Biomedical subjects
Publications and source records attributed to E C Ho.
The standard treatment of a pinna haematoma involves drainage and compression to prevent recurrence and subsequent disfigurement. Compressive methods can be non-invasive or invasive, utilising a head bandage or through and through sutures, respectively, to keep compression in place. Leonard buttons are effective alternative compressive devices. They are simple to use and easily available.
INTRODUCTION: We hypothesised that general practitioners and ENT specialists manage discharging ears differently. This study was designed to investigate this further. METHODS AND MATERIALS: Postal questionnaires were sent to all general practitioners in the Birmingham area and all UK consultants on the British Association of Otolaryngology-Head and Neck Surgery address list. RESULTS AND DISCUSSION: In the presence of an intact tympanic membrane, 99 per cent of consultants and 90 per cent of general practitioners would use topical antibiotics. In the presence of a perforated tympanic membrane, 97 per cent of consultants would continue to use topical antibiotics, compared with only 43 per cent of general practitioners. This was attributed to a fear of ototoxicity. If a topical non-ototoxic antibiotic of proven efficacy could be made available, 93 per cent of consultants and 88 per cent of general practitioners in this study would seriously consider using it as first line treatment. CONCLUSION: The majority of general practitioners would not use topical antibiotics in the presence of a perforated tympanic membrane. Most doctors would consider using a non-ototoxic topical antibiotic as first line treatment should one be made available.
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There is a significant risk of blood contamination during the non-surgical management of epistaxis. Contamination beyond gloves happens in 55% of cases and the contamination risk to eyes as high as 18%. There is a lack of awareness and a majority of ENT doctors underestimate this risk. Protective barrier equipment and eye protection in particular are suboptimally available in all clinical areas where epistaxis is dealt with. Consequently, there is poor utilization of protective barrier equipment.
KEY POINTS: There are various effective treatment options for refractory posterior epistaxis including endoscopic diathermy or endoscopic artery ligation. If these treatment options are not immediately available, posterior nasal packing with Foley catheter is an effective and rapid non-surgical treatment alternative. A systematic approach is presented. The principles and mechanisms of action of the posterior nasal packing are explained. Nevertheless, there are morbidities involved and posterior packing can be painful and uncomfortable for the patient. Marking and modifying the catheter will help one inflate the balloon in the correct place and avoid the problem of nasal alar pressure necrosis.
Assignment of a susceptibility locus for cutaneous malignant melanoma-dysplastic nevus (CMM/DN) to chromosome 1p remains controversial. We examined the relationship between CMM/DN and markers D1S47, PND, and D1S160 on seven new families (set B) plus updated versions of six previously reported families (set A). Three linkage analyses were performed: (1) CMM alone--all individuals without confirmed melanoma or borderline lesions were considered unaffected (model I); (2) CMM/DN with variable age at onset and sporadics (model II); and (3) CMM/DN using the model of Bale et al. (model III). For CMM alone and D1S47, Zmax = 3.12 at theta = .10. For D1S160 and CMM alone, Zmax = 1.76 at theta = .10. PND showed no evidence for linkage to CMM alone. Models II and III showed strong evidence for linkage to D1S47, D1S160, and PND in the set A pedigrees but not in the set B families. We tested for homogeneity of CMM/DN (model II) by splitting families into two groups on the basis of (1) the proportion of CMM/DN cases and (2) the occurrence of immune-related tumors. In group 1 there was significant evidence of heterogeneity with both D1S47 and D1S160, and in group 2 there was significant evidence of heterogeneity with D1S160. Thus, diagnostic, clinical, and genetic heterogeneity are the likely reasons that previous studies have failed to confirm linkage of CMM/DN to chromosome 1p. The results showed significant evidence for a CMM locus linked to D1S47, as well as significant evidence for heterogeneity with only a subset of the families appearing linked to chromosome 1p.
The use of balloon catheters to dilate obstructed vascular lesions represents one of the major advances in cardiology and dates back to 1964 when Dotter and Judkins reported their experience in dilating arteriosclerotic obstructive lesions. Since that time, the technique of balloon dilation has been used extensively for coronary and peripheral vascular lesions but also has been applied to such diverse cardiac lesions as pulmonic stenosis, mitral stenosis, aortic stenosis, aortic coarctation, superior vena caval and pulmonary venous obstructions. Balloon dilation has been used for both valvular and arterial pulmonary stenosis. The purpose of this study is to report on our initial experience in Hawaii with balloon dilation of valvular pulmonic stenosis and also with dilation of peripheral pulmonary artery stenosis due to congenital causes and as a residual postoperative lesion.
One hundred highly informative simple sequence repeat (SSR) polymorphisms have been isolated and mapped to specific human chromosomes by somatic cell hybrid analysis. These markers include 97 (CA)n, 2 (AGAT)n, and a single (AACT)n repeat. All the SSRs have heterozygosities greater than 0.50 and can be amplified using identical PCR conditions. At least one SSR was detected on every chromosome, except for chromosomes 22 and Y. The frequency of (CA)n repeats on each chromosome was proportional to the relative chromosomal length, except for chromosome 15, on which a substantial excess of markers was identified.
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