Liver transplantation

Human liver transplantation, which was first performed in man in Denver 15 years ago, has finally come of age in the past 2 years. The 1 year survival has improved from 28 per cent to 50 per cent in the recent Denver Second Series. Past experience has shown that long-term prognosis can usually be determined based on the 1 year assessment. Patients who are fit with a well functioning liver are likely to remain well. This applied to the 45 per cent of the 1 year survivors in the First Denver Series, who are still alive today at between 2 5/6 and 8 5/6 years. It has however, been a much more frequent finding in the Second Series, which suggests that a significant number of patients should be long-term survivors in the future. Improved survival has been attributed to a number of factors including a better understanding of the rejection and infection problems in immunosuppressed liver recipients. Postoperative hepatic dysfunction is no longer as easily ascribed to rejection, and an aggressive diagnostic approach has helped to prevent over-immunosuppression. Furthermore, new approaches to the biliary anastomosis, and a better understanding of the blood supply of the human bile duct, is currently preventing many of the earlier catastrophes related to this, the Achilles heel of liver tranplantation

Stimulation of hepatic regeneration after partial hepatectomy by infusion of a cytosol extract from regenerating dog liver

A cytosol liver extract was prepared from adult dog livers and from liver remnants that had been regenerating for one, two and three days after 72 per cent partial hepatectomy. Given intraportally, the most active of these cytosols did not stimulate proliferation in the livers of normal dogs. However, infused during a six hour period into the portal vein of test group dogs, the cytosol from 48 and, especially, 72 hour regenerating livers augmented the regeneration response ordinarily produced by 44 per cent partial hepatectomy. The effect was delayed. It became identifiable 48 hours after infusion and reached a peak at 72 hours. Neither augmentation nor significant inhibition of the normal regeneration response was produced by cytosol from normal liver and 24 hour regenerating liver or by a six hour infusion of insulin. The amplification effect of active cytosol was equivocal when the infusions were given intraperitoneally and was not demonstrable at all by the intravenous route. In these investigations, it is confirmed that there are growth control factors in regenerating liver but the nature or physiologic significance of the factor or factors has not been clarified

Fistula in ano: a five-year survey at Groote Schuur Hospital and a review of the literature

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A Foucauldian analysis of the CA profession in South Africa: Implications for society

Chartered accountants are often business leaders who frequently need to make decisions. Consequently, it is of importance for the fractured democratic South Africa that citizens (especially business leaders, such as chartered accountants) develop a socially just consciousness. In this article, we provide the results of an analysis of one of Michel Foucault’s genealogical works, and introduce some of Foucault’s views pertaining to knowledge and power. Foucault (1995) identified three disciplinary power mechanisms, namely hierarchical observation, normalising judgement, and the examination. Consequently, we used this particular Foucauldian lens to analyse the disciplinary power mechanisms evident in the CA educational landscape. Lastly, we identified the consequences for education (and therefore ultimately society) as a result of the particular power relations in the chartered accountant educational landscape and profession

GROWTH-STIMULATING FACTOR IN REGENERATING CANINE LIVER

Extracts from dog livers which had been regenerating for 24, 48, and 72 h after hepatectomy were infused for 6 h into the left portal vein of animals which had fresh portacaval shunts (Eck fistula) and which were killed 2 and 3 days later. The brief exposure to the 48-h and especially the 72-h regenerating liver extracts induced a delayed proliferative response predominantly in the left liver lobes, with a slight spillover effect to the right liver lobes but none to the kidney. The response reached its peak 3 days later. In the left but not the right liver lobes, both the 48-h and the 72-h regenerating liver extract reversed the atrophy ordinarily caused by Eck fistula in 3 days and partly prevented the ultrastructural hepatocyte deterioration characteristic of Eck fistula. The active liver extracts apparently contained a growth-control factor or factors which is (are) not insulin or glucagon. © 1979

Chartered accountancy and resistance in South Africa

In recent times, the chartered accountant profession was regularly in the news for reasons pertaining to the unethical and unprofessional behaviour of members. The profession has an important role to play in the South African economy, as members will often fulfil important decision-making roles in business. In a response to the dilemmas the profession is facing, we analysed the implications for the profession and society due to a resistance to include research as a pedagogical activity in the chartered accountancy educational landscape. Through deliberative research activities, students have the opportunity to engage with community members and with societal challenges that could foster reflexivity and humaneness in students. In addition, critical and problem-solving skills are cultivated. These are skills that are difficult to assess in the form of an examination, and the absence of research as pedagogical activity in this particular educational landscape, impacts the cultivation of these skills in future chartered accountants. This is so, as the chartered accountancy educational landscape is significantly influenced by the power that resonates within the profession and culminates into the disciplinary power mechanism of the examination. The South African Institute of Chartered Accountants (SAICA) set an external examination, called the Initial test of Competence (ITC), which graduates need to write upon leaving institutes of higher learning. Success in this SAICA-examination therefore impacts on the teaching and learning pedagogy adopted by chartered accountants in academe. If chartered accounting students were instead primarily being exposed to technical content assessed via an examination, also being exposed and introduced to deliberative research, the possibility exists that students, through critical reflexivity, could move beyond the constraints of the self to that of the communal other in line with the African notion of ubuntu can be enhanced

Profound hypothermia using extracorporeal circulation without an artificial oxygenator

No Abstract