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Biomedical subjects

A J Cain

Publications and source records attributed to A J Cain.

16 recordsLinked to original sources
PubMed2006

Satisfaction with cosmesis following nasal manipulation: do previous fractures matter?

OBJECTIVE: To determine if patients who have had multiple previous nasal fractures and who undergo manipulation of fractured nasal bones under general anaesthetic (MUA) are as likely to be satisfied with their post-operative nasal cosmesis as patients who have only sustained a single injury. DESIGN: Telephone survey. SETTING: District general hospital. PARTICIPANTS: Adult patients who had undergone MUA over the preceding three years. MAIN OUTCOME MEASURES: Patient satisfaction with nasal cosmesis and nasal airway and willingness to consider corrective surgery. RESULTS: One hundred and two patients were contacted. Overall patient satisfaction with cosmesis and nasal airway was 82 and 77 per cent, respectively, with 15 per cent willing to consider a procedure to improve their nasal cosmesis and 12 per cent willing to consider a procedure to improve nasal airway. Twenty-three (22.5 per cent) gave a history of one or more nasal bone fractures, either treated or untreated, prior to the most recently treated injury. Patient satisfaction with cosmesis in this group was 65 per cent, compared with 87 per cent satisfaction in the single injury group (p = 0.03). No statistically significant differences were demonstrated when comparing these groups for: satisfaction with nasal airway (70 vs 80 per cent, p = 0.46); willingness to consider a procedure to improve cosmesis (26 vs 11 per cent, p = 0.16); and willingness to consider a procedure to improve nasal airway (17 vs 10 per cent, p = 0.46). CONCLUSIONS: A history of multiple previous nasal fractures does appear to alter patient satisfaction with the cosmetic outcome of nasal manipulation. These patients should be informed that they have a decreased chance of attaining a cosmetically acceptable result.

Adolescent↗
PubMed2002

The use of topical nasal anaesthesia before flexible nasendoscopy: a double-blind, randomized controlled trial comparing cophenylcaine with placebo.

The objective was to evaluate the necessity to use topical nasal anaesthesia before flexible nasendoscopy and to compare its use with placebo. The study was carried out using a double-blind randomized controlled trial, with three treatment arms, at the out-patient department at Raigmore Hospital, Inverness. The participants were 90 patients attending the otolaryngology out-patient department who required flexible nasendoscopy as part of their assessment. Each participant was randomized to one of three groups. Group 1 received cophenylcaine spray, group 2 received a placebo spray, and group 3 received no nasal preparation. Flexible nasendoscopy was carried out via a stated protocol and the patient's diagnosis and findings were discussed in the usual way. After the consultation, the patient filled in a questionnaire marking answers on a visual analogue scale. The main outcome measures were pain and overall unpleasantness of procedure. Patient anxiety and willingness to be examined again in the same way if necessary were also assessed. Ease of examination and quality of view were asked from the operator's perspective. The mean scores on a visual analogue scale showed the main outcome measures to be as follows. Pain score measured 1.7 for cophenylcaine, 2.1 for no spray and 2.2 for placebo. Overall unpleasantness scores were 2.0 for cophenylcaine, 1.9 for no spray and 2.4 for placebo. On a visual analogue scale of 0-10, none of these mean main outcome measures reached levels of significance. It was concluded that the use of cophenylcaine spray before flexible nasendoscopy does not give significant advantages over the use of no nasal preparation.

Aerosols↗
PubMed2001

Metachronous bilateral submandibular gland metastases from carcinoma of the breast.

Metastases to the salivary glands from distant neoplasms are unusual, with most reported cases involving the parotid gland. Metastatic deposits in the submandibular gland are extremely rare with bilateral involvement not previously reported. We present the case of a patient with advanced breast carcinoma who has had metachronous involvement of both submandibular glands and review the literature on this subject.

Adenocarcinoma↗
PubMed2000

A review of otolaryngology equipment provision in a peripheral clinic setting.

OBJECTIVE: To assess the adequacy of otolaryngology equipment provision in peripheral outpatient clinics. DESIGN: Prospective questionnaire study. SETTING: Five peripheral otolaryngology clinics in the Highlands of Scotland. (Thurso, Golspie, Dingwall, Fort William and Skye). SUBJECTS: All patients attending the above clinics over a six-month period. RESULTS: The questionnaire return rate was 70%. 30% of patients may have had improved care had the equipment provision been adequate. Nine percent of patients required to be reviewed elsewhere due to inadequate equipment. The annual cost of these reviews exceeds 15,000 Pounds. CONCLUSION: The provision of adequate clinic equipment would have medium to long term economic advantages and also has relevance in relation to clinical governance and potential medico-legal concerns. The results of this review are timely as a recent BAO-HNS document has confirmed the equipment provision we describe above as being at the minimal acceptable level.

Ambulatory Care Facilities↗
PubMed1999

Bipolar scissor tonsillectomy.

We describe a new technique for tonsillectomy using dual-function scissors that cut and bipolar coagulate at the same time. The technique shortens operating time and decreases intra-operative blood loss. Forty patients had their tonsillectomy performed using this technique. The mean operating time was 5.5 min (SD 2.1) and mean blood loss was 1.3 ml (SD 3.6). All patients were able to eat and drink on the same postoperative day and all were discharged the following morning. None of the patients had primary haemorrhages and two patients (5%) had minor secondary haemorrhages. We found bipolar scissor tonsillectomy to be a safe technique that shortens surgery and minimises blood loss without causing increased postoperative morbidity.

Adult↗
PubMed1998

The 9-kDa phosphoprotein of photosystem II. Generation and characterisation of Chlamydomonas mutants lacking PSII-H and a site-directed mutant lacking the phosphorylation site.

The chloroplast gene psbH encodes a 9-10 kDa thylakoid membrane protein (PSII-H) that is associated with photosystem II and is subject to light-dependent phosphorylation at a threonine residue located on the stromal side of the membrane. The function of PSII-H is not known, neither is it clear what regulatory role phosphorylation may play in the control of PSII activity. Using particle gun-mediated transformation, we have created chloroplast transformants of Chlamydomonas reinhardtii in which the synthesis of PSII-H is prevented by the disruption of psbH, or in which the phosphorylatable threonine is replaced by alanine through site-directed mutagenesis of the gene. The mutants lacking PSII-H have a photosystem II-deficient phenotype, with no detectable functioning PSII complex present in whole cells or isolated thylakoid membranes. In contrast, the alanine mutant (T3A) grows photoautotrophically, and PSII activity is comparable to wild-type cells as determined by various biochemical and biophysical assays.

Animals↗
PubMed1998

Focal myositis of the sternocleidomastoid muscle.

Focal myositis is an unusual inflammatory lesion of skeletal muscle. It usually affects the extremities, but can present rarely in the head and neck region. We present a case of an elderly woman with focal myositis of the sternocleidomastoid muscle and review of the previous literature on this subject.

Aged↗
PubMed1977

Variation in the spire index of some coiled gastropod shells, and its evolutionary significance.

The spire index (height/maximum diameter of shell) is a fairly adequate measure of the shape of the coiled shell of most terrestrial and freshwater gastropod shells but less so in complex marine shells with thorns, flanges and spouts. In this study, only adult free-crawling forms with several whorls, able to retract completely into the shell, are considered. In the Stylommatophora of the Western European terrestrial fauna the distribution of the spire index is markedly bimodal, the modes, with values of about 3 and about 0.5, corresponding respectively to shells with a high to very high spire (and small spire angle) and those varying from more or less globular or trochoid to very flattened and disk-like (spire angle from 60 degrees to 180 degrees). The same two modes are found in the taxonomically different terrestrial stylommatophorans of the U.S.A., and in the faunas of Puerto Rico (Caribbean) and New Caledonia (southwest Pacific). Basommatophorans also show two, rather different, modes. North American marine archaeogastropods are mainly equidimensional but with a few disk-like forms and a very few high-spired ones, marine mesogastropods are mainly high-spired but with disk-like forms, neogastropods high-spired, and relevant euthyneurans sharply bimodal, like the stylommatophorans. Fossil archaeogastropods of the Palaeozoic were much more various at first than modern forms. There is some indication that they became restricted in variety as caenogastropods became abundant, but also that the proportion of marine disk-like shells has decreased markedly since the Palaeozoic. Modes of h/d are characteristic of large taxonomic groups but not taxonomically restricted since given values may appear as specific, generic or subfamilial variants from a mode, and appear sporadically in unrelated forms. There is also no broad association between modal value and broad ecological characters. Since nearly all values do occur in some group or other, no mechanical requirement can be invoked to explain such variation. In the land Stylommatophora enough is known of the broad ecology to suggest that in extreme habitats species with very different size or shell-shape may occur together, and that generalized feeders with similar shells may show separation, ecological or geographical (but in that case, also ecological). Since different shapes of shell will have different mechanical characteristics when considered as burdens to be carried, it is suggested tentatively that they may be related to the positions in which different species normally walk and hence to their preferred feeding places. This would explain an apparent tendency for different taxonomic groups to occupy the same part of the scatter of h/d in different regions of the world, for many groups in the same region to occupy different portions of the scatter, and perhaps the apparent exclusion by caenogastropods of archaeogastropods from part of the scatter since the Palaeozoic. It is argued that the distributions discovered are explicable only by natural selection.

Animals↗