (ET) of 22%; in group III, 82% of 309 oocytes were fertilized, with a 31% pregnancy rate; and in group IV, 91% of 69 oocytes were fertilized, with a pregnancy rate of 12%. Probability models indicated that there was a clear threshold in normal sperm morphologic features at 14%, with high fertilization and pregnancy rate in the groups with normal sperm morphologic features greater than 14%.

Embryo Transfer↗
PubMed1985

Results of phase I of the in vitro fertilization and embryo transfer programme at Tygerberg Hospital.

Phase I (3 June - 31 October 1983) of the in vitro fertilization (IVF) programme at Tygerberg Hospital is outlined in this article. This programme led to the birth of the first IVF baby in South Africa after fertilization and embryo transfer (ET) took place at this institution. The baby was born on 29 April 1984; a second baby was born on 20 June 1984. During phase I 24 laparoscopies were performed; 32 oocytes were obtained from 56 follicles, of which 62,5% were fertilized. Eleven ETs were performed, which led to 3 pregnancies. An ongoing pregnancy rate of 18% per ET and a pregnancy rate of 12,5% per laparoscopy were achieved.

Adult↗
PubMed1985

Intrahepatic gallstones. A case report.

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.

Acute Disease↗
PubMed1984

Extracranial internal carotid artery aneurysm. A case report.

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.

Adult↗
PubMed1980

Danazol in the treatment of endometriosis externa.

Thirty-six women with endometriosis externa were treated with danazol (Ladogar; Winthrop Laboratories, Division of Sterling Drug (SA) (Pty) Ltd) for 6 months. In 15 cases treatment was combined with conservative surgery. Of these patients 34 presented with the complaint of infertility. The results were evaluated by means of repeat laparoscopy and biopsy. Of 21 patients treated with danazol only 9 (42,9%) were completely healed, and 10 (47,6%) showed a good response, giving an overall response of 90,5% and a corrected conception rate of 52,9%. Of the 15 patients who were treated with danazol combined with conservative surgery, 9 (60%) have completely healed, and 3 had a recurrence of endometriosis. This group had a corrected pregnancy rate of 30,8%. The majority of conceptions (61,5%) occurred during the first 6 months after treatment, 92,3% within the 1st year and 1 a year after conclusion of treatment. Of the 13 conceptions, 11 were successful, 1 ended in an abortion and 1 in an ectopic pregnancy, and 1 small-for-gestational-age infant was delivered.

Adult↗
PubMed1980

The infertile couple. Part II. Examination and evaluation of semen.

Most laboratories in South Africa have their own methods for examining and evaluating semen. This situation contributes towards conditions unfair to patients and undesirable for physicians dealing with infertility. The technique of obtaining semen specimens for examination is described. All tests that should be done as a routine and according to international standards, as carried out at Tygerberg Hospital, are described, with special reference to pitfalls in the examination and evaluation of semen. An urgent plea to maintain international methods, standards and terminology and for adequate specific training of technologists in the field of andrology is made.

Color↗
PubMed1980

The infertile couple: Part I. Schedule of management.

The regimen for the management of couples who complain of infertility is presented as it is practised at Tygerberg Hospital. The doctor-patient relationship, the importance of the patient's comprehansion of the specific treatment regimen and why it should be adhered to are stressed. Special investigations are discussed and certain pitfalls in the management of infertile couples are pointed out. Controversy still exists with regard to many aspects of the management. Decisions about when to start with infertility investigations, whom the couple should consult, whether they should be examined as a couple or separately, and how long they should receive treatment are dealth with.

Family Planning Services↗
PubMed1977

[Value of scintigraphy in the treatment of single nodules of the thyroid].

The value of radionuclide scanning of the thyroid gland was investigated in 125 patients with solitary thyroid nodules. Fifty-seven of the 95 patients with 'cold' nodules underwent surgery. The incidence of malignant nodules in this group was 16%; therefore surgery is recommended for all solitary 'cold' nodules. Of the 30 patients with 'warm' nodules, 20 were treated surgically and in only 1 patient was the nodule malignant. This incidence is probably not significant. Surgery is, however, also recommended for all solitary 'warm' nodules because of the possibility of toxic change. Accurate planning of the surgical procedure depends on any function of the nodule in question and this can be determined with certainty only by radionuclide scanning.

Humans↗