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Biomedical subjects

B D Morgan

Publications and source records attributed to B D Morgan.

At least 19 recordsLinked to original sources
PubMed1998

A quantitative method for the assessment of facial rejuvenation: a prospective study investigating the carbon dioxide laser.

Laser resurfacing has been reported to have a useful role in the treatment of facial rhytides, however the results of published series have relied on subjective methods of assessment. The aim of this investigation was to develop an accurate method of measuring wrinkle depth and secondly to use this to assess the efficacy of laser rejuvenation. Wrinkle depth was measured in 30 patients with perioral rhytides using a silicone mask to provide a negative replica. Depth was measured using simple light microscopy and the accuracy of this was confirmed with the electron microscope. A highly significant correlation was found between these two methods of measurement (R2 = 0.97, P < 0.0001) with an accuracy of 0.03 mm. Using this method laser rejuvenation was evaluated in a prospective series of 30 patients with perioral rhytides (median follow-up 11.5 months, range 5-20 months). Resurfacing was found to achieve a significant reduction in mean wrinkle depth of 91% (paired t-test, P < 0.00001). The only complication reported was erythema which was always transient. The use of light microscopy on silicone moulds therefore provides a simple and accurate method for assessing the outcome of facial rejuvenation. Using this technique, the carbon dioxide laser was objectively found to provide a safe and effective treatment for facial rhytides.

Aged↗
PubMed1996

Management of hypopigmentation following burn injury.

Hypopigmentation is a troublesome often permanent sequelae following burn injury, particularly in dark races. A number of methods have been described to treat this phenomenon ranging from primary closure, split skin and particulate grafting as well as semipermanent and permanent camouflage. This article reviews the pathophysiology of this condition and discusses the indications for using each technique as well as the potential for future developments in melanocyte culture.

Burns↗
PubMed1996

Improving the early detection of malignant melanoma.

The early detection of cutaneous melanoma is known to be associated with reduced mortality. In order to improve early detection of suspicious skin lesions a Pigmented Lesion Clinic (PLC) was set up at Mount Vernon Hospital in January 1993. Its aims were to provide a rapid method of expert assessment and treatment for malignant skin tumours as well as reassurance for patients with benign lesions. In the first 2 years, 1779 new patients were seen and 674 lesions excised, of which 18% were malignant. Comparison of the Breslow thicknesses of melanomas diagnosed via the PLC revealed a significant shift towards thinner early tumours when compared with the two previous years (chi 2 = 12.8, P < 0.01) and during the same time period via normal routes of referral (chi 2 = 8.68, P < 0.02). The running of such a service and its hidden benefits are discussed.

England↗
PubMed1993

Darrier's disease.

Explore the source record for details and available documents.

Darier Disease↗
PubMed1993

Early diagnosis of staphylococcal toxaemia in burned children.

The features of toxic shock syndrome in burned children have been described in a review of seven patients (J. D. Frame et al., Burns 1985; 11, 234). These include a 'prodromal' 24-48 h period with diarrhoea, vomiting, general malaise, pyrexia, tachycardia and tachypnoea. The white cell count and haemoglobin concentration fall prior to the 'shock' phase, which occurs 3-4 days postburn. Once 'shock' has occurred the mortality of the condition is approximately 50 per cent; in the absence of 'shock' it is much reduced. We have undertaken a retrospective review of six burned children who were admitted in a 2-year period to the Mount Vernon NHS Trust Burns Unit with a clinical diagnosis of toxic shock syndrome. The evidence from our patients suggests that reliable early diagnostic signs are a rapidly developing severe pyrexia of 39.5 degrees C or above, and a simultaneously increasing tachycardia and tachypnoea to high levels. There is a sudden profound fall in the white cell count and haemoglobin concentration over a period of hours between 1 and 3 days from injury. Specific treatment should be instituted before the onset of 'shock'. The name staphylococcal toxaemia might promote earlier diagnosis and treatment of this condition and so reduce its mortality.

Bacterial Toxins↗
PubMed1991

Assessment of burn injury in the accident and emergency department: a review of 100 referrals to a regional burns unit.

Accurate assessment of the extent of thermal injury in the accident and emergency (A&E) department is essential if appropriate resuscitation and referral to a specialist unit is to occur. However, review of 100 referrals to a regional burns unit confirms that assessment is often inaccurate, and usually undertaken by no one more senior than a casualty officer, leading to suboptimal treatment and referral. Severe thermal injury should be assessed by a team of senior doctors, according to the major trauma protocol, and casualty officers should receive better training in the assessment of less extensive burns.

Burn Units↗
PubMed1989

The fate of meshed allograft skin in burned patients using cyclosporin immunosuppression.

Three patients with burns of 35%, 60% and 25% were treated with cyclosporin after the application of allograft skin. Biopsies of the allografts were taken at appropriate intervals. The drug was continued for 3 weeks, 3 months and 3 weeks respectively without ill-effects on the patients. The allografts survived during cyclosporin treatment but were rejected 12 days after cessation of treatment in Case 1 and 5-7 days in Case 2. In Case 3 where a meshed auto/allograft 'sandwich' technique was used, there was no visible evidence of rejection. It is likely that the allograft was replaced by a "creeping substitution" in the sandwich technique. The Langerhans cell is probably not solely responsible for allograft rejection.

Adult↗
PubMed1987

Multiple seagull flaps for digital contractures in electrical burns.

Following legislation in the early 1970s, electrical bar fire burns are much less common in the UK than 20 years ago. However, their long-term effects are still encountered as microdactyly, syndactyly and digital flexion contractures. A case is described in which multiple seagull flaps were used as a single stage procedure to achieve sustained improvement in function in a severely affected hand, 10 years after injury, without prolonged postoperative daytime splintage.

Burns, Electric↗
PubMed1987

Hypospadias and the embryogenesis of the penile urethra.

The findings of a histological study of a rare specimen of a human hypospadias penis are presented. These findings suggest that distal pits are due to arrested development of the glandar urethra. The present findings also indicate that accessory urethrae and possibly the ventral position of the urethral meatus are the result of an intrinsic abnormality of the urethral plate.

Humans↗
PubMed1985

Sclerotherapy for venous flare.

The aetiology of venous flare is discussed and a method of microsclerotherapy described. Visualisation of the injection of the sclerosant has been seen to be helped by the addition of a gelatin solution.

Capillaries↗
PubMed1983

Immediate total scalp and skull reconstruction.

A patient who required excision of a large basal cell carcinoma was left with a scalp defect measuring 23 cm x 23 cm, associated with an underlying bony defect of 18 cm x 16 cm with a similar dural defect. Simultaneous reconstruction of all three layers was performed using a large free latissimus dorsi flap, titanium strips, and lumbar fascia. A satisfactory cosmetic and functional result was obtained using this technique.

Adult↗