Biomedical subjects
Publications and source records attributed to D Gault.
A case is reported of length discrepancy between the two thumbs in a 12-year-old girl following trauma to her left thumb twice before the age of 3 years. The distal phalanx of the left thumb overgrew by 5 mm. There was no functional disability and surgery was requested to improve the appearance.
Compartment syndrome in the upper arm is uncommon, but early recognition and treatment is as essential as it is in other sites. A case of compartment syndrome in the upper arm is reported.
There is a high incidence of postoperative nausea and vomiting after surgical correction of prominent ears. A prospective, randomized study was performed to determine if the method of dressing the ears influenced the incidence of postoperative vomiting. Avoidance of packing the external auditory meatus and concha produced a significant reduction in postoperative nausea (83% vs 30%; P < 0.005) and vomiting (63% vs 22%; P < 0.01).
Two cases are reported of serious extravasation injuries due to parenteral nutrition in infants born at 24 and 28 weeks' gestation. Major scarring and the need for plastic surgery were prevented by using a technique of subcutaneous hyaluronidase and saline flushing.
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A method of calculating intracranial volume from horizontal computerized tomography scan slices is presented. The accuracy of this technique was confirmed by applying it to 10 dry skulls and comparing the values obtained with the true intracranial volumes, as determined by filling the skulls with water. Values ranging between 98.14% and 102.6% of the true values were obtained, the mean error being 1.13%. This technique is now being used to study intracranial volume changes in children with craniostenosis.
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There is recent evidence that circulating opioid peptides, or 'endorphins', act as chemical messengers responsible for the induction of the complex cardiovascular changes leading to hypotension in septicaemic shock. The pilot study of an investigation of opioid peptides in septicaemia in burned patients is presented. Serial measurements of plasma beta-endorphin and metenkephalin were performed throughout the recovery of six patients with large burns (20-70 per cent BSA). Our preliminary findings concur with previous evidence that opioid peptides may play a role in the hypotension of septicaemic shock.
The early results of 34 exteriorisation resections of the colon are presented, 25 being emergency procedures and 9 elective. The operative mortality in the emergency group was 20% and there were no deaths in the elective group. All patients who survived the postoperative period have had their colostomies closed. The operation was technically simple and quick to perform. It is one of the safest methods of resecting colon. The technique proved to be a useful alternative to standard techniques in colonic perforation, colonic obstruction with proximal faecal retention, nonviable sigmoid volvulus, diverticular disease requiring resection, and colovesical and colouterine fistula.