Showing papers in "South African Medical Journal in 1969"

The danger of an inadequate water intake during marathon running

Abstract: Sweat los e and rectal temperatures were measured on 31 marathon runners during two 20-mile marathon competitions in relatively cool weather, ie air temperature not exceeding 60i?½F

Diagnosis of Cushing's syndrome.

Abstract: No single test has a 100% diagnostic accuracy, and combinations of tests are required We routinely obtain 3 baseline IRMA-ACTH levels, followed by CRF stimulation and overnight high-dose (8 mg) dexamethasone suppression (HDS) If ACTH-independent adrenal disease is suspected, thin-section CT (with or without isotope scanning) of the adrenals is performed In ACTH-dependent Cushing's syndrome, the clinical manifestations in conjunction with the CRF and 8 mg overnight HDS tests are used to differentiate pituitary from ectopic ACTH production If plasma ACTH increases > 34% following CRF, and plasma cortisol decreases > 60% after HDS, pituitary MRI is the next step; if not, the ectopic ACTH syndrome is more likely and IPSS and attempts to localise the source of the ACTH production are required (see algorithmn)

The nutrient composition and dietary importance of some vegetable foods eaten by the Kung Bushmen.

Abstract: Although the ! Kung Bushmen living in the Dobe area in Botswana have a choice of 85 different species of edible plants, only one is classified as a primary food; 8 are classified as major, 14 as minor, 32 as supplementary, 13 as rare and 17 as problematic.

Clinical response to long-term propranolol therapy in hyperthyroidism.

Abstract: for a barium swallow and meal. On radiological examinalion a very large and atonic oe ophagus wa demonstrated. There was also a suggestion of muscular inco-ordination at the initiation of deglutition, which could be the result of a pseudobulbar palsy. However, a she was known to have amyloid disease and did not have any other signs of bulbar palsy, this disease and other conditions uch a scleroderma and enile degeneration could be reasonably left out of the differential diagno i . Uniform enlargement of the small bowel was also found.

Prevalence of glycosuria and diabetes among Indians and Bantu.

Abstract: The modal and altered patterns of the liver's efferent venous system were identified. The pWebographic aspects of the hindered return blood stream caused by caval and/or supra­ hepatic-caval obstacles (Budd-Chiari's syndrome, 'stagnant liver') were investigated. Such morphological alterations of the blood-vessels as originated in or developed through compression of the larger suprahepatic veins were investigated, together with the mechanics whereby functional compensation occurs through collateral circulation (echinococcus cysts, amoebic abscesses, tumours of the liver). The subtlest changes in vuscular structure patterns were evidenced in the parenchyrnatographic stage of phlebography (cirrhosis of the liver, Hanot's disease). The vascular picture was obtained under such liver-ailment conditions as are asso­ ciated with either a reduced inflow (prehepatic obstructions) or a hindered outflow (bile duct obstructions). Blood-vessel morphology in degenerative ailments of the liver was delineated. The method is indicated as a fundamental procedure for the correct assessment of both malignant and non-malignant liver­ expansion processes; as a valuable tool for the early detection of cirrhotic-type liver ailments and for evaluating their stage of development; and as a source of basic anatomical and surgical data on the condition of the suprahepatic peduncle. The method described is both easy io perform and capable of yielding hepatographic pictures of great completeness and significance.

The treatment of depression in general practice.

Abstract: of dealing with the problem of anaesthetic contamination. This venting system has been in use for over six monthes in two operating theatres. Although the whole problem of operating theatre pollution seems to merit further investigation, it is clear that until such time as the agent causing the possible deleterious effect on operating theatre personnel is identified all the anaesthetic gases and vapours should be vented from the operating room.-I am, etc. S. MEHTA Burnlcy General Hospital, Bumncy, Lancs

Health service administration in developing countries

Abstract: It is inevitable that in a developing country in its early phase emphasis should be placed on personal and curative medical services rather than on preventive services.

Histiocytic medullary reticulosis.

Abstract: Histiocytic medullary reticulosis was first reported by Scot! and Robb-Smith in 1939. A review of the clinical and pathological features of this condition is given with reference to the cases reported by these and other authors.

The radiology of asbestosis.

Abstract: Abstract Asbestos can damage the lung and may cause pulmonary fibrosis, pleurisy with the formation of thick plaques, mesothelioma of the pleura and peritoneum, and carcinoma of the lung. Forty-three cases of deceased asbestos workers who had X-rays of their chests taken during their working lifetime are reviewed. Most of the films available were frontal chest radiographs. The miners, to the best of knowledge, had not engaged in other forms of mining. Care has been exercised in excluding complicating factors such as associated tuberculosis, neoplasms, and any other pathology. The X-rays reviewed are, therefore, concerned with uncomplicated asbestosis. All of the miners had worked in crocidolite or amosite mines. It is important to realize that these minerals occur in banded iron-stone which contains up to 40% free silica and that mill dust may contain up to 20% free silica. The country rock, and to some extent the ore, contains important amounts of the iron minerals, magnetite, haematite, and ferric hydrate (40% or more) (Sluis-Cremer and Wagner, 1964) .

Nephropathy in Marathon Runners

Abstract: Histiocytic medullary reticulosis was first reported by Scot! and Robb-Smith in 1939. A review of the clinical and pathological features of this condition is given with reference to the cases reported by these and other authors. A case of this co~dit~on is. reported in a child aged 1 year and 3 months. This IS belIeved to be the first report of this condition specifically designated as 'histiocytic medullary reticulosis' in so young a child, and the first reported case in South Africa. A comparison is made between Letterer-Siwe disease, so-called haemophagocytic reticulosis and histiocytic medullary reticulosis. The last-mentioned condition is considered to be quite distinct from Letterer-Siwe disease and identical with haemophagocytic reticulosis. Furthermore, histiocytic medullary reticulosis should now be considered as an established entity, related to malignant lymphoma. I wish to thank Prof. J. Barnetson, Head of the Department of Pathological Anatomy, for permission to publish.

Temperature and its bearing on the distribution and chemical control of freshwater snails.

Abstract: SUM 1ARY The ill \\'ivo resulls show a close resemblance 10 a typical cardiac glycoside intoxicalion. Some aspeClS of lhe over-all haemodynamic changes can be explained by means of lhe micro-electrode studies. The sinus tachycardia observed ill vivo may be of secondary, sympathetic origin. for no marked increa e in rate of lhe isolated SA-nodal impulse generation could be demonstraled. The ventricular paroxysmal lachycardia recorded ill vivo seems 10 be a direct consequence of the sponraneou impulse generation evoked in ventricular muscle fibres. A consistent finding ill \\·;vo was the development of ventricular ectopic impulses from differen~ foci. A possible explanation for the coupled rhythms een ill vivo may be as follow : volleys of 2 or more impulses originating from papillary or other ventricular muscle fibres were recorded by means of micro-electrodes: secondly. coupled pacemaking by nodal fibres was found. The in vivo results showed a well-defined AV block. 111 vitro block conditions could be simulated in the SA node and the dissociation in papillary muscle. Decreased amplitude of the action potential resulting from depolarization may explain the progressive decrease in ampli· tude of the QRS complex observed in most experiments a a terminal event. tion in a single papillary muscle was often obsen ed one region contracted in rapid uccession while anolher region contracted more slOWly. In most experiment the conduction velocity of action potentia Is in Purkinje fibre and papillary mu cle wa decreased by epoxyscillirosidin. A concentration of 5 x 10\" M. however. increased lhe conduction velocity in papillary muscle. It therefore seem that the influence of the aglycone on conduction velocity i indirect through the depolarization of the membrane. In all preparation tudied epoxyscillirosidin had a powerful inotropic action. The onset of thi effect wa observed within 3 minute and increased progressively.

Depression in African patients.

Abstract: Seventy-six depressed African patients who presented at the psychiatric clinic of a general hospital over a 3-year period are reviewed.