Browsing by Author "Deale, C. J. C."

Now showing 1 - 8 of 8
  • Thumbnail Image
    Item
    Immature teratoma of the ovary with gliomatosis peritonei : a case report
    (Health and Medical Publishing Group (HMPG), 1985-06) Du Toit, J. P.; Deale, C. J. C.; Davey, P. M. J.
    Gliomatosis peritonei is a rare complication of immature teratoma of the ovary and should not be confused with metastatic ovarian carcinoma. Treatment depends on the histological grading of the gliomatous lesions. All grades, except grade 0, qualify for adjuvant chemotherapy. Repeated laparotomies for cytological sampling and the removal of tumour are essential. A 16-year-old Ovambo nulligravida presenting with gliomatosis peritonei was apparently cured after 5 laparotomies for removal of tumour and 13 courses of combination chemotherapy.
  • Thumbnail Image
    Item
    In search of more representative cervical cytology : a preliminary prospective study
    (Health & Medical Publishing Group, 1989-07) Brink, A. L.; Du Toit, J. P.; Deale, C. J. C.
    Non-representative cervical smears represented 26.5% of the 105,165 smears screened by the cytology laboratory at Tygerberg Hospital during the period 1986-1987. This figure varied from 21% to 41% depending on the skill of the performer. In an effort to secure more representative smears a preliminary prospective study was conducted to ascertain the value of a variety of devices (Ayre wooden spatula, saline-soaked cotton-wool swabs, Cytobrush). Initially these devices were employed by one specific clinician and subsequently by a variety of medical personnel. This study proved that in the hands of all the personnel endocervical cells were present in all smears taken by the Cytobrush technique, obviating the need for repeat smears. The combination of an ectocervical scrape by an Ayre wooden spatula with an endocervical Cytobursh smear applied to one slide should result in more representative smears at screening. The resultant higher cost should be offset by minimising repeat smears.
  • Thumbnail Image
    Item
    Morular metaplasia of the endometrium misdiagnosed as adeno-acanthoma in a patient with tubal pregnancy : a case report
    (Health & Medical Publishing Group, 1986) Von der Heyden, U.; Deale, C. J. C.; Nel, J. T.
    A 41-year-old woman underwent a fractional dilatation and curettage for menorrhagia and a diagnosis of adeno-acanthoma was made from the curettings. However, the subsequently hysterectomy and bilateral salpingo-oophorectomy specimen revealed the presence of a clinically undiagnosed tubal pregnancy and extensive immature squamous metaplasia (morules) of the endometrium. No malignancy was present. A review of the original curettings lead to the recognition of the benign lesion already present at that stage. Difficulties in the differential diagnosis are discussed. The presence of endometrial polyps is considered as a possible factor responsible for the morular metaplasia rather than the tubal pregnancy, which seems to be a previously undescribed and interesting coincidence.
  • Thumbnail Image
    Item
    Prevalence of primary papillary peritoneal neoplasia in patients with ovarian carcinoma
    (Health and Medical Publishing Group (HMPG), 1985-06) Lindeque, B. G.; Cronje, H. S.; Deale, C. J. C.
    Primary papillary peritoneal neoplasia (PPPN) is a recently recognized disease entity. Macroscopically it resembles ovarian carcinoma. On microscopic examination it also superficially resembles serous ovarian adenocarcinoma, but in PPPN the epithelial cells are single-layered and well differentiated with very rare mitoses, and numerous psammoma bodies are found. In a retrospective review of 61 consecutive patients with serous or papillary ovarian adenocarcinoma seen over a 7-year period, 4 patients with PPPN were found (6.5%). One of these patients was in clinical stage I, 2 were in stage II and 1 was in stage III. All had undergone total abdominal hysterectomy and bilateral salpingo-oophorectomy. Two of these patients received additional chemotherapy and 1 radiotherapy. After 3, 3, 8 and 4 years there were no recurrences in these patients, in contrast to a 29.1% 5-year survival rate for the other patients with serous carcinoma. Cytological examination of ascitic fluid specimens performed in 3 of the 4 patients with PPPN demonstrated the presence of highly differentiated serous tufted cells.
  • Thumbnail Image
    Item
    A review of 367 triplet pregnancies
    (Health & Medical Publishing Group, 1984) Deale, C. J. C.; Cronje, H. S.
    Questionnaires were sent to 452 hospitals in the RSA and SWA/Namibia requesting information on triplet pregnancies over a 10-year period. Information on 367 sets of triplets from 150 hospitals was adequate for analysis. The incidence of triplets was 0,04% of all deliveries. As many as 45% of triplets were diagnosed during the first or second stage of labour. These infants had a significantly lower birth weight than those diagnosed at an antenatal clinic (P <0,01). The mean birth weights of babies that died in utero or neonatally (within 7 days) were significantly lower than those in survivors (P <0,0001). Caesarean section was the delivery method for 14% of 1002 infants and perinatal mortality was improved for the second and third babies in comparison with second and third babies delivered vaginally (P <0,003 and P <0,002 respectively). It is concluded that the diagnosis of triplets should be made at the earliest possible stage of pregnancy, and that following adequate antenatal care all triplets should be delivered by caesarean section, except under ideal uncomplicated conditions where vaginal delivery may be feasible.
  • Thumbnail Image
    Item
    Routine investigations in the clinical staging of invasive carcinoma of the cervix : a critical evaluation
    (1980-11) Deale, C. J. C.; Du Toit, J. P.
    From July 1976 to December 1978 invasive carcinoma of the cervix in 369 new patients at Tygerberg Hospital, Parowvallei, CP, was classified into stages according to the International Federation of Gynaecology and Obstetrics (FIGO) classification. Most of these patients underwent routine intravenous pyelography, cystoscopy, and skeletal and chest radiography, the results of which were analysed in relation to the stage of the disease to decide whether all these investigations are needed in every case. It is concluded that under certain circumstances cystoscopy and skeletal radiography may be omitted with safety in stage I and stage II disease.
  • Thumbnail Image
    Item
    Staging of endometrial cancer by hysteroscopy
    (Health & Medical Publishing Group, 1988) Cronje, H. S.; Deale, C. J. C.
    Twenty-four consecutive patients with endometrial adenocarcinoma were staged pre-operatively by hysteroscopy and by fractional dilatation and curettage (D & C) to evaluate the accuracy of each method in differentiating between International Federation of Gynaecology and Obstetrics stage I and II cancer. Hysteroscopic staging was correct in 16 patients (69.6%) and incorrect in 7 (30.4%). In 1 additional patient hysteroscopy failed to diagnose the endometrial cancer. D & C staged 16 patients correctly (66.7%) and 8 incorrectly (33.3%). Where the hysteroscopic and D & C stagings correlated, the staging was correct in 16 patients (75%) and incorrect in 4 (25%). Therefore hysteroscopy and D & C are of similar value in the pre-operative staging of endometrial adenocarcinoma and their combined use has a slight advantage.
  • Thumbnail Image
    Item
    The value of cytological examination of the urine in the staging of invasive carcinoma of the cervix : a prospective study
    (Health and Medical Publishing Group -- HMPG, 1982-09) Deale, C. J. C.; Wranz, P. B.; Du Toit, J. P.
    During the period July 1976 - December 1978 midstream urine specimens were collected from all new patients with invasive cervical carcinoma admitted to Tygerberg Hospital, Parowvallei, CP. All specimens were cytologically screened to try and establish any correlation between the cytological result and the clinical staging. A very high proportion (24,2%) of specimens unsuitable for screening and unacceptable false-negative and false-positive rates forced us to abandon this prospective study. From January 1979 to July 1980 the study was repeated on catheter specimens of urine. The final analysis of the second series revealed that a catheter specimen had definite advantages, but a detection rate of only 37,5% and a false-negative rate of 62,5% forced us to conclude that urinary cytological examination is at present too inaccurate to be of any value in the staging of invasive cervical carcinoma.