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Biomedical subjects

J H Louw

Publications and source records attributed to J H Louw.

At least 19 recordsLinked to original sources
PubMed1979

Liver tumours and the contraceptive pill: Controversies in aetiology, diagnosis and management.

Six female patients seen at Groote Schuur Hospital between 1973 and 1977, with the types of liver lesion that have been linked aetiologically with the contraceptive pill, are described. Four had focal nodular hyperplasia (1 with spontaneous rupture), and 1 patient had a hepatocellular carcinoma. The sixth patient had spontaneous rupture of the liver but no tumour was demonstrated. Based on this experience and a review of the literature, controversies in aetiology, diagnosis and managment are presented. A defined management policy is proposed for the benign lesions, a less aggressive approach being advocated for focal nodular hyperplasia than for hepatic adenoma.

Adenoma↗
PubMed1979

A brief history of the Medical Faculty, University of Cape Town.

Outstanding events in the history of the Medical School, University of Cape Town, include the establishment of a full faculty in 1920, the move of the teaching departments from the Gardens to Observatory in 1926/1928, the opening of the Groote Schuur Hospital in 1938, the signing of the joint agreement with the Cape Provincial Administration in 1951, and the tremendous growth and research activities since that time.

Curriculum↗
PubMed1979

Acid secretion in the bile duct-ligated pig.

Bile duct ligation is associated with severe gastric ulceration in the pig, but the pathogenesis is unknown. Gastric acid secretion was therefore studied before and after bile duct ligation in pigs with Heidenhain pouches. Basal pouch secretion and the response to submaximal pentagastrin stimulation incresed significantly 6--14 days after ligation of the common bile duct (P < 0,05). Bile duct ligation was not followed by gastric ulceration in the pigs in this study which had had, in effect, a 50--70% gastric resection in the course of fashioning the Heidenhain pouch. These observations suggest that oesophagogastric junction ulceration in pigs is associated with gastric acid hypersecretion.

Animals↗
PubMed1979

The diabetic foot.

Modern thought regarding the pathogenesis, clinical features and management of the 'diabetic foot' is reviewed. The interplay of the triad of ischaemia, neuropathy and infection is emphasized throughout. Management is directed at maintaining or providing a pain-free, working foot.

Aging↗
PubMed1979

A 10-year survey of large bowel carcinoma at Groote Schuur Hospital with particular reference to patients under 30 years of age.

In a 10-year survey of large bowel carcinoma at Groote Schuur Hospital 926 cases were studied retrospectively. A marked difference was seen in both the age of presentation and histological differentiation in two different racial groups. All patients who were 29 years of age or less at the time of presentation have been studied in detail. Predisposing factors, symptomatology, treatment, pathology and prognosis are discussed. It is apparent that large bowel carcinoma in the young has a very poor prognosis.

Adolescent↗
PubMed1979

A comparative randomized trial of heparin versus streptokinase in the treatment of acute proximal venous thrombosis: an interim report of a prospective trial.

A controlled, prospective study comparing streptokinase and heparin treatment has been completed in 51 patients presenting with acute proximal venous thrombosis of less than 8 days' clinical duration. Patients were studied by means of pre-treatment, post-treatment, 3- and 12-monthly phlebography and pulmonary perfusion scanning and were followed up at 3-monthly intervals. Of the 26 patients randomized to receive streptokinase, therapy was stopped in 3 because of complications. Phlebography 5 days after starting treatment showed 80--100 per cent lysis in 17 of the 23 patients who completed the course of streptokinase. Two patients later developed partial rethrombosis. One patient developed an asymptomatic pulmonary embolus during treatment. During follow-up (mean 19 months) only 1 of the 17 patients with 80--100 per cent lysis developed postphlebitic symptoms, 3 patients died of unrelated causes and 1 patient was lost to follow-up. In patients randomized to heparin therapy no significant lysis was achieved in any of the 25 patients and only 2 of these patients were found to have asymptomatic legs on follow-up. Two patients in this group died and autopsy confirmed massive pulmonary embolus during treatment. These data suggest that streptokinase is superior to heparin in the treatment of acute proximal venous thrombosis of less than 1 week's clinical duration especially if the thrombus is largely non-occlusive. It must be stressed that in order to avoid the bleeding complications of thrombolytic therapy, streptokinase must not be used within 10 days of major surgery, or even longer after vascular, neurosurgical or eye operations.

Adult↗
PubMed1978

Skin necrosis after warfarin therapy.

A rare but potentially lethal complication of coumarin and its congeners is skin necrosis. A case of skin necrosis due to warfarin is reported and the literature is reviewed. It is suggested that if necrosis develops, the coumarin therapy should be terminated, and the patient should immediately be heparinized. Heparin, which never causes necrosis, can be used freely if further anticoagulation therapy is required, and may well prevent necrosis due to the thrombotic process.

Adolescent↗
PubMed1978

Central papillary atrophy of the tongue and denture stomatitis.

A retrospective study of the epidemiologic data of 4,417 subjects has been undertaken to study the possibility of a link existing between glossal central papillary atrophy (median rhomboid glossitis) and denture stomatitis. Neither the association between glossal central papillary atrophy and denture stomatitis nor the association between glossal central papillary atrophy and denture use was statistically significant. However, the correlation between wearing removable dental prostheses and finding candidal mycelia in smears from these tongue lesions was statistically highly significant. Debilitation caused by general age changes would not appear to predispose to atrophy of the pappillae of the middle portion of the tongue-dorsum.

Atrophy↗
PubMed1978

Total colonic aganglionosis.

This study is based on 17 neonates suffering from total colonic aganglionosis. The male:female ratio was 2:3 and there was a significant familial occurrence. The ages on admission varied between 1 and 90 days. The clinical presentation was extremely variable. Early diagnosis depends on clinical awareness of the condition in neonates who have intestinal obstruction or diarrhea, or both. The most important radiologic indication was retention of barium for 24 hours. Results of manometric studies were misleading. Suction biopsy of the rectum provided the only sure method of diagnosis, although determination of cholinesterase activity in the biopsy specimen and in the patient's serum was of some value. Two patients died before operation and two died from total colonic and small intestinal aganglionosis. Eight patients survived both the initial ileostomy and subsequent pull through operation. Of the various procedures utilized, the Lester Martin operation has proved to be the most satisfactory.

Cholinesterases↗
PubMed1977

Perforated duodenal ulcer: is the distinction between acute and chronic valid?

Perforations of acute and chronic duodenal ulcers were compared in 70 patients by analysis of the age and racial incidence, the acid output and the histology of the ulcer edge at the time of perforation. There was no significant difference between the ulcer types when these variables were considered. It is suggested that the only difference is the perseverance of symptoms and likelihood of relapse in the chronic group, and that in pathological terms the only true acute ulcer is the rare stress ulcer.

Acute Disease↗
PubMed1977

The coagulopathy associated with aortic aneurysms.

The authors in this article record their experience with eight-four patients with abdominal aortic aneurysms. Twenty-seven patients (32%) presented with ruptured aneurysms with an overall mortality of 56%. Of the unruptured aneurysms, 67% were operable with a mortality of 5.3%. The highest mortality amongst the patients with ruptured aneurysms was in the group who was shocked. In the group with ruptured aneurysms, of those in whom platelet counts were performed, 50% were abnormally low, and 56% had evidence of abnormal coagulation. Seventy per cent of those with coagulation abnormalities died. In the unruptured group 28.2% had thrombocytopenia but no other abnormalities of coagulation. All patients undergoint aneurysm resection should have a platelet count and a full clotting screen. Therapy should be directed to normalization of the coagulation system.

Adult↗