No description available.

Thesis supervisor: Gerald F. Gebhart. Includes bibliographic references (p. 134-144).

Techn. University, Diss., 2002--Dresden.

Thesis (Ph. D.)--University of Montana, 2007. / Title from title screen. Description based on contents viewed July 24, 2007. Includes bibliographical references (p. 154-161).

Thesis (M. S.) - Florida State University. / Bibliography: leaves 136-142.

Includes bibliographical references. / Introduction: High numbers of granulomata have been identified on kidney biopsy at Groote Schuur Hospital in HIV positive patients. In the literature granulomatous interstitial nephritis (GIN) is most commonly attributed to sarcoid and drug reactions and occurs in 0.5- 1.37% of kidney biopsies. Current data is only from developed countries and rarely in HIV positive individuals. As our yield of GIN appeared high we retrospectively reviewed the established HIV database of kidney biopsies to establish the likely causes of this histological finding in our HIV positive population. An extensive literature review was also performed with the intention of developing a diagnostic, and therapeutic, algorithm applicable to GIN in a South African setting. Subjects and Methods: A database of 370 HIV positive kidney biopsies dating from January 2005 was retrospectively reviewed. All patients with GIN on kidney biopsy were analysed. Medication history, creatinine, urine protein/creatinine ratio, CD4 count and serological evidence of vasculitis were recorded. A radiological evaluation and search for positive TB cultures was performed. Patients were divided according to the likely aetiology of GIN, ranging from least to most likely TB-GIN, together with the likelihood of a druginduced or ascending infection-related aetiology. Mortality data was obtained from reviewing the Clinicom system and patient records. Ethics was granted from the UCT ethics committee. Results: 45 patients (12.2%) had evidence of (GIN). 26 (57.8%) were female. Median age was 33 years (IQR 29-37). TB-GIN was likely in 62.2% of patients .Median CD4 was 126 cells/mm3 (IQR 54-237). There were 6 cases of possible paradoxical TB IRIS identified. [median CD4 count of 74 cells/mm3 (IQR 36-170)]. 49% of patients were on a drug implicated in GIN, with 11% on >1 drug [The most common drug being cotrimoxazole]. 6 patients had evidence of ascending infection. No patients had vasculitis.14/45 (31%) patients died on follow up with a median time to death of 119 days (IQR 30-444 days). Interpretation: GIN is common in our HIV population. TB is the most likely cause however other aetiologies require consideration, especially drugs. TB IRIS should be considered if cART has been recently initiated and the CD4 count is low. A proposed diagnostic algorithm was developed as part of this study, together with treatment guidelines. Further research is needed to evaluate the utility of these in a clinical setting.

No description available.

Interstitial laser photocoagulation (ILP) is a minimally invasive technique for destroying solid, localised tumours thermally by delivering infrared laser energy directly into the targeted volume via percutaneously implanted optical fibres. Using current treatment parameters, each fibre delivers sufficient energy to destroy a volume of one to two cm³; larger lesions may be created by using multiple fibres excited simultaneously. An efficient delivery system has been constructed consisting of several fibres bundled through a single cannula and splayed out through a specially designed tip. This delivery system is simple to use and provides accurate fire placement. By linearly superposing single source solutions to the bioheat transfer equation, a mathematical model for coalescent thermal lesions has been developed. It has been determined that large, clinically useful thermal lesions can be created by implanting four sources at the corners of a square. It has been demonstrated, through 𝘦𝘹 𝘷𝘪𝘷𝘰 experimentation in bovine liver, that the model correctly predicts the dimensions of the thermal lesions. / Thesis / Master of Science (MS)

No description available.

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfilment of the requirements for the degree of Master of Medicine in the branch of Internal Medicine. Johannesburg, 2014 / BACKGROUND: Interstitial lung disease (ILD) is one of the leading causes of death in systemic sclerosis (SSc). PATIENTS AND METHODS: A retrospective review of case records, over 20 years, of SSc patients attending a tertiary Connective Tissue Diseases Clinic. Comparisons between ILD and non-ILD groups at presentation were performed in order to identify baseline associations and predictors of ILD. RESULTS: Of the 151 participants that met inclusion criteria, 60 (40%) had ILD. On multivariate analysis the only three variables to remain significant were median duration of disease (OR 1.2 (1.1-1.3); p<0.001), speckled anti-nuclear antibody (ANA) pattern (OR 2.95 (1.22-7.15); p=0.017) and bibasal crackles (OR 5.4 (2.1- 13.5); p<0.0001). Univariate analysis of baseline variables associated with interstitial lung disease in systemic sclerosis. Baseline Variable ILD (n=60) Non-ILD (n=91) OR (CI 95%) p Bibasal crackles (%) 28 (46.7) 10 (11.0) 7.1 (3.1-16.3) <0.0001 Diffuse disease subtype (%) 49 (81.7) 45 (48.9) 4.6 (2.1-9.9) <0.001 Limited disease subtype (%) 8 (13.3) 38 (41.3) 0.2 (0.1-0.5) <0.001 Anti-centromere antibodies (%) 0 (0.0) 10 (13.0) - 0.006 Cough (%) 21 (35.0) 15 (16.5) 2.7 (1.3-5.9) 0.007 Median duration in years (IQR) 6.1 (8.3) 4.0 (5.0) 2.2 (1.8-2.4) 0.009 Speckled ANA pattern (%) 29 (50.9) 25 (32.5) 2.5(1.2-4.9) 0.010 Dyspnoea (%) 27 (45.0) 24 (26.4) 2.3 (1.1-4.6) 0.014 Gold mining history (%) 5 (8.3) 1 (1.1) 8.2 (0.9-71.9) 0.037 ANA=antinuclear antibody; ILD=interstitial lung disease; IQR= interquartile range; OR=odds ratio Additionally, dyspnoea was associated with ILD severity (p=0.008). Bibasal crackles (p=0.014), increased plasma urea (p=0.041), and reduced serum albumin (p=0.007) were associated with mortality in the ILD group. CONCLUSION: Interstitial lung disease in South African SSc patients is common. The diffuse cutaneous disease subtype appears to drive the disease process. There should be a high index of suspicion for ILD in SSc patients presenting with a gold mining history, dyspnoea, cough and bibasal crackles.