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Biomedical subjects

A E Kark

Publications and source records attributed to A E Kark.

At least 19 recordsLinked to original sources
PubMed1991

Obesity surgery in the United Kingdom: survey of 970 general surgeons.

The results of a questionnaire survey on obesity surgery sent to 970 consultant general surgeons working in the United Kingdom National Health Service are presented. The response rate was 37%. There were 38 surgeons actively practising this surgery. The majority were performing a gastric procedure, mostly gastroplasty, but some did gastric bypass or banding. Three were doing the biliopancreatic bypass. Most surgeons were doing less than 10 operations a year. A total of 109 expressed an interest in attending a UK symposium and 59 would participate in a UK Bariatric Register. This practice, though only a small part of UK surgery, is larger than expected.

Attitude of Health Personnel↗
PubMed1989

Gastroplasty for morbid obesity: technique, complications and results in 60 cases.

A series of 60 gastroplasty operations based on Mason's vertical banded procedure are described. Details of technique, modifications, complications and results are discussed. Operative treatment results in a reduction to within 40 per cent of ideal weight in 80 per cent of patients between 12 and 18 months after surgery. The constricting band should not be greater than 5 cm; if it is most procedures will fail after 18 months. Pouch size should be measured and made no greater than 20 ml. The importance of nutritional counselling is emphasized. The surgical treatment should form part of a multidisciplinary approach with careful selection and long-term follow-up.

Adolescent↗
PubMed1989

Complications of parotid surgery: the need for selectivity.

The morbidity rate following 112 operations on the parotid gland is reported. Facial nerve palsy (temporary, 38 per cent; permanent, 9 per cent) and Frey's syndrome (11 per cent) were common following superficial parotidectomy. For pleomorphic adenoma and malignant lesions this procedure is justified. Benign conditions, which can be diagnosed preoperatively, should be treated by more limited surgery which has a lower complication rate.

Facial Paralysis↗
PubMed1987

Nipple preservation during mastectomy.

In a retrospective study of 100 patients with operable breast cancer, microscopic involvement of the nipple-areola complex was found in 16 cases. Each of these 16 cases occurred in patients with centrally situated tumours. In contrast, nipple involvement did not occur with peripherally situated tumours lying greater than 2 cm outside the areolar margin (P less than 10(-6), Fisher's exact test). Nipple involvement was more likely in patients with greater than or equal to 4 positive axillary nodes (P less than 0.01, chi 2 test). From this study it appears that nipple preservation may be undertaken during mastectomy for small peripheral tumours, provided the nipple is clinically normal, and frozen section analysis of the sub-nipple area is shown to be free from tumour invasion. These criteria for nipple preservation were satisfied in 20 patients out of a prospective series of 60. In this group, nipple preservation on the skin flap improved the cosmetic result of breast reconstruction in 35 per cent, and facilitated skin closure in 20 per cent. After a mean follow-up period of 50.4 months, nipple preservation was not associated with any significant excess of local recurrences.

Breast↗
PubMed1987

Multiple symmetric lipomatosis (Launois-Bensaude syndrome): effect of oral salbutamol.

A 65-year-old Kenyan Asian developed rapidly progressive multiple symmetrical lipomatosis over 8 years. Noradrenaline infusion showed a normal response of plasma free fatty acids. In-vitro studies of the lipomatous tissue demonstrated intact lipolytic activities with a normal rate of free fatty acids release and cyclic AMP accumulation with or without isoprenaline and fenoterol stimulation. A clinical trial of oral salbutamol, a beta 2-agonist, was performed with significant therapeutic effect. The body fat mass showed a reversal of the rapid progression while on the treatment, associated with an increase in the resting metabolic rate.

Administration, Oral↗