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Biomedical subjects

D Lawlor

Publications and source records attributed to D Lawlor.

At least 19 recordsLinked to original sources
PubMed2005

Could your case of necrotising fascitis be Pyoderma gangrenosum?

Necrotising fascitis is a fulminant infective process which can result in significant morbidity and can indeed be life threatening. It needs to be recognised early and managed aggressively with extensive surgical debridement followed by appropriate antibiotics. On the other hand, Pyoderma gangrenosum is a disease process that needs to be managed non-surgically. We present one such case, the diagnosis of which had treaded along the thin line between the two.

Adult↗
PubMed2003

Efficacy of pulsed-dye laser for viral warts--an internal audit.

Pulsed-dye laser (PDL) surgery is a recognized treatment of viral warts. Initial studies in 1993 by Tan et al achieved a 72% cure rate for 39 patients after a mean of 1.68 treatments. Since then, conflicting response rates ranging from 47-95% have been reported. The records of 44 patients, who attended the Laser Unit at St. James's Hospital between January 1999 to June 2000, were reviewed. Follow-up was conducted by telephone interview or questionnaire. Twenty-eight (64%) patients identified for the study responded. The average number of treatments was 4 (range 1-12) and mean treatment intervals were 4.9 weeks (3-10). Our results showed 64% complete clearance of all the areas treated, and 46% complete clearance of the 13 areas identified as recalcitrant. Rates for complete clearance varied with anatomic site: 73% for the face, 68% for the hands, and 40% for feet. Seventy-eight percent (7/9) of periungal warts completely cleared, and 70% (7/10) mosaic warts cleared. Twenty-five percent of the patients complained of severe pain during treatment. Post-operative complications were few, and rarely affected the patients' lifestyle. The recurrence of warts, in weeks to months following the last treatment, was reported by 36% of the patients. Seventy-nine percent of patients were satisfied with the treatment they were given. PDL may be useful in treatment of refractory warts in selected patient populations. The study identified a need to address pain control in a significant number of patients.

Adolescent↗
PubMed2002

Split-thickness skin grafts and negative-pressure dressings in the treatment of axillary hidradenitis suppurativa.

Although a number of different reconstructive techniques have been described for the treatment of axillary skin defects, split-thickness skin grafting continues to be the most common surgical modality. Here, we present our recent experience of using split-thickness skin grafts together with negative-pressure dressings for the management of defects following wide surgical excision of severe hidradenitis suppurativa. This technique ensures complete skin-graft take whilst allowing full shoulder mobility, thereby minimising the undesirable sequelae associated with split-thickness skin grafting alone.

Adult↗
PubMed1996

Characterization of baboon class I major histocompatibility molecules. Implications for baboon-to-human xenotransplantation.

Increasingly strong medical and political pressures are stimulating consideration of the transplantation of baboon organs and cells into humans. Critical to the success of these xenotransplants is management of the immune system such that graft rejection and, in the case of bone marrow transplantation, graft-versus-host disease do not result in transplant failure. The polymorphic products of the major histocompatibility complex (MHC) are the primary barrier to successful allotransplantation, and here we describe class I MHC molecules from baboon (Papio anubis) to gain an understanding of how similarities and differences between baboon and human MHC molecules might affect xenograft survival and function. Comparative analyses of our five novel baboon class I molecules with defined HLA class I molecules demonstrate that the baboon class I molecule are up to 90% identical. Disparity between baboon class I proteins and their human homologues lies predominately at positions in the antigen-binding groove, while C-terminal portions of the class I heavy chain are more conserved between the two species. Such concentration of cross-species differences within the alpha1 and alpha2 domains involves a majority of substitutions at positions demonstrating polymorphism in human alleles; the location of substitutions distinguishing baboon and human molecules thus resembles the positioning of human class I allopolymorphisms. Because this preliminary characterization indicates that both baboon and human T cells with be restricted by xenogeneic class I molecules, immune responses triggered during baboon-to-human transplantation should mimic those arising during MHC mismatched human allotransplantation.

Amino Acid Sequence↗
PubMed1995

A 3-year epidemiological review of burn unit admissions in Dublin, Ireland: 1988-91.

A retrospective multifactorial epidemiological study of all patients admitted to the Burns Unit, St James's Hospital, Dublin during a 3-year period from January 1988 to December 1990 was undertaken. One hundred and twenty patients were admitted. All patients were aged over 14 years. The mean patient age was 48.2 years. Males accounted for 56 per cent of admissions. The mean percentage body surface area (%BSA) burned was 24.9 per cent. Flame was the cause of burns in 60 per cent of cases and produced the most extensive lesions. The home was the most common site of injury. Almost half the patients admitted from residential institutions sustained their burns in hot baths. Those aged over 60 years sustain smaller burns but are at increased risk from thermal injury. Twenty-one per cent of burns were caused by open fires used for heating the home. The mean time in hospital was 49.9 days. Twenty-three per cent of patients died as a result of their injuries. We have identified those living in residential institutions to be at increased risk from scald burns and suggest methods by which they may be protected.

Adolescent↗
PubMed1993

Bupivacaine and Kaltostat reduces post-operative donor site pain.

A prospective double blind controlled trial was carried out to examine the differences in post-operative split skin graft donor site pain between sites dressed with three differently treated types of dressing; a dry calcium alginate dressing (Kaltostat Britcair), a saline moistened Kaltostat dressing and a bupivacaine hydrochloride (0.5%) moistened Kaltostat dressing. There was a significant reduction in post-operative pain in the Kaltostat and bupivacaine group (group 3) at 24 and 48 h when compared to the other two groups (p < 0.04). There was no difference in ease of removal of dressings or the quality of wound healing on day 10 between the three groups. This study demonstrates a significant reduction in post-operative pain in bupivacaine soaked Kaltostat without reducing the beneficial effects of Kaltostat on donor site healing and we recommend its use in clinical practice.

Adult↗
PubMed1992

Serious suicide attempts among adolescents in custody.

The Royal Commission into Aboriginal Deaths in Custody has focused attention on people who are held in custody in police cells, prisons, remand centres and detention centres. A series of research papers has been released by the Royal Commission which delineates some important aspects of the needs of these people. Nearly half of the deaths which occur in these custodial settings appear to be self-inflicted. Suicide seems to be particularly common among younger age groups of those in custody [1,2]. This pattern parallels suicide levels among young people in the Australian community generally, so that suicide is now a leading cause of death among young Australians [3,4].

Adolescent↗
PubMed1991

Phenotypic changes in T-cyt-transformed potato plants are consistent with enhanced sensitivity of specific cell types to normal regulation by root-derived cytokinin.

From over forty independently isolated potato lines transformed with wild-type and promoter-mutated T-cyt genes, a number of lines were selected for examination of phenotypic changes in growth and development for plants grown in soil in a controlled environment. The three lines chosen for most detailed examination showed a wide spectrum of phenotypic changes. In comparisons with control potato cv. Désirée, the plants of one line had a two- to three-fold increase in biomass production during early vegetative growth, advanced senescence and a shortened plant life-span. Another line showed abnormal cellulytic senescence. In two lines there were increases in tuber numbers and more skewed tuber size distributions which correlated with reduced shoot apical dominance and shortened dormancy of the stored tubers. None of the lines showed altered timing of onset of tuberization or flowering, although tuberization was consistently delayed when expressed as a function of increasing total plant weight. A hypothesis is proposed to explain the diverse phenotypes which postulates that (1) T-cyt transformation causes enhanced sensitivity to cytokinins in specific types of shoot cells which are already targets for regulation by normal root-derived cytokinins; (2) two distinct types of shoot target cells are present, one in shoot meristems and one in leaves; (3) the two types can acquire enhanced sensitivity, either separately or in combination depending on the particular T-cyt transformation event. The scope for using the transformed plants in subsequent physiological, biochemical and molecular studies, aimed at examining the molecular basis of the model or selected consequences of T-cyt transformation in altering regulation of potato plant growth and development, is discussed. The attention is drawn to the possible involvement at the subcellular level of sucrose phosphate synthase in mediating the phenotypic effects caused by T-cyt transformation.

Adaptation, Physiological↗