Transplantation for diabetic nephropathy at Groote Schuur Hospital

Over a period of 6 years, 9 patients with diabetic nephropathy received renal allografts at Groote Schuur Hospital. This low figure represents 2,8% of the total number of renal transplants done at our institution, and is evidence of concern about the apparent poor results of transplantation in these patients. After 2 years, patients and graft survival rates in diabetics were 87% and 62% respectively. Vascular disease was a major problem. Six patients developed limb gangrene, and symptomatic coronary and cerebrovascular disease developed in 2 patients. Infections were common and included wound sepsis, cellulitis, candidiasis and urinary tract infections. Diabetes was poorly controlled after transplantation in 5 patients. Proliferative retinopathy was present in 6 patients but remained stable after transplantation.Despite very strict selection criteria, the results of renal transplantation in diabetic patients remain poor. Better treatment strategies are needed to justify acceptance of these patients for transplantation

KKbar molecules with momentum-dependent interactions

It is shown that the momentum-dependent kaon-antikaon interactions generated via vector meson exchange from the standard SU_V(3) x SU_A(3) interaction Lagrangian lead to a non-local potential in coordinate space that can be incorporated without approximation into a non-relativistic version of the Bethe-Salpeter wave equation containing a radial-dependent effective kaon mass appearing in a fully symmetrized kinetic energy operator, in addition to a local potential. Estimates of the mass and decay widths of f_0(980) and a_0(980), considered as KKbar molecules of isospin 0 and 1, as well as for K^+K^- atomic bound states (kaonium) are presented, and compared with previous studies of a similar nature. It is argued that without a better knowledge of hadronic form factors it is not possible to distinguish between the molecular versus elementary particle models for the structure of the light scalar mesons.Comment: 14 pages, 2 tables, 5 figures. Added subsection on s-channel exchange, additional remarks on the possible effect of gluon exchange, and 1 additional figur

Development of an Annular Helicon Source for Electric Propulsion Applications

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/76441/1/AIAA-2006-4841-172.pd

Restaurant menu re-design as a facilitator of more responsible consumer choice: An exploratory and preliminary study

Food service provision imposes significant environmental and societal impacts. The contemporary customer is getting increasingly conscious about these impacts, which is often reflected in restaurant food choice. The catering industry should foresee this trend in consumer choice and architect it so that it becomes more responsible. This study employs a qualitative method for primary data collection and analysis to explore how various environmental (provenance and carbon footprint) and health (nutritional and calorific) characteristics of food displayed on restaurant menus affect customer choice in the UK. It finds that while presenting the carbon footprint information is generally viewed positively by consumers, managerial and policy reinforcement is necessary for it to become a determinant of consumer choice. Displaying food provenance, nutritional and calorific values is considered paramount and these food attributes should become conventional menu items

Fumonisin-induced hepatocarcinogenesis: mechanisms related to cancer initiation and promotion.

We review the hepatocarcinogenic effects of fungal cultures of Fusarium verticillioides(= Fusarium moniliforme) strain MRC 826 in male BD IX rats. Subsequent chemical analyses of the fumonisin B (FB) mycotoxin content in the culture material used and long-term carcinogenesis studies with purified FB1 provide information about dose-response effects, relevance of hepatotoxicity during FB1-induced carcinogenesis, and the existence of a no-effect threshold. Fumonisin intake levels of between 0.08 and 0.16 mg FB/100 g body weight (bw)/day over approximately 2 years produce liver cancer in male BD IX rats. Exposure levels < 0.08 mg FB/100 g bw/day fail to induce cancer, although mild toxic and preneoplastic lesions are induced. The nutritional status of the diets used in the long-term experiments was marginally deficient in lipotropes and vitamins and could have played an important modulating role in fumonisin-induced hepatocarcinogenesis. Short-term studies in a cancer initiation/promotion model in rat liver provided important information about the possible mechanisms involved during the initial stages of cancer development by this apparently nongenotoxic mycotoxin. These studies supported the findings of long-term investigations indicating that a cytotoxic/proliferative response is required for cancer induction and that a no-effect threshold exists for cancer induction. The mechanisms proposed for cancer induction are highlighted and include the possible role of oxidative damage during initiation and the disruption of lipid metabolism, integrity of cellular membranes, and altered growth-regulatory responses as important events during promotion

Surgical resection for hepatocellular carcinoma in Cape Town - A clinical and histopathological study

Objective. Review of surgical resections performed for hepatocellular carcinoma (BCC) at our institution between 1990 and 1996, histology of resected specimens, and clinical outcome. Design, Retrospective and prospective study of 14 patients who underwent resection for HCC.Setting. The Hepatobiliary Unit and Liver Clinic, Groote Schuur Hospital, Cape Town.Patients. Fourteen patients who underwent liver resections for HCC.Interventions. Hepatic resections using prolonged vascular inflow occlusion.Outcome measures. Clinical outcome and disease-free survival following resection.Results. Fourteen patients (5.6% of the total number presenting with HCC) underwent liver resection for HCC at our institution between 1990 and 1996. There were 7 men, median age 40 years (range 18 - 74 years). Only 2 patients were black, and only 1 of these patients had evidence of hepatitis B virus (HBY) infection in the liver. Extensive liver resections were often required. The mean (SD) ischaemic time was 81 (26) minutes and mean estimated blood loss was 938 (649) ml. During hospital admission, 1 patient developed a minor bile leak that settled spontaneously, and 1 patient suffered a stroke and died. The mean hospital stay following operation was 12 days (range 7 - 21 days). Disease-free patient survival at 1, 2 and 3 years was 85%, 75%, and 62%, respectively. Histopathology of the resected specimens showed that 10 of 14 tumours had arisen in non-cirrhotic livers. Mean tumour size was 10.6 (4.6) cm. Only 1 specimen showed the fibrolamellar variant of HCC.Conclusions. Only a small proportion of patients with HCC seen at Groote Schuur Hospital were eligible for resection, and only a minority of these had HBV-associated 'African' HCC. The results of hepatic resection at our institution compare favourably with literature reports, despite the relatively large size of the tumours. It is of interest that most tumours arose in non-cirrhotic livers. There was no evidence of proliferation of 'oval-like' cells in non-neoplastic liver tissue

Adiabatic invariants and Mixmaster catastrophes

We present a rigorous analysis of the role and uses of the adiabatic invariant in the Mixmaster dynamical system. We propose a new invariant for the global dynamics which in some respects has an improved behaviour over the commonly used one. We illustrate its behaviour in a number of numerical results. We also present a new formulation of the dynamics via Catastrophe Theory. We find that the change from one era to the next corresponds to a fold catastrophe, during the Kasner shifts the potential is an Implicit Function Form whereas, as the anisotropy dissipates, the Mixmaster potential must become a Morse 0--saddle. We compare and contrast our results to many known works on the Mixmaster problem and indicate how extensions could be achieved. Further exploitation of this formulation may lead to a clearer understanding of the global Mixmaster dynamics.Comment: 24 pages, LaTeX, 5 figures (which can be obtained by sending a message to the first author), submitted to Phys.Rev.