Biomedical subjects

J P Nel

Publications and source records attributed to J P Nel.

6 recordsLinked to original sources

PubMed1996

Cerebral infarction and intracranial arterial dissection in closed head injury.

This report describes the autopsy findings in three cases of closed head injury dying of cerebral infarction, with brain swelling and herniation. In each instance the cause of the infarct was found to be subintimal dissection involving intracranial anterior circulation arteries. The autopsy findings underscore the value of histological examination of vessels that macroscopically appear thrombosed. We discuss factors that impact on the reported incidence and make brief mention of problems surrounding the true pathogenesis of this lesion.

Adolescent↗

PubMed1993

Identification of an American hiker.

The skeletonized remains of an American hitch-hiker were recovered from a forest near Knysna in the Cape. There were no recognizable features except the presence of dental restorations. The use of the "fax" to transmit dental records while being a speedy means of communication does have its limitations. Electrical faults on the telephone line can cause the document to become illegible and subsequent duplication of this document aggravates the problem. An appeal is made to standardize the notation of teeth by using the FDI code and to adopt a 2 digit code for restoration morphology.

Adult↗

PubMed1989

Morphometric analysis to detect suspected myocardial disease. A pilot study.

Myofibres in the normal left ventricle (LVs) of 24 healthy young accident victims and the diseased LVs of 10 subjects who died from constrictive pericarditis or congestive (African) cardiomyopathy were subjected to morphometric evaluation. Each myofibre was represented by a pair of measurements: cross-nuclear fibre (FD) and nuclear (ND) diameters. Using a VIDS image analyser interfaced with a light microscope, 150 paired measurements were determined for each of the 34 specimens. The bivariate relationship between FD and ND for each group of specimens were expressed as linear regressions. The limits for the group distribution of normal specimen FD/ND means were calculated and graphically depicted in the form of an ellipse. Disease specimens were plotted for comparison. Of the normal specimens, 23/24 FD/ND coordinates fell within the "normal' ellipse whereas the altered relationship between FD and ND in pathological myocardia caused all 10 specimen means to be plotted outside the ellipse and their regression lines to be displaced from normal. It is suggested that the normal data define the morphometric parameters of LV myofibres in healthy hearts and create a graphic standard by which myofibre pathology in hearts suspected of disease can be detected.

Adolescent↗

PubMed1988

Prevention of death from head injury in Natal.

A detailed review of 100 consecutive head injury deaths in the Natal area was undertaken after forensic autopsies had been performed; neurohistological examination was carried out in 69 cases. It was found that one-third of deaths could have been prevented by medical treatment. Hypoxic and ischaemic brain damage was judged to be a contributing cause of death in 88% of all victims. Factors isolated as major causes of preventable death included: failure to prevent hypoxic brain damage by timeous endotracheal intubation and rapid resuscitation; major delays in referral from feeder hospitals; and failure to detect intracerebral haematomas and contusions which subsequently caused raised intracranial pressure. Recommendations for improving this situation are discussed, with particular reference to the situation in Natal.

Adult↗

PubMed1986

Anatomy of the recurrent laryngeal nerve: a redescription.

The recurrent laryngeal nerves on each side of the neck consist of numerous branches. The demonstration of the diverse relationships of the recurrent laryngeal nerve in the thyroid area explains the variation in vocal cord and cricopharyngeal muscle paralysis produced by surgical or other trauma to this area. The anastomosis of the middle cervical ganglion with the recurrent laryngeal nerve adds a new dimension to the already confused theories on vocal cord and laryngeal function. Both the motor and sensory supply of the larynx inferior to the cords, lower pharynx, cervical oesophagus and cervical trachea are supplied by the recurrent laryngeal nerve branches and their sympathetic anastomoses. The blood vessel-nerve relationship in these neck dissection specimens is quite different from that documented in the standard literature in that there are numerous blood vessels from the inferior thyroid artery that interdigitate with the branches of the recurrent laryngeal nerve.

Adolescent↗

PubMed1984

Fatal air embolism following penetrating lung trauma: an autopsy study.

During a 3-month period an autopsy study was performed on cases of penetration lung trauma to assess the frequency and significance of air embolism. The technique of detecting air in the chambers of the heart and the coronary vessels was, in the early part of the study, to flood the pericardium with water and observe for air while stabbing the heart chambers. Later it was found preferable to manipulate the removed heart in a basin under water. Twelve cases demonstrated injury to the pulmonary parenchyma alone with no other injury, either intra- or extra-thoracic, to account for death. In nine of these cases significant amounts of air were demonstrated in the heart and coronary vessels using our autopsy techniques. Case reports are summarized to emphasize the clinical picture (unexplained hypovolemic shock, cerebral symptoms) and autopsy findings (evidence of air embolism). Successful management requires an awareness of the condition, correction of those factors exacerbating air embolism, and prompt thoracotomy in order to clamp the injured lung pedicle in patients failing to respond to therapy.

Adult↗