Penetrating wounds of the large bowel

No Abstract

Intussusception in the adult

No Abstract

Carotid body tumours

with case presentation and angiographic demonstratio

The influence of geochemistry on health risks to animals and humans in geographically localised livestock production systems

(South African J of Animal Science, 2000, 30, Supplement 1: 82-84

History of clinical transplantation

How transplantation came to be a clinical discipline can be pieced together by perusing two volumes of reminiscences collected by Paul I. Terasaki in 1991-1992 from many of the persons who were directly involved. One volume was devoted to the discovery of the major histocompatibility complex (MHC), with particular reference to the human leukocyte antigens (HLAs) that are widely used today for tissue matching.1 The other focused on milestones in the development of clinical transplantation.2 All the contributions described in both volumes can be traced back in one way or other to the demonstration in the mid-1940s by Peter Brian Medawar that the rejection of allografts is an immunological phenomenon.3,4 © 2008 Springer New York

Granulomatous orchitis

Granulomatous lesions of the testis are rare. The case to be described is of interest, clinically in that it closely mimicked a testicular neoplasm, and pathologically because of the difficulty in arriving at a definite diagnosis. A provisional rapid section was first considered to show tuberculosis of the testis; on further consideration the histological appearances were regarded as being consistent with sarcoidosis; perusal of the literature finally raised the question of granulomatous orchitis

Induction of transplantation tolerance in non-human primate preclinical models

Short-term outcomes following organ transplantation have improved considerably since the availability of cyclosporine ushered in the modern era of immunosuppression. In spite of this, many of the current limitations to progress in the field are directly related to the existing practice of relatively non-specific immunosuppression. These include increased risks of opportunistic infection and cancer, and toxicity associated with long-term immunosuppressive drug exposure. In addition, long-term graft loss continues to result in part from a failure to adequately control the anti-donor immune response. The development of a safe and reliable means of inducing tolerance would ameliorate these issues and improve the lives of transplant recipients, yet given the improving clinical standard of care, the translation of new therapies has become appropriately more cautious and dependent on increasingly predictive preclinical models. While convenient and easy to use, rodent tolerance models have not to date been reliably capable of predicting a therapy's potential efficacy in humans. Non-human primates possess an immune system that more closely approximates that found in humans, and have served as a more rigorous preclinical testing ground for novel therapies. Prior to clinical adaptation therefore, tolerance regimens should be vetted in non-human primates to ensure that there is sufficient potential for efficacy to justify the risk of its application

Experience with the Bjork-Shiley Prosthetic Valve

Gratifying results were obtained with the Bjork-Shiley prosthesis in this series of 63 patients. The surgical mortality of the entire series was 7,9%. Late morbidity was negligible. Of 8 patients who had right-sided valvular replacement, 1 died on the operating table, and the 7 surviving patients did extremely well, with no late morbidity. We believe this to be a satisfactory prosthesis which can effectively be used for right-sided valvular replacement

Sepsis: frontiers in diagnosis, resuscitation and antibiotic therapy

Sepsis is a major growing global burden and a major challenge to intensive care clinicians, researchers, guideline committee members and policy makers, because of its high and increasing incidence and great pathophysiological, molecular, genetic and clinical complexity. In spite of recent progress, short-term mortality remains high and there is growing evidence of long-term morbidity and increased long-term mortality in survivors of sepsis both in developed and developing countries. Further improvement in the care of patients with sepsis will impact upon global health. In this narrative review, invited experts describe the expected challenges and progress to be made in the near future. We focus on diagnosis, resuscitation (fluids, vasopressors, inotropes, blood transfusion and hemodynamic targets) and infection (antibiotics and infection biomarkers), as these areas are key, if initial management and subsequent outcomes are to be improved in patients with sepsis. © 2016, Springer-Verlag Berlin Heidelberg and ESICM